Effects of self-management exercise group participation in community-dwelling older adults.

BACKGROUND: The effects of physical fitness and age on motor function in older adults who continue to exercise remain unclear. This study aimed to examine the effects of participation in self-management exercise groups in adults aged ≥65 years. METHODS: The motor functions of 372 citizens who participated in a self-management exercise group for 1 year were examined. The motor functions were assessed by measuring grip strength, five-repetition sit-to-stand test, 5-m fastest walking time (walking time) and timed up and go test. The participants were grouped according to their baseline grip strength (low or high grip strength groups). The baseline parameters were compared to those assessed 1 year after group participation. In addition, the rates of long-term care/support need certification were examined at 2-year follow-up. RESULTS: In the low grip strength group aged ≥75 years, the grip strength of men, and grip strength and five-repetition sit-to-stand test results of women improved after 1 year. In the high grip strength group, the five-repetition sit-to-stand and timed up and go test results of men aged 65-74 years and five-repetition sit-to-stand test results of men aged ≥75 years improved. Among women in the high grip strength group, grip strength, five-repetition sit-to-stand test, walking time, and timed up and go test results improved in the participants aged 65-74 and ≥ 75 years. The number of new long-term care/support need certifications was comparable in both groups. CONCLUSIONS: Participation in self-management exercise groups led to maintaining or improving physical fitness among community-dwelling-older adults. Furthermore, higher baseline grip strength was associated with improvements in many motor functions; therefore, participation in self-management exercise groups before the onset of functional decline is desirable.

[Changes in serum Na+ and blood hemoglobin levels during three types of transurethral procedures for the treatment of benign prostatic hypertrophy].

BACKGROUND: Transurethral holmium YAG laser resection of the prostate (HoLR-P) and transurethral electrovaporization of the prostate (TUV-P) have recently received increasing attention as an effective minimally invasive approach for the treatment of prostatic hypertrophy. However, less information is available regarding the intraoperative changes in the serum Na+ and blood hemoglobin levels during either HoLR-P or TUV-P. METHODS: Intraoperative changes in serum Na+ and blood hemoglobin levels were investigated in 17 patients undergoing transurethral resection of the prostate (TUR-P, n = 7), HoLR-P (n = 7) or TUV-P (n = 3). The 3% D-sorbitol solution was used as the irrigating fluid in all the patients. RESULTS: In three patients, severe hyponatremia (118-123 mEq x l(-1)) developed abruptly (< or = 15 min) at various time points during TUR-P with (n = 1) or without (n = 2) cystostomy. However, no clinical symptoms were observed after development of the hyponatremia in those awake patients. No large (> 10 mEq x l(-1)) decreases in the Na+ level were observed in any of the patients undergoing HoLR-P or TUV-P. In patients undergoing TUR-P and HoLR-P, percent changes in serum Na+ level significantly correlated with those in blood hemoglobin level, but not with the resection time; the slopes were significantly larger than unity. CONCLUSIONS: The TUR syndrome is less likely to occur during HoLR-P or TUV-P. During TUR-P, the onset of severe hyponatremia appears to be unpredictable, and may not necessarily be accompanied by clinical symptoms. Frequent measurements of the serum Na+ level appear essential for early detection of severe hyponatremia.