Catheter Rehabilitation of Occluded Aberrant Pulmonary Artery.

Catheter rehabilitation of occluded aberrant pulmonary artery.

Interact Cardiovasc Thorac Surg. 2013 Mar 25;
Noonan PM, Ramchandani B, Barron DJ, Stumper O

A 10-year old girl underwent a CT angiogram to investigate right lung hypoplasia. This showed a normal bronchial tree, lung parenchyma and pulmonary venous drainage, but an absent right pulmonary artery. Cardiac catheterization with pulmonary vein wedge injections identified a disconnected hypoplastic right pulmonary artery system supplied by an occluded right-sided ductus arteriosus. Transcatheter recanalization of the ductus re-established right pulmonary artery flow and growth. Ultimately, this allowed for complete surgical repair and restoration of normal perfusion of the right lung, leading to complete functional rehabilitation. HubMed – rehab


Response to the Letter to the Editor by Berger.

J Rehabil Med. 2013 Mar 15;
Fegni MF

Abstract is missing (Letter). HubMed – rehab


The Use of Low-Osmolar Water-Soluble Contrast in Videofluoroscopic Swallowing Exams.

Dysphagia. 2013 Mar 26;
Harris JA, Bartelt D, Campion M, Gayler BW, Jones B, Hayes A, Haynos J, Herbick S, Kling T, Lingaraj A, Singer M, Starmer H, Smith C, Webster K

The selection of the contrast agent used during fluoroscopic exams is an important clinical decision. The purpose of this article is to document the usage of a nonionic, water-soluble contrast (iohexol) and barium contrast in adult patients undergoing fluoroscopic exams of the pharynx and/or esophagus and provide clinical indications for the use of each. For 1 year, data were collected on the use of iohexol and barium during fluoroscopic exams. The contrast agent used was selected by the speech language pathologist (SLP) or the radiologist based on the exam’s indications. A total of 1,978 fluoroscopic exams were completed in the 12-month period of documentation. Of these exams, 60.6 % were completed for medical reasons and 39.4 % for surgical reasons. Fifty-five percent of the exams were performed jointly by a SLP and a radiologist and 45 % were performed by a radiologist alone. Aspiration was present in 22 % of the exams, vestibular penetration occurred in 38 %, extraluminal leakage of contrast was observed in 4.6 %, and both aspiration and leakage were seen in 1 % of the exams. In cases with aspiration, iohexol was used alone in 8 %, iohexol and barium were both used in 45 %, and barium was used alone in 47 %. In cases with extraluminal leakage, iohexol was used alone in 58 %, iohexol and barium were both used in 31 %, and barium was used alone in 11 %. No adverse effects were seen with the use of iohexol. When barium was used in cases of aspiration and extraluminal leakage, the amount of aspirated barium was small and the extraluminal barium in the instances of leakage was small. Iohexol is a useful screening contrast agent and can safely provide information, and its use reduces the risk of aspiration and the chance of leakage of large amounts of barium. HubMed – rehab


Chronic refractory dyspnoea – Evidence based management.

Aust Fam Physician. 2013 Mar; 42(3): 137-40
Wiseman R, Rowett D, Allcroft P, Abernethy A, Currow DC

Chronic refractory dyspnoea is defined as breathlessness daily for 3 months at rest or on minimal exertion where contributing causes have been treated maximally. Prevalent aetiologies include chronic obstructive pulmonary disease, heart failure, advanced cancer and interstitial lung diseases.To distil from the peer reviewed literature (literature search and guidelines) evidence that can guide the safe, symptomatic management of chronic refractory dyspnoea.Dyspnoea is mostly multifactorial. Each reversible cause should be managed (Level 4 evidence). Non-pharmacological interventions include walking aids, breathing training and, in chronic obstructive pulmonary disease, pulmonary rehabilitation (Level 1 evidence). Regular, low dose, sustained release oral morphine (Level 1 evidence) titrated to effect (with regular aperients) is effective and safe. Oxygen therapy for patients who are not hypoxaemic is no more effective than medical air. If a therapeutic trial is indicated, any symptomatic benefit is likely within the first 72 hours. HubMed – rehab


Feedback reliance during an arm-tapping task with obstacle avoidance in adults with Down syndrome.

Exp Brain Res. 2013 Mar 26;
Vimercati SL, Galli M, Rigoldi C, Ancillao A, Albertini G

Optimal movement control reflects a combination of both feedback and feedforward processes. However, as motor control evolves, feedforward mechanisms become prevailing respect to feedback-based movements, and less reliance on sensory information leads to a decreased number of corrections in the trajectory. In subjects with Down syndrome (DS), the study of the wrist’s trajectory during an arm-tapping task revealed feedback-based corrections designed to reduce the degree of discrepancy between the position of the limb and the target, leading to the assumption that performers with DS have problems with movement planning and feedforward control. The present study was aimed at expanding the evidence about motor control in DS by evaluating the influence of a perturbing factor (an obstacle) on motor control strategies during an arm-tapping task and to clarify if the presence of an obstacle elicited a higher reliance on feedback control in controls and in DS. Sixteen right-handed adults with DS and 21 right-handed, age-matched control subjects (N) were evaluated by means of quantitative motion analysis. The results suggest that the presence of an obstacle elicited changes in the motor strategies of both DS and N, with a destabilizing effect that led subjects to rely more on feedback control. DS showed some aspects of movement efficiency that were in accordance with N strategies, but the prevailing factor of optimization in these subjects remained safety. A focused rehabilitation could help DS subjects to develop more efficient motor strategies in the presence of motor uncertainty and perturbations. HubMed – rehab



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