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M Heikkinen

Publications and source records attributed to M Heikkinen.

At least 37 records · Page 2Linked to original sources
PubMed2001

The effects of gender and age on the colonoscopic examination.

The data concerning the influence of gender and age on a patient's toleration of and the technical difficulty of colonoscopy are conflicting. One hundred eighty patients (108 women and 72 men) undergoing colonoscopy were categorized into three age groups: the young (aged 2040 years), the middle-aged (aged 41-60 years), and the old (aged 61-75 years). The endoscopists assessed the examination immediately after the procedure. The patients completed a questionnaire before leaving the endoscopy unit and again 2 weeks later. The women rated colonoscopy after the procedure more painful (p < 0.01) and in the repeat questionnaire more painful (p < 0.05) and more difficult (p < 0.05) than men. Also, the endoscopists judged colonoscopy to be more difficult (p < 0.001) and the time taken to reach cecum longer (p < 0.01) for women. The young experienced more discomfort than the middle-aged or the old, as evaluated after the procedure (p < 0.05). In the repeat questionnaire, the young reported more discomfort and pain than the middle-aged (p < 0.05). The endoscopists also judged the examination to be more difficult and the time taken to intubate cecum longer for the old than for the middle-aged (p < 0.05) or the young (p < 0.01). Correspondingly, the examination time was shorter among the young when compared with the middle-aged (p < 0.05) or the old (p < 0.001). The young were least willing to repeat the examination (p < 0.05). Colonoscopy is less tolerable and more difficult for women. Although colonoscopy among the old patients was technically more difficult, they tolerated the procedure better than the young.

Age Factors↗
PubMed2001

Cigarette smoking, alcohol intoxication and major depressive episode in a representative population sample.

OBJECTIVE: This study investigated the associations of cigarette smoking and alcohol intoxication with major depressive episode. DESIGN: Major depressive episode during the past 12 months was assessed in a national representative cross sectional study using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). SUBJECTS: A random sample of 5993 non-institutionalised Finnish people aged 15-75 years was interviewed as a part of the 1996 Finnish Health Care Survey. RESULTS: In logistic regression models the factors associated with major depressive episode in the past 12 months were smoking 10 or more cigarettes daily (odds ratio (OR) 2.26; 95% confidence intervals (95% CI) 1.68, 3.04) and alcohol intoxication at least once a week (OR 2.99; 95%CI 1.70, 5.25). Their effects were independent of each other, and remained significant even after adjusting for other major risk factors (marital status, education, unemployment and chronic diseases). The attributable proportion (a measure of the impact of the risk factors of the disease on the population) for daily smoking of 10 or more cigarettes was 0.15, and for alcohol intoxication at least once a week 0.04. CONCLUSION: Cigarette smoking and alcohol intoxication seem to be important risk factors for major depressive episode. In this population the impact of smoking was greater.

Adolescent↗
PubMed2001

Antidepressant treatment of depression in the Finnish general population.

OBJECTIVE: Antidepressant use has increased in the last decade, but whether depression continues to be undertreated is unknown. The authors investigated the prevalence of antidepressant treatment and its predictors in a recent general population sample of depressed subjects. METHOD: As part of the Finnish Health Care Survey, in 1996 a representative sample of Finns (N=5,993) aged 15-75 years underwent a standardized face-to-face interview that used the DSM-III-R criteria for major depressive episode. RESULTS: Only 13% of subjects with a major depressive episode during the preceding 12 months (70 of 557) reported current use of an antidepressant. In logistic regression models, use of psychiatric services for depression, regular use of any other medication, more than 1 month of sick leave, and smoking were associated with antidepressant treatment. CONCLUSIONS: Most depressed subjects in 1996 in Finland were not receiving antidepressant treatment despite the several-fold increase in antidepressant use in the 1990s.

Adolescent↗
PubMed2000

Needle design does not affect the success rate of spinal anaesthesia or the incidence of postpuncture complications in children.

BACKGROUND: In adults, pencil-point spinal needles are believed to be less traumatic and therefore to be superior compared to cutting-point needles with respect to success rate and postpuncture complications. The aim of this randomised, parallel groups and prospective study was to record the success rate and to evaluate the incidence of complications following spinal anaesthesia with the two types of needles in children. METHODS: We studied 215 children aged 1 to 18 years. A 25-gauge needle was used in children up to 7 years (n=96) and a 27-gauge needle in older children (n=119). During lumbar puncture with either a cutting-point (n=109) or a pencil-point (n=106) spinal needle, we recorded puncture characteristics and the success of cerebrospinal fluid (CSF) aspiration. Hyperbaric bupivacaine 5 mg ml(-1) at a dose of 0.3-0.4 mg kg(-1) was used for the spinal anaesthesia. The incidence of postdural puncture complications was recorded from diaries completed by the children and parents one week after the lumbar puncture. RESULTS: The success rate of the spinal anaesthesia was 97% without difference between the needles. The success rate was higher when the aspiration of CSF was easy compared to if it was difficult (98% vs. 88%, P=0.02). Two hundred and seven diaries were returned (97%). Twenty-four children developed a headache, 8 of which were classified as a postdural puncture headache (PDPH), 6 with the cutting-point needle and 2 with the pencil-point needle (n.s.). Nine children developed signs of transient radicular irritation with no difference between the needles. CONCLUSION: Both types of spinal needles can be used in children, and a free aspiration of CSF results in a high success rate of the spinal block. Postpuncture complications are as common in children as in adults.

Adolescent↗
PubMed2000

The 12-month prevalence and risk factors for major depressive episode in Finland: representative sample of 5993 adults.

OBJECTIVE: This study reports the 12-month prevalence of major depressive episode and its risk factors in a representative nationwide sample. METHOD: A random sample of non-institutionalized Finnish individuals aged 15-75 years (N = 5993) was interviewed in 1996. Major depressive episode during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). RESULTS: The population prevalence of major depressive episode was 9.3% [95% CI 8.5,10.0], and the age-adjusted prevalences for females and males were 10.9% [95% CI 9.7,12.0] and 7.2 [95% CI 6.2,8.2], respectively. In logistic regression analyses the factors associated with major depressive episode after adjustment for age were urban residency, smoking, alcohol intoxication and chronic medical conditions. In addition, being single and obese were found to be risk factors for males. CONCLUSION: The female to male risk ratio for major depressive episode was smaller than in many previous studies. The sex-specific risk factor associations warrant further investigation into sex differences in depression.

Adolescent↗
PubMed2000

Recovery after paediatric daycase herniotomy performed under spinal anaesthesia.

In this prospective survey, recovery in hospital and at home was evaluated in 195 children aged 6 months to 10 years who had undergone herniotomy under spinal anaesthesia as a daycase procedure. Spinal anaesthesia was successful in most of the children, with only two patients being given general anaesthesia. Eighty-three percent of the children had pain at home and 19% had moderate or severe pain. Eighty-five percent of the children needed pain medication at home; the median dose of analgesics was 4 (1-9, 10th and 90th percentiles). Vomiting was noted in two of 195 children in hospital and in 10 of 192 children at home. Eleven children developed a mild position-dependent headache. Most of the children (183/191) recovered their normal daily activities during the first three postoperative days. We conclude that spinal anaesthesia is a safe and effective technique for paediatric herniotomy. Moreover, pain is common following herniotomy and children should be given analgesics for the first two or three postoperative days.

Activities of Daily Living↗
PubMed2000

Projected workload for a vascular service in 2020.

OBJECTIVE: to estimate the workload of a vascular service during the next two decades as the proportion of people aged over 65 years increases. METHODS: the study used the vascular registry data of Tampere University Hospital and the population data of Pirkanmaa region provided by the Central Statistical Office in Finland. The current workload is 1420 vascular procedures per million inhabitants yearly (951 surgical and 207 endovascular). Sixty-five per cent of all procedures are done on people over 65 years old. Pirkanmaa has a population of 440 000 persons of whom 15.6% are over 65 years. According to the population data the population will increase to 460 000 persons by the year 2020 and 22.9% of them will be over 65 years old. RESULTS: The total amount of procedures will rise by 40.5% (1906) and the increase in endovascular and surgical group will be 39.2% (640) and 43.5% (1265) respectively. The proportion of treated patients over 65 years will rise from 65.0% to 70.5%. In the next two decades the amount of patients with claudication will increase by 35.4%, critical limb ischaemia by 44.2%, carotid surgery by 34.0%, abdominal aortic aneurysms by 40.7%, acute limb ischaemia by 45.0% and access surgery by 27.4%. CONCLUSION: In the next two decades the number of elderly people will increase so rapidly that, whatever happens to the incidence and prevalence of peripheral vascular disease, the workload for a vascular service will increase significantly.

Age Distribution↗
PubMed2000

Conscious sedation and cardiorespiratory safety during colonoscopy.

BACKGROUND: Cardiorespiratory events during colonoscopy are common. The effect of sedative premedication on cardiorespiratory parameters during colonoscopy has not been studied in controlled, prospective trials. METHODS: One hundred eighty patients undergoing colonoscopy were divided into 3 groups: (1) sedation with intravenous midazolam (midazolam group); (2) sedation with intravenous saline (placebo group); and (3) no intravenous cannula (control group). Arterial oxygen saturation (SaO(2)), systolic and diastolic blood pressure and continuous electrocardiogram were recorded prior to, during and after the endoscopic procedure. RESULTS: Midazolam produced lower SaO(2) values during colonoscopy compared with placebo or control groups (p < 0.001, repeated measures analysis of variance). Systolic and diastolic blood pressure during colonoscopy were lower in the midazolam group than in the placebo group (p < 0.01 and p < 0.05, respectively), but no difference was found between the midazolam and the control groups. Hypotension (systolic blood pressure less than 100 mm Hg) occurred more frequently in the midazolam group (19%) than in the placebo (3%; p < 0.01) or control groups (7%; p < 0.05). ST-segment depression developed in 7% of patients during the recording with no difference between the groups. In 75% of cases ST-depression appeared prior to the endoscopic procedure. CONCLUSIONS: Premedication with midazolam induced a statistically significant decrease in arterial oxygen saturation and increased the risk for hypotension. However, colonoscopy proved to be a safe procedure both with and without sedation.

Adult↗
PubMed2000

Effect of conscious sedation on cardiac autonomic regulation during colonoscopy.

BACKGROUND: Colonoscopy is associated with cardiovascular events including hypotension, hypertension, and myocardial ischemia. The pathogenetic mechanisms of these cardiovascular events are unknown, but there is evidence that the autonomic nervous system may play a role. Conscious sedation is often used to relieve the inconvenience caused by the procedure. In this study, we evaluated the effects of sedation on cardiac autonomic regulation during colonoscopy. METHODS: One hundred and eighty patients undergoing elective colonoscopy were prospectively randomized into three groups: (i) sedation with intravenous midazolam (midazolam group); (ii) sedation with intravenous saline (placebo group); and (iii) no intravenous cannula (control group). Continuous electrocardiogram was recorded prior to, during, and after the colonoscopic procedure. Heart rate variability (HRV) was assessed by means of the power spectral analysis; the powers of low-frequency (LF 0.04-0.15 Hz) and high-frequency (HF 0.15-0.40 Hz) components were calculated. RESULTS: Intubation of the colonoscope increased the LF component of HRV and decreased HF power in all study groups compared to baseline recording. Furthermore, compared to baseline, the LF/HF ratio--a marker of cardiac sympathetic regulation--increased during intubation in the midazolam (P < 0.001) and placebo (P < 0.05) groups, with no change in the control group. During intubation the midazolam group presented with higher LF and lower HF power than placebo (P < 0.001) and control groups (P < 0.01). Accordingly, the LF/HF ratio was higher in the midazolam group than in the placebo (P < 0.05) or control groups (P < 0.05). CONCLUSIONS: Midazolam potentiates the dominance of the sympathetic nervous system induced by colonoscopy. Therefore, conscious sedation with midazolam may contribute to the occurrence of cardiovascular events during colonoscopy.

Colonoscopy↗
PubMed2000

GPs' ability to diagnose dyspepsia based only on physical examination and patient history.

OBJECTIVES: To evaluate the diagnostic value of the general practitioner's (GP's) unaided working diagnoses in dyspepsia. To compare the proportions of final diagnoses and the characteristics of patients who would have been referred to gastroscopy or to empirical drug treatment. DESIGN: Clinical study. PATIENTS: 400 consecutive dyspeptic patients consulting their GPs. MAIN OUTCOME MEASURES: Sensitivity, specificity and positive and negative predictive values (PV+ and PV-) were calculated for the GP's working diagnoses in cases of dyspepsia. The outcome of his/her decisions on how to manage dyspeptic patients was also evaluated. RESULTS: Gastroesophageal reflux disease would have been diagnosed accurately, with a sensitivity of 0.59, specificity 0.83, PV+ 0.43 and PV- 0.90. GPs diagnosed functional disorders with a sensitivity of 0.43, specificity 0.69, PV+ 0.56 and PV- 0.54; peptic ulcer with a sensitivity of 0.37, specificity 0.83, PV+ 0.28 and PV- 0.88; and malignancy with a sensitivity of 0.13, specificity 0.97, PV+ 0.08 and PV- 0.98. Patients who would have been referred to gastroscopy had more often lost weight (p = 0.01), suffered from abdominal pain (p=0.03) and from symptoms partly suggesting irritable bowel syndrome (p< or =0.03). CONCLUSIONS: The clinical diagnosis of the causes of dyspepsia is unreliable. In selecting patients for gastroscopy, more attention should be paid to risk factors such as age, use of non-steroidal anti-inflammatory drugs and history of previous peptic ulcer.

Adolescent↗
PubMed2000

Percutaneous dilational tracheostomy or conventional surgical tracheostomy?

OBJECTIVE: Percutaneous dilational tracheostomy (PDT) is increasingly used in intensive care units (ICU), and it has a low incidence of complications. The aim of this study was to compare the costs, complications, and time consumption of PDT with that of conventional surgical tracheostomy (ST) when both procedures were performed in the ICU. DESIGN: The study was a prospective, randomized trial. SETTING: The procedures were performed routinely in the ICU of Satakunta Central Hospital. PATIENTS: During a 23-month period from December 1995 to November 1997, 30 patients underwent PDT and 26 patients had ST. In one patient, PDT was converted to ST. All patients were receiving ventilation in the ICU, and all tracheostomies were performed at the patient's bedside in the ICU. The Portex percutaneous tracheostomy kit was used for all PDTs. RESULTS: The mean time to perform PDT was 11 mins (SD, 6; range, 2-40), and the mean time to perform ST was 14 mins (SD, 6; range, 3-39). In the PDT group, five patients had moderate bleeding during the procedure. In three patients, the bleeding was resolved with compression; in one patient, it was resolved with ligation of the vessel; and in one patient, it was resolved with electrocoagulation. Bleeding did not cause any complications afterward. In the PDT group, one patient had minimal oozing from the wound edge on the first postoperative day and it was resolved spontaneously. In the ST group, there were no intraprocedural complications. One patient had bleeding from the wound on first postoperative day. The sutures were removed, and the bleeding vessel was ligated. The mean cost (in U. S. dollars) of PDT was $161 (SD, 10.4; range, $159-$219), and the mean cost of ST was $357 (SD, $74; range, $239-$599). The cost of PDT was significantly lower than the cost of ST (p < .001). CONCLUSION: We found that PDT is a cost-effective procedure in critically ill ICU patients. Although we performed ST at the bedside in the ICU to avoid the risks associated with moving critically ill patients to the operating room, we found PDT to be a simple and safe procedure.

Adult↗
PubMed2000

Pharmacokinetics of ketoprofen syrup in small children.

Ketoprofen is a nonsteroidal anti-inflammatory drug with analgesic, anti-inflammatory, and antipyretic properties. Its pharmacokinetics has not been determined in small children. The objective here was to determine the pharmacokinetics of ketoprofen syrup, 0.5 mg/kg, in two groups of 10 children. Group 1 was from ages 6 months up to 2 years (7/10 younger than 1 year), and Group 2 was from ages 2 to 7 years. Venous blood samples were collected before drug administration and 0.5, 1, 2, 4, 6, 8, and 12 hours after. A validated HPLC method was used to determine plasma levels of ketoprofen. The lower limit of quantification was 0.02 microgram/ml of plasma. Ketoprofen syrup was absorbed rapidly, the plasma level reaching its maximum at 0.5 hours, with C0.5 hours = 3 micrograms/ml. The pharmacokinetics was similar between the two groups of children. The elimination half-life, 2.0 hours in Group 1 or 1.9 hours in Group 2, was similar to that reported in adults.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Trends of vascular service in a well defined geographical area in 1990's.

BACKGROUND AND AIMS: The treatment policy of vascular surgical patients has undergone changes in the last decade. The aim of this study was to evaluate development of vascular service in a well defined geographical area, the district of Tampere University Hospital. MATERIAL AND METHODS: This population based study is established on the vascular registry. During the eight year period (1990-1997) totally 5019 procedures had been registered, 3363 vascular surgical operations and 1656 endovascular interventions. This data was analysed retrospectively. RESULTS: The annual amount of vascular surgical procedures was in average 959 per million inhabitants and the amount of endovascular procedures 474 per million inhabitants during the period and the trend was slightly increasing. The mean age of surgical patients increased significantly during the eight year period, from 63.6 to 66.6 years, while the mean age of endovascular patients remained fairly stable over the whole period. The proportion of critical limb ischaemia as an indication for surgical procedure increased during the period from 7.3% to 16.6% (p < 0.001). In the same time also the amount of femoropopliteal and femorodistal bypasses as a treatment of CLI increased significantly (p < 0.001). Further, the proportion of surgical procedures compared to the endovascular procedures in the treatment of CLI increased constantly over the 8-year period from 25% to 61% (p < 0.001). The absolute amount of access surgery increased over the period and the mean age of these patients increased significantly. The median of hospital stay decreased during the eight year period in the surgical group from 9 days to 6 days and in the endovascular group from 2 days to 1 day. CONCLUSIONS: The main changes have been the increased mean age of patients, their shortened hospital stay and the increasing surgical activity on patients with CLI and the larger number of patients with need for vascular access.

Aged↗
PubMed1999

Is routinely given conscious sedation of benefit during colonoscopy?

BACKGROUND: Sedative drugs are generally given to patients undergoing colonoscopy. However, the benefit of routinely administered conscious sedation for colonoscopy has not been studied in adequately controlled trials. METHODS: We randomly assigned 180 patients scheduled for diagnostic colonoscopy into 3 groups: (1) sedation with intravenous midazolam (midazolam group); (2) sedation with intravenous saline (placebo group); and (3) no intravenous cannula (control group). The endoscopist assessed the procedure immediately after the examination. The patients completed a questionnaire before leaving the endoscopy unit. Another questionnaire was sent to the patients 2 weeks after the examination. Answers were mainly given on a 100 mm visual analog scale. RESULTS: Shortly after the procedure, the patients in the midazolam group rated the examination less difficult than those in the placebo group (30 vs. 40 mm; p < 0.05; visual analog scale, 0 to 100 mm: 0 = not at all, 100 = extremely). However, no significant difference was found between midazolam and control groups (30 vs. 36 mm, respectively). Otherwise, there were no differences between the three groups with respect to the patients' or endoscopists' assessments or the examination time. CONCLUSIONS: Routinely administered sedation does not markedly increase patient tolerance or make colonoscopy technically easier.

Adult↗
PubMed1998

Association of CagA-positive and CagA-negative Helicobacter pylori strains with patients' symptoms and gastritis in primary care patients with functional upper abdominal complaints.

BACKGROUND: CagA-positive Helicobacter pylori strains have been reported to be associated with peptic ulcer or malignancy more often than cagA-negative strains. Less is known about the relation of H. pylori serology (CagA-negative or CagA-positive) to histologic changes in the stomach of patients with functional upper abdominal complaints. The association of H. pylori status with patient symptoms or with different subgroups of non-organic dyspepsia is also obscure. In the present study patients' symptoms and their relation to H. pylori serology (H. pylori-negative, H. pylori-positive but CagA-negative, and H. pylori-positive and CagA-positive) were evaluated in general practice patients who had functional upper abdominal complaints. The association of H. pylori serology with different symptom-based subgroups of functional upper abdominal complaints was also assessed. The severity and activity of inflammation and the presence of atrophy and intestinal metaplasia in the antrum and body were evaluated and compared with H. pylori status. METHODS: Four hundred consecutive unselected dyspeptic patients in primary care were investigated by means of gastroscopy, upper abdominal ultrasound, laboratory screening including H. pylori and CagA serology, and other examinations if needed. Of these patients 193 with functional upper abdominal complaints were enrolled in this study. RESULTS: Of the study patients 87 (45%) were H. pylori-negative, 70 (36%) were H. pylori- and CagA-positive, and 36 (19%) were H. pylori-positive but CagA-negative. There were no differences in the occurrence of any dyspeptic symptoms between H. pylori-related subgroups. Nor was there an association between H. pylori status and symptom-based subgroups in our study patients. Inflammation of the stomach was related to H. pylori infection, but CagA-seropositive patients did not have moderate or severe inflammation more often than CagA-seronegative ones. CagA-seropositive patients with functional upper abdominal complaints did not have atrophic changes or intestinal metaplasia in the stomach more often than those who were CagA-negative. CONCLUSIONS: H. pylori or more specific CagA serology is not associated with any specific symptom profile of dyspepsia or with any symptom-based subgroups in patients with functional upper abdominal complaints in primary care. The study patients with CagA seropositivity did not have more severe histologic changes in the stomach than the patients who were H. pylori-seropositive but CagA-seronegative.

Abdominal Pain↗
PubMed1998

Combination chemotherapy versus single-agent therapy as first- and second-line treatment in metastatic breast cancer: a prospective randomized trial.

PURPOSE: We report results of a randomized prospective study that compared single agents of low toxicity given both as the first-line and second-line chemotherapy with combination chemotherapy in advanced breast cancer with distant metastases. PATIENTS AND METHODS: Patients in the single-agent arm (n = 153) received weekly epirubicin (E) 20 mg/m2 until progression or until the cumulative dose of 1,000 mg/m2, followed by mitomycin (M) 8 mg/m2 every 4 weeks, and those in the combination chemotherapy arm (n = 150) were first given cyclophosphamide 500 mg/m2, E 60 mg/m2, and fluorouracil 500 mg/m2 three times per week (CEF) followed by M 8 mg/m2 plus vinblastine (V) 6 mg/m2 every 4 weeks. Exclusion criteria included age greater than 70 years, World Health Organization (WHO) performance status greater than 2, prior chemotherapy for metastatic disease, and presence of liver metastases in patients younger than 50. RESULTS: An objective response (complete [CR] or partial [PR]) was obtained in 55%, 48%, 16%, and 7% of patients treated with CEF, E, M, and MV, respectively. A response to CEF tended to last longer than a response to E (median, 12 v 10.5 months; P = .07). Treatment-related toxicity was less in the single-agent arm and quality-of-life (QOL) analysis favored the single-agent arm. No significant difference in time to progression or survival was found between the two arms. Similarly, no difference in survival was found when the patients who received both the planned first-and second-line treatments were compared or when survival was calculated from the beginning of the second-line therapy. CONCLUSION: Patients treated with single-agent E followed by single-agent M had similar survival, but less treatment-related toxicity and better QOL as compared with those treated with CEF followed by MV.

Adult↗
PubMed1997

Long-term anal sphincter performance after surgery for Hirschsprung's disease.

BACKGROUND/PURPOSE: The aim of the study was to assess anal sphincter performance in relation to clinical fecal continence in adult patients who have Hirschsprung's disease. METHODS: Fifty-four adult patients (mean age, 29 +/- 7.2 years; 46 men; 8 women) who had undergone surgery for Hirschsprung's disease during their childhood underwent anorectal manometry and clinical examination. Fecal continence was evaluated with a quantitative scoring method (scoring, 0-14; 14, normal bowel function; 10-13, good continence, no social problems; 5-9, fair continence, marked social limitations; 0-4, total incontinence). Thirty healthy adults were used as controls. RESULTS: Fourteen patients had normal bowel habits according to the quantitative scoring. The median anal resting pressure of these patients was 25 cm H2O (range, 15-37.5). The median resting pressure of patients with good continence (n = 30; median, 20 cm/H2O; range, 5-27.5) and with fair continence (n = 6; median, 15 cm/H2O; range, 5-27.5) was significantly lower (P < .01) than in patients who had normal continence. There was no statistical difference in maximal squeeze pressure between the patient groups (median normal, 52.5; good, 45; fair, 52.5). In the controls, the median resting pressure (61.5 cm H2O; range, 34-105) and maximal squeeze pressure (86 cm H2O; range, 55-148) were significantly higher than in all patient groups (P < .0001). The voluntary sphincter force (maximal squeeze pressure minus resting pressure) was similar in patients and controls (patients median, 27 cm H2O; controls median, 16 cm H2O, NS). CONCLUSIONS: There is a positive correlation between functional outcome and anal resting pressure in adults who have repaired Hirschsprung's disease. The overall low resting pressure reflects internal sphincter dysfunction, which may be caused by operative trauma. Despite this, most patients have a satisfactory functional outcome, which is probably related to normal voluntary sphincter performance.

Adult↗