Rehab Centers: Indications and Contraindications of Auditory Brainstem Implants: Systematic Review and Illustrative Cases.

Indications and contraindications of auditory brainstem implants: systematic review and illustrative cases.

Filed under: Rehab Centers

Eur Arch Otorhinolaryngol. 2013 Feb 13;
Merkus P, Lella FD, Trapani GD, Pasanisi E, Beltrame MA, Zanetti D, Negri M, Sanna M

The number of non-neurofibromatosis type 2 (NF2) indications for auditory brainstem implant (ABI) in the literature is increasing. The objective of this study was to analyze and discuss the indications for ABI. Retrospective chart review and systematic review were conducted at Quaternary referral skull base center and referring centers. Analysis of ABI cases with non-NF2 indications and systematic review presenting non-NF2 ABI cases were performed. Fourteen referred cases with ABI were identified. All cases had unsatisfactory results of ABI and all could have been rehabilitated with a cochlear implant (CI). Of these 14 cases, 9 improved with a cochlear implant, and 2 with a hearing aid, two are still planned for CI, one received bilateral CI, no ABI. In literature, we found 31 articles presenting 144 non-NF2 ABI cases with at least 7 different indications other than NF2. ABI should be restricted to those patients who have no other rehabilitation options. Patency of the cochlea and evidence of an intact cochlear nerve should be examined with imaging and electrophysiologic testing. Sometimes a CI trial should be planned prior to proceeding with ABI. We have shown that in many cases a CI is still possible and CI provided better results than ABI. In vestibular schwannoma in the only hearing ear, cochlear otosclerosis, temporal bone fractures, (presumed) bilateral traumatic cochlear nerve disruption, auto-immune inner ear disease and auditory neuropathy primarily CI are indicated. Traumatic bilateral cochlear nerve disruption is exceptionally unlikely. In cochlear nerve aplasia, testing should be performed prior to meeting indications for ABI. In malformations, ABI is indicated only in severe cochlear hypoplasia or cochlear aplasia.
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Comparative population analysis of Klebsiella pneumoniae with extended-spectrum ?-lactamases colonizing patients in rehabilitation centers in four countries.

Filed under: Rehab Centers

Antimicrob Agents Chemother. 2013 Feb 12;
Baraniak A, Izdebski R, Fiett J, Sadowy E, Adler A, Kazma M, Salomon J, Lawrence C, Rossini A, Salvia A, Vidal Samso J, Fierro J, Paul M, Lerman Y, Malhotra-Kumar S, Lammens C, Goossens H, Hryniewicz W, Brun-Buisson C, Carmeli Y, Gniadkowski M,

The international project MOSAR was conducted in five rehabilitation centers; patients were screened for rectal carriage of extended-spectrum ?-lactamase (ESBL)-producing Enterobacteriaceae. Among 229 Klebsiella pneumoniae isolates four clonal groups (CG) or complexes (CC) prevailed: CG17 in France, CG101 in Italy, CG15 in Spain, and CC147 in Israel. ESBLs, mainly CTX-Ms, were produced by 226 isolates; three isolates expressed AmpC-like cephalosporinases. High genetic diversity of K. pneumoniae populations was observed, with specific characteristics at each center.
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Inpatient Utilization Before and After Implementation of Psychosocial Rehabilitation Programs: Analysis of Cost Reductions.

Filed under: Rehab Centers

Psychol Serv. 2013 Feb 11;
Vanmeerten NJ, Harris JI, Nienow TM, Hegeman BM, Sherburne A, Winskowski AM, Schumacher M, Sponheim SR

Research on psychosocial rehabilitation (PSR) interventions generally indicates that these approaches are effective in facilitating improved functioning for persons with serious mental illness (SMI; schizophrenia, schizoaffective disorder, bipolar disorder, and other psychotic disorders). In this quasi-experimental study, we assessed the effectiveness of PSR interventions through a records review of 311 veterans who received outpatient services for SMI. From 2002 to 2008, a midwestern VA Medical Center implemented a number of PSR interventions. By 2008, veterans who used PSR interventions demonstrated reductions in their use of inpatient psychiatric care, whereas veterans who did not access PSR interventions showed no change in inpatient psychiatric care use. Analyses revealed that the provision of PSR services to veterans with SMI who had been hospitalized was associated with decreased duration of hospitalizations and costs savings of $ 17,739 per veteran per year in total mental health care. Findings are consistent with implementation of PSR programs within VA Medical Centers yielding the greatest cost savings through creation of effective outpatient services that reduce inpatient service needs for veterans with SMI. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
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