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Biomedical subjects

E Rintala

Publications and source records attributed to E Rintala.

43 records · Page 3Linked to original sources

Antimicrobial therapy of septicemic patients in intensive care units before and after blood culture reporting.

68 cases of positive blood cultures from 54 intensive care unit (ICU) patients were analyzed retrospectively. The empiric antimicrobial therapy was correct in 65% of the cases as judged by the species and sensitivity of the blood culture isolate. After initial Gram-staining results were known, coverage increased to 77%. After the final blood culture results the coverage was still only 81%. The bacteremia-related mortality was 13%. Although there was no significant difference between the occurrence of bacteremia-related and non-bacteremia-related deaths either in patients with correct or non-optimal empiric treatment, this study emphasizes the need for better utilization of culture reporting. A considerable part of the final blood culture results went unnoticed by the ICU physicians which stresses the importance of good communication between the laboratory and wards.

Adolescent↗

Evaluation of principles in intravesical chemo- and immunotherapy for superficial bladder cancer.

There is still much controversy about the diagnostics and therapy of carcinoma in situ (TIS/CIS) of the bladder. Reliance on cytological possibilities in the primary diagnosis and grading varies in separate centres. Hence, the small series published hitherto are often incomparable due to different start points and end points of trials. We regard cytology as the key examination in TIS. Complete response (CR) and progressive disease (PD) are end points which can be defined by histology/cytology and the timer factor. Our philosophy concerning the evaluation of therapy-principles in superficial bladder cancer is mainly based on our own experience. The efficacy of MMC and of BCG was equally modest in the Finnbladder I study: the CRs 38% and 40%; the PDs 8% and 20%, respectively. The interim of the ongoing Finnbladder II study are more promising after 6 months follow-up: the CR with MMC 67% and with alternating therapy with MMC and BCG 80%; there were no progressions so far. The primary grade of TIS has been a significant prognostic factor for instillation therapy in our earlier series of 62 pts since 1976. There were no progressions of grade I but 19% of grade II and 13% of grade III. A wide consensus of concepts dominates as to the superficial bladder cancer (Ta-T1). The recurrence rate (RR) and the recurrence index (RI/m) as the end points of prophylactic trials are capable of indicating the recurrence-preventive efficacy of different instillations, allow the use of a patient as his own control, and are suitable for statistical evaluation (table I).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical↗

[Duodenopancreatectomy as the treatment of primary duodenal cancer].

Nine patients were operated on for primary adenocarcinoma of the duodenum at the Second Surgical Department of Helsinki University, between 1966 and 1985. They were three males and six females and were aged between 37 and 76 years. The average interval between primary symptoms and diagnosis was 3.2 months. Pancreatico-duodenectomy, the classical Whipple operation, was performed on seven cases, including one with liver resection. Four of the patients who had undergone radical surgery are alive (by Mai 1988), after six postoperative years have passed, on average (57 per cent). They are without metastases. Three patients died, among them one with liver resection one month from surgery and two with recurrent carcinoma after 1.2 and 1.8 years. Healing rates for primary duodenal carcinoma might be improved by more aggressive evaluation of symptoms in the upper gastro-intestinal tract and subsequent radical surgery.

Adenocarcinoma↗

Chronic occupational exposure to toluene.

Chronic occupational exposure to toluene was studied in a factory preparing tarpaulins. Seventy-eight workers were studied; 46 were exposed to various concentrations of toluene in air (20--200 ppm), 32 were unexposed workers in the same factory. In many cases the exposure had lasted for 10--20 years. The urinary hippuric acid excretion at the end of work shift showed good correlations to toluene concentrations in air, and it seems to be a good measure of exposure. The hippuric acid in urine samples collected overnight showed that elimination of toluene still occurs several hours after exposure. Most of the biological parameters measured showed no correlation to toluene exposure. The blood leukocyte count did not show slight positive correlations to toluene exposure, but even this parameter stayed inside the range of normal values. The occurrence of chronic diseases, drug using habits, and drinking and smoking habits did not show any correlations to toluene exposure.

Adult↗

The effects of pretransplant conditioning, graft-versus-host disease and sepsis on the CRP levels in bone marrow transplantation.

To evaluate the diagnostic utility of C-reactive protein (CRP) for the detection of sepsis in bone marrow transplantation, CRP levels were analyzed after pretransplant conditioning and variably combined in septic, focal or viral infections with graft-versus-host disease (GvHD) in 64 bone marrow recipients. The CRP levels after pretransplant conditioning were low. The peak levels of CRP were influenced independently by the type of infection (p = 0.016; septic and viral infections were significantly different) and GvHD (p = 0.003). The area under the receiver-operator characteristic (ROC) curve for peak CRP in sepsis was 0.653 and 0.618 with and without GvHD, respectively. It was concluded that GvHD and the type of infection were independent determinants of the CRP responses. GvHD did not affect the extent of the CRP response. Therefore, although not highly specific for sepsis, CRP remains a useful detector of sepsis in bone marrow transplantation.

Adolescent↗

Synovial fluid acid phosphatase in seropositive and seronegative arthritides.

Synovial fluid acid phosphatase was investigated in 82 arthritic patients with hydropsy in a knee joint. 39 of the patients were seropositive and 43 seronegative. 36 of the seropositive group had erosive rheumatoid arthritis. The mean synovial fluid acid phosphatase in the seropositive group, 11.6 U/l (SD +/- 8.4), was significantly higher (p less than 0.001) than in the seronegative group, 6.5 U/l (SD +/- 4.8).

Acid Phosphatase↗