Browsing by Subject "Adult"

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  • Schiavone, Nella; Virta, Maarit; Leppämäki, Sami; Launes, Jyrki; Vanninen, Ritva; Tuulio-Henriksson, Annamari; Immonen, Satu; Järvinen, Ilkka; Lehto, Eliisa; Michelsson, Katarina; Hokkanen, Laura (2019)
    We investigated ADHD symptoms and life outcomes in adulthood and their association with childhood ADHD and subthreshold symptoms in a prospectively followed cohort with perinatal risks. We identified participants with childhood ADHD (cADHD, n = 37), subthreshold symptoms defined as attention problems (cAP, n = 64), and no ADHD or cAP (Non-cAP, n = 217). We compared the groups and a control group with no perinatal risks (n = 64) on self-reported ADHD symptoms, executive dysfunction, and life outcomes in adulthood. At age 40, 21.6% of the cADHD, 6.3% of the cAP, 6.0% of the Non-cAP group, and 1.6% of the controls reached a screener cutoff for possible ADHD. The cADHD group had lower educational level, more ADHD symptoms and executive dysfunction, and higher rates of drug use than the other groups. Childhood ADHD associated with perinatal risks persists into midlife whereas childhood subthreshold ADHD symptoms in this cohort were not associated with negative outcomes in adulthood.
  • Honkamäki, Jasmin; Hisinger-Mölkänen, Hanna; Ilmarinen, Pinja; Piirilä, Päivi; Tuomisto, Leena E.; Andersen, Heidi; Huhtala, Heini; Sovijärvi, Anssi; Backman, Helena; Lundbäck, Bo; Rönmark, Eva; Lehtimäki, Lauri; Kankaanranta, Hannu (2019)
    Background: Asthma is currently divided into different phenotypes, with age at onset as a relevant differentiating factor. In addition, asthma with onset in adulthood seems to have a poorer prognosis, but studies investigating age-specific incidence of asthma with a wide age span are scarce. Objective: To evaluate incidence of asthma diagnosis at different ages and differences between child- and adult-diagnosed asthma in a large population-based study, with gender-specific analyzes included. Methods: In 2016, a respiratory questionnaire was sent to 8000 randomly selected subjects aged 20-69 years in western Finland. After two reminders, 4173 (52.3%) subjects responded. Incidence rate of asthma was retrospectively estimated based on the reported age of asthma onset. Adult-diagnosed asthma was defined as a physician-diagnosis of asthma made at >= 18 years of age. Results: Among those with physician-diagnosed asthma, altogether, 63.7% of subjects, 58.4% of men and 67.8% of women, reported adult-diagnosed asthma. Incidence of asthma diagnosis was calculated in 10-year age groups and it peaked in young boys (0-9 years) and middle-aged women (40-49 years) and the average incidence rate during the examined period between 1946 and 2015 was 2.2/1000/year. Adult-diagnosed asthma became the dominant phenotype among those with physician-diagnosed asthma by age of 50 years and 38 years in men and women, respectively. Conclusions: Asthma is mainly diagnosed during adulthood and the incidence of asthma diagnosis peaks in middle-aged women. Asthma diagnosed in adulthood should be considered more in clinical practice and management guidelines.
  • Vehkalahti, Miira M; Palotie, Ulla; Valaste, Maria (2021)
    Objectives: This study assessed age-related variation in the volume and content of restorative dental care performed by private dentists for adults in Finland in 2012-2017. Methods: This retrospective register-based observational study utilized the Social Insurance database of private dental services in 2012 and 2017, including all patients. The data were aggregated into 5-year age groups for 20-89-year-olds; those aged 90+ formed one group. A patient was one who had received at least one treatment, and a restoration patient one who received at least one restoration (direct/indirect), excluding prosthetic crowns. Attendance rate was the proportion of the population treated. Volume of restorative treatment was the proportion of restoration patients among all patients using private dental services. Content of restorative treatment was described as the number of teeth receiving restoration and the size of restoration (number of surfaces restored). Correlation coefficient demonstrated associations between age groups and numbers of restorations. Results: Rate of restoration patients was 64.8 % in 2012 and 61.1 % in 2017, the rate for individuals aged under 80 years in each calendar year being smaller than in previous years. Mean number of restorations received per patient was 1.59 in 2012 and 1.42 in 2017, increasing with age (r = 0.85 in 2012; r = 0.95 in 2017). Small restorations dominated; one to two surfaces were covered in 72.3 % and 75.5 % of restorations in 2012 and 2017, respectively. Conclusions: Volume and content of restorative dental care for adults vary by age and have decreased slightly over time. Clinical significance: Restorative treatments are a prominent part of dental care for adults. This paper sheds light on the entity of restorative dental care for adults visiting private dentists. Variation in restoration volume and content is shown according to patient's age group, and changes are assessed across six years.
  • Pakkasela, Johanna; Ilmarinen, Pinja; Honkamäki, Jasmin; Tuomisto, Leena E.; Andersen, Heidi; Piirilä, Päivi; Hisinger-Mölkänen, Hanna; Sovijärvi, Anssi; Backman, Helena; Lundbäck, Bo; Rönmark, Eva; Kankaanranta, Hannu; Lehtimäki, Lauri (2020)
    Background Onset of allergic asthma has a strong association with childhood but only a few studies have analyzed incidence of asthma from childhood to late adulthood in relation to allergy. The purpose of the study was to assess age-specific incidence of allergic and non-allergic asthma. Methods Questionnaires were sent to 8000 randomly selected recipients aged 20-69 years in Finland in 2016. The response rate was 52.3% (n = 4173). The questionnaire included questions on e.g. atopic status, asthma and age at asthma diagnosis. Asthma was classified allergic if also a physician-diagnosed allergic rhinitis was reported. Results The prevalence of physician-diagnosed asthma and allergic rhinitis were 11.2 and 17.8%, respectively. Of the 445 responders with physician-diagnosed asthma, 52% were classified as allergic and 48% as non-allergic. Median ages at diagnosis of allergic and non-allergic asthma were 19 and 35 years, respectively. Among subjects with asthma diagnosis at ages 0-9, 10-19, 20-29, 30-39, 40-49, 50-59 and 60-69 years, 70, 62, 58, 53, 38, 19 and 33%, respectively, were allergic. For non-allergic asthma, the incidence rate was lowest in children and young adults (0.7/1000/year). It increased after middle age and was highest in older age groups (2.4/1000/year in 50-59 years old). Conclusions The incidence of allergic asthma is highest in early childhood and steadily decreases with advancing age, while the incidence of non-allergic asthma is low until it peaks in late adulthood. After approximately 40 years of age, most of the new cases of asthma are non-allergic.
  • Sinisalo, Juha; Kokkonen, Jorma; Jalanko, Mikko (2020)
  • Saari, Armi; Sainio, Markku; Leppämäki, Sami (2016)
    ADHD on kehityksellinen tarkkaavuuden, toiminnanohjauksen ja impulssikontrollin säätelyn vaikeus, joka usein jatkuu läpi elämän heikentäen työ- ja toimintakykyä. ADHD johtaa tavallisesti alisuoriutumiseen opinnoissa ja työelämässä. Tyypillisiä ongelmia ovat heikentynyt työteho, lisääntyneet sairauspoissaolot ja suurentunut työtapaturmariski. Työterveyshuolto on keskeisessä asemassa työelämässä olevien potilaiden tunnistamisessa ja tutkimuksiin ohjaamisessa. Lääkehoidolla on osoitettu olevan hyvä teho aikuispotilaiden keskeisiin oireisiin sekä työ- ja toimintakykyyn. Hoito on erittäin kustannustehokasta ja voidaan yhdistää psykososiaalisiin hoitomuotoihin.
  • Koskentausta, Terhi; Koski, Anniina; Tani, Pekka (2018)
  • Jokelainen, Kalle (2017)
    Pitkittynyt eli yli neljä viikkoa kestänyt ripuli on yleinen vaiva ja yksi tavallisimmista syistä hakeutua lääkärin vastaanotolle. Merkittävä osa potilaista voidaan tutkia ja hoitaa perusterveydenhuollossa. Koska pitkäaikaisen ripulin syynä voi olla joko orgaaninen sairaus tai toiminnallinen vaiva, selvittelyssä on välttämätöntä edetä järjestelmällisesti ja potilaan ikä sekä yksilöllinen oirekuva huomioon ottaen. Mikäli potilaalla esiintyy hälytysoireita, kuten verenvuotoa peräaukosta, painonlaskua tai poikkeava vatsan palpaatiolöydös, tai laboratoriokokeissa ilmenee poikkeavaa, hänet on syytä lähettää gastroenterologin arvioon.
  • Välimäki, Juha (2020)
  • Roivainen, Reina; Lauronen, Leena; Gaily, Eija; Metsähonkala, Liisa; Peltola, Maria; Laakso, Aki (2018)
  • Vänskä, Matti; Friman, Terhi; Kakko, Sakari; Keränen, Mikko; Rajala, Hanna; Poikonen, Eira (2019)
  • Tommiska, Pihla; Lönnrot, Kimmo; Raj, Rahul; Luostarinen, Teemu; Kivisaari, Riku (2020)
    Krooninen kovakalvonalainen verenpurkauma eli subduraalihematooma on yleinen neurokirurgista hoitoa vaativa sairaus. Sitä tulisi epäillä etenkin iäkkäillä potilailla, joiden yleistila on selittämättömästi heikentynyt. Taustalla on usein pään lievä vamma, joka johtaa hiljalleen kertyvään siltalaskimovuotoon kovakalvon ja lukinkalvon väliin. Merkittävimpiä riskitekijöitä ovat ikä, pään vamma, miessukupuoli, alkoholin liikakäyttö, antitromboottinen lääkitys, aivoatrofia ja kallonsisäisen toimenpiteen jälkitila. Tyypillisesti oireet ilmenevät viikkojen kuluttua, kun laajeneva hematooma alkaa painaa aivokudosta. Oireita ovat tasapainovaikeus, raajaheikkous, yleistilan heikkeneminen, päänsärky, sekavuus, puhehäiriö, muistin huononeminen, väsymys tai epileptinen kohtaus. Hoitona tehdään kallonporausleikkaus eli tre-panaatio, jossa hematooma purkautuu ulos. Varhainen diagnoosi ennustaa hyvää hoitotulosta. Etenkin iäkkäillä potilailla kuolleisuus vuoden sisällä on varsin suuri.
  • Vironen, Jaana (2017)
  • Stark, Christoffer; Kiss, Jan; Lemström, Karl (2020)
    Päätös elinsiirrosta pyritään tekemään hyvissä ajoin. Yhä useammalla siirtoa odottavalla potilaalla käytetään hengityksen ja verenkierron mekaanisia tukihoitoja, joiden avulla potilas voi pärjätä useita vuosia.
  • Thomander, Tuuli; Mäntylä, Jarkko; Hakulinen, Auli; Schwab, Ursula; Voutilainen, Helena; Kauppi, Paula (2018)
  • Heikinheimo, Terttu; Aarnio, Karoliina; Koivunen, Riku-Jaakko; Tatlisumak, Turgut; Putaala, Jukka (2017)
    Aivoverenkiertohäiriöt ovat yleistymässä alle 50-vuotiailla. Nuoret ja keski-ikäiset aivoverenkiertohäiriöpotilaat toipuvat yleensä paremmin kuin iäkkäät. Akuuttivaiheen hoito, kuten aivoinfarktin liuotushoito, mekaaninen aivovaltimon veritulpan poisto ja hoito aivohalvausyksikössä, parantavat ennustetta. Toipumiseen ja kuolleisuuteen vaikuttavat mm. häiriön syy, akuuttivaiheen oirekuva, diabetes, tupakointi ja infektiot. Noin puolet aivoverenkiertohäiriön sairastaneista palaa työelämään. Tavalliset riskitekijät ovat nuorillakin potilailla tavallisia, ja ne vaativat seurantaa ja sitoutumista pitkäaikaiseen lääkehoitoon. Pitkäaikaisseurannassa joka kymmenennelle iskeemisen aivoverenkiertohäiriön sairastaneista ja jopa joka neljännelle aivoverenvuotopotilaista kehittyy epilepsia.
  • Honkamäki, Jasmin; Piirilä, Päivi; Hisinger-Mölkänen, Hanna; Tuomisto, Leena E.; Andersen, Heidi; Huhtala, Heini; Sovijärvi, Anssi; Lindqvist, Ari; Backman, Helena; Lundbäck, Bo; Rönmark, Eva; Lehtimäki, Lauri; Pallasaho, Paula; Ilmarinen, Pinja; Kankaanranta, Hannu (2021)
    BACKGROUND: Child-onset asthma is known to remit with high probability, but remission in adult-onset asthma is seem-ingly less frequent. Reports of the association between remission and asthma age of onset up to late adulthood are scarce. OBJECTIVE: To evaluate the association between asthma remission, age at diagnosis and gender, and assess risk factors of nonremission. METHODS: In 2016, a random sample of 16,000 subjects aged 20 to 69 years from Helsinki and Western Finland were sent a FinEsS questionnaire. Physician-diagnosed asthma was catego-rized by age at diagnosis to early-(0-11 years), intermediate-(12-39 years), and late-diagnosed (40-69 years) asthma. Asthma remission was defined by not having had asthma symptoms and not having used asthma medication in the past 12 months. RESULTS: Totally, 8199 (51.5%) responded, and 879 reported physician-diagnosed asthma. Remission was most common in early-diagnosed (30.2%), followed by intermediate-diagnosed (17.9%), and least common in late-diagnosed asthma (5.0%) (P < .001), and the median times from diagnosis were 27, 18.5, and 10 years, respectively. In males, the corresponding remission rates were 36.7%, 20.0%, and 3.4%, and in females, 20.4%, 16.6%, and 5.9% (gender difference P < .001). In multivariable binary logistic regression analysis, signifi-cant risk factors of asthma nonremission were intermediate (odds ratio [OR] = 2.15, 95% confidence interval: 1.373.36) and late diagnosis (OR = 11.06, 4.82-25.37) compared with early diagnosis, chronic obstructive pulmonary disease (COPD) (OR = 5.56, 1.26-24.49), allergic rhinitis (OR = 2.28, 1.50-3.46), and family history of asthma (OR = 1.86, 1.22-2.85). Results were similar after excluding COPD. CONCLUSION: Remission was rare in adults diagnosed with asthma after age 40 years in both genders. Late-diagnosed asthma was the most significant independent risk factor for nonremission. (C) 2020 American Academy of Allergy, Asthma & Immunology
  • Kurko, Terhi; Saastamoinen, Leena; Tuulio-Henriksson, Annamari; Taiminen, Tero; Tiihonen, Jari; Airaksinen, Marja; Hietala, Jarmo (2018)
    Lähtökohdat Rekisteritutkimuksessa selvitettiin bentsodiatsepiinien pitkäaikaiskäytön yleisyyttä lääkeaineittain, ikäryhmittäin ja sukupuolittain koko väestössä. Menetelmät Kelan reseptitiedostosta tarkasteltiin sairausvakuutuksesta korvattuja bentsodiatsepiinien lääkeostoja vuosina 2006–2014. Pitkäaikaiskäytöksi määriteltiin vähintään 180 vuorokausiannoksen lääkeosto kalenterivuoden aikana. Tulokset Bentsodiatsepiinien pitkäaikaiskäyttö väheni kaikissa ikäryhmissä merkittävästi. Eniten se väheni75 vuotta täyttäneillä, mutta silti heistä 9,7 % oli pitkäaikaiskäyttäjiä vuonna 2014. Unilääkkeiden pitkäaikaiskäyttö oli yleisintä vanhimmissa ikäryhmissä ja rauhoittavien lääkkeiden 50–64-vuotiailla. Tsopikloni oli käytetyin lääkeaine ja myös sen pitkäaikaiskäyttö oli yleisintä. Tsolpideemin pitkäaikaiskäyttö lisääntyi kaikissa ja klonatsepaamin muissa paitsi 75 vuotta täyttäneiden ikäryhmässä. Päätelmät Vaikka bentsodiatsepiinien pitkäaikaiskäyttö on kokonaisuutena vähentynyt, käytön pitkittymiseen tulee edelleen kiinnittää huomiota.
  • Martiskainen, Mika; Oksala, Niku; Pohjasvaara, Tarja; Kaste, Markku; Oksala, Anni; Karhunen, Pekka J.; Erkinjuntti, Timo (2014)
  • Endén, Kira; Tainio, Juuso; Nikkilä, Atte; Helanterä, Ilkka; Nordin, Arno; Pakarinen, Mikko P.; Jalanko, Hannu; Jahnukainen, Kirsi; Jahnukainen, Timo (2020)
    Background The prevalence of malignancies after pediatric solid organ transplantation was evaluated in a nationwide study. Methods All patients who had undergone kidney, liver, or heart transplantation during childhood between the years 1982 and 2015 in Finland were identified. The inclusion criteria were age under 16 years at transplantation and age over 18 years at the last follow-up day. A total of 233 (137 kidney, 53 liver, and 43 heart) transplant recipients were enrolled. Controls (n = 1157) matched by the year of birth, gender, and hometown were identified using the Population Register Center registry. The cancer diagnoses were searched using the Finnish Cancer Registry. Results Altogether 26 individuals diagnosed with cancer were found, including 18 transplant recipients. Cancer was diagnosed at a median of 12.0 (IQR 7.8-17.8) years after the transplantation. The transplant recipients' risk for cancer was significantly higher when compared with the controls (HR 14.7; 95% CI 6.4-33.9). There was no difference for different graft types. Sixty-one percent of cancers among the transplant recipients were diagnosed at age older than 18 years. Conclusion The risk for cancer is significantly higher among young adults having undergone solid organ transplantation during childhood in comparison with population controls. Careful follow-up and attention to prevent cancers throughout adulthood are warranted.