RESUMO
BACKGROUND: Approximately two thirds of stroke patients initially suffer from at least impaired mobility. Various rehabilitation concepts have been proposed. OBJECTIVE: Based on the current literature, which rehabilitation methods can be recommended for improvement of gait, gait velocity, gait distance and balance? METHODS: A systematic literature search was carried out for randomized clinical studies and reviews with clinically relevant outcome variables. Formulation of recommendations, separated for target variables and time after stroke. RESULTS: Restoration and improvement of gait function relies on a high number of repetitions of gait movements, which for more severely affected patients is preferentially machine-based. For improvement of gait velocity for less severely affected patients intensive gait training does not necessarily rely on mechanical support. Gait distance can be improved by aerobic endurance exercises with a cardiovascular effect, which have to be performed in a functional context. Improvement of balance should be achieved by intensive functional gait training. Additional stimulation techniques are only effective when included in a functionally relevant training program. DISCUSSION: These guidelines not only provide recommendations for action but also provide pathophysiological insights into functional restoration of stance and gait after stroke.
Assuntos
Medicina Baseada em Evidências/métodos , Terapia por Exercício/métodos , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/reabilitação , Limitação da Mobilidade , Reabilitação do Acidente Vascular Cerebral/métodos , Transtornos Neurológicos da Marcha/etiologia , Humanos , Avaliação de Resultados em Cuidados de Saúde/métodos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Resultado do TratamentoRESUMO
Higher-education students face substantial risks for developing depressive symptoms during the COVID-19 pandemic or experiencing exacerbated pre-existing depressive symptoms. This study uses data from the COVID-19 International Student Well-Being Study, which collected data through a non-representative convenience sample in 125 higher-education institutions (HEI) across 26 high- and middle-income countries (N: 20,103) during the first wave of the COVID-19 pandemic. It describes the prevalence of depressive symptoms in higher-education students. We find substantial cross-national variation in depressive symptoms, with lowest mean levels established in the Nordic countries and France, while highest mean levels of depressive symptoms were found in Turkey, South Africa, Spain and the USA. Elevated risk for depressive symptoms was found in female students, students with fewer social support resources and in a more disadvantaged socioeconomic position, and students with a migrant background. COVID-19 related stressors, such as reduced social contact, increased financial insecurity, and academic stress explained a relatively larger proportion of the variance in depressive symptoms compared to non-COVID-19 related stressors. This finding shows that not the pandemic itself, but rather the secondary effects of the pandemic relate to students' mental health. Our results enable HEIs to be better equipped to target groups that are particularly at risk during a pandemic.
RESUMO
As regards treatment for overactive bladder, physiotherapeutic interventions can be seen as an alternative to drug treatment. Targeted pelvic floor and bladder training is used to decrease the number of voids and the incontinence episodes or to increase the average voided volume in women with overactive bladder (3 systematic reviews with evidence level 1/1a).An additional option to treat women with overactive bladder is to use functional electrical stimulation and magnetic stimulation.2 systematic reviews 1 2 and 2 RCTs 3 4 reveal a low level of evidence (2 studies with level 2/2b) for the use of electrical stimulation (transcutaneous, vaginal or transanal) to reduce incontinence episodes and the number of voids and to increase the average voided volume. The trial from Yamanishi et al. (2014) shows that magnetic stimulation has a positive effect 5. Further studies are needed to evaluate the benefit of conservative treatment procedures for overactive bladder.
Assuntos
Terapia por Estimulação Elétrica , Bexiga Urinária Hiperativa/tratamento farmacológico , Feminino , Humanos , Diafragma da Pelve , Modalidades de Fisioterapia , Incontinência UrináriaRESUMO
Whitish precipitations in three samples of raw cured ham, which appeared in the stereomicroscope as piles of crystals, were confirmed as tyrosine crystals. Tyrosine is readily soluble in nitric acid (yellowish discoloration) and, after addition of potash lye, it precipitates as yellow-orange picrate. Factors that influence the formation of tyrosine crystals are largely unknown. In raw cured ham of Parma experience has shown that tyrosine crystals are found in ham stored for a very long time.
Assuntos
Conservação de Alimentos , Carne/análise , Tirosina/química , Animais , Cristalização , Suínos , Fatores de Tempo , Tirosina/análiseRESUMO
In muscular tissue samples from two cows of different origin numerous greenish, spotlike tissue discolourations were diagnosed as eosinophilic myositis. Sarcosporidiosis is being suspected as the most likely cause. Factors leading to such cases of myositis due to sarcosporidiosis which is wide-spread in cattle and normally inapparent are largely unknown. According to Swiss and German meat inspection directives beef carcasses with these discolourations have to be declared as unfit for human consumption. However, during meat inspection such cases of myositis are problematic to diagnose, because the lesions are only visible on the cut end of muscle tissue. Hence, they can pass unnoticed through carcass inspection.
Assuntos
Criação de Animais Domésticos/legislação & jurisprudência , Doenças dos Bovinos , Cor , Eosinofilia/veterinária , Carne/normas , Músculo Esquelético/patologia , Miosite/veterinária , Animais , Bovinos , Eosinofilia/diagnóstico , Eosinofilia/patologia , Feminino , Alemanha , Humanos , Legislação sobre Alimentos , Miosite/diagnóstico , Miosite/patologia , SuíçaRESUMO
A method of harvesting fat with intact cells using a veterinary needle and a fine needle aspiration device is described. Viable fat cells are obtained in large amounts. A large subcutaneous postradiation thigh defect was reconstructed with harvested fat placed subcutaneously in various sessions. A good, but not perfect, reconstruction was obtained. This case indicates that viable fat cells can be transplanted and can survive even in the adverse environment of a postradiation defect.