Medición de resultados en el daño cerebral adquirido en una unidad de neurorrehabilitación. Estudio a largo plazo / Measurement of the outcomes in acquired brain injury in a neurorehabilitation unit. A long-term study

Introducción. Tras un daño cerebral brusco se produce una pérdida de capacidades que afectan a la autonomía de la persona. La recuperación de las secuelas físicas, psíquicas y cognitivas requiere la aplicación de múltiples terapias cuyos resultados precisan una medición objetiva. Nuestro objetivo es analizar la aplicación de instrumentos estandarizados en la determinación de resultados terapéuticos en el daño cerebral adquirido. Pacientes y métodos. Estudio observacional descriptivo retrospectivo de 13 meses de duración. Analizamos datos epidemiológicos y clínicos: tiempo de evolución, grado de independencia (índice de Barthel), presencia de espasticidad y tratamiento con toxina botulínica. Como medida de resultados se usó la Goal Attainment Scaling y la Rehabilitation Complexity Scale, pre y postratamiento. Resultados. Revisamos un total de 45 pacientes, el 60% debido a un ictus. La espasticidad estaba presente en 19 pacientes, y el 42% fue tratado con infiltración de toxina botulínica. Todos realizaron tratamiento con planificación de objetivos; en el 84% de los casos se planificó más de un objetivo terapéutico, y el más prevalente fue la reeducación de la marcha. Con el uso de las escalas se observó que los pacientes con mayor complejidad inicial presentaban una mayor dificultad para lograr los objetivos establecidos, aunque existía un mayor grado de mejora en comparación con su estado previo. Conclusión. La situación de dependencia inicial y el grado de complejidad en las necesidades del paciente con daño cerebral se correlaciona con la situación final tras un programa de tratamiento neurorrehabilitador, de ahí la importancia del uso de escalas como la Goal Attainment Scaling y la Rehabilitation Complexity Scale pre y postratamiento (AU)

Introduction. Following sudden brain damage, there is a loss of capabilities that affects the person’s autonomy. Recovery from the physical, psychic and cognitive sequelae requires the application of multiple therapies, the outcomes of which need to be measured objectively. Our aim is to analyse the application of standardised instruments in determining the therapeutic outcomes in acquired brain injury. Patients and methods. We conducted a retrospective descriptive observational study lasting 13 months. Both epidemiological and clinical data were analysed: elapsed time since onset, degree of independence (Barthel index), presence of spasticity and treatment with botulinum toxin. Outcomes were measured using Goal Attainment Scaling and the Rehabilitation Complexity Scale, pre- and post-treatment. Results. We reviewed a total of 45 patients, 60% of them having suffered a stroke. Spasticity was present in 19 patients, and 42% were treated with botulinum toxin infiltration. All of them underwent goal-setting treatment; in 84% of the cases more than one goal was planned, and the most prevalent was gait re-education. With the use of the scales it was observed that the patients with the greatest initial complexity had more difficulty to achieve the goals that had been set, although there was a higher degree of improvement in comparison to their prior status. Conclusion. The initial situation in terms of dependence and the degree of complexity of the needs of patients with brain damage correlate with the final situation after a programme of neurorehabilitation therapy. This reflects the importance of using scales like Goal Attainment Scaling and the Rehabilitation Complexity Scale, pre- and post-treatment (AU)

Effects of additional agitation process on the spectrophotometric profiles of homeopathic high dilutions

Introduction: Conventional homeopathy advocates giving 10 strokes (agitation/succussions) to a prescription bottle containing liquid dilution, before taking it. To scientifically support such activity, it must be based on studies on the physicochemical aspects of the memory of water and agitated water chains, supplemented with spectrometry. Objective: To analyze spectrometric profiles of homeopathic high dilutions, comparing additionally agitated and non-agitated dilutions, and to define differences according to each dilution´s kingdom. Methodology: Homeopathic dilutions were prepared using a ratio of 1:100 obtaining dilutions from 1cH to 15cH. Measurements of absorbance of 15cH dilutions were performed at 340 nm and 200 nm, with and without additional agitation. Results: Statistically significant differences were found between agitated and non-agitated dilutions (p <0.05) for Apis mellifica, Bufo rana, and Calcium iodatum, with a decrease in the mean value of absorbance (340 nm) in agitated solutions. For A nica montana, Matricaria chamomilla, Coffea arabica, Pulsatilla nigricans, Calcium iodatum and Natrum muriaticum, the absorbance values increased; these values decreased for Apis and Bufo. In addition, measurements were performed with a shorter wavelength (200 nm); it was observed that there are significant differences for all homeopathic dilutions studied. Additionally, when comparing the mean values of the absorbance for each kingdom, and observing the agitation factor, a statistically significant difference was found in the animal kingdom (p<0.05), having lower absorbance for agitated dilutions. Conclusion: Comparisons of the spectrometric profiles of agitated and non-agitated solutions allow to observe that there is a difference of the absorbance when comparing a previously agitated solution and a solution with no agitation before taking it. (AU)

Effects of additional agitation process on the spectrophotometric profiles of homeopathic high dilutions

INTRODUCTION: Conventional homeopathy advocates giving 10 strokes (agitation/succussions) to a prescription bottle containing liquid dilution, before taking it. To scientifically support such activity, it must be based on studies on the physicochemical aspects of the memory of water and agitated water chains, supplemented with spectrometry. OBJECTIVE: To analyze spectrometric profiles of homeopathic high dilutions, comparing additionally agitated and non-agitated dilutions, and to define differences according to each dilution´s kingdom. METHODOLOGY: Homeopathic dilutions were prepared using a ratio of 1:100 obtaining dilutions from 1cH to 15cH. Measurements of absorbance of 15cH dilutions were performed at 340 nm and 200 nm, with and without additional agitation. RESULTS: Statistically significant differences were found between agitated and non-agitated dilutions (p <0.05) for Apis mellifica, Bufo rana, and Calcium iodatum, with a decrease in the mean value of absorbance (340 nm) in agitated solutions. For A nica montana, Matricaria chamomilla, Coffea arabica, Pulsatilla nigricans, Calcium iodatum and Natrum muriaticum, the absorbance values increased; these values decreased for Apis and Bufo. In addition, measurements were performed with a shorter wavelength (200 nm); it was observed that there are significant differences for all homeopathic dilutions studied. Additionally, when comparing the mean values of the absorbance for each kingdom, and observing the agitation factor, a statistically significant difference was found in the animal kingdom (p<0.05), having lower absorbance for agitated dilutions. CONCLUSION: Comparisons of the spectrometric profiles of agitated and non-agitated solutions allow to observe that there is a difference of the absorbance when comparing a previously agitated solution and a solution with no agitation before taking it.