Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery

Objective

To investigate the effect of a 12‐session walking skill training program of weight‐bearing activities on physical functioning and self‐efficacy initiated in patients 3 months after total hip arthroplasty (THA).

Methods

Sixty‐eight patients with THA, 35 women and 33 men, with a mean age of 66 years (95% confidence interval [95% CI] 64, 67 years), were randomized to a training group (n = 35) or a control group without physiotherapy (n = 33). Assessments were performed before the intervention at 3 months (pretest), at 5 months (posttest 1), and at 12 months (posttest 2) after surgery. The primary outcome was the 6‐minute walk test (6MWT). The secondary outcomes were the stair climbing test (ST); figure‐of‐eight test; Index of Muscle Function (IMF); active hip range of motion (ROM) in flexion, extension, and abduction; Harris Hip Score (HHS); self‐efficacy; and Hip Dysfunction and Osteoarthritis Outcome Score.

Results

The training group had larger improvements than the control group at posttest 1 on the 6MWT with an adjusted mean difference of 52 meters (95% CI 29, 74 meters; P < 0.001) and on the ST of ?1 second (95% CI ?2, 0 seconds; P = 0.01).There were also improvements on the figure‐of‐eight test (P = 0.02), IMF (P = 0.001), active hip ROM in extension (P = 0.02), HHS (P = 0.05), and self‐efficacy (P = 0.04). The difference between the groups persisted at posttest 2 on the 6MWT of 52 meters (95% CI 24, 80 meters; P < 0.001) and on the ST of ?1 second (95% CI ?3, 0 seconds; P = 0.05).

Conclusion

The walking skill training program was effective, especially in improving walking both immediately after the intervention and 1 year after THA surgery.

     

A randomised crossover study investigating the effects of galacto-oligosaccharides on the faecal microbiota in men and women over 50 years of age

Faecal microbial changes associated with ageing include reduced bifidobacteria numbers. These changes coincide with an increased risk of disease development. Prebiotics have been observed to increase bifidobacteria numbers within humans. The present study aimed to determine if prebiotic galacto-oligosaccharides (GOS) could benefit a population of men and women of 50 years and above, through modulation of faecal microbiota, fermentation characteristics and faecal water genotoxicity. A total of thirty-seven volunteers completed this randomised, double-blind, placebo-controlled crossover trial. The treatments - juice containing 4 g GOS and placebo - were consumed twice daily for 3 weeks, preceded by 3-week washout periods. To study the effect of GOS on different large bowel regions, three-stage continuous culture systems were conducted in parallel using faecal inocula from three volunteers. Faecal samples were microbially enumerated by quantitative PCR. In vivo, following GOS intervention, bifidobacteria were significantly more compared to post-placebo (P = 0·02). Accordingly, GOS supplementation had a bifidogenic effect in all in vitro system vessels. Furthermore, in vessel 1 (similar to the proximal colon), GOS fermentation led to more lactobacilli and increased butyrate. No changes in faecal water genotoxicity were observed. To conclude, GOS supplementation significantly increased bifidobacteria numbers in vivo and in vitro. Increased butyrate production and elevated bifidobacteria numbers may constitute beneficial modulation of the gut microbiota in a maturing population.     

Strong regional links between socio-economic background factors and disability and mortality in Oslo, Norway

Study objective: To study geographical differences in mortality and disability and sosio-economic status in Oslo, Norway. Setting: A total of 25 local authority districts within the city of Oslo. Design: Analysis of age adjusted mortality rates aged 0–74 in the period 1991–1994, and cross sectional data on disability pensioners aged 50–66 and socio-economic indicators (low education, single parenthood, unemployment, high income) in 1994. Main outcome measures: The levels of correlation between the health outcomes (mortality and disability) and sosio-economic exposure variables. Main results: The geographical patterns of mortality and disability display substantial similarities and show strong linear correlation with area measures of socio-economic deprivation. The ratios between the highest and lowest area mortality rates were 3.3 for men and 2.1 for women, while the high-low ratios of disability were 7.0 for men and 3.8 for women. For women deprivation measures are better correlated with disability than mortality. While disability and mortality display similar correlations with deprivation measures for men. Conclusions: The social gradients in health are substantial in Oslo. Further ecological analysis of cause specific morbidity and mortality and the distribution of risk factors ought to be done to identify problem areas suitable for interventions. However, to understand the mechanisms and the relative importance of each etiological factor, studies based on individual data have to be performed.     

HIV/AIDS awareness and risk behavior among students in Semey,Kazakhstan: a cross-sectional survey

Background  

Until recently, young people in Kazakhstan have been only moderately affected by the global HIV epidemic. Today, however, the HIV epidemic in Central Asia is one of the most rapidly increasing epidemics in the world. It is mainly concentrated to vulnerable groups such as intravenous drug users, sex workers, the purchasers of sexual services and the financially marginalized. Young, sexually active people may however be the gateway for the epidemic to the general population, and knowledge about their attitudes and behavior is therefore important in planning preventive measures.     

Inhibition of Low Density Lipoprotein Oxidation by Myrigalone B,a Naturally Occurring Flavonoid

Abstract: The influence of myrigalone B, a flavonoid from the fruit exudate of Myrica gale L. on Cu²⁺-induced oxidation of low density lipoprotein from cholesterol fed rabbits was investigated. Myrigalone B was an effective antioxidant, as shown by its ability to dose-dependently prolong the lag time for the formation of conjugated dienes. A 100% increase in lag time corresponds to a myrigalone B concentration of 1.4±1.1 μM. For α-tocopherol, used as a reference, this effect corresponds to a concentration of 1.9± 1.2 μM. Myrigalone B also dose-dependently reduced the maximum rate of formation of conjugated dienes, 1.4 μM causing a 15±5% reduction, but it had no influence on the maximal amount of conjugated dienes formed.     

Fungal infection counters insecticide resistance in African malaria mosquitoes

The evolution of insecticide resistance in mosquitoes is threatening the effectiveness and sustainability of malaria control programs in various parts of the world. Through their unique mode of action, entomopathogenic fungi provide promising alternatives to chemical control. However, potential interactions between fungal infection and insecticide resistance, such as cross-resistance, have not been investigated. We show that insecticide-resistant Anopheles mosquitoes remain susceptible to infection with the fungus Beauveria bassiana. Four different mosquito strains with high resistance levels against pyrethroids, organochlorines, or carbamates were equally susceptible to B. bassiana infection as their baseline counterparts, showing significantly reduced mosquito survival. Moreover, fungal infection reduced the expression of resistance to the key public health insecticides permethrin and dichlorodiphenyltrichloroethane. Mosquitoes preinfected with B. bassiana or Metarhizium anisopliae showed a significant increase in mortality after insecticide exposure compared with uninfected control mosquitoes. Our results show a high potential utility of fungal biopesticides for complementing existing vector control measures and provide products for use in resistance management strategies.