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PubMed1978

Functional disability of geriatric patients in a family medicine program: implications for patient care, education, and research.

While the elderly comprise a large proportion of patients seen in ambulatory care settings, characteristics of these patients have not been well documented. This paper summarizes results of a survey of functional impairment of elderly patients seen in a family medicine center. Assessments were performed in the areas of social and economic resources, mental health, physical health, and the ability to perform routine activities needed for independent living. Results of the survey suggest that family physicians need to know how to perform a multidimensional functional assessment in order to formulate a comprehensive treatment plan for elderly patients.

Activities of Daily Living↗
PubMed1976

[Cardiodynamic changes in young sportsmen under the effect of systematic training (problem of development of "sportsman's heart" in children)].

In 53 hockey players the myocardial contractility was studied by the method of phasic analysis of the cardiac cycle. The volume of the heart was determined with the help of biplane teleroentgenography. Physical performance capacity was also estimated and for this veloergometric test PWC170 was used. The phasic analysis of the cardiac contraction revealed in most of the testees the presence of the syndrome of functionally controlled hypodynamics with all the symptoms common to it. Teleroentgenometric findings showed the youthful hockey players to have an enlarged heart as compared to untrained youths of the same age and to children of senior age. The physical performance capacity of 10-12 year old hockey players proved sufficiently high and in the majority of the examined it was more than twice as great as the PWC170 level registered in untrained children of the same age. Morphological-functional changes in the heart found in youthful hockey players are typical of the "sportsman's heart" and bear evidence to a highly proficient regulation and control over the operation of the circulatory system that finds its expression in the efficient work of the heart and in raising its reserve possibilities under various extreme conditions.

Adaptation, Physiological↗
PubMed1979

[Cardiodynamic characteristics of chronic coronary insufficiency patients at medical rehabilitation stages using therapeutic physical exercise measures].

The functional condition of the cardiovascular system was studied in patients with chronic coronary insufficiency in various stages of rehabilitation employing measures of remedial gymnastics with the elaboration of criteria for substaintiating the broadening of the movement regimen. Sixty patients suffering from ischemic heart disease marked by the clinical picture of chronic coronary insufficiency and 25 persons forming a control group were examined Polycardiography, aortic and arterial rheocardiography, and tele-electrocardiography were used. A follow-up of the functional condition of the cardiovascular system makes it possible to detect signs of the development of its reserve possibilities under the effect of long-term remedial gymnastics. Favourable shifts in the functional ability of the cardiovascular system may be only produced after long-term (12 months) remedial gymnastics performed regularly and with sufficient physical exertion, including walking and running.

Adaptation, Physiological↗
PubMed1977

Stability of phage T4 lysozymes. I. Native properties and thermal stability of wild type and two mutant lysozymes.

Two mutants of phage T4 lysozyme were prepared and characterized. One mutation substituted a tyrosine residue for tryptophan at position 138. The other substituted tyrosines at all three tryptophan positions of the wild type molecule (126, 138, 158). Comparative studies of the physical properties (absorption, fluorescence, circular dichroism) of the three enzymes were performed as a function of pH. Also, the proteins were reversibly melted as a function of pH. Since the unfolding reaction appeared to be a two-state process for all these proteins, the data were analyzed by the van 't Hoff procedure. The changes in stability and activity produced by substitution of Trp 138 were especially significant. The other substitutions were neutral. See the end of the paper for a summary of conclusions. In the appendix the appropriate thermodynamic relations are developed for a constant deltaCp transition.

Circular Dichroism↗
PubMedDate not supplied

[Physician and sports].

The main objective of physical activity should be to achieve the best possible level of physical fitness and thereby psychic wellbeing. This important objective in preventive medicine may be obtained by a well balanced leisure sport program. On the other hand, due to its high demands, modern competition sport or elite sport increasingly results in severe organic damages and therefore therapeutic measures are of more importance. The physician has important functions both in prevention and therapy in all aspects of physical activity. Unfortunately, in Switzerland he is ofter insufficiantly prepared to deal with these functions. Most of the requirements for manipulation of performance that the physician is confronted with are questionable and not compatible with the medical ethics.

Humans↗
PubMed2022

Improving risk indexes for Alzheimer's disease and related dementias for use in midlife.

Knowledge of a person's risk for Alzheimer's disease and related dementias (ADRDs) is required to triage candidates for preventive interventions, surveillance, and treatment trials. ADRD risk indexes exist for this purpose, but each includes only a subset of known risk factors. Information missing from published indexes could improve risk prediction. In the Dunedin Study of a population-representative New Zealand-based birth cohort followed to midlife (N = 938, 49.5% female), we compared associations of four leading risk indexes with midlife antecedents of ADRD against a novel benchmark index comprised of nearly all known ADRD risk factors, the Dunedin ADRD Risk Benchmark (DunedinARB). Existing indexes included the Cardiovascular Risk Factors, Aging, and Dementia index (CAIDE), LIfestyle for BRAin health index (LIBRA), Australian National University Alzheimer's Disease Risk Index (ANU-ADRI), and risks selected by the Lancet Commission on Dementia. The Dunedin benchmark was comprised of 48 separate indicators of risk organized into 10 conceptually distinct risk domains. Midlife antecedents of ADRD treated as outcome measures included age-45 measures of brain structural integrity [magnetic resonance imaging-assessed: (i) machine-learning-algorithm-estimated brain age, (ii) log-transformed volume of white matter hyperintensities, and (iii) mean grey matter volume of the hippocampus] and measures of brain functional integrity [(i) objective cognitive function assessed via the Wechsler Adult Intelligence Scale-IV, (ii) subjective problems in everyday cognitive function, and (iii) objective cognitive decline measured as residualized change in cognitive scores from childhood to midlife on matched Weschler Intelligence scales]. All indexes were quantitatively distributed and proved informative about midlife antecedents of ADRD, including algorithm-estimated brain age (β's from 0.16 to 0.22), white matter hyperintensities volume (β's from 0.16 to 0.19), hippocampal volume (β's from -0.08 to -0.11), tested cognitive deficits (β's from -0.36 to -0.49), everyday cognitive problems (β's from 0.14 to 0.38), and longitudinal cognitive decline (β's from -0.18 to -0.26). Existing indexes compared favourably to the comprehensive benchmark in their association with the brain structural integrity measures but were outperformed in their association with the functional integrity measures, particularly subjective cognitive problems and tested cognitive decline. Results indicated that existing indexes could be improved with targeted additions, particularly of measures assessing socioeconomic status, physical and sensory function, epigenetic aging, and subjective overall health. Existing premorbid ADRD risk indexes perform well in identifying linear gradients of risk among members of the general population at midlife, even when they include only a small subset of potential risk factors. They could be improved, however, with targeted additions to more holistically capture the different facets of risk for this multiply determined, age-related disease.

Alzheimer’s disease↗
PubMed2025

A randomized controlled trial to unveil the influence of an exercise intervention on brain integrity and gut microbiome structure in individuals with HIV.

OBJECTIVE: Exercise intervention programs enhance physical fitness, cognition, neuroimaging measures, and alter the structure of the gut microbiome in individuals without HIV. However, interventional studies exploring the effects of exercise in persons with HIV (PWH) have not included neuroimaging or gut microbiome analyses. DESIGN: A randomized controlled trial conducted at Washington University in St. Louis, MO, USA. METHODS: 65 PWH (aged ≥40 years, self-reported sedentary lifestyle) were randomly assigned to a 6-month cardiorespiratory and resistance training (EXS) or stretching control (SIS) intervention in a 2 : 1 ratio. Longitudinal change in cognition, cerebral blood flow (CBF), physical and cardiorespiratory fitness, and gut microbiome diversity and composition were examined among participants ( n  = 62) who completed any portion of the intervention (ClinicalTrials.gov: NCT02663934). RESULTS: Better fitness and better cognitive performance were associated with greater phylogenetic diversity in gut microbiome composition at baseline. Longitudinal findings indicated slight but significant improvements in psychomotor speed and executive function, reductions in body mass index, improvements in physical fitness, and increased gut microbiome diversity. These changes were observed regardless of assigned intervention group. There were no observed changes in CBF for either group. CONCLUSIONS: These findings highlight physical fitness as a modifiable factor in PWH that may improve cognitive performance and change gut microbiome composition. Both interventions were beneficial, suggesting light stretching exercise or study participation alone could have been sufficient to introduce positive cognitive shifts in previously sedentary PWH. Longer interventions with more participants are needed to identify changes in neuroimaging metrics related to brain integrity.

Humans↗
PubMed2026

Increasing gut short-chain fatty acids protects intestinal barrier function but does not spare muscle glycogen or impact aerobic performance.

Animal studies suggest gut microbiota-derived short-chain fatty acids (SCFA) provide an intestinal barrier-protecting, glycogen-sparing energy source that increases aerobic endurance performance, but confirmation in humans is needed. This study aimed to determine whether increasing colonic SCFA availability impacts intestinal barrier function, substrate metabolism, muscle glycogen and aerobic performance in healthy adults. Using a randomized, double-blind, crossover design 12 active men (age 18-30&#xa0;years;40.0&#xa0;&#xb1;&#xa0;7.1&#xa0;mL/kg/min) performed prescribed exercise and consumed a provided diet supplemented with acetylated and butyrylated high-amylose maize starch engineered to deliver SCFA to the colon (HAMS-A/B) or low-amylose maize starch (LAMS) for 7 days, separated by a 2 week washout. Indirect calorimetry, stable isotopes and blood, muscle and urine biomarkers were measured on intervention day 8 while participants completed 90&#xa0;min of steady-state cycle ergometry (ExSS; 60 &#xb1; 5%) followed by a 5&#xa0;km treadmill time trial. HAMS-A/B, relative to LAMS, increased faecal and serum SCFA. Multiple markers of intestinal barrier damage and permeability were lower, and the respiratory exchange ratio during ExSS was higher (0.02 [95% confidence interval (CI): 0.01, 0.03], Ptreatment&#xa0;<&#xa0;0.001) following HAMS-A/B versus LAMS. However no between-treatment difference in glucose turnover, muscle glycogen depletion (14&#xa0;&#xb5;mol/kg/g dry wt. [95% CI: -116, 143], Pinteractio n&#xa0;=&#xa0;0.613) or TT performance (5&#xa0;s [95%CI: -44, 54], Ptreatment&#xa0;=&#xa0;0.816) was observed. Increasing colonic and circulating SCFA modestly altered substrate oxidation and preserved intestinal barrier function during endurance exercise. However effects were not sufficient to spare muscle glycogen or increase aerobic endurance performance, leaving the practical relevance unclear and underscoring challenges inherent in translating promising preclinical findings to humans. KEY POINTS: Animal studies suggest gut microbiota-derived short-chain fatty acids (SCFA) provide an intestinal barrier-protecting, glycogen-sparing energy source that increases aerobic endurance performance, but confirmation in humans is lacking. A gut microbiota-targeted dietary supplementation strategy was used to deliver SCFA to the colon and successfully increased colonic and systemic SCFA concentrations in healthy, physically active adults before and during an endurance exercise bout and aerobic performance test. Increasing colonic and systemic SCFA availability preserved intestinal barrier function but did not impact glucose turnover, alter protein expression in muscle or spare muscle glycogen during endurance exercise. Increasing colonic and systemic SCFA availability did not impact aerobic endurance performance.

Humans↗
PubMed1975

Physical changes in banked baboon blood.

Studies of red blood cells, white blood cells, platelet function, and clotting factors were performed on banked baboon blood. It was found to be a suitable model for the study of micro-aggregate formation and other coagulation abnormalities encountered in storage of human blood.

Adenosine Diphosphate↗
PubMed1978

Noninvasive assessment of cardiac dysfunction in the cancer patient.

The concepts of left ventricular function are reviewed with an emphasis on the pitfalls in the clinical assessment of myocardial performance. The application of noninvasive cardiac diagnostic techniques is discussed, including physical examination, systolic time intervals with external pulse recordings, echocardiography, and radionuclide cineangiography.

Cineangiography↗
PubMedDate not supplied

Dexamethasone isonicotinate aerosol therapy in patients with chronic bronchial asthma.

Dexamethasone isonicotinate aerosols were used for the management of 106 patients (33 men, 73 women) with bronchial asthma (mean age 32.7 years); 62 of the patients were steroid-dependent (maintenance dose 1 to 25 mg prednisone/day for 0.5 to 11 years) at the start of the study. A diary of symptoms (including consumption of antiasthmatic drugs) was kept; physical examination and measurement of pulmonary function (peak flow rate, forced expiratory volume in one second) were performed during a one-to-four week control period, as well as at various intervals (up to 14 months) after the start of corticosteroid aerosol therapy. Clinical subjective and objective improvement was accompanied by a significant increase in ventilatory function indices (e.g. the FEV1.0 rose from a control average of 55.5% of predicted to 72% after 4 weeks and 85% after 12 months). The antiasthmatic drug consumption decreased markedly. Administration of systemic steroids could be withdrawn in 49 of the 62 steroid-dependent patients (79%); in the remaining 13 the dose was only lowered. The side-effects were minor (hoarseness of the voice, oropharyngeal candidosis), and limited to a few cases. It is concluded that bronchial asthma can be successfully controlled in four fifths of the patients by very low doses of dexamethasone isonicotinate aerosols, with practically no systemic effects.

Adolescent↗
PubMed1978

Fate of patients 1--6 years after operation on account of coronary artery disease.

The authors analyzed the fate of 234 patients 1--6 years after operation of the coronary arteries. In the majority of patients they recorded alleviation of complaints and improved physical performance. Part of the patients resumed employment. Successful revascularization of the heart muscle improved the mechanical function of the left ventricle. Indirect comparisons suggest that the number of patients who survived late myocardial infarction and late mortality are lower in operated patients than in similar patients treated only conservatively. Final evaluation of all possible methods of surgical treatment of the coronary arteries will call for further work. The experience as regards indications, surgical tactics and techniques in postoperative care assembled during the past period improve fundamentally the immediate results of surgical treatment of coronary artery disease and this must be manifested also in the subsequent fate of these patients.

Coronary Disease↗
PubMed1977

Physical health of 7-year-old children. An epidemiological study of school entrants and a comparison with their preschool health.

At 7 years of age, all 649 7-year-old children in a school district underwent a physical examination, a vision screening and an auditory screening. 210 of the children were previously examined in an extensive health control at 4 years of age. The purpose of the present study was to describe the children's health situation and to evaluate the special health control performed at 4 years of age. In 15% of the children, functionally important health problems were found. Visual defects were most common, comprising 7.5%, then came physical health problems such as motor disturbances, obesity, bacteriuria in 6.5%, and hearing defects in 1%. About half of the important health problems were previously known. Children who had passed the special health control at 4 years of age had fewer newly detected important health problems and more previously known ones than other children, which means that many children with above all visual defects but also motor disturbances, bacteriuria and testis retention, were detected and treated earlier than would have happened without the special control at 4 years. It is concluded that the "ordinary" preschool Child Health Services did fulfill their purpose to detect handicapping disorders in an acceptable way; by the introduction of the special health control at 4 years of age, this function was further improved.

Child↗
PubMed2026

The Impact of Baseline Negative Emotions on Postoperative Quality of Life in Adolescent Idiopathic Scoliosis Patients: A 2-Year Follow-Up Study.

OBJECTIVE: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that develops during puberty without a clear etiology. Beyond physical manifestations, AIS severely impacts adolescents' psychological and social well-being, leading to anxiety, depression, and low self-esteem. While advancements in surgical techniques have enhanced objective outcomes, existing studies on AIS have primarily focused on objective indices, with limited attention to the long-term impact of preoperative negative emotions on patient-reported subjective quality of life. METHODS: This was a retrospective cohort study. A total of 112 eligible AIS patients who underwent posterior spinal correction surgery between April and August 2023 were enrolled. Inclusion criteria included confirmed AIS, completion of 2-year follow-up, and informed consent; exclusion criteria included missing imaging/questionnaire data, comorbid psychiatric/neurological diseases, or prior spinal surgery. Patients were grouped using the Hospital Anxiety and Depression Scale (HADS) administered on admission. Quality of life was assessed preoperatively and 2&#x2009;years postoperatively using the Scoliosis Research Society-22 (SRS-22, evaluating self-image, mental health, pain, function, treatment satisfaction) and Short Form 36 Health Survey (SF-36, assessing 8 physical and mental health dimensions). Statistical analysis was performed via SPSS, using independent t-tests, paired t-tests, Mann-Whitney U test, and chi-square test. p&#x2009;<&#x2009;0.05 was considered significant. RESULTS: There were no significant differences in baseline characteristics (age, gender, BMI, surgical parameters, scoliosis type, preoperative/postoperative Cobb angles) between the two groups (all p&#x2009;>&#x2009;0.05). Preoperatively, SRS-22 and SF-36 scores showed no inter-group differences (all p&#x2009;>&#x2009;0.05). Postoperatively, the Negative Emotion Group had significantly lower scores in SRS-22 mental health (3.9&#x2009;&#xb1;&#x2009;0.3 vs. 4.5&#x2009;&#xb1;&#x2009;0.2) and treatment satisfaction (4.0&#x2009;&#xb1;&#x2009;0.3 vs. 4.6&#x2009;&#xb1;&#x2009;0.7), as well as SF-36 general health (68.6&#x2009;&#xb1;&#x2009;6.4 vs. 79.7&#x2009;&#xb1;&#x2009;13.3), role-emotional (61.3&#x2009;&#xb1;&#x2009;9.3 vs. 70.8&#x2009;&#xb1;&#x2009;9.7), and mental health (61.8&#x2009;&#xb1;&#x2009;14.3 vs. 68.9&#x2009;&#xb1;&#x2009;10.7) (all p&#x2009;<&#x2009;0.05); no inter-group differences were observed in physical function-related dimensions. Both groups showed significant improvements in physical function-related dimensions postoperatively. The Non-Negative Emotion Group also exhibited significant improvements in SRS-22 self-image/pain and SF-36 bodily pain (all p&#x2009;<&#x2009;0.05), while the Negative Emotion Group showed no significant improvements in these dimensions. CONCLUSIONS: Preoperative anxiety and depression do not affect the recovery of physical function in AIS patients after spinal correction surgery but significantly impede improvements in subjective quality of life dimensions, including mental health and treatment satisfaction. These findings highlight the need to integrate psychological assessment and targeted interventions into the perioperative management of AIS. Such a patient-centered approach will help optimize both physical and psychological outcomes, ultimately achieving comprehensive rehabilitation for AIS adolescents.

Humans↗
PubMed1976

Encoding the levels of information in pictures and words.

From a levels-of -processing framework (e.g., Craik & Lockhart, 1972), we derive the idea that the levels of information implicit in a stimulus, such as its physical configuration, its name, and the category to which it belongs, may become available for subsequent processing at different times after stimulus onset. In particular, tasks which allow the use of physical codes should be performed more rapidly than those which require "deeper" information. There are two important implications here: The first is that the ability to use a code does not mean that that code has been "matched to" a representation in memory. The second is that "depth" effects (i.e., physical less than name less than conceptual) should be demonstrable within both pictorial and verbal materials. The approach as a whole may be contrasted with current dual-coding approaches (e.g., Paivio, Note 1), which, while they allow for different levels of meaning in both verbal and imaginal symbolic systems, seem forced to assume that certain types of cenceptual information are more easily accommodated within the verbal system. This leads to the prediction that some kinds of conceptual information will not be directly available from pictures, but must instead become available to the subject via an interaction between the symbolic systems. We tested these assumptions with a speeded-inference task (Van Rijn, 1973), which has properties that allow for unambiguous interpretation of reaction time differences across stimulus materials which require processing to the same explicit depth. Briefly, we found that pictures yield faster inferences than do words when the same semantic information is required for performance (Experiments 1 and 2), and that physical information is available sooner than conceptual information for both pictures (Experiment 4) and words (Experiment 5). Moreover, some types of pictorial materials (e.g., representations of proper nouns) function symbolically to the extent that they do not have an advantage in discriminability over words (Experiments 6 and 7), unless physical features are added to them which are redundant with the conceptual information the subject needs to perform (Experiment 8). The results are best interpreted within a levels-of-processing framework, in which multiple codes or representations do not exist to be activated by the appropriate stimuli, but rather the stimuli themselves embody levels of information which are encoded and used as needed.

Auditory Perception↗