Effect on renal function of restoration of euthyroidism in hyperthyroid cats with iatrogenic hypothyroidism.

BACKGROUND: Iatrogenic hypothyroidism is associated with an increased incidence of azotemia after treatment of hyperthyroidism, and decreased survival time in azotemic hyperthyroid cats. HYPOTHESIS: Restoration of euthyroidism will decrease plasma creatinine concentrations. ANIMALS: Nineteen client-owned, methimazole- or carbimazole-treated, hyperthyroid cats with documented iatrogenic hypothyroidism (based on subnormal plasma total thyroxine concentrations [TT4] and increased plasma thyroid-stimulating hormone concentrations). METHODS: Prospective interventional study. Doses of antithyroid medication were reduced until euthyroidism was restored (TT4 10-40 nmol/L). Plasma creatinine concentration and selected other clinicopathologic variables were evaluated before and after restoration of euthyroidism and compared by nonparametric statistics. Data are presented as median [25th, 75th percentile]. RESULTS: Restoration of euthyroidism was associated with a significant decrease in plasma creatinine concentrations (2.61 [1.90, 3.26] mg/dL versus 2.07 [1.42, 2.82] mg/dL; P < .001) and body weight (4.03 [3.59, 4.53] kg versus 3.89 [3.34, 4.18] kg; P = .019), and a significant increase in packed cell volume (30 [28, 39]% versus 34 [29, 39]%; P = .038), heart rate (174 [163, 201] bpm versus 190 [164, 202] bpm; P = .009), and plasma alkaline phosphatase activity (26.6 [17.0, 33.0] IU/L versus 38.0 [23.5, 46.5] IU/L; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Restoration of euthyroidism in medically treated hyperthyroid cats with iatrogenic hypothyroidism causes a reduction in plasma creatinine concentrations, and thus might improve renal function; however, this could be influenced by concurrent changes in body weight

Participant perceptions of physical activity-enhancing interventions for adults with disability: A meta-synthesis of qualitative research

The United Nations Convention on the Rights of Persons with Disabilities enshrines the rights of disabled people to access services in all areas of citizenship including participation in recreational, leisure and sport activities. Despite this protection, people with disabilities face multiple personal, environmental and social barriers to participation in physical activity (PA). As a result, disabled people are more likely to be inactive compared to the able bodied population and are at a greater risk of inactivity-related diseases. Thus, there is an urgent need for behaviour change interventions to increase PA by specifically addressing the situations of people with disabilities and their barriers to participation. This original meta-synthesis of qualitative research was undertaken to explore participants’ perceptions of PA-enhancing interventions for adults with physical disability. To identify published articles relevant to the meta-synthesis, a rigorous systematic search of electronic databases and hand search of relevant journals was undertaken. In total, 76 papers were read in full, and based on the inclusion criteria, 10 papers were included for review. Following a critical appraisal of the papers, methods of thematic synthesis were drawn upon to generate analytical themes through interpretation and conceptual synthesis. Seven interrelated analytical themes were constructed representing both components and outcomes of the interventions. These were: (i) social support; (ii) diversity; (iii) communication; (iv) behavioural strategies; (v) changing thoughts; (vi) knowledge; (vii) health and well-being. The results of this meta-synthesis provide significant new information that will help interventionists design more effective PA-enhancing interventions, and researchers to better identify and measure key mechanisms and outcomes associated with successful PA-enhancing interventions for people with disabilities

Stories of hope or hopeful stories? Reflections on ethical dilemmas in spinal cord injury rehabilitation and physical activity

Ethical considerations in ethnographic research are not something to be ticked off once clearance is granted by the ethics committee. Rather, ethical considerations should remain at the forefront of the researcher’s mind as they face numerous ethical dilemmas throughout the course of a study. Ethics in practice should therefore be considered as a process of on-going maintenance and reflexivity. This paper draws upon the importance of reflexive ethics to highlight how broad procedural ethics considered at the beginning of a research project continue to inform ethical dilemmas as they arise during data collection and analysis. Ethical dilemmas encountered in a physical activity rehabilitation centre for people with spinal cord injury will be reflected upon to offer insights into negotiating the researcher’s desire to gain rich descriptions, whilst caring for the participants’ well-being. These dilemmas will include managing the expectations of the research project and negotiating delicate issues in spinal cord injury rehabilitation such as recovery and hope

From research to practice: Enabling healthcare professionals to promote a physically activity lifestyle to people with spinal cord injury.

Objective: It is vital that people with spinal cord injury (SCI) maintain a physically active lifestyle for lifelong health and well-being. Yet within hospital rehabilitation and upon discharge from this context into the community, people with SCI are largely inactive. Physiotherapists are well placed to promote a physically active lifestyle and have been identified by people with SCI as valued and trusted messengers of physical activity (PA). The purpose of this study was to explore what physiotherapists in SCI rehabilitation perceive about PA for people with SCI and what they do in relation to promoting PA. Design: The design of this interpretive qualitative study was underpinned by ontological relativism (i.e., reality is multiple and created) and epistemological constructionism (i.e., knowledge is constructed and subjective). Method: Semi-structured interviews were completed with eighteen neurological physiotherapists (2-22 years’ experience) from SCI centres (United Kingdom and Ireland). An inductive thematic analysis was conducted. Results: Three themes were identified: 1) perceived importance of physical activity; 2) inconsistent physical activity promotion efforts; and 3) unease with activity-based rehabilitation. Together these themes reveal that although physiotherapists do value PA, active promotion of PA remains largely absent from what they do. Conclusions: This study contributes to the exercise psychology literature by identifying the need for PA promotion to be a structured and integral component of physiotherapy practice. SCI specific PA guidelines must be developed and communicated via appropriate knowledge translation strategies to enable physiotherapists to effectively promote a physically active lifestyle

“It’s not just a means to an end” thinking about physical activity for people with spinal cord injury

Physical activity (PA) is vital for physical and psychological health and wellbeing. For individuals with spinal cord injury (SCI) engagement in PA can alleviate or reduce many of the associated health and well-being complications. For example, PA can reduce the risk of secondary health problems (Buchholz et al., 2009), improve fitness and cardio-vascular health (van der Scheer et al., 2017) and enhance well-being (Williams et al., 2014). However, despite this, disabled people are twice as likely to be inactive as non-disabled people (Sport England, 2018) and individuals with SCI have particularly high levels of inactivity. For these reasons the purpose of this article is to consider how we communicate the need for, and benefits of, PA to the SCI populatio

Whole-body fasciculation detection in amyotrophic lateral sclerosis using motor unit MRI (MUMRI)

\ua9 2024 International Federation of Clinical NeurophysiologyObjective: Compare fasciculation rates between amyotrophic lateral sclerosis (ALS) patients and healthy controls in body regions relevant for diagnosing ALS using motor unit MRI (MUMRI) at baseline and 6 months follow-up, and relate this to single-channel surface EMG (SEMG). Methods: Tongue, biceps brachii, paraspinals and lower legs were assessed with MUMRI and biceps brachii and soleus with SEMG in 10 healthy controls and 10 patients (9 typical ALS, 1 primary lateral sclerosis [PLS]). Results: MUMRI-detected fasciculation rates in typical ALS patients were higher compared to healthy controls for biceps brachii (2.40 \ub1 1.90 cm-3min−1 vs. 0.04 \ub1 0.10 cm-3min−1, p = 0.004), paraspinals (1.14 \ub1 1.61 cm-3min−1 vs. 0.02 \ub1 0.02 cm-3min−1, p = 0.016) and lower legs (1.42 \ub1 1.27 cm-3min−1 vs. 0.13 \ub1 0.10 cm-3min−1, p = 0.004), but not tongue (1.41 \ub1 1.94 cm-3min−1 vs. 0.18 \ub1 0.18 cm-3min−1, p = 0.556). The PLS patient showed no fasciculation. At baseline, 6/9 ALS patients had increased fasciculation rates compared to healthy controls in at least 2 body regions. At follow-up every patient had increased fasciculation rates in at least 2 body regions. The MUMRI-detected fasciculation rate correlated with SEMG-detected fasciculation rates (τ = 0.475, p = 0.006). Conclusion: MUMRI can non-invasively image fasciculation in multiple body regions and appears sensitive to disease progression in individual patients. Significance: MUMRI has potential as diagnostic tool for ALS