Olof Risto

Fibroblast proliferation due to exposure to a platelet concentrate in vitro is pH dependent

The influence of platelet‐rich plasma lysates on fibroblast proliferation was studied in culture. Cells were exposed to platelet lysates that had been preincubated at different pHs (5.0, 7.1, and 7.6). Proliferation was evaluated with the MTT assay and incorporation of [3H]thymidine into macromolecules, while type I collagen production was assayed by Western blotting. Enzyme‐linked immunosorbent assays were used to determine platelet‐derived growth factor and transforming growth factor‐β concentrations. Platelets preincubated in an acidic environment (pH 5.0) induced the highest degree of fibroblast proliferation, and the concentration of platelet‐derived growth factor in the different treated lysates was the highest at that particular pH. The concentration of transforming growth factor‐β, however, was lower after incubation at pH 5.0 than at either pH 7.1 or 7.6. These findings may be relevant to normal wound healing in vivo and useful in the treatment of wounds and delayed healing processes. (WOUND REP REG 2002;10:336–340)

Evaluation of a child safety program based on the WHO Safe Community model

Objectives: To evaluate the outcome of the World Health Organization (WHO) Safe Community model with respect to child injuries. Study design: A population based quasiexperimental design was used. Cross sectional pre-implementation and post-implementation data were collected in intervention (Motala municipality) and control (Mjölby municipality) areas, both in Östergötland county, Sweden. Results: The total relative risk of child injury in the intervention community decreased more (odds ratio 0.74; 95% confidence interval (CI) 0.68 to 0.81) than in a control community exposed only to national level injury prevention programs (0.93; 95% CI 0.82 to 1.05). The relative risk of moderately (abbreviated injury scale (AIS) 2) severe injury in the study area was reduced to almost a half (odds ratio 0.49; 95% CI 0.41 to 0.57), whereas the risk of minor (AIS 1) injuries decreased only slightly (odds ratio 0.89; 95% CI 0.80 to 0.99). The risk of severe or fatal (AIS 3–6) injuries remained constant. Conclusions: After introduction of an injury prevention program based on the WHO Safe Community model, the relative risk for child injury in the intervention community decreased significantly more than in a control community exposed only to national injury prevention programs.

Heterotopic bone formation prevented by diclofenac: Prospective study of 100 hip arthroplasties

A double-blind, placebo-controlled study was done on the influence of diclofenac, a nonsteroidal anti-inflammatory drug, on heterotopic bone formation after total hip arthroplasty. Totally, 100 operations were involved, and a follow-up was performed after 1 year. There were no cases of substantial bone formation in the treated group versus two thirds of the cases in the placebo group, and some of these had pain. Because side effects of treatment with diclofenac are few and mild, we advocate prophylactic use of this drug.

Evaluation of single event multilevel surgery and rehabilitation in children and youth with cerebral palsy - A 2-year follow-up study

Purpose. This study evaluated multilevel surgery and rehabilitation with functional measures and health related quality of life (HRQOL) of children and youth with cerebral palsy (CP). In addition this study evaluated parents satisfaction with care. Method. A prospective single-subject study with AB design and 2-year follow-up, included 11 children between 8 and 18 years old with CP, Gross Motor Function Classification System I–III. Visual analyses were used to present physical function with Physical Cost Index (PCI). Descriptive statistics were used to present number of children with a clinically important change in Gross Motor Function Measure (GMFM), self-reported walking ability, and HRQOL with child health questionnaire (CHQ). Results. PCI showed a trend of lower energy cost during gait in six children and GMFM was unchanged for 10 children and improved for one child. Walking ability was improved in 10 children. Gait distance increased in all 11. Both physical and psychosocial dimensions of CHQ improved in six of nine (two missing data). Expectations of outcomes were fulfilled in seven and partly fulfilled in four. Satisfaction with care was fulfilled in 10 of 11. Conclusion. Self-reported walking ability improved after multilevel surgery and intensive rehabilitation. This result was partly supported by lower energy cost and improved HRQOL. Expectations and satisfaction were fulfilled for the majority of children.

Time- and pH-dependent release of PDGF and TGF-ß from platelets in vitro

We studied the spontaneous and thrombin-induced activation of platelets and their release of platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) at different pH values. Platelet activation was assayed with anti-bodies against P-selectin and performed in serum-free media. The release of PDGF and TGF-β was determined by ELISA after 15 min and 12 h. There was no activation at pH 5.0, while a time-dependent release of growth factors occurred at neutral and alkaline pH. The results suggest that release of growth factors is not only dependent on platelet activation but also on incubation time and pH. Although the used serum-free experimental situation is different from normal conditions for platelets in vivo, the findings of a late release of growth factors may, nevertheless, be relevant to wound healing.

Effect of platelet derived growth factor on heterotopic bone formation in rats

Platelet derived growth factor (PDGF) and induction of newly woven bone growth were studied in rats. PDGF (20 ng/mL) was administered continuously for 2 weeks via micro-osmotic pumps to 6-mm-long pieces of demineralized rat femur inserted into muscle pouches. Each rat had a control piece of demineralized bone inserted into the contralateral gluteal muscle. The samples were collected after 4 weeks, and wet and ash weight were recorded. Fourteen rats were evaluated. There were no differences as regards wet weights. PDGF increased the ash weights.

Injury incidence in a men's elite bandy league : An epidemiological study of a full regular season

Bandy is a popular European winter team‐sport. The best bandy teams participate in semi‐professional leagues, where the play‐off games attract more than 10 000 spectators. Injury patterns in elite bandy have not been investigated previously. The aim of this study is to examine the incidence and types of injuries sustained during elite bandy games for men. Twelve of the 16 teams in the Swedish elite bandy league during the 2002 season participated in the study. In total, 36 injuries were recorded, corresponding to 7.3 injuries/1000 player game hours and 5.7 injuries/1000 athlete exposures. Collision was the most common injury cause (47%), while contusion was the most common injury type (25%), followed by fracture (22%) and ligament rupture (19%). The study showed that the injury incidence in elite bandy is low, but also that the injuries that are still sustained are relatively severe. This pattern can be explained by the fact that even though bandy rules do not allow body checks, collisions between skaters moving at high speeds still cause the majority of injuries. Further studies of the injury rehabilitation practices, and the implementation and evaluation of safety programs in elite bandy are warranted.

Injuries in competitive youth bandy: an epidemiological study of a league season.

PURPOSE Bandy, with a century-long tradition in northern Europe, is a winter team-sport similar to ice hockey. To investigate the occurrence of injuries during competitive youth bandy games, injury incidence, injury types, and age-related risks were analyzed for one youth league season. METHODS The National Athletic Injury/Illness Reporting System (NAIRS) definition of sports injury was used for the injury registration. All 416 games during the 1999-2000 season in the Swedish southeastern youth bandy league were included in the study. Primary data was collected by a questionnaire and completed by the team coaches after each game. At the end of the season, physician interviews with each team coach were performed to assure that no injuries had been missed as well as to ascertain whether there was any remaining disability. RESULTS In total, 2.0 injuries (95% confidence interval 1.2-2.9 injuries) per 1000 player game hours were recorded. Sixty-eight percent of the injuries caused the injured player to be absent from bandy play for more than a week. Collision was the most common cause of injury (36%), and contusion was the most common injury type (41%). The injury incidence in the leagues for older players (Youth 14 -Youth 16) was slightly higher than in the leagues for the younger players (Youth 12 -Youth 13), while participation by under-aged players in games organized for older players led to an almost four-fold increase of injury risk. For severe injuries, the mean rehabilitation time away from bandy practice or competition was 27 d (range 8-56 d). CONCLUSION The overall injury incidence during youth bandy games is low, but the injuries that occur cause extensive absences from the only four months long bandy season. From a public health perspective, bandy can be recommended for consideration when physical exercise is to be promoted among school-age children in countries with a winter climate.

Elderly men with a history of distal radius fracture have significantly lower calcaneal bone density and free androgen index than age-matched controls

Background: Age related bone loss is widely accepted as related to decreased serum levels of circulating sex hormones. Epidemiological data also show distal radius fractures in men to be a sensitive marker of bone fragility. The aim of this study was to assess if men with a history of distal radius fracture have lower bone mass density (BMD), lower free androgen index (FAI), lower total testosterone (T) and lower bio-available testosterone (Bio-T) than healthy age-matched controls. Patients and methods: A case-control study is based on consecutive cases treated for low energy distal radius fracture at our department and age-matched controls. Thirty-nine men treated between 1997–2004 and 45 age-matched controls underwent calcaneal bone density measurements (t-score) and analyses of T, Bio-T and serum hormone binding globulin (SHBG). Results: The fracture group had lower BMD (p < 0.01) and lower FAI (p = 0.01). Linear regression analysis showed a correlation between Bio-T and t-scores (p = 0.03). Using analysis of covariance, a significant difference with lower Bio-T in the fracture group was shown. Conclusion: Bio-T seems to correlate with BMD in elderly men and may serve as a marker for increased fracture risk in this patient group.

Towards safe environments for youth sports: Impact of a fair play programme on injury rates in youth bandy

Commitment to a sport can help adolescents stay out of dangerous social environments and thus also provide access to an arena for peer socialization and conflict resolution (Chen et al. 2004). The foundation for this arena for socialization is sportsmanship, a concept that has been described as a conduct during sports activities that increases rather than detracts the pleasure that both one’s self and fellow participants find in the sport (Keating 1995). It is based on the understanding that sport basically is a diversion that has for its direct end fun and pleasure and that a spirit of moderation and generosity should dominate it. Fair play is used to denote an institutionalized form of sportsmanship, where the constitutive rules of the sport are extended by the fact that athletes accept a responsibility for the internal interests of the particular sport and sporting community (Butcher and Schneider 1998). Keeping injury rates down is in the internal interest of any sport. Accordingly, from amateur and professional soccer (Junge et al. 2004) to women’s rugby (Comstock and Fields 2005), the importance of addressing fair play in the prevention of injury has been emphasized. The aim of this study is to examine the injury rates before and after the implementation of an educational fair play intervention in a youth bandy league. Bandy is a winter team sport played with skates and sticks on ice. It is played on an ice area that is the size of a soccer pitch and also with rules and a team composition similar to soccer. In Sweden (population nine million), there were in 2005 about approximately 22 000 bandy players, most of them youths and including many girls (figure 1).