The Mediating Role of Pain on Functional Recovery in White, Black, and Hispanic Stroke Survivors

To examine the mediating role of change in pain intensity in explaining the recovery of functional status for White, Black, and Hispanic stroke survivors from discharge to 3 month follow-up.
Source: Archives of Physical Medicine and Rehabilitation - Category: Rehabilitation Authors: Source Type: research

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An elderly woman with h/o stroke and aphasia seemed different to her daughter, and was pointing all over her body as if in pain.They called 911.She had a history of PCI to the circumflex and also of severe mitral regurgitation, status post bioprosthetic valve replacement.  Also a h/o LV aneurysm with thrombus, on anticoagulation, as well as a dual chamber pacemaker. On arrival, the BP was 60/30.Here is the initial ECG:There is atrial pacing and Right Bundle Branch Block (RBBB)There is STE in I and aVL, V5, V6, with reciprocal STD in II, III, aVFThere is appropriately discordant ST depression in V1-V3 (appropriate...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
(University of Western Ontario) The study demonstrated for the first time that in people with no underlying heart disease, after a stroke they were more than 20 times more likely than those who didn't have a stroke (23-fold in women and 25-fold in men) to have a first-in-life major adverse cardiovascular event. These events include things like heart attack, chest pain, cardiac failure or cardiac death.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Abstract Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or pain-related motor impairment with normal motor strength. Muscle weakness should then be graded objectively using a formal tool such as the Medical Research Council Manual Muscle Testing scale. The differential diagnosis of true muscle weakness is extensive, including neurologic, rheumatologic, endocrine, genetic, medication- or tox...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Photo credit Jeremy Wong Dear Carol: My dad, who had been Mom’s caregiver for years, died suddenly from a stroke. I can’t say that I’m surprised because he was under enormous stress trying to cope with first Mom’s illness from cancer treatments, and more recently her early-stage Alzheimer’s diagnosis. Needless to say, we’re all heartbroken over Dad’s sudden death as well as up in the air about how to handle Mom. She seems to be in total denial, though some of her repeated questions may be due to occasional short-term memory loss. How do we help her with this shock and grief? &mdash...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
Pain is a common and burdensome complication in patients with acute stroke. We assessed the impact of impaired communication in stroke patients on pain assessment and treatment.
Source: BMC Neurology - Category: Neurology Authors: Tags: Research article Source Type: research
Semin Neurol DOI: 10.1055/s-0039-3402737Isolated dizziness and vertigo due to vascular mechanisms are frequently misdiagnosed as peripheral vestibulopathy or vestibular migraine. For diagnosis of strokes presenting with an acute prolonged (≥ 24 hours) vestibular syndrome, findings on clinical examination, such as HINTS (negative head impulse tests, detection of direction-changing gaze-evoked nystagmus, and presence of skew deviation), are more sensitive than findings on neuroimaging. Since HINTS alone cannot securely detect anterior inferior cerebellar artery strokes, additional attention should be paid to the pa...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
Herein, we described 2 patients with posterior spinal artery syndrome (PSAS) caused by vertebral artery dissection. The patients complained of sudden neck pain or walking instability. Neurological examination revealed sensory loss, muscle weakness, and sensory ataxia. Angiography showed double lumen sign or intimal flap in the vertebral artery. T2-weighted imaging and diffusion-weighted imaging of MRI showed a hyperintense lesion in the dorsal side of the cervical spinal cord at different times after onset.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
ConclusionsThis retrospective case series provides level IV evidence supporting the use of axillary PNS therapy for the management of chronic shoulder pain. Additional, higher ‐level studies are required to further support its use.
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Case Series Source Type: research
Authors: Schmidt T, Simske NM, Audet MA, Benedick A, Kim CY, Vallier HA Abstract INTRODUCTION: It is well known that patients with diabetes mellitus experience higher complication rates after torsional ankle fracture; however, the functional consequences remain less clear. The goal of this study was to determine the effects of diabetes on complications, secondary operations, and functional outcomes after torsional ankle fracture. METHODS: Nine hundred seventy-nine adult patients treated surgically for a torsional ankle injury (Orthopaedic Trauma Association 44B, 44C) over 13 years were retrospectively reviewed....
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
A former resident texted me this ECG, done for epigastric pain in an 18 year old.  The pain resolved immediately with treatment for acid reflux, and in the clinician's opinion was clearly GI in origin, but he wanted to know what the strange waves in the QRS were:See the unusual notching in II, III, aVF, and V2-V4.I had no idea what they were.  They reminded me of theDelayed Activation Wave associated with circumflex acute MI.See this case: https://hqmeded-ecg.blogspot.com/2018/05/is-there-delayed-activation-wave.html.But they are clearly different from this.I put it on Facebook EKG club and this is the ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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