Exercise and Physical Activity eHealth in COVID-19 Pandemic: A Cross-Sectional Study of Effects on Motivations, Behavior Change Mechanisms, and Behavior.

OBJECTIVES: The aims of this research were (1) to compare the levels of physical activity of eHealth users and non-users, (2) to determine the effects of these technologies on motivations, and (3) to establish the relationship that could exist between psychological constructs and physical activity behaviors. METHODS: This cross-sectional study involved 569 adults who responded to an online questionnaire during confinement in France. The questions assessed demographics, usage of eHealth for exercise and physical activity, and behavioral levels. The questionnaire also measured the constructs of Social Cognitive Theory, the Theory of Planned Behavior, and automaticity facets toward eHealth for exercise and physical activity. RESULTS: Participants who were users of eHealth for exercise and physical activity presented significantly higher levels of vigorous physical activity and total physical activity per week than non-users (p < 0.001). The chi-square test showed significant interactions between psychological constructs toward eHealth (i.e., self-efficacy, behavioral attitudes, intentions, and automaticity) and physical activity levels (all interactions were p < 0.05). Self-efficacy was significantly and negatively correlated with walking time per week. Concerning the automaticity facets, efficiency was positive and significantly correlated with vigorous physical activity levels per week (p < 0.05). Then, regressions analyses showed that self-efficacy and automaticity efficiency explained 5% of the variance of walking minutes per week (ß = -0.27, p < 0.01) and vigorous physical activity per week (ß = 0.20, p < 0.05), respectively. CONCLUSION: This study has shown that people during confinement looked for ways to stay active through eHealth. However, we must put any technological solution into perspective. The eHealth offers possibilities to stay active, however its benefits and the psychological mechanisms affected by it remains to be demonstrated: eHealth could be adapted to each person and context.

Automaticity facets applied to screen-time sedentary behaviours and active commuting measured by accelerometers.

Background: The time adults spend sitting in front of screens is a health risk factor. In contrast, walking and cycling to and from work, also known as active commuting, could promote physical activity and improve population health. Objective: This study investigated automatic properties role in explaining active commuting and screen-based sedentary behaviours. The stable, daily conditions for carrying out active commuting and screen-based sedentary behaviour are most likely to develop automatic properties. These characteristics mean performing behaviours via external cues (i.e. lack of intentionality), with an unpleasant emotional experience of not carrying out a set routine (i.e. lack of controllability), and without paying much attention (i.e. efficiency). Method: This article describes findings of a prospective and correlational study in which 128 people participated. First, participants responded to questions assessed using the Generic Multifaceted Automaticity Scale (GMAS), which measured the automatic properties of screen-based sedentary behaviour and active commuting. The following week, both behaviours were assessed by daily logs to document active commuting and screen-based sedentary behaviour events, and by an accelerometer, worn for seven days, as an objective criterion. Confirmatory factor analyses, bivariate correlations, and multiple linear regressions were computed for the associations between the GMAS scores and objective criterion measures of screen-based sedentary behaviours and active commuting. Results: Automaticity facets displayed different relationships with screen-based sedentary behaviours and active commuting - people with higher lack of intentionality and lack of controllability for active commuting present higher levels of moderate physical activity. In contrast, the lack of controllability of screen-based sedentary behaviours was a significant predictor of sedentary screen time. Conclusions: The multidimensional approach to automaticity could be useful in determining more precisely the features that need to be addressed to promote the adoption of active commuting and limit the time spent sitting in front of screens.

[Reducing the amount of time spent sitting in a professional setting: the "Sedentariness at Work" (SAW) survey] / Réduire le temps assis en milieu professionnel : l'étude « Sédentarité au travail ¼ (SAuT).

OBJECTIVE: The purpose of this research was to evaluate the effects of an intervention on reducing sitting time in a professional setting. METHODS: The intervention consisted of a group presentation on sedentary behavior at work and active work breaks, followed by an individual planning phase. Participants were then invited to use alert software for four weeks. The intervention lasted six weeks; 38 people aged 29 to 59 years participated (80% women). Before and after the intervention, participants wore accelerometers to assess behaviors (sedentary and physical activity at work) and responded to a questionnaire measuring the degree of automaticity for sitting at work and taking active breaks. RESULTS: After the intervention, the time spent in a sitting position during a working day decreased significantly. Specifically, sitting time decreased more among those aged 29 to 43 years; who had decided to take breaks of at least 5 minutes; and had more extended sitting time before the intervention. CONCLUSIONS: This study demonstrated that combining an informational strategy with computer- or mobile-generated alerts reduces sitting time spent in the workplace. This intervention was inexpensive for employees and companies. An interesting perspective could be to compare these effects with those of interventions based on a change in the physical work environment (such as the installation of adjustable desks).

Intention and automaticity toward physical and sedentary screen-based leisure activities in adolescents: A profile perspective.

PURPOSE: Physical activity (PA) and sedentary behavior (SB) are increasingly considered independent health behaviors. Additionally, current research suggests that both controlled and automatic determinants account for their adoption. The purpose of this article was to identify intention-automaticity profiles toward PA and screen-based SB and to examine how those profiles are associated with different behavioral patterns. METHOD: Two cross-sectional studies based on self-report questionnaires were conducted with French high school students (Study 1: n = 198; Study 2: n = 185). RESULTS: In all, 4 distinct motivational profiles appeared. The first 3 clusters emerged in both studies: "PA" (high levels of automaticity and intention for PA, low levels of automaticity and intention for screen-based SB); "screen" (high levels of automaticity and intention for screen-based SB, low levels of automaticity and intention for PA), and "mixed" (high levels of all variables), whereas the fourth cluster was observed only in Study 2: "high control" (below-mean levels of automaticity, high levels of intention toward both PA and screen-based SB). Adolescents with a screen profile displayed the least healthy behavioral pattern, whereas those in the PA profile demonstrated the most favorable behaviors. CONCLUSION: Future research is needed to extend these results to other populations using complementary assessment methods of automatic psychological processes and PA and SB behaviors.

Squamous cell carcinoma of the conjunctiva with extraocular involvement: case report and literature review. / Carcinoma escamoso de la conjuntiva con compromiso extraocular: reporte de caso y revisión de la literatura.

Squamous cell carcinoma of the conjunctiva is the most frequent malignant tumor of the ocular surface. It is a rare disease with an incidence of 0.13 to 1.9 per 100,000 inhabitants, mainly affecting individuals between 50 and 75 years of age. It tends to have a slow, non-aggressive course. Treatment depends on the extent of the tumor. If there is intraocular involvement, enucleation is indicated, and in the presence of extraocular involvement the orbital exenteration is the standard treatment. We report and discuss the case of an 82 year old male patient having a conjunctival squamous cell carcinoma with intra and extraocular involvement, together with a review of the literature.

El carcinoma escamoso de la conjuntiva es el tumor maligno más frecuente de la superficie ocular. Constituye una enfermedad rara con una incidencia de 0,13 a 1,9 por 100 000 habitantes que afecta principalmente a individuos entre los 50 y los 75 años. Suele tener un curso lento y poco agresivo. El tratamiento depende de la extensión tumoral. En presencia de compromiso intraocular la enucleación está indicada y en presencia de compromiso extraocular la exanteración orbitaria es el tratamiento estándar. Reportamos el caso de un paciente de 82 años con carcinoma escamoso conjuntival con compromiso intra y extraocular, se discute el caso y se revisa la literatura.

Gelastic epilepsy: Beyond hypothalamic hamartomas.

Gelastic epilepsy or laughing seizures have been historically related to children with hypothalamic hamartomas. We report three adult patients who had gelastic epilepsy, defined as the presence of seizures with a prominent laugh component, including brain imaging, surface/invasive electroencephalography, positron emission tomography, and medical/surgical outcomes. None of the patients had hamartoma or other hypothalamic lesion. Two patients were classified as having refractory epilepsy (one had biopsy-proven neurocysticercosis and the other one hippocampal sclerosis and temporal cortical dysplasia). The third patient had no lesion on MRI and had complete control with carbamazepine. Both lesional patients underwent resective surgery, one with complete seizure control and the other one with poor outcome. Although hypothalamic hamartomas should always be ruled out in patients with gelastic epilepsy, laughing seizures can also arise from frontal and temporal lobe foci, which can be surgically removed. In addition, we present the first case of gelastic epilepsy due to neurocysticercosis.

Hematoma subdural crónico: una enfermedad del adulto mayor / Chronic subdural hematoma: a disease of elderly people

The lack of specificity and heterogeneity of the clinical picture of chronic subdural hematoma, hampers its diagnosis. Aim: To report the experience of a Neurosurgical Service in chronic subdural hematoma. Patients and methods: One hundred patients (77 male, mean age 77ñ13 years) with chronic subdural hematoma were analyzed. Results: The main clinical presentations were mental status changes (50 percent) and progressive focal neurological deficit (46 percent). Five cases presented as a transient neurological deficit. All patients were treated with burr hole drainage. Thirteen had recurrence of the hematoma and they were reoperated. The surgical mortality was 3 percent. Eighty seven patients were followed for a mean of 66 months. Eighty one of these had a complete recovery, 6 had permanent neurological deficit and 2 of these were unable to care for themselves. Bad prognosis was associated with the absence of a previous trauma to explain the hematoma and symptoms of dementia as the clinical presentation. Conclusions: Most patients with chronic subdural hematoma treated with burr hole drainage have a good outcome

Hematoma de fosa posterior no traumático: consideraciones clínicas y terapéuticas / Non-traumatic posterior fossa hematomas: clinical and therapeutical issues

Se analizan 52 pacientes portadores de hematoma de fosa posterior no traumático. Correspondieron a 28 hombres y 24 mujeres, con una media de edad de 60 años. Diez (19,2 por ciento) fueron secundarios a malformaciones arteriovenosa (5), cavernomas (3), angioma venoso (1) y hemangioblastoma (1). Cuarenta y dos (80,7 por ciento) fueron catalogados como primarios, encontrándose el antecedente de hipertensión arterial en 31, transtornos de coagulación en 5 y en 6 no se demostró un factor predisponente. Hipertensión intracraneana fue el cuadro clínico de presentación en la mayoría (84 por ciento). La Tomografía Computarizada demostró el hematoma en todos los casos. Cuatro de ellos medían menos de 2 cm., 24 entre 2 y 3 cm. y 24 eran mayores de 3 cm. Hidrocefalia estuvo presente en 22 casos (42,3 por ciento). Angiografía digital se realizó en 12 pacientes, siendo positiva en 7 (5 malformaciones arteriovenosas, 1 angioma venoso y 1 hemangioblastoma). Resonancia Magnética fue practicada en 2 enfermos, demostrando en uno angioma cavernoso. Treinta y un pacientes fueron operados realizándose vaciamiento del hematoma en 24, 14 de ellos con drenaje del LCR. En los restantes solo se trató la hidrocefalia. Se observó buenos resultados en el 67,3 por ciento y la mortalidad global fue de 9,6 por ciento. La mortalidad quirúrgica fue de 12,5 por ciento. Incide en los resultados el estado de conciencia inicial y el tamaño. Las cisternas troncales no fueron evaluadas en nuestra casuística. Sin embargo, creemos que el tratamiento debiera ser evaluado en cada caso particular, ya que ningún factor influyen en forma absoluta en la evolución

Consideraciones sobre los meningiomas intracraneanos / Considerations about intracraneal meningioma

Se analizan 79 pacientes con meningiomas intracraneanos. La media edad fue de 52,5 años y el 73 por ciento eran mujeres. El cuadro clínico más frecuente fue hipertensión endocraneana (39,5 por ciento), seguido de déficit focal (26.3 por ciento) y crisis convulsiva (17.5 por ciento). La mayoría se localizaron en la convexidad y la fosa posterior. Todos fueron tratados quirúrgicamente. lográndose Simpson I o II en el 78 por ciento. El estudio histopatológico mostró variedad fibroblástica en un 39,2 por ciento, sincicial en un 34,2 por ciento y 2,5 por ciento malignos. El 34 por ciento presentó alguna complicación postoperatoria. Se logró seguimiento a largo plazo en el 62 por ciento de los pacientes. En 10 (12,6 por ciento) persistió como secuela déficit neurológico focal, que en 6 (7,5 por ciento) era invalidante. Dos pacientes (2,5 por ciento) fallecieron y cuatro recidivaron. Los tumores ubicados en la convexidad se asociaron significativamente con menores complicaciones y hubo una tendencia a mayor morbilidad neurológica en pacientes sobre 70 años. Tres pacientes presentaron meningiomas múltiples y otra tenía antecedente de meningiomas en la familia. Se discuten factores que pudieran incidir en la morbimortalidad y algunos aspectos de los meningiomas familiares y múltiples

Metástasis en la médula espinal: una localización infrecuente: experiencia en 2 casos / Spinal cord metastases: an unfrequent location: report of 2 cases

Spinal cord metastases are an uncommon secondary location of a malignant neoplasm. They are rarely diagnosed during life and when that is the case, it is in the clinical setting of a disseminated cancer and very seldom as the first clinical manifestation. We report two patients, with no previous disease, who developed a progressive myelopathy. An intramedullary spinal cord tumor was diagnosed, based on the clinical picture and imaging studies. They were operated and biopsies showed spinal cord metastases whose primary tumor was a lung neoplasm. We discuss the clinical features in these patients, the diagnosis of progressive myelopathy in cancer patients, treatment and prognosis of this unusual secondary cancer location

Disectomía cervical anterior sin fusión intersomática / Anterior cervical discectomy without intervertebral fusion

La disectomía cervical por vía anterior habitualmente se acompaña de fusión intervertebral. El uso de injertos para fusión no está exento de complicaciones, en el sitio de obtención del injerto o a nivel cervical. Se afirma que la fusión diaria estabilidad vertebral, mejor descompresión radicular, detendría posibles artrosis facetaria. En Chile, rara vez se utiliza discetomía cervical sin fusión. Se analizaron retrospectivamente 58 pacientes con hernias cervicales discales únicas, no traumáticas, operados con esa técnica, seguidos a largo plazo 48 pacientes (78 por ciento) (promedio: 3,3 años). Está asintomáticos 89 por ciento de ellos y con algunas molestias episódicas el 11 por ciento y volvieron a sus actividades diarias el 93 por ciento de los pacientes. Hubo complicaciones que requirieron reoperación en 3 pacientes (infección local y dolor radicular), 15 pacientes presentaron complicaciones postoperatorias precoces, siendo más frecuentes las disfagias y las disfonías transitorias. Se trata de una técnica sencila, rápida y segura que no requiere de segunda incisión, que es recomendable para usar en pacientes con HNP cervical única, no traumática, con resultados en el largo plazo similares a las técnicas que usan fusión

Trauma espinal penetrante por arma de fuego / Gunshot spinal cord injury

El traumatismo raquimedular (TRM) penetrante por arma de fuego es una patología cada vez más prevalente, relevante y de un alto costo social y económico, por el grado de invalidez que genera en población generalmente joven. El tratamiento óptimo ha sido debatido ampliamente, estando sólo parcialmente establecido el rol de los antibióticos, corticoides y cirugía. Se presenta un caso clínico, con lesión incompleta a nivel de cauda equina, en el cual se realizó tratamiento quirúrgico con resultado final satisfactorio y se revisa la bibliografía correspondiente

Experiencia en monitorización metabólico-cerebral en pacientes críticos neurológicos / Cerebral metabolic monitoring in critical neurological patients

Background: Cerebral metabolic monitoring in critical neurological patients allows the assessment of neuronal tissue response to injury and to plan the best therapy to correct each critical brain situation. Aim: To evaluate the usefulness of cerebral metabolic monitoring in patients with acute cerebral injury. Patients and methods: A retrospective analysis of 29 patients with acute brain injury, in whom a catheter was located in the bulb of the jugular vein to perform a cerebral metabolic monitoring. These patients were compared with others that were not subjected to this monitoring. The evolution at six months of follow up was assessed using the Glasgow outcome score, considering a favorable evolution when this score was 4 or greater. Results: Patients with an hyperemic state on admission or after optimization of therapy did not have hospital mortality, and 73 per cent had Glasgow outcome score of 4 or greater at six months of follow up. On the other hand, 50 per cent of those with hypoperfusion or global ischemia died during hospitalization and 72 per cent had a Glasgow outcome score of 3 or less at six months. Patients not subjected to cerebral metabolic monitoring behave as those with hypoperfusion or global ischemia. Conclusions: Cerebral metabolic monitoring is an useful tool to optimize the management of patients with acute cerebral injury, and those patients with an hyperemic cerebral state have the best prognosis

Resultados de la cirugía electiva en aneurismas intracraneanos no rotos / Results of elective surgery in unrupted intracranial aneurysms

En el último tiempo se diagnostica un número apreciable de aneurismas intracraneanos no rotos, dada la alta resolución de las imágenes (RM y TC). No está del todo claro en nuestro medio si el tratamiento quirúrgico es de beneficio para estos pacientes. Para conocer el riesgo de la cirugía, se analizó una serie de 22 aneurismas intracraneanos sin ruptura, operados en los últimos 6 años. Se analizaron 16 pacientes de 51 años promedio, 12 de hallazgo incidental, 4 aneurismas múltiples con HSA previa en uno, todos de localización supratentorial, de tamaño entre 4 y 30 mm. Se cliparon 20 y en dos se ligó la arteria carótida interna. Se concluye que los beneficios de la cirugía en aneurismas supratentoriales sin ruptura son mayores que los riesgos de una eventual ruptura espontánea

Absceso epidural espinal: análisis de 10 casos y revisión / Spinal epidural abscess: analysis of 10 cases and review

La infección bacteriana supurada del espacio epidural espinal tiene una elevada morbilidad y mortalidad en las distintas series, cuya baja incidencia aún persiste. Su diagnóstico se ha facilitado con los modernos métodos de neuroimagen. Se analizan 10 casos considerando factores clínicos, diagnósticos, de terapia y evolución. Fiebre, dolor espinalñ, déficit sensitivo y motor fueron los síntomas más frecuentes. El diagnóstico topográfico fue corroborado por mielografía, TAC o RNM, se discute su oportunidad y eficacia. Se aisló germen en 7 casos. En todos los pacientes se realizó cirugía decompresiva seguida de terapia antibiótica, discutiendo su eficacia. La evolución fue satisfactoria en 5 casos, hubo un fallecido y otros cuatro pacientes mejoraron su condición de ingreso. Se pone énfasis en la intervención quirúrgica precoz y terapia antibiótica agresiva como condiciones que mejoran los resultados