Is anterior decompression and fusion superior to laminoplasty for cervical myelopathy due to ossification of posterior longitudinal ligament? A systematic review and meta-analysis

Context: Considerable controversy exists over surgical procedures for ossification of the posterior longitudinal ligament (OPLL).Objective: The purpose of the meta-analysis was to compare the clinical outcome of anterior decompression and fusion (ADF) with laminoplasty (LAMP) in treatment of cervical myelopathy due to OPLL.Methods: PubMed, EMBASE and the Cochrane Register of Controlled Trials database were searched to identify potential clinical studies compared ADF with LAMP for cervical myelopathy owing to OPLL. We also manually searched the reference lists of articles and reviews for possible relevant studies. Thirteen studies with 1120 patients were included in our analysis. Subgroup analyses were performed by the canal occupying ratio of OPLL.Results: Overall, the mean preoperative Japanese Orthopaedic Association (JOA) score was similar between two groups. Compared with LAMP group, ADF group was higher at the mean postoperative JOA scores and mean recovery rate, reoperation rate, and longer at mean operation time. There was not significantly different in mean blood loss and complication rate between two groups. In subgroup analysis, ADF had a higher mean postoperative JOA score and recovery rate than LAMP in cases of OPLL with occupying ratios ≥ 50%, while those difference were not found in cases of OPLL with occupying ratios < 50%.Conclusion: ADF achieves better neurological improvement compared with LAMP in treatment of cervical myelopathy due to OPLL, especially in cases of OPLL with occupying ratios ≥ 50%. Complication rate is similar between two groups, but ADF can increase the risk of reoperation     

针灸联合西药治疗中风恢复期随机平行对照研究

[目的]观察针灸联合西药治疗中风恢复期疗效。[方法]使用随机平行对照方法,将60例住院患者按病志号抽签简单随机分为两组。对照组30例营养神经细胞及促进脑组织功能恢复、胞二磷胆碱及脑活素等;颅内压高降颅压。治疗组30例取阳陵泉、风池、四神聪、曲池、外关、内关、合谷、丰隆、太冲、风市以及环跳,平泻、平补,留针30min;肘部拘挛加小海、三里;踝部拘挛加照海、太溪、解溪;膝部拘挛加阳谷、曲泉;手指部拘挛加后溪、八邪;烦躁加大陵、内关;言语不利加通里、哑门、廉泉;西药治疗同对照组。连续治疗10d为1疗程。观测临床症状、神经功能缺损程度评分、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组痊愈14例,显效9例,有效5例,无效2例,总有效率93.33%。对照组痊愈7例,显效10例,有效8例,无效5例,总有效率83.33%。治疗组疗效优于对照组(P0.05)。神经功能缺损程度评分两组均有明显降低(P0.01),治疗组降低优于对照组(P0.05)。[结论]针灸联合西药治疗中风恢复期效果显著,值得推广。     

综合康复护理在血管性痴呆患者中的应用

目的探讨综合康复护理在血管性痴呆患者中的应用效果。方法将60例血管性痴呆患者随机分为观察组和对照组。对照组给予血管性痴呆常规护理干预，观察组患者给予综合康复护理干预。采用简明精神状态量表（MMSE）对两组患者进行评分，采用巴氏指数（BI）对患者日常活动能力进行评定。结果观察组干预前MMSE评分、BI评分分别与对照组干预前比较，差异无显著意义（P〉0．05）；观察组和对照组干预后MMSE评分、BI评分与干预前比较，差异有显著意义（P〈0．05）；观察组干预后MMSE评分、BI评分与对照组干预后比较，差异有显著意义（P〈0．05）。结论综合康复护理干预能够显著改善血管性痴呆患者的认知功能，提高患者日常活动能力，护理效果显著，值得借鉴。     

Psychometric properties of the Recovery Assessment Scale in a sample with substance use disorder

Background: Conceptualisations of recovery from substance use disorder (SUD) and mental illness overlap significantly, and the rate of comorbidity of these problems is high. This study investigated the psychometric properties of the Recovery Assessment Scale (RAS), a measure originally developed for individuals with mental illness. Method: A sample of 1094 people with SUD attending residential treatment services provided by the Australian Salvation Army completed the RAS and other outcome measures at admission. Results: Confirmatory factor analysis (CFA) indicated a poor fit of the data to the five factor solution previously identified in mental illness samples. Exploratory factor analysis, however, produced three of the five factors included in the CFA, and two factors which arranged constructs in a slightly different manner from previous factor analytic studies in samples with mental illness. Correlations of these factors with other symptom distress and recovery measures indicated satisfactory convergent and divergent validity. Conclusions: The study provides modest support for the use of the RAS in groups with SUD.     

Effects of Repetitive Transcranial Magnetic Stimulation on Behavioral Recovery during Early Stage of Traumatic Brain Injury in Rats

Repetitive transcranial magnetic stimulation (rTMS) is a promising technique that modulates neural networks. However, there were few studies evaluating the effects of rTMS in traumatic brain injury (TBI). Herein, we assessed the effectiveness of rTMS on behavioral recovery and metabolic changes using brain magnetic resonance spectroscopy (MRS) in a rat model of TBI. We also evaluated the safety of rTMS by measuring brain swelling with brain magnetic resonance imaging (MRI). Twenty male Sprague-Dawley rats underwent lateral fluid percussion and were randomly assigned to the sham (n=10) or the rTMS (n=10) group. rTMS was applied on the fourth day after TBI and consisted of 10 daily sessions for 2 weeks with 10 Hz frequency (total pulses=3,000). Although the rTMS group showed an anti-apoptotic effect around the peri-lesional area, functional improvements were not significantly different between the two groups. Additionally, rTMS did not modulate brain metabolites in MRS, nor was there any change of brain lesion or edema after magnetic stimulation. These data suggest that rTMS did not have beneficial effects on motor recovery during early stages of TBI, although an anti-apoptosis was observed in the peri-lesional area.     

Rol de enfermería en los programas de recuperación intensificada (fast-track)

Rapid recovery (RR) or fast-track programmes are aimed at reducing surgical stress, leading to a reduction in nurse workload, costs and hospital stay, greater patient empowerment, early post-surgical recovery and reduced morbidity and mortality. These new protocols require the coordinated participation of a multidisciplinary team.Based on an integrative review of the literature, this paper aims to define the concept of a RR or fast track programme and show the existing evidence on the implementation of these programmes in nursing.The benefits and low incidence of damage of RR programmes in nursing justify their implementation. The programmes require greater support and diffusion in order to develop, as well as more research to increase the evidence on the effectiveness and efficiency of the protocols.     

Developing Item Response Theory–Based Short Forms to Measure the Social Impact of Burn Injuries

Objective

To develop self-reported short forms for the Life Impact Burn Recovery Evaluation (LIBRE) Profile.

Assessment of Nociception and Pain in Participants in an Unresponsive or Minimally Conscious State After Acquired Brain Injury: The Relation Between the Coma Recovery Scale–Revised and the Nociception Coma Scale–Revised

Objectives

To investigate the relation between consciousness and nociceptive responsiveness (ie, Nociception Coma Scale–Revised [NCS-R]), to examine the suitability of the NCS-R for assessing nociception in participants with disorders of consciousness (DOC), and to replicate previous findings on psychometric properties of the scale.