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

Hammashoitouudistus ja hoitopalvelujen käyttö ja sisältö terveyskeskuksissa

Tutkimuksen tavoitteena oli selvittää muutoksia terveyskeskusten hammashoidon kohdentumisessa, henkilöstön työnjaossa sekä hoitotoimenpiteissä ennen ja jälkeen vuosina 2001 – 2002 voimaan tullutta hammashoitouudistusta ja arvioida uudistuksen terveyspoliittisten tavoitteiden toteutumista. Tutkimuksen kohteena oli seitsemän erikokoista eri puolilla maata sijaitsevaa terveyskeskusta. Terveyskeskuksissa hoidossa käyneiden potilaiden kokonaismäärä nousi mihin vaikutti aikuispotilaiden määrän kasvu. Aikuisikäryhmissä myös hoidossa käyneiden osuus väestöstä kasvoi, mutta lasten vastaava väestöosuus pysyi ennallaan. Pienissä terveyskeskuksissa hoidossa käyneiden määrä ja väestöosuudet vähenivät erityisesti aikuisikäryhmissä. Hoidossa käyneistä potilaista oli vuonna 2003 suurempi osa aikuisia kuin vuonna 1998 sekä pienissä, keskikokoisissa että suurissa terveyskeskuksissa. Myös tehdyistä toimenpiteistä suurempi osa kohdistui aikuisiin vuonna 2003 kuin 1998 kaikissa terveyskeskuksissa. Hoidon sisältö pysyi kuitenkin lähes muuttumattomana. Hoitajien tekemien toimenpiteiden osuus kasvoi hieman. Aikuisväestön kasvaneeseen hoidon kysyntään ei oltu pystytty vastaamaan kovin hyvin eivätkä hoitotoimenpiteet vastanneet aikuisten hoitotarpeita. Uudistukselle asetetut (terveyspoliittiset) tavoitteet eivät vielä tässä vaiheessa näkyneet merkittävinä toimintamuutoksina tutkimusterveyskeskuksissa. Pieniä muutoksia toivottuun suuntaan oli kuitenkin tapahtunut