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991.
Combined endurance and muscle strength training in female and male patients with chronic heart failure 总被引:1,自引:0,他引:1
Eckart Miche Elisabeth Roelleke Ulrike Wirtz Bettina Zoller Melanie Tietz Maria Huerst Andrea Radzewitz 《Clinical research in cardiology》2008,97(9):615-622
BACKGROUND: Exercise training has now become established practice in patients with chronic heart failure. Women are often under-represented in intervention studies compared to men. For this reason it was our aim to conduct a combined endurance and muscle strength training program to evaluate its effect on clinical performance data and health-related psychosocial factors in women and men. METHODS: One hundred and sixteen women, mean age 69 +/- 9 years, body mass index (BMI) 25.8 +/- 4.9, and 169 men, mean age 66 +/- 9 years, BMI 26.6 +/- 3.6 underwent combined endurance/resistance training. The training program lasted 29 +/- 7 days and comprised bicycle ergometer training, a 6-min walk test as a training unit and muscle strength training for the lower and upper extremities. RESULTS: Differences between women and men were found in clinical parameters. In particular, statistically significant differences were revealed between the women and men with regard to cardiopulmonary performance. Quality of life was significantly improved on discharge with regard to both physical and mental health, whereas anxiety and depression showed no significant alteration. CONCLUSION: A specialized in-hospital program for women and men combining endurance/resistance training and education is feasible. But our program revealed a very low level of cardiopulmonary performance in women. Women need to be encouraged and motivated to participate in such programs. 相似文献
992.
Edward?S.?FriedmanEmail author Michael?E.?Thase Sander?J.?Kornblith Stephen?R.?Wisniewski Melanie?M.?Briggs A.?John?Rush Cheryl?Carmin Steven?D.?Hollon Timothy?Petersen Glen?Veenstra 《Cognitive therapy and research》2004,28(6):819-833
The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project will provide symptomatic and functional outcome data to evaluate the theoretical principles and clinical beliefs that currently guide the treatment of nonpsychotic major depression. Cognitive Therapy (CT) for depression has been chosen as a switch or augmentation treatment for patients who have failed an adequate trial of the antidepressant citalopram. We describe the rationale, organization, and role of CT in STAR*D. We discuss the issues involved in developing and implementing CT in a large, multisite, effectiveness study: therapist selection, training, certification, quality assurance, and post-training supervision. We conclude with a discussion of the implications of our implementation procedures on interpreting the results of the STAR*D study. 相似文献
993.
Meridith L. Eastman Brad Verhulst Lance M. Rappaport Melanie Dirks Chelsea Sawyers Daniel S. Pine Ellen Leibenluft Melissa A. Brotman John M. Hettema Roxann Roberson-Nay 《Behavior genetics》2018,48(6):421-431
The goal of the present investigation was to clarify and compare the structure of genetic and environmental influences on different types (e.g., physical, verbal) of peer victimization experienced by youth in pre-/early adolescence and mid-/late adolescence. Physical, verbal, social, and property-related peer victimization experiences were assessed in two twin samples (306 pairs, ages 9–14 and 294 pairs, ages 15–20). Cholesky decompositions of individual differences in victimization were conducted, and independent pathway (IP) and common pathway (CP) twin models were tested in each sample. In the younger sample, a Cholesky decomposition best described the structure of genetic and environmental contributors to peer victimization, with no evidence that common additive genetic or environmental factors influence different types of peer victimization. In the older sample, common environmental factors influenced peer victimization types via a general latent liability for peer victimization (i.e., a CP model). Whereas the pre-/early adolescent sample demonstrated no evidence of a shared genetic and environmental structure for different types of peer victimization, the mid-/late adolescent sample demonstrates the emergence of an environmentally-driven latent liability for peer victimization across peer victimization types. 相似文献
994.
Melanie Knufinke Arne Nieuwenhuys Sabine A. E. Geurts Anton M. L. Coenen Michiel A. J. Kompier 《Journal of sleep research》2018,27(1):78-85
Sleep is essential for recovery and performance in elite athletes. While actigraphy‐based studies revealed suboptimal sleep in athletes, information on their subjective experience of sleep is scarce. Relatively unexplored is also the extent to which athletes’ sleep is adversely affected by environmental conditions and daytime behaviours, that is sleep hygiene. This study aimed to provide insight in sleep quantity, quality and its putative association with sleep hygiene. Participants were 98 elite (youth) athletes competing at the highest (inter‐)national level. Sleep quantity, quality and sleep hygiene were assessed once covering a 1‐month period by using established (sub)clinical questionnaires, and repeatedly during 7 consecutive days. Sleep quality was generally healthy, although 41% of all athletes could be classified as ‘poor sleeper’, and 12% were identified as having a sleep disorder. Daily self‐monitoring revealed sleep durations of 8:11 ± 0:45 h, but elevated wake after sleep onset of 13 ± 19 min. Sleep quality, feeling refreshed, and morning vigor were moderate at best. Regarding sleep hygiene, general measures revealed irregular sleep–wake patterns, psychological strain and activating pre‐sleep behaviours. At the daily level, blue‐light exposure and late‐evening consumption of heavy meals were frequently reported. General sleep hygiene revealed significant associations with sleep quality (0.45 < r > 0.50; P < 0.001). Results indicate that there is ample room for optimization, specifically in onset latency and in wake after sleep onset. Subtle improvements in sleep seem possible, and optimizing sleep hygiene, such as regular sleep–wake patterns and reducing psychological strain, may facilitate this sleep upgrading process. 相似文献
995.
John J. Elias Kerwyn C. Jones S. Cyrus Rezvanifar Joseph N. Gabra Melanie A. Morscher Andrew J. Cosgarea 《The Knee》2018,25(2):262-270
Background
Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction.Methods
Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability. Knee extension against gravity and dual limb squatting were simulated with and without simulated MPFL reconstruction. Graft resting lengths were set to allow 10 mm and five millimeters of patellar lateral translation at 30° of knee flexion. The bisect offset index, lateral tibial tuberosity to posterior cruciate ligament tibial attachment (TT–PCL) distance, lateral trochlear inclination, and Caton–Deschamps index were quantified at every five degrees of knee flexion to characterize lateral tracking, lateral position of the tibial tuberosity, trochlear dysplasia, and patella alta, respectively. For the pre-operative and post-operative conditions and each type of motion, bisect offset index was correlated with the anatomical parameters using stepwise multivariate linear regression.Results
For both motions, the pre-operative and post-operative bisect offset indices were significantly correlated with lateral trochlear inclination and lateral TT–PCL distance. For both motions, the adjusted r2 decreased with MPFL reconstruction, but was still approximately 0.5 for MPFL reconstruction allowing five millimeters of lateral translation.Conclusion
MPFL reconstruction decreases but does not eliminate lateral maltracking related to trochlear dysplasia and a lateralized tibial tuberosity. Patients with these pathologies are likely at the highest risk for instability related to maltracking following MPFL reconstruction. 相似文献996.
Karen Aniol Larry L. Mullins Melanie C. Page Misty L. Boyd John M. Chaney 《Journal of developmental and physical disabilities》2004,16(3):273-285
This study longitudinally examined the impact of respite care services on child abuse potential and family relations in a sample of parents (N = 14) whose children were admitted for respite care to a center for developmental disability. A sample of parents (N = 18) whose children were admitted for short-term hospitalization (STH) was used as a contrast group. In addition, we examined the interrelationships between child abuse potential, family relations, and parenting stress at 3 time points. Parents completed measures of child abuse potential, family relations, and parenting stress at time of admission, discharge, and at a 2-month follow-up. Results indicated that neither respite care nor STH resulted in significant effects on child abuse potential or family relations although trends were found in the expected direction. Strong interrelationships were found between child abuse potential, family relations, and parenting stress at each of the 3 time points. These preliminary results suggest that respite care may be insufficient to directly impact child abuse potential; however, interventions that target variables related to abuse (e.g., quality of family relations, parenting stress) might be beneficial. 相似文献
997.
Craig D. Newgard MD MPH Sai-Hung Joshua Hui BS rew Griffin BA Melanie Wuerstle BS Franklin Pratt MD Roger J. Lewis MD PhD 《Academic emergency medicine》2005,12(8):679-687
Objectives: To prospectively validate a previously published out‐of‐hospital clinical decision rule to identify seriously injured children involved in motor vehicle crashes (MVCs). Methods: The authors selected 20 Los Angeles County Fire Department fire stations, based on pediatric MVC call volume and geographic diversity, and 21 associated hospitals for participation in the study. Immediately following an MVC call involving a pediatric patient aged 0–14 years, each engine/paramedic squad completed a data form (15 variables, including vital signs, Glasgow Coma Scale score, and vehicular and crash characteristics). This study was conducted over a 24‐month period. Outcomes included: 1) “serious injury” as defined by an Injury Severity Score (ISS) ≥ 16 (primary outcome), and 2) need for specialized trauma care (emergent intubation, major nonorthopedic operative intervention or death in the first 24 hours, or pediatric intensive care unit stay longer than 48 hours), as assessed by retrospective chart review. Accuracy measures and binominal confidence intervals (CIs) were calculated for the decision rule validation. Results: One hundred seventy‐five children were prospectively enrolled in the study; 36 children were excluded due to lack of hospital participation or missing hospital charts. There were four children with ISS ≥ 16 (3%) and six children requiring specialized trauma care (4%). The sensitivities and specificities of the rule were: 100% (95% CI = 40% to 100%) and 73% (95% CI = 65% to 81%) for serious injury, and 83% (95% CI = 36% to 100%) and 74% (95% CI = 65% to 81%) for specialized trauma care, respectively. Conclusions: Although definitive conclusions are limited by the sample size, the decision rule identified all seriously injured children involved in MVCs and had moderate specificity. The decision rule was less sensitive for identifying children requiring specialized trauma care. Larger validation studies are needed to adequately assess the utility of this rule before implementation. 相似文献
998.
The prevalence of type 2 diabetes mellitus (T2DM) is growing at an alarming rate and reaching epidemic proportions, and cardiovascular disease continues to be one of the leading causes of death in the United States. The key relationship between these two diseases (knowing that T2DM is a strong risk factor for cardiovascular disease) is insulin resistance and the detrimental effect it has on macrovasculature. Thiazolidinediones (TZDs) are peroxisome proliferator-activated receptor gammaagonists that are beneficial in the treatment of T2DM and have the added benefit of modifying lipid profiles. This review discusses the basic science linking insulin resistance to atherosclerosis and describes the major TZD trials in the recent literature. It also addresses the clinical implications of these studies and media scrutiny surrounding the recent controversial report that TZDs may be linked to an increased risk of myocardial infarction. 相似文献
999.
1000.
Koch O Awomoyi A Usen S Jallow M Richardson A Hull J Pinder M Newport M Kwiatkowski D 《The Journal of infectious diseases》2002,185(11):1684-1687
Interferon (IFN)-gamma is a critical mediator of immunity to malaria. This study explored the relationship between polymorphisms in the promoter region of the gene encoding IFN-gamma receptor 1 (IFNGR1) and susceptibility to malaria in African children. Four polymorphisms were found in the region between -1400 and +100 nt of the translational start site by sequencing, and analysis of 562 nuclear families revealed 6 haplotypes. Case-control analysis of 562 Gambian children with severe malaria and 569 umbilical cord blood samples (controls) showed that in Mandinka, the major Gambian ethnic group, heterozygotes for the IFNGR1-56 polymorphism were protected against cerebral malaria (odds ratio, 0.54; P=.016) and against death resulting from cerebral malaria (odds ratio, 0.22; P=.006). Analysis of a family study by transmission disequilibrium testing revealed a similar result. Further data are needed to validate this finding, but these results are reminiscent of those for other well-established heterozygote advantages, such as that associated with hemoglobin S. 相似文献