The role of the deep cervical extensor muscles in multi-directional isometric neck strength.

Clinical management of whiplash-associated disorders is challenging and often unsuccessful, with over a third of whiplash injuries progressing to chronic neck pain. Previous imaging studies have identified muscle fat infiltration, indicative of muscle weakness, in the deep cervical extensor muscles (multifidus and semispinalis cervicis). Yet, kinematic and muscle redundancy prevent the direct assessment of individual neck muscle strength, making it difficult to determine the role of these muscles in motor dysfunction. The purpose of this study was to determine the effects of deep cervical extensor muscle weakness on multi-directional neck strength and muscle activation patterns. Maximum isometric forces and associated muscle activation patterns were computed in 25 test directions using a 3-joint, 24-muscle musculoskeletal model of the head and neck. The computational approach accounts for differential torques about the upper and lower cervical spine. To facilitate clinical translation, the test directions were selected based on locations where resistance could realistically be applied to the head during clinical strength assessments. Simulation results reveal that the deep cervical extensor muscles are active and contribute to neck strength in directions with an extension component. Weakness of this muscle group leads to complex compensatory muscle activation patterns characterized primarily by increased activation of the superficial extensors and deep upper cervical flexors, and decreased activation of the deep upper cervical extensors. These results provide a biomechanistic explanation for movement dysfunction that can be used to develop targeted diagnostics and treatments for chronic neck pain in whiplash-associated disorders.

A Method for Quantification of Stretch Reflex Excitability During Ballistic Reaching.

Stretch reflexes are crucial for performing accurate movements and providing rapid corrections for unpredictable perturbations. Stretch reflexes are modulated by supraspinal structures via corticofugal pathways. Neural activity in these structures is difficult to observe directly, but the characterization of reflex excitability during volitional movement can be used to study how these structures modulate reflexes and how neurological injuries impact this control, such as in spasticity after stroke. We have developed a novel protocol to quantify stretch reflex excitability during ballistic reaching. This novel method was implemented using a custom haptic device (NACT-3D) capable of applying high-velocity (270 °/s) joint perturbations in the plane of the arm while participants performed 3D reaching tasks in a large workspace. We assessed the protocol on four participants with chronic hemiparetic stroke and two control participants. Participants reached ballistically from a near to a far target, with elbow extension perturbations applied in random catch trials. Perturbations were applied before movement, during the early phase of movement, or near peak movement velocity. Preliminary results show that stretch reflexes were elicited in the stroke group in the biceps muscle during reaching, as measured by electromyographic (EMG) activity both before (pre-motion phase) and during (early motion phase) movement. Reflexive EMG was also seen in the anterior deltoid and pectoralis major in the pre-motion phase. In the control group, no reflexive EMG was seen, as expected. This newly developed methodology allows the study of stretch reflex modulation in new ways by combining multijoint movements with haptic environments and high-velocity perturbations.

A Method for Quantifying Trunk Motor Control During Reaching in Individuals Post Hemiparetic Stroke.

After a hemiparetic stroke, the contralesional upper limb is left with significant motor impairments including: weakness, spasticity, and abnormal joint torque patterns resulting in the flexion synergy (i.e. abnormal coupling between shoulder abduction and elbow/wrist and finger flexion). These impairments, and in particular the flexion synergy, limit ability to reach to the full extent of their limb workspace. Motor control of the trunk is also altered post stroke, with compromised ability to stabilize the trunk and excessive trunk movement during reaching, abnormal isometric torque coupling patterns in the transverse and sagittal planes and weakness. These motor impairments in both trunk and arm limit their ability to perform activities of daily living. While the effect of stroke on reaching has been studied extensively, less is known about the impact of deficits in trunk motor control on reaching ability and the impact of the flexion synergy on trunk postural control. Methods for investigating altered trunk control, specifically during a reach when concurrent loads that elicit the flexion synergy are imposed on the limb and trunk, are limited. Specifically, trunk deficits have yet to be studied in the context of the flexion synergy whereby loads imposed on the arm to elicit shoulder abduction have a negative impact on reaching and potentially on trunk posture. In order to address this gap, we developed a system that integrates a robotic device to simulate varied reaching environments, surface electromyography to measure primary trunk and arm muscle activity, and a two-camera motion capture system that uses reflective markers to measure trunk and arm movement. Feasibility and usability of the system was established during evaluation of reaching ability with varying levels of shoulder abduction loads while the trunk is either restrained or unrestrained in two participants with stroke and a healthy control.Clinical Relevance- The system presented here is capable of monitoring changes in trunk postural control after a hemiparetic stroke during a reaching task as a first step in furthering our understanding of changes in trunk motor control during reaching with the goal of developing more targeted and effective interventions for stroke rehabilitation.

Características neuro-psicopedagógicas de las dificultades de aprendizaje escolar: un estudio de caso / Neuro-psychopedagogical characteristics of school learning difficulties: a case study

Este artículo tiene como objetivo presentar las características neuropsicopedagógicas de un niño con dificultades escolares y de comportamiento. Se llevó a cabo un estudio de caso con un participante de 11 años de edad, quien durante la investigación cursaba el grado quinto de básica primaria en una institución educativa de carácter privado del municipio de Itagüí, Antioquia. Los instrumentos aplicados para la evaluación fueron: el Test Breve de Inteligencia de KAUFMAN (K-BIT), la Batería Psicopedagógica EVALÚA - 5, el Cuestionario de Depresión para Niños (CDS) y una entrevista semiestructurada para padres y docentes, relacionada con los aspectos del desarrollo, el aprendizaje y la conducta del estudiante. Los resultados demostraron que el niño presentaba un coeficiente intelectual dentro de los parámetros normales y las principales dificultades se encontraron en el contexto familiar-social, lo que permitió evidenciar que el rendimiento escolar es el resultado de la interacción de diferentes factores que abarcan componentes cognitivos, del neurodesarrollo, emocionales, familiares y contextuales. Así mismo, se evidenció que las dificultades en el comportamiento asociadas al contexto escolar no siempre están relacionadas con trastornos del aprendizaje o de la conducta. Se hace necesaria la obtención de este tipo de perfiles neuropsicopedagógicos con el fin de establecer rutas de intervención pertinentes y eficaces que incorporen las características cognitivas individuales, los vínculos socio afectivos, el entorno social, escolar, y la dinámica familiar del estudiante.

This article aims to present the neuropsychopedagogical characteristics of a child with school and behavior difficulties. A case study was carried out with an 11-year- old participant, who during the research was studying the fifth grade of elementary school in a private educational institution in the municipality of Itagüí, Antioquia. The instruments applied for the evaluation were: the KAUFMAN Brief Intelligence Test (K-BIT), the EVALÚA Psychopedagogical Battery­5, the Depression Questionnaire for Children (CDS) and a semi-structured interview for parents and teachers, related to aspects of development, learning and behavior of the student. The results showed that the child had an IQ within normal parameters and the main difficulties were found in the social family context, which allowed to show that school performance is the result of the interaction of different factors, which include cognitive, neurodevelopmental, emotional, family and contextual components. It was also evidenced that behavioral difficulties associated with the school context are not always related to learning or conduct disorders. Obtaining this type of neuropsychopedagogical profiles is necessary in order to establish relevant and effective intervention routes, which incorporate individual cognitive characteristics, socio-affective ties, the social and school environment and the student's family dynamics.

Prevalence of Hospital Functional Impairment in a Colombian Elderly Population at the San Ignacio University Hospital / Prevalencia de deterioro funcional hospitalario en una población colombiana de ancianos en el Hospital Universitario San Ignacio / Prevalência de deterioro funcional hospitalar em uma população colombiana de idosos no Hospital Universitário San Ignacio

Abstract Introduction: Functional decline following hospitalization (FDH) is defined as the loss of the functional capacity to perform at least one basic activity of daily life (BADL) when being discharged from hospital; a situation compared to functional capacity performed in the last couple of weeks, prior the acute disease. This impairment is precipitated in the elderly by factors such as aging, architectural conditions, malnutrition, hospital routines and physical restraints. The objective of this study is determining the prevalence of functional impairment in adults over 65 years of age hospitalized in the San Ignacio University Hospital (SIUH) and its associated factors. Materials and Methods: A descriptive cross-sectional study of a hospital cohort was carried out from December 1st 2015 to December 31st 2017. Univariate and multivariate analyses were performed to identify associated variables. Results: 1055 people were included, with FDH prevalence of 41.14%. The three main factors associated with the development of FDH in the elderly population that consulted the SIUH were time of hospital stay [OR 1.88, CI95% (1.41-2.49), p = <0.0001], malnutrition [OR 1.59, CI95% (1.16-2.19), p = 0.004] and delirium [OR 2.38, CI95% (1.83-3.10), p = <0.001]. Conclusion: FDH is a highly prevalent condition in the geriatric population hospitalized in the San Ignacio University Hospital, where length of stay, malnutrition and delirium are the factors associated with its disease onset.

Resumen Introducción: El deterioro funcional hospitalario (DFH) se define como la pérdida de la capacidad para realizar al menos una actividad básica de la vida diaria (ABVD) en el momento del alta respecto a la situación funcional dos semanas previas al inicio de la enfermedad aguda; dicha situación es precipitada en los ancianos por factores como el envejecimiento, las condiciones arquitectónicas, la desnutrición, las rutinas hospitalarias y las restricciones físicas. El presente estudio busca determinar la prevalencia de deterioro funcional en adultos mayores de 65 años hospitalizados en el Hospital Universitario San Ignacio (HUSI) y sus factores asociados. Materiales y métodos: Se realizó un estudio descriptivo de corte transversal de una cohorte hospitalaria de diciembre de 2015 al 31 de diciembre de 2017; se llevó a cabo un análisis univariado y multivariado para identificar variables asociadas. Resultados: Se incluyeron 1055 personas, con una prevalencia de DFH del 41,14%. Los tres principales factores asociados al desarrollo de DFH en la población anciana que consulta al HUSI fueron tiempo de estancia hospitalaria [OR 1,88, CI95% (1,41-2,49), p = <0,0001], malnutrición [OR 1,59, CI95% (1,16-2,19), p = 0,004] y delirium [OR 2,38, CI95% (1,83-3,10), p = <0,001]. Conclusión: El DFH es una condición altamente prevalente en la población geriátrica hospitalizada en el Hospital Universitario San Ignacio, siendo el tiempo de estancia intrahospitalaria, la malnutrición y el delirium factores asociados a su aparición.

Resumo Introdução: O deterioro funcional hospitalar define-se como a perda da capacidade para realizar pelo menos uma atividade básica da vida diária (ABVD) no momento da alta médica respeito à situação funcional duas semanas prévias ao início da doença aguda. Dita situação e precipitada nos idosos por fatores como o envelhecimento, as condições arquitetônicas, a subnutrição, rutinas hospitalares e restrições físicas. O presente estudo busca determinar a prevalência de deterioro funcional em idosos de 65 anos hospitalizados no Hospital Universitário San Ignacio (HUSI) e seus fatores associados. Materiais e métodos: Se realizou um estudo descritivo de corte transversal de uma coorte hospitalar de dezembro de 2015 ao 31 de dezembro de 2017; se realizou uma análise univariada e multivariada para identificar variáveis associadas. Resultados: Se incluíram 1055 pessoas, com uma prevalência de DFH do 41,14%. Os três principais fatores associados ao desenvolvimento de DFH na população idosa que consulta ao HUSI foram tempo de permanência hospitalar [OR 1,88, CI95% (1,41-2,49), p = <0,0001], a subnutrição [OR 1,59, CI95% (1,16-2,19), p = 0,004] e o delirium [OR 2,38, CI95% (1,83-3,10), p = <0,001]. Conclusão: O DFH é uma condição altamente prevalente na população geriátrica hospitalizada no Hospital Universitário San Ignacio sendo o tempo de permanência intra-hospitalar, a subnutrição e o delirium fatores associados à sua aparição.

Ergodicity Reveals Assistance and Learning from Physical Human-Robot Interaction.

This paper applies information theoretic principles to the investigation of physical human-robot interaction. Drawing from the study of human perception and neural encoding, information theoretic approaches offer a perspective that enables quantitatively interpreting the body as an information channel, and bodily motion as an information-carrying signal. We show that ergodicity, which can be interpreted as the degree to which a trajectory encodes information about a task, correctly predicts changes due to reduction of a person's existing deficit or the addition of algorithmic assistance. The measure also captures changes from training with robotic assistance. Other common measures for assessment failed to capture at least one of these effects. This information-based interpretation of motion can be applied broadly, in the evaluation and design of human-machine interactions, in learning by demonstration paradigms, or in human motion analysis.

Otomyiasis: Systematic Review

Abstract Introduction Myiasis is a disease causedby fly larvae that growinthetissues of animals and humans. It can cause a variety of local symptoms, like erythema or pain, depending on its location, and generalized symptomatology, such as fever andmalaise.Myiasis can generate severe complications, for instance sepsis, or directly impact vital tissues. Its management varies depending on the location, and on the preferences of the doctor that faces this challenge. Myiasis usually occurs in tropical countries, and, in many places, it is not a rare condition. The cases are rarely reported, and there are no publishedmanagement protocols. Objective To review the literature regarding the most common agents, the predisposing factors and the treatment alternatives for otic myiasis, a rare form of human myiasis caused by the infestation of fly larvae in the ear cavities. Data synthesis We present a systematic review of the literature. The search in five databases (Medline, Embase, Cochrane Database of Systematic Reviews, LILACS and RedALyC) led to 63 published cases from 24 countries, in the 5 continents. The ages of the patients ranged fromnewborn to 65 years old. Themost common agents belong to the Sarcophagidae or Calliphoridae families. Chronic otitis media, previous otic surgical procedures, mental deficit, alcohol or drug abuse, sleeping outdoors, prostration, and malnutrition were predisposing factors. The treatment alternatives are herein discussed. Conclusion The results highlight the need for monitoring, follow-up and standardization of medical approaches. (AU)

Otomyiasis: Systematic Review.

Introduction Myiasis is a disease caused by fly larvae that grow in the tissues of animals and humans. It can cause a variety of local symptoms, like erythema or pain, depending on its location, and generalized symptomatology, such as fever and malaise. Myiasis can generate severe complications, for instance sepsis, or directly impact vital tissues. Its management varies depending on the location, and on the preferences of the doctor that faces this challenge. Myiasis usually occurs in tropical countries, and, in many places, it is not a rare condition. The cases are rarely reported, and there are no published management protocols. Objective To review the literature regarding the most common agents, the predisposing factors and the treatment alternatives for otic myiasis, a rare form of human myiasis caused by the infestation of fly larvae in the ear cavities. Data synthesis We present a systematic review of the literature. The search in five databases (Medline, Embase, Cochrane Database of Systematic Reviews, LILACS and RedALyC) led to 63 published cases from 24 countries, in the 5 continents. The ages of the patients ranged from newborn to 65 years old. The most common agents belong to the Sarcophagidae or Calliphoridae families. Chronic otitis media, previous otic surgical procedures, mental deficit, alcohol or drug abuse, sleeping outdoors, prostration, and malnutrition were predisposing factors. The treatment alternatives are herein discussed. Conclusion The results highlight the need for monitoring, follow-up and standardization of medical approaches.

Estimating Voluntary Activation Of The Elbow And Wrist Muscles In Chronic Hemiparetic Stroke Using Twitch Interpolation Methodology.

One of the cardinal motor deficits that occurs after stroke is paresis, a decrease in the voluntary activation of muscles. Paresis leads to a decrease in voluntary joint strength, impacting stroke survivors' ability to perform activities of daily living (ADLs). Quantifying this decrease in voluntary activation is important when designing rehabilitation interventions to address movement impairments and restore the ability to perform ADLs. Twitch interpolation is an experimental technique developed to quantify muscle voluntary activation [1]. This method has been used widely across pathologies but often limited to assessment of the voluntary activation of the plantar flexors, given the ease of activating these muscles through stimulation of the tibial nerve [2]. The complex innervation of elbow and wrist musculature imposes practical difficulties when applying the twitch interpolation technique to these joints [1]. Therefore, only a few studies have used this technique to examine the pathological [3]-[5] upper extremity, with little quantitative data documenting the degree of paresis present in the upper limb after stroke. The goal of this study is to evaluate the feasibility of applying twitch interpolation to quantify voluntary activation of the elbow and wrist flexors and extensors in chronic stroke survivors.

Uso de estatinas y riesgo de caídas en ancianos: revisión sistemática de la literatura / Statin and risk of falls in the elderly: A sytematic review of the literature

Antecedentes. La alta incidencia de eventos cardiovasculares en la población anciana ha demostrado la eficacia de las estatinas en la reducción de la mortalidad por eventos coronarios; sin embargo, se han producido efectos adversos, tales como mialgia, miopatía, mionecrosis, sin mencionar las caídas como consecuencia de daño muscular con el uso de estatinas. Objetivo. El objetivo de este estudio es realizar una revisión sistemática para evaluar la literatura sobre la asociación entre el uso de estatinas y el riesgo de caídas. Métodos. Las bases de datos que se incluyeron (PubMed y SCOPUS) con artículos publicados entre enero de 2000 y mayo de 2016. Los términos MESH utilizados para la búsqueda fueron «FALLS» AND «STATIN». Los estudios seleccionados incluyeron cohortes de población de la comunidad (>50 años) y fue analizado siguiendo las recomendaciones metodológicas SIGN (Scottish Intercollegiate Guidelines Network), ya que no se encontró ningún estudio controlado aleatorizado. Resultados. En el estudio de Ham et al. el uso de estatinas ha demostrado ser un factor protector para la presencia de caídas. En el segundo estudio realizado por Scott et al. se encontró un aumento del riesgo de caídas (p=0,029) y un deterioro de la fuerza muscular y la calidad del músculo (valor de p=0,033 y 0,046, respectivamente). En el tercer estudio Haerer et al. se encontró un mayor riesgo de caídas (p=0,63). Conclusiones. La evidencia disponible no permite determinar la asociación entre el uso de estatinas y el riesgo de caídas, aunque sí se encontró asociación con el compromiso de algunos determinantes de la función muscular (AU)

Background. With the high incidence of cardiovascular events in the elderly population the effectiveness of statins in reducing mortality from coronary events has been demonstrated. However, there have been adverse effects, such as myalgia, myopathy, myonecrosis, not to mention the falls as a result of muscle damage with statin use. Objective. The purpose of this study is to conduct a systematic review to assess the literature on the association between statin use and the risk of falls. Methods. The databases that were included PUBMED AND SCOPUS, with articles published from January 2000 to May 2016. The MESH terms used for the search were "FALLS" AND "STATIN". Selected studies included cohort populations from the community (>50 years old), and analysed using the Scottish Intercollegiate (SIGN) methodology guidelines, as no randomised controlled study was found. Results. In the study by Ham et al., statin use was shown to be a protective factor for presence of falls. In the second study by Scott et al., there was an increased risk of falls (P=.029) and an impairment in muscle strength and quality muscle (P=.033 and P=.046, respectively). In the third study Haerer et al., found an increased risk of falls (P=.63). Conclusions. The association between use of statins and risk of falls could not be determined with the available evidence, although an association with the involvement of some determinants of muscular function was found (AU)

Prevalence of hypothyroidism in major psychiatric disorders in hospitalised patients in Montserrat Hospital during the period March to October 2010 / Prevalencia de hipotiroidismo en trastorno psiquiátrico mayor de pacientes hospitalizados en la Clínica Montserrat en el periodo de marzo a octubre de 2010

Abstract Introduction: Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. Objective: To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. Material and methods: A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid stimulating hormone (TSH) was performed to assess the evidence of hypothyroidism. Results: The overall prevalence of hypothyroidism was found to be 10.5% (95%CI, 5-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. Conclusions: The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression.

Resumen Introducción: El hipotiroidismo resulta de una inadecuada producción de hormonas tiroideas. Es conocido que existe una relación entre los trastornos psiquiátricos mayores y el hipotiroidismo. Objetivo: Determinar la prevalencia de hipotiroidismo en los pacientes hospitalizados por trastorno psiquiátrico mayor en la Clínica Montserrat en el periodo de marzo a octubre de 2010. Material y métodos: Se realizó un estudio descriptivo transversal, para el que se seleccionó una muestra de 105 pacientes que ingresaron a la Clínica Montserrat con diagnóstico de trastorno psiquiátrico mayor (depresión mayor, trastorno afectivo bipolar, trastorno de ansiedad generalizada, trastornos de ansiedad, trastorno mixto ansioso-depresivo y esquizofrenia) en el periodo mencionado. Para evaluar el hipotiroidismo se realizó una prueba de Hormona Estimulante del Tiroides (TSH). Resultados: La prevalencia general del hipotiroidismo fue del 10,5% (intervalo de confianza del 95%, 5%-16%). Al determinar el hipotiroidismo por diagnóstico, se encontró que había mayor prevalencia en los trastorno de pánico (12,5%) y depresivo (11,1%) y menor en el trastorno bipolar (10,3%) y la esquizofrenia (9,9%). Conclusiones: La prevalencia general del hipotiroidismo fue menor que en la población general (18,5-4,6%) y se encontró hipotiroidismo en otros trastornos diferentes de la depresión.

Lower Extremity Motor Impairments in Ambulatory Chronic Hemiparetic Stroke: Evidence for Lower Extremity Weakness and Abnormal Muscle and Joint Torque Coupling Patterns.

Although global movement abnormalities in the lower extremity poststroke have been studied, the expression of specific motor impairments such as weakness and abnormal muscle and joint torque coupling patterns have received less attention. We characterized changes in strength, muscle coactivation and associated joint torque couples in the paretic and nonparetic extremity of 15 participants with chronic poststroke hemiparesis (age 59.6 ± 15.2 years) compared with 8 age-matched controls. Participants performed isometric maximum torques in hip abduction, adduction, flexion and extension, knee flexion and extension, ankle dorsi- and plantarflexion and submaximal torques in hip extension and ankle plantarflexion. Surface electromyograms (EMGs) of 10 lower extremity muscles were measured. Relative weakness (paretic extremity compared with the nonparetic extremity) was measured in poststroke participants. Differences in EMGs and joint torques associated with maximum voluntary torques were tested using linear mixed effects models. Results indicate significant poststroke torque weakness in all degrees of freedom except hip extension and adduction, adductor coactivation during extensor tasks, in addition to synergistic muscle coactivation patterns. This was more pronounced in the paretic extremity compared with the nonparetic extremity and with controls. Results also indicated significant interjoint torque couples during maximum and submaximal hip extension in both extremities of poststroke participants and in controls only during maximal hip extension. Additionally, significant interjoint torque couples were identified only in the paretic extremity during ankle plantarflexion. A better understanding of these motor impairments is expected to lead to more effective interventions for poststroke gait and posture.

[Statin and risk of falls in the elderly: A sytematic review of the literature]. / Uso de estatinas y riesgo de caídas en ancianos: revisión sistemática de la literatura.

BACKGROUND: With the high incidence of cardiovascular events in the elderly population the effectiveness of statins in reducing mortality from coronary events has been demonstrated. However, there have been adverse effects, such as myalgia, myopathy, myonecrosis, not to mention the falls as a result of muscle damage with statin use. OBJECTIVE: The purpose of this study is to conduct a systematic review to assess the literature on the association between statin use and the risk of falls. METHODS: The databases that were included PUBMED AND SCOPUS, with articles published from January 2000 to May 2016. The MESH terms used for the search were "FALLS" AND "STATIN". Selected studies included cohort populations from the community (>50 years old), and analysed using the Scottish Intercollegiate (SIGN) methodology guidelines, as no randomised controlled study was found. RESULTS: In the study by Ham et al., statin use was shown to be a protective factor for presence of falls. In the second study by Scott et al., there was an increased risk of falls (P=.029) and an impairment in muscle strength and quality muscle (P=.033 and P=.046, respectively). In the third study Haerer et al., found an increased risk of falls (P=.63). CONCLUSIONS: The association between use of statins and risk of falls could not be determined with the available evidence, although an association with the involvement of some determinants of muscular function was found.

[Prevalence of Hypothyroidism in Major Psychiatric Disorders in Hospitalised Patients in Montserrat Hospital During the period March to October 2010]. / Prevalencia de hipotiroidismo en trastorno psiquiátrico mayor de pacientes hospitalizados en la Clínica Montserrat en el periodo de marzo a octubre de 2010.

INTRODUCTION: Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. OBJECTIVE: To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. MATERIAL AND METHODS: A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid Stimulating Hormone (TSH) was performed to assess the evidence of hypothyroidism. RESULTS: The overall prevalence of hypothyroidism was found to be 10.5% (95% CI; 5%-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. CONCLUSIONS: The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression.

A Multiple Degree of Freedom Lower Extremity Isometric Device to Simultaneously Quantify Hip, Knee, and Ankle Torques.

Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and ankle of a single leg during maximum voluntary torque generation. Thus, joint-torque coupling strategies in the hip, knee, and concurrent torques at ankle and/or coupling patterns at the hip and knee driven by the ankle have yet to be quantified. This manuscript describes the design, implementation, and validation of a multiple degree of freedom, lower extremity isometric device (the MultiLEIT) that accurately quantifies simultaneous torques at the hip, knee, and ankle. The system was mechanically validated and then implemented with two healthy control individuals and two post-stroke individuals to test usability and patient acceptance. Data indicated different joint torque coupling strategies used by both healthy individuals. In contrast, data showed the same torque coupling patterns in both post-stroke individuals, comparable to those described in the clinic. Successful implementation of the MultiLEIT can contribute to the understanding of the underlying mechanisms responsible for abnormal movement patterns and aid in the design of therapeutic interventions.

Niveles de impulsividad y riesgo de alcoholismo en personas pertenecientes a barras bravas en la ciudad de Ibagué - Colombia / Levels of impulsivity and risk of alcoholism in adults Belonging to "barras bravas" in the city of ibagué - Colombia

El objetivo de este trabajo es determinar la relación entre niveles de impulsividad y riesgo de alcoholismo en adultos pertenecientes a "barras bravas" en la ciudad de Ibagué (Tolima) a partir de la aplicación del test de CAGE, la Escala de Impulsividad de Plutchik (EI) y una ficha de caracterización sociodemográfica. Se utilizó un modelo correlacional de corte transversal. Los hallazgos evidencian niveles bajos (78%) y promedios de impulsividad (20%). El 28% no presenta problemas relacionados con el alcohol, mientras que el 36% tiene indicios de consumo y el restante 36% dependencia alcohólica. Se hallaron correlaciones bajas entre las puntuaciones, la correlación significativa fue de tipo directamente proporcional entre edad y riesgo de alcoholismo (r= 0,287; p= 0.43), lo que indica que a mayor edad mayor es el riesgo de alcoholismo. © Revista Colombiana de Ciencias Sociales.

The objective of this study was to determine the relationship between levels of impulsivity and risk of alcoholism in adults belonging to "barras bravas" in the city of Ibagué (Tolima) from the application of the CAGE test, the scale of impulsiveness of Plutchik (EI) and a socio-demographic characterization data sheet. A correlational cross-sectional model was used. The findings show low levels (78%) and averages of impulsivity (20%). The 28% do not show problems related with alcohol, while 36% have signs of consumption and 36% alcoholic dependence. There were found low correlations between such scores, the significant correlation was directly proportional between age and risk of alcoholism (r = 0,287, p = 0.43) indicating that a greater age, greater is the risk of alcoholism.

Pilot study to test effectiveness of video game on reaching performance in stroke.

Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject's success rate increases.

Vulnerabilidad de los implantes dentales y ortopédicos / Vulnerability of dental and orthopedic implant

La colocación de implantes en diferentes partes del cuerpo ha sido realizada desde hace muchotiempo atrás. Se ha identificado diferentes factores de riesgo y complicaciones que pueden alterarlos tejidos perimplantares posterior a la colocación de estos. No existe evidencia científica que realice la comparación entre diferentes implantes colocados en diferentes partes del cuerpo.

The placement of implants on different body parts has been practiced since long ago. Variousrisk factors and complications that can alter perimplant tissue after placement of these have beenidentified. There is no scientific evidence to make the comparison among different implants placed indifferent parts of the body.

Medical and surgical treatments for obesity have opposite effects on peptide YY and appetite: a prospective study controlled for weight loss.

CONTEXT: The effects of medical and surgical treatments for obesity on peptide YY (PYY) levels, in patients with similar weight loss, remain unclear. OBJECTIVE: The objective of the study was to assess PYY and appetite before and after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and medical treatment (MED). DESIGN: This was a prospective, controlled, nonrandomized study. SETTING: The study was conducted at the Departments of Nutrition and Digestive Surgery at a university hospital. PARTICIPANTS: PARTICIPANTS included three groups of eight patients with similar body mass indexes (RYGB 37.8 +/- 0.8, SG 35.3 +/- 0.7, and MED 39.1 +/- 1.7 kg/m(2), P = NS) and eight lean controls (body mass index 21.7 +/- 0.7 kg/m(2)). MAIN OUTCOME MEASURES: Total plasma PYY, hunger, and satiety visual analog scales in fasting and after ingestion of a standard test meal were measured. RESULTS: At baseline there were no differences in the area under the curve (AUC) of PYY, hunger, or satiety in obese groups. Two months after the interventions, RYGB, SG, and MED groups achieved similar weight loss (17.7 +/- 3, 14.9 +/- 2.4, 16.6 +/- 4%, respectively, P = NS). PYY AUC increased in RYGB (P < 0.001) and SG (P < 0.05) and did not change in MED. PYY levels decreased at fasting, 30 min, and 180 min after a standard test meal in MED (P < 0.05). Hunger AUC decreased in RYGB (P < 0.05). Satiety AUC increased in RYGB (P < 0.05) and SG (P < 0.05). Appetite did not change in MED. PYY AUC correlated with satiety AUC (r = 0.35, P < 0.05). CONCLUSION: RYGB and SG increased PYY and reduced appetite. MED failed to produce changes. Different effects occur despite similar weight loss. This suggests that the weight-loss effects of these procedures are enhanced by an increase in PYY and satiety.