Factors influencing health-related quality of life after total hip replacement - a comparison of data from the Swedish and Danish hip arthroplasty registers

Abstract Background There is an increasing focus on measuring patient-reported outcomes (PROs) as part of routine medical practice, particularly in fields such as joint replacement surgery where pain relief and improvement in health-related quality of life (HRQoL) are primary outcomes. Between-country comparisons of PROs may present difficulties due to cultural differences and differences in the provision of health care. However, in order to understand how these differences affect PROs, common predictors for poor and good outcomes need to be investigated. This cross-sectional study investigates factors influencing health-related quality of life (HRQoL) one year after total hip replacement (THR) surgery in Sweden and in Denmark. Methods Data was retrieved from the Swedish (n = 14 560 patients) and Danish (n = 632 patients) Hip Arthroplasty Registers according to preset selection criteria. Using linear regression models, we examined how sex, age, comorbidity and country of surgery were associated with different aspects of HRQoL as measured by the EQ-5D index and EQ VAS. Results Danish patients had an overall higher EQ-5D index and EQ VAS than Swedish patients (p &lt; 0.001). After regression analysis, the estimated coefficients for sex, age, or the Charlson score did not differ between countries for either the EQ-5D index (p = 0.83) or EQ VAS (p = 0.41) one year after THR. Conclusions We conclude that there are clear similarities in how basic predictors influence patient-reported outcomes (PROs) in patients with THR in Sweden and Denmark and these known predictors of good or poor HRQoL outcomes are not specific for each country. </jats:sec

Cortisol is related to acute leukocytosis in maximal but not in hypertrophic dynamic resistance exercise

Introduction. Exercise induces immune changes that are multifactorial and include neuroendocrine factors. Acute resistance exercise is followed by marked increases in adrenaline, cortisol, growth hormone, and other factors that have immunomodulatory effects. The purpose of the present study was to investigate the relationship between leukocytosis and hormone responses to two different resistance exercises, low volume high load (gains in maximal strength, MAX) and high volume medium load (gains in muscle mass, HYP). Methods. Using a cross-over design twelve healthy men participated in bilateral leg press exercise consisting of 5 sets of 10 RM and 15 sets of 1 RM. The inter-set rest period was 3 minutes for MAX and 2 minutes for HYP. Venous blood samples were taken at baseline, immediately after (P0) and 15 (P15) and 30 (P30) minutes after the exercise. Basic blood count was analyzed using Sysmex KX-21N (TOA Medical Electronics Co., Ltd., Kobe, Japan). Serum cortisol (COR), testosterone (TES), and growth hormone (GH) concentrations were analyzed by an immunometric chemiluminence method (Immunlite R 1000, DPC, Los Angeles, USA) Results. Both exercises induced significant acute leukocytosis (p\u3c0.001). Leukocytosis was significantly higher after HYP (p\u3c0.01). COR and TES increased significantly after HYP (p\u3c0.01) but not in MAX. GH increased significantly (p\u3c0.05) in both exercises and stayed elevated at P30 in HYP. There was a significant negative correlation between acute leukocytosis and cortisol at P0 in MAX (R=-0.622, p=0.031) but not in HYP r=0.287 (p=0.366). Significant correlations between TES, GH and leukocytes were not observed. Conclusions. Clearly, manipulation of the rest period and load in resistance exercise alters endocrinal as well as immunological responses. Hypertrophic resistance exercise triggered significantly stronger immunological as well as endocrinal responses. In line with the previous studies (e.g. Kraemer et al. 1996) cortisol did not correlate with leukocytes nor with leukocyte subgroups in HYP. It might be that cortisol acts as an anti-inflammatory agent in MAX, however in HYP leukocytosis appears to be related to additional physiological mechanisms e.g. muscle damage and metabolic demands, which might explain why we did not observe the same in HYP. When considering recovery from resistance exercise the immune system should be monitored in addition to hormones

Conditions favouring hard seededness as a dispersal and predator escape strategy

1. The water-impermeable seed coat of &lsquo;hard&rsquo; seeds is commonly considered a dormancy trait. Seed smell is, however, strongly correlated with seed water content, and hard seeds are therefore olfactionally cryptic to foraging rodents. This is the rationale for the crypsis hypothesis, which proposes that the primary functions of hard seeds are to reduce seed predation and promote rodent seed dispersal. 2. We use a mechanistic model to describe seed survival success of plants with different dimorphic soft and hard seed strategies. The model is based on established empirical&ndash;ecological relationships of moisture requirements for germination and benefits of seed dispersal, and on experimentally demonstrated relationships between seed volatile emission, predation and predator escape. 3. We find that water-impermeable seed coats can reduce seed predation under a wide range of natural humidity conditions. Plants with rodent dispersed seeds benefit from producing dimorphic soft and hard seeds at ratios where the anti-predator advantages of hard seeds are balanced by the dispersal benefits gained by producing some soft seeds. 4. The seed pathway predicted from the model is similar to those of experimental seed-tracking studies. This validates the relevance and realism of the ecological mechanisms and relationships incorporated in the model. 5. Synthesis. Rodent seed predators are often also important seed dispersers and have the potential to exert strong selective pressures on seeds to evolve methods of avoiding detection, and hard seeds seem to do just that. This work suggests that water-impermeable hard seeds may evolve in the absence of a dormancy function and that optimal seed survival in many environments with rodent seed predators is obtained by plants having a dimorphic soft and hard seed strategy

The crypsis hypothesis explained: a reply to Jayasuriya et al. (2015)

In imbibing seeds, resumption of metabolism leads to the unavoidable release of volatile by-products that are perceived as cues by rodent seed predators. The crypsis hypothesis proposes that the primary function of a water-impermeable, hard seed coat is to reduce rodent seed predation by rendering seeds olfactorily cryptic. In an opinion paper, Jayasuriya et al. (2015) find the crypsis hypothesis unscientific and ‘not consistent with Darwin's theory of evolution by natural selection’. It is unfortunate that Jayasuriya et al. (2015) did not appreciate that the crypsis hypothesis offers an alternative explanation for the evolution of water-impermeable seeds: released seed volatiles are cues used by rodents to locate seeds, and variation in seed-coat permeability leading to differences in seed volatile release represents the variable under selection. Furthermore, the sealing of water-impermeable seed coats imposes a cost of increased generation time and, therefore, dormancy-release mechanisms are expected to subsequently evolve in response to local environmental conditions. We also disagree with most other claims by Jayasuriya et al. (2015), who failed to appreciate how species with dimorphic seeds – one morph with permeable and the other with impermeable seed coats – benefit from rodent caching behaviour and population dynamics. We welcome this opportunity to clarify and elaborate on key features and the evolution of water-impermeable seed coats according to the crypsis hypothesis

Neuromuscular fatigue and recovery in elite female soccer : effects of active recovery

PURPOSE: To investigate the time course of recovery from neuromuscular fatigue and some biochemical changes between two female soccer matches separated by an active or passive recovery regime. METHODS: Countermovement jump (CMJ), sprint performance, maximal isokinetic knee flexion and extension, creatine kinase (CK), urea, uric acid, and perceived muscle soreness were measured in 17 elite female soccer players before, immediately after, 5, 21, 45, 51, and 69 h after a first match, and immediately after a second match. Eight players performed active recovery (submaximal cycling at 60% of HRpeak and low-intensity resistance training at &lt; 50% 1RM) 22 and 46 h after the first match. RESULTS: In response to the first match, a significant decrease in sprint performance (-3.0 +/- 0.5%), CMJ (-4.4 +/- 0.8%), peak torque in knee extension (-7.1 +/- 1.9%) and flexion (-9.4 +/- 1.8%), and an increase in CK (+ 152 +/- 28%), urea (15 +/- 2), uric acid (+ 11 +/- 2%), and muscle soreness occurred. Sprint ability was first to return to baseline (5 h) followed by urea and uric acid (21 h), isokinetic knee extension (27 h) and flexion (51 h), CK, and muscle soreness (69 h), whereas CMJ was still reduced at the beginning of the second match. There were no significant differences in the recovery pattern between the active and passive recovery groups. The magnitude of the neuromuscular and biochemical changes after the second match was similar to that observed after the first match. CONCLUSION: The present study reveals differences in the recovery pattern of the various neuromuscular and biochemical parameters in response to a female soccer match. The active recovery had no effects on the recovery pattern of the four neuromuscular and three biochemical parameters

Inflammation status of healthy young men : initial and specific responses to resistance training

Our primary aim was to study the effects of a 4-week preparatory resistance-training (RT) period followed by 12 weeks of 2 specific RT protocols (either hypertrophic-strength (HS) or strength-hypertrophy-power training) on inflammation markers and the possible relationship of the changes in abdominal fat and lean mass to the changes in inflammation status. A total of 82 healthy men were included in the study. Maximal concentric leg press strength (1-repetition maximum), total body lean mass, total body and abdominal fat mass, circulating high-sensitivity C-reactive protein, interleukin-6, interleukin-1 receptor antagonist (IL-1ra), monocyte chemoattractant protein 1 (MCP-1), and selected adipocytokines (resistin, adiponectin, and leptin) concentrations were measured before and after 4 (wk4) and 16 weeks (wk16) of RT. After the initial phase of RT, on wk4, abdominal and total fat mass as well as plasma leptin concentrations were significantly reduced (p < 0.05), whereas muscle mass, IL-1ra, resistin, and MCP-1 concentrations were significantly increased (p < 0.05). During specialized training phase, at wk16, only HS led to further reduction in abdominal and total fat mass, resistin, and leptin (p < 0.05), whereas both training modes led to lower MCP-1 concentrations (p < 0.05). Abdominal fat mass and circulating leptin were reduced already after 4 weeks of RT. Simultaneously, circulating MCP-1 and resistin concentrations increased, possibly as markers of muscle adaptation and regeneration. The present findings also suggest that RT with hypertrophic focus is beneficial for further reductions in abdominal fat mass and to decrease circulating inflammatory markers.peerReviewe

Antibody-secreting plasma cells persist for decades in human intestine

Plasma cells (PCs) produce antibodies that mediate immunity after infection or vaccination. In contrast to PCs in the bone marrow, PCs in the gut have been considered short lived. In this study, we studied PC dynamics in the human small intestine by cell-turnover analysis in organ transplants and by retrospective cell birth dating measuring carbon-14 in genomic DNA. We identified three distinct PC subsets: a CD19+ PC subset was dynamically exchanged, whereas of two CD19− PC subsets, CD45+ PCs exhibited little and CD45− PCs no replacement and had a median age of 11 and 22 yr, respectively. Accumulation of CD45− PCs during ageing and the presence of rotavirus-specific clones entirely within the CD19− PC subsets support selection and maintenance of protective PCs for life in human intestine