| 1. |
- Al-Ani, Amer N., et al.
(författare)
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Does Rehabilitation Matter in Patients With Femoral Neck Fracture and Cognitive Impairment? : A Prospective Study of 246 Patients
- 2010
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 91:1, s. 51-57
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify factors associated with preserved walking ability and Katz activities of daily living (ADLs) index at 4-month and 12-month follow-up in cognitively impaired patients with femoral neck fracture. Design: Population-based cohort study. Setting: A multicenter study of the Stockholm Hip Fracture Group including 4 university hospitals. Participants: Consecutive patients (N=246) with femoral neck fracture, older than 65 years (mean, 84y; 72% women) with cognitive impairment (known dementia or low [0-2 points] score) in Short Portable Mental Status Questionnaire [0-10 points]) and able to walk before the fracture. Interventions: Not applicable. Main Outcome Measure: Walking ability and ADLs index at 4-month and 12-month follow-up. Results: Significant predictors of preserved walking ability at 12-month follow-up were discharge to rehabilitation unit (odds ratio [OR]=2.83: confidence interval [CI], 1.1-7.26; P=.03) and walking ability before the fracture (OR=8.98; Cl, 3.52-22.93; P<.001), while type of surgery was not (P=.197). Analyses were adjusted for age, sex, American Society of Anesthesiologists score, fracture type, and surgical method. Corresponding predictors of preserved Katz ADLs index at 12-month follow-up, after adjustment for age and sex, were discharge to rehabilitation unit (OR=5.33; Cl, 1.44-19.65: P=.012) and ADLs index before fracture (OR=2.5; Cl. 1.8-3.5: P<.001), while type of surgery was not (P=.376). Conclusions: Discharge to rehabilitation unit, a factor we can influence, was associated with preserved walking ability and ADLs index in cognitively impaired patients with hip fracture.
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| 2. |
- Flodin, Lena, et al.
(författare)
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Additive effects of nutritional supplementation, together with bisphosphonates, on bone mineral density after hip fracture : a 12-month randomized controlled study
- 2014
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 9, s. 1043-1050
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Tidskriftsartikel (refereegranskat)abstract
- Background: After a hip fracture, a catabolic state develops, with increased bone loss during the first year. The aim of this study was to evaluate the effects of postoperative treatment with calcium, vitamin D, and bisphosphonates (alone or together) with nutritional supplementation on total hip and total body bone mineral density (BMD). Methods: Seventy-nine patients (56 women), with a mean age of 79 years (range, 61-96 years) and with a recent hip fracture, who were ambulatory before fracture and without severe cognitive impairment, were included. Patients were randomized to treatment with bisphosphonates (risedronate 35 mg weekly) for 12 months (B; n=28), treatment with bisphosphonates along with nutritional supplementation (40 g protein, 600 kcal daily) for the first 6 months (BN; n=26), or to controls (C; n=25). All participants received calcium (1,000 mg) and vitamin D3 (800 IU) daily. Total hip and total body BMD were assessed with dual-energy X-ray absorptiometry at baseline, 6, and 12 months. Marker of bone resorption C-terminal telopeptide of collagen I and 25-hydroxy vitamin D were analyzed in serum. Results: Analysis of complete cases (70/79 at 6 months and 67/79 at 12 months) showed an increase in total hip BMD of 0.7% in the BN group, whereas the B and C groups lost 1.1% and 2.4% of BMD, respectively, between baseline and 6 months (P=0.071, between groups). There was no change in total body BMD between baseline and 12 months in the BN group, whereas the B group and C group both lost BMD, with C losing more than B (P=0.009). Intention-to-treat analysis was in concordance with the complete cases analyses. Conclusion: Protein-and energy-rich supplementation in addition to calcium, vitamin D, and bisphosphonate therapy had additive effects on total body BMD and total hip BMD among elderly hip fracture patients.
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| 3. |
- Flodin, Lena, et al.
(författare)
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Effects of protein-rich nutritional supplementation and bisphosphonates on body composition, handgrip strength and health-related quality of life after hip fracture : a 12-month randomized controlled study
- 2015
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: The catabolic state that follows hip fracture contributes to loss of muscle mass and strength, that is sarcopenia, which impacts functional ability and health-related quality of life. Measures to prevent such long-term postoperative consequences are of important concern. The aim of this study was to evaluate the combined effects of protein-rich nutritional supplementation and bisphosphonate on body composition, handgrip strength and health-related quality of life following hip fracture. Methods: The study included 79 men and women with hip fracture, mean age 79 years (SD 9), without severe cognitive impairment, who were ambulatory and living independently before fracture. Patients were randomized postoperatively to receive liquid supplementation that provided 40 g of protein and 600 kcal daily for six months after the fracture, in addition to bisphosphonates once weekly for 12 months (group N, n = 26), or bisphosphonates alone once weekly for 12 months (group B, n = 28). All patients, including the controls (group C, n = 25) received calcium 1 g and vitamin D3 800 IU daily. Body composition as measured by dual-energy X-ray absorptiometry (DXA), handgrip strength (HGS) and health-related quality of life (HRQoL) were registered at baseline, six and 12 months postoperatively. Results: There were no differences among the groups regarding change in fat-free mass index (FFMI), HGS, or HRQoL during the study year. Intra-group analyses showed improvement of HGS between baseline and six months in the N group (P = 0.04). HRQoL decreased during the first year in the C and B groups (P = 0.03 and P = 0.01, respectively) but not in the nutritional supplementation N group (P = 0.22). Conclusions: Protein-rich nutritional supplementation was unable to preserve FFMI more effectively than vitamin D and calcium alone, or combined with bisphosphonate, in this relatively healthy group of hip fracture patients. However, trends toward positive effects on both HGS and HRQoL were observed following nutritional supplementation.
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| 4. |
- Flodin, Lena, et al.
(författare)
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Increased 1-year survival and discharge to independent living in overweight hip fracture patients
- 2016
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Ingår i: Acta Orthopaedica. - : Informa UK Limited. - 1745-3674 .- 1745-3682. ; 87:2, s. 146-151
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Hip fracture patients usually have low body mass index (BMI), and suffer further postoperative catabolism. How BMI relates to outcome in relatively healthy hip fracture patients is not well investigated. We investigated the association between BMI, survival, and independent living 1 year postoperatively.Patients and methods - This prospective multicenter study involved 843 patients with a hip fracture (mean age 82 (SD 7) years, 73% women), without severe cognitive impairment and living independently before admission. We investigated the relationship between BMI and both 1-year mortality and ability to return to independent living.Results - Patients with BMI > 26 had a lower mortality rate than those with BMI < 22 and those with BMI 22-26 (6%, 16%, and 18% respectively; p = 0.006). The odds ratio (OR) for 1-year survival in the group with BMI > 26 was 2.6 (95% CI: 1.2-5.5) after adjustment for age, sex, and physical status. Patients with BMI > 26 were also more likely to return to independent living after the hip fracture (OR = 2.6, 95% CI: 1.4-5.0). Patients with BMI < 22 had similar mortality and a similar likelihood of independent living to those with BMI 22-26.Interpretation - In this selected group of patients with hip fracture, the overweight and obese patients (BMI > 26) had a higher survival rate at 1 year, and returned to independent living to a higher degree than those of normal (healthy) weight. The obesity paradox and the recommendations for optimal BMI need further consideration in patients with hip fracture.
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| 5. |
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| 6. |
- Flodin, Lena
(författare)
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Studies on hip fracture patients : effects of nutrition and rehabilitation
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hip fracture in the elderly is a serious condition associated with increased mortality. Survivors experience an increase in morbidity and disability that affect their independence and quality of life; the outcome for patients with dementia is particularly poor. Many hip fracture patients have signs of malnutrition already on admission and this patient group has been shown to have a lower body mass index (BMI) than aged-matched controls. A catabolic state develops following hip fracture, characterized by loss of bone mineral density (BMD) and muscle mass. The combination of generalized loss of muscle mass, muscle strength and/or physical performance is known as sarcopenia, which impacts functionality and health- related quality of life. This thesis has three major aims: 1) to study the possible association between BMI, a potentially modifiable factor, and one-year mortality, as well as the ability to return to independent living following hip fracture; 2) to evaluate the effect of nutritional supplementation on bone mineral density (BMD), body composition, muscle strength and health-related quality of life (HRQoL) following hip fracture; and 3) to investigate factors of importance for preservation of ambulatory function and activities of daily living (ADL) following hip fracture in patients with cognitive impairment. Study I: A prospective study of 843 elderly patients with hip fracture, without severe cognitive impairment, who came from an independent living situation at the time of admission. The results show that overweight was associated with increased one-year survival and a greater likelihood of independent living one year post-fracture. Study II: A randomized controlled study in which 79 patients with hip fracture were randomized to one of three treatment groups. Six months of postoperative treatment with protein and energy-rich supplementation combined with orally administered bisphosphonate, calcium and vitamin D were shown to have a small additive effect on bone mineral density compared with bisphosphonate and calcium alone. Study III: A randomized controlled study of the same population as in study II. Postoperative treatment with protein and energy-rich supplementation did not prevent loss of lean mass following hip fracture. However, trends toward improved handgrip strength and HRQoL were observed following nutritional supplementation. Study IV: A prospective study of 246 patients with femoral neck fracture and cognitive impairment, but ambulant prior to fracture. In addition to ambulatory and ADL function prior to fracture, the results showed that discharge to rehabilitation facilities was associated with preserved ambulatory function and ADL skills at the 4-and 12 month follow-ups.
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| 7. |
- Flodin, Lena, 1955-
(författare)
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Uppdrag arkeologi
- 1999
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Ingår i: Kulturmiljövård. - Stockholm : Riksantikvarieämbetet. - 1100-4800. ; :1, s. 2-3
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Hur kan man utveckla och bättre sprida den kunskap som tas fram då ingrepp i fornlämningar görs inför nödvändiga om- och nybyggnationer i vårt samhälle? Just nu pågår projekt och försök för att effektivisera och öka uppdragsarkeologins resultat.
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| 8. |
- Flodin, Veronica
(författare)
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Epistemisk drift : Genbegreppets rörelser i några av forskningens och undervisningens texter i biologi
- 2011
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med denna uppsats är att utveckla förståelsen för relationen mellan den kunskap som tas fram i forskning i biologi och den kunskap som det sedan undervisas om, i kurser på universitetet. Arbetet i denna uppsats är begränsat till den del av forskning och undervisning som är inriktad mot användningen av vetenskapliga begrepp i texter, och vilka innebörder användningarna leder till. Arbetet baseras på två studier.I den första studien visas att i en enda, mycket använd lärobok i biologi, kan man finna (åtminstone) fem olika innebörder av hur genbegreppet används. Det som är intressant är att dessa olika innebörder kan knytas till framväxten av olika biologiska discipliner. Det kan tyckas självklart när man ser det som resultat, men faktum är att genbegreppet inte framskrivs som kontextberoende. Detta borde i sin tur leda till att förståelsen av genbegreppet försvåras, eftersom betydelsen varierar med sammanhanget och dessutom kan olika innebörder blandas i ett och samma sammanhang. De lärandeproblem som tidigare studier har visat på, kan bland annat ha sin grund i ett innehållsproblem. Det vill säga, innehållet i sig är vagt och otydligt.I den andra studien baseras analysen på en fallstudie av användningen av genbegreppet i fem vetenskapliga artiklar. Olika innebörder av genbegreppet återfinns på samma sätt som den tidigare studien gjort gällande för en lärobok i biologi. Men även nya kategorier beskrivs. I läroboken kunde de olika innebörderna knytas till olika subdiscipliner. I de vetenskapliga artiklarna knyts de nya kategorierna snarare till olika kunskapsprojekt. Genen och genbegreppet fyller olika funktioner i relation till forskningsproblemen, frågorna och metoderna. Man kan säga att olika aspekter av genen används i olika kunskapsprojekt. Men kategorierna används inte renodlat. Både de tidigare kategoriserade innebörderna och nya kategorier används. Blandningen föreslås bero på att kunskaper om gener inte försvinner, utan lever vidare och används sida vid sida med nyutvecklad kunskap, vilket leder till att genbegreppet är utsatt för en epistemisk drift.Transformationen av innehåll mellan forskningstexten och lärobokstexten, diskuteras sedan utifrån resultaten i studie ett och studie 2 i termer av rekontextualisering. När innehållet ”transformeras” till läroboken, finns variationerna av genbegreppet kvar, men inte det vetenskapliga sammanhanget i form av frågor och metoder. De olika sätten att veta om gener förekommer blandat i forskningstexterna, men forskarna föreslås kunna använda sin disciplinbaserade kunskap till att utläsa sambanden. Det kan betyda att det som framstår som luddigt, blandat och oklart för en utomstående, inte är det för en fackman som befinner sig i den aktuella praktiken.
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| 9. |
- Larsson, Anders, et al.
(författare)
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Patient selection has a strong impact on cystatin C and Modification of Diet in Renal Disease (MDRD) estimated glomerular filtration rate
- 2008
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Ingår i: Clinical Biochemistry. - : Elsevier BV. - 0009-9120 .- 1873-2933. ; 41:16-17, s. 1355-1361
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Estimation of the glomerular filtration rate (GFR) is essential for the evaluation of patients with kidney disease, and for correct dosage of drugs that are eliminated from the circulation by the kidneys. In most cases GFR is estimated based on serum creatinine and the Modification of Diet in Renal Disease (MDRD) formula. As both cystatin C and creatinine are used for the determination of GFR it is important to investigate if estimated GFR by the two methods differ in various patient groups. DESIGN AND METHODS: We have compared cystatin C and MDRD estimated GFR calculated from the same request from primary care units (n=488), a cardiology ward (n=826), the cardiointensive care unit (n=1026), two oncology wards (n=919 and 1021), and the neurosurgical intensive care unit (n=1515) in an observational cross-sectional study. RESULTS: We found better agreement between the two GFR estimates in samples from primary care patients and patients in the cardiology wards, than in samples from oncology wards or the neurosurgical intensive care unit. In the latter settings there was a pronounced difference between the two GFR estimates. CONCLUSION: The comparisons show that differences in patient selections have a strong impact on the agreement between cystatin C and MDRD estimated glomerular filtration rate.
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| 10. |
- Magnusson Staaf, Björn, et al.
(författare)
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Fasta och brutna förbindelser
- 2001
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Ingår i: Möten med forntiden. - 9172092068 ; , s. 57-59
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Bokkapitel (populärvet., debatt m.m.)
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| 11. |
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| 12. |
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