American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Dec 2007
Myopathic dropped head syndrome: an expanding clinicopathological spectrum.
A number of neuromuscular conditions may lead to a dropped head syndrome (DHS), with some patients developing a late onset noninflammatory myopathy affecting only, or predominantly, neck extensor muscles (NEM). The cause, pathogenesis, and nosological classification of this condition are unclear. To further investigate this condition, the authors evaluated the clinical, electrodiagnostic and pathologic findings in seven patients with a myopathic DHS. ⋯ Myopathic DHS encompasses a wide spectrum of conditions that strongly affect NEM; however, as documented in the monozygotic twins, some patients may suffer from a distinct, genetically determined form of late-onset restricted myopathy leading clinically to DHS.
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Am J Phys Med Rehabil · Dec 2007
Review Case ReportsPersistent hiccups during rehabilitation hospitalization: three case reports and review of the literature.
Persistent hiccups have been reported to occur occasionally during rehabilitation hospitalizations. Hiccups can interfere with patient participation and progress, and this can lengthen and complicate the rehabilitation hospitalization. ⋯ However, chlorpromazine does not always provide favorable results. The intent of this paper is to (1) review hiccups and implications of persistent hiccups in the rehabilitation setting, (2) provide additional evidence that chlorpromazine is often not the best treatment choice for hiccups in rehabilitative patients, (3) report the effectiveness and favorable tolerability of modest doses of gabapentin in a small case series of three patients, and (4) review potentially effective treatment approaches for hiccups.
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Am J Phys Med Rehabil · Dec 2007
Case ReportsPersistent hiccup associated with intrathecal morphine infusion pump therapy.
Intraspinal drug-delivery therapy has been increasingly used in patients with intractable nonmalignant pain syndromes during the past two decades. Morphine, the only FDA-approved opioid for intrathecal administration, has been the principle agent for such therapy. Although intrathecal morphine infusion can produce profound spinal analgesia, it may also cause some untoward side effects. We describe the first case of persistent hiccup caused by intrathecal morphine infusion therapy.
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Am J Phys Med Rehabil · Dec 2007
Perceived preparedness for physiatric specialization and future career goals of graduating postgraduate year IV residents during the 2004-2005 academic year.
The purpose of this study was to evaluate trends among postgraduate year (PGY) IV physiatry residents, at the time of graduation from residency, in terms of their perceived experiences in the core clinical areas, confidence with procedural subspecialization, choice in career specialization, and desire to pursue clinical fellowship. ⋯ These results provide insight into how trainees perceive their current clinical education. With validation of measures for confidence and preparedness, this survey may be useful as an adjunct resource for residency programs to evaluate their trainees.