Validating accelerometry as a measure of physical activity and energy expenditure in chronic stroke.

Background: Accelerometers can objectively measure steps taken per day in individuals without gait deficits, but accelerometers also have the ability to estimate frequency, intensity, and duration of physical activity. However, thresholds to distinguish varying levels of activity intensity using the Actical brand accelerometer are standardized only for the general population and may underestimate intensity in stroke.

Objective: To derive Actical activity count thresholds specific to stroke disability for use in more accurately gauging time spent at differing activity levels.

Autonomic dysreflexia and sudden death in people with traumatic spinal cord injury.

Autonomic dysreflexia (AD) is an uncommon but potentially life-threatening clinical syndrome consisting of acute episodes of excessive, uncontrolled sympathetic output that may occur in quadriplegics and in paraplegics whose spinal cord lesions are above the level of T6. These uncontrolled bouts of sympathetic output can cause transient and pronounced elevations of blood pressure that on occasion can lead to serious sequela such as the precipitation of a hypertensive intracerebral hemorrhage. The episodes of AD are often triggered by some type of noxious stimulus such as a distended urinary bladder or a fecal impaction.

Indices of metabolic dysfunction and oxidative stress.

Metabolic alterations are a key player involved in the onset of Alzheimer disease pathophysiology and, in this review, we focus on diet, metabolic rate, and neuronal size differences that have all been shown to play etiological and pathological roles in Alzheimer disease. Specifically, one of the earliest manifestations of brain metabolic depression in these patients is a sustained high caloric intake meaning that general diet is an important factor to take in account. Moreover, atrophy in the vasculature and a reduced glucose transporter activity for the vessels is also a common feature in Alzheimer disease.

Homicidal ethylene glycol intoxication: a report of a case.

We report a case of a 75-year-old hypertensive, diabetic man who presented to the emergency room with symptoms and signs of nausea, acute intoxication, significant alteration in mental status with rapid neurologic deterioration, and blunt impact injuries sustained during a recent altercation with a 36-year-old female companion-caretaker. He denied a history of ethanol abuse or other recent toxic ingestion and had not been diagnosed with or treated for depression. Hospital laboratory tests revealed a metabolic acidosis and a negative urine toxicology screen.

Drug prevalence in drowning deaths in Cuyahoga County, Ohio: a ten-year retrospective study.

Previous studies have shown that up to 50% of adult drownings are related to the consumption of alcohol. Little information is available in the literature regarding the possible contribution of ethanol and other drugs to drownings. All records of deaths occurring in Cuyahoga County, Ohio, from 1994-2003, in which drowning was listed as the cause of death, were reviewed.

An unusual fatality in a child due to oxycodone.

An unusual fatality secondary to oxycodone in a child is reported. A 2-year-old female child was conveyed to a local hospital after exhibiting signs of rubbing of the mouth and staggering. A hospital toxicological immunoassay screen for drugs of abuse and tricyclic antidepressants was performed on a urine sample and reported as negative.

A metabolic basis for Alzheimer disease.

Most studies of Alzheimer's disease (AD) have focused on a single precipitating alteration as the etiological event rather than global changes closely linked to aging. Recent evidence suggests that the most significant of these global changes are metabolic. Here we present data indicating that metabolic rate, nutrition, and neuronal size are all early indicators of AD.

Oxidative damage is the earliest event in Alzheimer disease.

Recently, we demonstrated a significant increase of an oxidized nucleoside derived from RNA, 8-hydroxyguanosine (8OHG), and an oxidized amino acid, nitrotyrosine in vulnerable neurons of patients with Alzheimer disease (AD). To determine whether oxidative damage is an early- or end-stage event in the process of neurodegeneration in AD, we investigated the relationship between neuronal 8OHG and nitrotyrosine and histological and clinical variables, i.e.

DNA typing of samples for polymarker, DQA1, and nine STR loci from a human body exhumed after 27 years.

A body was exhumed from the ground after 27 years. Samples of femur bone, tooth, and a fingernail were collected and successfully subjected to DNA extraction, quantitation, amplification, and subsequently typed for DQA1, polymarker, and nine STR loci. All three types of samples were typed for D3S1358, vWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S17, D7S820, and amelogenin using ABI Prism 377 DNA sequencer.

Sudden death due to ventricular septal defect.

Ventricular septal defects (VSD) are usually considered non-life-threatening, usually closing spontaneously or causing symptoms of congestive heart failure, which can be surgically treated in time to save the patient's life. Despite the usually benign clinical course of VSD, serious arrhythmias occur in 16-31% of patients. Sudden death accounted for one-third of all deaths in a series of medically managed patients and occurred in 4.

Cocaethylene causes dose-dependent reductions in cardiac function in anesthetized dogs.

Twelve million Americans abuse both cocaine and ethanol each year because this drug combination produces a pronounced and prolonged euphoria. However, these substances in combination are substantially more toxic than either drug alone. This toxicity may be due to cocaethylene, which has been detected in the serum of patients who have used cocaine and ethanol and two require emergency treatment.

Atherosclerotic coronary artery disease and "low" levels of carboxyhemoglobin; report of fatalities and discussion of pathophysiologic mechanisms of death.

Levels of carboxyhemoglobin that would ordinarily cause little or no noticeable symptoms or other effects proved fatal in individuals suffering from atherosclerotic coronary artery disease. All such deaths that occurred in the Cuyahoga County during a period of 23 years were studied. The pathophysiologic mechanisms that may be operative in these deaths are discussed.

Wounding characteristics of "shotshell" ammunition: a report of three cases.

Wounds caused by "shotshells" in three homicides are presented. Characteristics of shotshell ammunition based on test firings of .38 Special shotshells are detailed.