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Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
Acute injuries can be classified based on the time of injury. Injuries should pass through reasonable predictable patterns of healing and repair. Chronicity refers to the stage of repair tissues are within. Acute – the first three days following the point of injurySub-Acute – 72 hours to 21 days from the point of injuryChronic – 21 days to two years from the point of injuryIf an injury is not resolving within a reasonable time scale, a trainer might consider whether there is 1) some degree of unresolved structural damage, 2) a reason for poor tissue healing (e.g. inadequate nutrition or underlying systemic disease) or 3) patterns of behavior that are aggravating or maintaining injury and preventing repair.
The Host Immune Response Against Parasitic Helminth Infection
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Several pertinent aspects of these diseases occur precisely because of chronicity. First, chronic infections by helminth parasites cause the release of large quantities of parasite antigens during their life span. These antigens have profound immunopathological consequences; they may be deposited in host tissue as immune complexes, or they may induce by themselves both immediate and delayed type hypersensitivity reactions. In addition, chronic stimulation by parasite antigens may result in immunosuppression, either of parasite-specific immune responses [as in human filariasis (1)]–a mechanism that probably promotes survival of the parasite–or of a more general, nonspecific type that has been implicated in diminished resistance to infection with other pathogens (2).
Economical evaluation
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Roberto W. Dal Negro, Claudio F. Donner
The first suggestion is that the topic of ‘respiratory chronicity’, and particularly that of COPD, has been truly regarded as a severe social health problem only in the last couple of decades, its burden being assessed and valued quite recently in all countries, even those characterized by advanced health models.
Transitioning from hurting to healing: self-management after distal radius fracture
Published in Disability and Rehabilitation, 2022
Brocha Z. Stern, Janet Njelesani, Tsu-Hsin Howe
Self-management refers to an individual’s active involvement in addressing the multidimensional consequences of a health condition, such as symptoms, emotional distress, and functional limitations [10–12]. It is discussed for chronic disease because of nonreversible pathology and the need for maintenance within a reactive episode-focused health care system [9]. Specific to musculoskeletal health, self-management has also been emphasized for chronic conditions (e.g., arthritis and persistent pain [13]) versus acute conditions (e.g., fractures). However, regardless of a condition’s chronicity, what individuals believe and how they act may contribute to health. Using a lens of self-management to frame recovery after musculoskeletal trauma can prevent transitions to chronicity, promote holistic health, and increase value of services [9]. This perspective merits further exploration.
Impact of a clinical pathway on cardiovascular risk in patients with diabetes
Published in Postgraduate Medicine, 2022
María Concepción Fernández-Planelles, Antonio Palazón-Bru, Miriam Calvo-Pérez, Antonio Miguel Picó-Alfonso, Vicente Francisco Gil-Guillén
Chronicity, in current epidemiology, is a common problem in Western countries. Its high prevalence, associated with multiple diseases and dependence, is a direct consequence of social and health system improvements in recent decades. Fatal diseases have consequently become chronic [4]. They require the design of interdependent processes [5], in which professionals from different disciplines care for the same patients. This reality generates the need to coordinate and create cross-functional teams to treat patients in an integrated and effective manner. Care must be organized together with the professional and involve the patient, which makes sense and is accepted by all professionals as something fundamental to be done. Nonetheless, it is difficult to execute, given that very often each department, accustomed to working in a fragmented manner [5], considers that the problem occurring is something isolated and acute, without having a global vision of the process and of what happens after their own intervention. To this must be added the lack of knowledge of the different care areas on the part of each agent, as well as their way of working and the content of this work.
The pharmacotherapeutics of sarcoidosis
Published in Expert Review of Clinical Pharmacology, 2022
Patrick Mangialardi, Richart Harper, Timothy E Albertson
Despite decades of literature, several questions remain when making treatment decisions for patients with sarcoidosis. Because sarcoidosis has a large variability in clinical presentation, organs affected, and clinical course, it is often difficult to know the risk/benefit ratio for treatment decisions a priori. Sarcoidosis is often self-limiting, and therefore utilizing a strategy to treat all sarcoidosis patients immediately on diagnosis exposes a substantial number of patients to unneeded therapies. Conversely, delayed treatment of organ-threatening disease can lead to undue harm to the patient. Evidence of chronicity of disease often suggests treatment is needed. For example, a pulmonary sarcoidosis patient with evidence of extensive (>20%) fibrosis on imaging studies is highly unlikely to spontaneously remit over several months of observation period and should be started on treatment. In contrast, the decision to treat is highly nuanced for the newly diagnosed patient with no previous trajectory to rely upon. A decision that is aided somewhat by extensive clinical experience with sarcoidosis patients.