Altered joint kinetic strategies of healthy older adults and individuals with Parkinson’s disease to walk at faster speeds

Individuals with Parkinson’s disease (PD) exhibit poorer walking performance compared to healthy, age-matched adults. Lower extremity joint kinetics may provide insight into this performance deficit but are currently lacking in the PD literature, especially across multiple speeds. The primary purpose of this study was to compare joint kinetics between individuals with PD and healthy older adults at both comfortable and maximal walking speeds. Secondarily, we quantified relationships between joint kinetics and walking speeds within each group. Biomechanical gait analyses were conducted for 13 individuals with PD and 12 age-matched controls during comfortable (CWS) and maximal (MWS) speed walking. Relative contributions to total positive work from the hip, knee, and ankle were compared across groups and speeds. Within each group, relationships between relative joint work and CWS and MWS were also quantified. Significant group by speed interactions indicated that healthy older adults increased hip and decreased ankle relative work at MWS compared to CWS whereas relative work at all joints in PD group remained stable across speeds. In the older group, positive relationships were observed between relative hip work and MWS. In the PD group, negative relationships were observed between relative hip work and CWS and MWS. Healthy older adults disproportionately increased mechanical contributions from the hip at MWS compared to CWS. Individuals with PD did not exhibit similar disproportionate scaling of joint kinetics across speed conditions. Inability to appropriately scale joint kinetics in PD may represent an inflexible neuromuscular system in PD, which may limit walking performance in this population.     

Enfermedades invasivas por hongos levaduriformes en pacientes quemados graves

Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective.     

眼科手术患者信息交互系统的开发和应用

眼病专科手术患者多、接台快，导致病房和手术室在接送手术患者时出现流程上不规范、不合理，出现差错和遗漏。为有效提高医疗、护理工作质量及工作效率，提高患者的满意度，为管理者和科研提供参考统计数据，利用信息化的技术，建立眼科手术患者信息交互系统，使医护共享有关数据，合理设计手术工作流程，实现科学化、规范化、信息化的手术患者全程管理目标。     

Molecular identification and subtyping of Blastocystis sp. in hospital patients in Central China

Blastocystis is a common enteric protist that inhabits the gastrointestinal tract of approximately 1 billion people worldwide. In this study, a total of 1,070 patients from two hospitals in Zhengzhou, Central China were enrolled to know molecular characteristics of Blastocystis sp. The microorganism was identified and subtyped with a PCR amplification and sequencing of the small subunit ribosomal deoxyribonucleic acid (SSU-rDNA). The overall minimum prevalence of Blastocystis sp. in participants was 3.1% (33/1070). Although there were no significant differences on Blastocystis sp. infections among study sites, age groups, and gender, the higher infection was observed in the patients with gastrointestinal diseases (8.8%, 15/170). Sequence analysis of the 33 isolates revealed three known subtypes, such as ST1 (n = 7), ST3 (n = 23), and ST7 (n = 3). Among them, ST3 was the dominant subtype being detected in 23 isolates (69.7%), followed by ST1 (21.2%, 7/33) and ST7 (9.1%, 3/33). The phylogenetic analysis demonstrated that three subtypes (ST1, ST3 and ST7) were clustered with their reference sequences with good bootstrap support. The subtype determination of Blastocystis sp. isolates by the phylogenetic analysis was well supported by online platform. The present study provides the first molecular report of Blastocystis sp. infections in hospital patients in Central China.     

Evaluation of a method for bimanual testing coordination of hand grip and load forces under isometric conditions

The purpose of the study was to evaluate a method for testing bimanual prehension based on a novel experimental device. The device consists of two handles allowing for simultaneous measurement of bimanual hand grip forces (GF) and different patterns of load forces (LF) exerted during compression and tension along the longitudinal axis. In order to assess the reliability of the obtained measures, eight healthy subjects were tested over three consecutive test, while three moderately impaired neurological patients were tested once. In healthy subjects, high coordination was observed between GFs and LFs, as well as between two GFs and two LFs. The results also suggest a satisfactory task performance in regards to exerting the instructed LF profile, as well as a sufficient, but not excessive GF. The reliability of most of the assessed variables proved to be either moderate or high. When compared to healthy subjects, the data obtained from neurological patients mainly revealed irregular patterns of LFs, excessive GFs, as well as a relatively weak relationship between GFs and LFs. It was concluded that the evaluated methodological approach can be applied not only to explore uni- and bi-manual coordination of arm and hand grip forces in various prehensile activities, but also to serve as a basis for future development of specific clinical tests for neurological patients and other populations that demonstrate impaired hand function.