Admission Norton scale scores correlate with rehabilitation outcome and length in elderly patients following cerebrovascular accident.

AIMS: To determine whether Norton scale scores used for evaluating pressure sore risk also correlate with rehabilitation outcome and length following cerebrovascular accident (CVA) in elderly patients. METHODS: A retrospective study was conducted at a geriatric rehabilitation department in a tertiary medical center during 2009. The medical charts of consecutive elderly (≥65 years) patients admitted for rehabilitation after CVA were studied for the following measurements: admission Norton scale scores, admission albumin serum levels, mini-mental status examination (MMSE) scores, discharge walking functional independence measure (FIM) scores, discharge transfer FIM scores, and rehabilitation length in days. RESULTS: The cohort included 110 patients, 64 (58.2%) women and 46 (41.8%) men. The mean age of the entire group was 80.5±7.4 years. Most patients had ischemic CVA (90.9%) and a first CVA (79.1%). The mean discharge walking FIM score was 4.7±1.4, the mean discharge transfer FIM score was 5.0±1.4, and the mean length of rehabilitation was 28.2±15.3 days. Admission Norton scale scores correlated with discharge walking FIM scores (r=0.51; p<0.0001), discharge transfer FIM scores (r=0.43; p<0.0001), and length of rehabilitation (r=-0.45; p<0.0001) after adjustment for age, albumin serum levels, and MMSE scores. Linear regression analysis showed that admission Norton scale scores were associated (p<0.0001) with the discharge walking FIM scores, the discharge transfer FIM scores and rehabilitation length, independent of age, gender, albumin serum levels, MMSE scores, type of CVA, and the appearance of pressure sores. CONCLUSIONS: The Norton scoring system may be used to predict the outcome and duration of rehabilitation in elderly patients after CVA.

Bioelectrocatalysis by redox enzymes at modified electrodes.

Self-assembled monolayers of thiolated compounds are used as promoters for protein-electrode reactions. They provide an anchor group based on thiol chemisorptions and also a functional group for effective interaction with the protein. These interactions are often governed by electrostatic attraction. For example, for positively charged proteins, such as cytochrome c and the selenoprotein glutathione peroxidase, mercaptoalkanoic acids have been used. Clay modification of the electrode surface has been found to facilitate the heterogeneous electron transfer process for heme proteins, e.g. cytochrome c, cytochrome P450 and myoglobin. Interestingly, nucleic acids at carbon electrodes and thiol-modified double stranded oligonucleotides act as promoters of the redox communication to proteins, whereas the mechanism is still subject to controversy interpretations. By interacting the protein immobilised at the electrode with species in solution, signal chains have been constructed. The interaction can result in a simple co-ordination or redox reaction, depending on the nature of the reaction partners. For analytical purposes, e.g. biosensors, the electrochemical redox conversion of the immobilised protein is evaluated.