Achiléa Lisboa Bittencourt
Full Text Available It is presented a case of auricular chromoblastomycosis mimicking an eczematous lesion. The authors refer the rarity of this localization. All reported cases of auricular chromoblastomycosis have been caused by Fonsecaea pedrosoi but in the present case the etiologic agent was Phialophora verrucosa.É apresentado um caso de cromoblastomicose auricular apresentado sob forma de lesão eritemato-escamosa, tendo tido o diagnóstico clínico de eczema. Os AA discutem sobre a raridade desta localização e aspecto clínico. Embora os poucos casos relatados de cromoblastomicose auricular tenham sido causados pela Fonsecaea pedrosoi, neste o agente etiológico foi a Phialophora verrucosa.
Wright, Robert F; Zemnick, Candice; Wazen, Jack J; Asher, Eric
The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment. Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance. Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction. The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of
Yotsuyanagi, Takatoshi; Yamauchi, Makoto; Yamashita, Ken; Sugai, Asuka; Gonda, Ayako; Kitada, Ayaka; Saito, Tamotsu; Urushidate, Satoshi
It has been suggested that there is a close association of abnormality in auricular muscles with various congenital auricular deformities. However, there has been no investigation to determine what muscles are involved and how they affect the deformity. The authors examined abnormalities of auricular muscles for patients with various auricular deformities. The authors examined 77 auricles of 62 patients with congenital auricular deformities, including cryptotia, Stahl's ear, prominent ear, lop ear, and others. The superior and posterior auricular muscles from the extrinsic auricular muscle group and the auricular oblique and transverse muscles from the auricular intrinsic muscle group were investigated. The authors found characteristic features of the abnormality of the muscle for each auricular deformity. In nearly all cases of cryptotia, abnormality was found in the superior auricular, auricular oblique, and auricular transverse muscles. Abnormal insertion was found mainly in the superior auricular muscle and was the main cause of cryptotia. In Stahl's ear, the major abnormality was abnormal insertion of the auricular transverse muscle, which creates an abnormal cartilaginous prominence in the scapha. The abnormality in cases of prominent ear was clearly limited mostly to the auricular transverse muscle and, in some cases, to the posterior auricular muscle. In lop ear, abnormality was mostly found in the auricular transverse muscle, with elongation, and in the superior auricular or auricular oblique muscle in some cases. There is a tendency for a specific muscle abnormality to be found in each deformity. It is important to identify the abnormal muscle and correct the abnormality during the operation.
Georgios S. Papadopoulos
Full Text Available We report a case of thoracic trauma (rib fractures with pneumothorax and pulmonary contusions with severe chest pain leading to ineffective ventilation and oxygenation. The patient presented to our emergency department. The patient had chronic obstructive pulmonary disease and was completely unable to take deep breaths and clear secretions from his bronchial tree. After obtaining informed consent, we applied auricular acupuncture to ameliorate pain and hopefully improve his functional ability to cough and breathe deeply. Within a few minutes, his pain scores diminished considerably, and his ventilation and oxygenation indices improved to safe limits. Auricular acupuncture analgesia lasted for several hours. Parallel to pain reduction, hemodynamic disturbances and anxiety significantly resolved. A second treatment nearly a day later resulted in almost complete resolution of pain that lasted at least 5 days and permitted adequate ventilation, restored oxygenation, and some degree of mobilization (although restricted due to a compression fracture of a lumbar vertebra. Nonopioid and opioid analgesics were sparsely used in low doses during the entire hospitalization period. Hemodynamic alterations and anxiety also decreased, and the patient was soon ready to be discharged.
Jeon, Younghoon; Kim, Saeyoung
The great auricular nerve can be damaged by the neck surgery, tumor, and long-time pressure on the neck. But, great auricular neuralgia is very rare condition. It was managed by several medication and landmark-based great auricular nerve block with poor prognosis. A 25-year-old man presented with a pain in the left lateral neck and auricle. He was diagnosed with great auricular neuralgia. His pain was not reduced by medication. Therefore, the great auricular nerve block with local anesthetics and steroid was performed under ultrasound guidance. Ultrasound guided great auricular nerve block alleviated great auricular neuralgia. This medication-resistant great auricular neuralgia was treated by the ultrasound guided great auricular nerve block with local anesthetic agent and steroid. Therefore, great auricular nerve block can be a good treatment option of medication resistant great auricular neuralgia.
A.L. Sesman Bernal
tejido autólogo o de material aloplástico y en los que la reconstrucción se inicia de forma tardía, proporciona una excelente opción de tratamiento, con muy buen resultado desde el punto de vista estético y de satisfacción para el paciente, así como con poca o nula morbilidad.Our goal is to demonstrate that the use of osseointegrated materials allows us to achieve a proper fixation of auricular prosthesis with a minimum degree of morbidity in children from 6 years without antecedent of reconstruction and in cases in which other reconstructive methods have failed. We introduce the experience of auricular reconstruction with osseointegrated implants in the National Institute of Pediatrics, México DF, from January 2007 to November 2009. Patients are selected from the age of 6, but mainly those in which other techniques have not had adequate results from the aesthetic point of view, and in those in which reconstruction started in late way (between 12-17 years, using more complicated autologous tissue and with less time to finish the reconstructive procedures before the age of 18 years. We present auricular malformations reconstructed in our hospital; some of these children had been treated from birth for this cause (up to 17 years; patients in which the aesthetic results with autologous tissue, Medpore® implants or tissue expansion have not been satisfactory or cases in which two or more techniques have been used for the same patient, presenting high morbidity and unacceptable esthetic results. Also, patients 9 years old who suffered this procedure as first intention. For us all of these cases have had an excellent aesthetic results with a 100 % patient satisfaction. Auricular reconstruction with osseointegrated implants, is an internationally accepted procedure for those patients with individual characteristics that determine the type of reconstruction as well as the experience of the physician, but in our particular case, for patients with failure of the
Full Text Available Differences in the balance of shape, size, and position of body organs are immediately perceived as "looking wrong" and this perception can subject the individual to significant peer ridicule and social ostracism, often expressing as intense shame and anguish in the attitude of the afflicted. Rehabilitation of such patients can be remarkably beneficial on the individual′s self-esteem and body image. The onus of the deed lies in the hands of a team that combines artistic excellence with surgical expertise, by combining the skills of anaplastologists, surgeons, and prosthodontists. This is a review of a few surgical and prosthetic considerations in the management of auricular defect and a case description of management of a patient of microtia following similar guidelines in fabrication of the epithesis.
Tokugawa, Joji; Nakao, Yasuaki; Kudo, Kentaro; Iimura, Koji; Esaki, Takanori; Yamamoto, Takuji; Mori, Kentaro
The posterior auricular artery (PAA) is one of the branches of the external carotid artery, but is usually too small for use as a donor artery for middle cerebral artery (MCA) territory revascularization. An extremely unusual case of PAA-MCA anastomosis was performed in a patient requiring MCA territory revascularization because the superficial temporal artery (STA) parietal branch was absent and the PAA was large enough. A 65-year-old man developed mild motor weakness in the right extremities caused by multiple small infarctions. Single photon emission computed tomography (CT) revealed deterioration of the vascular reserve capacity in the left MCA area. Cerebral angiography showed severe stenosis in the C2 portion of the left internal carotid artery, absence of the parietal branch of the left STA, and a well-developed PAA extending to the parietal area. The patient underwent STA (frontal branch)-MCA and PAA-MCA double anastomosis, and has suffered no stroke or transient ischemic attack. The STA with no bifurcation is known as a rare variation. The PAA also occurs with size variations but well-developed PAA is thought to be extremely rare. PAA can be used as a donor artery for MCA territory revascularization if the vessel size is suitable. Preoperative evaluation of the anatomy is mandatory for harvesting the arteries.
TOKUGAWA, Joji; NAKAO, Yasuaki; KUDO, Kentaro; IIMURA, Koji; ESAKI, Takanori; YAMAMOTO, Takuji; MORI, Kentaro
The posterior auricular artery (PAA) is one of the branches of the external carotid artery, but is usually too small for use as a donor artery for middle cerebral artery (MCA) territory revascularization. An extremely unusual case of PAA-MCA anastomosis was performed in a patient requiring MCA territory revascularization because the superficial temporal artery (STA) parietal branch was absent and the PAA was large enough. A 65-year-old man developed mild motor weakness in the right extremities caused by multiple small infarctions. Single photon emission computed tomography (CT) revealed deterioration of the vascular reserve capacity in the left MCA area. Cerebral angiography showed severe stenosis in the C2 portion of the left internal carotid artery, absence of the parietal branch of the left STA, and a well-developed PAA extending to the parietal area. The patient underwent STA (frontal branch)-MCA and PAA-MCA double anastomosis, and has suffered no stroke or transient ischemic attack. The STA with no bifurcation is known as a rare variation. The PAA also occurs with size variations but well-developed PAA is thought to be extremely rare. PAA can be used as a donor artery for MCA territory revascularization if the vessel size is suitable. Preoperative evaluation of the anatomy is mandatory for harvesting the arteries. PMID:24140773
Auricular acupuncture is a method which has been successfully used in various fields of medicine especially in the treatment of pain relief. The introduction of lasers especially low-level lasers into medicine brought besides the already existing stimulation with needles and electricity an additional technique to auricular acupuncture. This literature research looks at the historical background, the development and the anatomical and neurological aspects of auricular acupuncture in general and auricular laser acupuncture in detail. Preliminary scientific findings on auricular acupuncture with laser have been described in detail and discussed critically in this review article. The results of the studies have shown evidence of the effect of auricular laser acupuncture. However, a comparison of these studies was impossible due to their different study designs. The most important technical as well as study parameters were described in detail in order to give more sufficient evidence and to improve the quality of future studies. PMID:23935695
Watanabe, Kentaro; Tubbs, R Shane; Satoh, Shunsuke; Zomorodi, Ali R; Liedtke, Wolfgang; Labidi, Moujahed; Friedman, Allan H; Fukushima, Takanori
Glossopharyngeal, nervus intermedius, and vagus neuralgias can all present with ear pain. However, to our knowledge, there have been no reports of otalgia as the only symptom of vagus neuralgia. The seventh, ninth, and tenth cranial nerves have many interneural connections, and the exact anatomy and pathophysiology of these neuralgias are often not clear. Moreover, symptoms due to involvement of any of these nerves can be difficult to attribute solely to 1 of them. The overlapping sensory innervation of the external auditory canal can lead to misdiagnosis in patients suffering from otalgia. This report presents a case of pure otalgia due to vascular compression of the vagus nerve (VN) and considers the microanatomic differences between glossopharyngeal and nervus intermedius neuralgia via cadaveric dissections. We report 2 cases of external auditory canal pain that continued following microvascular treatment of trigeminal neuralgia. Intraoperatively and at secondary operation, the posterior inferior cerebellar artery was found to be adherent and to penetrate between the fibers of the VN. Following microvascular treatment of the VN, the pain resolved. This is the first report of vagus neuralgia presenting solely with ear pain. Surgeons should be aware that primary external auditory canal pain can be due to vagus neuralgia via its auricular branch and that such patients can be misdiagnosed with glossopharyngeal or nervus intermedius neuralgias. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Wong Chung, J.E.; Chussi, D.C; Heerbeek, N. van
BACKGROUND: The auricles are easily injured or amputated in case of head trauma. Inadequate treatment of the external auditory canal (EAC) after auricular injury is often seen and can lead to significant complications of the EAC. CASE REPORT: The authors report 4 cases of auricular injury or
Kotian Rashmishree R, Vinuta Hegde, Atul P. Sattur , Krishna N. Burde, Venkatesh G. Naikmasur
Full Text Available Goldenhar’s Syndrome (GS is a rare condition described initially by Von Arlt. It is characterized by a combination of anomalies: epibulbar tumors, preauricular tags and malformation of the ears. In 1963, Gorlin suggested the name oculo-auriculo-vertebral (OAV dysplasia for this condition and also included vertebral anomalies as signs of the syndrome. The malformations are said to arise from the first and second branchial arches. This work reports a case of GS in 11-years-old boy with the clinical signs of pseudo macrostomia, preauricular tags and epibulbar tumours.
K S Kedareshvara
Full Text Available A 12 year old girl child from the department of Ophthalmology posted for right eye limbal dermoid excision. Opthlamic examination and history revealed bilateral restricted eye movements, limbal dermoids, and decreased vision since birth. Fundus examination showed pathological myopia. There were multiple preauricular appendages in front of both ears. The lateral X-ray of cervical spine showed fused second and third cervical vertebra with loss of intervertebral disc space. Chest X-ray showed scoliosis of Cervico-Thorasic vertebra with convexity to right. Clinical examination of the airway revealed restricted head and neck movements with Mallampatti class II which indicates difficult intubation. The history, clinical examination and radiological findings confirmed her to be a case of Goldenhar syndrome. Difficult airway continues to be a major cause of anaesthesia related complications. Therefore fibre optic intubation under regional nerve block and sedation was planned for the surgery. Lack of associated cardiac and neurological anomalies encouraged us to present the advantage of fibre optic intubation. The larynx was adequately relaxed because of regional nerve block which helped us by decreasing the number of attempt of scopy and vocal cords injury. The intraoperative and postoperative period was uneventful.
Stuyt, Elizabeth B; Voyles, Claudia A; Bursac, Sara
Background: The National Acupuncture Detoxification Association (NADA) protocol, a simple standardized auricular treatment has the potential to provide vast public health relief on issues currently challenging our world. This includes but is not limited to addiction, such as the opioid epidemic, but also encompasses mental health, trauma, PTSD, chronic stress, and the symptoms associated with these conditions. Simple accessible tools that improve outcomes can make profound differences. We assert that the NADA protocol can have greatest impact when broadly applied by behavioral health professionals, Auricular Detoxification Specialists (ADSes). Methods: The concept of ADS is described and how current laws vary from state to state. Using available national data, a survey of practitioners in three selected states with vastly different laws regarding ADSes, and interviews of publicly funded programs which are successfully incorporating the NADA protocol, we consider possible effects of ADS-friendly conditions. Results: Data presented supports the idea that conditions conducive to ADS practice lead to greater implementation. Program interviews reflect settings in which adding ADSes can in turn lead to improved outcomes. Discussion: The primary purpose of non-acupuncturist ADSes is to expand the access of this simple but effective treatment to all who are suffering from addictions, stress, or trauma and to allow programs to incorporate acupuncture in the form of the NADA protocol at minimal cost, when and where it is needed. States that have changed laws to allow ADS practice for this standardized ear acupuncture protocol have seen increased access to this treatment, benefiting both patients and the programs.
Full Text Available Apresentamos o caso de um homem de 55 anos, com hepatite C crónica e com um volumoso hepatocarcinoma, cuja apresentação inicial foi como massa auricular direita. Apesar de ter sido descrita previamente a extensão endovascular deste tipo de tumor até ao interior das cavidades cardíacas direitas, a raridade e exuberância das imagens de ecocardiograma e TAC tornam invulgar e excepcional este caso.
Tokugawa, Joji; Cho, Narisumi; Suzuki, Hiroharu; Sugiyama, Natsuki; Akiyama, Osamu; Nakao, Yasuaki; Yamamoto, Takuji
To investigate the length variation of the posterior auricular artery and propose a novel classification of the posterior auricular artery based on angiographical appearance. A series of 234 consecutive patients who had undergone conventional cerebral angiography was analyzed. The posterior auricular artery was examined on the lateral projection of the external carotid or common carotid arteriography. The posterior auricular artery was classified into four groups by length, using the external auditory canal and the top of the helix as radiographical landmarks. Our proposed classification is as follows: Type A, posterior auricular artery terminates between its origin and the center of the external auditory canal; Type B, posterior auricular artery terminates between the center of the external auditory canal and the top of the helix; Type C, posterior auricular artery terminates between the top of the helix and the vertex; and Type D, posterior auricular artery reaches up to the vertex. A total of 424 (right, 214; left, 210) posterior auricular arteries were analyzed in 111 men and 123 women aged 11 to 91 years (mean, 61.0 years) examined for aneurysms in 78 cases, occlusive vascular diseases in 56, intracranial hemorrhages in 41, tumors in 35, and others in 24. Types A, B, C, and D were found in 15.1%, 34.9%, 48.8%, and 1.2% of the patients, respectively. A novel classification of the posterior auricular artery identifies four types based on its length on cerebral angiography.
Full Text Available To investigate the length variation of the posterior auricular artery and propose a novel classification of the posterior auricular artery based on angiographical appearance.A series of 234 consecutive patients who had undergone conventional cerebral angiography was analyzed. The posterior auricular artery was examined on the lateral projection of the external carotid or common carotid arteriography. The posterior auricular artery was classified into four groups by length, using the external auditory canal and the top of the helix as radiographical landmarks. Our proposed classification is as follows: Type A, posterior auricular artery terminates between its origin and the center of the external auditory canal; Type B, posterior auricular artery terminates between the center of the external auditory canal and the top of the helix; Type C, posterior auricular artery terminates between the top of the helix and the vertex; and Type D, posterior auricular artery reaches up to the vertex.A total of 424 (right, 214; left, 210 posterior auricular arteries were analyzed in 111 men and 123 women aged 11 to 91 years (mean, 61.0 years examined for aneurysms in 78 cases, occlusive vascular diseases in 56, intracranial hemorrhages in 41, tumors in 35, and others in 24. Types A, B, C, and D were found in 15.1%, 34.9%, 48.8%, and 1.2% of the patients, respectively.A novel classification of the posterior auricular artery identifies four types based on its length on cerebral angiography.
Joshi, Minal; Cheng, Ruth; Kamath, Hattiyangadi; Yarmush, Joel
Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position. The GAN, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. We recommend that for the procedures of the beach chair position, the auricle be protected and covered with cotton and gauze to avoid direct compression and the position of the head and neck be checked and corrected frequently.
Tarkan, Ö; Çetık, F; Uzun, S
Leishmaniasis comprises a group of diseases transmitted by the bite of infected sand flies. There are three basic clinical forms of leishmaniasis: cutaneous, mucocutaneous and visceral. Leishmaniasis may mimic neoplastic lesions and other infectious diseases because of similar disease localisation, physical characteristics and histopathological findings. A 35-year-old man was referred to our clinic with a presumed diagnosis of angiolymphoid hyperplasia of the auricle; however, this lesion proved to be cutaneous leishmaniasis. The definitive diagnosis was reached by identifying the parasites on smears obtained from the lesion. It should be borne in mind that cutaneous leishmaniasis presenting as isolated auricular lesions may mimic neoplasia. In the present case report, we discuss auricular cutaneous leishmaniasis and we review the relevant literature.
Full Text Available Minal Joshi,1 Ruth Cheng,2 Hattiyangadi Kamath,1 Joel Yarmush1 1Department of Anesthesiology, New York Methodist Hospital, New York, NY, USA; 2School of Medicine, St. George’s University, Grenada, West Indies Abstract: Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position. The GAN, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. We recommend that for the procedures of the beach chair position, the auricle be protected and covered with cotton and gauze to avoid direct compression and the position of the head and neck be checked and corrected frequently. Keywords: neuropraxia, anesthesia, arthroscopy, great auricular nerve
Lo Buono, Viviana; Corallo, Francesco; De Cola, Maria Cristina; Chillemi, Antonino; Grugno, Rosario; Bramanti, Placido; Marino, Silvia
We describe the effectiveness of rehabilitative training for a neuropsychological deficit following the removal and treatment of a fibrillary astrocytoma (Grade II) in a young man. The rehabilitative training was based on cognitive and motivational techniques and has been carried out for a period of 3 months (2 times per week). The results, even if limited to a single case, seem to support the idea that cognitive rehabilitation should facilitate the brain's reorganization of basic cognitive functions in the neuro-oncologic field.
Roessler, Richard T.; Rubin, Stanford E.
"Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…
Carlisi, E; Pavese, C; Mandrini, S; Carenzio, G; Dalla Toffola, E
Although the diagnosis of and therapy for acute disseminated encephalomyelitis (ADEM) have been extensively investigated, the role of rehabilitation in modifying its functional outcome has received little attention in the literature so far. We report a case of pediatric ADEM who showed complete functional recovery following early rehabilitative treatment, started in the Intensive Care Unit.
Dunham, Brian; Guttenberg, Martha; Morrison, Wynne; Tom, Lawrence
To determine the histologic relationship and distance between excised preauricular epithelial sinus tract and the adjacent auricular cartilage (sinocartilaginous distance) in a series of patients. The excision of preauricular sinuses is a common surgical procedure. Recurrences are frequent and can be technically challenging. While advocated by several authors, the surgical removal of adjacent auricular cartilage is not universally performed. Retrospective case series. Children's Hospital of Philadelphia. Fifty-two pediatric patients who underwent surgical excision of preauricular sinus tracts and adjacent auricular cartilage. Between September 1, 2005, and July 31, 2007, the preauricular sinus tracts and adjacent auricular cartilage were excised from 52 pediatric patients. A pathologist reviewed a total of 58 specimens to determine the relationship between epithelial tract and cartilage. The sinocartilaginous distance in microns. Patient ages ranged from 8 months to 17 years (mean age, 4 years). In all but 1 case, the tracts were in close proximity to the cartilage. The average sinocartilaginous distance was 472 mum (median distance, 400 mum); the 25th percentile was 250 mum. In over 50% of the specimens, the sinocartilaginous distance was less than 0.5 mm, and in nearly all of the these, the epithelial tract was in continuity with stromal tissue histologically indistinguishable from perichondrium. The observed sinocartilaginous distances suggest that it may be difficult to dissect most sinus tracts from the cartilage. The routine removal of a small portion of auricular cartilage along with the sinus tract may yield a more thorough excision and help to prevent recurrence.
Ng, Albert K H; Page, Richard S
Neuropraxia of the greater auricular nerve is an uncommon complication of shoulder surgery, with the patient in the beach chair position. The greater auricular nerve, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. In this case series, we present three cases of neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. We outline the risk of using devices of this nature and discourage the use of similar headrest devices due to the potential complications in headrest devices that exert pressure on the posterior auricular area to maintain head position during surgery.
... doing things you did before. This process is rehabilitation. Rehabilitation often focuses on Physical therapy to help your ... who has had a stroke may simply want rehabilitation to be able to dress or bathe without ...
Quintard, Benoît; Greunz, Eva Maria; Lefaux, Brice; Lemberger, Karin; Leclerc, Antoine
Squamous cell carcinoma (SCC) is well documented in snow leopards ( Uncia uncia ) and most common locations are oral, facial, or pedal. These two cases illustrate an unusual auricular presentation, which is more often reported in white domestic cats. The animals were aged and presented clinical signs of otitis such as head shaking and ear scratching. Clinical examinations showed auricular canal masses with chronic purulent otitis. In both cases, clinical deterioration led to euthanasia and histology of the ear canal was consistent with SCC and showed numerous vascular emboli. These cases illustrate an unreported aggressive localization for SCC in snow leopards, which should be included in the differential diagnosis of otitis in this species. Auricular SCC may be underdiagnosed as the ear canal is infrequently sampled for histopathology. This auricular localization should be considered when metastases are found upon necropsy without internal primary tumor.
Sato, M; Sugiyama, K; Kondo, T; Izumi, S-I
Single case report. We present a case of paraplegia due to neuromyelitis optica (NMO) with poor rehabilitation outcome. University hospital, Japan. A 27-year-old woman with NMO presented with T5 paraplegia of ASIA impairment scale grade A. Spinal cord magnetic resonance imaging revealed a lesion spanning C3 to L1 level. After acute phase treatment, flaccid paraplegia below T5 and a T2-weighted hyperintense lesion from T6 to T10 level remained. Rehabilitation aimed at independence of activities of daily living with wheelchair assistance, including transfer activity, was provided for 19 months. However, flaccid paralysis of the trunk and limbs persisted, and safe independent transfer was not achieved. Spinal lesions spanning many vertebral segments, a characteristic of NMO, can cause extensive flaccid paralysis of the trunk and limbs. Rehabilitation may achieve poorer functional recovery than that for spinal cord injury.
Kaplan, Steven P.
Agoraphobia is a pervasive constellation of fears and avoidance behaviors relating to open spaces, crowds, being alone, and other everyday situations. Presents the case of a client with agoraphobia on a medical rehabilitation unit. Outlines psychological interventions, giving discharge and follow-up status. Literature review focused on possible…
Liu, Juan; Liang-duo, Jiang; Zhao, Ji-ping
To probe into the correlativity of TCM syndromes to auricular points. Sixty-three cases of typical liver-qi stagnation syndrome and 52 healthy persons were divided into an observation group and a control group, respectively. The auricular points on both side were respectively detected by auricular point pressure pain method with spring pressure bar and a pressure of 50 g, and then the number of auricular points with positive response on both sides were respectively calculated and the positive rates between the two groups were compared. Can (liver), Shidao (esophagus), Sanjiao (triple energy), Pi (spleen), Yidan (pancreas and gall bladder), Tingzhong (center of superior concha), Wei (stomach), Shenmen had high tenderness positive rates, with significant differences between the liver-qi stagnation syndrome group and the healthy person group. The correlativity were Gan>Shidao>Sanjiao>Pi>Yidan>Tingzhong>Wei>Shenmen. TCM syndromes and auricular points have correlativity.
Full Text Available Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients, linked with morbidity, disability, and poor quality of life. As pharmacologic interventions have not yet proven effective in the treatment of cognitive deficits, cognitive rehabilitation could represent an alternative approach. This paper presents three case studies, describing the cognitive intervention and discussing its effectiveness in the light of current evidence.
Full Text Available Papillon-Lefevre syndrome is a rare recessive genetic disorder. The clinical manifestations include palmar-plantar hyperkeratosis with precocious rapidly progressive periodontal disease that results in premature exfoliation of primary and permanent dentitions. Patients are often edentulous at an early age. Here is the report of prosthodontic rehabilitation of a case of Papillon-Lefevre syndrome in a 6-year-old child.
Laures-Gore, Jacqueline; McCusker, Tiffany; Hartley, Leila L
Descriptions of speech-language interventions addressing the unique aspects of aphasia in adolescence appear to be nonexistent. The current paper presents the case of a male adolescent who experienced a stroke with resultant aphasia and the speech and language therapy he received. Furthermore, we discuss the issues that are unique to an adolescent with aphasia and how they were addressed with this particular patient. Traditional language and apraxia therapy was provided to this patient with inclusion of technology and academic topics. The patient demonstrated improvements in his speech and language abilities, most notably his reading comprehension and speech production. Age-related issues, including academic needs, group treatment, socialization, adherence/compliance, independence and family involvement, emerged during intervention. Although aphasia therapy for adolescents may be similar in many aspects to selected interventions for adults, it is necessary for the clinician to be mindful of age-related issues throughout the course of therapy. Goals and interventions should be selected based on factors salient to an adolescent as well as the potential long-term impact of therapy. Implications for Research Aphasia and its treatment in adolescence need to be further explored. Academics and technology are important aspects of aphasia treatment in adolescence. Issues specific to adolescence such as socialization, adherence/compliance, and independence are important to address in speech-language therapy.
Tolat, R D; O' Dell, M W; Golamco-Estrella, S P; Avella, H
Cocaine-associated stroke (CAS) is an important cause of disability, especially among younger adults. Improved management has increased survival but little has been discussed about rehabilitation, including medication management. Therefore, experience and therapeutic drug management are described during inpatient rehabilitation with three patients with CAS. Case 14 is a 50-year-old male with a history of hypertension who presented with right hemiparesis, aphasia and depression. He was treated with paroxetine for depression and bromocriptine for poor initiation with a good response, improving by 50 FIM points in 44 days. Case 2 is a 44 year-old female with quadriparesis, aphasia, and deficits in attention and initiation. Methylphenidate for attention deficits and bromocriptine for poor initiation was associated with an excellent functional gain (50 FIM points in 37 days). She eventually returned to work. Case 3 is a 46-year-old female with a history of hypertension who presented with right hemiparesis, aphasia and depression. Without neuropharmacologic intervention, she gained 35 FIM points during an uneventful 47 day rehabilitation stay. Acutely, cocaine can induce cerebral vasoconstriction, cerebrovascular spasm, cerebral vasculitis and intracerebral haemorrhage. Chronic use depletes and destroys dopaminergic pathways, which may be a major factor in depression, and attention and initiation deficits-all observed in these cases. Generally, rapid improvements were seen in mood and cognition in two cases where medication was used. Based on the current literature and pathophysiology of CAS, it is suggested that trials of dopaminergic agents for cognition and extremely cautious use of buproprion for depression may be warrented. Details of the above cases and the practical and theoretical issues of neuropharmacologic intervention in CAS are discussed.
Full Text Available Aim: In this paper we describe the physical therapy management of a 64-year-old female following a bilateral hip arthroplasty. Method: The patient featured in this study, after the surgical intervention had undergone specific recovery treatment consisting of: posture techniques, static (isometric contractions and dynamic kinetic techniques (passive motion, passive-actives, actives, actives with resistance, massage, respiratory gymnastics and reeducation of walking. Results: At the end of the rehabilitation program, hip muscular strength and joint range of motion were improved significantly. The Harris hip score was significantly improved, in comparison to the preoperative one. Conclusion: This case illustrates the importance of the rehabilitation management after bilateral hip replacement.
Lorna Kwai-Ping Suen
Full Text Available The ear has a reflexive property; therefore, various physical attributes may appear on the auricle when disorders of the internal organs or other parts of the body exist. Auricular diagnostics is an objective, painless, and noninvasive method that provides rapid access to information. Thus, the association between auricular signals and coronary heart disease (CHD should be further investigated. A case control study was conducted to determine the predictive value of auricular signals on 100 cases of CHD (CHD+ve = 50; CHD−ve = 50 via visual inspection, electrical skin resistance measurement, and tenderness testing. The results showed that the presence of an ear lobe crease (ELC was significantly associated with coronary heart disease. The “heart” zone of the CHD+ve group significantly exhibited higher conductivity on both ears than that of the controls. The CHD+ve group experienced significant tenderness in the “heart” region compared with those in the CHD−ve group in both acute and chronic conditions. Further studies that take into consideration the impact of age, race, and earlobe shape on ELC prevalence in a larger sample should be done.
Latuska, Richard F; Carlson, Matthew L; Neff, Brian A; Driscoll, Colin L; Wanna, George B; Haynes, David S
To raise awareness of the potential hazard of auricular burns associated with operating microscope use during otologic surgery. Retrospective case series and summary of the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database of voluntary adverse event reports pertaining to microscope related auricular thermal injuries. All patients who sustained auricular burns while using the operating microscope during otologic surgery at 2 tertiary academic referral centers. Surgical procedure, microscope model, intensity of illumination, length of procedure, focal length, location and severity of burn, and patient outcome. A total of 4 microscope-related auricular thermal injuries were identified from the authors' institutions. Additionally, 82 unique cases of soft tissue burns associated with the use of an operative microscope have been voluntarily reported to the FDA since 2004. A disproportionately large percent (∼ 30%) of these occurred within the field of otology, the majority of which were during tympanoplasty or tympanomastoidectomy procedures at focal length distances of 300 mm or less with xenon light source microscopes. Simultaneous advancements in light delivery technologies and lens optics have continued to improve the efficiency of the operating microscope; however, these improvements also increase the potential for thermal injuries. Although rare, a review of the FDA MAUDE database suggests that microscope-related soft tissue burns occur more frequently in otology than any other surgical specialty. A variety of factors may help explain this finding, including the unique anatomy of the external ear with thin skin and limited underlying adipose tissue. Preventative measures should be taken to decrease the risk of thermal injuries including use of the lowest comfortable light intensity, adjusting the aperture width to match the operative field, frequent wound irrigation, and covering exposed portions of the pinna
Torazawa, Seiei; Hasegawa, Hirotaka; Kin, Taichi; Sato, Hiroaki; Sora, Shigeo
Direct extracranial-intracranial (EC-IC) bypass is one of the fundamental techniques to prevent recurrent stroke in patients with adult-onset ischemic moyamoya disease. When the standard superficial temporal artery (STA) cannot be used for a graft, the posterior auricular artery (PAA) can be a potential surrogate graft. In this article, the authors reported a 34-year-old female patient suffering from ischemic moyamoya disease. To widely revascularize the anterior half of the hemisphere, direct double EC-IC bypass was considered beneficial; however, she had only a single-branched STA but had a prominent branch of the PAA. After discussion, a direct double surgical revascularization was successfully performed using a combination of the STA-middle cerebral artery (MCA) and the PAA-MCA bypass. The authors herein reported the detailed surgical technique of the PAA-MCA bypass with an informative video of the actual procedure. To clearly define the feasibility of PAA-MCA bypass, the authors also conducted a literature review, yielding 3 previous articles describing the bypass. In conclusion, the PAA becomes a potential donor for EC-IC bypass as long as its diameter is approximately 1.0 mm. Even though the PAA-MCA bypass is not primarily considered in the initial revascularization, it can be useful as a combination bypass with other grafts or as a rescue for recurrent ischemia. Copyright © 2017 Elsevier Inc. All rights reserved.
Zhao, Jingjun; Rong, Peijing; Zhu, Bing
Epilepsy is a group of chronic diseases characterized by recurrent and transient brain dysfunction induced by abrupt and intermittent abnormal discharge of neurons in the brain, which is difficult to be cured. Thee auricular concha are is he zone of visera in TCM auricular points, but also the innervating area of the auricular brach of the vagus nerve. Auricular acupuncture, as a special treatment, has superior therapeutic effect for epilepsy. In recent years, remarkable progress has been made in the theoretical basis and clinic application of auricular acupuncture for epilepsy, and the ear-vagus percutaneous electrical stimulation apparatus (auricular acupuncture apparatus) is developed for clinical trial researches. From the basic study to clinical research of auricular acupuncture for epilepsy, the epilepsy pathogenesis as well as the intervention pathway and clinical efficacy of auricular: experimental support and rich clinical experience for auricular acupuncture apparatus.
Cler, Gabriel J; Mittelman, Talia; Braden, Maia N; Woodnorth, Geralyn Harvey; Stepp, Cara E
Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Results suggest that video game-based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. https://doi.org/10.23641/asha.5116828.
Tsoupikova, Daria; Stoykov, Nikolay; Kamper, Derek; Vick, Randy
We describe a novel art-empowered Virtual Reality (VR) system designed for hand rehabilitation therapy following stroke. The system was developed by an interdisciplinary team of engineers, art therapists, occupational therapists, and VR artist to improve patient's motivation and engagement. We describe system design, development, and user testing for efficiency, subject's satisfaction and clinical feasibility. We report initial results following use of the system on the first four subjects from the ongoing clinical efficacy trials as measured by standard clinical tests for upper extremity function. These cases demonstrate that the system is operational and can facilitate therapy for post stroke patients with upper extremity impairment.
Silagi, Marcela Lima; Hirata, Fernanda Naito; de Mendonça, Lúcia Iracema Zanotto
Agrammatism is characterized by morphosyntactic deficits in production of sentences. Studies dealing with the treatment of these deficits are scarce and their results controversial. The present study describes the rehabilitation of a case diagnosed as chronic Broca's aphasia, with agrammatism, using a method directed to sentence structural deficits. The method aims to expand the grammatical repertoire by training production of sentences with support from contexts that stimulate actions and dialogues. The patient showed positive results on all types of sentences trained and generalized the gains to spontaneous speech. However, these benefits were not sustained in the long term. PMID:29213917
En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser.......En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser....
Panzer, R B; Chrisman, C L
A new canine auricular acupuncture point for the treatment for epilepsy is introduced. The new acupoint was used with a previously reported canine auricular acupoint (van Neikerk and Eckersley, 1988) for the treatment of epilepsy in five dogs. The testimonial results of these five cases indicate that the technique is worthy of scientific investigation, and controlled research is proposed. Only testimonial evidence currently supports its application, yet this innocuous treatment is recommended for use in all cases of canine epilepsy. The traditional Chinese medical explanation for the treatment is described, and hypothetical Western physiology is presented.
Kim, Young Soo; Yun, In Sik; Chung, Seum
One of the most common complications of total auricular reconstruction is delayed wound healing, which results in skin necrosis and exposure of the ear framework. Various options exist for salvage of the exposed ear framework. From January 2009 to May 2014, 149 patients underwent total auricular reconstruction using an autogenous cartilage framework or porous polyethylene framework (Medpor; Stryker, USA). An autogenous cartilage framework was used in 48 patients, and a Medpor framework was used in 101 cases. Three cases of framework exposure (3/48, 6.3%) were observed among the patients treated with an autogenous cartilage framework. In contrast, framework exposure took place in 11 patients who were treated with a Medpor framework (11/101, 10.9%). Depending on the method of total ear reconstruction and the location of exposure, the authors used local skin flaps, temporoparietal fascia flaps, deep temporal fascia (DTF) flaps, or mastoid fascia (MF) flaps with skin grafting. Among the 11 patients who experienced framework exposure after being treated with a Medpor framework, a DTF flap with skin grafting was used in 6 patients and an MF flap with skin grafting in 6 patients; 1 patient was treated with both a DTF flap and an MF flap. All 3 cases of cartilage framework exposure were salvaged using a temporoparietal fascia flap with skin grafting, and a local skin flap was used in 1 case. In all 3 cases, the exposed framework was completely covered with the flap, and the reconstructed ears showed well-defined convolutions. Salvage of framework exposure remains a challenging issue in total auricular reconstruction. However, appropriate wound management using various flaps allows the reconstructed ear to be safely preserved.
Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja
Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...
A. I. Mantilla Martín
Full Text Available La oreja, debido a su situación expuesta en la cabeza, es un órgano susceptible de sufrir múltiples traumas e incluso pérdida; así mismo, es asiento de neoplasias malignas, carcinomas y melanomas que igualmente finalizan en amputación. Fuera de estas razones, la ausencia congénita del pabellón auricular es la segunda malformación facial de origen congénito más frecuente después del labio y paladar fisurados. Es común por tanto para el cirujano plástico verse frente a pacientes que consultan solicitando la solución a su deformidad. El presente artículo trata de señalar el camino a seguir dividido en cuatro etapas de acuerdo a los principios definidos por el Dr. Radford Tanzer y perfeccionados a través de los años por el Dr. Burt Brent, e ilustra el manejo de la reconstrucción en casos de microtia, amputación auricular y el uso de colgajos de fascia temporal en los casos en que la piel de la región mastoidea ha sido comprometida y no es posible usarla como elemento primario para la reconstrucción auricular.Due to its very exposed situation on both sides of the head, the auricle is very susceptible to suffer severe traumas, that will at the end cause its amputation; it´s too one of the most common sites to present malignant tumors, carcinoma and melanoma, that will also end in the surgical amputation of the ear. Congenital absence of the ear, microtia, is the second most common facial anomaly after cleft lip and palate. Not infrequently plastic surgeon confronts with patients seeking an answer for correction of their deformities. The present article tries to show a four steps method, according to the principles described first by Dr. Radford Tanzer and later improved by Dr. Burt Brent and illustrates how to manage the auricular reconstruction in cases of congenital microtia or traumatic loss of the auricle, as well as the use of the temporal fascia flap as a way to provide skin coverage, when the skin of the mastoid area has
Ipsen, Catherine; Swicegood, Grant
Purpose: To examine rural and urban differences in Vocational Rehabilitation (VR) case mix, delivery practices, and employment outcomes. Methods: Rehabilitation Services Administration 911 (RSA-911) case data do not include location indicators that allow for rural analyses. We compiled RSA-911 data with county and ZIP code information from 47 VR…
Brown, Ben; Fadillah, Ratna; Nurdin, Yusran; Soulsby, Iona; Ahmad, Rio
While successful examples of large-scale (5 000-10 000 ha) ecological wetland/mangrove rehabilitation projects exist worldwide, mangrove rehabilitation efforts in Indonesia, both large and small, have mainly failed. The majority of projects (both government programs and non-government initiatives) have oversimplified the technical processes of mangrove rehabilitation, favouring the direct planting of a restricted subset of mangrove species (from the family Rhizophoracea), commonly in the lowe...
Kievit, H.; Verhage-Damen, G.W.; Ingels, K.J.A.O.; Mylanus, E.A.M.; Hol, M.K.S.
OBJECTIVE: To investigate the quality of life of people with an auricular prosthesis. METHODS: A retrospective case series study was conducted. Quality of life was evaluated by an open-ended question form and 3 questionnaires: the Glasgow Benefit Inventory, the Rosenberg Self-Esteem scale, and the
Bouwmeester, Lies; van de Wege, Anja; Haaxma, Rob; Snoek, Jos W.
This paper describes the rehabilitation process of a patient with severe topographical disorientation. The study demonstrates the sustained effects of a tailor-made, meticulous rehabilitation programme based on the gradual development of compensatory strategies. The patient (RB) had a memory
This article examines the rights of South African prisoners to rehabilitation in light of the entitlement to rehabilitation contained in the Correctional Services Act 111 of 1998 and the White Paper on Corrections, and thus enshrined in statute. The author contends that prison conditions play a significant role in the failure of the ...
Full Text Available Background and Purpose. Inpatient rehabilitation in countries other than the United States (US has been described as a time where patients are often not engaged in intensive physical activity. The purpose of this case report is to explore the amount and intensity of physical activity provided in inpatient rehabilitation after stroke in the US. Methods. This study presents a case report of a person admitted to an inpatient rehabilitation unit after sustaining a first stroke. A customized data collection tracked type of activity, activity intensity and social interaction every 5 minutes during the rehabilitation day. Results. 74 percent of the day was spent in low intensity, often seated, physical activity; 14% of the day was spent resting or sleeping. Only 2.91% the day was spent in moderate or high intensity activity with a mobility focus. Conclusions. Consistent with other studies, this case report suggests a relatively low physical demand to rehabilitation delivered in inpatient stroke rehabilitation. This case begins to raise questions about optimized rehabilitation parameters for acute stroke rehabilitation.
Kleffelgaard, Ingerid; Soberg, Helene Lundgaard; Bruusgaard, Kari A; Tamber, Anne L; Langhammer, Birgitta
There has been an increasing focus on vestibular rehabilitation (VR) after traumatic brain injury (TBI) in recent years. However, detailed descriptions of the content of and patient responses to VR after TBI are limited. The purposes of this case series are (1) to describe a modified, group-based VR intervention and (2) to examine changes in self-reported and performance-based outcome measures. Two women and 2 men (aged 24-45 years) with mild TBI, dizziness, and balance problems participated in an 8-week intervention consisting of group sessions with guidance, individually modified VR exercises, a home exercise program, and an exercise diary. Self-reported and performance-based outcome measures were applied to assess the impact of dizziness and balance problems on functions related to activity and participation. The intervention caused no adverse effects. Three of the 4 patients reported reduced self-perceived disability because of dizziness, diminished frequency and severity of dizziness, improved health-related quality of life, reduced psychological distress, and improved performance-based balance. The change scores exceeded the minimal detectable change, indicating a clinically significant change or improvement in the direction of age-related norms. The fourth patient did not change or improve in most outcome measures. A modified, group-based VR intervention was safe and appeared to be viable and beneficial when addressing dizziness and balance problems after TBI. However, concurrent physical and psychological symptoms, other neurological deficits, and musculoskeletal problems might influence the course of central nervous system compensation and recovery. The present case series may be useful for tailoring VR interventions to patients with TBI. Future randomized controlled trials are warranted to evaluate the short- and long-term effects of VR after TBI. © 2016 American Physical Therapy Association.
This interim report documents the application of a railroad classification : yard design methodology to CONRAIL's Elkhart Yard Rehabilitation. This : case study effort represents Phase 2 of a larger effort to develop a yard : design methodology, and ...
Anupam Gupta; Maitreyi Patil; Meeka Khanna; Rashmi Krishnan; Arun B Taly
We report three females who developed Guillain?Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and t...
Craig, E Stirling; Nagarajan, Priyadharsini; Lee, Esther S; Lazova, Rossitza; Terner, Jordan; Narayan, Deepak
Auricular melanomas are now considered less aggressive than originally thought, but those located on the conchal bowl and posterior ear can create particular challenges for reconstruction. Given the paucity of cases, no standardized recommendations exist for tumor resection. In this study, we provide a pathologic basis in support of conservative tumor resection along the perichondrial plane. Case series with review of pathology and medical records. Academic tertiary referral center. We retrospectively reviewed all ear melanomas from the archives of Yale Dermatopathology and Surgical Pathology laboratories between 1987 and 2009. Cases of melanoma in situ or malignant melanoma of the earlobe were excluded. Fifty-one cases were included in the study. Patients' age ranged from 26 to 94 years, with a mean (SD) of 58.9 (17.5) years. The male to female ratio was of 5.4:1. Melanomas were distributed similarly between right and left ears, at 52% and 48%, respectively. The most common location was the helix (74.5%). The Breslow depth ranged from 0.19 to 11 mm, with a mean (SD) of 1.64 (1.6) mm. The lesion-perichondrium distance ranged from 0 to 8.12 mm, with a mean (SD) of 1.11 (1.1) mm. Notably, the perichondrium was not invaded in any of the cases. Based on the histopathologic characteristics of our cases, the perichondrium can be considered an effective barrier and therefore a biological plane for wide local resection in some cases of auricular melanomas, allowing surgeons to achieve negative margins without necessarily sacrificing underlying cartilage.
Lorna Kwai Ping Suen
Full Text Available Objective: This study aims to determine the association between auricular signals and the risk factors of metabolic syndrome (MS. Methods: A case-control study with an equal number of cases and controls matched by age group and gender was conducted. A total of 204 participants were recruited. Patients were verified as having MS based on the International Diabetes Federation (IDF criteria. Auricular assessment was conducted in the following sequence: visual inspection, electrical skin resistance test (ESRT, and pressure pain test (PPT. Results: MS+ patients tend to have much more oily auricle complexion than the controls. The ‘endocrine’ (right of the participants with MS indicated a significantly higher electrical conductivity compared to that of the controls. The MS group participants experienced significant tenderness on the ‘heart’ and ‘endocrine’ acupoints. A number of auricular signals were also associated with the risk factors of MS, including age, gender, smoking status, family history of diabetes, and comorbid illnesses. Both the ‘heart’ and ‘endocrine’ acupoints showed the highest sensitivity to tenderness (60.8%, followed by the ‘endocrine’ (59.8% and ‘pancreas and gallbladder’ (55.9%. Conclusions: The results of this study suggest that electrical conductivity and tenderness of a number of auricular points, including the ‘heart’, ‘pancreas and gall bladder’, and ‘endocrine’, are associated with MS and its risk factors. Further investigations with a larger sample size could be conducted to verify the value of these auricular signals on MS risk prediction so that this method can be used as an early screening method for the population with a high MS risk.
Joshi M; Cheng R; Kamath H; Yarmush J
Minal Joshi,1 Ruth Cheng,2 Hattiyangadi Kamath,1 Joel Yarmush1 1Department of Anesthesiology, New York Methodist Hospital, New York, NY, USA; 2School of Medicine, St. George’s University, Grenada, West Indies Abstract: Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report...
Full Text Available Hamstring injuries and its rehabilitation in competitive events such as football targets safe and early return to play. This is because hamstring injuries are more related to prolonged recovery time and high rate of re-injury. In this case study, Zakeer Mundampara, 26-year-old footballer of Chennaiyin FC team (Indian super league tournament, who was rehabilitated for Grade 2 hamstring strain was briefed. To describe the importance of conservative rehabilitation in hamstring injuries and report on player's rehabilitation program and clinical outcome. Zakeer Mundampara was conservatively treated with active release technique for 2 weeks duration. Data collected includes passive knee extension test range of motion and verbal rating score. After 2 weeks of rehabilitation, Zakeer Mundampara had nearly full range of pain-free movement, normal gait and trained to run safely. By the 3rd week, he started to perform all sports specific drills. He was rehabilitated and set fit to play after 4 weeks from the date of injury. Active release technique is effective in hamstring injuries. In this case study, rehabilitation program with an emphasis on active release technique is found to be effective in returning the footballer back to play.
Garg, P; Garg, S; Bansal, D; Suresh, S
The loss of an eye has a crippling effect on the psychology of the patient, making rehabilitation process challenging for both doctor and patient. To report a case of anophthalmic socket with prosthetic rehabilitation in a cost effective manner. A 32-year-old female presented with anophthalmic socket for prosthetic rehabilitation. A custom made ocular prosthesis was implanted successfully. The custom made ocular prosthesis is simple, affordable and can be carried out in a small clinical set-up and provides a superior natural appearance. © NEPjOPH.
Sailer, Herman F; Tarawneh, Fadi; Fourkas, Panagiotis; Antoniades, Dimitrios Z; Athanasiou, Athanasios E
This case report describes the combined surgical, orthodontic and prosthodontic rehabilitation of an adult female patient with a previous history of follicular ameloblastoma, which was treated through partial mandibulectomy and an immediate replacement of missing bone with an autologous calvarial bone graft. Orthodontic treatment was undertaken in order to restore occlusal disturbances and obtain sufficient space for two dental implants and an optimum prosthodontic rehabilitation.
Full Text Available "nFabrication of dental prosthesis for patients with microstomia has long been a problem for dentists. Microstomia is defined as an abnormally small oral orifice. Prosthetic rehabilitation of microstomia patients presents difficulties at all stages, from the preliminary impressions to fabrication of prosthesis. This study described a method for making impressions for patients with limited opening of the oral cavity which the use of a full-size impression tray was not possible.
Patil, Shankargouda; Sarode, Gargi S.; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco
Background Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. Method A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of ‘Oral submucous fibrosis’, ‘prosthesis’, ‘dentures’ and/or ‘restricted mouth opening’. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. Results A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Conclusion Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results. PMID:28877246
Markiewicz, Michael R; Raina, Ankoo; Chuang, Sung-Kiang; Margarone, Joseph E; Dodson, Thomas B
The purpose of this study was to report a case of full-arch rehabilitation with single-tooth endosseous implant restorations. Secondly, the investigators aimed to review the literature systematically regarding full-mouth rehabilitation of the edentulous patient with single-tooth implant restorations. The investigators searched the databases PubMed, EMBASE Drugs and Pharmacology, the Cochrane library, and clinicaltrials.gov for relevant literature regarding full-mouth fixed rehabilitation of the edentulous patient with dental implants. In addition, the investigators provide a clinical case of full-mouth rehabilitation of an edentulous patient using single-tooth implant restorations. The literature search revealed 60 citations that addressed the topic at large. None of the papers reported full-mouth rehabilitation with single-tooth implant restorations; therefore, papers reporting full-arch rehabilitation with a full-arch fixed prosthesis were compared to the single-implant restoration protocol described herein. Although there are similarities between our protocol and those proposed in the past, differences include potentially higher patient satisfaction because of the close similarity between the final restorations and the patient's prior natural dentition. While the proposed treatment may not be within the financial means of most patients, because of its anecdotal advantages over conventional splinted fixed restorations, the investigators believe this is the next step in the evolution of the restorative management of the completely edentulous patient.
Full Text Available This paper presents a case study on the rehabilitation of a fire-damaged structure and describes the results of a site investigation and tests, leading to a plan for the rehabilitation of the structure. The fire took place in the main control room of a thermal power plant and lasted about three hours until it was finally extinguished. To set up a rehabilitation plan for the damaged structure, a visual inspection of the damaged condition was first carried out, which was followed by analysis and on-site material tests indicating the degree of neutralization progress in the remaining structure. Specimens of damaged concrete and reinforcing bars were sampled and tested for their residual strengths. As a conclusion, two methods of rehabilitation were suggested considering the current condition of the structure and the sequence of construction.
Anna Serene Babu
Full Text Available The rehabilitation of a patient who has suffered the psychological trauma due to loss of an eye requires a prosthesis that will provide the optimum cosmetic and functional result. The mode of rehabilitation varies based on the type of defect and surgical approach being adopted. A case series of prosthetic rehabilitation of three types of orbital defects - evisceration, enucleation and exenteration have been reported in this article. The clinical relevance of surgical approaches highlights the preservation of remaining anatomic structures creating a negative space or concavity to aid in future prosthetic rehabilitation. A multidisciplinary management and team approach is essential in providing esthetics and to regain the confidence. Follow-up care for the patient is mandatory.
Page-Karjian, Annie; Norton, Terry M; Harms, Craig; Mader, Doug; Herbst, Larry H; Stedman, Nancy; Gottdenker, Nicole L
Fibropapillomatosis (FP) is a debilitating neoplastic disease that affects all species of hard-shelled sea turtles, including loggerhead turtles Caretta caretta. FP can represent an important clinical concern in rehabilitating turtles, since managing these infectious lesions often requires special husbandry provisions including quarantine, and FP may affect clinical progression, extend rehabilitation duration, and complicate prognoses. Here we describe cases of rehabilitating loggerhead turtles with FP (designated FP+). Medical records of FP+ loggerhead cases from 3 sea turtle rehabilitation facilities in the southeastern USA were reviewed. Between 2001 and 2014, FP was observed in 8 of 818 rehabilitating loggerhead turtles (0.98% overall prevalence in admitted patients). FP+ loggerhead size classes represented were large juvenile (straight carapace length, SCL: 58.1-80 cm; n=7) and adult (SCL>87 cm; n=1). Three turtles presented with FP, and 5 developed tumors during rehabilitation within a range of 45 to 319 d. Sites of new tumor growth included the eyes, sites of trauma, neck, and glottis. FP+ turtles were scored as mildly (3/8), moderately (4/8), or heavily (1/8) afflicted. The mean total time in rehabilitation was 476±355 d (SD) (range: 52-1159 d). Six turtles were released without visible evidence of FP, 1 turtle was released with mild FP, and 1 turtle with internal FP was euthanized. Clinical decision-making for FP+ loggerhead patients can be aided by such information as time to tumor development, anatomic locations to monitor for new tumor growth, husbandry considerations, diagnostic and treatment options, and comparisons to FP in rehabilitating green turtles Chelonia mydas.
Full Text Available We report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN] had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.
Gupta, Anupam; Patil, Maitreyi; Khanna, Meeka; Krishnan, Rashmi; Taly, Arun B
We report three females who developed Guillain-Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.
Luiz Evaristo Ricci Volpato
Full Text Available Adenoid cystic carcinoma is a cancer of the salivary gland that primarily affects the parotid, submandibular, and accessory salivary glands. Its growth is slow and it has infiltrative nature. A 46-year-old female patient coming from the rural area presented a lesion on the palate and reported pain in the region for three years. After incisional biopsy, and histopathological diagnosis of adenoid cystic carcinoma of the cribriform type of minor salivary gland, superior hemimaxillectomy and adjuvant treatment with radiotherapy and maxillofacial prosthetic rehabilitation were performed.
Wang, Yun-Tung; Lin, Yi-Jiun
Purpose The aim of this study is to explore whether/which vocational rehabilitation case manager (VRCMer) factors were significantly associated with the vocational rehabilitation service (VRS) program outcomes in Taiwan. Method This study used the 2011 VRS Program for People with Disabilities Database in a metropolitan city in Taiwan (N = 466) to do a secondary data analysis using hierarchical logistic regression. Results This study found that the employment rate and stable employment rate created by the 2011 VRS program in a metropolitan city in Taiwan were 48.7% and 42.1%, respectively. For the predictors of employment/stable employment, "occurrences of the services provided by the VRCMer" variable was definitely dominant. In addition, "level of the disability" was the second-ranking predictor, and was significantly negatively correlated with both employment and stable employment outcomes. Conclusions Vocational rehabilitation case manager factors in this study were significantly correlated with VRS program outcomes for people with disabilities in Taiwan after controlling for the clients' socio-demographic variables. The results indicate that greater input by VRCMers for people with disabilities equates to better employment outcomes in metropolitan Taiwan. Implications for Rehabilitation This is the first study to build an inferential statistical model in attempt to explain and predict the association between vocational rehabilitation case manager factors and vocational rehabilitation service program outcomes for people with disabilities in Taiwan. In cases of severe disability, a vocational rehabilitation case manager should seek out more in-kind and in-cash resources, and choose a suitable job coach to cooperate in assisting the client to become employed. Based on the findings, government has to continue implementing opportunities for people with disabilities to attain higher and better quality educational levels, for increasing their employment rate
Mountain Debbie A
Full Text Available Abstract Background At any time, about 1% of people with severe and enduring mental illness such as schizophrenia require in-patient psychiatric rehabilitation. In-patient rehabilitation enables individuals with the most challenging difficulties to be discharged to successful and stable community living. However, the length of rehabilitation admission that is required is highly variable and the reasons for this are poorly understood. There are very few case-control studies of predictors of outcome following hospitalisation. None have been carried out for in-patient rehabilitation. We aimed to identify the factors that are associated with achieving discharge from in-patient rehabilitation by carrying out a case-control study. Methods We compared two groups: 34 people who were admitted to the Rehabilitation Service at the Royal Edinburgh Hospital and discharged within a six year study period, and 31 people who were admitted in the same period, but not discharged. We compared the groups on demographic, illness, treatment and risk variables that were present at the point of their admission to rehabilitation. We used independent t tests and Pearson Chi-Square tests to compare the two groups. Results We found that serious self harm and suicide attempts, treatment with high dose antipsychotics, antipsychotic polypharmacy and previous care in forensic psychiatric services were all significantly associated with non-discharge. The non-discharged group were admitted significantly later in the six year study period and had already spent significantly longer in hospital. People who were admitted to rehabilitation within the first ten years of developing psychosis were more likely to have achieved discharge. Conclusions People admitted later in the study period required longer rehabilitation admissions and had higher rates of serious self harm and treatment resistant illness. They were also more likely to have had previous contact with forensic services. This
Full Text Available Surgical resection of neoplasms or malformations of the face may result in defects that are not amenable to immediate surgical reconstruction. Such defects can have a severe adverse effect on patient perceptions of body image and self-esteem. In these cases, the use of an interim removable facial prosthesis can offer a rapid alternative treatment solution. The patient may then resume social interactions more comfortably while permitting easy access to the facial defect to observe tissue healing while awaiting definitive rehabilitation. This article presents a case report describing the use of interim nasal prostheses to provide rapid patient rehabilitation of facial defects.
To compare the differences in the therapeutic effect on child amblyopia between auricular point sticking therapy and routine complex treatment. Two hundreds and thirty cases of amblyopia were randomly divided into an observation group and a control group, 120 cases (212 eyes) were in the observation group and 110 cases (194 eyes) were in the control group. The observation group was treated with auricular point sticking therapy. The main points were Yan (eye), Shenmen, Gan (liver), Pi (spleen) and Shen (kidney), etc. The control group was treated with routine complex treatment, such as wearing glasses, shade therapy and family refined performance therapy. The changes of vision were observed after treatment in the two groups. The follow-up was 3 years. The effective rate was 81.0% (64/79) in the observation group of ametropic amblyopia and 52.2% (36/69) in the control group. The effective rate was 73.1% (49/67) in the observation group of anisometropic amblyopia and 47.7% (31/65) in the control group. The effective rate was 71.2% (47/66) in the observation group of strabismic amblyopia and 45.0% (27/60) in the control group. The therapeutic effect of the observation group was superior to that of the control group (all P < 0.05). Auricular point sticking therapy can obviously improve child visual acuity with simple manipulation.
La utilización de marcapasos en el tratamiento de taquiarritmias supraventriculares se ha centrado principalmente en la prevención y tratamiento de la fibrilación auricular. Diferentes estrategias de estimulación han sido desarrolladas para este propósito. Entre las más importantes está la estimulación auricular preferencial, sitios alternos de estimulación auricular, como la estimulación dual o la estimulación septal; algoritmos de prevención y tratamiento se han agregado a dichas formas de ...
Full Text Available Background: Rehabilitation is often challenging in South Africa, but South Africans living in remote rural settings might experience unique challenges. Objective: This article interrogates issues of access to rehabilitation in a selected sample from rural South Africa through case studies. Method: This qualitative study utilised a case study design. Eight case studies were done in a purposively sampled rural town in the Northern Cape Province. Data were collected through in-depth interviews. Data were analysed according to the principles of interpretative phenomenological analysis. Results: The case study participants were not integrated into the community. They experienced higher levels of disability than one would expect from their impairments. Their impairments were not modified. No retraining of function was implemented. Early intervention and childhood development activities were not provided. Participants were not linked with self-help or peer support groups. Provision of assistive devices was challenged. Environmental barriers aggravated the situation. Conclusion: We theorise that one-on-one therapy is not the solution to the rehabilitation needs of persons with disabilities in remote, rural settings. We recommend a move to community-based rehabilitation and transdisciplinary teamwork supported by family members, community health workers and peer mentors. Therapists are ideally situated to explore the feasibility of such programmes and to pilot them in various communities.
Jade PY Ho
Full Text Available We present a case of chronic acromioclavicular joint dislocation (Rockwood type 5 in which the choice of acromioclavicular reconstruction using autogenous semitendinosus tendon graft was made due to its superiority in anatomical reconstruction of the coracoclavicular ligaments, and the impact of postoperative rehabilitation on the recovery of this patient. We also discuss the rationale behind this.
Koyanagi, Ken'ichi; Kuwahara, Yuya; Kamida, Takehiro; Ozawa, Takuya; Mizukami, Rieko; Genda, Kiyokazu; Mori, Ayaka; Motoyoshi, Tatsuo; Masuta, Hiroyuki; Oshima, Toru
Following stroke, rehabilitation exercises paired with medical treatment are important for the recovery and maintenance of upper limb function. We developed a 2-DOF passive haptic system for upper limb rehabilitation and software focusing on reaching exercises, known as the coin collecting program, which provides training and evaluation of motor function, particularly dexterity. Past studies have revealed quantitative, reproducible evaluation indices using this software. In this paper, we compared case studies of post-stroke patients with results from healthy participants, and confirmed the reliability of the evaluation indices in grading or scoring motor skills.
Pajaczkowski, Jason A
To present the epidemiology, etiology, diagnostic criteria and therapeutic interventions for an important clinical entity - tibiofibular syndesmosis or "high ankle" sprains. The most common mechanism of injury is forced external rotation in a dorsiflexed foot. Pain is located anteriorly over the anterior tibiofibular ligament, and is elicited through a variety of tests designed to stress this articulation through diastatic forces. Pain with ambulation is typical, and is usually present during the push-off phase of gait. Radiographs may be useful in determining the extent of this injury, as syndesmotic sprains with malleolar fractures are more common than those without. Convalescence is generally protracted compared with a lateral ankle sprain, and care must be taken to avoid stressing the supporting ligaments during the early course of therapy. Initial treatment is aimed at reducing pain and inflammation using modalities such as microcurrent, electroacupuncture and P.R.I.C.E. principles. Treatment over subsequent weeks involves progressive resistance exercises, proprioceptive challenges, plyometric exercises and sport-specific agility drills, while maintaining cardiovascular fitness. The practitioner should also be cognizant of the indolent nature of this injury and possibility for sequelae. Anterior ankle pain and pain with a deep squat or during the push-off phase of gait are typical of this injury. Radiographs to rule out fracture and evaluate the extent of the injury may be warranted. Conservative therapy involving rehabilitation and tissue injury care is appropriate for Grade I and II injuries, while Grade III injuries require a surgical intervention.
Salvatore, Serena; Librando, Aloisa; Esposito, Mariacristina; Vingolo, Enzo M
To evaluate the usefulness of acoustic biofeedback by means of Mozart's Sonata for Two Pianos in D Major K. 448 to maintain and/or restore visual performance in a patient with macular pucker and glaucoma. A 74-year-old patient with open angle glaucoma in both eyes and macular pucker in the right eye (RE) underwent visual rehabilitation with acoustic biofeedback by means of the MAIA™ Vision Training Module (Centervue, Padova, Italy) 10 minutes each eye once a week for 5 weeks. The patient was asked to move his eyes according to a sound which changed into Mozart's Sonata for Two Pianos when the patient locked the fixation target. Best-corrected visual acuity improved in his right eye (RE) and was stable in the left eye (LE). Fixation stability improved in both eyes, and retinal sensitivity decreased in the RE and improved in the LE. The characteristic of the macular pucker did not change during the training as demonstrated with optical coherence tomography. The patient was very satisfied with the training, as demonstrated by a 25-item questionnaire (National Eye Institute - Visual Functioning Questionnaire, NEI-VFQ-25). The patient's reading speed and the character size which he was able to read improved in his RE. Music could enhance synaptic plasticity and affect neural learning and fixation training by means of MAIA vision training. Therefore it can improve visual performance in patients with macular pucker, postpone the surgical time, and assure a better quality of life for the patient.
Roxana Oana Darabont
Full Text Available Romania has one of the highest mortality rates in Europe for ischemic heart disease and, especially, for cerebrovascular disease. Taking into account the actual prevalence of cardiovascular diseases, an augmentation of the demand for specialized medical services is expected. As this paper argues, this situation can have an important impact on medical tourism. We analyze original data on the case study of a hospital, specialized in cardiovascular treatment, in the Romanian county of Covasna, which is offering specific balneal procedures, such as CO2 .hydrotherapy, alongside regular rehabilitation programs. The aim of our study is to evaluate the demographic characteristics, and the pathology of the hospitalized patients, as well as the specific rehabilitation procedures. Our findings suggest that the interest of patients, with cardiovascular diseases, for medical tourism can be influenced by accessibility, by some particularities of the location, but also by the holistic nature of the rehabilitation procedures.
Miller, Jason E.; Oakley, Paul A.; Levin, Scott B.; Harrison, Deed E.
[Purpose] To present a case of non-surgical reduction of thoracic hyperkyphosis utilizing a multimodal rehabilitation program emphasizing the mirror image® concept. [Subject and Methods] A 15-year-old female presented to a rehabilitation office suffering from back and neck pains and headaches. The patient was treated sporadically over a period of 13-months. Treatment consisted of anterior thoracic translation and thoracic extension exercises, spinal traction and spinal manipulation. [Results] After 13-months of treatment the patient displayed a significant reduction in hyperkyphosis and a dramatic correction of her overall posture and spine alignment corresponding to the reduction in back/neck pains, headaches and the simultaneous improvement of various other health issues. [Conclusion] Thoracic hyperkyphosis can be reduced through a multimodal rehabilitation program emphasizing mirror image thoracic extension procedures. PMID:28744061
Miller, Jason E; Oakley, Paul A; Levin, Scott B; Harrison, Deed E
[Purpose] To present a case of non-surgical reduction of thoracic hyperkyphosis utilizing a multimodal rehabilitation program emphasizing the mirror image(®) concept. [Subject and Methods] A 15-year-old female presented to a rehabilitation office suffering from back and neck pains and headaches. The patient was treated sporadically over a period of 13-months. Treatment consisted of anterior thoracic translation and thoracic extension exercises, spinal traction and spinal manipulation. [Results] After 13-months of treatment the patient displayed a significant reduction in hyperkyphosis and a dramatic correction of her overall posture and spine alignment corresponding to the reduction in back/neck pains, headaches and the simultaneous improvement of various other health issues. [Conclusion] Thoracic hyperkyphosis can be reduced through a multimodal rehabilitation program emphasizing mirror image thoracic extension procedures.
Full Text Available Serena Salvatore, Aloisa Librando, Mariacristina Esposito, Enzo M VingoloDepartment of Ophthalmology, University La Sapienza, Polo Pontino, Alfredo Fiorini Hospital, Terracina, ItalyPurpose: To evaluate the usefulness of acoustic biofeedback by means of Mozart’s Sonata for Two Pianos in D Major K. 448 to maintain and/or restore visual performance in a patient with macular pucker and glaucoma.Methods: A 74-year-old patient with open angle glaucoma in both eyes and macular pucker in the right eye (RE underwent visual rehabilitation with acoustic biofeedback by means of the MAIA™ Vision Training Module (Centervue, Padova, Italy 10 minutes each eye once a week for 5 weeks. The patient was asked to move his eyes according to a sound which changed into Mozart’s Sonata for Two Pianos when the patient locked the fixation target.Results: Best-corrected visual acuity improved in his right eye (RE and was stable in the left eye (LE. Fixation stability improved in both eyes, and retinal sensitivity decreased in the RE and improved in the LE. The characteristic of the macular pucker did not change during the training as demonstrated with optical coherence tomography. The patient was very satisfied with the training, as demonstrated by a 25-item questionnaire (National Eye Institute – Visual Functioning Questionnaire, NEI-VFQ-25. The patient’s reading speed and the character size which he was able to read improved in his RE.Conclusion: Music could enhance synaptic plasticity and affect neural learning and fixation training by means of MAIA vision training. Therefore it can improve visual performance in patients with macular pucker, postpone the surgical time, and assure a better quality of life for the patient.Keywords: glaucoma, macular cellophane, music, vision training
Pajaczkowski, Jason A
Objective To present the epidemiology, etiology, diagnostic criteria and therapeutic interventions for an important clinical entity – tibiofibular syndesmosis or “high ankle” sprains. Clinical Features The most common mechanism of injury is forced external rotation in a dorsiflexed foot. Pain is located anteriorly over the anterior tibiofibular ligament, and is elicited through a variety of tests designed to stress this articulation through diastatic forces. Pain with ambulation is typical, and is usually present during the push-off phase of gait. Radiographs may be useful in determining the extent of this injury, as syndesmotic sprains with malleolar fractures are more common than those without. Intervention and Outcome Convalescence is generally protracted compared with a lateral ankle sprain, and care must be taken to avoid stressing the supporting ligaments during the early course of therapy. Initial treatment is aimed at reducing pain and inflammation using modalities such as microcurrent, electroacupuncture and P.R.I.C.E. principles. Treatment over subsequent weeks involves progressive resistance exercises, proprioceptive challenges, plyometric exercises and sport-specific agility drills, while maintaining cardiovascular fitness. Conclusion The practitioner should also be cognizant of the indolent nature of this injury and possibility for sequelae. Anterior ankle pain and pain with a deep squat or during the push-off phase of gait are typical of this injury. Radiographs to rule out fracture and evaluate the extent of the injury may be warranted. Conservative therapy involving rehabilitation and tissue injury care is appropriate for Grade I and II injuries, while Grade III injuries require a surgical intervention. PMID:17657290
Chang, Ying; Liu, Ya-Bin; He, Jun-Jun
To search for the best method for child semiluxation of circo-axis vertebrae. Fifty cases were randomly divided into a treatment group of 25 cases treated with auricular point sticking, and a control group of 25 cases treated with normal acupuncture. The total effective rate was 92.0% in the treatment group and 64.0% in the control group with a significant difference between the two groups (P circo-axis vertebrae.
Wu, Juan; Cheng, Shuiping; Li, Zhu; Guo, Weijie; Zhong, Fei; Yin, Daqiang
In the past three decades, the fast development of economy and urbanization has caused increasingly severe pollutions of urban water bodies in China. Consequently, eutrophication and deterioration of aquatic ecosystem, which is especially significant for aquatic vegetation, inevitably became a pervasive problem across the Yangtze River Basin. To rehabilitate the degraded urban water bodies, vegetation replanting is an important issue to improve water quality and to rehabilitate ecosystem. As a case study, a representative polluted urban river, Nanfeihe River, in Hefei City, Anhui Province, was chosen to be a rehabilitation target. In October 2009 and May 2010, 13 species of indigenous and prevalent macrophytes, including seven species emergent, one species floating leaved, and five species submersed macrophytes, were planted along the bank slopes and in the river. Through 1.5 years' replanting practice, the water quality and biodiversity of the river had been improved. The concentrations of total nitrogen (TN), total phosphorus (TP), and ammonia nitrogen (NH4 (+)-N) declined by 46.0, 39.5, and 60.4 %, respectively. The species of macrophytes increased from 14 to 60, and the biodiversity of phytoplankton rose significantly in the river (p<0.05). The biomasses of zooplankton and benthos were also improved after the vegetation replanting. The study confirmed that vegetation replanting could alleviate the increasing water pollution and rehabilitate the degraded aquatic ecosystem. The case study would be an example for polluted urban waters restoration in the middle-downstream area of Yangtze River Base.
Rahimi, Rod A; Skrzat, Julie; Reddy, Dereddi Raja S; Zanni, Jennifer M; Fan, Eddy; Stephens, R Scott; Needham, Dale M
Neuromuscular weakness and impaired physical function are common and long-lasting complications experienced by intensive care unit (ICU) survivors. There is growing evidence that implementing rehabilitation therapy shortly after ICU admission improves physical function and reduces health care utilization. Recently, there is increasing interest and utilization of extracorporeal membrane oxygenation (ECMO) to support patients with severe respiratory failure. Patients receiving ECMO are at great risk for significant physical impairments and pose unique challenges for delivering rehabilitation therapy. Consequently, there is a need for innovative examples of safely and feasibly delivering active rehabilitation to these patients. This case report describes 3 patients with respiratory failure requiring ECMO who received physical rehabilitation to illustrate and discuss relevant feasibility and safety issues. In case 1, sedation and femoral cannulation limited rehabilitation therapy while on ECMO. In the 2 subsequent cases, minimizing sedation and utilizing a single bicaval dual lumen ECMO cannula placed in the internal jugular vein allowed patients to be alert and participate in active physical therapy while on ECMO, illustrating feasible rehabilitation techniques for these patients. Although greater experience is needed to more fully evaluate the safety of rehabilitation on ECMO, these initial cases are encouraging. We recommend systematically and prospectively tracking safety events and patient outcomes during rehabilitation on ECMO to provide greater evidence in this area.
Bång, M; Hagdahl, A; Eriksson, H; Timpka, T
This paper presents LINDA, a prototype system designed to support virtual rehabilitation teams. LINDA enables professionals from different welfare-state agencies to collaborate in case management. Our approach to supporting teamwork involves the sharing of minimal case sets across organizational borders needed to provide a shared situation assessment among team members. The system provides a shared workspace for the team; a lightweight client-database, visualization of case histories and plans, and means to communicate effectively in the team using yellow sticker-notes. We present LINDA and discuss how we approached the problem to design groupware to support work under changing and uncertain conditions.
Oliveira, Leandro Benetti de; Gabrielli, Marisa Aparecida Cabrini; Gabrielli, Mario Francisco Real; Pereira-Filho, Valfrido Antonio Pereira
The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.
Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle
Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.
Zgaljardic, Dennis J; Yancy, Sybil; Levinson, Jason; Morales, Gabrielle; Masel, Brent E
Balint's syndrome includes the clinical symptom triad of simultagnosia, ocular apraxia and optic ataxia. These symptoms, in combination, are rare and can be quite debilitating as they impact visuospatial skills, visual scanning and attentional mechanisms. The literature addressing rehabilitation of individuals with Balint's syndrome is sparse. The current case report describes the outcome of a 58-year old male who presented with Balint's syndrome secondary to severe traumatic brain injury and following completion of a comprehensive post-acute brain injury rehabilitation programme. The patient was 4-months post-injury onset upon admission and received 6 months of rehabilitation services as an inpatient. The patient's comprehensive rehabilitation programme involved a 3-pronged approach including the implementation of (a) compensatory strategies, (b) remediation exercises and (c) transfer of learned skills in multiple environments and situations with implementation of psychoeducation and psychotherapy. Comprehensive neuropsychological and occupational therapy evaluations were performed at admission and at discharge in order to monitor cognitive, affective, neurological and functional change over time. Neuropsychological test improvements were noted on tasks that assess visuospatial functioning, although most gains were noted for functional and physical abilities.
Markovics Emese Rita
Full Text Available In this case report we present the aesthetical correction of crowded anterior teeth in a patient who has refused the orthodontic treatment. We also discuss how this correction can be resolved from the point of view of dental prosthetic and what measurements can be helpful in order to collect the data used to restore a satisfying smile on the patient’s face using dental ceramic restoration. Case presentation: A 32-year-old patient complained about his crowded incisors. We examined the incisal curvature, the proportion between the height and the width of the teeth, and the relation between the widths of the teeth and the golden proportion. The results of the measurements were compared to the characteristic values of the ideal denture. After the examination of the dental plaster cast, calculating the difference between the existing space and the necessary space, we were able to calculate the lack of space, which caused the crowded teeth. Conclusion: Along the prosthetic planning, these measurements may serve as a guideline to the dentist as an objective basis for the formation of an aesthetic denture and smile.
Partial edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism. The main clinical findings were unopposed remaining teeth, overeruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment invol...
Suh, Min Ji; Han, Eun Young; Kim, Bo Ryun; Lee, Jong Hoo
[Purpose] The aim of this study was to ascertain the effect of comprehensive rehabilitation therapy on a quadriplegic patient with meningiomatosis and severe dysphagia. [Subject and Methods] Meningiomatosis is defined as multiple meningiomas involved in several intracranial regions, which occurs more frequently in elderly patients. The prognosis of meningiomatosis is mostly reported as benign, but the prognosis for some malignant cases can be poor. Furthermore, dysphagia in elderly patients w...
PICOS, ALINA MONICA; DONCA, VALER; PICOS, ANDREI
Complex treatment involving removable articulated to fixed prostheses is indicated in extended edentulous areas, which represent clinical conditions more frequently encountered in elderly patients. A number of aspects must be considered in elderly patients before starting the therapy: physical and mental condition, self-care capacity, time and cost of treatment, predictability. In institutionalized elders, suffering of systemic diseases, the therapy of choice should be the least invasive and able to restore function at an acceptable level. Active healthy elders can be beneficiaries of complex prosthetic treatments involving many long sessions and difficult treatments. We present a case of a 74 year-old male with extended maxillary edentulous areas, in whom a complex prosthetic treatment was performed. PMID:26528025
Picos, Alina Monica; Donca, Valer; Picos, Andrei
Complex treatment involving removable articulated to fixed prostheses is indicated in extended edentulous areas, which represent clinical conditions more frequently encountered in elderly patients. A number of aspects must be considered in elderly patients before starting the therapy: physical and mental condition, self-care capacity, time and cost of treatment, predictability. In institutionalized elders, suffering of systemic diseases, the therapy of choice should be the least invasive and able to restore function at an acceptable level. Active healthy elders can be beneficiaries of complex prosthetic treatments involving many long sessions and difficult treatments. We present a case of a 74 year-old male with extended maxillary edentulous areas, in whom a complex prosthetic treatment was performed.
Full Text Available Abstract Background Neck problems are often recurring or chronic. After pain, unsteadiness and balance problems are among the most frequent symptoms reported by chronic neck pain (CNP patients. Altered sensorimotor control of the cervical spine and sensorimotor integration problems affecting postural control have been observed in CNP patients. Very few data are available regarding the post-intervention effects of rehabilitation programs on postural control in CNP. Case presentation This is a case study of a traumatic CNP patient (a 45-year old female with postural unsteadiness who participated in an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy. Pre-intervention data revealed that the postural control system was challenged when postural control sensory inputs were altered, particularly during the head-extended-backward condition. Post-intervention centre of pressure measurements indicated a drastic reduction in postural sway during trials with changes in neck orientation. Conclusion This case report indicates that an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy may have had an effect on improvement of postural control in a trauma CNP patient with unsteadiness. These results warrant further studies to investigate the relationships between pain amelioration, sensorimotor control of the cervical spine, muscle fitness and postural steadiness.
Lautenschläger, Sindy; Muser, Jürgen; Müller, Elisabeth
Purpose The objective of the study is to describe how the theory of therapeutic nursing in neurological (early) rehabilitation can be transferred into nursing practice. Materials and Methods The theory was developed using the method of grounded theory by Glaser and Strauss. Open participatory observations (n=92) and episodic interviews (n=10) with nursing professionals and nursing auxiliaries were conducted in 5 inpatient rehabilitation clinics. Data analysis was performed using the constant comparative method by Glaser and Strauss. Results By means of a case study, the applicability of the theory into nursing practice with regard to the following care situations is described: (1) training for personal care, (2) therapeutic positioning, (3) oral hygiene, (4) training of sensory-motor perception and (5) counseling relatives. Consequently, the categories of the theory: (1) nursing care, (2) observation/perception, (3) communication, (4) autonomy and individual needs of patients and their relatives, (5) multi-professional team and (6) prerequisites are transferred into the case scenario. Conclusions The case study demonstrates how the therapeutic nursing theory in neurological (early-) rehabilitation can be transferred into nursing practice and reveals the complexity of nursing interventions. © Georg Thieme Verlag KG Stuttgart · New York.
Painter, Elizabeth E; Ogle, Melissa D; Teyhen, Deydre S
Case report. It has been suggested that altered neuromuscular control of the transversus abdominis and pelvic floor muscles may contribute to sacroiliac joint (SIJ) region pain and stress urinary incontinence. There are limited examples describing the evaluation and management of individuals with both SIJ region pain and stress urinary incontinence in the literature. This case report describes a patient with both conditions and details the integration of rehabilitative ultrasound imaging (RUSI) during physical therapy evaluation. 6 A 35-year-old female soldier presented with a 6-week history of left buttock pain and 4-year history of stress urinary incontinence during activities that involved running, jumping, and fast walking. RUSI was used to supplement the physical assessment process, revealing altered motor control strategies of the transversus abdominis and pelvic floor muscles, and as a form of biofeedback during the rehabilitation process. After completing a rehabilitation program that incorporated principles of lumbar stabilization and pelvic floor muscle re-education, this patient was able to complete all physical activities in basic combat training without SIJ region pain or urinary leakage. This case demonstrates the importance of considering pelvic floor muscle dysfunction and training in a patient with primary complaints of SIJ region pain. It also highlights the potential role of RUSI as both an evaluation and biofeedback tool for the deep abdominal and pelvic floor muscles.
Bach, Laura J
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto immune-disorder. It is a life threatening condition that typically presents with viral illness, headaches, severe psychiatric symptoms, seizures, behavioural changes, decreasing levels of unconsciousness and progressive unresponsiveness, cognitive impairment, abnormal movements (e.g., dyskinesia), ataxia and hypoventilation. This paper describes the long term outcome and rehabilitation management of patients with NMDAR encephalitis and highlights the diverse outcome of this condition and the unique and individual long term management needs associated with this disorder. This is a case report study of three different patients with NMDAR encephalitis. All three cases are young women, two of whom presented with ovarian teratoma. Patient KH is the most impaired and was resident in a slow stream rehabilitation care home and presented with challenging behaviour. Patients RM and OA both lived in the community and presented with similar anxieties but diverse levels of cognition and motivation. A review of the literature is provided summarizing the disorder, interventions, management and challenges of this varied and complex condition. Standard neuropsychological tests and questionnaires to assess community integration (BICRO-39), quality of life (QOLIBRI-OS) and mood (HADS) were administered. Positive outcomes were achieved for all three patients using a variety of interventions which included behavioural management, family psycho-education and an integrated holistic multi-disciplinary team community approach. Memory and executive deficits were persistent in the long term and severity of impairments showed wide variability between patients. Emotional distress and behavioural difficulties were prominent and persistent and had a pronounced impact on rehabilitation. Continence issues were also a major factor impacting on the rehabilitation. Long term integrated and multi-disciplinary input by a variety of
Full Text Available Restoration after endodontic treatment is the one important stage to get succesfull endodontics treatment that can return the function and esthetic. The remaining tooth structures generally less, occlusal loading and esthetic consideration is the significant factor to considered in choose type of restorations that in most cases. Onlay is an indirect restoration that covers all ofthe occlusal posterior tooth surface and still follow the contours of the tooth, in which the occlusal morfology experience because previously restoration, caries or the use of physical. A 25 years old male came with a diagnosis of pulp necrosis of the mandibular molars. Tooth of 37 was treatment by endodontic treatment. The clinical condition of dental crown post treatment looks that cusp remaining is not complete, so that the final restoration selected was an all porcelain onlays. The reason for choosing an all porcelain onlay is to get a good esthetic. All porcelain onlays chosen as the restoration of the 37 because have good retention, resistance and excellent esthetic.
Full Text Available Vertigo and dizziness are common symptoms in the general population. While the clinical picture is well known and widely described, there are different interpretations of Benign Paroxysmal Positional Vertigo. The purpose of this case report was to describe the treatment of a 56 year old woman with complains of positional vertigo for 35 consecutive years. She suffered from a sudden onset of rotatory, unilateral horizontal canal type benign paroxysmal positional vertigo (BPPV. The symtoms started a day after falling from a bus, where she injured her head. Otherwise her medical history was unremarkable. She was treated with an individualized home exercise program of eye movement exercises, Brandt/Daroff exercises, and general conditioning exercises (i.e., laying on the left side from sitting on the bed, while the head rotated 45 degrees to the right, waiting for about one minue; twice a day on gradual basis, not laying on the side all the way, but to use enough pillows to lay about at 60 degrees. Four weeks from the start of physical therapy, the patient was free of symptoms, even when her neck was in the extended position.
Mohanty, Sriloy; Shrestha, Rabin Lal
A 32-year-old male diagnosed with transverse myelitis in 2013 came to our clinic in 2015 with complaints of paraplegia, sensory disturbances, pain, exertional dyspnea, poor quality of sleep, emotional instability, and depression. This was a recurrent attack that had been exacerbated by post-traumatic stress. Owing to pain and functional disabilities, he was struggling to actively participate in the treatment modalities offered at our center. A modified protocol of electroacupuncture was planned for a period of 21 days, every day, with each session lasting for 30 minutes. Assessments based on the brief version of World Health Organization Brief Quality of Life (WHO Brief QOL) questionnaire, Pittsburgh sleep quality index, visual analog scale, and a disease-specific physical examination showed momentous improvement in functional health status as well as mental well-being. The quality of life showed significant improvement particularly in the physical and psychological dimensions of WHO Brief QOL. The patient reported a reduction in pain, dyspnea, and fatigue accompanied by an improvement in the quality of sleep and mood. This case report suggests that acupuncture can play a vital role in amelioration of symptoms, thereby improving the health status in patients with transverse myelitis. Copyright © 2017. Published by Elsevier B.V.
Full Text Available A 32-year-old male diagnosed with transverse myelitis in 2013 came to our clinic in 2015 with complaints of paraplegia, sensory disturbances, pain, exertional dyspnea, poor quality of sleep, emotional instability, and depression. This was a recurrent attack that had been exacerbated by post-traumatic stress. Owing to pain and functional disabilities, he was struggling to actively participate in the treatment modalities offered at our center. A modified protocol of electroacupuncture was planned for a period of 21 days, every day, with each session lasting for 30 minutes. Assessments based on the brief version of World Health Organization Brief Quality of Life (WHO Brief QOL questionnaire, Pittsburgh sleep quality index, visual analog scale, and a disease-specific physical examination showed momentous improvement in functional health status as well as mental well-being. The quality of life showed significant improvement particularly in the physical and psychological dimensions of WHO Brief QOL. The patient reported a reduction in pain, dyspnea, and fatigue accompanied by an improvement in the quality of sleep and mood. This case report suggests that acupuncture can play a vital role in amelioration of symptoms, thereby improving the health status in patients with transverse myelitis.
Dianna Ramírez Prada
Full Text Available Case: The objective is to present the successful experience of multidisciplinary management of a patient with short bowel syndrome and intestinal failure with progression to intestinal adaptation. This is a newly born premature with intestinal atresia type IV with multiple intestinal atresia who evolved to intestinal failure and required managed with prolonged parenteral nutritional support, multiple antibiotic schemes, prebiotics, multivitamins, enteral nutrition with elemental formula to achieve their adaptation intestinal until lead to a normal diet. The evolution of these patients intestinal failure is a challenge for the health team, as it not only involves the surgical management of your condition if not basic nutritional support, fluid and electrolyte balance, hepatic dysfunction cholestasis associated infections etc. Discussion: Short bowel syndrome with progression to intestinal failure in children is a condition whose prevalence is increasing worldwide, thanks to advances in neonatal intensive care, neonatal surgery, and nutritional support of patients with conditions such as gastroschisis, omphalocele and necrotizing enterocolitis. Despite the limitations of our health system, it is possible to offer a multidisciplinary and integrated to lead to intestinal adaptation treatment.
Viel, E; Vanoli, A; Melis, A; Rocher, F; Schipman, B; Truong, D
This paper aims to highlight the efficiency of auriculotherapy in the treatment of hot flushes, especially in cancer-related menopausal transition. We used systematically collected data from patients in 2014 in a medical oncology practice. The treatment was made according to the guidelines of The Inter-University Diploma and the cartography of the World Health Organization; data on satisfaction were collected orally. In 2014, 49 patients, among whom 41 had cancer, were treated for hot flushes. Although it is not recommended to treat several symptoms during the same session, we dealt with 1.7 symptoms per session on average. Sixty-nine percent of the patients were satisfied. We lacked data for nine patients, who did not come to the minimal recommended number of treatments (three). Only one patient among those who did not observe any improvement received three treatments. Auricular acupuncture is a safe and cheap method to treat hot flushes. It has been effective in numerous and various cases, among which were patients who presented cancer-related menopausal symptoms. It may be applied for a large variety of other symptoms.
Kludt, Nathan Andrew; Vu, Hugh
This study aimed to present our clinical experience using a prolonged tissue expansion technique and a Medpor framework for congenital microtia reconstruction. Auricular reconstruction was performed in 3 surgical stages. In the first surgical stage, a 60-mL custom kidney-shaped tissue expander is placed subcutaneously in the retroauricular mastoid region. The tissue expander is then serially expanded to maximum volume plus 30%. The tissue expander is then left fully expanded for 3 to 6 months. In the second surgical stage, the tissue expander is removed and a single-piece Medpor implant is placed and covered entirely by the expanded skin flap, without application of a fascial flap or skin graft. In the third stage, we perform an excision of the remnant microtic ear. A total of 15 patients were included with postoperative follow-up ranging from 6 months to 5 years. The draped soft tissue envelope was thin enough to show the reconstructed ear with excellent definition of the framework. Complications in this series included 1 case of partial implant exposure. The use of a Medpor framework after prolonged tissue expansion provides a well-defined, well-projected ear with robust soft tissue coverage. The expanded skin envelope with this method provides sufficient retroauricular non-hair-bearing skin tissues for draping the framework without the need for temporoparietal fascial flap or skin grafting. This alternative surgical method reduces surgical time and morbidity, and facilitates an aesthetic, natural-appearing reconstruction of the auricle.
Full Text Available Deletion of long arm of chromosome 13 is characterized by malformations of the craniofacial region, skeletal abnormalities, other physical abnormalities and intellectual disability. Deletion of the long arm of chromosome 18 is a rare chromosomal disorder with a phenotype that may vary considerably in range and severity, depending on the type of deletion and location of the breakpoint. Subjects have characteristic features including short stature, mental retardation, hypotonia, malformations of the hands and feet, craniofacial abnormalities and numerous neurologic deficiencies with a high incidence of dysmyelination. In this paper we report the case of a female infant with multiple congenital abnormalities, craniofacial dysmorphism, severe mental retardation and severe hypotonia, who was found to have deletions of the long arm of chromosomes 13 and 18. We included her in a rehabilitation program from the age of eleven months. Rehabilitation programs aimed improving hypotonia as well as stimulating the development of motor skills. We observed the case for a period of one year, periodic monitoring of muscle tone and performance, along with the neurological status, showing significant motor and mental improvement. In conclusions: rehabilitation treatment is effective and must be an early intervention.
Full Text Available Objective: to present the effectiveness of pulmonary rehabilitation programs in the treatment of a patient with asthma. Case: this is the case of a young Caucasian girl —17 years old— with severe asthma diagnosis, with symptoms since she was eight years old, 10th grade student. She was referred to the program of Pulmonary Rehabilitation after three hospitalizations during the last year due to asthmatic crises, dyspnoea in activities of daily living, and intolerance to physical exercise. In the initial evaluation, a patient with non-controlled asthma was found; she was receiving short-acting medication admitting that she was not complying with regular use and with a prescribed dose of the pharmacological treatment and that she ignored the importance of this commitment for optimal evolution. The patient expressed concern about the progressive deterioration at her respiratory and functional level during the last year and her fear and anxiety for not being able to breathe during activities befitting her age. One month after receiving bronchodilators and long-acting steroids permanently and complying with recommendations about regular use and adequate inhalatory technique, the patient was included in a three-timesa-week program of pulmonary rehabilitation during eight weeks for upper and lower extremity endurance and resistance training. This intervention showed significant changes in the patient at functional level and a greater social participation.
Dunning, Kari; Black, Kristy; Harrison, Andrea; McBride, Keith; Israel, Susan
Studies have suggested that peroneal nerve functional electrical stimulation (peroneal FES) during walking improves gait in patients with chronic stroke. The effect of peroneal FES during the acute stages of stroke recovery is not known. The purposes of this case report are: (1) to describe differences between walking with and without a neuroprosthesis during the first few weeks after stroke, (2) to offer a clinical perspective on decision making for the use of peroneal FES during acute rehabilitation, and (3) to determine the feasibility of rehabilitation with peroneal FES neuroprostheses during the acute phases of stroke recovery. This case report describes 2 patients with different clinical presentations but both receiving inpatient rehabilitation less than 2 weeks after stroke. Each patient received peroneal FES via a neuroprothesis as tolerated while gait training in therapy. One patient immediately increased gait speed (128%) and decreased time to perform the Timed "Up & Go" Test (40%) using the neuroprothesis. Both patients immediately increased the 6-Minute Walk Test distance using the neuroprothesis (121% and 101%). The patient who underwent testing with the instrumented walking system also demonstrated improved gait symmetry. After 1 to 3 weeks of using the neuroprothesis, the difference between outcomes with and without the neuroprothesis decreased. It is possible that peroneal FES delivered through a neuroprosthesis during acute stroke recovery may improve gait outcomes. Research is needed to determine proper duration and timing.
Lee, M S; Shin, B-C; Suen, L K P; Park, T-Y; Ernst, E
Auricular acupuncture (AA) is a therapeutic method by which specific points on the auricle are stimulated to treat various conditions. AA is often recommended as treatment for insomnia. The aim of this systematic review was to evaluate data from randomised, placebo-controlled clinical trials testing the effectiveness of AA for treating insomnia. We searched the literature using 18 databases from their inception to April 2008 without language restrictions. All prospective randomised clinical trials (RCTs) of AA for subjects with insomnia were considered. Methodological quality was assessed using the Jadad score. We identified 433 possible relevant articles, in which include 10 acceptable RCTs. The methodological quality of the trials was generally poor. Magnetic pellets AA was compared with placebo AA in three of the studies. The results suggested beneficial effects on sleep efficiency compared with placebo AA. One RCT tested needle AA compared with placebo AA and failed to show the effectiveness of AA. Four RCTs compared Semen Vaccariae or magnetic pellet AA with conventional drugs (estazolam or diazepam). Favourable effects for AA were found. Two RCTs tested thumbtack needle AA vs. no treatment suggested beneficial effects of AA on a sleep score. We conclude that, because of the paucity and of the poor quality of the data, the evidence for the effectiveness of AA for the symptomatic treatment of insomnia is limited. Further, rigorously designed trials are warranted to confirm these results.
Orlando D. Navarro
Full Text Available Los tumores cardiacos representan el 0.2% y pueden ser primarios o metastásicos (secundarios, siendo estos últimos 20 a 40 veces más comunes que los primarios. De los tumores primarios, el 75% son benignos y aproximadamente el 50-85% de estos corresponden a mixomas, con una incidencia de 0.5-1 por 106 individuos por año. Se presenta el caso de un paciente de 56 años de edad, sin factores de riesgo cardiovascular ni antecedentes patológicos, con un mixoma auricular izquierdo de 4,6 × 4,5 cm, que prolapsaba hacia la válvula mitral en diástole provocando obstrucción intermitente de la misma y estenosis mitral severa. El diagnóstico se realizó mediante una ecocardiografía transtorácica, sin requerir de otras pruebas diagnósticas. Se realizó resección quirúrgica, lográndose la resección completa del tumor. La evolución posterior del paciente fue satisfactoria, siendo egresado a los 11 días de la intervención.
Full Text Available Deqi sensation, a psychophysical response characterized by a spectrum of different needling sensations, is essential for Chinese acupuncture clinical efficacy. Previous research works have investigated the component of Deqi response upon acupuncture on acupoints on the trunk and limbs. However, the characteristics of Deqi sensations of transcutaneous electrical nerve stimulation (TENS on auricular points are seldom reported. In this study, we investigated the individual components of Deqi during TENS on auricular concha area and the superior scapha using quantitative measurements in the healthy subjects and depression patients. The most striking characteristics of Deqi sensations upon TENS on auricular points were tingling, numbness, and fullness. The frequencies of pressure, warmness, heaviness, and soreness were relatively lower. The dull pain and coolness are rare. The characteristics of Deqi were similar for the TENS on concha and on the superior scapha.
Romoli, Marco; Greco, Francesco; Giommi, Andrea
Auricular Acupuncture Diagnosis is a diagnostic method which is essential for the topographic identification on the auricle of the anatomical parts of the body carrying a particular ailment or dysfunction. To identify the specific zones related to lumbar hernia in patients treated with a series of epidural infiltrations with corticosteroids. In a consecutive group of thirty patients with lumbar hernia 2 diagnostic methods used in Auricular Acupuncture Diagnosis, Pain Pressure Test and Electric Skin Resistance Test, were applied before the first infiltration (T0), before the second and the third infiltration (T1, T2) and one week after the third infiltration (T3). The parameters, whose variations were analyzed at T0-T3, were the following: the number of points identified; the intensity of pain on a verbal rating scale and the foot-hand distance in cm with bent spine and extended knees. The identified points were reported on the Auricular Sectogram which is a validated graphic system suitable for a correct transcription of the points and indicated for a statistical analysis of their distribution on the different sectors. A significant association was found for some auricular areas, along the series of epidural infiltrations, with a progressive reduction in the number of tender and low electrical resistance points together with a decrease of pain and hand-foot distance. The auricular zones found with Auricular Acupuncture Diagnosis in our group of patients seem of clinical relevance and could be included in the complementary treatment of lumbar-sciatic pain in lumbar hernia. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Zambudio, G; Guirao, M J; Sánchez, J M; Girón, O; Ruiz, J I; Gutiérrez, M A
The utility of the nonsurgical correction of congenital auricular deformities by ear molding and splinting has been previously established. Occasionally, its application cannot be easy, and the later collaboration of the parents is necessary. We report a new method of splinting that simplifies the procedure. prospective, case series. Twenty ears in 15 patients between 7 and 60 days of age (average 22 days) were treated. They were 12 prominent ears, 4 Stahl's ears, 2 lop ears, 1 Crinkled ear, and 1 case of increase of antihelix folder. Cotton impregnated with 2-Octyl-Cyanoacrylate is placed as splint for 6 weeks. The bilateral application lasted less than 5 minutes, end there were no spills to the external auditory canal. The splint was given off to the 2 weeks, and a second procedure was necessary in all the cases. There were no dermatitis or skin ulcers. The treatment was successful in 11 cases, partial improvement in 3, poor correction in 4, and recurrence in 2. The splint therapy is an easy nonsurgical method for the treatment of congenital auricular deformities that applied during the first weeks of life provides good aesthetic results in more than 50% of the patients.
Full Text Available This paper explores the relationship between the indicators and different factors that “rating systems for green projects” concentrates on, and principles and factors considered in the rehabilitation of historical buildings. In recent years, different methods and systems concerned and improved for assessing environmental sustainability. LEED (Leadership in Energy and Environmental Design and BREEAM (Building Research Establishment (BRE Environmental Assessment Method are two most commonly used rating systems, established in U.S and UK. These systems comprise some categories and different factors to achieve environmentally responsible design. Firstly, this study focuses on the list of rating systems indicators and criteria. Secondly this paper investigates a historical rehabilitated building in the site of Tabriz Art University, as a case study and has tried to compile its green design elements. Finally, this work intends to compare mentioned elements with indicators and factors of building rating systems. Findings of the study revealed that “Materials and Resources”, “indoor environmental quality” and also “Sustainable Sites” ,the most significant indicator of rating systems, had major and important role in the rehabilitation of the building. Beyond this materials’ life cycle was considerable in construction.
Howell, Emily R
Two case reports review the chiropractic treatment and rehabilitation management of Symphysis Pubis Dysfunction (SPD). Patient 1: a 35-year-old female presented at 30 weeks pregnant with severe left sided Symphysis Pubis Dysfunction and low back pain. Patient 2: a 33-year-old female also 30 weeks pregnant, presented with right sided Symphysis Pubis Dysfunction and sacroiliac pain. Treatment included soft tissue therapy, pregnancy support belt, side-lying mobilizations, pelvic blocks and instrument-assisted pubic symphysis adjustments. Home advice included: ice, staying active, moving as a unit, stretching, use of a pillow between the knees while sleeping, regular breaks from sitting and pelvic floor (Kegel) exercises. Both patients reported some relief with treatment and home care. Post-partum, rehabilitation exercises were prescribed to restore muscular endurance, control and pelvic stability. On long-term follow-up patient 1 reported no pubic symphysis pain, but some low back pain secondary to a subsequent knee injury. Patient 2 reported being mostly pain free with a rare re-exacerbation of pubic symphysis pain. Conservative chiropractic management appears to reduce pain and improve mobility and function for SPD. Post partum rehabilitation of the associated lumbo-pelvic musculature with specific stabilization exercises is recommended to reduce pain, improve long term outcomes and prevent chronicity.
Mixoma auricular izquierdo asociado a insuficiencia severa de válvula mitral en paciente de género femenino de 31 años de edad: reporte de caso Left atrial mixoma associated with severe mitral valve insufficiency in a 31 years old female patient: a case report
Fernando Manzur J
Full Text Available Se presenta el caso de una paciente de 31 años de edad, sin antecedentes patológicos, con un mixoma auricular izquierdo de 9 cm x 8 cm, el cual se manifestó clínicamente, de manera súbita, con sintomatología de tipo obstructiva, y cuyo diagnóstico requirió ecocardiografía transtorácica. Se realizó cirugía inmediata, en la que se logró la resección completa del tumor y durante la cual se evidenció insuficiencia de la válvula mitral severa que requirió plastia valvular. Fue dada de alta al sexto día post-quirúrgico.We report the case of a 31 years old female patient without pathological antecedents, with a left atrial mixoma that measured 9 cm x 8 cm. It manifested clinically by sudden cardiac obstructive symptoms and was diagnosed by transthoracic echocardiography. Immediate surgery was performed, achieving complete tumor resection. A severe mitral valve insufficiency that required valvuloplasty was evidenced. The patient was discharged on the sixth day after surgery.
Çiğdem Canbay Türkyılmaz
Full Text Available The international workshop “Golden Horn Urban Rehabilitation, Reinventing a Productive Landscape” was hosted at Istanbul Kültür University (IKU, Turkey, during the dates of the 4th to 11th July 2011. It counted with the bilateral collaboration of Istanbul Kültür University (IKU, Yildiz Technical University (YTU, Instituto Superior Manuel Teixeira Gomes (ISMAT, in Portugal and Studiomeb. The case study was located in the estuary area of Golden Horn, in Istanbul, and it was centred in the neighbourhoods of Balat, Fener and Hasköy, which are in an advanced process of urban and architectonic degradation. The paper presents our educative research methodology inside the program GreenEngines, developed during three years of continuous collaboration, and shows the results of our international research cooperation in this specific case study. Our pedagogic research method uses the principles of landscape urbanism, landscape planning, and environmental planning. Our research aim, specifically for this workshop ws to educate students on the professional responsibility to create new sustainable planning alternatives for urban rehabilitation in deteriorated urban areas, and specifically, in the case study of Golden Horn in Istanbul. Our research questions were centred in how to preserve and protect the multicultural and multifunctional character of Golden Horn, evaluating its built and socio-cultural heritage, together with how to regenerate the physical urban tissue, reinventing a new productive landscape. Our research statement considered that to achieve a sustainable urban rehabilitation, it was necessary that the planning proposals should adapt to the cultural landscape and the local environment, creating a multifunctional character with different actors involved in the same urban context.
Bal-Boche?ska, Monika Anna
Rehabilitation may be helpful in the prevention of complications associated with the treatment of patients with pectus excavatum who are subjected to surgery using the Ravitch and Nuss methods. This paper presents the case of a patient who underwent successful physical rehabilitation after 8 weeks from the surgery using the combined method. As part of the Nuss procedure, two plates were implanted to form a scaffolding for the patient's chest, which had previously been corrected with the Ravit...
Erieta Nikolikj Dimitrova; Ivana Božinovikj; Simona Ristovska; Aleksandra Hadzieva Pejcikj; Aleksandra Kolevska; Mirjeta Hasani
BACKGROUND: Charcot-Marie-Tooth (CMT) disease is a hereditary disease with signs of chronic non-progressive motor-sensory neuropathy which is characterised by symmetric muscle atrophy and weakness of the distal portion of lower extremities. AIM: The aim is to present two cases with peroneal muscular atrophy, applied rehabilitation procedures and rehabilitation outcome. MATERIAL AND METHODS: Patient DR, aged 51, and patient KH, aged 78. Both patients had weakness and pronounced atrophy...
Partial edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism. The main clinical findings were unopposed remaining teeth, overeruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with crown lengthening surgery and strategic implant placement. Series of provisional prostheses were applied to facilitate the transition to the final treatment. PMID:21503192
Full Text Available Esthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demand of patients for esthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called “star of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. This article presents two case reports of esthetic rehabilitation of anterior teeth using direct composite veneering with two-year follow-up with acceptable outcome.
Sowmya, Kyatham; Dwijendra, K S; Pranitha, V; Roy, Konda Karthik
Esthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demand of patients for esthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called "star of minimal invasion" due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. This article presents two case reports of esthetic rehabilitation of anterior teeth using direct composite veneering with two-year follow-up with acceptable outcome.
de Andrade, Oswaldo Scopin; Ferreira, Luiz Alves; Hirata, Ronaldo; Rodrigues, Flavia Pires; D'Alpino, Paulo Henrique Perlatti; Di Hipolito, Vinicius
The use of ceramic veneers to restore crowded teeth in the maxilla has been widely discussed in the literature. However, the use of this technique in the mandible has received little attention. Therefore, this case report describes the treatment of crowded mandibular anterior teeth using ceramic veneers. The primary treatment challenge in this region is the reduced tooth structure available for rehabilitation. Proper communication between the clinician and dental technician is required to achieve clinical success. This article presents a straightforward treatment plan and restorative technique that includes both the clinical and laboratory sequences necessary for predictable and stable postoperative outcomes.
Full Text Available The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. This article describes the full mouth rehabilitation of a 54-year-old bruxer woman with a severely worn dentition and other dental problems including unsuitable restorations and several missing teeth. The treatment entailed using cast posts and cores, metal-ceramic restorations, and a removable partial denture. As with the treatment procedure of such cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were especially taken into account.
Piva, Sara R; Childs, John D; Klucinec, Brian M; Irrgang, James J; Almeida, Gustavo J M; Fitzgerald, G Kelley
Case report. Patellar fracture is a rare but significant complication following anterior cruciate ligament (ACL) reconstruction when using a bone-patellar tendon-bone (BPTB) autograft. The purpose of these case reports is to describe 2 cases in which patellar fracture occurred during rehabilitation after ACL reconstruction using a BPTB. Both patients were 23-year-old males referred for rehabilitation after ACL reconstruction using a BPTB autograft. They were both progressing satisfactorily in rehabilitation until sustaining a fracture of the patella. One fracture occurred during the performance of the eccentric phase of a knee extension exercise during the sixth week of rehabilitation (7 weeks postsurgery), whereas the other fracture occurred during testing of the patient is quadriceps maximum voluntary isometric contraction in the ninth week of rehabilitation (10 weeks postsurgery). Both patients were subsequently treated with open reduction and internal fixation of the patella. During rehabilitation following ACL reconstruction using BPTB autograft, clinicians should consider the need to balance the sometimes-competing goals of improving quadriceps strength while providing protection to the healing graft, minimization of patellofemoral pain, and protection of the patellar donor site.
Kukla, Marina; Whitesel, Frankie; Lysaker, Paul H
This case study illustrates the use of a long-term integrative psychotherapy approach with a middle- aged man with chronic schizophrenia and a mood disorder. The case of "Holst" describes a man with a history of insecure attachment and trauma who later went on to contract a serious chronic illness, precipitating the onset of psychotic symptoms, depression, and chronic suicidal ideation, resulting in multiple hospitalizations. Combining metacognition-oriented therapy with elements of cognitive behavioral therapy and psychiatric rehabilitation, this approach fostered significantly improved community functioning and attainment of personal goals over time. Through the journey of therapy, the patient also developed a more coherent narrative about his life, established a stable sense of self, and became an active agent in the world. This case illustration demonstrates that these three different approaches can be used in a sequential and complementary fashion to foster recovery in the midst of serious physical and mental illness. © 2015 Wiley Periodicals, Inc.
Full Text Available Abstract Introduction Adolescents with cerebral palsy often do not need a specific rehabilitative treatment; however, when specific needs are expressed, clinicians should listen and try to answer them. Case presentation We present the case of a 17-year-old Italian male patient with hemiplegia who had received standard physiotherapy and, ultimately, after a period of adapted physical activity performed in a group, was under consideration for discharge. However, due to unsatisfactory hand control, he asked for help to reach a personal goal, the ability to drive a motorbike, without surgery. Functional taping showed efficacy, but was neither cost-effective nor practical for the patient and his family; by contrast, a dynamic orthosis associated with training in a real-life environment was instead successful. Conclusion The present case underlines the importance of considering solutions involving the motivation and compliance of the patient in order to improve his activity and participation.
Ulusoy, Kivanç Utku
Introduction In attempting to provide a solution for cases that have been compromised by malpositioned anterior teeth, clinicians traditionally decide orthodontic approach. Nevertheless, in some cases changes in tooth morphology, tooth size, and shape is compulsory for optimal aesthetics. The advent in contemporary aesthetic materials and preparation techniques empowered the clinicians to deliver a promising result with minimal biologic cost. This article presents the clinical considerations that must be addressed when providing a prosthetic restoration for crowded teeth. Case presentation A 23 years old Turkish female patient who had malaligned anterior teeth was rehabilitated with ceramic veneers due to her rejection of orthodontic treatment. The paper describes ceramic veneers can be an alternative treatment to orthodontic therapy under variety of preparation forms when patient has anterior malalignment and rejects the orthodontic treatment. Conclusion The new smile line was satisfactory for the patient and the esthetics was considered as excellent. PMID:19830068
Oyola-Santiago, Tamara; Knopf, Rachel; Robin, Tracy; Harvey, Kristen
Auricular acupuncture using the National Acupuncture Detoxification Association (NADA) protocol stimulates 5 points in each ear--the Shen Men, sympathetic nervous system, liver, kidney, and lung. This protocol is also known as Acu Detox, and has been used for recovery in community-based settings and drug use treatment programs. It has also been…
@@ Irritable bowel syndrome (IBS), a disease of the digestive system related to mental factors, is clinically characterized by diarrhea (or alternation of diarrhea and constipation) and abdominal pain. In recent years, the authors have used auricular-plaster therapy plus pressing on the back-shu points to treat IBS, and obtained good therapeutic results.
Carender, Wendy J; Grzesiak, Melissa
Superior Canal Dehiscence Syndrome (SCDS) causes auditory and vestibular symptoms. Following surgical repair of the dehiscence, patients often experience dizziness and imbalance. This case report describes a postoperative vestibular exercise program, focusing on the principles of central compensation and habituation, and how it was modified for a patient with delayed progress secondary to strabismus and visual vertigo. A 63-year-old male with history of strabismus eye surgery, right hearing loss, aural fullness, and sensitivity to loud sounds was referred for vestibular rehabilitation (VR). He was seen for one preoperative and six postoperative PT visits over eight months. Outcome measures two weeks postoperative were as follows: Dizziness Handicap Inventory (DHI) 38/100; Timed Up & Go (TUG) 9.92 seconds; Dynamic Gait Index (DGI) 16/24; and a 3-line difference in Dynamic Visual Acuity (DVA). Improved outcomes at discharge included: DHI 18/100; TUG 6.87 seconds; DGI 23/24; and 1-line difference in DVA. He was able to return to work and previously enjoyed recreational activities. Postoperative vestibular rehabilitation programs are functionally and symptomatically beneficial following surgical repair for SCDS. Deviations from expected recovery should be addressed to achieve optimal outcomes as demonstrated in this complicated case report.
Ozçakar, Levent; Franchignoni, Franco; Negrini, Stefano; Frontera, Walter
Case reports (CRs) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. However, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine & Rehabilitation and the European Journal of Physical and Rehabilitation Medicine collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, the authors discuss different aspects of the preparation of a well written CR in accordance with the mission and editorial views of both journals.
Özçakar, L; Franchignoni, F; Frontera, W; Negrini, S
Case reports (CR) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side-effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. Yet, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine and Rehabilitation (AJPMR) and the European Journal of Physical and Rehabilitation Medicine (EJPRM) collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, we discuss different aspects of the preparation of a well-written CR in accordance with the mission and editorial views of both journals.
Lynch, C D
There are reports in the literature of the various dental features of hypophosphatasia, especially where it affects the deciduous dentition. The descriptions include both the manifestations of the disorder and the subsequent patterns of tooth loss. There are fewer descriptions of the effects of hypophosphatasia on the permanent dentition and little information on the subsequent prosthodontic management of these patients, particularly in relation to the use of dental implants. The aim of this paper was to review the literature on the dental effects of hypophosphatasia, present two cases and describe how one of those patients, a young adult, was successfully rehabilitated using dental implants. That latter patient\\'s pattern of tooth loss as well as some histological and scanning electron microscopic findings of root cementum from the other case is also described.
Tae, K; Ji, Y B; Song, C M; Sung, E S; Chung, J H; Lee, S H; Park, H J
The aim of this study was to evaluate the technical feasibility and safety of robot-assisted modified radical neck dissection (MRND) for head and neck cancer patients with a clinically node-positive neck. The cases of 10 head and neck cancer patients who underwent unilateral therapeutic robot-assisted MRND by post-auricular facelift approach were analyzed. The robot-assisted MRND was completed successfully in all patients without any conversion to conventional neck dissection. The mean number of lymph nodes removed was 36.7±8.6. The mean duration of surgery for robot-assisted MRND was 274±65min (range 175-395min). Transient marginal nerve palsy occurred in two patients and partial necrosis of the skin flap occurred in one patient. In terms of cosmetic satisfaction, 70% of patients were very satisfied or satisfied with postoperative cosmesis. In conclusion, robot-assisted MRND by post-auricular facelift approach is technically feasible and safe in selected patients with head and neck cancer, and yields excellent postoperative cosmesis. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
de Souza-e-Silva, Cíntia Maria; Parisotto, Thaís Manzano; Steiner-Oliveira, Carolina; Gavião, Maria Beatriz Duarte; Nobre-Dos-Santos, Marinês
The purpose of the case report was to describe the treatment of a 4(1/2)-year-old boy with amelogenesis imperfect (AI) in the primary dentition. AI is a hereditary condition that affects the development of enamel, causing quantity, structural, and compositional anomalies involving all dentitions. Consequently, the effects can extend to both the primary and secondary dentitions. A 4(1/2)-year-old boy was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of amelogenesis imperfecta. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms of both maxillary and mandibular primary incisors and canines. Improvements in the patient's psychological behavior and the elimination of tooth sensitiveness were observed, and the reestablishment of a normal occlusion resulted in improved eating habits. The child was monitored in the Pediatric Dentistry Clinic at four-month intervals until the mixed dentition stage. The oral rehabilitation of young children with AI is necessary to reestablish the stomatognathic system function, so important for a child's systemic health. An adequate medical history and a careful clinical examination were essential for a correct diagnosis. Treatment was rendered that was appropriate for the child's age and clinical/psychological characteristics. Cost-effective restorative techniques involving stainless steel and composite-resin crowns are shown for the restoration of a young patient with amelogensis imperfecta.
Meena Kumari Mishra
Full Text Available Case description: A 60 year old female patient presented to Department of Prosthodontics, CODS, BPKIHS, Dharan with a chief complain of loose obturator. History revealed that patient had undergone partial maxillectomy for squamous cell carcinoma 7 years back. The patient also has been wearing obturator which was loose when the patient reported to the department. On examination, the site of surgery was the maxillary right buccal sulcus area and a part of the hard palate including teeth number 11, 12, 13, 14, 15, 16, 17. The presented defect situation corresponded to a Class I situation (resection performed along the palatalmidline according to the Aramany classification of defects. The surgical site showed complete healing. A hollow-bulb obturator was fabricated for rehabilitation of the defect. Conclusion: The extensive surgical procedures necessary to eradicate cancer of the head and neck and to prevent local recurrence or regional metastasis often leave extremely large physical defects which present almost insurmountable surgical difficulties in restoring acceptable function or esthetics. The prosthesis rehabilitated the patient in terms of function by providing better masticatory efficiency, phonetics by adding resonance to the voice, hence improving the clarity of speech and also improved the esthetics of the patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i4.12976 JCMS Nepal 2014; 10(4:32-36
Villafañe, Jorge H; Silva, Guillermo B; Dughera, Andrea
The purpose of this case report is to describe management and outcomes of a patient with scoliosis. A 9-year-old female patient with a double curve pattern with Cobb angles of 18° and 24° (thoracic/thoracolumbar) compatible with scoliosis presented for physical therapy treatment. Physiotherapy treatment with a combination of manipulative and rehabilitation techniques was used. After finishing the treatment, the patient had Cobb angles of 7° and 11°, an improvement of 55% and 54%, respectively. After 6 months, these effects were maintained, as the patient had Cobb angles of 11° and 11°. The clinical appearance of the patient improved after the course of care. The patient was evaluated for psychological outcomes by applying the following tests: Scoliosis Research Society 22, Bad Sobernheim Stress, and the Brace Questionnaire The patient had the maximum score in all tests at the conclusion of therapy. The patient responded favorably to manipulative and rehabilitation techniques. At the end of care, the patient did not show psychological sequelae with selected outcome measures.
Rong, Pei-Jing; Zhao, Jing-Jun; Li, Yu-Qing; Litscher, Daniela; Li, Shao-yuan; Gaischek, Ingrid; Zhai, Xu; Wang, Lu; Luo, Man; Litscher, Gerhard
Treatment by auricular acupuncture has a long history. Ear-acupoint research has been advancing step by step in China and also in Europe. Auricles are rich in nerves, therefore a close relationship with different functions of the human body has been proved by the research teams of the two main authors of this article from China and Austria. In recent years, great progress has been made in the research of regulating human body functions through electroacupuncture at the auricular branch of the vagus nerve, which is part of auricular acupuncture therapy. It is well known that the auricular branch of the vagus nerve is the only peripheral pathway to the cerebral cortex. Studies of the Chinese team on hypertension, diabetes, epilepsy and depression have shown that the mechanism of auricular vagus nerve stimulation (VNS) may be comparable with cervical VNS in terms of pathways. Auricular VNS has a broad clinical application prospect.
Nanninga, Christa S; Postema, Klaas; Schönherr, Marleen C; van Twillert, Sacha; Lettinga, Ant T
There is growing awareness that the poor uptake of evidence in health care is not a knowledge-transfer problem but rather one of knowledge production. This issue calls for re-examination of the evidence produced and assumptions that underpin existing knowledge-to-action (KTA) activities. Accordingly, it has been advocated that KTA studies should treat research knowledge and local practical knowledge with analytical impartiality. The purpose of this case report is to illustrate the complexities in an evidence-informed improvement process of organized stroke care in a local rehabilitation setting. A participatory action approach was used to co-create knowledge and engage local therapists in a 2-way knowledge translation and multidirectional learning process. Evidence regarding rehabilitation stroke units was applied in a straightforward manner, as the setting met the criteria articulated in stroke unit reviews. Evidence on early supported discharge (ESD) could not be directly applied because of differences in target group and implementation environment between the local and reviewed settings. Early supported discharge was tailored to the needs of patients severely affected by stroke admitted to the local rehabilitation stroke unit by combining clinical and home rehabilitation (CCHR). Local therapists welcomed CCHR because it helped them make their task-specific training truly context specific. Key barriers to implementation were travel time, logistical problems, partitioning walls between financing streams, and legislative procedures. Improving local settings with available evidence is not a straightforward application process but rather a matter of searching, logical reasoning, and creatively working with heterogeneous knowledge sources in partnership with different stakeholders. Multiple organizational levels need to be addressed rather than focusing on therapists as sole site of change. © 2015 American Physical Therapy Association.
Pei-Jing Rong; Jing-Jun Zhao; Lei Wang; Li-Qun Zhou
The international standardization of auricular acupuncture points (AAPs) is an important basis for auricular therapy or auricular diagnosis and treatment. The study on the international standardization of AAPs has gone through a long process, in which the location method is one of the key research projects. There are different points of view in the field of AAPs among experts from different countries or regions. By only analyzing the nine representative location methods, this paper tried to o...
Moura, Carmem Dolores Vilarinho Soares de; Pontes, Alessandra Silva; Lopes, Teresinha Soares Pereira; Moura, Lúcia Fátima Almeida de Deus; Lima, Marina Deus Moura de
Amelogenesis imperfecta (AI) is a tooth disorder characterized by the abnormal development of the enamel in response to mutations in the genes involved in amelogenesis. The objective of this article is to present the clinical case of a child with AI in the primary dentition phase. A 4-year-old boy was presented to a clinic by his mother, who complained that her son's smile esthetics were compromised by "weak and yellow teeth." All the teeth showed yellowish discoloration as well as crumbling or missing enamel. Due to the absence of carious lesions and the presence of normal pulp in the teeth, it was decided to restore the dentition with indirect crowns of ceramic-optimized polymer, also known as ceromer. No preparations were performed on the teeth. For this patient, indirect ceromer restorations presented a good treatment option for the rehabilitation of primary teeth affected by AI.
Metzler-Baddeley, Claudia; Jones, Roy W
Craniopharyngiomas are rare brain tumors within the area of the craniopharyngeal duct. They are often diagnosed in children and young people and can be associated with significant cognitive impairments such as memory and executive problems. This single-case report describes a brief investigation into the effectiveness of goal management training for dysexecutive problems following the removal and treatment of a craniopharyngioma in a young woman. In contrast to previous laboratory-based studies, we exploited naturally occurring distractions within the patient's work environment as periodic alerts to facilitate goal management. Following a 2-month intervention, the patient reported improvements in her ability to focus attention at work and performed significantly better on neuropsychological tests requiring organized behavior posttraining relative to pretraining. Thus, the exploitation of naturally occurring external distractions as periodic alerts to facilitate goal management can be an effective and easy-to-adopt cognitive rehabilitation strategy for dysexecutive problems associated with craniopharyngioma.
Luterek, Maciej; Baranowski, Marcin; Zakiewicz, Wojciech; Biel, Artur; Pedzisz, Piotr
Haemophilia is a congenital haemorrhagic diathesis that in its most severe form leads to a seriously disabling arthropathy as a result of recurring intraarticular bleeding. Within the last couple of years there have been significant advances in the treatment of haemophiliacs that are helping to prevent crippling musculoskeletal deformities, but a relatively large number of young adults still present with advanced arthropathic changes when treatment was started too late or has failed to prevent changes from taking place. We present the case of a 44-year-old male with advanced haemophilic arthropathy of the knee and ankle joints, who, during 8 weeks of therapy that consisted of physical therapy and rehabilitation using PNF techniques (Proprioceptive Neuromuscular Facilitation), achieved mobility improvement according to the SPPB scale (Short Physical Performance Battery Test) and a reduction of pain in the knee and ankle joints, according to a VAS scale. The therapeutic regimen proved to be an effective method improving the locomotor function of the patient.
Full Text Available Objective. The effectiveness of an individualized and everyday approach to cognitive rehabilitation for schizophrenia was examined in a case study. Method. After cognitive and functional assessment, concrete objectives were targeted for the person’s everyday complaints. Strategies were constructed based on an analysis of the cognitive profile, daily life functioning, and processes involved in activities. They included a memory strategy for reading, a diary to compensate memory difficulties, and working memory exercises to improve immediate processing of information when reading and following conversations. Efficacy was assessed with outcome measures. Results. The program had beneficial effects on the person’s cognitive and everyday functioning, which persisted at a 3-year follow-up. Conclusion. Findings provide suggestive evidence that an individualized and everyday approach may be a useful alternative in order to obtain a meaningfully lasting transfer of training to daily life, compared to the nomothetic ones which dominate the field.
Masood, Tahir; Kalliokoski, Kari; Bojsen-Møller, Jens; Finni, Taija
Achilles tendon rupture (ATR) is the most common tendon rupture injury. The consequences of ATR on metabolic activity of the Achilles tendon and ankle plantarflexors are unknown. Furthermore, the effects of eccentric rehabilitation on metabolic activity patterns of Achilles tendon and ankle plantarflexors in ATR patients have not been reported thus far. We present a case study demonstrating glucose uptake (GU) in the Achilles tendon, the triceps surae, and the flexor hallucis longus of a post-surgical ATR patient before and after a 5-month eccentric rehabilitation. At baseline, three months post-surgery, all muscles and Achilles tendon displayed much higher GU in the ATR patient compared to a healthy individual despite lower plantarflexion force. After the rehabilitation, plantarflexion force increased in the operated leg while muscle GU was considerably reduced. The triceps surae muscles showed similar values to the healthy control. When compared to the healthy or a matched patient with Achilles tendon pain after 12 weeks of rehabilitation, Achilles tendon GU levels of ATR patient remained greater after the rehabilitation. Past studies have shown a shift in the metabolic fuel utilization towards glycolysis due to immobilization. Further research, combined with immuno-histological investigation, is needed to fully understand the mechanism behind excessive glucose uptake in ATR cases. Copyright © 2015 Elsevier Ltd. All rights reserved.
Leticia María Lemus Cruz
Full Text Available Se presenta un caso de un paciente rehabilitado en la consulta de Implantología de la Facultad de Estomatología de Ciudad de La Habana. La historia de la implantología moderna se remonta a principios de los años 60, cuando Per-Ingvar Branemark sienta las bases de la osteointegración y describe los primeros implantes de titanio con forma de tornillo. Aunque antigua, es la prótesis más moderna. Si la meticulosidad es obligada en la elaboración de todo tipo de prótesis, en los trabajos de implantes no se admite el más mínimo fallo, desde la planificación del caso hasta la implantación de la prótesis en boca. Para obtener buenos resultados, las técnicas y los procesos han de observarse escrupulosamente. En nuestra Facultad se ha creado el Grupo de Implantología, que es el encargado de la colocación de implantes y la rehabilitación prótesica de estos. Para ello han sido utilizado diferentes tipos de implantes comercializados y patentizados al nivel mundial. Se reafirma que la rehabilitación sobre implantes mejora la calidad estética y funcional de los pacientes.A case of rehabilitation patient is presented seen in Implantation Science consulting room of Stomatology Faculty of Havana City. History of implantation science dates back to at the beginning of 60s, when Per-Ingvar Branemark creates the bases of bone-integration and to describe the firsts titanium implants in a screw form. Although ancient, it is the more modern prosthesis. If meticulousness if mandatory in elaboration of all type of prosthesis, in implants works it inadmissible the minimum of failure, from the case planning until prosthesis implantation in mouth. To achieve good results, techniques and processes has to be scrupulously observed. In our Faculty it has been created a group of Implantation Science, which is in charge of implants placement, and of the prosthetic rehabilitation of these. Thus, we used different types of marketed and showed at world level. It
Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J
Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently. This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes. © 2016 American Physical Therapy Association.
Talaminos-Barroso, Alejandro; Estudillo-Valderrama, Miguel A; Roa, Laura M; Reina-Tosina, Javier; Ortega-Ruiz, Francisco
M2M (Machine-to-Machine) communications represent one of the main pillars of the new paradigm of the Internet of Things (IoT), and is making possible new opportunities for the eHealth business. Nevertheless, the large number of M2M protocols currently available hinders the election of a suitable solution that satisfies the requirements that can demand eHealth applications. In the first place, to develop a tool that provides a benchmarking analysis in order to objectively select among the most relevant M2M protocols for eHealth solutions. In the second place, to validate the tool with a particular use case: the respiratory rehabilitation. A software tool, called Distributed Computing Framework (DFC), has been designed and developed to execute the benchmarking tests and facilitate the deployment in environments with a large number of machines, with independence of the protocol and performance metrics selected. DDS, MQTT, CoAP, JMS, AMQP and XMPP protocols were evaluated considering different specific performance metrics, including CPU usage, memory usage, bandwidth consumption, latency and jitter. The results obtained allowed to validate a case of use: respiratory rehabilitation of chronic obstructive pulmonary disease (COPD) patients in two scenarios with different types of requirement: Home-Based and Ambulatory. The results of the benchmark comparison can guide eHealth developers in the choice of M2M technologies. In this regard, the framework presented is a simple and powerful tool for the deployment of benchmark tests under specific environments and conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Zhou, Rong; Chen, Hui; Xie, Yuan; Chen, Peng; Wang, Luo-lin
To investigate the feasibility of spray drying technology of Auricularia auricular extract and its optimum process. On the basis of single factor test, with the yield of dry extract and the content of polysaccharide as indexes, orthogonal test method was used to optimize the spray drying technology on the inlet air temperature, injection speed and crude drug content. Using ultraviolet spectrophotometry, thin layer chromatography(TLC) and pharmacodynamics as indicators, extracts prepared by traditional alcohol precipitation drying process and spray drying process were compared. Compared with the traditional preparation method, the extract prepared by spray drying had little differences from the polysaccharide content, TLC and the function of reducing TG and TC, and its optimum technology condition were as follows: The inlet air temperature was 180 °C, injection speed was 10 ml/min and crude drugs content was 0. 4 g/mL. Auricularia auricular extract by spray drying technology is stable and feasible with high economic benefit.
Juliana Feltrin de Souza; Camila Maria Bullio Fragelli; Marco Aurélio Benini Paschoal; Edson Alves de Campos; Leonardo Fernandes Cunha; Estela Maris Losso; Rita de Cássia Loiola Cordeiro
Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventiv...
Dillon, Laura; Colling, Kyle
This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…
Rubin, Stanford E.; Farley, Roy C.
This guide is the case study manual for the first in a series of instructor-assisted training modules for rehabilitation counselors, supervisors, and graduate students. This typescript manual for the first module focuses on basic intake interviewing skills consisting of: (1) systematic interview programming including attracting, planning and…
Llorens Rodríguez, Roberto; Colomer, C.; Baldovi Felici, A.; Verdecho, I.
Llorens Rodríguez, R.; Colomer, C.; Baldovi Felici, A.; Verdecho, I. (2014). Clinical and brain imaging changes after upper-limb rehabilitation with a virtual reality tabletop system: A case study. Brain Injury. 28(4):166-166. doi:10.3109/02699052.2014.892379. Senia 166 166 28 4
Nayyer, Leila; Jell, Gavin; Esmaeili, Ali; Birchall, Martin; Seifalian, Alexander M
Current biomaterials for auricular replacement are associated with high rates of infection and extrusion. The development of new auricular biomaterials that mimic the mechanical properties of native tissue and promote desirable cellular interactions may prevent implant failure. A porous 3D nanocomposite scaffold (NS) based on POSS-PCU (polyhedral oligomeric silsesquioxane nanocage into polycarbonate based urea-urethane) is developed with an elastic modulus similar to native ear. In vitro biological interactions on this NS reveal greater protein adsorption, increased fibroblast adhesion, proliferation, and collagen production compared with Medpor (the current synthetic auricular implant). In vivo, the POSS-PCU with larger pores (NS2; 150-250 μm) have greater tissue ingrowth (≈5.8× and ≈1.4 × increase) than the POSS-PCU with smaller pores (NS1; 100-50 μm) and when compared to Medpor (>100 μm). The NS2 with the larger pores demonstrates a reduced fibrotic encapsulation compared with NS1 and Medpor (≈4.1× and ≈1.6×, respectively; P < 0.05). Porosity also influences the amount of neovascularization within the implants, with no blood vessel observed in NS1 (12 weeks postimplantation). The lack of chronic inflammatory response for all materials may indicate that the elastic modulus and pore size of the implant scaffold could be important design considerations for influencing fibrotic responses to auricular and other soft tissue implants. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Glintborg, Chalotte; Hansen, Tia G B
A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her rehabilitation process, and how this is integrated with existing rehabilitation. The case study has been developed based on a semi-structured interview. A Thematic Content analysis was used to reveal dominant patterns and categories. This study revealed a lack of communication and collaboration between public administration (social service), service dog providers, health rehabilitation services, and providers of psychological treatment. It also revealed limited access for the dog to public services, limited success in incorporating the dog into goal-directed treatment and rehabilitation procedures, a strongly felt emotional support from the dog, and a perceived stigma by having the dog wearing a vest with he words "mentally ill
Full Text Available Cytarabine is an effective drug in the treatment of haematological malignancies. The therapy is associated with various complications. Frequencies of dermatological side-effects range from 2–72% and occur most commonly after high-dose regimens. Although most cutaneous reactions are mild and resolve spontaneously within several days, they may result in an increased risk of infection and alterations in comfort. In some cases, severe life-threatening reactions have been reported. Here we describe the case of a patient with acute myeloid leukaemia, who developed severe exceptional skin toxicity in terms of auricular oedema and palmar dyshidrotic eczema after the application of low-dose cytarabine. Re-administration of the drug resulted in reduced skin toxicity during further cycles of chemotherapy. Negative epicutaneous patch-testing supported the existence of cytarabine-provoked toxicity.
case is to emphasize the fact that rehabilitation programs using physical-kinetic therapeutic methods are the only way to limit functional deficit, playing an important role in the long-term management and care of the patient. The particularity of this case consists of the fact that the patient is young, without a known personal pathological history, and symptoms occurred two years after orthopedic surgery, with sudden motor deficit in the lower limbs. The regular follow-up of the patient and his inclusion in complex medical rehabilitation programs in order to limit the functional deficit, increase the autonomy and improve the quality of life of this patient are important. Key words: paraparesis, rehabilitation, spinal meningitis
Wei, Yi Hsuan; Liao, Shu Lang
To report the efficacy of a full-thickness skin graft (FTSG) for the reconstruction of a contracted eye socket. A retrospective, non-comparative, interventional case series. This was a retrospective review of patients with a contracted eye socket who underwent socket reconstruction using a post-auricular FTSG from 2001 to 2011 at the National Taiwan University Hospital. The postoperative results including prosthetic fitting, the cosmetic result, and eyelid function were assessed. There were 11 male and 15 female patients, with a mean age of 52.3 ± 15.6 years (range 21 to 76). The duration of the socket contracture varied from three months to three years (average 7.4 ± 8.1 months). The severity of the socket contracture ranged from grade 2 to grade 4, based on Tawfik's classification. The mean follow-up time was 35.7 ± 9.6 months. After socket reconstruction, using a post-auricular FTSG, 96% of the cases (25 of 26) demonstrated a successful prosthetic fitting and a satisfactory cosmetic outcome. Both good eyelid function and a stable fornix depth were maintained during the follow-up time. One case received a second socket reconstruction three months after the first operation, using a FTSG, because of an inadequate lateral fornix. The final result was satisfactory. There were no serious complications, but a granuloma formed in one case, and there was prolonged discharge in one case. The reconstruction of a contracted eye socket using a post-auricular FTSG is an effective method with a high success rate, which causes less discomfort to donor sites and results in few complications.
Re, D; Cerutti, F; Augusti, G; Augusti, D
When treating children, a conservative and minimally invasive approach is mandatory. In dental traumas with partial coronal destruction, veneers represent the fastest and most effective method to rehabilitate front teeth of a young patient, since these no- or minimal-preparation restorations were proved to have predictable results without reducing the enamel layer. Indirect additive anterior composite restorations, besides being quick and minimally invasive, have to be considered a good treatment option for rehabilitating children, because they are inexpensive and repairable over time. Current laboratory techniques, associated with a strict clinical protocol, satisfy patients' restorative and aesthetic needs in few appointments and in a short time. The cases reported describe the minimally invasive treatment of two lateral incisors with nano-hybrid resin composite veneers after traumatic events. The patient satisfaction and good integration of indirect restorations confirmed the success of this rehabilitation.
Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath
The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.
Vimal Kantilal Munot
Full Text Available The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.
Spinelli, D; Ottria, L; DE Vico, G; Bollero, R; Barlattani, A; Bollero, P
Implant surgery has been changing in different ways following improvements of computer technologies. Since its beginning, according to the original procedures of Branemårk system implants, guide-lines in implants-supported prosthetic rehabilitation have been founding on the placement of fixtures in a fairly upright position, after maxillary sinus floor elevation; while in the case of interforaminal rehabilitation, an upright distal implant may need to be placed anterior to the mental foramina without nerve damage (although the consequence would have been bilateral cantilevers to provide good chewing capacity). Some authors have proposed engaging the molar/tuberosity area: Bahat and Venturelli demonstrated these areas reliable and predictable alternative to distal cantilever prostheses or sinus elevation procedures. In recent years, the immediate loading of tilted implants with a provisional restoration has been proposed for the treatment of the atrophic maxilla. Tilted posterior implants in either arches could avoid (cantilever length) and provide to a better load distribution. Further studies have showed excellent outcomes for both tilted and axial implants; indeed this protocol allows to use longer implants, improve bone anchorage and avoid bone grafting procedures. Malò at al., in a retrospective clinical study, showed important results using two posterior tilted implants and two anterior non-tilted ones in the so-called All-on-four technique (Nobel Biocare, Göteborg, Sweden). Instead of the great loss of bone (amount and quality) in long-term edentuly the clinically documented computer-guided implantology software is able, through posterior tilted implants, to improve load distribution. Many authors have reported reduced surgical invasion (sinus grafting surgery is needless), shorter treatment time, lower cost, natural aesthetic profiles and functional bite.
Mikami, Yukio; Fukuhara, Kouki; Kawae, Toshihiro; Kimura, Hiroaki; Ochi, Mitsuo
The aim of this case study was to verify the efficacy and safety of anti-gravity treadmill training for prosthetic rehabilitation following below-knee amputation. The patient underwent left below-knee amputation as a result of diabetic foot gangrene. Since his physical strength and vitality had declined during the perioperative period, anti-gravity treadmill training was introduced for his outpatient prosthetic rehabilitation. Stable prosthetic gait exercise could be carried out under guidance on the anti-gravity treadmill, quickly resulting in improved gait. Furthermore, the patient's self-efficacy and exercise tolerance were elevated after the period of anti-gravity treadmill training. At the final evaluation following 6 weeks of rehabilitation with the anti-gravity treadmill, he had acquired prosthetic gait with the assistance of a T-cane. The anti-gravity treadmill was found to be a useful instrument for prosthetic rehabilitation following below-knee amputation. Anti-gravity treadmill training has the potential to support the prosthetic rehabilitation of below-knee amputees, especially for patients whose physical strength and vitality are decreased. © The International Society for Prosthetics and Orthotics 2014.
Brenner, Alexander K; Gill, Norman W; Buscema, Christopher J; Kiesel, Kyle
.... The use of rehabilitative ultrasound imaging (RUSI) may offer a convenient way to investigate and document possible changes occurring in the lumbar multifidus associated with manipulation intervention...
Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen
The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.
Full Text Available Introduction. Ankylosing spondylitis (AS/Morbus Bechterew is a chronic inflammatory rheumatoid disease. The temporomandibular joint (TMJ dysfunction is involved in 4–35% of AS cases, and is correlated to the severity and extension of AS. Even though AS-caused TMJ ankylosis is exceptional, one should have high index of suspicion of TMJ ankylosis in AS for an early detection, because it is an extremely serious and disabling condition that causes problems with mastication, swallowing, digestion, speech, appearance and poor oral hygiene with heavy caries. Case report. A 54-year-old male patient sought medical attention at the Department of Periodontology and Oral Medicine, Clinic for Dentistry at the Military Medical Academy, Belgrade, Serbia, with the chief complaint of pain in the area of the upper left canine in the presence of limited mouth opening. The treatment plan consisted of upper left canine management and rehabilitation of the remaining teeth in the frontal and the premolar region in both, the upper and lower jaw. Even though molar region needed to be treated, unfortunately it was not in the treatment plan because ankylosis of TMJ made the treatment impossible. Conclusions. The patients with AS-caused TMJ ankylosis are considered a diagnostic challenge to routine dentistry. Accent should be given to early diagnosis and multidisciplinary approach in the treatment of the AS patients towards the favorable disease course and outcome.
Full Text Available Cancer resection is the most common cause of acquired palatal defects, whereas cleft palate is the main cause of congenital defects. Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two maxillary edentulous patients, one with a surgically induced palatal defect and the other with congenital cleft palate. In case 1, an 86-year-old man underwent surgical removal of soft-palate squamous cell carcinoma. The acquired palatal defect was repaired by a maxillary complete denture with a posteriorly extended speech bulb. The final prostheses provided good chewing and speech functions. In case 2, a congenital cleft palate in a 65-year-old man was repaired by a maxillary complete denture with superior extension of the obturator, which was designed to improve retention and stability of the upper single denture. He was satisfied with the upper denture after prosthesis placement. Conventional maxillary complete denture with a posteriorly extended speech bulb or modified obturator provides a good chance to restore oral functions in patients with palatal defects. The patients' skill and previous experience of denture wearing might have been important in their successful treatment. However, different patients present with unique problems and need to be treated individually.
Gabbatore, Ilaria; Geda, Elisabetta; Gastaldo, Luigi; Duca, Sergio; Costa, Tommaso; Bara, Bruno G.; Sacco, Katiuscia
Introduction. The present study was intended to evaluate the effects of a rehabilitative training, the Cognitive Pragmatic Treatment (CPT), aimed at improving communicative-pragmatic abilities and the related cognitive components, on the cerebral modifications of a single case patient diagnosed with schizophrenia. Methods. The patient underwent two functional magnetic resonance imaging (fMRI) sessions, before and after the treatment. In order to assess brain changes, we calculated the Amplitude of Low Frequency Fluctuation (ALFF) index of the resting-state fMRI signal, which is interpreted as reflecting the intensity of the spontaneous regional activity of the brain. Behavioural measures of the patient's communicative performance were also gathered before and after training and at follow-up. Results. The patient improved his communicative performance in almost all tests. Posttraining stronger ALFF signal emerged in the superior, inferior, and medial frontal gyri, as well as the superior temporal gyri. Conclusions. Even if based on a single case study, these preliminary results show functional changes at the cerebral level that seem to support the patient's behavioural improvements. PMID:28239498
Toyokura, Minoru; Koike, Tomoharu
Balint's syndrome is characterized by three major disorders of spatial analysis: fixed gaze or psychic paralysis, simultagnosia, and optic ataxia or misreaching. Most patients with Balint's syndrome generally do not show all three of these signs. The authors herein reported the more than four-year clinical course of a case (a 43-year-old man) with Balint's syndrome presenting these three disorders. The patient also had a mild type of conduction aphasia, but his attentional, intellectual and memory functions were well preserved. SPECT showed cerebral hypoperfusion in the bilateral parieto-occipital areas. Whereas rehabilitative intervention with process specific approach for the impaired visual cognition seemed to be significantly ineffective, a functional adaptation approach successfully promoted the patient's social participation. However, the present patient could not help having to resign from his job. Additionally, double impairment of visual (including optic ataxia) and language functions made it impossible for him to obtain a new work. Like the present case, those who have a higher brain dysfunction, but retain good physical ability can hardly receive the benefit of the social welfare system in Japan. Legislation addressing this problem is a matter of great urgency.
Full Text Available Objective: The purpose of this presentation is to show the difficulty in prosthetization of a clinical case with a pronounced atrophy of the upper jaw and the various types and nature of restrictions imposed by the requirements of the patient. Methods: The clinical analysis, surgical protocol and prosthetic solution are presented in the treatment of 72 year-old woman with a pronounced atrophy of the upper jaw. OPG, standard CT of the upper jaw was used in the planning and a special surgical template was fabricated, helping us to find intraoperatively the exact locations of implants. The preliminary analysis of the number, height and diameter of intraossal implants helped us to find the exact prosthetic solution in this clinical case. The preparation of the implant bed was done by conical osteotomy in order to expand and condense the existing bone, which allowed us to use endoossal implants with a possible maximum size in a very limited maxillary volume and the reluctance of the patient to use other methods and surgical techniques. Conical threaded and self-tapping intraossal implants were used, placed according to a classic two-stage methodology with a flap and a long-term functional loading after a period of four months.Results and Conclusion: The applied surgical and prosthetic solution allowed us to achieve a good functional and aesthetic rehabilitation in this case of severe atrophy of the upper jaw, following a number of restrictions imposed on us by the reluctance of the patient to use other surgical solutions. This shows that in the case of severe atrophy of the upper jaw, a good clinical result can be achieved. For this reason, the use of CT,a well-planned surgical template, sufficient preparation ,the maximum use of available bone volume and the choice of a good prosthetic solution is very important.
Martin, Brett R
The purpose of this case report was to describe the use of dry needling in conjunction with auricular acupuncture, core exercises, and light aerobic activity for treating chronic tendinopathy of the biceps femoris. A 30-year-old white female presented with chronic biceps femoris tendinopathy. The injury had occurred 18 months prior while training for a triathlon. Active stretching of her right biceps femoris while standing with her feet 6 inches apart aggravated the pain at the origin in the right tendon of the biceps femoris at 0 degrees of movement. The combination of dry needling and auricular acupuncture with core rehabilitation exercises and light activity was employed. Alleviation of pain with full range of motion was achieved during hip extension, knee flexion, and standing biceps femoris stretch at the 11th, 16th, and 18th treatments. In addition, the patient also reported improvement in her symptoms, including night sweats, insomnia, anxiety, tension, and constipation. This patient's symptoms and function improved after 18 treatments of multimodal care. Dry needling employed simultaneously with auricular acupuncture, core exercises, and light activity could be considered a possible strategy for treating chronic tendinopathy.
King, Cdr Heather C; Moore, Lcdr Chad; Spence, Cdr Dennis L
Auricular acupuncture treatments are becoming increasingly available within military treatment facilities, resulting in an expansion of nonpharmacologic treatment options available to veterans with posttraumatic stress disorder (PTSD). This study aimed to explore the self-reported benefits of auricular acupuncture treatments for veterans living with PTSD. A qualitative research methodology, thematic content analysis, was used to analyze data. Seventeen active duty veterans with PTSD provided written comments to describe their experiences and perceptions after receiving a standardized auricular acupuncture regimen for a 3-week period as part of a pilot feasibility study. A variety of symptoms experienced by veterans with PTSD were improved after receiving auricular acupuncture treatments. Additionally, veterans with PTSD were extremely receptive to auricular acupuncture treatments. Four themes emerged from the data: (1) improved sleep quality, (2) increased relaxation, (3) decreased pain, and (4) veterans liked/loved the auricular acupuncture treatments. Veterans with PTSD reported numerous benefits following auricular acupuncture treatments. These treatments may facilitate healing and recovery for veterans with combat-related PTSD, although further investigations are warranted into the mechanisms of action for auricular acupuncture in this population. © The Author(s) 2015.
Background: Pre-auricular sinus frequently present with recurrent episodes of infections/abscesses causing severe discomfort and disturbance of daily activities, necessitating surgical intervention to eradicate the condition. Aim: To audit the surgeries that were done for pre-auricular sinus infection/abscess in University of ...
Farrell, Elizabeth; Naber, Erin; Geigle, Paula
This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.
Dimitrova, Erieta Nikolikj; Božinovikj, Ivana; Ristovska, Simona; Pejcikj, Aleksandra Hadzieva; Kolevska, Aleksandra; Hasani, Mirjeta
Charcot-Marie-Tooth (CMT) disease is a hereditary disease with signs of chronic non-progressive motor-sensory neuropathy which is characterised by symmetric muscle atrophy and weakness of the distal portion of lower extremities. The aim is to present two cases with peroneal muscular atrophy, applied rehabilitation procedures and rehabilitation outcome. Patient DR, aged 51, and patient KH, aged 78. Both patients had weakness and pronounced atrophy of the distal portion of lower extremities, numbness down the legs, contractures in the ankles and walking difficulties. Evaluation of patients included a clinical examination, Barthel Index, Time Up and Go test, measurement of the ankle range of motion, and a manual muscle test. On admission, the Barthel Index score was 60 in the first case, and 80 in the second. The rehabilitation program included exercise therapy with for lower extremity, occupational therapy, stationary bicycle riding, galvanic current, water exercises, and ankle-foot orthoses for both legs. The therapy applied had no significant changes in the clinical neurological status of the patients, but yet it provided some improvement in ankle contractures, better mobility, and a more stable gait. The application of rehabilitation procedures in patients with Charcot-Marie-Tooth disease can improve their functional status and walking stability.
Iizuka, Masayuki; Reding, Mike
To compare the morbidity, mortality, and functional recovery of patients who require percutaneous endoscopic gastrostomy (PEG) placement for the management of dysphagia after stroke. Retrospective case-matched controlled study. Acute stroke rehabilitation inpatient unit. Patients (N=193) who were admitted for stroke rehabilitation with a PEG tube in place from January 1, 1993, to December 31, 2002, were matched with 193 case controls without PEG. Patients and controls were within 90 days of stroke onset, and were matched for age, sex, type of stroke, FIM instrument score, duration from onset to stroke unit admission, and year of admission. Not applicable. Length of rehabilitation hospital stay, improvement in FIM scores, FIM efficiency score, need for transfer back to acute care hospital, diagnosis for which transfer was required, final discharge destination, and survival status. Significant differences were found between the 2 groups, PEG versus control, respectively, in the following variables: FIM efficiency (.42+/-.57 vs .56+/-.55, P =.016); need for transfer back to acute hospital (58/193 vs 23/193, P =.001); and survival status dead/alive (14/179 vs 3/190, P =.006). Nonsignificant differences were as follows: length of rehabilitation hospital stay (46.9+/-24.8d vs 43.3+/-19.7d, P =.11), improvement in total FIM score from admission to discharge (16.9+/-17.9 vs 21.0+/-15.5, P =.72), and final discharge destination home/institutional care (96/83 vs 101/89, P =.93). Pneumonia was the most frequent reason for transfer to acute care for patients with PEG. Patients who meet criteria for admission to a stroke rehabilitation unit and who have a PEG in place are at increased risk for medical complications and death. Those who survive, however, show similar functional recovery and rate of home discharge as case-matched controls.
Hou, Pu-Wei; Hsu, Hsin-Cheng; Lin, Yi-Wen; Tang, Nou-Ying; Cheng, Chin-Yi; Hsieh, Ching-Liang
Auricular therapy includes acupuncture, electroacupuncture, acupressure, lasering, cauterization, moxibustion, and bloodletting in the auricle. For 2500 years, people have employed auricular therapy for treating diseases, but the methods have been limited to bloodletting and cauterization. Only after 1957, the international scientific community became aware that the map of the ear resembles an inverted fetus, its introduction has led to auricular acupuncture (AA) becoming a more systemic approach, and, following the identification and standardization of more precise points, AA has been employed in clinical applications. The mechanisms of AA are considered to have a close relationship with the autonomic nervous system, the neuroendocrine system, neuroimmunological factors, neuroinflammation, and neural reflex, as well as antioxidation. Auricular therapy has been applied, for example, for pain relief, for the treatment of epilepsy, anxiety, and obesity, and for improving sleep quality. However, the mechanisms and evidence for auricular therapy warrant further study.
Full Text Available Auricular therapy includes acupuncture, electroacupuncture, acupressure, lasering, cauterization, moxibustion, and bloodletting in the auricle. For 2500 years, people have employed auricular therapy for treating diseases, but the methods have been limited to bloodletting and cauterization. Only after 1957, the international scientific community became aware that the map of the ear resembles an inverted fetus, its introduction has led to auricular acupuncture (AA becoming a more systemic approach, and, following the identification and standardization of more precise points, AA has been employed in clinical applications. The mechanisms of AA are considered to have a close relationship with the autonomic nervous system, the neuroendocrine system, neuroimmunological factors, neuroinflammation, and neural reflex, as well as antioxidation. Auricular therapy has been applied, for example, for pain relief, for the treatment of epilepsy, anxiety, and obesity, and for improving sleep quality. However, the mechanisms and evidence for auricular therapy warrant further study.
Bernateck, M; Becker, M; Schwake, C
BACKGROUND: In contrast to psychological interventions the usefulness of acupuncture as an adjuvant therapy in rheumatoid arthritis (RA) has not yet been demonstrated. OBJECTIVE: The efficacy of auricular electroacupuncture (EA) was directly compared with autogenic training (AT). METHODS: Patients...
Full Text Available Os autores apresentam o caso clínico de um doente de 71 anos, sem factores de risco vascular, admitido com clínica de acidente vascular cerebral transitório (AIT, cuja investigação etiológica veio revelar uma causa rara para esta faixa etária: um mixoma auricular esquerdo. The authors present a case of a patient of 71 years, without cardiovascular risk factors admitted by transient ischemic attack (TIA, whose diagnostic investigation led to the diagnosis of left atrial myxoma.
Briand, Catherine; Sablier, Juliette; Therrien, Julie-Anne; Charbonneau, Karine; Pelletier, Jean-François; Weiss-Lambrou, Rhoda
This study aimed to test the feasibility of using a mobile device (Apple technology: iPodTouch®, iPhone® or iPad®) among people with severe mental illness (SMI) in a rehabilitation and recovery process and to document the parameters to be taken into account and the issues involved in implementing this technology in living environments and mental health care settings. A qualitative multiple case study design and multiple data sources were used to understand each case in depth. A clinical and comprehensive analysis of 11 cases was conducted with exploratory and descriptive aims (and the beginnings of explanation building). The multiple-case analysis brought out four typical profiles to illustrate the extent of integration of a personal digital assistant (PDA) as a tool to support mental health rehabilitation and recovery. Each profile highlights four categories of variables identified as determining factors in this process: (1) state of health and related difficulties (cognitive or functional); (2) relationship between comfort level with technology, motivation and personal effort deployed; (3) relationship between support required and support received; and (4) the living environment and follow-up context. This study allowed us to consider the contexts and conditions to be put in place for the successful integration of mobile technology in a mental health rehabilitation and recovery process.
Full Text Available The term post-polio syndrome (PPS was introduced in 1985 by Halstead. It is characterized by sudden or progressive muscle weakness, new muscular atrophy, muscle pain, fatigue, functional impotence, cold intolerance, after a period of at least 15 years from acute polio virus infection, a period of neurological and functional stability, in the absence of other medical explanation . The reported prevalence of PPS is between 15% and 80% of all patients with previous polio virus infections [2, 3]. Poliomyelitis continues to be a public health problem, because the consequences of the disease last throughout life. In Europe, there are about 700,000 persons who survived the infection and are still alive. Non-randomized studies with kinesitherapy programs with a duration between 6 weeks and 7 months, involving isokinetic and isometric endurance muscle training, have demonstrated an increase of muscle strength in the case of patients with mild or moderate muscle weakness, and a reduction of muscle fatigue [7, 8, 9]. The differential diagnosis of PPS can be difficult because of the need to exclude both neurological and non-neurological conditions that aggravate the pre-existing motor deficit. Rehabilitation programs using therapeutic means: kinesitherapy, thermotherapy, hydrothermotherapy, occupational therapy represent the only way to limit functional deficit and to improve pain, playing an important role in the long-term management and care of patients.
Zărnica I. Manuela Mirela
Full Text Available Agenesis of corpus callosum is a new challenge for the puluridisciplinary team, in their efforts for the rehabilitation of childrens with this diagnose, because is a rare congenital desease with an unknown frequence of emergence. Scope. This paperwork aims to present the approach modalities of the child with agenesis of corpus callousum and the means of physical therapy that may help. Methods. This is a case study of a 5 years old girl with asenesis of corpus callosum. For assessment we used motor assessment, range of motion, reflexes. Exercises from different positions were done as games and motric songs. Sensory stimulation was also done. Rezults. By direct observation of the patient we observed significant improvement in motor function. We also foud unexpected improvement of quiet stance and dynamic balance, sensory-motor coordination. Conclusions. Game, tha main therapeutic method through its form, diversity and characteristics - atractivity, directness, creativity, movement freedom – is the main supplement of child psicho-motric development. A balanced distribution of influences upon motricity, psychic, thinking and action, nonverbal and expression language, represent the qualitative peculiarity of specialist’s and parents efforts.
Full Text Available Chih-Lan Kuo1, Sui-Foon Lo1,2, Chun-Lin Liu3, Chia-Hui Chou4, Li-Wei Chou1,2,5¹Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; ²School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan; 4Department of Infectious disease, China Medical University Hospital, Taichung, Taiwan; 5Department of Physical Therapy, China Medical University, Taichung, TaiwanAbstract: There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann's syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann's syndrome, and right-sided apraxia.Keywords: tuberculous brain abscess, Gerstmann's syndrome, rehabilitation
Full Text Available Introducción y Objetivos: La incidencia de queloides auriculares es cada vez mayor. Su alta frecuencia de recidiva es de gran interés, por ello su extirpación quirúrgica se asocia a otras terapias como radioterapia, corticoides, crioterapia, láser, presoterapia, etc. La presoterapia resulta un método efectivo, sencillo y accesible. Material y Método: Realizamos un estudio prospectivo, experimental, sobre 11 casos de queloides auriculares tratados con resección quirúrgica seguida de presoterapia usando imanes, tomando en cuenta la presión y fuerza magnética ejercida. Llevamos a cabo seguimiento de los casos entre 4 y 6 meses. Empleamos las pruebas de Mann-Whitney y Coeficiente Lineal de Pearson. Determinamos la tasa de recurrencia y realizamos un analisis de regresión para el estudio de la escala de Valor Análoga del Dolor (EVA. Resultados: La tasa libre de recurrencia fue del 90.91%. No hubo ningún tipo de complicación. En cuanto a la EVA, observamos una ascendente tolerancia a la terapia con imanes auriculares a través del tiempo. Conclusiones: El protocolo de uso de imanes que presentamos es un excelente tratamiento coadyuvante. El magnetismo parece cumplir un papel fundamental en la remodelación y organización de las fibras de colágeno de las cicatrices postoperatorias, añadiendo una efectividad mayor a la presoterapia.
Kho, Michelle E; Damluji, Abdulla; Zanni, Jennifer M; Needham, Dale M
Early rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the ICU. We conducted an observational study from September 1, 2009, to August 31, 2010, of adults admitted to a 16-bed medical ICU receiving video games as part of routine physical therapy (PT), evaluating use and indications and occurrence of 14 prospectively monitored safety events. Of 410 patients receiving PT in the medical ICU, 22 (5% of all patients; male, 64%; median age, 52 years) had 42 PT treatments with video games (median [interquartile range] per patient, 1.0 [1.0-2.0]). Main indications for video game therapy included balance (52%) and endurance (45%), and the most common activities included boxing (38%), bowling (24%), and balance board (21%). Of 42 treatments, 69% occurred while standing and 45% while mechanically ventilated. During 35 hours of PT treatment, 0 safety events occurred (95% upper confidence limit for safety event rate, 8.4%). Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients. Copyright © 2011 Elsevier Inc. All rights reserved.
Dra. E. Marianella Seguel R.
La fibrilación auricular es la arritmia más frecuente y se relaciona con una alta tasa de accidente cerebrovascular y embolia sistéc)mica. La terapia establecida tanto para prevención primaria como secundaria es la anticoagulación con warfarina, antagonista de la vitamina K. Existen escalas que predicen el riesgo tromboembólico y la probabilidad de beneficiarse de terapia antitrombótica. El CHADS2 ha sido la más simple y ampliamente utilizada, pero actualmente el CHA2DS2-VASc ha incorporado o...
Gilbert, Aubrey L; Hunter, David G
Duane syndrome is a congenital cranial dysinnervation disorder involving absent or anomalous innervation of the lateral and medial rectus muscles that is sometimes associated with other manifestations of dysinnervation. We describe a patient with right esotropic Duane syndrome with a long-standing retroauricular tugging sensation in right gaze who was noted to have prominent ipsilateral oculo-auricular phenomenon, representing either abnormal enhancement of existing innervation or an uncommon dysinnervation. After successful strabismus surgery the tugging sensation improved but the phenomenon could still be elicited. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
Glintborg, Chalotte; Hansen, Tia G. B.
Simple Summary The use of service dogs for adults with mental illnesses has become generally accepted. With reference to a single case study of a client with Post Traumatic Stress (PTSD), this study illustrates some of the potential advantages, but also note an important concern that appears to have gone unnoticed. The provision of service animals/therapy animals for adults with mental illnesses must be sufficiently informed by relevant knowledge and integrated with concurrent rehabilitation ...
Schaal Wilson, Rachel E
External hemipelvectomy (EHP) is an uncommon procedure involving surgical amputation of the lower extremity and hemipelvis. Soft tissue sarcomas of the pelvis are rare and accompanied by a high risk of disease progression after surgical intervention. The purpose of this case report is to describe the rehabilitation considerations and importance of interdisciplinary collaboration to achieve functional goals to allow discharge with improved independence and decreased caregiver burden. A 58-year-old Caucasian male patient underwent a hemipelvectomy and hemisacrectomy for treatment of a recurrent pelvic soft tissue sarcoma following 4 months of bed confinement secondary to pain and weakness of the involved lower extremity. This report outlines the physical therapy interventions during 3 weeks of inpatient rehabilitation. This case demonstrates that continuous interdisciplinary care of a complex patient with EHP and hemisacrectomy contributes to significant improvement in functional mobility exceeding prior level of function. This case is particularly interesting because in addition to having a rare diagnosis and undergoing an uncommon surgical procedure, this patient was confined to bed for 4 months prior to surgical intervention, and thus began rehabilitation with a baseline of limited functional mobility and high caregiver burden.
Peng, Bin; Dong, Hongjuan; Chu, Hong; Zhang, Shenqi; Lu, Zuneng
To investigate the involvement of posterior auricular muscle (PAM) and the effect of botulinum toxin type A (BTX-A) injection into PAM in patients with hemifacial spasm (HFS) complicated with auricular symptoms. Sixty-three consecutive HFS patients complicated with auricular symptoms such as tinnitus or murmur, "ticking" or a "clicking" sound and discomfort on the same side, who were referred to our department between July 2009 and January 2010, were enrolled. The diagnosis of idiopathic HFS was made clinically. The patients were largely randomized into two BTX-A treatment groups according to the order of referral. The first group included 33 cases where the injection sites were routinely located at the frontal, orbicularis oculi, zygomaticus and buccinator muscles while the other was the PAM group, which included 30 cases, where 4 units of BTX-A were additionally injected into the PAM prior to injection at other sites. A test of blink reflex was performed and the lateral spread of blink reflex to the orbicularis oris (OO) and PAM, i.e. abnormal muscle response (AMR), was recorded and the peak-peak amplitude of AMR was measured. The patients were followed up clinically and electrophysiologically for at least 4 weeks (29.47 ± 2.53 days). 1) Before injection, the latencies of R1, R2, R2' were normal, there was no significant difference between uninjured and affected side; The amplitudes of R1, R2, R2' in affected side were higher. 2) After injection, there was no significant change of the R1, R2 and R2' latencies; The amplitudes of R1, R2 and R2' decreased significantly. 3) Patients reported that their auricular symptoms subsided after injection in both groups; The remission rate was 45.5% (15/33) and 76.7% (23/30) in the regular and PAM group, respectively, with a higher rate in the PAM group (χ(2) = 6.40, P = 0.011). 4) In both groups the AMR amplitude decreased significantly after injection. In the regular group, the respective OO amplitudes (μV) before and
Carvalho, Carmo Gonçalves de; Flores-Colen, Inês; Faria, Paulina
The main purpose of the research is to present a proposal for a methodology to support the rehabilitation project of renders of old buildings in Portugal. To achieve the objective it was considered essential to define the main types of participants and aspects to integrate the proposal. The research methodology consists in an inquiry presented to professional participants in rehabilitation, a market study of materials and products available in Portugal, the design of a methodology proposal an...
Kaski, Diego; Buttell, Joseph; Greenwood, Richard
To further understand the mechanisms underlying gait impairment following traumatic brain injury. A 58-year-old man presented with marked unsteadiness and motion sensitivity following a severe traumatic brain injury. He underwent a 6-week inpatient rehabilitation program focused on re-weighting and subsequently re-integrating ascending interoceptive information, by gradual reduction of maladaptive visual fixation techniques. We report clinical neurological outcomes and measures of functional outcome, as well as an objective assessment of visual dependency (the rod and disk test) at baseline and after the rehabilitation. Clinically, the patient had gait unsteadiness exacerbated by visual motion. A significant reduction in visual dependency occurred with tailored multi-disciplinary rehabilitation via gradual removal of visual fixation strategies that the patient had developed to maintain balance (t-test; p visual dependency in the generation of maladaptive gait strategies following brain injury. Our data suggest assessing and treating visual dependency to be an important component of gait rehabilitation after traumatic brain injury. Implications for rehabilitation Whilst gait disturbance in TBI is multifactorial, abnormal visual dependency may be important but under-recognised component of the disorder. Visual dependency can be easily and objectively assessed by the bedside in patients using a dynamic rod and disc test. Tailored rehabilitation with gradual reduction of maladaptive visual fixation can reduce visual dependency and contribute to improved gait and balance following TBI.
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Burmaster, Chris; Eckenrode, Brian J; Stiebel, Matthew
Both traditional and progressive rotator cuff repair rehabilitation protocols often delay active motion of the shoulder for 6 weeks or more. The early inclusion of a comprehensive aquatic-assisted exercise program presents a unique approach to postoperative management. The purpose of this case study is to describe a comprehensive evidence-based, aquatic-assisted rehabilitation program following arthroscopic rotator cuff repair. A 73-year-old woman with a nonretracted, medium-size, full-thickness tear (2.5 cm) of the supraspinatus tendon underwent arthroscopic rotator cuff repair and was referred for postoperative physical therapy. The rehabilitation program was initiated at 2 weeks postoperatively and consisted of concurrent land- and aquatic-based interventions over 6 weeks for a total of 18 physical therapy visits. Improvements were made in all 5 patient-reported outcome measures that were recorded weekly over the course of care. Improvements reached or exceeded minimal detectable change levels for the Shoulder Pain and Disability Index and the Penn Shoulder Score. Her numeric pain rating scale score at rest decreased from 4/10 at the initial evaluation to 2/10 at 8 weeks postoperatively and with activity decreased from 9/10 to 6/10. Shoulder strength and range of motion values also exhibited improvement over the course of care. No adverse events occurred during the case study. This case study illustrates the safe inclusion of low-stress aquatic exercises as an early adjunct to traditional land-based rotator cuff repair rehabilitation programs in small- to medium-size repairs. Further studies are needed to determine the long-term effectiveness of adding aquatic therapy to traditional postoperative programs. © 2016 American Physical Therapy Association.
Randall, Natalie J; Blitvich, Bradley J; Blanchong, Julie A
Surveillance is critical for identifying and monitoring pathogen activity in wildlife populations, but often is cost- and time-prohibitive and logistically challenging. We tested the hypothesis that wildlife rehabilitation centers are useful for monitoring pathogen activity using West Nile virus (WNV) as a case study. We hypothesized that birds submitted to wildlife rehabilitation centers would have a similar prevalence of antibody to WNV as free-ranging birds. From 2008 to 2010, we collected sera from peridomestic birds submitted to the Wildlife Care Clinic (WCC), a wildlife rehabilitation center in central Iowa, and tested them for antibodies to WNV. We also collected and tested sera from free-ranging peridomestic birds in the area from which approximately 50% of WCC submissions historically originated. Prevalences of WNV antibodies in free-ranging birds and in peridomestic WCC birds were 2.3% (44/1,936) and 2.8% (2/72), respectively. However, none of the birds submitted to the WCC from the area where we captured free-ranging birds had antibodies (0/29). Our results indicate that rehabilitation facilities are not likely to be useful for monitoring WNV activity at small spatial scales or over short-time periods due to the low endemic prevalence of WNV, and low and variable submission rates. However, at larger spatial scales (ca. nine Iowa counties) WNV antibody prevalence in peridomestic birds submitted to the WCC was similar to that of free-ranging birds. Although limitations to using rehabilitation birds to monitor WNV must be considered, testing these birds could be useful for monitoring WNV activity regionally, especially with many states limiting surveillance due to budgetary constraints.
Dra. E. Marianella Seguel R.
Full Text Available La fibrilación auricular es la arritmia más frecuente y se relaciona con una alta tasa de accidente cerebrovascular y embolia sistécmica. La terapia establecida tanto para prevención primaria como secundaria es la anticoagulación con warfarina, antagonista de la vitamina K. Existen escalas que predicen el riesgo tromboembólico y la probabilidad de beneficiarse de terapia antitrombótica. El CHADS2 ha sido la más simple y ampliamente utilizada, pero actualmente el CHA2DS2-VASc ha incorporado otros factores de riesgo, otorgando una mejor estratificación. El estrecho margen terapécutico de la warfarina y la interacción con fármacos y alimentos requiere controles seriados de la intensidad de la anticoagulación, limitando su uso clínico. Han aparecido nuevos anticoagulantes que ofrecen ventajas sobre los antagonistas de vitamina K. Estos actúan en dos sitios distintos de la cascada de la coagulación: inhibiendo directamente la trombina como el dabigatran, o el factor X activado como el rivaroxaban, apixaban, edoxaban y betrixaban. Estos nuevos fármacos han ido reemplazando a la warfarina y ya están incluidos en las guías de manejo de fibrilación auricular no valvular.
Prashant G Bhat
Full Text Available BACKGROUND: Severe acute malnutrition (SAM is the most serious form of malnutrition affecting children under-five and is associated with many infectious diseases including Tuberculosis (TB. In India, nutritional rehabilitation centres (NRCs have been recently established for the management of SAM including TB. The National TB Programme (NTP in India has introduced a revised algorithm for diagnosing paediatric TB. We aimed to examine whether NRCs adhered to these guidelines in diagnosing TB among SAM children. METHODS: A cross-sectional study involving review of records of all SAM children identified by health workers during 2012 in six tehsils (sub-districts with NRCs (population: 1.8 million of Karnataka, India. RESULTS: Of 1927 identified SAM children, 1632 (85% reached NRCs. Of them, 1173 (72% were evaluated for TB and 19(2% were diagnosed as TB. Of 1173, diagnostic algorithm was followed in 460 (37%. Among remaining 763 not evaluated as per algorithm, tuberculin skin test alone was conducted in 307 (41%, chest radiography alone in 99 (13% and no investigations in 337 (45%. The yield of TB was higher among children evaluated as per algorithm (4% as compared to those who were not (0.3% (OR: 15.3 [95%CI: 3.5-66.3]. Several operational challenges including non-availability of a full-time paediatrician, non-functioning X-ray machine due to frequent power cuts, use of tuberculin with suboptimal strength and difficulties in adhering to a complex diagnostic algorithm were observed. CONCLUSION: This study showed that TB screening in NRCs was sub-optimal in Karnataka. Some children did not reach the NRC, while many of those who did were either not or sub-optimally evaluated for TB. This study pointed to a number of operational issues that need to be addressed if this collaborative strategy is to identify more TB cases amongst malnourished children in India.
Lahav, Orly; Schloerb, David W; Srinivasan, Mandayam A
This paper presents a virtual reality system (the BlindAid) developed for orientation and mobility training of people who are newly blind. The BlindAid allows users to interact with different virtual structures and objects via auditory and haptic feedback. This case study aims to examine if and how the BlindAid, in conjunction with a traditional rehabilitation programme, can help people who are newly blind develop new orientation and mobility methods. Follow-up research based on this study, with a large experiment and control group, could contribute to the area of orientation and mobility rehabilitation training for the newly blind. The case study research focused on A., a woman who is newly blind, for 17 virtual sessions spanning ten weeks, during the 12 weeks of her traditional orientation and mobility rehabilitation programme. The research was implemented by using virtual environment (VE) exploration and orientation tasks in VE and physical spaces. The research methodology used both qualitative and quantitative methods, including interviews, questionnaire, videotape recording, and user computer logs. The results of this study helped elucidate several issues concerning the contribution of the BlindAid system to the exploration strategies and learning processes experienced by the participant in her encounters with familiar and unfamiliar physical surroundings. [Box: see text].
Jivănescu, Anca; Bratu, A Em; Naiche, Diana; Scurtu, Adina; Bratu, Cristina Dana
Turner syndrome is a chromosomal disorder that manifests with short stature, gonadal dysfunction, hypothyroidism, congenital heart disease, and distinct craniofacial features including oro-maxillofacial dysmorphism. This paper presents a case of a 30-year-old female patient with Turner syndrome who sought dental care to improve the dental and facial morphology and restore the oral health. Detailed exobuccal examination revealed complex anomalies. Initial periodontal therapy and carious lesions treatment was followed by orthodontic treatment and prosthetic rehabilitation with two porcelain fused to metal fixed partial dental prostheses. Tooth whitening and restoration of the incisal edge of the anterior teeth was performed to complete the smile design improvement. The interdisciplinary approach pursued in this case resulted in successful oral rehabilitation with optimal treatment outcomes and high patient's satisfaction. Patients with Turner syndrome may present with complex morphologic oro-maxillofacial alterations that require individualized dental treatment plans. Appropriate interdisciplinary medical/dental treatment can lead to successful oral rehabilitation with a minimum of invasive procedures.
Sousa, Marlos G; Carareto, Roberta; Pereira-Junior, Valdo A; Aquino, Monally C C
Although the rectal mucosa remains the traditional site for measuring body temperature in dogs, an increasing number of clinicians have been using auricular temperature to estimate core body temperature. In this study, 88 mature healthy dogs had body temperatures measured with auricular and rectal thermometers. The mean temperature and confidence intervals were similar for each method, but Bland-Altman plots showed high biases and limits of agreement unacceptable for clinical purposes. The results indicate that auricular and rectal temperatures should not be interpreted interchangeably.
Bal-Bocheńska, Monika Anna
Rehabilitation may be helpful in the prevention of complications associated with the treatment of patients with pectus excavatum who are subjected to surgery using the Ravitch and Nuss methods. This paper presents the case of a patient who underwent successful physical rehabilitation after 8 weeks from the surgery using the combined method. As part of the Nuss procedure, two plates were implanted to form a scaffolding for the patient's chest, which had previously been corrected with the Ravitch method. The plates were to be removed after 24 months of treatment. After the procedure, in spite of the favorable cosmetic effect of the repair, there was a significant decrease in the spirometric values and physical fitness of the patient. He underwent an individual physiotherapy program, which lasted four weeks. The streamlining of the respiratory system has significantly improved the spirometric values and raised the overall performance of the patient's organism.
Pramod Kumar, A V; Vinni, T K; Mahesh, Mehul R
The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is supported by both natural teeth and implant. The periodontal ligament and osseointegrated interface distribute force differently to the supporting bone. Therefore problems can develop when tooth and implants are combined in the same prosthesis. However, clinicians can apply biomechanical principles, to negate the deleterious leverages exerted by the fixed prosthesis by using non rigid components and to equalize the stress applied by the prosthesis on implant and teeth. A case of partially edentulous situation was rehabilitated successfully with a combination of prostheses. Maxillary arch was restored to function with crowns, fixed dental prosthesis and with an extra coronal castable attachment prosthesis and the mandibular arch with a combination of tooth and implant supported attachment prosthesis. The clinical and laboratory steps for the fabrication of these prostheses are explained in this report.
Malandraki, Georgia A; Rajappa, Akila; Kantarcigil, Cagla; Wagner, Elise; Ivey, Chandra; Youse, Kathleen
To examine the effects of the Intensive Dysphagia Rehabilitation approach on physiological and functional swallowing outcomes in adults with neurogenic dysphagia. Intervention study; before-after trial with 4-week follow-up through an online survey. Outpatient university clinics. A consecutive sample of subjects (N=10) recruited from outpatient university clinics. All subjects were diagnosed with adult-onset neurologic injury or disease. Dysphagia diagnosis was confirmed through clinical and endoscopic swallowing evaluations. No subjects withdrew from the study. Participants completed the 4-week Intensive Dysphagia Rehabilitation protocol, including 2 oropharyngeal exercise regimens, a targeted swallowing routine using salient stimuli, and caregiver participation. Treatment included hourly sessions twice per week and home practice for approximately 45 min/d. Outcome measures assessed pre- and posttreatment included airway safety using an 8-point Penetration Aspiration Scale, lingual isometric pressures, self-reported swallowing-related quality of life (QOL), and level of oral intake. Also, patients were monitored for adverse dysphagia-related effects. QOL and adverse effects were also assessed at the 4-week follow-up (online survey). The Intensive Dysphagia Rehabilitation approach was effective in improving maximum and mean Penetration Aspiration Scale scores (PDysphagia Rehabilitation approach was safe and improved physiological and some functional swallowing outcomes in our sample; however, further investigation is needed before it can be widely applied. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Henry SR Kao,1 Stewart PW Lam,2 Tin Tin Kao3,4 1Calligraphy Therapy Laboratory, Shenzhen Institute of Neuroscience, Shenzhen, China; 2Research and Development Division, Calli-Health Society, 3Department of Geography, 4Department of Psychology, University of Hong Kong, Hong Kong Introduction: This study investigated the efficacy of Chinese calligraphy handwriting (CCH for the awakening of patients under a vegetative state after stroke. The theories, the instrument, and the treatment protocols were reported. A single case of a severe stroke patient who was in a coma state for 2 years is presented in this study. The objectives were to apply finger writing as a new method to awaken a stroke patient in a coma state and to test the effect of this method in improving the patient’s vegetative states over time. Case presentation: A 55-year-old man suffered a severe stroke in 2004 which left him in a coma for 2 years without any systematic rehabilitation. A culture-based finger-writing method of visual-spatial intervention was then applied to improve his condition. The writing tasks involved aided viewing and finger tracing of sets of innovative characters with enriched visual-spatial and movement characteristics. Following regular treatment protocols involving diverse movement and sensory feedback, the patient was awakened after 12 months. As a consequence, the patient showed significant behavioral changes favoring enhanced focusing, alertness, visual scan, visual span, and quickened visual and motor responses. The treatment continued for another 12 months. As the treatment progressed, we gradually observed improvements in his attention span and mental concentration. His eye ball movements – the left eye in particular – were quickened and showed wider visual angularity in his focal vision. Currently, the patient can now watch television, engage in improved visual sighting, and focus on visual-spatial and cognitive-linguistic materials. Conclusion
Brenner, Alexander K; Gill, Norman W; Buscema, Christopher J; Kiesel, Kyle
Case report. The use of spinal manipulation as a treatment to facilitate neuromuscular control of the paraspinal musculature is not well described in the literature. The use of rehabilitative ultrasound imaging (RUSI) may offer a convenient way to investigate and document possible changes occurring in the lumbar multifidus associated with manipulation intervention. The patient was a 33-year-old male with a 21-year history of low back pain and left posterior thigh pain who presented with lumbar hypomobility and met a previously published clinical prediction rule for spinal manipulation. During examination, the patient was asked to perform a prone upper extremity lifting task to assess activation in the lumbar multifidus during an automatic task. Through palpation the examiner noted a decreased contraction of the left multifidus between L4-S1 compared to the right. To explore this further, a decision was made to assess the multifidus with RUSI, which confirmed the activation deficit noted during palpation. A lumbar regional manipulation was performed with the intention of reducing spinal hypomobility and of assessing changes in multifidus activation. Imaging of the multifidus muscles at the L4-5 and L5-S1 levels were obtained premanipulation, immediately postmanipulation, and 1 day after manipulation. An increased ability to thicken the multifidus during a prone upper extremity lifting task was noted immediately and 1 day after manipulation. Average percent change in thickness at the L4-5 and L5-S1 levels with the prone arm lift was 3.6% premanipulation, 17.2% immediately postmanipulation, and 20.6% approximately 24 hours postmanipulation. Improvements in the thickening of the multifidus muscle during the upper extremity lifting task were greater than 3 standard errors of the measurement. Other changes included immediate palpable improvement in the contraction of the multifidus during the upper extremity lifting task, along with the patient report of increased ease
Naveen, H C; Porwal, Amit; Nelogi, Santosh
Phthisis bulbi is a condition of an eye wherein there is atrophy and disorganization of the intraocular structures, leading to anatomically disfigured and shrunken eyeball. Prosthetic rehabilitation over the residual eyeball is the preferred treatment of choice over surgical intervention such as enucleation or evisceration. A fundamental objective of any maxillofacial rehabilitation is to enable the patient to cope up with his loss and endure the process of rehabilitation. The present article reports a simplified technique of fabricating the customized prosthesis using digital imaging technique for phthisis bulbi patients. The customized Scleral shell provides better mobility, improved appearance and less discomfort to the patient. Copyright (c) 2010 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Full Text Available Dental implants have provided exceptional rehabilitative options for edentulous and partially edentulous patients. However, as more implants come into play, the more the clinicians come across problems where specific considerations must be taken into account to meet expectations. The Toronto Bridge is a treatment modality proposed for restoring several teeth lost in patients with increased crown height (interarch space. Herein, we applied the Toronto Bridge to rehabilitate a patient with generalized aggressive periodontitis; this article suggests that an implant-supported Toronto Bridge can be a reliable and acceptable treatment modality for patients suffering from tooth loss and vertical bone loss as the result of generalized aggressive periodontal disease.
Rasaeipour, Sasan; Siadat, Hakimeh; Rasouli, Amiralireza; Sajedinejadd, Neda; Ghodsi, Safoura
Dental implants have provided exceptional rehabilitative options for edentulous and partially edentulous patients. However, as more implants come into play, the more the clinicians come across problems where specific considerations must be taken into account to meet expectations. The Toronto Bridge is a treatment modality proposed for restoring several teeth lost in patients with increased crown height (interarch) space. Herein, we applied the Toronto Bridge to rehabilitate a patient with generalized aggressive periodontitis; this article suggests that an implant-supported Toronto Bridge can be a reliable and acceptable treatment modality for patients suffering from tooth loss and vertical bone loss as the result of generalized aggressive periodontal disease.
Full Text Available Background: Segmental mandibulectomy is most often performed as part of resection of advanced squamous cell carcinoma, which involves the mandible by extension from intraoral tissues and is usually followed by reconstruction of the mandible. However, not all mandibular defects can be surgically reconstructed, due to local or systemic factors. Oral rehabilitation with conventional removable dentures is often insufficient. In order to provide predictable support and denture retention, especially in the non-reconstructed cases of segmental mandibulectomy, dental implants are indicated.Case report: The authors describe oral rehabilitation with implant-supported overdenture in two non-reconstructed patients with similar mandibular defect, but different etiology, as well as different denture design and different outcome in terms of success and patient satisfaction. In the first case, the defect was caused by surgical treatment of cancer, which was followed by radiotherapy and prosthodontic treatment with an implant-supported mandibular overdenture anchored with a bar. In another case, the damage was due to a suicide attempt. This was initially followed by the surgical treatment of the injury. Afterwards, the prosthodontic treatment with an implant-supported and conical–crown-anchored mandibular overdenture was performed.Conclusions: The success of the prosthodontic oral rehabilitation of patients with segmental mandibulectomy depends on many factors. The size of the defect and the condition of the remaining hard and soft tissues, which are affected by radiotherapy, are crucial. The etiology of the defect, the opposing jaw status, maxillomandibular relationships, the consistency of mandibular movement and the denture design play an important role as well.
Pedersen, Malene; Bundgaard, Tina H; Zeeman, Peter; Jørgensen, Jørgen R; Sørensen, Peter M B; Berro, Hamza M; Larsson, Bodil W
Chronic stroke patients are primarily referred to general rehabilitation, rather than to specific neurorehabilitation. Currently, there are no Danish clinical guidelines for chronic stroke, but recent research in neuroplasticity has contributed to possible rehabilitation interventions for these patients. The purpose of this project is to describe the use of a specialized neuroplastic approach in combination with an already existing training program. The project is designed as an action research project concerning four participants with chronic stroke. Through ten intervention, a neuroplastic focus has been added to their group training program including daily home training. Participants were tested before and after the intervention with MAS, DGI, 6MWT, SSQLS. All four participants improved their functional levels and their quality of life following the intervention. This report indicates that a specific neuroplastic focus in combination with action research has an impact on the participants with chronic stroke. However, there is still no clarity regarding what type of rehabilitation methods can be considered the most efficacious in promoting neuroplasticity. This case report serves as a pilot project for further studies of how to implement neuroplasticity in physical therapy.
Full Text Available The international standardization of auricular acupuncture points (AAPs is an important basis for auricular therapy or auricular diagnosis and treatment. The study on the international standardization of AAPs has gone through a long process, in which the location method is one of the key research projects. There are different points of view in the field of AAPs among experts from different countries or regions. By only analyzing the nine representative location methods, this paper tried to offer a proper location method to locate AAPs. Through analysis of the pros and cons of each location method, the location method applied in the WFAS international standard of AAPs is thoroughly considered as an appropriate method. It is important to keep the right direction during developing an International Organization for Standardization (ISO international standard of auricular acupuncture points and to improve the research quality of international standardization for AAPs.
Ricardo Augusto Sandoval Vásquez; José Ricardo Navarro Vargas
.... La fibrilación auricular en el embarazo es infrecuente pero requiere un reconocimiento de manera precoz para prevenir el embolismo cerebral, las alteraciones circulatorias, el aborto y el parto prematuro. El manejo médico...
Bernateck, M.; Becker, M.; Schwacke, C.
BACKGROUND: In contrast to psychological interventions the usefulness of acupuncture as an adjuvant therapy in rheumatoid arthritis (RA) has not yet been demonstrated. OBJECTIVE: The efficacy of auricular electroacupuncture (EA) was directly compared with autogenic training (AT). METHODS: Patients...
Wolfert, Hendrik Pieter
Integrated spatial planning for river rehabilitation requires insight in the geomorphology of river systems. Procedures are elaborated to implement a functional-geographical approach in geomorphology, in which a view of rivers as four-dimensional systems and the use of a process-based hierarchy of
Rea Ventures Group, LLC, partnered with Southface Energy Institute (Southface), a member of the U.S. Department of Energy's Partnership for Home Innovation Building America research team, to develop a prescriptive approach for rehabilitating a portfolio of rural multifamily rental properties in Georgia, which was funded by the U.S. Department of Agriculture (USDA).
The transfer of NASA technolgy to rehabilitative applications of artificial limbs is studied. Human factors engineering activities range from orthotic manipulators to tiny dc motors and transducers to detect and transmit voluntary control signals. It is found that bicarbon implant devices are suitable for medical equipment and artificial limbs because of their biological compatibility with human body fluids and tissues.
Vining, Robert D; Gosselin, Donna M; Thurmond, Jeb; Case, Kimberlee; Bruch, Frederick R
This report describes interdisciplinary rehabilitation for a 51-year-old male recovering from incomplete cervical spinal cord injury (SCI) and multiple comorbidities following an automobile accident. The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures (C3-C6). Clinical presentation at the rehabilitation hospital included moderate to severe motor strength loss in both upper and lower extremities, a percutaneous endoscopic gastronomy tube (PEG), dysphagia, bowel/bladder incontinence, dependence on a mechanical lift and tilting wheelchair due to severe orthostatic hypotension, and pre-existing shoulder pain from bilateral joint degeneration. The interdisciplinary team formally coordinated rehabilitative care from multiple disciplines. Internal medicine managed medications, determined PEG removal, monitored co-morbid conditions, and overall progress. Chiropractic care focused on alleviating shoulder and thoracic pain and improving spinal and extremity mobility. Physical therapy addressed upright tolerance, transfer, gait, and strength training. Occupational therapy focused on hand coordination and feeding/dressing activities. Psychology assisted with coping strategies. Nursing ensured medication adherence, nutrient intake, wound prevention, and incontinence management, whereas physiatry addressed abnormal muscle tone. Eleven months post-admission the patient's progress allowed discharge to a long-term care facility. At this time he was without dysphagia or need for a PEG. Orthostatic hypotension and bilateral shoulder pain symptoms were also resolved while bowel/bladder incontinence and upper and lower extremity motor strength loss remained. He was largely independent in transferring from bed to wheelchair and in upper body dressing. Lower body dressing/bathing required maximal assistance. Gait with a 2-wheeled walker was possible up to 150 feet with verbal cues and occasional
Ferreira, Danielly Cunha Araújo; De Rossi, Andiara; Torres, Carolina Paes; Galo, Rodrigo; Paula-Silva, Francisco Wanderley Garcia; Queiroz, Alexandra Mussolino de
In several countries the most common cause of death in young people is cancer. Patients with head and neck cancer often have complications after cancer treatment. Radiation therapy can cause oral trismus, which is related to high doses of radiation. Although acupuncture is reported to be effective and is widely used for the treatment of peripheral facial paralysis by promoting an improvement of motor functions, few reports in the literature demonstrate its effectiveness. We report a case in which the symptoms of a patient with facial paralysis after surgical cancer treatment associated with chemotherapy and radiotherapy improved after laser treatment at acupuncture points. Ten weekly sessions of laser therapy were conducted, using the Twin laser device, applied to systemic acupuncture points (LR3, LI4, LI18, LI19, LI20, SI17, SI19, ST4, ST6, ST7, GV20), together with 10 weekly sessions of auricular acupressure. Significant improvement of the trismus was seen, confirmed by the increase in mouth opening from 33.26 to 53.3 mm. The patient's family also noted reduced anxiety and hyperactivity. These results suggest that laser acupuncture and auricular acupressure for trismus and facial paralysis following cancer treatment is worth further investigation.
Michalek-Sauberer, Andrea; Gusenleitner, Erich; Gleiss, Andreas; Tepper, Gabor; Deusch, Engelbert
The objective of this study was to analyse whether auricular acupuncture, acupuncture at the outer ear, could reduce state anxiety before dental treatment. This prospective, randomised patient-blinded study with 182 patients compared anxiety before dental treatment following auricular acupuncture at the relaxation-, tranquillizer- and master cerebral points (auricular acupuncture group) versus acupuncture at sham points (finger-, shoulder- and tonsil points; sham group) and a non-intervention control group. Anxiety was assessed using the Spielberger State Trait Anxiety Inventory (German version) before auricular acupuncture and 20 min thereafter, immediately before dental treatment. Auricular acupuncture reduced state anxiety score more effectively from 54.7 ± 10.8 to 46.9 ± 10.4 (mean ± SD) than sham acupuncture from 51.9 ± 10.2 to 48.4 ± 10.0. In contrast, state anxiety in the control group increased from 51.0 ± 11.7 to 54.0 ± 11.6 (mean increase +3.0; CI +4.7 to +1.2). The decrease in state anxiety in both intervention groups was statistically significant (p anxiety, the reduction in anxiety was -7.3 score points (CI -9.0 to -5.6) in the auricular acupuncture group and -3.7 score points (CI -5.4 to -1.9) in the sham group (p = 0.008). Auricular acupuncture, a minimally invasive method, effectively reduces state anxiety before dental treatment. Auricular acupuncture could be an option for patients scheduled for dental treatment, who experience an uncomfortable degree of anxiety and request an acute intervention for their anxiety.
Julián Aristizábal, MD
Full Text Available La fibrilación auricular es la arritmia más frecuente en la práctica clínica y conlleva implicaciones significativas en la morbilidad y mortalidad cardiovascular de la población, así como en los costos para los sistemas de salud. No obstante, el conocimiento de la fisiopatología de la arritmia y el surgimiento de nuevas alternativas terapéuticas han cambiado la perspectiva en el manejo de esta enfermedad. Se realiza una revisión del desarrollo reciente en conceptos etiológicos y fisiológicos de la arritmia, así como en los esquemas de clasificación y evaluación del riesgo trombohemorrágico, además de los nuevos avances en terapias farmacológicas e intervencionistas.
Full Text Available La fibrilación auricular es la taquiarritmia cardíaca más frecuente. Su incidencia aumenta con la edad, presentándose en un 1.5% entre los 50 a 59 años, y en un 8-10% entre los 80 a 89 años. Esta arritmia incrementa en cinco veces el riesgo de sufrir un evento cerebrovascular isquémico cardioembólico y causa el 15% de todos los accidentes cerebrovasculares isquémicos. Su manejo se enfoca en la prevención de los fenómenos tromboembólicos y el control de la frecuencia y ritmo cardíaco. El tratamiento anticoagulante ha demostrado ser la principal herramienta en la prevención de eventos cardioembólicos. Aunque las complicaciones hemorrágicas por el tratamiento son esperables y aumentan con la edad, el beneficio de usar anticoagulación sobrepasa por mucho al riesgo de sangrado. Precisamente debido a la heterogeneidad clínica de esta arritmia y a la dificultad de establecer un tratamiento adecuado para cada caso en particular, el American College of Cardiology, la American Heart Association, la European Society of Cardiology y el American College of Chest Physicians han establecido guías para mejorar el tratamiento de estos pacientes. La revisión de esta enfermedad y de las directrices propuestas puede facilitar y mejorar notablemente el tratamiento de los pacientes con fibrilación auricular.
Iturralde-Torres, Pedro; Lara-Vaca,Susano; Cordero-Cabra,Alejandro; Nava-Townsend,Santiago; Mendoza,Celso; Márquez,Manlio F; Saucedo-Sánchez,Néstor; Martínez-Flores,Enrique
La fibrilación auricular es una arritmia muy frecuente y afecta predominantemente a individuos mayores de 70 años. Se dispone de poca información sobre su manejo en México por lo que se diseñó el Registro Mexicano de Fibrilación Auricular (ReMeFA). Método: Se trata de un estudio multicéntrico, observacional, prospectivo sobre el tratamiento de la fibrilación auricular. Se incluyeron sujetos de ambos géneros, mayores de 18 años de edad, con fibrilación auricular documentada. Se excluyeron aque...
Gupta, Rajiv Kumar; Padmanabhan, T V
It is the god given right of human being to appear human, and the face is a person's visiting card. We can hide everything but we can't hide our face. Eyes are generally the first feature of the face to be noticed and the presence of a pair of eyes is quite essential to maintain the balance and the esthetics of the face. Loss of eye has a crippling effect on the psychology of the patient. The aim of all ocular prosthetic procedure is to enable rehabilitation of the patient in the society with a normal appearance and self esteem. This article describes a clinical report of rehabilitating post evisceration patient due to glaucoma of right eye with custom made artificial prosthesis using stock eye shell that can create esthetically pleasing results.
Bencharit, Sompop; Schardt-Sacco, Debra; Border, Michael B.; Barbaro, Colin P
Oral rehabilitation for a patient with severe loss of alveolar bone and soft tissue resulting from severe periodontitis presents a challenge to clinicians. Replacing loosening natural teeth with fixed prostheses supported by dental implants often requires either gingival surgery or bone grafting. The outcome of the bone grafting is sometimes unpredictable and requires longer healing time and/ or multiple surgeries. The presence of periodontal inflammation and periapical lesions often delay th...
Standal, Øyvind Førland
Avhandling (doktorgrad) – Norges idrettshøgskole, 2009. This dissertation investigates the learning that takes place between participants in a rehabilitation setting. More specifically, I have made use of the phenomenological philosophy of Maurice Merleau-Ponty (1963; 1968; 2002) in order to better understand the embodied and social aspects of learning as it relates to the topic of this dissertation. In addition, the educational theory situated learning (Lave & Wenger, 1991; We...
Standal, Øyvind Førland
This dissertation investigates the learning that takes place between participants in a rehabilitation setting. More specifically, I have made use of the phenomenological philosophy of Maurice Merleau-Ponty (1963; 1968; 2002) in order to better understand the embodied and social aspects of learning as it relates to the topic of this dissertation. In addition, the educational theory situated learning (Lave & Wenger, 1991; Wenger, 1998) has been utilized in order to frame the situ...
Kaplan, Lee D.; Musto, Tony; Gaunaurd, Ignacio A.; Gailey, Robert S.; Kelley, William P.; Alemi, Timothy J.; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A.; West, Dustin C.
ABSTRACT Background and Purpose Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. Case Description A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. Outcomes The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m2 to 30.6 kg/m2. Discussion This case report illustrates the positive effects of a
Rábago, Christopher A; Wilken, Jason M
Mild traumatic brain injury (mTBI) can compromise reaction time, visual perception, memory, attention, balance, and gait. These deficits, especially if persistent, can restrict participation in daily activities and the resumption of personal and profession roles. The purpose of this case study is to describe an mTBI-specific clinical assessment and rehabilitation intervention administered in a virtual reality environment. The case involved a 31-year-old male service member who had sustained an mTBI (concussion) during a recreational softball game 36 days prior to physical therapist evaluation. He had complaints of severe visual and physical motion intolerance. He demonstrated impaired static balance and was restricted from full military duty. The assessment included measurements of postural and gait balance during cognitive, visual, and vestibular challenges within a Computer-Assisted Rehabilitation Environment. Phase 1 of the intervention consisted of clinical techniques (ie, optokinetic stimulation/habituation, visual/physical perturbations, and postural stability exercises) targeting specific impairments. Phase 2 training consisted of weapon handling and target recognition tasks to simulate the requirements of his military occupation. At the conclusion of 6 treatments, the patient demonstrated significant increases in postural and gait balance with a near complete resolution of all postconcussion symptoms. He successfully returned to full duty and training for combat deployment. Service members and civilians exhibit similar impairments, limitations, and restrictions following mTBI. A rehabilitation program delivered in a virtual-reality environment can be structured to manage complex mTBI symptoms through the integration of multiple treatment modalities specific to a patient's personal and professional roles.
Delbrouck, C; Dauty, M; Huguet, D; Dubois, C
To define criteria of orientation in day-hospitalized or in-patient after shoulder rotator cuff surgery. Population of 71 patients (53.2 years +/-7) (76 shoulders) operated for rotator cuff tear by the same surgeon, then treated by physical therapy either in day-hospitalization or in-patient. Weekly, evaluation until the second month after surgery by setting as criteria: pain, passive and active range of motion and complications. Fifty-three shoulders benefited from rehabilitation therapy in hospitalization and 23 in day-hospitalization. There is no significant difference for criteria studied between the 2 populations except for pains at the fifteenth day after surgery. Pain and articular steepness seem more frequent if the surgery is complex. Day-hospitalization and in-patient give equivalent results, which explain themselves by the possibility of identical physical medicine and rehabilitation performances. The knowledge of the social context is important to choose the most adapted rehabilitation type because patients can benefit from assistance for the acts of the daily life and the domestic tasks. In-patient allows more comfort but implies a familial break.
Full Text Available Wave energy and storm surges threaten coastal ecology and nearshore infrastructures. Although coastal structures are conventionally constructed to dampen the wave energy, they introduce tremendous damage to the ecology of the coast. To minimize environmental impact, ecofriendly coastal protection schemes should be introduced. In this paper, we discuss an example of an innovative mangrove rehabilitation attempt to restore the endangered mangroves on Carey Island, Malaysia. A submerged detached breakwater system was constructed to dampen the energy of wave and trap the sediments behind the structure. Further, a large number of mangrove seedlings were planted using different techniques. Further, we assess the possibility of success for a future mangrove rehabilitation project at the site in the context of sedimentology, bathymetry, and hydrogeochemistry. The assessment showed an increase in the amount of silt and clay, and the seabed was noticeably elevated. The nutrient concentration, the pH value, and the salinity index demonstrate that the site is conducive in establishing mangrove seedlings. As a result, we conclude that the site is now ready for attempts to rehabilitate the lost mangrove forest.
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Feigenbaum, Luis A; Kaplan, Lee D; Musto, Tony; Gaunaurd, Ignacio A; Gailey, Robert S; Kelley, William P; Alemi, Timothy J; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A; West, Dustin C
Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m(2) to 30.6 kg/m(2). This case report illustrates the positive effects of a multidisciplinary approach where combining physical therapy and
Goldin, Diana; Shemesh, Frida; Eljashev-Shimshon, Rachel; Ohry, Avi
Via our description of a seemingly heterogeneous group of four patients who presented to our rehabilitation facility with a rather unusual clinical presentation of compartment syndrome with development of a flaccid paraparesis and rhabdomyolysis immediately after awakening from a prolonged sleep episode in an unusual posture - which might, in fact, be a 'new syndrome' - we have also come to address an important issue linking our group of patients - specifically, the complexities which present to a rehabilitative facility in the cases of unusual and unclear diagnoses. Eventually, all four of our patients remained severely disabled. All had suffered sensorimotor axonal demyelinative polyneuropathies and two patients had subclinical hypothyroidism. Prior to the prolonged sleep episode, they had all consumed alcohol and drugs. Using these four rather demanding diagnostic rehabilitative cases we address the ever-important issue of timely mutual communication and patience. For when a rehabilitative facility is confronted with patients whose diagnoses are not clear, the scope of the long-term comprehensive rehabilitation management faces some major obstacles with respect to how the rehabilitative team can succeed in designing a 'tailor-made' rehabilitation program for these patients, which often-times proves to be a rather tricky task requiring innovative and creative efforts on the parts of all those involved in the care of the patient. Quite a challenging task, indeed, yet one genuinely necessary to attempt to achieve so that the patient, family and, of course, the 'payer agency/provider' can all prepare themselves, realistically so as to obtain the best overall rehabilitative outcome for these patients. We conclude that what is most necessary for these unique patients is patience.
Full Text Available Hereditary sensory and autonomic neuropathies (HSAN are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.
Li, Yiyuan; Zhang, Ruhong; Zhang, Qun; Xu, Zhicheng; Xu, Feng; Li, Datao
Advances in staged total auricular reconstruction have resulted in improved anterior auricular appearance; however, satisfactory postreconstruction esthetics of the retroauricular fold remain challenging. The postauricular appearance of the reconstructed ear depends largely upon optimizing the covering material. When used as the covering soft tissue for ear elevation, a flap containing primarily the upper portion of the retroauricular fascia has potential advantages over the conventional book cover-type retroauricular fascia flap. We developed a geometrically designed, posterosuperior auricular fascia flap to replace the conventional retroauricular fascia flap for ear elevation. During the second-stage operation, the posterosuperior auricular fascia flap is rotated downward and turned over to wrap around the inner strut and entire posterior auricular surface. Compared to the conventional book cover-type retroauricular fascia flap, the novel posterosuperior auricular fascia flap was easier to harvest and the operative time significantly decreased (110.3 vs. 121.5 min, p fascia flap improves ear elevation. Compared to the conventional book cover-type retroauricular fascia flap, this covering tissue is easier to perform so the surgical time is decreased. It was highly vascularized, well defined, thinner, and yields reliable results. Thus, favorable postauricular surface results can be achieved during auricular reconstruction by using the modified fascia flap. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Mixoma auricular izquierdo asociado a insuficiencia severa de válvula mitral en paciente de género femenino de 31 años de edad: reporte de caso Left atrial mixoma associated with severe mitral valve insufficiency in a 31 years old female patient: a case report
Fernando Manzur J; Cristian Barbosa; Agustín Puello
Se presenta el caso de una paciente de 31 años de edad, sin antecedentes patológicos, con un mixoma auricular izquierdo de 9 cm x 8 cm, el cual se manifestó clínicamente, de manera súbita, con sintomatología de tipo obstructiva, y cuyo diagnóstico requirió ecocardiografía transtorácica. Se realizó cirugía inmediata, en la que se logró la resección completa del tumor y durante la cual se evidenció insuficiencia de la válvula mitral severa que requirió plastia valvular. Fue dada de alta al sext...
Full Text Available La fibrilación auricular es la taquiarritmia cardíaca más frecuente. Su incidencia aumenta con la edad, presentándose en un 1.5% entre los 50 a 59 años, y en un 8-10% entre los 80 a 89 años. Esta arritmia incrementa en cinco veces el riesgo de sufrir un evento cerebrovascular isquémico cardioembólico y causa el 15% de todos los accidentes cerebrovasculares isquémicos. Su manejo se enfoca en la prevención de los fenómenos tromboembólicos y el control de la frecuencia y ritmo cardíaco. El tratamiento anticoagulante ha demostrado ser la principal herramienta en la prevención de eventos cardioembólicos. Aunque las complicaciones hemorrágicas por el tratamiento son esperables y aumentan con la edad, el beneficio de usar anticoagulación sobrepasa por mucho al riesgo de sangrado. Precisamente debido a la heterogeneidad clínica de esta arritmia y a la dificultad de establecer un tratamiento adecuado para cada caso en particular, el American College of Cardiology, la American Heart Association, la European Society of Cardiology y el American College of Chest Physicians han establecido guías para mejorar el tratamiento de estos pacientes. La revisión de esta enfermedad y de las directrices propuestas puede facilitar y mejorar notablemente el tratamiento de los pacientes con fibrilación auricular.Atrial fibrillation is the most frequent cardiac arrhythmia in adults. Its frequency increases with age, being its incidence 1.5% in individuals 50 to 59 years old and 8-10% from 80 to 89 years. Atrial fibrillation increases 5 fold the risk of suffering stroke and actually causes 15% of all strokes. Its management focuses primary in the prevention of thromboembolic phenomena, heart rate and rhythm control. Anticoagulation, when indicated, has demonstrated to be the main tool in the prevention of these thromboembolic events. Although the bleeding complication is frequent in this population and increases with age, anticoagulation benefits are
Magrum, Eric M.
Background and Purpose: Distal biceps brachii tendinosis is a relatively uncommon clinical diagnosis seen by physical therapists. As a result, there is little evidence guiding clinical decisions regarding best practice or effective treatment options to restore individuals to their previous level of function. The purpose of this case report is to describe the use of eccentric training as the primary intervention in the rehabilitation of a patient with distal biceps tendinosis. Case Description: A 41-year-old male electrician and collegiate wrestling coach presented to a university outpatient physical therapy clinic with a two month duration of pain in the right antecubital space which occurred when the patient was performing close-grip body weight curl ups for the first time. Sharp pain was noted in the right arm during the lowering phase of the exercise. Following the examination, distal biceps tendinosis appeared to be the likely diagnosis. The patient was educated in eccentric exercise principles and was prescribed eccentric loading exercises for the distal biceps brachii tendon in two different positions of elbow flexion. Outcomes: The patient was seen in physical therapy for three visits over the course of four weeks. Following eccentric training, the patient reported decreased pain, demonstrated increased right elbow flexion and forearm supination strength, was no longer tender to palpation of the distal biceps tendon and showed clinically significant improvement in QuickDASH scores. Discussion: Given the lack of available research on the rehabilitation of distal biceps tendinosis, eccentric training showing benefits with other upper quarter tendinoses and the positive outcomes in this case, it may be appropriate for physical therapists to employ eccentric training for patients with distal biceps tendinosis. Level of Evidence: 5 (Single case report) PMID:22893861
Parisotto, Thaís Manzano; de Souza-E-Silva, Cintia Maria; Steiner-Oliveira, Carolina; Nobre-dos-Santos, Marinês; Gavião, Maria Beatriz Duarte
The purpose of this case report was to describe the oral rehabilitation of a 4-year-old girl presenting early childhood caries (ECC). ECC is highly prevalent in developing countries and its severity increases with age. This disease implies serious consequences for the development of the stomatognathic system and for the child's quality of life. As young children are usually anxious about dental treatment, their level of co-operation is limited, leading to a challenging situation. A 4-year-old girl was brought by her mother for dental treatment with the complaint of pain. The clinical examination revealed extensive carious coronary destructions. After preventive and curative measures, the oral rehabilitation was performed; it included the use of stainless steel crowns, resin filled celluloid crowns with previous cementation of glass post pins when necessary, an amalgam restoration, orthodontic treatment, and a partial removable prosthesis. The child has been monitored in the Pediatric Dentistry Clinic at 4-monthly intervals. The oral rehabilitation was able to reestablish the oral health in the primary arches mutilated by early childhood caries. This is important for the establishment of an adequate mixed and permanent dentition, for proper facial and maxillary growth, and to the child's psychological and social development. The full management, including preventive, psychological, and curative measures of a young child with severe ECC was found successful after 8 months of follow up. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, resin filled celluloid crowns, and partial removable prosthesis to reestablish the oral functions and improve the child's psycho-social development.
A single storied building was constructed on strip foundation system—on a subsoil, with high expansivity, without taking necessary precautions and it suffered extensive cracks and damages in roof slab, beams, columns and brick walls, subsidence /upheavals in floors etc. within 2/3 years of its construction and consequently it had to be abandoned. The study examines the reasons for the severe damages, cracks etc. and also suggests remediation by ground improvement and other necessary measures that were actually taken up, to rehabilitate the highly distressed and abandoned building within a reasonably short period of time—at a reasonable cost.
Putanikar, Nagaraj Y; Patil, Anandkumar G; Shetty, Pavithra K; Nagaral, Suresh; Mithaiwala, Hatimali I
Severe physical and psychological distress occurs due to disfigurement caused by loss of eye. Ocular prosthesis is the only mode of rehabilitation for the missing eye. There are different materials and techniques used for the fabrication of the same. Resin proved to be the better among the available materials. Either using the stock eye or using customized ocular prosthesis has their own advantages and disadvantages. Through our clinical report, we have fabricated a semi-customized ocular prosthesis with stock iris and customized sclera. This prosthesis had the advantages of both stock and custom ocular prosthesis providing functionally and esthetically satisfactory result.
A single storied building was constructed on strip foundation system—on a subsoil, with high expansivity, without taking necessary precautions and it suffered extensive cracks and damages in roof slab, beams, columns and brick walls, subsidence/upheavals in floors etc. within 2/3 years of its construction and consequently it had to be abandoned. The study examines the reasons for the severe damages, cracks etc. and also suggests remediation by ground improvement and other necessary measures that were actually taken up, to rehabilitate the highly distressed and abandoned building within a reasonably short period of time—at a reasonable cost.
Zeigelboim, Bianca; Liberalesso, Paulo; Jurkiewicz, Ari; Klagenberg, Karlin
Balance difficulties are common among multiple sclerosis patients. To evaluate the effectiveness of the Cawthorne and Cooksey protocol of vestibular rehabilitation (VR) exercises in reducing the physical, functional and emotional impact of multiple sclerosis among individuals who complained of vertigo. Four patients with remittent-recurrent multiple sclerosis underwent an interview, otorhinolaryngological and vestibular evaluation, VR exercises and the Dizziness Handicap Inventory pre- and post-intervention. There was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. The VR exercises appeared useful in reducing subjective complaints of the study participants.
Metha, Deepak; Gulati, Akanksha; Basappa, N; Raju, O S
Restoration of primary maxillary incisors severely damaged by caries or trauma is a clinical challenge in pediatric dental clinics. Early childhood caries is observed in approximately half the child population. In the past, the only treatment option would have been to extract the affected teeth and replace them with prosthetic substitutes. With the introduction of new adhesive systems and restorative materials, alternative approaches in treating these teeth have been proposed. The purpose of this paper was to describe the rehabilitation of primary anterior teeth in a 5-year-old patient using glass fiber reinforced composite resin as an intracanal post.
Fan, Yang-Teng; Lin, Keh-Chung; Liu, Ho-Ling; Wu, Ching-Yi; Wai, Yau-Yau; Lee, Tsong-Hai
Robot-assisted bilateral arm therapy (RBAT) has shown promising results in stroke rehabilitation; however, connectivity mapping of the sensorimotor networks after RBAT remains unclear. We used fMRI before and after RBAT and a dose-matched control intervention (DMCI) to explore the connectivity changes in 6 subacute stroke patients. Sensorimotor functions improved in the RBAT and DMCI groups after treatment. Enhanced activation changes were observed in bilateral primary motor cortex (M1) and bilateral supplementary motor area (SMA) after RBAT. Dynamic causal model analysis revealed that interhemispheric connections were enhanced in RBAT patients. These preliminary findings suggest that intracortical and intercortical coupling might underlie poststroke RBAT.
Innovación en la reconstrucción del pabellón auricular disgenésico con tejido expandido e implante Innovation in congenital auricular anomaly reconstruction using expanded tissue and prosthetic material
Full Text Available En la reconstrucción de un pabellón auricular disgenésico se plantean, básicamente, dos desafíos, reproducir un esqueleto cartilaginoso auricular de forma, tamaño y proyección similar al pabellón auricular normal, y obtener piel suficiente que combine color, textura y grosor semejante a la circundante. Debido a la escasa cantidad de piel útil en esta localización y a la dificultad en el tallado del esqueleto cartilaginoso auricular, iniciamos en 2005 en nuestro Hospital la reconstrucción auricular mediante combinación de tejidos expandidos locales y materiales protésicos, logrando un excelente resultado de apariencia natural.Reconstruction of congenital auricular anomalies includes two essential challenges. The first one is to sculpt an auricular cartilaginous structure that matches the shape, size and projection of a standard ear. The second challenge arises from the scarcity of the usable skin in the area. Because of the difficulty of sculpting a proper cartilage framework and the scarce quantity of skin in the area, in 2005 we began in our hospital auricular reconstruction procedure combining tissue expanders and prosthetic materials achieving a natural appearance and an excellent result.
Satish, Usha; Streufert, Siegfried; Eslinger, Paul J
To investigate whether identifying specific deficits after brain injury can lead to a more focused and potentially effective cognitive rehabilitation technology. Cognitive simulation assessment was undertaken in a 47-year-old man with trauma-related prefrontal damage and persisting occupational and cognitive-behavioral difficulties at 15 months post brain injury. Results revealed significant difficulties in measured levels of activity, initiative, information utilization, response flexibility, and effective decision-making strategies which accorded well with his real-life complaints despite normal neuropsychological test scores. This profile of findings was then used to design a two-stage intervention program. The first stage focused on participant education and awareness about his simulation-based problem solving difficulties. In the second stage specific goals were formulated to improve problem solving impairments that were then the target of weekly training sessions using pertinent decision-making and problem-solving vignettes. A parallel version of the cognitive simulation assessment was undertaken post-cognitive training (3 months after initial assessment) and revealed significant improvements in targeted executive cognitive-behavioral areas. Results of this cognitive rehabilitation probe supported the feasibility and validity of undertaking a cognitive simulation approach to identify residual executive function deficits after traumatic brain injury, even with a normal neuropsychological test profile. Further studies are needed to establish the reliability, generalizability and maintenance of such gains.
Hashida, Nao; Shamoto, Hiroshi; Maeda, Keisuke; Wakabayashi, Hidetaka; Suzuki, Motoyuki; Fujii, Takashi
Swallowing dysfunction is related to long-term weight loss and reduced body mass index in patients with head and neck cancer. We describe a 76-y-old woman who had severe sarcopenic dysphagia and atrophy of the reconstructed tongue for 17 mo after subtotal glossectomy due to tongue cancer and lost 14 kg during that period. Upon admission, the patient received diagnoses of malnutrition in the context of social or environmental circumstances with insufficient energy intake, loss of muscle mass, localized fluid accumulation, weight loss, and sarcopenia due to reduced skeletal muscle mass (skeletal muscle index dysphagia rehabilitation to improve sarcopenia, atrophy of the reconstructed tongue, and dysphagia. After 20 mo of treatment, she was considered to be no longer malnourished (11 kg weight gain) and without sarcopenia (skeletal muscle index 4.01 cm2/m2), and the volume of the reconstructed tongue was increased. Sarcopenia and atrophy of the reconstructed tongue may cause dysphagia after glossectomy due to tongue cancer. Additionally, nutritional support and rehabilitation could improve such dysphagia. Copyright © 2016 Elsevier Inc. All rights reserved.
Balan, I; Calcaterra, R; Lauritano, D; Grecchi, E; Carinci, F
Spiral dental implant (SDI) is an implant with a conical internal helix that confers the characteristic of self-drilling, self-tapping, and self-bone condensing. These proprieties offer better control during insertion of SDI giving a high primary stabilization, even in poor quality bone. A shorter diameter of SDI results in reduced drilling during insertion and consequently less trauma and minimal bone loss. To address the research purpose, the investigators designed a retrospective cohort study. The study population was composed of 25 patients, 11 males and 14 females that have been treated by Dr. Balan with 187 SDI positioned in mandible and into maxilla bone. The implants were placed during the years 2013 to 2014 in Dr. Balan clinic. All patients underwent the same surgical protocol. Several variables are investigated: demographic (age and gender), anatomic (upper/lower jaws and tooth site), implant (length and diameter and type) variables, edentulism (partial or total), and comorbid status of health (i.e.: hypothyroidism, parodontitis, hypertension, diabetes, presence of cancer, heart disease, hepatitis and rheumatologic disease). Pearson Chi-Square test was used to investigate variables and p flapless and computer tomography-planned surgery does not significantly increase the clinical outcome of SDIs in complex rehabilitation. Cancer represents the most important variable to consider when a patient wants to do oral rehabilitation because of its high risk of unsuccessful.
BALAN, I.; CALCATERRA, R.; LAURITANO, D.; GRECCHI, E.; CARINCI, F.
SUMMARY Spiral dental implant (SDI) is an implant with a conical internal helix that confers the characteristic of self-drilling, self-tapping, and self-bone condensing. These proprieties offer better control during insertion of SDI giving a high primary stabilization, even in poor quality bone. A shorter diameter of SDI results in reduced drilling during insertion and consequently less trauma and minimal bone loss. To address the research purpose, the investigators designed a retrospective cohort study. The study population was composed of 25 patients, 11 males and 14 females that have been treated by Dr. Balan with 187 SDI positioned in mandible and into maxilla bone. The implants were placed during the years 2013 to 2014 in Dr. Balan clinic. All patients underwent the same surgical protocol. Several variables are investigated: demographic (age and gender), anatomic (upper/lower jaws and tooth site), implant (length and diameter and type) variables, edentulism (partial or total), and comorbid status of health (i.e.: hypothyroidism, parodontitis, hypertension, diabetes, presence of cancer, heart disease, hepatitis and rheumatologic disease). Pearson Chi-Square test was used to investigate variables and p flapless and computer tomography-planned surgery does not significantly increase the clinical outcome of SDIs in complex rehabilitation. Cancer represents the most important variable to consider when a patient wants to do oral rehabilitation because of its high risk of unsuccessful. PMID:29285328
In the age-old debate between technological optimists and pessimists, desalination has been hailed as a "game changer" that can fundamentally alter the dynamics of water management under conditions of scarcity. While water from desalination facilities can reduce uncertainties in municipal supply, they are unlikely to replace the missing flow required to rehabilitate rivers and streams. The Jordan River is an iconic, but highly degraded water body whose restoration has been the subject of extensive research as well as numerous proposals and strategies. A review of the present state of the River and prospects for successful rehabilitation efforts reveals that neither the increase in the riparian population nor the reduced water supply due to climate change in the Jordan basin has been considered sufficiently in restoration strategies. Demographic pressures produce acute water shortages which make the provision of future environmental flows highly unlikely. While much can and should be done to improve its environmental condition, the Jordan River offers a cautionary tale for water scarce regions about the challenge of stream restoration initiatives in the face of accelerated population growth, notwithstanding the potential benefits of desalination as a source of drinking water. Copyright © 2016 Elsevier Ltd. All rights reserved.
Rea Ventures Group, LLC, (Rea Ventures) partnered with Southface Energy Institute (Southface) on the rehabilitation of 418 low-income rental multifamily apartments located at 14 different properties in Georgia (Climate Zones 2-4). These 22-year old, individually-metered units were arranged in rowhouse or townhouse style units. Rehabilitation plans were developed using a process prescribed by the US Department of Agriculture (USDA) Rural Development program, who partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide. In 2012, over $100 million was allocated in grants and loans. Due to the unique financing mechanism as well as long-term ownership requirements, property owners are especially motivated to invest in upgrades that will increase durability and tenant retention. These buildings represent a large stock of rural affordable housing that have the potential for significant energy and cost savings for property owners and tenants. Southface analyzed the energy upgrade potential of one stereotypical property in the Rea Ventures portfolio. This study will provide insight into the most cost-effective, implementable energy efficiency and durability upgrades for this age multifamily housing, having an enormous impact not only on the portfolio of Rea Ventures but on the vast USDA and larger Federal portfolio. Additionally, Southface will identify gaps in the current capital needs assessment process, examine available audit and simulation tools and protocols, and evaluate additional auditor training or certification needs.
Full Text Available Abstract Introduction Dysvascular amputations are increasingly performed in patients with underlying cardiac and pulmonary disorders. A limb prosthesis is rarely offered to patients with severe chronic obstructive pulmonary disease because of their inability to achieve the high energy expenditure required for prosthetic ambulation. We describe a case of successful prosthetic fitting and rehabilitation of a patient with severe chronic obstructive pulmonary disease with the aid of oxygen supplementation. Case presentation A 67-year-old aboriginal woman with severe chronic obstructive pulmonary disease and hypercapnic respiratory failure underwent right trans-tibial (below the knee amputation for severe foot gangrene. An aggressive rehabilitation program of conditioning exercises and gait training utilizing oxygen therapy was initiated. She was custom-fitted with a right trans-tibial prosthesis. A rehabilitation program improved her strength, endurance and stump contracture, and she was able to walk for short distances with the prosthesis. The motion analysis studies showed a cadence of 73.5 steps per minute, a velocity of 0.29 meters per second and no difference in right and left step time and step length. Conclusion This case report illustrates that patients with significant severe chronic obstructive pulmonary disease can be successfully fitted with limb prostheses and undergo rehabilitation using supplemental oxygen along with optimization of their underlying comorbidities. Despite the paucity of published information in this area, prosthesis fitting and rehabilitation should be considered in patients who have undergone amputation and have severe chronic obstructive disease.
Casartelli, Nicola C; Bizzini, Mario; Maffiuletti, Nicola A; Lepers, Romuald; Leunig, Michael
Case report. The aim of this case report was to describe the rehabilitation and return to sport of a professional ice hockey player with symptomatic femoroacetabular impingement (FAI) after bilateral open hip surgery. A 21-year-old professional ice hockey player with symptomatic FAI underwent bilateral surgical hip dislocations within a 6-week time period. After the second surgery (right hip), he experienced right hip pain due to iliotibial band dehiscence, which required additional revision surgery. The athlete underwent a standardized rehabilitation protocol. Hip muscle strength was objectively assessed during rehabilitation. Iliotibial band dehiscence did not allow the athlete to increase ipsilateral hip abductor strength. This prolonged the rehabilitation period for 12 weeks. The athlete returned to training on the ice without physical contact and to competitive matchplay after 7 and 8 months, respectively. This case report showed that iliotibial band dehiscence occurred after open hip surgery and delayed the return to sport of this athlete. Standardized rehabilitation following bilateral open hip surgery was however successful for the return to sport of this professional ice hockey player with bilateral symptomatic FAI. Copyright © 2014 Elsevier Ltd. All rights reserved.
C. Gutiérrez Gómez
Full Text Available La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y no con un simple injerto. Frente a esta dificultad técnica, diseñamos un colgajo ricamente vascularizado que preserva el cartílago no afectado con una buena cubierta y al mismo tiempo respeta la anatomía de la oreja. Para la cobertura del cartílago auricular anterior usamos un colgajo fasciocutáneo posterior que se asemeja a un plato típico de la cocina mexicana que llamamos "quesadilla", donde el cartílago por su color blanco recuerda el queso y el gran colgajo fasciocutaneo recuerda la tortilla que cubre al queso. Este colgajo incluye la piel enrollada del hélix, que en un segundo tiempo retornará a su lugar de origen anatómico mediante una z-plastía asimétrica. Presentamos, de entre una serie de 13 pacientes con carcinoma de pabellón auricular, 2 casos resueltos mediante esta técnica.Auricle reconstruction is one of the most difficult techniques because of the sophisticated and delicates forms of the ear. When we need to remove the auricular skin, preserving the cartilage is very important to keep the shape of the auricle. If treating an auricular skin cancer we find an unaffected cartilage, we can use a skin grafting, but in such delicates forms and curves many times it results inappropriate or the lack of pericondrium difficult skin graft integration. When pericondrium is affected, we will need a skin flap to cover de defect. We designed a rich vascularized flap that preserves the unaffected cartilage with an adequate coverage
de Souza, Juliana Feltrin; Fragelli, Camila Maria Bullio; Paschoal, Marco Aurélio Benini; Campos, Edson Alves; Cunha, Leonardo Fernandes; Losso, Estela Maris; Cordeiro, Rita de Cássia Loiola
Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.
Juliana Feltrin de Souza
Full Text Available Case Report. An 8-year-old girl with amelogenesis imperfecta (AI reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.
de Souza, Juliana Feltrin; Fragelli, Camila Maria Bullio; Paschoal, Marco Aurélio Benini; Campos, Edson Alves; Cunha, Leonardo Fernandes; Losso, Estela Maris; Cordeiro, Rita de Cássia Loiola
Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed. PMID:25061528
Hélder Fonseca Mendes
Full Text Available Introduction: The education and promotion of health she make guaranteeing knowledge, aptitudes and opportunities to the people so that they can make decisions and to have attitudes that improve your conditions of health. The training for promotion of patients' health with sequels of BIRD (it Alters Vascular Encefálico and patients' caretakers with sequels of BIRD, it can contribute to improve the life quality and to promote the solemnity-care. Methods: They were made case studies with five patient and your respective caretakers. The patients answered to the Functional Index of Barthel and the caretakers to a questionnaire of knowledge regarding the pathology and they participated of weekly encounters in the Regional Hospital of Planaltina, where they were answered your doubts, they received training and orientations in agreement with the theme proposed for each meeting and the patients' main needs. Results: Four patients concluded the study. We observed that all had it gets better in your functional state. The Index of medium initial Barthel was of 52,5 and the end of 85,0 points. The caretakers were shown disposed to participate in the process of the patients' rehabilitation in spite of they have not previous knowledge regarding the disease. Conclusion: We concluded that the presented data showthe relevance of the education and of the promotion of health as strategies for the patients' rehabilitation with sequel of BIRD.
Full Text Available Acid attacks committed as crimes of passion are unfortunately becoming far from infrequent occurrence. The injuries sustained in such attacks mainly involve the face and trunk, with the acid causing cutaneous and subcutaneous tissue burns that can result in permanent scarring, loss of the nose or external ear, and severe visual impairment. Different surgical solutions have been proposed for reconstruction of the auricle following loss of the ear through traumatic injury or cancer or in patients with congenital defects: surgical reconstruction may involve the insertion of an autogenous rib cartilage framework or the use of a porous polymer material inserted into an expanded postauricular flap. Reconstruction with rib cartilage has given good results but requires more than one surgical step and may be associated with adverse events involving both the donor site and the recipient site, while rejections of polymeric prostheses have been reported following their insertion into expanded postauricular flaps. The use of a titanium dowel-retained silicone prosthesis, in which the dowel is anchored to the temporal bone, is a surgical possibility, indicated particularly in cases of pinna resection due to tumour or auricular scarring following traumatic injury.
Wang, Lei; Zhao, Baixiao; Zhou, Liqun
To supply literature for developing an international standard of auricular acupuncture points. Electronic database searches were conducted in the Chinese National Knowledge Infrastructure and VIP, and the Western databases, Pubmed, the National Science and Technology Library, and the German Journal of Acupuncture, from 1990 to April, 2012. We also searched the documents of international symposiums for auricular acupuncture points (AAPs). Keywords were "auricular points", "auricular acupuncture points", "ear points", or "auriculotherapy". Basic and clinical research on AAPs was performed in China, the United States, France, and Germany. Clinical AAP research was done in Italy, Austria, Switzerland, Spain, the UK, Holland, Japan, Russia, and Africa. However, AAP research was not communicated internationally. The World Federation of Acupuncture-Moxibustion Societies recommended international standard of auricular acupuncture points (ISAAPs). Standardized nomenclature and locations of AAPs would provide a solid basis to draft an international standard organization. Experts need to find common points from different countries or regions, provide evidence of different ideas, and list the proposal as a recommendation for an international standard.
Gustatory sweating syndrome (also known as Frey syndrome or auriculotemporal nerve syndrome) is thought to result from a lesion of the auriculotemporal nerve. A lesion of this nerve can lead to aberrant regeneration of nerve fibers to the sweat glands and blood vessels. The occurrence of signs outside the region of the auriculotemporal nerve prompted the author to search for another anatomical basis for this syndrome. The author dissected 46 great auricular nerves from their origin to the parotid gland and in the infratemporal fossa. The author investigated the different connections of the great auricular nerve with the facial nerve and the auriculotemporal nerve. The great auricular nerve was found to essentially be a parotid nerve. There was a set of intraparotid nerve connections on 14 of the 46 half-heads that were dissected. The author was able to discern three types of parotid great auricular nerve connections, which he designates as either type 1, connection with the trunk of the facial nerve and its branches; type 2, connection with the auriculotemporal nerve; or type 3, connection with the auriculotemporal nerve and the facial nerve with the formation of an intraparotid nerve circle. Having clearly established the nerve connections of the great auricular nerve, the author believes that it is primarily this nerve that is responsible for gustatory sweating syndrome. This allows for a better understanding of the sympathetic nervous system features and the manifestation of the syndrome outside the region of the auriculotemporal nerve.
Rohrich, Rod J; Taylor, Nathan S; Ahmad, Jamil; Lu, An; Pessa, Joel E
Experience with anatomical dissection has suggested that two potential complications of rhytidectomy are related to the anatomy of the periauricular adipose compartments: great auricular nerve injury and the "subauricular band" phenomenon. This study describes this anatomy and its relationship to these potential complications. The results of 24 fresh hemifacial cadaver dissections were included in this study. Injections included the use of methylene blue and fixable dye injected into specific regions around the ear. The study incorporated digital macro photography, time-lapse photography, and three-dimensional cross-sections in multiple planes (coronal, sagittal, and axial planes) to identify structural relationships. This study defined five periauricular adipose compartments. The main branch of the great auricular nerve always ran within the subauricular membrane. The subauricular membrane was located between the subauricular and inferior adipose compartments. Inadequate dissection of the lateral neck and postauricular area along with failure to release this membrane completely results in banding of the lateral neck, a stigma of face lift surgery. McKinney's point was consistently found to lie where the great auricular nerve travels deep to the inferior border of Lore's fascia and the tail of the parotid. Below this point, the great auricular nerve is closer to the skin surface and more susceptible to potential injury. Two possible complications of rhytidectomy, great auricular nerve injury and the "subauricular band" phenomenon, are avoidable by understanding the anatomy of the periauricular adipose compartments.
He, Wei; Rong, Pei-Jing; Li, Liang; Ben, Hui; Zhu, Bing; Litscher, Gerhard
Auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction. An increasing number of studies have demonstrated that auricular acupuncture has a significant effect on inducing parasympathetic tone. Epilepsy is a neurological disorder consisting of recurrent seizures resulting from excessive, uncontrolled electrical activity in the brain. Autonomic imbalance demonstrating an increased sympathetic activity and a reduced parasympathetic activation is inv...
Moore, Chad B; Hickey, Anita H
Postoperative nausea and vomiting (PONV) affects more than 30% of surgical patients. Auricular acupuncture (AA) has been shown to decrease the incidence of PONV in select populations. An evidence-based quality improvement project made AA available to all adult surgical patients, and the results were recorded in a database. A retrospective between-groups analysis of 210 database entries was conducted, of those 25 receiving AA. More risk factors for PONV were present in the AA group (P < .001). Both groups experienced a less-than-expected rate of PONV. Similar rates were shown between groups for PONV, postanesthesia care unit length of stay, and opioid consumption. Patient satisfaction was 96% with AA. The AA group was treated with less antiemetic medication (P < .001), yet PONV rates remained similar. A multimodal approach treating patients at risk for PONV is recommended. Administration of multiple antiemetics may result in unnecessary cost or unfavorable side effects when effective and less costly alternatives exist. AA is a viable treatment for PONV, considering cost and patient satisfaction. Published by Elsevier Inc.
Murphy, Russell; Dziegielewski, Peter; O'Connell, Dan; Seikaly, Hadi; Ansari, Kal
The great auricular nerve (GAN) originates from the cervical plexus at the levels of C2 and C3, supplying sensation to the skin overlying the lower aspect of the pinna and angle of the mandible. The GAN can be injured during many procedures in the head and neck, resulting in a significant negative impact on the patient's quality of life. There are no reliable anatomic studies of GAN in the area where it is most likely to get injured. To determine the GAN relationship to the posterior border of the platysma and the external jugular vein (EJV). Patients undergoing neck dissections were included in the study. Measurements were taken between the posterior border of the platysma relative to the nearest edge of the EJV and the GAN. The distance between the GAN and the EJV was also noted. The posterior borders of the platysma and EJV are found, on average, 0.08 cm away from each other, and the free edge of the platysma was most often posterior to the EJV. The distance from the platysma to the GAN was, on average, 0.60 cm. The distance between the EJV and the GAN was 1.17 cm. We have added a safe, reliable, and surgically relevant technique to the head and neck surgeon's armamentarium for identifying the GAN and avoiding attendant injury with long-term debilitating neurologic sequelae.
Full Text Available Malignancies of the midface result in cosmetic deformities that make maxillofacial prosthesis as an integral part of the treatment plan. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life. Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis. This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids. The patient had no problem with the prosthesis, except for a partial loss of extrinsic coloration in the two-year follow-up.
Wollstein, Ronit; Michael, Dafna; Harel, Hani
Proprioception and sensorimotor input are used to treat neurological and joint injuries. Following distal radius fractures (DRF) there is a temporary loss of proprioception that should be addressed. We created a protocol for evaluation, and a treatment plan following wrist surgery that is based on proprioceptive and sensorimotor input. We describe a series of patients undergoing surgery for DRF that were evaluated and treated with these protocols. Both evaluation and treatment protocols included comprehensive sensorimotor procedures performed with eyes open and closed. These included Semmes- Weinstein, static and moving 2-point discrimination, vibration, temperature testing, Moberg pick-up- test, stereognosis and proprioception. A series of twelve patients was evaluated and treated with the protocol following surgical treatment for DRF. Patients demonstrated significant sensorimotor deficits, which improved utilizing the comprehensive sensorimotor treatment protocol. Further study is necessary to validate the results of this pilot series. Use of proprioception and sensorimotor input may improve outcomes of rehabilitation following DRF.
Full Text Available Zygomatic implants have been used for dental rehabilitation in patients with insufficient bone in the posterior upper jaw, due to, for example, tumor resection, trauma, or atrophy. Zygomatic implants are an alternative to complex free or vascularized bone grafting and distraction osteogenesis. A 42-year-old male patient with a severe defect in the right posterior maxilla, starting from the first canine region, which had occurred after tumor resection 3 years earlier, was referred to our department. One zygomatic implant (Brenemark System, Nobel Biocare, Goteborg, Sweden to the zygoma and one dental implant to the canine region were placed. After a 5-month osseointegration period, a fixed denture was fabricated and adapted to the implants. Although the surgical and prosthetic procedures for zygoma implants are not easy, the final outcomes can be successful with appropriate planning.
Sholapurkar, Amar A; Joseph, Robin Mathai; Varghese, Jothi M; Neelagiri, Krishna; Acharya, Shashi Rashmi R; Hegde, Veena; Pai, Keerthilatha M; Bhat, Mahalinga
This clinical report describes the oral rehabilitation of a young female patient diagnosed with the hypocalcified, autosomal recessive type of Amelogenesis imperfecta (AI). A brief discussion on diagnosis of AI is also included. AI has been defined as a group of hereditary enamel defects not associated with evidence of systemic disease. It can be characterized by enamel hypoplasia and/or hypomaturation or hypocalcification of the existing teeth. Restoration for patients with this condition should be oriented toward the functional and esthetic rehabilitation and the protection of these teeth. A 31-year-old female patient presented with concerns including extreme sensitivity; dissatisfaction with size, shape, and shade of teeth; and poor masticatory efficiency. She was very conscious about the appearance of her teeth and reported that her primary dentition was affected in the same manner. The specific objectives of this treatment were to eliminate tooth sensitivity, enhance esthetics, and restore masticatory function. Treatment included crown lengthening procedures and placement of anterior and posterior metal-ceramic crowns. A 12-month follow-up with clinical and radiographic examinations revealed no evidence of any untoward effects of the treatment on the restored teeth or their supporting structures. Management of a patient with AI is a challenge for the clinician. The treatment options vary considerably depending on several factors such as the age of the patient, socio-economic status, periodontal condition, loss of tooth structure, severity of the disorder, and, most importantly, the patient's cooperation. The clinician has to consider the long-term prognosis of the treatment outcome. This clinical report describes the fabrication of metal ceramic and all metal crowns for the restoration of severely worn teeth in a patient with AI which requires meticulous maintenance of oral hygiene and patient co-operation.
Full Text Available The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.
Renata G Rosa
Full Text Available The reconstruction of the external ear to correct congenital deformities or repair following trauma remains a significant challenge in reconstructive surgery. Previously, we have developed a novel approach to create scaffold-free, tissue engineering elastic cartilage constructs directly from a small population of donor cells. Although the developed constructs appeared to adopt the structural appearance of native auricular cartilage, the constructs displayed limited expression and poor localization of elastin. In the present study, the effect of growth factor supplementation (insulin, IGF-1, or TGF-β1 was investigated to stimulate elastogenesis as well as to improve overall tissue formation. Using rabbit auricular chondrocytes, bioreactor-cultivated constructs supplemented with either insulin or IGF-1 displayed increased deposition of cartilaginous ECM, improved mechanical properties, and thicknesses comparable to native auricular cartilage after 4 weeks of growth. Similarly, growth factor supplementation resulted in increased expression and improved localization of elastin, primarily restricted within the cartilaginous region of the tissue construct. Additional studies were conducted to determine whether scaffold-free engineered auricular cartilage constructs could be developed in the 3D shape of the external ear. Isolated auricular chondrocytes were grown in rapid-prototyped tissue culture molds with additional insulin or IGF-1 supplementation during bioreactor cultivation. Using this approach, the developed tissue constructs were flexible and had a 3D shape in very good agreement to the culture mold (average error <400 µm. While scaffold-free, engineered auricular cartilage constructs can be created with both the appropriate tissue structure and 3D shape of the external ear, future studies will be aimed assessing potential changes in construct shape and properties after subcutaneous implantation.
Masson, Jean-Baptiste; Sauviat, Martin-Pierre; Gallot, Guilhem
The authors demonstrate the direct, noninvasive and time resolved imaging of functional frog auricular fibers by ionic contrast terahertz (ICT) near field microscopy. This technique provides quantitative, time-dependent measurement of ionic flow during auricular muscle electrical activity, and opens the way of direct noninvasive imaging of cardiac activity under stimulation. ICT microscopy technique was associated with full three-dimensional simulation enabling to measure precisely the fiber sizes. This technique coupled to waveguide technology should provide the grounds to development of advanced in vivo ion flux measurement in mammalian hearts, allowing the prediction of heart attack from change in K+ fluxes.
Manlio F. Márquez; Gómez-Flores,Jorge; Aranda-Faustro,Alberto; Cazares-Campos,Iris; Cárdenas,Manuel
La presente revisión es un resumen de la fisiopatología de la fibrilación auricular (FA) y muestra los avances en el conocimiento de esta arritmia. En su génesis y mantenimiento deben considerarse los factores que se describen a continuación. Factor genético: está implicado en los casos de FA familiar. Factor predisponente estructural: dilatación auricular, el factor estructural más conocido que permite el desarrollo de la FA. Factor predisponente estructural: el haz de Bachmann y las vías de...
Wang, Saina; Sheng, Feng; Pan, Yunhua; Xu, Feng; Wang, Zhichao; Cheng, Lei
To compare the clinical efficacy on cervical spondylotic radiculopathy between the combined therapy of massage and magnetic-sticking at the auricular points and the simple massage therapy, and conduct the health economics evaluation. Seventy-two patients of cervical spondylotic radiculopathy were randomized into a combined therapy group, and a simple massage group, 36 cases in each one. Finally, 35 cases and 34 cases were met the inclusive criteria in the corresponding groups separately. In the combined therapy group, the massage therapy and the magnetic sticking therapy at auricular points were combined in the treatment. Massage therapy was mainly applied to Fengchi (GB 20), Jianjing (GB 21), Jianwaishu (SI 14), Jianyu (LI 15) and Quchi (LI 11). The main auricular points for magnetic sticking pressure were Jingzhui (AH13), Gan (On12) Shen (CO10), Shenmen (TF4), Pizhixia (AT4). In the simple massage group, the simple massage therapy was given, the massage parts and methods were the same as those in the combined therapy group. The treatment was given once every two days, three times a week, for 4 weeks totally. The cervical spondylosis effect scale and the simplified McGill pain questionnaire were adopted to observe the improvements in the clinical symptoms, clinical examination, daily life movement, superficial muscular pain in the neck and the health economics cost in the patients of the two groups. The effect was evaluated in the two groups. The effective rate and the clinical curative rate in the combined therapy group were better than those in the control group [100. 0% (35/35) vs 85. 3% (29/34), 42. 9% (15/35) vs 17. 6% (6/34), both Pclinical examnation, daily life movement and superficialmuscular pain in the neck were improved apparently after treatment as compared with those before treatment in the patients of the two groups (all Pclinical examination total scores and superficial muscular pain in the' neck were more significant in the combined therapy group
Pressman, Helaine Tobey
Traumatic brain injury (TBI) cases are medically complex, involving the physical, cognitive, behavioral, social, and emotional aspects of the survivor. Often catastrophic, these cases require substantial financial resources not only for the patient's survival but to achieve the optimal outcome of a functional life with return to family and work responsibilities for the long term. TBI cases involve the injured person, the family, medical professionals such as treating physicians, therapists, attorneys, the employer, community resources, and the funding source, usually an insurance company. Case management is required to facilitate achievement of an optimal result by collaborating with all parties involved, assessing priorities and options, coordinating services, and educating and communicating with all concerned.
Jiang, Bin; Ma, Zhu-hong; Zuo, Fang
To investigate the effect of auricular acupuncture therapy (AAT) and standardized acupoints on sleep parameters among people with insomnia. A single-blind, randomized pilot study where the treatment group AAT on active points and the control group received AAT on sham points during a 4-week treatment period. Participants were recruited from the Acupuncture Outpatient Clinics in the General Hospital of People's Liberation Army. In all, 125 patients were included in the study, with 63 in treatment group and 62 in control group. Sleep parameters were obtained by using the Pittsburgh Sleep Quality Index (PSQI). (1) Significant improvement in the PSQI total score and seven components score including sleep quality, time on falling asleep, sleeping time, efficiency and disorder of sleep, hypnotic and daytime functional disorder after treatment in both treatment group and control group (P<0.01). (2) After treatment, there was a statistically significant difference seen in the PSQI total score and six components score (P<0.01) except for hypnotic between the two groups. There were statistically significant differences in the rank differential value of total score and seven components of two groups (P<0.01). (3) There were statistically significant differences in the mean rank of PSQI seven components using Mann-Whitney test (P<0.01). Evidence was found to support the hypothesis that AAT played an effective role in improving the quantity and quality of sleep in those subjects with insomnia. A standardized AAT might help the treatment of insomnia, especially when combined with other treatments as psychological and behavioral therapies.
Gay-Escoda, Cosme; Pérez-Álvarez, Débora; Camps-Font, Octavi
Background The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. Material and Methods A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Results Nine participants (57 implants) were included. The patients’ median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Conclusions Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented. Key words:HIV infection, dental implants, oral implantology, complications, peri-implantitis, peri-implant diseases. PMID:26946205
Burdea, Grigore C; Polistico, Kevin; House, Gregory P; Liu, Richard R; Muñiz, Roberto; Macaro, Natalie A; Slater, Lisa M
BrightBrainer™ integrative cognitive rehabilitation system evaluation in an Adult Day Program by a subject with Primary Progressive Aphasia (PPA) assumed to be of the mixed nonfluent/logopenic variant, and for determination of potential benefits. The subject was a 51-year-old Caucasian male diagnosed with PPA who had attended an Adult Day Program for 18 months prior to BrightBrainer training. The subject interacted with therapeutic games using a controller that measured 3D hand movements and flexion of both index fingers. The computer simulations adapted difficulty level based on task performance; results were stored on a remote server. The clinical trial consisted of 16 sessions, twice/week for 8 weeks. The subject was evaluated through neuropsychological measures, therapy notes and caregiver feedback forms. Neuropsychological testing indicated no depression (BDI 0) and severe dementia (BIMS 1 and MMSE 3). The 6.5 h of therapy consisted of games targeting Language comprehension; Executive functions; Focusing; Short-term memory; and Immediate/working memory. The subject attained the highest difficulty level in all-but-one game, while averaging 1300-arm task-oriented active movement repetitions and 320 index finger flexion movements per session. While neuropsychological testing showed no benefits, the caregiver reported strong improvements in verbal responses, vocabulary use, speaking in complete sentences, following one-step directions and participating in daily activities. This corroborated well with therapy notes. Preliminary findings demonstrate a meaningful reduction of PPA symptoms for the subject, suggesting follow-up imaging studies to detail neuronal changes induced by BrightBrainer system and controlled studies with a sufficiently large number of PPA subjects.
... Parents/Teachers Resource Links for Students Glossary Rehabilitation Engineering What is rehabilitation engineering? How can future rehabilitation ... the area of rehabilitation engineering? What is rehabilitation engineering? Powered prosthetic leg. Source : M. Goldfarb, Vanderbilt U. ...
Full Text Available Complex periprosthetic cases are considered as challenges by clinicians. Clinical and radiographic parameters should be considered separately to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are specific parameters of both the patient and the clinician. In addition, the presence of periodontal, prosthetic, and orthodontic diseases requires patients to be set in multidisciplinary approach. The aim of this case report is to describe how the multidisciplinary approach could be the best way to manage difficult cases of implant-prosthetic rehabilitation. How to rehabilitate with fixed prosthesis on natural teeth and dental implants a smoker patient who presents with active periodontitis, multiple edentulous areas, dental malocclusion, and severe aesthetic problems was also described.
Wu, Shengjun; Liang, Jie; Zhu, Xia; Liu, Xufeng; Miao, Danmin
Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. Many studies have reported the effect of body acupuncture in reducing anxiety syndromes. The aim of this study is to compare the treatment effect of body acupuncture and auricular acupuncture in preoperative patients with preoperative anxiety. Thirty five elective ambulatory surgery patients were selected in the randomized and blinded trial. Subjects were randomly categorized in two intervention groups, the body acupuncture group who received acupuncture in the special points of body, and the auricular acupuncture group who received ear acupuncture. Zung Self-Rating Anxiety Scale (SAS) was used before and after the study. For the auricular acupuncture group, the mean score of SAS was 57.57 ± 8.22 before the intervention and 46.32 ± 6.37 afterward. For the body acupuncture group, the SAS score was 55.39 ± 5.41 and 44.82 ± 6.76 before and after the intervention, respectively. For both groups, the difference between pre- and post-treatment scores reached the significant level (p = 0.00). Both auricular and body acupuncture treatment methods were effective in decreasing anxiety in preoperative patients.
Conclusión: Los años de vida saludables perdidos estimados muestran que la fibrilación auricular es altamente discapacitante en la población colombiana durante el periodo de estudio, dado el predominio del componente de años vividos con discapacidad.
Andrés P Castaño; Carlos A Ruiz; Andrés Castillo; Elvio Heidenreich
..., de la duración del potencial de acción (APD) y velocidad de conducción (CV) en un tejido en tres dimensiones incorporando el direccionamiento de fibras para toda la anatomía auricular. Métodos...
Conclusion: Our results showed that auricular acupuncture did not have a better efficacy in smoking cessation compared to sham acupuncture. Combined acupuncture with behavior counseling or with nicotine replacement therapy should be used in further smoking cessation trials to enhance the success rate of smoking cessation.
Ono, Ichiro; Ohura, Takehiko; Iwao, Fumiya (Hokkaido Univ., Sapporo (Japan). School of Medicine) (and others)
Three-dimensional computer tomography (3D-CT) was performed in 60 patients with auricular anomaly to determine the site and severity of deformity in the hemifacial microsomia. Auricular anomaly, underdevelopment and malposition of the cranium, temporo-mandibular joint, zygoma, maxilla and mandible were observed in almost all of the patients; however, the severity of these malformations varied from patient to patient. Regarding severest deformity, there were positional differences among patients. According to impairment sites, hemifacial microsomia fell into the following five types: (1) cranium type, (2) maxillary alveolar process type, (3) localized mandibular ramus type, (4) overall mandibular type, and (5) complex type (combination of the aforementioned types). Facial asymmetry accompanied by auricular anomaly was associated with various pathologic conditions. The temporomandibular joint was often deviated towards the anteromedial side for localized mandibular ramus type and overall mandibular type. Posterial deviation was predominant for cranium type. In patients with hemifacial microsomia of the cranium type associated with protrusion mainly in the occipital region on the affected side, deformity was considered attributable to underdevelopment of the temporal bone and delay in closure of the temporo-occipital suture. The deformity for cranium type may be defined as the second branchial syndrome. In conclusion, hemifacial microsomia have various deformities and may fall into five categories. Craniofacial microsomia and hemi-auriculo-temporo-mandibular dysplastic syndrome give a more precise concept for auricular anomaly. (N.K.).
Diego Rosselli, MD.,EdM.,MSc
Conclusiones: Aunque la muestra corresponde a una sola ciudad colombiana y tiene potenciales sesgos de selección, la prevalencia de fibrilación auricular en el país podría ser similar a la que se describe en el estudio Framingham
Reilly, Patricia M; Buchanan, Teresa M; Vafides, Carol; Breakey, Suellen; Dykes, Patricia
The caring relationship between individual health care providers and patients is a critical component of healing. However, caring can result in physical, emotional, psychological, and spiritual symptoms in providers that can interfere with their capacity to enter into these relationships. The aim of this study was to evaluate whether auricular acupuncture is an effective tool for reducing health care provider stress and anxiety and, second, to determine if auricular acupuncture impacts provider capacity for developing caring relationships with patients. Preintervention and postintervention surveys were evaluated to see if auricular acupuncture was associated with changes in State-Trait Anxiety Inventory (STAI), Professional Quality of Life, and Caring Ability Inventory scores. Compared with baseline, participants had a significant reduction in state anxiety (STAI), trait anxiety (STAI), burnout, and secondary traumatic stress scores (Professional Quality of Life). Significant increases were noted in courage and patience, 2 dimensions of the Caring Ability Inventory. Auricular acupuncture is an effective intervention for the relief of stress/anxiety in providers and supports heightened capacity for caring.
Full Text Available Auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction. An increasing number of studies have demonstrated that auricular acupuncture has a significant effect on inducing parasympathetic tone. Epilepsy is a neurological disorder consisting of recurrent seizures resulting from excessive, uncontrolled electrical activity in the brain. Autonomic imbalance demonstrating an increased sympathetic activity and a reduced parasympathetic activation is involved in the development and progress of epileptic seizures. Activation of the parasympathetic nervous system such as vagus nerve stimulation has been used for the treatment of intractable epilepsy. Here, we propose that auricular acupuncture may suppress epileptic seizures via activating the parasympathetic nervous system.
He, Wei; Rong, Pei-Jing; Li, Liang; Ben, Hui; Zhu, Bing; Litscher, Gerhard
Auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction. An increasing number of studies have demonstrated that auricular acupuncture has a significant effect on inducing parasympathetic tone. Epilepsy is a neurological disorder consisting of recurrent seizures resulting from excessive, uncontrolled electrical activity in the brain. Autonomic imbalance demonstrating an increased sympathetic activity and a reduced parasympathetic activation is involved in the development and progress of epileptic seizures. Activation of the parasympathetic nervous system such as vagus nerve stimulation has been used for the treatment of intractable epilepsy. Here, we propose that auricular acupuncture may suppress epileptic seizures via activating the parasympathetic nervous system.
McAleer, Stephen S; Lippie, Ed; Norman, Darcy; Riepenhof, Helge
Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting, and cutting are the dominant movements. There are few nonoperative rehabilitation strategies for the condition reported in the literature, and the outcome of conservative treatment has not been documented. Case Description Five professional and academy soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment, were treated with a nonoperative rehabilitation program that featured functional and clinical objective markers as progression criteria. Interventions in the acute phase included pharmacological and physical therapeutic modalities to reduce pain initially. Rehabilitation management focused on improving range of motion at the hips and thorax, adductor strengthening, trunk and lumbopelvic stability, gym-based strength training, and field-based rehabilitation and conditioning. Clinical follow-up was performed at least 8 months following return to play. Outcomes All players demonstrated reduced or resolved pain, increased adductor squeeze strength, and return to pain-free training and match play. Return-to-training time averaged 40.6 days (range, 30-60 days) and return to play averaged 49.4 days (range, 38-72 days) within the 5 players. At final follow-up (mean, 29.6 months; range, 16-33 months), there had been no recurrences. Discussion This report of 5 cases suggests that a nonoperative protocol, using clinical and functional progression criteria, may be successful in rehabilitating athletes with PBS for return to sport within 11 weeks. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2017;47(9):683-690. Epub 3 Aug 2017. doi:10.2519/jospt.2017.7314.
Angel, Sanne; Kroll, Thilo
Although medical and technological advances have extended survival rates through ever more effective acute clinical management for people with spinal cord injuries, the links between rehabilitation and recovery are less well understood. With ever shorter length of stays in inpatient rehabilitation, the focus of support has been shifting toward outpatient support pathways. In this article, the narrated rehabilitation experiences of two young men with comparable spinal cord injuries in the United States and Denmark are contrasted. From their biographical narratives, we examine the sociocontextual factors that underpin the rehabilitation pathways in two quite distinctive social and healthcare environments. Our analysis raises questions about the importance of factors such as readiness, timeliness, duration, and appropriateness of rehabilitation to facilitate independent living, achieve meaningful recovery, and provide equitable access to the goods and services afforded by society.
Munday, John S; Gwyther, Stacy; Thomson, Neroli A; Malik, Richard
Cutaneous papillary squamous cell carcinomas (SCCs) are extremely rare in humans and have not been reported in any nonhuman species. In humans, oral papillary SCCs are often caused by papillomavirus infection and have a more favourable prognosis than other SCC subtypes. A 10-year-old ginger and white domestic short hair cat had a 12 month history of symmetrical, roughly circular, exophytic 2 cm diameter masses in both pre-auricular regions. Surgical excision was performed, although with only narrow margins. Histology of both masses revealed a proliferation of neoplastic keratinocytes arranged in numerous filiform projections that were supported by fibrovascular stalks. Although the cells were confined to the epidermis predominantly, nests of neoplastic cells were visible within the superficial dermis. The neoplastic cells demonstrated significant atypia with a variable nuclear:cytoplasmic ratio and a high mitotic index. A papillary subtype SCC was diagnosed. Felis catus papillomavirus type 2 (FcaPV-2) was the only papillomavirus detected in the masses and FcaPV-2 E6/E7 gene expression and p16 CDKN 2A protein immunostaining were detected. Six months after surgery neither recurrence nor further masses had developed. This is the first cutaneous papillary SCC reported in a nonhuman species. Papillary SCCs may be a rare manifestation of FcaPV-2 infection in cats. The unusual location of the SCCs suggests that both papillomavirus infection and ultraviolet light exposure could have contributed to neoplasia development. Evidence from this single case suggests that papillary SCCs may have a more favourable prognosis than conventional SCCs in cats. © 2016 ESVD and ACVD.
Kim, Sun-Hyun; Kim, Min-Young; Lee, Jae-Hyuk; Chun, Sae-il
This case report discusses the potential for art therapy to aid in the recovery of early-chronic stroke patients. The patient was diagnosed with having a subarachnoid hemorrhage from a cerebral aneurysm rupture 1 year prior to hospitalization. Therapies used as part of the patient's treatment included 10 weeks of art therapy conducted twice a…
Full Text Available Hicham Khabbache,1 Abdelhak Jebbar,2,* Nadia Rania,3,* Marie-Chantal Doucet,4 Ali Assad Watfa,5 Joël Candau,6 Mariano Martini,7 Anna Siri,8,* Francesco Brigo,9,10,* Nicola Luigi Bragazzi1,2,4–8,11,* 1Faculty of Literature and Humanistic Studies, Sais, Sidi Mohamed Ben Abdellah University, Fez, 2Faculty of Art and Humanities, Sultan Moulay Slimane University, Beni-Mellal, Morocco; 3School of Social Sciences, Department of Education Sciences, University of Genoa, Genova, Italy; 4Faculty of Human Sciences, School of Social Work, University of Québec-Montréal, Montreal, QC, Canada; 5Faculty of Education, Kuwait University, Kuwait City, Kuwait; 6Laboratory of Anthropology and Cognitive and Social Psychology, University of Nice Sophia Antipolis, Nice, France; 7Department of Health Sciences (DISSAL, Section of Bioethics, University of Genoa, 8UNESCO Chair “Health Anthropology, Biosphere and Healing Systems”, Genova, 9Department of Neurology, Franz Tappeiner Hospital, Merano, 10Department of Neurological, Biomedical, and Movement Sciences, University of Verona, Verona, 11School of Public Health, Department of Health Sciences (DISSAL, University of Genoa, Genova, Italy *These authors contributed equally to this work Abstract: Mental, neurological and substance use (MNS disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of
José Ramón Martínez Pérez
Full Text Available Background: hypertension is one of the main cardiovascular risk factors, so its control improves the life expectancy of patients.Objective: to assess the effects of a treatment combining medication with auricular therapy and phyto-therapy in hypertensive patients assisted at the health area of ”Romárico Oro” Polyclinic, in Puerto Padre, Las Tunas province.Methods: an intervention study was carried out in 68 hypertensive patients of the health area of “Romárico Oro” Polyclinic in Puerto Padre from April, 2013 to April, 2014. The patients were distributed at random into two equal groups; the first received medication combined with auricular therapy and phyto-therapy, while the second one received only medication. The statistical analysis was done by means of Statistic system, t-student and Chi-Square tests were used and p< or =0.05 was considered as level of statistical significance.Results: by the end of the intervention, 73, 53% of the patients of the group with the combination of drug treatment and auricular therapy and phyto-therapy were controlled. In this group, the diastolic filling pressure diminished to 2, 2 mm Hg and the systolic gradient to 3, 66 mm, regarding the group treated only with drugs. Only one patient, representing the 2, 94% showed adverse reaction to the natural and traditional treatment.Conclusions: the combination of medication with auricular therapy and phyto-therapy proved to be effective, corroborated by a significant decrease of quantity of crisis, diastolic and systolic filling pressure values and increase of number of patients with their disease controlled; the report of only one complication shows the innocuousness of the auricular therapy and phyto-therapy treatment.
Short, Steven M; Anloague, Philip A; Strack, Donald S
Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.
Gabel, Charles P; Rando, Natalie; Melloh, Markus
To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original ...
Full Text Available This case report describes a successful multidisciplinary approach used to improve the smile esthetics of a patient presenting with excessive gingival display, asymmetric gingival margins, and small upper anterior teeth and lower anterior teeth. The treatment combined esthetic crown lengthening, dental bleaching, and restorative dentistry using CAD/CAM veneer. The 6-month follow-up examination confirmed the stability of the modification and absence of adverse effects.
Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira
Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Full Text Available In the selection of thermo-energetic rehabilitation solutions, there are certain restrictions determined especially by the imperative of preserving the architectural characteristics, a large proportion of these buildings falling under the categories of historic or cultural monuments of high architectural value. Under the second category comes “Luceafărul” Theatre from Jassy, a representative edifice for the area in which it is located. The requirement of conserving the current appearance of the façade areas veneered with travertine has imposed the placing of thermal insulation on the interior surface. Taking into account that interior insulation implies a higher risk of interstitial condensation, a non-steady state coupled heat and mass transfer analysis was performed, by using the WUFI program. The results of this study are plotted as annual variations of relative humidity in the structure of envelope elements, pointing out the layers that are susceptible of excessive values. By numerical simulation of heat transfer with ANSYS program, the discussion is extended with the influence that the insulation of two adjacent envelope elements has on the surface condesation risk, for the case in which at the thermal bridge obtained there a discontinuity exists in the insulation layer.
Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N
This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.
de Araújo Nobre, Miguel Alexandre; Maló, Paulo
To investigate the influence of rehabilitation characteristics in the incidence of peri-implant pathology (P-iP). A total of 1350 patients (270 with P-iP matched for age, gender, and time of follow-up with 1080 controls without P-iP) rehabilitated with dental implants were included. The effect of the independent variables [Implant length in millimeters (IL); implant diameter in millimeters; implant surface (IS); presence of cantilevers; implant:crown ratio (ICR), type of abutment (TA); abutment height; fracture of prosthetic components (FPCs); type of prosthetic reconstruction (TPR); type of material used in the prosthesis (TMUP); loosening of prosthetic components (LPCs); and passive misfit (PM) diagnosed within the previous year] was evaluated through bivariate analysis (chi-square), with level of significance of 5%. Crude odds ratios (OR) with 95% confidence intervals and the attributable fraction (AF) were calculated for the independent variables individually identified as factors associated with the incidence of peri-implant pathology. The following variables were identified as risk factors: machined IS (p = 0.015; OR = 1.46), 17° TA (p = 0.000; OR = 3.06), completely edentulous TPR (p = 0.000; OR = 2.49), TMUP (p = 0.000; metal-acrylic OR = 2.29; acrylic OR = 4.90; metal-ceramic OR = 8.43), 1:1 ICR (p = 0.002; OR = 1.54), FPC (p = 0.000; OR = 3.01), LPC (p = 0.000; OR = 4.15), and PM (p = 0.002; OR = 20.36). The attributable fraction rendered the following theoretical potential reductions in the cases if the exposure to the variables was removed: IS (31.5%), TA (67.3%), TMUP (5.4% to 73.3%), ICR (35%), FPC (66.8%), LPC (73.8%), and PM (95.1%). Within the limitations of this study, machined implant surfaces, 17° abutments, completely edentulous reconstructions, the type of metal used in the prosthesis, 1:1 implant:crown ratio, fracture of prosthetic components, loosening of prosthetic components, and passive misfit emerged as risk factors for the incidence
Asensio Acevedo, Ramón; Suarez-Feito, José Maria; Suárez Tuero, Carlota; Jané, Luis; Roig, Miguel
The evolution of restorative dental materials has led to the development of more direct or indirect conservative techniques to solve both functional and esthetic problems in anterior and posterior teeth. Several authors have concluded that indirect restorations are the technique of choice in complex cases where shape and colour are difficult to achieve and function has to be restored. Even though there is no clinical evidence of the appropriateness of indirect composites in these treatments, the latest generation of composites used indirectly in the anterior teeth exhibits some interesting characteristics: it supports mechanical stress adequately, has an excellent esthetic result and can be repaired intraorally.
Cha, Nam Hyun; Park, Yi Kyun; Sok, Sohyune R
This study sought to examine the effect of auricular acupressure therapy on the stress and sleep status of middle-aged women in South Korea. A quasi-experimental pretest/posttest control group design was employed. The study sample consisted of 67 middle-aged women (experimental: 35 samples; control: 32 samples) in Seoul, South Korea. Auricular acupressure therapy including the auricular acupressure needle on the skin paper tape was applied on an ear for 2 weeks, 2 times per week. The acupoints were Gyogam, Sinmun, Bushin, Naebunbi, and Pijilha. For the placebo control group, only the skin paper tape without the auricular acupressure needle was applied on the same acupoints. Measures were a stress scale, cortisol level in blood, and a sleep status scale. The findings showed that there were significant differences on stress (physical: t = 2.170, P South Korea.
Monticone, M; Giovanazzi, E
Most spine-surgically treated patients are considered eligible for rehabilitative treatment. Unfortunately, an evidence-based consensus on the best postsurgical conservative treatment is not mentioned. In absence of a shared pathway, physical therapies, exercises, back schools, massages and other manual therapies are sometimes recommended by surgeons and clinicians. Like common low back pain, spinal problems in the postsurgical phase should be reconsidered through a bio-psycho-social model, advocating comprehensive evaluations and broader answers to patient-perceived pain, disability, and quality of life needs. The Authors report the clinical case of a 60-year-old woman, operated for lumbar spinal stenosis (LSS) and L4-L5 degenerative spondylolisthesis, early entered in a Rehabilitation Hospital Unit, undergoing rehabilitative and cognitive behavioural therapy. Physical and psychological evaluation, outcome measures, physical and psychological therapies are here illustrated. The obtained results are encouraging for pain, disability and quality of life, assessing usefulness of a bio-psycho-social approach for spine-operated patients. A randomized controlled trial for rehabilitative and cognitive behavioural postsurgical treatment for patients with lumbar spinal stenosis and degenerative spondylolisthesis is advocated to provide further evidence to approaches and results. Proper outcome measures, correct clinical relevance evaluation and adequate follow-ups are needed.
Jairo A. Rendón
Full Text Available Objetivo: Caracterizar la función del apéndice auricular izquierdo por speckle tracking bidimensional, en pacientes en ritmo sinusal y en fibrilación auricular. Métodos: Se realizó ecocardiografía transesofágica para valorar la deformación longitudinal, la tasa de deformación longitudinal, las velocidades del tejido, el volumen y la fracción de eyección del apéndice auricular izquierdo a través de speckle tracking bidimensional, en pacientes en ritmo sinusal y con fibrilación auricular. Resultados: Se incluyeron 91 pacientes de quienes fue posible analizar 80 (88%. El 25% estaba en fibrilación auricular y de éstos el 9% tenía trombo en el apéndice auricular izquierdo; el 46% correspondía a hombres con edad media de 60 años (18-93. Se encontraron diferencias significativas entre los pacientes con fibrilación auricular vs. ritmo sinusal en la facción de eyección del apéndice auricular izquierdo (26,7% vs. 50,1%, las velocidades de vaciamiento por Doppler (28,5 vs. 55,6 cm/s, las velocidades tisulares (3,6 vs. 9,9 cm/s, la deformación longitudinal (5,7% vs. 17%, la tasa de deformación longitudinal (0,9 vs. 3,1 y los volúmenes mínimos del apéndice auricular izquierdo (6,3 vs. 3,0 mL. No se encontraron diferencias significativas entre los pacientes en fibrilación auricular con trombo o sin éste. Conclusión: La valoración de la función del apéndice auricular izquierdo por medio de speckle tracking, es una herramienta útil para caracterizar la función de esta estructura; su alteración se podría relacionar con el riesgo de desarrollar trombos y eventos embólicos secundarios.
Rasmussen, K.; Andersen, JH
on sick leave or social benefits at this time. Individual background variables, as well as psychological well-being, mental health, pain level, and pain coping, seemed to have little effect on the outcome of rehabilitation, whilst clients' own evaluations of competence and ability of the involved health......There appears to be a lack of evidence concerning the effect of rehabilitation programmes for the long-term sick. More focus in this area would supplement an approach that has been directed toward process evaluation of rehabilitation programmes. It was the purpose of this study to shed light......"). Questionnaires were completed before the rehabilitation programme's start, at the end of the 8-week programme, and at the 9-months follow-up. Among 389 clients, 271 (69.7%) participated in the study at baseline as well at the 9-months follow-up. The majority of 212 participants were on sick leave--6.6% for more...
Erieta Nikolikj Dimitrova
CONCLUSION: Rehabilitation is integral part of multidisciplinary treatment of renal transplant recipient after total hip arthroplasty. Regular exercise training of these patients is very important for improving of their long-term outcome.
Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf
By the development of a mHealth tablet app together with modular interactive tiles for rehabilitation, we intend to facilitate the co-design, adaptation, demonstration and validation of modular ICT solutions for rehabilitation in deep rural sub-Saharan Africa. This results in highly mobile, modular......, the partners contextualise the eHealth solution to fit the needs in urban, rural and deep rural areas....
Vimal Kantilal Munot; Ramesh P Nayakar; Raghunath Patil
The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fix...
Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath
The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fix...
Raney, Nicole H; Teyhen, Deydre S; Childs, John D
Case series. A clinical prediction rule (CPR) has been developed and validated that accurately identifies a subgroup of patients with low back pain (LBP) likely to benefit from spinal manipulation; however, the mechanism of spinal manipulation remains unclear. The purpose of this case series was to describe changes in lateral abdominal muscle thickness using rehabilitative ultrasound imaging (RUSI) immediately following spinal manipulation in a subgroup of patients positive on the rule. Data from 9 patients (5 female, 4 male; 18-53 years of age) with a primary complaint of LBP are presented. All patients had symptoms for less than 16 days (range, 3-14 days) and did not have symptoms distal to the knee, satisfying the 2-factor rule for predicting successful outcome from spinal manipulation. The Oswestry Disability Index scores ranged from 8% to 52%. Lateral abdominal muscle thickness was assessed with the patient at-rest and while contracted during an abdominal drawing-in maneuver (ADIM) using RUSI. Measurements were taken before and immediately after spinal manipulation. Patients completed a 15-minute training session of the ADIM prior to assessment, to mitigate the potential for a learning effect to occur. Based on changes that exceeded the threshold for measurement error, 6 of 9 patients demonstrated an improved ability (11.5%-27.9%) to increase transversus abdominis (TrA) muscle thickness during the ADIM postmanipulation. Additionally, TrA muscle thickness at-rest postmanipulation decreased for 5 patients (11.5%-25.9%), while at-rest internal oblique muscle thickness decreased for 4 patients (6.4%-12.2%). This case series describes short-term changes in lateral abdominal muscle thickness post spinal manipulation. Although case series have significant limitations, including the fact that no cause-and-effect claims can be made, the decrease in muscle thickness at rest and the greater increase in muscle thickness during the ADIM postmanipulation observed in some of
Full Text Available We tested effects of auricular acupressure on peri- and early postmenopausal women with anxiety (PPWA. Fifty PPWA were randomly assigned to the auricular acupressure group (AG or the sham group (SG. After 3 meals and before sleep every day for 4 weeks, the AG received auricular acupressure on the bilateral ear shenmen and subcortex points for 3 min per point on alternating ears. The SG received sham auricular acupressure. The Alprazolam was reduced from 0.5 mg/day at baseline to 0.3 mg/day 4 weeks after auricular acupressure (4 W in the AG (P.05. The Zolpidem was reduced from 3.0 mg/day at baseline to 1.5 mg/day at 4 W (P.05, thus, significant tapering medication, suggesting auricular acupressure is helpful to PPWA.
Full Text Available Thayla Hellen Nunes Gouveia, Jéssica Dias Theobaldo, Waldemir Francisco Vieira-Junior, Débora Alves Nunes Leite Lima, Flávio Henrique Baggio Aguiar Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Campinas, SP, Brazil Background: In daily clinical practice, esthetics of anterior teeth is a common presenting complaint of patients.Objective: This case report discusses the management of asymmetric smile associated with unsatisfactory extensive composite restorations and describes a clinical protocol using the direct composite resin for smile enhancement to restore the dental harmony of anterior teeth.Methods: The treatment planning was based on a diagnostic wax-up and cosmetic mock-up. After clinical and patient approvals were obtained, the patient was subjected to direct and indirect restorative treatment.Conclusion: Nanocomposites are an effective alternative for anterior teeth restorations. Additionally, good planning enables satisfactory esthetic results, leading to the correction of an inappropriate axial inclination of incisors. Keywords: composite, adhesive, smile, esthetic, restoration
Qu, Fan; Zhang, Dan; Chen, Lu-Ting; Wang, Fang-Fang; Pan, Jie-Xue; Zhu, Yi-Min; Ma, Chun-Mei; Huang, Yi-Ting; Ye, Xiao-Qun; Sun, Sai-Jun; Zheng, Wen-Jun; Zhang, Run-Ju; Xu, Jian; Xing, Lan-Feng; Huang, He-Feng
The study was to explore whether auricular acupressure (AA) can relieve anxiety during the period from trans-vaginal oocyte retrieval to the embryo transfer in IVF treatment and whether AA can improve the outcomes of IVF. 305 infertile patients with tubal blockage who were referred for IVF were included. The women were randomized into a control group with 102 cases, a Sham-AA group with 102 cases and an AA group with 101 cases. The anxiety levels were rated with Spielberger's State Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information Scale. Data of clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) were obtained. The levels of neuropeptide Y (NPY) and transforming growth factor alpha (TGF-alpha) in the follicular fluids were detected with ELISA. After treatment, in AA group, the levels of state anxiety, preoperative anxiety and need-for-information were significantly lower, whereas CPR, IR, LBR and NPY levels in the follicular fluids were markedly higher than Sham-AA group and control group. We concluded that AA could help to reduce anxiety levels associated with IVF and improves the outcomes of IVF partly through increasing the levels of NPY in the follicular fluids.
Thoreson, Richard W.; And Others
Describes rehabilitation implications associated with psychosocial factors, patient reaction, and family adjustment to coronary heart disease. Patient education and counseling must stress specific long-term care and follow-up and deal with family anxiety and depression. The rehabilitation counselor can help patients incorporate medical…
This paper describes a team approach to coronary rehabilitation in a tertiary care hospital and the unique role of the family physician in a shared, multi-disciplinary service for in- and out-patients. Primary care physicians facilitate and supplement the work of the coronary-unit team in establishing an optimal rehabilitative program for MI patients and their families.
van Twillert, Sacha; Postema, Klaas; Geertzen, Jan H B; Lettinga, Ant T
In improvement of clinical practice, unidirectional approaches of translating evidence into clinical practice have been pinpointed as main obstacles. The concept of engaged scholarship has been introduced to guide knowledge-to-action (KTA) processes, in which research knowledge and practical knowledge derived from therapists, patients, and organizational structures mutually inform each other. Accordingly, KTA experts should engage end-users earlier in knowledge translation and work in concert with them on both knowledge creation and knowledge implementation. The purposes of this case report are: (1) to provide an illustrative example of an evidence-informed improvement process in prosthetic rehabilitation in a local setting and (2) to articulate the bidirectional translation work incorporated into an integrated KTA process. A KTA expert translated research knowledge on self-management and task- and context-specific training into a functional prosthetic training program for patients with a lower limb amputation. Therapists contributed as co-creators to the translation process with practical knowledge of the specificities of the target group and local organizational context. The KTA expert moved the co-created knowledge into action in iterative and interactive steps with local therapists, patients, and managers. This bidirectional KTA translation process led to shared ownership of the functional prosthetic training program, in which self-management and task- and context-specific training principles and practices were integrated. Bidirectional knowledge translation builds on explicating and integrating the different knowledge practices of researchers, therapists, and their patients. Knowledge-to-action experts and end-users have their own roles and activities in such knowledge translation processes. Appreciating these different roles in genuine partnerships and acknowledging the distinct but equally valued knowledge practices can help in effectively translating
Innis, Charles J; Braverman, Hillary; Cavin, Julie M; Ceresia, Michelle L; Baden, Lindsey R; Kuhn, Duncan M; Frasca, Salvatore; McGowan, J Patrick; Hirokawa, Keiko; Weber, E Scott; Stacy, Brian; Merigo, Constance
To evaluate clinical data for cold-stunned Kemp's ridley turtles (Lepidochelys kempii) with Enterococcus spp infections during rehabilitation. Retrospective case series. 50 stranded cold-stunned Kemp's ridley turtles hospitalized between 2006 and 2012. Medical records for turtles from which Enterococcus spp were isolated were reviewed retrospectively, and clinical data, including morphometric data, body temperature at admission, physical examination findings, antimicrobial medication history, history of medications administered IV, environmental data, day of diagnosis, clinical signs at diagnosis, microbiological testing results, sources of positive culture results, hematologic and plasma biochemical data, cytologic and histopathologic results, radiographic findings, antimicrobial treatments, time to first negative culture result, treatment duration, results of subsequent cultures, and case outcome, were collated and analyzed. Enterococcus spp were isolated from bacteriologic cultures of blood, bone, joint, and respiratory tract samples and a skin lesion, with supporting evidence of infection provided by histopathologic, cytologic, and radiographic data. Positive culture results were associated with clinical problems such as lethargy, anorexia, and lameness. Most (34/43 [79%]) turtles for which an antemortem diagnosis was made survived with treatment and were released into the wild. Cold-stunned Kemp's ridley turtles may be affected by serious Enterococcus spp infections during rehabilitation. Recognition and treatment of these infections are important for successful rehabilitation.
Kampusch, Stefan; Kaniusas, Eugenijus; Széles, Jozsef C
Primary cervical dystonia is characterized by abnormal, involuntary, and sustained contractions of cervical muscles. Current ways of treatment focus on alleviating symptomatic muscle activity. Besides pharmacological treatment, in severe cases patients may receive neuromodulative intervention such as deep brain stimulation. However, these (highly invasive) methods have some major drawbacks. For the first time, percutaneous auricular vagus nerve stimulation (pVNS) was applied in a single case of primary cervical dystonia. Auricular vagus nerve stimulation was already shown to modulate the (autonomous) sympathovagal balance of the body and proved to be an effective treatment in acute and chronic pain, epilepsy, as well as major depression. pVNS effects on cervical dystonia may be hypothesized to rely upon: (i) the alteration of sensory input to the brain, which affects structures involved in the genesis of motoric and nonmotoric dystonic symptoms; and (ii) the alteration of the sympathovagal balance with a sustained impact on involuntary movement control, pain, quality of sleep, and general well-being. The presented data provide experimental evidence that pVNS may be a new alternative and minimally invasive treatment in primary cervical dystonia. One female patient (age 50 years) suffering from therapy refractory cervical dystonia was treated with pVNS over 20 months. Significant improvement in muscle pain, dystonic symptoms, and autonomic regulation as well as a subjective improvement in motility, sleep, and mood were achieved. A subjective improvement in pain recorded by visual analog scale ratings (0-10) was observed from 5.42 to 3.92 (medians). Muscle tone of the mainly affected left and right trapezius muscle in supine position was favorably reduced by about 96%. Significant reduction of muscle tone was also achieved in sitting and standing positions of the patient. Habituation to stimulation leading to reduced stimulation efficiency was observed and
Bhakta, Shashwat; Deakin, Karl; Joshi, Rajendra
The clinical and laboratory steps involved in rehabilitating the maxillary arch following the loss of several teeth due to periodontal disease are outlined in this case report. This article illustrates the use of a laboratory based CAD/CAM system (Sirona In-Lab) and a copy milling technique in the fabrication of a fixed-movable bridge, high strength, all-ceramic, cross-arch bridge. Adopting a semi-fixed approach in cross-arch rehabilitation has conventionally involved the use of porcelain fused to metal (PFM) components but the demands placed by patients and clinicians have led to the development of novel techniques in order to achieve highly aesthetic and functional results.
Ackerman, Rosalie J
This article presents a case study of a 39-year-old European American married woman with a history of child and adolescent incest,marital rape, and physical abuse from her husband for more than 10 years. She was referred to a pain clinic for treatment of headaches and Tourette's syndrome. The client was evaluated with the Ackerman-Banks Neuropsychological Rehabilitation Battery to identify neuropsychological strengths and weaknesses. The Vulnerability to Stress Audit was used to identify life events that were positively and negatively influencing her life. The client was treated for mild traumatic brain injury, post-traumatic stress disorder,cognitive difficulties, impulsivity, confabulation, low frustration tolerance, and inability to evaluate and make decisions about socially appropriate behaviors. Treatment involved traditional psychotherapy, hypnosis, cognitive rehabilitation, biofeedback training, electromyography, finger temperature, and blood pressure.
Hussein G. El Charkawi
Full Text Available Background: A simple technique was presented in this clinical report for orientation of a bone anchored auricular prosthesis.Methods: The proposed technique includes drawing the intact ear on a transparent celluloid paper or radiographic film and flipping it to the opposite side and relating it to the fixed anatomical features on the face of patient.Results: The drawing, by this way provides a simple and easy way to duplicate and transfer the exact size and position of the intact ear to the defect side.Conclusions: This technique provides a simple, safe, inexpensive and time saving yet, an accurate and effective surgical template that orients the craniofacial implants to the confines of the definitive auricular prosthesis. It is indicated for restoration of single missing external ear either in aplasia, injuries and total resection.
Fluet, Gerard G; Patel, Jigna; Qiu, Qinyin; Yarossi, Matthew; Massood, Supriya; Adamovich, Sergei V; Tunik, Eugene; Merians, Alma S
The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated. This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl-Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation. Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing. This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. Implications for rehabilitation Intensive hand and finger rehabilitation activities can be added to an in-patient rehabilitation program for persons with subacute stroke. Targeted training of the thumb may have an impact on activity level function in persons with upper extremity hemiparesis. Untrained transfer tasks can be utilized to confirm that training tasks have elicited motor learning. Changes in cortical motor maps can be used to document
Shan, Yamin; Xu, Jing; Cai, Changping; Wang, Shili; Zhang, Hao
To introduce a novel modified surgical procedure of excision of anterior cartilage of the pseudocyst along with plastic sheet compression for the treatment of auricular pseudocyst and ascertain the effect of the surgical modality of this disease. A retrospective study. Medical college hospital. Eighty-seven auricular pseudocyst patients were subjected to excision of the anterior cartilage of the pseudocyst followed by plastic sheet compression from July 2006 to September 2013. The effects of the operation were evaluated. Eighty patients were males and 7 were females. The median age was 52 years old. The lesions of 86 patients were unilateral and only 1 was bilateral. The clinical features presented a hemispheric painless swelling, which was seen on the ventral side of the auricle, usually the scaphoid and triangular fossa. The average major axis of the pseudocyst was 1.7 ± 0.6 cm. The patients underwent excision of anterior cartilage of the pseudocyst along with plastic sheet compression. The average follow-up period was 51.9 ± 19.1 months. No recurrence was observed with this technique, and the appearance of the auricle was cosmetically acceptable. Our novel modified surgical procedure of excision of anterior cartilage of pseudocyst along with plastic sheet compression is an effective surgical management for the auricular pseudocyst. The advantages of a simple technique, a short-term therapeutic period, and no recurrence made the surgical procedure worth recommending as the definitive treatment of auricular pseudocysts. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.
Papadopoulos, Anestis; Bichara, David A.; Zhao, Xing; Ibusuki, Shinichi; Randolph, Mark A.; Anseth, Kristi S.; Yaremchuk, Michael J.
In this study we investigated the histological, biochemical, and integrative features of the neocartilage using swine auricular chondrocytes photoencapsulated into two poly(ethylene glycol) dimethacrylate (PEGDM) copolymer hydrogels of a different degradation profile: degradable (PEG-4,5LA-DM) and nondegradable (PEGDM) macromers in molar ratios of 60:40 and 70:30. Integration of the engineered tissue with existing native cartilage was examined using an articular cartilaginous ring model. Expe...
Flores, Roberto L; Liss, Hannah; Raffaelli, Samuel; Humayun, Aiza; Khouri, Kimberly S; Coelho, Paulo G; Witek, Lukasz
Currently, surgeons approach autogenous microtia repair by creating a two-dimensional (2D) tracing of the unaffected ear to approximate a three-dimensional (3D) construct, a difficult process. To address these shortcomings, this study introduces the fabrication of patient-specific, sterilizable 3D printed auricular model for autogenous auricular reconstruction. A high-resolution 3D digital photograph was captured of the patient's unaffected ear and surrounding anatomic structures. The photographs were exported and uploaded into Amira, for transformation into a digital (.stl) model, which was imported into Blender, an open source software platform for digital modification of data. The unaffected auricle as digitally isolated and inverted to render a model for the contralateral side. The depths of the scapha, triangular fossa, and cymba were deepened to accentuate their contours. Extra relief was added to the helical root to further distinguish this structure. The ear was then digitally deconstructed and separated into its individual auricular components for reconstruction. The completed ear and its individual components were 3D printed using polylactic acid filament and sterilized following manufacturer specifications. The sterilized models were brought to the operating room to be utilized by the surgeon. The models allowed for more accurate anatomic measurements compared to 2D tracings, which reduced the degree of estimation required by surgeons. Approximately 20 g of the PLA filament were utilized for the construction of these models, yielding a total material cost of approximately $1. Using the methodology detailed in this report, as well as departmentally available resources (3D digital photography and 3D printing), a sterilizable, patient-specific, and inexpensive 3D auricular model was fabricated to be used intraoperatively. This technique of printing customized-to-patient models for surgeons to use as 'guides' shows great promise. Copyright © 2017 European
Haisch, Andreas; Kläring, Svea; Gröger, Andreas; Gebert, Christopher; Sittinger, Michael
The established surgical methods of external ear reconstruction using autogenous tissue represent the current state of the art. Because of the limited possibilities for shaping conventional harvested autogenous rib cartilage, the cosmetic results of auricular reconstruction are frequently unsatisfactory. Tissue engineering could represent an alternative technique for obtaining a precisely shaped cartilage implant that avoids donor site morbidity and unsatisfactory cosmetic results. In this study, the reliability and quality of a tissue-engineering model for the manufacture of auricular-shaped human cartilage implants was investigated, focusing on the feasibility of the manufacturing process and the in vivo and in vitro maturation of an extracellular cartilage-like matrix. Implants were molded within an auricular-shaped silicone cylinder, and human nasal septal chondrocytes crosslinked by human fibrin within bioresorbable PGLA-PLLA polymer scaffolds were used. After an in vitro incubation of up to 6 weeks, defined fragments of the prefabricated auricular-shaped construct were implanted subcutaneously on the backs of nude mice for at least 6 to 12 weeks ( n=7). Scaffolds without cell loading served as controls. Macroscopic and histochemical examination after 3 and 6 weeks in vitro showed a solid compound of homogenously distributed chondrocytes within the polymer scaffold, leading only to a limited pericellular matrix formation. Analysis after 6 and 12 weeks of in vivo maturation demonstrated a solid tissue compound and neocartilage formation with the presence of cartilage-specific matrix components. Implants obtained shape and size during the entire period of implantation. The model of cartilage implant manufacturing presented here meets all biocompatible requirements for in vitro prefabrication and in vivo maturation of autogenous, individually shaped cartilage transplants.
Full Text Available Objetivo: estimar la prevalencia de fibrilación auricular en una muestra de electrocardiogramas de rutina en pacientes mayores de 60 años en un hospital universitario. Métodos: se seleccionó una muestra aleatoria estratificada por decenios de edad en la base de datos de electrocardiogramas prequirúrgicos, de pacientes hospitalizados por cualquier causa y de aquellos que consultan por urgencias en un hospital de alta complejidad de la ciudad de Bogotá. Cada electrocardiograma fue revisado exclusivamente para confirmar o descartar fibrilación auricular. Resultados: de un total de 31.716 registros se seleccionó una muestra de 2.308 registros de electrocardiogramas, de los cuales 110 (4,8% mostraban fibrilación auricular. La distribución según los grupos de edad fue la siguiente: 60-69 años: 1,8% (16 de 848, 70-79 años: 4,6% (38 de 821, 80-89 años: 8,9% (43 de 521, y mayores de 90 años: 11,0% (13 de 118. La prevalencia ajustada para la población colombiana mayor de 60 años es de 3,6% (IC 95%: 3,4-3,8. Conclusiones: aunque la muestra corresponde a una sola ciudad colombiana y tiene potenciales sesgos de selección, la prevalencia de fibrilación auricular en el país podría ser similar a la que se describe en el estudio Framingham.
Full Text Available The goal of this study is to determine the effects of Insulin-Transferrin-Selenium (ITS on proliferation of auricular chondrocytes and formation of engineered cartilage in vitro. Pig auricular monolayer chondrocytes and chondrocyte pellets were cultured in media containing 1% ITS at different concentrations of fetal bovine serum (FBS, 10%, 6%, 2%, 0%, or 10% FBS alone as a control for four weeks. Parameters including cell proliferation in monolayer, wet weight, collagen type I/II/X (Col I, II, X and glycosaminoglycan (GAG expression, GAG content of pellets and gene expression associated with cartilage formation/dedifferentiation (lost cartilage phenotype/hypertrophy within the chondrocyte pellets were assessed. The results showed that chondrocytes proliferation rates increased when FBS concentrations increased (2%, 6%, 10% FBS in ITS supplemented groups. In addition, 1% ITS plus 10% FBS significantly promoted cell proliferation than 10% FBS alone. No chondrocytes grew in ITS alone medium. 1% ITS plus 10% FBS enhanced cartilage formation in terms of size, wet weight, cartilage specific matrices, and homogeneity, compared to 10% FBS alone group. Furthermore, ITS prevented engineered cartilage from dedifferentiation (i.e., higher index of Col II/Col I mRNA expression and expression of aggrecan and hypertrophy (i.e., lower mRNA expression of Col X and MMP13. In conclusion, our results indicated that ITS efficiently enhanced auricular chondrocytes proliferation, retained chondrogenic phenotypes, and promoted engineered cartilage formation when combined with FBS, which is potentially used as key supplementation in auricular chondrocytes and engineered cartilage culture.
Wu, Shengjun; Liang, Jie; Zhu, Xia; Liu, Xufeng; Miao, Danmin
Background: Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. Many studies have reported the effect of body acupuncture in reducing anxiety syndromes. The aim of this study is to compare the treatment effect of body acupuncture and auricular acupuncture in preoperative pa-tients with preoperative anxiety. Methods: Thirty five elective ambulatory surgery patients were selected in the randomized and blinded trial. Subj...
Cha, Hyun Su; Park, Hyojung
The purpose of this study was to examine the effects of auricular acupressure on reducing obesity in adult women with abdominal obesity. The study design was a non-equivalent control group pretest-posttest design. Participants were 58 women, aged 20 years or older, assigned to the experimental group (n=30) or control group (n=28). Auricular acupressure using vaccaria seeds was administered to the experimental group. The sessions continued for 8 weeks. Outcome measures included body weight, abdominal circumference, and body mass index, body fat mass, body fat percentage, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and serum glucose. Women in the experimental group showed significant decreases in body weight (t=6.19, p<.001), abdominal circumference (t=4.01, p<.001), and body mass index (t=2.58, p=.006) after 8 weeks compared with those in the control group. Results show that auricular acupressure using vaccaria seeds was effective in decreasing body weight, abdominal circumference, body mass index, and triglyceride levels in adult women with abdominal obesity.
Papadopoulos, Anestis; Bichara, David A.; Zhao, Xing; Ibusuki, Shinichi; Anseth, Kristi S.; Yaremchuk, Michael J.
In this study we investigated the histological, biochemical, and integrative features of the neocartilage using swine auricular chondrocytes photoencapsulated into two poly(ethylene glycol) dimethacrylate (PEGDM) copolymer hydrogels of a different degradation profile: degradable (PEG-4,5LA-DM) and nondegradable (PEGDM) macromers in molar ratios of 60:40 and 70:30. Integration of the engineered tissue with existing native cartilage was examined using an articular cartilaginous ring model. Experimental group samples (total n = 96) were implanted subcutaneously into nude mice and harvested at 6, 12, and 18 weeks. Nonimplanted constructs (total n = 16) were used as controls for quantification of DNA, glycosaminoglycan, and hydroxyproline. Histologically, neocartilage resembled both the cellular population and composition of the extracellular matrix of the native swine auricular cartilage. DNA content demonstrated that the photoencapsulated chondrocytes were capable of survival and proliferation over time. Both glycosaminoglycan and hydroxyproline contents appeared higher in the neotissue, which was supported by less degradable PEGDM hydrogel. Integration of neocartilage with surrounding native cartilage improved with time, resulting in the development of tight integration interface. PEGDM copolymer hydrogels can support in vivo chondrogenesis by photoencapsulating auricular chondrocytes. PMID:20695772
Hin Cheung Tsang
Result. As compared to the baseline, only the true TENS group reported a significant reduction in VAS-rest (P=.001, VAS-huff (P=.004, and VAS-cough (P=.001, while no significant reduction in any of the VAS scores was seen in the sham TENS group (all P>.05. In contrast, a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group, while the VAS-cough score remained largely unchanged during the period of the study. A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention (all P<.02. No significant between-group difference was observed in PEFR at any point in time. Conclusion. A single session of auricular TENS applied at specific therapeutic points significantly reduced resting (VAS-rest and movement-evoked pain (VAS-huff, VAS-cough, and the effects lasted for at least 30 minutes after the stimulation. The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone. However, auricular TENS did not produce any significant improvement in the performance of PEFR.
Wu, Wocao; Chen, Junqi; Zhen, Erchuan; Huang, Huanlin; Zhang, Pei; Wang, Jiao; Ou, Yingyi; Huang, Yong
A total of 30 students scoring between 12 and 20 on the Test Anxiety Scale who had been exhibiting an anxious state > 24 hours, and 30 normal control students were recruited. Indices of heart rate variability were recorded using an Actiheart electrocardiogram recorder at 10 minutes before auricular pressing, in the first half of stimulation and in the second half of stimulation. The results revealed that the standard deviation of all normal to normal intervals and the root mean square of standard deviation of normal to normal intervals were significantly increased after stimulation. The heart rate variability triangular index, very-low-frequency power, low-frequency power, and the ratio of low-frequency to high-frequency power were increased to different degrees after stimulation. Compared with normal controls, the root mean square of standard deviation of normal to normal intervals was significantly increased in anxious students following auricular pressing. These results indicated that auricular pressing can elevate heart rate variability, especially the root mean square of standard deviation of normal to normal intervals in students with pre-exam anxiety. PMID:25206734
Pier Camillo Parodi
Full Text Available Purpose. To assess surgical outcomes of lower lid reconstruction surgery using auricular conchal tissue. Methods. This prospective study included 20 patients that underwent reconstructive lower lid surgery using autologous auricle chondral-perichondral graft tissue. Auricle tissue was used to provide adequate support and protection with similar conjunctiva tarsal structures on overlying soft tissues in patients with pathologic inferior lid tissue loss requiring reconstructive surgery. Biopsies with histopathology and cytology analysis were taken after 1 year. Cytology analysis using CK19 was used to confirm newly formed conjunctiva overlying the graft. Results. All patients showed no graft rejection. Surgical outcomes were generally good, with minimal or no ocular complications. 16 of 20 patients had excellent results, showing good lid symmetry and esthetics, minimal auricular discomfort, patient satisfaction and proper lid function. Surgical outcomes were highly dependent on proper post-op conjunctiva formation. All patients were positive for CK19, thus indicating proper conjunctiva tissue formation. Conclusions. Lower lid reconstruction surgery using auricular chondral-perichondral conchal tissue is a good alternative in patients with neoplastic lesions. Autologous chondral-perichondral tissue provides good functional and mechanical support in the reconstructed lid, thus reducing the risks of ectropion and corneal exposure and ensuring a protected ocular surface.
Kusumastuti, R.; Srilestari, A.; Abdurrohim, K.; Abdullah, M.
Colonoscopy is the standard procedure for colorectal cancer screening. One of its common complications is abdominal pain. Analgesia has not provided favorable outcomes so various complementary practices have been developed, including auricular acupuncture. In this study, a randomized controlled trial of 56 patients who underwent colonoscopy was conducted to determine the effect of acupuncture on the pain experienced during colonoscopy. Subjects were divided into two groups: The first received acupuncture combined with midazolam and pethidine, while the second were administered placebo puncture in addition to midazolam and pethidine. The median Critical Care Pain Observation Tool (CPOT) score was lower in the auricular acupuncture group than in the placebo puncture group(0.7 [0-4.83] vs. 1.9 [0-6.20] p = 0.010), while there were no significant differences to median Visual Analog Scale (VAS) scores (29 [0-100] vs. 44.5 [0-100] p = 0.147), heart rate changes (-2.58 [14.31] vs.-2.43 [12.28]; p = 0.970), or the mean time to the cecum (16 [8-51] vs. 22 [5-63] p = 0.206). Auricular acupuncture combined with midazolam and pethidine was found to be effective at reducing pain during colonoscopy.
Wang, Shu-Ming; Maranets, Inna; Lin, Eric C; DeZinno, Peggy
This study was done to determine the specificity and sensitivity of a commercial Pointer Plus (Point finder) in detecting a region of low skin resistance on the ear. This was a prospective blinded study. The study was done at the Yale New Haven Hospital, New Haven, CT. The subjects were men and women who work at Yale New Haven Hospital. There were no interventions. Correlations were made between self-reported musculoskeletal pain and the detection of low skin resistance on the ear. The positive predictive value for Pointer Plus detecting low skin resistance correlating to the neck region of French auricular map is 0.76 (76%). The positive predictive value for Pointer Plus to detect low skin resistance area correlating to the low back region of French auricular map is 0.25. The positive predictive value for Pointer Plus in detecting any low in skin resistance on the external auricles in patients who complained of more than two musculoskeletal pains is 0.29. The specificity and sensitivity of a commercial Pointer Plus (point finder) in detecting a region of low skin resistance on the ear being unreliable, depending on the correlating area based on a published auricular map. Additional assessments are needed to support the clinical practice.
Wu, Wocao; Chen, Junqi; Zhen, Erchuan; Huang, Huanlin; Zhang, Pei; Wang, Jiao; Ou, Yingyi; Huang, Yong
A total of 30 students scoring between 12 and 20 on the Test Anxiety Scale who had been exhibiting an anxious state > 24 hours, and 30 normal control students were recruited. Indices of heart rate variability were recorded using an Actiheart electrocardiogram recorder at 10 minutes before auricular pressing, in the first half of stimulation and in the second half of stimulation. The results revealed that the standard deviation of all normal to normal intervals and the root mean square of standard deviation of normal to normal intervals were significantly increased after stimulation. The heart rate variability triangular index, very-low-frequency power, low-frequency power, and the ratio of low-frequency to high-frequency power were increased to different degrees after stimulation. Compared with normal controls, the root mean square of standard deviation of normal to normal intervals was significantly increased in anxious students following auricular pressing. These results indicated that auricular pressing can elevate heart rate variability, especially the root mean square of standard deviation of normal to normal intervals in students with pre-exam anxiety.
Full Text Available Objectives. The objective of this one-group, repeated-measures design was to explore the acceptance of auricular point acupressure (APA to reduce chronic low back pain (CLBP and estimate minimum clinically important differences (MCIDs for pain intensity change. Methods. Subjects received 7-day APA treatment. After appropriate acupoints were identified, vaccaria seeds were carefully taped onto each selected auricular point for 7-day. The Brief Pain Inventory Short Form (BPI was used to collect outcome data. Results. A total of 74 subjects participated in the study. Ten subjects dropped out and the retention rate was 87%. Subjects reported a 46% reduction in BPI worst pain, and over 50% reduction in BPI average pain, overall pain severity and pain interference by the end of study, and 62.5% subjects also reported less pain medication use. The MCIDs for the subscale of BPI ranged from .70 to 1.86 points. The percentage improvement of MCIDs from baseline was between 14.5–24.9%. Discussion. APA appears to be highly acceptable to patients with CLBP. A sham group is needed in order to differentiate the true effects of APA from the possible psychological effects of more frequent visits by the auricular therapist and patients’ expectation of the APA treatment.
Korupolu, Radha; Ngo, Thien; Hack, Nawaz; Escott, Edward; Salles, Sara
A 5-year old female presented with acute tetraparesis and areflexia. Initial imaging and cerebrospinal fluid analysis were suggestive of acute disseminated encephalomyelitis (ADEM). Minimal clinical response with intravenous steroids prompted further work up. Limited nerve conduction studies suggested possible acute motor-sensory axonal neuropathy, a rare variant of Guillain-Barré syndrome (GBS). Repeat imaging was compatible with polyradiculopathy indicating concomitance of ADEM and GBS. The patient suffered severe motor deficits and neuropathic pain. Slow but significant functional recovery was noted after intensive inpatient rehabilitation followed by continued rehabilitation via home health services.
Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard
Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....
Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard
Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....
Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard
Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....
Yusuf O. Cakmak
Full Text Available Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS and the pedunculopontine nucleus (PPN significantly improve cardinal motor symptoms and postural instability and gait difficulty, respectively, in Parkinson’s disease (PD.Objective and Hypothesis: Intrinsic auricular muscle zones (IAMZs allow the potential to simultaneously stimulate the C2 spinal nerve, the trigeminal nerve, the facial nerve, and sympathetic and parasympathetic nerves in addition to providing muscle feedback and control areas including the STN, the PPN and mesencephalic locomotor regions. Our aim was to observe the clinical responses to IAMZ stimulation in PD patients.Method: Unilateral stimulation of an IAMZ, which includes muscle fibers for proprioception, the facial nerve, and C2, trigeminal and autonomic nerve fibers, at 130 Hz was performed in a placebo- and sham-controlled, double-blinded, within design, two-armed study of 24 PD patients.Results: The results of the first arm (10 patients of the present study demonstrated a substantial improvement in Unified Parkinson’s Disease Ratings Scale (UPDRS motor scores due to 10 min of IAMZ electrostimulation (p = 0.0003, power: 0.99 compared to the placebo control (p = 0.130. A moderate to large clinical difference in the improvement in UPDRS motor scores was observed in the IAMZ electrostimulation group. The results of the second arm (14 patients demonstrated significant improvements with dry needling (p = 0.011 and electrostimulation of the IAMZ (p < 0.001 but not with sham electrostimulation (p = 0.748. In addition, there was a significantly greater improvement in UPDRS motor scores in the IAMZ electrostimulation group compared to the IAMZ dry needling group (p < 0.001 and the sham electrostimulation (p < 0.001 groups. The improvement in UPDRS motor scores of the IAMZ electrostimulation group (ΔUPDRS = 5.29 reached moderate to high clinical significance, which was not the case for the dry needling
Rehabilitation of a dentate mandible requiring a full arch rehabilitation. Immediate loading of a fixed complete denture on 8 implants placed with a bone-supported surgical computer-planned guide: a case report.
Amorfini, Leonardo; Storelli, Stefano; Romeo, Eugenio
The use of technologies that merge computerized tomography X-ray imaging and 3-dimensional (3D) planning software allow the surgeon to digitally elaborate on the computer the position, length, and diameter of every implant to be placed. Following this approach, the placement is guided in a 3D digital model, and the implants are placed in the final position avoiding eventual anatomic structures. In this case report, the patient's remaining mandibular teeth were extracted, and the patient received 8 implants with the help of a computer surgical guide. The case was planned using SimPlant and a bone-supported guide. Because of the high precision of the planning, it was possible to realize a provisional rehabilitation before the actual surgery. The planning allows placement of parallel implants to optimize the prosthetic procedure and outcome. An immediate provisional implant was fixed with a flow composite on the temporary abutments and then refined in the dental laboratory. The patient received the provisional rehabilitation the same day of the surgery. After 6 weeks of healing, the final impression was taken and the prosthesis was finalized with a computer-aided design/computer-aided manufacturing titanium full-arch screwed framework with composite veneering. A 6-month follow-up showed good integration of the prostheses and success of all 8 implants. The use of surgical computer-guided planning changes the surgeon's approach: whereas before the use of conventional guides permitted a certain degree of offset from what was planned, the use of computer guides allows the implant to be inserted in a far more precise way. It is obvious that careful planning is the key factor to avoid implant misplacement.
Santamato, Andrea; Panza, Francesco; Ranieri, Maurizio; Amoruso, Maria Teresa; Amoruso, Loredana; Frisardi, Vincenza; Solfrizzi, Vincenzo; Fiore, Pietro
A few studies have reported the use of botulinum toxin injections after spinal cord injury, as this is the gold standard to treat focal spasticity. We report such a case here. A 38-year-old woman who had become paraplegic and care-dependent secondary to cervico-thoracic intramedullary ependymoma, presented 8 months later with painful lower limb spasticity, which was being treated with oral anti-spastic and benzodiazepine drugs with no therapeutic effect. We treated the patient with intrathecal baclofen to reduce her spasticity and in order to avoid the major side-effects of high dosages of oral baclofen. After motor rehabilitation programmes, which included functional electrical stimulation, the patient was able to wear an advanced reciprocating gait orthosis. However, she experienced painful muscle spasms in her toes of the feet that limited her gait. Therefore, she was also treated with bilateral injections of botulinum toxin type A into the flexor digitorum brevis muscles. The patient reported relief of spasms and pain, enabling her to wear an advanced reciprocating gait orthosis and facilitating rehabilitation programmes. The use of botulinum toxin type A may be an important adjunctive therapy to increase the therapeutic effect of baclofen on spasticity in small muscles, resulting in a more focal effect, and improving the use of orthoses and the effectiveness of rehabilitation programmes in patients after spinal cord injury.
Fortner, Miles O.; Oakley, Paul A.; Harrison, Deed E.
[Purpose] To present a case of the non-surgical reduction of ‘slouchy’ hyperkyphosis posture utilizing the multimodal Chiropractic BioPhysics® rehabilitation program emphasizing the mirror image® concept. [Subject and Methods] A 27-year-old female presented suffering from neck and back pains, headaches and gait dysfunction. The patient was treated 30 times over a period of 6-months. Treatment consisted of anterior thoracic translation, thoracic extension, and head retraction exercises as well as spinal traction and spinal manipulation. [Results] After 6-months of treatment the patient displayed a total correction of the posterior thoracic translation with a significant reduction in thoracic hyperkyphosis. The dramatic correction of her overall posture and spine alignment corresponded to the significant relief of neck and back pains, headaches and improvement of various other health issues as demonstrated by self-report and SF-36. [Conclusion] Poor postures corresponding to poor health can be changed for the better with multimodal rehabilitation programs that are now showing consistent postural improvements corresponding with improvements in various health conditions. We suggest that the postural correction of those with various pain symptoms be considered as a first line non-pharmalogical, non-surgical rehabilitation approach for those presenting with poor posture. PMID:28878486
Fortner, Miles O; Oakley, Paul A; Harrison, Deed E
[Purpose] To present a case of the non-surgical reduction of 'slouchy' hyperkyphosis posture utilizing the multimodal Chiropractic BioPhysics(®) rehabilitation program emphasizing the mirror image(®) concept. [Subject and Methods] A 27-year-old female presented suffering from neck and back pains, headaches and gait dysfunction. The patient was treated 30 times over a period of 6-months. Treatment consisted of anterior thoracic translation, thoracic extension, and head retraction exercises as well as spinal traction and spinal manipulation. [Results] After 6-months of treatment the patient displayed a total correction of the posterior thoracic translation with a significant reduction in thoracic hyperkyphosis. The dramatic correction of her overall posture and spine alignment corresponded to the significant relief of neck and back pains, headaches and improvement of various other health issues as demonstrated by self-report and SF-36. [Conclusion] Poor postures corresponding to poor health can be changed for the better with multimodal rehabilitation programs that are now showing consistent postural improvements corresponding with improvements in various health conditions. We suggest that the postural correction of those with various pain symptoms be considered as a first line non-pharmalogical, non-surgical rehabilitation approach for those presenting with poor posture.
Stezar, I C; Pizzol, L; Critto, A; Ozunu, A; Marcomini, A
Brownfield rehabilitation is an essential step for sustainable land-use planning and management in the European Union. In brownfield regeneration processes, the legacy contamination plays a significant role, firstly because of the persistent contaminants in soil or groundwater which extends the existing hazards and risks well into the future; and secondly, problems from historical contamination are often more difficult to manage than contamination caused by new activities. Due to the complexity associated with the management of brownfield site rehabilitation, Decision Support Systems (DSSs) have been developed to support problem holders and stakeholders in the decision-making process encompassing all phases of the rehabilitation. This paper presents a comparative study between two DSSs, namely SADA (Spatial Analysis and Decision Assistance) and DESYRE (Decision Support System for the Requalification of Contaminated Sites), with the main objective of showing the benefits of using DSSs to introduce and process data and then to disseminate results to different stakeholders involved in the decision-making process. For this purpose, a former car manufacturing plant located in the Brasov area, Central Romania, contaminated chiefly by heavy metals and total petroleum hydrocarbons, has been selected as a case study to apply the two examined DSSs. Major results presented here concern the analysis of the functionalities of the two DSSs in order to identify similarities, differences and complementarities and, thus, to provide an indication of the most suitable integration options. Copyright © 2013 Elsevier Ltd. All rights reserved.
Bates-Maves, Julie K.; O'Sullivan, Deirdre
Purpose: This article outlines findings from a sample of 137 vocational rehabilitation counselors regarding their stigmatizing attitudes, burnout levels, work experience, caseload composition, and working alliance with clients who have a range of disabilities and a criminal history. Method: Electronic surveys were sent to vocational rehabilitation…
Full Text Available Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy.
Full Text Available Retimax Vision Trainer is a device that has the purpose to improve visual function by means of the detection of a visual evoked potential associated with a sound feedback. We evaluated the effectiveness of rehabilitative treatment in two patients with Acquired Brain Injury (ABI. Results, subjectively appreciated, are objectively confirmed by the improvement of visual function.
Onyewotu, L.O.Z.; Stigter, C.J.; Abdullahi, A.M.; Ariyo, J.A.; Oladipo, E.O.; Owonubi, J.J.
As a trial relief measure to rehabilitate abandoned desertified fields at Yambawa in semiarid northern Nigeria, the forest department, acting on advice from the Forestry Research Institute of Nigeria (FRIN), established a system of multiple shelterbelts using a monoculture of Eucalyptus
Cardiac rehabilitation (rehab) is a medically supervised program to help people who have A heart attack Angioplasty or coronary artery bypass grafting for coronary heart disease A heart valve repair or replacement A ...
... ncbi.nlm.nih.gov/pubmed/25503364 . Balady GJ, Williams MA, Ades PA, et al. Core components of ... ncbi.nlm.nih.gov/pubmed/22070836 . Thompson PD. Exercise-based, comprehensive cardiac rehabilitation. In: Mann DL, Zipes ...
Belagaje, Samir R
Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a
Wang, Kaiyue; Liu, Zhicheng; Xu, Bin
To explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment. One hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group, 55 cases in each one. Additionally, a healthy group (52 cases) was set up as the control. In the control group, the warm needling therapy was applied to Taibai (SP 3), Chongyang (ST 42), Yinlingquan (SP 9), Zusanli (ST 36), etc., once every two days. In the observation group, on the basic treatment as the control group, the auricular acupuncture was applied to Pi (CO₁₃), Wei (CO₄), Fei (CO₁₄), Shen (CO₁₀), etc., once every 2 to 3 days. The efficacy was evaluated after 3-month, treatment in the two groups. The observation was conducted on the obesity outcomes [body mass, obesity degree (A), body mass index (BMI), body fat percentage (F%)], blood-lipoids indicators [such as serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], fat-islet endocrine axis outcomes [such as fasting plasma glucose (FPG) , fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR) and insulin β cell function index (Homa-β)], as well as autonomic nerve function index (Y) before and after treatment in the patients of the two groups. The efficacy was assessed in the two groups. The total effective rate was 96.4% (53/55) in the observation group, better than 87.3% (48/55, P obesity indices, the differences were not significant between the two groups (all P > 0.05). Before treatment, the levels of TC, TG, LDL-C, FLP, FPG, FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group (all P obesity of spleen deficiency and damp
Krebs, H I; Volpe, B T
This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.
KREBS, H.I.; VOLPE, B.T.
This chapter focuses on rehabilitation robotics which can be used to augment the clinician’s toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual’s functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We will provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we will then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We will present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. PMID:23312648
Lan, Ying; Wu, Xi; Tan, Hui-Juan; Wu, Nan; Xing, Jing-Jing; Wu, Fu-Sheng; Zhang, Lei-Xiao; Liang, Fan-Rong
Primary insomnia is a common health issue in the modern world. We conducted a systematic review of the auricular therapy, aiming to evaluate whether there are advantages of auricular acupuncture with seed or pellet attachments for the treatment of primary insomnia. A search of relevant literatures was performed on major medical databases, including Medline, Embase, CENTRAL, CBM, CNKI, VIP, Wanfang Data and so on. Risk of bias evaluation, meta-analysis, sensitivity analysis and evidence rating of all extracted information were conducted also. A total of 1381 records were identified, with 15 studies deemed eligible for the present review. Meta-analyses were conducted in two comparisons separately: participants received auricular acupuncture were more likely to make an improvement in clinical effective rate (RR = 1.40, 95% CI 1.07 to 1.83), sleep duration (MD = 56.46, 95% CI 45.61 to 67.31), sleep efficiency(MD = 12.86, 95% CI 9.67 to 16.06), global score on PSQI (MD = -3.41, 95% CI -3.93 to -2.89), number of awakenings( MD = -3.27, 95% CI -6.30 to -0.25) and sleep onset latency(MD = -10.35, 95% CI -14.37 to -6.33) when compared to sham auricular acupuncture or placebo; while in auricular acupuncture VS medications comparison, a better effective rate (RR = 1.24, 95% CI 1.15 to 1.34), better sleep efficiency(MD = 21.44, 95% CI 16.30 to 26.58), lower PSQI score (MD = -3.62, 95% CI -4.59 to -2.65) and less adverse effect (RR = 0.11, 95% CI 0.04 to 0.26) can be seen also in auricular acupuncture group. Although these results suggested benefits of auricular acupuncture, the overall quality of evidence rated by the GRADE system was low. Statistical analyses of the outcomes revealed a positive effect of auricular acupuncture for primary insomnia. Nonetheless, considering the poor methodological quality, insufficient sample size and possible publication bias, current evidence is not yet adequate to provide a strong support for the use of auricular acupuncture in the
Wilk, Kevin E; Macrina, Lonard C; Yenchak, Adrian J; Cain, E Lyle; Andrews, James R
Case report. Traumatic glenohumeral dislocations with concomitant rotator cuff and capsular injuries present a unique and challenging surgical and rehabilitative condition, particularly in the overhead-throwing athlete. Multiple injuries of the shoulder complex create the potential for complications in the course of recovery and place a full return to high-level sport at risk. The purpose of this case report is to present the multiphased rehabilitation approach of an elite professional quarterback after an acute 330° capsulolabral reconstruction and rotator cuff repair as a result of a luxatio erecta injury. A 26-year-old male professional football player, a quarterback, sustained a right luxatio erecta shoulder dislocation while trying to recover a fumble during a regular-season game. The injury occurred when he was hit in the back of his throwing shoulder, which was in an abducted and externally rotated position, while lying on the ground. Five days postinjury, he underwent a 330° capsulolabral repair, with concomitant rotator cuff repair and subacromial decompression. He completed 28 weeks of a multiphased rehabilitation program. The patient returned to play in the National Football League (NFL) 8 months later, for the start of the next season, during which he had his most productive year as a professional quarterback, leading the league in passing yards and finishing third in the league for the number of touchdowns. Since the injury, the patient has played 6 consecutive seasons, starting over 96 consecutive, regular-season games and maintaining a very high level of play. This case report highlights the clinical decision-making process and management of this rare, severe injury.
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Refinamientos en la reconstrucción del tercio superior auricular con la técnica de Davis: Estudio anatómico y serie clínica Refinements on reconstruction of auricular upper pole defects with Davi's technique: Anatomical study and clinical series
que la técnica de Davis representa un efectivo método de reconstrucción del tercio superior auricular; los refinamientos a la técnica que comunicamos mejoran los resultados, dando un contorno más natural al área reconstruida.Acquired defects of the upper third of the ear constitute a surgical challenge. Several techniques have been described, and results are sometimes unfavorable. An anatomical study in 10 fresh cadavers shows the constant presence of a neurovascular pedicle penetrating the root of helix. Location and vessel diameters are shown. Based on that anatomical knowledge, a series of 10 consecutive cases treated by the senior author is presented. Etiology, surgical technique, complications and long-term results are analyzed. The author's technique introduces a refinement of the Davis' technique, which uses a pedicled chondrocutaneous rotation conchal flap, cutaneous based on the upper auricular branch of superficial temporal artery. An axial pedicled superiorly based retroauricular flap provides the coverage of the new superior helical rim, and the posterior aspect of the chondrocutaneous flap is then covered with a full thickness skin graft. In a second stage, a Z plasty on the root of helix brings it a natural shape All the anatomical dissections demonstrate the presence of a neurovascular pedicle penetrating the root of the helix. The clinical series is composed by 8 traumatic defects, 1 electrical burn and 1 benign skin tumor. All flaps survived and so demonstrated pedicle safety. Two retroauricular flaps presented vascular deficit, one of them with complete spontaneous restoration and the other one with small distal cutaneous necrosis. Two cases suffered partial skin graft loss. Some technical details were developed while the series went on, which are discussed. All 9 patients recovered auricular contour, which seems better for us using the above described refinements. As a conclusion, the Davis's technique represents an effective method to
Mello-Moura ACV; Bonini GAVC; Suga S; Navarro R; Wanderley M
Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma ...
Pramod Kumar, A. V.; Vinni, T. K.; Mahesh, Mehul R.
The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is supported by both natural teeth and implant. The periodontal ligament and osseointegrated interface distribute force differently to the supporting bone. Therefore problems can develop when tooth and implants are combined in the same prosthesis. However, clinicians can apply biomechanical principles, to negate the deleterious lever...
Shimo, Satoshi; Sakamoto, Yuta; Tokiyoshi, Akinari; Yamamoto, Yasuhiro
[Purpose] The effect of early rehabilitation protocols after arthroscopic rotator cuff repair is currently unknown. We examined short-term effects of early rehabilitation on functional outcomes and activities of daily living after arthroscopic rotator cuff repair. [Subject and Methods] An 82-year-old male fell during a walk, resulting in a supraspinatus tear. Arthroscopic rotator cuff repair was performed using a single-row technique. He wore an abduction brace for 6 weeks after surgery. [Results] From day 1 after surgery, passive range of motion exercises, including forward flexion and internal and external rotation were performed twice per day. Starting at 6 weeks after surgery, active range of motion exercises and muscle strengthening exercises were introduced gradually. At 6 weeks after surgery, his active forward flexion was 150°, UCLA shoulder rating scale score was 34 points, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire disability/symptom score was 36 points. At 20 weeks after surgery, his active forward flexion was 120°, UCLA shoulder rating scale score was 34 points, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire disability/symptom score was 0 points. [Conclusion] These protocols are recommended to physical therapists during rehabilitation for arthroscopic rotator cuff repair to support rapid reintegration into activities of daily living.
Petrarca, M; Rossi, S; Bollea, L; Cappa, P; Castelli, E
The aim of this report was to illustrate and to discuss a method capable of improving the person-oriented decision-making process during three years of gait rehabilitation based on the integration of: 1) the fundamental principles of motor learning and 2) the outcomes made available by both clinical standardized assessment tools (SAT) and measures made available by a gait analysis system (GA). The subject studied was a six-year-old child affected by hemiplegia after arterial ischemic stroke (AIS) who had limited upper and lower right-limb function but unaffected sensory and cognitive skills. Four different rehabilitative treatments were chosen when the child was inpatient or outpatient. Measurements of gait performance before and after selected treatments were evaluated using PEDI and GMFM (i.e., SAT) and kinematic and kinetic parameters (i.e., GA). Gait pattern and inter- and intralimb-joint coordination changed over time during the three examined years. However, after the first eight months of recovery, gait pattern modifications were detected by GA measures but not by SAT. The integration of SAT and GA findings, during the examined recovery evolution, resulted effective in the decision-making process for a person-oriented rehabilitative treatment.
Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.
Cuppens, Arnoud; Smets, Ilse; Wyseure, Guido
Many wastewater managers in developing countries struggle with the daily operation of urban wastewater systems. Technically well-designed wastewater collection and treatments are often degraded and/or not properly functioning. In this paper, a realistic rehabilitation strategy is developed for the urban wastewater system of Coronel Oviedo (Paraguay), in which the actual performance is unsatisfactory, as revealed by a detailed technical assessment, including water quantity and quality monitoring data. Understanding the history, starting from the initial planning and design process, allows to explain the current failing status of the urban wastewater system of Coronel Oviedo. The key information for the specific local rehabilitation strategy was extracted from an interdisciplinary assessment of shortcomings of urban wastewater systems in Paraguay which were revealed by a survey of all existing wastewater systems. Opting for a stepwise rehabilitation strategy allows the wastewater manager to gradually improve the performance of the wastewater system. Reusing the wastewater in agriculture and recovering the energy of methane gas are possible advantageous options for attracting external financial resources. Finally, the crucial role that the wastewater manager must play for sustainable wastewater management to become effective in practice is discussed, and recommendations are provided on how decision makers, researchers and consultants can contribute by anticipating the challenging circumstances inherent to developing countries. Copyright © 2012 Elsevier Ltd. All rights reserved.
Chapin, Martha H.
Positive and negative rehabilitation experiences as a child and as an adult are examined to assess their effect as a consumer of rehabilitation services and as a rehabilitation counselor educator. The importance of case management, social supports, and use of an individualized treatment approach to rehabilitation are highlighted. This article…
Conclusiones: La fibrilación auricular no valvular es una de las principales causas del accidente vascular cerebral en nuestros pacientes. Se demuestra que el tratamiento anticoagulante en aquellos pacientes con alto riesgo embolígeno reduce los eventos cerebrovasculares en un 64% y la mortalidad en un 26%. En nuestro medio la mayoría de los pacientes diagnosticados con fibrilación auricular no valvular presentan ese riesgo, pero tenemos un 33% no anticoagulado y un 25% mal controlado con el acenocumarol (un total del 46% de los pacientes. Todo esto implica que casi el 50% de nuestros pacientes con fibrilación auricular no valvular presenten alto riesgo tromboembólico por falta de tratamiento o ineficacia de este.
Zhao, Yong; Liu, Xian-Dong; Wang, Xiao-Bing; Xu, Qiang; Zheng, Jin-Wen; Tang, Cheng-Jie; Chen, Xing-Yu
To explore the clinical results of postoperative rehabilitation of patellar fracture by modified seated position of different knee flexion angles, thereby enrich the therapeutic tool of orthopaedics of traditional Chinese and western medicine and provide the evidences for refinement and modernization of traditional Chinese exercise therapy. From January 2009 to June 2012,90 patients with patellar transverse fractures were treated with open reduction and internal fixation by tension band wire and rehabilitation exercises. There were 52 males and 38 females, aged from 21 to 77 years old with an average of 50.0 years old. Three methods of rehabilitation exercises were adopted in the patients after fractures clinical union. There were 21 males and 14 females in group A (trained by modified seated position of knee flexion about 60 degree), 21 males and 14 females in group B (trained by modified seated position of knee flexion about 30 degree), 10 males and 10 females in group C (trained by walk). The rehabilitation-training time was 1 month. Fracture healing informations were observed by X-ray films. The Böstman patellar fracture function scores were compared before and after training among three groups. Postoperative follow-up time was 6 months. All fractures obtained bone union and the average healing time was 3 months (ranged,2 to 4 months). Böstman patellar fracture function scores in group A, B, C before training were 18.89 ± 2.19, 18.74 ± 2.03, 18.85 ± 2.92, respectively; there was no significant differences in among three groups (P > 0.05). After training, Böstman patellar fracture function scores in group A, B, C were 29.40 ± 1.14, 26.09 ± 3.86, 25.70 ± 4.09, respectively; group A was highest than other two groups; and there was no significant differences between group A and group B. Modified seated position of knee flexion about 60 degree was practical and effective training in postoperative rehabilitation for the treatment of patellar fracture, it can
Del Din, Silvia; Bertoldo, Alessandra; Sawacha, Zimi; Jonsdottir, Johanna; Rabuffetti, Marco; Cobelli, Claudio; Ferrarin, Maurizio
The ability to walk independently is a primary goal for rehabilitation after stroke. Gait analysis provides a great amount of valuable information, while functional magnetic resonance imaging (fMRI) offers a powerful approach to define networks involved in motor control. The present study reports a new methodology based on both fMRI and gait analysis outcomes in order to investigate the ability of fMRI to reflect the phases of motor learning before/after electromyographic biofeedback treatment: the preliminary fMRI results of a post stroke subject's brain activation, during passive and active ankle dorsal/plantarflexion, before and after biofeedback (BFB) rehabilitation are reported and their correlation with gait analysis data investigated. A control subject and a post-stroke patient with chronic hemiparesis were studied. Functional magnetic resonance images were acquired during a block-design protocol on both subjects while performing passive and active ankle dorsal/plantarflexion. fMRI and gait analysis were assessed on the patient before and after electromyographic biofeedback rehabilitation treatment during gait activities. Lower limb three-dimensional kinematics, kinetics and surface electromyography were evaluated. Correlation between fMRI and gait analysis categorical variables was assessed: agreement/disagreement was assigned to each variable if the value was in/outside the normative range (gait analysis), or for presence of normal/diffuse/no activation of motor area (fMRI). Altered fMRI activity was found on the post-stroke patient before biofeedback rehabilitation with respect to the control one. Meanwhile the patient showed a diffuse, but more limited brain activation after treatment (less voxels). The post-stroke gait data showed a trend towards the normal range: speed, stride length, ankle power, and ankle positive work increased. Preliminary correlation analysis revealed that consistent changes were observed both for the fMRI data, and the gait
Hernioplastia experimental em coelhos por meio de cartilagem auricular bovina conservada em glutaraldeído Rabbits experimental hernioplasty by means of bovine auricular cartilage preserved in glutaraldehyde
Full Text Available Avaliou-se a viabilidade do emprego da cartilagem auricular bovina conservada em glutaraldeído a 4% na hernioplastia experimental, empregando-se seis coelhos adultos, machos, da raça Nova Zelândia. Para obtenção da hérnia incisional, removeu-se um segmento elíptico de 3cm de comprimento por 1cm de largura, no ponto central à primeira incisão, envolvendo fáscia e tecido muscular, na região da cicatriz umbilical. Dois animais de cada vez foram sacrificados aos 15, 30 e 45 dias após a cirurgia. Nos sacrificados aos 15 dias, observaram-se áreas focais de inflamação, caracterizadas por abscesso e fístula. À microscopia, observou-se área de inflamação e necrose próxima à periferia do implante. Nas amostras colhidas dos animais sacrificados aos 30 dias, não foram evidenciadas alterações clínicas relevantes. Desses, um animal apresentou à microscopia intensa proliferação fibroblástica, moderada neovascularização e células inflamatórias predominantemente mononucleares. Dos sacrificados aos 45 dias, em um ocorreu aderência de alça intestinal ao implante. É possível inferir que o material implantado apresentou satisfatória compatibilidade com o tecido receptor. Conclui-se que o implante de cartilagem auricular bovina conservada na hernioplastia experimental em coelhos apresentou evidências de boa integração tecidual e cicatrização, não havendo eliminação do material implantado.The auricular cartilage preserved in 4% glutaraldehyde was used for experimental hernioplasty in six male, adult, New Zealand rabbits. To create an incision hernia, an elliptic tissue fragment three centimeter-long and one-centimeter wide was removed at a point centrally located from the first incision, embracing fascia and muscle tissue, from the area of umbilical scar. Animals were euthanized, two at a time, 15, 30, or 45 days after surgery. In the animals euthanized after 15 days focal areas of inflammation were observed
Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7
Baili, Paolo; Hoekstra-Weebers, Josette; Van Hoof, Elke
Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel...... reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data...... on follow-up and treatments for samples of cases archived in cancer registries. (b) Indicators of rehabilitation success. These include: return to work, quality of life, and satisfaction of specific rehabilitation needs. Studies can be performed to estimate these indicators in individual countries...
Los estudios sobre el remodelado auricular eléctrico y estructural sugieren que la FA... Los efectos sobre la función auricular tras la ablación con radiofrecuencia se han investigado en escasos trabajos con resultados discordantes hasta la actualidad (93; 18). Los marcadores neurohormonales como el NT-proBNP, se encuentran elevados en pacientes con FA debido a una frecuencia ventricular elevada, perdida de la contribución hemodinámica y sobrecarga de la aurícula. También distintos parámetros...
Aiken, Glen; Flythe, Michael
A fungal endophyte (Neotyphodium coenophialum) infects most plants of ‘Kentucky 31’ tall fescue (Lolium arundinaceum) and produces ergot alkaloids that cause persistent constriction of the vascular system in grazing livestock. Consequently, animals undergoing this toxicosis cannot regulate core body temperature and are vulnerable to heat and cold stresses. An experiment was conducted to determine if the caudal and auricular arteries in goats (Capra aegagrus hircus) vasoconstrict in response to ergot alkaloids. Seven, rumen fistulated goats were fed ad libitum orchardgrass (Dactylis glomeratia) hay and ruminally infused with endophtye-free seed (E-) for a 7-day adjustment period. Two periods followed with E- and endophyte-infected (E+) seed being randomly assigned to the 2 goat groups in period 1 and then switching treatments between groups in period 2. Infused E+ and E- seed were in equal proportions to the hay such that concentrations of ergovaline and ergovalanine were 0.80 µg per g dry matter for the E+ treatment. Cross-sections of both arteries were imaged using Doppler ultrasonography on days 0, 2, 4, 6, 8, and 12 in period 1 and on days 0, 1, 2, 3, 6, 7, and 9 in period 2. Differences from average baseline areas were used to determine presence or absence of alkaloid-induced vasoconstriction. Carotid arteries initiated constriction on imaging day 2 in both periods, and auricular arteries initiated constriction on imaging day 2 in period 1 and on day 6 in period 2. Luminal areas of the carotid arteries in E+ goats were 46% less than baseline areas in both periods after vasoconstriction occurred, whereas auricular arteries in E+ goats were 52% less than baseline areas in period 1 and 38% in period 2. Both arteries in E+ goats in period 1 relaxed relative to baseline areas by imaging day 2 after they were switched to the E- treatment. Results indicated that goats can vasoconstrict when exposed to ergot alkaloids that could disrupt their thermoregulation.
Glen Eris Aiken
Full Text Available A fungal endophyte (Neotyphodium coenophialum infects most plants of ‘Kentucky 31’ tall fescue (Lolium arundinaceum and produces ergot alkaloids that cause persistent constriction of the vascular system in grazing livestock. Consequently, animals undergoing this toxicosis cannot regulate core body temperature and are vulnerable to heat and cold stresses. An experiment was conducted to determine if the caudal and auricular arteries in goats (Capra aegagrus hircus vasoconstrict in response to ergot alkaloids. Seven, rumen fistulated goats were fed ad libitum orchardgrass (Dactylis glomeratia hay and ruminally infused with endophtye-free seed (E- for a 7-day adjustment period. Two periods followed with E- and endophyte-infected (E+ seed being randomly assigned to the 2 goat groups in period 1 and then switching treatments between groups in period 2. Infused E+ and E- seed were in equal proportions to the hay such that concentrations of ergovaline and ergovalanine were 0.80 µg per g dry matter for the E+ treatment. Cross-sections of both arteries were imaged using Doppler ultrasonography on days 0, 2, 4, 6, 8, and 12 in period 1 and on days 0, 1, 2, 3, 6, 7, and 9 in period 2. Differences from average baseline areas were used to determine presence or absence of alkaloid-induced vasoconstriction. Carotid arteries initiated constriction on imaging day 2 in both periods, and auricular arteries initiated constriction on imaging day 2 in period 1 and on day 6 in period 2. Luminal areas of the carotid arteries in E+ goats were 46% less than baseline areas in both periods after vasoconstriction occurred, whereas auricular arteries in E+ goats were 52% less than baseline areas in period 1 and 38% in period 2. Both arteries in E+ goats in period 1 relaxed relative to baseline areas by imaging day 2 after they were switched to the E- treatment. Results indicated that goats can vasoconstrict when exposed to ergot alkaloids that could disrupt their
Chiu, Chung-Yi; Tansey, Timothy N.; Chan, Fong; Strauser, David; Frain, Michael P.; Arora, Simran
Objectives: To examine the effect of rehabilitation technology interventions on the employment or job retention outcomes of individuals with multiple sclerosis (MS) served by the state-federal vocational rehabilitation program using a case-control study design. Participants: Data for this study were extracted from the Rehabilitation Services…
Jiang, Tao; Shang, Jianzhong; Tang, Li; Wang, Zhuo
An optimized thickness of a transplantable auricular silicone scaffold was researched. The original image data were acquired from CT scans, and reverse modeling technology was used to build a digital 3D model of an auricle. The transplant process was simulated in ANSYS Workbench by finite element analysis (FEA), solid scaffolds were manufactured based on the FEA results, and the transplantable artificial auricle was finally obtained with an optimized thickness, as well as sufficient intensity and hardness. This paper provides a reference for clinical transplant surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available Yadong Li, Jinsong Zhang, Kai Yang Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China Background: Conventional radical neck dissection often causes a variety of complications. Although the dissection method has been improved by retaining some tissues to reduce complications, the incomplete dissection may cause recurrence of disease. In the present study, we developed a novel radical neck dissection, which preserves the external jugular vein, the greater auricular nerve, and the deep branches of the cervical nerve, to effectively reduce complications and subsequently, to promote the postoperative survival quality. Methods: A total of 100 cases of radical neck dissection were retrospectively analyzed to evaluate the efficacy, rate of complication, and postoperative dysfunction of patients treated with the novel radical neck dissection. Data analysis was performed using the Chi-square test. Results: Compared with conventional radical neck dissection, the novel radical neck dissection could significantly reduce complications and promote postoperative survival quality. Particularly, the preservation of the external jugular vein reduced the surgical risk (ie, intracranial hypertension and complications (eg, facial edema, dizziness, headache. Preservation of the deep branches of the cervical nerve and greater auricular nerve resulted in relatively ideal postoperative functions of the shoulders and ear skin sensory function (P 0.05. Conclusion: Our novel radical neck dissection procedure could effectively reduce the complications of intracranial hypertension, shoulder dysfunction, and ear sensory disturbances. It can be used as a regular surgical approach for oral carcinoma radical neck dissection. Keywords: oral cancer, head and neck cancer, squamous cell carcinoma, survival quality, neck dissection, recurrence
Laffont, F; Engelmajer, L; Vourc'h, G; Nahas, G
From 1974 to 1979, the rehabilitation centers of the association "Le Patriarche" located in the country side of southern France, have received 446 chronic polydrugs users who has consumed at one time or an other cannabis (marihuana, hashish) (87 p. cent), LSD (66 p. cent) and other hallucinogens (35 p. cent), psychodepressants (55 p. cent), psychostimulants (amphetamines, 85 p. cent; cocaïne, 50 p. cent) and opium and its derivatives (brown sugar, 47 p. cent; opiates, 67 p. cent; heroin, 50 p. cent). The dominant addictive drug was heroin and opiates, 52 p. cent, psychodepressants (barbitutiques and benzodiazepines, 33 p. cent, psychostimulants, 15 p. cent. Males were twice as numerous as female. Average age was 21 (range 14-38). Mean duration of drug abuse was 7 years. All these drug abusers display at entrance withdrawal symptoms. These were treated successfully by a drug free, psycho-physiological regimen comprising: 1. An elimination of all psychoactive drugs, including coffee, and alcohol. Tobacco was permitted. 2. Physical therapy (bath, exercise, massage) and forced fluid diuresis. 3. A supportive psychotherapy dispensed by rehabilitated addicts who had undergone successfully a similar regimen. This non-pharmacological method of treating withdrawal symptoms associated with opium, barbiturate and amphetamine addiction, was successful, and was not associated with any major clinical symptoms threatening the vital signs. Mean duration of detoxification was 5 days for opiates, 6 days for amphetamines and 10 days for barbiturates. 78 p. cent of these subjects remained in the centers from 3 months to 2 years, partaking in physical occupational and physiological rehabilitation paograms which allowed then to adopt a drug free life style and prepared them for social reinsertion.
Richardson, Julie; DePaul, Vincent; Officer, Alexis; Wilkins, Seanne; Letts, Lori; Bosch, Jackie; Wishart, Laurie
The incidence of stroke and subsequent level of disability will increase, as age is the greatest risk factor for stroke and the world's population is aging. Hospital admissions are too brief for patients to regain necessary function. Research to examine therapy delivered within the home environment has the potential to expedite relearning of function and reduce health care expenditures. This case report describes the use of the knowledge-to-action cycle (KTA) to develop and evaluate an evidence-based approach for rehabilitation in the home that incorporates self-management and task-oriented functional training (TOFT) for people with stroke. The KTA cycle was used to guide adaptation of evidence from self-management and TOFT into an approach titled START (Self-Management and Task-Oriented Approach to Rehabilitation Training). Three stakeholder symposiums identified barriers and supports to implementation. Clinical practice leaders were engaged as partners in the development of the intervention. An online learning management system housed the resources to support therapist training. Therapist focus groups were conducted and stroke outcomes were used to assess patient response. Eight therapists completed 4 workshops and applied the home intervention in 12 people with stroke. A mentoring process for therapists included feedback from peers and experts after viewing treatment videos. Therapist response was determined from the focus groups; patient response was measured by standardized assessments. The therapists noted that the intervention was easier to implement with patients who were motivated and had minimal cognitive impairment. The KTA cycle provided a structure for the development of this evidence-based rehabilitation intervention, which was feasible to implement in the home. Further evaluation needs to be undertaken to assess the effectiveness of START. © 2015 American Physical Therapy Association.
Barraca, Nuno; Almeida, Miguel; Varum, Humberto; Almeida, Fernando; Matias, Manuel Senos
Ancient buildings in historical town centers can be protected by Cultural Heritage legislation, thus implying that any rehabilitation must respect their main architectural features. These concerns also apply to Modern and Contemporary buildings, in particular if they are important examples of architectural styles from those periods. These extra problems, or motivations, add to the inherent structural delicacy of ancient building restoration that requires detailed knowledge of the building foundations, characteristics and materials, modification history, infrastructure mapping, current pathologies, etc., all relevant information for an informed rehabilitation project. Such knowledge is seldom available before the actual rehabilitation works begin, and the usual invasive preliminary surveys are frequently expensive, time-consuming and likely significantly alter/damage the building's main features or structural integrity. Hence, the current demand for indirect, non-invasive, reliable and high resolution imagery techniques able to produce relevant information at the early stages of a rehabilitation project. The present work demonstrates that Ground Penetrating Radar (GPR or Georadar) surveys can provide a priori knowledge on the structure, construction techniques, materials, history and pathologies in a classified Modern Age building. It is also shown that the use of GPR on these projects requires carefully designed surveys, taking into account the known information, spatial constraints, environmental noise, nature and dimensions of the expected targets and suitable data processing sequences. Thus, if properly applied, GPR produces high-resolution results crucial for sound engineering/architectural interventions aiming to restore and renovate Modern and Contemporary buildings, with (1) focus on the overall quality of the end-result, (2) no damage inflicted to the existing structure, (3) respect of the building's historical coherence and architectural elements and
Vertical distraction osteogenesis of a free vascularized fibula flap in a reconstructed hemimandible for mandibular reconstruction and optimization of the implant prosthetic rehabilitation. Report of a case.
Cho-Lee, Gui-Youn; Naval-Gías, Luis; Martos-Díaz, Pedro L; González-García, Raúl; Rodríguez-Campo, Francisco J
Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 centimeters) resulting from trauma, infections or tumor resections. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma, for optimization of the implant prosthetic rehabilitation. The distraction device was applied intraorally. After 10 days of latency period, distraction protocol was performed at a distraction rate of 0.5 mm per day. A consolidation period of 3 months followed. Afterwards the distraction device was removed and 3 osseointegrated dental implants were placed in the distracted area. As a result, the vertical discrepancy between the fibula and the native hemimandible was corrected. The amount of vertical height achieved after distraction was 17 milimeters. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. In conclusion, we consider that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumor surgery.
Scattone Silva, Rodrigo; Ferreira, Ana Luisa G; Nakagawa, Theresa H; Santos, José E M; Serrão, Fábio V
Study Design Case report. Background Although eccentric exercises have been a cornerstone of the rehabilitation of athletes with patellar tendinopathy, the effectiveness of this intervention is sometimes less than ideal. Athletes with patellar tendinopathy have been shown to have different jump-landing patterns and lower hip extensor strength compared to asymptomatic athletes. To our knowledge, the effectiveness of an intervention addressing these impairments has not yet been investigated. Case Description The patient was a 21-year-old male volleyball athlete with a 9-month history of patellar tendon pain. Pain was measured with a visual analog scale. Disability was measured with the Victorian Institute of Sport Assessment-patella questionnaire. These assessments were conducted before and after an 8-week intervention, as well as at 6 months after the intervention. Hip and knee kinematics and kinetics during drop vertical jump and isometric strength were also measured before and after the 8-week intervention. The intervention consisted of hip extensor muscle strengthening and jump landing strategy modification training. The patient did not interrupt volleyball practice/competition during rehabilitation. Outcomes After the 8-week intervention and at 6 months postintervention, the athlete was completely asymptomatic during sports participation. This favorable clinical outcome was accompanied by a 50% increase in hip extensor moment, a 21% decrease in knee extensor moment, and a 26% decrease in patellar tendon force during jump landing measured at 8 weeks. Discussion This case report provides an example of how an 8-week intervention of hip muscle strengthening and jump-landing modification decreased pain and disability and improved jump-landing biomechanics in an athlete with patellar tendinopathy. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2015;45(11):899-909. Epub 21 Sep 2015. doi:10.2519/jospt.2015.6242.
Postpolio sequelae (PPS) are new, late manifestations that occur many years after the initial poliomyelitis infection. Recurrence of symptoms and fear of reactivation of the polio virus is particularly distressing to polio survivors. This article outlines the diagnosis, pathophysiology, and management of PPS disabilities using a case vignette. Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. Diagnosis can be complicated particularly in nonparalytic cases of poliomyelitis. Disabilities in PPS may not be obvious to the observer but significantly affect the quality of life of the PPS patient. Previous rehabilitation intervention focussed on physical effort and determination to overcome disability at all costs. The treatment in PPS is now modified, and aggressive physical measures that may exacerbate muscle weakness are avoided. Most disabilities in PPS can be well managed with rehabilitation interventions that address limitations in patient activities of daily living, mobility and cardiopulmonary fitness.
Full Text Available Niña de 11 años, con clínica de astenia, fiebre y cefalea recurrente de dos meses de evolución, anemia macrocítica hipocroma y soplo cardíaco sístolo-diastólico. La ecocardiografía transtorácica confirmó masa auricular derecha de 6 cm de diámetro, superficie lisa, adherido al tabique interauricular por un pedículo corto. tras la resección se reconstruyó el tabique con parche de pericardio heterólogo. El diagnóstico anatomopatológico fue mixoma auricular, infrecuente en niños. Los tumores benignos observados en la población pediátrica son los rabdomiomas, fibro-mas y mixomas. La cirugía tiene excelentes resultados inmediatos y a largo plazo, con una tasa de recidiva inferior al 3%.
Full Text Available Auricular acupuncture has been described in ancient China as well as Egypt, Greece, and Rome. At the end of the 1950s, ear acupuncture was further developed by the French physician Dr. Paul Nogier. The goal of this study was to develop a new system for ear acupressure (vibration stimulation and to perform pilot investigations on the possible acute effects of vibration and manual ear acupressure on heart rate (HR, heart rate variability (HRV, pulse wave velocity (PWV, and the augmentation index (AIx using new noninvasive recording methods. Investigations were performed in 14 healthy volunteers (mean age ± SD: 26.3±4.3 years; 9 females, 5 males before, during, and after acupressure vibration and manual acupressure stimulation at the “heart” auricular acupuncture point. The results showed a significant decrease in HR (≤0.001 and a significant increase in HRV total (=0.008 after manual ear acupressure. The PWV decreased markedly (yet insignificantly whereas the AIx increased immediately after both methods of stimulation. The increase in the low-frequency band of HRV was mainly based on the intensification of the related mechanism of blood pressure regulation (10-s-rhythm. Further studies in Beijing using animal models and investigations in Graz using human subjects are already in progress.
Sousa, Marlos G; Carareto, Roberta; Pereira-Junior, Valdo A; Aquino, Monally C C
Measurement of body temperature is a routine part of the clinical assessment of a patient. However, this procedure may be time-consuming and stressful to most animals because the standard site of temperature acquisition remains the rectal mucosa. Although an increasing number of clinicians have been using auricular temperature to estimate core body temperature, evidence is still lacking regarding agreement between these two methods in cats. In this investigation, we evaluated the agreement between temperatures measured in the rectum and ear in 29 healthy cats over a 2-week period. Temperatures were measured in the rectum (using digital and mercury-in-glass thermometers) and ear once a day for 14 consecutive days, producing 406 temperature readings for each thermometer. Mean temperature and confidence intervals were similar between methods, and Bland-Altman plots showed small biases and narrow limits of agreement acceptable for clinical purposes. The interobserver variability was also checked, which indicated a strong correlation between two near-simultaneous temperature readings. Results are consistent with auricular thermometry being a reliable alternative to rectal thermometry for assessing core body temperature in healthy cats.
Gao, Xin-Yan; Wang, Lu; Gaischek, Ingrid; Michenthaler, Yvonne; Zhu, Bing; Litscher, Gerhard
Auricular acupuncture has been described in ancient China as well as Egypt, Greece, and Rome. At the end of the 1950s, ear acupuncture was further developed by the French physician Dr. Paul Nogier. The goal of this study was to develop a new system for ear acupressure (vibration stimulation) and to perform pilot investigations on the possible acute effects of vibration and manual ear acupressure on heart rate (HR), heart rate variability (HRV), pulse wave velocity (PWV), and the augmentation index (AIx) using new noninvasive recording methods. Investigations were performed in 14 healthy volunteers (mean age ± SD: 26.3 ± 4.3 years; 9 females, 5 males) before, during, and after acupressure vibration and manual acupressure stimulation at the "heart" auricular acupuncture point. The results showed a significant decrease in HR (P ≤ 0.001) and a significant increase in HRV total (P = 0.008) after manual ear acupressure. The PWV decreased markedly (yet insignificantly) whereas the AIx increased immediately after both methods of stimulation. The increase in the low-frequency band of HRV was mainly based on the intensification of the related mechanism of blood pressure regulation (10-s-rhythm). Further studies in Beijing using animal models and investigations in Graz using human subjects are already in progress.
Taras I. Usichenko
Full Text Available Auricular acupuncture (AA is effective in treating various pain conditions, but there have been no analyses of AA for the treatment of pain after ambulatory knee surgery. We assessed the range of analgesic requirements under AA after ambulatory knee arthroscopy. Twenty patients randomly received a true AA procedure (Lung, Shenmen and Knee points or sham procedure (three non-acupuncture points on the auricular helix before ambulatory knee arthroscopy. Permanent press AA needles were retained in situ for one day after surgery. Post-operative pain was treated with non-steroidal anti-inflammatory ibuprofen, and weak oral opioid tramadol was used for rescue analgesic medication. The quantity of post-operative analgesics and pain intensity were used to assess the effect of AA. The incidence of analgesia-related side effects, time to discharge from the anesthesia recovery room, heart rate and blood pressure were also recorded. Ibuprofen consumption after surgery in the AA group was lower than in the control group: median 500 versus 800 mg, P = 0.043. Pain intensity on a 100 mm visual analogue scale for pain measurement and other parameters were similar in both groups. Thus AA might be useful in reducing the post-operative analgesic requirement after ambulatory knee arthroscopy.
... maintenance and repair of certain materials, appliances or components of an existing residential building... following chart. Components of Multi-Family Building Rehabilitation Components Maintenance and repair... maintenance and repair work, moderate rehabilitation and substantial rehabilitation. In all cases, the...
Conclusiones: La FA permanente se presenta en nuestro medio quirúrgico preoperatorio en el 13,6%, preferentemente asociada a enfermedad mitral. Los factores de riesgo cardiovasculares están presentes con similar prevalencia en los pacientes con FA que en el resto, excepto el tamaño auricular.
Full Text Available Study Objectives. To examine the stimulation effect of auricular magnetic press pellet therapy on older female adults with sleep disturbance as determined by polysomnography (PSG. Design. Randomized, single-blind, experimental-controlled, parallel-group. Setting. Community. Participants. Twenty-seven older female adults with sleep disturbance according to the Pittsburgh Sleep Quality Index (PSQI >5 for at least 3 months were recruited. Participants were screened by both the Hospital Anxiety and Depression Scale (HADS and the Mini-Mental State Examination (MMSE, as well as polysomnography prior to randomization. Interventions. All eligible participants were randomly allocated into the experimental or control group. Both groups were taped with magnetic press pellet on auricular points for 3 weeks. The experimental group was treated by applying pressure on the magnetic press pellets 3 times per day while no stimulation was applied on the control group. Measurements and Results. Both groups were measured by PSG and PSQI at the beginning of the study and 3 weeks after the study. Both groups showed improvements on PSQI scores compared to the baseline. One-way analysis of covariance adjusted for baseline scores showed that significant improvements of PSG-derived sleep parameters, such as sleep efficiency, were found in the experimental group. However, no significant differences between groups were observed in the proportion of sleep stages with the exception of Stage 2. Conclusions. Auricular therapy using magnetic pellets and stimulation by pressing was more effective in improving the sleep quality compared to auricular therapy without any stimulation.
Bao, Na; Wang, Qiong; Jia, Ye-Juan; Yang, Ke; Kong, Ling-Juan; Sun, Yan-Hui; Li, Xiao-Feng; Xu, Jing; Zhang, Xuan-Ping; Zhang, Xin; Du, Yu-Zhu; Li, Jun-Lei; Yang, Qing-Qing; Feng, Xin-Xin; Shi, Jing; Jia, Chun-Sheng; Wang, Jian-Ling
In the present paper, using data mining technology,the authors downloaded information from databases on auricular needle therapy, and obtained data samples from journals and academic dissertations involving the application of auricular needle therapy to treat diseases, and then screened, audited, and extracted the data and performed a statistical analysis. The authors extracted data on the application of auricular needle therapy in the stimulation methods of medicine (needling instrument), selection of the side of ear to treat disease and the number of times the ear was pressed per day and the compression time. In the stimulation methods, the needling instrument varied, the seeds of cowherb Semen Vaccariae were applied in 60.89% of the total stimulation methods. The number of times the ear was pressed per day and the compression time in the clinic were optional. The main points in auricular needle therapy were the contralateral side; there was no significant difference in the effect of a single side or both sides of the ear to treat disease.
Full Text Available Hereditary ectodermal dysplasia is a rare group of inherited disorders characterized by aplasia or dysplasia of two or more tissues of ectodermal origin such as hair, nails, teeth, and skin. The dental characteristics of this syndrome include anodontia or hypodontia of the primary and/or permanent teeth, hypoplastic conical teeth, and underdevelopment of the alveolar ridges. The options for a definitive treatment plan include fixed, removable or implant-supported prostheses, singly or in combination. This clinical report describes the prosthetic rehabilitation of an 11-year-old boy with hereditary ectodermal dysplasia. Maxillary flexible removable partial denture and mandibular conventional complete denture were fabricated to establish an acceptable masticatory function, speech, and esthetics for the patient.
Full Text Available Objectives: Conservative treatments for anterior cruciate ligament (ACL tears may have just as good an outcome as invasive treatments. These include muscle strengthening and neuromuscular proprioceptive exercises to improve joint stability and restore motion to the knee. The Purpose of the current work presents was to examine the feasibility of a novel non-invasive biomechanical treatment to improve the rehabilitation process following an ACL tear. This is a single case report that presents the effect of this therapy in a patient with a complete ACL rupture who chose not to undergo reconstructive surgery. Methods: A 29-year old female athlete with an acute indirect injury to the knee who chose not to undergo surgery was monitored. Two days after injury the patient began AposTherapy. A unique biomechanical device was specially calibrated to the patient’s feet. The therapy program was initiated, which included carrying out her daily routine while wearing the device. The subject underwent a gait analysis at baseline and follow-up gait analyses at weeks 1, 2, 4, 8, 12 and 26. Results: A severe abnormal gait was seen immediately after injury, including a substantial decrease in gait velocity, step length and single limb support. In addition, limb symmetry was substantially compromised following the injury. After 4 weeks of treatment, patient had returned to normal gait values and limbs asymmetry reached the normal range. Conclusions: The results of this case report suggest that this conservative biomechanical therapy may have helped this patient in her rehabilitation process. Further research is needed in order to determine the effect of this therapy for patients post ACL injuries.
Wang, D; Su, L; Han, Y; Fan, X
High-flow arteriovenous malformations (AVMs) with a dominant outflow vein (DOV) remain difficult for ethanol embolotherapy, but improved technology and experience of detachable coils allows for the treatment of some of these AVMs with satisfactory results. A single-center experience and evaluation of technical and clinical safety, and effectiveness of electrolytically detachable coil (EDC)-assisted DOV occlusion for ethanol embolization of high-flow auricular AVMs, which has some advantages over conventional coils because of its controlled deployment, reposition, and removal is reported. From November 2010 to June 2013, 40 consecutive patients with auricular AVMs underwent staged ethanol embolizations, of which nine patients' auricular AVMs with a DOV who had undergone ethanol embolization of high-flow auricular AVMs in combination with EDCs-assisted DOV occlusion were retrospectively evaluated. Clinical follow-up (range, 5-29 months; mean, 15.1 months) was completed in all patients, and results from imaging follow-up (range, 7-25 months; mean, 14.7 months) were available from the last treatment session in six patients. Therapeutic outcomes were determined by evaluating the clinical outcome of symptoms and signs, as well as the degree of devascularization at follow-up arteriography. Twenty-eight ethanol embolizations and nine EDC-assisted DOV occlusions were performed in nine patients. Seventeen EDCs were used in nine patients. Five (55.6%) of the nine patients were cured, and four (44.4%) had partial palliation. One minor complication occurred in one of the nine patients. Transient hemoglobinuria occurred in six of nine patients in a total nine of the 28 procedures. There were no major complications. Ethanol embolization has the potential for cure in the management of high-flow auricular AVMs with the aid of occlusion DOV by EDCs with acceptable risk of minor and major complications. Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier
C. Gutiérrez Gómez
Full Text Available La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y no con un simple injerto. Frente a esta dificultad técnica, diseñamos un colgajo ricamente vascularizado que preserva el cartílago no afectado con una buena cubierta y al mismo tiempo respeta la anatomía de la oreja. Para la cobertura del cartílago auricular anterior usamos un colgajo fasciocutáneo posterior que se asemeja a un plato típico de la cocina mexicana que llamamos "quesadilla", donde el cartílago por su color blanco recuerda el queso y el gran colgajo fasciocutaneo recuerda la tortilla que cubre al queso. Este colgajo incluye la piel enrollada del hélix, que en un segundo tiempo retornará a su lugar de origen anatómico mediante una z-plastía asimétrica. Presentamos, de entre una serie de 13 pacientes con carcinoma de pabellón auricular, 2 casos resueltos mediante esta técnica.
Rehabilitation of esthetics in advanced periodontal cases using orthodontics for vertical hard and soft tissue regeneration prior to implants - a report of 2 challenging cases treated with an interdisciplinary approach.
Mankoo, Tidu; Frost, Laura
The esthetic rehabilitation of advanced periodontal cases remains a challenge, despite the numerous advances in treatment of periodontitis and regenerative therapies. Whilst understanding of periodontal diseases deepens with advances in cell biology, cell signaling, and genomic research, the restoration of the gingival tissues to anatomical norms remains a considerable challenge in advanced cases. The improvements in diagnosis and treatment of disease certainly enable successful management of disease and stabilization of the compromised and failing dentition. Nonetheless, effective "esthetic" rehabilitation of patients with advanced disease affecting teeth in the esthetic zone, where significant asymmetrical bone loss and tissue recession are present, still constitutes a significant dilemma. An interdisciplinary approach involving vertical augmentation of bone and soft tissues by means of orthodontic extrusion of severely compromised periodontally involved teeth to reconstitute esthetics, as well as ideal bone and soft tissue volume prior to immediate implant placement and restoration, may be a particularly useful treatment option in patients suffering advanced periodontal disease with asymmetrical bone and tissue loss in the esthetic zone. This paper discusses the concepts and illustrates its use in two complex and demanding cases.
Morsø, Lars; Sall Jensen, Morten; von Plessen, Christian
BACKGROUND: Rehabilitation after hospital stay implies several benefits for patients with chronic obstructive pulmonary disease (COPD); still few patients are referred and participate in rehabilitation programs. We conducted a case study to investigate the effects of interventions targeting...
Mixoma auricular izquierdo asociado a insuficiencia severa de válvula mitral en paciente de género femenino de 31 años de edad: reporte de caso Left atrial mixoma associated with severe mitral valve insufficiency in a 31 years old female patient: a case report
Fernando Manzur J; Cristian Barbosa; Agustín Puello
... válvula mitral severa que requirió plastia valvular. Fue dada de alta al sexto día post-quirúrgico.We report the case of a 31 years old female patient without pathological antecedents, with a left atrial mixoma that measured 9 cm x 8 cm...
N. V. Galtseva
Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire.
Chung, Ka-Fai; Yeung, Wing-Fai; Yu, Branda Yee-Man; Leung, Feona Chung-Yin; Zhang, Shi-Ping; Zhang, Zhang-Jin; Ng, Roger Man-Kin; Yiu, Gar-Chung
Few high-quality, large-scale, controlled trials comparing the effectiveness and safety of acupuncture,auricular acupuncture and combined acupuncture treatment for insomnia are available. To carry out a randomised, assessor-blinded, waitlist-controlled trial to test the superiority of combination treatment. After in-person and polysomnography screening, 224 subjects (mean age 53.4 years; 75.4% female) with DSM-5 insomnia disorder, who were free from major psychiatric disorders and with sleep-diary-derived sleep efficiency averaged over 1 week of acupuncture alone, acupuncture plus auricular acupuncture (combination treatment), or a waitlist in a 3:3:1 ratio. Standardised acupuncture and combination treatment were provided three times weekly for 3 weeks. The primary outcome was sleep-diary-derived sleep efficiency. Secondary outcomes included wrist actigraphy and self-reported scales on insomnia, anxiety and depression, fatigue, sleepiness and functioning. Assessments were conducted at baseline, 1 week, 4 weeks and 13 weeks after treatment. Participants on the waitlist were re-randomised to receive acupuncture or combination treatment after the second post-baseline assessment. There was no significant difference between acupuncture and combination treatment in the primary outcome and most secondary outcomes at all time points. However, both treatments were better than waitlist in reducing insomnia, anxiety/depressive symptoms and fatigue, and improving function. Within-group improvements were maintained at 13 weeks after treatment. Of 260 adverse events, 243 were mild (93.5%). Discontinuation due to adverse events was 2.1% and 3.1% for acupuncture and combination treatment, respectively. Limited by short-term treatment and follow-up, the attempt to augment acupuncture by auricular acupuncture was not supported. Acupuncture and combination treatment were safe and had mild hypnotic effects, which lasted for at least 13 weeks. NCT01891097; Results. © Article
Full Text Available Background: Auricular acupressure is one of the traditional health care treatments in oriental medicine. Approximately, 30~40% of the cancer patients have said to be suffering from insomnia and half of them having chronic and severe insomnia at the same time. Insomnia caused cancer patients feel more pain, fatigue, depression and anxiety and it sometimes let the power to have the best of cancer pull down. Objective: To investigate how effective the auricular acupressure treatment to cancer patients suffering from insomnia. Methods: We recruited participants from East-West Cancer Center of Daejeon University. Finally, of the people whose age range from 20 to 75, 12 patients who got less than 40 points from the score of Oh's sleeping score (OSS were recruited. Single-blind, randomized pilot study was performed. The treatment group received auricular acupressure treatment (AAT on active points and the control group had received sham acupressure treatment (SAT for five times. Sleep parameters were checked by using OSS and numeric rating scale (NRS. We checked the scale everytime, both before and after treatment. We analyzed the data statistically by using independent T-test, paired T-test and analysis of variance (ANOVA test. (p<0.05 Results: Twelve cancer patients participated in this pilot study and there was no significant difference between control and treatment group. Only 7 of them had completed the whole treatment process, 4 patients of AAT group and 3 participants of SAT. The OSS of AAT group had increased from 34.0± 4.3 to 39.5±3.1 and that of SAT group had increased from 38.3±3.5 to 40.0±0.0. There was no significant difference between them. The NRS of AAT group had increased from 6.3±2.9 to 4.8±2.1 and that of SAT group had increased from 7.0±1.0 to 5.0±2.6. No significant difference was observed between them. Conclusion: Although both groups did not show significant differences, most of the experimental participants showed
José Fernando Scarelli LOPES
Full Text Available A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework, allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.
Green, Dido; Wilson, Peter H
To evaluate the feasibility and therapeutic effect of engaging children of differing neuromotor and cognitive ability in a virtual reality (VR) tabletop workspace designed to improve upper-limb function. Single-subject experimental design with multiple baselines was employed. Four children with hemiplegia participated in VR-based training between nine and 19, 30-minute sessions, over three-four weeks. Outcomes were assessed from the perspective of the International Classification of Functioning, Disability and Health; considering body function, activity performance and participation. Upper-limb performance was assessed using system-measured variables (speed, trajectory and accuracy) and standardized tests. Trend analyses were employed to determine trends on system variables between baseline phase and treatment phases. Standardised measures were compared between pre- and post-training. Two children made progress across system variables with some translation to daily activities. Performance of the other two children was more variable, however, they engaged positively with the system by the end of the treatment phase. The VR (RE-ACTION) system shows promise as an engaging rehabilitation tool to improve upper-limb function of children with hemiplegia, across ability levels. Trade-offs between kinematic variables should be considered when measuring improvements in movement skill. Larger trials are warranted to evaluate effects of augmented feedback, intensity and duration of training, and interface type to optimise the system's effectiveness.
Full Text Available Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma in Primary Teeth of the Pediatric Dentistry of Dental College of University of São Paulo, Brazil. The patient presented bilateral posterior cross bite and the permanent left upper central incisor with ectopic eruption and enamel hypoplasy, preceded by avulsion of element 61, occurred when the patient was 1.6 years old. After diagnosis and treatment planning, a quick expansion of jaws was recommended with Hass-type rapid expander and orthodontic leveling with fixed braces. Due to the ectopic eruption, the gingival contour had been altered and hypertrophia was found, compromising aesthetics and avoiding local hygienic procedures. Gingivoplasty was carried out with high-intensity Diode Laser, followed by aesthetic restoration with compound resin. It was concluded that after deciduous teeth traumatism it is important that the patient undergoes clinic and radiographic assistance until the permanent teeth erupt so that an adequate multidisciplinary treatment can be offered to the patient.
Full Text Available Investigation of ranges of soil and climate characteristics appropriate for the tolerant species: Pistacia atlantica subsp. mutica according to field study was the main objective of this research. This study was carried out based on random sampling across 20×20 km wild pistachio forests of Fars province (Iran. Results showed that mountainous and hilly lands are the main land types that pistachio species have evolved on. Statistical analysis of physical and chemical soil characteristics based on principal component analysis (PCA method showed that wide ranges in soil characteristics, even up to about 40% differentiation in some measured properties, did not restricts this subspecies natural growth. The main growth limiting factors were shallow soil depth and light soil texture that decreased storage capacity of soil moisture, necessary for wild pistachios survival during drought and long dry periods. Climatic elements were analysed through the same approach and showed that temperature, precipitation and wind with overall variability of 85.9% were the most effectual factors. Pistacia atlantica subsp. mutica is one of the species refractory to various soil conditions and adapted to weak soils for the establishment and rehabilitation of forests in semi-arid regions.
Mello-Moura, A C V; Bonini, G A V C; Suga, S S; Navarro, R S; Wanderley, M T
Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma in Primary Teeth of the Pediatric Dentistry of Dental College of University of São Paulo, Brazil. The patient presented bilateral posterior cross bite and the permanent left upper central incisor with ectopic eruption and enamel hypoplasy, preceded by avulsion of element 61, occurred when the patient was 1.6 years old. After diagnosis and treatment planning, a quick expansion of jaws was recommended with Hass-type rapid expander and orthodontic leveling with fixed braces. Due to the ectopic eruption, the gingival contour had been altered and hypertrophia was found, compromising aesthetics and avoiding local hygienic procedures. Gingivoplasty was carried out with high-intensity Diode Laser, followed by aesthetic restoration with compound resin. It was concluded that after deciduous teeth traumatism it is important that the patient undergoes clinic and radiographic assistance until the permanent teeth erupt so that an adequate multidisciplinary treatment can be offered to the patient.
ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...
Life quality of patients with migraine related to menstrual period undergoing auricular therapy Qualidade de vida de pacientes com migrânea relacionada ao período menstrual submetidos à terapia auricular
Vivian Viani Picanço
Full Text Available Migraine is a chronic disease characterized by intermittent attacks of headache and associated symptoms. It is a disease that affects around 12 to 15% of the general population, most of them being women. The quality of life of these individuals is compromised, causing a major impact on physical, mental and social for those who suffer from migraine. One method of treatment that seems to be effective in relieving the symptoms of menstrual migraine is auricular therapy. The purpose of this study was to evaluate the quality of life of patients with migraine related to the menstrual period who underwent auricular therapy. To this end, sessions were held in patients previously selected and implemented the survey of quality of life SF-36 on three different occasions. Before the first session, sixty days after the start of treatment and a third evaluation, ninety days after the beginning of treatment. The results showed that from eight individuals, seven had a general improvement in their quality of life. It follows that the treatment with auricular therapy was effective for improving quality of life of women with migraine related to menstruation. A migrânea é uma doença crônica caracterizada por crises intermitentes de cefaléia e sintomas associados, e constitui uma afecção que acomete em torno de 12 a 15 % da população em geral, em sua maioria mulheres. A qualidade de vida desses indivíduos fica comprometida, gerando um grande impacto físico, mental e social para os migranosos. Um dos métodos de tratamento que se mostra eficaz para aliviar os sintomas da migrânea menstrual é a terapia auricular ou auriculoterapia. O objetivo dessa pesquisa foi avaliar a qualidade de vida de pacientes com migrânea relacionada ao período menstrual que foram submetidos à terapia auricular. Para tanto, foram realizadas sessões de auriculoterapia em pacientes previamente selecionados e aplicado o questionário de qualidade de vida SF-36, em três momentos
Blefaroplastia em coelhos por meio de cartilagem auricular alógena conservada em solução saturada de NaCl Rabbits eyelid repair by means of alogen auricular cartilage preserved in NaCl saturated solution
Full Text Available Avaliou-se a reconstrução da pálpebra inferior de coelhos, com cartilagem auricular alógena, conservada em solução saturada de NaCl em 12 coelhos, adultos, de ambos os sexos. Os animais receberam acepromazina (0,5mg/kg/IM e tiletamina e zolazepam (7,0mg/kg/IM, após o que removeu-se um fragmento de 1,0x0,5cm das pálpebras inferiores, esquerda e direita. A pálpebra esquerda foi reparada pela técnica de blefaroplastia em H (GC e a direita por um retalho de cartilagem auricular associado a blefaroplastia em H (GE. Aos sete dias de pós-operatório (PO, as feridas cirúrgicas dos animais do GC apresentavam retração cutânea. Aos 15 dias de PO, observou-se que as feridas nos coelhos do GE estavam cicatrizadas, mas 30% das do GC apresentavam deiscência e retração cicatricial. Aos 30 dias de PO, as feridas nos animais do GE e GC apresentavam-se cicatrizadas, mas, 30% nos do GC não apresentavam as bordas das feridas coaptadas. O enxerto de cartilagem auricular diminuiu a retração cicatricial, possibilitando reparo anatômico à pálpebra.The rabbit inferior eyelid repair was evaluated using NaCl satured-stored alogenous auricular cartilage. Twelve adult male and female rabbits had a 1.0x0.5cm fragment removed from the left and right inferior eyelids after pre-medication with acepromazine (0.5mg/kgIM and tiletamine-zolazepan (7.0mg/kgIM anesthesia. The "H" plasty technique was used to the left eyelid repair (CG and the right one was repaired with auricular cartilage associated with the "H" plasty technique (GG. The CG wounds presented cutaneous retraction at day 7th of the post-operative period. The GG wounds were healed on the day 15th, while the CG wounds presented 30% of deiscence and cicatricial retraction. The GG and CG wounds were healed at day 30th of the post-operative period, but 30% of the CG wounds did not present the edges lined up. It was concluded that the auricular cartilage graft decreases cicatricial retraction and
Hanning, Brian; Predl, Nicolle
Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally.
The International Rehabilitation Network's goal is to improve the quality of services for land mine survivors and other amputee's through the dissemination of educational programs to rehabilitation professionals...
Asfaha, Tesfaalem G.; Frankl, Amaury; Haile, Mitiku; Zenebe, Amanuel; Nyssen, Jan
Variability in supply and entrainment of stream bedload particles during storm events is an important hydrogeomorphologic response of steep mountain streams to land management in their catchments. Because of difficulties in its measurement and absence of accurate measuring equipment, bedload transport in mountain streams is, however, poorly understood. This study focuses on analyzing bedload supply and entrainment in 11 streams of sloping (27-65%) catchments (0.4-25 km2) in northern Ethiopia, which have experienced severe deforestation and degradation processes until the first half of the 1980s and considerable rehabilitation thereafter. Field measurements of the median diameter of the 10 coarsest bedload particles (Max10) moved in each event (n = 332) and stream bed particle sampling were carried out in three rainy seasons (2012-2014). Event peak discharges were calculated from daily measurements by 11 crest stage gauges using Manning's equation. Percentages of land cover classes in the catchments were detected from high resolution (0.6 m) Google Earth imagery (1 February, 2014). Morphometric characteristics of the catchments were computed from an ASTER digital elevation model and topographic maps. Hydraulic competence analysis for entrainment of the average Max10 was carried out using peak discharge, stream power, and critical shear stress approaches. The supply of Max10 was positively related to scar density on the surrounding slopes (R2 = 0.50, p < 0.05) and catchment area (R2 = 0.36, p < 0.05) while negatively related with total forest cover (R2 = 0.63, p < 0.05) or vegetation cover (R2 = 0.58, p < 0.05). A multiple regression analysis showed that 98% of the variability in Max10 is explained by scar density and catchment area. Entrainment of Max10 was positively related to peak discharge (Qp) (R2 = 0.60, p < 0.01), stream power (Ω) (R2 = 0.71, p < 0.01), Strickler's roughness (Sn) (R2 = 0.86, p < 0.01), and critical shear stress (τc) with reference to D50 (r
Feng, Cynthia; Popovic, Jovan; Kline, Richard; Kim, Jung; Matos, Rafael; Lee, Sarah; Bosco, Joseph
Successful antiemesis contributes significantly to quality, safety, and patient satisfaction. Patients undergoing general anesthesia often experience postoperative nausea and vomiting (PONV). Acupressure offers a side effect-free alternative to common first-line antiemetics. Because the patient may perceive needle acupuncture as uncomfortable, acupressure is a desirable alternative for the prevention of PONV. This study was a randomized, prospective, double-blinded clinical trial investigating the effect of acupressure in patients with a history of PONV and motion sickness. The three auricular acupressure points chosen were shen men, point zero, and the subcortex point. Rescue treatment for PONV with 4 mg intravenous ondansetron was used if the patient reported persistent nausea. A blinded observer recorded antiemetic rescue data, and postoperative analgesic use was recorded over 24 hours. Nausea, vomiting, and retching were assessed in the post-anesthesia care unit (PACU). Using univariate analysis, we ruled out the null hypothesis of equal means as a function of intervention group (p = 0.001). Pair-wise comparisons revealed a difference between placebo and test groups (p = 0.000) and also sham and test groups (p = 0.033) where age (p = 0.048) and gender (p = 0.003) were significant covariates. Our data reveal that auricular acupressure significantly decreases nausea during the PACU stay and within the 24 hours postoperatively. It is not clear whether the intervention decreases nausea as a primary effect or as a secondary result by decreasing narcotic requirements. Also, perception of nausea may be in part subjective. This is evidenced by our results in which subjects who received sham points fared better than the placebo subjects.
Full Text Available Novel polyelectrolyte complex nanoparticles (AAP/LCS NPs were prepared in this study and these were produced by mixing negatively charged auricularia auricular polysaccharide (AAP with positively charged low molecular weight chitosan (LCS in an aqueous medium. The AAP was extracted and purified from auricularia auricular, and then characterized by micrOTOF-Q mass spectrometry, UV/Vis spectrophotometry, moisture analyzer and SEM. The yield, moisture, and total sugar content of the AAP were 4.5%, 6.2% and 90.12% (w/w, respectively. The AAP sample was water-soluble and exhibited white flocculence. The characteristics of AAP/LCS NPs, such as the particle size, zeta potential, morphology, FT-IR spectra, DSC were investigated. The results obtained revealed that the AAP/LCS NPs had a spherical shape with a diameter of 223 nm and a smooth surface, and the results of the FT-IR spectra and DSC investigations indicated that there was an electrostatic interaction between the two polyelectrolyte polymers. Bovine serum albumin (BSA, pI = 4.8 and bovine hemoglobin (BHb, pI = 6.8 were used as model drugs to investigate the loading and release features of the AAP/LCS NPs. The results obtained showed that the AAP/LCS NPs had a higher entrapment efficiency (92.6% for BHb than for BSA (81.5%. The cumulative release of BSA and BHb from AAP/LCS NPs after 24 h in vitro was 95.4% and 91.9%, respectively. The in vitro release demonstrated that AAP/LCS NPs provided a sustained release matrix suitable for the delivery of protein drugs. These studies demonstrate that AAP/LCS NPs have a very promising potential as a delivery system for protein drugs.
Sigua-Rodriguez, Eder Alberto; Goulart, Douglas Rangel; Santos, Zarina Tatia; Alvarez-Pinzon, Natalia; Olate, Sergio; de Albergaria-Barbosa, José Ricardo
Auricular prostheses are artificial substitutes for facial defects. The retention of these has often been a problem. This study aimed to evaluate the mechanical behavior of 3 retained auricular prosthetic connections when submitted to a mechanical cycling test. Twelve samples with installed implants were obtained and divided into 3 groups according to their retention system with 4 samples in each group. I: bar-clip system; II: magnet system; and III: ball/o-ring system. Each of samples was submitted to the pull-out test during 3240 cycles (f = 0.5 Hz) to determine its tensile strength. The mechanical cycling test was performed using the servo-hydraulic machine MTS 810-Flex Test 40 (Eden Prairie, MN) that had a 2.5 mm shift at a 10 mm/s velocity. The retaining strength for each of the samples was obtained at 7 intervals. The tensile strength for the group retained by the bar-clip system (29.60 N) was higher with statistically significant difference (P < 0.05) when compared with the group retained by the ball/o-ring system (9.41 N) and magnets system (8.61 N) for all periods assessed. The ball/o-ring system showed loss of retention during the fatigue test (Kruskal-Wallis, chi-squared = 17.28; P < 0.01). The evaluated systems showed a tensile strength compatible with the clinical use and no fractures of the components were observed.
Raikos, Athanasios; English, Thomas; Yousif, Omar Khalid; Sandhu, Mandeep; Stirling, Allan
The great auricular point (GAP) marks the exit of the great auricular nerve at the posterior border of the sternocleidomastoid muscle (SCM). It is a key landmark for the identification of the spinal accessory nerve, and its intraoperative localization is vital to avoid neurological sequelae. This study delineates the topography and surface anatomy landmarks that used to localize the GAP. Thirty cadaveric heminecks were dissected on a layer-by-layer approach. The topography of the GAP was examined relative to the insertion point of the SCM at the clavicle, tip of the mastoid process, and angle of the mandible. The GAP and its relation to the SCM were determined as a ratio of the total length of the SCM. The GAP was demonstrated to be in a predictable location. The mean length of the SCM was 131.4 ± 22 mm, and the mean distance between the GAP and the mastoid process was found to be 60.4 ± 13.76 mm. The ratio of the GAP location to the total SCM length ranged between 0.33-0.57. The mean distance between the angle of the mandible and the GAP was determined to be 57 ± 22.2 mm. Based on the midpoint of the SCM, the GAP was above it in 66.7 % of subjects and classified to Type A, and below it in 33.3 % of subjects appointed to Type B. The anatomical landmarks utilized in this study are helpful in predicting the location of the GAP relative to the midpoint of the SCM and can reduce neural injuries within the posterior triangle of the neck.
Andrés F. Buitrago, MD
Full Text Available La fibrilación auricular es la arritmia cardiaca sostenida más común y su prevalencia se duplica cada decenio por encima de los cincuenta años. Entretanto, las condiciones clínicas que más se asocian con ésta son la hipertensión arterial, la insuficiencia cardíaca, la enfermedad valvular cardíaca y la diabetes mellitus. Como complicaciones está la falla cardiaca, pero tal vez una de las peores son los eventos cardioembólicos, que ocurren aproximadamente en 4,5% de los pacientes no anticoagulados. El tratamiento antitrombótico con antagonistas de la vitamina K fue, durante más de cincuenta años, la única alternativa disponible, a pesar de sus múltiples limitaciones, las mismas que llevaron al desarrollo de nuevos fármacos anticoagulantes que disminuyen muchos de los problemas de los antagonistas de la vitamina K. Pueden agruparse en dos clases: inhibidores orales directos de la trombina e inhibidores orales del factor X activado. Tanto dabigatrán, rivaroxabán como apixabán, cuentan ya con estudios clínicos controlados aleatorizados que apoyan su uso en el tratamiento antitrombótico de la fibrilación auricular y recientemente se incluyeron en las guías basadas en la evidencia como alternativa (ACC e incluso con un grado de recomendación superior (CCS, CHEST al de los antagonistas de la vitamina K.
Full Text Available Severely eroded lands of southern Guam are referred to as BadLands. These are actively eroding areas of very deep, well–drained saprolite derived from tuff and tuff breccia. These badlands are exposed to overland flow, wind and rain causing sever erosion as the result of rapid runoff from the pitted, sloping sites void of vegetation. Through soil removal or sediment transport, erosion also alters the inherent physical and chemical properties of these soils. This alteration resulted in degradation, in turn affecting the environment as well as water quality in the down stream. The on-site damage from erosion is indeed a problem to environmental ecosystem of the island. Sediment lost due to erosion clogs rivers, lakes, and waterways. It reduces the water storage capacity of reservoirs and canals and increases flooding.The challenge facing soil and environmental scientists is to develop conservation and restoration strategies at the farm as well as at the watershed level that address crop production and natural resources protection needs, within a framework of increasing environmental and financial constraints. In our soil conservation program at the College of Natural and Applied Sciences of the University of Guam we have adopted integrated approaches to evaluate a variety of strategies, including the effect of conservation tillage and residue management, crop rotation with leguminous plants (sunnhemp as green manure as well as the use of composted organic wastes as soil amendment for organic matter build up, all for soil rehabilitation and restoration of the badlands in southern Guam. In a companion study we are evaluating the effectiveness of Vetiver technology as a sediment trap to mitigate sediment transport in a typical watershed basin in southern Guam. This paper discusses the methodology as well as up to date data that shows the effect of Vetiver technology on sediment trapping at the watershed level.
Anderson, Nathan S.; Ramirez, Alexies; Slim, Ahmad; Malik, Jamil
Exercise induced bundle branch block is a rare observation in exercise testing, accounting for 0.5 percent of exercise tests. The best treatment of this condition and its association with coronary disease remain unclear. We describe a case associated with normal coronary arteries which was successfully treated with exercise training. While this treatment has been used previously, our case has a longer followup than previously reported and demonstrates that the treatment is not durable in the absence of continued exercise. PMID:24716091
Experiencia preliminar del tratamiento quirúrgico de la fibrilación auricular con ablación por radiofrecuencia Preliminary experience of the surgical treatment of auricular fibrillation with radiofrequency ablation
Alejandro Villar Inclán
Full Text Available INTRODUCCIÓN. La fibrilación auricular es la arritmia cardíaca preoperatoria más frecuente entre los pacientes de cirugía cardiovascular. Entre las modalidades de tratamiento se hallan el tratamiento médico, la cardioversión transtorácica o intracardíaca con choque de corriente continua sincronizada, la estimulación (marcapasos, la ablación con catéter y la cirugía, en la cual se incluyen los métodos quirúrgicos propiamente dichos, las técnicas de catéteres para ablación y las técnicas mixtas. MÉTODOS. Se realizó un estudio prospectivo descriptivo de 25 pacientes operados de patología mitral con fibrilación auricular crónica, a los cuales se realizó ablación con radiofrecuencia durante 60 s, con 150 W de energía y control de temperatura de 60 ºC. Se comenzó el procedimiento solamente alrededor de las venas pulmonares y luego se incluyeron estas. A todos los pacientes se les realizó seguimiento posoperatorio por espacio de un año y la eficacia del procedimiento se evaluó en éxito y fracaso. RESULTADOS. La mejor eficacia del tratamiento estuvo relacionada con la menor edad de los pacientes. A medida que el tiempo de evolución de la fibrilación auricular fue mayor, aumentó el ritmo de fracaso del procedimiento y de igual manera ocurrió con el tamaño de la aurícula izquierda. Se observó que, al año, el 76 % de los pacientes se encontraban en ritmo sinusal y ninguna de las complicaciones que se presentaron tuvieron relación con el método en sí. CONCLUSIONES. Consideramos que la ablación con radiofrecuencia intraoperatoria durante el tratamiento quirúrgico de la válvula mitral constituyó un proceder efectivo y seguro en el tratamiento de pacientes con fibrilación auricular crónica asociadaINTRODUCTION. Auricular fibrillation is the most frequent preoperative cardiac arrhytmia among the patients undergoing cardiovascular surgery. The medical treatment, the transthoracic or intracardiac cardioversion
Weill-Chounlamountry, A; Soyez-Gayout, L; Tessier, C; Pradat-Diehl, P
The cognitive model of music processing has a modular architecture with two main pathways (a melody pathway and a time pathway) for processing the musical "message" and thus enabling music recognition. It also features a music-specific module for tonal encoding of pitch which stands apart from all other known cognitive systems (including language processing). To the best of our knowledge, rehabilitation therapy for amusia has not yet been reported. We developed a therapeutic method (inspired by work on word deafness) in order to determine whether specific rehabilitation based on melody discrimination could prompt the regression of amusia. We report the case of a patient having developed receptive, acquired amusia four years previously. His tone deafness disorder was assessed using the Montreal Battery of Evaluation of Amusia (MBEA), which revealed impairment of the melody pathway but no deficiency in the time pathway. A computer-assisted rehabilitation method was implemented; it used melody discrimination tasks and an errorless learning paradigm with progressively fading visual cues. After therapy, we noted an improvement in the overall MBEA score and its component subscores which could not be explained by spontaneous recovery (in view of the number of years since the neurological accident). The improvement was maintained at seven months post-therapy. Although post-therapy improvement in daily life was not systematically assessed, the patient started listening to his favourite music again. Specific amusia therapy has shown efficacy.
Conclusiones: La prevalencia de fibrilación auricular fue del 2,1%, aumentando con la edad, con elevada proporción de cardiopatía concomitante. La proporción de pacientes anticoagulados y la calidad de la anticoagulación son deficientes, revelándose así la necesidad de mejor monitorización y mayor utilización de nuevos anticoagulantes directos en los casos indicados.
Tobón Zuluaga, Catalina
Las arritmias auriculares, como es la fibrilación auricular, la taquicardia reentrante o focal y el flúter auricular, son las arritmias cardiacas más frecuentes en la práctica clínica, constituyendo uno de los principales problemas sanitarios actuales. Diferentes trabajos experimentales han demostrado que los mecanismos electrofisiológicos subyacentes a las arritmias auriculares son muy variados, destacando las reentradas anatómicas y funcionales, los focos ectópicos y la existencia de ondas ...
Hansen, Agnete Meldgaard
‘rehabilitative’ care practices aiming to empower, train and activate elderly citizens provides opportunities for homecare workers to renegotiate their status and reconstruct their work and occupational identities with a ‘cleaner’ and more optimistic image. Drawing on ethnographic fieldwork in two Danish homecare...... units, this article analyses how rehabilitative care practices, drawing on a narrative of the third age, provide an optimistic and anti-ageist framing of homecare work that informs the development of new occupational identities for care workers as coaches rather than carers in relation to citizens......Care work for elderly people has been characterised as dirty work, owing to its proximity to the (dys)functions and discharges of aged bodies and the notions of disease, decay and death associated with the idea of ‘old age’. However, a wave of reform programmes in Danish municipalities promoting...
Fleming, Allison R.; Boeltzig-Brown, Heike; Foley, Susan M.
Purpose: We describe a modified Delphi method used to select effective state vocational rehabilitation agency practices to prioritize rehabilitation services for individuals with most significant disabilities within the context of Order of Selection, an area where there is little known and published. Specifically, we describe how we applied the…
Full Text Available OBJETIVO: Estudar a ação do ultra-som na veia auricular de coelhos. MÉTODOS: Vinte coelhos foram divididos em dois grupos de dez animais diferindo com relação ao local da aplicação, do ultra-som, o modo e o intervalo de tempo para a análise histopatológica (3 e 7 dias. Os animais foram submetidos à aplicação de ultra-som contínuo e pulsado em dois segmentos venosos da orelha previamente determinados. Cada animal foi o seu próprio controle. Empregou-se a freqüência de 3MHz, intensidade de 3W/cm² nos ciclos pulsado e contínuo por 10 minutos, de forma estacionária. O grupo I foi submetido a eutanásia após 3 dias e o grupo II em 7 dias contemplando a fase aguda do processo inflamatório. Empregou-se o teste exato de Fisher e o teste de Mc Nemar para análise estatística. RESULTADOS: Obteve-se trombose venosa e aumento de linfócitos de forma significativa (p= 0,032 nos grupos tratados com o modo contínuo. O modo pulsado não provocou efeitos deletérios. Outros achados foram congestão, edema, hemorragia e lesão da parede vascular. CONCLUSÕES: O ultra-som pulsado não provoca qualquer alteração na parede vascular nas condições do experimento.O ultra-som contínuo induz a trombose venosa e aumento dos linfócitos de forma significativa.PURPOSE: The purpose of this experimental work was evaluate the effects of low intensity in the auricular vein of rabbits. METHODS: Twenty rabbits were divided in two groups of ten animals. The groups differed about the place where the continuous and pulsed ultrasound were applied and the period that the material was collected for the morphologic examination (3 and 7 days. Acoustic coupling gel was used on marginal ear vein, each animal underwent continuous and pulsed ultrasound treatment, in segments previously marked with indelible ink. Each animal provided its own control. Ultrasound was used in the frequency of 3MHz, intensity of 3W/cm² in the pulsed and continuous modes during 10min
Nathan S. Anderson
Full Text Available Exercise induced bundle branch block is a rare observation in exercise testing, accounting for 0.5 percent of exercise tests. The best treatment of this condition and its association with coronary disease remain unclear. We describe a case associated with normal coronary arteries which was successfully treated with exercise training. While this treatment has been used previously, our case has a longer followup than previously reported and demonstrates that the treatment is not durable in the absence of continued exercise.
Filipa, Alyson; Barton, Kelli
Study Design Case report. Background An os trigonum can be a source of pain for dancers due to impingement during repetitive ankle plantarflexion movements. Following excision of an os trigonum, it is important to have a gradual, progressive return-to-dance program for optimal recovery. The purpose of this case report is to describe the post-operative management and return-to-dance progression of an adolescent dancer status post os trigonum excision. Case Description An adolescent pre-professional female dancer had an extensive history of left posterior heel pain beginning at age eight that led to surgical removal of an os trigonum at age fifteen. This case report describes the physical therapy interventions used to help her return to full, unrestricted activity. Outcomes The dancer had a full return of ankle range of motion, strength, and balance, improved patient reported outcome scores, and was able to fully return to dance participation. Discussion Treating a dancer following os trigonum excision should involve a screen for hypermobility, clear communication with the dance instructor, awareness of dance-specific biomechanics, and proper reintegration into dance participation. Level of Evidence Therapy, Level 5. J Orthop Sports Phys Ther, Epub 7 Nov 2017. doi:10.2519/jospt.2018.7508.
Barter, Linda S; Epstein, Steven E
To assess agreement between carotid arterial pressure and auricular arterial, thoracic limb Doppler or thoracic limb oscillometric blood pressure measurements. Prospective experimental study. Six adult New Zealand white rabbits. Rabbits were anesthetized with isoflurane in oxygen at 1, 1.5 and 2 MAC on two separate occasions. Catheters in the auricular and the contralateral external carotid artery were connected to calibrated pressure transducers via non-compliant tubing. Inflatable cuffs of width equal to approximately 40% of the limb circumference were placed above the carpus on both thoracic limbs with a Doppler transducer placed distal to the cuff on one. Systolic (SAP) and mean (MAP) arterial blood pressure measurements were obtained at each dose, on each occasion. Agreement between measurement techniques was evaluated by repeated measures Bland Altman analysis with carotid pressure as the reference. Variation in bias over the measurement range was evaluated by regression analysis. Carotid MAP and SAP ranged from 20 to 65 mmHg and 37 to 103 mmHg respectively. Bias and 95% limits of agreement for auricular and oscillometric MAP were 7 (0-14) and -5 (-21-11) mmHg, respectively, and for auricular, oscillometric and Doppler SAP were 23 (8-37), -2 (-24-20) and 13 (-14-39) mmHg, respectively. Bias varied significantly over the measurement range (p < 0.001) for all three SAP techniques but not for MAP measurements. Limits of agreement for all measurements were large but less so for MAP than SAP. Variation in bias with SAP should be considered when using these measurements clinically. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.
Jairo A. Rendón
Conclusión: La valoración de la función del apéndice auricular izquierdo por medio de speckle tracking, es una herramienta útil para caracterizar la función de esta estructura; su alteración se podría relacionar con el riesgo de desarrollar trombos y eventos embólicos secundarios.
Sissa Mara Nicodemo Sanches
Full Text Available A equoterapia é uma das técnicas de reabilitação utilizada para pacientes com disfunções neurológicas. Os movimentos provocados pelo cavalo no corpo do paciente podem interferir positivamente em seu controle postural, melhorando a mobilidade geral e o desempenho motor funcional. O objetivo deste estudo foi verificar o efeito da equoterapia no equilíbrio, coordenação motora e funcionalidade de uma criança com meningoencefalocele. Uma menina de 3 anos e 6 meses foi submetida a 18 sessões de equoterapia (em três fases - alimentação, escovação e montaria realizadas uma vez por semana. Para a avaliação foram utilizadas as escalas de equilíbrio de Berg e Tinneti e o Inventário de avaliação pediátrica de incapacidade (PEDI para habilidades motoras gerais e funcionais, aplicados antes e após o período de terapia; e uma reavaliação foi feita oito semanas (sem intervenção depois. A equoterapia melhorou de maneira significativa o equilíbrio e a coordenação motora da criança, o que se refletiu no controle de movimentos funcionais básicos para a realização de atividades de vida diária. O ganho funcional também foi percebido pela mãe da criança. Esse estudo oferece uma nova perspectiva sobre o uso da equoterapia como modalidade fisioterapêutica na reabilitação motora e funcional de criança com meningoencefalocele.Hippotherapy is one among techniques used in rehabilitation of patients with neurological dysfunctions. The patient body's reactions to horse movements are known to have positive effects on patients' postural control, thus improving general mobility and motor functional performance. The purpose of this paper was to assess the effects of hippotherapy on balance, motor coordination, and functionality of a child with meningoencephalocele. A 3-and-a-half year-old girl with meningoencephalocele was submitted to 18 hippotherapy sessions (in a three- phase procedure - feeding, brushing, and riding once a week
Kim, Dongwon; Ham, Ok Kyung; Kang, Changwan; Jun, Eunmi
To examine the effects of auricular acupressure with Sinapsis alba seeds on obesity and self-efficacy. Randomized controlled trial. College settings located in metropolitan areas of Korea. A total of 49 female college students who were overweight or obese (body-mass index [BMI] ≥25.0 kg/m(2)) were recruited and randomly assigned to the experimental group (n=25) or the control group (n=24). The experimental group applied three S. alba seeds to each of five auricular points (Shenmen, mouth, stomach, endocrine, and small intestine points). These participants were asked to stimulate those points 10 times at a rate of two times per second 30 minutes before mealtime, three times daily, for 1 month. They performed the procedure for each earlobe for alternating weeks (a total of 2 weeks' treatment for each ear). The obesity index included weight (kg), BMI (kg/m(2)), percentage body fat, and waist-to-hip ratio. Self-efficacy was measured by using a self-efficacy scale. Female students in the experimental group showed significant decreases in weight (t=10.76; p0.05) and waist-to-hip ratio (t=0.60; p>0.05) changes did not significantly differ between the two groups. These findings suggest that auricular acupressure using S. alba seeds may be an effective intervention for decreasing weight and BMI and increasing self-efficacy of overweight and obese individuals.
Kavi H Patel
Full Text Available Reconstruction of the human auricle remains a challenge to plastic surgeons, and current approaches are not ideal. Tissue engineering provides a promising alternative. This study aims to evaluate the chondrogenic potential of bone marrow–derived mesenchymal stem cells on a novel, auricular-shaped polymer. The proposed polyhedral oligomeric silsesquioxane-modified poly(hexanolactone/carbonateurethane/urea nanocomposite polymer has already been transplanted in patients as the world’s first synthetic trachea, tear duct and vascular bypass graft. The nanocomposite scaffold was fabricated via a coagulation/salt-leaching method and shaped into an auricle. Adult bone marrow–derived mesenchymal stem cells were isolated, cultured and seeded onto the scaffold. On day 21, samples were sent for scanning electron microscopy, histology and immunofluorescence to assess for neocartilage formation. Cell viability assay confirmed cytocompatability and normal patterns of cellular growth at 7, 14 and 21 days after culture. This study demonstrates the potential of a novel polyhedral oligomeric silsesquioxane-modified poly(hexanolactone/carbonateurethane/urea scaffold for culturing bone marrow–derived mesenchymal stem cells in chondrogenic medium to produce an auricular-shaped construct. This is supported by scanning electron microscopy, histological and immunofluorescence analysis revealing markers of chondrogenesis including collagen type II, SOX-9, glycosaminoglycan and elastin. To the best of our knowledge, this is the first report of stem cell application on an auricular-shaped scaffold for tissue engineering purposes. Although many obstacles remain in producing a functional auricle, this is a promising step forward.
Wang, Zhongshan; Qin, Haiyan; Feng, Zhihong; Zhao, Yimin
Total auricular reconstruction is still a challenge, and autologous cartilage transplant is the main therapy so far. Tissue engineering provides a promising method for auricular cartilage reconstruction. However, although degradable framework demonstrated excellent initial cosmetic details, it is difficult to maintain the auricular contour over time and the metabolites tended to be harmful to human body. In this study, biocompatible and safe nondegradable elastic polyurethane was used to make porous scaffold in specific details by rapid prototyping technology. Platelet-rich plasma contains fibrin and abundant autologous growth factors, which was used as cell carriers for in vitro expanded cells. When crosslinking polyurethane framework, platelet-rich plasma and cells together, we successfully made polyurethane/platelet-rich plasma/cell composites, and implanted them into dorsal subcutaneous space of nude mice. The results showed that this method resulted in more even cell distribution and higher cell density, promoted chondrocyte proliferation, induced higher level expressions of aggrecan and type II collagen gene, increased content of newly developed glycosaminoglycans, and produced high-quality cartilaginous tissue. This kind of cartilage tissue engineering approach may be a potential promising alternative for external ear reconstruction. © The Author(s) 2015.
Full Text Available Background. Dysmenorrhea and accompanying symptoms can have a negative impact on academic achievement, physical activity and functioning, and quality of life. Unfortunately, stress increases the sensitivity and severity of pain, activating sympathetic responses while inhibiting parasympathetic responses. Objective. This study used objective, physiological measurements to evaluate the effects of auricular acupressure on menstrual pain and menstrual distress in young college students with primary dysmenorrhea across two menstrual cycles. The aim was to determine if significant differences could be detected between the intervention and follow-up phases after controlling life stress. Design. A one-group experimental research design was used, and repeated measurements and followups were done. Thirty-two women completed questionnaires and physiological parameters were measured. Results. Significant differences between the intervention and follow-up phases were found for high frequency (HF and blood pressure on day 1 and no significant differences in menstrual pain and menstrual distress, heart rate variability, low frequency (LF, LF/HF ratio, or heart rate. Conclusion. Auricular acupressure effectively increases parasympathetic activity to maintain autonomic function homeostasis in young women with primary dysmenorrhea and may have a value in alleviating menstrual pain and menstrual distress in a high-stress life. Future studies should consider stress, stimulus dose of auricular acupressure, severity of menstrual pain, and a longitudinal research design.
Full Text Available Objectives. To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review. Methods. A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis. Results. A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = −1.13, 95% CI (-1.70, -0.56, P<0.001. But, for the disability level, the therapeutic effect was not significant (mean difference = −1.99, 95% CI (-4.93, 0.95, P=0.18. No serious adverse effects were recorded. Conclusions. The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.
Freyer, Johanna; Hueter, Lucie; Kasprick, Lysann; Frese, Thomas; Sultzer, Ralf; Schiek, Susanne; Bertsche, Thilo
Geriatric patients bear a high risk for having drug-related problems (DRPs). Transitions of care are especially susceptible to these DRPs. To highlight the prevalence of DRPs in geriatric patients' post-discharge medication lists and to assess physicians' ability to identify DRPs by using clinical case scenarios. A sequential prospective mixed-method study was performed. In a DRP prevalence analysis, an expert panel of clinical pharmacists analyzed DRPs in post-discharge medication lists of long-term hospitalized patients from a German inpatient geriatric rehabilitation center. Based on these results, the expert panel created two clinical case scenarios with applicable medication history. The cases were reflective of the most commonly identified DRPs. They were provided to hospital physicians and general practitioners (GPs) for assessment. Physicians were asked whether they approve the prescriptions in the clinical case scenarios. If a physician had not identified a prescription containing a defined DRP, the clinical pharmacist then provided drug information about it. With this, physicians' ability to identify DRPs and their response to a theoretical intervention was assessed. DRP prevalence analysis: A total of 639 prescriptions were analyzed from 63 enrolled patients of whom 52 (83%) were affected by at least one DRP. Twenty-eight hospital physicians and 26 GPs have been assessed. They identified 172 (46%) from 378 possible DRPs (seven DRPs multiplied by 54 physicians). For unidentified DRPs, physicians received tailored drug information and the number of identified DRPs rose to 298 (79%). A clear majority of patients were affected by DRPs. However, the results from the following pilot study confirm that many DRPs at care transitions can be reduced by providing applicable medication history and drug information. This intervention can be done by clinical pharmacists as part of the multidisciplinary care team in routine care. Geriatric patients bear a high risk
Full Text Available Orofacial clefts (OFC are one of the most common congenital problems seen with a very high incidence. It imparts a negative effect on the overall health of the child by hindering in his feeding practices, normal facial growth, development of dentition and hence speech. Infants born with orofacial clefts have oronasal communication which creates a problem with the creation of negative pressure inside the oral cavity required for suckling.The treatment for such patients is with the multidisciplinary approach but the preliminary concern for the neonate is to help with the feeding for which a feeding appliance is given. This case report presents a case of a 3-day old infant to whom a feeding appliance was given to aid in suckling.
Mekala, Gayathri Devi; Jones, Roger N.; MacDonald, Darla Hatton
In an effort to increase the livability of its cities, public agencies in Australia are investing in green infrastructure to improve public health, reduce heat island effects and transition toward water sensitive urban design. In this paper, we present a simple and replicable approach to building a business case for green infrastructure. This approach requires much less time and resources compared to other methods for estimating the social and economic returns to society from such investments. It is a pragmatic, reasonably comprehensive approach that includes socio-demographic profile of potential users and catchment analysis to assess the economic value of community benefits of the investment. The approach has been applied to a case study area in the City of Brimbank, a western suburb of Greater Melbourne. We find that subject to a set of assumptions, a reasonable business case can be made. We estimate potential public benefits of avoided health costs of about AU75,049 per annum and potential private benefits of AU3.9 million. The project area is one of the most poorly serviced areas in the municipality in terms of quality open spaces and the potential beneficiaries are from relatively low income households with less than average health status and education levels. The values of cultural (recreational benefits, avoided health costs, and increased property values) and regulating (reduction in heat island effect and carbon sequestration) ecosystem services were quantified that can potentially offset annual maintenance costs.
Mekala, Gayathri Devi; Jones, Roger N; MacDonald, Darla Hatton
In an effort to increase the livability of its cities, public agencies in Australia are investing in green infrastructure to improve public health, reduce heat island effects and transition toward water sensitive urban design. In this paper, we present a simple and replicable approach to building a business case for green infrastructure. This approach requires much less time and resources compared to other methods for estimating the social and economic returns to society from such investments. It is a pragmatic, reasonably comprehensive approach that includes socio-demographic profile of potential users and catchment analysis to assess the economic value of community benefits of the investment. The approach has been applied to a case study area in the City of Brimbank, a western suburb of Greater Melbourne. We find that subject to a set of assumptions, a reasonable business case can be made. We estimate potential public benefits of avoided health costs of about AU$75,049 per annum and potential private benefits of AU$3.9 million. The project area is one of the most poorly serviced areas in the municipality in terms of quality open spaces and the potential beneficiaries are from relatively low income households with less than average health status and education levels. The values of cultural (recreational benefits, avoided health costs, and increased property values) and regulating (reduction in heat island effect and carbon sequestration) ecosystem services were quantified that can potentially offset annual maintenance costs.
Kinaia, Bassam M; Hope, Kristyn; Zuhaili, Ahmed; Tulasne, Jean Francois
Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder of keratinization associated with palmoplantar keratoderma and severe periodontitis resulting in complete edentulism in late adolescence. The pathognomonic dental features of PLS are pathologic migration, hypermobility, and exfoliation of the teeth without any signs of root resorption. It has been suggested that an effective way to treat PLS patients presenting early in the disease progression is extraction of the erupted primary dentition or hopeless permanent teeth followed by antibiotic coverage with periodontal therapy for the remaining teeth. Unfortunately, studies have shown that this regimen only temporarily delays the progression of periodontal disease and does not prevent further tooth loss and bone destruction in the long term. Post-tooth loss, atrophic ridges make conventional prosthodontic rehabilitation quite challenging, and more recently, implant-supported prostheses have been considered as a viable alternative. In a PLS patient, implant placement is complicated by inadequate bone volume; thus, bone augmentation techniques or the use of short implants is often considered. When large volumes of bone are required, parietal calvarium bone can be used to predictably reconstruct severe defects. A PLS patient aged 21 years presented a chief complaint of ill-fitting conventional complete dentures. The patient had severely atrophic ridges, requiring significant bone augmentation for an implant-supported prosthesis. The present case is the first example of bone augmentation using autogenous calvarium parietal graft followed by endosseous implant placement and prosthetic restoration in a PLS patient.
MacLean, Scott; Hermans, Marc; Villata, Luke; Polizzi, Giovanni; Sisodia, Nikhil; Cherry, James E
Narrow-diameter implants are indicated for narrow sites, small interdental/interimplant spaces, or sites with congenitally missing teeth. They also offer a substitute for invasive augmentation procedures. The authors retrospectively evaluated the performance of a new 3.0-mm diameter implant for rehabilitating small anterior spaces. This observational multicenter retrospective case series included consecutive patients needing single-unit restoration for mandibular and lateral maxillary incisors. The outcome variables were: implant survival, Plaque Index, pocket probing depth (PPD), Jemt's papilla index, bleeding on probing (BOP), and marginal bone remodeling. In total, 45 patients received 58 3.0-mm implants placed in healed sites (n = 22), extraction sockets (n = 16), or sites with congenitally missing teeth (n = 20). Average follow-up time was 15.1 ± 5.2 months. Prosthetic loading was immediate (n = 23), early (n = 16), or delayed (n = 19). Two implants were lost, and two prosthetic complications occurred. One-year bone remodeling averaged -0.36 ± 0.85 mm (n = 44). PPD averaged 1.75 ± 0.58 mm. Neither BOP nor plaque was detected around implants. At 1-year follow-up, narrow 3.0-mm diameter implants placed in mandibular and lateral maxillary incisor sites demonstrate a high survival rate and support stable marginal bone levels and healthy soft tissue.
Yen, H. L.; Chua, K.; Chan, W.
This study reviewed 231 cases of spinal cord injury treated in Singapore. Data on demographic characteristics, common causes (mostly falls and traffic accidents), types of spinal damage, and outcomes are reported. Following rehabilitation, 68 patients were able to ambulate independently and 45 patients achieved independence in activities of daily…
Sharma, Deepak; Garg, Shalini; Sheoran, Neha; Swami, Shveta; Singh, Gundeep
Studies have shown that some children and adolescents are affected only once with dental trauma, while others seem to be accident-prone and suffer from multiple dental trauma episodes. Less is known about treatment consequences related to repeated traumatic dental injuries to the same tooth and treatment guidelines are not well established. Complicated crown fractures and crown-root fractures pose difficulties for dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis. The objective of this paper was to present and discuss a case of a child who sustained a second trauma to the same tooth following treatment of an earlier sustained crown fracture. The research-based background for establishment of the treatment plan is discussed. Reattachment of tooth fragment is a minimal invasive and esthetic method. Essential advantage of the reattached teeth is the fact that all the alternative methods as direct adhesive resin reconstruction, veneers and crowns can be performed in case of failure or a refracture. As a consequence of initial trauma, the tooth suffered a complicated crown fracture which was resolved by endodontic therapy and fragment reattachment. During follow-up, the child suffered a second trauma resulting in dislodgement and fracture of the reattached fragment and a crown-root fracture extending subgingivally with involvement of the biologic width. A conservative restorative option is described. After 1 year of follow-up, the clinical and radiographic findings demonstrated that the adopted clinical protocol was successful and yielded healthy periodontal tissues with no signs of periradicular pathosis. The occurrence of repeated traumatic dental injuries to teeth involving conservative management of both crown-root fracture and complicated crown fracture on the same tooth is extremely rare and a challenge for dental professionals to treat. © 2011 John
Jayaseelan, Dhinu J; Moats, Nick; Ricardo, Christopher R
Case report. Proximal hamstring tendinopathy is a relatively uncommon overuse injury seen in runners. In contrast to the significant amount of literature guiding the evaluation and treatment of hamstring strains, there is little literature about the physical therapy management of proximal hamstring tendinopathy, other than the general recommendations to increase strength and flexibility. Two runners were treated in physical therapy for proximal hamstring tendinopathy. Each presented with buttock pain with running and sitting, as well as tenderness to palpation at the ischial tuberosity. Each patient was prescribed a specific exercise program focusing on eccentric loading of the hamstrings and lumbopelvic stabilization exercises. Trigger point dry needling was also used with both runners to facilitate improved joint motion and to decrease pain. Both patients were treated in 8 to 9 visits over 8 to 10 weeks. Clinically significant improvements were seen in pain, tenderness, and function in each case. Each patient returned to running and sitting without symptoms. Proximal hamstring tendinopathy can be difficult to treat. In these 2 runners, eccentric loading of the hamstrings, lumbopelvic stabilization exercises, and trigger point dry needling provided short- and long-term pain reduction and functional benefits. Further research is needed to determine the effectiveness of this cluster of interventions for this condition. Therapy, level 4.
Andrés P Castaño
Full Text Available Objetivo: evaluar el grado de predictibilidad entre dos modelos de electrofisiología celular para aurícula humana, analizando las propiedades, a nivel tisular, de la duración del potencial de acción (APD y velocidad de conducción (CV en un tejido en tres dimensiones incorporando el direccionamiento de fibras para toda la anatomía auricular. Métodos: se implementaron los modelos celulares de Courtemanche-Ramírez-Nattel y Nygren; además se desarrolló un modelo geométrico detallado y realista de una aurícula humana, partiendo del modelo burdo de Harrild-Henriquez al que se le incorporó el direccionamiento de fibras en toda la anatomía auricular. Resultados: las constantes de difusión implementadas permitieron obtener en ambos modelos velocidades de conducción muy similares a las velocidades de conducción reales; además, en las regiones de alta conductividad el direccionamiento de fibras longitudinal permitió obtener velocidades de conducción más altas que en otras zonas de la aurícula. Conclusiones: la curva del potencial de acción muestra un APD90 (AP al 90% de la repolarización de 320 ms en NYG y 235 ms en CRN. En condiciones donde las propiedades de la membrana no han cambiado en la aurícula normal, se ha observado que en ambos modelos se generan subidas de potencial de acción rápidas que se aprecian en la forma del potencial, asociados con una baja velocidad de propagación en la dirección transversal y una subida lenta del potencial de acción, que se relaciona también con una alta velocidad de propagación en el sentido longitudinal.
Unkovskiy, Alexey; Spintzyk, Sebastian; Axmann, Detlef; Engel, Eva-Maria; Weber, Heiner; Huettig, Fabian
The use of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing in maxillofacial prosthetics has been widely acknowledged. Rapid prototyping can be considered for manufacturing of auricular prostheses. Therefore, so-called prostheses replicas can be fabricated by digital means. The objective of this study was to identify a superior additive manufacturing method to fabricate auricular prosthesis replicas (APRs) within a digital workflow. Auricles of 23 healthy subjects (mean age of 37.8 years) were measured in vivo with respect to an anthropometrical protocol. Landmarks were volumized with fiducial balls for 3D scanning using a handheld structured light scanner. The 3D CAD dataset was postprocessed, and the same anthropometrical measurements were made in the CAD software with the digital lineal. Each CAD dataset was materialized using fused deposition modeling (FDM), selective laser sintering (SLS), and stereolithography (SL), constituting 53 APR samples. All distances between the landmarks were measured on the APRs. After the determination of the measurement error within the five data groups (in vivo, CAD, FDM, SLS, and SL), the mean values were compared using matched pairs method. To this, the in vivo and CAD dataset were set as references. Finally, the surface structure of the APRs was qualitatively evaluated with stereomicroscopy and profilometry to ascertain the level of skin detail reproduction. The anthropometrical approach showed drawbacks in measuring the protrusion of the ear's helix. The measurement error within all groups of measurements was calculated between 0.20 and 0.28 mm, implying a high reproducibility. The lowest mean differences of 53 produced APRs were found in FDM (0.43%) followed by SLS (0.54%) and SL (0.59%)--compared to in vivo, and again in FDM (0.20%) followed by SL (0.36%) and SLS (0.39%)--compared to CAD. None of these values exceed the threshold of clinical relevance (1.5%); however, the qualitative
Agrawal, Sarvesh; Jose, Nidhin Philip; Bandi, Rohan S; Jain, Nimit; Rodrigues, Shobha J
Adult orthodontics has been an area of increasing focus in recent times. Comprehensive treatment of adults is more challenging due to a myriad of problems that coexist in an adult that makes treatment planning more challenging. A large number of individuals seek dental care because of aesthetic reasons, that is, the desire to look more attractive by improving their smiles. The role an attractive smile plays on a person's self-image and confidence cannot be overemphasized. Evaluating and treating patients for the purpose of smile design often involves a multi-discipline approach. Achieving an ideal smile may require orthodontics, orthognathic surgery, periodontal therapy, including soft tissue repositioning and bone re-contouring, cosmetic dentistry, and plastic surgery. This aesthetic approach to patient care produces the best dental and dental-facial beauty. This paper describes a case report in which an orthodontist, an endodontist, and a prosthodontist worked as a team to improve the patients smile and confidence.
Morán Pascual, Patricia; Mortes Roselló, Esther; Domingo Jacinto, Amparo; Belda Lois, Juan Manuel; Bermejo, Ignacio; Medina, Enric; Barberà Guillem, Ricard
Cerebral Palsy (CP) is the most common motor disability in childhood. It is a group of permanent disorders that affect child development causing disorders of movement and posture and activity limitations. The impairment of psychomotor skills of children with Cerebral Palsy is attributed to a permanent alteration occurred in non-progressive brain development of the fetus or nursing infant. Some motor related symptoms can be treated using proper physical therapy. However, one of the biggest problems of the usual physical therapy is adherence to therapy. Ballet can be an alternative or a complement to physiotherapy, with the added attraction of not being part of a to therapy, but a fun activity with the extra reward associated with the realization of an artistic activity. For some years the ballet is used as therapeutically valuable for both children with cerebral palsy: Intensive ballet training can generate changes in the sensorimotor cortex. Ballet is characterized by a complex process of movements that have to be in a musical rhythm (hence have to be precise), in which there is an overall coordination of the muscles. It is also a highly motivating and rewarding activity that allows many children with CP sharing the activities of their peers without special needs. Objective measurements of the Full Port de Bras movement has been chosen as an index of improvement. The results shows progressive improvements of the execution in a single case.
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false âRehabilitation to the... OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Case Status § 21.190 “Rehabilitation to the point of employability...
Luis C. Maroto
Full Text Available El tratamiento quirúrgico de la fibrilación auricular fue introducido por Cox en 1987. Se trata de un procedimiento muy eficaz, pero su uso no se ha extendido por su dificultad técnica y su mayor morbimortalidad en manos poco expertas. En los últimos años se han desarrollado dispositivos capaces de sustituir las múltiples incisiones y suturas de la intervención por líneas de ablación realizadas con diferentes fuentes de energía, haciéndola más sencilla y rápida. Aunque los resultados a corto y medio plazo son buenos, todavía quedan bastantes aspectos por definir: mecanismos de la arritmia, patrón de lesiones más apropiado, fuente de energía más segura y eficaz y manera de comunicar los resultados, entre otros.
Abbas, Ahmed A; Santiwong, Peerapong; Wonglamsam, Amornrat; Srithavaj, Theerathavaj; Chanthasopeephan, Teeranoot
The purpose of this study was to evaluate stress distribution around two craniofacial implants in an auricular prosthesis according to the removal forces. Three attachment combinations were used to evaluate the stress distribution under removal forces of 45 and 90 degrees. Three attachment designs were examined: (1) a Hader bar with three clips; (2) a Hader bar with one clip and two extracoronal resilient attachments (ERAs); and (3) a Hader bar with one clip and two Locators. The removal force was determined by means of an Instron universal testing machine with a crosshead speed of 10 mm/minute. All three designs were created in three dimensions using SolidWorks. The applied removal force and the models were then introduced to finite element software to analyze the stress distribution. The angle of removal force greatly affected the magnitude and direction of stress distribution on the implants. The magnitude of stress under the 45-degree removal force was higher than the stress at 90 degrees. The combination of the 1,000-g retention clip and 2,268-g retention Locator exhibited the highest stress on the implant flange when the removal force was applied at 45 degrees. The removal angle greatly influences the amount of force and stress on the implants. Prosthodontists are encouraged to inform patients to remove the prosthesis at 90 degrees and, if possible, use a low-retentive attachment to reduce stress.
Full Text Available Development of wearable point-of-care medical devices faces many challenges. Besides technological and clinical issues, demands on robustness, miniaturization, and user interface design are of paramount importance. However, a systematic assessment of these non-functional but essential requirements is often impossible within the first product cycle. Later, surveys on user satisfaction with existing devices and user demands can offer significant input for device re-development and improvement. In this paper, we present a survey on satisfaction with and demands for a wearable medical device for percutaneous auricular vagus nerve stimulation (pVNS. We analyzed 36 responses from patients treated with pVNS and five responses from experienced physicians in order to devise a future concept of pVNS. Main shortcomings of a current pVNS device were identified to be lacking water resistance and mechanical robustness, both impairing daily activities. Painful sensation during pVNS application, unwanted side effects like skin irritations and strongly varying perception of the stimulation were reported. Results urge for more patient self-governance and an (automatic adjustment of the stimulation to the current physiological state of the patient. Attained results support a strategic approach for future developments of pVNS towards personalized health care.
Rong, Peijing; Liu, Aihua; Zhang, Jianguo; Wang, Yuping; Yang, Anchao; Li, Liang; Ben, Hui; Li, Liping; Liu, Rupeng; He, Wei; Liu, Huanguang; Huang, Feng; Li, Xia; Wu, Peng; Zhu, Bing
Previous studies demonstrated that vagus nerve stimulation (VNS) is an effective therapy for drug-resistant epilepsy. Acupuncture is also used to treat epilepsy. This study was designed to examine the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with drug-resistant epilepsy. A total of 50 volunteer patients with drug-resistant epilepsy were selected for a random clinical trial to observe the therapeutic effect of ta-VNS. The seizure frequency, quality of life, and severity were assessed in weeks 8, 16, and 24 of the treatment according to the percentage of seizure frequency reduction. In the pilot study, 47 of the 50 epilepsy patients completed the 24-week treatment; three dropped off. After 8-week treatment, six of the 47 patients (12%) were seizure free and 12 (24%) had a reduction in seizure frequency. In week 16 of the continuous treatment, six of the 47 patients (12%) were seizure free; 17 (34%) had a reduction in seizure frequency. After 24 weeks' treatment, eight patients (16%) were seizure free; 19 (38%) had reduced seizure frequency. Similar to the therapeutic effect of VNS, ta-VNS can suppress epileptic seizures and is a safe, effective, economical, and widely applicable treatment option for drug-resistant epilepsy. (ChiCTR-TRC-10001023).
Klausenitz, Catharina; Hacker, Henriette; Hesse, Thomas; Kohlmann, Thomas; Endlich, Karlhans; Hahnenkamp, Klaus; Usichenko, Taras
Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MA-AT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p exam (p = 0.018). Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants. PMID:28033320
Seguel R. Marianella, DRA. E.
Full Text Available La Fibrilación Auricular es una arritmia frecuente, es la causa de un número importante de accidentes cerebro-vasculares, y tiene una incidencia y prevalencia que aumenta con la edad, lo que se está constituyendo en un problema de salud pública. Existen medidas terapéuticas farmacológicas y no farmacológicas que podrían prevenir esta arritmia. Se revisa la clasificación de la FA, los factores de riesgo relacionados con la ocurrencia de la FA y el rol de fármacos como los inhibidores del sistema renina-angiotensina- aldosterona, inhibidores de aldosterona, estatinas, ácidos grasos omega 3 y beta bloqueadores en la prevención primaria y secundaria de esta arritmia. Además, se revisan los criterios para estratificar el riesgo embólico y el rol de la warfarina y de los nuevos anticoagulantes en prevenir el trombo-embolismo.
Full Text Available La fibrilación auricular es la arritmia más frecuente en la práctica clínica y conlleva implicaciones significativas en la morbilidad y mortalidad cardiovascular de la población, así como en los costos para los sistemas de salud. No obstante, el conocimiento de la fisiopatología de la arritmia y el surgimiento de nuevas alternativas terapéuticas han cambiado la perspectiva en el manejo de esta enfermedad. Se realiza una revisión del desarrollo reciente en conceptos etiológicos y fisiológicos de la arritmia, así como en los esquemas de clasificación y evaluación del riesgo trombohemorrágico, además de los nuevos avances en terapias farmacológicas e intervencionistas.Atrial fibrillation is the most common arrhythmia in clinical practice and carries significant implications in the population's cardiovascular morbidity and mortality as well as in costs for the health systems. However, the knowledge of the pathophysiology of the arrhythmia and the emergence of new alternative therapies have changed the perspective in the management of this disease. We realize a review of recent developments in etiological and physiological concepts of the arrhythmia, as well as a review of the classification schemes and thrombohemorrhagic risk assessment in addition to the new advances in pharmacological and interventional therapies.
Full Text Available Auricular acupuncture (AA is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MA-AT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p < 0.003. AA was better at reducing anxiety than placebo in the evening before the exam (p = 0.018. Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants.
Klausenitz, Catharina; Hacker, Henriette; Hesse, Thomas; Kohlmann, Thomas; Endlich, Karlhans; Hahnenkamp, Klaus; Usichenko, Taras
Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MA-AT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p anxiety than placebo in the evening before the exam (p = 0.018). Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants.
Safi, Sami; Ellrich, Jens; Neuhuber, Winfried
Transcutaneous stimulation of the auricular branch of the vagus nerve (ABVN) resulted in deactivation of temporal lobe structures, similar to invasive cervical vagus nerve (CVN) stimulation. Presumably, both methods stimulated myelinated afferent beta axons mediating anti-convulsive effects. How numbers of A beta axons in the human ABVN compare to those of the CVN is unknown. The ABVN, CVN, recurrent laryngeal nerve (RLN) and thoracic vagus nerve (TVN) were dissected from embalmed bodies. Numbers and calibers of myelinated axons were analyzed in semithin sections. Myelinated axons in the left and right ABVN averaged to 385 and 363, respectively. Numbers of A beta axons measuring ≥7 µm averaged to 64 and 78 on the left and right, respectively. Numbers of A beta axons in CVN were estimated by subtracting myelinated presumed motor axons in RLN from the total count of CVN. This resulted in 280 and 504 A beta axons on the left and right, respectively, concurring well with the thick myelinated axon count of the ipsilateral TVN (255 and 466, respectively). Thus, the ratio of A beta axons in the ABVN and CVN was ∼1:5 and 1:6 on the left and right side, respectively. These results indicate that transcutaneous ABVN stimulation might be a promising alternative to invasive CVN stimulation. Anat Rec, 299:1184-1191, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
In all cases of trifurcation, superior thyroid artery was the third branch. The common carotid artery quadrifurcated into external, internal carotid, superior thyroid and ascending pharyngeal arteries. The pentafurcations comprised internal carotid, external carotid, superior thyroid, occipital and posterior auricular arteries.
We highlight the case of a two year old female who presented with a two month history of left posterior auricular swelling. The swelling developed following trauma, was painless and progressively enlarging. After extensive evaluation the mass was noted to be an extramedullary presentation of Acute T cell lymphoblastic ...
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Millennium Challenge Corporation — The key research questions guiding our design of the RRRP evaluation are: • Did rehabilitating roads affect the quality of roads? • Did rehabilitating roads improve...
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Full Text Available The goal of this study was to investigate the impact and acceptability of providing continuous auricular electroacupuncture as an adjunct to conventional medications for patients with depression. Ten patients with a mean age ± SD of 43.3 ± 10.4 years were able to provide informed consent. The quantitative and qualitative outcome measures were heart rate, heart rate variability (HRV, and different clinical scores. The study documented that a special kind of auricular electro acupuncture, applied over a period of three days, can improve various aspects of quality of life significantly but also highlighted the significant increase of HRV whilst having acupuncture treatment. In conclusion, our study shows stimulation-related and quantifiable clinical and physiological alterations in parameters after continuous auricular acupoint stimulation in patients with depression. Improved access to electro acupuncture treatment would be of major benefit for these patients. Further studies are necessary in order to verify the gained results.
Zeng, Feng; Zhao, Chao; Pang, Jie; Lin, Zhanxi; Huang, Yifan; Liu, Bin
A water-soluble crude polysaccharide was extracted by hot water from Auricularia auricular mycelium grown under solid-state fermentation (SSF). The crude polysaccharide was purified by DEAE Sephadex A-50 and Sephadex G-200 chromatography. Fourier transform infrared spectroscopy and nuclear magnetic resonance ((1) H NMR) spectroscopy were used to investigate the structure of the purified A. auricular polysaccharide (AAP-I) and revealed that it is α-glycosidically linked. After 14 and 28 days of AAP-I orally administered, the AAP-I significantly decreased the levels of total cholesterol, triglyceride, and low-density lipoprotein cholesterol in mice in which hyperlipidemia had been induced by a high fat diet (P < 0.05). The results revealed that AAP-I from SSF of A. auricular mycelium possesses potent hypolipidemic properties. The polysaccharide may be useful as a functional food additive and a hypolipidemic agent. © 2013 Institute of Food Technologists®
Ramírez M,Samuel; Sandoval R,Néstor; Cervantes S,Jorge L
El procedimiento de Cox modificado es el estándar de oro para el tratamiento de la fibrilación auricular asociada a valvulopatía mitral, por lo que los nuevos procedimientos diseñados para este fin deben compararse con éste. Nuestro protocolo de manejo busca determinar la influencia de la edad de la fibrilación auricular, el tamaño de la aurícula izquierda y otros factores de riesgo de la ablación de la fibrilación auricular y la cirugía combinada de la válvula mitral. Algunos pacientes tiene...
Di Iorio Tania
Full Text Available Abstract Background On a regional level, our aims were to describe rehabilitation patterns for elderly patients with stroke and hip fracture and to investigate mortality risk during the 6-month post acute period. Methods Data sources included administrative data relative to patients aged 65+ resident in Tuscany admitted in hospital for stroke or hip fracture between 2001 and 2003, traced up to 3 years before and 6 months following index admission. The study design involves computerized linkage of administrative data, and an exploratory analysis of the association between rehabilitation patterns and 6-month mortality, adjusting for clinical, demographic, and acute-related care characteristics using multivariate Cox regression. Results Rehabilitation patterns vary greatly across Tuscany with considerable cost implications. Six month mortality risk for stroke patients is significantly lower among residents of Local Health Authorities where patients are more frequently rehabilitated, specifically in extra-hospital settings. Conclusion Our study, targeting two crucial conditions for elderly patients, found a high variability of rehabilitation patterns across a region, albeit coherent between the two pathologies, associated with remarkable differences in average expenditure. Differences in hazard rates for 6-month mortality after stroke at population level were also found. These results need to be confirmed and further investigated through a more robust information framework.
Zhao, Xing; Hwang, Nathaniel S; Bichara, David A; Saris, Daniel B; Malda, Jos; Vacanti, Joseph P; Pomerantseva, Irina; Sundback, Cathryn A; Langer, Robert; Anderson, Daniel G; Randolph, Mark A
Bone marrow-derived mesenchymal stem cells (BMSCs) can be obtained by minimally invasive means and would be a favourable source for cell-based cartilage regeneration. However, controlling the differentiation of the BMSCs towards the desired chondrogenic pathway has been a challenge hampering their application. The major aim of the present study was to determine if conditioned medium collected from cultured auricular chondrocytes could promote chondrogenic differentiation of BMSCs. Auricular chondrocytes were isolated and grown in BMSC standard culture medium (SM) that was collected and used as chondrocyte-conditioned medium (CCM). The BMSCs were expanded in either CCM or SM for three passages. Cells were seeded onto fibrous collagen scaffolds and precultured for 2 weeks with or without transforming growth factor-beta 3 (TGF-β3). After preculture, constructs were implanted subcutaneously in nude mice for 6 and 12 weeks and evaluated with real-time polymerase chain reaction, histology, immunohistochemistry and biochemistry. Real-time polymerase chain reaction results showed upregulation of COL2A1 in the constructs cultured in CCM compared with those in SM. After 12 weeks in vivo, abundant neocartilage formation was observed in the implants that had been cultured in CCM, with or without TGF-β3. In contrast, very little cartilage matrix formation was observed within the SM groups, regardless of the presence of TGF-β3. Osteogenesis was only observed in the SM group with TGF-β3. In conclusion, CCM even had a stronger influence on chondrogenesis than the supplementation of the standard culture medium with TGF-β3, without signs of endochondral ossification. Efficient chondrogenic differentiation of BMSCs could provide a promising alternative cell population for auricular regeneration. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Full Text Available With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation.
Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine
A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation...... and a growth in residential cancer-rehabilitation initiatives in Denmark (Danish Cancer Society 1999; Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential-cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this discourse has...
Introducción: La picadura de jerjeles o simúlidos de la cara anterior del pabellón auricular presenta características clínicas diferente a las picaduras del mismo insecto en la piel del resto del cuerpo y requiere también un tratamiento diferente. Estos hechos no han sido descritos en la literatura. Objetivos: El objetivo es detallar los síntomas y signos de estas picaduras y las causas de las diferencias clínicas y de su tratamiento. Material y método: Para ello se hace el estudio y análisis...
Full Text Available Evitar la fragmentación del tejido mixoide durante el acto quirúrgico y resecar todo el espesor del septo interauricular con implantación tumoral son las dos claves para evitar las graves complicaciones de embolia peroperatoria y recidiva postoperatoria en el tratamiento quirúrgico del mixoma auricular izquierdo. La vía transeptal superior nos ha permitido, en tres pacientes, la extirpación en bloque de mixomas de gran tamaño con facilidad y sin complicaciones.
Rocha, Patrícia da
Trabalho final de mestrado integrado em Medicina, área cientifica de Cardiotorácica, apresentado á Faculdade de Medicina da Universidade de Coimbra Objetivos: A regurgitação mitral (RM) secundária (não isquémica e não associada a cardiomiopatia dilatada), caracterizada pela dilatação isolada do anel mitral é uma entidade pouco estudada, e o papel da fibrilhação auricular (FA) na génese deste tipo de RM está envolto em controvérsia. Por conseguinte, propusemo-nos: comparar as característica...
Cristiane Isabela de Almeida
Full Text Available Elders are the most representative installment among the universe ofdefi ciency bearer persons. Advanced age contributes for the advent ofdefi ciencies in general. Rehabilitation of elderly patients is imperativefor quality of life of the patient and for the society. Rehabilitation isable to help basically in four fronts: prevention of wounds, minimize,revert and adaptation to sequels. The elder is always prone to receivebenefi ts from rehabilitation. However, he tends to react more slowlyto the rehabilitative interventions. The objective of Physical Medicineand Rehabilitation is to insert independence and quality in the lifewhose duration was prolonged by the advancements of science.The success of Rehabilitation depends on many variables, including:the nature and severity of the illness or wound, kind and severity ofremaining incapacities, global health of the patient and support of thefamily. In this article, the main characteristics of the rehabilitation inGeriatric Rheumatology are described.
Giardini-Rosa, Renata; Joazeiro, Paulo P.; Thomas, Kathryn; Collavino, Kristina; Weber, Joanna
External ear reconstruction with autologous cartilage still remains one of the most difficult problems in the fields of plastic and reconstructive surgery. As the absence of tissue vascularization limits the ability to stimulate new tissue growth, relatively few surgical approaches are currently available (alloplastic implants or sculpted autologous cartilage grafts) to repair or reconstruct the auricle (or pinna) as a result of traumatic loss or congenital absence (e.g., microtia). Alternatively, tissue engineering can offer the potential to grow autogenous cartilage suitable for implantation. While tissue-engineered auricle cartilage constructs can be created, a substantial number of cells are required to generate sufficient quantities of tissue for reconstruction. Similarly, as routine cell expansion can elicit negative effects on chondrocyte function, we have developed an approach to generate large-sized engineered auricle constructs (≥3 cm2) directly from a small population of donor cells (20,000–40,000 cells/construct). Using rabbit donor cells, the developed bioreactor-cultivated constructs adopted structural-like characteristics similar to native auricular cartilage, including the development of distinct cartilaginous and perichondrium-like regions. Both alterations in media composition and seeding density had profound effects on the formation of engineered elastic tissue constructs in terms of cellularity, extracellular matrix accumulation, and tissue structure. Higher seeding densities and media containing sodium bicarbonate produced tissue constructs that were closer to the native tissue in terms of structure and composition. Future studies will be aimed at improving the accumulation of specific tissue constituents and determining the clinical effectiveness of this approach using a reconstructive animal model. PMID:24124666
Klausenitz, Catharina; Hesse, Thomas; Hacker, Henriette; Hahnenkamp, Klaus; Usichenko, Taras
Auricular acupuncture (AA) is effective for the treatment of preoperative anxiety. We aimed to study the feasibility and effects of AA on exam anxiety in a prospective observational pilot study. Healthy medical students received bilateral AA using indwelling fixed needles at points MA-IC1, MA-TF1, MA-SC, MA-AH7, and MA-T on the day before an anatomy exam. The needles were removed after the exam. Anxiety levels were measured using the State-Trait-Anxiety Inventory (STAI) and a 100 mm visual analogue scale (VAS-100) before and after the AA intervention and once again immediately before the exam. The duration of sleep on the night before the exam was recorded and compared to that over the preceding 1 week and 6 months (all through students' recollection). In addition, blood pressure, heart rate and the acceptability of AA to the students were recorded. Ten students (all female) were included in the final analysis. All tolerated the needles well and stated they would wish to receive AA again for exam anxiety in the future. Exam anxiety measured using both STAI and VAS-100 decreased by almost 20% after AA. AA was well accepted, the outcome measurement was feasible, and the results have facilitated the calculation of the sample size for a subsequent randomised controlled trial. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Kattalai Kailasam, Vasanth; Anand, Preeti; Melyan, Zara
The use of opioids in the treatment of chronic pain has increased dramatically in the past few decades making them one of the most commonly prescribed medications in the US. However, long-term use of opioids is limited by development of tolerance (decreased antinociceptive efficacy) and opioid-induced hyperalgesia - paradoxical sensitization to noxious (hyperalgesia) and non-noxious (allodynia) stimuli. Novel adjunctive therapies are needed to increase the efficacy and prolong the duration of action of opioids in chronic pain treatment. Acupuncture is often used as an adjunct therapy for the treatment of symptoms induced by non-clinical use of opioids. The National Acupuncture Detoxification Association (NADA) auricular acupuncture protocol is the most common form of acupuncture treatment for substance abuse. The standardized, easy to use and virtually painless procedure make it an attractive complementary treatment option for patients suffering from opioid-induced adverse effects. Clinical trials designed to test the efficacy of the NADA protocol yielded contradictory results. The mechanism by which NADA acupuncture could serve as a successful treatment remains unknown. Therefore, establishing an animal model of NADA acupuncture can provide a tool for investigating the efficacy and cellular mechanisms of NADA treatment. Previous studies have shown that repeated morphine administration in rodents can produce locomotor sensitization and reduce analgesic potency of a challenge dose of morphine, indicating development of morphine tolerance. Here we show that NADA acupuncture treatment can both reduce morphine-induced locomotor sensitization and prevent the development of morphine tolerance in rats, thus validating a new model for NADA acupuncture studies. Our data provides support for evidence-based use of NADA acupuncture as a new adjunctive approach that can potentially improve the side-effect profile of morphine and other prescription opioids. Copyright © 2016
Full Text Available Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i. However CBT-i may not suit everyone. Auricular acupuncture (AA is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4, with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI, Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16, Epworth Sleepiness Scale (ESS, and Hospital Anxiety and Depression scale (HAD, were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder. The trial is registered with ClinicalTrials.gov NCT01765959.
Ao, M; Wu, J; Chen, J
treatment units were divided into less than 500 cases group (n=8), 501-1 000 cases group (n=11), 1 001-1 500 cases group (n=10), and more than 1 500 cases group (n=6) according to the number of annual admitted patients. The number of authorized beds of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group (t=4.563, Pnurses of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group (t=2.837, Pnurses and that of rehabilitation therapists of units in more than 1 500 cases group were significantly more than those in the other 3 groups (with t values from 1.762 to 4.789, P values below 0.05). (3) The 35 burn treatment units were able to provide at least one rehabilitation treatment for patients, among which body positioning, motion of joint exercise, infrared ray irradiation, hydrotherapy, function training, activities of daily life training, scar massage, and drug injection in scar were carried out well, while psychological therapy, music therapy, occupational rehabilitation, and social rehabilitation were mostly not carried out. (4) Only 9 (25.7%) burn treatment units started rehabilitation treatment for patients within 3 days after injury. (5) Twenty-seven (77.1%) burn treatment units could carry out body positioning in ICU. (6) Twenty-three burn treatment units had full-time rehabilitation treating personnel, and the units were divided into less than 500 cases group (n=1), 501-1 000 cases group (n=8), 1 001-1 500 cases group (n=9), and more than 1 500 cases group (n=5) according to the number of annual admitted patients. The ratio of beds to doctors of units in more than 1 500 cases group was significantly higher than that in 501-1 000 cases group (t=2.810, P0.05). The ratios of beds to nurses and beds to full-time burn rehabilitation treating personnel in 4 groups were similar (with F values respectively 0.783 and 0.434, P values above 0.05). (7) Twenty burn treatment units had rehabilitation