Publications by authors named "P Aaltonen"

22 Publications

Outcomes of intraocular lens scleral fixation with the friction knot technique.

Acta Ophthalmol 2019 Jun 8;97(4):e506-e513. Epub 2018 Oct 8.

Vitreoretinal Surgery Unit, Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.

Purpose: To examine the clinical outcomes of intraocular lens (IOL) scleral fixation with the friction knot technique.

Methods: Retrospective case series of 152 eyes of 152 patients with inadequate capsular bag support operated with the friction knot IOL scleral fixation technique by a single surgeon. The fixated IOLs were one-piece or three-piece models all with open loop haptics. Main outcome measures were change in corrected distance visual acuity (CDVA) and postoperative complications.

Results: The mean follow-up time was 11.7 months (median 4.9, range 0.7-64.8). The mean logarithm of the minimum angle of resolution CDVA improved from preoperative 0.77 ± 0.73 (Snellen 20/118 ± 7.3 lines) to 0.44 ± 0.56 (Snellen 20/55 ± 5.6 lines) at the final visit (p < 0.001). The main postoperative complications were ocular hypertension (30.3%), uveitis-glaucoma-hyphaema syndrome (12.5%; UGHS), vitreous haemorrhage (11.2%) and retinal detachment (8.6%). Two (1.3%) cases of suture breakage were seen. In multivariate Cox regression analysis, age under 60 years [hazard ratio (HR) = 5.41; 95% confidence interval (CI) 1.95-15.01] and scleral fixated one-piece IOL (HR = 4.23; 95% CI 1.44-12.44) were found as significant independent risk factors for developing new UGHS.

Conclusion: The friction knot technique provides a firm scleral fixation. Scleral fixation may successfully be utilized in dislocated three-piece IOLs with loop haptics. We recommend avoiding scleral fixation of one-piece IOLs in young patients due to a high risk of UGHS.
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June 2019

Parental Vaccine Hesitancy: Clinical Implications for Pediatric Providers.

J Pediatr Health Care 2015 Jul-Aug;29(4):385-94

Despite being recognized as one of the greatest public health achievements, vaccines are increasingly under scrutiny for a multitude of reasons. "Parental vaccine hesitancy," an emerging term in today's literature, encompasses a wide range of concerns regarding vaccines and is believed to be responsible for decreasing coverage of many childhood vaccines. The threat to herd immunity posed by poor vaccine uptake increases the risk for resurgence of vaccine-preventable diseases. Pediatric primary health care providers have an obligation to respond to the increasing prevalence of vaccine hesitancy by providing education related to vaccines to ensure the safety and health of the population. The purpose of this article is to examine the most common concerns surrounding vaccine hesitancy and outline strategies for pediatric providers to address concerns with parents in the clinical setting.
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December 2016

Improving teaching assistants' orientation in a school of nursing: a lean approach.

Nurse Educ 2015 May-Jun;40(3):155-9

Author Affiliations: Associate Head (Dr Aaltonen), Associate Professor (Dr Foli), Clinical Assistant Professor (Ms Kirby), Clinical Assistant Professor (Dr Simpson), Clinical Assistant Professor (Ms Walters), School of Nursing, Purdue University, West Lafayette, Indiana.

Newly hired teaching assistants (TAs) come to schools of nursing with varying levels of experience in academic institutions. Therefore, the orientation of TAs becomes important at a micro level (student instruction) and macro level (mission of the organization). We describe a Lean approach to strengthening TA orientation and reducing waste and inconsistency. Developed solutions and tools through the lens of quality improvement are discussed.
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August 2015

Resection of the stenotic segment with individually tailored anastomosis for symptomatic congenital tracheal stenosis in infants.

Eur J Cardiothorac Surg 2014 Jun 28;45(6):e215-9. Epub 2014 Mar 28.

Department of Paediatric Cardiac Surgery, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland

Objectives: To analyse retrospectively population-based results of congenital tracheal stenosis (CTS) repair in infants in Finland.

Methods: Data on infants who were operated on for CTS in Helsinki Children's Hospital between August 1988 and May 2013 were analysed retrospectively. Fibreoptic bronchoscopy was performed perioperatively and in follow-up of all the surviving patients. The median follow-up time was 7 (range 1-20) years.

Results: Thirteen infants were operated on for CTS. Resection of the stenotic segment with individually tailored anastomosis was used in 12 patients and slide tracheoplasty in 1 patient. The median age at the operation was 2.9 (range 0.2-19) months. Eight (62%) patients had associated cardiovascular defects, which were corrected during the same operation. The median length of stenosis was 35% (range 25-60%) of the total length of the trachea. The median length of time of postoperative mechanical ventilation was 10 (range 5-19) days. The median length of time of intensive care treatment was 15 (range 7-40) days. One patient died from hypoplastic lung tissue and fibrosis, and multiorgan failure. One patient required reoperation, and 3 other patients received balloon bronchodilatations postoperatively. There was no late mortality. All of the 12 survivors had a good outcome.

Conclusion: Resection with individually tailored anastomosis with up to 55% of the stenotic segment of the trachea presented a good long-term outcome.
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June 2014