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- Aagaard, Per, 1957, et al.
(författare)
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Preparticipation Evaluation of Novice, Middle-Age Long-Distance Runners.
- 2013
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Ingår i: Medicine and science in sports and exercise. - 0195-9131 .- 1530-0315. ; 45:1, s. 130-137
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Tidskriftsartikel (refereegranskat)abstract
- Abstract PURPOSE: To assess the cardiovascular health and risk profile in middle-aged males making an entry to participate for their first time in a long-distance race. METHODS: Male first-time participants ≥45 years in the world's largest cross-country running race, the Lidingöloppet, were evaluated with a medical history and physical exam, European risk-SCORE, 12-lead ECG, echocardiography and blood tests. Further diagnostic work-up was performed when clinically indicated. RESULTS: Of 265 eligible runners, 153 (58%, age 51±5 y) completed the study. While the 10-year fatal cardiovascular event risk was low (SCORE: 1% (IQR: 0 - 1%)), mild abnormalities were common, e.g. elevated blood-pressure (19%), left ventricular hypertrophy (6%), elevated LDL cholesterol (5%). ECG changes compatible with "athlete's heart" were present in 82%, e.g. sinus bradycardia (61%) and/or early repolarization (32%). ECG changes considered training-unrelated were found in 24%, e.g. prolonged QTc: 13%; left axis deviation: 5.3%; left atrial enlargement: 4%). In 14 runners (9%) additional diagnostic work-up was clinically motivated, and 4 (2%) were ultimately discouraged from vigorous exercise due to QTc intervals >500 ms (n=2), symptomatic atrioventricular block (n=1), and a cardiac tumor (n=1). The physician exam and the ECG identified 12 of the 14 subjects requiring further evaluation. CONCLUSIONS: Cardiovascular evaluation of middle-aged men, including a physician exam and a 12-lead ECG, appears useful to identify individuals requiring further testing prior to vigorous exercise. The additional yield of routine echocardiography was small.
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- Aare, Sudhakar, et al.
(författare)
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Effects of corticosteroids in the development of limb muscle weakness in a porcine intensive care unit model
- 2013
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Ingår i: Physiological genomics. - : American Physiological Society. - 1531-2267 .- 1094-8341. ; 45:8, s. 312-320
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Tidskriftsartikel (refereegranskat)abstract
- Severe muscle wasting is a debilitating condition in critically ill intensive care unit (ICU) patients, characterized by general muscle weakness and dysfunction, resulting in a prolonged mobilization, delayed weaning from the ventilator, and a decreased quality of life post-ICU. The mechanisms underlying limb muscle weakness in ICU patients are complex and involve the impact of primary disease, but also factors common to critically ill ICU patients such as sepsis, mechanical ventilation (MV), immobilization, and systemic administration of corticosteroids (CS). These factors may have additive negative effects on skeletal muscle structure and function, but their respective role alone remain unknown. The primary aim of this study was to examine how CS administration potentiates ventilator and immobilization-related limb muscle dysfunction at the gene level. Comparing biceps femoris gene expression in pigs exposed to MV and CS for 5 days with only MV pigs for the same duration of time showed a distinct deregulation of 186 genes according to microarray. Surprisingly, the decreased force-generation capacity at the single muscle fiber reported in response to the addition of CS administration in mechanically ventilated and immobilized pigs was not associated with an additional upregulation of proteolytic pathways. On the other hand, an altered expression of genes regulating kinase activity, cell cycle, transcription, channel regulation, oxidative stress response, cytoskeletal, sarcomeric, and heat shock protein, as well as protein synthesis at the translational level, appears to play an additive deleterious role for the limb muscle weakness in immobilized ICU patients.
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- Aasheim, Vigdis
(författare)
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Becoming a mother at an advanced age : pregnancy, outcomes, psychological distress, experience of childbirth and satisfaction with life
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The objectives of this thesis were to investigate adverse pregnancy outcomes, and pregnancy and psychological experiences in women who become mothers in the later phase of the reproductive period. The age of first-time mothers has increased in most high-income countries in recent decades. Research into the postponement of childbirth phenomenon has predominantly focused on pregnancy and infant outcomes, and only to a lesser degree on psychological aspects of postponement. Study I is a population-based register study including 955 804 primiparous women from the Swedish and Norwegian Medical Birth Registers who gave birth between 1990-2010. It investigates the risk for preterm birth, infants small for gestation age, low Apgar score, stillbirth and neonatal death in women aged 30-34 years, 35-39 years and ≥40 years compared with women aged 25-29 years. Study I also compares risks associated with advanced maternal age with those associated with smoking and being overweight or obese. The adjusted Odds Ratios (aOR) of all outcomes increased with maternal age in a similar way in Sweden and Norway and the risk of fetal death already at age 30-35 years (Sweden OR 1.24; 95% CI 1.13-1.37, Norway aOR 1.26; 95% CI 1.12-1.41). The Swedish data showed that a maternal age of ≥30 years was associated with the same number of additional cases of fetal deaths as being overweight/obesity (251) and a larger number than smoking (67) compared with normal weight, nonsmokers aged 25-29 years, and estimated over the entire time period. Studies II-IV are longitudinal prospective population-based cohort studies based on data from the National Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Study II investigated psychological distress in 19 291nulliparous women from mid pregnancy to 18 months after the birth, comparing women of ≥32 years with those of 25-31 years. It was found that women in the oldest group had a slightly increased risk of psychological distress during pregnancy and the first 18 months of motherhood. Study III investigated 30 065 women’s experience of childbirth at six months postpartum in relation to antenatal expectations, using the same age categories as in Study II. The oldest women had a marginally higher risk of experiencing childbirth as worse than expected. Older women seemed to manage better than younger women when having an operative delivery. Study IV investigated 18 565 women’s satisfaction with life during pregnancy and the first three years of motherhood, comparing women of 32-37 years and ≥38 years respectively with the same reference groups as above. Women in the two oldest age groups reported a slightly lower degree of satisfaction with life, and the age effect was greatest three years after the birth. In conclusion, this thesis shows that the postponement of childbirth in high-income countries may increase the risk of adverse pregnancy outcomes at an earlier age than has previously been reported, and that it may have marginal negative effects on women’s emotional wellbeing and satisfaction with life. These findings should be included when giving reproductive health information to young people.
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- Abbott, Allan, et al.
(författare)
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CONTRAIS: CONservative TReatment for Adolescent Idiopathic Scoliosis : a randomised controlled trial protocol
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background:Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis.Methods/design:Patients: Previously untreated girls and boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth and a curve Cobb angle of 25–40 degrees will be included. A total of 135 participants will be randomly allocated in groups of 45 patients each to receive one of the three interventions.Interventions: All three groups will receive a physical activity prescription according to the World Health Organisation recommendations. One group will additionally wear a hyper-corrective night-time brace. One group will additionally perform postural scoliosis-specific exercises.Outcome: Participation in the study will last until the curve has progressed, or until cessation of skeletal growth. Outcome variables will be measured every 6 months. The primary outcome variable, failure of treatment, is defined as progression of the Cobb angle more than 6 degrees, compared to the primary x-ray, seen on two consecutive spinal standing x-rays taken with 6 months interval. Secondary outcome measures include the SRS-22r and EQ5D-Y quality of life questionnaires, the International Physical Activity Questionnaire (IPAQ) short form, and Cobb angle atend of the study.Discussion:This trial will evaluate which of the tested conservative treatment approaches that is the most effective for patients with adolescent idiopathic scoliosis.Trial registration: NCT01761305
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- Abdeldaim, Guma M. K., et al.
(författare)
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Quantitative fucK gene polymerase chain reaction on sputum and nasopharyngeal secretions to detect Haemophilus influenzae pneumonia
- 2013
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Ingår i: Diagnostic microbiology and infectious disease. - : Elsevier. - 0732-8893 .- 1879-0070. ; 76:2, s. 141-146
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Tidskriftsartikel (refereegranskat)abstract
- A quantitative polymerase chain reaction (PCR) for the fucK gene was developed for specific detection of Haemophilus influenzae. The method was tested on sputum and nasopharyngeal aspirate (NPA) from 78 patients with community-acquired pneumonia (CAP). With a reference standard of sputum culture and/or serology against the patient's own nasopharyngeal isolate, H. influenzae etiology was detected in 20 patients. Compared with the reference standard, fucK PCR (using the detection limit 10(5) DNA copies/mL) on sputum and NPA showed a sensitivity of 95.0% (19/20) in both cases, and specificities of 87.9% (51/58) and 89.5% (52/58), respectively. In a receiver operating characteristic curve analysis, sputum fucK PCR was found to be significantly superior to sputum P6 PCR for detection of H. influenzae CAP. NPA fucK PCR was positive in 3 of 54 adult controls without respiratory symptoms. In conclusion, quantitative fucK real-time PCR provides a sensitive and specific identification of H. influenzae in respiratory secretions.
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