COVID-19 cases in spectators returning to Finland from UEFA Euro 2020 matches in Saint Petersburg.

UEFA Euro 2020 tournament was scheduled to take place in 2020, but due to the coronavirus disease 2019 (COVID-19) pandemic was rescheduled to start on 11 June 2021. Approximately 4500 Finnish spectators participated, travelling between Finland and Russia during the period of 16 to 30 June to attend matches played on 16 and 21 June. A total of 419 persons returning from Russia or with a connection to Russia were detected positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Of the 321 sequenced samples 303 turned out to be of the Delta variant. None of these cases was hospitalised. In the following weeks findings of the Delta variant increased rapidly. Thus, EURO 2020 travel-related imported cases likely facilitated this rapid surge of Delta variant, but this impact would likely have been seen with the typical increase in the number of travellers entering Finland later in the summer.

COVID-19 outbreak at a reception centre for asylum seekers in Espoo, Finland.

Background shared accommodation may increase the risk of SARS-CoV-2 transmission. In April 2020, an increasing number of asylum seekers at a reception centre in Espoo, Finland presented with COVID-19 despite earlier implementation of preventive measures. We decided to screen the entire population of the centre for SARS-CoV-2. Methods we offered nasopharyngeal swab collection and SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) analysis to the centre's clients. Symptoms were recorded at the time of diagnostic sample collection using electronic forms and followed up for two weeks through phone interviews and a review of medical records. Findings 260 clients were screened. Of them, 96 (37%) were found positive for SARS-CoV-2 and isolated. The high attack rate prompted the local public health authority to set the other clients in quarantine for 14 days to prevent further spread. Of the positive cases, 61 (64%) reported having had symptoms at the time of the screening or one week prior. Of the 35 initially asymptomatic individuals, 12 developed symptoms during follow-up, while 23 (or 18% of all screened SARS-CoV-2 positive clients) remained asymptomatic. No widespread transmission of COVID-19 was detected after the quarantine was lifted. Interpretation in this large COVID-19 outbreak, voluntary mass screening provided valuable information about its extent and helped guide the public health response. Comprehensive quarantine and isolation measures were likely instrumental in containing the outbreak. Funding Finnish Institution for Health and Welfare, Finnish Immigration Agency, City of Espoo.

Comparison of amniotic fluid matrix metalloproteinase-8 and cathelicidin in the diagnosis of intra-amniotic infection.

OBJECTIVE: To evaluate the association of amniotic fluid (AF) matrix metalloproteinase-8 (MMP-8) and cathelicidin concentrations with microbial invasion of the amniotic cavity (MIAC) in pregnancies with preterm prelabor rupture of the membranes or intact membranes. STUDY DESIGN: Amniocentesis was performed in 54 singleton pregnancies between 22+0 and 34+2 gestational weeks with suspected intra-amniotic infection. AF-MMP-8 was analysed by immunoassay and AF-cathelicidin by commercial ELISA. Standard biochemical methods, molecular microbiology and culture techniques were used. RESULTS: MIAC was present in 18 (33%) women. The cutoff value for the diagnosis of MIAC was 41.5 ng ml-1 for AF-MMP-8, and 11.6 ng ml-1 for AF-cathelicidin. With these cutoff values AF-MMP-8 had a sensitivity of 100%, specificity of 69%, positive predictive value of 62% and negative predictive value of 100% for MIAC. The corresponding values for AF-cathelicidin were 89, 81, 70 and 94%. CONCLUSION: The performance of AF-cathelicidin in the prediction of MIAC is comparable to AF-MMP-8.

Late results of paraoesophageal hiatus hernia repair with fundoplication.

BACKGROUND: Most published reports on results of surgical treatment for paraoesophageal hiatus hernia have been based on patient questionnaires, and seldom included endoscopy or barium meal examinations. METHODS: Eight pure and 14 mixed-type paraoesophageal hernias were evaluated a median of 37 (range 2-241) months after surgical repair. An antireflux procedure was done in 19 cases. Before operation all had endoscopy or barium meal (20 and 19 patients respectively); after operation 19 had endoscopy and 12 also had barium meal examination. Oesophageal 24 h pH monitoring was done in five cases before surgery, and in 11 afterwards. RESULTS: Preoperative symptoms of reflux were reported by 18, and were often accompanied by dysphagia, postprandial vomiting or epigastric pain. Symptoms improved after operation, and 21 of the 22 patients were satisfied with the result. At follow-up examination, a recurrent hernia was found in eight of the 19 patients examined. Four of these hernias were sliding, two were mixed type and two purely paraoesophageal. DISCUSSION: Recurrence of symptoms was associated with persistence of reflux rather than hernia recurrence. Concomitant antireflux procedure is recommended in all operations for mixed-type hiatus hernia, but it should also be considered for purely paraoesophageal hernia if reflux cannot be excluded before operation, or if retro-oesophageal dissection is needed.

Inferior epigastric artery as a conduit for myocardial revascularization.

In 18 patients the inferior epigastric artery (IEA) was used for myocardial revascularization along with the left internal mammary artery and saphenous vein (4.5 grafts/patient). Preoperative duplex scan assessment of IEA correctly predicted its distal diameter. At operation the mean internal diameter was 1.6 (1.5-2.0) mm distally and 2.1 (2.0-2.5) mm proximally. The mean in situ flow after intraluminal injection of papaverine was 115 (36-210) ml/min in IEA and 136 (56-210) ml/min in internal mammary artery. There was no perioperative death or myocardial infarction. Morbidity associated with IEA harvesting was minor: ultrasonography showed diastasis and slower contraction of the rectus muscle at the harvesting site than contralaterally in one case. The preoperative duplex scan was useful for evaluating IEA size. All the patients were clinically improved. The patency rate at selective IEA angiography 3 months post-operatively was 72% (13/18). This poor early patency of IEA in our small series raises doubts concerning the vessel's suitability for myocardial revascularization.

Intravenous leiomyomatosis.

Intravenous leiomyomatosis of the uterus with extension to the right common iliac vein in a 34-year-old woman is reported. The successful treatment consisted of abdominal hysterectomy, bilateral salpingo-oophorectomy, venotomy and extraction of 3 cm long mobile tumour from the right common iliac vein. The presence of cytoplasmic oestrogen and progesterone receptors in the tumours indicates that intravenous leiomyoma is hormone-dependent.