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成年人中度到重度创伤性脑损伤的多学科急症康复治疗
This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10064-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decisionmakers--patients and clinicians, health system leaders, and policymakers, among othersmake well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.
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军事医学中的针灸
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头部受伤后前庭失去平衡:关于军队中的评估和康复设置
Vestibular pathology has been documented following barotrauma and/or head acceleration associated with exposure to explosions. The usual symptoms include dizziness and headache, with dizziness and associated imbalance contributing disproportionately to disability. Several agencies have noted the need for better vestibular evaluation and rehabilitation following exposure to improvised explosive devices (IEDs). The authors asked subject matter experts to assist in formulating recommendations for initial assessment and rehabilitation of balance problems following IED exposure, focusing on strategies that are either available or in development. This report summarizes feedback obtained from approximately 50 vestibular researchers, scientific advisors, clinicians, and biomedical engineers working for government agencies, universities, clinics/hospitals, and businesses. Tests appropriate for early (post-injury) functional assessment in the military setting are considered, along with the optimal application of novel tactile balance feedback technologies being developed to augment vestibular rehabilitation.
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通过可塑性诱导康复提高自闭症中的同步和功能连接
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对军事和退伍军人群体的创伤后应激障碍的治疗
The hallmarks of the recent conflicts in Iraq (20032011) and Afghanistan (2001-present) are blast injuries and the psychiatric consequences of combat, particularly posttraumatic stress disorder (PTSD), the subject of this report. According to the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), PTSD symptoms must be manifested in three clusters: 1. Persistent re-experiencing, such as recurrent thoughts, nightmares, and flashbacks; 2. Persistent avoidance of trauma-associated stimuli (for example, avoiding related thoughts, feelings, conversations, or places) and emotional numbing that was not present before the trauma; and 3. Persistent hyperarousal that may be manifested as hypervigilance, an exaggerated startle response, or difficulty in concentrating. Those symptoms must persist for at least a month and cause clinically significant distress or functional impairment. PTSD is unique among psychiatric disorders in that it is linked to a specific trigger--a traumatic event--such as combat, natural and accidental disasters, and victimization and abuse.