Principles of Rehabilitation in Reconstructive Surgery in the Upper Limb

2000 ◽  
Vol 5 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Sonia Ranelli ◽  
Susan Forsythe ◽  
Jagdeep Nanchahal
Keyword(s):  
Upper Limb ◽  
Reconstructive Surgery ◽  
Treatment Strategies ◽  
Treatment Goals ◽  
Reconstructive Procedure ◽  
Routine Treatment ◽  
Treatment Techniques ◽  
Appropriate Treatment

To best establish appropriate treatment aims and treatment strategies in the rehabilitation of the patient having undergone reconstructive surgery, the therapist must understand the general principles underpinning the reconstructive procedure/s performed by the surgeon. The therapist then applies his/her knowledge of anatomy and biomechanics during assessment of the patient and must consider possible contraindications of routine treatment techniques that may compromise the reconstruction. Communication with the surgeon and the patient is essential so that treatment goals are understood, agreed and ultimately achieved.

scholarly journals Thoracic Aortic Emergencies: Presenting Pathologies and Treatment Strategies

2020 ◽  
Vol 37 (01) ◽  
pp. 085-096
Author(s):  
Daniel P. Sheeran ◽  
Adam M. Zelickson ◽  
Luke R. Wilkins ◽  
J. Fritz Angle ◽  
David M. Williams ◽  
...  
Keyword(s):  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Clinical Settings ◽  
Accurate Identification ◽  
Treatment Techniques ◽  
Appropriate Treatment ◽  
Clinical Presentations ◽  
Wide Range ◽  
Pathologic Processes ◽  
Thoracic Stent Graft

AbstractThoracic aortic emergencies reflect a wide range of etiologies, pathologic processes, and clinical presentations. Accurate identification with an appropriate treatment algorithm is best accomplished in a multidisciplinary setting with interventional radiologists, vascular surgeons, and cardiothoracic surgeons. While knowledge of thoracic stent graft equipment and technique is essential in the treatment of thoracic aortic emergencies, many clinical settings may employ alternative treatment techniques. This article will review the most common thoracic aortic emergencies and treatment strategies.

Non-invasive ultrasound-based imaging of atherosclerosis

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 126-133 ◽  
Author(s):  
Mathias Kaspar ◽  
Iris Baumgartner ◽  
Daniel Staub ◽  
Heinz Drexel ◽  
Christoph Thalhammer
Keyword(s):  
Large Population ◽  
Treatment Strategies ◽  
Intima Media Thickness ◽  
Scientific Work ◽  
Flow Mediated Dilation ◽  
Non Invasive ◽  
Grey Scale ◽  
Current Review ◽  
Appropriate Treatment ◽  
Contrast Enhanced

Abstract. Early detection of vascular damage in atherosclerosis and accurate assessment of cardiovascular risk factors are the basis for appropriate treatment strategies in cardiovascular medicine. The current review focuses on non-invasive ultrasound-based methods for imaging of atherosclerosis. Endothelial dysfunction is an accepted early manifestation of atherosclerosis. The most widely used technique to study endothelial function is non-invasive, flow-mediated dilation of the brachial artery under high-resolution ultrasound imaging. Although an increased intima-media thickness value is associated with future cardiovascular events in several large population studies, systematic use is not recommended in clinical practice for risk assessment of individual persons. Carotid plaque analysis with grey-scale median, 3-D ultrasound or contrast-enhanced ultrasound are promising techniques for further scientific work in prevention and therapy of generalized atherosclerosis.

scholarly journals The Meniscus in Normal and Osteoarthritic Tissues: Facing the Structure Property Challenges and Current Treatment Trends

2019 ◽  
Vol 21 (1) ◽  
pp. 495-521 ◽  
Author(s):  
Caroline A. Murphy ◽  
Atul K. Garg ◽  
Joana Silva-Correia ◽  
Rui L. Reis ◽  
Joaquim M. Oliveira ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Biological Function ◽  
Treatment Strategies ◽  
Meniscal Repair ◽  
Current Treatment ◽  
Structure Property ◽  
Biological Structure ◽  
Treatment Techniques ◽  
Treatment Trends ◽  
Meniscus Injuries

The treatment of meniscus injuries has recently been facing a paradigm shift toward the field of tissue engineering, with the aim of regenerating damaged and diseased menisci as opposed to current treatment techniques. This review focuses on the structure and mechanics associated with the meniscus. The meniscus is defined in terms of its biological structure and composition. Biomechanics of the meniscus are discussed in detail, as an understanding of the mechanics is fundamental for the development of new meniscal treatment strategies. Key meniscal characteristics such as biological function, damage (tears), and disease are critically analyzed. The latest technologies behind meniscal repair and regeneration are assessed.

scholarly journals A Closer Look at the Cellular and Molecular Components of the Deep/Muscular Fasciae

2021 ◽  
Vol 22 (3) ◽  
pp. 1411
Author(s):  
Caterina Fede ◽  
Carmelo Pirri ◽  
Chenglei Fan ◽  
Lucia Petrelli ◽  
Diego Guidolin ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Connective Tissue ◽  
Treatment Strategies ◽  
Clear Understanding ◽  
Pathological Characteristics ◽  
Appropriate Treatment ◽  
Different Types ◽  
Molecular Components ◽  
Entire Network ◽  
Shed Light

The fascia can be defined as a dynamic highly complex connective tissue network composed of different types of cells embedded in the extracellular matrix and nervous fibers: each component plays a specific role in the fascial system changing and responding to stimuli in different ways. This review intends to discuss the various components of the fascia and their specific roles; this will be carried out in the effort to shed light on the mechanisms by which they affect the entire network and all body systems. A clear understanding of fascial anatomy from a microscopic viewpoint can further elucidate its physiological and pathological characteristics and facilitate the identification of appropriate treatment strategies.

scholarly journals Long Chronic Total Occlusions: Revascularization Strategies

2018 ◽  
Vol 35 (05) ◽  
pp. 469-476 ◽  
Author(s):  
Daniel Sheeran ◽  
Luke Wilkins
Keyword(s):  
Peripheral Arterial Disease ◽  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Arterial Disease ◽  
Chronic Total Occlusions ◽  
Multiple Treatment ◽  
Treatment Techniques ◽  
Peripheral Arterial

AbstractThe treatment of chronic total occlusions (CTO) in patients with peripheral arterial disease (PAD) is a complex topic with multiple treatment techniques and treatment strategies. The interventionalist treating patients with PAD should have both a defined treatment algorithm and multiple techniques available for crossing these challenging lesions. This article will cover techniques for treating CTOs and provide an overview of current available evidence.

scholarly journals Evaluation of Different Treatment Strategies Between Right-sided and Left-sided Pneumonectomy for Stage I-IIIA Non-small Cell Lung Cancer Patients

2020 ◽  
Author(s):  
Bo Jia ◽  
Qiwen Zheng ◽  
Jianjie Li ◽  
Jun Zhao ◽  
Meina Wu ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Treatment Strategies ◽  
The United States ◽  
Stage I ◽  
Cancer Specific Survival ◽  
Lung Cancer Patients ◽  
Propensity Score Matching Analysis ◽  
Appropriate Treatment ◽  
Iiia Nsclc ◽  
Nsclc Patients

Abstract BackgroundThis study aimed to assess the different survival outcome of stage I-IIIA NSCLC patients who received right-sided and left-sided pneumonectomy, and to further develop the most appropriate treatment strategies. MethodsWe accessed data from the Surveillance, Epidemiology, and End Results database in the United States for the present study. An innovative propensity score matching analysis was used to minimize the variance between groups.ResultsFor 2,683 patients who received pneumonectomy, cancer-specific survival (HR=0.863, 95%CI: 0.771 to 0.965, P=0.010) and overall survival (OS) (HR=0.875, 95%CI: 0.793 to 0.967, P=0.008) were significantly superior of left-sided pneumonectomy compared with right-sided pneumonectomy. Cancer-specific survival (HR=0.847, 95%CI: 0.745 to 0.963, P=0.011) and OS (HR=0.858, 95%CI: 0.768 to 0.959, P=0.007) were also significantly longer with left-sided over opposite-sided pneumonectomy after matching analysis for 2,050 patients. Adjuvant therapy could significantly prolong cancer-specific survival (67 versus 51 months, HR=1.314, 95%CI: 1.093 to 1.579, P=0.004) and OS (46 versus 30 months, HR=1.458, 95%CI: 1.239 to 1.715, P<0.001) among left-sided pneumonectomy patients after matching procedure. While adjuvant therapy did not increase cancer-specific survival for right-sided pneumonectomy patients (46 versus 42 months, HR=1.112, 95%CI: 0.933 to 1.325, P=0.236). Subgroup analysis showed that adjuvant chemotherapy could significantly improve cancer-specific survival and OS for all pneumonectomy patients. But radiotherapy was associated with worse survival for patients with right-sided pneumonectomy. ConclusionsPneumonectomy side could be deemed as an important factor when physicians choosing the most optimal treatment strategies.

scholarly journals Prediction of Post-hepatectomy Liver Failure in Patients With Hepatocellular Carcinoma Based on Radiomics Using Gd-EOB-DTPA-Enhanced MRI: The Liver Failure Model

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuyan Chen ◽  
Zelong Liu ◽  
Yunxian Mo ◽  
Bin Li ◽  
Qian Zhou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Failure ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Training Cohort ◽  
Clinical Model ◽  
Preoperative Prediction ◽  
Medical Centers ◽  
Appropriate Treatment ◽  
Magnetic Resonance Imaging Mri

Objectives: Preoperative prediction of post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC) is significant for developing appropriate treatment strategies. We aimed to establish a radiomics-based clinical model for preoperative prediction of PHLF in HCC patients using gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI).Methods: A total of 144 HCC patients from two medical centers were included, with 111 patients as the training cohort and 33 patients as the test cohort, respectively. Radiomics features and clinical variables were selected to construct a radiomics model and a clinical model, respectively. A combined logistic regression model, the liver failure (LF) model that incorporated the developed radiomics signature and clinical risk factors was then constructed. The performance of these models was evaluated and compared by plotting the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) with 95% confidence interval (CI).Results: The radiomics model showed a higher AUC than the clinical model in the training cohort and the test cohort for predicting PHLF in HCC patients. Moreover, the LF model had the highest AUCs in both cohorts [0.956 (95% CI: 0.955–0.962) and 0.844 (95% CI: 0.833–0.886), respectively], compared with the radiomics model and the clinical model.Conclusions: We evaluated quantitative radiomics features from MRI images and presented an externally validated radiomics-based clinical model, the LF model for the prediction of PHLF in HCC patients, which could assist clinicians in making treatment strategies before surgery.

Diagnosis and Treatment of MODY: An Updated Mini Review

2021 ◽  
Vol 11 (20) ◽  
pp. 9436
Author(s):  
Abegail Tshivhase ◽  
Tandi Matsha ◽  
Shanel Raghubeer
Keyword(s):  
Type 2 Diabetes ◽  
Single Gene ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Endogenous Insulin ◽  
Appropriate Treatment ◽  
Mild Hyperglycemia ◽  
Onset Of Diabetes

Maturity-Onset Diabetes of the Young (MODY) is the most common form of monogenic diabetes resulting from a single gene mutation. It is characterized by mild hyperglycemia, autosomal dominant inheritance, early onset of diabetes (<25 years), insulin resistance, and preservation of endogenous insulin secretion. Currently, 14 MODY subtypes have been identified, with differences in incidence, clinical features, diabetes severity and related complications, and treatment response. This type of diabetes is mostly misdiagnosed as either type 1 or type 2 diabetes mellitus because it is difficult to differentiate between these forms of diabetes due to clinical similarities, the high cost of genetic testing, and lack of awareness. As a result, thousands of patients are not receiving appropriate treatment. Accurate diagnosis would allow for more effective therapeutic management and treatment strategies that are distinct from those used for type 1 and type 2 diabetes. This review serves to explore MODY subtypes, diagnosis, and treatment, and increase awareness of MODY incidence.

Treatment of arm and hand dysfunction after CNS damage

2015 ◽  
pp. 238-250 ◽  
Author(s):  
Nick Ward
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Upper Limb ◽  
Cervical Spinal Cord ◽  
Treatment Strategies ◽  
High Dose ◽  
Upper Limb Function ◽  
Cord Injury ◽  
The Central Nervous System ◽  
Upper Limb Dysfunction

Residual upper limb dysfunction after injury to the central nervous system is a major clinical, socioeconomic and societal problem. Upper limb dysfunction can occur in many disorders of the central nervous system including cervical spinal cord injury and multiple sclerosis, but therapeutic approaches for upper limb dysfunction after stroke are the most thoroughly investigated. General approaches to treatment require:�(i)�avoidance of complications such as spasticity, pain, and loss of range; (ii) early high-dose engaging functional motor training; (iii) consideration of how neuroplastic processes might be engaged to enhance the effects of training. The evidence to deliver optimal personalized treatment strategies for all patients is lacking, but there is evidence that higher doses and intensity of upper limb therapy will be beneficial to most patients. Recent work has focused on how technological innovation might be used to promote recovery of upper limb function.

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