Rehab Centers: Spasticity in Multiple Sclerosis: Results of a Spanish Patient Survey.

Spasticity in multiple sclerosis: results of a Spanish patient survey.

Filed under: Rehab Centers

Int J Neurosci. 2013 Jan 9;
Oreja-Guevara C, González-Segura D, Vila C

Abstract Information regarding the epidemiology of spasticity in patients with multiple sclerosis (MS) in Spain is limited. This cross-sectional survey-based study was undertaken to evaluate the symptoms, severity and consequences of MS-related spasticity (MSS), and to estimate the prevalence of MSS overall and according to the degree of severity (mild/moderate/severe). Adult MS patients (n = 8463) from the two main Spanish MS patients’ associations were asked to complete a web-based questionnaire. 2627 responses were received of which 2029 were valid for analysis. Two-thirds were for women. The mean age of respondents was 40.2 years and the mean MS duration was 8.7 years. MSS was reported by 65.7% of respondents with 40% of these rating it as moderate/severe. MS patients with spasticity experienced more symptoms (including greater difficulty walking), consumed more healthcare resources (including care and rehabilitation sessions), and had a higher degree of disability than patients without spasticity. There was a significant correlation between increasing severity of spasticity and worsening of symptoms. Only 42.4% of patients with moderate spasticity and 52.6% of patients with severe spasticity were currently receiving antispasticity medication compared with 69% and 79%, respectively, reported in a similar survey-based study from the US; this is likely to reflect regional variations in practice. Early and effective treatment of MSS is important to minimise the consequences of spasticity-related symptoms on patients’ quality of life and the economic burden on healthcare systems. In appropriate patients, antispastic treatment including pharmacotherapy and physiotherapy/rehabilitation may provide such benefits. An overview of the 6E study was presented as a poster at the 5th Triennial Congress of the European and Americas Committees for Treatment and Research in Multiple Sclerosis (ECTRIMS/ACTRIMS). 19-22 October 2011, Amsterdam, The Netherlands.
HubMed – rehab

Hospital readmission after a pancreaticoduodenectomy: an emerging quality metric?

Filed under: Rehab Centers

HPB (Oxford). 2013 Feb; 15(2): 142-8
Kastenberg ZJ, Morton JM, Visser BC, Norton JA, Poultsides GA

Hospital readmission has attracted attention from policymakers as a measure of quality and a target for cost reduction. The aim of the study was to evaluate the frequency and patterns of rehospitalization after a pancreaticoduodenectomy (PD).The records of all patients undergoing a PD at an academic medical centre for malignant or benign diagnoses between January 2006 and September 2011 were retrospectively reviewed. The incidence, aetiology and predictors of subsequent readmission(s) were analysed.Of 257 consecutive patients who underwent a PD, 50 (19.7%) were readmitted within 30 days from discharge. Both the presence of any post-operative complication (P = 0.049) and discharge to a nursing/rehabilitation facility or to home with health care services (P = 0.018) were associated with readmission. The most common reasons for readmission were diet intolerance (36.0%), pancreatic fistula/abscess (26.0%) and superficial wound infection (8.0%). Nine (18.0%) readmissions had lengths of stay of 2 days or less and in four of those (8.0%) diagnostic evaluation was eventually negative.Approximately one-fifth of patients require hospital readmission within 30 days of discharge after a PD. A small fraction of these readmissions are short (2 days or less) and may be preventable or manageable in the outpatient setting.
HubMed – rehab

Detecting performance invalidity in children: Not quite as easy as A, B, C, 1, 2, 3 but automatized sequences appears promising.

Filed under: Rehab Centers

Child Neuropsychol. 2013 Jan 9;
Kirkwood MW, Connery AK, Kirk JW, Baker DA

In adult populations, embedded performance validity indicators are well established, as they are time efficient, resistant to coaching, and allow for more continuous monitoring of effort than standalone measures. Although several recent studies have demonstrated the appropriateness of using standalone validity tests with school-age children, a paucity of pediatric work has examined embedded indicators. The present study investigated the value of a simple automatized sequences task to detect performance invalidity in 439 clinically referred patients with mild head injury aged 8 through 17 years. Sixteen percent of the participants failed the Medical Symptom Validity Test (MSVT). Thirteen percent failed the MSVT and also performed below established cutoffs on either the Test of Memory Malingering or Wechsler Digit Span subtest. The group classified as providing invalid data performed significantly worse than the group passing the MSVT across all sequencing conditions. Sensitivity and specificity for the total time on the sequencing task compared favorably to data produced for many respected adult-based embedded indicators (i.e., sensitivity around 50% when specificity ? 90%). Classification statistics for any embedded performance validity test can be expected to be worse in more severely affected populations; however, the current sequencing task appears to have value in detecting invalid performance in relatively high-functioning older children and adolescents. The fact that the task takes less than a couple of minutes to administer makes it especially appealing.
HubMed – rehab

Intergenerational Health Responses to Adverse and Enriched Environments.

Filed under: Rehab Centers

Annu Rev Public Health. 2013 Jan 7;
Bygren LO

Health consequences of relative or absolute poverty constitute a definitive area of study in social medicine. As demonstrated in the extreme example of the Dutch Hunger Winter from 1944 to 1945, prenatal hunger can lead to adult schizophrenia and depression. A Norwegian study showed how childhood poverty resulted in a heightened risk of myocardial infarction in adulthood. In England, a study of extended impaired prenatal nutrition indicated three different types of increased cardiovascular risk at older ages. Current animal and human studies link both adverse and enriched environmental exposures to intergenerational transmission. We do not fully understand the molecular mechanisms for it; however, studies that follow up epigenetic marks within a generation combined with exploration of gametic epigenetic inheritance may help explain the prevalence of certain conditions such as cardiovascular disease, schizophrenia, and alcoholism, which have complex etiologies. Insights from these studies will be of great public health importance. Expected final online publication date for the Annual Review of Public Health Volume 34 is March 17, 2013. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
HubMed – rehab

Jacksonville Drug and Alcohol Rehab Centers (904) 274-3303 – jacksonvilledrugandalcoholrehabprogram.com Alcohol Drug Rehab Jacksonville (904) 274-3303 is a provider of the best treatment programs and facilities for alcohol, drug, meth, cocaine, heroin or prescription drug addiction.

More Rehab Centers Information…