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INTRODUCTION: Biological therapies used for the treatment of inflammatory bowel disease (IBD) have shown to be effective and safe, although these results were obtained from studies involving mostly a young population, who are generally included in clinical trials. The aim of our study was to determine the efficacy and safety of the different biological treatments in the elderly population. METHODS: Multicenter study was carried out in the GETECCU group. Patients diagnosed with IBD and aged over 65 years at the time of initiating biological therapy (infliximab, adalimumab, golimumab, ustekinumab or vedolizumab) were retrospectively included. Among the patients included, clinical response was assessed after drug induction (12 weeks of treatment) and at 52 weeks. Patients' colonoscopy data in week 52 were assessment, where available. Regarding complications, development of oncological events during follow-up and infectious processes occurring during biological treatment were collected (excluding bowel infection by cytomegalovirus). RESULTS: A total of 1090 patients were included. After induction, at approximately 12-14 weeks of treatment, 419 patients (39.6%) were in clinical remission, 502 patients (47.4%) had responded without remission and 137 patients (12.9%) had no response. At 52 weeks of treatment 442 patients (57.1%) had achieved clinical remission, 249 patients had responded without remission (32.2%) and 53 patients had no response to the treatment (6.8%). Before 52 weeks, 129 patients (14.8%) had discontinued treatment due to inefficacy, this being significantly higher (p<0.0001) for Golimumab - 9 patients (37.5%) - compared to the other biological treatments analyzed. With respect to tumor development, an oncological event was observed in 74 patients (6.9%): 30 patients (8%) on infliximab, 23 (7.14%) on adalimumab, 3 (11.1%) on golimumab, 10 (6.4%) on ustekinumab, and 8 (3.8%) on vedolizumab. The incidence was significantly lower (p=0.04) for the vedolizumab group compared to other treatments. As regards infections, these occurred in 160 patients during treatment (14.9%), with no differences between the different biologicals used (p=0.61): 61 patients (19.4%) on infliximab, 39 (12.5%) on adalimumab, 5 (17.8%) on golimumab, 22 (14.1%) on ustekinumab, and 34 (16.5%) on vedolizumab. CONCLUSIONS: Biological drug therapies have response rates in elderly patients similar to those described in the general population, Golimumab was the drug that was discontinued most frequently due to inefficacy. In our experience, tumor development was more frequent in patients who used anti-TNF therapies compared to other targets, although its incidence was generally low and that this is in line with younger patients based on previous literature.
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Recognizing faces regardless of their viewpoint is critical for social interactions. Traditional theories hold that view-selective early visual representations gradually become tolerant to viewpoint changes along the ventral visual hierarchy. Newer theories, based on single-neuron monkey electrophysiological recordings, suggest a three-stage architecture including an intermediate face-selective patch abruptly achieving invariance to mirror-symmetric face views. Human studies combining neuroimaging and multivariate pattern analysis (MVPA) have provided convergent evidence of view selectivity in early visual areas. However, contradictory conclusions have been reached concerning the existence in humans of a mirror-symmetric representation like that observed in macaques. We believe these contradictions arise from low-level stimulus confounds and data analysis choices. To probe for low-level confounds, we analyzed images from two face databases. Analyses of image luminance and contrast revealed biases across face views described by even polynomials-i.e., mirror-symmetric. To explain major trends across neuroimaging studies, we constructed a network model incorporating three constraints: cortical magnification, convergent feedforward projections, and interhemispheric connections. Given the identified low-level biases, we show that a gradual increase of interhemispheric connections across network-layers is sufficient to replicate view-tuning in early processing stages and mirror-symmetry in later stages. Data analysis decisions-pattern dissimilarity measure and data recentering-accounted for the inconsistent observation of mirror-symmetry across prior studies. Pattern analyses of human fMRI data (of either sex) revealed biases compatible with our model. The model provides a unifying explanation of MVPA studies of viewpoint selectivity and suggests observations of mirror-symmetry originate from ineffectively normalized signal imbalances across different face views.
Subject(s)
Facial Recognition , Humans , Male , Female , Facial Recognition/physiology , Adult , Neuroimaging/methods , Photic Stimulation/methods , Models, Neurological , Visual Cortex/physiology , Visual Cortex/diagnostic imaging , Magnetic Resonance Imaging/methods , Young AdultABSTRACT
Since the seminal work of Cundall and Strack (1979), the Discrete Element Method (DEM) has now become accepted as a key tool amongst researchers exploring the fundamental behavior of granular materials. Along with a sustained increase in the number of publications documenting use of DEM in research, intensive development of new open-source and commercial DEM codes has taken place in the last decades. The credibility of these software packages depends on their capacity to replicate physical observations and to reproduce theoretical expressions. Researchers often calibrate DEM codes against laboratory data to gain confidence about their predictions, however, theoretical verifications at the macro and particle levels are often omitted or not explicitly documented or acknowledged. The validation of DEM codes against theoretical expressions is fundamental to guarantee reproducibility and generality of the software, and to avoid bias in more complex simulations. In this article, a dataset providing numerical simulation data along with input files is presented. The dataset relates to a series of theoretical validation approaches, previously documented in the literature, that were here applied to verify the open-source DEM code LAMMPS. The ability of LAMMPS to capture the macroscopic behaviour of granular packages is evaluated by shearing a face-center-cubic (FCC) array of monosized spheres. The calculation of particle translational/rotational motions and forces/torques is checked by considering a clump rolling down an inclined plane. Additionally, the stress-strain behavior of Toyoura sand under "drained" and "undrained" shearing is characterized by a series of LAMMPS outputs. The dataset collected from these simulations can be employed by users to benchmark new or existing DEM codes. Both the LAMMPS input scripts and the simulation results for all the cases are available in a public repository.
ABSTRACT
We propose a new family of distributions, so-called the unit ratio-extended Weibull family ([Formula: see text]). It is derived from ratio transformation in an extended Weibull random variable. The use of this transformation is a novelty of the work since it has been less explored than the exponential and has not yet been studied within the extended Weibull class. Moreover, we offer a valuable alternative to model double-bounded variables on the unit interval. Five [Formula: see text] special models are studied in detail, namely the: i) unit ratio-Gompertz; ii) unit ratio-Burr XII; iii) unit ratio-Lomax; v) unit ratio-Rayleigh, and vi) unit ratio-Weibull distributions. We propose a quantile-parameterization for the new family. The maximum likelihood estimators (MLEs) are presented. A Monte Carlo study is performed to evaluate the behavior of the MLEs of unit ratio-Gompertz and unit ratio-Rayleigh distributions. This last model has closed-form and approximately unbiased MLE for small sample sizes. Further, the [Formula: see text] submodels are adjusted to the dropout rate in Brazilian undergraduate courses. We focus on the areas of civil engineering, economics, computer sciences, and control engineering. The applications show that the new family is suitable for modeling educational data and may provide effective alternatives compared to other usual unit models, such as the Beta, Kumaraswamy, and unit gamma distributions. They can also outperform some recent contributions in the unit distribution literature. Thus, the [Formula: see text] family can provide competitive alternatives when those models are unsuitable.
Subject(s)
Engineering , Brazil , Statistical Distributions , Sample Size , Monte Carlo MethodABSTRACT
Background and objective Invasive prolactinoma accounts for 1-5% of all prolactinomas. Its mass and compromise of the diencephalon and frontal and temporal lobes may result in a range of neuropsychiatric symptoms that are often missed during initial evaluations. Cabergoline is a dopaminergic agonist used as the first-line treatment for these patients; however, its effect on neuropsychiatric symptoms in this particular setting remains unexplored. In this study, our primary objective was to describe the epidemiology of neuropsychiatric comorbidities in Mexican patients with invasive prolactinomas. The secondary aim of the study was to describe how these comorbidities are modified by treatment with cabergoline, through follow-up with standardized clinical scales. Methods This was a retrospective analytic study. Data were pulled from clinical records and evaluations of patients at baseline and at six-month follow-ups. Results A total of 10 patients were included in the study. None of them had any prior psychiatric diagnosis. At the initial evaluation, 70% were diagnosed with depression or anxiety. During follow-up, two patients developed neuropsychiatric symptoms; there was a significant reduction in tumor size but no difference was found in clinimetric scores for neuropsychiatric comorbidities. Conclusions Patients with giant prolactinomas may present with several neuropsychiatric symptoms throughout the course of their disease. Although there are several mechanisms involved, it is important to keep in mind that cabergoline may interfere with the dopaminergic pathways involved. This study was underpowered to determine the association but can serve as a pilot for further research on this topic.
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The use of trace elements in agriculture as a complement to crop fertilization programs is a practice that is gaining importance and relevance worldwide. Iodine and selenium perform essential functions in human health, related to the proper functioning of the thyroid gland, acting as antioxidants and antiproliferatives, and their limited intake through food consumption can cause malnutrition, reflected in the abnormal development and growth of humans. This research aimed to evaluate the nutraceutical quality of tomato (Solanum lycopersicum L.) in response to seed priming based on KIO3 (0, 100, 150, 200, 250 mg L-1) and Na2SeO3 (0, 0.5, 1, 2, 3 mg L-1), performed by interaction from a 52-factorial design and by independent factors in a 24-h imbibition time. The tomato crop was established under greenhouse conditions in 10-L polyethylene containers containing peat moss and perlite 1:1 (v/v). Regarding non-enzymatic antioxidant compounds, lycopene, ß-carotene and flavonoid contents in tomato fruits significantly increased with KIO3 and Na2SeO3 treatments; however, vitamin C content was negatively affected. KIO3 increased the phenol and chlorophyll-a contents of leaves. In relation to enzymatic activity, KIO3 positively influenced GSH content and PAL activity in tomato fruits. KIO3 also positively influenced GSH content in leaves while negatively affecting PAL and APX activities. Na2SeO3 favored GSH content and GPX activity in tomato fruits and leaves. Na2SeO3 negatively affected the antioxidant capacity of hydrophilic compounds by ABTS in fruits and leaves and favored hydrophilic compounds by DPPH in leaves. Seed imbibition based on KIO3 and Na2SeO3 is a method that is implemented in the tomato crop and presents interesting aspects that favor the nutraceutical quality of tomato fruits, which may contribute to increasing the intake of these minerals in humans through tomato consumption.
ABSTRACT
Our ability to recognize faces regardless of viewpoint is a key property of the primate visual system. Traditional theories hold that facial viewpoint is represented by view-selective mechanisms at early visual processing stages and that representations become increasingly tolerant to viewpoint changes in higher-level visual areas. Newer theories, based on single-neuron monkey electrophysiological recordings, suggest an additional intermediate processing stage invariant to mirror-symmetric face views. Consistent with traditional theories, human studies combining neuroimaging and multivariate pattern analysis (MVPA) methods have provided evidence of view-selectivity in early visual cortex. However, contradictory results have been reported in higher-level visual areas concerning the existence in humans of mirror-symmetrically tuned representations. We believe these results reflect low-level stimulus confounds and data analysis choices. To probe for low-level confounds, we analyzed images from two popular face databases. Analyses of mean image luminance and contrast revealed biases across face views described by even polynomials-i.e., mirror-symmetric. To explain major trends across human neuroimaging studies of viewpoint selectivity, we constructed a network model that incorporates three biological constraints: cortical magnification, convergent feedforward projections, and interhemispheric connections. Given the identified low-level biases, we show that a gradual increase of interhemispheric connections across network layers is sufficient to replicate findings of mirror-symmetry in high-level processing stages, as well as view-tuning in early processing stages. Data analysis decisions-pattern dissimilarity measure and data recentering-accounted for the variable observation of mirror-symmetry in late processing stages. The model provides a unifying explanation of MVPA studies of viewpoint selectivity. We also show how common analysis choices can lead to erroneous conclusions.
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The understanding of the molecular- and colloidal-structure of asphaltenes has seen a major progress; however, there are still issues that require answer. One of them is the location of the heteroatoms in the polycyclic aromatic hydrocarbon (PAH) fused aromatic ring (FAR) region of asphaltenes. Therefore, the effect on the frontier molecular orbitals (HOMO-LUMO) energy-gap due to the addition of a heteroatom (N or S) to PAHs, which are candidates of the PAH region in asphaltenes, has been systematically analyzed by placing S or N in various sites of the PAH molecule. The S is introduced as a thiophenic ring in a bay region, while the N is introduced as a pyridinic-N, which are prevalent forms in the asphaltene-PAH. 174 PAHs are studied with five fused aromatic rings (5FAR) to 10FAR. The π-electron allocation in resonant π-sextets and isolated double bonds is obtained using the Y-rule. The frontier orbitals optical transition is calculated with the ZINDO/S method. Within a FAR family an increment of π-sextets produces and increase of the HOMO-LUMO energy-gap. There is a linear relationship between the Y-rule mapping (percentage of fraction of π-sextet bond divided by nFAR) and the HOMO-LUMO energy-gap. In addition, the effect on the frontier orbitals energy-gap and on the π-electronic allocation due to the presence of N and S is negligible; therefore, to reach conclusions related to the asphaltene-PAH based on conclusions reached for PAH systems, with no heteroatoms, is a reasonable approach.
ABSTRACT
INTRODUCTION: The opioid epidemic has evolved into a combined stimulant epidemic, with escalating stimulant and fentanyl-related overdose deaths. Primary care providers are on the frontlines grappling with patients' methamphetamine use. Although effective models exist for treating opioid use disorder in primary care, little is known about current clinical practices for methamphetamine use. METHODS: Six semistructured group interviews were conducted with 38 primary care providers. Interviews focused on provider perceptions of patients with methamphetamine use problems and their care. Data were analyzed using inductive and thematic analysis and summarized along the following dimensions: (1) problem identification, (2) clinical management, (3) barriers and facilitators to care, and (4) perceived needs to improve services. RESULTS: Primary care providers varied in their approach to identifying and treating patient methamphetamine use. Unlike opioid use disorders, providers reported lacking standardized screening measures and evidence-based treatments, particularly medications, to address methamphetamine use. They seek more standardized screening tools, Food and Drug Administration-approved medications, reliable connections to addiction medicine specialists, and more training. Interest in novel behavioral health interventions suitable for primary care settings was also noteworthy. CONCLUSIONS: The findings from this qualitative analysis revealed that primary care providers are using a wide range of tools to screen and treat methamphetamine use, but with little perceived effectiveness. Primary care faces multiple challenges in effectively addressing methamphetamine use among patients singularly or comorbid with opioid use disorders, including the lack of Food and Drug Administration-approved medications, limited patient retention, referral opportunities, funding, and training for methamphetamine use. Focusing on patients' medical issues using a harm reduction, motivational interviewing approach, and linkage with addiction medicine specialists may be the most reasonable options to support primary care in compassionately and effectively managing patients who use methamphetamines.
Subject(s)
Methamphetamine , Opioid-Related Disorders , Humans , Methamphetamine/adverse effects , Analgesics, Opioid/therapeutic use , Opioid-Related Disorders/drug therapy , Primary Health CareABSTRACT
Cavernous hemangiomas, also known as deep hemangiomas are benign tumors of blood vessels, including normal and abnormal vascular structures, that develop in skin tissue and sometimes even in deep tissues. Its intraneural development in the peripheral nerve is very rare with less than 50 cases reported in the literature. We present a case of a cavernous hemangioma of the medial sural nerve in a patient with symptoms of severe pain and allodynia with complete resolution of symptoms with microsurgery.
Subject(s)
Hemangioma, Cavernous , Humans , Hemangioma, Cavernous/complications , Hemangioma, Cavernous/diagnostic imaging , Hemangioma, Cavernous/surgery , Peripheral Nerves/pathologyABSTRACT
La meralgia parestésica es un desorden neurológico causado por una neuropatía del nervio femorocutáneo lateral. Su etiología puede ser idiopática o iatrogénica. Se caracteriza por dolor, parestesias y entumecimiento en la cara anterolateral del muslo. Su diagnóstico es básicamente clínico, aunque pueden ser útiles pruebas de imagen o neurofisiológicas. A pesar de que el tratamiento conservador suele ser eficaz en la mayoría de los pacientes, existen casos refractarios que pueden precisar de otras formas de tratamiento. Los procedimientos quirúrgicos disponibles son la descompresión nerviosa (neurólisis) o la sección (neurectomía) y las ablaciones por radiofrecuencia. Presentamos un caso de meralgia parestésica invalidante refractaria en el cual empleamos la estimulación medular como posible técnica eficaz en el alivio del dolor y poder evitar la realización de una neurectomía del nervio femorocutáneo lateral (AU)
Meralgia paresthetica is a neurological disorder caused by a neuropathy of the lateral femoral cutaneous nerve. Its etiology can be spontaneous or iatrogenic. It is characterized by pain, paresthesia, and numbness in the anterolateral aspect of the thigh. Diagnosis is based on clinical examination, although image and neurophysiological tests can be useful as well. Despite conservative measures use to be effective in most of patients, refractory cases can benefit from alternative treatments. Available surgical procedures are: nerve decompression (neurolysis) or section (neurectomy) and radiofrequency ablation. We present a case of refractory meralgia paresthetica where spinal cord stimulation was used as a possible effective technique in pain relief and to avoid the neurectomy of the lateral femoral cutaneous nerve (AU)
Subject(s)
Humans , Female , Adult , Femoral Neuropathy/diagnosis , Nerve Compression Syndromes/diagnosis , Spinal Cord Stimulation , Femoral Neuropathy/therapy , Nerve Compression Syndromes/therapy , Treatment OutcomeABSTRACT
In many practical situations, there is an interest in modeling bounded random variables in the interval (0, 1), such as rates, proportions, and indexes. It is important to provide new continuous models to deal with the uncertainty involved by variables of this type. This paper proposes a new quantile regression model based on an alternative parameterization of the unit Burr XII (UBXII) distribution. For the UBXII distribution and its associated regression, we obtain score functions and observed information matrices. We use the maximum likelihood method to estimate the parameters of the regression model, and conduct a Monte Carlo study to evaluate the performance of its estimates in samples of finite size. Furthermore, we present general diagnostic analysis and model selection techniques for the regression model. We empirically show its importance and flexibility through an application to an actual data set, in which the dropout proportion of Brazilian undergraduate animal sciences courses is analyzed. We use a statistical learning method for comparing the proposed model with the beta, Kumaraswamy, and unit-Weibull regressions. The results show that the UBXII regression provides the best fit and the most accurate predictions. Therefore, it is a valuable alternative and competitive to the well-known regressions for modeling double-bounded variables in the unit interval.
Subject(s)
Regression Analysis , Animals , Brazil , Monte Carlo Method , UncertaintyABSTRACT
Historical records (1980-2018) of potentially toxic phytoplankton and phycotoxins on the Argentine Continental Shelf (35°S-56.5°S) and adjacent ocean waters were systematically reviewed from scientific literature to assess their abundance and diversity over spatial and temporal scales. Records increased from 124 in the period 1980-1992 to 638 in 2006-2018, and the scanned area expanded from coastal to offshore waters including the shelf-break front. Alexandrium was the most reported genus (54%) during 1980-1992 and Pseudo-nitzschia (52%) during 1993-2005. By 2006-2018, a higher diversity was documented: Alexandrium (20%), Dinophysis (32%), Pseudo-nitzschia (31%), and the most recently described potentially toxic dinoflagellates of the family Amphidomataceae (8%). Likewise, a wider spectrum of phycotoxins was documented in the last decade, with lipophilic (LSTs) and paralytic shellfish toxins (PSTs) as the most recorded. Increased records are related to intensified monitoring, more detailed taxonomic analyses and more sensitive chemical techniques for marine biotoxin detection. This quantitative assessment brings light to the widespread occurrence of HABs along contrasting areas of the Patagonian Shelf and sets the basis for ecosystem risk evaluation. Moreover, comparison of toxic phytoplankton reported in the SW Atlantic with those in similar temperate seas in the North Atlantic and the Pacific Ocean, disclose ocean basin differences in strain toxicity of A. ostenfeldii, D. tripos and Azadinium species.
Subject(s)
Diatoms , Dinoflagellida , Argentina , Ecosystem , Marine Toxins/analysis , Phytoplankton , WaterABSTRACT
Resumen La Clasificación Internacional del Funcionamiento (CIF) define la movilidad como la posibilidad de "moverse cambiando la posición o ubicación del cuerpo o moviéndose de un lugar a otro, trans portando, moviendo o manipulando objetos, caminando, corriendo o trepando, y utilizando diversas formas de transporte". La fisioterapia se centra en la evaluación y el tratamiento de los problemas de movimiento. La deter minación del estado de movilidad es un componente central de la evaluación de la salud de los adultos mayores, ya que es un marcador importante de las capacidades físicas y la independencia, y un predictor de morbilidad y mortalidad. Sin embargo, a la fecha no disponemos de escalas que representen el grado de movilidad del paciente con algún tipo de imagen visual que facilite su documentación de forma rápida y fiable por parte de cualquier profesional sanitario que trabaje en el ámbito de la hospitalización. Por estas razones, desarrollamos una escala de movilidad intuitiva basada en iconos que es fácil de administrar en pacientes hospitalizados en diferentes entornos. La escala de movilidad ProMover proporciona a los profesionales de la salud una herramienta unificada para evaluar la movilidad de los pacientes hospitalizados, con el fin de unificar un lenguaje común. Se trata de una herramienta sencilla, práctica, fiable y objetiva y de uso común por todos los profesionales sanitarios.
Abstract. The International Classification of Functionality (CIF) defines mobility as the possibility of "moving by changing the position or location of the body or moving from one place to another, transporting, moving or manipulating objects, walking, running or climbing, and using various forms of transport ". Physical therapy focuses on the assessment and management of movement problems. Determining mobility status is a central component of the health assessment of older adults since it is an important marker of physical abilities and independence, and a predictor of morbidity and mortality. However, to date we did not have scales that represent the degree of mobility of the patient with some type of visual image that facilitates its documentation quickly and reliably by any health professional who works in the field of hospitalization. For these reasons, we developed an intuitive, icon-based mobility scale that is easy to administer in hospitalized patients in different settings. The ProMover mobility scale provides health professionals with a unified tool for evaluating the mobility of hospitalized patients, in order to unify a common language. This is a simple, practical, reliable and objective tool and commonly used by all health professionals.
ABSTRACT
Ependymomas are well defined glial tumours composed of uniform small cells with round nuclei in a fibrillar matrix. They have characteristic perivascular acellular areas (pseudorosettes) and, in some cases, ependymal rosettes. The three most well-known histological phenotypes are papillary, clear-cell and tanycytic. The WHO classification includes rare cases of ependymoma with lipomatous metaplasia. Lipomatous ependymomas of the posterior fossa are extremely rare; we only found 7reports of cases in adults. They usually arise in the fourth ventricle and may extend into the cerebellum, when they often show extensive vacuolization, pushing the nucleus to the periphery and giving rise to a signet-ring cell appearance. Radiologically, there are few findings characteristic of these tumours. Immunohistochemistry is essential to differentiate this subtype from other more common lesions, such as metastatic adenocarcinoma, especially from breast, intestine and kidney.
Subject(s)
Ependymoma , Lipoma , Ependymoma/pathology , Humans , Immunohistochemistry , MetaplasiaABSTRACT
Los ependimomas son tumores gliales bien circunscritos compuestos de células pequeñas uniformes con un núcleo redondo en una matriz fibrilar. Se caracterizan por zonas anucleadas perivasculares (pseudorrosetas) y, en algunos casos, rosetas ependimarias. Tres fenotipos histológicos son los más reconocidos: papilar, de células claras y tanicítico. La OMS reconoce casos raros de ependimomas con metaplasia lipomatosa. Los ependimomas lipomatosos de fosa posterior son extremadamente infrecuentes, y en nuestra búsqueda hemos encontrado 7casos reportados en la literatura (excluyendo niños). Se originan habitualmente del 4.° ventrículo y podrían presentar extensión cerebelosa. Estos suelen presentar extensa vacuolización empujando el núcleo a la periferia y simulando la apariencia de «signet-ring cells» (células en anillo de sello). Radiológicamente hay pocos hallazgos que sean característicos de este tipo de tumores. La inmunohistoquímica es decisiva para no confundir esta variante con lesiones más comunes, como el adenocarcinoma metastásico, especialmente los de mama, intestino y renal.(AU)
Ependymomas are well defined glial tumours composed of uniform small cells with round nuclei in a fibrillar matrix. They have characteristic perivascular acellular areas (pseudorosettes) and, in some cases, ependymal rosettes. The three most well-known histological phenotypes are papillary, clear-cell and tanycytic. The WHO classification includes rare cases of ependymoma with lipomatous metaplasia. Lipomatous ependymomas of the posterior fossa are extremely rare; we only found 7reports of cases in adults. They usually arise in the fourth ventricle and may extend into the cerebellum, when they often show extensive vacuolization, pushing the nucleus to the periphery and giving rise to a signet-ring cell appearance. Radiologically, there are few findings characteristic of these tumours. Immunohistochemistry is essential to differentiate this subtype from other more common lesions, such as metastatic adenocarcinoma, especially from breast, intestine and kidney.(AU)
Subject(s)
Humans , Ependymoma/pathology , Metaplasia , Neoplasm Metastasis , Brain Neoplasms , Immunohistochemistry , LipomaABSTRACT
The International Classification of Functionality (CIF) defines mobility as the possibility of "moving by changing the position or location of the body or moving from one place to another, transporting, moving or manipulating objects, walking, running or climbing, and using various forms of transport". Physical therapy focuses on the assessment and management of movement problems. Determining mobility status is a central component of the health assessment of older adults since it is an important marker of physical abilities and independence, and a predictor of morbidity and mortality. However, to date we did not have scales that represent the degree of mobility of the patient with some type of visual image that facilitates its documentation quickly and reliably by any health professional who works in the field of hospitalization. For these reasons, we developed an intuitive, icon-based mobility scale that is easy to administer in hospitalized patients in different settings. The ProMover mobility scale provides health professionals with a unified tool for evaluating the mobility of hospitalized patients, in order to unify a common language. This is a simple, practical, reliable and objective tool and commonly used by all health professionals.
La Clasificación Internacional del Funcionamiento (CIF) define la movilidad como la posibilidad de "moverse cambiando la posición o ubicación del cuerpo o moviéndose de un lugar a otro, transportando, moviendo o manipulando objetos, caminando, corriendo o trepando, y utilizando diversas formas de transporte". La fisioterapia se centra en la evaluación y el tratamiento de los problemas de movimiento. La determinación del estado de movilidad es un componente central de la evaluación de la salud de los adultos mayores, ya que es un marcador importante de las capacidades físicas y la independencia, y un predictor de morbilidad y mortalidad. Sin embargo, a la fecha no disponemos de escalas que representen el grado de movilidad del paciente con algún tipo de imagen visual que facilite su documentación de forma rápida y fiable por parte de cualquier profesional sanitario que trabaje en el ámbito de la hospitalización. Por estas razones, desarrollamos una escala de movilidad intuitiva basada en iconos que es fácil de administrar en pacientes hospitalizados en diferentes entornos. La escala de movilidad ProMover proporciona a los profesionales de la salud una herramienta unificada para evaluar la movilidad de los pacientes hospitalizados, con el fin de unificar un lenguaje común. Se trata de una herramienta sencilla, práctica, fiable y objetiva y de uso común por todos los profesionales sanitarios.
Subject(s)
Hospitalization , Language , Aged , Humans , WalkingABSTRACT
Spinal cord stimulation (SCS) consists of the application of electrical stimuli to the dorsal columns of the spinal cord or to the posterior nerve roots in order to modulate the pain signals carried by the ascending pain pathways to the brain. Two cases of SCS in patients with cauda equina syndrome after lumbar surgery are presented. They were treated for persistent neuropathic pain but also experienced improvement in their motor and urinary symptoms after this treatment. Although the primary indication for SCS is neuropathic pain control, its application can also lead to improvement of motor deficits, sensory disorders, and urinary incontinence, as shown in these two cases. SCS will likely play a fundamental role in rehabilitative therapies in different neurological diseases. Further investigation in the field is needed.