Effect of hormone replacement on exercise cardiopulmonary reserve and recovery performance in subclinical hypothyroidism

Subclinical hypothyroidism (SH) patients present cardiopulmonary, vascular and muscle dysfunction, but there is no consensus about the benefits of levothyroxine (L-T4) intervention on cardiopulmonary performance during exercise. The aim of the present study was to investigate the effects of L-T4 on cardiopulmonary exercise reserve and recovery in SH patients. Twenty-three SH women, 44 (40-50) years old, were submitted to two ergospirometry tests, with an interval of 6 months of normalization of thyroid-stimulating hormone (TSH) levels (L-T4 replacement group) or simple observation (TSH = 6.90 μIU/mL; L-T4 = 1.02 ng/dL). Patients with TSH >10 μIU/mL were excluded from the study to assure that they would receive treatment in this later stage of SH. Twenty 30- to 57-year-old women with no thyroid dysfunction (TSH = 1.38 μIU/mL; L-T4 = 1.18 ng/dL) were also evaluated. At baseline, lower values of gas exchange ratio reserve (0.24 vs 0.30; P < 0.05) were found for SH patients. The treated group presented greater variation than the untreated group for pulmonary ventilation reserve (20.45 to 21.60 L/min; median variation = 5.2 vs 25.09 to 22.45 L/min; median variation = -4.75, respectively) and for gas exchange ratio reserve (0.19 to 0.27; median variation = 0.06 vs 0.28 to 0.18; median variation = -0.08, respectively). There were no relevant differences in cardiopulmonary recovery for either group at baseline or after follow-up. In the sample studied, L-T4 replacement improved exercise cardiopulmonary reserve, but no modification was found in recovery performance after exercise during this period of analysis.

Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

Replacement of mechanically deboned chicken meat with its protein hydrolysate in mortadella-type sausages

Mortadella-type sausage manufactured using mechanically deboned chicken meat were reformulated replacing MDCM with increasing amounts of MDCM protein hydrolysates (10%, 20%, and 30%), and their physicochemical, microbiological, and sensorial characteristics were evaluated for 60 days of storage at 4 °C. The higher substitutions resulted in sausages more susceptible to lipid oxidation with higher TBARS values during storage; however, these values were lower than the organoleptic perception threshold. The sausages were darker and less red, with lower lightness (L*) and redness (a*) values than those of the control treatment. They had soft texture, which was evidenced by both the instrumental and sensory analysis. Therefore, the formulation containing 10% of MDCM protein hydrolysates proved to be the most suitable for mortadella-type sausage elaboration.

Preoperative education and its influence on perception of recovery for clients awaiting total hip and total knee replacement surgery /

The puqjose of this study was to examine the manner in which an inviting approach to a preoperative teaching and learning educational experience influenced the perception and subsequent recovery of clients who were awaiting total hip and total knee replacement surgery. An in-depth review of the internal and external factors that shape client perceptions was undertaken in this study. In addition, this study also explored whether or not the Prehab Program was preparing clients physically, socially, and psychologically for surgery. Data for this qualitative case study research were collected through preoperative interviews with 4 participants awaiting total hip replacement surgery and 1 participant awaiting total knee replacement surgery. Four postoperative interviews were conducted with the participants who had received total hip replacement surgery. The occupational therapist and physical therapist who were the coleaders of the Prehab Program at the time of this study were also interviewed. The results of this study suggest that while individuals may receive similar educational experiences, their perceptions of the manner in which they benefited from these experiences varied. This is illustrated in the research findings, which concluded that while clients benefited physically from the inviting approach used during the practical teaching session, not all clients perceived the psychological benefits of this practice session, especially clients with preexisting high levels of anxiety. In addition to increasing the understanding of the internal as well as external factors that influence the perceptions of clients, this study has also served as an opportunity for reflection on practice for the Prehab therapists and other healthcare educators.

Multiple Public Goods and Lexicographic Preferences Replacement Principle.

We study the problem of locating two public goods for a group of agents with single-peaked preferences over an interval. An alternative specifies a location for each public good. In Miyagawa (1998), each agent consumes only his most preferred public good without rivalry. We extend preferences lexicographically and characterize the class of single-peaked preference rules by Pareto-optimality and replacement-domination. This result is considerably different from the corresponding characterization by Miyagawa (2001a).

Effect of hormone replacement therapy on retinal and optic nerve head blood flow and topography in postmenopausal women, and retinal tissue perfusion in ovariectomized rats

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Factors that impact the sustainability of wait time management strategies for total joint replacement surgeries in canadian provinces

Pour répondre aux exigences du gouvernement fédéral quant aux temps d’attente pour les chirurgies de remplacement du genou et de la hanche, les établissements canadiens ont adopté des stratégies de gestion des listes d’attentes avec des niveaux de succès variables. Notre question de recherche visait à comprendre Quels facteurs ont permis de maintenir dans le temps un temps d’attente répondant aux exigences du gouvernement fédéral pendant au moins 6-12 mois? Nous avons développé un modèle possédant quatre facteurs, inspiré du modèle de Parsons (1977), afin d’analyser les facteurs comprenant la gouvernance, la culture, les ressources, et les outils. Trois études de cas ont été menées. En somme, le 1er cas a été capable d’obtenir les exigences pendant six mois mais incapable de les maintenir, le 2e cas a été capable de maintenir les exigences > 18 mois et le 3e cas a été incapable d’atteindre les objectifs. Des documents furent recueillis et des entrevues furent réalisées auprès des personnes impliquées dans la stratégie. Les résultats indiquent que l’hôpital qui a été en mesure de maintenir le temps d’attente possède certaines caractéristiques: réalisation exclusive de chirurgie de remplacement de la hanche et du genou, présence d’un personnel motivé, non distrait par d’autres préoccupations et un esprit d’équipe fort. Les deux autres cas ont eu à faire face à une culture médicale moins homogène et moins axés sur l’atteinte des cibles; des ressources dispersées et une politique intra-établissement imprécise. Le modèle d’hôpital factory est intéressant dans le cadre d’une chirurgie surspécialisée. Toutefois, les patients sont sélectionnés pour des chirurgies simples et dont le risque de complication est faible. Il ne peut donc pas être retenu comme le modèle durable par excellence.

CACHE REPLACEMENT STRATEGIES FOR MOBILE DATA CACHING.

Data caching is an important technique in mobile computing environments for improving data availability and access latencies particularly because these computing environments are characterized by narrow bandwidth wireless links and frequent disconnections. Cache replacement policy plays a vital role to improve the performance in a cached mobile environment, since the amount of data stored in a client cache is small. In this paper we reviewed some of the well known cache replacement policies proposed for mobile data caches. We made a comparison between these policies after classifying them based on the criteria used for evicting documents. In addition, this paper suggests some alternative techniques for cache replacement

A key based cache replacement policy for cooperative caching in mobile ad hoc networks

Cooperative caching in mobile ad hoc networks aims at improving the efficiency of information access by reducing access latency and bandwidth usage. Cache replacement policy plays a vital role in improving the performance of a cache in a mobile node since it has limited memory. In this paper we propose a new key based cache replacement policy called E-LRU for cooperative caching in ad hoc networks. The proposed scheme for replacement considers the time interval between the recent references, size and consistency as key factors for replacement. Simulation study shows that the proposed replacement policy can significantly improve the cache performance in terms of cache hit ratio and query delay

Cassava root peel as a replacement for maize in diets for growing pigs: effects on energy and nutrient digestibility, performance and carcass characteristics

Two experiments were conducted to evaluate cassava root peel (CRP) as diet component for fattening pigs. In the first experiment, ten male pigs were used to investigate the nutrient digestibility and the nutritive value of CRP as replacement for maize in the diet at 0 %, 30 %, 40 %, 50 % and 60 %, while supplementing free amino acids (fAA). During two experimental periods, faeces were quantitatively collected and analysed for chemical composition. In the second experiment, 40 pigs received the same diets as in Experiment 1, and daily feed intake and weekly weight changes were recorded. Four pigs per diet were slaughtered at 70 kg body weight to evaluate carcass traits. Digestibility of dry and organic matter, crude protein, acid detergent fibre and gross energy were depressed (p<0.05) at 60 % CRP; digestible energy content (MJ kg^(−1) DM) was 15.4 at 0 % CRP and 12.7 at 60 % CRP. In the second experiment, CRP inclusion had only a small impact on feed intake, weight gain and feed conversion ratio (p>0.05) as well as on the length of the small intestine and the Longissimus dorsi muscle area. The missing correlation of daily weight gain and feed-to-gain ratio up to a CRP inclusion of 40 % indicates that negative effects of CRP on pig growth can be avoided by respecting upper feeding limits. Hence, a combined use of CRP and fAA can reduce feeding costs for small-scale pig farmers in countries where this crop-by product is available in large amounts.

The effect of incremental replacement of wheat with soya hulls in diets for Jersey cows on lactational performance, diet digestibility and feeding behaviour

Eight Jersey cows were used in two balanced 4 x 4 Latin Squares to investigate the effects of replacement of dietary starch with non-forage fibre on productivity, diet digestibility and feeding behaviour. Total-mixed rations consisted of maize silage, grass silage and a soyabean meal-based concentrate mixture, each at 250g/kg DM, with the remaining 250g consisting of cracked wheat/soya hulls (SH) in the ratios of 250:0, 167:83; 83:167 and 0:250 g, respectively, for treatments SH0, SH83, SH167 and SH250. Starch concentrations were 302, 248, 193 and 140g/kg DM, and NDF concentrations were 316, 355, 394 and 434g/kg DM, for treatments SHO, SH83, SH167 and SH250, respectively. Total eating time increased (p < 0.05) as SH inclusion increased, but total rumination time was unaffected. Digestibility of DM, organic matter and starch declined (p < 0.01) as SH inclusion increased, whilst digestibility of NDF and ADF increased (p < 0.01). Dry-matter intake tended to decline with increasing SH, whilst bodyweight, milk yield and fat and lactose concentrations were unaffected by treatment. Milk protein concentration decreased (p < 0.01) as SH level increased. Feed conversion efficiency improved (p < 0.05) as SH inclusion rose, but it was not possible to determine whether this was due to the increased fibre levels alone, or the favourable effect on rumen fermentation of decreasing starch levels. (c) 2006 Elsevier B.V. All rights reserved.