Helena Kastarinen

Use of statins and the risk of acute pancreatitis: a population-based case–control study

The aim of this research was to examine the association between statin use and the risk of acute pancreatitis.

Effect of statin use on outcome of symptomatic cholelithiasis: a case-control study

BackgroundStatins can modify bile cholesterol and, thus, the formation of gallstones. We examined whether statin use also modifies the severity of symptomatic gallstone disease and its treatment.MethodsA total of 1,140 consecutive patients with symptomatic gallstone disease were recruited during 2008-2010 at Kuopio university hospital, Finland. Case-control analysis matched the patients using (n = 272) or not using (n = 272) statins by age and sex. The baseline characteristics of the patients, need and type of surgical treatment, duration of operation, perioperative bleeding, postoperative complications and overall mortality rate were compared statistically between the study groups.ResultsMorbidity and subsequent polypharmacy occurred more frequently among the patients with statins compared to the patients without statins. There were no significant differences between the statin users and non-users regarding surgical treatment (open vs. laparoscopic cholecystectomy). The mean operation time for laparoscopic cholecystectomy was 10% shorter for the patients with statin use than for the patients without. In addition, there was a non-significant tendency for statin users to bleed less during laparoscopic operations than the non-users. There were no differences in other procedure-related parameters (e.g., operation urgency, conversions, choledochotomies, complications and mortality) in patients with or without statins.ConclusionsCompared to no treatment, statin treatment was associated with a shorter operation time for laparoscopy cholecystectomy. Other surgical outcome parameters were similar in patients with or without statins, although statin users had more polypharmacy and circulatory illnesses than non-users.

Medical certificate education: controlled study between lectures and flipped classroom.

BackgroundFinnish permanent residents are covered by social security insurance administered by the Social Insurance Institution of Finland. The procedure of insurance is initiated with medical certificate written by the treating doctor. Thus, the doctor must have certificate writing skills accompanied with the knowledge of the content and goals for insurance. Quality certificates are important part of doctors’ professional skills worldwide and most effective teaching methods for learning these should be investigated.MethodsMedical certificate data were collected from two independent courses of fourth-year student taught in autumn 2015 (N = 141) and 2016 (N = 142) in the medical faculty of the University of Eastern Finland. A random sample of 40 students per course was drawn for the analysis. All certificates were analyzed as one sample. This was done to obtain reliable results with internal control group on the differences between two teaching methods, the traditional approach and the flipped classroom (FC) approach, in 2015 and 2016, respectively. The medical certificates were evaluated and scored with a rubric (range: − 4.00–14.25) by two independent experienced specialists.ResultsCompared to students in the traditional classroom, students involved in the FC received significantly higher scores in all relevant sections of the assessed certificates. The mean of the total scores was 8.87 (SD = 1.70) for the traditional group and 10.97 (SD = 1.25) for the FC group. Based on the common language effect size, a randomly selected student from the FC group had an 85% probability of receiving a higher total score than a student from the traditional group.ConclusionIn this study, the FC approach resulted in a statistical significant improvement in the content and technical quality of the certificates. The results suggest that the FC approach can be applied in the teaching of medical certificate writing.

ACE inhibitors and the risk of acute pancreatitis : a population-based case–control study

The aim of this study was to examine the association between angiotensin converting enzyme (ACE) inhibitor use and the risk of acute pancreatitis.