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Background: The COVID-19 pandemic generated uncertainty and disruption among the child and adolescent population. Multiple studies have documented a worsening of mental health following the pandemic. The main objective of this longitudinal study is to analyze the short-, medium-, and long-term evolution of the overall functioning of children and adolescents treated by a child and adolescent mental health team in the context of the COVID-19 pandemic. Methods: 420 patients aged 3 to 18 were assessed using the Global Assessment of Functioning (GAF) scale at three time points: during the lockdown, three months later, and three years later. Differences based on gender, diagnosis, and time were analyzed. Results: A significant improvement was observed in the short-term (three months) and long-term (three years) compared to the lockdown period. This improvement was maintained in all diagnostic subgroups except for mixed cases (severe mental pathology), which showed the least improvement. No significant differences were found between males and females. Conclusions: The child and adolescent population showed a greater capacity for adaptation to the lockdown than expected. Family support, decreased stress, and therapeutic intervention appear to have played an important role in improving mental health.

Breast cancer-related lymphedema (BCRL) of the upper limb is a very common condition in women undergoing breast cancer treatment; it can cause considerable alterations in the daily life of patients and a decrease in their health-related quality of life (HRQoL). Currently, there are many conservative therapies that try to palliate the symptoms, but the results are still controversial and there are still no globally accepted treatments. The purpose of this article is to determine the effect, according to the current available evidence, on HRQoL of different conservative interventions in the rehabilitation of BCRL in the upper limb in women. Eighteen articles that compared the effects of standard treatments, such as manual lymphatic drainage-based decongestive therapy or compression measures, and other newer treatments, including new technologies and other types of treatment programs, were reviewed. According to the results of this review, the most recommended modality for the improvement of HRQoL would be a complex decongestive technique without manual lymphatic drainage. Although there are clinical trials that have demonstrated the effectiveness of various treatments, the results of the positive effects on HRQoL remain highly controversial. There is a need to continue to develop studies to help guide therapeutic decisions that can promote HRQoL in women affected by upper limb BCRL.

Background and Objetives: Currently, total knee arthroplasty is one of the most common surgeries, increasing with the increase in life expectancy. Whether or not to replace the patella has been a subject of debate over the years, remaining in controversy and without reaching a consensus. Over the years, different meta-analyses have been carried out in order to provide evidence on the subject, although, in recent times, there have not been many new studies in this regard. Therefore, it is considered necessary that the latest works form part of a new meta-analysis. Materials and Method: We searched the literature using PUBMED, SCOPUS, the Cochrane database and VHL from 2010 to 2020. The search terms used were “patellar” AND “resurfacing” OR “Replacement” and “no resurfacing” OR “no replacement”. A meta-analysis was performed with Stata software (Stata version 15.1). Forest plots were generated to illustrate the overall effect of knee arthroplasty interventions. Results: As a result, it was obtained that there is a significantly higher risk of suffering AKP in the non-resurfacing group, in addition to a significant increase in the risk of undergoing a reoperation in the non-resurfacing group. On the other hand, significant differences were obtained in favor of the resurfacing group in both the clinical and Feller KSS, with functional KSS being inconclusive. After analyzing different variables throughout the literature, it does seem clear that the non-resurfacing group may present a higher risk of reoperation than the resurfacing group. Conclusions: For all these reasons, we think that, although it does seem that not replacing the patella can precipitate a reoperation, it is not clear whether this reoperation is a direct consequence of not having replaced the patella. Therefore, in our opinion, the treatment must be individualized for each patient.

BackgroundApproximately 40-70% of people with Parkinson's disease (PD) fall each year, causing decreased activity levels and quality of life. Current fall-prevention strategies include the use of pharmacological and non-pharmacological therapies. To increase the accessibility of this vulnerable population, we developed a multidisciplinary telemedicine program using an Information and Communication Technology (ICT) platform. We hypothesized that the risk for falling in PD would decrease among participants receiving a multidisciplinary telemedicine intervention program added to standard office-based neurological care.ObjectiveTo determine the feasibility and cost-effectiveness of a multidisciplinary telemedicine intervention to decrease the incidence of falls in patients with PD.MethodsOngoing, longitudinal, randomized, single-blinded, case-control, clinical trial. We will include 76 non-demented patients with idiopathic PD with a high risk of falling and limited access to multidisciplinary care. The intervention group (n = 38) will receive multidisciplinary remote care in addition to standard medical care, and the control group (n = 38) standard medical care only. Nutrition, sarcopenia and frailty status, motor, non-motor symptoms, health-related quality of life, caregiver burden, falls, balance and gait disturbances, direct and non-medical costs will be assessed using validated rating scales.ResultsThis study will provide a cost-effectiveness assessment of multidisciplinary telemedicine intervention for fall reduction in PD, in addition to standard neurological medical care.ConclusionIn this challenging initiative, we will determine whether a multidisciplinary telemedicine intervention program can reduce falls, as an alternative intervention option for PD patients with restricted access to multidisciplinary care.Trial registrationClinicalTrials.gov Identifier: NCT04694443.

El ictus es la enfermedad neurológica más prevalente y una de las principales causas de discapacidad a largo plazo. La pérdida de calidad de vida después de un ictus es una preocupación significativa debido a las diversas secuelas físicas, cognitivas y emocionales que pueden surgir. Además, los cambios emocionales, como la depresión y la ansiedad, pueden afectar negativamente la salud mental y social. La rehabilitación post- ictus es crucial para ayudar a los pacientes a adaptarse a estas nuevas circunstancias y mejorar su calidad de vida. El objetivo es comprobar la efectividad de la Terapia en Espejo (TE) sobre los pacientes con ictus para la mejora de la calidad de vida (CV). Se ha realizado un estudio longitudinal con una muestra de 44 personas con ictus a los que se les valoró el nivel de calidad de vida antes de la intervención, después de la intervención y a largo plazo. Se dividió la muestra de forma aleatoria en grupo control y grupo experimental al que se aplicó la TE. Se llevó a cabo un análisis bivariado mediante un ANCOVA para determinar la existencia de mejoras existentes. Se observaron diferencias estadísticamente significativas tras la aplicación del tratamiento (p=0.009) y a largo plazo (p=0.022), mostrando el grupo experimental una mejora superior en su CV respecto al grupo control. La TE puede ser una herramienta efectiva para mejorar la CV en pacientes que han sufrido un ictus. Dada la prevalencia del ictus y sus consecuencias debilitantes en la calidad de vida, es crucial encontrar intervenciones terapéuticas que ayuden a los pacientes a adaptarse y recuperar funciones perdidas. Los resultados indicaron que los participantes que recibieron TE experimentaron mejoras significativas en su CV tanto inmediatamente después del tratamiento como a largo plazo, en comparación con el grupo de control.

El COVID-19 persistente es una enfermedad que lleva asociado trastornos en diferentes sistemas corporales que están resultando incapacitantes para el paciente lo que afecta a su funcionalidad y calidad de vida. Debido a ello se han visto limitados también en su accesibilidad a muchas áreas. El objetivo que se plantea en este estudio es comparar el estado funcional y la calidad de vida de personas que se han infectado con COVID-19 y las que han desarrollado COVID persistente. Se ha realizado un estudio observacional con una muestra de 170 pacientes a los que se les ha pasado una escala de estado funcional post-COVID19 y la escala de calidad de vida SF-12. Se llevó acabo un análisis bivariado mediantechi-cuadrado para determinar las relaciones existentes. Se observó unarelación significativa en cuanto a una mayor limitación funcional en personas con COVID persistente, al mismo tiempo que un empeoramiento completo de su calidad de vida. La limitación en su funcionalidad se puede ver acentuada por un entorno poco integrador y accesible, por lo que es importante adaptar el entorno y seguir trabajando en una accesibilidad universal que promueva una mayor autonomía para todas las personas con alguna limitación funcional, y de forma específica también en aquellas con esta nueva condición de COVID persistente.

El ictus es la enfermedad neurológica más común y una de las principales causas de discapacidad a largo plazo. Provoca discapacidad en al menos el 50% de los pacientes que lo sufren. La hemiparesia es una deficiencia causada por el ictus que afecta de forma grave a las AVD, AIVD y calidad de vida. El objetivo del estudio es observar si existe relación entre la funcionalidad, nivel de dependencia de las personas tras un ictus y la calidad de vida. Se ha realizado un estudio transversal con una muestra de 50 personas con ictus a los que se les valoró la funcionalidad del miembro superior, nivel de dependencia y calidad de vida. Se llevó a cabo un análisis bivariado mediante r de Pearson para determinar las relaciones existentes. Se observó una relación significativa en cuanto a una mayor limitación funcional y mayor dependencia en la realización de AVD y AIVD con una peor calidad de vida, además de ser estas variables predictoras de la calidad de vida. El estado funcional y el nivel de dependencia pueden ser agravados por un entorno poco accesible que a su vez tiene repercusiones directas en la calidad de vida. Es importante la adaptación del entorno y seguir trabajando por conseguir la concienciación de una correcta accesibilidad y diseño para todos.