Artificial intelligence prediction of the effect of rehabilitation in whiplash associated disorder.

The active cervical range of motion (aROM) is assessed by clinicians to inform their decision-making. Even with the ability of neck motion to discriminate injured from non-injured subjects, the mechanisms to explain recovery or persistence of WAD remain unclear. There are few studies of ROM examinations with precision tools using kinematics as predictive factors of recovery rate. The present paper will evaluate the performance of an artificial neural network (ANN) using kinematic variables to predict the overall change of aROM after a period of rehabilitation in WAD patients. To achieve this goal the neck kinematics of a cohort of 1082 WAD patients (55.1% females), with mean age 37.68 (SD 12.88) years old, from across Spain were used. Prediction variables were the kinematics recorded by the EBI® 5 in routine biomechanical assessments of these patients. These include normalized ROM, speed to peak and ROM coefficient of variation. The improvement of aROM was represented by the Neck Functional Holistic Analysis Score (NFHAS). A supervised multi-layer feed-forward ANN was created to predict the change in NFHAS. The selected architecture of the ANN showed a mean squared error of 308.07-272.75 confidence interval for a 95% in the Monte Carlo cross validation. The performance of the ANN was tested with a subsample of patients not used in the training. This comparison resulted in a medium correlation with R = 0.5. The trained neural network to predict the expected difference in NFHAS between baseline and follow up showed modest results. While the overall performance is moderately correlated, the error of this prediction is still too large to use the method in clinical practice. The addition of other clinically relevant factors could further improve prediction performance.

Improving the staging of neck injuries using a new index, the Neck Functional Holistic Analysis Score: Clustering approach to determine degrees of impairment.

BACKGROUND: Traumatic cervical spine injuries are amongst the traffic injuries that can cause most harm to a person. Classifying subtypes of clinical presentations has been a method used in other pathologies to diagnose more efficiently and to address the appropriate treatment and the prognosis. The management of patients suffering from cervical injuries could be improved by classifying the severity of the impairment. This will allow clinicians to propose better treatment modalities according to the severity of the injury. MATERIALS AND METHODS: The present study is a retrospective cohort study performed with the clinical data from 772 patients stored at Fisi-(ON) Health Group. All the patients treated for cervical spine injuries are evaluated using the EBI-5® system, which is based on inertial measurement unit (IMU) technology. The normalized range of motion of each patient was incorporated into a single index, the Neck Functional Holistic Analysis Score (NFHAS). RESULTS: Clustering analysis of the patients according to their NFHAS resulted in five groups. The Kruskal-Wallis H test showed that there were statistically relevant differences in the ROM values and NFHAS of the patients depending on the cluster they were assigned to: FE X2(4) = 551.59, p = 0.0005; LB ROM X2(4) = 484.58, p = 0.0005; RT ROM X2(4) = 557.14, p = 0.0005; NFHAS X2(4) = 737.41, p = 0.0005. Effect size with ηp2 for the comparison of groups were: FE = 0.76, LB = 0.68, RT = 0.76 and NFHAS = 0.96. CONCLUSION: The NFHAS is directly correlated to the available ROM of the patient. The NFHAS serves as a good tool for the classification of cervical injury patients. The degree of impairment shown by the cervical injury can now be staged correctly using this new classification.

[Skin infection with Fusarium in an immunocompetent patient]. / Infección cutánea por fusarium en paciente inmunocompetente.

Fusarium spp. are fungi found throughout the world and can cause a great variety of skin infections, mainly in immunodepressed individuals. We present a case of skin infection with Fusarium sp. which manifested as painful superficial ulcers on the legs of an immunocompetent female patient, who had applied <> as a <> for leg pain. The condition was cured with oral itraconazole and local treatments.

Infección cutánea por fusarium en paciente inmunocompetente / Skin infection with fusarium in an immunocompetent patient

Fusarium spp. son hongos distribuidos por todo el mundo que pueden producir una gran variedad de infecciones cutáneas, principalmente en individuos inmunodeprimidos. Se presenta un caso de infección cutánea por Fusarium sp. que se manifestó como úlceras superficiales dolorosas en las piernas de una paciente inmunocompetente que se había aplicado «barros medicinales» como remedio «natural» para el dolor de piernas. Se obtuvo la curación con itraconazol oral y curas locales

Fusarium spp. are fungi found throughout the world and can cause a great variety of skin infections, mainly in immunodepressed individuals. We present a case of skin infection with Fusarium sp. which manifested as painful superficial ulcers on the legs of an immunocompetent female patient, who had applied «medicinal mud» as a «natural remedy» for leg pain. The condition was cured with oral itraconazole and local treatments

Estimulación eléctrica en fracturas recientes / Electric stimulation in recent fractures

Se realiza un estudio de las diferentes formas de estimulación preconizadas por distintos autores conocidos mundialmente, las mismas son llevadas a la práctica y se ofrecen los resultados. Se emplean diferentes variantes para obtener la solución de un problema que persiste: la aceleración del proceso de consolidación de una fractura reciente a través de la estimulación eléctrica. Se preconizan los magnificos resultados obtenidos con corriente continua de 4,5 V

Estimulación eléctrica en fracturas recientes / Electric stimulation in recent fractures

Se realiza un estudio de las diferentes formas de estimulación preconizadas por distintos autores conocidos mundialmente, las mismas son llevadas a la práctica y se ofrecen los resultados. Se emplean diferentes variantes para obtener la solución de un problema que persiste: la aceleración del proceso de consolidación de una fractura reciente a través de la estimulación eléctrica. Se preconizan los magnificos resultados obtenidos con corriente continua de 4,5 V