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In this study, we tested the hypotheses that, relative to the maximum capacities, ballroom dancing is more intensive for females than males, and that the hold technique (female vs. male) regulates dancing intensity. Ten dance couples were tested in a maximal treadmill test, competition simulation, and stationary dance hold position. Peak heart rate and relative oxygen consumption were measured during the tests, except that oxygen consumption was not measured during competition simulation. Regardless of gender, heart rate increased similarly in the treadmill test and in the competition simulation. In the treadmill test, females achieved an oxygen consumption of 78% of the males (p p

For improvements in exercise tolerance and cognitive function in geriatric patients Multimodal training programs (MTP) are used as combination of physiotherapy, occupational therapy and cardiovascular training. Intermittent Hypoxic-Hyperoxic Training (IHHT), a modified type of intermittent hypoxic training (IHT) is proposed to be included in MTP to elicit more pronounced beneficial effects in exercise tolerance and cognitive functions of geriatric patients likely by an additional pathway than a single MTP. Thirty four patients of the Geriatric Day Clinic aged between 64 and 92 years participated in the placebo controlled clinical trial. They were randomly assigned to receive MTP plus IHHT (experimental group - EG) or MTP plus placebo-breathing through a machine face mask (control group - CG) in a double blind fashion. Before and after the interventions course cognitive performance was assessed by the Dementia-Detection-Test (DemTect) and the Clock-Drawing-Test (CDT), and functional exercise capacity - by the total distance of 6-Minute-Walk-Test (6MWT). After IHHT combined with MTP cognitive performance (DemTect) increased significantly when compared to NG (+16,7 % vs. +0,39 %, p0,001). The CDT indicated similar results with a significant increase in the EG while the score of the CG even decreased (+10,7 % vs. -8%, p=0,031). Concerning the functional exercise capacity, both groups improved the total distance in the 6MWT but with a significantly larger increase in the EG compared to the CG (+24,1 % vs. +10,8 %, p=0,021). In addition, there was a significant relationship between the changes of the 6MWT and the DemTect Scores and the CDT. IHHT contributed significantly to improvements in cognitive performance and exercise capacity in elderly performing MTP. IHHT sessions are considered to be easily applicable to and well tolerated by geriatric patients up to 92 years.Для поддержания физической работоспособности и когнитивных функций у пожилых пациентов применяются мультимодальные реабилитационные программы (МРП) на основе физических тренировок, физиотерапевтических процедур, психологического тренинга и пр. Для повышения эффективности МРП у пожилых предложено применять новый вариант адаптации к интервальной нормобарической гипоксии — метод интервальных гипоксически-гипероксических тренировок (ИГГТ). В плацебо-контролируемом клиническом исследовании приняли участие 34 пациента 64-92 лет дневного гериатрического стационара Клиники Клагенфурта (Каринтия, Австрия), рандомизированных на две группы: опытная (ОГ) — получившие МРП и курс ИГГТ; контрольная (КГ) — прошедшие курс МРП при имитации процедур ИГГТ. До и после курса реабилитации когнитивные функции и нагрузочная выносливость пациентов были оценены с применением тестов определения деменции (DemTect), рисования часов (Clock-drawing Test), а также проведением 6-минутного теста ходьбы (6MWT). При проведении курса ИГГТ когнитивные возможности пациентов ОГ значимо улучшились по сравнению с пациентами КГ: прирост значений в тесте деменции составил +16,7 % (в КГ +0,39 %, p0,001), в тесте рисования часов +10,7 % (в КГ −8 %, p=0,031). Дистанция, пройденная в 6-минутном тесте, увеличилась в обеих группах, однако достоверно больше в ОГ — +24,1 % (в КГ +10,8 %, p=0,021). Выявлены прямые значимые корреляции между приростом в нагрузочной толерантности и когнитивных тестах. Таким образом, включение процедур адаптации к интервальной гипоксии-гипероксии в МРП у пожилых приводит к значимому повышению их эффективности, что проявляется в улучшении когнитивных функций и физической выносливости. Процедуры ИГГТ хорошо переносятся, не вызывают побочных эффектов.

Nursing homes are confronted more and more with palliative care patients, which present a challenge for nursing and medical personnel. Deficits in the palliative care of geriatric patients have been repeatedly demonstrated and many nursing home residents, especially those suffering from dementia, are undersupplied regarding pain management.The present study was carried out to measure the knowledge and self-efficacy of nursing staff in the province of Carinthia (Austria) regarding palliative care of nursing home residents.A total of 330 nursing personnel were surveyed using the Bonn test for knowledge in palliative care (BPW), which measures knowledge and self-efficacy in nursing home personnel. In addition to descriptive analyses, the effects of the professional group (registered nurses vs. nursing assistants) and working experience were tested.On average a little more than half of the knowledge items were answered correctly. Nurses' self-efficacy was high. Registered nurses exhibited more knowledge and higher self-efficacy compared to nursing assistants. Effects of working experience could only be demonstrated regarding self-efficacy.The results are to a large extent in line with results from Germany and indicate the necessity of interventions for improving nurses' knowledge as a major basis for adequate palliative care in nursing home residents.

Until recently the measurement of pain in cognitively impaired patients represented a neglected field in the diagnostics and treatment of pain. Investigations indicate a prevalence of pain in nursing home residents of between 45 % and 80 %.This study investigated the reliability of the German translation of the Doloshort scale and compared it with the visual analog scale (VS). The aim of this study was to determine the practical applicability of this scale in the clinical routine and to calculate the intrarater reliability (retest) and interrater reliability.The interrater and intrarater reliability of the Doloshort scale was between 0.949 and 0.970. There was a highly significant correlation between the values of the Doloshort scale and the VAS.The Doloshort scale is a well suited measurement instrument for the evaluation of pain in cognitively impaired patients. Because of the short form only simple instructions are necessary and it has a high acceptance with users.

Numerous studies have investigated lipoprotein(a) (Lp(a)) plasma concentrations in patients with ESRD, a patient group with an enormous risk for atherosclerosis. The reported differences in Lp(a) between controls and patients vary from a decrease of 49% to an increase of more than 1,000%. However, data are not consistent, mostly because of problems with statistical analysis, and only limited data are available for patients treated by continuous ambulatory peritoneal dialysis (CAPD). To estimate the significance of Lp(a) in ESRD and to demonstrate the statistical pitfalls concerning Lp(a) in case-control studies, a large multicenter study including 702 patients treated by either hemodialysis (HD) (N = 534) or CAPD (N = 168) was conducted, and results were compared with results from 256 healthy controls. Both patient groups showed significantly elevated Lp(a) levels in comparison with controls: 23.4 +/- 25.0 mg/dL (P < 0.005; HD) and 34.6 +/- 38.4 mg/dL (P < 0.0001; CAPD) versus 18.4 +/- 22.8 mg/dL (controls). CAPD patients showed significantly higher Lp(a) values than did patients treated by HD (P < 0.001). The difference between the two treatment groups possibly reflects an overproduction of Lp(a) to compensate for protein losses in CAPD patients. Both treatment groups included significantly more patients with Lp(a) values greater than the 75th percentile (25.6 mg/dL) of the control group (33.9 and 41.7% for HD and CAPD, respectively; P < 0.005). The higher Lp(a) values in patients were not explained by differences in isoform frequencies and the increase in Lp(a) was apolipoprotein(a) type specific: only patients with high-molecular-weight apolipoprotein(a) isoforms showed a significant elevation in Lp(a) levels. The increased plasma concentrations of Lp(a) may contribute to the high risk for atherosclerosis in ESRD, especially in patients treated by CAPD. Finally, it is believed that small sample sizes are responsible for the diverging results in Lp(a) literature.

Although glomerular damage plays a well-established and important role in the pathomechanism of diabetic nephropathy, it alone does not fully explain the progression of renal complications in long-term diabetes mellitus. We discuss experimental evidence showing involvement of the postglomerular microvessels (peritubular capillaries and venules) in diabetic microangiopathy. This involvement is manifest in increased permeability of these vessels to plasma proteins and in highly augmented lymphatic drainage of the extravasated proteins from the renal interstitium. We suggest that in the advanced phase of diabetic nephropathy, proteinuria (corresponding to excess leakage of proteins through the glomerular capillary wall) indicates the probability that postglomerular microvessels have also allowed leakage of plasma proteins. As long as lymphatic drainage is capable of removing the increased quantity of extravasated plasma proteins from the interstitium, renal function should not be deleteriously affected. However, if the excess amount of extravasated proteins exceeds the capacity of lymphatic drainage, increases in interstitial volume and pressure are unavoidable with detrimental consequences for glomerular filtration and tubular reabsorption. Under these conditions, a potential positive-feedback loop can be visualized that involves increased extravasation of plasma proteins leading to increased interstitial pressure that through dilation of the afferent and efferent arterioles results in a further increase in protein extravasation. These conditions combined with glomerular damage should lead to the eventual collapse of renal function.

We report the results of a randomized controlled multicentre study on interferon-gamma (IFN-gamma) treatment of systemic sclerosis as determined by skin sclerosis, renal and other organ involvement, global assessment, subjective symptoms and quality of life. Forty-four patients were enrolled into the trial, 27 in the treatment group and 17 in the control group. All patients presented with type I or type II scleroderma. Twenty-nine patients (64%) finished the study. The mean duration of Raynaud's phenomenon and skin sclerosis was 15.3 and 10.8 years, respectively. The skin scores tended to improve in the treatment group (P0.05). Mouth aperture increased significantly from 38.5 to 47.7 mm in the treatment group (P0.001). Subanalysis of IFN-gamma treated patients with normalized skin sclerosis scores/=1 showed significant improvement in both skin involvement and subjective symptoms (P0.05). Organ involvement improved in eight of 18 treatment patients and in three of 11 control patients. It worsened in three of 18 treatment patients and in four of 11 control patients. One control patient died due to cardiorespiratory failure during the study. No deterioration of renal function occurred during IFN-gamma treatment. There was a significant improvement in quality of life parameters in the control group but not in the treatment group. Plasma levels of neopterin increased significantly during IFN-gamma treatment but not in the control group, whereas N-terminal procollagen III peptide levels did not change in either group. There was a high frequency of mild to moderate influenza-like adverse events during IFN-gamma treatment. Only four of nine drop-out patients, however, experienced symptoms most probably associated with IFN-gamma treatment. We conclude that IFN-gamma therapy has mild beneficial effects on skin sclerosis and disease-associated symptoms in type I and II scleroderma. IFN-gamma treatment was associated with acceptable tolerability and did not induce major renal dysfunction in our patients.

A simple and specific chromatographic procedure for the quantitative determination of serum vitamin E is presented. Separation of vitamin E is accomplished by glass-fiber paper chromatography. Subsequently, vitamin E levels are estimated by a colorimetric procedure. The method was applied in a series of clinical experiments to illustrate the usefulness of this technique.