Search

Objective: To know all the benefits of a sensory intervention in premature infants.Method: descriptive study of systematic review, following the PRISMA Statement. Search for articles (PubMed, ProQuest and ScienceDirect) according to the inclusion criteria. Subsequent analysis of the articles. Result: Of the 28 studies obtained in the first phase, only 11 (8 quantitative and 3 descriptive articles) were included in the review. All of them provide evidence of the different benefits of carrying out a sensory intervention in premature infants: at the level of their development, in their physiological parameters, feeding, sleep and also their impact on families.Conclusions: Sensory interventions delivered early in preterm infants carry enormous benefits in this at-risk population. However, more studies are still needed to generalize the evidence and to determine the specific benefits of each of the different procedures., Objetivo: conocer todos los beneficios que aporta una intervención sensorial en prematuros. Metodología: estudio descriptivo de revisión sistemática, siguiendo la Declaración PRISMA. Búsqueda de artículos (PubMed, ProQuest y ScienceDirect) según los criterios de inclusión. Posteriormente, análisis de los mismos. Resultado: De los 28 estudios obtenidos en la primera fase, solamente 11 (8 artículos cuantitativos y 3 descriptivos) fueron incluidos en la revisión. Todos ellos aportan evidencias de los distintos beneficios de llevar a cabo una intervención sensorial en bebés prematuros: a nivel de su desarrollo, en sus parámetros fisiológicos, alimentación, sueño y también su repercusión en las familias. Conclusiones: Las intervenciones sensoriales realizadas de manera temprana en los recién nacidos antes de término conllevan enormes beneficios en esta población de riesgo. Sin embargo, siguen siendo necesarios más estudios para poder generalizar las evidencias, y precisar qué beneficios concretos proporcionan cada uno de los distintos procedimientos.

Cinco son los artículos científicos que conforman la presente tesis doctoral, titulada “Efectos de la Terapia en Espejo vs. Ejercicio Terapéutico Cognoscitivo en la mejora de las funciones del miembro superior en pacientes con ictus”, que sigue la modalidad por compendio de publicaciones. La rehabilitación de pacientes post-ictus representa un desafío significativo en la atención médica actual, dada la complejidad de las secuelas neurológicas que afectan la funcionalidad y la calidad de vida (CV) de los individuos. En este contexto, la investigación sobre los avances en la rehabilitación post-ictus se ha centrado en varios aspectos cruciales para mejorar los resultados clínicos. Como aspecto principal, para la aplicación de una intervención adecuada y adaptada se ha investigado la efectividad comparativa de la Terapia en Espejo (TE) vs. el Ejercicio Terapéutico Cognoscitivo (ETC), combinadas con Terapia Orientada a Tareas (TOT), en la mejora de la funcionalidad, la motricidad, la autonomía y CV de los pacientes post-ictus. Otro punto importante a considerar es la evaluación, siendo esencial comprender las características psicométricas de los instrumentos de evaluación. Algunos de estos, como el ARAT y MAL-30, están específicamente diseñados para evaluar a pacientes con ictus, por lo que es fundamental garantizar su validez y confiabilidad en la población española. Además, se ha investigado la relación entre diferentes variables demográficas y clínicas con la funcionalidad y la CV un mes después del ictus, lo que proporciona datos cruciales para adaptar los tratamientos de manera personalizada. Con el objetivo de estudiar nuevos avances en la rehabilitación post-ictus, se llevó a cabo un estudio longitudinal enfocado a probar la efectividad de la combinación de estas terapias. Así mismo, dentro de este estudio longitudinal, se utilizó un diseño transversal, analizando los datos en un punto concreto del proceso para determinar las propiedades psicométricas de las esca, There are five scientific articles that make up the present doctoral thesis, entitled "Effects of Mirror Therapy vs. Cognitive Therapeutic Exercise on Improving Upper Limb Functions in Stroke Patients," which follows the compilation of publications modality. The rehabilitation of post-stroke patients represents a significant challenge in current medical care, given the complexity of the neurological sequelae that affect individuals' functionality and quality of life (QoL). In this context, research on advances in post-stroke rehabilitation has focused on several crucial aspects to improve clinical outcomes. As a primary aspect, comparative effectiveness research has been conducted on Mirror Therapy (MT) vs. Cognitive Therapeutic Exercise (CTE), combined with Task-Oriented Therapy (TOT), in improving functionality, motor skills, autonomy, and QoL in post-stroke patients. Another important point to consider is evaluation, as it is essential to understand the psychometric characteristics of assessment instruments. Some of these, such as the ARAT and MAL-30, are specifically designed to assess stroke patients, so it is crucial to ensure their validity and reliability in the Spanish population. Furthermore, the relationship between different demographic and clinical variables with functionality and QoL one month after stroke has been investigated, providing crucial data for personalized treatment adaptation. In order to study new advances in post-stroke rehabilitation, a longitudinal study was conducted to test the effectiveness of combining these therapies. Within this longitudinal study, a cross-sectional design was used to analyze data at a specific point in the process to determine the psychometric properties of the scales and identify the characteristics and determining factors of functional independence and QoL in these patients. Our findings suggest that both techniques, Mirror Therapy (MT) and Cognitive Therapeutic Exercise (CTE) combined with Task-Oriented Thera, Doctorado en Avances en Ciencia y Biotecnología Alimentarias

Tesis doctoral en período de exposición pública, Avances en Ciencia y Biotecnología Alimentarias

Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy.

Clinical and electroencephalogram (EEG) features in frontal lobe epilepsy (FLE) vary considerably among patients, making the diagnosis a challenge. The objective of this study was to describe interictal and ictal EEG activity, identifying variables that could help to differentiate and diagnose frontal lobe epilepsy cases. A prospective cross-sectional study from patients with frontal interictal epileptiform discharges (IED) referred to the Vall d’Hebron University Hospital (Barcelona, Spain) after a clinical event compatible with epileptic seizures was designed. The interictal and ictal activity were analyzed to provide a detailed EEG description of the cases, using different statistical analyses. The morphological seizure pattern at the ictal onset remained globally unchanged over time in seizures arising from the frontal lobe for each patient. Isolated sharp waves were the most frequent waveforms in the expression of IED. Frontal lobe seizures are frequently short and sometimes appear grouped in clusters within the same recording. Often the ictal expression of the electrical activity in frontal lobe seizure is subtle and challenging to interpret. A description of the main findings is summarized to identify seizures arising from the frontal lobe and avoid false negatives findings in EEG interpretations.

Differential diagnosis in epilepsy is sometimes challenging. Video-electroencephalography (V-EEG) is an essential tool in the diagnosis and management of epilepsy. The prolonged duration of V-EEG recording increases the diagnostic yield of a conventional V-EEG. The right length of monitoring for different indications is still to be established. We present a retrospective descriptive study with a sample of 50 patients with long-term V-EEG monitoring, with a mean age of 36.1 years, monitored from 2013 to 2019 at the Burgos University Hospital. The mean monitoring time was 3.6 days. Events were obtained in 76% of the patients, corresponding to epileptic seizures (ES) in 57.9% of them, with psychogenic non-epileptic seizures (PNES) in 39.5%, and with episodes of both pathologies in 2.6% of the patients. We found that the first event was highly representative, and it correlated with the rest of the events that would be recorded. Moreover, 92% of the first PNES had been captured at the end of the second day, and 89% of the first ES by the end of the third day. V-EEG for differential diagnosis between ES and PNES can be performed in hospitals without specialized epilepsy surgery units. For this indication, the duration of long-term V-EEG can be adjusted individually depending on the nature of the first event.

En la actualidad, no existe una indicación formal de profilaxis anticomicial en neurocirugía oncológica. Tampoco existen recomendaciones específicas sobre el uso de fármacos antiepilépticos (FAE) en pacientes portadores de meningiomas y libres de crisis que van a ser intervenidos. En general, se prescriben FAE de forma discrecional, teniendo en cuenta diversos factores de riesgo clínico-radiológicos. Presentamos una revisión sistemática y metaanálisis sobre la efectividad de la profilaxis anticomicial en meningiomas sin historia previa de crisis., No formal indication currently exists for seizure prophylaxis in neurosurgical oncology patients. Neither have specific recommendations been made on the use of antiepileptic drugs (AED) in seizure-free patients with meningiomas scheduled for surgery. AEDs are generally prescribed on a discretionary basis, taking into consideration a range of clinical and radiological risk factors. We present a systematic review and meta-analysis exploring the effectiveness of antiepileptic prophylaxis in patients with meningioma and no history of seizures.

La presente tesis doctoral titulada “Implicaciones reeducativas en la funcionalidad y calidad de vida de las personas con enfermedad de parkinson: implementación de una ortesis de tejido elastomérico dinámica” se realiza según la modalidad de tesis por compendio de artículos científicos. El esquema de trabajo establecido para lograr el objetivo principal planteado se basa en un estudio compuesto por 3 artículos estructurados, un protocolo de estudio y dos ensayos clínicos de tipo longitudinal. La Enfermedad de Parkinson (EP) es un trastorno neurodegenerativo, caracterizado por una pérdida de neuronas de dopamina en la sustancia negra. Los síntomas motores más característicos de la enfermedad son temblor en reposo, bradicinesia, rigidez de las extremidades, problemas de marcha y equilibrio. Con el progreso de la enfermedad los síntomas motores se acentúan, lo que conlleva a una disminución en la funcionalidad de las Actividades de la Vida Diaria (AVD) del paciente. El tratamiento farmacológico actual se basa en tratamientos dopaminérgicos como la levodopa, agonistas dopaminérgicos y reducción de la degradación de la dopamina. La eficacia de este tratamiento disminuye progresivamente y produce otros efectos secundarios como discinesias y fluctuaciones motoras. En la actualidad existen diferentes tipos de tratamientos no farmacológicos que reduce la presencia e intensidad de los síntomas motores, sin embargo, no hay suficiente evidencia científica sobre ellos y los recursos son escasos. Por ello, el objetivo principal de la presente tesis es evaluar los efectos de la implementación de una ortesis de tejido elastomérico dinámico (DEFO) sobre la funcionalidad y calidad de vida de la persona con EP. Las Ortesis Dinámicas de Tejido Elastomérico (DEFO) son dispositivos no farmacológicos y de fácil implementación personalizados para cada paciente que proporcionan una alineación biomecánica y permite la libertad de movimiento del cuerpo al mismo tiempo que envía información s, The present doctoral thesis entitled “Effects of the implementation of a dynamic elastomeric fabric orthosis on the functionality and quality of life of the person with Parkinson's Disease (PD)” is carried out according to the thesis modality by compendium of scientific articles. The work scheme established to achieve the main objective is based on a study composed of 3 structured articles, a study protocol and two longitudinal clinical trials. Parkinson's Disease (PD) is a neurodegenerative disorder, characterized by a loss of dopamine neurons in the substantia nigra. It is characterized by the appearance of different motor and non-motor symptoms. The main motor symptoms of the disease are tremor at rest, bradykinesia, stiffness of the extremities, gait and balance problems. As the disease progresses, motor symptoms become accentuated, which leads to a decrease in the functionality of the patient's Activities of Daily Living (ADL). Current pharmacological treatment is based on dopaminergic treatments such as levodopa, dopamine agonists and reduction of dopamine degradation. The effectiveness of this treatment progressively decreases and produces other side effects such as dyskinesias and motor fluctuations. Currently, there are different types of non-pharmacological treatments that reduce the presence and intensity of motor symptoms; however, there is not enough scientific evidence about them and resources are scarce. Therefore, the main objective of this thesis is to evaluate the effects of the implementation of a dynamic elastomeric fabric orthosis (DEFO) on the functionality and quality of life of the person with PD. DEFO are a non-pharmacological and easily implemented device personalized for each patient that provides biomechanical alignment and allows freedom of movement of the body while sending sensory information to the brain, causing compression localized and stimulation of dermal and proprioceptive receptors that regulate motor activity. Goals To evaluat

La presente investigación se plantea visibilizar las necesidades formativas de los futuros docentes de Educación Secundaria a través del análisis del impacto de la formación inicial recibida en el Máster Universitario en Profesor de Educación Secundaria Obligatoria. A su vez se pretende explorar la posible relación entre las valoraciones y el nivel percibido de Inteligencia Emocional, como elemento facilitador de los procesos de inclusión socioeducativa, y entre éstas y otras variables relevantes como el sentimiento de Autoeficacia Docente ante el reto de afrontar la diversidad en las aulas. Los resultados han mostrado una pobre valoración general de la formación recibida y un alto nivel de preocupaciones en cuanto al desarrollo de las funciones más relacionadas con el trabajo diario en el aula. A su vez se han evidenciado variables predictoras de mayor capacitación hacia la atención a la diversidad en las aulas y mayor bienestar docente., This research aims to visualize the training needs of future secondary education teachers through the analysis of the impact of the initial training received in the Master's Degree in Secondary Education Teacher. Additionally, it seeks to explore the possible relationship between evaluations and the perceived level of Emotional Intelligence as a facilitating element in socio-educational inclusion processes, and between these and other relevant variables such as the sense of Teacher Self-Efficacy in facing the challenge of diversity in classrooms. The results have shown a generally poor evaluation of the received training and a high level of concerns regarding the development of functions most related to daily work in the classroom. Predictive variables of higher training towards diversity attention in classrooms and greater teacher well-being have also been evidenced.

Introducción: En la asistencia sanitaria se llevan a cabo procesos diagnósticos y terapéuticos repetitivos en grupos consecutivos de pacientes sin que existan a menudo protocolos, o los que existen no son eficientes por no estar avalados por la evidencia científica. La deficiencia de los mencionados protocolos conlleva la derivación errática de los pacientes, la realización de pruebas complementarias innecesarias y la gestión poco eficiente en el empleo de recursos en patologías muy prevalentes o que requieren pruebas diagnósticas cuya realización consume mucho tiempo. Objetivos: Evaluar nuestra propia práctica clínica centrada en el Servicio de Neurofisiología Clínica del Hospital Universitario de Burgos (HUBU) incidiendo en la detección de los "puntos débiles" en una serie de procesos diagnósticos, utilizando como ejemplo patologías cuyo diagnóstico requiere técnicas neurofisiológicas tales como la vídeo electroencefalografía (V-EEG), la neurografía (ENG) y la estimulación magnética transcraneal (EMTC) y potenciales evocados somatosensoriales (PESS). Interés y aplicabilidad: La evaluación y reevaluación periódica de la práctica clínica permite mantener aquellas prácticas que demuestran ser eficientes y eliminar aquellas que no son útiles y cuya realización se lleva a cabo por inercia en la práctica clínica. La identificación de puntos débiles permite crear estrategias de corrección y la aplicación de estas modificaciones en la población venidera de pacientes del propio servicio, repercutiendo en un incremento de la calidad asistencial, en el ahorro de tiempo y recursos que se manifestarán, presumiblemente, en mejora de tiempos asistenciales. Campos de aplicación: Se seleccionan una serie de patologías en las cuales se llevan a cabo procedimientos diagnósticos que serán costosos, bien por la necesidad de tiempos prolongados para su realización, bien por la frecuencia con la que se llevan a cabo al ser requeridos en patologías muy prevalentes. Elegimos, como paradig, Introduction: In health care, repetitive diagnostic and therapeutic processes are carried out in consecutive groups of patients for whom, often, there are no protocols or those that do exist are not efficient because they are not based on any type of scientific evidence. The lack of protocols leads to erratic referral of patients, unnecessary complementary tests and inefficient management in the use of resources, either in highly prevalent pathologies or other that require time consuming tests for their evaluation. Goals: To evaluate our own clinical practice on the Neurophysiology Department of the University Hospital of Burgos, focusing on the detection of "weak points" in a series of diagnostic processes, using as examples pathologies whose diagnosis requires neurophysiological techniques such as such as video electroencephalography (V-EEG), neurography (ENG) and transcranial magnetic stimulation (TCMS) and somatosensory evoked potentials (SSEP). Interest and applicability: The periodic evaluation and reevaluation of clinical practice leads to maintain proven efficient practices and eliminate those that are not useful and whose performance is carried out by inertia in clinical practice. The identification of weak points allows correction strategies for these and their application in the coming population of patients from the Service itself, resulting in an increase in the quality of care, in saving time, and resources that will lead to reduction of care times. Fields of application: A series of pathologies are selected in which diagnostic procedures are carried out that will be costly, either because of the need for long periods of time for their performance, or because of the frequency with which they are carried out as they are required in very prevalent pathologies. We chose as a paradigm of pathologies in the first group, long-term V-EEG monitoring in patients with drug-resistant epilepsies and the performance of TCMS and SSEP in patients with compressive mye

Tres artículos científicos conforman la presente tesis doctoral, titulada “Factores relacionados con la calidad de vida, la depresión, la ansiedad, la imagen corporal y la autoestima, en mujeres mastectomizadas supervivientes de cáncer de mama”, que sigue la modalidad por compendio de publicaciones. El cáncer de mama no solo es el cáncer más común entre las mujeres, sino que también es aquel que mayor tratamiento exige, derivando unos efectos secundarios de larga duración afectando varios aspectos de la calidad de vida de la paciente, como son las capacidades físicas y mentales. Con el objetivo principal de identificar los factores asociados a la calidad de vida, la depresión, la ansiedad, la imagen corporal y la autoestima, se realizaron tres artículos descriptivos a través de una muestra de 198 mujeres supervivientes de cáncer de mama, donde se estudiaron las variables edad, tipo de cirugía, si estaban recibiendo tratamiento durante la evaluación, el nivel de estudios, el estado civil, si tenían trabajo o no durante el diagnóstico y el tratamiento, el tiempo trascurrido desde el diagnóstico hasta la evaluación, si habían sido sometidas a una reconstrucción de mama, si tenían antecedentes familiares de primer grado, si habían recibido apoyo psicológico durante el transcurso de la enfermedad, si tenían sentido del humor y por último el grado de conocimiento que disponían sobre el diagnóstico, tratamiento y pronóstico de la enfermedad. En lo relacionado a la calidad de vida, la edad, el tipo de cirugía y el tiempo trascurrido desde el diagnóstico hasta la evaluación de la calidad de vida son factores asociados a la misma, donde las mujeres más jóvenes señalan una mayor sintomatología, el ser intervenida de una cirugía conservadora no indica una mejor calidad de vida y a más tiempo trascurrido desde el diagnóstico indica una mayor puntuación de salud general, una mejor funcionalidad, pero no por ello una menor sintomatología. En cuanto a la depresión y ansiedad, el no, Three scientific articles make up the present doctoral thesis, entitled "Factors related to quality of life, depression, anxiety, body image and self-esteem, in mastectomized women breast cancer survivors", which follows the publication compendium modality. Breast cancer is not only the most common cancer among women, but also the one that requires the most treatment, resulting in long-lasting side effects affecting several aspects of the patient's quality of life, such as physical and mental abilities. With the main objective of identifying the factors associated with quality of life, depression, anxiety, body image and self-esteem, three descriptive articles were carried out on a sample of 198 women survivors of breast cancer, where the variables studied were age, type of surgery, whether they were receiving treatment during the evaluation, level of education, marital status, whether or not they were employed during diagnosis and treatment, the time elapsed from diagnosis to evaluation, whether they had undergone breast reconstruction, whether they had a first-degree family history, whether they had received psychological support during the course of the disease, whether they had a sense of humor, and finally the degree of knowledge they had about the diagnosis, treatment and prognosis of the disease. In relation to quality of life, age, type of surgery and time elapsed from diagnosis to quality of life assessment are factors associated with quality of life, where younger women report greater symptomatology, conservative surgery does not indicate a better quality of life and the more time elapsed since diagnosis indicates a higher general healthcare score, better functionality, but not less symptomatology. As for depression and anxiety, not having a partner, being receiving treatment during the evaluation, having undergone mastectomy surgery and having a job are factors associated with greater symptoms of depression and anxiety, where the prevalence of these sympt

Parkinson’s disease (PD) is a chronic, neurodegenerative movement disorder, whose symptoms have a negative impact on quality of life and functionality. Although its main treatment is pharmacological, non-pharmacological aids such as the dynamic elastomeric fabric orthosis (DEFO) merit an evaluation. Our objective is to assess the DEFO in upper limb (UL) functional mobility and in the quality of life of PD patients. A total of 40 patients with PD participated in a randomized controlled crossover study, and were assigned to a control group (CG) and to an experimental group (EG). Both groups used the DEFO for two months, the experimental group the first two months of the study and the control group the last two. Motor variables were measured in the ON and OFF states at the baseline assessment and at two months. Differences from the baseline assessment were observed in some motor items of the Kinesia assessment, such as rest tremor, amplitude, rhythm or alternating movements in the ON and OFF states with and without orthosis. No differences were found in the unified Parkinson’s disease rating scale (UPDRS) or the PD quality-of-life questionnaire. The DEFO improves some motor aspects of the UL in PD patients but this does not translate to the amelioration of the standard of functional and quality-of-life scales., This study was supported by grants for the financing of research projects in biomedicine, health management and social health care approved by the Regional Health Management of the Junta de Castilla y León (No. EXP. GRS2020/A/19). Regional Health Management of Castilla y León–Sacyl GRS/2010/A/19.