Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

We examined the feasibility of radiostereometric analysis (RSA) in the assessment of the initial stability of internally fixed femoral neck fractures. The study included 16 patients (mean age 73 years). During surgery, multiple RSA‐beads were inserted on both sides of the fracture. Radiographs for RSA were taken in the supine position within the first 3 days and 6, 12, 24, and 52 weeks after surgery. To detect any inducible motion at the fracture‐site, radiographs for RSA were taken with the patient resting or applying a load through the fracture. Fracture loading was achieved by the patient pressing the ipsilateral foot as much as tolerated on a force plate while providing a counterforce through both hands. Micromotion exceeding the precision values of RSA (≥0.3 mm for the translation vector and/or ≥1.2 degrees for the rotation vector) was considered significant. Permanent three‐dimensional fracture‐site displacement was also recorded. Voluntary loading induced fracture‐site micromotion, which exhibited a dichotomous distribution. In patients with uncomplicated fracture union, inducible micromotion was detectable only at baseline—if at all. Conversely, fractures that developed a nonunion were characterized by the continuation of inducible micromotion beyond baseline. Permanent fracture‐site displacement was, on average, nearly an order of magnitude greater than the inducible micromotion. Fracture unions were characterized by the cessation of permanent fracture‐site displacement by 12 weeks. Nonunions presented as outliers in permanent fracture‐site displacement. Large‐scale studies are warranted to evaluate whether the detection of inducible micromotion beyond baseline could serve as an indicator of insufficient fixation stability.</p

Retirement age and type as predictors of frailty : a retrospective cohort study of older businessmen

Objectives To study the association between retirement characteristics and frailty in a homogenous population of former business executives. Design Cross-sectional cohort study using data from the Helsinki Businessmen Study. Setting Helsinki, Finland. Participants 1324 Caucasian men, born in 1919-1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires. Primary and secondary outcome measures Frailty assessed according to a modified phenotype definition at mean age 73.3 years. Results Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66-67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58-69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07-0.29, pPeer reviewe

Onsala Space Observatory – IVS Network Station Activities during 2017—2018

During 2017 and 2018 we participated in 88 legacy S/X sessions with the Onsala 20 m telescope. Additionally, we observed a number of VGOS test sessions with one or both of the Onsala twin telescopes

Effect of Exercise on Drug-Related Falls Among Persons with Alzheimer's Disease : A Secondary Analysis of the FINALEX Study

Introduction No study has investigated how exercise modifies the effect of fall-related drugs (FRDs) on falls among people with Alzheimer's disease (AD). Objective The aim of this study was to investigate how exercise intervention and FRDs interact with fall risk among patients with AD. Methods In the FINALEX trial, community-dwelling persons with AD received either home-based or group-based exercise twice weekly for 1 year (n = 129); the control group received normal care (n = 65). The number of falls was based on spouses' fall diaries. We examined the incidence rate ratios (IRRs) for falls among both non-users and users of various FRDs (antihypertensives, psychotropics, drugs with anticholinergic properties [DAPs]) in both control and combined intervention groups. Results Between the intervention and control groups, there was no difference in the number of falls among those without antihypertensives or psychotropics. In the intervention group taking antihypertensives, the IRR was 0.5 falls/person-year (95% confidence interval [CI] 0.4-0.6), while in the control group, the IRR was 1.5 falls/person-year (95% CI 1.2-1.8) [p <0.001 for group, p = 0.067 for medication, p <0.001 for interaction]. Among patients using psychotropics, the intervention group had an IRR of 0.7 falls/person-year (95% CI 0.6-0.9), while the control group had an IRR of 2.0 falls/person-year (95% CI 1.6-2.5) [p <0.001 for group, p = 0.071 for medication, p <0.001 for interaction]. There was a significant difference in falls between the intervention and control groups not using DAPs (0.6, 95% CI 0.5-0.7; 1.2, 95% CI 1.0-1.4), and between the intervention and control groups using DAPs (1.1, 95% CI 0.8-1.3; 1.5, 95% CI 1.0-2.1) [p <0.001 for group, p = 0.014 for medication, p = 0.97 for interaction]. Conclusion Exercise has the potential to decrease the risk for falls among people with AD using antihypertensives and psychotropics.Peer reviewe

How Do Community-Dwelling Persons with Alzheimer Disease Fall? Falls in the FINALEX Study

Peer reviewe

Bioactive glass granules versus standard autologous and allogeneic bone grafts: a randomized trial of 49 adult bone tumor patients with a 10-year follow-up

Background and purpose: As a synthetic bone void filler, bioactive glasses (BGs) may enhance angiogenesis and osteogenesis. In this randomized trial, we compared the clinical efficacy of BG granules and standard bone grafts in patients undergoing surgery for benign bone tumors.Patients and methods: 49 recruited patients were randomized to receive BG granules or undergo conventional bone grafting to fill defects following tumor removal. As the standard of care, small-sized defects were filled with autologous graft, and large-sized defects were filled with allogeneic graft. The primary endpoint was treatment success at 1 year, defined by no reoperation, no tumor recurrence, and no device-related adverse events. Secondary endpoints included patient-reported outcomes (Rand-36 and pain scores) and quantitative assessment of blood flow and metabolic activity by means of F-18-fluoride PET/CT imaging. As an off-trial group, 15 children and adolescents (age Results: At 1-year, 21 of 25 BG-treated patients (risk estimate 0.84, 95% confidence interval [CI] 0.70-0.98) and 20 of 24 patients in the standard of care group (0.83, CI 0.68-0.98) met the criteria for treatment success. The groups had similar Rand-36 scores. In patients with small defects, BG filling was associated with shorter operative time and less postoperative pain at 1 month. In patients with large defects, blood flow was similar, but BG-filled defects showed higher metabolic activity than allograft-filled defects at 1-year. The survey of the postoperative period >= 10 years revealed no BG-related adverse events.Interpretation: BG granules had similar overall rates of treatment success compared with autografts and allografts, but large-scale trials are needed for the confirmation of clinical equivalence. The extended metabolic activity confirms the expected cellular responses of osseointegrated BG granules.</p

Onsala Space Observatory – IVS Network Station Activities during 2015–2016

During 2015 and 2016 we participated in 98 IVS sessions. Additionally, we observed a small number of experimental sessions

Retirement age and type as predictors of frailty: a retrospective cohort study of older businessmen

Objectives To study the association between retirement characteristics and frailty in a homogenous population of former business executives.Design Cross-sectional cohort study using data from the Helsinki Businessmen Study.Setting Helsinki, Finland.Participants 1324 Caucasian men, born in 1919–1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires.Primary and secondary outcome measures Frailty assessed according to a modified phenotype definition at mean age 73.3 years.Results Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66–67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58–69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07–0.29, p&lt;0.05). Compared with men who transitioned into old age retirement, those who retired due to disability were at increased risk of prefrailty (adjusted OR 1.53, 95% CI 1.01 to 2.32) and frailty (adjusted OR 3.52, 95% CI 1.97 to 6.29), relative to non-frailty.Conclusion Exiting working life early and continuing to be occupationally active until age 70 years and older were both associated with increased risk of frailty among the men. Promotion of longer work careers could, however, promote healthier ageing, as the lowest prevalence of frailty was observed in former business executives who retired at ages 66–67 years

Severity of frailty and the outcome of exercise intervention among participants with Alzheimer disease : A sub-group analysis of a randomized controlled trial

Introduction: To investigate how frailty status affects the outcome of exercise intervention among home-dwelling participants with Alzheimer disease (AD). Methods: This is a sub-group analysis of a randomized controlled trial. In this trial, home-dwelling participants with AD received either home-based or group-based exercise twice a week for one year (n = 129); the control group received normal care (n = 65). Both the intervention and control group were subdivided into two groups according to modified Fried criteria: prefrail (0-1 criteria) and advanced frailty (2-5 criteria). The Functional Independence Measure (FIM) and number of falls per person-years served as outcome measures. Results: Whereas there was no significant difference in FIM between the prefrail intervention (PRI) and control (PRC) groups at 3 or 6 months, the PRI group deteriorated significantly slower at 12 months (-6.6 [95% CI -8.6 to -4.5] for PRI and -11.1 [95% CI -13.9 to -8.3] for PRC; P = 0.010). Similarly, there was no significant difference between the advanced frailty intervention (AFI) and control (AFC) groups at 3 months, but the difference became significant at 6 months (-8.1 [95% CI -11.1 to -5.2] for AFI and -15.5 [95% CI -20.0 to -11.1] for AFC; P = 0.007) and at 12 months (-8.9 [95% CI -11.9 to -5.9] for AFI and -15.3 [95% CI -20.2 to -10.3] for AFC; P = 0.031). There was also a significant difference in the number of falls in favor of PRI and AFI groups compared to their respective control groups. Conclusion: A long-term exercise intervention benefited people with AD regardless of their stage of frailty. Trial registration: : ACTRN12608000037303. (C) 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Peer reviewe

Retirement age and type as predictors of frailty: a retrospective cohort study of older businessmen

Abstract Objectives: To study the association between retirement characteristics and frailty in a homogenous population of former business executives. Design: Cross-sectional cohort study using data from the Helsinki Businessmen Study. Setting: Helsinki, Finland. Participants: 1324 Caucasian men, born in 1919–1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires. Primary and secondary outcome measures: Frailty assessed according to a modified phenotype definition at mean age 73.3 years. Results: Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66–67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58–69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07–0.29, p&lt;0.05). Compared with men who transitioned into old age retirement, those who retired due to disability were at increased risk of prefrailty (adjusted OR 1.53, 95% CI 1.01 to 2.32) and frailty (adjusted OR 3.52, 95% CI 1.97 to 6.29), relative to non-frailty. Conclusion: Exiting working life early and continuing to be occupationally active until age 70 years and older were both associated with increased risk of frailty among the men. Promotion of longer work careers could, however, promote healthier ageing, as the lowest prevalence of frailty was observed in former business executives who retired at ages 66–67 years