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Rehabilitation and intensive care

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https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#1
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29139007/adding-high-intensity-interval-training-to-conventional-training-modalities-optimizing-health-related-outcomes-during-chemotherapy-for-breast-cancer-the-optitrain-randomized-controlled-trial
#2
Sara Mijwel, Malin Backman, Kate A Bolam, Anna Jervaeus, Carl Johan Sundberg, Sara Margolin, Maria Browall, Helene Rundqvist, Yvonne Wengström
PURPOSE: Exercise training is an effective and safe way to counteract cancer-related fatigue (CRF) and to improve health-related quality of life (HRQoL). High-intensity interval training has proven beneficial for the health of clinical populations. The aim of this randomized controlled trial was to compare the effects of resistance and high-intensity interval training (RT-HIIT), and moderate-intensity aerobic and high-intensity interval training (AT-HIIT) to usual care (UC) in women with breast cancer undergoing chemotherapy...
November 14, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29123621/a-hybrid-cardiac-rehabilitation-is-as-effective-as-a-hospital-based-program-in-reducing-chest-pain-intensity-and-discomfort
#3
Mozhgan Saeidi, Ali Soroush, Saeid Komasi, Puneetpal Singh
Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29123562/the-role-of-occupational-and-physiotherapy-in-multi-modal-approach-to-tackling-delirium-in-the-intensive-care
#4
REVIEW
Jenny Rains, Nigel Chee
The presence of delirium within critical care remains a long-standing challenge for patients and clinicians alike. A myriad of pre-disposing and precipitating factors lead to this patient cohort being high risk for developing delirium during their critical care stay. Until now, non-pharmacological management of these patients usually encompasses a 'bundle' of principles to reduce delirium days. These bundles have limited focus on the entire multi-disciplinary team (including occupational therapists and physiotherapists) who could assist with the reduction of delirium...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29122733/readmissions-in-anticoagulated-intracranial-hemorrhage-patients-a-retrospective-review
#5
Monica M DiFiori, Laura C Lamb, Lori L Calavan, Christopher H Comey, James M Feeney
OBJECTIVE: The objective of this study was to determine the effect of Direct Oral Anticoagulants (DOACs) when compared to warfarin, on the 30-day readmission rates in patients with traumatic intracranial hemorrhage (ICH). METHODS: We conducted a retrospective review of patients from our hospital's trauma database admitted from June 2011 to October 2015 to our Level II trauma center after sustaining a traumatic ICH while anticoagulated. Patients were stratified based on the anticoagulation drug (DOAC or warfarin) they were prescribed upon admission...
November 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29117053/an-outcome-analysis-of-nurse-practitioners-in-acute-care-trauma-services
#6
Anna Holliday, Damayanti Samanta, Julie Budinger, Jessica Hardway, Audis Bethea
The department of trauma at a Level 1 trauma center sought to improve outcomes by enhancing the continuity of care for patients admitted to trauma services. Departmental leadership explored opportunities to improve this aspect of patient care through expansion of existing trauma nurse practitioner (NP) services. The restructured trauma NP service model was implemented in September 2013. A retrospective study was conducted with patients who presented at the trauma center between September 2012 and August 2015...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29105515/implementation-and-evaluation-of-the-norwegian-ullevaal-model-as-a-cardiac-rehabilitation-model-in-primary-care
#7
Birgitta Blakstad Nilsson, Pernille Lunde, Inger Holm
PURPOSE: To describe the Norwegian Ullevaal model, customised for cardiac patients in primary care, and to evaluate the feasibility of the model through patient outcomes after the 12 week outpatient cardiac rehabilitation programme. MATERIALS AND METHODS: A descriptive interventional cohort study with pre-post design. Patients referred to cardiac rehabilitation (n = 273) were enrolled. Group-based high-intensity interval training was offered twice weekly. The primary outcome measure was change in peak oxygen uptake...
November 5, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29089456/no-racial-difference-in-rehabilitation-therapy-across-all-post-acute-care-settings-in-the-year-following-a-stroke
#8
Lesli E Skolarus, Chunyang Feng, James F Burke
BACKGROUND AND PURPOSE: Black stroke survivors experience greater poststroke disability than whites. Differences in post-acute rehabilitation may contribute to this disparity. Therefore, we estimated racial differences in rehabilitation therapy utilization, intensity, and the number of post-acute care settings in the first year after a stroke. METHODS: We used national Medicare data to study 186 168 elderly black and white patients hospitalized with a primary diagnosis of stroke in 2011...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29082797/adaptive-equipment-use-by-people-with-motor-neuron-disease-in-australia-a-prospective-observational-consecutive-cohort-study
#9
Karol A Connors, Lisa M Mahony, Prue Morgan
PURPOSE: People with motor neuron sisease require adaptive equipment to enhance life quality. This study aimed to examine total and concurrent equipment items prescribed with phenotype consideration. METHODS: A prospective, observational consecutive cohort study was undertaken. Data regarding Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, phenotype, symptom onset and Functional Independence Measure (inpatients only) was recorded. Equipment utilized was coded by therapist as: speech devices; transfer devices; mobility devices (including power wheelchairs); orthoses; activities of daily living equipment; assisted technology and home modification equipment...
October 28, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/29078131/neuromuscular-electrophysiological-disorders-and-muscle-atrophy-in-mechanically-ventilated-traumatic-brain-injury-patients-new-insights-from-a-prospective-observational-study
#10
Paulo Eugênio Silva, Vinicius Maldaner, Luciana Vieira, Karina Livino de Carvalho, Hedian Gomes, Priscilla Melo, Nicolas Babault, Gerson Cipriano, Joao Luiz Quagliotti Durigan
PURPOSE: It is unclear whether the muscular changes in mechanically-ventilated traumatic brain injury patients (TBI) are only associated with disuse or additionally to neuromuscular electrophysiological disorders (NED). The correlation between muscle atrophy and NED may affect functional outcomes and rehabilitation programs significantly. MATERIAL AND METHODS: An observational study was performed to investigate the presence of NED and muscle atrophy in TBI patients undergoing mechanical ventilation...
October 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29075779/reconstruction-the-final-dimension-in-head-and-neck-surgery-the-2017-hayes-martin-lecture
#11
Mark K Wax
The Hayes Martin lecture is dedicated to a giant who was essential to developing the surgical management of patients with head and neck cancer. Since that time, advents in anesthesia, intensive care, and improved diagnostic abilities have improved our ability to surgically manage and treat head and neck cancer. The original paradigm of resection, reconstruction, and rehabilitation was formulated as we endeavored to develop paradigms of treatment for our patients. We have maximized our resective and reconstructive abilities...
October 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29066003/clinical-outcomes-after-burns-in-elderly-patients-over-70-years-a-17-year-retrospective-analysis
#12
Gregg Dexter, Sachin Patil, Kanwardeep Singh, Michael A Marano, Robin Lee, Sylvia J Petrone, Ronald S Chamberlain
INTRODUCTION: In the United Stated population >70years is likely to double by the year 2050. Elderly population (>70years) are most vulnerable to burns and outcomes following such injuries in this special group is poorly studied. This study aimed to look at outcomes following burns in patients >70years over a period of 17 years. MATERIALS AND METHODS: Data on 6512 patients admitted to a Level I Burn Center between 1995 and 2011 was analyzed. Age, gender, ethnicity, TBSA, burn etiology, hospital and burn intensive care unit (ICU) length of stay (LOS) and status at discharge were abstracted...
October 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29054892/transthoracic-littre-s-hernia-presenting-with-faecopneumothorax-following-perforation-of-the-meckel-s-diverticulum-a-late-complication-of-oesophagectomy
#13
Charles West, Karen Erskine, Khaled Hamdan
A Littre's hernia is an unusual phenomenon where a Meckel's diverticulum protrudes through a potential abdominal opening. We wish to present a unique case of a 79-year-old man with respiratory distress following a fall from standing, initially managed as a haemothorax. After a chest drain was placed, bowel contents were drained from the pleural cavity and he was taken to theatre. He had a history of minimally invasive oesophagectomy for cancer and had subsequently developed a diaphragmatic hernia. A blind ending diverticulum with a perforation at its tip was found in the left oblique lung fissure that was subsequently confirmed histologically as a perforated Meckel's diverticulum...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054691/impact-of-critical-illness-polyneuromyopathy-in-rehabilitation-a-prospective-observational-study
#14
Cameron Cunningham, Heather C Finlayson, William R Henderson, Russell J O'Connor, Andrew Travlos
BACKGROUND: Critical illness polyneuromyopathy (CIPNM) increasingly is recognized as a source of disability in patients requiring intensive care unit (ICU) admission. The prevalence and impact of CIPNM on patients in the rehabilitation setting has not been established. OBJECTIVES: To determine the proportion of at-risk rehabilitation inpatients with evidence of CIPNM and the functional sequelae of this disorder. DESIGN: Prospective observational study...
October 18, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29050383/early-detection-of-consciousness-in-patients-with-acute-severe-traumatic-brain-injury
#15
Brian L Edlow, Camille Chatelle, Camille A Spencer, Catherine J Chu, Yelena G Bodien, Kathryn L O'Connor, Ronald E Hirschberg, Leigh R Hochberg, Joseph T Giacino, Eric S Rosenthal, Ona Wu
See Schiff (doi:10.1093/awx209) for a scientific commentary on this article. Patients with acute severe traumatic brain injury may recover consciousness before self-expression. Without behavioural evidence of consciousness at the bedside, clinicians may render an inaccurate prognosis, increasing the likelihood of withholding life-sustaining therapies or denying rehabilitative services. Task-based functional magnetic resonance imaging and electroencephalography techniques have revealed covert consciousness in the chronic setting, but these techniques have not been tested in the intensive care unit...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29045409/psychometric-validation-of-the-italian-rehabilitation-complexity-scale-extended-version-13
#16
Francesca Roda, Maurizio Agosti, Andrea Merlo, Maurizio Maini, Francesco Lombardi, Claudio Tedeschi, Maria Grazia Benedetti, Nino Basaglia, Mara Contini, Domenico Nicolotti, Rodolfo Brianti
In Italy, at present, a well-known problem is inhomogeneous provision of rehabilitative services, as stressed by MoH, requiring appropriate criteria and parameters to plan rehabilitation actions. According to the Italian National Rehabilitation Plan, Comorbidity, Disability and Clinical Complexity should be assessed to define the patient's real needs. However, to date, clinical complexity is still difficult to measure with shared and validated tools. The study aims to psychometrically validate the Italian Rehabilitation Complexity Scale-Extended v13 (RCS-E v13), in order to meet the guidelines requirements...
2017: PloS One
https://www.readbyqxmd.com/read/29042299/non-pharmacological-interventions-for-spasticity-in-adults-an-overview-of-systematic-reviews
#17
REVIEW
Fary Khan, Bhasker Amatya, Djamel Bensmail, Alain Yelnik
OBJECTIVES: Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes. METHODS: Data sources: a literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15th June 2017...
October 16, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29039892/step-by-step-male-to-female-transsexual-surgery
#18
Rodrigo Uliano Moser da Silva, Fernando Jahn da Silva Abreu, Gabriel M V da Silva, João Vitor Quadra Vieira Dos Santos, Nelson Sivonei da Silva Batezini, Brasil Silva, Tiago Elias Rosito
INTRODUCTION: After the diagnosis of transsexualism is confirmed therapy commences with psychotherapeutic preparation for the conversion, and after conversion, long-term patient rehabilitation is maintained for at least two years. The indication for surgery is chronic discomfort caused by discord with the patient's natural gender, intense dislike of developing secondary sex characteristics and the onset of puberty. The surgical conversion of transsexuals is the main step in the complex care of these problematic patients (1)...
October 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29033556/swallowing-difficulties-with-medication-intake-assessed-with-a-novel-self-report-questionnaire-in-patients-with-systemic-sclerosis-a-cross-sectional-population-study
#19
Markus Messerli, Rebecca Aschwanden, Michael Buslau, Kurt E Hersberger, Isabelle Arnet
OBJECTIVES: To assess subjective swallowing difficulties (SD) with medication intake and their practical consequences in patients suffering from systemic sclerosis (SSc) with a novel self-report questionnaire. DESIGN AND SETTING: Based on a systematic literature review, we developed a self-report questionnaire and got it approved by an expert panel. Subsequently, we sent the questionnaire by post mail to SSc patients of the European Center for the Rehabilitation of Scleroderma Rheinfelden, Switzerland...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29033079/polytrauma-patients-in-the-netherlands-and-the-usa-a-bi-institutional-comparison-of-processes-and-outcomes-of-care
#20
Suzan Dijkink, Gwendolyn M van der Wilden, Pieta Krijnen, Lisa Dol, Steven Rhemrev, David R King, Marc A DeMoya, George C Velmahos, Inger B Schipper
BACKGROUND: Modern trauma systems differ worldwide, possibly leading to disparities in outcomes. We aim to compare characteristics and outcomes of blunt polytrauma patients admitted to two Level 1 Trauma Centers in the US (USTC) and the Netherlands (NTC). METHODS: For this retrospective study the records of 1367 adult blunt trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted between July 1, 2011 and December 31, 2013 (640 from NTC, 727 from USTC) were analysed...
October 10, 2017: Injury
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