scholarly journals Effectiveness of rehabilitation in post-COVID compared with post-cardiosurgery patients. A single Center experience

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
GQ Villani ◽  
A Rosi ◽  
D Corbellini ◽  
V Schettino ◽  
A Bosoni ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. The COVID 19 disease is frequently associated with significant disability related to intensive care unit-acquired weakness, decontitioning, myopathies and neuropathies. However there are no data on the results of a specific rehabilitative treatment in this group of patients. The aim of our work was to evaluate the effectiveness f a personalized rehabilitative therapy in group of post-COVID patients (A, 47 patients, average age 65.3± 11.6 y, 27 M,) comparing the results with a group of post-cardiosurgical patients COVID 19 negative (B, 47 patients, average age 63.5± 10.3 y, 29 M) evaluating the degree of clinical complexity (Rehabilitation Complexity Scale, RCS-E V13) and the degree of autonomy recovery (Six-minute walking test SMWT, Barthel Index, BI) pre and post-treatment. In Group A patients the Rehabilitation program is associated with a significant improvement in autonomy recovery (BI admission 29.7 ± 20 vs discharge 72.7 ± 28.6 p <0.005, SMWT admission  146 ± 25 vs 318 ± 18 m, p <0.005) and in clinical complexity  (RCS admission 10.9 ± 1.1 vs discharge 5.3, p< 0.05) Conclusions Post-COVID patients show a greater loss of autonomy than post-cardiosurgery patients. Rehabilitative treatment has proven effective in ensuring adequate functional recovery with similar results to those obtained in the population of cardiological subjects COVID 19 negative. Group A vs Group B Group A Group B p pre-rehabilitation hospital stay (days) 31 ± 5 8 ± 2 0.005 RCS admission 10.9 ± 1.1 11.6 ± 1.2 ns BI admission 29.7 ± 20 47.7 ± 19 0.05 SMWT admission (m) 146 ± 25 255 ± 18 0.05 Rehabilitation duration (days) 29.7 ± 12.8 29.6 ± 10.1 ns RCS discharge 5.3 ± 2 6.5 ± 2 ns BI discharge 72.7 ± 28 71.5 ± 22.5 ns SMWT discharge (m) 385 ± 18 410 ± 25 ns RCS rehabilitation complexity scale, BI: Barthel Index, SMWT: six-minute walking test

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G Q Villani ◽  
M Villani ◽  
G Halasz ◽  
A Rosi ◽  
M F Piepoli

Abstract   The COVID 19 disease is frequently associated with significant disability related to intensive care unit-acquired weakness, decontitioning, myopathies and neuropathies. However there are no data on the results of a specific rehabilitative treatment in this group of patients. The aim of our work was to evaluate the effectiveness f a personalized rehabilitative therapy in group of post-COVID patients (A, 47 patients, average age 65.3±11.6 y, 27 M,) comparing the results with a group of post-cardiosurgical patients COVID 19 negative (B, 47 patients, average age 63.5±10.3 y, 29 M) evaluating the degree of clinical complexity (Rehabilitation Complexity Scale, RCS-E V13) and the degree of autonomy recovery (Six-minute walking test SMWT, Barthel Index, BI) pre and post-treatment. In Group A patients the Rehabilitation program is associated with a significant improvement in autonomy recovery (BI admission 29.7±20 vs discharge 72.7±28.6 p<0.005, SMWT admission 146±25 vs 318±18 m, p<0.005) and in clinical complexity (RCS admission 10.9±1.1 vs discharge 5.3, p<0.05). At admission the comparison between Group A vs B has show: 1. a reduced pre-rehabilitation hospital stay (days) in Group Vs A (B 8.2±2 vs 31±5 0.005) 2. a similar degrre of clinical complexity (RCS scale A 10.9±1.1 vs 1.6±11.2 p ns) 3. a greater loss autonomy in post-COVID patients (BI scale A 29.7±20 vs B 47.7±19, p 0.05; SMWT A 145±25 m vs B 255±18 m, p 0.05) After a similar period of rehabilitation (A 29.7±12.8 days vs B 29.6±10 days, p ns) we observed in both Groups: 1. a reduction of clinical complexity ((RCS scale A 5.3±2 vs 6.6±2 p ns 2. an improvement of degree of autonomy recovery ((BI scale A 72.7±28 vs B 47.7±19, p ns; SMWT A 385±18 m vs B 410±25m, p ns) Conclusions Post-COVID patients show a greater loss of autonomy than post-cardiosurgery patients. Rehabilitative treatment has proven effective in ensuring adequate functional recovery with similar results to those obtained in the population of cardiological subjects COVID 19 negative. FUNDunding Acknowledgement Type of funding sources: None.


Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 085-089 ◽  
Author(s):  
Francesco Uboldi ◽  
Paolo Ferrua ◽  
Daniele Tradati ◽  
Pietro Zedde ◽  
Jim Richards ◽  
...  

Purpose This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Methods Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease-specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Results Kujala scale's values showed constant and progressive improvement. The mean score at 6 months was 79.8 ± 6.8 points in group A and 76.8 ± 8.6 in group B, rising at 12 months to 80.9 ± 7.5 in group A and 78.4 ± 8.3 in group B. VAS scores significantly differed (p < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12 months was 0.9 ± 1.3 in the brace-treated group and 1.8 ± 1.6 in the controls. The patients who used a brace showed a quicker return to sports and 75% of the patients in this group were satisfied. Conclusion All the scores improved progressively in both groups. The most significant improvement concerned pain, showing that the brace used in this study may allow a better subjective outcome and a quicker return to sport. Level of Evidence Level II, prospective randomized controlled trial.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bing-Juin Chiang ◽  
Yeong Shiau Pu ◽  
Shiu-Dong Chung ◽  
Shih-Ping Liu ◽  
Hong-Jeng Yu ◽  
...  

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%,P<0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001).E. coliwas the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.


2017 ◽  
Vol 89 (2) ◽  
pp. 148 ◽  
Author(s):  
Franco Mantovani

Objectives: Premature ejaculation (PE) is a sexual disorder characterised by excessive rapidity of orgasm. It is defined as either primary (60%), present since the onset of sexual activity, or secondary (40%), manifesting later in life. To date, dapoxetine is the only preparation approved for the on-demand treatment of PE. However, side effects, costs associated with the treatment of chronic PE, drug dependence and its variable effectiveness leads to a not insignificant drop-out rate. Dynamic rehabilitative/behavioural therapy may be a viable therapeutic option, working alongside pharmacological treatment, as long as the participation and involvement of both the individual and the couple is optimal. Materials and methods: 18 patients were enrolled, aged between 25 and 55 (mean: 40), all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A); 6 patients began the dynamic rehabilitative treatment (group B); 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C). Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment. Results: Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. "Cured" means a Premature Ejaculation Diagnostic Tool (PEDT) score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT) values from &lt; 1 to &gt; 6 minutes. Conclusions: the integration of pharmacological treatment with dynamic behavioural rehabilitation has the specific aim of optimising and stabilising the results, supporting a more efficient recovery of ejaculatory control. The close involvement of the partner is extremely useful for all results.


Author(s):  
Mehmet Ali Yesiltas

The aim of this study was to assess the influences of concomitant cardiac surgery on the risk for mortality and morbidity after Bentall procedure. This retrospective study was a review of patients who underwent Bentall procedure from a single center experience over a 7-year period. Demographic features, surgical data, postoperative period and outcomes were analyzed. Patients with isolated Bentall surgery (Group A) were compared and concomitant cardiac surgery with Bentall procedure were compared (Group B).


2022 ◽  
Vol 71 (6) ◽  
pp. 2207-10
Author(s):  
Muhammad Azhar ◽  
Munawer Latif Memon ◽  
Naeem Akhtar ◽  
Anam Altaf

Objective: To compare frequency of intra-abdominal complications in drainage and non-drainage group among patents who underwent intra-abdominal surgeries. Study Design: Comparative prospective study. Place and Duration of Study: Department of Surgery, Pakistan Ordinance Factory, Wah Cantt, from Mar 2018 to Jul 2018. Methodology: There were 32 patients, 16 in each group. Patients were selected through the process of consecutive sampling. Patients were randomly divided into two groups (random number table method); group A patients underwent intra-abdominal drain while group B was non-drainage group. Patients were followed up for 7 days and observed for complications. Results: Total 32 patients were included in the study. There were 14 (43.8%) males and 18 (56.3%) females. Mean age of patients was 43.2 ± 9.5 years. Drain group showed significantly low anastomosis leakage (p=0.02), wound infection (p=0.05), mortality (p=0.04), pulmonary complications (p=0.05) and bleeding (p=0.03) as compared to the non-drain group. Conclusion: Intra-abdominal drains are associated with several complications. Anastomosis leakage is the most common complication following pulmonary complications and bleeding. However, drains help in early detection of complications and timely management of such complications leads to better outcome of a surgical procedure.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Hesham M. Sheir ◽  
Tamer A. Wafa ◽  
Abdelrahman Elshafey ◽  
Mohamed Elzohiri

Abstract Background Although percutaneous endoscopic gastrostomy (PEG) is considered simple and effective, major complications have been reported because of the partly blind placement technique. Laparoscopic gastrostomy was described to overcome most of the problems and the contraindications of PEG. Various modifications have been reported to anchor the stomach to the abdominal wall. This study aims at highlighting a single center experience using a simplified technique for gastrostomy and evaluates its outcome. Results The age of the patients ranged from 7 days to 3 years (mean 11.75 ± 12 months in group A and 16 ± 3 months in group B). The mean body weight at time of gastrostomy was 6.5 ± 4.6 kg in group A and 7.5 ± 2 in group B. The mean operative time was 24.8 ± 4 min in group A and 25 ± 1.6 in group B, ranging from 18 to 31 min. The incidence of gastrostomy-related complications was 20% (three cases) in group A versus 12.5% (one case) among patients included in group B. Yet, this difference was statistically insignificant (p = 0.651). No major complications were reported apart from persistent gastrocutaneous fistula in one out of eight cases followed after removal of the gastrostomy (12.5%). There is no significant difference in the outcome either in neonates or in patients less than 5 kg. Conclusions The described simple technique of laparoscopic-assisted gastrostomy is easy, effective, and with a very low incidence of complications. It is also equally safe in neonates and children less than 5 kg.


2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Jinjian Yang ◽  
Deqin Geng

Objective: To observe the clinical efficacy and safety of butylphthalide joint human albumin in the treatment of the progress of type in acute cerebral infarction(PTCI). Methods: 120 patients with PTCI in Department of Neurology of Shuyang People’s Hospital were used to observe the efficacy. These patients were all treated by routine medicine including anti-platelet, statins, edaravone, ginkgo leaf extract and dipyridamole after admission. According to whether used butylphthalide and(or) human albumin in the treatment of PTCI, the patients were divided into A group 30 cases, B group 45 cases, and C group 45 cases.Patients of group C were given conventional treatment. Group B were given conventional treatment and human albumin injection(5g, ivgtt, qd, 3 days in a course); Group A were treated with butylphthalide (first,with butylphthalide and sodium chloride injection 100ml, ivgtt, for 7d, then with butylphthalide soft capsules 0.2g, tid, for 21d ), human albumin(5g, ivgtt, qd, for 3d) and routine medicine. The change of NIHSS score, Barthel Index, and mRS of three groups respectively during progress,1 week, 2 weeks and 90 days after progress were observed and analyzed. Results: NIHSS score, Barthel Index, and mRS of group A, group B and group C all showed no statistically significant (all p > 0.05) on 1 week after treatment; NIHSS score and mRS of group A were both lower than group B and group C on 2 weeks and 90 days after treatment, and both of them showed statistically significant (p<0.05);  Barthel Index of group A was higher than group B and group C on 90 days after treatment,it showed statistically significant (p<0.05); The total effective rate of group A(96.7%) > group B(88.9%) > group C(77.8%),showed statistically significant (p<0.05). Conclusions: Butylphthalide joint human albumin treatment of PTCI has good therapeutic effect and safety, it is useful to clinical promotion and further research.


2021 ◽  
Author(s):  
Yuan Liu ◽  
Siyi Guo ◽  
Jinsong Wu ◽  
Rongai Wang ◽  
Jinbo Liu ◽  
...  

The clinical presentation of primary hyperparathyroidism (PHPT) differs between patients from developed and developing countries. In China, the clinical pattern has changed over the past few decades. Our aim was to elucidate general changes in the clinical characteristics of PHPT from 2010 to 2021. We enrolled 343 patients with PHPT at the Qilu Hospital of Shandong University, Jinan, China, from January 2010 to May 2021, including both surgical and non-surgical patients. Patients were divided into two subgroups, 2010–2016 (group A, n = 152) and 2017–2021 (group B, n = 191), based on the time span. We compared clinical manifestations and laboratory result data between these two groups. The mean patient age was 52.59 ± 13.55 years, and the male-to-female ratio was 1:2.54. Of the 343 patients, 183 (53.35%) had symptomatic PHPT; bone pain, urolithiasis, and fatigue were the most common symptoms. Postoperative pathology showed that 96.20% of the patients had parathyroid adenoma, whereas 2.41% had parathyroid carcinoma. Great changes occurred between 2010 and 2021; the percentage of patients with asymptomatic PHPT (aPHPT) increased from 36.18% in group A to 54.97% in group B. Moreover, patients in group B showed significantly lower serum calcium, alkaline phosphatase, parathyroid hormone, and urinary phosphate levels but higher serum 25-hydroxyvitamin D levels than those in group A. Clinical presentations in group B were also milder. In conclusion, the clinical characteristics of Chinese PHPT patients changed dramatically from 2010 to 2021, with asymptomatic PHPT (aPHPT) becoming the predominant type over the last 3 years.


Author(s):  
Eva Christin Weber ◽  
Florian Recker ◽  
Ingo Gottschalk ◽  
Brigitte Strizek ◽  
Annegret Geipel ◽  
...  

Abstract Purpose To evaluate the outcome of first trimester intervention by intrafetal laser (IFL) in pregnancies complicated by twin reversed arterial perfusion (TRAP). Materials and Methods For a 10-year study period, all patients with TRAP diagnosed < 14.0 weeks of gestation were retrospectively analyzed for intrauterine course and outcome. Monoamniotic pregnancies were excluded. Patients were offered either intervention by IFL in the first trimester, expectant management, or termination of pregnancy (TOP). Adverse outcome was defined as either intrauterine death (IUD), neonatal death, or preterm birth. Results In 45 cases TRAP was diagnosed. 17 monoamniotics were excluded. The cohort was divided into two groups according to management. Group A: 24 cases underwent IFL and group B: 4 cases were managed expectantly. No patient opted for TOP. In group A, 70.8 % of pump twins were born alive, including one preterm delivery, and 29.2 % died within four days after the intervention. All 4 expectantly managed cases in group B had an adverse outcome (1 preterm delivery, 3 IUDs < 15.0 weeks). There were no neonatal deaths. In cases treated by IFL, a comparison of survivors and non-survivors identified no significant differences in gestational age at IFL or any of the assessed biometrical and functional parameters. There was a trend towards better outcome in the second half of the study period. Conclusion IFL in first trimester TRAP sequence is technically feasible but is associated with significant mortality, albeit less than previously reported. No risk stratification is possible using the investigated parameters. However, there seems to be a learning curve.


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