Medicina
-
Background and objective: In the current pandemic scenario, data mining tools are fundamental to evaluate the measures adopted to contain the spread of COVID-19. In this study, unsupervised neural networks of the Self-Organizing Maps (SOM) type were used to assess the spatial and temporal spread of COVID-19 in Brazil, according to the number of cases and deaths in regions, states, and cities. Materials and methods: The SOM applied in this context does not evaluate which measures applied have helped contain the spread of the disease, but these datasets represent the repercussions of the country's measures, which were implemented to contain the virus' spread. ⋯ The analyses showed that cities and states in the north and northeast regions of the country were the most affected by the disease, with the highest number of cases and deaths registered per 100,000 inhabitants. Conclusions: The SOM clustering was able to spatially group cities, states, and regions according to their coronavirus cases, with similar behavior. Thus, it is possible to benefit from the use of similar strategies to deal with the virus' spread in these cities, states, and regions.
-
Background and Objectives: This study investigates the impact of age upon the safety and outcomes of laparoscopic cholecystectomy performed for acute cholecystitis, by a multivariate approach. Materials and Methods: A 2-year retrospective study was performed on 333 patients admitted for acute cholecystitis who underwent emergency cholecystectomy. The patients included in the study group were divided into four age subgroups: A ≤49 years; B: 50-64 years; C: 65-79 years; D ≥80 years. ⋯ Conclusions: The degree of systemic inflammation was the main factor that influenced the adverse outcome of LC in the elderly. Among comorbidities, diabetes was associated with increased surgical and systemic postoperative morbidity, while stroke and chronic renal insufficiency were correlated with a high risk of cardiovascular complications. With adequate perioperative care, the elderly has much to gain from the benefits of a minimally invasive approach, which allows a decreased rate of postoperative complications and a reduced hospital stay.
-
Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. ⋯ It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.
-
Randomized Controlled Trial
Disaster Prevention Education along with Weekly Exercise Improves Self-Efficacy in Community-Dwelling Japanese People-A Randomized Control Trial.
Background and Objectives: Both disaster prevention and health promotion have become public health challenges in Japan. Maintaining physical fitness from the perspective of disaster prevention and maintaining physical fitness from the perspective of health are basically covering similar issues, they are seen as different from one another because of differences in administrative jurisdiction in Japan. In the case of disaster prevention education, physical fitness is not mentioned. ⋯ Conclusions: Disaster prevention education with weekly exercise significantly increased participants' self-efficacy compared to traditional exercise education. The combination of disaster prevention education and exercise practice may have a positive effect not only on disaster prevention behavior but also on self-efficacy in health promotion. Disaster prevention education does not directly influence health promotion, but it may be a very effective method for indirectly promoting health.
-
Background and Objectives: Application of the EMG-driven robotic training in everyday therapeutic processes is a modern and innovative form of neurorehabilitation among patients after stroke. Active participation of the patient contributes to significantly higher activation of the sensorimotor network during active motor control rather than during passive movement. The study objective was to determine the effect of electromyographic triggering (EMG-triggered) robotic rehabilitation device treatment on walking, muscle force, and spasticity after an ischemic stroke. ⋯ Additionally, the decrease in Ashworth values over time, although statistically credible in both groups, was credibly higher in the robot condition. Conclusion: The inclusion of the EMG-triggered neurorehabilitation robot in the patient's daily rehabilitation plan has a positive effect on outcomes of the treatment. Both proposed rehabilitation protocols significantly improved patients' condition regarding all measured outcomes, but the spasticity and thigh circumference improved significantly better in the robotic group in comparison to controls.