An Atypical Presentation of Acute Cholecystitis with Left Sided Chest Pain and ST Elevation - A Case Report.

Background: ST elevation combined with typical chest pain is an indication for acute coronary vascularization and is usually associated with acute myocardial infarction. Herein, we present an unusual case of ST elevation.

Case Presentation: A 57-year-old male patient presented to the emergency department with chest pain radiating to both arms and the back.

Impact of Neglect on the Relationship Between Upper Limb Motor Function and Upper Limb Performance in the (Hyper)acute Poststroke Phase.

Visuospatial neglect (VSN) is a negative, strong, and independent predictor of poor outcome after stroke, and is associated with poorer upper limb (UL) motor recovery in terms of function or capacity (ie, in standardized, lab-based testing). Although the main aim of stroke rehabilitation is to re-establish optimal functioning in daily life, the impact of VSN on UL performance (ie, in unstructured, everyday environments) is largely unknown. In this proof of principle study, the impact of VSN on the strength of the association between UL motor function (Jamar Hand Dynamometer) and UL performance (Upper Limb Lucerne ICF-based Multidisciplinary Observation Scale) was investigated in 65 (hyper)acute first-ever stroke patients.

External validation of the smartphone-based 6-minute walking test in patients with degenerative lumbar disorders undergoing epidural steroid injection.

Background: The 6-minute walking test (6WT) has previously shown to be reliable and valid outcome measure in patients undergoing surgery for degenerative lumbar disorders (DLD). A role of 6WT in conservatively treated patients undergoing epidural steroid injection (ESI) remains unclear.

Methods: About 50 patients with DLD, scheduled for ESI were assessed by the smartphone-based 6WT and common paper-based patient-reported outcome measures (PROMs), including the Core Outcome Measures Index [COMI] back, Oswestry Disability Index (ODI) and Short Form Survey (SF-12).

Vestibular perceptual learning improves self-motion perception, posture, and gait in older adults.

Vestibular motion perception declines with age, increasing the risk of falling substantially. We performed a two-week perceptual learning intervention using a self-motion direction discrimination task (2800 training trials per person) on a 6 degrees of freedom motion platform in healthy older adults (n = 40, aged 70-88 yr). Linear inter-aural and angular roll tilt vestibular thresholds improved with training (95% credible interval for pre/post difference), suggesting altered sensitivity post-training.

The association between dexterity and upper limb impairment during stroke recovery.

Introduction: Stroke-induced upper limb disabilities can be characterized by both motor impairments and activity limitations, commonly assessed using Fugl-Meyer Motor Assessment for Upper Extremity (FMMA-UE) and Action Research Arm Test (ARAT), respectively. The relationship between the two assessments during recovery is largely unstudied. Expectedly they diverge over time when recovery of impairment (restitution) plateaus, but compensation-driven improvements still occur.

Establishing and evaluating the gradient of item naming difficulty in post-stroke aphasia and semantic dementia.

Anomia is a common consequence following brain damage and a central symptom in semantic dementia (SD) and post-stroke aphasia (PSA), for instance. Picture naming tests are often used in clinical assessments and experience suggests that items vary systematically in their difficulty. Despite clinical intuitions and theoretical accounts, however, the existence and determinants of such a naming difficulty gradient remain to be empirically established and evaluated.

Implantation of C2 prosthesis with dorsal fusion C0-C4 due to pathologic C2 fracture. Case report and literature review.

Introduction: Pathological destruction of the axis vertebra leads to a highly unstable condition in an upper cervical spine. As surgical resection and anatomical reconstruction of the second cervical vertebrae represents a life threatening procedure, less radical approaches are preferred and only few cases of C2 prosthesis are described in literature.

Case Description: The focus of this case report is a 21-year-old man with a pathological fracture of C2 managed primarily surgically with the C1-C3 dorsal fusion.

Timing of Spinal Surgery in Polytrauma: The Relevance of Injury Severity, Injury Level and Associated Injuries.

Study Design: Retrospective database analysis.

Objective: Polytraumatized patients with spinal injuries require tailor-made treatment plans. Severity of both spinal and concomitant injuries determine timing of spinal surgery.

The Emergence of the Rehabilitative Strategy: The Driving Forces in the United States.

The aim of this essay was to show the impact that driving forces have had on the emergence of rehabilitation as a health strategy in the United States. Specifically, this essay (1) identifies the driving forces that have addressed the development of rehabilitation, (2) examines how the rehabilitative strategy has been driven by the driving forces through turning points and facilitators, and (3) identifies the barriers of each force against the development of rehabilitation. Critical and scoping review of the literature was conducted from the late 1910s until the end of the century.

Toward a Standardized Reporting of Outcomes in Hand Osteoarthritis: Developing a Common Metric of Outcome Measures Commonly Used to Assess Functioning.

Objective: Functioning is an important outcome in hand osteoarthritis (OA). The heterogeneity of patient-reported outcome measures (PROMs) available challenges the direct comparability of information collected by these instruments. This study aimed to examine whether it is possible to achieve metric equivalence of PROMs commonly used to measure functioning in people with hand OA.