SEARCH · PubMed Health

Results for “global functioning”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources

PubMed2006

Influence of metabolic network structure and function on enzyme evolution.

BACKGROUND: Most studies of molecular evolution are focused on individual genes and proteins. However, understanding the design principles and evolutionary properties of molecular networks requires a system-wide perspective. In the present work we connect molecular evolution on the gene level with system properties of a cellular metabolic network. In contrast to protein interaction networks, where several previous studies investigated the molecular evolution of proteins, metabolic networks have a relatively well-defined global function. The ability to consider fluxes in a metabolic network allows us to relate the functional role of each enzyme in a network to its rate of evolution. RESULTS: Our results, based on the yeast metabolic network, demonstrate that important evolutionary processes, such as the fixation of single nucleotide mutations, gene duplications, and gene deletions, are influenced by the structure and function of the network. Specifically, central and highly connected enzymes evolve more slowly than less connected enzymes. Also, enzymes carrying high metabolic fluxes under natural biological conditions experience higher evolutionary constraints. Genes encoding enzymes with high connectivity and high metabolic flux have higher chances to retain duplicates in evolution. In contrast to protein interaction networks, highly connected enzymes are no more likely to be essential compared to less connected enzymes. CONCLUSION: The presented analysis of evolutionary constraints, gene duplication, and essentiality demonstrates that the structure and function of a metabolic network shapes the evolution of its enzymes. Our results underscore the need for systems-based approaches in studies of molecular evolution.

Amino Acid Substitution↗

PubMed2005

Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: a longitudinal analysis.

BACKGROUND: Quality of life (QOL) has gained increasing attention as an important yet underappreciated component of functional outcome in mood disorders. In particular, the relationship between subjective life satisfaction and objective measures of psychosocial adjustment has not been well-studied. The goal of the present study was to examine the longitudinal associations between subjective life satisfaction and objective functional outcome among individuals with bipolar and unipolar mood disorders. METHOD: One hundred fifty-seven mood disordered subjects were assessed at index hospitalization for bipolar mania (n=35), unipolar psychotic depression (n=27), or unipolar nonpsychotic depression (n=95). All were prospectively followed up three times, at approximately 2, 4.5 and 7-8 years. Global outcome, work performance, social adjustment, recurrent depressive episodes, and dimensions of life satisfaction were assessed by semi-structured interviews using standardized ratings. RESULTS: Subjective life satisfaction strongly paralleled global functioning, work performance and social adjustment at each follow-up for patients with unipolar nonpsychotic depression, but not bipolar disorder or unipolar psychotic depression. Depressive symptoms and objective functional impairment contributed to poor QOL in most domains, independent of illness chronicity, medication use, or affective disorder subtype. LIMITATIONS: Findings might have differed had a different QOL measure been used, although the present measure showed concurrent validity with a previously used instrument. Sample sizes for the bipolar and psychotic depression groups were sufficient to detect moderate, but not small, correlations between objective functioning and subjective QOL. CONCLUSIONS: Recurrent depression remains a substantial contributor to poor life satisfaction across affective disorder subtypes. Subjective QOL in bipolar and unipolar psychotic depression patients may not accurately reflect objective functional outcome status, potentially due to diminished insight, demoralization, or altered life expectations over time.

Activities of Daily Living↗

PubMed1994

Redundant functions of the genes knirps and knirps-related for the establishment of anterior Drosophila head structures.

Developmental gene functions of Drosophila are typically characterized by a recognizable mutant phenotype. When molecular probes of such genes were used to isolate homologues, distinct spatially and temporally restricted expression patterns were observed in vertebrates as well. However, corresponding "gene knock-outs" often revealed subtle or no scorable phenotypes, a phenomenon attributed to redundant gene functions. We found that the evolutionarily related genes knirps (kni) and knirps-related (knrl) contribute to a similar phenomenon in Drosophila. The two closely situated genes show identical expression patterns in the developing embryo, including the posterior and anterior expression domains in the blastoderm. Here we show that the two biochemically equivalent gene products are both functional in the head anlage and that the lack of one gene activity can be overcome by the activity of the other. Whereas kni is also required for abdominal segmentation, knrl is nonfunctional in its posterior expression domain. Thus, the kni/knrl pair of genes provides a region-specific buffering system, rather than a case of global functional redundancy.

Animals↗

PubMed1984

Posturography and vestibular compensation.

In unilateral vestibular hypofunction, compensation has to be achieved at the several levels of the balance function. The development of compensation at each level has not necessarily a parallel course. Accordingly, a thorough evaluation of the functional state of the patient, requires a separate assessment for each level. In clinical practice, compensation is evaluated by the testing of provoked vertigo (with eventual positional nystagmus) and by the rotation test results. To these data a measurement of the vestibulospinal level has to be added. Posturography provides this assessment and in this way the global functional state is completed. In many cases the complaints can be objectified and the elaboration of adequate rehabilitation exercises can be founded upon these posturographic data. The detailed analysis of the posturograpohic curves furnishes a diversification of the dysfunctional patterns at this balance level, with also emphasis upon the sensory interaction.

Adaptation, Physiological↗

PubMed1994

Evaluation of left ventricular function based on simulated systolic flow dynamics computed from regional wall motion.

Left ventricular (LV) chamber flow is undoubtedly influenced by the time-dependent regional motion of the LV wall. In an attempt to obtain diagnostic parameters based on LV chamber flow, we computed the LV chamber, two-dimensional systolic velocity and pressure distribution for two right anterior oblique (RAO) ventriculograms: one normal, one with ischemic coronary artery disease, and several simulations with prescribed abnormal wall motion. The flow fields are obtained by solving the discretized two-dimensional Navier-Stokes equations for viscous, incompressible unsteady flow using the finite analytic method. These solutions were used as a basis for two LV assessment parameters: (1) local pressure gradient near the LV wall, and (2) the central ejection region (CER), defined as the region of flow domain in which the obtained velocity field vectors are aligned +/- 5 degrees from the LV long axis. A CER coefficient, R, derived from the location and orientation of the CER within the LV cavity, is defined such that R = 0 for a heart which produces no CER, and R = 1 for a heart whose contraction is perfectly even along the entire RAO LV outline. The computed local pressure gradients in the ischemic heart near the apical wall region were reduced compared with those computed in the normal heart. An observable decrease in magnitude of the pressure gradients in the apical region for increasing severity of abnormal wall motion was also indicated. However, the prescribed abnormal wall motion simulations generated reduced pressure gradients in regions of abnormal wall motion and normal regions as well. Therefore, the local wall pressure gradient may not be suitable for localization of coronary occlusion but for presence of disease only. The time-averaged CER coefficient was 0.709 for the normal heart and 0.453 for the diseased heart. The CER shifted toward the region of LV wall which exhibits the abnormal motion, and the CER coefficient decreased with increasing severity of abnormal wall motion. The CER coefficient provides a qualitative and quantitative measure of global function that regional wall motion analysis cannot provide, and is a parameter which is sensitive to regional and temporal abnormalities and the resulting compensatory actions which cannot be detected by global parameters.

Blood Flow Velocity↗

PubMed1986

The effect of multiple family therapy on addict family functioning: a pilot study.

Family therapy may help addicts remain drug abstinent by improving family functioning. In a outpatient pilot study eight addict families were evaluated before and after 16 weeks of multiple family therapy (MFT), while the addict was maintained on naltrexone, an opiate antagonist. The Beavers Timberlawn Family Assessment was used to rate videotapes on problem solving, family structure, individual autonomy, and affect. The 8 families showed significant improvement in global functioning, problem solving, structure, and autonomy, but not in affect. One addict relapsed during the 10 month follow up, and his was the only family that functioned worse at follow up. We concluded that MFT can help addict families progress from chaotic interactions to more stable family structures and from rigid to more flexible family functioning. This improvement in family functioning may be associated with ex-addicts remaining abstinent.

Adult↗

PubMed1994

[Functional venous explorations].

The methods for exploring venous function globally are presented first. These methods include venous pressure and plethysmography for which the methods using a garrot are separated from those using air volumetry which give reliable physiological and reproducible results. The Nachev method, the thermometry, the thermography and isotope clearances are also reviewed since they have been important in the development of exploration of venous function. The methods giving morphological or segmentary data are then presented in historical order: phlebography (completed by tomodensitography and nuclear magnetic resonance), then ultrasonography with Doppler, echography and duplex and colour techniques. Finally promising methods for the future including oxygen partial pressures, laser-Doppler, capillaroscopy and venous endoscopy are discussed. For each method, there is a description of the technique, a presentation of the measured parameters and their reliability, the signification of the measurement and its clinical use. Finally, each method is discussed in the context of concrete clinical situations with a schema for management of diagnosis.

Blood Pressure Determination↗

PubMed2004

Differences in regional systolic and diastolic function by Doppler tissue imaging in patients with hypertrophic cardiomyopathy and hypertrophy caused by hypertension.

OBJECTIVE: Doppler tissue (DT) velocity abnormalities have been described in patients with pathologic left ventricular hypertrophy (LVH). Impaired myocardial function has been suggested as a primary disorder in hypertrophic cardiomyopathy (HCM) and differences in DT parameters have been reported to be distinguishable from other LVH causes. We evaluated DT differences for patients with LVH caused by hypertension and patients with HCM, assessing regional systolic and diastolic function. METHODS: A total of 62 participants were studied: 21 with HCM; 22 with LVH secondary to hypertension; and 19 control subjects. DT was used to record mitral annulobasal segment motion in the longitudinal axis. Systolic and diastolic velocities were measured at lateral and septal sites, and well-known ratios were obtained for diastolic assessment. A new global function index (GFI) that evaluates both systole and diastole was also calculated (GFI = [Emi/E(DT)]/S(DT) [s x cm(-1)], where mi is mitral inflow, E is E wave, and S is systolic wave). RESULTS: Comparison showed significant differences in all parameters evaluated at the septal-basal segment and a GFI value of 1.77 showed 85% sensitivity and 75% specificity for detecting HCM when interventricular septum thickness was increased. CONCLUSIONS: In the presence of unexplained LVH, markedly decreased DT velocities at basal septum efficiently detect myocardial dysfunction at this segment, and a calculated GFI > 1.77 strongly supports the diagnosis of HCM.

Cardiomyopathy, Hypertrophic↗

PubMed1995

Family functioning: a correlate of diabetic control?

Poor diabetic control was found in nearly 50% of adolescents attending two paediatric clinics. Adolescents with well and poorly controlled diabetes differed in reported parental involvement in their diabetic regime. There was little association between glycaemic control and family functioning using the McMaster Family Assessment Device (FAD) whether rated by adolescent or a parent. Neither did sufferers with diabetes differ from families of matched community controls according to the FAD overall though the families of well controlled diabetics were more likely than the other two groups to score themselves in the unhealthy range on the subscale of global functioning.

Adolescent↗

PubMed2002

Correlation between physical functioning and gait measures in children with cerebral palsy.

The primary aim of this investigation was to assess the correlation between the POSNA Musculoskeletal Functional Health Questionnaire (POSNA) and gait analysis in children with cerebral palsy (CP). POSNA and computerized gait analysis were used to evaluate individuals with CP. Correlations were investigated between POSNA scales, gait parameters, and the Gillette Functional Assessment Questionnaire (FAQ) in 63 children (31 males, 32 females; mean age 9.17 years [SD 3.06], age range 3.75 to 16.44 years) with spastic CP. Twelve participants had hemiplegia, 29 diplegia, 12 quadriplegia, and 10 triplegia. The result of backwards stepwise multiple regression analysis indicated that the Log normalcy index (NI) was a significant predictor of the POSNA Global Function and Comfort scale. Energy expenditure (EE) did not add significantly to the prediction. The POSNA scales differentiated between the different topographical types of CP. The POSNA scale is a valid and useful clinical measure. Used in conjunction with the NI, EE, and FAQ, the POSNA scale provides a more complete appraisal of change in functioning.

Adolescent↗

PubMed1994

Group home residents' identities as patients and as community members.

OBJECTIVE: The study examined the extent to which group home residents identified with the roles of psychiatric patient and community member. It was hypothesized that a longer history of hospitalization and a lower level of functioning would be associated with a stronger patient identity and that longer community tenure would be related to a less pronounced identification with the patient role. METHODS: Fifty-seven group home residents were given a list of 50 features, or words describing thoughts, feelings, and personal characteristics. They were asked which features they would attribute to each of two identities--"myself as a psychiatric patient" and "myself as a community member." Correlations with hospitalization history, community tenure, and level of functioning were determined. RESULTS: Residents with greater cumulative time spent hospitalized attributed more features to their identity as a patient than to their identity as a community member, indicating a greater elaboration of patient identity. Residents with long community tenures were no more likely than those recently hospitalized to have a more extensively elaborated identity as a community member. Global functioning scores were not related to strength of identification with the patient role. CONCLUSIONS: Identification with the patient role persists among group home residents even after relatively long tenure in the community. Providers of residential services may find it more helpful to promote positive associations with community membership rather than to attempt to reduce identification with the patient role.

Activities of Daily Living↗

PubMed2001

Acupuncture for osteoarthritis of the knee: a systematic review.

OBJECTIVE: To evaluate trials of acupuncture for osteoarthritis (OA) of the knee, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects, to identify patient or treatment characteristics associated with positive response, and to identify areas of future research. METHODS: Eight databases and 62 conference abstract series were searched. Randomized or quasi-randomized trials of all languages were included and evaluated for methodologic quality using the Jadad scale. Outcomes were pain, function, global improvement, and imaging. Data could not be pooled; therefore, a best-evidence synthesis was performed to determine the strength of evidence by control group. The adequacy of the acupuncture procedure was assessed by 2 acupuncturists trained in treating OA and blinded to study results. RESULTS: Seven trials representing 393 patients with knee OA were identified. For pain and function, there was limited evidence that acupuncture is more effective than being on a waiting list for treatment or having treatment as usual. For pain, there was strong evidence that real acupuncture is more effective than sham acupuncture; however, for function, there was inconclusive evidence that real acupuncture is more effective than sham acupuncture. There was insufficient evidence to determine whether the efficacy of acupuncture is similar to that of other treatments. CONCLUSION: The existing evidence suggests that acupuncture may play a role in the treatment of knee OA. Future research should define an optimal acupuncture treatment, measure quality of life, and assess acupuncture combined with other modalities.

Acupuncture Analgesia↗

PubMed2003

The thyrotropin-releasing hormone (TRH) hypothesis of homeostatic regulation: implications for TRH-based therapeutics.

The functions of thyrotropin-releasing hormone (TRH) in the central nervous system (CNS) can be conceptualized as performed by four anatomically distinct components that together comprise a general TRH homeostatic system. These components are 1) the hypothalamic-hypophysiotropic neuroendocrine system, 2) the brainstem/midbrain/spinal cord system, 3) the limbic/cortical system, and 4) the chronobiological system. We propose that the main neurobiological function of TRH is to promote homeostasis, accomplished through neuronal mechanisms resident in these four integrated systems. This hypothesis offers a unifying basis for understanding the myriad actions of TRH and TRH-related drugs already demonstrated in animals and humans. It is consistent with the traditional role of TRH as a regulator of metabolic homeostasis. An appreciation of the global function of TRH to modulate and normalize CNS activity, along with an appreciation of the inherent limitations of TRH itself as a therapeutic agent, leads to rational expectations of therapeutic benefit from metabolically stable TRH-mimetic drugs in a remarkably broad spectrum of clinical situations, both as monotherapy and as an adjunct to other therapeutic agents. The actions of TRH are numerous and varied. This has been viewed in the past as a conceptual and practical impediment to the development of TRH analogs. Herein, we alternatively propose that these manifold actions should be considered as a rational and positive impetus to the development of TRH-based drugs with the potential for unique and widespread applicability in human illness.

Animals↗

PubMed2001

Acute phase predictors of subsequent psychosocial burden in carers of elderly stroke patients.

The objective was to describe the psychosocial burden experienced by informal carers of elderly stroke victims, and to identify its predictors among baseline characteristics of the patients. From a prospective study of 171 elderly stroke patients admitted to a geriatric ward for rehabilitation in the acute phase, 68 patients living at home with a primary caregiver were identified 6 months after the stroke. At baseline, all the patients were assessed with respect to motor function, cognitive function, global handicap and activities of daily living, and after 6 months the caregivers were assessed, using the Relatives' Stress Scale. According to this, the most frequent impacts were worries that an accident might befall their relatives, that they had to reorganise their household routines and further, that their social life and ability to take holidays had been reduced. Impaired cognitive function was the only baseline patient characteristic that predicted a subsequent psychosocial burden on the carer. Special attention should be paid to elderly stroke patients initially assessed with impaired cognitive function and their caregivers.

Activities of Daily Living↗

PubMed1987

Marrow uptake index (MUI): a quantitative scintigraphic study of bone marrow in aplastic anaemia.

Aplastic anaemia affects the entire bone marrow. Current methods of assessment of bone marrow function, like bone marrow biopsy or peripheral blood examination are either invasive or inadequate and cannot be expected to represent fully the changes in the entire bone marrow tissue. This prospective study was undertaken to develop and standardise a new Nuclear Medicine technique called 'Dynamic Bone marrow Imaging'. Eleven patients and ten controls were studied. Serial images of the pelvis were obtained in frame mode following intravenous injection of 185-370 mBq of 99mTc S. Colloid, and an index, called the Bone Marrow Uptake Index (P) was calculated by taking into consideration the time activity curve obtained over the iliac crest. This was followed by static imaging of the entire bone marrow in all cases. It was possible to obtain excellent information regarding topographic distribution of bone marrow as well as detect early changes in bone marrow function following treatment. An attempt was also made to correlate bone marrow cellularity as obtained by bone marrow biopsy with the results of dynamic bone marrow scintigraphy. On the basis of the encouraging results obtained in the present study, the authors feel that dynamic bone marrow imaging is an excellent technique for the objective evaluation of bone marrow in aplastic anaemia. Aplastic anaemia affects the entire bone marrow tissue. Although much progress has been made in the management of this disease, many aspects of it await better understanding. There is almost total lack of knowledge regarding the distribution of functioning marrow in various phases of aplastic anaemia, such as in relapse and remission. Current methods of assessment of marrow function rely mainly on bone marrow biopsy and peripheral blood examination. Bone marrow biopsy is invasive and cannot be expected to represent fully the changes in the entire tissue. Changes in peripheral blood picture lag behind the changes in the bone marrow. Thus, there is a need for an investigation which is safe, simple, sensitive, non invasive and capable of assessing the global function of bone marrow. Radio-nuclide imaging of bone marrow requires labelling of one or more components of this widely dispersed tissue. The reticuloendothelial and erythropoietic components can be labelled with radio-colloids and radio-iron respectively. Experimental studies have shown that the reticuloendothelial and erythropoietic elements are invariably found together in the marrow and have similar distribution. This report is based on a prospective study of bone marrow function in patients with aplastic anaemia, using 99mTc. Sulphur colloid.

Adolescent↗

PubMed1994

Three-dimensional planar and vector analysis of brainstem auditory evoked potentials as a function of intensity in guinea pig.

Brainstem auditory evoked potentials (BAEPs) have been studied in guinea pigs as a function of intensity by means of the Three-channel Lissajous' trajectory (3-CLT) method. Data were quantified in terms of duration, orientation of planar segments and orientation of equivalent dipoles. The auditory stimulus was a click varying from 48 dB pSPL to 108 dB pSPL by steps of 10 dB pSPL. A semi-automated procedure was used to identify planar segments, by calculating the curvature (apex) and magnitude curves. Dipole analysis was made at the corresponding magnitude peaks and apices. Taking into account a symmetrical orientation of planar segments and equivalent dipoles, similar results were obtained after right and left stimulation. Six planar segments, A, B, C, D, E, F were analysed as were six equivalent dipoles corresponding roughly to P1, N1, P3, N3, P4 and N4 on a vertical lead. There was a parallel latency shift of the first and last point of planar segments as a function of intensity, accounting for the stable duration of a planar segment. Planar segment D (roughly corresponding to N3 on a vertical lead) disappeared as the intensity decreased. Only planar segments C and F and dipole N3 showed a significant change in their orientation. The stable duration of planar segments suggests that intensity coding in the auditory brainstem, in terms of a global function of a system, involved the same number of synapses in a serial circuit while the activated neurons increase in the in parallel circuitry, as the intensity increases. Similar changes in orientation of planar segments C (including P3 of guinea pig BAEPs) and F (including N4 of guinea pig BAEPs) suggest a possible common source with a depolarization followed by a repolarization.

Acoustic Stimulation↗

PubMed1996

Assessment of myocardial perfusion and metabolism for assessment of myocardial viability.

Identifying preserved myocardial viability in the presence of severe regional left ventricular dysfunction is becoming increasingly more important for clinical decision-making to better select those patients with coronary artery disease who will benefit most from revascularization. 201Tl remains the most commonly employed radionuclide for detecting both ischemia and viability. A post-exercise defect showing complete or partial redistribution on delayed images implies transient ischemia and preserved viability with a 90% chance of exhibiting improved 201Tl uptake with repeat testing after coronary revascularization. Mild persistent defects with < 50% 201Tl uptake on 4-hour redistribution images also imply viability with a 60-70% probability of showing improved 201Tl uptake after repeat imaging following revascularization with concomitant enhancement of regional systolic function. In contrast, a severe persistent defect with < 50% 201Tl uptake compared to peak uptake has only a 15% chance of exhibiting improved perfusion and corresponding improved function after revascularization. Detection of defect reversibility on 201Tl imaging is enhanced by "reinjection" of a second 201Tl dose after acquisition of redistribution images. Initial and 4-hour rest/redistribution imaging has proven most useful for detection of viability in the resting state in patients with ischemic cardiomyopathy. The greater the extent of preoperative viability, the greater is the improvement in regional and global function after revascularization. 99mTc sestamibi has also been demonstrated to be extracted by myocardial cells in proportion to regional blood flow in the presence of viable myocites. Although this agent does not redistribute after intravenous injection, its > 50% uptake of the tracer implies viability and predicts improved regional function after revascularization. Finally, positron emission tomography with 18F fluorodeoxyglucose (FDG) is perhaps the most sensitive noninvasive imaging technique for detection of viability in stunned or hibernating myocardium. A mismatch pattern between regional flow and FDG uptake has approximately an 80-85% positive predicted value for predicting improved function in asynergic myocardial regions after revascularization. A match pattern where flow and FDG uptake are both reduced has an 80% negative predicted value for lack of functional recovery after revascularization.

Coronary Circulation↗

PubMed1997

Quality of life and sexuality following radical prostatectomy in patients with prostate cancer who use or do not use erectile aids.

OBJECTIVES: It is well established that prostate cancer patients undergoing radical prostatectomy may experience disruptive side effects, most notably urinary incontinence and erectile dysfunction. The purpose of this study is to compare relevant outcomes between patients awaiting radical prostatectomy for prostate cancer and patients who already underwent the surgery, taking into account type of prostatectomy and use of erectile aids. METHODS: We compared self-reports of global quality of life, sexuality, urinary continence, and physical capabilities in 86 nerve-sparing patients, 89 standard-prostatectomy patients, 74 prostatectomy patients who used erectile aids, and a comparison group of 45 patients awaiting radical prostatectomy. RESULTS: Regardless of type of surgery, use of erectile aid, or preoperative status, most patients reported good quality of life. The best outcomes in sexuality were reported by patients who used erectile aids, who appeared similar in sexuality to patients awaiting surgery. When differences were detected, standard prostatectomy patients who did not use erectile aids scored worse in most areas of sexuality than nerve-sparing patients who did not use erectile aids. There were no differences in frequency of urinary leakage among the three surgery subgroups. CONCLUSIONS: Although most patients reported problems in sexual and urinary function, global quality of life does not appear to be compromised following radical prostatectomy. Findings suggest that postsurgical sexuality differs depending on type of prostatectomy and use of erectile aids, while urinary function is similar across surgery groups. We conclude that erectile aids should be offered routinely to patients who are ineligible for nerve-sparing surgery or experience erectile difficulties following the nerve-sparing procedure.

Aged↗