Faculty of Medicine

Epilepsia on sairaus, joka ilmenee suurentuneena riskinä saada epileptisiä kohtauksia pitkällä aikavälillä. Tässä tutkielmassa selvitettiin, kuinka moni tutkimukseen otetuista potilaista sai epilepsiadiagnoosin ja näistä diagnooseista selvitettiin epilepsioiden etiologiat. Tutkittiin myös anamneesin tietojen ja tutkimustulosten yhteyttä epilepsian kehittymiseen. Tämän retrospektiivisen tutkimuksen potilaat olivat tulleet EEG-tutkimukseen Helsingin Uuteen lastensairaalaan ensikohtauksen tai kohtausepäilyn takia. Anamneesin tietojen ja tutkimustulosten yhteyttä arvioitiin khiin neliötestillä ja iän yhteyttä arvioitiin kahden riippumattoman otoksen t-testillä. Tutkimukseen otettiin mukaan 478 potilasta ja 115 näistä potilaista sai epilepsiadiagnoosin seuranta-aikana. Kehittyneistä epilepsioista geneettiset ja rakenteelliset syyt aiheuttivat suurimman osan epilepsioista. Varma epileptinen kohtausoire, akuutti altistava tekijä, akuuttilääkityksen tarve, neurologinen perussairaus, epänormaali EEG, piikit tai purkaukset EEG:ssä ja EEG:n aikainen epileptinen kohtaus olivat tilastollisesti merkittäviä epilepsian kehittymiselle. Epilepsiaan sairastuneet potilaat olivat keskimäärin vanhempia kuin ne, jotka eivät sairastuneet. Potilaille kehittyneiden epilepsiamuotojen jakauma eroaa maailmanlaajuisesta jakaumasta, mutta käytetyt tutkimusmenetelmät ja tutkimukseen sijainti selittävät paljolti tämän eron. Muut samasta aiheesta tehdyt tutkimukset tukevat tämän tutkimuksen tuloksia epilepsian riskiä kasvattavista tekijöistä. Yksikään näistä tekijöistä ei kuitenkaan ole varma viite epilepsian kehittymiselle.

Aims. Bilingual children might differ from monolinguals in learning to read and write according to previous research. The ability to read and write enables people to learn new things and allows for diverse participation in society. Bilingual children’s reading and writing difficulties can be more challenging to recognize and assess, and therefore it is important to understand the typical development in bilinguals. The differences in reading skills between monolingual and bilingual children have not been extensively researched. The purpose of this study is to examine the differences between monolingual and bilingual children’s reading and writing skills and also identify the underlying linguistic factors associated with them. Assessing linguistic factors related to reading has been found to predict reading and writing difficulties making an early intervention possible. This study also aims to explore the gender gap in reading considering the recent studies that highlight growing differences between boys’ and girls’ reading outcomes during Finnish comprehensive school. Methods. The participants (N = 371) were 3rd grade students who had acquired Finnish (n = 107), Swedish (n = 144) or both Finnish and Swedish (n = 120) as their native languages. Reading and spelling skills were assessed with real word, pseudoword and text reading fluency tasks, a dictation task and a reading comprehension task. Additionally, the relationships between linguistic factors and reading and writing tasks were examined with receptive vocabulary task and objects and letters rapid automatized naming (RAN) tasks. The data was analyzed using IBM Statistics SPSS 28 -program and the differences between language and gender groups were compared using T-test or its non-parametric counterpart Mann-Whitney U -test. The relationships between linguistic factors and reading and writing tasks were explored using linear regression models. Results and discussion. The main outcome of this study was that bilingual students who had acquired Finnish and Swedish as their native languages performed at least as well as monolingual students with Swedish as their native language when both groups were assessed in their language of schooling, Swedish. Additionally, bilingual students achieved statistically significantly better scores than monolingual students in pseudoword reading fluency. The results concerning the gender gap partially deviated from previous studies since monolingual Swedish-speaking boys scored statistically significantly higher than girls in pseudoword and text reading fluency. Bilingual girls’ performance was in line with prior research, as they performed better than boys in reading comprehension. The relationship between receptive vocabulary and all reading and writing tasks was found to be statistically significant in every language group, while objects and letters rapid automatized naming (RAN) showed varying relationships with reading and writing in all language groups. More research is needed to study how simultaneous bilingual children learn to read and write in both of their languages.

Especially obstetric anesthesia has been associated with the risk of aspiration pneumonia. However, by developing the pre-operative practices, such as ensuring a long enough fasting time, aspiration pneumonia has become rare. On the other hand, it has also suggested that unnecessarily long fasting time might have unfavorable effects on both to the mother and to the newborn child. According to current recommendations, patients arriving for a planned caesarean section are instructed not to eat for 6 hours before the scheduled operation. 2 hours before surgery patients are given a carbohydrate drink to avoid the disadvantages of prolonged fasting. In reality, most of the non-urgent caesarean section patients spend some time in the hospital's delivery unit before the decision to operate, which is why the fasting periods tend to be longer than the recommends suggest. In this retrospective study, the implementation of fasting times in relation to both food and drink were examined and analyzed in 279 caesarean section patients in the maternity unit of the Helsinki University Women's Hospital, Finland, during January-February in 2023. The primary outcome of this study was the absolute difference in fasting times between the different urgency groups, measured in hours and minutes. The secondary outcome was the proportion of those birth givers whose fasting time for solid food exceeded 12 hours or the fasting time for clear liquid consumption exceeded 4 hours. The fasting times of the groups were compared with each other using one-way ANOVA and the Chi-square test. In this study, fasting periods were shorter in emergency cesarean sections than they were in elective sections. Among the urgent cesarean sections, the fasting time was also affected by the urgency category of the surgery: in the most urgent surgeries the fasting times were the shortest. Also, the scheduled order of the surgery influenced the fasting times. Comparing the first and third caesareans of the day, the average fasting time increased from 10.55 hours (SD = 1.57) to 14.75 hours (SD = 2.02) (p-value < 0.01). The unadjusted odds ratio of 100% exceeding of the food and clear liquid fasting recommendations for planned operations was 6.53 (95% confidence interval; 2.67 – 15.9; p-value < 0.001) when comparing the third and fourth caesareans with the first and second caesareans. In labor units, where both elective and emergency cesarean sections are executed by the same operating team, birth-givers undergoing the third elective operation should be advised to eat breakfast before 5 o’clock in the morning prior to arriving at the hospital. In addition, birth-givers should be provided with a carbohydrate drink while waiting for the operation in the hospital to limit the fasting time.