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Biomedical subjects

M Lachman

Publications and source records attributed to M Lachman.

At least 19 recordsLinked to original sources
PubMed1999

Exercise--it's never too late: the strong-for-life program.

OBJECTIVES: This investigation determined whether an in-home resistance training program achieved health benefits in older adults with disabilities. METHODS: A randomized controlled trial compared the effects of assigning 215 older persons to either a home-based resistance exercise training group or a waiting list control group. Assessments were conducted at baseline and at 3 and 6 months following randomization. The program consisted of videotaped exercise routines performed with elastic bands of varying thickness. RESULTS: High rates of exercise adherence were achieved, with 89% of the recommended exercise sessions performed over 6 months. Relative to controls, subjects who participated in the program achieved statistically significant lower extremity strength improvements of 6% to 12%, a 20% improvement in tandem gait, and a 15% to 18% reduction in physical and overall disability at the 6-month follow-up. No adverse health effects were encountered. CONCLUSIONS: These findings provide important evidence that home-based resistance exercise programs designed for older persons with disabilities hold promise as an effective public health strategy.

Aged↗
PubMed1998

A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults.

A randomized, single-blind controlled trial was conducted to test the efficacy of a community-based group intervention to reduce fear of falling and associated restrictions in activity levels among older adults. A sample of 434 persons age 60+ years, who reported fear of falling and associated activity restriction, was recruited from 40 senior housing sites in the Boston metropolitan area. Data were collected at baseline, and at 6-week, 6-month, and 12-month follow-ups. Compared with contact control subjects, intervention subjects reported increased levels of intended activity (p < .05) and greater mobility control (p < .05) immediately after the intervention. Effects at 12 months included improved social function (p < .05) and mobility range (p < .05). The intervention had immediate but modest beneficial effects that diminished over time in the setting with no booster intervention.

Accidental Falls↗
PubMed1998

Home-based resistance training: predictors of participation and adherence.

This study identified factors associated with exercise participation and adherence in a sample of 102 sedentary, functionally limited, community-dwelling adults aged 60 to 94 years who participated in a home-based resistance training program. Stepwise regression analyses revealed that baseline physical factors (i.e., higher levels of mobility, weaker muscle strength, and fewer numbers of new medical conditions) were associated with higher rates of participation in the home program. Positive attitudes and a sense of control toward exercise, lower levels of confusion and depressive moods, and the development of fewer new medical problems during the program were related to higher levels of adherence to the program. Findings revealed that although physical health variables were the primary indicators of an older person's overall participation in the program, it was the psychological factors that were most important to adherence to this home-based program.

Aged↗
PubMed1998

[Microsurgery and micromanipulation in the treatment of male infertility: results of a one-year investigation].

A one-year study of 51 infertile couples, 47 couples evaluated--25 cases of testicular azoospermia and 22 cases of obstructive azoospermia. The mean age of the men in the group is 33 years (22-48 years). The follow-up period is 1-18 months. In 17 instances microsurgical epididymal sperm aspiration--MESA was made, five times testicular sperm aspiration--TESA and in 25 men testicular sperm extraction--TESE was used. In the group with testicular azoospermia it proved possible to obtain sperm in 12/25 cases, i.e. in 48%. In men with obstructive azoospermia all aspirations were successful, i.e. the yield was 100%. In this group five infants were born, another seven pregnancies are under way. Thus regardless of the etiology of male infertility 12/47 cases, i.e. 25.5%, were successfully resolved. When using differentiated evaluation of the two groups the results are as follows: in the group with testicular azoospermia one infant were born and five pregnancies are under way, i.e. 40.9%.

Adult↗
PubMed1998

[MESA, TESA, TESE + ICSI: results of the first 50 cases].

During the period between February 1996 and August 1997 51 infertile men were operated. The authors evaluate the results from 47 couples--25 cases of testicular azoospermia and 22 cases of obstructive azoospermia. The mean age of the men in the group was 33 years (22-48 years). The follow-up period is 1-18 months. In 17 cases, microsurgical epididymal sperm aspiration (MESA) was made, in five cases testicular sperm aspiration (TESA) and in 25 men, testicular sperm extraction (TESE) was performed. In the group with testicular azoospermia it proved possible to obtain sperm in 12 of 25 cases, i.e. in 48%. In men with obstructive azoospermia all aspirations were successful, i.e. the yield was 100%. In this group five children were born, seven pregnancies are under way. Thus regardless of the etiology of male infertility 12 of 47 cases, i.e. 25.5% were resolved successfully. When the results of the two groups are differentiated, the outcome is as follows: in the group with testicular azoospermia one child was born and two pregnancies are under way, i.e. 12%, in the group with obstructive azoospermia four children were born and five pregnancies are under way, i.e. 40.9%.

Adult↗
PubMed1996

The development of coping resources in adulthood.

We examined three community samples to determine whether stressful episodes form a context for the development of coping resources in adulthood. The first study found that 81.9% of a sample of 845 older men reported drawing upon prior experiences in coping with a recent problem. Content analysis revealed that only 22.7% drew upon similar stressful episodes; the rest drew upon problems from work, the military, illnesses, deaths, etc. The second study replicated the earlier findings in 102 men and women, ages 24 to 84, who reported on a recent low point in semistructured interviews. In addition, 75% reported long-term effects, equally split between negative, positive, and mixed effects. Those individuals who perceived advantages from the low point were significantly more likely to report positive long-term effects. The third study replicated the findings from the first two studies in a sample of 941 men and women ages 23 to 62. Path analyses showed that coping strategies differentially predicted perceived positive or negative outcomes, which in turn predicted current mastery and depression levels. While the findings are cross-sectional and causality cannot be inferred, they are nonetheless supportive of the effects of stress and coping on personality.

Adaptation, Psychological↗
PubMed1993

Evaluation of SHBG test for disclosure of insensitivity to androgens.

A laboratory test enabling to reveal and confirm the suspicion on the insensitivity to androgens was evaluated. The test consisted of determination of the decline in plasma level of sex hormone binding globulin (SHBG) on the 7th day after administration of a single dose of testosterone preparation (Testoviron Depot 100, Schering, 2 mg/kg body weight). The upper limit of percentual SHBG decline, below which the patients can be considered normal responders (i.e. subjects without insensitivity to androgens), obtained from the follow up of the time course of SHBG changes after Testoviron application to 6 healthy men, was established as 83.6%. The level of percentual SHBG decline, above which the patients were considered non-responders with impaired peripheral sensitivity to androgens was assessed from the imprecision of immunoradiometric determination of SHBG and amounted 91.9%. The test was used and evaluated in 26 patients with 46 XY karyotype, representing various cases of intersex, gonadal dysgenesis and male hypogonadism, out of which four subjects with clinically confirmed impaired peripheral sensitivity to androgens were discovered. The test however, appeared not to be reliable in cases of very low basal SHBG levels, i.e. below 15 nmol/l.

Adolescent↗
PubMed1992

Serum levels of steroid hormones in men with varicocele and oligospermia as compared to normozoospermic men.

In order to assess the contribution of individual steroidogenic organs to over-all steroid biosynthesis, the basal plasma levels of six hormonal steroids, reflecting the function of gonads and adrenals, as well as both gonadotropins and prolactin, have been determined in 63 oligo- and/or asthenozoospermic men with palpable varicocele, confirmed in each case by sonography. The values obtained were compared with the results of a group of age-matched normospermic men without endocrine disorders. Insignificantly lower levels of testosterone accompanied by significantly lower levels of dihydrotestosterone, slightly decreased LH but increased FSH undistinguishable concentrations of cortisol in patients with varicocele were in agreement with previous findings. Higher levels of an exclusively adrenal androgen 11 beta-hydroxyandrostenedione in men with varicocele indicate increased activity of the adrenal cortex. Significantly higher basal levels of 17 alpha-hydroxyprogesterone in the patient group (p < 0.001), so far not unequivocally proved, evidence for suggested decreased enzyme activity of C17-20 lyase in the testis in at least some of men with varicocele.

17-alpha-Hydroxyprogesterone↗
PubMed1992

[A laboratory test for the detection of androgen resistance using sex hormone-binding globulin].

A simple laboratory test for disclosure of peripheral androgen insensitivity has been suggested. The test is based on determination of sex hormone-binding globulin (SHBG) following single administration of testosterone preparation (Testoviron Depot, Schering, 2 mg/kg of body weight). The kinetics of SHBG response to exogenous testosterone was investigated first in a group of 5 healthy male volunteers. The highest highly significant decrease of SHBG level occurred 7th day after drug administration. The method of choice for SHBG determination is an immunoradiometric assay (IRMA). The test was used for a group of 15 children and young people suspected for androgen sensitivity disorder. In all cases, besides SHBG on days 0 and 7 testosterone, dihydrotestosterone and LH were measured, too. In three instances the response was negative: in the case of male Turner syndrome, with very low basal SHBG levels, in one case of confirmed diagnosis of testicular feminization and in the third case of suspected testicular feminization, which has not yet been concluded. In all other patients a significant decrease (in average to 62.8% of the basal level) was in agreement with clinical findings.

Adolescent↗
PubMed1991

Recidivous offence in sadistic homosexual pedophile with karyotype 48, XXXY after testicular pulpectomy. A case report.

The case of recidivous sexual offender with genetically caused mental retardation and primary hypogonadism (Klinefelter's syndrome with karyotype 48, XXXY) is described. He was examined after sadistic abuse of a boy aged 13 that he had committed 19 years after performed testicular pulpectomy. Plasmatic level of testosterone was found 4x higher than mean level in men after orchidectomy. Histological examination of residual scrotal tissues proved that the source of androgens were hyperplastic nodules of extratesticular Leydig cells.

Biopsy↗