Surgical closure of patent ductus arteriosus in very-low-birth-weight infants.

In many very-low-birth-weight (VLBW) infants the ductus arteriosus fails to close spontaneously, and they subsequently develop signs and symptoms of poor tissue perfusion and heart failure. This study evalutes the results of early surgical closure of patent ductus arteriosus (PDA). We retrospectively reviewed the records of all 101 VLBW infants who weighed 1,500 g or less when their PDA was surgically ligated in Turku University Hospital between 1988 and 1998. The mean gestational age at birth was 27.2 weeks and mean birth weight 963+/-239 g. The operation was performed at 12+/-8 days of age; the infants' weight at operation was 969+/-231 g and they were tracheally extubated 11+/-14 days after the operation. The surgery-related mortality was 3% (3/101) and overall mortality 10% (10/101). We conclude that surgical closure of PDA is safe and effective in VLBW infants.

Edentulousness and its rehabilitation over a 10-year period in a Finnish urban area.

In 1977 78, a baseline study group of 449 Finnish adults aged 30 years and over was examined in an urban area with a very high supply of dental services. The follow-up study in 1988 represents longitudinal data on 297 of these adults. In 1989 a new sample of persons aged 30-39 years was also obtained to provide cross-sectional information comparable to that of the corresponding age group in the 1977-78 survey. At baseline in 1977-78, the prevalence of total tooth loss was 19.4% for adults aged 30 years and over. The corresponding figures for maxillary and mandibular edentulousness alone were 16.7% and 0.4% respectively. Ninety-four percent of totally edentulous and 89.6% of single-arch edentulous subjects were prosthetically rehabilitated. In the follow-up study, 7.7% of the originally dentate women and 6.7% of men had lost the rest of their teeth. For the new totally edentulous subjects the mean number of teeth lost was 5.7 (s 3.45), most of which were incisors. In the follow-up study, 89% of the new edentulous subjects had already been edentulous in the maxilla at baseline. Among 30-39-year-olds the proportions of upper-arch and totally edentulous subjects in 1977-78/1989 were 6.7%/0.8% and 2.2%/0.8% respectively (P=0.024 for the difference between the time points). In the light of the repeated cross-sectional study, we can conclude that edentulism is very uncommon in the 30-39-year age group in this urban area.

Missing teeth and lost teeth of adults aged 30 years and over in south-western Finland.

The majority of Finnish adults have lost one, some or all of their teeth. The prosthetic replacement of missing teeth has thus been an important element of adult dental care. However, there have been no longitudinal studies focusing on the development of oral health among the Finnish adult population in terms of further tooth loss. A baseline sample from 1977-78 was selected from the city of Turku to represent the adult population aged 30 years and over. Ten years later, a follow-up examination was carried out on this baseline study group. A new sample of persons aged 30-39 years was also obtained to provide cross-sectional information, allowing comparisons between this study group and the youngest age-group of the 1977-78 study. In 1977-78, 52 per cent of all subjects had 20 or more remaining teeth. The mean number of missing teeth was 15.8 (SD 11.05) and the corresponding median 12 teeth. The number of missing teeth was on average higher in the older age-groups (P < 0.001). Women had more missing teeth than men (P < 0.01). In the ten-year follow-up study, the mean number of lost teeth was 1.5 (SD 2.32) and the median one tooth. The average number of lost teeth increased with age (P < 0.01). The rate of tooth loss was highest for those with 10 to 19 teeth at baseline, second highest for those with one to nine teeth and lowest for those with 20 to 32 teeth (P < 0.001). The reasons most often reported for tooth extraction were tooth mobility, pain and prosthetic treatment. In the cross-sectional study groups of persons aged 30-39 years, the proportion of subjects with a complete natural dentition of 28 to 32 teeth was 63.4 per cent in 1989, compared with 40.0 per cent ten years earlier. The average number of missing teeth was lower in 1989 than in 1977-78 (mean 4.7, SD 3.81 vs. mean 7.8, SD 6.92; P < 0.001). In both cross-sectional examinations women had a higher mean number of missing teeth than men. However, the difference between the genders was statistically significant only in 1977-78 (P < 0.01). Among the age-group of 30-39 years, there has been a considerable improvement in retention of natural teeth during the ten-year interval. However, among the middle-aged and elderly population reduced dentition was common; in addition, extraction was still used as a dental treatment especially among persons with reduced dentition. This suggests that the need for prosthetic replacement of lost teeth will continue to play a role in adult dental care in Finland for some decades to come.

Miconazole lacquer compared with gel in treatment of denture stomatitis.

An open, randomized, controlled study with two parallel treatment groups was done to evaluate the efficacy and safety of a single application of a miconazole 55 mg/g denture lacquer applied once on the mucosal denture surface, as compared with those of a commercially available miconazole 2% gel applied four times daily for 2 wk, in the treatment of Candida-associated denture stomatitis. The efficacy variables were Candida cultures on the Oricult plates taken from the palatal mucosa and the denture surface, erythema of the palatal mucosa, and smears for leukocyte migration into the palatal epithelium taken on entering the study and on days 3, 7, 14, 21, 28, and 35 after commencement of therapy. On entering the study, all patients had positive cultures of yeast in the samples from the palatal mucosa. Within the first 3 days, all gel patients and 88% of the lacquer patients had fewer than 10 colonies. The gel was statistically significantly more efficient than the lacquer on days 7 and 14. In the samples from the denture surface, all patients had more than 100 yeast colonies at inclusion and, on day 3, approximately 80% in both treatment groups had fewer than 10 colonies. From day 7 onward, the gel was statistically significantly more efficient than the lacquer. The reddening of the palatal mucosa was not statistically significantly different in the treatment groups at any of the examinations, but smears for the determination of leukocyte migration indicated that the gel was statistically significantly more efficient than the lacquer on day 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Burning mouth in a Finnish adult population.

Burning mouth syndrome is an oral pain disorder with a prevalence of 5-18% in patient materials. The aim of this study was to determine the prevalence of Burning mouth syndrome in a representative sample of the general adult population. Altogether 431 subjects (237 females, 194 males) participated in the study. Subjects were questioned about the experience of prolonged burning sensation; the site, severity, pattern, duration and possible associations of the onset of the burning sensation, and a thorough clinical examination was performed. In all, 15% of the subjects had experienced prolonged oral burning but a half of them had some clinically observable oral mucosal lesion or oral candidosis. The prevalence of the complaint was significantly higher in females than in males.

Sports-related injuries in children.

Within a 3-year period, from 1980 to 1982, 1124 sports injuries of children aged 6-15 years were treated in the Turku University Central Hospital casualty department. Two-thirds (69%) of the injuries were sustained by boys. Sports injuries represented 21% of the diagnoses related to accidents in this age group. Half of the sports accidents occurred during the 4 winter months. Boys were injured most commonly in ice hockey (36%) and football (20%) and girls in skating (18%) and riding (18%). One quarter (26%) of the injuries were located in the head and neck, 36% in the upper extremities, 33% in the lower limbs, and 4% in the trunk. The most common types of injuries were fractures (26%), sprains and strains (24%), contusions (22%) and wounds (17%). The proportional occurrence of fractures increased with age in boys (P less than 0.001) and decreased in girls (P less than 0.001), luxations (P less than 0.05) and sprains (P less than 0.001) increased with age in girls; skull injuries (P less than 0.01) and contusions and wounds (P less than 0.001) decreased in boys. Girls had more sprains (P less than 0.001) but fewer contusions and wounds (P less than 0.001). Most of the injuries were mild; 9% of the cases were hospitalized. Minor surgery was performed in 16% and reconstructive surgery in 2% of all injuries. About 70% of the injuries occurred in nonorganized sports.

Dental status of adults with and without periodontitis.

All 30- to 59-year old subjects (N = 757) from a representative sample of adult Finns (total sample = 1,105), showing advanced periodontitis (marginal bone loss more than 30%, n = 125), were compared with their age- and sex-matched pairs showing no marginal bone loss (n = 291) with respect to the number of intact teeth (no caries experience) present. Both male (n = 83) and female (n = 42) subjects with advanced periodontitis had more intact teeth and intact molars than their matched pairs (113 men and 178 women) (P less than or equal to 0.01 for intact teeth and P less than or equal to 0.05 for intact molars in both groups). The total number of teeth present did not differ significantly between the compared groups. Contrary to earlier hypotheses, our results suggest that periodontitis and dental caries do not necessarily share a common etiology.

The origin of 45,X males.

Maleness in association with the karyotype 45,X is a very rare and hitherto unexplained condition previously described in only four or five patients. This study was carried out to determine whether such males might actually possess Y-chromosomal material. Of the two 45,X males studied, one was found to be a low-grade mosaic with a 46,XY karyotype in less than 3% of fibroblasts; all lymphocytes karyotyped were 45,X. Fibroblast DNA from this individual was found to contain Y-specific repeated sequences in 1%-3% the amount observed in the father, consistent with mosaicism for a 46,XY cell line. No Y-specific repeated sequences were detected in the other patient, in whom all mitoses were 45,X. In neither patient were there detectable amounts of any of the single-copy Y-specific DNA sequences for which we tested. Studies of Xg blood groups and of X-linked restriction fragment length polymorphisms indicated that the single X chromosome was of maternal origin in both 45,X male probands. In contrast to the situation in XX males, we can exclude paternal X-Y interchange as the etiology in the cases described here. Our findings are compatible with mosaicism being the explanation of at least some "45,X" males.

Stimulated salivary flow rate, pH and lactobacillus and yeast concentrations in medicated persons.

Flow rate, pH and lactobacillus and yeast counts of paraffin-stimulated whole saliva were analyzed in an adult population of 463 medicated persons. Of the very large number of drugs only a few groups were found to decrease salivation to such an extent that they can be considered to cause dental harm. Persons using neuroleptics, tricyclic antidepressants or antihypertensives were nevertheless found to produce stimulated saliva at rates significantly lower than unmedicated persons. Age had no influence on the flow rate, but postmenopausal age seems to predispose medicated women to a decrease in salivary flow. Higher microbial counts were found in the medicated men.

Stimulated salivary flow rate, pH and lactobacillus and yeast concentrations in persons with different types of dentition.

The flow rate of stimulated whole saliva did not differ significantly in relation to dentition in men and premenopausal women in an unmedicated population. In the postmenopausal women the flow rate was lower in full denture wearers and in those having a highly reduced number of occluding pairs of teeth. Full denture wearers had salivary yeasts and lactobacilli more often and with higher counts than fully dentate persons, a group which in any case showed a difference in the yeast distribution between the sexes.

Stimulated salivary flow rate, pH and lactobacillus and yeast concentrations in non-smokers and smokers.

The effect of smoking habit on flow rate, pH and lactobacillus and yeast counts of paraffin stimulated whole saliva was analyzed in an unmedicated adult population of 462 nonsmokers and 180 smokers. Regular but not immediate smoking was not associated with any significant changes in the salivary flow rate. The pH of stimulated whole saliva was in both sexes lower in smokers than in non-smokers, the differences between the groups being statistically significant. Smoking did not affect salivary yeast counts, but smokers did show increased proportions of high lactobacillus counts.