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PubMed1986

Comparison of bronchial responses to ultrasonically nebulized distilled water, exercise, and methacholine in asthma.

We compared the responses to inhaled methacholine, ultrasonically nebulized distilled water, and exercise in 25 subjects with atopic asthma. The methacholine inhalation test and challenges with distilled water and exercise were performed on three separate days 48 hours apart. Bronchial responsiveness to methacholine and ultrasonically nebulized distilled water was measured as the concentration of methacholine (PC20M) and the volume output of the ultrasonic nebulizer (PO20 UNDW) producing a 20 percent fall in the forced expiratory volume in one second (FEV1). The response to exercise was expressed as the percentage of fall in FEV1 from the value before exercise. Seventeen subjects showed a fall in FEV1 of more than 20 percent after exercise. Eight subjects had a stimulus-response curve to distilled water that was flat up to the maximal volume output from the nebulizer, but only four of them also showed no significant response to exercise. The response to exercise correlated better with PO20 UNDW (r = -0.66; p less than 0.01) than with PC20M (r = -0.19; p greater than 0.5) in those responding to distilled water. In all of the tested subjects, exercise-induced bronchoconstriction correlated with PC20M (r = -0.61; p less than 0.01). The mean PC20M was significantly lower in the subjects with a significant response to distilled water and exercise (p less than 0.001 and p less than 0.0001, respectively). We concluded that ultrasonically nebulized distilled water and exercise provoke significant bronchoconstriction in the subjects with more severe nonspecific bronchial hyperresponsiveness. The correlation found between the two stimuli supports the hypothesis that they act by similar mechanisms.

Adolescent↗
PubMed2001

The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain.

BACKGROUND: With the advent of magnetic resonance imaging, or MRI, clinicians and researchers have sophisticated techniques by which to assess the anatomy of the temporomandibular joint, or TMJ. Imaging is indicated when the results will affect the patient's care beyond that which can be gained from a complete clinical assessment. One of the primary indications for treatment of patients with temporomandibular disorders, or TMDs, is jaw pain, including TMJ pain. Therefore, it is necessary to assess whether MRI-depicted TMJ findings are associated with TMJ pain. This study assessed the relationship between TMJ pain and clinical and MRI findings. METHODS: Subjects consisted of 85 patients with unilateral jaw pain in the area of the TMJ. The contralateral, nonpainful TMJ served as the matched control. All patients underwent a complete stomatognathic examination that included palpation of both TMJs. No care was given and no anti-inflammatory medications were prescribed until bilateral MRIs were obtained within one week. RESULTS: The authors found significant relationships between the side of reported jaw pain and the patient's report that palpation of the TMJ was painful and between the side of reported pain and the presence of MRI-detected effusions. The authors found no relationship between the side of reported pain and the presence of a disk displacement, or DD, or between the presence of effusions and DD on either side of the jaw. CONCLUSION: Although MRI-depicted effusions of the TMJ were associated with reports of TMJ pain, there was a high level of false-positive and false-negative findings. The results indicate that palpation of the TMJ is more accurate than MRI-depicted effusions in identifying the TMJ as the source of pain for patients with unilateral jaw pain. CLINICAL IMPLICATIONS: The results of this study suggest that palpation of the TMJ is superior to MRI in identifying the joint as the source of pain. Therefore, the most cost-effective and valid test to determine if the TMJ is a source of jaw pain is a complete clinical assessment.

Adolescent↗
PubMedDate not supplied

Correlates of low bone density in females with anorexia nervosa.

UNLABELLED: The objectives were to delineate those factors which correlate with low bone density in patients with anorexia nervosa and in turn to predict those at greatest risk for osteopenia. DESIGN: Bone density was evaluated by dual energy x-ray absorptiometry in 28 postmenarchal females with anorexia nervosa who had never received hormonal therapy. Bone density results were correlated with specific historical and physical factors utilizing descriptive statistics, scatter plots, and the Spearman correlation coefficient. RESULTS: Mean age was 18.6 years, mean age at menarche was 12.9 yrs, mean length of illness was 19.8 months and mean duration of amenorrhea was 13.4 months. Mean % ideal body weight was 84% at the time of bone density, 75% at minimum weight and 100% at maximum weight. Mean lumbar spine bone density was -1.69 standard deviations from the norm; mean lateral spine bone density was -1.45 standard deviations from the norm; mean femoral neck of the hip bone density was -1.18 standard deviations from the norm. There was a strong negative correlation between duration of amenorrhea and bone density at the lumbar spine (r = -0.50, p < .01) and a mild correlation at the lateral spine (r = -0.49, p < 0.05) and femoral neck (r = -0.41, p < 0.05). There was also a strong negative correlation between length of illness and bone density at the lumbar spine (r = -0.53, p < 0.01) and lateral spine (r = -0.77, p < 0.0001), and a mild correlation with the femoral neck (r = -0.48, p < 0.05). Scatter plots of lumbar bone density versus duration of amenorrhea, and versus length of illness clearly showed not only that longer duration of amenorrhea and longer length illness correlated to bone loss, but also strikingly that within a short time of being ill and amenorrheic, significant bone loss was seen. Age, and age at menarche correlated mildly with osteopenia at the lateral spine; age correlated mildly with osteopenia at the femoral neck as well. There was a trend for minimum BMI to correlate with osteopenia at the lateral spine. There were no correlations of bone density with % IBW at bone density, minimum % IBW, maximum % IBW, change in % IBW, BMI at the time of the bone density, maximum BMI or change in BMI. CONCLUSIONS: Low bone density, especially in the lumbar spine, correlated with both a longer duration of amenorrhea and longer length of illness, but not with other factors, in our patients with anorexia nervosa. As many of these patients, even those with a short duration of illness and amenorrhea, were osteopenic, it is advisable to continue to perform bone density studies in all patients with anorexia nervosa, on both a clinical and research basis.

Adolescent↗
PubMed1984

Quantitative and qualitative analysis of the relationship between exercise-induced R wave amplitude changes and severity of coronary artery disease.

The correlation between R wave voltage variations (delta R) and the angiographic severity of coronary artery disease (CAD) at progressively increasing heart rate (HR) steps was evaluated in 51 patients (pts) without CAD (OV), in 42 pts with single (SVD), in 43 with double (DVD) and in 59 pts with triple vessel disease (TVD). At the end of stress the sensitivity of delta R was higher in DVD and TVD pts than in SVD pts. There was no clear correlation between exercise-induced R wave changes and the angiographic severity of CAD, since the qualitative and quantitative delta R evaluation during effort showed similar changes in delta R for a wide range of HR's in the entire study population. Since different degrees of exercise tolerance were found in pts with SVD, DVD and TVD, we hypothesize that the correlation between delta R and the severity of CAD at the end of stress testing may be artifactual.

Analysis of Variance↗
PubMed2002

Novel intraoperative cerebral blood flow monitoring by laser-Doppler scanner.

Laser-Doppler (LD) flowmetry was used to measure tissue perfusion non-invasively and continuously during neurosurgical operations using an LD scanner. Scanning was usually completed in 20 seconds. Measurements were processed in software to provide a color-coded image of the tissue perfusion. Moreover, the measurement data, expressed in LD-units, could be used for statistical data analysis. No physical contact was necessary between the scanning device and the exposed brain tissue. The imager provided two-dimensional microvascular flow maps non-invasively and quantitatively during brain operations, and could show the CO2 reactivity in the vessels. LD scanning flowmetry is a promising intraoperative monitoring method for cerebral blood flow changes.

Adult↗
PubMed1994

Six ages of man as determined by athletic performance.

It is submitted that a useful quantitative measure of aging is provided by measures of athletic performance. Whereas there are enormous differences in the athletic ability of individuals, any individual's performance may be related to the top performance by means of a ratio. This article describes the development of a model for the top performance and hence a model for the performance of any person at any age. Previous work has concentrated on the effect of aging on oxygen consumption. Because of the close relationship between oxygen consumption and athletic performance, compatibility with previous research is assured. The model shows that athletic performance undergoes significant changes at certain ages and that these change points break the aging process into six "ages of man." The model is however far from complete and needs to be based on more representative data. It is hoped that publication of the model will result in further studies in this field.

Adolescent↗
PubMedDate not supplied

[Qualitative and quantitative methods in biomedical research]

OBJECTIVE: To describe the main characteristics of the qualitative and quantitative research methods, to compare their differences, strengths and weaknesses, and to review complimentary assumptions. METHOD: Medline search and review of textbooks and selected articles. RESULTS: In order to understand the world where he lives, man organizes investigations along with philosophy, with religion and, in the last centuries, with science. The two principal paradigms of science adopt different research strategies. The quantitative paradigm, dominant in biomedical research, uses methods adopted from the physical sciences, epidemiology and statistics. These methods are used deductively, and aim to generate measures that are objective, reliable and generalizable. The qualitative paradigm uses methods that are common to anthropology, and are most conducted for discovery, identification, qualitative description, and explanation-generation. Each methodological approach has its own strengths and limitations, and it is the nature of the research question that will determine which approach is preferable. In many circumstances, the use of both approaches is necessary, as complimentary. CONCLUSIONS: Although qualitative methods are poorly known by many investigators, particularly by physicians, they are not new to medicine. In fact, medicine is based on qualitative methods, and both investigators and practitioners should use multiple methodologies in order to achieve better health and quality of life for their patients.

Journal Article↗
PubMed2006

Risk factors associated with clinical signs of lower urinary tract disease in indoor-housed cats.

OBJECTIVE: To determine associations between environmental and cat-related factors and lower urinary tract signs in indoor-housed domestic cats. DESIGN: Case-control study. Animals-238 healthy cats, 157 cats with clinical signs of lower urinary tract disease, and 70 cats with other diseases. PROCEDURE: Data collected from owners of the cats were analyzed. Descriptive statistics, environmental variables, and physical and behavioral signs were analyzed by use of ANOVA and logistic regression analysis to assess which factors were associated with clinical signs of lower urinary tract disease. RESULTS: The only demographic or environmental factors associated with lower urinary tract signs were older age and months owned. In contrast, cats with clinical signs of lower urinary tract disease had significantly greater owner-observed gastrointestinal tract signs and scratching, fearful, nervous, and aggressive behaviors. CONCLUSIONS AND CLINICAL RELEVANCE: Lower urinary tract signs in indoor-housed cats may be more closely associated with cat-related factors than with demographic or environmental factors.

Age Factors↗
PubMed1999

Psychosocial factors associated with peptic ulcer in aged persons.

The relationship between psychosocial factors and the occurrence and aggravation of peptic ulcer was studied in elderly people. Thirty-nine (14 male) ulcer patients and 79 (30 male) elderly people aged 65 years and over and living in the community were tested. Information on health status, medication, lifestyle, and psychosocial status was obtained by means of interviews using a questionnaire and from the clinical records of the ulcer patients. The same questionnaire was distributed to the residents. Logistic regression analysis adjusting for age disclosed that peptic ulcer was significantly associated with having an occupation and low exercise practice in men. However, the relationship weakened below statistical significance after adjusting for some physical risk factors besides age. Low education was significant but low instrumental support fell short of statistical significance with peptic ulcer in women even after adjustment for several physical risk factors besides age. Thus, the specific psychosocial factors might be independently associated with the occurrence and aggravation of peptic ulcer in at least elderly women.

Aged↗
PubMed1992

Stress resistance of Drosophila transgenic for bovine CuZn superoxide dismutase.

Several oxidative and non-oxidative stresses were applied to two transgenic strains of Drosophila melanogaster (designated P(bSOD)5 and P(bSOD)11) that express superoxide dismutase (SOD) at elevated levels, and control strains that express normal SOD levels. Transgenic strain P(bSOD)5 exposed to paraquat (1,1'-dimethyl-4,4'-bipyridinium dichloride), a redox cycling agent that generates superoxide anion when metabolized in vivo, was significantly more resistant to this xenobiotic than control flies. When test flies were subjected to 100% oxygen for 20 min each day, the mean lifespan was 3.62 days for control strain 25, but 4.35 days for both transgenic strains. The mortality curves of strains fed 1% H2O2 were similar, but the median lifespan of 72 h for controls and 64 h for transgenics suggests that the transgenic flies were slightly more sensitive to H2O2. The activity of catalase was the same for all strains. Using starvation resistance as a non-oxidative stress, flies maintained on water without any food had identical survival curves; for all strains, the median lifespan was 72 h. Throughout the lifespan, no statistically significant difference in physical activity was displayed for transgenic versus control flies. Collectively, these data suggest that the increased lifespan previously observed in SOD transgenics is specifically related to resistance to oxidative stresses.

Animals↗
PubMed2004

[Comprehensive geriatric medicine].

This paper is written to make clear the new medical system in the elderly and to standardize of Geriatrics and care. There are two major important components in geriatrics and geriatric care which are comprehensive geriatric assessment and team approach. But this is sometimes difficulut to do geriatric medicine. This goal is to make clear the usefulness of comprehensive geriatric assessment (CGA) and team approach. And the research purpose is to make standardization of geriatric medicine and care of elderly patients and organization of professionals. I have studied QOL of elderly people in the community. The scale, SF36, was used in this study. I compared with QOL between elderly with dementia and healthy elderly. QOL was studied with statistical analysis of SPSS. Physical function and symptomatic vitality in lower items of QOL were much better in health people than demented elderly. But global subjective health was much better in demented elderly than healthy people in the community. And I made clinical path of dementia for examination in the hospital. The results were clinical path made clear the importance of team approaches and standard of medical course in the hospital. It was helpful in medicine and care and its bindings. Dr. Murashima and her group have developed a new check list of screening risk factor of long stay of elderly inpatient. And they studied about the effects of supportive group for discharge using assessment and team approaches. This unit has a good function which support home care of the elderly patients. Finally narrative based medicine is very important to take care for the elderly patients. It has been lacked to do the present medicine for the elderly patient by evidence based medicine. In conclusion, for the standardization of geriatrics, CGA is useful for support for the frail elderly and team approach is good for staff communication through team conference.

Aged↗
PubMed2005

A psychometric approach to intuitive physics.

The literature on intuitive physics shows that many people exhibit systematic errors when predicting the behavior of simple physical events. Most previous research has attributed these errors to factors specific to a certain class of tasks. In the present study, we investigated the possibility that intuitive physics performance may be related to general measures of cognitive ability. Two hundred four adults (ages, 20-91 years) were presented with five pairs of intuitive physics questions. It was found that performance on the intuitive physics items was moderately intercorrelated, suggesting that they were tapping into a unitary construct. Despite the correlation with factors that decline with advancing age, intuitive physics performance was not correlated with age (r = .00). The findings are discussed in the context of research on intuitive physics, as well as research on cognitive aging.

Adult↗
PubMed2006

Weight management program for treatment-emergent weight gain in olanzapine-treated patients with schizophrenia or schizoaffective disorder: A 12-week randomized controlled clinical trial.

BACKGROUND: The main objective was to assess the efficacy of a weight management program designed for outpatients taking olanzapine for schizophrenia or schizoaffective disorder and to compare these patients with a randomized control group. The effects of the weight management program were also assessed with regard to safety and quality of life. METHOD: Forty-eight patients were enrolled in a 12-week, randomized, multicenter weight management study. Thirty-three patients were randomly allocated to an intervention group in which they received olanzapine within a weight management program. Fifteen patients were allocated to a control group in which they were given olanzapine treatment as usual outpatients. Weight, body mass index (BMI), and measurements of safety and quality of life were evaluated. The study was conducted from January 7, 2003, to September 16, 2003. RESULTS: Thirty-six patients (75%) completed this study. We found significant differences in weight (-3.94 +/- 3.63 kg vs. -1.48 +/- 1.88 kg, p = .006) and BMI (-1.50 +/- 1.34 vs. -0.59 +/- 0.73, p = .007) change from baseline to endpoint between the intervention and control groups, respectively. Significant differences in weight reduction were initially observed at week 8 (p = .040). No significant differences were found with regard to the safety outcomes. When the ratio of low-density lipoproteins to high-density lipoproteins was calculated, change from baseline was greater in the intervention group than the control group (-0.19 vs. -0.04), but the difference was not statistically significant (p = .556). After the completion of the weight management program, there was a trend toward statistical difference in the physical health score changes between the weight management and control groups (1.12 in the intervention group vs. -0.93 in the control group, p = .067). CONCLUSION: The weight management program was effective in terms of weight reduction in patients with schizophrenia or schizoaffective disorder taking olanzapine and was also found to be safe in terms of psychiatric symptoms, vital signs, and laboratory data. In addition, such a weight management program might improve quality of life in patients with schizophrenia or schizoaffective disorder with respect to their physical well-being.

Adult↗
PubMed1995

Skin symptoms after the reduction of electric fields from visual display units.

OBJECTIVES: The objective of this work was to determine whether facial skin symptoms are reduced by decreasing static and low-frequency electric fields produced by visual display units. METHODS: The electric fields were reduced by electric-conducting screen filters. Twenty subjects took part in the study while working at their ordinary jobs, first two weeks without any filter, then two weeks with an inactive filter and two weeks with an active filter (or in reversed order). The inasctive filters were identical to the active ones except that the ground cable was cut. Measurements showed that the inactive filters reduced the static electric fields nonsignificantly less than the active filters. For extremely low-frequency fields the difference was greater, and the active filters reduced the very low-frequency fields significantly more than the inactive ones. RESULTS: Most symptoms were less pronounced with active filters than with inactive filters. The differences were small, and for one symptom only, tingling, pricking or itching, the result was statistically significant. The recorded physical and psychosocial factors did not explain the reduction with the use of active filters. Days with a long period spent near a visual display unit resulted in significantly more pronounced symptoms than days with short time. The findings registered by a dermatologist did not reveal any consistent difference between the two periods with filters. CONCLUSION: The results weakly support the hypothesis that skin symptoms can be reduced by a reduction of electric fields.

Adult↗
PubMedDate not supplied

Effective orthotic therapy for the painful cavus foot: a randomized controlled trial.

Patients with a cavus or high-arched foot frequently experience foot pain, which can lead to significant limitation in function. Custom foot orthoses are widely prescribed to treat cavus foot pain. However, no clear guidelines for their construction exist, and there is limited evidence of their efficacy. In a randomized, single-blind, sham-controlled trial, the effect of custom foot orthoses on foot pain, function, quality of life, and plantar pressure loading in people with a cavus foot type was investigated. One hundred fifty-four participants with chronic musculoskeletal foot pain and bilateral cavus feet were randomly assigned to a treatment group receiving custom foot orthoses (n = 75) or to a control group receiving simple sham insoles (n = 79). At 3 months, 99% of the participants provided follow-up data using the Foot Health Status Questionnaire. Foot pain scores improved more with custom foot orthoses than with the control (difference, 8.3 points; 95% confidence interval [CI], 1.2 to 15.3 points; P = .022). Function scores also improved more with custom foot orthoses than with the control (difference, 9.5 points; 95% CI, 2.9 to 16.1 points; P = .005). Quality-of-life data favored custom foot orthoses, although differences reached statistical significance only for physical functioning (difference, 7.0 points; 95% CI, 1.9 to 12.1 points; P = .008). Plantar pressure improved considerably more with custom foot orthoses than with the control for all regions of the foot (difference, -3.0 N . s/cm(2); 95% CI, -3.7 to -2.4 N . s/cm(2); P < .001). In conclusion, custom foot orthoses are more effective than a control for the treatment of cavus foot pain and its associated limitation in function.

Female↗
PubMed1999

Endurance training of the trunk extensor muscles in people with subacute low back pain.

BACKGROUND AND PURPOSE: Clinicians treating patients with low back pain often use exercise to reduce pain and improve function. The aim of this study was to evaluate the effectiveness of trunk extensor endurance training in reducing pain and decreasing disability in subjects with subacute low back pain (ie, onset of back pain within 7 days to 7 weeks). SUBJECTS AND METHODS: Patients were randomly assigned to either an experimental group or a control group. A visual analog scale and the pain rating index (PRI) of the McGill Pain Questionnaire (MPQ) were used to obtain baseline measurements of pain. The Roland Morris Disability Questionnaire (RMDQ) was used to measure disability, and the Sorensen Test was used to measure trunk extensor endurance. Subjects in the experimental group attended exercise sessions 3 times a week for 6 weeks. Subjects in the control group did not do exercises. Both groups were given back care advice and hot packs for 15 minutes, 3 to 5 times per week. Reassessments were carried out at 3 and 6 weeks. RESULTS: There were differences between the 2 groups at 3 weeks in regard to pain intensity during the evaluation session and pain experienced over the preceding 24 hours, the total MPQ PRI, the sensory component of the MPQ PRI, and the RMDQ. At 6 weeks, no differences were found for pain measurements, disability scores, and holding time on the Sorensen Test. CONCLUSION AND DISCUSSION: Trunk extensor endurance training reduced pain and improved function at 3 weeks but resulted in no improvement at 6 weeks when compared with the control group. Endurance exercise is considered to expedite the recovery process for patients with an acute episode of low back pain.

Adult↗