Decreased tibial nerve movement in patients with failed back surgery syndrome and persistent leg pain.

PURPOSE: To measure and compare the total and normalised tibial nerve movements during forward bending in patients with and without failed back surgery syndrome (FBSS) and persistent leg pain following anatomically successful lumbar decompression surgery and demonstrated no psychological stress. Nerve pathomechanics may contribute to FBSS with persistent leg pain following anatomically successful lumbar decompression surgery. METHODS: Tibial nerve movement during forward bending was measured in two groups of patients following anatomically successful lumbar decompression surgery. FBSS group (N = 37) consisted of patients with persistent leg pain following lumbar surgery, and non-FBSS (N = 37) were patients with no remaining leg pain following lumbar surgery. Total and normalised tibial nerve movement at the popliteal fossa was measured by a previously validated ultrasound imaging technique and compared between the two groups, and also between the painful and non-painful leg within the FBSS group. RESULTS: Both the mean total and normalised tibial nerve movement were significantly decreased in the FBSS group in both legs when compared to the non-FBSS group (P < 0.05). The total and normalised tibial nerve movements were also more restricted in the painful leg (P < 0.05) when compared to the non-painful side within the FBSS group. CONCLUSION: This was the first study to quantify the decreased total and normalised tibial nerve mobility in FBSS patients with persistent leg pain when compared with non-FBSS patients following anatomically successful lumbar decompression surgery. Further research could investigate the efficacy of intervention, such as nerve mobilisation in this particular group of patients with failed back surgery syndrome and limited nerve mobility. These slides can be retrieved under Electronic Supplementary Material.

Efficacy of inspiratory muscle training as a practical and minimally intrusive technique to aid functional fitness among adults with obesity.

OBJECTIVE: To examine the efficacy of inspiratory muscle training (IMT) as a non-intrusive and practical intervention to stimulate improved functional fitness in adults with obesity. As excess adiposity of the chest impedes the mechanics of breathing, targeted re-training of the inspiratory muscles may ameliorate sensations of breathlessness, improve physical performance and lead to greater engagement in physical activity. METHODS: Sixty seven adults (BMI=36±6.5) were randomized into either an experimental (EXP: n=35) or placebo (PLA: n=32) group with both groups undertaking a 4-week IMT intervention, comprising daily use of a inspiratory resistance device set to 55% (EXP), or 10% (PLA) of maximum inspiratory effort. RESULTS: Inspiratory muscle strength was significantly improved in EXP (19.1 cmH20 gain; P<0.01) but did not change in PLA. Additionally, the post training walking distance covered was significantly extended for EXP (P<0.01), but not for PLA. Bivariate analysis demonstrated a positive association between the change (%) of performance in the walking test and BMI (r=0.78; P<0.01) for EXP. CONCLUSION: The findings from this study suggest IMT provides a practical, self-administered intervention for use in a home setting. This could be a useful strategy to improve the functional fitness of obese adults and perhaps lead to better preparedness for engagement in physical activity initiatives.

Electropolymerization of Preadsorbed Layers of Some Azine Redox Dyes on Graphite.

The redox-active azine dyes Nile blue A (NB) and Toluidine blue O (TB) were electropolymerized after preadsorption onto the surface of graphite electrodes by potential cycling, using an anodic scan limit of 0.9 or 1.0 V vs SCE, where irreversible electrooxidation of the dye proceeds, yielding polymerizable species. Electropolymerization of both dyes is followed by the progressive disappearance of the characteristic current peaks in the cyclic voltammograms, and formation of new ones, shifted by ca. 0.21 V to the positive direction. Also, a decrease and gradual disappearance of the characteristic luminescence at a maximum of 671 nm was observed during the electropolymerization of NB. The resulting electrodes, modified by electropolymerized derivatives of NB and TB, were shown to be able to catalyze the electrooxidation of the coenzyme NADH. Thus, the modified electrodes prepared can be used for amperometric detection of the reduced form of the coenzyme. Copyright 2000 Academic Press.

Combining GUM and contraceptive services for young people: profile of an innovative clinic.(GUM = genitourinary medicine).

The 1990s have witnessed a growth in specialist family planning provision for adolescents including advisory clinics for young people. However there has been no parallel development of teenager-friendly genitourinary medicine (GUM) services despite the prevalence of sexually transmitted disease (STDs) in the adolescent age group. This article profiles a young person's clinic in Morecambe, UK which operates a combined family planning/GUM clinic one night a week in a multi-agency, 'shop front', youth project. Attendances are high, particularly amongst young teenagers and males. The clinic enjoys a 66 per cent follow up rate and 11 per cent of clients had crossed over from one service to the other on succeeding visits. Seventeen cases of chlamydia had been diagnosed, nine to females under 18. The benefits of a 'one stop' clinic and the youth project location are discussed.

The contribution of interagency collaboration to the promotion of young people's sexual health.

This paper employs a case study approach in order to examine the contribution of interagency working to the delivery of education and services in the difficult field of young people's sexual health. It reports on a collaborative UK initiative involving teachers, community health practitioners, health promotion staff, and youth and community workers. The provision included school-based sex education, drop-in advice and information facilities, 'detached' street work, and a young person's clinic. A qualitative study was completed involving detailed interviews with 25 staff from the different agencies involved. The findings suggest that interagency collaboration can enhance the work of each organization, and can achieve a comprehensive response to young people's sexual health needs by making positive use of the distinctive roles, skills, knowledge and approaches of the different agencies. The potential that such a collaboration will have a significant impact on young people's sexual health is discussed.