Metabolic syndrome is associated with impaired health-related quality of life: Lapinlahti 2005 study

Purpose  Association of Metabolic Syndrome (MetS) with Health-Related Quality of Life (HRQoL) is poorly documented. Our objective was to examine this association in an adult general population. Methods  In our cross-sectional community-based health survey in a semirural Finnish community, we invited all the adults (n = 760) of eight birth cohorts between 30 and 65 years, of which 480 (63%) participated. A 15-dimensional, standardized HRQoL instrument (15D) was used to measure the main outcome, and the National Cholesterol Education Programme (NCEP) 2005 criteria were used for MetS classification. Results  The prevalence of MetS was 38%. MetS was significantly associated with impaired HRQoL (P < 0.001) measured by the 15D score. Participants with MetS were statistically significantly worse off than participants without MetS in the dimensions of mobility (P < 0.001), hearing (P = 0.021), breathing (P < 0.001), usual activities (P = 0.001), discomfort and symptoms (P = 0.002), vitality (P = 0.003), and sexual activity (P = 0.008). In a logistic regression analysis, a significant association persisted between MetS and impaired HRQoL (OR = 1.9). Conclusions  MetS seems to be associated closely with perceived HRQoL at community level. Therefore, reduction of risk factors of MetS may improve HRQoL.     

A nationwide survey of mortality in acromegaly

CONTEXT: Increased mortality in acromegaly has been confined to those with posttreatment basal GH of 2.5 microg/liter or greater, but the impact of IGF-I and pituitary radiotherapy on mortality has remained controversial. OBJECTIVE: The purpose of this nationwide survey was to examine the all-cause mortality of patients with acromegaly and evaluate the impact of treatment outcome and mode of treatment on survival. DESIGN, SETTING, AND PATIENTS: All-cause mortality of all patients with acromegaly diagnosed during January 1980 and December 1999 in the five university hospitals of Finland was followed up by the end of 2002 (12.5 +/- 5.6 yr) and compared with that of the general population by using age- and gender-adjusted standardized mortality ratios (SMRs). Logistic regression analysis was used to investigate factors related to mortality within the survey population. MAIN OUTCOME MEASURE: Mortality was the main outcome measure. RESULTS: Of the 334 patients, 56 (16.8%) had died during follow-up. SMR of the patients was 1.16 [confidence interval (CI) 0.85-1.54, not significant (NS)]. However, patients with basal serum GH concentration 2.5 microg/liter or greater (SMR 1.63, CI 1.10-2.35, P < 0.001) measured 5.2 +/- 4.4 yr after the initial treatment, and those irradiated (SMR 1.69, CI 1.05-2.58, P < 0.001) showed excess mortality. In a multivariate model, the effect of radiotherapy was of borderline significance only (P = 0.083). Posttreatment IGF-I levels, available for 72.2% of the patients, did not have impact on mortality. CONCLUSIONS: The posttreatment basal GH concentration less than 2.5 microg/liter in acromegalic patients is associated with a normal lifespan. Excess mortality is confined to poorly controlled patients and possibly those who have received conventional radiotherapy.     

Early repetitive radiography is unnecessary after an uncomplicated cemented hip or knee arthroplasty for osteoarthritis

Radiographs are necessary at some early point after a hip and knee arthroplasty. The aim of this study was to assess the value of routine repetitive radiographic examinations and the value of a reading of the images by a radiologist. Data of 200 cemented hip and knee arthroplasties for osteoarthritis were reviewed. In-hospital and outpatient postoperative control radiographs were examined. If post-operative radiographs are of good quality, there seems to be no need for early repetitive radiographs. Neither is a radiologist reading of the radiographs after joint arthroplasty of any benefit.     

A widespread outbreak of Yersinia pseudotuberculosis O:3 infection from iceberg lettuce

BACKGROUND: The vehicles and sources of Yersinia pseudotuberculosis infection are unknown. In Finland, clinical microbiology laboratories routinely report Y. pseudotuberculosis isolations and submit isolates for serotype analysis. In October 1998, the number of serotype O:3 infections increased markedly. METHODS: Case patients with culture-confirmed Y. pseudotuberculosis O:3 infection were identified by use of laboratory-based surveillance. We conducted a population-based case-control study. Healthy community control subjects were matched by age, sex, and postal code. Isolates were subtyped by pulsed-field gel electrophoresis (PFGE). RESULTS: Nationwide, 47 case patients were identified (age range, 2-77 years; median, 19 years). One patient with bacteremia died; 5 underwent appendectomies. We enrolled 38 case patients and 76 control subjects in the case-control study. Seventy-one percent of case patients and 42% of control subjects reported having eaten iceberg lettuce (matched odds ratio, 3.8; 95% confidence interval, 1.3-9.4); a dose-response relationship was found for increasing frequency of consumption. Of the 27 isolates obtained from case patients and tested in the analysis, all had indistinguishable PFGE patterns. Four lunch cafeterias that had served iceberg lettuce were associated with clusters of case patients. The lettuce was traced back to originating farms. CONCLUSIONS: Iceberg lettuce was implicated as the vehicle of a widespread foodborne Y. pseudotuberculosis outbreak. Ongoing laboratory-based surveillance and serotype analysis were essential in the rapid detection of infection. Cases of yersiniosis, which appear to be sporadic, may be part of unrecognized outbreaks caused by contaminated fresh produce.     

International collaboration in mass disasters involving foreign nationals within the EU

Identification of and investigation into the cause of death of foreign nationals in mass disasters are generally conducted according to the jurisdiction of the country in which the disaster occurs. However, such identification can be achieved only through co-operation with the authorities of the victims' countries of residence. On October 8th 2001 at Linate airport in Milan, Italy, an MD87 SAS airplane with 110 crew members and passengers on board collided on the ground with a Cessna Citation II jet with 2 pilots and 2 passengers. The plane then caught fire after having crashed into an airport baggage hangar causing the death of 4 other victims among the groundstaff. The accident claimed a total of 118 victims of 9 nationalities. Based on our experience from investigation of the Finnish victims, we explore how current national legislations of the EU member states and varying compliance with existing recommendations may influence the medico-legal investigation of a mass disaster. Legislative measures and further harmonisation of medico-legal procedures in connection with mass disasters within the EU are needed.     

Supplemental oxygen does not reduce the incidence of postoperative nausea and vomiting after ambulatory gynecologic laparoscopy

Supplemental 80% oxygen administration halves the incidence of postoperative nausea and vomiting (PONV) in inpatients. Whether it prevents PONV after ambulatory surgery is unknown. We tested the efficacy of supplemental 80% oxygen in decreasing the incidence of PONV after ambulatory gynecologic laparoscopy. One hundred patients were given a standardized sevoflurane anesthetic. They were randomly assigned to two groups: routine oxygen administration with 30% oxygen, balance nitrogen (Group A); and supplemental oxygen with 80% oxygen, balance nitrogen (Group B). Oxygen was administered during surgery and up to 1 h after surgery. The incidence of nausea and vomiting and the need for rescue antiemetics did not differ between the groups in the postanesthesia care unit, in the Phase II unit, or during the 24-h follow-up. The overall incidence of nausea and vomiting during the first postoperative 24 h was 62% in Group A and 55% in Group B (P = 0.486). There were no differences in the recovery profiles and patient satisfaction between the groups. In this study, supplemental oxygen did not prevent PONV in patients undergoing ambulatory gynecologic laparoscopy. IMPLICATIONS: Supplemental 80% oxygen administration during surgery and until 1 h after surgery compared with 30% oxygen administration did not prevent postoperative nausea and vomiting after ambulatory gynecologic laparoscopy.     

Relationship between cells forming colonies in diffusion chambers in vivo (CFU-D) and cells with high proliferative potential in vitro (HPP-CFC-1 and -2)

In vivo diffusion chambers implanted in normal mice after 5 days of bone marrow cell culture contained precursor cells that in the presence of recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF), interleukin 3 (IL-3), or colony-stimulating factor 1 (CSF-1), alone or in combination, formed both small and large (high proliferative potential colony-forming cells, HPP-CFC) macrophage-containing colonies in vitro. Synergistic factor from serum-free 5637 cell-conditioned medium (SF5637) enhanced HPP-CFC colony growth only in cultures containing CSF-1. Higher numbers of CSF-1- plus IL-3-responsive colony-forming cells (HPP-CFC-2) were detected in diffusion chamber colony-forming unit (CFU-D) colonies than in intercolony areas, suggesting that they were derived from cells that give rise to the diffusion chamber colony. Further study demonstrated that CFU-D colonies contained cells that formed large macrophage-containing colonies (HPP-CFC-1) in CSF-1- plus SF5637-containing cultures. These findings suggest that single cells (CFU-D) forming colonies in diffusion chambers in mice can give rise to both HPP-CFC-1 and to cells probably representing their progeny, HPP-CFC-2.     

The toxicity of some N-methyl-N-formylhydrazones from Gyromitra esculenta and related compounds in mouse and microbial tests.

The acute oral toxicity of four N-methyl-N-formylhydrazones (compounds found in the edible mushroom Gyromitra esculenta Fr. ex Pers.), one N-methylhydrazone derivative and N-methyl-N-formylhydrazine, N-methylhydrazine, and hydrazine were compared in mice. The bacteriocidal effect of the last three compounds was also studied using Escherichia coli as a test organism. N-Methylhydrazine and N-methyl-N-formylhydrazine were both found to be considerably more toxic to mice than N-methyl-N-formylhydrazones or hydrazine. Both hydrazine and N-methylhydrazine were clearly bacteriocidal to Escherichia coli, whereas N-methyl-N-formylhydrazine had no effect on the test bacterium at the doses used. The results are compatible with the hypothesis that the metabolic products of N-methyl-N-formylhydrazones, possibly N-methylhydrazine, are responsible for the toxic effects of these compounds.     

Influence of non-ionic surfactants on permeation of hydrocortisone, dexamethasone, testosterone and progesterone across cellulose acetate membrane.

The lag-time method of diffusion has been used to investigate permeation of hydrocortisone, dexamethasone, testosterone and progesterone across cellulose acetate membranes between 10 degrees and 40 degrees. The process depended mainly on membrane-water partition coefficients of the steroids so that the least polar compound permeated the fastest. Permeation generally increased with increasing temperature and from the temperature dependance of the diffusion coefficient, energies of activation were derived. The varied from 2.4 kcal mol(-1) for the least polar steroid, progesterone, to 7.4 kcal mol(-1) for the most polar, hydrocortisone. n-C16 Polyoxyethylene surfactants when present below and above the cmc increased the steroids permeation rates. Varying the polyoxyethylene chain length (OE equals 17-63) did not significantly affect permeation rates, suggesting that the enhancing effect of surfactants arises from their hydrophobic group.