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Biomedical subjects

A Macaluso

Publications and source records attributed to A Macaluso.

At least 19 recordsLinked to original sources

Control of head stability during gait initiation in young and older women.

Transition tasks between static and dynamic situations may challenge head stabilization and balance in older individuals. The study was designed to investigate differences between young and older women in the upper body motion during the voluntary task of gait initiation. Seven young (25+/-2.3 years) and seven older healthy women (78+/-3.4 years) were required to stand on a force platform and initiate walking at their self-selected preferred speed. Angles of head, neck and trunk were measured by motion analysis in the sagittal plane and a cross-correlation analysis was performed on segments pairs. Variability of head and neck angular displacements, as indicated by average standard deviation, was significantly greater in the older than in the young participants. The young women maintained dynamic stability of the upper body, as forward flexion of the trunk was consistently counteracted by coordinated head-neck extension. Differently, movement patterns employed by the older women also included a rigid motion of all upper body segments leaning forward as a single unit. These results demonstrated that older women perform the transition from standing to walking with greater variability in the patterns of upper body motion compared to young women.

Adult↗

Waterborne gastroenteritis outbreak in Albania.

Three different studies are reported concerning the environmental pollution caused by viruses in Albania. The first study describes an outbreak of gastroenteritis in the capital city, involving 2,722 children attending the Paediatric Unit of Tirana Hospital. The age group with the highest morbidity was 0-5 years, with 89.5%; no fatalities were recorded during the outbreak. Rotavirus was detected in 26/28 faecal samples by RT-PCR, although astrovirus, adenovirus and calicivirus were also present. The second study describes an outbreak of hepatitis A virus involving the city of Lac. Two hundred cases were recorded, with the highest incidence in the age-group 5-9 years. Phylogenetic analysis of the VP1/2A region showed the presence of a unique sequence: genotype IA. Rotavirus was identified in drinking-water samples collected during the outbreak. The third study describes the prevalence of HAV and HEV in 202 sera randomly collected from 12 different cities in Albania. HAV showed a high incidence (66.2%), whereas none was positive for HEV. The genomic analysis of the VP1/2A junction revealed the presence of only one genotype (IA) with few point mutations and just two amino acid substitutions at codons 22 and 34. Additionally, two potential antigenic variants were detected, the first at position 46 of VP3 and the second at position 23 of VP1.

Adolescent↗

Time-resolved X-ray powder diffraction on a three-way catalyst at the GILDA beamline.

Time-resolved X-ray diffraction experiments carried out at the beamline BM08-GILDA of ESRF allowed a study of the structural modifications taking place in a Pt/ceria-zirconia catalyst while the CO oxidation reaction was in progress. The capillary tube in which the sample is stored acts effectively as a chemical microreactor that ensures homogeneity of the sample treatments and minimization of diffusion effects. During the flowing of the reactant CO/He mixture, the investigated catalyst undergoes a fast Ce(IV)-Ce(III) partial reduction that involves the release of one O atom for every two reduced Ce cations. Because Ce(III) has a larger ionic radius than Ce(IV), the structural modification produces an increase of the lattice constant of the ceria-zirconia mixed oxide, and this increase is monitored by the translating imaging-plate device implemented at GILDA. The CO(2) resulting from the oxidation of the fluxed CO is monitored by a quadrupole mass spectrometer during the recording of the time-resolved X-ray diffraction pattern. The chemical and structural information was combined to show that the CO(2) yield is nearly constant until the catalytic system can provide oxygen for the reaction, while the structural rearrangement of the catalyst is delayed with respect to the switching on of the CO/He flux. After this induction time, during which CO(2) is produced with no structural modification of the catalyst, a fast increase of the lattice constant takes place.

Journal Article↗

Is the coactivation of biceps femoris during isometric knee extension affected by adiposity in healthy young humans?

This study aimed to verify if the level of biceps femoris antagonist activity measured during isometric knee extension was affected by the individual degree of adiposity in 14 young healthy subjects of both genders aged between 18 and 24. Surface EMG signals were recorded from the biceps femoris muscle of the dominant leg during isometric knee extension at three levels of voluntary contraction: maximum (MVC), 80% MVC and 200 N, respectively. In addition, whole-body percentage of fat, volume of the thigh and skinfold thickness below the electrodes were achieved. Biceps femoris coactivation values were: 28.5 +/- 17.9%, 30.9 +/- 17.7% and 25.3 +/- 17.5% for MVC, 80% MVC and 200 N trials, respectively (NS). Neither the whole-body percentage of fat nor the skinfold thickness influenced percentage coactivation, irrespective of the intensity of contraction. However, an increase in the whole-body percentage of fat showed a tendency to augment the biceps femoris coactivation (P(I)=0.079; P(II)=0.575). No differences in coactivation were observed between genders. In addition, the duration of contraction did not affect the level of coactivation.

Adipose Tissue↗

Electromyogram changes during sustained contraction after resistance training in women in their 3rd and 8th decades.

The present study aimed at investigating the neuromuscular adaptations to 6 weeks of resistance training in women in their third (6 experimental, 8 controls) and eighth decades (8 experimental, 8 controls). The surface electromyogram (sEMG) was measured from the biceps brachii muscle during constant-force isometric contractions lasting 12 s at 80% of maximal voluntary contraction (MVC). All the signals were analysed adopting in the time domain the root mean square (RMS) as a measure of amplitude and in the frequency domain the median frequency (MDF) of the power spectrum. Quantitative analysis was performed from the 3rd to the 6th second, to describe the early phase of the contraction ("Early"), starting from point at which 80% of the MVC was reached, and from the 9th to the 12th second, to describe the last part of the constant-force sustained contraction ("Late"). After training, the MVC increased by 22.4% in the young (P < 0.0001) and by 13.4% in the older (P < 0.05) women. The "Early" RMS increased by 60.4% with respect to the pre-training condition in the young (P < 0.01) but not in the older women. In contrast, the "Late" RMS increased by 46.7% in the older (P < 0.05) but not in the young women. The MDF remained unchanged in both groups. These results indicate that young and older women showed different training-induced adaptation of the motor unit (MU) activation pattern, in order to keep a constant level of force during a sustained isometric contraction at 80% of MVC.

Adolescent↗

Cost of walking and locomotor impairment.

The aim of the present study was to evaluate the importance and the necessity of metabolic measurements to quantify locomotor impairment in a clinical context. Oxygen consumption, heart rate, pulmonary ventilation and walking speed were measured during locomotion in 14 normal subjects, used as a control group, and 82 patients with different pathologies [hemiparetic, paraparetic, tetraparetic, orthopaedic and paraplegic patients, who walked using a reciprocating gait orthosis (RGO)]. The subjects were characterized on the basis of a cumulative impairment score (CIS), based on clinical scales commonly used to evaluate impairment and disability in locomotion. Appropriate indices of energy, cardiac and ventilatory costs expressed per metre walked, globally called physiological costs, were obtained. It resulted that the most comfortable speed (MCS) of normal subjects was significantly higher than that of each group of patients. Normal subjects' physiological costs were found to be significantly lower than those of patients who needed either a device or the help of a person to walk. All measured parameters correlated significantly with each other. The MCS was found to be the most correlated parameter with the CIS (r = 0.8), and therefore it must be considered the best single measurement, if only one is to be used. Measurements more precise than MCS, such as the physiological costs, may be necessary in clinical trials.

Adult↗

Ambulation training of neurological patients on the treadmill with a new Walking Assistance and Rehabilitation Device (WARD).

STUDY DESIGN: Patients with neurological walking impairment were rehabilitated with a new system, consisting of an apparatus to constantly relieve the body weight and a treadmill: The Walking Assistance and Rehabilitation Device (WARD). Patients were evaluated before and after rehabilitation with clinical scales and physiological measurements. OBJECTIVES: To evaluate the effectiveness of the WARD in improving walking capability in these patients. SETTING: The study was carried out in a clinical environment (IRCCS S. Lucia, Rehabilitation Hospital, Rome, Italy). METHODS: Seven patients (six with spinal cord injuries, one with brain injury) underwent a 1 - 2 month training period with the WARD. During the WARD training the body weight constant unloading (BWCU) applied to the patient through the WARD was regularly evaluated. Oxygen consumption, carbon dioxide production and heart rate were measured in order to obtain energy and cardiac costs of walking. These measurements were carried out while walking with the WARD at an appropriate treadmill speed (ATS) and in the open field at the most comfortable speed (MCS). All measurements, in addition to clinical scores related to the walking capability, were carried out at the beginning of the WARD training period (BWT) and at the end (EWT). At the EWT the patients were tested walking with the WARD observing the same BWT conditions (same ATS and BWCU), referred to as beginning conditions second measurements (BCSM). The relationships between physiological costs and ATS were described through second order polynomial regression curves and studied. RESULTS: Comparing the data obtained at the BWT and EWT, the following results were found significantly different: (1) Clinical scores improved; (2) All patients increased their ATS; (3) The BWCU was reduced; (4) The Walking Energy Cost (WEC) and the Walking Cardiac Cost (WCC) measured when walking with the WARD at the ATS improved in all patients; and (5) The WEC and WCC measured in the open field improved in all patients. The WEC vs ATS curve found at the EWT in the BCSM was found significantly different from the BWT curve, demonstrating a major improvement due to the WARD training. CONCLUSION: Despite some limitations due to sample size and functional ambulation scale, this study has demonstrated that the WARD training is effective in improving the walking capability and efficiency of the patients.

Adult↗

Determinants of maximal instantaneous muscle power in women aged 50-75 years.

The present study aimed at analysing the age-related decline in maximal muscle power (W) in 52 sedentary healthy women aged between 50 and 75 years to determine whether force or velocity is the major determinant. Maximal muscle power was estimated from two types of vertical jumps, squatting (SJ) and countermovement (CmJ), performed on a force platform. It was obtained by measuring the vertical force (F(opt)) applied to the body centre of gravity and calculating the corresponding vertical velocity (v(opt)). An age-related decline in absolute W was statistically significant in all the conditions examined and in both peak W and average power (W) values. The decrease in v(opt) was also statistically significant. Also F(opt) declined but this reduction was not statistically significant with the exception of the average value in CmJ. Not surprisingly the highest W were obtained in CmJ, and the difference in power production between the two types of jump showed an age-related decrement only in W. The main finding of the study was the demonstration that v(opt) was the critical determinant of the age-related decline in W in healthy elderly women.

Aged↗

Streptococcus sanguis bacteremia and colorectal cancer.

Streptococcal bacteremia is an uncommon presentation for colorectal malignancy, yet most physicians are aware of the association between Streptococcus bovis infection and these malignancies. Many are unaware, however, that other streptococcal species are associated with colon and rectal cancers. In this case report and brief review, we highlight this association and discuss a case of Streptococcus sanguis bacteremia associated with an early invasive rectal cancer.

Adenocarcinoma↗

[Long-term central venous access. Our experience].

Prolonged venous access devices (PVAD) represent a useful tool for many patients with chronic diseases. In the last 3 years 50 PVAD have been placed. Polyurethane catheters with a subcutaneous tunnel > 6 cm, have been used. There were no complications related to catheter insertion. The average life of PVAD was 95 days (range 7-425).

Aged↗

Rehabilitation of walking for paraplegic patients by means of a treadmill.

The present study was aimed at investigating the use of a treadmill for ambulation training of paraplegic subjects. To investigate the likely effectiveness of this modality of rehabilitation, six paraplegic patients (three male and three female) were studied, using new generation reciprocating gait orthoses (RGO and ARGO), in a treadmill training program. Oxygen consumption, heart rate, and pulmonary ventilation were measured when the subjects were walking at their most comfortable speed on the treadmill and on the open field. These measurements were carried out at the beginning of the study and after two and six months of treadmill training. The following findings were significant: the treadmill walking required 30% less energy than open field ambulation prior to training (P < 0.001) and 50% after training (P < 0.05). The most comfortable walking speed was faster on the treadmill than on the open field by 18% prior to training (P < 0.05) and 42% afterwards (P < 0.05). The energy cost was 50% less after 2 months training on the treadmill (P < 0.05) showing that treadmill training can improve the efficiency of over ground ambulation. It can be concluded that the treadmill training improves the RGO/ARGO walking capability, probably both the walking efficiency (short term adaptation) and physical fitness (long term adaptation).

Adult↗

[Diverticula of the right colon. The diagnosis and treatment of complications].

BACKGROUND: Diverticula are localized in the right colon with a rate of 6.7-14% in Western countries. Two types of diverticula have been described in the right colon, on the basis of etiologic and pathological features: multiple diverticula and solitary diverticulum of the caecum. The most common clinical presentation of the right-sided colonic diverticula is an acute inflammatory complication, which is difficult to distinguish from other causes of right iliac fossa pain. METHODS: A survey of the literature is presented and personal experience relative to 4 cases of acute diverticulitis of the right colon observed over a 10-year period is described. RESULTS: In all the patients the preoperative diagnosis was acute appendicitis. In two cases the poor clinical conditions of the patients were associated with the free perforation of a solitary caecal diverticulum and diffuse faecal peritonitis. A temporary caecostomy was therefore required. In two cases a localized inflammatory mass was found around a perforated solitary diverticulum of the caecum. An ileocaecal resection was performed. CONCLUSIONS: The purpose of this study is to emphasize the epidemiological, etiologic and clinical features of right-sided colonic diverticula, and the diagnostic and therapeutic management of their complications.

Acute Disease↗

Dexamethasone adjunctive therapy for bacterial meningitis in children: a retrospective study in Brazil.

The clinical records of 87 children with bacterial meningitis treated with antibiotics (group 1) and of 92 treated with antibiotics plus dexamethasone (group 2), admitted to the Instituto Materno Infantil de Pernambuco, Recife, Brazil over 2 consecutive years (1991 and 1992), were analysed. There were no significant differences between treatment groups regarding characteristics on admission except that group 1 were younger. The overall case fatality rate was 19%, with 14% in group 2 and 24% in group 1 (p = 0.09). Rate of discharge without sequelae was 70% in the steroid-treated children and 56% in children treated with antibiotics alone (p = 0.07). Among children aged 6-59 months, those treated with dexamethasone compared with those treated with antibiotics alone had a better case fatality rate (11% vs 25%; p = 0.05) and a better rate of discharge without sequelae (73% vs 52%; p = 0.02). Among the cases with a CSF culture positive for Haemophilus influenzae, 77% were discharged without sequelae in group 2 compared with 51% in group 1 (p = 0.03). The addition of dexamethasone to standard antibiotic treatment improves the outcome of children between 6 and 59 months of age admitted to hospital with a diagnosis of bacterial meningitis.

Adolescent↗

Ergonomy of paraplegic patients working with a reciprocating gait orthosis.

A reciprocating gait orthosis (RGO) is, among others, the most widely adopted device to restore the standing and walking capability of paraplegic patients. The aim of the present study was the evaluation of the energy demand (VO2), and cardiopulmonary load (HR and VE) imposed on the subject by different working tasks while sitting in a wheelchair or standing using a RGO. In addition, a comparison with the performance of normal subjects was also attempted. The RGO use allowed a dramatic improvement of patients' mobility and reach space in the workplace. A further advantage provided by the use of the RGO was represented by the increased mobility of the subjects with respect to the wheelchair confined situation. The energy demand and the cardiorespiratory load imposed on the subjects by the use of the RGO were not different from those observed both in the same subjects sitting in a wheelchair and in the controls. The energy demand slightly exceeded the values typical of light work and was, thus, compatible with the normal duration of a working day. On the other hand, the cardiac load corresponded to that typical of moderate activity, thus limiting the duration of the working task to 5-8 h. Based on the ergometry test, all of the working activities considered can be classified as aerobic activities, energy demand being under the ventilatory threshold.

Adult↗