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Within Finish culture is a strong tradition of sauna bathing. This special environment predisposes the persons refreshing in the sauna to different kind of burns with varying etiologies. Despite the high prevalence of sauna related burns in Finland, there is paucity on the sauna related burns literature. In this 13-year retrospective study, all sauna-related contact burns in the adult population treated at the Helsinki Burn Centre were analyzed. Altogether 216 patients were included in this study. The incidence of sauna-related contact burns was significantly higher in males; they accounted for 71.8% of patients. In addition to male gender, another risk factor was high age, with the elderly also being more prone to have a longer length of stay in hospital and more often receiving operative treatment. Despite most burns being relatively small, they were deep and more than one-third (36.6%) of patients underwent surgery. A strong seasonal variation in the injuries was recorded; over 40% of the burns took place during the summer months. Sauna contact burns are common, and despite their small size, they frequently cause deep injuries indicating operative treatment. There is a clear male predominance in the patient population. Most probably the cultural aspects of sauna bathing at summer cottages explain the strong seasonal variation in the incidence of these burns. The long latency between initial injury and presentation at the Helsinki Burn Centre should be highlighted to health care centres and central hospitals. • sauna contact burns are due to direct contact to hot metallic sauna stove. • These burns are usually small in size. • These burns are typically deep and require operative treatment. [ABSTRACT FROM AUTHOR]

People align their beliefs and behaviors, including those related to health, increasingly along politically ideological lines. We investigated whether individual political orientation (PO) predicts the use of conventional (CM) and complementary/alternative medicine (CAM) across Europe. We used cross-sectional samples representative of persons aged 15 and over from 19 European countries (ESS 2015; round 7; N = 35,572). We assessed PO based on participants' vote choice in the most recent national election, using expert ratings of party positioning along five political-ideological dimensions: left-right general; left-right economic; Green/alternative/libertarian vs. Traditional/authoritarian/nationalist; anti-elite; and anti-corruption. Use of CM was defined as having consulted a general practitioner or specialist, and use of CAM as having used acupuncture, acupressure, Chinese medicine, homeopathy, herbal treatment, hypnotherapy, or spiritual healing. Participants with an anti-corruption PO were less likely to use CM and more likely to use CAM than other Europeans. Participants with a Green/alternative/libertarian PO were more likely to use CAM than others. Poorer health moderated the association between anti-corruption PO and CM, such that people in poor health tended to use CM regardless of their political leanings, but health status did not moderate the association between PO and CAM use. The results show that political and socio-cultural views are associated with how the European lay public engages with healthcare and complementary/alternative services, but the relevant boundary lines do not lie along the left-right dimension. People who preferred parties favoring expanded freedoms were more likely to use complementary/alternative services, but likely for other reasons than to seek cures for diseases in a traditional biomedical sense. Concerns about corruption among the lay public may be more relevant for conventional healthcare than has been recognized. • Political orientation predicts medical care preference. • Important differences were not found along the political left-right axis. • Voters who favor individual freedoms were more likely to use complementary medicine. • Voters of anti-corruption parties were less likely to use conventional medicine. • Voters of anti-corruption parties were more likely to use complementary medicine. [ABSTRACT FROM AUTHOR]

Background Severe frostbite can result in devastating injuries leading to significant morbidity and loss of function from distal extremity amputation. The modern day management approach to frostbite injuries is evolving from a historically very conservative approach to the increasingly reported use of early interventional angiography and fibrinolysis with tPA. The aim of this study was to evaluate the results of our frostbite treatment protocol introduced 3 years ago. Methods All frostbite patients underwent first clinical and then Doppler ultrasound examination. Angiography was conducted if certain clinical criteria indicated a severe frostbite injury and if there were no contraindications to fibrinolysis. Intra-arterial tissue plasminogen activator (tPA) was then administered at 0.5–1 mg/h proximal to the antecubital fossa (brachial artery) or popliteal fossa (femoral artery) if angiography confirmed thrombosis, as well as unfractionated intravenous heparin at 500 units/h. The vasodilator iloprost was administered intravenously (0.5–2.0 ng/kg/min) in selected cases. Results 20 patients with frostbite were diagnosed between 2013–2016. Fourteen patients had a severe injury and angiography was performed in 10 cases. The total number of digits at risk was 111. Nine patients underwent fibrinolytic treatment with tPA (including one patient who received iloprost after initial non response to tPA), 3 patients were treated with iloprost alone and 2 patients received neither treatment modality (due to contraindications). The overall digital salvage rate was 74.8% and the Hennepin tissue salvage rate was 81.1%. One patient developed a catheter-site pseudoaneurysm that resolved after conservative treatment. Conclusions Prompt referral to a facility where interventional radiology and 24/7 laboratory services are available, and the combined use of tPA and iloprost, may improve outcome after severe frostbite. [ABSTRACT FROM AUTHOR]

Summary: To measure the impact of reduction mammoplasty, the Breast-Related Symptoms Questionnaire (BRSQ) was translated into Finnish and tested among women seeking reduction mammoplasty. This previously validated questionnaire focuses on 13 breast hypertrophy-related symptoms and their frequency. In this prospective multicentre study, the breast-related symptoms of 98 women were measured preoperatively with BRSQ and the health-related quality of life (HRQoL) with the 15 dimension (15D), a well-established generic tool. A total of 59 participants were followed up at least 6 months postoperatively. The women were middle-aged (mean age 44 years) and most of them overweight (mean Body mass index (BMI) 29). All patients had frequent physical symptoms and disability due to their breasts and reported low breast severity symptom score (BSS mean 27, range 13–38). Mean amount of resected breast tissue was 1310 g per patient. Postoperatively, the breast-related symptoms were significantly relieved, and 55 of 59 operated patients reported less frequent or non-existent symptoms (mean BSS 59, range 22–65). BSS score improved especially in obese women and those with pendulous breasts. A low preoperative BSS was related to considerable benefit from surgery. HRQoL score improved significantly from 0.889 to 0.930 (P < 0.001) and significant improvement was seen especially in dimensions, such as discomfort, usual activities and breathing. In conclusion, BRSQ is an easy tool to use to quantify breast-related symptoms. It visualised effectively the impact of the reduction mammoplasty. Surgical breast reduction significantly improves breast-related symptoms and the HRQoL among women with many breast-related symptoms. The present guidelines for patient selection in breast reduction surgery should be updated to use valid measurement and scientific evidence. [Copyright &y& Elsevier]

We used whole-head magnetoencephalography (MEG) to investigate neural activity in human auditory cortex elicited by irrelevant tones while the subjects were engaged in a short-term memory task presented in the visual modality. As compared to a no-memory-task condition, memory load enhanced the amplitude of the auditory N1m response. In addition, the N1m amplitude depended on the phase of the memory task, with larger response amplitudes observed during encoding than retention. Further, these amplitude modulations were accompanied by anterior–posterior shifts in N1m source locations. The results show that a memory task for visually presented stimuli alters sensory processing in human auditory cortex, even when subjects are explicitly instructed to ignore any auditory stimuli. Thus, it appears that task demands requiring attentional allocation and short-term memory result in interaction across visual and auditory brain areas carrying out the processing of stimulus features. [Copyright &y& Elsevier]

Autologous split-thickness skin grafts (STSGs) are the standard of care for closure of deep and large burns. However, perforation and extensive fishnet-like expansion of the grafts to achieve greater area wound coverage can lead to treatment failures or esthetically poor healing outcomes and scarring. The purpose of this study was to validate an autologous advanced therapy medicinal product (ATMP)-compliant skin cell suspension and evaluate its efficacy to promote epithelialization. Cells isolated from a piece of STSG according to ATMP classification requirements were sprayed onto 20 patients during a single operation in a validation study. Comparative evaluation of treatment efficacy was carried out using side-by-side skin graft donor site wounds that were standardized in depth. Firstly, we characterized wound healing transcriptomes at 14 and 21 days from serial wound biopsies in seven patients. Then, side-by-side wounds in four patients were treated with or without the skin cells. The wounds were photographed, clinical outcomes assessed, and the treatment and control wound transcriptomes at 14 days were compared to the untreated wounds' healing transcriptomes. The average cell yield after isolation from the STSG was 2.4 × 106 cells/cm2 with 96 % viability. The product contained mainly keratinocytes and their precursors but also other skin cells such as fibroblasts were present. As compared to vehicle-treated donor site wounds, the wounds treated with cells demonstrated improved epithelialization by both direct comparison and machine learning analysis of the transcriptomes. We showed that rapid and scalable ATMP-classified processing of skin cells is feasible, and application of the skin cells effectively promotes healing and epithelization of donor site wounds. • This study introduces a scalable and GMP-compliant method of rapid cell isolation from a STSG and its spray-on application on injury site. • Production of this advanced therapy medicinal product (ATMP)-classified cell spray is fast allowing application during the same operation. • Standardized Split-thickness skin graft (STSG) donor sites were utilized as study wounds since they enable harvesting of small biopsies over time for molecular level analysis • This study reports the validation and clinical use of this product for the treatment of skin wounds. • The results show that this treatment promotes wound healing as evaluated both clinically and on gene expression level. [ABSTRACT FROM AUTHOR]