Noninvasive cardiorespiratory signals analysis for asthma evolution monitoring in preschool children

Despite its increasing prevalence, diagnosis of asthma in children remains problematic due to their difficulties in producing repeatable spirometric maneuvers. Moreover, low adherence to inhaled corticosteroids (ICS) treatment could result in permanent airway remodeling. The growing interest in a noninvasive and objective way for monitoring asthma, together with the apparent role of autonomic nervous system (ANS) in its pathogenesis, have attracted interest towards heart rate variability (HRV) and cardiorespiratory coupling (CRC) analyses. In this work, HRV and CRC were analyzed in 70 children who were prescribed ICS treatment due to obstructive bronchitis. They underwent three different electrocardiogram and respiratory signals recordings, during and after treatment period. After treatment completion, they were followed up during 6 months and classified attending to their current asthma status. Vagal activity, as measured from HRV, and CRC, were reduced after treatment in those children at lower risk of asthma, whereas it kept unchanged in those with a worse prognosis. Results suggest that HRV analysis could be useful for the continuous monitoring of ANS anomalies present in asthma, thus contributing to evaluate the evolution of the disease, which is especially challenging in young children

Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1-3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.Peer reviewe

Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1-3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.</p

Kuntoanalyysien uudet mallit

ISSN-L1798-665

Mikä ensihoitaja? : Abiturienttien käsityksiä ensihoitajan ammatista

Suomalainen ensihoitojärjestelmä on nuori, ja ammattina ensihoito on tullut esille vasta viime vuosina. Sen tunnettuus on melko heikkoa mutta kuitenkin kasvussa muun muassa median vaikutuksesta. Hakijamäärät ensihoidon koulutusohjelmiin ovat suuret ja kasvavat edelleen. Niinpä olisikin tärkeää antaa oikeanlainen kuva ensihoitoalasta, jotta oikeat henkilöt hakeutuisivat opiskelemaan näiksi terveydenhuollon ammattilaisiksi. Tämän tutkimuksen tavoitteena oli tuoda esille abiturienttien käsityksiä ensihoidosta ja tarjota Savonia-ammattikorkeakoululle mahdollisuus halutessaan hyödyntää tuloksia koulutusohjelman markkinoinnissa. Tarkoituksena oli selvittää kyselylomakkeen avulla kuopiolaisten abiturienttien käsityksiä ensihoidosta ammattina ja sen merkitystä yhteiskunnassa, ensihoidon ominaispiirteitä ja alalla tarvittavia ominaisuuksia. Lisäksi opiskelijoilta kysyttiin, mistä he ovat saaneet tietoa. Otokseen arvottiin kaksi Kuopion lukiota, joista saatiin vastaajia yhteensä 81. Heistä oli poikia 16 ja tyttöjä 65. Kysely toteutettiin internetissä Typala –palauteohjelman avulla. Kyselylomake muokattiin samankaltaista tutkimusta varten tehdystä lomakkeesta, jonka käyttöön kysyttiin lupa puhelimitse. Kysymykset olivat 5-portaisia Likert-asteikollisia ja kyllä–ei-kysymyksiä. Mukana oli myös yksi avoin kysymys. Vastaukset siirrettiin SPSS-ohjelmaan, jossa ne analysoitiin tilastollisin menetelmin. Tulokset esitettiin taulukoissa prosentein ja frekvenssein. Abiturientit pitivät ensihoitotyötä arvostettuna mutta epäoikeudenmukaisesti palkattuna, henkisesti vaativana, vaihtelevana ja vastuullisena. Heidän mielestään ala on turvallinen, mutta ei itsenäinen ala, joka sopii yhtä lailla miehelle kuin naiselle. Nuorten käsitys ensihoitajan työhönsijoittumismahdollisuuksista terveydenhuollossa oli puutteellinen. Lukiolaiset kokivat ammatissa tarvittavan erityisesti päätöksenteko- ja vuorovaikutustaitoja. Muun muassa johtamis- ja eettiset taidot arvioitiin selvästi vähemmän tarpeellisiksi. Suurin osa vastaajista ei uskonut mahdollisuuteen työskennellä 24 tuntia kerrallaan. Tietoa ensihoidosta vastaajat olivat saaneet mediasta, muun muassa Internetistä, kavereilta ja omien tai läheisten kokemuksista. Lukiolaisten käsitys ensihoidosta oli pääasiassa melko realistinen, mutta muutamat tärkeät piirteet ensihoitotyössä olivat heille tuntemattomia. Televisio-ohjelmat tuovat ammatin luonnetta esille, mutta sen todellista sisältöä ja arjen käytäntöä tulisi avata alasta kiinnostuneille.Finnish emergency care system is young and as a profession paramedics has become more known during recent years. Its conspicuousness is pretty weak but growing. It’s partly because of the media. The number of applicants is large and getting larger so it would be important to let the people see the correct picture of emergency care in order to get the right people to become health care professionals. The aim of this study was to examine the perceptions of emergency care profession according to candidates for the matriculation examination and that the Savonia University of Applied Sciences could choose to use the results to the benefit of marketing the training program in the future. The purpose was to use a questionnaire to find out the perceptions of emergency care as a profession and its meaning in society and also the emergency care characteristics and features needed in the field according to candidates of the matriculation examination. In addition we asked them where they got their information from. Two high schools in Kuopio were drawn to the sample and we had 81 respondents of which 65 were girls and 16 boys. The survey was conducted over the Internet via Typala –feedback program. The questionnaire was modified from another one which had been used in the same kind of survey. We asked the permission to use the form by phone. The questions were 5-step Likert-scaled and yes-no –questions. We had one open question. The replies were transferred to the SPSS program where they were analyzed using statistics. The results were presented in tables as percentages and frequencies. Students think that emergency care is appreciated, mentally demanding, varying and responsible as a profession and also unfairly paid. They feel that the profession fits for both men and women and that it is a safe but not so independent a job. Their understanding of paramedic’s possible working places in health care was inadequate. In addition the students felt that one must have decision-making and interpersonal skills when working in emergency care. Skills like leadership skills and ethics were much less notified. The majority of respondents didn’t believe in the possibility to work 24 hours straight. The respondents had received information for example from the media, Internet, friends and their own or their close ones’ experiences. The students’ picture of emergency care was mainly realistic but certain characteristics in paramedic’s job were unknown. TV-programs present the nature of the profession but the actual working image should be emphasized

Suomalaisen eläin- ja kasvitieteellisen seuran Vanamon julkaisuja osa 6

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