ABSTRACT
Low back pain (LBP) is a significant global health challenge due to its high prevalence, and chronicity and recurrence rates, with projections suggesting an increase in the next years due to population growth and aging. The chronic and recurrent nature of LBP, responsible for a significant percentage of years lived with disability, underscores the need for effective management strategies, including self-management strategies advocated by current guidelines, to empower patients and potentially improve healthcare efficiency and clinical outcomes. Therefore, the aim of this study was to analyze the added value of face-to-face visits in patients with chronic LBP undergoing a self-management program based on therapeutic exercises on pain intensity, disability, quality of life and treatment adherence and satisfaction. A randomized clinical trial was conducted, allocating 49 patients into a experimental group with a mobile health (mHealth) app usage and face-to-face sessions and 49 patients into an active control group without face-to-face sessions. Pain intensity, disability and quality of life were assessed at baseline, 4 weeks postintervention and 12 weeks postintervention. Patients' satisfaction and adherence were assessed at the end of the study. The multivariate general model revealed no statistically significant time × group interaction for any outcome (p > 0.0068) but mental quality of life (p = 0.006). Within-group differences revealed significant improvements for all the clinical indicators (all, p < 0.001). Patients allocated to the experimental group reported greater satisfaction and adherence (both, p < 0.001) compared to the control group. The use of mHealth apps such as Healthy Back® as part of digital health initiatives may serve as a beneficial approach to enhance the management of LBP.
Subject(s)
Low Back Pain , Mobile Applications , Humans , Low Back Pain/therapy , Quality of Life , Aging , Digital HealthABSTRACT
Balance disturbances in people with lived experience of stroke affect activities of daily living and social participation, so assessing them is essential to know the level of functional independence. Accelerometers are electronic devices that allow kinematic variables of balance to be recorded and are a tool of great interest in the assessment of functional balance. To determine the validity and reliability of, as well as the most performed protocols using accelerometers in the functional assessment of balance in people with experience of stroke, a systematic search of articles published in the electronic databases PubMed, Scopus, the Web of Science, the Cochrane Library, the PEDro and the Virtual Health Library from Spain was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We used QUADAS-2 to assess the quality of the included studies. Eight studies met the inclusion criteria, two studied reliability and validity, two studied reliability and four studied the validity of accelerometers in the assessment of balance in people with stroke. All studies indicated the kind of accelerometer, localization on the body, tests and outcome variables. The results indicate that accelerometers show excellent reliability values in the assessment of balance in people who had a prior stroke and disparate results in terms of validity. Triaxial accelerometers were most used, and the 4th and 5th lumbar and 1st and 2nd sacral vertebrae were the body areas most used for their placement.
ABSTRACT
(1) Background: Resting tremor is a motor manifestation present in most Parkinson's disease (PD) patients. For its assessment, several scales have been created, but mobile applications could help in objectively assessing resting tremor in PD patients in person and/or remotely in a more ecological scenario. (2) Methods: a systematic review following the PRISMA recommendations was conducted in scientific databases (PubMed, Medline, Science Direct, Academic Search Premier, and Web of Science) and in the main mobile application markets (Google Play, iOS App Store, and Windows Store) to determine the applications available for the assessment of resting tremor in patients with PD using only the measurement components of the phone itself (accelerometers and gyroscopes). (3) Results: 14 articles that used mobile apps to assess resting tremor in PD were included, and 13 apps were identified in the mobile application markets for the same purpose. The risk of bias and of applicability concerns of the articles analyzed was low. Mobile applications found in the app markets met an average of 85.09% of the recommendations for the development of medical mobile applications. (4) Conclusions: the use of mobile applications for the evaluation of resting tremor in PD patients has great potential, but validation studies for this purpose are scarce.
ABSTRACT
Neurorehabilitation is a fundamental aspect in the treatment approach for multiple sclerosis (MS), in which new technologies have gained popularity, especially the use of virtual reality (VR). The aim of this paper is to analyze an occupational therapy (OT) intervention compared with OT + VR (OT + VR) on the manual dexterity of patients with MS. 26 MS subjects were initially recruited from an MS patient association and randomized into two groups. The OT group received 20 conventional OT sessions distributed in two sessions per week. The OT + VR group received 20 sessions of VR interventions, twice weekly and lasting 30 minutes, consisting of VR games accessed via the online web page motiongamingconsole.com, in addition to the conventional OT sessions. Pre- and postintervention assessments were based on the Purdue Pegboard Test, the Jebsen-Taylor Hand Function Test, and the Grooved Pegboard Test. Clinical improvements were found regarding the precision of movements, the execution times, and the efficiency of certain functional tasks in the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test tests in the OT + VR group. Although significant differences were not found in the manual dexterity between the OT and OT + VR groups, improvements were found regarding the precision and effectiveness of certain functional tasks.
Subject(s)
Hand/physiology , Multiple Sclerosis, Relapsing-Remitting/physiopathology , Multiple Sclerosis, Relapsing-Remitting/rehabilitation , Occupational Therapy/methods , Virtual Reality , Adult , Female , Humans , Male , Middle Aged , Motor Skills , Recovery of Function , Single-Blind Method , Treatment Outcome , Video Games , Virtual Reality Exposure TherapyABSTRACT
BACKGROUND: Multiple sclerosis has considerable effects on patients' quality of life, limiting their daily activities and influencing their lifestyle. Additionally, adapting to pharmacological treatments represents a challenge for many patients. OBJECTIVE: The aim of this study was to explore the views and experiences of Spanish patients with multiple sclerosis regarding their pharmacological treatment. METHODS: A qualitative phenomenological study was conducted with 20 patients with Multiple Sclerosis from a hospital Neurology Unit. Data were collected through in-depth interviews and researchers' field notes. A systematic text condensation analysis was performed. The Consolidated Criteria for Reporting Qualitative Research and the Standards for Reporting Qualitative Research guidelines were followed. RESULTS: Twenty patients with Multiple Sclerosis completed the study. The mean age was 39.7 years (SD: 9,17). A thematic description of all the data collected was performed based on four descriptive themes which emerged from the analysed material: a) Undergoing the injections, b) Coping strategies, with two subthemes, resignation and integrating the treatment into their life, c) Other methods of pharmacological administration, and d) Dealing with discomfort. For patients with multiple sclerosis, their experience with pharmacological treatment is an apprenticeship which is sometimes met with resignation and discomfort. Patients must learn to take responsibility for their treatment, seeking other routes of administration, as well as integrating these changes into their daily life. CONCLUSIONS: Qualitative research offers insight into the way patients with Multiple Sclerosis experience their pharmacological treatment, and may be helpful in establishing a fruitful relationship with these patients.
Subject(s)
Adaptation, Psychological , Delivery of Health Care , Disabled Persons/psychology , Drug Therapy/psychology , Multiple Sclerosis/psychology , Quality of Life/psychology , Activities of Daily Living , Adult , Female , Humans , Male , Middle Aged , Multiple Sclerosis/drug therapy , Qualitative Research , SpainABSTRACT
Slo3 is a sperm-specific potassium (K+) channel essential for male fertility. Slo3 channels have so far been considered to be specific to mammals. Through exploratory genomics, we identified the Slo3 gene in the genome of terrestrial (birds and reptiles) and aquatic (fish) vertebrates. In the case of fish, Slo3 has undergone several episodes of gene loss. Transcriptomic analysis showed that vertebrate Slo3 transcript orthologues are predominantly expressed in testis, in concordance with the mammalian Slo3. We conclude that the Slo3 gene arose during the radiation of early vertebrates, much earlier than previously thought. Our findings add to the growing evidence indicating that the phylogenetic profiles of sperm-specific channels are intermittent throughout metazoan evolution, which probably reflects the adaptation of sperm to different ionic milieus and fertilization environments.
ABSTRACT
Gastroenteritis is a clinical illness of humans and other animals that is characterized by vomiting and diarrhea and caused by a variety of pathogens, including viruses. An increasing number of viral species have been associated with gastroenteritis or have been found in stool samples as new molecular tools have been developed. In this work, a DNA microarray capable in theory of parallel detection of more than 100 viral species was developed and tested. Initial validation was done with 10 different virus species, and an additional 5 species were validated using clinical samples. Detection limits of 1 × 10(3) virus particles of Human adenovirus C (HAdV), Human astrovirus (HAstV), and group A Rotavirus (RV-A) were established. Furthermore, when exogenous RNA was added, the limit for RV-A detection decreased by one log. In a small group of clinical samples from children with gastroenteritis (n = 76), the microarray detected at least one viral species in 92% of the samples. Single infection was identified in 63 samples (83%), and coinfection with more than one virus was identified in 7 samples (9%). The most abundant virus species were RV-A (58%), followed by Anellovirus (15.8%), HAstV (6.6%), HAdV (5.3%), Norwalk virus (6.6%), Human enterovirus (HEV) (9.2%), Human parechovirus (1.3%), Sapporo virus (1.3%), and Human bocavirus (1.3%). To further test the specificity and sensitivity of the microarray, the results were verified by reverse transcription-PCR (RT-PCR) detection of 5 gastrointestinal viruses. The RT-PCR assay detected a virus in 59 samples (78%). The microarray showed good performance for detection of RV-A, HAstV, and calicivirus, while the sensitivity for HAdV and HEV was low. Furthermore, some discrepancies in detection of mixed infections were observed and were addressed by reverse transcription-quantitative PCR (RT-qPCR) of the viruses involved. It was observed that differences in the amount of genetic material favored the detection of the most abundant virus. The microarray described in this work should help in understanding the etiology of gastroenteritis in humans and animals.
Subject(s)
Gastroenteritis/diagnosis , Gastroenteritis/virology , Oligonucleotide Array Sequence Analysis/methods , Virus Diseases/diagnosis , Virus Diseases/virology , Viruses/classification , Viruses/genetics , Child, Preschool , Gastroenteritis/epidemiology , Humans , Infant , Infant, Newborn , Oligonucleotide Array Sequence Analysis/standards , Prevalence , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and Specificity , Virus Diseases/epidemiologyABSTRACT
El artículo contribuye con la reflexión académica sobre las prácticas de lectura y escritura en la educación superior, realizada en el marco de la investigación interinstitucional financiada por Colciencias "¿Para qué se lee y se escribe en la universidad colombiana? Un aporte a la consolidación de la cultura académica del país", investigación nacional que convocó a 17 universidades. Con este fin se presentan algunos resultados de una encuesta aplicada a estudiantes universitarios de las instituciones participantes en el proyecto. Se plantea una reflexión sobre la alfabetización académica desde el análisis de los resultados de la encuesta, que enfatiza en las preguntas sobre qué leen y escriben los estudiantes universitarios, y con qué propósito lo hacen. La encuesta muestra como tendencias el predominio en la lectura y la escritura de apuntes de clase, y de las actividades académicas relacionadas con la evaluación, aspectos que son analizados desde las prácticas educativas propuestas en las instituciones y los funcionamientos cognitivos implicados en la escritura.
This article contributes to academic reflection on scholarly reading and writing practices in Higher Education, stemming from the Colciencias-funded inter-institutional research project "What do we read and write for in the Colombian University? A contribution to the consolidation of academic culture in the country". This project was a country-wide study of 17 universities. To this end, some results of a survey of college students from participating universities in the project are presented. We present a reflection on academic literacy from the analysis of the survey results, focusing on questions such as what did university students read and write about and what purpose did they fulfill. The survey showed, as tendencies, the predominance of the reading and writing on class notes, and the academic activities associated to assessment, aspects that are analyzed from educative practices proposed to institutions and the cognitive performance involved in writing.
ABSTRACT
BACKGROUND: Limited evidence is available about the effectiveness of virtual reality using low cost commercial consoles for children with developmental delay. OBJECTIVE: The aim of this preliminary study is to evaluate the usefulness of a videogame system based on non-immersive virtual reality technology (Xbox 360 KinectTM) to support conventional rehabilitation treatment of children with cerebral palsy. Secondarily, to objectify changes in psychomotor status of children with cerebral palsy after receiving rehabilitation treatment in addition with this last generation game console. METHODS: 11 children with cerebral palsy were included the study. A baseline, a post-treatment and a follow-up assessment were performed related to motor and the process skills, balance, gait speed, running and jumping and fine and manual finger dexterity. All the participants completed 8 weeks of videogame treatment, added to their conventional physiotherapy treatment, with Xbox 360 Kinect™ (Microsoft) game console. RESULTS: The Friedman test showed significant differences among the three assessments for each variable: GMFM (p = 0.001), AMPS motor (p = 0.001), AMPS process (p = 0.010), PRT (p = 0.005) and 10 MW (p = 0.029). Wilcoxon test showed significant statistically differences pre and post-treatment, in all the values. Similarly, results revealed significant differences between basal and follow-up assessment. There were not statistical differences between post-treatment and follow-up evaluation, indicating a long-term maintenance of the improvements achieved after treatment. CONCLUSIONS: Low cost video games based on motion capture are potential tools in the rehabilitation context in children with CP. Our Kinect Xbox 360 protocol has showed improvements in balance and ADL in CP participants in a school environment, but further studies are need to validate the potential benefits of these video game systems as a supplement for rehabilitation of children with CP.
Subject(s)
Cerebral Palsy/rehabilitation , Environment , Game Theory , Virtual Reality Exposure Therapy/instrumentation , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Motor Skills/physiology , Outcome Assessment, Health Care , Statistics, NonparametricABSTRACT
Se presenta un caso de micosis fungoides en fase tumoral que ha respondido favorablemente al manajo con cobalto luego de 15 sesiones con dosis fraccionadas de 200 rads diarios. Posteriormente, se ha manejado con puvaterapia, obteniendo excelentes resultados hasta el momento
Subject(s)
Humans , Female , Adult , Cobalt , Cobalt/therapeutic use , Methoxsalen , Methoxsalen/therapeutic use , Mycosis Fungoides/drug therapy , Mycosis Fungoides/pathology , PUVA Therapy/statistics & numerical data , Radiotherapy DosageABSTRACT
Mujer de 57 años, tratada quirúrgicamente a causa de un tumor triquilemal proliferante en la piel cabelluda, cuya evolución era de un año. El tumor triquilema proliferante es poco frecuente y representa el 0.1 por ciento de los tumores cutáneos benignos. Se hace una breve revisión acerca del tema
