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Background and purpose Regular rehabilitation is not sufficient for regaining function after a hip fracture, and more targeted interventions for home-dwelling elderly hip-fracture patients are needed. This paper describes the protocol of a study assessing the effectiveness and cost effectiveness of a task specific progressive gait and balance exercise programme for hip-fracture patients, performed 4 months after the fracture. Methods/design A single blind two-arm pragmatic randomised controlled trial was conducted with 142 hip-fracture patients randomized to a 10-week home-based exercise programme or to practice as usual 4 months following the surgery. Inclusion criteria were age >70 years and being home dwelling prior to the fracture. Exclusion criteria are life expectancy <3 months and inability to walk 10 m prior to the fracture. The content and organization of the programme was developed in collaboration between physiotherapy researchers and primary health-care physiotherapists. Participants were followed for 1 year post-surgery, evaluating short-term and long-term effects of the programme. The primary outcome is gait speed, and the secondary outcomes are spatial and temporal gait parameters, free living physical behaviour by activity monitoring, mobility performance, activities of daily living, fear of falling, cognitive function, depression and health-related quality of life. Cost-effectiveness analysis is planned. Discussion This paper describes a task specific exercise programme aimed to improve gait and balance after a hip fracture. Inclusion started in February 2011, and the last 1-year follow-up is performed in March 2014. Broad inclusion criteria and physiotherapy-guided home-based exercises may facilitate the participation from frail patients and thereby increase the generalizability of the findings. Development and completion of the intervention within routine clinical practice will enlighten the implementation of results into clinical practice. Results may add new insight into how physiotherapy can improve gait and thereby activity and functioning in everyday life and have implications on future content and organization of physiotherapy after a hip fracture. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To estimate the effect of education on the risk of Alzheimer's disease (AD). Methods 373 patients diagnosed with AD and 559 healthy control individuals without first degree relatives with known dementia, were included in a case-control study (2003–2006). All individuals were genotyped for APOE alleles. Odds ratio (OR) for developing AD was calculated by binary logistic regression, with the number of APOE ℇ4 alleles and educational level as covariates. Analyses were carried out separately for men and women and for different age groups. Results Carriers of one APOE ℇ4 allele had OR of 4.2, and carriers of two APOE ℇ4 alleles OR of 12.4 for developing AD. When adjusted for the number of APOE ℇ4 alleles, OR for developing AD was significantly reduced in participants with 8–9 years of education compared to those with only 6–7 years, and was reduced further for those with 10–18 years of education. These findings were obtained for all the age groups studied and for both men and women. Conclusions Education had a consistently protective effect on the risk of developing clinical AD in a dose-dependent manner in both men and women, and in all age groups, also when adjusting for the number of APOE ℇ4 alleles. Male gender was protective, probably at least in part because of a higher educational level. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract The proper diagnosis of the arrested or the progressive form of hydrocephalus has a critical impact on treatment, but remains difficult. The assessment of early changes in cerebral metabolism might help in the development of adequate non-invasive diagnostic tools. This study examined the alterations in label incorporation in neurotransmitter amino acids and other compounds in kaolin-induced progressive hydrocephalus in rats by means of magnetic resonance spectroscopy (MRS) combined with the administration of [1-[sup 13]C]glucose and [1,2-[sup 13]C]acetate. Some 2, 4 and 6 weeks after kaolin injection into the cisterna magna, cerebrum, brainstem and cerebellum were dissected. Interestingly, labelling of most amino acids derived from [1-[sup 13]C]glucose showed no alterations, whereas labelling from [1,2-[sup 13]C]acetate was affected. Two weeks after induction of hydrocephalus the taurine concentration was decreased, whereas the concentration of [1,2-[sup 13]C]lactate was increased in the cerebrum and that of [1,2-[sup 13]C]GABA in the brainstem. Furthermore, labelling from [1,2-[sup 13]C]acetate was significantly decreased in [4,5-[sup 13]C]glutamate, [1,2-[sup 13]C]glutamate and [1,2-[sup 13]C]GABA in cerebrum from 4 weeks after hydrocephalus induction. The concentration of N-acetylaspartate, a neuronal marker, was unchanged. However, labelling of the acetyl group from [1-[sup 13]C]glucose was decreased in cerebellum and brainstem at 6 weeks after the induction of hydrocephalus. As glucose is metabolized predominately by neurones, whereas acetate is exclusively taken up by astrocytes, these results indicate that mostly astrocytic, and only later neuronal, metabolism is disturbed in the kaolin model of hydrocephalus. If verified in patients using in vivo MRS, impaired astrocyte metabolism might serve as an early indication for operative treatment. [ABSTRACT FROM AUTHOR]

Presents a case of an aged woman with syncope and exertional dyspnea and hypertrophic cardiomyopathy. Overview of a study on the echocardiography of apical hypertrophic cardiomyopathy; Method used in assessing systolic wall shortening and diastolic elongation velocity; Details of the case report; Difference between tissue Doppler and strain rate; Mechanism of late ejection of the apex.

OBJECTIVES: Documentation of treatment effects in acutely sick frail older patients in geriatric evaluation and management units (GEMUs) is scarce. The present study evaluated whether treatment in a GEMU would reduce mortality as compared to traditional treatment delivered in the Department of Internal Medicine. DESIGN: Prospective randomized trial. SETTING: GEMU or general medical ward PARTICIPANTS: Acutely sick frail patients aged 75 and older who had been admitted to the Department of Internal Medicine were randomly assigned to treatment in the GEMU (n = 127) or to the general medical wards (n = 127). The following inclusion criteria were used to target frail patients: chronic disability, acute impairment of single activity of daily living, mild/moderate dementia, confusion, depression, imbalance/dizziness, falls, impaired mobility, urinary incontinence, malnutrition, polypharmacy, vision or hearing impairment, social problems, or prolonged bedrest. INTERVENTION: In the GEMU, the treatment strategy emphasized interdisciplinary assessment of all relevant disorders, prevention of complications and iatrogenic conditions, early mobilization/rehabilitation, and comprehensive discharge planning. The control group received treatment as usual from the Department of Internal Medicine. After discharge neither group received specific follow-up. MEASUREMENTS: Mortality and causes of death. RESULTS: Mortality in the intervention and control groups, respectively, was 12% and 27% at 3 months (P = .004), 16% and 29% (P = .02) at 6 months, and 28% and 34% (P = .06) at 12 months. The hazard ratio was 0.39 (95% confidence interval = 0.21–0.72) at 3 months. The main cause of death was cardiovascular disease. CONCLUSION: Treatment of acutely sick, frail, older patients in a GEMU substantially reduced mortality. [ABSTRACT FROM AUTHOR]