Robotrónica

2002/200

Satisfacción con la vida y autoeficacia en jugadores de baloncesto en silla de ruedas

El objetivo del estudio fue analizar la relación entre satisfacción con la vida, y autoeficacia de movilidad en personas con discapacidad física que practican baloncesto en silla de ruedas. El estudio siguió un diseño ex post facto. La muestra fue de 103 participantes. Las mediciones se mostraron fiables, con altos coeficientes de consistencia interna. Los deportistas declararon altos niveles de satisfacción con la vida y de autoeficacia de movilidad en silla de ruedas. No se encontraron diferencias significativas en dichas variables en función del nivel de excelencia competitiva. Se concluye que la satisfacción con la vida está más relacionada con la percepción de autoeficacia de movilidad en silla de ruedas que con la edad o la clasificación funcional de los deportistas.The main aim of this study was to analyse the relationship between life satisfaction and mobility self-efficacy in wheelchair basketball players. The study was developed with an ex post facto design. 103 people with physical disabilities took part in this study. The measurements were reliable, with high internal consistency. Subjects showed high levels of satisfaction with life and self-efficacy of mobility in a wheelchair. There were no outstanding differences in these variables in relation to the level of sporting excellence. Satisfaction with life was more related to the perception of wheelchair mobility self efficacy than to age or functional classification as a sportsperson.O objectivo do estudo foi analisar a relação entre satisfação com a vida, e autoeficácia de mobilidade em pessoas com incapacidade física que praticam basquetebol em cadeira de rodas. O estudo seguiu um delineamento ex post facto. A amostra foi constituída por 103 participantes. As medidas revelaram ser fiáveis, com altos coeficientes de consistência interna. Os atletas revelaram altos níveis de satisfação com a vida e de autoeficácia de mobilidade em cadeira de rodas. Não se verificaram diferenças significativas nestas variáveis em função do nível de excelência competitiva. Conclui-se que a satisfação com a vida está mais relacionada com a percepção de autoeficácia de mobilidade em cadeira de rodas que com a idade ou a classificação funcional dos desportistas

Research challenges for cross-cloud application

Federated clouds can expose the Internet as a homogeneous compute fabric. There is an opportunity for developing cross-cloud applications that can be deployed pervasively over the Internet, dynamically adapting their internal topology to their needs. In this paper we explore the main challenges for fully realizing the potential of cross-cloud applications. First, we focus on the networking dimension of these applications. We evaluate what support is needed from the infrastructure, and what are the further implications of opening the networking side. On a second part, we examine the impact of a distributed deployment for applications, assessing the implications from a management perspective, and how it affects the delivery of quality of service and non-functional requirements

Duplex mapping of 2036 primary varicose veins

ObjectiveTo produce a comprehensive anatomical and hemodynamic ultrasound scan mapping of the whole limb in patients with primary varicose veins (VVs).DesignAn analysis of venous duplex scans performed on patients referred for treatment of primary VVs.MethodsA total of 2036 limbs were evaluated, looking for the origin of VVs in the saphenous systems and in the perforating vein (PV) systems, as well as for the presence of non-saphenous reflux.ResultsThe sapheno-femoral junction (SFJ) of the great saphenous vein (GSV) was involved in 1330 limbs (65.3%). We have noted that finding reflux in the groin does not imply that it originates at that point necessarily, as reflux from the pelvis or abdominal wall can also cause primary VVs (SFJ reflux, 41.9% and competent SFJ with reflux from proximal veins, 35.4%). We also noted that analyzing only the presence of reflux in the SFJ of the GSV would miss 10.9% of limbs of reflux in the SFJ of the anterior accessory GSV. In 237 limbs (11.6%), reflux was observed in the popliteal fossa. In the PV system, we distinguished those PVs with retrograde flow that acted as an origin of the VVs, and other PVs that acted as re-entry points. Based on this difference, the location identified as the most frequent origin of VVs in the PV system was the thigh, specifically in the group of PVs of the medial thigh of the femoral canal, with 85 PVs with a total of 238 incompetent PVs identified. Pure non-saphenous reflux was observed in 162 limbs (8%).ConclusionThe assumption that the origin of VVs would be exclusively in the sapheno-femoral or sapheno-popliteal junction, is a mistaken attitude and a comprehensive duplex scan mapping is recommended

Endovascular treatment of thoracic aorta injury after spinal column surgery

Producción CientíficaA 61-year-old woman with a history of left dorso-lumbar scoliosis and severe dorso-lumbar kyphosis underwent surgical treatment of a spinal deformity. Surgery was conducted on the patient by performing a dorso-lumbar spinal arthrodesis (T6-L5) by means of the insertion of two longitudinal rods and a number of pedicle-expander screws at different vertebral levels. Following the orthopedic surgery, the patient presented paraparesis of the lower limbs and anemia that required transfusion. In the immediate postoperative period, a noncontrast-enhanced computed tomography (CT) scan was obtained to assess the medullary canal. A deviation of the left screw placed at T6 was detected; this screw projected outward from the vertebral cortex, protruding into the descending thoracic aorta. A contrast-enhanced CT scan showed that the screw had been malpositioned, and the image was highly suggestive of a perforation of the aortic wall, despite a lack of evidence of a peri-aortic hematoma, extravasation of contrast medium, or pleural effusion. The patient remained hemodynamically stable, and the decision was to perform an endovascular repair electively within 24 hours

Life satisfaction and self-efficacy in wheelchair basketball players

The main aim of this study was to analyse the relationship between life satisfaction and mobility self-efficacy in wheelchair basketball players. The study was developed with an ex post facto design. 103 people with physical disabilities took part in this study. The measurements were reliable, with high internal consistency. Subjects showed high levels of satisfaction with life and self-efficacy of mobility in a wheelchair. There were no outstanding differences in these variables in relation to the level of sporting excellence. Satisfaction with life was more related to the perception of wheelchair mobility self-efficacy than to age or functional classification as a sportspersonEl objetivo del estudio fue analizar la relación entre satisfacción con la vida, y autoeficacia de movilidad en personas con discapacidad física que practican baloncesto en silla de ruedas. El estudio siguió un diseño ex post facto. La muestra fue de 103 participantes. Las mediciones se mostraron fiables, con altos coeficientes de consistencia interna. Los deportistas declararon altos niveles de satisfacción con la vida y de autoeficacia de movilidad en silla de ruedas. No se encontraron diferencias significativas en dichas variables en función del nivel de excelencia competitiva. Se concluye que la satisfacción con la vida está más relacionada con la percepción de autoeficacia de movilidad en silla de ruedas que con la edad o la clasificación funcional de los deportistasO objectivo do estudo foi analisar a relação entre satisfação com a vida, e autoeficácia de mobilidade em pessoas com incapacidade física que praticam basquetebol em cadeira de rodas. O estudo seguiu um delineamento ex post facto. A amostra foi constituída por 103 participantes. As medidas revelaram ser fiáveis, com altos coeficientes de consistência interna. Os atletas revelaram altos níveis de satisfação com a vida e de autoeficácia de mobilidade em cadeira de rodas. Não se verificaram diferenças significativas nestas variáveis em função do nível de excelência competitiva. Conclui-se que a satisfação com a vida está mais relacionada com a percepção de autoeficácia de mobilidade em cadeira de rodas que com a idade ou a classificação funcional dos desportista

Reflux patterns and risk factors of primary varicose veins clinical severity

Producción CientíficaAbstract Objectives: Primarily, to determine the association between the clinical severity of primary varicose veins and different reflux patterns in an anatomic and haemodynamic clinical study using duplex ultrasonography (DU). Secondly, to analyse the association of clinical severity with other aspects, such as risk factors for chronic venous insufficiency (CVI) and other concurrent diseases. Method: A total of 2036 limbs were evaluated using DU. Clinical status was characterized by the CEAP (clinical, aetiological, anatomical and pathological elements) classification. The degree of clinical severity was grouped into two categories, mild to moderate CVI (C1–C3) and severe CVI, characterized by the presence of skin changes (C4–C6). We analysed the association of the different reflux patterns with CEAP status. Results: Saphenofemoral junction (SFJ) reflux of the great saphenous vein (GSV) was associated with the most severe form of the disease (odds ratio [OR] ¼ 2.96; confidence interval [CI] 95%: 2.2–3.8), whereas competent SFJ of the GSV with reflux from proximal veins (OR ¼ 2; CI 95%: 1.4–2.7) and the pure non-saphenous reflux (OR ¼ 4.1; CI 95%: 1.8–9.0) were associated with mild to moderate CVI. Obesity increased the frequency of severe CVI 2.7 times (OR ¼ 2.7; CI 95%: 1.6–4.6); being a woman also increased the frequency of more severe disease 1.3 times (OR ¼ 1.3; CI 95%: 1.0–1.7). Conclusion: Anatomical and haemodynamic studies by DU are postulated as a useful diagnostic tool that allow, by identifying the pattern of venous reflux of varicose pathology, characterization of the probable association to CVI clinical severity

SCORE and REGICOR function charts underestimate the cardiovascular risk in Spanish patients with rheumatoid arthritis

Introduction: Our objective was to determine which one of the two function charts available in Spain to calculate cardiovascular (CV) risk, Systematic COronary Risk Evaluation (SCORE) or Framingham-REgistre GIroní del COR (REGICOR), should be used in patients with rheumatoid arthritis (RA). Methods: A series of RA patients seen over a one-year period without history of CV events were assessed. SCORE, REGICOR, modified (m)SCORE and mREGICOR according to the European League Against Rheumatism (EULAR) recommendations were applied. Carotid ultrasonography (US) was performed. Carotid intima-media thickness (cIMT) > 0.90 mm and/or carotid plaques were used as the gold standard test for severe subclinical atherosclerosis and high CV risk (US+). The area under the receiver operating curves (AUC) for the predicted risk for mSCORE and mREGICOR were calculated according to the presence of severe carotid US findings (US+). Results: We included 370 patients (80% women; mean age 58.9 ± 13.7 years); 36% had disease duration of 10 years or more; rheumatoid factor (RF) and/or anticyclic citrullinated peptide (anti-CCP) were positive in 68%; and 17% had extra-articular manifestations. The EULAR multiplier factor was used in 122 (33%) of the patients. The mSCORE was 2.16 ± 2.49% and the mREGICOR 4.36 ± 3.46%. Regarding US results, 196 (53%) patients were US+. The AUC mSCORE was 0.798 (CI 95%: 0.752 to 0.844) and AUC mREGICOR 0.741 (95% CI; 0.691 to 0.792). However, mSCORE and mREGICOR failed to identify 88% and 91% of US+ patients. More than 50% of patients with mSCORE ≥1% or mREGICOR >1% were US+. Conclusions: Neither of these two function charts was useful in estimating CV risk in Spanish RA patients

Effect of anticoagulant therapy in tehe incidence of post-throbotic syndrome and recurrent thromboemboembolism : comparative study of euoxeparin versus coumarin

Producción CientíficaObjective: We evaluated the effect of long-term anticoagulant treatment (enoxaparin vs coumarin) in patients with deep venous thrombosis (DVT) as to incidence of post-thrombotic syndrome (PTS) and recurrent venous thromboembolism. We also analyzed the impact of thrombus regression after the anticoagulant treatment for these two outcomes. Methods: A prospective study was designed in which 165 patients with symptomatic, unilateral, first-episode DVT were randomized to a long-term anticoagulant treatment with coumarin or enoxaparin during at least 3 months. The rate of thrombus regression was defined as the difference in Marder score after 3 months of treatment by venography. Follow-up was performed at 3, 6, and 12 months, and yearly thereafter for 5 years. Venous disease was related to pathologic severity of PTS according to the validated scale of Villalta as rated by a physician blinded to treatment. Recurrence of symptomatic venous thromboembolism was documented objectively. Results: The 5-year follow-up period was completed for 100 patients (enoxaparin, 56; coumarin, 44). A lesser incidence of PTS was observed in the enoxaparin group (39.3% absent, 19.6% severe) than in the coumarin group (29.5% absent, 29.5% severe), although this difference was not statistically significant. The accumulated recurrence rate was 19.3% with enoxaparin compared with 36.6% with coumarin (P .02). Although the mean Marder score was significantly improved in both groups (49.1% for enoxaparin vs 24.0% for coumarin; P .016), a lower reduction in thrombus size was associated with higher clinical events of recurrence (hazard ratio 1.97; 95% CI, 1.06-3.66; P .032). A significant inverse correlation was also found between the degree of thrombus regression at 3 months and the incidence at 5 years of PTS (P .007). Conclusions: Residual venous thrombosis is an important risk factor for recurrent thromboembolism and PTS. A greater reduction in thrombus size was associated with lesser clinical events of recurrence and consequently a lesser rate of PTS. However, despite a greater recanalization with enoxaparin, the incidence of PTS was similar between both treatment groups, probably because of the small sample size. Further investigations are needed to clarify the implication of the anticoagulant treatment in the severity of PTS. (J Vasc Surg 2008;48:953-9.

Normal aortic diameters within the Mexican population and the impact of gender and ethnicity

Background: There is a lack of studies describing the normal size of the aorta in Mexican population. Objective: To analyze aortic measurements in Mexican patients and to compared them with patients from five different countries. Methods: Measurements of the aorta were divided in Mexicans and controls. Comparisons between ethnicities and groups were performed using Mann Whitney rank sum test. Results: The registry included 166 patients, 106 (63.8%) were enrolled in Mexico and 60 (36.1%) in the control group. Mexican patients had smaller aortic diameters compared to the control group, at the level of the right renal artery ostium, inferior mesenteric artery, and aortic bifurcation. The Hispanic population had significantly smaller aortic diameters from the level of the celiac artery to the aortic bifurcation. Conclusion: The normal aortic diameters in the Mexican population are smaller compared to other countries.</p