How is walking speed related to muscle strength? A study of healthy persons and persons with late effects of polio

OBJECTIVES: To evaluate the relationship between walking speed and muscle strength in the lower extremities in healthy persons and in persons with late effects of polio and to compare the models for these relationships. DESIGN: Retrospective analysis. SETTING: University hospital department. PARTICIPANTS: An urban sample of 144 healthy men and women (age range, 40-79 y) and 234 (146 women, 88 men) subjects with late polio. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Muscle strength in the lower extremities was measured and combined into an index. Walking speed for spontaneous and maximal walking was measured. A nonlinear regression model was developed. RESULTS: Evidence was provided for the nonlinear relationship between walking speed and strength. A specific strength threshold could not be identified. The asymptote of this curve for maximal walking was 2.57 m/s in the healthy group and 2.02 m/s in the subjects with late effects of polio. A high body mass index (>25 kg/m2) lowered the asymptote. CONCLUSIONS: It is important to prevent strength decrease that approaches the critical level where a further reduction affects walking speed more evidently. The difference in the relationship between muscle strength and walking speed for the 2 groups studied may partly depend on biomechanic imbalance between muscle groups.     

How is walking speed related to muscle strength? A study of healthy persons and persons with late effects of polio

Willén C, Sunnerhagen KS, Ekman C, Grimby G. How is walking speed related to muscle strength? A study of healthy persons and persons with late effects of polio.

Objectives

To evaluate the relationship between walking speed and muscle strength in the lower extremities in healthy persons and in persons with late effects of polio and to compare the models for these relationships.

Design

Retrospective analysis.

Setting

University hospital department.

Participants

An urban sample of 144 healthy men and women (age range, 40-79y) and 234 (146 women, 88 men) subjects with late polio.

Interventions

Not applicable.

Main outcome measures

Muscle strength in the lower extremities was measured and combined into an index. Walking speed for spontaneous and maximal walking was measured. A nonlinear regression model was developed.

Results

Evidence was provided for the nonlinear relationship between walking speed and strength. A specific strength threshold could not be identified. The asymptote of this curve for maximal walking was 2.57m/s in the healthy group and 2.02m/s in the subjects with late effects of polio. A high body mass index (>25kg/m²) lowered the asymptote.

Conclusions

It is important to prevent strength decrease that approaches the critical level where a further reduction affects walking speed more evidently. The difference in the relationship between muscle strength and walking speed for the 2 groups studied may partly depend on biomechanic imbalance between muscle groups.     

2016年云南省脊髓灰质炎疫情输入传播风险评估

目的 评估云南省各州（市） 2016 年脊髓灰质炎（脊灰）疫情输入传播的风险,为制定应对策略并采取针对性措施阻止脊灰疫情输入传播提供参考。方法 在中国2014年脊灰野病毒输入传播风险评估工具的基础上,用改良的两级指标体系评估云南省2016年脊灰输入传播的风险。通过收集相关资料,对各指标进行相应评分,累加得到各州（市）综合评分,并以此研判各州（市）脊灰疫情输入传播的风险水平。结果 本次评估从人群免疫情况、急性弛缓性麻痹病例监测信息报告管理系统运转质量和境外输入风险三方面对各州（市）进行评估,西双版纳傣族自治州、临沧市、红河哈尼族彝族自治州、文山壮族苗族自治州、昭通市综合评分最高为高风险;玉溪市等6个州（市）为中风险;大理白族自治州等5个州（市）为低风险。结论 利用调整后的评估工具将云南省16个州（市）分为脊灰疫情输入传播高、中、低3类风险地区,为不同风险水平地区和不同薄弱环节采取针对性措施和巩固无脊灰成果提供了参考依据。     

外环境中脊髓灰质炎病毒分离的实验研究

建立一种简便、实用的检测大量水样中的微量脊髓灰质炎病毒的方法。这种方法是将L2 0B细胞加入大量的含微量脊髓灰质炎病毒的水中 ,充分作用后收集细胞 ,作病毒分离培养。同时以NaCl-AlCl3 沉淀法作对照。结果表明 ,10 0 0ml水样中含病毒 10 0、10TCD50 时能全部检出 ;当含1～ 2TCD50 时 14份样本可检出 13份。NaCl-AlCl3 沉淀法在 10 0TCD50 时 4份样本中仅检出 1份 ,其它各浓度的 4份样都未能检出。     

广西自治区1995年急性弛缓性麻痹监测系统评价

1995年广西AFP监测系统工作在1994年改善的基础上又有进一步的提高。14岁儿童AFP报告发病率达1.55/10万，12项指标中有5项达卫生部、世界卫生组织规定的目标，地、县、乡、村的报病及时性、采便及时性都得到明显改善。但要使AFP所有监测指标都达到卫生部和世界卫生组织要求，仍需在加强实验室工作、加强卫生宣教、举办培训班、搜索AFF报告薄弱医院、加强主动监测和零报告制度建设等方面再作努力。     

Experiences of attitudes in Sierra Leone from the perspective of people with poliomyelitis and amputations using orthotics and prosthetics

Purpose: The aim of this study was to describe experiences of attitudes in the society of Sierra Leone from the perspective of individuals with poliomyelitis and people with amputations using orthotic or prosthetic devices.

Methods: Individual interviews were conducted using open-ended questions. Twelve participants with amputations or polio were included. Content analysis was applied to the data.

Results: The following six themes emerged during data analysis: Experience of negative attitudes; Neglected and respected by family; Traditional beliefs; The importance of assistive devices; People with disability struggle with poverty; and The need for governmental and international support.

Conclusions: In Sierra Leone, people with disabilities face severe discrimination. They need to be included, recognized, and supported to a greater extent by the society, the community, and the family, as well as by the government and international organizations. Traditional beliefs have a negative impact on people with physical disabilities and are an important cause of discrimination in Sierra Leone. Prosthetic and orthotic devices are vital for people with physical disability and offer increased dignity. Prosthetic and orthotic services need to be accessible and affordable. Poverty affects access to education, employment, and health care for Sierra Leoneans with physical disabilities, forcing them to resort to begging to cover basic living needs.

• Implications for Rehabilitation

• In Sierra Leone, traditional beliefs related to disability and public attitudes need to change in order to protect the human rights of people with disabilities.

• Increased public awareness of disability and implementation of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) at different levels in society is needed.

• To increase access to prosthetic and orthotic services in Sierra Leone, these services need to be affordable and related costs, such as transport, need to be covered by support.

• Increased access to education, employment, and financial support could contribute to an improved standard of living for people with physical disabilities.

• Governmental and international support is needed to decrease attitudinal and environmental barriers for people with disabilities in Sierra Leone.

     

江苏省赣榆县1～9岁儿童脊髓灰质炎、麻疹、风疹、流行性乙型脑炎抗体水平调查

目的 了解江苏省赣榆县1～9岁儿童脊髓灰质炎、麻疹、风疹和流行性乙型脑炎4种传染病特异性IgG抗体水平,为免疫规划工作提供参考数据. 方法 采用整群抽样的方法,共采集1～9 岁儿童手指血样39 363份,分离血清;采用酶联免疫吸附试验进行4 种病毒特异性IgG抗体水平检测,并进行统计分析. 结果 脊髓灰质炎病毒、麻疹病毒、风疹病毒和流行性乙型脑炎病毒IgG 抗体阳性率分别为97.5%、96.3%、 97.9%和95.9%.阳性率与调查对象的年龄、性别之间差异无统计学意义. 结论 赣榆县1～9岁4类传染病特异性IgG抗体均维持在较高水平,对控制传染病的暴发和流行起到了较好的免疫屏障作用.     

Ageing and severe physical disability: patterns of change and implications for services

For the first time in history, numbers of people with severe physical disabilities such as spinal cord injury or polio are surviving to old age. Ageing-related changes combined with pre-existing impairments present new challenges for these individuals and for service providers. Implications for professionals include the need to foster more collaborative relationships between themselves and recipients, to emphasize services that enable independence, to coordinate new services, and to address issues of wellness, not only disability.     

Update on Clinical Features and Brain Abnormalities in Neurogenetics Syndromes

Neuroimaging methods represent a critical tool in efforts to join the study of the neurobiology of genes with the neurobiology of behaviour, and to understand the neurodevelopmental pathways that give rise to cognitive and behavioural impairments. This article reviews the clinical features and highlights studies with a focus on the relevant gene–brain–behaviour connections observed in neurogenetic syndromes, such as Williams, Rett, Fragile X, Prader‐Willi, Angelman, Down and velocardiofacial (22q11.2 deletion) syndromes. The relationship of altered brain regions and activation patterns are discussed for each syndrome, as well as the clinical, cognitive and behavioural correlates of these neuroimaging findings.     

Shear Syndrome: The Worst Case Scenario of Crush Syndrome

Shear syndrome is described as a complication of crush syndrome. In addition to compression of and injury to the electrode, complete transection occurs. In this case, the free end migrated to the pulmonary artery with the potential for further complications.     

Superior mesenteric artery syndrome: Diagnosis and management

Superior mesenteric artery (SMA) syndrome (also known as Wilkie's syndrome, cast syndrome, or aorto-mesenteric compass syndrome) is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta. The median age of patients is 23 years old (range 0-91 years old) and predominant in females over males with a ratio of 3:2. The symptoms are variable, consisting of postprandial abdominal pain, nausea and vomiting, early satiety, anorexia, and weight loss and can mimic anorexia nervosa or functional dyspepsia. Because recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis, early diagnosis is required. The useful diagnostic modalities are computed tomography as a standard tool and ultrasonography, which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage. The initial treatment is usually conservative, including postural change, gastroduodenal decompression, and nutrient management (success rates: 70%-80%). If conservative therapy fails, surgical treatment (i.e., laparoscopic duodenojejunostomy) is recommended (success rates: 80%-100%).     

原发性肾病综合征合并布加综合征16例

目的：探讨原发性肾病综合征合并布加综合征的病因、发病情况、临床特点及治疗方案。方法：对2001—2004年16例原发性肾病综合征合并布加综合征的临床资料进行回顾性分析。结果：原发性肾病综合征合并布加综合征为血栓形成所致，起病急，表现为肝脾肿大、进行性顽固性腹水、上腹痛、消化道出血、水肿等。积极治疗原发病，溶栓抗凝治疗能促进腹水消退，防治肝肾功能衰竭，防治血管狭窄，缩短病程。介入治疗尤其局部溶栓术在短期内更能明显改善患者临床症状和实验室指标。结论：临床上应提高对本综合征的认识，对疑似病例应尽早做相关影像学检查以明确诊断，并根据病情制定恰当的治疗方案。     

Intermittent Preexcitation: Marked Enhancement of Anterograde Conduction in the Atrioventricular Accessory Pathway with Isoproterenol

A 29-year-old man presented with intermittent preexcitation and exertional syncope. Electrophysiological evaluation in the control state demonstrated a single, left posterior free-wall atrioventricular accessory pathway. The anterograde and retrograde effective refractory periods and block cycle lengths were long in the control state. No tachycardias were induced during programmed electrical stimulation. After intravenous administration of isoproterenol, anterograde conduction of the accessory pathway was markedly enhanced (block cycle length shortened 45% to less than 240 ms) and rapid antidromic reciprocating tachycardia (CL = 250 ms) associated with syncope was observed. Following successful surgical dissection of the accessory pathway the patient has been without tachycardia or exertional symptoms. We conclude that, under the influence of exercise or emotion, patients with intermittent preexcitation may be at risk for serious arrhythmias.     

高嗜酸性粒细胞综合征的临床及实验室特征研究

目的 探讨高嗜酸性粒细胞综合征(HES)各亚型的临床及实验室特点,尤其是骨髓及外周血涂片中嗜酸性粒细胞的形态学特征.方法 回顾性分析该院2017-2020年63例HES患者的临床和实验室资料,复检外周血和骨髓涂片中嗜酸性粒细胞的形态学特征.结果 63例H ES患者中有反应性HES患者54例,特发性HES患者9例.反应性...     

A Case of Delayed Presentation of Thigh Compartment Syndrome

Background

Thigh compartment syndrome is a rare and devastating process. It generally occurs within hours to days of a traumatic event, although cases have been reported nearly 2 weeks after the initial event.

Objectives

To evaluate the literature describing the timing between inciting event and presentation of thigh compartment syndromes, with a focus on delayed presentations of this rare condition. To describe the unique properties of thigh compartments, and finally, to review the anatomy and techniques needed to measure the compartment pressures of the thigh.

Case Report

A case of a 54-year-old man is presented. He sustained trauma to his thigh 17 days prior to presenting to our ED with severe, sudden-onset pain in his right thigh. Compartment pressures were measured and confirmed the diagnosis of compartment syndrome caused by two large intramuscular hematomas. No other contributing events were identified.

Conclusions

Compartment syndrome in the thigh should be considered in patients with a concerning examination and a history of recent trauma. This particular case represents the longest reported time between injury and development of a thigh compartment syndrome.     

单纯阻断肾静脉左肾静脉下移治疗胡桃夹综合征的临床护理

目的探讨单纯阻断肾静脉左肾静脉下移治疗胡桃夹综合征围手术期的护理。方法回顾性分析总结6例单纯阻断肾静脉左肾静脉下移术后患者围手术期护理过程及经验。结果对6例单纯阻断肾静脉左肾静脉下移术的护理要点包括心理护理、尿道准备、术后特殊体位的护理;血尿的观察及腹膜后出血、血肿等并发症的严密观察。结论良好的具有针对性的全程性护理对单纯阻断肾静脉左肾静脉下移术治疗胡桃夹综合征的成功至关重要。