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Vascular rehabilitation

John R Best, Janice J Eng, Jennifer C Davis, Robin Hsiung, Peter A Hall, Laura E Middleton, Peter Graf, Charles H Goldsmith, Teresa Liu-Ambrose
INTRODUCTION: Cerebrovascular disease-such as stroke-is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one's risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke)...
March 17, 2018: BMJ Open
Cimara Fortes Ferreira, Edival Barreto de Magalhães Junior, Barbara Zini
Achieving excellence in anterior rehabilitations requires close cooperation between the periodontist and the prosthodontist. Many techniques can be used to restore the lost alveolar hard and soft tissues. The more severe the peri-implant defect, the higher the challenge and lower the predictability of the procedure. The present case consists of Seibert class III with mal-aligned implants in the esthetic zone resolved with a cost-modified treatment plan to re-establish esthetics in the anterior maxilla using rotated palatal flap...
March 8, 2018: Journal of Oral Implantology
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
Avital Hershkovitz, Corina Angel, Shai Brill, Ran Nissan
BACKGROUND: Anticholinergic (AC) drugs are associated with significant impairment in cognitive and physical function which may affect rehabilitation in older people. We aimed to evaluate whether AC burden is associated with rehabilitation achievement in post-acute hip-fractured patients. METHODS: A retrospective cohort study carried out in a post-acute geriatric rehabilitation center on 1019 hip-fractured patients admitted from January 2011 to October 2015. The Anticholinergic Cognitive Burden Scale (ACB) was used to quantify the AC burden...
March 3, 2018: Drugs & Aging
Jason S Hawksworth, Chirag S Desai, Khalid M Khan, Stuart S Kaufman, Nada Yazigi, Raffaele Girlanda, Alexander Kroemer, Thomas M Fishbein, Cal S Matsumoto
Intestine failure-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with intestinal failure (IF). Visceral transplantation for IFALD includes variants of intestine, liver, or combined liver and intestine transplantation. Graft selection for an individual patient depends on the etiology of intestinal failure, abdominal and vascular anatomy, severity of IFALD, and potential for intestinal rehabilitation...
March 2, 2018: American Journal of Transplantation
Laura Jolliffe, Natasha A Lannin, Dominique A Cadilhac, Tammy Hoffmann
OBJECTIVES: Rehabilitation clinical practice guidelines (CPGs) contain recommendation statements aimed at optimising care for adults with stroke and other brain injury. The aim of this study was to determine the quality, scope and consistency of CPG recommendations for rehabilitation covering the acquired brain injury populations. DESIGN: Systematic review. INTERVENTIONS: Included CPGs contained recommendations for inpatient rehabilitation or community rehabilitation for adults with an acquired brain injury diagnosis (stroke, traumatic or other non-progressive acquired brain impairments)...
February 28, 2018: BMJ Open
Julien Vincent Brugniaux, Geoff B Coombs, Otto F Barak, Zeljko Dujic, Mypinder S Sekhon, Philip N Ainslie
Molecular oxygen (O2 ) is a vital element in human survival and plays a major role in a diverse range of biological and physiological processes. Although normobaric hyperoxia can increase arterial oxygen content (CaO2 ), it also causes vasoconstriction and hence reduces O2 delivery in various vascular beds including the heart, skeletal muscle, and brain. Thus, a seemingly paradoxical situation exists in which the administration of oxygen may place tissues at increased risk of hypoxic stress. Nevertheless, with various degrees of effectiveness, and not without consequences, supplemental oxygen is used clinically in an attempt to correct tissue hypoxia (e...
February 28, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Fei Wang, Minji Wang
OBJECTIVE: To observe the effects for vascular dementia (VD) of kidney essence deficiency among acupuncture at five mind points combined with modified kidney qi decoction, simple acupuncture at five mind points and simple modified kidney qi decoction. METHODS: A total of 180 VD patients were randomly assigned into a combination group, an acupuncture group and a herb group, 60 cases in each one. The conventional western medication and rehabilitation training were for all the patients...
February 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Dafin F Muresanu, Dana Slavoaca, Antox Alvarez, Volker Homberg, Ovidiu Bajenaru, Alla Guekht, Wolf-Dieter Heiss, Livia Popa, Johannes Vester, Ioana Muresanu, Codruta Birle, Maria Balea
Vascular dementia is the second most common cause of dementia, with clinical features that depend on neural substrates affected by the vascular lesions. Like most neurological disorders, it involves alterations that range from the molecular level to neuronal networks. Such alterations begin as compensatory mechanisms that reshape every subsystem involved in the brain's homeostasis. Although there have been recent huge advances in understanding the pathophysiology of cognitive dysfunction, a suitable therapeutic approach to vascular dementia remains elusive...
February 19, 2018: CNS & Neurological Disorders Drug Targets
João Ricardo Almeida Grossi, Tatiana Miranda Deliberador, Tielly Saad, Rafaela Scariot, Joao Cesar Zielak, Allan Fernando Giovanini
Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics...
January 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Jinyeol Kwon, Sung Mee Jung, Sae-Yeon Kim, Nyeong Keon Kwon, Sang-Jin Park
Vascularized composite allotransplantation for the forearm is a complex surgical procedure, requiring multidisciplinary collaboration. It is important to provide optimal blood flow to the grafts, effective immunosuppression, and early rehabilitation for graft survival and good functional outcomes. As ischemia-reperfusion injury and substantial but unquantifiable blood loss are inevitable in this type of surgery, anesthetic management should focus on providing adequate hemodynamic management with proper monitoring, and anesthetic and analgesic strategies to prevent vasoconstriction in the graft...
February 2018: Korean Journal of Anesthesiology
Angela Marra, Antonino Naro, Antonino Chillura, Alessia Bramanti, Giuseppa Maresca, Rosaria De Luca, Alfredo Manuli, Placido Bramanti, Rocco Salvatore Calabrò
BACKGROUND: Identifying the patients with mild cognitive impairment (MCI) who may develop dementia (MDC) is challenging. The study of peripersonal space (PPS) by using functional transcranial Doppler (fTCD) could be used for this purpose. OBJECTIVE: To identify changes in cerebral blood flow (CBF) during motor tasks targeting PPS, which can predict MDC. METHODS: We evaluated the changes in CBF in 22 patients with MCI and 23 with dementia [Alzheimer's disease (AD) and vascular dementia (VaD)] during a motor task (passive mobilization, motor imagery, and movement observation) in which the hand of the subject moved forward and backward the face...
2018: Journal of Alzheimer's Disease: JAD
Fabrício Diniz de Lima, Gustavo José Luvizutto, Arthur Oscar Schelp, Gabriel Pereira Braga, Rodrigo Bazan
Objective: Stroke chameleons encompass an atypical group of syndromes that do not initially appear to be cerebrovascular accidents. The objective of this study was to report patients with different lesions of central origin clinically presenting as wrist drop and with a semiology similar to that produced by peripheral lesions of the radial nerve at different topographical levels. Methods: This is a case series study of patients presenting with wrist drop during the acute phase of stroke who were assessed by clinical examination and CT and MRI brain scans...
September 2017: Case Reports in Neurology
Ku-Chou Chang, Jen-Wen Hung, Hsuei-Chen Lee, Chu-Ling Yen, Ching-Yi Wu, Chung-Lin Yang, Yu-Ching Huang, Pei-Li Lin, Hui-Hsuan Wang
BACKGROUND: It remains unclear whether rehabilitation has an impact on reducing the long-term risk of mortality or readmission following stroke or transient ischemic attack (TIA). OBJECTIVES: To investigate the association between the dosage and continuation of rehabilitation and the risk of outcome events (OEs) after stroke or TIA. RESEARCH DESIGN: A retrospective cohort study using Taiwan's National Health Insurance database. SUBJECTS: In total, 4594 patients admitted with first-ever acute stroke or TIA were followed-up for 32 months...
February 6, 2018: Medical Care
Dawn M Bravata, Laura J Myers, Greg Arling, Edward J Miech, Teresa Damush, Jason J Sico, Michael S Phipps, Alan J Zillich, Zhangsheng Yu, Mathew Reeves, Linda S Williams, Jason Johanning, Seemant Chaturvedi, Fitsum Baye, Susan Ofner, Curt Austin, Jared Ferguson, Glenn D Graham, Rachel Rhude, Chad S Kessler, Donald S Higgins, Eric Cheng
Importance: The timely delivery of guideline-concordant care may reduce the risk of recurrent vascular events for patients with transient ischemic attack (TIA) and minor stroke. Although many health care organizations measure stroke care quality, few evaluate performance for patients with TIA or minor stroke, and most include only a limited subset of guideline-recommended processes. Objective: To assess the quality of guideline-recommended TIA and minor stroke care across the Veterans Health Administration (VHA) system nationwide...
February 5, 2018: JAMA Neurology
Damien Garrigues, Béatrice Ferrari, Nicole Petrissans Ferrando, Thibaut Guiraut
WHAT WE KNEW: The vascular rehabilitation is an effective treatment for patients with an intermittent claudication linked to lower-extremity artery disease. This treatment increases the claudication distance of 180% with the Gardner's protocol (30 to 60 minutes of walking at least 3 times a week, walking until appearance of a mild pain) and allows also to control the vascular risk factors. This treatment is not enough prescribed for many reasons and often requires a hospitalization in a rehabilitation centre...
January 26, 2018: La Presse Médicale
E V Ekusheva, V B Voitenkov, N V Skripchenko, I G Samoilova, V A Filimonov
AIM: The objective of the present study was the evaluation and comparison of the effectiveness of the differential approaches to the neurorehabilitation of the somatosensory disturbances in the patients presenting with the spinal cord lesions. MATERIALS AND METHODS: A total of 68 patients with spinal cord lesions were enrolled in the study, including 38 suffering from vascular myelopathy, 18 with the consequences of extramedullar meningioma surgery, 12 with the sequelae of acute transverse myelitis...
December 28, 2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Pablo Toledo Frías, María Rosa Fernández Olmo, Mónica Recio Vázquez, Miren Morillas Bueno, Ana Peinado Esteban, Manuel Abeytua Jiménez
No abstract text is available yet for this article.
January 16, 2018: Revista Española de Cardiología
Subramania Iyer, Mohit Sharma, P Kishore, Jimmy Mathew, Sundeep Vijayaraghavan, Janarthanan Ramu, Abhijeet Wakure, Raghuveer Reddy, S M Mali Chetan, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar, V G Prasad
Introduction: Vascularized composite tissue allotransplantation is a relatively new concept, which was unavailable in the Indian subcontinent till a bilateral hand transplant was carried out successfully in January 2015. Materials and Methods: The setting up of the transplant programme involved obtaining legal clearances, creating public awareness, harnessing the institutional facilities, drawing up protocols, assembling the surgical team, managing immunological issues, rehabilitation and preparing the ancillary services...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Eisuke Amiya, Masanobu Taya
Exercise-based rehabilitation programs have been reported to have beneficial effects for patients with heart failure. However, there is little evidence about whether this is the case in patients with more severe heart failure. In particular, there is a question in the clinical setting whether patients with advanced heart failure and continuous inotropic infusion should be prescribed exercise training. In contrast, many studies conclude that prolonged immobility associated with heart failure profoundly impairs physical function and promotes muscle wasting that could further hasten the course of heart failure...
2018: Clinical Medicine Insights. Cardiology
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