Abstract:
:A period of significant agitation affects up to 30% of patients after traumatic brain injury. The severity and persistence of this agitation may be such as to require pharmacologic methods as part of the treatment plan. To define which subgroup of patients develop severe agitation warranting intervention and to utilize the information to predict therapeutic responsiveness to tricyclic antidepressants (TCA), we examined cortisol dynamics in 35 traumatically brain-injured (TBI) patients 2-10 months post-TBI. Fasting hypercortisolemia (cortisol greater than 20 micrograms/dl) and/or an absent diurnal variation (1600:0800 cortisol greater than 0.5) was noted in more than 70% of TBI subjects. These abnormalities in cortisol dynamics were not predictive of severe agitation (chi 2 = 0, df = 1, P = 0.99 for hypercortisolemia; chi 2 = 0.163, df = 1, P = 0.7 for absent diurnal variation) and did not differ significantly between TCA responders and nonresponders. The cortisol response to dexamethasone suppression was abnormal (postdexamethasone cortisol value at 0800 and 1600 greater than 5 micrograms/dl) in 34 of 35 subjects and was also not predictive of the presence of agitation. The 0800 cortisol was lower in TCA nonresponders in comparison with TCA responders (8.3 +/- 5 v 17.2 +/- 9). In summary, severe TBI warranting inpatient rehabilitation results in hypothalamic-pituitary-adrenal dysfunction. The extent of these abnormalities renders the assessment of cortisol secretion of limited value in making clinical judgments concerning the development of post-traumatic agitation or the management of that agitation by tricyclic therapy.
journal_name
Am J Phys Med Rehabiljournal_title
American journal of physical medicine & rehabilitationauthors
Jackson RD,Mysiw WJsubject
Has Abstractpub_date
1989-02-01 00:00:00pages
18-23issue
1eissn
0894-9115issn
1537-7385journal_volume
68pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:The aim of this study was to compare the rehabilitation length of stay and functional outcome of patients with amputation on chronic dialysis with a similar group of patients not on dialysis. DESIGN:This was a retrospective cohort study. Twenty-five patients with amputations on chronic dialysis and 25 nonren...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000000259
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To explore the relationship between frontal plane ankle range of motion (ROM) and frontal plane control during gait, as determined by step-width variability and step-width range, among middle-aged and older persons with peripheral neuropathy (PN). DESIGN:Observational study of 39 adults (mean age +/- standar...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0b013e318194fb3c
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:Correlation of muscle function, muscle mass and endurance, and exercise tolerance in chronic obstructive pulmonary disease (COPD). DESIGN:Sixteen COPD patients (forced expiratory volume during the first second 38 +/- 15% predicted) and 6 controls underwent magnetic resonance imaging of the thigh, muscle stre...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0b013e31818dff86
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the effects of an aquatic exercise program designed to enhance muscular strength in paretic lower limbs in subacute stroke patients. METHOD:Thirty-six subacute stroke patients were randomly divided to a conventional or an aquatic group (n = 18 each). Outcome measures were ...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1097/PHM.0000000000000512
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to explore the relationships between specific functional abilities assessed from the third version of the Spinal Cord Injury Measure and health-related quality of life after a traumatic spinal cord injury. DESIGN:A prospective cohort of 195 patients who had sustained a traumat...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000001006
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To evaluate health-related quality of life and disability in multiple-trauma patients requiring intensive care unit management. DESIGN:A total of 87 survivors of multiple trauma, with a median age of 31 yrs and a median Injury Severity Score of 22, were enrolled in the present study. The Nottingham Health Pr...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/01.phm.0000107497.77487.c1
更新日期:2004-03-01 00:00:00
abstract::A 58-yr-old woman presented after experiencing left hip and groin pain for 1 mo. She denies any history of trauma, falls or any bruising, or history of sports injury or extreme physical exertion before her symptoms. On ultrasonography, she was found to have an avulsion tear at the origin of the adductor muscles, predo...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000000000
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To examine the impact of the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS) on outcomes in a stroke rehabilitation program. DESIGN:An analysis was performed on a database including 945 stroke patients admitted to an inpatient stroke rehabilitation program 5 yrs before imple...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0b013e31804a7e2f
更新日期:2007-05-01 00:00:00
abstract::A 38-yr-old woman reported intermittent pain, paresthesia, and weakness in the right upper limb and sweating on the right side of her face and ipsilateral upper limb during the last 4 yrs. Eventually, she was diagnosed with thoracic outlet syndrome, whereby sympathetic nervous system involvement was thought to ensue b...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0b013e31820f96fe
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:This article presents analytic results from a prospective study of 313 stroke rehabilitation patients, looking at the relative contributions of different stroke impairments toward prediction of discharge function, rehabilitation length of stay, and discharge destination after inpatient rehabilitation. The re...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/01.phm.0000171005.08744.ab
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:Foot deformities are one of the most common musculoskeletal problems in children with cerebral palsy (CP). These deformities affect the walking ability and function of the patients. Talar cartilage is the hyaline joint cartilage of the tibiotalar joint that plantarflexes and dorsiflexes of the ankle. The aim ...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000001499
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:The aim of the study was to compare the clinical, radiographic, and ultrasound findings between simple and complicated Baker's cysts. METHODS:Forty-seven knees with Baker's cysts in 45 patients with knee pain were identified from a chart review. Baker's cysts were classified as simple or complicated according ...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000001263
更新日期:2020-01-01 00:00:00
abstract::Ultrasound-guided cervical medial branch block (CMBB) is commonly performed to diagnose and treat head, neck, and shoulder pain. However, its use at the C7 level has been shown to be less accurate than at other levels, which may increase the chance of injury owing to the imprecision of needle site provided by the ultr...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000000613
更新日期:2017-06-01 00:00:00
abstract::Moyamoya disease is a rare disorder of cerebrovascular circulation. A review of the literature failed to reveal the association of heterotopic ossification in patients with this disease; such a case is now presented. The patient described had atraumatic intracranial hemorrhage, was in a coma for a period of time, unde...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/00002060-199809000-00021
更新日期:1998-09-01 00:00:00
abstract::We report on the results of gait analysis in a patient with bilateral knee disarticulation amputations who used short nonarticulated prosthetic limbs (stubbies) to meet his ambulation needs over an extended period. To compensate for the loss of knee and ankle articulations, exaggerated pelvic obliquity (hip hiking), t...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/00002060-200204000-00015
更新日期:2002-04-01 00:00:00
abstract::Because of their expertise, physiatrists provide disability insurance assistance for cancer survivors. In this brief report, we perform a descriptive retrospective analysis of all new (354) outpatient physiatry consultations from January 1, 2009, to December 31, 2013, at a National Cancer Institute Comprehensive Cance...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000000641
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy, across a range of disability groups, of the Craig Handicap Assessment and Reporting Technique (CHART), a measure of societal participation. DESIGN:Cross-sectional analysis survey methodology. A total of 1110 community-based, nonhospitalized Coloradans with spinal cord injury, traumati...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/01.PHM.0000098041.42394.9A
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to demonstrate that the ankle frontal muscle power absorption and generation at push-off are related to the foot's initial position at heel-strike with respect to the body center of mass. DESIGN:Nineteen able-bodied male subjects participated in this study and were divided into two ...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 临床试验,杂志文章
doi:10.1097/00002060-200206000-00007
更新日期:2002-06-01 00:00:00
abstract::This article was prepared by physiatry residency training directors to provide the answer(s) to common questions asked by medical students with respect to the specialty. These responses should aid the student and their advisors in considering Physical Medicine and Rehabilitation as their career choice. ...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To investigate the relation between protein expression changes in the cerebellum and improvement of motor coordination in rats with cerebral infarction. DESIGN:The rat group with treadmill training (n = 10) were compared with the rat group without treadmill training (n = 10) after 2.5 hrs of transient middle...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0b013e3181b3323b
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to examine the associations of onset days, time from stroke onset to inpatient rehabilitation facility (IRF) admission, and patient outcomes (FIM gain, discharge destination, and IRF length of stay), using nationally representative data. DESIGN:A secondary data analysis was conducte...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000000226
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to systematically identify and summarize the literature examining the impact of physiologic and psychologic triggers on spasticity and discuss the evidence supporting various types of triggers. DESIGN:PubMed, EMBASE, CINAHL, and PEDro databases were searched using specific keyword...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章,评审
doi:10.1097/phm.0b013e31827d68a4
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To investigate the hypothesis that the multiple-site injection technique is associated with better outcomes than the single-point injection method in children with cerebral palsy and spastic equinus gait. DESIGN:A total of 17 children (nine boys, eight girls ages 1.8-9.4 yrs; eight hemiplegics, eight diplegi...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1097/PHM.0b013e31816ddaa9
更新日期:2008-05-01 00:00:00
abstract::Charcot-Marie-Tooth disease type 1A is the most common hereditary neuropathy. Affected individuals have a distal motor deficit, initially affecting the lower limbs and impairing walking performance. Isokinetic dynamometry can be used to objectively assess muscle strength of patients with neuromuscular disorders. No st...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0000000000001084
更新日期:2019-05-01 00:00:00
abstract::We carried out a prospective study to determine the association between immobilization in the immediate postinjury period and the development of pressure ulcers in spinal cord-injured patients following their admission to Charity Hospital, New Orleans. Of 39 patients consecutively admitted to the hospital, 23 (59%) de...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/00002060-198806000-00007
更新日期:1988-06-01 00:00:00
abstract::The objectives of this study were to examine the effectiveness of different types of exercise on risk factors of diabetic foot ulcers, including glycated hemoglobin, peripheral arterial disease, and diabetic peripheral neuropathy, in people with type 2 diabetes mellitus. PubMed, Web of Science, Cochrane Library, Scopu...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章,meta分析
doi:10.1097/PHM.0000000000001002
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To determine the clinical usefulness of the compound nerve action potential of the common peroneal nerve recorded immediately distal to or at the fibular neck, at the same time stimulating the common peroneal nerve laterally at the posterior knee. DESIGN:For recording the compound nerve action potential of t...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/00002060-200102000-00006
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:To study changes in quality of life (QOL) and to explore predictors of QOL of community-dwelling older adults with physical disabilities. DESIGN:A 2-yr longitudinal study involved a convenience sample of 49 people with physical disabilities aged 60-94 yrs. QOL was estimated twice at a 2-yr interval with the...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/PHM.0b013e318186b5bd
更新日期:2008-10-01 00:00:00
abstract::Neuroendocrine dysfunctions are among the various complications that occur after traumatic brain injury. We report a case of onset of diabetes insipidus during acute rehabilitation of a 20-yr-old patient with a traumatic brain injury caused by a gunshot wound. Our case is the latest onset of diabetes insipidus after t...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/00002060-200210000-00013
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:To establish the correlations of measures of self-reported disability, self-efficacy, physical performance, level of pain, and estimates of aerobic capacity (PvO2 ) in subjects with low back pain. DESIGN:Fifty-one low back pain subjects, ranging in age from 26 to 65 yr, entered the study. Participants compl...
journal_title:American journal of physical medicine & rehabilitation
pub_type: 杂志文章
doi:10.1097/00002060-200212000-00005
更新日期:2002-12-01 00:00:00