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https://www.readbyqxmd.com/read/28817481/incorporating-dynamic-assessment-of-fluid-responsiveness-into-goal-directed-therapy-a-systematic-review-and-meta-analysis
#1
Joseph M Bednarczyk, Jason A Fridfinnson, Anand Kumar, Laurie Blanchard, Rasheda Rabbani, Dean Bell, Duane Funk, Alexis F Turgeon, Ahmed M Abou-Setta, Ryan Zarychanski
OBJECTIVE: Dynamic tests of fluid responsiveness have been developed and investigated in clinical trials of goal-directed therapy. The impact of this approach on clinically relevant outcomes is unknown. We performed a systematic review and meta-analysis to evaluate whether fluid therapy guided by dynamic assessment of fluid responsiveness compared with standard care improves clinically relevant outcomes in adults admitted to the ICU. DATA SOURCES: Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, clinicaltrials...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28817088/the-role-of-neurogenic-inflammation-in-blood-brain-barrier-disruption-and-development-of-cerebral-oedema-following-acute-central-nervous-system-cns-injury
#2
REVIEW
Annabel J Sorby-Adams, Amanda M Marcoionni, Eden R Dempsey, Joshua A Woenig, Renée J Turner
Acute central nervous system (CNS) injury, encompassing traumatic brain injury (TBI) and stroke, accounts for a significant burden of morbidity and mortality worldwide, largely attributable to the development of cerebral oedema and elevated intracranial pressure (ICP). Despite this, clinical treatments are limited and new therapies are urgently required to improve patient outcomes and survival. Originally characterised in peripheral tissues, such as the skin and lungs as a neurally-elicited inflammatory process that contributes to increased microvascular permeability and tissue swelling, neurogenic inflammation has now been described in acute injury to the brain where it may play a key role in the secondary injury cascades that evolve following both TBI and stroke...
August 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28816933/breast-cancer-endometrial-cancer-and-cardiovascular-events-in-participants-who-used-vaginal-estrogen-in-the-women-s-health-initiative-observational-study
#3
Carolyn J Crandall, Kathleen M Hovey, Christopher A Andrews, Rowan T Chlebowski, Marcia L Stefanick, Dorothy S Lane, Jan Shifren, Chu Chen, Andrew M Kaunitz, Jane A Cauley, JoAnn E Manson
OBJECTIVE: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. METHODS: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observational Study, who were recruited at 40 US clinical centers, aged 50 to 79 years at baseline and did not use systemic estrogen therapy during follow-up (n = 45,663, median follow-up 7...
August 14, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28816783/association-of-testosterone-replacement-therapy-and-the-incidence-of-a-composite-of-postoperative-in-hospital-mortality-and-cardiovascular-events-in-men-undergoing-noncardiac-surgery
#4
Maged Y Argalious, Jing You, Guangmei Mao, Daniel Ramos, Sandeep Khanna, Kamal Maheshwari, Carlos Trombetta
BACKGROUND: Whether patients on testosterone replacement therapy undergoing noncardiac surgery have an increased risk of postoperative in-hospital mortality and cardiovascular events remains unknown. We therefore sought to identify the impact of testosterone replacement on the incidence of a composite of postoperative in-hospital mortality and cardiovascular events in men undergoing noncardiac surgery. METHODS: Data from male American Society of Anesthesiologists I through IV patients 40 yr or older who underwent noncardiac surgery between May 2005 and December 2015 at the Cleveland Clinic (Cleveland, Ohio) main campus were included...
September 2017: Anesthesiology
https://www.readbyqxmd.com/read/28816542/the-fate-of-asymptomatic-severe-carotid-stenosis-in-the-era-of-best-medical-therapy
#5
Rodolfo Pini, Gianluca Faggioli, Andrea Vacirca, Laura Maria Cacioppa, Enrico Gallitto, Mauro Gargiulo, Andrea Stella
BACKGROUND: Medical therapy for asymptomatic carotid artery stenosis (ACAS) may obviate the carotid revascularization, according to recent literature reports, but many studies also considered moderate carotid artery stenosis (50-69% NASCET). This study reviews the most recent series of ACAS focusing on ipsilateral transient ischemic attack (TIA) stroke and annual risk of stroke in patients with ACAS ≥70%, thereby also evaluating the adherence to best medical therapy (BMT). METHODS: A systematic review consisting of all the series of patients with ACAS being treated medically was performed, which was published after 2005...
August 17, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28816120/b-vitamins-in-stroke-prevention-time-to-reconsider
#6
REVIEW
J David Spence, Qilong Yi, Graeme J Hankey
B vitamin therapy lowers plasma total homocysteine concentrations, and might be a beneficial intervention for stroke prevention; however, cyanocobalamin (a form of vitamin B12) can accelerate decline in renal function and increase the risk of cardiovascular events in patients with impaired renal function. Although early trials did not show benefit in reduction of stroke, these results might have been due to harm in participants with impaired renal function. In patients with diabetic nephropathy, cyanocobalamin is harmful, whereas B vitamins appear to reduce cardiovascular events in study participants with normal renal function...
September 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28815788/association-between-radioiodine-treatment-for-thyroid-cancer-and-risk-of-stroke
#7
Chun-Yi Lin, Cheng-Li Lin, Yi-Chen Lo, Chia-Hung Kao
BACKGROUND: The purpose of this study was to evaluate the association between radioiodine (I-131) therapy for thyroid cancer and the risk of stroke in Taiwan. METHODS: A total of 10 104 of the patients aged 20 years or older, who were newly diagnosed with thyroid cancer during 2000-2010, were recruited and classified into 2 cohorts according to whether they received I-131 therapy through 1:1 propensity score matching. The cumulative Kaplan-Meier curves for the incidence of stroke in the 2 cohorts were compared using the log-rank test...
August 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/28815481/gene-delivery-approaches-for-mesenchymal-stem-cell-therapy-strategies-to-increase-efficiency-and-specificity
#8
REVIEW
Gopi Suresh Oggu, Shyama Sasikumar, Nirosha Reddy, Kranthi Kiran Reddy Ella, Ch Mohan Rao, Kiran Kumar Bokara
A significant number of clinical trials have been undertaken to explore the use of mesenchymal stem cells (MSCs) for the treatment of several diseases such as Crohn's disease, diabetes, bone defects, myocardial infarction, stroke etc., Due to their efficiency in homing to the tissue injury sites, their differentiation potential, the capability to secrete a large amount of trophic factors and their immunomodulatory effects, MSCs are becoming increasingly popular and expected to be one of the promising therapeutic approaches...
August 16, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28814273/add-on-neurological-benefits-of-antiviral-therapy-in-hcv-patients-with-chronic-kidney-disease-a-nationwide-cohort-study
#9
Ming-Shyan Lin, Tien-Hsing Chen, Wey-Yil Lin, Chi-Hung Liu, Yung-Yu Hsieh, Wen-Nan Chiu, Chih-Hsiang Chang, Mei-Yen Chen, Chang-Min Chung, Yu-Sheng Lin
BACKGROUND: Hepatitis C virus (HCV)-infected patients with chronic kidney disease (CKD) have rarely been studied because they rarely accept interferon-based therapy (IBT) and have been difficult to follow up. We investigated long-term outcomes of IBT on the population. METHODS: This population-based cohort study used the Taiwan National Health Insurance Research Database as its data source. HCV patients diagnosed with CKD between Jan. 1, 2003, and Dec. 31, 2013, were selected...
August 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28813943/conjunctive-rehabilitation-of-multiple-cognitive-domains-for-chronic-stroke-patients-in-virtual-reality
#10
Martina Maier, Nuria Leiva Banuelos, Belen Rubio Ballester, Esther Duarte, Paul F M J Verschure
Classically, cognitive deficits have been studied and treated in isolation from each other. A stroke patient is classified as being memory impaired, having executive dysfunction or showing attentional deficits after which a dedicated rehabilitation therapy is given. Studies seldom looked at the relationship between these different cognitive domains and syndromes, although, there is evidence that they might share common neuronal substrates and do not occur in isolation. Here, we propose a novel rehabilitation method in virtual reality to treat cognitive deficits in conjunction and report the preliminary results of an ongoing randomized controlled clinical trial...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813937/towards-quantifying-dynamic-human-human-physical-interactions-for-robot-assisted-stroke-therapy
#11
Mayumi Mohan, Rochelle Mendonca, Michelle J Johnson
Human-Robot Interaction is a prominent field of robotics today. Knowledge of human-human physical interaction can prove vital in creating dynamic physical interactions between human and robots. Most of the current work in studying this interaction has been from a haptic perspective. Through this paper, we present metrics that can be used to identify if a physical interaction occurred between two people using kinematics. We present a simple Activity of Daily Living (ADL) task which involves a simple interaction...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813931/making-neurorehabilitation-fun-multiplayer-training-via-damping-forces-balancing-differences-in-skill-levels
#12
Kilian Baur, Peter Wolf, Robert Riener, Jaime E Duarte
Multiplayer environments are thought to increase the training intensity in robot-aided rehabilitation therapy after stroke. We developed a haptic-based environment to investigate the dynamics of two-player training performing time-constrained reaching movements using the ARMin rehabilitation robot. We implemented a challenge level adaptation algorithm that controlled a virtual damping coefficient to reach a desired success rate. We tested the algorithm's effectiveness in regulating the success rate during game play in a simulation with computer-controlled players, in a feasibility study with six unimpaired players, and in a single session with one stroke patient...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813930/bemobil-developing-a-user-friendly-and-motivating-telerehabilitation-system-for-motor-relearning-after-stroke
#13
Michael Minge, Ekaterina Ivanova, Katharina Lorenz, Gesche Joost, Manfred Thuring, Jorg Kruger
Motor relearning after stroke is a lengthy process which should be continued after patients get discharged from the clinic. This project aims at developing a system for telerehabilitation which enables stroke patients to exercise at home autonomously or under supervision of a therapist. The system includes haptic therapy devices which are more promising and beneficial for stroke rehabilitation than non-haptic approaches. In this paper, we present the results of two initial studies investigating specific design solutions for the patient's user interface...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813902/hybrid-position-and-orientation-tracking-for-a-passive-rehabilitation-table-top-robot
#14
K K Wojewoda, P R Culmer, J F Gallagher, A E Jackson, M C Levesley
This paper presents a real time hybrid 2D position and orientation tracking system developed for an upper limb rehabilitation robot. Designed to work on a table-top, the robot is to enable home-based upper-limb rehabilitative exercise for stroke patients. Estimates of the robot's position are computed by fusing data from two tracking systems, each utilizing a different sensor type: laser optical sensors and a webcam. Two laser optical sensors are mounted on the underside of the robot and track the relative motion of the robot with respect to the surface on which it is placed...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813897/design-and-testing-of-an-under-actuated-surface-emg-driven-hand-exoskeleton
#15
A Lince, N Celadon, A Battezzato, A Favetto, S Appendino, P Ariano, M Paleari
Stroke and other neurological pathologies are an increasing cause of hand impairment, involving expensive rehabilitative therapies. In this scenario, robotics applied to hand rehabilitation and assistance appears particularly promising in order to lower therapy costs and boost its efficacy. This work shows a recently conceived hand exoskeleton, from the design and realization to its preliminary evaluation. A control strategy based on surface electromyography (sEMG) signals is integrated: preliminary tests performed on healthy subjects show the validity of this choice...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813895/customized-therapy-using-distributions-of-reaching-errors
#16
Moria F Bittmann, James L Patton, Felix C Huang
While there has been recent success with robotic therapy approaches, individual differences in motor impairments motivate the need for customized therapy. Our latest work with healthy participants considered the likelihood of one's error to construct a customized force field training environment, which we termed an error field. We believe error statistics could characterize individual motor impairments for stroke survivors. Here we present preliminary results from a pilot study testing this therapy technique on individuals following stroke...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813891/quantitative-assessment-of-paretic-limb-dexterity-and-interlimb-coordination-during-bilateral-arm-rehabilitation-training
#17
Chang Xu, Siyi Li, Kui Wang, Zengguang Hou, Ningbo Yu
In neuro-rehabilitation after stroke, the conventional constrained induced movement therapy (CIMT) has been well-accepted. Existing bilateral trainings are mostly on mirrored symmetrical motion. However, complementary bilateral movements are dominantly involved in activities of daily living (ADLs), and functional bilateral therapies may bring better skill transfer from trainings to daily life. Neurophysiological evidence is also growing. In this work, we firstly introduce our bilateral arm training system realized with a haptic interface and a motion sensor, as well as the tasks that have been designed to train both the manipulation function of the paretic arm and coordination of bilateral upper limbs...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813890/online-adaptive-assistance-control-in-robot-based-neurorehabilitation-therapy
#18
Fabio Stroppa, Simone Marcheschi, Nicola Mastronicola, Claudio Loconsole, Antonio Frisoli
Repetitive and task specific robot-based rehabilitation has been proved to be effective for motor recovery over time. During a therapy, the task should improve subject's impaired movements, but also enhance their efforts for a more effective recovery. This requires an accurate tuning of the task difficulty, which should be tailored directly to the patient. In this work, we propose a system for real-time assistance adaptation based on online performance evaluation for post-stroke subjects. In particular, the aim of the system is to implement the "assist-as-needed" paradigm based on actual patients' motor skills during a therapy session with an active upper-limb robotic exoskeleton...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813889/design-of-a-clinically-relevant-upper-limb-exoskeleton-robot-for-stroke-patients-with-spasticity
#19
Dong Jin Lee, Sung Jin Bae, Sung Ho Jang, Pyung Hun Chang
The purpose of this research is to propose a design of a clinically relevant upper-limb (hand, wrist, and elbow) exoskeleton that meets the clinical requirements. At first, the proposed robot was designed to have sufficient torque for passive exercise therapy and spasticity measurement of post-stroke patients with spasticity (grade 3 or lower in Modified Ashworth Scale). Because the therapy of patients with high level spasticity could be laborious for therapists by increased muscle tone, and the patients tend not to get enough rehabilitation treatment...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813888/fully-embedded-myoelectric-control-for-a-wearable-robotic-hand-orthosis
#20
Franziska Ryser, Tobias Butzer, Jeremia P Held, Olivier Lambercy, Roger Gassert
To prevent learned non-use of the affected hand in chronic stroke survivors, rehabilitative training should be continued after discharge from the hospital. Robotic hand orthoses are a promising approach for home rehabilitation. When combined with intuitive control based on electromyography, the therapy outcome can be improved. However, such systems often require extensive cabling, experience in electrode placement and connection to external computers. This paper presents the framework for a stand-alone, fully wearable and real-time myoelectric intention detection system based on the Myo armband...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
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