Predictors of Patient-Reported Recovery From Motor or Sensory Deficits Two Years After Acute Symptomatic Lumbar Disk Herniation.

Predictors of Patient-Reported Recovery From Motor or Sensory Deficits Two Years After Acute Symptomatic Lumbar Disk Herniation.

Filed under: Rehab Centers

PM R. 2012 Nov 13;
Suri P, Rainville J, Gellhorn A

OBJECTIVE: To determine the prevalence of patient-reported recovery from motor or sensory deficits over 2 years of follow-up after acute symptomatic lumbar disk herniation and to identify predictors of perceived recovery. DESIGN: A prospective inception cohort. SETTING: An outpatient spine clinic. PATIENTS: Consecutive adults with lumbosacral radicular syndrome (onset ?12 weeks) due to symptomatic lumbar disk herniation, confirmed by magnetic resonance imaging: 95 patients with a baseline motor deficit by physical examination and 59 patients with a baseline sensory deficit by physical examination. METHODS: The patients received individualized nonsurgical treatment or, in a minority of cases, surgical treatment. All of the patients underwent a standardized baseline neurologic examination, including motor and sensory testing. Patients with a motor or sensory deficit at the baseline examination reported on whether they perceived persisting weakness or sensory deficits at 1- and 2-year follow-up. We calculated the 1- and 2-year prevalence of patient-reported persisting weakness or sensory deficits. We examined factors associated with perceived recovery from motor or sensory deficits by using bivariate analyses and multivariate logistic regression. RESULTS: Among patients with a baseline motor deficit, the prevalence of patient-reported continuing weakness was 38% at 1 year and 25% at 2 years. Among patients with a baseline sensory deficit, the prevalence of patient-reported continuing sensory deficits was 53% at 1 year and 47% at 2 years. A positive straight leg raise test (odds ratio [OR] 0.26 [95% confidence interval (CI) 0.08-0.83]) and opioid use (OR 0.24 [95% CI 0.06-0.83]) were independently and negatively predictive of patient-reported motor recovery. Female gender was independently and negatively predictive of patient-reported sensory recovery (OR 0.20 [95% CI 0.04-0.99]). CONCLUSIONS: Patient-reported recovery from motor deficits after lumbar disk herniation occurs for 75% of patients over 2 years, but recovery from sensory deficits over this time frame occurs in only 53% of patients. A positive straight-leg raise test and female gender may predict poor recovery from motor and sensory deficits, respectively.
HubMed – rehab

Rehabilitation of edentulous posterior atrophic mandible: inferior alveolar nerve lateralization by piezotome and immediate implant placement.

Filed under: Rehab Centers

Int J Oral Maxillofac Surg. 2012 Nov 12;
Fernández Díaz JO, Naval Gías L

The height and consistency of the bone tissue located above the inferior alveolar nerve (IAN) represents an important challenge when a patient’s atrophied posterior mandible is rehabilitated with an osseointegrated implant. Usually, the surgical reconstruction of atrophic ridges is performed using several different techniques. The purpose of this study is to demonstrate the effectiveness and safety of the inferior alveolar nerve lateralization (IANL) technique performed with ultrasonic cutting technology (piezotome). To demonstrate this, 38 osseointegrated implants (11-15mm in length) were performed during 19 procedures on 15 different patients. After 8 weeks, 14 of those 15 patients (18 of 19 sites: 94.73%) showed normal IAN function. The implant success rate was 97.36%.
HubMed – rehab

The re-construction of women’s sexual lives after pelvic radiotherapy: A critique of social constructionist and biomedical perspectives on the study of female sexuality after cancer treatment.

Filed under: Rehab Centers

Soc Sci Med. 2012 Nov 6;
White ID, Faithfull S, Allan H

Pelvic radiotherapy creates physical effects and psychological responses that negatively affect the sexual health of women and couples, yet these sexual consequences are not frequently researched or clinically assessed. This focused ethnographic study explored factors that influence the clinical assessment of treatment-induced female sexual difficulties after pelvic radiotherapy within routine medical follow-up. Participant observation of follow-up clinics (n = 69) and in-depth interviews with 24 women, 5 partners and 20 health professionals were undertaken at two cancer centres in the South East of England from 2005 to 2006. Thematic analysis of interview transcripts resulted in five emergent themes, two of which are explored in detail within this paper. A social constructionist approach to human sexuality was used to explore representations of female sexuality in oncology follow-up constructed by clinicians, women and their partners. Yet neither social constructionist nor biomedical (the predominant model in medical follow-up) perspectives on human sexuality provided an adequate interpretation of these study findings. This paper argues that the comprehensive study and practice of sexual rehabilitation in oncology requires a synthesis of both biomedical and social constructionist perspectives in order to capture the complex, subjective and embodied nature of the female sexual response in both health and illness.
HubMed – rehab

Global Report 10 oct 2009 – Afghan leaders condemn bomb blast near Indian embassy in Kabul “The site of the blast that shook the Interior Ministry Square near the Indian Embassy in Kabul on Thursday was visited by prominent dignitaries who condemned the act calling it an act of cowardice and of the enemies of Afghan Indian Friendship. Amongst the visitors the Afghan Interior Minister Muhammad Haneef Atmar avoided a premature judgment calling it the act of enemies of the people of Afghanistan, Afghan Foreign Minister Rangin Dadfar Spanta accompanied by the Indian Ambassador to Afghanistan while condemning the act termed it as an act committed by the enemies of Afghan-Indian friendship. In the meantime, a statement released by the Presidential Palace condemned the act in the strongest possible terms. Kabul police has launched an investigation into the matter however, they didnt rule out the role of Pakistani intelligence agency ISI in the attack. Previously Indian Embassy was the target of a suicide attack which was also blamed on ISI of Pakistan.” Mexican drug violence targets addicts and rehab workers Tangled in the front line trenches of Mexican President Felipe Calderon’s anti-narcotics campaign are the country’s growing legions of addicts, who find themselves sought by gangsters as both customers and sometime targets of their violence. Cheap and plentiful narcotics have flooded the country as producers and traffickers have sought to open new markets for cocaine, heroin, methamphetamine and other …

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