Clinical Impact of a Dedicated Trauma Hybrid Operating Room

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Technical Exhibits

Some important but little-emphasized nutritional aspects of gastrointestinal physiology are discussed. Experimental studies which form the basis for present understanding of fluid and electrolyte problems are reviewed briefly. Other topics include harmful and beneficial effects of gastrointestinal bacteria, protein-losing enteropathies, and nutritional problems associated with gastrointestinal resection.     

Satisfaction with rehabilitation in relation to self‐perceived quality of life and function among patients with stroke – a 12 month follow‐up

Scand J Caring Sci; 2013; 27; 373–379 Satisfaction with rehabilitation in relation to self‐perceived quality of life and function among patients with stroke – a 12 month follow‐up Background and Purpose: Stroke causes complex disability and function, and perceived quality of life has been shown to correlate with satisfaction with care as well as with life in general among stroke patients. The aim of this study was to study the relation of satisfaction with how rehabilitation was provided with self‐perceived quality of life, self‐perceived function and rehabilitation received, 12 months after the incidence. Method: The subjects were assessed 12 months after the onset of stroke. The Barthel index was used to measure function, and the EuroQol‐5D to measure quality of life. To measure satisfaction with how rehabilitation was provided, a questionnaire from the Swedish Stroke Register was used. Results: Two hundred and eighty‐three patients participated in the follow‐up, 137 women and 146 men, aged between 42 and 95 years (mean age 75.2, SD 11.8). For the majority of patients rehabilitation was initiated at in‐hospital care (directly after onset). One hundred and sixty‐eight patients considered that rehabilitation was well provided for. Sixty‐six regarded that the rehabilitation was only partly provided for and 35 that it was not provided for at all. High value on Barthel Index was associated with satisfaction with how rehabilitation was provided for (OR 2.81). Also, rehabilitation on three or more levels was negatively associated with satisfaction with rehabilitation provision (OR 0.24) and so was being male (OR 0.49). Conclusion: In this study, patients with higher values on Barthel Index were more satisfied with how rehabilitation was provided for. However, male patients and patients who received rehabilitation on three or more levels of care were less satisfied. Given the assumption that patients with more severe dysfunction after stroke are being rehabilitated on more levels, this might imply that it is not the amount of rehabilitation that gives satisfaction but the patients self‐perceived function after rehabilitation.     

Arm folding,hand clasping,and Luria's concept of “latent left-handedness”

Luria (1947/1970) proposed left-top positions in arm folding (AF) and hand clasping (HC) to be signs of “latent left-handedness”. However, research since has revealed that (1) left-top positions are canonical for European right-handers and (2) combined AF/HC measures may provide more information about cerebral laterality than either measure considered alone. We tested whether AF and HC or AF/HC combinations predicted diminished right-handedness for 12 handedness items. Results from 509 healthy participants showed that (1) left-top positions in AF and HC were dominant across participants, as was right-handedness, and a right-top position in HC was associated with attenuated right-handedness, (2) right-hand preference was more frequently associated with congruent AF/HC combinations, especially of the LL type (AF: left-top / HC: left-top), and (3) non-right-hand preference was associated with non-congruent, predominantly LR combinations. We conjecture that the LL type combination indicates left hemispheric dominance for motor actions, whereas the LR combination, in which HC as the distally innervated posture deviates from the canonical pattern, indicates attenuated hemispheric asymmetry. Our data support Luria's proposition that a left-top preference in AF points to “latent” left-handedness, but only if associated with a right-top preference in HC. Consistent left-top preference for the combined AF/HC measure appears to predict right-handedness.     

Pulsation-pressure relationship in experimental aneurysms: Observation of aneurysmal hysteresis

Abstract

In this study the pulsation-pressure relationship in an experimental model of aneurysms was analyzed. In addition, we have examined pulsatility of the aneurysmal wall reinforced by Cuglielmi Detachable Coils (GDC). Bifurcation (BAn), aneurysms (LAn) and bilobar (BiA) aneurysms were produced in 15 mongrel dogs. The aneurysmal dome was constructed from a segment of the external jugular vein which was sutured to the window performed on the' apex of bifurcation of the ECA and lingual artery (BAn) or,on the ECA (LAn). One set of the GDC (diameter 5 mm, length 20 cm) were inserted into the aneurysm. Intra- aneurysmal pressure> aneurysmal pulsation, ECG and femoral artery pressure were recorded. Results showed that an experimental aneurysm pulsates in synchrony with the intraaneurysmal pressure and aneurysmal pulsation is proportional to the aneurysmal size. Pulsation profile also depends on the aneurysmal type (BAn, LAn, BiA). The looped pressure-pulsation curve indicates that aneurysms exhibit property of hysteresis. For the same pressure the aneurysm is smaller during the ascending (systolic) portion of the blood pressure wave. Insertion of catheter into the aneurysm and subsequent release of the GDC did not elicit any measurable changes of the intraaneurysmal pressure. Aneurysm reinforced by GDC showed smaller pulsation and the hysteresis was reduced as well. It was concluded that aneurysmal hysteresis could be an important factor resulting in degeneration of aneurysmal wall since it is known that hysteresis accelerates degeneration of all fibrous elements, predominantly of elastic fibers. GDC seems to buffer the intra-aneurysmal hemodynamic forces and hence they might have a stabilizing effect on the aneurysmal wall. [Neurol Res 1996; 18: 377-382]     

Development of the PedsQL? sickle cell disease module items: qualitative methods

Purpose  

The objective of this qualitative study was to develop the items and support the content validity of the PedsQL™ Sickle Cell Disease Module for pediatric patients with sickle cell disease (SCD).