Traumatic Tympanic Bulla Fracture in a Cat With Severe Head Trauma

A nine-year-old male European shorthair cat was referred to our practice with severe head trauma after suffering a road traffic accident (RTA). The patient presented marked facial swelling and multiple skin wounds and bruising, inspiratory dyspnea, palpable mandibular and maxillary fractures, serosanguinolent oronasal discharge and right eye exophthalmos and buphthalmos with loss of menace and pupillary reflex. After stabilizing the patient, a CT scan was performed under general anesthesia and an oesophagostomy tube was placed. The scan revealed the presence of multiple right tympanic bulla fractures. Multiple mandibular, maxillary, and palatine fractures were also present. The cat underwent surgery. Mandibular symphyseal separation and maxillary fractures were stabilized using intraoral cerclage wire fixation reinforced with composite and the right eye was enucleated. The rest of the fractures were treated conservatively. A CT scan 4 months after the trauma was also performed. At this point, the maxillofacial fractures were healing properly, and a bone callus demonstrating fusion of fragments of the right tympanic bulla was evident. There was absence of abnormal content inside the right tympanic bulla. The patient recovered uneventfully with no neurological deficits. To the author''s knowledge this is the first case reporting a traumatic tympanic bulla fracture in the cat with case follow up, and the first case reported using CT as diagnostic imaging test

The Dunkl–Williams constant, convexity, smoothness and normal structure

AbstractIn this paper we exhibit some connections between the Dunkl–Williams constant and some other well-known constants and notions. We establish bounds for the Dunkl–Williams constant that explain and quantify a characterization of uniformly nonsquare Banach spaces in terms of the Dunkl–Williams constant given by M. Baronti and P.L. Papini. We also study the relationship between Dunkl–Williams constant, the fixed point property for nonexpansive mappings and normal structure

Sexuality of Female Spina Bifida Patients : Predictors of a Satisfactory Sexual Function

Objective To assess the sexual function of women with spina bifida (SB), and to verify the factors that influence their sexual function. Methods A cross-sectional study in which a validated female-specific questionnaire was applied to 140 SB female patients from four different cities (Porto Alegre, Brazil; and Barcelona, Madrid, and Málaga, Spain) between 2019 and 2020. The questionnaires collected data on the clinical characteristics of SB, and female sexual function was assessed using the 6-item version of the Female Sexual Function Index (FSFI-6) validated to Portuguese and Spanish. Results Half of the patients had had sexual activity at least once in the life, but most (57.1%) did not use any contraception method. Sexual dysfunction was present in most (84.3%) patients, and all sexual function domains were impaired compared those of non-neurogenic women. The presence of urinary and fecal incontinence significantly affected the quality of their sexual activity based on the FSFI-6. Conclusion The specific clinical aspects of the SB patients, such as urinary and fecal incontinence, should be properly addressed by their doctors, since they are associated with reduced sexual activity and lower FSFI-6 scores in the overall or specific domains. There is also a need to improve gynecological care among sexually-active SB patients, since most do not use any contraceptive methods and are at risk of inadvertent pregnancy

Time since injury limits but does not prevent improvement and maintenance of gains in balance in chronic stroke

[EN] Objective To determine the influence of time since injury on the efficacy and maintenance of gains of rehabilitation of balance after stroke. Method Forty-seven participants were assigned to a least (6-12 months), a moderate (12-24 months), or a most chronic (>24 months) group. Participants trained for 20 one-hour sessions, administered three to five times a week, combining conventional physical therapy and visual feedback-based exercises that trained the ankle and hip strategies. Participants were assessed before, after the intervention, and one month later with a posturography test (Sway Speed and Limits of Stability) and clinical scales. Results In contrast to other subjects, the most chronic participants failed to improve their sway and to maintain the benefits detected in the Limits of Stability after the intervention. Although all the participants improved in those clinical tests that better matched the trained skills, time since injury limited the improvement, and over all, the maintenance of gains. Conclusion Time since injury limits but does not prevent improvement in chronic stages post-stroke, and this effect appears to be more pronounced with maintaining gains. These findings support that training duration and intensity as well as type of therapy may need to be adjusted based on time post-stroke.This work was supported by Universitat Politecnica de Valencia (Grant PAID-10-16).Llorens Rodríguez, R.; Noé, E.; Alcañiz Raya, ML.; Deutsch, JE. (2017). Time since injury limits but does not prevent improvement and maintenance of gains in balance in chronic stroke. Brain Injury. 32(3):303-309. https://doi.org/10.1080/02699052.2017.1418905S303309323Pekna, M., Pekny, M., & Nilsson, M. (2012). Modulation of Neural Plasticity as a Basis for Stroke Rehabilitation. Stroke, 43(10), 2819-2828. doi:10.1161/strokeaha.112.654228Teasell, R., & Hussein, N. (2016). General Concepts: Therapies for Rehabilitation and Recovery. Ischemic Stroke Therapeutics, 195-201. doi:10.1007/978-3-319-17750-2_18Page, S. J., Gater, D. R., & Bach-y-Rita, P. (2004). Reconsidering the motor recovery plateau in stroke rehabilitation11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated. Archives of Physical Medicine and Rehabilitation, 85(8), 1377-1381. doi:10.1016/j.apmr.2003.12.031Balasch i Bernat, M., Balasch i Parisi, S., Noé Sebastián, E., Dueñas Moscardó, L., Ferri Campos, J., & Lopez-Bueno, L. (2015). Study of the Recovery Patterns of Elderly Subacute Stroke Patients in an Interdisciplinary Neurorehabilitation Unit. Journal of Stroke and Cerebrovascular Diseases, 24(10), 2213-2218. doi:10.1016/j.jstrokecerebrovasdis.2015.05.014Maulden, S. A., Gassaway, J., Horn, S. D., Smout, R. J., & DeJong, G. (2005). Timing of Initiation of Rehabilitation After Stroke. Archives of Physical Medicine and Rehabilitation, 86(12), 34-40. doi:10.1016/j.apmr.2005.08.119Paolucci, S., Antonucci, G., Grasso, M. G., Morelli, D., Troisi, E., Coiro, P., & Bragoni, M. (2000). Early versus delayed inpatient stroke rehabilitation: A matched comparison conducted in Italy. Archives of Physical Medicine and Rehabilitation, 81(6), 695-700. doi:10.1016/s0003-9993(00)90095-9Cassidy, J. M., & Cramer, S. C. (2016). Spontaneous and Therapeutic-Induced Mechanisms of Functional Recovery After Stroke. Translational Stroke Research, 8(1), 33-46. doi:10.1007/s12975-016-0467-5Gauthier, L. V., Taub, E., Perkins, C., Ortmann, M., Mark, V. W., & Uswatte, G. (2008). Remodeling the Brain. Stroke, 39(5), 1520-1525. doi:10.1161/strokeaha.107.502229Yin, D., Luo, Y., Song, F., Xu, D., Peterson, B. S., Sun, L., … Fan, M. (2013). Functional reorganization associated with outcome in hand function after stroke revealed by regional homogeneity. Neuroradiology, 55(6), 761-770. doi:10.1007/s00234-013-1146-9Weiss, A., Suzuki, T., Bean, J., & Fielding, R. A. (2000). High Intensity Strength Training Improves Strength and Functional Performance After Stroke. American Journal of Physical Medicine & Rehabilitation, 79(4), 369-376. doi:10.1097/00002060-200007000-00009ENG, J. J., CHU, K. S., MARIA KIM, C., DAWSON, A. S., CARSWELL, A., & HEPBURN, K. E. (2003). A Community-Based Group Exercise Program for Persons with Chronic Stroke. Medicine & Science in Sports & Exercise, 35(8), 1271-1278. doi:10.1249/01.mss.0000079079.58477.0bMount, J., Bolton, M., Cesari, M., Guzzardo, K., & Tarsi, J. (2005). Group Balance Skills Class for People with Chronic Stroke. Journal of Neurologic Physical Therapy, 29(1), 24-33. doi:10.1097/01.npt.0000282259.81949.0eYang, Y.-R., Wang, R.-Y., Lin, K.-H., Chu, M.-Y., & Chan, R.-C. (2006). Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke. Clinical Rehabilitation, 20(10), 860-870. doi:10.1177/0269215506070701Fritz, S. L., Pittman, A. L., Robinson, A. C., Orton, S. C., & Rivers, E. D. (2007). An Intense Intervention for Improving Gait, Balance, and Mobility for Individuals With Chronic Stroke: A Pilot Study. Journal of Neurologic Physical Therapy, 31(2), 71-76. doi:10.1097/npt.0b013e3180674a3cMacko, R. F. (2008). Adaptive physical activity improves mobility function and quality of life in chronic hemiparesis. The Journal of Rehabilitation Research and Development, 45(2), 323-328. doi:10.1682/jrrd.2007.02.0025Lee, S. W., Shin, D. C., & Song, C. H. (2013). The Effects of Visual Feedback Training on Sitting Balance Ability and Visual Perception of Patients with Chronic Stroke. Journal of Physical Therapy Science, 25(5), 635-639. doi:10.1589/jpts.25.635Tsaklis, P. V., Grooten, W. J. A., & Franzén, E. (2012). Effects of Weight-Shift Training on Balance Control and Weight Distribution in Chronic Stroke: A Pilot Study. Topics in Stroke Rehabilitation, 19(1), 23-31. doi:10.1310/tsr1901-23Gil-Gómez, J.-A., Lloréns, R., Alcañiz, M., & Colomer, C. (2011). Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. Journal of NeuroEngineering and Rehabilitation, 8(1), 30. doi:10.1186/1743-0003-8-30Lloréns, R., Albiol, S., Gil-Gómez, J.-A., Alcañiz, M., Colomer, C., & Noé, E. (2014). Balance rehabilitation using custom-made Wii Balance Board exercises: clinical effectiveness and maintenance of gains in an acquired brain injury population. International Journal on Disability and Human Development, 13(3). doi:10.1515/ijdhd-2014-0323Lloréns, R., Gil-Gómez, J.-A., Alcañiz, M., Colomer, C., & Noé, E. (2014). Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke. Clinical Rehabilitation, 29(3), 261-268. doi:10.1177/0269215514543333Lloréns, R., Noé, E., Colomer, C., & Alcañiz, M. (2015). Effectiveness, Usability, and Cost-Benefit of a Virtual Reality–Based Telerehabilitation Program for Balance Recovery After Stroke: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 96(3), 418-425.e2. doi:10.1016/j.apmr.2014.10.019Dromerick, A. W., Edwardson, M. A., Edwards, D. F., Giannetti, M. L., Barth, J., Brady, K. P., … Newport, E. L. (2015). Critical periods after stroke study: translating animal stroke recovery experiments into a clinical trial. Frontiers in Human Neuroscience, 9. doi:10.3389/fnhum.2015.00231Geiger, R. A., Allen, J. B., O’Keefe, J., & Hicks, R. R. (2001). Balance and Mobility Following Stroke: Effects of Physical Therapy Interventions With and Without Biofeedback/Forceplate Training. Physical Therapy, 81(4), 995-1005. doi:10.1093/ptj/81.4.995Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). «Mini-mental state». Journal of Psychiatric Research, 12(3), 189-198. doi:10.1016/0022-3956(75)90026-6Romero, M., Sánchez, A., Marín, C., Navarro, M. D., Ferri, J., & Noé, E. (2012). Utilidad clínica de la versión en castellano del Mississippi Aphasia Screening Test (MASTsp): validación en pacientes con ictus. Neurología, 27(4), 216-224. doi:10.1016/j.nrl.2011.06.006Llorens, R., Latorre, J., Noé, E., & Keshner, E. A. (2016). Posturography using the Wii Balance Board™. Gait & Posture, 43, 228-232. doi:10.1016/j.gaitpost.2015.10.002Duncan, P. W., Weiner, D. K., Chandler, J., & Studenski, S. (1990). Functional Reach: A New Clinical Measure of Balance. Journal of Gerontology, 45(6), M192-M197. doi:10.1093/geronj/45.6.m192Jones, C. J., Rikli, R. E., & Beam, W. C. (1999). A 30-s Chair-Stand Test as a Measure of Lower Body Strength in Community-Residing Older Adults. Research Quarterly for Exercise and Sport, 70(2), 113-119. doi:10.1080/02701367.1999.10608028Hill, K. D. (1996). A New Test of Dynamic Standing Balance for Stroke Patients: Reliability, Validity and Comparison with Healthy Elderly. Physiotherapy Canada, 48(4), 257-262. doi:10.3138/ptc.48.4.257Zaino, C. A., Marchese, V. G., & Westcott, S. L. (2004). Timed Up and Down Stairs Test: Preliminary Reliability and Validity of a New Measure of Functional Mobility. Pediatric Physical Therapy, 16(2), 90-98. doi:10.1097/01.pep.0000127564.08922.6aPodsiadlo, D., & Richardson, S. (1991). The Timed «Up & Go»: A Test of Basic Functional Mobility for Frail Elderly Persons. Journal of the American Geriatrics Society, 39(2), 142-148. doi:10.1111/j.1532-5415.1991.tb01616.xBohannon, R. W., Andrews, A. W., & Thomas, M. W. (1996). Walking Speed: Reference Values and Correlates for Older Adults. Journal of Orthopaedic & Sports Physical Therapy, 24(2), 86-90. doi:10.2519/jospt.1996.24.2.86Cho, K., Lee, K., Lee, B., Lee, H., & Lee, W. (2014). Relationship between Postural Sway and Dynamic Balance in Stroke Patients. Journal of Physical Therapy Science, 26(12), 1989-1992. doi:10.1589/jpts.26.1989Gagnon, D., Nadeau, S., & Tam, V. (2006). Ideal timing to transfer from an acute care hospital to an interdisciplinary inpatient rehabilitation program following a stroke: an exploratory study. BMC Health Services Research, 6(1). doi:10.1186/1472-6963-6-151Myint, J. M. W. W., Yuen, G. F. C., Yu, T. K. K., Kng, C. P. L., Wong, A. M. Y., Chow, K. K. C., … Chun Por Wong. (2008). A study of constraint-induced movement therapy in subacute stroke patients in Hong Kong. Clinical Rehabilitation, 22(2), 112-124. doi:10.1177/0269215507080141Page, S. J., Sisto, S., Levine, P., & McGrath, R. E. (2004). Efficacy of modified constraint-induced movement therapy in chronic stroke: a single-blinded randomized controlled trial 11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated. Archives of Physical Medicine and Rehabilitation, 85(1), 14-18. doi:10.1016/s0003-9993(03)00481-7Ullberg, T., Zia, E., Petersson, J., & Norrving, B. (2015). Changes in Functional Outcome Over the First Year After Stroke. Stroke, 46(2), 389-394. doi:10.1161/strokeaha.114.006538Clanchy, K. M., Tweedy, S. M., & Trost, S. G. (2016). Evaluation of a Physical Activity Intervention for Adults With Brain Impairment. Neurorehabilitation and Neural Repair, 30(9), 854-865. doi:10.1177/1545968316632059Colomer, C., Llorens, R., Noé, E., & Alcañiz, M. (2016). Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. Journal of NeuroEngineering and Rehabilitation, 13(1). doi:10.1186/s12984-016-0153-6Geurts, A. C. H., de Haart, M., van Nes, I. J. W., & Duysens, J. (2005). A review of standing balance recovery from stroke. Gait & Posture, 22(3), 267-281. doi:10.1016/j.gaitpost.2004.10.002Lang, C. E., MacDonald, J. R., & Gnip, C. (2007). Counting Repetitions: An Observational Study of Outpatient Therapy for People with Hemiparesis Post-Stroke. Journal of Neurologic Physical Therapy, 31(1), 3-10. doi:10.1097/01.npt.0000260568.31746.34Whitall, J., Waller, S. M., Silver, K. H. C., & Macko, R. F. (2000). Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke. Stroke, 31(10), 2390-2395. doi:10.1161/01.str.31.10.2390Hesse, S., Schulte-Tigges, G., Konrad, M., Bardeleben, A., & Werner, C. (2003). Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects11An organization with which 1 or more of the authors is associated has received or will receive financial benefits from a commercial party having a direct financial interest in the results of the research supporting this article. Archives of Physical Medicine and Rehabilitation, 84(6), 915-920. doi:10.1016/s0003-9993(02)04954-