Rehab Centers: A Factor Analysis Approach to Examining Relationships Among Ovarian Steroid Concentrations, Gonadotrophin Concentrations and Menstrual Cycle Length Characteristics in Healthy, Cycling Women.

A factor analysis approach to examining relationships among ovarian steroid concentrations, gonadotrophin concentrations and menstrual cycle length characteristics in healthy, cycling women.

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Hum Reprod. 2012 Dec 18;
Barrett ES, Thune I, Lipson SF, Furberg AS, Ellison PT

STUDY QUESTION: How are ovarian steroid concentrations, gonadotrophins and menstrual cycle characteristics inter-related within normal menstrual cycles? SUMMARY ANSWER: Within cycles, measures of estradiol production are highly related to one another, as are measures of progesterone production; however, the two hormones also show some independence from one another, and measures of cycle length and gonadotrophin concentrations show even greater independence, indicating minimal integration within cycles. WHAT IS KNOWN ALREADY: The menstrual cycle is typically conceptualized as a cohesive unit, with hormone levels, follicular development and ovulation all closely inter-related within a single cycle. Empirical support for this idea is limited, however, and to our knowledge, no analysis has examined the relationships among all of these components simultaneously. STUDY DESIGN, SIZE, DURATION: A total of 206 healthy, cycling Norwegian women participated in a prospective cohort study (EBBA-I) over the duration of a single menstrual cycle. Of these, 192 contributed hormonal and cycle data to the current analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS: Subjects provided daily saliva samples throughout the menstrual cycle from which estradiol and progesterone concentrations were measured. FSH and LH concentrations were measured in serum samples from three points in the same menstrual cycle and cycle length characteristics were calculated based on hormonal data and menstrual records. A factor analysis was conducted to examine the underlying relationships among 22 variables derived from the hormonal data and menstrual cycle characteristics. MAIN RESULTS AND THE ROLE OF CHANCE: Six rotated factors emerged, explaining 80% of the variance in the data. Of these, factors representing estradiol and progesterone concentrations accounted for 37 and 13% of the variance, respectively. There was some association between measures of estradiol and progesterone production within cycles; however, cycle length characteristics and gonadotrophin concentrations showed little association with any measure of ovarian hormone concentrations. LIMITATIONS, REASONS FOR CAUTION: Our summary measures of ovarian hormones may be imprecise in women with extremely long or short cycles, which could affect the patterns emerging in the factor analysis. Given that we only had data from one cycle on each woman, we cannot address how cycle characteristics may covary within individual women across multiple cycles. WIDER IMPLICATIONS OF THE FINDINGS: Our findings are generalizable to other healthy populations with typical cycles, however, may not be applicable to cycles that are anovulatory, extreme in length or otherwise atypical. The results support previous findings that measures of estradiol production are highly correlated across the cycle, as are measures of progesterone production. Estradiol and progesterone concentrations are associated with one another, furthermore. However factor analysis also revealed more complex underlying patterns in the menstrual cycle, highlighting the fact that gonadotrophin concentrations and cycle length characteristics are virtually independent of ovarian hormones. These results suggest that despite integration of follicular and luteal ovarian steroid production across the cycle, cycle quality is a multi-faceted construct, rather than a single dimension. STUDY FUNDING/COMPETING INTEREST(S): The EBBA-I study was supported by a grant from the Norwegian Cancer Society (49 258, 05087); Foundation for the Norwegian Health and Rehabilitation Organizations (59010-2000/2001/2002); Aakre Foundation (5695-2000, 5754-2002) and Health Region East. The current analyses were completed under funding from the National Institutes of Health (K12 ES019852). No competing interests declared.
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[Neurological manifestations and their functional impact in subjects who have suffered heatstroke].

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Rev Neurol. 2013 Jan 1; 56(1): 19-24
Laxe S, Zuniga-Inestroza L, Bernabeu-Guitart M

INTRODUCTION. Heatstroke is a potentially fatal medical emergency characterised by an increase in body temperature above 40 °C and which is accompanied by negative effects on the central nervous system secondary to failure of the thermo-regulatory system. If timely care is not provided, the consequences can be fatal and the patient dies, but they can also result in permanent disabling neurological sequelae that compromise the individual’s quality of life. CASE REPORTS. Following a retrospective search on patients diagnosed with heatstroke who were admitted to a brain damage rehabilitation unit, we report the cases of five subjects. The clinical spectrum ranged from motor weakness with severely compromised coordination and balance with ataxia and dysarthria, which were accompanied by cognitive impairment of varying degrees of severity. All the patients required help in performing their basic activities of daily living both before and after treatment with rehabilitation. CONCLUSIONS. No functional improvement was observed in the five subjects after completing rehabilitation, which left them wholly dependent on some caregiver. It is therefore essential to prevent heatstroke, provide immediate medical care and, finally, once the clinical signs and symptoms have set in, rehabilitation treatment must be focused on preventing the appearance of complications. In such a situation the existence of social support for relatives and for patients plays a crucial role.
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[Rehabilitation of disturbances of walking in parkinsonian patients.]

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Zh Nevrol Psikhiatr Im S S Korsakova. 2012; 112(Vypusk 2 Nevrologiia i psihiatriia pozhilogo vozrasta): 20-24
Pokhabov DV

Disturbances of walking is one of the most significant presentations of Parkinson’s disease that frequently determine patient’s status and quality of life. In Parkinson’s disease (PD, which is the most frequent nosological form of parkinsonism (up to 80% of cases), disturbances of walking are related to dopaminergic mechanisms , e.g., hypokinesia and rigidity, and only partly respond to standard antiparkinsonian drugs. In less frequent vascular parkinsonism (VP), disturbances of walking develop early and do not respond to dopaminergic drugs. Therefore, the elaboration of non-pharmacological methods of treatment is urgent. Patients with PD and VP are characterized by shorter step length with the increase in the variability of length. The preliminary determination of the individual optimal frequency of sound waves provides the higher effectiveness of treatment. Audiostimulation using portable audio/sound reproduction devices is available in outpatient clinics and is able to maintain the achieved positive effect.
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[The changes in the brain’s electrical activity in children with cerebral palsy during the complex rehabilitation.]

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Zh Nevrol Psikhiatr Im S S Korsakova. 2012; 112(10): 28-30
Ukhanova TA, Gorbunov FE, Dement’eva EV, Volkova EA, Novikova EE

One hundred and five children, aged from 3 to 7 years, with the diagnosis “spastic diplegia cerebral palsy” were treated. Patients were stratified into three groups: group I (n=36) received three courses of microcurrent therapy (MENS) in addition to standard treatment; group II (n=38) received three courses of MENS in the combination with two treatment courses with the nootropic drug cortexin; children of group III (n=31) received standard therapy using massage and gymnastics. MENS was carried out in courses, including 15 sessions each, using the apparatus “MEKS”. Cortexin was introduced intramuscular in dosage 10 mg, the treatment course consisted of 10 injections. To the end of the rehabilitation program, positive changes were found: 50% patients of group I, 66% patients of group II and 16% patients of group III could perform complex instructions and acquired skills in modeling and recognition of geometric forms. Positive changes in the brain’s electrical activity were found in 75% of children in group I, in 82% of children in group II and in 64% of children in group III.
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