1,720,985 research outputs found
I sistemi di stabilizzazione possono generare eccessivi carichi di forza sulle strutture disco-legamentose attigue? Presentazione di uno studio prospettico.
No full textInfluence of systemic infection and comorbidities on rehabilitation outcomes in severe acquired brain injury
No full textSevere infectious complications are a frequent problem in patients with disability due to a severe acquired brain injury. Previous studies reported that the rehabilitation outcome is significantly lower in patients colonized or infected. However, these results could be influenced by comorbidities of those patients admitted in rehabilitation hospital with a lower functional status
Quality of life of patients with spinal cord injury in Italy: Preliminary evaluation
No full textQuality of life is a complex concept, entailing the person’s physical
health and level of independence, as well as psychological well-being, social
participation and the relationship with specific and relevant aspects of the
environment. The World Health Organization encourages the integration of a
comprehensive definition of health when examining patient-related outcomes after
injury or disease. This study aims at evaluating the quality of life of 130 Italian
patients with spinal cord injury, focusing on the associations among functional
status and health dimensions elicited by SF-36 questionnaire. The subscale scores
that revealed a stronger impact of the lesion were those related to the physical
domains, especially for the physical functioning and physical role functioning.
Physical functioning scores were significantly different in the acute phase with
respect to chronic phase, in inpatients with respect to outpatients and in patients
with lower functional impairment versus patients with higher functional
impairment. Moreover, the functional impairment influenced significantly physical
role, bodily pain and vitality scales. Disease phases also showed significantly
different scores for general health. No differences were highlighted between
tetraplegic and paraplegic patients
Quality of Life Measurements in Spinal Cord Injury Patients
No full textWe recently developed UceWeb, an application for direct elicitation of utility coefficients (UCs), i.e. a measure of health states quality perceived by patients. UceWeb was used to interview a sample of patients affected by spinal cord injury (SCI). A standard questionnaire for measuring quality of life (QoL) and another one for the system evaluation were also administered to the same patients. The aims of this work are to (i) evaluate UceWeb usability; (ii) investigate relationships among QoL values elicited with different methods, (iii) create a reference set of UCs for the health states experienced by SCI patients. We show preliminary results obtained with the first 20 patients. Despite great variability found among QoL values elicited with the different methods, interesting correlations with patients' condition and profile have been found
Mean Platelet Volume During Ischemic Stroke is a Potential Pro-inflammatory Biomarker in the Acute Phase and During Neurorehabilitation Not Directly Linked to Clinical Outcome
No full textThe prognostic role of increased mean platelet volume (MPV), as an indicator of platelet activation and large, more reactive platelets, in clinical and functional outcome of ischemic stroke is still conflicting. Studies are not currently available on the association between MPV and stroke recovery after neurorehabilitation. The relationship between MPV and clinical and functional outcome measures was assessed in twenty-four patients in the acute phase of first-ever ischemic stroke, and before and after 8-week intensive multifunctional neurorehabilitation. Neurorehabilitation was associated with improved scores of the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the modified PULSES profile (mPULSES). When compared with apparently healthy subjects, higher MPV values were observed in stroke patients 24 hours after stroke and before neurorehabilitative treatment started not later than 14 days after stroke. Decreased MPV values were found after neurorehabilitation, even if the absolute values were still higher than those detected in control subjects. No correlation was observed between MPV values and scores of the NIHSS and mRS scales evaluated in stroke acute phase. No correlation was also observed before and after neurorehabilitative treatment between MPV and NIHSS, mRS and mPULSES scores. Our data provide evidence of the effectiveness of neurorehabilitation on modulating MPV values and support the hypothesis that high MPV could represent an expression of proinflammatory condition of the stroke patients, realistically pre-existent to acute ischemic event, than a marker of neurologic deficit and disability or of stroke recovery including motor performance and functional independence
Uric Acid and Cu/Zn Superoxide Dismutase: Potential Strategies and Biomarkers in Functional Recovery of Post-Acute ischemic Stroke Patients after Intensive Neurorehabilitation
No full textNo evidence is currently provided on the involvement of uric acid (UA) and Cu/Zn Superoxide Dismutase
(Cu/Zn SOD) in functional recovery of stroke patients after neurorehabilitation. For this purpose, the relationship between
UA and Cu/Zn SOD plasma levels and clinical and functional outcome measures were analysed in twenty-five post-acute
stroke patients undergoing intensive neurorehabilitation. UA and Cu/Zn SOD plasma levels were evaluated in fifteen
healthy subjects as control values. Neurorehabilitation was associated with improved scores (P<0.05) of the National Institutes
of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the mPULSES profile. UA plasma levels
were higher before neurorehabilitation, decreased after, but were still higher than control values. Conversely, Cu/Zn SOD
plasma levels were lower than control values before neurorehabilitation and increased after, even though the absolute values
were still lower than controls. An inverse correlation was found between variations of UA plasma levels observed before
and after neurorehabilitation ( UA) and those of Cu/Zn SOD ( Cu/Zn SOD) (r= –0.386; P<0.001). No significant
correlations were observed between UA and the variations of the scores observed in all clinical outcome measures before
and after neurorehabilitation ( scores of clinical outcome measures). Cu/Zn SOD correlated positively with
NIHSS, mRS and mPULSES scores. Our data provide evidence of neurorehabilitation effectiveness on modulating
UA and Cu/Zn SOD plasma levels and suggest that Cu/Zn SOD could assume the significance of biomarker of functional
recovery, rather than UA that could be a marker of the magnitude of oxidative injury
Tablet technology for rehabilitation after spinal cord injury: a proof-of-concept
No full textNo abstract availabl
Biomarkers for alcohol abuse/withdrawal and their association with clinical scales and temptation to drink. A prospective pilot study during 4-week residential rehabilitation
No full textA bulk of evidence in the field of translational medicine applied to clinical toxicology and rehabilitation has highlighted the possibility of using biomarkers as a support in the diagnosis of alcohol-related diseases and in monitoring of alcohol withdrawal. In a cohort of 55 subjects admitted to a 4-week residential rehabilitation period for alcohol detoxification, we applied a complementary approach correlating novel and conventional peripheral blood and urine parameters in combination with clinical and functional evaluation, contextually considered with the patient's history. Biomarkers of oxidative, inflammatory, hepatic, and neurochemical effects paralleled by alcohol craving and clinical scale measurements were determined at two specific time points, i.e., admission and discharge. Concerning the post-discharge assessment (i.e., relapse evaluation one month after discharge), a follow-up oral interview during a clinical examination was applied to evaluate alcohol abstinence.Selected biomarkers, i.e., MCP1, F2-IsoPs, and SOD1, were altered in chronic alcoholics at admission, and then showed a clearly changing trend during hospitalization. Our findings demonstrated that these specific non-traditional biomarkers, measured together with more conventional ones (e.g., CDT, EtG, IL8, ALT, AST, GGT), could represent novel key parameters for monitoring alcohol use disorders and withdrawal, being also suggestive of the complexity of the psychoneuroimmune response to alcohol. A general improvement in psychological functioning (i.e., decreases in anxiety, depression, and psychological distress) was also revealed during the 4-week rehabilitation treatment, paralleled by an increase of well-being and positive changes in terms of scores. Moreover, a positive association between SOD1 and drink craving at admission was evidenced. Notably, both SOD1 and well-being displayed a significant relation with lower risk of alcohol relapse one month after discharge, indicating that SOD1 is a good predictor of reduced relapse probability. This 4-week residential rehabilitation protocol represents a sound strategy enabling identification of alcohol use disorders and monitoring of alcohol addiction state and withdrawal. However, it has to be emphasized that results derived from this pilot study need to be extensively validated in large and independent cohorts of subjects
Reduced plasma levels of tyrosine, precursor of brain catecholamines, and of essential amino acids in patients with severe traumatic brain injury after rehabilitation
No full textOBJECTIVE:
To investigate whether levels of plasma tyrosine and tryptophan, precursors of brain catecholamine and serotonin neurotransmitters, respectively, and other essential amino acids (EAA) may return to normal in patients with severe traumatic brain injury (TBI) after 2 months in a hospital rehabilitation center.
DESIGN:
Peripheral plasma concentrations of tyrosine, tryptophan, and other EAAs in subjects with severe TBI, both at admission (44+/-11d postinjury) and at discharge from the center (110+/-15d after acute event) were compared with concentrations in control subjects.
SETTING:
Tertiary care rehabilitation setting in Italy.
PARTICIPANTS:
Ten men (26.6+/-12.6y) with TBI and 6 healthy subjects (controls) matched for age, sex, voluntary loss of body weight, and sedentary lifestyle.
INTERVENTIONS:
Not applicable. Main Outcome Measures: Concentrations of brain neurotransmitter precursor amino acids and of EAA.
RESULTS:
On admission, patients had lower plasma tyrosine, leucine, valine, methionine, and phenylalanine concentrations than did control subjects. The plasma concentrations of tryptophan were similar in the 2 groups. These amino acid abnormalities were still present at discharge.
CONCLUSION:
The levels of plasma tyrosine and many EAA in patients with TBI did not recover by discharge (110+/-15d) from rehabilitation. Plasma tryptophan concentrations were similar in patients and controls
Peripheral biomarkers of oxidative stress and their limited potential in evaluation of clinical features of Huntington’s disease
No full textContext: Peripheral oxidative biomarkers could be useful for monitoring clinical features of
Huntington’s disease (HD).
Materials and methods: Cu/Zn-superoxide dismutase (Cu/Zn-SOD), neuron-specific enolase
(NSE) and 8-hydroxy-20-deoxyguanosine (8-oxoGua) serum levels were analysed in 18 HD
patients and 10 controls. Clinical measures were recorded from each HD patients.
Results: Cu/Zn-SOD, NSE and 8-oxoGua values were higher in HD patients than in controls.
Cu/Zn-SOD and NSE correlated positively. No correlation was observed between the biomarkers
analysed and the clinical measures assessed.
Discussion and conclusion: Serum oxidative biomarkers could express the neuronal
oxidative processes going on in HD patients but are inadequate to evaluate clinical features
of the disease
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