Benefits of Upper Limb Functional Electrical Stimulation in Children with Spastic Cerebral Palsy

Aim: The aim of this study was to assess the effectiveness of Functional Electrical Stimulation in upper limb rehabilitation in children with cerebral palsy. Methods: 90 children with spastic cerebral palsy, age between 6 and 9 years, were randomized into two groups. 45 children, represented the control group, performed conventional physical and occupational therapy and robot-assisted therapy. In addition to the control group, the experimental group received functional electrical stimulation interventions with postural control on the affected upper limb. Results: The experimental group's motor performance after treatment (improved coordination by 8.2%, wrist flexion by 9.75°, three-fingered grasp strength by 1.04°, and functional limitation lowered by 5.93) was considerably better than the control group's which coordination increased by 5.5%, wrist flexion by 8.72°, three-fingered grasp strength by 0.7 and functional limitation decreased by 2.33. Conclusions: Functional electrical stimulation intervention was found to be an effective manner to improve motor performance, in terms of coordination, range of motion, and three-fingered grasp strength, visibly reducing functional limitation and improving performance in activities of daily living

Statistical Study Regarding the Presence of Gram Bacteria in Patients with Cardiovascular Disease and Periodontal Disease

Pathogenic bacteria, originating in the inflamed periodontium, can make their way into the body through the vascular system, either by entering the bloodstream or lymph directly or as internalized particles of immune cells. This research aims to investigate the existence of a potential connection between two pathologies – periodontitis and ischemic heart disease – by utilizing a DNA-DNA hybridization technique to highlight the presence of seven periodontal pathogens: A. actinomycetemcomitans, P. gingivalis, P. endodontalis, P. intermedia, T. forsythia, C. rectus and F. Nucleatum. The study was conducted over a period of 3 years on a sample consisting of 119 patients with cardiovascular disease and periodontal disease, divided into 3 groups by pathologies, as follows: the first group consisted of 31 patients with ischemic cardiomyopathy, the second group consisted of 43 patients with periodontal disease and ischemic cardiomyopathy, and the third group consisted of 45 patients with periodontal disease. The results show the possibility of a correlation between the composition of the bacterial flora in the group of patients with cardiac disease and those with associated pathologies. In conclusion, we may state that periodontitis may be seen as a risk factor in heart disease, which may certify the possibility of an etiological connection between the two pathologies

DIAGNOSTICUL COMPUTER-TOMOGRAFIC ÎN URGENŢA PEDIATRICĂ

Introducere. Examinarea prin computer-tomograf (CT) deţine un rol important în orientarea diagnostică în Urgenţă. Obiective. Ne-am propus să identifi căm utilitatea examinării CT, în urgenţa pediatrică. Material şi metode. Studiul are un design cross-secţional, referindu-se la anul 2010. Din cele 92.959 de vizite înregistrate la Unitatea de Primiri Urgenţe, a Spitalului Clinic de Urgenţă pentru Copii „M.S. Curie“, Bucureşti, un număr de 9.258 pacienţi reprezentau urgenţe (lotul A), iar 90 constituiau urgenţe majore (lotul B). S-au efectuat un număr de 102 examinări CT. Datele au fost exprimate procentual. Rezultate. Procentul de vizite asociat cu examinare CT, a fost de 1% în lotul A şi 1‰, exprimat global. Toţi pacienţii lotului B au fost supuşi investigaţiei CT. Principalele indicaţii au fost: traumatismele cranio-cerebrale (TCC) – 50%, hipertensiune intracraniană (HIC) – 35%, politraumatisme – 12,7% şi suspiciunile de malformaţii – 5,9%. Rata de detecţie globală a unei leziuni a fost de 51%. Pentru TCC, rata a fost de 49%, identifi cându-se următoarele leziuni: edem cerebral difuz (19%), hemoragii intracraniene (15,6%), fracturi osoase (15,6%), leziuni de părţi moi (29%). Pentru HIC, rata de detecţie a fost de 43%, pentru politraumatisme 84,6%, iar pentru suspiciunile de malformaţii 100%. Ratele de detecţie lezională, pe diverse categorii de indicaţii (senzitivitatea metodei) nu diferă semnifi cativ statistic faţă de alte studii. Concluzie. La pacienţii de vârstă pediatrică, indicaţiile de CT, în urgenţă, s-au efectuat după o atentă selecţie a cazurilor, iar examinarea s-a dovedit utilă în cazul traumatismelor şi a suspiciunilor de hipertensiune intracraniană

New methodological aspects in rehabilitation after proximal humerus fracture

Proximal humerus fracture ranks third in the elderly after femoral neck fractures and distal radius fractures, and seventh in adults, and the risk of occurrence is related to advancing age. In this study we aimed to analyze the efficacy of a 24-weeks physical therapy programme based on a particular methodology consisting of the reprogramming of the specific proprioceptive neuromuscular facil-itation techniques added to the classical physical therapy and by introducing modern interactive therapies and technologies: Capacitive Resistive Electric Transference, Instrument Assisted Soft Tissue Mobilization, kinesiological tapes and PRAMA system, compared with classical physical therapy. Our study included 26 patients, aged between 18 and 55 years, with proximal humerus fracture, who complete the 24-weeks rehabilitation programme. We assessed pain, shoulder range of motion, muscle strength and the ability to perform activities of daily living. The statistical analysis was performed using IBM SPSS and Excel 2021. The results showed statistically significant im-provement in all shoulder motion, increased muscle strength, decreased pain, and a better ability to perform daily activities. The physical therapy programme based on the proposed particular methodology has proven to be more effective than classical physical therapy, both regarding the improvement of the movement parameters compared to the physiological values, as well as the symmetry of both shoulders

The Challenges of Melanoma during COVID-19 Pandemic

Diagnosis, tratament and follow-up of patients with melanoma during COVID-19 pandemic is quite challenging. These patients are often immunocompromised, but, on the other hand, management of this malignant skin cancer should not be delayed. It is necessary to diagnose and stage the melanoma as soon as possible, in an attempt to provide a better prognosis. There are few data regarding the treatament of melanoma during COVID-19 pandemia. However, the general recommandations suggest testing all cancer patients prior administration of the therapy. The European Society for Medical Oncology (ESMO) provided guidelines regarding therapy of this skin cancer during COVID-19 pandemic. Every patient is different, and it is always important to evaluate the risks and benefits

Influence of the upper limb motor deficit on the functional independence in patients with cerebral palsy

Cerebral palsies (CPs) disturb the voluntary movement control at extremities’ level, entailing various disability degrees. In over 80% of the CP cases there is an upper limb disorder, mainly manifested by the decrease in hand control and the presence of contractures, which, in time, lead to the adoption of abnormal postures which affect the abilities of the CP patients’ hands. The aim of this study was to identify the way the motor deficit at upper limb level – reflected by coordination disturbances and by the condition of the three fingered (tripod) grasp – influences the CP patient’s functional independence. The study demonstrated the existence of significant correlations between Functional Independence Measure (FIM) score, coordination and three fingered grasp. It was proven that the unilateral coordination dysfunctions have a strong negative influence on the coordination of the opposite side and lead to a decrease of the functional independence level. Therefore, the rehabilitation treatment is recommended to be based on a bilateral training, both in order to improve coordination and to obtain a functional level of the three fingered grasp power and of the physiological amplitude at wrist flexion level.</jats:p

Benefits of Upper Limb Functional Electrical Stimulation in Children with Spastic Cerebral Palsy

Aim: The aim of this study was to assess the effectiveness of Functional Electrical Stimulation in upper limb rehabilitation in children with cerebral palsy. Methods: 90 children with spastic cerebral palsy, age between 6 and 9 years, were randomized into two groups. 45 children, represented the control group, performed conventional physical and occupational therapy and robot-assisted therapy. In addition to the control group, the experimental group received functional electrical stimulation interventions with postural control on the affected upper limb. Results: The experimental group's motor performance after treatment (improved coordination by 8.2%, wrist flexion by 9.75°, three-fingered grasp strength by 1.04°, and functional limitation lowered by 5.93) was considerably better than the control group's which coordination increased by 5.5%, wrist flexion by 8.72°, three-fingered grasp strength by 0.7 and functional limitation decreased by 2.33. Conclusions: Functional electrical stimulation intervention was found to be an effective manner to improve motor performance, in terms of coordination, range of motion, and three-fingered grasp strength, visibly reducing functional limitation and improving performance in activities of daily living.</jats:p

Comparative assessment of dexterity tests results using two internationally recognized scales in patients with cerebral palsy, users of medical textiles

The recent studies report an increase in the percentage of newborns diagnosed with cerebral palsy (CP) in industrialized countries due to the increased survival rate of infants with low birth weight. The assessment of the upper limb motor function and manual skills are important steps in achieving a suitable multi-modal therapeutical plan, aiming at gaining functional independence and early integration into society. The study seeks to identify how the motor deficiency present at the level of the upper limbs influences the manual skills of CP patients reflected in daily activities (Activities of Daily Living – ADL) and using medical textiles. 35 patients diagnosed with CP were assessed during hospitalization using, for the comparative reflection of ADL dexterity assessment results, at the same patient, quantified, the Action Research Arm Test (ARAT) scale and ABILHAND-Kids. A highly significant correlation was found, the ABILHAND-Kids score being moderately correlated with the ARAT score, obtained in the upper limb with more deficient functionality (0.578) and respectively with better functionality (0.570). The assessment of the child suffering of CP, using the ABILHAND-Kids questionnaire and the ARAT test provides to the rehabilitation team useful information, with the benefit of complementarity for the elaboration, based on several correlated elements, of the case management plan and methodology. Proper treatment, instituted early, can have a favorable influence on the social integration of these people. A remarkable contribution has been made by the textile domain which, through its sustained concerns regarding the research and development of biotechnologies and biomaterials, proves its permanent concern in supporting and integrating these people.</jats:p

Statistical Study Regarding the Presence of Gram Bacteria in Patients with Cardiovascular Disease and Periodontal Disease

Pathogenic bacteria, originating in the inflamed periodontium, can make their way into the body through the vascular system, either by entering the bloodstream or lymph directly or as internalized particles of immune cells. This research aims to investigate the existence of a potential connection between two pathologies – periodontitis and ischemic heart disease – by utilizing a DNA-DNA hybridization technique to highlight the presence of seven periodontal pathogens: A. actinomycetemcomitans, P. gingivalis, P. endodontalis, P. intermedia, T. forsythia, C. rectus and F. Nucleatum. The study was conducted over a period of 3 years on a sample consisting of 119 patients with cardiovascular disease and periodontal disease, divided into 3 groups by pathologies, as follows: the first group consisted of 31 patients with ischemic cardiomyopathy, the second group consisted of 43 patients with periodontal disease and ischemic cardiomyopathy, and the third group consisted of 45 patients with periodontal disease. The results show the possibility of a correlation between the composition of the bacterial flora in the group of patients with cardiac disease and those with associated pathologies. In conclusion, we may state that periodontitis may be seen as a risk factor in heart disease, which may certify the possibility of an etiological connection between the two pathologies.</jats:p