Association between single limb standing test results and healthcare costs among community-dwelling older adults

Background and objectiveIdentifying risks for older adults who will require healthcare resources is critical for the government, healthcare providers, and consumers. The objective of this study was to examine the relationship between the results of the single limb standing (SLS) test and healthcare costs among community-dwelling older adults.MethodsWe used data obtained from a population-based prospective cohort study of the residents of Tadami town in Fukushima Prefecture, Japan. The participants were above 60 years of age and had undergone annual health check-ups, and data on their healthcare costs over the two-year study period were available. A censored regression model adjusted for potential confounders was used to estimate the mean difference in total healthcare costs between participants who could remain standing on a single limb for at least 30 s and those who could not.ResultsHealthcare costs of participants who passed the SLS test were significantly lower than those who did not. The mean difference between the two groups’ healthcare costs was 4064 USD (95 % confidence interval: 2661–5467 USD, p < 0.05). After adjusting for potential confounders, the mean difference between the two groups was smaller (1686 USD) but remained statistically significant (95 % confidence interval: 125–3246 USD, p < 0.05).ConclusionsAmong community-dwelling older adults, limited static balance (SLS time <30 s) was found to be associated with high healthcare costs in the two years after the SLS test. The SLS test may help identify individuals at high risk of becoming frequent users of healthcare services in the future.     

弹力绷带与医用棉两种衬垫在电动气压止血带中的应用比较

目的通过比较医用棉纸与弹力绷带作为电动气压止血带衬垫的方法,观察不同衬垫材料在电动气压止血带中的应用效果。方法将2018年1月至12月镇江市中西医结合医院骨科收治的100例患者采用随机数字表分为弹力绷带组(50例)和棉纸组(50例),分别采用弹力绷带和医用棉纸作为电动气压止血带衬垫材料,观察比较两组的止血效果、皮肤损伤发生率以及对电动气压止血带袖带的保护情况。结果弹力绷带组患者的皮肤压痕、瘀斑、水泡等皮肤损伤发生率低于棉纸组,差异有统计学意义(P<0.05);两组止血效果比较差异无统计学意义;弹力绷带组的袖带污染发生率(4%)明显少于棉纸组(16%),差异有统计学意义(P<0.05)。结论弹力绷带作为止血带衬垫材料止血效果明显,而且能有效降低患者受压处皮肤的损伤率,同时减少了止血带袖带的污染,有利于袖带的清洁消毒。     

直流电场对培养兔角膜上皮细胞形态及活力的影响

目的:观察直流电场对体外培养兔角膜上皮细胞形态及活力的影响。方法:采用组织块培养法培养兔角膜上皮细胞并进行传代培养,将第4代角膜上皮细胞置于强度为8 V/cm的直流电场中暴露4 h,停止电场作用后继续培养12 h;未置于电场中的角膜上皮细胞作为对照。显微成像系统观察细胞形态改变,各时间点培养的细胞行台盼蓝染色计数,比较各组活细胞率。结果:直流电场作用后大部分角膜上皮细胞变长,并垂直于场线方向排列,停止电场暴露后,大多数细胞恢复正常形态及分布。实验组和对照组活细胞率差异无统计学意义(P>0.05)。结论:短时间直流电场作用对培养的兔角膜上皮细胞的形态及活力无明显影响。     

Middle Components of Human Auditory Averaged Electroencephalic Response: Waveform Variations During Averaging

The bases for variations of the middle-component (8–50 ms) auditory averaged electroencephalic response (AER) to clicks during the averaging process were explored by examining (1) the trend of the mean variance of the averaged waveform, (2) averaged waveforms generated by successive blocks of stimuli fractioned from a total of 512 stimuli, and (3) averaged waveforms generated by successive, but partially overlapping, blocks of responses recorded for a train of 512 stimuli. These analyses indicated no systematic changes in peak latencies or peak-to-peak amplitudes as stimulation progressed. Fluctuations in middle AER waveform are more readily explained by non-stationarity of the background electrophysiologic noise. Previously reported amplitude reduction with increasing stimulus number possibly can be explained by progressive reduction of the background noise on which the consistent-amplitude middle components are superimposed.     

心血管系统病人发生跌倒与坠床原因分析与护理措施

目的:探讨如何预防和减少跌倒和坠床事件发生。方法:通过对跌倒与坠床事件发生的原因进行分析,提出相应的对策。结果:近1年来发生跌倒与坠床事故4例,跌倒后分别致股骨颈骨折1例,皮肤擦伤1例,血压下降2例。结论:预防和减少跌倒和坠床事件发生不仅需要护理人员严谨的工作态度,也需要医护之间良好的沟通,以及患者及家属的配合。     

Binge alcohol-induced alterations in BDNF and GDNF expression in central extended amygdala and pyriform cortex on infant rats

Mothers who consume alcohol during pregnancy may cause a neurotoxic syndrome termed fetal alcohol spectrum disorder (FASD) in the offspring, which includes cognitive deficits and emotional/social disturbances. These alterations are thought to be caused, at least in part, by alcohol-induced imbalance in neurotrophic factor levels, which are critically involved in normal neurodevelopment. Our goal was to study whether brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF) expression were affected by alcohol in central extended amygdala (CEXA) and pyriform cortex (Pyr), structures strongly involved in emotional/social behaviors. Further, we evaluated how these changes could be related to blood and brain alcohol concentrations. Postnatal day (PND) pups at 7, 15 and 20-days old were administered alcohol (2.5 g/kg s.c. at 0 and 2 h) or saline. Immunohistochemistry was used to detect the expression of BDNF and GDNF at 2, 12 and 24 h after drug administration. Also, gas chromatography was bused to measure blood alcohol levels (BALs) and brain alcohol levels (BrALs) at each hour, from 2 to 8 h after the second alcohol administration. Results showed: (1) alcohol-induced enhancement of BDNF positive cells on PND 7 and 20, a decrease on PND 15 in the CEXA, and no changes in the Pyr on PND 7 and 20, but a diminished on PND 15; (2) GDNF positive cells rise after alcohol administration for the three ages in the CEXA and Pyr except on PND 15, where there was a decline; and (3) pharmacokinetics analysis demonstrated age-related differences showing equal BALs on PND 7 and 20 but higher BALs on PND 15. In contrast, BrALs were higher on PND 7 than 15 and 20. Hence, BALs may not be predictive of BrALs in postnatal rats. Furthermore, we did not find a relationship between age in pharmacokinetic differences and neurotrophins response. In conclusion, the CEXA and Pyr are brain structures sensitive to alcohol-induced imbalance in neurotrophic factors expression; and BALs are not a mirror of BrALs.     

Effects of Prolonged Standing on Gait in Children with Spastic Cerebral Palsy

ABSTRACT

The purpose of this study was to determine the effects of prolonged standing on gait characteristics in children with spastic cerebral palsy. Six children with spastic cerebral palsy participated in this study with an average age of 6.5 years (SD = 2.5, range = 4.0–9.8 years). A reverse baseline design (A-B-A) was used over a 9-week period. During phase A, the children received their usual physical therapy treatment. During phase B, children received the prolonged standing program three times per week, in addition to their usual physical therapy treatment. During phase A2, children received their usual physical therapy treatment. Gait analysis and clinical assessment of spasticity were performed before and after each phase. Analysis of variance (ANOVA) for repeated measurements was used to test for changes in gait measures across the four measurement sessions. Friedman's was used to test for changes in muscle tone (Modified Ashworth Scale) across the four measurement sessions. Stride length (p <.001), gait speed (p <.001), stride time (p <.001), stance phase time (p <.001), double support time (p <.003), muscle tone (p <.02), and peak dorsiflexion angle during midstance (p <.004) improved significantly following the intervention phase. The results of this study demonstrate that the gait pattern of children with cerebral palsy classified as level II or III on the Gross Motor Functional Classification System (GMFCS) improved by a prolonged standing program. However, these improvements were not maintained at 3 weeks. Further research is necessary with larger sample sizes to replicate these findings and determine specific “dosing” for standing programs to create long-lasting functional effects on gait.     

穴位按摩对长期卧床患者发热恢复的效果观察

目的：探讨穴位按摩方法对长期卧床患者发热恢复的作用。方法：将84例长期卧床发热患者随机分为常规组和穴位按摩组，每组各42例。常规组给予发热后常规护理，穴位按摩组在常规护理基础上，实施双侧风池、太阳、合谷和大椎穴交替按摩。结果：两组患者体温恢复正常时间和三天内体温反弹例数比较，差异均存在统计学意义（P〈0．05）。其中按摩组体温恢复时间和三天内体温反弹例数均小于常规组。结论：穴位按摩可有效促进长期卧床发热患者体温的恢复。