Comparison of the influence of aerobic and resistance exercise of the upper and lower limb on intraocular pressure

Purpose: To compare the influence of aerobic and resistance exercise on intraocular pressure (IOP). Methods: Twenty‐one healthy subjects participated. Aerobic exercise was performed using a cycle ergometer, and resistance exercise was performed with a leg curl and a butterfly machine. Intraocular pressure was measured at baseline, during exercise and 10 min after. During resistance exercise, a Valsalva manoeuvre was prevented. Results: Before aerobic exercise, the mean IOP was 18.8 ± 2.7 mmHg. It was 16.5 ± 2.8 after 10, 17.1 ± 2.6 after 20 and 16.7 ± 3.3 mmHg after 30 min of exercise. After 10 min, the IOP returned to baseline (18.8 ± 2.7 mmHg). The mean IOP before resistance exercise with the leg curl machine was 17.0 (15.6–18.4; 65%W_max) and 16.8 (15.3–18.3) mmHg; 75%W_max) and did not change significantly during the experiment. The mean IOP before resistance exercise with the butterfly machine (65%W_max) was 16.4 (15.2–17.6) and increased to 17.2 (16.0–18.4) mmHg (p < 0.05). After 10 min of recreation, it recovered to 16.3 (15.0–17.5) mmHg. At 75%W_max, the mean baseline IOP was 16.3 (15.2–17.4) mmHg, and there were no significant changes. Conclusions: Aerobic exercise leads to a significant decrease of IOP. There was no influence of resistance exercise on IOP as long as a Valsalva manoeuvre was prevented.     

“Knocking on Doors that Don’t Open”: experiences of caregivers of children living with disabilities in Iquitos and Lima,Peru

Abstract

Background: More than one billion people worldwide live with a disability. Despite advances in recognising inequalities experienced by people with disabilities, barriers to services and stigmatisation still exist. The aims of this study were to explore: (1) perceptions and experiences of services specifically available to people with disabilities and their caregivers and (2) the perception of disability.

Methods: In-depth interviews were conducted with 20 caregivers of persons with a disability and 14?key informants in two cities in Peru; Lima and Iquitos. The social-ecological model was used as a framework to analyse and present data, stratifying the key barriers and opportunities at each level.

Results: At the individual level, interviewees reported a lack of support at the time of diagnosis, poor coping strategies, and communicated their desire for, and willingness to participate in support groups if they were established. On the community level, education and awareness were reportedly lacking and acts of discrimination and stigmatisation were common. Participants described opportunities for community-level campaigns to increase exposure and awareness of disability rights and inclusion. A dissatisfaction with government programmes was reported, as services were not available to everyone, in part due to geographical and socio-economic barriers.

Conclusions: The main findings were the lack of emotional, informational, and tangible support available to caregivers of people with disabilities, often exacerbated by lower socio-economic status; a lack of transparency of care pathways available to people with disabilities; and a lack of visibility of people with disability in both Lima and Iquitos.

• Implications for Rehabilitation

• Support groups could offer additional support to caregivers of people with disabilities in Lima, mitigating existing gaps in services for people with disabilities, and their families.

• Education campaigns implemented on a community level could start to curb discrimination and stigmatisation of people with disabilities in Lima and Iquitos.

• A national census with inclusive language and methodology specifically designed to capture the percentage of the population currently living with a disability would give a real indication of what services are needed in Peru.

• The provision of clear, publically available routes of attention would assist caregivers and families to access services for people with disabilities.

     

Sustained low hospitalization rates after four years of rotavirus mass vaccination in Austria

This hospital based surveillance study evaluates the effects of the rotavirus mass vaccination program, which was initiated in Austria in August 2007. Since then, incidence rates of rotavirus hospitalizations in children <15 years of age have decreased by 70% and 64% in 2010 and 2011 compared to the pre-vaccination era (2001–2005). Incidence rates were highest in children <90 days of age, highlighting the importance of the early start of active rotavirus immunization. In children between 2 and 3.5 years in 2011, who were in the second and third year after vaccination in the universal mass vaccination program, incidence rates remained low suggesting sustained protection after vaccination up to three years. In the years 2010 and 2011, field effectiveness of the vaccines was between 79% and 96%, depending on the assumptions made for children without information on vaccination history. From genotyping an increase of the prevalence of G2P[4] in children with breakthrough infection (disease despite vaccination) can be suspected. The rate of severe adverse events was 1.3–1.5 per 10⁻⁵ administered doses of rotavirus vaccines and no death, intussusception or Kawasaki disease was reported in 2010 and 2011 following rotavirus vaccination.     

Prospective pilot study on the incidence of infections caused by peripheral venous catheters at a general surgical ward

Device-associated infections comprise a significant proportion of all nosocomial infections. In this prospective, observational pilot study the incidence of infections in 89 peripheral venous catheters (PVCs) was documented on a general surgical ward employing an infection data sheet developed by the Institute of Hygiene and Environmental Medicine, Greifswald in adherence to CDC standards for infections. 16 of 20 infections were documented during a four-week time period when medical students in the first four months of their practical year performed their compulsory rotation on the general surgical ward. Insufficient knowledge of adequate hygienic measures as well as non-compliance to aseptical procedural measures prior to and following insertion of a peripheral venous catheter are the assumed instigators of these infections. In order to ensure a uniform hygienic standard in the performance of applied procedures, it is essential that medical students during this practical year receive not only theoretical, but also hands-on schooling prior to initiation of their subsequent official residency.     

Tophaceous gout in a young man with Gitelman syndrome: a case report with an overview

Clinical Rheumatology - Gitelman syndrome represents the clinical manifestations of inactivation of the Slc12a3 genes encoding the thiazide-sensitive sodium chloride cotransporter and the Trpm6-Mg...