Risk faktors for fracture in middle-aged men and women

The number of fractures is increasing worldwide, and fractures frequently cause long-term disability, impaired quality of life and sometimes death. The Malmö Preventive Project, a population-based, prospective study, consisting of 22 444 men, mean age 44 and 10 902 women, mean age 50 years, provides data for evaluation of common public health conditions, such as fracture and diabetes. The follow-up was 19 and 15 years for men and women, respectively. Multiple risk factors for fracture were identified. In women, the most important risk factors were advancing age (relative risk RR 1.56, Confidence Interval 95% 1.45-1.68), previous fracture (RR 2.00, CI 95% 1.56-2.58) and diabetes (RR 1.87, CI 95% 1.26-2,79). In men, advancing age (RR 1.19, CI 95% 1.12-1.26), mental health problems (RR 1.92, CI 95% 1.47-2.51), increased levels of ? glutamyl transferase (RR 1.24, CI 95% 1.18-1.31) and diabetes (RR 2.38, CI 95% 1.65-3.42) were major risk contributors. Impaired glucose tolerance, evaluated through an oral glucose tolerance test, was in both genders associated with a substantially decreased risk of fractures, independent of age, BMI and smoking. This thesis has identified multiple risk factors for low-energy fracture, in both men and women, highlighting diabetes and mental health problems as major contributors in this age group. Current management strategies and therapeutic guidelines are not addressing a number of the identified risk factors. Subsequently, risk assessment can be substantially improved by adding these risk factors to intervention algorithms for middle-aged individuals

Osittain selkäydinvammautuneen henkilön kävelymattoharjoittelu yhdistettynä visuaaliseen palautteeseen : Tapaustutkimus

Tämän opinnäytetyön tarkoitus on selvittää miten 7 viikon kävelymattoharjoittelu, yhdistettynä visuaaliseen palautteeseen, vaikuttaa osittain selkäydinvammautuneen kävely-vauhtiin. Työ on rajattu selkeästi käsittämään kävelymattoharjoittelua osittain selkäydinvammautuneilla, ja mitattavaksi muuttujaksi on valittu kävelyvauhti, ja siihen liittyen askel-pituus. Opinnäytetyön idea ja kysymyksenasettelu on syntynyt työn tilaajan, Validia Kuntoutuksen tarpeista selvittää uudehkon kävelymatto-järjestelmän käyttömahdollisuuksia. Opinnäytetyön menetelmänä on tapaustutkimus eli työssä tarkastellaan yhtä tapausta – tutkimushenkilöä jolla on osittainen selkäydinvamma. Mittausmenetelminä on käytetty 10 metrin kävelytestiä sekä GaitRite-kävelyanalyysijärjestelmää, sekä lisäksi kvalitatiivisena menetelmänä mukaan on otettu avoin havainnointi. Työhön on sisältynyt 7 viikon kävelymattoharjoittelu-interventio. Teoreettisen taustan kokoamiseen on käytetty erilaisia alan tietokantoja, joista on poimittu tietoa aiemmista kävelymattotutkimuksista, ja lisäksi teoreettiseen taustaan on koottu selvitys osittaisesta selkäydinvammasta, spastisuudesta, kävelyn syklistä, kävelyvauhdista, ICF toimintakyvyn luokitusjärjestelmästä, sekä interventiossa käytetystä H/P Cosmos- kävelymatosta ja siihen liittyvästä Zebris Rehawalk -käyttösovelluksesta. Työn tulosten valossa 7 viikon kävelymattoharjoittelulla yhdistettynä visuaaliseen palautteeseen ei pystytty vaikuttamaan tutkimushenkilön kävelyvauhtiin normaalilla alustalla, vaikka itse kävelymatolla harjoittelussa saavutettiinkin huomattavia parannuksia askel-pituudessa ja myös pieniä parannuksia kävelyvauhdissa. Toisaalta havaintojen sekä tutkimushenkilön oman palautteen perusteella, kävelymatto-harjoittelu oli tutkimushenkilölle miellyttävää sekä antoi mahdollisuuden kuntoiluun. Tulevaisuudessa kävelymattoharjoitteluun tulisi yhdistää myös normaalilla alustalla kävelyn harjoittelua, jotta kävelymatolla saavutetut parannukset siirtyisivät myös normaaliin kävelyyn. Lisäksi kävelymattoharjoittelussa tulisi ottaa huomioon spastisuus kävely-harjoittelua rajoittavan tekijänä, sekä harjoitteluun käytettävissä olevat resurssit.Det här examensarbete tar reda på hur en 7 veckors träning på en gångmatta, kombinerat med visuell feedback, påverkar på gånghastigheten hos en inkomplett ryggmärgskadad individ. Arbetets synvinkel är begränsad tydligt kring begreppena gångträning och inkomplett ryggmärgskada, och de mätbara faktorerna har varit gånghastigheten och steg längden. Som bakgrund för idèen och forskningsfrågan för hela arbetet har fungerat behovet av beställaren, Validia Kuntoutus. Deras önskemål har varit att ta reda på möjligheter av den nya löpmatta-apparaten. Som metod vid det här arbete är fallstudie, och som mätningsmetoder har det använts 10 meters gångtest och GaitRite-gånganalysmattan, samt som kvalitativ mätningsmetod har det använts en öppen observation. Vid arbetet har ingått också en 7 veckors praktisk intervention i form av löpmattaträning. Den teoretiska referensramen består av tidigare forskningar om löpmattaträning som har sökts från olika databaser, samt ingår det tydliga utredningar av följande begrepp inom den teoretiska referensramen: inkomplett ryggmärgskada, spasticitet, gångcykeln, gånghastigheten, ICF klassificeringssystem av funktionsförmågan, samt apparaterna som har använts vid interventionen - H/P Cosmos löpmattan och Zebris Rehawalk programmet. Som resultat av den här fallstudie kan man konstatera att man inte kunde påverka på gånghastigheten hos den här enskilda undersökningsperson på ett normalt underlag, även om på den själva löpmattan kunde man uppnå tydliga förbättringar vid steg längden, samt små förbättringar vid gånghastigheten. Trots det, på grund av observation samt på grund av undersökningspersonens egen feedback, var löpmattaträningen för undersökningspersonen behagligt, samt fick undersökningspersonen möjligheten att motionera. På framtiden borde man kombinera gångträning på ett normalt underlag med löpmattaträning, för att träningseffekten skulle överföras till den normala gången. Samt borde man ta i beaktande hur spasticiteten påverkar på löpmattaträning, och hur stora resurser har man för löpmattaträning.This thesis aims to find out if a 7 week treadmill training trial, combined with visual cueing, affects the gait speed of an individual with an incomplete spinal cord injury. The main themes of this thesis are clearly defined as treadmill training and incomplete spinal cord injury, and the main outcomes are gait speed and hence step length. The idea and the research questions for this thesis came out from the commissioner of this thesis, Validia Kuntoutus. They wanted to find out the possibilities of their newest treadmill device, in rehabilitation purpouse. The method of this thesis is a case study, which means there is one case in focus - an individual with an incomplete spinal cord injury. The main methods for the data collection are the 10m walk test and the GaitRite gait analysis, as well as open observation as a qualitative method. Also a 7 week treadmill training trial has been included in this thesis. The theoretical framework consists of previous research about treadmill training, which has been put together using different databases. In addition, the theoretical framework also includes comprehensive background information about an incomplete spinal cord injury, spasticity, gait cycle, gait speed, the ICF classification system, as well as the H/P Cosmos treadmill and the Zebris Rehwalk –program, both of which have been used in the practical trial of this thesis. In the light of the results, the 7 week treadmill trial did not have an impact to the over-ground gait speed of an individual with an incomplete spinal cord injury. However, fairly notable improvements were accomplished in the treadmill, especially in the step length. Eventhough no improvements were transferred in to the overground gait, based on the observations the research subject found the treadmill training pleasant, and the intervention gave the research subject a possibility for physical exercise. In the future, some overground gait training should be combined with the treadmill training, so that the gains accomplished in the treadmill would transfer into the overground gait. Besides that, things that should be considered are the possible spasticity as a restrictive factor, and the resources that are available for the treadmill training

Modeling Optimal Cadence as a Function of Time during Maximal Sprint Exercises Can Improve Performance by Elite Track Cyclists

In track cycling sprint events, optimal cadence PRopt is a dynamic aspect of fatigue. It is currently unclear what cadence is optimal for an athlete’s performance in sprint races and how it can be calculated. We examined fatigue-induced changes in optimal cadence during a maximal sprint using a mathematical approach. Nine elite track cyclists completed a 6-s high-frequency pedaling test and a 60-s isokinetic all-out sprint on a bicycle ergometer with continuous monitoring of crank force and cadence. Fatigue-free force-velocity (F/v) and power-velocity (P/v) profiles were derived from both tests. The development of fatigue during the 60-s sprint was assessed by fixing the slope of the fatigue-free F/v profile. Fatigue-induced alterations in PRopt were determined by non-linear regression analysis using a mono-exponential equation at constant slope. The study revealed that PRopt at any instant during a 60-s maximal sprint can be estimated accurately using a mono-exponential equation. In an isokinetic mode, a mean PRopt can be identified that enables the athlete to generate the highest mean power output over the course of the effort. Adding the time domain to the fatigue-free F/v and P/v profiles allows time-dependent cycling power to be modelled independent of cadence

Implantable Drainage After Major Abdominal Surgery in Compromised Patients

The risk of superinfection following routine abdominal drainage after major surgery is debated. Especially in patients with malignant diseases and a compromised host defense, this might be a factor increasing morbidity and mortality. During a 3-year period (1986–1988) 41 patients operated on for malignant abdominal conditions received a peritoneal catheter connected to a subcutaneous portal inserted in order to participate in a trial on postoperative intraperitoneal chemotherapy using 5- Fluorouracil. No abdominal drains were inserted. In 15 patients, the subcutaneous portal was used for evacuation of postoperative fluid accumulation within the abdomen. The mean age was 53 (range 41–70) years. Inserted catheters were used for drainage up to 14 days postoperatively. The daily amount of fluid drained varied from 20 to 2 000 ml with a mean of 610 ml/patient and day. One patient required removal of the catheter due to infection around the subcutaneous chamber. Otherwise, the catheter system was not associated with any other complications or complaints. One patient developed a postoperative left subphrenic abscess drained percutaneously by the guidance of ultrasonography, a complication that could not be attributed to the catheter system but merely to the major operation per se. An implantable device for peritoneal access thus also seem useful for drainage of postoperative fluid collection, as evaluated in this preliminary report

Inducible Siphoviruses in superficial and deep tissue isolates of Propionibacterium acnes

Background: Propionibacterium acnes is a commensal of human skin but is also known to be involved in certain diseases, such as acne vulgaris and infections of orthopaedic implants. Treatment of these conditions is complicated by increased resistance to antibiotics and/or biofilm formation of P. acnes bacteria. P. acnes can be infected by bacteriophages, but until recently little has been known about these viruses. The aim of this study was to identify and characterize inducible phages from P. acnes on a genetic and morphological basis. Results: More than 70% (65/92) of P. acnes isolates investigated have inducible phages, classified morphologically as Siphoviruses. The phages have a head of 55 nm in diameter and a tail of 145 155 nm in length and 9-10 nm in width. There was no difference in carriage rate of phages between P. acnes isolates from deep infections and isolates from skin. However, there was a significant lower carriage rate of phages in P. acnes biotype IB, mostly attributed to the low carriage rate of inducible phages in biotype IB isolated from deep tissue. Most phages have a strong lytic activity against all P. acnes isolates with inducible phages, but have less lytic activity against isolates that have no prophages. Phages only infected and lysed P. acnes and not other closely related propionibacteria. All phages could infect and lyse their non-induced parental host, indicating that these prophages do not confer superinfection immunity. The phages have identical protein pattern as observed on SDS-PAGE. Finally, sequencing of two phage genes encoding a putative major head protein and an amidase and showed that the phages could be divided into different groups on a genetic basis. Conclusion: Our findings indicate that temperate phages are common in P. acnes, and that they are a genetically and functionally homogeneous group of Siphoviruses. The phages are specific for P. acnes and do not seem to confer superinfection immunity

"Goa gubbar tjallar inte" - En fallstudie om lokal korruption och vilka konsekvenser den för med sig

Denna uppsats diskuterar problematiken när legitimiteten för ett demokratiskt styrskick minskar till följd av skandaler och av allmänheten uppfattad korruption. Detta kommer att göras utifrån ett specifikt fall, nämligen de händelser som avslöjades i Göteborg under 2010, vilka har kommit att kallas Muthärvan i Göteborg. En diskussion kommer att föras med hjälp av statsvetenskapliga teorier som appliceras på en presentation av mediebilden av muthärvan och statistiskt material om Göteborg. Uppsatsen resulterar inte i något bevis, men för en diskussion kring hur variabler såsom stöd för demokrati och förtroende för politiker kan ha påverkats av skandalerna. Förmodligen har dessa variabler minskat som en kortsiktig följd av avslöjandena, men det tycks också finnas en långsiktig effekt som kan öka dem. Göteborgsandan – en kulturell institution som anses vara en förutsättning för korruptionsbrotten – verkar nämligen ställas inför rätta. Uppsatsen ger en kluven, men intressant bild av en svensk korruptionsskandal och dess demokratiska följder

Broadband UBVRI Photometry of Horizontal-Branch and Metal-Poor Candidates from the HK and Hamburg/ESO Surveys. I

We report broadband UBV and/or BVRI CCD photometry for a total of 1857 stars in the thick-disk and halo populations of the Galaxy. The majority of our targets were selected as candidate field horizontal-branch or other A-type stars (FHB/A, N = 576), or candidate low-metallicity stars (N = 1221), from the HK and Hamburg/ESO objective-prism surveys. Similar data for a small number of additional stars from other samples are also reported. These data are being used for several purposes. In the case of the FHB/A candidates they are used to accurately separate the lower-gravity FHB stars from various higher-gravity A-type stars, a subsample that includes the so-called Blue Metal Poor stars, halo and thick-disk blue stragglers, main-sequence A-type dwarfs, and Am and Ap stars. These data are also being used to derive photometric distance estimates to high-velocity hydrogen clouds in the Galaxy and for improved measurements of the mass of the Galaxy. Photometric data for the metal-poor candidates are being used to refine estimates of stellar metallicity for objects with available medium-resolution spectroscopy, to obtain distance estimates for kinematic analyses, and to establish initial estimates of effective temperature for analysis of high-resolution spectroscopy of the stars for which this information now exists.Comment: 22 pages, including 3 figures, 5 tables, and two ascii files of full data, accepted for publication in the Astrophysical Journal (Supplements

Broadband UBVR_CI_C Photometry of Horizontal-Branch and Metal-poor Candidates from the HK and Hamburg/ESO Surveys. I.

We report broadband UBV and/or BVR_CI_C CCD photometry for a total of 1857 stars in the thick-disk and halo populations of the Galaxy. The majority of our targets were selected as candidate field horizontal-branch or other A-type stars (FHB/A, N = 576), or candidate low-metallicity stars (N = 1221), from the HK and Hamburg/ESO objective-prism surveys. Similar data for a small number of additional stars from other samples are also reported. These data are being used for several purposes. In the case of the FHB/A candidates they are used to accurately separate the lower gravity FHB stars from various higher gravity A-type stars, a subsample that includes the so-called blue metal poor stars, halo and thick-disk blue stragglers, main-sequence A-type dwarfs, and Am and Ap stars. These data are also being used to derive photometric distance estimates to high-velocity hydrogen clouds in the Galaxy and for improved measurements of the mass of the Galaxy. Photometric data for the metal-poor candidates are being used to refine estimates of stellar metallicity for objects with available medium-resolution spectroscopy, to obtain distance estimates for kinematic analyses, and to establish initial estimates of effective temperature for analysis of high-resolution spectroscopy of the stars for which this information now exists