PubMed Health⌕ Search

Biomedical subjects

S Niemela

Publications and source records attributed to S Niemela.

9 recordsLinked to original sources
PubMed2006

Use of sedation for routine diagnostic upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy Survey of National Endoscopy Society Members.

BACKGROUND/AIMS: Sedation rates may vary among countries, depending on patients' and endoscopists' preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives' endoscopy units. RESULTS: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders' endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available 'in most of the endoscopy units' in 46% (13/28) of the countries. Though they were available in 91% of the national representatives' endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. CONCLUSIONS: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.

Procedural Sedation↗
PubMed2002

Effect of CD14 promoter polymorphism and H. pylori infection and its clinical outcomes on circulating CD14.

CD14 is a pattern recognition receptor on the membranes of monocytes and macrophages for several microbial products, of which lipopolysaccharide (LPS) is the best known. A shed form of CD14 is present in serum. As the CD14 gene promoter polymorphism -159C/T and some bacterial infections may affect the sCD14 levels, we compared the impact of both the CD14 promoter polymorphism and Helicobacter pylori infection on serum sCD14 levels in 201 dyspeptic patients (group 1) who had undergone gastroscopy, and 127 staff members (group 2) with no endoscopy. sCD14 was measured from the sera by a commercial enzyme immunoassay (EIA), and CD14 genotyping was carried out with PCR. Helicobacter pylori infection was detected by serology and/or culture or PCR. sCD14 levels were elevated in the subjects carrying the T allele (CT or TT genotype) in both groups when compared with subjects with the CC genotype. Overall, H. pylori-positive subjects tended to have higher sCD14 levels compared with H. pylori-negative subjects. In group 1 consisting of dyspeptic patients, those with gastric ulcer, gastric erosion or duodenal ulcer had significantly elevated levels of sCD14 compared with the patients with normal endoscopic findings or macroscopic gastritis. The recent use of NSAIDs was also associated with enhanced sCD14. Thus, we were able to show several factors, one genetic and the other environmental (H. pylori infection and mucosal lesion), to have an impact on sCD14.

Adult↗
PubMed1997

Risk of malignancy and death in neurofibromatosis.

OBJECTIVE AND METHODS: Neurofibromatoses are cancer-prone hamartomatoses that involve a variety of tissue and cell types. As part of a population-based clinical and genetic study of neurofibromatosis in northern Finland, all surgical and autopsy specimens of neurofibromatosis patients were retrieved and histologic slides were reviewed. RESULTS: Specimens were available for 69 of the 197 neurofibromatosis type 1 patients identified. Six malignant peripheral nerve sheath tumors and nine other malignant tumors were detected. In this study, the risk for neurofibromatosis-related malignancy was 8%. Nine neurofibromatosis type 1 patients died, at a mean age of 37 years. The cause of death was related to neurofibromatosis in eight. CONCLUSIONS: The risk of developing malignant tumors and early death is increased in patients with neurofibromatosis, the most common malignancy being malignant peripheral nerve sheath tumors. These risks need to be recognized, and the families should be advised to seek genetic counseling and proper follow-up.

Adolescent↗
PubMed1989

[Biological testing and clinical assessment of composite restorations].

The vital-microscopic acute pulp test in rat incisors did not show any toxic effects of the light-curing composite material Lux-a-fill, independent of the remaining dentin thickness. The clinically controlled 2-year study of restorations of cavity class I, III, IV and V have yielded good results in the front teeth region. In addition to the clinical study a micromorphological follow-up study of the surface morphology was performed in cavity class I, and small restorations have been found clinically acceptable after 2 years. Despite of the good results further medium term studies are needed for extended restorations in posterior teeth. The combination of biological application tests in an adequate animal experiment and highly standardized clinical studies is a important prerequisite for the introduction of new filling materials.

Animals↗
PubMed1983

Antibiotic resistance among different species of fecal coliforms isolated from water samples.

The distribution of resistance to ampicillin, chloramphenicol, sulfonamides, tetracycline, and streptomycin among fecal coliforms in sewage, surface waters, and sea water was investigated. The incidence of resistant strains among isolates varied significantly among the water samples, without obvious connection with the water source or the level of pollution. The average frequency of multiple resistance was not always high in the same samples in which the overall resistance was high. The species composition varied considerably in different water samples. A significant correlation was observed between the relative frequency of Klebsiella species and the incidence of ampicillin resistance in water samples. The importance of species composition of fecal coliforms, affected by their source and by the aquatic environment, on the resistance pattern is noted.

Anti-Bacterial Agents↗