Evolución de la utilidad diagnóstica en demencias del test del reloj en mujeres mayores institucionalizadas

El aumento de la esperanza de vida sitúa el impacto mundial de la demencia en más de 50 millones de personas. La enfermedad genera deterioro cognitivo, pérdida de autonomía, y decremento de la calidad de vida en el paciente y en la familia. El diagnóstico tardío de la misma aumenta el gasto sanitario y social, por lo que la evaluación precoz resulta esencial. Factores como la edad y el género influyen notablemente, pero los estudios generalmente son mixtos asumiendo la igualdad básica. Esta investigación tiene como objetivo observar en un estudio longitudinal de 5 años en 157 mujeres mayores, la evolución en la detección de la demencia del Test del Reloj y su correlación con el Mini-Examen Cognoscitivo, los test de autonomía funcional y la edad. Los resultados muestran que el Test del Reloj resulta más idóneo en los primeros síntomas de demencia ya que predice más casos que el Mini-Examen Cognoscitivo en mujeres. Los cambios neuropatológicos producidos por el deterioro cognitivo en estados incipientes se relacionan con la pérdida de las actividades instrumentales de la vida diaria, y la demencia tardía con la pérdida de las actividades básicas de la vida diaria. La edad se asocia tanto al estado cognitivo como al funcional.<br /

Evolución de la utilidad diagnóstica en demencias del Test del Reloj en mujeres mayores institucionalizadas

El aumento de la esperanza de vida sitúa el impacto mundial de la demencia en más de 50 millones de personas. La enfermedad genera deterioro cognitivo, pérdida de autonomía, y decremento de la calidad de vida en el paciente y en la familia. El diagnóstico tardío de la misma aumenta el gasto sanitario y social, por lo que la evaluación precoz resulta esencial. Factores como la edad y el género influyen notablemente, pero los estudios generalmente son mixtos asumiendo la igualdad básica. Esta investigación tiene como objetivo observar en un estudio longitudinal de 5 años en 157 mujeres mayores, la evolución en la detección de la demencia del Test del Reloj y su correlación con el Mini-Examen Cognoscitivo, los test de autonomía funcional y la edad. Los resultados muestran que el Test del Reloj resulta más idóneo en los primeros síntomas de demencia ya que predice más casos que el Mini-Examen Cognoscitivo en mujeres. Los cambios neuropatológicos producidos por el deterioro cognitivo en estados incipientes se relacionan con la pérdida de las actividades instrumentales de la vida diaria, y la demencia tardía con la pérdida de las actividades básicas de la vida diaria. La edad se asocia tanto al estado cognitivo como al funcional

Thermal and non-thermal effects of capacitive–resistive electric transfer application on different structures of the knee: A cadaveric study

Capacitive–resistive electric transfer therapy is used in physical rehabilitation and sports medicine to treat muscle, bone, ligament and tendon injuries. The purpose is to analyze the temperature change and transmission of electric current in superficial and deep knee tissues when applying different protocols of capacitive–resistive electric transfer therapy. Five fresh frozen cadavers (10 legs) were included in this study. Four interventions (high/low power) were performed for 5 min by a physiotherapist with experience. Dynamic movements were performed to the posterior region of the knee. Capsular, intra-articular and superficial temperature were recorded at 1-min intervals and 5 min after the treatment, using thermocouples placed with ultrasound guidance. The low-power protocols had only slight capsular and intra-capsular thermal effects, but electric current flow was observed. The high-power protocols achieved a greater increase in capsular and intra-articular temperature and a greater current flow than the low-power protocols. The information obtained in this in vitro study could serve as basic science data to hypothesize capsular and intra-articular knee recovery in living subjects. The current flow without increasing the temperature in inflammatory processes and increasing the temperature of the tissues in chronic processes with capacitive–resistive electric transfer therapy could be useful for real patients

Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort—A Randomised Cross-Over Trial

Background: Stretching techniques for hamstring muscles have been described both to increase muscle length and to evaluate nerve mechanosensitivity. Aim: We sought to evaluate the short-term effects of three types of hamstring stretching on hamstring length and report the type of response (neural or muscular) produced by ankle dorsiflexion and perceived sense of effort in asymptomatic subjects. Methods: A randomised cross-over clinical trial was conducted. A total of 35 subjects were recruited (15 women, 20 men; mean age 24.60 ± 6.49 years). Straight leg raises (SLR), passive knee extensions (PKE), and maximal hip flexion (MHF) were performed on dominant and non-dominant limbs. In addition, the intensity of the applied force, the type and location of the response to structural differentiation, and the perceived sensation of effort were assessed. Results: All stretching techniques increased hamstring length with no differences between limbs in the time*stretch interaction (p &lt; 0.05). The perceived sensation of effort was similar between all types of stretching except MHF between limbs (p = 0.047). The type of response was mostly musculoskeletal for MHF and the area of more neural response was the posterior knee with SLR stretch. Conclusions: All stretching techniques increased hamstring length. The highest percentage of neural responses was observed in the SLR stretching, which produced a greater increase in overall flexibility

Does Upper Cervical Manual Therapy Provide Additional Benefit in Disability and Mobility over a Physiotherapy Primary Care Program for Chronic Cervicalgia? A Randomized Controlled Trial

Introduction: Neck pain is a condition with a high incidence in primary care. Patients with chronic neck pain often experience reduction in neck mobility. However, no study to date has investigated the effects of manual mobilization of the upper cervical spine in patients with chronic mechanical neck pain and restricted upper cervical rotation. Objective: To evaluate the effect of adding an upper cervical translatoric mobilization or an inhibitory suboccipital technique to a conventional physical therapy protocol in patients with chronic neck pain test on disability and cervical range of motion. Design: Randomized controlled trial. Methods: Seventy-eight patients with chronic neck pain and restricted upper cervical rotation were randomized in three groups: Upper cervical translatoric mobilization group, inhibitory suboccipital technique group, or control group. The neck disability index, active cervical mobility, and the flexion–rotation test were assessed at baseline (T0), after the treatment (T1), and at three-month follow-up (T2). Results: There were no statistically significant differences between groups in neck disability index. The upper cervical translatoric mobilization group showed a significant increase in the flexion–rotation test to the more restricted side at T1 (F = 5.992; p < 0.004) and T2 (F = 5.212; p < 0.007) compared to the control group. The inhibitory suboccipital technique group showed a significant increase in the flexion–rotation test to the less restricted side at T1 (F = 3.590; p < 0.027). All groups presented high percentages of negative flexion–rotation tests. (T1: 69.2% upper neck translator mobilization group; 38.5% suboccipital inhibition technique group, 19.2% control group; at T2: 80.8%; 46.2% and 26.9% respectively). No significant differences in the active cervical mobility were found between groups. Conclusion: Adding manual therapy to a conventional physical therapy protocol for the upper cervical spine increased the flexion–rotation test in the short- and mid-term in patients with chronic neck pain. No changes were found in the neck disability index and the global active cervical range of motion

Thermal and non-thermal effects off capacitive-resistive electric transfer application on the achilles tendon and musculotendinous junction of the gastrocnemius muscle: a cadaveric study

Background Calf muscle strain and Achilles tendon injuries are common in many sports. For the treatment of muscular and tendinous injuries, one of the newer approaches in sports medicine is capacitive-resistive electric transfer therapy. Our objective was to analyze this in vitro, using invasive temperature measurements in cadaveric specimens. Methods A cross-sectional study designed with five fresh frozen cadavers (10 legs) were included in this study. Four interventions (capacitive and resistive modes; low- and high-power) was performed for 5¿min each by a diathermy “T-Plus” device. Achilles tendon, musculotendinous junction and superficial temperatures were recorded at 1-min intervals and 5¿min after treatment. Results With the low-power capacitive protocol, at 5¿min, there was a 25.21% increase in superficial temperature, a 17.50% increase in Achilles tendon temperature and an 11.27% increase in musculotendinous junction temperature, with a current flow of 0.039 A¿±¿0.02. With the low-power resistive protocol, there was a 1.14% increase in superficial temperature, a 28.13% increase in Achilles tendon temperature and an 11.67% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.063 A¿±¿0.02. With the high-power capacitive protocol there was an 88.52% increase in superficial temperature, a 53.35% increase in Achilles tendon temperature and a 39.30% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.095 A¿±¿0.03. With the high-power resistive protocol, there was a 21.34% increase in superficial temperature, a 109.70% increase in Achilles tendon temperature and an 81.49% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.120 A¿±¿0.03. Conclusion The low-power protocols resulted in only a very slight thermal effect at the Achilles tendon and musculotendinous junction, but current flow was observed. The high-power protocols resulted in a greater temperature increase at the Achilles tendon and musculotendinous junction and a greater current flow than the low-power protocols. The high-power resistive protocol gave the greatest increase in Achilles tendon and musculotendinous junction temperature. Capacitive treatments (low- and high-power) achieved a greater increase in superficial temperature

Comparison of resistive capacitive energy transfer therapy on cadaveric molars and incisors with and without implants.

Capacitive-resistive energy transfer therapy (CRet) is used to improve the rehabilitation of different injuries. This study aimed to evaluate and compare the changes in temperature and current flow during different CRet applications on upper and lower molars and incisors, with and without implants, on ten cryopreserved corpses. Temperatures were taken on molars and incisors with invasive devices and skin temperature was taken with a digital thermometer at the beginning and after treatments. Four interventions: 15 VA capacitive hypothermic (CAPH), 8 watts resistive (RES8), 20 watts resistive (RES20) and 75 VA capacitive (CAP75) were performed for 5 min each. All treatments in this study generated current flow (more than 0.00005 A/m2) and did not generate a significant temperature increase (p > 0.05). However, RES20 application slightly increased surface temperature on incisors without implants (p = 0.010), and molar with (p = 0.001) and without implant (p = 0.008). Also, CAP75 application increased surface temperature on molars with implant (p = 0.002) and upper incisor with implant (p = 0.001). In conclusion, RES8 and CAPH applications seem to be the best options to achieve current flow without an increase in temperature on molars and incisors with and without implants

Precision of ultrasound-guided versus anatomical palpation-guided needle placement of the ulnar nerve at the cubital tunnel: a cadaveric study

Percutaneous electrical stimulation has been performed for years with only the assistance of anatomical landmarks. The development of real-time ultrasonography guidance has improved the precision and safety of these percutaneous interventions. Despite ultrasound-guided and palpation-guided procedures being performed routinely for targeting nerve tissues in the upper extremity, the precision and safety of these techniques are unknown. The aim of this cadaveric study was to determine and compare the precision and safety of ultrasound-guided versus palpation-guided needling procedure with and without the handpiece of the ulnar nerve on a cadaveric model. Five physical therapists performed a series of 20 needle insertion tasks each (n = 100), 10 palpation-guided (n = 50) and 10 ultrasound-guided (n = 50) on cryopreserved specimens. The purpose of the procedure was to place the needle in proximity to the ulnar nerve at the cubital tunnel. The distance to target, time performance, accurate rate, number of passes, and unintentional puncture of surrounding structures were compared. The ultrasound-guided procedure was associated with higher accuracy (66% vs. 96%), lower distance from needle to the target (0.48 ± 1.37 vs. 2.01 ± 2.41 mm), and a lower frequency of perineurium puncture (0% vs. 20%) when compared with the palpation-guided procedure. However, the ultrasound-guided procedure required more time (38.33 ± 23.19 vs. 24.57 ± 17.84 s) than the palpation-guided procedure (all, p &lt; 0.001). Our results support the assumption that ultrasound guidance improves the accuracy of needling procedures on the ulnar nerve at the cubital tunnel when compared with palpation guidance

Involvement of Mechanical Cues in the Migration of Cajal-Retzius Cells in the Marginal Zone During Neocortical Development

Emerging evidence points to coordinated action of chemical and mechanical cues during brain development. At early stages of neocortical development, angiogenic factors and chemokines such as CXCL12, ephrins, and semaphorins assume crucial roles in orchestrating neuronal migration and axon elongation of postmitotic neurons. Here we explore the intrinsic mechanical properties of the developing marginal zone of the pallium in the migratory pathways and brain distribution of the pioneer Cajal-Retzius cells. These neurons are generated in several proliferative regions in the developing brain (e.g., the cortical hem and the pallial subpallial boundary) and migrate tangentially in the preplate/marginal zone covering the upper portion of the developing cortex. These cells play crucial roles in correct neocortical layer formation by secreting several molecules such as Reelin. Our results indicate that the motogenic properties of Cajal-Retzius cells and their perinatal distribution in the marginal zone are modulated by both chemical and mechanical factors, by the specific mechanical properties of Cajal-Retzius cells, and by the differential stiffness of the migratory routes. Indeed, cells originating in the cortical hem display higher migratory capacities than those generated in the pallial subpallial boundary which may be involved in the differential distribution of these cells in the dorsal-lateral axis in the developing marginal zone

El derecho del trabajo y de la seguridad social en españa en 2018

En su quinta edición, el Informe “El Derecho del Trabajo y de la Seguridad Social en España 2018” le ofrece una síntesis, que por concreta no es menos rigurosa, de los principales hitos por los que ha transitado el iuslaboralismo a lo largo del último año. En concreto, en las páginas que siguen, los expertos integrantes de la Sección Juvenil de la Asociación Española de Derecho del Trabajo y de la Seguridad Social (AEDTSS) analizan para usted, en primer lugar, las principales resoluciones europeas y nacionales en materia de igualad y no discriminación, acoso en sus más diversas manifestaciones, liberad religiosa y libertad de expresión. Asimismo, se abordan también las cuestiones relativas al empleo y la contratación, casi monopolizadas por el impacto de las plataformas y las consecuencias del caso de Diego. En materia de vicisitudes, sin perder importancia el despido colectivo, observará un cierto auge de los casos relativos a sucesión empresarial, movilidad funcional y empleo público. En el ámbito del derecho colectivo, además de analizarse el IV AENC, encontrará un estudio pormenorizado de las principales resoluciones en materia de libertad sindical, representación unitaria y ultraactividad. La sección relativa a conciliación y corresponsabilidad incluye este año como novedad un apartado relativo a violencia de género, al hilo de los avances normativos derivados del Real Decreto-ley 9/2018. Los epígrafes concernientes a la protección social y la prevención de riesgos laborales crecen de forma significativa en esta edición, lo que ha permitido abordar la evolución jurisprudencial para buena parte de las prestaciones y riesgos previstos en la Ley. Por último, las expertas del apartado de derecho procesal se han encargado de revisar a fondo los casos más significativos en el marco de las modalidades procesales especiales, con especial hincapié en el ámbito concursal. También han abordado la jurisprudencia constitucional más reciente sobre el de recurso de reposición. En suma, tienen ante usted un trabajo científico consolidado en el tiempo y sólido en cuanto al contenido, fiel reflejo de, a pesar del difícil contexto, el buen hacer de la joven doctrina iuslaboralista española