Background
Deep-brain stimulation (DBS) programming for dystonia patients is a complex and time-consuming task.
Objective
To analyze whether programming a programming paradigm based on patient’s ...self-adjustment is practical, effective and time saving in dystonia.
Methods
We retrospectively compared dystonia rating scales as well as the time necessary to optimize programming and the number of in-hospital visits in all patients (
n
= 102) operated at our center who used simple mode (SM) or advanced mode (AM) programming; the latter uses groups of different stimulation parameters and allows the patient and their caregiver to change stimulation groups at home, using the patient remote control.
Results
Both AM- and SM-allocated patients improved clinically to the same extent after DBS, as assessed by the Burke–Fahn–Marsden (BFM) and the Toronto Western Spasmodic Torticollis (TWSTRS) dystonia rating scales. All subscores improved after DBS without statistically significant differences in improvement between AM and SM (BFM: − 43% vs. − 53%,
p
= 0.569; TWSTRS: − 63% vs. − 72%,
p
= 0.781). AM and SM patients reached optimization within a similar median time 5.5 months (95% CI 4.6–6.3) for AM vs. 6.2 months (4.2–7.6) for SM,
p
= 0.674) but patients on advanced programming needed fewer in-hospital visits to achieve the same improvement median of 5 visits (95% CI 4–7) for AM vs. 8 visits (7–9) for SM,
p
= 0.008.
Conclusions
Advanced DBS programming based on patient’s self-adjustment under the supervision of the treating physician is feasible, practical and significantly reduces consultation time in dystonia patients.
This paper describes a methodology for comparing the effects of an eduentertainment strategy involving a music concert, and a participatory class experience involving the description and making of a ...healthy breakfast, as educational vehicles for delivering obesity-preventing/cardiovascular health messages to children aged 7-8 years.
This study will involve a cluster-randomised trial with blinded assessment. The study subjects will be children aged 7-8 years of both sexes attending public primary schools in the Madrid Region. The participating schools (n=30) will be randomly assigned to one of two groups: 1) Group MC, in which the children will attend a music concert that delivers obesity-preventing/cardiovascular health messages, or 2) Group HB, in which the children will attend a participatory class providing the same information but involving the description and making of a healthy breakfast. The main outcome measured will be the increase in the number of correct answers scored on a knowledge questionnaire and in an attitudes test administered before and after the above interventions. The secondary outcome recorded will be the reduction in BMI percentile among children deemed overweight/obese prior to the interventions. The required sample size (number of children) was calculated for a comparison of proportions with an α of 0.05 and a β of 0.20, assuming that the Group MC subjects would show values for the measured variables at least 10% higher than those recorded for the subjects of Group HB. Corrections were made for the design effect and assuming a loss to follow-up of 10%. The maximum sample size required will be 2107 children. Data will be analysed using summary measurements for each cluster, both for making estimates and for hypothesis testing. All analyses will be made on an intention-to-treat basis.
The intervention providing the best results could be recommended as part of health education for young schoolchildren.
Clinicaltrials.gov: NCT01418872.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Virtual Communities of Practices (vCoP) offer patients the possibility to interact and share tools and knowledge necessary for their empowerment. This paper describes the co-design process of a vCoP ...for the empowerment of people with ischemic heart disease (IHD).
We used a modified experience-based design approach to co-design the vCoP in collaboration with people with IHD and health professionals consisting of two phases: exploratory and development phase. Data collection techniques included listening labs, workshops, and online participation.
Twenty-five people with IHD and ten health professionals participated. Experiences and needs for empowerment in IHD were identified in the exploratory phase allowing for the development of a Patient Journey Map. In the development phase, people with IHD prioritized needs to be addressed by the vCoP content framework in addition to content proposals.
The Patient Journey Map helped to easily visualize the empowerment needs of people with IHD and it might be transferable for the development of other people-centred interventions. The co-design process also allowed the development of training materials adapted to the priorities of people with IHD.
A people-centred co-design process of a vCoP may facilitate the empowerment of people with IHD.
Status dystonicus induced by deep brain stimulation surgery Ruiz-Lopez, Marta; Munhoz, Renato P; Kalia, Suneil K ...
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology,
03/2020, Letnik:
41, Številka:
3
Report
The role of exosomes on colorectal cancer: A review Ruiz‐López, Lidia; Blancas, Isabel; Garrido, José M ...
Journal of gastroenterology and hepatology,
April 2018, 2018-Apr, 2018-04-00, 20180401, Letnik:
33, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Exosomes are extracellular microvesicles released from cells, which are involved in many biological and pathological processes, mainly because of their role in intercellular communication. Exosomes ...derived from colorectal cancer (CRC) cells are related to oncogenesis, tumor cell survival, chemo‐resistance, and metastasis. The role of the exosomes in these processes involves the transfer of proteins, RNAs, or mutant versions of proto‐oncogenes to the target cells. In recent years, great efforts have been made to identify useful biomarkers in CRC exosomes for diagnosis, prediction of prognosis, and treatment response. This review focuses on recent studies on CRC exosomes, considering isolation, cargo, biomarkers, and the effects of exosomes on the development and progression of CRC, including resistance to antitumor therapy.
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