Physical Therapy Rehabilitation In A Patient With Guillain-Barre Syndrome With Acute Respiratory Failure: A Case Report

Background and Purpose. Guillain-Barre Syndrome (GBS) is a lower motor neuron autoimmune disorder that primarily affects the myelin sheaths of the peripheral nervous system (PNS). GBS results in generalized weakness and sensory deficits of the extremities and trunk; in severe cases it may impact cranial nerves, respiratory musculature, and the autonomic nervous system (ANS). The purpose of this case study is to describe the physical therapy interventions used for a patient diagnosed with GBS and the results from those interventions. Case Description. This case study describes the 9-week acute care Physical Therapy management of a 51-year-old transgender female diagnosed with GBS presenting with symmetrical acute flaccid paralysis, paresthesia, and neuropathic pain of the extremities and trunk. She also presented with autonomic dysfunction resulting in dyspnea, dysphagia, and dysarthria. Intervention. The physical therapy treatment of this patient involved range of motion, stretching, strengthening, aerobic endurance, neuromuscular re-education, balance and coordination, gait and assistive device training, and skin/joint protection. Outcomes. Following physical therapy rehabilitation, the patient demonstrated improvements with range of motion (ROM), strength, fine and gross motor coordination, balance, ambulation, transfers, endurance, and functional skills; along with reduced neuropathic pain, paresthesia, and disability. Discussion. This case illustrates the inpatient physical therapy interventions for a patient diagnosed with GBS based on the patient\u27s presentation and response to interventions. The rationale for treatment was based on the GBS/ AIDP Foundation International guidelines. A multidisciplinary approach which included physical therapy interventions was found to be very effective in regaining most of the patient\u27s previous function. More research is needed to assess effectiveness of specific physical therapy interventions in treating this patient population

Photon statistics in single molecule orientational imaging

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A priori information and optimisation in polarimetry

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Eigenfunction expansion of the electric fields in the focal region of a high numerical aperture focusing system

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Black hole spin inferred from 3:2 epicyclic resonance model of high-frequency quasi-periodic oscillations

Estimations of black hole spin in the three Galactic microquasars GRS 1915+105, GRO J1655-40, and XTE J1550-564 have been carried out based on spectral and timing X-ray measurements and various theoretical concepts. Among others, a non-linear resonance between axisymmetric epicyclic oscillation modes of an accretion disc around a Kerr black hole has been considered as a model for the observed high-frequency quasi-periodic oscillations (HF QPOs). Estimates of spin predicted by this model have been derived based on the geodesic approximation of the accreted fluid motion. Here we assume accretion flow described by the model of a pressure-supported torus and carry out related corrections to the mass-spin estimates. We find that for dimensionless black hole spin a<0.9, the resonant eigenfrequencies are very close to those calculated for the geodesic motion. Their values slightly grow with increasing torus thickness. These findings agree well with results of a previous study carried out in the pseudo-Newtonian approximation. The situation becomes different for a>0.9, in which case the resonant eigenfrequencies rapidly decrease as the torus thickness increases. We conclude that the assumed non-geodesic effects shift the lower limit of the spin, implied for the three microquasars by the epicyclic model and independently measured masses, from a~0.7 to a~0.6. Their consideration furthermore confirms compatibility of the model with the rapid spin of GRS 1915+105 and provides highly testable predictions of the QPO frequencies. Individual sources with a moderate spin (a<0.9) should exhibit a smaller spread of the measured 3:2 QPO frequencies than sources with a near-extreme spin (a~1). This should be further examined using the large amount of high-resolution data expected to become available with the next generation of X-ray instruments, such as the proposed Large Observatory for X-ray Timing (LOFT).Comment: 6 pages, 4 figures, accepted by Astronomy & Astrophysic

Inversion of the Debye-Wolf diffraction integral using an eigenfunction representation of the electric fields in the focal region

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Multi-Pion Systems in Lattice QCD and the Three-Pion Interaction

The ground-state energies of 2, 3, 4 and 5 \pi^+'s in a spatial volume V (2.5 fm)^3 are computed with lattice QCD. By eliminating the leading contribution from three-\pi^+ interactions, particular combinations of these n-\pi^+ ground-state energies provide precise extractions of the \pi^+\pi^+ scattering length in agreement with that obtained from calculations involving only two \pi^+'s. The three-\pi^+ interaction can be isolated by forming other combinations of the n-\pi^+ ground-state energies. We find a result that is consistent with a repulsive three-\pi^+ interaction for m_\pi < 352 MeV.Comment: 4 pages, 5 figure

Response to combination therapy with interferon alfa-2a and ribavirin in chronic hepatitis C according to a TNF-alpha promoter polymorphism

Background. Tumor necrosis factor-alpha (TNF-alpha) is involved in the pathogenesis of chronic active hepatitis C. Polymorphisms in the promoter region of the TNF-alpha gene can alter the TNF-alpha expression and modify the host immune response. The present study aimed at the correlation of the G308A TNF-alpha polymorphism with the response to antiviral combination therapy in chronic hepatitis C. Patients and Methods: 62 patients with HCV and 119 healthy unrelated controls were genotyped for the G308A TNF-alpha promoter polymorphism. The patients received 3 x 3 million units of interferon alfa-2a and 1,0001,200 mg ribavirin daily according to their body weight. A response was defined as absence of HCV-RNA and normalization of S-ALT after 6 months of combination therapy. Results:With respect to the allele and genotype frequency, a significant difference was not observed between controls and patients with chronic hepatitis C. Furthermore, such a difference was also not observed if responders and non-responders to antiviral therapy were compared. Conclusions: The promoter polymorphism of the TNF-alpha gene investigated herein is equally distributed in healthy individuals and patients with hepatitis C and does not seem to predict the response to therapy with interferon alfa-2a and ribavirin. Copyright (C) 2003 S. Karger AG, Basel