Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review

xlomafota13 shared this article with you from Inoreader Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review Via swallowing exercises Am J Occup Ther. 2022 Jan 1;76(1):7601180060. doi: 10.5014/ajot.2022.047589. ABSTRACT IMPORTANCE: Practitioners need to be familiar with, and involved in, managing quality-related adverse events in postacute care. OBJECTIVE: To determine interventions within the scope of occupational therapy that address preventable adverse events in adult postacute inpatient and home health settings. DATA SOURCES: Articles published from January 1995 through 2019 identified through sea rches of MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Study Selection and Data Collection: Articles were collected, evaluated, and analyzed by two independent reviewers. They were assessed and synthesized with a goal of informing clinical practice. FINDINGS: Twenty-four articles were included in the review. Of the 10 Centers for Medicare & Medicaid Services preventable adverse events, 6 were addressed: diabetes management (n = 2), dysphagia (n = 5), infection control (n = 1), pressure ulcers (n = 6), falls (n = 5), and discharge management (n = 5). There was strong strength of evidence that exercise programs should, when appropriate, be implemented in both inpatient and home health settings to decrease the risk of falls. There was moderate strength of evidence that practitioners could consider implementing a facility wide evidence-based pressure ulcer program; providing multidisciplinary rehabilitation and swallow strengthening exercises for dysphagia; impl ementing a multidisciplinary, multicomponent falls program; and using a manualized depression intervention in home health to decrease hospital readmission. CONCLUSIONS AND RELEVANCE: The review highlights the importance of preventable adverse events and of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and to control health care costs. What This Article Adds: Many interventions typically performed by occupational therapy practitioners address preventable adverse events. The review highlights the importance of practitioners being aware of this category of impairment or injury. PMID:34990510 | DOI:10.5014/ajot.2022.047589 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report

xlomafota13 shared this article with you from Inoreader Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Jan 6:34894211070135. doi: 10.1177/00034894211070135. Online ahead of print. ABSTRACT OBJECTIVES: Metal hypersensitivity reaction to surgical implants is a well- known phenomenon that is associated with pain, swelling, inflammation, and decreased efficacy of the implant. We present a unique case of a patient with placement a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. METHODS: The patient was a 33-ye ar old, severely atopic woman with history of asthma exacerbations requiring several intubations for acute respiratory failure with several subsequent tracheal dilations with steroid injections, and eventual tracheostomy placement with a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. RESULTS: Initial intervention included performing an airway evaluation, CO2 laser, and steroid injection of the area of complete subglottic stenosis. Follow up several months later revealed little improvement in level of tracheal narrowing proximal to the tracheostomy tube. Patient did not have shortness of breath but continued to be aphonic. Cricotracheal versus tracheal resection have been proposed but surgical morbidity was deemed too high due to patient's obesity. CONCLUSIONS: Metal hypersensitivity reactions are well known phenomena as it relates to surgical implants in other surgical specialties but are seldom reported within the ear, nose and throat literature. Oftentimes, it takes astute observation to diagnose and establish a connection. Prompt recognition and treatment can be acquired from interdisciplinary collaboration with allergy. PMID:34991357 | DOI:10.1177/00034894211070135 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Neck Emphysema Post Elective Tonsillectomy: Case Report and Literature Review

xlomafota13 shared this article with you from Inoreader Surgical Neck Emphysema Post Elective Tonsillectomy: Case Report and Literature Review Via ear nose throat Ear Nose Throat J. 2022 Jan 6:1455613211069352. doi: 10.1177/01455613211069352. Online ahead of print. ABSTRACT Neck emphysema after tonsillectomy surgery is very rare. We present a case documenting the conservative management of a post-tonsillectomy neck swelling, accompanied by crepitus. Computed tomography revealed a large air density at the region of the right masticator space and the masseter muscle, proximal to other deep neck spaces and muscles. Further investigations of her associated symptoms resulted in an additional diagnosis of systemic lupus erythematosus. We have also explored the signs and symptoms associated with such cases, along with a discussion of the literature published on surgical emphysema post-tonsillectomy. PMID:34991367 | DOI:10.1177/01455613211069352 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adherence and barriers to the vitamin D and calcium supplement recommendation at Danish nursing homes: a cross-sectional study

xlomafota13 shared this article with you from Inoreader Adherence and barriers to the vitamin D and calcium supplement recommendation at Danish nursing homes: a cross-sectional study Via swallowing exercises BMC Geriatr. 2022 Jan 6;22(1):27. doi: 10.1186/s12877-021-02719-4. ABSTRACT BACKGROUND: Nursing home residents are in high risk of vitamin D deficiency, which negatively affects bone health. Vitamin D and calcium supplements haves shown to increase bone density and reduce fracture risk. Therefore, The Danish Health Authority recommends all nursing home residents a daily supplement of 20 μg vitamin D and 800-1000 mg calcium. However, adherence to the recommendation and knowledge of it is unknown. The aims of this study were to investigate adherence, knowledge, and potential barriers to this recommendation in Denmark. METHODS: A cross-sectional electronic survey was conducted in May-June 2020 among 50 randomly selected nursing homes widely distributed in Denmark. Questions included degree of adherence to the recommendation at each nursing home as well as respondent's knowledge and attitudes towards it, and experienced barriers in relation to adherence. RESULTS: Respondents from 41 nursing homes answered the questionnaire, and these were mainly nurses (63%) or nursing home leaders (20%). Low adherence (≤ 40% of residents receiving both supplements) was reported at 35% of nursing homes, and only 8% of the nursing homes had a high adherence (> 80% of residents receiving both supplements). Most respondents (88%) had knowledge of the recommendation and 62% rated importance of increased implementation as high. Common explanations of low implementati on were a lack of prescription by the general practitioner in the central electronic database (60%), resident-refusal to eat tablets (43%), chewing-swallowing difficulties (40%), and a high number of tablets given to the residents daily (34%). CONCLUSIONS: The recommendation of daily vitamin D and calcium supplements to Danish nursing home residents is poorly implemented even though knowledge of the recommendation is relatively high. Barriers relate to an ambiguity of responsibility between the general practitioners and the nursing home staff, as well as the high number of tablets to be consumed in total by the residents. These barriers must be targeted to improve adherence in this vulnerable group of institutionalized older adults. PMID:34991498 | DOI:10.1186/s12877-021-02719-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Hearing Loss in Congenital Hypothyroid Children at a Tertiary Care Hospital in Central India

xlomafota13 shared this article with you from Inoreader Evaluation of Hearing Loss in Congenital Hypothyroid Children at a Tertiary Care Hospital in Central India Via Otolaryngology Indian Abstract Hearing loss has long been associated with congenital hypothyroidism and, if not noticed and treated early, may result in delayed language acquisition and difficulties in comprehension. In light of the implications of congenital hypothyroidism and its associated hearing loss, we decided to conduct this study. The aim of this study was to identify the prevalence of hearing loss in congenital hypothyroidism and its relation to the severity of the disease and age of initiation of treatment. This study was conducted from July 2016 to June 2021 at a tertiary care hospital in Bhopal. The hearing status of congenital hypothyroid children and matched controls was assessed by pure tone audiometry or free field audiometry and, in selected cases, with brainstem evoked response audiometry. Eight children (25%) with congenital hypothyroidism had hearing loss, compared to one (3.12%) in the control group (p < 0.05). No statistically significant difference has b een found in the gender, mean age of diagnosis, mean age of initiation of levothyroxine treatment, mean screening FT4 levels, and mean screening TSH levels between congenital hypothyroid children with and without hearing loss. Due to the high prevalence of hearing loss in congenital hypothyroidism and its impact on language and cognitive development, it is critical to create awareness among healthcare professionals that children diagnosed with congenital hypothyroidism must undergo audiological evaluation at the time of diagnosis and periodically thereafter. Alternatively, children with unexplained hearing loss must be screened for congenital hypothyroidism. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relation Between Posterior Canal Benign Paroxysmal Positional Vertigo and Vitamin D Deficiency

xlomafota13 shared this article with you from Inoreader Relation Between Posterior Canal Benign Paroxysmal Positional Vertigo and Vitamin D Deficiency Via Otolaryngology Indian Abstract The aim of this study is to establish a relationship between vitamin D levels and benign paroxysmal positional vertigo (BPPV) and its recurrence; and to evaluate the remedial effect of vitamin D on BPPV. In a pilot study, 40 patients with clinically diagnosed posterior canal BPPV were evaluated, treated and were followed up for a period of 6 months at ENT Department of Mahatma Gandhi Medical College, Jaipur. All the patients with clinical diagnosis of posterior canal BPPV were tested for 25(OH)D levels at their 1st visit. Patients were divided in two groups after appropriate matching. Group A was given vitamin D supplementation along with canal repositioning manoeuvre (CRM) and group B were only treated by canal repositioning manoeuvre. Patients underwent neuro-otological assessment during follow up visits and recurrent attacks were recorded. This study was conducted on 40 patients with BPPV (26 females and 14 males). The average age was 50 years. Avera ge serum of 25(OH)D at the first visit was (12.2 ng/ml) for group A, and (12.4 ng/ml) for group B, all patients had low serum level of 25(OH)D (below 20 ng/ml). Recurrent BPPV episodes, were significantly lower in group A than that of group B. We second the hypothesis that the patients with BPPV who have insufficient levels of Vitamin D may benefit from vitamin D supplementation and we suggest further epidemiological and pharmacological studies to detect the effect of vitamin D deficiency on development and recurrence of vertigo. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Robotic system for top to bottom MRgFUS therapy of multiple cancer types

xlomafota13 shared this article with you from Inoreader Robotic system for top to bottom MRgFUS therapy of multiple cancer types Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Background A robotic system for Magnetic Resonance guided Focused Ultrasound (MRgFUS) therapy of tumours in the breast, bone, thyroid, and abdomen was developed. Methods A special C-shaped structure was designed to be attached to the table of conventional MR imaging (MRI) systems carrying 4 computer-controlled motion stages dedicated to positioning a 2.75 MHz spherically focused transducer relative to a patient placed in the supine position. The developed system was evaluated for its MRI compatibility and heating abilities in agar-based phantoms and freshly excised tissue. Results Compatibility of the system with a clinical high-field MRI scanner was demonstrated. FUS heating in the phantom was successfully monitored by MR thermometry without any evidence of magnetically-induced phenomena. Cigar-shaped discrete lesions and well-defined areas of overlapping lesions were inflicted in excised tissue by robotic movement along grid patterns. Conclusions The developed MRgFUS robotic system was proven safe and efficient by ex-vivo feasibility studies. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between exposure to radioactive iodine after the Chernobyl accident and thyroid volume in Belarus 10-15 years later

xlomafota13 shared this article with you from Inoreader Association between exposure to radioactive iodine after the Chernobyl accident and thyroid volume in Belarus 10-15 years later Via radioactive iodine Environ Health. 2022 Jan 7;21(1):5. doi: 10.1186/s12940-021-00820-0. ABSTRACT BACKGROUND: While there is a robust literature on environmental exposure to iodine-131 (131I) in childhood and adolescence and the risk of thyroid cancer and benign nodules, little is known about its effects on thyroid volume. METHODS: To assess the effect of 131I dose to the thyroid on the volume of the thyroid gland, we examined the data from the baseline screening of the Bel arusian-American Cohort Study of residents of Belarus who were exposed to the Chernobyl fallout at ages ≤18 years. Thyroid dose estimates were based on individual thyroid activity measurements made shortly after the accident and dosimetric data from questionnaires obtained 10-15 years later at baseline screening. During baseline screening, thyroid gland volume was assessed from thyroid ultrasound measurements. The association between radiation dose and thyroid volume was modeled using linear regression where radiation dose was expressed with power terms to address non-linearity. The model was adjusted for attained age, sex, and place of residence, and their modifying effects were examined. RESULTS: The analysis was based on 10,703 subjects. We found a statistically significant positive association between radiation dose and thyroid volume (P < 0.001). Heterogeneity of association was observed by attained age (P < 0.001) with statistically significant association remain ing only in the subgroup of ≥18 years at screening (P < 0.001). For this group, increase in dose from 0.0005 to 0.15 Gy was associated with a 1.27 ml (95% CI: 0.46, 2.07) increase in thyroid volume. The estimated effect did not change with increasing doses above 0.15 Gy. CONCLUSIONS: This is the first study to examine the association between 131I dose to the thyroid gland and thyroid volume in a population of individuals exposed during childhood and systematically screened 10-15 years later. It provides evidence for a moderate statistically significant increase in thyroid volume among those who were ≥ 18 years at screening. Given that this effect was observed at very low doses and was restricted to a narrow dose range, further studies are necessary to better understand the effect. PMID:34996456 | DOI:10.1186/s12940-021-00820-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dual VEGF/PDGF knockdown suppresses vasculogenic mimicry formation in choroidal melanoma cells via the Wnt5a/β-catenin/AKT signaling pathway

xlomafota13 shared this article with you from Inoreader Dual VEGF/PDGF knockdown suppresses vasculogenic mimicry formation in choroidal melanoma cells via the Wnt5a/β-catenin/AKT signaling pathway Via histochem Acta Histochem. 2022 Jan 4;124(1):151842. doi: 10.1016/j.acthis.2021.151842. Online ahead of print. ABSTRACT OBJECTIVE: This study aimed to explore the effects of knocking down both vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) on vasculogenic mimicry (VM) formation in choroidal melanoma (CM) cells. METHODS: Cell counting Kit (CCK)-8, monoclonal formation, wound healing, transwell and flow cytometry assays were used to observe the cell effects in CM cell line, ocular choroidal melanoma-1 cells (OCM-1) with respect to proliferation, migration, invasion and apoptosis. Three-dimensional (3D) cultures were also used to characterize VM tube structural effects in OCM-1 cells and western blotting was used to characterize protein expression changes in VM-related markers. RESULTS: Dual VEGF/PDGF knockdown suppressed cell proliferation, migration and invasion, but promoted cell apoptosis. It also reduced VM tube structures in OCM-1 cells. VM associated markers including, VE-cadherin, EphA2 and MT1-MMP were also down-regulated in OCM-1 cells. Similarly, Wnt5a, β-catenin and phosphorylated-AKT levels were also down-regulated. Western blotting and 3D cultures further demonstrated that combined Wnt5a silencing with dual VEGF/PDGF knockdown significantly decreased VE-cadherin and EphA2 levels and reduced VM tube structures in OCM-1 cells. CONCLUSIONS: Dual VEGF/PDGF knockdown suppressed cell growth and metastas is in OCM-1 cells, and blocked the Wnt5a/β-catenin/AKT signaling pathway thereby inhibiting VM formation. PMID:34995928 | DOI:10.1016/j.acthis.2021.151842 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unusual Presentation of Otoacariasis

xlomafota13 shared this article with you from Inoreader Unusual Presentation of Otoacariasis: A Prospective Study at Referral Teaching Hospital Via Otolaryngology Indian Abstract Otoacariasis is the presence of ticks and mites within the ear canal. Though the coexistence of ticks and humans is known for thousands of years, tick infestation is relatively rare in urban population. The most common presenting symptoms are usually itching, otalgia and a foreign body sensation and less frequent ones are tinnitus and otorrhoea. We report cases of otoacariasis with unusual presentation. A total of 43 cases presented to the ENT clinic in our hospital over a period of three years from 2018 to 2021. We present patients who presented with unusual symptoms of conductive hearing loss, ear bleed, and facial palsy. Total of 6 cases of otoacariasis had unusual presentation. 2 cases presented with lower motor neuron palsy, 1 case with ear bleed, and 3 cases with hearing loss. Otocariasis can present with unusual symptoms of hearing loss, ear bleed or facial palsy and this should be included in the differential diagnosis of a patient with history of close p roximity to domestic or wild animals. Detailed examination often reveals the presence of the tick and identification and complete removal along with appropriate medication for associated symptoms often results in complete recovery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Induction and generalization of nocebo effects on itch

xlomafota13 shared this article with you from Inoreader Induction and generalization of nocebo effects on itch Via Experimental Dermatology Abstract Nocebo effects, i.e., negative treatment outcomes due to negative expectancies, can increase itch. Moreover, indirect evidence has shown that nocebo hyperknesis can generalize to another itch modality. Knowledge on response generalization can help to prevent and decrease negative effects. The aims of this study were to investigate 1) the efficacy of inducing nocebo effects on cowhage-evoked itch via verbal suggestions and 2) whether these effects can generalize to 2a) mechanically evoked touch and 2b) mechanically evoked itch. Forty-four healthy participants watched a video suggesting that a nocebo solution increases cowhage-evoked itch and that a control solution does not affect itch. Subsequently, cowhage, mechanical itch, and mechanical touch stimuli were applied. Nocebo effects were measured as the difference in both mean and peak of the outcomes itch and urge to scratch between nocebo and control trials. Main analyses revealed significant nocebo effects on mean and peak itch for all stimuli. For urge to scratch, a significant nocebo effect was only observed for mechanical touch (peak). As mechanical stimuli did not induce pure sensations as planned, post-hoc sensitivity analyses were run for mechanical stimuli that individually induced either touch or itch at baseline. These analyses showed similar results for generalization to mechanical itch, but generalization to mechanical touch was nonsignificant. This study showed that merely verbal suggestion can induce nocebo effects on cowhage-evoked itch and that these effects can generalize to another itch modality. Future studies may examine how to prevent negative experiences from generalizing to subsequent encounters. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.