scholarly journals Compliance to service standards for congenital upper limb deficiency: the Northern Ireland experience

2011 ◽  
Vol 36 (1) ◽  
pp. 39-44
Author(s):  
Josephine Hillan ◽  
Lorraine E Graham
Keyword(s):  
Northern Ireland ◽  
Upper Limb ◽  
Multidisciplinary Team ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Rehabilitation Medicine ◽  
British Society ◽  
Current Guidance ◽  
Limb Deficiency ◽  
Low Rate

Background: In 2003, the British Society of Rehabilitation Medicine (BSRM) published guidelines on amputee and prosthetic rehabilitation, including those with congenital limb deficiency.Objectives: The aim of the study was to evaluate the service provided by the Regional Disablement Service (RDS) to children with congenital upper limb deficiency, against BSRM guidelines.Study Design: Retrospective chart review.Methods: Chart review.Results: Analysis of the group ( n = 44) showed 52% were male, with 61% of children affected on the left side, and 73% having a transverse deficiency. Compliance to individual aspects of the guidelines varied considerably. Only 14 (32%) of children had met with the multidisciplinary team by the recommended age of six months. Analysis of referral sources and timings suggested that children were initially seen elsewhere and later referred to RDS after consultation with a surgeon.Conclusions: RDS compliance with the BSRM guidelines was variable. Particularly disappointing was the low rate of children and families meeting the multidisciplinary team at an early age (< 6 months). The low rate of early referral prompted us to contact all paediatricians in Northern Ireland highlighting the guidelines, the benefits of early contact with RDS and encouraging referral on diagnosis.Clinical relevanceThis work will be of interest particularly to those involved in treating paediatric amputees. The challenges we face in treating upper limb deficient children in accordance with current guidance may not be unique and our study may prompt other units to consider how best to improve service to this group.

scholarly journals Outcomes of Patients with Intestinal Failure after the Development and Implementation of a Multidisciplinary Team

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sabrina Furtado ◽  
Najma Ahmed ◽  
Sylviane Forget ◽  
Ana Sant’Anna
Keyword(s):  
Multidisciplinary Team ◽  
Chart Review ◽  
Intestinal Failure ◽  
Retrospective Chart Review ◽  
Historical Cohort ◽  
Transplant Program ◽  
Multidisciplinary Program ◽  
Tertiary Center ◽  
The Impact ◽  
Overall Mortality

Aim. A multidisciplinary team was created in our institution to manage patients with intestinal failure (INFANT: INtestinal Failure Advanced Nutrition Team). We aimed to evaluate the impact of the implementation of the team on the outcomes of this patient population.Methods. Retrospective chart review of patients with intestinal failure over a 6-year period was performed. Outcomes of patients followed up by INFANT (2010–2012) were compared to a historical cohort (2007–2009).Results. Twenty-eight patients with intestinal failure were followed up by INFANT while the historical cohort was formed by 27 patients. There was no difference between the groups regarding remaining length of small and large bowel, presence of ICV, or number of infants who reached full enteral feeds. Patients followed up by INFANT took longer to attain full enteral feeds and had longer duration of PN, probably reflecting more complex cases. Overall mortality (14.8%/7.1%) was lower than other centers, probably illustrating our population of “early” intestinal failure patients.Conclusions. Our data demonstrates that the creation and implementation of a multidisciplinary program in a tertiary center without an intestinal and liver transplant program can lead to improvement in many aspects of their care.

scholarly journals PHYSICAL THERAPY FOR PATIENTS AFTER STROKE

2021 ◽  
pp. 18-26
Author(s):  
А. V. Homola ◽  
Ye. V. Prokopovych ◽  
Y. V. Antonova-Rafi
Keyword(s):  
Physical Therapy ◽  
Upper Limb ◽  
Multidisciplinary Team ◽  
Rehabilitation Medicine ◽  
Late Period ◽  
Motor Functions ◽  
Everyday Activity ◽  
Rehabilitation Process ◽  
Clinical Hospital ◽  
Physical And Rehabilitation Medicine

  Abstract. Objectives: to summarize the data on the spread and complications of patients after stroke in Ukraine and in the world, the noted motor and cognitive impairments are the basis of disability; to prove the effectiveness of physical therapy methods for recovery of motor function of patients after a stroke. The strategy of solving the problem consists in reducing the limitations of daily living activities, increased mastering new skills and abilities. Patients are examined using modern tests and scales, which allow summarizing the examination results, and having a high level of reliability. Purpose of the study: the dynamics of the functional motor state of patients after undergoing complex physical therapy. The effectiveness of the methods at the stage of restoration of motor abilities has been substantiated. Methods. Every day at the MDK meeting, communication takes place in accordance with medical ethics and moral principles, the legal norms of the patient and his family. On the basis of the Kiev City Clinical Hospital № 6, the Department of Physical and Rehabilitation Medicine 34 patients were separated in the early recovery period with plegia of the upper limb and divided into two groups: the main and the control one. In the late period after a stroke with spasticity of the upper limb, 26 patients were also divided into two groups. Women age ranges from 35 to 83 years old; men - from 37 to 84 years old. The dynamics of the functional motor state of patients after undergoing complex physical therapy was investigated. Research results. In Ukraine, there are many versions of physical therapy for patients after stroke in the acute and early period. The Ukrainian Stroke Association has created protocols for rehabilitation assistance. Some success has been achieved in the rehabilitation of patients in the acute period. Difficulties arise in the late period of physical therapy, namely, functional motor disorders. This negatively affects the social and everyday activity and the usual activities of patients. The consequences of a stroke are muscular disorders such as a complete absence of voluntary movements (plegia), accompanied by a painful syndrome, loss of balance, coordination during movement. Also, the growing spasticity that forms contractures, there are pain sensations and restrictions in everyday activities. Patients face the problem of muscle spasticity, which interferes with a full-fledged rehabilitation process, becomes an obstacle in the restoration of motor functions, leads to a loss of working capacity, self-care skills, and sharply reduces the quality of life. A physical therapist must own, know and use the methods and means of physical therapy. The use of the international classification of functioning influences the course of work of a multidisciplinary team, aimed at a direct and specific rehabilitation process for the qualitative and complex restoration of the patient's lost motor functions. Conclusion. On the basis of the Kiev City Clinical Hospital № 6, Department of Physical and Rehabilitation Medicine, developed a complex program of physical therapy, for a group of patients after stroke. The multidisciplinary team does not divide life before and after a stroke, it tries, on the basis of evidence-based medicine, an integrated and individual approach to activate an independent life, help and restore the patient's lost functions, compensate and find a way out where others refuse.  

Prosthetic management of children in the Netherlands with upper limb deficiencies

2001 ◽  
Vol 25 (3) ◽  
pp. 228-234 ◽  
Author(s):  
M-A. Kuyper ◽  
M. Breedijk ◽  
A. H. M. Mulders ◽  
M. W. M. Post ◽  
A. J. H. Prevo
Keyword(s):  
The Netherlands ◽  
Upper Limb ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Congenital Defects ◽  
Rehabilitation Centre ◽  
Follow Up Study ◽  
Limb Deficiencies

The aim of the study was to assess which children with congenital and acquired upper limb deficiencies were fitted with prostheses, what types of prostheses were prescribed as first, second and third prostheses, at what age prostheses were first prescribed and how long the children wore their prostheses.The design was a retrospective chart review at De Hoogstraat Rehabilitation Centre, Utrecht (The Netherlands). Medical files of all patients with congenital or acquired upper limb deficiencies who visited the outpatient clinic between 1972 and 1996 were reviewed, collecting data on patient characteristics, prosthesis prescription and use of prostheses.The group included 224 children, of whom 206 (92%) had congenital deficiencies. Of all children with unilateral congenital deficiencies, 54% had been fitted with prostheses, against 3% of all children with bilateral congenital deficiencies and 67% of all children with acquired deficiencies. In the congenital group, it was children with transverse defects of one-third or two-thirds of the forearm who had most frequently had prostheses fitted (85% of the children). Most of the children with unilateral congenital deficiencies had received passive prostheses as their first prostheses (80 of the 90 prescribed prostheses); children with acquired defects usually had active prostheses (8 of the 12 prescribed prostheses). Body-powered prostheses were most commonly prescribed as the second type of prosthesis.In the group of 119 children who had been seen before the age of 4 years and had been followed for at least three years, 63 had been fitted with one or more prostheses at a mean age of 2.6 (SD 2.5) years. Of the 46 children with congenital defects, 30 had been fitted with prostheses, and at the age of 12, two-thirds of them still used their prostheses (63%, 19/30).“De Hoogstraat” rehabilitation centre uses a restrained prosthesis prescription policy, depending on the type of deficiency and the expected functional benefits. Data on prosthesis use are encouraging, although a follow-up study is required to determine the functional outcome for prosthesis users and non-users.

Clinical Analysis of 60 Patients with Hepatocellular Cancer Treated in Korean Medicine Hospital; A Retrospective Chart Review

2020 ◽  
Vol 41 (3) ◽  
pp. 447-456
Author(s):  
Mi-jung Yoon ◽  
Na-kyung Cho ◽  
Hong-sic Choi ◽  
Seung-mo Kim ◽  
Sang-chan Kim ◽  
...  
Keyword(s):  
Chart Review ◽  
Hepatocellular Cancer ◽  
Retrospective Chart Review ◽  
Clinical Analysis ◽  
Korean Medicine

Physical Medicine Rehabilitation Consults and 30 Day Readmissions: A Retrospective Chart Review

2014 ◽  
Vol 95 (10) ◽  
pp. e93-e94
Author(s):  
Aziza Azadali Kamani ◽  
Earl L. Smith ◽  
Jeffrey Fine ◽  
Lawrence M. Reich
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Physical Medicine

scholarly journals Cardiovascular Health in Individuals with Exceptional Longevity Residing in Arkansas

2021 ◽  
Vol 7 ◽  
pp. 233372142110189
Author(s):  
Brandi M. Mize ◽  
Brandon Duke ◽  
Amanda K. Pangle ◽  
Jeanne Y. Wei ◽  
Gohar Azhar
Keyword(s):  
Heart Failure ◽  
Chart Review ◽  
Cardiovascular Health ◽  
Ldl Cholesterol ◽  
Retrospective Chart Review ◽  
Hdl Cholesterol ◽  
Study Cohort ◽  
Old Patients ◽  
Genetic Components ◽  
Blood Pressures

Cardiovascular disease is a common comorbidity associated with an aging population. However, there is a unique group of individuals whose age-defying qualities are still being investigated. This retrospective chart review analyzed various cardiac and metabolic health parameters to characterize the prevalence of heart failure and metabolic derangements in individuals aged 90 years old or older in central Arkansas. Only 236 of the 291 patients in our study cohort had blood pressures recorded. Of these, 50% had systolic blood pressures ≥140 mmHg. Additionally, 77% had pulse pressures ≥50 mmHg. Of the 96 patients with BNP data, 44% had values ≥300 pg/mL. There was a slight positive correlation between aging and HDL cholesterol, while there was a negative correlation between aging and both total cholesterol and LDL cholesterol. A majority of our patients had both elevated systolic blood pressures and elevated pulse pressures. A majority also had high BNP values, indicative of some degree of heart failure. Additionally, atrial fibrillation was a common arrhythmia identified on EKG. However, these oldest of the old patients had fewer documented metabolic derangements. These findings lay important groundwork for further investigation into lifestyle and genetic components that allow them to live exceptionally long with such comorbidities.

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