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Rehabilitation and intensive care

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https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#1
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29327644/evaluation-of-supervised-multimodal-prehabilitation-programme-in-cancer-patients-undergoing-colorectal-resection-a-randomized-control-trial
#2
Guillaume Bousquet-Dion, Rashami Awasthi, Sarah-Ève Loiselle, Enrico M Minnella, Ramanakumar V Agnihotram, Andreas Bergdahl, Francesco Carli, Celena Scheede-Bergdahl
BACKGROUND: Prehabilitation has been previously shown to be more effective in enhancing postoperative functional capacity than rehabilitation alone. The purpose of this study was to determine whether a weekly supervised exercise session could provide further benefit to our current prehabilition program, when comparing to standard post-surgical rehabilitation. METHODS: A parallel-arm single-blind randomized control trial was conducted in patients scheduled for non-metastatic colorectal cancer resection...
January 12, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29327608/pregnancy-outcomes-of-women-with-spina-bifida
#3
Nathalie Auger, Laura Arbour, Mireille E Schnitzer, Jessica Healy-Profitós, Geneviève Nadeau, William D Fraser
PURPOSE: To assess the pregnancy outcomes of women with spina bifida. MATERIALS AND METHODS: We analyzed a population-based cohort of 397 pregnant women with spina bifida and 1,083,211 without spina bifida who delivered infants in hospitals in Quebec, Canada, 1989-2013. Outcomes included maternal and infant morbidity and mortality at delivery. We used log-binomial regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association of maternal spina bifida with pregnancy outcomes, accounting for maternal characteristics...
January 12, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29323630/fatal-innominate-artery-hemorrhage-in-a-patient-with-tetraplegia-case-report-and-literature-review
#4
Ahmad Zaheer Qureshi
Context Hemorrhage is one of the potentially fatal complications of tracheostomy. A rare but lethal cause of tracheostomy related bleeding is hemorrhage from the innominate artery. This occurs following tracheo-innominate artery fistula (TIF) formation, which is associated with a mortality rate of more than 85%. Here, we report the case of an individual with tetraplegia and a tracheostomy who died as a result of innominate artery hemorrhage. This case highlights the possible causes and interventions associated with this complication, and provides insight into tracheostomy related bleeding in patients with spinal cord injury (SCI)...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29322866/how-does-language-change-after-an-intensive-treatment-on-imitation
#5
Marina Zettin, Marzia Leopizzi, Valentina Galetto
The main aim of our study was to investigate the role of imitation in improving word-finding difficulties in a group of aphasic subjects. For this purpose, we designed software based on the computerised program described by Lee et al. (2010). Seven subjects with aphasia resulting from a brain injury were enrolled in the study. A battery of tests was administered to participants one month before the treatment (T0) and immediately before its beginning (T1) with the aim of detecting their language difficulties...
January 11, 2018: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/29319723/characteristics-and-outcomes-of-intensive-care-unit-survivors-experience-of-a-multidisciplinary-outpatient-clinic-in-a-teaching-hospital
#6
Péricles A D Duarte, Jaquilene Barreto Costa, Silvana Trilo Duarte, Sheila Taba, Claudia Regina Felicetti Lordani, Erica Fernanda Osaku, Claudia Rejane Lima Macedo Costa, Dalas Cristina Miglioranza, Daniela Prochnow Gund, Amaury Cesar Jorge
OBJECTIVES: To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country. METHODS: Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil...
December 2017: Clinics
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#7
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short and long-term outcomes. The aim of this study is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program(POSH) was launched with the aim of improving outcomes in elderly patients(>65-years-old) undergoing complex lumbar spine surgery...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29317223/cluster-analysis-of-vulnerable-groups-in-acute-tbi-rehabilitation
#8
Erkut N Kucukboyaci, Coralynn Long, Michelle Smith, Joseph F Rath, Tamara Bushnik
OBJECTIVE: To analyze the complex relationship between various social indicators that contribute to socioeconomic status and healthcare barriers. DESIGN: Cluster analysis of historical patient data obtained from inpatient visits. SETTING: Setting: Inpatient rehabilitation unit in a large, urban university hospital PARTICIPANTS: Adult patients receiving acute inpatient care, predominantly for closed head injury. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: We examined the membership of TBI patients in various "vulnerable group" (VG) clusters (e...
January 6, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29308945/rehabilitation-of-infant-oral-feeding-difficulties-a-survey-of-occupational-therapists-practice-approaches
#9
Caitlin Hardy, Jessica Senese, Sandra Fucile
This study identifies the scope of occupational therapy practice for the rehabilitation of oral feeding difficulties in infants who are in the neonatal intensive care unit (NICU). A written survey was administered to 127 occupational therapists who work with infants in the NICU. All 68 (54%) respondents used a client-centered approach, taking into consideration the infant (intrinsic), caregiver, and environmental (extrinsic) factors. Family and health team education was the most commonly provided service with the majority of occupational therapists providing services only until feeding problems were resolved...
January 8, 2018: Occupational Therapy in Health Care
https://www.readbyqxmd.com/read/29308778/adult-human-metapneumovirus-encephalitis-a-case-report-highlighting-challenges-in-clinical-management-and-functional-outcome
#10
Y L Tan, T C Wee
We report a rare case of adult human metapneumovirus (HMPV) in a healthy 32-year-old man. There was dramatic deterioration in his condition developing pneumonia with Type-I respiratory failure and encephalitis. He needed mechanical ventilation in the intensive care setting and was treated with intravenous ribavirin. Post-extubation he remained severely physically and cognitively impaired despite rehabilitation. Treatment of HMPV pneumonia is at present, still without specific antiviral therapy. Managing HMPV-encephalitis remained supportive and challenging...
December 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29301390/acoustic-features-and-cortical-auditory-evoked-potentials-according-to-emotional-statues-of-u-a-i-vowels
#11
Chunhyeok Kim, Seungwan Lee, Inki Jin, Jinsook Kim
Background and Objectives: Although Ling 6 sounds are often used in the rehabilitation process, its acoustic features have not been fully analyzed and represented in cortical responses. Current study was aimed to analyze acoustic features according to gender and emotional statuses of core vowels of Ling 6 sounds, /u/, /a/, and /i/. Cortical auditory evoked potentials (CAEPs) were also observed in those vowels. Subjects and Methods: Vowel sounds /u/, /a/, and /i/ out of Ling 6 sounds representing low, middle and high frequencies were recorded from normal 20 young adults...
January 5, 2018: Journal of Audiology & Otology
https://www.readbyqxmd.com/read/29300986/healthcare-services-utilization-following-admission-for-hip-fracture-in-elderly-patients
#12
Ehud Fliss, Orly Weinstein, Michael Sherf, Jacob Dreiher
Objectives: To assess the effect of hip fracture on healthcare utilization among elderly patients. Design: Retrospective cohort study. Setting: Eight general hospitals in Israel, owned by Clalit. Participants: Enrollees >65 years, admitted with a hip fracture during 2009-2013. Main outcome measures: Data collected included demographics, comorbidities, admission details related to the surgical and rehabilitation hospitalizations, mortality and costs...
December 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29298257/telephone-based-intervention-to-improve-rehabilitation-engagement-after-spinal-stenosis-surgery-a-prospective-lagged-controlled-trial
#13
Richard L Skolasky, Anica M Maggard, Stephen T Wegener, Lee H Riley
BACKGROUND: Spine surgery outcomes are variable. Patients who participate in and take responsibility for their recovery have improved health outcomes. Interventions to increase patient involvement in their care may improve health outcomes after a surgical procedure. We conducted a prospective interventional trial to compare the effectiveness of health behavior change counseling with usual care to improve health outcomes after lumbar spine surgical procedures. METHODS: In this study, 122 patients with lumbar spinal stenosis undergoing a decompression surgical procedure from December 2009 through August 2012 were enrolled...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29288172/effectiveness-and-cost-effectiveness-of-a-guided-internet-and-mobile-based-depression-intervention-for-individuals-with-chronic-back-pain-protocol-of-a-multi-centre-randomised-controlled-trial
#14
Jiaxi Lin, Lasse Sander, Sarah Paganini, Sandra Schlicker, David Ebert, Matthias Berking, Jürgen Bengel, Stephanie Nobis, Dirk Lehr, Oskar Mittag, Heleen Riper, Harald Baumeister
INTRODUCTION: Depression often co-occurs with chronic back pain (CBP). Internet and mobile-based interventions (IMIs) might be a promising approach for effectively treating depression in this patient group. In the present study, we will evaluate the effectiveness and cost-effectiveness of a guided depression IMI for individuals with CBP (eSano BackCare-D) integrated into orthopaedic healthcare. METHODS AND ANALYSIS: In this multicentre randomised controlled trial of parallel design, the groups eSano BackCare-D versus treatment as usual will be compared...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29280708/justifying-rehabilitation-intensity-through-functional-performance-measures-in-postacute-care
#15
Christine Kroll, Thomas Fisher
The Centers for Medicare and Medicaid Services (CMS) has scrutinized the provision of rehabilitation services in skilled nursing facilities (SNFs) for some time. Little research guidance exists on appropriate dosage or rehabilitation intensity (RI) among SNF patients or patients in other postacute care (PAC) settings. CMS developed a PAC assessment, the Continuity Assessment Record and Evaluation (CARE) Tool, in response to questions about what issues drive placement in various PAC settings under Medicare. The ability to adequately assess functional outcomes and correlate them to the RI provided by using the CARE Tool is promising...
January 2018: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/29279000/oxygen-uptake-on-kinetics-during-six-minute-walk-test-predicts-short-term-outcomes-after-off-pump-coronary-artery-bypass-surgery
#16
Isadora Salvador Rocco, Marcela Viceconte, Hayanne Osiro Pauletti, Bruna Caroline Matos-Garcia, Natasha Oliveira Marcondi, Caroline Bublitz, Douglas William Bolzan, Rita Simone Lopes Moreira, Michel Silva Reis, Nelson Américo Hossne, Walter José Gomes, Ross Arena, Solange Guizilini
PURPOSE: We aimed to investigate the ability of oxygen uptake kinetics to predict short-term outcomes after off-pump coronary artery bypass grafting. METHODS: Fifty-two patients aged 60.9 ± 7.8 years waiting for off-pump coronary artery bypass surgery were evaluated. The 6-min walk test distance was performed pre-operatively, while simultaneously using a portable cardiopulmonary testing device. The transition of oxygen uptake kinetics from rest to exercise was recorded to calculate oxygen uptake kinetics fitting a monoexponential regression model...
December 26, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29276219/indirect-calorimetry-measurement-of-energy-expenditure-related-to-body-position-changes-in-healthy-adults
#17
Kengo Obata, Tetsuya Yumoto, Soichiro Fuke, Kohei Tsukahara, Hiromichi Naito, Atsuyoshi Iida, Tetsuya Takahashi, Yoshihito Ujike, Atsunori Nakao
Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29273083/effectiveness-costs-and-cost-effectiveness-of-chiropractic-care-and-physiotherapy-compared-with-information-and-advice-in-the-treatment-of-non-specific-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#18
Filip Gedin, Martin Skeppholm, Kristina Burström, Vibeke Sparring, Mesfin Tessma, Niklas Zethraeus
BACKGROUND: Low back pain is a global public health problem and a leading cause of disability all over the world. The lifetime prevalence of low back pain is 70-80% and a significant proportion of people affected develop chronic low back pain (CLBP). Besides a severe negative impact on people's health and health-related quality of life, CLBP is associated with substantial costs for society. Medical costs for the management of CLBP and costs for production losses due to absenteeism from work are sizeable...
December 22, 2017: Trials
https://www.readbyqxmd.com/read/29258352/cultural-adaptation-and-construct-validation-of-the-arabic-version-of-children-s-assessment-of-participation-and-enjoyment-and-preferences-for-activities-of-children-measures
#19
Nihad A Almasri, Robert J Palisano, Lin-Ju Kang
PURPOSE: To establish the construct validity and internal consistency of the Arabic Children Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) and to determine the effects of age, gender, and disability status on diversity and intensity of participation. METHODS: The World Health Organization guidelines for translation of measures were applied to translate the CAPE and PAC, 75 children with cerebral palsy (mean age = 10...
December 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29251709/benchmarking-clinical-outcomes-and-the-immunocatabolic-phenotype-of-chronic-critical-illness-after-sepsis-in-surgical-intensive-care-unit-patients
#20
Julie A Stortz, Juan C Mira, Steven L Raymond, Tyler J Loftus, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Christiaan Leeuwenburgh, Mark S Segal, Azra Bihorac, Babette A Brumback, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
BACKGROUND: A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence of chronic critical illness (CCI) after sepsis and to determine whether selected biomarkers of inflammation, immunosuppression, and catabolism differ between these patients and those that rapidly recover (RAP). METHODS: This three-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit patients with sepsis for the development of CCI (≥14 days of ICU resource utilization with persistent organ dysfunction)...
December 14, 2017: Journal of Trauma and Acute Care Surgery
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