Reflexiones sobre rehabilitación vestibular a propósito de un caso con uso de paradigma de tareas dobles / Insights on vestibular rehabilitation concerning one case with the use of dual task paradigm

Resumen Se presenta una reflexión producto de la introducción del paradigma de tareas dobles en el abordaje terapéutico en un caso de vestibulopatía unilateral periférica. Se aplicaron pautas de autovaloración de la discapacidad y riesgo de caídas, complementándose con una completa evaluación del equilibrio funcional y la marcha. Se planificó una terapia personalizada, jerarquizándose objetivos con un criterio funcional. Se incorporó el paradigma de tareas dobles, incluyéndose tareas cognitivas simples a la terapia tradicional de rehabilitación vestibular, con el fin de reducir la influencia cortical sobre la ejecución motora, potenciar la ganancia y funcionalidad de los reflejos remanentes, estimular funciones cognitivas superiores y potenciar procesos atencionales subyacentes, necesarios para lograr la compensación. Los resultados de la reevaluación mostraron una evolución favorable, con remisión de la sintomatología, disminución significativa de los puntajes obtenidos en las diferentes pautas empleadas y una mejoría subjetiva en el equilibrio y marcha funcional después de la terapia. Lo anterior se asoció a la recuperación de la autonomía e independencia para la ejecución de actividades diarias, incidiendo favorablemente en la calidad de vida de la paciente. Los hallazgos confirman los beneficios del programa de rehabilitación vestibular diseñado. Se requieren estudios adicionales, orientados a evidenciar y corroborar el impacto específico de la incorporación del paradigma de tareas dobles en la rehabilitación de los trastornos del equilibrio y especialmente, en procesos de estimulación o rehabilitación vestibular en adultos mayores.

Abstract This article presents the analysis and reflections evoked from an experience in vestibular rehabilitation with the introduction of the paradigm of dual task in a unilateral peripheral vestibulopathy case. First, disability self-assessment guidelines, risk of falls scales and assessment tools of functional balance and gait were applied in order to determine the main symptoms and the main difficulties observed. Afterwards, a personalized therapy was planned, in which work objectives were hierarchized based on a functional criterion, introducing "dual-task" strategies as tools for diminish cortical influence on motor performances, allowing the automation of the required task; enhance the gain and functionality of the remaining reflexes, especially vestibulo ocular and vestibulospinal reflex and stimulate superior cognitive functions and underlying attentional processes, necessary to achieve central compensation. The final assessment showed a favorable evolution, with a significant decrease in the after-therapy scores obtained in fear of falling and disability self-perception protocols, before and after therapy and, finally, an improvement in functional balance and gait, through the pre and post therapy performance in the timed up and go and assessment of unipedal stand tests. This allowed the patient to regain her autonomy and independence in daily life activities improving her quality of life, confirming the benefits of the designed vestibular rehabilitation program. However, more studies are needed to corroborate the specific contribution of the dual-task paradigm in vestibular rehabilitation and specially, in vestibular stimulation or rehabilitation processes in older adults.

Evaluación de un sistema automatizado de siembra de orinas para urocultivos / Evaluation of an automated streaking system of urine samples for urine cultures

Introduction: Automated systems have simplified laboratory workflow, improved standardization, traceability and diminished human errors and workload. Although microbiology laboratories have little automation, in recent years new tools for automating pre analytical steps have appeared. Objectives: To assess the performance of an automated streaking machine for urine cultures and its agreement with the conventional manual plating method for semi quantitative colony counts. Materials and Methods: 495 urine samples for urinary culture were inoculated in CPS® agar using our standard protocol and the PREVI™ Isola. Rates of positivity, negativity, polymicrobial growth, bacterial species, colony counts and re-isolation requirements were compared. Results: Agreement was achieved in 98.97% of the positive/negative results, in 99.39% of the polymicrobial growth, 99.76% of bacterial species isolated and in 98.56 % of colony counts. The need for re-isolation of colonies decreased from 12.1% to 1.1% using the automated system. Discussion: PREVI™ Isola's performance was as expected, time saving and improving bacterial isolation. It represents a helpful tool for laboratory automation.

Introducción: Los sistemas automatizados han facilitado el flujo de trabajo, mejorado la estandarización, la trazabilidad, disminuido el error humano y la carga de trabajo en los laboratorios. A pesar de que la microbiología ha permanecido poco automatizada, en los últimos años han aparecido nuevas herramientas para la automatización de la etapa pre analítica. Objetivos: Evaluar el desempeño de un sistema automatizado de siembra de urocultivos y la concordancia con la siembra manual convencional en el recuento semicuantitativo de colonias. Materiales y Métodos: 495 muestras de orinas fueron sembradas según nuestro protocolo habitual y comparadas con las placas de CPS® obtenidas con PREVI™ Isola en cuanto a positividad/negatividad, muestras polimicrobianas, especies de bacterias aisladas, recuentos y necesidad de resembrar. Resultados: Hubo concordancia en 98,97% de los positivos y negativos, en 99,39% de las muestras polimicrobianas, en 99,76% de las especies aisladas y en 98,56% de los recuentos. La necesidad de resiembra disminuyo de 12,1% a un 1,1% usando este sistema automatizado. Discusión: El desempeño de PREVI™ Isola fue el esperado, mejorando el aislamiento bacteriano y el tiempo requerido y representa una buena herramienta para la automatización de laboratorios.

Improvement Effects of Automatization on Standardized Management of Inpatient Pharmacy / 中国药房

OBJECTIVE: To facilitate automatization in pharmacy of inpatient departments and promote the management level and quality of pharmaceutical service.METHODS: The transformation of operation mode and administration mode were observed after developing automatization in the inpatient pharmacy departments.RESULTS & CONCLUSIONS: The intelligent location storage and auto single-dose dispenser were combined with electronic information transmission technology to facilitate the automatization of inpatient pharmacy.The dispensing process of inpatient pharmacy is optimized and improved and standardized management of drugs is consummated.The efficiency and accuracy of the dispensing of tablets and injections are improved.Error rates of drug dispensary and costs of storage are cut down.Labor intensity and the number of staff are also reduced and the quality of pharmaceutical service in the inpatient pharmacy departments is upgraded roundly.

Development of control system for B→O blood conversion device / 医疗卫生装备

In order to realize standardization and automatization,it necessary to develop a device for B→O blood conversion.This paper emphasizes on the control system of B→O blood conversion device,including software and hardware design,which provides a safe and rapid method for B→O blood conversion.

Challenge and strategy in the development of full automatization of clinical laboratories in China / 中华检验医学杂志

The pivotal characteristics, the current situation, the challenge being faced with and the potential solution related to the automatized flow line of the clinical laboratory is introduced in order to provide the reference for the healthy development of the full automatization of the clinical laboratories in China.

Automatic Control of Air Quality in BSL-3 Laboratory / 环境与健康杂志

Objective To keep the homeostasis of pressure grad, temperature and humidity among every area, and to ensure the protective effect of engineering barrier in biology safety. Methods DDC was used in the control system based on the transducer and special data collection equipment, and the figure monitoring system was established. The computer was used to save and process the data of real time and then the related output devices were regulated according to the situation. The alarm will be sounded if any data is out of the limit. Results The system could collect real-time simulation quantity signal of pressure, temperature, humidity, resistance, device work condition and so on in every area in laboratory, such as air-condition, air filter, fan and electric-performer's start-stop(operate) state. The alarm information was showed by CRT coloured dynamic emulational figure. Monitoring center could rework the local control parameters through the DDC controller, the system could adjust the device output automatically. Monitoring center could make alert automatically and the tache and causation were displayed then the operator could deal with the alert message according to the user grade. Conclusion The automatic control system introduced in this article can observe the indoor environment state and control the running parameters of the device availably and immediately. It can meet the requirement of laboratory biological safety.

Feasibility of informatization, supermarketization, automatization for medical equipment inventory management / 医疗卫生装备

For a large-scale hospital, management of medical equipment is very important for its economic benefit and development. This paper discusses the implementation of informatization, supermarketization and automatization for medical equipment inventory management with computer network technology.