scholarly journals COMBINED THERAPY FOR PATIENTS AFTER ISCHEMIC STROKE FROM THE POINT VIEW OF COMPREHENSIVE REHABILITATION

2020 ◽  
Vol 11 (1) ◽  
pp. 119-125
Author(s):  
Michal Vostrý ◽  
Ladislav Zilcher

Aim. The main objective of the research was to find out the efficacy of the combined therapy suitable for patients after ischemic stroke (promoting social adaptability). The therapy itself is then focused on robotic, psychomotor and cognitive therapy. Methods. 58 probands diagnosed with a stroke participated on the research (ischemic type I60-I69; ICD-10: International Classification of Diseases and Related Health Problems), out of which 49 were male patients ages between 50-55 and women between the age of 52–57. The data collection was finished in 2017-2018. Indicators were evaluated and tested firstly after the initiation of the combined therapy, then after 15 weeks of intensive therapy, which took place 4 times a week 50 minutes for each patient participating in the research. Results. A statistically significant difference was recorded among all observed indicator areas (somatic, psychological, social and even cognitive), in which patients scored during the final testing significantly better results, than during the initial testing. Conclusion. The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect, and is suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas.

Author(s):  
Robert Doričić ◽  
Tanja Ćorić ◽  
Morana Tomljenović ◽  
Danijela Lakošeljac ◽  
Amir Muzur ◽  
...  

In the second half of the 20th century, the town of Bakar (Primorje-Gorski Kotar County, Croatia), where a coking plant was operational 1978–1994, experienced intensive industrialisation. The town of Mali Lošinj (Primorje-Gorski Kotar County, Croatia) in this period based its economy on non-industrial sectors. The study goal was comparing mortality characteristics of these populations in the northern Mediterranean for 1960–2012. An ecological study design was used. Data were analysed for 1960–2012 for the deceased with recorded place of residence in the study area. Data on the deceased for 1960–1993 were taken from death reports, for 1994–2012 from digital archives of the Teaching Institute of Public Health, Primorje-Gorski Kotar County. Data on causes of death for 1960–1994 were recoded to the three-digit code of underlying cause of death according to the International Classification of Diseases (ICD–10). Among studied populations significant difference was found among the causes of deaths coded within ICD–10 chapters: neoplasms (particularly stomach carcinoma), mental and behavioural disorders and diseases of the respiratory system (particularly chronic obstructive pulmonary disease, (COPD)). Increase in mortality from neoplasms, increase in respiratory diseases for the area exposed to industrial pollution, also stomach carcinoma and COPD particularly in the town Bakar require further research.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


Author(s):  
Philip Cowen

This chapter discusses the symptomatology, diagnosis, and classification of depression. It begins with a brief historical background on depression, tracing its origins to the classical term ‘melancholia’ that describes symptoms and signs now associated with modern concepts of the condition. It then considers the phenomenology of the modern experience of depression, its diagnosis in the operational scheme of ICD-10 (International Classification of Diseases, tenth edition), and current classificatory schemes. It looks at the symptoms needed to meet the criteria for ‘depressive episode’ in ICD-10, as well as clinical features of depression with ‘melancholic’ features or ‘somatic depression’ in ICD-10. It also presents an outline of the clinical assessment of an episode of depression before concluding with an overview of issues that need to be taken into account when addressing approaches to treatment, including cognitive behavioural therapy and the administration of antidepressants.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Ishitani ◽  
R Teixeira ◽  
D Abreu ◽  
L Paixão ◽  
E França

Abstract Background Quality of cause-of-death information is fundamental for health planning. Traditionally, this quality has been assessed by the analysis of ill-defined causes from chapter XVIII of the International Classification of Diseases - 10th revision (ICD-10). However, studies have considered other useless diagnoses for public health purposes, defined, in conjunction with ill-defined causes, as garbage codes (GC). In Brazil, despite the high completeness of the Mortality Information System, approximately 30% of deaths are attributable to GCs. This study aims to analyze the frequency of GCs in Belo Horizonte municipality, the capital of Minas Gerais state, Brazil. Methods Data of deaths from 2011 to 2013 in Belo Horizonte were analyzed. GCs were classified according to the GBD 2015 study list. These codes were classified in: a) GCs from chapter XVIII of ICD-10 (GC-R), and b) GC from other chapters of ICD-10 (GC-nonR). Proportions of GC were calculated by sex, age, and place of occurrence. Results In Belo Horizonte, from the total of 44,123 deaths, 5.5% were classified as GC-R. The majority of GCs were GC-nonR (25% of total deaths). We observed a higher proportion of GC in children (1 to 4 years) and in people aged over 60 years. GC proportion was also higher in females, except in the age-groups under 1 year and 30-59 years. Home deaths (n = 7,760) had higher proportions of GCs compared with hospital deaths (n = 30,182), 36.9% and 28.7%, respectively. The leading GCs were the GC-R other ill-defined and unspecified causes of death (ICD-10 code R99)), and the GCs-nonR unspecified pneumonia (J18.9), unspecified stroke (I64), and unspecified septicemia (A41.9). Conclusions Analysis of GCs is essential to evaluate the quality of mortality information. Key messages Analysis of ill-defined causes (GC-R) is not sufficient to evaluate the quality of information on causes of death. Causes of death analysis should consider the total GC, in order to advance the discussion and promote adequate intervention on the quality of mortality statistics.


2021 ◽  
Vol 10 (3) ◽  
pp. 499
Author(s):  
Umile Giuseppe Longo ◽  
Marco Viganò ◽  
Vincenzo Candela ◽  
Laura de Girolamo ◽  
Eleonora Cella ◽  
...  

Background: The posterior cruciate ligament (PCL) is an essential element in knee stability. PCL reconstructions represent an under-investigated topic in the literature due to the rarity of this type of knee injury. This study aims to investigate the incidence of PCL reconstructive surgeries in Italy, following their trend during a 15-year period. Methods: The National Hospital Discharge records (SDO) collected by the Italian Ministry of Health between January 2001 and October 2015 were analyzed. The database reports anonymous data comprising patients’ ages, genders, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for diagnosis and intervention, census regions, regions of hospitalization, lengths of hospitalization and types of reimbursement. Results: The overall incidence of PCL reconstructions in the Italian population during the study period was 0.46 surgeries per 100,000 inhabitants/year, ranging from 0.32 to 0.54. The median patient’s age was 30 years old, and the male:female ratio was 5.3. PCL lesions were isolated in 39.7% of patients, while anterior cruciate ligament injuries were the most frequently associated lesions (31.1%). Conclusions: The incidence of PCL reconstruction in Italy was low and stable during the study period. Young men are the category at the highest risk for these procedures. Given the paucity of epidemiological data on PCL reconstructions, this data may represent a reference for the current and foreseeable needs in PCL surgeries for countries sharing similar cultural context.


Hand ◽  
2021 ◽  
pp. 155894472199801
Author(s):  
Navapong Anantavorasakul ◽  
Ritsaart F. Westenberg ◽  
Arman T. Serebrakian ◽  
Meryam Zamri ◽  
Neal C. Chen ◽  
...  

Background The objectives of this study are to: (1) describe the demographics, injury patterns, and treatment characteristics of patients who sustained a gunshot injury (GSI) of the hand; and (2) examine the utilization of healthcare resources in patients with a GSI of the hand. Methods We retrospectively identified 148 adult patients who were treated for a GSI of the hand between January 2000 to December 2017 using multiple International Classification of Diseases Ninth and Tenth Edition (ICD-9 and ICD-10) codes. We used bivariate and multivariable analysis to identify which factors are associated with unplanned reoperation, length of hospitalization, and number of operations. Results Multivariable logistic regression showed that fracture severity was associated with unplanned reoperation. Multivariable linear regression showed that fracture severity is associated with a higher number of hand operations after a GSI of the hand, and that a retained bullet (fragment) and patients having gunshot injuries in other regions than the hand had a longer length of hospitalization. Seventy (47%) patients had sensory or motor symptoms in the hand after their GSI, of which 22 (15%) patients had a transection of the nerve. Conclusions Sensory and motor nerve deficits are common after a GSI of the hand. However, only 31% of patients with symptoms had a transection of the nerve. A retained bullet (fragment), having more severe hand fractures, and GSI in other regions than the hand are associated with a higher number of operation and a longer period of hospitalization.


Author(s):  
K. Neumann ◽  
B. Arnold ◽  
A. Baumann ◽  
C. Bohr ◽  
H. A. Euler ◽  
...  

Zusammenfassung Hintergrund Sprachtherapeutisch-linguistische Fachkreise empfehlen die Anpassung einer von einem internationalen Konsortium empfohlenen Änderung der Nomenklatur für Sprachstörungen im Kindesalter, insbesondere für Sprachentwicklungsstörungen (SES), auch für den deutschsprachigen Raum. Fragestellung Ist eine solche Änderung in der Terminologie aus ärztlicher und psychologischer Sicht sinnvoll? Material und Methode Kritische Abwägung der Argumente für und gegen eine Nomenklaturänderung aus medizinischer und psychologischer Sicht eines Fachgesellschaften- und Leitliniengremiums. Ergebnisse Die ICD-10-GM (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification) und eine S2k-Leitlinie unterteilen SES in umschriebene SES (USES) und SES assoziiert mit anderen Erkrankungen (Komorbiditäten). Die USES- wie auch die künftige SES-Definition der ICD-11 (International Classification of Diseases 11th Revision) fordern den Ausschluss von Sinnesbehinderungen, neurologischen Erkrankungen und einer bedeutsamen intellektuellen Einschränkung. Diese Definition erscheint weit genug, um leichtere nonverbale Einschränkungen einzuschließen, birgt nicht die Gefahr, Kindern Sprach- und weitere Therapien vorzuenthalten und erkennt das ICD(International Classification of Disease)-Kriterium, nach dem der Sprachentwicklungsstand eines Kindes bedeutsam unter der Altersnorm und unterhalb des seinem Intelligenzalter angemessenen Niveaus liegen soll, an. Die intendierte Ersetzung des Komorbiditäten-Begriffs durch verursachende Faktoren, Risikofaktoren und Begleiterscheinungen könnte die Unterlassung einer dezidierten medizinischen Differenzialdiagnostik bedeuten. Schlussfolgerungen Die vorgeschlagene Terminologie birgt die Gefahr, ätiologisch bedeutsame Klassifikationen und differenzialdiagnostische Grenzen zu verwischen und auf wertvolles ärztliches und psychologisches Fachwissen in Diagnostik und Therapie sprachlicher Störungen im Kindesalter zu verzichten.


2021 ◽  
Vol 27 (Suppl 1) ◽  
pp. i9-i12
Author(s):  
Anna Hansen ◽  
Dana Quesinberry ◽  
Peter Akpunonu ◽  
Julia Martin ◽  
Svetla Slavova

IntroductionThe purpose of this study was to estimate the positive predictive value (PPV) of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for injury, poisoning, physical or sexual assault complicating pregnancy, childbirth and the puerperium (PCP) to capture injury encounters within both hospital and emergency department claims data.MethodsA medical record review was conducted on a sample (n=157) of inpatient and emergency department claims from one Kentucky healthcare system from 2015 to 2017, with any diagnosis in the ICD-10-CM range O9A.2-O9A.4. Study clinicians reviewed medical records for the sampled cases and used an abstraction form to collect information on documented presence of injury and PCP complications. The study estimated the PPVs and the 95% CIs of O9A.2-O9A.4 codes for (1) capturing injuries and (2) capturing injuries complicating PCP.ResultsThe estimated PPV for the codes O9A.2-O9A.4 to identify injury in the full sample was 79.6% (95% CI 73.3% to 85.9%) and the PPV for capturing injuries complicating PCP was 72.0% (95% CI 65.0% to 79.0%). The estimated PPV for an inpatient principal diagnosis O9A.2-O9A.4 to capture injuries was 90.7% (95% CI 82.0% to 99.4%) and the PPV for capturing injuries complicating PCP was 88.4% (95% CI 78.4% to 98.4%). The estimated PPV for any mention of O9A.2-O9A.4 in emergency department data to capture injuries was 95.2% (95% CI 90.6% to 99.9%) and the PPV for capturing injuries complicating PCP was 81.0% (95% CI 72.4% to 89.5%).DiscussionThe O9A.2-O9A.4 codes captured high percentage true injury cases among pregnant and puerperal women.


2021 ◽  
Vol 11 (5) ◽  
pp. e612-e619
Author(s):  
Ali G. Hamedani ◽  
Leah Blank ◽  
Dylan P. Thibault ◽  
Allison W. Willis

ObjectiveTo determine the effect of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) coding transition on the point prevalence and longitudinal trends of 16 neurologic diagnoses.MethodsWe used 2014–2017 data from the National Inpatient Sample to identify hospitalizations with one of 16 common neurologic diagnoses. We used published ICD-9-CM codes to identify hospitalizations from January 1, 2014, to September 30, 2015, and used the Agency for Healthcare Research and Quality's MapIt tool to convert them to equivalent ICD-10-CM codes for October 1, 2015–December 31, 2017. We compared the prevalence of each diagnosis before vs after the ICD coding transition using logistic regression and used interrupted time series regression to model the longitudinal change in disease prevalence across time.ResultsThe average monthly prevalence of subarachnoid hemorrhage was stable before the coding transition (average monthly increase of 4.32 admissions, 99.7% confidence interval [CI]: −8.38 to 17.01) but increased after the coding transition (average monthly increase of 24.32 admissions, 99.7% CI: 15.71–32.93). Otherwise, there were no significant differences in the longitudinal rate of change in disease prevalence over time between ICD-9-CM and ICD-10-CM. Six of 16 neurologic diagnoses (37.5%) experienced significant changes in cross-sectional prevalence during the coding transition, most notably for status epilepticus (odds ratio 0.30, 99.7% CI: 0.26–0.34).ConclusionsThe transition from ICD-9-CM to ICD-10-CM coding affects prevalence estimates for status epilepticus and other neurologic disorders, a potential source of bias for future longitudinal neurologic studies. Studies should limit to 1 coding system or use interrupted time series models to adjust for changes in coding patterns until new neurology-specific ICD-9 to ICD-10 conversion maps can be developed.


2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 31S-39S
Author(s):  
Danielle M. Brathwaite ◽  
Catherine S. Wolff ◽  
Amy I. Ising ◽  
Scott K. Proescholdbell ◽  
Anna E. Waller

Objectives We assessed the differences between the first version of the Centers for Disease Control and Prevention (CDC) opioid surveillance definition for suspected nonfatal opioid overdoses (hereinafter, CDC definition) and the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) surveillance definition to determine whether the North Carolina definition should include additional International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and/or chief complaint keywords. Methods Two independent reviewers retrospectively reviewed data on North Carolina emergency department (ED) visits generated by components of the CDC definition not included in the NC DETECT definition from January 1 through July 31, 2018. Clinical reviewers identified false positives as any ED visit in which available evidence supported an alternative explanation for patient presentation deemed more likely than an opioid overdose. After individual assessment, reviewers reconciled disagreements. Results We identified 2296 ED visits under the CDC definition that were not identified under the NC DETECT definition during the study period. False-positive rates ranged from 2.6% to 41.4% for codes and keywords uniquely identifying ≥10 ED visits. Based on uniquely identifying ≥10 ED visits and a false-positive rate ≤10.0%, 4 of 16 ICD-10-CM codes evaluated were identified for NC DETECT definition inclusion. Only 2 of 25 keywords evaluated, “OD” and “overdose,” met inclusion criteria to be considered a meaningful addition to the NC DETECT definition. Practice Implications Quantitative and qualitative trends in coding and keyword use identified in this analysis may prove helpful for future evaluations of surveillance definitions.


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