Testicular Diffuse Large B-Cell Lymphoma-Clinical, Molecular, and Immunological Features

Simple Summary Testicular diffuse large B-cell lymphoma (T-DLBCL) is a rare and aggressive lymphoma entity that mainly affects elderly men. It has a high relapse rate with especially the relapses of the central nervous system associating with dismal outcome. T-DLBCL has a unique biology with distinct genetic characteristics and clinical presentation, and the increasing knowledge on the tumor microenvironment of T-DLBCL highlights the significance of the host immunity and immune escape in this rare lymphoma, presenting in an immune-privileged site of the testis. This review provides an update on the latest progress made in T-DLBCL research and summarizes the clinical perspectives in T-DLBCL. Primary testicular lymphoma is a rare lymphoma entity, yet it is the most common testicular malignancy among elderly men. The majority of the cases represent non-germinal center B-cell-like (non-GCB) diffuse large B-cell lymphoma (DLBCL) with aggressive clinical behavior and a relatively high relapse rate. Due to the rareness of the disease, no randomized clinical trials have been conducted and the currently recognized standard of care is based on retrospective analyses and few phase II trials. During recent years, the tumor microenvironment (TME) and tumor-related immunity have been the focus of many tumor biology studies, and the emergence of targeted therapies and checkpoint inhibitors has significantly modulated the field of cancer therapies. Testicular DLBCL (T-DLBCL) is presented in an immune-privileged site of the testis, and the roles of NF-kappa B pathway signaling, 9p24.1 aberrations, and tumor-infiltrating immune cells, especially immune checkpoint expressing lymphocytes and macrophages, seem to be unique compared to other lymphoma entities. Preliminary data on the use of immune checkpoint inhibitors in the treatment of T-DLBCL are promising and more studies are ongoing.Peer reviewe

Communicative challenges in an internationally decentralized nonprofit organization Case: Finn Church Aid

Communicative challenges in an internationally decentralized nonprofit organization - Case: Finn Church Aid Objective of the Study The main objective of the Thesis is to explore issues that the case organization needs to consider when developing a strategic communication plan for the field offices based in the developing countries. The Thesis will take into consideration both internal and external communications as well as the special conditions of international operating environment in developing countries. The research problem is investigated with the three questions: How do FCA’s employees perceive the challenges in the organization’s internal communications? How do FCA’s employees perceive the field offices’ external communication and the possibilities to develop it? What is the impact of the operating environment (i.e. developing countries) on FCA’s communications? Methodology and Data The research was conducted as a qualitative single case study with semi-structured interviews as the research method. Ten FCA employees were interviewed and they represented employees from the field as well as from the Helsinki headquarters. The theoretical framework guided the research process by taking into consideration all aspects of internal and external communication in the international environment. Findings and Conclusions The main findings of the Thesis indicate that the importance of internal and external communications are acknowledged within the case organization. However, communicative problems were identified and due to lack of resources, no actions have been taken to improve the situation. The Thesis provides suggestions concerning internal and external communications and focuses on the impact of the international environment on the development of a communication plan

Clinical Impact of Tumor-Associated Macrophage and T-Cell Contents in Diffuse Large B-Cell Lymphoma

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Järjestysregressiomalli huolto- ja asumisriidoille hovioikeuksissa

Oikeudellisten ilmiöiden tilastollinen mallintaminen on vielä harvinaista Suomessa. Tutkielmassa mallinnetaan lasten huolto- ja asumisriitoja hovioikeuksissa järjestysregressiomallilla. Oikeuden päätökset huolto- ja asumisriidoissa voidaan luokitella järjestysasteikolla, missä asteikon toinen pää käsittää äidin voittoluokat ja toinen isän voittoluokat. Mallin tarkoitus on löytää keskeiset oikeuden päätöstä sekä äitien ja isien voittomahdollisuuksia selittävät tekijät. Mallia voidaan käyttää myös uuden riidan lopputuloksen ennustamiseen. Koska osapuolten vaatimukset rajoittavat sen, millaisen päätöksen oikeus voi antaa, niin mallia laajennetaan skaala- ja nominaalivaikutuksilla. Vastaavaa laajennettua järjestysregressiomallia ei ole sovellettu huolto- ja asumisriitoihin aiemmin. Työssä käytetty oikeustapausaineisto käsittää 500 huolto- ja asumisriitaa Suomen jokaisesta viidestä hovioikeudesta vuosien 2000 ja 2016 väliseltä ajalta. Aineisto on rajattu riitoihin, joissa äiti ja isä ovat eri mieltä lasten asumisesta ja mahdollisesti myös huollosta. Aineiston laajuus ja ilmiön vähäinen mallinnushistoria tekevät aineistosta kansainvälisesti ainutlaatuisen. Tiedot riidoista on poimittu hovioikeuksien ratkaisuista sekä niiden tausta-asiakirjoista. Kaikista riidoista on poimittu tieto myös vastaavasta käräjäoikeuden ratkaisusta, josta äiti tai isä on valittanut hovioikeuteen. Äidit ja isät ovat valittajina yhtä usein, mutta äidit saavat isiä hieman useammin vaatimuksiansa vastaavia päätöksiä hovioikeudessa. Äidit vaativat lasten yksinhuoltoa useammin kuin isät. Aineistossa on paljon muuttujia, joiden yhdistelmistä pyritään muodostamaan mahdollisimman hyviä malleja erilaisiin lähtökohtiin. Selittäjiä tarkastellaan aluksi yhden selittäjän malleilla, mutta varsinaiset analyysit perustuvat usean selittäjän malleihin, jotka muodostetaan yhden selittäjän mallien pohjalta. Usean selittäjän mallien valitsemisessa käytetään tavanomaisia tilastollisten mallien mallinvalintamenetelmiä. Lopputuloksena saadaan kolme mallia, joista ensimmäisen on tarkoitus löytää keskeiset oikeuden päätöstä selittävät tekijät. Toinen malli pyrkii ennustamaan uuden riidan lopputuloksen ja kolmas ennustamaan lopputuloksen riidassa, josta on käräjäoikeuden päätös. Kolmas malli pyrkii myös löytämään tekijät, jotka parhaiten selittävät käräjäoikeuden päätöksen muuttumista. Lasten vakiintunut asuinpaikka, sosiaaliviranomaisten esittämä suositus ja oikeuden todeksi katsoma väkivalta-, päihteidenkäyttö- tai mielenterveyssyytös toisesta osapuolesta ovat merkityksellisimmät oikeuden päätöstä selittävät tekijät. Näiden tekijöiden merkityksen suuruus ei näytä riippuvan siitä, onko kyseessä äiti vai isä. Lasten vakiintunut asuinpaikka on useammin äidin kuin isän luona, mikä selittää sitä, miksi äidit voittavat riitoja hieman useammin kuin isät. Mitä suurempi vanhempien välinen ikäero on, sitä paremmat ovat nuoremman osapuolen voittomahdollisuudet. Mikäli vanhin lapsi on alle kouluikäinen, niin äidin voittomahdollisuudet paranevat. Mikäli äidin avustaja oikeudessa on mies tai mikäli äiti on työtön, niin isän voittomahdollisuudet paranevat. Hovioikeus muuttaa käräjäoikeuden päätöstä asumisriidoissa noin 14 prosentissa valituksista. Koska käräjä- ja hovioikeuden päätökset ovat hyvin vahvasti kytkeytyneet toisiinsa, niin päätöksen muuttumiselle jää vain vähän selittäviä tekijöitä. Tällaisia ovat edeltävä huolto- ja asumistilanne ja vanhempien välinen ikäero. Järjestysregressiomalli toimii ilmiön mallintamisessa melko hyvin ja erityisesti skaala- ja nominaaliselittäjien käyttäminen osoittautuu toimivaksi tavaksi huomioida osapuolten vaatimukset. Mallien ennusteet ovat lupaavia, vaikka ennustekykyä on arvioitu vain aineistolla, jolla malli on sovitettu. Aineiston suuren muuttujamäärän vuoksi kaikkia yhteyksiä on vaikea havaita, minkä vuoksi aineistosta olisi mielenkiintoista tehdä vielä useita lisätarkasteluja

Do Changes in Perioperative and Postoperative Treatment Protocol Influence the Frequency of Pulmonary Complications? A Retrospective Analysis of Four Different Bariatric Groups

The current understanding of prophylaxis of pulmonary complications in bariatric surgery is weak. Purpose: The aim of this study was to observe how changes in perioperative and postoperative treatments affect the incidence of pulmonary complications in bariatric patients. Materials: This is a retrospective clinical study of 400 consecutive bariatric patients. The patients, who either underwent a sleeve gastrectomy or a Roux-en-Y gastric bypass, were divided consecutively into four subgroups with different approaches to perioperative treatment. Methods: The first group (patients 0-100) was recovered in the intensive care unit with minimal mobilization (ICU). They had a urinary catheter and a drain. The second group (patients 101-200) was similar to the first group, but the patients used a continuous positive airway pressure (CPAP) device intermittently (ICU-CPAP). The third group (patients 201-300) was recovered on a normal ward without a urinary catheter or a drain and used a CPAP device (ward-slow). The fourth group (patients 301-400) walked to the operating theater and was mobilized in the recovery room during the first 2 h after the operation (ward-fast). CPAP was also used. Primary endpoints were pulmonary complications, pneumonia, and infection, non-ultra descriptus (NUD). Results: The number of pulmonary complications among the groups was significantly different. A long operation time increased the risk for infection (p <0.001 95 % CI from 2.02 to 6.59 %). Conclusions: Operation time increases the risk for pulmonary complications. Changes in perioperative care toward the ERAS protocol may have a positive effect on the number of pulmonary complications.Peer reviewe

Ladina päritolu juriidilised terminid Soome õigusteaduse keelekasutuses õigusajakirjas Lakimies, 2005-2007

http://tartu.ester.ee/record=b2659016~S1*es

Health inequalities among Russian-born immigrant women in Finland : Longitudinal analysis on cervical cancer incidence and participation in screening

Research has documented both lower and higher cancer incidence among migrants. Evidence among the large Russian-born migrant population, however, is scarce. We examined cervical cancer incidence and screening participation among Russian-born immigrant women in Finland, a country with complete cancer registration and universal public health care including organized cancer screening. Our study population included all the women that resided in Finland during 1970-2017 and was formed linking individual-level data from four nationwide registries. The linked data sets on cancer and cancer screening were analysed separately using different statistical models. Russian-born immigrant women had increased (+62%) incidence of cervical cancer compared to the general Finnish female population, and they participated in cervical cancer screening slightly less than other women. Our findings showed no consistent transition pattern in cancer incidence or screening participation rate with duration of stay. Potential explanations for the observed differences include institutional and behavioural factors. Cervical cancer is one of the most preventable cancers, and cancer screening can both prevent and reduce incidence and mortality of cervical cancer. Efforts should be made to encourage migrant populations to participate in cervical screening.Peer reviewe

Register-based study of the incidence, comorbidities and demographics of obsessive-compulsive disorder in specialist healthcare

Background: Incidence of obsessive-compulsive disorder (OCD) has been suspected to increase but nationwide epidemiological studies are limited. This study aims to examine sex-specific incidence time trends and characterize psychiatric and neurodevelopmental comorbidities and sociodemographic risk factors of OCD in specialist healthcare in Finland. Methods: A nationwide register-based study using data from four Finnish registers identified 3372 OCD cases and 13,372 matched controls (1: 4). Cumulative incidence in subjects born between 1987 and 2001 was estimated at ages of 10, 15, 20 and 23 years. Conditional logistic regression was used to examine the sociodemographic factors. Results: The cumulative incidence of OCD was 0.4% by age 23. Incidence by age 15 among three cohorts increased from 12.4 to 23.7 /10000 live born males and 8.5 to 28.0 /10000 live born females. 73% of the sample had a comorbid condition. Males were significantly more comorbid with psychotic and developmental disorders; females were more comorbid with depressive and anxiety disorders (p <0.001). Higher maternal SES was associated with an increased risk of OCD (OR 1.4; 95% CI 1.1-1.6). Conclusions: These findings suggest that incidence of treated OCD in specialist healthcare has increased. The reason may be increased awareness and rate of referrals but a true increase cannot be ruled out. Further research on risk factors of OCD is warranted.Peer reviewe

Obstetric and Neonatal Adversities, Parity, and Tourette Syndrome: A Nationwide Registry

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A Retrospective 2-Year Follow-up of Late Complications Treated Surgically and Endoscopically After Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and Laparoscopic Sleeve Gastrectomy (LSG) for Morbid Obesity

The laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the gold standard for bariatric surgery, but recently, the laparoscopic sleeve gastrectomy (LSG) has gained popularity. At present, limited data is available on the long-term complications of these two types of surgery. The aim of this retrospective study was to compare the 2-year data about late (more than 30 days after surgery) complications that were treated surgically or endoscopically after LRYGB and LSG operations in a large hospital area with a single patient database. This was a retrospective, non-randomized, single-center study of 760 (545 LRYGB and 215 LSG) bariatric patients surgically treated between 2008 and 2013 in the Bariatric Surgery Unit of Helsinki University Central Hospital. The patients were followed for 2 years, and late complications (more than 30 days after surgery) that were surgically and/or endoscopically treated were registered. Weight loss and the risk factors for complications were also monitored. The study found a difference between the LRYGB and LSG patients in a number of late complications treated by both intervention types: surgical intervention were required in 9.4% of LRYGB patients vs. 0.9 of LSG patients, and endoscopic intervention were required by 4.6% of LRYGB patients vs. 1.4% of LSG patients (both p <0.05). The risk of surgical complications was increased by better weight loss results in 12 months. LRYGB was found to be associated with a greater risk of late complications. If larger databases confirm these results, the trend toward LSG is justified.Peer reviewe