Anxiety after a fall in elderly subjects and subsequent risk of developing post traumatic stress disorder at two months. A pilot study.

BACKGROUND: The psychological burden suffered by elderly subjects after a fall adds to rehabilitation difficulties. We hypothesised that Post Traumatic Stress Disorder (PTSD) may be at the root of these psychological post-fall problems. The immediate psychological state was examined after 2 months post-fall in order to determine the prevalence of anxiety and PTSD and their possible correlates. METHOD: A single centre prospective survey including elderly subjects referred to an emergency department (ED) after a fall with a 2-month follow-up. RESULTS: 30.5% of patients showed a significant level of anxiety after their fall and (26%) showed evidence supporting the presence of PTSD at 2-months. Immediate anxiety, ability to re-establish upright posture and a history of repeated falls were significant predictors of PTSD at 2-months. CONCLUSION: persistent psychological problems post fall may be related to PTSD which is significantly correlated to immediate anxiety. This study can be seen as a first step in patient characterisation, and predicts who may benefit from which of the various approaches of rehabilitation.

The validity of regulating exercise intensity by ratings of perceived exertion.

The purpose of this investigation was to examine the regulation of exercise intensity by using Ratings of Perceived Exertion (RPE). The RPE equivalent to 50% and 70% VO2max was estimated by using standard clinical protocols on a treadmill and cycle ergometer. Subjects then produced the target RPEs on these modalities. Physiological validity of perceptually regulated exercise intensity was determined by comparing VO2 and heart rate between estimation and production trials at the same relative intensity. With one exception, RPE was found to be a valid means of regulating exercise intensity both intra- and intermodally at 50% and 70% VO2max. Perceptual regulation of intramodal treadmill exercise was not valid at 70% VO2max in that both VO2 and heart rate were significantly lower during production than estimation. The present results also indicate that target RPE estimated during a cycle ergometer graded exercise test is more accurate for regulating exercise intensity than when the target RPE is estimated during a treadmill test. The lower accuracy found for treadmill production at the higher exercise intensity may have been caused by the use of a test protocol during the estimation trial that included relatively slow speeds and large inclines. In general, RPE provide a physiologically valid method of regulating exercise intensity.

[Original technique for secondary impressions in complete removable dentures (CRD)]. / Technique originale de prise d'empreinte secondaire en prothèse adjointe complete (PAC).

Regardless of its anatomic shape, an edentulous arch is formed by two types of mucosa, different in both nature and behavior. This is why the impression of such a complex requires two distinct steps with two different modeling materials with different consistency. The first step is the border molding of the mucosal reflexion zone with a silicone of medium viscosity, placed on the borders of the custom tray. The second step is the static impression of the inner part of the denture, with a fluid or very fluid silicone.

Enzymatic polymerization of 5-mercuriuridine-5'-diphosphate with polynucleotide phosphorylase from E. coli.

We report the polymerization of 5-mercuriuridine-5'-diphosphate (ppUHgX), in the presence of an excess of beta-mercaptoethanol, with polynucleotide phosphorylase from E. coli. A degradation of mercurated nucleotides with mercaptans was observed and about 30% of incorporation of mercury in the polymer was obtained after treatment with pancreatic RNase. The influence of ppUHgX and pUHgX with or without beta-mercaptoethanol was also studied on the polymerization of UDP. The ppUHgX did not polymerize in the absence of beta-mercaptoethanol.

Use of methylphosphonic dichloride for the synthesis of oligonucleoside methylphosphonates.

Methylphosphonic dichloride was used to prepare protected deoxyribonucleoside 3'-methylphosphonate beta-cyanoethyl esters, d-[(MeO)2Tr]NpCNEt, and protected oligonucleoside methylphosphonates in solution. Reaction of d-[(MeO)2Tr]N with methylphosphonic dichloride gives d-[(MeO)2Tr]NpCl. The phosphonylation and subsequent esterification or condensation reactions are each complete within 60 min. The products are readily purified by "flash chromatography" on silica gel columns. d-[(MeO)2Tr]NpCl, or its tetrazole derivative, d-[(MeO)2Tr]Nptet, were tested as intermediates for the synthesis of oligothymidine methylphosphonates on a silica gel polymer support. The average yield per coupling step was 76% and did not increase with addition of more d-[(MeO)2Tr]TpCl. The formation of (5'-5') linked thymidine dimers indicated that the thymidine monomers are clustered closely together on the support. When N is ibuG, the yield for the coupling step on the support is very low. This may be due to steric hindrance of the 3'-phosphonate group by the N-2 isobutryl protecting group.

Poly-2'-deoxy-2'-fluoro-cytidylic acid: enzymatic synthesis, spectroscopic characterization and interaction with poly-inosinic acid.

The polymerization of 2'deoxy-2'-fluoro-cytidine-diphosphate (dCflDP) by polynucleotide phosphorylase is barely detectable in the presence of Mg++ under usual experimental conditions for polymerization of nucleoside diphosphates. High concentrations of enzyme have to be used to accomplish the synthesis. Mn++ is a better activator than Mg++ for the reaction. cCflDP inhibits the polymerization of CDP and has a Km=8.8X10-3M, six times higher than CDP.- The polymer, poly (dCfl), ressembles in many respects poly(C), but not poly(dC): the acid selfstructure forms at similar pK's; interaction with poly(I) yields a 1:1 complex the CD spectrum of which is similar to that of poly(I).poly(C). Finally, the Tm's of poly(I).poly(dCfl) are comparable to those of poly(I).poly(C).

Nucleoside conformations. XVII. A PMR study of 2'-anhydronucleosides and comparison with X-ray data.

A series of 2'-cyclo-nucleosides (2,2'-O-anhydro-uridine, -N(3)-uridine and cytidine and 8,2'-S-anhydro-guanosine) have been studied by PMR in DMSO and D(2)O. As expected these compounds are quite rigid, but their solution conformation is considerably different from that observed in single crystal x-ray studies. While the pyrimidine cyclonucleosides in the crystal form show a C(4')-endo conformation (pseudorotational phase angle P=212 degrees to 233 degrees ), their solution conformation is C(1')-exo (P=130 degrees to 138 degrees ) and the cyclothioguanosine shows a closely similar one (P=112 degrees ). Exocyclic rotamer distribution is different in the various compounds.