Outcome Of Intensive Therapy Research Articles

PREDICTING THE OUTCOME OF CIRCULATORY FAILURE, OR THE USE OF ANALOGIES IN MEDICINE

The article offers a method for predicting the outcome and monitoring of intensive therapy of circulatory failure based on the assessment of energy parameters of blood circulation. Development of prognostic criteria for the course of circulatory failure. Electrodynamic modeling of the circulatory system has been applied, as a result of which a number of new parameters of the circulatory system have been introduced and a new look at the known ones is presented. The reference values of the proposed energy indicators have been determined in the study of blood circulation in 30 healthy volunteers. It has been found that the integral energy parameter of blood circulation - circulatory reserve (CR) - in healthy individuals is (617±145) mW/m2. In heart failure on the background of acute coronary syndrome and ejection fraction not more than 40 % CR is (184±58) mW/m2, over 40 % - (367±86) mW/m2, in vascular failure, requiring the correction of α1-agoiiists - (202±65) mW/m2, in the absence of this - (384±77) mW/m2, in blood loss 40 % of BCV and more - less 50 mW/m2. The level 100 mW/m2 is dangerous and reflects the high probability of death, 50 mW/m2 is incompatible with life. Electrodynamic modeling of the functioning of the circulatory system in different conditions allows us to deepen the understanding of the mechanisms of its autoregulation. Autoregulation of blood circulation in different conditions is a multi-factorial and difficult to-predict process and can only be evaluated by taking into account various combinations of its kinetic and dynamic indicators. Energy analysis of the functioning of the circulatory system allows to make an integral assessment of the effectiveness of autoregulation of blood circulation and its correction, as well as to predict the outcome of intensive therapy of circulatory insufficiency. A CR level below 100 mW/m2 is dangerous and predicts an adverse outcome of circulatory failure with a high probability. Key words: circulatory energy, heart failure, vascular failure, hypovolemia.

PP06.9 – 2328: Gross motor outcome of intensive therapy in children with cerebral palsy and developmental delay

Objective Many physicians and parents of children with developmental delay expect some effect of intensive rehabilitative treatment, though the evidence of intensive intervention is not well defined. And indications of intensive therapy and factors that can have an influence on therapeutic effect are not well known. The aim of this study was to find out the short term effect of intensive therapy (3 hours daily x 5 days/week for 8 weeks physical and occupational therapy sessions) on gross motor function in miscellaneous developmental delay children. Methods Retrospectively 84 patients were reviewed and total GMFM score percentage was analyzed. Mean age was 35±17.17 months old (5 months to 7 years 8 months old) and 44 were boys. Forty six children were prematurity cerebral palsy (CP), 22 patients were full-term CP, 8 patients had genetic abnormality, and 8 patients had developmental delay of unknown origin. Numbers of patients according to GMFCS level were 11, 17, 12, 22, 22 on each GMFCS level 1 to 5, respectively. Results The GMFM score percentage change was significantly improved after 8 weeks of therapy (P Conclusion Intensive therapy was more effective in GMFCS level I-III children than GMFCS level IV-V children. And the younger age (36 months old or younger) had positive influence on the gross motor outcome and the children without seizure disorder had better effect than those with seizure disorder.

Effects of therapy targeted at verb retrieval and the realisation of the predicate argument structure: A case study

Background : Verb retrieval and sentence production difficulties are both common features of aphasia. Previous treatment studies have focused predominantly on verb retrieval and the mapping of semantic and syntactic structure. There have been more limited investigations of the production of the predicate argument structure (PAS). Aims : This study aimed to evaluate the outcome of intensive therapy for a client with aphasia. NS had multiple and interacting difficulties that resulted in problems in producing sentences. Therapy aimed to improve his sentence production by: (a) improving the retrieval of verbs, (b) increasing his awareness of the relationship between nouns and verbs, and (c) improving his production of one-, two-, and three-argument structures. The therapy thus targeted access to PAS information and PAS production as well as verb retrieval. Methods & Procedures : A period of intensive therapy, based around a set of 48 self-selected verbs, was preceded and followed by detailed assessment of NS's single word and sentence production and comprehension. Outcomes & Results : Therapy resulted in a significant improvement in NS's retrieval of the verbs involved in treatment but no generalisation to other verbs. His production of sentences showed more widespread changes. He produced more nouns within sentences, omitted fewer obligatory arguments, and produced a greater variety of argument structures in connected speech. Conclusions : Therapy resulted in a greater awareness of the need for a verb within a sentence and a strategy for producing the argument structure frame around that verb. Improved sentence production was therefore seen, although verb retrieval difficulties were still evident. The study replicates previous research that verb and sentence production difficulties can be treated effectively in people with aphasia. The effects of therapy on sentence production in constrained tasks and narrative speech are discussed.

Self-Care Autonomy and Outcomes of Intensive Therapy or Usual Care in Youth with Type 1 Diabetes

This article evaluated whether deviation from developmentally appropriate self-care autonomy moderated the effects of intensive therapy (IT) or usual care (UC) on glycosylated hemoglobin (HbA(1C)) in 142 youths with diabetes. Youths received an autonomy/maturity ratio (AMR) score at baseline that was a ratio of standardized scores on measures of self-care autonomy to standardized scores on measures of psychological maturity and were categorized by tertile split into low, moderate, and high AMR. Higher baseline AMR was associated with higher baseline HbA(1C) for IT and UC. Baseline AMR scores predicted glycemic outcomes from UC; the high AMR tertile showed deteriorating glycemic control over time, whereas the low AMR tertile maintained better glycemic control. All three AMR groups derived equal glycemic benefit from IT. Children with inordinate diabetes self-care autonomy may fare poorly in UC but these same children may realize less glycemic deterioration during IT.

Outcome of intensive therapy

Outcome of intensive therapy