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Health-Related Quality Of Life And Chronic Obstructive Pulmonary Disease In North Carolina, David Brown, Roy Pleasants, Jill Ohar, Monica Kraft, James Donohue, David Mannino, Winston Liao, Harry Herric

David C. Brown

Background:

Comparisons of health-related quality of life (HRQOL) between persons with chronic obstructive pulmonary disease (COPD) and adults in the general population are not well described.

Aims:

To examine associations between COPD and four measures of HRQOL in a population-based sample.

Patients & Methods:

These relationships were examined using data from 13,887 adults aged >18 years who participated in the 2007 Behavioral Risk Factor Surveillance System (BRFSS) conducted in North Carolina (NC). Logistic regression was used to obtain adjusted relative odds (aOR).

Results:

The age-adjusted prevalence of COPD among NC adults was 5.4% (standard error 0.27). Nearly half of adults …

Haematopoietic Stem Cells In Spleen Have Distinct Differentiative Potential For Antigen Presenting Cells., Jonathan Tan, Helen O'Neill

Jonathan Tan

Dendritic cells (DC) are known to develop from macrophage dendritic progenitors (MDP) in bone marrow (BM), which give rise to conventional (c)DC and monocytes, both dominant antigen presenting cell (APC) subsets in spleen. This laboratory has however defined a distinct dendritic-like cell subset in spleen (L-DC), which can also be derived in long-term cultures of spleen. In line with the restricted in vitro development of only L-DC in these stromal cultures, we questioned whether self-renewing HSC or progenitors exist in spleen with restricted differentiative capacity for only L-DC. Neonatal spleen and BM were compared for their ability to reconstitute mice …

Self-Assessed Emergency Readiness And Training Needs Of Nurses In Rural Texas, Holly Jacobson, Francisco Soto Mas, Chiehwen Hsu

Francisco Soto Mas

Nurses are potential first responders in the case of an emergency, and should play a key role in bioterrorism preparedness and response. The role of nurses becomes more critical in rural areas where local health departments are absent and health professionals are scarce. Given that nurses’ capacity to act will be vital to an emergency response in a rural community, it is imperative to determine their current level of bioterrorism training. The purpose of this study was to assess the level of bioterrorism-related preparedness and training needs of the nursing workforce in Regions 2 and 3 of the Texas Department …

Retention In Care Among Hiv-Infected Patients In Resource-Limited Settings: Emerging Insights And New Directions, Elvin Geng, Denis Nash, Andrew Kambugu, Yao Zhang, Paula Braitstein, Katerina Christopoulos, Winnie Muyindike, Mwebesa Bwana, Constantin Yiannoutsos, Maya Petersen, Jeff Martin

Elvin H Geng

In resource-limited settings—where a massive scale up of HIV services has occurred in the last 5 years—both understanding the extent of and improving retention in care presents special challenges. First, retention in care within the decentralizing network of services is likely higher than existing estimates that account only for retention in clinic, and therefore antiretroviral therapy services may be more effective than currently believed. Second, both magnitude and determinants of patient retention vary substantially and therefore encouraging the conduct of locally relevant epidemiology is needed to inform programmatic decisions. Third, socio-structural factors such as program characteristics, transportation, poverty, work/child care …

Enhancement Of Reactive Oxygen Species Production And Chlamydial Infection By The Mitochondrial Nod-Like Family Member Nlrx1, Ali A. Abdul-Sater, Najwene Saïd-Sadier, Verissa M. Lam, Bhavni Singh, Matthew A. Pettengill, Fraser Soares, Ivan Tattoli, Simone Lipinski, Stephen E. Girardin, Philip Rosenstiel, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

Chlamydia trachomatis infections cause severe and irreversible damage that can lead to infertility and blindness in both males and females. Following infection of epithelial cells, Chlamydia induces production of reactive oxygen species (ROS). Unconventionally, Chlamydiae use ROS to their advantage by activating caspase-1, which contributes to chlamydial growth. NLRX1, a member of the Nod-like receptor family that translocates to the mitochondria, can augment ROS production from the mitochondria following Shigella flexneri infections. However, in general, ROS can also be produced by membrane-bound NADPH oxidases. Given the importance of ROS-induced caspase-1 activation in growth of the chlamydial vacuole, we investigated the …

Application Of Shewhart Cycle Of "Plan-Do-Check-Act" Model To Improve The Waiting Time In Clinical Rehabilitation Therapy, Wen-Hsuan Lin, Ru-Lan Hsieh, Pei-Jei Tsai

Rehabilitation Practice and Science

The Shewhart cycle ”Plan-Do-Check-Act” (PDCA) can be applied by organizations as a model for designing, checking, evaluating, improving, or re-designing plans to improve the quality of service. We applied the PDCA model to clinical rehabilitation services in Taiwan and discussed its effects on the improvement in waiting time. Three issues facing current clinical rehabilitation services were proposed by the Department of Physical Medicine and Rehabilitation in a medical center to which PDCA was applied: (1) arranging occupational therapy for in-patients within 3 days after consultation, (2) shortening the waiting time for therapy in children with developmental delays, and (3) shortening …

Result Of Low Frequency Speech Therapy In Children With Articulation Disorder, Yu-Nan Wang, Mei-Li Cheng, Ya-Wen Li, Xiao-Jun Zhang

Rehabilitation Practice and Science

Articulation disorder refers to the mispronunciation of speech sounds by omitting, distorting, substituting, or adding sounds which make speech difficult to understand. It is not an uncommon disorder among children. The prevalence of articulation disorder in preschool and school-age children is about 10%. For children without associated condition, articulation disorder may be treatable with speech therapy. In this study, we examined 55 children with articulation disorder who received speech therapy in our hospital during the past four years. The boys to girls ratio is 2.4 to 1. Among the different types of articulation disorders, substitution is the most common type …

Moyamoya Disease Presenting With Hemichorea: A Casereport, Min-Hsin Lai, Shin-Yo Lu, Pei-Chi Chou, Shin-Tsu Chang, Heng-Yi Chu

Rehabilitation Practice and Science

We report an unusual case of a 13-year-old boy with moyamoya disease whose predominant manifestation was right hemichorea with initial dystonic spasms of the right limbs and face. A diffusion-weighted MR image of the brain in the initial stage showed no infarcted or other parenchymal lesions. However, MR angiography and intracranial angiography showed stenosis of the bilateral internal carotid and middle cerebral artery with prominent basal collaterals, which was compatible with moyamoya disease. Chorea or hemichorea is one of the rarer presenting features of moyamoya disease. Our findings suggest that moyamoya disease should be included in the differential diagnosis of …

Multiple Heterotopic Ossifications In A Patient With Traumatic Brain Injury And Femoral Fracture: A Casereport, Chun-Sheng Ho, Chein-Wei Chang, Eou-Ting Hsieh, Jen-Li Pan

Rehabilitation Practice and Science

Sporadic heterotopic ossification is a common complication in patients with spinal cord injury, traumatic brain injury, electrical burns, hip fracture, elbow fracture or total hip arthroplasty. However, multiple heterotopic ossifications in a traumatic brain injury case are quite rare. We report a case of a 23 year-old female patient with traumatic brain injury and a right femoral open fracture due to a traffic accident. She started to develop local erythema, swelling, warmth and pain over the left elbow and right hip about two months after the accident. The range of motion of the affected joints decreased and this severely impeded …

Orthostatic Postural Deficit In Subjects With Streptococcal Serology-Related Unclassified Arthritis Of The Lumbopelvis, Shao-Chi Lu, Liang-Cheng Chen, Shang-Lin Chiang, Tsung-Ying Li, Yau-Ren Tseng, Shin-Tsu Chang, Chen-Chung Dai

Rehabilitation Practice and Science

Titers of antistreptolysin-O (ASO) possess the diagnostic value in discriminating post-streptococcal reactive arthritis. Patients are labeled as ”unclassified arthritis” (UA) while hard to be classified as having a well-defined arthropathy. Posture is important to perform activities of daily living and its abnormality is a negative factor for trunk stability and balance. We hypothesized that an imbalance of the lumbopelvis due to sacroiliac joint disorder might produce a positional change. The purpose of this study was to determine whether there was a difference in postural sway during orthostatic standing in subjects with UA of the lumbopelvis and high ASO titers. All …

Efficacy Of Wii(Superscript Tm)-Based Virtual Reality Assisted Rehabilitation For Chronic Stroke Patients, Zheng-Yu Hoe, Jue-Long Wang, Yuk-Keung Lo, Shu-Fen Sun, Chao-Hung Chang, Hsin-I Tsai

Rehabilitation Practice and Science

Virtual reality assisted rehabilitation provides the opportunity for a safe training environment, allows intensive practice using repetitive tasks, provides real-time auditory and visual performance feedback and also may augment patients’ motivation. Wii(superscript TM) has all of these advantages. In addition, it is relatively cheap and thus it is affordable and practical to be used in clinical settings. We recruited patients with chronic stroke (＞1 yr) and limb function impairment. All patients participated in the Wii(superscript TM)-based virtual reality assisted rehabilitation program with a minimum of 30 minutes/session, three times/week for 3 months. The patients' cognitive function, motor function of both …

Subjective And Objective Evaluation On The Effect Of Splinting In Short-Term Use For Carpal Tunnel Syndrome: A Preliminary Study, Shu-Min Chen, Chun-Kai Liao, Hsiu-Yun Hsu, Ta-Shen Kuan

Rehabilitation Practice and Science

Splinting is a conservative treatment for carpal tunnel syndrome (CTS), but the duration of treatment required for symptom relief has not been determined definitively. The aim of this study was to use subjective and objective methods to investigate the short-term therapeutic effect of splinting for CTS.Six participants with CTS were enrolled in this study. Participants were required to wear the splints for at least eight hours a day. Symptom Severity and Functional Status Scales, pinch power, nerve conduction studies, and high resolution sonography were used to evaluate the patients before and at two weeks and one month after splinting. The …

Acute Abdominal Pain In Spinal Cord Injury Patient Induced By Indwelling Urethral Catheter Placed Into The Right Ureter Through The Ureteral Orifice: A Casereport, Chang-Jheng Wu, Huei-Yu Lo, Yau-Wai Wai, Han-Tin Lu

Rehabilitation Practice and Science

Diagnosis of acute abdomen in spinal cord injury (SCI) patients remains challenging. Classic peritoneal signs, such as rigid abdomen, rebounding pain and abdominal muscle guarding may be not reliable. It is still an important cause of morbidity and mortality in patients with SCI.A 45-year-old woman with SCI and 7th and 8th thoracic vertebrae fractures suffered from lower abdominal pain, fever and chills for three days. Physical examination revealed diffuse abdominal tenderness with muscle guarding. Laboratory studies showed severe leukocytosis and mild pyuria. Abdominal contrast-enhanced computed tomography scans (CTS) revealed a urinary catheter, which had been accidentally inserted into the right …

Clinical Outcomes Of Rehabilitation On An 11-Year-Old Girl With Devic's Syndrome: A Casereport, Cheng-Cheng Hsu, Wen-Chih Lin, Tan-Hwui Lau, Ming-Chi Lai, Rong-Bin Hong, Wei-Ni Chou

Rehabilitation Practice and Science

Devic's syndrome-neuromyelitis optica (NMO), a rare demyelinating central nervous system diseases, must be clinically differentiated from multiple sclerosis (MS). The diagnostic criteria of Devic's syndrome include optic neuritis, acute myelitis, and at least two of the three symptoms below: brain MRI different from MS, three or more consecutive spinal segments invaded on MRI, and NMO-IgG seropositive.The case prevails over females aged 30-40 years. The courses of Devic's syndrome could be categorized in two types: single invasion and recurrence. The latter has poorer prognosis. The medical treatment mainly lies in immune modulation and the rehabilitative intervention including retaining life functions, preventing …

Dysphagia After Anterior Cervical Spine Surgery: A Casereport, Hsi-Ting Chiu, Ssu-Yuan Chen, Tyng-Guey Wang, Yen-Ho Wang

Rehabilitation Practice and Science

Dysphagia is one of the complications that develops after anterior cervical spine surgery. Its etiology is multifactorial. It is transient in most patients, and few patients suffer from dysphagia for more than several months. This study reports 1 patient with a dislocation fracture at the C5-C6 level who suffered from dysphagia for 6 months after the anterior cervical spine surgery. Videofluoroscopic examination of swallowing revealed pharyngeal muscle weakness and cricopharyngeal muscle dysfunction with obstruction at the level of the left upper esophageal sphincter. Serial examination revealed neither laryngeal organic lesions, such as those observed in vocal cord palsy, nor evidence …

Ultrasonographic Diagnosis Of A Knee Prosthesis Polyethylene Loose Body: A Casereport, Ying-Fang Chen, Yi-Pin Chiang, Baii-Jia Yang

Rehabilitation Practice and Science

Polyethylene is an important component of a knee prosthesis, but wear of this material is one of the most frequent complications following total knee arthroplasty. Diagnosis of polyethylene wear is based mainly on history, physical examination, and plain radiographs. However, even when the damage is severe, plain radiographs may not be so sensitive enough to detect the debris. Musculoskeletal ultrasound is infrequently used to evaluate the operated knee, but it is a sensitive method for evaluating the polyethylene component of a knee prosthesis.We report an 80-year-old woman who had a painful, enlarging, inflamed mass on her left knee. She had …

Toe-Out Landing Position Increases Medial Ground Reaction Force During Walking In Young Individuals, Chein-Teng Chung, Chen-Chia Yang, Chin-Hwa Chiu, Chia-Hung Lin, Yueh-Ling Hsieh

Rehabilitation Practice and Science

Objective: The purpose of this study was to determine how toe-out foot landing position influences ground reaction forces (GRF) during gait.Design: Values of GRF components recorded with a force platform were used to compare 3D GRF vectors of toe-out and non toe-out (including neutral and toe-in) foot landing positions. Methods: Thirty-two healthy males (ranging from 19-21 years old) were repeatedly assigned three foot landing positions: maximum toe-out, maximum toe-in and neutral. Each participant walked with three foot landing positions across a force platform while their three-dimensional motion was captured. Results: No differences were observed for vertical or anteroposterior GRF among …

Effects Of Distributed Constraint-Induced Therapy On Trunk Control, Daily Function, And Quality Of Life In Patients With Chronic Stroke, Yi-An Chen, Keh-Chung Lin, Ching-Yi Wu, Yin-Chou Lin, Ngok-Kiu Chu, Jyh-Yuh Ke, Pei-Hsuan Wu

Rehabilitation Practice and Science

Objective: Patients commonly have impaired arm trunk coordination following a stroke. The trunk compensation often used by stroke patients may hinder recovery of the affected arm. Given that the extent to which constraint-induced therapy (CIT) affects arm-trunk coordination has not been investigated previously, this study examines how distributed CIT (dCIT) affects arm trunk coordination and trunk compensation strategy, as well as functional performance and quality of life.Materials and Methods: Sixteen participants (at least 6 months post-onset) after stroke were randomly assigned to either the dCIT group which received training 2 hours daily for 3 weeks, with the unaffected arm restrained …

The Effects Of Rehabilitation Exercises In Community-Dwelling Elderly With Osteoarthritis And Stroke: A Pilot Study, Jia-Ching Chen, Chun-Hsiang Lin, Li-Chun Chen, Yu-Chun Wei, Jung Hsiao, Nan-Yueh Lin, Chung-Chao Liang

Rehabilitation Practice and Science

The prevalence of chronic disease in community-dwelling elderly has increased with the increase in the elderly population in Taiwan. This study investigated the effects of regular rehabilitation exercises provided by rehabilitation professionals in community-dwelling elderly people with osteoarthritis and stroke. A single group with pretest-posttest design was used in this pilot study. A total of 32 elderly people in the community were recruited and classified into two groups, one with osteoarthritis (n=21) and the other with chronic stroke (n=11). The intervention of one consisted of one 3-hour rehabilitation exercise session each week provided by a physical therapist and consultation with …

Juvenile Muscular Amyotrophy Of Distal Upper Limbs: A Casereport, Tzu-Ying Sung, Shu-Fen Sun, Po-Chin Wang, Chiao-Wen Hwang, Jue-Long Wang

Rehabilitation Practice and Science

Juvenile muscular amyotrophy of distal upper limbs (Hirayama disease) is a rare disease predominantly affecting the anterior horn cells of the cervical cord in young men. It is a kind of cervical myelopathy characterized by insidious onset of unilateral distal dominant upper limbs muscle weakness and atrophy due to anterior cervical cord compression. It is difficult to differentiate this disease from other diseases with similar symptoms such as motor neuron disease. Cervical magnetic resonance (MR) study in flexed position is helpful to confirm the diagnosis.We reported a 21-year-old man who complained of slowly progressed muscle atrophy and weakness of right …

The Therapeutic Effect Of Selective Dorsal Rhizotomy On Severe Spasticity Related Spinal Cord Injury: A Casereport, Shin-Yo Lu, Tsui-Fen Yang, Tai-Tong Wong, Rai-Chi Chan, Chung-Yu Ho, Hung-Yi Chang

Rehabilitation Practice and Science

Spasticity refers to a velocity-dependent resistance to passive motion which was characterized as a symptom of upper motor neuron lesion. Though mild spasticity can help patients compensate for muscle weakness which is benefit for transferring and some daily living function, severe spasticity may cause difficulty in positioning, motor performance and predispose to pressure ulcer. The treatment option for spasticity includes physical therapy (positioning, stretching, range of motion exercise), splinting, oral medication (baclofen and diazepam are most commonly used), botulinum toxin or phenal block for focal spasticity, and more invasively, intrathecal baclofen pump (ITB) and selective dorsal rhizotomy (SDR). Selective dorsal …

Clinical Diagnosis And Prognosis Of Hirayama Disease: A Casereport, Min-Jung Wu, Jan-Wei Chiu, Chen-Liang Chou, Rai-Chi Chan

Rehabilitation Practice and Science

Hirayama disease is a rare disease with unique clinical manifestations. It was first reported by Japanese physician Keizo Hirayama, and tends to develop in young people in their teens and early twenties, predominantly in men. The lower cervical spinal anterior horn cells are usually involved, resulting in asymmetric muscular atrophy or weakness of distal upper extremity. The onset is insidious and gradual. It ends up in a stable status after years of progression. By now the mechanism is still unclear, and two hypotheses are discussed. One is anterior displacement of the cervical dural sac from repeated or sustained neck flexion, …

Autonomic Dysfunction As The Initial Presentation Of Vitamin B12 Deficiency: A Casereport, Hun-Pin Lee, Huey-Wen Liang, Tung-Chou Li

Rehabilitation Practice and Science

Background: Vitamin B12 deficiency may be associated with variable neurological involvement, and myelopathy is the most common disorder associated with this deficiency. However, initial presentation with autonomic dysfunction is very rare.Case: The present report describes the case of a 76-year-old man who initially presented with recurrent syncope, followed by impaired vibration and proprioception, and then progressive weakness of the limbs. Result: The findings of a hematological study, blood biochemistry, gastric biopsy by panendoscopy, and electrophysiological examinations all supported the diagnosis of chronic atrophic gastritis-related vitamin B12 deficiency associated with macrocytic anemia, myelopathy, peripheral neuropathy, and autonomic dysfunction. Conclusion: We presented …

台灣復健醫學雜誌通訊繼續教育測驗題, The Editors

Rehabilitation Practice and Science

No abstract provided.

The Effect Of Body Weight Support Treadmill Training On Walking Ability In Patients With Incomplete Spinal Cord Injury, Chien-Hsing Tseng

Rehabilitation Practice and Science

In modern health care systems that attach importance to acute treatment and health care, there is an increasing number of patients with incomplete spinal cord injury that have increased chance of regaining their ability to walk. However, how to effectively achieve this target of promoting the ability to walk is a question that must be urgently addressed by rehabilitation medicine and public health authorities. International research has already confirmed that body weight support treadmill training has a positive therapeutic effect on walking ability in patients with incomplete spinal cord injury, but in Taiwan not many relevant studies have been performed. …

Ultrasonographic Examination Of Tongue Movement During Articulation In Preschool Children, I-Chun Chen, Chien-Lun Peng

Rehabilitation Practice and Science

Ultrasound imaging provides a unique and complete representation of tongue structure in almost all planes of interest and is rapid enough to record real-time tongue movement during speech. Recording tongue movement with ultrasound is non-invasive, and has not been shown to have any biologic effects in humans at diagnostic intensities. As a result, ultrasound has been widely used in speech studies to measure tongue functions in recent years. However, these previous studies are subject to inconsistent plane images caused by additionally movement of the traditional handheld transducer. The artifacts that result from depression of the submental soft tissue contacted by …

Analysis Of Phonological Disorder Among Preschool Children, Shao-Li Han, Yen-Chi Chen, Hsiao-Yu Yen, Ya-Wen Tu, Tsung-Yu Wei

Rehabilitation Practice and Science

Speech sound errors have been noted as the most common speech disorder among children. However, recent studies about pronunciation errors among preschool children are lacking. Our aim was to evaluate the characteristics and frequency of pronunciation errors among pre-school children with phonological disorder in Taiwan. Between December 2006 and November 2008, we recruited children visiting our outpatient department for evaluation of speech sound errors. Children with speech delay, hearing loss, mental retardation, orofacial abnormalities, chromosomal abnormalities and other pervasive developmental disorders identified by clinical evaluation and clinical birth histories acquired from their families were excluded. Finally, 126 children who met …

Novel Orthoses For Male Hemiplegic Patients To Perform Clean Intermittent Catheterization: A Casereport, Yu-Lin Tsai, Mao-Hsiung Huang, Chia-Hsin Chen

Rehabilitation Practice and Science

A 37-year-old male suffered from hemorrhagic stroke with left side hemiplegia and neurogenic bladder. On admission, due to post-renal acute renal failure with hydronephrosis, he received indwelling catheterization but felt very uncomfortable. However, he was physically unable to perform clean intermittent catheterization (CIC) due to his hemiplegia. Two novel devices were designed to help him perform CIC using one side of his body. As in our experience with this case, hemiplegic patients may now be able to perform CIC by themselves to achieve adequate bladder drainage using one-sided limbs under the assistance of the novel orthoses.

Carpal Tunnel Syndrome As An Initial Presentation Of Glioblastoma Multiforme: A Casereport, Chih-Hung Tseng, Kun-Lin Wu, Sin-Hao Ho, Su-Ju Tsai

Rehabilitation Practice and Science

A 43-year-old woman was clinically diagnosed as carpal tunnel syndrome due to the presentation of intermittent numbness, tingling and pain in her right thumb and index finger. The symptoms gradually exacerbated together with positive Phalen's test and Tinel's sign. Endoscopic carpal tunnel release procedure failed to relieve her symptoms. Ensuing symptoms developed such as headache, extensive numbness and mild weakness in her right upper and lower limbs. MRI of brain revealed a left thalamic tumor. Stereotactic biopsy confirmed the pathologic diagnosis as glioblastoma. Post-operative radiotherapy and temozolomide chemotherapy were performed to suppress disease progression. She also received comprehensive rehabilitation program, …

Posterior Interosseous Neuropathy Related To Cumulative Trauma Disorder: A Casereport, Cheng-Hao Tseng, Tsung-Cheng Huang, Jen-Wen Hung, Bin-Chi Chang

Rehabilitation Practice and Science

Work related cumulative posterior interosseous neuropathy is a rare cumulative trauma disorder. To the best of our knowledge, a locksmith with this kind of disorder has never been reported. The locksmith was a 57-year-old man, and he had to perform repeated supination and pronation movements when working. He complained of weakness of right third and fourth finger extension when typing on a computer keyboard. Radial deviation was also noted when his wrist was extended. Electromyography was performed and right posterior interosseous neuropathy was suspected. Magnetic resonance imaging (MRI) showed perineural muscle edema, obliteration and fluid accumulation at the level of …