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Impaired Mobility (impaired + mobility)
Selected AbstractsObesity and metabolic changes are common in young childhood brain tumor survivorsPEDIATRIC BLOOD & CANCER, Issue 7 2009Sari Pietilä MD Abstract Background A population based cross-sectional study was used to examine the prevalence of metabolic syndrome and its components in childhood brain tumor survivors. Procedure Fifty-two survivors were examined at a mean age of 14.4 years (range 3.8,28.7). Lipid and glucose metabolism, thyroid function, and plasma uric acid were evaluated. Fat mass and fat percentage were assessed by dual-energy X-ray absorptiometry (DXA). Metabolic syndrome was defined on International Diabetes Federation criteria. Results Ten (19%) patients were overweight and four (8%) were obese. According to DXA, 16/46 (35%) patients were obese. Central obesity was found in 11 (21%) patients. Cranial irradiation, hypothalamic/hypophyseal damage, growth hormone (GH) deficiency and impaired mobility were associated with overweight/obesity and central obesity. Thirteen (25%) subjects had hypercholesterolemia, 14 (27%) had raised low-density lipoprotein cholesterol (LDL-C), 12 (23%) had raised blood pressure, four (8%) had metabolic syndrome, two (4%) had hyperinsulinemia and five (10%) had hyperuricemia. Cranial irradiation was associated with hypercholesterolemia (P,=,0.019), raised LDL-C (P,=,0.028), raised blood pressure (P,=,0.040), and metabolic syndrome (P,=,0.018). Impaired mobility was associated with hypercholesterolemia (P,=,0.034). Hypothalamic/hypophyseal damage was associated with metabolic syndrome (P,=,0.003) and hyperuricemia (P,=,0.011) as was GH deficiency (P,=,0.034 and P,=,0.008). GH supplementation alleviated adverse metabolic outcomes among brain tumor survivors with GH deficiency. Conclusions Obesity/overweight, dyslipidemia, hypertension, metabolic syndrome, and hyperuricemia were common in young childhood brain tumor survivors. Cranial irradiation, hypothalamic/hypophyseal damage, growth hormone deficiency, and/or impaired mobility were associated with higher risk for obesity and metabolic changes among these patients. Pediatr Blood Cancer 2009;52:853,859. © 2009 Wiley-Liss, Inc. [source] Consequences of injuries on survival and reproduction of common bottlenose dolphins (Tursiops truncatus) along the west coast of FloridaMARINE MAMMAL SCIENCE, Issue 4 2008Randall S. Wells Abstract Accurate identification of human-induced injuries that lead to death or interfere with reproduction is important for marine mammal management, as deaths exceeding established limits can lead to restrictions on fisheries or vessel operations. The fates of cetaceans last seen swimming with attached gear, particularly in pelagic fisheries, or with vessel strike lacerations, have been difficult to predict. Survival and reproduction data from long-term research on resident common bottlenose dolphins near Sarasota, Florida were examined relative to consequences of fishing gear ingestion, line entanglements, vessel strikes, and amputations of unknown origins. Fishing hooks embedded in the throat, goosebeak, or esophagus, or line wrapped around the goosebeak, generally lead to death. Multiple, constrictive line wraps around fin insertions can lead to amputation, blood loss, impaired mobility, or infection. Dolphins with ingested gear or severe entanglements may swim away with the gear, but likely die later. Propeller injuries involving only soft tissue were often survivable. Some dolphins survived amputations of the distal ends of fins, and continued to reproduce. As a precautionary approach, dolphins with ingested gear or severe constrictive entanglements should be considered mortalities, but extrapolations of findings from coastal bottlenose dolphins to other cetaceans and different gear must be done with caution. [source] Reliability and concurrent validity of the Expanded Timed Up-and-Go test in older people with impaired mobilityPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2008Pernille Botolfsen Abstract Background and Purpose.,,Expanded Timed Up-and-Go' (ETUG) was developed to assess each of the subtasks of the ,Timed Up-and-Go' (TUG). The aim of the study was to test the intrarater, interrater, test,retest reliability and internal consistency of the ETUG, and the concurrent validity with the TUG.,Methods.,The present study is a reliability and a validity study. Twenty-eight subjects (80 ± 4.1 years) with balance and gait problems were included. Three raters timed the ETUG subtasks from a video, using a computer-based scoring programme, and the total ETUG time was calculated. TUG was registered by a regular stopwatch.,Results.,The intrarater and interrater reliability (intraclass correlation [ICC][1,1]) ranged from 0.55 to 0.97. The test,retest reliability (ICC[1,1]) ranged from 0.54 to 0.85. The absolute measurement error of the total time (1.96 Sw) was 2.8 seconds. The internal consistency (Cronbach's alpha) was 0.74. The correlation (Pearson's r) between ETUG total time and TUG after correcting for attenuation caused by restricted reliability in each of the measures was 0.85.,Conclusion.,The ETUG scored from a video shows a good reliability for experienced raters and acceptable internal consistency. The ETUG showed a higher reliability than TUG when tested on the same sample of older subjects with impaired mobility, and the high concurrent validity between ETUG and TUG suggests that the two tests may have similar properties. Since ETUG also adds new information compared with TUG, we suggest that ETUG is an interesting alternative to existing clinical tests of mobility. Copyright © 2008 John Wiley & Sons, Ltd. [source] Organ Preservation Surgery for Advanced Unilateral Glottic and Subglottic Cancer,THE LARYNGOSCOPE, Issue 10 2007Pierre Delaere MD Abstract Objectives: Functional surgery of unilateral T2b to T3 glottic cancer and cricoid chondrosarcoma is possible using the technique of tracheal autotransplantation. The objective of this paper is to report the functional and oncologic outcome of 24 consecutive patients treated with this technique between 2001 and 2007. Methods: Seventeen patients, of whom nine were previously irradiated, had unilateral glottic cancer with impaired mobility of the vocal fold. Clinical staging was T2b to 3N0. Seven patients had a chondrosarcoma of the cricoid cartilage. In a first operation, an extended hemilaryngectomy was performed, and a radial forearm flap, comprising a distal fascial and a proximal skin component, was transferred to the neck. The fascial paddle was wrapped around the upper 4-cm segment of cervical trachea, and the skin paddle was used for temporary closure of the extended hemilaryngectomy defect. The definitive reconstruction was performed after 2 to 3 months and consisted of removal of the skin paddle from the laryngeal defect and a transplantation of a patch of revascularized cervical trachea to reconstruct the laryngeal defect. Results: Swallowing and speech were restored after the first operation. The glottic and subglottic airway lumen was restored during the second operation. The tracheostomy could be closed in 20 patients. After a median follow-up period of 33 (range, 1,66) months or almost 3 years, 23 patients remained free of tumor recurrence. Conclusions: Tracheal autotransplantation can be recommended as a functional treatment for selected T2b to T3 glottic cancers and for unilateral chondrosarcomas of the cricoid cartilage. The technique is oncologically robust while resulting in good postoperative function. [source] Endoscopic Vertical Partial Laryngectomy,THE LARYNGOSCOPE, Issue 2 2004R Kim Davis MD Abstract Objective: To explain the significant difference between microlaryngoscopy with cordectomy and endoscopic vertical partial laryngectomy (EVPL), to describe the efficacy of EVPL on T1b and T2 glottic squamous cell carcinoma, and to evaluate EVPL with postoperative irradiation in T2 glottic cancer with impaired true vocal cord mobility. Study Design: Retrospective review. Methods: Twenty-six patients seen at the University of Utah Health Science Center between 1987 and 2000 with bilateral T1 (T1b) or T2 squamous cell carcinoma of the glottic larynx underwent EVPL. T2 cancers were classified as follows: a = unilateral disease, b = bilateral disease; i = impaired mobility. T1b and T2a glottic cancer patients received surgery alone, whereas impaired mobility patients (T2ai + T2bi) patients received surgery followed by planned postoperative irradiation. Patients were assessed for primary site control, perioperative and long-term complications, and ultimate cancer control. Results: Survival in the total group was 88.5%, with local control at 92.3%. The two recurrent patients were salvaged by total laryngectomy. For the whole group, anterior commissure involvement was present in 57.7% (15 of 26). Thirteen T2 (5 T2ai + 8 T2bi) carcinoma patients underwent combined therapy, with 8 (61.5%) of these patients having anterior commissure involvement. Two of these patients were upstaged at surgery, one to T3 and one to T4. Local control was 84.5%. Thirteen patients were treated by surgery only, with five of these patients having failed previous irradiation. Survival was 92.3% and local control 100%. This group included two T2bi patients, two patients upstaged to T4 on the basis of extension beyond the subglottis to the anterior wall of the trachea, 3 T2b, and 6 T2a patients. Anterior commissure involvement was seen in 7 (53.8%) of these patients. Conclusions: EVPL alone controlled all T1b and T2a glottic cancer patients, even in the presence of greater than 50% anterior commissure involvement. The significant difference between EVPL and classical microlaryngoscopy with cordectomy was carefully described. EVPL with planned postoperative irradiation resulted in an 85% local control rate in clinically staged T2ai and T2bi cancer patients, including the three upstaged patients. [source] On intimacy, sexual activities and exposure to sexual abuse among children and adolescents with mobility impairmentACTA PAEDIATRICA, Issue 5 2008L Jemtå Abstract Aim: The aim was to describe experiences of intimacy and sexual activity and exposure to sexual abuse among children and adolescents with mobility impairment, and to relate these experiences to socio-demographic data, disability characteristics and well-being. Methods: This study included semi-structured interviews with 141 children and adolescents aged 7,18 years with mobility impairment. Interpersonal experiences of intimacy and sexuality, socio-demographic data, disability characteristics and well-being were registered. Results: About half of the children and adolescents in the study had been in a boy- or a girlfriend relationship, and about a fifth had an ongoing relationship. Of the adolescents, 15% had at least one experience of a sexual relationship. Whereas no particular sexual dysfunction was reported, 15% had concerns about their future sexual activities, presumably related to mobility impairment. A history of sexual abuse was reported by 7% in the age cohort of 13,18 years. The socio-demographic and disability-related features had a marginal influence on the experiences of intimacy and sexual activities. Conclusion: Several aspects of sexual health are not fully realized for children and adolescents with impaired mobility, and there is a need for specialized sexual health care services to protect the sexual rights of this group. [source] Well-being among children and adolescents with mobility impairment in relation to demographic data and disability characteristicsACTA PAEDIATRICA, Issue 5 2005Lena Jemtä Abstract Aim: To describe the well-being of children and adolescents with mobility impairment in relation to demographic data and disability characteristics. Methods: The present study is based on interviews with 141 subjects aged 7 to 18 y with impaired mobility. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale. Independence or dependence was evaluated by the Index of Independence in Activities of Daily Living. Motor capacity was assessed with an instrument including active movements, rapidity, locomotion and balance as well as the presence and localization of pain. Results: Since there were no significant differences in well-being regarding the diagnostic-related group, additional disorder/disability or the degree of disability, the impairment per se did not necessarily influence well-being negatively. Even though the majority of the children and adolescents in the study indicated a high level of well-being, several risk factors for a lower level of well-being were identified: greater age, not living with both parents, being a first-generation immigrant, having an acquired disease/injury and experience of pain. Conclusion: These findings increase our limited knowledge of well-being among children/adolescents with mobility impairment and provide a basis for effective care and future research. [source] | ||||||||||