Bernsteinslater5522

Context Patients with spinal cord injury (SCI) often require tracheostomy as an immediate life-saving measure. Successful decannulation, or removal of the tracheostomy, improves patient quality of life, function, and physical appearance and is considered an important rehabilitative milestone for SCI patients. Objective We sought to synthesize the existing published literature on SCI patients undergoing decannulation. Methods Ovid MEDLINE, Embase, Web of Science, CINAHL, and Cochrane Central Register of Controlled Trials were systematically searched through July 2, 2019 using appropriate keywords and MeSH terms pertaining to tracheostomy and SCI. Searches were human-subject only without language restrictions. Published literature discussing the outcomes of SCI patients who underwent decannulation were screened using inclusion/exclusion criteria determined a priori and reviewed. Results Twenty-six publications were eligible for review and synthesis out of 1,493 unique articles. Over half of the studies were retrospective case series or reports. The research was nearly all published within the fields of physical medicine and rehabilitation, neurology, and pulmonary/critical care. Three themes emerged from review (1) interdisciplinary or multidisciplinary tracheostomy team management to optimize decannulation processes, (2) non-invasive intermittent positive-pressure ventilatory support instead of tracheostomy-based ventilator support, and (3) wide variation in the reporting of post-decannulation clinical outcomes. Conclusion Published research lacks a consistent taxonomy for reporting post-decannulation outcomes in SCI patients. Non-invasive ventilation research could benefit many SCI patients but has been studied in depth primarily by a single authorship group. Further investigation into the socioeconomic and fiscal impact on tracheostomies on SCI patients is warranted.

Intermittent theta-burst stimulation (iTBS) has been suggested to improve poststroke rehabilitation. The cerebellum is considered crucial for motor control. However, the effects of cerebellar iTBS with routine physical therapy on balance and motor recovery in subacute and chronic stroke patients have not been explored.

To measure the short-term effects of cerebellar iTBS with physiotherapy on the balance and functional outcomes in subacute and chronic stroke patients with hemiparesis.

Thirty hemiparetic patients were recruited for this randomized, double-blinded, sham-controlled trial, and randomized into either the treatment or sham group. TPX-0005 supplier Both groups participated in physiotherapy 5 times per week for 2 weeks, and cerebellar iTBS or sham iTBS was performed daily, immediately before physiotherapy. The primary outcome was the Berg balance scale (BBS) score. Secondary outcomes included the trunk impairment scale (TIS) score, Fugl-Meyer assessment scale score for lower extremities (FMA-LE), Barthel index (BI), and corticospinal excitability, as measured by transcranial magnetic stimulation. The outcomes were measured before and 1 week and 2 weeks after the intervention.

Compared with those at baseline, significant increases were identified in all clinical scores (BBS, TIS, FMA-LE, and BI) in both groups after the 2-week intervention. The BBS and TIS scores improved more in the iTBS group than in the sham group.

Cerebellar iTBS with physiotherapy promotes balance and motor recovery in poststroke patients. Therefore, this method can be used in low-cost, fast, and efficient protocols for stroke rehabilitation (Chinese Clinical Trial Registry ChiCTR1900026450).

Cerebellar iTBS with physiotherapy promotes balance and motor recovery in poststroke patients. Therefore, this method can be used in low-cost, fast, and efficient protocols for stroke rehabilitation (Chinese Clinical Trial Registry ChiCTR1900026450).Western theories are often universalized, with non-Western experiences serving as empirical data for validation. The sociology of homosexuality suffers from this predicament. This article proposes a transnational queer sociology that challenges the dominance of the Western sociology of homosexuality, generates mutually referenced queer experiences that are often missing in the study of the globalization of sexuality, and engages sociology with queer theory by bringing material and textual analyses together in understanding sexualities. Through meta-analysis of the existing literature, the article conceptualizes the early histories of tongzhi (LGBT+) identities in three Chinese societies Hong Kong and Taiwan (1980s and 1990s) and China (late 1990s and early 2000s). It demonstrates that the formation of those identities in such periods respectively was the result of both differential Western impacts and mutually referencing effects among the three locales. The article thus provincializes Western sexual knowledge and provides nuanced analysis of the heterogeneity of contemporary Chinese homosexualities.A program evaluation of undergraduate nursing curricula content was completed and survey developed to assess undergraduate nursing students' knowledge about interpersonal violence. Students electively answered a 43-question survey regarding interpersonal violence as a public health problem. The sample included 104 traditional and accelerated undergraduate nursing students. Increasing scores during undergraduate program enrollment suggests that students receive some content on violence from the undergraduate curriculum. This study provides data about curricular deficits and proposes content revisions to prepare nursing students to address violence in patient populations.Context A patient followed in the outpatient spinal cord injury support clinic at a VA Medical Center with a prior remote history of a gunshot wound to the back and multiple prior myelograms presented with a recurrent waxing and waning weakness of the left lower extremity and intermittent incontinence of bowel and bladder. Findings During the evaluation, the patient experienced an immediate albeit temporary improvement in symptoms after a diagnostic lumbar puncture performed for CT myelogram. link2 The symptoms of myelopathy reoccurred several weeks, but then the patient had a similar experience with rapid improvement in symptoms after an accidental fall down a flight of steps. Subsequently, the foot weakness and incontinence returned one week later. The patient ultimately developed permanent improvement in signs and symptoms after surgical intervention which included intradural lysis of adhesions, incision of the arachnoid membrane and resection of a cystic lesion. Clinical relevance Patients who experience unexpected, albeit transient improvement in myelopathic symptoms who are known or suspected to have arachnoiditis should be evaluated for surgically remediable lesions. Remediation of these lesions can potentially improve long term outcome.The myotendinous junction (MTJ) is at high risk of muscle injury, and collagen XXII is strictly expressed at tissue junctions, specifically at the MTJ. We investigated the hypothesis that single-nucleotide polymorphisms (SNPs) related to collagen type XXII α-1 chain gene (COL22A1) mRNA expression are associated with susceptibility to muscle injury in athletes. History of muscle injury was assessed in 3,320 Japanese athletes using a questionnaire, and two expression quantitative trait loci (eQTL) SNPs for COL22A1 (rs11784270 A/C and rs6577958 T/C) were analyzed using the TaqMan SNP Genotyping Assay. rs11784270 [odds ratio (OR) = 1.80, 95% confidence interval (CI) = 1.27-2.62, P = 0.0006] and rs6577958 (OR = 1.45, 95% CI = 1.10-1.94, P = 0.0083) were significantly associated with muscle injury under A and T allele additive genetic models, respectively. These results suggest that the expression level of COL22A1 at the MTJ influences muscle injury risk in athletes.Background There is sparse literature evidence evaluating the applicability of the GLI-2012 spirometric norms for Australian Aboriginal adults. Methods Lung function parameters (LFPs) were compared between Australian Aboriginal and Australian Caucasians, and the fit of Australian Aboriginals LFPs with various ethnic GLI equations was tested. Results Of 1350 and 5634 Pulmonary function tests (PFTs) in Australian Aboriginal and Australian Caucasian adults, 153 and 208 PFTs matched for anthropometrics and normal chest radiology, respectively. Absolute FVC and FEV1 values were 20% lower in Australian Aboriginals compared to Australian Caucasians. Differences remained significant after accounting for age, sex, height, weight and smoking status in multivariate regression (FVC -0.84 L (-0.98, -0.71), FEV1 - 0.72 L (-0.84, -0.59), but with nearly preserved FEV1/FVC. GLI-2012 transformation resulted in z-scores significantly below zero for each of FVC, FEV1 and FEV1/FVC with z-scores ranging from -4.52 (-4.87, -4.16) for North East Asian FVC transformation for males, to -0.34 (-0.73, 0.05) for Black FVC transformation for females. Conclusions Australian Aboriginal adults had 20% lower values for FVC and FEV1 but nearly preserved absolute FEV1/FVC in comparison to Australian Caucasians. The GLI-2012 spirometric norms do not appear to fit for Australian Aboriginal adults regardless of which ethnicity options selected, including 'others/mixed'.Objective To investigate the prevalence of rotator cuff and long head of the biceps pathologies in manual wheelchair (MWC) users with spinal cord injury (SCI). Design Cross-sectional study. Setting Outpatient clinic at a tertiary medical center. Participants Forty-four adult MWC users with SCI (36 men and 8 women) with an average age (SD) of 42 (13) years. SCI levels ranged from C6 to L1; complete and incomplete SCI. Outcome Measures Participants' demographic and anthropometric information, presence of shoulder pain, Wheelchair User's Pain Index (WUSPI) scores, and magnetic resonance imaging findings of shoulder pathologies including tendinopathy, tendon tears, and muscle atrophy. Results Fifty-nine percent of the participants reported some shoulder pain. The prevalence of any tendinopathy across the rotator cuff and the long head of biceps tendon was 98%. The prevalence of tendinopathy in the supraspinatus was 86%, infraspinatus was 91%, subscapularis was 75%, and biceps was 57%. The majority of tendinopathies had mild or moderate severity. The prevalence of any tears was 68%. The prevalence of tendon tears in the supraspinatus was 48%, infraspinatus was 36%, subscapularis was 43%, and biceps was 12%. The majority of the tears were partial-thickness tears. Participants without tendon tears were significantly younger (P  less then  0.001) and had been wheelchair user for a significantly shorter time (P = 0.005) than those with tendon tears. Conclusion Mild and moderate shoulder tendinopathy and partial-thickness tendon tears were highly prevalent in MWC users with SCI. Additionally, the findings of this study suggest that strategies for monitoring shoulder pathologies in this population should not be overly reliant on patient-reported pain, but perhaps more concerned with years of wheelchair use and age.Objective In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance. Design Cross-sectional study. Setting Rehabilitation research laboratory and WR court. link3 Participants Eleven WR athletes with tetraplegia. Interventions ES was applied to the rectus abdominis, obliquus externus abdominis and erector spinae muscles. For every test, the ES condition was compared to the non-ES condition. Outcome measures Stability was assessed with reaching tasks, arm force/power with an isokinetic test on a dynamometer, BP during an ES protocol and WR skill performance with the USA Wheelchair Rugby Skill Assessment. Results Overall reaching distance (ES 14.6 ± 7.5 cm, non-ES 13.4 ± 8.2 cm), and BP showed a significant increase with ES.