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2.
Acta Psychiatr Scand ; 138(1): 5-14, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29457219

RESUMEN

OBJECTIVE: Daily smoking has been associated with a greater risk of psychosis. However, we are still lacking studies to adjust for baseline psychotic experiences and other substance use. We examined associations between daily smoking and psychosis risk in a 15-year follow-up while accounting for these covariates in a prospective sample (N = 6081) from the Northern Finland Birth Cohort 1986. METHODS: Self-report questionnaires on psychotic experiences (PROD-screen), tobacco smoking and other substance use were completed when the cohort members were 15-16 years old. Tobacco smoking was categorized into three groups (non-smokers, 1-9 cigarettes and ≥10 cigarettes/day). Psychosis diagnoses were obtained from national registers until the age of 30 years. RESULTS: Subjects in heaviest smoking category were at increased risk of subsequent psychosis (unadjusted HR = 3.15; 95% CI 1.94-5.13). When adjusted for baseline psychotic experiences the association persisted (HR = 2.87; 1.76-4.68) and remained significant even after adjustments for multiple known risk factors such as cannabis use, frequent alcohol use, other illicit substance use, parental substance abuse, and psychosis. Furthermore, number of smoked cigarettes increased psychosis risk in a dose-response manner (adjusted OR = 1.05; 1.01-1.08). CONCLUSION: Heavy tobacco smoking in adolescence was associated with a greater risk for psychosis even after adjustment for confounders.


Asunto(s)
Conducta del Adolescente , Fumar Cigarrillos/epidemiología , Trastornos Psicóticos/epidemiología , Adolescente , Adulto , Femenino , Finlandia/epidemiología , Estudios de Seguimiento , Humanos , Masculino
3.
Clin Genet ; 91(1): 100-105, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27311568

RESUMEN

Intellectual disability (ID) is a major health problem in our society. Genetic causes of ID remain unknown because of its vast heterogeneity. Here we report two Finnish families and one Dutch family with affected individuals presenting with mild to moderate ID, neuropsychiatric symptoms and delayed speech development. By utilizing whole exome sequencing (WES), we identified a founder missense variant c.983T>C (p.Leu328Pro) in seven affected individuals from two Finnish consanguineous families and a deletion c.799_1034-429delinsTTATGA (p.Gln267fs) in one affected individual from a consanguineous Dutch family in the C12orf4 gene on chromosome 12. Both the variants co-segregated in the respective families as an autosomal recessive trait. Screening of the p.Leu328Pro variant showed enrichment in the North Eastern sub-isolate of Finland among anonymous local blood donors with a carrier frequency of 1:53, similar to other disease mutations with a founder effect in that region. To date, only one Arab family with a three affected individuals with a frameshift insertion variant in C12orf4 has been reported. In summary, we expand and establish the clinical and mutational spectrum of C12orf4 variants. Our findings implicate C12orf4 as a causative gene for autosomal recessive ID.


Asunto(s)
Predisposición Genética a la Enfermedad/genética , Discapacidad Intelectual/genética , Péptidos y Proteínas de Señalización Intracelular/genética , Mutación , Anciano , Secuencia de Aminoácidos , Secuencia de Bases , Niño , Consanguinidad , Exoma/genética , Salud de la Familia , Femenino , Finlandia , Efecto Fundador , Genes Recesivos , Genotipo , Geografía , Humanos , Masculino , Países Bajos , Linaje , Análisis de Secuencia de ADN/métodos , Homología de Secuencia de Aminoácido
4.
Epidemiol Infect ; 143(3): 578-85, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24901607

RESUMEN

The deer ked (Lipoptena cervi) is a haematophagous ectoparasite of cervids that harbours haemotrophic Bartonella. A prerequisite for the vector competence of the deer ked is the vertical transmission of the pathogen from the mother to its progeny and transstadial transmission from pupa to winged adult. We screened 1154 pupae and 59 pools of winged adult deer keds from different areas in Finland for Bartonella DNA using PCR. Altogether 13 pupa samples and one winged adult deer ked were positive for the presence of Bartonella DNA. The amplified sequences were closely related to either B. schoenbuchensis or B. bovis. The same lineages were identified in eight blood samples collected from free-ranging moose. This is the first demonstration of Bartonella spp. DNA in a winged adult deer ked and, thus, evidence for potential transstadial transmission of Bartonella spp. in the species.


Asunto(s)
Bartonella/aislamiento & purificación , ADN Bacteriano/aislamiento & purificación , Ciervos/parasitología , Dípteros/microbiología , Animales , Bartonella/genética , ADN Bacteriano/genética , Finlandia , Reacción en Cadena de la Polimerasa , Pupa/microbiología
5.
Bone Joint J ; 96-B(12): 1631-6, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25452365

RESUMEN

The role of arthroscopy in the treatment of soft-tissue injuries associated with proximal tibial fractures remains debatable. Our hypothesis was that MRI over-diagnoses clinically relevant associated soft-tissue injuries. This prospective study involved 50 consecutive patients who underwent surgical treatment for a split-depression fracture of the lateral tibial condyle (AO/OTA type B3.1). The mean age of patients was 50 years (23 to 86) and 27 (54%) were female. All patients had MRI and arthroscopy. Arthroscopy identified 12 tears of the lateral meniscus, including eight bucket-handle tears that were sutured and four that were resected, as well as six tears of the medial meniscus, of which five were resected. Lateral meniscal injuries were diagnosed on MRI in four of 12 patients, yielding an overall sensitivity of 33% (95% confidence interval (CI) 11 to 65). Specificity was 76% (95% CI 59 to 88), with nine tears diagnosed among 38 menisci that did not contain a tear. MRI identified medial meniscal injuries in four of six patients, yielding an overall sensitivity of 67% (95% CI 24 to 94). Specificity was 66% (95% CI 50 to 79), with 15 tears diagnosed in 44 menisci that did not contain tears. MRI appears to offer only a marginal benefit as the specificity and sensitivity for diagnosing meniscal injuries are poor in patients with a fracture. There were fewer arthroscopically-confirmed associated lesions than reported previously in MRI studies.


Asunto(s)
Artroscopía , Traumatismos de la Rodilla/diagnóstico , Traumatismos de la Rodilla/cirugía , Imagen por Resonancia Magnética , Fracturas de la Tibia/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Lesiones de Menisco Tibial
6.
Dermatol Ther (Heidelb) ; 4(1): 115-24, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24865468

RESUMEN

INTRODUCTION: Psoriasis results in expenses to patients from many cost sources. Psoriasis treatments may result in considerable time and traveling costs, yet many studies fail to account for these costs. The objective of this study was to evaluate the multidimensional economic burden of psoriasis to patients. METHODS: The study was based on 232 Finnish patients with psoriasis or psoriatic arthritis visiting a tertiary level dermatological clinic during a 1-year study period between October 1, 2009 and September 30, 2010. The data were based on a patient questionnaire, clinical data from the medical records and reimbursement data from the Finnish Social Insurance Institution. Item costs were based on true costs charged from the patients and all time cost estimates were based on the Human Capital Approach method. RESULTS: 199 patients with psoriasis and 33 with psoriatic arthritis were included in the study. Total costs were higher for patients receiving traditional systemic medications or phototherapy than those not receiving such treatment. Travel costs and travel time costs accounted for more than 60% of the costs of phototherapy. Skin care at home was time consuming and thus caused significant burden to patients. The majority of the visit costs arose from hospital visits and only a small proportion were attributed to visiting primary health care providers. CONCLUSION: Visit charges and other patient co-payments were estimated to play a minor role in the total cost of psoriasis incurred by patients, while travel costs and lost time comprised the majority of the costs, which should not be omitted in future studies regarding costs of treatments.

7.
Scand J Surg ; 103(4): 256-62, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24737855

RESUMEN

BACKGROUND AND AIMS: The indications for operative treatment of lateral tibial plateau fractures are still controversial. The objective of this study was to determine whether residual articular surface depression and valgus malalignment of plated lateral tibial plateau fractures at medium-term follow-up affect the clinical and radiographic outcomes. MATERIAL AND METHODS: A chart review of patients with operatively treated (AO type B3.1) tibial plateau fractures that were admitted to our level I trauma center between 2002 and 2008 was performed. Out of 123 patients, 73 were available to participate in a clinical and radiographic follow-up examination. The mean follow-up time was 54 months. Patients were clinically assessed and completed the Lysholm knee score and Western Ontario and McMaster Universities Osteoarthritis Index. Maximal articular surface depression, radiological mechanical axis, and degree of posttraumatic osteoarthritis were evaluated from standing radiographs. RESULTS: Patients with valgus malalignment of 5° or greater at follow-up developed more advanced osteoarthritis (Kellgren-Lawrence grade 3-4) than patients with a normal mechanical axis (p = 0.006). Similarly, patients with articular depression greater than 2 mm at follow-up also developed more advanced osteoarthritis compared to patients with a depression of 2 mm or less (p = 0.001). The degree of valgus malalignment or articular depression had no effect on the Western Ontario and McMaster Universities Osteoarthritis Index or Lysholm scores. CONCLUSIONS: The postoperative articular congruity and normal mechanical axis of the lower leg after plate fixation in lateral tibial plateau fractures seem to have a role in prevention of posttraumatic osteoarthritis but does not appear to predict clinical outcome at medium-term follow-up. The role of initial dislocation and associated cartilage damage in the development of osteoarthritis following these fractures is still unknown.


Asunto(s)
Fijación Interna de Fracturas , Articulación de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/etiología , Fracturas de la Tibia/complicaciones , Adolescente , Adulto , Anciano , Femenino , Finlandia/epidemiología , Estudios de Seguimiento , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/epidemiología , Pronóstico , Radiografía , Rango del Movimiento Articular , Estudios Retrospectivos , Factores de Riesgo , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Factores de Tiempo , Adulto Joven
8.
Med Vet Entomol ; 28(3): 307-13, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24131141

RESUMEN

The deer ked, Lipoptena cervi (Diptera: Hippoboscidae), is a common ectoparasite of the moose, Alces alces (Artiodactyla: Cervidae). Salt licks are widely used to manipulate moose movements to prevent damage to saplings and traffic accidents. They may cause moose to gather in small areas, which could create aggregates of deer ked pupae as the parasite is a short-distance flyer and its dispersion depends on its hosts. We investigated whether the population density of flying deer keds could be influenced by manipulating salt licks and how environmental variables affect parasite density. Densities were estimated in 40 experimental sites with four treatments (no salt licks, introduced salt licks, removed salt licks, permanent salt licks) in September during 2007-2010. Forest edges, mixed forests on mineral soil and coniferous forests on peat soil were the habitats with high numbers of parasites. The manipulation of salt licks seemed to be ineffective in reducing the density of deer keds as the only factor to show statistical significance with parasite numbers in the mixed-model analysis was year of determination. Annual deer ked densities correlated with the abundance of moose in the region. Moreover, high spring and summer temperatures seemed to increase the numbers of flying imagos.


Asunto(s)
Distribución Animal , Ciervos/parasitología , Dípteros/fisiología , Infestaciones Ectoparasitarias/veterinaria , Cloruro de Sodio/farmacología , Animales , Infestaciones Ectoparasitarias/epidemiología , Infestaciones Ectoparasitarias/parasitología , Ambiente , Femenino , Finlandia/epidemiología , Masculino , Densidad de Población
9.
Med Vet Entomol ; 24(4): 411-7, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20868432

RESUMEN

The deer ked, Lipoptena cervi L. (Diptera: Hippoboscidae), is an ectoparasitic fly that spread to Finland in the early 1960s from the southeast across the Soviet border. It is currently a common parasite of the moose, Alces alces (Artiodactyla: Cervidae), in the southern part of the country and its area of distribution is gradually spreading to Finnish Lapland, where it will come into contact with another potential cervid host, the semi-domesticated reindeer, Rangifer tarandus tarandus. The aim of this study was to determine the intensity of deer ked parasitism on the moose in eastern Finland. Whole skins of 23 moose were examined for the presence of deer keds, which were extracted and their total numbers estimated. The intensity of deer ked parasitism was correlated to the age, sex, skin area and anatomical region of the host. Bulls had the highest total number of keds (10616 ± 1375) and the highest deer ked density (35.7 ± 4.4 keds/dm(2) of skin). Cows had a higher total number of keds than calves (3549 ± 587 vs. 1730 ± 191), but ked densities on cows and calves were roughly equal (11.8 ± 1.7 vs. 9.4 ± 1.1 keds/dm(2) of skin). The density of keds was highest on the anterior back, followed by the posterior back, front limbs, abdomen, head and hind limbs. The sex ratio of deer keds was close to equal (male : female, 1.0 : 1.1). After they had consumed blood, male keds were heavier than females. As the total numbers and densities of deer keds were higher than reported previously on moose or for any other louse fly species, the effects of parasitism on the health of the host species should be determined.


Asunto(s)
Ciervos/parasitología , Dípteros/fisiología , Infestaciones Ectoparasitarias/epidemiología , Interacciones Huésped-Parásitos/fisiología , Enfermedades Parasitarias en Animales/epidemiología , Animales , Femenino , Finlandia/epidemiología , Masculino , Densidad de Población , Factores Sexuales , Razón de Masculinidad
10.
J Med Genet ; 47(10): 704-9, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20577006

RESUMEN

BACKGROUND: Mutations in TRPV4, a gene that encodes a Ca(2+) permeable non-selective cation channel, have recently been found in a spectrum of skeletal dysplasias that includes brachyolmia, spondylometaphyseal dysplasia, Kozlowski type (SMDK) and metatropic dysplasia (MD). Only a total of seven missense mutations were detected, however. The full spectrum of TRPV4 mutations and their phenotypes remained unclear. OBJECTIVES AND METHODS: To examine TRPV4 mutation spectrum and phenotype-genotype association, we searched for TRPV4 mutations by PCR-direct sequencing from genomic DNA in 22 MD and 20 SMDK probands. RESULTS: TRPV4 mutations were found in all but one MD subject. In total, 19 different heterozygous mutations were identified in 41 subjects; two were recurrent and 17 were novel. In MD, a recurrent P799L mutation was identified in nine subjects, as well as 10 novel mutations including F471del, the first deletion mutation of TRPV4. In SMDK, a recurrent R594H mutation was identified in 12 subjects and seven novel mutations. An association between the position of mutations and the disease phenotype was also observed. Thus, P799 in exon 15 is a hot codon for MD mutations, as four different amino acid substitutions have been observed at this codon; while R594 in exon 11 is a hotspot for SMDK mutations. CONCLUSION: The TRPV4 mutation spectrum in MD and SMDK, which showed genotype-phenotype correlation and potential functional significance of mutations that are non-randomly distributed over the gene, was presented in this study. The results would help diagnostic laboratories establish efficient screening strategies for genetic diagnosis of the TRPV4 dysplasia family diseases.


Asunto(s)
Mutación , Osteocondrodisplasias/genética , Osteocondrodisplasias/patología , Canales Catiónicos TRPV/genética , Análisis Mutacional de ADN , Enanismo/diagnóstico por imagen , Enanismo/genética , Enanismo/patología , Genotipo , Humanos , Mutación Missense , Osteocondrodisplasias/diagnóstico por imagen , Fenotipo , Reacción en Cadena de la Polimerasa , Radiografía , Análisis de Secuencia de ADN
11.
Clin Genet ; 78(6): 541-7, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20456449

RESUMEN

Cerebro-oculo-facio-skeletal (COFS) syndrome is an autosomal recessive disorder characterized by microcephaly, congenital cataracts, facial dysmorphism, neurogenic arthrogryposis, growth failure and severe psychomotor retardation. We report a large consanguineous pedigree from northern Finland with six individuals belonging into four different sibships and affected with typical COFS syndrome phenotype. Two deceased patients have been published previously in 1982 as the first cases exhibiting cerebral calcifications typical for this disorder. Two living and one of the deceased patients were all shown to possess a novel homozygous mutation in the ERCC6 [Cockayne syndrome B (CSB)] gene, thereby confirming the diagnosis on molecular genetic level even for the earlier published cases. Genealogical investigation showed a common ancestor living in a northeastern village in Finland in the 18th century for all six patients implying a founder effect.


Asunto(s)
Anomalías Múltiples/genética , ADN Helicasas/genética , Enzimas Reparadoras del ADN/genética , Mutación , Secuencia de Bases , Catarata/genética , Preescolar , Síndrome de Cockayne/genética , Consanguinidad , Análisis Mutacional de ADN , Finlandia , Humanos , Masculino , Microcefalia/genética , Datos de Secuencia Molecular , Fenotipo , Proteínas de Unión a Poli-ADP-Ribosa , Síndrome
12.
Clin Genet ; 76(1): 76-84, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19659762

RESUMEN

Mucolipidosis II (ML II) and mucolipidosis III (ML III) are diseases in which the activity of the uridine diphosphate (UDP)-N-acetylglucosamine:lysosomal enzyme N-acetylglucosamine-1-phosphotransferase (GlcNAc-phosphotransferase) is absent or reduced, respectively. In the absence of mannose phosphorylation, trafficking of lysosomal hydrolases to the lysosome is impaired. In these diseases, mistargeted lysosomal hydrolases are secreted into the blood, resulting in lysosomal deficiency of many hydrolases and a storage-disease phenotype. GlcNAc-phosphotransferase is a multimeric transmembrane enzyme composed of three subunits (alpha, beta and gamma) encoded by two genes -GNPTAB and GNPTG. Defects in GNPTAB result in ML II and III whereas mutations in GNPTG were only found in ML III patients. We have performed a molecular analysis of the GNPTAB and GNPTG genes in 13 mucolipidosis II and III patients (10 Portuguese, one Finnish, one Spanish of Arab origin and one Indian). Mutations were identified by the study of both cDNA and gDNA. The GNPTAB and GNPTG mRNA expressions were determined by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). The study led to the identification of 11 different mutations. Eight of these mutations are novel, six in the GNPTAB gene [c.121delG (V41FfsX42), c.440delC (A147AfsX5), c.2249_50insA (N750KfsX8), c.242G>T (W81L), c.1208T>C (I403T) and c.1999G>T (p.E667X)] and two in the GNPTG gene [c.610-1G>T and c.639delT (F213LfsX7)]. With regard to the mRNA expression studies, the values obtained by qRT-PCR indicate the possible existence of feedback regulation mechanisms between alpha/beta and the gamma subunits.


Asunto(s)
Mucolipidosis/enzimología , Mucolipidosis/genética , Mutación/genética , Transferasas (Grupos de Otros Fosfatos Sustitutos)/genética , Niño , Preescolar , Regulación Enzimológica de la Expresión Génica , Genotipo , Humanos , Lactante , Recién Nacido , Fenotipo , Empalme del ARN/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transferasas (Grupos de Otros Fosfatos Sustitutos)/metabolismo
13.
Acta Radiol ; 49(8): 912-7, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18608021

RESUMEN

BACKGROUND: Magnetic resonance (MR) arthrography is an accurate imaging method for internal shoulder derangements and rotator cuff pathologies. Both anterior and posterior contrast injection techniques, under palpatory, fluoroscopic, or ultrasonographic guidance have been described in the literature. However, clinical comparisons of the injection techniques remain few. PURPOSE: To compare the performance of anterior and posterior ultrasonography (US)-guided arthrography injections of the shoulder regarding patient discomfort and influence on diagnostic MR reading, and to illustrate the typical artifacts resulting from contrast leakage in the respective techniques. MATERIAL AND METHODS: 43 MR arthrographies were prospectively randomized into anterior and posterior US-guided contrast injections and performed by two radiologists, with the study of artifacts from contrast leakage. Pain from the injections was assessed by a survey utilizing a 100-mm visual analogue scale (VAS). RESULTS: Of the 23 anterior injections, nine caused contrast artifacts in the subscapular tendon, and in three the leakage extended further anteriorly. Of the 20 posterior injections, 12 showed injection artifacts of the rotator cuff, extending outside the cuff in seven. Two of the anterior and none of the posterior artifacts compromised diagnostic quality. In posterior injections, the leakage regularly occurred at the caudal edge of the infraspinatus muscle and was easily distinguishable from rotator cuff tears. All patients completed the pain survey. Mean VAS scores were 25.0 (median 18, SD 22) for anterior, and 25.4 (median 16, SD 25) for posterior injections. The two radiologists achieved different mean VAS scores but closely agreed as to anterior and posterior VAS scores. CONCLUSION: Arthrography injections were fairly simple to perform under US guidance. Patient discomfort for anterior and posterior injections was equally minor. A tailored approach utilizing anterior or posterior injections, depending on anticipated shoulder pathology, is recommended. Because in posterior injections all artifacts were posterior and readily recognizable, it seems especially suitable for suspected anterior rotator cuff, joint capsule, and labral pathologies.


Asunto(s)
Artrografía/métodos , Medios de Contraste/administración & dosificación , Imagen por Resonancia Magnética/métodos , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/patología , Adolescente , Adulto , Anciano , Artrografía/efectos adversos , Artefactos , Medios de Contraste/efectos adversos , Extravasación de Materiales Terapéuticos y Diagnósticos , Femenino , Humanos , Aumento de la Imagen/métodos , Cápsula Articular/diagnóstico por imagen , Cápsula Articular/patología , Masculino , Persona de Mediana Edad , Dolor/inducido químicamente , Dolor/diagnóstico , Dimensión del Dolor/métodos , Estudios Prospectivos , Manguito de los Rotadores/diagnóstico por imagen , Manguito de los Rotadores/patología , Ultrasonografía
14.
Food Chem Toxicol ; 46(2): 781-6, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18055085

RESUMEN

The yellow tricholoma (Tricholoma flavovirens or Tricholoma equestre) is a wild mushroom species that was previously considered edible and tasty. Recently, it caused several cases of delayed rhabdomyolysis in humans and elevated serum creatine kinase (CK) activities in laboratory mice (Mus musculus) in a dose-response study. The present study continued to examine the effects of prolonged T. flavovirens consumption at 12 g freshly frozen mushroom kg(-1)d(-1) on the plasma clinical chemistry and organ histology of mice. The plasma CK and CK-MB activities and the plasma bilirubin concentrations were higher in the exposed mice than in the controls. In addition, pericardial lymphocyte infiltrates were present in the mice that had consumed the mushroom. The results indicate myo-, cardio- and hepatotoxic effects of T. flavovirens.


Asunto(s)
Cardiopatías/etiología , Hepatopatías/etiología , Intoxicación por Setas/complicaciones , Animales , Peso Corporal , Creatina Quinasa/sangre , Cardiopatías/metabolismo , Cardiopatías/fisiopatología , Hepatopatías/metabolismo , Hepatopatías/patología , Masculino , Ratones , Intoxicación por Setas/metabolismo , Intoxicación por Setas/fisiopatología , Necrosis
15.
Acta Radiol ; 48(1): 104-11, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17325934

RESUMEN

PURPOSE: To evaluate whether non-contrast multidetector computed tomography (MDCT) for suspected acute knee fractures can also be used to evaluate cruciate ligament pathology. MATERIAL AND METHODS: A total of 42 patients (17-65 years) underwent four-section MDCT. The images were independently evaluated at clinical workstations by four radiologists. They assessed the integrity (normal or torn) and the best slice direction (axial, sagittal, or coronal) for visualization of the cruciate ligaments. Magnetic resonance imaging (MRI), performed within 4 weeks (mean 6 days) in relation to MDCT, was considered the gold standard. RESULTS: Ligament integrity at MDCT: the mean interobserver proportion of agreement for a normal anterior cruciate ligament (ACL) was 0.73, for a torn ACL 0.41, for a normal posterior cruciate ligament (PCL) 0.96, and for a torn PCL 0.54. Interobserver variation for ACL was significant (P = 0.0136-0.0260), but insignificant for PCL (P = 0.3389-0.7212). Intra-observer variation was insignificant. Visualization was best in the axial and sagittal direction for ACL and PCL, respectively. At MRI, 29 normal, one partially, and 12 completely torn ACLs, and 37 normal, four partially and one completely torn PCL were found. CONCLUSION: MDCT can detect an intact ACL and PCL with good specificity, accuracy, and negative predictive value. The assessment of torn ligaments is unreliable.


Asunto(s)
Traumatismos de la Rodilla/diagnóstico , Ligamentos Articulares/diagnóstico por imagen , Ligamentos Articulares/patología , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Enfermedad Aguda , Adolescente , Adulto , Anciano , Ligamento Cruzado Anterior/diagnóstico por imagen , Ligamento Cruzado Anterior/patología , Femenino , Finlandia , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/patología , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Ligamento Cruzado Posterior/diagnóstico por imagen , Ligamento Cruzado Posterior/patología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad
16.
Acta Radiol ; 46(6): 587-98, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16334840

RESUMEN

Conventional radiography plays an essential diagnostic role in the primary evaluation of acute joint trauma. In complex fractures, however, computed tomography (CT) is an imaging modality often used second to radiography. As a result of technical breakthroughs in the field, multidetector CT (MDCT) allows faster imaging and better temporal, spatial, and contrast resolution compared with conventional single-slice spiral CT. MDCT with multiplanar reformation is helpful in disclosing fracture patterns, particularly in complex joint fractures, where they reveal occult fractures and show the exact number of fracture components and their degree of displacement.


Asunto(s)
Fracturas Óseas/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Articulaciones/lesiones , Tomografía Computarizada por Rayos X/métodos , Artrografía/métodos , Humanos , Intensificación de Imagen Radiográfica/métodos
17.
Acta Radiol ; 46(8): 866-74, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16392612

RESUMEN

PURPOSE: To evaluate the multidetector computed tomography (MDCT) findings of acute knee trauma and to compare radiography with MDCT in patients referred to a level 1 trauma center. MATERIAL AND METHODS: During a 5-year period, a total of 415 MDCT examinations were performed on 409 patients with acute knee trauma to reveal complex fracture anatomy or rule out a fracture. MDCT and primary radiographs were re-evaluated with respect to fracture location and trauma mechanism. Tibial plateau fractures were further analyzed depending on anatomical location: anterior-medial, anterior-lateral, posterior-lateral, and posterior-medial regions. Maximal depression of the tibial articular surface was measured. Findings on the primary knee radiographs were compared with MDCT findings. RESULTS: Of the 409 patients, 356 (87%) had a knee fracture. A total of 451 fractures were found in all anatomic regions: distal femur (n=49), proximal tibia (n=307), patella (n=23), and proximal fibula (n=72). Primary radiographs were available in 316 (76%) cases. Of these, 225 (71%) had MDCT in order to reveal the fracture anatomy better, and 91 (29%) had a subsequent MDCT after negative plain radiographs. Overall sensitivity of radiography was 83%, while negative predictive value was 49%. On radiography, tibial plateau articular depression was underestimated in all regions except when the fracture consisted of the whole half of the anterior or posterior plateau. The three main injury mechanisms were traffic accident, a simple fall, and sport. In 49 cases (15%), primary radiographs were suboptimal due to positioning. CONCLUSION: In severely injured patients, diagnostically sufficient radiographs are difficult to obtain, and therefore a negative radiograph is not reliable in ruling out a fracture. In these patients, MDCT is a fast and accurate examination and is also recommended in patients with tibial plateau fractures or complex knee injuries in order to evaluate the fracture adequately.


Asunto(s)
Traumatismos de la Rodilla/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fracturas del Fémur/diagnóstico por imagen , Peroné/diagnóstico por imagen , Peroné/lesiones , Fracturas Óseas/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Rótula/diagnóstico por imagen , Rótula/lesiones , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Fracturas de la Tibia/diagnóstico por imagen , Tomógrafos Computarizados por Rayos X
18.
Food Chem Toxicol ; 42(6): 945-51, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15110103

RESUMEN

Phytosterols (PS) are plant-derived compounds with estrogenic activity in vitro and beneficial effects on the serum lipid profile in vivo. In nature, PS exposure can derive from pulp mill effluents. The effects of a pulp-mill derived PS mixture on the reproduction, endocrine variables and enzyme activities of the tundra vole (Microtus oeconomus) were investigated in a two-generation study. The cumulative food intake of PS-treated females was higher than in the control group supporting previous results on the effects of PS on food consumption in rodents. 85% of the PS treated pairs reproduced, but the figure was only 60% for the control pairs. The plasma and testicular testosterone concentrations were lower in the adult PS males, but the PS-treated male offspring had higher testicular testosterone concentrations than their controls. In the female offspring, the liver lipase activity was higher in the PS-treated group, which could be a result of decreased cholesterol absorption in the gut. Chronic PS treatment increased the reproduction probability of the species and had a potential effect on the sex steroid hormones of maturing offspring, which could have applications in environmental monitoring.


Asunto(s)
Arvicolinae/fisiología , Fitosteroles/farmacología , Reproducción/efectos de los fármacos , Testosterona/análisis , Administración Oral , Alimentación Animal , Animales , Colesterol/metabolismo , Femenino , Residuos Industriales , Lipasa/farmacología , Hígado/enzimología , Masculino
19.
J Comp Physiol B ; 174(1): 1-12, 2004 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-14520494

RESUMEN

The raccoon dog (Nyctereutes procyonoides) is a middle-sized canid with profound autumnal fattening followed by winter sleep. This study investigated the effects of prolonged fasting-induced winter sleep on the fat and nitrogen metabolism of the species. Half of the animals were treated with continuous-release melatonin implants to induce artificial short photoperiod. Autumnal accumulation of fat was characterized by low plasma free fatty acid (FFA), diacylglycerol (DG), and triacylglycerol (TG) levels. After transition to winter catabolism, the circulating lipid levels increased due to enhanced lipolysis. Two months of fasting resulted in a steady 3.1 kg weight loss (28% of body mass, 0.47% day(-1)). Storage fat was mobilized during the winter sleep reflected by the elevated FFA and DG concentrations. The lowered insulin levels could be a stimulator for TG hydrolysis. The plasma total amino acid concentrations, urea levels, and urea-creatinine ratios decreased due to fasting, whereas ammonia and total protein concentrations remained stable. The effects of melatonin on energy metabolism were modest. The results indicate that the raccoon dog is well adapted to long-term wintertime fasting utilizing fat as the principal metabolic fuel. The species can maintain its protein catabolism constant for at least 60 days. Decreased cortisol and thyroid hormone concentrations may contribute to protein sparing.


Asunto(s)
Adaptación Fisiológica/efectos de los fármacos , Ayuno/fisiología , Grasas/metabolismo , Melatonina/farmacología , Nitrógeno/metabolismo , Estaciones del Año , Aminoácidos/sangre , Animales , Carnívoros , Creatinina/sangre , Diglicéridos/sangre , Perros , Ácidos Grasos/sangre , Hidrocortisona/sangre , Hormonas Tiroideas/sangre , Factores de Tiempo , Triglicéridos/sangre , Urea/sangre
20.
J Comp Physiol B ; 174(2): 157-62, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-14639485

RESUMEN

The arctic fox (Alopex lagopus) is a medium-sized predator of the high Arctic experiencing extreme seasonal fluctuations in food availability, photoperiod and temperature. In this study, the plasma leptin, ghrelin and growth hormone (GH) concentrations of male arctic foxes were determined during a food deprivation period of 13 days and the subsequent recovery in November and May. Leptin, ghrelin and GH were present in arctic fox plasma in amounts comparable to other carnivores. The plasma leptin concentrations did not react to food deprivation unlike in humans and rodents. However, the leptin levels increased during re-feeding as an indicator of increasing energy reserves. The relatively high ghrelin-leptin ratio, decrease in the plasma ghrelin concentration, an increase in the circulating GH concentrations and the observed negative correlation between plasma ghrelin and free fatty acid levels during fasting suggest that these hormones take part in the weight-regulation and energy metabolism of this species by increasing fat utilisation during food deprivation. The results strengthen the hypothesis that the actions of these weight-regulatory hormones are species-specific and depend on seasonality and the life history of the animals.


Asunto(s)
Zorros/fisiología , Animales , Ingestión de Alimentos/fisiología , Metabolismo Energético , Privación de Alimentos/fisiología , Zorros/sangre , Ghrelina , Hormona del Crecimiento/sangre , Leptina/sangre , Masculino , Noruega , Hormonas Peptídicas/sangre , Estaciones del Año
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