Patient-specific factors affecting survival following hip fractures-a 14-year follow-up study in Finland.

Unlabelled: The mortality of elderly hip fracture patients is high. Eighty-five percent of all patients were followed until death. The three most protective factors for 1-year survival were ASA class; BMI; and age, and the four most protective factors for 14-year survival were age; BMI; ASA class; and subtrochanteric fracture type.

Managing post-thoracotomy pain: Epidural or systemic analgesia and extended care - A randomized study with an "as usual" control group.

Background and aims Thoracotomies can cause severe pain, which persists in 21-67% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain.

Cycling injuries and alcohol.

Background: Most of the cycling accidents that occur in Finland do not end up in the official traffic accident statistics. Thus, there is minimal information on these accidents and their consequences, particularly in cases in which alcohol was involved. The focus of the present study is on cycling accidents and injuries involving alcohol in particular.

Obesity paradox disappears in coronary artery bypass graft patients during 20-year follow-up.

Aims: Although obesity is a risk factor for coronary heart disease (CHD), it might be associated with a favourable prognosis in patients with CHD. The aim of the study was to evaluate this so called 'obesity paradox' during a follow-up period of 20 years in patients who had undergone coronary artery bypass grafting (CABG).

Methods And Results: The study population consisted of 922 CHD patients who had undergone CABG between 1993 and 1994.

Positive Effects of a Sufficient Pre-fracture Serum Vitamin D Level on the Long-Term Survival of Hip Fracture Patients in Finland: A Minimum 11-Year Follow-Up.

Background: Several studies have shown that the mortality of elderly hip fracture patients is higher than that in the general population, and is higher in male than in female hip fracture patients.

Objective: The objective of this study was to investigate factors affecting overall mortality at a minimum of 11 years following a new hip fracture.

Methods: The sex, age, pre-fracture serum 25-hydroxyvitamin D level, American Society of Anesthesiologists physical status classification (ASA class), 1- to 12-month mortality, and 2- to 11-year mortality of hip fracture patients were collected.

Factors affecting time to death from start of treatment among children succumbing to bacterial meningitis.

Background: Many risks of death in childhood bacterial meningitis are well-identified, but factors influencing survival time have received less attention. Better understanding of this issue could help explain why adjuvant medications have performed unevenly in different trials.

Methods: In a post hoc analysis of prospectively collected data from a large bacterial meningitis treatment trial in Luanda, Angola, we compared time to death after initiation of antimicrobial treatment among 206 children with etiology and other patient characteristics.

Fluctuation in hearing thresholds during recovery from childhood bacterial meningitis.

Background: Hearing loss from childhood bacterial meningitis is believed to develop early and have little tendency for recovery. We performed serial hearing evaluations in a large number of children with bacterial meningitis in Luanda, Angola to clarify if, and how often, the result changed.

Methods: Children with confirmed bacterial meningitis and hearing evaluations on admission, day 7 of treatment and the follow-up visit formed the study group.

Associations of metabolic syndrome and diabetes mellitus with 16-year survival after CABG.

Background: The associations of metabolic syndrome (MetS) or diabetes mellitus (DM) on long-term survival after coronary artery bypass grafting (CABG) have not been extensively evaluated. The aim of the present study was to assess the impact of MetS and DM on the 16-year survival after CABG.

Methods: Diabetic and metabolic status together with relevant cardiovascular data was established in 910 CABG patients operated in 1993-94.

Predictive value of cerebrospinal fluid matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 concentrations in childhood bacterial meningitis.

Background: Increased concentrations of matrix metalloproteinases (MMP) in cerebrospinal fluid are part of the host response in bacterial meningitis (BM). We investigated whether the concentrations of MMP-9 and the tissue inhibitor of metalloproteinase (TIMP)-1 predict the outcome in childhood BM.

Methods: Cerebrospinal fluid MMP-9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) were quantified by an enzyme-linked immunosorbent assay from 264 and 335 patients, respectively; 43 children without BM served as controls.

Glycerol and acetaminophen as adjuvant therapy did not affect the outcome of bacterial meningitis in Malawian children.

We investigated the benefit of 2 candidate adjunctive therapies in bacterial meningitis: glycerol, which has shown promise in earlier studies, and acetaminophen, which is reportedly beneficial in adult septicemia. In a hospital in Blantyre, Malawi, we enrolled 360 children aged ≥ 2 months with proven bacterial meningitis (36% HIV infected) in a double-blind, randomized, placebo-controlled trial of glycerol and acetaminophen in a 2 × 2 factorial design. Of 4 groups, first group received oral glycerol, second received rectal acetaminophen, third received both therapies and the fourth received placebos only.

Development of renal cell carcinoma (RCC) diagnostics and impact on prognosis.

Objective: To evaluate imaging methods and prognoses between small renal cell carcinomas (RCCs) and larger tumours according to the era of diagnostics.

Patients And Methods: In all, 784 consecutive patients diagnosed with RCC between 1964 and 1997 at the Pirkanmaa Hospital District in Finland were included. Patients were divided into two groups: tumours of ≤3.

Influence of body mass index and smoking on the long-term survival of patients with renal cell cancer.

Background: Smoking and obesity are known risk factors for renal cell carcinoma (RCC). We determined the influence of smoking, body mass index (BMI), and symptoms on the survival of patients with RCC.

Patients And Methods: In this retrospective study, the relative overall survival (OS) up to 25 years was calculated among 948 Finnish patients with RCC diagnosed between 1964 and 1997 using a Bayesian univariate analysis and the life-table method.

Hearing impairment and its predictors in childhood bacterial meningitis in Angola.

Hearing was evaluated in 244 ears of 124 children in Angola by auditory brainstem response audiometry 3 months after bacterial meningitis. Of all ears, 81% recovered without impairment. Of all children, 74% recovered without impairment, 5% had unilateral and 11% bilateral impairment.

Prognostic accuracy of five simple scales in childhood bacterial meningitis.

Background: In childhood acute bacterial meningitis, the level of consciousness, measured with the Glasgow coma scale (GCS) or the Blantyre coma scale (BCS), is the most important predictor of outcome. The Herson-Todd scale (HTS) was developed for Haemophilus influenzae meningitis. Our objective was to identify prognostic factors, to form a simple scale, and to compare the predictive accuracy of these scales.

A long-term follow-up of 221 hip fracture patients in southeastern Finland: analysis of survival and prior or subsequent fractures.

Unlabelled: To analyze the type and effect of prior and subsequent fractures in a hip fracture cohort.

Materials And Methods: Hip fracture patients (n=221) were followed for a mean of 8 years and all prior and subsequent fractures were studied. Incidence of the first fracture and subsequent fractures according to sex, age group, and time between the first and the index hip fracture were measured.

Slow initial β-lactam infusion and oral paracetamol to treat childhood bacterial meningitis: a randomised, controlled trial.

Background: New antimicrobials or adjunctive treatments have not substantially reduced mortality from acute childhood bacterial meningitis. Paracetamol seems to have beneficial effects in bacteraemic adults and some experts recommend initial slow β-lactam infusion. We investigated whether these treatments had benefits in children with bacterial meningitis.

Second hip fracture and patients' medication after the first hip fracture: a follow-up of 221 hip fracture patients in Finland.

The national Finnish guidelines for medical treatment of hip fracture patients are: anti-osteoporotic drugs and the daily concomitant use of calcium plus vitamin D supplements. We investigated the incidence, the fracture type and the side of all second hip fractures among 221 consecutive hip fracture patients who were followed up for 5 years. The medication of the patients and the time interval between the first and second hip fracture were analyzed.

Changes in symptoms of renal cell carcinoma over four decades.

Objective: To determine whether there has been a change in typical symptoms of renal cell carcinoma (RCC), by evaluating the symptoms of patients diagnosed during four decades, as although the increasing incidence of a diagnosis of incidental RCC has been widely reported, the change in other symptoms has not.

Patients And Methods: The study included RCC cases diagnosed in the Pirkanmaa Hospital District between 1964 and 1997. The original medical records of 970 patients with 982 RCC tumours were analysed.

Prognostic factors and long-term survival in renal cell cancer patients.

Objective: The long-term survival of renal cell cancer (RCC) patients is not reported in the recent literature. This study evaluated the significance of known clinical prognostic factors and long-term survival in a large centrally treated Finnish RCC population.

Material And Methods: In 948 patients diagnosed between 1964 and 1997 the relative overall survival (OS) was calculated up to 25 years by Bayesian analysis and the life-table method.

Post-fracture prescribed calcium and vitamin D supplements alone or, in females, with concomitant anti-osteoporotic drugs is associated with lower mortality in elderly hip fracture patients: a prospective analysis.

Background: Several studies have shown excess mortality among hip fracture patients compared with the normal population of the same age. Finnish guidelines for medical treatment of hip fracture patients recommend anti-osteoporosis medication and the daily concomitant use of prescribed calcium and vitamin D supplements. However, whether post-fracture use of calcium and vitamin D supplements is associated with survival in such patients has not been evaluated.

Return to work after coronary artery bypass surgery. A 10-year follow-up study.

Objectives: To establish which factors influence patients' return to work and how well they remain at work after coronary artery bypass grafting (CABG).

Design: Five hundred and sixty nine consecutive CABG patients aged less than 65 years were followed for 10 years. Data were collected from patient records and by questionnaires supplemented with information from Finnish national archives.

Undertreatment of osteoporosis following hip fracture in the elderly.

The national Finnish guidelines for medical treatment of hip fracture patients are: osteoporosis medication and the daily concomitant use of vitamin D and calcium supplements. We investigated the post-fracture medical therapy for osteoporosis and the calcium and vitamin D therapy among hip fracture patients in two Finnish hospitals. The pre-fracture osteoporosis medication and use of calcium and vitamin D supplements of the patients were inquired on admission.