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51.
JH Burridge DE Wood HJ Hermens GE Voerman GR Johnson F. Van Wijck T. Platz M. Gregoric R. Hitchcock AD Pandyan 《Disability and rehabilitation》2005,27(1):69-80
Purpose: To discuss the measurement of spasticity in the clinical and research environments, make recommendations based on the SPASM reviews of biomechanical, neurophysiological and clinical methods of measuring spasticity and indicate future developments of measurement tools. Method: Using the results of the systematic reviews of the biomechanical, neurophysiological and clinical approaches, methods were evaluated across three dimensions: (1) validity, reliability and sensitivity to change; (2) practical quality such as ease of use and (3) qualities specific to the measurement of spasticity, for example ability to be applied to different muscle groups. Methods were considered in terms of applicability to research and clinical applications. Results: A hierarchy of measurement approaches was identified from highly controlled and more objective (but unrelated to function) to ecologically valid, but less objective and subject to contamination from other variables. The lack of a precise definition of spasticity may account for the problem of developing a valid, reliable and sensitive method of measurement. The reviews have identified that some tests measure spasticity per se, some phenomena associated with spasticity or consequential to it and others the effect of spasticity on activity and participation and independence. Conclusions: Methods appropriate for use in research, particularly into the mechanism of spasticity did not satisfy the needs of the clinician and the need for an objective but clinically applicable tool was identified. A clinical assessment may need to generate more than one 'value' and should include evaluation of other components of the upper motor neurone syndrome. There is therefore a need for standardized protocols for 'best practice' in application of spasticity measurement tools and scales. 相似文献
52.
Occult fractures of the proximal femur: MR imaging 总被引:9,自引:0,他引:9
53.
Larry J. Strausbaugh John A. Dilworth Jack M. Gwaltney Jr. Merle A. Sande 《Antimicrobial agents and chemotherapy》1976,9(3):546-548
The in vitro activity of josamycin and erythromycin against five bacterial species was compared. In general, erythromycin was slightly more active by weight than josamycin, although both agents had a similar range of activity. 相似文献
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Prenatal identification of potential donors for umbilical cord blood transplantation for Fanconi anemia 总被引:1,自引:0,他引:1
AD Auerbach ; Q Liu ; R Ghosh ; MS Pollack ; GW Douglas ; HE Broxmeyer 《Transfusion》1990,30(8):682-687
Reported here are studies of Fanconi anemia fetal cells that led to the first use of umbilical cord blood for hematopoietic reconstitution in a clinical trial. Prenatal diagnosis and HLA typing were performed in fetuses at risk for Fanconi anemia (FA) to identify, prior to birth, those that were unaffected with the syndrome and were HLA-identical to affected siblings. Umbilical cord blood was harvested at the delivery of these infants; assays of progenitor cells indicated the presence of colony-forming units-granulocyte-macrophage (CFU-GM) in numbers similar to those of bone marrow CFU-GM that are associated with successful engraftment in HLA-matched allogeneic bone marrow transplantation. The possibility that umbilical cord blood from a single individual can be used as an alternative to bone marrow for hematopoietic reconstitution has now been demonstrated by the successful engraftment of two patients with FA. Progenitor cell assays of umbilical cord blood collected at the birth of a child affected with FA, who had been misdiagnosed on the basis of chorionic villus sampling (CVS) studies, indicated a profound deficiency in colony formation, consistent with previously reported abnormalities in the growth of FA cells in vitro. These results suggest that the hematopoietic disorder in FA is related to an underlying problem with cell proliferation. 相似文献
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58.
Sheri D. Weiser Torsten B. Neilands Megan L. Comfort Samantha E. Dilworth Jennifer Cohen Jacqueline P. Tulsky Elise D. Riley 《American journal of public health》2009,99(8):1459-1463
Objectives. We assessed how different patterns of housing instability affect incarceration and whether correlates of incarceration are gender specific.Methods. We used multivariate logistic regression to assess associations between patterns of housing instability and recent jail stays among a reproducible sample of 1175 marginally housed adults in San Francisco, California.Results. Over the previous year, 71% of men and 21% of women in the sample reported jail stays. Among women, long-term single-room occupancy hotel stays ( > 90 days) were protective for incarceration. Stays in the street were associated with incarceration among both genders, but among men, short-term (i.e., ≤ 90 days) street stays were associated with the highest odds of incarceration, and among women, long-term street stays were most correlated with incarceration. Sex trade increased the odds of incarceration among men only; recent drug use was associated with incarceration among both genders.Conclusions. Correlates of incarceration differed by gender, and patterns of housing instability differentially affected incarceration for men and women. Policies to improve housing options and drug treatment for the urban poor are critical to breaking the cycle of incarceration and homelessness and improving health outcomes.Incarceration rates in the United States have more than quadrupled over the past 3 decades and have increased more rapidly among women than among men.1–3 Urban poor individuals are at especially high risk for incarceration. A strong body of literature shows bidirectional associations between homelessness and both jail and prison stays in that homelessness is a catalyst for incarceration and incarceration precipitates homelessness by disrupting social networks and employment opportunities.4–13Incarceration has public health consequences other than decreased housing and employment options; individuals who have been incarcerated in jails or prisons have higher rates of substance abuse, victimization, mental illness, chronic diseases, tuberculosis, HCV, HIV, and other sexually transmitted diseases (STDs) when compared with other low-income individuals.7,13–26 Among people with HIV, incarceration is associated with worse antiretroviral adherence and worse HIV clinical outcomes than among nonincarcerated individuals.27,28 Prison and jail stays are also associated with increased risk of needle sharing, unsafe sexual behavior, and drug overdose, which compounds the negative health consequences associated with incarceration.29–32 Finally, incarceration is associated with high mortality rates compared with the general population, particularly within the first 2 weeks after release.32In view of the many adverse public health effects of incarceration, it is critical to better understand its correlates. Although we have previously reported that correlates of homelessness differ between men and women,33 few data indicate whether correlates of incarceration vary by biological sex. This is particularly important because the reasons people are incarcerated in the first place seem to be gender specific (i.e., men are arrested more frequently for nearly every offense category other than prostitution, running away from home, and embezzlement)34 and also because women and men living on the street may experience different vulnerabilities and may have different survival strategies.Another important gap in the literature is that although links between homelessness and incarceration are well established, little is known about whether specific patterns of housing instability are differentially associated with incarceration. We therefore set out to assess gender-specific associations between patterns of homelessness and jail stays among low-income men and women in San Francisco, California. 相似文献
59.
AD Collaborative Group Bentham P Gray R Sellwood E Hills R Crome P Raftery J 《Lancet neurology》2008,7(1):41-49
BACKGROUND: Cardiovascular risk factors and a history of vascular disease can increase the risk of Alzheimer's disease (AD). AD is less common in aspirin users than non-users, and there are plausible biological mechanisms whereby aspirin might slow the progression of either vascular or Alzheimer-type pathology. We assessed the benefits of aspirin in patients with AD. METHODS: 310 community-resident patients who had AD and who had no potential indication or definite contraindication for aspirin were randomly assigned to receive open-label aspirin (n=156; one 75-mg enteric-coated tablet per day, to continue indefinitely) or to avoid aspirin (n=154). Primary outcome measures were cognition (assessed with the mini-mental state examination [MMSE]) and functional ability (assessed with the Bristol activities of daily living scale [BADLS]). Secondary outcomes were time to formal domiciliary or institutional care, progress of disability, behavioural symptoms, caregiver wellbeing, and care time. Patients were assessed at 12-week intervals in the first year and once each year thereafter. Analysis of the primary outcome measures was by intention to treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN96337233. FINDINGS: Patients had a median age of 75 years; 156 patients had mild AD, 154 had moderate AD, and 18 had concomitant vascular dementia. Over the 3 years after randomisation, in patients who took aspirin, mean MMSE score was 0.10 points higher (95% CI -0.37 to 0.57; p=0.7) and mean BADLS score was 0.62 points lower (-1.37 to 0.13; p=0.11) than in patients assigned to aspirin avoidance. There were no obvious differences between the groups in any other outcome measurements. 13 (8%) patients on aspirin and two (1%) patients in the control group had bleeds that led to admission to hospital (relative risk=4.4, 95% CI 1.5-12.8; p=0.007); three (2%) patients in the aspirin group had fatal cerebral bleeds. INTERPRETATION: Although aspirin is commonly used in dementia, in patients with typical AD 2 years of treatment with low-dose aspirin has no worthwhile benefit and increases the risk of serious bleeds. 相似文献
60.