Patricia Khan - Academia.edu (original) (raw)

Papers by Patricia Khan

Research paper thumbnail of Trauma raquimedular em crianças diferenças na etiopatogenia, tratamento e evoluçäo quando comparado com adulto: análise de 160 casos

Arq. bras. neurocir, 1995

Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características di... more Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características diferentes do que ocorre no indivíduo adulto. Estudamos 160 crianças admitidas para tratamento e reabilitaçäo nos últimos 12 anos (1982-1993) no Hospital do ...

Research paper thumbnail of Patient care pathways in spastic paresis and rehabilitation Table 2 : Overview of guidelines for managing spasticity

1. Siskin Spine and Rehabilitation, Chattanooga, Tennessee, USA; 2. Department of Neurorehabilita... more 1. Siskin Spine and Rehabilitation, Chattanooga, Tennessee, USA; 2. Department of Neurorehabilitation Gailtal-Klinik, Hermagor, Austria; 3. Catarinense Center of Rehabilitation, Florianopolis, Brazil; 4. King’s College London and St Thomas’ Hospital London, UK; 5. Division of Movement Disorders, Department of Neurology, Loma Linda University School of Medicine, Loma Linda, California, USA; 6. Department of Neurology, Georgetown University Hospital, Washington DC, USA; 7. Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA; 8. Scientific Research Psychoneurological Institute, St. Petersburg, Russia; 9. Ipsen Pharma, Paris, France; 10. Movement Disorders Center of Arizona, Scottsdale, USA

Research paper thumbnail of Post Hoc Subgroup Analysis of the BCause Study Assessing the Effect of AbobotulinumtoxinA on Post-Stroke Shoulder Pain in Adults

Toxins

Botulinum toxin type A is approved for the focal treatment of spasticity; however, the effectiven... more Botulinum toxin type A is approved for the focal treatment of spasticity; however, the effectiveness of abobotulinumtoxinA (aboBoNT-A) in patients with shoulder pain who have set reduced pain as a treatment goal is understudied. In addition, some patients encounter delays in accessing treatment programs; therefore, the suitability of aboBoNT-A for pain reduction in this population requires investigation. These factors were assessed in aboBoNT-A-naive Brazilian patients in a post hoc analysis of data from BCause, an observational, multicenter, prospective study (NCT02390206). Patients (N = 49, n = 25 female; mean (standard deviation) age of 60.3 (9.1) years; median (range) time since onset of spasticity of 16.1 (0–193) months) received aboBoNT-A injections to shoulder muscles in one or two treatment cycles (n = 47). Using goal attainment scaling (GAS), most patients achieved their goal of shoulder pain reduction after one treatment cycle (72.1%; 95% confidence interval: 57.2–83.4%). ...

Research paper thumbnail of Eficacia dos antidepressivos para dor cronica

Research paper thumbnail of The Effectiveness of Botulinum Toxin Type A (BoNT-A) Treatment in Brazilian Patients with Chronic Post-Stroke Spasticity: Results from the Observational, Multicenter, Prospective BCause Study

Toxins

Botulinum toxin type A (BoNT-A) is an effective treatment for post-stroke spasticity; however, so... more Botulinum toxin type A (BoNT-A) is an effective treatment for post-stroke spasticity; however, some patients cannot access treatment until ≥1 year post-stroke. This Brazilian post-marketing study (NCT02390206) assessed the achievement of person-centered goals in patients with chronic post-stroke spasticity after a BoNT-A injection. Patients had a last documented stroke ≥1 year before study entry and post-stroke upper limb (UL) spasticity, with or without lower limb (LL) spasticity. Patients received BoNT-A injections at baseline (visit 1) and visit 2 (3–6 months). Primary endpoint was responder rate (achievement of primary goal from Goal Attainment Scaling (GAS)) at visit 2. Overall, 204 patients underwent GAS evaluation at visit 2, mean (SD) age was 56.4 (13.2) years and 90.7% had LL spasticity. Median (range) time between first stroke and onset of spasticity was 3.6 (0−349) months, onset of spasticity and first injection was 22.7 (0−350) months and waiting time for a rehabilitatio...

Research paper thumbnail of Spastic Paresis and Rehabilitation – The Patient Journey

European Neurological Review

Spastic paresis is a complex condition associated with damage to the upper motor neurons, typical... more Spastic paresis is a complex condition associated with damage to the upper motor neurons, typically caused by cerebral palsy, multiple sclerosis, stroke or trauma. Despite substantial impact on patients’ independence and burden on caregivers, there is a lack of consensus on optimal management of this condition and the patient journey remains unclear. A group of physicians, experienced in spasticity management, recently convened with the objective of analysing the patient journey from a care pathway perspective in different geographical regions and under different conditions from acute phase to long-term/chronic disease status. The experts reviewed results from recent patient and healthcare practitioner surveys on the subject and assessed how current patient pathways could be improved, using their own experiences to highlight the issues related to management deficiencies in their individual countries. The group divided the patient journey into steps, considering the evidence from the...

Research paper thumbnail of Características das vítimas de acidentes motociclisticos atendidas em um centro de reabilitação de referência estadual do sul do Brasil

Acta Fisiatrica, Sep 1, 2011

Research paper thumbnail of Efficacy of antidepressants for chronic pain

Revista Brasileira De Medicina, May 1, 2003

Research paper thumbnail of Eficácia dos antidepressivos para dor crônica

Rbm Rev Bras Med, May 1, 2003

Research paper thumbnail of Trauma raquimedular em crianças diferenças na etiopatogenia, tratamento e evoluçäo quando comparado com adulto: análise de 160 casos

Arq Bras Neurocir, Sep 1, 1995

Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características di... more Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características diferentes do que ocorre no indivíduo adulto. Estudamos 160 crianças admitidas para tratamento e reabilitaçäo nos últimos 12 anos (1982-1993) no Hospital do ...

Research paper thumbnail of Poster 27 Analyzing the Patient Journey for Patients Living with Spastic Paresis

Research paper thumbnail of Pyrexia in hospitalised spinal cord injury patients

Paraplegia

To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Med... more To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Medicine of the Locomotor System (HMLS/SARAH), a review study was undertaken. For a period of 3 months, all new episodes of fever were recorded. During the study 221.3 patients/month were observed. The age ranged from 14 to 60 years and time of lesion from 1 to 6,264 days: 85 patients were paraplegia or paraparetic, and 44 tetraplegic or tetraparetic. At the beginning of the study 10.8% of the patients had fever. During follow up, we observed a rate of 33.9 new incidences per 100 patients/month. In 77.3% only one cause was identified, and in 8% no cause could be defined. The commonest causes were urinary tract infection (UTI) (44.3%), and soft tissue infections (11.4%). Frequent causes of fever in the acute stage other than UTI were complications related to the initial trauma and thromboembolic disease (p < 0.05). These results demonstrate the high incidence of fever in patients with SCI...

Research paper thumbnail of Pyrexia in hospitalised spinal cord injury patients

Paraplegia, 1993

To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Med... more To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Medicine of the Locomotor System (HMLS/SARAH), a review study was undertaken. For a period of 3 months, all new episodes of fever were recorded. During the study 221.3 patients/month were observed. The age ranged from 14 to 60 years and time of lesion from 1 to 6,264 days: 85 patients were paraplegia or paraparetic, and 44 tetraplegic or tetraparetic. At the beginning of the study 10.8% of the patients had fever. During follow up, we observed a rate of 33.9 new incidences per 100 patients/month. In 77.3% only one cause was identified, and in 8% no cause could be defined. The commonest causes were urinary tract infection (UTI) (44.3%), and soft tissue infections (11.4%). Frequent causes of fever in the acute stage other than UTI were complications related to the initial trauma and thromboembolic disease (p < 0.05). These results demonstrate the high incidence of fever in patients with SCI...

Research paper thumbnail of Characteristics of motorcycle accident victims treated at a leading rehabilitation center in the south of Brazil

Características das vítimas de acidentes motociclisticos atendidas em um centro de reabilitação d... more Características das vítimas de acidentes motociclisticos atendidas em um centro de reabilitação de referência estadual do sul do Brasil Characteristics of motorcycle accident victims treated at a leading rehabilitation center in the south of Brazil

Research paper thumbnail of Traumatic injury to the spinal cord. Prevalence in Brazilian hospitals

Paraplegia, 1992

Traumatic spinal cord lesions have a worldwide high morbidity and mortality, and in many develope... more Traumatic spinal cord lesions have a worldwide high morbidity and mortality, and in many developed countries the problem has received special attention, based on epidemiological studies. In Brazil these studies have been restricted to institutional data. In 1988 a survey conducted by the Integrated System of Traumatology and Orthopaedics, covering 36 public hospitals from 7 Brazilian capitals, revealed a point prevalence of 8.6% (108 patients) with spinal cord injury, aged from 6-56 years; 81% were men. The most frequent causes were traffic accidents (42%), firearms (27%) and falling from heights (15%). The main complications were pressure ulcers (54%) and urinary infections (32%).

Research paper thumbnail of Development of a grading instrument of functioning for Brazilian citizens: Brazilian Functioning Index - IF-Br

Acta Fisiátrica, 2013

Os sistemas usados no Brasil para definir a incapacidade variam de acordo com o setor. A partir d... more Os sistemas usados no Brasil para definir a incapacidade variam de acordo com o setor. A partir de uma recomendação da Presidência da República, uma força-tarefa interministerial foi organizada em janeiro de 2011 para desenvolver um modelo único de avaliação e classificação da incapacidade a ser usado em todo o país. O grupo de trabalho partiu de uma avaliação ampla de informações biodemográficas das pessoas com deficiência no Brasil obtidas a partir de fontes como o censo populacional, censo escolar, relação anual de informações sociais e pesquisa de informações básicas municipais, bem como grupos focais realizados com representantes de vários estados da federação, diferentes deficiências e faixas etárias. Por meio de reuniões mensais num período de 8 meses, foi escolhido o modelo conceitual da Classificação Internacional de Deficiências, Incapacidades e Saúde como base teórica e partir do qual foram selecionadas as 41 atividades e fatores ambientais que deveriam ser contemplados no em cada uma delas. A pontuação de cada atividade foi definida numa escala de 25 a 100, de acordo com o nível de independência. Ajustes para crianças foram realizados comparando o instrumento ao desenvolvimento esperado para cada faixa etária de acordo com a descrição presente em outros instrumentos. Além da avaliação quantitativa do grau de incapacidade, foi desenvolvida uma avaliação qualitativa seguindo a lógica fuzzy, específica para as deficiências visual, motora, auditiva e intelectual. A definição de notas de corte não foi efetuada e exige estudos futuros.

Research paper thumbnail of Trauma raquimedular em crianças diferenças na etiopatogenia, tratamento e evoluçäo quando comparado com adulto: análise de 160 casos

Arq. bras. neurocir, 1995

Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características di... more Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características diferentes do que ocorre no indivíduo adulto. Estudamos 160 crianças admitidas para tratamento e reabilitaçäo nos últimos 12 anos (1982-1993) no Hospital do ...

Research paper thumbnail of Patient care pathways in spastic paresis and rehabilitation Table 2 : Overview of guidelines for managing spasticity

1. Siskin Spine and Rehabilitation, Chattanooga, Tennessee, USA; 2. Department of Neurorehabilita... more 1. Siskin Spine and Rehabilitation, Chattanooga, Tennessee, USA; 2. Department of Neurorehabilitation Gailtal-Klinik, Hermagor, Austria; 3. Catarinense Center of Rehabilitation, Florianopolis, Brazil; 4. King’s College London and St Thomas’ Hospital London, UK; 5. Division of Movement Disorders, Department of Neurology, Loma Linda University School of Medicine, Loma Linda, California, USA; 6. Department of Neurology, Georgetown University Hospital, Washington DC, USA; 7. Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA; 8. Scientific Research Psychoneurological Institute, St. Petersburg, Russia; 9. Ipsen Pharma, Paris, France; 10. Movement Disorders Center of Arizona, Scottsdale, USA

Research paper thumbnail of Post Hoc Subgroup Analysis of the BCause Study Assessing the Effect of AbobotulinumtoxinA on Post-Stroke Shoulder Pain in Adults

Toxins

Botulinum toxin type A is approved for the focal treatment of spasticity; however, the effectiven... more Botulinum toxin type A is approved for the focal treatment of spasticity; however, the effectiveness of abobotulinumtoxinA (aboBoNT-A) in patients with shoulder pain who have set reduced pain as a treatment goal is understudied. In addition, some patients encounter delays in accessing treatment programs; therefore, the suitability of aboBoNT-A for pain reduction in this population requires investigation. These factors were assessed in aboBoNT-A-naive Brazilian patients in a post hoc analysis of data from BCause, an observational, multicenter, prospective study (NCT02390206). Patients (N = 49, n = 25 female; mean (standard deviation) age of 60.3 (9.1) years; median (range) time since onset of spasticity of 16.1 (0–193) months) received aboBoNT-A injections to shoulder muscles in one or two treatment cycles (n = 47). Using goal attainment scaling (GAS), most patients achieved their goal of shoulder pain reduction after one treatment cycle (72.1%; 95% confidence interval: 57.2–83.4%). ...

Research paper thumbnail of Eficacia dos antidepressivos para dor cronica

Research paper thumbnail of The Effectiveness of Botulinum Toxin Type A (BoNT-A) Treatment in Brazilian Patients with Chronic Post-Stroke Spasticity: Results from the Observational, Multicenter, Prospective BCause Study

Toxins

Botulinum toxin type A (BoNT-A) is an effective treatment for post-stroke spasticity; however, so... more Botulinum toxin type A (BoNT-A) is an effective treatment for post-stroke spasticity; however, some patients cannot access treatment until ≥1 year post-stroke. This Brazilian post-marketing study (NCT02390206) assessed the achievement of person-centered goals in patients with chronic post-stroke spasticity after a BoNT-A injection. Patients had a last documented stroke ≥1 year before study entry and post-stroke upper limb (UL) spasticity, with or without lower limb (LL) spasticity. Patients received BoNT-A injections at baseline (visit 1) and visit 2 (3–6 months). Primary endpoint was responder rate (achievement of primary goal from Goal Attainment Scaling (GAS)) at visit 2. Overall, 204 patients underwent GAS evaluation at visit 2, mean (SD) age was 56.4 (13.2) years and 90.7% had LL spasticity. Median (range) time between first stroke and onset of spasticity was 3.6 (0−349) months, onset of spasticity and first injection was 22.7 (0−350) months and waiting time for a rehabilitatio...

Research paper thumbnail of Spastic Paresis and Rehabilitation – The Patient Journey

European Neurological Review

Spastic paresis is a complex condition associated with damage to the upper motor neurons, typical... more Spastic paresis is a complex condition associated with damage to the upper motor neurons, typically caused by cerebral palsy, multiple sclerosis, stroke or trauma. Despite substantial impact on patients’ independence and burden on caregivers, there is a lack of consensus on optimal management of this condition and the patient journey remains unclear. A group of physicians, experienced in spasticity management, recently convened with the objective of analysing the patient journey from a care pathway perspective in different geographical regions and under different conditions from acute phase to long-term/chronic disease status. The experts reviewed results from recent patient and healthcare practitioner surveys on the subject and assessed how current patient pathways could be improved, using their own experiences to highlight the issues related to management deficiencies in their individual countries. The group divided the patient journey into steps, considering the evidence from the...

Research paper thumbnail of Características das vítimas de acidentes motociclisticos atendidas em um centro de reabilitação de referência estadual do sul do Brasil

Acta Fisiatrica, Sep 1, 2011

Research paper thumbnail of Efficacy of antidepressants for chronic pain

Revista Brasileira De Medicina, May 1, 2003

Research paper thumbnail of Eficácia dos antidepressivos para dor crônica

Rbm Rev Bras Med, May 1, 2003

Research paper thumbnail of Trauma raquimedular em crianças diferenças na etiopatogenia, tratamento e evoluçäo quando comparado com adulto: análise de 160 casos

Arq Bras Neurocir, Sep 1, 1995

Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características di... more Resumo: O traumatismo raquimedular em crianças é uma condiçäo rara e apresenta características diferentes do que ocorre no indivíduo adulto. Estudamos 160 crianças admitidas para tratamento e reabilitaçäo nos últimos 12 anos (1982-1993) no Hospital do ...

Research paper thumbnail of Poster 27 Analyzing the Patient Journey for Patients Living with Spastic Paresis

Research paper thumbnail of Pyrexia in hospitalised spinal cord injury patients

Paraplegia

To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Med... more To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Medicine of the Locomotor System (HMLS/SARAH), a review study was undertaken. For a period of 3 months, all new episodes of fever were recorded. During the study 221.3 patients/month were observed. The age ranged from 14 to 60 years and time of lesion from 1 to 6,264 days: 85 patients were paraplegia or paraparetic, and 44 tetraplegic or tetraparetic. At the beginning of the study 10.8% of the patients had fever. During follow up, we observed a rate of 33.9 new incidences per 100 patients/month. In 77.3% only one cause was identified, and in 8% no cause could be defined. The commonest causes were urinary tract infection (UTI) (44.3%), and soft tissue infections (11.4%). Frequent causes of fever in the acute stage other than UTI were complications related to the initial trauma and thromboembolic disease (p < 0.05). These results demonstrate the high incidence of fever in patients with SCI...

Research paper thumbnail of Pyrexia in hospitalised spinal cord injury patients

Paraplegia, 1993

To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Med... more To discover the frequency of pyrexia in spinal cord injury (SCI) patients in the Hospital for Medicine of the Locomotor System (HMLS/SARAH), a review study was undertaken. For a period of 3 months, all new episodes of fever were recorded. During the study 221.3 patients/month were observed. The age ranged from 14 to 60 years and time of lesion from 1 to 6,264 days: 85 patients were paraplegia or paraparetic, and 44 tetraplegic or tetraparetic. At the beginning of the study 10.8% of the patients had fever. During follow up, we observed a rate of 33.9 new incidences per 100 patients/month. In 77.3% only one cause was identified, and in 8% no cause could be defined. The commonest causes were urinary tract infection (UTI) (44.3%), and soft tissue infections (11.4%). Frequent causes of fever in the acute stage other than UTI were complications related to the initial trauma and thromboembolic disease (p < 0.05). These results demonstrate the high incidence of fever in patients with SCI...

Research paper thumbnail of Characteristics of motorcycle accident victims treated at a leading rehabilitation center in the south of Brazil

Características das vítimas de acidentes motociclisticos atendidas em um centro de reabilitação d... more Características das vítimas de acidentes motociclisticos atendidas em um centro de reabilitação de referência estadual do sul do Brasil Characteristics of motorcycle accident victims treated at a leading rehabilitation center in the south of Brazil

Research paper thumbnail of Traumatic injury to the spinal cord. Prevalence in Brazilian hospitals

Paraplegia, 1992

Traumatic spinal cord lesions have a worldwide high morbidity and mortality, and in many develope... more Traumatic spinal cord lesions have a worldwide high morbidity and mortality, and in many developed countries the problem has received special attention, based on epidemiological studies. In Brazil these studies have been restricted to institutional data. In 1988 a survey conducted by the Integrated System of Traumatology and Orthopaedics, covering 36 public hospitals from 7 Brazilian capitals, revealed a point prevalence of 8.6% (108 patients) with spinal cord injury, aged from 6-56 years; 81% were men. The most frequent causes were traffic accidents (42%), firearms (27%) and falling from heights (15%). The main complications were pressure ulcers (54%) and urinary infections (32%).

Research paper thumbnail of Development of a grading instrument of functioning for Brazilian citizens: Brazilian Functioning Index - IF-Br

Acta Fisiátrica, 2013

Os sistemas usados no Brasil para definir a incapacidade variam de acordo com o setor. A partir d... more Os sistemas usados no Brasil para definir a incapacidade variam de acordo com o setor. A partir de uma recomendação da Presidência da República, uma força-tarefa interministerial foi organizada em janeiro de 2011 para desenvolver um modelo único de avaliação e classificação da incapacidade a ser usado em todo o país. O grupo de trabalho partiu de uma avaliação ampla de informações biodemográficas das pessoas com deficiência no Brasil obtidas a partir de fontes como o censo populacional, censo escolar, relação anual de informações sociais e pesquisa de informações básicas municipais, bem como grupos focais realizados com representantes de vários estados da federação, diferentes deficiências e faixas etárias. Por meio de reuniões mensais num período de 8 meses, foi escolhido o modelo conceitual da Classificação Internacional de Deficiências, Incapacidades e Saúde como base teórica e partir do qual foram selecionadas as 41 atividades e fatores ambientais que deveriam ser contemplados no em cada uma delas. A pontuação de cada atividade foi definida numa escala de 25 a 100, de acordo com o nível de independência. Ajustes para crianças foram realizados comparando o instrumento ao desenvolvimento esperado para cada faixa etária de acordo com a descrição presente em outros instrumentos. Além da avaliação quantitativa do grau de incapacidade, foi desenvolvida uma avaliação qualitativa seguindo a lógica fuzzy, específica para as deficiências visual, motora, auditiva e intelectual. A definição de notas de corte não foi efetuada e exige estudos futuros.