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BackgroundEmergency medical services are an important part of trauma care, but data comparing urban and rural areas is needed. We compared 30-day mortality and length of intensive care unit (ICU) stay for trauma patients injured in rural and urban municipalities and collected basic data on trauma care in Northern Finland.MethodsWe examined data from all trauma patients treated by the Finnish Helicopter Emergency Medical Services in 2012 and 2013. Only patients surviving to hospital were included in the analysis but all pre-hospital deaths were recorded. All data was retrieved from the national Helicopter Emergency Medical Services database, medical records, and the Finnish Causes of Death Registry. Patients were defined as urban or rural depending on the type of municipality where the injury occurred.ResultsA total of 472 patients were included. Age and Injury Severity Score did not differ between rural and urban patients. The pre-hospital time intervals and distances to trauma centers were longer for rural patients and a larger proportion of urban patients had intentional injuries (23.5 % vs. 9.3 %, P <0.001). The 30-day mortality for severely injured patients (Injury Severity Score >15) was 23.9 % in urban and 13.3 % in rural municipalities. In the multivariate regression analysis the odds ratio (OR) for 30-day mortality was 2.8 (95 % confidence interval 1.0 to 7.9, P = 0.05) in urban municipalities. There was no difference in the length of ICU stay or scores. Twenty patients died on scene or during transportation and 56 missions were aborted because of pre-hospital death.ConclusionsThe severely injured urban trauma patients had a trend toward higher 30-day mortality compared with patients injured in rural areas but the length of ICU stay was similar. However, more pre-hospital deaths occurred in rural municipalities. The time before mobile ICU arrival appears to be critical for trauma patients’ survival, especially in rural areas.

Our aims were to genotype Chlamydia trachomatis strains present in urogenital samples and to investigate the occurrence of the Swedish new variant of C. trachomatis in Finland. We genotyped 160 C. trachomatis positive samples with ompA real-time PCR and analyzed 495 samples for the new variant. The three most prevalent genotypes were E (40%), F (28%), and G (13%). Only two specimens containing bacteria with the variant plasmid were detected. It seems that in Finland the percentage of infections due to genotypes F and G has slightly increased during the last 20 years. Genotypes E and G appear to be more common, and genotypes J/Ja and I/Ia appear to be less common in Europe than in the USA. Although the genotype E was the most common genotype among C. trachomatis strains, the new variant was rarely found in Finland.

Heterobasidion parviporum Niemelä & Korhonen is responsible for the majority of decay in conifers in northern Europe, which causes severe economic losses. In nature, heterokaryotic isolates of H. parviporum cause infection in Norway spruce (Picea abies (L.) Karst.). However, little is known on whether homokaryons of H. parviporum can infect trees under field conditions. In this study, 40-year-old clonal Norway spruce stems and roots were inoculated with a homokaryotic isolate of H. parviporum under field conditions. After four months, the infection frequency and necrotic lesion lengths were recorded. The homokaryon caused infection and provoked the development of necrotic lesions. Necrotic lesions were larger in roots than in stems. Among the studied Norway spruce genotypes, a Russian clone had the smallest necrotic lesions, whereas a Finnish clone developed the largest necrotic lesions. Clones with higher growth rates were more sensitive to fungal infection and wound damage. Under microscopic observation, H. parviporum grew adpressed to lumen cell walls, colonized tracheids next to rays, and induced lignification in cell walls close to the point of inoculation. This study provides a starting point for further studies on the ability of homokaryons to cause infection under field conditions and for discussions on factors affecting the resistance of Norway spruce against H. parviporum.Résumé : Chez les conifères d'Europe du Nord, la majeure partie de la carie qui est responsable d'importantes pertes économiques est causée par Heterobasidion parviporum Niemelä & Korhonen. En nature, des isolats hétérocaryotes de H. parviporum infectent l'épicéa commun (Picea abies (L.) Karst.). Cependant, on ne sait pas si des homocaryons de H. parviporum peuvent infecter les arbres sur le terrain. Dans cette étude, les racines et la tige d'individus clonaux d'épicéa commun âgés de 40 ans ont été inoculés avec un isolat homocaryote de H. parviporum sur le terrain. Après quatre mois, la fréquence des infections et la longueur des lésions nécrotiques ont été notées. L'homocaryon a causé une infection et provoqué le développement de lésions nécrotiques. Les lésions nécrotiques étaient plus grandes sur les racines que sur la tige. Parmi les génotypes d'épicéa commun étudiés, un clone russe avait les lésions nécrotiques les plus petites tandis que les plus grandes lésions se retrouvaient sur un clone finlandais. Les clones qui avaient le taux de croissance le plus élevé étaient plus sensibles aux infections fongiques et aux dommages causés par les blessures. Sous observation microscopique, H. parviporum croissait adossé à la paroi cellulaire à l'intérieur des cellules, colonisait les trachéides adjacentes aux rayons et induisait la lignification dans la paroi des cellules situées près du point d'inoculation. Cette étude constitue un point de départ pour d'autres études portant sur la capacité des homocaryons à causer des infections sur le terrain et pour alimenter la discussion concernant les facteurs qui influencent la résistance de l'ép...