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Biomedical subjects

J Takala

Publications and source records attributed to J Takala.

At least 199 records · Page 11Linked to original sources

Metabolic response to experimental trauma: the time relation of post-traumatic protein metabolism.

The relationship between time and the post-traumatic metabolic response was studied in a commonly used experimental model of trauma. Twenty nine rats underwent laparotomy and jugular vein sham catheterization as the standard trauma. The rats were fed ad libitum and compared to pair fed controls in terms of nitrogen balance and liver protein synthesis. The pairs of rats were divided into three groups according to the duration of the experiment, which was 24 h, 48 h or 72 h. The nitrogen balance was calculated daily and the liver protein synthesis in vitro measured in 10 rats after 48 h with an asanguinous perfusion system using L-(1-C(14))-Leucine. The metabolic effect of trauma was first detected in liver protein synthesis, which was diminished in the early post-traumatic period (percentage synthesis rates: post-traumatic 34.6 +/- 10.7 and pair fed 60.4 +/- 21.3, Mean +/- SD, P < 0.05). During this period the whole body nitrogen balances were similar (post-traumatic -1.200 +/- 1.440 and pair fed -0.880 +/- 1.130, gN/kg/48 h, mean +/- SD). On the third day, the response to nitrogen intake and the nitrogen balance became significantly worse in the post-traumatic rats (post-traumatic 0.214 +/- 1.680 and pair fed 1.236 +/- 1.220, gN/kg/day, mean +/- SD). These observations suggest that, firstly, the 'flow' phase has its onset on the third post-trauma day, and secondly that trauma does decrease liver protein synthesis, and this decrease lasts at least through the 'ebb' phase. The results indicate the necessity of defining the metabolic phase in experimental studies of post-traumatic metabolism.

Journal Article↗

Hypophosphatemia in hypercatabolic patients.

Twenty-four hypercatabolic surgical intensive care patients were treated with a daily phosphate dosage of 0.5 mmol/kg b.wt during the postoperative total parenteral nutrition (TPN). The adequacy of this regimen was evaluated by measuring the plasma phosphate concentration before and after five days of TPN. All the patients were in negative nitrogen balance throughout the study. Ten of them were hypophosphatemic at the beginning, while none was hypophosphatemic at the end of the study. Hyperphosphatemia was observed once, at the end of the study. The catabolic surgical patient receiving parenteral nutrition is at risk of hypophosphatemia, and particularly vulnerable to its consequences. A daily dosage of 0.5 mmol/kg b.wt of phosphate appeared adequate in covering the increased requirements of these patients.

Humans↗

Health status and social conditions of the elderly in remote districts. Results of a screening programme.

In 1978 a cohort of 1040 individuals aged 65 years or over was screened by public health nurses in Kuusamo. The screening produced basic data about health status and social conditions for an intervention of active medical care of the elderly by means of a mobile unit in rural districts. The response rate of the screening was 90%. 72% of the men and 35% of the women lived with their spouse; 6% of the men and 20% of the women lived alone. Poor health was assessed least commonly (36%) by those living alone, and most commonly by women living with their spouse (51%), even though 87% of them were under 75 years old. A visit to a physician during the past 12 months was more common among younger subjects. 15% of the men and 18% of the women had slightly restricted mobility. Men living alone had better mobility than women living alone.

Activities of Daily Living↗

Development of thyroid autoimmunity.

Two blood samples were taken at an interval of 5 years in a continuing epidemiological study of a rural population in south-western Finland with an age range of 40-64 years at commencement. Paired sera of 680 subjects were tested for antibodies against thyroglobulin and thyroid microsomal antigen. In the seroconversion cases the titres in the second specimens were either low or medium but never high. In the cases selected on the basis of the highest titres in the follow-up specimens, the titres in the baseline specimens were either high or medium but never low. These findings suggest that the emergence and the development of thyroid autoimmune seroreactions are slow processes.

Adult↗

Strategies for improving compliance in hypertensive patients.

The results of the present trial, aimed at elucidating and improving the treatment situation of hypertensives, show that--within the domain of the Finnish community health centres--it continues to be unsatisfactory. The prevalence of the male hypertensives (those without treatment and with a permanent diastolic pressure level of at least 100 mmHg and those under treatment) aged 35 to 49 years, was 12.8%. Only half of them were receiving treatment and of these the treatment was adequate (diastolic pressure less than 90 mmHg) in only one case out of five. Overweight turned out to be common among hypertensives, 63.2% of them had at least 10% overweight (BMI greater than or equal to 27.0 kg/m2) while 15.7% had at least 30% overweight (BMI greater than or equal to 32.0 kg/m2). There were no differences worth noting in overweight between treated and untreated cases. With respect to tobacco smoking there was a clear difference in favour of the hypertensives receiving treatment, among whom only 26.1% were regular smokers, while the corresponding figure for untreated hypertensives were 41.7%. Within short time an improved, supervising physician-based treatment system could be seen to have led to favourable results in the treatment of hypertensive community health centre patients. The proportion of those receiving adequate treatment among subjects already under treatment prior to the screening, for instance, had become threefold within a few months.

Adult↗

Immediate enteral feeding after abdominal surgery.

Enteral feeding by nasoenteral tube was begun immediately after surgery of the alimentary tract in 120 patients. In 37 cases the feeding was delivered proximally to a fresh anastomosis or enterotomy. Immediate enteral feeding was well tolerated even after major elective surgery of the gastrointestinal tract. The feeding promoted recovery of bowel function and evoked no major complications. Abdominal discomfort and diarrhea were the most common side effects. The response was less favorable after nonelective surgery associated with intraabdominal or systemic sepsis.

Enteral Nutrition↗

Rheumatoid factor seroconversions in relation to clinical rheumatoid arthritis.

Two blood samples were taken with an interval of five years in a continuing epidemiological study of a rural population with an age range of 40-64 at the commencement. Paired sera from 1805 subjects were tested for rheumatoid factors using Waaler-Rose and latex tests. Simultaneous conversion in both tests from negative to positive occurred in seven cases and from positive to negative in eight cases, corresponding to 20% of the Waaler-Rose positives. The mean Waaler-Rose titre in the cases converting to positive was nearly four times higher than in the cases converting to negative. Five subjects developed Waaler-Rose-positive rheumatoid arthritis after the baseline survey. In three of them, positive rheumatoid factor reactions were observed to precede the joint disease; in two others the chronological order could not be established.

Adult↗

Auditory sensitivity in the middle-aged population in southwestern Finland.

The present study deals with the auditory sensitivity of men and women 40 to 64 years of age living in two municipalities situated in the southwestern part of Finland and the prevalence of defective hearing in this middle-aged population. Hearing acuity was tested in 1043 men (93.2%) and 1221 women (93.1%). It appeared in the investigation that hearing loss increased markedly with age in both sexes. Auditory sensitivity was clearly better in women than in men. Of the entire population 7.1% had evident bilateral hearing loss when an average loss of 25 dB in the speech range was used as the cut-off point. Hearing loss of 35 dB in the speech area was regarded as requiring an otological examination and possible care even when present in only one ear. Of the men 12.1% and 7.9% of the women were in this category; this represents an overall prevalence of 9.9%.

Adult↗

Prolonged impairment of cell-mediated immunity after major abdominal surgery in malnourished patients.

The effect of the nutritional status on postoperative impairment of the immune response was studied in adults undergoing major abdominal surgery. The immune function was evaluated by measuring in vitro the lymphocytic response to phytohaemagglutinin (PHA), concanavalin A (Con A) and the purified protein derivative of tuberculin (PPD) in whole blood cultures, and in vivo delayed skin hypersensitivity to candida, mumps, streptokinase-streptodornase and PPD. Nutritional assessment was carried out by evaluating recent weight loss, the weight for height index and by measuring the arm muscle circumference (AMC), triceps skinfold thickness (TSF), the creatinine-height index (CHI) and the serum concentration of albumin and prealbumin. The patient was considered malnourished, if at least three of these criteria were abnormal. The immune parameters were measured preoperatively, at the end of the surgery and five days after operation. Before the operation both malnourished and well-nourished patients had normal lymphocytic responses, but the malnourished patients had a slower recovery of immune responses after the operation and they had an increased number of postoperative complications. No significant differences in the incidence of anergy were observed between the well and malnourished patients pre or postoperatively.

Journal Article↗

Screening, treatment and adherence to treatment for hypertension.

The population aged 40 to 64 years of the municipality of Köyliö, situated in southwestern Finland, was screened for hypertension in 1973-74; a total of 1018 persons (92%) participated in the program. On the basis of two separate blood pressure measurements a total of 147 hypertensive individuals who were not under treatment were identified. These individuals were divided into two groups by randomization of matched pairs. One group (the control group) was merely advised by letter to see a physician for raised blood pressure, while the other group (the experimental group), in addition to being so notified, received written information explaining the nature of hypertension and the importance of its treatment. After two years, the individuals in both groups were invited for a follow-up blood-pressure measurement, with the object of investigating the number of individuals who had sought treatment and who had continued it, and the differences between the groups in treatment seeking and adherence. A total of 79% of those who were notified to seek medical care had done so. Antihypertensive drug therapy had been begun for 85% of these. After two years, 56% of those who had been found initially to be hypertensive and who were seen in the follow-up were still under treatment. In 43% of these the blood pressure was at the target level. No statistically significant differences in treatment seeking and adherence to it were found between the experimental and control groups, nor were differences found in the decline in the blood pressure or its target levels. Comparing with other studies shows, that results can be better if the health care system that carries out the screening procedure for hypertension also take active steps to bring the patient under treatment and keep him on the regimen.

Adult↗

Thyroid autoimmunity in siblings: a population study.

Familial occurrence of thyroid autoantibodies and elevated TSH levels was investigated among siblings from a middle-aged rural population in Finland. The initial sample consisted of 801 subjects representing 311 sibling groups. Paired sera taken at a five-year interval were available for testing from most of them. Thyroglobulin antibodies were detected in 26% of the siblings of probands with thyroglobulin antibodies, compared with 11% among siblings of probands who did not have these antibodies. The corresponding figures for thyroid microsomal antibodies were 32% and 11%, respectively. The frequency of positive test results among the siblings was about the same irrespective of the antibody titre of the proband. When the proband had only thyroid microsomal antibodies, most (66%) of the autoantibody-positive siblings were positive in this system only. When the proband had only thyroglobulin antibodies, the pattern among siblings was less clear. Nearly half of the cases with elevated TSH level but negative in the thyroid autoantibody tests were in families in which other members had evidence of thyroid autoimmunity. The findings are compatible with the concept that a few major genes affect susceptibility to thyroid autoimmune diseases.

Adult↗

Smoking and influenza in the elderly: a sero-epidemiological study.

Two blood samples were taken at an interval of five years in a continuing epidemiological study of a rural population with an age range of 40-64 years at commencement. Paired sera of 111 light smokers and their non-smoker controls, matched for age and sex, and of 68 heavy smokers and their respective controls were tested for haemagglutination inhibiting antibodies against four different influenza strains. Antibodies were detected in the baseline specimens more frequently and in higher titres among the smokers than among the controls. Significant rises in titre between the baseline specimens and the follow-up specimens occurred slightly more frequently among the smokers.

Adult↗

Genetics of autoantibodies in relation to disease. An epidemiological study of two population series.

Familial occurrence of three types of autoantibodies, viz. rheumatoid factors, antinuclear antibodies and thyroid autoantibodies, was investigated in two population series: twins from the Finnish Twin Registry representing the adult twin population living in an urban area (76 monozygotic and 82 dizygotic same-sex twin pairs) and siblings from a middle-aged rural population subject to an ongoing epidemiological study (311 sibling groups comprising 801 subjects and 584 married couples). The observations were compatible with the concept of two components in the above autoantibody system. The major component is determined predominantly by environmental factors and is manifested with increasing age. The autoantibodies belonging to the minor, familial component occur in somewhat higher titers, exhibit certain specificity features of their own (RF reacting with rabbit gamma globulin), and are associated with "autoimmune" diseases.

Adult↗

Essential tremor in a Finnish population.

A two-phase epidemiological study of essential tremor was carried out by investigating a rural population aged over 40 years in 2 municipalities in southwestern Finland. In the first phase, the subjects answered a questionnaire as to whether they had experienced tremor during the month preceding the inquiry. In the second phase, the persons who had tremor often or fairly often, were examined clinically. The total prevalence of essential tremor, calculated on the basis of clinically established cases, was 55.5/1000 of the population aged over 40 years. The disease became more prevalent with advancing age and was, with the exception of the oldest age-group, more common in men than in women.

Adult↗

Epidemiology of rheumatic diseases in Finland in 1964-76.

Finnish national interview surveys show that the prevalence rate of self-reported chronic rheumatic disease was 8.8% of the adult population in 1964 and 13.3% in 1976. Most of these diseases were back complaints, which also showed a rapid increase. The prevalence rate of osteoarthritis was 3.2% in 1976, and that of rheumatoid arthritis 1.2%. In 1964 45% and in 1976 more than 60% of the chronic rheumatics reported other chronic diseases as well. 10% were severely and one third slightly restricted with mobility in 1976. Also certain psychic symptoms were surprisingly common among them, and 42% used regularly analgesics. The occurrence of these diseases seems to be associated with socioeconomic changes. The prevalence rate was highest in the poorest areas with negative immigration. Of the working-aged population the diseases were commonest among agricultural workers in 1964, and among disability pensioners retired from this occupational group in 1976. Because of its magnitude and multiple problems this group has become a special challenge to the health care system.

Adult↗