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Laurence Vico, Alan Hargens
Space sojourns are challenging for life. The ability of the human body to adapt to these extreme conditions has been noted since the beginning of human space travel. Skeletal alterations that occur during spaceflight are now better understood owing to tools such as dual-energy X-ray densitometry and high-resolution peripheral quantitative CT, and murine models help researchers to understand cellular and matrix changes that occur in bone and that are difficult to measure in humans. However, questions remain with regard to bone adaptation and osteocyte fate, as well as to interactions of the skeleton with fluid shifts towards the head and with the vascular system...
March 21, 2018: Nature Reviews. Rheumatology
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
James H Rimmer, Cassandra Herman, Brooks Wingo, Kevin Fontaine, Tapan Mehta
BACKGROUND: Hybrid research designs targeting adults with neurologic disability are critical for improving the efficiency of models that can identify, track and intervene on identified health issues. METHODS: Our Russian doll framework encompasses three study phases. Phase 1 involves prospectively following a cohort of participants with disability to examine the relationships between rates of health and functional deficits (e.g., pain, fatigue, deconditioning), functional measures (e...
March 14, 2018: BMC Medical Research Methodology
E R Waclawski, P Noone
Background: The majority of liver transplant recipients survive long term after the procedure. Aim: To assess if this positive outcome is associated with improved employment post-transplant. Methods: A systematic review of publications between 2001 and 2016 was performed. A standard procedure was used to search for suitable publications from two databases (PubMed and EMBASE). Duplicates were removed and abstracts screened by both authors for possible inclusion...
March 9, 2018: Occupational Medicine
Amy C Arnold, Jessica Ng, Satish R Raj
Postural tachycardia syndrome (POTS) is a heterogeneous clinical syndrome that has gained increasing interest over the past few decades due to its increasing prevalence and clinical impact on health-related quality of life. POTS is clinically characterized by sustained excessive tachycardia upon standing that occurs in the absence of significant orthostatic hypotension and other medical conditions and or medications, and with chronic symptoms of orthostatic intolerance. POTS represents one of the most common presentations of syncope and presyncope secondary to autonomic dysfunction in emergency rooms and in cardiology, neurology, and primary care clinics...
February 28, 2018: Autonomic Neuroscience: Basic & Clinical
Felipe Vilaça Cavallari Machado, Fabio Pitta, Nidia Aparecida Hernandes, Gisele Lopes Bertolini
PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by persistent and progressive airflow obstruction that is associated with an abnormal chronic inflammatory response in the airways and lungs to noxious particles. COPD often leads to physical inactivity and deconditioning that added to inappropriate/excessive inflammatory responses leads to systemic consequences. Studies have shown that metabolic syndrome and manifested diabetes are more frequent in COPD than in healthy subjects; a possible explanation is that different pathophysiological aspects of COPD can lead to insulin resistance...
March 6, 2018: Endocrine
V E Baracos, L Arribas
Body composition, defined as the proportions and distribution of lean and fat tissues in the human body, is an emergent theme in clinical oncology. Severe muscle depletion (sarcopenia) is most easily overlooked in obese patients; the advent of secondary analysis of oncologic images provides a precise and specific assessment of sarcopenia. Here, we review the definitions, prevalence and clinical implications of sarcopenic obesity (SO) in medical and surgical oncology. Reported prevalence of SO varies due to the heterogeneity in the definitions and the variability in the cut points used to define low muscle mass and high fat mass...
February 1, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
Erin J Howden, André La Gerche, Jane F Arthur, Julie R McMullen, Garry L Jennings, David W Dunstan, Neville Owen, Sharon Avery, Bronwyn A Kingwell
Hematological cancer survivors are highly vulnerable to cardiometabolic complications impacting long-term health status, quality of life and survival. Elevated risk of diabetes and cardiovascular disease arises not only from the effects of the cancers themselves, but also from the toxic effects of cancer therapies, and deconditioning arising from reduced physical activity levels. Regular physical activity can circumvent or reverse adverse effects on the heart, skeletal muscle, vasculature and blood cells, through a combination of systemic and molecular mechanisms...
February 21, 2018: Blood Reviews
Amy L Deckert, Galina Gheihman, Rinat Nissim, Cynthia Chung, Aaron D Schimmer, Camilla Zimmermann, Gary Rodin
PURPOSE: The symptom burden of acute myeloid leukemia (AML) and its treatment can accelerate physical deconditioning and impair mobility and quality of life. In the present study, we explore the subjective experience of functional capacity in people living with AML. METHODS: A secondary qualitative analysis was performed on a subset of interviews (n = 21) obtained from an observational cohort study of people with acute leukemia. Conventional content analysis was employed to identify key themes and concepts...
February 15, 2018: Leukemia Research
Stacey E Aaron, Catherine J Vanderwerker, Aaron E Embry, Jennifer H Newton, Samuel C K Lee, Chris M Gregory
PURPOSE: After a cerebrovascular accident (CVA) aerobic deconditioning contributes to diminished physical function. Functional electrical stimulation (FES)-assisted cycling is a promising exercise paradigm designed to target both aerobic capacity and locomotor function. This pilot study aimed to evaluate the effects of an FES-assisted cycling intervention on aerobic capacity and locomotor function in individuals post-CVA. METHODS: Eleven individuals with chronic (>6 months) post-CVA hemiparesis completed an 8-wk (three times per week; 24 sessions) progressive FES-assisted cycling intervention...
March 2018: Medicine and Science in Sports and Exercise
Michael J Gardner, Thomas A Higgins, William H Harvin, James P Stannard, Mark A Lee, Brett D Crist
Fracture surgeons do a great job of managing bone issues, but they may overlook the associated soft tissue injuries that play a significant role in the final outcome after musculoskeletal injury. The soft tissue reconstruction ladder can help guide reconstructive procedures based on the least complex procedure that allows the best chance of fracture healing. Muscle injury, volume loss, and deconditioning occur with traumatic injury and during the recovery phase. Neuromuscular stimulation, nutrition, and strength training are potential ways to aid in recovery...
March 2018: Journal of Orthopaedic Trauma
I Churilov, L Churilov, R J MacIsaac, E I Ekinci
Sarcopenia is associated with poor function and increased risk of falls and disability. This work reports a systematic review and meta-analysis of prevalence of sarcopenia in post acute inpatient rehabilitation. Sarcopenia is found to be present in approximately 50% of rehabilitation patients and its prevalence may vary with admission diagnosis. PURPOSE:  To conduct a systematic review and meta-analysis of reported prevalence of sarcopenia in post acute inpatient rehabilitation. METHODS:  Systematic review conducted according to PRISMA guidelines (PROSPERO registration number CRD42016054135)...
February 18, 2018: Osteoporosis International
Olivia Le Saux, Claire Falandry
PURPOSE OF REVIEW: We will review the reasons that explain the poor accrual of elderly patients to clinical trials, then we will discuss the relevance of an age threshold for holding off on testing novel therapies. RECENT FINDINGS: Little progress has been made in enrolling elderly patients in clinical trials. Reasons to hold off on testing novel therapies in elderly patients are mainly explained by exclusion criteria and industrials' reluctance to include elderly patients for fear of negative results...
February 7, 2018: Current Oncology Reports
Jessica Behennah, Rebecca Conway, James Fisher, Neil Osborne, James Steele
BACKGROUND: Chronic low back pain is associated with lumbar extensor deconditioning. This may contribute to decreased neuromuscular control and balance. However, balance is also influenced by the hip musculature. Thus, the purpose of this study was to examine balance in both asymptomatic participants and those with chronic low back pain, and to examine the relationships among balance, lumbar extension strength, trunk extension endurance, and pain. METHODS: Forty three asymptomatic participants and 21 participants with non-specific chronic low back pain underwent balance testing using the Star Excursion Balance Test, lumbar extension strength, trunk extension endurance, and pain using a visual analogue scale...
January 31, 2018: Clinical Biomechanics
G L Ackland, T E F Abbott, R M Pearse, S N Karmali, J Whittle, G Minto
BACKGROUND: Systemic arterial pulse pressure (systolic minus diastolic pressure) ≤53 mm Hg in patients with cardiac failure is correlated with reduced stroke volume and is independently associated with accelerated morbidity and mortality. Given that deconditioned surgical and heart failure patients share similar cardiopulmonary physiology, we examined whether lower pulse pressure is associated with excess morbidity after major surgery. METHODS: This was a prospective observational cohort study of patients deemed by their preoperative assessors to be at higher risk of postoperative morbidity...
January 2018: British Journal of Anaesthesia
Dolores Sánchez-Rodríguez, Ester Marco, Natalia Ronquillo-Moreno, Liev Maciel-Bravo, Abel Gonzales-Carhuancho, Xavier Duran, Anna Guillén-Solà, Olga Vázquez-Ibar, Ferran Escalada, Josep M Muniesa
BACKGROUND: The aim of this study was to assess the prevalence of malnutrition by applying the ASPEN/AND definition and the ESPEN consensus definition in a postacute-care population, and secondly, to determine the metrological properties of the set of six clinical characteristics that constitute the ASPEN/AND basic diagnosis, compared to the ESPEN consensus, based mostly on objective anthropometric measurements. METHODS: Prospective study of 84 consecutive deconditioned older inpatients (85...
January 25, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Danielle Bender, Paul Holyoke
In an optimal healthcare system, patients receive care in the most appropriate, least expensive setting. In Canada, too many patients remain in hospital well after they no longer require hospital-based care. This study examines the observations on this problem by a team with a home and community lens in six cases. The underlying issues across the six are the insufficiency of home and community supports before hospitalization, the routine underestimation of these patients' potential for independence, the deconditioning of patients while in hospital, and hospital staff's lack of understanding of home care...
January 1, 2018: Healthcare Management Forum
Jiun C Chang, Blaine A Christiansen, Deepa K Murugesh, Aimy Sebastian, Nicholas R Hum, Nicole M Collette, Sarah Hatsell, Aris N Economides, Craig D Blanchette, Gabriela G Loots
Patients with anterior cruciate ligament (ACL) rupture are 2X as likely to develop post traumatic osteoarthritis (PTOA). Annually, there are ∼900,000 knee injuries in the US, which account for ∼12% of all OA cases. PTOA leads to reduced physical activity, deconditioning of the musculoskeletal system and in severe cases, requires joint replacement to restore function. Therefore, treatments that would prevent cartilage degradation post injury would provide attractive alternatives to surgery. Sclerostin (Sost), a Wnt antagonist and a potent negative regulator of bone formation has recently been implicated in regulating chondrocyte function in osteoarthritis (OA)...
January 26, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Manuel J Escalona, Rachel Brosseau, Martin Vermette, Alain Steve Comtois, Cyril Duclos, Mylène Aubertin-Leheudre, Dany H Gagnon
BACKGROUND: Many wheelchair users adopt a sedentary lifestyle, which results in progressive physical deconditioning with increased risk of musculoskeletal, cardiovascular and endocrine/metabolic morbidity and mortality. Engaging in a walking program with an overground robotic exoskeleton may be an effective strategy for mitigating these potential negative health consequences and optimizing fitness in this population. However, additional research is warranted to inform the development of adapted physical activity programs incorporating this technology...
January 22, 2018: Annals of Physical and Rehabilitation Medicine
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