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Biomedical subjects

L J Enloe

Publications and source records attributed to L J Enloe.

12 recordsLinked to original sources
PubMed1999

Health related quality of life in patients with total hip or knee replacement.

OBJECTIVE: The Quality of Well Being index (QWB) and the SF-36 are questionnaires that have received widespread use in outcomes research. The relationship between the QWB index and the SF-36 was studied in patients receiving total hip or knee replacement because of primary osteoarthritis, and the health status of these individuals was contrasted to that of the general population. DESIGN: The QWB and SF-36 were both administered preoperatively and postoperatively and at 3 and 6 months in individuals with hip or knee replacement. SETTING: A primary care university teaching hospital. PATIENTS: Forty-three subjects with an age range of 30 to 78 years (mean 58 yrs, SD 10.6) who received total joint replacement, either hip or knee. RESULTS: The change in the QWB at 3 and 6 months after a total hip replacement or total knee replacement was most associated with the change in general health (.50), bodily pain (.72), and vitality (.62) of the SF-36. Both tools (QWB, SF-36) demonstrated similar levels of responsiveness and the scores were lower than the scores from the general population. CONCLUSION: The summary score of the QWB and various health concepts of the SF-36 respond similarly after joint replacement from osteoarthritis. The relationship between the change in the QWB and SF-36 depends on the time after surgery (3 vs. 6 months) and the type of joint replacement (knee vs. hip).

Adult↗
PubMed1997

Evaluation of health-related quality of life in individuals with vestibular disease using disease-specific and general outcome measures.

BACKGROUND AND PURPOSE: The Dizziness Handicap Inventory (DHI) is a condition-specific health status measure for persons with vestibular disease, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) is a generic health status assessment. The purposes of this study were (1) to describe the relationship between the DHI and the SF-36, (2) to examine the reliability and responsiveness of these measures for persons in a vestibular rehabilitation program, and (3) to compare health-related quality of life between individuals with vestibular disease and the general population. SUBJECTS: Ninety-five patients, aged 25 to 88 years (mean = 57.0, SD = 14.9), were assessed. METHODS: To determine reliability, 20 subjects completed both questionnaires twice, 24 to 48 hours apart. Thirty-one subjects completed both questionnaires before and after 6 to 8 weeks of vestibular rehabilitation to establish responsiveness. To establish the relationship between the two assessment tools, 95 subjects completed both questionnaires. RESULTS: Each test was moderately to highly reliable (intraclass correlation coefficients [2, 1] = .64-.95), but the tests were poorly to moderately correlated to each other (r = .11-.71). The DHI was more responsive to change than the SF-36. The SF-36 scores of individuals were lower than scores of the general population. CONCLUSION AND DISCUSSION: The DHI and the SF-36 provide reliable and responsive measurements, but they appear to provide different information about the health status of patients with vestibular disease. Compared with the general population, patients with vestibular disease had lower scores for health-related quality of life, but these scores improved after 6 to 8 weeks of treatment. Future studies should clarify whether this improved health status is due to vestibular rehabilitation.

Activities of Daily Living↗
PubMed1996

Total hip and knee replacement treatment programs: a report using consensus.

Physical therapists may use varied treatment protocols for the acute care of patients with to hip or knee replacements. The purpose of this study was to develop, via consensus, a standardized treatment program for patients receiving total hip or knee replacement for primary osteoarthritis. Eighteen clinicians nationwide participated in a three-round consensus process. In Round 1, over 80% of the panel identified exercise, transfers, ambulation, and discharge criteria as the important treatment categories. In Round 2, they reviewed the preliminary physical therapy treatment program and recommended additional exercise regimes. In Round 3, 76% of the panel accepted the final total hip replacement program while 70% of the panel accepted the total knee replacement program. Using the consensus development process, physical therapists may begin to define their treatment programs which is fundamental to establishing a baseline standard of care.

Hip Prosthesis↗
PubMed1995

Reliability, validity, and responsiveness of functional tests in patients with total joint replacement.

BACKGROUND AND PURPOSE: High-quality measurements are needed to develop meaningful clinical practice databases to assess the effectiveness of physical therapy. This study determined the reliability, validity, and responsiveness of measurements obtained with five functional tests graded with the newly developed Iowa Level of Assistance Scale. SUBJECTS AND METHODS: Eighty-six patients with total hip or knee replacements were tested at various time periods during their hospitalization. Patients were tested for five functional activities by four therapists to establish the reliability and test responsiveness. The Harris Hip Rating Scale was administered to assess the validity of the functional score. RESULTS: The weighted Kappa statistic supported good intratester (K = .79-.90) and moderate intertester (K = .48-.78) reliability. The correlation between the Harris Hip Rating Scale scores and the total functional scores was high (r = -.86). The total functional score was responsive to 4 days of therapy postoperatively. CONCLUSION AND DISCUSSION: The assessment of function using the Iowa Level of Assistance Scale was shown to be highly reliable, valid, and responsive in patients following total hip or knee replacements.

Activities of Daily Living↗
PubMed1989

Neurotensin(8-13): comparison of novel analogs for stimulation of cyclic GMP formation in neuroblastoma clone N1E-115 and receptor binding to human brain and intact N1E-115 cells.

Neurotensin(8-13), the carboxyl-terminal portion of neurotensin, is 4-50 times more potent than native neurotensin in binding to intact neuroblastoma N1E-115 cells and human brain tissue and in stimulation of intracellular cyclic GMP production and inositol phospholipid hydrolysis in clone N1E-115 (Gilbert JA and Richelson E, Eur J Pharmacol 99: 245-246, 1984; Gilbert JA et al., Biochem Pharmacol 35: 391-397, 1986; Kanba KS et al., J Neurochem 46: 946-952, 1986; and Kanba KS and Richelson E, Biochem Pharmacol 36: 869-874, 1987). A series of novel analogs of neurotensin (8-13) was synthesized, and a structure-activity study was done comparing the abilities of these peptides to stimulate intracellular cyclic GMP production in intact neuroblastoma clone N1E-115 and to inhibit the binding of [3H]neurotensin to these cells and to membranal preparations from human brain. A direct correlation was found for each analog between its EC50 for biochemical activity and its KD for binding ability in studies with clone N1E-115. Furthermore, a strong correlation existed for each peptide between its KD for binding to neurotensin receptors on these cells and its KD for binding to neurotensin receptors in human brain tissue. In this study, the residues that were important to the biochemical and binding activities of neurotensin (8-13) proved to be identical to the amino acids that are necessary for the functional integrity of native neurotensin (Gilbert JA et al., Biochem Pharmacol 35: 391-397, 1986.

Brain↗
PubMed1988

Popliteal artery injury complicating arthroscopic menisectomy.

Inadvertent popliteal artery injury during arthroscopic menisectomy is an unusual occurrence. Prompt diagnosis and treatment are essential to achieve a good outcome, as illustrated in two of the five patients described herein. Pitfalls in diagnosis led to late recognition and therapy in three patients, with subsequent serious complications; namely, arteriovenous fistula, false aneurysm, and amputation. On the basis of this limited but poignant experience, we propose an outline of steps in management to help others avoid similar problems. If popliteal injury is suspected, we advise exploration immediately to avoid a potential limb-loss crisis. Heparin should be given as soon as diagnosis is made. A posterior incision in the knee crease, rather than the conventional medial approach, gives expedient exposure for precise repair. We also advise passing a no. 3 thrombectomy catheter distally to rule out or retrieve any clot that may have embolized. A completion angiogram is also helpful. Compartment pressure may be measured, but if any doubt exists, a three-compartment fasciotomy should be performed.

Amputation, Surgical↗
PubMed1976

Effects of successive unilateral ablations of principalis cortex upon performances of delayed alternation and delayed response by monkeys.

Monkeys were trained on delayed alternation (DA), and were then subjected to serial unilateral or simultaneous bilateral ablations of the banks of the sulcus principalis of each frontal lobe. When subjects with unilateral lesions were retrained on DA, their performances were intermediate to those of normal and bilateral animals. This interoperative training failed to protect the serially operated monkeys from losses of DA following their second-stage ablations, for they then performed as poorly as one-stage subjects and subjects prepared with serial ablations that were not given practice on the task between the two operations. Additional postoperative tests of delayed responding (DR) showed that both serially and simultaneously ablated subjects also had severe impairments of performance of DR. This result confirmed, in principle, a finding that monkeys with large unilateral ablations, if reoperated after many months for the removal of the contralateral dorsolateral perfrontal cortex, will thereafter exhibit DR deficits that are both severe and endure for a period of years. It contrasted sharply with a recent observation that DR is retained by monkeys subjected to two-stage symmetrical ablations of the principalis cortex, which suggests that recoveries of frontal-lobe functions are powerfully affected by the orders in which serial extirpations are performed.

Animals↗
PubMed1975

Extralimbic mediation of emotionality and social cohesiveness effects.

Long-Evans hooded rats were tested for emotionality and observed by pairs in an open field for 6 consecutive days. Postoperative observations indicated that both emotionality and social cohesiveness were dramatically altered by ventromedial and anterolateral hypothalamic lesions. Tegmental, interpeduncular and habenular lesions were shown to have no effect on these behaviors. Alterations in behavior observed following hypothalamic ablations were related to septal and amygdaloid effects, and the possibility of separate projection systems for emotionality and social cohesiveness was discussed.

Amygdala↗