Rehabilitation management of the lower extremity in HIV disease

1995 ◽  
Vol 85 (7) ◽  
pp. 394-402 ◽  
Author(s):  
MA McReynolds
Keyword(s):  
Lower Extremity ◽  
Treatment Strategies ◽  
Gait Pattern ◽  
Hiv Disease ◽  
Peripheral Neuropathies ◽  
Skin Ulcers ◽  
Immunodeficiency Virus ◽  
And Function

The sequelae of human immunodeficiency virus (HIV) disease include a host of devastating conditions involving the lower extremity. These include rheumatologic dysfunction, Kaposi's sarcoma, peripheral neuropathies, and skin ulcers. Pain, weakness, and loss of range of motion caused by these conditions can lead to changes in gait pattern, loss of mobility and function, and limited quality of life. The role of the rehabilitation specialist in the care and treatment of HIV disease as it affects the lower extremity, and the treatment strategies, precautions, and suggestions will be discussed.

Quality of Life and Self-Reported Lower Extremity Function in Adults With HIV-Related Distal Sensory Polyneuropathy

2014 ◽  
Vol 94 (10) ◽  
pp. 1455-1466 ◽  
Author(s):  
Mary Lou A. Galantino ◽  
David M. Kietrys ◽  
James Scott Parrott ◽  
Maureen E. Stevens ◽  
Anne Marie Stevens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Extremity ◽  
Hiv Disease ◽  
Lower Extremity Function ◽  
Medical Outcomes ◽  
Mental Health Summary ◽  
Outcomes Study ◽  
And Function ◽  
Sensory Polyneuropathy

Background Distal sensory polyneuropathy (DSP) is a common complication of HIV disease. Its effects on quality of life (QOL) and function have not been well described. Objective The study objectives were: (1) to compare QOL and lower extremity function in people with HIV-related DSP and people with HIV disease who do not have DSP, (2) to determine the extent to which function predicts QOL, (3) to evaluate the agreement of 2 function scales, and (4) to describe the use of pain management resources. Design This was a cross-sectional survey study with predictive modeling and measurement tool concordant validation. Methods A demographic questionnaire, the Medical Outcomes Study HIV Health Survey, the Lower Extremity Functional Scale (LEFS), the Lower Limb Functional Index (LLFI), and a review of medical records were used. General linear modeling was used to assess group differences in QOL and the relationship between function and QOL. Bland-Altman procedures were used to assess the agreement of the LEFS and the LLFI. Results Usable data for analyses were available for 82 of the 94 participants enrolled. The 67% of participants who reported DSP symptoms tended to be older, had HIV disease longer, and were more likely to receive disability benefits. Participants without DSP had better LLFI, LEFS, and physical health summary scores. In multivariate models, lower limb function predicted physical and mental health summary scores. The LLFI identified participants with a lower level of function more often than the LEFS. Participants with DSP were more likely to use medical treatment, physical therapy, and complementary or alternative treatments. Limitations A sample of convenience was used; the sample size resulted in a low power for the mental health summary score of the Medical Outcomes Study HIV Health Survey. Conclusions Quality of life and function were more impaired in participants with HIV disease and DSP. The LLFI was more likely to capture limitations in function than the LEFS. Participants with DSP reported more frequent use of pain management resources.

scholarly journals Treatment strategies for chemotherapy-induced peripheral neuropathy: potential role of exercise

2011 ◽  
Vol 4 (2) ◽  
pp. 117
Author(s):  
Karen Y. Wonders ◽  
Beverly S. Reigle ◽  
Daniel G. Drury
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Lifestyle Modification ◽  
Treatment Strategies ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Exercise Rehabilitation

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting effect of cancer therapy that often has negative implications on a patient’s quality of life. The pain associated with CIPN has long been recognized as one of the most difficult types of pain to treat. Historically, much effort has been made to explore pharmacological therapies aimed at reducing symptoms of CIPN. While many of these agents provide a modest relief in the symptoms of peripheral neuropathy, many have been shown to have additional negative side effects for cancer patients. Therefore, the authors suggest exercise rehabilitation as one lifestyle modification that may positively impact the lives of patients with CIPN. To our knowledge, there are currently no published clinical trials examining the role of exercise in preserving neurological function following chemotherapy. However, investigations using low-to-moderate intensity exercise as an intervention in patients with diabetic peripheral neuropathy and hereditary motor and sensory neuropathies have produced promising results. Given that cancer patients appear to tolerate exercise, it seems plausible that exercise rehabilitation could be used as an effective strategy to minimize CIPN-induced detriments to quality of life.

scholarly journals Immune Checkpoints Expression in Chronic Lung Allograft Rejection

2021 ◽  
Vol 12 ◽  
Author(s):  
Ilaria Righi ◽  
Valentina Vaira ◽  
Letizia Corinna Morlacchi ◽  
Giorgio Alberto Croci ◽  
Valeria Rossetti ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
Bronchiolitis Obliterans Syndrome ◽  
Immune Checkpoints ◽  
Hla Antibodies ◽  
Restrictive Allograft Syndrome ◽  
And Function ◽  
Shed Light

Chronic lung allograft dysfunction (CLAD) is the main cause of poor survival and low quality of life of lung transplanted patients. Several studies have addressed the role of dendritic cells, macrophages, T cells, donor specific as well as anti-HLA antibodies, and interleukins in CLAD, but the expression and function of immune checkpoint molecules has not yet been analyzed, especially in the two CLAD subtypes: BOS (bronchiolitis obliterans syndrome) and RAS (restrictive allograft syndrome). To shed light on this topic, we conducted an observational study on eight consecutive grafts explanted from patients who received lung re-transplantation for CLAD. The expression of a panel of immune molecules (PD1/CD279, PDL1/CD274, CTLA4/CD152, CD4, CD8, hFoxp3, TIGIT, TOX, B-Cell-Specific Activator Protein) was analyzed by immunohistochemistry in these grafts and in six control lungs. Results showed that RAS compared to BOS grafts were characterized by 1) the inversion of the CD4/CD8 ratio; 2) a higher percentage of T lymphocytes expressing the PD-1, PD-L1, and CTLA4 checkpoint molecules; and 3) a significant reduction of exhausted PD-1-expressing T lymphocytes (PD-1pos/TOXpos) and of exhausted Treg (PD-1pos/FOXP3pos) T lymphocytes. Results herein, although being based on a limited number of cases, suggest a role for checkpoint molecules in the development of graft rejection and offer a possible immunological explanation for the worst prognosis of RAS. Our data, which will need to be validated in ampler cohorts of patients, raise the possibility that the evaluation of immune checkpoints during follow-up offers a prognostic advantage in monitoring the onset of rejection, and suggest that the use of compounds that modulate the function of checkpoint molecules could be evaluated in the management of chronic rejection in LTx patients.

The Irresponsible Expert Witness: A Failure of Biomedical Graduate Education and Professional Accountability

PEDIATRICS ◽  
1982 ◽  
Vol 70 (5) ◽  
pp. 754-762 ◽  
Author(s):  
Robert L. Brent
Keyword(s):  
Expert Witness ◽  
Expert Witnesses ◽  
Contributing Factors ◽  
Witness Testimony ◽  
Expert Witness Testimony ◽  
Professional Accountability ◽  
Proper Role ◽  
And Function

Many forces have created the epidemic of negligence and malpractice litigation. One of the contributing factors to the rising rate of nonmeritorious litigation is the increasing number of unqualified and irresponsible expert witnesses. The high remuneration has attracted physican-scientists who are unaware of the proper role of an expert witness. They are frequently manipulated by the attorneys and function as partisans rather than scholars. The role of the expert witness should be taught in medical and graduate school. Testimony should be treated as a scholarly endeavor and experts should be encouraged to seek peer review of their opinions and not to testify secretly and in isolation. It is suggested that greater visibility of experts and their testimony (light of day phenomenon) should raise the quality of expert witness testimony and encourage more qualified experts to participate as expert witnesses, thus removing the stigmata usually associated with unqualified expert witnesses.

scholarly journals Contribution of HIV Infection, AIDS, and Antiretroviral Therapy to Exocrine Pathogenesis in Salivary and Lacrimal Glands

2018 ◽  
Vol 19 (9) ◽  
pp. 2747 ◽  
Author(s):  
Imran Nizamuddin ◽  
Peter Koulen ◽  
Carole McArthur
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Exocrine Function ◽  
Lacrimal Glands ◽  
Immunodeficiency Virus ◽  
And Function ◽  
The Impact

The structure and function of exocrine glands are negatively affected by human immunodeficiency virus (HIV) infection and its co-morbidities, including innate and adaptive immune responses. At the same time, exocrine function may also be influenced by pharmacotherapies directed at the infectious agents. Here, we briefly review the role of the salivary glands and lacrimal glands in normal physiology and exocrine pathogenesis within the context of HIV infection and acquired immune deficiency syndrome (AIDS), including the contribution of antiretroviral therapies on both. Subsequently, we discuss the impact of HIV infection and the types of antiretroviral therapy on disease management and therapy development efforts.

scholarly journals The Role of Adrenoceptors in the Retina

Cells ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2594
Author(s):  
Yue Ruan ◽  
Tobias Böhmer ◽  
Subao Jiang ◽  
Adrian Gericke
Keyword(s):  
Visual Information ◽  
Vision Loss ◽  
Retinal Diseases ◽  
System A ◽  
The Central Nervous System ◽  
The Individual ◽  
And Function ◽  
The Brain

The retina is a part of the central nervous system, a thin multilayer with neuronal lamination, responsible for detecting, preprocessing, and sending visual information to the brain. Many retinal diseases are characterized by hemodynamic perturbations and neurodegeneration leading to vision loss and reduced quality of life. Since catecholamines and respective bindings sites have been characterized in the retina, we systematically reviewed the literature with regard to retinal expression, distribution and function of alpha1 (α1)-, alpha2 (α2)-, and beta (β)-adrenoceptors (ARs). Moreover, we discuss the role of the individual adrenoceptors as targets for the treatment of retinal diseases.

scholarly journals A PROSPECTIVE EVALUATION OF ORTHOTIC DEVICE IMPLICATION ON THE LOWER LIMB IN CHILDREN WITH CEREBRAL PALSY

2021 ◽  
Vol 11 (1) ◽  
pp. 12-16
Author(s):  
Akshay Kumar ◽  
◽  
Vinita N/A ◽  
Keyword(s):  
Cerebral Palsy ◽  
Lower Limb ◽  
Financial Burden ◽  
Gait Pattern ◽  
Orthotic Devices ◽  
Motor Disability ◽  
Children With Cerebral Palsy ◽  
The Relationship

CP is the foremost cause of motor disability in children and affects two to five children in 1000 live births worldwide. It is been recognized as a global concern medically, socially, and economically due to the increasing financial burden to the states. About half of the children with cerebral palsy suffer a range of motion difficulties. The study aims to understand the role of orthotic devices and its efficacy in the treatment of the patient with cerebral palsy and gait improvement. An online database of Pubmed, Science Direct, Google Scholar, etc. searched to find the articles with the keywords, cerebral palsy, orthotic devices, orthosis, lower limb, and results were synthesized and narrated to explore the effectiveness of the devices on the gait pattern and quality of life of a patient with cerebral palsy. The database search was done without the barrier of dates and regions. Orthoses applied externally appear to be supported and had a diverse effect on gait depending on the type of orthosis. However, the relationship between gait pattern and AFOs and ankle properties is yet to be established. Additional research in this area is needed to complement the development of passive and active AFOs to provide larger improvements in walking capabilities.

scholarly journals Revisiting the Role of Leukocytes in Cystic Fibrosis

Cells ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 3380
Author(s):  
Monica Averna ◽  
Paola Melotti ◽  
Claudio Sorio
Keyword(s):  
Cystic Fibrosis ◽  
Therapeutic Response ◽  
Bacterial Colonization ◽  
Immune Dysregulation ◽  
Clinical Applications ◽  
And Function ◽  
Leukocyte Populations ◽  
Cftr Modulators

Cystic fibrosis in characterized by pulmonary bacterial colonization and hyperinflammation. Lymphocytes, monocytes/macrophages, neutrophils, and dendritic cells of patients with CF express functional CFTR and are directly affected by altered CFTR expression/function, impairing their ability to resolve infections and inflammation. However, the mechanism behind and the contribution of leukocytes in the pathogenesis of CF are still poorly characterized. The recent clinical introduction of specific CFTR modulators added an important tool not only for the clinical management of the disease but also to the investigation of the pathophysiological mechanisms related to CFTR dysfunction and dysregulated immunity. These drugs treat the basic defect in cystic fibrosis (CF) by increasing CFTR function with improvement of lung function and quality of life, and may improve clinical outcomes also by correcting the dysregulated immune function that characterizes CF. Measure of CFTR function, protein expression profiling and several omics methods were used to identify molecular changes in freshly isolated leukocytes of CF patients, highlighting two roles of leukocytes in CF: one more generally related to the mechanism(s) causing immune dysregulation in CF and unresolved inflammation, and another more applicative role, which identifies in myeloid cells, an important tool predictive of the therapeutic response of CF patients. In this review we will summarize available data on CFTR expression and function in leukocyte populations and will discuss potential clinical applications based on available data.

scholarly journals Diabetic Kinome Inhibitors—A New Opportunity for β-Cells Restoration

2021 ◽  
Vol 22 (16) ◽  
pp. 9083
Author(s):  
Barbara Pucelik ◽  
Agata Barzowska ◽  
Janusz M. Dąbrowski ◽  
Anna Czarna
Keyword(s):  
High Throughput Screening ◽  
Human Life ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Binding Modes ◽  
Β Cells ◽  
Β Cell ◽  
And Function

Diabetes, and several diseases related to diabetes, including cancer, cardiovascular diseases and neurological disorders, represent one of the major ongoing threats to human life, becoming a true pandemic of the 21st century. Current treatment strategies for diabetes mainly involve promoting β-cell differentiation, and one of the most widely studied targets for β-cell regeneration is DYRK1A kinase, a member of the DYRK family. DYRK1A has been characterized as a key regulator of cell growth, differentiation, and signal transduction in various organisms, while further roles and substrates are the subjects of extensive investigation. The targets of interest in this review are implicated in the regulation of β-cells through DYRK1A inhibition—through driving their transition from highly inefficient and death-prone populations into efficient and sufficient precursors of islet regeneration. Increasing evidence for the role of DYRK1A in diabetes progression and β-cell proliferation expands the potential for pharmaceutical applications of DYRK1A inhibitors. The variety of new compounds and binding modes, determined by crystal structure and in vitro studies, may lead to new strategies for diabetes treatment. This review provides recent insights into the initial self-activation of DYRK1A by tyrosine autophosphorylation. Moreover, the importance of developing novel DYRK1A inhibitors and their implications for the treatment of diabetes are thoroughly discussed. The evolving understanding of DYRK kinase structure and function and emerging high-throughput screening technologies have been described. As a final point of this work, we intend to promote the term “diabetic kinome” as part of scientific terminology to emphasize the role of the synergistic action of multiple kinases in governing the molecular processes that underlie this particular group of diseases.

Sign in / Sign up

Export Citation Format

Share Document