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https://www.readbyqxmd.com/read/28105945/assessment-of-transfemoral-amputees-using-a-passive-microprocessor-controlled-knee-versus-an-active-powered-microprocessor-controlled-knee-for-level-walking
#1
Veerle Creylman, Ingrid Knippels, Paul Janssen, Evelyne Biesbrouck, Knut Lechler, Louis Peeraer
BACKGROUND: In transfemoral (TF) amputees, the forward propulsion of the prosthetic leg in swing has to be mainly carried out by hip muscles. With hip strength being the strongest predictor to ambulation ability, an active powered knee joint could have a positive influence, lowering hip loading and contributing to ambulation mobility. To assess this, gait of four TF amputees was measured for level walking, first while using a passive microprocessor-controlled prosthetic knee (P-MPK), subsequently while using an active powered microprocessor-controlled prosthetic knee (A-MPK)...
December 19, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28099186/poststroke-depression-risk-factors-and-potential-effects-on-functional-recovery
#2
Ozgur Z Karaahmet, Eda Gurcay, Ozlem C Avluk, Ebru K Umay, Ibrahim Gundogdu, Oznur Ecerkale, Aytul Cakci
The factors that may cause poststroke depression were investigated in the literature focusing on lesion localization, age, stroke severity, and impairments in physical and cognitive function. The aim of this study was to examine the risk factors influencing the development of poststroke depression and to determine the effect of depression on the patients' functional improvement after rehabilitation. Patients in the first 6-month period after stroke who were hospitalized in the Physical Medicine and Rehabilitation Clinic were included in this study...
January 17, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28087807/field-validation-of-the-los-angeles-motor-scale-as-a-tool-for-paramedic-assessment-of-stroke-severity
#3
Joon-Tae Kim, Pil-Wook Chung, Sidney Starkman, Nerses Sanossian, Samuel J Stratton, Marc Eckstein, Frank D Pratt, Robin Conwit, David S Liebeskind, Latisha Sharma, Lucas Restrepo, May-Kim Tenser, Miguel Valdes-Sueiras, Jeffrey Gornbein, Scott Hamilton, Jeffrey L Saver
BACKGROUND AND PURPOSE: The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. METHODS: We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28079776/enhanced-recovery-program-and-length-of-stay-after-laparotomy-on-a-gynecologic-oncology-service-a-randomized-controlled-trial
#4
Elizabeth L Dickson, Erica Stockwell, Melissa A Geller, Rachel Isaksson Vogel, Sally A Mullany, Rahel Ghebre, Boris J N Witherhoff, Levi S Downs, Linda F Carson, Deanna Teoh, Michelle Glasgow, Matt Gerber, Colleen Rivard, Britt K Erickson, Jacob Hutchins, Peter A Argenta
OBJECTIVE: To estimate whether a rapid recovery program would reduce length of stay among patients undergoing laparotomy on a gynecologic oncology service. METHODS: We conducted a prospective, randomized, controlled trial comparing an enhanced recovery after surgery protocol with routine postoperative care among women undergoing laparotomy on the gynecologic oncology service. Protocol elements included: preoperative counseling, regional anesthesia, intraoperative fluid restriction, and early postoperative ambulation and feeding...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28072708/life-threatening-motor-vehicle-crashes-in-bright-sunlight
#5
Donald A Redelmeier, Sheharyar Raza
: Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight.This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28066521/interventions-to-manage-residual-limb-ulceration-due-to-prosthetic-use-in-individuals-with-lower-extremity-amputation-a-systematic-review-of-the-literature
#6
M Jason Highsmith, Jason T Kahle, Tyler D Klenow, Casey R Andrews, Katherine L Lewis, Rachel C Bradley, Jessica M Ward, John J Orriola, James T Highsmith
Patients with lower extremity amputation (LEA) experience 65% more dermatologic issues than non-amputees, and skin problems are experienced by ≈75% of LEA patients who use prostheses. Continuously referring LEA patients to a dermatologist for every stump related skin condition may be impractical. Thus, physical rehabilitation professionals should be prepared to recognize and manage common non-emergent skin conditions in this population. The purpose of this study was to determine the quantity, quality, and strength of available evidence supporting treatment methods for prosthesis-related residual limb (RL) ulcers...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28062325/a-system-based-nursing-approach-to-improve-outcomes-in-the-postoperative-esophagectomy-patient
#7
REVIEW
Susan Collazo, Nicole L Graf
OBJECTIVE: To review essential nursing implications in the care of postoperative esophagectomy patients. DATA SOURCES: Peer-reviewed literature, institutional experience, journal articles. CONCLUSION: Utilizing a system-based approach to assess the post-esophagectomy patient will assist the nurse in ensuring safe and comprehensive care. IMPLICATIONS FOR NURSING PRACTICE: Nursing care measures to reduce perioperative esophagectomy morbidity includes aggressive fluid management, pain management, use of epidural analgesia, and early ambulation...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28050911/caring-for-elder-patients
#8
Karin Nordström, Tenzin Wangmo
BACKGROUND: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. OBJECTIVES: The goal was to understand caregivers' concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28050391/comparison-of-efficacy-and-safety-of-intramuscular-piroxicam-and-tramadol-for-post-operative-pain-in-patients-undergoing-caesarean-delivery
#9
Tejashree Thippeswamy, Bhuvana Krishnaswamy, Girish M Bengalorkar, Narayanaswamy Mariyappa
INTRODUCTION: Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child. AIM: To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain. MATERIALS AND METHODS: Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28042882/systematic-review-describing-the-effect-of-early-mobilization-after-dysvascular-major-lower-limb-amputations
#10
REVIEW
Ulla Riis Madsen, Ami Hommel, Connie Bøttcher Berthelsen, Carina Bååth
AIMS AND OBJECTIVES: To assess the effect of early mobilization of patients after dysvascular lower limb amputation and to compare the effectiveness of different mobilization regimens. BACKGROUND: Patients who have undergone dysvascular major lower limb amputations are at high risk of postoperative complications, which include loss of basic functions, and early mobilization interventions might prevent these complications. DESIGN: Systematic review...
January 2, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28033266/combined-adductor-canal-block-with-periarticular-infiltration-versus-periarticular-infiltration-for-analgesia-after-total-knee-arthroplasty
#11
Jinhui Ma, Fuqiang Gao, Wei Sun, Wanshou Guo, Zirong Li, Weiguo Wang
BACKGROUND: Both adductor canal block (ACB) and periarticular infiltration (PI) have been shown to reduce pain after total knee arthroplasty (TKA) without the motor blockade. However, the efficacy and safety of combined ACB with PI (ACB + PI) as compared to PI alone for analgesia after TKA remains controversial. We therefore performed a meta-analysis to compare the effects of ACB + PI with PI alone on pain controll after TKA. METHODS: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify studies comparing ACB + PI with PI alone for TKA patients...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029270/intervening-to-reduce-the-risk-of-future-disability-from-multiple-sclerosis-are-we-there-yet
#12
Maurice Dahdaleh, Raed Alroughani, Mohammed Aljumah, Abdulrahman AlTahan, Issa Alsharoqi, Saeed A Bohlega, Abdulkader Daif, Dirk Deleu, Jihad Inshasi, Rana Karabudak, Mohammed A Sahraian, Karim Taha, Bassem I Yammout, Magd Zakaria
Disease-modifying therapies (DMTs) delay or may prevent the progression of patients with high-risk clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (MS), and from relapsing-remitting MS to secondary progressive MS. Current evidence on the effects of DMT on disability in MS is supported by the use of the Expanded Disability Status Scale (EDSS), which is dominated by ambulation, and usually used as a secondary outcome measure. Less is known about the long-term effects of DMTs on other aspects of functional status, particularly cognition, which is a key determinant of ability to work...
December 28, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28018063/endoprosthetic-reconstruction-for-metastatic-phaeochromocytoma-in-the-distal-femur-a-case-report
#13
Kanchana Pala Srikanth, Chirukuri Srinivas, Lakshmipura Gangadharaiah Gowrishankarswamy, Chikkamuniyappa Chandrasekar
Metastatic spread of malignant phaeochromocytoma is known to involve multiple organs including the axial skeleton. Its presentation as a solitary lesion in the long bones of the extremities is extremely rare. We report a unique case of solitary metastatic phaeochromocytoma presenting in the distal femur, 16 years after excision of primary abdominal tumor. A 60 year old female, operated for adrenal phaeochromocytoma 16 years back was detected to have a bone tumor in her left distal femur. Chest and abdominal CT evaluation including bone scintigraphy confirmed the lesion to be solitary...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28005912/benchmarking-prehospital-and-emergency-department-care-for-argentine-children-with-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#14
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Gustavo J Petroni, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Anthony Fabio, Michael J Bell
OBJECTIVE: There is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0)...
2016: PloS One
https://www.readbyqxmd.com/read/27999675/mechanical-insufflation-exsufflation-for-an-individual-with-duchenne-muscular-dystrophy-and-a-lower-respiratory-infection
#15
Emma Koenig, Bhajan Singh, Jamie Wood
Duchenne muscular dystrophy (DMD) is an X-linked recessive myopathy associated with progressive muscle weakness and wasting, loss of ambulation, respiratory insufficiency, weak cough, repeated respiratory infections, and ultimately death from respiratory failure in early adulthood. Mechanical insufflation-exsufflation (MI-E) devices, such as the CoughAssist®, are used in individuals with neuromuscular weakness to augment cough and help clear secretions; however, there is no consensus on the optimal treatment regimen...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/27992417/mutations-in-the-histone-methyltransferase-gene-kmt2b-cause-complex-early-onset-dystonia
#16
Esther Meyer, Keren J Carss, Julia Rankin, John M E Nichols, Detelina Grozeva, Agnel P Joseph, Niccolo E Mencacci, Apostolos Papandreou, Joanne Ng, Serena Barral, Adeline Ngoh, Hilla Ben-Pazi, Michel A Willemsen, David Arkadir, Angela Barnicoat, Hagai Bergman, Sanjay Bhate, Amber Boys, Niklas Darin, Nicola Foulds, Nicholas Gutowski, Alison Hills, Henry Houlden, Jane A Hurst, Zvi Israel, Margaret Kaminska, Patricia Limousin, Daniel Lumsden, Shane McKee, Shibalik Misra, Shekeeb S Mohammed, Vasiliki Nakou, Joost Nicolai, Magnus Nilsson, Hardev Pall, Kathryn J Peall, Gregory B Peters, Prab Prabhakar, Miriam S Reuter, Patrick Rump, Reeval Segel, Margje Sinnema, Martin Smith, Peter Turnpenny, Susan M White, Dagmar Wieczorek, Sarah Wiethoff, Brian T Wilson, Gidon Winter, Christopher Wragg, Simon Pope, Simon J H Heales, Deborah Morrogh, Alan Pittman, Lucinda J Carr, Belen Perez-Dueñas, Jean-Pierre Lin, Andre Reis, William A Gahl, Camilo Toro, Kailash P Bhatia, Nicholas W Wood, Erik-Jan Kamsteeg, Wui K Chong, Paul Gissen, Maya Topf, Russell C Dale, Jonathan R Chubb, F Lucy Raymond, Manju A Kurian
Histone lysine methylation, mediated by mixed-lineage leukemia (MLL) proteins, is now known to be critical in the regulation of gene expression, genomic stability, cell cycle and nuclear architecture. Despite MLL proteins being postulated as essential for normal development, little is known about the specific functions of the different MLL lysine methyltransferases. Here we report heterozygous variants in the gene KMT2B (also known as MLL4) in 27 unrelated individuals with a complex progressive childhood-onset dystonia, often associated with a typical facial appearance and characteristic brain magnetic resonance imaging findings...
December 19, 2016: Nature Genetics
https://www.readbyqxmd.com/read/27987468/neurotomy-of-the-rectus-femoris-nerve-short-term-effectiveness-for-spastic-stiff-knee-gait-clinical-assessment-and-quantitative-gait-analysis
#17
R Gross, J Robertson, F Leboeuf, O Hamel, S Brochard, B Perrouin-Verbe
BACKGROUND: Stiff knee gait is a troublesome gait disturbance related to spastic paresis, frequently associated with overactivity of the rectus femoris muscle in the swing phase of gait. OBJECTIVE: The aim of this study was to assess the short-term effects of rectus femoris neurotomy for the treatment of spastic stiff-knee gait in patients with hemiparesis. PATIENTS AND METHODS: An Intervention study (before-after trial) with an observational design was carried out in a university hospital...
November 19, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27965279/sex-differences-in-prodromal-symptoms-in-acute-coronary-syndrome-in-patients-aged-55%C3%A2-years-or-younger
#18
Nadia A Khan, Stella S Daskalopoulou, Igor Karp, Mark J Eisenberg, Roxanne Pelletier, Meytal Avgil Tsadok, Kaberi Dasgupta, Colleen M Norris, Louise Pilote
BACKGROUND: Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS). OBJECTIVES: To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients. METHODS: Prospective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged ≤55 years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009-April 2013)...
December 13, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27951536/glial-fibrillary-acidic-protein-for-prehospital-diagnosis-of-intracerebral-hemorrhage
#19
Michal Rozanski, Carolin Waldschmidt, Alexander Kunz, Ulrike Grittner, Martin Ebinger, Matthias Wendt, Benjamin Winter, Kerstin Bollweg, Kersten Villringer, Jochen B Fiebach, Heinrich J Audebert
BACKGROUND: Both, acute ischemic stroke (AIS) and hemorrhage stroke (intracerebral hemorrhage, ICH) require early attention but different treatment strategies. Plasma glial fibrillary acidic protein (GFAP) levels were found to be elevated in ICH patients after they arrived in the hospital. Because treatment options differed, we sought to determine whether GFAP can be used to accurately differentiate between of AIS and ICH in the prehospital setting. METHODS: We assessed acute stroke patients in the Stroke Emergency Mobile (STEMO)...
December 13, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27930356/impact-of-insurance-status-on-outcomes-and-use-of-rehabilitation-services-in-acute-ischemic-stroke-findings-from-get-with-the-guidelines-stroke
#20
Laura N Medford-Davis, Gregg C Fonarow, Deepak L Bhatt, Haolin Xu, Eric E Smith, Robert Suter, Eric D Peterson, Ying Xian, Roland A Matsouaka, Lee H Schwamm
BACKGROUND: Insurance status affects access to care, which may affect health outcomes. The objective was to determine whether patients without insurance or with government-sponsored insurance had worse quality of care or in-hospital outcomes in acute ischemic stroke. METHODS AND RESULTS: Multivariable logistic regressions with generalized estimating equations stratified by age under or at least 65 years were adjusted for patient demographics and comorbidities, presenting factors, and hospital characteristics to determine differences in in-hospital mortality and postdischarge destination...
November 14, 2016: Journal of the American Heart Association
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