Degenerative rotator cuff tear – Results and prognostic factors of arthroscopic repair

Factors affecting outcome after arthroscopic rotator cuff repair are unclear and there is still insufficient evidence of efficacy of any treatment modality for rotator cuff tears. The purpose of the current study was to determine in a prospective randomized multicenter trial whether there is a difference in clinical outcome between three different treatment modalities in the treatment of degenerative, atraumatic supraspinatus tendon tear in elderly patients. 180 shoulders were randomized into three treatment groups: 1) physiotherapy, 2) arthroscopic acromioplasty and physiotherapy, 3) arthroscopic rotator cuff reconstruction, acromioplasty and physiotherapy. The objective of this study was also to evaluate retrospectively the effect of trauma, the size of the rotator cuff tear, smoking habits and glenohumeral osteoarthritis on the clinical treatment outcome after arthroscopic rotator cuff repair in a consecutively prospectively collected series of patients. The patient data was gathered to the electronic database. The Constant score was used as a primary outcome measure. The follow‐up time was one year. The main finding was that operative treatment did not provide benefit over conservative regimen in elderly patients with atraumatic supraspinatus tear. Trauma did not affect on the clinical outcome and there was neither difference in the age of patients with traumatic vs. non‐traumatic rotator cuff tears. The size of the rotator cuff tear correlated significantly with the clinical results. The outcome was significantly poorer in tears with infraspinatus involvement compared to anterosuperior tears. Operatively treated rotator cuff tear patients who smoked were significantly younger than non‐smokers, and smoking was associated with poorer clinical outcome. Concomitant osteoarthritis of the glenohumeral joint was found to be a relatively common finding in supraspinatus tear patients. Osteoarthritis of the glenohumeral joint in operatively treated supraspinatus tear patients predicted poorer clinical results comparing to patients without osteoarthritis.Siirretty Doriast

Tummien metsäjärvien vedenlaadun muutokset sedimentin piilevien ilmentämänä

Pohjois-Karjalan vesistöjen tilan parantaminen -hankkeen paleolimnologian osiossa selvitettiin 16 pohjoiskarjalaisen järven veden laadun historiaa sedimentin hehkutuksen ja piilevälajistomuutosten avulla. Järvien valuma-alueiden pääasiallinen maankäyttö on metsätalous ja maatalous sekä muutamassa kalanviljely. Valuma-alueen maankäyttö on selvästi vaikuttanut kohdejärvien vedenlaatuun, mikä on nähtävissä sedimentistä analysoitujen piilevien lajimuutoksissa. Tulosten mukaan osa järvistä on lähellä luonnontilaa, osa on selvästi rehevöityneitä ja tummuneita ja osa on rehevöitynyt, mutta viime aikoina palutunut. Lisäksi osa, varsinkin turvemaiden alapuoliset reittivedet, ovat aina olleet melko ravinteikkaita. Osassa järvistä on veden värin osalta näkyvissä tummumista ja osassa taas kirkastumista. Vuonna 2000 hyväksytty Euroopan unionin vesipuitedirektiivi (EU 2000) edellyttää vesien hyvää tilaa vuoteen 2015 mennessä. Vesistöjen vertailutila ja järvessä tapahtuneet muutokset on hyvä selvittää arvioitaessa vesistön kunnostustarvetta. Selvityksiin voidaan käyttää paleolimnologisia menetelmiä, jos pitkäaikainen vedenlaadun seuranta puuttuu

Associations of muscular fitness and body composition in children

Purpose: To examine the associations between muscular fitness (MF) and body composition. Method: MF was assessed with three tests of FitnessGram test battery. Total body fat percentage (BF%), abdominal fat percentage (AF%) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DXA). The IOTF body mass index (BMI) cut-offs were used to define healthy weight, overweight, and obesity. Results: MF was inversely associated with BF% and AF%. The children in the moderate and high MF groups had significantly lower BF% and AF% compared with the children in the low MF group within the same BMI category. After adjusting for cardiorespiratory fitness (CRF), BMI and sex, the differences between the MF groups were significant for BF% but not for AF%. Conclusion: There were significant inverse associations between MF and DXA -measured adiposity. Within the same BMI category, total and abdominal adiposity were lower in children with moderate or high MF than in children with low MF.Peer reviewe

Associations of muscular fitness and body composition in children

Purpose: To examine the associations between muscular fitness (MF) and body composition. Method: MF was assessed with three tests of FitnessGram test battery. Total body fat percentage (BF%), abdominal fat percentage (AF%) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DXA). The IOTF body mass index (BMI) cut-offs were used to define healthy weight, overweight, and obesity. Results: MF was inversely associated with BF% and AF%. The children in the moderate and high MF groups had significantly lower BF% and AF% compared with the children in the low MF group within the same BMI category. After adjusting for cardiorespiratory fitness (CRF), BMI and sex, the differences between the MF groups were significant for BF% but not for AF%. Conclusion: There were significant inverse associations between MF and DXA -measured adiposity. Within the same BMI category, total and abdominal adiposity were lower in children with moderate or high MF than in children with low MF.Peer reviewe

Suomen ympäristökeskuksen vertailulaboratorion arviointi 2005

Ympäristöministeriö (YM) on 11.3.2005 kirjeellään Dnro YM15/481/2005 pyytänyt tarjouksia Suomen ympäristökeskuksen (SYKE) vertailulaboratorion arvioinnista. YSL:n (86/2000) 24§ nojalla annetulla, 27.4.2001 päivätyllä YM:n määräyksellä 2/401/1999, SYKE on määrätty toimimaan ympäristöalan kansallisena vertailulaboratoriona vuodesta 2001 lähtien ja nykyinen määräaika päättyy 31.12.2005. Edellisen nimeämisen pohjaksi toteutettiin laaja kansainvälinen arviointi toteuttajana tanskalainen Vandkvalitetsinstitutet (VKI), jonka tulokset on raportoitu Suomen ympäristökeskuksen sarjassa The Finnish Environment julkaisu n:o 246. Arvioinnissa todettiin SYKE:n laboratorio tehtävään sopivaksi ja päteväksi. Nyt suoritetun arvioinnin avulla on tarkoitus tuottaa taustatietoa ympäristöalan kansallisen vertailulaboratorion nimeämistä varten vuodesta 2006 alkaen

Laukaisevat allergeenit ja anafylaksia

Vertaisarvioitu.Anafylaksian tärkeimmät laukaisijat ovat lasten osalta ruoka-aineet ja aikuisten osalta lääkkeet sekä ruoka. Suomessa 2-3 ihmistä kuolee vuosittain anafylaksiaan. He ovat lähinnä aikuisia, joiden anafylaksian laukaisevat lääkkeet tai pistiäiset. Lasten pähkinäanafylaksiat ovat lisääntyneet voimakkaasti viime vuosina. Molekyyliallergologiset diagnostiset menetelmät ja altistustutkimuksista kertynyt tieto reaktioon vaadittavasta proteiinimäärästä auttavat anafylaksiariskin arvioinnissa. Lääkeanafylaksioiden selvittämisessä tulisi huomioida valmisteiden apuaineet kuten povidoni ja makrogolit. Lääkeanafylaksiat eivät aina ole IgE-välitteisiä, ja niiden selvittely on vaikeampaa - uusien menetelmien tarve on ilmeinen.Peer reviewe

Increasing incidence of primary shoulder arthroplasty in Finland - a nationwide registry study

Background: The incidence of shoulder arthroplasties is reportedly increasing and the types of arthroplasty are changing. The purpose of this study was to investigate the incidence of primary shoulder arthroplasty in Finland.Methods: We analyzed nationwide data from the Finnish Arthroplasty Register (FAR) and the Finnish National Hospital Discharge Register (NHDR) during time period 2004-2015. The primary outcome variable was the incidence of shoulder arthroplasty per 100,000 person-years stratified by age, sex and year of surgery. The secondary outcome variables were surgical indication, arthroplasty type and prosthesis model.Results: The number of primary shoulder arthroplasties was 7504 (women = 4878, men = 2625). The rate of operations increased from 6 to 15 per 100,000 person-years among men, and 11 to 26 per 100,000 person-years among women. The indication for arthroplasty was osteoarthritis in 56%, acute fracture in 21%, inflammatory arthritis in 13%, and rotator cuff arthropathy in 4% of the cases. Hemiarthroplasties accounted for 66%, total shoulder arthroplasties 8%, and reverse shoulder arthroplasties 12% of the cases, 14% of the cases was missing. During the 12-year study period the incidence of hemiarthroplasties decreased by 23% and the number of total shoulder and reverse shoulder arthroplasty increased by 500 and 4500%, respectively.Conclusions: The incidence of primary shoulder arthroplasty has increased by 160% during the study period in Finland. The incidence of hemiarthroplasties decreased while total and reverse shoulder arthroplasties increased

Acute kidney injury following hip fracture

BACKGROUND: Hip fracture causes disability and excess mortality in the aging population. Acute kidney injury (AKI), is known to diminish survival of critically ill and trauma patients. AKI is also a common perioperative complication among surgical patients. We examined the effect of AKI on the survival of hip fracture patients in a Finnish hip fracture population and the risk factors for AKI in a prospective study.METHODS: The study cohort constituted of 486 consecutive low-energy trauma hip fracture patients referred to Satakunta Central Hospital (Pori, Finland) and Turku University Hospital (Turku, Finland). The patients underwent standard diagnostics and treatment in the emergency department (ER) and were operated according to the local treatment protocol. Serum creatinine (sCr) was analyzed daily pre- and post-operatively during the hospital stay. Patients were divided into groups; AKI and non-AKI based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria.RESULTS: The incidence of AKI in the study cohort was 8.4% (40/475). Eleven patients were excluded due to missing sCr data. The baseline characteristics of AKI and non-AKI groups differed significantly concerning baseline sCr but were otherwise similar. At 90-day follow-up, the overall mortality was 14.4%. Patients with AKI had a significantly higher mortality (35.0%) than those with no AKI (12.7%) (p < 0.001). Dementia, preoperative sCr and any stage of AKI were independent predictors for mortality. Dementia and preoperative sCr were independently associated with post-operative AKI.CONCLUSION: In this study AKI was a significant factor associated with a 3 -fold mortality during the first three months after surgery for low-energy trauma hip fracture.</p

Trends of shoulder instability surgery in Finland: a nationwide register study

Objective Rate of shoulder instability surgery (SIS) has increased in different specific populations. We analysed nationwide trend of SIS in adults in Finland between 1997 and 2014. Design A retrospective register study. Setting National Hospital Discharge Register of Finland. Participants A total of 22 550 adult patients with SIS in Finland (1997-2014). Primary and secondary outcome measures Analysis included appropriate diagnosis (International Classification of Diseases 10) and procedure coding combinations applicable for SIS. The primary outcome variable was the incidence of SIS per 100 000 person-years, and the secondary outcomes were the study year, sex, age groups (18-29, 30-49 and over 50 years of age) and the type of hospital (public or private). Results The overall nationwide rate of SIS in adults increased 177% between 1997 and 2014 in Finland. The rate was the lowest (13/100 000 person-years) in 1997, and the peak rate (40/100 000 person-years) was noted in 2007. The increase in rate was rapid between 1997 and 2007, after which the rate became stable. During the study period, the highest increases were noted in the young adults age group (270%), and especially in the middle-aged group who were operated on in private hospitals (930%). Conclusions The rate of SIS increased almost threefold in Finland from 1997 to 2014. The increase was most significant in young and middle-aged adults (18-50 years), in men, and in private hospitals

New geophysics study programs at the University of Helsinki

Peer reviewe