Relationships between wheelchair skills, wheelchair mobility and level of injury in individuals with spinal cord injury.

STUDY DESIGN: Cross-sectional. OBJECTIVES: To describe the manual wheelchair (MWC) skill profiles of experienced MWC users with spinal cord injury and their wheeled mobility (distance and speed) while considering their level of injury and age. SETTING: Rehabilitation centers, participant's home and the community. METHODS: MWC skills were evaluated using the wheelchair skills test (WST) and wheeled mobility data were collected in the participants' own environment over a 7-day period, using a Cateye cycle computer (VELO 8). A total of 54 participants took part in the study. RESULTS: The mean total performance score of the sample on the WST was 80.7±11.8%, with a significant difference between participants with tetraplegia (C4-C8) and those with low-level paraplegia (T7-L2) (P<0.01). The average daily distance covered was 2.5±2.1 km at 1.7±0.9 km h(-1), with no significant difference between participants with paraplegia and those with tetraplegia (wheeled distance: P=0.70; speed: P=0.65). Significant relationships were found between MWC skills and daily wheeled distance (r=-0.32, P<0.05), but the correlation between these variables did not remain significant when controlling for age (partial r=0.26, P=0.07). CONCLUSION: These results suggest that the level of injury is related to MWC skills but not wheeled mobility. MWC skills are related to greater wheeled distance, but to a lesser extent when controlling for age.

[Hemoptysis in sarcoidosis. Apropos of 6 cases including 4 with fatal outcome]. / Les hémoptysies des sarcoïdoses. A propos de 6 cas dont 4 mortels.

Haemoptysis rarely occurs in sarcoidosis. Most cases usually occur in patients with advanced disease and major fibrosis. We observed 6 cases including 5 with fibrosis and 1 with inaugural unilateral lymph node involvement. Haemoptysis is a sign of gravity since it is the second most frequent cause of death described in the literature. In our series 4 of the 6 cases were fatal. Aspergillus colonization of a cavity is the most frequently found aggravating factor. Ideally, surgery is indicated but usually cannot be performed due to the patients respiratory function and the extent of the lesions. Oral drugs have little effect. Certain authors have had success with local, initially intrabronchic anti-aspergillus treatment. CT-guided application is often helpful. Embolization may stop the bleeding but in the long-term, a more or less voluminous haemoptysis often recurs. Other causes of bleeding are rare. Systemic hypervascularization of sarcoidosis lesions has been proposed as one mechanism other than infection. The cause may also be a simple granuloma. Symptomatic initial treatment by embolization is also proposed in these cases. Finally, massive haemoptysis can occur by erosion of the pulmonary artery due to a necrotic sarcoidosis lesion. In our series, surgery was impossible in three patients who died. In the three others, embolization was possible in 2 and the third underwent successful surgery.

Exercise and negative energy balance in males who perform mental work.

BACKGROUND: Although energy expenditure during mental work is not higher than energy expenditure at rest, a stressful mental task is related to an increase in energy intake. It is suggested that mental work produces physiological changes, thereby influencing food intake. OBJECTIVE: Because physical activity can influence hunger, the aim of the study was to determine if the introduction of an active pause could counteract the negative effects of mental work on energy intake and energy balance. METHOD: Twelve male students, of normal weight, between 15 and 20 years old were evaluated. All subjects participated in three different sessions realized in a randomized order: (i) without pause = relaxation/mental work/meal; (ii) relaxation pause = mental work/relaxation/meal; and (iii) exercise pause = mental work/exercise/meal. Energy expenditure was measured with indirect calorimetry, energy intake was measured with a cold buffet-type meal of 40 items, and appetite-related sensations were measured with visual analogue scales. The effect of introducing an active pause in energy intake and energy balance was studied. RESULTS: The introduction of an active pause did not influence energy intake; although, higher appetite-related sensations were observed (16-26 mm on a 150-mm scale; P < 0.05). After accounting for the energy expenditure related to physical activity, a lower energy balance was measured for the exercise pause visit compared with the visit without a pause (-1137 kJ; P < 0.05). CONCLUSION: This study indicates that being active between mental work and a meal could represent a strategy to create a negative energy balance following mental work via an increased energy expenditure and a maintenance of energy intake. Globally, these results could help individuals attain and/or maintain a healthy body weight in a context where mental work is omnipresent.

Child abuse, psychiatric disorder, and running away in a community sample of women.

OBJECTIVE: Studies involving clinical samples of adolescents indicate that running away is a common problem associated with substantial emotional impairment, yet little information is available from community-based samples. This study aimed to investigate runaway behaviour in female adolescents with and without a history of maltreatment in childhood. METHOD: We analyzed data from a province-wide community survey conducted in Ontario (n = 3760 girls and women, aged 15 to 64 years). Respondents returned a self-completed questionnaire regarding their history of maltreatment as children. Psychiatric disorder was assessed with a revised version of the Composite International Diagnostic Interview. RESULTS: Respondents who reported physical abuse only, sexual abuse only, and physical abuse with sexual abuse were 2 to 4 times more likely to report running away from home before age 16 years. Parental psychiatric disorder, respondent psychiatric disorder, respondent age, and income were also significant correlates of running away. CONCLUSIONS: Understanding the relation between exposure to maltreatment as a child, psychiatric disorder, and running away in women is important for determining ways to prevent a behaviour that puts youth at high risk for a wide range of difficulties.

Effects of melatonin in vivo upon luteinizing hormone and prolactin releases induced by opiate receptor antagonists in adult male rats.

The effects of melatonin on LH and PRL releases induced by treatment with naloxone, naloxone methyliodide and nalmefene were studied in adult male rats. Subcutaneous melatonin injection (1.4 mg/Kg) had no effect on LH secretion, but caused an inhibition effect (84%) on LH release induced by naloxone (2.4 mg/Kg). Melatonin too totally inhibited LH secretion induced by naloxone methyliodide (2.8 mg/Kg) and nalmefene (2 mg/Kg) when it was simultaneously administered with each opioid receptor antagonist. Melatonin alone had no significant effect on serum PRL levels, but decreased by 25.5% the inhibitory effect potency of nalmefene on PRL secretion after simultaneous injections. The inhibitory effect potency of naloxone on PRL release increased (16%) when it was administered with melatonin. Simultaneous injection of melatonin with naloxone methyliodide inhibited PRL release (78%) while naloxone methyliodide alone did not modify this secretion. The results obtained with a quaternary opioid antagonist indicate that the opioid receptor type which mediates LH and PRL responses is located respectively outside and inside the blood-brain barrier. Our findings show that opiate antagonists and their quaternary ammonium salts affect secretion of LH and PRL through different mechanisms susceptible to the influence of melatonin.