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Biomedical subjects

M Toivanen

Publications and source records attributed to M Toivanen.

7 recordsLinked to original sources
PubMed1997

[Day case surgery nursing development].

Day case surgery in the North Karelia Central Hospital has been centred to LYHKI-unit which was opened in the autumn of 1994. The work and development is guided by a perioperative nursing model in which the patient's experiences and functions of nursing take place in three successive preoperative, intraoperative and postoperative phases. The more extensively the nurse participates in the pre and postoperative phases, the more skilled she is. The objective of development is a planned preadmission assessment between the patient and the nurse before the operation day. It is already realized for several patients, and documentation is improved by bringing into use a new case history form which is created according to the new perioperative nursing model. The nurses have committed themselves to implementation of the perioperative nursing. Developmental and educational activity is good in the unit. Plentiful positive feedback from the patients, encouraging support from the administration and continuous cooperation in developmental work have had an effect on the nurses' improved motivation for work. In the future the resources will be especially focused to the quality of care and to meet the societal challenges for day surgery.

Ambulatory Surgical Procedures↗
PubMed1992

Influence of topical steroid treatment on maxillary sinusitis.

The clinical efficacy and adverse effects of budesonide administered as a nasal aerosol in addition to sinus washings and erythromycin therapy was assessed by comparison with placebo in a randomized, double-blind study of 40 patients with chronic or recurrent maxillary sinusitis. Most of the patients had been referred for operative treatment. Corticosteroid therapy, 400 micrograms daily, or placebo was continued for 3 months. Budesonide and antral irrigations reduced nasal symptoms more effectively than placebo, and there was a significantly greater reduction in facial pain and sensitivity in the budesonide group than in the placebo group. During the treatment period, mucosal thickening as evaluated by radiology decreased more clearly in the budesonide group than in the placebo group, but the difference did not reach statistical significance. The most frequently isolated bacteria were Staphylococcus aureus, Staphylococcus epidermidis and Haemophilus influenzae. Only 2 of 20 Haemophilus strains were beta-lactamase producers. The cellular picture was dominated by neutrophils in all secretions. There was no significant difference in clinical outcome between the two groups. Topical steroid therapy did not cause any adverse effects.

Administration, Topical↗
PubMed1990

Bacterial findings in middle ear effusion in children.

During 1983-87, tympanostomy tubes were inserted in a total of 4952 ears of 2575 children remitted to the ENT Department of our hospital because of chronic or recurrent otitis media problems. The children were included in a prospective study and referred to one of three groups for comparison of findings. Group 1 included all 6- to 12-month-old infants undergoing primary tube treatment; group 2, all children 1 year or older who had their first ventilation tube(s) inserted in connection with adenoidectomy; and group 3, all children in whom tympanostomy had been performed one or more times previously. Middle ear effusion was aspirated from 2392 ears (48%); 67.6% of all ears were negative for bacteria and 22.1% of the ears with effusion grew pathogenic bacteria. S. pneumoniae was the most frequently cultured pathogen among the 6 to 12 month olds in group 1, but in groups 2 and 3 H. influenzae occurred more frequently than S. pneumoniae. Beta-lactamase-producing strains of pathogenic bacteria were formed in only 4% of all ears with effusion: H. influenzae in 1.2% and B. catarrhalis in 2.8%. Compared with figures from the United states, the frequency of beta-lactamase-producing strains is low in the present series. This is probably explained by differences in antimicrobial treatment practices; in Finland and the Scandinavian countries, penicillin V is the primary drug for acute otitis media. In light of present results, it seems well-suited for treatment of otitis media in young children.

Acute Disease↗
PubMed1987

Histochemical demonstration of adrenergic nerves in the stroma of human cornea.

Both fetal and adult human corneas were subjected to a variety of histochemical techniques for the demonstration of catecholamines. The techniques included both sodium-potassium-glyoxylic acid-induced fluorescence (SPG) and formaldehyde-induced fluorescence after freeze-drying (FIF) procedure. In fetal corneas the presence of adrenergic nerve fibers could be demonstrated by both SPG and FIF techniques. In contrast, in adult human corneas the adrenergic nerves could be identified only with the SPG technique, whereas with FIF the identification of specific catecholamine fluoresence was not possible due to extensive collagen autofluorescence.

Adrenergic Fibers↗
PubMed1985

Immunohistochemical localization of neurotensin in hamster adrenal medulla.

Neurotensin-like immunoreactivity was localized in nerve fibers and terminals of hamster adrenal medulla at light and electron microscopy using the peroxidase-antiperoxidase method. Numerous varicose neurotensin-immunoreactive nerves and terminals were found among nonlabeled cell groups situated peripherally in the adrenal medulla. Combined formaldehyde-glutaraldehyde (Faglu) fluorescence and immunohistochemistry of the same vibratome section showed that only norepinephrine cells were innervated by neurotensin-immunoreactive nerves. All norepinephrine cells seemed to be innervated by neurotensin-immunoreactive nerves. Neurotensin-immunoreactive nerves disappeared after extrinsic denervation of the adrenal gland. By electron microscopy numerous neurotensin-immunoreactive terminals were seen to make synaptic contacts with norepinephrine cells and with autonomic ganglion cells present in small numbers among norepinephrine cells. In the terminals neurotensin-like immunoreactivity was localized mainly in large dense-cored vesicles, but some precipitates were also associated with small vesicles, diffusely scattered in the axoplasm. The present findings suggest that in the hamster adrenal medulla part of the nerve terminals arising from splanchnic nerves contain neurotensin-like peptide. The functional significance of these nerves in the hamster adrenal medulla remains to be elucidated.

Adrenal Medulla↗
PubMed1982

Catecholamine- and acetylcholinesterase-containing nerves in human lower respiratory tract.

The innervation of human lower respiratory tract was studied with special emphasis on airways with sodium-potassium glyoxylic acid (SPG) and acetylcholinesterase (AChE) methods to demonstrate catecholamine-containing and acetylcholinesterase-containing nerve fibers. AChE-method revealed a rich network of cholinesterase positive nerves both inside the bronchial glands where they run around and between the acini, and the airway smooth muscle from secondary bronchi to terminal bronchioli. No AChE-positive fibers were found in connection with the blood vessels or within the epithelium of bronchi or bonchioli. The AChE-positive nerve fibers in bronchial smooth muscle greatly outnumbered those containing catecholamine. The SPG-method revealed the presence of adrenergic nerves from the level of secondary bronchi to that of terminal bronchioli. These nerve fibers were most abundant in bronchial glands, where their amount was equal and distribution similar to those of AChE-containing nerve fibers. Outside the glands adrenergic fibers were constantly seen in connection with the bronchial blood vessels in connective tissues surrounding bronchi. A few nerve fibers were also present in airway smooth muscle from the secondary bronchi to terminal bronchioli.

Acetylcholinesterase↗