Browsing by Subject " etiology"

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  • Vehviläinen, Mari (Helsingfors universitet, 2010)
    Avopurenta on yksi vaikeimmin hoidettavista purentavirheistä johtuen suuresta palautumisriskistä. Sen etiologia on monitekijäinen ja hoitovaihtoehtoja on useita. Avopurennan etiologiasta ja hoitomenetelmistä on lukuisia artikkeleita, mutta katsottiin tärkeäksi kerätä yhteen artikkeleissa oleva tieto kirjallisuuskatsauksen muotoon. Tutkimuksessa pyrittiin selvittämään, mitkä tekijät aiheuttavat avopurentaa ja millä mekanismilla, sekä käsittelemään avopurennan hoidossa käytettäviä ortodonttisia kojeita ja hoidolla saatuja tuloksia. Avopurennan hoidon onnistumisesta on useita raportoituja tutkimuksia, mutta kuitenkaan ei voida määritellä, mikä hoitomenetelmistä olisi paras. Valintaa hankaloittaa se, että tutkimuksia hoidon pitkäaikaistuloksista on melko vähän ja toisaalta tutkimuksissa saatetaan käyttää eri menetelmiä vertikaalisen ylipurennan mittaamiseen, joten tutkimustulokset eivät aina ole vertailukelpoisia.
  • Brucoli, Matteo; Boffano, Paolo; Romeo, Irene; Corio, Chiara; Benech, Arnaldo; Ruslin, Muhammad; Forouzanfar, Tymour; Jensen, Thomas Starch-; Rodríguez-Santamarta, Tanía; de Vicente, Juan Carlos; Snäll, Johanna; Thorén, Hanna; Aničić, Boban; Konstantinovic, Vitomir S.; Pechalova, Petia; Pavlov, Nikolai; Daskalov, Hristo; Doykova, Iva; Kelemith, Kadri; Tamme, Tiia; Kopchak, Andrey; Shumynskyi, Ievgen; Corre, Pierre; Bertin, Helios; Goguet, Quentin; Anquetil, Marine; Louvrier, Aurélien; Meyer, Christophe; Dovšak, Tadej; Vozlič, David; Birk, Anže; Tarle, Marko; Dediol, Emil (2020)
    ABSTRACT Introduction: The progressive aging of European population seems to determine a change in the epidemiology, incidence and etiology of maxillofacial fractures with an increase in the frequency of old patients sustaining craniofacial trauma. The objective of the present study was to assess the demographic variables, causes, and patterns of facial fractures in elderly population (with 70 years or more). Materials and Methods: The data from all geriatric patients (70 years or more) with facial fractures between January 1, 2013, and December 31, 2017, were collected. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, etiology, site of facial fractures, synchronous body injuries, Facial Injury Severity Score (FISS). Results: A total of 1334 patients (599 male and 735 female patients) were included in the study. Mean age was 79.3 years, and 66% of patients reported one or more comorbidities. The most frequent cause of injury was fall and zygomatic fractures were the most frequently observed injuries. Falls were associated with a low FISS value (p<.005). Concomitant injuries were observed in 27.3% of patients. Falls were associated with the absence of concomitant injuries. The ninth decade (p <.05) and a high FISS score (p <.005) were associated with concomitant body injuries too. Conclusions: This study confirms the role of falls in the epidemiology of facial trauma in the elderly, but also highlights the frequency of involvement of females, and the high frequency of zygomatic fractures.
  • Ibounig, Thomas; Simons, T. A. (2016)
    Background and Aims: Quadriceps and patella tendon ruptures are uncommon injuries often resulting from minor trauma typically consisting of an eccentric contraction of the quadriceps muscle. Since rupture of a healthy tendon is very rare, such injuries usually represent the end stage of a long process of chronic tendon degeneration and overuse. This review aims to give an overview of the current understanding of the pathophysiology, diagnostic principles, and recommended treatment protocols as supported by the literature and institutional experience. Material and Methods: A non-systematic review of the current literature on the subject was conducted and reflected against the current practice in our level 1 trauma center. Results and Conclusion: Risk factors for patella and quadriceps tendon rupture include increasing age, repetitive micro-trauma, genetic predisposition, and systemic diseases, as well as certain medications. Diagnosis is based on history and clinical findings, but can be complemented by ultrasound or magnetic resonance imaging. Accurate diagnosis at an early stage is of utmost importance since delay in surgical repair of over 3weeks results in significantly poorer outcomes. Operative treatment of acute ruptures yields good clinical results with low complication rates. Use of longitudinal transpatellar drill holes is the operative method of choice in the majority of acute cases. In chronic ruptures, tendon augmentation with auto- or allograft should be considered. Postoperative treatment protocols in the literature range from early mobilization with full weight bearing to cast immobilization for up to 12weeks. Respecting the biology of tendon healing, we advocate the use of a removable knee splint or orthotic with protected full weight bearing and limited passive mobilization for 6weeks.
  • Pousi, Pipsa (Helsingin yliopisto, 2020)
    Avopurennassa vastakkaisten hammaskaarten hampaat eivät ole kontaktissa toisiinsa yhteen purtaessa vaan niiden väliin jää vertikaalinen aukko. Etualueen avopurennan esiintyvyys suomalaisessa aikuisväestössä on 1-2%, maitohampaistossa kuitenkin jopa 6-7%. Tämän kirjallisuuskatsauksen tavoitteena on esittää olemassa olevan tiedon ja tutkimusnäytön perusteella, mitkä ovat etualueen avopurennan hoitomuodot sen etiologia huomioiden, sekä arvioida hoidon pysyvyyttä. Tutkimusaineistona käytettiin tutkielman aiheesta laadittuja tieteellisiä julkaisuja. Julkaisujen hakemiseen käytettiin Medline-tietokannan Pubmed-käyttöliittymää. Etualueen avopurenta voidaan luokitella hampaistolliseksi ja luustolliseksi purentavirheeksi. Hampaistollinen avopurenta kehittyy varhaislapsuudessa aiheutuen tyypillisesti pitkittyneestä tutin tai peukalon imemisestä, suuhengityksestä tai kielen ja huulten virheellisistä funktioista. Tutista tulisi luopua 2-3 vuoden iässä. Avopurennan varhaishoidossa käytettäviä oikomiskojeita ovat mm. quad-helix, kiinteä kielieste, sekä myofunktionaaliset kojeet. Myös suurten risakudosten poisto on indikoitu. Haitalliset tavat yhdistettynä perinnöllisiin tekijöihin aiheuttavat usein luustollista etualueen avopurentaa. Myös leukanivelen kasvuhäiriöt ja sairaudet, kuten reuma, voivat olla avopurennan taustalla. Luustollisen avopurennan erityispiirteet ovat suuri goniaalikulma ja etukasvokorkeus, pieni takakasvokorkeus ja taaksepäin kallistunut kondyyli. Luustollisen avopurennan hoitoperiaatteita ovat molaarien puhkeamisen esto ekstraoraalivedolla tai luustoankkuroidulla palatinaalikaarella. Molaareita voidaan myös aktiivisesti intrudoida luustoankkureiden avulla tai posteriorisilla purentaesteillä. Alaleuan kasvusuuntaan pyritään vaikuttamaan vertikaalisella leukakapalla. Avopurennan palautumisluvut ovat suuria. Useiden tutkimusten mukaan hoitotuloksen pysyvyys on parhaimmillaan silloin, kun hoito on aloitettu varhain, ennen avopurennan kehittymistä luustolliseksi. Lukuisilla eri hoitomenetelmillä on saatu hyviäkin tuloksia avopurennan hoidossa, mutta pitkäaikaistutkimuksia on vähän. Tarvitaan pidempiä seurantajaksoja, jotta voidaan arvioida hoitotuloksien palautuvuutta tarkemmin. Jokaiselle potilaalle tulee tehdä yksilöllinen hoitosuunnitelma, jossa huomioidaan avopurennan etiologiset syyt. (228 sanaa)
  • Pelkonen, Tuula; dos Santos, Mauro Dias; Roine, Irmeli; dos Anjos, Elisabete; Freitas, Cesar; Peltola, Heikki; Laakso, Sanna; Kirveskari, Juha (2018)
    Background: Globally, diarrhea kills almost 1500 children daily. In diagnostics, molecular methods are replacing traditional assays. We aimed to investigate enteropathogens in children with and without diarrhea in Luanda, the capital of Angola. Methods: One hundred and ninety-four stool samples from 98 children with acute diarrhea and 96 children without diarrhea were investigated for 17 enteropathogens with multiplex real-time polymerase chain reaction. Results: The median age of children was 10.5 months. Enteropathogens, bacteria, viruses and parasites were detected in 91%, 78%, 50% and 25%, respectively. A positive finding was significantly (P = 0.003) more common in diarrhea when testing for all pathogens combined, for bacteria alone and for viruses alone. More than one pathogen was found more frequently in diarrhea than in non-diarrhea stool samples, in 87% and in 59% (P <0.0001), respectively. The median number (interquartile range) of pathogens detected was 3 (2) versus 1.5 (2; P <0.0001), respectively. When age was taken into account, diarrhea was found to be associated with enterotoxigenic and enteroaggregative Escherichia coli, Shigella, Campylobacter, rotavirus, sapovirus and Cryptosporidium. Conclusions: Multiplex polymerase chain reaction detected enteropathogens in almost all stool samples of children in Luanda, albeit this occurred more often in diarrhea. Children with diarrhea showed more mixed infections than children without diarrhea.
  • Carpen, Timo; Sjöblom, Anni; Lundberg, Marie; Haglund, Caj; Markkola, Antti; Syrjänen, Stina; Tarkkanen, Jussi; Mäkitie, Antti; Hagström, Jaana; Mattila, Petri (2018)
    Objectives: Oropharyngeal squamous cell carcinoma (OPSCC) is divided in two different disease entities depending on HPV involvement. We investigated differences in presenting symptoms and clinical findings in patients with HPV-positive and -negative OPSCC tumors. Methods: Altogether 118 consecutive patients diagnosed with primary OPSCC between 2012 and 2014 at the Helsinki University Hospital were included. HPV-status of the tumors was assessed by PCR detection of HPV DNA and immunostaining with p16-INK4a antibody. Results: Fifty-one (47.7%) of the patients had HPV-positive and 56 (52.3%) HPV-negative tumors. Forty-nine (49/51, 96.1%) of the HPV+ tumors were also p16+ showing high concordance. The most common presenting symptom among HPV+/p16+ patients was a neck mass (53.1%), whereas any sort of pain in the head and neck area was more frequently related to the HPV-/p16- (60.0%) group. HPV+/p16+ tumors had a tendency to locate in the tonsillar complex and more likely had already spread into regional lymph nodes compared with HPV-/p16- tumors. Smoking and heavy alcohol consumption were significantly more common among HPV-/p16- patients but also rather common among HPV+/p16+ patients. Conclusions: This analysis of symptoms and signs confirm that OPSCC can be dichotomized in two distinct disease entities as defined by HPV status.