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Biomedical subjects

G Bravo

Publications and source records attributed to G Bravo.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

The impact of a support group programme for care-givers on the institutionalisation of demented patients.

Support group programmes have been proposed to alleviate the care-givers' burden and postpone institutionalisation of demented patients. Experimental studies on these programmes failed to detect any impact on care-givers' burden, but none have examined the effect on institutionalisation. The objective of this paper is to assess the impact of a support group programme for care-givers on the institutionalisation of demented patients. Forty-five care-givers of community-dwelling demented patients were allocated randomly to the study group (n = 24) and the control group (n = 21). Subjects in the study group attended a structured programme of 8 weekly sessions of 3 h each. Subjects assigned to the control group were referred to the informal monthly meetings of the Alzheimer's Society. Using survival analysis, the median length of time until institutionalisation was 30 months from the time of the entry into the study. At 24 months, the probability of being institutionalised was 0.33 in the study group and 0.45 in the control group. This difference was not statistically significant (log-rank test: chi2 = 1.02; P = 0.31). These results emphasize the lack of scientific evidence about efficacy of such programmes and the need for a large multi-centre study on this topic.

Journal Article↗
PubMedDate not supplied

Efficacy of a support group programme for care-givers of demented patients in the community: a randomized controlled trial.

Dementia induces morbidity not only in the patients but also in the families taking care of them. Many studies described the impact of care-giving on physical and psychological health. Support groups were designed to alleviate the burden of care-givers. The objective of this study was to measure the efficacy of a support group programme for care-givers of demented patients in the community. Forty-one primary care-givers were randomly assigned to a study (n=23) or a control group (n=18). Subjects of the study group attended a structured programme of eight 2-h sessions. These weekly sessions consisted of information on the disease, role-playing on management of behavior problems, discussion on emotional impact of care-giving, and learning of stress management techniques. Subjects of the control group were referred to informal monthly meetings of the Alzheimer's Society. Subjects of both groups were evaluated at the entry (T1), after 8 weeks (T2) and after 8 months (T3). The outcome variables were the Burden Interview, the Revised Memory and Behavior Problems Checklist, the Brief Symptoms Inventory, the Alzheimer's Disease Knowledge Test and a questionnaire on health care utilization. Compared with the control group, subjects of the study group yielded only a significant increase in knowledge about the disease (p<0.0001) but no significant difference on the other outcome variables. It is concluded that this type of support group programme seems to have only a minimal impact on morbidity and on the burden of care-givers. These results are similar with two other studies examining the same issue.

Clinical Trial↗
PubMedDate not supplied

Isometric grip endurance of healthy elderly men and women.

Grip endurance is one of the important prerequisites for good performance of the upper extremity and hence it is important to evaluate it correctly. However, we know little about normal grip endurance, especially for elderly people. The main objective of this study was to examine the age-related changes in grip isometric endurance of healthy community-dwelling elderly people. Two-hundred and eighty-six subjects aged between 60 and 90, were randomly selected from the electoral list of the city of Sherbrooke, Quebec, Canada. Grip relative isometric endurance was evaluated using the Jamar dynamometer. Isometric grip endurance was estimated by the number of seconds a subject could sustain 50% of his/her maximal voluntary grip strength. Contrary to other upper extremity sensorimotor parameters, no grip isometric endurance difference was found with age, in spite of a slight tendency towards a decrease. The women tended to have better scores than the men and endurance of dominant hand is better than the non-dominant. The stability with age could be explained by muscle fiber composition modifications.

Journal Article↗
PubMedDate not supplied

Impact of elbow position on grip strength of elderly men.

Grip strength is frequently measured in rehabilitation settings in order to monitor patient progress. Many factors influence grip strength measurements, including body segment positions and particularly elbow position. The objective of this study was to compare grip strength measurements obtained with two different elbow positions: full extension and 90 degrees of flexion. Forty-nine healthy right-handed men aged 60 to 84 years were tested with a Jamar dynamometer. Results indicated that left grip strength was significantly higher when the elbow was flexed to 90 degrees compared with when it was fully extended. No statistical difference between the two elbow positions was found for the dominant hand.

Aged↗
PubMedDate not supplied

Shamans, sacraments, and psychiatrists.

This article reviews the role of psychedelic drugs as potential tools for psychiatric research and practice. The decline in the utilization of these substances is linked to social reactions, which led to psychedelics being scheduled as controlled substances and consequently unavailable for human research. Three different paradigms for the use of psychedelics in psychiatry are reviewed: the psychotomimetic, the psycholytic, and the psychedelic approaches. The psychotomimetic paradigm, which viewed hallucinogens as agents for temporarily inducing psychoses, proved to be of limited value to the understanding and treatment of mental illness. The psycholytic approach, which was derived from the psychoanalytic paradigm, is a technique employing low doses of psychedelic drugs to reduce psychological defenses and to release unconscious information. The high-dose psychedelic paradigm frequently produced reports of mystical or spiritual experiences, thus recasting the psychiatrist as the modern-day shaman. This paradigm has alienated many in the psychiatric profession and has led to a reaction against the use of psychedelics in psychotherapy. If the opportunity should arise to pursue sanctioned clinical research with these unique psychoactive substances, however, it will be imperative to learn from the traditional models of shamanic healers in order to optimally assess true clinical efficacy and safety.

Hallucinogens↗
PubMedDate not supplied

Normative data for grip strength of elderly men and women.

OBJECTIVES: Grip strength is an important prerequisite for good performance of the upper limb, hence it is important to evaluate it correctly. However, one of the main difficulties in evaluating the grip strength of elderly patients is the absence of valid norms. Therefore, the objective of this study was to develop normative data for maximum grip strength of persons aged 60 years and older. METHOD: The grip strength of 360 subjects aged 60 years and older, randomly recruited by age and gender strata, was evaluated with the Jamar dynamometer and the Martin vigorimeter according to the protocol of the American Society of Hand Therapists. RESULTS: Grip strength diminishes curvilinearly with age, and men are consistently stronger than women. The data are presented by the means, standard deviations, and range, and as predictive equations obtained by regression analysis. In addition to age and gender, hand circumference and body height proved to be the best indicators of grip strength for this population of elderly subjects. CONCLUSION: The random recruitment of subjects, the high participation rate in the study, and the comparability of the subjects who agreed to participate and those who refused give this study the high external validity that is essential to any norm study. The predictive equations will help occupational therapists to better estimate the expected grip strength of elderly patients than they could if using only age and gender.

Age Factors↗
PubMedDate not supplied

[Neural transplants en Parkinson disease: clinical results of 10 years of experience. Group of Neural Transplants of the CPH].

INTRODUCTION: At the end of the 1970s people considered the possibility that transplants might be useful to replace degenerate specific cell populations, such as the mesencephalic dopaminergic neurones in Parkinson's disease (PD). Since then this has become an experimental alternative treatment for patients with degenerative diseases. The history of transplants of catecholamine producing tissues within the brain of patients with PD started in 1985, when Backlund et al published the results of the first implants of autologous adrenal medulla in two patients with Parkinsonism. Since then, many patients throughout the world have benefited from the results obtained using this method. Two main types of tissue have been used in this method: autologous adrenal medulla and human foetal ventral mesencephalic tissue. DEVELOPMENT: In this paper we first review the clinical effects of the diverse types of transplant done to date. Then in the second part we give a summary of the clinical results obtained by our group with the different types of transplant carried out. We explain their evolution, original hypothesis and justify the reasons which led us to use three different types of donor material: autologous adrenal medulla, fetal tissue and adrenal medulla co-incubated with peripheral nerve. Then, after showing that the clinical improvement is different depending on the type of tissue transplanted, we comment on the probable reason for the improvement seen in patients with implants. CONCLUSION: The transplantation of nervous tissue seems to us to be no longer an experimental alternative for the treatment of PD but has become an effective, lasting treatment for patients with Parkinson's disease.

Adrenal Medulla↗
PubMedDate not supplied

[Personal exposure to ELF magnetic fields in workers engaged in various occupations].

Using personal dosimeters worn during two complete work-shifts, we measured occupational exposure to Extremely Low Frequency-Magnetic Fields (ELF-MF) in 290 workers employed in 56 jobs, representative of the main occupational activities in the area of Modena and Reggio Emilia (Italy). Environmental nonoccupational exposure was also monitored. In the whole sample, the mean Time-Weighted Average (TWA) exposure during work resulted 0.59 microT (SD 3.2), while the median was 0.13 microT. Exposure was lower than 1 microT in more than 90% of the workers. In one job only exposure was greater than 1 microT (job-related median TWA); in other 8 exposure was between 1 and 0.4 microT, while about 84% of the jobs presented a median TWA lower than 0.4 microT. A high variability among workers engaged in the same job resulted in various occupational tasks. Non-occupational exposure was lower than 0.4 microT in more than 98% of the examined workers. Our results show a low to moderate occupational exposure to ELF-MF in the greatest part of the workers and working activities. Also the non-occupational exposure resulted low in the large majority of the subjects. The high variability observed among workers engaged in some occupations may represent a problem in exposure evaluation. Personal monitoring is particularly useful in such a situations.

Electromagnetic Phenomena↗
PubMedDate not supplied

[Gamma Knife radiosurgery treatment of trigeminal neuralgia and atypical facial pain].

INTRODUCTION: Typical trigeminal neuralgia (TTN) is a condition that is treated initially by pharmacological means and, if this fails, with different surgical techniques. With the advent of radiosurgery a relatively bloodless form of treatment with low toxicity and good results has become available and can be considered for use as the first choice procedure. AIMS: Our aim was to report the findings obtained from treating this pathology using Gamma Knife radiosurgery in order to assess the possibility of using it for patients with neuralgia associated to multiple sclerosis (MS) or who have atypical facial pain (AFP). We also assessed the patients who were re-treated owing to recurrence or persistence. PATIENTS AND METHODS: The sample was made up of 74 patients, including seven cases of lesions in the brain stem at the nerve entry point, 45 cases of associated vascular compression, 15 cases of AFP and eight cases of re-treatment. The median maximum dose was 84 Gy (60.2-120). The mean follow-up time was 23.26 months (1-97.83). RESULTS: Of those with TTN, 76.2% of subjects had no pain at the end of the study (75% in cases of second treatments, 69% in cases of associated vascular compression, 52% of those with prior interventions and 43% with MS), and 33% in the case of AFP. The mean time elapsed before pain disappeared was 4.34 months (0-23.72). Sensitivity was newly affected in 20.3% of patients with TTN or AFP. CONCLUSIONS: Gamma Knife radiosurgery is a first choice therapeutic option for use with patients who have TTN or AFP, as well as in cases of neuralgia associated to MS. It can also be considered for use as re-treatment with a tolerable rate of morbidity.

Adult↗
PubMedDate not supplied

[Pharmacologic study of dopamine catabolites on the contractility of isolated guinea pig myocardium].

Tetrahydroisoquinolines (TIQs) are alkaloids originated as natural catabolic derivatives of catecholamines (CAT). Dopamine, under special circumstances, condenses with aldehydes to produce tetrahydropapaveroline (THP), salsolinol (SOL) and salsoline (SAL). We investigated the inotropic activity of THP, SOL and SAL on the isometric contractility of papillary muscles isolated from guinea pigs hearts and compared their actions to those corresponding to adrenaline (A) and isopropylarterenol (ISO). In order to analyze their combined effects, TIQs and A were applied simultaneously. THP, SOL and SAL produced positive inotropic effects as beta receptor agonists; their actions were antagonized with propranolol. The inotropic efficacy of TIQs compared to that of catecholamines, is: CAT = 1; SAL = 0.32; THP = 0.47 and SOL = 0.32. Their middle effective dose (DE50), indicates an order of potency of: ISO = SAL greater than A = THP greater than SOL. Combination of THP or ISO with A produces an additive effect; however, SAL behaves as a partial agonist, meaning that it produces an antagonistic, non-competitive type effect on the inotropic action of adrenaline. Chemical structure of TIQs shows significant relationship with their pharmacological activity on ventricular myocardium, similar to that of catecholamines. The influence of the methoxyl group attached to C-7 in SAL, as the only difference with SOL which instead has a hydroxyl group in that position, deserves special mention; such structural difference provides to SAL bigger inotropic efficacy and potency, as well as beta adrenergic antagonistic activity. The results of the present paper emphasize the biological significance of active catabolites from catecholamines as are the tetrahydroisoquinoline compounds.

Animals↗