12 research outputs found

    Characteristics and Outcomes of 79 Patients with an Insulinoma : A Nationwide Retrospective Study in Finland

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    Objective. Insulinomas are rare pancreatic tumours. Population-based data on their incidence, clinical picture, diagnosis, and treatment are almost nonexistent. The aim of this study was to clarify these aspects in a nationwide cohort of insulinoma patients diagnosed during three decades. Design and Methods. Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980-2010. Results. Seventy-nine patients were diagnosed with insulinoma over the research period. The median follow-up from diagnosis to last control visit was one (min 0, max 31) year. The incidence increased from 0.5/million/year in the 1980s to 0.9/million/year in the 2000s (p = 0 002). The median diagnostic delay was 13 months and did not change over the study period. The mean age at diagnosis was 52 (SD 16) years. The overall imaging sensitivity improved from 39% in the 1980s to 98% in the 2000s (p <0 001). Seventy- one (90%) of the patients underwent surgery with a curative aim, two (3%) had palliative surgery, and 6 (8%) were inoperable. There were no significant differences in the types of surgical procedures between the 1980s, 1990s, and 2000s; tumour enucleations comprised 43% of the operations, distal pancreatic resections 45%, and pancreaticoduodenectomies 12%, over the whole study period. Of the patients who underwent surgery with a curative aim, 89% had a full recovery. Postoperative complications occurred in half of the patients, but postoperative mortality was rare. Conclusions. The incidence of insulinomas has increased during the past three decades. Despite the improved diagnostic options, diagnostic delay has remained unchanged. To shorten the delay, clinicians should be informed and alert to consider the possibility of hypoglycemia and insulinoma, when symptomatic attacks are investigated in different sectors of the healthcare system. Developing the surgical treatment is another major target, in order to lower the overall complication rate, without compromising the high cure rate of insulinomas.Peer reviewe

    Children with specific language impairment in Finnish: the use of tense and agreement inflections

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    Children with specific language impairment (SLI) vary widely in their ability to use tense/agreement inflections depending on the type of language being acquired, a fact that current accounts of SLI have tried to explain. Finnish provides an important test case for these accounts because: (1) verbs in the first and second person permit null subjects whereas verbs in the third person do not; and (2) tense and agreement inflections are agglutinating and thus one type of inflection can appear without the other. Probes were used to compare the verb inflection use of Finnish-speaking children with SLI, and both age-matched and younger typically developing children. The children with SLI were less accurate, and the pattern of their errors did not match predictions based on current accounts of SLI. It appears that children with SLI have difficulty learning complex verb inflection paradigms apart from any problem specific to tense and agreement

    The development of narrative productivity, syntactic complexity, referential cohesion and event content in four- to eight-year-old Finnish children

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    This study focuses on the development of narrative structure and the relationship between narrative productivity and event content. A total of 172 Finnish children aged between four and eight participated. Their picture-elicited narrations were analysed for productivity, syntactic complexity, referential cohesion and event content. Each measure showed a developmental trend. Concerning consecutive age groups, significant differences were observed between four- and five-year-olds in productivity and event content and between five- and six-year-olds in referential cohesion. Multiple regression analysis showed that the relationship between productivity and event content was important, and especially the number of different word tokens proved to be useful in explaining the event content, whereas the number of communication units did not. This suggests that some productivity measures should be interpreted with caution

    Detection of Helicobacter species in chronic liver disease and chronic inflammatory bowel disease

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    Aim. To study the association between helicobacters and chronic liver diseases and chronic inflammatory bowel diseases. Patients and methods. Thirty-two patients with various chronic liver diseases and 137 patients with inflammatory bowel disease were enrolled. Antibodies to H. pylori, H. hepaticus, H. bilis, and H. pullorum were measured by enzyme immunoassay (EIA), and sera positive in a non-pylori helicobacter EIA were further examined by immunoblot assay. Detection of Helicobacter DNA in liver biopsies was done by denaturating gradient gel electrophoresis of PCR products (PCR-DGGE) and DNA sequence analysis. Results. Six inflammatory bowel disease patients, four with ulcerative colitis and two with Crohn's disease, and one liver disease patient with autoimmune cholangitis had antibodies to non-pylori helicobacters by an immunoblot assay. Four immunoblot assay-negative patients, three with autoimmune and one with non-autoimmune liver disease, had Helicobacter DNA in liver biopsies; three of the polymerase chain reaction (PCR) products were closely related to non-pylori helicobacters. Conclusion. Evidence for non-pylori helicobacters was scant in Finnish patients with inflammatory bowel disease or chronic but not end stage liver disease. We cannot, however, rule out their role in these diseases
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