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1.
Medicine (Baltimore) ; 99(19): e19624, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32384425

RESUMEN

BACKGROUND: Patients suffering from degenerative scoliosis (DS) were commonly associated with coronal and sagittal imbalance which made deformity correction surgery necessary. The study aimed to explore the efficacy and feasibility of the limited correction of lumbar lordosis (LL) in the treatment of patients with DS. METHODS: This was a retrospective study including 58 DS patients who underwent spinal deformity correction surgery and were followed up at least 2 years between January 2013 and January 2017. According to the difference of postoperative LL, the patients were divided into 2 groups: the limited correction group: Pelvic incidence(PI)-18°≤ LL .05). In terms of surgery, the limited group had less intra-operative blood loss and operation time (P < .05). At the last follow-up, significant differences were found in terms of LL(-38.2 ±â€Š4.7° and -46.9 ±â€Š4.7°), PT (18.8 ±â€Š5.2° and 11.1 ±â€Š3.6°), sacrum slope (33.7 ±â€Š7.0° and 41.4 ±â€Š6.1°) (P < .05), while there were no significant differences in terms of lumbar Cobb angle (10.5 ±â€Š9.3°and 8.3 ±â€Š6.7°), Oswestry Disability Index scores (25.6 ±â€Š10.2 and 26.4 ±â€Š12.1), and JOA scores (23.6 ±â€Š5.2 and 22.3 ±â€Š5.7) (P > .05). CONCLUSION: Limited correction of LL in the treatment of DS patients can achieve favorable clinical outcomes including effective Cobb angle correction with less blood loss and operative time.


Asunto(s)
Lordosis/fisiopatología , Vértebras Lumbares/fisiopatología , Escoliosis/fisiopatología , Fusión Vertebral , Anciano , Evaluación de la Discapacidad , Femenino , Humanos , Lordosis/etiología , Lordosis/cirugía , Vértebras Lumbares/cirugía , Masculino , Persona de Mediana Edad , Huesos Pélvicos/fisiopatología , Periodo Posoperatorio , Estudios Retrospectivos , Sacro/fisiopatología , Escoliosis/complicaciones , Escoliosis/cirugía , Resultado del Tratamiento
2.
Medicine (Baltimore) ; 99(18): e19975, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32358370

RESUMEN

BACKGROUND: Bee venom acupuncture has been used in treating patients with shoulder adhesive capsulitis, yet the effectiveness and safety remains unclear. Therefore, this systematic review will aim to assess the effectiveness and safety of bee venom acupuncture for shoulder adhesive capsulitis. METHODS: Electronic databases including EMBASE, PUBMED, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, and Chinese Biomedical Literature Database will be searched for relevant randomized controlled trials from their inception to the search data without language and publication status. Randomized controlled trials involving bee venom acupuncture for treating shoulder adhesive capsulitis will be included. The primary outcome will be pain visual analogue scale, and secondary outcomes include active and passive range of motions, shoulder pain and disability index. Meta-analysis will be conducted using Review Manager software (V.5.3). The results will be presented as risk ratio for dichotomous data, and standardized or weighted mean difference for continuous data. RESULTS: The results will be disseminated through a peer-reviewed journal publication. CONCLUSION: These systematic review findings will provide an evidence of bee venom acupuncture for shoulder adhesive capsulitis, and help to inform clinical practitioners and policy-makers in the decision-making. ETHICS AND DISSEMINATION: Ethics approval and patient consent are not required as this study is a systematic review based on published articles.


Asunto(s)
Terapia por Acupuntura/métodos , Venenos de Abeja/administración & dosificación , Bursitis/terapia , Terapia por Acupuntura/efectos adversos , Venenos de Abeja/efectos adversos , Evaluación de la Discapacidad , Humanos , Dimensión del Dolor , Ensayos Clínicos Controlados Aleatorios como Asunto , Rango del Movimiento Articular , Proyectos de Investigación
3.
Medicine (Baltimore) ; 99(18): e20023, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32358380

RESUMEN

RATIONALE: Migraine is a recurrent, disabling neurovascular headache disorder. The patient's quality of life can be severely impaired by migraine attacks. Stellate ganglion block (SGB) can be used to relieve pain in the head, neck, and upper extremities. In the present cases, we performed SGB in 2 patients with migraine that responds poorly to drugs. PATIENT CONCERNS: Patients 1 and 2 suffered from chronic, bilateral pulsating headache, accompanied by nausea and vomiting. Patient 1 presented with headache of 8 on the visual analog scale (VAS), and 37 on the migraine disability assessment (MIDAS). Patient 2 reported headache of 7 on the VAS, and 32 on the MIDAS. DIAGNOSIS: The patients were diagnosed with migraine without aura based on the International Classification of Headache Disorders version 3. INTERVENTIONS: Patient 1 was treated with bilateral SGB every week for a month and then every month for 3 months. Patient 2 received bilateral SGB every 2 weeks for a month and then every month for 3 months. OUTCOMES: Four months after SGB, patient 1 reported pain intensity of 4 on VAS and 6 on MIDAS and patient 2 rated pain intensity of 3 on VAS, and 6 on MIDAS, respectively. LESSONS: The SGB can be an effective option to improve headache-related disability and relieve pain intensity in the patients with refractory migraine.


Asunto(s)
Bloqueo Nervioso Autónomo/métodos , Trastornos Migrañosos/tratamiento farmacológico , Ganglio Estrellado , Adulto , Evaluación de la Discapacidad , Esquema de Medicación , Femenino , Humanos , Persona de Mediana Edad , Trastornos Migrañosos/complicaciones , Náusea/etiología , Calidad de Vida , Escala Visual Analógica , Vómitos/etiología
4.
Medicine (Baltimore) ; 99(18): e20153, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32358405

RESUMEN

At present, the posterior cervical approach with open reduction and internal fixation (ORIF) remains a commonly effective treatment for unstable Atlas fracture. However, the inserted screws into the C1 lateral mass of some unstable atlas fracture are very difficult, so that the operation is forced to change into C0 to C2 fusion. In order to improve the successful rate of lateral mass screw placement, we introduced a method of fixing lateral mass with a towel clamp in posterior transpedicular fixation, and explore the efficacy and feasibility.Twenty-one consecutive patients with unstable atlas fracture were treated via this method from October 2012 to July 2017. All cases had neck pain and restricted motion of neck movement on admission. Electronic medical records and pre- and postoperative radiographs were reviewed. Screw and rod placement, bone fusion, and spinal cord integrity were assessed via long-term follow-up with anteroposterior and lateral radiographs and computed tomography. Follow-up included clinical assessment of neurological function, assessment of pain using the visual analog scale (VAS), and assessment of the activities of daily living using the neck disability index (NDI).The mean follow-up duration was 22.1 months (range: 12-54 months). No screw loosening or breakage, plate displacement, neurovascular injury, and severe complications occurred during follow-up. The mean operative time was 112.4 ±â€Š14.9 min (range: 82-135 min), and mean blood loss was 386.2 ±â€Š147.9 mL (range: 210-850 mL). One patient experienced continuous neck pain postoperatively, but this gradually disappeared with analgesic administration. At final follow-up, all patients had bone fusion, the VAS scores and NDI were significantly improved compared with preoperatively.Fixing the C1 lateral mass with a towel clamp during posterior transpedicular fixation for unstable atlas fracture appears to be a safe and reliable method, with the advantages of being a simple technique with few complications.


Asunto(s)
Atlas Cervical/lesiones , Atlas Cervical/cirugía , Fijación Interna de Fracturas/métodos , Fracturas de la Columna Vertebral/cirugía , Actividades Cotidianas , Pérdida de Sangre Quirúrgica , Placas Óseas , Tornillos Óseos , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Tempo Operativo , Complicaciones Posoperatorias/epidemiología , Rango del Movimiento Articular , Estudios Retrospectivos
6.
Am J Phys Med Rehabil ; 99(5): 359-365, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32301768

RESUMEN

OBJECTIVE: The aim of this study was to assess the impact of the burden and patterns of multimorbidity on disability domains. DESIGN: In a cross-sectional study of 425 older adults from the Boston Rehabilitative Impairment Study of the Elderly, participants self-reported 13 chronic conditions and underwent assessment of body function (leg strength, velocity, and power, trunk extensor endurance, leg range of motion, foot sensation), activities (400-m walk test, Short Physical Performance Battery, Late Life Function and Disability Instrument function scores) and participation (Late Life Function and Disability Instrument participation scores). The association between multimorbidity patterns (identified by latent class analysis) and disablement measures, as well as multimorbidity burden (captured by a multimorbidity score) and disablement measures, was tested. RESULTS: Latent class analysis identified three classes-low multimorbidity, high multimorbidity, and predominantly musculoskeletal conditions. Class membership (multimorbidity pattern) was not associated with disablement measures, but multimorbidity score was associated with poor performance in all domains. A 1-point higher multimorbidity score was associated with lower scores in body functions (by 0.06 SD unit), activities (0.07-0.10 SD units), as well as participation (0.07-0.09 units). CONCLUSION: Multimorbidity counts may be an excellent tool for risk stratification and identification of persons in need of rehabilitation. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) describe and distinguish the effect of multimorbidity burden and multimorbidity patterns on three disability domains in older adults; (2) identify and discuss possible reasons why high multimorbidity burden may result in a restriction among social participation in older adults; and (3) detect disability risk among older patients during clinical assessment by using a simple count of common chronic conditions. LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Asunto(s)
Evaluación de la Discapacidad , Personas con Discapacidad , Multimorbilidad , Anciano , Boston , Estudios Transversales , Femenino , Humanos , Análisis de Clases Latentes , Estudios Longitudinales , Masculino , Medición de Riesgo
8.
Autoimmun Rev ; 19(5): 102512, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32173519

RESUMEN

A proper clinical evaluation of patients with Multiple Sclerosis (MS) is of great importance to detect MS progression. It provides important data for physicians on their daily practice as well as with scientific purpose, especially useful with the development of newer therapeutic options in MS. Clinical outcome measures (COMs) are instruments that enable a standardized characterization of the patient's clinical disease status. A proper COM should have - among other psychometric characteristics - a good validity, reliability and responsiveness. For MS disability, the Expanded Disability Status Scale (EDSS) is currently the most frequently used scale. However, different less known COMs are also available and could be implemented on clinical practice. We review the most frequently used COMs of MS progression including their operationalization and statistical considerations, as well as newer composite COMs and digital tools on development. We focus on their responsiveness or capacity to detect clinically relevant changes to identify progression or transition to progressive forms of the disease, as well as therapeutic response.


Asunto(s)
Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/terapia , Evaluación de la Discapacidad , Progresión de la Enfermedad , Humanos , Esclerosis Múltiple/fisiopatología , Evaluación de Resultado en la Atención de Salud , Reproducibilidad de los Resultados
10.
Gene ; 743: 144617, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32222535

RESUMEN

Osteoprotegerin is involved in the progression of atherosclerosis. This study aimed to determine whether TNFRSF11B polymorphisms are associated with prognosis of large artery atherosclerosis (LAA) stroke. Three TNFRSF11B polymorphisms (rs2073617, rs2073618 and rs3134069) were genotyped in 1010 patients with LAA stroke. Short-term outcome was evaluated using the modified Rankin Scale score at 3-month after stroke onset. Long-term outcome was assessed using the stroke recurrence. We found that rs2073617G was associated with an increased risk of poor outcome of LAA stroke (additive model: odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.06-1.73). This association was also observed in rs3134069C (additive model: OR = 1.53, 95% CI = 1.10-2.12). Furthermore, when we combined these two polymorphisms according to the numbers of risk alleles (rs2073617G and rs3134069C), we found that the patients with 3-4 risk alleles were statistically significantly associated with an increased risk of poor outcome of LAA stroke (OR = 1.90, 95% CI = 1.10-3.28) compared with 0-2 risk alleles, and this increased risk was more evident among those with hypertension (OR = 2.02, 95% CI = 1.04-3.91), those without diabetes (OR = 2.02, 95% CI = 1.02-4.01) and those with smoking (OR = 2.43, 95% CI = 1.09-5.42). In silico analysis showed that rs2073617 and rs3134069 are located in various histone modification marked regions, DNase I hypersensitive sites and can change the binding of regulatory motifs. Moreover, rs2073617 is also located in the binding site of transcription factors. Our findings suggested that TNFRSF11B polymorphisms may be associated with an increased risk of short-term poor outcome of LAA stroke.


Asunto(s)
Arterias/patología , Aterosclerosis/complicaciones , Evaluación de la Discapacidad , Osteoprotegerina/genética , Accidente Cerebrovascular/genética , Alelos , Aterosclerosis/genética , Aterosclerosis/patología , Estudios de Casos y Controles , Simulación por Computador , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Código de Histonas/genética , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Pronóstico , Recurrencia , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/patología
11.
Rev Bras Epidemiol ; 23: e200002, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32130391

RESUMEN

OBJECTIVES: To estimate the magnitude of gender differences in disability among adults aged 60 and older and to evaluate whether they can be associated with social gender inequality and socioeconomic contextual factors at the level of Brazilian federative units. METHODS: This is a multilevel study that used data from 23,575 older adults of 27 federative units who participated in the 2013 Brazilian Health Survey. The activity limitation index was developed from the item response theory, using activities of daily living and instrumental activities of daily living variables. The association of individual and contextual variables with disability was estimated by assessing the magnitude of differences between genders, using cross-level interaction effects in multilevel generalized linear models, including only the variables that were statistically significant in the final model. RESULTS: The prevalence of disability was higher among women (37.6%) than among men (26.5%), totaling 32.7% of the older adults. In the adjusted multilevel analysis, disability was influenced by income inequality (γgini = 0.022, p < 0.001) among federative units. In addition, gender differences in disability were associated with social gender inequalities (γmgiiXsex = 0.020, p = 0.004). CONCLUSION: Women had higher disability disadvantages compared to men, and those differences were associated with social gender inequalities among the Brazilian federative units influenced by income inequality.


Asunto(s)
Evaluación de la Discapacidad , Personas con Discapacidad/estadística & datos numéricos , Encuestas Epidemiológicas/estadística & datos numéricos , Renta/estadística & datos numéricos , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Estudios Transversales , Femenino , Disparidades en el Estado de Salud , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multinivel , Distribución por Sexo , Factores Sexuales , Factores Socioeconómicos
12.
Medicine (Baltimore) ; 99(11): e19512, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176098

RESUMEN

To investigate the relationships between grip strengths and self-care activities in stroke patients using a non-linear support vector machine (SVM).Overall, 177 inpatients with poststroke hemiparesis were enrolled. Their grip strengths were measured using the Jamar dynamometer on the first day of rehabilitation training. Self-care activities were assessed by therapists using Functional Independence Measure (FIM), including items for eating, grooming, dressing the upper body, dressing the lower body, and bathing at the time of discharge. When each FIM item score was ≥6 points, the subject was considered independent. One thousand bootstrap grip strength datasets for each independence and dependence in self-care activities were generated from the actual grip strength. Thereafter, we randomly assigned the total bootstrap datasets to 90% training and 10% testing datasets and inputted the bootstrap training data into a non-linear SVM. After training, we used the SVM algorithm to predict a testing dataset for cross-validation. This validation procedure was repeated 10 times.The SVM with grip strengths more accurately predicted independence or dependence in self-care activities than the chance level (mean ±â€Šstandard deviation of accuracy rate: eating, 0.71 ±â€Š0.04, P < .0001; grooming, 0.77 ±â€Š0.03, P < .0001; upper-body dressing, 0.75 ±â€Š0.03, P < .0001; lower-body dressing, 0.72 ±â€Š0.05, P < .0001; bathing, 0.68 ±â€Š0.03, P < .0001).Non-linear SVM based on grip strengths can prospectively predict self-care activities.


Asunto(s)
Evaluación de la Discapacidad , Fuerza de la Mano , Paresia/rehabilitación , Autocuidado , Rehabilitación de Accidente Cerebrovascular , Anciano , Femenino , Humanos , Aprendizaje Automático , Masculino , Paresia/fisiopatología , Alta del Paciente , Valor Predictivo de las Pruebas
13.
Rev Bras Epidemiol ; 23: e200019, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32159629

RESUMEN

OBJECTIVE: To characterize spatiotemporal patterns of operational indicators for leprosy control in the state of Bahia from 2001 to 2014. METHODS: This is a population-based ecological study, with spatial distribution and autocorrelation of operational indicators for leprosy control. RESULTS: From 2001 to 2007, 42.7% (n=178) of the municipalities presented a cure rate lower than 75%, increasing to 61.4% (n =291) from 2009 to 2014. Between 2001 and 2007, 32.5% (n=54) of the municipalities reported more than 10% of the total number of relapses in the state, increasing to 36.9% (n=75) between 2008 and 2014. From 2001 to 2014, 38% (n=159) of the municipalities presented an assessment index of disability grading at the time of diagnosis within the regular performance parameter. Between 2009 and 2014, the number of municipalities with a high incidence of grade 2 disability (G2D) at the time of diagnosis increased, reaching 55.3% (n=230) of the municipalities. Most municipalities in the state of Bahia showed poor performance in the implementation of planned actions for leprosy control, with little change or relative worsening in the patterns of operational indicators throughout the historical series. CONCLUSION: The operational context in Bahia indicates significant institutional vulnerability, leading to the need for expansion and qualification of the surveillance and health care network in the different regions and conditions analyzed in the public health system (Sistema Único de Saúde - SUS).


Asunto(s)
Personas con Discapacidad , Enfermedades Endémicas/estadística & datos numéricos , Lepra/prevención & control , Brasil/epidemiología , Ciudades , Estudios de Cohortes , Evaluación de la Discapacidad , Humanos , Incidencia , Lepra/epidemiología , Vigilancia de la Población , Características de la Residencia , Factores de Riesgo , Análisis Espacio-Temporal
14.
Medicine (Baltimore) ; 99(11): e19457, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176077

RESUMEN

BACKGROUND: Lumbar degenerative disease (LDD) is a very common disease. And decompression alone, posterior lumbar interbody fusion (PLIF), and interspinous device (Coflex) are generally accepted surgical techniques. However, the effectiveness and safety of the above techniques are still not clear. Network meta-analysis a comprehensive technique can compare multiple treatments based on indirect dates and all interventions are evaluated and ranked simultaneously. To figure out this problem and offer a better choice for LDD, we performed this network meta-analysis. METHODS: PubMed and WanFang databases were searched based on the following key words, "Coflex," "decompression," "PLIF," "Posterior Lumbar Interbody Fusion," "Coflex" "Lumbar interbody Fusion." Then the studies were sorted out on the basis of inclusion criteria and exclusion criteria. A network meta-analysis was performed using The University of Auckland, Auckland city, New Zealand R 3.5.3 software. RESULTS: A total of 10 eligible literatures were finally screened, including 946 patients. All studies were randomized controlled trials (RCTs). Compared with decompression alone group, there were no significant differences of Oswestry Disability Index (ODI) in Coflex and lumbar interbody fusion groups after surgery. However, Coflex and PLIF were better in decreasing Visual Analogue Scale (VAS) score compared with decompression alone. Furthermore, we found Coflex have a less complication incidence rate. CONCLUSION: Compared with decompression alone, Coflex and lumbar interbody fusion had the similar effectiveness in improving lumbar function and quality of life. However, the latter 2 techniques were better in relieving pain. Furthermore, Coflex included a lower complication incidence rate. So we suggested that Coflex technique was a better choice to cue lumbar spinal stenosis (LSS). LEVEL OF EVIDENCE: Systematic review and meta-analysis, level I.


Asunto(s)
Descompresión Quirúrgica , Fijadores Internos , Degeneración del Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Fusión Vertebral/métodos , Estenosis Espinal/cirugía , Evaluación de la Discapacidad , Humanos , Dolor de la Región Lumbar/cirugía , Manejo del Dolor , Calidad de Vida
15.
Medicine (Baltimore) ; 99(12): e19549, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195962

RESUMEN

BACKGROUND: Evidences suggest that cognitive training facilitates cognitive function, and most studies have targeted adults and children older than 4 years of age. This study investigated the applicability and efficacy of a tablet computer-based cognitive training program for young children with cognitive impairment of cognitive age between 18 and 36 months. METHODS: Thirty-eight children were randomly assigned to the intervention (n = 20, administered a tablet computer-based cognitive training program, for 30 minutes per session and twice a week over a period of 12 weeks) and control (n = 18, received the traditional rehabilitation program) groups. Mental scale of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), interest/persistence domain of the Laboratory Temperament Assessment Battery (LAP-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. RESULTS: The tablet computer-based cognitive training program was applicable to all children in the intervention group without any problems including irritable behavior or obsession about a tablet computer. After 12 weeks, Mental scale of BSID II, PEDI (social function), LAB-TAB (observation), LAB-TAB (manipulation), and GAS showed statistically significant improvements in the intervention group, compared with the values in the control group (P < .05). After adjusting for the pre-treatment measurements and cognitive age, the tablet computer-based cognitive training program had significant effect on the post-treatment measurements of Mental scale of BSID II, PEDI (social function), LAB-TAB (observation), LAB-TAB (manipulation), and GAS (P < .05). There was no association between the change in the scores and the severity of cognitive delay in the most of the measurements, however, the self-care domain of PEDI showed a negative association with the severity of the cognitive delay (r = -0.462, P = .04). CONCLUSIONS: Application of a tablet computer-based cognitive training program was feasible and showed improvements in cognitive function in young children with cognitive impairment of cognitive age between 18 and 36 months, regardless of the severity of the cognitive delay. But severe cognitive delay can be related with less improvement in the self-care domain of PEDI. TRIAL REGISTRATION NUMBER: https://cris.nih.go.kr (KCT0002889).


Asunto(s)
Terapia Cognitivo-Conductual/instrumentación , Disfunción Cognitiva/terapia , Computadoras de Mano/estadística & datos numéricos , Intervención Educativa Precoz/métodos , Niño , Preescolar , Cognición/fisiología , Terapia Cognitivo-Conductual/métodos , Disfunción Cognitiva/diagnóstico , Evaluación de la Discapacidad , Femenino , Humanos , Lactante , Masculino , Evaluación de Resultado en la Atención de Salud , Índice de Severidad de la Enfermedad
17.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 24-30, Jan.-Mar. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1090560

RESUMEN

Abstract Introduction Facial nerve palsy results in both functional disability and psychological morbidity. There are several well-established grading scales to quantify the quality of life of these patients. Objective Translate and validate the Facial Clinimetric Evaluation (FaCE) scale and Synkinesis Assessment Questionnaire (SAQ) to Brazilian Portuguese. Methods This study adopted a forward-backward translation method and performed cross-cultural adaptation. A pilot study was conducted to correct any confusing language and to evaluate content validity. A validation study was then performed. Internal consistency of the Brazilian Portuguese version of the FaCE and SAQ items was evaluated by Cronbach's alpha coefficient. Construct validity was assessed by Spear- man's Rank Correlation Coefficient between FaCE and SAQ scores to eFACE, House- Brackmann, Short Form 12 (SF-12) and Facial Disability Index (FDI) (sub)scores. Results A total of 90 patients were included. Cronbach's alpha for total domain scored 0.881 for FaCE and 0.809 for SAQ. FaCE total score correlation to eFACE total and House- Brackmann showed Spearman's r value of 0.537 and -0.538, respectively (p < 0.001). SAQ correlation to eFACE synkinesis subdomain was -0.449 (p < 0.001). No correlation was found between SAQ and HB score. FaCE total score correlations were of 0.301 and 0.547 for SF-12 PCS and MCS, respectively (p < 0.001). Correlation between FaCE total and FDI Physical and Social/well-being functions were 0.498 and 0.567 (p < 0.001). Conclusion Brazilian Portuguese FaCE scale and SAQ versions achieved high validity and reliability in the present study. These translated instruments demonstrated good psychometric properties, being proper to use in clinical practice in Brazil and with Brazilian Portuguese speakers.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Traducción , Encuestas y Cuestionarios , Sincinesia , Parálisis Facial , Calidad de Vida , Índice de Severidad de la Enfermedad , Brasil , Proyectos Piloto , Estudios Prospectivos , Reproducibilidad de los Resultados , Evaluación de la Discapacidad
18.
Brain Nerve ; 72(3): 215-225, 2020 Mar.
Artículo en Japonés | MEDLINE | ID: mdl-32152255

RESUMEN

This article examines how the characteristics of ADHD (attention-deficit hyperactivity disorder) affect self-formation and what kind of supporter's involvement is desirable for the person's self-formation. For those with ADHD, prevention of over-adaptation and resilience after failure are important, and it is desirable for them to utilize the characteristics of ADHD in society while preventing secondary obstacles in their social life. In addition, this article introduces International Classification of Living Function model by World Health Organization, which states that "the state of health and the level of disability change depending on the environment," and the importance of family support based on this model.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/terapia , Evaluación de la Discapacidad , Calidad de Vida , Familia , Humanos , Desarrollo de la Personalidad , Apoyo Social , Organización Mundial de la Salud
19.
Zhonghua Yi Xue Za Zhi ; 100(3): 192-196, 2020 Jan 21.
Artículo en Chino | MEDLINE | ID: mdl-32008285

RESUMEN

Objectives: To evaluate the effect of minimally invasive lateral lumbar interbody fusion (LLIF/OLIF) on the sagittal balance of adult degenerative scoliosis. Methods: From January 2014 to June 2017, a total of 23 patients with degenerative scoliosis underwent staged minimally invasive surgery in Shanghai Ruijin Hospital. All patients were implanted with LLIF or OLIF cage from the lateral approach first, and was followed by the posterior percutaneous pedicle screw fixation or pedicle screw fixation via Wiltse approach. If the sagittal deformity correction was not satisfactory after the first surgery, a posterior osteotomy can be performed during the second stage operation. A biplanar X-ray of the whole spine was taken with the EOS imaging system before and after surgery. The EOS software was used to measure and evaluate the patient's sagittal balance parameters including pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), the sagittal vertical axis (SVA) and the coronal Cobb angle. The visual analogue scale (VAS) score for low back pain, the Oswestry Disability Index (ODI) score were evaluated before and after surgery. Paired t test or repeated measures ANOVA was used to compare the data before and after surgery. Results: There were 6 males and 17 females with a mean age of (72±4) years (62-79 years). Nine patients were treated with LLIF and 14 patients with OLIF. Sixteen cases were implanted with three cages, five with two cages and two with four cages. The mean follow-up period was 24.2 months (15-42 months). After the first operation, the Cobb angle of the patient was significantly improved (18°±7° vs 33°±8°, t=13.2, P<0.01). All the parameters for sagittal balance, including PI-LL (20°±8° vs 31°±8(o)), SVA ((5.3±2.0) cm vs (8.2±3.5) cm), PT (16°±6° vs 23°±4°) were all significantly improved as well (t=6.8, 4.5, 9.0, ALL P<0.01). At the last follow-up, the VAS score of low back pain (3.4±1.1 vs 6.3±1.0) and ODI scores (27.3%±3.0% vs 47.1%±5.9%) were also significantly improved (t=11.3, 17.8, both P<0.01). No major complications occurred in this group. Conclusions: Minimally invasive LLIF/OLIF can significantly improve the coronal and sagittal balance of adult degenerative scoliosis. Staged minimally invasive surgery can significantly alleviate pain and improve function in these patients.


Asunto(s)
Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Escoliosis/cirugía , Fusión Vertebral/métodos , Adulto , Anciano , China , Evaluación de la Discapacidad , Femenino , Humanos , Vértebras Lumbares , Masculino , Estudios Retrospectivos , Escoliosis/patología , Resultado del Tratamiento , Escala Visual Analógica
20.
Ideggyogy Sz ; 73(1-2): 27-34, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-32057201

RESUMEN

Background and purpose: Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods: Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients' disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results: Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusion: According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.


Asunto(s)
Personas con Discapacidad , Satisfacción Personal , Calidad de Vida , Traumatismos de la Médula Espinal , Evaluación de la Discapacidad , Humanos , Traumatismos de la Médula Espinal/complicaciones
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