A 12-month randomized controlled trial of balance training in elderly women with osteoporosis: Improvement of quality of life

Objective

Physical and psychological incapacity, including fear of falling is related to decreased satisfaction with life in osteoporosis (OP). The impact of a balance exercise program on improving the quality of life is not well established. We have, therefore, investigated the effect of 12-month Balance Training Program in quality of life, functional balance and falls in elderly OP women.

Methods

Sixty consecutive women with senile OP were randomized into a Balance Training Group (BT) of 30 patients and no intervention control group (CG) of 30 patients. The BT program included techniques to improve balance over a period of 12 months (1 h exercise session/week and home-based exercises). The quality of life was evaluated before and at the end of the trial using the Osteoporosis Assessment Questionnaire (OPAQ), functional balance was evaluated by Berg Balance Scale (BBS). Falls in the preceding year were noted and compared to the period of study.

Results

The comparison of OPAQ variations (INITIAL–FINAL) revealed a significant improvement in quality of life in all parameters for BT compared to CG: well-being (1.61 ± 1.44 vs. −1.46 ± 1.32, p < 0001), physical function (1.30 ± 1.33 vs. −0.36 ± 0.82, p < 0.001), psychological status (1.58 ± 1.36 vs. −1.02 ± 0.83, p < 0.001), symptoms (2.76 ± 1.96 vs. −0.63 ± 0.87, p < 0.001), social interaction (1.01 ± 1.51 vs. 0.35 ± 1.08, p < 0.001). Of note, this overall benefit was paralleled by an improvement of BBS (−5.5 ± 5.67 vs. +0.5 ± 4.88 p < 0.001) and a reduction of falls in 50% in BT group vs. 26.6% for the CG (RR: 1.88, p < 0.025).

Conclusion

The long-term Balance Training Program of OP women provides a striking overall health quality of life improvement in parallel with improving functional balance and reduced falls.     

Longitudinal changes in family outcomes of very low birth weight

OBJECTIVES: Although children with very low birth weight (VLBW, <1500 g) are at high risk for developmental impairments, we know little about the long-term effects of VLBW on families. This study examined long-term family outcomes and their stability over time. METHODS: Participants were the families of 64 children with <750 g birth weight, 54 with 750-1499 g birth weight, and 66 term-born controls. Family burden and parental distress were assessed annually as part of longitudinal follow-up of the children from mean ages 11-14 years. RESULTS: Family burden and parental distress were higher in the <750 g group than in the term-born group, but differences varied with the child's age and family environment. CONCLUSIONS: The findings document long-term effects of VLBW on families that are moderated by the degree of low birth weight, child's age, and family environment.     

Pathogenesis of hemorrhage induced by bilitoxin, a hemorrhagic toxin isolated from the venom of the common cantil (Agkistrodon bilineatus bilineatus)

The pathogenesis of hemorrhage induced by the i.m. injection of the hemorrhagic toxin, bilitoxin, was studied using light and electron microscopy. White mice were injected with sublethal doses of the toxin, and tissue samples were obtained at 5 and 30 min, and 1, 3 and 24 hr after the injection. There was a good correlation between amount of toxin injected and amount of hemorrhage observed. Microscopically, hemorrhage was visible in all parts of the connective tissue surrounding muscle cells just 5 min after injection and fibrin was present both intravascularly and extravascularly. At later time periods the hemorrhage was more extensive and there was more fibrin. Many vessels were plugged with platelets. At 30 min after the injection, muscle cells appeared to be damaged having either delta lesions or disrupted myofibrils. Electron microscopy revealed damaged capillaries with ruptured endothelial cells, disrupted basal lamina and intact intercellular junctions. Thus, this hemorrhagic toxin acts rapidly to disrupt the capillary endothelium without damaging the intercellular junctions, and it also appears to damage skeletal muscle cells.     

Therapie mit dem LHRH-Agonisten Leuprorelinacetat bei Paraphilien und sexuell aggressiven Impulshandlungen

Up to now there are no published results of therapy of paraphilia (Pedophilia, Sadism) and sexual aggressive impulsiveness with LHRH-(luteinizing hormone-releasing hormone) Agonists in the Germanspeaking countries. In this report we describe 11 patients which were treated with the LHRH-Agonist Leuprolide Acetate in a period of 12 months. The patients showed no tendency of sexual aggressive behaviour and reported an evident reduction of penile erection, ejaculation, masturbation, sexual deviant impulsiveness and fantasies. One patient died from suicide. In combination with other treatments LHRH-Agonists seem to be a very promising alternative to cyproterone acetate and its possible carcinogene effects.     

Relationship of neonatal endotracheal tube size and airway resistance

BACKGROUND: Infants receiving mechanical ventilation require narrow-lumen, small-diameter endotracheal tubes. OBJECTIVE: Compare the resistances of endotracheal tubes used in the neonatal intensive care unit. METHODS: Endotracheal tubes of internal diameter 2.5, 3.0, 3.5, and 4.0 mm were tested with a standard neonatal ventilator and a test lung. An endotracheal tube of each diameter was cut to 12 cm and connected to a flow transducer at one end and the test lung at the other. Serial measurements of resistance were made at various flows (6, 8, 10, and 12 L/min) and ventilator rates (30-90 breaths/min) encompassing the ranges of clinical practice. Analysis of variance was performed for each tube size, comparing resistance to flows and ventilator rates. RESULTS: Resistance was significantly higher with the 2.5 mm tube than with the others. There was also a consistent trend, in all the tube sizes, towards higher resistance as flow was increased. CONCLUSIONS: The higher resistance of the 2.5 mm tube may be detrimental to extremely low birthweight infants kept on mechanical support merely "to grow." The higher resistance may increase the work of breathing and thus increase caloric expenditure and impede growth.     

Immunohistochemical analysis of a primary ovarian leiomyosarcoma. Case report

BACKGROUND: Primary ovarian leiomyosarcoma is an extremely rare malignant smooth muscle neoplasm. We report a case of a primary leiomyosarcoma of the ovary managed at our institution. CASE REPORT: Surgical exploration in a 71-year-old woman revealed a large left adnexal tumor and one separate metastatic implant in one part of the omentum, being classified as a primary ovarian leiomyosarcoma stage III C. The patient was treated with an adjuvant chemotherapy regimen consisting of cisplatin and ifosfamide. The patient remained without any evidence of disease until she died due to apoplexy 14 months after initial surgery. High cellularity, nuclear polymorphism as well as patchy necrosis and large areas of hemorrhage, characterized the tumor. Mitotic activity exceeded 5 mitoses per 10 high-power fields with lots of atypical mitoses. Immunohistochemically, the tumor showed a strong positive staining reaction for muscle actin, alpha-smooth muscle actin and neuron-specific enolase as well as a weak positive reaction for vimentin. Furthermore, immunohistochemistry revealed a positive staining for Ki-67, MMP-1 and MMP-2, and VEGF. CONCLUSION: Until recently, prognostic parameters in ovarian leiomyosarcoma have still not been identified. Thus, the prognostic value of different clinicopathological and immunohistochemical parameters, especially Ki-67, MMPs and VEGF, should be proven in additional cases with long-term follow-up.     

Protein tyrosine phosphatases in T cell physiology

The molecular mechanisms of signal transduction have been the focus of intense research during the last decade. In T cells, much of the work has centered on protein tyrosine kinase-mediated signaling from the TCR and cytokine receptors, while the study of protein tyrosine phosphatases has lagged behind. Nevertheless, it has now become clear that many protein tyrosine phosphatases play equally important roles in T cell physiology and that no kinase-regulated system would work without the counterbalancing participation of phosphatases. In fact, we have learned that many processes are regulated primarily on the phosphatase side. This minireview summarizes the current state-of-the art in our understanding of the regulation and biology of protein tyrosine phosphatases in T lymphocyte physiology.