Long-Term Results of Intralesional Triamcinolone Acetonide Injections in Keloid Treatment

Background: Intralesional triamcinolone acetonide (TAC) injections are often used as the first alternative for treating keloid scarring. The long-term outcome of this treatment is unclear. Also, undesirable local side effects have been recognized in clinical work and literature but they have been labelled as harmless and rare. Methods: We documented the long-term outcome of intralesional TAC injections in the treatment of keloid scars in Tampere University Hospital. The main objectives were to investigate the remission rate and the occurrence of local side effects. We assessed 105 patients (46 women, 59 men) with 138 TAC treated keloid scars at the outpatient clinic. The keloids were photographed and assessed with Patient and Observer Scar Assessment Scale (POSAS). Results: Of the 138 keloids, 90 (65%) were clinically in remission. Local side effects, including atrophy of the skin or the subdermal fat, telangiectasia and cortisone traces, occurred in 55% of the cases. The number of injections did not correlate with remission rate or the occurrence of local side effect. ROC curve analysis showed that surface area >620 mm2 was a prognostic factor for not responding to TAC treatment. Conclusion: According to this study, intralesional TAC injections seem to be effective in the treatment of small keloids but not in larger than 620 mm2. Local side effects were more frequent than previously reported and occurred even after just 1 injection. The side effects seem to be permanent in nature.fi=vertaisarvioitu|en=peerReviewed

Active lifestyle as a reflection of cognitive reserve : The Modified Cognitive Reserve Scale

Cognitive reserve (CR) refers to individual differences in cognitive processing that can protect from and compensate for functional decline related to ageing or brain pathology. The CR theory postulates that attaining an active and cognitively stimulating lifestyle can accumulate CR. The Cognitive Reserve Scale (CRS) is a questionnaire that measures lifelong attainment in leisure activities. This cross-sectional study aimed to examine the usefulness, validity and reliability of a modified Finnish translation of the CRS, the Modified Cognitive Reserve Scale (mCRS). The mCRS consists of 20 questions concerning studying and information seeking, hobbies and social relationships during three age phases: young adulthood (18-35 years), adulthood (36-64 years) and late adulthood (>= 65 years). A group of 69 neurologically healthy adults aged 26-78 filled the mCRS and completed a neuropsychological test battery. We examined the internal consistency of the mCRS and associations between the mCRS, demographical variables and cognitive performance. The mCRS was normally distributed and showed satisfactory internal consistency (Cronbach's alpha 0.81). It was significantly associated with occupation (ԑ(2) = 0.14) and education (rho = 0.51) but not with age or gender. There were significant associations between the mCRS and verbal reasoning (rho = .306), visual reasoning (r = .319), learning (r = .293) and inhibition (rho = -.368). Our study suggests that the mCRS is a reliable and valid method to assess lifelong leisure activity. The mCRS is related to other factors that enhance CR, occupation and education, and associated with cognitive performance of healthy adults. It provides an easily administrable means to assess lifelong attainment in stimulating leisure activities.Peer reviewe

Toisella asteella toimien : opas oppilaitoksen opiskeluhuoltoryhmälle

Opiskeluhuoltoryhmällä on tärkeä tehtävä toisen asteen oppilaitoksen hyvinvointityössä. Opiskeluhuoltoryhmä vastaa opiskeluhuollon kokonaisuuden suunnittelusta, toteutuksesta ja arvioinnista oppilaitoksessa. Tärkeänä tavoitteena on yhteisöllisellä työllä ehkäistä opiskelijoiden hyvinvointia heikentäviä ongelmia. Tämä opas on laadittu tukemaan opiskeluhuoltoryhmien toimintaa toisen asteen oppilaitoksissa. Oppaassa esiteltävä toimintamalli yhdenmukaistaa ryhmien työskentelyä ja varmistaa yhteisöllisen opiskeluhuoltotyön toteutumisen entistä tasalaatuisempana. Toimintamallissa korostuu opiskelijoiden ja huoltajien osallisuuden lisääminen erityisesti yhteisöllisessä opiskeluhuoltotyössä. Opas on suunnattu ensisijaisesti toisen asteen oppilaitoksissa toimiville rehtoreille ja johtajille, opetushenkilöstölle ja opiskeluhuoltopalvelujen ammattilaisille sekä heidän yhteistyötahoilleen. Opas soveltuu esimerkiksi opiskeluhuoltoryhmän jäsenten perehdyttämiseen. Myös opiskelijat ja huoltajat saavat oppaasta kokonaiskuvan opiskeluhuoltoryhmän työskentelystä ja omasta roolistaan siinä