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At least 469 records · Page 26Linked to original sources

PubMed2005

Sensori-motor adaptation to knee osteoarthritis during stepping-down before and after total knee replacement.

BACKGROUND: Stepping-down is preceded by a shift of the center of mass towards the supporting side and forward. The ability to control both balance and lower limb movement was investigated in knee osteoarthritis patients before and after surgery. It was hypothesized that pain rather than knee joint mobility affects the coordination between balance and movement control. METHODS: The experiment was performed with 25 adult individuals. Eleven were osteoarthritic patients with damage restricted to one lower limb (8 right leg and 3 left leg). Subjects were recruited within two weeks before total knee replacement by the same orthopedic surgeon using the same prosthesis and technics of surgery. Osteoarthritic patients were tested before total knee replacement (pre-surgery session) and then, 9 of the 11 patients were tested one year after the surgery when re-educative training was completed (post-surgery session). 14 adult individuals (men: n = 7 and women: n = 7) were tested as the control group. RESULTS: The way in which the center of mass shift forward and toward the supporting side is initiated (timing and amplitude) did not vary within patients before and after surgery. In addition knee joint range of motion of the leading leg remained close to normal before and after surgery. However, the relative timing between both postural and movement phases was modified for the osteoarthritis supporting leg (unusual strategy for stepping-down) before surgery. The "coordinated" control of balance and movement turned to be a "sequential" mode of control; once the body weight transfer has been completed, the movement onset is triggered. This strategy could be aimed at shortening the duration-time supporting on the painful limb. However no such compensatory response was observed. CONCLUSION: The change in the strategy used when supporting on the arthritis and painful limb could result from the action of nociceptors that lead to increased proprioceptor thresholds, thus gating the proprioceptive inputs that may be the critical afferents in controlling the timing of the coordination between balance and movement initiation control.

Adaptation, Physiological↗

PubMed2005

Stepping stability: effects of sensory perturbation.

BACKGROUND: Few tools exist for quantifying locomotor stability in balance impaired populations. The objective of this study was to develop and evaluate a technique for quantifying stability of stepping in healthy people and people with peripheral (vestibular hypofunction, VH) and central (cerebellar pathology, CB) balance dysfunction by means a sensory (auditory) perturbation test. METHODS: Balance impaired and healthy subjects performed a repeated bench stepping task. The perturbation was applied by suddenly changing the cadence of the metronome (100 beat/min to 80 beat/min) at a predetermined time (but unpredictable by the subject) during the trial. Perturbation response was quantified by computing the Euclidian distance, expressed as a fractional error, between the anterior-posterior center of gravity attractor trajectory before and after the perturbation was applied. The error immediately after the perturbation (Emax), error after recovery (Emin) and the recovery response (Edif) were documented for each participant, and groups were compared with ANOVA. RESULTS: Both balance impaired groups exhibited significantly higher Emax (p = .019) and Emin (p = .028) fractional errors compared to the healthy (HE) subjects, but there were no significant differences between CB and VH groups. Although response recovery was slower for CB and VH groups compared to the HE group, the difference was not significant (p = .051). CONCLUSION: The findings suggest that individuals with balance impairment have reduced ability to stabilize locomotor patterns following perturbation, revealing the fragility of their impairment adaptations and compensations. These data suggest that auditory perturbations applied during a challenging stepping task may be useful for measuring rehabilitation outcomes.

Journal Article↗

PubMed2003

Dose-dependent effects of gonadotropin releasing hormone on matrix metalloproteinase (MMP)-2, and MMP-9 and tissue specific inhibitor of metalloproteinases-1 messenger ribonucleic acid levels in human decidual Stromal cells in vitro.

Matrix metalloproteinases (MMPs) and their endogenous inhibitors, tissue-specific inhibitor of matrix metalloproteinases (TIMPs), play key roles in the cyclic remodeling events that occur in the human endometrium in preparation for pregnancy. To date, the factors capable of regulating the expression of MMPs and TIMPs in the human decidua remain poorly characterized. The spatiotemporal expression of GnRH in the human endometrium during the menstrual cycle and early pregnancy suggests that this hormone may have a regulatory role in the development of this dynamic tissue. In view of these observations, we have examined the ability of GnRH to regulate MMP-2, MMP-9, and TIMP-1 mRNA levels in primary cultures of human decidual stromal cells using a quantitative competitive PCR strategy. GnRH was capable of increasing MMP-2 and MMP-9 mRNA levels in these primary cell cultures in a dose-dependent manner. The GnRH antagonist, antide, was capable of inhibiting the GnRH-mediated increase in the levels of the MMP-2 and MMP-9 mRNA transcripts present in these decidual stromal cells in a dose-dependent manner. In contrast, GnRH or antide did not have a significant effect on TIMP-1 mRNA level in these primary cell cultures at any of the concentrations used in these studies. Taken together, these observations suggest that GnRH plays an integral role in human implantation, by virtue of its ability to regulate the balance between MMP and TIMP expression in decidual cells.

Cells, Cultured↗

PubMedDate not supplied

Hyperoxia-induced alterations of rat alveolar lavage composition and properties.

Although lethal exposures of most animal species to oxygen result in a reduced amount of surfactant phospholipids (PL), hyperoxia in rats leads to elevated levels of PL on the alveolar surface. Because of this different response, a study was made of the amount, composition, surface properties, and subfraction distribution (obtained by differential centrifugation) of alveolar lavage materials from rats exposed to > 95% oxygen for 64 h. The exposures lead to severe lung damage, which includes the appearance of pleural effusion, pulmonary edema, and increased protein levels on the alveolar surface. However, the PL levels of lavage fluid are increased two- to threefold, and the PL composition is altered. In O2-exposed rats, only 39(+/- 1)% of the phospholipid is disaturated phosphatidylcholine (DSPC), the major surface active component of surfactant, as compared to 46(+/- 1)% DSPC in lavage from control animals. The distribution of PL and DSPC in subfractions of lavage materials obtained by differential centrifugation is approximately reversed following hyperoxia. In lavage from control animals, 36% of the PL is in the heavier, more dense subfractions and 64% is in the lighter, less dense subfractions, while 72% is heavier and 28% lighter in lavage from O2-exposed animals. Measurements of surface properties with the Wilhelmy balance indicate that the ability of the lavage materials to reduce surface tension is impaired following hyperoxia. Thus, lethal exposures of rats to oxygen lead to increased amounts of surfactant on the alveolar surface, but the surface properties of the surfactant are impaired, probably due to reduced levels of DSPC, increased amounts of protein, and alterations in its physical form.

Animals↗

PubMed1998

Inpatient group psychotherapy: the role of the staff nurse.

Inpatient groups are inherently different from outpatient groups and require modification in approach. Patients' needs, staff interests and expertise, and the needs of the health care system are major driving forces in the development of inpatient groups. A co-therapy model helps to achieve a balance between skills and abilities of the therapist.

Hospitalization↗

PubMed2006

Mechanistic insights into the regulation of the spermatogonial stem cell niche.

Potential therapeutic use of stem cells in the treatment of human diseases depends on our ability to control the balance of their differentiation and self-renewal in vitro and in vivo. The stem cell "niche," or specialized microenvironment, is now recognized as one of the major contributors to this regulation in many species. Our recent study, which was reported in Nature, was the first to demonstrate that expression of a vertebrate animal transcription factor is essential for the maintenance of a stem cell niche. In that letter, targeted disruption of ERM (Ets-related molecule), which was localized only in the somatic support cell of the testis, the Sertoli cell, resulted in failure of self-renewal by spermatogonial stem cells, following the first wave of spermatogenesis. One of the more important conclusions drawn was the realization that regulation of the stem cell niche during the perinatal period, a phase characterized by rapid mitosis of both spermatogonial stem cells and Sertoli cells, differed from that in the adult. It appears that the ERM-regulated pathways are coincident with the termination of Sertoli cell proliferation and commencement of the cycle of spermatogenesis, which is sustained by the same cell that regulates the stem cell niche. Several likely targets for ERM regulation are discussed, as well as their potential implications for increasing our understanding of spermatogonial stem cell activity and the uniqueness of the Sertoli cell's immune privilege and possible utility for the protection of transplanted adult stem cells.

Animals↗

PubMed2001

Job-sharing in paediatric training in Australia: availability and trainee perceptions.

OBJECTIVE: To examine the current availability of job-sharing in paediatric training hospitals in Australia and to evaluate job-sharing from the trainees' perspective. DESIGN: National survey with structured telephone interviews and postal questionnai res. SETTING: The eight major paediatric training hospitals in Australia. PARTICIPANTS: Directors of Paediatric Physician Training (DPPTs) at each hospital (or a staff member nominated by them) provided information by phone interview regarding job-sharing. All paediatric trainees who job-shared in 1998 (n=34) were sent written questionnaires, of which 25 were returned. RESULTS: Hospitals differed in terms of whether a trainee was required to give a reason for wishing to job-share, and what reasons were acceptable. One hospital stated that two specialty units (Intensive Care and Neonatal Intensive Care) were excluded from job-sharing, and another stated that certain units were unlikely to be allocated job-sharers. The remaining six hospitals said that all units were available for job-sharing, but the majority of their trainees disagreed. Only one hospital had a cap on the number of job-share positions available yearly. Trainees perceived benefits of job-sharing to include decreased tiredness, increased enthusiasm for work, and the ability to strike a balance between training and other aspects of life. Trainees believed job-sharing did not adversely affect the quality of service provided to patients, and that part-time training was not of lower quality than full-time training. CONCLUSIONS: Job-sharing in Australian paediatric training hospitals varies in terms of the number of positions available, eligibility criteria, and which units are available for job-sharing. In our survey, trainees' experience of job-sharing was overwhelmingly positive.

Attitude of Health Personnel↗

PubMed2000

Continuous renal replacement therapy: an overview.

Continuous renal replacement therapy is a treatment option that is especially suited to the critical care setting. Greater hemodynamic stability, the ongoing ability to optimize fluid balance, and the potential for clearing inflammatory mediators are among the frequently cited advantages continuous veno-venous dialysis modalities offer over traditional intermittent therapies. The concept is simple: blood is pumped from the patient, anticoagulated, and passed through a porous filter where, depending on the desired goal, fluid and/or solutes are removed. The blood is then returned to the patient, without large fluctuations in electrolyte and acid-base balance or renal hypoperfusion. This article includes a review of acute renal failure, a discussion of the indications for continuous renal replacement therapy, the mechanisms of action of this therapy, and the nursing considerations.

Acute Kidney Injury↗

PubMed1972

Energy requirements of man living in a weightless environment.

The ability to maintain energy balance is a vital factor in maintaining body composition. A negative energy balance requires that body tissue be consumed to sustain biochemical and physiological activity. Such a caloric imbalance coupled with reduced physical activity results in (among other things): a negative balance which can not be reversed by increased protein intake; negative balances for electrolytes; and a suspension of erythrocyte production. Body weight losses were experienced by all astronauts during Gemini and Apollo missions. Data on the magnitude of the changes, together with data on energy consumption, were used to calculate energy imbalances. These data, when compared with results obtained from precise energy balance measurements made on 64 men living in low pressure chambers, show close correlation. When energy requirements are expressed in kilocalories per kilogram of body weight, the difference in energy requirements among the astronauts and chamber subjects was small and not statistically significant. These data indicated that reliable prediction of energy needs for astronauts, during long-term space missions, can be made by studying either the astronauts or healthy subjects in a ground-based environment similar to that of the spacecraft. These data also indicate that changes in body weight and certain other body measurements detected during Gemini and Apollo missions were probably caused, at least in part, by a calorie deficit.

Adipose Tissue↗

PubMed2003

The AMSUS History of Military Medicine Essay Award. The story of the mobile army surgical hospital[corrected].

The critical task of the physician uniting effective surgical intervention within close proximity to the front lines, and therefore the wounded, must be matched with the challenge of not becoming a casualty as well. The U.S. Army Medical Services during the Korean War balanced the surgeon's ability to protect himself and save others. This article tells the story of perhaps one of the most characteristically highlighted medical aspects of the Korean War, the Mobile Army Surgical Hospital. Originally intended to be close to the front lines of fighting, the Mobile Army Surgical Hospital was equipped to move on its own. Initially, the unit was formed to provide surgical capabilities for one division. It transformed through the course of the war into a multidivision and multinational all-purpose hospital. With this expansion in workload (medical cases in addition to surgery) without an equitable increase in personnel, rapid evacuation of patients was the only means of keeping up.

General Surgery↗

PubMed2005

Workplace disaster preparedness and response: the employee assistance program continuum of services.

Response programs for workplace critical and traumatic events are becoming an acknowledged and sought after standard of care. The current trauma literature recognizes what goes on in the workplace between the Employee Assistance Program (EAP) and management. The authors have taken this intra-organizational relationship, assimilated the information, and developed a model that recognizes and supports management throughout the continuum of response to workplace traumatic events. The model recognizes the EAP as an important workplace resource and tool in management's ability to strike the balance of managing the workforce while assisting in recovery following workplace trauma. The introduced concept defines the continuum and highlights the before, during, and after phases, showing how EAP supports management in most effectively doing their job.

Crisis Intervention↗

PubMed1989

[Therapeutic research on kidney-tonifying herbs on the adrenocortical function in the aged].

The authors have observed the aging change of the adrenocortical function and the effect of the Kidney-tonifying herbs on such a change. The result showed that there was no statistical difference in the plasma cortisol levels between the aged and the young persons, and so was in the plasma corticosterone levels between the aged and the young rats. As the circulating steroids level depends on the balance of the secretion ability of the adrenal cortex and the peripheral degradation rate of the hormone, the authors measured the corticosterone concentration of the culture solution of the adrenocortical cells in vitro of the rats with different age to observe the secretion ability of the adrenocortical cell exclusively. The result showed that the corticosteróne concentration was significantly lower in the culture solution of the adrenocortical cell of the aged rats than that of the young rats, which suggests that the secretion ability of the adrenal cortex declines with aging. In addition, the authors determined the reserve power of the adrenal cortex with different age and found that the increased multiple of the salivary cortisol concentration 60 minutes after the stimulation of ACTH analogue was markedly lower in the aged persons than that in the young persons. The response of the cultured adrenocortical cells to secret corticosterone to the stimulation of ACTH analogue was also significantly lower in the aged rats than that in the young rats, which suggests that the reserve power of the adrenal cortex was also decreased with aging.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex↗

PubMedDate not supplied

A structured approach to expert financial management: a financial development plan for nurse managers.

Faced with tighter budgets and diminishing resources, the success of nurse managers will be measured by their ability to identify and balance cost/quality issues effectively while managing staffing under variable patient census and demanding patient acuity. A structured approach to expert financial management can insure that nursing departments meet financial targets while maintaining integrity of clinical care.

Budgets↗

PubMed1996

Functional assessment in older patients. Key to improving quality of life.

Functional assessment in older patients focuses on their level of functioning rather than on medical diagnoses alone. Patients who have multiple medical problems also have functional and support issues that affect their quality of life. Areas of concern include basic and instrumental activities of daily living, balance and mobility, mental ability, vision and hearing, bowel and bladder function, nutritional status, and environmental factors. Formal geriatric evaluation and management units composed of a physician, a social worker, and a nurse have been developed to address the functional needs in this population. However, primary care physicians can effectively apply the functional assessment approach in evaluation of their older patients with the help of the three-part problem list, along with selected tests and rating scales.

Activities of Daily Living↗

PubMedDate not supplied

Meaningful participation of minors with HIV/AIDS in decisions regarding medical treatment. Balancing the rights of children, parents, and state.

The ability to define clinical classifications and articulate theoretical frameworks must be balanced with deep respect for and awareness of the impact of HIV on clients' lives. Working with these youngsters and their families calls us to dare to be in touch with their very spirits as well as with their clinical issues. So, what should we do for the children? At the risk of oversimplifying, the best answer still is to walk with them.

Adolescent↗

PubMed1998

[Effect on preparing curved artificial root cancals with five handle endodonic instruments I.comparison of cutting ability]

OBJECTIVE: To compare the cutting ability of five handle endodontic instruments. METHODS: The speciments weight loss following serial preparation of artificial root canal were measured with electronic analysis balance. RESULTS: The greatest cutting ability occurred with H file,then with K-flex file,Unifile,K file and K reamer. CONCLUSION: The cutting ability of endodontic instrument is influenced by several factors,such as metallurgical properties,cross-sectional configuration of shaft,flute design and tip design.

Journal Article↗

PubMed2001

Interactive control of Rhodobacter capsulatus redox-balancing systems during phototrophic metabolism.

In nonsulfur purple bacteria, redox homeostasis is achieved by the coordinate control of various oxidation-reduction balancing mechanisms during phototrophic anaerobic respiration. In this study, the ability of Rhodobacter capsulatus to maintain a balanced intracellular oxidation-reduction potential was considered; in addition, interrelationships between the control of known redox-balancing systems, the Calvin-Benson-Bassham, dinitrogenase and dimethyl sulfoxide reductase systems, were probed in strains grown under both photoheterotrophic and photoautotrophic growth conditions. By using cbb(I) (cbb form I operon)-, cbb(II)-, nifH-, and dorC-reporter gene fusions, it was demonstrated that each redox-balancing system responds to specific metabolic circumstances under phototrophic growth conditions. In specific mutant strains of R. capsulatus, expression of both the Calvin-Benson-Bassham and dinitrogenase systems was influenced by dimethyl sulfoxide respiration. Under photoheterotrophic growth conditions, coordinate control of redox-balancing systems was further manifested in ribulose 1,5-bisphosphate carboxylase/oxygenase and phosphoribulokinase deletion strains. These findings demonstrated the existence of interactive control mechanisms that govern the diverse means by which R. capsulatus maintains redox poise during photoheterotrophic and photoautotrophic growth.

Bacterial Proteins↗

PubMed2003

Brain white matter lesions detected by magnetic resonance [correction of resosnance] imaging are associated with balance and gait speed.

OBJECTIVE: To investigate the relations between premorbid and current mental ability, mood, and white matter signal abnormalities detected by T2 weighted brain magnetic resonance imaging (MRI) and impairment of balance and mobility in older adults. METHODS: 97 subjects from the Aberdeen 1921 birth cohort underwent brain MRI, evaluation of balance, and measurement of gait speed. White matter hyperintensities detected on T2 weighted MRI scans were rated by three independent raters on three variables: white matter lesions; periventricular lesions; and brain stem lesions. RESULTS: Decreased gait speed was correlated with impaired visual acuity (p = 0.020), shorter stature (p = 0.008), a lower childhood IQ (p = 0.030), a lower current Raven's progressive matrices score (Raven score) (p < 0.001), a higher hospital anxiety and depression scale (HADS) score (p = 0.004), and an increased grade of brain stem lesions on MRI. Inability to balance was correlated with Raven score (p = 0.042), brain stem lesions (p = 0.003), white matter lesions (p = 0.003), and periventricular lesions (p = 0.038). Binary logistic regression identified brain stem lesions (odds ratio (OR) 0.22; 95% confidence interval 0.09 to 0.54) and HADS depression score (OR 0.75; 0.58 to 0.97) as the only significant associations with balance. Structural equation modelling detected an association between two latent traits representing white matter disease and an integrating function, respectively. CONCLUSIONS: In this cohort, white matter lesions, periventricular lesions, and brain stem lesions were associated with impaired balance. Current mental ability was strongly related to gait speed. There appears to be a concordance between motor skills and intellect in old age, which is degraded by white matter disease.

Aged↗