Methods for evaluating the intrauterine location of carcinoma.

The intrauterine location of endometrial carcinoma was investigated with curettage, hysterography and hysteroscopy in 83 patients. These three methods are complementary. Curettage provides important information about the differentiation of the tumor. Hysterography is suitable especially for elucidating the anatomy of the cervical canal and uterine cavity. Direct examination by hysteroscopy gives a reliable picture when defining the boundary between stages I and II.     

Auditory ERPs reveal brain dysfunction in infants with plagiocephaly

It is suspected that the developmental delay in school-aged children diagnosed as infants suffering from plagiocephaly is caused by the modification of the skull form. To detect possible cognitive impairment in these children, we examined auditory ERPs to tones in infant patients. The infants with plagiocephaly exhibited smaller amplitudes of the P150 and the N250 responses to tones than healthy controls. Differences between the patients and control subjects indicate that already at this early age the presence of the plagiocephalic skull signals compromise of brain functioning. The present data suggest that most of the plagiocephalic infants have an elevated risk of auditory processing disorders. In the current study we demonstrated, for the first time, that the central sound processing, as reflected by ERPs, is affected in children with plagiocephaly.     

Base catalyzed proton transfer polymerization of 1‐hydroxypentamethylcyclotrisiloxane. Comparison of hyperbranched polymer microstructure and properties to those of highly regular linear analogs

Treatment of 1‐hydroxypentamethylcyclotrisiloxane ( 1 ), an A₂B monomer, with a phosphazene P₄‐t‐Bu superbase followed by quenching with phenyldimethylchlorosilane/triethylamine leads to a hyperbranched polysiloxane ( 2 ). The microstructure and properties of 2 are compared to those of highly regular linear analogs obtained by anionic or cationic regiospecific ring opening polymerization of 1‐(phenyldimethylsiloxy)pentamethylcyclotrisiloxane ( 3 ).     

Rosiglitazone improves myocardial glucose uptake in patients with type 2 diabetes and coronary artery disease: a 16-week randomized, double-blind, placebo-controlled study

Rosiglitazone therapy improves insulin sensitivity and glucose uptake in patients with uncomplicated type 2 diabetes. In coronary artery disease (CAD), glucose is an important source of energy and preserved myocardial glucose uptake is essential for the viability of jeopardized myocardium. The aim was to test whether rosiglitazone changes myocardial metabolism in type 2 diabetic patients with CAD. We studied 54 patients (38 men and 16 women) with type 2 diabetes (HbA(1c) 7.2 + 0.9%) and CAD. Myocardial glucose uptake was measured with [(18)F]fluoro-2-deoxy-d-glucose positron emission tomography in ischemic (evaluated by single-photon emission tomography and coronary angiography) and nonischemic regions during euglycemic-hyperinsulinemic clamp before and after a 16-week intervention period with rosiglitazone (n = 27) or placebo (n = 27). Rosiglitazone significantly improved glycemic control (P < 0.0001) and whole-body insulin sensitivity (P < 0.0001). Rosiglitazone increased myocardial glucose uptake from 20.6 +/- 11.8 to 25.5 +/- 12.4 micromol . 100 g(-1) . min(-1) (P = 0.038 vs. baseline, P = 0.023 vs. placebo) in ischemic regions and from 21.7 +/- 12.1 to 28.0 +/- 12.7 micromol . 100 g(-1) . min(-1) (P = 0.014 vs. baseline, P = 0.003 vs. placebo) in nonischemic regions. The increase in myocardial glucose uptake was partly explained by the suppression of free fatty acid levels during clamp. Rosiglitazone therapy significantly increased insulin sensitivity and improved myocardial glucose uptake in type 2 diabetic patients with CAD. These results suggest that rosiglitazone therapy may facilitate myocardial glucose storage and utilization in these patients.     

Intrauterine device and ectopic pregnancy

In Turku, Finland, 345 ectopic pregnancies were diagnosed in the period 1966 – 1975. Calculated from the number of deliveries, the incidence of ectopic pregnancy was 0.60 % in 1966 – 70, and 1.08 % in 1971 – 75. This difference is significant (p < 0.001). During the period studied, 59 cases of ectopic pregnancy presented with an intrauterine device $\text{in situ}$, thus accounting for 17 % of the total number seen. The use of intrauterine devices increased considerably after 1972. From that year, 29 % of all ectopic pregnancies occurred with an intrauterine device $\text{in situ.}$ Our findings accord well with other investigations, which emphasize the major role of intrauterine devices in raising the incidence of ectopic pregnancy.     

Reference values for pulmonary diffusing capacity for adult native Finns

Measurement standards for pulmonary diffusing capacity were updated in 2005 by the ATS/ERS Task Force. However, in Finland reference values published in 1982 by Viljanen et al. have been used to date. The main aim of this study was to produce updated reference models for single-breath diffusing capacity for carbon monoxide for Finnish adults. Single-breath diffusing capacity for carbon monoxide was measured in 631 healthy non-smoking volunteers (41.5% male). Reference values for diffusing capacity (DLCO), alveolar volume (VA), diffusing capacity per unit of lung volume (DLCO/VA), and lung volumes were calculated using a linear regression model. Previously used Finnish reference values were found to produce too low predicted values, with mean predicted DLCO 111.0 and 104.4%, and DLCO/VA of 103.5 and 102.7% in males and females, respectively. With the European Coalition for Steel and Coal (ECSC) reference values there was a significant sex difference in DLCO/VA with mean predicted 105.4% in males and 92.8% in females (p?相似文献   

Cooperation of return-to-work professionals: the challenges of multi-actor work disability management

Purpose: This article explores which concrete factors hinder or facilitate the cooperation of return-to-work (RTW) professionals in a complex system of multiple stakeholders.

Method: The empirical material consists of in-depth interviews with 24 RTW professionals from various organizations involved in work disability management in Finland. The interviews were analyzed using thematic content analysis.

Results: The study revealed several kinds of challenges in the cooperation of the professionals. These were related to two partly interrelated themes: communication and distribution of responsibility. The most difficult problems were connected to the cooperation between public employment offices and other stakeholders. However, the study distinguished notable regional differences depending primarily on the scale of the local network. The main areas of improvement proposed by the interviewees were related to better networking of case managers and expansion of expertise.

Conclusions: The article argues for the importance of systematic networking and stresses the role of public employment services in the multi-actor management of work disabilities. The article contributes to existing work disability case management models by suggesting the employment administration system as an important component in addition to health care, workplace and insurance systems. The study also highlights the need for expansion of expertise in the field.

• Implications for Rehabilitation

• Cooperation between RTW professionals in public employment offices and other organizations involved in work disability management was considered inadequate.

• In order to improve the cooperation of RTW professionals, the stakeholders need to create more systematic ways of communication and networking with professionals in other organizations.

• There is a need to expand the expertise in work disability management and rehabilitation, partly by increasing the role of other professionals than physicians.

     

A systematic review of empirical studies between 1966 and 2005 of patient outcomes of total hip arthroplasty and related factors

Aim. To determine patient outcomes of total hip arthroplasty and the research methods used to produce knowledge of use to clinical nursing and for purposes of health education. The review consists of three parts. Firstly, it describes the patient outcomes of total hip arthroplasty. Secondly, it addresses the factors related to the patient outcomes and thirdly the research methods used are explored. Background. Previous research has identified that total hip arthroplasty is a very common procedure to reduce pain and improve physical function in patients with osteoarthritis. The greatest improvements have been found in reduction in pain. Methods. Two databases, Medline and CINAHL were searched from 1966–2005. Studies were eligible for review and included if they met the following criteria: (1) publication in English, (2) empirical research and (3) the indication for total hip arthroplasty was osteoarthritis; 17 studies met the criteria. Results. Total hip arthroplasty resulted in pain relief, improved physical function and enhanced health‐related quality of life regardless of patients’ characteristics, type of operation or type of prosthesis. The only factor affecting patient outcomes was patients’ poor pre‐operative function. These patients were more likely to have postoperative pain and low postoperative physical function. Long‐waiting time for surgery may reduce quality‐adjusted life years. Different kinds of questionnaires were used in the studies reviewed leaving out patients’ perceptions concerning the outcomes of total hip arthroplasty. Conclusions. Patients’ perceptions should be assessed more closely in further research to gain subjective knowledge about the outcomes of total hip arthroplasty. This could be achieved by using qualitative methods also. Relevance to clinical practice. The findings can be seen as a challenge for nurses to plan patients’ education. It is also important that the outcomes of total hip arthroplasty correspond to patients’ expectations. Patients’ preoperative function should be taken into consideration when planning the timing of surgery so that the best possible outcomes were attainable.