Leukocyte Interferon-alpha in the Treatment of Chronic Hepatitis C in Finland

Background: Food intake, accompanied by systemic and splanchnic haemodynamic changes, has only been studied in males. The extent to which splanchnic postprandial hyperaemia shows gender differences is unknown. Methods: We tested 1) the splanchnic hyperaemic response to food in females and 2) whether postprandial haemodynamic changes show gender differences. Twenty-four healthy women (aged 20-35 years) and 20 healthy men (aged 21-34 years) participated in the study. A liquid test meal (Ensure plus, 1.5 kcal/ml) was perfused intraduodenally for 75 min through an enteral feeding tube at a rate of 3 ml/min after a 45-min basal period. Blood flow parameters were measured using Echo-Doppler technology. Results: Basal diastolic arterial blood pressure was significantly (P     

The Role of Herpes simplex and Helicobacter pylori Infection in the Etiology of Persistent or Recurrent Gastric Erosions: A Follow-Up Study

The etiology of chronic gastric erosions is unknown. We have evaluated the significance of Helicobacter pylori and herpes simplex virus (HSV) infections, the use of nonsteroidal antiinflammatory drugs (NSAIDs), alcohol, and smoking in a prospective long term follow-up study. A prospective series of 117 patients with gastric erosions and 117 controls were studied in 1974–1981, and invited for reendoscopy in 1996. At both visits, H. pylori infection was diagnosed by histology, serum HSV antibodies were measured, and the use of NSAIDs, alcohol, and smoking was evaluated by interview. Biopsies from erosions from the latter visit were studied for HSV by immunohistochemistry and polymerase chain reaction (PCR). In the follow-up visit, 16 of 42 patients had still gastric erosions while six of 47 controls had developed erosions. No HSV antigen or DNA could be detected in biopsy specimens. However, only high antibody titers (32) against HSV at the first visit predicted persistence of erosions (P = 0.000), while H. pylori infection, use of NSAIDs, alcohol, or smoking were not associated with chronic erosions. High HSV titers at the follow-up visit were also significantly associated with concurrent erosions in the patient group. In conclusion, the results suggest that a significant proportion of chronic gastric erosions are related to HSV infection.     

Predictors of mortality following primary hip and knee replacement in the aged: A single-center analysis of 1,998 primary hip and knee replacements for primary osteoarthritis

Background and purpose High age is associated with increased postoperative mortality, but the factors that predict mortality in older hip and knee replacement recipients are not known.

Methods Preoperative clinical and operative data on 1,998 primary total hip and knee replacements performed for osteoarthritis in patients aged ≥ 75 years in a single institution were collected from a joint replacement database and compoared with mortality data. Average follow-up was 4.2 (2.2–7.6) years for the patients who survived. Factors associated with mortality were analyzed using Cox regression analysis, with adjustment for age, sex, operated joint, laterality, and anesthesiological risk score.

Results Mortality was 0.15% at 30 days, 0.35% at 90 days, 1.60% at 1 year, 7.6% at 3 years, and 16% at 5 years, and was similar following hip and knee replacement. Higher age, male sex, American Society of Anesthesiologists risk score of > 2, use of walking aids, preoperative walking restriction (inability to walk or ability to walk indoors only, compared to ability to walk > 1 km), poor clinical condition preoperatively (based on clinical hip and knee scores or clinical severity of osteoarthritis), preoperative anemia, severe renal insufficiency, and use of blood transfusions were associated with higher mortality. High body mass index had a protective effect in patients after hip replacement.

Interpretation Postoperative mortality is low in healthy old joint replacement recipients. Comorbidities and functional limitations preoperatively are associated with higher mortality and warrant careful consideration before proceeding with joint replacement surgery.     

Does the use of Health Care and Special School Services, Prior to Admission for Psychiatric Inpatient Treatment, Differ Between Adolescents Housed by Child Welfare Services and Those Living with Their Biological Parent(s)?

We examined whether the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differed between adolescents from child welfare units and those living at their parental home. 208 boys and 300 girls aged 12–17 years were admitted for psychiatric hospital between 2001 and 2006. Child welfare adolescents had used more health services/treatments prior to psychiatric hospital admission than adolescents living with their biological family. The best discriminating factors between study groups for both genders, were previous psychiatric hospitalizations, unemployed parents, use of special school services and self-perceived serious anxiety/tension or trouble controlling violent behavior. Repeated school grades and previous use of psychotropic medications were discriminating factors only in girls. Adolescents in child welfare deserve adequate mental health evaluations at an early stage, with referral to appropriate adolescent psychiatric services if required. Appropriate service provision and properly planned treatments may reduce the amount of intensive and sometimes unnecessary psychiatric inpatient treatments.     

Communication style before and after aphasia: A study among Finnish population

Background: Communication difficulties in aphasia have a big effect on communicative activity and social participation. Contacts with other people than family become more infrequent because of problems in communicating. Rehabilitation should make a real difference in being able to communicate and in the life of people with aphasia.

Aims: The aim of this study was to explore the impact of aphasia on the communication style of people with aphasia in the Finnish population. The term “communication style” is used to describe how active the person is in communication situations and in participating in social interaction. In addition, a clinical evaluation of the communication style was made 6 months after an intervention concentrating on training total communication and guiding the partner to facilitate the use of different communication methods and support the interaction.

Methods & Procedures: The data were collected during natural rehabilitation courses for people with aphasia and their communication partners. The participants were 38 communication partners of people with aphasia. The courses were carried out in two parts (8 + 4 days) with a 3-month interval. A questionnaire concerning the communication style of people with aphasia was constructed using parts of Green’s questionnaire (1984) and its unpublished Finnish modification. The communication partners estimated the communication style of people with aphasia. At first, they estimated how the communication style was before the onset of aphasia and how it was 2 weeks before the intervention. Six months after the intervention, they estimated the communication style again.

Outcomes & Results: Aphasia has a drastic impact on the communicative activity and social participation of people with aphasia in Finland. Activity in conversations decreases and contacts with people other than family members and relatives become much more infrequent. The social interaction occurs mostly at home. The conversation topics focus on health, home matters and TV programmes when other topics such as work, hobbies, leisure time and plans for the future are discussed much less often.

Conclusion: Aphasia has a drastic impact on communication style, activity in communication and participation in social interaction, also according to this study conducted in Finland. There seems to be a decrease in communication between the people with aphasia and people other than their significant others and outside the home. To be able to have an impact on social participation, interventions also including people other than family members are needed.     

Long-term maintenance of novel vocabulary in persons with chronic aphasia

Background: The study of novel word learning in aphasia can shed light on the functionality of patients' learning mechanisms and potentially help in treatment planning. Previous studies have indicated that persons with aphasia are able to learn some new vocabulary. However, these learning outcomes appear short-lived and evidence for the ability to use the newly learned words in the long term is lacking.

Aims: Participants with aphasia and matched controls underwent short training where they were taught to name novel objects with novel names. We studied the participants' word learning and particularly their long-term maintenance. We also examined whether the language and verbal short-term memory impairments of the participants with aphasia related to their ability to acquire and maintain phonological and semantic information on novel words.

Methods & Procedures: Two participants with nonfluent aphasia, LL and AR, and two matched controls took part in the experiment. They were taught to name 20 unfamiliar objects by repeating the names in the presence of the object picture. Half of the items carried a definition that was used to probe incidental semantic learning. There were four training sessions, a post-training test, and follow-up tests up to 6 months post-training. Learning measures included recognition of the trained objects, as well as spontaneous and cued recall in visual confrontation naming. Incidental semantic learning was measured by spontaneous recall of the definitions.

Outcomes & Results: Combining spontaneous and phonologically cued responses, LL acquired 70% and AR 55% of the novel words. With phonological cueing, LL named 50% of the items correctly up to 6 months post-training (vs 95–100% for the controls) and AR 25% up to 8 weeks post-training. AR's lexical-semantic processing, pseudoword repetition and verbal short-term capacity were inferior to those of LL. In line with this, AR learned fewer words and showed more decline in recognition memory for the trained items, and weaker recall of the semantic definitions.

Conclusions: Our results support previous findings that people with aphasia can learn to name novel items. More importantly, the results show for the first time that, with phonological cueing, an individual with aphasia can maintain some of this learning up to 6 months post-training. Moreover the results provide further evidence for the significance of the functional status of lexical-semantic processing on word learning success.