Mobile Applications for Resting Tremor Assessment in Parkinson’s Disease: A Systematic Review

(1) Background: Resting tremor is a motor manifestation present in most Parkinson’s disease (PD) patients. For its assessment, several scales have been created, but mobile applications could help in objectively assessing resting tremor in PD patients in person and/or remotely in a more ecological scenario. (2) Methods: a systematic review following the PRISMA recommendations was conducted in scientific databases (PubMed, Medline, Science Direct, Academic Search Premier, and Web of Science) and in the main mobile application markets (Google Play, iOS App Store, and Windows Store) to determine the applications available for the assessment of resting tremor in patients with PD using only the measurement components of the phone itself (accelerometers and gyroscopes). (3) Results: 14 articles that used mobile apps to assess resting tremor in PD were included, and 13 apps were identified in the mobile application markets for the same purpose. The risk of bias and of applicability concerns of the articles analyzed was low. Mobile applications found in the app markets met an average of 85.09% of the recommendations for the development of medical mobile applications. (4) Conclusions: the use of mobile applications for the evaluation of resting tremor in PD patients has great potential, but validation studies for this purpose are scarce.Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería)Fac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Política pública de mujer y equidad de género La Virginia, Risaralda 2017

CD-T 323.34 S31; 153 pla política pública se determina como una necesidad, puesto que las mujeres, por medio de este mecanismo Estatal, podrán garantizar sus derechos, además de generar una promoción de sus potencialidades, lo cual cumple con el fin de las políticas públicas, que según el IEXE Escuela de Políticas Públicas en México, define a las políticas públicas como “acciones de gobierno con objetivos de interés público, que surgen de decisiones sustentadas en un proceso de diagnóstico y análisis de factibilidad”. Es decir, que es un mecanismo del Estado que responde a las necesidades de la población, en el caso particular a la mujer y a la equidad de género en el municipio de la Virginia. Por otra parte, el aspecto jurídico, tiene como propósito, defender, garantizar y restablecer los derechos de las mujeres, es por ello que se tiene como fundamento legal, los siguientes estamentos que generan la protección de la mujer a lo largo de su ciclo vital.Universidad Libre Seccional Pereir

Medical students maintain their humanistic and patient‑centred vocation throughout Medicine Degree in Spain: a study based on narratives

Narrative medicine has great educational potential in the degree of medicine. This study explores for the frst time the use of narrative medicine in relation to longitudinal evolution of medical vocation for the same group of students. In the context of the Degree in Medicine at the Universidad Autónoma de Madrid (Spain), students wrote narratives about what it meant to them to be a doctor at the beginning and end of their studies. The narratives of 338 students of the academic years 2012/13– 2017/18 and 2013/14–2018/19 were analysed and compared. Students mostly pursued a degree in medicine on account of humanistic motivations, which are reinforced throughout their degree. In contrast, up to 10% of students reference to have experienced vocational crises and sufered frustration, with up to 25% of the references pertaining to having made signifcant sacrifces. Students maintain and evolve their humanistic, patient-centred vision throughout their degree studies, despite the difculties they appear to encounter. We suggest that eforts must be made to include more humanistic perspectives in the medical degree to keep this trend, which may improve both the educational experience created in universities and the health care given to patient

Bloqueo específico en el anciano con enfermedad facetaria : medición de calidad de vida y funcionalidad

La enfermedad facetaria y sacroileitis de origen mecánico son entidades que se asocian a dolor lumbar, y el bloqueo lumbar específico es una alternativa terapéutica en pacientes que no responden a manejos convencionales. En ancianos se desconoce su eficacia e impacto en su funcionalidad debido a la escasa población incluida en los estudios y ausencia de análisis por edad. Se realizó un estudio observacional descriptivo entre el enero y junio del 2018 en el Hospital San Ignacio. Se seleccionaron 24 pacientes mayores de 60 años, edad promedio de 72 años (60-93) con diagnóstico de enfermedad facetaria, se realizó medición de funcionalidad, calidad de vida y uso de medicamentos analgésicos, encontrando una mejoría en el puntaje de las diversas escalas realizadas, un mes después de la aplicación del bloqueo lumbar específico: Barthel (89.58 a 92.08, p = 0.0428), EuroQOL 5D (8.41 a 6.33, p = 0.0000), EuroQOL EVA (58.33 a 79.58, p = 0.0001), y logró una disminución del uso de medicamentos analgésicos (1.91 a 0.95, p = 0.0001). Conclusión: El bloqueo lumbar específico es una alternativa terapéutica en el tratamiento del síndrome facetario lumbar en el anciano, con beneficios potenciales en mejoría funcional, calidad de vida, y reducción del uso de analgésicos.noFacet disease and sacroileitis of mechanical origin are entities that are associated with low back pain, and lumbar sympathetic block is a therapeutic alternative unresponsive to medical management. In elderly people, its efficacy and impact on functionality are unknown due to the low population included in the studies, and the absence of analysis by age. A descriptive observational study was conducted between January and June 2018 at the San Ignacio Hospital. Twenty-four patients over 60 years of age, average of 72 years (60-93) with diagnosis of facet disease, were selected, the performance of the function, quality of life and use of analgesic drugs was verified, finding an improvement in the score of the various scales performed, one month after the application of the specific lumbar block: Barthel (89.58 to 92.08, p = 0.0428), EuroQOL 5D (8.41 to 6.33, p = 0.0000), EuroQOL EVA (58.33 to 79.58, p = 0.0001), and decrease of the use of analgesic drugs (1.91 to 0.95, p = 0.0001). Conclusion: The specific lumbar block is a therapeutic alternative in the treatment of the lumbar syndrome in the elderly, with benefits in the functional recovery, improvement in quality of life, and the reduction in the use of analgesics.Especialista en GeriatríaEspecializació

La cultura de género en las organizaciones

279 p.En este libro nos planteamos la contradicción existente en los centros educativos, en los que, por un lado, hay un elevado número de profesoras que ejercen sus funciones en las tareas docentes y, por otro lado, las estadísticas son tan persistentes en demostrar que el número de mujeres en puestos directivos en centros educativos es mucho menor de lo que correspondería en proporción a su presencia en esta profesión. Esta situación supone que, aunque en la teoría o en las leyes hablemos de igualdad entre hombres y mujeres, el modelo de educación que transmitimos en la práctica real en nuestras organizaciones contribuye a desarrollar una cultura, unas “formas de hacer”, unas costumbres y unas prácticas implícitas contrarias a los planteamientos de la igualdad de oportunidades entre mujeres y hombres. Y esto es importante porque lo que las futuras generaciones de hombres y mujeres aprenden en la escuela, no es sólo lo que les transmitimos, sino también lo que ven y viven en la organización y el funcionamiento de esas instituciones en las que pasan al menos 14 años de su vid

Diagnostico del Impacto del Palangre de Fondo en los Hábitats Bentónicos en los LICs de la RN20000

En prens

Neuroimaging and serum biomarkers of neurodegeneration and neuroplasticity in Parkinson’s disease patients treated by intermittent theta-burst stimulation over the bilateral primary motor area: a randomized, double-blind, sham-controlled, crossover trial study

Background and objectivesIntermittent theta-burst stimulation (iTBS) is a patterned form of excitatory transcranial magnetic stimulation that has yielded encouraging results as an adjunctive therapeutic option to alleviate the emergence of clinical deficits in Parkinson’s disease (PD) patients. Although it has been demonstrated that iTBS influences dopamine-dependent corticostriatal plasticity, little research has examined the neurobiological mechanisms underlying iTBS-induced clinical enhancement. Here, our primary goal is to verify whether iTBS bilaterally delivered over the primary motor cortex (M1) is effective as an add-on treatment at reducing scores for both motor functional impairment and nonmotor symptoms in PD. We hypothesize that these clinical improvements following bilateral M1-iTBS could be driven by endogenous dopamine release, which may rebalance cortical excitability and restore compensatory striatal volume changes, resulting in increased striato-cortico-cerebellar functional connectivity and positively impacting neuroglia and neuroplasticity.MethodsA total of 24 PD patients will be assessed in a randomized, double-blind, sham-controlled crossover study involving the application of iTBS over the bilateral M1 (M1 iTBS). Patients on medication will be randomly assigned to receive real iTBS or control (sham) stimulation and will undergo 5 consecutive sessions (5 days) of iTBS over the bilateral M1 separated by a 3-month washout period. Motor evaluation will be performed at different follow-up visits along with a comprehensive neurocognitive assessment; evaluation of M1 excitability; combined structural magnetic resonance imaging (MRI), resting-state electroencephalography and functional MRI; and serum biomarker quantification of neuroaxonal damage, astrocytic reactivity, and neural plasticity prior to and after iTBS.DiscussionThe findings of this study will help to clarify the efficiency of M1 iTBS for the treatment of PD and further provide specific neurobiological insights into improvements in motor and nonmotor symptoms in these patients. This novel project aims to yield more detailed structural and functional brain evaluations than previous studies while using a noninvasive approach, with the potential to identify prognostic neuroprotective biomarkers and elucidate the structural and functional mechanisms of M1 iTBS-induced plasticity in the cortico-basal ganglia circuitry. Our approach may significantly optimize neuromodulation paradigms to ensure state-of-the-art and scalable rehabilitative treatment to alleviate motor and nonmotor symptoms of PD