OnabotulinumtoxinA and multiple sclerosis.

Lower urinary tract dysfunction is present in two of three patients with multiple sclerosis five years after the diagnosis. Most frequent symptoms are related to neurogenic detrusor overactivity, often associated with detrusor-sphincter dyssynergia. From the end of the 1990s, there is growing evidence that neurogenic detrusor overactivity can be effectively managed by intradetrusorial injections of botulinum toxin type A. This treatment has shown, in different randomised placebo-controlled trials, to be safe and effective on clinical and urodynamic parameters with significant improvement in quality of life. The median duration of effect is in mean nine months. The vast majority of studies have been conducted with onabotulinumtoxinA. The dose of onabotulinumtoxinA commonly used to treat neurogenic detrusor overactivity in patients with multiple sclerosis is 200 UI, even if in selected patients lower doses can be preferred. To be considered eligible for treatment, all patients should accept and be instructed to perform clean intermittent self-catheterisation, since the risk of increased post-void residual volume and/or urinary retention after injection is high, especially with 200 UI of onabotulinumtoxinA. However, quality of life and patient satisfaction seem not to be affected by the need of intermittent catheterisation. The risk of urinary infection after the procedure is to be kept in mind, mainly in patients with multiple sclerosis, so that adequate antibiotic prophylaxis is highly recommended

Determinants of Neurological Functional Recovery Potential after Stroke in Young Adults

BACKGROUND/OBJECTIVES: Despite recent progress in stroke prevention and acute treatment, neurorehabilitation remains one of the main methods of treatment in the management of stroke patients. The aim of this study is to point out some important predicting factors of in-hospital neurorehabilitation outcomes. METHODS: A rehabilitation registry including all patients who had undergone a standardized program of neurorehabilitation at the neurorehabilitation unit of the Lausanne University Hospital, Lausanne, Switzerland, was created. Patients aged <65 years and having experienced a first ever nontraumatic stroke from 2005 to 2010 were admitted. Using logistical regression models, predicting factors for each patient were compared to the exit Functional Independence Measure (FIM) score. RESULTS: Age >55 years, gender, aphasia, hemilateral spatial neglect, spasticity, complications, length of stay >70 days, entry FIM >100 and relative possible FIM gain/week of >10% were considered to be significant and independent predicting factors of the neurorehabilitation outcome. DISCUSSION/CONCLUSION: Some factors of the in-hospital rehabilitation period have been identified before (spasticity, complications, length of stay, relative possible FIM gain/week) and should be considered for a better management of the neurorehabilitation therapy. In addition, a personalized rehabilitation strategy based on the patient's individual needs should be aimed at. The question of resource allocation can also be addressed with regard to the present findings

a single blinded randomized pilot study of botulinum toxin type a combined with non pharmacological treatment for spastic foot

OBJECTIVE: To explore the effect of treatment after botulinum toxin type A combined with treatments for the spastic foot. DESIGN: Single-blind, randomized trial, with 3-month follow-up. SUBJECTS: Twenty-three chronic hemiplegic adult patients with spastic equinus foot. METHODS: Following botulinum toxin type A injection at the medial and lateral gastrocnemius, patients were assigned randomly to 3 groups, and treated with taping, electrical stimulation or stretching. They were evaluated before treatment (t0), and at 10 (t1), 20 (t2) and 90 (t3) days after treatment. Outcome measures were: Modified Ashworth Scale; passive range of motion at the ankle; measurement of muscle action potential at the gastrocnemius medialis; and measurement of maximum ankle dorsiflexion angle in stance using gait analysis. RESULTS: The group treated with electrical stimulation performed better at t1 on the Modified Ashworth Scale. The taping and electrical stimulation groups performed better in all outcome measures at t3. The taping group performed better mainly for maximum ankle dorsiflexion angle in stance. The stretching group showed a less durable result, with some worsening at the t3 evaluation compared with the assessment performed before treatment. CONCLUSIONS: This pilot study indicates that combining botulinum toxin type A administration for the ankle plantar flexors with taping and electrical stimulation might be beneficial

La terapia enterostomal una alternativa para el ejercicio profesional independiente

La delimitación de las especialidades en enfermería ha sido una preocupación de las enfermeras, de los organismos que las agrupan y de las unidades académicas, por la necesidad de prestar mayores y mejores cuidados. Así podemos ver cómo hoy las diferentes especialidades amplían el horizonte de la profesión, los campos de desempeño se han desarrollado y las perspectivas para el ejercicio independiente son mayores. Dentro de ese mismo contexto la enfermera como estomaterapéuta amplía su rol, bien en la institución en la cual se desempeña o en forma independiente. Provee cuidado, asistencia y rehabilitación a personas con estomas, fístulas enterocutáneas, con lesiones del tejido integumentario y con incontinencia. Sus acciones se extienden más allá de la institución hospitalaria, orientando al paciente y su familia y  proporcionándoles el apoyo necesario para que a través del cuidado, la orientación y el aprendizaje, las personas objeto de nuestra asistencia, encuentren sus propias soluciones a las limitaciones que se derivan de su condición de salud. Como enfermera terapista enterostomal desarrollo mis funciones en la consulta privada, en clínicas, a nivel del hogar y en el programa de la Clínica de Estomaterapia del Hospital Universitario Ramón González Valencia en Bucaramanga. Uno de mis propósitos es presentar algunos resultados y experiencias obtenidos a lo largo de mi desempeño en éste trabajo

Multifunctional smart coatings on novel ceramics and glassceramic substrates in the context of the circular economy

Nowadays is time of products generated by “smart coatings” that exhibit multiple functionalities. In particular, the construction industry is reached the point where it is possible to fabricate “smart and sustainable” buildings that fulfll the requirements of a growing marketplace of products and devices for “smart cities” generation. In addition, if the buildings are “green”, i.e. in accordance with the today‘s economic model “made to be made again” or so-called “circular economy” they are very attractive and viable alternative for future businesses and industrial exploring. In this concept, we report a development sustainable ceramic and glass-ceramic tile substrates made by cheap, easily accessible and recycled materials that are further functionalized by different “smart coatings” for specifc applications. Devices that generate and save energy, air and pollution cleaning, with anti-slip and phosphorescence properties are some examples of the overview that this publication described

Síntesis, caracterización y evaluación eléctrica de circonatos de bario dopados con lantánidos trivalentes

El circonato de bario es un material oxídico con estructura de tipo perovskita que muestra alta estabilidad química tanto en ambientes oxidantes como reductores, como en presencia de agua y dióxido de carbono; su conductividad ha permitido examinarlo como electrolito para celdas de combustible de óxido sólido encontrando buenos resultados, con la limitante de operar a temperaturas superiores a los 800 °C. Diversos investigadores han propuesto que es posible mejorar su conductividad eléctrica por modifi caciones en su composición química, en particular por dopaje con cationes trivalentes que reemplacen el circonio en el sitio B de la perovskita. En este estudio se sintetizó el circonato de bario por el método citrato amorfo a fi n examinar la posibilidad de obtenerlo en condiciones más favorables que las presentadas por el método de síntesis convencional (método cerámico o reacción de estado sólido). Se preparó circonato de bario dopado con europio, gadolinio, holmio, lantano, neodimio y praseodimio; la identifi cación de fases presentes se verifi có por difracción de rayos X (DRX), las propiedades eléctricas se examinaron por espectroscopía de impedancias (IS) a temperaturas entre 480 y 680 °C, con miras a evaluar su potencial uso como electrolito en celdas de combustible de óxido sólido. Los aportes de esta investigación se han centrado en el método de síntesis; en la obtención de polvos cerámicos de circonato de bario a temperaturas inferiores a las requeridas por el método cerámico; en la obtención de información química, estructural, morfológica y eléctrica de los materiales sintetizados. Se encontró la fase deseada en las condiciones de síntesis establecidas, así mismo, se aprecia un incremento signifi cativo en la conductividad de los sólidos dopados con lantano, holmio y europio en relación al material sin dopaje alguno.Barium zirconate is an oxidic material having perovskite structure that exhibits high chemical stability in both oxidizing and reducing environments, such as in the presence of water and carbon dioxide, its conductivity has led to consider it as a electrolyte for solid oxide fuel cell fi nding good results, with the limitation of operating at temperatures above 800 °C. Several researchers have proposed that it is possible to improve their electrical conductivity by changes in chemical composition, particularly for doping with trivalent cations that replace the zirconium in B site of perovskite. In this study, barium zirconate was synthetized by the amorphous citrate method to examine the possibility of obtaining in more favorable conditions than those made by the conventional method of synthesis (ceramic method or solid state reaction) conditions are synthesized. Barium zirconate doped with europium, gadolinium, holmium, lanthanum, neodymium and praseodymium was prepared, the present phase identifi cation was verifi ed by X-ray diffraction (XRD), the electrical properties were examined by impedance spectroscopy (IS) at temperatures between 480 and 680 °C in order to evaluate its potential use as a fuel cell electrolyte in solid oxide. The contributions of this research has focused on the synthesis method, in the production of ceramic powders of barium zirconate at temperatures lower than those required by the ceramic method, in obtaining chemical, structural, morphological and electrical information of material synthesized. The desired phase synthesis conditions set found, also, a signifi cant increase is seen in the solid conductivity of doped lanthanum, holmium and europium zirconate of barium in relation to the material without doping

Incorporación de residuos derivados de la fabricación cerámica y del vidrio reciclado en el proceso cerámico integral

The following research work shows the results of the introduction of waste generated by the ceramic industry, such as the calcined clay from fired porcelain of stoneware and raw biscuit, sludge and cleaning water, as well as waste from other sectors like the recycling glass. In this way, it can be obtained a stoneware porcelain slab, engobe-glaze and satin glaze that contains high percentage of recyclable raw material

(1R,4R,5R)-1,3,4-Triphenyl-7-[(R)-1-phenyl­ethyl]-2-oxa-3,7-diaza­spiro­[4.5]decan-10-one

In the title compound, C33H32N2O2, the polysubstituted piperidine ring adopts a chair conformation. The isoxazolidine ring is in an envelope conformation. In the crystal structure, intra- and inter­molecular C—H⋯π inter­actions involving the phenyl rings are observed

Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study.

To evaluate the effects of electrically assisted movement therapy (EAMT) in which patients use functional electrical stimulation, modulated by a custom device controlled through the patient's unaffected hand, to produce or assist task-specific upper limb movements, which enables them to engage in intensive goal-oriented training. Randomized, crossover, assessor-blinded, 5-week trial with follow-up at 18 weeks. Rehabilitation university hospital. Patients with chronic, severe stroke (N=11; mean age, 47.9y) more than 6 months poststroke (mean time since event, 46.3mo). Both EAMT and the control intervention (dose-matched, goal-oriented standard care) consisted of 10 sessions of 90 minutes per day, 5 sessions per week, for 2 weeks. After the first 10 sessions, group allocation was crossed over, and patients received a 1-week therapy break before receiving the new treatment. Fugl-Meyer Motor Assessment for the Upper Extremity, Wolf Motor Function Test, spasticity, and 28-item Motor Activity Log. Forty-four individuals were recruited, of whom 11 were eligible and participated. Five patients received the experimental treatment before standard care, and 6 received standard care before the experimental treatment. EAMT produced higher improvements in the Fugl-Meyer scale than standard care (P<.05). Median improvements were 6.5 Fugl-Meyer points and 1 Fugl-Meyer point after the experimental treatment and standard care, respectively. The improvement was also significant in subjective reports of quality of movement and amount of use of the affected limb during activities of daily living (P<.05). EAMT produces a clinically important impairment reduction in stroke patients with chronic, severe upper limb paresis

Ultrastructural analysis of mesenchymal differentiation into cartilage induced by PEA/PHEA scaffold (Abstract)

Viñuela-Prieto, J.; Panadero Pérez, JA.; Antolinos Turpín, CM.; Ribeiro, C.; Gómez-Tejedor, JA.; Lanceros-Méndez, S.; Gómez Ribelles, JL.... (2013). Ultrastructural analysis of mesenchymal differentiation into cartilage induced by PEA/PHEA scaffold (Abstract). Histology and Histopathology. 28:47-47. doi:10.14670/HH-sehit13S47472