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Rehabilitation and intensive care

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https://www.readbyqxmd.com/read/28099277/benefits-of-comprehensive-rehabilitation-therapy-in-thymectomy-for-myasthenia-gravis-a-propensity-score-matching-analysis
#1
Vincenzo Ambrogi, Tommaso Claudio Mineo
OBJECTIVE: To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). DESIGN: From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28096681/the-relatives-voice-how-do-relatives-experience-participation-in-reablement-a-qualitative-study
#2
Kari Margrete Hjelle, Herdis Alvsvåg, Oddvar Førland
BACKGROUND: Reablement is an early and time-limited home-based model of rehabilitation intervention with an emphasis on intensive, goal-oriented, and multidisciplinary assistance for persons experiencing functional decline. When rehabilitation in general takes place in the person's own home, in contrast to an institution, relatives may have larger responsibilities in helping and supporting the family member. Although there is evidence, showing that family caregivers, such as spouses and children, experience burdens and demanding situations related to their caregiving role, there are currently few publications exploring relatives' experiences of participating in reablement...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28091723/changes-in-the-severity-and-subtype-of-guillain-barr%C3%A3-syndrome-admitted-to-a-specialist-neuromedical-icu-over-a-25%C3%A2-year-period
#3
C J Taylor, N P Hirsch, D M Kullmann, Robin S Howard
We report a retrospective review of 110 patients with acute Guillain-Barré syndrome (GBS) admitted to a specialised intensive care unit (ICU) in a tertiary referral centre over a 25 year period, the start of which coincided with the widespread introduction of plasma exchange (PE) and intravenous immunoglobulin (IVIG). The results were analysed by comparing 52 patients admitted in the first decade (1991-2000; Group 1) with 58 patients admitted between 2001-2014 (Group 2). Patients in both groups were comparable with respect to age and sex, and had a similar incidence and range of ICU complications...
January 16, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28088377/intracapsular-hip-fractures-in-the-elderly-do-we-know-what-is-important
#4
Diana Crego-Vita, Coral Sanchez-Perez, Jose Adolfo Orellana Gomez-Rico, Celia Clemente de Arriba
BACKGROUND: Hip fractures in the elderly are a common reason for admission to the department of orthopaedic surgery, this condition asks an important part of health resources and is associated with high levels of co-morbidity and mortality. Many improvements have been introduced in the treatment of these patients, preoperative regional analgesia, intensive physical therapy, interdisciplinary care program; but still remain unresolved gaps. The aim of this study is to document the natural history of early versus delayed surgical intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge...
January 9, 2017: Injury
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#5
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069850/spending-on-care-after-surgery-driven-by-choice-of-care-settings-instead-of-intensity-of-services
#6
Lena M Chen, Edward C Norton, Mousumi Banerjee, Scott E Regenbogen, Anne H Cain-Nielsen, John D Birkmeyer
The rising popularity of episode-based payment models for surgery underscores the need to better understand the drivers of variability in spending on postacute care. Examining postacute care spending for fee-for-service Medicare beneficiaries after three common surgical procedures in the period 2009-12, we found that it varied widely between hospitals in the lowest versus highest spending quintiles for postacute care, with differences of 129 percent for total hip replacement, 103 percent for coronary artery bypass grafting (CABG), and 82 percent for colectomy...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28054280/successful-bypass-operation-for-esophageal-obstruction-after-acute-esophageal-necrosis-a-case-report
#7
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Masato Nagino
BACKGROUND: Acute esophageal necrosis (AEN) is a rare clinical disorder. Esophageal stenosis or obstruction is one of severe complications, but there are a few reports about surgical treatments. In such a situation, it still remains controversial which to choose, esophagectomy or bypass operation. CASE PRESENTATION: A 61-year-old woman was admitted to the local hospital for septic shock with diabetic ketoacidosis due to necrotizing fasciitis of the right thigh. Three days later, she had hematemesis, and gastrointestinal endoscopy revealed black mucosal coloration throughout the entire esophagus...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28043721/effect-of-daily-use-of-electronic-checklist-on-physical-rehabilitation-consultations-in-critically-ill-patients
#8
Rashid Ali, Patrick J Cornelius, Vitaly Herasevich, Ognjen Gajic, Rahul Kashyap
RATIONALE: In intensive care unit (ICU) practice, great emphasis is placed on the functional stabilization of the major organ systems, sometimes at the expense of physical rehabilitation. Checklists have shown to be an effective tool for standardizing care models. Our aim was to the study the effect of the use of an electronic checklist on occupational therapy/physical therapy (OT-PT) consults in critically ill patients. METHODS: A retrospective observational study of all adults admitted for the first time in an academic medical ICU in year 2014 was conducted...
December 22, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28043504/rehabilitation-of-treated-tb-patients-social-psychological-and-economic-aspects
#9
Blessina Amulya Kumar
AIM AND OBJECTIVE: To highlight the need for post-treatment rehabilitation of TB patient; including social psychological and economic aspects. METHODS: Patient interaction, informal interviews, field observations and secondary research. The minimum duration of treatment (for drug-susceptible TB) is 6months. Treatment for drug-resistant TB can be from anywhere between 18 and 24months. In some cases treatment can last for more than 5years. Despite this, little attention is given to the social, psychological and economic impact extended treatment can have on the lives of individuals...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28042370/review-of-critical-illness-myopathy-and-neuropathy
#10
Starane Shepherd, Ayush Batra, David P Lerner
Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28030509/impact-of-early-operative-pelvic-fixation-on-long-term-self-reported-outcome-following-severe-pelvic-fracture
#11
John P Sharpe, Louis J Magnotti, Wade C Gobbell, Xin Huang, Edward A Perez, Timothy C Fabian, Martin A Croce
BACKGROUND: Traumatic disruption of the pelvic ring is a significant cause of life-threatening hemorrhage. For those patients who survive the initial injury, these fractures are associated with long periods of immobilization and intense rehabilitation. There is little published information available regarding long-term functional outcomes in these patients. This study evaluated the impact of severe pelvic fractures on those long-term outcomes. METHODS: All patients with severe pelvic fractures over an 18-year period were identified...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28029070/an-exploration-of-factors-influencing-physical-activity-levels-amongst-a-cohort-of-people-living-in-the-community-after-stroke-in-the-south-of-england
#12
Sharon Jackson, Christopher Mercer, Barbara Jennifer Singer
PURPOSE: To explore factors influencing physical activity (PA) reported by people living in rural/semi-rural communities in the south of England post-stroke, and to understand relationships between personal, interpersonal and environmental barriers and self-reported levels of PA. METHOD: A survey was mailed to patients of NHS Trusts who were identified as potential participants. Self-reported PA levels, type, and frequency of reported barriers were tabulated. Spearman's rank correlation coefficient was used to explore associations between self-reported PA level and: age, gender, level of physical function, fear of falling, beliefs regarding PA, available supports, and socioeconomic status...
December 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28017276/patient-journey-in-decompensated-heart-failure-an-analysis-in-departments-of-cardiology-and-geriatrics-in-the-greater-paris-university-hospitals
#13
Florent Laveau, Nadjib Hammoudi, Emmanuelle Berthelot, Joël Belmin, Patrick Assayag, Ariel Cohen, Thibaud Damy, Denis Duboc, Olivier Dubourg, Albert Hagege, Olivier Hanon, Richard Isnard, Guillaume Jondeau, Florian Labouree, Damien Logeart, Nicolas Mansencal, Christophe Meune, Eric Pautas, Yves Wolmark, Michel Komajda
BACKGROUND: Hospitalization for worsening/acute heart failure is increasing in France, and limited data are available on referral/discharge modalities. AIM: To evaluate patients' journeys before and after hospitalization for this condition. METHODS: On 1 day per week, between October 2014 and February 2015, this observational study enrolled 260 consecutive patients with acute/worsening heart failure in all 10 departments of cardiology and four of the departments of geriatrics in the Greater Paris University Hospitals...
December 21, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28011082/-neonatal-arterial-ischemic-stroke-review-of-the-current-guidelines
#14
E Saliba, T Debillon, S Auvin, O Baud, V Biran, J-L Chabernaud, S Chabrier, F Cneude, A-G Cordier, V Darmency-Stamboul, J-F Diependaele, T Debillon, M Dinomais, C Durand, A Ego, G Favrais, Y Gruel, L Hertz-Pannier, B Husson, S Marret, S N'Guyen The Tich, T Perez, E Saliba, J-B Valentin, C Vuillerot
Neonatal arterial ischemic stroke (NAIS) is a rare event that occurs in approximately one in 5000 term or close-to-term infants. Most affected infants will present with seizures. Although a well-recognized clinical entity, many questions remain regarding diagnosis, risk factors, treatment, and follow-up modalities. In the absence of a known pathophysiological mechanism and lack of evidence-based guidelines, only supportive care is currently provided. To address these issues, a French national committee set up by the French Neonatal Society (Société française de néonatologie) and the national referral center (Centre national de référence) for arterial ischemic stroke in children drew up guidelines based on an HAS (Haute Autorité de santé [HAS]; French national authority for health) methodology...
December 20, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28003134/benefits-of-centralized-scheduling-in-a-post-acute-residential-rehabilitation-program-for-people-with-acquired-brain-lesions-a-pilot-study
#15
Alec Vestri, Silvia Pizzighello, Sara Piccoli, Andrea Martinuzzi
OBJECTIVE: To verify if the use of a designated staff person to coordinate and schedule therapy services in a post acute residential rehabilitation program for people with acquired brain lesions results in a higher intensity treatment allowing the reaching of clinical outcome in a reduced length of stay. Cost saving and perceived satisfaction were explored. DESIGN: This nonrandomized retrospective study uses data collected relative to two different methods of scheduling: Self Planning in which each single team member makes appointments which are then displayed on a shared board, and Managed Planning in which appointments were made by a designated staff person...
December 18, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28002636/caregiver-mediated-exercises-for-improving-outcomes-after-stroke
#16
REVIEW
Judith Dm Vloothuis, Marijn Mulder, Janne M Veerbeek, Manin Konijnenbelt, Johanna Ma Visser-Meily, Johannes Cf Ket, Gert Kwakkel, Erwin Eh van Wegen
BACKGROUND: Stroke is a major cause of long-term disability in adults. Several systematic reviews have shown that a higher intensity of training can lead to better functional outcomes after stroke. Currently, the resources in inpatient settings are not always sufficient and innovative methods are necessary to meet these recommendations without increasing healthcare costs. A resource efficient method to augment intensity of training could be to involve caregivers in exercise training. A caregiver-mediated exercise programme has the potential to improve outcomes in terms of body function, activities, and participation in people with stroke...
December 21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27980377/temporal-trends-of-healthcare-associated-infections-and-antimicrobial-use-in-2011-2013-observed-with-annual-point-prevalence-surveys-in-ferrara-university-hospital-italy
#17
REVIEW
P Antonioli, M C Manzalini, A Stefanati, B Bonato, A Verzola, A Formaglio, G Gabutti
INTRODUCTION: Healthcare associated infections (HAIs) and misuse of antimicrobials (AMs) represent a growing public health problem. The Point Prevalence Surveys (PPSs) find available information to be used for specific targeted interventions and evaluate their effects. The objective of this study was to estimate the prevalence of HAIs and AM use, to describe types of infections, causative pathogens and to compare data collected through three PPSs in Ferrara University Hospital (FUH), repeated in 3 different years (2011-2013)...
September 2016: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/27976920/understanding-informal-carers-experiences-of-caring-for-older-people-with-a-hip-fracture-a-systematic-review-of-qualitative-studies
#18
Lorena Saletti-Cuesta, Elizabeth Tutton, Debbie Langstaff, Keith Willett
PURPOSE: This systematic review aimed to reconceptualize experiences from a variety of papers to provide direction for research, policy and practice. METHOD: Meta-ethnography was used to inform the review, and 21 studies were included. FINDINGS: The analysis identified a core theme of "engaging in care: struggling through", as carers, who wanted to be involved in caring, learnt to live with the intense and stressful impact of caring and changes to their life...
December 15, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27932360/the-effects-of-a-high-intensity-functional-exercise-group-on-clinical-outcomes-in-hospitalised-older-adults-an-assessor-blinded-randomised-controlled-trial
#19
Melissa J M Raymond, Kimberley J Jeffs, Adele Winter, Sze-Ee Soh, Peter Hunter, Anne E Holland
OBJECTIVE: to investigate a high-intensity functional exercise (HIFE) group in hospitalised older adults. DESIGN: assessor-blinded, randomised-controlled trial. SETTING: sub-acute wards at a metropolitan rehabilitation hospital. PARTICIPANTS: older adults ≥65 years (n = 468) able to stand with minimum assistance or less from a chair and follow instructions. INTERVENTION: 'group' participants were offered a standing HIFE group three times a week and individual physiotherapy sessions twice a week...
December 7, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27930803/pulmonary-rehabilitation-following-exacerbations-of-chronic-obstructive-pulmonary-disease
#20
REVIEW
Milo A Puhan, Elena Gimeno-Santos, Christopher J Cates, Thierry Troosters
BACKGROUND: Guidelines have provided positive recommendations for pulmonary rehabilitation after exacerbations of chronic obstructive pulmonary disease (COPD), but recent studies indicate that postexacerbation rehabilitation may not always be effective in patients with unstable COPD. OBJECTIVES: To assess effects of pulmonary rehabilitation after COPD exacerbations on hospital admissions (primary outcome) and other patient-important outcomes (mortality, health-related quality of life (HRQL) and exercise capacity)...
8, 2016: Cochrane Database of Systematic Reviews
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