Browsing by Subject " diagnosis"

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  • Sorsa, Timo; Alassiri, Saeed; Grigoriadis, Andreas; Räisänen, Ismo T.; Pärnänen, Pirjo; Nwhator, Solomon O.; Gieselmann, Dirk-Rolf; Sakellari, Dimitra (2020)
    The aim of this study was to investigate the utility of incorporating active matrix metalloproteinase-8 (aMMP-8) as a biomarker into the new periodontitis classification system (stage/grade) presented in 2018. This study included 150 Greek adults aged 25-78, of whom 74 were men and 76 women. Participants were tested with an aMMP-8 point-of-care mouthrinse test, after which a full-mouth clinical examination was performed to assess their periodontal and oral health. The aMMP-8 levels in mouthrinse were significantly lower among healthy patients compared with patients in more severe periodontitis stages and grades (Kruskal-Wallis test and Dunn-Bonferroni test for pairwise post-hoc comparisons; p <0.01 and p <0.05, respectively). Furthermore, aMMP-8 levels were less correlated with plaque levels than bleeding on probing (BOP) (Spearman's rho = 0.269, p <0.001; Spearman's rho = 0.586, p <0.001); respectively). Thus, aMMP-8 was more robust to the confounding effects of oral hygiene than traditional periodontal parameter bleeding on probing. The aMMP-8 point-of-care mouthrinse test can be utilized as an adjunctive and preventive diagnostic tool to identify periodontal disease, classified by stage and grade, and ongoing periodontal breakdown chairside in clinical practice in only 5 min. Overall, integrating aMMP-8 into the new periodontitis classification system seems beneficial.
  • Wuokko-Landen, Annina; Blomgren, Karin; Välimaa, Hannamari (2019)
    Background: Odontogenic sinusitis (OS) is a common but underdiagnosed form of acute rhinosinusitis (ARS). OS carries no specific characteristics, but unilateral symptoms and certain microbiological as well as radiological findings indicate odontogenic origin. Aims/objectives: We studied the proportion of OS in ARS patients, the presence and associations of unilateral symptoms, and possible OS microbial and radiological findings. In addition, we investigated how this condition is recognised among ear, nose and throat specialists and radiologists. Materials and methods: All 676 ARS patients treated in the Department of Otorhinolaryngology at Helsinki University Hospital in 2013 were retrospectively enrolled. The data were collected from patients' hospital medical records, the laboratory database and radiological reports. Results: Odontogenic origin of ARS was suspected in 59 (15.3%) patients. Altogether (29.9%) 115 patients complained of unilateral symptoms and these were found to associate with probable oral microbial findings (p <.001). These findings covered 20.2% of isolates. Teeth were mentioned in 89.6% of the radiological reports.
  • Harbach, Ralph E.; Dallimore, Thom; Briscoe, Andrew G.; Culverwell, C. Lorna; Vaux, Alexander G. C.; Medlock, Jolyon M. (2017)
    We report the discovery of Aedes nigrinus (Eckstein, 1918) in the New Forest of southern England, bringing to 36 the number of mosquito species recorded in Britain. Because it seems that this species has been misidentified previously in Britain as the morphologically similar Aedes sticticus (Meigen, 1838), the two species are contrasted and distinguished based on distinctive differences exhibited in the adult and larval stages. The pupa of Ae. nigrinus is unknown, but the pupa of Ae. sticticus is distinguished from the pupae of other species of Aedes by modification of the most recent key to British mosquitoes. The history of the mosquito fauna recorded in the UK is summarized and bionomical information is provided for the two species.
  • Kautto, A.; Vehkalahti, M. M.; Ventä, I. (2018)
    The purpose of this study was to assess the age of patients at the time of extraction of third molars. Our data included all routine and surgical extractions of third molars (n = 8199 teeth) performed by general and specialist dentists of the public oral health services of the city of Helsinki over the period 2013-2014. Measurements included patient's age, gender, the identified third molar, the type of anaesthesia, the method of extraction, and the diagnosis at extraction. Patients' ages ranged from 10 to 99 years. We found significant differences between younger and older age groups: third molar extractions occurred more often for women than for men below the age of 30 years (P <0.001) and vice versa for patients older than 30. Extractions were more prevalent for the upper jaw (P <0.001), and surgical extractions were more common than routine extractions (P <0.001) below the age of 40 years, but the corresponding prevalences reversed after the age of 40 years. Diagnoses at extraction differed between younger and older patients. We conclude that the treatment pattern of third molars at public health services varies greatly over a lifetime, and that a greater variety exists than had been reported previously from oral and maxillofacial units.
  • Lee, Jiwoo; Kiiskinen, Tuomo; Mars, Nina; Jukarainen, Sakari; Ingelsson, Erik; Neale, Benjamin; Ripatti, Samuli; Natarajan, Pradeep; Ganna, Andrea (2021)
    Background: Acute coronary syndrome (ACS) is a clinically significant presentation of coronary heart disease. Genetic information has been proposed to improve prediction beyond well-established clinical risk factors. While polygenic scores (PS) can capture an individual's genetic risk for ACS, its prediction performance may vary in the context of diverse correlated clinical conditions. Here, we aimed to test whether clinical conditions impact the association between PS and ACS. Methods: We explored the association between 405 clinical conditions diagnosed before baseline and 9080 incident cases of ACS in 387 832 individuals from the UK Biobank. Results were replicated in 6430 incident cases of ACS in 177 876 individuals from FinnGen. Results: We identified 80 conventional (eg, stable angina pectoris and type 2 diabetes) and unconventional (eg, diaphragmatic hernia and inguinal hernia) associations with ACS. The association between PS and ACS was consistent in individuals with and without most clinical conditions. However, a diagnosis of stable angina pectoris yielded a differential association between PS and ACS. PS was associated with a significantly reduced (interaction P=2.87x10(-8)) risk for ACS in individuals with stable angina pectoris (hazard ratio, 1.163 [95% CI, 1.082-1.251]) compared with individuals without stable angina pectoris (hazard ratio, 1.531 [95% CI, 1.497-1.565]). These findings were replicated in FinnGen (interaction P=1.38x10(-6)). Conclusions: In summary, while most clinical conditions did not impact utility of PS for prediction of ACS, we found that PS was substantially less predictive of ACS in individuals with prevalent stable coronary heart disease. PS may be more appropriate for prediction of ACS in asymptomatic individuals than symptomatic individuals with clinical suspicion for coronary heart disease.
  • Ala-Houhala, M.; Koukila-Kahkola, P.; Antikainen, Jenni; Valve, J.; Kirveskari, J.; Anttila, V. -J. (2018)
    Objectives: To assess the clinical use of panfungal PCR for diagnosis of invasive fungal diseases (IFDs). We focused on the deep tissue samples. Methods: We first described the design of panfungal PCR, which is in clinical use at Helsinki University Hospital. Next we retrospectively evaluated the results of 307 fungal PCR tests performed from 2013 to 2015. Samples were taken from normally sterile tissues and fluids. The patient population was nonselected. We classified the likelihood of IFD according to the criteria of the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG), comparing the fungal PCR results to the likelihood of IFD along with culture and microscopy results. Results: There were 48 positive (16%) and 259 negative (84%) PCR results. The sensitivity and specificity of PCR for diagnosing IFDs were 60.5% and 91.7%, respectively, while the negative predictive value and positive predictive value were 93.4% and 54.2%, respectively. The concordance between the PCR and the culture results was 86% and 87% between PCR and microscopy, respectively. Of the 48 patients with positive PCR results, 23 had a proven or probable IFD. Conclusions: Fungal PCR can be useful for diagnosing IFDs in deep tissue samples. It is beneficial to combine fungal PCR with culture and microscopy. M. Ala-Houhala, Clin Microbiol Infect 2018;24:301 (C) 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
  • Silén, Yasmina; Sipilä, Pyry N; Raevuori, Anu; Mustelin, Linda; Marttunen, Mauri; Kaprio, Jaakko; Keski-Rahkonen, Anna (2020)
    OBJECTIVE: We aimed to assess the lifetime prevalence, 10-year incidence, and peak periods of onset for eating disorders as defined by the Fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) among adolescents and young adults born in the 1980s in Finland. METHOD: Virtually all Finnish twins born in 1983-1987 (n = 5,600) were followed prospectively from the age of 12 years. A subsample of participants (n = 1,347) was interviewed using a semi-structured diagnostic interview in their early twenties. RESULTS: The prevalence of lifetime DSM-5 eating disorders was 17.9% for females and 2.4% for males (pooled across genders, 10.5%). The estimated lifetime prevalences for females and males, respectively, were 6.2 and 0.3% for anorexia nervosa (AN), 2.4 and 0.16% for bulimia nervosa (BN), 0.6 and 0.3% for binge-eating disorder (BED), 4.5 and 0.16% for other specified feeding or eating disorder (OSFED), and 4.5 and 1.6% for unspecified feeding or eating disorder (UFED). Among females, the prevalence of OSFED subcategories was as follows: atypical AN 2.1%, purging disorder 1.3%, BED of low frequency/limited duration 0.7%, and BN of low frequency/limited duration 0.4%. The 10-year incidence rate of eating disorders was 1,700 per 100,000 person-years among females (peak age of onset 16-19 years) and 220 per 100,000 person-years among males. DISCUSSION: Eating disorders are a common public health concern among youth and young adults, affecting one in six females and one in 40 males. Adequate screening efforts, prevention, and interventions are urgently needed.
  • Osiewicz, Magdalena A.; Lobbezoo, Frank; Bracci, Alessandro; Ahlberg, Jari; Pytko-Polonczyk, Jolanta; Manfredini, Daniele (2019)
    Objectives: The aim is to describe the process of translating the smartphone application BruxApp into Polish within the context of an ongoing multicenter project on awake bruxism (AB) epidemiology. Material and Methods: An ongoing cooperation involving 11 universities is based on the adoption of the smartphone-based EMA protocol to collect real time report of AB behaviors in the natural environment. The English version of BruxApp is adopted as a template for the multi-language translation, according to a step-by-step procedure led by mother-tongue experts in the field. A dedicated web platform for translation (viz., POEditor) is used. The process of translation into Polish is here described as an example. Results: There are two software versions available, viz., BruxApp and BruxApp Research. For both versions, back translation from Polish to English was performed to verify the accuracy of the translation procedure. The validity of the translation has been confirmed by the perfect agreement between the original and back-translated English versions, and the Polish version of BruxApp can thus be introduced in the clinical and research setting to get deeper into the study of AB epidemiology in Poland. Conclusions: As far as clinical studies are concerned, the described strategy to record data can be very useful -patients can acknowledge their habits, monitor changes over time, and implement remedial measures. In the field of research, BruxApp makes possible to collect and store a huge amount of data about the epidemiology of different forms of awake bruxism, both at the individual level and at the population level.
  • Stacchiotti, S.; Miah, A. B.; Frezza, A. M.; Messiou, C.; Morosi, C.; Caraceni, A.; Antonescu, C. R.; Bajpai, J.; Baldini, E.; Bauer, S.; Biagini, R.; Bielack, S.; Blay, J. Y.; Bonvalot, S.; Boukovinas, I.; Bovee, J. V. M. G.; Boye, K.; Brodowicz, T.; Callegaro, D.; De Alava, E.; Deoras-Sutliff, M.; Dufresne, A.; Eriksson, M.; Errani, C.; Fedenko, A.; Ferraresi, V.; Ferrari, A.; Fletcher, C. D. M.; Del Muro, X. Garcia; Gelderblom, H.; Gladdy, R. A.; Gouin, F.; Grignani, G.; Gutkovich, J.; Haas, R.; Hindi, N.; Hohenberger, P.; Huang, P.; Joensuu, H.; Jones, R. L.; Jungels, C.; Kasper, B.; Kawai, A.; Le Cesne, A.; Le Grange, F.; Leithner, A.; Leonard, H.; Pousa, A. Lopez; Broto, J. Martin; Merimsky, O.; Merriam, P.; Miceli, R.; Mir, O.; Molinari, M.; Montemurro, M.; Oldani, G.; Palmerini, E.; Pantaleo, M. A.; Patel, S.; Piperno-Neumann, S.; Raut, C. P.; Ravi, Arumugam Veera; Razak, A. R. A.; Reichardt, P.; Rubin, B. P.; Rutkowski, P.; Safwat, A. A.; Sangalli, C.; Sapisochin, G.; Sbaraglia, M.; Scheipl, S.; Schoffski, P.; Strauss, D.; Strauss, S. J.; Hall, K. Sundby; Tap, W. D.; Trama, A.; Tweddle, A.; van der Graaf, W. T. A.; Van de Sande, M. A. J.; Van Houdt, W.; van Oortmerssen, G.; Wagner, A. J.; Wartenberg, M.; Wood, J.; Zaffaroni, N.; Zimmermann, C.; Casali, P. G.; Dei Tos, A. P.; Gronchi, A. (2021)
    Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typically refractory to the antitumor drugs used in sarcomas. The degree of uncertainty in selecting the most appropriate therapy for EHE patients and the lack of guidelines on the clinical management of the disease make the adoption of new treatments inconsistent across the world, resulting in suboptimal outcomes for many EHE patients. To address the shortcoming, a global consensus meeting was organized in December 2020 under the umbrella of the European Society for Medical Oncology (ESMO) involving >80 experts from several disciplines from Europe, North America and Asia, together with a patient representative from the EHE Group, a global, disease-specific patient advocacy group, and Sarcoma Patient EuroNet (SPAEN). The meeting was aimed at defining, by consensus, evidence-based best practices for the optimal approach to primary and metastatic EHE. The consensus achieved during that meeting is the subject of the present publication.
  • Ibounig, Thomas; Simons, T. A. (2016)
    Background and Aims: Quadriceps and patella tendon ruptures are uncommon injuries often resulting from minor trauma typically consisting of an eccentric contraction of the quadriceps muscle. Since rupture of a healthy tendon is very rare, such injuries usually represent the end stage of a long process of chronic tendon degeneration and overuse. This review aims to give an overview of the current understanding of the pathophysiology, diagnostic principles, and recommended treatment protocols as supported by the literature and institutional experience. Material and Methods: A non-systematic review of the current literature on the subject was conducted and reflected against the current practice in our level 1 trauma center. Results and Conclusion: Risk factors for patella and quadriceps tendon rupture include increasing age, repetitive micro-trauma, genetic predisposition, and systemic diseases, as well as certain medications. Diagnosis is based on history and clinical findings, but can be complemented by ultrasound or magnetic resonance imaging. Accurate diagnosis at an early stage is of utmost importance since delay in surgical repair of over 3weeks results in significantly poorer outcomes. Operative treatment of acute ruptures yields good clinical results with low complication rates. Use of longitudinal transpatellar drill holes is the operative method of choice in the majority of acute cases. In chronic ruptures, tendon augmentation with auto- or allograft should be considered. Postoperative treatment protocols in the literature range from early mobilization with full weight bearing to cast immobilization for up to 12weeks. Respecting the biology of tendon healing, we advocate the use of a removable knee splint or orthotic with protected full weight bearing and limited passive mobilization for 6weeks.
  • Mäkitie, Antti A.; Almangush, Alhadi; Youssef, Omar; Metsälä, Markus; Silen, Suvi; Nixon, Iain J.; Haigentz, Missak; Rodrigo, Juan P.; Saba, Nabil F.; Vander Poorten, Vincent; Ferlito, Alfio (2020)
    Head and neck cancer (HNC) comprises a heterogeneous group of upper aerodigestive tract malignant neoplasms, the most frequent of which is squamous cell carcinoma. HNC forms the eighth most common cancer type and the incidence is increasing. However, survival has improved only moderately during the past decades. Currently, early diagnosis remains the mainstay for improving treatment outcomes in this patient population. Unfortunately, screening methods to allow early detection of HNC are not yet established. Therefore, many cases are still diagnosed at advanced stage, compromising outcomes. Exhaled breath analysis (EBA) is a diagnostic tool that has been recently introduced for many cancers. Breath analysis is non-invasive, cost-effective, time-saving, and can potentially be applied for cancer screening. Here, we provide a summary of the accumulated evidence on the feasibility of EBA in the diagnosis of HNC.
  • Braicu, Elena Ioana; Darb-Esfahani, Silvia; Schmitt, Wolfgang D.; Koistinen, Kaisa M.; Heiskanen, Laura; Pöhö, Päivi; Budczies, Jan; Kuhberg, Marc; Dietel, Manfred; Frezza, Christian; Denkert, Carsten; Sehouli, Jalid; Hilvo, Mika (2017)
    Ovarian cancer is a very severe type of disease with poor prognosis. Treatment of ovarian cancer is challenging because of the lack of tests for early detection and effective therapeutic targets. Thus, new biomarkers are needed for both diagnostics and better understanding of the cellular processes of the disease. Small molecules, consisting of metabolites or lipids, have shown emerging potential for ovarian cancer diagnostics. Here we performed comprehensive lipidomic profiling of serum and tumor tissue samples from high-grade serous ovarian cancer patients to find lipids that were altered due to cancer and also associated with progression of the disease. Ovarian cancer patients exhibited an overall reduction of most lipid classes in their serum as compared to a control group. Despite the overall reduction, there were also specific lipids showing elevation, and especially alterations in ceramide and triacylglycerol lipid species were dependent on their fatty acyl side chain composition. Several lipids showed progressive alterations in patients with more advanced disease and poorer overall survival, and outperformed CA-125 as prognostic markers. The abundance of many serum lipids correlated with their abundance in tumor tissue samples. Furthermore, we found a negative correlation of serum lipids with 3-hydroxybutyric acid, suggesting an association between decreased lipid levels and fatty acid oxidation. In conclusion, here we present a comprehensive analysis of lipid metabolism alterations in ovarian cancer patients, with clinical implications.
  • Vesala, Tommi; Ekholm, Marja; Ventä, Irja (2021)
    Objective:The purpose of this study was to determine, if a dental panoramic tomograph (DPT) is appropriate for every young adult due to third molars. Materials and methods:The study sample consisted of 217 university students (20% men and 80% women; mean age 20.7 years; SD +/- 0.6 years) and included a questionnaire about symptoms caused by third molars, clinical oral examination of third molars, and a DPT. Subjects were divided into the following groups: subjects with a clinical indication for a DPT and subjects without such indication. The DPTs were then examined for findings regarding third molars. Results:Clinical indication for a DPT was observed in 64% of the subjects. Radiography revealed an additional 1.4% of the subjects with >= 1 radiographic signs of disease in relation to their third molars. Also, an additional 27% of the subjects had >= 1 other radiographic findings in relation to third molars that may have affected the clinical decision making. Conclusions:In our study population, clinically undetectable pathology cannot be considered as an indication for a DPT. However, if prevailing clinical practice supports preventive removals and detecting or monitoring of unerupted third molars, a referral to DPT can be considered as good clinical practice.
  • Uusitalo, Susanne; Tuominen, Jarno; Arstila, Valtteri (2020)
    How to classify the human condition? This is one of the main problems psychiatry has struggled with since the first diagnostic systems. The furore over the recent edi- tions of the diagnostic systems DSM-5 and ICD-11 has evidenced it to still pose a wicked problem. Recent advances in techniques and methods of artificial intelligence and computing power which allows for the analysis of large data sets have been pro- posed as a possible solution for this and other problems in classification, diagnosing, and treating mental disorders. However, mental disorders contain some specific inherent features, which require critical consideration and analysis. The promises of AI for mental disorders are threatened by the unmeasurable aspects of mental disor- ders, and for this reason the use of AI may lead to ethically and practically undesir- able consequences in its effective processing. We consider such novel and unique questions AI presents for mental health disorders in detail and evaluate potential novel, AI-specific, ethical implications.
  • Ivaska, Lotta E.; Christensen, Andreas; Waris, Matti; Puhakka, Tuomo; Vuorinen, Tytti; Allander, Tobias; Söderlund-Venermo, Maria; Jartti, Tuomas (2019)
    Human bocavirus 1 (HBoV1) can persist in nasopharynx and tonsils. Using HBoV1 serology, reverse-transcription polymerase chain reaction (PCR) for detecting messenger RNA (mRNA) and quantitative PCR for HBoV1 genome load count, we studied to what extent the HBoV1 DNA loads in nasopharynx correlate with acute infection markers. Tonsillar tissue, nasopharyngeal aspirate, and serum were obtained from 188 elective adeno-/tonsillectomy patients. Relatively high loads of HBoV1 DNA were detected in the nasopharynx of 14 (7%) primarily asymptomatic subjects with negative mRNA and/or serodiagnostic results. Quantitative HBoV1 DNA PCR may have lower specificity than HBoV1 mRNA detection for diagnosing symptomatic infection.
  • Porsbjerg, Celeste; Ulrik, Charlotte; Skjold, Tina; Backer, Vibeke; Laerum, Birger; Lehman, Sverre; Janson, Crister; Sandstrom, Thomas; Bjermer, Leif; Dahlen, Barbro; Lundback, Bo; Ludviksdottir, Dora; Bjornsdottir, Unnur; Altraja, Alan; Lehtimaki, Lauri; Kauppi, Paula; Karjalainen, Jussi; Kankaanranta, Hannu (2018)
    Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma ('difficult asthma') should undergo systematic assessment, in order to differentiate between true severe asthma, and 'difficult-to-treat' patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.
  • Dent, E.; Morley, J. E.; Cruz-Jentoft, A. J.; Woodhouse, L.; Rodriguez-Manas, L.; Fried, L. P.; Woo, J.; Aprahamian,; Sanford, A.; Lundy, J.; Landi, F.; Beilby, J.; Martin, F. C.; Bauer, J. M.; Ferrucci, L.; Merchant, R. A.; Dong, B.; Arai, H.; Hoogendijk, E. O.; Won, C. W.; Abbatecola, A.; Cederholm, T.; Strandberg, T.; Gutierrez Robledo, L. M.; Flicker, L.; Bhasin, S.; Aubertin-Leheudre, M.; Bischoff-Ferrari, H. A.; Guralnik, J. M.; Muscedere, J.; Pahor, M.; Ruiz, J.; Negm, A. M.; Reginster, J. Y.; Waters, D. L.; Vellas, B. (2019)
    Objective The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.
  • Grigoriadis, Andreas; Räisänen, Ismo T.; Pärnänen, Pirjo; Tervahartiala, Taina; Sorsa, Timo; Sakellari, Dimitra (2021)
    Objective: The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics. Material and methods: Alpha chairside system was used for assessment of glycated hemoglobin 1c (HbA1c) and active Matrix Metalloproteinase-8 levels (aMMP-8) were analyzed by immunotest in patients (n = 150) who fulfilled the criteria for screening of the Centers for Disease Control and Prevention. Full-mouth periodontal parameters were assessed and various data such as Body Mass Index (BMI), smoking and education were recorded. Results: Thirty-one patients out of 150 tested were found with unknown hyperglycaemia (20.7%). Regarding sex, education, parent with diabetes, normal BMI, smoking, age >= 45 years and prior testing for diabetes, no differences were observed between subjects displaying HbA1c <5.7 and >= 5.7% (Pearson's Chi-square test, p > .05). Subgroups differed regarding BMI (kg/m(2)), tooth count, percentages of 4 and 5 mm pockets (Mann-Whitney and z-test, p <.05). The diagnostic performance for HbA1c >= 5.7 was tested by Receiving Operator Characteristic curves and Areas Under the Curve (AUC) for the following: age >= 45 years and BMI (AUC 0.651, p = .010), the above and aMMP-8 (AUC 0.660, p = .006), age >= 45 years, BMI and Stage of Periodontitis (AUC 0.711, p <.001) and age >= 45 years, BMI, aMMP-8 and stage of periodontitis (AUC 0.713, p <.001). Conclusions: Findings of the study suggest that the combination of stage of periodontitis, increasing age, BMI and aMMP-8, without chairside HbA1c assessment appears to be a viable screening strategy for referring dental patients for testing for prediabetes/diabetes.