Preventing Acute Exacerbations and Hospital Admissions in COPD.

Preventing Acute Exacerbations and Hospital Admissions in COPD.

Chest. 2013 May; 143(5): 1444-54
Marchetti N, Criner GJ, Albert RK

COPD is a leading cause of morbidity and mortality worldwide and is now the third leading cause of death in the United States. Acute exacerbations of COPD (AECOPDs) are common events that often lead to hospitalization, and their frequency worsens with disease progression. AECOPDs are associated with worsened quality of life, increased health-care costs, and increased mortality. Accordingly, there is great interest in preventing AECOPDs to improve outcomes. Both pharmacologic and nonpharmacologic interventions alter the frequency of AECOPDs and COPD-related hospitalizations. To examine the best available evidence, we restricted this review to include studies that used randomized controlled designs lasting at least 6 months. Pharmacologic interventions discussed include inhaled corticosteroids, long-acting ?-agonists, long-acting antimuscarinic agents, macrolide antibiotics, and phosphodiesterase-4 inhibitors. The nonpharmacologic interventions discussed include lung volume reduction surgery, pulmonary rehabilitation, and disease management programs. HubMed – rehab


Health-Related Quality of Life in Children with Intestinal Failure.

J Pediatr Gastroenterol Nutr. 2013 May 4;
Sanchez SE, McAteer JP, Goldin AB, Horslen S, Huebner CE, Javid PJ

OBJECTIVE:: Survival of infants with intestinal failure (IF) has increased in the past decade. However, data on their health-related quality of life (HRQOL) are lacking. We hypothesized that HRQOL would be lower among children with IF compared to that of healthy children. METHODS:: We performed a cross-sectional study of the HRQOL of children enrolled in the outpatient intestinal rehabilitation program at Seattle Children’s Hospital using the PedsQL 4.0 Generic Core Scales parent proxy-report and the Family Impact Module questionnaires. Parents were asked two open-ended questions pertaining to the suitability and completeness of the PedsQL to assess their and their child’s HRQOL. RESULTS:: Parents of 23 children with IF completed the questionnaires. Compared to norms for healthy children, parents reported significantly lower total PedsQL scores for children ages 1-2 years (mean difference?=?-13.16, 95% CI?=?-21.86, -4.46, p?=?0.003) and 2-6 years (mean difference?=?-15.57, 95% CI?=?-22.66, -8.48, p?HubMed – rehab


Diffusion tensor imaging predicts the outcome of constraint-induced movement therapy in chronic infarction patients with hemiplegia: A pilot study.

Restor Neurol Neurosci. 2013 May 6;
Marumoto K, Koyama T, Hosomi M, Takebayashi T, Hanada K, Ikeda S, Kodama N, Domen K

Purpose: To test whether diffusion tensor imaging could evaluate potential motor capability of patients with chronic cerebral infarction. Methods: We used constraint-induced movement therapy (CIMT) as a rehabilitation, which reveals potential motor capability. We also investigated the relationship between the outcome of CIMT and the ratio between fractional anisotropy values (rFA) in affected and unaffected sites of the corticospinal tract before CIMT. Imaging was performed in cerebral infarction patients (n = 14) and the rFA of the posterior limb of internal capsule (PLIC) was measured before CIMT. Patients were evaluated before and after CIMT using the Fugl-Meyer (F-M) assessment, Wolf Motor Function Test, Action Research Arm Test, and Motor Activity Log and association between PLIC- rFA and these scores was determined. Results: All patients showed an improvement in mobility following the 10-day CIMT session. Strong positive correlation was found only between F-M after CIMT and PLIC-rFA (r = 0.8098, p = 0.0004). A strong linear relationship was observed after CIMT. Conclusion: These data support PLIC-rFA as a new marker of the CIMT-induced improvement in motor function (F-M). HubMed – rehab


Just how bad is it? Comparison of the mental health of Mexican traumatic brain injury caregivers to age-matched healthy controls.

NeuroRehabilitation. 2013 Jan 1; 32(3): 679-86
Perrin PB, Stevens LF, Villaseñor Cabrera T, Jimenez-Maldonado M, Martinez-Cortes ML, Arango-Lasprilla JC

To compare the mental health of family caregivers of individuals with Traumatic brain injury (TBI) to an age-matched healthy control from Guadalajara, Mexico.Hospital Civil Fray Antonio Alcade, a public medical facility in Guadalajara, Mexico.Ninety family caregivers of individuals with TBI and 89 healthy controls (n = 179) did not differ with respect to age, sex, marital status, education, or household income.Outcome measures assessed satisfaction with life (Satisfaction with Life Scale), depression (Patient Health Questionnaire-9), social support (Interpersonal Support Evaluation List), self-esteem (Rosenberg Self-Esteem Scale), and anxiety (State-Trait Anxiety Inventory).A multivariate analysis of variance found that in comparison to controls, TBI caregivers reported substantially lower mental health scores across all indices, as well as lower social support in two out of three comparisons. The effect sizes of the social support differences were small; two out of five mental health differences reached medium-sized effects; and the other three reached large-sized effects.Because TBI caregivers’ mental health influences the quality of informal care they can provide, mental health interventions for family caregivers are an extremely important part of TBI rehabilitation in Latin America, especially considering familism as a core value in Latino culture. HubMed – rehab