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PubMed1990

Effects of nisoldipine on stress-induced changes in haemodynamics and plasma catecholamines in normotensives and hypertensives.

In a double-blind, placebo-controlled crossover study 10 mg nisoldipine was given orally twice daily for 3.5 days to 12 normotensives and 12 essential hypertensives. In each study period, subjects were exposed to 6 min of physical exercise and 3 min of mental stress following the morning dose on day 3 and 4, respectively. Blood pressure, heart rate, systolic time intervals (day 3 only) and plasma levels of noradrenaline, adrenaline, dopamine as well as dihydroxyphenylglycol (DOPEG; the main presynaptic metabolite of noradrenaline) were determined at rest and at the end of both tests. Nisoldipine increased resting heart rate in normotensives and hypertensives, but reduced resting BP and BP during mental stress in hypertensives only. It also increased plasma concentrations of noradrenaline and DOPEG at rest and plasma noradrenaline concentrations during mental stress in both groups. However, nisoldipine affected neither exercise- nor stress-induced changes in any of the parameters monitored here. There was a correlation between the drug-induced percentage fall in resting BP and the height of BP during placebo treatment. While the resting values of plasma DOPEG were higher in hypertensives than in normotensives, those of plasma noradrenaline were not. Consequently, the linear relationship that existed between the resting plasma concentrations of DOPEG and noradrenaline in both groups was shifted to higher DOPEG levels in hypertensives when compared with normotensives. In conclusion, the effectiveness of nisoldipine in lowering BP was the more pronounced the higher the BP to begin with. Nisoldipine did not attenuate exercise- or stress-induced increases in plasma catecholamines. Essential hypertension may be associated with an enhanced presynaptic formation of DOPEG.

Adult↗

PubMed1999

Factor of risk for hip fracture in normal Chinese men and women in Taiwan.

We have investigated the age-related change in factor of risk (Phi) for the proximal femoral load during free fall in 548 females and 240 males aged 21-79 years. These individuals were divided into either young (age <50 years) or old group (age >/=50 years). Another 26 females with hip fractures were included for comparison. The bone mineral density (BMD) of proximal femoral neck was measured by a Norland XR-26 dual-energy X-ray absorptiometer (DXA). The estimated fracture load (L) of femoral neck was calculated from the BMD with the regression equation derived by Courtney et al. [2,3] and estimated fall force (F) by body weight and height according to the regression equation derived by Nakamura et al. [6] respectively. Phi was defined as the quotient of F/L. The results showed an age-related decrease of BMD (P < 0.001) in both genders corrected for weight and height. By multiple linear regression analysis, the F decreased significantly with aging corrected for BMD in old males (partial r = -0.255, P < 0.01) and increased with aging in all females (young, partial r=0.287, p < 0.001; old, partial r = 0.252, P < 0.001). L decreased significantly with aging corrected for height and weight in males (young, partial r = -0.401, P < 0.01; old, partial r = -0.178, P < 0.05) and females (young, partial r = -0. 168, P < 0.05; old, partial r = -0.459, P < 0.001). However Phi decreased with aging in young males (P < 0.01) and females (young: P < 0.001, old: P < 0.001). Phi increased in old women but not in old men, and was higher in old women compared with old men. The 26 patients with hip fractures had a significantly higher Phi value than 85 age-matched women. In conclusion, Phi may provide a comprehensive comparison of the risk of hip fracture in the elderly population.

Absorptiometry, Photon↗

PubMed1983

Genotype X environment interaction in Hereford cattle: III. Postweaning trait of heifers.

The postweaning performance of heifers from contrasting lines of Hereford cattle was compared simultaneously at Miles City, Montana and at Brooksville, Florida in an experiment designed to evaluate the importance of genotype X environment interactions in beef cattle. During Phase 1 of the study (1964 to 1973), the performance of two unrelated lines, M1 and F6, was compared at the two locations. During Phase 2 (1967 to 1974), two related lines, M1 of Montana origin and F4 derived from M1 by selection in Florida, were compared at each of the two locations. The line X location interaction term was highly significant in either Phase 1, Phase 2 or both for weaning weight, daily gain from weaning to spring, spring yearling weight, daily gain from weaning to fall, fall yearling weight, yearling condition score, conformation score, wither height, body depth, body length, shoulder width, hook width and forecannon circumference. Daily gain of yearlings from spring to fall was the only objective measurement for which the interaction term was nonsignificant in both phases. These results, consistent with the results on performance to weaning age reported previously, indicate the existence of highly significant genotype X environment interactions in beef cattle. The results indicate that genetic adaptation to the local environment is important in beef cattle production and should be considered in designing breeding programs or performance testing procedures and in interregional transfer of breeding stock.

Animals↗

PubMed1977

Comparative rapidity of response of height, limb muscle and limb fat to treatment with human growth hormone in patients with and without growth hormone deficiency.

The widths of muscle and fat in the upper arm and calf have been measured radiologically before treatment and at intervals of 1, 3. 6 and 12 months during administration of human growth hormone in 41 pre-pubertal patients with "isolated" growth hormone deficiency and in 22 patients with multiple deficiencies following gross CNS lesions. Height was also measured. The curves of response of muscle and fat on the one hand and height on the other were strikingly dissimilar. A very rapid increase of muscle took place in the first month; but after 6 months the increments had fallen to normal values for size and bone age. Decrements in fat followed the same pattern. Height, however, showed a smaller increment in the first month than in the period 1 to 3 months in the "isolated" deficiency cases, and much slower fall back towards normal. The first-year height increment was not at all correlated with the first-month height increment in the "isolated" deficiency cases, though it had a correlation coefficient of 0.46 with the first-month muscle increment. Nine cases of short stature not due to GH deficiency were similarly studied. There was considerable overlap between deficient and non-deficient in all responses in the first 3 months, though children in the top half of the responder's distribution could be distinguished. A 1-month radiological test of responses to hGH in doubtful cases is proposed, using in all only 40 IU of hormone. It is emphasised that a small response of muscle and fat may occur in cases who do nevertheless respond in height to hGH administration; a large response in muscle and fat, however, is indivative that treatment will be effective, though it does not well predict the precise amount of height that may be gained.

Adipose Tissue↗

PubMedDate not supplied

Impact forces following the unexpected removal of a chair while sitting.

This report documents the impact forces measured during trials of dropping an anthropometric dummy (80.3 kg) (Hybrid III, First Technologies Corporation) in three different positions onto it's pelvis (gluteal region) from a seated height, which was meant to simulate a chair being pulled out from an individual in the process of sitting. Peak forces on the pelvis were measured by a force plate covered with industrial carpet. These impact forces were translated to the compressive and shear forces on the lumbar spine. The peak impact forces during the different body postures were 20000-29900 N (torso upright); 13000-22200 N (torso-legs 45 degrees to floor); 6000-15200 N (layout position). The impact forces generated from falling onto the pelvis from a seated height, appear to be sufficient to cause injury as the forces well exceed documented injury tolerance levels.

Accidental Falls↗

PubMedDate not supplied

Ventilatory function of workers at Okpella cement factory in Nigeria.

Simple ventilatory function tests were done in 447 cement factory workers. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) were higher in males than females and correlated well with age and height. FEV1 was smaller in workers who were in closer contact with cement dust. The three measured indices of ventilatory function decreased with years of service and the fall was neither accounted for by age nor height. Eleven chronic bronchitics were found, but these were heavy smokers. Overall, the lung volumes obtained were within the normal range for Nigerians. However, the nature of job done in the cement factory, and duration of service may well be important in the aetiology of "cement factory lung disease".

Adult↗

PubMed2004

Short stature, obesity and arterial hypertension in a very low income population in North-eastern Brazil.

BACKGROUND AND AIM: This cross-sectional study involved the adult population (age >18 and <60 years) of a 315-shack slum on the outskirts of the city of Maceió in North-eastern Brazil. The purpose was to investigate whether short stature in adults (an indicator of undernutrition in early life) is associated with arterial hypertension and obesity. METHODS AND RESULTS: We collected the subjects socio-economic data, and arterial hypertension (AH), weight, height, waist circumference and waist/hip (W/H) circumference ratio measurements. Hypertension was diagnosed as diastolic AH f 90 mmHg and/or systolic AH f 140 mmHg. The body mass index (BMI) was used to determine nutritional status, with overweight/obesity being defined on the basis of a cut-off point of 25 kg/m2. A W/H ratio of f 0.80 for women or f 0.95 for men was considered indicative of abdominal obesity. Short stature was defined as falling into the 1st quartile (Q) of height distribution. Hypertension was prevalent in 28.5% of the population (women=38.5%; men=18.4%). The systolic and diastolic AH readings were significantly higher in women in the 1st Q than in those in the 4th Q, and the same was true of W/H. The prevalence of hypertension was statistically significant for the first two Q's in comparison with the last two: 22.1% vs 14.6% (men), and 42.4% vs 34.6% (women). Hypertension was more prevalent in women who were obese and short (50%) than in those who were obese but not short (OR=1.98; CI=1.22-2.96). CONCLUSIONS: Living conditions were extremely precarious and the prevalence of hypertension was quite high. Stature negatively correlated with hypertension and overweight in women but not in men.

Adult↗

PubMed2006

Deficient limb support is a major contributor to age differences in falling.

Older adults are more likely than young to fall upon a loss of balance, yet the factors responsible for this difference are not well understood. This study investigated whether age-related differences in movement stability, limb support, and protective stepping contribute to the greater likelihood of falling among older adults. Sixty young and 41 older, safety-harnessed, healthy adults were exposed to a novel and unexpected forward slip during a sit-to-stand task. More older than young adults fell (76% vs. 30%). Falls in both age groups were related to lesser stability and lower hip height at first step touchdown, with 97.1% of slip outcomes correctly classified based on these variables. Decreases in hip height at touchdown had over 20 times greater effect on the odds of falling than equivalent decreases in stability. Three age differences placed older adults at greater risk of falling: older adults had lower and more slowly rising hips at slip onset, they were less likely to respond to slipping with ample limb support, and they placed their stepping foot less posterior to their center of mass. The first two differences, each associated with deficient limb support, reduced hip ascent and increased hip descent. The third difference resulted in lesser stability at step touchdown. These results suggest that deficient limb support in normal movement patterns and in the reactive response to a perturbation is a major contributor to the high incidence of falls in older adults. Improving proactive and reactive limb support should be a focus of fall prevention efforts.

Accidental Falls↗

PubMed1995

[Limb injuries at the Aerodium hover sport facility in Eilat].

The Aerodium hover sport facility in Eilat has been in operation for the past 4 years and 33 patients have been treated for injuries caused by falls while hovering. The Aerodium is a new sport facility in Israel, similar to others in the US and Switzerland. It includes a 4-meter-wide wind tunnel with air pushed vertically upwards toward its center. Air flow velocity is adjustable and ranges between 120 and 140 km/hr, with a maximum of approximately 180 km/hr. Participants wear special suits and jump into the center of the column of air to hover. The hover suits are very wide, and puff up like a balloon; the sleeves and leggings have vents through which air escapes. Participants hover with their arms spread out and their legs slightly spread apart. The inexperienced hover at a height about 2 m. and the more experienced at heights of up to 5 m. During falls the person hovering lands on air mattresses surrounding the air column. Failure to follow rules and procedures, usually while changing limb position during hovering, can unbalance the inexperienced participant and lead to uncontrolled spins and falls.

Athletic Injuries↗

PubMed1997

[New spine and non-spine fractures in 871 women/year treated with oral pamidronate plus calcium and vitamin D supplements].

A sample of 871.3 patients/year was conformed by 205 postmenopausal women, aged 64.8 +/- 18.2 years (mean +/- SD), followed up during 51 +/- 12 months. All have osteoporosis, diagnosis assessed through radiological findings of at least one atraumatic fracture or vertebral crush ("severe osteoporosis" according to the new WHO classification). Each woman received 100 mg/day oral pamidronate (enteric coated soft gelatin capsules), half an hour before breakfast. Additional calcium and vitamin D were supplemented as follows: Total daily calcium = 1 g provided by diet and/or calcium carbonate. Vitamin D equivalent to 400-1200 IU/day. All patients were recommended to improve their physical activity, at least by walking exercise. Clinical examination radiological, bone mineral density (BMD) and biochemical studies were periodically performed. But, fracture indicence was the end-point of the study. Same was related to the 1,673 fall episodes recorded in the sample. In addition, height loss, lumbar BMD, proximal femur BMD, are also reported. Data has been cross-sectional collected in March 1995. All patients improved the symptomatology, specifically pain. This, and the good tolerability of the treatments proved to be considerably favorable for their compliance. Within the observation period, only 12 patients decreased their height (5.85%; mean = 0.85 cm; range = 0.5-2.0 cm). Lumbar spine BMD increased in 90% of 48 women. Mean gain after 2 years was 5.3 +/- 1.0% (p < 0.001). Proximal femur increased in 78% of other 32 women. Mean gain 6.3 +/- 0.7% (p < 0.001) after 2 years. A total of 78 new fractures were recorded, 47 vertebral crush, 29 forearm fractures and 2 hip fractures. Its incidence related to the fall episodes was of 2.8; 1.7 and 0.12% respectively. When compared with a historical estimated data, from an untreated population (Cummings SR et al, 1994), both, the total number of new fractures and the new hip fractures were significantly lower (p < 0.01) in our treated population than the reference data. Pamidronate, in oral doses of 100 mg/day, adequately supplemented with calcium and vitamin D, proved to be effective and a well tolerated therapy. The low rate of height's loss, BMD significant increases in subgroups of patients and the low rate of new fractures, strongly support the use of the compound to treat severe osteoporotic women. To our knowledge, this is the first time, that the new fracture incidence is related to the fall frequency reported in a bisphosphonate treated sample.

Accidental Falls↗

PubMed1999

Risk of fracture in elderly patients: a new predictive index based on bone mineral density and finite element analysis.

Hip fracture is more and more frequent in elderly population. For this reason, an increasing attention has been focused on the development of a non-invasive method to predict femoral neck fracture. A conventional approach to fracture diagnosis is the measurement of bone mass by dual-energy X-ray absorptiometry in some regions of interest. The aim of this work is to assess a method that accounts for the structural details of the bone providing a more direct determination of strength properties, and improving the diagnostic power of the current densitometric systems. A 2D finite element model of the proximal femur is derived from dual-energy X-ray absorptiometry data. Initially, the method is validated in vitro using a replica of the human femur. The predicted results are compared to strain-gauge measurements and to a 3D finite element model, with good agreement being observed. Then, an in vivo preliminary study on a limited group of patients is carried out. The loading condition that simulates a fall to the side onto the greater trochanter from standing height is employed. All simulations show a peak strain at the femoral neck region with a strain distribution typical of a fall on the side. The proposed method seems to supply a useful tool for the in vivo analysis of the risk of hip fracture.

Aged↗

PubMed2006

Isolated superior mesenteric vein injury from blunt abdominal trauma: report of a case.

Solitary injury of the superior mesenteric vein (SMV) after blunt abdominal trauma is a rare but frequently fatal injury. A 63-year-old man was admitted to our hospital after falling on his right side from a height of 5 m. Computed tomography (CT) showed blood in the peritoneal cavity, but no liver or spleen injury. Emergency laparotomy revealed complete disruption of the SMV across the site of confluence with the splenic vein. We performed primary reconstruction by connecting both ends of the vein as an end-to-end anastomosis. Following restoration of gastrointestinal passage the patient was discharged in good health. At his 6-month follow-up, angio-CT showed an unobstructed SMV and portal vein. There was slight stenosis at the site of the suture and no sign of development of collateral venous circulation into the liver. This case report shows that primary repair of an SMV injury can be done in a stable patient without concomitant life-threatening injuries once proximal and distal control of bleeding has been achieved. Ligation should be reserved for patients with multiple injuries and an unstable condition.

Abdominal Injuries↗

PubMed2002

Longitudinal brainstem laceration associated with complex basilar skull fractures due to a fall: an autopsy case.

This report describes an autopsy case of a rare longitudinal brainstem laceration associated with complex basilar skull fractures. The victim was a 40-year-old male who died immediately after falling from a roof (9.2m in height) of a factory onto a concrete floor. The postmortem examination revealed an incomplete ring fracture of the base of the skull with longitudinal fractures of the sphenoid (clivus of the dorsum sellae turcicae) and occipital bones, cerebral contusions in the frontal and temporal poles, a longitudinal brainstem laceration at the posterior median sulcus of the pons accompanied with multiple contusional hemorrhages in the brainstem and corpus callosum. Related blunt-force injuries were observed in the parieto-occipital region of the head, shoulder and upper back involving the fractures of the cervical and thoracic vertebrae, and sternum and ribs, indicating a huge impact to the occiput and subsequent impression of the vertebral column into the base of the skull due to violent anteroflexion of the neck, which caused the complex basilar skull fractures, contusions and longitudinal laceration of the brainstem.

Accidental Falls↗

PubMedDate not supplied

Ethnic differences in growth and nutritional status: a study of poor schoolchildren in southern New Jersey.

The growth and nutritional status of 2,056 schoolchildren from a poor community in southern New Jersey were assessed. Age-adjusted differences in growth among black, white, and Hispanic children were examined. Black youths were 2.5 centimeters (cm) taller (P less than .001) and 0.9 kilograms (kg) heavier than white youths (P less than .05). Black girls were 4.1 cm taller (P less than .001) and 2.8 kg heavier than white girls (P less than .01). Hispanic girls were 1 kg heavier (P less than .05) and 0.9 cm taller (not significant) than white girls. There was little difference in growth between Hispanic and white youths. Children were assessed with the use of the Centers for Disease Control's nutritional surveillance cutpoints; less than 5 percent of each ethnic group fell below the fifth percentile, according to the National Center for Health Statistics' weight-for-height standards. White and Hispanic youths were twice as likely as blacks to fall below the 5th percentile for stature or to be overweight (above the 95th percentile for weight-for-height). Compared with black girls, white and Hispanic girls were three to four times more likely to fall below the fifth percentile for stature. The prevalence of short stature was also higher among white girls (15.9 percent) compared with Hispanics (10.3 percent). There was little difference in the prevalence of overweight by ethnic group for girls. These data show that white children from poor communities have decreased growth and suggest that they may be at increased risk of nutritional problems.

Black or African American↗

PubMed1984

Relations among threshold, spike height, electrode distance, and conduction velocity in electrical stimulation of certain medullospinal neurons.

This report describes how the threshold for extracellular, electrical stimulation of cell bodies in the rat's rostromedial medulla depends on the distance to the stimulating electrode. A monopolar microelectrode both delivered current pulses near medullospinal neurons and, after decay of the stimulus artifact, detected whether an orthodromic spike had occurred by collision of that spike with a suitably timed antidromic spike initiated at the thoracic spinal cord. The liminal current and the height of antidromic spikes were noted at a series of vertical electrode positions. Regression analysis was performed to determine whether threshold and the inverse of peak-to-peak spike height varied more as the radial distance or its square. The square relationship provided a much better fit for threshold and a marginally better fit for the inverse of spike height. The spatial decline in excitability (K2) averaged 859 microA/mm2, falling within the range of values found for fibers and cell bodies in other studies. The constant of spatial decline in spike height (C2) in millivolts per square millimeter was positively correlated with K2. Both C2 and K2 were negatively correlated with conduction velocity. From threshold distance curves fitted by regression analysis, the mean separation of sites of spike maxima and threshold minima along each electrode path was 16 micron; the estimated distance from these sites to, respectively, the loci of spike generation and spike excitation were positively correlated and similar. The variation of C2 and K2 with conduction velocity may be due either to an influence of the size and shape of the dendritic tree on the spatial decrement of excitability and spike height or to a confounding in the studied equations of the space-independent effect of the size of a cell body on spike height and excitability.

Action Potentials↗

PubMedDate not supplied

Human growth in southern Zambia: a first study of Tonga children predating the Kariba Dam (1957-1958).

During the late 1950s the Kariba hydro-electric dam was constructed on the border of Zambia and Zimbabwe forcing the relocation of 57,000 people, mainly Tonga. As part of a larger study to assess the effects of the relocation, research into the human biology of the Tonga people was conducted. The research reported here provides a basis for comparison with long-term follow-up data on growth and physical status of Gwembe Tonga to determine the effects of resettlement. The sample consists of 303 schoolchildren, 7 to 13 years, from two schools that were not relocated and three schools that were to be relocated. Homogeneity of the two groups led us to combine them as a single baseline sample before relocation. Comparisons with NCHS (National Center for Health Statistics) reference data and with contemporary urban data from southern Zambia indicate sub-optimal nutritional status. After ages 6 and 7, height-for-age and weight-for-age Z-scores of boys decline steadily towards -2.0 SD throughout the 12th year, whereas mean Z-scores of girls decline markedly from 8 years on. Mean HAZ (Height-for-age-Z-score) of girls falls below -2.0 SD by 11 years and approaches -3.0 SD by 13 years. Thirty-nine percent of males and 47% of females in the baseline sample showed effects of moderate or severe protein energy malnutrition at the time of relocation. Because these children were from a school sample, gender differences in opportunity to attend school may be a factor in what appears to be gender bias, favoring the status of boys. This sample provides a baseline for assessing the long-term impact of forced relocation on the Gwembe Tonga.

Child↗

PubMed1995

Skull fractures in children: altered conscious level is the main indication for urgent CT scanning.

It has been suggested that all children with skull fractures require urgent CT scanning to exclude intracranial injury. Adhering to such a policy could both tax limited scanning facilities and result in unnecessary exposure to radiation. The aim of this study is to assess the level of consciousness in determining the need for urgent CT scanning, and the possible role of the mechanism of injury as a secondary risk factor. We identified 140 children admitted during a 7-year period with a skull fracture after falling outside the home. Thirteen children had a diminished level of consciousness. Scans were performed in nine, and seven of the scans revealed significant intracranial injuries. By comparison, all 127 children with a normal level of consciousness recovered fully. Scanning was performed in only eight of them; seven scans were normal and one revealed a small subarachnoid heamorrhage which did not require active treatment. In addition, all 13 children with a diminished level of consciousness had sustained their injuries by falling from greater than their own standing height. By comparison, none of the children who had sustained their skull fractures by tripping up had a diminished level of consciousness or a significant intracranial injury. We conclude that all children with a diminished level of consciousness need to undergo an urgent CT scan. Children with skull fractures and a normal conscious level may be managed initially by neuroobservations and the clinician may be further reassured if the child's injury resulted from tripping up.

Child↗

PubMed2006

Assessment of low quantitative ultrasound values of calcaneus in Chinese mainland women.

Calcaneus quantitative ultrasound (QUS) assessment is a safe and reliable method for evaluating skeletal status. Until now, considerable data have been accumulated on the distribution of QUS in Caucasian populations, whereas such data are still insufficient in Asian populations, especially in Chinese mainland. The present study aimed to obtain the distribution characteristic of calcaneus QUS in healthy Chinese women, and to further investigate the distribution of low bone mass by QUS stiffness index (SI). This study included 2,498 healthy Chinese females aged 10-87 yr. The QUS exhibited a characteristic mild rise and then fall pattern with increasing age. Age, body height, and weight were significant influencing factors on SI, especially age and weight. The prevalence of osteoporosis detected using instrument-derived T-score or internal T-score was different from that calculated according to calcaneus bone mass density (BMD) previously reported. Furthermore, between instrument-derived T-scores and internal T-scores, there were also significant differences. We concluded that the World Health Organization criteria from BMD may not be appropriate for QUS, and the instrument-derived T-score may also not be appropriate for the studied population. The results will be useful for predicting fracture risk of Chinese women and determining diagnostic criteria of osteoporosis by QUS.

Adolescent↗