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debate physical therapy

Robinder J S Dhillon, Sarfaraz Hasni
Sarcopenia represents a loss of muscle strength and mass in older individuals. Sarcopenia in the elderly has now become a major focus of research and public policy debate due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. The management of sarcopenia is primarily focused on physical therapy for muscle strengthening and gait training...
February 2017: Clinics in Geriatric Medicine
C Kopkow, T Lange, J Schmitt, T Petzold
Background: Both at the national and international levels, direct access for patients to physical therapy services is currently under debate. Direct access for patients seeking physical therapy care might reduce waiting time and costs, and thus be of benefit for patients and health insurance companies. To critically evaluate this situation, reliable and valid data are needed, but currently lacking. The aim of this study is to evaluate the health care situation for physical therapy services included in the catalogue of remedies from 2004 up to 2014 in Germany...
November 17, 2016: Das Gesundheitswesen
Elisabetta De Filippo, Anke C Schiedel, Prashiela Manga
Developmental eye defects in X-linked ocular albinism type 1 are caused by G-protein coupled receptor 143 (GPR143) mutations. Mutations result in dysfunctional melanosome biogenesis and macromelanosome formation in pigment cells, including melanocytes and retinal pigment epithelium. GPR143, primarily expressed in pigment cells, localizes exclusively to endolysosomal and melanosomal membranes unlike most G protein-coupled receptors, which localize to the plasma membrane. There is some debate regarding GPR143 function and elucidating the role of this receptor may be instrumental for understanding neurogenesis during eye development and for devising therapies for ocular albinism type I...
October 6, 2016: Journal of Investigative Dermatology
J Stone, A Carson, M Hallett
There is widespread agreement that the way health professionals communicate the diagnosis of functional neurologic disorders (FND) has a central role in treatment, as it does arguably for most conditions. In this chapter we discuss barriers to effective diagnosis, different models of explanation and evidence regarding the importance of effective communication of the diagnosis in FND, especially movement disorders, and dissociative (nonepileptic) seizures. Debates and disagreements about how to go about this task often reflect different theoretic models held by health professionals rather than evidence...
2017: Handbook of Clinical Neurology
Sebastian Kufner, Erion Xhepa, Christoph Lutter, Salvatore Cassese, Michael Joner
Owing to the overall increase in the use of DES, the number of patients presenting with DES restenosis is not insignificant in absolute terms. When DES restenosis occurs, it represents a challenging clinical entity in terms of classification and treatment. By providing near histology-level images, intravascular optical coherence tomography (OCT) has been used to describe vascular responses following PCI. Subsequently, OCT has been introduced to assess neointimal morphology and tissue characteristics of restenotic lesions to clarify the underlying pathophysiology...
February 2017: Minerva Cardioangiologica
Whitney M Guerrero, Jeremiah L Deneve
The management of recurrent soft tissue sarcoma is a challenging problem for clinicians and has a significant physical, mental, emotional, and oncologic impact for the patient. Despite excellent limb-preservation therapies, approximately one-quarter of patients may eventually develop recurrence of disease. How to most appropriately manage these patients is a matter of debate. Several treatment options exist, including surgical resection, irradiation, systemic chemotherapy, amputation, and regional therapies...
October 2016: Surgical Clinics of North America
Aimee Goel
Spinal cord injury (SCI) remains one of the most physically, psychologically and socially debilitating conditions worldwide. While rehabilitation measures may help limit disability to some extent, there is no effective primary treatment yet available. The efficacy of stem cells as a primary therapeutic option in spinal cord injury is currently an area under much scrutiny and debate. Several laboratory and some primary clinical studies into the use of bone marrow mesenchymal stem cells or embryonic stem cell-derived oligodentrocyte precursor cells have shown some promising results in terms of remyelination and regeneration of damaged spinal nerve tracts...
April 2016: Journal of Craniovertebral Junction and Spine
H-Q Sun, X Zhang, W-J Huang, W-W Chen
Alzheimer's disease (AD) is a multifaceted disorder, characterized by the failure of memory and dementia. AD affects mostly elder above 65 years of age and is confirmed by post-mortem detection in the brain, of extracellular senile plaques of amyloid-beta (Aβ) and intracellular neurofibrillary tangles. These pathological hallmarks appear in the brain when the disease is already installed. The difficulty of earlier diagnosis and possibly, the poor understanding of the disease etiology, limit the benefits afforded by available treatments...
May 2016: European Review for Medical and Pharmacological Sciences
Stephen Kellett, Kimberley Webb, Nic Wilkinson, Paul Bliss, Tom Ayers, Gillian Hardy
BACKGROUND: There are national policy drivers for mental health services to demonstrate that they are effectively meeting the psychological needs of people with long-term health conditions/medically unexplained symptoms (LTC/MUS). AIMS: To evaluate the implementation of a stepped-care service delivery model within an Improving Access to Psychological Therapies (IAPT) service for patients with depression or anxiety in the context of their LTC/MUS. METHOD: A stepped-care model was designed and implemented...
September 2016: Behavioural and Cognitive Psychotherapy
Arden R Barry, Deirdre E O'Neill, Michelle M Graham
Primary prevention of cardiovascular events in older adults is challenging because of a general paucity of evidence for safe and efficacious therapy. Furthermore, there is no validated cardiovascular risk assessment tool for older adults (≥75 years of age), yet most are intermediate-to high-risk. Assessment of cardiovascular risk should include a discussion of the potential benefits and risks of therapy, and allow for incorporation of the patients' values and preferences, functionality and/or frailty, comorbidities, and concomitant medications (eg, polypharmacy, drug-drug interactions, adherence)...
September 2016: Canadian Journal of Cardiology
Alhasan M Elhefnawy
BACKGROUND: Hypertrophic scars are dermal fibroproliferative disorders that typically develop after a skin injury heals. They can cause physical, psychological, and cosmetic problems. The management of such scars remains a matter of debate due to lack of effective treatment methods and the inability to prevent recurrences. Recent reports have demonstrated that botulinum toxin type A improves wound healing so it may play a role in treating hypertrophic scars. AIMS: We assessed the effectiveness of intralesional botulinum toxin type A injection for treating hypertrophic scars...
May 2016: Indian Journal of Dermatology, Venereology and Leprology
Joe Y Chang, Salma K Jabbour, Dirk De Ruysscher, Steven E Schild, Charles B Simone, Ramesh Rengan, Steven Feigenberg, Atif J Khan, Noah C Choi, Jeffrey D Bradley, Xiaorong R Zhu, Antony J Lomax, Bradford S Hoppe
Radiation dose escalation has been shown to improve local control and survival in patients with non-small cell lung cancer in some studies, but randomized data have not supported this premise, possibly owing to adverse effects. Because of the physical characteristics of the Bragg peak, proton therapy (PT) delivers minimal exit dose distal to the target volume, resulting in better sparing of normal tissues in comparison to photon-based radiation therapy. This is particularly important for lung cancer given the proximity of the lung, heart, esophagus, major airways, large blood vessels, and spinal cord...
May 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Jonathan Boote, Ruth Newsome, Michael Reddington, Ashley Cole, Munyaradzi Dimairo
BACKGROUND AND PURPOSE: Sciatica is a common clinical condition that can be extremely painful, disabling and life-changing. Whether conservative or surgical treatment for sciatica secondary to an intervertebral disc prolapse is most effective is still much debated. An important component of conservative treatment is physiotherapy, which aims to promote physical and psychological health for the patient, whilst resorption of the disc takes place. This paper reports a qualitative study of patients' views and experiences of a bespoke physiotherapy intervention for the treatment of sciatica...
February 23, 2016: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Grzegorz Kaminski, Mirosław Dziuk, Ewelina Szczepanek-Parulska, Ariadna Zybek-Kocik, Marek Ruchala
Subclinical hyperthyroidism (sHT) was found to be associated with elevated heart rate, blood pressure and increased risk of extrasystoles. However, the full clinical relevance of morphological and functional implications of sHT on the cardiovascular system is still a matter of debate. The aim of the study was to prospectively assess the influence of endogenous sHT on exercise capacity and cardiac function during workout with the use of exercise electrocardiography (ExECG) and perfusion scintigraphy. The studied group consisted of 44 consecutively recruited patients diagnosed with sHT...
August 2016: Endocrine
J Haxby Abbott
In this month's issue, we debut a new feature: Viewpoint. Viewpoint articles are scholarly papers containing opinion or perspectives relevant to musculoskeletal and sports physical therapy. They are editorial-/perspective-/professional commentary-type articles, authored by experts in their topic field, and intended to put research into context for readers by delivering clinically meaningful synopsis, debate, and discussion. J Orthop Sports Phys Ther 2016;46(2):37. doi:10.2519/jospt.2016.0102.
February 2016: Journal of Orthopaedic and Sports Physical Therapy
Dali Han, Yinping Yuan, Xuqing Song, Yonghua Yu, Jinming Yu
Accurate delineation of clinical target volume (CTV) is critical in the effective management of squamous cell carcinoma (SCC) of esophagus using radiation therapy. Accurate delineation may improve the probability of local control and reduce the risk of complications. However, there are no consistent standards on the proper size of the margins added to the gross tumor volume (GTV). Different institutions and radiation oncologists have discordant opinions. In this paper, we review pathological and clinical outcomes to determine the most appropriate CTV for squamous cell carcinomas (SCC) of esophagus...
2016: Journal of Cancer
Alhasan M Elhefnawy
BACKGROUND: Hypertrophic scars are dermal fibroproliferative disorders that typically develop after a skin injury heals. They can cause physical, psychological, and cosmetic problems. The management of such scars remains a matter of debate due to lack of effective treatment methods and the inability to prevent recurrences. Recent reports have demonstrated that botulinum toxin type A improves wound healing so it may play a role in treating hypertrophic scars. AIMS: We assessed the effectiveness of intralesional botulinum toxin type A injection for treating hypertrophic scars...
January 14, 2016: Indian Journal of Dermatology, Venereology and Leprology
Fucai Han, Anirban Banerjee, Liang Shen, Lingaraj Krishna
BACKGROUND: Successful return to sport is an important outcome measure after anterior cruciate ligament (ACL) reconstruction and a reason for patients' decisions to elect surgery. Rehabilitation programs supervised by physical therapists are routinely prescribed after ACL reconstruction surgery. However, the added advantage of supervised physical therapy after ACL reconstruction is still debatable. HYPOTHESIS: Attending more supervised physical therapy sessions after arthroscopic ACL reconstruction in recreational athletes increases their chance of successful return to sport...
December 2015: Orthopaedic Journal of Sports Medicine
Nurka Pranjić, Ljiljana Maleš-Bilić
Low back pain is the second most common symptom-related reason for physician visits and the first reason of working disability. Low back pain is a ubiquitous complaint, with particularly high prevalence among people in their working years (67%). For many individuals, episodes of back pain are self-limited and resolve without specific therapy. For others, however, back pain is recurrent or chronic, causing significant pain that interferes with employment and quality of life. Many occupations have been anecdotally linked to certain low back pain syndrome...
March 2015: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
Corinne Taniguchi, Elivane S Victor, Talita Pieri, Renata Henn, Carolina Santana, Erica Giovanetti, Cilene Saghabi, Karina Timenetsky, Raquel Caserta Eid, Eliezer Silva, Gustavo F J Matos, Guilherme P P Schettino, Carmen S V Barbas
INTRODUCTION: A recent meta-analysis showed that weaning with SmartCare™ (Dräger, Lübeck, Germany) significantly decreased weaning time in critically ill patients. However, its utility compared with respiratory physiotherapist-protocolized weaning is still a matter of debate. We hypothesized that weaning with SmartCare™ would be as effective as respiratory physiotherapy-driven weaning in critically ill patients. METHODS: Adult critically ill patients mechanically ventilated for more than 24 hours in the adult intensive care unit of the Albert Einstein Hospital, São Paulo, Brazil, were randomly assigned to be weaned either by progressive discontinuation of pressure support ventilation (PSV) with SmartCare™...
2015: Critical Care: the Official Journal of the Critical Care Forum
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