Sense of coherence (SOC) related to health and mortality among the very old: the Umeå 85+ study.

We describe associations between sense of coherence (SOC) and sense of well-being, diseases, physical function and the predictive value of SOC on depression and mortality. The study included 190 participants, aged 85-103 years. Linear correlation analysis was used for relationships between SOC scores and continuous variables. The effects of SOC score on 1- and 4-year mortality, as well as on depression at the 5-year follow-up, were investigated using Cox regression models. The mean SOC score was 71.8±10.2 (±S.D.). SOC score was positively related to well-being (p≤0.001). Heart failure (p=0.009), chronic obstructive pulmonary disease (p=0.015), depression (p=0.015), and osteoarthritis (p=0.032) were significantly associated with low SOC scores, as were high scores on the Geriatric Depression Scale (GDS) (p=0.002). One-year mortality was significantly associated with the SOC score (OR=0.945, confidence interval (CI)=0.898-0.995, p=0.032), while the 4-year mortality was not (OR=0.995, CI=0.973-1.018, p=0.674). The SOC score did not predict depression at 5-year follow-up (OR=0.977, CI=0.937-1.018, p=0.267). Strong SOC was associated with well-being in this group of old people. Low SOC was found among those with diseases known to have a negative influence on daily life.

Influence of design variations on early migration of a cemented stem in THA.

UNLABELLED: The clinical results of using different cemented stems in total hip arthroplasty may vary because of shape, surface finish, and choice of metal alloy. Less is known about the influence of size and offset using one and the same design. Data from 140 patients (140 hips) of a cohort constituting 197 patients (231 hips) implanted with cemented Spectron Primary stems were extracted from patients studied in four randomized studies primarily designed for other purposes. Stem size (1, 2, 3, or larger), normal/extra offset, neck length and true offset (horizontal length between the stem and head center of the inserted modular implant) were recorded in millimeters. The radiographic appearance of the cementing was graded on the immediate postoperative radiograph according to Barrack. The patients were examined with radiostereometric analysis of stem migration for a 2-year followup period. Stem Size 1 (the smallest) showed an insignificant increase in subsidence compared with the bigger sizes. Using stepwise linear regression analysis, the quality of the cementing (Barrack C2) was the only parameter that had any certain influence of the subsidence at 2 years. Stem size 2 tended to show minimum valgus alignment and sizes 1 and 3 and bigger showed minimum varus tilting. Our findings suggest that placement of the stem with the tip against the posterior cortex (C2) and stem size influence the primary fixation in different ways. This effect is small, however, indicating that further confirmation with longer followup is necessary. LEVEL OF EVIDENCE: Therapeutic Level II-1 (prospective cohort study). See the Guidelines for Authors for a complete description of levels of evidence.