Exogenous fibroblast growth factors-1 and -2 do not accelerate fracture healing in the rabbit

Both fibroblast growth factors-1 (acidic FGF) and -2 (basic FGF) increase the proliferation of osteoblasts and chondrocytes in vitro and FGF-2 stimulates angiogenesis and bone formation in vivo. to test their effects on rabbit tibial fracture-healing under stable and unstable mechanical conditions, 3 ug of either FGF-1 or FGF-2 was injected around rabbit tibial fractures on day 4 after fracture. Neither growth factor had a significant effect on either the size of, or the amounts of bone and cartilage in, the 10-day callus irrespective of the mechanical conditions under which the fracture was healing. the 10-day FGF-2-treated calluses were, however, more mature than FGF-1-treated calluses because the cartilage was separated from the periosteum by bone and endochondral ossification had progressed further. in conclusion, the application of FGF-1 or FGF-2 to normally healing fractures of the rabbit tibia does not have a significant effect on the rate of healing.     

The role of biofeedback and relaxation therapy in arterial occlusive disease

Eleven patients with chronic arterial occlusive disease and intermittent claudication were treated with biofeedback-relaxation therapy in an attempt to increase walking time by improving peripheral blood flow. Criteria for admission to the study included (1) participation in an exercise program without improvement in symptoms (2) a maximal treadmill walking time (MWT) of <5 min and (3) an ankle blood pressure of <60 mm Hg immediately postexercise. Patients were randomized into two groups: Group I entered biofeedback training immediately, and Group II served as controls for 3 months prior to undergoing the same treatment protocol as Group I. Patients were taught EMG and skin temperature feedback during 30 1-h training sessions over a 13-week period. Following biofeedback therapy all patients in Group I significantly increased their MWT (P < 0.001) while patients in the control Group (II) showed minimal improvement in MWT. After undergoing biofeedback therapy, Group II also improved their MWT. At the completion of the study, 9 of 11 patients walked >8 min. The improved MWT was associated with a fall in resting (P < 0.05) and exercise (P < 0.01) arm systolic blood pressure. Both the exercise ankle blood pressure (P < 0.05) and exercise ankle/arm blood pressure ratio (P < 0.01) increased significantly following biofeedback therapy, suggesting a reduction in resistance around the site of occlusion. Our findings indicate that biofeedback training may be an effective nonoperative treatment for selected patients with arterial occlusive disease and intermittent claudication.     

Innovations in dementia care

Creating a homelike environment in an institutional setting that caters for dementia sufferers requires flexibility, understanding and insight. A homelike environment frequently only addresses the physical appearance of the facility without ever considering what was homelike for the resident prior to coming into care. The use of chemical and mechanical restraints to overcome adverse behaviour has been the accepted norm in many nursing homes without consideration being given to the diverse effects of these management tools. The use of the clinical type setting for routines and policies has been in place for many years, yet it is these very routines that have been found to cause the most distress to dementia sufferers. The challenge of change is the greatest reason for maintaining the status quo but change can bring its rewards with the improved quality of life experienced by those residents who lived in a nursing home. This paper describes a programme that addresses the advantages of changing the environment for dementia sufferers and demonstrates that an improved quality of life can be achieved by removing the need for chemical and mechanical restraints.