Progesterone treatment reduces disease severity and increases IL-10 in experimental autoimmune encephalomyelitis.

Ovarian hormones, including progesterone, are known to have immunomodulatory and neuroprotective effects which may alter the disease course of experimental autoimmune encephalomyelitis (EAE). In the current study, we examined the treatment potential of progesterone beginning at the onset of EAE symptoms. Progesterone treated animals showed reduced peak disease scores and cumulative disease indices, and decreased inflammatory cytokine secretion (IL-2 and IL-17). In addition, increased production of IL-10 was accompanied by increased numbers of CD19+ cells and an increase in CD8+ cells. Decreased chemokine and chemokine receptor expression in the spinal cord also contributed to decreased lesions in the spinal cord.

Regional variability in age-related loss of neurons from the primary visual cortex and medial prefrontal cortex of male and female rats.

During aging, changes in the structure of the cerebral cortex of the rat have been seen, but potential changes in neuron number remain largely unexplored. In the present study, stereological methods were used to examine neuron number in the medial prefrontal cortex and primary visual cortex of young adult (85-90 days of age) and aged (19-22 months old) male and female rats in order to investigate any age-related losses. Possible sex differences in aging were also examined since sexually dimorphic patterns of aging have been seen in other measures. An age-related loss of neurons (18-20%), which was mirrored in volume losses, was found to occur in the primary visual cortex in both sexes in all layers except IV. Males, but not females, also lost neurons (15%) from layer V/VI of the ventral medial prefrontal cortex and showed an overall decrease in volume of this region. In contrast, dorsal medial prefrontal cortex showed no age-related changes. The effects of aging clearly differ among regions of the rat brain and to some degree, between the sexes.

Pubertal ovarian hormone exposure reduces the number of myelinated axons in the splenium of the rat corpus callosum.

The size of the female rat corpus callosum decreases in response to pubertal ovarian hormone exposure, but the underlying changes in axonal composition have not been examined. In the current study, animals underwent ovariectomy or sham surgery at day 20, and the number of myelinated and unmyelinated axons were examined in young adulthood (2 months) using electron microscopy. Ovariectomized animals had a greater number of myelinated axons compared to intact animals, while total axon number was not affected. Ovarian hormone exposure seems to limit the number of axons that become myelinated in the splenium, while not affecting the number of axons crossing through the region.

Increases in size and myelination of the rat corpus callosum during adulthood are maintained into old age.

Although there are indications of growth in the size and myelination of the rat corpus callosum during adulthood, it is not known how long this growth continues. In addition, the potential for age-related changes in these measures to affect the sex differences seen in adulthood has not been examined. Here the size of callosal subregions and area occupied by myelin were examined in the genu and splenium of male and female rats in adulthood, middle age and old age. Our findings revealed increases both in size and in the area composed of myelin between adulthood and middle age that were maintained into old age, with no indications of age-related loss in either the genu or splenium of the rat.

"Starting from scratch".

The process of establishing a new orthodontic service in any area requires a combination of patience and perseverance. It is a prolonged project littered with frustrating experiences, many of which we encountered. We endeavour to outline the pros and cons of such an undertaking and describe our experiences in implementing a marketing strategy prior to the practice opening. This was specifically geared to running a practice in a 'mixed' NHS/Private environment.

Nursing's approach to the care of the elderly.

This article describes the role and challenges nursing has assumed in the care of elderly patients in an Adult Day Health Care Program (ADHC). It describes the application of the standards of nursing practice from gerontological and rehabilitative nursing settings along with the standards (for Adult Day Care) proposed by the National Institute on Adult Day Care in an interdisciplinary, community based practice setting.

Atrial fibrillation and stroke in elderly hospitalized patients.

Of 4100 consecutive admissions to the Department of Geriatric Medicine, 414 patients (10.1%) were identified as having atrial fibrillation (AF); 138 (33%) had transient AF and 276 (67%) had constant AF. In the constant group, 41.7% of patients had had a stroke compared with 26.8% in the transient group (P less than 0.01). A random sample of 200 patients in sinus rhythm from the 4100 admissions had a stroke prevalence of 19%. This study suggests that constant AF has a greater association with stroke than transient AF.

Cost savings as an indicator of successful nursing intervention.

The purpose of this study was to provide cost-related data from an intervention study in the care of patients with peripheral vascular disease (PVD). In a previously reported study, the study group patients increased exercise more than control patients, but there were no differences on any other health promoting behaviors or clinical outcomes. However, analysis of the differences between the study (N = 44) and the control patients (N = 42) on costs for health care during the course of the study demonstrated substantial differences. A fixed per diem rate was used to determine inpatient and outpatient costs. Study patients required significantly fewer PVD-related hospitalization and health care costs than control patients but not on vascular-related and nonvascular-related illnesses. Since there were no differences between the study and control on non-PVD illnesses, it appears that the intervention targeted to influence PVD problems did so. Limitations to the study are identified and additional research in this area is warranted.

Effectiveness of health promotion interventions.

The purpose of the study was to determine whether patients who participated in an intervention program would improve exercise and foot-care habits, reduce smoking, and would, in turn, have fewer PVD-related illnesses than patients not exposed to the intervention. Eighty-six patients with ankle/brachial pressure indices of less than 1.0 on one or both legs were randomly assigned to a study (N = 42) or control (N = 44) group. All patients were assessed on a variety of health-related and activity behaviors prior to and again 26 weeks after enrollment in the study. Study patients who participated in the intervention worked with professionals on selecting programs designed to modify and improve their smoking, exercise, and/or foot-care habits. At the end of 26 weeks, chi-square analysis showed no significant differences between study and control groups on change in smoking and foot care, although the results were in the anticipated direction. Study patients who chose to increase their exercise showed greater increase than control patients in frequency (p = .001), distance (p = .007), and length (p = .002) of walks. Although behaviors were modified, especially in the area of exercise, it was felt that longer interventions on a larger sample size are needed.