A 1-year prospective monocentric study of limb, spinal and pelvic fractures: Can monitoring fracture epidemiology impact injury prevention programmes?

OBJECTIVES: The aim of this study was to assess fractures of extremities, spine and pelvis in patients with respect to mechanism, time of the incident and demography of patients in order to propose preventive measures. METHODS: A mono-centric (Level I Trauma Centre, predominantly urban population) prospective study was carried-out during the one-year period from 1 January to 31 December 2012. Patients with bone fractures of extremities, spine and pelvis were studied. Demography, mechanism and time of the injury were analysed. RESULTS: The study group consisted of 3,148 patients, 53% being women and treated for 3,909 fractures. The mean age of patients was 53 years. The most traumatised patients were of the 3rd and 4th decade, a further increase in the incidence of fractures was seen in the 7th and 9th decade. Multiple fractures were significantly higher in men (p = 0.002). A car crash or fall from a height was more common cause of spinal fracture or pelvic fracture than fracture to the upper or lower limbs (p < 0.001). Most of the fractures occurred during the day between 9 a.m. and 6 p.m., on Saturdays and during the winter season. The bones most often broken were the radius (739 patients, 18.5%) and femur (436 patients, 11.1%). CONCLUSIONS: Our study highlights the need for injury prevention focused on sex, age and types of activities performed. Among younger individuals, such programmes should primarily be targeted toward men who, as observed in our sample, have a higher fracture frequency compared to women. Conversely, injury prevention programmes for individuals ≥ 60 years should primarily be targeted toward women, who have the highest fracture prevalence in this population.

Computer Kinesiology: New Diagnostic and Therapeutic Tool for Lower Back Pain Treatment (Pilot Study).

The aim of this study was to demonstrate the effectiveness of the diagnostic and therapeutic medical information system Computer Kinesiology in physiotherapy in patients with low back pain who were not responding to conventional therapy. Computer Kinesiology is primarily intended for the diagnostics and therapy of functional disorders of the locomotor system. This pilot study population included 55 patients (Group 1) with acute and chronic back pain and 51 persons (Group 2) without back pain. The third group was a control group of 67 healthy volunteers with no evidence of musculoskeletal pathologies and no back pain. All 173 subjects were examined three times by the diagnostic part of the Computer Kinesiology method. Groups 1 and 2 were treated after every diagnostics. Group 3 was not treated. The effect was evaluated by H score. Improvements after therapy were defined by reducing the H score by at least 1 point. In Group 1, the H score decreased by at least 1 point in 87.3% (95% CI: 75.5-94.7) and in Group 2 in 78.4% (95% CI: 64.7-88.7). There was no change of distribution of H Score grade in Group 3. The improvement neither depended on gender, age, and BMI nor was it influenced by the length of the therapy. This study demonstrated a high therapeutic efficacy of the Computer Kinesiology system in patients with back pain (Group 1) and in persons without back pain (Group 2) who used the Computer Kinesiology system for primary and secondary prevention of back pain.

Severe childhood burns in the Czech Republic: risk factors and prevention.

OBJECTIVE: To assess risk factors for paediatric burn injuries in the Czech Republic and to suggest preventive measures. METHODS: This study included all children aged 0-16 years hospitalized during 1993-2000 at the Prague Burn Centre and data from the Czech Ministry of Health on national paediatric burn hospitalizations during 1996-2006. Personal, equipment and environmental risk factors were identified from hospital records. FINDINGS: The incidence of burn admissions among 0-14 year-olds increased from 85 to 96 per 100,000 between 1996 and 2006, mainly due to a 13% increase among 1-4 year-olds. Between 1993-2000 and 2006, the proportion of burn victims in the country hospitalized at the Prague Burn Centre increased from 9% to 21%. Detailed data were available on 1064 children (64% boys). Around 31% of all burn hospitalizations were in 1 year-olds. Some 79% of burns occurred at home: 70% in the kitchen, 14% in the living room or bedroom and 11% in the bathroom. Of the 18% occurring outdoors, 80% involved boys. Scalds from hot liquids accounted for 70% of all burns. The mean hospital stay was 22 days for boys and 18 days for girls. CONCLUSION: Most burns involved scalds from hot liquids at home: beverages in kitchens and water in bathrooms. There is a need for passive preventive measures, such as redesigned domestic cooking and eating areas, safer electrical kettles and temperature control devices for bathrooms. Educational programmes should be developed for parents and caregivers. A national plan for child burn prevention with specific targets would be helpful.

Long term correlation between cancer and cardiovascular deaths according to various trends in Slovak districts 1994-2003.

The aim of the article was to point out recorded cardiovascular deaths did not copy the real number of cardiovascular deaths, but may also include other causes of deaths. We evaluated all death notifications reported to the Statistical Office of the Slovak republic during the 10-year period, that is 519,680 cases in total. We analysed the year of death, location of death and the cause of death. The causes of deaths were split into three groups: cancer deaths, cardiovascular deaths (CVD) and other deaths. We used the fuzzy c cluster analysis and the basic epidemiological and statistical methods for the evaluation. We uncovered some Slovak districts had long-term higher mortality (Lucenec, Rimavská Sobota, Roznava, Trebisov and Krupina), as well as the other districts having the long-term lower mortality (Bratislava, Kosice, almost all Zilina region, Poprad, Spisská Nová Ves and Dunajská Streda). The cancer and cardiovascular deaths significantly correlated in terms of the Slovak districts. Evaluating the mutual causes of death proportion we identified two groups of Slovak districts; the first group of districts showing higher CVD deaths had lower cancer and other deaths, the second having higher proportion of cancer and other deaths reached the lower CVD deaths. It seems deaths have the similar pattern throughout the whole country, and the numerical differences are probably given only by the quality and the quantity of the death certification.

The effect of dance on depressive symptoms in nursing home residents.

OBJECTIVE: To evaluate the effect of a dance-based therapy on depressive symptoms among institutionalized older adults. DESIGN: Randomized controlled trial. SETTING: Nursing homes. PARTICIPANTS: Older adults (60 years or older) permanently living in a nursing home. INTERVENTION: Exercise Dance for Seniors (EXDASE) Program designed for the use in long-term care settings performed once a week for 60 minutes for 3 months. MEASUREMENTS: Baseline measures included sociodemographic characteristics, ability to perform basic as well as instrumental activities of daily living, basic mobility, self-rated health, and cognitive status. Outcome measures were collected before and after the intervention and included assessment of depressive symptoms using the geriatric depression scale (GDS). RESULTS: Comparison of participants with MMSE of 15 or higher showed that GDS scores in the intervention group significantly improved (P = .005), whereas the control group had a trend of further worsening of depressive symptoms (P = .081). GLM analysis documented highly statistically significant effect of dance therapy (P = .001) that was not influenced by controlling for intake of antidepressants and nursing home location. Dance therapy may have decreased depressive symptoms even in participants with MMSE lower than 15 and resulted in more discontinuations and fewer prescriptions of antidepressants in the intervention group than in the control group. CONCLUSION: This study provides evidence that dance-based exercise can reduce the amount of depressive symptoms in nursing home residents. In general, this form of exercise seems to be very suitable and beneficial for this population.