RESUMO
Dating of wood is a major task in historical research, archaeology and paleoclimatology. Currently, the most important dating techniques are dendrochronology and radiocarbon dating. Our approach is based on molecular decay over time under specific preservation conditions. In the models presented here, construction wood, cold soft waterlogged wood and wood from living trees are combined. Under these conditions, molecular decay as a usable clock for dating purposes takes place with comparable speed. Preservation conditions apart from those presented here are not covered by the model and cannot currently be dated with this method. For example, samples preserved in a clay matrix seem not to fit into the model. Other restrictions are discussed in the paper. One model presented covers 7,500 years with a root mean square error (RMSE) of 682 years for a single measurement. Another model reduced to the time period of the last 800 years results in a RMSE of 92 years. As multiple measurements can be performed on a single object, the total error for the whole object will be even lower.
Assuntos
Hidradenite Supurativa/epidemiologia , Expectativa de Vida , Mortalidade/tendências , Fatores Etários , Idoso , Estudos de Casos e Controles , Comorbidade , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Medição de RiscoRESUMO
Various studies report substantial increases in intrinsic water-use efficiency (W i ), estimated using carbon isotopes in tree rings, suggesting trees are gaining increasingly more carbon per unit water lost due to increases in atmospheric CO2. Usually, reconstructions do not, however, correct for the effect of intrinsic developmental changes in W i as trees grow larger. Here we show, by comparing W i across varying tree sizes at one CO2 level, that ignoring such developmental effects can severely affect inferences of trees' W i . W i doubled or even tripled over a trees' lifespan in three broadleaf species due to changes in tree height and light availability alone, and there are also weak trends for Pine trees. Developmental trends in broadleaf species are as large as the trends previously assigned to CO2 and climate. Credible future tree ring isotope studies require explicit accounting for species-specific developmental effects before CO2 and climate effects are inferred.Intrinsic water-use efficiency (W i ) reconstructions using tree rings often disregard developmental changes in W i as trees age. Here, the authors compare W i across varying tree sizes at a fixed CO2 level and show that ignoring developmental changes impacts conclusions on trees' W i responses to CO2 or climate.
Assuntos
Dióxido de Carbono/metabolismo , Clima , Árvores/metabolismo , Água/metabolismo , Algoritmos , Isótopos de Carbono/metabolismo , Cedrela/crescimento & desenvolvimento , Cedrela/metabolismo , Fagus/crescimento & desenvolvimento , Fagus/metabolismo , Modelos Teóricos , Pinus/crescimento & desenvolvimento , Pinus/metabolismo , Quercus/crescimento & desenvolvimento , Quercus/metabolismo , Especificidade da Espécie , Temperatura , Fatores de Tempo , Árvores/crescimento & desenvolvimentoRESUMO
In mammography dosimetry, phantoms are often used to represent breast tissue. The conformance of phantom- and patient-based mean glandular dose (MGD) estimates was evaluated mainly from the aspect of diagnostic reference levels. Patient and phantom exposure data were collected for eight diagnostic and three screening mammography devices. More extensive assessments were performed for two devices. The average breast thickness was close to the nationally used reference of 50 mm in diagnostic (50 mm, SD = 13 mm, n = 5342) and screening (47 mm, SD = 13 mm, n = 395) examinations. The average MGD for all breasts differed by 2% from the MGD determined for breasts in the limited compressed thickness range of 40-60 mm. The difference between phantom- and patient-based MGD estimations was up to 30%. Therefore, phantom measurements cannot replace patient dose data in MGD determination.
Assuntos
Neoplasias da Mama/diagnóstico , Mama/patologia , Detecção Precoce de Câncer/métodos , Mamografia/métodos , Imagens de Fantasmas , Radiometria/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Simulação por Computador , Feminino , Humanos , Pessoa de Meia-Idade , Método de Monte Carlo , Doses de Radiação , Adulto JovemRESUMO
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disease of elderly people. Some studies have suggested that the incidence of BP has increased, but the diagnostic accuracy and methodology of studies have varied considerably. OBJECTIVES: To examine the incidence of BP in Northern Finland, and whether the incidence has changed over time. METHODS: This was a retrospective database study of all BP cases diagnosed in the Oulu University Hospital, Finland between 1985 and 2009. The diagnostic criteria were clinical features characteristic of BP (all patients) and positive direct or indirect immunofluorescence in the skin biopsy. The age-standardized incidences were calculated by the direct standardization method. Incidence rate ratios (IRR) were estimated by the Poisson regression model. To derive adjusted IRRs, age and sex were used as potential confounding factors. RESULTS: The crude incidence of BP was 17 per 1 million person-years [95% confidence interval (CI) 15-20] between 1985 and 2009. Using the general European population as a reference, the age-standardized incidence was 14 per 1 million person-years (95% CI 12-17). The incidence of BP increased 1·8-fold (IRR 1·8, 95% CI 1·3-2·6; P < 0·001) in 2005-09 compared with the mean incidence of BP between 1985 and 2004, but after the adjustment for age and sex the increase was 1·4-fold (IRR 1·4, 95% CI 1·0-2·0; P = 0·043). CONCLUSIONS: This is the first study with immunohistologically verified BP diagnoses that reports the increase in the incidence of BP in age- and sex-adjusted populations.
Assuntos
Penfigoide Bolhoso/epidemiologia , Adulto , Distribuição por Idade , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por SexoRESUMO
Arthroscopy enables direct inspection of the articular surface, but provides no information on deeper cartilage layers. Optical coherence tomography (OCT), based on measurement of reflection and backscattering of light, is a diagnostic technique used in cardiovascular surgery and ophthalmology. It provides cross-sectional images at resolutions comparable to that of low-power microscopy. The aim of this study was to determine if OCT is feasible for advanced clinical assessment of lesions in equine articular cartilage during diagnostic arthroscopy. Diagnostic arthroscopy of 36 metacarpophalangeal joints was carried out ex vivo. Of these, 18 joints with varying degrees of cartilage damage were selected, wherein OCT arthroscopy was conducted using an OCT catheter (diameter 0.9 mm) inserted through standard instrument portals. Five sites of interest, occasionally supplemented with other locations where defects were encountered, were arthroscopically graded according to the International Cartilage Repair Society (ICRS) classification system. The same sites were evaluated qualitatively (ICRS classification and morphological description of the lesions) and quantitatively (measurement of cartilage thickness) on OCT images. OCT provided high resolution images of cartilage enabling determination of cartilage thickness. Comparing ICRS grades determined by both arthroscopy and OCT revealed poor agreement. Furthermore, OCT visualised a spectrum of lesions, including cavitation, fibrillation, superficial and deep clefts, erosion, ulceration and fragmentation. In addition, with OCT the arthroscopically inaccessible area between the dorsal MC3 and P1 was reachable in some cases. Arthroscopically-guided OCT provided more detailed and quantitative information on the morphology of articular cartilage lesions than conventional arthroscopy. OCT could therefore improve the diagnostic value of arthroscopy in equine orthopaedic surgery.
Assuntos
Artroscopia/veterinária , Doenças das Cartilagens/veterinária , Cartilagem Articular/patologia , Doenças dos Cavalos/patologia , Tomografia de Coerência Óptica/veterinária , Animais , Artroscopia/métodos , Cadáver , Doenças das Cartilagens/patologia , Doenças dos Cavalos/diagnóstico , Cavalos , Tomografia de Coerência Óptica/métodosRESUMO
OBJECTIVE: The aim of the study was to investigate whether high frequency ultrasound technique, originally designed for arthroscopic use can be utilized to detect traumatic cartilage injuries. METHODS: A total of four intact osteochondral plugs were prepared from eight patellas for parallel comparison (total of 32 plugs). The plugs were injured by dropping an impactor on them from heights of 2.5 cm, 5.0 cm, 10.0 cm and 15.0 cm (corresponding to impact energies of 0.12, 0.25 0.50 and 0.74 J, respectively), in a custom made dropping tower. The samples were imaged with a high frequency (40 MHz) ultrasound device before and after the injury. Reflection coefficient (R), integrated reflection coefficient (IRC), apparent integrated backscattering (AIB) and ultrasound roughness index (URI) were determined for each sample. RESULTS: Injuries invisible to the naked eye could be sensitively detected via the decreased values of the ultrasound reflection parameters (P < 0.05). Furthermore, a decreasing trend was detected in the values of R and IRC as the momentum of the impactor increased. The values of AIB were significantly lower for samples injured by dropping the impactor on the cartilage from heights of 2.5 cm and 15 cm but the URI values were similar in intact and injured cartilage. Histological analysis of the cartilage samples revealed that the injured cartilage exhibited depletion of the cartilage surface proteoglycans but the structure of collagen network was almost normal. CONCLUSIONS: Quantitative ultrasound imaging enables the detection of minor visually non-detectable cartilage injuries. As the present technique is feasible for arthroscopic use it might have clinical value in the evaluation of cartilage lesions during arthroscopy e.g., after tear of the anterior cruciate ligament.
Assuntos
Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/lesões , Animais , Artroscopia/métodos , Cartilagem Articular/metabolismo , Bovinos , Colágeno/metabolismo , Proteoglicanas/metabolismo , UltrassonografiaRESUMO
BACKGROUND: Anxiety frequently accompanies low-grade inflammation-associated conditions like depression, insulin resistance, coronary heart disease and metabolic syndrome. The association between anxiety and low-grade inflammation is, unlike between depression and low-grade inflammation, a very sparsely studied area in general populations. The aim of the present study was to investigate whether anxiety symptoms as well as comorbid anxiety and depressive symptoms are associated with low-grade inflammation at population level. METHODS: The general population-based Northern Finland 1966 Birth Cohort was followed until age 31 (n=2688 males and 2837 females), when the highly sensitive CRP concentrations were measured. Anxiety and depressive symptoms were defined by Hopkins Symptom Checklist-25 (HSCL-25). RESULTS: After adjusting for confounders, logistic regression analyses showed that anxiety symptoms alone increased the probability for elevated hs-CRP levels (>3.0mg/L) in males over two-fold (2.19 CI 95% 1.08-4.46), while comorbid anxiety and depressive symptoms caused a 1.7-fold (1.76 CI 95% 1.13-2.74) increase in the probability for elevated hs-CRP levels (1.0-3.0mg/L). CONCLUSIONS: Our results support the hypothesis that anxiety as well as comorbid anxiety and depression can be associated with an increased risk for low-grade inflammation in males at population level.
Assuntos
Transtornos de Ansiedade/sangue , Ansiedade/sangue , Proteína C-Reativa/metabolismo , Adulto , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Comorbidade , Depressão/sangue , Depressão/epidemiologia , Transtorno Depressivo/sangue , Transtorno Depressivo/epidemiologia , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Prevalência , Inquéritos e QuestionáriosRESUMO
Indentation measurements have been proposed to serve as sensitive in vivo diagnostics of cartilage degeneration. However, practical difficulties have hindered the use of quantitative indentation techniques during routine arthroscopies. In this study we modified the previously commercial indentation technique by designing software for quality control of manual indentations. With the modifications, our aim was to introduce more rapid and less erroneous measurements, as well as more automatic and objective analyses. The performance of the technique was tested in situ using six bovine medial tibial plateaus. All measurements were conducted by three operators. The intraoperator reproducibility was reasonable (CV% â= 7.1%) and the interoperator reproducibility was good (intraclass correlation coefficientâ = 0.976). Further, the novel technique was tested by a single operator using 10 bovine medial tibial plateaus. The indentation stiffness values determined with the arthroscopic instrument correlated significantly with the dynamic (r = 0.823) and equilibrium (r = 0.752) moduli as well as tissue water (r =â -0.830) and hydroxyproline (r = 0.776) contents. To conclude, the novel measurement technique showed good reproducibility and was found to give valuable information on cartilage properties. Most importantly, the measurements and analyses were more straightforward and automatic than those introduced in the original indentation approach.
Assuntos
Cartilagem Articular/fisiologia , Software , Animais , Artroscopia , Fenômenos Biomecânicos , Bovinos , Técnicas In Vitro , Articulação do Joelho/fisiologia , Tíbia/fisiologiaRESUMO
AIMS/HYPOTHESIS: The aim of the study was to assess the effect of hyperglycaemia on regional concentrations of glucose and other substrates within the brain in non-diabetic individuals and in patients with type 1 diabetes. METHODS: The brain metabolites of 17 men with type 1 diabetes and 12 age-matched non-diabetic men (22-43 years old) were studied after an overnight fast (plasma glucose 9.2 +/- 3.0 vs 4.8 +/- 0.5 mmol/l, respectively). N-Acetylaspartate (NAA), creatine, choline, myo-inositol (mI) and glucose in the frontal cortex, frontal white matter and thalamus were quantified with proton magnetic resonance spectroscopy. RESULTS: In the non-diabetic participants, the glucose level was 47% higher (p < 0.01) in the frontal cortex than in the frontal white matter. In contrast, this regional variation was not observed in the diabetic participants, in whom the glucose level in the frontal white matter was 64% higher (p < 0.001) and in the frontal cortex 25% higher (p = 0.033) than that of the non-diabetic participants. In the diabetic participants, the glucose level in each of the three regions studied correlated with fasting plasma glucose (r = 0.88-0.67, p < 0.01). In addition, in the diabetic participants, mI was 20% higher (p < 0.001) and NAA 6% lower (p = 0.037) in the frontal white matter, and mI was 8% higher (p = 0.042) in the frontal cortex, than in the non-diabetic participants. CONCLUSIONS/INTERPRETATION: In type 1 diabetes, hyperglycaemia is associated with accumulation of glucose and mI in the cortex and in the white matter.
Assuntos
Encéfalo/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Glucose/metabolismo , Hiperglicemia/metabolismo , Inositol/metabolismo , Adulto , Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , HDL-Colesterol/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Hemoglobinas Glicadas/metabolismo , Frequência Cardíaca , Humanos , Lipídeos/sangue , Imageamento por Ressonância Magnética , Masculino , Seleção de Pacientes , Valores de Referência , Adulto JovemRESUMO
The association between insulin resistance (IR) and depression is a subject of growing research interest, especially as previous population-based studies have presented conflicting findings. The present study extends our understanding about the putative impact of the severity of depressive symptoms on this association and it provides further epidemiological evidence in support of earlier findings, suggesting that the association between IR and depression is present already in young adult males. To determine the impact of the severity of depressive symptoms on the putative association between IR and depression in young adult males, we were given access to the Northern Finland 1966 Birth Cohort database. During the 31-year follow-up survey of this genetically homogeneous birth cohort, IR was assessed by 'Qualitative Insulin Sensitivity Check Index' (QUICKI), and severity of depressive symptoms by 'Hopkins' Symptom Checklist-25' (HSCL-25). This study involved 2,609 male cohort members with complete variable information. In men, the means of the QUICKI-values decreased (i.e., IR increased) in line with the increased severity of depressive symptoms as assessed by HSCL-25 subgroups (analysis of covariance P-value for trend, P=0.003). In multivariate generalized logistic regression analyses, after adjusting for confounders, IR was positively associated with current severe depressive symptoms, the odds ratio (OR) being over threefold (adjusted OR 3.15, 95% confidence interval 1.48-6.68) and the value of OR increased in parallel with a tighter definition of IR (P-value for trend=0.007). The results indicate that in young males, a positive association exists specifically with severe depressive symptoms.
Assuntos
Transtorno Depressivo/epidemiologia , Resistência à Insulina , Vigilância da População , Estudos de Coortes , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/fisiopatologia , Finlândia/epidemiologia , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Índice de Gravidade de DoençaRESUMO
This article summarizes the current status of 1H MRS in detecting and quantifying a boron neutron capture therapy (BNCT) boron carrier, L-p-boronophenylalanine-fructose (BPA-F) in vivo in the Finnish BNCT project. The applicability of 1H MRS to detect BPA-F is evaluated and discussed in a typical situation with a blood containing resection cavity within the gross tumour volume (GTV). 1H MRS is not an ideal method to study BPA concentration in GTV with blood in recent resection cavity. For an optimal identification of BPA signals in the in vivo 1H MR spectrum, both pre- and post-infusion 1H MRS should be performed. The post-infusion spectroscopy studies should be scheduled either prior to or, less optimally, immediately after the BNCT. The pre-BNCT MRS is necessary in order to utilise the MRS results in the actual dose planning.
Assuntos
Compostos de Boro/sangue , Terapia por Captura de Nêutron de Boro , Frutose/análogos & derivados , Espectroscopia de Ressonância Magnética/métodos , Adulto , Idoso , Boro/uso terapêutico , Compostos de Boro/análise , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/radioterapia , Carcinoma/patologia , Carcinoma/radioterapia , Feminino , Finlândia , Frutose/análise , Frutose/sangue , Glioblastoma/patologia , Glioblastoma/radioterapia , Humanos , Hidrogênio , Isótopos/uso terapêutico , Masculino , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/radioterapia , Imagens de Fantasmas , Plasma , Compostos Radiofarmacêuticos/uso terapêuticoRESUMO
Several studies have suggested an association between IgE-mediated atopic allergies and depression. The present study extends our understanding about putative gender differences of this association and provides further epidemiological evidence for our previous finding that the association between atopy and depression may be characteristic for females only. In order to clearly determine the presence of atopic disorders and depression, we used more valid tools than had been employed earlier and we had access to a database (the Northern Finland 1966 Birth Cohort), in which individuals were followed up prospectively until the age of 31 years. The information on allergic symptoms, verified by skin-prick tests and comprising data of 5518 individuals, was used to ascertain the presence of atopy. Depression was assessed with the help of Hopkins' Symptom Checklist-25 and self-reported doctor-diagnosed depression. After adjusting for a father's social class, mother's parity, and place of residence, logistic regression analyses showed that the risk of developing depression increased in parallel with the increasing severity of depression and, when compared with nonatopic subjects, was 3.0 to 4.7-fold up in atopic females and statistically significant. In atopic males, the association between atopy and depression was statistically significant only in the highest depression scores, the odds ratio being 6.3-fold. The results indicate that females suffering from atopic diseases might possess an elevated risk of developing depression already during early adulthood. In males, the association between these two disorders is evident only among the most severe manifestations of depression. Possible background theories, that is, genetic abnormalities in serotonin metabolism, HPA-axis dysfunction, and histamine theory are discussed.
Assuntos
Transtorno Depressivo/epidemiologia , Transtorno Depressivo/imunologia , Hipersensibilidade/epidemiologia , Adulto , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Seguimentos , Humanos , Masculino , Fatores de Risco , Distribuição por Sexo , Fatores SocioeconômicosRESUMO
The quantification of a BNCT 10B-carrier, L-p-boronophenylalanine-fructose complex (BPA-F), was evaluated using 1H magnetic resonance spectroscopy (1H MRS) with phantoms at 1.5 and 3.0 T. For proper quantification, relaxation times T1 and T2 are needed. While T1 is relatively easy to determine, the determination of T2 of a coupled spin system of aromatic protons of BPA is not straightforward with standard MRS sequences. In addition, an uncoupled concentration reference for aromatic protons of BPA must be used with caution. In order to determine T2, the response of an aromatic proton spin system to the MRS sequence PRESS with various echo times was calculated and the product of the response curve with exponential decay was fitted to the measured intensities. Furthermore, the response curve can be used to correct the intensities, when an uncoupled resonance is used as a concentration reference. BPA was quantified using both phantom replacement and internal water referencing methods with accuracies of +/- 5% and +/- 15%. Our phantom results suggest that in vivo studies on BPA concentration determination will be feasible.
Assuntos
Compostos de Boro/análise , Terapia por Captura de Nêutron de Boro/métodos , Espectroscopia de Ressonância Magnética/métodos , Fenilalanina/análogos & derivados , Fenilalanina/análise , Radiometria/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Compostos de Boro/uso terapêutico , Simulação por Computador , Relação Dose-Resposta à Radiação , Estudos de Viabilidade , Espectroscopia de Ressonância Magnética/instrumentação , Modelos Teóricos , Imagens de Fantasmas , Fenilalanina/uso terapêutico , Prótons , Dosagem RadioterapêuticaRESUMO
OBJECTIVE: To assess the demographic and psychosocial profiles of patients with rheumatoid arthritis (RA) who committed suicide. Two control groups were used: osteoarthritis (OA) and suicide victims with neither RA nor OA. METHOD: A study based on a prospective, 13-yr follow-up database with linkage to national hospital discharge registers of all suicides (1296 males, 289 females) committed during the years 1988-2000 in the province of Oulu situated in northern Finland. RESULTS: Females were significantly over-represented among RA patients who committed suicide (52.6% RA women vs 17.3% women with neither RA nor OA). Comorbid depressive disorders preceded suicides in 90% of the female RA patients. Before their suicide, 50% of the female RA patients (vs 11% of the male RA patients) had experienced at least one suicide attempt. The method of suicide was violent in 90% of the RA females. RA males were less often depressive, but committed suicide after experiencing shorter periods of RA and fewer admissions than females. CONCLUSION: Attempted suicides and especially depression in female RA patients should be taken more seriously into account than previously in clinical work so that the most appropriate psychiatric treatment can be provided for such patients.
Assuntos
Artrite Reumatoide/psicologia , Suicídio/psicologia , Adulto , Idoso , Artrite Reumatoide/mortalidade , Transtorno Depressivo/psicologia , Feminino , Finlândia/epidemiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/psicologia , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Suicídio/estatística & dados numéricos , Fatores de Tempo , Violência/estatística & dados numéricosRESUMO
BACKGROUND: It has earlier been suggested that one-third of violent offenders are recorded in psychiatric case registers. Our aim was to study whether violent and non-violent offenders differ with respect to admissions to any health care inpatient service due to psychiatric disorders. METHODS: We used a genetically homogeneous, general population database from the Northern Finland 1966 Birth Cohort, together with the Finnish Hospital Discharge Register and national crime registers. RESULTS: We found that one-third of violent and one-fourth of non-violent male offenders had at least one hospital admission due to a psychiatric disorder before the age of 32. Sixty-five violent criminals - 1.2% of all cohort males (n = 5636) - accounted for 14.4% of all psychiatric treatment days. The admission rates among both violent and non-violent male offenders were significantly higher when compared with males with no criminal history. Among violent males, only half (55.5%) of the inpatient hospital days due to psychiatric disorders occurred in psychiatric hospitals. The corresponding percentages for non-violent criminals and non-criminals were 64.9% and 74.1%, respectively. Among the violent offenders, one-third of hospital inpatient days occurred in university hospitals or central hospitals, and only 1.9% of them occurred in a comprehensive community care system. CONCLUSIONS: Violent offenders' admission rates due to a psychiatric diagnosis are high, and they are frequently treated at an inappropriate health care level.
Assuntos
Crime , Transtornos Mentais/epidemiologia , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/provisão & distribuição , Admissão do Paciente/estatística & dados numéricos , Adulto , Área Programática de Saúde , Estudos de Coortes , Finlândia/epidemiologia , Hospitalização , Humanos , Masculino , Estudos Prospectivos , Violência/psicologiaRESUMO
Between December 1997 and January 1998 an increase in the number of isolates of Salmonella enterica serovar Newport, a serotype rarely causing indigenous infections in Finland, was detected. This included two clusters of gastroenteritis following funeral meals. An inquiry via Enter-net revealed a concomitant increase in cases of S. Newport in the United Kingdom. To investigate the Finnish outbreak, a total of 56 S. Newport strains (22 from the outbreak period, 27 from pre- and post-outbreak period, and 7 from imported food producing animals) were studied by pulsed-field gel electrophoresis (PFGE); selected isolates were also phage typed. Two retrospective questionnaire studies evaluating food exposures among the funeral attendants were conducted. All isolates from the clusters had an identical PFGE pattern which was also found in 13 infections temporally close to but not associated with the clusters. The Finnish outbreak was caused by the same phage type as the one in the United Kingdom. In both clusters, an epidemiological link between illness and exposure to cured ham was found. In conclusion, the outbreak was not limited to the two clusters but was more widely spread both in and outside Finland. Early alarm systems of food-borne outbreaks and collaboration between European countries are needed for investigating international outbreaks.
Assuntos
Surtos de Doenças , Intoxicação Alimentar por Salmonella/epidemiologia , Intoxicação Alimentar por Salmonella/microbiologia , Salmonella enterica/isolamento & purificação , Dor Abdominal/epidemiologia , Estudos de Coortes , Comorbidade , DNA Bacteriano/isolamento & purificação , Diarreia/epidemiologia , Fezes/microbiologia , Febre/epidemiologia , Finlândia/epidemiologia , Genótipo , Humanos , Carne/microbiologia , Náusea/epidemiologia , Fenótipo , Estudos Retrospectivos , Intoxicação Alimentar por Salmonella/diagnóstico , Inquéritos e Questionários , Reino Unido/epidemiologiaRESUMO
A patient with delusional parasitosis has a strong conviction of being infested with parasites: for example, lice or worms. Such a patient is not satisfied with assurances or test results that no parasites are present, but is so convinced that he or she will go as far as to bring the parasites in "matchboxes" to a physician. Subjectively worried, the patient may try to pick the parasites out of the skin, causing cutaneous lesions and even ulcerations. The condition is classified as a delusional/paranoid disorder, somatic type according to DSM-III-R. Not much is known epidemiologically of this rare disorder, which usually affects older women who often are isolated socially. Therapy is regarded as difficult, and a wide variety of treatment methods have been attempted. In this article six female cases are presented, showing that a typical patient is an elderly woman who has suffered losses or is socially isolated. These patients lack deeper psychiatric insight into their problem, so they are mostly in the care of nonpsychiatric physicians. Treatment with a low dose of high-potency neuroleptics combined sometimes with antidepressants appears to be effective. Reducing social isolation is also important.