Aquatic Therapy for Persons with Neuromuscular Diseases - A Scoping Review.

BACKGROUND: Aquatic exercise is among the most common physical activity modalities performed by people with disabilities. OBJECTIVE: The present paper reviews currently-available research on aquatic therapy (AT) for persons with neuromuscular diseases (NMD). METHODS: A scoping review of the existing literature was conducted on PubMed, Embase, Medline, Scopus, Web of Science, SPORTdiscus, CINAHL and Lilacs from the earliest date available until October 2020. It follows the methodological framework for conducting a scoping review proposed by the Joanna Briggs Institute. RESULTS: A total of 28 articles were analyzed and the study parameters grouped by the topography of NMD; most of the studies (n = 16) addressed myopathies. A considerable increase in the number of studies was found over time, and heterogeneity was identified across and within AT interventions for persons with NMD; hence, to allow more effective interpretation of study results, there is a need to standardize the fundamental parameters and procedures for AT. CONCLUSIONS: This scoping review provides a comprehensive outline of available literature; the findings could serve as a starting point for clinical studies on the effects of AT on persons with NMD, and encourage a more coherent approach to their design.

Impressions of aquatic therapy treatment in children with prolonged mechanical ventilation - clinician and family perspectives: a qualitative case study.

PURPOSE: To describe the experiences of applying aquatic therapy (AT) to children with ventilation needs after discharge from the paediatric intensive care unit (PICU). MATERIAL AND METHODS: A qualitative and descriptive case study with integrated units. Purposive sampling was carried out, including the parents of the children participating in the AT programme and the healthcare professionals treating them. Fourteen participants were included: four parents, five physicians, three physiotherapists and two nurses. The study was carried out as part of a program on AT in critically ill children. Semi-structured interviews were conducted. A thematic analysis was performed. RESULTS: Three themes were identified. Theme (1) Difficulties for implementation: AT was not perceived as a viable therapeutic modality; lack of knowledge and resources. Theme (2) Risks and challenges: Perceptions of anxiety at the beginning; planning and precautions. Theme (3) AT facilitates new possibilities and benefits: The necessity of the presence of parents during the AT session; a sense of "normalcy;" outcomes of AT in relation to post-intensive care syndrome. CONCLUSIONS: Our results will help to better understand a safe and feasible way to work with children with PPMV, even though this approach is not yet widespread due to its special circumstances. These results can be used in future AT programmes in children undergoing special treatments.IMPLICATIONS FOR REHABILITATIONChildren with ventilation needs after discharge from the intensive care unit present physical, cognitive, and mental alterations that decrease functional capacity and quality of life.In a relatively small sample, positive outcomes were found for AT in relation to post-intensive care syndrome, enabling children to participate in aquatic therapy activities with the involvement of parents.This study highlighted the positive impact on the quality of life of both children and their parents.Aquatic therapy is a feasible intervention in children requiring prolonged mechanical ventilation, although certain difficulties should be addressed in terms of implementation, together with challenges regarding safety and planning.These difficulties may be overcome by promoting coordination between professionals, creating security protocols, and/or facilitating specialised education for therapists.

An Open Label Study of an Occlusive Heat Patch in the Treatment of Warts

Background: Local hyperthermia has been demonstrated to be a safe and efficacious treatment for warts. Objective: We aimed to evaluate the safety and efficacy of an epicutaneous heat patch to induce local hyperthermia for the treatment of warts. Methods: We performed an uncontrolled, proof of concept study by applying a novel, reproducible, epicutaneous heat patch to a target wart for 2 hours per day for 12 weeks. There were 15 evaluable participants. An untreated wart was also observed and measured. Wart measurements included the diameter in two dimensions, an investigator global assessment (IGA) score, wart clearance, and monitoring for adverse events as endpoints at week 12 (end of treatment) and week 24 (end of study). Results: No major adverse events were observed. 6.7% of participants reported minor cutaneous events. At week 24, 46.7% of participants achieved complete clearance of both warts. Limitations: The small sample size and lack of independent control in each participant were the main limiting factors. Conclusion: Local hyperthermia delivered by epicutaneous heat patches was well-tolerated, safe, and achieved complete clearance in both treated as well untreated warts in 46.7% of participants at week 24 after 12 weeks of daily use. Clinicaltrials.gov: NCT01746056 J Drugs Dermatol. 2019;18(4):368-373.

Patología de las uñas en la infancia. Cómo interpretar los cambios en la superficie ungueal / Nail alterations in children. How to interpret the changes in the ungueal surface

La patología ungueal en la infancia es muy amplia y su conocimiento es imprescindible para el diagnóstico de variados procesos que muestran en las uñas su seña de identidad propia. En muchos casos la afectación ungueal es la pionera de la enfermedad, permitiendo un diagnóstico precoz. A nivel de la atención pediátrica extrahospitalaria, el conocimiento de la semiología ungueal permite orientaciones diagnósticas en las que no es preciso el uso de complejas y costosas técnicas complementarias. Revisaremos los cambios en la superficie de la lámina ungueal (cambios en la lisura, curvatura, grosor...) y su implicación clínica, mostrando especial interés en recalcar los procesos dermatológicos o sistémicos que acompañan a cada síntoma ungueal

Ungueal pathology in children is very extensive and its knowledge is essential to diagnose varied processes that leave an identifying mark on the nails. In many cases, the affected nail is the pioneer of the disease, allowing for an early diagnosis. In regards to outpatient pediatric care, knowledge of nail semiology allows for diagnostic orientations in which the use of complex and costly complementary techniques is not necessary. We review the changes on the nail plate surface (changes in smoothness, curvature, thickness, etc.) and its clinical implication, showing special interest in emphasizing the dermatological or systemic processes that accompany each ungueal symptom

Diagnóstico diferencial de las micosis cutáneas / Differential diagnosis of cutaneous mycoses

Las manifestaciones clínicas de las micosis superficiales abarcan un amplio espectro. De esta forma, en cada ubicación anatómica el hongo adopta un comportamiento muy similar y repetible en cada nuevo paciente, lo que nos permite establecer pautas de diagnóstico diferencial concretas según la localización. La morfología de las lesiones, la evolución del cuadro y, en ocasiones, la epidemiología, sentarán las bases de la sospecha clínica. Los estudios complementarios, incluyendo básicamente la exploración con luz de Wood, la visión directa de escamas para detectar hongos, el cultivo micológico y, en los casos más complejos, la valoración histológica de la lesión, serán útiles para establecer el diagnóstico definitivo. Desde un punto de vista eminentemente práctico, se revisan las micosis según la zona del tegumento afectada y, tras una breve descripción clínica, en la que se resaltan los aspectos sobre los que se centran las consideraciones diagnósticas, se enumeran las diferentes entidades nosológicas con las que se puede confundir. Se presta especial atención fundamentalmente a los rasgos morfologicoevolutivos, útiles a la hora de plantear un diagnóstico diferencial práctico. Con este mismo ánimo, se valoran las dermatosis más habitualmente implicadas, y se obvian aquellas que por su infrecuencia o excepcionalidad dermatológica escapan del ámbito de esta revisión (AU)

The clinical manifestations of superficial mycoses span a wide spectrum. In each anatomical site, the fungus adopts very similar behavior that is replicated in each new patient. This allows us to establish concrete guidelines for the differential diagnosis in each localization. The bases for clinical suspicion are the morphology of the lesions, clinical course and sometimes epidemiology. Complementary studies, including Wood’s light examination, direct visualization of scrapings to detect fungi, mycological culture and, in the most complex cases, histological evaluation of the lesion, are useful in establishing the definitive diagnosis. From an eminently practical point of view, we review the various mycoses according to the area of integument affected and, after a brief clinical description, in which we stress the aspects around which we center diagnostic considerations, we enumerate the various nosological entities that can cause confusion. Special attention is paid to the mainly morphological features and characteristics of the clinical course that are useful when making a practical differential diagnosis. With the same aim, we evaluate the most commonly implicated dermatoses, leaving aside those which, due to their infrequency or exceptionality, fall outside the scope of this review (AU)

[An evaluation of dietetic treatment in juvenile hypercholesterolemia]. / Evaluación del tratamiento dietético en la hipercolesterolemia infantil.

OBJECTIVE: To evaluate compliance with dietetic treatment and its influence on levels of cholesterol and lipoproteins in hypercholesterolaemia in young children, over a period of two years. DESIGN: A descriptive longitudinal study. SETTING: Two paediatric clinics at the "Soria Norte" Health Centre. PATIENTS: 47 patients between 3 and 10 years old, with overall cholesterol levels > 185 mg/dl and C-LDL > 110 mg/dl. MEASUREMENTS AND MAIN RESULTS: 51% of the children correctly followed the dietetic advice given and at the 6 months follow-up showed an overall decrease in cholesterol and C-LDL. This decrease was less significant at a year from the start of the treatment. CONCLUSIONS: Diet is an efficacious treatment of hypercholesterolaemia in children. However, it is difficult to maintain over a long period.

[Health problems detected in check-ups for the healthy child]. / Problemas de salud detectados en las revisiones del niño sano.

OBJECTIVE: To assess the results of check-ups carried out on children when putting into practice the Programme for Healthy Children and various screenings. DESIGN: Crossover, descriptive study of the check-ups of healthy children carried out over a year (January to December, 1991). SETTING: Primary Care: the Pediatric Clinics of Soria Norte Health Centre, Soria. PATIENTS: All the children who had one or more check-ups during the study period. MEASUREMENTS AND MAIN RESULTS: The check-ups identified 0.78 problems per child. The greatest number of problems were found in the 15 day check-up, due to perinatal pathologies, followed by those at ages 3 and 6. The number of problems/number of check-ups relationship is 0.79 in children under 2 and 1.42 in those over 2. The problems occurring most often correspond to groups XV1, X1V and X11 (WONCA CIPSAP 11 Code). Groups V and V1 problems occurred most often at the ages when specific screenings were carried out. CONCLUSIONS: A high percentage of problems are found when checking healthy children, although many of them have very little clinical implication. The introduction of screening procedures at these check-ups assists the early identification of illnesses among this sector of the population.