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At least 523 records · Page 29Linked to original sources
PubMed2002

Use of a cane for ambulation: marker and mitigator of impairment in older people who report no difficulty walking.

OBJECTIVES: To measure disability, patients are often asked whether they have difficulty performing daily tasks. However, recent work suggests that functional problems may be detected earlier by inquiring about modifications in the way tasks are performed. We sought to describe the characteristics of older people who deny difficulty walking but nevertheless have modified the manner in which they walk, by use of a cane. We also tested the hypothesis that, among older people who deny difficulty walking, those using a cane have more mobility problems and are at greater risk for future mobility problems than those not using a cane. DESIGN: Longitudinal survey study, with measures at baseline and 2-year follow-up. SETTING: Population-based survey of urban older people. PARTICIPANTS: One thousand two hundred fifty-one community-dwelling older persons without severe cognitive impairment who reported no difficulty walking at baseline. MEASUREMENTS: Self-reported health, activities of daily living (ADL), and mobility status. RESULTS: Among older people who denied difficulty walking, those who used a cane at baseline (7 of subjects) were older and more likely to have taken medication for a heart condition or arthritis, to have an ADL deficit, and to have been hospitalized in the past year. They were less likely to have walked for pleasure in the past month and more likely to report difficulty crossing roads or intersections. Moreover, those using a cane at baseline were more likely to develop new mobility problems at follow-up. For example, 15 of those who used a cane at baseline reported new difficulty walking at follow-up, compared with 2 of those who did not use a cane. CONCLUSION: Older people who deny difficulty walking but who use a cane are at greater risk than those who do not use a cane for the development of difficulty walking and other new mobility problems. Asking patients about task modification rather than difficulty alone may be a more sensitive way to detect early or mild functional problems.

Activities of Daily Living↗
PubMed2001

Co-administration of etomoxir and RU-486 mitigates insulin resistance in hepatic and muscular tissues of STZ-induced diabetic rats.

Insulin resistance is a condition of central importance in a cluster of clinical disorders including diabetes mellitus, hypertension, dyslipidemia, central obesity and coronary heart disease. Despite its association with numerous health problems, the mechanism responsible for the development of this phenomenon remains to be established. A novel theory has proposed that insulin resistance in diabetes stems, at least in part, from enhanced free fatty acid (FFA) oxidation and/or excessive production of glucocorticoids (GCs). Several key predictions of this premise were subjected to experimental testing using streptozotocin (STZ)-treated rats as a model for insulin-dependent diabetes mellitus and euglycemic-hyperinsulinemic clamp technique for the in vivo measurement of insulin actions. Euglycemic clamp studies with an insulin infusion index of 5 mU/kg/min were used to measure endogenous glucose production (EGP), glucose infusion rate (GIR), glucose disposal rate (GDR) and skeletal muscle glucose utilization index (GUI). Post-absorptive basal EGP and plasma levels of glucose and free fatty acids (FFA) were elevated in the STZ diabetic rats compared to their corresponding control values. In contrast, hypoinsulinemia was evident in these animals. Steady-state GIR and GDR during euglycemic-hyperinsulinemic clamp were markedly decreased in the STZ diabetic rats. Similarly, insulin-mediated suppression of EGP and plasma FFA concentration was also impaired in these animals. GUI, a measure of 2-deoxyglucose (2-DG) uptake, was increased in response to insulin in the order of white gastrocnemus (WG), red gastrocnemus (RG), extensor digitorum longus and soleus muscles. This parallels the percentage of red fibers in these muscles. Diabetes interferes with insulin's ability to increase 2-DG uptake in all of the above muscles with the exception of WG. Nullification of the associated hyperlipidemic and hypercortisolemic states of diabetes with etomoxir (hyperlipidemic) and the glucocorticoid receptor blocker RU-486 (hypercortisolemic) ameliorated the diabetes-related impairment of the in vivo insulin action. Overall these results together with those garnered from the literature support the notion that hypercortisolemia and the enhancement of FFA oxidation are involved, at least in part, in the development of hepatic and skeletal muscle insulin resistance in poorly controlled type I diabetes.

Animals↗
PubMed2004

Alpha-lipoic acid mitigates insulin resistance in Goto-Kakizaki rats.

Impaired glucose uptake and metabolism by peripheral tissues is a common feature in both type I and type II diabetes mellitus. This phenomenon was examined in the context of oxidative stress and the early events within the insulin signalling pathway using soleus muscles derived from non-obese, insulin-resistant type II diabetic Goto-Kakizaki (GK) rats, a well-known genetic rat model for human type II diabetes. Insulin-stimulated glucose transport was impaired in soleus muscle from GK rats. Oxidative and non-oxidative glucose disposal pathways represented by glucose oxidation and glycogen synthesis in soleus muscles of GK rats appear to be resistant to the action of insulin when compared to their corresponding control values. These diabetes-related abnormalities in glucose disposal were associated with a marked diminution in the insulin-mediated enhancement of protein kinase B (Akt/PKB) and insulin receptor substrate-1 (IRS-1)-associated phosphatidylinostol 3-kinase (PI 3-kinase) activities; these two kinases are key elements in the insulin signalling pathway. Moreover, heightened state of oxidative stress, as indicated by protein bound carbonyl content, was evident in soleus muscle of GK diabetic rats. Chronic administration of the hydrophobic/hydrophilic antioxidant alpha -lipoic-acid (ALA, 100 mg/kg, i.p.) partly ameliorated the diabetes-related deficit in glucose metabolism, protein oxidation as well as the activation by insulin of the various steps of the insulin signalling pathway, including the enzymes Akt/PKB and PI-3 kinase. Overall, the current investigation illuminates the concept that oxidative stress may indeed be involved in the pathogenesis of certain types of insulin resistance. It also harmonizes with the notion of including potent antioxidants such as ALA in the armamentarium of antidiabetic therapy.

Animals↗
PubMed2006

Mitigation of CO2 emissions from the EU-15 building stock: beyond the EU Directive on the Energy Performance of Buildings.

UNLABELLED: GOAL SCOPE AND BACKGROUND: The European Directive on Energy Performance of Buildings which came into force 16 December 2002 will be implemented in the legislation of Member States by 4 January 2006. In addition to the aim of improving the overall energy efficiency of new buildings, large existing buildings will become a target for improvement, as soon as they undergo significant renovation. The building sector is responsible for about 40% of Europe's total end energy consumption and hence this Directive is an important step for the European Union in order that it should reach the level of saving required by the Kyoto Agreement. In this the EU is committed to reduce CO2 emissions relative to the base year of 1990 by 8 per cent, by 2010. But what will be the impact of the new Directive, how large could be the impacts of extending the obligation for energy efficiency retrofitting towards smaller buildings? Can improvement of the insulation offset or reduce the growing energy consumption from the increasing installation of cooling installations? EURIMA, the European Insulation Manufacturers Association and EuroACE, the European Alliance of Companies for Energy Efficiency in Buildings, asked Ecofys to address these questions. METHODS: The effect of the EPB Directive on the emissions associated with the heating energy consumption of the total EU 15 building stock has been examined in a model calculation, using the Built Environment Analysis Model (BEAM), which was developed by Ecofys to investigate energy saving measures in the building stock. The great complexity of the EU-15 building stock had to be simplified by examining five standard buildings with eight insulation standards, which are assigned to building age and renovation status. Furthermore, three climatic regions (cold, moderate, warm) were distinguished for the calculation of the heating energy demand. This gave a basic 210 building types for which the heating energy demand and CO2 emissions from heating were calculated according to the principles of the European Norm EN 832. RESULTS AND DISCUSSION: The model calculations demonstrates that the main contributor to the total heating related CO2 emissions of 725 Mt/a from the EU building stock in 2002 is the residential sector (77%) while the remaining 23% originates from non-residential buildings. In the residential sector, single-family houses represent the largest group responsible for 60% of the total CO2 emissions equivalent to 435 Mt/a. THE TECHNICAL POTENTIAL: If all retrofit measures in the scope of the Directive were realised immediately for the complete residential and non-residential building stock the overall CO2 emission savings would add up to 82 Mt/a. An additional saving potential compared to the Directive of 69 Mt/a would be created if the scope of the Directive was extended to cover retrofit measures in multi-family dwellings (200-1000 m2) and non-residential buildings smaller than 1000 m2 used floor space. In addition including the large group of single-family dwellings would lead to a potential for additional CO2 emission reductions compared to the Directive of 316 Mt/a. TEMPORAL MOBILIZATION OF THE POTENTIAL: Calculations based on the building stock as it develops over time with average retrofit rates demonstrated that regulations introduced following the EPB Directive result in a CO2 emissions decrease of 34 Mt/a by the year 2010 compared to the business as usual scenario. Extending the scope of the EPB Directive to all residential buildings (including single and multi-family dwellings), the CO2 emission savings potential over the 'business as usual' scenario could be doubled to 69 Mt/a in the year 2010. This creates an additional saving potential compared to the Directive of 36 Mt/a. COOLING DEMAND: The analysis demonstrated that in warm climatic zones the cooling demand can be reduced drastically by a combination of lowering the internal heat loads and by improved insulation. With the reduction of the heat loads to a moderate level the cooling demand, e.g. of a terraced house located in Madrid, can be reduced by an additional 85% if the insulation level is improved appropriately. CONCLUSIONS: This study demonstrates that the European Directive on Energy Performance of Buildings will have a significant impact on the CO2 emissions of the European building stock. The main saving potential lies in insulation of the existing building stock. Beyond this, CO2 emissions could, however, be greatly reduced if the scope of the Directive were to be extended to include retrofit of smaller buildings. RECOMMENDATION AND PERSPECTIVE: The reductions should be seen in relation to the remaining gap of 190 Mt CO2 eq. per annum between the current emission levels of EU-15 and the target under the Kyoto-Protocol for the year 2010. The energy and industrial sector will probably contribute only a fraction of this reduction via the newly established EU emissions trading scheme and connected projects under the flexible mechanism. In addition, the traffic sector is likely to continue its growth path leading to a widening of the gap. Thus, there is likely to be considerable pressure on the EU building sector to contribute to the EU climate targets beyond what will be achieved by means of the current EPB Directive. Legislators on the EU and national level are therefore advised to take accelerated actions to tap the very significant emission reduction potentials available in the EU building stock.

Air Pollutants↗
PubMed2004

Minocycline inhibits contusion-triggered mitochondrial cytochrome c release and mitigates functional deficits after spinal cord injury.

We investigated whether permeability transition-mediated release of mitochondrial cytochrome c is a potential therapeutic target for treating acute spinal cord injury (SCI). Based on previous reports, minocycline, a second-generation tetracycline, exerts neuroprotection partially by inhibiting mitochondrial cytochrome c release and reactive microgliosis. We first evaluated cytochrome c release at the injury epicenter after a T10 contusive SCI in rats. Cytochrome c release peaked at approximately 4-8 h postinjury. A dose-response study generated a safe pharmacological regimen that enabled i.p. minocycline to significantly lower cytosolic cytochrome c at the epicenter 4 h after SCI. In the long-term study, i.p. minocycline (90 mg/kg administered 1 h after SCI followed by 45 mg/kg administered every 12 h for 5 days) markedly enhanced long-term hind limb locomotion relative to that of controls. Coordinated motor function and hind limb reflex recoveries also were improved significantly. Histopathology suggested that minocycline treatment alleviated later-phase tissue loss, with significant sparing of white matter and ventral horn motoneurons at levels adjacent to the epicenter. Furthermore, glial fibrillary acidic protein and 2',3' cyclic nucleotide 3' phosphodiesterase immunocytochemistry showed an evident reduction in astrogliosis and enhanced survival of oligodendrocytes. Therefore, release of mitochondrial cytochrome c is an important secondary injury mechanism in SCI. Drugs with multifaceted effects in antagonizing this process and microgliosis may protect a proportion of spinal cord tissue that is clinically significant for functional recovery. Minocycline, with its proven clinical safety, capability to cross the blood-brain barrier, and demonstrated efficacy during a clinically relevant therapeutic window, may become an effective therapy for acute SCI.

Animals↗
PubMed2005

Clioquinol down-regulates mutant huntingtin expression in vitro and mitigates pathology in a Huntington's disease mouse model.

In investigating the role of metal ions in the pathogenesis of Huntington's disease, we examined the effects of clioquinol, a metal-binding compound currently in clinical trials for Alzheimer's disease treatment, on mutant huntingtin-expressing cells. We found that PC12 cells expressing polyglutamine-expanded huntingtin exon 1 accumulated less mutant protein and showed decreased cell death when treated with clioquinol. This effect was polyglutamine-length-specific and did not alter mRNA levels or protein degradation rates. Clioquinol treatment of transgenic Huntington's mice (R6/2) improved behavioral and pathologic phenotypes, including decreased huntingtin aggregate accumulation, decreased striatal atrophy, improved rotarod performance, reduction of weight loss, normalization of blood glucose and insulin levels, and extension of lifespan. Our results suggest that clioquinol is a candidate therapy for Huntington's disease and other polyglutamine-expansion diseases.

Animals↗
PubMed2006

Mitigation strategies for pandemic influenza in the United States.

Recent human deaths due to infection by highly pathogenic (H5N1) avian influenza A virus have raised the specter of a devastating pandemic like that of 1917-1918, should this avian virus evolve to become readily transmissible among humans. We introduce and use a large-scale stochastic simulation model to investigate the spread of a pandemic strain of influenza virus through the U.S. population of 281 million individuals for R(0) (the basic reproductive number) from 1.6 to 2.4. We model the impact that a variety of levels and combinations of influenza antiviral agents, vaccines, and modified social mobility (including school closure and travel restrictions) have on the timing and magnitude of this spread. Our simulations demonstrate that, in a highly mobile population, restricting travel after an outbreak is detected is likely to delay slightly the time course of the outbreak without impacting the eventual number ill. For R(0) < 1.9, our model suggests that the rapid production and distribution of vaccines, even if poorly matched to circulating strains, could significantly slow disease spread and limit the number ill to <10% of the population, particularly if children are preferentially vaccinated. Alternatively, the aggressive deployment of several million courses of influenza antiviral agents in a targeted prophylaxis strategy may contain a nascent outbreak with low R(0), provided adequate contact tracing and distribution capacities exist. For higher R(0), we predict that multiple strategies in combination (involving both social and medical interventions) will be required to achieve similar limits on illness rates.

Computer Simulation↗
PubMed1989

Chimeric cytotoxin IL2-PE40 delays and mitigates adjuvant-induced arthritis in rats.

Adjuvant arthritis in rats is a T-cell dependent "autoimmune" disease with close similarities to several forms of human arthritis. Injection of mycobacterial adjuvant leads to T-cell activation and proliferation, processes in which the de novo expression of the interleukin 2 (IL-2) receptor plays a pivotal role. The subsequent massive mononuclear cell infiltration of the joints ultimately results in complete joint destruction. Because activation of the helper/inducer subset of T lymphocytes is critical to the establishment of disease, we reasoned that IL2-PE40, a cytotoxic IL-2-Pseudomonas exotoxin fusion protein that targets the membrane-penetration and ADP-ribosylation domains of the toxin to cells bearing the IL-2 receptor, would be an effective and specific therapy. Adjuvant-injected rats were randomized to treatment with IL2-PE40, phosphate-buffered saline, or either of two control proteins related to IL2-PE40 but lacking either the receptor-binding moiety or an enzymatically active toxin domain and previously demonstrated to lack cytotoxicity in vitro. Intraperitoneal IL2-PE40 given before the establishment of overt clinical disease proved an effective and specific modifier of adjuvant arthritis by clinical, histological, and radiographic criteria. Our data suggest that IL2-PE40 may be effective in those diseases in which activated T-cells play an important role.

ADP Ribose Transferases↗
PubMed2002

Impaired trafficking of connexins in androgen-independent human prostate cancer cell lines and its mitigation by alpha-catenin.

Gap junctions, composed of connexins, provide a pathway of direct intercellular communication for the diffusion of small molecules between cells. Evidence suggests that connexins act as tumor suppressors. We showed previously that expression of connexin-43 and connexin-32 in an indolent prostate cancer cell line, LNCaP, resulted in gap junction formation and growth inhibition. To elucidate the role of connexins in the progression of prostate cancer from a hormone-dependent to -independent state, we introduced connexin-43 and connexin-32 into an invasive, androgen-independent cell line, PC-3. Expression of these proteins in PC-3 cells resulted in intracellular accumulation. Western blot analysis revealed a lack of Triton-insoluble, plaque-assembled connexins. In contrast to LNCaP cells, connexins could not be cell surface-biotinylated and did not reside in the cell surface derived endocytic vesicles, in PC-3 cells, suggesting impaired trafficking to the cell surface. Intracellular accumulation of connexins was observed in several androgen-independent prostate cancer cell lines. Transient expression of alpha-catenin facilitated the trafficking of both connexins to the cell surface and induced gap junction assembly. Our results suggest that impaired trafficking, and not the inability to form gap junctions, is the major cause of communication deficiency in human prostate cancer cell lines.

Biotinylation↗
PubMed2005

Up-regulation of AMP-activated kinase by dysfunctional cystic fibrosis transmembrane conductance regulator in cystic fibrosis airway epithelial cells mitigates excessive inflammation.

AMP-activated kinase (AMPK) is a ubiquitous metabolic sensor that inhibits the cystic fibrosis (CF) transmembrane conductance regulator (CFTR). To determine whether CFTR reciprocally regulates AMPK function in airway epithelia and whether such regulation is involved in lung inflammation, AMPK localization, expression, and activity and cellular metabolic profiles were compared as a function of CFTR status in CF and non-CF primary human bronchial epithelial (HBE) cells. As compared with non-CF HBE cells, CF cells had greater and more diffuse AMPK staining and had greater AMPK activity than their morphologically matched non-CF counterparts. The cellular [AMP]/[ATP] ratio was higher in undifferentiated than in differentiated non-CF cells, which correlated with AMPK activity under these conditions. However, this nucleotide ratio did not predict AMPK activity in differentiating CF cells. Inhibiting channel activity in non-CF cells did not affect AMPK activity or metabolic status, but expressing functional CFTR in CF cells reduced AMPK activity without affecting cellular [AMP]/[ATP]. Therefore, lack of functional CFTR expression and not loss of channel activity in CF cells appears to up-regulate AMPK activity in CF HBE cells, presumably through non-metabolic effects on upstream regulatory pathways. Compared with wild-type CFTR-expressing immortalized CF bronchial epithelial (CFBE) cells, DeltaF508-CFTR-expressing CFBE cells had greater AMPK activity and greater secretion of tumor necrosis factor-alpha and the interleukins IL-6 and IL-8. Further pharmacologic AMPK activation inhibited inflammatory mediator secretion in both wild type- and DeltaF508-expressing cells, suggesting that AMPK activation in CF airway cells is an adaptive response that reduces inflammation. We propose that therapies to activate AMPK in the CF airway may be beneficial in reducing excessive airway inflammation, a major cause of CF morbidity.

AMP-Activated Protein Kinases↗
PubMed1989

Intraventricular infusion of 2-amino-7-phosphonoheptanoate (APH) mitigates ischaemic brain damage.

Intracerebroventricular infusion of the competitive N-methyl-D-aspartate (NMDA) antagonist 2-amino-7-phosphonoheptanoate (APH) was evaluated as a neuroprotective regimen in a rat transient cerebral ischaemia model allowing long-term recovery. Ventricular delivery of APH via an osmotic minipump was chosen to allow continuous and direct access to brain tissue of this polar molecule, and because of the potential applicability of such a regimen in clinical situations where the brain is at risk from cerebral ischaemia and a ventricular catheter is in place. The highest tolerable concentration of APH, 50 mM, was given at 1 microliter/h. Selective neuronal necrosis was significantly reduced in the cerebral cortex and the incidence of infarction in the substantia nigra pars reticulata (SNPR) was decreased. A borderline protective effect was seen in the hippocampal CA1 pyramidal neurons, and no significant protection was seen in the caudate nucleus. The results suggest a limited usefulness for APH as a cerebral protective agent.

2-Amino-5-phosphonovalerate↗
PubMedDate not supplied

Preparation of double-encapsulated microcapsules for mitigating drug loss and extending release.

The double-encapsulated microcapsules were prepared by the non-solvent addition, phase-separation method to form core material and, encapsulated with the O/W emulsion non-solvent addition method to increase drug loading and regulate drug release rate. The drug used was theophylline, which is water-soluble. Dichloromethane and n-hexane were used as the solvent and non-solvent, respectively. This study investigated how various core material and microcapsule EC/TH ratios affect the drug loss, particle size, surface morphology and release rate. The drug loss of the double-encapsuLated microcapsules was 12.8% less than that of microcapsules prepared by the O/W emulsion non-solvent addition method alone. The particle size of these double-encapsulated microcapsules decreased as the concentration of EC polymer was increased in the second encapsulation process. The roughness of their surface was also in proportion to the concentration of polymer solution used in the second encapsulation process. The dissolution study showed that the T20 of the double-encapsulated microcapsules ranged from 2-35.4 h, while that of the O/W emulsion non-solvent addition method microcapsules was from 2.7-7.7 h. The greater the level of EC in the polymer solution, the slower the release rate of the drug from the microcapsules when the EC was not over the critical amount.

Capsules↗
PubMed1990

Hypothesis: the effect of oral nitrite on blood pressure in the spontaneously hypertensive rat. Does dietary nitrate mitigate hypertension after conversion to nitrite?

Increasing doses of nitrite (3.7-14.8 mg/kg BW) were administered via intragastric intubation to 64 spontaneously hypertensive Sprague-Dawley rats. Systemic blood pressure, measured in conscious animals with the tail cuff method, significantly decreased in a dose-related manner 16 and 32 minutes later, and pulse rate slightly increased. Since orally ingested nitrate may be partially converted to nitrite, it seems worthwhile to study correlations between dietary nitrate and blood pressure in experimental animals and man.

Administration, Oral↗
PubMed2006

Continuing bonds and reconstructing meaning: mitigating complications in bereavement.

Drawing on attachment theory and constructivist conceptualizations of bereavement, the authors assessed the relation between continuing bonds coping and meaning reconstruction following the death of a loved one and complicated grief symptomatology. Five hundred six young adults in the first two years of bereavement from a variety of losses completed the Inventory of Complicated Grief along with measures of the strength of their ongoing attachment to the deceased and their capacity to make sense of the loss, find benefit in the experience, and reconstruct a progressive sense of identity following the death. Several variables concerning the survivor, his or her relationship to the deceased, and the nature of the death functioned as risk factors for heightened distress, but their role was generally moderated by meaning-making, often to the point of non-significance. In contrast, higher levels of benefit-finding and positive identity change were associated with lower levels of bereavement complication. Finally, an interaction emerged between sense-making and ongoing attachment to the deceased, suggesting that strong continuing bonds predicted greater levels of traumatic and especially separation distress, but only when the survivor was unable to make sense of the loss in personal, practical, existential, or spiritual terms.

Adaptation, Psychological↗