Recurrent Episodic Hypoxaemic Respiratory Failure Following a Stroke.

Recurrent episodic hypoxaemic respiratory failure following a stroke.

Filed under: Rehab Centers

BMJ Case Rep. 2012; 2012:
Foo AS, Tan ZK, Lee E, Koh NY

A 68-year-old man with no cardiovascular risk factors was admitted with a stroke because of multiple brain infarcts in different vascular territories. He required mechanical ventilation for hypoxia as a result of aspiration pneumonia. Subsequent recovery was hindered by episodic, unexplained hypoxia. Investigations excluded pulmonary embolism, pulmonary hypertension and severe lung diseases. Transthoracic echocardiography (TTE) with saline bubble contrast showed mild, delayed, right-to-left shunting, thought to represent an insignificant, intrapulmonary, non-cardiac shunt. Hypoxic episodes worsened, requiring admission from community rehabilitation hospital to our centre and another period of mechanical ventilation. Elevated alveolar-arterial gradients indicated a non-hypoventilatory cause. Repeat TTE bubble contrast study and transoesophageal echocardiography (TOE) demonstrated a patent foramen ovale (PFO) with large shunt potential, associated with an aneurysmal interatrial septum. This provided a unifying explanation for cryptogenic stroke and recurrent hypoxaemia. After percutaneous PFO closure hypoxic episodes ceased and he returned successfully to rehabilitation.
HubMed – rehab

 

Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms.

Filed under: Rehab Centers

J Rheumatol. 2012 Aug 1;
Emad Y, Ragab Y, Gheita T, Anbar A, Kamal H, Saad A, Darweesh H, El-Shaarawy N, Azab A, Ismail A, Rasker JJ,

OBJECTIVE: This case-control study was designed to evaluate magnetic resonance imaging (MRI) findings of knee joints in patients with psoriasis without clinical peripheral or axial joint involvement, and to correlate MRI findings with disease and demographic variables. METHODS: In total 48 patients with psoriasis and no clinical evidence of synovitis or enthesitis in any peripheral or axial joints were enrolled. A random sample of 20 healthy subjects without knee or other joint complaints and matched for age and sex served as controls. All patients and controls underwent enhanced MRI studies of both knee joints, and MRI findings were compared. RESULTS: Among 48 patients (96 knees), a total of 90 entheseal lesions were detected, with no enthesitis in 2 cases (6.3%). Signs of continuing inflammation bilaterally were frequently found: soft tissue edema (STE; n = 52), bone marrow edema (BME; n = 20), perientheseal BME (n = 3), cartilaginous erosions (n = 42), and bone erosions (n = 27). In controls, 2 (10%) subjects had BME and another 5 (25%) showed cartilaginous erosions. None showed evidence of enthesitis. Significant correlations were observed between the number of entheseal lesions of both knees vs STE (present vs absent; r = 0.314, p = 0.030) and STE (number of lesions; r = 0.351, p = 0.014). Enthesitis (unilateral vs bilateral) was significantly and positively correlated with STE (r = 0.304, p = 0.036), cartilaginous erosions (r = 0.304, p = 0.036), and villous projections (r = 0.347, p = 0.016). CONCLUSION: Subclinical synovitis and enthesitis are frequently found in the knee joint of patients with psoriasis. These may be an early sign of psoriatic arthritis.
HubMed – rehab

 

Multidisciplinary rehabilitation in women following breast cancer treatment: A randomized controlled trial.

Filed under: Rehab Centers

J Rehabil Med. 2012 Aug 1;
Khan F, Amatya B, Pallant JF, Rajapaksa I, Brand C

Objective: To assess the effectiveness of a multidisciplinary ambulatory rehabilitation programme for women following definitive breast cancer treatment in an Australian community cohort. Methods: Eighty-five women in the community randomized to a treatment group (n?=?43) for individualized high-intensity programme, or a control group (n?=?42) comprising usual activity. The primary outcome Depression Anxiety Stress Scale (DASS) scale measured restriction in participation. Secondary measures included Perceived Impact Problem Profile (PIPP) and Cancer Rehabilitation Evaluation System Short-Form (CARES-SF); and Functional Independence Measure (FIM) motor subscale for activity limitation. Assessments were at baseline and 4 months. Results: Intention-to-treat analysis of data showed a significant difference between both groups in DASS Depression scores (p = 0.006) (moderate effect size, r?>?0.3), PIPP Mobility (p?=?0.05) and Participation (p?= 0.04) scales, and CARES-SF Global score (p = 0.02) (small effect size, r?HubMed – rehab

 

Assessing stroke patients for rehabilitation during the acute hospitalization: findings from the Get With The Guidelines-Stroke Program.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2012 Jul 30;
Prvu Bettger JA, Kaltenbach L, Reeves MJ, Smith EE, Fonarow GC, Schwamm LH, Peterson ED

OBJECTIVE: To examine the frequency and determinants of an assessment for rehabilitation during the hospitalization for acute stroke. DESIGN: Prospective cohort of patients admitted with acute stroke in the Get With The Guidelines (GWTG)-Stroke program from 01/08/2008 to 03/31/2011. SETTING: 1,532 acute hospitals in the United States participating in the GWTG-Stroke program. PARTICIPANTS: Adults with a stroke diagnosis from a GWTG-Stroke participating acute hospital (N=616,982). INTERVENTION: Not applicable MAIN OUTCOME MEASURE: Documentation of an assessment for rehabilitation services during the acute hospitalization. RESULTS: Overall almost 90% of stroke patients had documentation of an acute assessment for rehabilitation. In multivariable analysis, patients significantly more likely to be assessed for rehabilitation were younger, male, Black or of other non-White races (Asian, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander) when compared with White, independently ambulating prior to admission, and admitted from the community. Patients who received a stroke consult, cared for in a stroke unit, and treated in the Northeast region of the United States were also more likely to be assessed. CONCLUSION: There is evidence that rehabilitation was considered for 90% of acute stroke patients in this sample. Future research is needed to examine what assessments are conducted and by whom, and how these are used to determine the appropriate level of rehabilitation care for their needs.
HubMed – rehab

 


 

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CMS to Increase Payments for Inpatient Rehab Facilities

Filed under: Rehab Centers

… as a 0.1 percentage point reduction called for in the Patient Protection and Affordable Care Act. Additionally, the final rate includes a 0.2 percentage point increase to take into account potential decreases in payments to outlier rehab facilities …
Read more on Becker’s Hospital Review

 

Three Extendicare Health Centers Earn National Recognition for Providing High

Filed under: Rehab Centers

The three health centers awarded this recognition include Tendercare Mt. Pleasant Health and Rehab Center in Mt. Pleasant, MI, Cedar Springs Health and Rehabilitation Center in Cedarburg, WI and Medco Center of Hardinsburg in Hardinsburg, KY.
Read more on MarketWatch (press release)

 

Georgetown University, MedStar Rehab Create New Brain Center

Filed under: Rehab Centers

Georgetown University and MedStar National Rehabilitation Network, both in Washington, D.C., announced the creation of the Center for Brain Plasticity and Recovery through a new partnership. The center is dedicated to the study of neural plasticity …
Read more on Becker’s Hospital Review

 

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