114 research outputs found

    Prognostic factors in childhood acute lymphoblastic leukemia (ALL)

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    ”A Change Is Gonna Come” – Avoimen tieteen palveluita rakentamassa Turun yliopiston kirjastossa

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    Yliopistojen toimintaympäristö on muuttunut monin tavoin 2010-luvulla. Sen myötä tutkimuksen arvioinnille, näkyvyydelle ja vaikuttavuudelle asettavat tavoitteita niin yhteiskunnalliset päättäjät kuin yliopistot itse. Yliopistokirjastoissa tämä näkyy siinä, että luodaan uusia tehtäviä ja jo olemassa olevia tehtäviä uudistetaan, kuten julkaisutiedonhallinta, metriikka- ja arviointipalvelut sekä avoimen tieteen palvelut

    Churg-Strauss Syndrome as an Unusual Aetiology of Stroke with Haemorrhagic Transformation in a Patient with No Cardiovascular Risk Factors

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    Background: We present here a case of haemorrhagic brain infarction in a middle-aged and physically active male, who had never smoked. This case report aims to remind the internist and neurologist to bear in mind unusual aetiologies of brain infarcts in patients without classical cardiovascular risk factors. Case Description: A 49-year-old male with pulmonary asthma and a prior history of nasal polyps had a wake-up stroke with left-sided symptoms and speech disturbance. A head MRI and MR angiography revealed a recent haemorrhagic infarct in the right putamen and corona radiata. The left hemiparesis progressed to sensory-motor hemiplegia on the 4th day. In the head CT, it was shown that the haemorrhagic infarct had progressed to a large haematoma. A pansinusitis was also diagnosed. The aetiological investigations revealed a minor atrial septal defect (ASD) with shunting and a heterozygotic clotting factor V R506Q mutation. A remarkable blood eosinophilia of 9.80 E9/l (42%) together with fever, sinusitis, wide-spread bilateral nodular pulmonary infiltrates that did not respond to wide-spectrum antimicrobial treatment, positive anti-neutrophilic cytoplasmic antibodies, a high myeloperoxidase antibody level and slightly positive anti-proteinase 3 antibodies suggested the diagnosis of Churg-Strauss syndrome. These inflammatory symptoms and findings promptly responded to treatment with corticosteroids and cyclophosphamide. Conclusions: Even after the concomitant findings of the low risk factors, i.e. small ASD and heterozygotic clotting factor mutation, continued search for the final aetiology of stroke revealed Churg-Strauss syndrome, which was the key to the treatment

    Improving the Public–Public Partnership between a Rescue Department and an Integrated Social and Health Care Organization

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    Public social and health care organizations everywhere are facing challenges caused by an aging population, declining birth rates, and urbanization. To address these challenges, innovative operating models and flexible IT solutions supporting collaboration between public-sector organizations are required. Our paper introduces an example of a progressive collaboration model between the Rescue Department of South Karelia (EKP) and South Karelia social and health care district (Eksote), which are frontrunners in the synergy-producing cooperation of rescue board services at the rescue department level with social and health services. The purpose of our qualitative case study is to investigate how Eksote and EKP could further strengthen their public-public partnership (PuP) to improve regional risk management by jointly planning and executing preventive actions and services. The main objectives are to: 1) understand the reasoning behind and the success factors of a public-public partnership; 2) investigate how a joint customer and process management system could support the partnership between a social and health care organization and a rescue department; and 3) identify ways to improve the public-public partnership between a social and health care organization and a rescue department. This study builds on the existing literature on public-public partnerships by incorporating a customer and process management system into the partnership between a social and health care organization and a rescue department. The empirical data were collected via 16 semi-structured interviews conducted between June 2020 and April 2021. The results indicate that the public sector must determine new and innovative ways of working together to overcome the challenges prevalent in the current operational environment. To support collaborative actions and processes between social and health care organizations and rescue departments, actions are needed on national, regional, organizational, and professional levels. As the public sector is facing similar challenges everywhere, the results can be utilized in Finland and in the international setting

    Suitability of random forest analysis for epidemiological research: Exploring sociodemographic and lifestyle-related risk factors of overweight in a cross-sectional design.

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    Aims: Factors that contribute to the development of overweight are numerous and form a complex structure with many unknown interactions and associations. We aimed to explore this structure (i.e. the mutual importance or hierarchy of sociodemographic and lifestyle-related risk factors of being overweight) using a machine-learning technique called random forest (RF). The results were compared with traditional logistic regression (LR) analysis. Methods: The cross-sectional FINRISK 2007 Study included 4757 Finns (aged 25-74 years). Information on participants' lifestyle and sociodemographic characteristics were collected with questionnaires. Diet was assessed, using a validated food-frequency questionnaire. Height and weight were measured. Participants with a body mass index (BMI) 25 kg/m(2) were classified as overweight. R-statistical software was used to run RF analysis (randomForest') to derive estimates for variable importance and out-of-bag error, which were compared to a LR model. Results: In total, 704 (32%) men and 1119 (44%) women had normal BMI, whereas 1502 (69%) men and 1432 (57%) women had BMI 25. Estimated error rates for the models were similar (RF vs. LR: 42% vs. 40% for men, 38% vs. 35% for women). Both models ranked age, education and physical activity as the most important risk factors for being overweight, but RF ranked macronutrients (carbohydrates and protein) as more important compared to LR. Conclusions: RF did not demonstrate higher power in variable selection compared to LR in our study. The features of RF are more likely to appear beneficial in settings with a larger number of predictors.Peer reviewe

    Syöpälääketutkimus lasten lääketutkimuksen eturintamassa

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    Teema : lastenlääkkeet. English summar

    Mitä uutta Ewingin sarkooman hoidossa?

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    Teema : luukasvaimet. English summaryPeer reviewe

    Moniresistenttien ongelmamikrobien aiheuttamat hoitoon liittyvät infektiot Suomessa vuonna 2011

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    Lähtökohdat Moniresistenttien mikrobien aiheuttamien hoitoon liittyvien oireisten infektioiden määrästä Suomessa ei ole tarkkaa tietoa. Esitämme arvion vuoden 2011 tilanteesta. Menetelmät Arvioimme seitsemän keskeisen moniresistentin mikrobin (Staphylococcus aureus, Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Enterobacter-lajit, Pseudomonas aeruginosa ja Acinetobacter-lajit) aiheuttamien bakteremioiden määriä valtakunnallisen tartuntatautirekisterin, mikrobiologian laboratorioiden resistenssiverkon (Fire) ja sairaalainfektio-ohjelman (SIRO) tapaus-lukumäärien ja bakteerien herkkyystietojen perusteella. Näiden mikrobien aiheuttamien muiden infektioiden (leikkausalueen infektiot, keuhkokuume ja virtsatieinfektiot) määrät arvioitiin sairaala-infektioiden valtakunnallisen prevalenssitutkimuksen infektiojakauman perusteella. Kuolemat arvioitiin prevalenssitutkimuspotilaiden kuolin- ja kuolemansyytiedoista. Tulokset Vuonna 2011 moniresistenttien mikrobien aiheuttamia infektioita oli Suomen akuuttisairaaloissa arviolta 2 412, noin 5 % kaikista hoitoon liittyvistä infektioista. Näihin infektioihin liittyi lähes 80 kuolemaa. Yleisimpiä olivat laajakirjoisia beetalaktamaaseja (ESBL) tuottavien E. coli -bakteerien aiheuttamat infektiot. Päätelmät Moniresistentit ongelmamikrobit aiheuttavat Suomessa toistaiseksi melko vähän hoitoon liittyviä infektioita. Koska suuri osa hoitoon liittyvistä infektioista on muiden kuin moniresistenttien mikrobien aiheuttamia ja infektioiden aiheuttajamikrobit ovat useimmiten peräisin potilaan omasta mikrobi-floorasta, pelkällä tartunnan torjunnalla ei voida ehkäistä hoitoon liittyviä infektioita. Siksi on keskeistä tarjota hoitohenkilökunnalle selkeää opastusta erityyppisten hoitoon liittyvien infektioiden ehkäisy- ja torjuntakeinoista

    The impact of tree crops and temperature on the timing of frugivorous bird migration

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    Migration has evolved to tackle temporal changes in availability of resources. Climate change has been shown to affect the migration dates of species, which raises the question of whether the variation in the timing of migration is climate or resource dependent? The relative importance of temperature and availability of food as drivers of migration behaviour during both spring and autumn seasons has been poorly studied. Here, we investigated these patterns in frugivorous and granivorous birds (hereafter frugivorous) that are assumed to postpone their autumn migration when there is plenty of food available, which may also advance upcoming spring migration. On the other hand, especially spring migration dates have been negatively connected with increasing temperatures. We tested whether the autumn and spring migration dates of eleven common frugivorous birds depended on the crop size of trees or ambient temperatures using 29 years of data in Finland. The increased crop sizes of trees delayed autumn migration dates; whereas, autumn temperature did not show a significant connection. We also observed a temporal trend towards later departure. Increasing temperature and crop sizes advanced spring arrival dates. Our results support the hypothesis that the timing of autumn migration in the frugivorous birds depends on the availability of food and is weakly connected with the variation in temperature. Importantly, crop size can have carry-over effects and affect the timing of spring arrival possibly because birds have overwintered closer to the breeding grounds after an abundant crop year.Peer reviewe
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