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Purpose:We investigated whether active video gaming (AVG) could bring about regular, enjoyable, physical exercise in children treated for brain tumours, what level of physical activity could be reached and if the children’s physical functioning improved. Methods:Thirteen children, aged 7–17 years, were randomised to either AVG or waiting-list. After 10–12 weeks they crossed-over. Weekly Internet coaching sessions were used to sustain motivation and evaluate enjoyment. Energy expenditure (EE) levels were measured as Metabolic Equivalent of Task (MET), using a multisensory activity monitor. Single-blinded assessments of physical functioning were done, using the Bruininks–Osteretsky Test of Motor Performance, second edition, evaluating participants before and after the intervention period, as well as comparing the randomisation groups after the first period. Results:All patients completed the study. AVG sessions (mean duration 47 minutes) were performed on 72% of all days. Mean EE level during AVG sessions was 3.0 MET, corresponding to moderate physical activity. The Body Coordination score improved by 15% (p = 0.021) over the intervention period. Conclusions:In this group of childhood brain tumour survivors, home-based AVG, supported by a coach, was a feasible, enjoyable and moderately intense form of exercise that improved Body Coordination.Implications for RehabilitationChildhood brain tumour survivors frequently have cognitive problems, inferior physical functioning and are less physically active compared to their healthy peers.Active video gaming (AVG), supported by Internet coaching, is a feasible home-based intervention in children treated for brain tumours, promoting enjoyable, regular physical exercise of moderate intensity.In this pilot study, AVG with Nintendo Wii improved Body Coordination. [ABSTRACT FROM AUTHOR]

Conclusion: ECT can be a safe curative mono modality treatment, especially in tongue cancer. The future role for ECT in head and neck cancer needs to be further investigated. Introduction: Electrochemotherapy (ECT) is a cancer treatment modality that uses electroporation to increase the intracellular accumulation of hydrophilic chemotherapeutic drugs, especially bleomycin. Objectives: To report the 5-year local tumor control, safety of treatment and survival after ECT, and the 1-year quality-of-life (QoL) data. Materials and methods: Nineteen patients with primary head and neck cancer were included and treated with ECT with curative intent. All except one patient had squamous cell carcinoma (SCC). Radiotherapy (RT) was performed in all patients with SCC and tumor infiltration ≥5 mm. The EORTC H&N 35 questionnaire was used at baseline and 12 months after treatment. The Wilcoxon signed rank test and McNemar's test were used for paired data and Mann Whitney U-test and Fishers exact test were used for independent data (sub-group comparison). Results: There were no local recurrences in the follow-up period. Thirteen patients were treated with adjuvant RT. The six patients that were treated with ECT alone were tumor-free and alive 5 years after treatment. There was one serious adverse event reported; aspiration after treatment of a tongue base tumor. The tumor-specific 5-year survival was 75%. The QoL outcome 1 year after ECT showed a significant increase in problems with senses (taste, smell), speech, mouth opening and xerostomia. The QoL outcome also showed worse outcome in the smoking patients regarding speech, in the patients receiving adjuvant RT regarding mouth dryness and swallowing and in the patients with non-tongue oral cavity cancer regarding need for painkillers. [ABSTRACT FROM AUTHOR]

Little is known about how to support a lifestyle change for persons with acquired brain injury (ABI), who have poor health compared with the rest of the population. This study investigates whether the Health Profile Assessment (HPA) combined with individual support in individually adjusted interventions could affect the lifestyle of persons with ABI. This longitudinal prospective and quasi-experimental study has a before and after design. HPA aims to improve health habits, perceived health and physiological measurements. In addition, this study includes interventions based on individual goals and actions decided on by the participants. The intervention process was supported through various communication methods such as Motivational Interviewing (MI) and Transactional Analyses (TA). The studied group ( n = 25) included persons with cognitive impairments due to ABI who were considered for outpatient rehabilitation at a specialized facility at a university hospital in south-eastern Sweden. Results at follow-up showed significant improvements in physical activity, perceived health and diet. Significant improvements were also shown in sagittal abdominal diameter, waist circumference, body mass index (BMI) and physical fitness. Consequently, this study describes a method that successfully supported lifestyle changes in persons with ABI. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-related low back and pelvic pain is a worldwide problem. A large proportion of women still experience disabling daily back pain 2 years after childbirth, resulting in major changes in activities and general well-being. In spite of this, the source of pain and effective treatment are uncertain. Objective: To evaluate the short-term effects on function of a single corticosteroid injection treatment to the ischiadic spine in women with persistent pregnancy-related pelvic pain (PPPP). Methods: Thirty-six women were allocated to injection treatment with slow-release triamcinolone and lidocain or saline and lidocain, given once at the sacrospinous ligament insertion on the ischiadic spine bilaterally with follow-up at 4 weeks. Outcome measures were Disability Rating Index (DRI), self-rated functional health (SF-36), gait speed and endurance (6MWT), and strength and endurance of trunk muscles (isometric trunk extensor and flexor tests). Results: Women in the triamcinolone group showed significantly improved DRI ( p = 0.046), 6MWT ( p = 0.016), and isometric trunk extensor tests ( p = 0.004), as compared with the saline group. Close co-variation was shown between improved function and reduced pain intensity. Conclusions: Improved function was achieved among women with PPPP after a single injection treatment with slow-release corticosteroid. The effect was positively correlated to the reduced pain intensity. [ABSTRACT FROM AUTHOR]

Lifetime experience of selling sex among adolescents was investigated together with sociodemographic correlates, parent–child relationship, and the existence of people to confide in. Changes over time regarding the selling of sex were investigated through a comparison of data from 2004 and 2009. This study was carried out using 3,498 adolescents from a representative sample of Swedish high school students with a mean age 18.3 years. Of these adolescents, 1.5% stated that they had given sexual services for reimbursement and both male and female buyers existed. The adolescents who had sold sex had a poorer parent–child relationship during childhood and had fewer people to confide in about problems and worries. Changes over time were found especially regarding the Internet as a contact source and also immigrant background. [ABSTRACT FROM PUBLISHER]

Background: Short-term mortality from invasive Staphylococcus aureus infections (ISA) is high. Death rates from 20% to 60% are reported. Long-term outcome has not been investigated. Studies of other critical illnesses have demonstrated incremental health effects that persist after hospital discharge. Several researchers have proposed that evaluation of mortality secondary to sepsis should take place after 1 y. Methods: We performed an observational, prospective, population-based study of long-term mortality and recurrence in a cohort of ISA patients during 2 y. Results: One hundred and fifty-seven patients were included. All-cause mortality after 1 y was 37.6% and after 3 y was 45.5%. The multivariate survival analysis explored different independent factors for short-term compared to long-term mortality. Age, comorbidity, and place of acquisition were the determinants of long-term outcome. In contrast, infection-related factors such as disease severity and systolic blood pressure determined short-term mortality. The relapse-reinfection rate was 11.2% (16 in 143 episodes in 127 patients living 4 weeks after inclusion). Predictive factors for relapse-reinfection in a univariate analysis were joint prosthesis (28.6%, p == 0.027), haemodialysis (27.8%, p == 0.017), kidney disease (22.2%, p == 0.015), and healthcare- and nosocomial-related infection (18.3%, p == 0.029). No association to length of antibiotic therapy and relapse-reinfection rate was observed, nor any sex differences. The majority of relapses-reinfections (11 of 16) occurred during the first 11 months after the initial episode. Conclusion: Patients with ISA infections, irrespective of age, suffer a high long-term mortality and recurrence rate. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular complications (CVC) in infective endocarditis (IE) are common. The only established treatments to reduce the incidence of CVC in IE are antibiotics and in selected cases early cardiac surgery. Potential effects of previously established antiplatelet therapy are under debate. Methods: In a prospective cohort study in Sweden and Demark, the influence of previously established antiplatelet therapy on CVC incidence and mortality in IE was assessed using logistic regression models. Results: Among 684 left-sided definite IE episodes, 23.0% were seen in patients on established antiplatelet therapy (96% acetylsalicylic acid). Patients on antiplatelet therapy were older and significantly more often had a history of congestive heart failure prior to IE diagnosis. No difference in CVC rate was seen between patients with and without ongoing antiplatelet therapy (23.6% vs 25.0%, adjusted odds ratio (AOR) 0.8, 95% confidence interval (CI) 0.48-1.5). Ischemic stroke, which occurred in 115 episodes (16.8%), was the most common cerebral lesion, and haemorrhagic complications were seen in 16 (2.3%) patients without correlation to chronic antiplatelet therapy. Unadjusted 1-y mortality was higher for patients on previously established antiplatelet therapy (33.8% vs 24.1%, odds ratio (OR) 1.6, 95% CI 1.1-2.4), but after adjustment for covariables associated with mortality an opposite statistical trend was seen (AOR 0.7, 95% CI 0.4-1.1). Conclusions: The incidence of symptomatic CVC in IE patients was not reduced by previously established antiplatelet therapy. One-y mortality was higher in patients on antiplatelet therapy in univariate analysis, but after multivariable modelling this association was lost. [ABSTRACT FROM AUTHOR]