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He supported himself from savings and he raised money from well-wishers and sponsors for a variety of projects purchase cheap rebetol on-line. In 1985 Davis began seeing patients at Mentmore and in 1986 he did another four months further training in India in pulse diagnosis and herbal treatments purchase rebetol 200mg without prescription. With his background in surgery he naturally took an interest in the treatment of more serious conditions like cancer generic 200mg rebetol visa, through Maharishi Ayur-Ved. A member of Frontliners used the herbal remedies for three weeks and reported that he felt very well. As a consequence of that case, Davis found himself treating two other members of Frontliners. In 1987 however this did not seem a relevant consideration for either Davis or Ron Macevoy. Davis admits even now, to having been sceptical himself about the treatments in 1987. Five years later, his confidence in the Ayur-Vedic preparations has been strengthened by clinical experience and by research showing that these treatments contain powerful antioxidants. While Davis dealt with only three patients in London, in 1987, each of whom showed short-term benefits from the treatment. Collecting information about twelve cases, with two other doctors, Davis wrote them up as case histories. He realised that he would have to carry out a properly structured trial if Ayur-Vedic treatment was to be recognised. Between 1987 and 1989, Dr Leslie Davis approached a large number of orthodox specialists in the field, seeking support and guidance. Pinching also agreed to look at a protocol for a trial of Ayur-Vedic treatment which Dr Davis was then working on. Pinching replied in December and from then on Davis and Pinching exchanged letters for well over a year. He did, however, suggest that he go to the voluntary sector organisations and obtain their help in drawing patients into the trial. For the links between Professor Robin Weiss and the Wellcome Foundation see Chapter Twenty Three. For the links between Wellcome and the Institute of Cancer Research see Chapter Thirty Six. Davis met with very little direct opposition from the orthodox doctors and research scientists he approached. In fact there appeared, superficially at least, to be a tolerable equanimity about the advice that he was proffered. I became very superficially familiar with Ayur-Vedic medicine when I worked in Kerala in 1961/62. Secondly, he understood that any trial of Ayur-Vedic medicine and its protocols should really dovetail into other trials. Questions about other treatments in the case of opportunist infections and the avoidance of other medications while on the trial were far more likely to be resolved, within the more formal environment of the National Health Service than they would be working with a small voluntary cohort which was drifting between other agencies and treatments. At that time, Frontliners still had a section which dealt with alternative medicines. Despite such wildly optimistic ideas, as 1988 wore on, it was becoming clear to Davis that interest in alternative treatments was quickly waning. An antipathy towards independent non-orthodox practitioners was beginning to seep through the voluntary sector. Having made little progress in his attempts to get practical help within the National Health Service, Davis helped establish the Disease Free Society Trust. One sponsor gave £10,000 to help set up the Trust, and with other money the Trust came to be worth £15,000. From the beginning he had been advised by those he had written to, that the estimated cost of a study involving twenty patients would be in the region of £100,000. He had continued to revise his protocols throughout 1988 and the first month of 1989; he continued as well, to send these to a variety of people, for criticism and support. Dr Weir came closer than any of the other doctors contacted to playing a part in the trial. Having suggested that the Ayur-Vedic treatments should be tested for toxicity, and such tests having been incorporated in the study, Dr Weir agreed to act as an observer and attended a number of consultations. Apart from a lack of money, there was one problem with the protocols and the trials which kept cropping up. It was pointed out by a number of advisors that they might have difficulty in separating out the cause and effect of the different aspects of the study.

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We present a case of a patient with pulmonary involve- On physical examination purchase rebetol on line amex, bilateral wrists purchase rebetol 200 mg line, 1 order rebetol 200mg on-line. Lum- al and Methods: Case: A 70-year-old man with a 36-year history of bar range of motion was limited minimally in all directiond. Lumbar rheumatoid arthritis had been on methotrexate, sulfosalazine, and Schober test was measured as 4,5 cm and chest expansion was meas- prednisone admitted to our outpatient clinic. There was decreased left lung sounds by ausculta- matoid arthritis was diagnosed with ankylosing spondylitis in the tion. Laboratory tests revealed: erythrocyte sedimentation rate of light of these fndings and treatment has been revised. Chest X-ray showed decreased left tis is a rare situation, it should be considered in the diagnosis. Conclusion: There is 1 1 1 evidence of an association between pulmonary complications and E. Adalimumab is a humanized monoclonal antibody, it would Training Hospital, Physical Medicine and Rehabilitation, Istanbul, have the potential advantage of being less immunogenic. However, Turkey some authors have suggested that its use might induce pulmonary complications. Herein, we want to draw attention to successful Introduction/Background: Pulmonary involvement is one of the treatment of pulmonary involvement of rheumatoid arthiritis with extra-articular manifestations of rheumatoid arthritis and includes adalimumab but it should be kept in mand that it may also cause pleural effusion, parenchymal nodules, interstitial involvement, pulmonary complications. We present a case of a patient with pulmonary involvement of rheumatoid arthiritis and treated with pulse steroid therapy. All questions are about sleep and they were well understood by ment of Otorhinolaryngology, Ankara, Turkey, 3Ministry of Health patients which showed the face validity. Introduction/Background: The aim of this study was to investigate Pearson’s (r) Signifcance (p) the inner ear function in patients with psoriatic arthritis. Statistical comparisons between both groups were per- formed using chi-square test and Mann- WhitneyU test. Latif3 the evaluation of hearing frequencies of the patients between 4,000 1Ahvaz Jundishapur Univeristy of Medical Sciences - Ahvaz - Iran, and 6,000 Hz, a statistically signifcant difference was found relative 2 Physical Medicine and Rehabilitation, Ahvaz, Iran, Ahvaz Jundis- to the control group (p<005). When compared with 3 the control group, a statistically signifcantly difference was found Ahvaz, Iran, Ahvaz Jundishapur Univeristy of Medical Sciences at 3,000 and 4,000 Hz. Conclusion: Our study provides - Ahvaz - Iran, Health Research Center-Diabetes Research Center, strong evidence suggesting the necessity of monitorization of these Ahvaz, Iran patients regarding sensorineural hearing loss so as to take measures Introduction/Background: Median nerve involvement in wrist is against the development of hearing loss during early stage which one of the most common compression neuropathy which drives the may be another disability in patients with PsA which is itself a po- patients to musculocutaneus clinics such as orthopedy, neurology tential cause of severe disability. For estimating the amount of nerve injury, all the amounts of patients’ pain severity, 264 clinical and electrodiagnostic severity data were used by different researchers. The patients’ report of pain severity did Not show Introduction/Background: The aim of this study is to assess the va- correlation with electrodiagnostic severity. The electrodiagnostic severity was correlated with the consuming scale which assesses the sleep disturbance with 4 ques- clinical symptom severity at: p=0. The tom severity and the electro diagnostic severity were more reliable internal consistency (Cronbach’s alpha) was assessed for reliability. Face validity and construct validity (convergent and divergent va- lidities) were evaluated. Material and Methods: A total of 60 1 patients who fulflled the “Revised Criteria for the Classifcation of D. Sung 1Samsung Medical Center, Physical Medicine and Rehabilitation, Rheumatoid Arthritis 1987” were included in this study. The pa- tients who satisfed at least 4 out of 7 criteria were included in the Seoul, Republic of Korea study. Demographic characteristics, clinical features, laboratory tients with inactive disease. Morning stiffness was reported in 31 the calculation of absolute cardiovascular disease risk. Incidence of giant cell arteritis is higher than tion, Mahdia, Tunisia other previous Korean reports. We report a new case of this as- sociation and we describe its management in physical medicine. Material and Methods: This is a 26 year old patient with a his- 269 tory of juvenile rheumatoid arthritis since the age of 4 years. She received physical 1 University of Malaya Medical Centre, Rehabilitation Medicine, therapy without any improvement. Its incidence is unknown whereas the preva- the patient in internal medicine for suspected Takayasu arteritis. Material and Meth- coabdominal angioscan revealed a damage of common carotid, ods: A 57-year-old man with chronic diabetes mellitus presented subclavian, vertebral and thoracic aorta. The patient was treated with a grossly deformed, painless, swollen and unstable right knee, witha high-dose of corticosteroids in combination with methotrex- which rapidly progressed over 5 months with no history of trauma. Radiological studies an appropriate rehabilitation program with a signifcant improve- showed subluxation of the right knee joint with all major ligaments ment. He was limited to hopping with a walking frame and pro- juvenile rheumatoid arthritis is rare.

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Other devastating ad- Introduction/Background: OnabotulinumtoxinA treatment for pa- verse effects such as anterior spinal artery syndrome buy 200 mg rebetol with visa, thrombosis of tients with spasticity is individualized order cheap rebetol line, variable purchase rebetol 200mg overnight delivery, and dependent on posterior spinal arteries and persistent paraplegia following the in- numerous factors, many of which are related to disease and burden jections were rare. Baseline demographics and clinical characteris- as improvement of spasms and pain, mobility, activity of daily liv- tics of patients treated with onabotulinumtoxinA for spasticity are ing and reduced nursing care. N) were signifcantly studies have examined the effects of repetitive magnetic stimula- lower, and trabecular separation(Tb. Conclusion: The results demonstrated that electroa- frequency (10 Hz, 1 Tesla) groups (n=4 dishes/group) and were cupuncture can inhibit subchondral bone loss and protected articu- stimulated for 3 days. However, whether electroacupuncture Akt and Erk was investigated by Western blotting analysis 3 days protect against articular cartilage erosion by inhibiting subchondral after repetitive magnetic stimulation. Re- 138 sults: There were differences in cell proliferation based on stimulus frequency. These fndings represent a promising op- loss, especially on the weight bearing bone. In mature bone, dis- portunity to gain insight into how different frequenciesof repetitive use osteoporosis is manifested by increased bone resorption and magnetic stimulation may mediate cell proliferation. Exercise will increase the thickness of cortical more than trabecular bone but electrostimulation inhibited the loss of trabecular more than 137 cortical bone. Li3 biphasic, asymmetrical square wave, frequency 2 Hz, pulse width 1The First Affliated Hospital of University of South China, Depart- 250 μs, duty cycle 5:10s. Two sets of 3 hours period daily with 2-h ment of Rehabilitation-, Hengyang, China, 2Hunan Polytechnic of rest in between, 3×/week for 4 weeks), but the left legs were not Environment and Biology, Department of Rehabilitation, Heng- stimulated. After yang, China, 3The First Affliated Hospital of University of South 4 weeks, all samples were sacrifced and taken the tibial bone, de- China, Department of Rehabilitation, Hengyang, China calcifed, microtomized and prepared with Hematoxycillin Eosin staining. Trabecular, cortical dan periosteum thickness were meas- Introduction/Background: To investigate effects of electroacupunc- ured with micrometer and compared. Our results showed that 1 respiration, especially deep inspiration, changes the morphology of Dulap 1 the pharynx and larynx. During deep inspiration, larger pharyngeal Southwestern University, College of Rehabilitative Sciences, Cebu volume and area was observed with no change in length, suggested City, Philippines that the larger volume was produced by increasing cross-sectional Introduction/Background: Spasticity management has evolved in area. Further study is necessary to determine the mechanism for many years from the use of pharmacologic agents to application of these changes in anatomical confguration. This study determined the effect of Baclofen and elec- trical simulation on patients with spasticity. Material and Meth- 141 ods: Included in this quasi-experimental study were 21 patients with upper motor neuron lesion who manifested spasticity. Saitoh1 groups were treated for 10 sessions and the spasticity of the sub- 1Fujita Health University- School of Medicine, Department of Re- jects were measured using the Tardieu scale before and after 10 habilitation Medicine, Toyoake, Japan, 2Fujita Health University treatment sessions. Paired t-test was used to determine whether Hospital, Department of Rehabilitation, Toyoake, Japan, 3Fujita there is a signifcant change in the mean spasticity score before Health University, Faculty of Rehabilitation, Toyoake, Japan and after treatment in each group, and independent t-test was used to determine the signifcant difference in the mean score between Introduction/Background: Various bolus have been used for pa- groups, all at p<0. However, physiological effects of viscosity in the Tardieu mean score before and after treatment in group 3 and volume have been rarely investigated in detail. Material and Methods: Conclusion: The combination of electrical stimulation and oral Thirteen healthy adults (average age; 28. Participants swallowed saliva, 3 ml thin liquid, 3ml nectar thick liquid, and 20 ml thin liquid, and 20 ml nectar 140 thick liquid. Two trials were performed for each bolus and the task order was randomly assigned. They had signifcantly longer duration compared to saliva (428±90 ms), 3 ml thin liquid (519±83 ms), or 3 ml nectar thick Y. Palmer3 pharyngeal pressure of 20 ml thin liquid was signifcantly larger 1Fujita Health Univesity, Faculty of Rehabilitation, Toyoake, Ja- than that of 20 ml thin liquid (p<0. Maximum velopharyngeal pan, 2Fujita Health Univesity, Department of Rehabilitation Medi- pressure of 3 ml thin liquid was signifcantly larger than that of 3 cine I, Toyoake, Japan, 3Johns Hopkins Univerisity, Department of ml thin liquid (p<0. The purpose of this study was to examine the effects of respiratory phase on the shape and size of pharynx and larynx. For patients after radiotherapy of nasopharyngeal measurement to fnd unmet needs in post stroke patient. Without the proper nutritional support, even the best rehabilitation regimen may not yield targeted results. Lin1 In this study, we analyzed the current situation of tube feeding and 1Changhua Christian Hospital, Physical Medicine & Rehabilita- dysphagia therapy in our rehabilitation ward. Material and Meth- tion, Changhua, Taiwan ods: Patients admitted into our rehabilitation ward from Jan 2012 to Dec 2014 (three years) were screened. However, its design was based on Delphi rehabilitation ward during the three year period. The patients were requested to answer the questionnaire and to viding the nutritional needs of patients with post-stroke dysphagia. Hundred Supervision, Kita-ku- Tokyo, Japan and thirty nine subjects participated to the inter-rater reliability as- sessment; thirty were enrolled in the intra-rater reliability assess- Introduction/Background: There are few well-established statistical ment. Two observers measured the spinal sagittal curves of each methods to assess the validities of content (Selected items of measure- participant with the surface goniometer IncliMed®.

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