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Biomedical subjects

T Aalto

Publications and source records attributed to T Aalto.

18 recordsLinked to original sources
PubMed2001

Exposure of Listeria monocytogenes within an epidemic caused by butter in Finland.

Data on the levels of bacteria and the amounts of food consumed in food-borne outbreaks provides an excellent opportunity to study the effects of exposure to Listeria monocytogenes. Between June 1998 and April 1999, an outbreak caused by L. monocytogenes serotype 3a in butter occurred in Finland. The majority of the cases were immunocompromised and hospitalized at the Helsinki University Central Hospital (HUCH), where 7-g butter packages produced by a dairy plant were used as the only butter brand. The butter had also been sold to 10 other central hospitals as well as to the retail market. Based on the data on hospital stay, butter consumption and the qualitative and quantitative analyses of L. monocytogenes in butter, the attack rates and exposure were estimated. Incubation studies on the naturally contaminated small butter packages showed that the levels found in the packages at the time of detection of the outbreak could reliably be used for these estimations. However, the levels of L. monocytogenes in 500-g packages increased. The attack rate among HUCH patients varied from 70 to 117 cases per 1000 patients at risk, depending on which estimate of the contamination level of butter (100-60%) was used. The highest single dose (7.7 x 10(4) CFU in one meal) could have been sufficient to cause the listeriosis cases at HUCH. However, this data also supports another hypothesis, according to which these listeriosis cases were caused by a prolonged daily consumption of contaminated butter during the hospital stay. The estimated daily dose, based on the hospital kitchen data or the highest detected level in a wholesale sample (11,000 CFU/g), would have varied from 1.4 x 10(1) to 2.2 x 10(3) CFU/day or from 2.2 x 10(4) to 3.1 x 10(5) CFU/day, respectively. The choice of the hypothesis has a crucial impact on the interpretation of this data for the dose-response estimations as well as for the discussion on Food Safety Objectives. Due to the susceptibility of hospital patients, special care must be taken in order to avoid even low levels of L. monocytogenes in food served.

Butter↗
PubMed2001

Effect of electrocardiographic left ventricular hypertrophy on left ventricular systolic function in systemic hypertension (The LIFE Study). Losartan Intervention For Endpoint.

Left ventricular (LV) ejection fraction is normal in most patients with uncomplicated hypertension, but the prevalence and correlates of decreased LV systolic chamber and myocardial function, as assessed by midwall mechanics, in hypertensive patients identified as being at high risk by the presence of LV hypertrophy on the electrocardiogram has not been established. Therefore echocardiograms were obtained in 913 patients with stage I to III hypertension and LV hypertrophy determined by electrocardiographic (Cornell voltage duration or Sokolow-Lyon voltage) criteria after 14 days' placebo treatment. The 913 patients' mean age was 66 years, and 42% were women. Fourteen percent had subnormal LV endocardial shortening, 24% had subnormal midwall shortening, and 13% had reduced stress-corrected midwall shortening. Nineteen percent had normal LV geometry, 11% had concentric remodeling, 47% had eccentric hypertrophy, and 23% had concentric hypertrophy. LV systolic performance evaluated by LV endocardial shortening and midwall shortening was impaired in 10% of patients with normal geometry, 20% with concentric remodeling, 27% with eccentric hypertrophy, and 42% with concentric hypertrophy. Relative wall thickness, an important independent correlate of LV chamber function, was related directly to endocardial shortening and negatively to midwall shortening and stress-corrected midwall shortening. LV mass was the strongest independent correlate of impaired endocardial shortening, midwall shortening, or both. In hypertensive patients with electrocardiographic LV hypertrophy, indexes of systolic performance are subnormal in 10% to 42% with different LV geometric patterns. Depressed endocardial shortening is most common in patients with eccentric LV hypertrophy, whereas impaired midwall shortening is most prevalent in patients with concentric remodeling or hypertrophy. Thus, in hypertensive patients with electrocardiographic LV hypertrophy, impaired LV performance occurs most often, and is associated with greater LV mass and relative wall thickness and may contribute to the high rate of cardiovascular events.

Aged↗
PubMed2000

An outbreak of Listeria monocytogenes serotype 3a infections from butter in Finland.

In February 1999, an outbreak of listeriosis caused by Listeria monocytogenes serotype 3a occurred in Finland. All isolates were identical. The outbreak strain was first isolated in 1997 in dairy butter. This dairy began delivery to a tertiary care hospital (TCH) in June 1998. From June 1998 to April 1999, 25 case patients were identified (20 with sepsis, 4 with meningitis, and 1 with abscess; 6 patients died). Patients with the outbreak strain were more likely to have been admitted to the TCH than were patients with other strains of L. monocytogenes (60% vs. 8%; odds ratio, 17.3; 95% confidence interval, 2.8-136.8). Case patients admitted to the TCH had been hospitalized longer before cultures tested positive than had matched controls (median, 31 vs. 10 days; P=.008). An investigation found the outbreak strain in packaged butter served at the TCH and at the source dairy. Recall of the product ended the outbreak.

Adolescent↗
PubMed2000

Impact of different partition values on prevalences of left ventricular hypertrophy and concentric geometry in a large hypertensive population : the LIFE study.

Left ventricular (LV) hypertrophy and concentric remodeling have been defined by using a variety of indexation methods and partition values (PVs) for LV mass and relative wall thickness (RWT). The effects of these methods on the distribution of LV geometric patterns in hypertensive subjects remain unclear. Echocardiograms were obtained in 941 patients with stage I to III hypertension and LV hypertrophy by ECG. LV mass was calculated by using different methods of indexation for body size and different PVs to identify hypertrophy: LV mass/body surface area (g/m(2)) PV for men/women 116/104, 125/110, or 125/125; LV mass/height (g/m) PV 143/102 or 126/105; and LV mass/height(2.7) (g/m(2.7)) PV 51/51 or 49.2/46.7. RWT was calculated by either 2xend-diastolic posterior wall thickness (PWT)/end-diastolic LV internal dimension (LVID) or end-diastolic interventricular septum dimension+end-diastolic PWT/end-diastolic LVID. LV hypertrophy or remodeling was present in 63% to 86% of subjects, and LV hypertrophy was present in 42% to 77%. By any index, eccentric hypertrophy was the common LV geometric pattern. Use of interventricular septum dimension+PWT/LVID to calculate RWT slightly increased the prevalence of normal geometry and eccentric hypertrophy compared with the use of 2xPWT/LVID. Subjects with LV hypertrophy identified by only LV mass/height(2.7) PV 49.2/46.7 were more obese, whereas those identified by only LV mass/body surface area PV 116/104 were taller and thinner than those in the 2 concordant groups with or without LV hypertrophy by both criteria. By either criterion, there were no significant differences between different LV geometric patterns in clinical cardiovascular disease. Hypertensive patients with LV hypertrophy by ECG have a high prevalence of geometric abnormalities, especially eccentric hypertrophy, irrespective of method of indexation or PV. LV mass indexation by body surface area or height(2.7) identifies lean and obese subjects, respectively. We found no difference in prevalent cardiovascular disease in subjects identified by either criterion, suggesting a similar high risk.

Aged↗
PubMed1999

A three-dimensional stomatal CO2 exchange model including gaseous phase and leaf mesophyll separated by irregular interface

A three-dimensional model was constructed for studying the diffusion of CO2 molecules from air into stomatal air spaces and further into leaf mesophyll cells. The model covers two different phases, mesophyll and air, with appropriate boundary conditions. Sinks for CO2 molecules were obtained from a well-known biochemical photosynthesis model parametrized for Scots pine. The effects of the varying stomatal geometry on the CO2 flux and intercellular-air-space (IAS) and mesophyll concentrations were examined. The net CO2 flux is sensitive to the size of the IAS-mesophyll interface when the mesophyll transport coefficient is low, equalling the diffusivity of CO2 in water. The simulations have revealed an optimum between the volume of the assimilating mesophyll and the air-mesophyll interface. The solubility of CO2 molecules into water in the cell surfaces, which depends on temperature and pH, had a clear effect on the flux. Increasing pH from the value indicated by the physical solubility (pH reverse similar6) leads to an increase in the temperature maximum for CO2 flux into higher temperatures and to unrealistically high CO2 concentrates in the mesophyll. Copyright 1999 Academic Press

Journal Article↗
PubMed1995

Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters.

OBJECTIVE: To determine the relationship between different physical loading conditions and findings of knee osteoarthritis (OA). METHODS: We selected 117 male former top-level athletes (age range 45-68 years) who had participated in sports activities with distinctly different loading conditions: 28 had been long-distance runners, 31 soccer players, 29 weight lifters, and 29 shooters. Histories of lifetime occupational and athletic knee loading, knee injuries, and knee symptoms were obtained, and subjects were examined clinically and radiographically for knee findings of OA. RESULTS: The prevalence of tibiofemoral or patellofemoral OA based on radiographic examination was 3% in shooters, 29% in soccer players, 31% in weight lifters, and 14% in runners (P = 0.016 between groups). Soccer players had the highest prevalence of tibiofemoral OA (26%), and weight lifters had the highest prevalence of patellofemoral OA (28%). Subjects with radiographically documented knee OA had more symptoms, clinical findings, and functional limitations than did subjects without knee OA. By stepwise logistic regression analysis, the risk for having knee OA was increased in subjects with previous knee injuries (odds ratio [OR] 4.73), high body mass index at the age of 20 (OR 1.76/unit of increasing body mass index), previous participation in heavy work (OR 1.08/work-year), kneeling or squatting work (OR 1.10/work-year), and in subjects participating in soccer (OR 5.21). CONCLUSION: Soccer players and weight lifters are at increased risk of developing premature knee OA. The increased risk is explained in part by knee injuries in soccer players and by high body mass in weight lifters.

Aged↗
PubMed1992

Prevalence of isthmic lumbar spondylolisthesis in middle-aged subjects from eastern and western Finland.

Isthmic spondylolisthesis of the lumbosacral spine is a common radiologic finding in patients with low back pain, but its prevalence in unselected populations is poorly known. We examined X-ray pictures of the lumbosacral region of 1147 randomly selected 45-64-yr-old subjects living in eastern or western Finland. Of them, 69 subjects were found to have isthmic spondylolisthesis. The finding was more common in men (7.7%) than in women (4.6%; p = 0.026). The prevalence of spondylolisthesis was not age-related; it was higher in women with an occupation causing a high back load than in those with a low load occupation (p = 0.049), but this difference was not seen in men. The prevalence of spondylolisthesis tended to be higher in women with multiple pregnancies than in those with less than or equal to 2 pregnancies (p = 0.074). Women from eastern Finland had a higher prevalence of spondylolisthesis (7.2%) than those from western Finland (2.6%; p = 0.007), whereas no such difference was seen in men. The difference in women may partly be explained by factors causing loading of the low back, i.e. heavier work and a higher number of pregnancies.

Female↗
PubMed1991

CT five years after myelographic diagnosis of lumbar disk herniation.

Fifty-seven patients were examined with CT 5 years after primary myelography for disabling sciatica and suspected herniated lumbar disk. Forty were in an operated group, 22 with good and 18 with poor results evaluated by occupational handicap (21) 5 years after surgery. Seventeen patients had myelography indicating disk herniation, but were treated conservatively, 9 with good and 8 with poor result. Various spinal dimensions measured at CT did not correlate with outcome. Operated patients had narrower canals than others, and male canals were broader than those in females. Increased amount of scar tissue at L4 level correlated with poor result (p = 0.008). Operated patients with poor result had more advanced lateral stenosis than those treated conservatively (p less than 0.001). Patients with good result after operation had more degeneration observed on CT of erector spinae muscle than those treated conservatively with good outcome. Only 9% of operated patients did not have muscle degeneration. A tendency for more frequent recurrent disk herniations could be seen for conservatively treated patients. The narrowing of the spinal canal 5 years after operation did not correlate with the 5-year outcome.

Adult↗
PubMed1987

Lower limb asymmetry and patellofemoral joint incongruence in the etiology of knee exertion injuries in athletes.

The association between different knee exertion injuries and lower limb malalignments was studied in 121 male athletes with knee exertion injuries and in 20 male athletes without knee symptoms. The associations between different malalignments was also analyzed. Leg length inequality (LLI), knee valgus, and different indexes of patellofemoral joint congruence were measured using radiological methods. Male athletes with patellar apicitis (n = 59) had significantly more LLI (P less than 0.001) and patella alta (P less than 0.05) than athletes without knee symptoms. The knee valgus was of the same numerical value in the shorter and longer leg sides in subjects with LLI of at least 5 mm (n = 58). A positive correlation was found between lateral patellar displacement (LPD) and patella alta (LT/LP) (P less than 0.001). Negative correlations were found between the sulcus angle (SA) and the lateral patello-femoral angle (LPA) (P less than 0.001) as well as between the LPD and the LPA (P less than 0.001).

Adult↗
PubMed1986

Factors predisposing to patellar chondropathy and patellar apicitis in athletes.

Factors predisposing to patellar chondropathy (the PC group) and inferior patellar apicitis (jumper's knee - the PA group) were sought by means of a questionnaire, detailed quantitative physical measurements and radiological examination in male athletes. There were 20 athletes in the two groups who had typical symptoms and signs of each disorder. A group of 20 high-level athletes without knee symptoms served as a control group. The factors found in the PC group which differed significantly from those in the control group included increased anterior drawer sign (p less than 0.05), increased passive mediolateral patellar range of movement (p less than 0.001) and increased hyperextension (p less than 0.05). More leg length inequality (p less than 0.001) and patella alta (p less than 0.05) was observed in the PA group than in the controls. There was statistically significant positive correlation between the different measurements of knee laxity (anterior drawer sign, passive mediolateral patellar movement and hyperextension) in the 60 cases. The correlation coefficient between the length of the patellar tendon and passive mediolateral patellar movement was 0.82 (p less than 0.001).

Adult↗
PubMed1986

Factors predisposing Army conscripts to knee exertion injuries incurred in a physical training program.

Factors causing predisposition to knee exertion injuries were sought by means of a questionnaire and detailed quantitative physical measurements in 62 healthy Finnish Army conscripts. The subjects consisted of two groups of 18- to 26-year-old conscripts; Group A comprised 34 subjects without knee exertion injuries and Group B, 28 subjects who experienced knee exertion injuries during the first eight weeks of military service. In Group B the extensor mechanism was the most common source of symptoms. The factors found in Group B that differed significantly from those in Group A included increased height (p less than 0.05), increased leg length inequality (LLI) (p less than 0.01), increased passive mediolateral patellar range of motion (PMLPM) (p less than 0.01), and increased knee laxity sum index (LSI) (p less than 0.05).

Adolescent↗
PubMed1976

Globus hystericus-a psychosomatic disease?

Twenty patients with a chief complaint of a lump in the throat, were examined otolacyngologically, radiographically, and psychiatrically with special attention directed to psychosomatic aspects. The control material consisted of matched sample persons of the general population, and of the total patient material treated at a general hospital.

Adult↗
PubMed1975

Hiatal hernia. A follow-up study.

A series of 68 patients who had been surgically treated for hiatal hernia were followed up and re-studied. Several repair procedures were used, but an antireflux operation was carried out in 80% (49 Nissen-Rossetti fundoplications and 6 Belsey Mark IV repairs). The primary hospital mortality rate was 3%. Late results were evaluated by studying the patients with endoscopy, cineradiography, and intraluminal pH probe. The overall clinical late results were good in 96%, excluding the 3% primary mortality rate. To achieve these results, however, several secondary operations were necessary. Good primary results after antireflux procedures were obtained in 89%. The present surgical principles are: (1) the hernias of the good-risk normoacid patients are repaired with a Belsey Mark IV procedure, (2) the hernias of hyperacidity patients are repaired with transabdominal fundoplication combined with parietal cell vagotomy without drainage and (3) moderate oesophageal strictures with an antireflux procedure followed by periodical oesophageal dilatation. Resection of oesophagus is reserved for advanced strictures only.

Adult↗
PubMedDate not supplied

The effect of volleyball playing on the knee extensor mechanism.

The knee extensor mechanism was examined in 32 male competitive volleyball players (Group V) and in a control group of 49 young adult males (Group C) to evaluate the effects of previous jumping activity on the knee extensor mechanism. Several variables were recorded by means of a structured questionnaire, and by clinical and radiographic examination. The amount of physical activity from the age of 7 years onward was significantly greater in Group V than in Group C. The incidence of anterior knee pain during the year preceding the examination was higher in Group V (31%) than in Group C (6%; P less than 0.01). The most common reason for anterior knee pain in Group V was so-called "jumper's knee." No significant difference between the groups was found in the incidence of clinical symptoms and signs of patellar chondromalacia. There were radiologically detectable soft tissue calcifications at the upper or lower pole of the patella or anterior to the patella in 38% of the subjects in Group V, but no such calcifications were seen in Group C (P less than 0.001). However, persistent symptoms did not correlate with the calcifications. Group V subjects had a slight but significant trend to patella alta when compared to Group C (P less than 0.05) according to the Blackburne and Peel index.

Adult↗
PubMedDate not supplied

Lumbar spinal canal size of sciatica patients.

Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p less than 0.001) or for cadavers (p less than 0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment.

Adolescent↗