Τρίτη, 22 Μαρτίου 2016

Does Delay in Taking the American Board of Physical Medicine and Rehabilitation Certification Examinations Affect Passing Rates?.

Objectives: The objective of this study was to examine whether a delay in initially taking the Part I or Part II American Board of Physical Medicine and Rehabilitation certification examinations influences the score or passing rates of candidates and whether enrollment in a subspecialty fellowship influences performance on the Part II certification examination. Design: This was a retrospective review of first-time candidates taking the American Board of Physical Medicine and Rehabilitation initial certification examinations from 2010 to 2014. Results: Passing rates declined as candidates delayed the examination past the time of initial eligibility. Passing rates for Part I were as follows (mean [95% confidence interval]): no delay, 91% (89%-94%); 1-yr delay, 68% (56%-82%); and more that 2 yrs' delay, 59% (55%-68%). For Part II, passing rates were as follows: no delay, 90% (85%-94%); 1-yr delay, 83% (72%-94%); and more than 2 yrs' delay, 68% (50%-83%). Those completing an accredited fellowship performed better (92% pass rate) on the Part II examination than did those who did not (81% pass rate), but they also had higher final year evaluations from their residency program directors. Conclusions: It seems preferable to take both Part I and Part II examinations as soon as one is eligible. Enrollment in an accredited fellowship may be associated with a higher chance of passing the examination. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/25ljjFx
via IFTTT

Cardiac Structure and Function in Elite Para-Cyclists with Spinal Cord Injury.

Purpose: We sought to explore the association between spinal cord injury (SCI) level on cardiac structure and function observed in elite para-cyclists. Methods: Cross-sectional echocardiographic data from 44 elite SCI hand-cyclists (39.8 +/- 9 years, 68% male/32% female) stratified by level of SCI (cervical, N = 9; T1-T5, N = 10; below T5, N = 25) and 19 non-SCI blind-visually impaired (BVI) tandem cyclists (32.4 +/- 7 years, 58% male / 42% female) were analyzed prior to the initiation of international competition. Results: Compared to non-SCI BVI cyclists, cervical SCI para-cyclists were observed with lower indexed left ventricular mass [99.6 +/- 12 versus 125 +/- 20 gm/m2; P = 0.01], posterior wall thickness [4.5 +/- 0.3 versus 5.8 +/- 0.7 mm/m2; P

from Sports Medicine via xlomafota13 on Inoreader http://ift.tt/1RfovEU
via IFTTT

How Do Candidates Perform When Repeating the American Board of Physical Medicine and Rehabilitation Certification Examinations?.

Objective: The objective of this study was to examine the likelihood of passing the Part I and Part II American Board of Physical Medicine and Rehabilitation (ABPMR) certification examinations after initially failing. Design: This was a retrospective review of candidates who had taken the ABPMR initial certification examinations between 2010 and 2014. Results: Passing rates declined markedly with repeated attempts for both part I and part II. Passing rates (mean [95% confidence interval]) for part I were first attempt, 90% (87%-92%); second attempt, 58% (52%-66%); third attempt, 41% (26%-54%); fourth or greater attempt, 17% (3%-31%). For part II, the passing rates were first attempt, 87% (82%-92%); second attempt, 65% (56%-75%); third attempt, 41% (17%-65%); fourth or greater attempt, 20% (0%-59%). Those who were closer to the passing score on their initial attempt had a greater chance of passing on successive attempts. Conclusions: Passing rates for the ABPMR certification examination decline markedly with greater numbers of attempts. Those who fail again after one repeat attempt should rethink their examination preparation strategy before attempting the examination again. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1Zr2zZj
via IFTTT

Fitness Is Independently Associated with Central Hemodynamics in Metabolic Syndrome.

Purpose: Fit individuals with metabolic syndrome (MetS) have lower mortality risk compared to less fit counterparts, despite the presence of obesity as a component of the syndrome. To understand the importance of fitness in treating this condition, we examined the association of fitness and fatness with central hemodynamic indices that are known independent predictors of cardiovascular events (CVEs). Methods: 68 individuals with MetS participated in this cross-sectional study. Central hemodynamics were calculated from radial applanation tonometry and comprised: aortic reservoir pressure, backward pressure wave (Pb), reflection magnitude (RM), and augmentation index at 75bpm (AIx75). Cardiorespiratory fitness (CRF) and body fat percentage (BF%) were determined via indirect calorimetry during maximal exercise testing and dual energy x-ray absorptiometry, respectively. Results: CRF was inversely associated with aortic reservoir pressure (r = -0.29, p = 0.02), Pb (r = -0.42, p

from Sports Medicine via xlomafota13 on Inoreader http://ift.tt/1MBjyRf
via IFTTT

Ultrasound Imaging of Persistent Median Artery and Veins in an Asymptomatic Patient With a Bifid Median Nerve.

No abstract available

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/25ljmBe
via IFTTT

Protection from Muscle Damage in the Absence of Changes in Muscle Mechanical Behavior.

Introduction: The repeated bout effect characterises the protective adaptation following a single bout of unaccustomed eccentric exercise that induces muscle damage. Sarcomerogenesis and increased tendon compliance have been suggested as potential mechanisms for the repeated bout effect by preventing muscle fascicles from being stretched onto the descending limb of the length-tension curve (the region where sarcomere damage is thought to occur). In this study, evidence was sought for three possible mechanical changes that would support either the sarcomerogenesis or increased tendon compliance hypotheses; a sustained rightward shift in the fascicle length-tension relationship, reduced fascicle strain amplitude, and reduced starting fascicle length. Methods: Subjects (n=10) walked backward, downhill (5 km/h, 20% incline) on a treadmill for 30-min on two occasions separated by seven days. Kinematic data and medial gastrocnemius fascicle lengths (ultrasonography) were recorded at 10-min intervals to compare fascicle strains between bouts. Fascicle length-torque curves from supramaximal tibial nerve stimulation were constructed pre-, 2-hr post- and 2-d post- each exercise bout. Results: Maximum torque decrement and elevated muscle soreness were present following the first, but not the second, backward-downhill walking bout signifying a protective repeated bout effect. There was no sustained rightward shift in the length-torque relationship between exercise bouts, nor decreases in fascicle strain amplitude or shortening of the starting fascicle length. Conclusion: Protection from a repeated bout of eccentric exercise was conferred without changes in muscle fascicle strain behaviour, indicating that sarcomerogenesis and increased tendon compliance were unlikely to be responsible. As fascicle strains are relatively small in humans, we suggest that changes to connective tissue structures, such as extracellular matrix remodelling, are better able to explain the repeated bout effect observed here. (C) 2016 American College of Sports Medicine

from Sports Medicine via xlomafota13 on Inoreader http://ift.tt/1RfoxwB
via IFTTT

Injury of the Ascending Reticular Activating System by Subfalcine Herniation After Subdural Hematoma: A Case Report.

No abstract available

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1Zr2x3C
via IFTTT

Ideomotor Apraxia Due to Injury of the Superior Longitudinal Fasciculus: A Case Report.

We report on a patient who showed ideomotor apraxia due to injury of the superior longitudinal fasciculus following brain tumor and tumor bleeding, which was demonstrated by diffusion tensor tractography (DTT). A 60-yr-old, right-handed male patient underwent removal of brain meningioma and drainage of intraventricular hemorrhage and intracerebral hemorrhage in the left fronto-parietal lobe. At the time of DTT scanning (5 wk after onset), he was able to move the right upper extremity against gravity. The patient exhibited an intact ideational plan for motor performance. In addition, he was able to use actual objects (scissors, eraser) using his right wrist and hand. However, he had difficulty in using his right upper extremity for pantomime of object use, imitating gestures (meaningless or meaningful), and movement of his right upper extremity proximal. Score on the ideomotor apraxia test for the right side was 4 (cut-off score

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1RjVMvh
via IFTTT

"Numb Chin Syndrome": Two Additional Cases of Mental Nerve Mononeuropathy Resulting from Metastasis and Infection: -A Redux!

No abstract available

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1Mlwpwd
via IFTTT

Determining the Minimal Clinically Important Difference for 6-Minute Walk Distance in Fibromyalgia.

Objective: The aim of this study was to estimate the minimal clinically important difference (MCID) for 6-min walk distance (6MWD) in patients with fibromyalgia. Design: Data from a recently completed trial that included 187 patients who completed the 6-min walk test, Fibromyalgia Impact Questionnaire (FIQ), and Short-Form 36 (SF36) at 12 and 36 wks were used to examine longitudinal changes in 6MWD. An anchor-based approach that used linear regression analyses was used to determine the MCID for 6MWD, using the total FIQ score (FIQ-Total) and SF36-physical function domain as clinical anchors. Results: The mean (SD) change in 6MWD from baseline to week 36 was 34.4 (65.2) m (P

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1RjVPal
via IFTTT

BLIND INJECTIONS: ETHICAL BUT NOT ELIGIBLE.

No abstract available

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1MlwpfN
via IFTTT

A genome-wide study of lipid response to fenofibrate in Caucasians: a combined analysis of the GOLDN and ACCORD studies.

Background: Fibrates are commonly prescribed for hypertriglyceridemia, but they also lower LDL cholesterol and increase HDL cholesterol. Large interindividual variations in lipid response suggest that some patients may benefit more than others and genetic studies could help identify such patients. Methods: We carried out the first genome-wide association study of lipid response to fenofibrate using data from two well-characterized clinical trials: the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) Study and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Study. Genome-wide association study data from both studies were imputed to the 1000 Genomes CEU reference panel (phase 1). Lipid response was modeled as the log ratio of the post-treatment lipid level to the pretreatment level. Linear mixed models (GOLDN, N=813 from 173 families) and linear regression models (ACCORD, N=781) adjusted for pretreatment lipid level, demographic variables, clinical covariates, and ancestry were used to evaluate the association of genetic markers with lipid response. Among Caucasians, the results were combined using inverse-variance weighted fixed-effects meta-analyses. The main findings from the meta-analyses were examined in other ethnic groups from the HyperTG study (N=267 Hispanics) and ACCORD (N=83 Hispanics, 138 African Americans). Results: A known lipid locus harboring the pre-B-cell leukemia homeobox 4 (PBX4) gene on chromosome 19 is important for LDL cholesterol response to fenofibrate (smallest P=1.5x10-8). The main results replicated with nominal statistical significance in Hispanics from ACCORD (P

from Genetics via xlomafota13 on Inoreader http://ift.tt/1VCSGrD
via IFTTT

Ultrasound Guidance for Technically Challenging Intrathecal Baclofen Pump Refill: Three Cases and Procedure Description.

Intrathecal baclofen (ITB) therapy is a common treatment used to reduce spasticity due to neurologic disorders and injuries. A variety of factors can increase the difficulty of ITB pump refill. Excess subcutaneous fat overlying the pump, spasticity, suboptimal positioning, pump rotation or inversion, and scar formation over the reservoir fill port can create challenges during pump refill. As a result, multiple unsuccessful attempts at accessing the reservoir fill port can be painful and increase the risk of infection, particularly when repeat skin puncture is required. Blind attempts to refill a pump in challenging cases may also result in subcutaneous injection or pocket fill, resulting in a potentially fatal baclofen withdrawal syndrome. We describe 3 successful ITB pump refills in technically challenging cases when using ultrasound guidance. This represents an innovative approach to using ultrasound guidance to facilitate ITB refill in adults with intractable spasticity. We present these new clinical data with a literature review of potential complications related to inaccurate pump refill procedures and discuss the utility of ultrasound guidance for preventing such adverse events. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1RjVODt
via IFTTT

Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke: A Prospective Population-Based Study.

Objective: Hemiplegic shoulder pain is a common complication of stroke. The primary aim of this study was to determine the association of hemiplegic shoulder pain with health-related quality of life at 12 months after first stroke in a population-based registry. The secondary aim was to identify other factors associated with health-related quality-of-life outcomes. Design: A prospective population-based study in a geographically defined region of Adelaide, South Australia was conducted. Multiple ascertainment methods identified all cases of stroke within a 12-month period. Objective and subjective measures were undertaken at baseline and at 4 and 12 months' follow-up. Multiple regression analyses identified independent variables (including exposure to shoulder pain and depression, 12-month dependence, access to formal rehabilitation) associated with health-related quality of life, defined by the summary index score derived from EuroQol-5D-3L at 12 months post-stroke. Results: Hemiplegic shoulder pain, depression, increased dependency, stroke severity, and absence of initial rehabilitation were each associated with reduction in quality of life. Age, sex, stroke type, Oxfordshire classification, and discharge destination were not related to quality of life. Conclusion: Hemiplegic shoulder pain reduces health-related quality of life at 12 months. More effort should be directed towards screening and management of this frequent complication of stroke. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1Mlwmk5
via IFTTT

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

Objective: To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults. Design: WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS). Results: SSWS (P

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1RjVOmW
via IFTTT

Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head: A Case Report.

This case report describes the first patient with avascular necrosis of the femoral head of Association Research Circulation Osseous stage IV, treated with radial extracorporeal shock wave therapy. By contrast, previous studies demonstrated the efficacy of a single treatment of focused extracorporeal shock wave therapy in improving pain and Harris Hip Scale in patients with avascular necrosis of the femoral head of Association Research Circulation Osseous stage I to III. The affected hip was treated with 6000 impulses of radial extracorporeal shock wave therapy at 10 Hz and an intensity ranging from 2.5 to 4.0 bar at 7-day intervals for 24 mos. The Harris Hip Scale values were 33, 43, 56, 77, 81, 88, and 92 at baseline and 1, 3, 6, 12, 18, and 24 mos, respectively. The radiographs showed that the subluxation of the right hip was slightly aggravated. Joint effusion was reduced, bone marrow edema disappeared, the density became more uniform, and the gluteal muscles were more developed based on magnetic resonance imaging. Increased tracer uptake was evident along the joint margin and superolateral aspect of the head both before and after radial extracorporeal shock wave therapy. This case report demonstrates the feasibility of long-term radial extracorporeal shock wave therapy in Association Research Circulation Osseous stage IV patients. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1UM2i2x
via IFTTT

Enhanced Osteoblast Response to Porosity and Resolution of Additively Manufactured Ti-6Al-4V Constructs with Trabeculae-Inspired Porosity

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 10-21.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/25kRHk5
via IFTTT

A Novel Approach for Patellofemoral Tracking Using a Knee Model Reconstructed with a Three-Dimensional Printer

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 32-38.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/1S4PZJI
via IFTTT

Additive Hybrids

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 1-1.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/25kRHjT
via IFTTT

Craft Driven Robotic Composites

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 2-9.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/1S4PXS1
via IFTTT

Design and Implementation of Novel Multifunctional 3D Bioprinter

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 64-68.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/25kRH3u
via IFTTT

Open Source 3D-Printing Approach for Economic and Fast Engineering of Perfusable Vessel-Like Channels Within Cell-Laden Hydrogels

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 22-31.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/1S4PXBy
via IFTTT

Large-Scale Deposition System by an Industrial Robot (I): Design of Fused Pellet Modeling System and Extrusion Process Analysis

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 39-47.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/25kRGN4
via IFTTT

Implications of Additive Manufacturing for Spare Parts Inventory

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 56-63.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/1S4PZcK
via IFTTT

Directionality of Cavities and Porosity Formation in Powder-Bed Laser Additive Manufacturing of Metal Components Investigated Using X-Ray Tomography

3D Printing and Additive Manufacturing Mar 2016, Vol. 3, No. 1: 48-55.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/1RiFpRS
via IFTTT

Editorial Board

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4





from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1RxvPYj
via IFTTT

Table of Contents

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4





from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1LFysLI
via IFTTT

Editors' Selections From This Issue: Volume 97 / Number 4 / April 2016

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4





from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1PqkaZS
via IFTTT

Masthead

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4





from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1q1an8b
via IFTTT

Lower Limb Strength Is Significantly Impaired in All Muscle Groups in Ambulatory People With Chronic Stroke: A Cross-Sectional Study

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4
Author(s): Simone Dorsch, Louise Ada, Colleen Grace Canning
ObjectiveTo measure the strength of the major muscle groups of the affected and intact lower limbs in people with stroke compared with age-matched controls.DesignCross-sectional study.SettingUniversity laboratory.ParticipantsAmbulatory stroke survivors (n=60; mean age, 69±11y), who had had a stroke between 1 and 6 years previously, and age-matched controls (n=35; mean age, 65±9y) (N=95).InterventionsNot applicable.Main Outcome MeasuresThe maximum isometric strength of 12 muscle groups (hip flexors and extensors, hip adductors and abductors, hip internal rotators and external rotators, knee flexors and extensors, ankle dorsiflexors and plantarflexors, ankle invertors and evertors) of both lower limbs was measured using handheld dynamometry. All strength measurements were taken in standardized positions by 1 rater.ResultsThe affected lower limb of the participants with stroke was significantly weaker than that of the control participants for all muscle groups (P<.01). Strength (adjusted for age, sex, and body weight) was 48% (range, 34%–62%) of that of the control participants. The most severely affected muscle groups were hip extensors (34% of controls), ankle dorsiflexors (35%), and hip adductors (38%), and the least severely affected muscle groups were ankle invertors (62%), ankle plantarflexors (57%), and hip flexors (55%). The intact lower limb of the participants with stroke was significantly weaker than that of the control participants for all muscle groups (P<.05) except for ankle invertors (P=.25). Strength (adjusted for age, sex, and body weight) was 66% (range, 44%–91%) of that of the control participants. The most severely affected muscle groups were hip extensors (44% of controls), ankle dorsiflexors (52%), and knee flexors (54%).ConclusionsAmbulatory people with chronic stroke have a marked loss of strength in most of the major muscle groups of both lower limbs compared with age-matched controls.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1Pqkec6
via IFTTT

Motor Planning for Loading During Gait in Subacute Stroke

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4
Author(s): Sue Peters, S. Jayne Garland, Kimberly J. Miller, Christopher K. Cochrane, Tanya D. Ivanova, Michael A. Hunt
ObjectivesTo determine the characteristics of motor planning surrounding initial contact during gait through examination of thigh muscle timing, amplitude, and co-contraction of the paretic and nonparetic limbs in people poststroke, and to investigate whether muscle timing, amplitude, and clinical performance measures of balance and mobility differ based on the level of co-contraction.DesignObservational study.SettingUniversity-based research laboratory.ParticipantsIndividuals (n=27) in the subacute phase after stroke and healthy controls (n=8) (N=35).InterventionsNot applicable.Main Outcome MeasuresTiming (onset and offset) and normalized amplitude (percent electromyography maximum) of the biceps femoris (BF) and rectus femoris (RF) muscles were measured during terminal swing and early stance. A co-contraction index (CCI) was calculated for the BF and RF muscle activity. Individuals with CCI values equal to or below the mean of the healthy group were in the low CCI group, whereas those with values above the mean were in the high CCI group. Functional balance and mobility evaluation used the Community Balance and Mobility Scale (CB&M).ResultsFor the paretic and nonparetic limbs, measures of timing, amplitude, and co-contraction were similar for both limbs. Compared with the healthy group, the high CCI group had lower CB&M scores, longer durations, and higher levels of RF and BF muscle activity, whereas the low CCI group had electromyographic measures statistically similar to healthy controls.ConclusionsThe motor control of gait after subacute stroke is characterized by symmetry of timing and amplitude of muscle recruitment at the knee. High co-contraction levels surrounding the knee were associated with lower functional balance and mobility. These findings suggest a compensatory strategy of increased co-contraction in those with more impairment while maintaining symmetry of lower-limb biomechanics between limbs.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1q1aksY
via IFTTT

Survey of US practitioners on the validity of the Medicare Functional Classification Level system and utility of clinical outcome measures for aiding K-level assignment

Publication date: Available online 22 March 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Dylan Borrenpohl, Brian Kaluf, Matthew J. Major
ObjectiveThis study characterized the opinion of the prosthetic clinical care community on the Medicare Functional Classification Level (K-level) assignment process to classify mobility and rehabilitation potential of persons with lower-limb loss, including limitations and practicalities involved with the integration of outcome measures (OMs) into the clinical practice framework for K-level assignment.DesignSurvey.SettingEnglish online questionnaire with built-in logic.ParticipantsVolunteer sample of prosthetics practitioners (n=236). Data were analyzed only for United States practitioners (n=213).InterventionsNot applicable.Main Outcome MeasuresSubjective responses to 19 multiple choice, Likert scale, and open-ended questions.ResultsForty-seven percent of respondents indicated that they were the sole determinant in the K-level assignment process, while 43% indicated that it was a collaborative process with another healthcare professionals. Sixty-nine percent of respondents reported using standardized outcome measures to assist in K-level assignment, and the majority did not agree that commonly-reported barriers to implementation (e.g., lack of time and training) were relevant. Sixty-seven percent of respondents did not believe the K-level system can accurately assign a level of rehabilitation potential, with 75% agreeing that incorporating OMs into clinical practice would enhance objectivity of the K-level assignment process.ConclusionThe results suggest that the majority of prosthetics practitioners are involved in the K-level assignment at some level, and most agreed that there are considerable limitations with this system. To address these issues, many practitioners are utilizing OMs to assess various aspects of patient mobility and rehabilitation potential, and minimize the subjectivity of the assignment process.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1PqkdVI
via IFTTT

Respiratory Health and Spinal Cord Injury

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4
Author(s): Eric Garshick, Phil Klebine, Daniel J. Gottlieb, Anthony Chiodo




from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/1q1aksQ
via IFTTT

Request for Proposals

Publication date: April 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 4





from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/25kNXii
via IFTTT

Total antioxidant status in newly-diagnosed type II diabetes patients in Bangladeshi population

2016-03-22T18-37-25Z
Source: Journal of Molecular Pathophysiology
Mohammad Abdul Hai Siddique, Zinat Tamannaa, Syed Mohammad Kamaluddin, Mohammad Saiedullah, Mohammad Aminul Haque Khan, Matiar Rahman, Liaquat Ali.
Background: Prevalence and complications of type 2 diabetes mellitus (DM) is increasing in Bangladeshi population. Oxidative stress plays an important role in the pathogenesis of DM and its complications. However, antioxidant status and its contribution to type 2 DM are less explored in Bangladeshi population. Aim: The aim of this study was to evaluate antioxidant status (TAS) in newly diagnosed never treated type 2 diabetic subjects against apparently healthy nondiabetic subjects of Bangladeshi origin. Methods: In this cross-sectional study, 179 adult subjects were included. Fasting and postprandial blood specimens were collected and plasma glucose concentrations were measured by standard methods. Fasting plasma total antioxidant capacity (TAC) was measured by ferric reducing ability of plasma (FRAP) assay and compared among diabetic, prediabetic and nondiabetic. Results: TAC was 1077±217 µmol/L, 1225 ±285 µmol/L and 1425±319 µmol/L in diabetic (n=79), prediabetic (n=42) and nondiabetic (n=58) subjects respectively. TAS in diabetic subjects was 148 µmol/L lower than that of prediabetic subjects (p


from Scope via xlomafota13 on Inoreader http://ift.tt/1S4MuTE
via IFTTT

Alcoholic hepatitis histological score has high accuracy to predict 90-day mortality and response to steroids

A histological classification system (AHHS) has been recently proposed to predict 90-day mortality in patients with alcoholic hepatitis (AH). We analyzed the spectrum of histological features in patients with AH and assessed the ability of AHHS for predicting both response to steroids and 90-day mortality.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/1T5Eiay
via IFTTT

Methylation and expression of Epstein–Barr virus latent membrane protein 1, 2A and 2B in EBV-associated gastric carcinomas and cell lines

Promoter CpG methylation of Epstein–Barr virus (EBV) genome plays an essential role in maintaining viral latency. Latent membrane protein (LMP) 1, 2A and 2B of EBV exert multiple oncogenic properties by activating multiple signal pathways and modulating the expression of various oncogenes.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/1S4vgWB
via IFTTT

Serum transglutaminase 3 antibodies correlate with age at celiac disease diagnosis

Transglutaminase (TG)2 is the autoantigen in celiac disease, but also TG3 antibodies have been detected in the serum of celiac disease patients.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/1VBOgkJ
via IFTTT

Comparison of the diameter, cross-sectional area, and position of the left and right internal jugular vein and carotid artery in adults using ultrasound

gr1.sml

Central venous access is indicated for transduction of central venous pressure and the administration of inotropes in the perioperative period. The right internal jugular vein (RIJV) is cannulated preferentially over the left internal jugular vein (LIJV). Cannulation of the LIJV is associated with a higher complication rate and a perceived increased level of difficulty when compared with cannulation of the RIJV. Possible explanations for the higher complication rate include a smaller diameter and more anterior position relative to the corresponding carotid artery (CA) of the LIJV compared with the RIJV.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1UDN4h6
via IFTTT

Endotracheal tube displacement during head and neck movements. Observational clinical trial

gr1.sml

Measure the displacements of endotracheal tube (ETT) tip displacement during head and neck movements.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1UDN1BR
via IFTTT

Prediction of obstructive sleep apnea using visual photographic analysis

gr1.sml

Obstructive sleep apnea (OSA) has been historically underdiagnosed and may be associated with grave perioperative complications. The ASA and American Academy of Sleep Medicine recommend OSA screening prior to surgery; however, only a minority of patients are screened. The objective of this study was to determine the proficiency of anesthesiologists, otolaryngologists, and internists at predicting the presence of OSA by visual photographic analysis without the use of a computer program to assist, and determine if prediction accuracy varies by provider type.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1UDN3K1
via IFTTT

Guideline-recommended 15° left lateral table tilt during cesarean section in regional anesthesia—practical aspects

gr1.sml

Left lateral table tilt of 15° to 30° is recommended for cesarean section, although little is known about the practical problems of its implementation. This study examines these issues from the perspective of anesthesiologists, obstetricians, theater nurses, and patients. Initially, the tilt was set by visual estimation in 100 women and checked by inclinometer afterwards.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1UDN3ty
via IFTTT

Awake intubating laryngeal mask airway placement in a morbidly obese patient with ankylosing spondylitis and unstable thoracic spine

Intubating laryngeal mask airways can be used to provide continuous ventilation throughout intubation. This is a case of a morbidly obese (body mass index = 58) 65-year-old woman with T10 and T11 compression fractures. Optimal positioning for airway management was hindered by her unstable spine, minimal neck range of motion, and extreme pain with any movement. An intubating laryngeal mask airway was placed in the awake, topically anesthetized patient, and the laryngeal mask airway and endotracheal tube combination was left in place throughout surgery.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1UDN0xY
via IFTTT

Health risk factors in the anesthesia population

gr1.sml

We investigated the prevalence of lifestyle risk factors in patients admitted to our preoperative assessment outpatient clinic, and compared patient self-reports and anesthetist reports of health risk factors to evaluate the patient self-image of preoperative health status.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1RjkU5m
via IFTTT

A case of anaphylaxis apparently induced by sugammadex and rocuronium in successive surgeries

Rocuronium is the agent most frequently involved in perioperative anaphylaxis, and sugammadex has also been known to induce anaphylactic reactions. We describe a case of successive anaphylactic episodes that seemed to be induced by clinical doses of rocuronium and sugammadex. The patient was a 19-year-old woman who had a medical history of asthma, but no history of surgery. She had been injured in a fall, and several surgeries were scheduled for multiple bone fractures. At the first surgery under general anesthesia, she developed anaphylaxis 5 min after sugammadex administration.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1RjkRGN
via IFTTT

Airway obstruction by an unexpected equipment damage

article_notepad.gif

Intubating introducers are often used to facilitate difficult endotracheal intubation. We report a case in which a Frova catheter was used for insertion of a laser-resistant endotracheal tube and in which a strip of plastic was shaved off from the catheter. The plastic strip formed a convolute mass, causing relevant airway obstruction. Clinicians should be aware of this potentially dangerous complication and should be cautious in using Frova intubating introducers in combination with laser-resistant tubes.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1UDN00O
via IFTTT

Bipedality and hair loss in human evolution revisited: The impact of altitude and activity scheduling

Publication date: May 2016
Source:Journal of Human Evolution, Volume 94
Author(s): Tamás Dávid-Barrett, Robin I.M. Dunbar
Bipedality evolved early in hominin evolution, and at some point was associated with hair loss over most of the body. One classic explanation (Wheeler 1984: J. Hum. Evol. 13, 91–98) was that these traits evolved to reduce heat overload when australopiths were foraging in more open tropical habitats where they were exposed to the direct effects of sunlight at midday. A recent critique of this model (Ruxton & Wilkinson 2011a: Proc. Natl. Acad. Sci. USA 108, 20965-20969) argued that it ignored the endogenous costs of heat generated by locomotion, and concluded that only hair loss provided a significant reduction in heat load. We add two crucial corrections to this model (the altitude at which australopiths actually lived and activity scheduling) and show that when these are included there are substantial reductions in heat load for bipedal locomotion even for furred animals. In addition, we add one further consideration to the model: we extend the analysis across the full 24 h day, and show that fur loss could not have evolved until much later because of the thermoregulatory costs this would have incurred at the altitudes where australopiths actually lived. Fur loss is most likely associated with the exploitation of open habitats at much lower altitudes at a much later date by the genus Homo.



from Genetics via xlomafota13 on Inoreader http://ift.tt/1VBlpgq
via IFTTT

Alcoholic hepatitis histological score has high accuracy to predict 90-day mortality and response to steroids

A histological classification system (AHHS) has been recently proposed to predict 90-day mortality in patients with alcoholic hepatitis (AH). We analyzed the spectrum of histological features in patients with AH and assessed the ability of AHHS for predicting both response to steroids and 90-day mortality.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/1T5Eiay
via IFTTT

Methylation and expression of Epstein–Barr virus latent membrane protein 1, 2A and 2B in EBV-associated gastric carcinomas and cell lines

Promoter CpG methylation of Epstein–Barr virus (EBV) genome plays an essential role in maintaining viral latency. Latent membrane protein (LMP) 1, 2A and 2B of EBV exert multiple oncogenic properties by activating multiple signal pathways and modulating the expression of various oncogenes.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/1S4vgWB
via IFTTT

Serum transglutaminase 3 antibodies correlate with age at celiac disease diagnosis

Transglutaminase (TG)2 is the autoantigen in celiac disease, but also TG3 antibodies have been detected in the serum of celiac disease patients.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/1VBOgkJ
via IFTTT

ACCURACY OF SERUM URIC ACID IN PREDICTING COMPLICATIONS OF PRE-ECLAMPSIA

2016-03-22T01-32-16Z
Source: International Journal of Current Research and Review
A. Ramana Priya, K. Jeyapriya, N. S. Kannan.
Introduction: Pre-eclampsia, is a pregnancy-specific syndrome that occurs after mid gestation comprising of gestational hypertension with significant proteinuria. If not treated properly will lead to maternal and foetal complications. Aims: To study the accuracy of serum uric acid in predicting complications of pre-eclampsia and its effect on pregnancy outcome. Methods: Sixty pregnant women at term gestation with diagnosis of pre-eclampsia were included in our study after informed consent. For all patients included in the study all routine investigations including serum uric acid were done and recorded. All the patients were followed up until delivery and all maternal and foetal events were recorded. All complications of pre-eclampsia both maternal and foetal were statistically analysed to prove the predictive value of serum uric acid levels. Results: 18.3% of mothers were between the age group 18-21 years, 26.7% were between 22-25 years, 28.3% were between 26-29 years, and 26.7% were above 30 years. 83.4% of 60 mothers were primi para, 8.3% were para 2, and 8.3% were para 3. The difference in the first minute APGAR in the high risk and no risk category was not statistically significant at p value of 0.1798. The difference in the 5th minute APGAR in the high risk and no risk category was statistically significant at p value of 0.001. 4 out of 42 women (9.52%) with serum uric acid ≥6mg/dl had maternal complications and 7 out of 18 women with serum uric acid


from Scope via xlomafota13 on Inoreader http://ift.tt/1pwA0NB
via IFTTT

Dexmedetomidine Combined with General Anesthesia Provides Similar Intraoperative Stress Response Reduction When Compared with a Combined General and Epidural Anesthetic Technique

imageBACKGROUND: Epidural anesthesia may attenuate the sympathetic hyperactivity and stress response from surgery. In this study, we compared the stress response, hemodynamic variables, and recovery profiles of patients undergoing total IV anesthesia (TIVA) and intraoperative dexmedetomidine with those receiving epidural anesthesia and TIVA. METHODS: Ninety patients undergoing elective open gastrectomy under TIVA were recruited. The dexmedetomidine group (group D, n = 30) received IV dexmedetomidine 0.6 μg/kg before the induction of general anesthesia, followed by dexmedetomidine 0.4 μg/kg/h until peritoneal closure. The control group (group C, n = 30) received volume-matched normal saline infusion as placebo. The epidural group (group E, n = 30) received epidural anesthesia with 0.375% ropivacaine combined with TIVA. The hemodynamic variables and recovery characteristics during emergence were evaluated. Blood samples for norepinephrine (NE), epinephrine (E), cortisol (Cor), and cytokines (tumor necrosis factor-α [TNF-α], interleukin [IL]-6, and IL-10) were obtained before the administration of dexmedetomidine or epidural anesthesia (baseline), immediately after tracheal intubation, upon incision, at the time of celiac exploration, and at tracheal extubation. RESULTS: Compared with group E, there were no differences in the plasma concentration levels of NE, E, Cor, and cytokines (TNF-α, IL-6, and IL-10) in group D at all time points. The levels of NE and E in groups D and E were significantly lower than that in group C, at all time points following induction (all P

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1U43e3p
via IFTTT

Phenotype Driven Molecular Autopsy for Sudden Cardiac Death

ABSTRACT

A phenotype driven approach to molecular autopsy based in a multidisciplinary team comprising clinical and laboratory genetics, forensic medicine and cardiology is described. Over a 13 year period, molecular autopsy was undertaken in 96 sudden cardiac death cases. 46 cases aged 1–40 years had normal hearts and suspected arrhythmic death. 7 (15%) had likely pathogenic variants in ion channelopathy genes (KCNQ1 (1), KCNH2 (4), SCN5A (1), RyR2(1)). 50 cases aged between 2 and 67 had a cardiomyopathy. 25 had Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), 10 Dilated Cardiomyopathy (DCM) and 15 Hypertrophic Cardiomyopathy (HCM). Likely pathogenic variants were found in 3 ARVC cases (12%) in PKP2, DSC2 or DSP, 2 DCM cases (20%) in MYH7, and 4 HCM cases (27%) in MYBPC3 (3) or MYH7 (1). Uptake of cascade screening in relatives was higher when a molecular diagnosis was made at autopsy. In 3 families, variants previously published as pathogenic were detected, but clinical investigation revealed no abnormalities in carrier relatives. With a conservative approach to defining pathogenicity of sequence variants incorporating family phenotype information and population genomic data, a molecular diagnosis was made in 15% of sudden arrhythmic deaths and 18% of cardiomyopathy deaths.

Thumbnail image of graphical abstract

from Genetics via xlomafota13 on Inoreader http://ift.tt/1Uhl3wo
via IFTTT

Economic and Environmental Considerations During Low Fresh Gas Flow Volatile Agent Administration After Change to a Nonreactive Carbon Dioxide Absorbent

imageBACKGROUND: Reducing fresh gas flow (FGF) during general anesthesia reduces costs by decreasing the consumption of volatile anesthetics and attenuates their contribution to greenhouse gas pollution of the environment. The sevoflurane FGF recommendations in the Food and Drug Administration package insert relate to concern over potential toxicity from accumulation in the breathing circuit of compound A, a by-product of the reaction of the volatile agent with legacy carbon dioxide absorbents containing strong alkali such as sodium or potassium hydroxide. Newer, nonreactive absorbents do not produce compound A, making such restrictions moot. We evaluated 4 hypotheses for sevoflurane comparing intervals before and after converting from a legacy absorbent (soda lime) to a nonreactive absorbent (Litholyme®): (1) intraoperative FGF would be reduced; (2) sevoflurane consumption per minute of volatile agent administration would be reduced; (3) cost savings due to reduced sevoflurane consumption would (modestly) exceed the incremental cost of the premium absorbent; and (4) residual wastage in discarded sevoflurane bottles would be 50%) canisters CONCLUSIONS: We showed that an anesthesia department can transition to a premium, nonreactive carbon dioxide absorbent in a manner that is at least cost neutral by reducing FGF below the lower flow limits recommended in the sevoflurane package insert. This was achieved, in part, by electronically monitoring PICO2, automatically notifying the anesthesia technicians when to change the absorbent, and by providing personalized feedback via e-mail to the anesthesia providers.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1U43dMV
via IFTTT

Interventional Management of Head and Face Pain, 1st ed.

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/1RcMNiR
via IFTTT

MANAGEMENT OF CANCER WITH MUNZIJ AND MUS’HIL THERAPY: A REGIMEN OF ILAJ BIT TADBEER (REGIMENAL THERAPY) IN UNANI SYSTEM OF MEDICINE

2016-03-21T23-32-13Z
Source: International Journal of Current Research and Review
Yasmeen Shamsi, Asim Ali Khan, Tabassum Alam, Azhar Jabeen.
Cancer is one of the most perplexing diseases which have been plaguing worldwide and had been accounted for 8.2 million of all deaths in 2012 as reported by World Health Organization (WHO) in 2014.According to WHO, it is the second leading cause of death in the developing countries after cardiovascular diseases. American Cancer Society defines it as a large group of diseases, all characterized by uncontrolled growth and spread of abnormal cells. Its etiology is still not completely understood but certain dietary factors and environmental agents act on the genetic material in cells leading to the chemical changes that may initiate the progression of abnormal cell mass. The Sartan (cancer) is well described in the Unani Classical Medical Literature as Sartan or Warm-e-Sulb-Saudavi. While going through the literature review of various compendiums written by Unani physicians, it is clear that this system of medicine had vast knowledge about sartan. In spite of the present advanced treatment options there is no effective and satisfactory treatment for cancer. The treatment besides being very expensive, are associated with serious side effects and morbidity due to their toxic effects. The search still continues for a treatment that has minimal side effects and is cost effective. Unani medicine has produced many useful leads in developing medications for chronic systemic diseases as proved by numerous clinical trials. Therefore, a Unani alternative approach is being explored in the light of classical Unani literature for the management of Sartan as a safe and efficacious treatment option. The role of Munzij and Mushil therapy, which isan important part of Ilaj bit Tadbeer (Regimenal therapy)in treating such disorders, is well recognized in Unani classical literature.


from Scope via xlomafota13 on Inoreader http://ift.tt/1pwzY8o
via IFTTT

DEVELOPMENT AND ANALYSIS OF OIL FINISH ON COTTON FABRIC

2016-03-21T23-32-13Z
Source: International Journal of Current Research and Review
S. Grace Annapoorani, S. Yamuna Devi.
Aim: In the present scenario of environmental consciousness the requirement of environment friendly textiles is increased. Plant extracts and oils demonstrating antifungal properties may provide protection for textile application. Methodology: This study was to evaluate the antifungal properties of natural plant extracts, such as essential oils, for se on wood. Three essential oils were evaluated for their ability to inhibit growth of Aspergillus Niger, Trichoderma Reesis. Lemon grass oil, pepper mint oil and pine oil inhibited growth of fungi. Cotton fabric is chosen for the study and the selected oils are applied on to the fabric by dip dry method. Result: The treated fabric is tested with two fungal pathogens(Aspergillus niger, Trichoderma reesis). It shows the better antifungal properties. Also the fabric show better result for physical test. Conclusion: These findings support the application of essential oils for surface treatment or vapour exposure of textile to prevent fungal infection and fungal growth.


from Scope via xlomafota13 on Inoreader http://ift.tt/1UhcYYk
via IFTTT