Hypertrophy of extensor digitorum longus muscle, overloaded by the removal of the synergist tibialis anterior (TA) muscle, in growing rats is inhibited if endogenous satellite cells are sterilized by exposure to irradiation. However, normal muscle growth is not eliminated, only diminished. To test whether irradiated, overloaded muscle can hypertrophy in the absence of normal growth-related stimuli, experiments were conducted on mature rats. TA muscle ablation caused hypertrophy of EDL muscle, characterized by a significant increase in muscle mass and the size of type IIx and type IIb fibers, and a proportional increase in the number of myonuclei. When ablation was preceded by irradiation, hypertrophy did not occur. The results indicate that satellite cell activation, division, and fusion is necessary for compensatory hypertrophy of fully mature muscle, and may be important to the understanding of the limits of recovery of inherited muscle myopathies treated by myogenic cell implantation.
Length of hospital stay and discharges to institutions from rehabilitation settings are significantly determined by medical complications. Importance of adhering to clinical pathway/protocol for stroke care is further discussed.
These data suggest that improving depressive symptoms in stroke patients may accelerate functional recovery, but the level of physical functioning achieved post-stroke is determined by neurological and cognitive factors, consistent with the evidence that improvement of depressive symptoms through therapeutic intervention is limited by cognitive impairment.
BackgroundIntraosseous (IO) access is an alternative to conventional intravenous access.AimsWe evaluate the use of the EZ-IO™ as an alternative vascular access for patients in the emergency department.MethodsA non-randomized, prospective, observational study was performed in adults using the EZ-IO™ powered drill device.ResultsTwenty-four patients were recruited. There were 35 intraosseous insertions, including 24 tibial and 11 humeral insertions. All EZ-IO™ insertions were achieved within 20 s and were successful at the first attempt except for one. Of the intraosseous insertions, 88.6% were reported to be easier than intravenous cannulation. We found flow rates to be significantly faster using a pressure bag. The seniority of operators did not affect the success of insertion. Complications included a glove being caught in the drill device and extravasation of fluid although they were easily preventable.ConclusionThe use of the EZ-IO™ provides a fast, easy and reliable alternative mode of venous access, especially in the resuscitation of patients with no venous vascular access in the emergency department. Flow rates may be improved by the use of pressure bags.
Continuous screening and appropriate intervention, especially at baseline, would significantly decrease the burden posed by stroke patients with such psychological impairments in the community.
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