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Biomedical subjects

K Lehtinen

Publications and source records attributed to K Lehtinen.

At least 37 records · Page 2Linked to original sources
PubMed1994

Antibodies to Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis in ankylosing spondylitis: effect of sulfasalazine treatment.

OBJECTIVE: To make a longitudinal study of antibodies to Klebsiella pneumoniae in patients with ankylosing spondylitis (AS) and to assess treatment effects. As a comparison we measured antibodies of 2 other gut associated bacteria, Escherichia coli and Proteus mirabilis. METHODS: In a double blind study in 84 Finnish outpatients with AS before and after 26 weeks' treatment with sulfasalazine or placebo we measured serum antibodies to Klebsiella pneumoniae, E. coli and Proteus mirabilis with ELISA: Serum samples of 100 healthy blood donors served as controls. RESULTS: The levels of IgA class antibodies to all 3 bacteria were statistically significantly higher in the sera of the patients compared to the controls. During sulfasalazine treatment significant decreases were observed in concentrations of the IgA class antibodies to Klebsiella and E. coli whereas only a slight decrease was observed in the concentrations of IgA antibodies to Proteus mirabilis. There were no correlations between the clinical and laboratory results observed with sulfasalazine and decrease in concentrations of IgA class antibodies. CONCLUSION: Our results agree with the role of gut associated lymphoid tissue in the pathogenesis of AS, but do not totally exclude Klebsiella pneumoniae as a specific agent contributing to the development of AS.

Adult↗
PubMed1994

Need-adapted treatment of schizophrenia: family interventions.

Need-adapted treatment of schizophrenia is an integrative treatment model developed in the Turku Schizophrenia Project. It is based on the interactional viewpoint and understanding on the interactional level. Experience of family and network therapy has shown that immediate interactions-oriented intervention is an essential starting-point for the treatment. It creates the possibility for the treatment as a whole to become a therapeutic process. For clinical purposes, it has seemed logical to divide the patients into three groups; the methods and focus of the family-oriented work differ somewhat between the groups. The main separator between these is the level of social functioning before the psychosis.

Combined Modality Therapy↗
PubMed1993

Need-adapted treatment of schizophrenia: a five-year follow-up study from the Turku project.

The five-year follow-up results of 28 first-contact schizophrenic patients are compared with an older patient series of 53 patients from the same district. The treatment of the new series followed the principles of the need-adapted model. The emphasis was on immediate initial crisis-oriented family interventions. The treatment of the old series followed psychodynamic principles with an emphasis on individual and milieu therapy. The patients in the new group manage better with half the number of hospital days and less outpatient treatment. The differences are most clear in men. The crisis orientation caused failure in sustaining longer treatment relationships. This was harmful for patients and families with a more chronic development. In future, better continuity of treatment must be emphasized.

Ambulatory Care↗
PubMed1993

Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis.

The mortality and causes of death in 398 patients (47 women, 351 men) with definite ankylosing spondylitis, admitted to hospital for the first time between 1961 and 1969, were investigated. The mean age at first admission was 36.5 years (SD 11.8). After a mean follow up time of 25.7 years, a total of 152 patients (12 women, 140 men) had died. The expected mortality based on the mortality statistics of the general population of the same sex and age was 103.1 (9.4 women and 93.7 men). Thus the overall mortality of the patients with ankylosing spondylitis was 1.5 times that expected. Those patients who had died were significantly older, had a higher erythrocyte sedimentation rate, and more inflamed peripheral joints when first seen than the surviving patients. The main difference between the observed and expected causes of death was the high incidence of deaths from ankylosing spondylitis, which was the underlying cause of death in 27 patients. The mechanism of death in these patients was secondary amyloidosis in 19, cardiovascular complications in six, fracture of the spine in one, and it was not known in one patient. Excess deaths due to circulatory, gastrointestinal and renal diseases, and violence were also observed.

Adult↗
PubMed1992

HLA typing and seropositivity in Finnish and in Polish patients with rheumatoid arthritis and amyloidosis.

We determined HLA-A, -B, -C and -DR antigens in 83 patients with rheumatoid arthritis (RA) and reactive secondary amyloidosis (RSA), 60 in Finland and 23 in Poland, and compared the results with control RA patients and blood donors. There were no significant differences in the frequencies of HLA between the RA patients with and those without RSA in either Finland or Poland, and no significant differences between the Finnish and Polish patients with RSA. All the RSA patients from Finland and 70% of the RSA patients from Poland were seropositive. In the development of RSA, the prolonged period of inflammatory stimuli may play a more important role than genetic factors.

Adolescent↗
PubMed1992

A suicide epidemic in a psychiatric hospital.

The authors report in detail on an epidemic of six inpatient suicides in a psychiatric hospital in Finland. Suggestion and identification had an effect on the timing as well as on the method of four of the suicides. The epidemic is viewed from individual, network, and organizational perspectives. The authors speculate on how such epidemics could be avoided. An increase in inpatient suicide rates has been reported from many countries, and the Werther effect may thus become a topic of considerable importance in psychiatric hospitals in the future.

Adult↗
PubMed1991

Need-adapted treatment of new schizophrenic patients: experiences and results of the Turku Project.

This article describes a psychotherapeutically oriented approach to schizophrenia developed especially to meet the needs of the community psychiatric field. Because of the heterogeneous nature of the schizophrenic psychoses, the authors emphasize that these patients should always be treated based on case-specific premises. The main principles of the need-adapted approach are: 1. The therapeutic activities are planned and carried out flexibly and individually in each case so that they meet the real and changing needs of the patients as well as of their family members. 2. Examination and treatment are dominated by a psychotherapeutic attitude. 3. The different therapeutic activities should support and not impair each other. 4. The process quality of therapy is clearly perceived. A family-centred initiation of the treatment is especially emphasized for both diagnostic and therapeutic reasons. The positive experiences of this led the Finnish national programme for the treatment and rehabilitation of schizophrenic patients to recommend the establishment of family- and environment-oriented acute psychosis teams (APT) in the mental health districts. In later phases of treatment, the significance of individual psychotherapy is increased. The preliminary results of the approach are presented and compared with an earlier sample of patients.

Adult↗
PubMed1991

Bacterial antibodies in ankylosing spondylitis.

Antibodies to Salmonellae, Yersiniae, Campylobacter jejuni, Borrelia burgdorferi, Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis and Chlamydia trachomatis were measured by ELISA in the sera of 99 patients with ankylosing spondylitis. Increased prevalence of IgA and IgG class antibodies against K. pneumoniae and of IgA class against E. coli was observed in ankylosing spondylitis. No clear correlation between the disease activity and occurrence of antibodies was revealed. The results are in line with the previously published findings suggesting that K. pneumoniae may have a role in the aetiopathogenesis of ankylosing spondylitis.

Adolescent↗
PubMed1991

Intramuscular gold therapy is associated with long survival in patients with rheumatoid arthritis.

To investigate whether the premature death of patients with rheumatoid arthritis (RA) was associated with intramuscular (im) gold treatment or side effects due to gold, a sample of 573 adult patients with RA treated at hospital for the first time during 1961-66 was retrospectively studied for the duration and side effects of im gold treatment as well as death and causes of death. By 1989 a total of 251 patients had died. Gold treatment was not associated with premature death. On the contrary, longterm gold treatment was associated with a high survival rate. Secondary amyloidosis was diagnosed in 28 out of 63 patients, who had gold associated renal disease and who died.

Adult↗
PubMed1990

Seronegative rheumatoid arthritis: a clinical study with HLA typing.

We examined both clinically and by determining HLA-A, -B, -C and -DR antigens 50 patients thought to have seronegative erosive polyarticular rheumatoid arthritis (RA) in Finland and the USSR. All the patients fulfilled at least 4 of the 1987 ARA criteria for RA. According to HLA typing and clinical findings, of which a part was collected by followup, the patients fell into 5 groups: HLA-B27 related diseases, putative psoriatic arthritis, putative juvenile chronic polyarthritis, and seropositive and seronegative RA. Our results indicate that most of the patients with seronegative RA had some other disease. In the remaining cases the presence of rheumatoid factors had not been examined adequately, especially at the early phase of disease. The classification of erosive seronegative polyarticular patients is discussed.

Adolescent↗
PubMed1989

Hidden psoriatic arthritis in seronegative oligoarthritis: a 14-year follow-up study.

Out of a cohort of 64 patients with seronegative oligoarthritis (SO), 8 patients with HLA-B13, 5 with Bw16 and 3 with HLA-B17 were invited to participate in a 14-year check-up. Thirteen patients showed some features of psoriatic arthritis, including 5 with suspected skin or nail disease, 5 with a family history of psoriasis, 3 with DIP joint affliction, and 2 with aortic valve insufficiency. It is concluded that a quarter of the patients with SO may have hidden psoriatic arthritis.

Adolescent↗
PubMed1989

The effect of different indomethacin formulations in young and elderly patients: a comparative controlled clinical trial.

In a double-blind, crossover trial a controlled-release multiple-units indomethacin formulation (50 mg twice daily) was compared with conventional capsules (25 mg twice daily with 50 mg in the evening) in 12 young and 18 elderly in-patients with rheumatoid arthritis. Earlier findings that younger patients preferred a slow-release formulation and the elderly a standard formulation could not be confirmed. As a whole, the duration of morning stiffness was reduced more (p = 0.02) with the controlled-release formulation than with the conventional formulation. During the treatment period (7 days), 4 patients reported side-effects from the conventional capsules, 3 from the controlled-release formulation, and 6 from both treatments; 53% of the patients preferred the controlled-release formulation, while 20% preferred the conventional capsule (p = 0.046).

Adult↗
PubMed1989

Subjective disease experience in Sjögren's syndrome. A computerized discrimination analysis.

A study was made of the ability of a computerized discrimination analysis to distinguish between primary or secondary Sjögren's syndrome on the one hand and, on the other, various rheumatic diseases which may be, but in this study were not, complicated by Sjögren's syndrome. The analysis was based on a questionnaire including 76 two- or three-scale items. Among these 76 questions, five with a maximum potential for distinguishing between various subgroups were selected and obviously represent the questions for the physician to ask when taking the patient's history. As shown by classification matrix tables, computerized analysis of questionnaires might represent a useful way to assess the prevalence of clinical cases of Sjögren's syndrome and to aid health care administrators in assessing the extent of the Sjögren's syndrome problem. In contrast, manual analysis of patients' graded answers did not provide any simple or practicable method for the diagnostic work-up of cases. Therefore it seems that subjective symptoms should not be included in the diagnostic criteria for Sjögren's syndrome, which in clinical work should be based on objective evidence alone.

Arthritis, Rheumatoid↗
PubMed1988

Sulfasalazine in the treatment of ankylosing spondylitis. A twenty-six-week, placebo-controlled clinical trial.

Eighty-five patients with active ankylosing spondylitis (AS) were randomized to receive either sulfasalazine (less than or equal to 3 gm/day, mean 2.5) or placebo for 26 weeks. There was a statistically significant improvement, compared with baseline, in most of the clinical variables in patients receiving the active drug. Laboratory parameters (erythrocyte sedimentation rate, C-reactive protein, IgG, IgM, and IgA) also improved during the active treatment, suggesting a beneficial effect of sulfasalazine on AS. At the end of the treatment, significant differences between the sulfasalazine and placebo groups were observed in morning stiffness, chest expansion, erythrocyte sedimentation rate, and in all immunoglobulin classes. Two patients in each treatment group discontinued the trial because of side effects. Enteric-coated sulfasalazine seemed to be effective and well tolerated in patients with active AS.

Analysis of Variance↗