The use of digital tools by general practitioners in Finnish public health centres

Electronic health services (eHealth) have increased rapidly in the last few years. These services hold the potential to facilitate today’s challenging primary care. The aim of the study was to examine how digitalisation manifests in Finnish health centres in 2021. We aimed to find out which digital tools are used in health centres and how they are exploited. In addition, we were interested in general practitioners’ attitudes towards digitalisation in their everyday work. An online survey was distributed to general practitioners (GPs) working in primary health care centres throughout Finland, and 265 GPs replied. A health portal and various digital calculators were used daily. In remote communication with their patients, general practitioners preferred telephone calls over new tools (chat/video). Attitudes towards eHealth were positive, but digital tools were not yet commonly used. The implementation of digital solutions still needs more effort

Metaphyseal dysplasia without hypotrichosis' can present with late-onset extraskeletal manifestations

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Lasten ja nuorten aikuisten akuutin lymfoblastileukemian hoito kehittyy

Teema : Hematologiset syövät. English summaryPeer reviewe

Medical and nursing students’ co-learning in digitalized health care eco-system

The demographic change in Finnish population has forced us to develop digital solutions to meet health care requirements. To respond to the need, we designed and piloted a one-day Multidisciplinary Digital Clinic (MDC) education for medical and nursing students. In this report, we describe our project of the one-day MDC education of digital solutions in primary care for medical and nursing students, and their learning experiences. Additionally, we describe the realization of the intended learning outcomes. The MDC education was conducted by flipped learning method with pre-studying materials. The MDC day was divided into three topical workshops: Remote Care, Digital Symptoms and Health care assessment, and Assessment of Need for care. Students formed three multidisciplinary teams. The students (N=108) valued the opportunity to train with modern technological equipment. Learning in the multidisciplinary teams enabled their knowledge and expertise sharing beyond study field limits, and provided a unique opportunity to discuss together, and thus, helped generate future-proof cooperation skills. The MDC training improved students' understanding of digitally enhanced health care services and increased their understanding of the automated digitalized service pathways, and the continuity of care. In conclusion, the students described MDC as a unique opportunity, and future oriented education. The MDC encouraged students to get involved in the digitally and technologically enhanced health care eco-system in their professional careers

Asparaginase-Associated Pancreatitis in Acute Lymphoblastic Leukemia : Results From the NOPHO ALL2008 Treatment of Patients 1-45 Years of Age

PURPOSE Asparaginase-associated pancreatitis (AAP) is common in patients with acute lymphoblastic leukemia (ALL), but risk differences across age groups both in relation to first-time AAP and after asparaginase re-exposure have not been explored. PATIENTS AND METHODS We prospectively registered AAP (n = 168) during treatment of 2,448 consecutive ALL patients aged 1.0-45.9 years diagnosed from July 2008 to October 2018 and treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol. RESULTS Compared with patients aged 1.0-9.9 years, adjusted AAP hazard ratios (HRa) were associated with higher age with almost identical HRa (1.6; 95% CI, 1.1 to 2.3; P = .02) for adolescents (10.0-17.9 years) and adults (18.0-45.9 years). The day 280 cumulative incidences of AAP were 7.0% for children (1.0-9.9 years: 95% CI, 5.4 to 8.6), 10.1% for adolescents (10.0 to 17.9 years: 95% CI, 7.0 to 13.3), and 11.0% for adults (18.0-45.9 years: 95% CI, 7.1 to 14.9; P = .03). Adolescents had increased odds of both acute (odds ratio [OR], 5.2; 95% CI, 2.1 to 13.2; P = .0005) and persisting complications (OR, 6.7; 95% CI, 2.4 to 18.4; P = .0002) compared with children (1.0-9.9 years), whereas adults had increased odds of only persisting complications (OR, 4.1; 95% CI, 1.4 to 11.8; P = .01). Fifteen of 34 asparaginase-rechallenged patients developed a second AAP. Asparaginase was truncated in 17/21 patients with AAP who subsequently developed leukemic relapse, but neither AAP nor the asparaginase truncation was associated with increased risk of relapse. CONCLUSION Older children and adults had similar AAP risk, whereas morbidity was most pronounced among adolescents. Asparaginase re-exposure should be considered only for patients with an anticipated high risk of leukemic relapse, because multiple studies strongly indicate that reduction of asparaginase treatment intensity increases the risk of relapse. (C) 2019 by American Society of Clinical OncologyPeer reviewe

Remote consultation training for GP trainees in primary care

Not availablepublishedVersio

Pellava- ja hamppukuidun käyttö nesteen imeytyksessä

Pellavan ja kuituhampun soveltuvuus nesteen imeyttämiseen riippuu mm. korjuuajasta, käsittelymenetelmästä ja tuotetusta kuitulajista tai jakeesta. Tässä tutkimuksessa selvitetään vuosina 1999 2001 kasvien korjuuteknologiaa, imuominaisuuksia ja kasvien anatomista rakennetta imutuotteiden kannalta.Harvesting time, processing method and the fibre type or fraction produced all affect the absorptive properties of flax, linseed and fibre hemp. The project investigated harvest technology, capillarity properties and the anatomy of plants.vokKVAFlax and hemp as absorbent

Diagnostics of rare disorders : whole-exome sequencing deciphering locus heterogeneity in telomere biology disorders

Background: The telomere biology disorders (TBDs) include a range of multisystem diseases characterized by mucocutaneous symptoms and bone marrow failure. In dyskeratosis congenita (DKQ, the clinical features of TBDs stem from the depletion of crucial stem cell populations in highly proliferative tissues, resulting from abnormal telomerase function. Due to the wide spectrum of clinical presentations and lack of a conclusive laboratory test it may be challenging to reach a clinical diagnosis, especially if patients lack the pathognomonic clinical features of TBDs. Methods: Clinical sequencing was performed on a cohort of patients presenting with variable immune phenotypes lacking molecular diagnoses. Hypothesis-free whole-exome sequencing (WES) was selected in the absence of compelling diagnostic hints in patients with variable immunological and haematological conditions. Results: In four patients belonging to three families, we have detected five novel variants in known TBD-causing genes (DKC1, TERT and RTEL1). In addition to the molecular findings, they all presented shortened blood cell telomeres. These findings are consistent with the displayed TBD phenotypes, addressing towards the molecular diagnosis and subsequent clinical follow-up of the patients. Conclusions: Our results strongly support the utility of WES-based approaches for routine genetic diagnostics of TBD patients with heterogeneous or atypical clinical presentation who otherwise might remain undiagnosed.Peer reviewe