Stress radiography for osteoarthritis of the knee: a new technique.

Stress radiographs have been used for several years to detect the amount of varus/valgus knee laxity and to evaluate the degree of compartmental involvement in degenerative osteoarthritis. However, the popularity of these radiographic methods has been affected by their technical limits due to the x-ray exposure for the personnel involved and the variability of the stress forces applied. A device was developed with the aim to create a constant varus or valgus stress force to the knee with the patient in a supine position.

Physician assessment of appropriate healthcare level among nonurgent patients.

Objectives: To analyze the appropriateness of healthcare level chosen by nonurgent patients in an emergency department (ED) compared with unscheduled primary care (PC) patients and the factors influencing physician consideration of appropriate care level.

Study Design: Cross-sectional study.

Methods: This study used structured face-to-face interviews with nonurgent patients at an urban ED and with unscheduled PC patients from a defined catchment area, concomitant with a questionnaire to the treating physician.

Quality of life and functional outcome after a 2-part proximal humeral fracture: a prospective cohort study on 50 patients treated with a locking plate.

Background: The aim of the study was to report the 2-year outcome after a displaced 2-part fracture of the proximal humerus in elderly patients treated with a locking plate, including an assessment of the health-related quality of life (HRQoL).

Material And Methods: We included 50 patients, mean age 75 (range, 55-93) years with 80% women. The fracture inclusion criteria were a displacement of the shaft of >50% of its width and/or >45 degrees of angulation.

Lactate dehydrogenase predicts hypoxic ischaemic encephalopathy in newborn infants: a preliminary study.

Background: Enzyme leakage as a result of hypoxia-ischaemia induced cell damage in affected organs is seen together with hypoxic ischaemic encephalopathy (HIE) after perinatal asphyxia.

Aim: To investigate whether plasma lactate dehydrogenase [LDH], alanine aminotransferase [ALT] and aspartate aminotransferase [AST] during the first 12 h after birth predict HIE and adverse neurodevelopment outcome in newborn term infants with intra-partum signs of foetal distress.

Methods: Enzymes were measured within 12 h post partum in newborn infants with differing degree of HIE (n = 41) and in infants with signs of foetal distress during birth (n = 205) without HIE (non-HIE group).

Inflammatory bowel disease confers a lower risk of colorectal cancer to females than to males.

Background & Aims: Reported differences in cancer risk between male and female animals after chronic inflammation suggest that estrogen has inflammation-modifying properties. Little is known about these effects in human beings. Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC); we studied differences in inflammation-associated CRC between men and women patients with IBD.

Direction of hip arthroplasty dislocation in patients with femoral neck fractures.

In order to prevent hip arthroplasty dislocations, information regarding the direction of the dislocation is important for accurate implant positioning and for optimising the postoperative regimens in relation to the surgical approach used. The aim of this study was to analyse the influence of the surgical approach on the direction of the dislocation in patients treated by a hemiarthroplasty (HA) or total hip arthroplasty (THA) after a femoral neck fracture. Fracture patients have a high risk for dislocations, and this issue has not been previously studied in a selected group of patients with a femoral neck fracture.

Glucose as a marker of fluid absorption in bipolar transurethral surgery.

Background: Historically, a reduced serum sodium concentration has been used to diagnose absorption of electrolyte-free irrigating fluid during transurethral resection of the prostate (TURP). In bipolar TURP, the irrigating solution contains electrolytes, thus invalidating the serum sodium method. In this study, we investigated whether glucose can be used to diagnose the absorption of irrigating fluid during TURP procedures.

Quality of life after dislocation of hip arthroplasty: a prospective cohort study on 319 patients with femoral neck fractures with a one-year follow-up.

Purpose: A primary arthroplasty constitutes a standard procedure in the treatment of patients with displaced fractures of the femoral neck. Although dislocation of the prosthesis remains a significant clinical problem, there are no previous reports on its influence on health-related quality of life (HRQoL). We analysed how a dislocation of the hip arthroplasty influenced the patients' HRQoL.

Muscle activation and length changes during two lunge exercises: implications for rehabilitation.

Eccentric exercises are commonly used as a treatment for various muscle and tendon injuries. During complex motions such as the forward lunge, however, it is not always clear which muscles may be contracting eccentrically and at what time. Because this exercise is used during rehabilitation, the purpose of this investigation was to determine what type of contractions take place during two different types of forward lunge and assess the implications for rehabilitation.

Decreasing time-trends of colorectal cancer in a large cohort of patients with inflammatory bowel disease.

Background & Aims: Inflammatory bowel disease (IBD) is a risk factor for colorectal cancer (CRC). There have been marked changes in the management and treatment of IBD over the past decades, but little is known about how these changes have impacted morbidity and mortality (time trends in risk) of CRC in patients with IBD.

Methods: We assessed cancer occurrence and mortality in a large population-based cohort of patients with IBD who were diagnosed from 1954 to 1989 (n = 7607).

Dislocation of total hip replacement in patients with fractures of the femoral neck.

Background: Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors influencing the stability of the total hip replacement, paying special attention to the surgical approach.

Forward lunge: a training study of eccentric exercises of the lower limbs.

A few studies have shown that eccentric exercise is effective for prevention and treatment of muscle injuries. Most earlier studies on eccentric exercises have used training with advanced equipment. Forward lunges are considered eccentric exercises, and they may be performed without any equipment.

Plasma porphobilinogen as a sensitive biomarker to monitor the clinical and therapeutic course of acute intermittent porphyria attacks.

Background: Acute intermittent porphyria (AIP) is a metabolic disease affecting hepatic heme biosynthesis. The clinical course in overt disease is characterized by acute attacks of neurovisceral symptoms. Treatment is based on symptomatic relief together with carbohydrate loading and in more severe attacks heme therapy.

The Holstein-Lewis humeral shaft fracture: aspects of radial nerve injury, primary treatment, and outcome.

Objective: The primary aim was to describe the epidemiology of the Holstein-Lewis humeral shaft fracture, its association with radial nerve palsy, and the outcome regarding recovery from the radial nerve palsy and fracture healing. The secondary aim was to analyze the long-term functional outcome.

Setting: Six major hospitals in Stockholm County.

CT diagnosis of temporal bone anomalies and cochlear implant surgery in CHARGE association.

Children with CHARGE have multiple disabilities. Impairments of vision and hearing, balance problems and facial palsy are common. Few reports have dealt with their radiological temporal bone changes and none with cochlear implant surgery.

Association between lactate concentration in amniotic fluid and dysfunctional labor.

Objectives: To assess whether there is an association between high lactate concentration in amniotic fluid (AF) and labor dystocia.

Design: Prospective observational study.

Setting: Labor ward at General South Hospital, Stockholm, Sweden.

Matrix metalloproteinase-21 expression is associated with keratinocyte differentiation and upregulated by retinoic acid in HaCaT cells.

In the skin, expression of several matrix metalloproteinases (MMPs) occurs in response to tissue injury, tumorigenesis, angiogenesis, apoptosis, and inflammation. The recently cloned MMP-21 has been implicated in skin development and various epithelial cancers. In this study, we found that it is also expressed by differentiated keratinocytes (KCs) in various benign skin disorders, in which it was not associated with KC apoptosis or proliferation, and in organotypic cultures.

Characteristics of non-urgent patients. Cross-sectional study of emergency department and primary care patients.

Objective: To describe characteristics of patients seeking medical attention for non-urgent conditions at an emergency department (ED) and patients who use non-scheduled services in primary healthcare.

Design: Descriptive cross-sectional study.

Setting: Primary healthcare centres and an ED with the same catchment area in Stockholm, Sweden.

Primary radial nerve palsy in patients with acute humeral shaft fractures.

Objective: The primary aim was to report on the recovery of radial nerve function in patients with acute closed humeral shaft fractures and associated primary radial nerve palsy. The secondary aim was to report on the long-term functional outcome and health-related quality of life (HRQoL) in patients with this specific injury.

Setting: Six major hospitals in Stockholm County.

Bilateral vagotomy inhibits apnea and attenuates other physiological responses after blunt chest trauma.

Background: Behind armor blunt trauma (BABT) is defined as the nonpenetrating injury resulting from a ballistic impact on body armor. Some of the kinetic energy is transferred to the body, causing internal injuries and, occasionally, death. The aim of this study was to investigate if apnea and other pathophysiological effects after BABT is a vagally mediated reflex.

Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial.

Objective: To examine the effectiveness of pH analysis of fetal scalp blood compared with lactate analysis in identifying hypoxia in labour to prevent acidaemia at birth.

Design: Randomised controlled multicentre trial.

Setting: Labour wards.

Dislocation of hemiarthroplasty after femoral neck fracture: better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips.

Background And Purpose: Hip replacement using a hemiarthroplasty is a common surgical procedure in elderly patients with fractures of the femoral neck. The optimal surgical approach regarding the risk of dislocation is controversial. We analyzed factors influencing the stability of the hemiarthroplasty, with special regard to the surgical approach.

Long-term pattern of disease recurrence among patients with early-stage breast cancer according to estrogen receptor status and use of adjuvant tamoxifen.

Purpose: Recent studies on the pattern of gene expression in estrogen receptor positive and negative tumours have revealed profound differences according to receptor status. However, it remains unclear if these differences reflect phenotypic traits in addition to sensitivity to endocrine therapy. This paper describes the long-term pattern of disease recurrence among ca.

Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: a randomized placebo-controlled, double-blind study.

Background: Skeletal trauma and immobilization are well-known risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE). While prophylaxis against thromboembolic complications has become routine after major orthopedic surgery, whether or not prophylaxis after minor surgery and lower limb immobilization is necessary is still under debate.

Methods: In a double-blind, placebo-controlled study, 272 consecutive patients were randomized to receive either thromboprophylaxis with Dalteparin (n = 136) or placebo (n = 136) for 5 weeks after ankle fracture surgery.

Efficacy of preoperative radiochemotherapy in patients with locally advanced pancreatic carcinoma.

Background: The optimal care for patients with unresectable, non-metastatic pancreatic adenocarcinoma (PAC) is debated. We treated 17 consecutive cases with preoperative radiochemotherapy (RCT) as a means for downstaging their tumours and compared outcome with 35 patients undergoing direct surgery for primarily resectable PAC during the same time period.

Methods: The patients had biopsy proven, unresectable, non-metastatic PAC which engaged >or=50% of the circumference of a patent mesenteric/portal vein for a distance >or=2 cm and/or <50% of the circumference of a central artery for <2 cm.