European journal of physical and rehabilitation medicine
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Eur J Phys Rehabil Med · Feb 2013
Review Comparative StudyThe utilization of opiates in pain management: use or abuse.
Despite governmental regulations, opiate medications continue to be abused in some populations. Some clinicians have advocated non-opioid therapy for pain patients that suffer from non-malignant conditions; while others have suggested that chronic benign pain conditions may successfully be managed with opiates in non-escalating dosages. ⋯ Studies demonstrating functional improvements with the utilization of opiate medications are also lacking. Physical Medicine and Rehabilitation researchers therefore have an ideal opportunity to positively influence education, regulation and patient care in this field.
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Eur J Phys Rehabil Med · Feb 2013
ReviewEducation and training of pain medicine specialists in the United States.
Many pain patients present with a complex set of symptoms and comorbidities that defy the acumen of any one specific medical specialty; thus the knowledge and skills of the pain physician must, out of necessity cross specialty borders. The competency that comes from mastering essential skills is accomplished during the pain medicine training. The goal of pain medicine training in the United States is to provide the postgraduate trainee with the exposure to multiple disciplines of medicine, as well as multiple interventions, so that upon completion of training, the pain physician will have the necessary skill set to provide competent, appropriate, comprehensive care for the often medically complicated pain patient. In the United States, many training programs are governed by guidelines that have been established by the Accreditation Council for Graduate Medical Education (ACGME).
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Eur J Phys Rehabil Med · Feb 2013
Comparative StudyPsychiatric disorders in patients suffering from an acute cerebrovascular accident or traumatic injury, and their effects on rehabilitation: an observational study.
The presence of a post-traumatic psychiatric disorder in patients with acute injuries may have adverse effects on outcomes. ⋯ The presence of psychiatric disorders may potentially influence the rehabilitation process and outcomes; thus their recognition and management are key factors during a rehabilitation program.
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Eur J Phys Rehabil Med · Feb 2013
Systemic vascular resistance is increased and associated with accelerated arterial stiffening change in patients with chronic cervical spinal cord injury.
Despite of stiffening change of conduit arteries, how total peripheral resistance (TPR) is adapted to chronic spinal cord injury (SCI) remains unclear. ⋯ Chronic cervical SCI leads to a progressively accelerated increase in vascular stiffness, which is associated with increase in systemic vascular resistance. Furthermore, the cervical SCI-related orthostatic hypotension lies in the impairment of vasoconstriction without cardiac dysfunction. Clinical Rehabilitation Impact. SI, rather than blood pressure, reflects not only cardiovascular risk but also TPR in chronic cervical SCI.
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Eur J Phys Rehabil Med · Feb 2013
Comparative StudyPulmonary rehabilitation at home guided by telemonitoring and access to healthcare facilities for respiratory complications in patients with neuromuscular disease.
Pulmonary complications are the main cause of morbidity and mortality in neuromuscular patients. Aim of this study was to evaluate the feasibility of a home follow-up program combining telemonitoring and chest physiotherapy (CPT) in preventing acute respiratory episodes. ⋯ An apparent reduction of hospitalisation and emergency room admissions for respiratory complications can justify a randomized control trial to confirm efficacy and effectiveness.