Profile of children referred to primary health care physiotherapy: a longitudinal observational study in Norway.
- 作者列表："Evensen KAI","Sellæg S","Stræte AC","Hansen AE","Meisingset I
BACKGROUND:Physiotherapy services are an important part of the primary health care services for children, serving a broad spectrum of children referred from different sources and for a variety of reasons. There is limited knowledge about their characteristics and outcome. The aim of this study was to describe the profile, i.e. referral patterns, baseline demographical and clinical characteristics, as well as treatment outcome at follow-up 6 months after baseline, of children receiving physiotherapy in primary health care. METHODS:Children referred to primary health care physiotherapy in a large municipality in Norway were invited to participate in this longitudinal observational study. The children's demographics, referral sources, causes of referral, functional diagnoses, influence on their daily activities, main goals and planned treatments were registered at baseline. Goal attainment and treatment compliance were registered at follow-up maximum 6 months after baseline. RESULTS:The physiotherapists registered baseline characteristics for 148 children. Parent-reported data at baseline were available for 101 (68.2%) of these children. Children were mainly referred from child health care centres (n = 74; 50.0%), hospital (n = 25; 16.9%) and kindergarten (n = 22; 14.9%). The most frequent causes of referral were concerns for motor development (n = 50; 33.8%), asymmetry (n = 40; 27.0%) and orthopaedic conditions (n = 25; 16.9%). Eighty-one (54.7%) children were below the age of 1 year. There was partly agreement between causes of referral and the physiotherapists' functional diagnoses. Parents of 69 (71.1%) children reported that their child's daily activities were little to not at all affected by the problem or complaint for which they were referred. Follow-up data were registered for 64 children. The main treatment goal was achieved in 37 (57.8%) and partly achieved in 26 (40.6%) children and the treatment was carried out as planned in 55 (87.3%) children. CONCLUSIONS:The large variation in the profile of children receiving physiotherapy in a primary health care setting in Norway shows how primary health care physiotherapists can contribute to fulfil the broad purpose of the primary health care services. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT03626389 . Registered on August 13th 2018 (retrospectively registered).
背景: 物理治疗服务是儿童初级保健服务的重要组成部分，为来自不同来源和各种原因的广泛儿童提供服务。关于他们的特征和结果的知识有限。本研究的目的是描述概况，即在初级保健中接受理疗的儿童的转诊模式、基线人口学和临床特征，以及基线后6个月随访时的治疗结果。 方法: 在挪威的一个大型城市中接受初级保健物理治疗的儿童被邀请参加这项纵向观察研究。在基线时登记了儿童的人口统计学、转诊来源、转诊原因、功能诊断、对其日常活动的影响、主要目标和计划的治疗。在基线后最长6个月的随访中记录目标达成和治疗依从性。 结果: 物理治疗师记录了148名儿童的基线特征。这些儿童中的101 (68.2%) 可获得父母报告的基线数据。儿童主要来自儿童保健中心 (n = 74 74; 50.0%) 、医院 (n = 25; 16.9%) 和幼儿园 (n = 22; 14.9%)。转诊最常见的原因是关注运动发育 (n = 50; 33.8%)，不对称 (n = 40 40; 27.0%) 和骨科疾病 (n = 25; 16.9%)。81名 (54.7%) 儿童在1岁以下。转诊原因与理疗师的功能诊断部分一致。69名 (71.1%) 儿童的父母报告说，他们的孩子的日常活动几乎没有受到他们被转介的问题或投诉的影响。登记了64名儿童的随访数据。37名 (57.8%) 儿童实现了主要治疗目标，26名 (40.6%) 儿童部分实现了主要治疗目标，55名 (87.3%) 儿童按计划进行了治疗。 结论: 挪威在初级卫生保健环境中接受物理治疗的儿童状况差异很大，这表明初级卫生保健物理治疗师如何有助于实现初级卫生保健服务的广泛目的。 试验注册: clinicaltrials.Gov标识符: NCT03626389。2018年8月13日登记 (回顾性登记)。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.