El parque geriátrico: fisioterapia para nuestros mayores / Geriatric park: physical therapy for our elders

La colaboración entre varias instituciones públicas como el ayuntamiento de Vélez-Rubio, la Junta de Andalucía, Aprovélez y la Residencia Comarcal de Personas Mayores ha dado lugar al desarrollo de un proyecto en el municipio de Vélez-Rubio (Almería) denominado "Parque para personas mayores" o "Parque geriátrico". Éste consta de un conjunto de aparatos que desarrollan una rama tan importante de la fisioterapia como es la mecanoterapia. A través de paneles explicativos, la persona mayor comprende el funcionamiento y los objetivos del mismo. Así, se hace llegar a los ancianos la fisioterapia como medio para mantener o mejorar su estado físico, así como para concienciar a la población de que lleve a cabo una rutina de ejercicio

The collaboration between several public institutions as the town hall of Vélez-Rubio, the Junta de Andalucía, Aprovélez and the Residencia Comarcal de Personas Mayores has developed a project in the municipality of Vélez-Rubio (Almería) so called "Park for major persons " or "Geriatric park ". This one consists of a set of devices that develop such an important branch of the Physical therapy as it is the mecanotherapy. Across explanatory panels, the elders understand the functioning and the targets of the same one. This way, the physical therapy as way makes come to the elders to support or to improve his physical state, as well as to make aware the population that carries out a routine of exercise

Estudio de prevalencia de los trastornos motores en la población de una residencia geriátrica / Study of prevalency of the motor disorders in the population of a geriatric residence

Al elevarse la esperanza de vida de la sociedad actual, el envejecimiento ha traído consigo un aumento de las discapacidades, ya que el alargamiento de los años no siempre asocia una buena calidad de vida. Y ha sido esta discapacidad la que ha llevado a una mayor institucionalización de las personas mayores, al no poderse hacer cargo la familia de ellos, ya sea por sus limitaciones físicas, problemas psíquicos o sociales. En este nuevo entorno que se crea, la residencia geriátrica, aparece la figura del fisioterapeuta y la estrecha relación de éste y el resto del personal sanitario con el anciano, intentando paliar de alguna forma las consecuencias del envejecimiento fisiológico o patológico y mejorar su calidad de vida. Entre las posibles dolencias que pueden afectar a la población anciana nos vamos a ceñir a los trastornos motores, por ser éstos los que más van a ocupar el trabajo del fisioterapeuta, sin dejar de llevar a cabo un tratamiento global e interdisciplinar. Se pretende estudiar la prevalencia de los trastornos motores en la población de una residencia geriátrica y mostrar los resultados más significativos relacionados con la Fisioterapia

After rose the life expectancy of the current society, the aging has brought with it an increase of the disabilities, since the lengthening ofthe years not always associates a good quality of life. And it has be en this disability the one that has led to a major institutionalization of the elders, after the family of them was not able to take charge, be already for his physical limitations, psychic or social problems. In this new environment that is created, the geriatric residence, there appears the figure of the physiotherapist and the narrow relation of this one and the rest of the sanitary personnel with the elder, trying to relieve of some form the consequences of the physiological or pathological aging and to improve his quality of life. Between the possible ailments that can affect the aged population we go away to surround to the motor disorders, for being these those who more are going to occupy the work of the physiotherapist, without stopping carrying out a global treatment and interdisciplining. There tries to be studied the prevalency of the motor disorders in the population of a geriatric residence and to show the most significant results related to the Physical therapy

Further studies on childhood leprosy

A review is made of some previous studies on leprosy incidence among contacts, particularly children born of patients in leprosaria. Fluctuations in incidence rate constantly occur, even in the same area. The changes may be due to a number of factor, including different methods of study and varying pathogenic potential which involve susceptibility and resistance among the contacts and intensity and duration of exposure to m.leprae in the enviromment. The incidence is studied in detail in l206 childreen, nearly all of them born in the Culion Sanatorium, and observed closely by the same continuing group of workers for from l year to 20 years during the period l948 through 1967. Most of the children had been separated at birth and brought up in a nursey where they were given lepromin, BCG, or their combinations before being returned tio theier parent at ages of from 1 year to a little over 6 years. a still smaller group among the unisolated children was also given injections

Leprosy in children general considerations: initial and early stages / ?

In the foregoing account it has been deemed desirable to trace the general background and setting and the sources of the materials which have served as the basis for the succesive series of studies on childhood leprosy in the Philippines in the past 45 years. The methods employed by the various workers, the scope of their observations, and their main findings are also reviewed. It is evident that no single worker or group has so far been able to deal with the subject in a very comprehensive manner. However, each new attempt has probably added a little to the pre-existing knowledge, or provided fresh stimulus for renewed effort...

Children of leprosy patients isolated at birth, given lepromin and BCG injections, then returned to the colony, first report

1- Since May 1948, 100 Culion-born children of leprosy patients have been isolated at birth in the nonleprous environment of the Culion Nursey. Of this number 11 have been released to families outside Culion, 55 have been returned to their parents in the colony after attaining moderate to strong Mitsuda reactions or after successful BCG vaccination, and 33 remained in the nursery in March 1956; 1 died at the age of 10 days of a congenital heart defect. 2-Forty children were given repeated lepromin tests, and the 16 who did not attain 3+ reactivity were then vaccinated with BCG and retested afterward; 12 children were tested with lepromin only after BCG vaccination; 34 were given repeated lepromin tests alone; and 10 had only BCG vaccination. Four children received neither lepromin nor BCG. 3- Of the 11 children released to guardians, 5 have not been heard from. Four were still nonleprous at recent follow-up examinations. Two were brought back to the colony, still nonleprous, at the ages of 3 years 9 months and 1 year 7 months, and they subsequently developed leprous lesions after periods of exposure of 2 years 5 months and 3 years, respectively. 4- The exposure periods in these two cases approximate the average incubation period of cases among unisolated, constantly-exposed children developing similar types of lesions. The first of them had been discharged from the nursery at the age of 2 years 6 months, after receiving four lepromin tests but developing only 1+ reactivity; the other had received neither lepromin nor BCG. Both probably acquired the infection after their return to the colony. Neither had received breast feeding, which indicates that maternal feedings is not a necessary factor in transmission...

Self-healing, or abortive, and residual forms of childhood leprosy and their probable significance

Practically continuos observations of Culion-born children of the patients over the past twenty-four years has revealed that many of them have developed unquestionable leprosy lesions. Approximately three-fourths of the cases of infection actually healed spontaneously, a majority of them apparently permanebtly, in spite of continued residence in the infected environment. There was correlation between the process of healing and the clinical morphology of the initial or earliest recognizable lesions, as well as with bacteriologic, histologic and immunologic features. The papulonodular forms and other definitely circumscribed, thickened lesions were associated with the highest proportions of subsequently healed cases, the infiltration-like, more or less diffusely thickened lesions, with the lowest proportion. The wheal-like and the raised and flat macular lesions occupied an intermediate position, in that order. There was found fairly good correlation between low bacterial content of the lesion, strong Mitsuda reactivity, and a high proportion of healed cases. The correlation between clinical morphology and healing seemed to be even more consistent. Also, the correlation with respect to the healing time showed definite advantage for the circumscribed, thickened lesions. As regards the histologic correlation, healing occurred earlier in the case with lesions with undifferentiated, round-cell or monocytic infiltrates than in those with lesions showing the tuberculoid structure, except with the papulonodules. Knowledge of the clinical morphology of the early lesions and the pattern of their corresponding subsequent course, therefore, is usually of greater value than reliance on uncorrelated histologic, bacteriologic or immunologic observations. Relapses, when they occurred, were chiefly noted within less than three years of apparent healing, gradually becoming more rare after longer pperiods, and practically not seen at all after 10 years. Relapses occurred more frequently in cases whose early lesions were of tuberculoid histology than in those with undifferentiated lesions. They were also more frequently seen among the cases with wheal-like and macular types of early lesions than among those with papuilonodules, lichenoid, or scar-like indurated lesions...

The problem of the negative inmates in the Culion Sanitarium

This article, adopted from an official memorandum not designed for publication, deals with the problems of the "negatives" at the Culion Sanitarium, i.e., those inmates whose disease has so thoroughly cleared up that they are entitled to release or discharge. There are 440 such individuals, constituing about 25 per cent of the inmate population. They are of two categories, namely, adults (268) brought from elsewhere as patients, and children (172) born at Culion who have shown manifestations of the disease but are now clean. Among the adults, 216 (81 per cent) are unwilling or unprepared to leave. The reasos most frequently given are difficulties arising from mutilations due to the disease (171 adults have them in some degree), or the desire not to leave spouses or other relatives not ready for discharge. An important factor, discussed from more than one point of view, is the normality of life in the Culion Reservation and the many opportunities of self-help. Incidentally, less than one quarter of the adult negatives had taken any treatment during the past six months. Even among the patients still bacteriologically positive, less than one-half are taking treatment, in some cases because of difficulties with sulfone, but more often because they do not wish to become negative and therefore liable to be discharged. Many, but by no means all, have been at Culion so long that they have lost contact with the outside world. The negative-children group, almost all without interested relatives outside and 15 of them are already married to other inmates, is an especially intersting one from several points of view. They have had no outside contacts and therefore are highly "institution-minded". With a single exception, they have had no antileprosy treatment; their lesions disappeared spontaneously, not one of them showing any deformity resulting from the disease. Such cases have rarely shown any tendency to relapse. The conditions of life of patients at Culion are discussed. Recommendations are offered which, although intended only for local application, have features of wider interest.

Histological study of an early case of leprosy in a young child of leprous parents: report of a case, with autopsy

1- An autopsied case of very early leprosy in a 17-months-old child of leprous parents is reported. 2- The single, isolated, heavily bacillated lesions discovered two months before death, no longer identifiable clinically two days before death, was found in histological sections after a systematic search for it. 3- Histologically the lesion was a very young leproma with beginning formation of foamy cells and numerous bacilli, in close association with three scars that presumably were due to scabies. 4- Evidence is presented which tends to corroborate the belief that the early skin lesions of leprosy is the primary inoculation lesion. This conclusion is based on the finding of bacilli in considerable numbers only in the corresponding reagional lymphatic nodes of drainage, with none in the other groups of lymph nodes, the nerves, or the other organs examined. 5- The spread of the infection in this case of early leprosy by way of the lymphatics is discussed.

Mitsudas skin reaction (lepromin test) in children of leprous parents. II. Observations on newly-born to eighteen-month-old children

One hundred and ten unisolated nonleprous children of leprous parents, ranging in age from newly-born to eighteen months, all closely observed since birth, were given the lepromin test repeatedly at intervals of four months, with special attention to the appearance of early, recognizable lesions of leprosy, and the results of the tests were analyzed and correlated with the clinical observations. Sex was found to have on the lepromin reaction. The frequency of positive reactions was in direct relation to the age, a small but not negligible proportion of undoubtedly positive reactions accurring, in the first test, among the children less than one year old. In the retests there was a further progressive increase in the proportion of positive reactors which could not wholly be attributed to further ageing, but was probably in part the effect of retesting. Thus a majority of the children who were still less than one year old gave definitely positive reactions in the second or third test. Retesting of strongly positive reactors with a markedly reduced dose of lepromin more frequently resulted in a distinctly diminished reaction in the absence of manifest leprosy than when lesions were already in evidence. The appearance or existence of early leprotic lesions in the children was associated with an apparently undiminished, and possibly even greater tendency to react positively to the test. Both the duration and the constancy of exposure to leprous environment seemed also to bear a direct relation to the proportion of positive reactions.Intercurrent disease not of a serious nature showed no depressing influence on the reaction.

Clinical observations with reference to leprosy in children of lepers

A group of 240 children born of leprous parents, ranging in age from newly born to 8 years, has been observed with the object of detecting the earliest clinically recognizable changes that may be attributed to leprosy. A group of 78 children of nonleprous parents was also examined once, for comparison. The observation were for the most part clinical, microscopic examination of smears having been made only for definitely suspicious lesions: sections could not be obtained except from cases that came to autopsy. The commonest type of suspected (that is unidentified) skin lesion found that could not be attributed directly to known nonleprotic skin affections was the hazy pale area first described by Chiyuto. Its incidence was found to increase with age, and it was observed in 96 per cent of all the children of lepers above one year of age. Of much less frequent occurrence were the rough, scaly or granular pale areas and the pale mottlings which showed no definite relation to age, the markedly pale or depigmented areas without definite borders, and the gooseflesh, follicular, or lichenoid areas which were found more frequently in the older than in the younger age groups...