RESUMEN
BACKGROUND AND AIMS:: Patients undergoing restorative proctocolectomy have often suffered from active ulcerative colitis which should be remembered when assessing quality of life after operation. The aim of this study was to explore health-related quality of life after restorative proctocolectomy in those with poor or good pouch function and to compare that to patients with active or inactive ulcerative colitis and to the general population. MATERIAL AND METHODS:: Altogether, 282 restorative proctocolectomy patients were investigated. The control group comprised 408 ulcerative colitis patients from the local register. Generic 15D and disease-specific inflammatory bowel disease questionnaire health-related quality of life instruments were used. Population-based data were available for 15D. Pouch function was evaluated with Öresland score and colitis activity with simple clinical colitis activity index. RESULTS:: 15D results showed that patients with good pouch function had health-related quality of life similar to that of the general population. Health-related quality of life with inflammatory bowel disease questionnaire was equally good in patients with good pouch function (n = 131; 70%) and inactive colitis (n = 95; 63%), and equally impaired in patients with poor pouch function (n = 56; 30%) and active colitis (n = 18; 12%). CONCLUSION:: The majority of patients had health-related quality of life comparable to that in general population. Most patients with active ulcerative colitis are likely to improve their health-related quality of life after successful surgery. These findings are important when informing colitis patients about life after surgery.
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Colitis Ulcerosa/cirugía , Reservorios Cólicos , Proctocolectomía Restauradora , Calidad de Vida , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Individual annual cosmic radiation doses for fulltime airline crewmembers were calculated for 12 consecutive months using data from flight profiles and previously reported cosmic radiation intensity measurements at various altitudes. METHODS: Every flight of each crewmember was analyzed using block time and aircraft flight profiles. Actual flight time at various flight levels was first calculated, then cumulative total body radiation doses were calculated for each flight phase and altitude. RESULTS: Cabin crewmembers averaged 673 block hours (range 906-273 h) and pilots 568 block hours (range 833-168 h). Average annual cosmic ray dose for cabin crews was 2.27 mSv x a(-1) (range between 3.1 - 0.72 mSv x a(-1)). Long-distance MD11 flight captains received the highest annual doses of 2.19 mSv x a(-1) (2.83 - 1.08 mSv x a(-1)). M.D.80 pilots who also fly long high-altitude sectors in Europe received 1.94 mSv x a(-1) (2.37 - 1.12) and other aircraft type cockpit crews averaged between 1.49 - 1.26 mSv x a(-1). CONCLUSION: The calculated individual doses reflect the type of aircraft flown and the amount of flight time. The calculated doses are lower than those received by simply assuming constant radiation exposure at all altitudes during flight. Annual individual doses are well below the maximum 5 mSv x a(-1) allowed by the national laws.
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Aviación , Radiación Cósmica , Aeronaves , Altitud , Humanos , Exposición ProfesionalRESUMEN
The etiology of travelers' diarrhea was studied in 579 adult Finnish tourists participating in two packaged tours to Morocco in the winter (n = 233) and fall (n = 346) of 1989. A research team accompanied the travelers, and a laboratory for enteric pathogens was established in Agadir. At least one pathogen was found in 62% of the 60 diarrhea cases in winter and in 58% of the 111 diarrhea cases in fall. Multiple pathogens were found less often in winter (8%) than in fall (21%, P less than .05). Campylobacter strains were the leading cause of travelers' diarrhea in winter, found alone or with other pathogens in 28% of the cases (but in only 7% in fall), whereas enterotoxigenic Escherichia coli (ETEC) was the most common pathogen in fall, present in 32% of the cases (8% in winter). Both differences are highly significant (P less than .001). Salmonella enterica was almost as common as ETEC in fall (25% of diarrhea cases) but rare in winter (10%, P less than .05). Thus, the etiology of travelers' diarrhea varied according to the season in the same tourist destination. This finding has relevance to both antimicrobial treatment and prophylaxis.
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Infecciones por Campylobacter/microbiología , Diarrea/microbiología , Disentería Bacilar/microbiología , Infecciones por Escherichia coli/microbiología , Infecciones por Salmonella/microbiología , Adolescente , Adulto , Aeromonas/aislamiento & purificación , Anciano , Anciano de 80 o más Años , Infecciones por Campylobacter/epidemiología , Diarrea/epidemiología , Disentería Bacilar/epidemiología , Infecciones por Escherichia coli/epidemiología , Heces/microbiología , Femenino , Finlandia , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Masculino , Persona de Mediana Edad , Marruecos , Infecciones por Rotavirus/epidemiología , Infecciones por Rotavirus/microbiología , Infecciones por Salmonella/epidemiología , Estaciones del Año , ViajeRESUMEN
B-subunit/whole-cell cholera vaccine (BS-WC) has been shown to give Bangladeshi mothers and children only 3 months' protection against severe diarrhoea due to enterotoxigenic Escherichia coli (ETEC). Since a long-lasting effect is not necessary for protection against travellers' diarrhoea, a prospective double-blind study was conducted among tourists who went to Morocco from Finland. 307 tourists received two oral doses of BS-WC, whereas 308 controls received a placebo before departure. A research team went out with tourists and a laboratory for enteric pathogens was set up on location. A faecal specimen was taken from 100 randomly selected subjects before departure, from all travellers with diarrhoea, and routinely after return. Enteropathogenic bacteria were not isolated from any of the pre-departure specimens but were present during or after the holiday in 47% of tourists with travellers' diarrhoea, and in 14% of those without diarrhoea. BS-WC induced a 52% protection (p = 0.013) against diarrhoea caused by ETEC. The protection was better for mixed infections (65%, p = 0.016). The protective efficacy against a combination of ETEC and any other pathogen was 71% (p = 0.02), and that against ETEC plus Salmonella enterica even better at 82% (p = 0.01). Partial protection against travellers' diarrhoea is thus obtainable by active immunisation with BS-WC.
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Toxina del Cólera/administración & dosificación , Vacunas contra el Cólera/administración & dosificación , Diarrea/prevención & control , Fragmentos de Péptidos/administración & dosificación , Viaje , Vacunación , Administración Oral , Adulto , Toxina del Cólera/efectos adversos , Vacunas contra el Cólera/efectos adversos , Diarrea/microbiología , Heces/microbiología , Humanos , Esquemas de Inmunización , Fragmentos de Péptidos/efectos adversos , Proyectos Piloto , Estudios Prospectivos , Factores de Tiempo , Vacunación/efectos adversosRESUMEN
A placebo-controlled double-blind study was conducted on the efficacy of Lactobacillus GG in preventing travellers' diarrhoea. Altogether 820 persons travelling on holiday to southern Turkey to two destinations were randomized into two groups receiving either Lactobacillus GG or placebo in identical sachets. On the return flight each participant completed a questionnaire indicating the incidence of diarrhoea and related symptoms during the trip. Of the original group 756 (92%) subjects completed the study acceptably. The overall incidence of diarrhoea was 43.8% (331 cases). The total incidence of diarrhoea in the placebo group was 46.5% and in the Lactobacillus GG 41.0% indicating an overall protection of 11.8%. Protection rates varied between two different destinations with the maximum protection rate reported as 39.5%. Among older age groups there was significantly less diarrhoea when compared to younger travellers. Lactobacillus GG appeared to be effective in reducing the occurrence of travellers' diarrhoea in one of the two destinations with no side effects.
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Diarrea/prevención & control , Lactobacillus/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Encuestas y Cuestionarios , Viaje , TurquíaRESUMEN
The mechanical efficiencies (ME) of pure positive and pure negative work as well as of stretch-shortening cycle (SSC) exercise were investigated with a special sledge apparatus. The subjects were 20 young females who performed six different types of submaximal exercise: two of pure concentric exercise (positive work), two of pure eccentric exercise (negative work) and two SSC exercises. The work intensities were determined individually, from the recordings of distance obtained during a single maximal concentric exercise. Each exercise involved 60 muscle actions lasting a total of 3 min per testing condition. The MEs of pure positive work with intensities of 30% and 60% maximum (C30 and C60 respectively) were 15.5%, SD 2.6% and 14.3%, SD 1.9%, respectively. In pure negative work, when the dropping heights were 20 cm (E20) and 80 cm (E80), MEs were 28.4%, SD 6.9% and 47.9%, SD 10.1%, respectively. In SSC-exercise, the MEs during the positive phase of the take-off were 31.3%, SD 6.3% (E20/C90) and 35.0%, SD 7.0% (E80/C69). The total MEs in SSC-exercise were 29.1%, SD 4.0% (E20/C90) and 40.1%, SD 5.2% (E80/C60 x 100). In pure negative work, the increased stretching velocity increased the value of ME. In the concentric phase of SSC-exercise, the integrated electromyographic activity (iEMG) of vastus lateralis (VL) and vastus medialis (VM) muscles were lower (P less than 0.05) than in pure concentric work, when the mechanical work was the same (C60 vs E80/C60). During pure eccentric work, iEMGs were lower in comparison to the eccentric phase of SSC-exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
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Eficiencia/fisiología , Locomoción/fisiología , Músculos/fisiología , Adolescente , Adulto , Fenómenos Biomecánicos , Electromiografía , Ejercicio Físico/fisiología , Femenino , HumanosRESUMEN
Errors in measurements of mechanical work, net energy expenditure and mechanical efficiency (ME) were calculated, when subjects performed isolated eccentric or concentric muscle actions and combinations of these actions [stretch-shortening cycle (SSC) exercises] with a special sledge apparatus. The relative error of mechanical work was 6.1%. When estimating the error of energy metabolism from oxygen consumption the error would be about 4% (McArdle et al. 1981). The maximum error of ME was the sum of these two values (10.1%). Obviously the error of ME was less than 5%, because 30 muscle actions were averaged and, in addition, the errors of mechanical work and energy expenditure were not in the same direction every time. It was concluded that mechanical work can be determined accurately when the force is measured as a function of the moved distance of the sledge. Thus calculation of ME can be performed quite reliably in isolated eccentric and concentric exercises. The greatest problems were, however, in the SSC exercises, where the errors were higher, because of the problems of dividing the net energy expenditure into eccentric and concentric phases. Therefore, further developments must be made to minimize the errors in measurement and calculation during SSC-exercise.