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- Herbertsson, Pär, et al.
(författare)
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Uncomplicated Mason type-II and III fractures of the radial head and neck in adults. A long-term follow-up study.
- 2004
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Ingår i: Journal of Bone and Joint Surgery. American Volume. - 1535-1386. ; 86-A:3, s. 569-574
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study was to evaluate the incidence and the long-term results of closed uncomplicated Mason type-II and III fractures in a defined population of adults. Methods: Seventy women and thirty men who were a mean of forty-seven years old when they sustained a fracture of the radial head or neck (a Mason type-II fracture in seventy-six patients and a Mason type-III fracture in twenty-four) were reexamined after a mean of nineteen years. Radiographic signs of degenerative changes of the elbow were recorded. The fracture had been treated with an elastic bandage or a collar and cuff sling with mobilization for forty-four individuals, with cast immobilization for thirty-four, with resection of the radial head in nineteen, with open reduction of the radial head in two, and with a collateral ligament repair in one. Secondary excision of the radial head was performed because of residual pain in nine patients, and a neurolysis of the ulnar nerve was performed in one patient. Results: Seventy-seven individuals had no symptoms in the injured elbow at the time of follow-up, twenty-one had occasional pain, and two had daily pain. The injured elbows had a slight flexion deficit compared with the uninjured elbows (mean and standard deviation, 138° ± 8° compared with 140° ± 7°) as well as a small extension deficit (mean and standard deviation, –4° ± 8° compared with –1° ± 6°) (p < 0.001 for both). The prevalence of degenerative changes was higher in the injured elbows than in the uninjured ones (76% compared with 16%, p < 0.001). Conclusions: The results following uncomplicated Mason type-II and III fractures are predominantly favorable. A secondary radial head resection is usually effective for patients with an unfavorable outcome (predominantly long-standing pain). Levels of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
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| 2. |
- Karlsson, Caroline, et al.
(författare)
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Pregnancy and lactation confer reversible bone loss in humans
- 2001
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 12:10, s. 828-834
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Tidskriftsartikel (refereegranskat)abstract
- The influence of pregnancy on bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry (DXA) in 73 women (mean age 29 years, range 20-44 years) postpartum. Fifty-five age-matched women served as controls. The influence of lactation was evaluated in 65 of the delivered women who were followed with repeated measurements, a mean of 4.5 +/- 0.1 and 11.5 +/- 0.1 months after the delivery. The influence of multiple pregnancies was evaluated in 39 premenopausal women (mean age 38 years, range 31-54 years) with a minimum of four pregnancies (range 4-7). Fifty-eight age-matched healthy premenopausal women with a maximum of two pregnancies (range 0-2) served as controls. Data are presented as mean +/- SEM. BMD data are adjusted for differences in total fat mass and total lean mass. Lumbar spine BMD was 7.6 +/- 0.1% and total body BMD 3.9 +/- 0.1% lower in women postpartum compared with controls (both p<0.001). BMD did not decrease significantly in non-breastfeeding mothers. Mothers breastfeeding for 1-6 months decreased femoral neck BMD by 2.0 +/- 1.0% during the first 5 months postpartum (p<0.001). No further BMD loss was seen between 5 and 12 months postpartum. Femoral neck BMD 12 months after delivery was 1.3 +/- 0.8% lower than after delivery in mothers breastfeeding for 1-6 months (p = 0.05). Mothers breastfeeding for more than 6 months decreased Ward's triangle BMD by 8.5 +/- 1.0% and lumbar spine BMD by 4.1 +/- 0.8% during the first 5 months postpartum (both p<0.05). No further BMD loss was seen between 5 and 12 months postpartum. Femoral neck BMD 12 months after delivery was 4.0 +/- 1.1% lower and Ward's triangle BMD 5.3 +/- 1.9% lower than after delivery in mothers breastfeeding for more than 6 months (both p<0.05). BMD loss was higher during the first 5 months following delivery in the lactating women compared with the non-lactating women (p<0.05 comparing lumbar spine BMD loss in lactating mothers versus non-lactating mothers). However, in women with a minimum of four pregnancies the BMD was no lower than in age-matched women with fewer pregnancies. Total duration of lactation was not correlated with the present BMD. In summary, pregnancy seem to confer a low BMD with additional BMD loss during 5 months of lactation. Even if complete restoration in BMD was not reached within 5 months of weaning, women with four pregnancies or more had a BMD no lower than women with two pregnancies or fewer. We conclude that neither an extended lactation period nor multiple pregnancies could be used as a risk factor when predicting women at risk for future osteoporosis.
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| 3. |
- Karlsson, Magnus, et al.
(författare)
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A modeling capacity of vertebral fractures exists during growth - an up to 47-year follow-up
- 2003
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Ingår i: Spine. - 0362-2436. ; 28:18, s. 2087-2092
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. The study is an observational cohort study. Objectives. To determine the incidence and the long-term outcome of thoracic or lumbar vertebral fractures in children. Summary of Background Data. The incidence of vertebral fractures in children is described as rare and the outcome as favorable. However, no studies evaluate the clinical and radiographic long-term outcome and if a fractured vertebra could be rebuilt during growth. Method. The incidence of vertebral fractures in children was evaluated through the radiographic archives. Twelve boys and 12 girls, aged 7-16 when sustaining the fracture, 21 one-column compression fractures and 3 burst fractures Denis type B, all without neurologic deficits, attended the follow-up. Primary treatment consisted of immediate mobilization without brace. Clinical and radiographic examination were performed 27-47 years after the injury. Results. The annual incidence of thoracic and lumbar vertebral body fractures in individuals below age 16 was 0.07%. Twenty-one individuals had, at follow-up. no subjective complaints, 3 had occasional back pain (Oswestry Scores, 8, 22, and 26), 23 were classified as Frankel E, and 1 as Frankel D. The radiographic ratio anterior height/posterior height of the fractured vertebral body increased from 0.75 after injury to 0.87 at follow-up (P<0.001). The posttraumatic kyphosis in the fracture region decreased in 8 individuals (33%), all aged 13 or less at fracture. No increased disc degeneration was observed. Conclusion. Thoracolumbar vertebral fractures without neurologic deficits, sustained during growth, have a favorable long-term outcome. A modeling capacity, reducing the fracture deformity exists at least in the youngest patients.
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| 9. |
- Smith, Caroline M, et al.
(författare)
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The response of the poplar transcriptome to wounding and subsequent infection by a viral pathogen
- 2004
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Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 164, s. 123-136
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Tidskriftsartikel (refereegranskat)abstract
- The Populus–Poplar Mosaic Virus (PopMV) pathosystem is the best characterized of all forest tree–virus interactions. The details of the host response to this virus are completely unknown.The transcript abundance for approximately 10 000 Populus genes was simultaneously interrogated using spotted cDNA microarrays. Relative transcript abundance was compared for RNA extracted from Populus leaves that were untreated, mock-inoculated leaves that were wounded by leaf abrasion and inoculated leaves that were abraded and then infected by virus.Statistical analysis of the microarray data identified suites of genes that exhibited increased or decreased transcript abundance in response to wounding, systemic PopMV infection or both together. Genes implicated in programmed cell death, and cell wall reinforcement were a major feature of the wound response, whereas genes encoding metallothionein-like proteins, and proteins implicated in cell wall remodelling were a major feature of the PopMV response.The identification of wound- and PopMV-regulated genes opens the door for future studies aimed at testing specific hypotheses related to the mechanisms used by forest trees to contend with stress.
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