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Biomedical subjects

L Halme

Publications and source records attributed to L Halme.

50 records · Page 3Linked to original sources
PubMed1994

Gingival and dental status, salivary acidogenic bacteria, and yeast counts of patients with active or inactive Crohn's disease.

To investigate dental, gingival, and salivary aspects during an exacerbation of Crohn's disease, 53 patients with long-standing Crohn's disease were clinically, endoscopically, and radiologically examined. The patients were divided in two groups: 32 patients had active disease and 21 patients had inactive disease. Oral examination of the patients did not reveal any statistically significant differences in gingival or dental indexes between the groups, but patients with active disease tended to have higher scores of gingivitis than patients with inactive disease despite the fact that the patients with active disease were younger than those in remission. No differences between the groups were observed in salivary flow rate or buffering capacity. Lactobacilli and yeast counts of saliva tended to be higher among patients with active disease than with inactive disease, but the difference between the groups was significant only for high mutans streptococci counts.

Adult↗
PubMed1994

Late biliary stenosis after conservative management of traumatic liver rupture: case report.

An extensive liver rupture developed in a 50-year-old woman after she received severe blunt injuries in a criminal assault. Nonsurgical management of the liver injury led to recovery of the patient despite a serious blood loss and multiorgan failure. However, 3 months after the injury a complete left bile duct stenosis with liver dysfunction and two hepatic artery pseudoaneurysms were found. Biliodigestive bypass restored normal liver function.

Aneurysm, False↗
PubMed1993

Good long-term results in patients surviving severe acute pancreatitis.

Thirty-seven patients treated for severe acute pancreatitis were investigated a mean of 6.2 years after the attack; 30 were found to be in good condition and 24 were working normally. Two-thirds of previously heavy drinkers had either reduced their intake considerably or become abstainers. The main complication observed on follow-up was diabetes mellitus, which affected 20 patients and required insulin treatment in nine. Of the remaining patients, four were taking oral antidiabetic agents and seven were on a strict diabetic diet. Before severe acute pancreatitis none had been diabetic. All patients who underwent resection of the pancreas developed diabetes. In 21 of 24 patients with over or imminent diabetes, pancreatitis had been primarily alcoholic in origin. Polyneuropathy, as diagnosed by clinical signs and/or neurophysiological tests, was observed in six patients, all of them heavy drinkers. It is concluded that patients with severe acute pancreatitis have a high chance of returning to normal activity and productive work. These results serve to encourage all those involved to persist with the exacting work involved in treating such patients.

Acute Disease↗
PubMed1993

Oral findings in patients with active or inactive Crohn's disease.

The frequency and type of oral mucosal lesions, dental infections, and salivary constituents were evaluated in 53 patients with Crohn's disease, who were divided into inactive, mildly active, and severely active groups on the basis of clinical and endoscopic criteria. Buccal biopsies from nine patients with active disease showed morphologic changes that suggested Crohn's disease-related lesions. Panoramic radiographs revealed more infectious foci in the teeth of patients with active Crohn's disease than in patients with inactive disease. Salivary flow rate, buffering capacity, total protein, amylase, and IgA and IgG concentrations did not differ with respect to the activity of Crohn's disease. The observed mucosal inflammation in patients with active Crohn's disease, although high in frequency, was mild and did not need therapy, but the great number of dental infections in association with the activity of Crohn's disease should be taken into account in the treatment of these patients.

Adult↗
PubMed1993

Concentrations of pancreatic secretory trypsin inhibitor (PSTI), acute phase proteins, and neopterin in Crohn's disease. Comparison with clinical disease activity and endoscopical findings.

The usefulness of pancreatic secretory trypsin inhibitor (PSTI) as a marker of chronic inflammation was studied in patients with Crohn's disease. Pancreatic secretory trypsin inhibitor was compared with other laboratory tests (C-reactive protein, orosomucoid, and urinary neopterin), for evaluation of disease activity as measured by a clinical scoring system and endoscopical findings. The clinical utility of the tests was compared by four different methods. All tests showed significant differences in laboratory values between inactive and severely active disease. Using earlier established cut-off values PSTI showed the best combination of sensitivity and specificity for differentiation between inactive and severely active disease. When the efficacy of the test was compared by ROC-curve analysis, neopterin and orosomucoid produced the best combination of sensitivity and specificity, but for both assays the earlier established cut-off levels were too high for optimal separation between active and inactive disease. There was a poor agreement between endoscopically and clinically determined disease activity and the laboratory tests correlated better with clinical activity. The present study shows that serum PSTI reflects changes in the clinical activity of Crohn's disease equally well as C-reactive protein, which previously has been found to be an useful index of disease activity.

Adult↗
PubMed1993

Increased urinary excretion of iohexol after enteral administration in patients with ileal Crohn's disease. A new test for disease activity.

Iohexol is a water-soluble contrast medium that is partly absorbed/permeated through mucosa of the small bowel and excreted unchanged in the urine. Iohexol was administered orally to 12 patients with Crohn's disease of the ileum and to 10 healthy controls to measure its excretion in the urine. The location and activity of Crohn's disease were determined by barium double-contrast radiography in all patients and by ileoscopy and biopsy in 9 patients. Iohexol concentrations in serum and 24-hour urine were measured using reversed phase high-performance liquid chromatography. Urinary excretion of iohexol was significantly greater in patients with active Crohn's disease than in controls. We suggest this method as a new way of measuring Crohn's disease activity and mucosal damage in the small bowel. Bowel inflammation and mucosal cell damage are strongly indicated if the iohexol excreted in the urine is over 1% of the oral intake.

Administration, Oral↗
PubMed1992

Pancreatic surgery, not pancreatitis, is the primary cause of diabetes after acute fulminant pancreatitis.

Acute fulminant pancreatitis is associated with significant morbidity and mortality. To examine the outcome of conservative and surgical treatment of this disorder, 36 patients who survived an initial episode were restudied after a mean of six years. Fifty three per cent had developed diabetes mellitus, half of whom required insulin therapy. Pancreatic resection was associated with a 100% frequency of diabetes, while only 26% of those treated with peritoneal lavage developed this (p less than 0.001). Insulin secretion and sensitivity were assessed using the hyperglycaemic glucose clamp technique. First phase insulin secretion was impaired in surgically treated patients (mean (SEM) 14 (5) microU/ml x 10 minutes) compared with conservatively treated patients and control subjects (144 (66) and 87 (12) microU/ml x 10 minutes, respectively; p less than 0.05). Second phase and 'maximal' insulin secretion were also impaired among the surgically treated patients compared with the conservatively treated patients and the controls. Insulin sensitivity was reduced among the surgically treated patients (2.88 (58) mg/kg.minute) when compared with conservatively treated patients and healthy control subjects (5.87 (1.02) and 6.45 (0.66) mg/kg.minute; p less than 0.05). Pancreatic resection is associated with a very high frequency of diabetes compared with peritoneal lavage, and these results favour conservative treatment of active fulminant pancreatitis whenever possible.

Acute Disease↗
PubMed1990

Development of acute myelocytic leukemia in patients with Crohn's disease.

In our hospital within one year two patients with Crohn's disease were seen who developed an acute myelocytic leukemia. A review of the literature reveals eight previously reported patients with both Crohn's disease and leukemia. Six of the reported 10 patients have had acute myelocytic leukemia and, interestingly, three of them, including our two patients, have shown monocytic differentiation (FAB type M4). It has been suggested that the relative risk of leukemia, especially acute myelocytic leukemia, is increased in patients suffering from ulcerative colitis. More data of patients with Crohn's disease and acute leukemia are needed to evaluate the possible association between these diseases.

Crohn Disease↗
PubMed1989

The incidence of Crohn's disease in the Helsinki metropolitan area during 1975-1985.

The hospital incidence of Crohn's disease in the Helsinki metropolitan area during 1975-1985 was studied retrospectively. The resident population in this urban, well-defined district was 790,000 in the year 1985. During this period 193 new patients suffering from Crohn's disease were diagnosed. The annual incidence increased three times from 1/100,000 to 3/100,000, while the annual mean incidence was 2,3/100,000. The age-specific incidence was highest in the age-groups 15-24 with no sex difference. After the initial rapid increase the incidence of Crohn's disease in the Helsinki metropolitan area has stabilized on the level 3/100,000. These figures are similar to those reported from other Scandinavian and Western countries.

Adolescent↗