Biomedical subjects

M Patel

Publications and source records attributed to M Patel.

511 records · Page 29Linked to original sources

PubMedDate not supplied

High-intensity inspiratory muscle training in patients with chronic obstructive pulmonary disease and severely reduced function.

PURPOSE: This study examined the effects of inspiratory muscle training (IMT) with high-intensity inspiratory pressure loads on respiratory muscle performance and exertional dyspnea. METHODS: This was a randomized single-blind clinical trial. Twenty-seven patients with chronic obstructive pulmonary disease (18 men, 9 women) with severe to very severe airflow obstruction and severely limited functional performance were assigned randomly to an IMT group (n = 12) or an educational control group (n = 15). The IMT group trained with a threshold loaded device for 30 minutes a day for 16 weeks using interval training techniques. Training was initiated with inspiratory pressure loads equal to 30% of maximal inspiratory pressure (Plmax) and increased as tolerated to 60% of Plmax. Dependent variables were measured before and after 4 months of IMT: inspiratory muscle strength (Plmax), respiratory muscle endurance (discontinuous incremental threshold loading test [DC-ITL]), dyspnea (Chronic Respiratory Disease Questionnaire [CRQ]), and the Borg Category-Ratio Scale ratings of perceived breathing difficulty (RPBD) at equal loads during the DC-ITL. RESULTS: In the IMT group, Plmax increased from 64 +/- 15 to 75 +/- 17 cm H2O (P < .05), performance on the DC-ITL test increased from a maximal load of 37 +/- 12 to 53 +/- 13 cm H2O (P < .05), RPBD decreased from 5.5 +/- 2.5 to 3.8 +/- 2.6 for equal loads on the DC-ITL (P < .05) and the CRQ Dyspnea Scale improved from 18.1 +/- 5.1 to 22.4 +/- 5.2 (P < .05). CONCLUSIONS: Inspiratory muscle training at high-intensity loads significantly improved inspiratory muscle strength, respiratory muscle endurance, and respiratory symptoms during daily activities and respiratory exertion.

Aged↗

PubMedDate not supplied

The efficacy of bilingual health advocacy in ethnic minority patients with cancer.

AIM: This research aims to establish the efficacy of introducing trained bilingual health advocates to non-English speaking cancer patients. METHOD: Male and female Bengali advocates received appropriate training. They were then given a group of patients to manage, while a control group received no such intervention. Outcomes were determined at the baseline and after three months. The study finally concludes in April 2000. RESULTS: The progress so far shows that the advocates had only recruited half of the expected number of Bengali cancer patients. Focus groups showed, however, that healthcare professionals felt that their training was inadequate to overcome the language and cultural barriers, and many were distressed that they were not meeting the needs of minority ethnic patients. CONCLUSION: The authors anticipate that this study will concur with research in other health sectors where bilingual health advocacy has been beneficial, and that future care will be better informed as a result.

Humans↗

PubMedDate not supplied

Gliomatosis cerebri: a case report.

We report a case of gliomatosis cerebri in a 46-year-old woman with five-year history of seizures and psychiatric disturbance. There were also two episodes of lethargy, disorientation, and headache which cleared promptly with Mannitol. A 3rd episode terminated in her death. Remarkably, between the episodes of presumed increased intracranial pressure, the neurologic examination was normal except for the patient's denial of her illness. Postmortem examination revealed the entire right cerebral hemisphere to be enlarged and infiltrated by cells resembling astrocytes. The clinical signs, symptoms, and controversial histopathologic features of this rare entity are discussed.

Brain Neoplasms↗

PubMedDate not supplied

Use of magnitude estimation for estimating the parameters of dyspnea.

Magnitude estimation, a psychophysic method, allows examination of variables associated with the respiratory sensation of loaded breaths. The subject's perceptual sensitivity can be quantified by magnitude-scaling exponents which describe the rate of growth of the dyspnea sensation associated with increases in the magnitude of the stimulus. Measurement of the perception of dyspnea by magnitude estimation can complement other measurements of variables that contribute to this complex sensation. Use of magnitude estimation techniques can enhance the study of similar clinical problems such as pain and fatigue.

Dyspnea↗

PubMedDate not supplied

Stimulation of neutrophil phagocytosis of Aspergillus fumigatus conidia by interleukin-8 and N-formylmethionyl-leucylphenylalanine.

The effect of the chemoattractants, interleukin-8 (IL-8) and N-formylmethionyl-leucylphenylalanine (fmlp) on neutrophil phagocytosis of serum-opsonised Aspergillus fumigatus conidia were studied. Pre-exposure of neutrophil monolayers to IL-8 (10-100 ng ml-1) or fmlp (10(-6)M) for 20 min increased phagocytosis from 15% to 35%. Furthermore, there was a significant increase in the numbers of conidia ingested by active neutrophils. The chemoattractants did not enhance phagocytosis of conidia when added contemporaneously to neutrophil monolayers. The ability of each chemoattractant to act as a primer for the other was investigated. It was found that fmlp could prime for IL-8 and fmlp enhancement of phagocytosis, but IL-8 could not. An increase from 15% to 55% in phagocytosis was seen at a pre-exposure concentration of 10(-5) M fmlp followed by an incubation period of 30 min in the presence of 20 ng ml-1 IL-8. There was no significant increase in the average number of internalized conidia under these conditions. The response of human neutrophils to priming stimuli may have important implications in the pathogenesis of aspergillosis.

Aspergillus fumigatus↗

PubMedDate not supplied

Inspiratory muscle training in patients with chronic obstructive pulmonary disease.

The effects of 6 months of muscle training with an inspiratory pressure load equal to 30% of the maximal inspiratory pressure (PImax) was compared with sham training with a light inspiratory pressure load. In this double-blind randomly assigned study, 67 patients with chronic obstructive pulmonary disease were followed for 6 months. Both groups demonstrated improvements in performance of PImax, respiratory muscle endurance time for breathing against an inspiratory pressure load equal to 66% of PImax, 12-minute distance walk, and dyspnea. The treatment group did not demonstrate significant effects beyond those observed in the control group. Improvements in performance were related to improved coordination of the inspiratory muscles and desensitization to dyspnea.

Activities of Daily Living↗

PubMedDate not supplied

Responses of preterm infants to unimodal and multimodal sensory intervention.

PURPOSE: To examine the immediate responses of preterm infants to two forms of unimodal [auditory only (A) and tactile only (T)] and two forms of multimodal sensory stimulation [auditory, tactile and visual (ATV); auditory, tactile, visual and vestibular (ATVV)]. METHOD: A convenience sample of 54 clinically stable preterm infants (33-34 postconceptional weeks) was randomly assigned to 1 of 5 experimental groups [Control (C); (A); (T); (ATV); and (ATVV)]. Stimulation was applied for 15 minutes once daily for 4 consecutive days. RESULTS: Outcome measures included pulse (PR) and respiratory rate (RR), oxygen saturation, behavioral state (BS), and body temperature. Repeated measures ANOVA identified significant differences among the groups during intervention for PR (p < .001), RR (p = .01), and BS (p < .02). Infants receiving any intervention with a tactile component showed increasing arousal (change in BS), and increased PR and RR during stimulation. Group T infants had higher proportions of PR > 180 while Group ATVV had higher proportions of PR < 140 (p = .0001). Group ATVV showed increased alertness following stimulation (24%) in contrast to having the least alertness during stimulation (11%). CONCLUSIONS: Tactile stimulation alone may be too arousing for these infants while the addition of vestibular stimulation may modulate arousal and facilitate optimal arousal prior to feeding.

Arousal↗