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At least 163 records · Page 9Linked to original sources
PubMed2002

Femur bone mineral density is independently associated with functional recovery after hip fracture in elderly women.

OBJECTIVE: To evaluate the association between femur bone mineral density (BMD) and functional recovery after hip fracture. DESIGN: Cross-sectional study. SETTING: Rehabilitation hospital in Italy. PARTICIPANTS: A total of 233 of 263 white women with hip fracture consecutively admitted to a rehabilitation hospital. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients underwent BMD assessment by dual-energy x-ray absorptiometry (DXA) at the proximal femur (5 sites) on admission. Functional recovery was evaluated by using Barthel Index scores. RESULTS: A positive correlation was found between BMD and Barthel Index scores assessed on both admission and discharge (r range,.16-.24, depending on the site of BMD measurement). Linear multiple regression showed that the association between BMD and Barthel Index score was independent of 10 confounding variables: age, body mass index, fracture type, pressure ulcers, cognitive impairment, neurologic diseases, total lymphocyte count as a nutritional index, time between fracture occurrence and DXA assessment, comorbidity, and surgical procedure. Conversely, no significant associations were found between BMD and the change in Barthel Index score attributable to rehabilitation. CONCLUSIONS: In the study population, femur BMD was an independent predictor of the functional recovery assessed by Barthel Index score after hip fracture, but not of the change in the functional score resulting from rehabilitation.

Absorptiometry, Photon↗
PubMed2000

Simultaneous avulsion fracture of the insertion of the ulnar and radial collateral ligaments of the metacarpophalangeal joint of the thumb.

We present a case of simultaneous avulsion fracture of the insertion on the volar base of the proximal phalanx of the ulnar and radial collateral ligaments of the metacarpophalangeal joint of the thumb. To our knowledge this combination has never been published before. The mechanism of this injury is not clearly understood. (c) 2000 Harcourt Publishers Ltd Copyright 2000 The British Association of Plastic Surgeons DOI: 10.1054/bjps.1999.3227.

Journal Article↗
PubMed2002

[Digital nerve block anaesthesia: historical development and two cases of finger-tip necrosis, a rare complication].

Two cases of finger-tip necrosis following digital blocks are presented. These are rare complications of this technique. Pathogenesis and treatment options are discussed and the literature reviewed. Circulatory problems can be avoided by using adrenalin free anaesthetics, infiltrating at the metacarpal level with small volumes, and using upper-arm tourniquets instead of rubber bands at the phalangeal level.

Adult↗
PubMed2004

Collective dynamics in molten potassium: an inelastic x-ray scattering study.

The high-frequency collective dynamics of molten potassium has been investigated by inelastic x-ray scattering, disclosing an energy/momentum transfer region unreachable by previous inelastic neutron scattering (INS) experiments. We find that a two-step relaxation scenario, similar to that found in other liquid metals, applies to liquid potassium. In particular, we show how the sound velocity determined by INS experiments, exceeding the hydrodynamic value by approximately 30%, is the higher limit of a speedup, located in the momentum region 1 < Q < 3 nm(-1), which marks the departure from the isothermal value. We point out how this phenomenology is the consequence of a microscopic relaxation process that, in turn, can be traced back to the presence of "instantaneous" disorder, rather than to the crossover from a liquid to solidlike response.

Journal Article↗
PubMed2003

Functional recovery after concomitant fractures of both hip and upper limb in elderly people.

OBJECTIVE: To investigate functional recovery after concomitant fractures of both hip and upper limb in elderly people. DESIGN: Survey study. SETTING: Rehabilitation hospital in Italy. PARTICIPANTS: 586 consecutive in-patients with hip fracture. MAIN OUTCOME MEASURES: Functional recovery was evaluated by using Barthel index score. RESULTS: 4.1% of patients (i.e. 24/586) suffered from a concomitant fracture of an upper limb, involving proximal humerus (n = 8) or distal radius (n = 16). After adjustment for 9 prognostic factors, a significant reduction in the Barthel index score on admission but not on discharge was found in the patients with an upper limb fracture. The length of stay was not significantly associated with the presence of the concomitant upper limb fracture. CONCLUSIONS: In a sample of hip-fractured patients, neither the functional recovery at the end of a course of rehabilitation nor the length of stay were influenced by the presence of a concomitant fracture involving an upper limb.

Aged↗
PubMed2002

Functional recovery and length of stay after recurrent hip fracture.

OBJECTIVE: To evaluate the functional recovery and the rehabilitation length of stay after the sequential fracture of both hips in elderly patients. DESIGN: A total of 372 in-patients with hip fractures consecutively admitted to our rehabilitation hospital were included in this retrospective study. A total of 333 out of 372 were admitted for rehabilitation of their first hip fracture, and the other 39 patients had a second contralateral fracture. The functional recovery was evaluated by the Barthel index. The comparison between the two groups was performed by unpaired t test. Stepwise linear multiple regression analysis was performed, including nine prognostic factors together with the number of hip fractures (first or recurrent) as independent variables and the Barthel index score on discharge as the dependent variable. The statistical analysis was repeated, substituting hospital length of stay for Barthel index. RESULTS: Both the functional recovery and the length of stay of the patients affected by recurrent fracture were similar to the ones of the patients suffering from a single fracture. Regression analysis showed that the previous hip fracture was associated neither with the Barthel index nor with the length of stay. CONCLUSIONS: Our data suggest that the functional recovery in elderly patients with hip fractures is not significantly influenced by a previous fracture of the contralateral hip and that no significant prolonged rehabilitation length of stay is needed after the recurrent fracture.

Age Factors↗
PubMed2003

Functional recovery and length of stay after hip fracture in patients with neurologic impairment.

OBJECTIVE: To evaluate the functional recovery and the length of stay after hip fracture in patients with neurologic impairment. DESIGN: A total of 577 inpatients with hip fracture consecutively admitted to our rehabilitation hospital were included in this retrospective study. A total of 71 of 577 were affected by neurologic impairment caused by stroke with hemiplegia (n = 37), Parkinson's disease (n = 25), or other diseases (n = 9). RESULTS: Mean Barthel index was significantly lower in the patients with neurologic impairment than in the controls: 10.8 (95% confidence interval, 5.9-15.6; P < 0.001) at admission and 13.1 (95% confidence interval, 5.55-20.65; P < 0.001) at discharge. Multiple regression including eight confounding variables showed that neurologic impairment was negatively associated with the Barthel index. However, the mean increase in Barthel index through the course of rehabilitation was not affected by neurologic impairment. The length of stay was significantly higher in the patients with neurologic impairment, 3.84 days (95% confidence interval, 0.51-7.17; P < 0.05), and multiple regression showed that neurologic impairment was positively associated with the length of stay. CONCLUSIONS: After hip fracture, the presence of neurologic impairment was associated with lower Barthel index and longer length of stay, but it did not affect the increase in Barthel index due to a course of rehabilitation.

Activities of Daily Living↗
PubMed2004

Functional recovery and length of stay after hip fracture in patients taking corticosteroids.

OBJECTIVE: To evaluate the functional recovery and the length of stay after hip fracture in patients receiving corticosteroids. DESIGN: A total of 796 inpatients with hip fracture consecutively admitted to our rehabilitation hospital were included in this retrospective study. A total of 36 of 796 were currently treated with either oral (n = 23) or inhaled (n = 13) corticosteroids. RESULTS: No significant differences were shown between corticosteroid users and controls for Barthel index score at admission or discharge, change in Barthel index score resulting from rehabilitation, and length of stay. Multiple regression, including 11 confounding variables, showed that several factors, but not the treatment with corticosteroids, were significantly associated with the Barthel index score or the length of stay. The results were similar when the two subgroups of patients receiving corticosteroids were evaluated separately. In the subgroup of the patients receiving oral corticosteroids, no meaningful correlations were observed between the daily dose (milligrams of prednisone equivalent) and the Barthel index score, the change in the Barthel index score attributable to rehabilitation, or the length of stay. CONCLUSIONS: After hip fracture, neither the functional recovery nor the length of stay were significantly affected by the current treatment with corticosteroids.

Aged↗
PubMed2006

Muscle mass and functional recovery in women with hip fracture.

OBJECTIVE: To investigate the association between muscle mass and functional recovery in women with hip fracture. DESIGN: A total of 200 of 230 women with hip fracture admitted consecutively to a rehabilitation hospital were investigated in this survey study. Lean mass (LM) was assessed by dual-energy x-ray absorptiometry, 23.1 +/- 7.9 (mean +/- SD) days after fracture occurrence. Appendicular LM (aLM) was calculated as the sum of LM in arms and legs. Because metal implants (prostheses and nails) affect the regional assessment of body composition, aLM was corrected by substituting LM in the unfractured leg for LM in the fractured leg: corrected aLM = (LM in unfractured leg x 2) + LM in arms. We used two approaches to adjust corrected aLM for body size: corrected aLM divided by height squared (aLM/ht), and corrected aLM adjusted for height and fat mass (residuals). Functional recovery was assessed by using Barthel index scores. RESULTS: After adjustment for body size, corrected aLM was neither significantly correlated with Barthel index scores nor with the change in Barthel index scores after rehabilitation. Also, after stratification for quintiles of aLM/ht and residuals, no significant differences in functional recovery were found among the five groups. CONCLUSIONS: LM assessed after hip fracture is not associated with functional outcome in women.

Absorptiometry, Photon↗
PubMed2006

Density of vibrational states of a hyperquenched glass.

The vibrational density of states of a hyperquenched and an annealed glass has been measured using nuclear inelastic scattering. The hyperquenched sample shows a higher number of vibrational states in the low-energy region with respect to the annealed glass. It reveals, however, lower density and sound velocity and, therefore, smaller Debye energy. After rescaling the energy axes in Debye energy units and area renormalization, the density of states of both samples becomes identical. Thus, the effect of quenching is described by the transformation of the continuous medium.

Journal Article↗
PubMed2006

Effect of densification on the density of vibrational states of glasses.

We studied the effect of densification on the vibrational dynamics of a Na(2)FeSi(3)O(8) glass. The density of vibrational states (DOS) has been measured using nuclear inelastic scattering. The corresponding changes in the microscopic, intermediate-range, and macroscopic properties have also been investigated. The results reveal that, in the absence of local structure transformations, the Debye level and the glass-specific excess of vibrational states above it have the same dependence on density, and the evolution of the DOS is fully described by the transformation of the elastic medium.

Journal Article↗
PubMedDate not supplied

Positive association between total lymphocyte count and femur bone mineral density in hip-fractured women.

BACKGROUND: Protein depletion appears to play a detrimental role in the causes of hip fracture and low bone mineral density has been observed in protein-depleted subjects. OBJECTIVE: To investigate the association between femur bone mineral density and total lymphocyte count, a marker of the protein nutrition status, in elderly hip-fractured women. METHODS: 210 white women affected by their first hip fracture either spontaneous or due to minimal trauma consecutively admitted to a rehabilitation hospital were studied. 34 women were ruled out because of confounding factors altering their lymphocyte count. Both total lymphocyte count and bone mineral density at the unfractured femur were evaluated. The correlation between these two variables was studied by Pearson's coefficient. Bonferroni adjustment was used for multiple comparisons. Bone density was measured by DXA (Hologic QDR 4500W). RESULTS: A positive correlation was observed between lymphocyte count and bone mineral density measured at both total proximal femur (r = 0.21; p < 0.05) and intertrochanteric area (r = 0.21; p < 0.05). Stepwise linear multiple regression analysis showed that the association with total lymphocyte count was independent of age, weight, height, body mass index, time between surgery and blood sample collection for lymphocyte count and type of hip fracture (cervical or trochanteric) when bone mineral density was evaluated both at total proximal femur (p < 0.05) and intertrochanteric area (p < 0.05). CONCLUSION: Our results support the role exerted by protein nutrition in bone health, at least in elderly frail women. From this point of view, a total lymphocyte count is a suitable, inexpensive marker.

Aged↗
PubMedDate not supplied

Biochemical markers of nutrition and bone mineral density in the elderly.

BACKGROUND: Protein depletion is detrimental in bone health, but the association between bone mineral density (BMD) and serum albumin is controversial. We recently showed a positive association between femur BMD and total lymphocyte count (TLC), a validated marker of protein nutrition status, in hip-fractured women. OBJECTIVE: To investigate the association between femur BMD and both serum albumin and TLC in hip-fractured men and women. METHODS: 286 of 315 hip-fractured patients (243 women and 43 men) consecutively admitted to a rehabilitation hospital were studied. BMD was measured by DXA in the unfractured femur. The correlation between BMD and both TLC and serum albumin was studied by Pearson's coefficient and Bonferroni adjustment. RESULTS: In women a positive correlation was observed between, TLC but not albumin, and BMD measured in the total femur (r = 0.26; p < 0.01), femur neck (r = 0.21, p < 0.01), trochanter (r = 0.22, p < 0.01), intertrochanteric area (r = 0.25, p < 0.01) and Ward's triangle (r = 0.17, p < 0.05). Conversely in men a positive correlation was found between albumin, but not TLC, and BMD measured in the total femur (r = 0.50, p < 0.01), femur neck (r = 0.52, p < 0.01), intertrochanteric area (r = 0.52, p < 0.01) and Ward's triangle (r = 0.49, p < 0.01). Linear multiple regression showed that the associations were independent of age, weight, height, body mass index, erythrocyte sedimentation rate, time between surgery and blood sample collection and type of hip fracture. CONCLUSION: Our results support the role of protein nutrition in bone health, at least in elderly frail patients. TLC and serum albumin were suitable markers, however sex-related differences in their usefulness were observed.

Aged↗
PubMed1975

Thyroglobulin biosynthesis in "cold" and "hot" nodules in the human thyroid gland.

Studies on "cold" and "hot" nodules from human thyroid gland have been carried out to investigate thyroglobulin biosynthesis and to correlate carbohydrates incorporation and thyroid hormone formation in thyroglobulin. The aim of the investigation was to ascertain the role of carbohydrates of the protein molecule in its migration to the iodinating site of the cell. Thyroid slices from two cases with "cold" and two with "hot" nodules were incubated for 30 to 120 min with [3H]leucine, [3H]carbohydrates (ManNAc, Gal, Man, GlcNAc, GalNAc) and 125I. Soluble and particulate iodoproteins, solubilized by digitonin, were identified by density gradient centrifugation and immunoprecipitation; following hydrolysis carbohydrates and iodothyronines were identified by paper chromatography and chemically determined. While the rate of leucine incorporation into TG increased with time in both "cold" and "hot" nodules, the "cold" nodule, with respect to the "hot" tissue, showed: much lower efficiency incorporating carbohydrates and iodine into TG; lower thyroid/medium ratio of radioiodine; less total soluble protein and soluble TG; more particulate protein and solubilized TG; 1/3 of the carbohydrate and iodine chemical content; only minute amounts of labeled iodothyronines in TG compared to normal levels in "hot" tissue. The formation of thyroid hormone, in enzymatically iodinated TG, and the iodinating activity of the 105,000 X g pellet, incubated with low iodine TG, were similar in both "cold" and "hot" tissues. These results demonstrate that the "cold" nodule is able to synthesize thyroglobulin but the protein is defective in its carbohydrate content. The deficient iodine transport into "cold" tissue and impaired hormonal synthesis are confirmed. The incomplete incorporation of carbohydrates into thyroglobulin in the "cold" nodule could be important for the maturation and migration of the molecule to the iodinating site of the cell

Acetylgalactosamine↗
PubMed2005

Phosphorylated 14-3-3zeta protein in the CSF of neuroleptic-treated patients.

The authors describe 12 neuroleptic-treated patients with dementia of various etiologies who showed CSF elevation of phosphorylated 14-3-3zeta and normal tau protein levels. This contrasted with elevated amounts of 14-3-3 gamma, epsilon, and unphosphorylated zeta coupled to high tau protein levels in Creutzfeldt-Jakob disease and negative 14-3-3 assay in drug-free patients with dementia. Characterization of CSF 14-3-3 isoforms and determination of tau protein level can help to distinguish different etiologies of dementia.

14-3-3 Proteins↗
PubMed2006

Detection of CSF 14-3-3 protein in Guillain-Barré syndrome.

OBJECTIVE: To search for biologic markers in the Guillain-Barré syndrome (GBS), we studied CSF samples from patients with GBS and neuropathy of various etiologies for the presence of 14-3-3 protein. METHODS: CSF samples from patients with GBS, chronic neuropathies, motor neuron disease (MND), definite sporadic Creutzfeldt-Jakob disease (sCJD), and normal control subjects were analyzed by standard immunoblot assay, using a polyclonal anti-14-3-3 antibody. CSF samples were also tested with antibodies recognizing specific isoforms of 14-3-3 proteins, either after one-dimensional or two-dimensional electrophoretic separation. RESULTS: A positive 14-3-3 assay was observed in 29 of 38 patients with GBS and in 4 patients with MND and other neuropathies, including 2 subjects with vasculitic neuropathy (VN). In GBS, 14-3-3 protein was detected as early as 12 to 48 hours after disease onset and showed an isoform pattern different from that encountered in patients with noninflammatory neuropathies, VN, MND, and sCJD. Immunohistochemical studies performed in archival fatal GBS cases disclosed marked 14-3-3 expression by mononuclear inflammatory infiltrates and Schwann cells. CONCLUSION: CSF 14-3-3 assay may represent a useful biologic marker in patients with Guillain-Barré syndrome.

14-3-3 Proteins↗
PubMed2005

[Erectile dysfunction: a marker for myocardial perfusion impairment?].

OBJECTIVE: To study the correlation between erectile dysfunction (ED) and myocardial perfusion impairment in men with suspected or diagnosed coronary artery disease (CAD). METHODS: In this prospective study a self-administered IIEF-5 questionnaire was answered by 287 patients that underwent myocardial perfusion imaging under both resting and stress condition with technetium-99m sestamibi, through gated SPECT nuclear scintigraphy technique, before and after physical or pharmacological stress. RESULTS: Some degree of erectile dysfunction (group ED+) was found in 137 (47.8%) patients and in these, age was significantly higher (60.60+/-9.84 vs 50.67+/-9.94 - p<0.001)) than in those without erectile dysfunction (group ED-). In the ED+ group, it was observed a higher prevalence of hypertension, diabetes, myocardial infarction (MI) and percutaneous coronary angioplasty (PCTA). Regardless of the age factor, ED+ patients also presented higher occurrence of myocardial perfusion impairment (necrosis and/or ischemia) and left ventricular systolic wall motion and thickening abnormalities. CONCLUSION: Patients with ED have higher estimated probability of presenting segmental myocardial perfusion and functional contraction impairment and, therefore, CAD, independent of the aging factor. The authors conclude that ED may be considered not only a marker for CAD but also a condition related to the occurrence of major coronary events such as MI and PCTA.

Adult↗
PubMed2000

[Elective and emergency minimally invasive surgery in pleural diseases].

In the last years the video-assisted thoracic surgery (V.A.T.S.) assumed an important order for the diagnosis and treatment of the pleural disease. In this particular field, the procedure allows obtaining almost the same outcomes of traditional surgery and is very safety. V.A.T.S. reduces hospital time and trauma with a fast return to the working life. The Authors describe their experience and outline the diagnostic and therapeutic indications for the treatment of choice and emergency.

Elective Surgical Procedures↗