Mycosis fungoides and Sezary syndrome : a population-wide study on prevalence and health care use in Finland in 1998-2016

Background Information about health care use and costs of cutaneous T-cell lymphoma (CTCL) patients is limited, particularly in a European setting. Methods In this population-wide study we set out to investigate prevalence, and trends in health care use in two CTCL subtypes, mycosis fungoides (MF) and Sezary syndrome (SS) over a time period of 19 years in 1998-2016 by using a nation-wide patient register containing data on all diagnosed MF and SS cases in Finland. Results The prevalence of diagnosed MF and SS rose from 2.04 to 5.38/100000, and from 0.16 to 0.36/100000 for MF and SS respectively during 1998-2016. We found a substantial decrease in inpatient treatment of MF/SS in the past two decades with a mean of 2 inpatient days/patient/year due to MF/SS in 2016, while the mean numbers of MF/SS related outpatient visits remained stable at 8 visits/year/patient. Most MF/SS-related outpatient visits occurred in the medical specialty of dermatology. In a ten-year follow-up after MF/SS diagnosis, the main causes for outpatient visits and inpatient stays were MF/SS itself, other cancers, and other skin conditions. Also cardiovascular disease and infections contributed to the number of inpatient days. Mean total hospital costs decreased from 11,600 eur/patient/year to 3600 eur/patient/year by year 4 of the follow-up, and remained at that level for the remainder of the 10-year follow-up. MF/SS accounted for approximately half of the hospital costs of these patients throughout the follow-up. Conclusions The nearly 3-fold increase in prevalence of diagnosed MF/SS during 1998-2016 puts pressure on the health care system, as this is a high-cost patient group with a heavy burden of comorbidities. The challenge can be in part answered by shifting the treatment of MF/SS to a more outpatient-based practice, and by adapting new pharmacotherapy, as has been done in Finland.Peer reviewe

Mycosis fungoides and Sezary syndrome : a population-wide study on prevalence and health care use in Finland in 1998-2016

Background Information about health care use and costs of cutaneous T-cell lymphoma (CTCL) patients is limited, particularly in a European setting. Methods In this population-wide study we set out to investigate prevalence, and trends in health care use in two CTCL subtypes, mycosis fungoides (MF) and Sezary syndrome (SS) over a time period of 19 years in 1998-2016 by using a nation-wide patient register containing data on all diagnosed MF and SS cases in Finland. Results The prevalence of diagnosed MF and SS rose from 2.04 to 5.38/100000, and from 0.16 to 0.36/100000 for MF and SS respectively during 1998-2016. We found a substantial decrease in inpatient treatment of MF/SS in the past two decades with a mean of 2 inpatient days/patient/year due to MF/SS in 2016, while the mean numbers of MF/SS related outpatient visits remained stable at 8 visits/year/patient. Most MF/SS-related outpatient visits occurred in the medical specialty of dermatology. In a ten-year follow-up after MF/SS diagnosis, the main causes for outpatient visits and inpatient stays were MF/SS itself, other cancers, and other skin conditions. Also cardiovascular disease and infections contributed to the number of inpatient days. Mean total hospital costs decreased from 11,600 eur/patient/year to 3600 eur/patient/year by year 4 of the follow-up, and remained at that level for the remainder of the 10-year follow-up. MF/SS accounted for approximately half of the hospital costs of these patients throughout the follow-up. Conclusions The nearly 3-fold increase in prevalence of diagnosed MF/SS during 1998-2016 puts pressure on the health care system, as this is a high-cost patient group with a heavy burden of comorbidities. The challenge can be in part answered by shifting the treatment of MF/SS to a more outpatient-based practice, and by adapting new pharmacotherapy, as has been done in Finland.Peer reviewe

Ayrshiresonnit lihakkaampia kuin holsteinit - lihan laadussa vain pieniä eroja

Lehtiartikkeli (rinnakkaistallennusluvan asianumero: 515/12 05 01 02/2022)Suomalainen naudanlihantuotanto perustuu pääosin maitorotuisten vasikoiden kasvatukseen. Sen vuoksi maitorotuisten eläinten lihantuotanto-ominaisuuksilla on tärkeä merkitys kotimaisen lihantuotannon kannalta. Meillä kaksi yleisintä lypsyrotua ovat holstein ja ayrshire. Rekina-hankkeessa vertailtiin näiden rotujen välisiä eroja lihantuotannossa. Tuotanto-ominaisuuksien lisäksi tarkastelussa olivat mukana myös lihan laatuun liittyvät ominaisuudet. Ay-sonnien ruhot olivat puolestaan lihakkaampia hol-sonneihin verrattuna. Ulkofileen leikkuuvasteeseen tai aistinvaraisesti arvioituun mureuteen, mehukkuuteen ja makuun rotu ei tässä tutkimuksessa vaikuttanut millään tavalla

Ruokinta vaikutti vain vähän naudanlihan laatuun

Lehtiartikkeli (rinnakkaistallennusluvan asianumero: 515/12 05 01 02/2022)Lihan syöntilaatu ja ulkonäkö ovat tärkeitä ominaisuuksia, jotka vaikuttavat kuluttajien valintoihin ja ostopäätöksiin. Siksi hyvän syöntilaadun turvaaminen on tärkeää, vaikka syöntilaatua ei meillä kaupallisessa tuotannossa mitata eikä tuottajalle siitä makseta

Opioid trends in Finland : a register-based nationwide follow-up study

The opioid epidemic in the U.S has gotten payers, prescribers, and policymakers alike interested in trends in opioid use. Despite no recognized opioid crisis in Europe, several countries have reported an increase in opioid-related deaths, which has further prompted discussion on the need of monitoring of opioid prescriptions. This study was conducted to offer information on opioid use during the escalation of the U.S. opioid epidemic in Finland, a Nordic country with universal tax-based health care. This is a nationwide retrospective register-based cohort study on all individuals in Finland who were dispensed opioids in 2009-2017 (n of unique patients = 1,761,584). By using the unique personal identification code assigned to every Finnish resident, we linked data from nationwide registers on dispensed drugs, medical history, and socio-demographic parameters. We report a wide set of patient demographics, dispensing trends for all opioid Anatomical Therapeutic Chemical (ATC) classes, and reasons for opioid initiation based on diagnostic coding for the most recent health care visit. For a cohort of incident opioid users with a four-year wash-out period (n = 1 370 057), we also present opioid use patterns in a three-year follow-up: the likelihood of becoming a persistent user or escalating from weak to strong opioids. A steady 7% of the Finnish population were dispensed opioids annually in 2009-2017. The mean annual quantity of dispensed opioids per opioid patient increased between 2009 and 2017 by 33%, reaching 2 583 oral morphine equivalent mg (OMEQ)/patient/year in 2017. The median quantity of dispensed opioids was lower: 315 OMEQ/year/patient. Depending on the opioid ATC class, there were either increasing or decreasing numbers of patients who had been dispensed said opioid class, and also in the mean quantity. The most common reason for opioid initiation was post-surgical pain (20%), followed by musculoskeletal pain (15%), injury (8.3%), and non-postsurgical dental pain (6.2%). 94% of new opioid initiators started with a weak opioid, i.e. codeine or tramadol. 85% of the patients who had been dispensed a weak opioid were not dispensed an opioid subsequently 3-6 months after the first one, and 95% of them had not escalated to a strong opioid in a 3-year follow-up. The number of patients dispensed opioids in Finland did not change during the escalation of the opioid epidemic in the U.S., but there were changes in the quantity of opioids dispensed per patient. Opioid therapy was typically initiated with weak opioid, the initial dispensed prescription was relatively small, and escalation to strong opioids was rare. A considerable share of patients had been prescribed opioids for chronic non-cancer pain - a type of pain where the risk-benefit ratio of opioids is controversial.Peer reviewe

A pilot study: consumer acceptability of Polish style cooked sausages containing house cricket flour

There is a growing interest on insects as food in Western countries. Currently, EU legislation limits the use of insects as food, however, new regulation coming to force in 2018 will clarify the situation. In the ScenoProt project funded by Strategic Research Council of Finnish Academy insects are considered as potential protein source for human consumption, and therefore, some food technological properties of insects are studied in the project. Scientific research has proven mealworm larvae and silkworm pupae originated protein fraction equal to meat protein in emulsion sausages. Generally, it is also of interest how unfractionated, chitin containing insect flour would affect the sensory properties of sausages. The objective of the present study was to investigate the consumer attitudes to Polish style sausages containing unfractionated house cricket (Acheta domesticus) flour. Lean and fatty meat was purchased from local supplier, and three different sets of smoked and cooked sausages were made. The basic recipe contained pork, water, house cricket flour, nitrite salt, and spices. Salt content of sausages was approx. 1.8%. In the first set 1/5, and in the second and third set approx. 1/6 of lean meat was replaced with house cricket flour. The fat content was approx. 12% in the first and 19–20% in the second and third set of sausages. The third set included ordinary Polish style sausage as a reference. Cooking loss of the sausages was acceptable, below 10%. Odor, texture and taste were evaluated by ordinary consumers (n=26) for the first, by media people (n=34) for the second, and by representatives of food industry (n=17) for the third set. Because of potential allergic reaction in shellfish sensitive people, the consumers were informed about the contents of the sausages. Consumer willingness to eat sausages again was recorded for the first and second set and free comments were collected for all the sets. The evaluation scale had five points (1=extremely negative, 5=extremely positive).Only in the first set the evaluations on odor, texture, and taste of the sausages averaged lower than 3. Even the willingness to eat sausages again was approx. 3. This may reflect the interest of the consumers towards food containing insects in general. The increased fat content in the second and third sets of sausages may be one factor responsible for increase in the valuation of the sensory parameters as Finnish consumers are used to the fat content of around 20 % in cooked sausages. In the third set the control sausages showed slightly higher acceptance for texture than the house cricket sausages. In free comments, dryness, dark colour, floury texture, and liver flavor were most often mentioned. In conclusion, consumers may accept non-fractionated house cricket flour as a sausage ingredient but its strong flavor may limit the level of inclusion or lead towards stronger, masking, spicing in the house cricket sausages

Pohjoissuomenkarjaa lihantuotantoon?

Pohjoissuomenkarjaa eli lapinlehmiä on pidetty maatiloilla perinteisesti pääasiassa maidontuotannossa. Se soveltuu monipuolisuutensa ansiosta moneen muuhunkin tarkoitukseen, kuten maisemanhoitoon, hyvinvointipalveluihin tai kotieläinpihoill

Kotieläintila sopii tutkimuksen toteutuspaikaksi vain osittain

Luonnonvarakeskuksen sika- ja siipikarjatutkimusta alettiin siirtää kumppanuustiloille vuosien 2012 ja 2013 aikana. Ensimmäiset laajemmat tutkimus- ja kehityshankkeet ovat nyt v. 2019 raportointivaiheessa ja siten on mahdollisuus arvioida toimintamallin toimivuutta eri näkökulmista. Kumppanuustilatutkimuksessa tutkija koordinoi maatilalla tehtävän tutkimuksen. Silti tutkija on maatilalla vain kyläilemässä ja sopeuttaa tutkimuksensa maatilan toimintoihin, tuotantopanoksiin ja sitoumuksiin. Riskien ottaminen tieteen nimissä kumppanuustilatutkimuksessa ei ole mahdollista. Osa eläinkoetoiminnasta on luvanvaraista. Jos lupa tarvitaan koeasetelmalle, se tarvitaan myös kokeen toteutuspaikalle. Kotieläintila ei välttämättä halua tällaista lupaa hakea, koska tilan oma liiketoiminta ei sellaista tarvitse ja viranomaiset työllistävät tilaa muutenkin ihan riittävästi. Kotieläintilan tuotantosopimukset saattavat edellyttää sitoutumista esim. yhteen rehutoimittajaan ja/tai yhteen tuotannon ostajaan. Ruokintatutkimuksessa tutkijalla on mahdollisuus ehdottaa muutoksia kaupallisten rehujen koostumuksiin. Kumppanuustilatutkimuksen omissa sopimuksissa sovitaan luottamuksellisten tietojen käsittelystä ja tutkimustulosten julkaisuoikeuksista. Tässä tutkijan täytyy olla tarkkana, koska julkisrahoitteisen hankkeen tulosten kuuluu olla julkisia, vaikka ne tuotettaisiin kaupallisen toimijan liikesalaisuuksia hyödyntäen. Koetoimintaa kotieläintilalle suunnitellessa täytyy tarkistaa, että tilalla on mahdollisuus osoittaa ylimääräistä työvoimaa tutkimuksesta johtuviin tehtäviin. Kotieläintilalla tehtävät järjestelyt yksittäistä koetta varten ovat usein ainutkertaiset ja vastaavan järjestelyn toistaminen tyypillisen kolmevuotisen hankkeen aikana voi olla vaikeaa. Siksi kumppanuustilatutkimuksen etukäteissuunnittelu rahoituksen hakuvaiheesta lähtien korostuu. Suunnitteluun kuuluu esim. koeasetelman luominen, koska se määrittelee mm. koekäsittelyjen ajoituksen, tiedonkeruumallin ja siten koetoiminnan hinnan. Koeasetelmaan vaikuttavat kumppanuustilan tekniset rakenteet kuten osastojen, karsinoiden ja eläinten ruokintapisteiden (venttiilien) lukumäärä. Siksi koeasetelma on aina tila- ja tutkimusaihekohtainen. Lisäksi kriittistä on tieto, pystytäänkö eläin tunnistamaan yksilöllisesti koko kokeen läpi, koska tämä useimmiten lisää tutkimuksen tarkkuuttaa verrattuna esimerkiksi pahnuekohtaisiin mittauksiin. Tarkkuuden lisääminen voi nostaa kokeen kustannuksia, mutta yksilömittaukset voivat myös laskea tarvittavaa eläinmäärää niin, että kokonaiskustannukset laskevat. Tämän vuoksi budjetoinnin yhteydessä mittaustarkkuus arvotetaan euroina. Lisäksi on huomioitava, että tulosten hajonta on suurempi maatilaolosuhteissa kuin tutkimuslaitoksessa tehdyissä mittauksissa. Koetoiminta kotieläintiloilla lisää vuoropuhelua tutkimuksen ja elinkeinon eri osapuolten välillä. Tieteellisen tutkimuksen toteutusmalliksi se soveltuu kuitenkin harvoin

Growth performance, carcass characteristics and meat quality of Northern Finncattle steers compared to Holstein steers offered grass silage-grain-based ration

Background: Finnish beef production is largely based on dairy breeds. Eastern Finncattle, Western Finncattle, and Northern Finncattle (NFC) are native breeds, whereas Holstein (HO) and Nordic Red are the most important commercial dairy breeds. The NFC has been the closest to extinction among Finnish native cattle breeds. The objective of the experiment was to provide data on meat quality of NFC compared to HO. To our knowledge no previously published scientific data about the meat quality traits of NFC is available. Results: The targeted slaughter age was 600 days for both NFC and HO. The carcass gain of the HO steers was 60% higher compared to NFC steers. No breed differences in dressing proportion, carcass conformation, or carcass fat score were observed. Breed had no effect on the pH, color, drip loss, chemical composition, shear force value, or sensory tenderness of the longissimus lumborum muscle. However, beef flavor of the NFC steers was evaluated 7% better compared to the HO steers. In addition, the longissimus lumborum muscle of the NFC steers tended to be juicier than that of the HO steers. Conclusions: Only little variability in meat quality traits was observed between the breeds. However, NFC requires a longer growing period than HO when targeting the same carcass weight. To promote the use of the NFC in beef production, it is necessary to find other than economic production efficiency features, which would provide added value for premium meat quality to compensate the lower production efficiency