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Acute appendicitis in patients over the age of 65 years; comparison of clinical and computer based decision making.

https://arctichealth.org/en/permalink/ahliterature217866
Source
Int J Biomed Comput. 1994 Jul;36(3):239-49
Publication Type
Article
Date
Jul-1994
Author
M. Eskelinen
J. Ikonen
P. Lipponen
Author Affiliation
Department of Surgery, University Hospital, Kuopio, Finland.
Source
Int J Biomed Comput. 1994 Jul;36(3):239-49
Date
Jul-1994
Language
English
Publication Type
Article
Keywords
Abdominal Pain - diagnosis
Acute Disease
Adult
Aged
Aging
Appendicitis - diagnosis
Decision Making
Diagnosis, Computer-Assisted
Female
Finland
Follow-Up Studies
Forecasting
Humans
Leukocyte Count
Male
Medical History Taking
Multivariate Analysis
Pain
Palpation
Prospective Studies
Rectum
Sensitivity and specificity
Abstract
The role of clinical and computer based decision in the diagnosis of acute appendicitis in the elderly was studied in connection with the Research Committee of the World Organization of Gastroenterology (OMGE) survey of acute abdominal pain. A total of 220 patients over the age of 65 years presenting with acute abdominal pain were included in the study at the Central Hospital of Savonlinna and at the University Hospital of Tampere. Twenty-two preoperative clinical history variables, 14 clinical signs and three tests were evaluated in a single variable and multivariate analysis to find the best combination of predictors of acute appendicitis in the aged. In order to sum up the contributions of independent diagnostic factors, a diagnostic score (DS) was built: DS = 2.81 x (rectal digital tenderness; 1 = yes, 0 = no) + 2.54 x (rigidity; 1 = yes, 0 = no) + 2.06 x (renal tenderness; 1 = no, 0 = yes) + 2.33 x (bowel sounds; 1 = normal, 2 = absent/abnormal) - 8.13. The sensitivity of preoperative clinical decision in detecting acute appendicitis in the aged was 0.79 with a specificity of 0.92, an efficiency of 0.90 and usefulness index (UI) of 0.56. At a cut-off level of -2.78 the DS reached a sensitivity of 0.84 in detecting acute appendicitis with a specificity of 0.87, an efficiency of 0.87 and UI of 0.68. When the patients with a DS value between -2.78 and -0.45 were considered as non-defined (n = 28, follow-up required before the decision to operate), the sensitivity of the computer-aided diagnosis in detecting acute appendicitis in the elderly was 0.77 with a specificity of 0.97, an efficiency of 0.96 and UI of 0.57. In the elderly patients where a leucocyte count was available (n = 157), location of pain, rectal digital tenderness and leucocyte count predicted significantly acute appendicitis. At a cut-off level of -2.62 the DS reached a sensitivity of 0.81 in detecting acute appendicitis with a specificity of 0.92, an efficiency of 0.91 and UI of 0.59. When the patients with a DS value between -2.62 and 0.06 were considered as nondefined (n = 12, follow-up required before the decision to operate), the sensitivity of the computer-aided diagnosis (leucocyte count available) in detecting acute appendicitis in the elderly improved to 0.86 with a specificity of 0.94, an efficiency of 0.93 and UI of 0.69. In our study the diagnostic scoring system for the elderly performed well considering the simple nature of its structure.(ABSTRACT TRUNCATED AT 400 WORDS)
PubMed ID
7960209 View in PubMed
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Acute impact of submaximal resistance exercise on immunological and hormonal parameters in young men.

https://arctichealth.org/en/permalink/ahliterature9539
Source
J Sports Sci. 2003 Dec;21(12):1001-8
Publication Type
Article
Date
Dec-2003
Author
Alfons Ramel
Karl-Heinz Wagner
Ibrahim Elmadfa
Author Affiliation
Unit for Nutrition Research, University of Iceland, PO Box Nyi Gardur, IS-101 Reykjavik, Iceland. ramel@hi.is
Source
J Sports Sci. 2003 Dec;21(12):1001-8
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adult
CD4-CD8 Ratio
Comparative Study
Hematocrit
Humans
Hydrocortisone - blood
Killer Cells, Natural - physiology
Leukocyte Count
Lymphocyte Count
Male
Monocytes - physiology
Neutrophils - physiology
Norepinephrine - blood
Physical Education and Training - methods
Reference Values
T-Lymphocytes, Helper-Inducer - physiology
T-Lymphocytes, Regulatory - physiology
Time Factors
Abstract
In this study, we examined the acute effects of submaximal resistance exercise on immunological and hormonal parameters in 7 resistance-trained and 10 non-resistance-trained males. The participants, who were aged 29.5 +/- 7.1 years (mean +/- s), performed submaximal resistance exercise at 75% of their one-repetition maximum. Blood samples were taken before, during, immediately after, and 30, 60 and 120 min after exercise and analysed for leukocyte subpopulations and stress hormones. Total leukocytes, neutrophils and monocytes increased during exercise, reaching their maximum 2 h after exercise. Lymphocytes increased during exercise, T-helper cells returned to resting values after exercise, and natural killer cells and T-suppressor cells decreased below resting values. The CD4/CD8 ratio decreased during exercise but increased during recovery. The resistance-trained participants tended to have lower T-helper cell counts before, during and immediately after exercise and a lower CD4/CD8 ratio during recovery than the non-resistance-trained participants. Plasma cortisol correlated positively with leukocytes during exercise (r = 0.572, P
PubMed ID
14748457 View in PubMed
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Acute laryngotracheitis in the rat induced by Sendai virus: the influx of six different types of immunocompetent cells into the laryngeal mucosa differs strongly between the subglottic and the glottic compartment.

https://arctichealth.org/en/permalink/ahliterature31970
Source
Laryngoscope. 2001 Sep;111(9):1645-51
Publication Type
Article
Date
Sep-2001
Author
P. Jecker
A. McWilliam
A. Marsh
P G Holt
W J Mann
R. Pabst
J. Westermann
Author Affiliation
Department of Otolaryngology, Mainz Medical School, Mainz, Germany.
Source
Laryngoscope. 2001 Sep;111(9):1645-51
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Animals
B-Lymphocytes - immunology
Dendritic Cells - cytology - immunology
Disease Models, Animal
Gene Expression Regulation, Viral - immunology
Genes, MHC Class II - immunology
Glottis - cytology - immunology
Immunity, Cellular - immunology
Immunity, Mucosal - immunology
Immunocompetence - immunology
Immunohistochemistry
Killer Cells, Natural - immunology
Laryngeal Mucosa - cytology - immunology
Laryngitis - immunology - virology
Leukocyte Count
Macrophages - immunology
Neutrophils - immunology
Rats
Respirovirus
Respirovirus Infections - complications
T-Lymphocytes - immunology
Tracheitis - immunology - virology
Abstract
OBJECTIVES: Acute laryngotracheitis is a disease in which mainly the subglottic area is infected, whereas adjacent parts of the larynx, especially the narrow glottic fold, remain unaffected. The reason for the difference between these two directly adjacent regions is unknown. Therefore, in the present study the influx of dendritic cells, neutrophils, T and B lymphocytes, natural killer cells, and macrophages into the mucosa of different laryngeal compartments was investigated after Sendai virus infection in the rat. The aims were to study both the influx of immunocompetent cells and the adhesion of the pathogen and to correlate them to the different reactions of the laryngeal areas during pseudocroup. METHODS: Acute laryngotracheitis was induced by intranasal application of Sendai virus in brown Norway rats. This virus is exclusively pneumotropic in rodents and belongs to the parainfluenza virus type 1, the main pathogen of acute laryngotracheitis in children. The numbers of dendritic cells, neutrophils, T and B lymphocytes, natural killer cells, and macrophages were determined in the supraglottic, glottic, subglottic, and tracheal mucosa on days 2, 5, 7, and 14 after virus application. Furthermore, the nucleoprotein of the virus and major histocompatibility complex (MHC) Class II expression were detected immunohistologically on the laryngeal epithelium. RESULTS: All cell subsets entered the laryngeal mucosa during inflammation. The highest influx was detected among dendritic cells subglottically. This was accompanied by a strong virus adhesion and MHC Class II expression on the subglottic epithelium. In contrast, only a few immunocompetent cells entered the adjacent glottic mucosa, and on the glottic epithelium staining for virus nucleoprotein and MHC Class II expression was weak. CONCLUSIONS: The inflammatory response of the laryngeal mucosa shows great regional differences in this animal model during experimental viral infection. The response was characterized by a strong subglottic and a weak glottic reaction. A possible reason for this difference might be region-specific viral adhesion on the epithelium of the laryngeal areas, as well as differences in MHC Class II expression. Thus, these data agree with the clinical observation during acute laryngotracheitis and may explain why the subglottic part of the larynx is affected preferentially during pseudocroup. The molecular mechanisms mediating the different reactions await clarification.
PubMed ID
11568621 View in PubMed
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Acute lymphoblastic leukemia in adolescents and young adults in Finland.

https://arctichealth.org/en/permalink/ahliterature92984
Source
Haematologica. 2008 Aug;93(8):1161-8
Publication Type
Article
Date
Aug-2008
Author
Usvasalo Anu
Räty Riikka
Knuutila Sakari
Vettenranta Kim
Harila-Saari Arja
Jantunen Esa
Kauppila Marjut
Koistinen Pirjo
Parto Katriina
Riikonen Pekka
Salmi Toivo T
Silvennoinen Raija
Elonen Erkki
Saarinen-Pihkala Ulla M
Author Affiliation
Hospital for Children and Adolescents, University of Helsinki, P.O. Box 281, 00029 HUS, Helsinki, Finland. anu.usvasalo@helsinki.fi
Source
Haematologica. 2008 Aug;93(8):1161-8
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antineoplastic Agents - therapeutic use
Blast Crisis
Child
Disease-Free Survival
Female
Finland
Humans
Leukemia-Lymphoma, Adult T-Cell - drug therapy - genetics - mortality - pathology
Leukocyte Count
Male
Phenotype
Philadelphia Chromosome
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy - genetics - mortality - pathology
Survival Analysis
Abstract
BACKGROUND: Interest has recently been paid to adolescents and young adults with acute lymphoblastic leukemia, particularly because all reports so far published indicate that these patients have a better outcome when treated with pediatric rather than adult therapeutic protocols. There are different biological subtypes of acute lymphoblastic leukemia with distinct features and prognoses; the distribution of these subtypes is not well known among adolescents. We, therefore, studied acute lymphoblastic leukemia in adolescents and young adults aged 10 to 25 years in Finland. DESIGN AND METHODS: This population-based study included 225 consecutive patients aged 10-25 years diagnosed with acute lymphoblastic leukemia during 1990-2004. One hundred and twenty-eight patients (10-16 years) were treated with pediatric Nordic (NOPHO) protocols, and 97 patients (17-25 years) with Finnish Leukemia Group National protocols. We characterized the biological subtypes, clinical features and outcome of these patients. RESULTS: For the whole cohort, the remission rate was 96%, 5-year event-free survival 62% and overall survival 72%.The 5-year event-free survival was 67% for the pediatric treatment group and 60% for the adult treatment group (p=n.s.). Patients with inferior outcome were those with a white blood cell count >or= 100 x 10(9)/L, the Philadelphia chromosome and MLL. Good prognostic features were TEL-AML1, hyperdiploidy, and pediatric intermediate risk stratification. CONCLUSIONS: Unlike all previous studies, we found that the outcome of adolescents and young adults with acute lymphoblastic leukemia treated with pediatric or adult therapeutic protocols was comparable. The success of the adult acute lymphoblastic leukemia therapy emphasizes the benefit of central referral of patients to academic centers and adherence to research protocols.
Notes
Comment In: Haematologica. 2008 Aug;93(8):1124-818669975
PubMed ID
18556413 View in PubMed
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Acute mastoiditis in children aged 0-16 years--a national study of 678 cases in Sweden comparing different age groups.

https://arctichealth.org/en/permalink/ahliterature122281
Source
Int J Pediatr Otorhinolaryngol. 2012 Oct;76(10):1494-500
Publication Type
Article
Date
Oct-2012
Author
Anita Groth
Frida Enoksson
Malou Hultcrantz
Joacim Stalfors
Karin Stenfeldt
Ann Hermansson
Author Affiliation
Strama Skåne, Grynmalaregatan 1, Lund, Sweden. groth.medical@telia.com
Source
Int J Pediatr Otorhinolaryngol. 2012 Oct;76(10):1494-500
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Age Distribution
Anti-Bacterial Agents - therapeutic use
C-Reactive Protein - analysis
Child
Child, Preschool
Ear, Middle - microbiology
Edema - epidemiology
Fever - epidemiology
Hospitalization
Humans
Incidence
Infant
Infant, Newborn
Length of Stay - statistics & numerical data
Leukocyte Count
Mastoid - surgery
Mastoiditis - complications - epidemiology - therapy
Middle Ear Ventilation - statistics & numerical data
Otitis Media - epidemiology
Pain - epidemiology
Severity of Illness Index
Sweden - epidemiology
Abstract
To compare the characteristics of acute mastoiditis in children in different age groups in order to identify risk groups and risk factors for acute mastoiditis.
Records for all children aged 0-16 years treated for acute mastoiditis during 1993-2007 at 33 Ear, Nose and Throat departments in Sweden were reviewed retrospectively according to defined criteria for acute mastoiditis.
A total of 678 cases fulfilled the inclusion criteria. Acute mastoiditis was most common in children younger than two years of age and this group was characterized by less prior history of other diseases and ear diseases, fewer visits to health care centers and less antibiotic treatment before admission, shorter duration of symptoms before admission, hospitalization for fewer days and lower frequency of complications and mastoidectomies. These children also showed a higher incidence of clinical findings, increased inflammatory markers such as fever and heightened counts of C-reactive protein and white blood cells compared with older children. They also tested positive for significantly more samples of Streptococcus pneumoniae while the older children more often exhibited growth of Streptococcus pyogenes or Pseudomonas aeruginosa or no microbial growth.
The characteristics of pediatric acute mastoiditis differed significantly between age groups. Acute mastoiditis was most common in children younger than two years of age. They showed more rapid progress of symptoms and more distinct signs of acute mastoiditis. This is probably the reason why parents rapidly seek medical care for small children and hospital treatment thus starts earlier in the youngest children, which may in turn explain the excellent outcome. This study showed that younger children have neither more severe acute mastoiditis nor more complications than older ones. The differences between age groups suggest that there are distinctions in the pathophysiology behind the onset and course of acute mastoiditis in younger and older children.
PubMed ID
22832239 View in PubMed
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Adoptive transfer of allergen-specific CD4+ T cells induces airway inflammation and hyperresponsiveness in brown-Norway rats.

https://arctichealth.org/en/permalink/ahliterature57604
Source
Immunology. 1997 Jun;91(2):176-85
Publication Type
Article
Date
Jun-1997
Author
A. Haczku
P. Macary
T J Huang
H. Tsukagoshi
P J Barnes
A B Kay
D M Kemeny
K F Chung
R. Moqbel
Author Affiliation
Department of Allergy and Clinical Immunology, Guy's Hospital, London, UK.
Source
Immunology. 1997 Jun;91(2):176-85
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Adoptive Transfer
Animals
Bronchial Hyperreactivity - immunology
Bronchoalveolar Lavage Fluid - immunology
CD4-Positive T-Lymphocytes - immunology - transplantation
CD8-Positive T-Lymphocytes - immunology - transplantation
Cell Culture Techniques
Cell Division - immunology
Eosinophils - immunology
Leukocyte Count
Lymphocyte Transfusion
Male
Rats
Rats, Inbred BN
Research Support, Non-U.S. Gov't
Spleen - immunology
Abstract
Following allergen exposure, sensitized Brown-Norway rats develop airway hyperresponsiveness (AHR) and eosinophilic inflammation together with an increase in activated T cells (CD25+) in the airways. We tested the hypothesis that CD4+ T cells are involved directly in the acquisition of AHR. Spleen T cells from animals that were injected intraperitoneally on three consecutive days with ovalbumin/Al(OH)3, showed a dose-dependent proliferative response in vitro to ovalbumin, but not to bovine serum albumin, as measured by [3H]thymidine uptake. For total T-cell transfer, spleen cells obtained from donor rats 4 days after sensitization were depleted of adherent cells by a nylon wool column separation. CD4+ and CD8+ T cells were purified by immunomagnetic beads cell separation. Recipient naive rats were injected intravenously with 50 x 10(6) total T cells, 20 x 10(6) and 5 x 10(6) CD4+ cells, and 5 x 10(6) CD8+ cells, and were exposed to ovalbumin aerosol 24 hr afterwards. After a further 24 hr, airway responsiveness to acetylcholine (ACh) was measured and provocative concentration (PC) values PC100, PC200 and PC300) (the ACh concentration needed to achieve 100, 200 and 300% increase in lung resistance above baseline) were calculated. Airway responsiveness was significantly increased in recipients of sensitized total T cells compared with recipients of cells from saline-injected donor rats (P
PubMed ID
9227314 View in PubMed
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[Age distribution of urinary tract infections (UTIs) and their severity grade in children (author's transl)].

https://arctichealth.org/en/permalink/ahliterature243373
Source
Monatsschr Kinderheilkd. 1982 Mar;130(3):139-42
Publication Type
Article
Date
Mar-1982
Author
J. Elo
L G Tallgren
S. Sarna
Source
Monatsschr Kinderheilkd. 1982 Mar;130(3):139-42
Date
Mar-1982
Language
German
Publication Type
Article
Keywords
Age Factors
Blood Sedimentation
Child
Child, Preschool
Female
Finland
Humans
Leukocyte Count
Male
Sex Factors
Urinary Tract Infections - blood - epidemiology - radiography
Urography
Abstract
Urinary tract infections in 339 children (77 boys and 262 girls) have been followed up. An excretory urography and a urethrocystography were done for all the children. The frequency of functional and anatomical abnormalities is given. The severity grade of UTI was determined according to the classification of Elo and Stenström. Almost all episodes of UTI among boys occurred during the first three years of life and were mostly severe. After the 3rd year of life the occurrence of UTI among the boys was sporadic. Among the girls the severe episodes dominates during the first three years of life, but after that the episodes tended to become milder in character becoming mostly asymptomatic. The peak of asymptomatic episodes among girls was at 10 years of age. After that age the number of episodes dropped abruptly. The classification used, based on the erythrocyte sedimentation rate (ESR) and on white blood cell count (WBC), has shown to be useful and makes it possible to differentiate between renal (pyelonephritic) episodes and the lower tract episodes.
PubMed ID
7087971 View in PubMed
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Age-related changes in immune parameters in a very old population of Swedish people: a longitudinal study.

https://arctichealth.org/en/permalink/ahliterature217452
Source
Exp Gerontol. 1994 Sep-Oct;29(5):531-41
Publication Type
Article
Author
A. Wikby
B. Johansson
F. Ferguson
J. Olsson
Author Affiliation
Department of Natural Science and Biomedicine, University College of Health Sciences, Jönköping, Sweden.
Source
Exp Gerontol. 1994 Sep-Oct;29(5):531-41
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aging - immunology
Humans
Leukocyte Count
Longitudinal Studies
Lymphocyte Activation
Lymphocyte Subsets
Middle Aged
Sweden
Abstract
This study used a longitudinal design to examine age-related changes in a well-defined sample of Swedish people ranging from 86 to 92 years of age at baseline. The longitudinal design encompassed three measurement occasions with 1 year intermeasurement intervals. The results were analyzed by multivariate analyses of variance (MANOVA), which is useful for comparing individuals over time. Healthy middle-aged subjects (39 years SD +/- 5.8) served as controls. The proliferative responses to Concanavalin A (Con A), a T-cell mitogen, indicated significant lower levels in responses of the old when the two groups were compared. The MANOVA revealed no significant change in mitogen responses over measurement occasions in the old sample as compared with the young. However, when cell types and lymphocyte subpopulations were examined, significant differences were found between the two age groups in many of these parameters and for some (lymphocyte percentages and numbers, CD3 numbers) the MANOVA indicated significant decreases over the measurement occasions in the very old. The results also consistently indicated significant intraindividual correlations in cell types, lymphocyte subpopulations, and mitogen responses over time.
PubMed ID
7828662 View in PubMed
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Airway inflammatory responses following exposure to occupational agents.

https://arctichealth.org/en/permalink/ahliterature129355
Source
Chest. 2012 Jun;141(6):1522-7
Publication Type
Article
Date
Jun-2012
Author
Philippe Prince
Catherine Lemière
Marie-Hélène Dufour
Simone Chaboillez
Louis-Philippe Boulet
Author Affiliation
Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Quebec City, Canada.
Source
Chest. 2012 Jun;141(6):1522-7
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Asthma, Occupational - chemically induced - immunology - physiopathology
Bronchial Provocation Tests
Eosinophils - immunology
Female
Humans
Leukocyte Count
Male
Molecular Weight
Neutrophils - immunology
Occupational Exposure - adverse effects
Quebec
Regression Analysis
Respiratory Function Tests
Retrospective Studies
Smoking - adverse effects
Sputum - cytology
Abstract
Airway inflammatory responses to specific inhalation challenges (SICs) with low-molecular-weight (LMW) and high-molecular-weight (HMW) agents have not been studied thoroughly. We assessed the changes in airway inflammatory cells following SIC in sensitized workers, and looked at the influence of various factors on the pattern of inflammatory responses to SIC.
Induced sputum analysis was performed in workers sensitized to LMW (n = 41) or HMW agents (n = 41) after a control day and after a positive SIC. Cell counts were compared with lung function and various clinical parameters.
In the LMW group, eosinophils were increased following late asthmatic responses (median [interquartile range], 0.02 [0.04] × 10(6) cells/g vs 0.30 [0.80] × 10(6) cells/g and 1.0% [3.5] vs 8.9% [8.0], P
PubMed ID
22116794 View in PubMed
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289 records – page 1 of 29.