Leisure time physical activity and the risk of pre-eclampsia: a systematic review.

Today, pre-eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality. It has been proposed that leisure time physical activity (LTPA) is associated with a decreased risk of PE. The objective of this study was to perform a systematic literature review examining the association between LTPA before and/or during pregnancy and the risk of PE. A systematic search of the EMBASE and PUBMED databases from inception to November 17, 2011 was conducted by two independent reviewers. Only studies describing the association between the intensity or amount of LTPA before and/or during pregnancy and the risk of PE were included. A narrative synthesis of the results was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A quality assessment was performed using the Newcastle Ottawa Scale. Eleven studies were included. None of the studies found light- or moderate-intensity LTPA to be associated with PE. Three studies reported that vigorous-intensity LTPA before and/or during pregnancy may reduce the risk of PE. One study reported a reduced risk among women who participated in LTPA at least 25 times per month or more than 4 h per week. However, one study found an elevated risk of severe PE with high amounts of LTPA, defined as 4.5 h per week or more. Results are mixed, but high intensity LTPA before and/or during pregnancy or more than 4 h per week of LTPA may reduce the risk of PE. However, an urgent need remains for high-quality studies including different ethnicities to further explore this relationship.

Distribution and predictors of exercise habits among pregnant women in the Danish National Birth Cohort.

Physical activity is recommended during pregnancy, although strong evidence on reproductive health is lacking. We present exercise habits and predictors of exercise during pregnancy. From the Danish National Birth Cohort (1996-2002), 88,200 singleton pregnancies were analyzed in logistic regression. About one-third of the women exercised in early/mid pregnancy and slightly less in late pregnancy. Bicycling, swimming, and low-impact activities were most common. Exercising more than three times per week was strongly correlated with older age, being a student or out of work, eating disorders, moderate alcohol consumption, and a healthy diet. Multiparity, a normal or less good self-rated health, smoking, and a less health conscious diet were the strongest predictors of not doing exercise. Women of 25 years or older, with metabolic or psychiatric disorders, or who had received subfecundity treatment were more likely to increase their activity level substantially from early to late pregnancy than comparison groups. In conclusion, exercising during pregnancy correlated with a number of maternal characteristics. The findings may be used to identify pregnant women not likely to exercise, to target activities that may fit their needs, and, for research purposes, to identify adjustment variables or guide sensitivity analyses when data on confounders are lacking.

Mechanical strength of ceramic scaffolds reinforced with biopolymers is comparable to that of human bone.

Eight groups of calcium-phosphate scaffolds for bone implantation were prepared of which seven were reinforced with biopolymers, poly lactic acid (PLA) or hyaluronic acid in different concentrations in order to increase the mechanical strength, without significantly impairing the microarchitecture. Controls were un-reinforced calcium-phosphate scaffolds. Microarchitectural properties were quantified using micro-CT scanning. Mechanical properties were evaluated by destructive compression testing. Results showed that adding 10 or 15% PLA to the scaffold significantly increased the mechanical strength. The increase in mechanical strength was seen as a result of increased scaffold thickness and changes to plate-like structure. However, the porosity was significantly lowered as a consequence of adding 15% PLA, whereas adding 10% PLA had no significant effect on porosity. Hyaluronic acid had no significant effect on mechanical strength. The novel composite scaffold is comparable to that of human bone which may be suitable for transplantation in specific weight-bearing situations, such as long bone repair.

Smoking and pregnancy-related pelvic pain.

OBJECTIVE: To investigate possible associations between smoking and pregnancy-related pelvic pain. DESIGN: Nested case-control study. SETTING: Denmark 2000-2001. POPULATION: The Danish National Birth Cohort. METHODS: The women were interviewed twice in pregnancy and twice after childbirth. The first pregnancy interview provided information on smoking and possible confounding factors,whereas the first interview after birth addressed case identification.Cases (n = 2302) were defined on the basis of self-reported pelvic pain, and controls were selected among women who did not report pelvic pain (n = 2692). Logistic regression analysis was used to estimate associations between smoking and pelvic pain. MAIN OUTCOME MEASURE: Pregnancy-related pelvic pain. RESULTS: Compared with non-smokers, women who smoked during pregnancy had an adjusted odds ratio of 1.2 (1.0-1.4) for overall pelvic pain, similar to women who stopped smoking in early pregnancy 1.3 (1.1-1.7). The equivalent adjusted odds ratio for severe pelvic pain was 1.2 (1.0-1.5) for smokers, and 1.5 (1.2-1.9)for women who stopped smoking. Smoking intensity, measured as number of cigarettes smoked per day, was associated with pelvic pain in a dose-response pattern. Information about smoking was collected prospectively, which makes it unlikely that differential recall alone explains the results. CONCLUSIONS: Smoking was associated with pregnancy-related pelvic pain, with a dose-response pattern between reported smoking intensity and pelvic pain. These findings suggest a possible new risk factor for a common ailment during pregnancy

Does leisure time physical activity in early pregnancy protect against pre-eclampsia? Prospective cohort in Danish women.

OBJECTIVE: To examine the association between physical activity in early pregnancy and risk of pre-eclampsia. DESIGN: Prospective cohort. SETTING: Denmark. POPULATION: A total of 85,139 pregnant Danish women, recruited between 1996 and 2002. METHODS: The authors assessed leisure time physical activity in first trimester by a telephone interview and categorised women a priori into seven groups: 0 (reference), 1-44, 45-74, 75-149, 150-269, 270-419 and 420+ minutes/week. Pre-eclampsia diagnoses were extracted from the Danish National Patient Registry. A number of potential confounders were adjusted for by logistic regression. MAIN OUTCOME MEASURES: Pre-eclampsia and severe pre-eclampsia. RESULTS: The two highest physical activity levels were associated with increased risk of severe pre-eclampsia compared with the nonexercising group, with adjusted odds ratios of 1.65 (95% CI: 1.11-2.43) and 1.78 (95% CI: 1.07-2.95), whereas more moderate levels of physical activity (1-270 minutes/week) had no statistically significant association with risk of pre-eclampsia (total n = 85,139). CONCLUSIONS: We were unable to document a protective effect of leisure time physical activity against pre-eclampsia. Our data even suggest that leisure time physical activity exceeding 270 minutes/week in first trimester may increase risk of severe pre-eclampsia.

Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort.

OBJECTIVE: To examine the association between leisure time physical exercise during pregnancy and the risk of miscarriage. DESIGN: Prospective study with elements of retrospective data collection. SETTING: Denmark 1996-2002. POPULATION: A total of 92,671 pregnant women enrolled in the Danish National Birth Cohort and interviewed subsequently. METHODS: Data on exercise during pregnancy and potential confounders were obtained through computer-assisted telephone interviews either during pregnancy or after an early miscarriage. Outcome of pregnancy was identified by register linkage. Using Cox regression analysis, we estimated the hazard ratio (HR) of miscarriage according to weekly amount of exercise and the type of exercise. The HR was estimated for <11, 11-14, 15-18, and 19-22 weeks of gestation, respectively. MAIN OUTCOME MEASURES: Miscarriage, defined as fetal loss before 22 completed weeks of gestation. RESULTS: A stepwise increasing relation was found between amount of exercise and risk of miscarriage, where risk of miscarriage increased by amount of exercise up to HR = 3.7 (95% CI 2.9-4.7) for women who exercised more than 7 hours per week compared with nonexercisers. Particularly 'high-impact exercise' was associated with an increased risk of miscarriage. No association was seen between exercise and risk of miscarriage after 18 weeks of gestation. CONCLUSIONS: This study suggests that exercise early in pregnancy is associated with an increased risk of miscarriage. The results should, however, be interpreted cautiously as potential bias arising from retrospective data collection may explain part of the association.

Ligature-induced marginal inflammation around osseointegrated implants and ankylosed teeth: stereologic and histologic observations in cynomolgus monkeys (Macaca fascicularis).

The aim of the investigation was to provide quantitative and qualitative histologic data on marginal inflammation around osseointegrated implants. The significance of the lack of a periodontal ligament in the initial breakdown phase of supporting tissues in implants was examined by comparing stereologic and histologic manifestations of ligature-induced marginal inflammation around osseointegrated implants with those around ankylosed and normal control teeth in 8 cynomolgus monkeys (Macaca fascicularis). Clinical and radiographic findings have been reported elsewhere. The marginal connective tissue around ligated implants was infiltrated by a significantly increased total number of lymphocytes, plasma cells, and neutrophils compared to non-ligated implants and teeth. The total number of lymphocytes around ligated implants was significantly higher than around ligated ankylosed and normal control teeth. There were, however, no significant differences in the total number of plasma cells and neutrophils within the ligated group. Osteoclasts were exclusively observed around ligated implants and ankylosed teeth. Although variations in microbiota and susceptibility of different jaw positions to periodontal break-down may influence the results of the present study, the results seem to substantiate the theory that marginal inflammation around implants and ankylosed teeth may have more serious implications than does marginal inflammation around teeth with a periodontal ligament. Since presence of osteoclasts was not related to the absence of cervical cementum with inserting gingival fibers around ligated ankylosed teeth, the increased susceptibility of bone loss of implants is probably not caused by the absence of these tissue components. In contrast, the histologic observations seem to support that the increased susceptibility for bone loss around implants may be related to the absence of a periodontal ligament.

A custom-made prosthesis for the treatment of supracondylar femoral fractures after total knee arthroplasty: report of four cases.

Four supracondylar femoral fractures following total knee arthroplasty, two because of intraoperative notching of the anterior femoral cortex and two because of osteoporosis, were revised using a custom-made prosthesis with femoral condyle section. At 1-6 year follow-up (median 3 years) after the revision, all patients had an excellent clinical result, although 2 had a prolonged rehabilitation period because of severe osteoporosis. At roentgenographic examination, no signs of loosening of the prostheses at the cement-bone interface were present.

Fumaric and citric acids as feed additives in starter pig diets: effect on performance and nutrient balance.

The effect of dietary citric acid (CA) and fumaric acid (FA) on pig weight gain (ADG) and gain/feed (G/F) was studied in two trials using 192 crossbred, 4-wk-old weaning pigs. Three dietary levels (0, 1.5 or 3.0%) of either FA (Trial 1) or CA (Trial 2) with or without an antibiotic supplement (110 mg chlortetracycline, 110 mg sulfamethazine and 55 mg penicillin/kg diet) formed six treatment combinations in each trial. These six diets were fed to two replicate pens of eight pigs each for a 4-wk period. In Trial 1, ADG was improved (P less than .01) during wk 1, and G/F was improved during wk 1 (P less than .01) as well as during wk 1 to 2 (P less than .05) for pigs consuming FA-supplemented diets. In Trial 2, CA had no beneficial influence on ADG during the 4-wk trial. However, feed intake during wk 1 was depressed (P less than .05) by adding CA, as was G/F during wk 1 to 2 (P less than .05). Based on these results, FA was selected to be used in a nutrient balance study. Twelve 4-wk-old weanling pigs were fed one of three diets: control (C), C + 1.5% FA, or C + antibiotic supplement (A). Diet digestible energy (DE), ME and N-corrected ME (MEN) were not different among treatments. Nitrogen balance, percentage N retained and apparent N digestibility were not affected by dietary treatment. Calcium balance and percentage of Ca retained were unaffected by diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy in diagnosis and treatment of hip disorders.

Fourteen hip arthroscopies between January 1985 and May 1988 were reviewed. Included were ten women and four men with an age ranging from 12 to 76 years. Indications were avascular necrosis; loose bodies; osteoarthrosis, arthritis, or pain; and snapping hip. The diagnosis was verified in five cases, including arthroscopic removal of a loose body in one and resection of a plica bridging the space between the femoral head and acetabular roof in two patients. The diagnosis was rejected in three cases. In five cases, no pathologic changes were found. One arthroscopy was inconclusive because of a narrow field of vision in a dysplastic hip. No serious complications occurred. Hip arthroscopy is useful in diagnostics and surgical treatment of selected hip disorders. The rehabilitation time is short. Hip arthroscopy is, however, a technically demanding procedure.

[Delayed diagnosis of epiphysiolysis capitis femoris]. / Forsinket diagnose af epiphysiolysis capitis femoris.

The prognosis in epiphysiolysis of the head of the femur (ECF) depends on immediate treatment in the earliest stage of the disease. The reasons for and the extent of delayed diagnosis of slipping of the epiphysis in the hip were analysed in 56 children (72 hips) with ECF. The median total delay was six months with a delay of one month due to the patient and delay of three months due to the doctor. Pain in the lower limbs not related to the hip, including pain in the knee, occurred in 1/3 of the patients and resulted in more extensive delays due to the doctor (median four months). Other reasons for delay due to the doctor were erroneous interpretation of the x-ray films (14 patients). The most characteristic clinical finding was limited internal rotation of the affected hip. Comparison with the literature revealed that delay in the diagnosis of ECF has not been reduced during the past 35 years. Clinical examination of the hips should be undertaken in any child who complains of pain in the knee or thigh. If internal rotation is limited, x-ray examination including Lauenstein's projection should be carried out or the child should be referred to a department of orthopaedic surgery on account of suspected hip disease.

[Accidental explosions in Denmark when working on containers for combustible fluids]. / Eksplosionsulykker i Danmark ved bearbejdning af beholdere til braendbare vaesker.

Gases may be formed in containers for inflammable fluids and these may burn explosively if lit. Even apparently empty containers may contain sufficient quantities of gas to result in violent explosions precipitated by procedures which produce heat or sparks in the neighbourhood of the container. Seventeen persons were found to be injured in accidents of this type in a Danish investigation. Two of the accidental injuries proved fatal. The serious risk involved in handling and treating containers which contain or have contained inflammable fluids is, therefore, emphasized.