Chronic ulcers and antibiotic treatment

This study analysed 656 wound samples from patients with chronic wounds in order to determine the bacterial flora and patterns of antibiotic use and resistance. Almost all wounds (95.1%) were colonised with at least one bacterial species; 26% of all patients were on antibiotic treatment. The total number of bacterial isolates resistant to antibiotics was low.     

Work ability of young adults

This paper reviews the themes related to work ability of young adults. Premature working discapacity causes significant economical and social costs in Finland compared to other Nordic countries and has for that reason been studied most intensively there. Work ability is an interaction of social, environmental and individual factors such as physical fitness, coping skills, social support behaviour and health behaviour. Environmental factors influencing work ability can be concrete, like physical and chemical exposures or more abstract like unemployment. The work ability of ageing people has been studied intensively, while work ability of young adults has not been properly evaluated so far. The worsened economic situation in Finland has meant an excessive work load for those who still have work. At the same time the risk of permanent unemployment is increasing. This polarizationing affects especially the young because they may fail to enter the working life. Also factors related to childhood may affect and even determine work ability in adulthood.     

What hygienic criteria should apply to community care? The risk of infection is increasing when more and more seriously ill patients are treated outside hospital

In Sweden, the provision of health care (i.e. non-physician care) of elderly residents in community housing and care facilities has been the statutory responsibility of local authorities since 1992. The Health and Medical Services Act stipulates that such care should be of good quality, As infection control is one aspect of good quality, in 1997 the Dept. of Infection Control at University Hospital, Uppsala, and the six municipalities of the County of Uppsala that are responsible for the care of a total of 4,400 elderly people, launched a joint enterprise to provide the care required by the Act. The program includes the education of staff in the basic concepts of infection control/recruitment of link surses and surveillance of risk factors, in order to minimise nosocomial infections in nursing homes for the elderly.     

Nanofibrillated cellulose,poly(vinyl alcohol), montmorillonite clay hybrid nanocomposites with superior barrier and thermomechanical properties

Nanocomposites of poly(vinyl alcohol) (PVA), nanofibrillated cellulose (NFC), and montmorillonite (MMT) clay were prepared via solvent casting. In addition to investigating the effect of clay loading, PVA matrices crosslinked with poly(acrylic acid) (PAA) were prepared and compared with linear (noncrosslinked) PVA nanocomposites. ¹³C NMR and infrared spectroscopy confirmed the presence of crosslinks. Scanning electron microscopy revealed effective NFC and MMT clay dispersion throughout the nanocomposites, while X‐ray diffraction highlighted the effectiveness of PAA to encourage clay dispersion. MMT clay provided a barrier against the diffusion of water and oxygen (molecules) through the nanocomposite films. Permeability and adsorption were further reduced by crosslinking, while oxygen barrier properties were remarkably enhanced at elevated relative humidities. Thermal stability of the PVA segments was strengthened by the presence of MMT clay and crosslinks. MMT clay–reinforced PVA and NFC within the films, increasing the Young's modulus, tensile strength, and glass transition temperature. Crosslinking further enhanced the thermomechanical properties by imparting physical restraints on polymer chain segments, providing elasticity, and ductility. The hybrid films were successfully reinforced at elevated humidities, with nanocomposites displaying enhanced storage moduli and near‐complete recovery. POLYM. COMPOS., 35:1117–1131, 2014. © 2013 Society of Plastics Engineers     

Production of the Finnish Wind Atlas

The Finnish Wind Atlas was prepared applying the mesoscale model AROME with 2.5 km horizontal resolution and the diagnostic downscaling method Wind Atlas Analysis and Application Programme (WAsP) with 250 m resolution. The latter was applied for areas most favourable for wind power production: a 30 km wide coastal/offshore zone, highlands, large lakes and large fields. The methodology included several novel aspects: (i) a climatologically representative period of real 48 months during 1989–2007 was simulated with the mesoscale model; (ii) in addition, the windiest and calmest months were simulated; (iii) the results were calculated separately for each month and for sectors 30° wide; (iv) the WAsP calculations were based on the mesoscale model outputs; (v) in addition to point measurements, also radar wind data were applied for the validation of the mesoscale model results; (vi) the parameterization method for gust factor was extended to be applicable at higher altitudes; and (vii) the dissemination of the Wind Atlas was based on new technical solutions. The AROME results were calculated for the heights of 50, 75, 100, 125, 150, 200, 300 and 400 m, and the WAsP results for the heights of 50, 75, 100, 125 and 150 m. In addition to the wind speed, the results included the values of the Weibull distribution parameters, the gust factor, wind power content and the potential power production, which was calculated for three turbine sizes. The Wind Atlas data are available for each grid point and can be downloaded free of charge from dynamic maps at www.windatlas.fi . Copyright © 2011 John Wiley & Sons, Ltd.     

In vitro fracture resistance of endodontically treated premolar teeth restored with a direct layered fiber-reinforced composite post and core

Methods for restoring endodontically treated teeth fall short of restoring the physiologic mechanical properties. Fracture of endodontically treated teeth is a common type of clinical failure. New treatment modalities or perfected versions of existing treatment concepts need to be tested to find a biomimetic solution. A novel method of restoring endodontically treated teeth is presented and compared in vitro with currently accepted restorative methods. Seventy-two extracted and endodontically treated maxillary premolar teeth were divided into six groups (n = 12) depending on restorative technique (Groups 1–6). Group 1: fiber-reinforced composite post (FRC), Group 2: direct layered short FRC post and core, Group 3: short fiber-reinforced obliquely layered composite restoration, Group 4: microhybrid composite restoration, Group 5: fiber-reinforced box, Group 6: control. Specimens were submitted to static fracture resistance test. Fracture thresholds and fracture patterns were evaluated. Group 6 exhibited the highest fracture resistance. Group 2 yielded the highest fracture resistance among the restored groups. The fracture resistance of Group 2 did not differ significantly from Group 6. Groups 1, 3, 4, 5 proved to be significantly different from the control group. There was no statistically significant difference among restored groups. Fracture patterns of tested groups were dominantly non repairable opposed to control groups mostly repairable fractures. Application of direct-layered short FRC post and core in endodontically treated premolars performed statistically similarly in the studied conditions as natural teeth. Therefore, it seems a promising alternative to current endo-restorative solutions. However, further testing is required.     

Sternal wound complications--incidence, microbiology and risk factors

OBJECTIVE: Sternal wound complications, i.e. instability and/or infection (mediastinitis), are important causes of morbidity in patients undergoing cardiac surgery via median sternotomy. Coagulase negative staphylococci, a normal inhabitant of the skin, have evolved as a cause of sternal wound infections. Since these opportunistic pathogens often are multiresistant, they can cause therapeutic problems. METHODS: From 1980 through 1995 open heart surgery, was performed on 13,285 adult patients. Reoperation necessitated by sternal wound complications occurerd in 203 patients (1.5%). The incidence was 1.7% (168/9987) after coronary artery bypass grafting (CABG group) and 0.7% (35/3413) after heart valve surgery with or without concomitant CABG (HVR group). RESULTS: Factors independently related to sternal complications in the CABG group (variable odds ratio [95% C.I.]): year of surgery, 1.9 [1.3-2.8] in 1990-1992, 2.0 [1.4-2.9] in 1993-1995; female sex, 0.4 [0.2-0.6]; diabetic disease, 1.8 [1.2-2.5]; bilateral ITA procedure, 3.3 [1.1-7.7]; and postoperative dialysis, 3.1 [1.4-6.9]. In the HVR group they were: use of ITA graft, 3.7 [1.7-7.7]; early re-exploration because of bleeding 3.0 [1.1-8.2]; and postoperative dialysis 3.1, [1.4-9.3]. Multivariate models were used to compute the risk for sternal complications in each patient. However, the prognostic models based on these risk scores provided low sensitivity and low predictive value. Patients with sternal wound complications showed no increased early mortality but worse long-term survival even after adjustment for other factors (relative hazard in CABG group 1.9 [1.2-2.8]; in HVR group 2.1 [1.1-4.3]. CONCLUSIONS: The use of ITA grafts seems to be one of the most important factors related to sternal wound complications. However, patients at truly increased risk for this complication could not be identified on the basis of the risk factors considered in this study.