Poroisäntä ja Emäntä Juhani Valkeapää 5/1 1965

Kirje 5.1.1965

Juhani Lehdon vastineesta

Kirjoitus on vastine Kasvatus-lehden tässä numerossa julkaistuun Juhani Lehdon puheenvuoroon

The 2013 Arvid Wretlind lecture: evolving concepts in parenteral nutrition.

Fifty years after the clinical introduction of total parenteral nutrition (TPN) the Arvid Wretlind lecture is an opportunity to critically analyse the evolution and changes that have marked its development and clinical use. The standard crystalline amino acid solutions, while devoid of side effects, remain incomplete regarding their composition (e.g. glutamine). Lipid emulsions have evolved tremendously and are now included in bi- and tri-compartmental feeding bags enabling a true "total" PN provided daily micronutrients are prescribed. The question of exact individual energy, macro- and micro-nutrient requirements is still unsolved. Many complications attributed to TPN are in fact the consequence of under- or over-feeding: the historical hyperalimentation concept is the main cause, along with the use of fixed weight based predictive equations (incorrect in 70% of the critically ill patients). In the late 80's many complications (hyperglycemia, sepsis, fatty liver, exacerbation of inflammation, mortality) were attributed to TPN leading to its near abandon in favour of enteral nutrition (EN). Enteral feeding, although desirable for many reasons, is difficult causing a worldwide recurrence of malnutrition by insufficient feed delivery. TPN indications have evolved towards its use either alone or in combination with EN: several controversial trials published 2011-13 have investigated TPN timing, an issue which is not yet resolved. The initiation time varies according to the country between admission (Australia and Israel), day 4 (Swiss) and day 7 (Belgium, USA). The most important issue may prove to be and individualized and time dependent prescription of feeding route, energy and substrates.

Ihmisluonto ja Juhani Pietarisen moraali

Artikkeli on vastine Juhani Pietarisen väittämään (Tieteessä tapahtuu 8/2003)

Vue de la maison de Corten-Niemi et de la montagne Kittis

Ranskalainen tiedemiesryhmä Pierre Louis Moreau de Maupertuis¿n johdolla selvitti Lapissa 1736 maapallon muotoa kolmiomittauksen avulla. Vaaran laella merkkikartio ja retkikunnan teltat. - Digitoitu valokuvasta, joka julkaistu kirjassa : R. Knapas & P. Koistinen, Historiallisia kuvia, 1993.

Aulangon niemi

Kuvalla myös ruots. nimeke. - Järvimaisema Aulangolta; Aulangonjärvi ja Aulangon niemi.

Kuvia Suomen lasten elämästä : 10 piirrosta tehnyt R. Åkerblom; selitykset sommitellut Juhani H. - [Kansi]

Helsinki : G. W. Edlund 1882, F. Tilgmannin kirja- ja kivipaino

Vue de la Montagne de Niemi, du côté du Midy

Ranskalaisen Pierre Louis Moreau de Maupertuis'n johtama retkikunta selvitti 1736 maapallon muotoa Lapissa kolmiomittauksen avulla. Retkikunta majaili Korteniemen talossa, vaaran laella observatorio. - Digi toitu valokuvasta, joka julkaistu 1993 kirjassa Historiallisia kuvia / R. Knapas & P. Koistinen