2 research outputs found
The relationship between quality of life and compliance to a brace protocol in adolescents with idiopathic scoliosis: a comparative study
<p>Abstract</p> <p>Background</p> <p>Corrective bracing for adolescent idiopathic scoliosis (AIS) has favourable outcomes when patients are compliant. However, bracing may be a stressful and traumatic experience and compliance with a bracing protocol is likely to be dependent upon patients' physical, emotional and social wellbeing. The Brace Questionnaire (BrQ), a recently-developed, condition-specific tool to measure quality of life (QOL) has enabled clinicians to study relationships between QOL and compliance.</p> <p>Methods</p> <p>The BrQ was administered to 31 AIS patients after a minimum of 1 year of wearing a brace. Subjects were 13–16 year old South African girls with Cobb angles of 25–40 degrees. Participants were divided into two groups according to their level of compliance with the bracing protocol. Brace Questionnaire sub- and total scores were compared between the two groups using the t-test for comparison of means.</p> <p>Results</p> <p>Twenty participants were classified as compliant and 11 as non-compliant. Mean total BrQ scores (expressed as a percentage) were 83.7 for the compliant group and 64.4 for the non-compliant group (p < 0.001), and on analysis of the 8 domains that make up the BrQ, the compliant group scored significantly higher in the 6 domains that measured vitality and social, emotional and physical functioning.</p> <p>Conclusion</p> <p>Poor compliance with a brace protocol is associated with poorer QOL, with non-compliant patients lacking vitality and functioning poorly physically, emotionally and socially. Quality of life for adolescents with idiopathic scoliosis may relate more to psychosocial coping mechanisms than to physical deformity and its consequences. It is important to establish whether remedial programmes are capable of addressing personal, group and family issues, improving QOL and promoting compliance.</p
Apoptosis in cells of bronchoalveolar lavage: A cellular reaction in patients who die with sepsis and respiratory failure
Objective. Apoptosis represents a physiologic clearance mechanism in
human tissues. The role of apoptosis has not been examined in lung cell
populations, such as alveolar macrophages of septic patients, an organ
frequently insulted in these patients. This study was designed to
examine the effect of sepsis on the apoptosis of alveolar macrophages.
Design: Prospective study.
Setting. Intensive care unit and surgical intensive care and trauma unit
of a large university hospital in Athens, Greece.
Patients. Bronchoalveolar lavage was obtained from 20 consecutive
patients who met the criteria for sepsis, admitted to two intensive care
units. Bronchoalveolar lavage was obtained from nine volunteers without
lung disease who served as controls.
Interventions. None.
Measurements and Main Results. The specimens were analyzed by using
annexin V binding, terminal deoxynucleotidyl transfer-mediated
deoxyuridine 5-triphosphate nick end labeling (TUNEL), DNA laddering,
light microscopy, and immunohistochemistry. Spontaneous apoptosis of
bronchoalveolar lavage cells and particularly of alveolar macrophages
was significantly decreased in septic patients compared with nonseptic
controls. This finding was confirmed by using morphologic criteria and
the TUNEL method. Furthermore, gel electrophoresis of DNA obtained from
bronchoalveolar cells revealed that DNA fragmentation was not
necessarily associated with apoptotic cell death. The bcl-2 gene was
minimally expressed in the control group. An inverse correlation was
found between the percentage of apoptotic alveolar macrophages and the
severity of sepsis.
Conclusions. The prolonged survival of lung cells in septic patients and
especially of alveolar macrophages may be attributable to the inhibition
of apoptosis. This seems to represent an initial attempt of the host to
increase the defense capacity to kill the invading microorganism,
resulting in an unbalanced tissue load of cells and an uncontrolled
release of toxic metabolites. Furthermore, the inhibition of apoptosis
in septic patients may explain why lung function is impaired, leading to
sepsis-Induced acute respiratory distress syndrome and death