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PubMed2006

Education by general practitioners or education and exercises by physiotherapists for patients with whiplash-associated disorders? A randomized clinical trial.

STUDY DESIGN: Randomized clinical trial. OBJECTIVE: To compare the effectiveness of education and advice given by general practitioners (GPs) with education, advice, and active exercise therapy given by physiotherapists (PTs) for patients with whiplash-associated disorders. SUMMARY OF BACKGROUND DATA: Available evidence from systematic reviews has indicated beneficial effects for active interventions in patients with whiplash-associated disorders. However, it remained unclear which kind of active treatment was most effective. METHODS: Whiplash patients with symptoms or disabilities at 2 weeks after accident were recruited in primary care. Eligible patients still having symptoms or disabilities at 4 weeks were randomly allocated to GP care or physiotherapy. GPs and PTs treated patients according to a dynamic multimodal treatment protocol primarily aimed to increase activities and influence unfavorable psychosocial factors for recovery. We trained all health care providers about the characteristics of the whiplash problem, available evidence regarding prognosis and treatment, and protocol of the interventions. The content of the information provided to patients during treatment depended on the treatment goals set by the GPs or PTs. Also, the type of exercises chosen by the PTs depended on the treatment goals, and it was not explicitly necessary that exercise therapy was provided in all patients. Primary outcome measures included neck pain intensity, headache intensity, and work activities. Furthermore, an independent blinded assessor measured functional recovery, cervical range of motion, disability, housekeeping and social activities, fear of movement, coping, and general health status. We assessed outcomes at 8, 12, 26, and 52 weeks after the accident. RESULTS: A total of 80 patients were randomized to either GP care (n = 42) or physiotherapy (n = 38). At 12 and 52 weeks, no significant differences were found concerning the primary outcome measures. At 12 weeks, physiotherapy was significantly more effective than GP care for improving 1 of the measures of cervical range of motion (adjusted mean difference 12.3 degrees ; 95% confidence interval [CI] 2.7-21.9). Long-term differences between the groups favored GP care but were statistically significant only for some secondary outcome measures, including functional recovery (adjusted relative risk 2.3; 95% CI 1.0-5.0), coping (adjusted mean difference 1.7 points; 95% CI 0.2-3.3), and physical functioning (adjusted mean difference 8.9 points; 95% CI 0.6-17.2). CONCLUSIONS: We found no significant differences for the primary outcome measures. Treatment by GPs and PTs were of similar effectiveness. The long-term effects of GP care seem to be better compared to physiotherapy for functional recovery, coping, and physical functioning. Physiotherapy seems to be more effective than GP care on cervical range of motion at short-term follow-up.

Adult↗

PubMed2003

Internal consistency and validity of the Stroke Impact Scale 2.0 (SIS 2.0) and SIS-16 in an Australian sample.

BACKGROUND AND PURPOSE: The impact of stroke is multidimensional however standard stroke measures do not discriminate well when stroke patients are less physically impaired. The Stroke Impact Scale 2.0 (SIS 2.0) is a multidimensional measure of the impact of stroke but its' psychometric properties require further testing. The SIS-16 is a measure of physical functioning designed to be more sensitive to differences in physical functioning than current stroke outcome measures but there is only preliminary information detailing its' reliability and validity. The current study examined the internal consistency and validity of the SIS 2.0 and SIS-16 in an Australian sample of stroke patients. METHODS: The SIS 2.0, SIS-16, World Health Organization Bref-Scale (WHOQOL-BREF) and Zung's Self-Rating Depression Scale (SDS) were completed by 74 stroke patients in rural Victoria, Australia. RESULTS: The item convergent validity index indicated good item convergence of the SIS-16 and SIS 2.0 domains. The item discriminant validity index had only adequate divergence for most SIS 2.0 domains. Internal consistencies of the SIS-16 and SIS 2.0 domains were acceptable (alpha = 0.87-0.95). Correlations between the SIS-16 and SIS 2.0 and the WHOQOL-BREF and SDS supported the convergent and discriminant validity of the SIS-16 and all the dimensions of the SIS 2.0 except 'Participation' which lacked discriminant validity. CONCLUSIONS: The SIS 2.0 and SIS-16 had good psychometric properties with support for the internal consistency and validity of both measures.

Activities of Daily Living↗

PubMedDate not supplied

Altruistic social interest behaviors are associated with better mental health.

OBJECTIVE: This study investigated whether altruistic social interest behaviors such as engaging in helping others were associated with better physical and mental health in a stratified random sample of 2016 members of the Presbyterian Church throughout the United States. METHODS: Mailed questionnaires evaluated giving and receiving help, prayer activities, positive and negative religious coping, and self-reported physical and mental health. RESULTS: Multivariate regression analysis revealed no association between giving or receiving help and physical functioning, although the sample was highly skewed toward high physical functioning. Both helping others and receiving help were significant predictors of mental health, after adjusting for age, gender, stressful life events, income, general health, positive and negative religious coping, and asking God for healing (R2 =.27). Giving help was a more important predictor of better reported mental health than receiving help, and feeling overwhelmed by others' demands was an independent predictor of worse mental health in the adjusted model. Significant predictors of giving help included endorsing more prayer activities, higher satisfaction with prayer life, engaging in positive religious coping, age, female gender, and being a church elder. Frequency of prayer and negative religious coping were not related to giving help. CONCLUSIONS: Helping others is associated with higher levels of mental health, above and beyond the benefits of receiving help and other known psychospiritual, stress, and demographic factors. The links between these findings and response shift theory are discussed, and implications for clinical interventions and future research are described.

Adaptation, Psychological↗

PubMed2004

Effectiveness of occupational therapy following organ transplantation.

BACKGROUND: Individuals who receive a solid organ transplant have pre-operative and post-operative impairments in physical function. PURPOSE: This pilot study evaluated the changes in physical function of 23 individuals with an organ transplant who received 2 or more hours of occupational therapy while inpatients in an acute care facility. These individuals also received physiotherapy treatment that was retrospectively quantified. Post-operative function was evaluated at assessment and discharge from occupational therapy with the Functional Independence Measure (FIM). RESULTS: Significant improvements in FIM scores (mean change +22) were noted at discharge from occupational therapy and there was a positive correlation between attendances or minutes of occupational therapy and study participants' changes in function. Occupational therapy attendances or minutes were also negatively correlated with study participants' initial functional status, which suggests that individuals with lower function received more occupational therapy. PRACTICE IMPLICATIONS: Notwithstanding the benefit of physiotherapy, and the methodological limits of an uncontrolled pre-test/post-test design, this study provides novel, preliminary evidence for the benefit of occupational therapy during the acute care stay of individuals with a solid organ transplant.

Activities of Daily Living↗

PubMed2003

Associations of visual function with physical outcomes and limitations 5 years later in an older population: the Beaver Dam eye study.

PURPOSE: To examine the association of performance-based measures of visual functioning with the occurrence of falls, fractures, physical outcomes, and limitations in an older population. DESIGN: A population-based study of Beaver Dam, Wisconsin, of persons who were 43 to 86 years of age was performed from 1988 through 1990 (n = 4926), 1993 through 1995 (n = 3722), and 1998 through 2000 (n = 2962). PARTICIPANTS: Participants in the Beaver Dam Eye Study at the 1993 through 1995 examination. METHODS: Historical information was obtained by interview at each examination. Current binocular visual acuity, best-corrected visual acuity, near acuity, log contrast sensitivity, and visual sensitivity (threshold) were measured by standard protocols at the 5-year follow-up (1993-1995) of the cohort. Outcomes were ascertained at the 10-year follow-up examination (1998-2000). MAIN OUTCOME MEASURES: History of physical limitations, falls, fractures, and change in time to walk a measured course. RESULTS: The incidence of outcomes was as follows: nursing home residence, 4.6%; not driving at night, 9.7%; any fracture, 11.0%; two or more falls, 7.5%; fear of falling, 11.9%; and use of walking aids, 3.6%. The increase in time to walk a 10-foot course was 0.14 seconds. Age was associated with higher incidence of virtually every outcome and with time to walk a measured course. Incidence of not driving at night, any fracture, and fear of falling were more common in women after adjusting for age. We evaluated the relationship of outcomes to current binocular vision, best-corrected vision, near vision, contrast sensitivity, and visual sensitivity (threshold), as measured by perimetry (the latter four for the better eye). When controlling for confounders in multivariable models, the odds ratios of nursing home placement for the poorest categories of function were 3.20 (95% confidence interval [CI], 1.85, 5.56) for current binocular vision, 4.23 (95% CI, 2.34, 7.64) for best-corrected visual acuity in the better eye, 5.00 (95% CI, 2.28, 10.94) for near vision, and 2.40 (95% CI, 1.46, 3.92) for contrast sensitivity. The odds ratio for not driving at night for the poorest category of visual sensitivity was 2.22 (95% CI, 1.31, 3.75). The odds ratios for any fractures for the categories of poorest function were 1.75 (95% CI, 1.02, 2.99) for current binocular acuity, 2.00 (95% CI, 1.10, 3.62) for best-corrected vision in the better eye, 3.04 (95% CI, 1.34, 6.86) for near vision, and 1.64 (95% CI, 1.05, 2.56) for visual sensitivity. The odds ratios for 2 or more falls in the past year for the poorest categories of visual function were 2.02 (95% CI, 1.13, 3.63) for current binocular acuity and 1.85 (95% CI, 1.10, 3.12) for visual sensitivity. The incidence of fear of falling was associated with the poorest category of best-corrected acuity (odds ratio, 2.95; 95% CI, 1.52, 5.70), and use of walking aids was associated with visual sensitivity (odds ratio, 3.51; 95% CI, 1.72, 7.18). Change in time to walk the measured course was not significantly associated with any of the visual functions. CONCLUSIONS: Visual function is associated with some physical outcomes and limitations 5 years later in middle- to older-aged adults. These associations are likely to be related, in part, to the presence of other medical conditions.

Accidental Falls↗

PubMed2004

Effects of Tai Chi exercise on physical and mental health of college students.

The purpose of this pilot study is to examine the effects of Tai Chi Quan, a body-mind harmony exercise, on college students' perceptions of their physical and mental health. A three-month intervention of Tai Chi exercise was administered to college students, and multidimensional physical (PHD) and mental (MHD) health scores were assessed using the SF-36v2 health survey questionnaire before and after the intervention. Thirty college students participated in a 1-hour-long Tai Chi exercise intervention twice a week for 3 months. Each practice session included 10 minutes of breathing and stretching exercises followed by 50 minutes of Tai Chi Quan 24-form practice. PHD including physical function (PF), role physical (RP), bodily pain (BP), general health (GH), and MHD including social function (SF), role mental/emotion function (RE), vitality (VT), perceptions of mental health (MH) were assessed. The normalized scores of each variable and the combined PHD or MHD scores before and after the Tai Chi intervention were examined by paired t-test (p < 0.05). Physical measures of BP and GH, and mental measures of RE, VT and MH were significantly improved after Tai Chi exercise intervention. When the overall PHD or MHD scores were evaluated, the MHD had increased significantly. In conclusion, Tai Chi exercise had positive effects on the self-assessed physical and mental health of college students. Scores on the mental health dimension appeared to be particularly sensitive to change. Colleges/universities might consider offering Tai Chi as a component of their ongoing physical activity programs available to students.

Adult↗

PubMed1999

Functional and physical interaction between WRN helicase and human replication protein A.

The human premature aging disorder Werner syndrome (WS) is associated with a large number of symptoms displayed in normal aging. The WRN gene product, a DNA helicase, has been previously shown to unwind short DNA duplexes (</=53 base pairs) in a reaction stimulated by single-stranded DNA-binding proteins. We have studied the helicase activity of purified WRN protein on a variety of DNA duplex substrates to characterize the unwinding properties of the enzyme in greater detail. WRN helicase can catalyze unwinding of long duplex DNA substrates up to 849 base pairs in a reaction dependent on human replication protein A (hRPA). Escherichia coli SSB and bacteriophage T4 gene 32 protein (gp32) completely failed to stimulate WRN helicase to unwind long DNA duplexes indicating a specific functional interaction between WRN and hRPA. So far, there have been no reports of any physical interactions between WRN helicase and other proteins. In support of the functional interaction, we demonstrate a direct interaction between WRN and hRPA by coimmunoprecipitation of purified proteins. The physical and functional interaction between WRN and hRPA suggests that the two proteins may function together in vivo in a pathway of DNA metabolism such as replication, recombination, or repair.

Bacteriophage T4↗

PubMedDate not supplied

The quality of life of elderly diabetic patients.

The objective of this study was to evaluate the health-related quality of life (HRQoL) of elderly diabetic patients. A cross-sectional, questionnaire survey of diabetic subjects aged 65-84 years (n=177 respondents) from three community health centers in Stockholm County. The HRQoL was assessed by the Swedish Health-Related Quality of Life Survey (SWED-QUAL), a generic HRQoL questionnaire adapted from the Medical Outcomes Study (MOS) and consisting of 67 items covering broad aspects of the HRQoL. Diabetic subjects were compared with age- and gender-matched controls from a random standard population sample (SPS) of the Swedish population. Medical data on the diabetic subjects were extracted from medical records. The HRQoL, as regarded 7 of the 13 scales, was poorer in diabetic subjects than in the SPS controls. These scales were "general health perceptions," "physical functioning," "satisfaction with physical health," "role limitations due to physical health," "pain," "sleep problems," and "role limitations due to emotional health." Atheromatous complications and nonvascular disease were significant predictors of a poor HRQoL. "Cognitive functioning" was the only HRQoL scale on which diabetic subjects with high levels of HbA(1c) (HbA(1c)>7.0%) scored worse than those with acceptable levels (HbA(1c)<7.0%). In our study, elderly diabetic subjects had a poorer HRQoL than the general population, especially regarding physical health. Poor metabolic control was associated with reduced cognitive function.

Activities of Daily Living↗

PubMed1992

Predictors of functional outcomes after arthroscopic partial meniscectomy.

OBJECTIVE: To confirm previous studies that have identified knee osteoarthritis as the principal correlate of poor outcomes after arthroscopic partial meniscectomy (APM), we considered a range of other preoperative characteristics using multivariable analyses to control for confounding variables. METHODS: One hundred five patients who had APM were studied. Selected demographic and clinical features were obtained from charts and operative notes. Preoperative and current functional status were determined by patient interviews. The principal outcomes were functional status at the time of followup, measured by the Physical Activity Scale of the SF-36 Health Status Inventory, and the Lysholm Knee Rating Scale. RESULTS: SF-36 scores improved from a mean of 53.7 to a mean of 18.2. The percentage of patients with satisfactory (> or = 77) Lysholm scores increased from 5% preoperatively to 73%. In multivariable analyses, Worker's Compensation (p = 0.003), worse baseline physical functional status (p = 0.007), and Grade III-IV cartilage damage (p = 0.05) were associated with worse post-operative function. CONCLUSION: The outcome of APM is generally favorable. The extent of cartilage damage was confirmed as a correlate of poor outcome. However, Worker's Compensation and preoperative physical functional status had the greatest prognostic value and should be ascertained routinely in orthopedic outcome studies.

Adult↗

PubMedDate not supplied

Quality of life for veterans with multiple sclerosis on disease-modifying agents: Relationship to disability.

Our objective was to compare self-reported health-related quality of life (HRQOL) for U.S. veterans with multiple sclerosis (MS) on disease-modifying agents with provider reports of HRQOL from standard disability measures. We conducted a 3-year prospective observational study of 204 subjects who used interferon beta or glatiramer acetate and compared subjects' responses on the Veterans Short-Form 36 (VSF-36) (36-item short-form functional status assessment for veterans) with the Kurtzke Expanded Disability Status Scale (EDSS) and the Functional System (FS) scales, which are standard MS disability scales. EDSS and FS scores were significantly correlated with some VSF-36 domains (physical function [r = -0.57], role physical [r = -0.37], and physical component summary [r = -0.40]) and weakly correlated with other domains. HRQOL scores did not predict disability or compliance with therapy. We observed decrements in HRQOL at relatively low disability levels. HRQOL measures directly associated with physical function were correlated with standard MS disability scales. Researchers need to clarify the role of HRQOL in clinical outcomes assessment, as shown by the lack of outcome sensitivity and predictive value of the VSF-36.

Activities of Daily Living↗

PubMedDate not supplied

Quality of life in Brazilian breast cancer survivors age 45-65 years: associated factors.

The objectives of this study were to evaluate quality of life (QOL) and identify its associated factors in climacteric women with a history of breast cancer. A cross-sectional study was performed including 75 breast cancer survivors age 45-65 years who had undergone complete oncologic treatment and nonusers of hormone therapy or tamoxifen in the last 6 months. Sociodemographic and clinical characteristics in addition to the prevalence of climacteric symptoms were evaluated. QOL was evaluated by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire, including eight components that can be condensed into two summaries: a physical component summary (physical functioning, role-physical, body pain, general health) and a mental component summary (vitality, social functioning, role-emotional, and mental health). Generalized linear models were used to analyze the data, allowing the identification of factors affecting QOL, adjusting for confounding variables. The mean age of the participants was 53.1+/-5.9 years. Breast cancer survivors reported good QOL. The most prevalent symptoms were nervousness (69%) and hot flashes (56%). Factors associated with poorer QOL were dizziness, postmenopausal status, and breast-conserving therapy (physical component), as well as insomnia and being married (mental component). In conclusion, participants demonstrated good QOL. We identified factors that may influence QOL in women with breast cancer, highlighting being married, climacteric symptoms, postmenopausal status, and breast-conserving therapy. Given the impact of these factors, health professionals and patients must discuss choices for alleviating climacteric symptoms and explanations for the potential repercussions of breast cancer treatment.

Aged↗

PubMed2006

Simulated computerized adaptive test for patients with lumbar spine impairments was efficient and produced valid measures of function.

OBJECTIVE: To equate physical functioning (PF) items with Back Pain Functional Scale (BPFS) items, develop a computerized adaptive test (CAT) designed to assess lumbar spine functional status (LFS) in people with lumbar spine impairments, and compare discriminant validity of LFS measures (theta(IRT)) generated using all items analyzed with a rating scale Item Response Theory model (RSM) and measures generated using the simulated CAT (theta(CAT)). METHODS: We performed a secondary analysis of retrospective intake rehabilitation data. RESULTS: Unidimensionality and local independence of 25 BPFS and PF items were supported. Differential item functioning was negligible for levels of symptom acuity, gender, age, and surgical history. The RSM fit the data well. A lumbar spine specific CAT was developed that was 72% more efficient than using all 25 items to estimate LFS measures. theta(IRT) and theta(CAT) measures did not discriminate patients by symptom acuity, age, or gender, but discriminated patients by surgical history in similar clinically logical ways. theta(CAT) measures were as precise as theta(IRT) measures. CONCLUSION: A body part specific simulated CAT developed from an LFS item bank was efficient and produced precise measures of LFS without eroding discriminant validity.

Activities of Daily Living↗

PubMed1997

Measuring prognosis and case mix in hospitalized elders. The importance of functional status.

OBJECTIVE: Although physical function is believed to be an important predictor of outcomes in older people, it has seldom been used to adjust for prognosis or case mix in evaluating mortality rates or resource use. The goal of this study was to determine whether patients' activity of daily living (ADL) function on admission provided information useful in adjusting for prognosis and case mix after accounting for routine physiologic measures and comorbid diagnoses. SETTING: The general medical service of a teaching hospital. PARTICIPANTS: Medical inpatients (n = 823) over age 70 (mean age 80.7, 68% women). MEASUREMENTS: Independence in ADL function on admission was assessed by interviewing each patient's primary nurse. We determined the APACHE II Acute Physiology Score (APS) and the Charlson comorbidity score from chart review. Outcome measures were hospital and 1-year mortality, nursing home use in the 90 days following discharge, and cost of hospitalization. Patients were divided into four quartiles according to the number of ADLs in which they were dependent. MAIN RESULTS: ADL category stratified patients into groups that were at markedly different risks of mortality and higher resource use. For example, hospital mortality varied from 0.9% in patients dependent in no ADL on admission, to 17.4% in patients dependent in all ADLs. One-year mortality ranged from 17.5% to 54.9%, nursing home use from 3% to 33%, and hospital costs varied by 53%. In multivariate analyses controlling for APS. Charlson scores, and demographic characteristics, compared with patients dependent in no ADL, patients dependent in all ADLs were at greater risk of hospital mortality (odds ratio [OR] 13.7; 95% confidence interval [CI] 3.1-58.8), 1-year mortality (OR 4.4; 2.7-7.4), and 90-day nursing home use (OR 14.9; 6.0-37.0). The DRG-adjusted hospital cost was 50% higher for patients dependent in all ADLs. ADL function also improved the discrimination of hospital and 1-year mortality models that considered APS, or Charlson scores, or both. CONCLUSIONS: ADL function contains important information about prognosis and case mix beyond that provided by routine physiologic data and comorbidities in hospitalized elders. Prognostic and case-mix adjustment methods may be improved if they include measures of function, as well as routine physiologic measures and comorbidity.

Activities of Daily Living↗

PubMed2000

Quality of life among women with interstitial cystitis.

PURPOSE: Clinical case series suggest that the impact of interstitial cystitis on quality of life is severe and debilitating, however, little epidemiologic information is available. We examined the impact of interstitial cystitis on quality of life in a population based cohort of United States women. MATERIALS AND METHODS: We collected multidimensional measures of quality of life from 159,419 participants in the Nurses' Health Study I and II using a validated instrument, the Medical Outcome Study Short-Form 36 Health Survey Instrument. This instrument measures physical function, role limitations due to physical and emotional problems, bodily pain, vitality, social function and mental health. Quality of life measures were collected on 99 women with prevalent self reported interstitial cystitis confirmed by medical record review. RESULTS: After adjusting for age and co-morbid conditions, women with interstitial cystitis had significantly lower quality of life scores in 4 of the 7 quality of life dimensions, including role/physical (beta -13.1, p <0.001), bodily pain (beta -9.8, p <0.001), vitality (beta -7.7, p <0.001) and social function (beta -7.2, p <0.001) compared to women without interstitial cystitis. Women with interstitial cystitis experienced less decrement in physical function compared to women with rheumatoid arthritis but more compared to women with hypertension. In addition, they experienced greater differences in vitality and mental health than women with rheumatoid arthritis or hypertension. CONCLUSIONS: The quality of life among women with interstitial cystitis was especially limited in the psychosocial dimensions, such as vitality and mental health. Future research on interstitial cystitis should incorporate multidimensional measures of quality of life, especially with respect to response to the various treatments.

Adult↗

PubMed2006

Patterns of recovery following percutaneous coronary intervention: a pilot study.

Percutaneous coronary intervention (PCI) is the most common type of cardiac revascularization performed. However, there has been limited research examining the recovery of PCI patients after their hospital discharge. This descriptive, longitudinal study examined patterns of recovery (cardiac symptoms experienced, impact of cardiac symptoms on physical functioning and enjoyment of life, postprocedure problems experienced, and functioning) of 37 PCI patients at 2, 4, and 6 weeks following PCI. Fatigue was the most frequent and persistent symptom, and significantly, F(2, 26) = 3.6, p < .05, it impacted physical functioning at 4 weeks following PCI. Both physical and psychosocial functioning improved over time. Coronary restenosis and heart rhythm disturbance were the most common self-reported heart-related problems. Understanding normal variation in recovery patterns can assist clinicians in developing interventions to facilitate optimal outcomes.

Analysis of Variance↗

PubMed2004

Anabolic hormones in aging women: effects of supplementation vs. physical activity.

Aging is associated with a decline in bone mass, muscle mass, strength, and physical function, and women are more likely to suffer from these physical changes than men. The model presented in this paper illustrates the age related changes in anabolic hormones and how this may partly explain the diminished physical function of older women. The model can also be used to identify potential sites of intervention that could delay the atrophy of the musculoskeletal system. Various pharmacological hormone therapies have been shown to be beneficial, but there may be health risks associated with their use. There is evidence that regular physical activity is related to higher levels of anabolic hormones in older persons, therefore exercise could be an alternative to drugs for slowing the age related changes in the endocrine system. However, some research suggests that the hormone response to exercise is blunted in older women. This lower hormonal response may not be a consequence of aging per se but instead may result from secondary characteristics of aging such as a decline in physical fitness and exercise intensity or changes in body composition. Further research is needed to determine whether exercise-induced increases in endogenous hormones have clinical significance in improving muscle or bone mass in aging women.

Aging↗

PubMed2004

Functional and physical interactions of Krr1p, a Saccharomyces cerevisiae nucleolar protein.

The Krr1 protein of Saccharomyces cerevisiae is involved in processing of pre-rRNA and assembly of pre-ribosomal 40S subunits. To further investigate the function of Krr1p we constructed a conditional cold sensitive mutant krr1-21, and isolated seven genes from Schizosaccharomyces pombe whose products suppressed the cold sensitive phenotype of krr1-21 cells. Among the multicopy suppressors we found genes coding for translation elongation factor EF-1alpha, a putative ribose methyltransferase and five genes encoding ribosomal proteins. Using the tandem affinity purification (TAP) method we identified thirteen S. cerevisiae ribosomal proteins interacting with Krr1p. Taken together, these results indicate that Krr1p interacts functionally as well as physically with ribosomal proteins. Northern blot analysis revealed that changes in the level of krr1-21 mRNA were accompanied by similar changes in the level of mRNAs of genes encoding ribosomal proteins. Thus, Krr1p and the genes encoding ribosomal proteins it interacts with seem to be coordinately regulated at the level of transcription.

Cell Nucleolus↗

PubMed1998

Length of hospital stay following elective abdominal aortic aneurysm repair. U.K. Small Aneurysm Trial Participants.

OBJECTIVES: To investigate factors associated with a prolonged hospital stay after elective open surgical repair of abdominal aortic aneurysm. PATIENTS AND METHODS: We have investigated prospectively base-line risk factors associated with an increased length of postoperative hospital stay in 474 of the patients undergoing surgery as part of the U.K. Small Aneurysm Trial. RESULTS: The median length of hospital stay was 11 days (interquartile range 9-14 days). Age (within the range 60-76 years), sex body mass index, aneurysm diameter, graft type (tube or bifurcated), hospital (university or other), ECG characteristics, angina (from Rose questionnaire) and/or previous myocardial infarction were not associated with length of hospital stay. Quality of life also was assessed before surgery using the Medical Outcomes Study SF20. Psychosocial aspects including level of social functioning, role functioning, mental health, health perceptions and pain were not associated with length of postoperative stay. The level of preoperative physical functioning was associated inversely with length of hospital stay, p = 0.004. Patients' length of hospital stay also was inversely associated with preoperative lung function: FEV1, p = 0.011 and FVC, p = 0.006. In contrast, smoking habit was of only borderline significance, p = 0.09. CONCLUSION: Conditional logistic regression analysis identified only preoperative lung function (FEV1 and FVC) and physical functioning, three intrinsically linked factors, as predictors of length of hospital stay after elective repair of an abdominal aortic aneurysm.

Aged↗