Relationship between strength, balance, and swallowing deficits and outcome after traumatic brain injury: a multicenter analysis

OBJECTIVE: To examine the relation among strength, balance, and swallowing deficits, as measured on rehabilitation admission, and functional outcome at discharge and 1 year after traumatic brain injury (TBI). DESIGN: Multicenter analysis of consecutive admissions to designated Traumatic Brain Injury Model Systems (TBIMS) facilities. SETTING: Seventeen TBIMS centers. PARTICIPANTS: Adults and children older than 16 years of age with TBI (N=2363) enrolled in the national database from January 1989 to November 2000. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Transfers, locomotion, stairs, lower-body dressing, grooming, bathing, upper-body dressing, toileting, and eating as measured by the FIM instrument at acute rehabilitation discharge and at 1 year after TBI. RESULTS: Lower-extremity strength less than 3/5 on admission to acute rehabilitation was associated with increased need for assistance in locomotion, transfers, and lower-body dressing and less than 3/5 upper-extremity strength was associated with the need for assistance in self-care at rehabilitation discharge and at 1 year postinjury. Similar relations were found between impaired swallowing and assistance with eating, grossly impaired dynamic sitting, or standing balance and assistance with locomotion, transfers, eating, and self-care at rehabilitation discharge and at 1 year after TBI. CONCLUSIONS: Assessments of physical strength, swallowing ability, and dynamic balance on acute rehabilitation admission are helpful as screening tests in predicting the need for assistance of another person for mobility and self-care at rehabilitation discharge. This association remains strong at 1 year after TBI. By using this information, clinicians should initiate therapeutic interventions that optimize rehabilitation of the identified impairments and should make necessary arrangement for the patient's anticipated postdischarge needs. Further studies are necessary to delineate the amount of unique variance that these early physical examination findings contribute to outcome prediction.     

Timing, intensity, and duration of rehabilitation for hip fracture and stroke: report of a workshop at the National Center for Medical Rehabilitation Research

This article summarizes the proceedings of an NIH workshop on timing, intensity, and duration of rehabilitation for acute stroke and hip fracture. Participants concentrated on methodological issues facing investigators and suggested priorities for future research in this area.     

Benefits of an inpatient pulmonary rehabilitation program: a prospective analysis

OBJECTIVE: To examine the effect of an inpatient pulmonary rehabilitation program on functional outcome, supplemental oxygen use, quality of life (QOL), and rehospitalization. DESIGN: A prospective study. SETTING: Inpatient pulmonary rehabilitation unit. PATIENTS: One hundred fifty-seven patients with moderate to severe chronic obstructive pulmonary disease (COPD) admitted to an inpatient pulmonary rehabilitation program over a 3-year period. INTERVENTION: Comprehensive interdisciplinary inpatient pulmonary rehabilitation program with an average length of stay of 21 days. MAIN OUTCOME MEASURES: Improvements in QOL questionnaire scores, COPD knowledge questionnaire scores, 6-minute walking test (with 3 ambulation categories: bed-bound, household ambulators, community ambulators), and supplemental oxygen use. Rehospitalization 1 year after completion of the program was also assessed and compared with hospital days for the year before the program. RESULTS: On discharge from the program, 88% of individuals walked farther (p <.0001), and community ambulators doubled their walking distance, whereas bed-bound patients decreased 10-fold; supplemental oxygen use dropped 33% during the day (p <.0001) and 57% during the night (p <.0001); 82% showed improved QOL (p <.0001); 67% showed improved knowledge of COPD (p <.0001); and 67% of the sample spent less time in the hospital during the 12 months after program completion compared with the 12 months before admission (p <.001). CONCLUSIONS: An inpatient pulmonary rehabilitation program leads to improved endurance and functional ambulation, decreased supplemental oxygen use, and fewer hospitalizations 1 year after discharge for patients with COPD.     

氟中毒对新生儿及产妇的影响的研究

氟中毒对新生儿及产妇影响的研究表明，地氟病区的畸胎率，死胎率和新生儿死亡率与非病区比较均无显著性差异，而病区的产妇难产率显著高于非病区，其原因可能是高氟对产妇骨骼的损害，导致骨盆的变形所致。     

血小板激活因子对大鼠脑血管通透性的影响及药物的保护作用

颈内动脉注射血小板激活因子(PAF),再给伊文思蓝,可见脑实质染色程度加深,而颈内动脉只注射伊文思蓝,脑实质未见染色。而我们合成的新药SZ-1可剂量依赖性地抑制PAF诱导的脑实质伊文思蓝染色程度的加深。在体外培养的脑微血管平滑肌细胞上,PAF能显著刺激~(14)-花生四烯酸的释放,而SZ-1能剂量依赖性地抑制这种释放,提示PAF在脑内产生的损害除与其他因素相关外,还与其刺激花生四烯酸释放有密切关系,SZ-1对PAF引起的脑部损害有保护作用。     

原卟啉肟同系物对2＇，3＇－亚丙基鸟苷光分解的光敏作用

合成了一些原卟啉肟同系物，它们的最大吸收波长为６７０ｎｍ，在肟衍生物的存在下，用红光照射２’，３＇－哑丙基鸟苷（ＩｐＧｕ）溶液，它们对ＩｐＧｕ的光分解作用比对照品血卟啉强约一倍。     

山莨菪碱和蝙蝠葛碱对白三烯和PAF诱导的牛脑前动脉平滑肌细胞DNA合成的影响(英文)

白三烯和血小板活化因子在低于nmol浓度时就能刺激培养的牛脑前动脉平滑肌细胞的DNA合成,在10^-7mol/L时达最大刺激。LTB₄,LTD₄和PAF在10^-7mol/L时对上述细胞DNA合成的刺激率分别为32%,29%和77%。山莨菪碱和蝙蝠葛碱在10^-7～10^-4mol/L范围内呈剂量依赖性地抑制白三烯和血小板活化因子的上述作用。