American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Jul 2014
Case ReportsCommon peroneal nerve palsy caused by compression stockings after surgery.
Peroneal nerve palsy is one of the more common entrapment neuropathies of the lower limb and can be a result of a multitude of causes. Compression stockings are commonly used for prophylaxis of deep venous thromboembolism after surgery. The entrapment on the head and the neck of the fibula caused by compression stockings is uncommon. ⋯ He had left foot drop and difficulty in walking during gait assessment. The needle electromyography confirmed total axonal degeneration of the left peroneal nerve with denervation potentials. The aim of this report was to emphasize the importance of the size and length of the compression stockings and regular skin control in avoiding the risk for peroneal nerve palsy.
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Am J Phys Med Rehabil · Jul 2014
Duchenne muscular dystrophy: life prolongation by noninvasive ventilatory support.
American, Japanese, and Canadian centers have demonstrated that noninvasive intermittent positive pressure ventilatory support (NVS) can be used continuously and in the long-term by people with Duchenne muscular dystrophy as a definitive alternative to tracheostomy mechanical ventilation. The aim of this study was to report this for the first time in Europe. ⋯ Noninvasive respiratory management can prolong survival without resorting to tracheotomy and without hospitalization.
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Am J Phys Med Rehabil · Jul 2014
New challenges for the graduate medical educator: implementing the milestones.
Physical medicine and rehabilitation residency programs will face new challenges as they implement the Milestones and establish a Clinical Competency Committee, new requirements in the Accreditation Council of Graduate Medical Education's Next Accreditation System. The milestones require programs to measure the capabilities of individual residents, and programs will be expected to show how residents progress to successively higher levels of behavior during the course of the residency. Program directors will be assisted by a committee of faculty whose role is to assess each individual resident's attainment of milestones and assist in the early identification of residents not making the expected progress. ⋯ Because the milestones are based on observable behaviors, a key component of this system will be direct observation by faculty of residents during patient care. However, many faculty are not trained in this skill. Faculty development in observational skills, workplace-based assessment skills, and providing formative feedback will be a very important aspect if the milestones are to be successfully used to help residents make developmental progress in their clinical competence.