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Biomedical subjects

G Bravo

Publications and source records attributed to G Bravo.

At least 55 records · Page 3Linked to original sources
PubMed1996

Impact of a 12-month exercise program on the physical and psychological health of osteopenic women.

OBJECTIVE: To describe the effect of a supervised physical activity program on the physical and psychological health of osteopenic women. DESIGN: A randomized controlled trial. SETTING: Sherbrooke, Quebec, Canada. PARTICIPANTS: A total of 124 community-living postmenopausal women, between 50 and 70 years of age, with low bone mass took part in the study. INTERVENTION: Subjects allocated to the experimental group performed weight-bearing exercises (walking, stepping up and down from benches), aerobic dancing, and flexibility exercises for 60 minutes, three times a week, over a period of 12 months. All subjects were invited to attend bi-monthly educational seminars covering topics related to osteoporosis. OUTCOME MEASURES: Spinal and femoral bone mineral density (BMD), functional fitness (flexibility, coordination, agility, strength/endurance, cardiorespiratory endurance), psychological well-being, back pain intensity, and self-perceived health. RESULTS: Spinal BMD stabilized in the exercisers while decreasing significantly in the controls (P = .031). No change in femoral BMD was observed in either group (P = .597). Four of the five parameters chosen to evaluate functional fitness, namely flexibility, agility, strength, and endurance, were affected positively by the exercise program (all P < .01). Adjusting for prescores by means of an analysis of covariance revealed a significant difference between the groups in psychological well-being, which favored the exercisers (P = .012). After 12 months, back pain reported by exercisers was lower than that reported by controls (P = .008). Finally, self-perceived health increased in the exercise group, whereas no difference was observed in the control group (P = .790). CONCLUSION: These results suggest that after 12 months, exercising can produce a significant increase above initial levels in the functional fitness, well-being, and self-perceived health of osteopenic women. Intensity of back pain can also be lowered by exercise. The exercise program succeeded in stabilizing spinal BMD but had no effect on femoral BMD.

Aged↗
PubMed1996

Performance of the 'unaffected' upper extremity of elderly stroke patients.

BACKGROUND AND PURPOSE: The main objective of this study was to compare the sensorimotor performance of the unaffected upper extremity (UE) of elderly stroke patients with that of healthy elderly people. METHODS: The group of stroke patients was composed of 43 hemiplegic/paretic subjects who had had a cerebrovascular accident at least 6 months earlier. They were > or = 60 years old, were right-handed before the stroke, had visual perception within normal limits, and showed no major cognitive impairments. A group of 43 healthy subjects matched for dominance, age, and sex was used for comparison. The main parameters of the performance of the unaffected UE of the stroke subjects and of the same side of the healthy subjects were measured with valid, reliable instruments. Some variables potentially related to the unaffected UE were also measured: affected UE motor function, functional independence, length of time since the stroke, self-perceived health status, activity level, and hand anthropometry. RESULTS: Statistical analyses showed significant deficits in the unaffected UE of hemiplegic/paretic subjects compared with normal subjects with regard to the following parameters: gross manual dexterity, fine manual dexterity, motor coordination, global performance, and kinesthesia (P < .01 to P < .0001). No significant clinical or statistical difference was found for grip strength (P < .81), static and moving two-point discrimination (P = .21 and P = .12), or touch/pressure threshold (P < .91). CONCLUSIONS: Many factors (frequency of use of the unaffected hand, sensorimotor interaction tasks, severity of the deficits in corticifugal projections, and deficits in postural stabilization) could interact to provide the clinical picture obtained in the present study.

Aged↗
PubMed1996

Investigation of the positive inotropic action of 6,7-dimethoxy-3-cyano-3,4-dihydrocarbostyril.

6.7-Dimethoxy-3-cyano-3.4-dihydrocarbostyril (7A61, 1), a 2-quinolinone derivative, showed interesting cardiotonic properties in vitro. It exerted potent positive inotropic effects, without any change in heart rate, in guinea pig atrial preparations, and its effects were not dependent upon inhibition of phosphodiesterases, opening of Na+ channels, or inhibition of adenosine receptors. Notwithstanding its structural relationships with milrinone, vesnarinone, and other quinolinones endowed with cardiotonic activity, it appeared that 7A61 does not share any of the main mechanisms of action involved in the pharmacological activity of these compounds. Other experiments also excluded the involvement of other well known mechanisms of cardiac stimulation, such as adrenergic receptor activation or opening of Ca++ channels, the mode of action of 7A61 remaining unexplained. However, contrary to milrinone, 7A61 did not exert cardiotonic effects in human ventricular muscle preparations, thus discouraging further investigation. Although the lack of effect on human heart could not be predicted from the results obtained in several cardiac preparations commonly used in laboratory investigations, the scarce efficacy of 7A61 in comparison with milrinone in dog and cat papillary muscle and in guinea pig ventricular muscle suggests the utility of the latter preparations in laboratory experiments aimed at selecting new potential cardiotonic agents.

Animals↗
PubMed1995

Upper extremity performance test for the elderly (TEMPA): normative data and correlates with sensorimotor parameters. Test d'Evaluation des Membres Supérieurs de Personnes Agées.

OBJECTIVES: Objectives of this study were to develop normative data for the Test d'Evaluation des Membres Supérieurs de Personnes Agées (TEMPA) and determine its relation to upper extremity sensorimotor parameters such as fine and gross dexterity, coordination, strength, endurance, range of motion, and several types of sensibility. DESIGN: Cross-sectional study. SETTING: Community-dwelling subjects. PARTICIPANTS: Three hundred sixty healthy subjects randomly recruited by age and sex strata (60 to 69, 70 to 79, and 80 or older). MAIN OUTCOME MEASURES: Length of execution of the tasks in the TEMPA. RESULTS: Normative data are reported by gender and age group. The time taken to execute the tasks increased significantly with age. The women were faster on the tasks requiring a higher degree of fine dexterity, whereas the task requiring a lesser degree of fine dexterity and sensibility and more grip strength was accomplished faster by the men. Subjects who were more active and described themselves as being in excellent or good health performed better. CONCLUSION: The norms will help clinicians differentiate better between normal and pathological aging in upper extremity performance.

Aged↗
PubMed1995

Upper-extremity motor co-ordination of healthy elderly people.

Motor co-ordination is an important prerequisite to adequate upper-extremity performance. With the ageing of the population, more and more elderly people are at risk of acquiring upper-extremity motor inco-ordination following sensorimotor deficit. The main objective of the study was to develop normative data on upper-extremity motor co-ordination for elderly people. Three hundred and sixty subjects aged 60 and over were randomly selected and evaluated with the Finger-Nose Test. The results revealed a linear decline in the performance of this test with age. Younger, more active and subjectively healthier subjects presented better motor co-ordination. Some differences were found between sexes and sides. The normative data will help clinicians to identify pathological reduction in motor co-ordination in an elderly population.

Aged↗
PubMed1995

Reliability of the revised functional autonomy measurement system (SMAF) for epidemiological research.

The Functional Autonomy Measurement System (SMAF) is an instrument designed to assess disabilities related to 29 functions with a four-point scale (from 0: independent to -3: dependent). For epidemiological studies, a total score and five sub-scores can be obtained. A revised version was developed adding a -0.5 level to many items to indicate an activity accomplished independently but with difficulty. The objective of the study was to verify the test-retest and inter-rater reliability of the total score and sub-scores of the SMAF. Ninety subjects were randomly recruited in nine different residential settings ranging from home to long-term-care hospitals. Half of the subjects were assessed by the same nurse within a 2-week interval (test-retest) and the other half were assessed twice by two different nurses within the same interval (inter-rater). Results show intra-class correlation coefficients (ICC) of 0.95 and 0.96 for the total scores on test-retest and inter-rater reliability, respectively. The ICC were over 0.74 for all sub-scores for both types of reliability. A small systematic bias was present for two SMAF subscores on the inter-rater reliability. The addition of a new level did not modify the reliability of the scale.

Activities of Daily Living↗
PubMed1995

The Purdue Pegboard Test: normative data for people aged 60 and over.

Manual dexterity is frequently evaluated in rehabilitation services to estimate hand function. Several tests have been developed for this purpose, including the Purdue Pegboard, which measures fine manual dexterity. The goals of the study were to verify the test-retest reliability with subjects aged 60 and over without upper limb impairment, and to develop normative data based on a random sample of healthy older community-living individuals. The results show that the test-retest reliability is good (intra-class correlation coefficients from 0.66 to 0.90, depending on the subtest). Norms are presented to help clinicians involved in rehabilitation services to better differentiate real dexterity deficits from those that may be attributed to normal ageing.

Aged↗
PubMed1995

The heart in the primary antiphospholipid syndrome.

Twenty consecutive female patients (mean age 30.1 years) with Primary Antiphospholipid Syndrome (PAPS) were studied cardiologically through noninvasive methods and compared with 20 age-and sex-matched healthy subjects. On physical examination 13/20 patients (65%) with PAPS had a valvular abnormality. In 12/20 (60%) patients with PAPS the ECG was abnormal, mainly due to sinus tachycardia in 5 (25%) and acute myocardial infarction in 3 (15%). In 7/20 patients with PAPS (35%) abnormal pulmonary findings were detected by X-ray and in 6 (30%) they were related to dilated pulmonary arch and pulmonary hypertension. In 14/20 cases (70%) with PAPS, abnormal echocardiographic findings were present; 13/20 patients (65%) had valvular complications attributable to PAPS: mitral insufficiency in six cases; mitral valve prolapse in three and aortic insufficiency in three. Two had pulmonary artery hypertension and two, tricuspid regurgitation (one attributable to PAPS). All valve diseases were regurgitant with mild to moderate hemodynamic repercussion. No stenotic lesions were detected. The mean mitral thickness in patients with mitral valve involvement was 7.0 +/- 1.6 mm, compared to 2.8 +/- 0.7 mm in patients with normal valves and 3.1 +/- 0.9 mm in the control group (p < 0.001). The mean aortic valve thickness in patients with aortic valve involvement was 3.6 +/- 0.5 mm compared to 1.5 +/- 0.3 mm in patients with normal valves and 1.4 +/- 0.4 in the control group (p < 0.001). None of the patients from the control group had valve disease (p < 0.0001). Three cases (15%) had pericardial effusion diagnosed by echo. Two patients with PAPS died during the 4.7 +/- 1.2 years of cardiological follow up, due to acute myocardial infarction and embolic cerebrovascular accident, respectively. In conclusion, cardiologic complications are common in PAPS, including left side regurgitant lesions that might be hemodynamically significant, acute myocardial infarction, pericardial effusion and pulmonary hypertension.

Adult↗
PubMed1995

[Phyllodes tumor: diagnosis and treatment].

We reviewed 1.178 benign tumors treated between 1981/93 among which 39 appeared with a Phylodes Tumors diagnosis, disregarding 5 of them because they did not have a precise description and histologic classification, studying 34 proved cases which represented 2.89% of all benign tumors; if we add 89% cancers in these years, we have 2.074 and the relation becomes 1.64% of the total. We found 22 benign phylodes (64.7%) 7 border line (20.5%) and 5 malignant (14.8%) whose clinic, histologic and evolutive characteristics are presented in this paper.

Adolescent↗
PubMed1995

Comparison of the Jamar dynamometer and the Martin vigorimeter for grip strength measurements in a healthy elderly population.

Grip strength is considered to be a good indicator of upper limb strength. The Jamar dynamometer and the Martin vigorimeter are two instruments frequently used to assess grip strength in clinical and research settings. The purpose of this study was to compare these instruments for assessing grip strength in 360 people aged 60 to 94 years, randomly selected from the electoral list. Anthropometric data were also collected. Data analyses were done using the maximum value on 3 trials with each instrument. Although the Martin vigorimeter is a pressure measure implying a dynamic movement as opposed to the static strength measure of the Jamar dynamometer, results indicate a very high correlation between the two measures. Grip strength measured by the Jamar dynamometer is even more dependent on hand anthropometry than measurements with the Martin vigorimeter.

Aged↗
PubMed1994

Medulloblastoma in adulthood: prognostic factors influencing survival and recurrence.

Thirty adult patients presenting with medulloblastoma between 1974 and 1991 were studied and treated at Puerta de Hierro Clinic. After diagnosis, all patients were treated by surgery followed by radiotherapy and eight of them received adjuvant chemotherapy. We have studied the influence of some factors such as age, sex, location of tumour in the cerebellum, amount of surgical resection and histological variants on survival and recurrence of the disease. Only the histological type has a statistically significant influence on survival and recurrence: we have found that patients presenting classic medulloblastoma have a long survival and a long relapse-free interval.

Adolescent↗
PubMed1994

Brainstem haematomas: early and late prognosis.

The purpose of the present retrospective study is to analyse 14 patients harbouring brainstem haematomas and to discuss the early and late prognosis. The patients were divided into two groups: group A (survivors), 8 patients with follow-up duration ranging between 8 months and 12 years; and group B (nonsurvivors), 6 patients. At the time of onset or hospital admission, the former were under 50 years of age and had no important clinical history. Their degree of consciousness was altered only slightly or moderately and their brainstem haemorrhages were focal or only slightly diffuse. Three patients in this group underwent surgical treatment. The members of group B, who died within days of their admission to the hospital, were over 60 years of age, had a number of clinical antecedents and severe alterations of consciousness, while 83% of them presented diffuse brainstem haemorrhages. None of the patients of this group were treated surgically. It was concluded that: 1) the indications for surgery for these lesions were progressive hydrocephalus, increase in the mass effect with progressive symptomatology and suspected "cryptic vascular malformation" with risk of later rebleeding or brain tumour; 2) surgical treatment was necessary to improve the symptomatology in 3 patients in group A, although there were no significant differences between surgically treated and nonsurgically treated patients in the same group with respect to prognosis; 3) age, clinical history, degree of alteration of consciousness and type of haemorrhage are the major factors affecting the early and late prognosis of brainstem haemorrhages.

Adult↗
PubMed1994

Early and intensive physiotherapy accelerates recovery postarthroscopic meniscectomy: results of a randomized controlled study.

The efficacy of an early, intensive, supervised rehabilitation program to accelerate knee strength recovery in the first 3 weeks postmeniscectomy by arthroscopy was evaluated using a randomized controlled trial design. The maximal voluntary isokinetic strength of 31 men, randomly allocated to either a treatment (EXP) or a control (CTL) group, was measured twice by a blind rater: preoperatively (pretest) and 3 weeks postsurgery (posttest), using a computer-controlled Kin-Com dynamometer (Chattecx Corporation, Chattanooga, TN). Strength deficits of the operated leg at the pretest and posttest were established in percent of the values obtained for the sound leg at the pretest. In the interval between the surgery and the posttest, the patients of the EXP group (n = 15) received nine supervised treatments combined to home exercises whereas patients of the control group (n = 16) had no specific physiotherapy treatment but were given instructions in postsurgical management and prescribed exercises by the orthopedic surgeons. Patients of the EXP group had better knee extensor strength recovery than patients of the CTL group (ANCOVA, p < 0.001). The size of the strength difference (3 weeks postsurgery) between EXP and CTL subgroups (n = 8) matched according to preoperative deficits was as large as 26% and the residual deficits of the untreated patients were two to three times larger than those of the treated patients. The results of this study highlight the importance of instituting an early intensive and supervised rehabilitation program, especially for workers returning to a strenuous job requiring good knee extensor muscle function.

Activities of Daily Living↗
PubMed1994

Glibenclamide vs gliclazide in type 2 diabetes of the elderly.

The objective of this study was to compare the effect of two sulphonylureas on the frequency of hypoglycaemic events and glycaemic control in elderly patients with Type 2 diabetes. Twenty-two untreated elderly patients were treated with glibenclamide or gliclazide in a randomized double-blind fashion. Prior to treatment, a biochemical profile, an oral glucose tolerance test, and a 2-h hyperglycaemic glucose clamp (glucose 5.4 mmol l-zs-1 above baseline) were performed. Patients were seen regularly over 6 months to assess glycaemic control and the frequency of hypoglycaemic reactions. Hyperglycaemic clamp studies and oral glucose tolerance tests were repeated at 1 and 6 months. The area under the curve for the oral glucose tolerance test (glibenclamide: 15.5 +/- 0.7; gliclazide: 14.9 +/- 0.8 mmol l-1 (p = NS)) and the haemoglobin A1C (glibenclamide: 7.4 +/- 0.2%; gliclazide: 7.9 +/- 0.5% (p = NS)) were similar at 6 months. Hypoglycaemic reactions were significantly more frequent with glibenclamide than with gliclazide: 17 vs 4 (p < 0.01). Insulin sensitivity index (ml kg-1 min-1 pmol-1 x 100) was increased significantly by glibenclamide but not gliclazide (glibenclamide: 0.284 +/- 0.116 (baseline) vs 0.518 +/- 0.102 (6 months) (p < 0.05), gliclazide: 0.260 +/- 0.048 (baseline) vs 0.358 +/- 0.048 (6 months) (p = NS)). We conclude that glycaemic control was equivalent with the two drugs but the incidence of hypoglycaemic reactions was significantly greater with glibenclamide probably because this drug increases insulin sensitivity to a greater degree.

Aged↗
PubMed1994

Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies.

Manual dexterity is a skill frequently evaluated in rehabilitation to estimate hand function. Several tests have been developed for this purpose, including the Box and Block Test (BBT) that measures gross manual dexterity. The goal of the present study was to verify the test-retest reliability and construct validity of the BBT with subjects aged 60 and over with upper limb impairment. The second objective of this research was to develop normative data based on a random sample of healthy elderly community-living individuals. The results show that the test-retest reliability is high (intraclass correlations coefficients of 0.89 to 0.97) and the validity of the test is shown by significant correlations between the BBT, an upper limb performance measurement and a functional independence measurement. The norms will help rehabilitation clinicians to differentiate better between real difficulties and those that may be attributed to normal aging.

Activities of Daily Living↗
PubMed1993

Motor recovery after arthroscopic partial meniscectomy. Analyses of gait and the ascent and descent of stairs.

We studied motor recovery as shown by locomotor activities after arthroscopic partial medial meniscectomies in seventeen men who were twenty-five to forty-nine years old. The patients were evaluated before the operation and two, four, and eight weeks after the operation. Control values were obtained from twenty-two healthy men whose ages, weights, and heights were similar to those of the patients who had had a meniscectomy. Motion of the hip, knee, and ankle in the sagittal plane and the electromyographic activities (as measured with surface electrodes) in five muscles were recorded while each subject walked on a level walkway and then ascended and descended stairs at free speeds. The results showed that meniscal tears affect the motor-control mechanisms involved in the submaximum locomotor activities that were studied and that these abnormalities may persist for as long as eight weeks after a meniscectomy.

Adult↗