Postpartum women are at increased risk for lower limb musculoskeletal disorders. Foot arch collapse following pregnancy has been reported as a mechanism for this increased risk. However, dynamic changes during gait in postpartum women have not been reported. Therefore, we assessed the association between parity and dynamic foot pronation during gait.To determine (1) if there is an association between parity and dynamic foot pronation (center of pressure excursion index, CPEI) during gait; and (2) the extent to which there is a dose-effect of parity on foot pronation.The Multicenter Osteoarthritis Study (MOST) Study is a longitudinal cohort study of adults with or at risk for knee osteoarthritis (OA).Two communities in the United States, Birmingham, Alabama and Iowa City, Iowa.Not applicable PARTICIPANTS: A population-based sample of 1177 MOST participants who were female, had complete CPEI and parity data and completed the baseline, 30- and 60-month visits.Odds of a one quintile decrease in CPEI by parity group and mean CPEI by parity group.In 1177 women, mean age was 67.7 years and mean body mass index (BMI) was 30.6 kg/m2 . As parity increased, there was significantly greater foot pronation, lower mean CPEI: 19.1 (18.2-20.1), 18.9 (18.4-19.4), 18 (17.5-18.6) to 17.5 (16.4-18.6) in the 0 to 4 and >5 children groups, respectively; (P = .002), which remained significant after adjusting for race and clinic site (P = .005). There was a positive linear trend (β = 1.08, 1.03-1.14) in odds ratios of a one quintile decrease in CPEI (greater pronation) with increasing parity level (P = .004), which remained significant after adjusting for race and clinic site (P = .01). After adjusting for age and BMI, these two associations were no longer statistically significant.This study indicates a positive correlation between parity and greater dynamic pronation of the feet.
p SEUDOMONAS AERUGINOSA, formerly called B. pyocyanea, is one of the group of gram-negative organisms that have caused an increased percentage of hospital-acquired infections in recent years. 1,1~ Because pseudomonas rarely produces primary infections in man, 6 it has been referred to as an opportunist organism, a term suggesting a micro-organism that is part of the normal flora of man but that occasionally produces progressive infections in a host with impaired defenses. Pseudomonas infections may be relatively indolent, producing only slow host reactions, and therefore may persist for long periods before being diagnosed and properly treated. The characteristics noted above are particularly pertinent to pseudomonas infections of the central nervous system. Pseudomonas is the cause of about 5% of neonatal meningitis. 13,~4 In most instances pseudomonas meningitis has been superimposed on underlying disease, wound infection or eerebrospinal-fluid fistula; has extended from adjacent foci; or has been introduced by lumbar puncture, spinal anesthesia, or indwelling catheters draining cerebrospinal fluid. 2,3,~,~,12 In one large series, covering 10 years, pseudomonas was the causative organism in four out of 294 cases of bacterial meningitis (1.4%).5 An extensive review of reports of pseudomonas meningitis through 1955 is found in Forkner's monograph. 4 We are reporting 16 cases of pseudomonas infections of the central nervous system seen at the University of California Hospitals, and Fort Miley Veterans Administration Hospital, San Francisco, in the past 18 years. Two of the cases included in this series were described in detail previously. 7,s
T HE usual response to a major surgical procedure is temporary oliguria which persists for several days. 1,3,~2,17 The secretion of antidiuretic hormone (ADH) tha t produces this oliguria is, in a sense, an inappropria te secretion, in tha t it is not controlled by osmotic stimuli. After surgical nlanipulation in the sellar and suprasellar areas, however, the supraopt ico-hypophyseal system may be temporarily or permanent ly damaged, so that a t ransient or permanent diabetes insipidus results. The coexistence of uncontrolled polyuria with postoperat ive sodium retention, or with possible excessive sodium loss in pat ients with prolonged hypopituitarism, may make the management of these patients very difficult. Two cases will be described to illustrate some of these problems. In the charts illustrating these cases, crude water balance indicates only fluid intake and urine output . Insensible fluid loss, water of oxidation, and water in the food are not indicated. However, when this balance is considered along with changes in body weight, a good first approximation of the actual water balance can be made. Corrected serum sodium concentration, or osmolality, indicates the ratio between body water and body electrolytes and tends to va ry directly with changes of exchangeable electrolytes and inversely with changes of total body water? ,9
To determine whether the amount of physical activity (PA) is a determinant of joint space narrowing (JSN) worsening over 48 months in participants with knee osteoarthritis.Data were obtained from the Osteoarthritis Initiative. PA, measured using the Physical Activity Scale for the Elderly (PASE), was defined as the mean value of the annual measurements conducted prior to development of worsening JSN. Worsening JSN was defined as at least a partial grade increase in the Osteoarthritis Research Society International JSN score over 48 months, in comparison with baseline. Restricted cubic spline function was used to group participants based on the linear association between PA and JSN worsening. A pooled logistic regression model was used to evaluate the association between PA and JSN worsening adjusted for confounders.A total of 2,167 participants were included. In total, 625 participants (28.8%) had JSN worsening over 48 months. Compared with a PASE score of 141-180, PASE scores of 101-140 and >220 were associated with an increased risk of JSN worsening in men, with odds ratios (ORs) of 1.73 (95% confidence interval [95% CI] 1.07-2.81) and 1.83 (95% CI 1.14-2.93), respectively. Similarly, in participants with Kellgren/Lawrence (K/L) grade 2, compared with a PASE score of 141-180, PASE scores of ≤100 and >220 were associated with increased risks of JSN worsening, with an OR of 1.69 (95% CI 1.13-2.54) and 1.64 (95% CI 1.05-2.56), respectively.Compared to moderate PA, higher or lower amounts of PA are associated with an elevated risk for JSN worsening in men and in participants with K/L grade 2 knees.
SOSORBIDE is a dihydric alcohol with a molecular weight of 146, formed by the removal of 2 molecules of water from 1 molecule of sorbitol. We recently reported that orally administered isosorbide lowered cerebrospinal fluid (CSF) pressure in dogs. 9 This paper reports our findings when this osmotic diuretic was administered orally to humans. Methods A dose of 2 gm/kg body weight was chosen as being probably both safe and effective. The 50% isosorbide solutiont was administered via nasogastric tube to comatose patients; conscious cooperative patients drank the iced solution. The CSF pressure was measured with a water manometer attached to a needle in the lumbar subarachnoid space. Osmolality of samples of serum and CSF were determined by the method of freezing point depression.,
