Evaluation of admittance control as an alternative to passive arm supports to increase upper extremity function for individuals with Duchenne muscular dystrophy

The degree of upper extremity active range of motion provided by an admittance control robot compared with a commercially available passive arm support for individuals with DMD who have limited arm function was investigated in this study. The reachable workspace evaluation was used to assess active range of motion provided by both devices. A visual analog scale was also used to secure participant-reported outcome measures. The admittance control robot significantly increased reachable surface area scores compared with the passive arm support for the dominant arm (Wilcoxon T = 5, P = .022, r² = 0.263) and for the nondominant arm (paired-samples t test, t(9) = 4.66, P = .001, r² = 0.71). The admittance control robot also significantly decreased participant-reported exertion compared with the passive arm support. Results of this study substantiated the benefits of admittance control for individuals with DMD compared with a commercially available passive arm support.     

耐一线药物及注射药物对耐多药结核病治疗效果的影响

背景和目的:最近的研究结果表明,对其他一线药物和注射类药物(如卡那霉素、卷曲霉素)等耐药是影响耐多药结核病(MDR-TB)患者治疗效果的独立危险因素.本研究旨在明确耐其他一线药物和注射类药物对韩国不合并人免疫缺陷病毒(HIV)感染的MDR-TB患者临床疗效的影响.方法:采用回顾性队列研究分析1996年1月至2005年12月首尔国家大学附属医院治疗的211例MDR-TB患者治疗效果,排除7例丢失和7例迁出,对197例患者进行了最终分析.     

Aven‐mediated checkpoint kinase control regulates proliferation and resistance to chemotherapy in conventional osteosarcoma

Conventional high‐grade osteosarcoma is the most common primary bone sarcoma, with relatively high incidence in young people. In this study we found that expression of Aven correlates inversely with metastasis‐free survival in osteosarcoma patients and is increased in metastases compared to primary tumours. Aven is an adaptor protein that has been implicated in anti‐apoptotic signalling and serves as an oncoprotein in acute lymphoblastic leukaemia. In osteosarcoma cells, silencing Aven triggered G₂ cell‐cycle arrest; Chk1 protein levels were attenuated and ATR–Chk1 DNA damage response signalling in response to chemotherapy was abolished in Aven‐depleted osteosarcoma cells, while ATM, Chk2 and p53 activation remained intact. Osteosarcoma is notoriously difficult to treat with standard chemotherapy, and we examined whether pharmacological inhibition of the Aven‐controlled ATR–Chk1 response could sensitize osteosarcoma cells to genotoxic compounds. Indeed, pharmacological inhibitors targeting Chk1/Chk2 or those selective for Chk1 synergized with standard chemotherapy in 2D cultures. Likewise, in 3D extracellular matrix‐embedded cultures, Chk1 inhibition led to effective sensitization to chemotherapy. Together, these findings implicate Aven in ATR–Chk1 signalling and point towards Chk1 inhibition as a strategy to sensitize human osteosarcomas to chemotherapy. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

败血症病人死亡危险性预评估方法的探讨

目的:探索可早期预测严重败血症病人死亡的临床和实验室指标或系统模型。方法:对ICU连续收治的26例严重败血症病人行前瞻性观察28天,分析其死亡的相关临床和实验室指标。结果:共有14人(54％)死亡,多死于第1周内(74％)。根据循环中的细胞间粘附分子-1水平能早期预测其脏器衰竭和死亡。一些临床指标水平在死亡病人与生存病人之间差别较大,其中包括血总胆红素、pH值、红细胞压积、氧合指数、动静脉血氧差、四项SIRS指标和一些血流动力学指标等。结论:综合上述指标可以尝试建立起了一个能够早期评估病人死亡可能性的积分系统。     

Analysis of the relationship between age and treatment response in migraine

In migraine, headache severity varies with age. As a consequence, the effectiveness of medication may also depend on a patient's age. The purpose of this study was to assess the combined effect of age and drug treatment on headache characteristics. Using data from clinical trials of sumatriptan in adolescents and adults, we show how the interaction between age and drug exposure can be parameterised as a covariate on a Markov model that describes the decline of headache severity over three clinically defined stages (no relief, relief and pain-free status). The model explains important clinical observations: (i) the rates at which the pain relief and pain-free status were attained were found to be inversely related to age; (ii) in placebo-treated patients, the mean transit time from 'no relief' to 'relief' is 3 h for young adolescents and increases to 6 h for patients aged ≥ 30 years; and (iii) sumatriptan reduces the transit time to 2 h, irrespective of age. These findings indicate that the therapeutic gain over placebo increases with age. Prospective studies of antimigraine drugs should take this relationship into account when extrapolating efficacy data from adults to adolescents.     

Symptoms of ＂Heat＂ as a Pattern of Physiopathology

Objective： The guiding criteria are considered the backbone of Chinese medicine. They have previously been described as functional features （symptoms） leading to the overall assessment of human functions on the basis of a regulatory （cybernetic） model referring to the I Ging. Methods： The Heidelberg model can explain symptoms such as created by ＂heat＂ on a rational physiological level. Results ＆ Conclusion： The overall of physiological symptoms are shown as a schematic draft. The basis of ＂heat＂ is considered to be a general increase of microcirculation in the periphery. This leads to a couple of local pathophysiological consequences and sensations like 1） red tongue （the tongue is considered an embryological somatotopic system）. 2） Sensation of warmth （by increase of capillary flow）. 3） pre-inflammatory state, leading to pain modalities like ＂worse if pressed＂, as inflammations tend to be increasingly painful under pressure; 4） reddish skin, the mechanisms by which this is induced may include the release of substance P, therefore accompanied by burning sensation. Systemic pathophysiological consequences may include. Relative lack of fluid in the larger vessels, as fluid supplies peripheral capillary flow. This may lead to water saving mechanisms like thirst, dry mucosa with do, mouth, dry nose, dry lips, dry skin, and also dry stool, yellow and sparse urine.     

Effect of a program to facilitate parent-child communication about sex

U.S. teens have high rates of premarital sexual activity resulting in alarming rates of teenage pregnancy and sexually transmitted disease. One possible way to combat the problem of teenage sexual activity is to promote sexuality education within the family. The purpose of this study was to increase parent-child communication about sex through an educational program for parents. The effect of the educational program was evaluated by a nonrandomized, controlled trial. Volunteer parents were recruited from three middle schools (grade six through eight) located in middle to upper-middle socioeconomic class neighborhoods. The parents participated in four 2-hour sessions which included factual information about sexuality and exercises to improve communication skills. The experimental group (N = 47) were requested to fill out questionnaires immediately before and one month after the program. The control group (N = 17) were requested to fill out questionnaires one month before and again immediately before the program. Parents were asked to report the number of times they talked with their adolescents about 11 sex-related topics. The difference in reported frequency of communication before and after the program was compared using a two-tailed, matched pairs t-test. Twenty-four (51%) experimental group parents and eight (47%) control group parents completed both questionnaires. There was a significant increase in communication reported by the experimental group. The mean difference of the number of topics discussed was 10.9 (SD 7.3) for participants versus -2.5 (SD 5.9) for controls (p = .00053). This study shows that parent-child communication about sex can be facilitated by an educational program for parents.     

One-year audit of admissions to the Intensive Care Unit of the Queen Elizabeth Central Hospital,Blantyre

The intensive care unit at Queen Elizabeth Central Hospital (QECH) has 4 beds and offers level 2 care. A retrospective audit of all admissions to the unit during 2002 was carried out. There were a total of 339 admissions giving a bed occupancy rate of 82 %. Surgical patients made up 81 % of admissions. 45% of all admissions were ventilated. Overall mortality was 38%. Ventilated patients had a mortality of 71% compared with 10% for non-ventilated. Data are also presented for mortality within the surgical and paediatric surgical admissions.