Primary

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Primary

  • human primary
  • presidential primary
  • second primary
  • unknown primary

  • Terms modified by Primary

  • primary Percutaneou coronary intervention
  • primary abnormality
  • primary adenocarcinoma
  • primary adrenocortical insufficiency
  • primary advantage
  • primary afferent
  • primary afferent neuron
  • primary agent
  • primary aim
  • primary alcohol
  • primary amide
  • primary amine
  • primary amine groups
  • primary amino groups
  • primary analysis
  • primary anastomosis
  • primary angioplasty
  • primary angiosarcoma
  • primary antibody
  • primary antiphospholipid syndrome
  • primary area
  • primary aromatic amine
  • primary astrocyte
  • primary astrocytoma
  • primary auditory cortex
  • primary b cell
  • primary barrier
  • primary biliary cirrhosis
  • primary binding site
  • primary bone
  • primary brain tumor
  • primary branch
  • primary breast cancer
  • primary breast cancer patient
  • primary breast cancers
  • primary breast carcinoma
  • primary breast tumor
  • primary cancer
  • primary cancers
  • primary carbon source
  • primary carcinoma
  • primary care
  • primary care clinic
  • primary care clinician
  • primary care consultation
  • primary care doctor
  • primary care evaluation
  • primary care groups
  • primary care mental health
  • primary care nurse
  • primary care organisation
  • primary care organization
  • primary care patient
  • primary care physician
  • primary care population
  • primary care practice
  • primary care practitioner
  • primary care provider
  • primary care services
  • primary care setting
  • primary care staff
  • primary care system
  • primary care team
  • primary care trust
  • primary care worker
  • primary caregiver
  • primary caries
  • primary case
  • primary category
  • primary cause
  • primary cell
  • primary cell culture
  • primary cell wall
  • primary central nervous system lymphoma
  • primary challenge
  • primary chondrocyte
  • primary ciliary dyskinesia
  • primary cilium
  • primary classroom
  • primary closure
  • primary colorectal cancer
  • primary colorectal carcinoma
  • primary commodity
  • primary complaint
  • primary component
  • primary concern
  • primary constituent
  • primary consumer
  • primary contribution
  • primary contributor
  • primary control
  • primary cortical culture
  • primary cortical neuron
  • primary culture
  • primary culture system
  • primary cutaneous
  • primary cutaneous amyloidosis
  • primary cutaneous anaplastic large cell lymphoma
  • primary cutaneous b-cell lymphoma
  • primary cutaneous melanoma
  • primary cutaneous squamous cell carcinoma
  • primary cutaneous t-cell lymphoma
  • primary data
  • primary data collection
  • primary defect
  • primary deficiency
  • primary dendrite
  • primary dentition
  • primary determinant
  • primary diagnosis
  • primary disease
  • primary driver
  • primary drivers
  • primary dystonia
  • primary ebv infection
  • primary education
  • primary effect
  • primary efficacy
  • primary efficacy endpoint
  • primary efficacy measure
  • primary efficacy outcome
  • primary efficacy variable
  • primary effusion lymphoma
  • primary emphasis
  • primary end point
  • primary end-point
  • primary endpoint
  • primary energy
  • primary energy consumption
  • primary epstein
  • primary etiology
  • primary event
  • primary ewing sarcoma
  • primary excision
  • primary explanation
  • primary exposure
  • primary expression
  • primary face
  • primary factor
  • primary failure
  • primary family caregiver
  • primary fibroblast
  • primary flow
  • primary focus
  • primary forest
  • primary form
  • primary function
  • primary gastric cancers
  • primary glioblastoma
  • primary goal
  • primary graft failure
  • primary growth
  • primary haemostasi
  • primary headache
  • primary headaches
  • primary health care
  • primary health care centre
  • primary health care provider
  • primary health care services
  • primary health care team
  • primary healthcare
  • primary hemostasi
  • primary hepatic malignancy
  • primary hepatocellular carcinoma
  • primary hepatocyte
  • primary hip replacement
  • primary hippocampal neuron
  • primary hiv infection
  • primary hiv-1 infection
  • primary host
  • primary hpt
  • primary human
  • primary human cell
  • primary human chondrocyte
  • primary human fibroblast
  • primary human hepatocyte
  • primary human keratinocyte
  • primary human nasal epithelial cell
  • primary human osteoblast
  • primary hyperparathyroidism
  • primary hypertension
  • primary hypothesis
  • primary hypothyroidism
  • primary immune deficiency
  • primary immune response
  • primary immunization
  • primary immunodeficiency
  • primary immunodeficiency disease
  • primary immunosuppression
  • primary implant stability
  • primary importance
  • primary incisor
  • primary indication
  • primary infection
  • primary infections
  • primary infertility
  • primary influence
  • primary inoculum
  • primary insomnia
  • primary interest
  • primary intervention
  • primary intracranial tumor
  • primary invasive melanoma
  • primary involvement
  • primary ion
  • primary language
  • primary leaf
  • primary leiomyosarcoma
  • primary lesion
  • primary level
  • primary literature
  • primary liver cancer
  • primary liver transplant
  • primary location
  • primary locus
  • primary lt
  • primary lung adenocarcinoma
  • primary lung cancer
  • primary lung cancers
  • primary lung carcinoma
  • primary lung tumor
  • primary lymphoma
  • primary malignancy
  • primary malignant melanoma
  • primary malignant tumor
  • primary management
  • primary manifestation
  • primary mass
  • primary material
  • primary mean
  • primary measure
  • primary mechanism
  • primary mediator
  • primary melanoma
  • primary metabolism
  • primary metabolite
  • primary method
  • primary microglia
  • primary mineral
  • primary mode
  • primary model
  • primary molar
  • primary molar tooth
  • primary monocyte
  • primary motivation
  • primary motor cortex
  • primary motor cortex excitability
  • primary myelofibrosis
  • primary myoblast
  • primary neoplasm
  • primary neuroblastoma
  • primary neuron
  • primary neuronal culture
  • primary nitro compound
  • primary nocturnal enuresis
  • primary non-hodgkin lymphoma
  • primary nucleation
  • primary nurse
  • primary objective
  • primary open angle glaucoma
  • primary open-angle glaucoma
  • primary open-angle glaucoma patient
  • primary oral squamous cell carcinoma
  • primary osteoblast
  • primary osteosarcoma
  • primary outcome
  • primary outcome measure
  • primary outcome variable
  • primary ovarian tumor
  • primary parasitoid
  • primary particle
  • primary particle size
  • primary patency
  • primary patency rate
  • primary pathogen
  • primary pci
  • primary percutaneou coronary intervention
  • primary physician
  • primary position
  • primary postpartum haemorrhage
  • primary predictor
  • primary prevention
  • primary prey
  • primary problem
  • primary producer
  • primary producers
  • primary product
  • primary production
  • primary productivity
  • primary products
  • primary progressive
  • primary progressive aphasia
  • primary progressive multiple sclerosis
  • primary prophylaxis
  • primary protein
  • primary pulmonary hypertension
  • primary purpose
  • primary question
  • primary radiation
  • primary radiotherapy
  • primary rat hepatocyte
  • primary rcc
  • primary reason
  • primary receptor
  • primary reconstruction
  • primary reference
  • primary renal disease
  • primary repair
  • primary research
  • primary resistance
  • primary response
  • primary responsibility
  • primary result
  • primary risk factor
  • primary role
  • primary root
  • primary route
  • primary sample
  • primary sarcoma
  • primary scale
  • primary school
  • primary school child
  • primary school teacher
  • primary schoolchildren
  • primary sclerosing cholangitis
  • primary screen
  • primary screening
  • primary screening test
  • primary sector
  • primary seed dispersal
  • primary sensitization
  • primary sensorimotor cortex
  • primary sensory cortex
  • primary sensory neuron
  • primary sequence
  • primary sex ratio
  • primary signal
  • primary site
  • primary sjögren syndrome
  • primary small cell carcinoma
  • primary soft tissue sarcoma
  • primary somatosensory cortex
  • primary source
  • primary spermatocyte
  • primary squamous cell carcinoma
  • primary ss
  • primary stability
  • primary stage
  • primary stenting
  • primary step
  • primary structure
  • primary studies
  • primary study
  • primary success rate
  • primary succession
  • primary surgeon
  • primary surgery
  • primary surgical excision
  • primary surgical treatment
  • primary symptom
  • primary target
  • primary task
  • primary technique
  • primary test
  • primary themes
  • primary therapy
  • primary threat
  • primary tissue
  • primary tool
  • primary tooth
  • primary torsion dystonia
  • primary total hip replacement
  • primary trabeculectomy
  • primary transcript
  • primary transplant
  • primary transplantation
  • primary treatment
  • primary treatment modality
  • primary tumor
  • primary tumor cell
  • primary tumor growth
  • primary tumor site
  • primary tumour
  • primary unknown
  • primary use
  • primary vaccination
  • primary variable
  • primary vector
  • primary visual cortex
  • primary way
  • primary xylem

  • Selected Abstracts


    RAPID ANTAGONISTIC COEVOLUTION BETWEEN PRIMARY AND SECONDARY SEXUAL CHARACTERS IN HORNED BEETLES

    EVOLUTION, Issue 9 2008
    Harald F. Parzer
    Different structures may compete during development for a shared and limited pool of resources to sustain growth and differentiation. The resulting resource allocation trade-offs have the potential to alter both ontogenetic outcomes and evolutionary trajectories. However, little is known about the evolutionary causes and consequences of resource allocation trade-offs in natural populations. Here, we explore the significance of resource allocation trade-offs between primary and secondary sexual traits in shaping early morphological divergences between four recently separated populations of the horned beetle Onthophagus taurus as well as macroevolutionary divergence patterns across 10 Onthophagus species. We show that resource allocation trade-offs leave a strong signature in morphological divergence patterns both within and between species. Furthermore, our results suggest that genital divergence may, under certain circumstances, occur as a byproduct of evolutionary changes in secondary sexual traits. Given the importance of copulatory organ morphology for reproductive isolation our findings begin to raise the possibility that secondary sexual trait evolution may promote speciation as a byproduct. We discuss the implications of our results on the causes and consequences of resource allocation trade-offs in insects. [source]


    PARTNER AWARENESS REGARDING THE ADULT SEQUELAE OF CHILDHOOD SEXUAL ABUSE FOR PRIMARY AND SECONDARY SURVIVORS

    JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2003
    Noelle S. Wiersma
    This qualitative study investigates factors that may facilitate or impede awareness within couples regarding the sequelae of chuildhood sexual abuse for adult females and their partner. Six couples were interviewed about perceived effects of the abuse for self and partner and their perceptions regarding their awareness of these effects. Transcribed data were analyzed using grounded-theory methodolgy. Emergent themes regarding potential barriers to and facilitators of agreement are outlined in the context of the expressive and receptive abilities and motivations of each partner in communicating about the abuse. Preliminary implications for marriage and family therapy and further research are provided. [source]


    FINE NEEDLE ASPIRATION IN ASSESSMENT OF PRIMARY AND METASTATIC GASTROINTESTINAL STROMAL TUMOURS

    PATHOLOGY INTERNATIONAL, Issue 12 2001
    Robson DJ
    No abstract is available for this article. [source]


    Adenoid cystic carcinoma: A retrospective clinical review

    INTERNATIONAL JOURNAL OF CANCER, Issue 3 2001
    Atif J. Khan M.D.
    Abstract Adenoid cystic carcinoma (ACC) are uncommon tumors, representing about 10% to 15% of head and neck tumors. We compare the survival and control rates at our institution with those reported in the literature, and examine putative predictors of outcome. All patients registered with the tumor registry as having had ACC were identified. Demographic and survival variables were retrieved from the database. Additionally, a chart review of all patients was done to obtain specific information. Minor gland tumors were staged using the American Joint Committee on Cancer's criteria for squamous cell carcinomas in identical sites. Histopathologic variables retrieved included grade of the tumor, margins, and perineural invasion. Treatment modalities, field sizes, and radiation doses were recorded in applicable cases. An effort to retrieve archival tumor specimens for immunohistochemical analysis was undertaken. A total of 69 patients were treated for ACC from 1955 to 1999. One patient, who presented with fatal brain metastasis, was excluded from further analysis. Of the remaining 68 patients, 30 were men and 38 were women. The average age at diagnosis was 52 years, and mean follow-up was 13.2 years. Mean survival was 7.7 years. Overall survival (OS) rates at 5, 10, and 15 years were 72%, 44%, and 34%, and cause-specific survival was 83%, 71%, and 55%, respectively. Recurrence-free survival rates were 65%, 52%, and 30% at 5, 10, and 15 years, with a total of 29 of 68 (43%) eventually suffering a recurrence. Overall survival was adversely affected by advancing T and AJCC stage. Higher tumor grades were also associated with decreased OS, although the numbers compared were small. Primaries of the nasosinal region fared poorly when compared with other locations. Total recurrence-free survival, local and distant recurrence rates were distinctly better in primaries of the oral cavity/oropharynx when compared with those in other locations. Reduced distant recurrence-free survival was significantly associated with increasing stage. No other variables were predictive for recurrence. Additionally, we found that nasosinal tumors were more likely to display higher stage at presentation, and were more often associated with perineural invasion. Also of interest was the association of perineural invasion with margin status, with 15 of 20 patients with positive margins displaying perineural invasion, while only 5 of 17 with negative margins showed nerve invasion (P = 0.02). On immunohistochemistry, 2 cases of the 29 (7%) tumor specimens found displayed HER-2/neu positivity. No correlation between clinical behavior and positive staining could be demonstrated. Our data concur with previous reports on ACC in terms of survival and recurrence statistics. Stage and site of primary were important determinants of outcome. Grade may still serve a role in decision making. We could not demonstrate any differences attributable to primary modality of therapy, perhaps due to the nonrandomization of patients into the various treatment tracks and the inclusion of palliative cases. Similarly, perineural invasion, radiation dose and field size, and HER-2/neu positivity did not prove to be important factors in our experience. © 2001 Wiley-Liss, Inc. [source]


    Retrospective Voting in Presidential Primaries

    PRESIDENTIAL STUDIES QUARTERLY, Issue 4 2010
    WILLIAM G. MAYER
    Though retrospective performance evaluations are now widely appreciated as a major influence on voting in general elections, their influence in presidential primaries has rarely been noticed. Using exit polls conducted by major media organizations over the last nine election cycles, this article shows that retrospective voting is an important, indeed dominant, factor in two types of situations: when an incumbent president is running for reelection, and when an incumbent vice president is seeking to become his party's next presidential candidate. This finding, in turn, helps explain two significant institutional features of the contemporary presidential nomination process: why most recent presidents have been renominated without much difficulty, and why the vice presidency has become such a good launching pad for presidential candidacies. [source]


    Subungual Metastasis from a Rectal Primary: Case Report and Review of the Literature

    DERMATOLOGIC SURGERY, Issue 4 2006
    BARRY GALLAGHER MD
    BACKGROUND Subungual metastases from colorectal cancer are unusual and have mainly been reported in patients with lung, genitourinary, and breast cancer. OBJECTIVE We present the case of a 72-year-old man with rectal adenocarcinoma and a subungual metastasis to the left thumb 5 years later. METHODS A case report and a brief review of the literature of subungual metastases are given. RESULTS The thumb was amputated and the patient died 6 months later with extensive metastatic disease. CONCLUSION Metastatic carcinoma should be considered in the differential diagnosis of persistent subungual masses, particularly in patients with a history of cancer. The prognosis with such lesions is generally poor. [source]


    Rescuer Fatigue: Standard versus Continuous Chest-Compression Cardiopulmonary Resuscitation

    ACADEMIC EMERGENCY MEDICINE, Issue 10 2006
    Joseph W. Heidenreich MD
    Abstract Objectives Continuous chest-compression cardiopulmonary resuscitation (CCC-CPR) has been advocated as an alternative to standard CPR (STD-CPR). Studies have shown that CCC-CPR delivers substantially more chest compressions per minute and is easier to remember and perform than STD-CPR. One concern regarding CCC-CPR is that the rescuer may fatigue and be unable to maintain adequate compression rate or depth throughout an average emergency medical services response time. The specific aim of this study was to compare the effects of fatigue on the performance of CCC-CPR and STD-CPR on a manikin model. Methods This was a prospective, randomized crossover study involving 53 medical students performing CCC-CPR and STD-CPR on a manikin model. Students were randomized to their initial CPR group and then performed the other type of CPR after a period of at least two days. Students were evaluated on their performance of 9 minutes of CPR for each method. The primary endpoint was the number of adequate chest compressions (at least 38 mm of compression depth) delivered per minute during each of the 9 minutes. The secondary endpoints were total compressions, compression rate, and the number of breaks taken for rest. The students' performance was evaluated on the basis of Skillreporter Resusci Anne (Laerdal, Wappingers Falls, NY) recordings. Primary and secondary endpoints were analyzed by using the generalized linear mixed model for counting data. Results In the first 2 minutes, participants delivered significantly more adequate compressions per minute with CCC-CPR than STD-CPR, (47 vs. 32, p = 0.004 in the 1st minute and 39 vs. 29, p = 0.04 in the 2nd minute). For minutes 3 through 9, the differences in number of adequate compressions between groups were not significant. Evaluating the 9 minutes of CPR as a whole, there were significantly more adequate compressions in CCC-CPR vs. STD-CPR (p = 0.0003). Although the number of adequate compressions per minute declined over time in both groups, the rate of decline was significantly greater in CCC-CPR compared with STD-CPR (p = 0.0003). The mean number of total compressions delivered in the first minute was significantly greater with CCC-CPR than STD-CPR (105 per minute vs. 58 per minute, p < 0.001) and did not change over 9 minutes in either group. There were no differences in compression rates or number of breaks between groups. Conclusions CCC-CPR resulted in more adequate compressions per minute than STD-CPR for the first 2 minutes of CPR. However, the difference diminished after 3 minutes, presumably as a result of greater rescuer fatigue with CCC-CPR. Overall, CCC-CPR resulted in more total compressions per minute than STD-CPR during the entire 9 minutes of resuscitation. [source]


    Divergent roles of the DEAD-box protein BS-PL10, the urochordate homologue of human DDX3 and DDX3Y proteins, in colony astogeny and ontogeny

    DEVELOPMENTAL DYNAMICS, Issue 6 2006
    Amalia Rosner
    Abstract Proteins of the highly conserved PL-10 (Ded1P) subfamily of DEAD-box family, participate in a wide variety of biological functions. However, the entire spectrum of their functions in both vertebrates and invertebrates is still unknown. Here, we isolated the Botryllus schlosseri (Urochordata) homologue, BS-PL10, revealing its distributions and functions in ontogeny and colony astogeny. In botryllid ascidians, the colony grows by increasing the number of modular units (each called a zooid) through a whole colony synchronized and weekly cyclical astogenic budding process (blastogenesis). At the level of the colony, both BS-PL10 mRNA and its protein (78 kDa) fluctuate in a weekly pattern that corresponds with the animal's blastogenic cycle, increasing from blastogenic stage A to blastogenic stage D. At the organ/module level, a sharp decline is revealed. Primary and secondary developing buds express high levels of BS-PL10 mRNA and protein at all blastogeneic stages. These levels are reduced four to nine times in the new set of functional zooids. This portrait of colony astogeny differed from its ontogeny. Oocytes and sperm cells express high levels of BS-PL10 protein only at early stages of development. Young embryos reveal background levels with increased expressions in some organs at more developed stages. Results reveal that higher levels of BS-PL10 mRNA and protein are characteristic to multipotent soma and germ cells, but patterns deviate between two populations of differentiating stem cells, the stem cells involved in weekly blastogenesis and stem cells involved in embryogenesis. Two types of experimental manipulations, zooidectomy and siRNA assays, have confirmed the importance of BS-PL10 for cell differentiation and organogenesis. BS-PL10 (phylogenetically matching the animal's position in the evolutionary tree), is the only member of this subfamily in B. schlosseri, featuring a wide range of biological activities, some of which represent pivotal roles. The surprising weekly cyclical expression and the participation in cell differentiation posit this molecule as a model system for studying PL10 protein subfamily. Developmental Dynamics 235:1508,1521, 2006. © 2006 Wiley-Liss, Inc. [source]


    Targeting the p53 tumor suppressor gene function in glioblastomas using small chemical molecules

    DRUG DEVELOPMENT RESEARCH, Issue 10 2006
    Roberta Magrini
    Abstract Glioblastoma multiforme (GBM) is recognized as the most frequent and malignant glioma of which two genetically different subtypes can be distinguished. Primary, de novo glioblastomas show a p53 wild type (wt) status and in 10% of the cases hdm2 overexpression/amplifications occur. In these tumors, the inactivation of the tumor suppressor p53 is elicited by enhanced hdm2-mediated degradation of p53. Secondary glioblastomas, on the other hand, show inactivating p53 mutations (mut) in 40% of the cases. Based on these observations, reactivating the function of p53 might hold promise for treatment of GBM. In wt p53 tumors showing increased hdm2 levels, the therapeutic strategy might be to inhibit the activity of hdm2 by treatment with small molecules like nutlin-3. For mut p53 glioblastomas, p53 function might be restored using small chemical entities such as PRIMA-1. Drug Dev. Res. 67:790,800, 2006. © 2007 Wiley-Liss, Inc. [source]


    Working memory: Its role in dyslexia and other specific learning difficulties

    DYSLEXIA, Issue 3 2004
    Sharman Jeffries
    Abstract This paper reports a study contrasting dyslexic children against a control group of children without special educational needs (SEN) and a group with varied SENs. Children's abilities were compared on tasks assessing phonological processing, visuo-spatial/motor coordination and executive/inhibitory functioning; being targeted for assessment based on theoretical proposals related to the working memory model. Primary and secondary school level children were tested: 21 assessed as dyslexic with no comorbid difficulties, 26 children assessed with difficulties including dyspraxia, emotional/behavioural problems and attention deficits, 40 children with no known education-related deficits were controls. Results indicated both SEN groups performed worse than controls on working memory phonological loop measures. However, SEN groups could only be differentiated on phonological awareness measures: the dyslexics showing lower scores. Dyslexics performed as well as controls on working memory visuo-spatial scratch pad measures and one of two additional visual,motor coordination tasks, whereas the performance of the other SEN children was lowest on the majority of these measures. Central executive and interference measures engendered mixed performances, both SEN groups showing evidence of deficits in one or more of these areas of functioning, although, of the two SEN groups, the dyslexics seem to have performed the worse when digit name processing was required. Copyright © 2004 John Wiley & Sons, Ltd. [source]


    The spatial pattern of soil-dwelling termites in primary and logged forest in Sabah, Malaysia

    ECOLOGICAL ENTOMOLOGY, Issue 1 2007
    SARAH E. DONOVAN
    Abstract 1.,Primary and logged lowland dipterocarp forest sites were sampled for subterranean termites using soil pits located on a grid system in order to detect any patchiness in their distribution. 2.,A spatial pattern in termite distributions was observed in the primary and logged sites, but the response differed between soil-feeding and non-soil-feeding termites. 3.,Spatial analysis showed that soil-feeding termites were homogeneously distributed in the primary forest but significantly aggregated in the logged forest. This pattern was reversed for non-soil-feeding termites and may result from differences in resource provisioning between the two sites. 4.,Gaps in termite distribution comprised a greater area than patches for both feeding groups and sites, but gaps dominated the logged site. 5.,A significant association between soil-feeding and non-soil-feeding termite distributions occurred at both sites. This arose from an association between patches in the primary forest and between gaps in the logged forest. 6.,Termite spatial pattern was optimally observed at a minimum extent of 64 m and lag of 2 m. 7.,The spatially explicit SADIE (Spatial Analysis by Distances IndicEs) analyses were more successful than (non-spatially explicit) multivariate analysis (Canonical Correspondence Analysis) at detecting associations between termite spatial distributions and that of other biotic and abiotic variables. [source]


    The social causes of inequality in epilepsy and developing a rehabilitation strategy: A U.K.-based analysis

    EPILEPSIA, Issue 10 2009
    Leone Ridsdale
    Summary A rehabilitation approach has been adopted for many long-term neurologic conditions, but not for epilepsy. The disabilities associated with epilepsy are cognitive, psychological, and social, which are not as readily identified by medical doctors as are physical disabilities. A rehabilitation approach moves the emphasis from a medically driven process to a focus on the personal, social, and physical context of long-term illness. It is suggested that a missed opportunity for education and support for self-management occurs after diagnosis. This results in disadvantage to those whose educational level and knowledge of epilepsy are low. People who do not achieve epilepsy control may then experience higher levels of psychological distress, and a negative cycle of loss of self-efficacy, poor epilepsy control, social disadvantage, and disability. Rehabilitation services have benefited communities surrounding centers of excellence. Not so in epilepsy. Despite centers of excellence, areas with deprivation have higher than national average levels of patients reporting a seizure in the prior year, and higher emergency hospital admissions. Specialists working in partnership with general practitioners (GPs) and practice nurses can do more to increase participation and reduce distress for people with epilepsy. When available, GPs and nurses with special interest in epilepsy promote integrated services. Primary,secondary networks are likely to be more effective in preventing downward drift. This requires evaluation. [source]


    Interaction between the CCR5 chemokine receptors and microbial HSP70

    EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 9 2006
    Trevor Whittall
    Abstract Evidence is presented that the microbial 70-kD heat shock protein (HSP70) binds to CCR5 chemokine receptors in CCR5-transfected cell lines and in primary human cells. Significant CCR5-mediated calcium mobilization was stimulated by HSP70 and inhibited with TAK,779, which is a specific CCR5 antagonist. HSP70-mediated activation of the p38 MAPK phosphorylation signaling pathway was also demonstrated in CCR5-transfected HEK 293 cells. Direct binding of three extracellular peptides of CCR5 to HSP70 was demonstrated by surface plasmon resonance. Functional evidence of an interaction between HSP70, CCR5 and CD40 was shown by enhanced production of CCL5 by HEK 293 cells transfected with both CD40 and CCR5. Primary monocyte-derived immature DC stimulated with HSP70 produced IL-12 p40, which showed dose-dependent inhibition of >90% on treatment with both TAK 779 and anti-CD40 mAb. Stimulation of IL-12 p40 or TNF-, by HSP70 was related to the differential cell surface expression of CCR5 in primary human immature and mature DC, and those with the homozygous ,,32 CCR5 mutation. These findings may be of significance in the interaction between HSP70 and immune responses of CCR5+ T cells in HIV-1 infection, as well as in inflammatory bowel disease. See accompanying commentary: http://dx.doi.org/10.1002/eji.200636551 [source]


    Primary and secondary neural networks of auditory prepulse inhibition: a functional magnetic resonance imaging study of sensorimotor gating of the human acoustic startle response

    EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2007
    Linda E. Campbell
    Abstract Feedforward inhibition deficits have been consistently demonstrated in a range of neuropsychiatric conditions using prepulse inhibition (PPI) of the acoustic startle eye-blink reflex when assessing sensorimotor gating. While PPI can be recorded in acutely decerebrated rats, behavioural, pharmacological and psychophysiological studies suggest the involvement of a complex neural network extending from brainstem nuclei to higher order cortical areas. The current functional magnetic resonance imaging study investigated the neural network underlying PPI and its association with electromyographically (EMG) recorded PPI of the acoustic startle eye-blink reflex in 16 healthy volunteers. A sparse imaging design was employed to model signal changes in blood oxygenation level-dependent (BOLD) responses to acoustic startle probes that were preceded by a prepulse at 120 ms or 480 ms stimulus onset asynchrony or without prepulse. Sensorimotor gating was EMG confirmed for the 120-ms prepulse condition, while startle responses in the 480-ms prepulse condition did not differ from startle alone. Multiple regression analysis of BOLD contrasts identified activation in pons, thalamus, caudate nuclei, left angular gyrus and bilaterally in anterior cingulate, associated with EMG-recorded sensorimotor gating. Planned contrasts confirmed increased pons activation for startle alone vs 120-ms prepulse condition, while increased anterior superior frontal gyrus activation was confirmed for the reverse contrast. Our findings are consistent with a primary pontine circuitry of sensorimotor gating that interconnects with inferior parietal, superior temporal, frontal and prefrontal cortices via thalamus and striatum. PPI processes in the prefrontal, frontal and superior temporal cortex were functionally distinct from sensorimotor gating. [source]


    Synthesis of New Sterically Hindered Anilines

    EUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 19 2007
    Barry R. Steele
    Abstract Ring-alkylated primary, secondary and tertiary anilines have been ethylated with ethylene at benzylic positions in a simple and inexpensive one-pot procedure which is mediated bythe use of the superbase system nBuLi/LiK(OCH2CH2NMe2)2in the presence of Mg(OCH2CH2OEt)2. Primary and secondary anilines are ethylated readily at ortho -benzylic positions but with difficulty or not at all at other positions. Tertiaryanilines are ethylated at all positions. Mono- or diethylation occurs depending on the steric constraints present.(© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007) [source]


    Enantioselective Recognition of Aliphatic Amino Acids by ,-Cyclodextrin Derivatives Bearing Aromatic Organoselenium Moieties on the Primary or Secondary Side

    EUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 8 2003
    Yu Liu
    Abstract Spectrophotometric titrations have been performed in order to determine the stability constants of inclusion complexation of some aliphatic amino acids with four structurally related organoselenium-modified ,-cyclodextrins: mono(6-phenylseleno-6-deoxy)-,-cyclodextrin (1a), mono[6-(p -methoxyphenylseleno)-6-deoxy]-,-cyclodextrin (1b), mono(2-phenylseleno-2-deoxy)-,-cyclodextrin (2a), and mono[2-(p -methoxyphenylseleno)-2-deoxy]-,-cyclodextrin (2b). Conformation analysis by circular dichroism and 2D NMR spectroscopic studies revealed that the aryl-substituted ,-cyclodextrins gave self-inclusion intramolecular complexes in aqueous solution, while the extent of penetration depended both on the positions and on the structures of substituents. Quantitative investigation on the binding ability of the hosts with amino acids showed that they were able to recognize the size and the shape of guests, affording supramolecular complexes with quite small stability constants ranging from 24 to 355 M,1. The molecular recognition abilities are discussed from the viewpoints of induced-fitting mechanisms, geometric complementary, and cooperative binding processes. Furthermore, these ,-cyclodextrin derivatives displayed considerable enantioselectivity towards L/D -amino acid isomers, giving the highest L -enantioselectivity (up to 8.4) for inclusion complexation between leucine and 2a. The binding modes of L/D -leucine with 1b were elucidated from NOESY studies and the chiral recognition phenomena were interpreted accordingly. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2003) [source]


    Primary to Secondary LOTE Articulation: A Local Case in Australia

    FOREIGN LANGUAGE ANNALS, Issue 3 2001
    Article first published online: 31 DEC 200, Robert C. Kleinsasser
    Data taken from an independent school's admission documents over a 4-year period provide insights and reveal trends concerning students' preferences for language study, LOTE study continuity, and reasons for LOTE selection. The data also provides an accounting of some multiple LOTE learning experiences. The analysis indicates that many students who begin a LOTE in the early grades are thwarted in becoming proficient, because (1)continuation in the language is impossible due to unavailability of instruction; (2)expanded learning is hampered by teachers' inability to deal with a range of learners, (3)extended learning is hampered by administrative decisions or policies, or (4)students lose interest in the first LOTE and switch to another: Finally, a call is made for data gathering and research in local contexts to gain a better understanding of LOTE articulation challenges at the local, state, national, and international levels. [source]


    Composition and evolution of fluids during skarn development in the Monte Capanne thermal aureole, Elba Island, central Italy

    GEOFLUIDS (ELECTRONIC), Issue 3 2008
    F. ROSSETTI
    Abstract We describe the chemistry of the fluids circulating during skarn formation by focusing on fluids trapped in calcsilicate minerals of the inner thermal aureole of the Late Miocene Monte Capanne intrusion of western Elba Island (central Italy). Primary, CH4 -dominant, C-O-H-S-salt fluid inclusions formed during prograde growth of the main skarn-forming mineral phases: grossular/andradite and vesuvianite. The variable phase ratios attest to heterogeneous entrapment of fluid, with co-entrapment of an immiscible hydrocarbon,brine mixture. Chemical elements driving skarn metasomatism such as Na, K, Ca, S and Cl, Fe and Mn were dominantly partitioned into the circulating fluid phase. The high salinity (apparent salinity between 58 and 70 wt% NaCl eq.) and the C-component of the fluids are interpreted as evidence for a composite origin of the skarn-forming fluids that involves both fluids derived from the crystallizing intrusion and contributions from metamorphic devolatilization. Oxidation of a Fe-rich brine in an environment dominated by fluctuation in pressure from lithostatic to hydrostatic conditions (maintained by active crack-sealing) contributed to skarn development. Fluid infiltration conformed to a geothermal gradient of about 100°C km,1, embracing the transition from high-temperature contact metamorphism and fluid-assisted skarn formation (at ca 600°C) to a barren hydrothermal stage (at ca 200°C). [source]


    Down-regulation of neurocan expression in reactive astrocytes promotes axonal regeneration and facilitates the neurorestorative effects of bone marrow stromal cells in the ischemic rat brain

    GLIA, Issue 16 2008
    Li Hong Shen
    Abstract The glial scar, a primarily astrocytic structure bordering the infarct tissue inhibits axonal regeneration after stroke. Neurocan, an axonal extension inhibitory molecule, is up-regulated in the scar region after stroke. Bone marrow stromal cells (BMSCs) reduce the thickness of glial scar wall and facilitate axonal remodeling in the ischemic boundary zone. To further clarify the role of BMSCs in axonal regeneration and its underlying mechanism, the current study focused on the effect of BMSCs on neurocan expression in the ischemic brain. Thirty-one adult male Wistar rats were subjected to 2 h of middle cerebral artery occlusion followed by an injection of 3 × 106 rat BMSCs (n = 16) or phosphate-buffered saline (n = 15) into the tail vein 24 h later. Animals were sacrificed at 8 days after stroke. Immunostaining analysis showed that reactive astrocytes were the primary source of neurocan, and BMSC-treated animals had significantly lower neurocan and higher growth associated protein 43 expression in the penumbral region compared with control rats, which was confirmed by Western blot analysis of the brain tissue. To further investigate the effects of BMSCs on astrocyte neurocan expression, single reactive astrocytes were collected from the ischemic boundary zone using laser capture microdissection. Neurocan gene expression was significantly down-regulated in rats receiving BMSC transplantation (n = 4/group). Primary cultured astrocytes showed similar alterations; BMSC coculture during reoxygenation abolished the up-regulation of neurocan gene in astrocytes undergoing oxygen-glucose deprivation (n = 3/group). Our data suggest that BMSCs promote axonal regeneration by reducing neurocan expression in peri-infarct astrocytes. © 2008 Wiley-Liss, Inc. [source]


    Primary and secondary small cell neuroendocrine carcinoma of the larynx: A review

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2008
    Alfio Ferlito MD, DPath, FASCP, FDSRCS, FHKCORL, FRCPath, FRCSEd, FRCSGlasg, FRCSI
    Abstract Primary laryngeal small cell neuroendocrine carcinoma (SCNC) is an unusual malignancy accounting for <0.5% of laryngeal carcinomas. To date, approximately 200 cases of primary and 5 of secondary SCNC of the larynx have been reported. This tumor most often presents in the sixth and seventh decades in men who are heavy cigarette smokers. The lesion may be associated with different paraneoplastic syndromes (ectopic adrenocorticotropic hormone syndrome, Schwartz,Bartter syndrome or syndrome of inappropriate secretion of antidiuretic hormone, and Eaton,Lambert myasthenic syndrome) or with ectopic hormone production. The diagnosis is based essentially on the histologic appearance of the tumor, confirmed by immunocytochemical investigations. Concurrent chemoradiotherapy regimens offer potential for long-term survival. This tumor is biologically aggressive, and the extent of the disease is the most significant independent prognostic factor of survival. The survival rate is similar to that with pulmonary SCNC. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [source]


    Primary and salvage (hypo)pharyngectomy: Analysis and outcome

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2006
    FRACS, Jonathan R. Clark BSc(Med)
    Abstract Background. Surgery for squamous cell carcinoma (SCC) arising or extending to the hypopharynx is generally reserved for advanced disease or salvage. The prognosis of patients requiring pharyngectomy is poor, and the perioperative morbidity is significant. The aim of the present study is to describe the disease-related and treatment-related outcomes of patients undergoing primary and salvage pharyngectomy for cancer of the hypopharynx and larynx over a 10-year period from a single institution. Methods. We retrospectively reviewed 138 partial and circumferential pharyngectomies performed at a tertiary referral center between 1992 and 2002. There were 31 females and 107 males. The median age was 62 years (range, 27,81 years), and mean follow-up was 3.6 years. Salvage pharyngectomy for radiation failure was performed in 72 patients (52%), and in 66 patients (48%) pharyngectomy was performed as the primary treatment. Results. The 5-year overall survival rate after salvage pharyngectomy was 31% and after primary pharyngectomy was 38%. The 5-year disease-specific survival (DSS) for salvage was 40% and after primary surgery was 45%. The 5-year local and regional control rates for salvage pharyngectomy were 71% and 70%, respectively, and for primary pharyngectomy were 79% and 67%, respectively. The perioperative mortality rate was 3.6%, and the combined morbidity rate was 70%. Postoperative hypocalcemia developed in 44% of patients, a pharyngocutaneous fistula developed in 31% of patients, and the long-term stricture rate was 15%. Variables adversely affecting DSS on univariate analysis were nodal metastases (p = .044), extracapsular spread (ECS) (p = .006), poorly differentiated tumors (p = .015), lymphovascular invasion (p = .042), and positive tumor margins (p = .026). ECS (p = .023) was the only independent prognostic variable on multivariable analysis; however, there was a trend toward significance for nodal metastases (p = .064) and tumor differentiation (p = .079). Conclusion. This study demonstrates that both salvage pharyngectomy and primary surgery for advanced disease are viable options with high locoregional control. However, this represents a high-risk group in terms of both operative morbidity and survival. Patients with nodal metastases, ECS, and poorly differentiated tumors are likely to succumb to their disease and should be selected for adjuvant therapy when possible. © 2006 Wiley Periodicals, Inc. Head Neck 28: 671,677, 2006 [source]


    Effect of intermittent compression of upper arm veins on forearm vessels in patients with end-stage renal disease

    HEMODIALYSIS INTERNATIONAL, Issue 3 2005
    Rina R. Rus
    Abstract Native arteriovenous fistula is the best vascular access for chronic hemodialysis. Primary and long-term success depends, in part, on the state of arteries and veins at the time of the operation. The aim of our study was to investigate the effects of intermittent compression of upper arm veins on forearm vessels in patients with terminal renal disease. The study group was composed of 16 chronic hemodialysis patients who performed daily intermittent compression of the upper arm without vascular access by elastic band (Eschmarch). Ten chronic hemodialysis patients were included in the control group, which performed no specific activity. Forearm measurements were obtained at the beginning of the study and 4 and 8 weeks later during the course of intermittent compression of the upper arm veins. The forearm circumference and maximal handgrip strength were measured. The artery measures, including endothelium-dependent vasodilatation and forearm vein variables, were obtained by ultrasonography measurements. The forearm circumference, maximal handgrip strength, and artery variables, including endothelium-dependent vasodilatation, remained unchanged. The basal venous diameters (2.29 ± 0.19 mm at the beginning, 2.46 ± 0.19 mm after 4 weeks, and 2.53 ± 0.18 mm after 8 weeks) were significantly increased in the study group. The distensibility of veins was preserved in the study group. There were no significant changes in the control group. Our study demonstrated that daily intermittent compression of the upper arm veins increases the forearm vein diameter and preserves the distensibility of veins in patients with end-stage renal failure. [source]


    Primary and multisensory cortical activity is correlated with audiovisual percepts

    HUMAN BRAIN MAPPING, Issue 4 2010
    Margo McKenna Benoit
    Abstract Incongruent auditory and visual stimuli can elicit audiovisual illusions such as the McGurk effect where visual /ka/ and auditory /pa/ fuse into another percept such as/ta/. In the present study, human brain activity was measured with adaptation functional magnetic resonance imaging to investigate which brain areas support such audiovisual illusions. Subjects viewed trains of four movies beginning with three congruent /pa/ stimuli to induce adaptation. The fourth stimulus could be (i) another congruent /pa/, (ii) a congruent /ka/, (iii) an incongruent stimulus that evokes the McGurk effect in susceptible individuals (lips /ka/ voice /pa/), or (iv) the converse combination that does not cause the McGurk effect (lips /pa/ voice/ ka/). This paradigm was predicted to show increased release from adaptation (i.e. stronger brain activation) when the fourth movie and the related percept was increasingly different from the three previous movies. A stimulus change in either the auditory or the visual stimulus from /pa/ to /ka/ (iii, iv) produced within-modality and cross-modal responses in primary auditory and visual areas. A greater release from adaptation was observed for incongruent non-McGurk (iv) compared to incongruent McGurk (iii) trials. A network including the primary auditory and visual cortices, nonprimary auditory cortex, and several multisensory areas (superior temporal sulcus, intraparietal sulcus, insula, and pre-central cortex) showed a correlation between perceiving the McGurk effect and the fMRI signal, suggesting that these areas support the audiovisual illusion. Hum Brain Mapp, 2010. © 2009 Wiley-Liss, Inc. [source]


    Art & Design:The Rhetoric and the Practice

    INTERNATIONAL JOURNAL OF ART & DESIGN EDUCATION, Issue 1 2000
    John Bowden
    In this paper I will outline what I perceive to be the current context in which Art and Design activities operate in Primary and Secondary Schools in England. I will argue that significant advances in the teaching of the subject in the last two decades are being threatened, particularly in the primary sector, due to the impact of a number of factors, including the new ,standards' agenda, and constraints arising from limitations in resources, teaching expertise and deployment, and the effects of assessment. The under achievement of boys will be considered in relation to some observations on differentiation in the subject at Secondary level. The paper will suggest that the attempts by teachers to offer an art curriculum that covers all aspects of artistic activity has led to a superficiality of experience for pupils, and therefore a ,depth' rather than a breadth approach to art curriculum planning is now necessary. The variable impact of Critical Studies activities will be considered, including that of Artists in Schools, and I will suggest that there is an opportunity to extend current art practice encouraging greater risk-taking, through an open-ended problem-solving approach, and a development of work which celebrates pupils' own cultures and interests. [source]


    Osteoporosis management: a perspective based on bisphosphonate data from randomised clinical trials and observational databases

    INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2009
    S. Boonen
    Summary Aims:, The efficacy of treatments for osteoporosis can be evaluated using a variety of study designs. This article aims to comprehensively review the evidence for bisphosphonate anti-fracture efficacy in postmenopausal women, discussing the strengths and limitations associated with each study method. Methods:, Literature analysis included English-language publications reporting results of randomised controlled trials (RCTs), post hoc analyses, meta analyses and observational studies evaluating the efficacy of alendronate (ALN), ibandronate (IBN), risedronate (RIS) and zoledronate (ZOL), with an initial sample size , 100 patients, and follow-up data for at least 1 year. Results:, Primary and secondary analyses of RCT data suggest differences among bisphosphonates with regard to site-specific anti-fracture efficacy and onset of fracture risk reduction. While some observational studies indicate differences in clinical outcomes among these agents, others report similar effectiveness. ALN and RIS data demonstrate sustained fracture protection for up to 10 and 7 years of treatment respectively. The efficacy of IBN and ZOL has been evaluated for up to 3 and 5 years respectively. Conclusions:, Understanding of the benefits of bisphosphonate treatment can be maximised by evaluating complementary data from RCTs and observational database studies. Fracture risk reduction with bisphosphonates is shown in RCTs and in real-world clinical settings. [source]


    Follicular thyroid carcinoma: metastasis to the sternum, 13 years after total thyroidectomy

    INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2006
    A. EROGLU
    Summary Primary and metastatic malignancies of the sternum are uncommon. Secondary lesions to the sternum occur more commonly in patients with lung and breast cancer, and only a few cases of sternal metastasis arising from a follicular thyroid carcinoma have been reported in the literature. Rarely, metastases to the sternum present in the guise of primary sternal tumours may be treated surgically with that diagnosis in mind. We describe a case of a sternal mass treated by radical surgery, which ultimately proved to be a solitary metastasis from a follicular carcinoma of the thyroid, appearing 13 years after total thyroidectomy and radioactive iodine therapy. Late metastatic thyroid carcinoma to the sternum should be kept in mind in the differential diagnosis of sternal lesions. For patients with thyroid carcinoma and sternal metastasis, we recommend surgical resection of the metastasis, not only as a curative or palliative measure but also to maximise the effect of subsequent radioiodine treatment. [source]


    Cue reactivity as a predictor of outcome with bulimia nervosa

    INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2002
    Frances A. Carter
    Abstract The present study sought to evaluate specific hypotheses concerning the relation between cue reactivity and outcome among women with bulimia nervosa. Participants were 135 women aged between 17 and 45 years with a current, primary diagnosis of bulimia nervosa who participated in a randomized clinical trial evaluating the additive efficacy of exposure and nonexposure-based behavior therapy, to a core of cognitive behavior therapy (CBT). Physiological, self-report, and behavioral measures of cue reactivity to individualized high-risk binge foods were obtained at pretreatment and posttreatment. Primary, secondary, and tertiary outcome measures are reported for posttreatment and six-month follow-up. Self-report measures of cue reactivity at posttreatment were significantly positively associated with symptomatology at posttreatment. Cue reactivity at posttreatment was significantly positively associated with symptomatology at 6-month follow-up. However, cue reactivity at posttreatment did not contribute to the prediction of outcome at follow-up over and above posttreatment outcome. The notion that pretreatment cue reactivity may predict which treatment modality will be most beneficial (exposure or nonexposure-based treatment), as measured by reductions in symptomatology at posttreatment could not be supported. Implications for future research are discussed. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 31: 240,250, 2002; DOI 10.1002/eat.10041 [source]


    Immunocytochemical investigation of immune cells within human primary and permanent tooth pulp

    INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 1 2006
    H. D. RODD
    Summary. Aim., The aim of this study was to determine whether there are any differences in the number and distribution of immune cells within human primary and permanent tooth pulp, both in health and disease. Design., The research took the form of a quantitative immunocytochemical study. One hundred and twenty-four mandibular first permanent molars and second primary molars were obtained from children requiring dental extractions under general anaesthesia. Following exodontia, 10-µm-thick frozen pulp sections were processed for indirect immunofluorescence. Triple-labelling regimes were employed using combinations of the following: (1) protein gene product 9·5, a general neuronal marker; (2) leucocyte common antigen (LCA); and (3) Ulex europaeus I lectin, a marker of vascular endothelium. Image analysis was then used to determine the percentage area of immunostaining for LCA. Results., Leucocytes were significantly more abundant in the pulp horn and mid-coronal region of intact and carious primary teeth, as compared to permanent teeth (P < 0·05, anova). Both dentitions demonstrated the presence of well-localized inflammatory cell infiltrates and marked aborization of pulpal nerves in areas of dense leucocyte accumulation. Conclusions., Primary and permanent tooth pulps appear to have a similar potential to mount inflammatory responses to gross caries The management of the compromised primary tooth pulp needs to be reappraised in the light of these findings. [source]


    Polymer-Supported Bisacetoxybromate(I) Anion ,-An Efficient Co-Oxidant in the TEMPO-Mediated Oxidation of Primary and Secondary Alcohols

    ADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 5 2003
    Marco Brünjes
    Abstract A polymer-bound reagent for the efficient oxidation of primary alcohols to aldehydes and secondary alcohols to ketones in the presence of a catalytic amount of 2,2,6,6-tetramethyl-1-piperidinyloxyl (TEMPO) is described. The oxidation process is particular mild and allows one to prepare aldehydes with ,-chirality without racemization. This also includes the synthesis of ,-aminoaldehydes. In most cases, work-up of this heavy metal-free oxidation is achieved by simple filtration followed by removal of the solvent. Insight into the role of the bromate(I) anion in the oxidation process was gained from the TEMPO-mediated oxidation of benzaldehyde in the presence of the hypochlorite anion loaded on an anion exchange resin. [source]


    Weighted Stair Climbing in Mobility-Limited Older People: A Pilot Study

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002
    MD Jonathan Bean MS
    OBJECTIVES: To evaluate weighted stair climbing exercise (SCE) as a means of increasing lower extremity muscle power in mobility-limited older people. DESIGN: Single-blinded, randomized controlled pilot study INTERVENTIONS: Subjects were randomized into one of two 12-week exercise programs. The intervention group (SCE) (n = 23) ascended and descended stairs, at a set pace, while wearing a weighted vest. The control group (WALK) (n = 22) participated in a standardized walking program. MEASUREMENTS: Primary and secondary outcomes included measures of muscle power and strength, submaximal aerobic capacity, and physical performance. RESULTS: SCE produced 17% improvement in double leg press peak power in comparison with WALK (P = .013) and significant improvement in stair climbing power from baseline (12%). Improvement in submaximal aerobic performance was equivalent for both groups. Although not statistically significant, effect size estimates suggest that SCE can potentially influence knee extension power and strength. Stair climb time was improved in both groups, whereas SCE produced significant improvements from baseline SPPB score in a subcohort of participants. CONCLUSIONS: These findings suggest that SCE may be a useful component of a home exercise program designed to enhance lower extremity muscle power, aerobic capacity, and functional performance. Further investigation is needed involving larger sample sizes and direct comparisons with other forms of resistance training. [source]