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Biomedical subjects

Avi Ohry

Publications and source records attributed to Avi Ohry.

At least 19 recordsLinked to original sources
PubMed2006

Heterotopic ossification in Guillain-Barré syndrome: incidence and effects on functional outcome with long-term follow-up.

OBJECTIVE: To define the incidence, effects on functional abilities, and possible causation of heterotopic ossification (HO) in Guillain-Barré syndrome (GBS) patients admitted for inpatient rehabilitation. DESIGN: Long-term prospective study on neurologic and functional outcome of GBS patients admitted for rehabilitation. SETTING: Rehabilitation department, inpatient and outpatient, within a university-affiliated medical center. PARTICIPANTS: All GBS patients admitted for rehabilitation and followed for a minimum of 3 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Presence of HO, factors that may be etiologically significant, and effects on functionality. Data included: medical interventions, Disability Grading Scale, need for assisted ventilation, electrodiagnostic findings, autonomic function, standard neuro-musculo-skeletal evaluation, and hospital length of stay. RESULTS: Four (6%) of 65 patients had HO, 24 of whom required mechanical ventilation. All had decreased range of motion in the involved hips that affected mobility. CONCLUSIONS: Even though it has been rarely reported, HO does occur in GBS and affects functional outcome.

Activities of Daily Living↗
PubMed2006

[Late morbidity among Holocaust survivors: myth or fact?].

The harsh life in the ghettos and concentration/extermination camps during the Holocaust was characterized by hunger, exposure to extreme cold temperatures, continuous threats, infectious diseases and injuries with acute or permanent disabilities and extreme psychological stress. There is no definite scientific evidence that the Holocaust survivors are exposed to premature aging or premature appearance of various physical diseases. These aspects were thoroughly investigated in other populations: ex-prisoners of war, ex-displaced persons, prisoners and survivors of torture. Famine, disabilities, diseases and stress, particularly at the beginning of or during puberty, were found to increase vulnerability to later morbidity, especially hypertensive and cardiovascular disease and to increased mortality. This article discusses the possibility of premature aging among Holocaust survivors as a late effect of their life conditions during the Holocaust.

Cardiovascular Diseases↗
PubMed2006

[Physicians who experimented on themselves: risk-taking among physicians and researchers].

Throughout history, we can find physicians and scientists who made important discoveries through self-experimentation or by risk-taking. Some were consciously exposed to plagues, some swallowed germs or chemicals and some put themselves in extreme physiological situations. Today, it seems that these stories are completely unnecessary: ethics, together with concrete controlled studies guidelines, suffice to avoid self-experimentations.

Autoexperimentation↗
PubMed2006

[The foundation of the first civil rehabilitation center by the Hadassah organization during the War of Independence].

Following the War of Independence and the establishment of the State of Israel (November 1947 July 1949), there were large numbers of wounded and disabled soldiers and civilians. This situation forced the State of Israel to develop temporary rehabilitation centers. Rehabilitation centers for disabled patients to attend following hospital release were non-existent at the time in civilian hospitals. In August 29, 1948 the first civilian rehabilitation center was founded by the Hadassah Medical Organization in Jerusalem. By the end of the war, the center was closed due to lack of financial support and political reasons. This article describes the establishment of this center by the Hadassah Medical Organization during the War of Independence.

History, 20th Century↗
PubMed2005

Decubitus direct current treatment (DDCT) of pressure ulcers: results of a randomized double-blinded placebo controlled study.

Electrostimulation for the treatment of pressure sores remains problematic and controversial. We studied the decubitus direct current treatment (DDCT) electrostimulation treatment of pressure sores stage 3 degree, with respect to rates of ulcer closure and wound area reduction. This was a multicenter, double-blind, randomized, placebo-controlled study involving 11 departments of geriatric and rehabilitation medicine including 63 patients. We compared a placebo treated group (PG) with an active treatment group (TG). Treatment lasted for 8 consecutive weeks, followed by a 12-week-period of follow-up. At day 57 (end of treatment) and at day 147 (end of follow-up), there was no difference between the groups with regards to rates of complete closure of ulcers (p=0.28 and 0.39, respectively), as well as for the mean time needed to achieve complete wound closure (p=0.16). Absolute ulcer area reduction and speed rate of wound area reduction (reflected by change from baseline ulcer area, percentage) were better in participants allocated in the treatment group only until day 45 (standardized estimate for trend of healing speed -0.44 and -0.14 for TG and PG, respectively). Afterwards, there were no differences between the two groups. A logistic regression analysis favored complete healing in TG, compared with PG (odds ratio 1.6, CI 0.4-4.73). Analysis of per protocol patients revealed that time needed for wound closure was 52% longer in PG (p=0.03, compared with TG). The results suggest that DDCT treatment for pressure ulcers grade 3 degree, in addition to the conservative wound care, may be useful in accelerating the healing process during the first period of care.

Aged↗
PubMed2005

Coronary artery disease and risk factors in people with posttraumatic vision loss.

OBJECTIVE: To examine the prevalence of coronary artery disease (CAD) and its risk factors in people with posttraumatic vision loss (PTVL). DESIGN: Cross-sectional, controlled study. SETTING: The general community. PARTICIPANTS: Study groups included 82 subjects with PTVL, 49 siblings, 58 blind subjects with retinitis pigmentosa (RP), and the general population in Israel. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Sociodemographic and biomedical data collected by using a structured questionnaire and medical records. RESULTS: The prevalence of CAD among subjects with PTVL (24%) was 2 to 3 times higher than the control groups ( P <.001). However, the prevalence of the CAD risk factors in these subjects was similar to or lower than those in the control groups. For example, significantly fewer subjects with PTVL were physically inactive (16%) than patients with RP (55%, P <.01). The only variable that was significantly associated with CAD prevalence was the cause of blindness-that is, trauma versus disease; the odds of having CAD after traumatic vision loss was 3.75 times higher than after RP. CONCLUSIONS: People with PTVL exhibit elevated rates of risk for CAD similar to those of other groups with physical disability. The traumatic injury that caused vision loss might be an important factor underlying that risk.

Adult↗
PubMed2005

[Physicians and terror: the historical perspective].

The topic of physicians who committed crimes or were involved in terrorists' activities, is not well known. This article does not present the well known horrific stories of the atrocities of the Nazi German physicians. The authors describe a number of doctors who were active during the French revolution, some murderous physicians-leaders, and present a few historical anecdotes. These examples might only emphasize the fact that, like other human beings, doctors, too, may suffer from bad character.

Germany↗
PubMed2005

Characteristics and outcomes of ninth and tenth decade patients hospitalized in a sub-acute geriatric hospital.

BACKGROUND: Population structures are changing across the western world, with particularly rapid growth in the number of very old people. Life expectancy has been increasing gradually over years, resulting in a larger subpopulation of people aged 90 and over. OBJECTIVES: To describe the sociodemographic, medical and functional characteristics of people aged 80-90 and 90+ who were admitted to a sub-acute geriatric hospital and to compare the hospitalization outcomes between these subgroups. METHODS: We compared the demographic and clinical data (extracted by means of chart review) of two groups of elderly who were admitted to the Reuth Medical Center during 2001-2002: those aged 90+ and those 80-89. Among survivors, the main outcome measures at discharge were mortality rate, functional ability, and place of residence. RESULTS: The study included 108 patients who were admitted to different divisions of Reuth: 55 patients aged 90+ and 53 aged 80-90. The mortality rate was significantly elevated in the older age group (49.1% vs. 28.1% in the younger age group). On multivariate analysis, the most important prognostic factors for mortality were incontinence (odds ratio 3.45) and being dependent before admission (OR 4.76). Among survivors, an association was found between being incontinent and dependent before hospitalization, and being dependent on discharge. CONCLUSIONS: The main prognostic factors for mortality and functional outcome in patients admitted to a non-acute geriatric hospital are incontinence and functional state prior to admission, and not age per se.

Activities of Daily Living↗
PubMed2004

People with disabilities before the days of modern rehabilitation medicine: did they pave the way?

Prior to the historical appearance of modern comprehensive rehabilitation medicine, people with disabilities were treated at their families' residence or by religious establishments. It is interesting to note some famous severely disabled who succeeded not only to survive against all odds but rather to contribute to their societies and to enter the pages of encyclopedias. The following case studies are randomly selected to reflect the historical position on disability and rehabilitation. The stories of Claudius, Herman von Reichenau, Gottfried von- Berlichingen, Georges Couthon, Aleijadinho, are given along with information on some other famous rulers, Kings and Popes who suffered from various disabilities and deformities.

Brazil↗
PubMed2004

[Ivan Illich's revenge and death: on iatrogenesis and related phenomena].

Dr Ivan Illich, the devoted fighter for the elimination of the various complications of modern medicine, died last year. This caused us to re-read and to remind the readers about the various ingredients of this iatrogenic phenomenon: polyphragmasia, the false diagnosis of "non-diseases", over-activity and over confidence of the medical establishment, non-adherence to logical work-up of diagnostic algorithm, etc. Although medicine has progressed immensely, we often encounter the various maladies of modern medicine. In rehabilitation medicine practice, we also often face a few more aspects of this subject.

Algorithms↗
PubMed2004

[Restorgenesis: a new concept].

This article suggests a new concept, named "restorgenesis". It addresses issues related to the essence of rehabilitation, such as defining the patient's potential for recovery, the milestones of the recovery process, its facilitating and impinging factors. This concept is a "hybrid" of two already existing notions: "pathogenesis", i.e. the definition of the factors in the individual and his/her environment that are causative of illness, and "salutogenesis", i.e. the definition of factors in the individual as well as in the environment that promote health. We suggest the notion of "restorgenesis" to embrace the processes of re-building and re-equilibrating that are at the core of the recovery process. Finally, we study the relevance of the recently introduced concept of allostasis, which includes the psychological and physiological factors related to the human system optimal functioning, to the process of rehabilitation.

Attitude to Health↗
PubMed2003

Some problems of the lower extremity in patients with spinal cord injuries.

Spinal cord injury (SCI) is devastating, leaving patients wholly or partly paralyzed. Health care providers who care for SCI patients during the acute or chronic phases are faced with different phenomena in the lower extremities of these subjects. In this article, the authors review the relevant changes associated with SCI. Preventive measures of these medical complications are directed according to the specific cause. Early comprehensive rehabilitation carried out by a specialized team prevents complications while enhancing functional gains.

Journal Article↗
PubMed2003

A home-based, self-administered stimulation program to improve selected hand functions of chronic stroke.

OBJECTIVES: To test if a combined stimulation-training program can improve selected hand functions and impairments of chronic stroke survivors. DESIGN: Pretest-Posttest, multi-site 5-week training program. Stroke survivors (N = 77) with chronic upper limb paresis completed a home-based stimulation program combining activation of the wrist-fingers flexors and extensors with functional grasp, hold and release training. Subjects trained 2-3 times each day, 7 days a week. Outcome measures included: the Jebsen-Taylor simulated feeding (S-feed); light object lift (J-T light); heavy object lift (J-T heavy); Box and Blocks test (B+B); Nine-Hole Peg (9-HP); Ashworth scale (Spasticity); Visual analog scale-VAS (Pain). Paired t-tests (alpha < 0.01) were performed on each study outcome. RESULTS: Simulated feeding time decreased from 39.1 +/- 30.9 sec to 25.5 +/- 23.3 sec (34.8% improvement). The task time of the J-T light decreased by 13.3 sec and the J-T heavy by 11.5 sec (44.9% and 40.9% improvement respectively). The number of blocks moved increased from 19.4 +/- 11.6 to 24.5 +/- 12.5 (26.3% improvement) and the time to complete the 9-HP decreased from 178.8 +/- 170.8 to 105.0 +/- 117.1 sec (58.7% improvement). Mean reduction of spasticity was 0.87 and 0.78 points at the elbow and wrist respectively. Patients with persistent pain (N = 33) reported mean reduction from 3.5 +/- 2.5 to 1.9 +/- 1.8. CONCLUSIONS: Five weeks of daily home training with a task-specific stimulation program improved selected hand functions and upper limb impairments associated with chronic post-stroke paresis.

Activities of Daily Living↗
PubMed2003

[Spinal cord injury due to penetrating missiles].

Gunshot wound of the spine is a major cause of spinal cord injury among US civilian population, members of the military armed conflict personnel, or civilians injured in terrorists attacks. The bullet fragments cause damage to the spinal cord even without penetrating the spinal canal. Concussive effects, heat, fractures or vascular injury may cause the neurological damage. Unfortunately, bullet or shrapnel removal or laminectomy do not change the prognosis. In this article we review the historical background, the Israeli experience, ballistic-forensic considerations, complications, treatment and prognosis.

Humans↗
PubMed2003

[Our experience with rehabilitation of patients with Pott's tuberculous paraplegia].

Spinal tuberculosis with paraplegia is rarely seen in Israel. All the 10 patients that were hospitalized in our rehabilitation departments had contracted the disease abroad prior to their immigration to Israel. The comprehensive rehabilitation process must include close cooperation between pulmonary physicians, orthopedic surgeons and rehabilitation medicine specialists. An updated review of the relevant literature is presented.

Adolescent↗
PubMed2002

Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: relation to functional outcome of stroke patients.

OBJECTIVES: To compare 3 cognitive tests, used on admission, for predicting discharge functional outcome and to assess the efficacy of these tests in predicting functional outcome at discharge in stroke patients undergoing rehabilitation. DESIGN: Cohort study. SETTING: Geriatric rehabilitation department of a tertiary care hospital in Israel. PATIENTS: Sixty-six patients undergoing acute inpatient comprehensive rehabilitation after first clinical stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENTS: Cognitive status was assessed with the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), the Mini-Mental State Examination (MMSE), and the cognitive subscale of the FIM instrument. The FIM motor subscale was used to assess functional outcome status. Functional gain was determined by the motor FIM gain (efficacy), and the relative (to potential) functional gain was determined by the Montebello Rehabilitation Factor Score. Efficiency was calculated by efficacy divided by the length of hospital stay. RESULTS: A significant increase in total FIM scores (34.8 points) occurred during rehabilitation mainly because of improvement in motor functioning (31.5 points). Significant improvement in global cognitive status was documented by all 3 tests. Intertest correlation coefficients ranged between.47 and.67. The LOTCA showed somewhat higher correlation coefficients with most of the parameters of functional motor outcomes. Correlation between the MMSE and FIM cognitive subscale and these outcome parameters were nearly identical. CONCLUSION: The LOTCA is slightly better than the MMSE and the FIM cognitive subscale in predicting functional status change after stroke rehabilitation but it is a time-consuming and exhausting instrument to use. The FIM cognitive subscale requires a better overall understanding of the patient's situation at time of administration and therefore is less convenient for the initial assessment. The similar correlation of all 3 tests with functional outcomes and the simplicity of administration of the MMSE suggests its use in the initial assessment of stroke patients.

Activities of Daily Living↗