Sydämen vajaatoiminnan lääkkeetön hoito

Lääke- ja laite- ja kirurginen hoito eivät ratkaise kaikkia sydämen vajaatoimintapotilaan ongelmia. Oireiset, suuren riskin vajaatoimintapotilaat tarvitsevat lisäksi ammattitaitoisen moniammatillisen vajaatoimintatiimin seurantaa, ohjausta ja tukea. Moniammatilliseen vajaatoimintatiimiin kuuluu lääkäreiden lisäksi vajaatoiminnan hoitoon perehtyneitä sairaanhoitajia, fysioterapeutteja, sosiaalityöntekijöitä ja muita erityisasiantuntijoita. Moniammatillinen hoidon toteutus ja seuranta sekä liikuntaharjoittelu on osoitettu hyödylliseksi. Lisäksi on olemassa suosituksia muun muassa ravitsemuksesta ja suolan käytöstä, vaikka tutkimusnäyttö niiden hyödystä puuttuukin. Käytäntö on osoittanut, että vajaatoimintapoliklinikka on ainakin suurissa yliopisto- ja keskussairaaloissa tarkoituksenmukaisin tapa koordinoida vaikeaa vajaatoimintaa sairastavien potilaiden moniammatillista hoitoa. Erikoissairaanhoidon ja perusterveydenhuollon saumattoman yhteistyön merkitys korostuu erityisesti monisairaita potilaita hoidettaessa, sekä taudinkulun alku- ja loppuvaiheessa

Eteisvärinäpotilaan aivohalvauksen esto

Teema : eteisvärinä. English summaryPeer reviewe

N-glycomic profiling of colorectal cancer according to tumor stage and location

Alterations in glycosylation are seen in many types of cancer, including colorectal cancer (CRC). Glycans, the sugar moieties of glycoconjugates, are involved in many important functions relevant to cancer and can be of value as biomarkers. In this study, we have used mass spectrometry to analyze the N-glycan profiles of 35 CRC tissue samples and 10 healthy tissue samples from non-CRC patients who underwent operations for other reasons. The tumor samples were divided into groups depending on tumor location (right or left colon) and stage (II or III), while the healthy samples were divided into right or left colon. The levels of neutral and acidic N-glycan compositions and glycan classes were analyzed in a total of ten different groups. Surprisingly, there were no significant differences in glycan levels when all right- and left-sided CRC samples were compared, and few differences (such as in the abundance of the neutral N-glycan H3N5) were seen when the samples were divided according to both location and stage. Multiple significant differences were found in the levels of glycans and glycan classes when stage II and III samples were compared, and these glycans could be of value as candidates for new markers of cancer progression. In order to validate our findings, we analyzed healthy tissue samples from the right and left colon and found no significant differences in the levels of any of the glycans analyzed, confirming that our findings when comparing CRC samples from the right and left colon are not due to normal variations in the levels of glycans between the healthy right and left colon. Additionally, the levels of the acidic glycans H4N3F1P1, H5N4F1P1, and S1H5N4F1 were found to change in a cancer-specific but colon location-nonspecific manner, indicating that CRC affects glycan levels in similar ways regardless of tumor location.Peer reviewe

Potilas- ja asiakasturvallisuudelle uusi kansallinen mittaristo

Uudessa mittaristossa on jokaisen sote-ammattilaisen arkea koskettavia osia

Potilas- ja asiakasturvallisuudelle uusi kansallinen mittaristo

Uudessa mittaristossa on jokaisen sote-ammattilaisen arkea koskettavia osia.</p

Helical computerized tomography and NT-proBNP for screening of right ventricular overload on admission and at long term follow-up of acute pulmonary embolism

WOS:000307820300001Peer reviewe

Laskimotukos ja keuhkoembolia : Käypä hoito -suosituksen päivitystiivistelmä

English summar

The nationwide Finnish anticoagulation in atrial fibrillation (FinACAF) : study rationale, design, and patient characteristics

Atrial fibrillation (AF) is a major cause of ischemic stroke and the number of AF patients is increasing. Thus, up-to-date multifaceted data about the characteristics of AF patients, their treatments, and outcomes are urgently needed. The Finnish anticoagulation in atrial fibrillation (FinACAF) study has collected comprehensive data on all Finnish AF patients from 1st January 2004 to 31st December 2018. The aim of this paper is to describe the study rationale, the process of integrating data from the applied resources and to define the study cohort. Using national unique personal identification number, individual patient data is linked from nationwide health care registries (primary, secondary, and tertiary care), drug purchases, education, and socio-economic status as well as places of domicile, incomes, and taxes. Six regional laboratory databases (similar to 282,000, 77% of the patients) are also included. The study cohort comprises of a total of 411,000 patients. Since the introduction of the national primary care register in 2012, 9% of all AF patients were identified outside hospital care registers. The prevalence of AF in Finland-4.1% of whole population-is for the first time now established. The FinACAF study allows a unique possibility to investigate the epidemiology and socio-medico-economic impact of AF as well as the cost effectiveness of different AF management strategies in a completely unselected, nationwide population. This article provides the rationale and design of the study together with a summary of the characteristics of the cohort.Peer reviewe