Long-Term Survival After Traumatic Brain Injury: A Population-Based Analysis Controlled for Nonhead Trauma.
Long-Term Survival After Traumatic Brain Injury: A Population-Based Analysis Controlled for Nonhead Trauma.
Filed under: Rehab Centers
J Head Trauma Rehabil. 2013 Feb 1;
Brown AW, Leibson CL, Mandrekar J, Ransom JE, Malec JF
OBJECTIVE:: To examine the contribution of cooccurring nonhead injuries to hazard of death after traumatic brain injury (TBI). PARTICIPANTS:: A random sample of Olmsted County, Minnesota, residents with confirmed TBI from 1987 through 1999 was identified. DESIGN:: Each case was assigned an age- and sex-matched, non-TBI “regular control” from the population. For “special cases” with accompanying nonhead injuries, 2 matched “special controls” with nonhead injuries of similar severity were assigned. MEASURES:: Vital status was followed from baseline (ie, injury date for cases, comparable dates for controls) through 2008. Cases were compared first with regular controls and second with regular or special controls, depending on case type. RESULTS:: In total, 1257 cases were identified (including 221 special cases). For both cases versus regular controls and cases versus regular or special controls, the hazard ratio was increased from baseline to 6 months (10.82 [2.86-40.89] and 7.13 [3.10-16.39], respectively) and from baseline through study end (2.92 [1.74-4.91] and 1.48 [1.09-2.02], respectively). Among 6-month survivors, the hazard ratio was increased for cases versus regular controls (1.43 [1.06-2.15]) but not for cases versus regular or special controls (1.05 [0.80-1.38]). CONCLUSIONS:: Among 6-month survivors, accounting for nonhead injuries resulted in a nonsignificant effect of TBI on long-term mortality.
HubMed – rehab
Impaired Self-Awareness After Acquired Brain Injury: Clinicians’ Ratings on Its Assessment and Importance for Rehabilitation.
Filed under: Rehab Centers
J Head Trauma Rehabil. 2013 Feb 1;
Winkens I, Van Heugten CM, Visser-Meily JM, Boosman H
BACKGROUND:: Impaired self-awareness is a potential obstacle to successful rehabilitation. OBJECTIVE:: To obtain clinicians’ ratings of the importance of self-awareness for brain injury rehabilitation and use of instruments to assess self-awareness. PARTICIPANTS:: One hundred sixty-three members of 3 major Dutch organizations for neuropsychology or rehabilitation. MAIN MEASURE:: Online survey addressing: (1) factors participants consider important for the course and success of rehabilitation, (2) whether they assess patients’ levels of self-awareness, and (3) the instruments they use to do so. RESULTS:: Of the 163 respondents, 116 (71.2%) considered self-awareness to be important for the course of rehabilitation; 113 (69.3%) considered it to be important for the success of rehabilitation. One hundred fifty-six clinicians (95.7%) reported assessing patients’ levels of self-awareness, but only 12 (7.4%) reported using standardized instruments specifically designed for this purpose. The instruments most frequently reported to be used were the Awareness Questionnaire and Patient Competency Rating Scale. CONCLUSIONS:: It is difficult to capture different aspects of self-awareness in a standardized manner. There is a need for instruments that are valid and reliable and that have good clinical utility.
HubMed – rehab
Evaluation of Dysphagia in Early Stroke Patients by Bedside, Endoscopic, and Electrophysiological Methods.
Filed under: Rehab Centers
Dysphagia. 2013 Feb 5;
Umay EK, Unlu E, Saylam GK, Cakci A, Korkmaz H
We aimed in this study to evaluate dysphagia in early stroke patients using a bedside screening test and flexible fiberoptic endoscopic evaluation of swallowing (FFEES) and electrophysiological evaluation (EE) methods and to compare the effectiveness of these methods. Twenty-four patients who were hospitalized in our clinic within the first 3 months after stroke were included in this study. Patients were evaluated using a bedside screening test [including bedside dysphagia score (BDS), neurological examination dysphagia score (NEDS), and total dysphagia score (TDS)] and FFEES and EE methods. Patients were divided into normal-swallowing and dysphagia groups according to the results of the evaluation methods. Patients with dysphagia as determined by any of these methods were compared to the patients with normal swallowing based on the results of the other two methods. Based on the results of our study, a high BDS was positively correlated with dysphagia identified by FFEES and EE methods. Moreover, the FFEES and EE methods were positively correlated. There was no significant correlation between NEDS and TDS levels and either EE or FFEES method. Bedside screening tests should be used mainly as an initial screening test; then FFEES and EE methods should be combined in patients who show risks. This diagnostic algorithm may provide a practical and fast solution for selected stroke patients.
HubMed – rehab
[The influence of visual rehabilitation on secondary depressive disorders due to age-related macular degeneration : A randomized controlled pilot study.]
Filed under: Rehab Centers
Ophthalmologe. 2013 Feb 6;
Mielke A, Wirkus K, Niebler R, Eschweiler G, Nguyen NX, Trauzettel-Klosinski S
BACKGROUND: Age-related macular degeneration (AMD) often leads to visual impairment, loss of reading ability, reduced quality of life and secondary depression. The present study examined if visual rehabilitation has a preventive effect on secondary depression in these patients. MATERIAL AND METHODS: In a controlled pilot study 20 patients were randomized into 2 groups whereby 9 underwent visual rehabilitation at first examination and 11 received magnifying visual aids only after 3 months. Psychosocial status was assessed by the geriatric depression scale (GDS) and the German version of the Centre for Epidemiologic Studies depression (CES-D) scale (main outcome parameter), cognitive status by the dementia detection test (DemTecT), minimental status (MMS) and quality of life by the National Eye Institute visual function questionnaire (NEI-VFQ 25). Ophthalmological examination included reading speed measurement by standardized texts (International Reading Speed Texts; IReST). RESULTS: Parameters of the CES-D scale, DemTect and the subitem exercise of social roles of the NEI-VFQ 25 emerged in a divergent manner. Patients of the rehabilitation group became less depressive and improved in cognitive and social abilities and in the control group vice versa. The interactive effect of group and time was statistically significant for all three tests. CONCLUSIONS: Visual rehabilitation has a positive impact on depression as well as cognitive status and quality of life in patients with AMD. The effects have to be confirmed in future studies with more patients and a longer observation period.
HubMed – rehab
Mexican drug violence targets addicts and rehab workers – Tangled in the front line trenches of Mexican President Felipe Calderon’s anti-narcotics campaign are the country’s growing legions of addicts, who find themselves sought by gangsters as both customers and sometime targets of their violence. Cheap and plentiful narcotics have flooded the country as producers and traffickers have sought to open new markets for cocaine, heroin, methamphetamine and other drugs. And the gangland violence, which has killed thousands, also has targeted addicts and rehab workers: At least 43 in the last 13 months have been murdered in attacks on drug rehab centers in Ciudad Juarez, bordering El Paso. After years of cracking down on gangsters, Calderon has turned at least some attention to prevention and treatment. Using money seized from drug traffickers, his administration in the past year has opened more than 300 new drug rehab centers, some located in small farm towns.
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