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71.
Isometric muscle strength is an indicator of self-reported physical functional disability in patients with rheumatoid arthritis 总被引:4,自引:1,他引:3
The objective of our study was to examine (1) whether isometric muscle
strength contributes to the explanation of the physical functional
disability of a rheumatoid arthritis (RA) patient population after
accounting for other disease parameters and demographic variables and (2)
whether change in isometric muscle strength is an indicator of change in
physical functional disability. Sixty-five consecutive patients fulfilling
the American Rheumatism Association 1987 revised criteria for RA were
included in the study. Isometric muscle strength was measured with a
validated Muscle Strength Index (MSI) calculated as the mean score of
standardized isometric extension and flexion strength of the knee and elbow
joints. Physical functional disability was measured with the physical
dimension of the Health Assessment Questionnaire (HAQ). For 56 patients, we
could obtain 1 yr follow-up data. Cross-sectionally, there was a
significant correlation (r = - 0.51, P < 0.01) between the MSI and the
HAQ. Muscle strength remained a significant determinant of the HAQ in
multivariate analysis accounting for disease and demographic variables.
Longitudinally, change in MSI explained additional variance of change in
HAQ after accounting for change in pain, the most important correlate of
change in HAQ.
相似文献
72.
Postoperative radiotherapy for locally advanced colon cancer 总被引:1,自引:0,他引:1
Dr. E. Henry Amos MD William M. Mendenhall MD Patricia J. McCarty BA John O. Gage MD J. Logan Emlet MD Gerald C. Lowrey MD Craig A. Peterson MD Warren R. Amos MD 《Annals of surgical oncology》1996,3(5):431-436
Background: The role of adjuvant postoperative radiotherapy for locally advanced colon cancer is not well documented.
Methods: Seventy-eight patients who underwent a complete resection of B2-C colon cancer received postoperative radiotherapy. Twenty-eight
patients received ⩽45 Gy; 50 patients received 50–55 Gy. Twenty-seven patients received adjuvant fluorouracil-based chemotherapy.
All patients were followed for a minimum of 3 years; no patients were lost to follow-up.
Results: The overall local control rate was 88%. The 5-year actuarial rate of local control was 96% after 50–55 Gy postoperative radiotherapy
compared with 76% after <50 Gy (p=0.0095). Multivariate analysis of local control showed that only radiotherapy dose significantly
influenced this end point. Cause-specific survival rates at 5 years were B2, 67%; B3, 90%; C1, 100%; C2, 61%; C3, 36%; and
overall, 63%. Multivariate analysis of cause-specific survival showed that only stage significantly influenced this end point.
Bowel obstruction caused by adhesions developed in three patients and required a laparotomy; radiation-induced sarcoma developed
in one additional patient.
Conclusions: Postoperative radiotherapy appears to reduce the risk of local recurrence in patients with locally advanced colon cancer.
The optimal dose is probably 50–55 Gy at 1.8 Gy per fraction. Postoperative radiotherapy may improve cause-specific survival
for patients with stages B3 and C2 cancers. 相似文献
73.
G Hussein Rassool MSc BA RMN RCNT RNT FETC CertEd CertCouns CertSupervision & Consultation 《Journal of advanced nursing》1993,18(9):1401-1407
The widespread use and misuse of alcohol, drug and other psychoactive substances are major health and social concerns that affect the lives of many The social and health sequelae of psychoactive drugs and alcohol are preventable and manageable with minimal interventions Nurses and other health workers can effectively respond to substance misuse problems and their existing generic skills can be easily adapted in working with substance misusers This paper considers some of the issues such as the extent of the problem, attitudinal considerations, response to substance misusers and a brief outline of the role of the nurse The urgent need for education and training in substance misuse and addictive behaviour for nurse practitioners is also addressed 相似文献
74.
Tai-Chan Peng MD Robert P. Kusy PhD Philip F. Hirsch PhD John R. Hagaman BA 《Alcoholism, clinical and experimental research》1988,12(5):655-659
Chronic ingestion of ethanol resulted in ultrastructural and mechanical changes in rat femurs. Scanning electron microscopy of the distal end of the femur revealed that the trabeculae of bones from ethanol-fed rats were thinner, more columnar, and more extensive than those from control rats. Three-point bending tests of the rat femurs showed that the maximum force or so-called "strength" required to break the bone was less in ethanol- than in control-fed animals. A significant inverse correlation was observed between the strength required to break the femur and the dose of ethanol calculated on a body weight basis. For the first time our study presents quantitative proof that a relationship exists between bone strength and the consumption of ethanol in rats. The study revealed that ethanol consumption resulted in a weaker femur compared to controls. We suggest that a common mechanism may be responsible for the decreased bone strength of ethanol-fed rats and the increased incidence of fractures in human alcoholics. 相似文献
75.
Summary The effects of personality characteristics on social support and hence risk of depression are explored in a group of 150 largely working-class mothers, a subsample of 400 women who took part in a prospective study. This established that once those with depression at first interview were excluded, practically all of the onsets of depression in the follow-up year occurred among 150 women with a severe event or major difficulty — that is a provoking agent. It was also found that low self-esteem and lack of support from a core tie at the time of the crisis was associated with a considerably increased risk. In the subsample as a whole, measures of dependency and attitudinal constraints to support taken at first interview were not associated with risk of depression. But, it is argued, any enduring personality traits that play a role in the link between lack of support and depression would most likely be seen in a smaller group, namely those who had had early inadequate parenting. And the most promising lead concerning the role of personality characteristics did in fact emerge in relation to a small high risk group with such parenting. Most of them had low self-esteem, and they appeared to confide in inappropriate and unreliable sources of support at time of crisis. 相似文献
76.
77.
78.
James B. Harris MD Richard C. Ahrens MD Gary Milavetz PharmD Linda Annis Rebecca Ries BA Connie Hendricker RRT 《The Journal of allergy and clinical immunology》1990,85(6):1043-1049
Inhaled beta-agonists can produce bronchodilatation and reduce airway hyperreactivity in patients with asthma. Using these two measures, we compared inhaled bitolterol (three puffs, 1110 micrograms), albuterol (two puffs, 180 micrograms), and placebo administered by metered-dose inhaler in a blinded, crossover study of 40 subjects with chronic asthma. On each study day, subjects underwent histamine challenges at 1 1/2 hours before, and 1/2, 2, 4, 6, and 8 hours after inhaling one of the three test-drug treatments. Both drugs produced significant bronchodilatation at 30 minutes through 4 hours and significant effects on airway reactivity at 30 minutes through 2 hours (p less than 0.05). Bitolterol also produced small but significant bronchodilator effects at 6 hours and effects on airway reactivity at 4 hours (p less than 0.05). Effects of bitolterol on airway reactivity diminished significantly more slowly than effects of albuterol in subjects with baseline provocative concentration causing a 20% fall in FEV1 greater than or equal to 1.0 mg/ml of histamine (half-life of biologic effect 1.37 versus 0.92 hours; p less than 0.05) but not in subjects with baseline provocative concentration causing a 20% fall in FEV1 less than or equal to 1.0 mg/ml (half-life of biologic effect of 1.01 versus 1.00 hours; p greater than 0.05). 相似文献
79.