ABSTRACT
It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years；37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.
ABSTRACT
It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years；37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.
ABSTRACT
<b>Objective: </b>There is enormous information flow via the Internet and papers. Physicians require appropriate drug information from medical representatives (MRs), so fair promotion activities of MRs are necessary. To clarify the activity and visiting aims of MRs, we investigated the visiting records for MRs.<br><b>Methods: </b>We improved the visiting record form because there were some gaps in the records. Subsequently, we investigated the validity of the records. The correlations between visiting numbers of MRs and both purchase prices of our hospital and scale of drug companies were also investigated. Two months after revision of the visiting records, a questionnaire survey was administered among MRs to determine their thoughts about promotion activities.<br><b>Results: </b>The visiting numbers of MRs and companies did not change with revision of the visiting record. Insufficient visiting records were significantly reduced from 5.1% to 0.8%. There were no correlations between visiting numbers and purchase prices or scale of drug companies. Meanwhile, sub-analysis of the visiting data indicated that MRs significantly promoted new drugs and drugs coming off patent. The revision of visiting record format re-emphasized the importance of the visiting record on MRs.<br><b>Discussion: </b>Almost all MRs promoted their products fairly, as there was no correlation between the purchase price and company scale. However, they may actively promote new drugs and those with patents that have elapsed. The visiting records are useful to determine the promotion activities of MRs.
ABSTRACT
A study was conducted to investigate changes in muscle soreness, serum creatine kinase (CK) activity and white blood cell (WBC) count following exercise bouts spaced three weeks apart.<BR>The subjects were six male students (aged 23-25 yr), who had not participated in any training program for over 18 months. They performed muscular exercise of the nondominant arm using elbow flexors. Twenty percent of maximum voluntary contraction was used as the exercise intensity. After three weeks, the subjects repeated the same exercise bout. Perceived muscle soreness, CK activity and WBC count were assessed before, immediately after, 6h after and over 9 days after each exercise bout.<BR>After the first exercise bout (1 st Ex), the subjects experienced muscle sorenss for 3-7 days. Also, a large increase of CK was found in five subjects (266-763%) . When the peak CK efflux was observed (day 3-4 after exercise), soreness had almost disappeared. WBC count was increased immediately and 6 h after exercise, then returned to the resting level. However, a significant increase (p<0.05) in WBC count was observed again on day 7 after exercise when CK had returned to the resting level. After the second exercise (2 nd Ex), a significant decrease of muscle soreness and the CK response was found in comparison with the 1 st Ex (p<0.41) . One interesting feature was that the CK efflux of subjects who had shown a large increase of CK after the 1 st Ex was not increased after the 2 nd Ex.<BR>The initial exercise bout may have induced some damage to the muscle fibers or mem. bran. This damage would induce a process of repair in the damaged tissue, which in turn would adapt the muscle to the next stimulus. However, the subjects who showed a slight increase of CK after the 1 st Ex did not show this adaptation. Therefore an adaptive threshold for fiber or membrane damage may exist.