Health Behavior and Self-Assessed Health Among Some Long-Term Unemployed Living in Turku, Finland

Background: A number of previous studies have concluded that long-term unemployment is destructive to health.Objective: This study examined health behavior and self-assessed health of some long-term unemployed persons living in the city of Turku, in Southwestern Finland.Methodology: The qualitative data were collected from February to March 2016 from 40 long-term unemployed men and women, aged between 31 to 63 years.Results: Of the participants 85% (n=34) reported that their long-term unemployment situation had had a negative impact on their health. There were 95% (n=36) who needed medical care because of their health condition. There were 59% (n=24) who were not satisfied with the healthcare and social services compared to 49% (n=16) who were satisfied with the services.Conclusion: There were more single men than single women among the participants. Half of the participants had a profession of which the women constituted the majority. Several participants were suffering from a chronic disease. The participants were not satisfied of their lives and attributed their health behavior and poor health conditions to their long-term unemployment situation. They were not satisfied also with the healthcare and social services provided to them.</div

Maternal risk factors for congenital limb deficiencies : A population-based case-control study

Background Risk factors for congenital limb deficiencies are poorly understood. Objective To investigate risk factors for congenital limb deficiencies. Methods We conducted a nationwide population-based case-control (1:5) study in Finland, using national registers on congenital anomalies, births, and induced abortions, cross-linked with data on maternal prescription medicine use obtained from the registers on Reimbursed Drug Purchases and Medical Special Reimbursements. Five hundred and four children with limb deficiencies (241 isolated, 181 syndromic, and 82 other associated anomalies) were identified, and 2,520 controls were matched to cases on residence and year of pregnancy. Non-syndromic cases (n = 323) were subdivided into longitudinal (n = 120), transverse (n = 123), intercalary (n = 24), mixed (n = 18), and unknown (n = 38) deficiencies. Results Pregestational diabetes was associated with all limb deficiencies (adjusted odds ratio [OR] 12.71, 95% confidence interval [CI] 2.37, 68.25) and with isolated (OR 11.42, 95% CI 2.00, 64.60) deficiencies. Primiparity was associated with increased risk of congenital limb deficiencies among all cases (OR 1.49, 95% CI 1.15, 1.93), isolated cases (OR 1.46, 95% CI 1.09, 1.96), and among cases with longitudinal (OR 1.90, 95% CI 1.24, 2.90) and transverse deficiencies (OR 1.75, 95% CI 1.13, 2.70). Young maternal age (= 35 years) was associated with syndromic (OR 1.82, 95% CI 1.19, 2.78) and transverse deficiencies (OR 1.94, 95% CI 1.06, 3.57). Maternal antiepileptic medication was associated with all (OR 5.77, 95% CI 1.75, 19.04) and with isolated cases (OR 3.83, 95% CI 1.02, 14.34). Conclusions It is important that pregnant women taking medications, especially antiepileptics, or women with pregestational diabetes are carefully monitored with regard to the occurrence and risk of limb deficiencies in the fetus.Peer reviewe

Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures

Introduction: No single tool is able to distinguish fallers from non-fallers. The aim of this study was to detect subacute stroke inpatients at higher risk for falls, predictors for the number of falls and near falls and the impact of these incidents on functional outcome.Methods: An observational prospective cohort study comparing clinical differences between non-fallers, onetime and repeat fallers. Bivariate and multivariate Poisson regression analyses with length of stay as an offset variable were conducted.Results: Fallers had mostly intermediate level of impairment and disability (NIHSS, FIM, mRS, the ICF minimal generic data set). The onetime fallers who were oldest, most disabled and most often institutionalised achieved the same functional improvement as the non-fallers, however, after significantly longer inpatient rehabilitation. The repeat fallers who were youngest and had the longest rehabilitation in-stay, achieved equal functioning as the non-fallers having faster motor gain and the greatest overall functional improvement compared to the other two subgroups.Conclusions: Right hemispheric stroke, previous myocardial infarction and shorter time from stroke onset were independent predictors for the number of incidents. In the future, larger studies are recommended to investigate fall rate and different severities of incidents, falls and near falls separately

Short-term and one-year outcome of infective endocarditis in adult patients treated in a Finnish teaching hospital during 1980–2004

<p>Abstract</p> <p>Background</p> <p>Previous studies on factors predicting the prognosis of infective endocarditis have given somewhat conflicting results. Our aim was to define the factors predicting the outcome of patients treated in a Finnish teaching hospital.</p> <p>Methods</p> <p>A total of 326 episodes of infective endocarditis in 303 patients treated during 1980–2004 were evaluated for short-term and 1-year outcome and complications.</p> <p>Results</p> <p>Infection of 2 native valves and the occurrence of neurological complications, peripheral emboli, or heart failure significantly predicted both in-hospital and 1-year mortality, while age ≥65 years or the presence of a major criterion or vegetation on echocardiography predicted death within 1 year. A significant trend was observed between the level of serum C-reactive protein (CRP) on admission and both the short-term and 1-year outcome. In the patients who had CRP values ≥100 mg/l on admission, the hazard ratio for in-hospital death was 2.9-fold and the hazard ratio for 1-year death was 3.9-fold as compared to those with lower CRP values. Male sex and age < 64 years significantly predicted a need for both in-hospital and 1-year surgery, as did the development of heart failure or the presence of a major criterion or vegetation on echocardiography. Peripheral emboli were associated with a need for in-hospital surgery, while <it>Streptococcus pneumoniae </it>as the causative agent or infection of 2 native valves predicted a need for surgery within 1 year from admission.</p> <p>Conclusion</p> <p>Some of the factors (e.g. heart failure, neurological complications, peripheral emboli) predicting a poor prognosis and/or need for surgery were the same observed in previous studies. A new finding was that high CRP values (≥100 mg/l) on admission significantly predicted both short-term and 1-year mortality.</p

Impact of sphincter lesions and delayed sphincter repair on sacral neuromodulation treatment outcomes for faecal incontinence : results from a Finnish national cohort study

PurposeThe aim of this multicentre study was to analyse the effects of patent sphincter lesions and previous sphincter repair on the results of sacral neuromodulation (SNM) treatment on patients with faecal incontinence (FI).MethodsPatients examined by endoanal ultrasound (EAUS) with FI as the indication for SNM treatment were included in the study. Data was collected from all the centres providing SNM treatment in Finland and analysed for differences in treatment outcomes.ResultsA total of 237 patients treated for incontinence with SNM had been examined by EAUS. Of these patients, 33 had a history of previous delayed sphincter repair. A patent sphincter lesion was detected by EAUS in 128 patients. The EAUS finding did not influence the SNM test phase outcome (p=0.129) or the final treatment outcome (p=0.233). Patient's history of prior sphincter repair did not have a significant effect on the SNM test (p=0.425) or final treatment outcome (p=0.442).ConclusionsResults of our study indicate that a sphincter lesion or previous sphincter repair has no significant effect on the outcome of SNM treatment. Our data suggests that delayed sphincter repair prior to SNM treatment initiation for FI is not necessary.Peer reviewe

Maternal risk factors for congenital limb deficiencies: A population-based case-control study

Background Risk factors for congenital limb deficiencies are poorly understood.Objective To investigate risk factors for congenital limb deficiencies.Methods We conducted a nationwide population-based case-control (1:5) study in Finland, using national registers on congenital anomalies, births, and induced abortions, cross-linked with data on maternal prescription medicine use obtained from the registers on Reimbursed Drug Purchases and Medical Special Reimbursements. Five hundred and four children with limb deficiencies (241 isolated, 181 syndromic, and 82 other associated anomalies) were identified, and 2,520 controls were matched to cases on residence and year of pregnancy. Non-syndromic cases (n = 323) were subdivided into longitudinal (n = 120), transverse (n = 123), intercalary (n = 24), mixed (n = 18), and unknown (n = 38) deficiencies.Results Pregestational diabetes was associated with all limb deficiencies (adjusted odds ratio [OR] 12.71, 95% confidence interval [CI] 2.37, 68.25) and with isolated (OR 11.42, 95% CI 2.00, 64.60) deficiencies. Primiparity was associated with increased risk of congenital limb deficiencies among all cases (OR 1.49, 95% CI 1.15, 1.93), isolated cases (OR 1.46, 95% CI 1.09, 1.96), and among cases with longitudinal (OR 1.90, 95% CI 1.24, 2.90) and transverse deficiencies (OR 1.75, 95% CI 1.13, 2.70). Young maternal age (= 35 years) was associated with syndromic (OR 1.82, 95% CI 1.19, 2.78) and transverse deficiencies (OR 1.94, 95% CI 1.06, 3.57). Maternal antiepileptic medication was associated with all (OR 5.77, 95% CI 1.75, 19.04) and with isolated cases (OR 3.83, 95% CI 1.02, 14.34).Conclusions It is important that pregnant women taking medications, especially antiepileptics, or women with pregestational diabetes are carefully monitored with regard to the occurrence and risk of limb deficiencies in the fetus.</p

Benign proliferative epithelial lesions of oral mucosa are infrequently associated with α‐, β‐, or γ human papillomaviruses

BackgroundOral papillomas and verruca vulgaris have been associated with human papillomavirus (HPV) infection. However, approximately half of these have remained HPV‐negative when tested for mucosal HPV genotypes. In this study, we evaluated presence of α‐, β‐, and γ‐HPVs in benign papillary and verrucous lesions.MethodsEighty‐three clinical lesions with suspected HPV etiology were analyzed for HPV types of genus α (n = 24), β (n = 46), and γ (n = 52). Immunohistochemistry was used for p16 as a possible surrogate marker of high‐risk HPV, accompanied by Ki‐67 proliferation marker.ResultsAltogether, α‐HPVs were detected in 6.4%, β‐HPVs in 2.4%, and γ‐HPV in 4.8%. The following genotypes were identified: HPV6, 8, 11, 16, 22, 161, and 170. Neither Ki‐67 nor p16 positivity alone were associated with HPV but combined staining showed significant inverse association (P = .042).ConclusionHPV infection is found only in a minority of benign verrucous and papillary oral lesions, with the predominance of α‐HPVs.</div

Association between Deep Gray Matter Changes and Neurocognitive Function in Mild Cognitive Impairment and Alzheimer’s Disease: A Tensor-Based Morphometric MRI Study

Background Atrophy of deep gray matter (DGM) has been associated with a risk of conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD) and the degree of cognitive impairment. However, specific knowledge of the associations between degenerative DGM changes and neurocognitive functions remains scarce.Objectives To examine degenerative DGM changes and evaluate their association with neurocognitive functions.Method We examined DGM volume changes with tensor-based morphometry (TBM) and analyzed the relationships between DGM changes and neurocognitive functions in the control (n =58), MCI (n = 38) and AD (n = 58) groups with multiple linear regression analyses.Results In all DGM areas, the AD group had the largest TBM volume changes. The differences in TBM volume changes were larger between the control group and the AD group than between the other pairs of groups. In the AD group, volume changes of the right thalamus were significantly associated with episodic memory, learning and semantic processing. Significant or trend-level associations were identified between the bilateral caudate nucleus changes and episodic memory as well as semantic processing. In the control and MCI groups, very few significant associations emerged.Conclusions Atrophy of the DGM structures, especially the thalamus and caudate nucleus is related to cognitive impairment in AD. DGM atrophy is associated with tests reflecting both subcortical and cortical cognitive functions. </p

Validation of the individualized metabolic surgery score for bariatric procedure selection in the merged data of two randomized clinical trials (SLEEVEPASS and SM-BOSS).

Background: LSG and LRYGB are globally the most common bariatric procedures. IMS score categorizes T2D severity (mild, moderate, and severe) based on 4 independent preoperative predictors of long-term remission as follows: T2D duration, number of diabetes medications, insulin use, and glycemic control. IMS score has not been validated in a randomized patient cohort.Objectives: To assess the feasibility of individualized metabolic surgery (IMS) score in facilitating procedure selection between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) for patients with severe obesity and type 2 diabetes (T2D).Setting: Merged individual patient-level 5-year data of 2 large randomized clinical trials (SLEEVEPASS and SM-BOSS [Swiss Multicenter Bypass or Sleeve Study]).Methods: IMS score was calculated for study patients and its performance was analyzed.Results: One hundred thirty-nine out of 155 patients with T2D had available preoperative data to calculate IMS score as follows: mild stage (n = 41/139), moderate stage (n = 77/139), severe stage (n = 21/139). At 5 years, 135 (87.1%, 67 LSG/68 LRYGB) were available for follow-up and 121 patients had both pre- and postoperative data. Diabetes remission rates according to preoperative IMS score were as follows: mild stage 87.5% (n = 14/16) after LSG and 85.7% (n = 18/21) after LRYGB (P = .999), moderate stage 42.9% (n = 15/35) and 45.2% (n = 14/31) (P = .999), and severe stage 18.2% (n = 2/11) and 0% (n = 0/7) (P = .497), respectively. The T2D remission rate varied significantly between the stages as follows: mild versus moderate odds ratio (OR) 8.3 (95% CI, 2.8-24.0; P Conclusions: In our study, remission rates of T2D were not statistically different after LSG and LRYGB among all patients and among patients with mild, moderate, and severe diabetes stratified by the IMS score. However, the study may be underpowered to detect differences due to small number of patients in each subgroup. IMS score seemed to be useful in predicting long-term T2D remission after bariatric surgery.</p

Reduced Fluoroquinolone Susceptibility in Salmonella enterica Isolates from Travelers, Finland

We tested the fluoroquinolone susceptibility of 499 Salmonella enterica isolates collected from travelers returning to Finland during 2003–2007. Among isolates from travelers to Thailand and Malaysia, reduced fluoroquinolone susceptibility decreased from 65% to 22% (p = 0.002). All isolates showing nonclassical quinolone resistance were from travelers to these 2 countries