Ambulation Frequency Research Articles

Assessment of the potential protective effectsof culture filtrate ofTrichoderma harzianum to ameliorate the damagedhistoarchitecture of brain in epileptic rats.

The simultaneous hyperexcitability of the neural network is the most well-known manifestation of epilepsy that causes recurrent seizures. The current study was aimed to examine any potential safety benefits of the culture filtrate of Trichoderma harzianum (ThCF) to ameliorate damaged histoarchitecture of the brain in epileptic rats by assessing seizure intensity scale and behavioral impairments and follow up the spontaneous motor seizures during status epilepticus phases in rats. Twenty-four rats were divided into four groups; control (C), epileptic (EP) valproic acid-treated epileptic (EP-VPA), and epileptic treated with T. harzianum cultured filtrate (ThCF). In addition to a seizure intensity score and behavioral tests, routine H&E and Golgi-Copsch histopathology, were used to examine the cell somas, dendrites, axons, and neural spines. ThCF treatment increased activity and recorded movements during grooming, rearing, and ambulation frequency. Brain tissues of epileptic rats exhibited detached meninges, hypercellularity, mild edema in the cortex and markedly degenerated neurons, degenerated glial cells, and microcyst formation in the hippocampus. Moreover, brains of EP-ThCF were noticed with average blood vessels, and increased dendritogenesis. The current data revealed some of negative effects of epileptogenesis brought on by seizure intensity score and retarded histopathological alterations in the hippocampus. Therefore, the study is forecasting to identify novel active components from the metabolites of T. harzianum with a crucial therapeutic role in various disorders.

Myotonic dystrophy type 1 (Steinert disease): 29 years of experience at a tertiary pediatric hospital

BackgroundMyotonic dystrophy type 1 (DM1) is a multisystemic disorder caused by the expansion of a noncoding triplet repeat. MethodsA cross-sectional study was performed to characterize pediatric patients with DM1 followed in a tertiary hospital over the last 29 years, comparing the congenital and the childhood/juvenile-onset forms. ResultsThirty-seven patients (59.5 % male) were included, with a median age at the latest assessment of 16.8 years and a median follow-up of 7.7 years. Eleven patients were lost to follow-up, and two died. Twenty-five had congenital DM1 (CDM1), and this form had significantly higher triplet repeat length, history of polyhydramnios, lower median age at diagnosis, and first and last assessment. Common symptoms included distal skeletal muscle weakness (75.7 %) and facial involvement (94.6 %), along with dysphonia/dysarthria (73.0 %) and myotonia (73.0 %). Delayed independent ambulation frequency was significantly higher for CDM1 cases. Skeletal deformities affected 54.1 %, with talipes equinovarus and scoliosis occurring exclusively in CDM1 patients. Cognitive deficit was present in 75.7 % of cases. Polysomnograms revealed seven cases of obstructive sleep apnea and two of hypoventilation. Noninvasive ventilation was used in nine cases, and three had recurrent respiratory infections. The cardiovascular system was affected in 21.6 % of cases. Gastrointestinal issues included constipation (24.3 %), feeding difficulties (16.2 %), and cholelithiasis (5.4 %). Cataracts, epilepsy, and diabetes mellitus were reported in two cases each. ConclusionOur study highlights the diverse spectrum of severity and multiorgan involvement of DM1 in pediatric patients. It underscores the importance of establishing a pediatric-specific standard of care to enhance health outcomes through comprehensive multidisciplinary management.

Gardenia jasminoides J. Ellis extract attenuates memory impairment in rats with Alzheimer’s disease by suppressing NLRP3 inflammasome

Alzheimer’s disease (AD) is characterized by degeneration of the central nervous system. Recently, many studies have emphasized the beneficial role of Gardenia jasminoides J. Ellis extract (GJ-4) in neuroprotection, which is considered a potential drug for treating AD. However, the mechanism underlying its neuroprotective effects is obscure. This research intended to analyze the effectiveness of GJ-4 to induce neuronal protective role on a rat model of neurotoxicity and probe the potential mechanism. An AD model was established by intraperitoneal injection of aluminum chloride (AlCl3). Then, AlCl3-induced rats were administered 25 mg/kg and 50 mg/kg of GJ-4 orally. This study indicated that GJ-4 (25 and 50 mg/kg) mitigated AD-like behaviors, as evidenced by enhanced ambulation frequency, rearing frequency, and time spent in the target quadrant and decreased grooming frequency, defecation frequency, and escape latency in AlCl3-challenged rats. Also, GJ-4 at 25 and 50 mg/kg exerted an anti-apoptosis effect in the hippocampus of AlCl3-treated rats. Furthermore, GJ-4 (25 and 50 mg/kg) exhibited an anti-inflammatory effect in the hippocampus by repressing the activation of NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome, further inhibiting the activation of Caspase 1, ASC, IL-1β, and IL-18 in AD hippocampus. Altogether, GJ-4 mitigated AlCl3-triggered impairment of learning and memory in AD rats via repressing NLRP3 inflammasome.

Bee venom ameliorates oxidative stress and histopathological changes of hippocampus, liver and testis during status epileptics

The unrelenting progression of neurodegenerative diseases has a negative impact on affected individuals, their families, and society. Recurrent epileptic seizures are the hallmark of epilepsy, and treating it effectively remains difficult. Clarify and understanding effects of the antiepileptic drugs (AEDs) in epilepsy by comparing the therapeutic effects between rats receiving valproic acid (VPA) and Bee venom (BV) was aimed throughout the present study. Four male Wistar rat groups were included: control, epileptic group receiving pilocarpine (PILO), epileptic group treated with VPA and BV respectively. Cognitive functions were assessed by evaluating latency time in hot plate, despair swim test, grooming, rearing and ambulation frequency in the open field. BV has ameliorative effect on electrolytes balancing, assured by decreasing lipid peroxidation, nitric oxide and increasing catalase, superoxide dismutase and glutathione peroxidase activities. BV enhanced restoration of liver functions indicated by alanine transaminase (ALT) and aspartate transaminase (AST), total proteins, and albumin; hormonal parameters total and free testosterone, follicle stimulating hormone (FSH) and Luteinizing hormone (LH) were preserved by BV with great recovery of hippocampus, liver and testicular histopathology and ultrastructure comparing with the epileptic rats. The present findings suggested that BV and its active components offer fresh options for controlling epilepsy and prospective methods via minimize or manage the severe consequences.

Tulane STAR (Sending Texts, Advancing Results): impact of text messaging on bariatric post-operative protocol compliance.

BackgroundText messaging is frequently employed in the outpatient setting to communicate with or send reminders to patients. However, there is a paucity of literature on the impact of text messaging on inpatient care. In this study, the use of text messaging in hospitalized patients is evaluated by assessing patient compliance to a post-operative bariatric protocol.MethodsThis was a randomized controlled trial that studied compliance to a post-operative bariatric protocol in patients who underwent bariatric surgery at a tertiary, academic medical center between February and May 2021. Patients were randomized to either the control group, in which they received standard post-operative education alone or the Tulane Sending Texts, Advancing Results (STAR) intervention arm, in which participants received the same post-operative education along with two text message reminders to drink water, use their incentive spirometers, and ambulate (per post-operative instructions) on post-operative day (POD) # 0 and POD # 1. The primary outcome was compliance with the protocol, defined as the number of 1-oz cups of water consumed, incentive spirometry usage, and ambulation frequency and distance. Secondary outcomes include length of stay and complications.ResultsA total of 35 patients were enrolled in the study (17 control, 18 STAR intervention). There was no significant difference in age, BMI, or type of surgery performed between the two groups. Clear liquid consumption was significantly higher in the STAR intervention group with an average of 27.7 ± 3.5 cups as compared to 18.2 ± 8.9 in the control group (p < 0.001). Similarly, statistically significant increases in incentive spirometry usage (p < 0.01) and ambulation distance and frequency (p < 0.02) were observed in the STAR intervention group.ConclusionsWhile patients are in the hospital, text messaging can improve compliance to post-operative protocols. Peri-operative text messaging can enhance patient education and communication.

Demographic and clinical characteristics of patients with transverse myelitis and traumatic spinal cord injury: A comparative retrospective study

Objectives To identify the demographic and clinical characteristics of patients with transverse myelitis (TM) and to compare functional status between those patients and a matched group with traumatic spinal cord injury (T-SCI). Study Design Retrospective study. Setting A tertiary rehabilitation hospital Participants The demographic and clinical characteristics of 484 T-SCI patients and 25 TM patients were compared. Functional status was further analyzed by matching the two groups. Outcome Measurements The matched patients were compared in terms of motor and sensory functions, bladder and bowel symptoms, ambulation level, the Rivermead Mobility Index, and SCI-related medical complications. Results The mean age of the TM patients was 35.6 years and was similar to that of the T-SCI patients. There were significantly more females in the TM group (P = 0.017). Individuals with TM had fewer cervical injuries (P = 0.032) and a higher rate of paraplegia (P = 0.047) and were more often incomplete (P = 0.009) than those with T-SCI. Sensory function was significantly better in the TM group compared to the matched T-SCI group (P = 0.05). Independent ambulation frequency was higher in the TM patients. The SCI-related complications seen in the TM group were as common as those in the T-SCI group. Conclusion The TM and T-SCI groups differed in terms of the demographic and clinical characteristics recorded. Additionally, when matched for these differences, functional status was slightly better in the TM group. However, like T-SCI, TM was a significant cause of disability and SCI-related complications were common.

Early Mobilization in the ICU: A Collaborative, Integrated Approach.

Objectives:To develop and implement a protocol to increase patient mobility in three adult ICUs using an interdisciplinary approach and existing resources.Design:The Iowa Model of Evidence-Based Practice was used for synthesis of literature and intervention planning. A retrospective pre- and post-intervention data collection design was used to compare outcomes of interest.Setting:Three adult ICUs (64 total beds) in an urban, academic hospital. Physician, nursing, respiratory therapy, physical therapy, and occupational therapy representatives participated in planning and development. All adult ICU patients were included.Interventions:Development and implementation of an inclusive early mobility protocol in three adult ICUs. Focus on interdisciplinary collaboration to restructure workflow, focusing on optimization and coordination of standard tasks. Multimodal education occurred in an interdisciplinary setting and on-site champions facilitated implementation.Measurements and Main Results:Time from admission to ambulation, overall frequency of ambulation, and frequency of ambulation by age group were assessed across three time periods: no awareness (Time 1), awareness without protocol (Time 2), and protocolization (Time 3). Decrease in hours from admission to ambulation were seen in the cardiovascular ICU (62.3 vs 56.1; p = 0.10) and surgical ICU (64.9 vs 58.6; p = 0.022). Significant increase demonstrated in the proportion of patients who ambulated while in the ICU (24.6% vs 33.0%; p < 0.001). All age groups had increase in frequency of ambulation. The largest gains in patients over 65 years old (T1 = 19.7%, T2 = 26.6%, T3 = 30.9%; p < 0.001). No change found in ICU length of stay, hospital length of stay, or ventilator days.Conclusions:This single-center evidenced-based practice project demonstrated increased mobility for ICU patients without addition of staff resources following implementation of an early mobility protocol using an interdisciplinary approach. Successful implementation led to creation of mobility protocol toolkit for use across all ICUs in the broader health system.

Assessment of Patient Ambulation Profiles to Predict Hospital Readmission, Discharge Location, and Length of Stay in a Cardiac Surgery Progressive Care Unit

Promoting patient mobility during hospitalization is associated with improved outcomes and reduced risk of hospitalization-associated functional decline. Therefore, accurate measurement of mobility with high-information content data may be key to improved risk prediction models, identification of at-risk patients, and the development of interventions to improve outcomes. Remote monitoring enables measurement of multiple ambulation metrics incorporating both distance and speed. To evaluate novel ambulation metrics in predicting 30-day readmission rates, discharge location, and length of stay using a real-time location system to continuously monitor the voluntary ambulations of postoperative cardiac surgery patients. This prognostic cohort study of the mobility of 100 patients after cardiac surgery in a progressive care unit at Johns Hopkins Hospital was performed using a real-time location system. Enrollment occurred between August 29, 2016, and April 4, 2018. Data analysis was performed from June 2018 to December 2019. Outcome measures included 30-day readmission, discharge location, and length of stay. Digital records of all voluntary ambulations were created where each ambulation consisted of multiple segments defined by distance and speed. Ambulation profiles consisted of 19 parameters derived from the digital ambulation records. A total of 100 patients (81 men [81%]; mean [SD] age, 63.1 [11.6] years) were evaluated. Distance and speed were recorded for more than 14 000 segments in 840 voluntary ambulations, corresponding to a total of 127.8 km (79.4 miles) using a real-time location system. Patient ambulation profiles were predictive of 30-day readmission (sensitivity, 86.7%; specificity, 88.2%; C statistic, 0.925 [95% CI, 0.836-1.000]), discharge to acute rehabilitation (sensitivity, 84.6%; specificity, 86.4%; C statistic, 0.930 [95% CI, 0.855-1.000]), and length of stay (correlation coefficient, 0.927). Remote monitoring provides a high-information content description of mobility, incorporating elements of step count (ambulation distance and related parameters), gait speed (ambulation speed and related parameters), frequency of ambulation, and changes in parameters on successive ambulations. Ambulation profiles incorporating multiple aspects of mobility enables accurate prediction of clinically relevant outcomes.

Exploiting Citrus aurantium seeds and their secondary metabolites in the management of Alzheimer disease

Fruit by-products are considered nature’s golden gift for human health and a good starting point to discover new drugs depending on the fact that they contain millions of bio-active compounds that are responsible for therapeutic activities. In this context, the main goal of this study is to recycle Citrus aurantium (C. aurantium) seeds to produce pharmaceutical molecules to be used in the prevention of the progressive neurological damage associated with Alzheimer disease (AD). Donepezil (0.75 mg/kg), hesperidin (125 and 250 mg/kg) and limonoids (50 and 100 mg/kg) were used for treatment of rats for 2 weeks prior to concomitant administration of AlCl3 for three successive weeks. Protection against cognitive deterioration was observed among study group with insignificant difference from normal control group and significant difference from positive control group in the Y-Maze test. On the other hand, treatment with both doses of hesperidin (125 and 250 mg/kg) and high dose of limonoids only (100 mg/kg) produced improvement in psychological state, observed by significant increase in ambulation frequency in comparison to positive control group, however it was not as frequent as normal group, as it was significantly less than normal group in the open field test. Regarding acetylcholine esterase (AChE) and beta-amyloid (β amyloid) levels, the effect of limonoids low dose was the best as it didn’t have a significant effect when compared to normal control, also hesperidin in both doses showed insignificant effects on β amyloid levels when compared to normal control group. Our results encourage the use of C. aurantium seeds which are wasted in huge amounts, as Alzheimer prophylactic food additives.

Utility of Mobility in Post Open-Heart Surgery Patients: A Pilot Trial

ABSTRACT Background: As the role of the clinical exercise physiologist expands, early mobility is an area of potential focus. A rural Midwestern intensive care unit began a mobility program alongside its open-heart surgery program. The mobility specialist, who was trained as a clinical exercise physiologist, was tasked to ambulate the open-heart surgery patients. The purpose of this pilot study was to determine the effectiveness of a mobility specialist on ambulation frequency and distance on post open-heart surgery patients. Methods: Data were collected retrospectively for 1 month on ambulation frequency and distance to determine the mobility specialist's impact on the variables. Results: Data was collected on 18 patients (15 male, 3 female) over the month. Overall, when the mobility specialist was present, patients ambulated further (M = 421 feet versus 189 feet, P = 0.039) and more often (M = 3.32 versus 1.43 ambulations per day, P &amp;lt; 0.001). Conclusion: In this study, having a mobility specialist with a background in exercise physiology led to more frequent and distant ambulation. Therefore, a mobility specialist should be considered an integral member of a multidisciplinary clinical team in rural intensive care units.

Ambulation Patterns Post-Discharge in Older Adults Identified as Fall Risk: A Descriptive Pilot Study.

Older adults identified as fall risk during a hospital stay may be at high risk for decreased ambulation during hospitalization and after discharge. Little is known about ambulation frequency in older adults identified as fall risk during a hospital stay or their trajectory of ambulation patterns after an acute hospitalization. Individual ambulation frequency, patterns, functional performance, and fear of falls for 14 older adults were studied. Accelerometers were worn by patients during their hospital stay and for 4 weeks post-discharge. Novel analytics using piecewise regression were used to analyze data. Patterns of ambulation were heterogeneous, and 64% of patients demonstrated no change in the first 2 weeks post-discharge. Increase in ambulation frequency was positively correlated with higher Katz Activities of Daily Living Index scores, gait speed, and lower fear of falls score. Ambulation patterns in older adults identified as fall risk show promise in capturing ambulation recovery and functional ability post-discharge. [Res Gerontol Nurs. 2019; 12(3):113-119.].

Walking to recovery: the effects of missed ambulation events on postsurgical recovery after bowel resection.

Early ambulation after surgery is demonstrated to reduce complications and decreases patient length of stay (LOS) as part of an enhanced recovery after surgery (ERAS) program. This study hypothesizes that missed and refused ambulation attempts prolong patient LOS. From January 2014 to December 2016, all patients admitted to one ward who had undergone bowel resection surgery were assigned a dedicated ambulation team with the goal of ambulating 3 times per day. Clinical data was collected prospectively. Statistical analysis of ambulation frequency, percentage of ambulation sessions completed and overall LOS was performed to test the hypothesis. A total of 127 patients were analyzed for mean age, breakdown of laparoscopic/open procedures/pre-surgery ambulation status. The median LOS (mLOS) for all patients was 4.3 days. When ambulation was not offered for a 24-hour period, the mLOS increased from 3.6 to 6.6 days (P<0.001). When a patient refused to ambulate at any time, the mLOS increased from 4.0 to 4.7 days (P=0.004). There was a significant association between completed ambulation attempts and mLOS (r=-0.536, P<0.001). Increasing narcotic use (r=0.548, P<0.001) including the use of a patient-controlled analgesia (PCA) (r=0.213, P=0.011) increased mLOS. Ambulation participation is a critical component of an enhanced bowel resection pathway. Non-compliance is associated with an increased LOS. Optimizing pain control, minimizing narcotics, and ensuring adequate ambulation resources also contribute to decreased LOS.

Relationship Between L-DOPA-Induced Reduction in Motor and Exploratory Activity and Striatal Dopamine D2 Receptor Binding in the Rat.

Purpose: The present study assessed the influence of L-DOPA administration on neostriatal dopamine (DA) D2 receptor binding in relation to motor and exploratory behaviors in the rat.Methods: D2 receptor binding was measured in baseline, after challenge with the aromatic L-amino acid decarboxylase inhibitor benserazide, and after challenge with either 5 or 10 mg/kg L-DOPA plus benserazide. Additional rats received injections of saline. For baseline and challenges, striatal equilibrium ratios (V) were computed as estimation of the binding potential. Motor and exploratory behaviors were assessed for 30 min in an open field prior to administration of [123I]IBZM. D2 receptor binding was measured with small animal SPECT 2 h after radioligand administration for 60 min.Results: Both L-DOPA doses significantly reduced D2 receptor binding relative to baseline and led to significantly less ambulation, less head-shoulder motility, and more sitting relative to saline. Moreover, 10 mg/kg L-DOPA induced less head-shoulder motility, more sitting, and more grooming than 5 mg/kg L-DOPA. Analysis of time-behavior curves showed that L-DOPA-treated animals relative to saline exhibited a faster rate of decrease of ambulation frequency and a slower rate of decrease of both duration and frequency of head-shoulder motility from a lower maximum level.Conclusions: The reductions of striatal D2 receptor binding after L-DOPA may be conceived to reflect elevated concentrations of synaptic DA. L-DOPA-treated animals showed less ambulation and less head-shoulder motility than saline-treated animals, indicating an association between less behavioral activity and increased availability of striatal DA. The faster rate of decrease of ambulation frequency and the lower maximum levels of both head-shoulder motility duration and frequency may be interpreted in terms of influence of increased DA availability on behavioral habituation to a novel environment.

Attenuation of visceral nociception by α-bisabolol in mice: investigation of mechanisms

BackgroundWe previously described the visceral antinociceptive property of α-bisabolol (BISA) in mouse models of visceral nociception induced by cyclophosphamide and mustard oil (MO). This study examined the effect of BISA in mouse models of visceral nociception induced by acetic acid, capsaicin, formalin, and the contribution of the nitric oxide system, α2, KATP, 5-HT3 and TRPV1 receptors to the effect of BISA on MO-evoked nociceptive behaviors. Mice were pretreated orally with BISA (50, 100 and 200 mg/kg) or vehicle, and the pain-related behavioral responses to intraperitoneal administration of acetic acid or intracolonic injection of MO were analyzed.ResultsBISA significantly suppressed the nociceptive behaviors in a dose-unrelated manner. The antinociceptive effect of BISA (50 mg/kg) was show to be glibenclamide resistant, but it was not blocked by pretreatment with the other antagonists tested. In the open-field test that detects sedative or motor abnormality, mice received 50 mg/kg BISA did not show any per se influence in ambulation frequency.ConclusionsHowever, their precise antinociceptive mechanisms of action have not been determined.

Major role of suckling stimulation for inhibition of estrous behaviors in lactating rabbits: Acute and chronic effects

Lactation in rabbits induces anestrus: sexual receptivity and scent-marking (chinning) are reduced despite the brevity of suckling (one daily nursing bout, lasting around 3 min). The mechanisms underlying this effect are unknown but, as chinning, lordosis, and ambulation in an open field are immediately inhibited by the peripheral stimulation received during mating we hypothesized that, across lactation, suckling stimulation would provoke a similar effect. To test this possibility we provided litters of 1, 3, 5, or 10 pups across lactation days 1–15 and quantified chinning and ambulation frequencies, the lordosis quotient, and milk output. Baseline chinning frequency, determined before the daily nursing bout, was low across lactation days 1–15 in does nursing 3, 5 or 10 pups but it increased steadily across days 1–10 in rabbits suckling one pup. Yet, a single young was sufficient to abolish chinning for about 1 h, after which this behavior rose again. Suckling litters of all sizes reduced (but did not abolish) ambulation frequency, both chronically (baseline levels declined across days 1–5) and acutely. Sexual receptivity was significantly reduced on lactation day 15 only in does that had nursed 10 pups. Large litter size promoted a larger milk output and a normal duration of nursing episodes. Results support a major role of suckling stimulation for the suppression of estrous behaviors and ambulation through as yet unidentified mechanisms.

Oleanolic Acid, a Pentacyclic Triterpene Attenuates the Mustard Oil-Induced Colonic Nociception in Mice

Many natural terpenoid compounds from plants exhibit antinociceptive property but very few studies have addressed their efficacy in visceral models of nociception. The present study evaluated the antinociceptive potential of oleanolic acid, a pentacyclic triterpene in the mouse model of colonic nociception induced by mustard oil. We further examined the possible participation of opioid, alpha2-adrenergic, and transient receptor potential vanilloid 1 (TRPV1)-receptors in its mechanism. Mice were pretreated orally with oleanolic acid (3, 10, 30 mg/kg) or vehicle, and the pain-related behavioral responses to intracolonic injection of mustard oil was analysed. Oleanolic acid significantly suppressed the mustard oil-induced nociceptive behaviors at test doses of 10 and 30 mg/kg, in a dose-related manner. The antinociceptive effect of oleanolic acid (30 mg/kg) was significantly blocked by pretreatment with the opioid antagonist, naloxone (2 mg/kg, i.p.), while the alpha2-adrenoceptor antagonist, yohimbine (2 mg/kg, s.c.), had no effect. Pretreatment with ruthenium red (3 mg/kg, s.c.), a non-competitive TRPV1 antagonist alone caused significant inhibition of mustard oil-induced nociception but its co-administration with oleanolic acid produced neither antagonism nor potentiation of oleanolic acid antinociception. In the open-field test that detects sedative or motor abnormality, mice received 30 mg/kg oleanolic acid did not show any per se influence, but significantly inhibited the mustard oil-induced decrease in ambulation frequency. These data demonstrate the visceral antinociceptive potential of oleanolic acid that involves an opioid mechanism and possibly a modulatory influence on vanilloid-receptors, which needs further study.

Frequency of hallway ambulation by hospitalized older adults on medical units of an academic hospital.

Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to determine the frequency of hallway walking by older adults hospitalized for medical illness. The study was an observational time-sampled study, which was conducted in the hallways of 3 medical units of a 485-bed academic health care center. Each unit was observed weekdays for eight 3-hour intervals covering 8 AM to 8 PM. Before each observation, nursing staff were questioned about walking abilities of patients aged <or=55 years. During observation, frequency and minutes of patients' hallway ambulation were recorded. Of 118 patients considered by nurses as able to walk in the hallways, 18.6% walked once, 5.1% twice, 3.4% more than twice, and 72.9% did not walk at all per 3-hour period. The median minutes for ambulation was 5.5. Frequency of ambulation was as low for patients independent in walking as for those dependent (28% vs 26%, P=.507). Of the 32 patients who walked in the hallways, most did so alone (46.8%, n=15) or with therapy staff (41%, n=13); few walked with nursing staff (9.4%, n=3) or family (18.8%, n=6). In this setting, hallway walking was very low for hospitalized older patients. If this trend of limited walking is found to be prevalent across other settings, then both independent and dependent patients will require additional interventions to improve ambulation during hospitalization.

Pain intensity and postoperative pulmonary complications among the elderly after abdominal surgery

Objective: The purpose of this study was to determine whether postoperative pain intensity differs between elderly abdominal surgery patients in whom postoperative pulmonary complications (PPC) develop and those in whom they do not. Methods: The exploratory secondary analysis of data from a prospective study of risk factors for PPC had a convenience sample of 86 patients (≥60 years old) after abdominal surgery at 3 Midwestern hospitals. Daily measurements from postoperative day (POD) 1 to 6 included: pain (rated 0 to 10) at rest, with coughing, deep breathing, movement and walking, and frequency of ambulation. Results: Sixteen subjects (18.6%) had a PPC develop. Subjects with PPCs had higher mean pain intensities on all measures on each POD than those without. Those with PPCs had significantly higher pain intensities at rest on POD4 (P =.010), with deep breathing on POD2 (P =.015), POD4 (P =.009), POD5 (P =.006), and POD6 (P =.009), were up to a chair significantly fewer times on POD2 (P =.043), and walked significantly fewer times on POD5 (P =.002) and POD6 (P =.000) than those without PPCs. Length of stay for those with PPCs (mean, 17.9 days; standard deviation, 15.9 days; median, 10.0 days) was significantly longer than for those without PPCs (mean, 8.5 days; standard deviation, 4.8 days; median, 7.0 days; P =.000). Conclusion: Results provide support for viewing pain as a factor that contributes to the development of PPCs among the elderly population after abdominal surgery. Therefore, nursing interventions of pain assessment and management, deep breathing, and ambulation may influence the incidence of this outcome. (Heart Lung® 2002;31:440-9.)

Acute buspirone abolishes the expression of behavioral dopaminergic supersensitivity in mice.

Previous studies have shown that rats withdrawn from long-term treatment with dopamine receptor blockers exhibit dopaminergic supersensitivity, which can be behaviorally evaluated by enhanced general activity observed in an open-field. Recently, it has been reported that co-treatment with the non-benzodiazepine anxiolytic buspirone attenuates the development of haloperidol-induced dopaminergic supersensitivity measured by open-field behavior of rats. The aims of the present study were: 1) to determine, as previously reported for rats, if mice withdrawn from long-term neuroleptic treatment would also develop dopaminergic supersensitivity using open-field behavior as an experimental paradigm, and 2) to examine if acute buspirone administration would attenuate the expression of this behavioral dopaminergic supersensitivity. Withdrawal from long-term haloperidol treatment (2.5 mg/kg, once daily, for 20 days) induced a significant (30%) increase in ambulation frequency (i.e., number of squares crossed in 5-min observation sessions) but did not modify rearing frequency or immobility duration in 3-month-old EPM-M1 male mice observed in the open-field apparatus. Acute intraperitoneal injection of buspirone (3.0 and 10 but not 1.0 mg/kg, 12-13 animals per group) 30 min before open-field exposure abolished the increase in locomotion frequency induced by haloperidol withdrawal. These data suggest that the open-field behavior of mice can be used to detect dopaminergic supersensitivity, whose expression is abolished by acute buspirone administration.

Impact of Cognitive Impairment on Wandering Behavior

The purpose of this study was to explore cognitive impairment as a predictor of wandering rhythm and pattern in a sample of 25 demented residents from two long-term care settings. Parameters of rhythm indicating cycle frequency and structure were examined for wandering patterns (random, lapping, and pacing) and for nonwandering (direct) ambulation. All measures of cognitive impairment (Mini-Mental State Exam, Mattis Dementia Rating Scale, and a neuropsychologist's clinical rating) were significant predictors of parameters signifying frequency of wandering for random and lapping patterns but not for the pacing pattern. In addition, for nonwandering ambulation, cognitive impairment predicted some parameters of cycle structure (mean locomoting and nonlocomoting phase durations) but not those denoting frequency of ambulation. Results indicate that cognitive impairment plays an important role in determining the frequency of wandering cycles, but other factors may better explain parameters that characterize its cycle structure.