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1.
Cureus ; 16(8): e67913, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39328696

RESUMO

Myocardial Infarction (MI) is an obstruction in the coronary arteries, resulting in restricted blood flow and oxygen supply to the heart, leading to damage to the heart's tissues. Beyond the cardiovascular system, the impact of MI extends to potentially affecting cognitive abilities, especially in elderly populations. To optimize patient recovery and long-term outcomes, timely cardiac interventions and subsequent rehabilitation programs are essential. This systematic review aims to assess the potential benefits of cardiac rehabilitation (CR) in enhancing cognitive function among elderly individuals who have experienced an MI. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and utilizes PubMed, PubMed Central, Cochrane, Google Scholar, and ScienceDirect databases. Studies included in the review encompass meta-analyses, controlled trials, systematic/narrative reviews, randomized/nonrandomized trials, observational studies, and research articles published within the past five years. Only accessible, full-text English-language studies meeting the inclusion criteria are selected, while books, documents over five years old, animal studies, and individuals under 65 are excluded. Following a predefined template, the initial search identifies 4,915 studies. From this pool, 27 free full-text articles are then selected for quality appraisal based on relevance. After performing a quality assessment on each survey, 12 high-quality studies are included in this systematic review. The research studies demonstrate notable cognitive improvements among elderly patients who have experienced an MI and participated in CR programs. Additional clinical trial studies are recommended to substantiate these findings further and advance our understanding.

2.
J Sport Rehabil ; : 1-5, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39244193

RESUMO

CONTEXT: Adductor longus muscle strains are one of the most common injuries occurring in intermittent sports such as soccer. OBJECTIVE: The purpose of this study was to know the effect of a specific rehabilitation and reconditioning program, which was previously validated, after adductor longus injury in professional soccer players. METHODS: A specific rehabilitation and reconditioning program was applied to 11 injured male professional soccer players. PARTICIPANTS: Eleven male professional soccer players (age = 29.18 [4.45] y; height = 179.64 [4.97] cm; mass = 75.33 [3.84] kg). INTERVENTIONS: In the first place, the days taken to return to full team training and to return to competition (RTP) was analyzed; second, the most important performance parameters were analyzed and compared in the preinjury match (PRE) and after the return to competition at 2 different points in time (RTP1-RTP2). RESULTS: The return to full team training recorded was 11.91 (1.92) days and the RTP was 15.36 (3.04) days. Match performance parameters showed significant improvements after injury. Significant improvements were observed during RTP2, in the variables of high-speed running (P = .002), very high-speed running (P = .006), acceleration (>3 m/s2; P = .048), and high metabolic load distance (P = .009). CONCLUSION: The results allow us to conclude that this program was very effective, as it allowed the players to obtain similar and/or higher performance values in a reduced period of time after the injury.

3.
Cureus ; 16(8): e66210, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39105206

RESUMO

BACKGROUND: Enamel conditioning with 37% phosphoric acid is the most common technique during orthodontic bracket bonding procedures. However, due to the repeated de-bonding of the orthodontic brackets during treatment, other methods were needed to condition the enamel surface and increase the bond strength. This study aimed to compare the effect of conditioning the enamel surface by sandblasting with aluminum oxide particles or 5.25% sodium hypochlorite gel in combination with acid etching compared to acid etching alone on shear bond strength (SBS). MATERIAL AND METHODS: One hundred eight extracted upper premolars were randomly divided into three groups according to the conditioning enamel surface method. After the first and second bonding of metal brackets, new metal brackets were bonded with a total-etching adhesive after enamel conditioning using different methods: acid etching only (37% phosphoric acid for 30 seconds) (AE group), sodium hypochlorite associated with acid etching (5.25% NaOCl gel for 60 seconds and then acid etching for 30 seconds) (NaOCl-AE group), and sandblasting associated with acid etching (sandblasting for five seconds and then acid etching for 30 seconds) (SB-AE group). The shear bond strengths of the brackets were tested with a universal testing machine. One-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests were used to detect significant differences in shear bond strength among groups at the third bonding. Repeated-measure ANOVA and Bonferroni's tests were used to detect significant differences in shear bond strength among the bonding attempts within each group. RESULTS: 5.25% sodium hypochlorite associated with the acid etching method produced significantly greater shear bond strength than sandblasting associated with acid etching and acid etching only methods at the third bonding (16.40 ± 5.80 MPa, 13.60.47 ± 6.40 MPa, and 9.90 ± 4.40 MPa, respectively; P < 0.001). However, there was no significant difference between the AE and SB-AE groups (P = 0.247). In addition, we found a significant decrease in the shear bond strength within each group after each bonding attempt. CONCLUSION: Conditioning the enamel surface with 5.25% sodium hypochlorite associated with acid etching produced greater bond strength than conditioning by sandblasting associated with acid etching and acid etching only at the third bonding. The bond strength of the metal bracket decreased with increasing bonding attempts, even with the application of enamel surface conditioning methods.

4.
Disabil Rehabil ; : 1-11, 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39105538

RESUMO

PURPOSE: To explore the views of healthcare professionals and patients about the advantages and disadvantages of rehabilitation in the home (RITH) for reconditioning, and identify factors that should contribute to the successful implementation of a consensus-based RITH model for reconditioning. MATERIALS AND METHODS: Interviews with 24 healthcare professionals and 21 surveys (comprising Likert scale and free text responses) of inpatients undergoing rehabilitation for reconditioning provided study data. Interpretive thematic analysis was used to analyse interview data; descriptive statistics analysed Likert scale responses; patient written responses assisted with the interpretation of themes developed from the interview data. RESULTS: Two major themes were elicited in this study: the home is a physical setting and the home is a lived space. Advantages and disadvantages of RITH for patients, carers and healthcare professionals were identified within these themes. Appropriate patient selection; effective communication with patients and carers, and within RITH teams; adequate patient and carer support; ensuring the safety of patients and staff; and education of patients, carers and healthcare professionals are essential for the satisfactory implementation of RITH. CONCLUSION: The concept of home shapes the delivery of RITH. Recognising the advantages and disadvantages of RITH highlights important considerations needed to successfully implement RITH for reconditioning.


The home setting facilitates a person-centred approach to care, especially when staff consider patients to be equal partners in their care.Home offers an opportunity to negotiate contextually relevant rehabilitation goals with patients.Effective communication between patients, their local doctor, family, and rehabilitation staff is essential for the successful delivery of rehabilitation in the home.Safety concerns (for patients and staff) and the shift in the burden of care from hospital staff to family must be adequately addressed prior to the commencement of rehabilitation in the home.

5.
Biomed Phys Eng Express ; 10(5)2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39013391

RESUMO

To date, a myriad of neural microelectrodes has been meticulously developed, but the focus of existing literature predominantly revolves around fabrication methodologies rather than delving into the reconditioning processes or strategies for salvaging electrodes exhibiting diminished performance due to material failure. This study aims to elucidate the underlying factors contributing to the degradation in performance of neural microelectrodes. Additionally, it introduces a comprehensive, cost-effective protocol for the reconditioning and repurposing of electrodes afflicted by material failure, tailored for a broad spectrum of electrode types. The efficacy of the proposed reconditioning protocol is substantiated through experimental validation on single-site tungsten microelectrodes. The results of neural signal recording unequivocally demonstrate the successful restoration of a substantial number of electrodes, underscoring the protocol's effectiveness.


Assuntos
Microeletrodos , Eletrodos Implantados , Encéfalo/fisiologia , Humanos , Animais , Neurônios/fisiologia , Desenho de Equipamento , Eletrofisiologia/métodos , Eletrofisiologia/instrumentação , Falha de Equipamento , Tungstênio
6.
Physiol Rep ; 12(11): e16051, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38811348

RESUMO

To determine the effects of astaxanthin (ASTX) supplementation on the equine gut microbiota during a deconditioning-reconditioning cycle, 12 polo ponies were assigned to a control (CON; n = 6) or supplemented (ASTX; 75 mg ASTX daily orally; n = 6) group. All horses underwent a 16-week deconditioning period, with no forced exercise, followed by a 16-week reconditioning program where physical activity gradually increased. Fecal samples were obtained at the beginning of the study (Baseline), after deconditioning (PostDecon), after reconditioning (PostRecon), and 16 weeks after the cessation of ASTX supplementation (Washout). Following DNA extraction from fecal samples, v4 of 16S was amplified and sequenced to determine operational taxonomic unit tables and α-diversity and ß-diversity indices. The total number of observed species was greater at Baseline than PostDecon, PostRecon, and Washout (p ≤ 0.02). A main effect of ASTX (p = 0.01) and timepoint (p = 0.01) was observed on ß-diversity, yet the variability of timepoint was greater (13%) than ASTX (6%), indicating a greater effect of timepoint than ASTX. Deconditioning and reconditioning periods affected the abundance of the Bacteroidetes and Fibrobacteres phyla. Physical activity and ASTX supplementation affect the equine gut microbiome, yet conditioning status may have a greater impact.


Assuntos
Suplementos Nutricionais , Microbioma Gastrointestinal , Condicionamento Físico Animal , Xantofilas , Animais , Cavalos/microbiologia , Microbioma Gastrointestinal/efeitos dos fármacos , Xantofilas/farmacologia , Masculino , Fezes/microbiologia , Feminino
7.
Ann Cardiol Angeiol (Paris) ; 73(3): 101763, 2024 Jun.
Artigo em Francês | MEDLINE | ID: mdl-38723315

RESUMO

INTRODUCTION: The reuse pacemakers is a beneficial technique for patients in countries with a low economic standard of living where health care is almost non-existent. We offered to share the experience of Senegal on the reconditioning of pacemakers. METHODOLOGY: We conducted a retrospective study over a period from January 2015 to December 2020 including all patients who benefited from a reconditioned pacemaker for primary implantation or reimplantation. The criteria for reconditioning pacemakers are the absence of dysfunction or damage and a residual battery life of more than 5 years of the pacemaker. Refurbished pacemakers are acquired either from deceased families or from extraction centers. Sterilization is carried out using phenoxypropanol + benzalkonium chloride solution, 70% ethanol and ethylene oxide. RESULTS: We collected 161 patients during the study period, including 77 men (48%) and 84 women (52%), i.e. a M/F sex ratio of 0.94. The average age of the population was 65 years. Functional symptomatology was dominated by syncope in 54%. Electrocardiographically, 72% of patients were in complete atrioventricular block. A primary implantation was noted in 91.5% of patients. The vascular approach most used during implantation was cephalic in 49.5% of cases. In our series, we noted that 58% of patients had benefited from temporary stimulation before implantation. At implantation, single-chamber stimulation was used in 60% of patients and 46.5% of patients had programming in VVI mode. We had 5.5% major complications with 3% box infection occurring between 3 and 6 months post-implantation and 2.5% pacemaker syndrome. We noted 1 case of death linked to underlying heart disease. CONCLUSION: Reconditioning of cardiac pacemakers is a safe and beneficial therapeutic strategy for patients. In Senegal, reconditioning has shown satisfactory results. In our countries this technique can be an alternative for certain patients.


Assuntos
Reutilização de Equipamento , Hospitais Universitários , Marca-Passo Artificial , Humanos , Masculino , Feminino , Estudos Retrospectivos , Senegal , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adulto
8.
ChemMedChem ; 19(11): e202400037, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38459687

RESUMO

Non-invasive delivery of drugs is important for the reversal of respiratory diseases essentially by-passing metabolic pathways and targeting large surface area of drug absorption. Here, we study the inhalation of a redox nano medicine namely citrate functionalized Mn3O4 (C-Mn3O4) duly encapsulated in droplet evaporated aerosols for the balancing of oxidative stress generated by the exposure of Chromium (VI) ion, a potential lung carcinogenic agent. Our optical spectroscopic in-vitro experiments demonstrates the efficacy of redox balancing of the encapsulated nanoparticles (NP) for the maintenance of a homeostatic condition. The formation of Cr-NP complex as an excretion of the heavy metal is also demonstrated through optical spectroscopic and high resolution transmission optical microscopy (HRTEM). Our studies confirm the oxidative stress mitigation activity of the Cr-NP complex. A detailed immunological assay followed by histopathological studies and assessment of mitochondrial parameters in pre-clinical mice model with chromium (Cr) induced lung inflammation establishes the mechanism of drug action to be redox-buffering. Thus, localised delivery of C-Mn3O4 NPs in the respiratory tract via aerosols can act as an effective nanotherapeutic agent against oxidative stress induced lung inflammation.


Assuntos
Cromo , Nanopartículas , Oxirredução , Estresse Oxidativo , Pneumonia , Estresse Oxidativo/efeitos dos fármacos , Animais , Camundongos , Cromo/química , Cromo/farmacologia , Pneumonia/tratamento farmacológico , Pneumonia/metabolismo , Nanopartículas/química , Compostos de Manganês/química , Compostos de Manganês/farmacologia , Nanomedicina , Óxidos/química , Óxidos/farmacologia , Sistemas de Liberação de Medicamentos , Ácido Cítrico/química , Humanos , Tamanho da Partícula
9.
Foods ; 13(5)2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38472765

RESUMO

The effect of temperature reconditioning on cold-stored potato tubers was investigated for three popularly consumed potato varieties (Shangi, Unica, and Dutch robjin) grown in Kenya. The potatoes were stored at 4 °C for 30 days, followed by removal and storage at 22 ± 3 °C for 9 days during which changes in sugar concentration were evaluated every two days. In parallel, potato chips and French fries were processed, and their colors were determined. The results showed that sugar content decreased significantly with increasing reconditioning time. The relative decrease in fructose content was the highest (p < 0.05) in Dutch robjin (57.49%), followed by Shangi (49.22%) and Unica (38.18%). Glucose content decreased by 54.1% in Dutch robjin, 49.5% in Shangi, and 50.8% in Unica. The lightness (L*) of French fries and chips increased significantly (p < 0.05) with reconditioning time while the redness (a*) values decreased significantly (p < 0.05) across all varieties. The correlation between lightness and the total reducing sugar content of the potatoes was r < -0.93, indicating a strong negative correlation for both products. The coefficient of determination showed that the glucose content of the tubers accounted for 80.5-97.6% of the lightness of French fries and 88.4-94.2% for potato chips. The critical glucose content range for acceptable products in French fries and chips based on the color (L* and a*) values was 12-22 mg/100g and 8-14 mg/100g, respectively, for the varieties in this study.

10.
BMC Health Serv Res ; 24(1): 151, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38291402

RESUMO

BACKGROUND: Inpatient rehabilitation services are challenged by increasing demand. Where appropriate, a shift in service models towards more community-oriented approaches may improve efficiency. We aimed to estimate the hypothetical cost of delivering a consensus-based rehabilitation in the home (RITH) model as hospital substitution for patients requiring reconditioning following medical illness, surgery or treatment for cancer, compared to the cost of inpatient rehabilitation. METHODS: Data were drawn from the following sources: the results of a Delphi survey with health professionals working in the field of rehabilitation in Australia; publicly available data and reports; and the expert opinion of the project team. Delphi survey data were analysed descriptively. The costing model was developed using assumptions based on the sources described above and was restricted to the Australian National Subacute and Non-Acute Patient Classification (AN-SNAP) classes 4AR1 to 4AR4, which comprise around 73% of all reconditioning episodes in Australia. RITH cost modelling estimates were compared to the known cost of inpatient rehabilitation. Where weighted averages are provided, these were determined based on the modelled number of inpatient reconditioning episodes per annum that might be substitutable by RITH. RESULTS: The cost modelling estimated the weighted average cost of a RITH reconditioning episode (which mirrors an inpatient reconditioning episode in intensity and duration) for AN-SNAP classes 4AR1 to 4AR4, to be A$11,371, which is 28.1% less than the equivalent weighted average public inpatient cost (of A$15,820). This represents hypothetical savings of A$4,449 per RITH reconditioning substituted episode of care. CONCLUSIONS: The hypothetical cost of a model of RITH which would provide patients with as comprehensive a rehabilitation service as received in inpatient rehabilitation, has been determined. Findings suggest potential cost savings to the public hospital sector. Future research should focus on trials which compare actual clinical and cost outcomes of RITH for patients in the reconditioning impairment category, to inpatient rehabilitation.


Assuntos
Pacientes Internados , Humanos , Austrália , Previsões
11.
Am J Transl Res ; 15(8): 5197-5205, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37692939

RESUMO

OBJECTIVES: The benefit of machine perfusion during storage of liver grafts retrieved after cardiac death should be investigated as applied either at the beginning or near the end of the preservation period. METHODS: Rat livers were explanted 20 min after cardiac arrest of the donor and cold-stored (CS) for 18 h. Other grafts were additionally subjected to 2 h of normothermic machine perfusion (MP) either 3 h after retrieval (early MP) or 3 h before reperfusion (late MP), thus extending total ischemic time to 20 h. The 3 h period should represent a short transport period between a resident regional pumping center and the explant or implant hospital, respectively. Viability of all livers was assessed thereafter by warm reperfusion in vitro. RESULTS: In comparison to the controls, both regimens significantly improved hepatic recovery upon post-preservation reperfusion as evaluated by enzyme release, bile production, and energetic recovery. Molecular upregulation of pro-inflammatory signals was also significantly mitigated. No functional differences between early and late machine perfusion could be disclosed. CONCLUSION: Our data suggest that it might not be necessary to hurry with the attempt to connect the graft to a machine early after retrieval.

12.
Artif Organs ; 47(11): 1700-1709, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37455548

RESUMO

Lung transplantation is accepted as a well-established and effective treatment for patients with end-stage lung disease. While the number of candidates added to the waitlist continues to rise, the number of transplants performed remains limited by the number of suitable organ donors. Ex vivo lung perfusion (EVLP) emerged as a method of addressing the organ shortage by allowing the evaluation and potential reconditioning of marginal donor lungs or minimizing risks of prolonged ischemic time due to logistical challenges. The currently available FDA-approved EVLP systems have demonstrated excellent outcomes in clinical trials, and retrospective studies have demonstrated similar post-transplant survival between recipients who received marginal donor lungs perfused using EVLP and recipients who received standard criteria lungs stored using conventional methods. Despite this, widespread utilization has plateaued in the last few years, likely due to the significant costs associated with initiating EVLP programs. Centralized, dedicated EVLP perfusion centers are currently being investigated as a potential method of further expanding utilization of this technology. In the preclinical setting, potential applications of EVLP that are currently being studied include prolongation of organ preservation, reconditioning of unsuitable lungs, and further enhancement of already suitable lungs. As adoption of EVLP technology becomes more widespread, we may begin to see future implementation of these potential applications into the clinical setting.


Assuntos
Transplante de Pulmão , Pulmão , Humanos , Perfusão/métodos , Estudos Retrospectivos , Pulmão/cirurgia , Circulação Extracorpórea/métodos , Transplante de Pulmão/métodos , Preservação de Órgãos/métodos
13.
Respir Med Res ; 83: 101022, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37207378

RESUMO

BACKGROUND: The identification of the first ventilatory threshold (VT1) on an incremental cardiopulmonary exercise test (CPET) is useful to guide exercise reconditioning. However, determination of the VT1 is sometimes difficult in patients with chronic respiratory disease. Our hypothesis was that it would be possible to identify a "clinical threshold" based on patients' perceptions at which they subjectively consider that they can perform endurance training during a rehabilitation programme. METHODS: Workloads at which patients identified a "clinical threshold" during a submaximal exercise were compared with workloads recorded at VT1 determined during a maximal CPET. Patients with a VT1 and/or a "clinical threshold" obtained at a workload <25 W were excluded from the analysis. RESULTS: A "clinical threshold" could be determined in the 86 patients included. Data from 63 patients were retained for the analysis, of which only 52 had a VT1 that could be identified. The agreement between the workloads determined at VT1 and at the "clinical threshold" was almost perfect, with a Lin's concordance coefficient (cc) of 0.82. CONCLUSIONS: In the context of chronic respiratory diseases, it is possible to use patients' sensations (which are by nature subjective) to identify a workload on a cycle ergometer, which corresponds to the workload at the first ventilatory threshold determined objectively during CPET.


Assuntos
Teste de Esforço , Doenças Respiratórias , Humanos , Estudos de Viabilidade , Exercício Físico , Ergometria
14.
J Clin Med ; 12(9)2023 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-37176647

RESUMO

The use of high-risk renal grafts for transplantation requires the optimization of pretransplant assessment and preservation reconditioning strategies to decrease the organ discard rate and to improve short- and long-term clinical outcomes. Active oxygenation is increasingly recognized to play a central role in dynamic preservation strategies, independent of preservation temperature, to recondition mitochondria and to restore the cellular energy profile. The oxygen-related decrease in mitochondrial succinate accumulation ameliorates the harmful effects of ischemia-reperfusion injury. The differences between normothermic and hypothermic machine perfusion with regard to organ assessment, preservation, and reconditioning, as well as the logistic and economic implications, are factors to take into consideration for implementation at a local level. Therefore, these different techniques should be considered complementary to the perfusion strategy selected depending on functional intention and resource availability. This review provides an overview of the current clinical evidence of normothermic and oxygenated hypothermic machine perfusion, either as a continuous or end-ischemic preservation strategy, and future perspectives.

16.
J Clin Med ; 12(5)2023 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-36902572

RESUMO

The increasing number of patients on the kidney transplant waiting list underlines the need to expand the donor pool and improve kidney graft utilization. By protecting kidney grafts adequately from the initial ischemic and subsequent reperfusion injury occurring during transplantation, both the number and quality of kidney grafts could be improved. The last few years have seen the emergence of many new technologies to abrogate ischemia-reperfusion (I/R) injury, including dynamic organ preservation through machine perfusion and organ reconditioning therapies. Although machine perfusion is gradually making the transition to clinical practice, reconditioning therapies have not yet progressed from the experimental setting, pointing towards a translational gap. In this review, we discuss the current knowledge on the biological processes implicated in I/R injury and explore the strategies and interventions that are being proposed to either prevent I/R injury, treat its deleterious consequences, or support the reparative response of the kidney. Prospects to improve the clinical translation of these therapies are discussed with a particular focus on the need to address multiple aspects of I/R injury to achieve robust and long-lasting protective effects on the kidney graft.

17.
BMC Health Serv Res ; 23(1): 113, 2023 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-36737750

RESUMO

BACKGROUND: Reconditioning for patients who have experienced functional decline following medical illness, surgery or treatment for cancer accounts for approximately 26% of all reported inpatient rehabilitation episodes in Australia. Rehabilitation in the home (RITH) has the potential to offer a cost-effective, high-quality alternative for appropriate patients, helping to reduce pressure on the acute care sector. This study sought to gain consensus on a model for RITH as hospital substitution for patients requiring reconditioning. METHODS: A multidisciplinary group of health professionals working in the rehabilitation field was identified from across Australia and invited to participate in a three-round online Delphi survey. Survey items followed the patient journey, and also included items on practitioner roles, clinical governance, and budgetary considerations. Survey items mostly comprised statements seeking agreement on 5-point Likert scales (strongly agree to strongly disagree). Free text boxes allowed participants to qualify item answers or make comments. Analysis of quantitative data used descriptive statistics; qualitative data informed question content in subsequent survey rounds or were used in understanding item responses. RESULTS: One-hundred and ninety-eight health professionals received an invitation to participate. Of these, 131/198 (66%) completed round 1, 101/131 (77%) completed round 2, and 78/101 (77%) completed round 3. Consensus (defined as ≥ 70% agreement or disagreement) was achieved on over 130 statements. These related to the RITH patient journey (including patient assessment and development of the care plan, case management and program provision, and patient and program outcomes); clinical governance and budgetary considerations; and included items for initial patient screening, patient eligibility and case manager roles. A consensus-based model for RITH was developed, comprising five key steps and the actions within each. CONCLUSIONS: Strong support amongst survey participants was found for RITH as hospital substitution to be widely available for appropriate patients needing reconditioning. Supportive legislative and payment systems, mechanisms that allow for the integration of primary care, and appropriate clinical governance frameworks for RITH are required, if broad implementation is to be achieved. Studies comparing clinical outcomes and cost-benefit of RITH to inpatient rehabilitation for patients requiring reconditioning are also needed.


Assuntos
Pessoal de Saúde , Hospitais , Reabilitação , Humanos , Austrália , Consenso , Técnica Delphi , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-36778755

RESUMO

The severe shortage of functional donor lungs that can be offered to recipients has been a major challenge in lung transplantation. Innovative ex vivo lung perfusion (EVLP) and tissue engineering methodologies are now being developed to repair damaged donor lungs that are deemed unsuitable for transplantation. To assess the efficacy of donor lung reconditioning methods intended to rehabilitate rejected donor lungs, monitoring of lung function with improved spatiotemporal resolution is needed. Recent developments in live imaging are enabling non-destructive, direct, and longitudinal modalities for assessing local tissue and whole lung functions. In this review, we describe how emerging live imaging modalities can be coupled with lung tissue engineering approaches to promote functional recovery of ex vivo donor lungs.

19.
Front Neurol ; 14: 1062349, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36815001

RESUMO

Human movement is optimized to Earth's gravity and based on highly complex interactions between sensory and neuro-muscular systems. Yet, humans are able to adapt-at least partially-to extreme environments upon and beyond Earth's surface. With upcoming Lunar Gateway and Artemis missions, it is crucial to increase our understanding of the impact of hypogravity-i.e., reduced vertical loading-on physiological and sensory-motor performances to improve countermeasure programs, and define crewmember's readiness to perform mission critical tasks. Several methodologies designed to reduce vertical loading are used to simulate hypogravity on Earth, including body weight support (BWS) devices. Countering gravity and offloading the human body is also used in various rehabilitation scenarios to improve motor recovery in neurological and orthopedic impairments. Thus, BWS-devices have the potential of advancing theory and practice of both space exploration and terrestrial rehabilitation by improving our understanding of physiological and sensory-motor adaptations to reduced vertical loading and sensory input. However, lack of standardization of BWS-related research protocols and reporting hinders the exchange of key findings and new advancements in both areas. The aim of this introduction paper is to review the role of BWS in understanding human movement in simulated hypogravity and the use of BWS in terrestrial rehabilitation, and to identify relevant research areas contributing to the optimization of human spaceflight and terrestrial rehabilitation. One of the main aims of this research topic is to facilitate standardization of hypogravity-related research protocols and outcome reporting, aimed at optimizing knowledge transfer between space research and BWS-related rehabilitation sciences.

20.
Tissue Eng Part B Rev ; 29(1): 10-27, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35848526

RESUMO

The most common preservation technique for liver grafts is static cold storage. Due to the organ shortage for liver transplantation (LT), extended criteria donor (ECD) allografts are increasingly used-despite the higher risk of inferior outcome after transplantation. Ex vivo liver machine perfusion (MP) has been developed to improve the outcome of transplantation, especially with ECD grafts, and is currently under evaluation in clinical trials. We performed a literature search on PubMed and ISI Web of Science to assemble an overview of rodent and porcine animal models of ex vivo liver MP for transplantation, which is essential for the present and future development of clinical liver MP. Hypothermic, subnormothermic, and normothermic MP systems have been successfully used for rat and pig LT. In comparison with hypothermic systems, normothermic perfusion often incorporates a dialysis unit. Moreover, it enables metabolic assessment of liver grafts. Allografts experiencing warm ischemic time have a superior survival rate after MP compared with cold storage alone, irrespective of the temperature used for perfusion. Furthermore, ex vivo MP improves the outcome of regular and ECD liver grafts in animal models. Small and large animal models of ex vivo liver MP are available to foster the further development of this new technology. Impact Statement Ex vivo machine perfusion is an important part of current research in the field of liver transplantation. While evidence for improve storage is constantly rising, the development of future applications such as quality assessment and therapeutic interventions necessitates robust animal models. This review is intended to provide an overview of this technology in common large and small animal models and to give an outlook on future applications. Moreover, we describe developmental steps that can be followed by others, and which can help to decrease the number of animals used for experiments based on the replace, reduce, refine concept.


Assuntos
Transplante de Fígado , Preservação de Órgãos , Animais , Suínos , Ratos , Preservação de Órgãos/métodos , Fígado , Transplante de Fígado/métodos , Perfusão/métodos , Modelos Animais
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