27 research outputs found
Physiotherapy Rehabilitation for Individuals with Lower Limb Amputation: A 15-Year Clinical Series
No full textThis author accepted manuscript (post print) is made available in accordance with the publisher copyright policy.Background and Purpose
Individuals with amputations are a core group in Australian rehabilitation units that have a long index length of stay. The Repatriation General Hospital (RGH) offers general rehabilitation services to the population of Southern Adelaide (a population of 350,000) and includes an on-site prosthetic manufacturing facility. Using a physiotherapy database at the RGH, we sought to answer the following questions: What are the demographic and clinical characteristics of patients admitted for lower limb prosthetic rehabilitation over 15 years? What are the times to rehabilitation outcomes? How have these changed over 15 years with changes in service delivery?
Methods
This paper is a retrospective observational study using a physiotherapy clinical database (1996–2010) of 531 consecutive individuals with lower limb amputation at one South Australian hospital (RGH). There were two changes in service delivery: 1) a multidisciplinary interim prosthetic programme (IPP) introduced in 1998 and 2) removable rigid dressings (RRDs) introduced in 2000. Outcome measures were patient demographics, clinical characteristics and time to rehabilitation outcome markers.
Results
Mean age was 68 years (standard deviation [SD]: 15), with 69% male, 80% dysvascular and 68% transtibial. The overall median inpatient rehabilitation length of stay (RLOS) was 39 days (interquartile range [IQR]: 26–57). Individuals with amputation entering rehabilitation each year had a higher number of co-morbidities (β: 0.08; 95% confidence interval: 0.05–0.11). Introduction of the IPP was associated with a significant reduction in time to initial prosthetic casting, independent walking and inpatient RLOS. Introduction of RRDs was associated with a significant reduction in time to wound healing, initial prosthetic casting and independent walking.
Conclusions
Individuals with amputation were typically elderly dysvascular men with transtibial amputations. Introduction of the IPP and RRDs successfully reduced time to rehabilitation outcomes including independent walking, an outcome that is rarely reported but is of significance to patients and physiotherapist
The evaluation of growth hormone state and anthropometric measurements after completion treatment with growth hormone in patients of childhood-onset hypopituitarism
No full textAuthor: Radvilė Dobrovolskytė Title of the work: The evaluation of growth hormone state and anthropometric measurements after completion treatment with growth hormone in patients of childhood-onset hypopituitarism. Aim of the work: To perform the analysis of growth hormone (GH) state metabolic profile and anthropometric measurements in those patients with childhood-onset hypopituitarism who have undergone a recombinant GH (rGH) treatment. Objectives: 1. To determine the incidence of permanent and transient growth hormone deficiency (GHD) among the patients with hypopituitarism (HPP) after completion of treatment with growth hormone in Endocrinology Clinic at the Lithuanian University of Health Sciences hospital Kaunas clinics between the years 2007 and 2017. 2. To compare the anthropometric data (final height, body mass index) after completion the treatment with rGH in patients groups of permanent and transient ADH. 3. To evaluate the metabolic profile (metabolism of carbohydrates, lipids, calcium and phosphorus) of patients with childhood-onset HPP that have undergone a childhood treatment with rGH. Methodology: A retrospective analysis was performed on the data of those patients with childhood-onset HPP, who have undergone a treatment with rGH and have subsequently been retested in Kaunas Endocrinology Clinic between the years 2007 and 2017. These patients have been retested at least 3 months after discontinuation of rGH. Data were collected from a cohort of 118 patients. The anthropometric, hormonal and metabolic parameters were analyzed. The data analysis was performed using Microsoft Office Excel 2010 and SPSS 20.0 statistics package. Data are displayed as mean ± SD unless stated otherwise. Paired t test was used for comparison of paired values, whereas one-sample ttest was used for comparison of sets of standardized SDS data against the zero value (birth weight, birth length, body height, body mass index [BMI]), with statistical significance level set at 0.05. Correlation of two independent variables was evaluated by a linear regression test. Results: 118 patients (62 males and 56 females) between the ages of 11,4 and 19,6 (average 16,2 years) have been examined. Out of 118 patients, isolated GHD has been identified in 77 patients, multiple pituitary hormone deficiency (MPHD) – in 38 and13 of them had a PROP1 gene mutation. Out of 118 patients, 24 have been diagnosed with permanent GHD, 87 – with transient GHD, for 7 patients the GH secretion was not evaluated. The age average of patients (n=118) at the start of treatment with rGH was 10,1±3,4 years, age average at the end of rAH treatment was 16,2±1,3 years, the duration of treatment was 6,1±3,2 years. The patient group with MPHD has achieved a reaching greater final heights compared with patient group of isolated GHD. The standard deviation of their height at the start of treatment was -4,1±1,0 for boys and -3,8±1,0 for girls; at the end of treatment it was -0,6±0,74, for boys and -0,6±1,1 for girls. The standard deviation of height of patient group with isolated GHD were -3,5±0,9 for boys and -3,4±0,8 for girls at the start of treatment; -1,2±1,1 and -1,3±1,1, respectively at the end of treatment. The patient group with permanent GHD had a statistically significant difference in pathological levels of total cholesterol compared to the transient GHD group (38,9% and 6.8%, respectively, (p0,05). 3. Patients with identified transient GHD, exhibited statistically significant higher HOMA-IR (p=0,009). The patient group with permanent GHD had a statistically significant difference in pathological levels of total cholesterol (p<0,01). The prevalence of osteopenia and osteoporosis within the groups was similar and statistically significant difference according BMD was not observed
Pitfalls of diagnosing pituitary hypoplasia in the patients with short stature
No full textPurpose: Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD. Methods: Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined. Results: The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA. Conclusion: PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response. © The Author(s) 2024
Evidence for the autocrine/paracrine regulation of tissue growth by the insulin-like growth factors
No full textMany tissues can undergo tissue specific (local) growth in response to various stimuli. The objectives of this thesis were to investigate the local growth of skeletal muscle and brown adipose tissue and the possible involvement of the insulin-like growth factors (IGF-I and IGF-II) in regulating this growth in an autocrine/paracrine manner.In Chapter 1, the effects of varying amounts of stretch stimulus on chicken skeletal muscle hypertrophy and atrophy were examined. The results indicated that the muscle hypertrophy response can be regulated by modulating the amount of time per day that the stretch stimulus is applied. In addition, intermittent stretch (for 4 hours/day) significantly inhibited regression of muscle atrophy.In Chapters 2 and 3, the role of the IGFs in skeletal muscle growth was investigated. Compensatory hypertrophy of the plantaris and soleus muscles in normal (Chapter 2) and hypophysectomized (hypox; Chapter 3) rats was induced by cutting the tendon of the synergistic gastrocnemius muscle. Hypertrophy and IGF mRNA levels were then examined at 2, 4, and 8 days post-surgery. Significant hypertrophy was observed in both muscles in normal and hypox rats. IGF-I and IGF-II mRNA levels were elevated in hypertrophy muscles as compared to contralateral control muscles both in normal and hypox rats. The effects on IGF mRNA levels of rat growth hormone (rGH) administration to hypox rats was also investigated. IGF-I mRNA levels were elevated in the plantaris and soleus in response to rGH. These results indicate that IGF gene expression can be modulated by both systemic and local factors and suggest a role for the IGFs in autocrine/paracrine regulation of skeletal muscle growth.In Chapter 4, the effects of (1) cold exposure of normal rats and (2) administration of rGH to hypox rats on IGF mRNA levels in rat brown adipose tissue (BAT) were investigated. IGF-I mRNA levels were high in BAT and were rGH dependent, but were not modulated by cold exposure. IGF-II mRNA levels were low and unaffected by rGH in BAT; however, exposure of rats to a cold environment appeared to increase IGF-II mRNA levels 2 to 3 fold in as little as 8 hours. A significant hyperplasia response was observed in BAT of rats exposed to the cold. These results suggest a potential autocrine/paracrine role for IGF-II in regulating BAT hyperplasia, although further studies on the IGF-II response in BAT are needed.Made available in DSpace on 2011-05-07T13:18:20Z (GMT). No. of bitstreams: 2
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Miss Mabel Marryat MBE and the league of loyal women
No full textAn Author Event presented by the Friends of the University of Adelaide Library, 15 November 2018, Ira Raymond Exhibition Room, Barr Smith LibraryMiss Marryat's Circle: a not so distant past In 1915, the second year of the Great War, Mabel Marryat - granddaughter of South Australia's first colonial chaplain Charles Howard - joined the newly formed League of Loyal Women. Mabel was active in the League's emergency corps, 'women who are prepared to give their service in any need that may arise'. It wasn't long before Mabel was appointed Honorary Supervisor of the Red Cross Depot at the Keswick Military Hospital: No. 7 AGH. After the war, the hospital was renamed RGH Keswick. Here Mabel stayed for 30 years. This book gives voice to the women of South Australia's first 110 years of European settlement and opportunity to reflect on the changing position of women in society. But the spotlight shines on Mabel. Her long and devoted community service - particularly to her 'Diggers' - was extraordinary
Dandelion uses the single-cell adaptive immune receptor repertoire to explore lymphocyte developmental origins
No full text\ua9 2023, The Author(s).Assessment of single-cell gene expression (single-cell RNA sequencing) and adaptive immune receptor (AIR) sequencing (scVDJ-seq) has been invaluable in studying lymphocyte biology. Here we introduce Dandelion, a computational pipeline for scVDJ-seq analysis. It enables the application of standard V(D)J analysis workflows to single-cell datasets, delivering improved V(D)J contig annotation and the identification of nonproductive and partially spliced contigs. We devised a strategy to create an AIR feature space that can be used for both differential V(D)J usage analysis and pseudotime trajectory inference. The application of Dandelion improved the alignment of human thymic development trajectories of double-positive T cells to mature single-positive CD4/CD8 T cells, generating predictions of factors regulating lineage commitment. Dandelion analysis of other cell compartments provided insights into the origins of human B1 cells and ILC/NK cell development, illustrating the power of our approach. Dandelion is available at https://www.github.com/zktuong/dandelion
OBSERVATION OF LUMINESCENCE SPECTRA OF KrD RYDBERG MOLECULE AT LOW (40K) TEMPERATURE
No full text I. Dabrowski, D. A. Sadovskii, Molecular Physics, 81(2), 291, (1994).Author Institution: Institute for Energy Problems of Chemical PhysicsThe luminescence spectra of KrD Rydberg molecule in spectral range from 400 nm to 800 nm in gas phase at low temperatures (40k) were observed for the first time by means of original experimental technique. In this method two gas jets were intersected over the surface of superfluid helium (temperature 1.5K, pressure of helium vapor 10 torr). Gas mixture of He with 1-5frequency electrodeless discharge. The resulting luminescent jet was introduced in a helium cryostat and crossed by a stream of or molecules to produces RgH or RgD. First experiments with Kr and were carried out. A number of bands observed in the luminescence spectra was assinged to KrD extensively studied by Dabrowski et al. . The most pronounced bands observed at 515 nm and 773 nm originate from 4d state and correspond to transitions to 5p states. Transitions from the np complexes were also identified but their intensity were much weaker. Near 483 nm there was rather broad band assigned to transitions from nf complexes. The luminescence spectra of nitrogen molecules and ions, and CN radicals at such low temperatures were also studied and a number of peculiarities in the spectra were observed. These results will be presented as well
Age-specific nasal epithelial responses to SARS-CoV-2 infection
No full textChildren infected with SARS-CoV-2 rarely progress to respiratory failure. However, the risk of mortality in infected people over 85 years of age remains high. Here we investigate differences in the cellular landscape and function of paediatric (<12 years), adult (30-50 years) and older adult (>70 years) ex vivo cultured nasal epithelial cells in response to infection with SARS-CoV-2. We show that cell tropism of SARS-CoV-2, and expression of ACE2 and TMPRSS2 in nasal epithelial cell subtypes, differ between age groups. While ciliated cells are viral replication centres across all age groups, a distinct goblet inflammatory subtype emerges in infected paediatric cultures and shows high expression of interferon-stimulated genes and incomplete viral replication. In contrast, older adult cultures infected with SARS-CoV-2 show a proportional increase in basaloid-like cells, which facilitate viral spread and are associated with altered epithelial repair pathways. We confirm age-specific induction of these cell types by integrating data from in vivo COVID-19 studies and validate that our in vitro model recapitulates early epithelial responses to SARS-CoV-2 infection
Self-consistent method to extract non-linearities from pulsating star light curves - I. Combination frequencies
No full textStellar pulsation is a common phenomenon and is sustained because of coherent driving mechanisms. When pulsations are driven by heat or convective mechanisms, it is usual to observe combination frequencies in the power spectra of the stellar light-curves. These combination frequencies are not solutions of the perturbed stellar structure equations. In dense power spectra from a light-curve of a given multiperiodic pulsating star, they can compromise the mode identification in asteroseismic analyses, and hence they must be treated as spurious frequencies and removed. In this paper, a method based on fitting the set of frequencies that best describes a general non-linear model, like the Volterra series, is presented. The method allows these frequencies to be extracted from the power spectrum, thereby improving the frequency analysis and enabling hidden frequencies to emerge from what was initially considered as noise. Moreover, the method yields frequencies with uncertainties several orders of magnitude smaller than the Rayleigh dispersion, which is sometimes used as if it were an error when identifying combination frequencies. Furthermore, it is compatible with the classical counting cycles method, the so-called O-C method, which is valid only for mono-periodic stars. The method creates the possibility of characterizing the non-linear behaviour of a given pulsating star by studying in detail the complex generalized transfer functions on which the model is based. © 2020 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical SocietyMLM, RGH and JPG acknowledge financial support from the State Agency for Research of the Spanish MCIU through the Center of Excellence Severo Ochoa' award to the Instituto de Astrofisica de Andalucía (SEV-2017-0709). The authors acknowledge funding support from Spanish public funds for research under project ESP201787676-C5-5-R.Peer reviewe
