Family history of psychosis and social, occupational and global outcome in schizophrenia: a meta-analysis.

OBJECTIVE: We aimed to investigate associations between family history of psychosis and long-term occupational, social and global (i.e. combined occupational, social and clinical) outcome in schizophrenia. METHOD: A systematic search to identify potentially relevant studies was conducted using seven electronic databases and a manual search of literature. Only observational studies with a follow-up period of at least 2 years were included. RESULTS: The search identified 4081 unique potentially relevant articles, of which 14 met our inclusion criteria. The presence of family history of psychosis was associated with poor occupational and global outcome (n=3; r=0.17; P=0.008, n=11; r=0.13; P=0.002, respectively). CONCLUSION: This was the first systematic review on the effects of family history of psychosis on occupational and social outcome in schizophrenia. Based on the review, the presence of family history of psychosis has a relatively small but statistically significant association with long-term occupational and global outcome in patients with schizophrenia.

Cervical hip fracture in a Finnish population: incidence and mortality.

BACKGROUND AND AIMS: Our aim was to describe the incidence of cervical hip fractures and to describe the relationships between selected background variables and mortality at 30 days, 6 months, and 3 years postoperatively. MATERIAL AND METHODS: The basic material consisted of population-based data set of patients aged 65 years or older who had sustained a hip fracture and were treated operatively between 1999 and 2000. Out of these, we identified 266 consecutive patients with cervical hip fracture. RESULTS: The age-adjusted incidence of cervical hip fractures in women was 1.3-fold compared to men. In age-adjusted analysis, occurrence of chronic lung disease, cardiovascular disease or 2-5 comorbidities, male gender, the need for 2-person mobility assistance, and poor ambulation postoperatively were associated with excess mortality at least at one evaluation point. CONCLUSIONS: Only chronic lung disease and male gender were independent predictors of increased mortality at each follow-up assessment in multivariate analysis.

The impact of proximal femur geometry on fracture type--a comparison between cervical and trochanteric fractures with two parameters.

INTRODUCTION: Only a few studies have tested the ability of proximal femur geometry parameters to discriminate between cervical hip fractures and those of the trochanter. The main objective of this study was to evaluate the geometrical differences between these two fracture types by measuring the neck shaft angle (NSA) and the femoral neck axis length (FNAL). We also compared the distributions of these parameters and the distributions of fracture type by gender. MATERIAL AND METHODS: A retrospective analysis was made in a population-based material of 428 hip fractures collected during a two-year period from 1999 to 2000 (323 women and 105 men aged 65 years or older). NSA and FNAL were manually measured from pelvic radiographs. RESULTS: No significant differences in NSA or FNAL were found between cervical and trochanteric hip fractures in women or in men. Men had significantly higher NSA and FNAL than women. Age was not related to these geometrical parameters. The distributions by fracture type were similar in both genders. CONCLUSIONS: The different pathogenesis of cervical and trochanteric hip fractures cannot be explained by NSA or FNAL. A standardized measurement setup is needed when evaluating the role of hip geometry in fracture patients.

Incidence of hip fractures among the elderly in Satakunta, Finland.

BACKGROUND AND AIMS: The aim was to describe the incidence rate of hip fractures in the elderly in a specific region in Finland and circumstances around them. MATERIAL AND METHODS: Retrospective analysis of 461 women and men aged 65 or older undergoing an operation for hip fracture during a two-year period between 1999 and 2000. 80 variables in all were obtained from the hospital discharge register and patient documents. RESULTS: The age-specific incidence of hip fractures was higher in women than in men (women 6.88/1000 person/y vs. 3.50/1000 person/y). Prior to the fracture, patients were primarily doing well; 63.4% lived at home and 65.1% used no mobility equipment or aids. Altogether 41.9% of hip fractures occurred in institutions. Both women and men more often suffered their injury indoors (91.1% and 75.7% respectively), and only a slight seasonal variation was observed. More than every fourth (26.9%) had experienced a previous fracture. CONCLUSIONS: The age-specific incidence of hip fractures was higher in women than in men. The fractures took place mostly indoors and often in institutions. Therefore the measures that impact on indoor safety are particularly important for the elderly.

Coregulation of neurite outgrowth and cell survival by amphoterin and S100 proteins through receptor for advanced glycation end products (RAGE) activation.

Amphoterin is a protein enhancing process extension and migration in embryonic neurons and in tumor cells through binding to receptor for advanced glycation end products (RAGE), a multiligand transmembrane receptor. S100 proteins, especially S100B, are abundantly expressed in the nervous system and are suggested to function as cytokines with both neurotrophic and neurotoxic effects. However, the cell surface receptor for the cytokine function of S100B has not been identified. Here we show that two S100 family proteins, S100B and S100A1, activate RAGE in concert with amphoterin inducing neurite outgrowth and activation of transcription factor NF-kappaB. Furthermore, activation of RAGE by amphoterin and S100B promotes cell survival through increased expression of the anti-apoptotic protein Bcl-2. However, whereas nanomolar concentrations of S100B induce trophic effects in RAGE-expressing cells, micromolar concentrations of S100B induce apoptosis in an oxidant-dependent manner. Both trophic and toxic effects are specific for cells expressing full-length RAGE since cells expressing a cytoplasmic domain deletion mutant of RAGE are unresponsive to these stimuli. These findings suggest that activation of RAGE by multiple ligands is able to promote trophic effects whereas hyperactivation of RAGE signaling pathways promotes apoptosis. We suggest that RAGE is a signal-transducing receptor for both trophic and toxic effects of S100B.