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Biomedical subjects

M Mattila

Publications and source records attributed to M Mattila.

At least 19 recordsLinked to original sources
PubMed1991

Hazard screening and proposals for prevention by occupational health service: an experiment with job load and hazard analysis at a Finnish construction company.

In this study a systematic method for workplace investigation was developed and then tested as part of the regular occupational health care procedures in the building trade. Workplace investigation is a concept which entails the analysis of hazards inherent in the work as well as assessment of their effects on workers' well-being. The aim of this paper is to evaluate the effectiveness of the workplace investigation method. The newly developed method, called Job Load and Hazard Analysis, has the following characteristics: a job analytic approach; the application of group problem-solving; and cooperation between occupational health professionals, occupational safety personnel, and line management. The method comprises the identification of health hazards, their assessment, and conclusions and proposals as to their prevention and follow-up. The method was tested as part of one constructor's actual occupational health care programme, over a 2.5-year period. The method worked well as a central component of preventive occupational health care. It yielded concrete data that could be applied to make the occupational health care programme better suited to preventing the hazards inherent in the building trade. The contents of the occupational health care programme were clearly enhanced, the number of preventive measures increased, and the organizational climate improved; the workers praised the increased emphasis on safety. More research is needed, eg in other production settings and to determine the most effective utilization of the data gathered by the method.

Finland↗
PubMed1991

Pharmacokinetics and clinical response of hyoscine plus morphine premedication in connection with cardiopulmonary bypass surgery.

Plasma hyoscine and morphine levels and various pharmacodynamic responses have been examined in seven patients scheduled for a coronary-artery bypass graft. Hyoscine 0.006 mg kg-1 and morphine 0.20 mg kg-1 were administered intramuscularly as routine premedication. Surgery was performed using high-dose fentanyl anaesthesia (100 micrograms kg-1). The clinical responses followed were heart rate, blood pressure, subjective sedation and antisialogogue effect. The plasma hyoscine levels were determined by radioreceptor assay, and plasma morphine levels by liquid chromatography, both up to 24 h. The maximum levels of plasma hyoscine (6.6 micrograms l-1) and morphine (158 micrograms l-1) and the time they were reached (13.0 and 9.7 min, respectively) were comparable with the values obtained in earlier studies using young healthy subjects. After the start of cardiopulmonary bypass, significant decreases in plasma levels of both hyoscine and morphine were found. The elimination half-life of hyoscine in the plasma was 2.4 h, which is somewhat greater than obtained in earlier studies with young healthy patients under regional anaesthesia. Elimination of plasma morphine (t1/2el = 3.3 h) was not significantly altered by the procedure. The sedative and antisialogogue effects of the drugs appeared quickly and were significant, but no tachycardia or other side effects were observed. In conclusion, the kinetic properties of both hyoscine and morphine are suitable for routine use as premedicants before cardiac surgery.

Anesthesia, Intravenous↗
PubMed1990

Drug interaction studies with remoxipride.

The interaction potential of remoxipride was investigated with biperiden, warfarin, diazepam, and ethanol. The studies were conducted in 12 healthy volunteers each of whom received single doses of remoxipride, the interacting drug, and the combination in a randomized crossover design. Remoxipride and biperidene had no influence on each other's pharmacokinetics. The pharmacokinetics of warfarin enantiomers were uninfluenced by remoxipride. Ethanol and diazepam had no effect on the pharmacokinetics of remoxipride. The effect of remoxipride on the elevation of plasma prolactin levels was not modified by biperiden and the effect of warfarin on the prolongation of prothrombin time was uninfluened by remoxipride. Remoxipride showed no pharmacokinetic interaction with any of the drugs studied, nor was any pharmacodynamic interaction observed in the remoxipride versus biperiden and remoxipride versus warfarin studies.

Adolescent↗
PubMed1989

Improvement in the occupational health program in a Finnish construction company by means of systematic workplace investigation of job load and hazard analysis.

The aim of the present study was to improve an occupational health program by means of systematic workplace investigations. The 8-month study was done at three building sites of one construction firm. The method for workplace investigations was a simple job hazard analysis of chemical hazards, physical hazards, physical work load, mental stress, and risk of injury, each factor being rated on a three-point scale. Information was gathered by observations, interviews, and a worker questionnaire. Occupational health and safety personnel and worker representatives dealt with problems cooperatively. Together they assessed occupational loads and hazards, whereafter the occupational health and safety personnel devised an occupational health care program and proposed preventive measures. The workplace investigation method proved to function well. It improved the occupational health care program, produced an overall analysis of occupational hazards, and dramatically increased the number and quality of proposed preventive measures. The new method was evaluated to be clearly superior to previous practices and was implemented at moderate cost. The study showed that attention to issues of environmental and occupational health can effectively prevent health impairment even in difficult setting such as construction work. More research is needed for effective utilization of information accumulated by systematic workplace investigations.

Finland↗
PubMed1989

Connective tissue changes of the multifidus muscle in patients with lumbar disc herniation. An immunohistologic study of collagen types I and III and fibronectin.

The connective tissue components, Types I and III collagen fibronectin, were immunohistologically analyzed using their specific antibodies for localization and semiquantitative estimation in 24 patients (11 women and 13 men, all under 55 years of age) operated on for herniated lumbar intervertebral disc. Nine cadavers without known back problems (2 women, 7 men) served as controls. In controls, Type I collagen was present in the endo- and perimysial structures of the muscle, more conspiciously in the former. Type III collagen, together with fibronectin, were more abundant in the perimysium than in the endomysium. Thickening of these structures was not evident in the controls. In most patients Types I and III collagen and fibronectin distribution was similar to that of the controls. However, fibrotic changes of both and endo- and perimysial structures involved all Types I and III collagen and fibronectin in ten cases. In two patients an increase in Type I collagen staining intensity in the endomysium was recorded and thickening of the endomysial structures was observed in six patients. There were correlations with the severity of the connective tissue structural changes to atrophy of the muscle and furthermore to disability of the patient in the 1-year postoperative check-up. These findings suggest that if marked fibrosis of the muscle occurs, it can be a factor impairing recovery from the disease during the long-term postoperative course.

Adult↗
PubMed1989

Actions and interactions of psychotropic drugs on human performance and mood: single doses of ORG 3770, amitriptyline, and diazepam.

Actions and interactions of two antidepressants and diazepam on human skilled performance and mood were studied in a randomized double-blind cross-over trial with single oral doses of 50 mg amitriptyline (AMI), 15 mg Org 3770 (ORG) and placebo, given alone and in combination with 15 mg diazepam (DZ) to 12 young healthy subjects at one-week intervals. Objective tests (digit substitution, tapping, flicker fusion, Maddox wing, tracking, choice reactions, body sway, memory) and subjective assessments (visual analogue scale) were performed at baseline and 1.5, 3, 4.5 and 6 hours after drug administration. Side-effects were reported, blood pressure and heart rate measured and blood samples taken after each testing run. Placebo was nearly inert on performance and mood. DZ impaired some objective skills and showed sedative effects in the subjective tests. AMI produced sedation and impaired coordination as well as cognitive performance (digit substitution), most clearly at 3 to 4.5 hr. ORG resembled AMI in impairing objective and subjective performance, however, not necessarily in the same tests. Their combined effects with DZ were additive in objective tests but less additive in subjective tests. The drug combinations, but not any single drug, impaired learning acquisition. Plasma concentrations of the drugs given alone were about as expected, without important interactions. We conclude that the combinations of benzodiazepines with the antidepressants used impair skilled performance but may not cause major hazards.

Adult↗
PubMed1988

Objective and subjective assessments of the effects of flupentixol and benzodiazepines on human psychomotor performance.

The aim of this double-blind crossover trial was to compare the objective and subjective effects of flupentixol and lorazepam on human performance, and to reveal possible interactions between flupentixol and diazepam. Twelve healthy students received at 1-week intervals oral single doses of flupentixol 1 mg, flupentixol 2 mg, lorazepam 2.5 mg, placebo, and diazepam 15 mg alone and with flupentixol 1 mg. After the baseline measurements, the drugs were given in capsule form, and the tests were repeated 1.5, 3 and 4.5 h later. Diazepam was given at 1.5 h, to time its peak effect to coincide with that of lorazepam. Drug effects were measured objectively (two tracking tests, digit substitution, letter cancellation, flicker fusion, Maddox wing, tapping, memory) and subjectively (visual analogue scales, questionnaire). Blood samples were taken after each test time. Flupentixol 1 mg did not differ from placebo objectively or subjectively. Flupentixol 2 mg proved nearly inert objectively and on visual analogue scales. Lorazepam impaired objectively measured test performance, the clearest effects occurring at 3 and 4.5 h. It also impaired subjectively assessed performance. Diazepam impaired objective performance less than lorazepam, its effects peaking at 1.5 h after intake. Diazepam caused subjective drowsiness, clumsiness, mental slowness etc. as much as or more than lorazepam. The combination of 1 mg flupentixol and diazepam modified performance as much as diazepam alone. After the administration of 1 mg flupentixol, plasma concentrations were undetectable and levels after 2 mg were hardly detectable. Concentrations of lorazepam exceeded those of diazepam in direct bioassay, but they were much lower when bioassayed after solvent extraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Anxiogenic effect of yohimbine in healthy subjects: comparison with caffeine and antagonism by clonidine and diazepam.

Three placebo-controlled double-blind and crossover trials were carried out to analyze the effects of oral yohimbine (YOH) 0.8 mg/kg on mood and performance in 16 healthy students. Subjective assessments (visual analogue scales, side-effects on questionnaire) and objective measurements (digit symbols, flicker fusion, tapping, heterophoria) were done at baseline, and post treatment. YOH shifted the healthy subjects' mood towards feeling panicked, elevated systolic blood pressure and plasma prolactin concentrations, reduced digit symbol substitution, and induced drowsiness and passiveness. Caffeine (CAF) 10 mg/kg raised plasma cortisol and rendered the subjects slightly panicked. Muzziness, clumsiness, tremor, chills and nausea were common after both YOH and CAF. Diazepam (DZ) 0.3 mg/kg given at 60 min antagonized some effects of CAF but failed to antagonize YOH. Clonidine (CLO) 100 micrograms counteracted YOH effects on blood pressure but less the subjective and hormonal effects. CLO 200 micrograms partly antagonized the pressor, sedative but not the hormonal responses of YOH. DZ counteracted YOH effects on plasma cortisol on panic but not on other subjective measures or plasma prolactin. Since CLO did not abolish YOH-induced prolactin increase, it is suggested that these effects of YOH are mediated not only via adrenergic alpha 2-receptors; other mechanisms made important contributions.

Adult↗
PubMed1988

Acute and subacute effects of diazepam on human performance: comparison of plain tablet and controlled release capsule.

The psychomotor performance of 9 healthy volunteers was measured in a randomized, double-blind, cross-over manner after single doses (Day 1) and one-week maintenance (Day 8) with diazepam given in uncoated tablets (DZ) or in controlled-release capsule (DZ-CR). The performance was measured objectively (simulated driving, digit symbol substitution, Maddox wing, flicker fusion, tapping rate) and subjectively (visual analogue scales, questionnaires) at baseline and 1.5 and 3 hrs after the intake of DZ 15 mg, DZ-CR 20 mg, or placebo. The maintenance dose for diazepam was 10 mg daily. Subjective, but not objective, responses to placebo were evident on Day 1, but not on Day 8. As expected, DZ impaired most objective test performances on Day 1, the strongest effects seen at 1.5 hr. Subjectively it caused drowsiness and impaired performance. These effects were weaker but still significant on Day 8. DZ-CR produced less effects on both objective and subjective measurements on Day 1. It was about inert on Day 8, yet exophoria and subjective muzziness increased after the last dose; the subjects did not experience their performance as impaired. Measurements of plasma benzodiazepine concentrations confirmed the different pharmacokinetic profiles of DZ and DZ-CR due to different rates of absorption, yet characteristic accumulation of diazepam and its active metabolites during maintenance was seen with both formulations. The results suggest that DZ-CR capsule with less acute psychomotor impairment and steady pharmacokinetic profile would well suit to the treatment of anxiety for longer periods.

Adult↗
PubMed1988

Acute effects of sertraline, amitriptyline, and placebo on the psychomotor performance of healthy subjects over 50 years of age.

A double-blind, placebo-controlled, crossover study in 12 subjects (greater than or equal to 50 years) compared the effects of single oral doses of sertraline (100 mg) and amitriptyline (50 mg) with placebo as assessed by psychomotor function testing. Unlike sertraline and placebo, amitriptyline increased tracking error severity and impaired digit/symbol substitution. Sertraline slightly improved flicker frequency recognition. Both active drugs caused subjective drowsiness, although amitriptyline's effect was greater and of longer duration. Both drugs impaired subjectively assessed performance. Sertraline caused nausea, and amitriptyline, dry mouth; sertraline tended to increase supine systolic blood pressure. The authors conclude that sertraline has a considerably less detrimental effect on psychomotor performance and may have a slight activating effect not found with amitriptyline.

1-Naphthylamine↗
PubMed1986

Acute and subacute actions on human performance and interactions with diazepam of temelastine (SK&F93944) and diphenhydramine.

Thirteen healthy subjects participated in a combined acute and subacute double-blind, cross-over trial of two H1-antihistamines diphenhydramine (DPH) and temelastine (SKF) against placebo. The doses were DPH 50 mg b.d. and SKF 100 mg b.d. Objective (digit symbol substitution, flicker fusion, Maddox wing, attention, tracking, choice reaction) and subjective (visual analogue scales, side-effects on questionnaire) tests were done on Days 1, 4 and 5, on each occasion before drug intake and after 90 min and 3 h. On Day 1 DPH caused clear sedation of unpleasant character and impaired flicker fusion, attention and digit symbol substitution. SKF shifted the VAS assessment "drowsy/alert" towards drowsiness at 90 min, without objective impairment. On Day 4 DPH reduced exophoria and impaired flicker fusion without subjective sedation. On Day 5, diazepam 0.3 mg/kg (DZ) given with the other drugs caused subjective sedation of pleasant character and impaired various functions in the objective tests. Neither SKF nor DPH increased the effects of DZ; DPH slightly counteracted the effect of DZ on exophoria. At home, SKF did not differ from placebo while DPH proved sedative. DPH did not improve sleep but caused dry mouth and blurred vision. Measurement of plasma levels of antihistamines on each test day revealed the development of tolerance to antihistamine-induced sedation. The concentration of DZ measured by bioassay was somewhat elevated in the presence of DPH. Since the majority of the performance tests were not influenced by temelastine, it appears to be an acceptable, novel H1-antihistamine for the treatment of allergic disorders.

Adult↗
PubMed1986

Combined effects of buspirone and diazepam on objective and subjective tests of performance in healthy volunteers.

The combined effects on performance of two anxiolytics with different mechanisms of action were evaluated double-blind and crossover in 12 healthy students. Objective (tracking, divided attention, Maddox wing, etc.) and subjective (visual analogue scales and questionnaires) tests were done before and twice after single oral doses. Diazepam (0.15 and 0.30 mg/kg) impaired performance dose relatedly and rendered the subjects drowsy, calm, mentally slow, and clumsy. Buspirone (15 mg) proved inactive in objective tests but matched diazepam (0.30 mg/kg) subjectively. In combinations, buspirone added to the effects of diazepam in Maddox wing and letter cancellation but tended to counteract diazepam effects on divided attention and learning acquisition. Subjectively buspirone prolonged diazepam-induced sedation. Increased calmness caused by diazepam was not affected by concomitant buspirone. It is suggested that combining small doses of buspirone to diazepam does not cause any additional decrement in psychomotor performance. Possible advantages of the diazepam-buspirone combination in therapeutic use are discussed.

Adult↗
PubMed1986

The multifidus muscle in patients with lumbar disc herniation. A histochemical and morphometric analysis of intraoperative biopsies.

Structural changes in the multifidus muscle were analyzed in 41 patients operated on for herniated intervertebral disc. Twelve cadavers served as controls. The two main findings follow: Both in the patients and in the controls the Type 2 muscle fibers were markedly and selectively smaller than the Type 1 fibers, which were of normal size for striated muscles, and the internal structure of Type 1 fibers showed so-called core-targetoid and/or moth-eaten change. Group atrophy or fiber-type grouping (indicators of denervation and reinnervation) were observed only in a few patients. The selective small size of the Type 2 fibers may indicate atrophy due to relative inactivity of the multifidus muscle both in the patients and in the controls, ie, it does not need to be related to the herniated disc. Definite proof for denervation of the multifidus muscle was not observed, but neither the possibility be excluded. The cause of the core-targetoid and/or moth-eaten changes cannot yet be determined with certainty, because these changes are not specific for any single entity but may be due, for example, to denervation, ischemia, or altered use of the muscles because of pain. In any case, because the changes were significantly more common in the patients than in the controls, they signal for a pathologic condition, the character of which remains to be elucidated.

Adult↗
PubMed1985

Dihydroergotamine in the prevention of hypotension associated with extradural anaesthesia.

The efficacy of a single dose of dihydroergotamine (DHE) 0.5 mg i.v. in preventing the decrease in arterial pressure resulting from extradural anaesthesia was studied in 47 patients; 24 received DHE and 23 a placebo, in a randomized double-blind manner. Although the decrease in systolic arterial pressure was more pronounced in the placebo group than in the DHE group, the difference was not significant. Diastolic and mean arterial pressures were both significantly lower in the placebo group than in the DHE group during the initial phase of extradural anaesthesia. Administration of DHE did not cause any significant changes in heart rate. In both groups the heart rate decreased significantly during the 5-h period following the induction of extradural anaesthesia. The patients in the placebo group needed additional medication to increase unacceptably low arterial pressures or heart rate more frequently than the patients in the DHE group.

Adolescent↗
PubMed1985

Acute pharmacokinetic and pharmacodynamic comparison of two different formulations of temazepam.

Twelve healthy subjects ingested temazepam 20 mg in two different formulations (soft gelatine capsule or uncoated tablet) and matched placebo at one-week intervals in double-blind and cross-over conditions. Venous blood was sampled before the drug intake and 0.5, 1, 2, 3, 8, 12, and 24 hours after it, and plasma temazepam concentrations were assayed by gas chromatography. Psychomotor performance was measured objectively (digit symbol substitution, letter cancellation, Maddox wing) and subjectively (visual analogue scales) before the drug intake and 1, 2, and 3 hours after it. Peak concentrations of plasma temazepam were reached at about one hour, and they were higher after the capsule than after the tablet (mean values 750 vs. 587 ng/ml), while the computed AUCs and elimination half-lives (6-22 hours) proved to be similar after either formulation. Impaired performance was measured in objective tests over the first three hours, the capsule being somewhat more effective than the tablet. Self-assessments indicating subjective sedation returned to the placebo level within 3 hours after the capsule but not after the tablet. This rapid subjective recovery after the capsule might result from an acute tolerance developed after the high peak, and it tallies with the lack of residual sedation previously reported in trials with temazepam 20 mg given in soft gelatine capsules.

Adult↗
PubMed1979

Dosage of salicylates for children with juvenile rheumatoid arthritis. A prospective clinical trial with three different preparations of acetylsalicylic acid.

41 children with juvenile rheumatoid arthritis (JRA) and 6 with postinfectious arthropathies, aged 3--15 years, were treated with acetylsalicylic acid for 14 days during which time the patients were hospitalized. Three different acetylsalicylic acid preparations were used: a microencapsulated form, an enteric-coated form and standard acetylsalicylic acid tablets. Serum salicylate concentrations were measured by Trinder's photometric method. With doses of 90--120 mg/kg/day symptoms of salicylism appeared in about 50% of the cases. Daily doses of 2 g/m2 (not exceeding 70 mg/kg) proved relatively safe in this study, whereas symptoms and signs of intoxication appeared at doses exceeding 3 g/m2/day. In this respect there were no significant differences between the three acetylsalicylic acid preparations used. The results of this study also suggest that the serum salicylate concentrations should not exceed 2000 mumol/l (about 27 mg/100 ml). The symptoms of salicylism correlated closely with serum salicylate levels, which, in turn, correlated well with the dosage in g/m2. Elevation of serum aspartate aminotransferase was noted in 1/3 of the cases. All of these had a dose exceeding 2 g/m2, and the frequency of elevated enzyme activities increased with increasing dosage. In the group receiving enteric coated form of acetylsalicylic acid, there were fewer positive benzidine tests (12%) than in the two other groups (22--28%).

Adolescent↗