To compare home-based rehabilitation (RITH) and standard outpatient rehabilitation in a hospital setting, in terms of improving the functional recovery and quality of life of stroke patients.
This ...was a prospective cohort study in Andalusia (Spain).
One hundred and forty-five patients completed the outcome data.
Daily activities were measured by the Barthel index, Canadian Neurological Scale (to assess mental state), Tinetti scale (balance and gait), and Short Form Health Survey-36 (SF-36 to compare the quality of life).
No statistically significant differences were found between the two groups regarding the clinical characteristics of patients in the initial measurement, except for age and mental state (younger and with greater neurological impairment in the hospital group). After physical therapy, both groups showed statistically significant improvements from baseline in each of the measures. These improvements were better in RITH patients than in the hospital patients on all functionality scales with a smaller number of sessions.
Home rehabilitation is at least as effective as the outpatient rehabilitation programs in a hospital setting, in terms of recovery of functionality in post-stroke patients. Overall quality of life is severely impaired in both groups, as stroke is a very disabling disease that radically affects patients' lives.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Physical training at home by making individuals play active video games is a new therapeutic strategy to improve the condition of patients with cystic fibrosis (CF). We reviewed studies on the use of ...video games and their benefits in the treatment of CF. We conducted a systematic review with data from six databases (PubMed, Medline, Scopus, Web of Science, PEDro, and Cochrane library plus) since 2010, according to PRISMA standards. The descriptors were: "Cystic Fibrosis", "Video Game", "Gaming Console", "Pulmonary Rehabilitation", "Physiotherapy", and "Physical Therapy". Nine articles with 320 participants met the inclusion criteria and the study objective. Patients who played active video games showed a high intensity of exercise and higher ventilatory and aerobic capacity compared to the values of these parameters in tests such as the cardiopulmonary stress test or the six-minute walk test. Adequate values of metabolic demand in these patients were recorded after playing certain video games. A high level of treatment adherence and satisfaction was observed in both children and adults. Although the quality of the included studies was moderate, the evidence to confirm these results was insufficient. More robust studies are needed, including those on evaluation and health economics, to determine the effectiveness of the treatment.
(1) Background: The aim of this systematic review was to compare the cost-effectiveness of two follow-up methods (face-to-face and telemedicine) used in dermatology in the last ten years. (2) ...Methods: A search for articles that included economic analyses was conducted in August 2021 in the databases PubMed, Medline, Scielo and Scopus using the following keywords: "Cost-Benefit Analysis", "Dermatology", "Telemedicine", "Primary Health Care", as well as other search terms and following the PICOS eligibility criteria. (3) Results: Three clinical trials and five observational studies were analyzed, providing information for approximately 16,539 patients (including four cost-minimization or saving analyses, three cost-effectiveness analyses, and one cost-utility analysis) in Europe and the United States. They describe the follow-up procedures in each of the cases and measure and analyze the direct and indirect costs and effectiveness. All the articles indicate that teledermatology lowers costs and proves satisfactory to both patients and professionals. (4) Conclusions: Although it has been found that follow-up via teledermatology can be more efficient than traditional hospital follow-up, more work is needed to establish evaluation protocols and procedures that measure key variables more equally and demonstrate the quality of the evidence of said studies.
The purpose of health and social policies is to encourage older people more longevity, remain free of disability and experience quality of life while living in their homes. The aim of this study was ...to describe the characteristics of 473 patients diagnosed with motor impairment in primary care, the objectives of home-based rehabilitation and its functional impact.
This prospective observational study was conducted in the Almería Health District. The analysed variables included age, gender, secondary diagnosis, Barthel Index (BI), physiotherapeutic objectives and techniques, and number of sessions.
The sample had a mean age of 83 years, and 59% were women. The assessed conditions with a high prevalence included osteoarticular pathology (55%), Alzheimer's disease (15.1%), cardiovascular disease (13.7%) and stroke (6.5%). The techniques applied mainly consisted of functional exercises (57.1%), caregiver education (13.8%), and technical assistance (5.7%). There were statistically significant differences (t = -15.79; p < 0.001) between initial (X = 34.8) and final BI (X = 48.1), with an improvement of 13.4 points in patients' functional capacity (95% confidence interval CI: -15.0 to -11.7). An equation was constructed to predict patients' final BI as a function of the initial BI using a multiple linear regression model. The regression model explained 78% of the variance in patients with motor impairment.
Important improvements were obtained in terms of functional capacity with a mean of ten sessions of physiotherapy. Lower patient age was correlated with higher initial and final functional capacities in primary care. This study aimed to present a useful starting point for decision making among management and health administration regarding this population group by approaching the process from the reality of practice and in relation to the rehabilitation provided.
ClinicalTrials.gov identifier: NCT02715245 ; Date of registration: 18 January 2016.
The health-related quality of life (HRQoL) of the patients cared for with teledermatology (TD) services was analyzed as compared with face-to-face dermatology (F-F/D) at the hospital. This study was ...a controlled, non-blinded, intra-level, and multicenter randomized clinical trial, with a 6-month follow-up. A total of 450 patients were randomly assigned to two different groups. The Spanish version of the generic EuroQol-5-dimensions-5-Levels (EQ-5D-5L) questionnaire and the specific Skindex-29 questionnaire were used at 0 and 6 months. The number of primary care visits (2.24 TD; 1.68 F-F/D) and number of hospital visits (0.01 TD; 1.48 F-F/D) were statistically significant. It was observed that from month 0 onwards, the users included in the F-F/D group self-perceived a lower HRQoL than the users included in the TD group (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). At the end of the study, the patients included in the F-F/D group still obtained lower scores in their perception of HRQoL, as compared to those included in the other type of follow-up (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). TD was an effective diagnosis and follow-up tool. At the end of the study period, the HRQoL of the patients in both groups was significantly higher as compared to their baseline levels. Additionally, both the general and specific HRQoL perceived by the TD patients was higher than the F-F/D group from the start of the study.
This study aimed to evaluate the functional impact of a shared intervention model by the mobile physiotherapy and rehabilitation team (MPRT) and primary care case management nurses (PCCMNs) on ...chronic patients. This was a prospective, observational study involving 1086 patients (mean age, 80 years; 63.7% females) in the province of Almeria, which was conducted between 2004 and 2018. Most of the registered diseases included cerebrovascular and neurological diseases (56.7%), osteoarticular diseases (45.3%), diabetes mellitus (25.7%), cardiovascular diseases (25.5%), and chronic respiratory diseases. The study included a home care intervention by the MPRT and PCCMNs and included the following main outcome measures: age, sex, main caregiver, disabling process (ICD-9), type and number of inclusion categories for chronic disease, initial and final Barthel index (BI), treatment or intervention on the patient (techniques), objectives, and number of sessions. The main techniques used were kinesiotherapy (44.6%) and caregiver training (23%), along with technical aid. An equation predicting the patients' final BI, according to the initial BI, was constructed using multiple linear regression modelling. A marked improvement in functional capacity was found after an average of 10 physiotherapy sessions. A lower patient age was correlated with a higher functional capacity, both initial and final BI, as well as a greater number of sessions.
Objetivo: describir la percepción que tienen 201 enfermeros en relación a la Seguridad del Paciente (SP) en sus centros, valorar cuáles son los puntos fuertes y las áreas de mejora en los Distritos ...Sanitarios de la provincia de Almería.Metodología: Se ha utilizado el cuestionario denominado MOSPSC (Medical Office Survey on Patient Safety Culture), traducido, adaptado y validado para profesionales españoles de Atención Primaria. A través del programa estadístico SPSS, se calculó la media y el intervalo de confianza al 95% de cada una de las dimensiones del cuestionario.Resultados: se observa una percepción positiva de la SP en casi todas las dimensiones, a excepción de la “Comunicación sobre el error”, el “Seguimiento de la atención a los pacientes”, la “Comunicación franca” y el “Ritmo y Carga de trabajo”. Uno de los puntos fuertes de los enfermeros es el “trabajo en equipo”.Conclusiones: Los resultados de esta investigación también han destacado “el intercambio de información con otros equipos”; en cambio, entre las áreas de mejora que deberían tenerse en cuenta se halla, “la Comunicación franca y sobre el error”. Estos resultados deberían ayudar a evaluar la importancia de la SP en las organizaciones, para dialogar sobre los errores y crear un clima de aprendizaje y deseo de mejora en los profesionales que repercuta en la calidad de la atención ofrecida a los usuarios.
In this research, evaluation instruments were designed that allow measuring the impact on the development of specific
competences and the graduation profile that is had when introducing physics ...laboratory practices in engineering
students at the Polytechnic University of San Luis Potosí (UPSLP) and the University of Guanajuato (UG). These
physics laboratory practices have a didactic design that addresses the teaching-learning processes, developing skills in
the student that already presents different characteristics from traditional training, such as the use of videos, materials
and instruments designed and printed in 3D. The evaluation is not oriented only to knowledge of disciplinary physics,
but also to how the skills developed impact the student's graduation profile, considering the specific engineering
program. For this work, 4 cases of engineering programs are presented: Industrial, Information Technology,
Environmental and Civil.
En este trabajo de investigación se diseñaron instrumentos de evaluación que permiten medir el impacto en el
desarrollo de competencias específicas y el perfil de egreso que se tiene al introducir prácticas de laboratorio de física
en estudiantes de ingeniería de la Universidad Politécnica de San Luis Potosí (UPSLP) y de la Universidad de
Guanajuato (UG). Estas prácticas de laboratorio de física tienen un diseño didáctico que abordan los procesos de
enseñanza-aprendizaje, desarrollando habilidades en el estudiante ya que presenta características diferentes a la
formación tradicional, tales como el uso de vídeos, materiales e instrumentos diseñados e impresos en 3D. La
evaluación no va orientada solamente a conocimientos de física disciplinar, sino, además de cómo impactan las
habilidades desarrolladas en el perfil de egreso del estudiante, tomando en cuenta el programa de ingeniería específico.
Para este trabajo se presentan para 4 casos de programas de ingeniería: Industrial, Tecnologías de la Información,
Ambiental y Civil.
Abstract We present the case of a 1-month-old female with repaired gastroschisis who presented with pneumatosis ani as the initial manifestation of necrotizing enterocolitis (NEC). NEC may present in ...as much as 20% of patients with gastroschisis. This relationship should prompt urgent evaluation and management as soon as any sign or symptom of the disease appears. Even though pneumatosis ani is a rare clinical finding, the anal region should always be examined in all patients where NEC is suspected.
Rheumatoid arthritis (RA) affects approximately 1.5% of the population worldwide and 0.5–3.3% of the Mexican population. The presence of rheumatoid factor (RF), anti‐citrullinated protein antibodies ...(ACPA) and anti‐carbamylated protein (anti‐CarP) antibodies has been described in populations at risk of RA development, such as first‐degree relatives (FDR). Anti‐CarP antibodies are present in RA patients (44%), FDR of RA patients (18%) and healthy controls (4.7%). Anti‐CarP antibodies have not been described in FDR of the Mexican population. The objective of this study was to determine the prevalence of Rheumatoid Factors (RF) isotypes, ACPA and anti‐CarP antibodies isotypes in FDR of RA patients. An observational, cross‐sectional study, in an FDR of RA cohort, was performed. We measured IgA, IgG and IgM isotypes of RF, ACPA and anti‐CarP antibodies. A total of 144 FDRs from 99 RA patients were enrolled. The prevalence of anti‐CarP antibodies was 2.8% for IgA, 4.2% for IgG, whereas IgM was not detected. The serologic association was for RF/ACPA 4.48%, RF/anti‐CarP 2.7%, FR 64.5%, ACPA 1.3%, ACPA/anti‐CarP 0.69%, anti‐CarP 3.4%, and no RF/ACPA/anti‐CarP was observed. We found a low prevalence of anti‐CarP antibodies in our cohort of FDR of RA patients, but the prevalence of ACPA and RF were higher than other cohorts previously reported.
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