To assess the feasibility of measuring ventilatory threshold (VT) in higher-level motor-complete spinal cord injury (SCI) using 4 different analysis methods based on noninvasive gas exchange.
Design
Observational.
Setting
Laboratory testing.
Participants
Individuals with C4-T6 motor-complete SCI (16 paraplegia, 22 tetraplegia; American Spinal Injury Association Impairment Scale A/B; 42±10 years old).
Interventions
Not applicable.
Main Outcome
VT from a graded arm cycling test to volitional exhaustion using 4 methods: ventilatory equivalents, excess CO2, V-slope, and combined method.
Results
VT could be identified in all individuals with paraplegia, but in only 68% of individuals with tetraplegia. Individuals without observable VT completed the graded exercise test with lower ventilatory rate, peak power output, and peak oxygen consumption (Vo2peak) (all P<.05), compared to those with a detectable VT. Bland-Altman plots indicate minimal bias between methods (range: 0.01-0.03 L/min), with 95% limits of agreement of the difference within 0.25 L/min. Absolute o2 at VT with individual methods were all correlated to peak power output (r>0.74; P<.01) and Vo2peak (r>0.91; P<.01), with negligible differences between methods.
Conclusions
The assessment of VT is a feasible alternative to peak exercise testing for aerobic fitness in individuals with higher-level, motor-complete SCI, although care should be taken when interpreting VT in individuals with tetraplegia who have lower cardiorespiratory fitness and lower peak power outputs. 相似文献
Journal of Thrombosis and Thrombolysis - To study whether a diagnosis of cancer affects the clinical presentation and outcomes of patients with pulmonary embolism (PE). A retrospective analysis was... 相似文献
OBJECTIVE: To examine whether promoter polymorphisms associated with
variation in interleukin-10 (IL-10) production are relevant to the
development of rheumatoid arthritis (RA) or Felty's syndrome (FS). METHODS:
DNA was obtained from 44 FS patients, 117 RA patients and 295 controls. The
promoter region between -533 and - 1120 was amplified by polymerase chain
reaction, and polymorphisms detected by restriction enzyme digest or
sequence-specific oligonucleotide probing. RESULTS: We found no significant
difference in allele or haplotype frequencies between the groups.
CONCLUSION: There is no association between FS or RA and these recently
identified IL-10 promoter polymorphisms. Other genetic or environmental
factors could explain the alterations in IL-10 levels seen in these
conditions.
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Pulmonary infection by Nocardia is an uncommon opportunistic infection in humans. Thirty-five patients with pulmonary nocardiosis were identified in two tertiary referral hospitals. A retrospective review of the patient characteristics, clinical and laboratory features including antimicrobial susceptibility at diagnosis was carried out. Radiological features derived from chest radiographs and CT scans were also documented. In our population, the predominant risk factors were immuno-compromised state, corticosteroid therapy, and underlying pulmonary pathology. The presenting features were similar to those previously described but disseminated infection was not common. The radiological changes were diverse and non-specific. Nocardia asteroides was the commonest species. Most Nocardia isolates were susceptible to imipenem, ceftriaxone, amikacin, and cotrimoxazole. Co-existing microbial agents are common and reflect the underlying complex disorders. 相似文献
A Chinese family with concurrent hereditary spherocytosis (HS) and haemoglobin (Hb) Q-Thailand is described. The Hb Q-Thailand mutation was found on the remaining alpha1 globin gene on a chromosome 16 containing the (-alpha 4.2) deletion. Active haemolysis in members of this family is segregated with the HS phenotype, and the Hb Q-Thailand in the heterozygous state does not seem to show any modulating effect on HS. 相似文献
Brief heating (43 C for 15 min) of the scrota of adult rats was used to induce reversible spermatogenic damage to the testes. In these animals the changes in testicular inhibin content and an index of inhibin production rate, measured after efferent duct ligation, were examined and correlated with serum gonadotropin levels. The effect of heating was not evident until after 1 week when testis weight, inhibin content, and inhibin production rate were significantly reduced and both serum FSH and LH were elevated. By 2 weeks, the maximal effects were observed, and, thereafter, all parameters gradually returned to control values (FSH: by 6 weeks; testis and epididymal weight, inhibin content, inhibin production rate, and seminiferous tubule fluid production: by 17 weeks). Throughout the study, serum testosterone levels showed no significant changes. Significant inverse correlations were found between serum FSH levels and inhibin content (r = -0.502, P less than 0.001) or inhibin production rate (r = -0.533, P less than 0.001), and these were taken as supportive evidence for the hypothesis that inhibin is involved in the feedback control of pituitary FSH secretion. Although serum LH levels were also negatively correlated to the corresponding inhibin content (r = -0.669, P less than 0.001) or inhibin production rate (r = -0.420, P less than 0.001), recent findings of Leydig cell dysfunction in these animals led us to relate the transient rise in LH to the altered state of Leydig cell function. 相似文献
Although extracurricular music activities are common in Hong Kong, private music teachers’ perceptions of children with autism spectrum disorder (ASD) are underexplored in research in this context. This study examined private music teachers’ knowledge of ASD and their attitudes toward students with ASD in Hong Kong, and the relationship between these two factors. The study collected data from a questionnaire survey (n?=?200) and eleven individual interviews. Unexpectedly, the findings showed that the teachers had a good understanding and a marginally positive perception of ASD, despite some anxiety about teaching students with ASD. Furthermore, knowledge of and attitude toward ASD were positively correlated. Teachers with previous training in special education needs had a better understanding of ASD and a more positive attitude toward ASD than those without related training. These results imply that further formal and public education could promote acceptance of and equal learning opportunities for students with ASD.
ObjectiveSocial isolation and loneliness are associated with morbidity and mortality in older adults. Limited evidence exists regarding which interventions improve connectedness in this population.Design/Setting/ParticipantsIn this pre-post study we assessed community-based group health class participants’ (age ≥50) loneliness and social isolation. Participants (n = 382) were referred by a Cedars-Sinai Medical Network (Los Angeles, California) healthcare provider or self-referred from the community (July 2017–March 2020).InterventionParticipants met with a program coordinator and selected Arthritis Exercise, Tai Chi for Arthritis, EnhanceFitness, or the Healthier Living Workshop.MeasurementsWe measured social isolation using the Duke Social Support Index (DSSI) and loneliness using the UCLA 3-item Loneliness Scale at baseline, class completion, and 6 months.ResultsMean age was 76.8 years (standard deviation, SD = 9.1); 315 (83.1%) were female; 173 (45.9%) were Non-Hispanic white; 143 (37.9%) were Non-Hispanic Black; 173 (46.1%) lived alone; mean baseline DSSI score was 26.9 (SD = 4.0) and mean baseline UCLA score was 4.8 (SD = 1.8). On multivariable analysis adjusted for gender, race/ethnicity, income, self-rated health, and household size, DSSI improved by 2.4% at 6-week compared to baseline (estimated ratio, ER: 1.024; 95% confidence interval [CI]: 1.010–1.038; p-value = 0.001), and 3.3% at 6-month (ER: 1.033; 95% CI: 1.016–1.050; p-value <0.001). UCLA score after adjusting for age, gender, race/ethnicity, live alone, number of chronic conditions, income, and self-rated health, did not change at 6-week (ER: 0.994; 95% CI: 0.962–1.027; p-value = 0.713), but decreased by 6.9% at 6-months (ER: 0.931; 95% CI: 0.895–0.968; p-value <0.001).ConclusionCommunity-based group health class participants reported decreased loneliness and social isolation at 6-month follow-up. 相似文献