Background
The emotional state of parents of babies with Down syndrome affects their babies' development and their parent–child bonding. The aim for this study was to conduct a pilot randomised ...controlled evaluation of the effect of infant massage on parents of babies with Down syndrome.
Methods
This pilot study compared two groups (intervention and control), each with 16 parents of babies with Down syndrome. Indices of acceptance, engagement and awareness of influence were measured at two different time points (pre‐test and after 5 weeks) using the ‘This Is My Baby’ Interview. The allocation of families to each group was randomised. The experimental group performed infant massage, applied by the parents, for 5 weeks, every day for at least 10 min. The massage protocol was based on the methodology created by Vimala McClure. Parents in the control group received the intervention after completion of the study.
Results
The indices of acceptance, commitment and awareness of influence improved in the experimental group and in the control group. The 2 × 2 mixed‐model analysis of variance indicates a statistically significant group‐by‐time interaction for all indices (P < 0.001), which was significantly higher in the experimental group than in the control group.
Conclusions
The application of infant massage, by parents to their babies, improves the rates of acceptance, commitment and awareness of influence of parents of babies with Down syndrome in the short term.
To develop a Spanish version of the Rett Syndrome Motor Evaluation Scale (RESMES) for the locomotor function of Rett Syndrome (RTT) using a transcultural methodology.
The RESMES was cross-culturally ...adaptated and validated in the Spanish language (RESMES-sp). This study was divided into two well-differentiated phases: 1) a cross-cultural translation and adaptation; 2) psychometric characteristics analysis of the RESMES-sp (reliability, test-retest, construct validity, criteria validity, error measurements). For criteria validity, PAINAD questionnaire, the scoliosis values and PedsQL™, were used.
A total of 63 girls and women diagnosed with RTT participated in this validation study. The total value of the RESMES-sp correlates significantly with all its dimensions, with the correlation value oscillating between 0.645 and 0.939. The correlation value with PAINAD ranges between 0.439 and 0.805; the scoliosis values ranges between 0.245 and 0.564; with PedsQOL™ questionnaire, the correlation values range between 0.273 and 0.663 for the PedsQL™ dimensions, and between 0.447 and 0.648 for the total value of PedsQOL™ questionnaire. The reliability values of Crombach's alpha ranged between 0.897 and 0.998 for the intra-observer analyses and between 0.904 and 0.998 for the inter-observer reliability. The SEM showed a value of 2,829, while the MDC90 showed a value of 6601. The Exploratory Factor Analysis showed 6 factors and values of variance of 86.163%.
The Spanish version of the RESMES is a reliable and valid tool for the functional assessment and follow-up of patients with RTT.
•In Rett syndrome it is essential to assess locomotor impairment with appropriate tools.•As The phenotype of rett syndrome is varied, both girls and adult women have been evaluated.•The outcome from any study or research design should be measured by validated instruments.
This article is part of the Focus Theme of Methods of Information in Medicine on "Methodologies, Models and Algorithms for Patients Rehabilitation".
To identify support of a virtual reality system in ...the kinematic assessment and physiotherapy approach to gait disorders in individuals with stroke.
We adapt Virtual Reality Rehabilitation System (VRRS), software widely used in the functional recovery of the upper limb, for its use on the lower limb of hemiplegic patients. Clinical scales have been used to relate them with the kinematic assessment provided by the system. A description of the use of reinforced feedback provided by the system on the recovery of deficits in several real cases in the field of physiotherapy is performed. Specific examples of functional tasks have been detailed, to be considered in creating intelligent health technologies to improve post-stroke gait.
Both participants improved scores on the clinical scales, the kinematic parameters in leg stance on plegic lower extremity and walking speed > Minimally Clinically Important Difference (MCID).
The use of the VRRS software attached to a motion tracking capture system showed their practical utility and safety in enriching physiotherapeutic assessment and treatment in post-stroke gait disorders.
Ionic liquids showed promising separation properties for pyrolytic sugar streams with high selectivity of aromatics over sugars and produced sugar was hydrolyzed and then fermented to ethanol. ...Display omitted
•Aromatics were effectively extracted from pyrolytic sugars by P666,14N(CN)2.•Sugars were not extracted at all.•Regenerated IL exhibited similar aromatics extraction efficiency.•Pure 40gL−1 pyrolytic-glucose stream could directly be fermented.
Fermentative bioethanol production from pyrolytic sugars was improved via aromatics removal by liquid–liquid extraction. As solvents, the ionic liquid (IL) trihexyltetradecylphosphonium dicyanamide (P666,14N(CN)2) and ethyl acetate (EA) were compared. Two pyrolytic sugar solutions were created from acid-leached and untreated pinewood, with levoglucosan contents (most abundant sugar) of 29.0% and 8.3% (w/w), respectively. In a single stage extraction, 70% of the aromatics were effectively removed by P666,14N(CN)2 and 50% by EA, while no levoglucosan was extracted. The IL was regenerated by vacuum evaporation (100mbar) at 220°C, followed by extraction of aromatics from fresh pyrolytic sugar solutions. Regenerated IL extracted aromatics with similar extraction efficiency as the fresh IL, and the purified sugar fraction from pretreated pinewood was hydrolyzed to glucose and fermented to ethanol, yielding 0.46g ethanol/(g glucose), close to the theoretical maximum yield.
To analyse the effect of virtual reality (VR) ther-apy combined with conventional physiotherapy on balance, gait and motor functional disturbances, and to determine whether there is an influence on ...motor recovery in the subacute (< 6 months) or chronic (>> 6 months) phases after stroke.
A total of 59 stroke inpatients (mean age 60.3 years (standard deviation (SD) 14.8); 14.0 months (SD 25.7) post-stroke) were stratified into 2 groups: subacute (n = 31) and chronic (n = 28). Clinical scales (Fugl-Meyer lower extremity (FM LE); Functional Independence Measure (FIM); Berg Balance Scale (BBS); Functional Ambulation Category (FAC); modified Ashworth scale (MAS); 10-metre walk test (10MWT); and kinematic parameters during specific motor tasks in sitting and standing position (speed; time; jerk; spatial error; length) were applied before and after treatment. The VR treatment lasted for 15 sessions, 5 days/week, 1 h/day.
The subacute group underwent significant change in all variables, except MAS and length. The chronic group underwent significant improvement in clinical scales, except MAS and kinematics. Motor impairment improved in the severe ≤ 19 FM LE points, moderate 20-28 FM LE points, mild ≥ 29 FM LE points. Neither time since stroke onset nor affected hemisphere differed significantly between groups. The correlations were investigated between the clinical scales and the kinematic parameters of the whole sample. Moreover, FM LE, BBS, MAS, and speed showed high correlations (R2>> 0.70) with independent variables.
VR therapy combined with conventional physiotherapy can contribute to func-tional improvement in the subacute and chronic phases after stroke.
Cis-dichloro(1,3-diamino-2-propanol)palladium(II),
cis-Pd(dapol)Cl
2, reacts with stoichiometric amounts of AgClO
4 to give chloride free solutions of
cis-Pd(dapol)(H
20)
2(ClO
4)
2 (compound 1). ...Twelve mixed compound I/acetic acid (AcOH) solutions having three different I/AcOH molar ratios and/or total molar complex concentration have been titrated with NaOH 0.1 mol dm
−3 at 37°C and
I = 0.15 mol dm
−3 (NaClO
4). Formation constants (log
β
pqr
) of mixed hydroxoacetato complexes were fitted for the equilibrium:
pPdL(
H
2
O)
2 +
gAcO −
rH ⇄ (PdL)
p
(AcO)
q
(H
2
O)
2-
r
(OH)
r
using the log β of acetate ion protonation (also determined) and the corresponding log
β
pqr
data for aqua- and/or hydroxo-complexes previously reported (as fixed values). New calculations were performed by the HYPERQUAD program. Simulated and experimental titrations agree well. Several distribution diagrams are used to show that acetate ions prevent the alkaline hydrolysis of compound I to a lesser extent than they do chloride ions. Both chloride and acetate ions could compete but also contribute to preventing such hydrolysis in weakly acid or nearly neutral solutions. These findings also apply inside cells at physiological conditions (pH = 7.2–7.4 and Cl
− ∼4 mM) for a total molar complex concentration of ∼1 mM in which compound I could react with DNA and related biopolymers @ 1998 Elsevier Science B.V All rights reserved.
La aparición de infecciones por estafilococo dorado resistente a meticilina en la comunidad es un problema de creciente importancia.
Presentamos el caso de una niña que padeció una osteomielitis ...aguda complicada con una neumonía no necrotizante. Cobra interés la buena evolución del proceso neumónico que contrasta con la refractariedad en la resolución del foco óseo. Destacamos la importancia del correcto drenaje del acúmulo séptico como pilar de una adecuada evolución. Revisamos la literatura médica sobre este patógeno emergente.
The appearance of a community-acquired methicillinresistant Staphylococcus aureus (CA-MRSA) is a increasingly important problem.
We describe the case of a child suffering a CA-MRSA osteomyelitis complicated with a non-necrotizing pneumonia. The fast resolution of the pulmonary infection contrasts with the poor evolution of the septic bone. We emphasise the importance of correct surgical drainage to clear the infection. We review the literature on this emergent pathogen.
Abstract
Background
Coronavirus disease 2019 (COVID-19) rapidly spread worldwide since it first emerged in December 2019, with more than 100 million cases reported to date, causing a great impact on ...healthcare systems. Heart failure (HF) is a major health problem. It affects about 10 million people in Europe and is the leading cause of hospitalization for patients older than 65 years. During the first wave of COVID-19 there was an important decrease in HF hospitalizations. Data regarding HF admissions during the second and third waves and inter-waves periods is scarce.
Purpose
To examine the impact of COVID-19 on HF hospitalizations during the first year of the pandemic and to compare the clinical characteristics and in-hospital outcomes of patients admitted during the three pandemic waves with those admitted the previous year during the same periods.
Methods
Data from a tertiary Heart Failure Unit in Southern Spain between 1 March 2020 and 28 February 2021 were compared to the corresponding time period in the previous year. The impact of the pandemic on weekly hospitalizations was assessed using a Poisson Regression model, with year, season and pandemic wave as covariates. Clinical characteristics and in-hospital outcomes of patients admitted during the three waves were compared to those admitted during the same periods one year after.
Results
A significantly lower weekly number of admissions for HF was observed during the three pandemic wave periods compared to all other included periods (inter-wave periods and same periods in the previous year) (p=0.002, IRR 0.81, 0.77–0.86). Figure 1 shows monthly HF admissions between 1 March 2020 and 28 February 2021 (pandemic year) and the previous year, as well as COVID-19 hospitalized cases in our area. Clinical characteristics and in-hospital outcomes of patients admitted during the COVID-19 waves and the same periods in the previous year are shown in Figure 2. Patients admitted during the COVID-19 waves were younger, and fewer had diabetes mellitus (DM), atrial fibrillation (AF) and valvular heart disease (VHD). There were no differences in clinical outcomes (intensive care unit admission, in-hospital mortality).
Conclusion
There was decline in HF hospitalization during the three waves of the pandemic year, but not during the inter-wave periods. Patients admitted during the wave periods had some clinical differences but similar in-hospital outcomes.
Funding Acknowledgement
Type of funding sources: None.
Figure 1Figure 2
Abstract
Background and purpose
Pulmonary homograft stenosis can appear in long-term follow-up after Ross
intervention. Our aim was to describe the incidence, clinical impact and predictors of ...homograft stenosis and reintervention after the Ross procedure in a prospective series in a tertiary referral hospital after 21 years followup.
Methods
From 1997 to 2009, 107 patients underwent the Ross procedure (mean age: 30 ± 11 years; 69% men; 21 aged <18 years). In all of them, a comprehensive clinical and echocardiographic evaluation was performed before the intervention and at discharge, at 6, 12 months and annually after surgery. We analyzed echocardiographic homograft stenosis (peak gradient > 36 mmHg) and surgical or percutaneous homograft reintervention.
Results
At the end of follow-up (21 years, median: 17 years, interquartile rank 12-19 years), echocardiographic and clinical data were available in 95 (89%) and 105 (98%) patients, respectively: 28/95 (29%) patients developed homograft stenosis and 13/105 (12%) patients underwent diferent homograft reintervention procedures (five patients underwent surgical replacement, four received a percutaneous pulmonary valve and one needed stent implantation). The other three patients underwent two or even three consecutive procedures in follow-up; two died because of complications after percutaneous pulmonary valve implantation and other one after surgical replacement. Rates of survival free from homograft stenosis and reintervention at the end of the follow-up were 71% and 88%, respectively. Younger age, and especially being part of paediatric group (<18 years) at surgical
time predicted worse survival free from homograft stenosis (hazard ratio HR 3.88, 95% confidence interval CI: 1.78-8,43; p = 0.001), although there were no significant differences regarding reintervention (HR 1.54, CI 95% 0.42-5.58, p = 0.52). We found no significant association of this outcome with previous cardiac surgery, donor age, donor or recipient sex, homograft size, time of freezing or congenital aetiology.
Conclusions
After 21 years follow-up, incidence of homograft stenosis and reintervention after the Ross procedure were 29% and 12%, respectively; three patients had a reintervention-related death. Younger recipient age at Ross procedure was associated with a higher rate of stenosis.
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