Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.

Assessment of outcomes of hearing and speech rehabilitation in children with cochlear implantation

Objectives:This study aimed to assess the effect of hearing and speech rehabilitation in patients with Nurotron■cochlear implants.Design:Ninety-eight paediatric patients with bilateral severe-to-profound sensorineural deafness who received cochlear implantation were divided into three groups according to age:group A(≤3 years),group B(4-7 years),and group C(8-16 years).All patients were followed up for one year for hearing and speech performance after the surgery.The comprehensive Auditory Perception Assessment,MAIS,CAP and SIR hearing and speech assessments and rating materials were used for assessment before the surgery and at 3,6,and 12 months after implant activation.Results:The scores of patients in the open-set speech assessment,Chinese Auditory Perception Assessment,MAIS,CAP and SIR significantly improved after cochlear implantation in all age groups.The younger the age at implantation,the better the results.Moreover,the hearing and speech performance of cochlear implant recipients gradually improved with the extension of rehabilitation time.Conclusions:Nurotron■Venus^TM cochlear implantation can improve the hearing and speech performance of patients with bilateral severe-to-profound sensorineural deafness.

Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

Background Evaluation of patient outcomes following transcatheter aortic valve implantation （TAVI） has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days （range： 192-738 days）, five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.

Research Advances in Post-Operative Rehabilitation Following Cochlear Implant

Cochlear implantation is a unique method to re-construct audition for patients with severe to profound hearing loss. With increasing clinical application of this technique, its rehabilitative effects in patients has become an important topic of hearing and speech rehabilitation research. This article is an overview of hearing and speech rehabilitative training, rehabilitative efficacy evaluation and factors affecting rehabilitation efficacy following cochlear implantation.

Implantosuported Rehabilitation after Marginal Recession of Mandibular Calcifying Epithelial Odontogenic Tumor: Case Report

The Calcifying Epithelial Odontogenic Tumor (CEOT) also called the Pindborg’s Tumor represents a rare benign epithelial odontogenic neoplasm with locally aggressive behavior. Surgical excision with a safety margin is one of the treatment options, requiring bone and soft tissue reconstruction for implant-supported rehabilitation, providing the individual with a return to adequate oral functions. The objective of the present study is to report on the case of the treatment stages and the factors involved in the rehabilitation of a 23-year-old man with a history of mandibular lesion diagnosed as CEOT. A marginal resection of the mandible lesion was performed, with posterior reconstruction with iliac crest bone graft and soft tissue graft to allow the implant-supported rehabilitation. Currently, in the postoperative control, the individual shows no signs of tumor recurrence and is rehabilitated without functional and/or aesthetic complaints. Surgical excision should be framed as a form of treatment, aiming for better resolution in the more complex cases of these invasive tumors.

Outcome measures following tele-rehabilitation and conventional face to face rehabilitation in paediatric cochlear implant users during COVID-19 pandemic:A pilot study in a tertiary care setup

Background:Following the COVID-19 pandemic,majority of paediatric cochlear implantees(CI)lost follow ups for rehabilitation and tele-therapy was initiated.Present study thus compared the outcome measures of paediatric CI users on tele-therapy versus conventional face to face therapy following COVID-19 pandemic.Method:Twenty seven unilateral paediatric cochlear implantees in the age range of 2e11 years were divided into two groups based on the therapy modality,viz,tele-and face-to-face therapy.Based on the hearing age,participants were further divided into three groups,viz,0e2,2e4,and greater than four years.A complete the test battery comprising Integrated Scales of Development,Speech Intelligibility Rating scale,and Revised Categorical Auditory Perception were administered.The speech&language test battery was performed prior to initiating the rehabilitation and post 12 months of rehabilitation.Results:Results of the present study revealed that conventional rehabilitation had better outcomes compared to teletherapy.The rate of progress after one year of rehabilitation with respect to hearing-age showed a significant difference for the hearing-age group of 0e2 years across the domains of audition,speech and language.Conclusion:The present study indicates that conventional method of the speech-language and auditory rehabilitation is far better compared to the tele rehabilitation services especially for those visiting tertiary care hospitals as most of them belong to lower and middle socioeconomic status.From the results,it can be delineated that with lesser hearing experience,paediatric CI users always need to initially enroll for conventional therapy for better speech-language and auditory outcomes.

Relative Impact of Oral Rehabilitation on Quality of Life and Patient Satisfaction Following Mandibular Resection in a Sub-Urban Nigerian Tertiary Hospital

Background: Resection of the mandible can lead to bony defect which has a direct bearing on the quality of life of the patient. Reconstruction of such defect is necessary to restore aesthetics but optimal functioning of the oral cavity can only be achieved with prosthodontic rehabilitation. We, hereby, report the impact of oral rehabilitation on patients’ satisfaction and quality of life after mandibular reconstruction in our institution. Materials and Method: Patients who had oral rehabilitation following mandibular reconstruction from January 2010 to December 2015 were included. Patients’ oral health related quality of life [OHRQL] before and after rehabilitation was evaluated using the head and neck module of the European Organization for Research and Treatment of Cancer [EORTC]. Oral functions and denture satisfaction were also evaluated with Visual Analogue Scale [VAS]. Data obtained were analyzed with SPSS version 20 and level of significance was set at p Result: Of the 43 patients who had mandibular reconstruction during the study period, only 21 [48.8%] had dental rehabilitation. Twelve patients [57.1%] had conventional acrylic denture, 5 had fixed denture [bridge] while 4 patients had rehabilitation with dental implants. The mean follow-up period after rehabilitation was 8.42 months [Range: 6 - 22 months]. Although, OHRQL analysis revealed an improvement following rehabilitation, only the social aspect of the evaluation was statistically significant [p p = 0.00]. On the contrary, there was no statistically significant difference in aesthetics amongst the patients regardless of type of rehabilitation [p = 0.26]. Conclusion: Findings from this study showed that there is improvement in OHRQL following dental rehabilitation. Also, Patients who were rehabilitated with dental implant had better oral function than those with fixed or conventional denture.

Stages of Emotional Experience of Parents of Children with Cochlear Implantation (CI)

Rehabilitation is a set of measures aimed at compensating or fully restoring the functions of the patient impaired by the disease. In the rehabilitation of children with a cochlear implant, a comprehensive, systematic approach is essential in the work of doctors, teachers, sign language teachers, psychologists, and families. Rehabilitation and social adaptation of children with a cochlear implant depend not only on specialists but also on the ability of parents to help the child organize educational activities in an optimistic mood and the ability to provide emotional support. This means that the role of parents in the way to successful rehabilitation is high, and therefore this topic is especially relevant today. .

叙事护理结合心脏康复护理对冠心病支架植入术患者自护能力、生活质量的影响

目的 观察叙事护理结合心脏康复护理对冠心病支架植入术患者自护能力、生活质量的影响。方法 选取2022年1月至2022年12月河南省胸科医院收治的100例冠心病支架植入术患者,以简单随机抽样法分组。对照组(50例)接受常规护理联合心脏康复护理,观察组(50例)在此基础上接受叙事护理。对比各指标。结果 应用叙事护理结合心脏康复护理后,观察组自我护理能力测定量表(ESCA)评分高于对照组(P<0.05);观察组生活质量水平更高(P<0.05)。结论 对冠心病支架植入术患者应用叙事护理结合心脏康复护理,可更好地提高患者自护能力,改善生活质量。

儿童人工耳蜗植入术后听觉言语康复情况的影响因素

目的 分析儿童人工耳蜗植入术后听觉言语康复情况的影响因素。方法 回顾性收集2015年1月至2020年1月南阳市中心医院收治的120例人工耳蜗植入术后耳聋儿童临床资料,术后均随访24个月,比较所有儿童开机前及术后1、3、6、9、12、24个月听觉行为分级、语言可懂度分级、婴幼儿有意义听觉整合量表评分,以多重线性回归分析耳聋儿童人工耳蜗植入术后24个月听觉言语康复情况的影响因素。结果 开机前及术后1、3、6、9、12、24个月,耳聋儿童人工耳蜗植入术后听觉行为分级、语言可懂度分级、婴幼儿有意义听觉整合量表评分均呈逐渐升高趋势,不同时间点比较,差异有统计学意义(P<0.05)。多重线性回归分析结果显示,术前有残余听力且佩戴助听器、植入时年龄≤3岁、人工耳蜗植入术电极类型为弯电极、监护人受教育程度为中及以上、康复模式为康复机构联合家庭、基因突变类型为GJB2、监护人为父母均为影响耳聋儿童人工耳蜗植入术后24个月听觉行为分级评分、婴幼儿有意义听觉整合量表评分的保护因素(P<0.05);术前有残余听力且佩戴助听器、植入时年龄≤3岁、人工耳蜗植入术电极类型为弯电极、康复模式为康复机构联合家庭、基因突变类型为GJB2、监护人受教育程度为高中及以上均为影响耳聋儿童人工耳蜗植入术后24个月语言可懂度分级评分的保护因素(P<0.05)。结论 影响耳聋儿童人工耳蜗植入术后24个月婴幼儿听觉言语康复的相关因素包括植入时年龄、术前有残余听力且佩戴助听器情况、人工耳蜗植入术电极类型情况、监护人情况、康复模式、基因突变类型,临床可针对以上因素对耳聋儿童进行干预,促进其听觉言语康复。

植入式静脉输液港肩关节受限患者的康复训练

目的 探讨康复训练方案在植入式静脉输液港肩关节受限患者中的应用效果。方法 选取植入式静脉输液港肩部活动受限患者,按入院时间先后将69例设为对照组,采用常规握力球进行训练;72例设为干预组,采用康复训练方案进行干预。3个月后,比较两组患者肩关节活动度、日常生活活动能力及并发症发生情况。结果 两组干预后肩关节活动度前屈、外展、外旋、内旋、后伸活动度及日常生活活动能力评分显著优于本组干预前,干预后干预组关节活动度及日常生活活动能力评分显著优于对照组,血栓发生率显著低于对照组(均P<0.05);两组导管堵塞、异位发生率比较,差异无统计学意义(均P>0.05)。结论 康复训练方案简单易学,容易掌握,不受场地与时间限制,能改善静脉输液港肩关节受限患者肩关节活动度、日常生活活动能力,降低患者血栓发生率。

不同助听模式下儿童言语康复效果观察

观察不同助听模式下儿童言语康复效果。随机挑选苏州大学附属儿童医院2022年1月—2023年8月收治的60例听障儿童,且分为A组、B组,每组患儿数量均为30例。A组使用单侧人工耳蜗植入,B组使用双耳双模式,对两组患儿CAP评分、SIR评分、SSQ-P评分、语言康复效果进行观察。结果显示,助听前,两组患儿CAP评分情况比较无显著差异(P>0.05);助听后,B组患儿CAP评分要明显高于A组(P<0.05)。助听前,两组患儿SIR评分情况比较无显著差异(P>0.05);助听后,B组患儿SIR评分要明显高于A组(P<0.05)。B组患儿SSQ-P总分要明显高于A组(P<0.05)。A组患儿言语康复有效率为76.67%,B组患儿言语康复有效率为93.33%,B组患儿言语康复效果明显好于A组(P<0.05)。研究发现,听障儿童利用双耳双模式的助听模式具有较好的言语康复效果,临床推广应用价值高。

数字化设计全牙列种植固定修复中[牙合]平面的确定

各类牙科数字化技术在种植固定修复中已经得到了充分应用。多种模态的数字化数据提供了较传统方法不可比拟的信息量及信息精确度,使得医师和技师能够更直观、更精准的进行方案设计。在全牙列数字化修复设计中,平面的确定是其中的重要一环,对于咬合功能协调具有重要影响,然而在义齿设计加工中尚缺少可供参考的设计原则及规范方法。本文以[牙合]平面为出发点,讨论了全牙列种植固定修复中涉及的数字化技术及数据、虚拟颌位关系转移,以及平面定位的各类参考方法,以期为全牙列种植咬合重建的临床工作提供参考。

Ⅱ型神经纤维瘤病疾病特征与人工耳蜗植入

目的 分析1例表现较为复杂的Ⅱ型神经纤维瘤病(neurofibromatosis type Ⅱ,NF2)患者的临床表现、听力康复方法和效果,明确一种特殊类型的NF2听神经瘤的听力重建方法及术后康复效果。方法 整理该患者临床表现及既往史,术前检查,临床手术方法及术后随访听力康复效果。结果 患者双侧听神经瘤,听力表现为双耳极重度感音神经性听力下降。外周血基因检测未见治病基因突变,考虑为嵌合体。患者右耳为内耳神经鞘膜瘤,且双眼视力极差,右耳行带瘤人工耳蜗植入术,术后通过为期2个月的以家庭为主的听力语言康复,听觉能力分级(CAP)由0分提高到5分。结论 NF2临床表现复杂,临床预后差。带有微小的内耳神经鞘膜瘤的NF2患者可以通过带瘤植入人工耳蜗重建听力。

家庭环境对语前聋儿童人工耳蜗植入后言语能力影响研究

目的探讨家庭环境对语前聋儿童人工耳蜗植入后言语功能康复的影响。方法选择2021年10月~2023年3月在本院行人工耳蜗植入的84例语前聋儿童为调查对象,术后1、3、6个月采用家庭环境量表中文版(fmily environment scaleChinese version,FES-CV)评估患儿家庭环境;采用听觉能力分级标准(CAP)及言语可懂度分级评估标准(SIR)评估患儿术后听觉言语能力,检验FES-CV各维度与CAP、SIR的相关性。结果语前聋儿童在人工耳蜗植入后6个月CAP、SIR评分显著提升;植入后1、3、6个月家庭环境中亲密度、情感表达、独立性、知识性及娱乐性维度与CAP、SIR评分呈正相关,矛盾性与之呈负相关,差异具有统计学意义(P<0.05)。结论临床医护人员可通过制订以家庭为单位的康复训练计划,调动儿童术后康复训练的积极性,提升言语康复效果。

PCI术后患者运动恐惧潜在剖面分析及与体力活动的关系

目的调查PCI术后患者运动恐惧现况,探讨运动恐惧潜在类别及其与体力活动水平的关系。方法采用便利抽样法选取328例PCI术后患者,采用一般资料调查表、心脏病运动恐惧量表、国际体力活动问卷进行调查。通过潜在剖面分析明确患者的运动恐惧类别,有序logistic回归分析体力活动水平的影响因素。结果PCI术后患者运动恐惧得分为(40.74±5.40)分,运动恐惧可分为低恐惧-适应型(15.2%)、中恐惧-边缘型(50.6%)和高恐惧-回避型(34.2%)。职业状态、心功能分级、患病前运动锻炼情况、运动恐惧类别是体力活动分级的影响因素(均P<0.05)。结论PCI术后患者运动恐惧具有异质性,运动恐惧类别是体力活动的影响因素,医护人员可针对运动恐惧类别采取针对性干预措施,提高患者体力活动水平。

Noonan综合征人工耳蜗植入患者1例

目的结合文献分析1例努南综合征(Noonan syndrome,NS)相关性极重度感音神经性聋患儿行人工耳蜗植入手术,为临床提供借鉴。方法报告1例NS相关性极重度感音神经性聋患儿的临床表现、遗传学特点、诊治要点及康复情况,并对文献进行综述。结果通过结合文献分析,发现患儿临床表现典型,早期通过对典型颜面部畸形提高警惕并进行基因检测有助于NS的早期诊断。双耳保留部分残余听力、高频陡降型听力损失适于一侧行人工耳蜗植入,对侧配戴助听器(双模式干预)。围手术期出血及心功能评估是必要的。结论典型颜面部畸形及基因检测是诊断NS的关键;NS不是人工耳蜗植入禁忌症,但术后康复有挑战性。

缺血性脑卒中支架置入术后患者运动恐惧影响因素的质性研究

目的探讨缺血性脑卒中支架置入术后患者运动恐惧的影响因素,为制定针对性的干预措施提供参考。方法采取目的抽样法,选取2023年4月—9月在武汉市某三级甲等医院神经内科住院的缺血性脑卒中支架置入术后的14例患者为研究对象,对其进行半结构式深度访谈,使用内容分析法对访谈资料进行分析、归纳并提炼主题。结果共提炼运动恐惧内部影响因素和外部影响因素两大主题。内部影响因素包括支架置入术后自我感觉衰弱、对体内支架状态产生过度警觉、对机体不适的敏感性增强、认知偏差引发自我设限、运动自我效能降低5个子主题;外部因素包括疾病经济负担、照顾者支持不足、社交疏远、医疗信息缺乏4个子主题。结论缺血性脑卒中支架置入术后患者的运动恐惧受多种因素的共同影响,医护人员应重视此类患者的早期评估和干预,提高患者对支架置入手术的心理调适能力和术后运动康复认知水平,改善社会支持系统,激发患者运动意愿,促进疾病康复。

循证护理对视网膜脱离患者术后康复的影响

目的探讨循证护理对孔源性视网膜脱离术后康复的影响。方法选取厦门大学附属第一医院眼科2021年10月—2023年10月行玻璃体切除+硅油植入手术治疗的单纯孔源性视网膜脱离患者72例,采用单纯随机抽样分为2组,各36例。对照组给予常规护理,观察组给予循证护理,对比2组患者术后1个月视力康复情况、用药准确性、体位依从性、术后不良反应情况。结果相较于对照组,观察组术后1个月视力>0.10者多(P<0.05),同时患者用药准确性高,患者体位正确性较好。观察组术后并发症发生率(2.78%)低于对照组(22.22%)(P<0.05)。结论循证护理比常规护理可能更有利于孔源性视网膜脱离患者术后的康复。

分期双侧人工耳蜗植入儿童康复效果分析

目的比较分期双侧人工耳蜗植入(CI)儿童后植入侧与先植入侧助听听阈及言语识别率的差异,分析影响后植入侧与先植入侧康复效果的因素。方法测试10例学龄前分期CI儿童先植入侧、后植入侧助听听阈及言语识别率,通过配对t检验比较差异;采用皮尔逊相关分析对被试先植入侧及后植入侧言语识别率与首次植入年龄、植入间隔时间进行相关性分析。结果后植入侧开机1月助听听阈基本达先植入侧助听水平(25.78±5.65 dB HL),后植入侧开机9月较先植入侧开机24月识别率差异显著(P<0.05);先植入侧开机24月言语识别率与首次植入年龄呈显著负相关(r=-0.695,P<0.05),后植入侧开机6月、9月言语识别率与植入间隔时间呈显著负相关(r=-0.743,P<0.05,r=-0.793,P<0.05)。结论后植入侧康复进程较快,言语识别率受年龄、植入间隔时间、助听效果、言语可懂度等因素影响。