Mindfulness en discapacidad intelectual. Un estudio

Resumen: Introducción: La discapacidad intelectual presenta una serie de manifestaciones clínicas que repercuten a nivel psicológico, emocional, social y funcional. El Mindfulness pretende cambiar la relación que las personas mantienen con las actividades diarias, procurando dirigirlas al momento presente. De esta forma conocerán mejor sus respuestas en el medio, y se favorecerá una regulación emocional y conductual. Objetivo: Evidenciar el efecto que la aplicación de la técnica Mindfulness tiene como medio para mejorar las destrezas de comunicación y sociales en personas con discapacidad intelectual, desde terapia ocupacional. Metodología: Estudio de tipo longitudinal, cuasi-experimental. Se recogen datos sobre las habilidades sociales de los usuarios y las facetas del Mindfulness, mediante las escalas EHS y FFMQ respectivamente. La intervención se realizó con la técnica Mindfulness en 8 sesiones de 45 minutos. Y una muestra de 12 usuarios, con una edad promedio de 40 años (DT = ± 8,21307). Resultados: Se obtuvieron mejoras estadísticamente significativas en la autoexpresión en situaciones sociales y en el inicio de interacciones positivas con el sexo opuesto. Conclusiones: Las puntuaciones han mejorado en todas las variables en el post-test, aunque no todas de forma significativa. Probablemente aumentar el número de sesiones incrementaría la probabilidad de encontrar resultados más significativos.Abstract: Introduction: Intellectual disability presents a series of clinical manifestations that affect psychological, emotional, social, and functional level. The Mindfulness aims to change the relationship that people have with daily activities, trying to point them at the present moment. In this way you will know better answers in the Middle, and you will favour emotional regulation, and behavioral. Objective: Demonstrate the effect of applying the Mindfulness technique as a means to improve communication skills and social in people with intellectual disabilities from occupational therapy. Methodology: Type longitudinal, quasi-experimental study. Collected data about the social skills of the users and the facets of the Mindfulness, using the EHS and FFMQ scales respectively. The intervention was carried out with the Mindfulness technique in 8 sessions of 45 minutes. And a sample of 12 users, with an average age of 40 years (DT = ± 8,21307). Results: Were statistically significant improvement in self-expression in social situations and in the beginning of positive interactions with the opposite sex. Conclusions: Scores have improved in all the variables in the post-test, but not all in a meaningful way. Likely to increase the number of sessions would increase the probability of finding more significant results

Factores de riesgo en el ictus - influencia de la edad

Objective: To analyze the influence of different risk factors on the age at which a stroke occurs. Method: An observational cross-sectional study was conducted including all patients admitted consecutively with ischemic stroke at the University Hospital of Burgos (Spain). Sociodemographic and clinical, parameters were collected, exploring possible association with patient’s age by univariate and multivariate analysis. Results: 436 patients were included, with a mean age of 75.39 years (SD ±12.674). The most frequent risk factors were high blood pressure and cardiovascular disease. In the case of having a personal history of arterial hypertension (Odds Ratio [OR] 2.49; 95% Confidence Interval [CI] 1.49-4.16), having a sedentary lifestyle (OR 3.24; 95%CI 1.97-5.31) was related with a greater probability that the patient is aged 75 years or older. However, being overweight/obese (OR 0.51; 95%CI 0.30-0.88), being an active smoker (OR 0.47; 95%CI 0.02-0.11) or alcohol consumption (OR 0.42; 95%CI 0.26-0.69) increased the probability of stroke occurrence before 75 years. Conclusion: The age of occurrence of a case is related to the occurrence of certain risk factors, which are determined in the planning of future education campaigns.Objetivo: Analizar la influencia que los distintos factores de riesgo ejercen sobre la edad a la que se produce un ictus. Método: Estudio observacional transversal en el que se incluyeron a todos los pacientes con ictus ingresados de forma consecutiva en el Hospital Universitario de Burgos (España). Se recogieron parámetros sociodemográficos y clínicos, estudiándose su posible relación con la edad mediante análisis univariante y multivariante. Resultados: Se incluyeron 436 pacientes, siendo la edad media de 75,39 años (DE ±12,674). Los factores de riesgo más frecuentes fueron la hipertensión arterial y la enfermedad cardiovascular. Se observó que el tener antecedentes personales de hipertensión arterial (OR 2,49; IC95% 1,49-4,16) ó el no tener un estilo de vida sedentario (OR 3,24; 1,97-5,31) se relacionó con una mayor probabilidad de que el paciente tuviera una edad igual o superior a 75 años. Sin embargo, el tener sobrepeso/obesidad (OR 0,51; IC95% 0,30-0,88), el ser fumador activo (OR 0,47; 0,02-0,11) ó el consumir alcohol (OR 0,42; 0,26-0,69) aumentó la probabilidad de que el ictus ocurriera antes de 75 años. Conclusión: La edad de aparición de un ictus se relaciona con la ocurrencia de determinados factores de riesgo, los cuales deberían ser considerados en la planificación de futuras campañas educacionales

Explanatory Factors for Periprosthetic Infection in Total Knee Arthroplasty

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment

Effects of home-based mirror therapy and cognitive therapeutic exercise on the improvement of the upper extremity functions in patients with severe hemiparesis after a stroke: a protocol for a pilot randomised clinical trial

Introduction Neuroplasticity is defined as the capacity of the brain to reorganise new neuronal pathways. Mirror therapy (MT) and cognitive therapeutic exercise (CTE) are two neurorehabilitation techniques based on neuroplasticity and designed to improve the motor functions of the affected upper extremity in patients with severe hemiparesis after a stroke. Home-based interventions are an appropriate alternative to promote independence and autonomy. The objective of this study is to evaluate which of these techniques, MT and CTE, combined with task-oriented training, is more effective in functional recovery and movement patterns of the upper extremities in patients with severe hemiparesis after a stroke.Methods and analysis This is a home-based, single-blind, controlled, randomised clinical trial with three parallel arms, including 154 patients who had a stroke aged above 18 years. The primary outcome will be the functionality of the affected upper extremity measured using the Fugl-Meyer Assessment. Secondary variables will include cognitive performance, emotional state, quality of life and activities of daily living. During 6 weeks, one of the intervention groups will receive a treatment based on MT and the other one on CTE, both combined with task-oriented training. No additional interventions will be provided to the control group. To assess the progress of patients who had a stroke in the subacute phase, all variables will be evaluated at different visits: initial (just before starting treatment and 4 weeks post-stroke), post-intervention (6 weeks after initial) and follow-up (6 months).Ethics and dissemination This protocol has been approved by the Institutional Review Board (CEIm-2.134/2.019) and registered at ClinicalTrials.gov (NCT04163666). The results will be disseminated through open-access peer-reviewed journals, conference presentation, broadcast media and a presentation to stakeholders. These study results will provide relevant and novel information on effective neurorehabilitation strategies and improve the quality of intervention programmes aimed at patients after a stroke.Trial registration number ClinicalTrials.gov (NCT04163666)

Explanatory Factors for Periprosthetic Infection in Total Knee Arthroplasty

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment

To Resurface or Not to Resurface the Patella in Total Knee Arthroplasty, That Is the Question: A Meta-Analysis of Randomized Controlled Trials

Background and Objetives: Currently, total knee arthroplasty is one of the most common surgeries, increasing with the increase in life expectancy. Whether or not to replace the patella has been a subject of debate over the years, remaining in controversy and without reaching a consensus. Over the years, different meta-analyses have been carried out in order to provide evidence on the subject, although, in recent times, there have not been many new studies in this regard. Therefore, it is considered necessary that the latest works form part of a new meta-analysis. Materials and Method: We searched the literature using PUBMED, SCOPUS, the Cochrane database and VHL from 2010 to 2020. The search terms used were “patellar” AND “resurfacing” OR “Replacement” and “no resurfacing” OR “no replacement”. A meta-analysis was performed with Stata software (Stata version 15.1). Forest plots were generated to illustrate the overall effect of knee arthroplasty interventions. Results: As a result, it was obtained that there is a significantly higher risk of suffering AKP in the non-resurfacing group, in addition to a significant increase in the risk of undergoing a reoperation in the non-resurfacing group. On the other hand, significant differences were obtained in favor of the resurfacing group in both the clinical and Feller KSS, with functional KSS being inconclusive. After analyzing different variables throughout the literature, it does seem clear that the non-resurfacing group may present a higher risk of reoperation than the resurfacing group. Conclusions: For all these reasons, we think that, although it does seem that not replacing the patella can precipitate a reoperation, it is not clear whether this reoperation is a direct consequence of not having replaced the patella. Therefore, in our opinion, the treatment must be individualized for each patient