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1.
Mette Nissen Tiina‐Mari Ikheimo Jukka Huttunen Ville Leinonen Henna‐Kaisa Jyrkknen Mikael von und zu Fraunberg 《Neuromodulation》2021,24(1):102-111
ObjectiveSpinal cord stimulation (SCS) is an effective treatment in failed back surgery syndrome (FBSS). We studied the effect of preimplantation opioid use on SCS outcome and the effect of SCS on opioid use during a two-year follow-up period.Materials and methodsThe study cohort included 211 consecutive FBSS patients who underwent an SCS trial from January 1997 to March 2014. Participants were divided into groups, which were as follows: 1) SCS trial only (n = 47), 2) successful SCS (implanted and in use throughout the two-year follow-up period, n = 131), and 3) unsuccessful SCS (implanted but later explanted or revised due to inadequate pain relief, n = 29). Patients who underwent explantation for other reasons (n = 4) were excluded. Opioid purchase data from January 1995 to March 2016 were retrieved from national registries.ResultsHigher preimplantation opioid doses associated with unsuccessful SCS (ROC: AUC = 0.66, p = 0.009), with 35 morphine milligram equivalents (MME)/day as the optimal cutoff value. All opioids were discontinued in 23% of patients with successful SCS, but in none of the patients with unsuccessful SCS (p = 0.004). Strong opioids were discontinued in 39% of patients with successful SCS, but in none of the patients with unsuccessful SCS (p = 0.04). Mean opioid dose escalated from 18 ± 4 MME/day to 36 ± 6 MME/day with successful SCS and from 22 ± 8 MME/day to 82 ± 21 MME/day with unsuccessful SCS (p < 0.001).ConclusionsHigher preimplantation opioid doses were associated with SCS failure, suggesting the need for opioid tapering before implantation. With continuous SCS therapy and no explantation or revision due to inadequate pain relief, 39% of FBSS patients discontinued strong opioids, and 23% discontinued all opioids. This indicates that SCS should be considered before detrimental dose escalation. 相似文献
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Comparison of four different sampling methods for detecting pharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children. 总被引:2,自引:0,他引:2
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S Rapola E Salo P Kiiski M Leinonen A K Takala 《Journal of clinical microbiology》1997,35(5):1077-1079
Samples from 96 children with acute respiratory infection were obtained simultaneously with nasal, nasopharyngeal, and oropharyngeal swabs and by nasopharyngeal aspiration and were cultured on chocolate and blood agar plates. The rates of isolation of Streptococcus pneumoniae and Haemophilus influenzae detected by the four sampling methods were compared. Nasopharyngeal aspirates were optimal for the detection of both S. pneumoniae (isolation rate, 33%) and H. influenzae (isolation rate, 31%). When a nasopharyngeal aspirate is not available, such as for healthy children or children with no obtainable secretions, the nasopharyngeal swab seems optimal for the detection of both S. pneumoniae and H. influenzae among children younger than 13 months of age. Among older children, similarly, the nasopharyngeal swab seems optimal for the detection of S. pneumoniae; however, for H. influenzae, the oropharyngeal swab seems optimal. 相似文献
5.
Evaluation of sampling sites for detection of upper respiratory tract carriage of Streptococcus pneumoniae and Haemophilus influenzae among healthy Filipino infants. 总被引:1,自引:1,他引:0
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M R Capeding H Nohynek L T Sombrero L G Pascual E S Sunico G A Esparar E Esko M Leinonen P Ruutu 《Journal of clinical microbiology》1995,33(11):3077-3079
Two sampling techniques, nasal swabbing and oropharyngeal swabbing, for detection of the upper respiratory tract carriage of Streptococcus pneumoniae and Haemophilus influenzae were studied prospectively with 296 healthy Filipino infants at various ages: 6 to 8, 10 to 12, 14 to 17, 18 to 22, 32 to 39, and 46 to 65 weeks. In all age groups S. pneumoniae was isolated significantly more often (P < 0.0001) from the nasal site than from the oropharyngeal site. H. influenzae was found equally often at both sites. 相似文献
6.
Aaro Leinonen Topi Siniluoto Markku Päivänsalo Ari Karttunen Matti I. Kairaluoma Ilkka Suramo 《European radiology》1993,3(3):213-218
Nineteen patients with 49 symptomatic non-neoplastic non-parasitic simple hepatic cysts were subjected to ultrasonographically guided percutaneous aspiration and temporary injection of 99% ethanol into the cyst. Small cysts were treated twice, the large ones three times at the same sitting. The volume of alcohol per injection varied from 20 to 100 ml, depending on the size of the cyst. A cure was usually achieved with one ethanol sclerotherapy treatment. Only minor side effects such as transient pain and temperature elevation occurred. Forty-seven of the 49 cysts could be treated adequately, and did not recur during a follow-up period af 12–40 months. The results indicate that aspiration an and ethanol sclerotherapy is the treatment of choice in patients with symptomatic non-neoplastic simple hepatic cysts or polycystic liver disease.
Correspondence to: A. Leinonen 相似文献
7.
Donor insemination: child development and family functioning in lesbian mother families 总被引:1,自引:5,他引:1
Brewaeys A; Ponjaert I; Van Hall EV; Golombok S 《Human reproduction (Oxford, England)》1997,12(6):1349-1359
Findings are presented of a comparative study investigating the family
relationships and the emotional and gender development of children raised
in lesbian mother families. A total of 30 lesbian mother families with 4-8
year old children created as a result of donor insemination (DI) were
compared with 38 heterosexual families with a DI child and with 30
heterosexual families who had a naturally conceived child. A variety of
assessment measures, including a standardized interview and questionnaires
from the parents and psychological testing of the child were used to
collect the data. The quality of the couples' relationships and the quality
of the mother-child interaction did not differ between lesbian mother
families and either of the heterosexual family groups. The quality of the
interaction between the social mother and the child in lesbian families was
superior to that between the father and the child in both groups of
heterosexual families. Childrens' own perception of their parents was
similar in all family types; the social mother in lesbian families was
regarded by the child to be as much a 'parent' as the father in both types
of heterosexual families. With regard to their emotional/behavioural
development, boys and girls raised in lesbian mother families were well
adjusted and their gender role development did not differ from that of
children raised in heterosexual families. These results indicate that child
and family development in lesbian mother families is similar to that of
heterosexual families.
相似文献
8.
Donor insemination: Dutch parents' opinions about confidentiality and donor anonymity and the emotional adjustment of their children 总被引:1,自引:4,他引:1
Brewaeys A; Golombok S; Naaktgeboren N; de Bruyn JK; van Hall EV 《Human reproduction (Oxford, England)》1997,12(7):1591-1597
Results from a comparative study investigating 38 donor insemination (DI)
Dutch families with 4-8 year old children are presented. The aims of this
study were to investigate parents' opinions on the issues of
confidentiality and donor anonymity, to assess the emotional development of
the children, and to examine in DI families the association between secrecy
with regard to the use of a donor and the emotional adjustment of the
children. The DI families were compared to families with a child conceived
by in-vitro fertilization (IVF) and to families with a naturally conceived
child. Secrecy appeared to be associated with DI and not with IVF: 74% of
the DI parents intended not to inform the child about the way in which
she/he was conceived, whereas none of the IVF parents intended to keep the
secret. Only one set of DI parents and two sets of IVF parents had actually
told the child. As to donor anonymity, a spread of opinions appeared among
DI parents; 57% preferred an anonymous donor, 31% would have liked non-
identifying information about the donor, 9% preferred the donor's identity
to be registered and 3% remained unsure. Parents' major concern was to know
more about the medical/genetic background of the donor. Mothers and fathers
in the DI families differed in their opinions concerning the issues of
confidentiality and donor anonymity: fathers, more often than mothers, were
secretive with regard to the use of a donor and husbands, more often than
their wives, were in favour of donor anonymity. With regard to the
emotional development of the children, more emotional/behavioural problems
were revealed among DI children than among children who were naturally
conceived. No association was found between secrecy and the
emotional/behavioural adjustment of the children.
相似文献
9.
Comparison of PCR assay with bacterial culture for detecting Streptococcus pneumoniae in middle ear fluid of children with acute otitis media. 总被引:2,自引:1,他引:2
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A Virolainen P Salo J Jero P Karma J Eskola M Leinonen 《Journal of clinical microbiology》1994,32(11):2667-2670
We have studied etiological diagnosis of acute otitis media (AOM) by comparing a newly developed pneumococcal PCR for Streptococcus pneumoniae to bacterial culture with 180 middle ear fluid (MEF) samples of 125 children with 125 episodes of AOM. For pneumococcal PCR assay, DNA from MEF samples was extracted by phenol-chloroform. The outer primers used amplified a 348-bp region of the pneumolysin gene, and the inner primers amplified a 208-bp region. S. pneumoniae was cultured in 33 (18%) samples, and pneumolysin PCR was positive for 51 (28%) of 180 MEF samples. Only 2 of 21 PCR-positive, S. pneumoniae culture-negative samples were positive for other otitis pathogens. By combining MEF culture and PCR results, 54 (30%) of 180 MEF samples had evidence of pneumococcal etiology. In conclusion, pneumolysin PCR is a sensitive and specific new method to study pneumococcal involvement in MEF samples of children with AOM. 相似文献
10.
Use of AffiProbe HPV test kit for detection of human papillomavirus DNA in genital scrapes. 总被引:1,自引:0,他引:1
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M Ranki A W Leinonen T Jalava P Nieminen V R Soares J Paavonen A Kallio 《Journal of clinical microbiology》1990,28(9):2076-2081
The presence of human papillomavirus (HPV) DNA in cervical and vaginal scrapes was analyzed by the AffiProbe HPV test kit (Orion Corp., Orion Pharmaceutica, Helsinki, Finland), which is a 1-day solution hybridization test for HPV type 6/11, 16, or 18. The AffiProbe test was compared with a commercially available dot blot test (ViraPap and ViraType tests; Life Technologies Inc., Gaithersburg, Md.). The study group consisted of 178 patients seen in a gynecological outpatient clinic. Altogether, 64 specimens (36 cervical and 28 vaginal scrapes) from 49 patients were positive by the AffiProbe test. Concurrently collected cervical scrapes from 174 patients were available for the reference test, which yielded 27 positive results for HPV type 6/11 or 16/18 and 25 positive results for HPV type 31/33/35. Agreement as to the presence of HPV type 6/11, 16, or 18 by the two tests was reached in 85% of the specimens. Eleven cervical specimens were positive by the AffiProbe test only, and nine cervical specimens were positive by the ViraType test only. Independent evidence obtained by the polymerase chain reaction, repeat examination, or the concurrent presence of HPV DNA in vaginal or vulval epithelium supported the AffiProbe and the ViraType test results for 6 of the 11 and 6 of the 9 specimens with discrepant results, respectively. Thus, the DNA tests had similar sensitivities for HPV type 6/11, 16, and 18 DNAs, but the results were obtained within 1 day by the AffiProbe test, whereas results for the ViraPap and ViraType analyses required from 4 days to 2 weeks. 相似文献