| 1. |
- Jobory, Ammar, et al.
(författare)
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Hip precautions not meaningful after hemiarthroplasty due to hip fracture. Cluster-randomized study of 394 patients operated with direct anterolateral approach.
- 2019
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Ingår i: Injury. - : Elsevier BV. - 1879-0267 .- 0020-1383. ; 50:7, s. 1318-1323
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to compare two treatment regimes, one with and one without postoperative precautions in hemiarthroplasty patients, in terms of dislocation rate and patient-reported outcome. Direct lateral approach was used.394 patients were included in a cluster-randomized study 2010-2014. Depending on which ward they were admitted to, they were allotted to free rehabilitation (non-precaution group, NPG, n = 226) or our conventional regime with precautions and mandatory assistive equipment (precaution group, PG, n = 168). Patients were followed during hospital stay, at 6 weeks (postal questionnaire), 3 month (visit) and 6 months (reading of medical records) by means of function tests, health-related quality of life (EQ-5D) and other patient-reported outcome measures (PROM).One patient in each group had dislocation(s). We found no statistically significant differences regarding in-hospital-mortality, severe adverse events, EQ5D index or other PROM. In the NPG, rehabilitation personnel had significantly shorter work effort during hospital stay (p < 0.001). 7 in the NPG and 13 of the PG had reoperations (p = 0.038), 4 and 8 had deep infections, 3 and 5 periprosthetic fractures.Rehabilitation precautions are not needed for preventing dislocation when direct lateral approach is used. Without precautions, rehabilitation personnel implement significantly shorter work effort during hospital. We found no statistically significant differences regarding PROM and complications except for somewhat more reoperations in total in the precaution group.
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| 2. |
- Rogmark, Cecilia, et al.
(författare)
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Post-discharge use of assistive devices following hemiarthroplasty : comparison of fracture patients with or without hip precautions
- 2019
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Ingår i: Disability and Rehabilitation: Assistive Technology. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 14:8, s. 792-797
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe which types of assistive devices prescribed and actually used, either due to precautions or due to true functional reasons, after hip fracture-related hemiarthroplasty. Materials and methods: About 394 patients cluster-randomized 2010–2014 at a university hospital. Control group with standard postoperative precautions to reduce dislocations, mandatory assistive devices and knee brace for 6 weeks (in cognitively impaired) compared to non-precaution group with assistive devices only if needed. Postal questionnaire at 6 weeks and 3 months. Results: Both prescription and usage of reacher were higher in the precaution group. About 55% of patients with precautions was instructed to use stocking aids, 21% continued to do so. Significantly fewer without precautions, 11%, used it at 3 months. Raised toilet seat was used by ∼40% of all pre-fracture and was prescribed to 79% with precautions. It was unchanged at 42% in non-precaution group. Nevertheless, 64% in non-precaution group used a raised toilet both at 6 weeks and 3 months. The usage persisted around 70% in precaution group. Usage of raised chair/bed were similar, even if non-precaution patients was not prescribed such. In the precaution group, 102 were prescribed a knee brace, only 5 used it at 6 weeks. Conclusions: The use of assistive devices did not follow what was prescribed from the hospital, regardless of precautions or not. The use of higher furniture was similar regardless of precautions or not. Other devices were more common in the precaution group. The compliance of knee bracing was low, and bracing should not be standard-of-care.Implications for rehabilitation Hemiarthroplasty is the most common treatment of displaced femoral neck fracture in elderly. Dislocation occur in 2 to 10% of these patients, and traditionally patients have been instructed to be careful when moving their leg and to use a number of assistive devices, in order to reduce the dislocation risk. The evidence base for such precautions is weak and occupational therapy and assistive devices may be costly. The current study shows that prescriptions and instructions from occupational therapists in hospital is more or less not follow after dismissal. Assistive devices should be prescribed based on the hip fracture patient’s true functional needs, and not routinely or due to arthroplasty precautions.
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| 3. |
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| 4. |
- Nilsson, Inger, et al.
(författare)
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Hemiarthroplasty for displaced femoral neck fracture: good clinical outcome but uneven distribution of occupational therapy.
- 2011
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 33, s. 2329-2332
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To assess rehabilitation, type of follow-up visits and outcome after bipolar hemiarthroplasty for femoral neck fracture. Method. Two hundred thirty-six consecutive patients with femoral neck fractures treated with hemiarthroplasty were followed for 30 months. Results. One hundred sixty-eight (71%) were women, 175 (74%) over 80 years old and 53 (22%) were demented. Of 150 patients with available 3-month data, 7 patients (5%) had not regained their walking ability. Seventy (47%) were pain-free and 112 (75%) were back in their original habitat. A hip-related complication leading to a contact with the orthopaedic department occurred in 20 of all patients (8%), and 7 (3%) of these underwent a revision surgery. One hundred eighty-seven patients (79%) received occupational therapy (OT). Demented patients received OT more seldom (p < 0.001), as did patients aged 90 and older (p = 0.049). Conclusion. Due to the low rate of orthopaedic complications, these patients are now referred to their general practitioners, without any further follow-up at the orthopaedic department. Rehabilitation efforts are unevenly distributed. The need of increased rehabilitation efforts for demented or 'old old' patients is discussed.
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| 5. |
- Nylén, Karin, 1961, et al.
(författare)
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Serum levels of S100B, S100A1B and S100BB are all related to outcome after severe traumatic brain injury.
- 2008
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Ingår i: Acta neurochirurgica. - : Springer Science and Business Media LLC. - 0942-0940 .- 0001-6268. ; 150:3, s. 221-7; discussion 227
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: S100B is an established marker of brain damage. Used in the context as a biochemical marker, S100B denotes a measurement of all S100 proteins, including at least one S100B monomer, i.e. the sum of the two dimers S100A1B and S100BB. Almost all published studies are based on this "sum concentration". However, the brain specificity of S100B has been questioned and increased serum levels have also been reported after trauma without head injury. Since the S100B monomer dominates in the brain, we hypothesised that the S100BB dimer should be better related to outcome after severe traumatic brain injury than S100A1B or the "sum concentration". METHODS: Daily serum samples were collected from 59 patients with severe traumatic brain injury. Three different ELISA methods were used for measurements of S100B, S100A1B and S100BB respectively. Outcome was assessed after one year and categorised according to the Glasgow Outcome Scale. RESULTS: Serum levels of S100B, S100A1B and S100BB followed the same temporal course, with early maximum and rapidly decreasing values over the first days after the trauma. Maximum serum concentrations of each of the parameters were increased in the patient group with an unfavourable outcome compared with those with a favourable outcome (p = 0.01, 0.006 and 0.004, respectively). CONCLUSION: Both S100A1B and S100BB were related to outcome after severe traumatic brain injury. Even though this study is small, it seems unlikely that separate analyses of the dimers are of any advantage compared with measuring S100B alone.
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| 6. |
- Arvidsson, Barbro, 1945-, et al.
(författare)
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A nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis : A qualitative study
- 2006
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Ingår i: Nursing and Health Sciences. - Richmond, Australia : Wiley-Blackwell. - 1441-0745 .- 1442-2018. ; 8:133-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe a nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic, inflammatory disease that attacks many joints, causing considerable functional restrictions for patients. Consequently, these patients are dependent on a wide variety of health-care services. A descriptive, qualitative design inspired by phenomenography was chosen. The conceptions were collected through interviews with 16 strategically selected patients with RA. Three descriptive categories comprising eight conceptions emerged: teaching (gaining insight and receiving information), regular review (receiving security, realizing regularity, and achieving accessibility), and attention (getting a holistic assessment, receiving coordinated care, and getting sufficient time). A nurse-led rheumatology clinic can be a source for empowering patients with RA to adopt new stances to alternative actions and achieve a higher level of faith in their own abilities.
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| 7. |
- Nylen, K, et al.
(författare)
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Increased serum-GFAP in patients with severe traumatic brain injury is related to outcome
- 2006
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Ingår i: J Neurol Sci. - : Elsevier BV. - 0022-510X. ; 240:1-2, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Several studies have established the relevance of S-100 in blood as a marker of brain damage after traumatic brain injury. However, a more specific marker is required and glial fibrillary acidic protein (GFAP) is considered to be a good candidate. METHODS: In order to assess the increase of GFAP in serum (s-GFAP) after a severe traumatic brain injury (TBI) we collected daily serum samples from 59 patients with severe TBI starting on the day of the trauma. S-GFAP was measured using a sandwich ELISA. The Glasgow outcome scale (GOS) assessed outcome after 1 year. RESULTS: All but one patient had maximal s-GFAP values above the laboratory reference value (median increased 10-fold). The highest detected levels were seen during the first days after TBI and then decreased gradually. Patients with unfavourable outcome had significantly (p<0.001) higher maximal s-GFAP values in the acute phase compared with patients with favourable outcome. All patients (n=5) with s-GFAP>15.04 microg /L died (reference level<0.15 microg/L). We found no significant difference in the maximal s-GFAP levels of patients with isolated brain injury in comparison with patients with multiple traumas. CONCLUSION: Serum-GFAP is increased during the first days after a severe traumatic brain injury and related to clinical outcome.
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| 8. |
- Nilsson, Inger
(författare)
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Krakel Spektakel, hör hur det låter! Studier i Lennart Hellsings språkvärld
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis deals with Lennart Hellsing's works, and especially his texts for small children, from 1945 to 2000. In an introductory survey the oral transmission of literature is discussed in relation to orality and literacy. The presupposition is that there are similarities between oral culture and texts for the very young. Hellsing's production is surveyed along with his position as a poet, his interests in other art forms, and his ideas on education. Attention is drawn to a fascination for carnival and festivity, and a strong affection for folklore and tradition found in his texts. His nursery rhymes, poems and songs are discussed from an auditive point of view: rhythm, rhyme, onomatopoeia, puns. The analysis also demonstrates how the poet has cooperated with musicians and how his texts have been interpreted by composers. The form of the poems and stories is found to be adapted to a situation of oral performance and auditive reception, and to mnemotechnical needs. The existence of a "double audience", a grown-up performer and a listening child, is of great importance, implemented with both sound repetitions for language training and many allusions for the adult to enjoy. As is the case in many orally transmitted texts there is often a "double scene", where what is being told in the story or poem coincides with the setting of the performance. The final chapter examines characters, settings and activities. It reveals that many features of Hellsing's fictive world can be regarded as closely related to what is found in traditional oral storytelling.
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| 9. |
- Unnerstad, Helle, et al.
(författare)
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Division of Listeria monocytogenes serovar 1/2a strains into two groups by PCR and restriction enzyme analysis
- 1999
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Ingår i: Applied and Environmental Microbiology. - Washington DC, USA : American Society for Microbiology. - 0099-2240 .- 1098-5336. ; 65:5, s. 2054-2056
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Tidskriftsartikel (refereegranskat)abstract
- Altogether, 100 strains of Listeria monocytogenes serovar 1/2a isolated from humans, animals, food, and the environment were typed by a combination of PCR and restriction enzyme analysis (REA). A PCR product of 2,916 bp, containing the downstream end of the gene inlA (955 bp), the space between inlA and inlB (85 bp), and 1,876 bp of the gene inlB, was cleaved with the enzyme AluI, and the fragments generated were separated by gel electrophoresis. By this method two different cleavage patterns were obtained. Seventy of the 100 strains shared one restriction profile, and the remaining 30 strains shared the second one. No relation was found between the types differentiated by PCR-REA and the origins of the strains.
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| 10. |
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