ABSTRACT
Duchenne muscular dystrophy (DMD) is a fatal X-linked genetic disease caused by complete absence of Dystrophin due to mutation of DMD gene. Typical symptoms are progressive muscle loss which cause slow walking, gait abnormalities, falls, and difficult squatting. The adult patients often died from the respiratory and cardiovasucula failure in their early life stage.The early introduction of steroids has altered the natural history of the disease, but can exacerbate weight gain in a population already susceptible to obesity. Prior to commencing steroids, anticipatory guidance for weight management should be provided. Malnutrition is a feature of end stage disease requiring a multidisciplinary approach, such as texture modification and supplemental feeding. Micronutri- ent requirements are yet to be determined but, as a result of corticosteroid treatment, vitamin D and calcium should be supplemented. The multidisciplinary management of boys with DMD including nutrition treatment has progressed significantly and improved the life qulity of both patients and their parents.
ABSTRACT
This study aimed to examine characteristics of physical functions, physical activity, and cognitive functions among community-dwelling older people who stopped driving automobiles. Participants were 589 community-dwelling older people (age: 65–89, 71.4 ± 5.1 years; 403 men, 186 women). The participants underwent nine physical assessments—hand grip strength, knee extension strength, timed up-and-go test, chair stand, one leg standing with open eyes, functional reach, vertical jump, preferred gait speed, maximal gait speed—and were evaluated for physical activity; and five cognitive assessments—the Mini-Mental State Examination (MMSE), Logical Memory I and II (WMS-R LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and Trail Making Test A and B (TMT-A, TMT-B). They were divided into current driver (379 men, 169 women) and driving cessation (24 men, 17 women) groups. Among men, the driving cessation group had poorer vertical jump, TMT-A, and TMT-B results, while women had poorer hand grip strength, one leg standing with open eyes, WMS-R LM-II, and LM-II results, and longer inactivity time, compared with the current driver group and adjusted for covariates (P < 0.05 for all). The findings suggest driving cessation among community-dwelling older people is significantly associated with poorer physical functions, physical activity, and cognitive functions compared with those in current drivers.
ABSTRACT
Abstract Background Acute myeloid leukemia (AML) is a potentially fatal hematological disease. Along with disease-related factors, patient-related factors, in particular age, are a strong predictor of outcome that influence treatment decisions. Many acute myeloid leukemia risk stratification models have been developed to predict the outcome of intensive chemotherapy. However, these models did not include physical function assessments. Methods This study investigated the impact of several factors, namely the performance status, physical function and age on the short-term outcomes of intensive chemotherapy in a cohort of 50 Egyptian patients with de novo acute myeloid leukemia. Results Complete remission after intensive chemotherapy in these myeloid leukemia patients at Day 28 was 56% and the mortality rate was 12% and 34% at Day 28 and Day 60, respectively. The pretreatment Eastern Cooperative Oncology Group score was significantly correlated with outcomes on Day 28 and Day 60 (p-value = 0.041 and p-value = 0.032, respectively). There were significant correlations between the two-minute walk test and outcomes of therapy on Day 28 and 60 (p-value = 0.032 and p-value = 0.047, respectively) and between grip strength test and outcomes of therapy on Day 28 and 60 (p-value = 0.046 and p-value = 0.047 respectively). Furthermore, there was a significant correlation between chair stand test and outcome of therapy on Day 28 (p-value = 0.023). Conclusion Performance status and physical function assessments were strong predictors of outcome of intensive chemotherapy in acute myeloid leukemia and we recommend the incorporation of these variables in risk stratification models for the personalization of therapy before treating acute myeloid leukemia patients with intensive chemotherapy.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Leukemia, Myeloid, Acute , ElectrocorticographyABSTRACT
PURPOSE: The purpose of this study was to determine the effects of a fall prevention program on gait ability, one leg standing-right, one leg standing-left, fear of falling, fall efficacy, and depression in the elderly. METHODS: A fall prevention program was consisted of fall preventing exercise with laughter therapy. Quasi-experimental design with one group pre- and post-test was used. Twenty-two elderly were participated in this study from a community health center located in a rural area, South Korea. SPSS/WIN 18.0 was used for descriptive analysis and paired t-test. RESULTS: After 12 weeks with a fall prevention program, gait ability (t=3.44, p=.002), one leg standing-right (t=-3.73, p=.001), one leg standing-left (t=-4.17, p<.001) and fear of falling (t=2.12, p=.046) in the elderly were significantly improved. CONCLUSION: A fall prevention program was effective on physical and psychological functions. This study suggested that control groups and a larger sample should be included in order to validate the effects of a fall prevention program for the elderly.
Subject(s)
Aged , Female , Humans , Community Health Centers , Depression , Gait , Laughter Therapy , Leg , Republic of KoreaABSTRACT
Objective To understand the declining pattern of physical activities on daily living (PADL) and instrumental activities of daily living (IADL) and its influencing factors among the Chinese elderly aged 65 years and over. Methods Using data from 2002 and 2005 of the Chinese Longitudinal Health Longevity Study (CLHLS), 6761 Chinese elderly with fully independent PADL in 2002 and 3556 Chinese elderly with fully independent IADL in 2002 were studied. Results Data showed that the male elderly with fully dependent IADL at baseline in 2002 declined to 59.3% but kept the IADL in full independent in 2005, while that of female elderly were 51.8 % still keeping the IADL full independent in2005. Male elderly who at baseline with the PADL fully dependent in 2002 declined to 87.1% but kept the PADL full independent in 2005, while that of female elderly were 81.5% keeping the PADL full independent in 2005.There were only 70.0% ,47.0% ,24.0% and 15.0% elderly keeping the IADL fullindependent among the age groups of 65-74,75-84,85-94 and 95-105, respectively, from 2002 to 2005;while there were 95.0 %, 87.0 %, 74.0 % and 55.0 % elderly keeping the PADL full independent amongthe above age groups of 65-74,75-84,85-94 and 95-105, from 2002 to 2005. Age, numbers of episodes that suffering from serious illness in the past two years and cognitive ability were significantly associated with IADL or PADL had a decline after controlling for sex, socioeconomic factors in the multinomial logistical regression analysis among the Chinese elderly aged 65 years and older,during the period from 2002 to 2005.Conclusion The declining physical functional status among the 65 and older elderly went severe with age in China,with IADL more severe than that of PADL. Chinese female elderly suffered more in PADL or IADL than that of male elderly. Age, numbers of episode that suffering from serious illness in the past two years and cognitive ability were considered as predictive factors of functional status among the Chinese elderly. However,gender,living conditions, education background and marital status that appearring to be the significant predictors only seen in partial IADL/PADL declining models.