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Rehabilitation and intensive care

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https://www.readbyqxmd.com/read/28433979/lethal-high-acute-disseminated-encephalomyelitis-adem-triggered-by-toxic-effect-of-synthetic-cannabinoid-black-mamba
#1
Kiran Samra, Ian S Boon, Gregory Packer, Saiju Jacob
A previously well 25-year-old man presented with agitation, double incontinence and left-sided incoordination. His symptoms started after smoking a synthetic cannabinoid (black mamba) 5 days earlier. Over 48 hours, he developed aphasia, generalised hypertonia, hyper-reflexia and dense left hemiparesis. This progressed to profuse diaphoresis, fever, tachycardia, hypertension and a possible seizure necessitating admission to the intensive care unit. CT head and cerebrospinal fluid analysis were unremarkable...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#2
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#3
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28421032/spasticity-motor-recovery-and-neural-plasticity-after-stroke
#4
REVIEW
Sheng Li
Spasticity and weakness (spastic paresis) are the primary motor impairments after stroke and impose significant challenges for treatment and patient care. Spasticity emerges and disappears in the course of complete motor recovery. Spasticity and motor recovery are both related to neural plasticity after stroke. However, the relation between the two remains poorly understood among clinicians and researchers. Recovery of strength and motor function is mainly attributed to cortical plastic reorganization in the early recovery phase, while reticulospinal (RS) hyperexcitability as a result of maladaptive plasticity, is the most plausible mechanism for poststroke spasticity...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28419206/short-term-preoperative-exercise-therapy-does-not-improve-long-term-outcome-after-lung-cancer-surgery-a-randomized-controlled-study%C3%A2
#5
Wolfram Karenovics, Marc Licker, Christoph Ellenberger, Michel Christodoulou, John Diaper, Chetna Bhatia, John Robert, Pierre-Olivier Bridevaux, Frédéric Triponez
OBJECTIVES: Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer. This randomized trial evaluates the impact of adding rehabilitation (Rehab) with high-intensity interval training (HIIT) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome. METHODS: Patients with operable lung cancer were randomly assigned to usual care (UC, n  = 77) or to intervention group (Rehab, n  = 74) that entailed HIIT that was implemented only preoperatively...
April 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28417610/functional-outcome-of-critical-illness-polyneuropathy-in-patients-affected-by-severe-brain-injury
#6
Domenico Intiso, Filomena DI Rienzo, Andrea Fontana, Maurizio Tolfa, Michelangelo Bartolo, Massimiliano Copetti
BACKGROUND: Critical illness polyneuropathy and myopathy (CIPNM) frequently occur in intensive care unit (ICU) critically ill subjects; about 55-70% of subjects achieve full recovery. CIPNM can occur in ICU subjects with severe acquired brain injury (sABI), but no data have been reported regarding their outcome. AIM: The aim of the present study was to investigate the functional recovery in subjects suffering from both CIPNM and sABI and whether they had poorer outcome than those with sABI only...
April 14, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28416561/requirements-for-and-current-provision-of-rehabilitation-services-for-children-after-severe-acquired-brain-injury-in-the-uk-a-population-based-study
#7
Louise Hayes, Simon Shaw, Mark S Pearce, Rob J Forsyth
OBJECTIVES: Survival with brain injury is an outcome of severe illness that may be becoming more common. Provision for children in this situation has received little attention. We sought to estimate rates of severe paediatric acquired brain injury (ABI) requiring rehabilitation and to describe current provision of services for these children in the UK. METHODS: This study conducted an analysis of Hospital Episode Statistics data between April 2003 and March 2012, supplemented by a UK provider survey completed in 2015...
April 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28416042/earthquakes-fuel-crisis-power-outages-and-health-care-in-nepal-implications-for-the-future
#8
Bipin Adhikari, Shiva Raj Mishra, Sujan Babu Marahatta, Nils Kaehler, Kumar Paudel, Janak Adhikari, Shristi Raut
Earthquakes are a major natural calamity with pervasive effects on human life and nature. Similar effects are mimicked by man-made disasters such as fuel crises and power outages in developing countries. Natural and man-made disasters can cause intangible human suffering and often leave scars of lifelong psychosocial damage. Lessons from these disasters are frequently not implemented. The main objective of this study was to review the effects of the 2015 earthquakes, fuel crisis, and power outages on the health services of Nepal and formulate recommendations for the future...
April 18, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28401613/implementing-augmentative-and-alternative-communication-in-critical-care-settings-perspectives-of-healthcare-professionals
#9
Charlotte Handberg, Anna Katarina Voss
AIM: The aim of the current study was to describe the perspectives of healthcare professionals caring for intubated patients on implementing Augmentative and Alternative Communication (AAC) in critical care settings. BACKGROUND: Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalization and rehabilitation...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28399095/-modern-principles-of-integrated-diagnostics-and-rehabilitation-of-perinatal-lesions-of-the-nervous-system-and-their-consequences
#10
S A Nemkova
The article is devoted to the comprehensive diagnosis and treatment of perinatal lesions of the nervous system and their consequences in children. Reflects modern approaches to data classification conditions, taking into account ideas on the etiology and pathogenesis of the disease, the clinical manifestations of the main syndromes (excitation and depression, hypertensive, convulsive, movement disorders) as the neonatal period, and in the formation of long-term effects (motor and mental delay and speech development, hyperkinetic syndrome, cerebral palsy and others)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28388378/protein-turnover-and-metabolism-in-the-elderly-intensive-care-unit-patient
#11
Stuart M Phillips, Roland N Dickerson, Frederick A Moore, Douglas Paddon-Jones, Peter J M Weijs
Many intensive care unit (ICU) patients do not achieve target protein intakes particularly in the early days following admittance. This period of iatrogenic protein undernutrition contributes to a rapid loss of lean, in particular muscle, mass in the ICU. The loss of muscle in older (aged >60 years) patients in the ICU may be particularly rapid due to a perfect storm of increased catabolic factors, including systemic inflammation, disuse, protein malnutrition, and reduced anabolic stimuli. This loss of muscle mass has marked consequences...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28379571/safety-and-feasibility-of-a-protocolized-approach-to-in-bed-cycling-exercise-in-the-intensive-care-unit-quality-improvement-project
#12
Ibtehal Kimawi, Bryanna Lamberjack, Archana Nelliot, Amy Lee Toonstra, Jennifer Zanni, Minxuan Huang, Earl Mantheiy, Michelle E Kho, Dale M Needham
Background: : In-bed, supine cycle ergometry as a part of early rehabilitation in the intensive care unit (ICU) appears to be safe, feasible, and beneficial, but no standardized protocol exists. A standardized protocol may help guide use of cycle ergometry in the ICU. Objective: We investigated whether a standardized protocol for in-bed cycling is safe and feasible, and results in cycling for a longer duration and achieves a higher resistance. Design: A quality improvement (QI) project was conducted...
March 31, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28374811/active-rehabilitation-a-community-peer-based-approach-for-persons-with-spinal-cord-injury-international-utilisation-of-key-elements
#13
A Divanoglou, T Tasiemski, M Augutis, K Trok
INTRODUCTION: Active Rehabilitation (AR) is a community peer-based approach that started in Sweden in 1976. As a key component of the approach, AR training camps provide intensive, goal-oriented, intentional, group-based, customised training and peer-support opportunities in a community environment for individuals with spinal cord injury. STUDY DESIGN: Prospective cross-sectional study. OBJECTIVES: To describe the profile of the organisations that use components of the AR approach, and to explore the characteristics and the international variations of the approach...
April 4, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28364678/effect-of-neuromuscular-stimulation-and-individualized-rehabilitation-on-muscle-strength-in-intensive-care-unit-survivors-a-randomized-trial
#14
Irini Patsaki, Vasiliki Gerovasili, Georgios Sidiras, Eleftherios Karatzanos, Georgios Mitsiou, Emmanuel Papadopoulos, Anna Christakou, Christina Routsi, Anastasia Kotanidou, Serafim Nanas
PURPOSE: Intensive Care Unit (ICU) survivors experience muscle weakness leading to restrictions in functional ability. Neuromuscular electrical stimulation (NMES) has been an alternative to exercise in critically ill patients. The aim of our study was to investigate its effects along with individualized rehabilitation on muscle strength of ICU survivors. MATERIAL AND METHODS: Following ICU discharge, 128 patients (age: 53±16years) were randomly assigned to daily NMES sessions and individualized rehabilitation (NMES group) or to control group...
March 22, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28359235/halving-your-cake-and-eating-it-too-a-case-based-discussion-and-review-of-metabolic-rehabilitation-for-obese-adults-with-diabetes
#15
R Bishay, N Kormas
BACKGROUND: The global epidemic of obesity will see normal weight adults constituting a mere one-third of the global population by 2025. Although appetite and weight are regulated by a complex integration of neurological, endocrine and gastrointestinal feedback mechanisms, there is a constant interaction between psychological state, physical impairment, presence of comorbid chronic disease and medications. METHODS: We discuss two cases and reveal a practical approach to investigating and managing patients with obesity and diabetes in the 'real world'...
March 29, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28356370/comorbidities-in-the-management-of-patients-with-lung-cancer
#16
Charlotte Leduc, Delphine Antoni, Anne Charloux, Pierre-Emmanuel Falcoz, Elisabeth Quoix
Lung cancer represents a major public health issue worldwide. Unfortunately, more than half of them are diagnosed at an advanced stage. Moreover, even if diagnosed early, diagnosis procedures and treatment can be difficult due to the frequent comorbidities observed in these patients. Some of these comorbidities have a common major risk factor, i.e. smoking, whereas others are unrelated to smoking but frequently observed in the general population. These comorbidities must be carefully assessed before any diagnostic and/or therapeutic decisions are made regarding the lung cancer...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28356197/risk-factors-for-depression-following-traumatic-injury-an-epidemiological-study-from-a-scandinavian-trauma-center
#17
Rebecka Ahl, Rickard Lindgren, Yang Cao, Louis Riddez, Shahin Mohseni
INTRODUCTION: A significant proportion of patients suffer depression following traumatic injuries. Once manifested, major depression is challenging to overcome and its presence risks impairing the potential for physical rehabilitation and functional recovery. Risk stratification for early detection and intervention in these instances is important. This study aims to investigate patient and injury characteristics associated with an increased risk for depression. METHODS: All patients with traumatic injuries were recruited from the trauma registry of an urban university hospital between 2007 and 2012...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28342829/effects-of-peer-mentoring-on-self-efficacy-and-hospital-readmission-following-inpatient-rehabilitation-of-individuals-with-spinal-cord-injury-a-randomized-controlled-trial
#18
Julie Gassaway, Michael L Jones, W Mark Sweatman, Minna Hong, Peter Anziano, Karen DeVault
OBJECTIVE: Investigate the effect of intensive peer mentoring on patient reported outcomes of self-efficacy and unplanned hospital readmissions for persons with spinal cord injury/disease (SCI/D) within the first 6 months after discharge from inpatient rehabilitation DESIGN: Randomized controlled trial; SETTING: Non-profit inpatient rehabilitation hospital specializing in care of persons with SCI/D and brain injury PARTICIPANTS: 158 patients admitted to the SCI rehabilitation program whose discharge location was a community setting...
March 22, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28336024/postoperative-pain-self-management-behavior-in-patients-who-underwent-total-knee-or-hip-arthroplasty
#19
Ning-Ning Zhu, Pei-Pei Xu, Ting-Ting Lei, Ting Sun, Sally Wai-Chi Chan
The self-management of acute postoperative pain is not well researched. This cross-sectional study investigates postoperative pain and pain self-management behavior. We recruited 127 patients who underwent total knee or total hip arthroplasty in an acute care hospital. We measured postoperative pain intensity and pain self-management behavior for three postoperative days. The results showed that the participants experienced mild and moderate pain intensity and perceived moderate to severe pain interference, which influenced their mood, sleep patterns, ability to walk, and performance of general activities and rehabilitation exercises...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28328946/a-randomized-clinical-trial-in-preterm-infants-on-the-effects-of-a-home-based-early-intervention-with-the-caretoy-system
#20
Giuseppina Sgandurra, Jakob Lorentzen, Emanuela Inguaggiato, Laura Bartalena, Elena Beani, Francesca Cecchi, Paolo Dario, Matteo Giampietri, Gorm Greisen, Anna Herskind, Jens Bo Nielsen, Giuseppe Rossi, Giovanni Cioni
CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor and visual development in preterm infants. 41 preterm infants (range age: 3.0-5.9 months of corrected age) were enrolled and randomized into two groups, CareToy and Standard Care. 19 infants randomized in CareToy group performed a 4-week CareToy program, while 22 allocated to control group completed 4 weeks of Standard Care...
2017: PloS One
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