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Biomedical subjects

V Avikainen

Publications and source records attributed to V Avikainen.

13 recordsLinked to original sources
PubMed1992

Hip fractures in urban population in Finland.

We studied prospectively the occurrence of hip fractures among the over 49-year-old urban populations (n = 88,206) in the cities Tampere, Jyväskylä and Kotka in 1989 and compared the results with a parallel Scandinavian multicentre study. During 1989, there were 266 inhabitants who were treated for a hip fracture, 213 of them were women. Women had in 132 cases a femoral neck fracture and in 81 cases a trochanteric fracture, and the corresponding numbers for men were 22 and 31. Among women, the total hip fracture incidence in Jyväskylä (n = 22) was the lowest when compared with the ones in Tampere (n = 47) and Kotka (n = 36). These incidences were on average lower than in the other Scandinavian cities studied in parallel. The all over ratio of femoral neck/trochanteric fractures was 1.1 in Tampere, 3.0 in Jyväskylä and 2.2 in Kotka and in Tampere, women had 9.3 times more femoral neck fractures than men. Our study showed that in Finland in three major cities the hip fracture incidence was lower than what has been similarly registered in corresponding urban populations in other Scandinavian countries. We also point out that the relative part of trochanteric fractures appears to be increasing.

Aged↗
PubMed1992

Platelet activation during acute phase after multiple trauma.

The acute phase after multiple trauma is associated with both thrombotic phenomena and a bleeding diathesis. To evaluate the activation of platelets, beta-thromboglobulin (BTG) in plasma and serum and thromboxane B2 (TxB2) in serum were measured in 14 patients with multiple trauma. BTG in plasma was significantly increased on days 1, 2 and 10 to 14 after the trauma. The highest median value 90 micrograms/l was measured on day 1. BTG in serum was significantly reduced 1 to 7 days after the trauma (median levels 4450-9100 micrograms/l). TxB2 was significantly reduced (median levels 18-97 ng/l) on days 1 to 14. The increased plasma levels of BTG is due to the posttraumatic activation of platelets in vivo. The reduced levels of serum BTG and TxB2 reflect the deficient functional capacity of circulating platelets to respond to extreme stress. Therefore, platelet count alone may correlate poorly with the haemostatic potential and may underestimate the need of platelet transfusions.

Acute-Phase Reaction↗
PubMed1992

Hip fractures in two health care regions in Finland in 1989: an analysis of treatment.

We studied prospectively the demographic data, fracture types and modes of treatment in 390 patients with acute traumatic hip fractures in two health care regions in Finland, the Middle Finland region and the Kymenlaakso region in 1989. In Middle Finland population (251,203 inhabitants) 199 patients with a hip fracture were admitted to two acute care hospitals, while 191 patients were admitted in Kymenlaakso (population 189,726) to four acute hospitals. There were no significant differences in the sex- and age-specific incidences between the two regions. In Middle Finland, 70% of the fractures were of the femoral neck, 28% were trochanteric and 2% subtrochanteric. The corresponding figures in Kymenlaakso were 57%, 38% and 5% (P < 0.05). In Middle Finland, 73% of the femoral neck fractures were treated primarily with a hemiendoprosthesis, 2% with primary total hip replacement and 25% by osteosynthesis. The corresponding figures in Kymenlaakso were 81%, 7% and 12% (P < 0.001). The mean duration of hospital stay was 14 days in Middle Finland and 21 days in Kymenlaakso (P < 0.01).

Adult↗
PubMed1979

Acromioclavicular complete dislocation. Analysis of the operative results in 48 patients.

Complete acromioclavicular separation in 48 patients was treated by operation, using Kirschner wire for fixation in 20 cases and the A--O cortical screw in 17. Late resection of the distal end of the clavicle was performed in 11 cases. Follow-up examination was performed on average two years after the operation. Attention was paid to subjective symptoms, the objective state, duration of incapacity, radiological evidence of dislocation without stress and under stress, osteoarthrosis and soft-tissue calcification. Pain, function and mobility were evaluated by a point system. In the groups primarily treated by surgery the result was at least good in 73%, fair in 16% and poor in 11%. Excellent results were noticed more often in patients under 30 years old than in those over 45 (p less than 0.01). Mobility of the shoulder joint was significantly more often normal when Kirschner wire was used for fixation than after screw fixation (p less than 0.05). Late resection gave at least a fair functional result.

Acromioclavicular Joint↗
PubMed1978

Basal osteotomy of the first metatarsal bone in hallux valgus: experiences with the use of AO plate.

In young patients with hallux valgus, osteotomy with excision of the exostosis is frequently indicated. The basal, laterally based wedge osteotomy, is relatively seldom used. However this operation may produce a considerable reduction of the metatarsus primus varus. We modified the method by adding a small AO plate to ensure stabilization. The series consisted of 36 patients, in whom 52 feet were operated on. Pain was the most frequent indication for seeking treatment. A followup was performed an average of 1.5 years postoperatively. The subjective results were good in 41 cases, fair in nine, and poor in one. Objectively the results were good in 42 cases and fair in nine. The mean period of work was seven weeks. The metatarsus varus angle was reduced from 14.8 degrees to 9.3 degrees and the hallux valgus angle from 33.2 degrees to 17.7 degrees. The distance between the first and second metatarsal bones was reduced from 13. 7 mm to 10.2 mm. A good functional and cosmetic result was achieved in most of the cases.

Adult↗
PubMed1977

Catecholamines in shock.

The role of endogenous catecholamines in various clinical shock and stress states is reviewed; the effects, especially on the peripheral circulation, of catecholamine secretion are the same independent of the cause. Risks of using sympathomimetic agents in the treatment of shock are evaluated. A prolonged noradrenaline activity is to be expected in surgical stress states, e.g. multiple injuries, fat embolism syndrome, burns and infections; therapeutic approaches to minimize the sympathoadrenal activity are outlined.

Catecholamines↗
PubMed1977

Coagulation disorders in severely and critically injured patients.

Forty-five patients with multiple injuries treated at an intensive care unit were studied prospectively. The patients were divided into two groups: the severely injured (no mortality) and critically injured (56% mortality). Treatment was started within two hours from the accident in all cases. The following coagulation parameters were measured for eight days: euglobulin lysis time (ELT), thromboelastography (TEG), vecalcification time (RECA), partial thromboplastin time (PTT), factor V, factor VIII, Normotest, Thrombotest, thrombin time, fibrinogen and platelets. Severe coagulation disorders were observed in one-third of the patients 12-48 hours after trauma. The abnormalities were more pronounced in patients who had sustained very severe injuries and arrived in a state of shock. The ELT was shortened 0-6 hours after the accident and accelerated coagulation was indicated simultaneously by decreased PTT, RECA, and r-values as well as by elevated Thrombotest and factor VIII values. The factor V and fibrinogen levels were initially lowered. Low platelet values at 2-4 days, prolonged thrombin and r-times, secondary decrease of fibrinogen FV, FVIII, and low Thrombotest values suggested disseminated intravascular coagulation associated with complications, such as fat embolism and "shock lung" syndromes. General bleeding tendency with high mortality was observed in 16% of the patients.

Adult↗
PubMed1977

A study of disseminated intravascular coagulation with the ethanol gelation test in severely injured patients.

The role of intravascular coagulation in severely injured patients was studied by the ethanol gelation test (EGT). Increased frequency of positive EGT's was observed following trauma, the highest on the fifth posttraumatic day (25 %). A positive test did not correlate with the quantity of blood received and the severity of the trauma. Patients with higher haematocrit, serum protein and platelet values showed a positive test more frequently.

Blood Cell Count↗
PubMed1976

[Serum enzymes in seriously injured patients].

In 45 patients with multiple injuries due to trauma, admitted consecutively to our clinic, the following enzyme activities were studied, beginning at the onset of treatment: SDH, GPT, GLDH, and acid phosphatase. The mean levels of SDH rose in all patients between 2 and 24 h after trauma. The mean values of GPT were above normal between 2 and 48 h after trauma; this rise was more pronounced and statistically significant in those patients who eventually died of trauma than in the less severely injured ones. Twenty-four hours after trauma, the levels of GLDH were 16 times higher in the first group of patients than in the less severely injured group. These results lead us to the conclusion that through serum level measurements of these enzymes particularly of GPT it is possible to evaluate the degree of tissue damage and the general state of this group of patients.

Acid Phosphatase↗
PubMed1975

Plasma catecholamines in severely injured patients: a prospective study on 45 patients with multiple injuries.

Plasma catecholamine levels were studied in 45 severely injured patients for 8 days after the trauma. Sixteen of the patients were classified as critically injured and 29 as seriously injured. The total plasma catecholamine values of the whole group immediately after the injury were almost twice as high as the eighth day reference values and remained significantly higher than these values for 6 hours after the trauma. On admission both the plasma adrenaline and noradrenaline levels were elevated. The plasma adrenaline levels on admission correlated with the blood volume replacement which was required within the first 6 hours. The plasma noradrenaline levels in the critically injured group were significantly higher throughout the observation period than in the seriously injured group. A corresponding difference was observed in the plasma adrenaline concentrations only during the first 12 hours. The results showed that strong stimulation of the sympathetic nervous system occurs in severely injured patients. Factors stimulating the sympathetic nervous system apparently included hypovolaemia, tissue hypoxia, acidosis and the pain produced by the trauma and therapeutic measures.

Adult↗
PubMed1975

Biochemical quantification of blunt injuries.

During eight post-traumatic days, the blood loss and severity of trauma were correlated with the blood levels of lactate, creatinine and catecholamines in 45 patients with multiple blunt injuries. During two days these biochemical indicators correlated with the extent of thoracoabdominal, pelvic and cerebral injuries. In the critically injured patients all three parameters were elevated throughout the observation period. No correlations were observed between plasma catecholamines and lower limb injuries, which seems to make the importance of catecholamines for predicting the onset of fat embolism syndrome less useful.

Catecholamines↗
PubMed1975

Fat embolism in severely injured patients.

Forty-five patients with severe blunt injuries were examined during eight posttraumatic days. At random, 14 patients were given three doses of methylprednisolone intravenously; 10 mg/kg at 8-hour intervals. Fat embolism syndrome was diagnosed in 13/45 patients, only one of whom had received corticosteroid (p = 0.03). Shock, acidosis and elevated plasma catecholamines showed no correlation with the occurrence of fat embolism syndrome. Platelet counts immediately after trauma were significantly lower in the fat embolism patients than in the other trauma patients, indicative of early platelet aggregation. Prophylactically administered methylprednisolone in pharmacological doses appeared to inhibit the emergence of fat embolism syndrome.

Embolism, Fat↗