[Toxoplasmosis and stomatitis aphthosa--Phenacetin abuse].
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Biomedical subjects
Publications and source records attributed to E Mann.
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BACKGROUND: Strength training (ST) may be beneficial for preservation of lean tissue, increasing bone mineral content, decreasing falls, and enhancing quality of life. Strength training is becoming an appropriate mode of exercise for cardiac rehabilitation (CR) patients. One method for determining optimal exercise intensity for safe and effective ST requires one repetition maximum (1RM) testing. Clinicians may be reluctant to perform 1RM testing in CR patients because of potential muscle soreness/injury and adverse hemodynamic responses in deconditioned patients. The purpose of this investigation was to perform 1RM testing in CR patients and determine muscle soreness/injury rate. METHODS: Seventy-four CR patients stratified by risk (low n = 30, intermediate n = 21, high n = 23) and sex (males = 55, females = 19) participated. Subject's ages ranged from 39 to 76 years and time from procedure ranged from 19 days to 2 years. No patient had ever undergone 1RM testing. The method of Kraemer and Fry was used to assess 1RM. High-risk patients' heart rates/rhythms and blood pressures were monitored. Patients were evaluated for occurrence of muscle soreness/injury immediately after 1RM testing and on days 2 and 7 using a soreness scale developed by Shaw et al. Muscle soreness/injury was considered significant if a patient reported altering or stopping physical activities. RESULTS: No injury or significant muscle soreness occurred as a result of 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients. CONCLUSIONS: Results indicate that with proper technique, 1RM testing may be performed in CR patients without injury or significant muscle soreness.
BACKGROUND: Developing adequate levels of muscular strength in the cardiac rehabilitation (CR) patient helps return the patient to an active lifestyle. This study evaluated the effects and safety of an 8-week high-intensity strength training (ST) program combined with a traditional aerobic-based CR program on the muscular strength of a diverse phase II CR population. METHODS: Sixty-one phase II CR patients (age = 60.5 +/- 10.6 years) stratified by risk (high risk: n = 18, ejection fraction = 23.6 +/- 7.8%; intermediate risk: n = 19, ejection fraction = 40.0 +/- 4.6%; low risk: n = 24, ejection fraction = 58.0 +/- 7.7%) and gender (males = 46, females = 15) participated. One repetition maximum (1RM) testing was performed on the horizontal squat, shoulder press, leg extension, lat pulldown, and biceps curl. Patients performed two sets of each exercise 2 days per week at an intensity that started at 60% 1RM and progressed to 80% 1RM by week 4. Weeks 4 to 8 intensity was adjusted individually to maintain 8RM per set. Blood pressure and heart rate/rhythm responses to 1RM testing were monitored in high-risk patients. Muscle soreness and injury were monitored for all patients immediately after 1RM testing and on days 2 and 7. RESULTS: All patient groups made significant gains (P < 0.05) in muscle strength (mean increase: lower body = 15.3%, upper body = 16.7%). No injury or significant muscle soreness occurred due to 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients. CONCLUSIONS: Diverse phase II CR patients can improve their strength significantly with a combination of high-intensity strength and aerobic training.
There is compelling evidence that despite growing research into the complex neurophysiology of pain, the development of acute pain services, increasing educational interest in pain management and the proliferation of literature, many patients continue to suffer from unrelieved acute pain while in hospital. Educational efforts to bring about a change in practice have been relatively unsuccessful or slow to have real impact. Although it is still recognized that poor knowledge of pain control by all healthcare professionals is the major barrier to improving pain management, contemporary studies show that other, more subtle barriers can just as effectively inhibit a timely and effective response to patients' reports of pain. These barriers are not just the ones created by poor knowledge, myth and misconception; the most powerful barriers to change may be the invisible institutional barriers that can be entrenched within hospital policies and nursing rituals.
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Epidural infusions are being employed more frequently for postoperative and posttraumatic pain. This paper looks at the possible complications involved in the use of epidural analgesia. The evidence concerning possible causes of infection and abscess formation is discussed. The small amount of literature available suggests that the potential for infection is increased when ward-based staff are involved with changing epidural infusions. The potential benefits of ready-prepared solutions for epidural analgesia are considered.