Cardenasogden1362

This article outlines a practical approach to quickly implementing virtual care for physiatrists. This skill is relevant not only during times of a pandemic, when face to face care is impossible, but is also valuable when caring for patients who have physical, financial, logistic, or other challenges to on-site care. Key themes covered in this article include selecting appropriate virtual care platforms, consenting patients for virtual care and conducting successful virtual visits. It also reviews strategies for performing virtual physical exams and engaging learners in virtual care.OBJECTIVE To compare the effectiveness of concentrically-focused resistance training (CNCRT) to eccentrically-focused resistance training (ECCRT) on physical function and functional pain in knee osteoarthritis (OA). DESIGN Randomized, single-blinded controlled four-month trial. Older adults with knee OA (N=88; 68.3±6.4 yr, 30.4±6.9 kg/m and 67.4% women) were randomized to ECCRT, CNCRT or no-exercise control (CON). Main outcomes included chair rise time, stair climb time, six-minute walk test distance, temporalspatial parameters of gait, community ambulation and functional pain. RESULTS Leg muscle strength improved in both training groups compared to CON. There were no significant group x time interactions for any functional performance score (chair rise time, stair climb time, six-minute walk test distance, gait parameters, community ambulation). Compared to CON, functional pain scores were reduced for chair rise (-38.6% CNCRT, -50.3% ECCRT vs +10.0%) and stair climb (-51.6% CNCRT, -41.3% ECCRT vs +80.7%; all p less then 0.05). Pain scores were reduced during the six-minute walk and in early recovery with CNCRT compared to the remaining two groups (p less then 0.05). CONCLUSION Either resistance exercise type improves activity-related knee OA pain, but CNCRT more effectively reduced severity of ambulatory pain and pain upon walking cessation.PURPOSE OF REVIEW Tuberculous meningitis (TBM) is associated with significant mortality and morbidity yet is difficult to diagnose and treat. We reviewed original research published in the last 2 years, since 1 January 2018, which we considered to have a major impact in advancing diagnosis, treatment and understanding of the pathophysiology of TBM meningitis in children and adults. RECENT FINDINGS Studies have sought to identify a high sensitivity diagnostic test for TBM, with new data on modified Ziehl--Neelsen staining, urinary and cerebrospinal fluid (CSF) lipoarabinomannan and GeneXpert Ultra. Recent studies on CSF biomarkers provide a better understanding of the detrimental inflammatory cascade and neuromarkers of brain damage and suggest potential for novel host-directed therapy. Tryptophan metabolism appears to affect outcome and requires further study. Increased clinical trials activity in TBM focuses on optimizing antituberculosis drug regimens and adjuvant therapy; however, there are few planned paediatric trials. SUMMARY Tuberculous meningitis still kills or disables around half of sufferers. Although some progress has been made, there remains a need for more sensitive diagnostic tests, better drug therapy, improved management of complications and understanding of host-directed therapy if outcomes are to improve.PURPOSE OF REVIEW This review describes the gaps in cancer patient information and comprehension and provides examples of interventions aimed at filling the gaps. RECENT FINDINGS Despite the technologically advanced era, unmet information needs remain a challenge in current cancer care, even though the beneficial effects of adequate information provision are well described.It starts with the basics of patient-physician communication and information exchange. Barriers are described both patient and physician-specific. For patients to comprehend and recall information correctly, information provision should be tailored to the specific patient in content, as well as in readability level. Tailored content based on bidirectional and iterative information exchange (i.e., patients reported outcomes, followed by specific/personalized feedback) is of focus in the current development of interventions aimed at meeting the gaps. However, the effects of such interventions are not overwhelming and the explanation could be multifactorial. SUMMARY Unmet informational needs are still a gap in current cancer care. The effect of eHealth interventions is not yet well established. Key is to educate patients and (future) healthcare professionals in eHealth. Future research should focus on identifying what kind of interventions are able to fill the gaps.Having responded well to an antidepressant I was determined to continue treatment for 6 months, to increase the probability of a full and lasting recovery. My productivity at work and confidence in social situations increased and it seemed easier to talk about emotional matters. Side effects became gradually less bothersome, though at times I was somewhat apathetic. Escitalopram may have helped to reduce long-standing back pain and niggly acoustic problems. Some symptoms appeared whilst I reduced the antidepressant dosage steadily these were mild and resolved swiftly, but a few were quite puzzling. I hope this experience will enhance my understanding of the concerns of patients as they approach the end of a course of medication, and contribute to discussions of how to assess and manage symptoms that occur on and after stopping antidepressant treatment.Hallucinations are important diagnostic symptoms in schizophrenia, but also occur in other medical and neuropsychiatric conditions. SM-102 research buy Not all patients with hallucinations are psychotic. There has been a surge of interest in the topic of hallucinations, as new research data have begun to reveal their neurobiology. Hallucinogenic molecules may also serve as new scaffolds for the development of new psychotropic drugs. We searched and reviewed recent literature, focusing on the refinement of clinical management, which was inspired by new data regarding the neurobiology of hallucination subtypes. We concluded that the successful management of hallucinations depends on accurate differential diagnosis to identify subtypes, which would then determine the most appropriate treatment.