Work resumption or not after rehabilitation? A descriptive study from six social insurance offices

The objective of this study was to describe measures and outcomes of vocational rehabilitation at six local national insurance offices in the same county in Sweden. Data were collected from mainframe registers and other records at each office. There were great differences in sickness allowance, incapacity rate, selected rehabilitation measures and resuming work. The percentage of sick-listed people who received any rehabilitation measure differed from 1.2 to 8.7%. The gender distribution for the study population was 36% men and 64% women and the predominant diagnosis was musculoskeletal pain conditions, which was followed by psychiatric disorders. Outcomes varied from office B, which reported 58% fully fit after completed planned rehabilitation, to office C, which reported only 24% fully fit. The clear differences in outcome between the offices indicate that various rehabilitation measures differ in effectiveness. The rehabilitation measure 'investigation of working ability' was not linked to any great proportion of people resuming work, but showed a greater correspondence to full disability pension. There were also large differences in social and demographic factors in the different municipalities. The effect of these on the rehabilitation process requires further investigation.     

Analytical aspects of oxidatively modified substances in sports and exercises

Despite the health-promoting effects of physical activity, exercise enhances the formation of free radicals and other reactive species in animals and humans. Numerous techniques have been established to investigate the diverse modifications of biomolecules by oxidative stress. These analytical procedures include different methods, ranging from simple photometric assays to a combination of chromatographic methods with mass spectrometry. We summarize briefly those analytical techniques of oxidative damage to biomolecules that have been applied to the investigation of oxidative stress during exercise.     

Bone marrow microenvironment facilitating dendritic cell: CD4 T cell interactions and maintenance of CD4 memory

This study shows that bone marrow (BM) stroma expresses constitutively multiple adhesion molecules (ICAM-1, VCAM-1, MadCAM-1, P-selectin) relevant for the homing and infiltration of BM by blood derived T lymphocytes, and also the co-stimulatory molecule CD80, relevant for T cell activation. T cells were capable of homing to BM but not to thymus. Homing to BM involved the integrins LFA-1alpha and alpha4 which interact with the above constitutively expressed cell adhesion molecules (CAMs). CD3 T cells were detected together with BM resident CD11c dendritic cells (DCs), often enriched in follicle-like structures in BM parenchyma. Cognate interactions between transferred antigen specific transgenic CD4 T cells and antigen laden BM-DCs led to formation of multicellular clusters in situ in BM, to generation of lymphoblasts and to clonal T cell expansion within such clusters. The great majority of BM-CD4 T cells had a memory phenotype suggesting that the BM microenvironment facilitates maintenance of CD4 memory. These results extend and corroborate our previous findings on BM-CD8 T cell mediated immune responses. Together these findings suggest that DC-T cell interactions in BM play an important role in immune responses to blood-borne antigen and in the establishment of systemic immunity and long-term memory.     

Microencapsulation of low molecular weight heparin into polymeric particles designed with biodegradable and nonbiodegradable polycationic polymers

Owing to its lack of oral absorption, heparin has to be administered parenterally. However, parental administration has negative aspects such as multiple injections, possible infection, patient inconvenience, and high cost. Now, low molecular weight heparin (LMWH) is taking part in antithrombotic treatment and is proven to confer more advantages than unfractionated heparin. The aim of our present study was to formulate, by the w/o/w emulsification process, LMWH microparticles as potential oral carriers prepared with biodegradable (poly-epsilon-caprolactone and poly-lactic-co-glycolic acid) and nonbiodegradable polycationic polymers (Eudragit RS and RL), used alone or blended. The encapsulation efficiency ranged from 16 to 47% and was highly dependent on the presence of the positively charged polymers. In the same way, a low in vitro LMWH release was observed when Eudragit polymers composed totally or partially the polymeric matrix, compared with biodegradable polymers exhibiting higher LMWH release (40 and 60%). For each formulation, LMWH released from microparticles preserved its biological activity as shown by the antifactor Xa activity. Experiments performed with fluorescein-labeled LMWH showed the drug distribution in microparticles and may give information about the mechanisms controlling LMWH encapsulation and release.     

Vulnerability and salutogenesis in health and disease

In this brief overview psychosocial factors which contribute to health and disease are briefly discussed. These opposing factors are mainly investigated in a unidirectional sense and often neutralize each other and thereby explain only little variance. The normally investigated pathological factors would have to be supplemented by salutogenic (health promoting) factors and vice versa. The salutogenic perspective opens up a resource-oriented approach, which can reduce suffering and also health care costs in almost any kind of disease. There is enough empirical evidence, of which only a small part is presented here, to support this claim.     

Upregulation of the apoptosis regulators cFLIP,CD95 and CD95 ligand in peripheral blood mononuclear cells in relapsing-remitting multiple sclerosis

Multiple sclerosis (MS) is a chronic disease involving an inflammatory reaction within the white matter of the CNS, mediated by T cells, B cells and macrophages. The pathogenesis of MS may involve impaired activation-induced cell death of activated myelin-specific mature T cells. We investigated the mRNA expression of the apoptosis mediators cellular FLICE-inhibitory protein (cFLIP), caspase-8, CD95 and CD95L in peripheral blood mononuclear cells (PB MNCs) from MS patients using real-time PCR. The overall increased expression of the four key players in the CD95 pathway in relapsing-remitting MS suggests their involvement in the inflammatory process in this disease.     

Effects of goats' or cows' milks on nutritive utilization of calcium and phosphorus in rats with intestinal resection

We analysed the effects of goats' milk (GM) on the nutritive utilization of Ca and P in rats with resection of 50 % distal small intestine in comparison with cows' milk (CM) and a standard non-milk diet. The three test diets contained 200 g protein and 100 g fat/kg. The apparent digestibility coefficient (ADC) of Ca and P were considerably higher in the two groups of rats given the GM diet than those given the other two diets. Ca and P retention did not decrease by effect of intestinal resection with GM diet. In both groups of animals, serum Ca and P levels and ionic Ca were higher in the case of the GM diet than the other two diets, whereas the parathyroid hormone levels were lower. Ca content in femur, sternum and longissimus dorsi muscle was higher in rats given the GM diet. P content in femur and sternum was higher among the two groups of rats given a milk-based diet (GM or CM), especially with GM diet. The GM diet has beneficial effects on nutritive utilization of Ca and P in control rats and those with resection of the distal small intestine.     

Study quality and effect-sizes - a metaanalysis of EMDR-treatment for posttraumatic stress disorder

Although the good efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of patients with PTSD is up to now documented by a number of studies, this new treatment technique is still the target of highly controversial critique. Our meta-analysis tries to answer the question of whether EMDR-therapy studies with higher quality standards achieve better results than others. Therefore, all published studies underwent a scoring procedure of study quality and effect sizes were computed. It can be shown that carefully planned studies, including treatment by well-trained therapists and with a sufficiently high number of treatment session achieve better results compared to studies with low methodological standards.     

Cerebral palsy in Norway: prevalence, subtypes and severity.

BACKGROUND/AIM: To describe prevalence, subtypes and severity of cerebral palsy (CP) in Norway using criteria proposed by the Surveillance of Cerebral Palsy in Europe (SCPE) network. MATERIAL: All children in Norway with CP born in January 1996-December 1998 were registered in the Cerebral Palsy Registry of Norway. The Medical Birth Registry of Norway provided the perinatal data. RESULTS: A total of 374 children with CP were identified with a prevalence of 2.1 per 1000 live births. Detailed information was obtained from 294 (79%) children. Median age at clinical assessment was 6.9 years (range: 1.9-10.2 years). Thirty-three percent of the children had spastic unilateral CP, 49% spastic bilateral, 6% dyskinetic, 5% ataxic CP and 7% were not classified. Severely impaired vision and hearing were present in 5% and 4% of the children, respectively. Active epilepsy was present in 28%, mental retardation in 31% and severely impaired or no speech in 28% children. The most severe impairments in gross motor function were observed in children with low Apgar scores, and the most severe impairments in fine motor function in children born at term, with normal birth weight and low Apgar scores. CONCLUSION: Compared with other populations, the prevalence of CP as well as the proportions of subtypes and gross motor impairments were similar, whereas fine motor impairments and associated impairments were more common. The classification of children with mixed forms of CP is still a challenge. Children were more severely affected if Apgar scores were low, and if they were born at term.