Influence of perioperative dexamethasone on delayed union in mandibular fractures: a clinical and radiological study

Background: The aim was to clarify the occurrence of delayed union after surgical treatment of mandibular fracture and investigate whether an association exists between perioperative use of dexamethasone and delayed union. Material and Methods: Thirty-seven patients were included in a prospective randomized study. Of these patients, 19 (51.4%) were randomized to receive a total dose of 30 mg of dexamethasone and 18 (48.6%) served as controls. Patients underwent clinical and radiological investigation immediately, one month, three months and six months postoperatively. Radiographs were evaluated by an experienced, blinded senior oral radiologist. Results: Delayed fracture union was found in 9 patients (24.3%). It was associated significantly with angle fractures (p=0.012). Delayed union occurred more frequently in patients who received dexamethasone (36.8%) than in those who did not (11.1%) (p=0.068). The association of infection with delayed union was significan t ( p=0.027). Moreover, dexamethasone was significantly ( p=0.019) associated with delayed fracture union with concomitant infection. Gender, age group, smoking habit, treatment delay and duration of surgery were not associated with delayed union. Conclusions: Infection was associated with delayed union. Short-term high-dose dexamethasone predisposed to complicated fracture union, especially in patients with angle fractures. The relationship between dexamethasone and delayed bone healing without infection remains unresolve

Gender differences in health care use among the elderly population in areas of Norway and Finland. A cross-sectional analysis based on the HUNT study and the FINRISK Senior Survey

BACKGROUND: The aim of the study was to examine gender differences in the self-reported use of health care services by the elderly in rural and metropolitan areas of two Nordic countries with slightly different health care systems: Finland and Norway. METHODS: Population based, cross-sectional surveys conducted in Nord-Tröndelag Norway (1995–97) and in rural and metropolitan areas of Finland (1997) were employed. In the Norwegian data, a total of 7,919 individuals, aged 65–74 years old were included, and the Finnish data included 1,500 individuals. The outcome variables comprised whether participants had visited a general practitioner or a specialist, or had received hospital care or physiotherapy during the past 12 months. Gender differences in the use of health care services were analysed by multiple logistic regression, controlling for health status and socio-demographic characteristics. RESULTS: In Norway, elderly women visited a specialist or were hospitalised less often than men. In Finland, elderly women used all health care services except hospital care more often than men. In Norway, less frequent use of specialist care by women was not associated with self-reported health or chronic diseases. CONCLUSION: The findings revealed differences in self-reported use of secondary care among different genders in areas of Norway and Finland

Fish Consumption and Omega-3 Polyunsaturated Fatty Acids in Relation to Depressive Episodes: A Cross-Sectional Analysis

High fish consumption and omega-3 polyunsaturated fatty acid (PUFA) intake are suggested to benefit mental well-being but the current evidence is conflicting. Our aim was to evaluate whether a higher level of fish consumption, a higher intake of omega-3 PUFAs, and a higher serum concentration of omega-3 PUFAs link to a lower 12-month prevalence of depressive episodes

Fish consumption and polyunsaturated fatty acids in relation to psychological distress Downloaded from

Background It has been suggested that high fish consumption improves mental well-being. The aim of this study was to assess whether high fish consumption or omega-3 polyunsaturated fatty acid (PUFA) intake was associated with reduced self-reported psychological distress. Methods We used three cross-sectional data sets, the nationwide Health 2000 Survey (n = 5840), the Fishermen Study on Finnish fishermen and their family members (n = 1282) and the Finntwin16 Study on young adults (n = 4986). Data were based on self-administered questionnaires, interviews, health examinations and blood samples. Psychological distress was measured using the 12-item and 21-item General Health Questionnaires (GHQs). Fish consumption was measured by a food frequency questionnaire (FFQ, g/day) and independent frequency questions (times/month). Dietary intake (g/day) and serum concentrations (% from fatty acids) of PUFAs were determined. Relationships were analysed using regression analysis. Results Regardless of the measure, fish consumption and omega-3 PUFA dietary intake were not associated with distress in any of the data sets. In contrast to the hypothesis, high serum docosahexaenoic acid was associated with high distress in the Fisherman Study men. Some non-linear associations were detected between serum omega-3 PUFAs or fish consumption (times/month) and distress. In the Fishermen Study, the associations were modified by alcohol consumption, smoking and physical activity. Conclusions Our results do not support the hypothesis that fish consumption or omega-3 PUFA intake are associated with reduced psychological distress in the general population or in a population with high fish consumption

Odds ratios with 95% confidence intervals (95%CI) for occurrence of depressive episodes during the previous 12 months¹ by quartiles of fish consumption (1^st quartile as a reference) in the Health 2000 Survey and the Fishermen Study men.

<p>FFQ = Food Frequency Questionnaire.</p>1<p>In the Health 2000 Survey, major depressive episodes (MDE) measured by a Finnish translation of the German, computerized version of the M-CIDI interview with DSM-IV<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010530#pone.0010530-Wittchen1" target="_blank">[10]</a> sub-threshold cases included. In the Fishermen Study, depressive episodes measured by the CIDI-SF stem questions ‘During the previous 12 months, have you felt sad, blue or depressed for at least 2 weeks?’ and ‘During the previous 12 months, have you lost interest in most things like work or hobbies or things you usually like to do for fun for at least two weeks?<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010530#pone.0010530-Kessler1" target="_blank">[16]</a>. A person was considered to have depressive episodes if she/he answered ‘yes’ to both questions.</p>2<p>Adjusted for age as continuous, total energy intake for fish consumption g/day as continuous, Body Mass Index as continuous (self-reported for consumption of fish times/month), level of education, marital status, smoking history, physical activity, alcohol intake (ethanol, g/day) for fish consumption g/day as continuous, alcohol induced intoxication for consumption of fish times/month, fish oil supplement use for fish consumption g/day, current medication for depression or psychiatric disorders, occurrence of severe illness, bronchial asthma, or back pain or illness.</p>3<p>Adjusted as in footnote 2 but without current medication for depression or psychiatric disorders</p>4<p>Self-reported Body Mass Index.</p

Distributions of the participants by sex and occurrence of depressive episodes during the previous 12 months ¹ in the Health 2000 Survey and the Fishermen Study.

1<p>In the Health 2000 Survey, major depressive episodes (MDE) measured by a Finnish translation of the German, computerized version of the M-CIDI interview with DSM-IV<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010530#pone.0010530-Wittchen1" target="_blank">[10]</a> sub-threshold cases included. In the Fishermen Study, depressive episodes measured by the CIDI-SF stem questions ‘During the previous 12 months, have you felt sad, blue or depressed for at least 2 weeks?’ and ‘During the previous 12 months, have you lost interest in most things like work or hobbies or things you usually like to do for fun for at least two weeks?<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010530#pone.0010530-Kessler1" target="_blank">[16]</a>. A person was considered to have depressive episodes if she/he answered ‘yes’ to both questions.</p>2<p>Standard Error.</p>3<p>Available only for the Sub-study.</p>4<p>Self-report.</p>5<p>Cancer, myocardial infarction, cerebral stroke, angina pectoris, cardiac heat insufficiency, diabetes or rheumatoid arthritis. Cancer, myocardial infarction, and cerebral stroke diagnosed by a physician ever in both surveys. Other diseases in the Health 2000 Survey diagnosed by a physician ever, and in the Fishermen Study diagnosed or treated by a physician during the previous 12 months.</p