[Pain, fear of falling and functional performance in nursing home residents - a cross-sectional study]

Pain and fear of falling (FOF) are modifiable factors that might play an important role in functional performance of nursing homes residents (NHR). Both factors are characterised by deficits in research and provision of long-term care services. The purpose of this study was to examine the functional performance of NHR with and without pain or FOF. Quantitative data were collected on NHR in Berlin and Brandenburg using a cross-sectional design. The cognitive status was assessed using the Minimental state test. Existing pain and FOF were assessed as a question part of interview. Functional performance was examined using the Barthel Index (BI) the Timed «up & go»-Test. Multiple linear regression analyses were performed to investigate the research question and the influence of additional explanatory variables (age, sex, relevant somatic morbidity). 217 NHR without considerable cognitive impairment (MMST >= 20) participated. 65 % of the NHR suffered from pain and 48 % had FOF. There was a statistically significant association between Pain or FOF und lower functional mobility. With respect to NHR able to walk, there was statistically significant association between Pain or FOF und lower performance in activities of daily living. Possibilities for interventions which might have positive effects on functional performance of NHR are an improved pain treatment and interventions to reduce FOF.

Application of the PEDD flow detector for analysis of natural dissolved organic substances in coloured water

The automated techniques of measurement of water parameters are developed based on flow analysis (flow injection analysis, sequential injection analysis). PEDD detectors (paired emitter-detector diode), built with the use of two paired light-emitting diodes (LEDs) - emission and detection, can serve that purpose. The aim of the studies was to optimize the system for determination of the dissolved organic substances in coloured water with the use of PEDDs in the flowing-stream measurement system. The investigations were conducted for a number of concentrations of the humic, fulvic and tannic acids, which were measured as the dissolved organic carbon (DOC). Three arrangements of diodes (PEDD) with a selected emission spectrum and absorption characteristics were used. A two-beam flow cell was designed for the measurements. The signal from the detection diode was recorded and converted into absorbance through software written for that purpose. The results obtained showed a high sensitivity in relation to the concentration as well as the selectivity in the type of substances studied. A miniature and cheap photometric flow analysis set was proposed, adapted to work with one or several light wavelengths and steered by a microprocessor unit.

Antipsychotic drugs predominate in pharmacotherapy of nursing home residents with dementia

INTRODUCTION

The aim of this study was to investigate the frequency of benzodiazepines, antidementia and antipsychotic drug prescriptions in nursing home residents (NHR).Data of a German health insurance company were retrospectively analyzed for the year 2008.

METHODS

The study cohort comprised 13,042 NHR (82% women, mean age 83.6 ± 7 years). Following analgetics, antipsychotic drugs were the second most frequently prescribed drug group with 13.3% of all prescriptions. Dementia was diagnosed in 8 017 (61.5%) NHR. Thereof 51.6% received an antipsychotic, 17.3% a benzodiazepine and 15.2% an antidementia pharmaceutical, respectively. 18.1% of NHR with dementia and antipsychotic drug prescriptions were in combined treatment with antidementia pharmaceuticals. The rate of antipsychotic drug prescribing was significantly doubled in NHR with dementia compared to those without this diagnosis (p<0.01); the most frequently prescribed antipsychotics were melperone, risperidone and pipamperone.

DISCUSSION

This study demonstrates the wide-spread use of psychotropic drugs in NHR. Moreover, dementia in NHR was associated with antipsychotic drug prescribing in every second patient. This highlights the need for further studies analyzing alternative treatments for dementia-related symptoms.

Changes of structural and dynamic properties of model lipid membranes induced by alpha-tocopherol: implication to the membrane stabilization under external electric field

The effects of alpha-tocopherol on electric properties of bilayer lipid membranes were investigated. Planar bilayer membranes formed by the Mueller-Rudin method were used. Voltammetric and chronopotentiometric measurements were performed using a four-electrode potentiostat-galvanostat. It was demonstrated that registration of membrane capacitance, resistance, and voltammetric characteristics provided information about the change in the structure and permeability of bilayer lipid membranes. The results suggested that incorporation of alpha-tocopherol into lipid membrane destabilized its structure and facilitated the electrogeneration of pores. The possible role of observed changes in physiological functions of alpha-tocopherol was discussed.

Chronopotentiometric studies of electroporation of bilayer lipid membranes

The constant-intensity current chronopotentiometric measurements of egg yolk phosphatidylcholine bilayer membranes (BLM) are presented. It is demonstrated that a constant-intensity current flowing through the bilayer membranes generates the pores in their structures. For the current intensity from 0.1 to 2.0 nA, the generated pores open and close cyclically. The frequency of oscillations depends on the current intensity: the higher current intensity, the higher frequency of pore oscillations. It is suggested that the presented method may allow to create one pore in BLM and to observe its dynamical behaviour. Based on chronopotentiometric curves, a method of pore conductance calculations is presented. It is demonstrated that the value of obtained conductance can be applied for pore diameter estimation. The hypothetical application of constant-current method as a biotechnological tool for selective and controlled incorporation of molecules into microorganisms is discussed.

Genetic variation of major histocompatibility complex and microsatellite loci: a comparison in bighorn sheep

Examining and comparing genetic variation for major histocompatibility complex (MHC) and micro-satellite (MS) loci in the same individuals provides an opportunity to understand the forces influencing genetic variation. We examined five MHC and three MS loci in 235 bighorn sheep (Ovis canadensis) from 14 populations and found that both types of loci were highly variable and were in Hardy-Weinberg proportions. Mean FST values for both markers were very similar and MHC and MS genetic variability was predominantly distributed within rather than among populations. However, analyses of genetic distances and tree topologies revealed different spatial patterns of variation for the two types of loci. Collectively, these results indicated that neutral forces substantially influenced MS and MHC variation, and they provided limited evidence for selection acting on the MHC.

Expression of human hepatic glucokinase in transgenic mice liver results in decreased glucose levels and reduced body weight

Glucokinase is the predominant hexokinase in pancreatic beta-cells and liver parenchymal cells and functions as a critical component of the glucose-sensing apparatus in these glucose-responsive cell types. In the beta-cells, the sensing leads to insulin secretion, while the role in hepatocytes is thought to be in hepatic glucose uptake. To determine the physiological response to an increase in hepatic glucokinase expression, transgenic mice expressing the human hepatic glucokinase gene under the control of a liver-specific human apolipoprotein A-I gene enhancer were generated. Transgenic mice had twofold higher total fasting hepatic glucokinase mRNA, which resulted in a modest 20% increase in fasting glucokinase activity. These animals showed lower fasting plasma glucose, insulin, and lactate levels and improved tolerance to glucose. In addition, glucokinase transgenic animals weighed less and had lower BMI than nontransgenic animals. Thus, glucokinase transgenic animals demonstrate that a modest change in hepatic glucokinase activity enhances the metabolism of glucose.

A new system for bilayer lipid membrane capacitance measurements: method, apparatus and applications

A new method and a new apparatus for capacitance measurements on bilayer lipid membranes are described. The membrane is charged and discharged with a constant current during the measurement. The charge-discharge cycle duration, which is proportional to the membrane capacitance, is measured. The measured time period is converted into a binary number by digital systems and then this number is either further converted into a constant capacity-proportional voltage or read out by the computer. The apparatus makes it possible to measure the capacitances of voltage-polarized membranes. Application of the apparatus to capacitance measurements of bilayer lipid membranes during their potential on the capacitance is presented. The capacitances of membranes stimulated by rectangular voltage pulses and of those stimulated by a linearly varying potential were reported.

Abnormal differentiation of human papillomavirus-induced laryngeal papillomas

We studied the proliferation and differentiation of human laryngeal papillomas, which are benign tumors induced by human papillomaviruses. Immunofluorescent stains of tissues for a number of differentiation-specific proteins showed abnormal differentiation. Papilloma tissue fragments in vitro showed a slightly decreased fraction of proliferating cells that incorporated tritiated thymidine and a markedly reduced incorporation of tritiated uridine when compared with normal tissue. We propose that papillomavirus infection results in normal basal cell proliferation but abnormal terminal differentiation and that this abnormality significantly contributes to the hyperplasia of the papillomas.