Mobile phone effects on children's event-related oscillatory EEG during an auditory memory task

PURPOSE: To assess the effects of electromagnetic fields (EMF) emitted by mobile phones (MP) on the 1 - 20 Hz event-related brain oscillatory EEG (electroencephalogram) responses in children performing an auditory memory task (encoding and recognition). MATERIALS AND METHODS: EEG data were gathered while 15 subjects (age 10 - 14 years) performed an auditory memory task both with and without exposure to a digital 902 MHz MP in counterbalanced order. RESULTS: During memory encoding, the active MP modulated the event-related desynchronization/synchronization (ERD/ERS) responses in the approximately 4 - 8 Hz EEG frequencies. During recognition, the active MP transformed these brain oscillatory responses in the approximately 4 - 8 Hz and approximately 15 Hz frequencies. CONCLUSIONS: The current findings suggest that EMF emitted by mobile phones has effects on brain oscillatory responses during cognitive processing in children.     

Local immune response to upper urinary tract infections in children

Vaccines are needed against urinary tract infections (UTIs) in children, as episodes of pyelonephritis (PN) may cause renal scarring. Local immune mechanisms are regarded to confer protection, yet they have been poorly characterized for children. This study explores the local immune response in children by looking for newly activated pathogen-specific antibody-secreting cells (ASC), expected to appear transiently in the circulation as a response to UTI. Urinary tract-originating ASC specific to each patient's own pathogen or P fimbria were studied in 37 children with PN. The children were examined for recidivism and renal scarring in a 6-month follow-up study. Pathogen-specific ASC were found in 33/37 children, with the magnitude increasing with age. In contrast to the case for adults, with immunoglobulin A (IgA) dominance, in 18/33 cases IgM dominated the response, and this occurred more frequently in infants (63%) than in older children (30%). The most vigorous response was found to whole Escherichia coli bacteria (geometric mean, 63 ± 2,135 ASC/10⁶ peripheral blood mononuclear cells [PBMC]), yet responses were found to P fimbriae (13 ± 33 ASC/10⁶ PBMC), too. The response peaked at 1 to 2 weeks and was low/negligible 3 to 7 weeks after the beginning of symptoms. Recidivism was seen in seven patients, and renal scarring was seen in nine patients. In conclusion, a response of circulating ASC was found in children with UTIs, with the magnitude increasing with age. Since IgM is not present in urine, the IgM dominance of the response suggests that systemic immune mechanisms are more important in the immune defense in children than in adults. In 81% of patients, no recidivism was seen, suggesting a successful immune defense.     

Effect of low-dose endurance training on heart rate variability at rest and during an incremental maximal exercise test

We evaluated the effects of low-dose endurance training on autonomic HR control. We assessed the heart rate variability (HRV) of 11 untrained male subjects (36.8 +/- 7.2 years) at rest and during an incremental maximal aerobic exercise test prior to a 7-week preparatory period and prior to and following a 14-week endurance training period, including a low to high intensity exercise session twice a week. Total (0.04-1.2 Hz), low (0.04-0.15 Hz) and high (0.15-1.2 Hz) frequency power of HRV were computed by short-time Fourier transform. The preparatory period induced no change in aerobic power or HRV. The endurance training period increased peak aerobic power by 12% (P < 0.001), decreased the HR (P < 0.01) and increased all HRV indices (P < 0.05-0.01) at absolute submaximal exercise intensities, but not at rest. In conclusion, low-dose endurance training enhanced vagal control during exercise, but did not alter resting vagal HR control.     

Large genomic rearrangements and germline epimutations in Lynch syndrome

In one‐third of families fulfilling the Amsterdam criteria for hereditary nonpolyposis colorectal cancer/Lynch syndrome, and a majority of those not fulfilling these criteria point mutations in DNA mismatch repair (MMR) genes are not found. The role of large genomic rearrangements and germline epimutations in MLH1, MSH2 and MSH6 was evaluated in 2 such cohorts. All 45 index patients were mutation‐negative by genomic sequencing and testing for a prevalent population‐specific founder mutation, and selectively lacked MMR protein expression in tumor tissue. Eleven patients (“research cohort”) represented 11 mutation‐negative families among 81 verified or putative Lynch syndrome families from the nation‐wide Hereditary Colorectal Cancer Registry of Finland. Thirty‐four patients from 33 families (“clinic‐based cohort”) represented suspected Lynch syndrome patients tested for MMR gene mutations in a diagnostic laboratory during 2004–2007. Multiplex ligation‐dependent probe amplification (MLPA) and methylation‐specific (MS)‐MLPA were used to detect rearrangements and epimutations, respectively. Large genomic deletions occurred in 12/45 patients (27%), being present in 3/25 (12%), 9/16 (56%) and 0/4 (0%) among index patients lacking MLH1, MSH2 or MSH6 expression, respectively. Germline epimutations of MLH1, one of which coexisted with a genomic deletion, occurred in 2 patients (4%) and were accompanied by monoallelic expression in mRNA. Large genomic deletions (mainly MSH2) and germline epimutations (MLH1) together explain a significant fraction of point mutation‐negative families suspected of Lynch syndrome and are associated with characteristic clinical and family features. Our findings have important implications in the diagnosis and management of such families. © 2008 Wiley‐Liss, Inc.     

A mini-invasive adductor magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note

Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed, safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3–4 cm is located at the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor magnus tendon is cut at 12–14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is tightened at 30° knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion.     

An analysis of dental patient safety incidents in a patient complaint and healthcare supervisory database in Finland

Objective. Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland. Materials and methods. The sample included all available fully resolved dental cases (n = 948) during 2000–2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases. Results. Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications. Conclusions. Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.     

Treatment and follow-up strategies in hereditary nonpolyposis colorectal carcinoma

The treatment and follow-up strategies of patients with hereditary nonpolyposis colorectal carcinoma (HNPCC) were analyzed in 22 Finnish HNPCC families in systematic follow-up between 1983 and 1990. During the sevenyear study period metachronous colorectal neoplasia was diagnosed in 41 percent (15/37) of the patients treated by segmentai colonic resection and in 24 percent (4/17) of those treated by subtotal colectomy. Extracolonic carcinoma was diagnosed in 12 (30 percent) of the 40 patients during the long-term follow-up. The most common extracolonic malignancy was biliopancreatic carcinoma which accounted for all five cancer-related deaths in the whole series during the study period. It was concluded that subtotal colectomy is superior to hemicolectomy or segmental resection in HNPCC patients with colorectal carcinoma. A regular annual endoscopic follow-up of the residual rectum is still necessary, and surveillance for extracolonic cancers must be considered.This work was supported by the Finnish Cancer Society and the Foundation of Gastroenterological Research.