Comparison between Corticosteroid and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial

No abstract available

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Outcome Trends of Adult Cancer Patients Receiving Inpatient Rehabilitation: A 13-year review

AbstractObjectiveThis study describes characteristics and trends of inpatient rehabilitation among cancer patients within the United States over a 13-year period.DesignThis was a retrospective study of data from the Uniform Data System for Medical Rehabilitation (UDSMR®) from 2002 to 2014. Patients over the age of 17 admitted to inpatient rehabilitation facilities with a diagnosis of malignant cancer were included. Trends of rehabilitation outcomes including length of stay, Functional Independence Measure (FIM®) Instrument scores, and discharge location were examined.ResultsData from 115,570 cancer patients was evaluated. Mean age was 66 ±14 and 49% were female. Mean length of stay decreased over time (2002: 14 days to 2014:13 days, p70%) were discharged to the community.ConclusionCancer patients receiving acute inpatient rehabilitation demonstrated significant improvements in functional outcomes from admission to discharge. Cancer patients became more independent in important activities of daily living, thereby potentially reducing caregiver burden and ensuring safer discharges back to the community. This study suggests potential benefit of inpatient rehabilitation for appropriate cancer patients. Objective This study describes characteristics and trends of inpatient rehabilitation among cancer patients within the United States over a 13-year period. Design This was a retrospective study of data from the Uniform Data System for Medical Rehabilitation (UDSMR®) from 2002 to 2014. Patients over the age of 17 admitted to inpatient rehabilitation facilities with a diagnosis of malignant cancer were included. Trends of rehabilitation outcomes including length of stay, Functional Independence Measure (FIM®) Instrument scores, and discharge location were examined. Results Data from 115,570 cancer patients was evaluated. Mean age was 66 ±14 and 49% were female. Mean length of stay decreased over time (2002: 14 days to 2014:13 days, p70%) were discharged to the community. Conclusion Cancer patients receiving acute inpatient rehabilitation demonstrated significant improvements in functional outcomes from admission to discharge. Cancer patients became more independent in important activities of daily living, thereby potentially reducing caregiver burden and ensuring safer discharges back to the community. This study suggests potential benefit of inpatient rehabilitation for appropriate cancer patients. Corresponding Author: Jeffrey C. Schneider, 300 1st Avenue, Charlestown, MA 02129. jcschneider@partners.org Disclosures: None Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Effects of anodal transcranial direct current stimulation on somatosensory recovery after stroke: a randomized controlled trial

AbstractObjectiveTo evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living (ADL) in patients with subacute stroke.DesignThis study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham tDCSs over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed.ResultsAlthough there was no clear significant difference between the two groups, when the changes from baseline to post-treatment evaluation were compared between the groups, we observed a partially significant improvement in the anodal stimulation group compared to the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in ADL function was observed in the anodal stimulation group too.ConclusionAnodal tDCS over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and ADL function in patients with sensory deficits after stroke. Objective To evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living (ADL) in patients with subacute stroke. Design This study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham tDCSs over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed. Results Although there was no clear significant difference between the two groups, when the changes from baseline to post-treatment evaluation were compared between the groups, we observed a partially significant improvement in the anodal stimulation group compared to the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in ADL function was observed in the anodal stimulation group too. Conclusion Anodal tDCS over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and ADL function in patients with sensory deficits after stroke. Corresponding author: Chung Reen Kim M.D., MS, Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Jeonha 1(il)-dong, Dong-gu, Ulsan, Korea. E-mail: crkim@uuh.ulsan.kr, Tel : 82-52-250-8730, Fax : 82-52-250-8071 We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated. No funds were received in support of this manuscript. Additionally, no benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Letter to the editor involving the article ‘’Comparison Between Corticosteroids and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomised, Double-Blinded, Controlled Trial”

No abstract available

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Characterizing Intervention Strategies Used in Community-Based Mental Health Care for Infants and Their Families

Abstract

Mental health interventions for infants typically target high-risk groups and can prevent long-term negative outcomes. Despite federal initiatives promoting early intervention, minimal research has examined usual care services for infants, which is important to improve routine care. The current study characterized usual care practices in infant mental health through the adaptation and administration of a provider survey. Providers (n = 126) reported using a wide range of intervention strategies and few intervention programs with varied evidence. Findings can inform future research to identify quality improvement targets of usual mental health care for high-risk infants and their families.

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Foreign-Born Blacks Experience Lower Odds of Obesity but Higher Odds of Diabetes than US-Born Blacks in New York City

Abstract

Research is limited on the health of foreign-born Blacks (FBBs), who are often grouped with African Americans. This study compared obesity and diabetes odds in FBBs and US-born Blacks (USBBs) in NYC. Analyzing the 2009–2013 NYC Community Health Survey (3701 FBBs and 6297 USBBs), weighted multivariate logistic regression examined odds of obesity and diabetes, adjusting for age, gender, education, income, marital status, children < 18, BMI (for diabetes only) and duration of residence. FBBs had lower odds of obesity [OR  0.62 (95% CI 0.54, 0.72)] and greater odds of diabetes [OR 1.24 (95% CI 1.01, 1.52)] compared to USBBs. FBBs had 1.4 times the odds of diabetes at overweight status, compared to USBBs [OR  1.40 (95% CI 1.01, 1.95)]. Living in the US ≥ 10 years was not associated with odds of obesity and diabetes. Future research should seek to uncover unique risk profiles of sub-ethnic groups in the African diaspora.

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Reduced arterial vasodilation in response to hypoxia impairs cerebral and peripheral oxygen delivery in hypertensive men

Abstract

This study investigated whether hypertension impairs isocapnic hypoxia (IH)-induced cerebral and skeletal muscle hyperemia to an extent that limits oxygen supply. Oxygen saturation (Oxymetry), mean arterial pressure (MAP, photoplethysmography), muscle sympathetic nerve activity (MSNA, microneugraphy), and femoral (FA), internal carotid (ICA) and vertebral (VA) artery blood flow (BF, Doppler ultrasound) were quantified in 9 normotensive (NT, 40 ± 11 yrs., systolic (SP) 119 ± 7 mmHg and diastolic pressure (DP) 73 ± 6 mmHg) and 9 hypertensive men (HT, 44 ± 12 yrs., SP 152 ± 11 mmHg and DP 90 ± 9 mmHg) during 5 min of normoxia (NX – 21% O₂) and IH (10% O₂). Total cerebral blood flow (tCBF), brain (CDO₂) and leg (LDO₂) oxygen delivery were estimated. IH provoked similar oxygen desaturation without changing MAP. ICA perfusion increased in both groups during IH. However, VA and FA BF only increased in NT. Thus, IH-induced increase in tCBF was smaller in HT. CDO₂ only increased in NT and LDO₂ decreased in HT. Furthermore, IH evoked a greater increase in HT MSNA. Changes in MSNA were inversely related to FA BF, LDO₂ and end-tidal oxygen tension. In conclusion, hypertension disturbs regional and total cerebrovascular and peripheral responses to IH and consequently limits oxygen supply to the brain and skeletal muscle. While increased chemoreflex-induced sympathetic activation may explain impaired peripheral perfusion, attenuated vasodilatory signalling in the posterior cerebrovasculature seems responsible for the small increase in tCBF when HT were exposed to IH.

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