Work ability among Finnish workers with type 1 diabetes.

BACKGROUND: Work ability represents the balance between individual resources, health status and job demands. As far as we are aware, these issues have not been examined in working people with type 1 diabetes (T1D). AIMS: To examine how work-related and diabetes-related factors are associated with work ability among male and female workers. METHODS: Questionnaires were mailed to a random sample of 2500 people with T1D from the Medication Reimbursement Register of The Social Insurance Institution of Finland. The associations of the predictors of poor work ability were examined in a logistic regression analysis. RESULTS: The final sample comprised 767 working people aged 18-64 with T1D; overall response rate 49%. One in every three working men and women with T1D had poor work ability. High job demands and low job control were associated with poor work ability in both genders. Physical work and low worktime control were significantly associated with poor work ability in men but not in women with T1D. A self-reported high value of glycosylated haemoglobin was the only diabetes-related variable associated with poor work ability in both men and women. CONCLUSIONS: Work-related factors and poor glycaemic control were associated with poor work ability in individuals with T1D. Thus, job control and worktime control should be taken into account in supporting the work ability of workers with T1D.

Phosphorus in manure and sewage sludge more recyclable than in soluble inorganic fertilizer.

Phosphorus (P) flow from deposits through agriculture to waterways leads to eutrophication and depletion of P reserves. Therefore, P must be recycled. Low and unpredictable plant availability of P in residues is considered to be a limiting factor for recycling. We identified the determinants for the plant-availability of P in agrifood residues. We quantified P in Italian ryegrass (Lolium multiflorum) and in field soil fractions with different plant availabilities of P as a response to manure and sewage sludge with a range of P capture and hygienization treatments. P was more available in manure and in sludge, when it was captured biologically or with a moderate iron (Fe)/P (1.6), than in NPK. Increasing rate of sludge impaired P recovery and high Fe/P (9.8) prevented it. Anaerobic digestion (AD) reduced plant-availability at relevant rates. The recovery of P was increased in AD manure via composting and in AD sludge via combined acid and oxidizer. P was not available to plants in the sludge hygienized with a high calcium/P. Contrary to assumed knowledge, the recyclability of P in appropriately treated residues can be better than in NPK. The prevention of P sorption in soil by organic substances in fertilizers critically enhances the recyclability of P.

Protected zone ventilation and reduced personal exposure to airborne cross-infection.

The main objective of this study was to examine the performance of protected zone ventilation (PZV) and hybrid protected zone ventilation (HPZV) to reduce the direct exposure to exhaled air from others' breathing. Experimental measurements are carried out to test the performance of PZV in a full-scale office room with two breathing thermal manikins. The measurements were performed under three configurations, including two standing manikins at different distances: 0.35, 0.5, and 1.1 m. When the supply air velocity is increased to 4 m/s in the downward plane jet, the dimensionless concentration is 40% lower than for fully mixed ventilation, which can be considered as a measure of protection from the zoning condition. The measurement results showed that in both the PZV and the HPZV system it is possible to decrease the transmission of tracer gas from one manikin to the opposite manikin; therefore, it probably would reduce the risk of air borne cross-infection between two people at the same relative positions. The results suggest that PZV and HPZV may be used to reduce the exposure of people in a protected zone from indoor pollutants emitted in a source zone.

Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period.

We investigated the epidemiology of total Achilles tendon ruptures and complication rates after operative and nonoperative treatments over a 33-year period in Oulu, Finland. Patients with Achilles tendon ruptures from 1979 to 2011 in Oulu were identified from hospital patient records. Demographic data, treatment method, and complications were collected retrospectively from medical records. Overall and sex- and age-specific incidence rates were calculated with 95% confidence intervals (CIs). The overall incidence per 100,000 person-years increased from 2.1 (95% CI 0.3-7.7) in 1979 to 21.5 (95% CI 14.6-30.6) in 2011. The incidence increased in all age groups. The mean annual increase in incidence was 2.4% (95% CI 1.3-4.7) higher for non-sports-related ruptures than for sports-related ruptures (P = 0.036). The incidence of sports-related ruptures increased during the second 11-year period whereas the incidence of non-sports-related ruptures increased steadily over the entire study period. Infection was four times more common after operative treatment compared with nonoperative treatment, re-rupture rates were similar. The incidence of Achilles tendon ruptures increased in all age groups over a 33-year period. Increases were mainly due to sports-related injuries in the second 11-year period and non-sports-related injuries in the last 11-year period.

Pesticide residues in boreal arable soils: Countrywide study of occurrence and risks.

Large volumes of pesticides are applied every year to support agricultural production. The intensive use of pesticides affects soil quality and health, but soil surveys on pesticide residues are scarce, especially for northern Europe. We investigated the occurrence of 198 pesticide residues, including both banned and currently used substances in 148 field sites in Finland. Results highlight that pesticide residues are common in the agricultural soils of Finland. A least one residue was found in 82% of the soils, and of those 32% contained five or more residues. Maximum total residue concentration among the conventionally farmed soils was 3043 µg/kg, of which AMPA and glyphosate contributed the most. Pesticide residues were also found from organically farmed soils, although at 75-90% lower concentrations than in the conventionally farmed fields. Thus, despite the application rates of pesticides in Finland being generally much lower than in most parts of central and southern Europe, the total residue concentrations in the soils occurred at similar or at higher levels. We also established that AMPA and glyphosate residues in soil are significantly higher in fields with cereal dominated rotations than in grass dominated or cereal-grass rotations. However, risk analyses for individual substances indicated low ecological risk for most of the fields. Furthermore, the total ecological risk associated with the mixtures of residues was mostly low except for 21% of cereal dominated fields with medium risk. The results showed that the presence of mixtures of pesticide residues in soils is a rule rather than an exception also in boreal soils. In highly chemicalized modern agriculture, the follow-up of the residues of currently used pesticides in national and international soil monitoring programs is imperative to maintain soil quality and support sustainable environment policies.

Knowledge, Attitudes, and Practices of Finnish Dairy Farmers on Cryptosporidiosis.

Calf-mediated zoonotic cryptosporidiosis is an emerging occupational health risk among Finnish dairy farmers. We studied farmers' knowledge, attitudes, and practices (KAP) regarding cryptosporidiosis to reveal possible weaknesses, which might increase the risk of zoonotic infection. KAP study was carried out as a cross-sectional questionnaire survey (n = 243). A total of 400 cryptosporidiosis-negative and 138 cryptosporidiosis-positive dairy farms, with more than 50 cows, were invited to participate in the study. The response rate was 45%. Half (49%) of the respondents had adequate knowledge concerning zoonotic cryptosporidiosis. Knowledge score was associated with age (p < 0.01), level of education (p < 0.01), and cryptosporidiosis status of the farm (p < 0.01). Though most respondents had favorable attitudes, one-third (32.5%) had poor zoonotic transmission prevention practices. Use of a personal mobile device was the most common risky practice (90%) performed daily in the cowhouse. Most respondents (93%) reported gaining information about infectious diseases in animals from more than two information sources. Veterinarians were the most mentioned source (n = 228), whereas primary care physicians were among the least common sources (n = 16). Having favorable attitudes towards the prevention of zoonotic cryptosporidiosis was common. However, shortages in knowledge and several risky practices were identified in both cryptosporidiosis positive and negative farms. The role of the occupational health sector should be strengthened in work-related zoonotic disease prevention and may require further education of the personnel. A one-health approach to control zoonotic diseases is recommended.

Long-term life satisfaction in ageing women with work disability due to mental and musculoskeletal disorders.

BACKGROUND: Mental disorders (MDs) and musculoskeletal disorders (MSDs) are the major causes of global disability and increase in prevalence with age. AIMS: To support healthy ageing, we studied how work disability due to MDs or MSDs is related to life satisfaction (LS) cross-sectionally and in 5- and 10-year follow-ups among ageing women. METHODS: In the population-based OSTPRE cohort (women aged 58-67 in 1999), data on lifetime permanent work disability pensions (DPs) due to 'MDs only' (n = 337), 'MSDs only' (n = 942) and 'MDs + MSDs' (n = 212) and 'no DP' (n = 6322) until 1999 was obtained from the Finnish national register. The OSTPRE postal enquiry included a four-item life satisfaction (LS) scale (range 4-20: satisfied 4-6, intermediate 7-11, dissatisfied 12-20) at 5-year intervals, in 1999-2004 (n = 6548) and in 1999-2009 (n = 5562). RESULTS: In 1999, the risks of belonging to the dissatisfied LS group (score 12-20) vs. the satisfied group (score 4-6) were higher in 'MDs only' (OR = 4.30; 95%CI 2.95-6.28), 'MSDs only' (OR = 2.69; 2.12-3.40) and 'MDs + MSDs' (OR = 2.72; 1.77-4.16) groups than in the 'no DP' group. In the follow-ups, these risks were OR5yr = 5.59 (3.54-8.84) and OR10yr = 4.94 (2.80-8.73) for 'MDs only', OR5yr = 3.36 (2.58-4.37) and OR10yr = 3.18 (2.40-4.21) for 'MSDs only', and OR5yr = 4.70 (2.75-8.05) and OR10yr = 6.84 (3.53-13.27) for 'MDs + MSDs' (all: p ≤ 0.001). Adjusting for baseline LS did not change the pattern (all p ≤ 0.001). CONCLUSION: Work disability due to MDs and MSDs undermines healthy ageing among women via life dissatisfaction.

Early prognosticators of later TSPO-PET-measurable microglial activation in multiple sclerosis.

BACKGROUND: Factors driving increased innate immune cell activation in multiple sclerosis (MS) brain are not well understood. As higher prevalence of microglial/macrophage activation in association with chronic lesions and diffusely in the normal appearing white matter predict more rapid accumulation of clinical disability, it is of high importance to understand processes behind this. Objective of the study was to explore demographic, clinical and paraclinical variables associating with later positron emission tomography (PET)-measurable innate immune cell activation. METHODS: PET-imaging using a TSPO-binding [11C]PK11195 was performed to evaluate microglial activation in patients with relapsing-remitting MS aged 40-55 years with a minimum disease duration of five years (n = 37). Medical records and diagnostic MR images were reviewed for relevant early MS disease-related clinical and paraclinical parameters. RESULTS: More prominent microglial activation was associated with higher number of T2 lesions in the diagnostic MRI, a higher immunoglobulin G (IgG) index in the diagnostic CSF and Expanded Disability Status Scale (EDSS) ≥ 2.0 five years after diagnosis. CONCLUSION: The number of T2 lesions in MRI, and CSF immunoglobulin content measured by IgG index at the time of MS diagnosis associated with later TSPO-PET-measurable innate immune cell activation. This suggests that both focal and diffuse early inflammatory phenomena impact the development of later progression-related pathology.

Multiscale investigations of drift-wave turbulence and plasma flows: measurements and total-distribution-function gyrokinetic simulations.

Direct measurements of micro-, meso-, and macroscale transport phenomena in the FT-2 tokamak are shown to be quantitatively reproduced by global full f nonlinear gyrokinetic simulation predictions. A detailed agreement with mean equilibrium E×B flows, oscillating fine-scale zonal flows, and turbulence spectra observed by a set of sophisticated microwave backscattering techniques as well as a good fit of the thermal diffusivity data are demonstrated. A clear influence of the impurity ions on the fluctuating radial electric field is observed.

Once-monthly oral ibandronate provides significant improvement in bone mineral density in postmenopausal women treated with glucocorticoids for inflammatory rheumatic diseases: a 12-month, randomized, double-blind, placebo-controlled trial.

OBJECTIVES: To study the efficacy and safety of once-monthly oral ibandronate in the prevention of glucocorticoid (GC)-induced osteoporosis (GIOP) in postmenopausal women with inflammatory rheumatic diseases. METHOD: A randomized, double-blind, placebo-controlled, parallel-group study of 140 postmenopausal women was conducted. At baseline, the mean lumbar spine (LS) (L1-L4) bone mineral density (BMD) was normal or osteopaenic (T-score ≥ -2.0) and the patients were receiving treatment with 5-15 mg/day of prednisone equivalent. Patients were randomized 1:1 to receive either monthly oral ibandronate 150 mg or placebo for 12 months. All patients received vitamin D and calcium supplements. The primary endpoint was the relative change in mean LS BMD from baseline to 12 months. RESULTS: Mean LS BMD increased significantly by 2.6% and 3.2% from baseline to 6 and 12 months with ibandronate compared to 0.3% and -0.1% with placebo, respectively (p < 0.001). Comparable significant mean increases were also found in trochanter, femoral neck and total hip BMDs at 12 months. Reductions in the serum levels of bone turnover markers C-terminal telopeptide of type I collagen (sCTX), N-terminal propeptide of type I procollagen (P1NP), and tartrate-resistant acid phosphatase (TRACP) were significantly more marked in the ibandronate group than in the placebo group at 1, 6, and 12 months. Adverse events (AEs) were reported at a similar frequency in both groups. A higher proportion of serious AEs (SAEs) were reported in the ibandronate group without emergence of any single SAE. CONCLUSIONS: Once-monthly oral ibandronate provides a significant increase in LS and total hip BMD with an acceptable safety profile in postmenopausal women treated with low-dose GCs for inflammatory rheumatic diseases.

Pseudomonas M162 confers protection against rainbow trout fry syndrome by stimulating immunity.

AIMS: To evaluate the antagonistic effect of Pseudomonas M162 against Flavobacterium psychrophilum. METHODS AND RESULTS: The antagonistic activity of M162 was tested in vivo and in vitro, and its mode of action examined by siderophore production and immunological responses of rainbow trout (Oncorhynchus mykiss) fry. Pseudomonas M162 inhibited the growth of Fl. psychrophilum in vitro and increased the resistance of the fish against the pathogen, resulting in a relative per cent survival (RPS) of 39·2%. However, the siderophores produced by M162 did not have an inhibitory effect on Fl. psychrophilum. In fish fed with M162, the probiotic colonized the gastrointestinal tract and stimulated peripheral blood leucocyte counts, serum lysozyme activity and total serum immunoglobulin levels after 3 weeks from the start of feeding. CONCLUSIONS: This study showed the potential of Pseudomonas M162 as a probiotic by reducing the mortalities that occurred during an experimental Fl. psychrophilum infection, resulting mainly through the immunostimulatory effects of the bacterium. SIGNIFICANCE AND IMPACT OF THE STUDY: Rainbow trout fry syndrome (RTFS) causes high mortalities during the early life stages of the fish's life cycle, partly because their adaptive immunity has not yet fully developed. Thus, immunomodulation by probiotics could be an effective prophylactic method against RTFS.

Comorbidity of mental and musculoskeletal disorders in ageing women: A data linkage study using national registries.

BACKGROUND: Mental disorders (MDs) and musculoskeletal disorders (MSDs) are the main causes of disability. Yet, their comorbidity has not received the deserved attention. OBJECTIVE: To investigate the extent of the comorbidity between MDs and MSDs in ageing women using national registries on prescription medications and work disability pensions (DPs). METHODS: The study included 7,809 Finnish women, born during 1932-41, from the population-based Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort, established in 1989. Lifetime permanent DPs due to: 1) 'MDs only' (n = 359), 2) 'MSDs only' (n = 954), 3) 'MDs + MSDs' (n = 227), were recorded till 2003. The reference group was 'no DP' (n = 6,269). Data from the OSTPRE questionnaires was obtained in 1994. Use of medications was recorded in 1995 and 2003. The use of musculoskeletal or psychotropic medications by women having a DP or medication due to MD, or MSD diagnoses, respectively, was considered as an indicator of comorbidity. RESULTS: In 1995, all DP groups had used psychotropic and musculoskeletal medications more often than the referents. Use of musculoskeletal medications was associated with a higher use of psychotropic medications, and vice versa (OR=2.45; 95% CI 2.17-2.77), compared with non-use. The 'MSDs only' group was more likely to use psychotropic (OR=1.79; 95% CI 1.50-2.12), and the 'MDs only' group musculoskeletal medications (OR=1.38; 95% CI 1.09-1.74), compared with those without DPs. The proportions of medication users were similar in 1995 and 2003; however, the amounts used increased. CONCLUSIONS: There was strong evidence for comorbidity between MDs and MSDs in ageing women. Further research concerning their longitudinal relationships is warranted.

MRI Findings in Acute Tonsillar Infections.

BACKGROUND AND PURPOSE: Previous literature is vague on the prevalence and exact nature of abscesses in tonsillar infections, ranging from intratonsillar and peritonsillar collections to deep extension involving the parapharyngeal and retropharyngeal spaces. MR imaging has excellent diagnostic accuracy in detecting neck infections and can potentially clarify this issue. We sought to characterize the spectrum of MR imaging findings regarding tonsillar infections. MATERIALS AND METHODS: We conducted a retrospective cohort study of emergency neck MR imaging scans of patients with tonsillar infections. Imaging data were assessed in terms of signs of infection and the location of abscesses and were compared with clinical findings, final diagnoses, and surgical findings as reference standards. RESULTS: The study included 132 patients with tonsillar infection. Of these, 110 patients (83%) had ≥1 abscess (99 unilateral, 11 bilateral; average volume, 3.2 mL). Most abscesses were peritonsillar, and we found no evidence of intratonsillar abscess. Imaging showed evidence of parapharyngeal and retropharyngeal extension in 36% and 10% of patients, respectively. MR imaging had a high positive predictive value for both abscesses (0.98) and deep extension (0.86). Patients with large abscesses and widespread edema patterns had a more severe course of illness. CONCLUSIONS: Emergency neck MR imaging can accurately describe the extent and nature of abscess formation in tonsillar infections.

Pseudomonas sp. M174 inhibits the fish pathogen Flavobacterium psychrophilum.

AIMS: To study the antagonic affect of probiotic Pseudomonas M174 on the fish pathogen Flavobacterium psychrophilum. METHODS AND RESULTS: The ability of Pseudomonas M174 to inhibit the growth of Fl. psychrophilum was examined in iron-sufficient and -deficient media. Possible siderophore production was also investigated. Antagonistic activity was confirmed in disease challenge experiments using a rainbow trout (Oncorhynchus mykiss) model. Adhesion of Pseudomonas M174 to fish surfaces and its ability to stimulate innate immunity was also investigated in vivo. Pseudomonas M174 antagonized Fl. psychrophilum and produced siderophores in vitro. In challenge experiments with Fl. psychrophilum, fish fed with Pseudomonas M174 had lower levels of mortalities than the controls. It was possible to find Pseudomonas M174 in the intestinal content of these fish after feeding and bathing with the probiotic, but probiotic was obtained from the gills only after feeding. Respiratory burst activity was also found to be enhanced in the M174 fed fish. CONCLUSIONS: These results suggest that M174 is a potential probiotic against Fl. psychrophilum and has several modes of action. SIGNIFICANCE AND IMPACT OF THE STUDY: Probiotics are a promising alternative to the use of antibiotics in aquaculture and could be a more sustainable disease control method.

Immediate and 5-year outcome after coronary artery bypass surgery in very high risk patients (additive EuroSCORE ≥ 10).

AIM: We have evaluated the outcome after coronary artery bypass surgery in very high risk patients (additive EuroSCORE ≥ 10). The impact of beating heart coronary artery bypass surgery (BHCAB) on their outcome has been evaluated. METHODS: Retrospective study including 160 consecutive patients with additive EuroSCORE ≥ 10. RESULTS: . The overall survival rates at 30-day, 1-year, 3-year and 5-year were 83.8%, 76.0%, 72.4% and 66.8%, respectively. Baseline cardiac index (O.R. 0.20, 95%C.I. 0.08-0.53), preoperative inotropic support (O.R. 4.55, 95%C.I. 1.41-14.73) and preoperative resuscitation (O.R. 3.937, 95%C.I. 1.02-15.26) were independent predictors of 30-day mortality. Baseline cardiac index (R.R. 0.48, 95%C.I. 0.28-0.85), left ventricular ejection fraction (P=0.032), preoperative use of intraaortic balloon pump (R.R. 3.22, 95% C.I. 1.50-6.93), preoperative tracheal intubation (R.R. 3.44, 95%C.I. 1.37-8.68) and creatinine (R.R. 1.004, 95%C.I. 1.00-1.01) were independent predictors of late death. OPCAB/BHCAB was associated with somewhat lower 30-day mortality rate (16.2% vs. 18.0%, P=0.73), stroke (2.0% vs. 4.9%, P=0.37), red blood cells transfusion (3.4 vs. 5.4 units, P=0.004) and combined adverse outcome (43.4% vs. 50.8%, P=0.42). OPCAB/BHCAB surgeons compared with surgeons with a prevalent conventional approach achieved slightly better the 30-day mortality rate (16.7% vs. 27.9%, P=0.15) and stroke rate (2.8% vs. 4.7%, P=0.60) and 5-year survival rate (65.3% vs. 57.4%, P=0.35). CONCLUSION: Despite their poor immediate postoperative outcome, 5-year survival of these high risk patients is satisfactory and supports efforts in the treatment of this very high risk population. A more confident approach toward OPCAB/BHCAB is also suggested in these patients.

Comprehensive optimization process of paranasal sinus radiography.

BACKGROUND: The optimization of radiological examinations is important in order to reduce unnecessary patient radiation exposure. PURPOSE: To perform a comprehensive optimization process for paranasal sinus radiography at Mikkeli Central Hospital, Finland. MATERIAL AND METHODS: Patients with suspicion of acute sinusitis were imaged with a Kodak computed radiography (CR) system (n=20) and with a Philips digital radiography (DR) system (n=30) using focus-detector distances (FDDs) of 110 cm, 150 cm, or 200 cm. Patients' radiation exposure was determined in terms of entrance surface dose and dose-area product. Furthermore, an anatomical phantom was used for the estimation of point doses inside the head. Clinical image quality was evaluated by an experienced radiologist, and physical image quality was evaluated from the digital radiography phantom. RESULTS: Patient doses were significantly lower and image quality better with the DR system compared to the CR system. The differences in patient dose and physical image quality were small with varying FDD. Clinical image quality of the DR system was lowest with FDD of 200 cm. Further, imaging with FDD of 150 cm was technically easier for the technologist to perform than with FDD of 110 cm. CONCLUSION: After optimization, it was recommended that the DR system with FDD of 150 cm should always be used at Mikkeli Central Hospital. We recommend this kind of comprehensive approach in all optimization processes of radiological examinations.

Strategies of carbon and nitrogen acquisition by saprotrophic and ectomycorrhizal fungi in Finnish boreal Picea abies-dominated forests.

We compared the δ13C and δ15N of forest material with an extensive sporocarp collection to elucidate the role of litter, wood and soil as fungal carbon and nitrogen sources in Finnish boreal Picea abies-dominated forests. Ectomycorrhizal Hydnum and Cortinarius had higher δ15N than other ectomycorrhizal fungi, suggesting use of 15N-enriched, deeper nitrogen. Russula had lower δ15N than other ectomycorrhizal fungi and resembled some litter decay genera, suggesting use of litter-derived nitrogen. There was little variation in δ15N among other genera of ectomycorrhizal fungi, indicating limited functional diversity in nitrogen use. Saprotrophic Leotia, Gymnopus, Hypholoma, Pholiota, Rhodocollybia and Calocera had δ15N values similar to ectomycorrhizal fungi, indicating overlap in use of older nitrogen from soil or roots or use of newly fixed nitrogen. Genera of litter and wood decay fungi varied up to 6‰ in δ13C and 10‰ in δ15N, suggesting large differences in carbon and nitrogen sources and processing. Similar δ13C between white and brown rot wood decay fungi also suggest that white rot fungi do not use lignin-derived carbon. Together, these δ13C and δ15N patterns of fungi from Finnish boreal forests enhance our knowledge of fungal functional diversity and indicate broad use of litter, wood and soil resources.

Local inflammatory response in choriodecidua induced by Ureaplasma urealyticum.

Ureaplasma urealyticum is the bacterial species most often connected with preterm birth, although it often colonises the amniotic fluid without any adverse effects. The induction of preterm labour seems to depend on whether the bacteria produce an inflammatory reaction. In vitro stimulation of choriodecidual tissue with high amounts of U. urealyticum or with lipopolysaccharide induced a qualitatively similar inflammatory response detected by the production of tumour necrosis factor alpha, followed by secretion of anti-inflammatory cytokine interleukin-10 and of prostaglandin E2. Lower quantities of bacteria failed to induce any response.

Risk of retinal microembolism after off-pump and on-pump coronary artery bypass surgery.

AIM: In order to investigate the neuroprotective efficacy of off-pump coronary artery bypass surgery (OPCAB) over conventional on-pump coronary artery bypass surgery (CCAB), we have performed a prospective randomized study evaluating retinal circulation changes after OPCAB and CCAB. METHODS: Twenty patients were randomized to OPCAB or CCAB. Retinal fluorescein angiography and 60 degrees black-and-white as well as color fundus photographs of both eyes of each patient were taken 1 to 24 h before and 5 to 6 days after the operation. RESULTS: Patients undergoing OPCAB had more severely stenosed carotid arteries (P=0.075), higher incidence of slightly diseased ascending aorta (P=0.087) and higher Northern New England Cardiovascular Study Group stroke risk score (P=0.075). Neither stroke nor transient ischemic attack occurred postoperatively in these patients. Inferotemporal retinal arterial embolization and microinfarction was detected in one patient after CCAB, but in none of the OPCAB group. CONCLUSION: The risk of retinal embolism can be minimized by the use of OPCAB and, most likely, by adequate epiaortic ultrasound scanning of the ascending aorta and avoiding clamping in case of severely diseased aorta.

Effect of education on ability of AI professionals and herd-owner inseminators to detect cows not in oestrus and its relation with progesterone concentration on day of re-insemination.

The effect of training background of persons performing artificial insemination (AI) (herd-owner inseminators (OWNER), AI technicians (AI-T), and fertility consultants (FC)) on pregnancy rate and their ability to detect cows not in oestrus were studied. A total of 1584 re-AI occasions on 754 dairy farms were included. Milk samples for progesterone (P4) analysis in all cases were collected, as were data on the herd, previous breeding attempts, oestrous signs, uterine tone, slipperiness of cervix, and co-operation of the cow. Further breeding attempts and next calving or culling date were sought from registers. The cases were distributed into three categories based on P4 concentrations; <6 nmol/l (no luteal activity, could be in oestrus), 6-10 nmol/l (some luteal activity), and >10 nmol/l (high luteal activity, not in oestrus). Of cows offered for re-AI 7.7% had P4 concentration >10 nmol/l, with no difference between OWNER farms and farms using AI service. OWNERs chose for AI more cows having intermediate P4 than farms using AI service (9.8% vs. 5.9%, p < 0.05). AI-Ts recommended no AI significantly less often than FCs (1.6% vs. 4.9%, p < 0.01). Both groups were equally right: 71% and 68% of cows that were recommended to have no AI had high P4 concentration. Due to courageous and correct rejection of cows with high P4, FCs inseminated proportionally more cows in low P4 and less cows in intermediate P4 than OWNERs (p < 0.05). Of cows finally inseminated, 36.7% became pregnant, with no difference between OWNER farms and farms using AI service. Fertility consultants had higher pregnancy rates than AI-Ts (39.6% vs. 32.6%, p < 0.05). Toneless uterus and sticky cervix at AI significantly correlated with AI occurring at the wrong time (p < 0.001). Behaviour of the cow at AI did not predict P4 concentration. In conclusion, 7.7% of cows offered for re-AI had high P4 concentration. Training of AI personnel increased their ability to detect and reject these cows.