Surgical treatment of spondylodiscitis in critically ill septic patients.

Purpose: Surgical procedures in critically ill patients with spondylodiscitis are challenging and there are several controversies. Here, we present our experience with offering surgical intervention early in critically ill septic patients with spondylodiscitis.

Method: After we introduced a new treatment paradigm offering early but limited surgery, eight patients with spondylodiscitis complicated by severe sepsis and multiple organ failure underwent urgent surgical treatment over a 10-year period.

Validity of the Early Functional Ability scale (EFA) among critically ill patients undergoing early neurological rehabilitation.

Background: A reliable assessment of the functional abilities of patients after severe brain damage is crucial for valid prognostication and treatment decisions, but most clinical scales are of limited use among this specific group of patients.

Aim: The present study investigates the usefulness of the Early Functional Ability (EFA) scale, which determines the functional abilities of severely impaired patients.

Methods: Critically ill patients consecutively admitted to early neurological rehabilitation were screened for eligibility.

The predictive validity of the Hessisch Oldendorf Risk of Falling Scale (HOSS) decreases during the course of rehabilitation.

Background: Falls are highly frequent among neurological patients during rehabilitation and subsequent risk assessments are crucial to prevent falls.

Objective: This study aims to determine the predictive values of the Hessisch Oldendorf Risk of Falling Scale (HOSS, "Hessisch Oldendorfer Sturzrisiko Skala") for two timeframes: the first month of rehabilitation and from the second month to the end of rehabilitation.

Methods: Scale performances were assessed for 512 patients during inpatient neurological rehabilitation by calculating the sensitivity and the specificity.

Thyroid Hormone Levels Help to Predict Outcome of Critically Ill Patients Undergoing Early Neurological Rehabilitation.

The present study was aimed at examining thyroid hormones and other clinical factors to improve the accuracy of outcome prediction among critically ill patients undergoing early neurological rehabilitation. Patients consecutively admitted to an intensive or intermediate care unit were screened for eligibility. Serum levels of free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were collected during the first three days after admission.

One-year outcome of brain injured patients undergoing early neurological rehabilitation: a prospective observational study.

Background: The present study intended to analyze the outcome of patients with severe brain injury one-year after discharge from early rehabilitation.

Methods: Early neurological rehabilitation patients admitted to intensive or intermediate care units and discharged between June 2018 and May 2020 were screened for eligibility. The level of consciousness was evaluated using the Coma Recovery Scale-Revised (CRS-R) upon admission and at discharge.

Treatment of upper limb spasticity with inhibitory repetitive transcranial magnetic stimulation: A randomized placebo-controlled trial.

Background: Upper limb dysfunction is a frequent complication after stroke impairing outcome. Inhibitory repetitive transcranial magnetic stimulation (rTMS) applied over the contralesional hemisphere is supposed to enhance the positive effects of conventional rehabilitative treatment.

Objective: This double-blind randomized placebo-controlled trial investigated whether inhibitory rTMS as add-on to standard therapy improves upper limb spasticity.

[Relevance of the Clinical Ethics Committee (CEC) for Clinical Staff of a Specialized Neurological Clinic].

Background: Clinical ethics committees (CECs) have been implemented in German clinics since the 1990s. Besides problems with the integration into clinical routines, CECs result in an enrichment and relief for employees and relatives. Investigating the current status of CECs in specialized neurological clinics is crucial because changes in therapy goals towards palliative care are often requested and the treatment team is sometimes overwhelmed with clarifying the presumed patient's wishes.

Evaluation of the predictive validity of the Hessisch Oldendorf Risk of Falling Scale (HOSS).

Objective: This study aims to further validate the Hessisch Oldendorf Risk of Falling Scale (HOSS) for neurological rehabilitation patients.

Design: The overall scale performance and fall rate was calculated in a retrospective data analysis.

Setting: The study was performed in a subacute care facility during inpatient neurological rehabilitation.

Auditory Stimulation Modulates Resting-State Functional Connectivity in Unresponsive Wakefulness Syndrome Patients.

Passive listening to music is associated with several psychological and physical benefits in both, healthy and diseased populations. In this fMRI study, we examined whether preferred music has effects on the functional connectivity within resting-state networks related to consciousness. Thirteen patients in unresponsive wakefulness syndrome (UWS) and 18 healthy controls (HC) were enrolled.

The influence of the CRS-R score on functional outcome in patients with severe brain injury receiving early rehabilitation.

Background: The aim of the study was to determine the role of the Coma Recovery Scale-Revised (CRS-R) in the prediction of functional status at the end of neurological early rehabilitative treatment.

Methods: Patients consecutively admitted to intensive or intermediate care units of a neurological rehabilitation center were enrolled in the study. Consciousness and functional status were assessed with the Coma Recovery Scale-Revised (CRS-R) and the Early Rehabilitation Barthel Index (ERBI), respectively.

Expected Valence Predicts Choice in a Recurrent Decision Task.

There is empirical evidence that expected yet not current affect predicts decisions. However, common research designs in affective decision-making show consistent methodological problems (e.g.

[Weaning in neurological and neurosurgical early rehabilitation-Results from the "WennFrüh" study of the German Society for Neurorehabilitation].

Neurological and neurosurgical early rehabilitation patients are often so critically ill that they must be weaned from mechanical ventilation in addition to early rehabilitative treatment. The German Society for Neurorehabilitation (DGNR) carried out a survey and asked neurological weaning units to provide information on structural characteristics of the facility, including personnel and technical resources and the number of cases and outcome based on anonymous data. In total 36 weaning units from 11 federal states with a total of 496 beds participated in the survey.

[The cramp-fasciculation-syndrome (CFS)].

The present review focuses on the cramp-fasciculation syndrome, a benign disorder which is regarded as a hyperexcitability syndrome of the peripheral nervous system. The article presents clinical features, pathophysiology, differential diagnosis, therapy and a case report to illustrate the cramp-fasciculation-syndrome.

Prevalence of serum IgG antibodies against SARS-CoV-2 among clinic staff.

The SARS-CoV-2 pandemic threatens health care providers and society. For planning of treatment capacities, it is of major importance to obtain reliable information on infection and fatality rates of the novel coronavirus. A German community study, the so-called Heinsberg study, found a 5-fold higher infection rate (and thus a remarkably lower fatality rate) than the officially reported cases suggest.

[Impact of occupational problems on employment status six months after inpatient neurological rehabilitation].

Background: By identifying occupational problems, job-related therapies may be included in rehabilitation at an early stage, increasing the return-to-work rate. The aim of the present study was to examine whether occupational problems that were identified were associated with the employment status six months after inpatient rehabilitation.

Methods: A total of 122 neurological patients undergoing neurological inpatient rehabilitation at the BDH-Clinic Hessisch Oldendorf were retrospectively analysed using clinical routine data from the database of the clinic.

[Long-term neuropsychological and participation impairment after aneurysmal subarachnoid hemorrhage (aSAH)].

The present review focuses on cognitive and participation impairments after aneurysmal subarachnoidal hemorrhage (aSAH). Such impairments may be present even in cases without evidence of damage in the neuropsychologically expected brain area. Neuroinflammation and oxidative stress may be responsible for this finding.

Musical Sonification of Arm Movements in Stroke Rehabilitation Yields Limited Benefits.

Neurologic music therapy in rehabilitation of stroke patients has been shown to be a promising supplement to the often strenuous conventional rehabilitation strategies. The aim of this study was threefold: (i) replicate results from a previous study with a sample from one clinic (henceforth called Site 1; = 12) using an already established recording system, and (ii) conceptually replicate previous findings with a less costly hand-tracking system in Site 2 ( = 30), and (iii) compare both sub-studies' outcomes to estimate the efficiency of neurologic music therapy. Stroke patients in both sites were randomly assigned to treatment or control groups and received daily training of guided sequential upper limb movements additional to their standard stroke rehabilitation protocol.

[MRSA screening in early neurological and neurosurgical rehabilitation].

Strains of methicillin-resistant Staphylococcus aureus (MRSA) are of major economic and health-related importance to early neurological and neurosurgical rehabilitation. It is crucial to identify MRSA-carriers as soon as possible upon admission in order to prevent transmissions and to initiate contact precautions and decolonization. The present study focuses on validity of a polymerase chain reaction (PCR) test to identify MRSA genetic material from nasopharyngeal samples (BD MAX MRSA XT, BD Diagnostics, Heidelberg, Germany) of early neurological and neurosurgical rehabilitation patients.

Influence of paroxysmal sympathetic hyperactivity (PSH) on the functional outcome of neurological early rehabilitation patients: a case control study.

Background: Paroxysmal Sympathetic Hyperactivity (PSH) is a frequently observed condition among critically ill patients on intensive care units. According to different studies, PSH is associated with worse recovery and increased mortality in acute-care facilities. In this monocentric, retrospective case-control study, we investigated whether this association also applies to post-acute neurological early rehabilitation.

Clinical neurophysiology of neurologic rehabilitation.

Clinical neurophysiologic testing provides valuable support in predicting outcome in the setting of disorders of consciousness (DOC), including coma and traumatic brain injury (TBI). Electroencephalography (EEG) and evoked potentials (EP) are simple to apply, inexpensive, safe, and available in most rehabilitation facilities. This chapter reviews the use of EEG and EP in postanoxic coma and TBI.

[Therapy of Benign Essential Blepharospasm with Botulinum Toxin].

Blepharospasm is a focal dystonia and a rare disease of the brain that causes involuntary spasms of the muscles responsible for eyelid closure. The diagnosis is made clinically and in unclear cases on the basis of results of electrophysiological tests. Therapy of choice consists of local injections with botulinum toxin that have to be repeated on a regular basis.

[Neurological and neurosurgical early rehabilitation in Lower Saxony and Bremen].

Introduction: We analyzed the delivery of healthcare services among patients in neurological and neurosurgical early rehabilitation programmes in the German states of Lower Saxony and Bremen.

Methods: Patients´applications and admissions for neurological and neurosurgical early rehabilitation in Lower Saxony and Bremen were recorded during a period of two weeks both in November 2015 as well as 2016. The proportion of patients admitted to early rehabilitation within a six-week-period after disease onset was calculated.

[Effects of Respiratory Muscle Training on the Incidence of Pneumonia in Neurological and Neurosurgical Early Rehabilitation: Results from a Matched-Pair Analysis].

Background: Most disorders in neurological and neurosurgical early rehabilitation (NNER) are associated with an increased pneumonia risk. Respiratory therapy aims to prevent respiratory complications. However, there are no studies showing an effect of respiratory muscle training on the incidence of pneumonia in NNER.

Factors influencing weaning from mechanical ventilation in neurological and neurosurgical early rehabilitation patients.

Background: Studies analyzing risk factors of weaning failure in neurological and neurosurgical early rehabilitation (NNER) patients are rare.

Aim: The aim of this study was to identify clinical factors influencing the weaning of NNER patients.

Design: An observational, retrospective data analysis of a German multicenter study was performed.

The effect of a natural food based tube feeding in minimizing diarrhea in critically ill neurological patients.

Background & Aims: Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients.

Methods: A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage.