Colitis after polytrauma: case report.

Across the medical literature, delayed diagnosis and treatment leads to more costly and worse outcomes. Rehabilitation patients, especially those with polytrauma, often have a complex mixture of medical, social, and psychological health problems that can impair effective diagnosis and treatment. The case presentation describes the procession toward the diagnosis of ulcerative colitis in a preinjury asymptomatic male, suggesting a potential mechanism for its emergence and describing the effect of delayed diagnosis on the efficiency of rehabilitative care. As such, the differential diagnosis for early posttraumatic diarrhea should remain broad, particularly if unexplained or ineffectively controlled.

Can American Board of Physical Medicine and Rehabilitation Part 2 board examination scores be predicted from rotation evaluations or mock oral examinations?

OBJECTIVE: The aim of this study was to determine whether either Physical Medicine and Rehabilitation residency performance on core competency evaluations or on practice mock oral examinations is correlated to performance on future American Board of Physical Medicine and Rehabilitation Part 2 board-certifying examination. DESIGN: This is a retrospective cohort study of residents who took part 2 of the American Board of Physical Medicine and Rehabilitation certification examination between 1995 and 2011 (N = 31 or 38 or 67). RESULTS: The postgraduate year 4 mock oral examination average achieved significance in correlation analysis (Spearman ρ, 0.0391; P = 0.030). Patient care and a composite average of the other core competencies evaluations were also significantly correlated with performance on part 2 of the board-certifying examination (Spearman ρ, 0.329; P = 0.044). The only independent variable that was uniquely predictive was postgraduate year 4 mock oral examinations (χ = 7.09; P = 0.029). More specifically, when controlling for rotation performances, residents with higher mock oral examination scores were 9.6 times (Exp B = 9.6; 95% confidence interval, 1.2-80; P = 0.036) more likely than those one grade lower to achieve the upper half on oral board examinations vs. either of the lower 2 quartiles. CONCLUSIONS: The postgraduate year 4 mock oral examinations and the core competency evaluations composite are each predictive of performance on American Board of Physical Medicine and Rehabilitation part 2 examination. Further research into this area, with a larger sample size and with multiple institutions, would be helpful to allow for a better measurement of these evaluation tools' effectiveness.

Patient safety in rehabilitation medicine: traumatic brain injury.

This article describes patient safety after traumatic brain injury (TBI). Patient safety in rehabilitation after TBI is important. Thorough assessment on initial evaluation, vigilance for medical and procedural errors, appropriate communication between medical professionals, and evaluation of systems-based practices increases patient safety. It is the responsibility of the rehabilitation treatment team to ensure that appropriate measures are taken to reduce risk of adverse events. This article is intended to promote discussion of patient safety after TBI within rehabilitation teams and to help improve outcomes throughout the spectrum of recovery.

Rehabilitation of injured U.S. servicemember with traumatic brain injury, stroke, spinal cord injury, and bilateral amputations: a case report.

The complexity of injuries that can arise from combat situations, specifically as a result of the Operation Iraqi Freedom/Operation Enduring Freedom conflicts, is challenging. As injured troops leave the war zone early for medical care, they are treated by an interwoven system of care that includes both the Department of Defense and Veterans Health Administration. Physicians across these settings are increasingly faced with patients who have multiple rehabilitation diagnoses as a result of the severity of blast injuries; therefore, the importance of active communication across the system must be highlighted. This case describes the seamless transition of an injured soldier across the continuum of care.