Deep Vein Thrombosis and Pulmonary Embolism After Spine Surgery: Incidence and Patient Risk Factors.
Deep Vein Thrombosis and Pulmonary Embolism After Spine Surgery: Incidence and Patient Risk Factors.
Am J Orthop (Belle Mead NJ). 2013 Jun; 42(6): 267-270
Schulte LM, O’Brien JR, Bean MC, Pierce TP, Yu WD, Meals C
Anticoagulation after spine surgery confers the unique risk of epidural hematoma. We sought to determine the incidence of and patient risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) after spine surgery. We retrospectively reviewed the charts of 1485 patients who had spine surgery at a single tertiary-care center between 2002 and 2009. DVT and PE incidence were recorded along with pertinent patient history information. Univariate and multivariate analyses were performed on the data. VTE incidence was 1.1% (DVTs, 0.7%; PEs, 0.4%). Univariate analysis demonstrated that VTEs had 9 positive risk factors: active malignancy, prior DVT or PE, estrogen replacement therapy, discharge to a rehabilitation facility, hypertension, major depressive disorder, renal disease, congestive heart failure, and benign prostatic hyperplasia (P<.05). Multivariate analysis demonstrated 4 independent risk factors: prior DVT or PE, estrogen replacement therapy, discharge to a rehabilitation facility, and major depressive disorder (P>.05). Surgeons with an improved understanding of VTE after spine surgery can balance the risks and benefits of postoperative anticoagulation. HubMed – rehab
Is Pain Intensity Really That Important to Assess in Chronic Pain Patients? A Study Based on the Swedish Quality Registry for Pain Rehabilitation (SQRP).
PLoS One. 2013; 8(6): e65483
Bromley Milton M, Börsbo B, Rovner G, Lundgren-Nilsson A, Stibrant-Sunnerhagen K, Gerdle B
Incorporating the patient’s view on care and treatment has become increasingly important for health care. Patients describe the variety of consequences of their chronic pain conditions as significant pain intensity, depression, and anxiety. We hypothesised that intensities of common symptoms in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. This study has three aims: 1) to determine the importance of different symptoms with respect to participation and ill-health; 2) to identify subgroups based on data concerning important symptoms; and 3) to determine the secondary consequences for the identified subgroups with respect to participation and health factors.This study is based on a cohort of patients referred to a multidisciplinary pain centre at a university hospital (n?=?4645, participation rate 88%) in Sweden. The patients answered a number of questionnaires concerning symptoms, participation, and health aspects as a part of the Swedish Quality Registry for Pain Rehabilitation (SQRP).Common symptoms (such as pain intensity, depression, and anxiety) in patients with chronic pain showed great variability across subjects and 60% of the cohort had normal values with respect to depressive and anxiety symptoms. Pain intensity more than psychological symptoms showed stronger relationships with participation and health. It was possible to identify subgroups based on pain intensity, depression, and anxiety. With respect to participation and health, high depressive symptomatology had greater negative consequences than high anxiety.Common symptoms (such as pain intensity and depressive and anxiety symptoms) in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. HubMed – rehab
“Sightblind”: Perceptual Deficits in the “Intact” Visual Field.
Front Neurol. 2013; 4: 80
Bola M, Gall C, Sabel BA
Unilateral visual cortex lesions caused by stroke or trauma lead to blindness in contralateral visual field – a condition called homonymous hemianopia. Although the visual field area processed by the uninjured hemisphere is thought to be “intact,” it also exhibits marked perceptual deficits in contrast sensitivity, processing speed, and contour integration. Such patients are “sightblind” – their blindness reaches far beyond the primary scotoma. Studies showing perceptual deficits in patients’ intact fields are reviewed and implications of these findings are discussed. It is concluded that consequences of partial blindness are greater than previously thought, since perceptual deficits in the “intact” field likely contribute to subjective vision loss in patients with visual field defect. This has important implications for vision diagnosis and rehabilitation. HubMed – rehab
Reduction of Pain Sensitivity After Somatosensory Therapy in Adults with Cerebral Palsy.
Front Hum Neurosci. 2013; 7: 276
Riquelme I, Zamorano A, Montoya P
Objective: Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP). Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods: Adults with CP participated in the study and were randomly assigned to the intervention (n?=?17) or the control group (n?=?20). The intervention group received a somatosensory therapy including four types of exercises (touch, proprioception, vibration, and stereognosis). All participants were asked to continue their standardized motor therapy during the study period. Several somatosensory (pain and touch thresholds, stereognosis, proprioception, texture recognition) and motor parameters (fine motor skills) were assessed before, immediately after and 3?months after the therapy (follow-up). Results: Participants of the intervention group showed a significant reduction on pain sensitivity after treatment and at follow-up after 3?months, whereas participants in the control group displayed increasing pain sensitivity over time. No improvements were found on touch sensitivity, proprioception, texture recognition, or fine motor skills. Conclusion: Data suggest the possibility that somatosensory therapy was effective in eliciting changes in central somatosensory processing. This hypothesis may have implications for future neuromodulatory treatment of pain complaints in children and adults with CP. HubMed – rehab
qive us our ALCOHOL ! – no we were not drunk ;; jus bored.