Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.9.606
Craig H Lichtblau
Cerebral palsy patients and their families need to predict patients’ length of survival for emotional, medical, and financial planning reasons. Providing these estimations is wrought with challenges, some of which are specific to the significant variations in survival that are observed amongst this group of patients. The statistical models that are used to assess life expectancy are plagued by mathematical limitations, faulty assumptions, and the exclusion of factors that are critical to prognosis. In this commentary, we provide evidence that the medical community generally underestimates life expectancy in cerebral palsy. With medical innovations extending lives, some of the literature on life expectancy is outdated, but old data does not explain the extent of the discrepancies we see between what we observe in our communities and what is espoused in the literature. Herein, we offer potential explanations for these discrepancies and call on the medical community to improve predictions of survival in cerebral palsy patients so that they can get the care they need. The harms and dangers of biased life expectancy data cannot be overstated, and cerebral palsy patients are consistently living longer than the current literature would suggest. We demonstrate here why life expectancy models underestimate cerebral palsy survival in the community.
{"title":"Cerebral Palsy Life Expectancy: Discrepancies between Literature and Community Data","authors":"Craig H Lichtblau","doi":"10.35248/2329-9096.21.9.606","DOIUrl":"https://doi.org/10.35248/2329-9096.21.9.606","url":null,"abstract":"Cerebral palsy patients and their families need to predict patients’ length of survival for emotional, medical, and financial planning reasons. Providing these estimations is wrought with challenges, some of which are specific to the significant variations in survival that are observed amongst this group of patients. The statistical models that are used to assess life expectancy are plagued by mathematical limitations, faulty assumptions, and the exclusion of factors that are critical to prognosis. In this commentary, we provide evidence that the medical community generally underestimates life expectancy in cerebral palsy. With medical innovations extending lives, some of the literature on life expectancy is outdated, but old data does not explain the extent of the discrepancies we see between what we observe in our communities and what is espoused in the literature. Herein, we offer potential explanations for these discrepancies and call on the medical community to improve predictions of survival in cerebral palsy patients so that they can get the care they need. The harms and dangers of biased life expectancy data cannot be overstated, and cerebral palsy patients are consistently living longer than the current literature would suggest. We demonstrate here why life expectancy models underestimate cerebral palsy survival in the community.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89841766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.S5.004
Naglaa A. Hussein, M. Bartels, Mark Thomas
Objective: Determine the relationship between frequency of steroid injections, duration between injections and diabetic status among shoulder impingement patients. Design: Retrospective. Setting: Outpatient. Participants: Charts of 412 patients presented with unilateral or bilateral shoulder pain diagnosed shoulder impingement syndrome and treated with steroid injections over a period of 01/2019-12/2020. Exclusion criteria: Those having manifestations suggesting of cervical radiculopathy, neuromuscular diseases, or shoulder trauma history. Interventions: Reviewing and collecting patient charts data; demographic data including occupation, body mass index, detailed medical history including DM history. Shoulder exam including impingement provocative tests; Hawkins test, Neer’s sign. Neck exam including Spurling test. Full neurological exam. Main outcome measures: Number of steroid injections received and duration between each injection over past 2 years. Laboratory results: Glycosylated hemoglobin (HgA1c), liver and kidney functions. MRI shoulder results if available. Results: Mean age 59.4 ± 11.123. All patients were right-handed, Male 37.1%, female 62.9%, Mean body mass index (BMI) 32.2 ± 8.2. Majority were manual workers (55.1%). significant relationship between shoulder impingement and sex and BMI. HgA1c <5.5 has the fewest patients (7.3%), highest number of patients with HgA1c 5.5-6.0. significant incidence of shoulder impingement with rising category of HgA1c with highest among HgA1c >7 (p=0.0001) with significant bilateral disease. Significant incidence of shoulder impingement (unilateral or bilateral among diabetics (HgA1c>6) compared to non- diabetics (p=0.011). Mean number of injections among diabetics 1.1756 ± 1.17283, non-diabetics 0.6391 ± 0.89051 (p=0.0001). No significant relation between DM and duration between injections (p=0.129). Conclusion: Steroid injection has proven efficacy in diabetic shoulder impingement patients. No studies discussed effect of DM on frequency of steroid injection. This study showed that presence of DM among shoulder impingement patients significantly increases the frequency of steroid injection but not affecting duration between injections.
{"title":"Is There Any Relationship between Frequency of Shoulder Impingement Steroid Injection and Diabetes Mellitus","authors":"Naglaa A. Hussein, M. Bartels, Mark Thomas","doi":"10.35248/2329-9096.21.S5.004","DOIUrl":"https://doi.org/10.35248/2329-9096.21.S5.004","url":null,"abstract":"Objective: Determine the relationship between frequency of steroid injections, duration between injections and diabetic status among shoulder impingement patients. Design: Retrospective. Setting: Outpatient. Participants: Charts of 412 patients presented with unilateral or bilateral shoulder pain diagnosed shoulder impingement syndrome and treated with steroid injections over a period of 01/2019-12/2020. Exclusion criteria: Those having manifestations suggesting of cervical radiculopathy, neuromuscular diseases, or shoulder trauma history. Interventions: Reviewing and collecting patient charts data; demographic data including occupation, body mass index, detailed medical history including DM history. Shoulder exam including impingement provocative tests; Hawkins test, Neer’s sign. Neck exam including Spurling test. Full neurological exam. Main outcome measures: Number of steroid injections received and duration between each injection over past 2 years. Laboratory results: Glycosylated hemoglobin (HgA1c), liver and kidney functions. MRI shoulder results if available. Results: Mean age 59.4 ± 11.123. All patients were right-handed, Male 37.1%, female 62.9%, Mean body mass index (BMI) 32.2 ± 8.2. Majority were manual workers (55.1%). significant relationship between shoulder impingement and sex and BMI. HgA1c <5.5 has the fewest patients (7.3%), highest number of patients with HgA1c 5.5-6.0. significant incidence of shoulder impingement with rising category of HgA1c with highest among HgA1c >7 (p=0.0001) with significant bilateral disease. Significant incidence of shoulder impingement (unilateral or bilateral among diabetics (HgA1c>6) compared to non- diabetics (p=0.011). Mean number of injections among diabetics 1.1756 ± 1.17283, non-diabetics 0.6391 ± 0.89051 (p=0.0001). No significant relation between DM and duration between injections (p=0.129). Conclusion: Steroid injection has proven efficacy in diabetic shoulder impingement patients. No studies discussed effect of DM on frequency of steroid injection. This study showed that presence of DM among shoulder impingement patients significantly increases the frequency of steroid injection but not affecting duration between injections.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"26 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89223978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.9.602
J. Farragher, Gavin Williams, A. Pranata, D. El-ansary, S. Parry, A. Bryant
Background: Non-specific chronic low back pain (NSCLBP) represents a growing global burden. Individuals with LBP inherently adapt in a variety of ways, across psychological, behavioural and physical domains. However, adaptive changes (e.g., altered lifting behaviour) may persist, becoming maladaptive, resulting in negative functional consequences (i.e., persistence of pain, increased disability). Clinical practice guidelines lack specificity to direct the type of interventions, dosage and treatment duration. A better understanding of how the maladaptive changes seen in people with NSCLBP relate to meaningful outcomes (i.e., disability, function, quality of life) and defined subgroups of people with NSCLBP may inform effective interventions. The aim of this review is to investigate the interrelationship of psychological, behavioural and neuromuscular NSCLBP-related adaptations, and their clinical significance with respect to disability, function, quality of life and pain. Methods and findings: Three MEDLINE searches were conducted to investigate the psychological, behavioural and neuromuscular adaptations in people with NSCLBP. The initial search returned 12972 articles and 238 were identified for full-text review. A total of 93 articles were included in this review. Psychological and behavioural maladaptations (i.e., fear-avoidance beliefs) are associated with poorer patient outcomes, whereas there is uncertainty regarding the impact of maladaptations in the neuromuscular system on important clinical outcomes. Moreover, the evidence is more supportive of the interrelationship between psychological and behavioural maladaptations than any interrelation with neuromuscular maladaptations. To date, methodologies designed to assess NSCLBP-related functional deficits lack ecological validity. Assessment of patients with NSCLBP should focus on psychological and behavioural domains that relate to an individual’s disability and functional impairments. Individuals with NSCLBP present with a variety of diverse adaptions that should focus intervention that aligns patient goals and functional deficits.
{"title":"Adaptations Associated with Non-Specific Chronic Low Back Pain: A Narrative Review","authors":"J. Farragher, Gavin Williams, A. Pranata, D. El-ansary, S. Parry, A. Bryant","doi":"10.35248/2329-9096.21.9.602","DOIUrl":"https://doi.org/10.35248/2329-9096.21.9.602","url":null,"abstract":"Background: Non-specific chronic low back pain (NSCLBP) represents a growing global burden. Individuals with LBP inherently adapt in a variety of ways, across psychological, behavioural and physical domains. However, adaptive changes (e.g., altered lifting behaviour) may persist, becoming maladaptive, resulting in negative functional consequences (i.e., persistence of pain, increased disability). Clinical practice guidelines lack specificity to direct the type of interventions, dosage and treatment duration. A better understanding of how the maladaptive changes seen in people with NSCLBP relate to meaningful outcomes (i.e., disability, function, quality of life) and defined subgroups of people with NSCLBP may inform effective interventions. The aim of this review is to investigate the interrelationship of psychological, behavioural and neuromuscular NSCLBP-related adaptations, and their clinical significance with respect to disability, function, quality of life and pain. Methods and findings: Three MEDLINE searches were conducted to investigate the psychological, behavioural and neuromuscular adaptations in people with NSCLBP. The initial search returned 12972 articles and 238 were identified for full-text review. A total of 93 articles were included in this review. Psychological and behavioural maladaptations (i.e., fear-avoidance beliefs) are associated with poorer patient outcomes, whereas there is uncertainty regarding the impact of maladaptations in the neuromuscular system on important clinical outcomes. Moreover, the evidence is more supportive of the interrelationship between psychological and behavioural maladaptations than any interrelation with neuromuscular maladaptations. To date, methodologies designed to assess NSCLBP-related functional deficits lack ecological validity. Assessment of patients with NSCLBP should focus on psychological and behavioural domains that relate to an individual’s disability and functional impairments. Individuals with NSCLBP present with a variety of diverse adaptions that should focus intervention that aligns patient goals and functional deficits.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"9 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81754917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.9.597
Avishek Choudhury
Objective: A patient’s medical insurance coverage plays an essential role in determining the Post-Acute Care (PAC) discharge disposition. The prior authorization process postpones the PAC discharge disposition, increases the inpatient length of stay, and effects patient health. Our study implements predictive analytics for the early prediction of the PAC discharge disposition to reduce the deferments caused by prior authorization, the inpatient length of stay, and inpatient stay expenses. Methodology: We conducted a group discussion involving 25 Patient Care Facilitators (PCFs) and two Registered Nurses (RNs) and retrieved 1600 patient data records from the initial nursing assessment and discharge notes Results: The Chi-Squared Automatic Interaction Detector (CHAID) algorithm enabled the early prediction of the PAC discharge disposition, accelerated the prior health insurance process, decreased the inpatient length of stay by an average of 22.22%.The model produced an overall accuracy of 84.16% and an area under the Receiver Operating Characteristic (ROC) curve value of 0.81. Conclusion: The early prediction of PAC discharge dispositions can reduce authorization process and simultaneously minimize the inpatient the PAC delay caused by the prior health insurance length of stay and related expenses.
{"title":"Using Machine Learning to predict post-acute care and minimize delays caused by Prior","authors":"Avishek Choudhury","doi":"10.35248/2329-9096.21.9.597","DOIUrl":"https://doi.org/10.35248/2329-9096.21.9.597","url":null,"abstract":"Objective: A patient’s medical insurance coverage plays an essential role in determining the Post-Acute Care (PAC) discharge disposition. The prior authorization process postpones the PAC discharge disposition, increases the inpatient length of stay, and effects patient health. Our study implements predictive analytics for the early prediction of the PAC discharge disposition to reduce the deferments caused by prior authorization, the inpatient length of stay, and inpatient stay expenses. Methodology: We conducted a group discussion involving 25 Patient Care Facilitators (PCFs) and two Registered Nurses (RNs) and retrieved 1600 patient data records from the initial nursing assessment and discharge notes Results: The Chi-Squared Automatic Interaction Detector (CHAID) algorithm enabled the early prediction of the PAC discharge disposition, accelerated the prior health insurance process, decreased the inpatient length of stay by an average of 22.22%.The model produced an overall accuracy of 84.16% and an area under the Receiver Operating Characteristic (ROC) curve value of 0.81. Conclusion: The early prediction of PAC discharge dispositions can reduce authorization process and simultaneously minimize the inpatient the PAC delay caused by the prior health insurance length of stay and related expenses.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"151 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73482205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.S7.004
Kaori Muraoka
Post-Stroke Depression (PSD) is a common and disturbing complication of stroke that affects rehabilitation outcomes. A past history of depression and severe stroke are risk factors for PSD, and thus, more attention should be paid to such patients. Appropriately diagnosing and screening for PSD is important because proper treatment could improve depressive symptoms and disturbed abilities. Treatment for PSD includes psychological care, nutritional care, pharmacotherapy, and exercise. Pharmacotherapy is currently the leading treatment for PSD, but antidepressants are associated with various adverse effects. Psychological and nutritional care can help manage depressive symptoms and exercise has been proven to be an effective treatment associated with fewer contraindications than pharmacotherapy. These non-pharmacological approaches could be expected to expand in clinical practice.
{"title":"Post-Stroke Depression and Stroke Rehabilitation: Literature Review","authors":"Kaori Muraoka","doi":"10.35248/2329-9096.21.S7.004","DOIUrl":"https://doi.org/10.35248/2329-9096.21.S7.004","url":null,"abstract":"Post-Stroke Depression (PSD) is a common and disturbing complication of stroke that affects rehabilitation outcomes. A past history of depression and severe stroke are risk factors for PSD, and thus, more attention should be paid to such patients. Appropriately diagnosing and screening for PSD is important because proper treatment could improve depressive symptoms and disturbed abilities. Treatment for PSD includes psychological care, nutritional care, pharmacotherapy, and exercise. Pharmacotherapy is currently the leading treatment for PSD, but antidepressants are associated with various adverse effects. Psychological and nutritional care can help manage depressive symptoms and exercise has been proven to be an effective treatment associated with fewer contraindications than pharmacotherapy. These non-pharmacological approaches could be expected to expand in clinical practice.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"72 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88011720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.S3.E003
Rishika Meadwle
sickness, meds, careful therapy, and different treatments can frequently ease a few manifestations.
疾病、药物、精心的治疗和不同的治疗通常可以缓解一些症状。
{"title":"Treatment for Cerebral Aneurysms of Ruputured Aneurysms","authors":"Rishika Meadwle","doi":"10.35248/2329-9096.21.S3.E003","DOIUrl":"https://doi.org/10.35248/2329-9096.21.S3.E003","url":null,"abstract":"sickness, meds, careful therapy, and different treatments can frequently ease a few manifestations.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"1 1","pages":"0-1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86237023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Neurorehabilitation is facing a unique challenge as COVID-19 circumstances magnify the access and resource barrier in healthcare provision; and are causing disruption in the continuity of care of children with disability. An affirmative action is required as a ‘Disability-inclusive response to the COVID-19 crisis.’ This study thus aimed to determine if Telerehabilitation (TR) model of service delivery is a feasible and effective alternative for pediatric neurophysiotherapy. Methodology: This is a clinical trial conducted on children diagnosed with developmental delay or neurological condition and referred for Physiotherapy at a tertiary care center. Clinical consultation was provided remotely with the use of real time interactive technology. Outcome indicators used were: 1)Timely receipt of physiotherapy services; 2) Child’s clinical outcomes; and 3) Familiy’s acceptability and satisfaction with the provision of TR. Results: With regards to feasibility, the most common issues faced during TR sessions were technical; lack of time with mother; child’s medical illness, etc. Children’s clinical outcomes showed improvement reported as ‘acquisition of developmental skills’ and ‘the use of appropriate functional behaviors to meet their needs’. Families showed satisfaction with TR services however, expressed the need for in-person sessions. Conclusion: In the current scenario, TR may enhance the capacity of families to meet the needs of their child with a disability by connecting them with health care providers, resources and supports; thus ensuring continuity of care. While guidelines to tackle this unprecedented situation continue to develop, TR demonstrates the potential as an alternative rehabilitation strategy thereby ameliorating the impact of social distancing on underprivileged children. However, some psychosocial factors act as barriers to feasibility of TR in pediatric population.
{"title":"Telerehabilitation: An Alternative Service Delivery Model for Pediatric Neurorehabilitation Services at a Tertiary Care Center in India","authors":"Telerehabilitation, Neurophysiotherapy, Disability., Covid","doi":"10.35248/2329-9096.21.S4.001","DOIUrl":"https://doi.org/10.35248/2329-9096.21.S4.001","url":null,"abstract":"Background: Neurorehabilitation is facing a unique challenge as COVID-19 circumstances magnify the access and resource barrier in healthcare provision; and are causing disruption in the continuity of care of children with disability. An affirmative action is required as a ‘Disability-inclusive response to the COVID-19 crisis.’ This study thus aimed to determine if Telerehabilitation (TR) model of service delivery is a feasible and effective alternative for pediatric neurophysiotherapy. Methodology: This is a clinical trial conducted on children diagnosed with developmental delay or neurological condition and referred for Physiotherapy at a tertiary care center. Clinical consultation was provided remotely with the use of real time interactive technology. Outcome indicators used were: 1)Timely receipt of physiotherapy services; 2) Child’s clinical outcomes; and 3) Familiy’s acceptability and satisfaction with the provision of TR. Results: With regards to feasibility, the most common issues faced during TR sessions were technical; lack of time with mother; child’s medical illness, etc. Children’s clinical outcomes showed improvement reported as ‘acquisition of developmental skills’ and ‘the use of appropriate functional behaviors to meet their needs’. Families showed satisfaction with TR services however, expressed the need for in-person sessions. Conclusion: In the current scenario, TR may enhance the capacity of families to meet the needs of their child with a disability by connecting them with health care providers, resources and supports; thus ensuring continuity of care. While guidelines to tackle this unprecedented situation continue to develop, TR demonstrates the potential as an alternative rehabilitation strategy thereby ameliorating the impact of social distancing on underprivileged children. However, some psychosocial factors act as barriers to feasibility of TR in pediatric population.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"148 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78593946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The human gut microbiota involve in metabolism of carbohydrates, proteins and bile acids. Primary bile acids Cholic acid (CA) and Chenodeoxycholic acid (CDCA) are synthesized in the liver and conjugated with the amino acids glycine or taurine, stored in the gall bladder. Glycine and taurine conjugates of CA and CDCA are transformed into the secondary bile acids deoxycholic acid (DCA), lithocholic acid (LCA) and a small amount of urosodeoxycholic acid (UDCA) by microbiol actions. The bile acids have a unique relationship with the gut microbiota. Although a great deal of work has shown that different bile acids play different roles in maintaining the intestinal barrier according to their uniqueness, the underlying mechanisms are complex and need to be further studied.
{"title":"Function of Bile Acid Associated with Gut Microbiota","authors":"Jieqin Song, Hongwei Hu, Meng Li, Jingjing Xiong, Mei Liu, Yongkun Huang","doi":"10.35248/2329-9096.21.9.587","DOIUrl":"https://doi.org/10.35248/2329-9096.21.9.587","url":null,"abstract":"The human gut microbiota involve in metabolism of carbohydrates, proteins and bile acids. Primary bile acids Cholic acid (CA) and Chenodeoxycholic acid (CDCA) are synthesized in the liver and conjugated with the amino acids glycine or taurine, stored in the gall bladder. Glycine and taurine conjugates of CA and CDCA are transformed into the secondary bile acids deoxycholic acid (DCA), lithocholic acid (LCA) and a small amount of urosodeoxycholic acid (UDCA) by microbiol actions. The bile acids have a unique relationship with the gut microbiota. Although a great deal of work has shown that different bile acids play different roles in maintaining the intestinal barrier according to their uniqueness, the underlying mechanisms are complex and need to be further studied.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"190 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74449109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.9.593
Khine Zin Aung, Takuji Hinoura, Naomi Kozaka, Y. Kuroda
Title: The relationship between lithium concentration in drinking water and suicide mortality rate: A systematic review. Background: Suicide is one of the leading causes of death worldwide and is influenced by multiple factors. Recently, several studies have shown that lithium in drinking water is useful for reducing the suicide mortality rate. However, it is still uncertain whether lithium intake from drinking water can achieve an anti-suicidal effect. We performed a systematic review to determine the relationship between lithium in drinking water and suicide mortality rate. Methods and Findings: We reviewed articles related to the lithium concentration in drinking water and suicide mortality rate in various geographical areas between 1990 and 2020. Of 17 articles in our systematic review, 13 reported that lithium in drinking water was significantly negatively associated with standardized mortality ratio (SMR), while 4 studies did not show any associations. On the other hand, others with meta-analysis indicated that there was a negative association between lithium concentration in drinking water and suicide mortality rate. Conclusion: Most of the studies in this review revealed that lithium concentration in drinking water was inversely related to the expected suicide mortality rate in these studies. We reviewed these articles and maintain that the balance of lithium concentration in drinking water and SMR is important in determining whether lithium in drinking water affects suicide mortality rate. If the lithium concentration is stable over the entire study region, or suicide mortality rate is very low, an association between the lithium concentration in drinking water and suicide mortality rate could not be detected even with high lithium concentrations. Therefore, it may be difficult to evaluate the effect of lithium in drinking water on suicide. Further studies are needed to determine the factors related to suicide and lithium intake from sources other than drinking water to assess the relationship between tap water lithium concentration and suicide mortality rate.
{"title":"The Relationship between Lithium Concentration in Drinking Water and Suicide Mortality: A Systematic Review","authors":"Khine Zin Aung, Takuji Hinoura, Naomi Kozaka, Y. Kuroda","doi":"10.35248/2329-9096.21.9.593","DOIUrl":"https://doi.org/10.35248/2329-9096.21.9.593","url":null,"abstract":"Title: The relationship between lithium concentration in drinking water and suicide mortality rate: A systematic review. Background: Suicide is one of the leading causes of death worldwide and is influenced by multiple factors. Recently, several studies have shown that lithium in drinking water is useful for reducing the suicide mortality rate. However, it is still uncertain whether lithium intake from drinking water can achieve an anti-suicidal effect. We performed a systematic review to determine the relationship between lithium in drinking water and suicide mortality rate. Methods and Findings: We reviewed articles related to the lithium concentration in drinking water and suicide mortality rate in various geographical areas between 1990 and 2020. Of 17 articles in our systematic review, 13 reported that lithium in drinking water was significantly negatively associated with standardized mortality ratio (SMR), while 4 studies did not show any associations. On the other hand, others with meta-analysis indicated that there was a negative association between lithium concentration in drinking water and suicide mortality rate. Conclusion: Most of the studies in this review revealed that lithium concentration in drinking water was inversely related to the expected suicide mortality rate in these studies. We reviewed these articles and maintain that the balance of lithium concentration in drinking water and SMR is important in determining whether lithium in drinking water affects suicide mortality rate. If the lithium concentration is stable over the entire study region, or suicide mortality rate is very low, an association between the lithium concentration in drinking water and suicide mortality rate could not be detected even with high lithium concentrations. Therefore, it may be difficult to evaluate the effect of lithium in drinking water on suicide. Further studies are needed to determine the factors related to suicide and lithium intake from sources other than drinking water to assess the relationship between tap water lithium concentration and suicide mortality rate.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"61 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74491207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.9.596
Abigail Maria O'Reilly
With the advent of the Covid-19 pandemic and resulting exponentially increased workload for occupational and other health departments worldwide; telemedicine has been brought to the fore at rapid pace. Healthcare and the management of services have seen a drive to innovate and reinvent the way we conduct our communication with colleagues and patients alike. It is imperative that healthcare professionals, especially occupational health physicians, continue to uphold standards and maintain utmost professional levels of communication to preserve the doctor patient relationship in these challenging times. After all, occupational health in particular is responsible for the health and wellbeing of so many staff, most notably the hard working, -and most at risk- health care staff.
{"title":"A Telephone First Approach in the COVID-19 era","authors":"Abigail Maria O'Reilly","doi":"10.35248/2329-9096.21.9.596","DOIUrl":"https://doi.org/10.35248/2329-9096.21.9.596","url":null,"abstract":"With the advent of the Covid-19 pandemic and resulting exponentially increased workload for occupational and other health departments worldwide; telemedicine has been brought to the fore at rapid pace. Healthcare and the management of services have seen a drive to innovate and reinvent the way we conduct our communication with colleagues and patients alike. It is imperative that healthcare professionals, especially occupational health physicians, continue to uphold standards and maintain utmost professional levels of communication to preserve the doctor patient relationship in these challenging times. After all, occupational health in particular is responsible for the health and wellbeing of so many staff, most notably the hard working, -and most at risk- health care staff.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":"59 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81426352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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