Cognitive Motor Dual Task Costs in Older Adults with Motoric Cognitive Risk Syndrome.

The purpose of this study was to characterize Cognitive Motor Dual Task (CMDT) costs for a community-based sample of older adults with Motoric Cognitive Risk Syndrome (MCR), as well as investigate associations between CMDT costs and cognitive performance. Twenty-five community-dwelling older adults (ages 60-89 years) with MCR performed single and dual task complex walking scenarios, as well as a computerized cognitive testing battery. Participants with lower CMDT costs had higher scores on composite measures of Working Memory, Processing Speed, and Shifting, as well as an overall cognitive composite measure. In addition, participants with faster single task gait velocity had higher scores on composite measures of Working Memory, Processing Speed, and overall cognition. Taken together, these results suggest that CMDT paradigms can help to elucidate the interplay between cognitive and motor abilities for older adults with MCR.

Antibiotic-disc tests for rapid identification of non-sporing anaerobes.

The sensitivity patterns to a number of antibiotic-impregnated discs of 126 strains of Gram-negative anaerobes and 36 strains of Gram-positive non-sporing anaerobes from various sources have been examined. The sensitivity patterns shown by Bacteroids fragilis and Bacteroides melaninogenicus were useful for the rapid identification of these organisms. Consistent and useful sensitivity patterns were not shown by the Gram-positive anaerobes.

The isolation of anaerobic bacteria from wound swabs.

The isolation of anaerobic bacteria from routine wound swabs by three procedures was evaluated. Recovery of anaerobic organisms was doubled by immediate incubation of seeded plates, and the recovery could be further dramatically improved by the use of prereduced media, in conjunction with an anaerobic chamber. Recommendations for the treatment of swabs and cultures for anaerobic investigation are made.

Asymptomatic carriage of Clostridium difficile in patients with cystic fibrosis.

Faecal samples from 37 patients with cystic fibrosis and 40 control patients at the Brompton Hospital and the London Chest Hospital were examined for the presence of Clostridium difficile. The organism was isolated from 2 (17%) of control patients who were receiving antibiotics and from one (3.6%) of control patients who had no antimicrobial treatment. Thirty two per cent of the patients with cystic fibrosis excreted C difficile, though none of them had diarrhoea. Two of the three isolates from control patients and nine of the 12 isolates from patients with cystic fibrosis produced toxin B (cytotoxin) in vitro. Toxin B was present in the stools of one of the control patients and three of the patients with cystic fibrosis; toxin A (enterotoxin) was not detected in the faeces of the patients with cystic fibrosis. Two cytotoxigenic strains of C difficile isolated from patients with cystic fibrosis were examined in hamsters; both were virulent, and the animals died.

Clostridia isolated from faeces.

Clostridia were isolated from human faecal samples from England, Scotland, Wales, USA, Hong Kong, Uganda and Japan. Strains were identified on the basis of various biochemical reactions and on the type of fatty acid produced from glucose. Analysis of these acids was by gas-liquid chromatography. Clostridium paraputrificum was common in stool samples from England, Scotland, Wales, and USA, but rare in samples from Hong Kong, Uganda and Japan.

The effects of ascorbic acid and iron co-supplementation on the proliferation of 3T3 fibroblasts.

Exposure of 3T3 fibroblasts to FeII reveals a concentration-dependent inhibition of cell proliferation compared to control cells, the apparent threshold for this iron-mediated effect being 5 microM FeII. The inhibition of cell proliferation was accompanied by an enhancement of total malondialdehyde (MDA) levels (as detected directly by hplc) in the cells at higher iron concentrations. The co-supplementation of FeII with varying concentrations of ascorbic acid over the range 5 microM to 240 microM had no significant effect on the threshold for iron toxicity or lipid peroxidation. These results show that there is neither a significant exacerbation of the pro-oxidant effect of FeII nor any protective effect of ascorbate when cultures of 3T3 mouse fibroblasts are exposed to co-supplementation regimes of iron with ascorbic acid.

Malondialdehyde formation in liver mitochondrial and microsomal fractions of vitamin E- and selenium-deficient rats as a function of alpha-tocopherol level: the effect of treatment in vitro with iron.

Weanling rats were given diets with adequate vitamin E and selenium or deprived of one or the other or both, nutrients. After 28 days, liver mitochondrial and microsomal fractions were prepared and alpha-tocopherol (alpha-T) and selenium measured. alpha-Tocopherol fell by eight-fold in the doubly deficient rats and selenium fell three-fold. Malondialdehyde (MDA) was found to be undetectable by a sensitive HPLC method. The fractions were subjected to peroxidative stress in in vitro using 0.5 mM Fe2+/10 mM ADP, and MDA and alpha-T were measured at intervals during 30 min. The results showed that in the mitochondrial fractions there was a lag time of at least 2 min before peroxidation became significant, during which time most of the alpha-T was consumed. In the microsomal fraction the lag phase was very short prior to the establishment of a linear rate of peroxidation, although little alpha-T was used up. It was concluded that the mitochondrial fraction withstood the peroxidative challenge better than the microsomal fraction even though the initial level of alpha-T in the microsomal fraction was about double that in the mitochondrial fraction. Selenium deficiency had no effect on the length of the lag phase of the fractions which therefore appears to be a characteristic of mitochondrial or microsomal fractions.

Ileoanal pouch procedures: clinical outcomes and quality-of-life assessment.

Ileoanal pouch (IAP) anastomosis following total colectomy for ulcerative colitis or familial adenomatous polyposis is performed with the goal of avoiding a permanent ileostomy and its effects on life satisfaction. During a retrospective 10-year study period, 55 patients underwent IAP construction for ulcerative colitis (36) and familial adenomatous polyposis (19). We assessed complications by chart review and surveyed patients regarding quality of life via a standardized questionnaire. There was no operative mortality, and there were three late deaths (6%). Twenty-nine patients (54%) sustained 68 early and late complications. Pouchitis was the most common complication (24%), and two patients required pouch excision (4%), one for pouchitis and one for rectovaginal fistula. Thirty-one patients (65%) have completed questionnaires. Forty-seven patients (87%) responded that their overall quality of life is "always" better since creation of the IAP, and only one patient in the IAP group has greater than ten bowel movements a day. Twenty-one patients (68%) never have interference with intimate relationships and 20 (65%) never have interference with physical activities. However, 20 patients (65%) sometimes have sleep interference, and 19 patients (61%) sometimes have fecal soilage. None of the patients continue to take steroids. We conclude that the complication rate following IAP construction is high, but pouch loss is infrequent. Despite a high complication rate, the majority of patients experience an improvement in quality of life.

Definitive identification methods: antibiotic sensitivity and microtube system.

The definite identification of species and subspecies of an anaerobe implies certain difficulties, such as the poor and slow fermentation of carbohydrates under anaerobic conditions and the fact of having many keys in common. As a result several tests are required and as the number of tests increases the chances of error and the number of variables also increase. Hence specific methods have been developed in order to try and obtain satisfactory results. The A. refers his experience and judgement on V.P.I. and A.P.I. and on identification based upon antibiotic sensitivity spectrum. When properly used, such techniques enable the species and subspecies of non-sporing anaerobes to be more easily identified.

Intestinal bacterial flora in normal adults in the U.K.

The A. reports on the composition of the bacterial flora being present all through the intestine of normal adults in the United Kingdom, listing the number and families of the aerobes and anaerobes occupying the various portions of the alimentary tract. Emphasis is then laid on a comparison between the normal "British" flora in the colon and rectum, where the ratio of anaerobes to aerobes is 100 to 1, and the flora found in normal adults in Africa, India and Japan, stressing the major differences in the numbers of clostridia and non-sporing anaerobes. The A. finally highlights the importance of the factors governing the intestinal bacterial ecology, as well as the serious consequences likely to arise from the alteration of such flora.

Some implications for the clinical use of music facilitated imagery.

In this study, Helen Bonny's Guided Imagery and Music technique provided the base experience for questionnaire responses from short-term psychiatric inpatients, students, and staff (total/n = 107). Independent measures of age range, sex, medication type, and recent relaxation practice were compared statistically with dependent responses of skin temperature, perceived ability to relax, production of images, and perceived helpfulness of the experience. Results demonstrated increases in skin temperature and relaxation perception and defined the average experience as manifesting three concurrent imagery modes. Among the man independent-dependent variable relationships, some significant differences in mean responses were present. These differences and their possible clinical implications are discussed; further research in the area, including replication, is recommended.

The value of flexor hinge hand splints.

Functional hand splints have been in use in a number of spinal injury units in the USA since the early 1950s. The splints are designed to provide a pinch-grip either by harnessing wrist dorsiflexion or by external power. Such devices are little used in the United Kingdom. This paper describes the results of late provision of 62 such splints in a Disabled Living Unit. A proportion of tetraplegic patients found such splints of considerable functional value. It is estimated that some 30--60 patients each year would benefit from them if appropriate facilities for early fitting were available.

Mass spectral measurement of residual oxygen in the atmosphere of an anaerobic culture chamber.

A simple and reproducible procedure has been devised for sampling gases and for analysis of the residual oxygen in the atmosphere of the anaerobic culture chamber by mass spectrometer.

Some studies of the bacterial flora associated with the mucosa of the human gastrointestinal tract.

Specimens of mucosal tissue of the small and large bowel obtained either by a colonoscope or during surgical operations were investigated quantitatively for their bacterial flora. A detailed prescription of the methodology using an anaerobic chamber is given. Most of the mucosal specimens of the small intestine as well as all the specimens of the large intestine contained bacteria (about 10(4) germs/g). Predominantly, Bacteroides, gram-positive rods, and cocci were isolated. In contrast to the gut lumen flora anaerobic bacteria of the mucosal flora did not outnumber the aerobes. In patients with inflammatory bowel disease or with carcinoma of the colon the mucosal flora showed no demonstrable alterations even after undergoing a sulphonamide therapy.

Occupational asthma in a mineral analysis laboratory.

An epidemic of symptoms suggestive of occupational asthma in workers in a mineral analysis laboratory necessitating exposure to vapours of hydrochloric, hydrofluoric, nitric, perchloric, and sulphuric acid solutions was investigated. Variable airflow obstruction was confirmed by serial measurement of FEV1 in two subjects who showed 18% and 22% fall in FEV1 during a workshift. Of a workforce of 21 laboratory staff, 20 took part in a study of ventilatory capacity and bronchial reactivity. All but one subject had normal ventilatory capacity but five had bronchial hyperreactivity (PC20 less than or equal to 8 mg/ml histamine). Four of the five with hyperreactivity had a history of chest tightness at work whereas only two subjects with chest tightness had PC20 greater than 8 mg/ml (p less than 0.01). Other work related symptoms were cough (two subjects) and breathlessness (three subjects). Four of the subjects with bronchial hyperreactivity were atopic, suggesting that hyperreactivity may have predated exposure to irritant material at work and resulted in their being susceptible to the development of symptoms and raises the possibility of identifying susceptible subjects by preplacement examination. In two of these subjects, however, bronchial reactivity has returned to normal after 205 and 376 days away from work, suggesting that bronchial inflammation resulted from occupational exposure to acid vapours.

Anaesthesia and hypoparathyroidism. A case report.

A 34-year-old White woman underwent surgery for the correction of bilateral ptosis. She had a known diagnosis of hypoparathyroidism following previous thyroidectomy, and was receiving replacement therapy. The peri-operative handling and the physiopathology and therapeutic management of hypoparathyroidism are discussed.