The purpose of this article is to propose creation of a consistent, measureable 12-week aquatic exercise progression for individuals diagnosed with asthma. An aquatic exercise option not requiring swim skills may offer real value, but no previous literature explicitly describes a standardized nonswimming aquatic exercise progression. Participants were diagnosed: medically managed asthmatics in a rural community. Guidelines set forth by AEA and ACSM were used in the development of the exercise program and progression. By the end of the 12 weeks, instructors were challenging participants with multilevel travel sets and complex timed sequences, meeting programmatic goals for exercise intensity progression. In conclusion, this 12-week aquatic exercise protocol could effectively be prescribed by aquatic exercise specialists to increase physical activity in an asthmatic population. The design may be used in research studies as a consistent and measurable treatment protocol. According to the National Health Interview Study, in 2007 approximately 40.6 million Americans have been diagnosed with asthma at some point during their life. Approximately 16.2 million are affected by asthma symptoms daily. Asthma ranks within the most prevalent conditions causing limitation of activity, which can make asthmatics more likely to suffer from cardiovascular and metabolic conditions resulting from a sedentary lifestyle. Physical activity has been shown to have extensive health benefits both in normally functioning adults as well as in adults with asthma (Lucas & Platts-Mills, 2005; Pedersen & Saltin, 2006). Aquatic exercise programs focusing on respiratory endurance have significantly improved athletic performance in the general population (Romer, McConnell, & Jones, 2002a, 2002b). Researchers have also reported that individuals suffering from asthma typically have subnormal exercise tolerance (
Diazepam (DZ) placental transfer in pregnant women at term, following single or repeated drug administration by various routes, was evaluated. DZ and its metabolite N-demethyldiazepam (NDZ) were constantly present in umbilical cord plasma at concentrations comparable to the mother's shortly after drug administration. N-methyloxazepam (MOX) was detected in cord plasma only in a limited number of cases following chronic DZ treatment. Postmortem analysis of fetal tissue concentrations showed accumulation of NDZ in heart and lungs. Differences in NDZ concentrations between venous cord (VC) and arterial cord (AC) plasms suggest metabolic degradation of DZ in the fetus. The DZ apparent plasma half-life in the newborn was found to be longer (31 plus or minus 2 hr) than previously observed in infants and children. The low drug clearance appears to be linked to reduced urinary excretion of hydroxylated metabolites, suggesting limited capability to dispose of DZ in the newborn.
Diazepam (D Z) placental transfer in pregnant women at term, following single or repeated drug administration by various routes, was evaluated. DZ and its metabolite N-demethyldiazepam (NDZ) were constantly present in umbilical cord plasma at concentrations comparable to the mother's shortly after drug administration. N-methyloxazepam ( MO X) was detected in cord plasma only in a limited number of cases following chronic DZ treatment. Postmortem analysis of fetal tissue concentrations showed accumulation of NDZ in heart and lungs. Differences in NDZ concentrations between venous cord (VC) and arterial cord (AC) plasma suggest metabolic degradation of DZ in the fetus. The DZ apparent plasma half-life in the newborn was found to be longer (31 ± 2 hr) than previously observed in irifants and children. The low drug clearance appears to be linked to reduced urinary excretion of hydroxylated metabolites, suggesting limited capability to dispose of DZ in the newborn.
A cochlear implant (CI) is an electronic device that enables hearing recovery in patients with severe to profound hearing loss. Although CIs are a successful treatment for profound hearing impairment, their effectivity may be improved by reducing damages associated with insertion of electrodes in the cochlea, thus preserving residual hearing ability. Inner ear trauma leads to inflammatory reactions altering cochlear homeostasis and reducing post-operative audiological performances and electroacoustic stimulation. Strategies to preserve residual hearing ability led to the development of medicated devices to minimize CI-induced cochlear injury. Dexamethasone-eluting electrodes recently showed positive outcomes. In previous studies by our research group, intratympanic release of dexamethasone for 14 days was able to preserve residual hearing from CI insertion trauma in a Guinea pig model. Long-term effects of dexamethasone-eluting electrodes were therefore evaluated in the same animal model. Seven Guinea pigs were bilaterally implanted with medicated rods and four were implanted with non-eluting ones. Hearing threshold audiograms were acquired prior to implantation and up to 60 days by recording compound action potentials. For each sample, we examined the amount of bone and fibrous connective tissue grown within the scala tympani in the basal turn of the cochlea, the cochleostomy healing, the neuronal density, and the correlation between electrophysiological parameters and histological results. Detection of tumor necrosis factor alpha, interleukin-6, and foreign body giant cells showed that long-term electrode implantation was not associated with an ongoing inflammation. Growth of bone and fibrous connective tissue around rods induced by CI was reduced in the scala tympani by dexamethasone release. For cochleostomy sealing, dexamethasone-treated animals showed less bone tissue growth than negative. Dexamethasone did not affect cell density in the spiral ganglion. Overall, these results support the use of dexamethasone as anti-inflammatory additive for eluting electrodes able to protect the cochlea from CI insertion trauma.
Aspiration risk has a substantial influence on clinical management of swallowing disorders, and can be associated with pharyngeal residue. The aims of this cross-sectional study are to examine the correlation between the presence of pharyngeal residue and penetrationaspiration during fiberoptic endoscopic evaluation of swallowing (FEES), examine the correlation between objective data and Functional Oral Intake Scale (FOIS) and determine whether using objective assessment (Pooling score and Penetration Aspiration Scale-PAS) to categorise patients as pathological or not identifies the same patients identified by FOIS. Fifty-five patients with neurogenic dysphagia were evaluated during FEES by using the Pooling Score scale and PAS. They underwent an assessment of nutritional modalities using FOIS. There was a significant positive correlation between Pooling score and PAS scores for semisolid bolus (Pearson = 0.305; p = 0.024) and liquids (Pearson = 0.841; p = 0.000). The semi-solid bolus Pooling score had a negative correlation with FOIS (Pearson =-0.355; p = 0.008), but there were no other significant correlations for FOIS with Pooling score or PAS. There were significant differences between objective assessments (P-score/PAS) and functional measure (FOIS) for identifying patients as pathological; although the positive predictive values were high, the negative predictive values were very low. Although pharyngeal residues are significantly associated with the presence of penetration-aspiration during endoscopy, the real intake modalities are not correlated with objective assessments of swallowing disorders. Therefore, clinicians need to implement a comprehensive approach to assess dysphagia.
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