1
|
States RA, Salem Y, Krzak JJ, Godwin EM, McMulkin ML, Kaplan SL. Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline. Pediatr Phys Ther 2024; 36:182-206. [PMID: 38568266 DOI: 10.1097/pep.0000000000001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
BACKGROUND Children with cerebral palsy (CP) who walk have complex gait patterns and deviations often requiring physical therapy (PT)/medical/surgical interventions. Walking in children with CP can be assessed with 3-dimensional instrumented gait analysis (3D-IGA) providing kinematics (joint angles), kinetics (joint moments/powers), and muscle activity. PURPOSE This clinical practice guideline provides PTs, physicians, and associated clinicians involved in the care of children with CP, with 7 action statements on when and how 3D-IGA can inform clinical assessments and potential interventions. It links the action statement grades with specific levels of evidence based on a critical appraisal of the literature. CONCLUSIONS This clinical practice guideline addresses 3D-IGA's utility to inform surgical and non-surgical interventions, to identify gait deviations among segments/joints and planes and to evaluate the effectiveness of interventions. Best practice statements provide guidance for clinicians about the preferred characteristics of 3D-IGA laboratories including instrumentation, staffing, and reporting practices.Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A524.
Collapse
Affiliation(s)
- Rebecca A States
- Physical Therapy Program, School of Health Professions and Human Services, Hofstra University, Hempstead, New York (Drs States and Salem); Faculty of Physiotherapy, Cairo University, Cairo, Egypt (Dr Salem); Midwestern University - Physical Therapy Program, Downers Grove, Illinois (Dr Krzak); Shriners Children's Chicago, Gerald F. Harris Motion Analysis Center, Chicago, Illinois (Dr Krzak); Department of Physical Therapy, Long Island University - Brooklyn, Brooklyn, New York (Dr Godwin); Shriners Children's Spokane, Walter E. & Agnes M. Griffin Motion Analysis Center, Spokane, Washington (Dr McMulkin); Department of Rehabilitation & Movement Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey (Dr Kaplan)
| | | | | | | | | | | |
Collapse
|
2
|
Liu H, Wiedman CM, Lovelace-Chandler V, Gong S, Salem Y. Deep Diaphragmatic Breathing-Anatomical and Biomechanical Consideration. J Holist Nurs 2024; 42:90-103. [PMID: 36734111 DOI: 10.1177/08980101221149866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Deep diaphragmatic breathing (DDB) involves slow and fully contraction of the diaphragm with expansion of the belly during inhalation, and slow and fully contraction of the abdominal muscles with reduction of the belly during exhalation. It is the key component of the holistic mind-body exercises commonly used for patients with multimorbidity. Purpose: The purpose of this study was to re-visit and address the fundamental anatomical and biomechanical consideration of the DDB with the relevant literature. Method: Peer-reviewed publications from last the 15 years were retrieved, reviewed, and analyzed. Findings: In this article, we described the updated morphological and anatomical characteristics of the diaphragm. Then, we elucidated in a biomechanical approach how and why the DDB can work on the gastrointestinal, cardiopulmonary, and nervous systems as well as on regulating the intra-abdominopelvic pressure and mind-body interaction to coordinate the diaphragm-pelvic floor-abdominal complex for a variety of physical and physiological activities. Conclusion: Understanding of this updated DDB knowledge may help holistic healthcare professionals including holistic nurses provide better patient education and care management during the DDB or DDB-based mind-body intervention time.
Collapse
Affiliation(s)
- Howe Liu
- Physical Therapy Program, Allen College, Waterloo, IA, USA
| | | | | | - Suzhen Gong
- Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yasser Salem
- Physical Therapy Program, Hofstra University, Hempstead, NY, USA
| |
Collapse
|
3
|
Saygin D, Glaubitz S, Zeng R, Bottai M, de Visser M, Dimachkie MM, Fiorentino D, Gerhardson I, Kuwana M, Miller FW, Needham M, Rider LG, Salem Y, Schlüter S, Shinjo SK, Wang G, Werth VP, Aggarwal R, Lundberg IE. Performance of the 2017 EULAR/ACR Classification Criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: a scoping review. Clin Exp Rheumatol 2024; 42:403-412. [PMID: 38436279 DOI: 10.55563/clinexprheumatol/vuc5py] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/22/2024] [Indexed: 03/05/2024]
Abstract
The 2017 EULAR/ACR classification criteria for adult/juvenile idiopathic inflammatory myopathies (IIM) were established using a data-driven approach by an international group of myositis experts to allow classification of IIM and its major subtypes. Since their publication, the performance of the criteria has been tested in multiple cohorts worldwide and significant limitations have been identified. Moreover, the understanding and classification of IIM have evolved since 2017. This scoping review was undertaken as part of a large international project to revise the EULAR/ACR criteria and aims to i) summarise the evidence from the current literature on the performance characteristics of the 2017 EULAR/ACR classification criteria in various cohorts and IIM subtypes, and ii) delineate the factors that need to be considered in the revision of the classification criteria. A systematic search of Medline (via PubMed), Cumulative Index to Nursing and Allied Health Literature, and conference abstract archives was conducted independently by three investigators for studies on the EULAR/ACR criteria published between October 2017 and January 2023. This scoping review of 19 articles and 13 abstracts revealed overall good performance characteristics of the EULAR/ACR criteria for IIM, yet deficiencies in lack of inclusion of certain IIM subtypes, such as immune mediated necrotising myopathy, amyopathic dermatomyositis, antisynthetase syndrome and overlap myositis. Published modifications that may improve the performance characteristics of the criteria for classification of IIM subtypes were also summarised. The results of this review suggest that a revision of the EULAR/ACR criteria is warranted.
Collapse
Affiliation(s)
- Didem Saygin
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, PA, USA
| | - Stefanie Glaubitz
- Department of Neurology, University Medical Center Göttingen, Germany
| | - Rachel Zeng
- Department of Neurology, University Medical Center Göttingen, Germany
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marianne de Visser
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Mazen M Dimachkie
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - David Fiorentino
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, USA
| | | | - Masataka Kuwana
- Department of Allergy and Rheumatology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Merrilee Needham
- Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Yasser Salem
- Physical Therapy Program, Hofstra University, Hemstead, NY, USA
| | - Silke Schlüter
- Diagnosegruppe Myositis, Deutsche Gesellschaft für Muskelkranke, Freiburg, Germany
| | - Samuel K Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Guochun Wang
- Department of Rheumatology, The Key Laboratory of Myositis, China-Japan Friendship Hospital, Beijing, China
| | - Victoria P Werth
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, and Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, PA, USA.
| | - Ingrid E Lundberg
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm; and Department of Gastroenterology, Dermatology and Rheumatology, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
4
|
Liu H, Thomas P, Salem Y, Miller K, McGee M. Comparison of gait between walking up and down an incline with a walking device in older adults. Geriatr Nurs 2023; 53:141-145. [PMID: 37540908 DOI: 10.1016/j.gerinurse.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
To identify the gait differences between cane and rolling walker (RW) use on incline and how these walking devices were received and used, 26 qualified older adults walked randomly on downward and upward with a cane and a RW respectively. With the RW use, downward walking show a faster velocity, higher cadence, less stance time, bigger steps and strides than upward walking (p≤.05); but no differences were seen with cane use. When comparing walking between a RW and a cane, those using a cane had faster velocity, larger step and stride lengths (P≤.01) but only during the upward condition. Incline surface plays a critical role in gait differences when walking with walking device. Geriatric professionals need to know the changes in gait that result from the type of device being used and need to incorporate this knowledge in the education provided to older adults for proper use of a walking device.
Collapse
Affiliation(s)
- Howe Liu
- Department of Physical Therapy, Allen College, Waterloo, IA 50703 USA.
| | - Prince Thomas
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, Texas, 76107 USA
| | - Yasser Salem
- Department of Physical Therapy, Hofstra University, Hespstead, NY 11549. USA
| | - Kenneth Miller
- Department of Physical Therapy, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Margaret McGee
- Department of Physical Therapy, University of Central Arkansas, Conway, AR 72035 USA
| |
Collapse
|
5
|
Liu H(H, Salem Y, Arguello E. BRAIN RESPONSE IN THE ELDERLY AFTER TAI CHI PRACTICE ASSESSED WITH NEUROIMAGING TECHNIQUES: A LITERATURE REVIEW. Innov Aging 2022. [PMCID: PMC9767056 DOI: 10.1093/geroni/igac059.2595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Tai Chi (TC) has been often provided to older adults by rehabilitation professionals for medical dysfunction and anti-aging healthcare. In the last 10 years, there has been an increase in the number of studies examining the effects of TC on brain as assessed by neuroimaging including near infrared spectroscopy (NIRS), and structure and functional magnetic resonating imaging (sMRI & fMRI). Thus, the purpose of this literature review is to evaluate how TC practice may affect the brain in the elderly as assessed by neuroimaging techniques. A comprehensive literature search was conducted using a variety of key words with different search engines to search from the last 10 years until January 15, 2022. Studies were included if they investigated topographic brain responses after TC practice in the elderly population. A total of 12 original studies with 15 articles met the criteria and were included for the review process. The results showed increased volume of cortical grey matter, improved neural activity, and increased neural connectivity in different brain regions, including the frontal, temporal, and occipital lobes, followed by cerebellum and thalamus. Intriguingly, the longer one practices TC, the more his/her brain areas may be altered. Such neural findings after TC practice are often associated with neurobehavioral improvements in attention, cognitive execution, memory, emotion, and risk-taking behaviors. Tai Chi is a promising exercise that is able to improve morphological capability and neurofunctional activity in the brain in the elderly. These improvements seem to be associated with time-length of TC practice.
Collapse
Affiliation(s)
| | - Yasser Salem
- Hofstra University, Hempstead, New York, United States
| | | |
Collapse
|
6
|
Godwin EM, Salem Y, States RA, Krzak JJ, McMulkin M, Bodkin-Winter A. Instrumented Gait Analysis (IGA) for Management of Children With Cerebral Palsy: A Needs Assessment Survey. Pediatr Phys Ther 2022; 34:221-228. [PMID: 35184074 DOI: 10.1097/pep.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This needs assessment survey identifies the priorities of the clinical and research communities involved with the use of instrumented gait analysis (IGA) for a clinical practice guideline on IGA use with children with cerebral palsy (CP). METHODS Thirteen Likert scale questions asked about the importance of topics related to IGA. Other questions addressed respondents' demographics, experience with IGA, patient populations, and gait laboratory characteristics. Several open-ended questions were included and analyzed. RESULTS The survey was completed by 43 physical therapists and 53 non-physical therapists involved with IGA. More than 90% rated the following as critically or highly important: reliability and validity of IGA to identify gait pathology (94%); ability to longitudinally track gait pathology (93%); use in planning interventions (93%); use in evaluating outcomes (93%); and definition of IGA (90%). CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE This needs assessment survey identified the topic priorities of clinicians and practitioners who use IGA for the management of children with CP. These results will guide the development of a clinical practice guideline on the use of IGA for the management of CP.
Collapse
Affiliation(s)
- Ellen M Godwin
- Department of Physical Therapy (Drs Godwin and States), Long Island University Brooklyn, Brooklyn, New York; Department of Allied Health and Kinesiology (Dr Salem), School of Health Professions and Human Services, Hofstra University, Hempstead New York; Faculty of Physiotherapy (Dr Salem), Cairo University, Midwestern University (Dr Krzak), Downers Grove, Illinois; Shriners Hospitals for Children-Chicago (Dr Krzak), Chicago, Illinois; Walter E. & Agnes M. Griffin Motion Analysis Center (Dr McMulkin), Shriners Hospital for Children-Spokane, Spokane, Washington; Department of Physical Medicine & Rehabilitation (Dr Bodkin-Winter), University of Colorado Anschutz Medical Campus, Aurora
| | | | | | | | | | | |
Collapse
|
7
|
Liu H, Salem Y. Effects of Tai Chi on Biomarkers and Their Implication to Neurorehabilitation – A Systemic Review. Innov Aging 2021. [PMCID: PMC8681804 DOI: 10.1093/geroni/igab046.3252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: As an effective holistic therapeutic exercise program, Tai Chi (TC) has been widely used for patients with a variety of neurological disorders. In last 1-2 decades, there has been an increase in the number of research studies that examined the TC effects on biomarkers andIntroduction: As an effective holistic therapeutic exercise program, Tai Chi (TC) has been widely used for patients with a variety of neurological disorders. In last 1-2 decades, there has been an increase in the number of research studies that examined the TC effects on biomarkers including inflammatory cytokines, oxidative stressors, and neurotrophic factors. Thus, the purpose of this article is to review such effects and their possible implications to neurorehabilitation. Method: In this systematic review, we searched TC-related articles from the last 15 years until July 2020 that had investigated changes of biomarkers after TC practice. The search identified 24 studies that were included in our analysis. Results: It is found that TC practice is able to 1) reduce pro-inflammatory and increase anti-inflammatory cytokines (including Interleukins -1, 6, 10, 12, tumor necrosis factor, the nuclear factor kappa-light-chain-enhancer of activated B cells, and the C-reactive protein); 2) decrease oxidative stress factors (like plasma 8-isoprostane, malondialdehyde, and protein carbonylation); and 3) increase neurotrophic factors (brain-derived neurotrophic factor (BDNF), and N-Acetylaspartate). Conclusions: TC may take effect on patients with neurological dysfunctions through anti-inflammation, anti-oxidative stress, and neural health promotion.
Collapse
Affiliation(s)
- Howe Liu
- University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Yasser Salem
- University of North Texas Health Science Center/, Fort Worth, Texas, United States
| |
Collapse
|
8
|
States RA, Krzak JJ, Salem Y, Godwin EM, Bodkin AW, McMulkin ML. Instrumented gait analysis for management of gait disorders in children with cerebral palsy: A scoping review. Gait Posture 2021; 90:1-8. [PMID: 34358847 DOI: 10.1016/j.gaitpost.2021.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/09/2021] [Accepted: 07/16/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The use of Instrumented Gait Analysis (IGA) for the clinical management of individuals with cerebral palsy (CP) has increased in recent years. Previous systematic reviews have been completed to evaluate and summarize the evidence related to the efficacy of IGA in general. However, a focused summary of research studies on IGA for children with CP related gait disorders is needed. RESEARCH QUESTION The purpose of the current work was to perform a scoping review to describe and categorize the range of existing literature about IGA as applied to the clinical management of children with CP related gait disorders. METHOD A health sciences librarian developed a search strategy to include four key inclusion criteria of original research study, population included children with CP, study employed IGA, available in English. The available literature was organized into six study categories: reliability and validity, documentation of subgroups or model development, IGA for clinical decision making, effectiveness of treatments that depend on IGA, cost effectiveness, IGA used to evaluate the outcome of surgical, medical or rehabilitation treatment. RESULTS 909 studies met the inclusion criteria and were placed into the six study categories. 14 % of studies were in reliability and validity, 33 % in subgroups or modeling, 2% in IGA for clinical decision making, 2% in treatments that depend on IGA, 1% in cost effectiveness, and 49 % of studies had IGA used as an outcome measure for treatment. SIGNIFICANCE This scoping review has documented the wide range, diversity and extent of original research studies investigating the use of IGA for the clinical management of children with CP related gait disorders. The large volume of studies provides a basis for future work to develop a CPG about the use of IGA for the clinical management of children with CP related gait disorders.
Collapse
Affiliation(s)
- Rebecca A States
- Long Island University - Brooklyn, Department of Physical Therapy, United States
| | - Joseph J Krzak
- Midwestern University, Physical Therapy Program, Downers Grove, IL, United States; Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, United States
| | - Yasser Salem
- Hofstra University, School of Health Professions and Human Services, United States; Cairo University, Faculty of Physical Therapy, Egypt
| | - Ellen M Godwin
- Long Island University - Brooklyn, Department of Physical Therapy, United States
| | - Amy Winter Bodkin
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, United States
| | - Mark L McMulkin
- Walter E. & Agnes M. Griffin Motion Analysis Center, Shriners Hospitals for Children, Spokane, WA, United States.
| |
Collapse
|
9
|
Hegazy F, Aboelnasr E, Abuzaid M, Kim IJ, Salem Y. Comparing Validity and Diagnostic Accuracy of Clarke's Angle and Foot Posture Index-6 to Determine Flexible Flatfoot in Adolescents: A Cross-Sectional Investigation. J Multidiscip Healthc 2021; 14:2705-2717. [PMID: 34611407 PMCID: PMC8486009 DOI: 10.2147/jmdh.s317439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/31/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Clinically, the foot posture index-6 (FPI-6) and Clarke's angle (CA) are widely utilized to assess static foot posture; however, due to scarcity of scientific evidence, clinicians continue to debate the validity and diagnostic accuracy of these measures in children and adolescents. This study aimed to evaluate and compare the validity and diagnostic accuracy of the FPI-6 and CA in determining adolescents' flexible flatfoot between ages of 12 and 18 years, considering radiographic investigation as a reference standard measure. DESIGN Cross-sectional study. SETTING Governmental hospitals. PARTICIPANTS AND METHODS A sample of 460 people (920 feet) with flexible flatfoot between the ages of 12 and 18 (15.23 ± 0.84 years) was enrolled in the study. The findings of the investigated measures were compared to the reference standard radiographic measure and plotted on the receiver operating characteristic (ROC) curve. The area under the ROC curve (AUC) was determined as a measure of FPI-6 and CA diagnostic accuracy. Intra-rater reliability, sensitivity, specificity, predictive values, and likelihood ratios of FPI-6 and CA were calculated and compared. The post-test probability of flatfoot was determined using the Fagan nomogram. RESULTS CA had a substantially higher intra-rater reliability (ICC=0.99) than the FPI-6 (ICC=0.96), with p-value of 0.001. CA has greater sensitivity (98%) than FPI-6, as well as a superior specificity (99%), positive predictive value (98%), negative predictive value (98.9%), positive likelihood ratio (97), and a lower negative likelihood ratio (0.02). CA had such an area under ROC curve of 0.98 with a 95% confidence interval of 0.95-1.00, while FPI-6 had an area under ROC curve of 0.80 with a 95% confidence interval of (0.77-0.85). CONCLUSION FPI-6 and Clarke's angle are both valid and diagnostically accurate clinical tests for flatfoot detection, with Clarke's angle outperforming FPI-6 in adolescents aged 12 to 18 years with a normal BMI.
Collapse
Affiliation(s)
- Fatma Hegazy
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Emad Aboelnasr
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Mohamed Abuzaid
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - In-Ju Kim
- Department of Industrial Engineering and Engineering Management; College of Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Yasser Salem
- Department of Health Professions, School of Health Professions and Human Services, Hofstra University, Long Island, NY, USA
| |
Collapse
|
10
|
Bao X, Wang MH, Liu H, Shi HF, Salem Y, Xu S, Zhu ZM, Xie JY, Yang Q. Treatment effect and mechanism of Fu's subcutaneous needling among patients with shoulder pain: A retrospective pilot study. Anat Rec (Hoboken) 2021; 304:2552-2558. [PMID: 34324795 DOI: 10.1002/ar.24710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/24/2021] [Accepted: 05/30/2021] [Indexed: 11/06/2022]
Abstract
Fu's subcutaneous needling (FSN) is a new acupuncture therapy developed from acupuncture and Traditional Chinese Medicine models. The aim of this study was to investigate the effect of FSN on shoulder pain. In this retrospective comparative study, patient case files with shoulder pain (Group A) treated with FSN were analyzed and compared with the same number of patients with shoulder pain (Group B) treated with conventional acupuncture and physical therapy. Motion-related pain (MRP), pain under pressure (PUP), and Range of motion (ROM) were collected before and after intervention. In the 68 patients, there were 39 males and 29 females, aged 21-53 years old (mean ± SD = 36.4 ± 8.15) with onset time ranging from 1 day to 7 days (mean ± SD = 3.15 ± 1.73). MRP, PUP, and ROM scores were improved after FSN intervention (p < .05). There were significant differences between group A and group B in MRP, PUP, and ROM scores after FSN intervention and 1 week follow-up (p < .05). No adverse events, such as fainting and sharp pain, occurred during the treatment process. FSN can be an effective rehabilitation intervention for improving shoulder pain and shoulder range of motion.
Collapse
Affiliation(s)
- Xiao Bao
- Department of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, China
| | - Ming-Hong Wang
- Department of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, China
| | - Howe Liu
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Hong-Fei Shi
- Department of Rehabilitation Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yasser Salem
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Shu Xu
- Department of Rehabilitation Medicine, Shaoguan Railway Hospital, Shaoguan, China
| | - Zhi-Min Zhu
- Department of Rehabilitation Medicine, Lianjiang People's Hospital, Lianjiang, China
| | - Ju-Ying Xie
- Department of Rehabilitation Medicine, Affiliated Hospital of Xiangnan University, Chenzhou, China
| | - Quan Yang
- Department of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, China
| |
Collapse
|
11
|
Guo Y, Zhao Y, Salem Y, Miller K, Quiben M, Liu H. Postural effect on gait characteristics by using rolling walkers. Geriatr Nurs 2020; 41:916-920. [PMID: 32684297 DOI: 10.1016/j.gerinurse.2020.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 11/27/2022]
Abstract
This study was to examine the effect of leaning-forward posture (LFP) on gait parameters while using a rolling walker (RW). A cross-sectional study was conducted in which 23 older female adults were asked to walk with a RW on the GaitRite walkway in two posture situations: upright posture, and LFP caused by pushing the RW forward and then following the RW. The temporal and spatial gait parameters were obtained for data analysis. Results showed that compared with the upright posture, participants with LFP demonstrated significantly increased cadence, decreased velocity and gait cycle time (both swing and stance time decreased). Of spatial parameters, both step and stride length significantly decreased, but the base of support increased significantly. These indicate that LFP during ambulation with a RW could lead participants to a shuffling-like (many steps on short distance) gait pattern. They may help clinicians find proper rehabilitation interventions and appropriate patient education for this specific postural presentation.
Collapse
Affiliation(s)
- Yuanyuan Guo
- Department of Rehabilitation Medicine, The Fifth Affiliated, Hospital of Guangzhou Medical University, 621 Gangwan Road, Huangpu District, Guangzhou, Guangdong 510700, China
| | - Yawen Zhao
- Guangzhou Geriatrics Rehabilitation Hospital, 3016 Kaichuang Avenue, Huangpu District, Guangzhou, Guangdong 510000, China
| | - Yasser Salem
- Department of Physical Therapy, University of North Texas, Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Kenneth Miller
- Department of Physical Therapy, University of North Texas, Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Myla Quiben
- Department of Physical Therapy, University of North Texas, Health Science Center, 3500 Camp Bowie Blvd, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Howe Liu
- Department of Physical Therapy, University of North Texas, Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
| |
Collapse
|
12
|
Yacov N, Salem Y, Prophate-Meira O, Kafri P, Breitbart E, Mendel I. FRI0007 MOSPD2: A NOVEL THERAPEUTIC TARGET FOR THE TREATMENT OF RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease with an unknown etiology that affects the joints. B and T lymphocytes are major drivers of arthritis, mediated through their secretion of antibodies against self-antigens and the production of pro-inflammatory cytokines. Nevertheless, innate immune cells play an important role in disease progression, and recruitment of blood monocytes/macrophages was highly correlated with tissue damage in RA patients1,2. Once infiltrated into the joint, monocytes can produce proinflammatory cytokines and chemokines that further escalate the inflammatory process and tissue damage. Consistent with that, genetic and pharmacological intervention targeting CCR2 and CCR5, chemokine receptors which are abundantly expressed on monocytes, was shown to reduce disease severity in multiple preclinical models of RA3. Blocking monocyte migration in RA can be therefore an attractive therapeutic approach, if implied in a manner that can overcome the redundancy of chemokine receptors and ligands.Motile sperm domain-containing protein 2 (MOSPD2) is a 518 amino acids single-pass membrane protein to which no function was ascribed up until recently. Assessment of MOSPD2 in immune cell subsets showed it is expressed by monocytes and neutrophils. We previously discovered that MOSPD2 regulates human monocyte and neutrophil migration in a chemokine-agnostic manner4.Objectives:Using anti MOSPD2 mAbs, the role of MOSPD2 in mouse monocyte migration in-vitro and RA progression in mice was assessed.Methods:In-vitro, MCP-1 and SDF-1 chemokines were used to induce migration of mouse splenic monocytes through a trans-well plate in the presence of anti MOSPD2 mAbs. In-vivo, DBA-1 mice were injected with type II collagen on days 0 and 21 to induce arthritis. Mice were then treated twice a week with anti MOSPD2 mAb, anti TNF-α or an isotype control antibody until study end (day 42). Animals were monitored for arthritis score, and upon sacrifice, hind limb joints were examined for pathology.Results:Anti MOSPD2 mAbs significantly inhibited migration of mouse monocytes in-vitro. Treatment with anti MOSPD2 mAb after disease was already initiated, limited disease progression and significantly ameliorated clinical manifestation at the climax phase of the disease by more than 50% compared with isotype control and anti TNF-α treatment. Pathological examination revealed that treatment with anti MOSPD2 mAb reduced pannus formation and joint inflammation.Conclusion:The results further support the involvement of monocytes in RA pathogenesis and highlight the key role MOSPD2 plays in this disease. Accordingly, targeting of monocyte migration using anti MOSPD2 mAbs may hold promise as a treatment for various chronic inflammatory diseases, including RA.References:[1]Tak PP et al., (1997) Analysis of the synovial cell infiltrate in early rheumatoid synovial tissue in relation to local disease activity. Arthritis Rheum 40:217.[2]Mulherin D et al., (1996) Synovial tissue macrophage populations and articular damage in rheumatoid arthritis. Arthritis Rheum 39:115.[3]Zhao, Q et al., (2010) Dual targeting of CCR2 and CCR5: therapeutic potential for immunologic and cardiovascular diseases. J. Leukoc. Biol. 88: 41.[4]Mendel et al., 2017 Identification of Motile Sperm Domain-Containing Protein 2 as Regulator of Human Monocyte Migration. J Immunol. 198: 2125.Disclosure of Interests:None declared
Collapse
|
13
|
Yacov N, Kafri P, Salem Y, Propheta-Meiran O, Feldman B, Breitbart E, Mendel I. MOSPD2 is a therapeutic target for the treatment of CNS inflammation. Clin Exp Immunol 2020; 201:105-120. [PMID: 32353176 PMCID: PMC7366745 DOI: 10.1111/cei.13448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/22/2020] [Accepted: 04/22/2020] [Indexed: 12/17/2022] Open
Abstract
In multiple sclerosis and experimental autoimmune encephalomyelitis (EAE), myeloid cells comprise a major part of the inflammatory infiltrate in the central nervous system (CNS). We previously described that motile sperm domain‐containing protein 2 (MOSPD2) is expressed on human myeloid cells and regulates monocyte migration in vitro. The role of MOSPD2 in EAE pathogenesis was studied by generating MOSPD2 knock‐out (KO) mice and monoclonal antibodies directed against MOSPD2. We found that EAE development in MOSPD2 KO mice was significantly suppressed. While frequency representation of leukocyte subsets in lymphoid tissues was comparable, the ratio of inflammatory monocytes in the blood was markedly reduced in MOSPD2 KO mice. In addition, T cells from MOSPD2 KO mice displayed reduced secretion of proinflammatory cytokines and increased production of interleukin (IL)‐4. Prophylactic and post‐onset treatment using monoclonal antibodies (mAbs) generated against MOSPD2 abrogated development and reduced EAE severity. These results suggest that MOSPD2 is key in regulating migration of inflammatory monocytes, and that anti‐MOSPD2 mAbs constitute a potential therapy for the treatment of CNS inflammatory diseases.
Collapse
Affiliation(s)
- N Yacov
- VBL Therapeutics, Modi'in, Israel
| | - P Kafri
- VBL Therapeutics, Modi'in, Israel
| | - Y Salem
- VBL Therapeutics, Modi'in, Israel
| | | | | | | | - I Mendel
- VBL Therapeutics, Modi'in, Israel
| |
Collapse
|
14
|
Hegazy FA, Aboelnasr EA, Salem Y, Zaghloul AA. Validity and diagnostic accuracy of foot posture Index-6 using radiographic findings as the gold standard to determine paediatric flexible flatfoot between ages of 6-18 years: A cross-sectional study. Musculoskelet Sci Pract 2020; 46:102107. [PMID: 31989966 DOI: 10.1016/j.msksp.2020.102107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/16/2019] [Accepted: 01/10/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Diagnosis of flexible flatfoot is usually based upon radiographic or clinical measures. Radiographic measures pose a potential risk of radiation exposure especially in Paediatric population. Clinicians need a valid, accurate, easily used, noninvasive and cost effective measure to evaluate static foot posture clinically. Although, foot posture index-6 (FPI-6) are commonly used in clinical practice, its validity and diagnostic accuracy in evaluation of paediatric flexible flatfoot have not been fully proven yet. OBJECTIVES To investigate validity and diagnostic accuracy of FPI-6 to determine Paediatric flexible flatfoot between ages of 6-18 years using radiographic findings as the gold standard measure. STUDY DESIGN Cross-sectional study. METHODS A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6-18 years (mean age ± standard deviation of 12.36 ± 3.39 years). The results of FPI-6 were compared to the gold standard radiographic measures and displayed on the receiver operating characteristic curve. Intra-rater reliability, sensitivity, specificity, predictive values and likelihood ratios were calculated. Posttest probability was calculated from Fagan nomogram. RESULTS FPI-6 demonstrate high intra-rater reliability (ICC = 0.96) with p value < 0.001. FPI-6 showed a sensitivity of 83.7%, a specificity of 80.4, a positive predictive value of 64.7, a negative predictive value of 92, a positive likelihood ratio of 4.62 and a negative likelihood ratio of 0.20. FPI-6 shows moderate diagnostic accuracy [AUC = 0.82; 95%CI (0.78-0.85)]. CONCLUSION FPI-6 is valid with moderate diagnostic accuracy to determine paediatric flexible flatfoot between ages of 6-18 years.
Collapse
Affiliation(s)
- Fatma A Hegazy
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
| | | | - Yasser Salem
- Department of Physical Therapy, University of North Texas Health Science Center, Texas, USA.
| | - Ashraf A Zaghloul
- Department of Health Administration and Behavioural Sciences, High Institute of Public Health, Alexandria University, Egypt.
| |
Collapse
|
15
|
Yavuz M, Ersen A, Monga A, Lavery LA, Garrett A, Salem Y, Hirschman GB, Myers R. Temperature- and Pressure-Regulating Insoles for Prevention of Diabetic Foot Ulcers. J Foot Ankle Surg 2020; 59:685-688. [PMID: 32386918 PMCID: PMC7329615 DOI: 10.1053/j.jfas.2019.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/19/2019] [Accepted: 05/13/2019] [Indexed: 02/03/2023]
Abstract
Diabetic foot ulcers (DFUs) pose a major threat to the United States healthcare system as well as patients and their families. High ulcer recurrence rates indicate that existing preventive measures are not effective. A new generation of multimodal preventive devices may reduce ulceration and amputation rates. Because previous research has revealed that tissue maintained at cooler temperatures is more resistant to breaking down, the evaluated technology may prevent foot ulceration. The purpose of this study was to test previously designed Temperature and Pressure Monitoring and Regulating Insoles (TAPMARI) in diabetic neuropathic and healthy subjects. A cooling unit, a mini-water pump, a battery pack, and a microcontroller (or simply thermostat) were placed inside a box attached to the subjects' calf, which provided cooling inside the shoe. The microcontroller was set at 28°C. Eight subjects provided informed consent, 3 of whom had diabetic neuropathy. Subjects used the instrumented shoe on the right foot and the matching control shoe on the left and walked on a treadmill for 5 minutes at self-selected speeds. Baseline and postwalking thermographs were obtained with a thermal camera. At the 2-hour midpoint, subjects again walked on the treadmill for 5 minutes at self-selected speeds. Second baseline and postwalking thermographs were captured. Plantar pressure distributions were also quantified. The TAPMARI successfully regulated foot temperatures at or below the target temperature. The mean baseline temperature of the right (regulated) and left (control) feet were 28.1 ± 1.9°C (mean ± standard deviation) for all subjects. The mean temperatures at the end of the study were 25.9 ± 2.5°C (right) and 31.7 ± 1.6°C (left) in all subjects. In the diabetic neuropathy group, the final mean temperatures were 27.5 ± 2.4°C (right) and 31.6 ± 0.8°C (left), which indicated that the temperature goal was met inside the instrumented shoe. By regulating temperatures, TAPMARI may reduce the metabolic demands in the foot and prevent cell autolysis by eliminating the imbalance between oxygen demand and supply. This study warrants further development and testing of TAPMARI as well as investigating the clinical effectiveness in preventing DFUs.
Collapse
Affiliation(s)
- Metin Yavuz
- Department of Health Care Sciences, The University of Texas Southwestern Medical Center, Dallas, TX,Department of Orthopaedic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX,Prosthetics-Orthotics Program, The University of Texas Southwestern Medical Center, Dallas, TX,Corresponding author: Metin Yavuz, D.Eng, Associate Professor, Prosthetics-Orthotics Program, Department of Health Care Sciences, Department of Orthopaedic Surgery, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, 214-645-8398,
| | - Ali Ersen
- Prosthetics-Orthotics Program, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Aakshita Monga
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX
| | - Lawrence A. Lavery
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Alan Garrett
- Department of Orthopaedics, John Peter Smith Hospital, Fort Worth, TX
| | - Yasser Salem
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX
| | | | | |
Collapse
|
16
|
Du Q, Salem Y, Liu HH, Zhou X, Chen S, Chen N, Yang X, Liang J, Sun K. A home-based exercise program for children with congenital heart disease following interventional cardiac catheterization: study protocol for a randomized controlled trial. Trials 2017; 18:38. [PMID: 28115007 PMCID: PMC5259847 DOI: 10.1186/s13063-016-1773-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 12/28/2016] [Indexed: 11/13/2022] Open
Abstract
Background Cardiac catheterization has opened an innovative treatment field for cardiac disease; this treatment is becoming the most popular approach for pediatric congenital heart disease (CHD) and has led to a significant growth in the number of children with cardiac catheterization. Unfortunately, based on evidence, it has been demonstrated that the majority of children with CHD are at an increased risk of “non-cardiac” problems. Effective exercise therapy could improve their functional status significantly. As studies identifying the efficacy of exercise therapy are rare in this field, the aims of this study are to (1) identify the efficacy of a home-based exercise program to improve the motor function of children with CHD with cardiac catheterization, (2) reduce parental anxiety and parenting burden, and (3) improve the quality of life for parents whose children are diagnosed with CHD with cardiac catheterization through the program. Methods/design A total of 300 children who will perform a cardiac catheterization will be randomly assigned to two groups: a home-based intervention group and a control group. The home-based intervention group will carry out a home-based exercise program, and the control group will receive only home-based exercise education. Assessments will be undertaken before catheterization and at 1, 3, and 6 months after catheterization. Motor ability quotients will be assessed as the primary outcomes. The modified Ross score, cardiac function, speed of sound at the tibia, functional independence of the children, anxiety, quality of life, and caregiver burden of their parents or the main caregivers will be the secondary outcome measurements. Discussion The proposed prospective randomized controlled trial will evaluate the efficiency of a home-based exercise program for children with CHD with cardiac catheterization. We anticipate that the home-based exercise program may represent a valuable and efficient intervention for children with CHD and their families. Trial registration http://www.chictr.org.cn/ on: ChiCTR-IOR-16007762. Registered on 13 January 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1773-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Qing Du
- Department of Rehabilitation Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yasser Salem
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Hao Howe Liu
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Xuan Zhou
- Department of Rehabilitation Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Sun Chen
- Department of Pediatric Cardiology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Nan Chen
- Department of Rehabilitation Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xiaoyan Yang
- Department of Rehabilitation Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Juping Liang
- Department of Rehabilitation Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Kun Sun
- Department of Pediatric Cardiology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| |
Collapse
|
17
|
Hassan M, Salem Y. 036 Comparison of Paroxetine and Dapoxetine Regarding Intra Vaginal Ejaculatory Latency Time and Frequency of Sexual Intercourse in the Management of Lifelong Premature Ejaculation. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Hassan M, Salem Y. 358 Assessment of Female Sexual Dysfunction and its Possible Risk Factors Among Patients Undergoing Haemodialysis. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
19
|
States RA, Sweeny TL, Rossi A, Spierer DK, Salem Y. Physical Functioning After 1, 3, and 5 Years of Exercise Among People With Parkinson's Disease: A Longitudinal Observational Study. J Geriatr Phys Ther 2016; 40:127-134. [PMID: 27058217 DOI: 10.1519/jpt.0000000000000084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Regular physical activity is thought to be crucial to maintaining optimal physical function in people with Parkinson's disease (PWP), and it may have neuroprotective effects. As with many medical treatments, exercise is most effective when performed consistently over a period of years. The primary aim of this study was to examine multiyear adherence to a community-based group exercise program for PWP. A secondary aim was to document how physical functioning progressed after 1, 3, and 5 years for participants who consistently attended a community-based, group, exercise program. METHODS Forty-six individuals with idiopathic Parkinson's disease, who were at modified Hoehn and Yahr stage I, II, or III and were community ambulators, were recruited on a rolling basis between 2008 and 2013. Each provided yearly medical clearance to exercise. Participants engaged in a free, community-based, group exercise program offered 2 days per week, 1 hour per day, for three 10-week sessions per year. The program included supervised floor exercises for balance, coordination, strength, and flexibility along with resistance training on dual-action exercise machines. Participants who attended more than half the classes for 1, 3, or 5 years (n = 27, n = 14, n = 7, respectively) were considered to have completed the fitness program (consistent exercisers) and were included in the longitudinal data analysis; participants who either dropped out or attended less than half the classes (n = 19) were not included. Physical functioning was evaluated at baseline for all participants and yearly thereafter for consistent exercisers. Wilcoxon signed rank tests were used to compare baseline data with data collected after 1, 3, and 5 years of consistent exercise. RESULTS AND DISCUSSION Over half of the participants initially evaluated completed at least 1 year of the fitness program (27 of the 46 = 59%) and a proportion completed 3 years (14 of the 39 = 39%), and 5 years (7 of the 24 = 29%). At baseline, consistent exercisers were younger than those who dropped out (63.9 vs 69.9 years, P < .05), but had similar modified Hoehn and Yahr medians (2.0 vs 2.3), and similar time since diagnosis (8.0 vs 5.6 years). Consistent exercisers showed small statistically significant improvements in grip strength (8.9% change), Berg Balance scores (5.1% change), and 6-minute walk test (11% change) from baseline to year 1. No significant differences were found in these variables after 3 or 5 years, or for gait speed and timed up and go after 1, 3, or 5 years. CONCLUSION Despite the progressive nature of Parkinson's disease, many PWP can sustain a regular program of varied modes of community-based, group exercise over a period of years. Participants who did so maintained initial performance levels on key measures of physical functioning. By working with an interprofessional team in a supportive community-based exercise program, physical therapists can help many PWP engage in consistent and sustained exercise activity over multiyear periods.
Collapse
Affiliation(s)
- Rebecca A States
- 1Long Island University-Brooklyn, Brooklyn, New York. 2University of North Texas Health Science Center, Fort Worth, Texas
| | | | | | | | | |
Collapse
|
20
|
Liu HH, Quiben M, Holmes C, Connors M, Salem Y. Differences in the Limits of Stability Between Older Rolling Walker Users and Older Single-Tip-Cane Users - A Preliminary Study. Rehabil Nurs 2015; 42:109-116. [PMID: 26497836 DOI: 10.1002/rnj.228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To identify the differences in the limits of stability (LOS) between older rolling walker and single-tip-cane users. DESIGN This was a matched paired t-test design with repeated measure. METHODS Eighteen older subjects were matched based on age, gender, and functional level. The subjects were assessed using the multidirectional reach test initially and 5-month later in four directions: forward, backward, leftward, and rightward. FINDINGS Initially, there were no differences between cane users and rolling walker users in the LOS in all directions. However, 5-month later, the cane users who held their canes in their right hand had significantly better stability in forward and rightward reach than the walker users (p < .05). Further, the walker users demonstrated significantly decreased functional reach in forward reach (p < .05). CONCLUSION Cane users might have better stability than walker users in the forward direction and in the direction toward the side holding the cane. This study may provide guide for clinicians including nurses for selecting appropriate rehabilitative interventions for older adults using walkers and canes.
Collapse
Affiliation(s)
- Hao Howe Liu
- Physical Therapy Department, University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | | | | | | |
Collapse
|
21
|
Zhao Y, Salem Y, Li M, Master H, Liu H(H. Comparison of Surface Landmarks for Measuring the Individualized Height of Rolling Walker. Physical & Occupational Therapy In Geriatrics 2015. [DOI: 10.3109/02703181.2015.1009228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
22
|
Salem Y, Liu H, Podgore J, Schwarz B, Holmes C. Benefits and barriers of physical therapy students participation in resource-poor international clinical education. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
23
|
Hegazy F, Salem Y, Aboelnasr E. Lidocaine iontophoresis combined with physical therapy interventions for children with spastic hemiplegic cerebral palsy. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
24
|
Bakry W, Salem Y, Elokda A, Liu H. Effectiveness of aquatic exercise program for patients with multiple sclerosis: a systematic review. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
25
|
Salem Y, Liu H, Altuna D, Ditthakasem K. Physical function in children with 22q11.2 deletion syndrome/velo-cardio-facial syndrome (DiGeorge syndrome). Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Mendel I, Feige E, Yacov N, Salem Y, Levi I, Propheta-Meiran O, Shoham A, Ishai E, George J, Harats D, Breitbart E. VB-201, an oxidized phospholipid small molecule, inhibits CD14- and Toll-like receptor-2-dependent innate cell activation and constrains atherosclerosis. Clin Exp Immunol 2014; 175:126-37. [PMID: 24116867 DOI: 10.1111/cei.12212] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2013] [Indexed: 12/21/2022] Open
Abstract
Atherosclerosis is an inflammatory disease of the vascular wall. Activated monocytes and dendritic cells (DC) in the intima layer of the vasculature promote atherogenesis. Toll-like receptor (TLR)-2 and TLR-4, which are predominantly expressed on these cells and mediate their activation, are essential for atherosclerosis development. In this study we demonstrate that VB-201, an oxidized phospholipid (Ox-PL) small molecule, inhibits TLR signalling restricted to TLR-2 and TLR-4 in human and mouse monocytes and DC. Mechanistically, we show that VB-201 binds directly to TLR-2 and CD14, the TLR-4 co-receptor, to impair downstream cues and cytokine production. In a rabbit model, oral administration of VB-201 constrained atherosclerosis progression. This effect was not due to reduced cholesterol abundance, as hyperlipidaemia was sustained. We suggest that VB-201 may counter inflammation where TLR-2 and/or CD14 complicity is essential, and is therefore beneficial for the treatment of atherosclerosis.
Collapse
Affiliation(s)
- I Mendel
- VBL Therapeutics, Or Yehuda, Israel
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Children who are critically ill are frequently viewed as "too sick" to tolerate physical activity. As a result, these children often fail to develop strength or cardiovascular endurance as compared to typically developing children. Previous reports have shown that early participation in physical activity in is safe and feasible for patients who are critically ill and may result in a shorter length of stay and improved functional outcomes. The use of the virtual reality gaming systems has become a popular form of therapy for children with disabilities and has been supported by a growing body of evidence substantiating its effectiveness with this population. The use of the virtual reality gaming systems in pediatric rehabilitation provides the children with opportunity to participate in an exercise program that is fun, enjoyable, playful, and at the same time beneficial. The integration of those systems in rehabilitation of children who are critically ill is appealing and has the potential to offer the possibility of enhancing physical activities. The lack of training studies involving children who are critically ill makes it difficult to set guidelines on the recommended physical activities and virtual reality gaming systems that is needed to confer health benefits. Several considerations should be taken into account before recommended virtual reality gaming systems as a training program for children who are critically ill. This article highlighted guidelines, limitations and challenges that need to be considered when designing exercise program using virtual reality gaming systems for critically ill children. This information is helpful given the popular use of virtual reality gaming systems in rehabilitation, particularly in children who are critically ill.
Collapse
Affiliation(s)
- Yasser Salem
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ahmed Elokda
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt Florida Gulf Coast University, Fort Myers, FL, USA
| |
Collapse
|
28
|
Katorza E, Salem Y, Shashar D, Gilboa Y, Achiron R, Hoffmann C. Virtual angiography of the fetal brain using postmortem MRI. Ultrasound Obstet Gynecol 2014; 43:111-112. [PMID: 23576234 DOI: 10.1002/uog.12483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 03/18/2013] [Accepted: 03/28/2013] [Indexed: 06/02/2023]
Affiliation(s)
- E Katorza
- Antenatal Diagnostic Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | | |
Collapse
|
29
|
|
30
|
|
31
|
Abstract
Spinal muscular atrophy (SMA) is a neuromuscular disorder characterized by degeneration of alpha motor neurons. This case report describes an aquatic therapy program and the outcomes for a 3-year-old girl with type III SMA. Motor skills were examined using the 88-item Gross Motor Function Measure (GMFM), the Peabody Developmental Motor Scales (PDMS-2), and the GAITRite system. The child received aquatic therapy twice per week for 45-min sessions, for 14 weeks. The intervention included aquatic activities designed to improve gross motor skills and age-appropriate functional mobility. The GMFM total score improved by 11% following the intervention. The Standing Dimension score improved by 28% and the Walking, Running, and Jumping Dimension score improved by 18%. The gross motor quotient for the PDMS-2 improved from 66 to 74. The child's gait showed improvement in walking velocity, stride length, and single-limb support time as a percentage of the gait cycle. The outcomes of this case report demonstrate the successful improvement of gross motor function and gait in a 3-year-old child with SMA. This study provides clinical information for therapists utilizing aquatic therapy as a modality for children with neuromuscular disorders.
Collapse
Affiliation(s)
- Yasser Salem
- Division of Physical Therapy, Long Island University, Brooklyn Campus, Brooklyn, New York, USA
| | | |
Collapse
|
32
|
Salem Y, Scott AH, Karpatkin H, Concert G, Haller L, Kaminsky E, Weisbrot R, Spatz E. Community-based group aquatic programme for individuals with multiple sclerosis: a pilot study. Disabil Rehabil 2010; 33:720-8. [DOI: 10.3109/09638288.2010.507855] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
33
|
Abstract
The purpose of this study was to determine the effects of prolonged standing on gait characteristics in children with spastic cerebral palsy. Six children with spastic cerebral palsy participated in this study with an average age of 6.5 years (SD = 2.5, range = 4.0-9.8 years). A reverse baseline design (A-B-A) was used over a 9-week period. During phase A, the children received their usual physical therapy treatment. During phase B, children received the prolonged standing program three times per week, in addition to their usual physical therapy treatment. During phase A2, children received their usual physical therapy treatment. Gait analysis and clinical assessment of spasticity were performed before and after each phase. Analysis of variance (ANOVA) for repeated measurements was used to test for changes in gait measures across the four measurement sessions. Friedman's was used to test for changes in muscle tone (Modified Ashworth Scale) across the four measurement sessions. Stride length (p <.001), gait speed (p <.001), stride time (p <.001), stance phase time (p <.001), double support time (p <.003), muscle tone (p <.02), and peak dorsiflexion angle during midstance (p <.004) improved significantly following the intervention phase. The results of this study demonstrate that the gait pattern of children with cerebral palsy classified as level II or III on the Gross Motor Functional Classification System (GMFCS) improved by a prolonged standing program. However, these improvements were not maintained at 3 weeks. Further research is necessary with larger sample sizes to replicate these findings and determine specific "dosing" for standing programs to create long-lasting functional effects on gait.
Collapse
Affiliation(s)
- Yasser Salem
- Division of Physical Therapy, Long Island University, Brooklyn, New York 11201, USA.
| | | | | | | |
Collapse
|
34
|
Affiliation(s)
- Rebecca A. States
- From the Department of Physical Therapy, Long Island University, Brooklyn, NY
| | - Evangelos Pappas
- From the Department of Physical Therapy, Long Island University, Brooklyn, NY
| | - Yasser Salem
- From the Department of Physical Therapy, Long Island University, Brooklyn, NY
| |
Collapse
|
35
|
Abstract
BACKGROUND Overground gait training forms a major part of physical therapy services for chronic stroke patients in almost every setting. Overground gait training refers to physical therapists' observation and cueing of the patient's walking pattern along with related exercises, but does not include high-technology aids such as functional electrical stimulation or body weight support. OBJECTIVES To assess the effects of overground physical therapy gait training on walking ability for chronic stroke patients with mobility deficits. SEARCH STRATEGY We searched the Cochrane Stroke Group Trials Register (last searched March 2008), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2008), MEDLINE (1966 to May 2008), EMBASE (1980 to May 2008), CINAHL (1982 to May 2008), AMED (1985 to March 2008), Science Citation Index Expanded (1981 to May 2008), ISI Proceedings (Web of Science, 1982 to May 2006), Physiotherapy Evidence Database (http://www.pedro.org.au/) (May 2008), REHABDATA (http://www.naric.com/research/rehab/) (1956 to May 2008), http://www.clinicaltrials.gov (May 2008), http://www.controlled-trials.com/ (May 2008), and http://www.strokecenter.org/ (May 2008). We also searched reference lists of relevant articles, and contacted authors and trial investigators. SELECTION CRITERIA Randomised controlled trials comparing overground physical therapy gait training with a placebo intervention or no treatment for chronic stroke patients with mobility deficits. DATA COLLECTION AND ANALYSIS Pairs of authors independently selected trials. Three authors independently extracted data and assessed quality. We contacted study authors for additional information. MAIN RESULTS We included nine studies involving 499 participants. We found no evidence for a benefit on the primary variable, post-test gait function, based on three studies with 269 participants. Uni-dimensional performance variables did show significant effects post-test. Gait speed increased by 0.07 metres per second (95% confidence interval (CI) 0.05 to 0.10) based on seven studies with 396 participants, timed up-and-go (TUG) test improved by 1.81 seconds (95% CI -2.29 to -1.33), and six-minute-walk test (6MWT) increased by 26.06 metres (95% CI 7.14 to 44.97) based on four studies with 181 participants. We found no significant differences in deaths/disabilities or in adverse effects, based on published reports or personal communication from all of the included studies. AUTHORS' CONCLUSIONS We found insufficient evidence to determine if overground physical therapy gait training benefits gait function in patients with chronic stroke, though limited evidence suggests small benefits for uni-dimensional variables such as gait speed or 6MWT. These findings must be replicated by large, high quality studies using varied outcome measures.
Collapse
Affiliation(s)
- Rebecca A States
- Long Island UniversityDivision of Physical Therapy1 University Plaza, HS 213BrooklynNYUSA11201
| | - Evangelos Pappas
- Long Island UniversityDivision of Physical Therapy1 University Plaza, HS 213BrooklynNYUSA11201
| | - Yasser Salem
- Long Island UniversityDivision of Physical Therapy1 University Plaza, HS 213BrooklynNYUSA11201
| | | |
Collapse
|
36
|
Affiliation(s)
- Yasser Salem
- Division of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | - Ellen M. Godwin
- SUNY Down State Medical Center, University Hospital of Brooklyn, Brooklyn, NY, USA
| |
Collapse
|
37
|
Pasder P, Salem Y, Yaffe E, Shpungin S, Nir U. FER as a novel intervening target for cancer therapy. DRUG FUTURE 2007. [DOI: 10.1358/dof.2007.032.01.1065737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
38
|
|
39
|
Khosla S, Ahmed A, Siddiqui M, Trivedi A, Benatar D, Salem Y, Elbzour M, Vidyarthi V, Lubell D. Safety of Angiotensin-Converting Enzyme Inhibitors in Patients with Bilateral Renal Artery Stenosis Following Successful Renal Artery Stent Revascularization. Am J Ther 2006; 13:306-8. [PMID: 16858164 DOI: 10.1097/00045391-200607000-00005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Angiotensin-converting enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal artery stenosis due to risk of azotemia resulting from preferential efferent arteriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II. Patients with renal artery stenosis who can derive survival benefit from ACE inhibition, therefore, may not receive ACEI therapy. We evaluated the safety of ACEI therapy in patients with bilateral renal artery stenosis following successful revascularization using renal artery stenting. This study is a retrospective analysis of 25 patients who underwent bilateral renal artery stenting for refractory hypertension and had a strong clinical indication for long-term ACEI use (left ventricular dysfunction or diabetes). Eighteen of the 25 patients (72%) have been safely maintained on a target dose of ACEIs, 2 of the 25 have been treated with angiotensin receptor blockers due to cough, and 5 of the 25 are being treated with a hydralazine/nitrate combination due to cough (2 patients) or baseline renal insufficiency (3 patients). We conclude that patients with bilateral renal artery stenoses that have been successfully revascularized using renal stenting may be safely treated with long-term ACEI therapy.
Collapse
Affiliation(s)
- Sandeep Khosla
- Section of Cardiology, Department of Medicine, Rosalind Franklin University of Medicine & Science/The Chicago Medical School, North Chicago, and Mount Sinai Hospital, Chicago, Illinois 60606, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Pasder O, Shpungin S, Salem Y, Makovsky A, Vilchick S, Michaeli S, Malovani H, Nir U. Downregulation of Fer induces PP1 activation and cell-cycle arrest in malignant cells. Oncogene 2006; 25:4194-206. [PMID: 16732323 DOI: 10.1038/sj.onc.1209695] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Fer is a nuclear and cytoplasmic intracellular tyrosine kinase. Herein we show that Fer is required for cell-cycle progression in malignant cells. Decreasing the level of Fer using the RNA interference (RNAi) approach impeded the proliferation of prostate and breast carcinoma cells and led to their arrest at the G0/G1 phase. At the molecular level, knockdown of Fer resulted in the activation of the retinoblastoma protein (pRB), and this was reflected by profound hypo-phosphorylation of pRB on both cyclin-dependent kinase CDK4 and CDK2 phosphorylation sites. Dephosphorylation of pRB was not seen upon the direct targeting of either CDK4 or CDK2 expression, and was only partially achieved by the simultaneous depletion of these two kinases. Amino-acid sequence analysis revealed two protein phosphatase 1 (PP1) binding motifs in the kinase domain of Fer and the association of Fer with the pRB phosphatase PP1alpha was verified using co-immunoprecipitation analysis. Downregulation of Fer potentiated the activation of PP1alpha and overexpression of Fer decreased the enzymatic activity of that phosphatase. Our findings portray Fer as a regulator of cell-cycle progression in malignant cells and as a potential target for cancer intervention.
Collapse
Affiliation(s)
- O Pasder
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
Clozapine is an atypical dibenzodiazepine antipsychotic used for resistant schizophrenia. Uncommonly, it is associated with myocarditis. We report a case of myopericarditis masquerading as an acute myocardial infarction based on presenting electrocardiogram and cardiac markers. Emergent coronary angiography confirmed the absence of epicardial coronary occlusion and revealed severe left ventricular systolic dysfunction. Immediate discontinuation of the clozapine, along with aggressive supportive care resulted in complete recovery to baseline. Cardiovascular health professionals should be aware of this uncommon but serious side effect of clozapine since failure to recognize the association may result in adverse clinical outcome and inappropriate therapy.
Collapse
Affiliation(s)
- Mansour Razminia
- Section of Cardiology, Department of Medicine, Rosalind Franklin University of Medicine and Science, Mount Sinai Hospital Medical Center, Chicago, Illinois 60608, USA
| | | | | | | | | |
Collapse
|
42
|
Desai AD, Burke MC, Hong TE, Kim S, Salem Y, Yong PG, Knight BP. Predictors of Appropriate Defibrillator Therapy Among Patients with an Implantable Defibrillator That Delivers Cardiac Resynchronization Therapy. J Cardiovasc Electrophysiol 2006; 17:486-90. [PMID: 16684019 DOI: 10.1111/j.1540-8167.2006.00355.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The purpose of this study was to determine predictors of appropriate implantable defibrillator (ICD) therapy among patients with heart failure who are treated with a cardiac resynchronization therapy-defibrillator (CRT-D). METHODS AND RESULTS Patients enrolled in the Ventak CHF/Contak CD study were treated with a CRT-D device and were required to have NYHA class II-IV CHF, QRS duration > or = 120 msec, and a class I or II indication for an ICD. The study database was retrospectively analyzed during the 6-month postimplant period to identify predictors of appropriate ICD therapy. Five hundred and one of the 581 patients enrolled in the trial had successful device implantation and were included in this analysis. Patients were mostly male (83%), 66 +/- 11 years old, and had coronary artery disease (69%), a mean left ventricular ejection fraction (EF) = 0.22 +/- 0.07, and NYHA class II (33%), III (58%), or IV (9%) CHF symptoms. During 6 months of follow-up, 73 of 501 (14%) patients received an appropriate ICD therapy. Two independent predictors of appropriate therapy were identified: a history of a spontaneous, sustained ventricular arrhythmia (HR = 2.05; 95% CI = 1.31-3.20; P = 0.002) and NYHA class IV CHF (HR = 1.81; 95% CI = 1.10-2.96; P = 0.019). When patients with NYHA class II were excluded from analysis, a history of a sustained ventricular arrhythmia and the presence of NYHA class IV CHF symptoms remained as independent predictors of appropriate ICD therapy. CONCLUSIONS In a select population of advanced heart failure patients receiving a CRT-D, NYHA class IV CHF was a powerful independent predictor of appropriate ICD therapy. Approximately one-quarter of the patients with NYHA class IV CHF who received a CRT-D device received an appropriate ICD therapy within 3 months after implant. Additional studies are needed to confirm an association between class IV CHF symptoms and an increased frequency of ICD shocks.
Collapse
Affiliation(s)
- Aseem D Desai
- Section of Cardiology, Department of Internal Medicine, University of Chicago, Chicago, Illinois 60637, USA
| | | | | | | | | | | | | |
Collapse
|
43
|
Burke MC, Morton J, Lin AC, Tierney S, Desai A, Hong T, Kim S, Salem Y, Alberts M, Knight BP. Implications and Outcome of Permanent Coronary Sinus Lead Extraction and Reimplantation. J Cardiovasc Electrophysiol 2005; 16:830-7. [PMID: 16101623 DOI: 10.1046/j.1540-8167.2005.40802.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We examined the implications and outcome of coronary sinus (CS) lead removal including the feasibility of laser use within the CS. BACKGROUND Cardiac anatomy and lead interactions are more complex with the advent of biventricular pacemakers and atrial cardioverters requiring permanent lead/shocking coil placement in the coronary sinus and its branches. METHODS Fifty-five permanent cardiac leads were extracted during 2003 in 28 consecutive patients. Our study population included a 10/55 (18%) subset (all males; age 73 +/- 6 years; EF = 0.24 +/- 0.09) that underwent CS (1/10) or vein branch (9/10) lead extraction. Leads were extracted with an excimer laser sheath (n = 4) or by direct traction (n = 6). Median times between implantation and lead removal were 9.5 months (range 5-59) in the laser group and 3 months (range 3-4) in the direct traction group. Indication for extraction was infection (n = 4), dislodgement (n = 3), diaphragm stimulation (n = 2), and elevated threshold (n = 1). The CS was divided into distal, mid, and proximal segments by venogram. RESULTS Entry of the laser sheath into the CS was necessary in three of four laser patients. The two distal CS laser cases (left lateral CS coil and anterior-lateral left ventricular (LV) lead) required both 14- and 12-Fr sheaths, separately. The proximal CS laser case (posterior-lateral LV lead) required a 12 Fr sheath. The remaining laser patient required a 12-Fr sheath to pass to the mid SVC. There were no procedural complications as a result of CS lead extraction. Reimplantation of a CS lead was attempted in 7/10 patients at a median of 4 days (range 1-300). CS venograms were available for review in patients before initial implantation (6/10) and after extraction (7/10). The postextraction venograms demonstrated complete occlusion of the vein from which the lead was extracted, and its distal branches, which were unusable in 5/10 (50%). The vein occlusions were present in patients with indwelling leads for greater than 3 months and were independent of extraction method. CONCLUSIONS Laser lead extraction in the coronary sinus appears feasible in carefully selected cases with mandatory indications. However, special intraoperative monitoring and echocardiographic imaging with surgical backup ready is strongly recommended. Target vein selection may be limited for the purpose of reimplantation when leads are indwelling for greater than 3 months.
Collapse
Affiliation(s)
- Martin C Burke
- Section of Cardiology, University of Chicago, Illinois 60637, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Razminia M, Salem Y, Elbzour M, Teves D, Deshmukh H, Khosla S. Importance of early diagnosis and therapy of acute meningococcal myocarditis: a case report with review of literature. Am J Ther 2005; 12:269-71. [PMID: 15891272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Acute meningococcemia is a clinical syndrome resulting from Neisseria meningitides infection. The clinical presentation is varied, but when associated with myocardial dysfunction, it carries a poor prognosis. We report a case of meningococcal myocarditis causing severe left ventricular systolic dysfunction that improved over a 4-day period after appropriate antimicrobial treatment following prompt diagnosis. The case highlights the importance of prompt recognition and treatment of this disorder.
Collapse
Affiliation(s)
- Mansour Razminia
- Section of Cardiology, Department of Medicine, Rosalind Franklin University of Medicine & Science, Mount Sinai Hospital Medical Center, Chicago, Illinois 60608, USA
| | | | | | | | | | | |
Collapse
|
45
|
Abstract
It is generally accepted that the diagnosis of an epicardial origin of ventricular tachycardia (VT) can be made indirectly by observing VT termination during ablation on the epicardial surface of the heart. There is a caveat, however, which is that termination of VT during radiofrequency current application on the epicardial surface could be due to extension of the lesion beyond the epicardium. Therefore, successful ablation of VT using an epicardial approach does not necessarily prove the reentrant circuit is located superficially. We present a case of a 44-year-old man with VT storm who demonstrated successful termination of VT with radiofrequency current application on the epicardial surface of the heart. This site corresponded to a site where pacing during VT resulted in termination of VT without global capture. Isolated mid-diastolic potentials were only seen at this site as well. We hypothesize that the finding of termination of VT by pacing without global capture supports the argument that the site of pacing is a critical part of the VT circuit.
Collapse
Affiliation(s)
- Aseem D Desai
- Section of Cardiology, Department of Internal Medicine, University of Chicago, Chicago, Illinois 60637, USA.
| | | | | | | | | | | |
Collapse
|
46
|
Razminia M, Trivedi A, Molnar J, Elbzour M, Guerrero M, Salem Y, Ahmed A, Khosla S, Lubell DL. Validation of a new formula for mean arterial pressure calculation: The new formula is superior to the standard formula. Catheter Cardiovasc Interv 2004; 63:419-25. [PMID: 15558774 DOI: 10.1002/ccd.20217] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Mean arterial pressure (MAP) has traditionally been derived from systolic and diastolic pressures, weighted 1/3 systolic and 2/3 diastolic. No correction is made for the increasing time dominance of systole with increasing heart rates. In a previous study, we developed a new and more accurate heart rate-corrected MAP formula from central aorta pressure determinations in a large number of patients: MAP = DP + [0.33 + (HR x 0.0012)] x [PP] where SP and DP are systolic and diastolic pressure and HR is heart rate. The current study validates the new MAP formula in the same patient at increasing paced heart rates. A central aorta catheter was used to obtain computer-determined systolic, diastolic, and MAP in 12 patients. Values were obtained at baseline and then at increasing right atrial paced heart rates. The new and standard MAP formula-derived values were compared with computer-determined values. The new formula showed a much closer correlation with the computer-derived values for MAP. Standard MAP calculations for MAP can easily be improved by inclusion of a heart rate factor.
Collapse
Affiliation(s)
- Mansour Razminia
- Cardiovascular Disease Program, Rosalind Franklin University of Medicine and Science, Chicago, Illinois, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Abstract
To evaluate the necessity for retrograde pyelography in the preoperative evaluation of children undergoing pyeloplasty, we reviewed the records of 108 consecutive patients (age range 5 days to 18 years, median 1 year) who underwent pyeloplasty at our institution during a 6-year period. The routine preoperative evaluation consisted of a renal/bladder sonogram, furosemide renal scan (99mtechnetium-diethylenetriaminepentaacetic acid or 99mtechnetium-mercaptoacetyltriglycine) and voiding cystogram. No other imaging studies were obtained in 95 patients (88%). Other upper tract studies usually performed before referral included excretory urography in 9 cases and computerized tomography in 5. Preoperative retrograde pyelography was only performed in 1 symptomatic patient before referral to our institution. Surgical findings confirmed obstruction at the ureteropelvic junction in all patients. Undetected ureteral dilatation, which might suggest undiagnosed distal obstruction, was not encountered. After pyeloplasty 2 patients were lost to followup, renal drainage improved in 104 (98%) and drainage failed to improve in 2 of whom 1 (0.9%) required reoperation. All patients who presented with symptomatic uretero-pelvic junction obstruction experienced postoperative resolution of the presenting complaints. Our series demonstrates that routine retrograde pyelography to define the level of obstruction is not necessary for successful primary pyeloplasty. In experienced hands and with careful attention to detail, the combination of renal/bladder sonography and diuretic renography can reliably exclude the possibility of distal obstruction in children with hydronephrosis before pyeloplasty.
Collapse
Affiliation(s)
- H G Rushton
- Department of Urology and Radiology, George Washington University Medical Center, Washington, D. C
| | | | | | | |
Collapse
|
48
|
Abstract
The kidney is the second most common site for metastasis of lymphoma though it remains asymptomatic and is not commonly detected with cross-sectional imaging studies. Primary renal lymphoma is a very rare lesion whose existence is controversial. The lymphoma reported here presented as a solitary renal mass without any other evidence of disease. Lymphoma should be included in the differential diagnosis for solitary renal masses even though the usual presentation is bilateral. Renal involvement with lymphoma requires a thorough search for extrarenal disease.
Collapse
Affiliation(s)
- Y Salem
- Department of Urology, George Washington University Medical Center, Washington, DC
| | | | | |
Collapse
|
49
|
Salem Y, Linares C, Jacquier B, Saine MC, Gasperin M, Lejus AM, Vivien D. The sites of Gd3+ in the luminescent matrix La1−xGdxMgAl11O19: Single crystal structure determination and site‐selective excitation of Gd3+. J Chem Phys 1990. [DOI: 10.1063/1.459430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
50
|
Salem Y, Jacquier B, Cone RL. Fluorescence measurements of the exciton dispersion in Gd(OH)3. Phys Rev B Condens Matter 1990; 41:1735-1738. [PMID: 9993899 DOI: 10.1103/physrevb.41.1735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
|