Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis.

We investigated the timeline of functional recovery after hip fracture over 12 months in adults age ≥ 65 years using objective lower extremity function tests and subjective physical functioning. Objective functional recovery was largely complete in the first 6 months, whereas subjective recovery improved up to 9 months after hip fracture. INTRODUCTION: Hip fractures are a major cause of loss of function among seniors. We assessed the timeline of objective and subjective functional recovery after hip fracture. METHODS: We conducted a prospective observational secondary analysis of a 1-year clinical trial on vitamin D and home exercise treatment and complications after hip fracture among 173 patients age ≥ 65 years (mean age 84 years; 79.2% women; 77.4% community-dwelling) conducted from January 2005 through December 2007. Lower extremity function (Timed Up and Go test (TUG), knee extensor and flexor strength) and grip strength was assessed at baseline and at 6 and 12 months follow-up. Subjective physical functioning was assessed using the SF-36 questionnaire also at 3 and 9 months follow-up. Multivariable-adjusted repeated-measures models were used to assess the timeline of functional recovery in the total population and in subgroups of patients. RESULTS: Lower extremity function including TUG (- 61.1%), knee extensor (+ 17.6%), and knee flexor (+ 11.6%) strength improved significantly in the first 6 months (P < 0.001). However, between 6 and 12 months, there was no further significant improvement for any of the functional tests. Grip strength decreased from baseline to 6 months (- 7.9%; P < 0.001) and from 6 to 12 months (- 10.8%; P < 0.001). Subjective physical functioning improved from 3 to 9 months (+ 15.2%, P < 0.001), but no longer thereafter. CONCLUSIONS: Functional recovery after hip fracture may be largely complete in the first 6 months for objective functional tests, whereas may extend up to 9 months for subjective recovery, with oldest-old, female, institutionalized, and cognitively impaired patients recovering most poorly. CLINICAL TRIALS REGISTRY (ORIGINAL TRIAL): NCT00133640.

[Surface properties of serum in case of premature onset of labour (author's transl)]. / Oberflächeneigenschaften des Serums bei vorzeitigem Wehenbeginn.

Fifty-eight pregnant women with premature onset of labour were compared to 149 women with normal course of pregnancy. Surface activity of the serum in the former group was found to be higher than that in the latter. The information obtained from determining the hysteresis curve of the serum by means of Wilhelmy's balance was much more complete than that recordable from surface tension with 20 per cent surface expansion (gamma minimum). An analysis was made, at the same time, of those serum parameters with highest surface activity, such as free fatty acids and lecithin. Their growth in concentration was found to coincide with onset of labour proper rather than with a condition in which the organism simply exhibited a trend towards premature labour. Hence, measurement of serum surface tension proved to be the more sensitive parameter by which to predict forthcoming premature labour. The actual cause underlying such behaviour so far has remained unelucidated, since an extremely sophisticated process has to be assumed to take place on the serum surface. These studies, consequently, have not been completed. They are likely, however, to provide some preliminary hints on quite peculiar serum changes in concomitance with premature labour or with the trend to it.