Ballroom dancing is more intensive for the female partners due to their unique hold technique

In this study, we tested the hypotheses that, relative to the maximum capacities, ballroom dancing is more intensive for females than males, and that the hold technique (female vs. male) regulates dancing intensity. Ten dance couples were tested in a maximal treadmill test, competition simulation, and stationary dance hold position. Peak heart rate and relative oxygen consumption were measured during the tests, except that oxygen consumption was not measured during competition simulation. Regardless of gender, heart rate increased similarly in the treadmill test and in the competition simulation. In the treadmill test, females achieved an oxygen consumption of 78% of the males (p < 0.05). Compared with males, females achieved 14% higher heart rate (p < 0.05) and similar oxygen consumption during the hold position. Heart rate during competition simulation relative to maximum was greater for females than males. Both heart rate and oxygen consumption measured during the hold, relative to maximum, were greater for females than males. It is concluded that lower class ballroom dancers perform at their vita maxima during competition simulation. Using heart rate as an intensity indicator, ballroom dancing is more intensive for females because of their unique hold technique.

[Pain measurement in cognitively impaired patients with the Doloshort scale]

BACKGROUND

Until recently the measurement of pain in cognitively impaired patients represented a neglected field in the diagnostics and treatment of pain. Investigations indicate a prevalence of pain in nursing home residents of between 45 % and 80 %.

MATERIAL AND METHODS

This study investigated the reliability of the German translation of the Doloshort scale and compared it with the visual analog scale (VS). The aim of this study was to determine the practical applicability of this scale in the clinical routine and to calculate the intrarater reliability (retest) and interrater reliability.

RESULTS

The interrater and intrarater reliability of the Doloshort scale was between 0.949 and 0.970. There was a highly significant correlation between the values of the Doloshort scale and the VAS.

CONCLUSION

The Doloshort scale is a well suited measurement instrument for the evaluation of pain in cognitively impaired patients. Because of the short form only simple instructions are necessary and it has a high acceptance with users.

[Adaptation to intermittent hypoxia-hyperoxia improves cognitive performance and exercise tolerance in elderly]

For improvements in exercise tolerance and cognitive function in geriatric patients Multimodal training programs (MTP) are used as combination of physiotherapy, occupational therapy and cardiovascular training. Intermittent Hypoxic-Hyperoxic Training (IHHT), a modified type of intermittent hypoxic training (IHT) is proposed to be included in MTP to elicit more pronounced beneficial effects in exercise tolerance and cognitive functions of geriatric patients likely by an additional pathway than a single MTP. Thirty four patients of the Geriatric Day Clinic aged between 64 and 92 years participated in the placebo controlled clinical trial. They were randomly assigned to receive MTP plus IHHT (experimental group - EG) or MTP plus placebo-breathing through a machine face mask (control group - CG) in a double blind fashion. Before and after the interventions course cognitive performance was assessed by the Dementia-Detection-Test (DemTect) and the Clock-Drawing-Test (CDT), and functional exercise capacity - by the total distance of 6-Minute-Walk-Test (6MWT). After IHHT combined with MTP cognitive performance (DemTect) increased significantly when compared to NG (+16,7 % vs. +0,39 %, p<0,001). The CDT indicated similar results with a significant increase in the EG while the score of the CG even decreased (+10,7 % vs. -8%, p=0,031). Concerning the functional exercise capacity, both groups improved the total distance in the 6MWT but with a significantly larger increase in the EG compared to the CG (+24,1 % vs. +10,8 %, p=0,021). In addition, there was a significant relationship between the changes of the 6MWT and the DemTect Scores and the CDT. IHHT contributed significantly to improvements in cognitive performance and exercise capacity in elderly performing MTP. IHHT sessions are considered to be easily applicable to and well tolerated by geriatric patients up to 92 years.

[Opioid therapy in Austria: results and analysis of a survey]

INTRODUCTION

Many causes are given as the main reason for inadequate pain therapy. The objective of our study was to demonstrate the current position of doctors in general practice all over Austria who prescribe prescriptions.

METHODS

A total of 5,359 questionnaires were sent out to general practitioners in all federal states of Austria. These questionnaires contained 21 main questions on subjects relevant to pain therapy.

RESULTS

On average, 16% of all general practitioners returned the questionnaires; 89.3% of these are acquainted with the WHO graduated scale, 87% have prescribed strong opioids. Old prejudices such as concerns about the side effects are hardly to be found now. Modern therapy strategies are used.

CONCLUSION

Based on the data at hand, pain therapy for patients should be excellent. The reality, however, is somewhat different. The large number of doctors who did not reply makes it enormously difficult to make a statement about the position of pain therapy in Austria.

Interferon-gamma in the treatment of systemic sclerosis: a randomized controlled multicentre trial

We report the results of a randomized controlled multicentre study on interferon-gamma (IFN-gamma) treatment of systemic sclerosis as determined by skin sclerosis, renal and other organ involvement, global assessment, subjective symptoms and quality of life. Forty-four patients were enrolled into the trial, 27 in the treatment group and 17 in the control group. All patients presented with type I or type II scleroderma. Twenty-nine patients (64%) finished the study. The mean duration of Raynaud's phenomenon and skin sclerosis was 15.3 and 10.8 years, respectively. The skin scores tended to improve in the treatment group (P > 0.05). Mouth aperture increased significantly from 38.5 to 47.7 mm in the treatment group (P < 0.001). Subanalysis of IFN-gamma treated patients with normalized skin sclerosis scores >/=1 showed significant improvement in both skin involvement and subjective symptoms (P < 0.05). Organ involvement improved in eight of 18 treatment patients and in three of 11 control patients. It worsened in three of 18 treatment patients and in four of 11 control patients. One control patient died due to cardiorespiratory failure during the study. No deterioration of renal function occurred during IFN-gamma treatment. There was a significant improvement in quality of life parameters in the control group but not in the treatment group. Plasma levels of neopterin increased significantly during IFN-gamma treatment but not in the control group, whereas N-terminal procollagen III peptide levels did not change in either group. There was a high frequency of mild to moderate influenza-like adverse events during IFN-gamma treatment. Only four of nine drop-out patients, however, experienced symptoms most probably associated with IFN-gamma treatment. We conclude that IFN-gamma therapy has mild beneficial effects on skin sclerosis and disease-associated symptoms in type I and II scleroderma. IFN-gamma treatment was associated with acceptable tolerability and did not induce major renal dysfunction in our patients.

Influence of various heparin preparations on lipoproteins in hemodialysis patients: a multicentre study

Recent studies have indicated controversial effects of low molecular weight heparin (LMWH) on lipid metabolism in patients on chronic hemodialysis as compared to unfractionated heparin (UFH). We therefore conducted a cross-sectional multicentre study comparing 153 patients treated with LMWH and 153 patients with UFH, matched for sex, age and diabetes mellitus. Both groups have been treated with LMWH or UFH for six months or longer (14.9 vs. 23.4 months). We observed no differences between the UFH and LMWH treatment groups for total cholesterol, LDL cholesterol, triglycerides, apoB, apoA-IV or Lp(a). The only significant differences were seen for HDL cholesterol and the corresponding apolipoprotein apoA-I, which were significantly higher in the UFH group (HDL cholesterol: 0.97 +/- 0.35 mM/l vs. 0.87 +/- 0.37 mM/l, p < 0.05; apoA-I 1.23 +/- 0.27 g/l vs. 1.15 +/- 0.27 g/l, p < 0.05). We conclude that the results of studies investigating the influence of LMWH on lipid metabolism are as heterogeneous as the substances themselves. This challenges the beneficial influence supposedly had by LMWH preparations on lipid metabolism.

Multicenter study of lipoprotein(a) and apolipoprotein(a) phenotypes in patients with end-stage renal disease treated by hemodialysis or continuous ambulatory peritoneal dialysis

Numerous studies have investigated lipoprotein(a) (Lp(a)) plasma concentrations in patients with ESRD, a patient group with an enormous risk for atherosclerosis. The reported differences in Lp(a) between controls and patients vary from a decrease of 49% to an increase of more than 1,000%. However, data are not consistent, mostly because of problems with statistical analysis, and only limited data are available for patients treated by continuous ambulatory peritoneal dialysis (CAPD). To estimate the significance of Lp(a) in ESRD and to demonstrate the statistical pitfalls concerning Lp(a) in case-control studies, a large multicenter study including 702 patients treated by either hemodialysis (HD) (N = 534) or CAPD (N = 168) was conducted, and results were compared with results from 256 healthy controls. Both patient groups showed significantly elevated Lp(a) levels in comparison with controls: 23.4 +/- 25.0 mg/dL (P < 0.005; HD) and 34.6 +/- 38.4 mg/dL (P < 0.0001; CAPD) versus 18.4 +/- 22.8 mg/dL (controls). CAPD patients showed significantly higher Lp(a) values than did patients treated by HD (P < 0.001). The difference between the two treatment groups possibly reflects an overproduction of Lp(a) to compensate for protein losses in CAPD patients. Both treatment groups included significantly more patients with Lp(a) values greater than the 75th percentile (25.6 mg/dL) of the control group (33.9 and 41.7% for HD and CAPD, respectively; P < 0.005). The higher Lp(a) values in patients were not explained by differences in isoform frequencies and the increase in Lp(a) was apolipoprotein(a) type specific: only patients with high-molecular-weight apolipoprotein(a) isoforms showed a significant elevation in Lp(a) levels. The increased plasma concentrations of Lp(a) may contribute to the high risk for atherosclerosis in ESRD, especially in patients treated by CAPD. Finally, it is believed that small sample sizes are responsible for the diverging results in Lp(a) literature.

Permeability changes at blood-retinal barrier in diabetes and effect of aldose reductase inhibition

Sensitive quantitative in vivo techniques were used to assess the permeability at the blood-retinal barrier (BRB) to [14C]sucrose in the anesthetized streptozocin-diabetic rat at various time points (3 wk, 6 mo, 13 mo) after induction of diabetes. The effects of concomitant administration of an aldose reductase inhibitor (ARI) on sorbitol levels in the retina and on BRB permeability were also measured. No increase in BRB permeability was found in rats diabetic for 3 wk or 6 mo, but after 13 mo of hyperglycemia there was an increase in permeability of 240%. No effect on permeability was seen in diabetic animals given the ARI despite the retinal sorbitol levels being decreased in the treated compared with the untreated diabetic group fed a normal diet. This study suggests that the accumulation of sorbitol within the cells of the BRB is not responsible for the breakdown of BRB permeability seen after 7-13 mo of hyperglycemia and that the enzyme aldose reductase is not involved in its pathogenesis.

Beta-2-microglobulin for differentiation between ciclosporin A nephrotoxicity and graft rejection in renal transplant recipients

The clinical relevance of daily measurement of beta 2-microglobulin in serum and urine was evaluated in 49 patients undergoing renal transplantation. The changes in beta 2-microglobulin levels were compared to standard parameters for assessment of renal function. One hundred episodes of acute deterioration of renal function, clinically diagnosed as rejection, were analyzed retrospectively: (1) In 18 episodes renal malfunction did not respond to methylprednisone but improved immediately upon dose reduction of ciclosporin A, thus indicating a nephrotoxic effect of the drug. In these cases a mean increase of beta 2-microglobulin in urine as high as 7.9 mg/l was observed while serum values decreased. (2) Fifty episodes of apparent rejection (responsive to steroids) were preceded by a 3-day lasting continuous rise of beta 2-microglobulin in serum of up to 3.6 mg/l as a mean with only a moderate elevation in urine. (3) In 13 episodes antirejection treatment could have been avoided as continuously declining laboratory parameters indicated spontaneous improvement of renal function. We conclude that parallel determination of beta 2-microglobulin in serum and urine allows to differentiate between ciclosporin A nephrotoxicity and rejection in 91% of the cases.

[Mechanism of action of interferon-alpha 2 in hairy cells and lymphoblastoid cell lines: the significance of type I interferon receptors and RNA synthesis]

Lymphoblastoid cells were subjected to Western Blot analysis for detection of Interferon-alpha-binding proteins. JOK-1 cells--a human hairy cell leukemia line--revealed three proteins with apparent molecular weights of 120, 100 and 32 kD, respectively. Down-regulation of the receptor was observed. A differential binding pattern of two proteins (100 and 85 kD) was observed in T-CLL, whereas no signal detection was achieved in B-CLL. Mononuclear cells from 6 patients with hairy cell leukemia and 6 patients with CLL were found to differ significantly in terms of nucleic acid precursor incorporation.