Comparison of patient-reported functional recovery from different types of ophthalmic surgery

2021 ◽  
Author(s):  
Amanda K. Bicket ◽  
Aleksandra Mihailovic ◽  
Chengjie Zheng ◽  
Michael Saheb Kashaf ◽  
Niranjani Nagarajan ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Ophthalmic Surgery ◽  
Patient Reported ◽  
Different Types

scholarly journals Simulating lesion-dependent functional recovery mechanisms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Noor Sajid ◽  
Emma Holmes ◽  
Thomas M. Hope ◽  
Zafeirios Fountas ◽  
Cathy J. Price ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Model Performance ◽  
Neuronal System ◽  
Learning Capacity ◽  
Word Repetition ◽  
Alternative System ◽  
Long Term Effect ◽  
Different Types ◽  
Recovery Mechanisms ◽  
Incomplete Damage

AbstractFunctional recovery after brain damage varies widely and depends on many factors, including lesion site and extent. When a neuronal system is damaged, recovery may occur by engaging residual (e.g., perilesional) components. When damage is extensive, recovery depends on the availability of other intact neural structures that can reproduce the same functional output (i.e., degeneracy). A system’s response to damage may occur rapidly, require learning or both. Here, we simulate functional recovery from four different types of lesions, using a generative model of word repetition that comprised a default premorbid system and a less used alternative system. The synthetic lesions (i) completely disengaged the premorbid system, leaving the alternative system intact, (ii) partially damaged both premorbid and alternative systems, and (iii) limited the experience-dependent plasticity of both. The results, across 1000 trials, demonstrate that (i) a complete disconnection of the premorbid system naturally invoked the engagement of the other, (ii) incomplete damage to both systems had a much more devastating long-term effect on model performance and (iii) the effect of reducing learning capacity within each system. These findings contribute to formal frameworks for interpreting the effect of different types of lesions.

scholarly journals Patient-Reported Symptom Interference as a Measure of Postsurgery Functional Recovery in Lung Cancer

2016 ◽  
Vol 52 (6) ◽  
pp. 822-831 ◽  
Author(s):  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
Ara A. Vaporciyan ◽  
David C. Rice ◽  
Keyuri U. Popat ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Functional Recovery ◽  
Patient Reported

A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community-Living Older Persons

2021 ◽  
Vol 16 (8) ◽  
Author(s):  
Cameron J Gettel ◽  
Arjun K Venkatesh ◽  
Linda S Leo-Summers ◽  
Terrence E Murphy ◽  
Evelyne A Gahbauer ◽  
...  
Keyword(s):  
Nursing Home ◽  
Ambulatory Care ◽  
Functional Recovery ◽  
Older Persons ◽  
Functional Disability ◽  
Ambulatory Care Sensitive Conditions ◽  
Disability Score ◽  
Patient Reported ◽  
The Mean ◽  
Monthly Probability

BACKGROUND/OBJECTIVE: Hospitalizations for ambulatory care sensitive conditions (ACSCs) are considered potentially preventable. With little known about the functional outcomes of older persons after ACSC-related hospitalizations, our objectives were to describe: (1) the 6-month course of postdischarge functional disability, (2) the cumulative monthly probability of functional recovery, and (3) the cumulative monthly probability of incident nursing home (NH) admission. METHODS: The analytic sample included 251 ACSC-related hospitalizations from a cohort of 754 nondisabled, community-living persons aged 70 years and older who were interviewed monthly for up to 19 years. Patient-reported disability scores in basic, instrumental, and mobility activities ranged from 0 to 13. Functional recovery was defined as returning within 6 months of discharge to a total disability score less than or equal to that immediately preceding hospitalization. RESULTS: The mean age was 85.1 years, and the mean disability score was 5.4 in the month prior to the ACSC-related hospitalization. After the ACSC-related hospitalization, total disability scores peaked at month 1 and improved modestly over the next 5 months, but remained greater than the pre-hospitalization score. Functional recovery was achieved by 70% of patients, and incident NH admission was experienced by 50% within 6 months after the 251 ACSC-related hospitalizations. CONCLUSIONS: During the 6 months after an ACSC-related hospitalization, older persons exhibited total disability scores that were higher than those immediately preceding hospitalization, with 3 of 10 not achieving functional recovery and half experiencing incident NH admission. These findings provide evidence that older persons experience clinically meaningful adverse patient-reported outcomes after ACSC-related hospitalizations.

scholarly journals A novel nerve transection and repair method in mice: histomorphometric analysis of nerves, blood vessels, and muscles with functional recovery

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jung Il Lee ◽  
Anagha A. Gurjar ◽  
M. A. Hassan Talukder ◽  
Andrew Rodenhouse ◽  
Kristen Manto ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Functional Recovery ◽  
Functional Outcomes ◽  
Nerve Transection ◽  
Histomorphometric Analysis ◽  
Sciatic Nerve Transection ◽  
Functional Deficit ◽  
Reliable Model ◽  
Different Types ◽  
Branching Index

AbstractPeripheral nerve transection is associated with permanent functional deficit even after advanced microsurgical repair. While it is difficult to investigate the reasons of poor functional outcomes of microsurgical repairs in humans, we developed a novel pre-clinical nerve transection method that allows reliable evaluation of nerve regeneration, neural angiogenesis, muscle atrophy, and functional recovery. Adult male C57BL/6 mice were randomly assigned to four different types of sciatic nerve transection: Simple Transection (ST), Simple Transection & Glue (TG), Stepwise Transection and Sutures (SU), and Stepwise Transection and Glue (STG). Mice were followed for 28 days for sciatic function index (SFI), and sciatic nerves and hind limb muscles were harvested for histomorphological and cellular analyses. Immunohistochemistry revealed more directional nerve fiber growth in SU and STG groups compared with ST and TG groups. Compared to ST and TG groups, optimal neural vessel density and branching index in SU and STG groups were associated with significantly decreased muscle atrophy, increased myofiber diameter, and improved SFI. In conclusion, our novel STG method represents an easily reproducible and reliable model with close resemblance to the pathophysiological characteristics of SU model, and this can be easily reproduced by any lab.

scholarly journals Measurement issues when assessing quality of life outcomes for different types of hernia mesh repair

2011 ◽  
Vol 93 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Andras Zaborszky ◽  
Rita Gyanti ◽  
John A Barry ◽  
Brian K Saxby ◽  
Panchanan Bhattacharya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Future Research ◽  
Life Outcomes ◽  
Hernia Surgery ◽  
Recurrence Rates ◽  
Quality Of Life Outcomes ◽  
Inguinal Hernia Surgery ◽  
Patient Reported ◽  
Different Types

INTRODUCTION The NHS is required to collect data from patient reported outcome measures (PROMs) for inguinal hernia surgery. We explored the use of one such measure, the Carolinas Comfort Scale® (CCS), to compare long-term outcomes for patients who received two different types of mesh. The CCS questionnaire asks about mesh sensation, pain and movement limitations, and combines the answers into a total score. PATIENTS AND METHODS A total of 684 patients were treated between January 2007 and August 2008 and were followed up in November 2009. RESULTS Data on 215 patients who met the inclusion criteria were available (96 patients who received Surgipro™ mesh and 119 who received Parietene™ Progrip™ mesh). Recurrence rates were similar in the Surgipro™ group (2/96, 2.1%) and Progrip™ group (3/118, 2.5%) (Fisher's exact test = 1.0). Chronic pain occurred less frequently in the Surgipro™ group (11/95, 11.6%) than in the Progrip™ group (22/118, 18.6%) (p<0.157). Overall, 90% of CCS total scores indicated a good outcome (scores of 10 or less out of 115). A principal component analysis of the CCS found that responses clustered into two subscales: ‘mesh sensation’ and ‘pain+movement limitations’. The Progrip™ group had a slightly higher mesh sensation score (p<0.051) and similar pain+movement limitations scores (p<0.120). CONCLUSIONS In this study of quality of life outcomes related to different mesh types, the CCS subscales were more sensitive to differences in outcome than the total CCS score for the whole questionnaire. Future research should consider using the CCS subscales rather than the CCS total score.

scholarly journals Research methodology for orthopaedic surgeons, with a focus on outcome

2018 ◽  
Vol 3 (5) ◽  
pp. 160-167 ◽  
Author(s):  
Anne Lübbeke
Keyword(s):  
Public Health ◽  
Research Methodology ◽  
Patient Reported Outcomes ◽  
Conceptual Models ◽  
Clinical Care ◽  
Clinically Important Difference ◽  
Key Points ◽  
Significant Difference ◽  
Patient Reported ◽  
Different Types

Since improving the patient’s condition is the ultimate goal of clinical care and research, this review of research methodology focuses on outcomes in the musculoskeletal field. This paper provides an overview of conceptual models, different types of outcomes and commonly assessed outcomes in orthopaedics as well as epidemiological and statistical aspects of outcomes determination, measurement and interpretation. Clinicians should determine the outcome(s) most important to patients and/or public health in collaboration with the patients, epidemiologists/statisticians and other stakeholders. Key points in outcome choice are to evaluate both the benefit and harm of a health intervention, and to consider short- and longer-term outcomes including patient-reported outcomes. Outcome estimation should aim at identifying a clinically important difference (not the same as a statistically significant difference), at presenting measures of effects with confidence intervals and at taking the necessary steps to minimize bias. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170064

scholarly journals Irreparable Radial Nerve Palsy Due to Delayed Diagnostic Management of a Giant Lipoma at the Proximal Forearm Resulting in a Triple Tendon Transfer Procedure: Case report and Brief Review of Literature

2017 ◽  
Vol 11 (1) ◽  
pp. 794-803 ◽  
Author(s):  
Ingo Schmidt
Keyword(s):  
Functional Recovery ◽  
Radial Nerve ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Radial Nerve Palsy ◽  
Patient Reported ◽  
Diagnostic Management ◽  
Giant Lipoma ◽  
Proximal Forearm

Background: Non-traumatic radial nerve palsy (RNP) caused by local tumors is a rare and uncommon entity. Methods: A 62-year-old female presented with a left non-traumatic RNP, initially starting with weakness only. It was caused by a benign giant lipoma at the proximal forearm that was misdiagnosed over a period of 2 years. The slowly growth of the tumor led to an irreparable overstretching-related partial nerve disruption. For functional recovery of the patient, a triple tendon transfer procedure had to be performed. Results: Four months after surgery, the patient was completely able to perform her activities of daily living again. At the 10-months follow-up, strength of wrist extension, thumb's extension and abduction, and long fingers II-V extension had all improved to grade 4 in Medical Research Council scale (0-5). In order to restore motion, the patient reported that she would undergo the same triple tendon transfer procedure a second time where necessary. Due to the initially misdiagnosed tumor, there was an overall delayed duration of time for functional recovery of the patient. Conclusion: The triple tendon transfer procedure offers a useful and reliable method to restore functionality for patients sustaining irreparable RNP. However, it must be noted critically with our patient that this procedure probably would have been avoided. Initially, there was weakness only by entrapment of the radial nerve. RNP caused by local tumors are uncommon but known from the literature, and so it should be considered generally in differential diagnosis of non-traumatic RNP.

scholarly journals Validation and equivalency of electronic clinical outcomes assessment systems

2020 ◽  
Vol 7 (4) ◽  
pp. 271
Author(s):  
Sarah T. Gary ◽  
Antonio V. Otero ◽  
Kenneth G. Faulkner ◽  
Nadeeka R. Dias
Keyword(s):  
Clinical Outcomes ◽  
Patient Reported Outcomes ◽  
Bring Your Own Device ◽  
Equivalence Testing ◽  
Patient Reported ◽  
The Us ◽  
Different Types ◽  
Fit For Purpose ◽  
Clinical Outcomes Assessment ◽  
Recent Patient

<p>The US food and drug administration (FDA) has long called for clinical outcomes assessments (COA), such as patient-reported outcomes (PRO), to be ‘fit-for-purpose’ meaning the COA has been validated to support the context of use. The FDA’s recent patient-focused drug development guidance series has renewed the importance of ensuring that COA is ‘fit-for-purpose’ and valid.  In addition, the FDA has recommended that COA be collected electronically and that the electronic (eCOA) system and devices also be validated. Advancing technology requires eCOA systems and devices to evolve; eCOA devices may change over time. As bring your own device (BYOD) models gain popularity and acceptance, devices may also be mixed within trials. Changes in eCOA devices or mixing devices may require equivalence testing to prove validity across platforms. The aim of this article is to provide an overview of the different types of validation at both the assessment level and the eCOA system (device) level to help clinical trial sponsors determine the appropriate level of validation or equivalence testing required for COA used in their clinical trials.   </p>

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