Safety of Lamivudine Treatment for Chronic Hepatitis B in Early Pregnancy.

Safety of lamivudine treatment for chronic hepatitis B in early pregnancy.

Filed under: Rehab Centers

World J Gastroenterol. 2012 Dec 7; 18(45): 6645-50
Yi W, Liu M, Cai HD

To evaluate the safety of lamivudine (LAM) treatment for chronic hepatitis B in early pregnancy.A total of 92 pregnant women who received LAM treatment either before pregnancy or in early pregnancy were enrolled in this study. All of the pregnant women volunteered to take lamivudine during pregnancy and were not co-infected with hepatitis C virus, human immunode?ciency virus, cytomegalovirus, or other viruses. All infants received passive-active immunoprophylaxis with 200 IU hepatitis B immunoglobulin and three doses of 10 ?g hepatitis B vaccines (0-1-6 mo) according to the guidelines for the prevention and treatment of chronic hepatitis B. Adverse events were observed throughout the entire pregnancy and perinatal period, and the effectiveness of lamivudine treatment for blocking mother-to-infant transmission of hepatitis B virus (HBV) was evaluated. All adverse events in mothers and infants during pregnancy and the perinatal period and the HBV mother-to-infant transmission blocking rate were compared with the literature.Among the 92 pregnant women, spontaneous abortions occurred in 11 cases, while 3 mothers had a second pregnancy after the initial abortion; 72 mothers delivered 73 live infants, of whom 68 infants were followed up for no less than 6 mo, and 12 mothers were still pregnant. During pregnancy, the main maternal adverse events were vaginitis (12/72, 16.7%), spontaneous abortion (11/95, 11.6%), and gestational diabetes (6/72, 8.3%); only one case had 1-2 degree elevation of the creatine kinase level (195 U/L). During the perinatal period, the main maternal adverse events were premature rupture of the membranes (8/72, 11.1%), preterm delivery (5/72, 6.9%), and meconium staining of the amniotic fluid (4/72, 5.6%). In addition, 2 infants were found to have congenital abnormalities; 1 had a scalp hemangioma that did not change in size until 7 mo, and the other had early cerebral palsy, but with rehabilitation training, the infant’s motor functions became totally normal at 2 years of age. The incidence of adverse events among the mothers or abnormalities in the infants was not higher than that of normal mothers or HBV-infected mothers who did not receive lamivudine treatment. In only 2 cases, mother-to-infant transmission blocking failed; the blocking rate was 97.1% (66/68), which was higher than has been previously reported.Lamivudine treatment is safe for chronic HBV-infected pregnant mothers and their fetuses with a gestational age of less than 12 wk or throughout the entire pregnancy.
HubMed – rehab

 

Distal forelimb representations in primary motor cortex are redistributed after forelimb restriction: a longitudinal study in adult squirrel monkeys.

Filed under: Rehab Centers

J Neurophysiol. 2012 Dec 12;
Milliken GW, Plautz EJ, Nudo RJ

Primary motor cortex (M1) movement representations reflect acquired motor skills. Representations of muscles and joints used in a skilled task expand. However, it is unknown whether motor restriction in healthy individuals results in complementary reductions in M1 representations. Using intracortical microstimulation techniques in squirrel monkeys, detailed maps of movement representations in M1 were derived before and up to 35 weeks after restriction of the preferred distal forelimb by use of a soft cast. While total distal forelimb area and movement threshold remained constant, casting resulted in a redistribution of digit and wrist/forearm representations. Digit representations progressively decreased, while wrist/forearm representations progressively increased in areal extent. In 3 of 4 monkeys, hand preference returned to normal by the end of the post-cast recovery period, and post-recovery maps demonstrated reversal of restriction-induced changes. However, in one monkey, a chronic motor impairment occurred in the casted limb. Rehabilitation via a forced use paradigm resulted in recovery in use and skill of the impaired limb, as well as restoration of normal motor maps. These results demonstrate that plasticity in motor representations can be induced either by training or restricting movements of the limb. Physiological changes induced by restriction appear to be reversible, even in the case of adverse motor outcomes. The respective contributions of both disuse and lost motor skills are discussed. These results have relevance for clinical conditions requiring forelimb casting as well as interpreting the differential effects of injury and disuse that are necessarily intertwined after cortical injury, as occurs in stroke.
HubMed – rehab

 

[“Norwegian Rehabilitation – What is the Situation in 2012?” RI Norway 50-Years Celebration Conference May 15, 2012 in Oslo].

Filed under: Rehab Centers

Rehabilitation (Stuttg). 2012 Dec; 51(6): 434-7
Schmollinger M

HubMed – rehab

 

[Community-based rehabilitation and outpatient care for patients with acquired brain injury and chronic neurological disability in Germany: continuing support for social participation and re-integration in the neurological care system?].

Filed under: Rehab Centers

Rehabilitation (Stuttg). 2012 Dec; 51(6): 424-30
Reuther P, Hendrich A, Kringler W, Vespo E

In Germany a number of patients who are suffering from acquired brain injury and chronic neurological disability are either undersupplied or exposed to inappropriate care in their social environment. The number of these patients is increasing due to the changes in the procedures of care and due to demographic factors. While acute medical care and early rehabilitative treatment is accessible throughout the German health care system the necessary multimodal and competent care is rare or absent in the social participative sites such as life and occupational environments of the patients. The complex impairment of the brain, the central organ for sensorial, executive and other cognitive functions of human beings, renders the affected patient an exception in the system of medical and social care – this has only inadequately been considered in the past. The authors explain the necessity to disclose the status of a “human-with acquired-brain damage (Mensch-mit-erworbener-Hirnschädigung, MeH)” explicitly as severely disabled. The paper recommends a number of structural and procedural elements that have proven to overcome the insufficient or inappropriate support in integrating the patients suffering from acquired brain injury and chronic neurological disability in their social environment as well as for a demand-focused support with sustainable rehabilitative and ambulant follow-up procedures. Comparisons with other developed health care systems and international guidelines show that with organizing of early-supported-discharge, community-ambulation, shared-care and community-based-rehabilitation these problems have long since been identified elsewhere. Community-based and resident-oriented concepts have already been systematically implemented. In order to achieve the necessary support for the individual patient, a nation-wide development is necessary in Germany to perform the principles of the German social code and the principles of the Convention on the Rights of Persons with Disabilities of the United Nations: Goals of rehabilitation have to be more than functional treatment. Activation of the patient and supporting their coping and adaptive processes are necessary to achieve social participation and (re)integration into the community and in occupational life as implied by the standards of our society. Important elements of these are (1) identification of the individual patient and his/her burden during acute phase treatment or early rehabilitation (defined red-flag), (2) an individual clinical reasoning and planning of interventions and help, (3) general acceptance of the defined demands by all “players” in medical and social networks, (4) coordination and supervision of the medical and social interventions and of the assistive processes necessary in the individual environment. What seems to be needed is (5) systematic orientation to the goal of individual social participation at all levels of support, (6) cross linking, cooperation and development of the existing medical and social structures on site, (7) expansion of the legal framework and (7a) especially control of the implementation of the existing rights of social benefits and (7b) surveillance (transparency and quality management not only in the area of caregivers but also for the administration of social insurances!). The recommendations of the authors integrate systematically into the phase model of neurorehabilitation (VDR/BAR) in Germany. The focus of this work is the needs-appropriate programming of phase E, i.?e., the transition between inpatient and outpatient care, between the clinical facility-oriented and the community-based (domicile-oriented, occupational-oriented) sectors, between welfare and independency.
HubMed – rehab

 

 

Amy Winehouse – 27 Roses – Rehab – To purchase a print go to: www.peterjurik.com Amy Winehouse is immortalized in this artwork by Jurik Designs. jurikdesigns.com All profits from the sale of the prints will be donated to the Amy Winehouse Foundation. For more information about the prints visit: www.peterjurik.com The original artwork is a pencil drawing that captures Amy in an elegant pose with her eyes fixed on the viewer. Black is a theme because Amy used the term black in her music, inferring a state of being. Included are sections of several iconic musical scores including “Rehab”, “Back To Black”, “Tears Dry On Their Own” and “Love Is A Losing Game.” A signature style of Amy’s was to wear a rose in her hair, so roses intertwine between Amy and her music. Each of the 27 roses symbolize a year of Amy’s life. A moving YouTube of the artwork highlights the symbolism in the artwork and the lyrics. The prints that are now available are lithographic art prints. Available for a limited time. Facebook: www.facebook.com Twitter: twitter.com Google Plus: plus.google.com

 

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