Tibial Fractures in Alpine Skiing and Snowboarding in Finland : A Retrospective Study on Fracture Types and Injury Mechanisms in 363 Patients

Background and Aim: Alpine skiing and snowboarding share the hazards of accidents accounting for tibial fractures. The aim of this study was to evaluate the fracture patterns and mechanisms of injury of tibial fractures taking place in downhill skiing and snowboarding. Materials and methods: All patients with tibial fracture due to alpine skiing or snowboarding accident treated in four trauma centers next to the largest ski resorts in Finland were analyzed between 2006 and 2012. The hospital records were retrospectively reviewed for data collection: equipment used (skis or snowboard), age, gender, and mechanism of injury. Fractures were classified according to AO-classification. Results: There were 342 skiing and 30 snowboarding related tibial fractures in 363 patients. Tibial shaft fracture was the most common fracture among skiers (n=215, 63%), followed by proximal tibial fractures (n=92, 27%). Snowboarders were most likely to suffer from proximal tibial fracture (13, 43%) or tibial shaft fracture (11, 37%). Snowboarders were also more likely than skiers to suffer complex AO type C fractures (23% vs 9%, p Conclusion: The most important finding was the relatively high number of the tibial plateau fractures among adult skiers. The fracture patterns between snowboarding and skiing were different; the most common fracture type in skiers was spiral tibial shaft fracture compared to proximal tibial fractures in snowboarders. Children had more simple fractures than adults.Peer reviewe

Cardiac manifestations in Finnish gelsolin amyloidosis patients

Introduction Finnish gelsolin amyloidosis (AGel amyloidosis) is an inherited systemic amyloidosis with well-known ophthalmological, neurological and cutaneous symptoms. Additionally, cardiomyopathies, conduction disorders and need of cardiac pacemakers occur in some patients. This study focuses on electrocardiographic (ECG) findings in AGel amyloidosis and their relation to cardiac magnetic resonance (CMR) changes. We also assessed whether ECG abnormalities were associated with pacemaker implantation and mortality. Materials and methods In this cohort study, 51 genetically verified AGel amyloidosis patients (mean age 66 years) without cardiac pacemakers underwent 12-lead ECG and CMR imaging with contrast agent in 2017. Patients were followed-up for 3 years. Results Conduction disturbances were found in 22 patients (43%). Nine (18%) presented with first-degree atrioventricular block, six (12%) with left anterior hemiblock, seven (14%) with left or right bundle branch block and two (4%) with non-specific intraventricular conduction delay. Low QRS voltage was present in two (4%) patients. Late gadolinium enhancement (LGE) concentrating on the interventricular septum and inferior parts of the heart was present in 19 (86%) patients with conduction abnormalities. During the follow-up, only one patient received a pacemaker, and one patient died. Discussion Conduction disorders and septal LGE are common in AGel amyloidosis, whereas other ECG and CMR findings typically observed in most common cardiac amyloidosis types were rare. Septal pathology seen in CMR may interfere with the cardiac conduction system in AGel amyloidosis, explaining conduction disorders, although pacemaker therapy is rarely required.Peer reviewe

Evaluation of business continuity plan maturity level using business continuity maturity model

Business Continuity Plan (BCP) plays an important part in ensuring the business continuity of an organization in the event of major disruptions. In order to ensure the continuity of their critical business functions and critical services during and after a disaster, healthcare organizations such as hospitals, clinics, hospices and others can implement BCP models in their respective organizations to ensure their business continuity during and after disruptive incidents. After implementing BCP models in their respective healthcare organizations how can they ensure the BCP models will be useful and effective when disasters strike. Therefore, maturity models can help to analyze the maturity level of the BCP model. The higher the level of maturity of the BCP models, the higher the probability of effectiveness and usefulness of the BCP models. The goal of this research is to determine how compliance the existing maturity models for business continuity towards ISO 22301 standard and to map existing BCP healthcare model with business continuity maturity model

Effects of live music therapy on heart rate variability and self-reported stress and anxiety among hospitalized pregnant women : A randomized controlled trial

Introduction: This study aims to evaluate the effects of live music therapy on heart rate variability (HRV) and self-reported stress and anxiety among hospitalized women with high-risk pregnancies. A total of 102 women at an antenatal ward due to pregnancy-related complications participated in a randomized controlled trial. Methods: The participants were randomly assigned to a music therapy group (N = 52) or control group (N = 50). The women in the music therapy group received live music therapy on three consecutive days, for half an hour at a time. The participants belonging to the control group were instructed to rest for equally long time periods. The physiologic stress of the participants was assessed using HRV measures. The participants also rated their perceived stress and anxiety. The physiologic stress of the participants was assessed using 12 HRV measures. Results: The SD2 measure of HRV increased significantly more in the music therapy group than in the control group during the therapy sessions. Moreover, the low frequency (LF) HRV measure decreased during the three-day therapy period. The self-reported stress was not significantly altered after the intervention. For women with high initial self-reported anxiety in both groups, their anxiety was significantly reduced during the three-day period.Peer reviewe