Predictors for falls among hospital inpatients with impaired mobility.

Gait and balance disturbances have been shown to predispose to falls in hospital. We aimed to investigate the patient characteristics associated with an unsafe gait and to determine what features predispose to falling in this group of hospital inpatients. In a prospective open observational study we studied 825 patients admitted for rehabilitation following acute medical illness or a surgical procedure.

Processing words with emotional connotation: an FMRI study of time course and laterality in rostral frontal and retrosplenial cortices.

Responses of rostral frontal and retrosplenial cortices to the emotional significance of words were measured using functional magnetic resonance imaging (fMRI). Twenty-six strongly right-handed participants engaged in a language task that alternated between silent word generation to categories with positive, negative, or neutral emotional connotation and a baseline task of silent repetition of emotionally neutral words. Activation uniquely associated with word generation to categories with positive or negative versus neutral emotional connotation occurred bilaterally in rostral frontal and retrosplenial cortices.

Do general practitioners believe that their older patients physical symptoms are somatized?

Objective: To establish general practitioner (GP) ratings of the origins of their older patients' physical symptoms, and to test the hypothesis that those older patients rated as somatizing would have similar clinical characteristics to those found in studies of younger attenders.

Methods: A prospective study among older primary care attenders in two UK practices. All were rated for psychiatric disorder, physical illness, frequency of attendance and demographics.

A pneumatic vibrotactile stimulation device for fMRI.

Mapping the functional response of the somatosensory cortex is useful both for characterizing normal brain activity and for determining the functional integrity of damaged cortex compromised by stroke or other neurological insults. A variety of stimulators have been used to produce somatosensory cortex activation in functional brain imaging, including brushes and swabs operated manually, pneumatically and mechanically powered mechanical vibrators, air puffs, and vibrating ceramic piezoelectric wafers and benders. A closed-system, pneumatically driven rubber diaphragm is reported that overcomes many of the limitations of existing vibrotactile devices and produces robust sensory cortex activation in an fMRI experiment.

The effect of changing practice on fall prevention in a rehabilitative hospital: the Hospital Injury Prevention Study.

Objectives: To determine whether a change in practice to introduce a multidisciplinary fall-prevention program can reduce falls and injury in nonacute patients in a rehabilitation hospital.

Design: A quasi-experimental study.

Setting: Three geriatric wards with a similar design, equipment, staffing levels, and skill mix.

Maternally derived humoral immunity to bovine viral diarrhea virus (BVDV) 1a, BVDV1b, BVDV2, bovine herpesvirus-1, parainfluenza-3 virus bovine respiratory syncytial virus, Mannheimia haemolytica and Pasteurella multocida in beef calves, antibody decline by half-life studies and effect on response to vaccination.

The passive immunity transferred to calves from their dams was investigated in a beef herd to determine half-life of antibody, estimated time to seronegative status and effect on immunization. One hundred two beef calves in a commercial ranch under standard management conditions were utilized. Samples were collected at branding (day 0).

Functional magnetic resonance imaging before and after aphasia therapy: shifts in hemodynamic time to peak during an overt language task.

Background And Purpose: Comparing the temporal characteristics of hemodynamic responses in activated cortical regions of aphasic patients before and after therapy would provide insight into the relationship between improved task performance and changes in blood oxygenation level-dependent (BOLD) functional MRI (fMRI) signal. This study investigated differences in the time to peak (TTP) of hemodynamic responses in activated regions of interest (ROIs), before and after therapy, and related them to changes in task performance.

Methods: Three aphasic patients and 3 controls overtly generated a single exemplar in response to a category.

Left and right basal ganglia and frontal activity during language generation: contributions to lexical, semantic, and phonological processes.

fMRI was used to determine the frontal, basal ganglia, and thalamic structures engaged by three facets of language generation: lexical status of generated items, the use of semantic vs. phonological information during language generation, and rate of generation. During fMRI, 21 neurologically normal subjects performed four tasks: generation of nonsense syllables given beginning and ending consonant blends, generation of words given a rhyming word, generation of words given a semantic category at a fast rate (matched to the rate of nonsense syllable generation), and generation of words given a semantic category at a slow rate (matched to the rate of generating of rhyming words).

Smoking in chronic rhinosinusitis: a predictor of poor long-term outcome after endoscopic sinus surgery.

Objective: This study was designed to determine whether smoking patients have poorer outcomes after endoscopic sinus surgery (ESS) based on a reliable validated rhinosinusitis-specific quality-of-life outcomes test.

Study Design: Retrospective chart and computed tomography (CT) review with telephone and letter questionnaire.

Methods: Charts of 230 adult patients undergoing ESS for chronic rhinosinusitis between January 1995 and December 1998 were reviewed.

Is grip strength a useful single marker of frailty?

Background: chronological age is widely used as a marker of frailty in clinical practice. However there can be wide variation in frailty between individuals of a similar age. Grip strength is a powerful predictor of disability, morbidity and mortality which has been used in a number of frailty scores but not as a single marker of frailty.

Review of efforts to decrease costly leg wound complications in the medicare population following coronary revascularization.

Background: Current trends show that patients referred for coronary artery bypass grafting (CABG) are significantly older, sicker, and at higher risk for complications than ever before. Eliminating leg wound complications would significantly benefit these patients and reduce the consumption of health care time and dollars. Endoscopic vein harvesting (EVH) decreases the risk of wound complications in patients following CABG and may decrease costly long-term wound-related problems.

Somatization among older primary care attenders.

Background: The importance of somatization among older primary care attenders is unclear. We aimed to establish the prevalence, persistence and associations of somatization among older primary care attenders, and the associations of frequent attendance.

Method: One hundred and forty primary care attenders over 65 years were rated twice, 10 months apart, on measures of somatization, psychiatric status, physical health and attendance.

Response of calves persistently infected with noncytopathic bovine viral diarrhea virus (BVDV) subtype 1b after vaccination with heterologous BVDV strains in modified live virus vaccines and Mannheimia haemolytica bacterin-toxoid.

Seronegative persistently infected (PI) calves with bovine viral diarrhea virus (BVDV) subtype 1b were vaccinated with each of four modified live virus (MLV) BVDV vaccines and a Mannheimia haemolytica bacterin-toxoid. Nasal swabs and peripheral blood leukocytes (PBL) were collected for virus isolation and serums were collected after vaccination and tested for BVDV1a, BVDV1b, BVDV2, bovine herpesvirus-1 (BHV-1), bovine parainfluenza-3 virus (PI-3V), and bovine respiratory syncytial virus (BRSV) antibodies. M.

Effect of intranasal exposure to leukotoxin-deficient Mannheimia haemolytica at the time of arrival at the feedyard on subsequent isolation of M haemolytica from nasal secretions of calves.

Objective: To determine the effect of intranasal exposure to live leukotoxin (LktA)-deficient Mannheimia haemolytica (MH) at the time of feedyard arrival on nasopharyngeal colonization by wild-type MH in calves.

Animals: 200 calves.

Procedure: Calves from Arkansas (AR calves; n = 100; mean body weight, 205 kg) were purchased from an order buyer barn.

Central representation of visceral and cutaneous hypersensitivity in the irritable bowel syndrome.

We have previously shown that irritable bowel syndrome (IBS) patients have both visceral and cutaneous hyperalgesia. The neural mechanisms of these forms of hyperalgesia were further characterized by comparing cortical processing of both rectal distension (35, 55mmHg) and cutaneous heat nociceptive stimuli (foot immersion in 45 and 47 degrees C water bath) in IBS patients and in a group of healthy age/sex-matched controls. Our approach relied on functional magnetic resonance imaging neuroimaging analyses in which brain activation in age/sex-matched control subjects was subtracted from that found in IBS patients.

Biological effects of two genetically defined leukotoxin mutants of Mannheimia haemolytica.

Mannheimia(Pasteurella)haemolytica serotype 1 is the primary causative agent responsible for bovine pneumonic mannheimiosis, also known as shipping fever in cattle. The bacterium produces a variety of virulence factors, foremost of which is the exotoxic leukotoxin. The leukotoxin is a calcium-dependent cytolysin that is a member of the RTX (repeats in toxin) family and exhibits a narrow cell-type and species specificity and has biological effects only on ruminant leukocytes and platelets.

Characteristics of early fallers on elderly patient rehabilitation wards.

Background: falls are one of the most frequent complications on rehabilitation wards for elderly patients.

Objective: to study the characteristics of early and late fallers.

Design: prospective observational study with blinded end-point evaluation.

Polymorphism of the IGF2 gene, birth weight and grip strength in adult men.

Background: Grip strength is a simple measure of skeletal muscle function but a powerful predictor of disability, morbidity and mortality. Recent evidence has shown that prenatal and infant growth influence grip strength in later life; this may reflect genetic influences on muscle size and function, although strong candidate genes have not been identified. IGF II has proliferative effects in adult muscle and is one of the major determinants of fetal growth; polymorphism in the IGF2 gene could therefore link early growth to adult grip strength.

Evaluation of the internal auditory canal with virtual endoscopy.

Objective: Three-dimensional imaging can improve the understanding and comprehension of complex anatomy. Recent advances in software development allow the construction of a virtual endoscopic view of anatomic structures. This report applies virtual endoscopic capabilities to imaging of the internal auditory canal.

Semantic monitoring of words with emotional connotation during fMRI: contribution of anterior left frontal cortex.

Previous studies showed that cortex in the anterior portions of the left frontal and temporal lobes participates in generating words with emotional connotations and processing pictures with emotional content. If these cortices process the semantic attribute of emotional connotation, they should be active whenever processing emotional connotation, without respect to modality of input or mode of output. Thus, we hypothesized that they would activate during monitoring of words with emotional connotations.

Cystic metastasis versus branchial cleft carcinoma: a diagnostic challenge.

Objectives: There is controversy regarding the existence of branchial cleft carcinomas. The objectives are to familiarize the clinician with the presentation and treatment of cystic metastases from head and neck primary sites and differentiate these from primary branchial cleft cyst carcinomas.

Study Design: Retrospective case study and literature review.

Bovine viral diarrhea virus (BVDV) 1b: predominant BVDV subtype in calves with respiratory disease.

The prevalence of bovine viral diarrhea virus (BVDV) infections was determined in 2 groups of stocker calves with acute respiratory disease. Both studies used calves assembled after purchase from auction markets by an order buyer and transported to feedyards, where they were held for approximately 30 d. In 1 study, the calves were mixed with fresh ranch calves from a single ranch.

Bovine adenovirus serotype 7 infections in postweaning calves.

Objective: To detect bovine adenovirus serotype 7 (BAV-7) infections in calves by use of viral isolation and serologic testing.

Animals: 205 postweaning calves.

Procedure: 121 calves were assembled by an order buyer through auction markets in eastern Tennessee and transported to New Mexico where they were commingled with 84 healthy ranch-reared calves.