A validation study of devices designed to reduce loads in provision of care: whether these assistive devices are used, or not, and whether work posture is appropriate or not.

Our country already faces an aging society, but many care workers suffer from work-related musculoskeletal disorders and assistive devices have not been adopted in care-work sites. In order to evaluate the effectiveness of assistive devices, we conducted a study on care work-load; whether the assistive devices are used or not, and whether work posture is appropriate or not, on five female healthcare workers by measuring surface electromyography (SEMG) of biceps brachii, the trapezius (upper extremity) and lumbar paraspinals between L3 and L4 (low back), and the trunk inclination angle (TIA). Moreover, subjective evaluations both by the caregivers and also the care receivers were verified. The caregivers were asked to rate perceived exertion using the Borg scale and the care receiver was asked to rate dissatisfaction. Work condition 1: Repositioning of a supine patient towards the head of bed. Work condition 2: Transferring a patient from sitting on the bed to sitting in a wheelchair. Under the two work conditions there were five set tasks in which subjects used or did not use the assistive devices and worked with or without the appropriate procedure and posture. The representative value adopted was the 95 percentile value. SEMG: Under both work conditions and at all measurement sites, we observed the statistically significant effectiveness of the appropriate procedure and posture as compared to manual handling. When the assistive devices were used improperly, or in work with low bed height, there was no reduction in workloads on the upper extremities. TIA: In both work conditions we observed statistically significant effectiveness of the appropriate procedure and posture as compared to not only manual handling but also working with improper assistive devices and with low bed heights. Findings of the subjective evaluations: The caregiver's perceived exertion and care receiver's dissatisfaction, showed statistical significance in satisfaction with the appropriate procedure and posture as compared to manual handling. Therefore, to reduce workload, and prevent work-related musculoskeletal disorders of caregivers, it is necessary not only to provide assistive devices but also to supervise the proper procedures and work postures and to improve the work environment.     

Association of osteopontin with ischemic axonal death in periventricular leukomalacia

Osteopontin (OPN) is a bone matrix protein expressed my macrophages and related to the process of tissue calcification, and is also known to protect ischemic cells. To understand how OPN is involved in the process of ischemic axonal death in periventricular leukomalacia (PVL), we examined the immunoreactivity of OPN and ionized calcium binding adaptor molecule 1 (Iba1; microglia/ macrophage marker) at various stages of PVL. OPN immunoreactivity paralleled the number of Iba1-positive foam cells; a finding which suggests the production of OPN protein by foam cells. OPN immunoreactivity was not found in either normal white matter or acute PVL lesions, but was detected at the subacute and chronic stages in swollen and calcified axons bordering the ischemic zone. These findings suggest that OPN is closely associated with death of swollen axons at the periphery of the ischemic zone, regulating the presence or absence of calcification. Received: 20 January 1999 / Revised, accepted: 21 September 1999     

Inhibition of all-trans retinoic acid-induced granulocytic differentiation of WEHI-3B D+ cells by forced expression of SCL (TAL1) and GATA-1

All-trans retinoic acid (ATRA) induces granulocytic maturation of WEHI-3B D⁺ leukemia cells and LiCl enhances this maturation, while WEHI-3B D^? cells are non-responsive to ATRA. Transfection of SCL, expressed in D^? but absent in D⁺ cells, into D⁺ cells, caused resistance to ATRA, while transfection of GATA-1 into D⁺ cells produced resistance to the combination of ATRA and LiCl. SCL expression in D⁺ cells did not induce the expression of c-Kit, a putative target gene for SCL. LiCl, known to inhibit some kinases by displacing Mg²⁺, did not affect tyrosine kinase activity of the cytoplasmic domain of c-Kit.     

Evaluation of Efficacy in Platelet Collection by the Haemonetics Component Collection System

Abstract: Platelet concentrate product derived from plateletpheresis from a single donor is preferable in terms of reducing the risks of adverse reactions in platelet transfusion. This study evaluated the status of platelet transfusion and the efficacy and safety of plateletpheresis machines. The average number of donors of platelet product per patient has been decreasing and recently reached nearly 1.0; however, some patients still receive multiple random donor platelet products. Platelet collection efficacy was comparable between the Haemonetics Component Collection System (CCS) and the Multi Component System (Multi). However, the CCS has been shown to be effective in terms of processed blood volume and procedure time, especially in donors with lower hematocrits. These results suggest that the CCS may be preferable and safer for donors with lower hematocrits and lighter body weights. Blood centers should collect platelets more effectively to achieve platelet transfusion with the use of platelets derived from a single donor using effective equipment.     

Adverse effects of anticholinergic activity on cognitive functions in Alzheimer's disease

Background:  Elderly patients with Alzheimer's disease (AD) take more medicines, other than those for anti-dementia agents, than healthy people and are sensitive to anticholinergic medications. There are only a few reports, however, on the relationship between cognitive function and anticholinergic activity in AD patients, which is caused by taking prescribed medication.
Methods:  We measured serum anticholinergic activity (SAA) in 76 AD patients referred to a Psychogeriatric Unit and separated them into SAA positive group ( n = 26, SAA (+) group) and SAA negative group ( n = 50, SAA (−) group). The difference in demographic data and cognitive functions were compared between the two groups.
Results and Conclusions:  The total scores of the Mini-Mental State Examination (MMSE), the score of MMSE domain of registration and recall were significantly lower ( P < 0.05) and the Functional Assessment Staging (FAST) score, the number of different kinds of prescribed psychotropic medications (the number of prescribed psychotropic medications) were significantly higher ( P < 0.05) in the SAA (+) group than in the SAA (−). These results suggest that a higher number of psychotropic medications prescribed leads to a tendency for SAA to be positive and that anticholinergic activity accelerates Alzheimer's pathology and decreases cognitive function, especially memory in AD patients. We should more prudently prescribe psychotropic medications to AD patients, because the prescribed psychotropic medications are one of the important causes of decline in cognitive function of AD patients by way of anticholinergic activity.     

Emergence of macrolide-resistant Mycoplasma pneumoniae with a 23S rRNA gene mutation

A total of 195 Mycoplasma pneumoniae strains were isolated from 2,462 clinical specimens collected between April 2002 and March 2004 from pediatric outpatients with respiratory tract infections. Susceptibilities to six macrolide antibiotics (ML), telithromycin, minocycline, levofloxacin, and sitafloxacin were determined by the microdilution method using PPLO broth. A total of 183 M. pneumoniae isolates were susceptible to all agents and had excellent MIC90s in the following order: 0.00195 microg/ml for azithromycin and telithromycin, 0.0078 microg/ml for clarithromycin, 0.0156 microg/ml for erythromycin, 0.0625 microg/ml for sitafloxacin, 0.5 microg/ml for minocycline, and 1 microg/ml for levofloxacin. Notably, 12 ML-resistant M. pneumoniae strains were isolated from patients with pneumonia (10 strains) or acute bronchitis (2 strains). These strains showed resistance to ML with MICs of >or=1 microg/ml, except to rokitamycin. Transition mutations of A2063G or A2064G, which correspond to A2058 and A2059 in Escherichia coli, in domain V on the 23S rRNA gene in 11 ML-resistant strains were identified. By pulsed-field gel electrophoresis typing, these strains were classified into groups I and IIb [corrected] as described previously (A. Cousin-Allery, A. Charron, B. D. Barbeyrac, G. Fremy, J. S. Jensen, H. Renaudin, and C. Bebear, Epidemiol. Infect. 124:103-111, 2000). These findings suggest that excessive usage of MLs acts as a trigger to select mutations on the corresponding 23S rRNA gene with the resultant occurrence of ML-resistant M. pneumoniae. Monitoring ML susceptibilities for M. pneumoniae is necessary in the future.