A Comparative Study of Splint Effectiveness in Limiting Forearm Rotation

Study DesignCase Study Series.IntroductionRestriction of forearm rotation may be required for effective management and rehabilitation of the upper limb after trauma.Purpose of the StudyTo compare the effectiveness of four splints in restricting forearm rotation.MethodsMuenster, Sugartong, antipronation distal radioulnar joint (DRUJ), and standard wrist splints were fabricated for five healthy participants. Active range of motion (AROM) in forearm pronation and supination was measured with a goniometer for each splint, at the initial point of sensory feedback and during exertion of maximal force.ResultsRepeated-measures analysis of variance indicated significant differences between splints for all four AROM measures. Post hoc paired t-tests showed that the Sugartong splint was significantly more restrictive in pronation than the Muenster splint. The antipronation DRUJ splint provided significantly greater restriction in pronation than the standard wrist splint. No splints immobilized the forearm completely.ConclusionsThe Sugartong splint is recommended for maximal restriction in pronation, but individual patient characteristics require consideration in splint choice.Level of EvidenceIV     

Perceptions of a service redesign by adults living with type 2 diabetes

Title.  Perceptions of a service redesign by adults living with type 2 diabetes.
Aim.  This article is a report of a study conducted to explore the perceptions of adults with type 2 diabetes towards the service redesign.
Background.  Diabetes is reaching epidemic proportions and the management of this chronic illness is changing in response to this challenge. In the United Kingdom, there is ongoing restructuring of healthcare services for people with chronic illnesses to ensure that their general health and clinical needs are met predominantly in primary care.
Method.  An explorative qualitative approach was used. Eight focus groups were conducted with 35 people with type 2 diabetes in one urban location between 2003 and 2004. Five focus groups were conducted with people who had recently experienced the restructured service and three groups with people who had up to 2 years' experience of the new service. Concurrent data collection and thematic analysis were conducted by three researchers and credibility and verification sought by feedback to participants.
Findings.  Five main themes were identified: impact of living with diabetes; understanding diabetes; drivers for organizational change; care in context and individual concerns. Participants identified issues for ongoing development of the service.
Conclusion.  People with type 2 diabetes appreciate their care management within the primary care setting where there has been investment in staff to deliver this care. Healthcare resources are required to support the development of staff and the necessary infrastructure to undertake management in primary care. Policy makers need to address the balance of resources between primary and secondary care.     

Peyssonenynes a and B, novel enediyne oxylipins with DNA methyl transferase inhibitory activity from the red marine alga peyssonneliacaulifera

Two novel omega3 fatty acids, obtained as monoacyl glycerol derivatives, were isolated as DNA methyl transferase inhibitors following bioassay-guided fractionation of the Fijian red marine alga Peyssonnelia caulifera. Both active metabolites, peyssonenynes A (1) and B (2), possess an unusual enediyne motif, whereas an inactive co-metabolite, peyssopyrone (3), contains an unusual gamma-pyrone functionality. The molecular structures of all three compounds were determined by NMR spectroscopy in combination with UV, IR, and MS data analysis. The instability of the enediyne monoacyl glycerol derivatives prevented their complete stereochemical assignments.     

Galectin-1 in regenerating motoneurons

The exogenous application of recombinant galectin-1 has recently been shown to promote the rate of peripheral nerve regeneration. Endogenous neuronal galectin-1 expression has recently been demonstrated to increase after axotomy. Here we demonstrate a significant increase in the endogenous neuronal expression of galectin-1 mRNA in facial motoneurons after either a nerve resection or crush injury in mice. This increase in galectin-1 expression was due in part to the loss of target-derived factor(s) as indicated by both the return of galectin-1 expression to control levels following target re-innervation and the increase in galectin-1 expression after blockade of axonal transport by an interneuronal colchicine injection. Furthermore, interneuronal injections of glial-derived neurotrophic factor into the uninjured nerve also increased galectin-1 mRNA expression within facial motoneurons suggesting that positive signals may also be involved in the regulation of galectin-1 expression. Galectin-1 null mutant mice showed an attenuated rate of functional recovery of whisking movement after a facial nerve crush.     

Caspase inhibition attenuates transection-induced oligodendrocyte apoptosis in the developing chick spinal cord

A developmental model of spinal cord injury in the embryonic chick was specifically developed to characterize the involvement of caspases in injury-induced oligodendrocyte apoptosis remote from the lesion and the ability of caspase inhibitors to attenuate this process. Developmental apoptosis in the cervical spinal cord increased within the white matter between embryonic days 13 and 18, the period of myelination of this region. Spinal cord transection during this period induced a rapid increase in apoptotic cells in the ventral and lateral white matter over several millimeters caudal to the injury. Immunostaining identified large numbers of these cells as oligodendrocytes. Catalytic activity assays and immunostaining demonstrated caspase-3-like but not caspase-1-like activity to be involved in this apoptotic response. In vivo application of specific caspase inhibitors significantly attenuated transection-induced apoptosis. Thus, we describe a developmental period during which spinal oligodendrocytes exhibited a heightened, caspase-dependent sensitivity to transection-induced apoptosis that is attenuated by caspase inhibition.     

Conformationally constrained anesthetic steroids that modulate GABA(A) receptors

Various cyclic ether and other 3 alpha-hydroxyandrostane derivatives bearing a conformationally constrained hydrogen-bonding moiety were prepared. Their anesthetic potency and their binding affinity for GABA(A) receptors, measured by intravenous administration to mice and inhibition of [(35)S]TBPS binding to rat whole brain membranes, were compared with that of known anesthetic 3 alpha-hydroxypregnan-20-ones. Synthetic steroids with similar in vitro and in vivo activities to the endogenous 3 alpha-hydroxypregnan-20-ones all had an ether oxygen on the beta-face of the steroid D-ring. These results suggest that for optimal GABA(A) receptor modulation, the hydrogen bond-accepting substituent should be near perpendicular to the plane of the D-ring on the beta-face of the steroid.