Background: Ultrasound diagnostics in muscuskeletal injuries has been more popular in recent years. Clinical examination after anamnesis is the basics for a correct diagnosis although in combination with muscuskeletal ultrasound diagnostics (MSKUL) diagnose can be more precise. This study will show how MSKUL can be a complement to physical testing with a brief history overwiew, pros and cons and areas of use. Objective: The aim of this study was to summerize scientific litterature with focus on how ultrasound diagnostics can amplify and increase accuracy of an physioterapeutic examination on muscuskeletal injuries and how it can be a complement to the physical examination. Method: Design: Descriptive litterature study. Review on what ultrasound disgnostics is and how it can be a help in determing correct diagnosis in different muscuskeletal injuries to respond to the objective of this study. Results: A total of six articles was included in the result compilation which aims to respond to the objective of this study. All articles were retrieved from PubMed and most articles were reviews with the focus on how diagnostics with ultra sound can amplify and increase the accuracy af the physioterapheutic examination in muscuskeletal injuries, and how ultra sound can complement the clinical examination and what the benefits are in relation to other assesments. Conclusion: Muscuskeletal ultra sound diagnosis is a valuble tool in physiotherapy on muscuskeltal injuries. It can increase the accuracy in diagnosis and complement the clinical examination by finding pathology that can`t be found thru a clinical examination. Keywords: Muscuskeletal ultra sound, ultra sound diagnostics, sports injuries, power doppler ultra sound, radiation, physical therapy.

Bakgrund: I Sverige utförs cirka 40 000 koronarangiografier årligen. I samband med koronarangiografi används intraarteriellt jodkontrastmedel. Tyreoidea (sköldkörteln) är avgörande för metabolismen och hormonproduktionen kan påverkas av jod-injicering. Skador och biverkningar på tyreoidea efter jodkontrast tillförsel är inte lika omdiskuterat som inducerade njurskador. Syfte: Syftet var att sammanställa hur tyreoidea påverkas av intraarteriellt jodkontrastmedel efter koronarangiografi.Metod:Denna studie genomfördessom en allmän litteraturstudie. Databaserna PubMed och Cinahl användes och totalt inkluderades och analyserades 10 vetenskapliga artiklar i resultatet. Resultat:Studiens resultat sammanfattades i två kategorier; Patienter med “eutyroid (frisk) tyreoidea” och patienter med “avvikande tyreoidea” före studiernas start. Resultatet för varje kategori visade hur tyreoidea påverkades efter en koronarangiografi med jodkontrastmedel. Båda kategorierna visade att det förekom patienter som utvecklade olika former av tyreoideadysfunktion. Slutsats: Rapportens resultat samstämmer med de nationella rekommendationerna för jodkontrastmedel att hänsyn ska tas till patientens tyreoideastatus före en koronarangiografi. Detta för att eventuellt kunna premedicinera riskpatienter och uppmana remittenten om uppföljning av fritt T3, fritt T4 och TSH.

Aim

The aim of this pilot study was to evaluate two new retelling tasks intended for clinical use in terms of language sample size, effects of picture support, and order of presentation.

Methods

Forty Swedish-speaking children in grades 4–6 participated in the study, 31 children with typical language development (TLD, mean age 11;1), and nine children with developmental language disorder (DLD, mean age 11;5). Two oral retells, one with and one without picture support, were analyzed with regards to productivity, syntactic complexity, basic Story Grammar (SG) units, and Internal Responses (IR).

Results

Results showed no systematic order effects in the TLD group, although this needs to be investigated further, and good inter-rater reliability. Both tasks elicited sufficiently large language samples, except from one participant with DLD whose samples were excluded from subsequent comparisons. When appropriate, data were analyzed with ANOVA (productivity, mean length of C-unit/MLCU), otherwise t-tests (TLD-group) or non-parametric tests (DLD-group) were used. As expected, retells from participants with DLD were shorter, with shorter MLCU and fewer SG units compared to the TLD group. There were also task effects: in the task with picture support, all participants had longer MLCU, and participants with TLD also showed a higher proportion of subordinate clauses, indicating that pictures may function as a support for syntactic complexity. The task without picture support, on the other hand, elicited more C-units indicated by a significant main effect, and more SG units, which was a significant effect in the TLD group.

Conclusions

We conclude that both tasks might be useful for Swedish speech-language pathologists.

Abstrakt

Bakgrund: Forskning visar att generell anestesi kan bidra till kognitiv dysfunktion postoperativt. En alltför djup anestesi och/eller en lång duration av anestesi är två faktorer som kan inverka på kognitionen med besvär såsom minnesproblem och koncentrationssvårigheter. Anestesisjuksköterskans roll är att individanpassa anestesin för att inte orsaka för djup anestesi och därmed har det blivit alltmer vanligt att monitorera anestesidjupet för att minska på onödigt lidande för patienten. Syfte: Syftet är att kartlägga anestesidjup och anestesiduration  hos patienter med självskattad  kognitiv svikt efter elektiv ortopedisk operation. Metod: För att kartlägga detta valdes en retrospektiv observationsstudie med tvärsnittsdesign med insamlad data från kvalitetsregister. Resultat: Av 920 patienter var det 116 patienter som uppgav kognitiv dysfunktion dag 1 postoperativt och upp till över 16 dagar postoperativt med  ett genomsnittsvärde på 37,7 i entropy och 104,4 minuter i anestesiduration. Slutsats: Desto längre duration av anestesin och ju djupare anestesi desto mer kognitiv påverkan postoperativt. Anestesidjupsmonitorering bör användas mer frekvent och önskvärt är att bedöma kognition preoperativt med ett mätinstrument för att kunna se om skillnad finns postoperativt.

Purpose - The aim of the study was to measure the sense of coherence in people with overweight or obese. Method - The study design was quantitative and used the SOC-29 (Sense of Coherence Scale) questionnaire. SOC-29 is based on the salutogenic model created by Aaron Antonovsky. It measures sense of coherence via a seven-point Likert scale. Results - A total of 152 people answered the survey and after dropouts there remained 126. The results of this study show that people with a BMI >28 have a lower sense of coherence than the average value for a Swedish population. Distribution in the study due to SOC scores was as follow: High SOC 6% (n = 7), moderate SOC 23% (n = 29), low SOC 60% (n = 76) and weak SOC 11% (n = 14). The comparison between SOC and age groups showed that older age groups had higher SOC compared the younger ones. Conclusion - Based on our results, people with a BMI >28 have a lower SOC than the average value for a Swedish population. The result also shows a tendency between high SOC and increased age. More research is needed in the area to reduce stigmatization and generalization of the cause of overweight or obesity as well as what the cause is behind the degree of perceived health.

Background This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction.

Methods A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire.

Results Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

Objective: To investigate whether professional athletes with post-concussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) have elevated cerebrospinal fluid (CSF) and plasma neurofilament light (NF-L) and tau as compared to controls, and whether elevated concentrations of these biomarkers are associated with persistent PCS.

Background: Recently, CSF NF-L and tau have been reported to increase following acute repetitive head trauma. However, whether these biomarkers are elevated in CSF and plasma of athletes with PCS following rcTBI is unknown.

Design/Methods: A total of 109 participants (31 professional athletes with PCS due to rcTBI, 48 concussed athletes without PCS, and 30 non-concussed athletic controls) were enrolled between September 2013 and September 2017. Athletes with PCS due to rcTBI also underwent paired CSF and plasma biomarker assessments, Rivermead Post-Concussion Symptoms Questionnaire (RPQ), and structural MRI of the brain (median, 1.5 years since last concussion).

Results: Plasma NF-L concentrations were significantly increased in both the concussed and PCS group as compared with athletic controls. Among athletes with PCS, the highest concentrations of NF-L were observed in athletes with PCS > 1 year as compared to those with PCS < 1 year (area under the receiver-operating characteristics, 0.85). Furthermore, plasma concentrations of NF-L correlated with RPQ scores and lifetime number of concussions. In contrast, CSF and plasma concentrations of tau were not associated with injury severity or duration of PCS. Consistently, CSF NF-L correlated with corresponding plasma (r = 0.81, P < 0.001), while there was no significant correlation between CSF tau and corresponding plasma.

Conclusions: Persistent PCS due to rcTBI is associated with axonal injury, which can be monitored by measuring NF-L in plasma samples months to year after last concussion. From a clinical standpoint, incorporation of plasma NF-L in the work-up may aid in distinguishing patients at increased risk of developing persistent PCS.

Disclosure: Dr. Shahim has nothing to disclose. Dr. Tegner has nothing to disclose. Dr. Blennow has nothing to disclose. Dr. Zetterberg has nothing to disclose.

Exoskeletons are wearable devices that enhance or supplement the user’s natural abilities. They have been demonstrated to be efective in alleviating pain, reducing work related injuries, improving working conditions, and can play a pivotal role in improving recovery times and recovery outcomes. Commercial exoskeletons are expensive, specialised and not easily accessible to the average user. This thesis describes the design and manufacturing processes for the OpenXO, an open-source knee exoskeleton. The focus of the thesis is the design and manufacture of the exoskeleton drive system. It implements a cycloidal drive design. Additionally, a method of designing tapered crossed roller bearings was developed that allows for easy integration into elements of the drive system. The open source aspect is further supported by designing the OpenXO around commercially available additive manufacturing technologies. Rapid prototyping and iterative test-based design methods were used in conjunction with empirical testing and validation of both the design and manufacturing methods. Performance validations were conducted on an unpowered exoskeleton. The tests focus on ease of use and comfort. Validation on the exoskeleton and its components was performed at various stages during the design process. The resulting drive design was signifcantly lighter than commercially available solutions. The stator design implemented allows for press ft accuracy between the rotor and stator while allowing for smooth rotation. The fully assembled exoskeleton was tested by 5 individuals. All participants performed tasks to test the usability the exoskeleton in common day to day activities. The participants managed to perform several tasks with ease. However, the exoskeleton was prone to misalignment in specifc circumstances. Gait analysis on a user wearing the exoskeleton shows that the exoskeleton does infuence gait patterns. However, the user does not experience signifcant impact on their perceived range of motion. These tests do not demonstrate the efectiveness of the exoskeleton when it comes to powered assistance. Further work is needed to test and validate the powered assist functionality of the exoskeleton.