Posturography and locomotor tests of dynamic balance after long-duration spaceflight.

The currently approved objective clinical measure of standing balance in astronauts after space flight is the Sensory Organization Test battery of computerized dynamic posturography. No tests of walking balance are currently approved for standard clinical testing of astronauts. This study determined the sensitivity and specificity of standing and walking balance tests for astronauts before and after long-duration space flight.

Variability and persistence of aspirin response in lower extremity peripheral arterial disease patients.

Objective: To determine the prevalence of poor response to aspirin (ASA) therapy over 12-month follow-up in patients with lower extremity peripheral arterial disease (PAD), and to compare the classification agreement among different ASA response assays.

Methods: Patients with PAD on ASA therapy at baseline were included from the ongoing Effect of Lipid Modification on Peripheral Arterial Disease after Endovascular Intervention Trial (ELIMIT), which is a randomized trial testing whether combination treatment with ezetimibe, niacin, and a statin will halt/regress atherosclerosis compared with statin monotherapy. Patients who had baseline platelet testing and repeat testing at 6-month or 12-month follow-up were included.

Differences in responses of platelets to fluid shear stress in patients with peripheral artery disease (PAD) and coronary artery disease (CAD).

Information on differences in platelet function between patients with peripheral arterial disease (PAD) and patients with coronary artery disease (CAD) is limited. We sought to examine the differences in the platelets response to shear stress in patients with PAD compared to those with CAD. Men with symptomatic PAD (ankle brachial index [ABI] < 0.

Usefulness of some current balance tests for identifying individuals with disequilibrium due to vestibular impairments.

The goal of this study was to determine which of several clinical balance tests best identifies patients with vestibular disorders. We compared the scores of normals and patients on the Berg Balance Scale (Berg), Dynamic Gait Index (DGI), Timed Up and Go (TUG), Computerized Dynamic Posturography Sensory Organization Test (SOT), and a new obstacle avoidance test: the Functional Mobility Test (FMT). The study was performed in an out-patient balance laboratory at a tertiary care center.

Effectiveness of treatments for benign paroxysmal positional vertigo of the posterior canal.

Objective: To determine which common, nonpharmacological, nonsurgical treatments are most effective for treatment of benign paroxysmal positional vertigo (BPPV).

Study Design: Prospective, randomized, sham-controlled.

Patients: Patients (n = 124) with BPPV of the posterior semicircular canal.

Prognostic value of adenosine Tl-201 myocardial perfusion imaging after acute myocardial infarction: results of a prospective clinical trial.

Background: We have previously shown in retrospective studies that adenosine myocardial perfusion imaging (MPI) done after acute myocardial infarction (AMI) can effectively predict the risk of future cardiac events in these patients. The objective of this study was to validate these observations in a prospective clinical trial.

Methods And Results: One hundred twenty-six stable patients underwent quantitative adenosine MPI at a mean of 4.

Prognostic value of quantitative stress myocardial perfusion imaging in unstable angina patients with negative cardiac enzymes and no new ischemic ECG changes.

Background: Limited data are available on the value of quantitative stress myocardial perfusion imaging (MPI) in patients with unstable angina. In this report we sought to study the long-term prognostic value of quantitative stress MPI in patients hospitalized with unstable angina with no new ischemic electrocardiographic changes and negative cardiac enzymes.

Methods And Results: The study population consisted of 136 patients who were hospitalized at the Methodist Hospital, Houston, Tex, with unstable angina and subsequently underwent MPI before discharge.

Tracking regression and progression of atherosclerosis in human carotid arteries using high-resolution magnetic resonance imaging.

Background And Purpose: Magnetic resonance imaging (MRI) can accurately and reproducibly measure the volume of atherosclerotic plaque in human carotid arteries. Atherosclerotic plaques may either progress or regress over time, depending on individual risk factors and treatment regimens. This study was designed to determine if regression or progression of human carotid atherosclerosis in patients receiving statin therapy over 24 months can be detected by high-resolution MRI.

Benign paroxysmal positional vertigo and comorbid conditions.

Purpose: To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety.

Procedures: Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography.

Results: Subjects had high rates of diabetes, mild head trauma, and probable sinus disease.

Decreased ataxia and improved balance after vestibular rehabilitation.

Objectives: To determine the effects of vestibular rehabilitation on gait ataxia and balance.

Setting: Tertiary care center. Study design Subjects were patients with chronic vertigo due to peripheral vestibular impairments, referred for vestibular rehabilitation.

Changes in a repetitive head movement task after vestibular rehabilitation.

Objective: Many papers describe vestibular rehabilitation programmes to reduce vertigo and disequilibrium caused by peripheral vestibular disorders, but few studies have assessed performance on purposeful activities. This study determined if performance on a purposeful activity improves after vestibular rehabilitation exercises, and if the speed of treatment exercises influences performance.

Setting: Medical school practice; tertiary care facility.

Treatment variations on the Epley maneuver for benign paroxysmal positional vertigo.

Purpose: To determine if using more head rotation during the Epley maneuver or specific posttreatment instructions for sleeping position would affect treatment effectiveness, compared with the usual maneuver without extra instructions.

Materials And Methods: Patients with unilateral benign paroxysmal positional vertigo of the posterior semicircular canal were randomized to a standard Epley maneuver group, a group that received an additional 45 degrees head rotation during the maneuver (Augmented Epley), and a group that received instructions about sleeping position after treatment.

Results: Posttests from 1 week to 6 months showed no differences in vertigo intensity or frequency or responses to the Dix-Hallpike maneuver.

Driving disability and dizziness.

Problem: People with dizziness caused by vestibular (i.e., inner ear) disorders complain of difficulty driving.

Increased independence and decreased vertigo after vestibular rehabilitation.

Objective: We sought to determine the effectiveness in decreasing some symptoms, such as vertigo, and increasing performance of daily life skills after vestibular rehabilitation.

Study Design And Setting: Patients who had chronic vertigo due to peripheral vestibular impairments were seen at a tertiary care center. They were referred for vestibular rehabilitation and were assessed on vertigo intensity and frequency with the use of the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the Vestibular Disorders Activities of Daily Living Scale, and the Dizziness Handicap Inventory.

Factors affecting recovery after acoustic neuroma resection.

In order to determine which variables influence recovery from acoustic neuroma resection, acutely postoperative patients were divided into two groups and treated twice daily at bedside as inpatients at a tertiary care center. Treatment times were increased gradually from 5 to 30 min. Exercise subjects underwent passive and active head movements and walking with augmented head movements.

Improvements in path integration after vestibular rehabilitation.

Fifty-three subjects with peripheral, chronic vestibulopathies, who were referred for vestibular rehabilitation, were tested on a path integration task before and after doing four weeks of five times daily habituation exercises for vertigo reduction. The task involved walking over a 7.62 m path with eyes closed.

Cigarette smoking and increased urine albumin excretion are interrelated predictors of nephropathy progression in type 2 diabetes.

Background: Increased urine albumin excretion (UAE) predicts nephropathy progression in type 2 diabetes, whereas improved blood pressure (BP) control and angiotensin-converting enzyme (ACE) inhibition ameliorate both albuminuria and nephropathy progression. Cigarette smoking (CS) predicts nephropathy progression in patients with type 2 diabetes despite improved BP control and ACE inhibition. We tested the hypothesis that CS and increased UAE are interrelated predictors of nephropathy progression in patients with type 2 diabetes undergoing improved BP control and ACE inhibition.

Bilateral symmetry of human carotid artery atherosclerosis.

Background And Purpose: Atherosclerosis is a principal cause of stroke and myocardial infarction. The carotid arteries provide a site at which progression of atherosclerosis can be monitored reproducibly and noninvasively. This study was conducted to determine the similarity of atherosclerotic plaques in the left and right carotid arteries.

Effects of normal aging on visuo-motor plasticity.

Normal aging is associated with declines in neurologic function. Uncompensated visual and vestibular problems may have dire consequences including dangerous falls. Visuo-motor plasticity is a form of behavioral neural plasticity, which is important in the process of adapting to visual or vestibular alteration, including those changes due to pathology, pharmacotherapy, surgery or even entry into microgravity or an underwater environment.