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Äyräväinen A, Pasanen A, Ahvenainen T, Heikkinen T, Pakarinen P, Härkki P, Vahteristo P. Systematic molecular and clinical analysis of uterine leiomyomas from fertile-aged women undergoing myomectomy. Hum Reprod 2021; 35:2237-2244. [PMID: 32829387 DOI: 10.1093/humrep/deaa187] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/12/2020] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION What are the distributions and associated clinical characteristics of mediator complex subunit 12 (MED12), high mobility group AT-hook 2 (HMGA2) and fumarate hydratase (FH) aberrations in uterine leiomyomas from fertile-aged myomectomy patients? SUMMARY ANSWER These driver mutations account for the majority (83%) of tumours in fertile-aged patients. WHAT IS KNOWN ALREADY Alterations affecting MED12, HMGA2 and FH account for 80-90% of uterine leiomyomas from middle-aged hysterectomy patients, while the molecular background of tumours from young myomectomy patients has not been systematically studied. STUDY DESIGN, SIZE, DURATION A retrospective series of 361 archival uterine leiomyoma samples from 234 women aged ≤45 years undergoing myomectomy in 2009-2014 was examined. Associations between the molecular data and detailed clinical information of the patients and tumours were analysed. PARTICIPANTS/MATERIALS, SETTING, METHODS DNA was extracted from formalin-fixed paraffin-embedded samples and MED12 exons 1 and 2 were sequenced to identify mutations. Level of HMGA2 expression was evaluated by immunohistochemistry. Biallelic FH inactivation was analysed with 2-succinylcysteine staining, which is an indirect method of assessing FH deficiency. All patients' medical histories were reviewed, and clinical information of patients and tumours was combined with molecular data. MAIN RESULTS AND THE ROLE OF CHANCE The median age at operation was 34 years. The majority (58%) of patients were operated on for a single leiomyoma. Known driver mutations were identified in 83% of tumours (71% MED12; 9% HMGA2; 3% FH). In solitary leiomyomas, the MED12 mutation frequency was only 43%, and 29% were wild-type for all driver alterations. MED12 mutations were associated with multiple tumours, smaller tumour size and subserosal location. LIMITATIONS, REASONS FOR CAUTION Although comprehensive, the study is retrospective in nature and all samples have been collected for routine diagnostic purposes. The use of paraffin-embedded samples and immunohistochemistry may have led to an underestimation of mutations. Due to the limited sample size and rarity of especially FH-deficient leiomyomas, the data are partly descriptive. WIDER IMPLICATIONS OF THE FINDINGS The contribution of driver mutations in leiomyomas from young myomectomy patients is comparable to tumours obtained from hysterectomies of mostly middle-aged women. Our results support the earlier findings that MED12 mutations are associated with multiple tumours, smaller tumour size and subserosal location. The study emphasizes the distinct molecular background of solitary leiomyomas, and more research is needed to clarify the underlying causes of the notable proportion of wild-type leiomyomas. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by the Academy of Finland (307773), the Sigrid Jusélius Foundation, the Cancer Foundation Finland and the iCAN Digital Precision Cancer Medicine Flagship. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A Äyräväinen
- Applied Tumor Genomics Research Program and Department of Medical and Clinical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Pasanen
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Ahvenainen
- Applied Tumor Genomics Research Program and Department of Medical and Clinical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,iCAN Digital Precision Cancer Medicine Flagship, University of Helsinki, Helsinki, Finland
| | - T Heikkinen
- Applied Tumor Genomics Research Program and Department of Medical and Clinical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - P Pakarinen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Härkki
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Vahteristo
- Applied Tumor Genomics Research Program and Department of Medical and Clinical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,iCAN Digital Precision Cancer Medicine Flagship, University of Helsinki, Helsinki, Finland
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Farnell DJJ, Richmond S, Galloway J, Zhurov AI, Pirttiniemi P, Heikkinen T, Harila V, Matthews H, Claes P. An exploration of adolescent facial shape changes with age via multilevel partial least squares regression. Comput Methods Programs Biomed 2021; 200:105935. [PMID: 33485077 PMCID: PMC7920996 DOI: 10.1016/j.cmpb.2021.105935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/05/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Multilevel statistical models represent the existence of hierarchies or clustering within populations of subjects (or shapes in this work). This is a distinct advantage over single-level methods that do not. Multilevel partial-least squares regression (mPLSR) is used here to study facial shape changes with age during adolescence in Welsh and Finnish samples comprising males and females. METHODS 3D facial images were obtained for Welsh and Finnish male and female subjects at multiple ages from 12 to 17 years old. 1000 3D points were defined regularly for each shape by using "meshmonk" software. A three-level model was used here, including level 1 (sex/ethnicity); level 2, all "subject" variations excluding sex, ethnicity, and age; and level 3, age. The mathematical formalism of mPLSR is given in an Appendix. RESULTS Differences in facial shape between the ages of 12 and 17 predicted by mPLSR agree well with previous results of multilevel principal components analysis (mPCA); buccal fat is reduced with increasing age and features such as the nose, brow, and chin become larger and more distinct. Differences due to ethnicity and sex are also observed. Plausible simulated faces are predicted from the model for different ages, sexes and ethnicities. Our models provide good representations of the shape data by consideration of appropriate measures of model fit (RMSE and R2). CONCLUSIONS Repeat measures in our dataset for the same subject at different ages can only be modelled indirectly at the lowest level of the model at discrete ages via mPCA. By contrast, mPLSR models age explicitly as a continuous covariate, which is a strong advantage of mPLSR over mPCA. These investigations demonstrate that multivariate multilevel methods such as mPLSR can be used to describe such age-related changes for dense 3D point data. mPLSR might be of much use in future for the prediction of facial shapes for missing persons at specific ages or for simulating shapes for syndromes that affect facial shape in new subject populations.
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Affiliation(s)
- D J J Farnell
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
| | - S Richmond
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - J Galloway
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - A I Zhurov
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - P Pirttiniemi
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - T Heikkinen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - V Harila
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - H Matthews
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; Facial Sciences Research Group, Murdoch Children's Research Institute, Melbourne; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - P Claes
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; Department of Electrical Engineering, ESAT/PSI, KU Leuven, 3000 Leuven, Belgium
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Farnell DJJ, Richmond S, Galloway J, Zhurov AI, Pirttiniemi P, Heikkinen T, Harila V, Matthews H, Claes P. Multilevel principal components analysis of three-dimensional facial growth in adolescents. Comput Methods Programs Biomed 2020; 188:105272. [PMID: 31865094 DOI: 10.1016/j.cmpb.2019.105272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/19/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVES The study of age-related facial shape changes across different populations and sexes requires new multivariate tools to disentangle different sources of variations present in 3D facial images. Here we wish to use a multivariate technique called multilevel principal components analysis (mPCA) to study three-dimensional facial growth in adolescents. METHODS These facial shapes were captured for Welsh and Finnish subjects (both male and female) at multiple ages from 12 to 17 years old (i.e., repeated-measures data). 1000 "dense" 3D points were defined regularly for each shape by using a deformable template via "meshmonk" software. A three-level model was used here, namely: level 1 (sex/ethnicity); level 2, all "subject" variations excluding sex, ethnicity, and age; and level 3, age. The technicalities underpinning the mPCA method are presented in Appendices. RESULTS Eigenvalues via mPCA predicted that: level 1 (ethnicity/sex) contained 7.9% of variation; level 2 contained 71.5%; and level 3 (age) contained 20.6%. The results for the eigenvalues via mPCA followed a similar pattern to those results of single-level PCA. Results for modes of variation made sense, where effects due to ethnicity, sex, and age were reflected in modes at appropriate levels of the model. Standardised scores at level 1 via mPCA showed much stronger differentiation between sex and ethnicity groups than results of single-level PCA. Results for standardised scores from both single-level PCA and mPCA at level 3 indicated that females had different average "trajectories" with respect to these scores than males, which suggests that facial shape matures in different ways for males and females. No strong evidence of differences in growth patterns between Finnish and Welsh subjects was observed. CONCLUSIONS mPCA results agree with existing research relating to the general process of facial changes in adolescents with respect to age quoted in the literature. They support previous evidence that suggests that males demonstrate larger changes and for a longer period of time compared to females, especially in the lower third of the face. These calculations are therefore an excellent initial test that multivariate multilevel methods such as mPCA can be used to describe such age-related changes for "dense" 3D point data.
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Affiliation(s)
- D J J Farnell
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
| | - S Richmond
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - J Galloway
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - A I Zhurov
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - P Pirttiniemi
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - T Heikkinen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - V Harila
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - H Matthews
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Facial Sciences Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - P Claes
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; Department of Electrical Engineering, ESAT/PSI, KU Leuven, 3000 Leuven, Belgium
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Launonen A, Maikku M, Vuollo V, Pirttiniemi P, Valkama AM, Heikkinen T, Kau CH, Harila V. Cover Image. Orthod Craniofac Res 2018. [DOI: 10.1111/ocr.12238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Launonen A, Maikku M, Vuollo V, Pirttiniemi P, Valkama AM, Heikkinen T, Kau CH, Harila V. 3D follow-up study of facial asymmetry after developmental dysplasia of the hip. Orthod Craniofac Res 2018; 21:146-152. [PMID: 29971961 DOI: 10.1111/ocr.12230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To evaluate the change in facial asymmetry among subjects treated for developmental dysplasia of the hip (DDH) from childhood to adolescence. SETTING AND SAMPLE POPULATION A total of 39 adolescents (26 females and 13 males), born and treated for DDH during 1997-2001, participated in the first examination in 2007 (T1; at the age of 8.2) and in the follow-up in 2016 (T2; at the age of 16.6). MATERIAL AND METHODS In this longitudinal study, three-dimensional (3D) images were taken using a 3DMD face system based on a stereophotogrammetric method. Facial asymmetry was determined as the average distance (mm) calculated between the original and superimposed mirrored face and the symmetry percentage (%) calculated as the face area where the distance between the original face and the mirrored surface does not exceed 0.5 mm. RESULTS Results showed increased asymmetry from T1 to T2. The average distance increased for whole face (from 0.51 mm to 0.59 mm, P = .001), upper face (from 0.41 mm to 0.49 mm, P = .005), mid-face (from 0.48 mm to 0.57, P = .002) and lower face (from 0.74 mm to 0.85 mm, P = .147). Facial symmetry percentage decreased for whole face from 61.23% to 55.38% (P = .011), for upper face from 69.27% to 62.24% (P = .005) and for mid-face from 62.29% to 55.63% (P = .007) and for lower face from 43.37% to 42.19% (P = .66). CONCLUSION Facial asymmetry increases from childhood to adulthood in subjects treated for DDH. Orthodontic treatment does not eliminate this asymmetric facial growth.
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Affiliation(s)
- A Launonen
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
| | - M Maikku
- Medical Research Center Oulu, Oulu, Finland
- Department of Surgery, Oulu University Hospital, Oulu, Finland
- Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland
- PEDEGO Research group, Oulu, Finland
| | - V Vuollo
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
| | - P Pirttiniemi
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
| | - A M Valkama
- Medical Research Center Oulu, Oulu, Finland
- Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland
- PEDEGO Research group, Oulu, Finland
| | - T Heikkinen
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
| | - C H Kau
- Department of Orthodontics, University of Alabama, Birmingham, USA
| | - V Harila
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
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Mikk ML, Heikkinen T, El-Amir MI, Kiviniemi M, Laine AP, Härkönen T, Veijola R, Toppari J, Knip M, Ilonen J. The association of the HLA-A*24:02, B*39:01 and B*39:06 alleles with type 1 diabetes is restricted to specific HLA-DR/DQ haplotypes in Finns. HLA 2017; 89:215-224. [PMID: 28185422 DOI: 10.1111/tan.12967] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/09/2016] [Accepted: 01/05/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND We analysed the previously reported association of the HLA-A*24:02, B*18 and B*39 alleles with type 1 diabetes and diabetes associated autoimmunity in the Finnish population applying HLA-DR/DQ stratification. MATERIALS & METHODS Haplotype transmission was analysed in 2424 nuclear families from the Finnish Paediatric Diabetes Register. Survival analysis was applied to study the development of islet autoantibodies and further progression to clinical diabetes in the prospective follow-up cohort from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study. The subjects were genotyped for specific HLA class I alleles by sequence-specific hybridization using lanthanide labelled nucleotide probes. RESULTS The HLA-B*39:06 allele was found almost exclusively on the (DR8)-DQB1*04 haplotype in which its presence changed the disease risk status of the whole haplotype from neutral to predisposing. The HLA-A*24:02 and the B*39:01 alleles increased the diabetes-associated risk of the DRB1*04:04-DQA1*03-DQB1*03:02 haplotype but the alleles were in linkage disequilibrium and no independent effect could be detected. Within the DIPP cohort, neither the A*24:02 nor the B*39:01 allele were associated with seroconversion but were in contrast associated with increased progression from seroconversion to clinical disease. DISCUSSION & CONCLUSIONS The independent predisposing effect of the HLA-B*39:06 allele with type 1 diabetes was confirmed in the Finnish population but the association of the A*24:02 and B*39:01 alleles remained inconclusive whilst both A*24:02 and B*39:01 affected the progression rate from seroconversion to autoantibody positivity to overt type 1 diabetes.
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Affiliation(s)
- M-L Mikk
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - T Heikkinen
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - M I El-Amir
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland.,Department of Microbiology and Immunology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - M Kiviniemi
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - A-P Laine
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - T Härkönen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - R Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - J Toppari
- Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - M Knip
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Folkhälsan Research Centre, Helsinki, Finland
| | - J Ilonen
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
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Heikkinen T, Willig R, Hänninen A, Koskinen K, Mannismäki P, Alavaikko A, von und zu Fraunberg M, Jalovaara P. Hip Fractures in Finland — A Comparison of Patient Characteristics and Outcomes in Six Hospitals. Scand J Surg 2016; 93:234-40. [PMID: 15544081 DOI: 10.1177/145749690409300312] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and Aims: To compare six Finnish hospitals for the quality of treatment of hip fractures and to obtain information for the development of care. Material and Methods: Data of 1179 consecutive hip fracture patients (about 200 patients per hospital) was collected prospectively, using similar standardized forms and focusing on background factors and the four-month functional outcome. Results: There were significant differences between the hospitals in patient characteristics (age, place of residence, walking ability, use of walking aids, morbidity and type of fracture) and in the unadjusted outcome variables at four months' follow-up (place of residence, mobility, use of walking aids and pain in injured hip). After adjustment for baseline characteristics, there was a significant difference in the post-fracture walking ability between the centres but no significant differences in post-fracture place of residence. Unadjusted mortality did not vary between the centres, but adjustment resulted in significant differences. The most marked difference in surgical methods between the hospitals was seen in the use of either sliding hip screw or Gamma Nail for trochanteric fractures, but this difference was not reflected in the results of multivariate analysis. Conclusions: We found minor differences in mobility and mortality between the participating hospitals, and these might serve them as a stimulus for improving their standard of good practice. Continuous quality improvement by repeating the audit cycle is recommended in order to reach and then improve the prevalent standards in the care of hip fracture patients. Confounding factors should be adjusted when comparing the medical centres treating hip fractures, and the evaluation of the results should be multidimensional.
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Affiliation(s)
- T Heikkinen
- Oulu University Hospital, Department of Orthopedic and Trauma Surgery, Oulu, Finland
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Heikkinen T, Silvennoinen H, Heinonen S, Vuorinen T. Clinical and socioeconomic impact of moderate-to-severe versus mild influenza in children. Eur J Clin Microbiol Infect Dis 2016; 35:1107-13. [PMID: 27086364 DOI: 10.1007/s10096-016-2641-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/28/2016] [Indexed: 01/05/2023]
Abstract
Some studies have assessed the efficacy of influenza vaccination in children separately for moderate-to-severe and any influenza, but the definition used for identifying children with moderate-to-severe illness has not been validated. We analyzed clinical and socioeconomic data from two prospective cohort studies of respiratory infections among children aged ≤13 years (four influenza seasons, 3,416 child-seasons of follow-up). We categorized children with laboratory-confirmed influenza into two mutually exclusive groups of moderate-to-severe and mild influenza using the previously proposed criteria. We obtained the data for the analyses from structured medical records filled out by the study physicians and from daily symptom cards filled out by the parents. Of 434 cases of influenza, 217 (50 %) were classified as moderate-to-severe and 217 (50 %) as mild. The mean duration of fever was 4.0 days in children with moderate-to-severe influenza and 3.1 days in those with milder illness (P < 0.0001). Antibiotics were prescribed to 111 (51 %) children with moderate-to-severe and to ten (5 %) children with mild influenza (P < 0.0001). The rates of parental work absenteeism were 184 days per 100 children with moderate-to-severe influenza and 135 days per 100 children with mild influenza (P = 0.02). The corresponding rates of children's own absenteeism from day care or school were 297 and 233 days respectively per 100 children (P = 0.006). Categorization of children into groups with moderate-to-severe and mild influenza is meaningful, and it identifies children in whom the clinical and socioeconomic impact of influenza is highest. Illness severity should be considered when assessing influenza vaccine effectiveness in children.
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Affiliation(s)
- T Heikkinen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.
- Department of Pediatrics, University of Turku, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland.
| | - H Silvennoinen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - S Heinonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
- Department of Pediatrics, Helsinki University Hospital, Helsinki, Finland
| | - T Vuorinen
- Department of Clinical Virology, Division of Microbiology and Genetics, Turku University Hospital, Turku, Finland
- Department of Virology, University of Turku, Turku, Finland
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Kämpjärvi K, Heikkinen T, Keskitalo S, Von Nandelstadh P, Rantanen V, Pitkänen E, Lehti K, Mustjoki S, Varjosalo M, Vahteristo P. Somatic MED12 exon 1 nonsense mutation in T-cell acute lymphoblastic leukemia escapes nonsense-mediated mRNA decay and prevents protein nuclear localization. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61308-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Backgrounds and Aims: The standardized forms of the Standardized Audit of Hip Fractures in Europe (SAHFE) are aimed for the evaluation of hip fracture treatment in different hospitals and countries. The purpose was to evaluate and characterize a cohort of hip fracture patients with these forms and to evaluate their value in quality control. Material and Methods: The non-pathological hip fractures in patients over 49 years of age treated in the Oulu University Hospital were prospectively recorded during a one-year period using SAHFE forms. Results: There were 238 (52 male and 186 female) patients with a mean age of 78 (50–102) years. Fifty-nine percent of the patients were admitted from their own homes. Fifty-seven percent were able to walk alone outdoors and 48% could walk without walking aids before the fracture. A hundred and fifty patients had cervical fractures and 88 trochanteric fractures. The most frequent treatment of cervical fractures was Austin-Moore hemiarthroplasty (68%) and that of trochanteric fractures Gamma nail fixation (86%). At four months after the fracture, 50% lived in their own homes, 33% could walk alone out-doors and 13% could walk without any aids. Thirty-two percent had no pain in the hip. The overall mortality at four months was 17.6% and that of the operated patients 16.2%. The reoperation rate was 8.5%. Conclusion: SAHFE forms were very useful in the evaluation of the quality of the hip fracture treatment.
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Affiliation(s)
- I Saarenpää
- Department of Orthopaedic and Trauma Surgery, University of Oulu, Finland
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11
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Abstract
Background and Aims: As a rule, follow-up for at least one year is recommended for fracture studies. This is considered the shortest reliable interval. Still, in the case of hip fractures of the elderly, shorter follow-up might be more practical, since the life expectancy of these patients is often short. The aim of this study was to see if a short four months follow-up period would be acceptable in hip fracture surveys. Material and Methods: Information on 196 consecutive non-pathological hip fracture patients aged 50 years or over (mean 79 years) was collected using a standardised hip fracture audit concentrating on functional measurements at admission and at four and twelve months' follow-ups. Results: 167 patients were alive at four months and 152 and at one year. The patients who died between four and twelve months had poorer functional capacity in the four-month evaluation than those who survived one year. The analysis of repeated measures, including only the patients alive at the last follow-up, showed that residential status, use of walking aids and 6 out of 10 and ADL variables (bathing, toileting, shopping, household activities, doing laundry, banking) did not change significantly. Walking ability and the rest 4 ADL variables (dressing, eating, food preparation, use of transportation) improved and pain decreased. Conclusions: Due to high mortality and age-related deterioration of functioning, no steady state i.e. “final result” is ever reached after hip fracture in the elderly. Four-month follow-up is justified as the shortest possible period, because the socioeconomically most important variable, i.e. place of living, and most of the ADL functions do not change significantly after that.
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Affiliation(s)
- T Heikkinen
- University of Oulu, University Hospital of Oulu, Department of Orthopaedic and Trauma Surgery, Finland
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Abstract
OBJECTIVES To explore asymmetry values of antimeric deciduous tooth crown dimensions in three types of twins: monozygotic (MZ), dizygotic same-sex (DZ) and opposite-sex (OS) vs. single-born controls. SETTING AND SAMPLE POPULATION Mesiodistal and labio-lingual crown dimensions of second deciduous molars and mesiodistal canine and first molar crown dimensions of 2159 children at 6-12 years of age were evaluated, originating from the US cross-sectional Collaborative Perinatal Study from the 1970s, including altogether MZ (n = 28), DZ same-sex (n = 33) and OS (n = 39) pairs. Single born (n = 1959) were used as controls. MATERIAL AND METHODS Dental casts were measured for comparison of variance relationships calculated from antimeric teeth, exhibiting fluctuating (FA), and directional (DA) asymmetry using anova. RESULTS Significant differences appeared in MZ and OS girls in DA of deciduous canines, which gain size in the first and second trimester, and deciduous second molars, which finally stop crown growth during the early post-natal period. Significantly, increased FA values appeared for lower deciduous canines and second molars, indicating greatest environmental stress in OS girls, MZ girls and DZ boys. Twin girls had more fluctuating and directional crown asymmetry than twin boys, but in some dimensions, the twins were more symmetric than controls. CONCLUSIONS Transmembrane hormonal influence between opposite-sex twins, and late gestational stress factors, caused by placental malfunction and/or monochorionicity, may be involved in asymmetric growth of antimers, during critical periods of crown size gain.
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Affiliation(s)
- T Heikkinen
- Oral Development and Orthodontics, Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - V Harila
- Oral Development and Orthodontics, Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - A Ollikkala
- Oral Development and Orthodontics, Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - L Alvesalo
- Oral Development and Orthodontics, Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
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13
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Fagerholm R, Sprott K, Heikkinen T, Bartkova J, Heikkilä P, Aittomäki K, Bartek J, Weaver D, Blomqvist C, Nevanlinna H. Overabundant FANCD2, alone and combined with NQO1, is a sensitive marker of adverse prognosis in breast cancer. Ann Oncol 2013; 24:2780-5. [DOI: 10.1093/annonc/mdt290] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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14
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Silvennoinen H, Peltola V, Vainionpää R, Ruuskanen O, Heikkinen T. Admission diagnoses of children 0-16 years of age hospitalized with influenza. Eur J Clin Microbiol Infect Dis 2011; 31:225-31. [PMID: 21643867 DOI: 10.1007/s10096-011-1297-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 05/11/2011] [Indexed: 12/30/2022]
Abstract
The prompt diagnosis of influenza enables the institution of antiviral therapy and adequate cohorting of patients, but scarce data are available to help clinicians correctly suspect influenza in children at the time of admission. This 16-year retrospective study assessed the main admission diagnoses of 401 children aged ≤16 years hospitalized with virologically confirmed influenza. The clinical data were derived from a systematic review of the medical records of the children. Sepsis-like illness was the main reason for admission in 52% of infants aged <6 months and in 7-16% of the older children. Respiratory symptoms accounted for 38% of admissions, and 15% of children were hospitalized due to acute neurologic conditions, primarily febrile convulsions. Wheezing or exacerbation of asthma was the primary reason for admission in 14% of children aged <3 years. No differences were observed in the admission diagnoses between children with influenza A and B infections. The main admission diagnoses vary widely in different age groups of children with influenza, and only a minority of children are hospitalized for respiratory symptoms. The leading role of sepsis-like illness in infants aged <6 months calls for increased efforts to find protective measures against influenza in this age group.
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Affiliation(s)
- H Silvennoinen
- Department of Pediatrics, Turku University Hospital, 20520, Turku, Finland.
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15
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Heuser M, Damm F, Schuermann P, Zucknick M, Shah M, Harrington P, Pharoah P, Schmidt M, Broeks A, van Hien R, Tollenaar RA, Nevanlinna H, Heikkinen T, Aittomaki K, Blomqvist C, Krauter J, Hillemanns P, Ganser A, Park-Simon T, Dork T. A polymorphism in the coding sequence of WT1 is an independent prognostic marker in 1,101 patients with lobular breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Abstract
Smoking has substantial local and systemic adverse effects on the immune system, respiratory tract and skin and soft tissues. Smokers are at increased risk of invasive pneumococcal disease, pneumonia, periodontitis, surgical infections, tuberculosis, influenza and meningococcal disease. The results of several studies indicate that smokers with periodontitis or tuberculosis suffer more severe disease. Data on the impact of smoking on sepsis and pneumonia are controversial and limited, and systematic data regarding the outcome of the majority of infections in smokers are scarce. Abundant data indicate that children exposed to environmental tobacco smoke (ETS) suffer from more severe infections. However, information regarding the effects of ETS on the outcome of infections in adults is limited. Various aspects of the relation between smoking and the outcome of bacterial infection (e.g. potential dose-dependent effects and the interactions between smoking and other environmental factors that may affect the course of infectious diseases) remain to be established.
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Affiliation(s)
- R Huttunen
- Department of Internal Medicine, Tampere University Hospital, University of Tampere Medical School, Tampere, Finland.
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17
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Djordjevic J, Pirttiniemi P, Harila V, Heikkinen T, Toma AM, Zhurov AI, Richmond S. Three-dimensional longitudinal assessment of facial symmetry in adolescents. Eur J Orthod 2011; 35:143-51. [DOI: 10.1093/ejo/cjr006] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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18
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Heinonen S, Silvennoinen H, Lehtinen P, Vainionpää R, Heikkinen T. Feasibility of diagnosing influenza within 24 hours of symptom onset in children 1–3 years of age. Eur J Clin Microbiol Infect Dis 2010; 30:387-92. [DOI: 10.1007/s10096-010-1098-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Accepted: 10/09/2010] [Indexed: 10/18/2022]
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19
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Weaver DT, Pierceall W, Sprott KM, Heikkinen T, Heikkila P, Bartek J, Blomqvist C, Nevanlinna H. Top2A FISH with cytokeratin discriminators in breast cancer using automated high throughput analysis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Sprott KM, Wang X, Pierceall W, Kutok J, Heikkinen T, Heikkila P, Bartek J, Weaver DT, Blomqvist C, Nevanlinna H. DNA repair biomarker alterations in breast cancer relevant to adjuvant chemotherapy treatment decisions. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Osorio A, Milne RL, Pita G, Peterlongo P, Heikkinen T, Simard J, Chenevix-Trench G, Spurdle AB, Beesley J, Chen X, Healey S, Neuhausen SL, Ding YC, Couch FJ, Wang X, Lindor N, Manoukian S, Barile M, Viel A, Tizzoni L, Szabo CI, Foretova L, Zikan M, Claes K, Greene MH, Mai P, Rennert G, Lejbkowicz F, Barnett-Griness O, Andrulis IL, Ozcelik H, Weerasooriya N, Gerdes AM, Thomassen M, Cruger DG, Caligo MA, Friedman E, Kaufman B, Laitman Y, Cohen S, Kontorovich T, Gershoni-Baruch R, Dagan E, Jernström H, Askmalm MS, Arver B, Malmer B, Domchek SM, Nathanson KL, Brunet J, Ramón Y Cajal T, Yannoukakos D, Hamann U, Hogervorst FBL, Verhoef S, Gómez García EB, Wijnen JT, van den Ouweland A, Easton DF, Peock S, Cook M, Oliver CT, Frost D, Luccarini C, Evans DG, Lalloo F, Eeles R, Pichert G, Cook J, Hodgson S, Morrison PJ, Douglas F, Godwin AK, Sinilnikova OM, Barjhoux L, Stoppa-Lyonnet D, Moncoutier V, Giraud S, Cassini C, Olivier-Faivre L, Révillion F, Peyrat JP, Muller D, Fricker JP, Lynch HT, John EM, Buys S, Daly M, Hopper JL, Terry MB, Miron A, Yassin Y, Goldgar D, Singer CF, Gschwantler-Kaulich D, Pfeiler G, Spiess AC, Hansen TVO, Johannsson OT, Kirchhoff T, Offit K, Kosarin K, Piedmonte M, Rodriguez GC, Wakeley K, Boggess JF, Basil J, Schwartz PE, Blank SV, Toland AE, Montagna M, Casella C, Imyanitov EN, Allavena A, Schmutzler RK, Versmold B, Engel C, Meindl A, Ditsch N, Arnold N, Niederacher D, Deissler H, Fiebig B, Varon-Mateeva R, Schaefer D, Froster UG, Caldes T, de la Hoya M, McGuffog L, Antoniou AC, Nevanlinna H, Radice P, Benítez J. Evaluation of a candidate breast cancer associated SNP in ERCC4 as a risk modifier in BRCA1 and BRCA2 mutation carriers. Results from the Consortium of Investigators of Modifiers of BRCA1/BRCA2 (CIMBA). Br J Cancer 2009; 101:2048-54. [PMID: 19920816 PMCID: PMC2795432 DOI: 10.1038/sj.bjc.6605416] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: In this study we aimed to evaluate the role of a SNP in intron 1 of the ERCC4 gene (rs744154), previously reported to be associated with a reduced risk of breast cancer in the general population, as a breast cancer risk modifier in BRCA1 and BRCA2 mutation carriers. Methods: We have genotyped rs744154 in 9408 BRCA1 and 5632 BRCA2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and assessed its association with breast cancer risk using a retrospective weighted cohort approach. Results: We found no evidence of association with breast cancer risk for BRCA1 (per-allele HR: 0.98, 95% CI: 0.93–1.04, P=0.5) or BRCA2 (per-allele HR: 0.97, 95% CI: 0.89–1.06, P=0.5) mutation carriers. Conclusion: This SNP is not a significant modifier of breast cancer risk for mutation carriers, though weak associations cannot be ruled out.
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Affiliation(s)
- A Osorio
- Human Genetics Group, Spanish National Cancer Research Centre, C/Melchor Fernández Almagro 3, 28029 Madrid, Spain.
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22
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Valkonen H, Waris M, Ruohola A, Ruuskanen O, Heikkinen T. Recurrent wheezing after respiratory syncytial virus or non-respiratory syncytial virus bronchiolitis in infancy: a 3-year follow-up. Allergy 2009; 64:1359-65. [PMID: 19416146 DOI: 10.1111/j.1398-9995.2009.02022.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Recent studies have suggested that rhinovirus-associated early wheezing is a greater risk factor for development of recurrent wheezing in children than is early wheezing associated with respiratory syncytial virus (RSV). We determined the development of recurrent wheezing in young children within 3 years after hospitalization for RSV or non-RSV bronchiolitis. METHODS We identified retrospectively all children <2 years of age who were admitted to Turku University Hospital because of bronchiolitis in the months of August-December during 1988-2001. The primary outcome was recurrent wheezing that required long-term asthma medication. Data on asthma medications of the individual children were derived from the Social Insurance Institution of Finland. RESULTS Within the first year after hospitalization, 36 of 217 (16.6%) children with non-RSV bronchiolitis developed recurrent wheezing, compared with five of 199 (2.5%) children with RSV bronchiolitis [relative risk (RR) 6.6; 95% confidence interval (CI) 2.6-16.5]. The rates of recurrent wheezing were significantly increased in the non-RSV group also within 2 years (RR 2.9; 95% CI 1.7-5.1) and 3 years (RR 3.4; 95% CI 2.0-5.7) after hospitalization. The increased risk of recurrent wheezing in children with non-RSV-associated bronchiolitis was observed both in boys and girls at all time points of the 3-year follow-up, and it was not explained by the age difference between the RSV and non-RSV groups or any confounding seasonal factors. CONCLUSION Children hospitalized with bronchiolitis caused by other viruses than RSV develop recurrent wheezing at substantially higher rates during a 3-year follow-up period than do children with RSV-induced bronchiolitis.
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Affiliation(s)
- H Valkonen
- Department of Pediatrics, Turku University Hospital, Finland
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23
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Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009. [DOI: 10.1007/s10029-009-0529-7 and 1=2-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
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24
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Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009. [DOI: 10.1007/s10029-009-0529-7 and 1=2#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009. [DOI: 10.1007/s10029-009-0529-7 and 1=1-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009. [DOI: 10.1007/s10029-009-0529-7 and 1=1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Saarenpää I, Heikkinen T, Ristiniemi J, Hyvönen P, Leppilahti J, Jalovaara P. Functional comparison of the dynamic hip screw and the Gamma locking nail in trochanteric hip fractures: a matched-pair study of 268 patients. Int Orthop 2009; 33:255-60. [PMID: 17943284 PMCID: PMC2899252 DOI: 10.1007/s00264-007-0458-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2007] [Revised: 07/30/2007] [Accepted: 07/31/2007] [Indexed: 12/01/2022]
Abstract
The aim of this prospective matched-pair (age, sex, fracture type, residential status, and walking ability at fracture) study was to analyse the short-term outcome after Gamma nail (GN) and dynamic hip screw (DHS) fixation, focusing especially on functional aspects (Standardised Audit of Hip Fractures in Europe [SAHFE] hip fracture follow-up forms), reoperations, and mortality. Both groups consisted of 134 patients. DHS and GN groups did not differ significantly with respect to location of residence at 4 months or returning to the prefracture dwelling (78% vs. 73%, P = 0.224). The change in walking ability at 4 months compared to prefracture situation was better in the DHS group (p = 0.042), although there was no difference in the change of use of walking aids. The frequency of reoperations during the first year was somewhat lower in the DHS group (8.2% vs. 12.7%, p = 0.318). Mortality was lower in the DHS group both at 4 months (6.0% vs. 13.4%, p = 0.061) and 12 months (14.9% vs. 23.9%, p = 0.044). Although walking ability was better and mortality lower in the DHS group, both methods are useful in the treatment of trochanteric femoral fractures.
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Affiliation(s)
- I. Saarenpää
- Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland
| | - T. Heikkinen
- Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland
| | - J. Ristiniemi
- Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland
| | - P. Hyvönen
- Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland
| | - J. Leppilahti
- Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland
| | - P. Jalovaara
- Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland
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Waris M, Ylinen T, Ruuskanen O, Heikkinen T. O.7.5 Human bocavirus infections have seasonal transmission dynamics. J Clin Virol 2009. [PMCID: PMC7128083 DOI: 10.1016/s1386-6532(08)70060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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29
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Osorio A, Pollán M, Pita G, Schmutzler RK, Versmold B, Engel C, Meindl A, Arnold N, Preisler-Adams S, Niederacher D, Hofmann W, Gadzicki D, Jakubowska A, Hamann U, Lubinski J, Toloczko-Grabarek A, Cybulski C, Debniak T, Llort G, Yannoukakos D, Díez O, Peissel B, Peterlongo P, Radice P, Heikkinen T, Nevanlinna H, Mai PL, Loud JT, McGuffog L, Antoniou AC, Benitez J. An evaluation of the polymorphisms Ins16bp and Arg72Pro in p53 as breast cancer risk modifiers in BRCA1 and BRCA2 mutation carriers. Br J Cancer 2008; 99:974-7. [PMID: 18781154 PMCID: PMC2538750 DOI: 10.1038/sj.bjc.6604624] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 07/30/2008] [Indexed: 01/17/2023] Open
Abstract
The close functional relationship between p53 and the breast cancer susceptibility genes BRCA1 and BRCA2 has promoted the investigation of various polymorphisms in the p53 gene as possible risk modifiers in BRCA1/2 mutation carriers. Specifically, two polymorphisms in p53, c.97-147ins16bp and p.Arg72Pro have been analysed as putative breast cancer susceptibility variants, and it has been recently reported that a p53 haplotype combining the absence of the 16-bp insertion and the presence of proline at codon 72 (No Ins-72Pro) was associated with an earlier age at the onset of the first primary tumour in BRCA2 mutation carriers in the Spanish population. In this study, we have evaluated this association in a series of 2932 BRCA1/2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1 and BRCA2.
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Affiliation(s)
- A Osorio
- Human Cancer Genetics Programme, Human Genetics Group, Spanish National Cancer Centre, Madrid, Spain.
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30
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Rahi M, Heikkinen T, Hakkola J, Hakala K, Wallerman O, Wadelius M, Wadelius C, Laine K. Influence of adenosine triphosphate and ABCB1 (MDR1) genotype on the P-glycoprotein-dependent transfer of saquinavir in the dually perfused human placenta. Hum Exp Toxicol 2008; 27:65-71. [PMID: 18480151 DOI: 10.1177/0960327108088971] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The ATP-dependent drug-efflux pump, P-glycoprotein (P-gp) encoded by ABCB1 (MDR1), plays a crucial role in several tissues forming blood-tissue barriers. Absence of a normally functioning P-gp can lead to a highly increased tissue penetration of a number of clinically important drugs. METHODS We have studied the dose-response effect of exogenous ATP on the placental transfer of the well-established P-gp substrate saquinavir in 17 dually perfused human term placentas. We have also studied the influence of the ABCB1 polymorphisms 2677G>T/A and 3435C>T on placental P-gp expression (n = 44) and the transfer (n = 16) of saquinavir. RESULTS The present results indicate that the addition of exogenous ATP to the perfusion medium does not affect the function of P-gp as measured by saquinavir transfer across the human placenta. The variant allele 3435T was associated with significantly higher placental P-gp expression than the wild-type alleles. However, neither polymorphism affected placental transfer of saquinavir nor there was any correlation between P-gp expression and saquinavir transfer. CONCLUSIONS Our results indicate that addition of exogenous ATP is not required for ATP-dependent transporter function in a dually perfused human placenta. Although the ABCB1 polymorphism 3435C>T altered the expression levels of P-gp in the human placenta, this did not have any consequences on P-gp-mediated placental transfer of saquinavir.
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Affiliation(s)
- M Rahi
- Department of Pharmacology, Drug development and Therapeutics, University of Turku, Turku, Finland.
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Abstract
Tritium in urine was analysed from 227 randomly selected Finnish adults. The people were 18 to 65 of age. Urine samples were collected over night. The mean activity concentration of tritiated water in urine was 2.5 Bq l(-1) and the maximum activity concentration 18.3 Bq l(-1). The minimum detectable activity varied from 1.5 to 2.3 Bq l(-1). Because organically bound tritium is approximately 10% of the total tritium, its concentration was below the detection limit and could be ignored. The mean effective dose for Finnish people from tritium was 2.4 x 10(-3) microSv y(-1).
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Affiliation(s)
- M Puhakainen
- STUK-Radiation and Nuclear Safety Authority, PO Box 14, FIN-00881 Helsinki, Finland.
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32
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Harila V, Heikkinen T, Grön M, Alvesalo L. Open bite in prematurely born children. J Dent Child (Chic) 2007; 74:165-170. [PMID: 18482508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The aims of this study were to: examine the expression of open bite in prematurely born children and discuss the etiological factors that may lead to bite it. METHODS The subjects were 328 prematurely born (<37 gestational weeks) Caucasoid and African American children and 1,804 full-term control children, who participated in the cross-sectional study of the Collaborative Perinatal Project in the 1960s and 1970s. Dental documents, including casts and photographs, were taken once at the age of 6-12 years in the mixed dentition. The occlusion was recorded by examining and measuring the hard stone casts. Vertical open bite was recorded only for full erupted teeth. The statistical method used was chi-square analysis. RESULTS Significant differences in the incidence of anterior open bite (from left to right canine) was found between the preterm and control groups and between gender and ethnic groups. The prevalence of anterior open bite was nearly 9% in the preterm group and almost 7% in the control group. African Americans (9%) had a significantly greater incidence of open bite than Caucasians (3%; P<.0001). Generally, girls had a greater incidence of open bite than boys (8% vs 6%; P<.11). When the study groups were divided by prematurity, gender, and ethnic group, the prevalence of open bite was increased--especially in preterm African American boys compared to controls (11% vs 8%). CONCLUSIONS The results show differences in the development of anterior open bite between ethnic and gender groups. Premature birth may also influence dental occlusal development. Of importance are the patient's: general health condition; respiratory infections; inadequate nasal- and mouth-breathing; oral habits; and other medical problems. Preterm children may be relatively more predisposed to etiological factors for the development of anterior open bite.
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Affiliation(s)
- V Harila
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Oulu, Oulu, Finland.
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Muikku M, Heikkinen T, Puhakainen M, Rahola T, Salonen L. Assessment of occupational exposure to uranium by indirect methods needs information on natural background variations. Radiat Prot Dosimetry 2007; 125:492-5. [PMID: 17309870 DOI: 10.1093/rpd/ncm155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Urine monitoring is the preferred method to determine exposure to soluble compounds of uranium in workplaces. The interpretation of uranium contents in workers bioassay samples requires knowledge on uranium excretion and its dependence on intake by diet. Exceptionally high concentrations of natural uranium in private drinking water sources have been measured in the granite areas of Southern Finland. Consequently, high concentrations of natural uranium have been observed in the urine and hair samples of people using water from their own drilled wells. Natural uranium content in urine and hair samples of family members, who use uranium-rich household water, have been analyzed by using ICP-MS. The uranium concentrations both in urine and hair samples of the study subjects were significantly higher than the world-wide average values. In addition, gammaspectrometric methods have been tested for determining uranium in hair samples. This method can be used only for samples with highly elevated uranium concentrations.
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Affiliation(s)
- M Muikku
- Radiation and Nuclear Safety Authority, P.O. Box 14, FIN-00881 Helsinki, Finland.
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Saarenpää I, Heikkinen T, Jalovaara P. Treatment of subtrochanteric fractures. A comparison of the Gamma nail and the dynamic hip screw: short-term outcome in 58 patients. Int Orthop 2006; 31:65-70. [PMID: 16633810 PMCID: PMC2267546 DOI: 10.1007/s00264-006-0088-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 02/10/2006] [Accepted: 02/14/2006] [Indexed: 11/26/2022]
Abstract
The aim of this non-randomised prospective study was to evaluate the short-term outcome of Gamma nail and dynamic hip screw (DHS) fixation in the treatment of subtrochanteric hip fractures due to low-energy trauma in the elderly. All of the 1,624 femoral hip fractures in 1,511 patients of the Oulu Hospital, aged over 49 years, were prospectively registered from 1991-1999 using special forms. Seventy-three (4.5%) of the fractures were subtrochanteric. After exclusions, 58 patients constituted the final study group. Of these, 43 were treated with Gamma nails and 15 with DHS. Background factors before the fracture, complications, reoperations and functional parameters at 4 months were recorded using standardised forms. Intraoperative and hospital data were collected from patient records. The Seinsheimer fracture types IIIA, IIC and V were the most common fracture patterns when the Seinsheimer classification system was used, and Fielding II and AO 31A3.3, respectively, were the most common types in the Fielding and AO classification system. There were four (9%) intraoperative complications in the Gamma nail group as compared to none in the DHS group. On the other hand, postoperative complications were more common in the DHS group (27%) than in the Gamma nail group (7%). We recognised a correlation between certain fracture types and the likelihood of typical intra- or postoperative complications or difficulties with both devices: In Gamma nailing, difficulty in closed reduction as well as the rate of open reduction and the use of supplementary fixation were most frequent in the Seinsheimer IIC fractures. It is also noticeable that all of the postoperative device failures and fracture displacements of the DHS group occurred in the Seinsheimer type IIIA category. Detailed fracture classification is essential for the choice of the fixation device, and the present study confirms the presumption that, despite the perioperative problems associated with Gamma nailing, this technique may be preferable to plate fixation for specific fracture types with medial cortical comminution, such as Seinsheimer type IIIA.
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Affiliation(s)
- I. Saarenpää
- Department of Orthopaedic and Trauma Surgery, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
| | - T. Heikkinen
- Department of Orthopaedic and Trauma Surgery, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
| | - P. Jalovaara
- Department of Orthopaedic and Trauma Surgery, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
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Heikkinen T, Partanen J, Ristiniemi J, Jalovaara P. Evaluation of 238 consecutive patients with the extended data set of the Standardised Audit for Hip Fractures in Europe (SAHFE). Disabil Rehabil 2006; 27:1107-15. [PMID: 16278179 DOI: 10.1080/09638280500061220] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this paper is to introduce the extended data set inquiries of the Standardised Audit of Hip Fractures in Europe (SAHFE) and to report our experiences of its use. METHOD The extended SAHFE data set was applied to 238 consecutive patients (mean age 78.4 (50 - 102) years, 52 males, 186 females) aged over 50 years with non-pathological fractures of the hip. The extended data set contains 95 questions concerning the patient's abilities prior fall and at follow-up, detailed background factors, concomitant diseases, additional details of the injury, treatment, fracture type and reduction and complications. RESULTS Thirty-nine percent of the fractures occurred at home and 38% in a hospital. Thirteen percent of the cervical fractures were non-displaced (Garden 1 & 2) and half of the trochanteric fractures intertrochanteric two-part fractures (A11 - A13). The mean Garden alignment index evaluated from antero-posterior roentgenograms changed from the preoperative 144 degrees to the postoperative 168 degrees and that from lateral projections from 144 degrees to 171 degrees , respectively. Most of the patients (89%) had associated diseases, especially cardiovascular conditions. The patients' functioning was significantly impaired at four months compared with the preoperative situation according to the ADL score. The need for social support and assistance had increased, respectively. A total of 63% of the surgeries were delayed for more than 24 hours. Low molecular weight heparin was given to every patient for thromboembolic prophylaxis and 92% received antibiotic prophylaxis. Urinary tract (21%) and chest infections (7%) were the most common complications. The deep infection rate was 2.5%. CONCLUSION The extended SAHFE data set is useful and makes it possible to study in more detail the background and outcome factors of hip fractures in a standardized manner.
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Affiliation(s)
- T Heikkinen
- Department of Orthopaedic and Trauma Surgery, University of Oulu, Yliopisto, Finland
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Iivonen S, Heikkinen T, Puoliväli J, Helisalmi S, Hiltunen M, Soininen H, Tanila H. Effects of estradiol on spatial learning, hippocampal cytochrome P450 19, and estrogen alpha and beta mRNA levels in ovariectomized female mice. Neuroscience 2005; 137:1143-52. [PMID: 16326017 DOI: 10.1016/j.neuroscience.2005.10.023] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Revised: 10/17/2005] [Accepted: 10/17/2005] [Indexed: 11/26/2022]
Abstract
The brain is an important target organ for peripherally synthesized estrogen but it also has its own steroid biosynthesis producing estrogen from testosterone catalyzed by the aromatase enzyme. This study examined the effects of estrogen treatment in two spatial memory tasks, one-arm-baited radial arm maze and a position discrimination task in the T-maze in ovariectomized female mice. Hippocampal cytochrome P450 19 (encoding aromatase), and estrogen receptor alpha and beta gene expressions were also measured using real time quantitative polymerase chain reaction analysis. Estrogen (17beta-estradiol) was administered either tonically via s.c. minipellets or phasically via daily i.p. injections. In ovariectomized mice, the tonic estrogen decreased the number of reference memory errors in radial arm maze. Tonic estrogen treatment also up-regulated the expression of cytochrome P450 19 and estrogen receptors. In contrast, estrogen injections decreased the expression of cytochrome P450 19 and estrogen receptor alpha genes. The number of reference memory errors correlated negatively with estrogen receptor alpha expression. These findings indicate that peripheral estrogen levels affect neuronal estrogen synthesis by regulating the cytochrome P450 19 gene expression and also influence estrogen receptor alpha expression. The results also suggest that tonic rather than cyclic estrogen treatment might be more beneficial for cognitive functions.
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Affiliation(s)
- S Iivonen
- Department of Neuroscience and Neurology, University Hospital and University of Kuopio, P.O. Box 1627, 70211, Kuopio, Finland
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Bringman S, Wollert S, Osterberg J, Smedberg S, Granlund H, Felländer G, Heikkinen T. One year results of a randomised controlled multi-centre study comparing Prolene and Vypro II-mesh in Lichtenstein hernioplasty. Hernia 2005; 9:223-7. [PMID: 16450078 DOI: 10.1007/s10029-005-0324-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2004] [Accepted: 02/02/2005] [Indexed: 10/25/2022]
Abstract
A standard polypropylene mesh used in Lichtenstein's operation induces a strong foreign tissue reaction with potential harmful effects. A mesh with less polypropylene could possibly be beneficial. Six hundred men with primary unilateral inguinal hernias were randomised to Lichtenstein's operation using a Prolene- or Vypro II-mesh in six centres. The patients were blinded to which mesh they received. A validated questionnaire assessing recurrence and pain along with SF-36 Health Survey was sent after 1 year to all patients and a selected group was clinically examined. Of the 591 operated patients, 526 (89.0%) returned the questionnaire. 188 patients had some complaints or sensations of which 111 patients were clinically examined. The mean follow-up time was 13.6 (SD. 4.0) months. The incidence of hernia recurrence (four vs. four patients) and neuralgia (three vs. four patients) did not differ between Prolene and Vypro II-groups, respectively. One Vypro II-patient was re-operated due to neuralgia. There was no difference in the SF-36 scores. The results of Lichtenstein's operation with either Prolene or Vypro II do not seem to differ significantly.
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Affiliation(s)
- S Bringman
- Center for Surgical Sciences, Karolinska Institutet, Department of Surgery, Södertälje Hospital, 15286 Södertälje, Sweden.
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Heikkinen T, Wollert S, Osterberg J, Smedberg S, Bringman S. Early results of a randomised trial comparing Prolene and VyproII-mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias. Hernia 2005; 10:34-40. [PMID: 16088358 DOI: 10.1007/s10029-005-0026-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2004] [Accepted: 06/23/2005] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to compare a lightweight mesh to a standard polypropylene hernia mesh in endoscopic extraperitoneal hernioplasty in recurrent hernias. A total of 140 men with recurrent unilateral inguinal hernias were randomised to a totally extraperitoneal endoscopic hernioplasty (TEP) with Prolene or VyproII in a single-blinded multi-center trial. The randomisation and all data handling were performed through the Internet. 137 patients were operated as allocated. Follow-up was completed in 88% of the patients. The median operation times were 55 (24-125) min and 53.5 (21-123) min for the Prolene and VyproII groups, respectively. The meshes had comparable results in the surgeon's assessment of the handling of the mesh, return to work, return to daily activities, complications, postoperative pain and quality of life during the first 8 weeks of rehabilitation, except in General Health (GH) SF-36, where the VyproII-group had a significantly better score (P=0.045). The use of Prolene and VyproII-meshes in endoscopic repair of recurrent inguinal hernia seems to result in similar short-term outcomes and quality of life.
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Affiliation(s)
- T Heikkinen
- Department of Surgery, Oulu University hospital, 90021 OYS, PL 21, Oulu, Finland,
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Bringman S, Wollert S, Osterberg J, Heikkinen T. Early results of a randomized multicenter trial comparing Prolene and VyproII mesh in bilateral endoscopic extraperitoneal hernioplasty (TEP). Surg Endosc 2005; 19:536-40. [PMID: 15759178 DOI: 10.1007/s00464-004-9100-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2004] [Accepted: 10/04/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND The use of mesh in inguinal hernia surgery has become increasingly popular despite the potentially harmful effects that foreign material may exert on human tissue. The purpose of this study was to compare the use of a lightweight mesh vs a standard hernia mesh in bilateral endoscopic hernioplasty. METHODS This single-blinded multicenter trial, 140 men with bilateral inguinal hernias were randomized to undergo totally extraperitoneal endoscopic hernioplasty (TEP) with either Prolene or VyproII. The randomization and all data management were done via the Internet. RESULTS A total of 139 patients were operated on as allocated. The follow-up was complete in 94% of the patients. The median (range) operating times were 85 min (45-140) and 73 min (35-165) for the Prolene and VyproII groups, respectively. (p = 0.01). The difference was due to uneven distribution of the allocated patients to study groups among individual surgeons. The time to return to work was similar (11 vs 9 days, p = 0.08). The time to return to normal daily activities was 19 days (1-133) in the Prolene group and 12.5 days (0-237) in the VyproII group (p = 0.06). There were no significant differences between the groups in their scores on the Visual Analogue Scale or SF-36 Health Scores during the 8-week follow-up. CONCLUSIONS The use of Prolene and VyproII meshes in bilateral endoscopic repair of inguinal hernia seems to result in similar short-term outcome and quality of life. However, there was a tendency toward faster return to normal activity among VyproII patients.
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Affiliation(s)
- S Bringman
- Center for Surgical Sciences, Karolinska Institutet, Sodertalje Hospital, SE-15286, Sodertalje, Sweden.
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Heikkinen T, Valkonen H, Lehtonen L, Vainionpää R, Ruuskanen O. Hospital admission of high risk infants for respiratory syncytial virus infection: implications for palivizumab prophylaxis. Arch Dis Child Fetal Neonatal Ed 2005; 90:F64-8. [PMID: 15613580 PMCID: PMC1721807 DOI: 10.1136/adc.2003.029710] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the rates of hospital admission for respiratory syncytial virus (RSV) infection among children born at different gestational ages. To assess the theoretical impact of palivizumab prophylaxis on admissions for RSV infection. DESIGN Retrospective cohort study of children born in 1991-2000. SETTING Tertiary care university hospital. METHODS Data on all children born during the 10 year period were combined with information on laboratory confirmed RSV infections in these children until the end of 2002. The theoretical impact of palivizumab on RSV associated admissions was estimated by applying the current recommendations for prophylaxis to the study population and using the observed rates of admission in the calculations. INTERVENTIONS None. MAIN OUTCOME MEASURES Rates of RSV infection and hospital admission in different subgroups of children. RESULTS Children with chronic lung disease (CLD) were admitted for RSV infection at a rate of 12.0%. The corresponding rates in children born at </=28 or 29-32 weeks gestation were 7.1% and 6.8% respectively. Children born at </=32 weeks gestation accounted for 6.6% of all admissions due to RSV. Of 586 children who would have met the criteria for palivizumab prophylaxis, 27 (4.6%) were admitted with RSV during the presumed prophylactic period. The number needed to treat to prevent one admission for RSV infection was 15 for children with CLD (with a total cost of 75 000) and 43 for children without CLD born at </=32 weeks gestation (with a total cost of 215 000). CONCLUSIONS The rates of hospital admission for RSV infection in premature infants were substantially lower than those in most previous reports from other countries. Determination of the local rates of RSV admissions in different groups of children would be useful in making decisions about the use of palivizumab.
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Affiliation(s)
- T Heikkinen
- Department of Paediatrics, Turku University Hospital, FIN-20520 Turku, Finland.
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Puhakainen M, Heikkinen T, Steinnes E, Thørring H, Outola I. Distribution of 90Sr and 137Cs in Arctic soil profiles polluted by heavy metals. J Environ Radioact 2005; 81:295-306. [PMID: 15795041 DOI: 10.1016/j.jenvrad.2005.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2005] [Indexed: 05/24/2023]
Abstract
Effects of industrial pollution on the behaviour of radionuclides in spruce forest ecosystems were studied along a gradient from of a copper-nickel smelter in Monchegorsk, NW Russia. A reference site was situated in Lapland, Finland, 152 km west of Monchegorsk. Most of the total 137Cs activity in soil was in mineral (E and B) horizons, except at the reference site where the major part was still in the organic surface layer. Most of the total 90Sr activity still remaining in the soil profile was found in the surface layer, but the relative amount decreased with increasing level of industrial pollution. Pollutants from the smelter clearly affected the chemical speciation of radionuclides. Smaller amounts of exchangeable radionuclides were present in the organic surface layer at the most polluted sites. The decline of 137Cs with decreasing distance from the smelter correlated strongly with a similar depletion in exchangeable K and Mg. Total concentrations of 137Cs and 90Sr showed high correlations with exchangeable cations, particularly in the E and upper B horizon. A sudden change in behaviour of 137Cs in the lower B horizon may be associated with changes in clay mineralogy along the soil profile caused by weathering.
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Affiliation(s)
- M Puhakainen
- STUK-Radiation and Nuclear Safety Authority, P.O. Box 14, FIN-00881 Helsinki, Finland.
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Heikkinen T, Koivukangas V, Wiik H, Saarnio J, Rautio T, Haukipuro K. The quality of life of gastroesophageal reflux disease patients waiting for an antireflux operation. Surg Endosc 2004; 18:1712-5. [PMID: 15809777 DOI: 10.1007/s00464-004-9062-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Accepted: 06/17/2004] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of this trial was to measure the health-related quality of life (HRQL) of gastroesophageal reflux disease (GERD) patients waiting for an antireflux operation. METHODS A total of 120 patients waiting for a laparoscopic fundoplication were sent questionnaires measuring their symptoms and quality of life. RESULTS Ninety-five of the patients still needing an operation returned the questionaires and were included in the analysis. Thirty-one of 84 patients (37%) felt that the symptoms had worsened, and 51/90 (57%) were unsatisfied. Thirty percent suffered from throat or airway infections, 25% from swallowing difficulties, 48% from retrosternal pain, and 18% had asthma. The mean GERD HRQL score (0-45) was 21.7 (95% confidence interval, 19.7-23.7). Short Form-36 scores of this population were significantly worse when compared to patients with inguinal hernia or moderate asthma. CONCLUSIONS Patients waiting for a fundoplication seem to have a significantly decreased health-related quality of life due to poor symptom control regardless of continuous medical treatment.
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Affiliation(s)
- T Heikkinen
- Department of Surgery, Oulu University Hospital, 90021, PL 21, Oulu, OYS, Finland.
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Heikkinen T, Kalesnykas G, Rissanen A, Tapiola T, Iivonen S, Wang J, Chaudhuri J, Tanila H, Miettinen R, Puoliväli J. Estrogen treatment improves spatial learning in APP + PS1 mice but does not affect beta amyloid accumulation and plaque formation. Exp Neurol 2004; 187:105-17. [PMID: 15081593 DOI: 10.1016/j.expneurol.2004.01.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Revised: 12/30/2003] [Accepted: 01/15/2004] [Indexed: 11/24/2022]
Abstract
We investigated the effects of ovariectomy (OVX) and 17 beta-estradiol (0.18 mg per pellet) treatment on spatial learning and memory, hippocampal beta amyloid (A beta) levels, and amyloid plaque counts in double transgenic mice (A/P) carrying mutated amyloid precursor protein (APPswe) and presenilin-1 (PS1-A246E). After OVX at 3 months of age, the mice received estrogen treatment for the last 3 months of their lifetime before they were killed at 6, 9, or 12 months of age. Estrogen treatment in A/P OVX mice increased the number of correct choices in a position discrimination task in the T-maze, and slightly improved their performance in a win-stay task (1/8 arms baited) in the radial arm maze (RAM). However, estrogen treatment did not reverse the A beta-dependent cognitive deficits of A/P mice in the water maze (WM) spatial navigation task. Furthermore, ovariectomy or estrogen treatment in OVX and sham-operated A/P mice had no effect on hippocampal amyloid accumulation. These results show that the estrogen treatment in a transgenic mouse model of Alzheimer's disease (AD) improves performance in the same learning and memory tasks as in the normal C57BL/6J mice. However, the estrogen effects in these mice appeared to be unrelated to A beta-induced cognitive deficits. Our results do not support the idea that estrogen treatment decreases the risk or alleviates the symptoms of Alzheimer's disease by inhibiting the accumulation of A beta or formation of amyloid plaques.
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Affiliation(s)
- T Heikkinen
- Department of Neuroscience and Neurology, University of Kuopio, FIN-70211 Kuopio, Finland
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Abstract
The aim of this study was to explore unilateral Angle II-type malocclusion prevalences in functionally true right-sided (TRS) and non-right-sided (NRS) children having one or more left-sided functions (eye, hand, foot). A half cusp sagittal relationship of the upper and lower M1 and Dm2 was determined on dental casts of 1423 young American black and white children in a cross-sectional sample with the mean age of 8.5 years (range 6-12 years). Hand, foot and eye preferences were recorded at the age of 4 years during the Collaborative Perinatal Study. The prevalences of symmetric bilateral Angle I and II and asymmetric unilateral Angle II right and Angle II left cases were compared between TRS and NRS children using Chi-square analysis. In general, unilateral Angle II right occurred in 9 per cent of the population and Angle II left in 6.5 per cent. In moderate non-right sideness (two-thirds of left dominant functions), these proportions were 17 and 3 per cent, respectively, and in true right sidedness 8 and 6 per cent, respectively. TRS subjects were more symmetric (bilateral Angle I or II in 85 per cent of cases) than NRS children (80 per cent), and the differences were statistically significant (P < 0.02). These results highlight the anatomical relationships of structures supporting the occlusion and the symmetry/asymmetry of the neurocranium, cranial base, masticatory apparatus, and probably also the sidedness and the growth-stimulating effect of lateralized jaw function. Based on the results and considering earlier observations on brain asymmetry in functional lateralities, it can be hypothesized that a normal symmetric sagittal occlusal relationship is based on unilateral sagittal compensatory growth to maintain optimal bite, challenging early preventive orthodontic treatment in suspect unilateral Angle II cases.
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Affiliation(s)
- T Heikkinen
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Oulu, Finland
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Heikkinen T, Bringman S, Ohtonen P, Kunelius P, Haukipuro K, Hulkko A. Five-year outcome of laparoscopic and Lichtenstein hernioplasties. Surg Endosc 2004; 18:518-22. [PMID: 14735339 DOI: 10.1007/s00464-003-9119-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2003] [Accepted: 09/02/2003] [Indexed: 02/06/2023]
Abstract
BACKGROUND Laparoscopic hernia repair has been proved superior to open repairs in terms of short-term results, but long-term results of laparoscopic and open mesh repairs have been lacking until recently. METHODS A total of 123 patients were randomly allocated to two treatment groups comparing laparoscopic and Lichtenstein hernioplasties in three separate trials. The first and second trials compared small and large mesh used in transabdominal preperitoneal repairs, and the third study compared totally extraperitoneal hernioplasty with the Lichtenstein operation. A 5-year follow-up visit was scheduled to assess recurrencies, symptoms, and patient satisfaction. RESULTS For the follow up evaluation, 121 (98.4%) of the patients were reached. There were five hernia recurrences in the laparoscopic group (small mesh) and two in the Lichtenstein group (difference, 5%; 95% confidence interval, -4-13%; p = 0.3). One patient who underwent the transabdominal preperitoneal polypropylene procedure underwent reoperation 3 years later because of dense small bowel adhesions at the inguinal surgical site. Chronic groin pain was more common after open operation (0 vs 4) patients (difference 7%; confidence interval, -0.4-16%; p = 0.04). Ten patients (16%) in the laparoscopic group and 12 (20%) in the open group reported discomfort or pain at the surgical site. CONCLUSIONS Both laparoscopic and Lichtenstein hernioplasties have a low risk for hernia recurrence if proper mesh size is used. The patients who undergo hernioplasty with open mesh hernioplasty seem to experience chronic symptoms and pain more often than those managed with the laparoscopic procedure.
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Affiliation(s)
- T Heikkinen
- Department of Surgery, Oulu University Hospital, 90021 OYS, Oulu, PL 21, Finland.
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Abstract
The aim of this study was to estimate the current concentrations of 90Sr and 137Cs in the urine of Finnish people and to estimate the doses. Two to three daily urine samples were collected from 18 adult Finnish volunteers in connection with studies of 137Cs body burdens in 1999-2001. The 90Sr activities in urine varied between 1.4 and 11 mBq l(-1). The 137Cs activity in urine varied between 0.36 and 56 Bq l(-1). The daily urinary excretion was found to be 4.8-17 mBq for 90Sr and 0.81-68 Bq for 137Cs. Assuming that the daily 90Sr intake was constant and that 18% of the ingested activity was excreted in urine, the mean intake in the investigated group would vary between 27 and 96 mBq d(-1). Based on these estimated intake values, the respective annual effective internal doses from 90Sr and 90Y varied from 0.3 to 1.0 microSv and from 137Cs from 4 to 350 microSv during the sampling period.
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Affiliation(s)
- M Puhakainen
- STUK-Radiation and Nuclear Safety Authority, PO Box 14, FIN-00881 Helsinki, Finland.
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Abstract
OBJECTIVES To explore deciduous tooth crown dimensions in strabismic children and the relationship between the type of strabismus and tooth crown mesio-distal (M-D) and labio-lingual (L-L) size asymmetries. MATERIAL Dental casts at mixed dentition of 2159 Collaborative Perinatal Study black and white children were measured, 123 of them strabismic at 1 year of age, age ranging from 6 to 12 years. METHODS Directional and fluctuating asymmetries in antimeric teeth were explored in various types of strabismus having unilateral, bilateral or alternating expression. ANOVA and T-square test were used for size comparisons and calculated asymmetries were explored by comparing the variances and Pearson correlations. RESULTS Strabismus was associated with significant M-D size increase of deciduous maxillary canines in black boys and white girls, black girls had size reduction in their mandibular canine, but white boys were unaffected. Right side size dominance was found in the strabismic children in the lower second deciduous molar M-D dimensions and in the children with alternating strabismus in their upper deciduous canine M-D dimensions. Children with unilateral strabismus had random fluctuating dental asymmetry in their upper deciduous second molar L-L dimensions when compared with healthy normals. Higher left-right correlations were found in lower second deciduous molar dimensions in strabismic girls when compared with that in controls and in strabismic boys, suggesting better developmental canalization in female. CONCLUSIONS Asymmetries in the head area, such as promoted here in strabismic children, may have associations with asymmetries in the dentition, focusing the embryonal origins and timing of developmental processes.
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Affiliation(s)
- T Heikkinen
- Department of Oral Development and Orthodontics, University of Oulu, Finland.
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48
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Heikkinen T, Ruuskanen O. [Child and recurrent infections]. Duodecim 2002; 117:731-6. [PMID: 12116790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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49
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Kalliomäki M, Peltola V, Heikkinen T. [Brief period of unconsciousness in a 3-year-old child]. Duodecim 2002; 116:2785-7. [PMID: 12077882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- M Kalliomäki
- TYKS:n lastentautien klinikka Kiinamyllynkatu 4-8 20520 Turku
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50
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Puhakka H, Hagman E, Heikkinen T, Huovinen P, Jero J, Karma P, Mäkelä M, Ruuskanen O, Sairanen S. [Recommended treatment of acute otitis]. Duodecim 2002; 115:2155-61. [PMID: 11941807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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