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Biomedical subjects

T Laine

Publications and source records attributed to T Laine.

At least 19 recordsLinked to original sources

Malignant catarrhal fever in pigs and a genetic comparison of porcine and ruminant virus isolates in Finland.

An outbreak of the sheep-associated form of malignant catarrhal fever (MCF) in a Finnish sow herd was diagnosed by histopathology and confirmed by PCR. Several gilts and sows were suffering from high fever and anorexia and had aborted, and six of them had died. Typical signs of lymphoproliferation and vasculitis were observed histologically in several tissues, including the uterus. Ovine herpesvirus-2 (OvHV-2) was detected by PCR in two sows. Sequences of the OvHV-2 tegument protein gene obtained from the sows and from three cases of sheep-associated mcf in Finnish cattle were compared and found to be identical. These are the first confirmed cases of mcf in pigs in Finland.

Animals↗

The effect of antimicrobial growth promoter withdrawal on the health of weaned pigs in Finland.

The use of the antimicrobial growth promoters (AGPs) carbadox and olaquindox has been banned in the European Union (EU) since September 1999. We studied the effects of the withdrawal on the health of weaned piglets on two types of piglet-producing farms (farrowing herds and farrow-to-finish herds) from the different regions of Finland. Farms with no major problems with post-weaning diarrhoea were selected for the study to better evaluate the effect of AGPs alone. Data on production, medication and incidence of diarrhoea were collected from 73 farms during 1 year after the withdrawal. On 29 of these farms, the data collection began 4 months before the withdrawal. The health management of the pigs is considered good in Finland, and special attention has been paid to improve the husbandry practices and management of the farms. Eighty-two percent of the farms in the study were free of both Mycoplasma hyopneumoniae and Sarcoptes scabiei infection. Brachyspira hyodysenteriae infection was not detected in any of the farms. The median number of sows in the herds was 56.0 (IQR=43.0; 72.5) in 2000. The level of antimicrobial use in each herd was classified as low, moderate and high when the percentage of weaned pigs treated for diarrhoea during a 4-month period was 0-5%, 6-19% and > or =20%, respectively. Only on four herds (14%), there was an increase in the level of antibiotic use after the AGP withdrawal, when seasonally corresponding 4-month periods were compared. Fourty-one percent of these 29 farms were categorized as low users of antimicrobials, 38% as moderate users and 21% as high users. The level of antimicrobial use for treatment of diarrhoea after weaning (and the incidence of diarrhoea in weaned piglets) did not increase significantly after the withdrawal of AGPs from weaner feeds according to farmers' evaluations. In this study, the Escherichia coli infection was the most-common cause of diarrhoea in weaned pigs. The age at weaning did not change after the withdrawal of AGPs.

Animal Husbandry↗

Glove perforations in open and laparoscopic abdominal surgery: the feasibility of double gloving.

BACKGROUND AND AIMS: According to the traditional view, the glove protects the patient from the bacterial growth of the surgeons' hands and doing so prevents infections. Today, with growing incidences of HIV and Hepatitis B and C, surgical gloves are also important as protection for the surgeon. We compared the safety of double indicator gloves to standard single surgical gloves by investigating how often surgical gloves are punctured in laparoscopic and open gastrointestinal surgery. STUDY: As study material we gathered all gloves that had been used in gastrointestinal surgery in Satakunta Central Hospital during two months. 814 gloves from 274 operations were tested by using standardized water filling test method. RESULTS: In open surgery 67 gloves out of 694 had been punctured (9.6 percent). Puncture occurred in 22.5 percent of operations (53 out of 236). During open surgery 24 holes out of 35 were undetected with single gloves (69 percent). With double indicator gloves, only 3 out of 31 holes were unnoticed (10 percent). Long duration of operation increased the risk of puncture. In laparoscopic operations 4 gloves out of 120 had been perforated (3.3 percent). CONCLUSION: Double surgical gloves give markedly better protection in surgery. This is important especially in high risk operations.

Chi-Square Distribution↗

Glove perforation in orthopaedic and trauma surgery. A comparison between single, double indicator gloving and double gloving with two regular gloves.

The spread of viral diseases such as HIV has highlighted the importance of protecting medical personnel against contamination from blood. We have assessed the frequency of the perforation of surgical gloves during orthopaedic and trauma surgery and compared the efficiency of single and double gloving. We examined all the gloves used by surgeons for a period of two months. There were 1769 gloves from 349 operations. Perforations occurred in 18.5% of conventional and 5.8% of arthroscopic procedures. The risk of contamination from blood was 13 times higher when using single compared with double gloves. Surprisingly, the combination of two regular gloves was much less efficient than double indicator gloves when comparing the rate of perforation of the inner glove when the outer had been damaged (24% vs 4.9%; p = 0.02). We recommend double gloving in orthopaedic surgery in general and also in long arthroscopic procedures.

Arthroscopy↗

Nutrient content of served food, nutrient intake and nutritional status of residents with dementia in a finnish nursing home.

PURPOSE: The aim of this study was to determine the energy and nutrient content of the served food, the actual energy and nutrient intake and the nutritional status of elderly residents in a nursing home. METHODS: The nutritional status of 23 individuals aged 69 to 89 years with dementia were assessed by Mini Nutrition Assessment -test (MNA). The nutrient content of the served food was calculated from all meals during a 14-day period. Food consumption was determined by precise weighing method. RESULTS: Of 23 residents, 20 were at risk of malnutrition and three were malnourished according to MNA. The mean energy content of the served food was 1665 kcal (7.4 MJ) per day. The amount of vitamin D in served food was too little and the amounts of vitamin E, folic acid, and fibre were somewhat lower than the recommended level. The amounts of other nutrients were sufficient or substantial. However, the true mean intake of energy in the whole group was only 1205 kcal (5.4 MJ) per day. The mean protein intake was 59 g. Intakes of vitamin D, E, and folic acid were clearly less than recommended whereas intakes of calcium, magnesium and zinc were as recommended. CONCLUSIONS: It may be possible to get enough energy and most nutrients from the served food, but many elderly nursing home residents did not eat enough. It may be helpful to individually assess, assist and monitor those residents who eat very little in a variety of ways to promote their quality of life.

Aged↗

Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN).

AIMS: To evaluate the safety and efficacy of levosimendan in patients with left ventricular failure complicating acute myocardial infarction. METHODS AND RESULTS: Levosimendan at different doses (0.1-0.4 microg x kg(-1) x min(-1)) or placebo were administered intravenously for 6h to 504 patients in a randomised, placebo-controlled, double-blind study. The primary end-point was hypotension or myocardial ischaemia of clinical significance adjudicated by an independent Safety Committee. Secondary end-points included risk of death and worsening heart failure, symptoms of heart failure and all-cause mortality. The incidence of ischaemia and/or hypotension was similar in all treatment groups (P=0.319). A higher frequency of ischaemia and/or hypotension was only seen in the highest levosimendan dose group. Levosimendan-treated patients experienced lower risk of death and worsening heart failure than patients receiving placebo, during both the 6h infusion (2.0% vs 5.9%; P=0.033) and over 24h (4.0% vs 8.8%; P=0.044). Mortality was lower with levosimendan compared with placebo at 14 days (11.7% vs 19.6%; hazard ratio 0.56 [95% CI 0.33-0.95];P =0.031) and the reduction was maintained at the 180-day retrospective follow-up (22.6% vs 31.4%; 0.67 [0.45-1.00],P =0.053). CONCLUSION: s Levosimendan at doses 0.1-0.2 microg x kg(-1) x min(-1) did not induce hypotension or ischaemia and reduced the risk of worsening heart failure and death in patients with left ventricular failure complicating acute myocardial infarction.

Acute Disease↗

How often does glove perforation occur in surgery? Comparison between single gloves and a double-gloving system.

BACKGROUND: In surgery, intact gloves protect the surgeon from bloodborne pathogens and the surgical wound from microorganisms on the skin of the surgeon. However, glove perforation is very common, and puncture rates as high as 61% are published in the literature. One objective of this study was to compare puncture rates between a unique double-gloving puncture indication system and single-use gloves, and another was to determine the extent to which glove perforations remain undetected during surgery. METHODS: The study material comprised all gloves used in surgical operations at our hospital for a period of 2 months. The analysis was made by the glove type in a prospective and randomized manner. Gloves were tested immediately after the surgical procedure using the approved standardized water-leak method for 2 minutes to detect any holes. The gloves used in this study were either a double-gloving puncture indication system or the standard glove used at our hospital. RESULTS: In 885 operations altogether, 2,462 gloves were tested; 1,020 single gloves, 1,148 double-glove systems, and 294 combination gloves were studied. The overall perforation rate was 192 out of 2,462 gloves (7.80%), and 162 out of 885 operations (18.3%). The detection of perforation during surgery was 28 out of 76 (36.84%) with single gloves, 77 out of 89 with the double-gloving system (86.52%), and 9 out of 27 with combination gloves (33.33%; P <0.001). The inner glove of the double-gloving system was punctured in 6 out of 88 outer glove perforations (6.82%). CONCLUSIONS: In view of the critical importance of safety at work by having a sterile barrier between surgeon and patient, it is very important to use a double-gloving puncture indication system, at least in operations where there is a high risk of glove perforation.

Color↗

Glove perforation rate in vascular surgery--a comparison between single and double gloving.

BACKGROUND: In surgery intact gloves act as a sterile barrier between surgeon and patient. The impermeable gloves protect the surgeon from bloodborne pathogens such as HIV, hepatitis B, and hepatitis C. On the other hand, the surgical wound is protected from micro-organisms from the skin of the surgeon. One objective of this study was to compare puncture rates between the double gloving color indication system and single-use gloves and the other to determine the extent to which glove perforations remain undetected during the course of vascular surgical operations. PATIENTS AND METHODS: The study material comprised all gloves used in vascular surgical operations at Satakunta Central Hospital for a period of two months. The analysis was made by the glove type in a prospective and randomised manner. Gloves were tested immediately after the surgical procedure using the approved standardized water-leak method. With this method the glove is filled with water using a special filling tube, and the water-filled glove is then checked for two minutes to detect any holes. The gloves used in this study were either double gloves with indicator, or the standard glove used at our hospital. RESULTS: In 73 operations altogether 200 gloves were tested, half of them were double gloves and half were single gloves. The perforation occurred in the double gloves 3 times and with single gloves 12 times. The overall perforation rate was 15 out of 200 gloves (7.5%). The detection of perforation during surgery was 60%. Most frequently the perforation was located in the second finger of the left hand, 9 out of 15 perforations. CONCLUSION: In view of the critical importance of safety at work both transmitting the pathogens from the skin of the surgeon to the wound and transmitting the bloodborne pathogens from the patient to the surgeon, it is very important to use double gloving at least in operations where there is a high risk of glove perforation.

Blood-Borne Pathogens↗

Neuropsychological test battery in the follow-up of patients with juvenile neuronal ceroid lipofuscinosis.

The aim of the present study was to develop a neuropsychological test battery for patients with juvenile neuronal ceroid lipofuscinosis (JNCL) and to study the development of cognitive functions during the first 5 years after diagnosis. Fourteen patients with JNCL entered the study. Nine patients were homozygous for the major mutation, whereas five were compound heterozygotes. All patients were studied annually with a special neuropsychological test battery (NEPSY) adapted from Luria's neuropsychological test, and modified for the visually handicapped; the Wechsler Intelligence Scale for Children - Revised (WISC-R) was also included. The neurological examinations were scored. Furthermore, 1.OT magnetic resonance imaging scan was performed at the beginning of follow-up and after a mean of 5 years. A decline in verbal IQ (WISC-R) during the follow-up period was found in all subjects except one compound heterozygous male. Short-term memory and digit memory span were already impaired at an early stage of the disease. Orientation to time was found to decline more than orientation to person and place. Motor speed usually became impaired after 10 years of age. Spatial orientation was impaired only in the patients homozygous for the major mutation. The test battery was found to be reliable and easy to use, and offered valuable information on the progress of the disease. It also provided important guidelines for rehabilitation.

Adolescent↗

Novice construction of chess memory.

Novice acquisition of skilled recall of chess positions was studied in an experiment in which two novices studied a series of five hundred chess positions during a period of several months. They spent fifteen minutes to half an hour a day teaching themselves these positions. As a result their skill in recalling chess positions rose from sixteen percent to somewhere between forty to fifty percent. The learning curve proved to have a shape which indicates that in the beginning learning is very fast but after some 100-150 studied positions the speed of learning decreases substantially. A computer simulation was used to model the results and analyse alternative explanations. Two alternative ways of thinking were tested. In the first, chunk construction was assumed to be based on the neighbourhood of associated pieces. The second model assumed a frequency-based correlative association process. Although the learning curves of the two models are very similar in shape to those of the subjects, the frequency-based associative model gave a better explanation for the data. This is why it is natural to suggest that common co-occurrence in addition to easily recognizable chess-specific characteristics, like colour and type of pieces, guide associative processes during chess players' learning of chess-specific chunks.

Association Learning↗

What do computer models of cognition explain: a reply to Gobet.

The differences between Gobet's views and ours call attention to some points concerning the argumentative status of computational models. If we have two fundamentally different models which reasonably accurately simulate a phenomenon, we must ask, what is the argumentative status of the models in psychological terms. Moreover, if it is possible to present different models of same phenomena, what is the general argumentative power of models in psychology? As the kind of differences between our views and the ones of Gobet's are common in modelling, we briefly call attention to these foundational issues in our paper.

Cognition↗

Effect of dose on the absorption of estradiol from a transdermal gel.

OBJECTIVES: To study whether dose adjustments in transdermal estradiol gel treatment would result in proportional changes in estradiol bioavailability and concentrations. METHODS: In an open study, 23 healthy postmenopausal women were treated consecutively with 0.5, 1.0 and 1.5 mg estradiol daily as a transdermal gel. Each dose was given for 16 days. Venous blood samples for serum estradiol and estrone measurements with RIA were taken at steady state on the 16th study day. From these concentrations, pharmacokinetic parameters for estradiol were calculated and corrected to correspond to equal dose by dividing the values by the dose. RESULTS: Area under the estradiol time-concentration curve and peak estradiol level increased linearily and dose-proportionally with daily estradiol doses of 0.5-1.5 mg. This was shown by lack of significant differences in the dose-corrected parameters. However, the 90% confidence intervals between the doses were outside the commonly accepted levels for bioequivalence. Peak estradiol level was clearer and occurred earlier with the highest 1.5 mg estradiol dose, while more stable estradiol levels were seen with the lowest 0.5 mg estradiol dose. CONCLUSIONS: The amount of estradiol on a certain skin area seems to be the determining factor in absorption. With higher estradiol doses, the absorption will be accelerated with a clearer peak estradiol level. The linear and dose proportional absorption indicates that flexible dose adjustments within the dose range of 0.5-1.5 mg estradiol daily can be made with an anticipated effect in estradiol bioavailability and concentrations.

Administration, Cutaneous↗

Computer-assisted spine surgery.

Computer assistance has been shown to improve significantly the accuracy and safety of pedicle screw insertion under clinical conditions. The technique of image-guided navigation is described in this article, based on the authors' clinical experience of over 4 years. The value of navigation systems for preoperative planning is discussed. Clinical results of the application of this new method in the cervical, thoracic, and lumbosacral spine as well as the iliosacral joints are presented by means of the authors' own studies and reports from the literature. Pros and cons of computer guidance are discussed. The authors predict computer navigation will be used in percutaneous and minimally invasive procedures in the near future.

Clinical Trials as Topic↗

A new approach to computer-aided spine surgery: fluoroscopy-based surgical navigation.

A new computer-based navigation system for spinal surgery has been designed. This was achieved by combining intraoperative fluoroscopy-based imaging using conventional C-arm technology with free-hand surgical navigation principles. Modules were developed to automate digital X-ray image registration. This is in contrast to existing computed tomography- (CT) based spinal navigation systems, which require a vertebra-based registration procedure. Cross-referencing of the image intensifier with the surgical object allows the real-time image-interactive navigation of surgical tools based on one single registered X-ray image, with no further image updates. Furthermore, the system allows the acquisition and real-time use of multiple registered images, which provides an advanced multi-directional control (pseudo 3D) during surgical action. Stereotactic instruments and graphical user interfaces for image-interactive transpedicular screw insertion have been developed. A detailed validation of the system was performed in the laboratory setting and throughout an early clinical trial including eight patients in two spine centers. Based on the resulting data, the new technique promises improved accuracy and safety in open and percutaneous spinal surgery.

Bone Screws↗

[Computer-assisted spine surgery: principles, technique, results and perspectives].

Computer-assisted techniques were introduced in spine surgery in the 1990s to improve accuracy and safety of operative procedures. Several reports on clinical results of computer-aided screw insertion in the cervical, thoracic, and lumbar spine as well as the sacro-iliac joints are available. They show a significant decrease of screw malplacement rates as compared to conventional insertion techniques. The quality of preoperative planning of spinal procedures has improved markedly by using computer navigation systems. Drawbacks, reliability problems, and safety issues of computer navigation are discussed. In the near future, the use of computer guidance for minimally invasive and percutaneous spine procedures is expected.

Bone Screws↗

Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients.

We performed a randomised controlled study to assess the accuracy of computer-assisted pedicle screw insertion versus conventional screw placement under clinical conditions. One hundred patients scheduled for posterior thoracolumbar or lumbosacral pedicle screw instrumentation were randomised into two groups, either for conventional pedicle screw placement or computer-assisted screw application using an optoelectronic navigation system. From the computer-assisted group, nine patients were excluded: one because of an inadequate preoperative computed tomography study, seven because of problems with the specific instruments or the computer system, and one because of an intraoperative anesthesiological complication. Thus, there were 50 patients in the conventional group and 41 in the computer-assisted group, and the number of screws inserted was 277 and 219, respectively. There was no statistical difference between the groups concerning age, gender, diagnosis, type of operation performed, mean operating time, blood loss, or number of screws inserted. The time taken for screw insertion was significantly longer in the computer-assisted group. Postoperatively, screw positions were assessed by an independent radiologist using a sophisticated CT imaging protocol. The pedicle perforation rate was 13.4% in the conventional group and 4.6% in the computer-assisted group (P = 0.006). Pedicle perforations of more than 4 mm were found in 1.4% (4/277) of the screw insertions in the conventional group, and none in the computer-assisted group. Complications not related to pedicle screws were two L5 nerve root lesions, one end plate fracture, one major intraoperative bleeding and one postoperative death in the conventional group, and one deep infection in the computer-assisted group. In conclusion, pedicular screws were inserted more accurately with image-guided computer navigation than with conventional methods.

Adult↗

Piezoelectric pulse sensor device (Pulse Chek)-monitoring after the treatment of lower leg ischemia.

BACKGROUND: The aim of this study was to evaluate the usefulness of the piezoelectric pulse sensor device (Pulse Chek) as a continuous monitoring method in early surveillance after the treatment of lower leg ischemia with either surgical or interventional procedures. METHODS EXPERIMENTAL DESIGN: prospective study. SETTING: institutional practice. PATIENTS AND INTERVENTIONS: two patient groups with peripheral arterial occlusive disease were included; a surgical group undergoing femoropopliteal bypass grafting (22 patients) and a group undergoing PTA of the femoral or popliteal arteries (18 patients). MEASURES: the piezoelectric pulse sensor was applied on the skin over the dorsalis pedis artery. A baseline waveform was recorded preoperatively and continuous monitoring begun immediately after the surgical or interventional procedure. Hard copy recordings of the pulse wave were done in the immediate postoperative period, the postoperative evening, the following morning or at any time the alarm was triggered. A late follow-up waveform was recorded after an average of 34 days. Simultaneous ABI measurements were recorded. RESULTS: Preoperatively or pre-intervention, the pulse waveform was accurately recorded in 15/22 (68%) patients in the surgical group and 14/18 (78%) patients of the PTA group. In 20 (91%) surgical group patients and in 14 (78%) PTA group patients, postoperative monitoring was reliable, the pulse waveform confirmed patency of the vessel. Piezoelectric pulse sensor device monitoring did not detect graft occlusion in only one patient in the surgical group where interpretation of the pulse wave was complicated by a slow atrial fibrillation. There were 19 alarms in the pulse waveform during monitoring for 11 (55%) surgical group patients and 18 alarms for 9 (64%) PTA group patients. None of the alarms resulted from graft occlusion. Reliable pulse waveform recordings were obtained in 16/21 (76%) surgical group patients of the original 22 (one graft occluded) and for 15/18 (83%) PTA group patients in the follow-up assessment after the mean 34 days. One surgical patient was lost to follow-up. CONCLUSIONS: The piezoelectric pulse sensor device can be recommended as a method of continuous monitoring immediately after the revascularization procedure in those patients who have a pedal artery where a reliable pulse waveform can be recorded.

Aged↗

Roost selection in the pipistrelle bat, Pipistrellus pipistrellus (Chiroptera: Vespertilionidae), in northeast Scotland.

Availability of suitable roost sites may limit bat distribution and abundance. We compared nine internal and 26 external features of 21 known roost buildings with those of 17 random buildings in northeast Scotland, U.K. (57 degreesN) to assess whether pipistrelle bats, Pipistrellus pipistrellus (55-kHz phonotype) are selective in their use of roosts. Bats did not select roosts with specific structural attributes. Compared with random buildings, roosts were closer to a tree over 10 m tall and had a greater percentage cover (of trees over 10 m tall) within a radius of 50 m. Trees may provide benefits by providing shelter and thus ameliorating the microclimate of the roost. Cover may also provide protection from predators so that bats are able to emerge earlier, thus increasing foraging time. Bats in the present study emerged 11 min earlier from roosts with 29% cover than from roosts with 3% cover, potentially gaining as much as 10% of their daily energy requirements in this extra time. Roosts were also more likely to have linear vegetation elements leading away from them. These features may be important for navigation, foraging or predator avoidance. Compared with random buildings roosts were closer to and surrounded by a greater area of deciduous woodland within a radius of 0.5 km, had a greater area of coniferous woodland within a radius of 0.5 km, and were more likely to be found within 0.5 km of a major river. All these factors are likely to be beneficial for foraging. A logistic regression model indicated that percentage cover within 50 m of the building was the best predictor of the presence or absence of bats roosting in a building. Copyright 1998 The Association for the Study of Animal Behaviour.

Journal Article↗