Gender differences in balance performance at the time of retirement.

BACKGROUND: Impairments in balance performance are a commonly accepted risk factor for falling in older people. Since there is a higher reported incidence of falling in women, it is of interest to test whether this correlates with poorer balance performance in women than men at the time of retirement in order to plan health promotional strategies. The purpose of this study was to investigate whether any gender differences exist in balance performance in people approaching retirement age. METHODS: Ninety-seven healthy volunteers (44 males, 53 females) planning to retire shortly were enrolled in the study (age range 50-67 years). Balance assessments during quiet standing were performed under various conditions; feet together eyes open, feet together eyes closed and single limb stance eyes open. The range of centre of pressure displacement in both the anterior-posterior and medial-lateral planes was collected for each task using a force platform. FINDINGS: For several of the balance tasks the men exhibited a statistically significant larger range of centre of pressure displacement than the women (P<0.01). However, after normalising the data for height, no gender differences were seen. Over half of the group failed to complete all three single limb stance trials on both limbs. INTERPRETATION: When the data was normalised for height, no differences were found in static balance performance between men and women of retirement age. A number of participants demonstrated balance impairments whilst performing the single limb stance likely to affect functional activities. Health promotional messages should be targeted equally at men and women.

Effect of rioprostil on aspirin-induced gastrointestinal mucosal changes in normal volunteers.

Rioprostil, a 15-deoxy-16-methyl prostaglandin E1, was evaluated for its effect on aspirin-induced gastrointestinal mucosal changes in normal volunteers. Fifty-six normal male volunteers were evaluated by endoscopy in a double-blind, placebo-controlled study. Aspirin was given at a dose of 975 mg four times per day. Rioprostil was given at doses of 60, 120, and 300 micrograms four times per day. Rioprostil, at both antisecretory and subantisecretory doses, prevented or reduced aspirin-induced injury. Increased stool frequency was the most common side effect and appeared to be a dose-related effect of rioprostil occurring at only antisecretory doses.

Prolongation of the latency period in preterm premature rupture of the membranes using prophylactic antibiotics and tocolysis.

Mixed results have been obtained in several studies using tocolysis or antibiotics individually in the treatment of premature rupture of membranes (PROM). We compared the outcomes of a management protocol consisting of tocolysis, prophylactic antibiotic administration, and documentation of pulmonary maturity with a control group treated with passive expectant management for premature rupture of membranes. There were 55 women in the treatment group and 57 women in the control group. The mean latent phase (+/- SEM) in the treatment group was 7.34 (+/- 1.25) days compared with 1.86 (+/- .431) days in the control group (P less than .001). Eighteen of 55 patients (33%) in the treatment group were electively delivered after documentation of lung maturity, contributing to a falsely lowered mean latent phase in the treatment group. Twenty-four patients in the treatment group and 6 in the control group had a latent phase of 5 days or greater (P = .00018). There were 9 postpartum infections in the control group and 10 infections in the treatment group (P = NS). There was no difference in the length of latent phase of patients treated with ceftizoxime compared with the other antibiotics used (cefoxitin, cefazolin, ampicillin), although postpartum ceftizoxime was more effective in preventing postpartum infections (1 of 28 vs 9 of 27) (P = .005). There were fewer infected neonates in the study group, but this was not significant. It appears that treatment with this protocol significantly prolongs the latent phase in patients with preterm PROM without increasing infectious morbidity.

Active expectant management in very early gestations complicated by premature rupture of the fetal membranes.

Premature rupture of the membranes (PROM) in the previable gestation is frequently associated with fetal or neonatal death. Passive expectant management is successful in only a small minority of cases. Women presenting with PROM at < or = 27 weeks' gestation were treated with tocolysis and prophylactic antibiotics and delivered electively for lung maturity. The corrected perinatal survival was > 92%. The mean latency phase was 21.6 days (+/- 18.12 SD). Twenty-one percent of patients presented in labor; the mean latency phase for this subgroup was 14.4 (+/- 8.54) days. Nineteen patients (79%) had a latency phase > 7 days, and 14 (58%) had a latency phase > 14 days. Thirty-nine percent of infants required < 48 hours of mechanical ventilation. Six infants were delivered with intraventricular hemorrhage; in all cases it was grade 1 or 2. There were three (12.5%) postpartum infections and three septic neonates. Active expectant management using tocolysis and prophylactic antibiotics was associated with a prolonged latency phase, low infectious morbidity and good neonatal outcome.

Lower limb muscle strength and physical activity in healthy individuals approaching retirement.

The purpose of this study was to examine knee extensor/flexor muscle strength and physical activity in healthy males and females approaching retirement. Peak torques of the knee extensor and knee flexor muscle groups were measured bilaterally in 95 individuals (mean age 59.4 years) using an isokinetic dynamometer. Isokinetic concentric contractions were performed at angular velocities of 1.05 and 3.14 rad x s(-1). Physical activity, including household, leisure, and sporting activities, was assessed. The results show that the average peak torques exhibited were lower than previously reported in studies using the same methodology with different populations of similar age and body size. Over one-third of the participants were sedentary, with just 13% being active enough to obtain health benefits. The poor muscle strength and low physical activity of this self selecting group of healthy working adults were surprising, and potentially a cause for concern. The combination of retirement being a potential watershed for a decrease in physical activity and the known age-related decline in physical performance indicates that some of these participants are at risk of losing their functional independence fairly early in the retirement stage. We recommend the introduction of effective health promotion interventions for individuals approaching retirement, encouraging them to become more physically active.

Transfer of Timentin (ticarcillin and clavulanic acid) across the in vitro perfused human placenta: comparison with other agents.

OBJECTIVES: In vitro perfusion of human placentas was used to quantify the net placental transfer of ticarcillin and clavulanic acid. STUDY DESIGN: Placentas were obtained from uncomplicated pregnancies at term. The maternal and fetal circulations were reestablished at flow rates of 17.5 ml/min and 5 ml/min, respectively. Open circulations were used to evaluate steady-state pharmacodynamics and transplacental gradient formation. Drug levels were measured by high-pressure liquid chromatography. RESULTS: The clearance index of ticarcillin was 0.037 +/- 0.004. The fetal/maternal ratio was 0.91. Therapeutic concentrations of clavulanate (2 to 6 micrograms/ml) in the maternal media resulted in undetectable transfer to the fetal compartment. By using higher levels of clavulanate, a clearance index of 0.061 +/- 0.001 (mean +/- SEM) and 1:1 fetal/maternal gradient was obtained. CONCLUSIONS: These data correspond to relatively low transfer of ticarcillin with a cord/maternal ratio of < 1. Clavulanate transfer is slightly greater. Agents with similar activity and superior transfer would optimize intrauterine treatment.

Clinical evaluation of Rho(D) immune globulin (human) in Canada.

-During 1966, clinical trials were conducted in three Canadian centres to determine the safety and efficacy of Rh(0)(D) immune globulin (human) in preventing isoimmunization by the Rh(0)(D) antigen in Rh-negative women delivering ABO-compatible Rh-positive infants.The candidates were randomly divided into control and treated groups; the treated mothers received an intramuscular injection of 300 mug. of anti-Rh(0)(D) within 72 hours of delivery. Follow-up antibody screening tests were conducted on the sera of all patients six to nine months post partum.Of the 175 control patients, 11 or 6.2% became actively immunized to the Rh antigen, whereas complete protection against maternal Rh immunization was observed in the 191 treated patients.