Medicine and Health Sciences Commons^™

The Health Insurance Resources Utilization And Rehabilitation Intervention In Patients With Traumatic Spinal Cord Injury: A Pilot Study, Pao Huang, Jen-Hung Wang, Chih-Cheng Fan, Po-Ting Chen, Chung-Chao Liang

Rehabilitation Practice and Science

Spinal cord injury is associated with a substantial and long-term economic burden on both the patients and the national health insurance. Due to the advancements in medical techniques, the mortality rate of patients with spinal cord injury has decreased. Moreover, as the life expectancy has increased in Taiwan, patients with spinal cord injury may need long-term rehabilitation to restore their functions of daily living and prevent further complications. Nonetheless, long-term rehabilitation would increase the economic burden on the long-term care facilities, as expected. This study aimed to analyze the impact (from admission to 3-year follow-up after discharge) of medical expenses …

Unilateral Diaphragm Paralysis Secondary To Subarachnoid Hemorrhage And Ischemic Stroke With Phrenic Nerve Dysfunction: A Casereport, Shih-Shin Huang, Chien-Min Chen, Chia-Hung Lin

Rehabilitation Practice and Science

Background: Cerebrovascular accident may lead to neurological symptoms and functional defects. Impaired respiratory and swallowing function as well as limited mobility make pneumonia a common complication after stroke. The diaphragm is innervated by the phrenic nerve and is a major respiratory muscle. Phrenic nerve dysfunction can lead to diaphragm paralysis and result in abnormal respiratory function. Cerebrovascular accident of cerebral hemisphere is one of the etiologies of phrenic nerve dysfunction and can lead to respiratory symptoms. There are few discussions in current literature regarding secondary diaphragm paralysis after cerebrovascular accident of cerebral hemisphere. This casereport presents the clinical signs of …

Swallowing Rehabilitation Of Dysphagia In Parkinson Disease: Recent Advances And Recommendations, Chin-Man Wang, Yih-Ru Wu, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is common in Parkinson disease (PD). Dysphagia may affect quality of life in the early stage of PD and can cause dehydration, malnutrition, or even result in pneumonia and mortality in the late stage. Accordingly, management of dysphagia is a crucial issue in PD. Clinicians and researchers should spend more effort developing sensitive evaluation tools and effective intervention strategies for dysphagia in PD. In the early stage of disease, the Swallowing Disturbance Questionnaire, Münich Dysphagia Test for Parkinson’s Disease questionnaire, or noninvasive tools involving surface electromyography or sensors should be used to detect subtle or mild dysphagia. In the …

Management Of Dysphagia In Spinal Muscular Atrophy, Kuo-Chang Wei, Wen-Chin Weng, Tyng-Guey Wang

Rehabilitation Practice and Science

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease. SMA phenotypes can be determined by the timing of disease onset and the highest level of motor development reachable by the patient. Generally speaking, proximal muscle involvement is more severe than in the distal extremities. In addition, cervical and the masticatory and pharyngeal muscles were likely affected by the disease, which can cause feeding problems and dysphagia. Clinically, dysphagia is more common among patients with type I and type II SMA. To thoroughly evaluate swallowing-related issues, both subjective information from patients and their caregivers and findings from objective tools including …

Swallowing Exercisesin Enforcing And Augmenting Suprahyoid Muscles To Improve Dysphagia And Upper Esophageal Sphincter Dysfunction For Stroke Patients: A Systematic Reviewarticle, Heng-An Yeh, Yu-Jen Chen

Rehabilitation Practice and Science

Dysphagia often occurs in stroke patients, who may present oral, pharynx, and upper esophageal sphincter dysfunction, including insufficient chewing and stirring bolus ability, poor pharyngeal contraction, pharynx to upper esophageal sphincter incoordination, and relaxation of the upper esophageal sphincter. Insufficient opening of the upper esophageal sphincter is an obstacle for moving a bolus from the pharynx to the esophagus. In addition to provide swallowing training, most of the treatments for upper esophageal sphincter dysfunction are invasive. However, several non-invasive swallowing exercises have been published with the aim of treating upper esophageal sphincter dysfunction. The purpose of this article is to …

Effect Of Balance In Home Program Training With Head And Neck Stability Device For Teenagers With Cerebral Palsy-A Preliminary Report, Shao-Chih Hsu, Yin-Chou Lin, Chia-Ying Chung, Kuo-Kuang Yeh, Wen-Yu Liu, Shu-Tin Chang, Alice Mk Wong, Chih-Kuang Chen

Rehabilitation Practice and Science

Background and aims: Cerebral palsy (CP) is impaired development in movement and postural control due to brain damage during the fetal or early infancy stage of life. Poor control of the neck muscle affects the peripheral sensory input and central nervous signal output, inhibiting the pre-action feedback response and expected postural regulation, which might result in impaired postural stability of the head and trunk. Therefore, the main purpose of this study is to conduct head and neck vertical stabilization training for teenage students with cerebral palsy, and to examine its balance effect. Methods: In addition to maintaining regular rehabilitation training, …

The Effect Of Exercise Intervention Held In A Community Care Center On Physical Function In Elders With Dementia: A Pilot Study, Jui-Chi Hsu, Jung-Cheng Yang, Yu-Ying Chu, Yi-Chun Chein, Yi-Chen Tsai, Hsiao-Ting Tsai, Ching-Fei Lo, Yen-Ting Lai

Rehabilitation Practice and Science

The care-issue for dementia is becoming more important as the elderly dementia population rapidly increases in Taiwan. Although many studies show exercise intervention is effective in slowing the disease progression of people with dementia living in institutions, there is insufficient evidence regarding individuals with dementia living in the community. Therefore, the purpose of this study is to assess if a once a week group exercise session along with four home exercise sessions per week is effective in improving the balance, mobility, muscle strength and aerobic endurance in community dwelling elders with dementia. This study recruited 18 elders above 65 years …

Therapeutic Efficacy Of Dynamic Hand Splints In Spastic Hemiparetic Hands: A Randomized Controlled Single-Blind Trial, Yi-Ching Huang, Shih-Che Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Chu-Hsu Lin

Rehabilitation Practice and Science

Background: It is usually challenging to treat patients following stroke or brain injury with spastic hemiparetic upper limbs. Dynamic hand splints have been used to manage this issue for years, but evidence of their efficacy is still lacking. Objective: To investigate the treatment efficacy of dynamic hand splinting in spastic hemiparetic patients. Methods: In this randomized controlled single-blind clinical trial, patients with spastic hemiparesis lasting more than half a year after a stroke or brain injury were enrolled. They were randomly divided into a splint group and a control group, and received 1 month of task-oriented training with or without …

Applying The Pzb Model In Evaluating The Service Quality Of Rehabilitation In A Rural Local Hospital, Guan-Bo Chen, I-Hisu Liou, Hui-Wen Lu, Chien-Hui Li, Ssu-Yu Chen, Sheng-Hui Tuan

Rehabilitation Practice and Science

Background: Previous studies on rehabilitation have rarely focused on the medical service quality. Not to mention studies about the medical service quality of rehabilitation in the rural public hospital. The expectations and needs of the patients and their caregivers should be emphasized. We applied the concept of Parsuraman,-Zeithaml,-Berry (PZB) service quality gap model and expected zone of tolerance to determine the difference in the medical service quality between the expectations and satisfaction of patients and their caregivers who received rehabilitation in a rural local public hospital in southern Taiwan. Methods: We used a 30-item structured questionnaire, modified from the 22- …

The Investigation Between Voiding Function Medication And The Risk Of Bladder Cancer In Patients With Spinal Cord Injury, Kai-Hua Chen, Ting-Yao Wang, Chien-Min Chen, Chuan-Pin Lee, Yao-Hsu Yang, Chu-Hsu Lin, Kuan-Yu Kung, Vincent Chin-Hung Chen

Rehabilitation Practice and Science

Bladder cancer (BC) is a chronic complication of spinal cord injury (SCI). Limited studies have focused on the risks of BC in SCI patients using voiding function medication for bladder dysfunction. In this retrospective, national-wide, population-based cohort study, SCI patients with registration in the National Health Insurance Research Database (NHIRD) from 1998 to 2013 were included. We investigated the risk of BC in SCI patients administered voiding function medications and other comorbidities by 2-year landmark analysis. SCI patients were divided into medication user (bethanechol, oxybutynin, or tolterodine) and non-medication user groups at landmark period. They were followed until the development …

Tibial Neuropathy After Revision Total Knee Prosthesis: A Casereport, Chun-Ping Wang, Wei-Ting Wu, Lin-Fen Hsieh

Rehabilitation Practice and Science

We describe a 74-year-old woman with right knee osteoarthritis experiencing right tibial neuropathy because of complications of total knee arthroplasty revision. Weakness in the right toe flexors and paresthesia over the sole of the right foot were observed after operation. A nerve conduction study and electromyographic examination indicated right tibial neuropathy. Radiography indicated a prosthesis fragment in the right popliteal fossa, and its location was different before and after surgery. Prosthesis fragment dislodgement was also confirmed through ultrasonography, and the nearby tibial nerve may have been entrapped because of the dislocation process and surrounding tissue fibrosis. Ultrasonography confirmed the prosthesis …

Research Of Medical Service Quantity And Quality Of Rehabilitation In A Rural Public Health Center, Guan-Bo Chen, Hung-Tzu Su, Chien-Hui Li, Yung-Heng Lee, Fung-Yi Chen, Hong Lin, Sheng-Hui Tuan

Rehabilitation Practice and Science

Background: Liugui District, that locates in the rural Kaohsiung city, is defined as the area with insufficient medical resources by National Health Insurance. In 2017, service of rehabilitation was established in Liugui District with the help from Department of Health, Kaohsiung City Government. It's an innovative model by combining the private physical therapy clinic with public health center and it was the first one in Taiwan. The physical therapy clinic was run by a private therapist and it was set up in the Liugui public health center. The rehabilitation outpatient clinic service was provided by one physiatrist from Ci-Shan hospital …

Celecoxib Did Not Impair Proliferation, Migration And F-Actin Formation Of Skeletal Muscle Cells, Hang-Ming Chen, Zhi-Jia Chen, Li-Ping Lin, Wen-Chung Tsai, Jong-Hwei S. Pang

Rehabilitation Practice and Science

Muscle injury is the most common sport related soft-tissue injury. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for muscle injury treatment. The newest guideline (PEACE and LOVE) from British Journal of Sports Medicine in 2019 emphasized the avoidance of anti-inflammatory modalities in acute phase for the concerning about the negative effect on long-term tissue healing. It has been investigated that NSAIDs impeded cell migration which is crucial role in muscle healing. This study was designed to determine the effects of celecoxib, one of the cyclooxygenase-2 (COX-2) inhibitor on cell proliferation and migration in skeletal muscle cells. MTT assay (3-[4,5-dimethylthiazol- 2-yl]-2,5-diphenyltetrazolium …

Myxoid Liposarcoma: A Soft-Tissue Sarcoma Mimicking Hematoma In A Baseball Player, Chia-Hua Lee, Hao-Hung Tsai, Yat-Yin Law, Chuan-Chao Lin

Rehabilitation Practice and Science

There are multiple histological types of soft-tissue sarcomas (STS) that are associated with different prognoses. Liposarcoma (LPS) is the most frequent subtype of STS in extremities and trunk wall in Taiwan.The myxoid liposarcoma is the second most common subtype of LPS and is associated with an intermediate-grade malignancy. STS and hematoma may be difficult to differentiate clinically. We report a case of a 35-year-old male presented with a mass lesion over the left thigh, which was initially misinterpreted as a hematoma on ultrasound. We also conducted a magnetic resonance imaging (MRI) study, which revealed the possible diagnosis of STS. After …

Comparative Analytical Study Of Phytochemicals In Selected Antidiabetic Medicinal Plant Seeds In Sri Lanka, Gowri Rajkumar, Mihiri Rangika Jayasinghe, Vinotha Sanmugarajah

Pharmaceutical Sciences and Research

Medicinal plants are universally used in the management of various diseases in different medical practices. A varied diversity of compounds extracted from plants may show anticancer, antibacterial, and antidiabetic activities. Comparative laboratory studies and scientific approach of efficacy related to phytochemicals found in medicinal plants in Sri Lanka have not been reported yet. This study aims to evaluate the phytochemicals in selected four different plant seeds such as Syzygium cumini (L.) Skeels, Brassica alba (L.) Rabenh, Trigonella foenum-graecum L. and Nigella sativa L., which are used in the management of diabetes mellitus in Sri Lanka. The ethanol extracts of …

Biologic Tnf-Α Inhibitors Reduce Microgliosis, Neuronal Loss, And Tau Phosphorylation In A Transgenic Mouse Model Of Tauopathy, Weijun Ou, Joshua Yang, Juste Simanauskaite, Matthew Choi, Demi M. Castellanos, Rudy Chang, Jiahong Sun, Nataraj Jagadeesan, Karen D. Parfitt, David H. Cribbs, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Background

Tumor necrosis factor-α (TNF-α) plays a central role in Alzheimer’s disease (AD) pathology, making biologic TNF-α inhibitors (TNFIs), including etanercept, viable therapeutics for AD. The protective effects of biologic TNFIs on AD hallmark pathology (Aβ deposition and tau pathology) have been demonstrated. However, the effects of biologic TNFIs on Aβ-independent tau pathology have not been reported. Existing biologic TNFIs do not cross the blood–brain barrier (BBB), therefore we engineered a BBB-penetrating biologic TNFI by fusing the extracellular domain of the type-II human TNF-α receptor (TNFR) to a transferrin receptor antibody (TfRMAb) that ferries the TNFR into the brain via …

Acknowledgment Of Culture And Stereotypes: Black Participants’ Perceptions Of Specific Therapist Behaviors, Tsotso T. Ablorh

Graduate Masters Theses

Mental health disparities for Black people of diverse ethnicities compared to people of other racial identities has been well-documented (Alegría et al., 2008; Maura & Weisman de Mamani, 2017). Research addressing this pervasive systemic and interpersonal problem often focuses on client-related factors that create or intensify barriers to care. However clinician-related factors (i.e., racial identity, multicultural training, implicit biases, behavior, etc.) also have a significant impact on barriers to care, retention in therapy, and clinical outcomes for people of African descent (Larrison & Schoppelrey, 2011; Owen, Imel, Adelson, & Rodolfa, 2012). Researchers suggest that the favoring of historically white perspectives, …

Neural Correlates Of Syntactic Comprehension: A Longitudinal Study, Shannon M. Sheppard, Erin L. Meier, Kevin T. Kim, Bonnie L. Breining, Lynsey M. Keator, Bohao Tang, Brian Caffo, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Broca’s area is frequently implicated in sentence comprehension but its specific role is debated. Most lesion studies have investigated deficits at the chronic stage. We aimed (1) to use acute imaging to predict which left hemisphere stroke patients will recover sentence comprehension; and (2) to better understand the role of Broca’s area in sentence comprehension by investigating acute deficits prior to functional reorganization. We assessed comprehension of canonical and noncanonical sentences in 15 patients with left hemisphere stroke at acute and chronic stages. LASSO regression was used to conduct lesion symptom mapping analyses. Patients with more severe word-level comprehension deficits …

Dermoscopic Features Of Uncomplicated Tinea Versus Steroid-Modified Tinea: An Observational Study In Indian Patients, Mithila Ninad Gadekar, Nausheen Syed, Ashutosh Chate, Sushrut Save

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Tinea is one of the most common superficial fungal skin infections. Steroid-modified tinea infections may present with atypical morphology. This study aims to observe the difference between dermoscopic features of uncomplicated dermatophytosis and steroid-modified dermatophytosis.
Methods: This observational study was conducted in 60 patients with tinea cruris, tinea corporis and tinea faciei in the outpatient dermatology department of a tertiary care center. Patients were divided into group A and group B. Group A included 30 patients with no history of steroid use in the past three months. Group B included 30 patients with a history of steroid …

Plasma Malondialdehyde Levels Related To Acne Vulgaris Severity, Fitri Puspita, Nelva Karmila Jusuf, Ariyati Yosi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris (AV) is a multifactorial disorder characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Oxidative stress plays a role in the pathogenesis of AV. Reactive Oxygen Species (ROS), especially lipid peroxides (LPO), plays a role in mediating acne inflammation. Malondialdehyde (MDA) is one of the byproducts of LPO commonly used as a biomarker of cell damage.
Methods: This cross-sectional analytic study consisted of sixty patients with AV. The samples were taken from the blood plasma of AV subjects. An enzyme-linked immunosorbent assay (ELISA) examination was performed. The normality of data …

The Differences Of Blood Type In Relation To Psoriasis And Its Onset: Cross Sectional Study, Nugrohoaji Dharmawan, Suci Widhiati, Triasari Oktavriana, Irene Jessica Pinarsinta Harahap

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Psoriasis is a chronic skin disease caused by inflammatory response and attacks 2% of population, with the prevalence influenced by age, geographical location, and genetic background. Until this day, there are several studies that discuss about the relationship between blood type with disease. However, discussion about the difference between blood type and the relationship with skin disease remains limited. The objective of this study is to know the relationship between blood type, psoriasis, and onset of psoriasis.
Methods: This study adopted cross-sectional design of analytic observational study. The subjects of this study were patients in Department of …

Indonesian Clinical Practice Guidelinesfor Systemic And Biologic Agents For Adults With Plaque Psoriasis, Novianto E, Budianti Wk, Fitri Em, Wiryadi Be, Soebaryo Rw, Pusponegoro Ehd, Effendi Eh, Rahmayunita G

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: In response to various biologic and non-biologic systemic agents available in Indonesia, proper and accredited treatment guidelines are required to ensure patient safety. Appropriate treatment is crucial and may affect remission time and morbidities. These guidelines were developed by the Indonesian Society of Dermatology and Venereology – Kelompok Studi Psoriasis Indonesia (INSDV-KSPI) to provide updated decision-making algorithms for the biologic and non-biologic systemic agents for the treatment of adult patients with plaque psoriasis.
Methods: Experts from twelve institutions across Indonesia were involved in developing the guidelines. Subsequently, a focus group discussed various journals, researchable questions, eligibility criteria, …

Platelet-Rich-Fibrin For Venous Leg Ulcer Therapy, Karin Rachmani, Lis Surachmiati Suseno, Mutiara Ramadhiani

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Venous leg ulcer (VLU) is a chronic condition in the chronic venous insufficiency clinical spectrum. It’s becoming a burden because of its chronicity, slower wound healing, accumulated high cost, and treatment is a challenging task. Platelet-rich-fibrin (PRF) is one of the newer modalities available for treating VLU. Previous studies have shown successful results by using PRF in leg ulcers. We reported a case of venous leg ulcer treated with PRF.
Case Illustration: A 47-year-old male came with an ulcer on the lower left leg for one year. The ulcer was preceded with a reddish, tender nodule with …

Intense Pulsed Light (Ipl) As Adjuvant Therapy For Acne Vulgaris: A Case Series, Widyaningsih Oentari, Angie Regina Sutrisno, Nelva Karmila Jusuf, Khairina Nasution

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment.
Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the …

Management Of Basal Cell Carcinoma With Excision Followed By Rotation Advancement Flap, Remenda Siregar, Fitri Puspita, Widyaningsih Oentari, Ari Karmila Sari

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Basal cell carcinoma (BCC) is the most common malignant skin tumor and is derived from pluripotent cells in the basal layer of the epidermis. One of the BCC management options is surgery followed by a skin flap to close the wound defect.
Case Illustration: We present a 43-year-old woman with a major complaint of non-healing sores on the left zygomatic region, close to the medial canthus, with frequent episodes of bleeding and itching since one year before admission. The lesion was excised and followed by histopathological examination, which revealed the BCC diagnosis with tumor-free edges. Closure of …

It Cannot Happen, Never: A Qualitative Study Exploring Youth Views On Disclosure Of Hiv Diagnosis To Their Sexual Partners In Southern Malawi, Maggie Zgambo, Diana Arabiat, Deborah M. Ireson Dr

Research outputs 2014 to 2021

With the availability of antiretroviral therapy, more children living with HIV live longer than before and grow into young adulthood. This study examined the concerns of youth about disclosure of an HIV diagnosis to their sexual partners and attempted to gain an understanding of their HIV status disclosure experiences, views, and plans. A focused ethnography was undertaken. Using semi-structured interviews, data were collected from 20 youth between the ages of 15 and 24 years who were attending an HIV clinic. The findings highlight that youth generally struggled to disclose their HIV status to their sexual partners. The most frequent reasons …

The Benefits Of Astaxanthin To Improve Pain Relief In Patients With Painful Diabetic Neuropathy: An Open-Label, Randomized Controlled Trial, Rizaldy Taslim Pinzon, Mary Rose Angelina Budi Harsana

Pharmaceutical Sciences and Research

Treatment of diabetic neuropathy is still carried out by providing symptomatic therapy, which only improves ± 50% of the total symptoms felt by patients, but does not tackle the underlying causes of the disease. Astaxanthin is a potent antioxidant, anti-inflammatory, and anti-diabetic carotenoid that could be an additional treatment option. We aimed to measure the effectiveness of administering astaxanthin as an additional therapy to improve the impact of pain and discomfort experienced daily by diabetes mellitus patients with painful diabetic neuropathy. We conducted a randomized experimental study with an open label design of 36 patients who had been diagnosed with …

Caring For Older Adults In The Hallway Of A Crowded Emergency Department, Rebecca Weeks, Kathy Sawasky, Michael Malone

Journal of Geriatric Emergency Medicine

This paper describes strategies for emergency department providers to address the needs of older adults when facilities are overcrowded and care extends into the hallway.

Risk Factors Associated With Mother-To-Child Transmission Of Hiv In Dar Es Salaam, Tanzania, Felix Elias, Nyimvua Shaban, Edwin Rutalebwa

Tanzania Journal of Science

Despite Tanzania's efforts and substantial progress in PMTCT, about 11% new infections were recorded among Tanzanian children in 2019 (UNAIDS 2020a). The objective of this study was to determine the rate of HIV transmission and to identify its risk factors among HIV exposed infants born to HIV-positive mothers in Dar es Salaam, Tanzania. A cross-sectional study was conducted using retrospective data collected from HIV-positive mothers and their exposed babies who were followed and registered in health facilities in four administrative districts (Ilala, Temeke, Kinondoni, and Ubungo) in Dar es Salaam between January 2016 and December 2019.  To identify risk factors …

Response To: A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Joanna Sax

Texas A&M Law Review

In A Telehealth Explosion: Using Lessons from the Pandemic to Shape the Future of Telehealth Regulation, published in the Texas A&M Law Review, Professor Deborah Farringer tackles the critical issue of the efficacy and implementation of telehealth, using our experience(s) of telehealth during the COVID–19 pandemic as the guide. This is important, as Professor Farringer acknowledges, because while telehealth advocates pre-date the pandemic, barriers prevented the implementation of telehealth in a widespread manner. These barriers included a concern about fraud and a question as to whether telehealth visits could provide effective outcomes compared to in-person visits. Professor Farringer …