Rehab Centers: Outcomes of Surgical Aortic Valve Replacement in Octogenarians.
Outcomes of Surgical Aortic Valve Replacement in Octogenarians.
Filed under: Rehab Centers
Heart Lung Circ. 2013 Feb 16;
Harris RS, Yan TD, Black D, Bannon PG, Bayfield MS, Hendel PN, Wilson MK, Vallely MP
BACKGROUND: In the era of TAVI, there has been renewed interest in the outcomes of conventional AVR for high-risk patients. This study evaluates the short- and long-term outcomes of AVR in octogenarians. METHODS: A retrospective review was performed of all 117 patients aged ?80 years who underwent AVR, (isolated AVR (n=60) or AVR+CABG (n=57),) from August 2005 to February 2011 at Royal Prince Alfred Hospital and Strathfield Hospital. Univariate analysis was used to compare pre- and post-operative variables between younger and older subgroups (age 80-84, n=82; age 85-89, n=35 respectively). Long-term survival data was obtained from the National Death Index at the Australian Institute of Health and Welfare and survival curves were constructed using the Kaplan-Meier method. RESULTS: The median age was 83 years (interquartile range, 81-85 years), 46.2% were females, the median EuroSCORE was 10.89% (interquartile range, 8.20-16.45%) and 16.2% of patients had a EuroSCORE ?20%. The difference between subgroups for history of stroke was significant (p=.042). Post-operative complications included pleural effusion (12.8%), new renal failure (4.3%) and respiratory failure (4.3%). The rate of major adverse events was extremely low, with no cases of stroke. The 30-day mortality rate was 3.4%. There was a significant difference between subgroups for 30-day mortality (p=.007). 38.9% of patients were discharged home, 11.5% were transferred to another hospital and 38.9% spent a period of time in a rehabilitation institution post discharge. In terms of long-term survival, the six-month, one-year and three-year survival was 95.6%, 87.6% and 58.4% respectively. CONCLUSIONS: Surgical AVR yields excellent short- and long-term outcomes for potentially high-risk, elderly patients.
HubMed – rehab
The effect of transcranial direct current stimulation on the motor suppression in stop-signal task.
Filed under: Rehab Centers
NeuroRehabilitation. 2013 Jan 1; 32(1): 191-6
Kwon JW, Nam SH, Lee NK, Son SM, Choi YW, Kim CS
This study examined whether transcranial direct current stimulation (tDCS) of the primary motor cortex alters the response time in motor suppression using the stop-signal task (SST).Forty healthy subjects were enrolled in this study. The subjects were assigned randomly to either the tDCS condition or sham control condition. All subjects performed a stop-signal task in three consecutive phases: without, during or after the delivery of anodal tDCS on the primary motor cortex (the pre-tDCS motor phase, on-tDCS motor phase, and after-tDCS motor phase).The response times of the stopping process were significantly lower in each SST motor phase during or after tDCS (p < 0.05) and shorter immediately during delivery of the tDCS, whereas there was no change after the delivery of tDCS compared to sham condition. In contrast, the response times of the going process were similar under the two conditions (p > 0.05). No subjects complained of any adverse symptoms or signs.Anodal tDCS enhances voluntary going and stopping of movement in executive control. tDCS appears to be an effective modality to modulate motor suppression and its related dynamic behavioral changes in motor sequential learning.
HubMed – rehab
Study of accent-based music speech protocol development for improving voice problems in stroke patients with mixed dysarthria.
Filed under: Rehab Centers
NeuroRehabilitation. 2013 Jan 1; 32(1): 185-90
Kim SJ, Jo U
Based on the anatomical and functional commonality between singing and speech, various types of musical elements have been employed in music therapy research for speech rehabilitation. This study was to develop an accent-based music speech protocol to address voice problems of stroke patients with mixed dysarthria. Subjects were 6 stroke patients with mixed dysarthria and they received individual music therapy sessions. Each session was conducted for 30 minutes and 12 sessions including pre- and post-test were administered for each patient. For examining the protocol efficacy, the measures of maximum phonation time (MPT), fundamental frequency (F0), average intensity (dB), jitter, shimmer, noise to harmonics ratio (NHR), and diadochokinesis (DDK) were compared between pre and post-test and analyzed with a paired sample t-test. The results showed that the measures of MPT, F0, dB, and sequential motion rates (SMR) were significantly increased after administering the protocol. Also, there were statistically significant differences in the measures of shimmer, and alternating motion rates (AMR) of the syllable /K$ \inve$ / between pre- and post-test. The results indicated that the accent-based music speech protocol may improve speech motor coordination including respiration, phonation, articulation, resonance, and prosody of patients with dysarthria. This suggests the possibility of utilizing the music speech protocol to maximize immediate treatment effects in the course of a long-term treatment for patients with dysarthria.
HubMed – rehab
Differential language trajectories following treatment for pediatric posterior fossa tumor: An investigation of four cases.
Filed under: Rehab Centers
NeuroRehabilitation. 2013 Jan 1; 32(1): 165-83
Lewis FM, Murdoch BE
Up to 85% of children treated for brain tumor survive beyond five years; hence optimizing quality of life in survivorship has become a priority. As multiple factors contribute to the heterogeneity of neurocognitive and language outcomes for individual children following treatment, a means of monitoring subsequent development is needed for the individual child, particularly when pre-morbid performance indices are not available. The current study investigated the use of developmental language trajectories as a means of monitoring language development subsequent to treatment for tumors located within the posterior fossa. The language skills of four children treated for posterior fossa tumor (PFT) were monitored over time (range of monitoring: 2-6 years) and the resultant trajectories were plotted against the trajectories based on tests’ normative data as well as the trajectories of control children drawn from each child’s local community. Each child’s trajectory was considered in terms of age-appropriate developmental gains and discussed regarding the need for ongoing clinical monitoring of emerging, developing or established language skills. The study’s findings highlight the heterogeneity of language outcomes following PFT. The utility of the application of developmental trajectories for the provision of individualized post-treatment support is discussed.
HubMed – rehab
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