Análisis de los protocolos de rehabilitación pre y post-cirugía del ligamento cruzado anterior (LCA) de la rodilla. Revisión bibliográfica.

Se realiza una revisión bibliográfica con el objetivo de conocer los protocolos actuales de rehabilitación tras la reconstrucción quirúrgica del ligamento cruzado anterior de la rodilla. Se efectúa una búsqueda de los estudios clínicos experimentales actuales que evalúan los procedimientos y protocolos de fisioterapia utilizados durante la rehabilitación del LCA. La búsqueda se realiza en las bases de datos: Medline, PEDro y Science Direct, entre diciembre de 2013 y enero de 2014. Se incluyen los publicados a partir del 2010, desarrollados en humanos con ruptura parcial o total del ligamento y redactados en español o inglés. Se analizan los 21 estudios que cumplen con los criterios de inclusión y exclusión estipulados y se valora el proceso metodológico empleado, la presencia de sesgos y limitaciones, la aplicabilidad de los resultados y la descripción precisa de los protocolos. Se concluye afirmando que no existe unanimidad en los protocolos y procedimientos de fisioterapia y que éstos no ofrecen diferencias destacables si se comparan con los diseñados 20 años atrás. Por lo que se propone y elaborar un protocolo de rehabilitación propio teniendo en cuenta la información obtenida y usando como referencia las guías clínicas más empleadas en la práctica clínica.

Handwriting and pre-frailty in the Lausanne cohort 65+ (Lc65+) study

BACKGROUND: Frailty is detected by weight loss, weakness, slow walking velocity, reduced physical activity or poor endurance/exhaustion. Handwriting has not been examined in the context of frailty, despite its functional importance. OBJECTIVE: Our goal was to examine quantitative handwriting measures in people meeting 0, 1, and 2 or more (2+) frailty criteria. We also examined if handwriting parameters were associated with gait performance, weakness, poor endurance/exhaustion and cognitive impairment. METHODS: From the population-based Lc65+, 72 subjects meeting 2+ frailty criteria with complete handwriting samples were identified. Gender-matched controls meeting 1 criterion or no criteria were identified. Cognitive impairment was defined by a Mini-Mental State Examination score of 25 or less or the lowest 20th percentile of Trail Making Test Part B. Handwriting was recorded using a writing tablet and measures of velocity, pauses, and pressure were extracted. RESULTS: Subjects with 2+ criteria were older, had more health problems and need for assistance but had higher education. No handwriting parameter differed between frailty groups (age and education adjusted). Writing velocity was not significantly slower among participants from the slowest 20th percentile of gait velocity but writing pressure was significantly lower among those from the lowest 20th percentile of grip strength. Poor endurance/exhaustion was not associated with handwriting measures. Low cognitive performance was related to longer pauses. CONCLUSIONS: Handwriting parameters might be associated with specific aspects of the frailty phenotype, but not reliably with global definitions of frailty at its earliest stages among subjects able to perform handwriting tests.

Selected Aspects Related to Pre-development Stages of International Software projects. Case of Finland and Russia

The question of Pilot Project creation, due to support pre-development stage of software product elaboration, nowadays might be used as an approach, which allows improving the whole scheme of information technology project running. This subject is not new, but till now no model has been presented, which gives deep description of this important stage on the early phase of project. This Master's Thesis represents the research's results and findings concerning the pre-development study from the Software Engineering point of view. The aspects of feasibility study, pilot prototype developments are analyzed in this paper. As the result, the technique of Pilot Project is formulated and scheme has been presented. The experimental part is focused on particular area Pilot Project scheme's implementation- Internationally Distributed Software projects. The specific characteristic, aspects, obstacles, advantages and disadvantages are considered on the example of cross border region of Russia and Finland. The real case of Pilot Project technique implementation is given.

Educational intervention for parents of adolescents with chronic illness: a pre-post test pilot study.

OBJECTIVE: This pilot experimental study tested the feasibility and intended effect of an educational intervention for parents to help them assist their adolescent child with chronic illness (CI) in becoming autonomous. METHODS: A two-phase pre-post pilot intervention study targeting parents of adolescents with CI was conducted. Parents were allocated to group 1 and 2 and received the four-module intervention consecutively. Intended effect was measured through online questionnaires for parents and adolescents before, at 2 months after, and at 4-6 months after the intervention. Feasibility was assessed through an evaluation questionnaire for parents. RESULTS: The most useful considered modules concerned the future of the adolescent and parents and social life. The most valued aspect was to exchange with other parents going through similar problems and receiving a new outlook on their relationship with their child. For parents, improvement trends appeared for shared management, parent protection, and self-efficacy, and worsening trends appeared for coping skills, parental perception of child vulnerability, and parental stress. For adolescents, improvement trends appeared for self-efficacy and parental bonding and worsening trends appeared for shared management and coping skills. CONCLUSION: Parents could benefit from peer-to-peer support and education as they support the needed autonomy development of their child. Future studies should test an online platform for parents to find peer support at all times and places.

The tightness performance of pre-formed trays as package

Suojakaasupakkaaminen (MAP) on yleistynyt viime aikoina, koska sen avulla voidaan säilöä tuoreita tai vähän käsiteltyjä elintarvikkeita pidempään. Suurin syy hyllyiän pidentymiseen on hiilidioksidin aiheuttama mikrobien kasvun hidastuminen. Toisaalta huolena on patogeenisten mikrobien lisääntyminen anaerobisissa olosuhteissa. Pidempi säilyvyys voidaan saavuttaa myös käyttämällä vähemmän lisä- ja säilöntäaineita. Samalla suojakaasupakkaaminen kuitenkin vähentää myös pilaantuneiden tuotteiden määrää. Eniten suojakaasua käytetään lihan pakkaamisessa. Suojakaasupakkaamisessa elintarvikepakkaukseen syötetään normaalista huoneilmasta poikkeava kaasuseos. Pääasiassa kaasuseos koostuu hiilidioksidista, hapesta ja typestä. Lisäksi voidaan käyttää pieniä määriä hiilimonoksidia, argonia ja rikkidioksidia. Kaasuseoksen koostumus määräytyy elintarvikkeiden ominaisuuksien ja vaatimusten perusteella. Halutun kaasukoostumuksen tulee säilyä pakkauksessa muutamasta päivästä muutamaan kuukauteen riippuen elintarvikkeesta. Siksi tärkein pakkaukselta vaadittava ominaisuus on riittävä kaasutiiveys ja erityisesti hapenläpäisevyys. Koska suurin osa suojakaasupakkauksista on tällä hetkellä muovisia, tutkittiin kokeellisessa osiossa kartonkipakkausten tiiveysominaisuuksia. Kokeet tehtiin vertailemalla erilaisten vuoka- ja kansimateriaalien vaikutusta pakkausten tiiveyteen. Vuokien onnistuminen oli suurin yksittäinen tuloksiin vaikuttanut tekijä. Epäonnistuneen vuoan vaikutukset näkyivät myös saumauksessa, koska saumaustyökalun ja vuoan piti sopia yhteen. Lisäksi näkymättömät mikroreiät hankaloittivat todellisten vuotokohtien paikallistamista. Vuototestausten perusteella materiaaleille löydettiin kuitenkin viitteelliset optimiparametrit. Tärkein saumauksessa vaikuttanut tekijä oli sopivan saumauslämpötilan valinta. Prässättyjen vuokien laatu oli epätasainen. Siksi erityisesti rinnakkaisten kansitus- ja hapenläpäisymittausten väliset erot olivat merkitseviä. Lisäksi prässäys laski materiaalien hapenläpäisyominaisuuksia. Yksittäisten vuokien tiiveysominaisuudet täyttivät kuitenkin kaupallisille kaasupakkauksille asetetut vaatimukset. Vesihöyrynläpäisevyydessä materiaalin vesihöyrynläpäisy oli merkittävämpää kuin vesihöyryn kulkeutuminen vuotokohtien tai epäonnistuneiden saumojen kautta.

Aportaciones de la prospección geofísica al estudio del subsuelo del Berguedà y Solsonés, (pre-pirineo Catalán, N.E. de la Península Ibérica)

En este trabajo se presenta la interpretaciónpor métodos geofísicos combinados de un sector del contacto entre el Pre-Pirineo y la La zona objeto del presente estudio se halla a Depresión Central Catalana...

Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the International Collaboration of Endocarditis-Prospective Cohort Study.

BACKGROUND: The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. METHODS: Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. RESULTS: EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). CONCLUSIONS: In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.

Striatal pre- and postsynaptic profile of adenosine A2A receptor antagonists

Striatal adenosine A2A receptors (A2ARs) are highly expressed in medium spiny neurons (MSNs) of the indirect efferent pathway, where they heteromerize with dopamine D2 receptors (D2Rs). A2ARs are also localized presynaptically in cortico-striatal glutamatergic terminals contacting MSNs of the direct efferent pathway, where they heteromerize with adenosine A1 receptors (A1Rs). It has been hypothesized that postsynaptic A2AR antagonists should be useful in Parkinson's disease, while presynaptic A2AR antagonists could be beneficial in dyskinetic disorders, such as Huntington's disease, obsessive-compulsive disorders and drug addiction. The aim or this work was to determine whether selective A2AR antagonists may be subdivided according to a preferential pre- versus postsynaptic mechanism of action. The potency at blocking the motor output and striatal glutamate release induced by cortical electrical stimulation and the potency at inducing locomotor activation were used as in vivo measures of pre- and postsynaptic activities, respectively. SCH-442416 and KW-6002 showed a significant preferential pre- and postsynaptic profile, respectively, while the other tested compounds (MSX-2, SCH-420814, ZM-241385 and SCH-58261) showed no clear preference. Radioligand-binding experiments were performed in cells expressing A2AR-D2R and A1R-A2AR heteromers to determine possible differences in the affinity of these compounds for different A2AR heteromers. Heteromerization played a key role in the presynaptic profile of SCH-442416, since it bound with much less affinity to A2AR when co-expressed with D2R than with A1R. KW-6002 showed the best relative affinity for A2AR co-expressed with D2R than co-expressed with A1R, which can at least partially explain the postsynaptic profile of this compound. Also, the in vitro pharmacological profile of MSX-2, SCH-420814, ZM-241385 and SCH-58261 was is in accordance with their mixed pre- and postsynaptic profile. On the basis of their preferential pre- versus postsynaptic actions, SCH-442416 and KW-6002 may be used as lead compounds to obtain more effective antidyskinetic and antiparkinsonian compounds, respectively.