International Practice of Laryngectomy Rehabilitation Interventions: A Perspective From South Africa.

International practice of laryngectomy rehabilitation interventions: a perspective from South Africa.

Curr Opin Otolaryngol Head Neck Surg. 2013 Apr 1;
Fagan JJ, Lentin R, Quail G

PURPOSE OF REVIEW: This review reflects on the experience of speech rehabilitation of laryngectomees at the Groote Schuur Hospital in Cape Town and expands on ways of dealing with the challenges that practising in a developing world setting presents. RECENT FINDINGS: Postlaryngectomy speech rehabilitation is unavailable in most African countries because of a profound shortage of speech and language therapists, otolaryngologists, and trained head and neck surgeons, as well as fiscal limitations. This article presents our recent tracheoesophageal speech results; discusses the employment of early postlaryngectomy feeding, selection criteria for patients for tracheoesophageal speech, the choice of voice prosthesis, follow-up care of patients coming from afar; and presents the results of a comparative study of the efficacy of different methods of airway humidification. SUMMARY: Our data and experience illustrate that excellent postlaryngectomy speech results can be achieved in a developing world setting by a dedicated team comprising speech and language therapists and otolaryngologists, that early postlaryngectomy feeding is well tolerated, and that a simple cotton cloth stoma cover is as effective as more expensive heat moisture exchange devices. HubMed – rehab

Patient and Program Characteristics of Early Outpatient Cardiac Rehabilitation Programs in the United States.

J Cardiopulm Rehabil Prev. 2013 Apr 1;
Kaminsky LA, Thur LA, Riggin K

PURPOSE:: The purpose of this study was to perform a brief survey to determine the patient and program characteristics associated with early outpatient cardiac rehabilitation (EOCR) in the United States. METHODS:: To assess these characteristics, a brief survey (13 items, some with multiple responses) was sent by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) to all program administrators or directors on the AACVPR mailing list in 2009. RESULTS:: Responses were received from 138 program administrators or directors in 44 states, accounting for 19 689 patients who completed at least 1 EOCR exercise session. More men (68%) were enrolled in EOCR programs, and the 3 most prevalent primary diagnoses were percutaneous coronary intervention or stent (31%), coronary artery bypass graft surgery (30%), and myocardial infarction (22%). Seventy-two percent of responding programs were AACVPR certified and had staff trained primarily (66%) in either nursing or exercise physiology. Eighty-four percent of the programs offered an outpatient maintenance cardiac rehabilitation program, and 62% were located in a rural setting. CONCLUSIONS:: This study provides valuable information on use and patient demographics of EOCR programs in the United States. This information may be beneficial for health care professionals, health care institutions, third-party payers, and regulatory agencies that seek to quantify health care quality. HubMed – rehab

Prophylactic Effects of Duloxetine on Post-Stroke Depression Symptoms: An Open Single-Blind Trial.

Eur Neurol. 2013 Mar 14; 69(6): 336-343
Zhang LS, Hu XY, Yao LY, Geng Y, Wei LL, Zhang JH, Chen W

Post-stroke depression (PSD) is a common yet severe sequela of stroke, and is often accompanied with somatic symptoms. Duloxetine, a new serotonin-norepinephrine reuptake inhibitor, may help to prevent depression after stroke. 95 ischemic stroke patients without depression were randomly divided into two groups: duloxetine group (n = 47) and control group (n = 48). Patients in the control group received routine ischemic stroke therapy, whereas patients in the duloxetine group received duloxetine (dose range 30-90 mg) for 12 weeks in addition to routine therapy. Follow-up observations lasted for 24 weeks. The Hamilton Depression Scale was used to measure depression, and the National Institute of Stroke Scale, Mini-Mental State Examination, Activities of Daily Living Scale (Chinese version) and Short Form 36 Health Survey Questionnaire were used to assess neurological function, cognitive function, rehabilitation from stroke and quality of life. Results showed that in general, duloxetine spared ischemic stroke patients from both minor and major depression by 16%. In addition, duloxetine helped patients to rehabilitate more rapidly from stroke, and was associated with better cognitive function and quality of life. In conclusion, the prophylactic use of duloxetine not only decreased the incidence of PSD, but also promoted rehabilitation, cognitive function and quality of life. Copyright © 2013 S. Karger AG, Basel. HubMed – rehab

Methodological considerations in longitudinal morphometry of traumatic brain injury.

Front Hum Neurosci. 2013; 7: 52
Kim J, Avants B, Whyte J, Gee JC

Traumatic brain injury (TBI) has recently been reconceptualized as a chronic, evolving disease process. This new view necessitates quantitative assessment of post-injury changes in brain structure that may allow more accurate monitoring and prediction of recovery. In particular, TBI is known to trigger neurodegenerative processes and therefore quantifying progression of diffuse atrophy over time is currently of utmost interest. However, there are various methodological issues inherent to longitudinal morphometry in TBI. In this paper, we first overview several of these methodological challenges: lesion evolution, neurosurgical procedures, power, bias, and non-linearity. We then introduce a sensitive, reliable, and unbiased longitudinal multivariate analysis protocol that combines dimensionality reduction and region of interest approaches. This analysis pipeline is demonstrated using a small dataset consisting of four chronic TBI survivors. HubMed – rehab