Oral health of patients with insulin-dependent diabetes mellitus

Abstract — Oral health, the amount of salivary Streptococcus mutans and lactobacilli, and the flow rate, pH and buffer capacity of paraffin-stimulated whole saliva were analyzed in 35 adult diabetic patients and their age- and sex-matched non-diabetic, clinically healthy controls. All patients had insulin-dependent diabetes (IDDM) with a mean (± SD) duration of 14.0 ± 9.1 yr. The prevalence of dental caries was as high in the diabetic group as in the controls but the past caries experience was remarkably lower in those individuals whose diabetes had started at a very early age (= 7 yr). In agreement with the clinical data, the salivary levels of cariogenic microorganisms were of the same order of magnitude in both study groups. However, the relative proportion of S. mutans from the total cultivable aerobic microflora was significantly higher ( P <0.01) in diabetics compared to the controls. The other studied salivary parameters did not differ between the groups. Remarkable individual differences were observed in the correlation between glucose levels of blood and whole saliva among diabetics. In spite of the noncariogenic dietary habits, the adult diabetic patients seem to be at least as susceptible to dental caries as non-diabetics, probably due to the leakage of glucose from blood into the oral cavity.     

Increased vascular resistance in the descending aorta of the human fetus in hypoxia

Summary. Blood velocity waveforms from the fetal thoracic aorta, obtained by a combination of real-time and Doppler ultrasound and a spectral analyser, detected a total end-diastolic block in the curve in nine pregnancies with chronic fetal hypoxia. Simultaneous cardiotocographic recordings were normal except in one patient. These findings suggest that hypoxia causes an increase of peripheral vascular resistance in the tissues distal to the thoracic aorta and that this change appears earlier than pathological changes in the cardiotocogram. The potential clinical value of this technique justifies further research.     

Neonatal Septicaemia in Finland 1981–85

ABSTRACT. A survey of blood culture-confirmed neonatal septicaemia was carried out in seven delivery hospitals in 1981–85, for a second successive five-year period. The total number of cases was 377, to compare with 410 in the previous five-year period. Group B streptococcus (GBS) was throughout the major pathogen (29%), followed by Staphylococcus aureus (15%) and Escherichia coli (14%), while Staphylococcus epidermidis (10%) has emerged as a significant new causative agent. Septicaemia with very early onset was predominant: 49% of the cases had onset within the first 24 hours; in the majority the symptoms were present from birth. GBS was responsible for 49% of the cases detected in the first 24 hours of life. The overall mortality was 20% as compared to 23% in the previous five-year period, whereas in the very early onset septicaemia mortality was now 18%, down from the preceding 30%. Despite the modest progress, GBS septicaemia with very early onset remains a significant problem, and effective preventive measures are needed.     

Acute effect of maternal smoking on the human fetal blood flow

Summary. The immediate effect of maternal smoking of one cigarette on blood flow in the descending thoracic aorta and umbilical vein was studied in 19 fetuses at between 29 and 39 weeks gestation. Blood flow was measured with a combined real-time ultrasound and Doppler ultrasound technique immediately before smoking and immediately after cessation of smoke inhalation. The measured flow changes immediately after maternal smoking were insignificant and suggest that the haemodynamic and chemical effects of smoking in the mother do not produce immediate alterations in the blood flow in the fetal thoracic aorta or in the umbilical vein.     

Advances in Perinatal Care and Declining Regional Neonatal Mortality in Finland, 1968-82

ABSTRACT. Neonatal mortality (NNM) was investigated in the region of the University Central Hospital of Turku (UCHT), Finland, during a 15-year period from 1968 till 1982. During the study period 81620 livebom infants were born. The NNM rate declined from 13.5 in 1968 to 3.0 in 1982 during the study period. Significant declines occurred in NNM due to respiratory distress syndrome (RDS) and asphyxia. The decline in NNM was more obvious during the early neonatal period (0-6 days after birth) and in the low birth weight (LBVV) group (BW less than 2500 g). We believe that centralization of obstetric and neonatal services in risk cases and the new neonatal intensive care accounted for the decline in NNM.     

Tumour-associated antigen CA 125 in patients with ovarian cancer

Summary. The serum levels of antigen CA 125 expressed by epithelial ovarian carcinoma were measured in 27 postmenopausal women with ovarian tumours and in 16 controls. Increased serum levels of CA 125 were found in nine (75%) out of 12 patients with ovarian cancer; in three with stage I disease levels were not elevated. No significant difference was found in the concentration of CA 125 detected in peripheral or ovarian venous blood. Decreased antigen levels were found 6–30 weeks after radical operation and cytostatic chemotherapy in the ovarian cancer group. The results indicate the value of measuring CA 125 as a tumour marker in the follow-up of ovarian cancer.     

Late Ophthalmological Sequelae of Tuberculous Meningitis

One hundred and three patients who had recovered from tuberculous meningitis in 1949—54 were thoroughly re-examined ophthalmologically an average of 8 1/2 years (range 6—12 1/2 years) after recovery. One blind patient and one with severe visual impairment were found. In addition to these, a number of cases with ophthalmological sequelae of minor importance were found; partial structural and functional lesions of the optic nerve were found in 17 cases (including 1 case with associated abducens nerve palsy), nystagmus was found in 2, pupillary disturbances in 6 and scars of choroidal tubercles in 16 cases. Thus 36 cases (35 per cent) showed ophthalmological sequelae of the past illness. Permanent visual disability was found in the 2 cases mentioned above, both of them being late cases with a high block treated with trephination. Of the other sequelae of the disease only intracranial calcification showed some degree of correlation with the ophthalmological sequelae.     

Subglottic Stenosis in Neonates and Children

ABSTRACT. From 1978 through 1987, acquired subglottic stenosis was confirmed endoscopically in 31 children. The mean gestational age of the children was 32 weeks and mean birthweight 2180 g. Of the children 84 % were below 12 months of age at the time of diagnosis. Respiratory distress syndrome was confirmed in 17 children. Before diagnosis, 97 % of the children had been treated by endotracheal intubation for ventilatory support, the mean duration of intubation being 37 days. In 10 children, subglottic stenosis was mild and mature and these children were followed up only. Endolaryngeal prosthesis was employed in 2 children and laryngotomy with autogenous bone graft in 5 children. Mean follow-up time was 5 years 4 months. At follow-up, 18 of the children showed good or excellent results.     

SCSB Method Compared to EEG-Based Polygraphy in Sleep State Scoring of Newborn Infants

Abstract. Knowledge of the sleep state is important in physiological studies since many physiological variables show different properties in different sleep states. The recently developed static charge sensitive bed (SCSB) method allows long-term recordings of body movements, respiration and ballistocardiogram without electrodes attached to the subject. The recordings are easy to carry out and they do not disturb the subject in any way. The recorded variables are basic characteristics of different sleep states. SCSB-recordings and electroencephalography (EEG) based polygraphy as well as blind sleep state scoring were carried out in 8 newborn infants. The positive correlation between SCSB-scoring and EEG-based polygraphy scored by two clinical neurophysiologists was 68.1 and 64.1%. Only in 2 % of all epochs was active sleep scored as quiet sleep or vice versa. The results indicate the usefulness of the SCSB method in sleep state scoring of newborn infants.     

Late Psychological and Psychiatric Sequelae of Tuberculous Meningitis

The psychological and psychiatric sequelae of tuberculous meningitis in 103 children were studied by thorough clinical follow-up examinations at the Children's Hospital, University of Helsinki, and extensive correspondence with the parents and teachers of the children. Forty five per cent of the series were found to be of subnormal or borderline intelligence. The achievements of those attending school were, on the whole, comparable with those of the siblings and classmates. Only 4 children were found to be severely mentally disturbed — of these 1 has greatly improved in the last 2 years — and 17 were slightly disturbed. Mental retardation was found to be more frequent in the youngest age groups (under 3 years of age) and social re-adjustment problems more frequent in the older age groups, particularly the school-age children. The latter seemed to pose the major problems in this series, especially the cases with major intellectual, sensory or motor handicaps.