Studies in Proprioception(一)

Proprioceptivetrainingandrehabilitationtechniquesareusedextensivelytotrytomaximizeprotectionfrominjuryandalsoprovideoptimalfunctionalrestorationinrehabilitationprograms.Jointlaxityitselfdoesnotnecessarilypredictthepresenceorseverityoffunctionalinstability[1] .Inaddition ,studieshaveshownthatproprioceptionistrainableandthatproprioceptive basedrehabilitationprogramsimproveobjec tivemeasurementsoffunctionalstatusindependentofchangesinjointlaxity[2 ] .Ithasbeenpostulatedthatim paired”positionsens…     

Savene? (dexrazoxane) use in clinical practice

Introduction  

Anthracycline extravasation (ACEV) is a rare but potentially devastating event which can result in severe injuries including ulceration and necrosis, slow-healing lesions, serious joint damage and permanent disfigurement. It can delay further scheduled chemotherapy and affect cancer treatment outcome. Savene? (dexrazoxane) is the only approved antidote for ACEV in Europe (Totect? in the USA) and is administered by intravenous infusion. Its efficacy has been demonstrated in clinical trials with biopsy-verified ACEV with a 98% success rate (no need for surgical debridement) allowing for immediate continuation of chemotherapy in 71% of patients. Adverse events, mainly haematological toxicity, were rapidly reversible. The objective of the study was to assess, in clinical practice, the efficacy and safety profile of Savene? for ACEV in different Belgian hospitals.     

Rehabilitation in the 21~(st) Century

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Seasonal variations in acute toxoplasmosis in pregnant women in the Rh?ne-Alpes region (France)

Clin Microbiol Infect 2012; 18: E401-E403 ABSTRACT: To search for seasonal variations we analysed data on 1998 acute toxoplasmic infections diagnosed between 1988 and 2009 in pregnant women. Two distinctive transmission profiles were observed: one in rural areas, which was strongly influenced by seasons with significantly fewer infections in the first half of the year but maximal risks at the end of summer and end of autumn, and a stable urban distribution with only moderate peaks. Further studies on individual risks and environmental and climatic factors are needed to understand what prevention message should be given to susceptible pregnant women.     

Skeletal muscle adaptation in response to exercise (Ⅰ)

INTRODUCTIONSkeletalmusclesofadultmammalianspecies,includinghumans,arethesourceofpowerforlocomotionandotherdailyactivitiesessentialforsurvival.Lossofskeletalmusclecontractilefunctionisamajorcauseoffalling,morbidityandmortality,especiallyinelderlypopulations[1].Moreimportantly,skeletalmusclescollectivelyinfluencetotalbodymetabolismofglucose,fatandprotein,abnormalitiesofwhichareasso鄄ciatedwithavarietyofcommondiseases[2-3].Physicalinactivi鄄ty,adecreaseduseofthemusculoskeletalsystem,isassoc…     

Mutations in Igα (CD79a) result in a complete block in B-cell development

Mutations in Btk, mu heavy chain, or the surrogate light chain account for 85-90% of patients with early onset hypogammaglobulinemia and absent B cells. The nature of the defect in the remaining patients is unknown. We screened 25 such patients for mutations in genes encoding components of the pre-B-cell receptor (pre-BCR) complex. A 2-year-old girl was found to have a homozygous splice defect in Igalpha, a transmembrane protein that forms part of the Igalpha/Igbeta signal-transduction module of the pre-BCR. Studies in mice suggest that the Igbeta component of the pre-BCR influences V-DJ rearrangement before cell-surface expression of mu heavy chain. To determine whether Igalpha plays a similar role, we compared B-cell development in an Igalpha-deficient patient with that seen in a mu heavy chain-deficient patient. By immunofluorescence, both patients had a complete block in B-cell development at the pro-B to pre-B transition; both patients also had an equivalent number and diversity of rearranged V-DJ sequences. These results indicate that mutations in Igalpha can be a cause of agammaglobulinemia. Furthermore, they suggest that Igalpha does not play a critical role in B-cell development until it is expressed, along with mu heavy chain, as part of the pre-BCR.     

About 7–day (circaseptan) and circadian changes in cold pressor test (CPT)

We assess circadian (CD) and circaseptan (CS) changes in the blood pressure (BP) response to a 1–min immersion of the hand into ice water, the cold pressor test (CPT). An about 8 mmHg BP increase in the CPT reported by others for health and an elevation >25 mmHg for patients with “hypertension” have been viewed as predisease, but variables related to the vascular system exhibit prominent CD, CS and circannuals, among other components of their genetically anchored time structure or chronome, and may also have to be considered. Hence, a 16-year-old adolescent (ML) immersed her hand into ice water every 2–4 h for 2 days and once daily in the morning thereafter for 1 week (N = 25), as did, only for <2 days (≥24 h), four adults 20–66 years of age. BP and heart rate (HR) were monitored automatically around the clock at 15–min intervals and at 1–min intervals before and immediately after the CPT. Data were analyzed by cosinor. The difference between the first post-CPT BP value and the mean of the last seven values prior to the CPT was a measure of CPT response (at 1–min). Overall, ML’s systolic (S) BP increased by 8.2 ± 1.4 mmHg and her diastolic (D) BP by 6.2 ± 0.9 mmHg (P < 0.001). Increases were found in 96% of the tests for SBP, 92% for DBP and 20% for HR. There was only one tie for HR (4%), resulting in a HR decrease in 76% of CPTs. The BP response to CPT at 1 min was CS-dependent. The CS double amplitudes are 12.5 ± 4.1 for SBP (P = 0.019) and 7.8 ± 2.8 mmHg for DBP (P = 0.030), with acrophases occurring on late Sunday, early Monday (at –50° and –67° from 00:00 h from Saturday to Sunday for SBP and DBP, respectively, with 360° ≡ 1 week). The response of HR did not allow the detection of a CS rhythm (P = 0.969). The CD response peaked in the early morning hours; with 24 h ≡ 360° and 0° = local midnight, the acrophase (φ) for SBP is at –80° and for DBP at –113°, in keeping with earlier results from four adult subjects (SBP: –37°; DBP: –42°), individual differences notwithstanding. The average timing of the largest overall response of BP to CPT coincides with the timing of the response to other stimuli. The CS acrophases coincide with the times of increased morbidity/mortality from vascular diseases. Chronomes, time structures broader than circadian, notably their about-weekly components, should be considered, not only at the extremes of life when the CS and about-half-weekly rhythms are particularly prominent in BP and HR but also in interpreting BP responses as a gauge of vascular disease status in adolescents.     

Does the Mainz Emergency Evaluation Scoring (MEES) in combination with capnometry (MEESc) help in the prognosis of outcome from cardiopulmonary resuscitation in a prehospital setting?

We present an improved Mainz Emergency Evaluation Scoring (MEES) combined with capnometry. MEES combined with capnometry in a new scoring system MEESc compared with MEES is significantly better and has greater value in predicting survival after cardiopulmonary resuscitation (CPR) in patients with normothermic nontraumatic cardiac arrest. We show that higher pre-CPR and final post-CPR values of partial end-tidal CO(2) pressure (p(et) CO(2)) at the time of the return of spontaneous circulation (ROSC) are connected with improved rate of survival. In our prospective clinical study we observed 246 patients 18 years of age and over who were found in nontraumatic normothermic cardiac arrest from February 1998 to February 2001. 128 (52%) were men. Initial and final (post-CPR) values of p(et) CO(2) were significantly higher in the group of patients with ROSC and in those who survived than in the group of patients without ROSC and those who died. All the patients with ROSC and those who survived had initial values of p(et) CO(2) higher than 1.33 kPa (10 mmHg). The mean of all the initial values of pet CO2 in patients without ROSC was 2.12 kPa+/-0.68 and the mean of all the final values in patients with ROSC was 3.11 kPa+/-0.55 kPa. Our study shows that the initial and final values of p(et) CO(2) of less than 2.13 kPa are connected with higher mortality rate and the values of less than 1.33 kPa incompatible with survival in normothermic nontraumatic cardiac arrest. We also must not forget the fact that prehospital use of the improved MEESc system enabled more efficient communication between the prehospital and hospital setting.