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Evaluación de la utilización del Threshold IMT con resistencia combinado con ventilación dirigida en pacientes tetrapléjicos traqueotomizados sobre la Presión Inspiratoria Máxima. Un protocolo de investigación
Get PDFBackground: Spinal cord injury is a pathology that affects a large part of the population, with
the proportion of patients increasing every year. In quadriplegic patients with tracheotomy,
respiratory impairment is the most serious consequence. The training of the inspiratory muscles
with the Threshold IMT with resistance would be intended to test ether it has a positive effect
and whether it has a long-term effect.
Objective: To analyze whether the Threshold IMT with resistance combines with targeted
ventilation produces changes in peak inspiratory pressure in patients with tetraplegia and
tracheostomy in an eight-week protocol.
Methods: A 16-week randomized clinical trial of tetraplegic and tracheostomized patients is
performed. They will be divided into two groups, a control group receiving active treatment with
th Threshold IMT without resistance (placebo) and a conventional treatment with controlled
ventilation. At the same time, the experimental group will receive the same treatments, but the
Threshold IMT will have resistance; After 8 weeks, the two groups will stop the Threshold IMT
and will be left with controlled ventilation only. The primary variable that will be assessed is
Maximum Inspiratory Pressure, secondary variables will be taken in the following order: The
quality of life using the SF-36 questionnaire, the fatigue with the Fatigue Severity Scale tool and
finally, Forced Vital Capacity with spirometry.
Expected results: An improvement in all variables of the experimental group is expected after
8 weeks of intervention.
Conclusion: inspiratory muscle training with the Threshold IMT with resistance in
tracheostomized tetraplegic patients has a positive effect on each measured variable after the 8
weeks of study. For the other 8 weeks without active treatment, it would be necessary to
perform future studies with a longer duration to know if the effect lasts over time.Antecedentes: La lesión medular es una patología que afecta a una gran parte de la
población, siendo que la proporción de enfermos aumenta mas cada año. En los pacientes
tetrapléjicos con traqueotomía, las afectaciones respiratorias son la consecuencia mas grave
que existe. El entrenamiento de los músculos inspiratorios con el Threshold IMT con resistencia
seria destinados a comprobar si tiene un efecto positivo y si tiene efecto a largo plazo.
Objetivos: Analizar si el Threshold IMT con resistencia combinado con ventilación dirigida
producen cambios en la presión de inspiración máxima en los pacientes con tetraplejia y
traqueotomía en un protocolo de ocho semanas.
Métodos: Se realiza un ensayo clínico aleatorizado de 16 semanas con pacientes tetrapléjicos y
traqueotomizados. Se dividirán en dos grupos, un grupo control que recibirá un tratamiento
activo con el Threshold IMT sin resistencia (placebo) y un tratamiento convencional con
ventilación dirigida. En el mismo tiempo, el grupo experimental recibirá los mismos
tratamientos, pero el Threshold IMT tendrá resistencia. Después de 8 semanas, los dos grupos
dejaran el Threshold IMT para quedar solo con ventilación dirigida. La variable principal que se
valorara es la Presión Inspiratoria Máxima, se tomaran como variables secundarias en el
siguiente orden, el cuestionario SF-36 sobre la calidad de vida, la fatiga con la herramienta
Fatigue Severity Scale y, para terminar, la Capacidad Vital Forzada con una espirometría.
Resultados esperados: Se espera una mejora en todas las variables del grupo experimental
después de las 8 semanas de intervención.
Conclusión: El entrenamiento de los músculos inspiratorios con el Threshold IMT con
resistencia en los pacientes tetrapléjicos traqueotomizados tiene un efecto positivo en cada
variable mediada después de las 8 semanas de estudios. Para las otras 8 semanas sin
tratamiento activo, seria necesario realizar futuros estudios con una duración mas larga para
saber si el efecto perdure en el tiempo
Importance of Pharmacogenetics and Drug-Drug Interactions in a Kidney Transplanted Patient
Get PDFTacrolimus (TAC) is a narrow-therapeutic-range immunosuppressant drug used after organ
transplantation. A therapeutic failure is possible if drug levels are not within the therapeutic range
after the first year of treatment. Pharmacogenetic variants and drug–drug interactions (DDIs) are
involved. We describe a patient case of a young man (16 years old) with a renal transplant receiving
therapy including TAC, mycophenolic acid (MFA), prednisone and omeprazole for prophylaxis
of gastric and duodenal ulceration. The patient showed great fluctuation in TAC blood concentration/
oral dose ratio, as well as pharmacotherapy adverse effects (AEs) and frequent diarrhea
episodes. Additionally, decreased kidney function was found. A pharmacotherapeutic follow-up,
including pharmacogenetic analysis, was carried out. The selection of the genes studied was based on
the previous literature (CYP3A5, CYP3A4, POR, ABCB1, PXR and CYP2C19). A drug interaction with
omeprazole was reported and the nephrologist switched to rabeprazole. A lower TAC concentration/
dose ratio was achieved, and the patient’s condition improved. In addition, the TTT haplotype of
ATP Binding Cassette Subfamily B member 1 (ABCB1) and Pregnane X Receptor (PXR) gene variants
seemed to affect TAC pharmacotherapy in the studied patient and could explain the occurrence of
long-term adverse effects post-transplantation. These findings suggest that polymorphic variants and
co-treatments must be considered in order to achieve the effectiveness of the immunosuppressive
therapy with TAC, especially when polymedicated patients are involved. Moreover, pharmacogenetics
could influence the drug concentration at the cellular level, both in lymphocyte and in renal tissue,
and should be explored in future studies.GreenLife thanks the Government of Aragon and the European Regional Development Funds (Consolidated Group E105). Research carried out with the support of the Banco Sabadell Foundation
RunScribe Sacral Gait Lab™ Validation for Measuring Pelvic Kinematics during Human Locomotion at Different Speeds
Get PDFOptoelectronic motion capture systems are considered the gold standard for measuring
walking and running kinematics parameters. However, these systems prerequisites are not feasible
for practitioners as they entail a laboratory environment and time to process and calculate the data.
Therefore, this study aims to evaluate the validity of the three-sensor RunScribe Sacral Gait Lab™
inertial measurement unit (IMU) in measuring pelvic kinematics in terms of vertical oscillation, tilt,
obliquity, rotational range of motion, and the maximum angular rates during walking and running
on a treadmill. Pelvic kinematic parameters were measured simultaneously using an eight-camera
motion analysis system (Qualisys Medical AB, GÖTEBORG, Sweden) and the three-sensor RunScribe
Sacral Gait Lab™ (Scribe Lab. Inc. San Francisco, CA, USA) in a sample of 16 healthy young adults.
An acceptable level of agreement was considered if the following criteria were met: low bias and
SEE ( 0.90), and good reliability
(ICC > 0.81). The results obtained reveal that the three-sensor RunScribe Sacral Gait Lab™ IMU
did not reach the validity criteria established for any of the variables and velocities tested. The
results obtained therefore show significant differences between the systems for the pelvic kinematic
parameters measured during both walking and running
De lo adorable a lo perturbador. Análisis de estrategias visuales en proyectos anime y su aplicación en videojuegos.
Get PDFThis project talks about an alternative vision of the use of terror in videogames, through a psychological approach and with a deceptive and innocent appearance, using as a base the Japanese terror present in films, series, and videogames of the industry of this country and those that have been influenced by it. Through an extensive analysis of video games, movies and series related to the theme of terror
and psychology, a guide has been prepared with a project that serves as a reference to create a psychological video game with an emphasis on creating a deceptive appearance to confuse the player. The results of this project are synthesized in a small demo that follows the motto of the project title “From the adorable to the disturbing” through a priority focus on the visuals. In which the concepts studied in the extensive analysis of psychological horror works present in the work are
applied.Este proyecto trata sobre una visión alternativa del uso del terror en videojuegos, mediante un enfoque psicológico y con aspecto engañoso e inocente utilizando como base el terror japonés presente en películas, series y videojuegos de la industria de este país y aquellas que han sido influenciadas por este tipo particular de terror. Mediante un análisis de videojuegos, películas y series englobados en el ámbito de un enfoque de terror o psicológico, se ha elaborado una guía acompañada de un proyecto que sirve como referencia para crear un videojuego psicológico haciendo un énfasis en crear una apariencia engañosa para confundir al jugador.
Los resultados de este proyecto se sintetizan en una pequeña demo que sigue el lema del título del proyecto “De lo adorable a lo perturbador” mediante un enfoque prioritario en el apartado visual. En la que se aplican los conceptos estudiados en el extenso análisis de obras de terror psicológico presente en el trabajo
Procedimientos generales de Fisioterapia - I Electroterapia
No full textThis book presents the theoretical and practical knowledge of electrotherapy based on scientific and clinical findings. It allows students and professionals of physical therapy to understand the theoretical knowledge with a scientific basis that addresses their clinical application through the procedures of the various modalities of electrotherapy.Esta obra presenta los conocimientos teóricos y prácticos de la electroterapia basada en la evidencia científica y clínica. Permite al estudiantado y a los profesionales de la fisioterapia comprender los conocimientos teóricos con una fundamentación científica abordando su aplicación clínica a través de los procedimientos de las distintas modalidades de electroterapia
Deep eutectic solvents based on sugars for oral applications (versión aceptada)
No full textSolubility is a critical parameter in drug formulation to achieve the desired therapeutical concentration. Most drugs are weak acids or bases and, therefore, exhibit low solubility and poor oral availability. The main aim of this work is the use of Deep Eutectic Systems (DESs) for improving the solubility of drugs in aqueous medium. In this case, we use DESs formed by choline chloride and sugars (xylitol, fructose, glucose and sorbitol) at different proportions of water. These compounds present low toxicity, and thus can be used in syrups or liquid formulations. Different physicochemical properties, such as density, refractive index, and surface tension, were obtained. In addition, a rheological study of the different systems was carried out. Finally, these DESs were applied to analyse the solubility of the following active principles: caffeine (Class I) and furosemide (Class IV) of the Biopharmaceutics Classification System (BCS). The selection of the drugs attends to different reasons. On one hand, we want to develop a new liquid formulation for model drug furosemide and, on the other hand, the study of caffeine, instead, will be used as a model for comparing purposes. Solubility results show that the systems that best solubilize caffeine are those with the highest water content; however, they do not reach the levels of solubility of pure water. On the other hand, for furosemide, a great increase in solubility was observed, especially for systems formed by xylitol and, fundamentally, in the system with the lowest water content. Obtaining an increase in solubility of up to 4530 times. These systems provide an opportunity to improve the formulation of drugs in the liquid medium of active ingredients that are poorly soluble in an aqueous medium
Effects of the combination of exercise and education in the treatment of low back and/or pelvic pain in pregnant women: Systematic review and meta-analysis
No full textBackground: Lumbopelvic pain is considered the most frequent complication during
pregnancy.
Objective: To compare whether the combination of exercise with education is more effective for the treatment of low back and/or pelvic pain (PP) than each of these interventions separately in pregnant women.
Search Strategy: A systematic review was performed in WOS, PEDro, PubMed, Cochrane, and Clini calTr ials.gov. The terms used were low back pain, PP, pregnancy, pregnant woman, exercise, exercise therapy, health education, and prenatal education.
Selection Criteria: The PICO question was then chosen as follows: P—population: pregnant women with nonspecific low back pain or PP; I—intervention: exercise therapy plus health education; C—control: only exercise therapy or only health education; O—outcome: characteristics of pain, disability, and kinesophobia; S—study designs: randomized controlled trial.
Data Collection and Analysis: Two reviewers independently screened articles for eligibility. The following inclusion criteria were applied for the selection of studies: (i) published in the past 10 years; (ii) exercise plus health education was administered compared with a group receiving either exercise or education alone; and (iii) the sample consisted of pregnant women with nonspecific low back pain or PP. This review excluded: (i) nonrandomized controlled trials; and (ii) articles whose full text was not available. The meta-analysis was performed using the random-effects model, due to the observed heterogeneity.
Main Results: A total of 13 articles were selected. There is a significant decrease in pain in the combination of exercise and education compared with education alone (standardized mean difference, −0.29 [95% confidence interval, −0.47 to −0.11]). With respect to disability, there is a significant decrease in the exercise and education group compared with the group that only addressed education (standardized mean difference, −0.37 [95% CI, −0.60 to −0.14]). One article analyzed kinesophobia, reporting no significant changes.
Conclusion: The combination of exercise and education seems to be more effective in reducing pain and disability in pregnant women with low back and/or PP than the use of education alone. In kinesophobia, the results found are not significant
Diseño y desarrollo de una herramienta modular para la elaboración de cinemáticas en Unity adaptada a un sistema de diálogos
No full textThis project, carried out in the Unity engine, focused on the creation and adaptation of a specific tool for the management of kinematics. Although there are several tools on the market, the main purpose was not to overcome the existing ones, but to deeply understand the methodologies and techniques involved in the creation of development tools, and what better way to achieve this learning than immersed in a real business environment and in the dynamic world of videogame development?
The development journey ranged from familiarization with professional tools to the effective integration of the tool into a real video game project. The resulting tool, while intuitive and efficient, served to understand the challenges, solutions and trade-offs inherent in video game software development. A critical phase of the project was the evaluation, where feedback was sought from industry professionals. The results provided not only validation, but also areas for future optimization and
improvement. In summary, beyond the creation of a tool, this project has been an educational immersion into how solutions are built and adapted in the real world of game development, and how technical needs are balanced with vision and functionality.Este proyecto, llevado a cabo en el motor Unity, se centró en la creación y adaptación de una herramienta específica para la gestión de cinemáticas. Si bien existen diversas herramientas en el mercado, el propósito principal no era superar lo existente, sino comprender profundamente las metodologías y técnicas involucradas en la creación de herramientas de desarrollo. ¿Y qué mejor manera de lograr este aprendizaje que inmerso en un entorno empresarial real y en el dinámico mundo del desarrollo de videojuegos? El viaje de desarrollo abarcó desde familiarizarse con herramientas profesionales hasta la efectiva integración de la herramienta dentro de un proyecto real de videojuego. La herramienta resultante, si bien intuitiva y eficiente, sirvió como un medio para entender los desafíos, soluciones y compromisos inherentes al desarrollo de software para videojuegos.
Una fase crítica del proyecto fue la evaluación, donde se buscó feedback de profesionales del sector. Los resultados proporcionaron no solo validación, sino también áreas para futuras optimizaciones y mejoras. En resumen, más allá de la creación de una herramienta, este proyecto ha sido una inmersión educativa sobre cómo se construyen y adaptan soluciones en el mundo real de desarrollo de videojuegos, y cómo se equilibran las necesidades técnicas con la visión y la funcionalidad
Development and Validation of a Mobile Application as an Adjuvant Treatment for People Diagnosed with Long COVID-19: Protocol for a Co-Creation Study of a Health Asset and an Analysis of Its Effectiveness and Cost-Effectiveness
No full textObjective: To analyse the overall effectiveness and cost-efficiency of a mobile application
(APP) as a community health asset (HA) with recommendations and recovery exercises created
bearing in mind the main symptoms presented by patients in order to improve their quality of life, as
well as other secondary variables, such as the number and severity of ongoing symptoms, physical
and cognitive functions, affective state, and sleep quality. Methods: The first step was to design and
develop the technologic community resource, the APP, following the steps involved in the process of
recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing
its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st)
usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use
of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI),
as an interventional group. An evaluation will be carried out at baseline with further assessments
three and six months following the end of the intervention. Discussion: Although research and care
for these patients are still in their initial stages, it is necessary to equip patients and health care
practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved
through telerehabilitation (TR).This work is supported by Carlos III Health Institute, grant number PI21/01356, FEDER Funds 'Another way to make Europe'. The funding body will conduct an audit trial once a year
The graphic process as a narrative act
No full textThe innovation practice presented here aims to investigate the creative synergies
extracted from the various intersections generated between architecture and
literature through its incardination in the teaching field. It is based on the concept of
"defamiliarization", in which the introduction of another discipline (literature)
interferes in an architectural or design program, trying to trigger creative processes.
Through a graphic approach, a relationship is established between the stories of
Invisible cities (Calvino, 1972) and their architectural decline, interpreted under the
leitmotif of “the landscapes of abandonment”. The development of the exercises,
raised with a high degree of indeterminacy, seeks not only to provide the student
with design tools but also to consolidate critical judgment and adjust, through the
analytical-educational process, the convergences of thought and the graphic
method.La práctica de innovación aquí presentada tiene por objeto indagar en las sinergias
creativas extraídas de las diversas intersecciones generadas entre arquitectura y la
literatura a través de su incardinación en el ámbito docente. Se basa en el concepto
de “desfamiliarización”, en el que la introducción de otra disciplina (la literatura)
interfiere en un programa arquitectónico o de diseño, pretendiendo desencadenar
procesos creativos. A través de una aproximación gráfica, se establece una relación
entre los relatos de Las ciudades invisibles (Calvino, 1972) y su declinación
arquitectónica, interpretados bajo el leitmotiv de “los paisajes del abandono”. El
desarrollo de los ejercicios, planteados con un alto grado de indeterminación,
procura no solo dotar al alumno de herramientas de diseño sino de consolidar el
juicio crítico y ajustar, mediante el proceso analítico-educativo, las convergencias
del pensamiento y el método gráfico