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1.	Lewerin, Catharina, 1961, et al. (författare) Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden. 2014 Ingår i: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 25:1, s. 131-140 Tidskriftsartikel (refereegranskat)abstract In a population-based study on cobalamin status and incident fractures in elderly men (n=790) with an average follow-up of 5.9years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C.
2.	Kahn, Robin, et al. (författare) Population-based study of multisystem inflammatory syndrome associated with COVID-19 found that 36% of children had persistent symptoms 2022 Ingår i: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253 .- 1651-2227. ; 111:2, s. 354-62 Tidskriftsartikel (refereegranskat)abstract Aim: Our aim was to describe the outcomes of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. Methods: This national, population-based, longitudinal, multicentre study used Swedish data that were prospectively collected between 1 December 2020 and 31 May 2021. All patients met the World Health Organization criteria for MIS-C. The outcomes 2 and 8weeks after diagnosis are presented, and follow-up protocols are suggested. Results: We identified 152 cases, and 133 (87%) participated. When followed up 2weeks after MIS-C was diagnosed, 43% of the 119 patients had abnormal results, including complete blood cell counts, platelet counts, albumin levels, electrocardiograms and echocardiograms. After 8weeks, 36% of 89 had an abnormal patient history, but clinical findings were uncommon. Echocardiogram results were abnormal in 5% of 67, and the most common complaint was fatigue. Older children and those who received intensive care were more likely to report symptoms and have abnormal cardiac results. Conclusion: More than a third (36%) of the patients had persistent symptoms 8weeks after MIS-C, and 5% had abnormal echocardiograms. Older age and higher levels of initial care appeared to be risk factors. Structured follow-up visits are important after MIS-C.
3.	Nilsson, Peter, et al. (författare) The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese. 2002 Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 252:1, s. 70-78 Tidskriftsartikel (refereegranskat)abstract Objective. To study effects on non-cancer mortality of observational weight loss in middle-aged men stratified for body mass index (BMI), taking a wide range of possible confounders into account. Design. Prospective, population based study. Setting. Male population of Malmö, Sweden. Participants. In all 5722 men were screened twice with a mean time interval of 6 years in Malmö, southern Sweden. They were classified according to BMI category at baseline (<21, 22-25, overweight: 26-30, and obesity: 30+ kg m-2) and weight change category until second screening (weight stable men defined as having a baseline BMI ± 0.1 kg m-2 year-1 at follow-up re-screening). Main outcome measures. Non-cancer mortality calculated from national registers during 16 years of follow-up after the second screening. Data from the first year of follow-up were excluded to avoid bias by mortality caused by subclinical disease at re-screening. Results. The relative risk (RR; 95% CI) for non-cancer mortality during follow-up was higher in men with decreasing BMI in all subgroups: RR 2.64 (1.46-4.71, baseline BMI <21 kg m-2), 1.39 (0.98-1.95, baseline BMI 22-25 kg m-2), and 1.71 (1.18-2.47, baseline BMI 26+ kg m-2), using BMI-stable men as reference group. Correspondingly, the non-cancer mortality was also higher in men with increasing BMI, but only in the obese group (baseline BMI 26+ kg m-2) with RR 1.86 (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m-2) men with decreased BMI had an increased non-cancer mortality compared with BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for nonsmoking overweight men who increased their BMI compared with BMI-stable men was also significant (P=0.006), but not in corresponding obese men (P=0.094). Conclusions. Weight loss in self-reported healthy but overweight middle-aged men, without serious disease, is associated with an increased non-cancer mortality, which seems even more pronounced in obese, nonsmoking men, as compared with corresponding but weight-stable men. The explanation for these observational findings is still enigmatic but could hypothetically be because of premature ageing effects causing so-called weight loss of involution.
4.	Abtahi, Jahan, et al. (författare) Bisphosphonate coating might improve fixation of dental implants in the maxilla: A pilot study 2010 Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier Science B.V., Amsterdam. - 0901-5027 .- 1399-0020. ; 39:7, s. 673-677 Tidskriftsartikel (refereegranskat)abstract This pilot study evaluates the clinical stability of bisphosphonate-coated dental implants placed using a two-stage surgical procedure in five patients. Each patient received seven regular Brånemark implants, one of which was coated with bisphosphonate in a fibrinogen matrix. The coated implant was inserted where the bone was expected to have the least favourable quality. The level of the marginal bone around each implant was measured by intraoral periapical radiographs and implant stability was recorded using resonance frequency measurements. Frequency values (ISQ) were obtained peroperatively before flap closure and after 6 months at abutment connection. At abutment connection the bisphosphonate-coated implants were removed en bloc in two patients for histological examination. An animal experiment had previously confirmed that gamma-sterilization did not reduce bioactivity of the bisphosphonate coating. In each patient, the bisphosphonate-coated implant showed the largest improvement in ISQ level of all implants. Their values at the start tended to be lower, and the absolute value at 6 months did not differ. No complications occurred with the coated implants. Histology showed no abnormalities. Improvement in ISQ values was an expected effect of the bisphosphonate coating, but could be due to the choice of insertion site. This finding warrants a randomized, blinded study.
5.	Anderberg, Leif, et al. (författare) Pisksnärtsskada ingen indikation för kraniocervikal fusion 2004 Ingår i: Läkartidningen. - 0023-7205. ; 101:9, s. 7-806 Tidskriftsartikel (refereegranskat)
6.	Klaff, Rami, 1971- (författare) Disease-Specific Survival in Prostate Cancer Patients : Results from the Scandinavian Prostate Cancer Group (SPCG) Trial No. 5 and Regional Cancer Register Data 2016 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract IntroductionProstate cancer (PCa) is the most common cancer among men in Sweden. The clinical course varies considerably, which makes it difficult to predict the prognosis in the individual case. In order to explore the early as well as the late course of the disease, large study groups and population-based cohorts are necessary.AimsTo explore factors that influence the long-term outcome of men with low-risk tumours in a population-based register, to predict the long-term course, and to assess the mortality rate for men with prostate cancer (Paper I)To analyse long-term outcome and to investigate factors associated with long-term survival in patients with metastases to the skeleton (Paper II)To analyse early androgen deprivation treatment (ADT) failure and to define clinical predictors associated with short survival due to early ADT failure in prostate cancer patients with bone metastases (Paper III)To analyse the prognostic significance of the extent of bone metastases in relation to other pretreatment variables in prostate cancer patients, and to explore the impact of bone metastases on quality-of-life (Paper IV)Material and methodsThe study groups were assembled from The South East Region Prostate Cancer Register (SERPCR), and The Scandinavian Prostate Cancer Group (SPCG) Trial No. 5. In the first study, prognostic factors and long-term disease-specific mortality rates of low-risk prostate cancer patients from the early PSA era were analysed. In the second study, patient-related factors, quality-of-life (QoL) and long-term survival in 915 PCa patients with bone metastases (M1b) under ADT, were analysed. In Study III factors predicting primary failure to respond to ADT were identified. Study IV explored the impact of the extent of bone metastases on survival and QoL for these men.Result and conclusionsThe long-term disease-specific mortality of low-risk localised PCa is low, but the annual mortality rate gradually increases. This indicates that some tumours slowly develop into lethal cancer, particularly in men 70 years or older and with a PSA level ≥ 4 μg/L. From the SPCG Trial No. 5, a subgroup of patients with M1b disease and favourable set of predictive factors survived more than 10 years under ADT with an acceptable QoL. Independent predictors of long-term survival were identified as performance status (PS) < 2, limited extent of bone metastases, and a PSA level < 231 μg/L at the time of enrolment in the trial. However, four independent clinical predictors of early ADT failure could be defined. Men exhibiting these features should be considered for an alternative treatment. Patient grouping based on three categories of extent of bone metastases related to PS, haemoglobin, and QoL at presentation, as independent predictors of mortality, may provide improved accuracy of prognosis.
7.	Li, Peishun, 1988, et al. (författare) Metabolic Alterations in Older Women With Low Bone Mineral Density Supplemented With Lactobacillus reuteri 2021 Ingår i: JBMR Plus. - : Wiley. - 2473-4039. ; 5:4 Tidskriftsartikel (refereegranskat)abstract JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. Osteoporosis and its associated fractures are highly prevalent in older women. Recent studies have shown that gut microbiota play important roles in regulating bone metabolism. A previous randomized controlled trial (RCT) found that supplementation with Lactobacillus reuteri ATCC PTA 6475 (L.reuteri) led to substantially reduced bone loss in older women with low BMD. However, the total metabolic effects of L. reuteri supplementation on older women are still not clear. In this study, a post hoc analysis (not predefined) of serum metabolomic profiles of older women from the previous RCT was performed to investigate the metabolic dynamics over 1 year and to evaluate the effects of L. reuteri supplementation on human metabolism. Distinct segregation of the L. reuteri and placebo groups in response to the treatment was revealed by partial least squares-discriminant analysis. Although no individual metabolite was differentially and significantly associated with treatment after correction for multiple testing, 97 metabolites responded differentially at any one time point between L. reuteri and placebo groups (variable importance in projection score >1 and p value <0.05). These metabolites were involved in multiple processes, including amino acid, peptide, and lipid metabolism. Butyrylcarnitine was particularly increased at all investigated time points in the L. reuteri group compared with placebo, indicating that the effects of L. reuteri on bone loss are mediated through butyrate signaling. Furthermore, the metabolomic profiles in a case (low BMD) and control population (high BMD) of elderly women were analyzed to confirm the associations between BMD and the identified metabolites regulated by L. reuteri supplementation. The amino acids, especially branched-chain amino acids, showed association with L. reuteri treatment and with low BMD in older women, and may serve as potential therapeutic targets. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
8.	Lundberg, Peter, et al. (författare) Kvantifiering av leversteatos: diagnostisk utvärdering av protonmagnetresonansspektroskopi jämfört med histologiska metoder 2016 Konferensbidrag (refereegranskat)abstract BakgrundLeversteatos är den vanligaste manifestationen av leversjukdom i västvärlden. Leverbiopsi med semikvantitativ histologisk gradering är referensmetod vid gradering av leversteatos. Med protonmagnetsresonansspektroskopi (1H-MRS), en metod som föreslagits ersätta leverbiopsi för värdering av steatos, kan leverns innehåll av triglycerider mätas icke-invasivt. Triglyceridinnehåll >5,00 % används ofta som ett diagnostiskt kriterium för leversteatos vid undersökning med 1H-MRS. Syftet med studien var att jämföra 1H-MRS med semikvantitativ histologisk steatosgradering och kvantitativ histologisk steatosmätning.MetodPatienter remitterade för utredning av förhöjda leverenzymer in-kluderades i studien. Samtliga patienter genomgick klinisk undersökning, laboratorieprovtagning samt 1H-MRS direkt följd av leverbiopsi. För konventionell histologisk semikvantitativ gradering av steatos användes kriterierna utarbetade av Brunt och medarbetare. Kvantitativ mätning av fett i biopsierna utfördes genom att med hjälp av stereologisk punkträkning (SPC) mäta andelen av ytan som innehöll fettvakuoler.ResultatI studien inkluderades 94 patienter, varav 37 hade icke-alkoholor-sakad fettleversjukdom (NAFLD), 49 hade andra leversjukdomar och 8 hade normal leverbiopsi. En stark korrelation noterades mel-lan 1H-MRS och SPC (r=0,92, p<0,0001; к=0.82). Korrelationen mellan 1H-MRS och Brunts kriterier (к=0.26) samt mellan SPC och Brunts kriterier (к=0.38) var betydligt sämre. När patologens gradering (Brunts kriterier) användes som referensmetod för diag-nos av leversteatos så hade alla patienter med triglyceridinnehåll >5,00 % mätt med 1H-MRS steatos (specificitet 100 %). Emellertid hade 22 av 69 patienter med triglyceridinnehåll ≤5,00 % också le-versteatos enligt Brunts kriterier (sensitivitet 53 %). Motsvarande siffror när man använde gränsvärdet 3,02 % var sensitivitet 79 % och specificitet 100 %. Vid ytterligare reduktion av gränsvärdet för triglyceridinnehåll till 2,00 % ökade sensitiviteten till 87 % med upprätthållande av hög specificitet (94 %).Slutsats1H-MRS och SPC uppvisade en mycket hög korrelation vid kvantifiering av leversteatos. SPC borde därför föredras framför Brunts kriterier när noggrann histologisk kvantifiering av leversteatos är önskvärd. Många patienter kan ha histologisk leversteatos trots triglyceridinnehåll ≤5,00 % mätt med 1H-MRS. Gränsvärdet för diagnostisering av leversteatos med 1H-MRS bör därför reduceras.
9.	Naeser, Ylva, et al. (författare) Survival in patients diagnosed with melanoma in situ compared to the general population. A Swedish population-based matched cohort study 2023 Ingår i: eClinicalMedicine. - : Elsevier. - 2589-5370. ; 65 Tidskriftsartikel (refereegranskat)abstract Background: The incidence of melanoma in situ (MIS) is increasing even more rapidly than the incidence of cutaneous malignant melanoma (CMM). No previous studies have in detail investigated the survival in individuals diagnosed with MIS compared to the general population.Methods: This population-based study included individuals with MIS diagnosed in Sweden between 2001 and 2010 and randomly selected MIS-free comparators matched on age, sex and county of residence. Exclusion criterion was a previous CMM. Data on socioeconomic status (SES) including educational level, income and marital status, comorbidity and cause of death were obtained from population-based registers. Overall survival (OS) was estimated by the Kaplan-Meier method. The mortality risk adjusted for SES and comorbidity was assessed by multivariable Cox regression analyses.Findings: The survival analyses included 7963 cases and 39,662 comparators. Median age at MIS diagnosis were 63 (IQR 50-75) and 67 (IQR 57-76) years in women and men respectively. Median follow-up time was 120 months (IQR 102-152 months). In individuals with MIS, the ten-year OS was 77% (95% CI 0.76-0.78) compared to 72% (95% CI 0.72-0.73) in comparators. The MIS patients had a higher SES and lower comorbidity burden than the comparators. In a fully adjusted multivariable analysis, including 7772 cases and 38,103 comparators, the mortality was significantly lower in women with MIS (HR 0.88, 95% CI 0.82-0.94) compared to the background population. The corresponding estimate in men was HR 0.94 (95% CI 0.88-1.0). The risk of melanoma-related deaths during the study period was ten-fold higher in MIS patients.Interpretation: Despite being at increased risk of developing CMM, MIS patients had a better OS compared to their matched comparators from the background population, findings which could not fully be explained by differences in SES and comorbidity. Our results are reassuring and should be communicated to patients who have been diagnosed with MIS.
10.	Lindgren, Stefan, et al. (författare) Integrerad klinisk examination vid medicinska fakulteten i Lund. Stimulerar till djupinlärning 1999 Ingår i: Läkartidningen. - 0023-7205. ; 96:36, s. 3775-3782 Tidskriftsartikel (refereegranskat)
11.	Khassebaf, Jasmine, et al. (författare) Antibiotic susceptibility of Propionibacterium acnes isolated from orthopaedic implant-associated infections 2015 Ingår i: Anaerobe. - : Elsevier. - 1075-9964 .- 1095-8274. ; 32, s. 57-62 Tidskriftsartikel (refereegranskat)abstract Introduction: Prosthetic joint infections (PJIs) caused by Propionibacterium acnes account for a larger proportion of the total number of PJIs than previously assumed and thus knowledge of the antimicrobial susceptibility patterns of P. acnes is of great value in everyday clinical practice.Materials and methods: Using Etest, the present study investigated the susceptibility of 55 clinical isolates of P. acnes, obtained from orthopaedic implant-associated infections of the knee joint (n = 5), hip joint (n = 17), and shoulder joint (n = 33), to eight antimicrobial agents: benzylpenicillin, clindamycin, metronidazole, fusidic acid, doxycycline, moxifloxacin, linezolid and rifampicin. Synergy testing was also conducted, in which rifampicin was combined with each of the remaining seven antibiotics.Results: All isolates (n = 55) were susceptible to most of the antibiotics tested, with the exception of 100% resistance to metronidazole, five (9.1%) isolates displaying decreased susceptibility to clindamycin, and one (1.8%) to moxifloxacin. None of the antimicrobial agents investigated were synergistic with each other when combined and nine isolates were antagonistic for various antimicrobial combinations. The majority of the antimicrobial combinations had an indifferent effect on the isolates of P. acnes. However, the combination of rifampicin and benzylpenicillin showed an additive effect on nearly half of the isolates.Conclusion: Almost all P. acnes, isolated from orthopaedic implant-associated infections, predominantly PJIs, were susceptible to the antibiotics tested, with the exception of complete resistance to metronidazole. Synergy test could not demonstrate any synergistic effect but additive effects were found when combining various antibiotics. Antagonistic effects were rare.
12.	Carrwik, Christian, 1977-, et al. (författare) Survival after surgery for spinal metastatic disease: a nationwide multiregistry cohort study. 2021 Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11 Tidskriftsartikel (refereegranskat)abstract To evaluate survival after surgery and indications for surgery due to spinal metastatic disease.A retrospective longitudinal multiregistry nationwide cohort study.19 public hospitals in Sweden with spine surgery service, where 6 university hospitals account for over 90% of the cases.1820 patients 18 years or older undergoing surgery due to spinal metastatic disease 2006-2018 and registered in Swespine, the Swedish national spine surgery registry.Decompressive and/or stabilising spine surgery due to spinal metastatic disease.Survival (median and mean) after surgery.Indications for surgery, types of surgery and causes of death.The median estimated survival after surgery was 6.2 months (95% CI: 5.6 to 6.8) and the mean estimated survival time was 12.2 months (95% CI: 11.4 to 13.1). Neurologic deficit was the most common indication for surgery and posterior stabilisation was performed in 70.5% of the cases. A neoplasm was stated as the main cause of death for 97% of the patients.Both median and mean survival times were well above the generally accepted thresholds for surgical treatment for spinal metastases, suggesting that patient selection for surgical treatment on a national level is adequate. Further research on quality of life after surgery and prognostication is needed.
13.	Kjeldgård, Linnea, 1985-, et al. (författare) Sickness absence and disability pension among injured working-aged pedestrians - a population-based Swedish register study 2021 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1 Tidskriftsartikel (refereegranskat)abstract Background: The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods: A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results: In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36). Conclusions: In this explorative nationwide study of the working-aged pedestrians injured in traffic-related accidents including falls, one fifth started a new SA spell >14 days. Fractures, internal injuries, collisions with motor vehicle, and falls related to snow and ice had the strongest associations with new SA.
14.	Westbom, Lena, et al. (författare) Nya behandlingsmetoder vid spasticitet och dystoni hos barn med cerebral pares kräver multidisciplinärt samarbete. 2003 Ingår i: Läkartidningen. - 0023-7205. ; 100:3, s. 30-125 Tidskriftsartikel (refereegranskat)
15.	Hommel, Ami, et al. (författare) Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year 2008 Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 39:10, s. 1164-1174 Tidskriftsartikel (refereegranskat)abstract Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
16.	Nordström, Anna, 1973-, et al. (författare) Interleukin-6 promoter polymorphism is associated with bone quality assessed by calcaneus ultrasound and previous fractures in a cohort of 75-year-old women. 2004 Ingår i: Osteoporosis international. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 15:10, s. 820-6 Tidskriftsartikel (refereegranskat)abstract Interleukin 6 (IL-6) is a multifunctional cytokine and a potent stimulator of bone resorption and has been implicated in the pathogenesis of osteoporosis in postmenopausal women. The aim of this study was to investigate if a functional IL-6 promoter polymorphism (-174) was related to bone mass and fractures in a cohort consisting of 964 postmenopausal Caucasian women aged 75 years. Bone mineral density (BMD; g/cm2) of the femoral neck, lumbar spine and total body was measured using dual energy X-ray absorptiometry (DXA). Quantitative ultrasound (QUS) was also measured in the calcaneus and quantified as speed of sound (SOS; m/s), broadband ultrasound attenuation (BUA; dB/MHz), and stiffness index (SI). IL-6 genotypes was determined by restriction fragment length polymorphism (RFLP) using the restriction enzyme NlaIII. The frequencies of the different IL-6 genotypes were 27.5% (GG), 47.9% (GC), 24.6% (CC). The IL-6 polymorphism (presence of G) was independently related to a lower stiffness (beta=-0.07; P=0.03) and BUA (beta=-0.08; P=0.02), but not to BMD at any site measured by DXA. In the cohort, 420 subjects (44%) reported at least one fracture during their lifetime, and 349 (36%) reported at least one fracture after the age of 50. Using binary logistic regression, the IL-6 polymorphism (presence of G) was significantly related to an increased risk of a previous fracture during life (odds ratio 1.46, 95% CI 1.08-1.97) and to an increased risk of a fracture occurring after 50 years of age (odds ratio 1.37, 95% CI 1.004-1.88). The risk was further increased for fractures grouped as osteoporotic fractures (odds ratio 1.67, 95% CI 1.14-2.45), including forearm fractures (odds ratio 1.59, 95% CI 1.05-2.40). In conclusion, presence of G allele in the IL-6 promoter polymorphism at position -174 is independently related to previous fractures in postmenopausal women. This association may be related primarily to an altered bone quality identified by QUS and not a lower bone mass. This is also the first demonstration of association of IL-6 gene polymorphism to calcaneal QUS.
17.	Rosengren, Björn, et al. (författare) Inferior physical performance test results of 10,998 men in the MrOS Study is associated with high fracture risk. 2012 Ingår i: Age and ageing. - : Oxford University Press (OUP). - 1468-2834 .- 0002-0729. ; 41:3, s. 339-44 Tidskriftsartikel (refereegranskat)abstract Background: most fractures are preceded by falls. Objective: the aim of this study was to determine whether tests of physical performance are associated with fractures. Subjects: a total of 10,998 men aged 65 years or above were recruited. Methods: questionnaires evaluated falls sustained 12 months before administration of the grip strength test, the timed stand test, the six-metre walk test and the twenty-centimetre narrow walk test. Means with 95% confidence interval (95% CI) are reported. P < 0.05 is a statistically significant difference. Results: fallers with a fracture performed worse than non-fallers on all tests (all P < 0.001). Fallers with a fracture performed worse than fallers with no fractures both on the right-hand-grip strength test and on the six-metre walk test (P < 0.001). A score below –2 standard deviations in the right-hand-grip strength test was associated with an odds ratio of 3.9 (95% CI: 2.1–7.4) for having had a fall with a fracture compared with having had no fall and with an odds ratio of 2.6 (95% CI: 1.3–5.2) for having had a fall with a fracture compared with having had a fall with no fracture. Conclusion: the right-hand-grip strength test and the six-metre walk test performed by old men help discriminate fallers with a fracture from both fallers with no fracture and non-fallers.
18.	Sarwar, Nadeem, et al. (författare) Interleukin-6 receptor pathways in coronary heart disease : a collaborative meta-analysis of 82 studies 2012 Ingår i: The Lancet. - New York, NY, USA : Elsevier. - 0140-6736 .- 1474-547X. ; 379:9822, s. 1205-1213 Tidskriftsartikel (refereegranskat)abstract Background: Persistent inflammation has been proposed to contribute to various stages in the pathogenesis of cardiovascular disease. Interleukin-6 receptor (IL6R) signalling propagates downstream inflammation cascades. To assess whether this pathway is causally relevant to coronary heart disease, we studied a functional genetic variant known to affect IL6R signalling. Methods: In a collaborative meta-analysis, we studied Asp358Ala (rs2228145) in IL6R in relation to a panel of conventional risk factors and inflammation biomarkers in 125 222 participants. We also compared the frequency of Asp358Ala in 51 441 patients with coronary heart disease and in 136 226 controls. To gain insight into possible mechanisms, we assessed Asp358Ala in relation to localised gene expression and to postlipopolysaccharide stimulation of interleukin 6. Findings: The minor allele frequency of Asp358Ala was 39%. Asp358Ala was not associated with lipid concentrations, blood pressure, adiposity, dysglycaemia, or smoking (p value for association per minor allele >= 0.04 for each). By contrast, for every copy of 358Ala inherited, mean concentration of IL6R increased by 34.3% (95% CI 30.4-38.2) and of interleukin 6 by 14.6% (10.7-18.4), and mean concentration of C-reactive protein was reduced by 7.5% (5.9-9.1) and of fibrinogen by 1.0% (0.7-1.3). For every copy of 358Ala inherited, risk of coronary heart disease was reduced by 3.4% (1.8-5.0). Asp358Ala was not related to IL6R mRNA levels or interleukin-6 production in monocytes. Interpretation: Large-scale human genetic and biomarker data are consistent with a causal association between IL6R-related pathways and coronary heart disease.
19.	Brandt, Lennart, et al. (författare) Myelography in the late postoperative period in patients subjected to anterior cervical decompression and fusion 1993 Ingår i: Acta Neurochirurgica. - 0001-6268. ; 122:1-2, s. 97-101 Tidskriftsartikel (refereegranskat)abstract During a 13 year period, 286 patients with cervical disc herniation and/or spondylotic spurs, were subjected to anterior decompression and vertebral interbody fusion with autologous bone. Twenty patients were re-admitted in the late postoperative period due to recurrent radicular symptoms and/or signs of myelopathy. In these patients myelography was performed again. In 14 patients spinal cord compression and/or nerve root involvement at a new level was visualized. At the operated level, however, the myelograms demonstrated a smooth anterior wall in the spinal canal. The series confirms the safety, effectiveness and reliability of the Cloward procedure in achieving long term spinal cord and nerve root decompression, and a solid vertebral interbody fusion.
20.	Granath, Aina, et al. (författare) Lactose intolerance and long-standing pelvic pain after pregnancy: a case control study 2007 Ingår i: Acta Obstetricia et Gynecologica.. - : Wiley. - 0001-6349 .- 1600-0412. ; 86, s. 1273-1276 Tidskriftsartikel (refereegranskat)abstract Background. Long-standing pelvic pain during pregnancy and after delivery (PPP) is common. Its causes are not fully understood. A scientifically, undocumented, clinical observation is PPP patients often reporting unspecific abdominal pain and adverse reactions to milk. The main objective in this pilot study was to investigate if lactose intolerance, celiac disease or allergic propensity are risk factors for developing pelvic pain after delivery. Methods. A matched, case control study, where consecutive patients consulting a registered physiotherapist specialised in treating women with postpartum pelvic pain were compared to matched controls. Results. Lactose intolerance was found in 10 of 15 patients, and in 3 of 15 matched, healthy controls (p=0.05). No difference was seen between groups in the prevalence of celiac disease or allergic propensity. Conclusion. This study suggests that lactose intolerance might be a possible risk factor for pelvic pain after delivery.
21.	Hedbrant, Johan, 1959-, et al. (författare) Ny mätmetod för käkmuskulaturen kan finna orsaken till tinnitus : Slutrapport Nutek 92-11904 1997 Rapport (övrigt vetenskapligt/konstnärligt)abstract Tinnitus är en åkomma som i lindrigare eller allvarligare former drabbar 17% av västvärldens befolkning. Ca 85 000 svenskar har tinnitus på invalidiserande nivå. Förutom mänskligt lidande orsakar tinnitus samhällskostnader på ca 1.5 miljard kr årligen. Orsaken är till största delen okänd.Vissa tecken tyder på ett samband mellan tinnitus och funktionsstörning i en käkmuskel. Några olika icke–invasiva metoder för mätning av muskelstörning i M Pterygoideus Lateralis har utvärderas. Två av dessa är intressanta för fortsatta studier.Termografi användes för att diagnosticera muskelstörningar på ytligt liggande muskler. Vi såg åtskilliga varma områden på ytliga käk– och nackmuskler på de patienter som hade käkledsstörningar, samt möjligen tecken på onormal värme från M Pterygoideus Lateralis. Mätförhållandena var dock ej ideala.En metod att mäta EMG med adaptiv noise cancelling provades. EMG från en ryggmuskel, stört av en “EKG–signal” från hjärtat användes. Metoden fungerade bra. Fortsatt metodutveckling på t.ex. ryggmuskler borde göras.
22.	Nyberg, Jan, 1960-, et al. (författare) Osseointegration of implants in irradiated bone with and without hyperbaric oxygen treatment : an experimental study in rat tibiae 2013 Ingår i: International Journal of Oral & Maxillofacial Implants. - : Quintessence Publishing Co., Inc.. - 0882-2786 .- 1942-4434. ; 28:3, s. 739-746 Tidskriftsartikel (refereegranskat)abstract Purpose: Hyperbaric oxygen (HBO) has been recommended to enhance implant osseointegration in irradiated bone. The aim of this study was to further investigate the effects of HBO on implant integration in irradiated bone tissue.Materials and Methods: The present study was an experimental intraindividual study in 16 rats. A single fraction of 20 Gy external irradiation was applied to one rat hind leg, while the other served as a nonirradiated control. Three days after radiation, two implants were inserted in each tibial tuberosity. The rats were divided into two groups: non-HBO treated (group 1) and HBO treated (group 2). Five weeks after radiation, removal torque tests were performed. Implants with surrounding tissue were processed to undecalcified cut and ground sections for histomorphometric evaluations of bone-to-implant contact and bone area. Retrieved bones were also investigated with dual-energy x-ray absorptiometry.Results: The non-HBO treated rats (group 1) demonstrated higher, but not statistically significantly higher, values in the nonirradiated leg for all investigated parameters compared to the HBO-treated rats (group 2). However, the mean value for bone area was significantly higher in the irradiated sides compared to the nonirradiated control sides.Conclusions: In the present study, HBO treatment did not have a significant impact on osseointegration of implants in irradiated bone.
23.	Reinke, M, et al. (författare) Brown-Séquard syndrome caused by a high velocity gunshot injury: a case report. 2007 Ingår i: Spinal cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 45:8, s. 579-82 Tidskriftsartikel (refereegranskat)abstract Case report.To present an unusual traumatic neurologic pathology caused by gunshot injury.Spine unit of Department of Trauma and Orthopaedic Surgery, University Medical School, Charité - Campus Benjamin Franklin, Berlin, Germany.A 35-year-old male sustained a gunshot injury from a machine gun. The projectile caused a fracture of the left pedicle of Th10. The spinal cord was indirectly damaged by cavitation that caused a Brown-Séquard syndrome (BSS). After a microscopically assisted posterior revision at T9/10 with removal of bullet and bone fragments from the spinal canal and debridement of the bullet cavity via extended fenestrectomy the patient gained his motor function back. The sensory deficit remained unchanged.BSS can be caused by bullet-related injury of the spinal canal with no direct damage of neural structures. The initial treatment is always based on the total injury pattern. Possible spinal cord injuries are only clarified after restitution of vital functions. Decompression of neural structures in shotgun injury is indicated in incomplete paraplegia, injury of intra-abdominal hollow organs or high velocity bullet wounds. Through debridement and decompression of neural structures and chronic damage caused by foreign body granulomas can be prevented. Secondary destabilization of the spine should be avoided.
24.	Robinson, Yohan, 1977, et al. (författare) Erythropoiesis in multiply injured patients. 2006 Ingår i: The Journal of trauma. - : Ovid Technologies (Wolters Kluwer Health). - 0022-5282 .- 1529-8809. ; 61:5, s. 1285-91 Forskningsöversikt (refereegranskat)abstract Posttraumatic anemia in multiply injured patients is caused by hemorrhage, reduced red blood cell survival, and impaired erythropoiesis. Trauma-induced hyperinflammation causes impaired bone-marrow function by means of blunted erythropoietin (EPO) response, reduced iron availability, suppression and egress of erythroid progenitor cells. To treat posttraumatic anemia in severely injured patients, symptomatic therapy by blood transfusion is not sufficient. Furthermore, EPO, iron, and the use of red cell substitutes should be considered. The posttraumatic systemic inflammatory response syndrome (SIRS) induces posttraumatic anemia. Thus, a worsening of SIRS by a "second-hit" through blood transfusion ought to be avoided.
25.	Pettersson, Ulrika, 1970- (författare) Bone mass in the young athlete 1999 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Bone mass and bone size accumulate during childhood and adolescence and peak in the twenties. The obtained peak bone mass has been suggested to be a major determinant of bone mass even in the very elderly. Although, genetic factors are the main determinants, environmental and lifestyle factors also play a crucial role in modulating maximal bone mass. Assessing these lifestyle factors would be of great importance for the intervention strategies against osteoporosis. The first aim of this thesis was to compare the bone mass and bone size in male and female young adults on a high level of physical activity with males or females on a low level of physical activity. Furthermore, it also aimed to investigate the influence of pubertal maturity, menstrual disturbances, and different body constitutional factors on bone mass and size during adolescence and young adulthood. The female activity groups consisted of cross-county skiers, soccer players, and rope skippers. Compared to their age-matched inactive controls, all these athletic groups demonstrated a significantly higher bone mineral density (BMD) at those sites subjected to the sport-specific loading. Rope-skipping, a very high impact activity was associated with a higher bone size, preferentially in the lower extremity, suggesting an effect of weight-bearing activity also on bone geometry. The effect of menstrual disturbances was evaluated in a group of long-distance runners, where amenorrheic runners had significantly lower BMD in both trabecular and also cortical bone in the lower extremity compared to eumenorrheic runners, suggesting that weight-bearing activity cannot compensate for the shortfall of reduced estrogen levels. The male activity groups consisted of ice hockey players and badminton players. Compared to their age-matched controls, both athletic groups demonstrated a significantly higher BMD at those sites subjected to the sport-specific loading. Especially badminton was associated with a high BMD, suggesting that physical activity, including jumps in unusual directions has a great osteogenic potential. The main determinants of BMD in both male and females were, except for type of physical activity, activity, muscle strength, height, and different body constitutional factors. However, the relationships with muscle strength and body constitution were somewhat weaker in the athletic groups, especially in the males, indicating that impact forces may be of greater importance in regulating bone mass in highly trained athletes. Yet bone size was largely determined by parameters related to body size and less strongly to physical activity. In a prospective study on adolescent boys, the changes in bone mass during late puberty were mainly accounted for by growth and development, including height and pubertal maturation, and less to physical activity level. Thus, the osteogenic effect from physical activity seems to be of importance for bone mass achievement predominantly before late puberty.
26.	Wallander, Marit, et al. (författare) Patients with prostate cancer and androgen deprivation therapy have increased risk of fractures : a study from the fractures and fall injuries in the elderly cohort (FRAILCO) 2019 Ingår i: Osteoporosis International. - : Springer. - 0937-941X .- 1433-2965. ; 30:1, s. 115-125 Tidskriftsartikel (refereegranskat)abstract Summary: Osteoporosis is a common complication of androgen deprivation therapy (ADT). In this large Swedish cohort study consisting of a total of nearly 180,000 older men, we found that those with prostate cancer and ADT have a significantly increased risk of future osteoporotic fractures. Introduction: Androgen deprivation therapy (ADT) in patients with prostate cancer is associated to increased risk of fractures. In this study, we investigated the relationship between ADT in patients with prostate cancer and the risk of incident fractures and non-skeletal fall injuries both compared to those without ADT and compared to patients without prostate cancer. Methods: We included 179,744 men (79.1 ± 7.9 years (mean ± SD)) from the Swedish registry to which national directories were linked in order to study associations regarding fractures, fall injuries, morbidity, mortality and medications. We identified 159,662 men without prostate cancer, 6954 with prostate cancer and current ADT and 13,128 men with prostate cancer without ADT. During a follow-up of approximately 270,300 patient-years, we identified 10,916 incident fractures including 4860 hip fractures. Results: In multivariable Cox regression analyses and compared to men without prostate cancer, those with prostate cancer and ADT had increased risk of any fracture (HR 95% CI 1.40 (1.28–1.53)), hip fracture (1.38 (1.20–1.58)) and MOF (1.44 (1.28–1.61)) but not of non-skeletal fall injury (1.01 (0.90–1.13)). Patients with prostate cancer without ADT did not have increased risk of any fracture (0.97 (0.90–1.05)), hip fracture (0.95 (0.84–1.07)), MOF (1.01 (0.92–1.12)) and had decreased risk of non-skeletal fall injury (0.84 (0.77–0.92)). Conclusions: Patients with prostate cancer and ADT is a fragile patient group with substantially increased risk of osteoporotic fractures both compared to patients without prostate cancer and compared to those with prostate cancer without ADT. We believe that this must be taken in consideration in all patients with prostate cancer already at the initiation of ADT.
27.	Gustafsson, Patrik, et al. (författare) Muscle oxygenation in Type 1 diabetic and non-diabetic patients with and without chronic compartment syndrome 2017 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:10 Tidskriftsartikel (refereegranskat)abstract Background. Type 1 diabetic patients and non-diabetic patients were referred for evaluation for chronic exertional compartment syndrome (CECS) based on clinical examination and complaints of activity-related leg pain in the region of the tibialis anterior muscle. Previous studies using near-infrared spectroscopy (NIRS) showed greater deoxygenation during exercise for CECS patients versus healthy controls; however, this comparison has not been done for diabetic CECS patients.Methods. We used NIRS to test for differences in oxygenation kinetics for Type 1 diabetic patients diagnosed with (CECS-diabetics, n = 9) versus diabetic patients without (CON-diabetics, n = 10) leg anterior chronic exertional compartment syndrome. Comparisons were also made between non-diabetic CECS patients (n = 11) and healthy controls (CON, n = 10). The experimental protocol consisted of thigh arterial cuff occlusion (AO, 1-minute duration), and treadmill running to reproduce symptoms. NIRS variables generated were resting StO2%, and oxygen recovery following AO. Also, during and following treadmill running the magnitude of deoxygenation and oxygen recovery, respectively, were determined.Results. There was no difference in resting StO2%between CECS-diabetics (78.2±12.6%) vs. CONdiabetics (69.1±20.8%), or between CECS (69.3±16.2) vs. CON (75.9±11.2%). However, oxygen recovery following AO was significantly slower for CECS (1.8±0.8%/sec) vs. CON (3.8±1.7%/sec) (P = 0.002); these data were not different between the diabetic groups. StO2%during exercise was lower (greater deoxygenation) for CECS-diabetics (6.3±8.6%) vs. CON-diabetics (40.4±22.0%), and for CECS (11.3±16.8%) vs. CON (34.1±21.2%) (P<0.05 for both). The rate of oxygen recovery post exercise was faster for CECS-diabetics (3.5±2.6%/sec) vs. CON-diabetics (1.4±0.8%/sec) (P = 0.04), and there was a tendency of difference for CECS (3.1±1.4%/sec) vs. CON (1.9±1.3%/sec) (P = 0.05).Conclusion. The greater deoxygenation during treadmill running for the CECS-diabetics group (vs. CON-diabetics) is in line with previous studies (and with the present study) that compared non-diabetic CECS patients with healthy controls. Our findings could suggest that NIRS may be useful as a diagnostic tool for assessing Type 1 diabetic patients suspected of CECS.
28.	Holmberg, Anna H, et al. (författare) Forearm bone mineral density in 1294 middle-aged women: a strong predictor of fragility fractures. 2004 Ingår i: Journal of Clinical Densitometry. - 1094-6950. ; 7:4, s. 419-423 Tidskriftsartikel (refereegranskat)
29.	Marques, Catarina, 1969- (författare) Studies on Cervical Artificial Disc Replacement 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Artificial disc replacement (ADR) was developed as an alternative to anterior fusion after decompression for cervical degenerative radiculopathy. By preserving motion, it was expected to prevent acceleration of adjacent segment pathology (ASP) associated with fusion, and lead to better clinical outcomes. The aims of this thesis were to evaluate whether ADR surgery leads to better outcomes than fusion surgery, to investigate if it prevents the acceleration of ASP, and to analyze its potential complications. In a multicenter randomized controlled trial (RCT) 153 patients were randomized to ADR (DiscoverTM implant) or fusion surgery (autograft, plate and screws). The outcomes at 5 and 10 years postoperatively were analyzed with Neck Disability Index (NDI) as primary measure. Heterotopic ossification (HO), ASP, and secondary surgery where analyzed. The measurements of radiographic parameters used in the assessment of cervical alignment where validated.To further analyze secondary surgery after ADR, a descriptive register cohort study was done with 42 patients whose data were retrieved from Swespine and completed with medical charts, images, and a telephone interview. There was no difference in NDI scores between groups in the RCT, 5 or 10 years postoperatively. Radiological and clinically significant ASP were similar in both groups. There was more secondary surgery in the ADR group compared with the fusion group, mainly due to device loosening in women. Severe HO was seen in 71% of the ADR implants 5 years postoperatively, and 27% were fused, male sex being a clear risk factor.Normative data for measurement error were provided on the cervical alignment measurements, and the most reliable were the K-line tilt and the cervical sagittal vertical axis (cSVA). In the 42 patients in the register cohort study the most common diagnosis leading to reoperation was loosening of the ADR implant and/or ASP, predominantly treated with fusion surgery. Reoperation resulted in good outcomes in the vast majority of patients. At the long-term, there is no clinical benefit of ADR over fusion surgery after decompression for cervical degenerative radiculopathy. ADR, compared with fusion surgery, does not prevent acceleration of ASP, and results in more reoperations. Revision surgery for failed cervical ADRs is effective and justified.
30.	Möller, Karin, 1962, et al. (författare) Avanta versus Swanson silicone implants in the MCP joint--a prospective, randomized comparison of 30 patients followed for 2 years 2005 Ingår i: J Hand Surg [Br]. - : SAGE Publications. - 0266-7681. ; 30:1, s. 8-13 Tidskriftsartikel (refereegranskat)abstract The results of Swanson and Avanta metacarpophalangeal joint arthroplasties in rheumatoid patients were compared in a prospective, randomized study of 30 patients (120 implants). At 2-year follow-up, grip strength was measured, hand function was assessed with the Sollerman test and the subjective outcome was determined with visual analogue scores. With both implants ulnar deviation and flexion deformities decreased, and there was no difference between the groups. The increase in range of motion was 7 degrees greater with Avanta implants than with Swanson implants. Grip strength and hand function were unaltered but the visual analogue scales showed decreased pain levels and subjective improvements in hand function, grip strength and cosmesis. Twenty-four of 30 patients were satisfied. Fracture of the silicone spacer occurred with 12 Avanta (20%) and eight Swanson implants (13%), with a higher fracture frequency in men.
31.	Norinder, A, et al. (författare) Costs for screening, intervention and hospital treatment generated by the Malmö Preventive Project: a large-scale community screening programme. 2002 Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 251:1, s. 44-52 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: The purpose of this study was to estimate retrospectively the costs of health care resources used in the Malmö Preventive Project, Sweden and estimate the costs of in-patient care that were avoided because of early intervention. SETTING AND SUBJECTS: A large-scale community intervention programme was conducted from 1974 to 1992 in Malmö, Sweden with the aim of reducing morbidity and mortality of cardiovascular diseases (CVD), alcohol related illnesses, and breast cancer. Between 1974 and 1992, 33 336 male and female subjects were screened for hypertension, hyperlipidaemia, type-2 diabetes and alcohol abuse. Intervention programmes that included life-style modifications, follow-up visits with physicians and nurses and drug therapy were offered to about 25% of screened subjects. METHODS: Recruitment costs were generated through out the screening period. Intervention costs were estimated for 5 years after screening. Excess in-patient care costs were estimated by subtracting hospital consumption for an unscreened, matched cohort from that of the screened cohort over follow-up periods of 13-19 years. Intervention and excess in-patient care costs were estimated until 1996. RESULTS: The net expenditures for recruitment and intervention was SEK253 million and saved costs for in-patient care of SEK143 millions (1998 prices). Considering the opportunity cost of the resources used in the study, the net cost rises to about SEK200 millions. CONCLUSIONS: The results suggest that only part of the intervention costs were offset by reduction in future morbidity health care costs. This is in line with results from prospective analyses of other primary prevention programmes.
32.	Bidgoli, Hassan Haghparast, et al. (författare) Pre-hospital trauma care resources for road traffic injuries in a middle-income country-A province based study on need and access in Iran. 2011 Ingår i: Injury. - : Elsevier BV. - 0020-1383 .- 1879-0267. ; 42:9, s. 879-884 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Access to pre-hospital trauma care can help minimize many of traffic related mortality and morbidity in low- and middle-income countries with high rate of traffic deaths such as Iran. The aim of this study was to assess if the distribution of pre-hospital trauma care facilities reflect the burden of road traffic injury and mortality in different provinces in Iran. METHODS: This national cross-sectional study is based on ecological data on road traffic mortality (RTM), road traffic injuries (RTIs) and pre-hospital trauma facilities for all 30 provinces in Iran in 2006. Lorenz curves and Gini coefficients were used to describe the distributions of RTM/RTIs and pre-hospital trauma care facilities across provinces. Spearman rank-order correlation was performed to assess the relationship between RTM/RTI and pre-hospital trauma care facilities. RESULTS: RTM and RTIs as well as pre-hospital trauma care facilities were distributed unequally between different provinces. There was no significant association between the rate of RTM and RTIs and the number of pre-hospital trauma care facilities across the country. CONCLUSIONS: The distribution of pre-hospital trauma care facilities does not reflect the needs in terms of RTM and RTIs for different provinces. These results suggest that traffic related mortality and morbidity could be reduced if the needs in terms of RTM and RTIs were taken into consideration when distributing pre-hospital trauma care facilities between the provinces.
33.	Charalampidis, Anastasios, et al. (författare) Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis 2024 Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 7:1 Tidskriftsartikel (refereegranskat)abstract IMPORTANCE Moderate-grade adolescent idiopathic scoliosis (AIS) may be treated with full-timebracing. For patients who reject full-time bracing, the effects of alternative, conservativeinterventions are unknown.OBJECTIVE To determine whether self-mediated physical activity combined with either nighttimebracing (NB) or scoliosis-specific exercise (SSE) is superior to a control of physical activity alone (PA)in preventing Cobb angle progression in moderate-grade AIS.DESIGN, SETTING, AND PARTICIPANTS The Conservative Treatment for Adolescent IdiopathicScoliosis (CONTRAIS) randomized clinical trial was conducted from January 10, 2013, throughOctober 23, 2018, in 6 public hospitals across Sweden. Male and female children and adolescentsaged 9 to 17 years with an AIS primary curve Cobb angle of 25° to 40°, apex T7 or caudal, and skeletalimmaturity based on estimated remaining growth of at least 1 year were included in the study. Datesof analysis were from October 25, 2021, to January 28, 2023.INTERVENTIONS Interventions included self-mediated physical activity in combination with eitherNB or SSE or PA (control). Patients with treatment failure were given the option to transition to afull-time brace until skeletal maturity.MAIN OUTCOMES AND MEASURES The primary outcome was curve progression of 6° or less(treatment success) or curve progression of more than 6° (treatment failure) seen on 2 consecutiveposteroanterior standing radiographs compared with the inclusion radiograph before skeletalmaturity. A secondary outcome of curve progression was the number of patients undergoing surgeryup until 2 years after the primary outcome.RESULTS The CONTRAIS study included 135 patients (45 in each of the 3 groups) with a mean (SD)age of 12.7 (1.4) years; 111 (82%) were female. Treatment success was seen in 34 of 45 patients (76%)in the NB group and in 24 of 45 patients (53%) in the PA group (odds ratio [OR], 2.7; 95% CI, 1.1-6.6).The number needed to treat to prevent curve progression with NB was 4.5 (95% CI, 2.4-33.5).Treatment success occurred in 26 of 45 patients (58%) in the SSE group (OR for SE vs PA, 1.2; 95% CI,0.5-2.8). Up to 2 years after the primary outcome time point, 9 patients in each of the 3 groupsunderwent surgery.CONCLUSIONS AND RELEVANCE In this randomized clinical trial, treatment with NB preventedcurve progression of more than 6° to a significantly higher extent than did PA, while SSE did not; inaddition, allowing transition to full-time bracing after treatment failure resulted in similar surgicalfrequencies independent of initial treatment. These results suggest that NB may be an effectivealternative intervention in patients rejecting full-time bracing.
34.	de Dios, Eddie, 1987, et al. (författare) Comparison of the patient-derived modified Japanese Orthopaedic Association scale and the European myelopathy score 2024 Ingår i: European Spine Journal. - : SPRINGER. - 0940-6719 .- 1432-0932. ; 33:3, s. 1205-1212 Tidskriftsartikel (refereegranskat)abstract Purpose: To compare the patient-derived modified Japanese Orthopaedic Association (P-mJOA) scale with the European myelopathy score (EMS) for the assessment of patients with degenerative cervical myelopathy (DCM). Methods: In this register-based cohort study with prospectively collected data, included patients were surgically treated for DCM and had reported both P-mJOA and EMS scores at baseline, 1-year follow-up, and/or 2-year follow-up to the Swedish Spine Register. P-mJOA and EMS scores were defined as severe (P-mJOA 0–11 and EMS 5–8), moderate (P-mJOA 12–14 and EMS 9–12), or mild (P-mJOA 15–18 and EMS 13–18). P-mJOA and EMS mean scores were compared, and agreement was evaluated with Spearman’s rank correlation coefficient (ρ), the intraclass correlation coefficient (ICC), and kappa (κ) statistics. Results: Included patients (n = 714, mean age 63.2years, 42.2% female) completed 937 pairs of the P-mJOA and the EMS. The mean P-mJOA and EMS scores were 13.9 ± 3.0 and 14.5 ± 2.7, respectively (mean difference –0.61 [95% CI –0.72 to –0.51; p < 0.001]). Spearman’s ρ was 0.84 (p < 0.001), and intra-rater agreement measured with ICC was 0.83 (p < 0.001). Agreement of severity level measured with unweighted and weighted κ was fair (κ = 0.22 [p < 0.001]; κ = 0.34 [p < 0.001], respectively). Severity levels were significantly higher using the P-mJOA (p < 0.001). Conclusion: The P-mJOA and the EMS had similar mean scores, and intra-rater agreement was high, whereas severity levels only demonstrated fair agreement. The EMS has a lower sensitivity for detecting severe myelopathy but shows an increasing agreement with the P-mJOA for milder disease severity. A larger interval to define severe myelopathy with the EMS is recommended.
35.	Gerdhem, Paul, et al. (författare) Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. 2005 Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 16:Mar 3, s. 1425-1431 Tidskriftsartikel (refereegranskat)abstract Vitamin D supplements have been used to prevent fractures. The effect may be mediated through increased bone mass, but also through reduced falling propensity. The aim of this study was to evaluate the association between 25-hydroxy vitamin D levels (25OHD), fall-associated variables (including tests of functional performance), and fracture in ambulatory women. At baseline 25OHD was measured in 986 women. Fall-associated variables were investigated at baseline. Fractures were recorded during a 3-year follow-up. Four percent of the women had 25OHD levels below 20 ng/ml (50 nmol/l), and 26% had 25OHD levels below 30 ng/ml (75 nmol/l). 25OHD correlated with gait speed (r =0.17, P <0.001), the Romberg balance test (r =0.14, P <0.001), self-estimated activity level (r =0.15, P <0.001), and thigh muscle strength (r =0.08, P =0.02). During the 3-year follow-up, 119 out of the 986 women sustained at least one fracture. The Cox proportional hazard ratio (HR) (95% confidence interval) for sustaining a fracture during the follow-up was 2.04 (1.04-4.04) for the group of women with 25OHD below 20 ng/ml, in which 9 out of 43 women sustained a fracture. Thirty-two of the 256 women with 25OHD levels below 30 ng/ml sustained a fracture during the follow-up, with a non-significant HR of 1.07 (1.07-1.61). This cohort of elderly, ambulatory women had a high mean 25OHD. A low 25OHD was associated with inferior physical activity level, gait speed and balance. A 25OHD level below 30 ng/ml was not associated with an increased risk of fractures in this study. However, a subgroup of women with 25OHD levels below 20 ng/ml had a tendency to an increased risk of fractures, which may be associated with an inferior physical activity and postural stability.
36.	Hasle, Henrik, et al. (författare) Gemtuzumab ozagamicin is well tolerated as post-consolidation therapy in childhood AML 2008 Ingår i: British Journal of Haematology. ; 141:s1 Konferensbidrag (refereegranskat)
37.	Kilebrant, Sophie, et al. (författare) WHOLE-BODY VIBRATION THERAPY IN CHILDREN WITH SEVERE MOTOR DISABILITIES 2015 Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 47:3, s. 223-228 Tidskriftsartikel (refereegranskat)abstract Objective: To study the effect of whole-body vibration therapy on bone mass, bone turnover and body composition in severely disabled children. Methods: Nineteen non-ambulatory children aged 5.1-16.3 years (6 males, 13 females) with severe motor disabilities participated in an intervention programme with standing exercise on a self-controlled dynamic platform, which included whole-body vibration therapy (vibration, jump and rotation movements). Whole-body vibration therapy was performed at 40-42 Hz, with an oscillation amplitude of 0.2 mm, 5-15 min/treatment, twice/week for 6 months. Bone mass parameters and bone markers were measured at the study start, and after 6 and 12 months. Results: Whole-body vibration therapy was appreciated by the children. Total-body bone mineral density increased during the study period (p less than0.05). Z-scores for total-body bone mineral density ranged from -5.10 to -0.60 at study start and remained unchanged throughout. Approximately 50% of the subjects had increased levels of carboxy-terminal telopeptides of type I collagen and decreased levels of osteocalcin at the start. Body mass index did not change during the intervention period, but had increased by the 12-month follow-up (pless than 0.05). Conclusion: Whole-body vibration therapy appeared to be well tolerated by children with severe motor disabilities. Total-body bone mineral density increased after 6 months of whole-body vibration therapy. Higher carboxy-terminal telopeptides of type I collagen and lower osteocalcin values indicated that severely disabled children have a reduced capacity for bone acquisition.
38.	MacDowall, Anna, et al. (författare) Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial 2023 Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 24:1 Tidskriftsartikel (refereegranskat)abstract Background Cervical spondylotic myelopathy (CSM) is the predominant cause of spinal cord dysfunction in the elderly. The patients are often frail and susceptible to complications. Posterior surgical techniques involving non-fusion are complicated by postlaminectomy kyphosis and instrumented fusion techniques by distal junction kyphosis, pseudarthrosis, or implant failure. The optimal surgical approach is still a matter of controversy.Since anterior and posterior fusion techniques have been compared without presenting any superiority, the objective of this study is to compare stand-alone laminectomy with laminectomy and fusion to determine which treatment has the lowest frequency of reoperations. Methods This is a multicenter randomized, controlled, parallel-group non-inferiority trial. A total of 300 adult patients are allocated in a ratio of 1:1. The primary endpoint is reoperation for any reason at 5 years of follow-up. Sample size and power calculation were performed by estimating the reoperation rate after laminectomy to 3.5% and after laminectomy with fusion to 7.4% based on the data from the Swedish spine registry (Swespine) on patients with CSM. Secondary outcomes are the patient-derived Japanese Orthopaedic Association (P-mJOA) score, Neck Disability Index (NDI), European Quality of Life Five Dimensions (EQ-5D), Numeric Rating Scale (NRS) for neck and arm pain, Hospital Anxiety and Depression Scale (HADS), development of kyphosis measured as the cervical sagittal vertical axis (cSVA), and death. Clinical and radiological follow-up is performed at 3, 12, 24, and 60 months after surgery. The main inclusion criterium is 1-4 levels of CSM in the subaxial spine, C3-C7. The REDcap software will be used for safe data management. Data will be analyzed according to the modified intention to treat (mITT) population, defined as randomized patients who are still alive without having emigrated or left the study after 2 and 5 years. Discussion This will be the first randomized controlled trial comparing two of the most common surgical treatments for CSM: the posterior muscle-preser ving selective laminectomy and posterior laminectomy with instrumented fusion. The results of the myelopathy randomized controlled (MyRanC) study will provide surgical treatment recommendations for CSM. This may result in improvements in surgical treatment and clinical practice regarding CSM.
39.	Möller, Anders, et al. (författare) A vertebral fracture in childhood is not a risk factor for disc degeneration but for Schmorl's nodes: a mean 40-year observational study. 2007 Ingår i: Spine. - 0362-2436. ; 32:22, s. 2487-2492 Tidskriftsartikel (refereegranskat)abstract STUDY DESIGN: Observational cohort study. OBJECTIVE: To evaluate by MRI whether a vertebral fracture during childhood is a risk factor for degeneration of adjacent discs. SUMMARY OF BACKGROUND DATA: Several studies infer that trauma is a major cause of disc degeneration. Only 1 study has by magnetic resonance imaging (MRI) evaluated disc degeneration in children with a former thoracic or lumbar vertebral fracture. That study reported a 50% prevalence of degenerative disc changes 4 years after the fracture. However, due to the sparse literature, it is still unclear whether a vertebral fracture in childhood represents a risk factor for disc degeneration in a long-term perspective. METHOD: Nine boys and 11 girls with a mean age of 12 years (range, 7-16 years) when sustaining a lumbar or thoracic vertebral fracture without neurologic deficits were examined at a mean of 40 years (range, 33-53 years) after the injury. Eighteen of the subjects had 1-column compression fractures, and 2 had Denis Type B burst fractures. All were mobilized without brace or surgery directly after being injured. A favorable long-term clinical and plain radiographic outcome has previously been reported for this cohort. In the present study, the intervertebral discs were evaluated with MRI by applying the Oner classification scheme. Degenerative disc changes were defined as loss of signal intensity on T2-weighted images with or without disc height reduction. RESULTS: Degenerative changes were not more prevalent in discs adjacent to the previously fractured vertebrae than in discs at a distance from those segments. However, there were more Schmorl's nodes at the disc levels adjacent to the earlier fractures. CONCLUSION: Stable vertebral fractures in childhood with no neurologic deficits at injury do not render more degenerative changes than can be expected according to age, but they are associated with more Schmorl's nodes at adjacent disc levels.
40.	Nordström, Peter, et al. (författare) Geriatric Rehabilitation and Discharge Location After Hip Fracture in Relation to the Risks of Death and Readmission 2016 Ingår i: Journal of the American Medical Directors Association. - : Elsevier. - 1525-8610 .- 1538-9375. ; 17:1 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To investigate the effects of geriatric rehabilitation on short-term risk of death and readmission after a hip fracture were investigated in a nationwide cohort. In addition, the association of discharge location (nursing home or patient's home) with the short-term risk of death was assessed.DESIGN, SETTING, AND PARTICIPANTS: The cohort consisted of 89,301 individuals at least 50 years of age, with a first hip fracture registered in the Swedish quality register RIKSHÖFT, the years 2004-2012.MEASURES: Short-term risk of death and readmission to hospital after discharge was compared at 8 hospitals, where most patients received inpatient care in geriatric wards, and those treated at 71 regular hospitals.RESULTS: The risks of death within 30 days of admission were 7.1% in patients admitted to geriatric ward hospitals and 7.4% in those treated at regular hospitals (multivariable-adjusted hazard ratio [HR] 0.91, 95% CI 0.85-0.97), whereas the odds of readmission within 30 days of discharge were 8.7% and 9.8%, respectively (multivariable-adjusted odds ratio 0.86, 95% CI 0.81-0.91). The risk of death was influenced by discharge location and inpatient length of stay (LOS). Thus, for patients discharged to short-term nursing homes with a LOS of at most 10 days, each additional day of LOS reduction increased the risk of death within 30 days of discharge by 13% (HR 1.13, 95% CI 1.08-1.18). This association was reduced in patients discharged to permanent nursing homes (HR 1.04, 95% CI 1.02-1.07), and not significant in those discharged to their own home (OR 1.00, 95% CI 0.91-1.10).CONCLUSION: The risks of death and readmission were lower in patients with hip fracture who received care in hospitals with geriatric wards. The risk of death after discharge increased with shorter LOS, especially in patients discharged to short-term nursing homes.
41.	Ortiz Catalan, Max Jair, 1982, et al. (författare) A highly integrated bionic hand with neural control and feedback for use in daily life 2023 Ingår i: Science Robotics. - 2470-9476. ; 8:83 Tidskriftsartikel (refereegranskat)abstract Restoration of sensorimotor function after amputation has remained challenging because of the lack of human-machine interfaces that provide reliable control, feedback, and attachment. Here, we present the clinical implementation of a transradial neuromusculoskeletal prosthesis-a bionic hand connected directly to the user's nervous and skeletal systems. In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.
42.	Persson, G. Rutger, et al. (författare) Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis 2011 Ingår i: Bone. - : Elsevier. - 8756-3282 .- 1873-2763. ; 48:3, s. 552-556 Tidskriftsartikel (refereegranskat)abstract Purpose: In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. Materials and methods: Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. Results: 788 Caucasians (52.4% women, overall mean age: 76 years, S.D. +/- 9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3 years. Calcaneus PIXI T-values < - 1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p < 0.001). Older persons with osteoporosis had more severe periodontitis (p < 0.01). Periodontitis defined by >= 30% of sites with >= 5 mm distance between the cemento-enamel junction (CEJ) and bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p < 0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T-value <-2.5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p < 0.001). Conclusions: Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures.
43.	Torstensson, Thomas, 1961-, et al. (författare) Corticosteroid Injection Treatment to the IschiadicSpine Reduced Pain in Women With Long-LastingSacral Low Back Pain With Onset During Pregnancy : A Randomized, Double Blind, Controlled Trial 2009 Ingår i: Spine. - Philadelphia : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 34:21, s. 2254-2258 Tidskriftsartikel (refereegranskat)abstract Study DesignRandomized double blind controlled clinical trial.Objective. To evaluate the pain relief effect of locally injected corticosteroid treatment in women with long-lasting sacral low back pain with onset during pregnancy.Summary of Background DataPregnancy-related low back pain is a global problem. Almost 1 of 10 women still experienced disabling daily back pain 2 years after childbirth with high impact on the individual, family, and society. In spite of this, the sources of pain and effective treatment are uncertain.MethodsThirty-six women were allocated to injectiontreatment, with slow-release triamcinolone and lidocaine or saline and lidocaine, given at the sacrospinous ligament insertion on the ischial spine bilaterally with 4 weeks follow-up time. Primary outcome measure was reported pain intensity on visual analogue scale and secondary outcome measures number of pain-drawing locations and pain-provoking test results.'ResultsThe triamcinolone treatment group had significantly reduced pain intensity, number of pain locations,and pain-provoking test results between baseline and follow-up as compared with the saline treatment group. The absolute median change of visual analogue scale score in the triamcinolone treatment group was 24 mm and in the saline group 4.5 mm (P‹0.05). A reducednumber of pain drawing locations was reported by16 of 18 women in the triamcinolone group as compared with 10 of 18 in the saline group (P‹0.05). In the triamcinolone treatment group, 17 of 18 women had an improved pain provocation test result as compared with 9 of 18 in the saline treatment group (P‹0.01).ConclusionThe anatomic region around the sacrospinousligament insertion on the ischial spine is suggestedto be one source of long-lasting sacral low back pain withonset during pregnancy. The pain was relieved by slowrelease corticosteroid injection treatment to the ischial spine.
44.	Vala, Cecilie Hongslo, 1983, et al. (författare) Risk for hip fracture before and after total knee replacement in Sweden 2020 Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 31:5, s. 887-895 Tidskriftsartikel (refereegranskat)abstract We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. Purpose It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. Methods We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. Results The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. Conclusion Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.
45.	Florén, Claes-Henrik, et al. (författare) Bone mineral density in patients with Crohn's disease during long-term treatment with azathioprine 1998 Ingår i: Journal of Internal Medicine. - 1365-2796. ; 243:2, s. 123-126 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To ascertain whether patients with Crohn's disease treated with azathioprine maintained bone mineral mass better than patients treated with steroids alone. DESIGN: Retrospective study. SETTING: University Hospital of Malmo, Sweden. SUBJECTS: A total of 59 patients with ileocolonic, ileocaecal or colonic Crohn's disease. METHODS: Bone mass was assessed by dual photon X-ray absorptiometry at the level of L2-L4. RESULTS: Patients treated with a high lifetime dose of steroids (> 5 g prednisolone) had significantly (P = 0.011) lower Z-score of L2-L4 (-0.87 +/- 1.11; 11 SD) than steroid-treated patients, who had received a low dose of prednisolone (< 5 g) (0.08 +/- 1.16 SD). Azathioprine did not negatively influence the steroid effect on bone mineral density. CONCLUSIONS: Azathioprine does not seem to affect bone mineral density by itself. However, by being steroid-saving, it seems to conserve bone mineral mass in patients with Crohn's disease.
46.	Fältström, Anne, et al. (författare) Functional Performance Among Active Female Soccer Players After Unilateral Primary Anterior Cruciate Ligament Reconstruction Compared With Knee-Healthy Controls 2017 Ingår i: American Journal of Sports Medicine. - : Sage Publications. - 0363-5465 .- 1552-3365. ; 45:2, s. 377-385 Tidskriftsartikel (refereegranskat)abstract Background: Good functional performance with limb symmetry is believed to be important to minimize the risk of injury after a return to pivoting and contact sports after anterior cruciate ligament reconstruction (ACLR).Purpose: This study aimed to investigate any side-to-side limb differences in functional performance and movement asymmetries in female soccer players with a primary unilateral anterior cruciate ligament (ACL)–reconstructed knee and to compare these players with knee-healthy controls from the same soccer teams.Study Design: Cross-sectional study; Level of evidence, 3.Methods: This study included 77 active female soccer players at a median of 18 months after ACLR (interquartile range [IQR], 14.5 months; range, 7-39 months) and 77 knee-healthy female soccer players. The mean age was 20.1 ± 2.3 years for players with an ACL-reconstructed knee and 19.5 ± 2.2 years for controls. We used a battery of tests to assess postural control (Star Excursion Balance Test) and hop performance (1-legged hop for distance, 5-jump test, and side hop). Movement asymmetries in the lower limbs and trunk were assessed with the drop vertical jump and the tuck jump using 2-dimensional analyses.Results: The reconstructed and uninvolved limbs did not differ in any of the tests. In the 5-jump test, players with an ACL-reconstructed knee performed worse than controls (mean 8.75 ± 1.05 m vs 9.09 ± 0.89 m; P = .034). On the drop vertical jump test, the ACL-reconstructed limb had significantly less knee valgus motion in the frontal plane (median 0.028 m [IQR, 0.049 m] vs 0.045 m [IQR, 0.043 m]; P = .004) and a lower probability of a high knee abduction moment (pKAM) (median 69.2% [IQR, 44.4%] vs 79.8% [IQR, 44.8%]; P = .043) compared with the control players’ matched limb (for leg dominance). Results showed that 9% to 49% of players in both groups performed outside recommended guidelines on the different tests. Only 14 players with an ACL-reconstructed knee (18%) and 15 controls (19%) had results that met the recommended guidelines for all 5 tests (P = .837).Conclusion: The reconstructed and uninvolved limbs did not differ, and players with an ACL-reconstructed knee and controls differed only minimally on the functional performance tests, indicating similar function. It is worth noting that many players with an ACL-reconstructed knee and controls had movement asymmetries and a high pKAM pattern, which have previously been associated with an increased risk for both primary and secondary ACL injury in female athletes.
47.	Jöud, Anna, et al. (författare) Healthcare consultation and sick leave before and after neck injury: a cohort study with matched population-based references. 2013 Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 3:8, s. 003172-003172 Tidskriftsartikel (refereegranskat)abstract Recent studies based on self-assessed data on exposure and outcome suggest a negative association between poor health before neck injury and recovery. Our aim was to study actual healthcare consultation and work disability before and after neck injury (whiplash).
48.	Kjeldgård, Linnea, 1985-, et al. (författare) Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals 2020 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1 Tidskriftsartikel (refereegranskat)abstract Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.
49.	Arai, Takeru, et al. (författare) Axonal outgrowth in muscle grafts made acellular by chemical extraction 2000 Ingår i: Restorative Neurology and Neuroscience. - 0922-6028. ; 17:4, s. 165-174 Tidskriftsartikel (refereegranskat)abstract Purpose: To compare nerve regeneration in autologous detergent extracted and freeze-thawed muscle grafts and to electrophoretically characterize the grafts. Methods: Autologous acellular muscle grafts were created either by freeze/thawing or by detergent extraction and then used to bridge a 10 mm gap in rat sciatic nerve. The autologous grafts were compared with respect to protein content, using electrophoresis preimplantation, and axonal outgrowth, Schwann cell and macrophage content, using immunocytochemistry (neurofilaments, S-100 protein, ED 1 macrophages) at 5-20 days postimplantation. Results: The extracted muscle grafts were elastic, but the amount of several proteins was reduced and laminin was still present at a position of basal laminae of the muscle fibers. The freeze/thawed grafts were brittle and lacked elasticity, but resulted in minor changes in major proteins. The axons regenerated through both types of grafts (initial delay 6 days and rate 0.7-0.8 mm/day), which shrunk in length by 25 %. There were no apparent differences with respect to Schwann cells and macrophages. Conclusions: The results suggest that detergent extracted mucle tissue, in which some basal lamina proteins remain but cells are removed, could present a new favourable option for nerve grafting.
50.	Azer, Amanda, et al. (författare) Forearm and elbow secondary surgical procedures in neonatal brachial plexus palsy : a systematic scoping review 2024 Ingår i: JSES Reviews, Reports, and Techniques. - : Elsevier. - 2666-6391. ; 4:1, s. 61-69 Forskningsöversikt (refereegranskat)abstract Background: Neonatal Brachial plexus palsy is an injury during delivery that can lead to loss of motor function and limited range of motion in patients due to damage of nerves in the brachial plexus. This scoping review aims to explore types of procedures performed and assess outcomes of forearm and elbow secondary surgery in pediatric patients.Methods: Searches of PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Web of Sciences, and Scopus were completed to obtain studies describing surgical treatment of elbow and forearm in pediatric patients with neonatal Brachial plexus palsy. 865 abstracts and titles were screened by two independent reviewers resulting in 295 full text papers; after applying of inclusion and exclusion criteria 18 articles were included. The level of evidence of this study is level IV.Results: Ten main procedures were performed to regain function of the forearm and elbow in neonatal brachial plexus birth palsy patients. Procedures had different aims, with supination contracture (6) and elbow flexion restoration (5) being the most prevalent. The variance between preoperative and postoperative soft tissue and bony procedures outcomes decreased and showed improvement with respect to the aim of each procedure category. For soft tissue procedures, a statistically significant increase was found between preoperative and postoperative values for active elbow flexion, passive supination, and active supination. For bony procedures, there was a statistically significant decrease between preoperative and postoperative values of passive and active supination.Conclusion: Overall, all procedures completed in the assessed articles of this study were successful in their aim. Bony procedures, specifically osteotomies, were found to have a wider range of results, whereas soft tissue procedures were found to be more consistent and reproducible with respect to their outcomes. Bony and soft tissue procedures were found vary in their aims and outcomes. This study indicates the need for further research to augment knowledge about indications and long-term benefits to each procedure.

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