[Growth hormone therapy is useful even for adults].
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Adult↗
Biomedical subjects
M Kataja
Publications and source records attributed to M Kataja.
Functional vs. radical maxillary surgery. Failures after functional endoscopic sinus surgery.
Randomized FES or Caldwell-Luc (C-L) operations were performed in 150 patients suffering from chronic maxillary sinusitis during 1987-1989. Follow-up examination was done for 143 patients (95%) 1 year postoperatively. Although 15 patients had already deceased, questionnaires were obtained from 128 patients (85%) 5-9 years after operation. One year after surgery 51% of the C-L patients and 77% of the FES patients reported no symptoms or distinct improvement in their global symptoms, whereas 5-9 years postoperatively 82% of the C-L and 76% of the FES patients reported this outcome, respectively. Thirteen C-L operated patients (18%) and 14 FES patients (20%) have been reoperated during 7-9 years follow-up. In most cases revision surgery was done for polyposis or maxillary sinusitis. In the long term, altogether 21 patients (28%), including 14 reoperated patients, were failures after FES. These included also 4 patients with global symptoms unchanged at late inquiry and 3 other patients, though getting better, reported unwillingness for FES operation if they had known the result beforehand.
Chronic Disease↗
Treatment-related factors predisposing to chronic pain in patients with breast cancer--a multivariate approach.
A study was carried out to assess the factors predisposing to chronic post-treatment pain in the breast area and in the ipsilateral arm in patients treated for breast cancer using two multivariate models. In the study 509 patients with non-metastasized breast cancer who were treated during 1988-1994 completed the questionnaire about pain in the operated breast and in the ipsilateral arm 10-58 months after surgery. The factors included in the analysis were: age, type of operation, size of the tumour, number of lymph nodes removed, involvement of lymph nodes, complications of surgery, intensity of the acute postoperative pain remembered by the patient, number of doses of analgesics, number of months from surgery, adjuvant radiotherapy, chemotherapy and endocrine treatment. The most important factors included in the models of chronic pain were: intensity of the acute postoperative pain, the type of operation, involvement of regional lymph nodes and radiotherapy.
Adult↗
Efficacy and safety of spirapril, a new ace-inhibitor, in elderly hypertensive patients.
OBJECTIVE: To compare the safety, efficacy, tolerability and duration of the antihypertensive effect of an ACE-inhibitor spirapril 3 mg or 6 mg in elderly (> or = 60 y) hypertensive patients in a multicentre, observational, double-blind randomised study. METHODS: After a four-week placebo period, 39 patients were randomised to six weeks of treatment with spirapril 3 mg and 47 patients with spirapril 6 mg. RESULTS: In the sitting position the mean (SD) decrease in systolic blood pressure (SBP) was 12(15) mmHg (95% confidence interval 7 to 17 mmHg) and in diastolic blood pressure (DBP) 10(7) mmHg (8 to 12 mmHg) in the 3-mg group and 10(13) mmHg (6 to 14 mmHg) and 9(7) mmHg (7 to 11 mmHg), respectively, in the 6-mg group (P < 0.001 compared to placebo period in both groups). Spirapril 3 mg and 6 mg produced DBP < or = 90 mmHg or a fall > or = 10 mmHg in 53% and 51% of the patients, respectively. DBP was < or = 90 mmHg in 36% and SBP < or = 160 mmHg in 67% of the patients taking 3 mg and in 26% and 63% of the patients taking 6 mg spirapril. The most commonly reported adverse effects were cough (13-17%), dizziness, headache and insomnia. A trend to a more frequent adverse effects was observed in patients receiving spirapril 6 mg. Spirapril was both cholesterol- and glucose-neutral. CONCLUSIONS: According to our study, spirapril 3mg seems to be a suitable starting dose for the treatment of hypertension in the elderly patients.
Aged↗
Preoperative prediction of postoperative morbidity in coronary artery bypass grafting.
BACKGROUND: The risk factors of patients selected for coronary artery bypass grafting have increased in recent years because of the aging population. Prediction of postoperative complications is essential for optimal use of the available resources. The aim of this study was to develop a scoring method for prediction of postoperative morbidity of individual patients undergoing bypass grafting. METHODS: Data from 386 consecutive patients who underwent coronary artery bypass grafting in a single center were retrospectively collected. The relationship between the preoperative risk factors and the postoperative morbidity was analyzed by the Bayesian approach. Three risk indices (15-factor and seven-factor computed and seven-factor manual models) were developed for the prediction of morbidity. The criterion for morbidity was a prolonged hospital stay postoperatively (> 12 days) because of adverse events. RESULTS: The best predictive preoperative factors for increased morbidity were emergency operation, diabetes, rhythm other than sinus rhythm on the electrocardiogram or recent myocardial infarction, low ejection fraction (< 0.49), age greater than 70 years, decreased renal function, chronic pulmonary disease, cerebrovascular disease, and obesity. The sensitivity of the scoring methods ranged from 51% to 72% and the specificity, from 77% to 86%. CONCLUSIONS: The results show that individual patients can be stratified according to postoperative risk for complications on the basis of preoperative information that is available for most patients.
Age Factors↗
Prevalence of tooth agenesis and peg-shaped maxillary lateral incisor associated with palatally displaced canine (PDC) anomaly.
Fifty-eight nonsyndromic North American white orthodontic patients with palatal displacement of one or both maxillary canine teeth were studied for associated tooth agenesis and peg-shaped maxillary lateral incisors. Agenesis of permanent teeth was identified by x-ray film analysis. Conical crown-size reduction (peg-shape anomaly) of the maxillary lateral incisor (l2) was determined by direct observation. Increases in absence of third molars and second premolars associated with the palatally displaced canine (PDC) anomaly were statistically very highly significant compared with normative data for tooth-agenesis prevalence. In contrast, the prevalence of l2 agenesis in the PDC sample showed no difference statistically compared with reference values. Reasons for this posterior site-specific suppression of tooth formation are not clear. The l2 peg-shape anomaly exceeded a 10-fold elevation in expression in the PDC sample, a very highly significant increase from normal prevalence. The findings are consistent with a hypothesis that the anomalies of tooth agenesis, tooth-size reduction, and PDC are biologic covariables in a complex of genetically related dental disturbances.
Adolescent↗
Site-specificity of tooth agenesis in subjects with maxillary canine malpositions.
Tooth agenesis (hypodontia) was studied in two samples of nonsyndromic subjects possessing either maxillary canine-first premolar transposition (Mx.C.P1; N=43, M9:F34) or palatal displacement of the maxillary canine (PDC; N=58, M21:F37). Agenesis of permanent teeth was identified by x-ray film analysis. Significantly elevated tooth-agenesis frequencies were noted in both samples. Statistically significant differences between the Mx.C.P1 and PDC samples were found in locations of absent teeth, indicating site-specificity of tooth agenesis associated with these canine malpositions. In Mx.C.P1, agenesis of third molars (M3) occurred at a near-normal rate (19%) while maxillary lateral incisor (I2) agenesis showed a thirteen-fold increase (26%). In PDC, the prevalence rate for associated M3 agenesis was 40%, twice the normal rate, while I2 agenesis was 3%, a slight elevation of no statistical significance. These new findings may warrant a hypothesis of anteroposterior site-specific shift in the occurrence of tooth agenesis, associated genetically or epigenetically with distinct anomalies of maxillary canine position and possibly other abnormalities.
Adolescent↗
Tortuous flow in porous media.
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Journal Article↗
Falls among institutionalized elderly--a prospective study in four institutions in Finland.
We analyzed prospectively the incidence, the intrinsic and extrinsic factors and the consequences of falls during a 7-month period in 4 institutions in Finland in 1993. A total of 370 falls among 160 patients were recorded. Of the fallers 56% fell once and 44% more than once (range 2-24). The mean fall rate in men was higher than that in women (p < 0.01). Fallen men were younger but less ambulatory than women. Of the falls 95% occurred without eyewitness and 27% during the night shift; 30% (114/370) resulted in an injury and 7% (11/160) of the fallers suffered a fracture.
Accidental Falls↗
Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland.
A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.
Adolescent↗
Is continuous intranasal salmon calcitonin effective in treating axial bone loss in patients with active rheumatoid arthritis receiving low dose glucocorticoid therapy?
OBJECTIVE: To investigate the efficacy of intranasal salmon calcitonin (sCT) in treating axial bone loss in patients with rheumatoid arthritis (RA) taking low dose glucocorticoids. METHODS: In this open, multicenter study 32 women with RA were treated one year with sCT 100 IU/day and calcium (Ca) 500 mg/day; 31 women were treated with Ca alone. Bone mineral density (BMD) was measured at the lumbar spine and proximal femur (femoral neck, Ward's triangle, trochanter) before sCT therapy and again after 6 and 12 months. RESULTS: Among valid completers treated with sCT and Ca (n = 26), the mean BMD increased at the lumbar spine (L1-L4), femoral neck, and Ward's triangle. In contrast, valid completers treated with Ca (n = 23) showed bone loss at the spine (L1-L4), femoral neck, Ward's triangle, and trochanter area. The differences of the changes in BMD were statistically significant between these groups at the femoral neck, Ward's triangle, and trochanter. There were no significant differences between groups in bone loss over 12 months at the lumbar spine (L1-L4), although analysis of the upper segment (L1-L2) suggested some possible benefit of sCT. CONCLUSION: Intranasal sCT (100 IU/day) appears to have beneficial effects on bone loss at the proximal femur in patients with active RA treated with low dose glucocorticoids for 12 months; longer studies are needed to exclude transient bone remodelling effects.
Administration, Intranasal↗
Pain and other symptoms after different treatment modalities of breast cancer.
PURPOSE: The aim of this study was to analyse the risk factors that predispose women to chronic symptoms related to the treatment of breast cancer. PATIENTS AND METHODS: A questionnaire was sent to 569 women who had undergone modified radical mastectomies with axillary evacuation (MRM) or breast resection with axillary evacuation (BCT). RESULTS: Pain, paraesthesias and strange sensations were reported by half of the patients. The chronic pain slightly affected the daily lives of about 50% of the patients and moderately or more the daily lives of about 25% of the patients. Pain was reported significantly more often after BCT than after MRM both in the breast scar (BS) and in the ipsilateral arm (IA). The patients with chronic pain were significantly younger and had larger primary tumours. Postoperative complications increased the incidence of chronic pain in the IA. The highest incidence of pain in the IA was reported by patients who had had both radio- and chemotherapy. The fact that the incidence of pain (IA) had a significant correlation with the incidence of paraesthesias, oedema, strange sensations and muscle weakness may be an indication of nerve injury. CONCLUSIONS: Chronic pain was more common after breast-conserving surgery than after radical surgery. Surgical complications and postoperative radiotherapy and chemotherapy increased the risk of chronic pain and other symptoms. Modifications in the treatment protocol and preclusion of postoperative complications may be necessary in order to minimize chronic treatment-related symptoms.
Adult↗
No differences in the incidences of old people's hip fractures between urban and rural populations--a comparative study in two Finnish health care regions in 1989.
In a prospective study, incidences of hip fractures among the aged in urban and rural populations were compared in two health care regions in Finland in 1989. Both the administrative and the more informative functional classification of the municipalities were used. During 1989, a total of 366 patients, aged 55 years and above, who had a permanent place of domicile in either one of the two health care regions, were treated for a fresh hip fracture. In both regions women sustained 80% of the fractures. No significant differences were found in the incidences of hip fractures between the urban and rural populations. However, a significant difference was found in the mean incidence between the towns of the two health care regions (t = 4.228, d.f. = 6, p < 0.01).
Aged↗
Incidence of pelvic fractures in Finland in 1988.
In 1988, 1212 patients with an acute pelvic fracture were registered in Finnish hospitals for primary treatment. The overall incidence in women was 29/10(5) and in men 20/10(5). The female to male ratio was 2.9 in patients who were over 49 years of age, while in younger age groups the ratio was 0.5. Half of the cases were pubic fractures. In half of the cases the mechanism of injury was a fall and in one quarter a traffic accident. Slightly more than half of the cases were stable and half of the cases were of moderate severity. The average length of hospital stay varied from 17 days in men to 21 days in women.
Accidental Falls↗
Sense and nonsense regarding palatal canines.
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Cuspid↗
Four-year survival after hip fractures--an analysis in two Finnish health care regions.
We studied the survival of 390 patients with fresh hip fractures sustained in 1989 by a population of about 441 thousand in two health care regions in Finland during four years. The most significant explanatory factors of mortality were place of injury, place after primary treatment and age. The excess mortality of men compared with the reference population at one year was 21% and in women 16%. After this, the excess mortality rates increased slowly in both sexes and were 37% for men and 24% for women at four years. In those who had sustained the fracture in a traffic accident the mortality at four years was slightly lower than that in the reference population, and in those who had sustained the fracture in other accident outdoors there was a 10% excess mortality. Patients who had sustained the injury at home had at four years a 25% and those who had sustained the injury in institutions a 46% excess mortality. The excess mortality at four years was lowest in those who were discharged home (14%) and highest in those who were discharged to other institutions (27%).
Adult↗
The palatally displaced canine as a dental anomaly of genetic origin.
Palatal displacement of the maxillary canine tooth is a positional variation thought generally to develop as a result of local factors, such as retained deciduous canines, anomalous permanent lateral incisors, or dental crowding. This article contributes biologic evidence pointing to genetic factors as the primary origin of most palatal displacements and subsequent impactions of maxillary canine teeth. Data gathered from multiple sources are integrated to support a genetic etiology for the palatally displaced canine (PDC) on the basis of five evidential categories: 1. Occurrence of other dental anomalies concomitant with PDC; 2. Bilateral occurrence of PDC; 3. Sex differences in PDC occurrence; 4. Familial occurrence of PDC; 5. Population differences in PDC occurrence. From analysis of available evidence, the PDC positional anomaly appears to be a product of polygenic, multifactorial inheritance.
Cuspid↗
Risk of infection with Mycobacterium tuberculosis among children and mothers in Somalia.
The prevalence of infection with Mycobacterium tuberculosis in prewar Somalia was surveyed by testing the tuberculin sensitivity of 2,792 infants and children and 446 mothers in two towns: Burao in the dry north and Kismayo in the humid south. Sensitivity increased with age, but considerable differences prevailed between the towns. In Burao a roughly linear increase in sensitivity was found, with no sensitivity in infancy, sensitivity in 19% of children at 7 years, and sensitivity in 54% of children at 15 years; in Kismayo the corresponding figures were 9%, 28%, and 47%, respectively. Together, the correlation of prior BCG vaccination with a positive tuberculin test in Burao and the lack of these findings in Kismayo suggested that vaccination had partly failed in Kismayo, where living conditions also favored the transmission of M. tuberculosis. The annual risk of M. tuberculosis infection was approximately 1% higher in the south than in the north and was much higher during the first 3 years of life than later. This study--the first defining the risk of M. tuberculosis infection among children of various ages in Somalia--indicates that this risk is greatest in the southern parts of the country and among infants and young children.
Adolescent↗