ABSTRACT
Introducción: En la primera infancia existen diferentes condiciones y síndromes neurológicos que presentan hipotonía de origen central. La American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) elaboró una guía en 2019 sobre recomendaciones terapéuticas para esta población de 0 a 6 años, basadas en un consenso de expertos y en la evidencia científica. El objetivo de este estudio fue ver cómo esas recomendaciones terapéuticas se están implementando en España. Sujetos y métodos: Se realizó una encuesta a fisioterapeutas pediátricos que tratan niños con hipotonía central de 0 a 6 años a través de un cuestionario que constaba de 31 preguntas: 10 preguntas sobre datos sociodemográficos y relativos al ejercicio de la profesión, y las 21 restantes relacionadas con el uso de las recomendaciones terapéuticas basadas en la guía de la AACPDM dirigidas a niños con hipotonía de origen central. Resultados: A partir de una muestra de 199 fisioterapeutas, se pudo objetivar que el conocimiento de la guía de la AACPDM se asociaba de forma significativa con los años de experiencia clínica, el nivel de titulación y la comunidad donde ejercen.Conclusión: Esta guía puede servir para concienciar y unificar los criterios en cuanto al abordaje terapéutico de los niños con hipotonía central. Los resultados indican que, excepto algunas técnicas, la mayoría de las estrategias terapéuticas se está implementado en nuestro país en el marco de la atención temprana.
Introduction: In early childhood, there are a number of different neurological conditions and syndromes that present with hypotonia of central origin. In 2019, the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) drew up a set of guidelines on therapeutic recommendations for the population aged from 0 to 6 years, based on the consensus of experts and on scientific evidence. The aim of this study is to determine how those therapeutic recommendations are being implemented in Spain. Subjects and methods: A survey of paediatric physiotherapists treating 0-6-year-old children with central hypotonia was carried out by means of a questionnaire consisting of 31 questions: 10 questions on sociodemographic and practice-related data, and the remaining 21 related to the use of the therapeutic recommendations based on the AACPDM guidelines for children with hypotonia of central origin. Results: From a sample of 199 physiotherapists, it was found that familiarity with the AACPDM guidelines was significantly associated with the number of years of clinical experience, level of qualification and the community in which the professionals practise. Conclusion: These guidelines can serve to raise awareness and unify criteria regarding the therapeutic approach to children with central hypotonia. The results indicate that, with the exception of a few techniques, in our country most of the therapeutic strategies are being implemented within the framework of early care.(AU)
Subject(s)
Humans , Male , Female , Muscle Hypotonia/diagnosis , Consensus , 35170 , Physical Therapists , Physical Therapy Specialty , Neurology , Nervous System Diseases , Spain , Surveys and Questionnaires , PediatricsABSTRACT
INTRODUCTION: In early childhood, there are a number of different neurological conditions and syndromes that present with hypotonia of central origin. In 2019, the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) drew up a set of guidelines on therapeutic recommendations for the population aged from 0 to 6 years, based on the consensus of experts and on scientific evidence. The aim of this study is to determine how those therapeutic recommendations are being implemented in Spain. SUBJECTS AND METHODS: A survey of paediatric physiotherapists treating 0-6-year-old children with central hypotonia was carried out by means of a questionnaire consisting of 31 questions: 10 questions on sociodemographic and practice-related data, and the remaining 21 related to the use of the therapeutic recommendations based on the AACPDM guidelines for children with hypotonia of central origin. RESULTS: From a sample of 199 physiotherapists, it was found that familiarity with the AACPDM guidelines was significantly associated with the number of years of clinical experience, level of qualification and the community in which the professionals practise. CONCLUSION: These guidelines can serve to raise awareness and unify criteria regarding the therapeutic approach to children with central hypotonia. The results indicate that, with the exception of a few techniques, in our country most of the therapeutic strategies are being implemented within the framework of early care.
TITLE: Grado de implementación en España de las recomendaciones terapéuticas para la hipotonía de origen central según el consenso de expertos de la AACPDM.Introducción. En la primera infancia existen diferentes condiciones y síndromes neurológicos que presentan hipotonía de origen central. La American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) elaboró una guía en 2019 sobre recomendaciones terapéuticas para esta población de 0 a 6 años, basadas en un consenso de expertos y en la evidencia científica. El objetivo de este estudio fue ver cómo esas recomendaciones terapéuticas se están implementando en España. Sujetos y métodos. Se realizó una encuesta a fisioterapeutas pediátricos que tratan niños con hipotonía central de 0 a 6 años a través de un cuestionario que constaba de 31 preguntas: 10 preguntas sobre datos sociodemográficos y relativos al ejercicio de la profesión, y las 21 restantes relacionadas con el uso de las recomendaciones terapéuticas basadas en la guía de la AACPDM dirigidas a niños con hipotonía de origen central. Resultados. A partir de una muestra de 199 fisioterapeutas, se pudo objetivar que el conocimiento de la guía de la AACPDM se asociaba de forma significativa con los años de experiencia clínica, el nivel de titulación y la comunidad donde ejercen. Conclusión. Esta guía puede servir para concienciar y unificar los criterios en cuanto al abordaje terapéutico de los niños con hipotonía central. Los resultados indican que, excepto algunas técnicas, la mayoría de las estrategias terapéuticas se está implementado en nuestro país en el marco de la atención temprana.
Subject(s)
Cerebral Palsy , Child , Child, Preschool , Humans , United States , Cerebral Palsy/therapy , Muscle Hypotonia/etiology , Muscle Hypotonia/therapy , Consensus , Spain , SyndromeABSTRACT
BACKGROUND: Lepisma saccharina (silverfish) is a common insect which is often found in human dwellings. Our aim was to determine the IgE antibody pattern to this arthropod in children with allergic respiratory symptoms. METHODS: The individual sera and a pool of selected sera of 45 children with asthma and/or rhinitis were used for an immunoblotting test with an extract of Lepisma saccharina; an immunoblotting inhibition test was performed with extracts of L. saccharina, D. pteronyssinus and cockroach. RESULTS: Between one and ten IgE binding bands were found in the sera of patients. The immunoblotting pattern was clearly different from that of D. pteronyssinus. Inhibition was found with D. pteronys-sinus and cockroach, which proves cross-reactivity between extracts. CONCLUSION: Allergenicity of Lepisma is demonstrated through in vitro tests. A pathogenic role still remains to be proved, but it should be considered in respiratory allergy, due to primary sensitisation to Lepisma, or to cross-reactivity with other indoor allergens.
Subject(s)
Allergens/immunology , Asthma/immunology , Immunoglobulin E/blood , Insecta/immunology , Rhinitis, Allergic, Perennial/immunology , Adolescent , Animals , Asthma/blood , Asthma/metabolism , Child , Cross Reactions/immunology , Female , Humans , Male , Rhinitis, Allergic, Perennial/bloodABSTRACT
Background: Lepisma saccharina (silverfish) is a common insect which is often found in human dwellings. Our aim was to determine the IgE antibody pattern to this arthropod in children with allergic respiratory symptoms. Methods: The individual sera and a pool of selected sera of 45 children with asthma and/or rhinitis were used for an immunoblotting test with an extract of Lepisma saccharina; an immunoblotting inhibition test was performed with extracts of L. saccharina, D. pteronyssinus and cockroach. Results: Between one and ten IgE binding bands were found in the sera of patients. The immunoblotting pattern was clearly different from that of D. pteronyssinus. Inhibition was found with D. pteronyssinus and cockroach, which proves cross-reactivity between extracts. Conclusion: Allergenicity of Lepisma is demonstrated through in vitro tests. A pathogenic role stillre mains to be proved, but it should be considered inrespiratory allergy, due to primary sensitisation to Lepisma, or to cross-reactivity with other indoor allergens
No disponible
Subject(s)
Humans , Male , Female , Child , Food Hypersensitivity/complications , Food Hypersensitivity/diagnosis , Food Hypersensitivity/therapy , Respiratory Hypersensitivity/complications , Tropomyosin/therapeutic use , Asthma/complications , Asthma/diagnosis , Immunoblotting , Immunoglobulin E/physiology , Receptors, IgE/chemistryABSTRACT
No disponible
Subject(s)
Female , Adult , Humans , Diagnosis, Differential , Biomarkers/analysis , Laparotomy/methods , Myoma/diagnosis , Myoma/surgery , Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Neurofibroma/complications , Neurofibroma/diagnosis , Neurofibroma/surgery , Tamoxifen/therapeutic use , Myoma/complications , Ovary/pathology , Ovary/surgery , Ovary , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/pathology , Ovarian Neoplasms/radiotherapy , Ovarian Neoplasms/surgery , Ovarian NeoplasmsABSTRACT
INTRODUCTION: The performance of increasingly invasive surgical techniques involves higher consumption of blood products, along with associated immunological problems and infections. Measures intended to reduce the use of homologous blood products include autologous transfusion and the application of transfusion criteria. We describe our experience with a group of patients scheduled for aortic surgery. PATIENT AND METHODS: Three hundred fifty- eight patients were studied prospectively over a period of 60 months, during which various techniques for conserving blood were applied. Up to 2 units were donated before surgery by patients who had baseline hemoglobin (Hb) counts equal to or greater than 13 g/dl. The donated blood was stored in the form of packed red cells (PRC) and fresh frozen plasma (FFP). Plasmapheresis was performed before surgery whenever a loss of 1,200 ml was expected to occur. Intraoperative salvage of lost blood, with the "Cell- Saver" system, was also used in such cases. No patient was given PRC if Hb was equal to or greater than 10 g/dl; nor was plasma given unless analytical levels indicated need. RESULT: Between 25 and 33% of the patients, depending on age, required no blood products. In up to 55%, self- donated blood was used. Salvage during surgery conserved around 50% of estimated blood lost. The percentage of autologous blood replaced during surgery increase from 21% in 1989 to 38% in 1993. The amount of autologous plasma used also increased with time, reaching nearly 80% of total plasma infused thanks to the introduction of preoperative plasmapheresis. CONCLUSION: The establishment of strict protocols regarding use of blood products and the application of self-donation techniques provided a savings of homologous blood products during the period this study lasted. Preoperative donation of blood was accepted in all cases in which it was indicated and there were no adverse reactions when the autologous blood was replaced.
Subject(s)
Aortic Diseases/surgery , Blood Transfusion, Autologous , Intraoperative Care , Aged , Humans , Middle Aged , Prospective StudiesSubject(s)
Agglutination Tests , Antigens, Surface/immunology , Bacterial Outer Membrane Proteins , Bacterial Proteins/immunology , Yersinia enterocolitica/immunology , Yersinia pseudotuberculosis/immunology , Antigens, Bacterial , Bacteriological Techniques , Cross Reactions , Epitopes , Species Specificity , Yersinia enterocolitica/genetics , Yersinia enterocolitica/isolation & purification , Yersinia pseudotuberculosis/genetics , Yersinia pseudotuberculosis/isolation & purificationSubject(s)
Antigens, Bacterial/biosynthesis , Antigens, Surface/biosynthesis , Bacterial Outer Membrane Proteins , Culture Media/chemistry , Yersinia enterocolitica/immunology , Yersinia enterocolitica/metabolism , Antigens, Bacterial/isolation & purification , Antigens, Surface/isolation & purification , Bacteriological Techniques , Caseins , Hydrogen-Ion Concentration , Protein Hydrolysates , Yersinia enterocolitica/pathogenicitySubject(s)
Renal Insufficiency/nursing , Child , Child, Preschool , Color , Diagnosis, Differential , Humans , Infant , Infant, Newborn , Male , Renal Insufficiency/urine , Smell , Urine/chemistryABSTRACT
To gain a better understanding of the pathogenesis, natural history, therapeutic response, and the potential of prevention of anastomotic aneurysms in general and those following aortofemoral interventions in particular, we have reviewed 4,214 reconstructive vascular operations performed in the past 15 years during which procedures (prosthetic bypass, autogenous vein graft, and endarteriectomy) of fairly uniform technical details have been used. Among these operations representing 9,561 anastomotic sites, we encountered 205 anastomic aneurysms, a per site incidence of 1.7 percent. By far the most common site of occurrence was the femoral artery following Dacron bypass procedures, with a per site incidence of 3.0 percent. The lowest rate of incidence was observed after endarteriectomies, regardless of anatomic location (0.4 percent). The most frequent causative factor was found to be structural deficiency of the parent artery, which accounted for 30.7 percent of the aneurysmal lesions. Other etiological agents, in order of importance, were arterial hypertension, mechanical stress, defect of the graft material, and noninfective healing complications. The therapeutic approach was an aggressive one and only patients with prohibitive operative risks were treated conservatively. In the elective surgical cases the rate of good results was 81.6 percent, with no operative deaths.
Subject(s)
Aneurysm/etiology , Blood Vessel Prosthesis/adverse effects , Endarterectomy , Veins/transplantation , Aneurysm/epidemiology , Aneurysm/surgery , Arteries/injuries , Follow-Up Studies , Humans , Hypertension/complications , Stress, Mechanical , Sutures , Transplantation, Autologous , Wound HealingABSTRACT
Twenty-four patients (average age, 46 years) with 29 instances of lobular carcinoma in situ of the breast have been treated from 1952 to 1971 at the Henry Ford Hospital (incidence, 1%). Six patients had bilateral lesions, one synchronous and 5 metachronous. The initial complaint in 23 of 24 patients was a mass in the breast. Diagnosis was based on permanent histologic section as mammorgraphy and frozen section analysis were inconclusive. Treatment consisted of radical mastectomy in six, modified radical mastectomy in five, and simple mastectomy in 20. All lymph nodes recovered showed no metastatic disease. All patients are alive and well with no evidence of disease. Based on our experience, we recommend a simple mastectomy for treatment of lobular carcinoma in situ with contraleteral bipsy examination in those instances when clinical or roentgenographic evidence suggests a pathologic process.
