New research from the Netherlands shows that older patients with
chronic obstructive pulmonary disease (COPD) are at increased risk for carotid
artery plaque formation and for the presence of vulnerable plaques with a lipid
core, according to
the American Thoracic Society.
cross-sectional study, part of the Rotterdam Study, an ongoing population-based
cohort study examining the occurrence of and risk factors for chronic diseases
in subjects aged 55 years and older, involved 253 patients with COPD and 920
patients without the condition. COPD was confirmed by spirometry.
Participations with carotid wall thickening (intima-media thickness ≥ 2.5 mm)
on ultrasonography underwent high-resolution MRI to characterize carotid
with COPD had a twofold increased risk of carotid wall thickening on
ultrasonography compared with controls. This risk increased significantly with
the severity of airflow limitation. On MRI, vulnerable lipid core plaques were
significantly more frequent in participants with COPD compared with those
should be aware that COPD patients are at increased risk for asymptomatic
carotid atherosclerosis and that COPD might lead to vulnerable plaques by
inducing or aggravating the presence of plaques with a lipid core," said researcher Bruno H.C. Stricker, MD, PhD.
underlying risk factors for stroke in COPD patients can help identify those at
high risk and lead to the development of more personalized preventive treatment
strategies targeting this devastating complication," he added.
findings were published online ahead of print publication in the American
Thoracic Society's American Journal of
Respiratory and Critical Care Medicine.
of Haitian Rehabilitation (FONHARE) is a grassroots Haitian organization
providing rehabilitation services to the citizens of Ouanaminthe. It is the
only organization providing rehab services in the northeast of Haiti to 13
cities with almost 500,000 citizens. Ivens Louius, the founder and
director, is a physical therapist and an occupational therapist. FONHARE currently
is providing services in a medical clinic owned and run by Louius's brother, who is a physician. A foundation has
been laid for a large onsite rehabilitation clinic adjacent to the medical
clinic. There is a genuine need for volunteers to be part of establishing
rehabilitation and physical therapy as a specialized service in a country
that had virtually none before the 2010 earthquake. For more information about
volunteer opportunities, as well as opportunities to provide financial support,
visit FONHARE at www.fonhare.org.
Self-reported function, hip range of motion (HROM), and patient-perceived improvement
occurred after an 8-week program of exercise therapy (ET) for patients with hip
osteoarthritis (OA), say authors of an article
published in Archives of Physical
Medicine and Rehabilitation. Manual therapy (MT) as an adjunct provided no
further benefit, except for achieving higher patient satisfaction, they add.
For this investigation, 131 patients with hip OA recruited from general
practitioners, rheumatologists, orthopedic surgeons, and other hospital
consultants in Dublin, Ireland, were randomized to 1 of 3 groups: ET (n=45),
ET+MT (n=43), and wait-list control (n=43).
Participants in both ET and ET+MT groups received up to 8 treatments over 8
weeks. Control group participants were rerandomized into either the ET or ET+MT
group after the 9 week follow-up. Their data were pooled with original
treatment group data—ET (n=66) and ET+MT (n=65).
The primary outcome was the WOMAC physical function (PF) subscale. Secondary
outcomes included physical performance, pain, HROM, anxiety/depression, quality
of life, medication usage, patient-perceived change, and patient satisfaction.
There was no significant difference in WOMAC PF between ET (n=66) and ET+MT (n=65)
groups at 9 weeks (mean difference 0.09) or at 18 weeks (mean difference 0.42),
or other outcomes, except "patient satisfaction with outcome," which was higher
in the ET+MT group. Improvements in WOMAC, HROM, and patient-perceived change
occurred in both treatment groups compared with the control group.
therapists (PTs) should consider a number of details before contracting with
payers, whether private or public. View
APTA's new Managed Care Contracting Toolkit
today to learn valuable information about joining a managed care plan, and
securing and tracking contracts. A chapter on "doing the math"
can help you decide which fee schedules, patient populations, and
payment methodologies are best suited to your practice. The toolkit also breaks down the pros and cons of common
methodologies that third-party payers use to pay for physical therapy services
and offers information on negotiating contracts.
APTA's Payment and Practice Management Department created the member-only toolkit to help PTs make informed decisions about joining a provider network.
analysis of clinical practice guidelines archived on the National Guideline
Clearinghouse (NGC) website as of June 2011 demonstrated poor compliance with
Institute of Medicine (IOM) standards, with little if any improvement over the
past 2 decades, say authors of an article published this month in Archives
For the study, 2 reviewers independently screened 130 guidelines selected at
random from NGC's website for compliance with 18 of 25 IOM standards.
The overall median number of IOM
standards satisfied (out of 18) was 8 (44.4%). Fewer than half of
the guidelines surveyed met more than 50% of IOM standards. Barely a third of
the guidelines produced by subspecialty societies satisfied more than 50% of
the IOM standards surveyed.
Information on conflicts of interest was given in fewer than half of the
guidelines surveyed. Non-English literature, unpublished data, and/or abstracts
were rarely considered in developing guidelines. Differences of opinion among
committee members generally were not aired in guidelines. Benefits of
recommendations were enumerated more often than potential harms. Guidelines
published from 2006 through 2011 varied little with regard to average number of
IOM standards satisfied.
everywhere is developing guidelines and there is no real quality control,"
lead author Philip A. Mackowiak, MD, told Reuters
"There is no good oversight of who actually develops the guidelines or
what criteria need to be met in order for them to be published."
IOM's standards were not published until 2011. Mackowiak acknowledges that
the experts who developed the guidelines reviewed by his team would not have
been able to use IOM's standards. However,
he added that similar standards have been published before and that they were
basic enough that they should have been followed, says Reuters.
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a deserving APTA member who is 50 years or older, committed to being active and
fit, and encourages others to be the same. Go to www.apta.org/FitAfter50/ to learn more about the campaign
and to nominate yourself or another deserving 50+ year old.