Brakykefaalisten rotujen silmäongelmat - kirjallisuuskatsaus

Ocular disorders in brachycephalic breeds – ReviewPeer reviewe

PET-tutkimus syövän diagnostiikassa ja levinneisyysselvittelyssä

PET-TT- ja -MK-tutkimukset ovat vakiinnuttaneet asemansa syöpäkuvantamisen työkaluna tavanomaisten anatomisten kuvausmenetelmien rinnalla. Tästä on osoituksena kuvausmäärien tasainen kasvu Suomessa ja uusien kameroiden hankkiminen paitsi yliopistosairaaloissa, myös keskussairaaloissa. PET-kuvantaminen vaikuttaa syövän hoitoon ja hoitomuotojen valintaan. Menetelmä on herkkä, ja sillä voidaan paikantaa aiempaa pienempiä imusolmuke-etäpesäkkeitä tai etäpesäkkeitä jo ennen anatomisia muutoksia, erottaa aktiivisen kasvainkudoksen keuhkojen atelektaasista tai hoitojen aiheuttamista arvista sekä fibroosista. PET-menetelmästä on hyötyä syövän hoidossa hoidon suunnittelusta hoitovastearvioon sekä taudin uusiutumisen osoittamiseen. Oikein kohdennettuna kalliin kuvausmenetelmän käyttö on kustannustehokasta. Syövän tarkka levinneisyysselvittely auttaa potilaalle soveltuvimman hoidon valinnassa. PET-tutkimus ei tuo lisäarvoa kaikkien syöpien levinneisyyden selvittelyyn. Kliininen tutkimusnäyttö tarkentuu koko ajan PET-menetelmän käyttöaiheista, ja nykyään syöpätautien hoitosuosituksissa otetaan aiempaa tarkemmin kantaa, milloin PET-kuvantamisesta on osoitettu olevan kliinistä hyötyä

Yliopisto-opintojen työelämärelevanssi:Oulun yliopiston tutkinto-ohjelmien vastuuhenkilöiden käsityksiä työelämärelevanssista

Tiivistelmä. Tutkimuksessa tarkastellaan yliopisto-opintojen työelämärelevanssia Oulun yliopiston tutkinto-ohjelmien vastuuhenkilöiden näkökulmasta. Tutkimuksessamme pyritään selvittämään tutkimushenkilöiden käsityksiä työelämärelevanssin tavoitteista, työelämäyhteyksien nykyisistä toteutumismuodoista sekä opiskelijoiden työelämäorientaation tukemisesta. Aihe on relevantti, koska työelämä on jatkuvassa muutoksessa ja etenkin viime vuosikymmenien aikana kokenut suuria uudistuksia. On tärkeää, että korkeakoulutus pystyy vastaamaan muuttuvan maailman tarpeisiin. Yksi yliopistojen tehtävä on tuottaa asiantuntijoita julkisen- ja yksityisen sektorin työtehtäviin. Tähän tavoitteeseen päästäkseen, yliopistoissa pyritään tarjoamaan työelämäyhteyksiä opiskelijoille jo opintojen aikana sekä edistämään heidän työelämäorientaatiotaan. Myös Oulun yliopistossa tehdään töitä näiden tavoitteiden täyttämiseksi. Pro gradu-työmme tutkimussuuntaus on fenomenografia, joka tutkii ihmisten käsityksiä tutkimuksen alla olevista ilmiöistä. Tutkimuksemme lähtökohta on tutkimushenkilöiden käsitykset työelämärelevanssista. Aineisto on kerätty Oulun yliopiston toimesta vuonna 2015 laajan sisäisen auditoinnin tarpeisiin. Tutkimukseen vastanneita henkilöitä on 56. Aineistonkeruumenetelmänä käytettiin kyselylomakehaastattelua. Sen yhdessä osiossa tutkitaan käytänteitä opintojen työelämärelevanssia koskien. Käytämme tätä osiota tutkimuksessamme ja se koostuu avoimista kysymyksistä. Aineisto on analysoitu abduktiivisen laadullisen sisällönanalyysin menetelmin. Tutkimuksessa selvisi, että Oulun yliopiston tutkinto-ohjelmien vastuuhenkilöt ovat omaksuneet kansainväliset ja kansalliset korkeakoulutusta määrittävät säädökset ja viitekehykset, jotka määrittelevät työelämärelevanssin sisältymisen korkeakouluopintoihin. Teorian vastaisesti tutkimushenkilöt eivät nostaneet kandidaatintutkinnon tunnistamista, kansainvälistymistä eivätkä työskentelyä opintojen ohella työelämärelevanssia edistäviksi tekijöiksi. Tutkimus on suoritettu paikallisesti Oulun yliopistossa, joten tutkimuksen tulokset eivät ole yleistettävissä. Siitä huolimatta tutkimuksemme antaa osviittaa mahdollisista kehityskohteista Oulun yliopistossa. Esimerkiksi opiskelijoiden työskentelyä opintojen ohella voisi tukea, koska on tieteellistä näyttöä siitä, ettei se hidasta opintojen suorittamista, mutta kehittää opiskelijan työelämäorientaatiota

Estimate of Opportunistic Prostate Specific Antigen Testing in the Finnish Randomized Study of Screening for Prostate Cancer

Purpose: Screening for prostate cancer remains controversial, although ERSPC (European Randomized Study of Screening for Prostate Cancer) showed a 21% relative reduction in prostate cancer mortality. The Finnish Randomized Study of Screening for Prostate Cancer, which is the largest component of ERSPC, demonstrated a statistically nonsignificant 16% mortality benefit in a separate analysis. The purpose of this study was to estimate the degree of contamination in the control arm of the Finnish trial. Materials and Methods: Altogether 48,295 and 31,872 men were randomized to the control and screening arms, respectively. The screening period was 1996 to 2007. The extent of prostate specific antigen testing was analyzed retrospectively using laboratory databases. The incidence of T1c prostate cancer (impalpable prostate cancer detected by elevated prostate specific antigen) was determined from the national Finnish Cancer Registry. Results: Approximately 1.4% of men had undergone prostate specific antigen testing 1 to 3 years before randomization. By the first 4, 8 and 12 years of follow-up 18.1%, 47.7% and 62.7% of men in the control arm had undergone prostate specific antigen testing at least once and in the screening arm the proportions were 69.8%, 81.1% and 85.2%, respectively. The cumulative incidence of T1c prostate cancer was 6.1% in the screening arm and 4.5% in the control arm (RR 1.21, 95% CI 1.13-1.30). Conclusions: A large proportion of men in the control arm had undergone a prostate specific antigen test during the 15-year followup. Contamination is likely to dilute differences in prostate cancer mortality between the arms in the Finnish screening trial.Peer reviewe

Exercise training improves adipose tissue metabolism and vasculature regardless of baseline glucose tolerance and sex

Introduction We investigated the effects of a supervised progressive sprint interval training (SIT) and moderate-intensity continuous training (MICT) on adipocyte morphology and adipose tissue metabolism and function; we also tested whether the responses were similar regardless of baseline glucose tolerance and sex. Research design and methods 26 insulin-resistant (IR) and 28 healthy participants were randomized into 2-week-long SIT (4-6x30 s at maximum effort) and MICT (40-60 min at 60% of maximal aerobic capacity (VO2peak)). Insulin-stimulated glucose uptake and fasting-free fatty acid uptake in visceral adipose tissue (VAT), abdominal and femoral subcutaneous adipose tissues (SATs) were quantified with positron emission tomography. Abdominal SAT biopsies were collected to determine adipocyte morphology, gene expression markers of lipolysis, glucose and lipid metabolism and inflammation. Results Training increased glucose uptake in VAT (pPeer reviewe

The Clinical Impact of Using 18F-FDG-PET/CT in the Diagnosis of Suspected Vasculitis: The Effect of Dose and Timing of Glucocorticoid Treatment

18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, ), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, ) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, ). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis.</p

A Prospective Comparison of F-18-prostate-specific Membrane Antigen-1007 Positron Emission Tomography Computed Tomography, Whole-body 1.5 T Magnetic Resonance Imaging with Diffusion-weighted Imaging, and Single-photon Emission Computed Tomography/Computed Tomography with Traditional Imaging in Primary Distant Metastasis Staging of Prostate Cancer (PROSTAGE)

Background: Computed tomography (CT) and bone scintigraphy (BS) are the imaging modalities currently used for distant metastasis staging of prostate cancer (PCa). Objective: To compare standard staging modalities with newer and potentially more accurate imaging modalities. Design, setting, and participants: This prospective, single-centre trial (NCT03537391) enrolled 80 patients with newly diagnosed high-risk PCa (International Society of Urological Pathology grade group >= 3 and/or prostate-specific antigen [PSA] >= 20 and/or cT >= T3; March 2018-June 2019) to undergo primary metastasis staging with two standard and three advanced imaging modalities. Outcome measurements and statistical analysis: The participants underwent the following five imaging examinations within 2 wk of enrolment and without a prespecified sequence: BS, CT, Tc-99m-hydroxymethylene diphosphonate (Tc-99m-HMDP) single-photon emission computed tomography (SPECT)-CT, 1.5 T whole-body magnetic resonance imaging (WBMRI) using diffusion-weighted imaging, and F-18-prostate-specific membrane antigen-1007 (F-18-PSMA-1007) positron emission tomography(PET)-CT. Each modality was reviewed by two independent experts blinded to the results of the prior studies, who classified lesions as benign, equivocal, or malignant. Pessimistic and optimistic analyses were performed to resolve each equivocal diagnosis. The reference standard diagnosis was defined using all available information accrued during at least 12 mo of clinical follow-up. Patients with equivocal reference standard diagnoses underwent MRI and/or CT to search for the development of anatomical correspondence. PSMA PET-avid lesions without histopathological verification were rated to be malignant only if there was a corresponding anatomical finding suspicious for malignancy at the primary or follow-up imaging. Results and limitations: Seventy-nine men underwent all imaging modalities except for one case of interrupted MRI. The median interval per patient between the first and the last imaging study was 8 d (interquartile range [IQR]: 6-9). The mean age was 70 yr (standard deviation: 7) and median PSA 12 ng/mL (IQR:7-23). The median follow-up was 435 d (IQR: 378-557). Metastatic disease was detected in 20 (25%) patients. The imaging modality F-18-PSMA-1007 PET-CT had superior sensitivity and highest inter-reader agreement. The area under the receiver-operating characteristic curve (AUC) values for bone metastasis detection with PSMA PET-CT were 0.90 (95% confidence interval [CI]: 0.85-0.95) and 0.91 (95% CI: 0.87-0.96) for readers 1 and 2, respectively, while the AUC values for BS, CT, SPECT-CT, and WBMRI were 0.71 (95% CI: 0.58-0.84) and 0.8 (95% CI: 0.67-0.92), 0.53 (95% CI: 0.39-0.67) and 0.66 (95% CI: 0.54-0.77), 0.77 (95% CI: 0.65-0.89) and 0.75 (95% CI: 0.62-0.88), and 0.85 (95% CI: 0.74-0.96) and 0.67 (95% CI: 0.54-0.80), respectively, for the other four pairs of readers. The imaging method F-18-PSMA-1007 PET-CT detected metastatic disease in 11/20 patients in whom standard imaging was negative and influenced clinical decision making in 14/79 (18%) patients. In 12/79 cases, false positive bone disease was reported only by PSMA PET-CT. Limitations included a nonrandomised study setting and few histopathologically validated suspicious lesions. Conclusions: Despite the risk of false positive bone lesions, F-18-PSMA-1007 PET-CT outperformed all other imaging methods studied for the detection of primary distant metastasis in high-risk PCa. Patient summary: In this report, we compared the diagnostic performance of conventional and advanced imaging. It was found that F-18-prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (F-18-PSMA-1007 PET-CT) was superior to the other imaging modalities studied for the detection of distant metastasis at the time of initial diagnosis of high-risk prostate cancer. PSMA PET-CT also appears to detect some nonmetastatic bone lesions. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.Peer reviewe

Exercise training improves adipose tissue metabolism and vasculature regardless of baseline glucose tolerance and sex

Introduction We investigated the effects of a supervised progressive sprint interval training (SIT) and moderate-intensity continuous training (MICT) on adipocyte morphology and adipose tissue metabolism and function; we also tested whether the responses were similar regardless of baseline glucose tolerance and sex.Research design and methods 26 insulin-resistant (IR) and 28 healthy participants were randomized into 2-week-long SIT (4-6x30 s at maximum effort) and MICT (40-60 min at 60% of maximal aerobic capacity (VO2peak)). Insulin-stimulated glucose uptake and fasting-free fatty acid uptake in visceral adipose tissue (VAT), abdominal and femoral subcutaneous adipose tissues (SATs) were quantified with positron emission tomography. Abdominal SAT biopsies were collected to determine adipocyte morphology, gene expression markers of lipolysis, glucose and lipid metabolism and inflammation.Results Training increased glucose uptake in VAT (pConclusions Short-term training improves adipose tissue metabolism both in healthy and IR participants independently of the sex. Adipose tissue angiogenesis and gene expression was only significantly affected in IR participants.</div

Decreased insulin‐stimulated brown adipose tissue glucose uptake after short‐term exercise training in healthy middle‐aged men

Aims To test the hypothesis that high‐intensity interval training (HIIT) and moderate‐intensity continuous training (MICT) improve brown adipose tissue (BAT) insulin sensitivity. Participants and methods Healthy middle‐aged men (n = 18, age 47 years [95% confidence interval {CI} 49, 43], body mass index 25.3 kg/m2 [95% CI 24.1‐26.3], peak oxygen uptake (VO2peak) 34.8 mL/kg/min [95% CI 32.1, 37.4] ) were recruited and randomized into six HIIT or MICT sessions within 2 weeks. Insulin‐stimulated glucose uptake was measured using 2‐[18F]flouro‐2‐deoxy‐D‐glucose positron‐emission tomography in BAT, skeletal muscle, and abdominal and femoral subcutaneous and visceral white adipose tissue (WAT) depots before and after the training interventions. Results: Training improved VO2peak (P = .0005), insulin‐stimulated glucose uptake into the quadriceps femoris muscle (P = .0009) and femoral subcutaneous WAT (P = .02) but not into BAT, with no difference between the training modes. Using pre‐intervention BAT glucose uptake, we next stratified subjects into high BAT (>2.9 µmol/100 g/min; n = 6) or low BAT (<2.9 µmol/100 g/min; n = 12) groups. Interestingly, training decreased insulin‐stimulated BAT glucose uptake in the high BAT group (4.0 [2.8, 5.5] vs 2.5 [1.7, 3.6]; training*BAT, P = .02), whereas there was no effect of training in the low BAT group (1.5 [1.2, 1.9] vs 1.6 [1.2, 2.0] µmol/100 g/min). Participants in the high BAT group had lower levels of inflammatory markers compared with those in the low BAT group. Conclusions: Participants with functionally active BAT have an improved metabolic profile compared with those with low BAT activity. Short‐term exercise training decreased insulin‐stimulated BAT glucose uptake in participants with active BAT, suggesting that training does not work as a potent stimulus for BAT activation