RESUMO
La falta de información sobre el uso de la tecnología en niños con trastorno del espectro autista (TEA) de diferentes perfiles puede dificultar que docentes y alumnos se estén beneficiando del apoyo tecnológico más eficaz y ajustado a sus necesidades. El objetivo de esta revisión fue analizar y sintetizar la evidencia científica sobre la eficacia de los recursos tecnológicos en la mejora de la comprensión emocional de estudiantes con TEA con perfiles de alto y bajo funcionamiento. Para ello se realizó una revisión sistemática de las publicaciones científicas indexadas en algunas de las bases de datos de mayor relevancia siguiendo los criterios establecidos en la declaración PRISMA. En total se analizaron 38 artículos que cumplieron con los criterios de inclusión preestablecidos. Los resultados muestran la importancia de diseñar sistemas versátiles que puedan personalizarse y adaptarse en tiempo real y en contextos naturales con un enfoque claramente inclusivo. Pero también sugieren que la tecnología puede no ser una herramienta de intervención complementaria adecuada para todos los niños con TEA. Lo que subraya la necesidad de ensayos adicionales bien controlados sobre las características que permitan identificar qué estudiantes podrían o no beneficiarse de diferentes modalidades de tecnología. (AU)
The lack of information on the use of technology in children with autism spectrum disorder (ASD) of different profiles can make it difficult for teachers and students to benefit from the most effective technology support tailored to their needs. The aim of this review was to analyze and synthesize scientific evidence on the effectiveness of technological resources in improving the emotional understanding of students with high and low functioning ASD profiles. A systematic review of the scientific publications indexed in some of the most relevant databases was carried out following the criteria established in the PRISMA declaration. A total of 38 articles that met the pre-established inclusion criteria were analyzed. The results show the importance of designing versatile systems that can be customized and adapted in real time and in natural contexts with a clearly inclusive approach. But they also suggest that technology may not be an appropriate complementary intervention tool for all children with ASD. This underlines the need for additional well-controlled tests on the characteristics that would allow identifying which students might or might not benefit from different technology modalities. (AU)
Assuntos
Humanos, Pré-Escolar, Criança, Adolescente, Tecnologia Educacional, Transtorno do Espectro Autista, Transtorno AutísticoRESUMO
La falta de información sobre el uso de la tecnología en niños con trastorno del espectro autista (TEA) de diferentes perfiles puede dificultar que docentes y alumnos se estén beneficiando del apoyo tecnológico más eficaz y ajustado a sus necesidades. El objetivo de esta revisión fue analizar y sintetizar la evidencia científica sobre la eficacia de los recursos tecnológicos en la mejora de la comprensión emocional de estudiantes con TEA con perfiles de alto y bajo funcionamiento. Para ello se realizó una revisión sistemática de las publicaciones científicas indexadas en algunas de las bases de datos de mayor relevancia siguiendo los criterios establecidos en la declaración PRISMA. En total se analizaron 38 artículos que cumplieron con los criterios de inclusión preestablecidos. Los resultados muestran la importancia de diseñar sistemas versátiles que puedan personalizarse y adaptarse en tiempo real y en contextos naturales con un enfoque claramente inclusivo. Pero también sugieren que la tecnología puede no ser una herramienta de intervención complementaria adecuada para todos los niños con TEA. Lo que subraya la necesidad de ensayos adicionales bien controlados sobre las características que permitan identificar qué estudiantes podrían o no beneficiarse de diferentes modalidades de tecnología. (AU)
The lack of information on the use of technology in children with autism spectrum disorder (ASD) of different profiles can make it difficult for teachers and students to benefit from the most effective technology support tailored to their needs. The aim of this review was to analyze and synthesize scientific evidence on the effectiveness of technological resources in improving the emotional understanding of students with high and low functioning ASD profiles. A systematic review of the scientific publications indexed in some of the most relevant databases was carried out following the criteria established in the PRISMA declaration. A total of 38 articles that met the pre-established inclusion criteria were analyzed. The results show the importance of designing versatile systems that can be customized and adapted in real time and in natural contexts with a clearly inclusive approach. But they also suggest that technology may not be an appropriate complementary intervention tool for all children with ASD. This underlines the need for additional well-controlled tests on the characteristics that would allow identifying which students might or might not benefit from different technology modalities. (AU)
Assuntos
Humanos, Pré-Escolar, Criança, Adolescente, Tecnologia Educacional, Transtorno do Espectro Autista, Transtorno AutísticoRESUMO
Background and objectives: The invention described herein is a prototype based on computer vision technology that measures depth perception and is intended for the early examination of stereopsis. Materials and methods: The prototype (software and hardware) is a depth perception measurement system that consists on: (a) a screen showing stereoscopic models with a guide point that the subject must point to; (b) a camera capturing the distance between the screen and the subject's finger; and (c) a unit for recording, processing and storing the captured measurements. For test validation, the reproducibility and reliability of the platform were calculated by comparing results with standard stereoscopic tests. A demographic study of depth perception by subgroup analysis is shown. Subjective comparison of the different tests was carried out by means of a satisfaction survey. Results: We included 94 subjects, 25 children and 69 adults, with a mean age of 34.2 ± 18.9 years; 36.2 % were men and 63.8 % were women. The DALE3D platform obtained good repeatability with an interclass correlation coefficient (ICC) between 0.94 and 0.87, and coefficient of variation (CV) between 0.1 and 0.26. Threshold determining optimal and suboptimal results was calculated for Randot and DALE3D test. Spearman's correlation coefficient, between thresholds was not statistically significant (p value > 0.05). The test was considered more visually appealing and easier to use by the participants (90 % maximum score). Conclusions: The DALE3D platform is a potentially useful tool for measuring depth perception with optimal reproducibility rates. Its innovative design makes it a more intuitive tool for children than current stereoscopic tests. Nevertheless, further studies will be needed to assess whether the depth perception measured by the DALE3D platform is a sufficiently reliable parameter to assess stereopsis.(AU)
Assuntos
Humanos, Masculino, Feminino, Criança, Adolescente, Adulto Jovem, Visão Binocular, Percepção de Profundidade, Visão Ocular, Testes VisuaisRESUMO
Purpose: To analyze binocular vision of individuals aged 18 to 35 years diagnosed with keratoconus, utilizing spectacles and rigid gas-permeable (RGP) contact lenses. Research was led by the Universidad Autónoma de Aguascalientes, México and Fundación Universitaria del Área Andina Pereira, Colombia. Methods: A single center, prospective non-randomized, comparative, interventional, open-label study, in which the differences in binocular vision performance with both spectacles and RGP contact lenses was carried out from December 2018 to December 2019. Sampling was performed according to consecutive cases with keratoconus that met the inclusion criteria until the proposed sample size was reached. Results: Rigid gas-permeable (RGP) contact lenses notably enhanced distance and near visual acuity in keratoconus patients compared to spectacles. Visual alignment analysis shows exophoria at both distances and is slightly higher with RGP contact lenses. The difference was statistically significant (p<0.05), with 82.5 % presenting compensated phoria with spectacles and pnly 42.50% with RGP contact lenses. Stereoscopic vision improved while wearing RGP contact lenses (42.59 %), although accommodation and accommodative flexibility remained within normal ranges. Conclusions: Patients with keratoconus fitted with RGP contact lenses have improved binocular vision skills such as visual acuity, stereopsis, and accommodative flexibility. However, even when the vergence and motor system is decompensated with respect to normal ranges, the range between break and recovery points for both fusional reserves and the near point of convergence (NPC) improves with the use of RGP contact lenses, giving indications of an adaptive condition of the motor system from the medium to the long term.(AU)
Assuntos
Humanos, Masculino, Feminino, Adolescente, Adulto Jovem, Ceratocone, Óculos, Lentes de Contato, Visão Binocular, Testes Visuais, Colômbia, México, Oftalmologia, Estudos ProspectivosRESUMO
La adicción digital, que se determina como un problema común entre los adolescentes en los últimos años, afecta negativamente la vida de los adolescentes en muchos aspectos. El objetivo del estudio es examinar las relaciones entre la adicción digital, la soledad, la timidez y la ansiedad social de los adolescentes. Gate se reunió con adolescentes que completaron la Escala de adicción digital, la versión corta de la Escala de soledad de UCLA, la Escala de timidez y la Escala de gravedad del trastorno de ansiedad social DSM-5 - Formulario infantil. Las hipótesis sugeridas se han probado utilizando los datos recopilados de 991 adolescentes y un análisis de regresión jerárquica. Los resultados de la investigación encontraron una relación positiva y significativa entre la adicción digital, la soledad, la timidez y la ansiedad social entre los adolescentes. Además, los hallazgos muestran que la adicción digital, la soledad y la timidez predicen la ansiedad social. Los resultados obtenidos demuestran que la adicción digital, la soledad y la timidez tienen efecto sobre la ansiedad social. Según los hallazgos, se sugiere aplicar diversas intervenciones educativas por parte de profesionales de la salud mental a adolescentes que presenten signos de adicción digital, soledad, timidez y ansiedad social.(AU)
Digital addiction, which is determined as a common problem among adolescents in the last years, affects the lives of adolescents nega-tively in terms of many aspects. The aim of the study is to examine the re-lationships between adolescents' digital addiction, loneliness, shyness and social anxiety. Gate gathered from adolescents who completed Digital Ad-diction Scale, Short Form of UCLA Loneliness Scale, Shyness Scale, and DSM-5 Social Anxiety Disorder Severity Scale -Child Form. The suggest-ed hypotheses have been tested using the data gathered from 991 adoles-cents and hierarchical regression analysis. The research findings found a positive and significant relationship between digital addiction, loneliness, shyness and social anxiety among adolescents. Furthermore, the findings show that digital addiction, loneliness, and shyness predict social anxiety. The results obtained prove that digital addiction, loneliness and shyness have an effect on social anxiety. According to the findings, it is suggested to applyvarious educational interventions by mental health professionals to adolescents who show signs of digital addiction, loneliness, shyness, and social anxiety.(AU)
Assuntos
Humanos, Masculino, Feminino, Adolescente, Solidão, Timidez, /psicologia, AnsiedadeRESUMO
Introduction: The scientific evidence regarding the effects of online social media use on the well-being of adolescents is mixed. In gen-eral, passive uses (receiving, viewing content without interacting) and more screen time are related to lower well-being when compared with active uses (direct interactions and interpersonal exchanges). Objectives:This study ex-amines the types and motives for social media usage amongst adolescents, differentiating them by gender identity and sexual orientation, as well as its effects on eudaimonic well-being and minority stress. Method: A cross-sectional study was conducted with 1259 adolescents, aged 14 to 19 (M= 16.19; SD= 1.08), analysing the Scale of Motives for Using Social Net-working Sites, eudaimonic well-being, the Sexual Minority Adolescent Stress Inventory, screen time and profile type. Results:The results found that longer use time is related to finding partners, social connection and friendships; that gay and bisexual (GB) adolescents perceive more distal stressors online;and that females have higher levels of well-being. Discus-sion: The public profiles of GB males increase self-expression, although minority stress can be related to discrimination, rejection or exclusion. Dif-ferentiated socialization may contribute to a higher level of well-being in females, with both active and passive uses positively effecting eudaimonic well-being in adolescents.(AU)
Introduction: The scientific evidence regarding the effects of online social media use on the well-being of adolescents is mixed. In general, passive uses (receiving, viewing content without interacting) and more screen time are related to lower well-being when compared with active uses (direct interactions and interpersonal exchanges). Objectives: This study examines the types and motives for social media usage amongst adolescents, differentiating them by gender identity and sexual orientation, as well as its effects on eudaimonic well-being and minority stress. Method: A cross-sectional study was conducted with 1259 adolescents, aged 14 to 19 (M = 16.19; SD = 1.08), analysing the Scale of Motives for Using Social Networking Sites, eudaimonic well-being, the Sexual Minority Adolescent Stress Inventory, screen time and profile type. Results: The results found that longer use time is related to finding partners, social connection and friendships; that gay and bisexual (GB) adolescents perceive more distal stressors online; and that females have higher levels of well-being. Discussion: The public profiles of GB males increase self-expression, although minority stress can be related to discrimination, rejection or exclusion. Differentiated socialization may contribute to a higher level of well-being in females, with both active and passive uses positively effecting eudaimonic well-being in adolescents.(AU)
Assuntos
Humanos, Masculino, Feminino, Adolescente, Redes Sociais Online, Mídias Sociais, Saúde do Adolescente, Psicologia do Adolescente, MotivaçãoRESUMO
Background and objectives Alterations in the molecular mechanisms of specific amino acids (AAs) may be implicated in the pathophysiology of schizophrenia (SZ). However, little is known about antipsychotic drugs influence on levels of AAs. This study aimed to further explore antipsychotics' effects on AAs and serum lipid levels in first-episode SZ. Methods Eighty subjects with the International Classification of Diseases, Tenth Edition (ICD-10) criteria-defined SZ were enrolled. The levels of 31 AAs were measured in plasma samples using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Results Ten AAs (i.e., citrulline, sarcosine, tyrosine, leucine, proline, hydroxyproline, kynurenine, tryptophan, valine and isoleucine) were observed to be higher and three AAs (i.e., GABA, aminobutyric acid and asparaginic acid) were lower in 80 patients with first-episode SZ after various antipsychotics treatment. In addition, there were 1 out of 31 AAs altered after olanzapine treatment and there were only 2 out of 31 AAs altered after risperidone treatment. Furthermore, serum triglyceride (TG) was markedly upregulated after olanzapine treatment, while Apolipoprotein A1 (ApoA1) was generally upregulated after risperidone treatment in patients with first-episode SZ. Conclusions Taken together, antipsychotic treatment can affect the plasma levels of AAs in patients with first-episode SZ, and olanzapine and risperidone have differential effects on the levels of AAs. (AU)
Assuntos
Humanos, Masculino, Feminino, Adolescente, Adulto Jovem, Adulto, Pessoa de Meia-Idade, Idoso, Antipsicóticos/uso terapêutico, Aminoácidos, Esquizofrenia/tratamento farmacológico, Estudos ProspectivosRESUMO
Introducción: Actualmente la conmoción cerebral se considera un problema de gran magnitud, siendo los adolescentes y jóvenes la población de riesgo, ya que se encuentran en proceso de maduración. Nuestro objetivo ha sido comparar la eficacia de diferentes intervenciones (ejercicio físico terapéutico, terapia vestibular y descanso) en adolescentes y jóvenes con conmoción cerebral.Desarrollo: Se realizó una búsqueda bibliográfica en las principales bases de datos. Una vez aplicados los criterios de inclusión/exclusión y la escala metodológica Physiotherapy Evidence Database PEDro, fueron revisados seis artículos. Los resultados apoyan la utilización del ejercicio y la terapia vestibular en las etapas iniciales para disminuir los síntomas posconmoción. Según la mayoría de los autores, el ejercicio físico terapéutico y la terapia vestibular reportan mayores beneficios, aunque se necesitaría un protocolo que unificara escalas de valoración, variables de estudio y parámetros de análisis para poder realizar la inferencia en la población diana.Conclusión: Desde el momento del alta hospitalaria del paciente, la aplicación combinada de ejercicio físico y terapia vestibular, podría considerarse como la mejor opción para disminuir los síntomas posconmoción.(AU)
Introduction: Currently, concussion considers a problem of great magnitude, adolescents and young people being the population at risk, since it is in the process of maturation. Our goal has been to compare the effectiveness of different interventions (exercise therapy, vestibular rehabilitation and rest) in adolescents and young people with concussion. Development: A bibliographic search was carried out in the main databases. Once the inclusion / exclusion criteria and the PEDro methodological scale were applied, 6 articles were reviewed. The results support the use of exercise and vestibular rehabilitation in the initial stages to reduce post-concussion symptoms. According to most authors, therapeutic physical exercise and vestibular rehabilitation report greater benefits, although a protocol that unifies assessment scales, study variables and analysis parameters would be needed to be able to make the inference in the target population. Conclusión: From the moment of hospital discharge, the combined application of exercise and vestibular rehabilitation could be the best option to reduce post-concussion symptoms.(AU)
Assuntos
Humanos, Masculino, Feminino, Adolescente, Adulto Jovem, Síndrome Pós-Concussão, Exercício Físico, Concussão Encefálica, Lesões Encefálicas Traumáticas, Neurologia, Doenças do Sistema NervosoRESUMO
Introducción La trombosis portal (TVP) es la causa más frecuente de hipertensión portal en población pediátrica. El Consenso de Baveno VI considera la ligadura endoscópica de varices como segunda opción terapéutica tras el meso-Rex-bypass (shunt quirúrgico). Objetivo Analizar la rentabilidad diagnóstica de escalas no invasivas para predecir el riesgo de varices esofágicas en niños con TVP. Material y métodos Estudio descriptivo retrospectivo donde se incluyeron endoscopias digestivas altas (EDA) en pacientes<15 años con TVP no cirróticos. Se dividieron según la presencia de varices esofágicas y se estudiaron sexo, etiología, edad, hemorragia digestiva o tratamientos previos, resultados de EDA y las escalas (Regla Predicción Clínica-CPR, Regla Predicción Varices-VPR, King's Variceal Prediction Score-K-VaPS y ratio plaquetas/bazo-RPB). Las variables cualitativas se expresaron mediante frecuencia absoluta y porcentaje, y las cuantitativas mediante mediana y rango intercuartílico. Para las comparaciones se emplearon los test U de Mann-Whitney y Hanley-McNeil. Resultados Se realizaron 45 EDA. Un 80%(n=36) presentaron varices esofágicas: mediana de 3(2 3) y un 33,3%(n=12) precisó ligadura endoscópica de varices. Se demostraron diferencias estadísticamente significativas entre ambos grupos: CPR (142,39 [132,22 - 166,53] vs. 122,75 [115,24 133,15] p=0,003), VPR (9,91 [9,36 11,75] vs. 5,6 [3,34 8,39] p=0,001), K-VaPS (117,86 [99,66 - 126,58] vs. 99,64 [94,88 - 110,18] p=0,019), RPB (2384,62 [1902,22 - 3201,63] vs. 1252,5 [579,6 - 2144,42] p=0,05), con un área bajo la curva>75%, sin demostrarse diferencias entre escalas. Conclusiones En pacientes pediátricos con TVP no cirróticos se pueden emplear escalas no invasivas como herramienta para predecir la presencia de VE y plantear con ello la indicación de EDA. (AU)
Introduction Portal vein thrombosis (PVT) is the most frequent cause of portal hypertension in paediatric population. Baveno VI Consensus considers endoscopic variceal ligation as the second therapeutic option after meso-Rex bypass (surgical shunt). Aim Analyse the diagnostic profitability of non-invasive scales in order to predict the risk of oesophageal varices (OV) in children with PVT. Material and methods Descriptive retrospective study where every upper gastrointestinal endoscopy (UGE) carried on patients <15 years old with non-cirrhotic PVT were included. There were divided according to the presence of OV and sex, cause, age, previous gastrointestinal bleeding or treatments, results of UGE and scales (Clinical Prediction Rule CPR), Varices Prediction Rule VPR), King's Variceal Prediction Score K-VaPS) and Platelet count/Spleen diameter Ratio PSR). Qualitative variables were expressed as absolute frequency and percentage, and quantitative variables as median and interquartile range. U MannWhitney and HanleyMcNeil tests were used for comparisons. Results Forty-five UGE were analysed. 80% (n=36) presented OV: median of 3 (23) and 33.3% (n=12) required endoscopic variceal ligation. Statistical differences were demonstrated between both groups: CPR (142.39 [132.22-166.53] vs. 122.75 [115.24-133.15]; p=0.003), VPR (9.91 [9.36-11.75] vs. 5.6 [3.34-8.39]; p=0.001), K-VaPS (117.86 [99.66-126.58] vs. 99.64 [94.88-10.18]; p=0.019), PSR (2384.62 [1902.22-3201.63] vs. 1252.5 [579.6-2144.42]; p=0.05), with and area under the curve AUROC>75%, without statistical differences between scales. ConclusionsIn paediatric patients with non-cirrotic PVT non-invasive scales can be used as a tool to predict the presence of OV and raise the indication of UGE. (AU)
Assuntos
Humanos, Masculino, Feminino, Criança, Adolescente, Varizes Esofágicas e Gástricas/diagnóstico por imagem, Varizes Esofágicas e Gástricas/diagnóstico, Trombose Venosa/diagnóstico por imagem, Trombose Venosa/diagnóstico, Trombose, Ligadura, Epidemiologia Descritiva, Estudos RetrospectivosRESUMO
Introducción Las miopatías genéticas constituyen un conjunto de enfermedades raras que impactan significativamente en la funcionalidad y la calidad de vida del paciente. Un diagnóstico temprano de las miopatías genéticas puede prevenir complicaciones futuras y proporcionar a las familias asesoramiento genético. A pesar del impacto sustancial de las miopatías genéticas en población adulta, la epidemiología global de estos trastornos está inadecuadamente abordada en la bibliografía.ObjetivosMejorar el entendimiento tanto de la epidemiología como de la genética de estos trastornos en la provincia de Alicante, situada en el sureste de España. Material y métodos. Entre 2020 y 2022, se llevó a cabo un estudio observacional prospectivo en el área de salud Alicante-Hospital General, que incluyó a pacientes de 16 años o más con sospecha de miopatías genéticas. Se recopilaron datos sociodemográficos, clínicos y genéticos. La fecha de referencia para el cálculo de la prevalencia se estableció el 31 de diciembre de 2022. Se utilizaron datos demográficos oficiales del área de salud para establecer la población en riesgo.ResultadosEn total, se identificó a 83 pacientes con miopatía genéticamente confirmada, lo que dio lugar a una prevalencia total de 29,59 casos por cada 100.000 habitantes. El rendimiento diagnóstico de las pruebas genéticas moleculares fue del 69,16%. Las miopatías genéticas más frecuentes incluyeron la distrofia miotónica (27,5%), las distrofinopatías (15,7%) y la distrofia facioescapulohumeral (15,7%).ConclusiónLa prevalencia de las miopatías genéticas puede variar considerablemente dependiendo de la región geográfica y la población estudiada. El análisis del rendimiento diagnóstico sugiere que los estudios genéticos deberían considerarse útiles en el diagnóstico de las miopatías genéticas. (AU)
Introduction. Genetic myopathies constitute a collection of rare diseases that significantly impact patient functionality and quality of life. Early diagnosis of genetic myopathies can prevent future complications and provide families with genetic counselling. Despite the substantial impact of genetic myopathies on the adult population, the global epidemiology of these disorders is inadequately addressed in the literature.Aims. To enhance understanding of both the epidemiology and genetics of these disorders within the province of Alicante, situated in southeastern Spain.Material and methods. Between 2020 and 2022, a prospective observational study was conducted at the Alicante Health Area-General Hospital, enrolling patients aged 16 years or older with suspected genetic myopathies. Sociodemographic, clinical, and genetic data were collected. The reference date for prevalence calculation was established as December 31, 2022. Official demographic data of the health area were used to set the population at risk.Results. In total, 83 patients were identified with confirmed genetically related myopathy, resulting in an overall prevalence of 29.59 cases per 100,000 inhabitants. The diagnostic yield for molecular genetic testing was found to be 69.16%. The most prevalent genetic myopathies identified included myotonic dystrophy (27.5%), dystrophinopathies (15.7%), and facioscapulohumeral dystrophy (15.7%).Conclusion. The prevalence of GMs can vary considerably depending on the geographical region and the studied population. The analysis of diagnostic yield suggests that genetic studies should be considered useful in the diagnosis of genetic myopathies. (AU)
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Humanos, Masculino, Feminino, Adolescente, Adulto Jovem, Adulto, Pessoa de Meia-Idade, Idoso, Doenças Musculares, Doenças Musculares/congênito, Doenças Musculares/epidemiologia, Estudos Transversais, Espanha/epidemiologiaRESUMO
AIM: The aim of this study was to evaluate specific single nucleotide polymorphisms (SNP) of transforming growth factor-beta (TGF-ß) (rs1800469) and insulin-like growth factor-1 (IGF-1) (rs17032362) genes in Class II individuals with a normal maxilla and retrognathic (short) mandible.
Assuntos
Fator de Crescimento Insulin-Like I, Má Oclusão Classe II de Angle, Mandíbula, Polimorfismo de Nucleotídeo Único, Fator de Crescimento Transformador beta, Humanos, Fator de Crescimento Insulin-Like I/genética, Fator de Crescimento Transformador beta/genética, Masculino, Feminino, Má Oclusão Classe II de Angle/genética, Retrognatismo/genética, Adolescente, Adulto, Peptídeos Semelhantes à InsulinaRESUMO
INTRODUCTION: Dural closure is an important part of neurosurgery, failure which may lead to wound infection, pseudomeningoceles, meningitis, severe morbidity to a patient, and even mortality. In cases where primary dura closure is not possible, a bovine pericardial patch is a good alternative with the benefits of suturability and the ability to provide watertight closure, hence preventing Cerebrospinal Fluid (CSF) leak. The present study demonstrates the use of the bovine pericardial patch in both cranial and spinal disorders for dural closure as well as for transposition technique in microvascular decompression. OBJECTIVES: The aim of our study is to understand the advantages and feasibility of a bovine pericardial patch in various neurosurgical procedures. MATERIAL METHODS: Fifty-one patients were analyzed prospectively and followed up in which glutaraldehyde-free bovine pericardial patch was used in various cranial and spinal disorders. RESULTS: The most common indications where a bovine pericardial patch was used, in decreasing order of frequency, were meningioma excision surgery (47%), followed by Chiari malformation operated for foramen magnum decompression (17.6%), meningomyelocele (7.8%), spinal dural defects (7.8%), trigeminal neuralgia (5.8%), traumatic decompression with lax duraplasty (4%), glioma (4%), encephalocele (4%), and skull base defects (2%). Two patients had complications, one with CSF leak and the other had superficial wound infection, which were managed appropriately. CONCLUSIONS: The use of a bovine pericardial patch as a dural substitute in various cranial and spinal disorders is feasible with good outcomes, and it can be considered an ideal dural substitute.
Assuntos
Procedimentos Neurocirúrgicos, Pericárdio, Humanos, Pericárdio/cirurgia, Bovinos, Masculino, Feminino, Adulto, Pessoa de Meia-Idade, Procedimentos Neurocirúrgicos/métodos, Animais, Dura-Máter/cirurgia, Idoso, Adolescente, Adulto Jovem, Estudos Prospectivos, CriançaRESUMO
BACKGROUND: In neurosurgical practice, continuous care after discharge and the ability to detect subtle indicators of clinical deterioration are mandatory to prevent the progression of a disease. The care of 'unknown' patients discharged to rehabilitation homes may not have this privilege, especially in resource-poor countries such as India. OBJECTIVE: We have attempted to study the causes and outcomes of re-admissions of 'unknown' patients with previous traumatic brain injury (TBI) to estimate the quality of nursing care in our rehabilitation centers. MATERIAL AND METHODS: The electronic hospital records of all consecutive 'unknown' TBI patients with unplanned re-admissions at our institute from January 2014 to December 2018 were retrospectively reviewed and analyzed for the factors determining the risk and outcomes of re-admission. RESULTS: Out of 245 patients sent to rehabilitation homes at discharge, 47 patients (19.18%) were re-admitted. A total of 33 patients (70%) were re-admitted between 1 month and 1 year. Out of these, 38 patients (80.9%) were re-admitted because of preventable causes. Fifteen patients (31.9%) died during the hospital stay. The rest of the 32 (68%) patients were discharged after the management of the concerned condition with an average hospital stay of 9 ± 11.1 days. The average Glasgow coma scale (GCS) at re-admission of the patients who died was 6 (range 3-11). Two patients were brought in the brain dead status, whereas 20 patients (42.6%) had a GCS of 5 or below at the time of re-admission. The risk of mortality among patients with non-preventable causes was 88.9% (8/9) compared to preventable causes 18.4% (7/38). However, preventable causes for re-admission are much more common, resulting in nearly a similar overall contribution to mortality. CONCLUSIONS: There is a high rate of mortality and morbidity in 'unknown' patients with TBI because of poor post-discharge care in developing countries. Because preventable causes are the major contributor to re-admissions, the re-admission rate is a good indicator of a lack of adequate rehabilitative services. The need for improving the post-discharge management of 'unknown' patients with TBI in resource-poor countries cannot be over-emphasized.
Assuntos
Lesões Encefálicas Traumáticas, Países em Desenvolvimento, Readmissão do Paciente, Humanos, Lesões Encefálicas Traumáticas/reabilitação, Lesões Encefálicas Traumáticas/mortalidade, Masculino, Feminino, Índia, Adulto, Readmissão do Paciente/estatística & dados numéricos, Estudos Retrospectivos, Pessoa de Meia-Idade, Escala de Coma de Glasgow, Centros de Reabilitação, Adulto Jovem, Tempo de Internação/estatística & dados numéricos, Alta do Paciente/estatística & dados numéricos, AdolescenteRESUMO
BACKGROUND AND AIM: Chronic subdural hematoma (CSH) refers to intracranial hemorrhages frequently caused by minor head trauma and is mostly seen in middle and advanced age. One of the hypotheses regarding the development of CSH is that the inflammatory cascade plays a pivotal role in this process. MATERIALS AND METHODS: The inclusion criteria covered patients in all ages who were diagnosed as CSH by computed tomography and/or magnetic resonance imaging and treated by surgical intervention in our clinic between 2018 and 2020. Patient files were reviewed retrospectively, and medical records of age, gender, trauma history, unilateral or bilateral lesion, and leukocyte, neutrophil, lymphocyte, monocytes, and platelet counts were obtained. Receiver operating characteristic (ROC) analysis was used for the most appropriate neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and age discrimination in the presence of CSH, and multiple logistic regression analyses were used to determine the effect of independent factors on dependent variables. RESULTS: A total of 68 cases, 57 (83.8%) male and 11 (16.2%) female, aged between 13 and 93, were included in the study. The mean age of the patients included in the study was 72.59 ± 13.13 years. NLR of the cases ranged from 1.37 to 34.18, with a mean of 6.53 ± 6.74 and a median of 3.57. NLR and PLR were found to be statistically significantly higher in CSH patients compared to the healthy control group, and the cut-off values for NLR, PLR, and age were 2.8, 132, and 55, respectively. Age and NLR were found to be independent factors associated with CSH (P < 0.05). CONCLUSION: As seen from the results of this study, peripheral blood values in CSH patients may be significantly higher than in the healthy control group, while they are below the normal laboratory cut-off values.
Assuntos
Biomarcadores, Hematoma Subdural Crônico, Humanos, Masculino, Feminino, Hematoma Subdural Crônico/sangue, Hematoma Subdural Crônico/diagnóstico por imagem, Hematoma Subdural Crônico/diagnóstico, Pessoa de Meia-Idade, Idoso, Adulto, Idoso de 80 Anos ou mais, Estudos Retrospectivos, Biomarcadores/sangue, Adulto Jovem, Adolescente, Neutrófilos, Linfócitos, Inflamação/sangueRESUMO
IMPORTANCE: Static picture (SP) schedules are an established intervention for children with autism spectrum disorder (ASD), but the use of video modeling (VM) has not been thoroughly investigated. OBJECTIVE: To compare the effectiveness of VM prompts versus SP prompts in improving autistic children's independence with daily living skills. DESIGN: An experimental alternating treatment design. SETTING: Approved private school for children with disabilities. PARTICIPANTS: Seventeen participants (13 male and 4 female; ages 9-18 yr) with an ASD diagnosis. INTERVENTION: Visual prompts using a tablet were provided during task participation, with data collected in two phases. OUTCOMES AND MEASURES: Type and frequency of the prompts required to complete the task were documented for each participant during the intervention session. RESULTS: Both VM and SP conditions resulted in improvements in at least one phase. Most participants demonstrated a decrease in the number of required cues to complete the task and an increase in independence to complete the task. The decrease in number of cues required from baseline to end of data collection indicated clinically meaningful improvement in task completion. CONCLUSION: Both VM and SP prompts resulted in an increase in independence in daily living skills, with most participants demonstrating improvement in either condition, indicating that the use of visual prompts (either VM or SP) is effective with the ASD population. Plain-Language Summary: Occupational therapy practitioners who work with autistic children and adolescents often identify improving daily living skills as a goal area. Findings from this study build on evidence that supports the use of a visual aid (either static picture or video modeling) to improve autistic children's acquisition of daily living skills. The findings also highlight emerging evidence related to the level of function and effectiveness associated with the type of visual cue. Positionality Statement: This article primarily uses identity-first language (i.e., autistic person) and at times person-first language (i.e., person with autism) to reflect the variability in the language preferences of the autism community (Lord et al., 2022).
Assuntos
Atividades Cotidianas, Transtorno do Espectro Autista, Terapia Ocupacional, Humanos, Criança, Feminino, Masculino, Adolescente, Terapia Ocupacional/métodos, Transtorno do Espectro Autista/reabilitação, Sinais (Psicologia), Gravação em VídeoRESUMO
OBJECTIVE: Aim: The current study introduces a novel diagnostic algorithm employing bioimpedance analysis to comprehensively evaluate body composition in children, assessing fat content, skeletal muscle content, and fat distribution. PATIENTS AND METHODS: Materials and Methods: Bioelectrical impedance measurements were obtained using the TANITA MC-780 MA analyzer. Indicators such as body weight, BMI, total fat content, absolute limb muscle mass, skeletal muscle strength, and waist-to-hip ratio (WHR) were assessed. A sample of 101 children aged 9 to 14 were studied using the proposed algorithm, refining BMI-based classifications. RESULTS: Results: The algorithm comprises three steps, categorizing children based on fat content, presence of sarcopenia, and central fat distribution. It identified diverse somatotypes within the groups classified by BMI. Notably, it revealed prognostically unfavorable somatotypes, such as sarcopenic obesity with central fat distribution, highlighting potential health risks. Current BMI-centric diagnoses may misclassify cardiometabolic risks, making early detection challenging. The algorithm enables a detailed evaluation, unmasking metabolically unfavorable conditions like sarcopenic obesity. The incorporation of functional tests, such as a standardized hand-grip test, enhances diagnostic accuracy. The proposed WHR indicator for characterizing fat distribution provides a practical method for determining somatotypes in children. CONCLUSION: Conclusions: This comprehensive algorithm offers an alternative to BMI-based classifications, enabling early detection of obesity and associated risks. Further validation through large-scale epidemiological studies is essential to establish correlations between somatotypes and cardiometabolic risks, fostering a more nuanced and individualized approach to pediatric obesity management.
Assuntos
Composição Corporal, Impedância Elétrica, Obesidade Infantil, Humanos, Criança, Masculino, Feminino, Adolescente, Obesidade Infantil/diagnóstico, Índice de Massa Corporal, Sobrepeso/diagnóstico, AlgoritmosRESUMO
OBJECTIVE: Aim: Dynamic comparison of the lower limbs length, depending on the type of sport, followed by the construction of a mathematical model for predicting sports abilities. PATIENTS AND METHODS: Materials and Methods: The comparison of the lower limbs length in dynamics was carried out on 132 students of higher education institutions of Bukovyna. While the primary study was carried out during September-October 2021, next study of these same students was conducted in September-October 2022. The main group consists of 92 (69.7%) students, the control group - 40 (30.30%) students aged 16 to 18 years. All students underwent an anthropometric study (determination of the length of the lower limbs) according to the method of P.P. Shaparenka. The comparesment of anthropometric parameters in the main group depending on the type of sport used the Kruskel-Wallis test (non-parametric analysis of variance) in order to identify a reliable difference in the average indicators of the respondents depending on the type of sport (the median of the distribution was considered as a measure of central tendency). In order to establish which pairs of age groups had a statistical difference in the medians, the Conover-Iman test was used. A paired t-test (t-test of paired samples) was performed to compare the length of the respondents' lower limbs during the first measurement and again one year later. Statistical analysis of the obtained data was performed using the licensed RStudio program. RESULTS: Results: The distribution of the length of the right lower limb of the respondents of the main group by measurement shows that the average value of the length of the right lower limb has changed: a significant difference in the length of the right lower limb was found between the first (M = 88.812, SD = 5.287) and the second (M = 89.377, SD = 5.347) measurements; t (68) = -5.223, p < 0.001. The distribution of the length of the left lower limb shows that the average value of the length of the left lower limb has changed also: a significant difference in the length of the left lower limb was found between the first (M = 88.667, SD = 5.266) and the second (M = 89.435, SD = 5.309) measurements; t (68) = -8.289, p < 0.001. CONCLUSION: Conclusions: In order to dynamically compare the length of the lower limbs for comprehensive control and selection of promising students in football, volleyball, handball and basketball, a mathematical model was derived for predicting the length of the lower limbs, in corresponding sports: right lower limb y = 0.506 x and left y = 0.507x, where y - is the length of the left lower limb, x - is the height. The coefficient of determination is 99.8%. A significant predictor for the length of both lower limbs is the height.
Assuntos
Extremidade Inferior, Estudantes, Humanos, Adolescente, Masculino, Feminino, Estudantes/estatística & dados numéricos, Antropometria, Esportes, UniversidadesRESUMO
OBJECTIVE: Aim: To analyze the data and evaluate the prevalence of ocular lesions in patients with moderate ulcerative colitis. PATIENTS AND METHODS: Materials and Methods: We observed 112 patients aged 18-75 years old with clinically, endoscopically and histologically confirmed moderate ulcerative colitis which lasted at least 6 months. An ophthalmologic exam was performed to determine the presence of ocular symptoms. RESULTS: Results: Of the 112 patients with moderate ulcerative colitis, 21 (18,75%) had the following ocular lesions: episcleritis - 7 patients (6,25%), keratopathy - 5 patients (4,46%), uveitis - 5 patients (4,46%), cataract - 2 (1,78%) and scleritis - 2 (1.78%). CONCLUSION: Conclusions: Because ocular symptoms in patients with UC are often nonspecific, it may be beneficial to perform ophthalmologic examinations as a routine follow-up component of in such patients.
