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Tomminen T, Huhtala H, Kotaluoto S, Veitonmäki T, Wirta EV, Hyöty M. Surgical and oncological results after rectal resections with or without previous treatment for prostate cancer. Front Surg 2024; 11:1298865. [PMID: 38362461 PMCID: PMC10867186 DOI: 10.3389/fsurg.2024.1298865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Previous treatment for prostate cancer (PC) may potentially affect the surgical and oncological outcomes of subsequent rectal cancer surgery, but there are only a few studies regarding this particular group. In this study, we present the 3-year surgical and oncological results of rectal cancer patients who had received previous treatment for PC at a single Finnish tertiary referral centre. Material and methods Data regarding all male patients diagnosed with rectal cancer and treated at Tampere University Hospital (TAUH) between 1997 and 2016 were gathered from medical records. In total, this study included 553 rectal cancer patients who underwent curative surgery, and 54 of them (9.8%) had a prior history of treatment for prostate cancer. Results Patients in the PC group were older and had more comorbidities compared with those in the non-PC group. The PC patients had a significantly higher risk of permanent stoma compared with the non-PC patients (61.5% vs. 45.2%, respectively, p = 0.025). The PC patients seemed to have lower tumours than the non-PC patients (87% vs. 75%, respectively, p = 0.05). Overall, the 3-year overall survival (OS) for the PC and non-PC patients was 74.1% and 80.6%, respectively. No significant differences were observed between the study groups even in the age-adjusted comparison [hazard ratio (HR): 1.07, confidence interval (CI) 95%: 0.60-1.89]. In the univariable analysis, radically operated patients without a history of PC exhibited an improved overall survival, (HR: 2.46, 95% CI: 1.34-4.53, p = 0.004). However, only a higher age-adjusted Charlson comorbidity index (CCI) and a low tumour location (<10 cm) were found to have an independent prognostic impact on worse OS in the multivariable analysis (HR: 1.57, 95% CI: 1.36-1.82, p < 0.001 and HR: 2.74, 95% CI: 1.32-5.70, p = 0.007, respectively). No significant differences were observed between the groups in terms of disease-free or local recurrence-free survival. Conclusion Rectal cancer is more frequently found in the middle or lower part of the rectum in patients who have previously received treatment for prostate cancer. These patients also have a higher likelihood of requiring a permanent stoma. In radically operated rectal cancer, the PC group had a worse OS rate, according to the univariable analysis. However, the only independent prognostic factors for a worse OS that were highlighted in the multivariable analysis included a higher CCI and a low tumour location.
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Affiliation(s)
- T. Tomminen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - H. Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - S. Kotaluoto
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - T. Veitonmäki
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - E.-V. Wirta
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - M. Hyöty
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
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Laamanen A, Salmi T, Huhtala H, Reunala T, Hervonen K, Kaukinen K, Pasternack C. Gastrointestinal symptoms at diagnosis and during long-term gluten-free diet treatment in dermatitis herpetiformis patients. J Eur Acad Dermatol Venereol 2024; 38:e91-e93. [PMID: 37595955 DOI: 10.1111/jdv.19443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/11/2023] [Indexed: 08/20/2023]
Affiliation(s)
- A Laamanen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - T Salmi
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - T Reunala
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - K Hervonen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - K Kaukinen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - C Pasternack
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Dermatology, Tampere University Hospital, Tampere, Finland
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3
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Kivistö JE, de Blok BF, Protudjer JLP, Ojaniemi I, Karjalainen J, Huhtala H, Dunn Galvin A. Validation of the Finnish version of the food allergy quality of life questionnaire-parent form (F-FAQLQ-PF). Acta Paediatr 2024; 113:91-97. [PMID: 37548086 DOI: 10.1111/apa.16937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/08/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
AIM Specific questionnaires about food allergy and health-related quality of life (HRQoL) have been developed and validated in several languages, but not Finnish. We aimed to validate the Finnish Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) for children under age 13 years. METHODS The original FAQLQ-PF and Food Allergy Independent Measure (FAIM) were translated into Finnish per World Health Organisation guidelines and tested by 72 parents of children under age 13 years with suspected severe peanut or tree nut allergy who were recruited at Allergy Centre in Tampere University Hospital in Tampere, Finland. We calculated the construct validity of the questionnaire by calculating the coefficients between the two measures and used Cronbach's alpha to establish the internal consistency. RESULTS The FAQLQ-PF showed strong correlations with domain structure and internal consistency, based on Spearman's correlations (rho) for the HRQoL questions, FAIM questions and FAIM mean values. The total questionnaire score correlated significantly with the mean FAIM (rho = 0.95, p < 0.001) and individual FAIM questions. The FAQLQ-PF and domains had good or excellent internal consistency (Cronbach's alpha >0.70). CONCLUSION The Finnish FAQLQ-PF demonstrated good construct validity and excellent internal consistency for measuring food allergy HRQoL in children under age 13 years.
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Affiliation(s)
- J E Kivistö
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - B Flokstra de Blok
- General Practitioners Research Institute, Groningen, The Netherlands
- University Medical Center Groningen, Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, Groningen, The Netherlands
| | - J L P Protudjer
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Ojaniemi
- Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - J Karjalainen
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - A Dunn Galvin
- School of Applied Psychology, University College Cork, Cork, Ireland
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Tervo L, Outinen T, Kiekara T, Tietäväinen J, Paakkala A, Pörsti I, Huhtala H, Mäkelä S, Mustonen J. The presence of intraperitoneal, retroperitoneal and pleural fluid in acute Puumala hantavirus infection. Infect Dis (Lond) 2023; 55:207-215. [PMID: 36562294 DOI: 10.1080/23744235.2022.2160010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Puumala hantavirus (PUUV) causes most cases of haemorrhagic fever with renal syndrome (HFRS) in Europe. PUUV infection is characterised by acute kidney injury, thrombocytopenia and increased capillary leakage. Typical symptoms are fever, headache, nausea, abdominal and back pain. This study aimed to evaluate the amount and distribution of intraperitoneal, retroperitoneal and pleural fluid and the association of fluid collections to the symptoms and clinical findings in patients with acute PUUV infection. METHODS Abdominal magnetic resonance imaging (MRI) was performed on 27 hospitalised patients with acute PUUV infection. The clinical and laboratory findings and patients' symptoms were analysed in relation to the imaging findings. The thickness of the fluid collections was measured in millimetres (mm) from axial images. RESULTS Fluid collections were found in all patients. The amount of intraperitoneal fluid correlated positively with plasma C-reactive protein (CRP) level (r = 0.586, p = .001), while it had an inverse correlation with serum creatinine concentration (r = -0.418, p = .030). Retroperitoneal fluid also correlated inversely with serum creatinine and cystatin C concentrations (r = -0.501, p = .008 and r = -0.383, p = .048, respectively). The amount of fluid was not greater in patients with abdominal or back pain. Patients with back pain had higher serum creatinine compared with patients without back pain, 452 µmol/L (range 88-1071) vs. 83 µmol/L (range 60-679), p = .004. CONCLUSIONS Fluid collections were found in all patients. A greater amount of intraperitoneal fluid associates with higher CRP concentrations but not with higher serum creatinine levels. Back pain associates with higher creatinine level but not with the presence of fluids.
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Affiliation(s)
- L Tervo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - T Outinen
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - T Kiekara
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - J Tietäväinen
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - A Paakkala
- Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - I Pörsti
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - S Mäkelä
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - J Mustonen
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Abstract
Background and Aims: Deep sternal wound infection is a major concern after cardiac surgery. This study describes the incidence of postoperative deep sternal wound infections after cardiac surgery and compares two available treatment modalities. Materials and Methods: In Tampere University Hospital, 7973 open heart operations were performed between 2007 and 2016. Patients treated for a postoperative deep sternal wound infection were categorized in two groups based on treatment: revision surgery with early reconstruction (revision group; 74 patients) or vacuum-assisted closure treatment (VAC group; 55 patients). The end points in comparisons were overall mortality and hospitalization time. Results: A total of 129 patients (1.6%) developed a postoperative deep sternal wound infection. The 30-day mortality rates were 8.1% and 3.6%, the 90-day mortality rates were 15.5% and 18.2%, and the 1-year mortality rates were 17.6% and 23.6% for the revision and VAC group, respectively. There was no statistically significant difference in mortality rates. The hospital stay was 18 days in the revision group and 38 days in the VAC group (p < 0.001). The secondary intensive care unit stay was longer in the VAC group (median 1 vs 4, p = 0.011). The most common pathogens isolated in the first reoperation were coagulase-negative staphylococci (33.8% and 41.8%, respectively; p = 0.366), and positive candida findings were more common in the VAC group (4.1% vs 37.0 %, p < 0.001). Conclusion: Vacuum-assisted closure treatment induces an inferior outcome in terms of fungal infections, treatment times, and the number of reoperations.
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Affiliation(s)
- E Hämäläinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - J Laurikka
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Cardiothoracic Surgery, Tampere Heart Hospital, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - O Järvinen
- Department of Cardiothoracic Surgery, Tampere Heart Hospital, Tampere, Finland
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Niemeläinen S, Huhtala H, Ehrlich A, Kössi J, Jämsen E, Hyöty M. Long-term survival following elective colon cancer surgery in the aged. A population-based cohort study. Colorectal Dis 2020; 22:1585-1596. [PMID: 32645253 DOI: 10.1111/codi.15242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/18/2020] [Indexed: 01/01/2023]
Abstract
AIM The number of colorectal cancer patients increases with age. Long-term data support personalized management due to heterogeneity within the older population. This registry- and population-based study aimed to analyse long-term survival, and causes of death, after elective colon cancer surgery in the aged, focusing on patients who survived more than 3 months postoperatively. METHODS The data included patients ≥ 80 years who had elective surgery for Stage I-III colon cancer in four Finnish centres. The prospectively collected data included comorbidities, functional status, postoperative outcomes and long-term survival. Univariate and multivariate Cox regression analysis were conducted to determine factors associated with long-term survival. RESULTS A total of 386 surgical patients were included, of whom 357 survived over 3 months. Survival rates for all patients at 1, 3 and 5 years were 85%, 66% and 55%, compared to 92%, 71% and 59% for patients alive 3 months postoperatively, respectively. Higher age, American Society of Anesthesiologists (ASA) score ≥ 4, Charlson Comorbidity Index ≥ 6, tumour Stage III, open compared to laparoscopic surgery and severe postoperative complications were independently associated with reduced overall survival. Higher age (hazard ratio 1.97, 1.14-3.40), diabetes (1.56, 1.07-2.27), ASA score ≥ 4 (3.27, 1.53-6.99) and tumour Stage III (2.04, 1.48-2.81) were the patient-related variables affecting survival amongst those surviving more than 3 months postoperatively. Median survival time for patients given adjuvant chemotherapy was 5.4 years, compared to 3.3 years for patients not given postoperative treatment. CONCLUSIONS Fit aged colon cancer patients can achieve good long-term outcomes and survival with radical, minimally invasive surgical treatment, even with additional chemotherapy.
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Affiliation(s)
- S Niemeläinen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - A Ehrlich
- Central Hospital of Central Finland, Jyväskylä, Finland
| | - J Kössi
- Päijät-Häme Central Hospital, Lahti, Finland
| | - E Jämsen
- Centre of Geriatrics, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Gerontology Research Center (GEREC), Tampere, Finland
| | - M Hyöty
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
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Hautakangas T, Uotila J, Huhtala H, Palomäki O. Intrauterine versus external tocodynamometry in monitoring labour: a randomised controlled clinical trial. BJOG 2020; 127:1677-1686. [PMID: 32491233 DOI: 10.1111/1471-0528.16343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate whether the use of intrauterine tocodynamometry versus external tocodynamometry (IT versus ET) during labour reduces operative deliveries and improves newborn outcome. As IT provides more accurate information on labour contractions, the hypothesis was that it may more appropriately guide oxytocin use than ET. DESIGN Randomised controlled trial. SETTING Two labour wards, in a university tertiary hospital and a central hospital. POPULATION A total of 1504 parturients with singleton pregnancies, gestational age ≥37 weeks and fetus in cephalic position: 269 women with uterine scars, 889 nulliparas and 346 parous women with oxytocin augmentation. METHODS Participants underwent IT (n = 736) or ET (n = 768) during the active first stage of labour. MAIN OUTCOME MEASURES Primary outcome: rate of operative deliveries. SECONDARY OUTCOMES duration of labour, amount of oxytocin given, adverse neonatal outcomes. RESULTS Operative delivery rates were 26.9% (IT) and 25.9% (ET) (odds ratio 1.05, 95% CI 0.84-1.32, P = 0.663). The ET to IT conversion rate was 31%. We found no differences in secondary outcomes (IT versus ET). IT reduced oxytocin use during labours with signs of fetal distress, and trial of labour after caesarean section. CONCLUSIONS IT did not reduce the rate of operative deliveries, use of oxytocin, or adverse neonatal outcomes, and it did not shorten labour duration. TWEETABLE ABSTRACT IT (versus ET) reduced oxytocin use in high-risk labours but did not influence operative delivery rate or adverse neonatal outcomes.
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Affiliation(s)
- T Hautakangas
- Department of Obstetrics and Gynaecology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - J Uotila
- Department of Obstetrics and Gynaecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - O Palomäki
- Department of Obstetrics and Gynaecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Toppila-Salmi S, Julkunen-Iivari A, Luukkainen A, Vento S, Apajalahti S, Saat R, Lehtinen A, Jarnstedt J, Numminen J, Markkola A, Huhtala H, Geneid A, Heikkinen A, Meurman J. Radiologic periodontal findings in paranasal sinus computed tomography scans of chronic rhinosinusitis patients. RHINOL 2020. [DOI: 10.4193/rhinol/20.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Irmola T, Kangas J, Eskelinen A, Niemeläinen M, Huhtala H, Mattila VM, Moilanen T. Functional outcome of total knee replacement: a study protocol for a prospective, double-blinded, parallel-group randomized, clinical controlled trial of novel, personalized and conventional implants. BMC Musculoskelet Disord 2019; 20:443. [PMID: 31604440 PMCID: PMC6790022 DOI: 10.1186/s12891-019-2830-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 09/12/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The development of total knee replacement (TKR) implant designs aims to improve outcome regarding pain, function, joint stiffness, instability, patellar problems, and ultimately wear of the implant. Recently, two major orthopaedic implant manufacturers launched a new generation of TKR implants which, according to the manufacturers, provide improved functional outcome. However, the benefits of these new TKR designs claimed by the manufacturers in terms of improved functional outcome still lack scientific documentation. The present randomized controlled trial has been designed to compare three fixed bearing, cemented cruciate-retaining (CR) designs; one of the new personalized TKR design with two conventional TKR designs with the main emphasis being on functional outcome. METHODS The present study is a prospective, double-blinded, randomized, single-center intervention trial. A total of 240 patients will be recruited to participate in a parallel-group study at Coxa Hospital for Joint Replacement, Tampere, Finland. We will compare the short-term functional outcome of TKR performed with a novel personalized TKR design (Persona CR, Zimmer, Warsaw, IN, USA) against TKRs performed with two conventional designs (PFC CR, DePuy, Warsaw, IN, USA and Nexgen CR, Zimmer, Warsaw, IN, USA). In total, 80 patients will be randomized in each of the three study arms. The primary outcome in this study is the Oxford Knee Score (OKS), which is a validated patient-reported outcome measure (PROM). Secondary outcome measures include the Forgotten Joint Score, the 15D, the UCLA activity score, and the VAS pain scale. The results will be analyzed after 2-year follow-up. DISCUSSION This paper presents a prospective, randomized, single-center trial study protocol. It provides details of patient randomization, PROMs, follow-up, methods of analysis of the material, and publication plan. An important aspect that will be considered in the study will be the economic effects of the novel designs as they are substantially more expensive, and the benefits of the added costs remain unknown. In addition, it is especially important to carry out evaluative studies in independent centers that are not biased by the interests of the manufacturers. TRIAL REGISTRATION Retrospectively registered, November, 2017, ClinicalTrials.gov Identifier: NCT03339557 .
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Affiliation(s)
- T. Irmola
- Coxa Hospital for Joint Replacement, Tampere, Finland
| | - J. Kangas
- Coxa Hospital for Joint Replacement, Tampere, Finland
| | - A. Eskelinen
- Coxa Hospital for Joint Replacement, Tampere, Finland
| | | | | | - V. M. Mattila
- Coxa Hospital for Joint Replacement, Tampere, Finland
- Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - T. Moilanen
- Coxa Hospital for Joint Replacement, Tampere, Finland
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Nurmi R, Metso M, Pörsti I, Niemelä O, Huhtala H, Mustonen J, Kaukinen K, Mäkelä S. Corrigendum to "Celiac disease or positive tissue transglutaminase antibodies in patients undergoing renal biopsies" [Dig Liver Dis (2018);50:27-31]. Dig Liver Dis 2019; 51:1207-1208. [PMID: 31253487 DOI: 10.1016/j.dld.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- R Nurmi
- Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Finland.
| | - M Metso
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
| | - I Pörsti
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - O Niemelä
- Medical Research Unit, Seinäjoki Central Hospital, Finland; University of Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, University of Tampere, Finland
| | - J Mustonen
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - K Kaukinen
- Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Finland; Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
| | - S Mäkelä
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland
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11
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Niemeläinen M, Moilanen T, Huhtala H, Eskelinen A. Outcome of knee arthroplasty in patients aged 65 years or less: a prospective study of 232 patients with 2-year follow-up. Scand J Surg 2018; 108:313-320. [PMID: 30522409 DOI: 10.1177/1457496918816918] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Previous studies have reported lower implant survival rates, residual pain, and higher patient dissatisfaction rates following knee arthroplasty in younger knee arthroplasty patients. We aimed to assess the real-world effectiveness of knee arthroplasty in a prospective non-selected cohort of patients aged 65 years or less with 2-year follow-up. MATERIAL AND METHODS In total, 250 patients (272 knees) aged 65 years or less were enrolled into this prospective cohort study. Patient-reported outcome measures were used to assess the outcome. RESULTS The mean Oxford Knee Score and all Knee Injury and Osteoarthritis Outcome Score subscales increased significantly (p < 0.001) from preoperative situation to the 2-year follow-up. Significant increase (p < 0.001) in physical activity was detected in High-Activity Arthroplasty Score and RAND-36 Physical Component Score (PCS). Pain was also significantly (p < 0.001) relieved during the follow-up. Total disappearance of pain was rare at 2 years. Patients with milder (Kellgren-Lawrence grade 2) osteoarthritis were less satisfied and reported poorer patient-reported outcome measure than those with advanced osteoarthritis (Kellgren-Lawrence grade 3-4). There was no difference in the outcome (any patient-reported outcome measure) between patients who underwent total knee arthroplasty and those who received unicondylar knee arthroplasty. CONCLUSION We found that measured with a wide set of patient-reported outcome measures, both total knee arthroplasty and unicondylar knee arthroplasty resulted in significant pain relief, as well as improvement in physical performance and quality of life in patients aged 65 years or less. Real-world effectiveness of these procedures seems to be excellent. 15% of patients still had residual symptoms and were dissatisfied with the outcome at 2 years after the operation.
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Affiliation(s)
- M Niemeläinen
- Coxa Hospital for Joint Replacement, Tampere, Finland
| | - T Moilanen
- Coxa Hospital for Joint Replacement, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - A Eskelinen
- Coxa Hospital for Joint Replacement, Tampere, Finland
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12
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Kuitunen I, Skyttä ET, Eskelinen A, Huhtala H, Artama M. Induced Abortions Among Women Having Undergone Total Hip Replacement: A Nationwide Register Study in Finland. Scand J Surg 2018; 108:258-264. [PMID: 30442077 DOI: 10.1177/1457496918812229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS No previous studies have analyzed the connection between total hip replacement and induced abortion. We evaluated the nationwide induced abortion rates among women with and without total hip replacement. MATERIALS AND METHODS Data for this cohort study were gathered from national registers from 1987 to 2007. All fertile-aged (15-44 years old) females who had undergone primary total hip replacement in Finland were selected. The total hip replacement patient group comprised 1713 women and the reference group 5148 women. Information on all pregnancies for both groups before and after total hip replacement/index date was gathered from the medical birth register and the register of induced abortion. Logistic regression model was used to analyze the adjusted odds ratio for induced abortion. Adjustment was made for age at induced abortion, parity, previous induced abortions, previous deliveries, and marital status. RESULTS Women had higher induced abortion proportions after total hip replacement (17.9%) compared with women before total hip replacement (14.1%) and the referents (13.9%), but the differences were not statistically significant. Women in the total hip replacement patient group had significantly more induced abortions after total hip replacement due to maternal health issues (14.7%) compared with the referents (2.7%), p = 0.003. Patients in the total hip replacement group were not more likely to have their pregnancy ending in induced abortion than the women in the reference group (odds ratio 1.32, 95% confidence interval 0.89-1.96, p = 0.17). However, in the adjusted analysis, there was a trend for higher risk for pregnancy to end in induced abortion in the total hip replacement group in relation to the reference group (adjusted odds ratio 1.50 (confidence interval 0.99-2.28, p = 0.05). CONCLUSION The total hip replacement patient group had higher, but statistically insignificant, induced abortion proportions compared with the reference group before and after the operation. After total hip replacement, the patients were not more likely to have a pregnancy ending in induced abortion. This finding remained statistically insignificant after adjusting with possible confounders.
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Affiliation(s)
- I Kuitunen
- 1 Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - E T Skyttä
- 2 COXA Hospital for Joint Replacement, Tampere, Finland
| | - A Eskelinen
- 2 COXA Hospital for Joint Replacement, Tampere, Finland
| | - H Huhtala
- 3 Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - M Artama
- 3 Faculty of Social Sciences, University of Tampere, Tampere, Finland.,4 National Institute of Health and Welfare (THL), Tampere, Finland
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13
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Kangasniemi H, Setälä P, Huhtala H, Kämäräinen A, Virkkunen I, Jämsen E, Yli-Hankala A, Hoppu S. Out-of-hospital cardiac arrests in nursing homes and primary care facilities in Pirkanmaa, Finland. Acta Anaesthesiol Scand 2018; 62:1297-1303. [PMID: 29845604 DOI: 10.1111/aas.13152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/10/2018] [Accepted: 04/23/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dispatching Emergency Medical Services to treat patients with deteriorating health in nursing homes and primary care facilities is common in Finland. We examined the cardiac arrest patients to describe this phenomenon. We had a special interest in patients for whom cardiopulmonary resuscitation was considered futile. METHODS We conducted an observational study between 1 June 2013 and 31 May 2014 in the Pirkanmaa area. We included cases in which Emergency Medical Services participated in the treatment of cardiac arrest patients in nursing homes and primary care facilities. RESULTS Emergency Medical Services attended to a total of 355 cardiac arrest patients, and 65 patients (18%) met the inclusion criteria. The included patients were generally older than 65 years, but otherwise heterogeneous. Nineteen patients (29%) had a valid do-not-attempt-resuscitation order, but paramedics were not informed about it in 10 (53%) of those cases. Eight (12%) of the 65 patients survived to hospital admission and 3 (5%) survived to hospital discharge with a neurologically favourable outcome. Two patients were alive 90 days after the cardiac arrest; both were younger than 70 years of age and had ventricular fibrillation as primary rhythm. There were no survivors in nursing homes. CONCLUSIONS The do-not-attempt-resuscitation orders were often unavailable during a cardiopulmonary resuscitation attempt. Although resuscitation attempts were futile for patients in nursing homes, some patients in primary care facilities demonstrated a favourable outcome after cardiac arrest. Emergency Medical Services seem to be able to recognise potential survivors and focus resources on their treatment.
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Affiliation(s)
- H. Kangasniemi
- Research and Development Unit; FinnHEMS Ltd; WTC Helsinki Airport; Vantaa Finland
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - P. Setälä
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
| | - H. Huhtala
- Faculty of Social Sciences; University of Tampere; Tampere Finland
| | - A. Kämäräinen
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
| | - I. Virkkunen
- Research and Development Unit; FinnHEMS Ltd; WTC Helsinki Airport; Vantaa Finland
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
| | - E. Jämsen
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - A. Yli-Hankala
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
| | - S. Hoppu
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
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14
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Setälä P, Hellevuo H, Huhtala H, Kämäräinen A, Tirkkonen J, Hoppu S. Risk factors for cardiopulmonary resuscitation-related injuries sustained during out-of-hospital cardiac arrests. Acta Anaesthesiol Scand 2018; 62:1290-1296. [PMID: 29797706 DOI: 10.1111/aas.13155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND We aimed to determine the incidence of and associated risk factors for cardiopulmonary resuscitation (CPR)-related injuries in non-survivors of out-of-hospital cardiac arrests (OHCAs) in an emergency medical service (EMS) system in which all CPR procedures are performed on scene and patients are not routinely transported to the hospital with ongoing CPR. MATERIAL AND METHODS We conducted this prospective observational study between 1 June 2013, and 31 May 2014. Data were collected from EMS datasheets and forensic autopsy records. The exclusion criteria were OHCAs due to trauma in the thoracic or abdominal area. EMS adhered to the European Resuscitation Council Resuscitation Guidelines (2010) during the resuscitation attempts. RESULTS Emergency medical service provided CPR in 280 attended OHCAs with 207 cases terminated on scene. A total of 149 patients underwent a forensic autopsy and 47% had a CPR-related injury. The most common injuries were multiple rib fractures (43%), with 22% of patients having more than eight fractured ribs. Abdominal visceral injuries or injuries related to airway management were rare. The injuries were associated with older age, male gender, initial shockable rhythm and public location of the cardiac arrest (P < .05 respectively). In the multivariable regression analysis, older age, male gender, and public location were independent predictors for injuries. There were no differences in the durations of the CPR attempt between the injured and non-injured groups. CONCLUSION Older age, male gender, and public location were independently associated with CPR-related injuries. The duration of the resuscitation attempts did not affect the incident of injuries.
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Affiliation(s)
- P. Setälä
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
- FinnHEMS Research and Development Unit; FinnHEMS Ltd; WTC Helsinki Airport; Vantaa Finland
| | - H. Hellevuo
- Department of Intensive Care; Tampere University Hospital; Tampere Finland
| | - H. Huhtala
- Faculty of Social Sciences; University of Tampere; Tampere Finland
| | - A. Kämäräinen
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
| | - J. Tirkkonen
- Department of Intensive Care; Tampere University Hospital; Tampere Finland
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
| | - S. Hoppu
- Emergency Medical Services; Tampere University Hospital; Tampere Finland
- Department of Intensive Care; Tampere University Hospital; Tampere Finland
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15
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Tuohinen SS, Skytta T, Huhtala H, Virtanen V, Kellokumpu-Lehtinen PL, Raatikainen P. 5018Changes in left ventricular systolic strain and rotation in speckle tracking echocardiography among early-stage breast cancer patients three years after radiotherapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S S Tuohinen
- Helsinki University Central Hospital, Heart and Lung Center, Helsinki, Finland
| | - T Skytta
- Tampere University Hospital, Faculty of Medicine and Life Sciences, Department of Oncology, Tampere, Finland
| | - H Huhtala
- University of Tampere, Faculty of Social Sciences, Tampere, Finland
| | - V Virtanen
- Tampere University Hospital, Heart Center, Department of Cardiology, Tampere, Finland
| | - P.-L Kellokumpu-Lehtinen
- Tampere University Hospital, Faculty of Medicine and Life Sciences, Department of Oncology, Tampere, Finland
| | - P Raatikainen
- Helsinki University Central Hospital, Heart and Lung Center, Helsinki, Finland
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16
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Hietanen KE, Järvinen TA, Huhtala H, Tolonen TT, Kuokkanen HO, Kaartinen IS. Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial. J Plast Reconstr Aesthet Surg 2018; 72:4-11. [PMID: 30448246 DOI: 10.1016/j.bjps.2018.05.052] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 05/09/2018] [Accepted: 05/27/2018] [Indexed: 02/04/2023]
Abstract
Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p < 0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p < 0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p < 0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p < 0.05) but increased in the 5-FU group (p < 0.05). TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas.
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Affiliation(s)
- K E Hietanen
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland; Central Finland Health Care District, Jyväskylä, Finland.
| | - T A Järvinen
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - T T Tolonen
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - H O Kuokkanen
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - I S Kaartinen
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
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17
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Helavirta I, Hyöty M, Oksanen P, Huhtala H, Haapamäki J, Aitola P. Health-Related Quality of Life after Restorative Proctocolectomy: A Cross-Sectional Study. Scand J Surg 2018; 107:315-321. [PMID: 29774794 DOI: 10.1177/1457496918772362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS: Patients undergoing restorative proctocolectomy have often suffered from active ulcerative colitis which should be remembered when assessing quality of life after operation. The aim of this study was to explore health-related quality of life after restorative proctocolectomy in those with poor or good pouch function and to compare that to patients with active or inactive ulcerative colitis and to the general population. MATERIAL AND METHODS: Altogether, 282 restorative proctocolectomy patients were investigated. The control group comprised 408 ulcerative colitis patients from the local register. Generic 15D and disease-specific inflammatory bowel disease questionnaire health-related quality of life instruments were used. Population-based data were available for 15D. Pouch function was evaluated with Öresland score and colitis activity with simple clinical colitis activity index. RESULTS: 15D results showed that patients with good pouch function had health-related quality of life similar to that of the general population. Health-related quality of life with inflammatory bowel disease questionnaire was equally good in patients with good pouch function (n = 131; 70%) and inactive colitis (n = 95; 63%), and equally impaired in patients with poor pouch function (n = 56; 30%) and active colitis (n = 18; 12%). CONCLUSION: The majority of patients had health-related quality of life comparable to that in general population. Most patients with active ulcerative colitis are likely to improve their health-related quality of life after successful surgery. These findings are important when informing colitis patients about life after surgery.
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Affiliation(s)
- I Helavirta
- 1 School of Medicine, University of Tampere, Tampere, Finland.,2 Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - M Hyöty
- 2 Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - P Oksanen
- 1 School of Medicine, University of Tampere, Tampere, Finland.,2 Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - H Huhtala
- 3 School of Health Sciences, University of Tampere, Tampere, Finland
| | - J Haapamäki
- 4 Department of Gastroenterology, Helsinki University Hospital, Helsinki, Finland
| | - P Aitola
- 2 Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
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18
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Honkanen M, Jämsen E, Karppelin M, Huttunen R, Huhtala H, Eskelinen A, Syrjänen J. The impact of preoperative bacteriuria on the risk of periprosthetic joint infection after primary knee or hip replacement: a retrospective study with a 1-year follow up. Clin Microbiol Infect 2018; 24:376-380. [DOI: 10.1016/j.cmi.2017.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 01/07/2023]
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19
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Törmänen S, Lauhkonen E, Riikonen R, Koponen P, Huhtala H, Helminen M, Korppi M, Nuolivirta K. Risk factors for asthma after infant bronchiolitis. Allergy 2018; 73:916-922. [PMID: 29105099 DOI: 10.1111/all.13347] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Five studies carried out after bronchiolitis at less than 24 months of age, with a follow-up of more than 10 years, reported that atopic dermatitis, family asthma, early-life exposure to tobacco smoke and rhinovirus aetiology were early-life risk factors for later asthma. This study evaluated the long-term outcome at 11-13 years of age of children who were hospitalized for bronchiolitis in early infancy. METHODS We previously prospectively followed 166 children hospitalized for bronchiolitis at less than 6 months of age until 5-7 years of age. The current study included a structured questionnaire, parental interviews, clinical examinations and bronchodilation test of 138 of those children at 11-13 years of age. RESULTS Respiratory syncytial virus caused 66% of the bronchiolitis cases, and nearly half of the patients were exposed to tobacco smoke in early life. Doctor-diagnosed asthma was present in 13% of the former bronchiolitis patients at 11-13 years of age. Maternal asthma was the only independently significant risk factor in early life (adjusted OR 3.45, 95% CI 1.07-11.74), as was allergic rhinitis at 5-7 years of age (adjusted OR 4.06, 95% CI 1.35-12.25). CONCLUSIONS After bronchiolitis at less than 6 months of age, the risk of doctor-diagnosed asthma at 11-13 years was about twice that of the general Finnish population. Maternal asthma was the only independently significant early-life risk factor for current asthma at 11-13 years of age.
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Affiliation(s)
- S. Törmänen
- Center for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - E. Lauhkonen
- Center for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - R. Riikonen
- Center for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - P. Koponen
- Center for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - H. Huhtala
- School of Health Sciences; Tampere University; Tampere Finland
| | - M. Helminen
- Center for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - M. Korppi
- Center for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - K. Nuolivirta
- Department of Pediatrics; Seinäjoki Central Hospital; Seinäjoki Finland
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20
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Hellevuo H, Sainio M, Huhtala H, Olkkola KT, Tenhunen J, Hoppu S. Good quality of life before cardiac arrest predicts good quality of life after resuscitation. Acta Anaesthesiol Scand 2018; 62:515-521. [PMID: 29315466 DOI: 10.1111/aas.13065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 04/21/2017] [Accepted: 12/06/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The survival rate of cardiac arrest patients is increasing. Our aim was to compare the quality of life before and after cardiac arrest and analyse the factors associated with outcome. METHODS All adult cardiac arrest patients admitted to the Tampere University Hospital intensive care unit between 2009 and 2011 were included in a retrospective follow-up study if surviving to discharge and were asked to return a questionnaire after 6 months. Data on patient demographics and pre-arrest quality of life were retrieved from medical records. Data are given as means (SD) or medians [Q1 , Q3 ]. We used logistic regression to identify factors associated with better quality of life after cardiac arrest. RESULTS Six months after cardiac arrest, 36% (79/222) were alive and 70% (55/79) of those patients completed the follow-up EuroQoL (EQ-5D) quality of life questionnaire. Median values for the EQ-5D before and after cardiac arrest were 0.89 [0.63, 1] and 0.89 [0.62, 1], respectively (P = 0.75). Only the EQ-5D prior to cardiac arrest was associated with better quality of life afterwards (OR 1.2; 95% CI 1.0-1.3; P = 0.02). CONCLUSIONS Quality of life remained good after cardiac arrest especially in those patients who had good quality of life before cardiac arrest.
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Affiliation(s)
- H. Hellevuo
- Department of Intensive Care Medicine; Tampere University Hospital and University of Tampere; Tampere Finland
| | - M. Sainio
- Department of Intensive Care Medicine; Tampere University Hospital and University of Tampere; Tampere Finland
- Emergency Medical Services; Department of Emergency Medicine; University of Turku and Turku University Hospital; Turku Finland
| | - H. Huhtala
- Faculty of Social Sciences; University of Tampere; Tampere Finland
| | - K. T. Olkkola
- Department of Anaesthesiology, Intensive Care and Pain Medicine; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - J. Tenhunen
- Department of Surgical Sciences, Anaesthesiology and Intensive Care; Uppsala University; Uppsala Sweden
| | - S. Hoppu
- Department of Intensive Care Medicine; Tampere University Hospital and University of Tampere; Tampere Finland
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21
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Miettinen SSA, Mäkinen TJ, Mäkelä K, Huhtala H, Kettunen JS, Remes V. Intraoperative Complications and Mid-Term Follow-Up of Large-Diameter Head Metal-on-Metal Total Hip Arthroplasty and Hip Resurfacing Arthroplasty. Scand J Surg 2018; 107:180-186. [PMID: 29333941 DOI: 10.1177/1457496917748220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Large-diameter head total hip arthroplasty and hip resurfacing arthroplasty were popular in Finland from 2000 to 2012 for the treatment of hip osteoarthritis. The aim of this retrospective study was to investigate the mid-term survival of large-diameter head total hip arthroplasty patients operated on in three university hospitals and to compare these results to the survival of hip resurfacing arthroplasty patients. MATERIAL AND METHODS A total of 3860 hip arthroplasties (3029 large-diameter head total hip arthroplasties in 2734 patients and 831 hip resurfacing arthroplasties in 757 patients) were operated on between January 2004 and December 2009. The mean follow-up was 4.3 years (range: 0.3-8.0 years) in the total hip arthroplasty group and 5.1 years (range: 1.7-7.9 years) in the hip resurfacing arthroplasty group. Cox multiple regression model and Kaplan-Meier survival analysis were used to study the survival of the total hip arthroplasties and the hip resurfacing arthroplasties. Intraoperative complications and reasons for revisions were also evaluated. RESULTS In Cox regression analysis, the hazard ratio for revision of hip resurfacing arthroplasty was 1.5 compared with large-diameter head total hip arthroplasty (95% confidence interval: 1.0-2.2) ( p = 0.029). The cumulative Kaplan-Meier survival rate was 90.7% at 7.7 years for the large-diameter head total hip arthroplasty (95% confidence interval: 86.8-94.6) and 92.2% at 7.6 years for hip resurfacing arthroplasty (95% confidence interval: 89.9-94.6). There were a total of 166/3029 (5.5%) intraoperative complications in the large-diameter head total hip arthroplasty group and 20/831 (2.4%) in the hip resurfacing arthroplasty group ( p = 0.001). Revision for any reason was performed on 137/3029 (4.5%) of the arthroplasties in the large-diameter head total hip arthroplasty group and 52/831 (6.3%) in the hip resurfacing arthroplasty group ( p = 0.04). CONCLUSION The mid-term survival of both of these devices was poor, and revisions due to adverse reactions to metal debris will most likely rise at longer follow-up. There were more intraoperative complications in the large-diameter head total hip arthroplasty group than in the hip resurfacing arthroplasty group.
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Affiliation(s)
- S S A Miettinen
- 1 Department of Orthopedics, Traumatology, and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - T J Mäkinen
- 2 Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - K Mäkelä
- 3 Department of Orthopedics and Traumatology, Turku University Hospital, Turku, Finland
| | - H Huhtala
- 4 School of Health Sciences, University of Tampere, Tampere, Finland
| | - J S Kettunen
- 1 Department of Orthopedics, Traumatology, and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - V Remes
- 2 Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.,5 Pihlajalinna Oy, Helsinki, Finland
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22
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Toppila‐Salmi S, Luukkainen A, Lemmetyinen R, Karjalainen J, Huhtala H, Renkonen R, Wang DY, Mäkelä MJ, Pekkanen J. Birth decade affects the sensitization pattern and asthma risk in Finnish adult population. Allergy 2017; 72:1791-1795. [PMID: 28444953 DOI: 10.1111/all.13194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 11/26/2022]
Abstract
We have previously shown that sensitizations to several types of allergens distinguish subjects with and without adult-onset asthma in Finland. The aim was to analyze how age affects sensitization and asthma risk. We used previous population-based case-control data (N=456) from Finnish adult asthma patients with one or two matched controls. Asthma was diagnosed based on a typical history of asthmatic symptoms and lung function tests. Allergic sensitization was determined by skin prick test (SPT) to 17 aeroallergens. Information on demographics was obtained by a questionnaire. Sensitization to more than one allergen type and the number of positive SPT reactions associated with younger age and asthma. Atopic subjects aged 65 and above were characterized by sensitization to only one to two allergens, with very few animal danders and without an association with asthma. Multiple sensitizations and animal dander sensitization are more common among Finnish asthmatic adults aged under 56 than among older asthmatics. Cohort studies are needed to understand timing of host-environmental interactions behind this.
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Affiliation(s)
- S. Toppila‐Salmi
- Haartman Institute University of Helsinki Helsinki Finland
- Skin and Allergy Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - A. Luukkainen
- Haartman Institute University of Helsinki Helsinki Finland
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - R. Lemmetyinen
- Haartman Institute University of Helsinki Helsinki Finland
| | - J. Karjalainen
- Allergy Centre Tampere University Hospital Tampere Finland
| | - H. Huhtala
- Faculty of Social Sciences University of Tampere Tampere Finland
| | - R. Renkonen
- Haartman Institute University of Helsinki Helsinki Finland
- HUSLAB Helsinki University Hospital Helsinki Finland
| | - D. Y. Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - M. J. Mäkelä
- Skin and Allergy Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - J. Pekkanen
- Department of Public Health University of Helsinki Helsinki Finland
- Department of Health Protection National Institute for Health and Welfare Kuopio Finland
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23
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Pekki H, Kurppa K, Mäki M, Huhtala H, Laurila K, Ilus T, Kaukinen K. Performing routine follow-up biopsy 1 year after diagnosis does not affect long-term outcomes in coeliac disease. Aliment Pharmacol Ther 2017; 45:1459-1468. [PMID: 28326597 DOI: 10.1111/apt.14048] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 01/15/2017] [Accepted: 02/26/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND A repeat biopsy is recommended, but often omitted in coeliac disease patients on a gluten-free diet. The effect of performing or not performing repeat biopsies is currently unknown. AIM To identify factors associated with and the significance of lacking biopsy for long-term outcome. Predictors and the importance of incomplete histological recovery after 1 year was investigated in re-biopsied patients. METHODS A total of 760 patients participated in a nationwide follow-up study. Medical data were gathered via interviews and patient records, and blood samples were drawn for serology. Current symptoms and well-being were assessed by validated PGWB, SF-36 and GSRS questionnaires. RESULTS Malabsorption was more common among those with a repeat biopsy (46%) than those without repeat biopsy (33%), P < 0.001, as were severe symptoms at diagnosis (24% vs. 16%, P = 0.05) and concomitant gastrointestinal (40% vs. 32%, P = 0.049) or musculoskeletal (35% vs. 27%, P = 0.023) diseases such as arthritis, osteoporosis and back pain. Repeat biopsy was more rare in subjects diagnosed in private care (11% vs. 23%, P < 0.001) or by screening (10% vs. 16%, P = 0.010). The groups were comparable as to current symptoms and dietary adherence, but those without re-biopsy were less confident of their diet (89% vs. 94%, P = 0.002) and more often seropositive on diet (14% vs. 9%, P = 0.012). They reported better SF-36 physical functioning (P = 0.043) and less pain and indigestion (P = 0.013 and P = 0.046 respectively) and total GSRS (P = 0.052) score. Incomplete mucosal recovery was predicted by more advanced histological (P < 0.001) and serological (P = 0.001) disease at diagnosis, whereas the groups did not differ in long-term adherence, symptoms, seropositivity, questionnaire scores, frequency of fractures or malignancies. CONCLUSIONS Severe disease at diagnosis predicted the record of a repeat biopsy and incomplete mucosal recovery. Neither lacking biopsy nor incomplete recovery in a relative short time span of 1 year was associated with poorer long-term outcome, although survival bias cannot be excluded.
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Affiliation(s)
- H Pekki
- The Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - K Kurppa
- Tampere Center for Child Health, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - M Mäki
- Tampere Center for Child Health, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - H Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - K Laurila
- Tampere Center for Child Health, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - T Ilus
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - K Kaukinen
- The Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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Ojala B, Nygård CH, Huhtala H, Nikkari ST. Does perceived work ability improve after a cognitive behavioral intervention program? Occup Med (Lond) 2017; 67:230-232. [DOI: 10.1093/occmed/kqx008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Luukkainen A, Seppala M, Renkonen J, Hagstrom J, Huhtala H, Rautiainen M, Myller J, Paavonen T, Ranta A, Torkkeli T, Toppila-Salmi S. Low lymphatic vessel density associates with chronic rhinosinusitis with nasal polyps. Rhinology 2017; 55:181-191. [DOI: 10.4193/rhin16.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Karhunen V, Forss H, Goebeler S, Huhtala H, Ilveskoski E, Kajander O, Mikkelsson J, Penttilä A, Perola M, Ranta H, Meurman JH, Karhunen PJ. Radiographic Assessment of Dental Health in Middle-aged Men Following Sudden Cardiac Death. J Dent Res 2016; 85:89-93. [PMID: 16373688 DOI: 10.1177/154405910608500116] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Poor oral health has been suggested to be a risk factor for myocardial infarction. To study if dental pathology might predispose to pre-hospital sudden cardiac death, and using a sum index of panoramic tomography findings, we compared the oral health of middle-aged (33–69 yrs) male victims (Helsinki Sudden Death Study) of sudden cardiac death (n = 117) with that of controls, who died of non-cardiac diseases (n = 63) or suffered unnatural sudden death (n = 120). The mean number of teeth was 15.2, and 17.4% of the men were edentulous. Frequent age-associated findings in dentate victims were fillings (79.9%), horizontal bone loss (72.1%), periapical lesions (45.6%), residual roots (38.2%), and vertical pockets (30.9%). In multivariate analysis with coronary heart disease risk factors and number of teeth as covariates, poor oral health was associated (p = 0.053) with the risk of sudden cardiac death along with age, smoking, and body mass index. This association was especially strong (p = 0.009) among victims < 50 yrs.
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Affiliation(s)
- V Karhunen
- Medical School, University of Tampere and Research Unit of Clinical Chemistry, Tampere University Hospital, Finland.
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Kerminen H, Jämsen E, Jäntti P, Huhtala H, Strandberg T, Valvanne J. How Finnish geriatricians perform comprehensive geriatric assessment in clinical practice? Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kalliomäki ML, Puolakka P, Huhtala H, Sisto T, Järvelä K. Bedside diagnosis of persistent post-sternotomy pain. Acta Anaesthesiol Scand 2016; 60:969-76. [PMID: 26919717 DOI: 10.1111/aas.12704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 01/19/2016] [Accepted: 01/23/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND The prevalence of persistent post-sternotomy pain (PPSP) varies largely and has been mainly studied using questionnaires. We decided to perform a systematic qualitative and quantitative sensory examination study on a power-calculated sample of patients who had undergone sternotomy for cardiac surgery. Pain was diagnosed as PPSP if the patient complained of sternal pain that had developed after surgery together with corresponding sensory disturbances. PATIENTS AND METHODS One hundred elective patients undergoing coronary artery bypass via sternotomy were recruited for dynamic sensory mapping 4-6 months after surgery. Sensory testing was performed using thermal rollers, a cotton stick and pinprick. The intensity of sensation was registered as a score on a numeric rating scale. The area of sensory dysfunction on the chest wall was traced onto paper and calculated with the help of a computer-based program. The patient also answered a validated pain questionnaire. RESULTS Altogether 90 patients took part in the examination. Thirteen (15.4%) of the patients had pain and formed the PPSP group, while the remaining patients formed the non-PPSP group. Both groups had sensory abnormalities over the chest wall (69% of all patients). Sensory disturbances were more common, more profound and extended over a larger skin area in the PPSP group. Furthermore, daily activity performance in the PPSP group was poorer compared to the non-PPSP group. CONCLUSION PPSP is a clinical diagnosis easily achieved using simple diagnostic tools and a medical history. Severity and extent of sensory abnormalities were found to be greater in the PPSP group.
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Affiliation(s)
- M.-L. Kalliomäki
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
| | - P. Puolakka
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
| | - H. Huhtala
- School of Health Sciences; University of Tampere; Tampere Finland
| | - T. Sisto
- Heart Centre; Tampere University Hospital; Tampere Finland
| | - K. Järvelä
- Heart Centre; Tampere University Hospital; Tampere Finland
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Pöyhönen L, Teräsjärvi J, Nuolivirta K, Vuononvirta J, Gröndahl-Yli-Hannuksela K, Kröger L, Huhtala H, Mertsola J, Ilonen J, Peltola V, Korppi M, He Q. Interleukin-10 gene promoter region polymorphisms are not associated with BCG osteitis in vaccinated infants. Int J Tuberc Lung Dis 2016; 19:1158-62. [PMID: 26459526 DOI: 10.5588/ijtld.15.0348] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Complications arising from bacille Calmette-Guérin (BCG) vaccination were recorded in a national register in Finland until 1988. In the period 1960-1988, 222 patients suffered from BCG osteitis. OBJECTIVE To evaluate whether single nucleotide polymorphisms (SNPs) in the promoter region of the gene encoding interleukin 10 (IL-10) are associated with BCG osteitis after vaccination in neonates. DESIGN Blood samples of 132 former BCG osteitis patients now aged 21-49 years were analysed in a controlled study for IL10 rs1800896 (-1082G/A), rs1800871 (-819C/T), rs1800872 (-592C/A) and rs1800890 (-3575T/A) polymorphisms. RESULTS The frequencies of genotypes of IL10 rs1800896, rs1800871, rs1800872 and rs1800890, the frequencies of variant genotypes and the frequencies of major or minor alleles did not differ between patients and controls. Furthermore, the frequencies of the eight possible combinations of the three IL10 alleles located close to each other (IL10 rs1800896, IL10 rs1800871 and IL10 rs1800872) were surprisingly similar. CONCLUSION Our results suggest that polymorphisms of the IL-10 encoding gene do not play a central role in the development of complications due to BCG vaccination, although the IL10 gene, especially IL10 rs1800896 (-1082G/A) polymorphism, is known to be associated with tuberculosis risk in Europeans and North Americans.
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Affiliation(s)
- L Pöyhönen
- Center for Child Health Research, University of Tampere and University Hospital, Tampere, Finland
| | - J Teräsjärvi
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland; Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
| | - K Nuolivirta
- Department of Paediatrics, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - J Vuononvirta
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland; Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
| | - K Gröndahl-Yli-Hannuksela
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland; Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
| | - L Kröger
- Department of Paediatrics, University Hospital, Kuopio, Finland
| | - H Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - J Mertsola
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - J Ilonen
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland; Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - V Peltola
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - M Korppi
- Center for Child Health Research, University of Tampere and University Hospital, Tampere, Finland
| | - Q He
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland; Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
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Njuma Libwea J, Kobela M, Koki Ndombo P, Syrjänen R, Huhtala H, Fointama N, Shiro K, Nohynek H, Nourti P, Palmu A. Assessing the baseline burden of otitis media in children 2 to 3 years of age for estimating the effecfs of 13-valent pneumococcal conjugate vaccine (PCV) on otitis media. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Setälä P, Kalliomäki ML, Järvelä K, Huhtala H, Sisto T, Puolakka P. Postoperative hyperalgesia does not predict persistent post-sternotomy pain; observational study based on clinical examination. Acta Anaesthesiol Scand 2016; 60:520-8. [PMID: 26659097 DOI: 10.1111/aas.12659] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/15/2015] [Accepted: 10/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Persistent post-sternotomy pain is a common problem, but the risk of developing it varies among patients. We sought to find out whether the risk of persistent post-sternotomy pain could be predicted by measuring the area of acute sensory dysfunction around the sternotomy wound. The secondary aim was to determine risk factors for persistent post-sternotomy pain. PATIENTS AND METHODS Hundred patients who were scheduled to undergo elective coronary artery bypass surgery were recruited to the study. Patients were excluded if they had undergone previous cardiac surgery or if they lacked co-operation. Preoperative pain scores were determined and the patients filled in questionnaires about depression, anxiety, and pain. The area of sensory dysfunction around the sternotomy wound was assessed by pin prick on postoperative day 4. The presence of persistent post-sternotomy pain was determined at a follow-up evaluation at 4-6 months after surgery. RESULTS The sizes of the area of hyperalgesia or overall sensory dysfunction were not associated with persistent post-sternotomy pain. Independent risk factors for persistent post-sternotomy pain were found to be smoking and high pain score on postoperative day 1. The prevalence of persistent post-sternotomy pain in our study population was 38% analyzed by only the questionnaire and 15% according to the clinical examination. CONCLUSION Measuring the area of hyperalgesia in the acute phase does not give any additional information on the risk of developing a persistent post-sternotomy pain. We do thus not recommend measuring the area in this particular group of patients. Evaluation of pain by only a questionnaire risks to overestimate the presence of persistent post-sternotomy pain as compared to clinical examination.
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Affiliation(s)
- P. Setälä
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
| | - M.-L. Kalliomäki
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
| | - K. Järvelä
- Heart Center; Tampere University Hospital; Tampere Finland
| | - H. Huhtala
- School of Health Sciences; University of Tampere; Tampere Finland
| | - T. Sisto
- Heart Center; Tampere University Hospital; Tampere Finland
| | - P. Puolakka
- Department of Anaesthesia; Tampere University Hospital; Tampere Finland
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Rimpilä V, Saaresranta T, Hosokawa K, Huhtala H, Salminen A, Polo O. Transcutaneous carbon dioxide during sleep-disordered breathing. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sandelin H, Jalanko T, Huhtala H, Lassila H, Haapala J, Helkamaa T. Translation and Validation of the Finnish Version of the Patient-Rated Wrist Evaluation Questionnaire (PRWE) in Patients with Acute Distal Radius Fracture. Scand J Surg 2015; 105:204-10. [PMID: 26503440 DOI: 10.1177/1457496915613649] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/23/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Patient-rated outcome measures have become increasingly important in clinical research. They provide research and clinical tools which can be utilized in the assessment of patient recovery and treatment efficacy. The purpose of our study was to translate and validate the original version of the PRWE form into Finnish. MATERIAL AND METHODS We conducted the translation of the PRWE questionnaire according to standardized guidelines. Patients (N = 119) with an acute distal radius fracture were recruited, and they completed the PRWE and QuickDASH questionnaires at 2 months and 4 months after the wrist injury. RESULTS The mean answering times were 52 days (standard deviation [SD] 9.8 days) and 116 days (standard deviation [SD] 14.8 days), respectively. Both the internal consistency (Cronbach's alpha) of 0.976 and the intraclass correlation coefficient (ICC) of 0.992 (95% CI 0.966-0.998) showed excellent reliability for the total PRWE score. The correlation coefficients between the total score, the subscales, and for improvement over time for PRWE and QuickDASH were excellent. The responsiveness was good with an effect size of 0.83 and a standard response mean of 1.22. CONCLUSION Our study shows that the Finnish version of the PRWE is reliable, valid, and responsive for the evaluation of pain and disability after distal radius fracture.
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Affiliation(s)
- H Sandelin
- Department of Orthopaedic Surgery and Traumatology, Töölö Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - T Jalanko
- Department of Orthopaedic Surgery, Päijät-Häme Central Hospital, Lahti, Finland
| | - H Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - H Lassila
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Haapala
- Department of Orthopaedic Surgery, Päijät-Häme Central Hospital, Lahti, Finland
| | - T Helkamaa
- Department of Orthopaedic Surgery, Peijas Hospital, Helsinki University Central Hospital, Helsinki, Finland
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Toppila-Salmi S, Huhtala H, Karjalainen J, Renkonen R, Mäkelä MJ, Wang DY, Pekkanen J. Sensitization pattern affects the asthma risk in Finnish adult population. Allergy 2015; 70:1112-20. [PMID: 26095518 DOI: 10.1111/all.12670] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is a large global variation in the sensitization pattern and its association with allergic diseases. In temperate and tropical urban environments, mite monosensitization can be the predominant cause of allergic airway diseases, whereas in other environments, polysensitization is more typical. Sensitization to mite allergens associates with asthma. However, it is suggested that mite sensitization might play a minor role in Northern Europe. The aim of the study was to analyze how sensitization pattern affects the asthma risk in Finnish adults, with a special focus on mites. METHODS A population-based case-control data (N = 523) from Finnish adult asthma patients with one or two matched controls were used. Asthma was diagnosed based on a typical history of asthmatic symptoms and lung function tests. The allergic sensitization was determined based on skin prick test (SPT) of five mites, three molds, and nine other aeroallergens. Information on demographics was obtained by a questionnaire. RESULTS The proportion of sensitization to any allergen was 55% in the asthma group and 39% in the control group (P = 0.001, OR 2.06, 95% CI = 1.35-3.14). Sensitization to animal dander, pollen, or Aspergillus fumigatus was associated with asthma. Polysensitization to more than one allergen types and the number of SPT-positive reactions associated with asthma, whereas sensitization to only one allergen type was not associated with asthma. CONCLUSIONS The large number of sensitizations to several types of allergens distinguishes subjects with asthma. Mite sensitization had little independent association with asthma in Finland.
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Affiliation(s)
- S. Toppila-Salmi
- Haartman Institute; University of Helsinki; Helsinki Finland
- Department of Allergy; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - H. Huhtala
- School of Health Sciences; University of Tampere; Tampere Finland
| | - J. Karjalainen
- Allergy Centre; Tampere University Hospital; Tampere Finland
| | - R. Renkonen
- Haartman Institute; University of Helsinki; Helsinki Finland
- HUSLAB; Helsinki University Hospital; Helsinki Finland
| | - M. J. Mäkelä
- Department of Allergy; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - D. Y. Wang
- Department of Otorhinolaryngology; National University of Singapore; Singapore Singapore
| | - J. Pekkanen
- Department of Public Health; Hjelt Institute; University of Helsinki; Helsinki Finland
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Kerminen H, Jämsen E, Jäntti P, Huhtala H, Strandberg T, Valvanne J. O-065: How Finnish geriatricians perform comprehensive geriatric assessment in clinical practice? Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30078-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Aho A, Kamata K, Jäntti V, Kulkas A, Hagihira S, Huhtala H, Yli-Hankala A. Comparison of Bispectral Index and Entropy values with electroencephalogram during surgical anaesthesia with sevoflurane †. Br J Anaesth 2015; 115:258-66. [DOI: 10.1093/bja/aev206] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2015] [Indexed: 11/13/2022] Open
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Helavirta I, Huhtala H, Hyöty M, Collin P, Aitola P. Restorative Proctocolectomy for Ulcerative Colitis in 1985-2009. Scand J Surg 2015; 105:73-7. [PMID: 26063652 DOI: 10.1177/1457496915590540] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 05/06/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Restorative proctocolectomy is the most common operation in patients with ulcerative colitis. The aim was to evaluate long-term changes in our operative treatment and early and late complications related to restorative proctocolectomy. MATERIAL AND METHODS The study comprised 352 (149 females) patients over 18 years of age with ulcerative colitis who underwent restorative proctocolectomy in 1985-2009 median follow-up time of 5 years. RESULTS The indication for surgery was active chronic colitis in 168 (47.7%), acute colitis in 159 (45.2%), and cancer or dysplasia in 25 (7.1%) patients. Ileal pouch-anal anastomosis was performed using hand-sewn anastomosis with mucosectomy in 283 patients and stapled anastomosis in 69. A shift from hand-sewn to stapler ileal pouch-anal anastomosis took place in 2005. Covering ileostomy was carried out in 133 (37.8%) patients. There were 82 (23.3%) J-pouch-related complications. The operative mortality was 0.3%. There were significantly fewer leakages and early re-operations when covering ileostomy was used than when it was omitted: 6.0% versus 16.4% (p = 0.004), 4.5% versus 11.9% (p = 0.02), respectively. There were more strictures in hand-sewn than in stapled ileal pouch-anal anastomoses (17.6% vs. 0%, p = 0.001). Pouchitis occurred at least once in 134 (38.1%) patients. CONCLUSION The ileal pouch-anal anastomosis technique used in restorative proctocolectomy had changed over the past years from hand-sewn to stapled anastomosis. Covering ileostomy seemed to protect against major complications. Pouchitis was the most common late complication.
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Affiliation(s)
- I Helavirta
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland School of Medicine, University of Tampere, Tampere, Finland
| | - H Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - M Hyöty
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - P Collin
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - P Aitola
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
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Rosti-Otajärvi E, Ruutiainen J, Huhtala H, Hämäläinen P. Relationship between subjective and objective cognitive performance in multiple sclerosis. Acta Neurol Scand 2014; 130:319-27. [PMID: 24571681 DOI: 10.1111/ane.12238] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Self- and informant reports of patients' cognitive performance are an important source of information for clinicians to consider in neuropsychological evaluation. The aim of the study was to find out whether the relationship between subjective or informant observations of cognitive deterioration and objective cognitive performance differ in patients with relapsing and progressive multiple sclerosis (MS). MATERIALS & METHODS One ninety-six MS patients (relapsing-remitting n = 138; progressive n = 58) underwent neuropsychological assessment with the Brief Repeatable Battery of Neuropsychological Tests. Subjective and informant-reported cognitive symptoms, mood, impact of the disease, and quality of life were evaluated with self-reports. According to consistency of evaluations, patients and informants were classified as accurate estimators (consistent subjective and objective cognitive performance), underestimators (subjectively but not objectively cognitively impaired), or overestimators (objectively but not subjectively cognitively impaired). RESULTS Patients' and informants' reports on patients' cognitive performance were approximately equally appropriate, slightly over half being accurate. Mood was associated with patients' subjective cognitive complaints. The relapsing group reported more subjective cognitive symptoms than the progressive group, although the objective cognitive performance did not differ between the groups. Overestimation occurred especially among patients with more severe physical disability, progressive phenotype of the disease, more pronounced cognitive impairment, and less education. CONCLUSIONS Slightly over half of patient and informant observations of cognitive deterioration were appropriate. Patients with progressive phenotype were more prone to overestimation than patients with relapsing phenotype.
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Affiliation(s)
- E. Rosti-Otajärvi
- Department of Neurology and Rehabilitation; Tampere University Hospital; Tampere Finland
| | - J. Ruutiainen
- Masku Neurological Rehabilitation Centre; Masku Finland
| | - H. Huhtala
- School of Health Sciences; Tampere University; Tampere Finland
| | - P. Hämäläinen
- Masku Neurological Rehabilitation Centre; Masku Finland
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Kajander OA, Koistinen LS, Eskola M, Huhtala H, Bhindi R, Niemela K, Jolly SS, Sheth T, Sheth T, Jolly S, Kassam S, Vijayraghavan R, Lavi S, Bhindi R, Niemela K, Kajander O, Fung A, Cheema A, Alexopoulos D, Kocka V, Cantor W, Stankovic G, Dzavik V, Della Siega A. Feasibility and repeatability of optical coherence tomography measurements of pre-stent thrombus burden in patients with STEMI treated with primary PCI. Eur Heart J Cardiovasc Imaging 2014; 16:96-107. [DOI: 10.1093/ehjci/jeu175] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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40
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Ilus T, Kaukinen K, Virta LJ, Huhtala H, Mäki M, Kurppa K, Heikkinen M, Heikura M, Hirsi E, Jantunen K, Moilanen V, Nielsen C, Puhto M, Pölkki H, Vihriälä I, Collin P. Refractory coeliac disease in a country with a high prevalence of clinically-diagnosed coeliac disease. Aliment Pharmacol Ther 2014; 39:418-25. [PMID: 24387637 DOI: 10.1111/apt.12606] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 09/29/2013] [Accepted: 12/13/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Refractory coeliac disease (RCD) is thought to be a rare disorder, but the accurate prevalence is unknown. AIM We aimed to identify the prevalence of and the risk factors for developing RCD in a Finnish population where the clinical detection rate of coeliac disease is high. METHODS The study involved 11 hospital districts in Finland where the number of treated RCD patients (n = 44), clinically diagnosed coeliac disease patients (n = 12 243) and adult inhabitants (n = 1.7 million) was known. Clinical characteristics at diagnosis of coeliac disease between the RCD patients and patients with uncomplicated disease were compared. RESULTS The prevalence of RCD was 0.31% among diagnosed coeliac disease patients and 0.002% in the general population. Of the enrolled 44 RCD patients, 68% had type I and 23% type II; in 9% the type was undetermined. Comparing 886 patients with uncomplicated coeliac disease with these 44 patients that developed RCD later in life, the latter were significantly older (median 56 vs 44 years, P < 0.001), more often males (41% vs. 24%, P = 0.012) and seronegative (30% vs. 5%, P < 0.001) at the diagnosis of coeliac disease. Patients with evolving RCD had more severe symptoms at the diagnosis of coeliac disease, including weight loss in 36% (vs. 16%, P = 0.001) and diarrhoea in 54% (vs. 38%, P = 0.050). CONCLUSIONS Refractory coeliac disease is very rare in the general population. Patients of male gender, older age, severe symptoms or seronegativity at the diagnosis of coeliac disease are at risk of future refractory coeliac disease and should be followed up carefully.
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Affiliation(s)
- T Ilus
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland
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41
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Hosokawa K, Sariola R, Huhtala H, Polo O. Subjective sleepiness is not required to adhere to cpap therapy. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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42
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Korhonen T, Kuukasjärvi T, Huhtala H, Alarmo EL, Holli K, Kallioniemi A, Pylkkänen L. The impact of lobular and ductal breast cancer histology on the metastatic behavior and long term survival of breast cancer patients. Breast 2013; 22:1119-24. [DOI: 10.1016/j.breast.2013.06.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022] Open
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43
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Salonen P, Rantanen A, Kellokumpu-Lehtinen PL, Huhtala H, Kaunonen M. The quality of life and social support in significant others of patients with breast cancer--a longitudinal study. Eur J Cancer Care (Engl) 2013; 23:274-83. [PMID: 24237363 DOI: 10.1111/ecc.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate prospectively the quality of life (QOL) and received social support from the network and nurses in significant others of breast cancer patients and identify factors predicting negative changes in their QOL within 6 months. The quasi-random longitudinal study conducted for the breast cancer patients and their significant others. Patients were quasi-randomised to supportive intervention group (via telephone at baseline and face-to-face at follow-up) and control group. This paper reports results of significant others (N = 165). The QOL data were collected using the Quality of Life Index - Cancer Version (QLI-CV). Support from network in aid increased the risk of negative changes in health and functioning. Retired significant others had a greater risk of more negative changes in their global and in socio-economic QOL than other. Relatives had a smaller risk to negative changes both in their global and in their family QOL than spouses/partners/boyfriends of patients with breast cancer. QOL of the significant others should be supported more intensively and enhanced by the use of individually tailored methods on the basis of significant others and their family needs.
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Affiliation(s)
- P Salonen
- Tauh Division of Administrative Services, Tampere University Hospital, Tampere, Finland
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44
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Ketola S, Lehtinen J, Rousi T, Nissinen M, Huhtala H, Konttinen YT, Arnala I. No evidence of long-term benefits of arthroscopicacromioplasty in the treatment of shoulder impingement syndrome: Five-year results of a randomised controlled trial. Bone Joint Res 2013; 2:132-9. [PMID: 23836479 PMCID: PMC3728648 DOI: 10.1302/2046-3758.27.2000163] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objectives To report the five-year results of a randomised controlled trial
examining the effectiveness of arthroscopic acromioplasty in the
treatment of stage II shoulder impingement syndrome. Methods A total of 140 patients were randomly divided into two groups:
1) supervised exercise programme (n = 70, exercise group); and 2)
arthroscopic acromioplasty followed by a similar exercise programme
(n = 70, combined treatment group). Results The main outcome measure was self-reported pain as measured on
a visual analogue scale. At the five-year assessment a total of
109 patients were examined (52 in the exercise group and 57 in the
combined treatment group). There was a significant decrease in mean
self-reported pain on the VAS between baseline and the five-year follow-up
in both the exercise group (from 6.5 (1 to 10) to 2.2 (0 to 8);
p < 0.001) and the combined treatment group (from 6.4 (2 to 10)
to 1.9 (0 to 8); p < 0.001). The same trend was seen in the secondary
outcome measures (disability, working ability, pain at night, Shoulder
Disability Questionnaire and reported painful days). An intention-to-treat
analysis showed statistically significant improvements in both groups
at five years compared with baseline. Further, improvement continued
between the two- and five-year timepoints. No statistically significant differences
were found in the patient-centred primary and secondary parameters
between the two treatment groups. Conclusions Differences in the patient-centred primary and secondary parameters
between the two treatment groups were not statistically significant,
suggesting that acromioplasty is not cost-effective. Structured
exercise treatment seems to be the treatment of choice for shoulder
impingement syndrome.
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Affiliation(s)
- S Ketola
- Coxa Hospital for Joint Replacement, Biokatu6b, P.O. Box 652, FI-33101Tampere, Finland
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45
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Korhonen L, Kondrashova A, Tauriainen S, Haapala AM, Huhtala H, Ilonen J, Simell O, Knip M, Lönnrot M, Hyöty H. Enterovirus infections in early childhood and the risk of atopic disease - a nested case-control study. Clin Exp Allergy 2012; 43:625-32. [DOI: 10.1111/cea.12068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 10/27/2012] [Accepted: 11/26/2012] [Indexed: 11/27/2022]
Affiliation(s)
| | - A. Kondrashova
- Department of Virology; School of Medicine; University of Tampere; Tampere; Finland
| | - S. Tauriainen
- Department of Virology; School of Medicine; University of Tampere; Tampere; Finland
| | - AM. Haapala
- Fimlab Medical Laboratories; Clinical Microbiology; Tampere; Finland
| | - H. Huhtala
- School of Health Sciences; University of Tampere; Tampere; Finland
| | | | - O. Simell
- Department of Pediatrics; University of Turku; Turku; Finland
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Hakala T, Kellokumpu-Lehtinen P, Kholová I, Holli K, Huhtala H, Sand J. Rising Incidence of Small Size Papillary Thyroid Cancers with No Change in Disease-Specific Survival in Finnish Thyroid Cancer Patients. Scand J Surg 2012; 101:301-6. [DOI: 10.1177/145749691210100415] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The aim of this study was to investigate trends in the incidence, diagnostics, treatment and survival of thyroid cancer in Tampere University Hospital (TAUH) region in recent decades. Material and Methods: New thyroid cancer cases from 1981 to 2002 were ascertained from the Finnish Cancer Registry. Follow-up data was collected from medical records of TAUH. Differentiated thyroid cancer (DTC; consisting of papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC)) patients' data was analyzed and divided into two equal time periods (1981–1991 and 1992–2002). Results: The total amount of thyroid cancer cases was 553, of which 427 (77%) were papillary and 72 (13%) follicular. Thyroid cancer was four times more common in females than in males and the median age at the time of diagnosis was 52 years. The incidence of DTC was 4.5/100 000 in the earlier group and 6.0/100 000 in the later group (IRR 1.33, CI 1.11–1.60). The proportion of papillary thyroid cancer rose from 81% to 89% (p = 0.02) in two study periods. Median tumour size became smaller, from 25 mm to 15 mm (p < 0.001). Surgery became more radical as total thyroidectomies were performed almost exclusively on the later group (p < 0.001). Median cumulative dose of radioiodine (I131) therapy was higher in the later group (p = 0.04). There was no difference in number of cancer recurrences (p = 0.54). The prognosis of DTC was good; 10-year disease-specific survival was 92% in the earlier group and 94% in the later group (p = 0.43). Conclusions: The incidence of thyroid cancer has risen and proportion of papillary cancer has increased, however, median size of tumour has decreased. No difference was seen in either all-cause or disease-specific survival.
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Affiliation(s)
- T. Hakala
- Department of Surgery, Tampere University Hospital, Tampere, Finland
- University of Tampere, Medical School, Tampere, Finland
| | - P. Kellokumpu-Lehtinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
- University of Tampere, Medical School, Tampere, Finland
| | - I. Kholová
- Fimlab Laboratories, Pathology, Tampere University Hospital, Tampere, Finland
| | - K. Holli
- University of Tampere, Medical School, Tampere, Finland
| | - H. Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - J. Sand
- University of Tampere, Medical School, Tampere, Finland
- Division of Surgery, Gastroenterology and Oncology, Tampere University Hospital, Tampere, Finland
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47
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Karppelin M, Siljander T, Huhtala H, Aromaa A, Vuopio J, Hannula-Jouppi K, Kere J, Syrjänen J. Recurrent cellulitis with benzathine penicillin prophylaxis is associated with diabetes and psoriasis. Eur J Clin Microbiol Infect Dis 2012; 32:369-72. [DOI: 10.1007/s10096-012-1751-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/05/2012] [Indexed: 11/29/2022]
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48
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Skyttä ET, Honkanen PB, Eskelinen A, Huhtala H, Remes V. Fewer and older patients with rheumatoid arthritis need total knee replacement. Scand J Rheumatol 2012; 41:345-9. [DOI: 10.3109/03009742.2012.681061] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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49
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Saarinen JT, Sillanpää N, Rusanen H, Hakomäki J, Huhtala H, Lähteelä A, Dastidar P, Soimakallio S, Elovaara I. The mid-M1 segment of the middle cerebral artery is a cutoff clot location for good outcome in intravenous thrombolysis. Eur J Neurol 2012; 19:1121-7. [PMID: 22416757 DOI: 10.1111/j.1468-1331.2012.03689.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE We studied the impact of the location of the thrombus (internal carotid artery, proximal M1 segment, distal M1 segment, M2 segment, and M3 segment of the middle cerebral artery) in predicting the clinical outcome of patients treated with intravenous thrombolytic therapy (<3 h) in a retrospective cohort. METHODS Anterior circulation thrombus was detected with computed tomography angiography in 105 patients. Baseline clinical and radiological information was collected and entered into logistic regression analysis to predict favorable clinical outcome (3-month modified Rankin Scale from 0 to 2 was a primary outcome measure). RESULTS Three months after stroke, there was a significant increase in mortality (32% vs. 3%, P < 0.001) and functional dependency (82% vs. 29%, P < 0.001) in patients with internal carotid artery or proximal M1 segment of the middle cerebral artery thrombus compared to a more distal occlusion. In the regression analysis, after adjusting for National Institutes of Health Stroke Scale, age, sex, and onset-to-treatment time, the clot location was an independent predictor of good clinical outcome (P = 0.001) and exhibited dose-response type behavior when moving from a proximal vessel position to a more distal one. When the location was dichotomized, a cutoff between the proximal and the distal M1 segments best differentiated between good and poor clinical outcome (OR = 16.0, 95% CI 3.9-66.2). CONCLUSIONS The outcome of acute internal carotid artery or proximal M1 segment of the middle cerebral artery occlusion is generally poor even if treated with intravenous thrombolysis. Alternative revascularization strategies should be considered. Vascular imaging at the admission is required to guide this decision.
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Affiliation(s)
- J T Saarinen
- Department of Neurology, Tampere University Hospital, Tampere, Finland.
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50
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Honkanen T, Luukkainen A, Lehtonen M, Paavonen T, Karjalainen J, Hurme M, Myller J, Huhtala H, Rautiainen M, Toppila-Salmi S. Indoleamine 2,3-dioxygenase expression is associated with chronic rhinosinusitis with nasal polyps and antrochoanal polyps. Rhinology 2011; 49:356-63. [PMID: 21858269 DOI: 10.4193/rhino10.191] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic rhinosinusitis without and with nasal polyps (CRSwNP and CRSsNP), and antrochoanal polyps are different phenotypes with different pathomechanisms. Indoleamine 2,3-dioxygenase (IDO) is an enzyme expressed in many cells involved in the catabolism of the essential amino acid tryptophan to kynurenine. IDO might have a role in allergic airway inflammation. The aim was to evaluate if IDO expression is associated with CRSsNP, CRSwNP, or ACP. One hundred fifty specimens from the nasal cavity and sinus mucosa were immunohistochemically stained with mAb anti-IDO. The expression of epithelial and leukocyte IDO was associated with CRSwNP and ACP. The presence of ASA intolerance, asthma, atopy, smoking and use of medication did not significantly change the results. The different expression of IDO could putatively indicate the differences in the pathomechanisms of CRSsNP, CRSwNP and ACP. Further studies on the role of IDO in upper airways pathologies are required.
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Affiliation(s)
- T Honkanen
- Department of Pathology, University of Tampere, Tampere, Finland
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