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

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

A practical booklet for ultrasound-guided botulinum toxin injections.

In the last 15 years, the use of ultrasound to guide botulinum neurotoxin type A injections has been advocated by many authors, with growing evidence showing the benefits of using ultrasound guidance to improve the efficacy of injections. Patients with spasticity may show severely altered postures, atrophy and fibrotic modifications of target muscles, leading to significant challenges in recognising and differentiating between the muscles to be injected or not. At present time, there are no available books with images that clarify how to identify and inject muscles in patients showing these problems. Another problem we considered is the accessibility, from an economic standpoint, of medical books for clinicians in low-income countries. We have created a practical booklet to help clinicians acquire the confidence and expertise needed to administer US-guided injections in patients with severe spasticity, combining the experience of more than 10 years in training clinicians in ultrasound-guided injections. We utilised our experience to create a method that offers a consistent way to recognise muscles, even in challenging conditions. The aim of our booklet is to offer a reliable technique for identify and target muscles in patients with altered muscular structure and pathological postures due to spasticity, relying on easily identifiable anatomical structures such as bones, vessels or nerves, or "iconic" patterns that can easily be learned and remembered. We have provided images and anatomical schemes, as well as ergonomic clinical pearls, to help clinicians providing reliable ultrasound-guided injections. To reduce barriers to education, this booklet is be distributed for free without any royalties

Biomimetic rehabilitation engineering: the importance of somatosensory feedback for brain-machine interfaces.

Brain-machine interfaces (BMIs) re-establish communication channels between the nervous system and an external device. The use of BMI technology has generated significant developments in rehabilitative medicine, promising new ways to restore lost sensory-motor functions. However and despite high-caliber basic research, only a few prototypes have successfully left the laboratory and are currently home-deployed. The failure of this laboratory-to-user transfer likely relates to the absence of BMI solutions for providing naturalistic feedback about the consequences of the BMI's actions. To overcome this limitation, nowadays cutting-edge BMI advances are guided by the principle of biomimicry; i.e. the artificial reproduction of normal neural mechanisms. Here, we focus on the importance of somatosensory feedback in BMIs devoted to reproducing movements with the goal of serving as a reference framework for future research on innovative rehabilitation procedures. First, we address the correspondence between users' needs and BMI solutions. Then, we describe the main features of invasive and non-invasive BMIs, including their degree of biomimicry and respective advantages and drawbacks. Furthermore, we explore the prevalent approaches for providing quasi-natural sensory feedback in BMI settings. Finally, we cover special situations that can promote biomimicry and we present the future directions in basic research and clinical applications. The continued incorporation of biomimetic features into the design of BMIs will surely serve to further ameliorate the realism of BMIs, as well as tremendously improve their actuation, acceptance, and use

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

Mini invasive skeletal muscle biopsy technique with a tri-axial end cut needle

OBJECTIVE: Skeletal Muscle Biopsy is a minor surgical procedure for the diagnosis of different neuromuscular pathological conditions and has recently gained popularity also in the research field of age-related muscular modifications and sarcopenia. Few studies focused on the application of mini-invasive muscular biopsy in both normal and pathological conditions.The aim of our study was to describe a mini invasive ultrasoundguided skeletal muscular biopsy technique in complete spinal cord injured (SCI) patients and healthy controls with a tri-axial end-cut needle. PATIENTS AND METHODS: Skeletal muscle biopsies were collected from 6 chronic SCI patients and 3 healthy controls vastus lateralis muscle with a tri-axial end cut needle Biopince -Angiotech. Muscle samples were stained for ATPase to determine fibers composition, moreover, gene expression of cyclooxygenase-1 (COX-1) and prostaglandin E2 receptor has been analyzed by Real Time RT-PCR. RESULTS: All the procedures were perfomed easily without failures and complications. Control tissue was macroscopically thicker than SCI one. Control specimen displayed an equal distribution of type I and type II fibers, while SCI sample displayed a prevalence of type II fibers SCI specimen displayed a significant reduction in COX-1 gene expression. This mini-invasive approach was easy, accurate and with low complication rate in performing skeletal muscle biopsy in both SCI patients and controls. CONCLUSIONS: This technique could be useful in conditions in which the overall quantity of specimen required is small like for molecular biology analysis. For histological diagnostic purposes and/or conditions in which the original tissue is already pathologically modified, this technique should be integrated with more invasive techniques

Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials.

Cancer pain is one of the most disabling symptoms complained by cancer patients, with a crucial impact on physical and psychological well-being. Botulinum neurotoxins (BoNTs) type A and B have emerged as potential interventions for chronic pain; however, their role in these patients is still debated. Thus, this systematic review of randomized controlled trials aimed at assessing the effects of BoNT treatment for cancer pain to guide physicians in an evidence-based approach integrating BoNT in cancer care. Out of 5824 records, 10 RCTs satisfied our eligibility criteria and were included in the present work for a total of 413 subjects with several cancer types (breast, head and neck, esophageal, and thoracic/gastric cancers). While some studies demonstrated significant pain reduction and improved quality of life post-BoNT-A injections, outcomes across different cancer types were inconclusive. Additionally, several effects were observed in functioning, dysphagia, salivary outcomes, esophageal strictures, gastric emptying, and expansions. This review emphasizes the need for further standardized research to conclusively establish the efficacy of BoNT in comprehensive cancer pain management