ABSTRACT
Introduction: The evaluation of integrated care programmes for high-need high-cost older people is a challenge. We aim to share the early implementation results of the ProPCC programme in the North-Barcelona metropolitan area, in Catalonia, Spain. Methods: We analysed the intervention with retrospective data from May 2018 to December 2021 by describing the cohort complexity and by showing its 6-months pre-post impact on time spent at home and resources used: primary care visits, emergency department visits, hospital admissions and hospital stay. Findings: 264 cases were included (91% at home; 9% in nursing homes). 6-month pre vs. 6-months post results were (mean, p-value): primary care visits 8.2 vs. 11.5 (p < 0.05); emergency department visits 1.4 vs. 0.9 (p < 0.05); hospital admissions 0.7 vs. 0.5 (p < 0.05); hospital stay 12.8 vs. 7.9 days (p < 0.05). Time spent at home was 169.2 vs.174.2 days (p < 0.05). Conclusion: Early implementation of the ProPCC programme results in an increase in time spent at home (up to 3%) and significant reductions in emergency department attendance (-37.2%) and hospital stays (-38.3%). The increased use of primary care resources is compensated by the hospital resources savings, with a result in the average total cost of -46.3%.
ABSTRACT
FUNDAMENTOS: La cesárea es una intervención quirúrgica que consiste en la extracción del feto por vía abdominal. Como cualquier intervención quirúrgica, la cesárea no está exenta de complicaciones y éstas se pueden clasificar en a corto plazo (dolor agudo)y a largo plazo (adherencias en la cicatriz, dolores lumbares y pélvicos, obstrucción intestinal y embarazos ectópicos). La fisioterapiacuenta con diferentes herramientas para abordar estas complicaciones. El objetivo de este trabajo fue revisar la bibliografía científicapara conocer los efectos de la fisioterapia en las consecuencias del parto por cesárea.MÉTODOS: Se realizó una búsqueda de artículos durante el mes de diciembre de 2021 en las bases de datos PubMed, Medline, Cinahl, Scopus, PEDro y WOS empleando los términos de búsqueda Cesarean Section, Physical Therapy Modalities y Physical Therapy. Como criterio de inclusión se estableció que el tipo de estudio fuese Estudio Clínico Aleatorizado (ECA). RESULTADOS: Se obtuvieron un total de 280 artículos, de los cuales 9 fueron seleccionados tras aplicar los criterios de elegibilidad. En ellos, la intervención más utilizada de fisioterapia fue electroterapia, seguida de masoterapia y ejercicio terapéutico. Los estudios arrojan efectos de estas formas de fisioterapia, con una duración y frecuencia determinada, con mejoras en el dolor, las actividades de la vida diaria, el nivel de comodidad, los rangos articulares y la reducción del consumo de analgésicos. CONCLUSIONES: La fisioterapia cuenta con diversas modalidades con las que atender tanto en una fase inmediata como en una tardía las complicaciones tras una cesárea, destacando especialmente la reducción del dolor.(AU)
ACKGROUND: Caesarean section is a surgical intervention that consists of the extraction of the fetus by abdominal route through the incision in the uterus. Like any surgical intervention, caesarean section is not exempt from complications and these can be classified as short-term (acute pain) and long-term (adhesions in the scar, lumbar and pelvic pain, intestinal obstruction and ectopic pregnancies). Physiotherapy has different tools to address these complications. The aim of this study was to review the scientific bibliography to know the effects of physiotherapy on patients who have given birth by cesarean section. METHODS: A search for articles was carried out during the month of December 2021 in the databases: PubMed, Medline, Cinahl, Scopus, PEDro and WOS using the search termsCesarean Section, Physical Therapy Modalities and Physical therapy. As an inclusion criterion, it was established that the type of study was a Randomized Clinical Trial (RCT). RESULTS: A total of 280 articles were obtained, of which 9 were selected after applying the eligibility criteria. In them, the most used physiotherapy intervention was electrotherapy, followed by massage therapy and therapeutic exercise. Studies show effects of these forms of physiotherapy, with a determined duration and frequency, with improvements in pain, activities of daily living, comfort level, joint ranges and reduction in the consumption of analgesics. CONCLUSIONS: Physiotherapy has various modalities with which to attend complications after cesarean section, both in an immediate and a late phase, especially highlighting the reduction of pain.(AU)
Subject(s)
Humans , Physical Therapy Specialty , Cesarean Section , Parturition , Labor Pain , Obstetric Labor Complications , Public HealthABSTRACT
OBJECTIVE: Caesarean section is a surgical intervention that consists of the extraction of the fetus by abdominal route through the incision in the uterus. Like any surgical intervention, caesarean section is not exempt from complications and these can be classified as short-term (acute pain) and long-term (adhesions in the scar, lumbar and pelvic pain, intestinal obstruction and ectopic pregnancies). Physiotherapy has different tools to address these complications. The aim of this study was to review the scientific bibliography to know the effects of physiotherapy on patients who have given birth by cesarean section. METHODS: A search for articles was carried out during the month of December 2021 in the databases: PubMed, Medline, Cinahl, Scopus, PEDro and WOS using the search terms Cesarean Section, Physical Therapy Modalities and Physical therapy. As an inclusion criterion, it was established that the type of study was a Randomized Clinical Trial (RCT). RESULTS: A total of 280 articles were obtained, of which 9 were selected after applying the eligibility criteria. In them, the most used physiotherapy intervention was electrotherapy, followed by massage therapy and therapeutic exercise. Studies show effects of these forms of physiotherapy, with a determined duration and frequency, with improvements in pain, activities of daily living, comfort level, joint ranges and reduction in the consumption of analgesics. CONCLUSIONS: Physiotherapy has various modalities with which to attend complications after cesarean section, both in an immediate and a late phase, especially highlighting the reduction of pain.
OBJETIVO: La cesárea es una intervención quirúrgica que consiste en la extracción del feto por vía abdominal. Como cualquier intervención quirúrgica, la cesárea no está exenta de complicaciones y éstas se pueden clasificar en a corto plazo (dolor agudo) y a largo plazo (adherencias en la cicatriz, dolores lumbares y pélvicos, obstrucción intestinal y embarazos ectópicos). La fisioterapia cuenta con diferentes herramientas para abordar estas complicaciones. El objetivo de este trabajo fue revisar la bibliografía científica para conocer los efectos de la fisioterapia en las consecuencias del parto por cesárea. METODOS: Se realizó una búsqueda de artículos durante el mes de diciembre de 2021 en las bases de datos PubMed, Medline, Cinahl, Scopus, PEDro y WOS empleando los términos de búsqueda Cesarean Section, Physical Therapy Modalities y Physical Therapy. Como criterio de inclusión se estableció que el tipo de estudio fuese Estudio Clínico Aleatorizado (ECA). RESULTADOS: Se obtuvieron un total de 280 artículos, de los cuales 9 fueron seleccionados tras aplicar los criterios de elegibilidad. En ellos, la intervención más utilizada de fisioterapia fue electroterapia, seguida de masoterapia y ejercicio terapéutico. Los estudios arrojan efectos de estas formas de fisioterapia, con una duración y frecuencia determinada, con mejoras en el dolor, las actividades de la vida diaria, el nivel de comodidad, los rangos articulares y la reducción del consumo de analgésicos. CONCLUSIONES: La fisioterapia cuenta con diversas modalidades con las que atender tanto en una fase inmediata como en una tardía las complicaciones tras una cesárea, destacando especialmente la reducción del dolor.
Subject(s)
Cesarean Section , Physical Therapy Modalities , Pregnancy , Female , Humans , Spain , Cesarean Section/adverse effects , Exercise Therapy , Pain , Randomized Controlled Trials as TopicABSTRACT
The present study examines the ability of melatonin to protect striatal dopaminergic loss induced by 6-OHDA in a rat model of Parkinson's disease, comparing the results with L-DOPA-treated rats. The drugs were administered orally daily for a month, their therapeutic or dyskinetic effects were assessed by means of abnormal involuntary movements (AIMs) and stepping ability. At the cellular level, the response was evaluated using tyrosine hydroxylase immunoreactivity and striatal ultrastructural changes to compare between L-DOPA-induced AIMs and Melatonin-treated rats. Our findings demonstrated that chronic oral administration of Melatonin improved the alterations caused by the neurotoxin 6-OHDA. Melatonin-treated animals perform better in the motor tasks and had no dyskinetic alterations compared to L-DOPA-treated group. At the cellular level, we found that Melatonin-treated rats showed more TH-positive neurons and their striatal ultrastructure was well preserved. Thus, Melatonin is a useful treatment to delay the cellular and behavioral alterations observed in Parkinson's disease.