Role of physiotherapy in the rehabilitation of patients with idiopathic inflammatory myopathies

Physical exercise plays a crucial role in the treatment of inflammatory myopathies. In the phase of active muscle inflammation the prevention of contractures in the joints and physiotherapy for the respiratory system are the most important goals, whereas in the recovery phase of dermatomyositis and polymyositis the emphasis must be on the strengthening of the remaining muscle fibers and the treatment of the myopathy caused by corticosteroids. The authors discuss in detail the special rehabilitation problems of myositis patients depending on the activity and subtype of the disease and the possible solutions.     

Nursing appointment (consultation) for the promotion of sexual health

Methodological bases and instruments are presented in this academic paper for holding a nursing consultation focused on the sexual health of adults and adolescents. The systematized proposal is based on a promotional perspective of sexual health and on a comprehensive concept of sexuality. Emphasis is placed on the recognition of related vulnerabilities, on an ample approach of needs, and on the inter-relational and educative dimension and educative dimension in the work of nurses.     

Task-specific sensory and motor preparatory activation revealed by contingent magnetic variation

The present report studied the magnetic counterpart (CMV) of the auditory contingent negative variation (CNV). The ear where the target auditory stimulus would be presented was cued with a visual central arrow at a validity of 84%. The subject's behavioral response and the magnetoencephalographic (MEG) and electroencephalographic (EEG) signals were recorded. The central cue diminished reaction times (RTs) to the auditory target in the valid conditions with respect to the invalid conditions, indicating that the attentional manipulation was effective. The averaged magnetic field power during the preparatory period was significantly higher than baseline, suggesting the simultaneous presence of a magnetic counterpart of the electric CNV--the CMV. The field maps of the CMV grand averages showed two different and well-established periods: an early one with a magnetic field distribution that suggests a central source, and a late one with a field topography comparable to a low-intensity auditory-evoked field (M1). Single-dipole analysis of the preparatory phase in the subject's magnetic resonance images (MRI) demonstrated the presence of dipolar activity in the posterior cingulate (PCC) and posterior parietal cortices (PPC), superior temporal gyrus (STG) and motor cortices (MC). The lateralization of this activity depended on the orientation of the central cue. These results suggest that the action and perceptual-related areas needed to process the expected subsequent imperative task are recruited during the preparatory periods, influencing the behavioral RTs.     

Medial temporal MR spectroscopy is related to memory performance in normal adolescent subjects

In addition to the study of pathological conditions, magnetic resonance spectroscopy can provide useful information about brain-behavior relationships in normal subjects. Recently, there have been reports of correlations between N-acetylaspartate (NAA) values and cognitive functions in normal adults. We tested the possible specific relationship between the NAA/choline (Cho) ratio in the medial temporal lobe and memory performance in normal adolescents. The medial temporal NAA/Cho ratio was unrelated to age, gender and general intelligence but presented a clear correlation with several memory measures. In the regression analysis two memory variables (RAVLT learning and a face-name recognition task) explained 55.6% of NAA/Cho variance. We conclude that NAA values in the medial temporal lobe are related to memory abilities but not to global intelligence in normal adolescent subjects.     

Medulloblastoma presenting as an extra-axial tumor in the cerebellopontine angle

Differences in the imaging characteristic of adult medulloblastomas have been reported, including involvement of lateral cerebellar hemispheres with an extra-axial appearance. We present a case report of this rare circumstance: a 40 year old man presented with a 3 weeks history of headache, morning vomiting and left hearing difficulties. Magnetic resonance imaging revealed a left cerebellopontine angle (CPA) tumor, like a well circumscribed homogeneously enhancing mass. Through a left suboccipital craniectomy the tumor was totally removed. It presented as a cerebellopontine angle tumor, like a meningioma, and not as an intra-axial tumor. Histological analysis revealed that the tumor was composed of densely packed with highly proliferative cells that produce a dense intercellular reticulin fiber network. Inmunohistochemical analysis showed positive expression to synaptophysin, specific neuronal enolase and cromogranin. Histological diagnosis was crucial to define it as a desmoplastic medulloblastoma the present case and to perform postoperative adjuvant therapy. Neurosurgeons should be aware of the possibility that a CPA tumor is of intraaxial origin, because this increase the variability on pathological diagnosis.     

Women, family demands and health: the importance of employment status and socio-economic position

Although it is generally assumed that women engaged in paid work have better health than full-time homemakers, little is known about the situation in Southern European countries like Spain or about differences in the impact of family demands by employment status or the potential interaction with educational level. The objectives of this study are to analyse whether inequalities in health exist among housewives and employed women, and to assess whether the relationship between family demands and health differs by employment status. Additionally, for both objectives we examine the potential different patterns by educational level. The data have been taken from the 1994 Catalonian Health Survey (Spain). The sample was drawn from all women aged 25-64 years who were employed or full-time homemakers and married or cohabiting. Four health indicators (self-perceived health status, limiting long-standing illness, chronic conditions and mental health) and two health related behaviours (hours of sleeping and leisure-time physical activity) were analysed. Family demands were measured through household size, living with children under 15 and living with elderly. Overall, female workers had a better health status than housewives, although this pattern was more consistent for women of low educational level. Conversely, the health related behaviours analysed were less favourable for workers, mainly for those of low educational level. Among workers of low educational level, family demands showed a negative effect in most health indicators and health related behaviours, but had little or no negative association at all in workers of high educational level or in full-time homemakers. Moreover, among women of low educational level, both workers and housewives, living with elderly had showed a negative association with poor health status and health related behaviours. These results emphasise the need of considering the interaction between family demands, employment status and educational level in analysing the impact of family demands on women's health as well as in designing family policies and programmes of women's health promotion.     

Age differences in human skeletal muscle fatigue during high-intensity intermittent exercise

It has been shown at similar relative work rates that children have higher resistance to fatigue than adults during repeated bouts of high-intensity exercise. This age-related difference in fatigue resistance may be explained by factors including muscle mass, muscle morphology, energy metabolism and neuromuscular activation.

Conclusion: During high-intensity intermittent exercise, recovery periods play an important role in limiting fatigue. Age-related differences in fatigue resistance could also be explained by differences in the rates of resynthesis of some energetic substrates and the rates of removal of various muscle metabolites.     

Accuracy of sonography with a hydration test in differentiating between excretory renal obstruction and renal sinus cysts

PURPOSE: The aim of this prospective study was to determine whether sonography with a hydration test to induce diuresis can be used to reliably differentiate between excretory renal obstruction and renal sinus cysts. METHODS: We performed sonographic examination of all patients diagnosed with minimal or moderate obstruction of the intrarenal collecting system or renal sinus cysts on the basis of excretory urography, CT, or both between September 1, 1998, and October 31, 1999. The largest fluid-filled structures in the renal sinus were sonographically measured before and after each patient ingested 1.5 l of water. Cases in which the maximum diameters of the largest anechoic structures increased by at least 10% after hydration were diagnosed with excretory renal obstruction. The sonographic diagnoses were compared with the final diagnoses on excretory urography, CT, or both. RESULTS: Both kidneys were affected in 16 of the 36 patients examined, for a total of 52 kidneys. The sonographic diagnosis was consistent with the results of urography or CT in 48 (92%) of the 52 kidneys. The sonographic approach had a specificity of 92% and a sensitivity of 93% for the diagnosis of excretory renal obstruction, with only 1 false-negative and 3 false-positive results. CONCLUSIONS: When used with the stimulated diuresis test, sonography can reliably distinguish between excretory renal obstruction and renal sinus cysts and can be used as an alternative to other imaging techniques such as urography.