S-ketamine in patient-controlled analgesia reduces opioid consumption in a dose-dependent manner after major lumbar fusion surgery: A randomized, double-blind, placebo-controlled clinical trial

Background Spinal fusion surgery causes severe pain. Strong opioids, commonly used as postoperative analgesics, may have unwanted side effects. S-ketamine may be an effective analgesic adjuvant in opioid patient-controlled analgesia (PCA). However, the optimal adjunct S-ketamine dose to reduce postoperative opioid consumption is still unknown.Methods We randomized 107 patients at two tertiary hospitals in a double-blinded, placebo-controlled clinical trial of adults undergoing major lumbar spinal fusion surgery. Patients were randomly allocated to four groups in order to compare the effects of three different doses of adjunct S-ketamine (0.25, 0.5, and 0.75 mg ml-1) or placebo on postoperative analgesia in oxycodone PCA. Study drugs were administered for 24 hours postoperative after which oxycodone-PCA was continued for further 48 hours. Our primary outcome was cumulative oxycodone consumption at 24 hours after surgery.Results Of the 100 patients analyzed, patients receiving 0.75 mg ml(-1) S-ketamine in oxycodone PCA needed 25% less oxycodone at 24 h postoperatively (61.2 mg) compared with patients receiving 0.5 mg ml(-1) (74.7 mg) or 0.25 mg ml(-1) (74.1 mg) S-ketamine in oxycodone or oxycodone alone (81.9 mg) (mean difference: -20.6 mg; 95% confidence interval [CI]: -41 to -0.20; P = 0.048). A beneficial effect in mean change of pain intensity at rest was seen in the group receiving 0.75 mg ml(-1) S-ketamine in oxycodone PCA compared with patients receiving lower ketamine doses or oxycodone alone (standardized effect size: 0.17, 95% CI: 0.013-0.32, P = 0.033). The occurrence of adverse events was similar among the groups.Conclusions Oxycodone PCA containing S-ketamine as an adjunct at a ratio of 1: 0.75 decreased cumulative oxycodone consumption at 24 h after major lumbar spinal fusion surgery without additional adverse effects

Troponin T-release associates with cardiac radiation doses during adjuvant left-sided breast cancer radiotherapy

Background Adjuvant radiotherapy (RT) for left-sided breast cancer increases cardiac morbidity and mortality. For the heart, no safe radiation threshold has been established. Troponin T is a sensitive marker of myocardial damage. Our aim was to evaluate the effect of left-sided breast cancer RT on serum high sensitivity troponin T (hscTnT) levels and its association with cardiac radiation doses and echocardiographic parameters. Methods A total of 58 patients with an early stage, left-sided breast cancer or ductal carcinoma in situ (DCIS) who received adjuvant breast RT without prior chemotherapy were included in this prospective, non-randomized study. Serum samples were taken before, during and after RT. An increase of hscTnT >30 % was predefined as significant. A comprehensive 2D echocardiograph and electrocardiogram (ECG) were performed before and after RT. Dose-volume histograms (DVHs) were generated for different cardiac structures. Results The hscTnT increased during RT from baseline in 12/58 patients (21 %). Patients with increased hscTnT values (group A, N = 12) had significantly higher radiation doses for the whole heart (p = 0.02) and left ventricle (p = 0.03) than patients without hscTnT increase (group B, N = 46). For the left anterior descending artery (LAD), differences between groups A and B were found in volumes receiving 15 Gy (p = 0.03) and 20 Gy (p = 0.03) Furthermore, after RT, the interventricular septum thickened (p = 0.01), and the deceleration time was prolonged (p = 0.008) more in group A than in group B. Conclusions The increase in hscTnT level during adjuvant RT was positively associated with the cardiac radiation doses for the whole heart and LV in chemotherapy-naive breast cancer patients. Whether these acute subclinical changes increase the risk of excessive long-term cardiovascular morbidity or mortality, will be addressed in the follow-up of our patients.BioMed Central open acces

Chemical composition of the water extract of young spruce (Picea abies (L.) Karst) shoots

Young shoots of spruce are a natural resource that have been used as a remedy or a food ingredient for a long time. Although, it cannot be harvested from the forest without the permission of the landowner, it could be exploited more. Almost third of Finnish forests resources is spruce, forming enormous reservoir for the spruce shoots and more refined spruce shoot products. Lactic acid bacteria is one of the most, if not the most, used group of microbes in the food industry. In our earlier growth experiments the water extract from young spruce shoots had an enhancing effects in the growth of some strains of Lactobacillus species. Particularly, Lactobacillus plantarum grew better and had shorter lag time, when growth medium contained spruce shoot extract. To apprehend better, what could generate an effect seen with the growth of the bacteria, we analyzed the chemical composition of the water extract of the spruce shoots. For the evaluation of the chemical composition of the spruce shoot water extract chromatographic, capillary electrophoretic and spectrophotometric methods were used. Sugars and sugar alcohols were measured with the capillary electrophoresis (CE), glucose and inositol respectively being of most abundant. Also non phenolic acids and inorganic cations were analyzed with the CE. Quinic acid was the main non phenolic acid detected, and of the inorganic cations K, Mg, Ca, Ni, Zn and ammonium were recognized from the extract. Antioxidant capacity (reduction potential) of 772mg GAE/L was measured for the extract using spectrophotometric method of Folin-Ciocalteu. To analyze phenolic compounds, chromatographic methods developed for the detection of catechins, proantocyanidin, phenolic acids and stilbenoids were utilized. Main catechins in the water extract were the catechin and epicatechin. Type B dimers were the most apparent of the proantocyanidins. The extract contained several benzoic and cinnamic acid derivatives, but protocatechuic acid and p-coumaric acid were the most apparent ones. Of the stilbenoids trans and cis forms of piceid, sugar derivative of resveratrol, and astringin were the most abundant. Future research will focus on, whether Lactobacillus bacteria will metabolize one or more of these detected compounds found when in growth with the extract

Puurakentamisen terveysvaikutukset – Tutkimuksella tietoperusteista tukea puurakentamiselle ja puun käyttömuotojen lisäämiselle:Loppuraportti

Abstract Wooden buildings have a good reputation. They are considered pleasant in appearance, not to have problems with indoor air and even promote well-being. Short-stay tests carried out in controlled conditions support these assumptions. On the other hand, studies on how long-term living or working in a wooden building affects people, as far as we know, are nearly lacking besides resident satisfaction surveys. The only exception is a follow-up study of two groups of schoolchildren with under 20 people, carried out in Austria at the beginning of 2010’s. In this study, Tuupala wooden school in Kuhmo and as a reference Tuupala stone school and a primary school in town of Vaala were monitored for temperature, indoor air humidity, carbon dioxide content, particulate matter and total concentration of volatile organic compounds by IoT sensors for 10 months. Samples of indoor air were taken to determine individual volatile organic compounds and microbiological quality. Noise level in the classrooms was monitored for one month. In three weeks during the study, concentration of the stress hormone cortisol was monitored in daily saliva samples. A total of approximately 1,300 saliva samples from schoolchildren were collected in the primary schools in both Kuhmo and Vaala. In addition, smaller groups of schoolchildren were monitored for the stress with a smart ring that measured electrodermal activity. Based on the results, the wooden school of Tuupala is an excellent learning environment for its schoolchildren. It has a quiet and peaceful noise level. The variation in humidity is lower there than in the control school, and stress of schoolchildren is lower than in the classes of the control school. The difference in the stress is in some time periods statistically significant. Of course, the results of the study do not show that all wooden schools are equally good or that similar results cannot be achieved in other types of schools as well. The wooden building does likely not explain all the results, but it is certainly one important factor in a good school environment. This study was funded by the Finnish Forest Foundation and the European Agricultural Funds for Rural Development of Mainland Finland. The study was carried out during 2020 by the Unit of Measurement Technology of the University of Oulu at the Kajaani University Centre.Tiivistelmä Puurakennuksilla on hyvä maine. Niitä pidetään ulkonäöltään miellyttävinä ja sisäilmaltaan ongelmattomina ja jopa hyvinvointia edistävinä. Kontrolloiduissa olosuhteissa tehdyt lyhytaikaista oleskelua seuranneet kokeet myös tukevat näitä oletuksia. Sen sijaan tutkimuksia siitä kuinka pitkäaikainen asuminen tai työskentely puurakennuksessa vaikuttaa henkilöihin on tietääksemme selvitetty vain asukastyytyväisyyskyselyillä sekä yhdessä Itävallassa 2010-luvun alussa tehdyssä kahden vajaan 20 hengen koululaisryhmän seurannassa. Puurakentamisen terveysvaikutukset -tutkimuksessa seurattiin Kuhmon Tuupalan puukoulun sekä verrokkina olleiden Tuupalan kivikoulun ja Vaalan yhtenäiskoulun lämpötilaa, sisäilman kosteutta, hiilidioksidin pitoisuutta, paine-eroa, pienpartikkeleiden määrää ja haihtuvien orgaanisten yhdisteiden kokonaismäärää jatkuvatoimisella sensoriseurannalla 10 kuukauden ajan. Sisäilmasta otettiin näytteitä haihtuvien orgaanisten yhdisteiden ja mikrobiologisen laadun yksityiskohtaiseksi selvittämiseksi. Äänenvoimakkuutta ja valoisuutta luokkahuoneissa seurattiin yhden kuukauden ajan. Kolmena tutkimusviikkona seurattiin päivittäin otetuista sylkinäytteistä stressihormoni kortisolin pitoisuutta. Sylkinäytteitä kerättiin sekä Kuhmossa että Vaalassa alakoulun kolmen luokan oppilailta yhteensä noin 1300. Lisäksi pienemmissä ryhmissä seurattiin koululaisten stressaantuneisuutta ihon sähköistä aktiivisuutta mitanneella älysormuksella. Tutkimuksen perusteella Tuupalan puukoulu on erinomainen opiskeluympäristö koululaisilleen. Se on melutasoltaan hiljainen ja rauhallinen. Ilmankosteuden vaihtelu on siellä tutkimuksen verrokkikoulua vähäisempää ja koululaisten stressaantuneisuus on vähäisempää kuin verrokkikoulun luokissa. Ero stressaantuneisuudessa on ajoittain tilastollisesti merkittävää. Tutkimustulokset eivät tietenkään osoita, että kaikki puukoulut olisivat yhtä hyviä tai etteikö samanlaisia tuloksia voitaisi saavuttaa myös muunlaisissa kouluissa. Puinen rakennus tuskin on ainoa selittävä tekijä kaikille tuloksille, mutta se varmasti on yksi tärkeä tekijä hyvässä kouluympäristössä. Tutkimuksen rahoittajat olivat Suomen Metsäsäätiö ja Manner-Suomen maaseuturahasto. Tutkimuksen toteuttaja oli Oulun yliopiston Mittaustekniikan yksikkö Kajaanin yliopistokeskuksesta. Tutkimus toteutettiin vuoden 2020 aikana

Psychological distress, dental health, and dental fear among Finnish university students:a national survey

Abstract The aim of this study was to investigate the association between dental fear, psychological distress, and perceived symptoms of teeth controlled for age, gender, educational sector, and tobacco use. The data from the Finnish University Student Health Survey 2016 targeting students (n = 10,000) of academic universities and universities of applied sciences were used. Psychological distress was measured with the Clinical Outcomes in Routine Evaluation 10 (CORE-10) and the General Health Questionnaire 12 (GHQ-12) and dental fear with the question ‘Do you feel scared about receiving dental care?’. The study included 3110 students. In logistic regression analyses those with psychological distress (measured with CORE-10 and GHQ-12) and those reporting teeth-related symptoms were more likely than their counterparts to have high dental fear. In gender-specific analyses men with psychological distress (measured with CORE-10) and women with teeth-related symptoms were more likely to have high levels of dental fear. Finnish university students with psychological distress and teeth-related symptoms were more likely to experience higher levels of dental fear than their counterparts were. The results of this study support possible common vulnerability factors that dental fear and other psychological disorders may share

Towards microbioprocess control:an inexpensive 3D printed microbioreactor with integrated online real-time glucose monitoring

Abstract Bioprocessing is of crucial importance in pharmaceutical, biofuel, food and other industries. Miniaturization of bioprocesses into microbioreactors allows multiplexing of experiments as well as reduction of reagent consumption and labour-intensity. A crucial part of the research within microbioreactors is biochemical analysis of product, byproduct and substrate concentrations that currently heavily relies on large analytical equipment. Biosensors are a promising analytical tool, however, integration into a microbioreactor is associated with challenges in ensuring sterility, appropriate sensing range, control of matrix effects and stability. In this work we present a novel biosensor integrated analytical chip that features an internal, actuated buffer flow in contact with a biosensor downstream and a diffusion limiting membrane exposed to the sample upstream. The technology was developed and tested using an electrochemical glucose oxidase biosensor and was found to successfully surmount the aforementioned challenges including the extension of the linear range of sensitivity to more than 20 g L⁻¹ for online, real time monitoring of glucose. The biosensor integration chip with the glucose biosensor was then mounted onto a 3D printed microbioreactor with 1 mL of internal volume. The system successfully monitored the consumption of glucose of Saccharomyces cerevisiae in real time for more than 8 h. The developed technology and measurement methodologies are transferrable to other biosensors and microbioreactors as well as large scale applications

Psychological distress, oral health behaviour and related factors among adolescents:Finnish School Health Promotion Study

Abstract Background: Psychological distress may affect health behaviour. We examined how psychological distress, social phobia (SP) and anxiety associated with tooth brushing among Finnish adolescents with respect to gender, school grade, parents’ education, family structure, smoking and perceived general health. Methods: This study is part of the Finnish national School Health Promotion Study (SHP). The study population comprised a representative sample of Finnish 15-year-olds (N = 45,877). Mini-Social Phobia Inventory (Mini-SPIN) and generalized anxiety disorder (GAD) served to assess SP and anxiety. A questionnaire enquired about the respondents’ oral health habits (tooth brushing, smoking), background factors (age, gender, family structure and parents’ education) and perceived general health. Chi-squared tests and logistic regression analyses served in the statistical analyses. Results: About two-thirds of the girls (66.7%) and less than half of the boys (40.1%) followed the international recommendation of tooth brushing twice daily. Girls reported possible problems with SP and GAD more often than boys did. Those reporting possible problems with SP or moderate or severe anxiety brushed their teeth at least twice daily less often than did those reporting no possible problems with SP and those with no, slight or mild anxiety. Logistic regression analyses showed that male gender (OR = 3.2; 95% CI 3.1–3.4), parents’ basic education (OR = 1.5; 95% CI 1.4–1.5), and adolescents’ perception of their current state of health as moderate, fairly or very poor (OR = 1.8; 95% CI 1.5–2.0) associated with not brushing teeth twice daily. Gender-specific logistic regression analyses showed that boys who smoked (OR = 1.7; 95% CI 1.6–1.8) were less likely than non-smokers to brush their teeth twice daily. Conclusion: Adolescents with psychological distress, such as possible SP or possible general anxiety, had less favourable oral health behaviour. Psychological distress indicates a greater risk for oral health problems already in adolescence