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排序方式: 共有1211条查询结果,搜索用时 359 毫秒
1.
Gerard J Molloy Derek W Johnston Chuan Gao Miles D Witham Joan M Gray Ishbel S Argo Allan D Struthers Marion E T McMurdo 《European journal of cardiovascular prevention and rehabilitation》2006,13(3):381-387
BACKGROUND: The impact of exercise programmes for heart failure on those close to the patient is largely unknown. We examined the effect of a hospital and home-based exercise intervention on burden, anxiety and depression of informal caregivers. DESIGN: The study was a randomized, controlled trial. Heart failure patients were randomized to a seated 12-week hospital-based exercise programme. Caregiver measures were gathered at baseline, 3 months later and 6 months following baseline. METHODS: Sixty caregivers (mean age 63.4 years, 65% female) of heart failure patients (n = 82, mean age 80.5 years, 44% female) participating in a trial of an exercise intervention were recruited. Caregiver burden, anxiety and depression were assessed. RESULTS: There were no differences in caregiver burden, depression or anxiety between the two groups of caregivers at baseline (caregiver burden, patient control 33.1 versus patient exercise 34.1; anxiety 4.1 versus 5.5; depression 2.8 versus 3.8). At 3 months there were no differences between caregivers in the two groups on outcomes. At 6-month follow-up caregivers of heart failure patients in the exercise group had burden scores that were significantly worse than the control group. There were no differences between the carers of exercise and control groups in anxiety and depression. Levels of anxiety and depression in the entire carer sample were marginally higher than reference values in a healthy non-clinical sample. CONCLUSION: The present exercise interventions for frail older patients did not benefit caregivers and was associated with an increase in caregiver burden. We suggest that future exercise interventions for heart failure patients should actively incorporate informal caregivers into research designs. 相似文献
2.
Osteochondral Fracture of the Fourth Metatarsal Head Treated by Open Reduction and Internal Fixation
Praveen K.R. Mereddy MBBS MSOrth DNB Orth MRCSEd Andrew Molloy MBchB MRCS FRCS Michael S. Hennessy BSc MBchB FRCSEd 《The Journal of foot and ankle surgery》2007,46(4):320-322
Fracture of the metatarsal head is uncommon, and reports of isolated osteochondral fracture of the metatarsal head are rare. Because of the distal location of the fracture, it is difficult to achieve and maintain reduction, and potential complications include avascular necrosis and subchondral fatigue fracture. The authors present a case of an osteochondral fracture in a 40-year-old man, which was treated by open reduction and internal fixation with a single twist-off screw, with good results 12 months postoperatively. 相似文献
3.
D. Ramsbottom J.M. Scott A. Molloy D. G. Weir P. N. Kirke J. L. Mills P. M. Gallagher A. S. Whitehead 《Clinical genetics》1997,51(1):39-42
Mildly elevated maternal plasma homocysteine (Hcy) levels (hyperhomocysteinemia) have recently been observed in some neural tube defect (NTD) pregnancies. Plasma levels of Hcy are governed by both genetic and nutritional factors and the aetiology of NTDs is also known to have both genetic and nutritional components. We therefore examined the frequency of relatively common mutations in the enzyme cystathionine β-synthase (CBS), which is one of the main enzymes that controls Hcy levels, in the NTD population. Neither the severely dysfunctional G307S CBS allele nor the recently reported 68 bp insertion/I278T CBS allele was observed at increased frequency in the cases relative to controls. We therefore conclude that loss of function CBS alleles do not account for a significant proportion of NTDs in Ireland. 相似文献
4.
T J Molloy Y Wang A Horner T M Skerry G A C Murrell 《Journal of orthopaedic research》2006,24(4):842-855
Tendon healing is a complex process consisting of a large number of intricate pathways roughly divided into the phases of inflammation, proliferation, and remodeling. Although these processes have been extensively studied at a variety of levels in recent years, there is still much that remains unknown. This study used microarray analyses to investigate the process at a genetic level in healing rat Achilles tendon at 1, 7, and 21 days postinjury, roughly representing the inflammation, proliferation, and remodeling phases. An interesting temporal expression profile was demonstrated, identifying both known and novel genes and pathways involved in the progression of tendon healing. Both inflammatory response and pro-proliferative genes were shown to be significantly upregulated from 24 h postinjury through to 21 days. Day 7 showed the largest increase in genetic activity, particularly with the expression of collagens and other extracellular matrix genes. Interestingly, there was also evidence of central nervous system-like glutamate-based signaling machinery present in tendon cells, as has recently been shown in bone. This type of signaling mechanism has not previously been shown to exist in tendon. Another novel finding from these analyses is that there appears to be several genes upregulated during healing which have exclusively or primarily been characterized as key modulators of proliferation and patterning during embryonic development. This may suggest that similar pathways are employed in wound healing as in the tightly regulated progression of growth and development in the embryo. These results could be of use in designing novel gene-based therapies to increase the efficacy and efficiency of tendon healing. 相似文献
5.
D P Molloy 《Journal of the American Mosquito Control Association》1992,8(1):24-31
Except for moderate mortality among filter-feeding chironomids, Rheotanytarsus spp., the results of 10 field trials with Bacillus thuringiensis var. israelensis (B.t.i.) indicated a wide margin of safety to the chironomid community and other stream nontarget insects. Mayflies, caddisflies and 2 other types of chironomids, i.e., tube-dwelling (Chironominae) and surface-dwelling, caseless larvae (mix of Chironominae, Diamesinae, Orthocladiinae, Tanypodinae), did not appear to be affected. The susceptibility of filter-feeding chironomids was considerably less than black flies; for example, 4 months of data collected during an operational black fly control program indicated a mean (+/- 95% CI) mortality among Rheotanytarsus larvae of 23 (15-32)% vs. 98 (97-99)% among black flies. Although clearly demonstrating the potential of adverse impact on filter-feeding chironomids in operational black fly programs, these trials also confirmed the narrow impact of B.t.i. on the overall stream insect community. 相似文献
6.
C. Veigel R. D. von Maydell K.R. Kress J. E. Molloy R. H. A. Fink 《Pflügers Archiv : European journal of physiology》1998,435(6):753-761
Recent atomic 3-D reconstructions of the acto-myosin interface suggest that electrostatic interactions are important in the
initial phase of cross-bridge formation. Earlier biochemical studies had also given strong evidence for the ionic strength
dependence of this step in the cross-bridge cycle. We have probed these interactions by altering the ionic strength (Γ/2)
of the medium mainly with K+, imidazole+ and EGTA2– to vary charge shielding. We examined the effect of ionic strength on the kinetics of rigor development at low Ca2+ (experimental temperature 18–22°C) in chemically skinned single fast-twitch fibres of mouse extensor digitorum longus (EDL)
muscle. On average the delay before rigor onset was 10 times longer, the maximum rate of rigor tension development was 10
times slower, the steady-state rigor tension was 3 times lower and the in-phase stiffness was 2 times lower at high (230 mM)
compared to low (60 mM) ionic strength. These results were modelled by calculating ATP depletion in the fibre due to diffusional
loss of ATP and acto-myosin Mg.ATPase activity. The difference in delay before rigor onset at low and high ionic strength
could be explained in our model by assuming a 15 times higher Mg.ATPase activity and a threefold increase in K
m in relaxing conditions at low ionic strength. Activation by Ca2+ induced at different time points before and during onset of rigor confirmed the calculated time course of ATP depletion.
We have also investigated ionic strength effects on rigor development with the activated troponin/tropomyosin complex. ATP
withdrawl at maximum activation by Ca2+ induced force transients which led into a ”high rigor” state. The peak forces of these force transients were very similar
at low and high ionic strength. The subsequent decrease in tension was only 10% slower and steady-state ”high rigor” tension
was reduced by only 27% at high compared to low ionic strength. Addition of 10 mM phosphate to lower cross-bridge attachment
strongly suppressed the transient increases in force at high ionic strength and reduced the steady-state rigor tension by
17%. A qualitatively similar but smaller effect of phosphate was observed at low ionic strength where steady-state rigor force
was reduced by 10%. The data presented in this study show a very strong effect of ionic strength on rigor development in relaxed
fibres whereas the ionic strength dependence of rigor development after thin filament activation was much less. The data confirm
the importance of electrostatic interactions in cross-bridge attachment and cross-bridge-attachment-induced activation of
thin filaments.
Received: 3 September 1997 / Received after revision and accepted: 12 December 1997 相似文献
7.
L. T. Bilaniuk P. T. Molloy R. A. Zimmerman P. C. Phillips S. N. Vaughan G. T. Liu L. N. Sutton M. Needle 《Neuroradiology》1997,39(9):642-653
We describe the clinical and imaging findings of brain stem tumours in patients with neurofibromatosis type 1 (NF1). The
NF1 patients imaged between January 1984 and January 1996 were reviewed and 25 patients were identified with a brain stem
tumour. Clinical, radiographical and pathological results were obtained by review of records and images. Brain stem tumour
identification occurred much later than the clinical diagnosis of NF1. Medullary enlargement was most frequent (68 %), followed
by pontine (52 %) and midbrain enlargement (44 %). Patients were further subdivided into those with diffuse (12 patients)
and those with focal (13 patients) tumours. Treatment for hydrocephalus was required in 67 % of the first group and only 15
% of the second group. Surgery was performed in four patients and revealed fibrillary astrocytomas, one of which progressed
to an anaplastic astrocytoma. In 40 % of patients both brain stem and optic pathway tumours were present. The biological behaviour
of brain stem tumours in NF1 is unknown. Diffuse tumours in the patients with NF1 appear to have a much more favourable prognosis
than patients with similar tumours without neurofibromatosis type 1.
Received: 21 November 1996 Accepted: 22 December 1996 相似文献
8.
We report a modified technique of delayed primary wound closure using a wound wick. A rodent model was used to determine its influence on healing. After loose primary closure of two paravertebral incisions on the dorsum of male rats, a 10 cm length of ribbon gauze, soaked in either saline or 1% povidone-iodine, was inserted into the right sided wound. Wicks were soaked daily with the same solution until removal on the third post-operative day. The inclusion of a wick soaked in saline had an early transient effect on healing. A more prolonged impairment of healing was demonstrated in povidone-iodine wicked wounds and their respective controls. These data suggest that povidone-iodine impaired healing not only in the wicked wound, but also inhibited healing in the adjacent unwicked wound which was not directly exposed to the antiseptic. The observed delay in healing in povidone-iodine wicked wounds must however be balanced against its beneficial effect on wound infection rates. We suggest that further evaluation of this method of closure in contaminated wounds is warranted. 相似文献
9.
Factors affecting physicians' decisions on caring for an incompetent elderly patient: an international study. 总被引:3,自引:0,他引:3
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D W Molloy G H Guyatt E Alemayehu W McIlroy A Willan M Eisemann G Abraham J Basile G Penington M E McMurdo et al. 《Canadian Medical Association journal》1991,145(8):947-952
OBJECTIVES: To determine what treatment decisions physicians will make when faced with a hypothetical incompetent elderly patient with life-threatening gastrointestinal bleeding and to examine the relative importance of physician characteristics and factors (legal and ethical concerns, hospital costs, level of dementia, patient's age, physician's religion, patient's wishes and family's wishes) in making those decisions. DESIGN: Survey. SETTING: Family practice, medical and geriatrics rounds in academic medical centres and community hospitals in seven countries. PARTICIPANTS: Physicians who regularly cared for incompetent elderly patients. MAIN OUTCOME MEASURES: A self-administered questionnaire describing the elderly patient. Respondents were asked to choose one of four levels of care and to identify the level of importance factors had in making that decision. Older physicians, those less concerned about litigation, those for whom the level of dementia was important and those for whom the patient's age was important were expected to give less aggressive care than the other physicians. MAIN RESULTS: Supportive care was chosen by 8.1% of the respondents, limited therapeutic care by 41.5%, maximum therapeutic care without admission to the intensive care unit (ICU) by 32.2% and maximum care with admission to the ICU by 18.2%. The patient's wishes were reported by 91.0% as being extremely or very important in choosing the treatment. Stepwise logistic regression analysis revealed that the following variables independently predicted the level of treatment: level of dementia, country of residence, duration of practice, legal concerns, patient's age and ethical concerns. These factors were significantly correlated with the physicians' treatment choices (p less than 0.05). CONCLUSIONS: The importance that the physicians placed on the level of dementia was the strongest predictor of the level of care that would be provided. A societal consensus on the influence of cognitive function on the appropriate level of care as well as training of physicians in ethical issues are required. 相似文献
10.
D W Molloy D A Beerschoten M J Borrie R G Crilly R D Cape 《Journal of the American Geriatrics Society》1988,36(1):29-33
Fit elderly score higher on tests of fluid intelligence than aged-matched sedentary controls. Elderly patients who have taken part in exercise programs have shown improvement in mental function. We compared the effects of 45 minutes of exercise on memory, mood, and cognitive function in elderly subjects to a control intervention using a randomized control study design. Neuropsychological tests employed where the color slide test, digit symbol test, digit span test, logical memory test, word fluency test, and the Mini-Mental State Examination. We measured mood using a mood test and geriatric depression scale. Each subject was tested before, and immediately after, control and exercise sessions. Fifteen elderly subjects [ten men and five women; mean age, 66 years, (range, 60 to 85 years)] completed the study. There was a greater improvement in six of the eight scores of cognitive function following exercise, compared to control. These differences were significantly greater following exercise for the logical memory test score (P less than or equal to 0.02) and Mini-Mental State Examination (P less than or equal to 0.025) compared with the control intervention. 相似文献