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Physical therapy in critical care

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https://www.readbyqxmd.com/read/28928729/high-throughput-genetic-screen-reveals-that-early-attachment-and-biofilm-formation-are-necessary-for-full-pyoverdine-production-by-pseudomonas-aeruginosa
#1
Donghoon Kang, Natalia V Kirienko
Pseudomonas aeruginosa is a re-emerging, multidrug-resistant, opportunistic pathogen that threatens the lives of immunocompromised patients, patients with cystic fibrosis, and those in critical care units. One of the most important virulence factors in this pathogen is the siderophore pyoverdine. Pyoverdine serves several critical roles during infection. Due to its extremely high affinity for ferric iron, pyoverdine gives the pathogen a significant advantage over the host in their competition for iron. In addition, pyoverdine can regulate the production of multiple bacterial virulence factors and perturb host mitochondrial homeostasis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28872596/survey-of-veterinarians-using-a-novel-physical-compression-squeeze-procedure-in-the-management-of-neonatal-maladjustment-syndrome-in-foals
#2
Monica Aleman, Kalie M Weich, John E Madigan
Horses are a precocious species that must accomplish several milestones that are critical to survival in the immediate post-birth period for their survival. One essential milestone is the successful transition from the intrauterine unconsciousness to an extrauterine state of consciousness or awareness. This transition involves a complex withdrawal of consciousness inhibitors and an increase in neuroactivating factors that support awareness. This process involves neuroactive hormones as well as inputs related to factors such as cold, visual, olfactory, and auditory stimuli...
September 5, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/28864434/psychotropic-drug-use-in-physically-restrained-critically-ill-adults-receiving-mechanical-ventilation
#3
Melanie Guenette, Lisa Burry, Alexandra Cheung, Tara Farquharson, Marlene Traille, Ioanna Mantas, Sangeeta Mehta, Louise Rose
BACKGROUND: Restraining therapies (physical or pharmacological) are used to promote the safety of both patients and health care workers. Some guidelines recommend nonpharmacological or pharmacological interventions be used before physical restraints in critically ill patients. OBJECTIVES: To characterize psychotropic drug interventions before and after use of physical restraints in critically ill adults receiving mechanical ventilation. METHODS: A single-center, prospective, observational study documenting psychotropic drug use and Sedation-Agitation Scale (SAS) scores in the 2 hours before and the 6 hours after application of physical restraints...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28807140/acute-psychological-trauma-in-the-critically-ill-patient-and-family-perspectives
#4
Volha Dziadzko, Mikhail A Dziadzko, Margaret M Johnson, Ognjen Gajic, Lioudmila V Karnatovskaia
OBJECTIVE: Post-intensive care syndrome (PICS), which encompasses profound psychological morbidity, affects many survivors of critical illness. We hypothesize that acute psychological stress during the intensive care unit (ICU) confinement likely contributes to PICS. In order to develop strategies that mitigate PICS associated psychological morbidity, it is paramount to first characterize acute ICU psychological stress and begin to understand its causative and protective factors. METHODS: A structured interview study was administered to adult critical illness survivors who received ≥48h of mechanical ventilation in medical and surgical ICUs of a tertiary care center, and their families...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28802474/integrative-oncology
#5
REVIEW
Gabriel Lopez, Jun J Mao, Lorenzo Cohen
Integrative oncology helps support the health of patients with cancer and their caregivers through an evidence-informed approach to lifestyle and behavior modification and the use of complementary health therapies as part of conventional cancer care. Integrative approaches can provide patients relief from cancer and cancer treatment-related symptoms, leading to improvements in their physical and psychosocial health. An evidence-informed approach is important when recommending an integrative cancer plan. Efforts at enhancing communication between patients and health care providers, as well as between integrative practitioners and conventional health care teams, are critical to achieving optimal health and healing for patients with cancer...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28780504/intensive-versus-standard-physical-rehabilitation-therapy-in-the-critically-ill-epicc-a-multicentre-parallel-group-randomised-controlled-trial
#6
Stephen E Wright, Kirsty Thomas, Gillian Watson, Catherine Baker, Andrew Bryant, Thomas J Chadwick, Jing Shen, Ruth Wood, Jennifer Wilkinson, Leigh Mansfield, Victoria Stafford, Clare Wade, Julie Furneval, Andrea Henderson, Keith Hugill, Philip Howard, Alistair Roy, Stephen Bonner, Simon Baudouin
BACKGROUND: Early physical rehabilitation in the intensive care unit (ICU) has been shown to improve short-term clinical outcomes but long-term benefit has not been proven and the optimum intensity of rehabilitation is not known. METHODS: We conducted a randomised, parallel-group, allocation-concealed, assessor-blinded, controlled trial in patients who had received at least 48 hours of invasive or non-invasive ventilation. Participants were randomised in a 1:1 ratio, stratified by admitting ICU, admission type and level of independence...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#7
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28667221/effectiveness-of-behavioural-change-techniques-in-physiotherapy-interventions-to-promote-physical-activity-adherence-in-patients-with-hip-and-knee-osteoarthritis-a-systematic-review-protocol
#8
Matthew Willett, Joan Duda, Charlotte Gautrey, Sally Fenton, Carolyn Greig, Alison Rushton
INTRODUCTION: Osteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28654474/excellence-in-promoting-participation-striving-for-the-10-cs-client-centered-care-consideration-of-complexity-collaboration-coaching-capacity-building-contextualization-creativity-community-curricular-changes-and-curiosity
#9
Lisa A Chiarello
Participation of children with physical disabilities is critical to optimizing their life roles and lived experiences. This perspective explores the complex and multidimensional construct of participation and presents recommendations for practice, education, and research to transform pediatric physical therapy service delivery. Two models are reviewed of participation-based service delivery grounded in client-centered care and the principles of coaching to engage clients in their rehabilitation. The roles and responsibilities of the physical therapist and the importance of team collaboration are emphasized...
July 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#10
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28628591/movement-system-diagnosis
#11
Ann F Van Sant
BACKGROUND AND PURPOSE: This article presents the concept of movement system diagnoses (MSDxs), including an examination of the evolution of the ideas that are shaping the development of MSDxs. SUMMARY OF KEY POINTS: Ideas leading to development of the need for MSDxs are traced, and an overview of Diagnosis Dialog and points of consensus are provided. Four examples from areas of neurologic and pediatric practice where additional work is needed on movement system diagnosis are highlighted...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28582253/translating-comprehensive-conservative-care-for-chronic-knee-pain-into-a-digital-care-pathway-12-week-and-6-month-outcomes-for-the-hinge-health-program
#12
Peter Smittenaar, Jennifer C Erhart-Hledik, Rose Kinsella, Simon Hunter, Gabriel Mecklenburg, Daniel Perez
BACKGROUND: Chronic knee pain (CKP) affects a large number of adults, many of whom do not receive best-practice care and are at high risk for unnecessary surgery. OBJECTIVE: The aim of this study was to investigate the effect of the Hinge Health 12-week digital care program (DCP) for CKP on knee pain and function, with secondary outcomes of surgery interest and satisfaction, at 12 weeks and 6 months after starting the program. METHODS: Individuals with CKP were recruited onto the 12-week program, comprising sensor-guided physical exercises, weekly education, activity tracking, and psychosocial support such as personal coaching and cognitive behavioral therapy (CBT)...
April 5, 2017: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28582249/design-and-development-of-a-telerehabilitation-platform-for-patients-with-phantom-limb-pain-a-user-centered-approach
#13
Andreas Rothgangel, Susy Braun, Rob Smeets, Anna Beurskens
BACKGROUND: Phantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients' adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain...
February 15, 2017: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28554378/high-healthcare-utilization-near-the-onset-of-medically-unexplained-symptoms
#14
Lisa M McAndrew, L Alison Phillips, Drew A Helmer, Kieran Maestro, Charles C Engel, Lauren M Greenberg, Nicole Anastasides, Karen S Quigley
OBJECTIVE: Patients with medically unexplained syndromes (MUS) often do not receive appropriate healthcare. A critical time for effective healthcare is the inception of MUS. The current study examined data from a prospective longitudinal study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) soldiers to understand the relationship of increasing physical symptom burden to healthcare utilization. METHODS: Data was examined from a prospective study of OEF/OIF soldiers assessed before and one year after deployment (n=336)...
July 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28548315/aapm-medical-physics-practice-guideline-8-a-linear-accelerator-performance-tests
#15
Koren Smith, Peter Balter, John Duhon, Gerald A White, David L Vassy, Robin A Miller, Christopher F Serago, Lynne A Fairobent
PURPOSE: The purpose of this guideline is to provide a list of critical performance tests in order to assist the Qualified Medical Physicist (QMP) in establishing and maintaining a safe and effective quality assurance (QA) program. The performance tests on a linear accelerator (linac) should be selected to fit the clinical patterns of use of the accelerator and care should be given to perform tests which are relevant to detecting errors related to the specific use of the accelerator. METHODS: A risk assessment was performed on tests from current task group reports on linac QA to highlight those tests that are most effective at maintaining safety and quality for the patient...
May 26, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28538781/effects-that-passive-cycling-exercise-have-on-muscle-strength-duration-of-mechanical-ventilation-and-length-of-hospital-stay-in-critically-ill-patients-a-randomized-clinical-trial
#16
Aline Dos Santos Machado, Ruy Camargo Pires-Neto, Maurício Tatsch Ximenes Carvalho, Janice Cristina Soares, Dannuey Machado Cardoso, Isabella Martins de Albuquerque
Objective: To evaluate the effects that passive cycling exercise, in combination with conventional physical therapy, have on peripheral muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients admitted to the ICU of a tertiary care university hospital. Methods: This was a randomized clinical trial involving 38 patients (≥ 18 years of age) on mechanical ventilation who were randomly divided into two groups: control (n = 16), receiving conventional physical therapy; and intervention (n = 22), receiving conventional physical therapy and engaging in passive cycling exercise five days per week...
March 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28474326/palliative-care-in-cardiac-transplantation-an-evolving-model
#17
REVIEW
Essraa Bayoumi, Farooq Sheikh, Hunter Groninger
It is currently estimated that 5.7 million Americans live with heart failure. Of these, less than 3000 will receive a heart transplant this year, according to the US Department of Health and Human Services Organ Procurement and Transplantation Network. With successful transplantation can come significant emotional and physical symptoms that are not always addressed. Although palliative care is an interdisciplinary subspecialty designed to alleviate multiple domains of suffering in serious illness, many mistakenly associate it solely with the end of life...
May 5, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#18
COMPARATIVE STUDY
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28378133/-palliative-therapy-concepts-in-intensive-care-medicine
#19
M Schuster, M Ferner, M Bodenstein, R Laufenberg-Feldmann
Involvement of palliative care is so far not common practice for critically ill patients on surgical intensive care units (ICUs) in Germany. The objectives of palliative care concepts are improvement of patient quality of life by relief of disease-related symptoms using an interdisciplinary approach and support of patients and their relatives considering their current physical, psychological, social and spiritual needs. The need for palliative care can be identified via defined screening criteria. Integration of palliative care can either be realized using a consultative model which focusses on involvement of palliative care consultants or an integrative model which embeds palliative care principles into the routine daily practice by the ICU team...
April 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28367748/conceptions-of-agency-and-constraint-for-hiv-positive-patients-and-healthcare-workers-to-support-long-term-engagement-with-antiretroviral-therapy-care-in-khayelitsha-south-africa
#20
Erin Stern, Christopher Colvin, Nobom Gxabagxaba, Charlotte Schutz, Rosie Burton, Graeme Meintjes
In the context of the optimism around antiretroviral therapy (ART) as prevention of HIV/AIDS, addressing the barriers to long-term ART adherence is critical. This is particularly important given the tendency to individualise or use a blame discourse when exploring why HIV-infected patients "fail" to adequately adhere to ART, and not sufficiently exploring contextual reasons for poor adherence that may require varying solutions. This study took place at three clinics and one hospital in Khayelitsha, South Africa, to document the contextual factors that challenged ART adherence in this community...
March 2017: African Journal of AIDS Research: AJAR
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