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Sickle Cell Disease vs. the California Stem Cell Agency: Disease-a-week Challenge #19

Imagine: inside the veins of an African-American child, red blood cells: round and soft, doing their job, keeping the person alive. What would happen if those cells hardened and changed shape, curving into the letter "C", like a wheat-cutting sickle? First, the capillaries would clog, in what Sickle Cell Disease (SCD) doctors call a "crisis". Excruciating agony, like broken glass in the veins, a crisis may last an hour or a day, and the pain is just the beginning. "By twenty years of age, about 15% of children with SCD suffer major strokes...by 40 years of age, almost half have central nervous system damage ... cognitive dysfunction (mental problems) ... damage to lungs and kidneys.... frequent hospitalizations... (and face the likelihood of) early death..." Why does this nightmare condition single out African-Americans? The carrier state for SCD may be a defense against malaria, common to sub-Saharan Africa, but the defense is worse than the disease. Poverty makes things worse: African-Americans are almost three times more likely than whites to be poor, and accordingly lack decent medical insurance: Without medical advice, SCD sufferers may not even know even the most basic care: like the vital importance of drinking lots of water to stay well-hydrated. The more water a person drinks, the less likely it is that their abnormal blood cells will clog the capillaries. "Another effective treatment is a medication called hydroxyurea, which reduc...
Source: Science - The Huffington Post - Category: Science Source Type: news

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Authors: Alanazy MH, Barakeh RB, Asiri A, Edrees MF, Abuzinadah AR, Aljafen BN, Muayqil T Abstract Only a small fraction of patients with acute ischemic stroke receive intravenous thrombolysis (IVT). We sought to assess barriers and practice patterns in using IVT for acute ischemic stroke among neurologists in Saudi Arabia. An electronic survey was sent to all neurologists registered with the Saudi Commission for Health Specialties. A total of 148 (77.5%) neurologists responded. The most common reported barriers for IVT administration were delayed presentation to hospitals (82.4%) and unclear time of symptom onset ...
Source: Neurology Research International - Category: Neurology Tags: Neurol Res Int Source Type: research
CONCLUSION: Similar to stroke units, inpatients in a specialised brain injury unit spend large parts of the day sedentary, alone and doing non-therapeutic activities. Strategies need to be evaluated to address this problem, particularly for people with greater physical dependence. PMID: 29667440 [PubMed - as supplied by publisher]
Source: Brain Injury - Category: Neurology Tags: Brain Inj Source Type: research
Abstract Pain reduction is a primary goal of physical therapy for patients who present with acute or persistent pain conditions. The purpose of this review is to describe a mechanism-based approach to physical therapy pain management. It is increasingly clear that patients need to be evaluated for changes in peripheral tissues and nociceptors, neuropathic pain signs and symptoms, reduced central inhibition and enhanced central excitability, psychosocial factors, and alterations of the movement system. In this Perspective, 5 categories of pain mechanisms (nociceptive, central, neuropathic, psychosocial, and movemen...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Abstract The variability and delay in utilizing evidence in clinical practice are barriers to improving care, quality, and cost in health care, as charged by the "triple aim" framework. Scientific research provides an avenue not only to further the field of pain research, but also to study and change the patterns and processes that drive systemic and individual clinical practices. Implementation science is an emerging field that can be integrated with more traditional effectiveness research to accomplish a combination of aims within the same study. This type of concurrent study of effectiveness and imple...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Conclusions: The sustained effort to self-manage chronic pain could be exhausting, and motivation could wane over time following intervention. Providing intermittent support in the form of booster sessions and peer support groups may be important. Person-centered care via shared decision making and guided problem solving is essential to facilitating ongoing self-management. PMID: 29669089 [PubMed - in process]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Abstract Geriatric low back pain (LBP) can have a profound impact on physical activity and can cause a decline in physical function, which is a major health risk for older adults. Within the last decade, physical therapist management of LBP has shifted from an emphasis on pathoanatomical mechanisms, such as spine degeneration, to addressing psychological distress factors. Although this approach is promising, the complexity of LBP in older adults (including biological, psychological, cognitive, and social influences), which may differ from that in younger adults, must be considered. Further, outcome assessment shou...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
In conclusion, understanding the psychological processes underlying the etiology of chronic pain provides testable ideas and a path forward for improving treatment interventions. PMID: 29669087 [PubMed - in process]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Conclusions: This pilot trial demonstrated that home-based telephone-supported PA interventions were feasible, acceptable, and safe for older adult veterans. The results provide support for a larger trial investigating these interventions. PMID: 29669086 [PubMed - in process]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Abstract The implementation of recent Centers for Disease Control and Prevention recommendations to move away from opioids and toward nonpharmacological therapies for the treatment of chronic pain could involve a difficult transition period for patients and practitioners. The focus of treatment should shift from eliminating pain completely to minimizing the impact of pain on quality of life. Many patients with chronic pain take opioids either because opioids were previously prescribed as a first-line treatment for chronic pain, on the basis of old standards of care, or because opioids were initially prescribed for...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Abstract There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
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