PERCEIVED INDOOR AIR QUALITY AND PSYCHOSOCIAL WORK ENVIRONMENT IN OFFICE, SCHOOL AND HEALTH CARE ENVIRONMENTS IN FINLAND

Objectives: The study examined the extent and prevalence of perceived indoor environment-related (IE-related) symptoms environmental complaints and psychosocial work environmental factors in Finnish office, school and health care environments. Material and Methods: The data were collected from non-industrial workplaces (N = 455) in 2011-2012 and 2015-2017 using the Finnish Institute of Occupational Health's Indoor Air Questionnaire (IA Questionnaire). Suspicion of IE-related problems was reported in 59% of workplaces. The data consisted of 28 826 employees' responses. Results: The employees reported symptoms and environmental discomfort in office environments less often than in school or health care environments. The most often reported IE-related complaints were stuffy air (39% of respondents), dry air (34%) and insufficient ventilation (33%). The most often reported symptoms were irritation of the nose (27% of respondents), irritation of the eyes (26%), and hoarse or dry throat (24%). The results showed differences between the perceived IE in office, school and health care environments. Conclusions: Compared to earlier findings, the most often perceived IE-related symptoms and complaints have increased in Finnish health care environments. The office employees' perceptions of psychosocial work environment remained fairly unchanged whereas health care personnel more often assessed their psychosocial environment as positive compared to previous reports. Instead of exact reference values, comparing the results of IA Questionnaires with the distributions and mean values of the results of this study may be more informative for those striving to solve IE-related problems. The presented distribution and mean values of perceived symptoms, environmental complaints and psychosocial work environment might help to relate the results to other workplaces. This, in turn, might increase the understanding that IA Questionnaire results are influenced by many factors. The results presented can be used as new reference material when interpreting the results of IA Questionnaires in office, school and health care environments.Peer reviewe

Thrombotic microangiopathy associated with bortezomib treatment in a patient with relapsed multiple myeloma

Thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS) describe microvascular occlusive disorders characterized by thrombocytopenia due to increased platelet aggregation and fragmentation hemolysis. We report here what to our knowledge is the second case of TTP/HUS associated with bortezomib treatment

Mitochondrial DNA haplogroups in early-onset Alzheimer's disease and frontotemporal lobar degeneration

<p>Abstract</p> <p>Background</p> <p>Mitochondrial dysfunction, oxidative damage and the accumulation of somatic mutations in mitochondrial DNA (mtDNA) have been associated with certain neurodegenerative disorders. Previous studies have also provided controversial results on the association of mtDNA haplogroups with susceptibility to Alzheimer's disease (AD), but possible relationships between mtDNA and frontotemporal lobar degeneration (FTLD) have been less frequently studied.</p> <p>Methods</p> <p>We analysed the role of mtDNA and its maintenance enzymes in 128 early-onset AD (eoAD) and in 66 FTLD cases. Patients and 99 controls were collected from a defined region of Finland, that of Northern Ostrobothnia, for the determination of mtDNA haplogroups and the analysis of two common mtDNA mutations (m.3243A>G, m.8344A>G). In addition, screening was performed for five common <it>POLG1 </it>mutations (T251I, A467T, P587L, W748S and Y955C) and all the coding exons of the <it>PEO1 </it>and <it>ANT1 </it>genes were screened for mutations.</p> <p>Results</p> <p>The frequency of haplogroup cluster IWX was 2.3 fold higher among the FTLD cases than in the controls (OR 2.69, 95% CI 1.09-6.65, <it>p </it>= 0.028). The frequency of mtDNA haplogroups or clusters did not differ between the eoAD cases and controls. The two mtDNA mutations and five <it>POLG1 </it>mutations were absent in the eoAD and FTLD patients. No pathogenic mutations were found in the <it>PEO1 </it>or <it>ANT1 </it>genes.</p> <p>Conclusions</p> <p>We conclude that the haplogroup cluster IWX was associated with FTLD in our cohort. Further studies in other ethnically distinct cohorts are needed to clarify the contribution of mtDNA haplogroups to FTLD and AD.</p

Luovuttajan lymfosyytti-infuusiot allogeenisen kantasolujen siirron jälkihoidossa

JOHDANTO. Allogeenisen kantasolujen siirron (ASCT) jälkihoidossa luovuttajan lymfosyytti-infuusio (DLI) on mahdollinen hoitokeino pahanlaatuisen veritaudin relapsin ehkäisemiseksi tai hoitamiseksi. Tutkimuksessa selvitettiin DLI-hoidon tehoa Tyksin kantasolujensiirtoyksikössä.AINEISTO. Tyksissä vuosina 2009-2019 allogeenisen kantasolujen siirron jälkeen DLI:n sai 46 potilasta. Lymfosyytti-infuusioita annettiin ennakoivasti, kliinisen taudin hoidoksi tai profylaktisesti suuren relapsiriskin pienentämiseksi.TULOKSET. Ennakoivan hoidon saaneiden elinikä ja taudin etenemättömyysaika olivat merkitsevästi pidemmät kuin kliinisen taudin tai profylaktisen hoidon saaneiden. DLI-hoidon merkittävin riski on käänteishyljintä. Yli puolelle tutkimuksen potilaista ei ilmaantunut akuuttia tai kroonista käänteishyljintäreaktiota, mutta toisaalta yksi potilas kuoli akuuttiin ja yksi krooniseen käänteishyljintäreaktioon.PÄÄTELMÄT. DLI on keino lisätä siirron jälkeistä graft-versus-leukemia-vaikutusta. Sen hyöty on suurin ennakoivana hoitona vähäisen tautimäärän hoidossa. DLI-hoidon tehoon ja turvallisuuteen voidaan vaikuttaa sopivilla annoksilla ja liitännäishoidoilla.</p

Methacholine, cold air and exercise challenge tests in the diagnosis of bronchial responsiveness at school age: A follow-up study from birth to school age

ABSTRACTBackgroundThe aim of the present study was to compare three bronchial challenge tests for assessing bronchial hyperresponsiveness (BHR) in twin pairs followed up from birth to school age.MethodsWe studied three different bronchial challenge tests (methacholine inhalation challenge, cold air inhalation challenge and exercise-bronchodilation tests) at school age in 29 children born at or before 38 weeks gestation (median 35 weeks gestation) from multiple pregnancies. The children had been followed up from birth and were examined at the age of 7-15 years (median age 10 years).ResultsBronchial hyperresponsiveness was found in 28-34% of children when these tests were analyzed separately. Eight children (28%) were exercise responders; two of them and three additional children were bronchodilator responders. Thus, 11 children (38%) had a pathologic result in the exercise-bronchodilation test. Ten children (34%) responded to cold air and nine children (31%) responded to methacholine inhalation. At least one test was pathologic in 18 children (62%), but only two children (7%) responded in all three challenges. A positive result in the exercise-bronchodilation test was associated with cold air reactivity, but not with methacholine reactivity. The exercise and cold air tests detected predominantly the same children. No differences were found in bronchial challenge test results between children who, at birth, were appropriately grown and those who had intrauterine growth retardation.conclusionsBronchial hyperresponsiveness was common (up to 62%) at school age in children born as moderately preterm. The outdoor exercise-bronchodilation test found 61% of all BHR cases. Bronchial hyperresponsiveness was not associated with intrauterine growth status. The most sensitive test was the cold air inhalation challenge and a good agreement was seen between this test and the exercise challenge outdoors

Raudanpuute ilman anemiaa - miten ferritiiniarvoa tulkitaan?

Plasman ferritiinipitoisuuden mittaus on elimistön rautapitoisuuden perusseulontakoe. Sen tulkinta ei ole kuitenkaan aina helppoa. Osoitettu raudanpuute voi olla rautahoidon aihe, vaikkei siihen liittyisikään anemiaa. Terveen henkilön varastorautavajaus korjataan yleensä suun kautta otettavilla valmisteilla

Double versus single high-dose melphalan 200 mg/m2 and autologous stem cell transplantation for multiple myeloma: a region-based study in 484 patients from the Nordic area

Autologous stem cell transplantation is still considered the standard of care in young patients with multiple myeloma (MM). This disease is the most common indication for high-dose therapy (HDT) supported by hematopoietic stem cell transplantation and much data support the benefit of this procedure. Results of randomized studies are in favor of tandem autologous transplantation although the effect on overall survival is unclear. Based on sequential registration trials in the Nordic area, we aimed to evaluate the outcome of conventional single or double HDT

Yhteistyö tuki-ja liikuntaelinvaivoihin liittyvän työkyvyttömyyden ehkäisyssä : Monimenetelmällinen tutkimus työterveyshuollon sisäisestä yhteistyöstä sekä työterveys- ja kuntoutusyhteistyöstä

Tuki- ja liikuntaelinvaivoista johtuvan työkyvyttömyyden ehkäisyä voidaan hoitaa tehokkaasti työterveyshuollon ja työpaikan yhteistyönä. Jos työpaikalla toteutettavat työjärjestelyt ja työterveyshuollon tukitoimet eivät riitä, käytettävissä on erilaisia kuntoutusratkaisuja. Kuntoutuksen tuloksellisuus edellyttää työpaikan, työterveyshuollon ja kuntoutuksen välistä yhteistyötä. Monimenetelmällisessä tutkimuksessa selvitettiin kyselyllä työterveyshuollon sisäistä yhteistyötä sekä työterveyshuollon yhteistyötä työpaikan ja kuntoutuksen kanssa tuki- ja liikuntaelinongelmiin (tuleongelmiin) liittyvässä työkyvyn tuessa. Kuntoutusprosessiin liittyvää yhteistyötä tutkittiin laadullisin menetelmin kolmella Tules-kurssilla. Tulosten perusteella moniammatillinen yhteistyö työterveyshuollon sisällä sekä yhteistyö muiden toimijoiden kanssa vaatii selkeitä rakenteita ja yhteisiä toimintamalleja. Kuntoutuksessa tule-ongelmaisen työntekijän aktiivisuuden tukeminen työkyvyn edistämiseksi tarvitsee nykyistä tietoisempaa yhteistyötä erityisesti työhön liittyvissä tavoitteissa ja tukitoimissa

Cognitive impairment is not uncommon in patients with biallelic RFC1 AAGGG repeat expansion, but the expansion is rare in patients with cognitive disease

Introduction: The biallelic repeat expansion (AAGGG)(exp) in RFC1 causes cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS). Recently, cognitive impairment has been reported in patients with CANVAS and a broader neurodegenerative process associated with RFC1 has been suggested. Furthermore, rare cases of multiple system atrophy, Parkinson's disease, amyotrophic lateral sclerosis or CANVAS with features of dementia with Lewy bodies have been found. Objective: We hypothesized that the biallelic (AAGGG)(exp) is associated with neurodegeneration manifested as cognitive symptoms and that atypical RFC1 disease may be found among patients with cognitive disorder. Methods: Clinical data on nine patients with biallelic (AAGGG()exp) were reviewed and 564 patients with Alz-heimer's disease or frontotemporal dementia (FTD) were investigated for biallelic RFC1 (AAGGG)(exp). Results: Five patients with biallelic (AAGGG)(exp) were found with a cognitive impairment and in four of them the phenotype resembled FTD. However, biallelic (AAGGG)(exp) was not detected among patients with Alzheimer's disease or FTD. Conclusion: Cognitive impairment is a feature in patients with the biallelic (AAGGG)(exp), but the pathogenic expansion seems to be rare in patients with dementia. Studies on patients with diverse phenotypes would be useful to further explore the involvement of RFC1 in neuronal degeneration and to identify atypical phenotypes, which should be taken into account in clinical practice.Peer reviewe

Cost analysis of a randomized stem cell mobilization study in multiple myeloma

Upfront autologous stem cell transplantation (ASCT) is the standard therapy for younger multiple myeloma (MM) patients. MM patients usually undergo stem cell mobilization with cyclophosphamide (CY) followed by granulocyte colony-stimulating factor (G-CSF), or with G-CSF alone. A limited number of randomized studies are available comparing costs of different mobilization strategies. Eighty transplant-eligible patients aged up to 70 years with untreated MM were included in this prospective study. The patients were treated with RVD induction for three 21-day cycles and randomized 1: 1 at inclusion into one of the two mobilization arms CY 2 g/m(2) + G-CSF [arm A] vs. G-CSF alone [arm B]. Plerixafor was given according to a specific algorithm if needed. Sixty-nine patients who received mobilization followed by blood graft collection were included in the cost analysis. The median total costs of the mobilization phase were significantly higher in arm A than in arm B (3855 (sic) vs. 772 (sic), pPeer reviewe