Design of a Wearable Vibrotactile Stimulation Device for Individuals With Upper-Limb Hemiparesis and Spasticity.

Vibratory stimulation may improve post-stroke symptoms such as spasticity; however, current studies are limited by the large, clinic-based apparatus used to apply this stimulation. A wearable device could provide vibratory stimulation in a mobile form, enabling further study of this technique. An initial device, the vibrotactile stimulation (VTS) Glove, was deployed in an eight-week clinical study in which sixteen individuals with stroke used the device for several hours daily.

Assessment of variability in motor grading and patient-reported outcome reporting: a multi-specialty, multi-national survey.

Background: The goal of this survey-based study was to evaluate the current practice patterns of clinicians who assess patients with peripheral nerve pathologies and to assess variance in motor grading on the Medical Research Council (MRC) scale using example case vignettes.

Methods: An electronic survey was distributed to clinicians who regularly assess patients with peripheral nerve pathology. Survey sections included (1) demographic data, (2) vignettes where respondents were asked to assess on the MRC scale, and (3) assessment of practice patterns regarding the use of patient-reported outcome measures.

Home-based virtual reality therapy for hand recovery after stroke.

Background: Many stroke survivors experience arm and hand weakness, but there are only limited efficacious options for arm therapy available.

Objective: To assess the feasibility of unsupervised home-based use of a virtual reality device (Smart Glove) for hand rehabilitation post stroke.

Design: Prospective single-arm study consisting of a 2-week run-in phase with no device use followed by an 8-week intervention period.

Adverse cognitive effect of gabapentin in individuals with spinal cord injury: preliminary findings.

Study Design: Prospective observational cohort study.

Objectives: To assess the effects of gabapentin on neuropsychological variables including memory, attention, and executive function in individuals with spinal cord injury.

Setting: Santa Clara Valley Medical Center inpatient spinal cord injury unit.

Salivary cortisol, dehydroepiandrosterone, and testosterone interrelationships in healthy young males: a pilot study with implications for studies of aggressive behavior.

The present small pilot study was designed to demonstrate the feasibility and relevance of using salivary assessments of biological markers to model a complex biological substrate of aggressive behavior. Five college-aged males completed the State-Trait Anger Expression Inventory on enrollment and provided saliva samples at 2000, 0200 and 0800 h during one mid-week 24-h period for three consecutive weeks. Saliva samples were assayed for cortisol (C), dehydroepiandrosterone (DHEA), and testosterone (T).

Variability in the use of thromboprophylaxis and outcomes in critically ill medical patients.

Purpose: To describe practices for preventing venous thromboembolism in critically ill medical patients and to identify associations between prophylactic measures and survival.

Methods: We reviewed the records of all medical admissions to the intensive care units of a university hospital and an affiliated Veterans Affairs hospital over a 1-year period. We recorded patients' demographic characteristics, risk factors for venous thromboembolism, methods of prophylaxis, and in-hospital deaths.

Outcomes in critically ill patients before and after the implementation of an evidence-based nutritional management protocol.

Objective: To determine whether the implementation of a nutritional management protocol in the ICU leads to the increased use of enteral nutrition, earlier feeding, and improved clinical outcomes in patients.

Design: Prospective evaluation of critically ill patients before and after the introduction of an evidence-based guideline for providing nutritional support in the ICU.

Setting: The medical-surgical ICUs of two teaching hospitals.

Variability in antibiotic prescribing patterns and outcomes in patients with clinically suspected ventilator-associated pneumonia.

Study Objectives: To describe the variation in clinical practice strategies for the treatment of suspected ventilator-associated pneumonia (VAP) in a population of critically ill patients, and to determine whether initial empiric treatment with certain antibiotics, monotherapy vs combination antibiotic therapy, or appropriate vs inappropriate antibiotic therapy is associated with survival, length of hospital stay, or days free of antibiotics.

Design: Prospective, observational cohort study.

Setting: Medical-surgical ICUs of two university-affiliated tertiary medical centers.