Rehab Centers: Cognitive Testing of the WHOQOL-BREF Bangladesh Tool in a Northern Rural Bangladeshi Population With Lymphatic Filariasis.

Cognitive testing of the WHOQOL-BREF Bangladesh tool in a northern rural Bangladeshi population with lymphatic filariasis.

Filed under: Rehab Centers

Qual Life Res. 2013 Jan 1;
Zeldenryk L, Gordon S, Gray M, Speare R, Melrose W, Hossain M, Williams G

PURPOSE: The purpose of this study was to test the cultural suitability of the WHOQOL-BREF Bangladesh for a rural village population in Bangladesh. METHODS: Participants (n = 35) were purposefully stratified for age, gender, education level and location from the Nilphamari district in northern rural Bangladesh. Cognitive interviews were conducted via an emergent probing method to identify issues with language and constructs within the tool. Data were collected through note taking and recordings of interviews. A coding framework was used to identify key issues with questions, which were analysed using SPSS version 19 and Chi-square analysis using a Fisher’s exact test to determine statistically significant variances within the sample. RESULTS: Twenty-two of the 26 questions in the tool were found to be problematic. The majority of problems with questions related to wording and conceptual difficulties. The majority of participants found the tool to be overly formal. Issues with translation appeared to affect the interpretation of a number of questions, and some concepts in the tool were found to be irrelevant in a village setting. There were statistically significant differences between those of different educational backgrounds and between genders. CONCLUSIONS: The study found that the WHOQOL-BREF Bangladesh as it currently stands is not culturally or linguistically suitable for use within a rural northern Bangladeshi population.
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Ten-year Evolution Utilizing Computer-Assisted Reconstruction for Giant Ameloblastoma.

Filed under: Rehab Centers

J Reconstr Microsurg. 2012 Dec 31;
Broer PN, Tanna N, Franco PB, Thanik VD, Levine SM, Garfein ES, Saadeh PB, Ceradini DJ, Hirsch DL, Levine JP

Background?The authors describe our current practice of computer-aided virtual planned and pre-executed surgeries using microvascular free tissue transfer with immediate placement of implants and dental prosthetics.Methods?All patients with ameloblastomas treated at New York University (NYU) Medical Center during a 10-year period from September 2001 to December 2011 were identified. Of the 38 (36 mandible/2 maxilla) patients that were treated in this time period, 20 were identified with advanced disease (giant ameloblastoma) requiring aggressive resection. Reconstruction of the resultant defects utilized microvascular free tissue transfer with an osseocutaneous fibular flap in all 20 of these patients.Results?Of the patients reconstructed with free vascularized tissue transfer, 35% (7/20) developed complications. There were two complete flap failures with consequent contralateral fibula flap placement. Sixteen patients to date have undergone placement of endosteal implants for complete dental rehabilitation, nine of which received immediate placement of the implants at the time of the free flap reconstruction. The three most recent patients received immediate placement of dental implants at the time of microvascular free tissue transfer as well as concurrent placement of dental prosthesis.Conclusions?To our knowledge, this patient cohort represents the largest series of comprehensive computer aided free-flap reconstruction with dental restoration for giant type ameloblastoma.
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Regulated Neuronal Neuromodulation via Spinal Cord Expression of the Gene for the Inwardly Rectifying Potassium Channel 2.1 (Kir2.1).

Filed under: Rehab Centers

Neurosurgery. 2012 Dec 28;
Boulis NM, Handy CR, Krudy CA, Donnelly EM, Federici T, Franz CK, Barrow EM, Teng Q, Kumar P, Cress D

BACKGROUND:: Neuromodulation is used to restore neural function in disorders that stem from an imbalance in the activity of specific neural networks when they prove refractory to pharmacological therapy. The Kir2.1 gene contributes to stabilizing the resting potential below the threshold of activation of voltage gated sodium channels and action potentials. Therefore, the delivery of the Kir2.1 gene to neuronal cells could reduce the probability of action potential generation, inhibiting excessive neural activity. OBJECTIVE:: We focused on the hypothesis that overexpression of the inwardly rectifying potassium channel 2.1 (Kir2.1) gene could inhibit motor neuron activity and, therefore, be therapeutically used in gene-based neuromodulation. METHODS:: In order to induce expression of the Kir2.1, the inducible RheoSwitch™ promoter was used and controlled by ligand. In vivo gene expression was accomplished by an adenoviral vector to deliver unilaterally into the lumbar spinal cord of rats. RESULTS:: Behavioral assays demonstrated that neuromuscular inhibition was exclusive to rats that received the ligand. Histological analysis also showed evidence of some motor neuron loss in these animals. Behavioral effects of Kir2.1 expression were completely reversible, arguing that the behavioral effect did not result from motor neuron death. CONCLUSION:: Delivery of the gene for Kir2.1 inhibits neurons by resisting depolarization to the action potential threshold. Regulated neuronal expression of Kir2.1 may provide an elegant means for neuromodulation in a selected neuronal population.
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