Search PubMed⌕ Search

Biomedical subjects

H Ring

Publications and source records attributed to H Ring.

At least 73 records · Page 4Linked to original sources
PubMed1987

Urinary continence after stroke: association with cystometric profile and computerised tomography findings.

Repeated cystometry was performed in 17 patients after a cerebrovascular accident. Cranial computerised tomography (CT) was performed in all patients. In this series, urinary continence showed a significant correlation both with cystometric bladder tone and with the CT brain findings. The most favourable prognostic factors for urinary continence were a non-hypertonic bladder and absence of extensive brain lesions.

Adult↗
PubMed1986

Evaluation of Tinel's and Phalen's signs in diagnosis of the carpal tunnel syndrome.

In 80 upper extremities clinically suspected of carpal tunnel syndrome, electromyography (EMG) was performed and the Phalen and Tinel signs were sought. These two signs showed relatively low sensitivity (60-67%) and specificity (59-77%) despite a statistically significant association with the EMG findings. These two signs are not reliable as clinical criteria for carpal tunnel syndrome.

Adult↗
PubMed1985

A system for evaluating the earning capacity of the disabled.

A comprehensive system for evaluating the earning capacity of disability benefit claimants was developed. It is based on theoretical considerations of the factors constituting the loss of such capacity, and involves assessments made by a multi-disciplinary team (including at least a rehabilitation physician, registered nurse, psychologist and a social worker). Each team member conducts an assessment by means of a questionnaire with a strong emphasis on the claimant's functional capacity. In this study the physician was requested to evaluate the claimant according to a "profile of insufficiencies" in addition to the traditional percentage system which is used to reflect the degree of impairment. The results obtained with the first sample of 50 examinees are reported in this paper. The comprehensiveness of the variables covered by the team are demonstrated. A composite score agreed upon by the team was a better predictor of the final degree of disability (determined by an independent disability commission) than each team member's independent assessment. In addition, the "profile of insufficiencies", representing a functional approach to the medical evaluation, proved to be superior to the percentage system commonly used.

Adult↗
PubMed1985

Temporal changes in electrophysiological, clinical and radiological parameters in the hemiplegic's shoulder.

The relationship between electrophysiological, clinical and radiological parameters in the shoulder of hemiplegic patients was examined in a group of 24 subjects. Measurements and observations were made about the fourth month after CVA and again some eight months later. Total follow-up period extended to a maximum of 28 months. Electrophysiological tests included concentric needle EMG and conduction tests. In the shoulder X-ray four stages were described: normal, V-shaped space, initial subluxation and advanced subluxation. The presence of pain, reflex sympathetic dystrophy, atrophy and return of movement were registered. The most striking findings, consistent with lower motor neuron lesion, were those of parallel changes in axillary nerve latencies (obtained through stimulation from Erb's point) and shoulder X-ray stage. Age and time lapse between examinations turned out to be significantly related to such changes: younger patients did better and changes were registered even after one year from the first examination. An anatomical explanation linking the axillary nerve with humeral head disposition on the hemiplegic side is offered.

Cerebrovascular Disorders↗
PubMed1985

Prediction of functional outcome in hemiplegic patients.

A follow-up study of 40 hemiplegic patients two years after discharge from hospital was aimed at (a) identifying variables capable of predicting general functional ability in everyday life (work, home, family and social life) and (b) examining the relationship between levels of functioning and subjective evaluation of their rehabilitation state. The results showed that a composite measure of functioning ability was closely related to self-reports of satisfaction in significant areas of life: physical well-being, emotional security, satisfaction of family and social needs and vocational self-actualization. The best objective predictor of overall domestic and outdoor functioning was the primary ADL (eating, dressing, bathing, etc.). Other significant variables were ambulation (walking freely for 300 meters), sustaining mental load and emotional acceptance of disability. Predisposing and concurrent diseases (such as congestive heart failure, diabetes mellitus, hypertension and others) were not found to be of predictive value. The findings thus obtained could provide the physician with a good prognostic tool to evaluate the rehabilitation outcome of hemiplegic patients. They also suggested that intervention aimed at emotional acceptance of disability could facilitate the rehabilitation process.

Activities of Daily Living↗
PubMed1985

The "key-form" system for data collection in disability evaluation.

A new system for comprehensive disability evaluation has been developed in the framework of our Hospital. This system is based on multidisciplinary evaluation during one day of tests and the summarization of the data collected. The process takes place at the Institute for Functional Evaluation, a joint project of the National Insurance Institute and the Loewenstein Hospital in Israel. The process was designed to provide the basis for the determination of the degree of disability according to the requirements of the General Disability Law. In order to carry out the experimental program a computerized system of recording was created. The method of recording is based upon the "Key-form" where the different systems of the body appear one after the other and next to them the term "normal" or "abnormal". In the case of an abnormal mark, the tester goes on to the next stage which involves completion of a detailed form for that system. The forms are coded for the transfer of information to the computer without intermediary stages and this enables processing of a vast amount of data with relative ease. The system enables compilation of individual profiles and statistical tables and analysis. Theoretical and practical applications of the system are discussed on the basis of the pilot study.

Data Collection↗
PubMed1985

Criteria for referral of CVA patients for rehabilitation.

A multi-stage follow-up project is in progress at the Loewenstein Rehabilitation Hospital. In the first stage, a group of 153 patients was examined while in the acute phase of CVA (1 to 5 days from stroke), and again 6 months later, by a physician, a physiotherapist and an occupational therapist. Medical, demographical and functional profiles were determined. The most severe cases were admitted for rehabilitation and those with apparently good functioning ability were discharged to their homes. Six months later, the group referred for rehabilitation remained at a very low functional level (35% of them were still at the rehabilitation hospital); on the other hand, those sent home were lacking in general function (37%), in spite of their good ADL and hand performance. Most strikingly, 72% were not engaged in any meaningful activity. Age proved to be a strongly limiting factor. A more selective criterion for referral is required, while allowing patients with medium-grade cognitive and locomotor disturbances the chance of admission to rehabilitation.

Activities of Daily Living↗
PubMed1985

Sex and aphasic syndromes.

Sex differences in the incidence of aphasia and its types has been the subject of interest in recent literature. We studied the records of 275 patients with C.V.A. and 62 with C.C.I., serially admitted to the Loewenstein Rehabilitation Hospital between 1965 and 1980. Aphasia Test results were recorded within one month of onset and again 3-5 months later. No significant sex differences were found in the incidence of aphasia or in aphasia syndromes in C.V.A. patients, but males far outnumbered female patients with C.C.I. The average ages of males and females in our aphasia population and among the syndrome types were not significantly different. We found that severity of disabilities, as measured by auditory comprehension, failed to show significant sex differences, although males tended to have more severe types of aphasia with poorer prognosis for recovery. Patterns of improvement to less severe types of aphasia were not statistically significant in males and females.

Adult↗
PubMed1985

Type of aphasia: relationship to age, sex, previous risk factors, and outcome of rehabilitation.

Relationship of types of aphasia in hemiplegics to survival, outcome of rehabilitation, activities of daily living (ADL) and pre-existing risk factors, hypertension (HT), ischemic heart disease (IHD), diabetes mellitus (DM) were studied in a group of 257 patients. The control group was a large population of CVA cases previously documented. Four main categories were considered: expressive-receptive (global), predominantly expressive (Broca), predominantly receptive (Wernicke) and predominantly amnestic (anomia) aphasias. 40% of each category were female. No clear pattern emerged concerning relationship with risk factors; however, hypertension, the factor most frequently encountered, was significantly less prevalent among expressive ahphasics, and diabetes mellitus was rare among those with the receptive pattern. For all categories, the most frequent etiology was thrombosis, the second being embolia. The oldest groups were the expressive-receptive and the predominantly receptive aphasia groups: showed the poorest rehabilitation outcome in both ADL and locomotion, and lived less time after stroke (5.8 years). Amnestic and expressive patients were younger and fared better in all other parameters; an etiology of embolia was much more frequent among the former. It can be said that patients with the expressive-receptive kind of aphasia have the worst survival and rehabilitation prognoses.

Activities of Daily Living↗
PubMed1984

Glenohumeral malalignment in the hemiplegic shoulder. An early radiologic sign.

A new radiologic sign is described which seems to diagnose an early presubluxation phase of glenohumeral malalignment in hemiplegic shoulders. The sign consists of a V-shaped widening of the upper part of the space between the humeral head and the glenoid cavity on anteroposterior shoulder films in the erect position. Twelve of 14 patients showing this sign went on to develop chronically painful shoulders, and four of them developed radiologically evident subluxation within several months. The sign may be helpful in diagnosing shoulder pathology following stroke at an early stage, when orthotic measures may still have preventive value.

Adult↗
PubMedDate not supplied

Left-right asymmetry of visual evoked potentials in brain-damaged patients: a mathematical model and experimental results.

The left-right asymmetry in the potential amplitude on the scalp was studied in poststroke patients by using flash visual evoked potential (VEP) and a numerical two-dimensional model of the head. The left-right asymmetry of the VEP was measured in three patients after thrombosis, in one after hemorrhage, and in one healthy subject. The numerical model used computed tomography images to define the different compartments of the head. The volume conductor equation for the potential distribution created by a dipole source in the occipital region was solved numerically with use of a finite volume method. Left-right asymmetry was calculated with several values of conductivity of the damaged region. The experimental results revealed a negative asymmetry in the three patients after thrombosis (i.e., the potential amplitude over the ischemic hemisphere was smaller than that over the intact hemisphere), whereas, in the patient after hemorrhage, a positive asymmetry was found. Nonsignificant left-right asymmetry was found in the healthy subject. The numerical model revealed that the electrical conductivity of the damaged tissue has a major effect on the left-right asymmetry. Negative asymmetry, such as that found for patients after thrombosis, was obtained when the conductivity of the damaged region was greater than that of the brain, whereas positive asymmetry (hemorrhage patient) was obtained when that conductivity was smaller than that of the brain. This finding indicates that the left-right asymmetry in the scalp VEP of patients after brain damage may be a result of changes in the conductivity of the volume conductor (the ischemic region) between the source and the electrodes.

Cerebrovascular Disorders↗
PubMedDate not supplied

Poliomyelitis-like syndrome following asthmatic attack (Hopkins' syndrome)--recovery associated with i.v. gamma globulin treatment.

A report on a 15-year-old male with a diagnosis of poliomyelitis-like syndrome (Hopkins' syndrome) following an asthmatic attack is presented. The prognosis of Hopkins' syndrome is usually poor and the patients remain with permanent paralysis of the affected limb. The outcome correlates with severity of the initial injury to the anterior horn cell as reflected by abnormal electrophysiologic studies. This is the first case report of treatment with i.v. gamma globulin in Hopkins' syndrome which resulted in a nearly complete recovery.

Adolescent↗
PubMedDate not supplied

Hemiplegics after a first stroke: late survival and risk factors.

Scanning 3000 cases admitted for rehabilitation after cerebrovascular accident over a 20 year period produced a sample of 1369 subjects, without age restrictions, admitted within six months of a first stroke of thrombotic etiology. In this sample, survival rates showed no significant difference between men and women. Age at onset, however, clearly influenced survival changes; the expected mean survival was 6 years at 40 and 2 at age 80; average loss of life was 14 years for the whole sample, meaning a vital prognosis two to three times worse than that of the general population. At least 86% of the sample presented one or more of five etiological antecedents to stroke: hypertensive heart disease, peripheral vascular disease, diabetes mellitus, myocardial infarction and atrial fibrillation. In 87% of those, HHD and/or PVD were present. Presence of hypertension significantly lowered life expectancy and so did PVD; their influence is felt from the earliest stages. In contrast, diabetes mellitus, the next most common factor, has a late influence, starting about the fifth year after stroke. MI and AF were present in relatively fewer patients, but they contributed towards a considerable decrease in life expectancy, evident from the first stages, the more drastic reduction being observed in the AF group.

Adult↗
PubMedDate not supplied

Matrix management in a rehabilitation centre.

This paper considers an old topic from a newer perspective, that of current management theory. A high degree of differentiation is intrinsic to most rehabilitation inpatient facilities. At Loewenstein, patients are accommodated according to medical categories in purpose departments, of which medical and nursing staff are a part. Allied health professionals are organized in functional departments. Care is provided by a team derived from both types of department. A matrix organization is thus established, superimposing a patient care team (for lateral horizontal co-ordination) on the organization of functional departments (for vertical hierarchical co-ordination) and built around a temporary project, the individual patient. This organizational structure maximizes the advantages and minimizes the disadvantages of both types of department in solving the conflict between specialization and integration. It has facilitated effective and efficient vertical and horizontal co-ordination and enhanced the provision of care by a multidisciplinary rehabilitation team.

Communication↗