Effect of ACL graft material on joint forces during a simulated in vivo motion in the porcine knee: Examining force during the initial cycles

This study compared three‐dimensional forces in knees containing anterior cruciate ligament (ACL) graft materials versus the native porcine ACL. A six‐degree‐of‐freedom (DOF) robot simulated gait while recording the joint forces and moments. Knees were subjected to 10 cycles of simulated gait in intact, ACL‐deficient, and ACL‐reconstructed knee states to examine time zero biomechanical performance. Reconstruction was performed using bone‐patellar tendon‐bone allograft (BPTB), reconstructive porcine tissue matrix (RTM), and an RTM‐polymer hybrid (Hybrid). Forces and moments were examined about anatomic DOFs throughout the gait cycle and at three key points during gait: heel strike (HS), mid stance (MS), toe off (TO). Compared to native ACL, each graft restored antero‐posterior (A‐P) forces throughout gait. However, all failed to mimic normal joint forces in other DOFs. For example, each reconstructed knee showed greater compressive forces at HS and TO compared to the native ACL knee. Overall, the Hybrid graft restored more of the native ACL forces following reconstruction than did BPTB, while RTM grafts were the least successful. If early onset osteoarthritis is in part caused by altered knee kinematics, then understanding how reconstruction materials restore critical force generation during gait is an essential step in improving a patient's long‐term prognosis. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1458–1463, 2014.     

Aging and Diversity: An Active Learning Experience,by Chandra M. Mehorta and Lisa S. Wagner

This study evaluated a 10-week chair yoga intervention on cognition, balance, activities of daily living (ADLs), anxiety, and depression for persons with Alzheimer's disease (AD). Residents were assigned to three groups: (a) mild AD (n?=?6), (b) moderate AD (n?=?6), or (c) severe AD (n?=?7). There was no significant change in balance, anxiety, or cognition. ADLs showed a significant effect (p?=?.02), which suggests that yoga may have more benefit early in the progression of AD. Depression increased significantly (p < .01). Yoga over an extended period of time with a larger sample size may demonstrate benefits to persons with AD and serve as means to improve overall quality of life.     

Visual Concerns that Interfere with Daily Activities in Patients on Rehabilitation Units: A Descriptive Study

The purpose of this study was to estimate the prevalence of patients with visual concerns that interfere with their activities of daily living (ADL) performance in physical rehabilitation units through occupational therapy assessment. Over the two-month study period, 215 adult inpatients from a physical rehabilitation hospital were evaluated using the Brief Vision Screen (BVS) through ADL. The BVS assessed four areas of visual concerns, namely left visual field, focusing, and near- and low-contrast acuity, while patients engaged in ADL. The occupational therapists identified 33% of patients who had at least one area of visual concern, with the largest proportion diagnosed with stroke (55%), followed by pulmonary disease (40%) and joint replacement (35%). When comparing the four areas of visual concerns in the BVS between the two major diagnostic groups (acquired brain injury, ABI and non-acquired brain injury, non-ABI), a significantly higher proportion of patients with ABI were identified as having left hemianopsia concerns compared to patients with non-ABI. No significant difference was observed in other areas of visual concern between the two groups. Findings indicated that visual concerns that interfere with ADL performance among older patients in rehabilitation units are common. The high proportion of patients with pulmonary disease identified as having visual concerns warranted further confirmation and investigation. Preliminary evidence to support the psychometric properties of the BVS for identifying visual concerns in patients on rehabilitation units was established.     

Change in quality of life of medically hospitalized patients – A one-year follow-up study

Objectives: To examine changes in quality of life (QOL) among elderly medically hospitalized patients one year after hospitalization, and to explore factors associated with the changes.

Methods: A one-year follow-up study included 363 (175 men) medical inpatients with age range 65–98 (mean 80.2, SD 7.5) years. Information was collected at baseline and follow-up using the WHOQOL-BREF questionnaire assessing the physical, psychological, social and environment domain of QOL as the dependent variable, and the Mini-Mental State Examination, Lawton and Brody's scales for physical self-maintenance and instrumental activities of daily living, the Hospital Anxiety and Depression scale and assistance in living as the independent variables.

Results: The mean score of the physical domain of QOL had increased (mean change 0.6, SD 2.5; p?p? Conclusion: Good cognitive, physical and emotional health at baseline and follow-up were associated with improved QOL in previously hospitalized elderly patients independent of their need for assistance in living.     

Human urinary kallidinogenase in treating acute ischemic stroke patients: analyses of pooled data from a randomized double-blind placebo-controlled phase IIb and phase III clinical trial

ABSTRACT

Objectives: Intravenous thrombolysis and thrombectomy are recommended for patients whose stroke onsets are within first 6 h, and very few options are available for patients whose stroke onset is more than 6 h, which includes most ischemic stroke patients. Human urinary kallidinogenase (HUK) showed potential clinical benefits in acute ischemic stroke patients. This study aims to investigate the safety and clinical benefits of HUK in ischemic stroke patients.

Patients and methods: Patients were recruited for a multicenter double-blind, placebo-controlled phase II b and phase III trial. Neurophysiological outcomes were assessed by the European Stroke Scale (ESS) and the functional outcomes were assessed by the activity of daily living scale (ADL). Safety was monitored by recording adverse events.

Results: The improvements in ESS scores and ADL scores in the HUK group were significantly greater than that in patients receiving placebo. Furthermore, HUK treatment was also associated with a lower rate of disable, according to ADL. HUK-related adverse events occurred at a low rate, in 1.73% of HUK-treated patients.

Conclusion: HUK is safe and provides potential clinical benefits as a treatment for acute ischemic stroke. Further large post-marketing observational studies are needed.     

Subthalamic nucleus deep brain stimulation improves sleep in Parkinson's disease patients: a retrospective study and a meta-analysis

BackgroundMost Parkinson's patients suffered from sleep problems. There is increasing evidence that Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) has a positive effect on several sleep parameters, improving overall sleep quality in patients with PD. However, the results are controversial.MethodsWe performed a retrospective study and meta-analysis to assess the Parkinson's disease sleep scale (PDSS) in Parkinson's patients.ResultsWe reviewed our data of patients who underwent STN-DBS, and then extracted five other trials to perform a meta-analysis. The pooled results showed an advantage on post-operative PDSS in both our medical center and pooled results (MD = 20.41, 95% CI = [13.03, 27.79], I² = 61%, P < 0.001). There was a significant difference in Unified Parkinson's Disease Rating Scale (UPDRS)-Ⅲ score between pre and post-operation (MD = −12.59, 95% CI = [−14.70, −10.49], I² = 90%, P < 0.001). What's more, Parkinsonian medication was significantly lower in the post-operative groups after DBS (MD = −314.71, 95% CI = [−468.13, −161.28], I² = 53%, P < 0.001).ConclusionIn the retrospective study and meta-analysis of 6 trials, we found that DBS can significantly increase sleep quality. Furthermore, motor function improved and Parkinsonian medication was significantly decreased postoperatively. The sample size was enough and no further investigations would change the conclusion.     

急诊科联合病房早期肺康复程序在AECOPD患者中的应用

目的 促进慢性阻塞性肺疾病急性加重期（AECOPD）患者肺康复。 方法 按急诊就诊时间将82例AECOPD患者分为对照组40例、观察组42例，两组均予常规治疗及护理，在此基础上对照组行常规肺康复措施；观察组组建多学科肺康复团队、制订和实施为期4周的三阶段肺康复方案。 结果 干预后，观察组患者的肺功能指标、动脉血氧饱和度、上下肢运动耐力评分、日常生活活动能力评分显著高于对照组，焦虑抑郁评分显著低于对照组（均P＜0.05）。 结论 多学科协作下急诊科联合病房早期分阶段肺康复方案可有效改善AECOPD患者肺功能及运动耐力，从而改善患者心身状态。     

“三期十步法”护理干预对脑梗死病人神经功能、日常生活能力的影响

[目的]探讨"三期十步法"护理干预对脑梗死病人神经功能及日常生活能力的影响。[方法]将2017年2月—2019年2月收治的88例脑梗死病人随机分为对照组和观察组各44例,对照组采用常规护理,观察组采用"三期十步法"护理干预。采用脑梗死病人神经功能评价量表、日常生活能力评价量表评价两组病人神经功能及日常生活能力。[结果]观察组病人神经功能评分优于对照组(P<0.05);观察组日常生活能力评分优于对照组(P<0.05)。[结论]在脑梗死病人中应用"三期十步法"护理干预,能改善病人的神经功能及日常生活能力。