Browsing by Subject "Death"

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  • Kuisma, Markku; Salo, Ari; Puolakka, Jyrki; Nurmi, Jouni; Kirves, Hetti; Vayrynen, Taneli; Boyd, James (2017)
    Introduction: The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR), also known as the Lazarus phenomenon, is a rare event described in several case reports. This study aims to determine the incidence and the time of occurrence of the Lazarus phenomenon after cessation of out-of-hospital CPR. Methods: This prospective observational cohort study was conducted in the Helsinki Emergency Medical Service in Finland from 1 January 2011 through 31 December 2016. All out-of-hospital CPR attempts were carefully monitored for 10 min after the cessation of CPR in order to detect delayed ROSC. Results: Altogether, 2102 out-of-hospital cardiac arrests occurred during the six-year study period. CPR was attempted in 1376 (65.5%) cases. In 840 cases (61.0% of all attempts) CPR attempts were terminated on site. The Lazarus phenomenon occurred five times, with an incidence of 5.95/1000 (95% CI 2.10-14.30) in field-terminated CPR attempts. Time to delayed ROSC from the cessation of CPR varied from 3 to 8 min. Three of the five patients with delayed ROSC died at the scene within 2-15 min while two died later in hospital within 1.5 and 26 h, respectively. Conclusions: We observed that the Lazarus phenomenon is a real albeit rare event and can occur a few minutes after the cessation of out-of-hospital CPR. We suggest a 10-min monitoring period before diagnosing death. CPR guidelines should be updated to include information of the Lazarus phenomenon and appropriate monitoring for it. (C) 2017 Elsevier B.V. All rights reserved.
  • Eranti, Antti; Kerola, Tuomas; Aro, Aapo L.; Tikkanen, Jani T.; Rissanen, Harri A.; Anttonen, Olli; Junttila, M. Juhani; Knekt, Paul; Huikuri, Heikki V. (2016)
    Background: Diabetes predisposes to sudden cardiac death (SCD). However, it is uncertain whether greater proportion of cardiac deaths are sudden among diabetes patients than other subjects. It is also unclear whether the risk of SCD is pronounced already early in the course of the disease. The relationship of impaired glucose tolerance (IGT) and SCD is scarcely documented. Methods: A general population cohort of 10594 middle-aged subjects (mean age 44 years, 52.6 % male, follow-up duration 35-41 years) was divided into diabetes patients (n = 82), subjects with IGT (n = 3806, plasma glucose = 9.58 mmol/l in one-hour glucose tolerance test), and controls (n = 6706). Results: Diabetes patients had an increased risk of SCD after adjustment confounders (hazard ratio 2.62, 95 % confidence interval 1.46-4.70, p = 0.001) but risk for non-sudden cardiac death was similarly increased and the proportion of SCD of cardiac deaths was not increased. The SCD risk persisted after exclusion of subjects with baseline cardiac disease or non-fatal cardiac events during the follow-up. Subjects with IGT were at increased risk for SCD (univariate hazard ratio 1.51; 95 % confidence interval 1.31-1.74; p <0.001) and also for non-sudden cardiac deaths and non-fatal cardiac events but adjustments for other risk factors attenuated these effects. Conclusions: Diabetes was associated with increased risk of SCD but also the risk of non-sudden cardiac death was similarly increased. The proportion of cardiac deaths being sudden in subjects with diabetes was not increased. The higher SCD risk in diabetes patients was independent of known cardiac disease at baseline or occurrence of nonfatal cardiac event during the follow-up.
  • Koivusalo, Anna-Maria; Nordin, Arno; Lempinen, Marko; Ulander, Veli-Matti; Ala-Kokko, Tero (2021)
    • Elinsiirrot ovat kustannustehokasta hoitoa. Niitä rajoittaa elinluovuttajien määrä ja siirrännäisten puute. • Elinsiirto- ja -luovutustoimintaa säädellään ja valvotaan tarkkaan lailla. • Luovuttajien määrää on yritetty lisätä lainsäädännöllä ja toimintaa koordinoimalla. • Kuolleet elinluovuttajat Suomessa ovat olleet aivokuolleita. • Monissa maissa on käytössä elinluovutus verenkierron pysähtymisen ja kuoleman toteamisen jälkeen -toiminta. Se mahdollistaa elinluovutuksen potilaalta, jolla on palautumaton aivovaurio mutta tila ei etene aivokuolemaan. Tämä toiminta on tarkoitus aloittaa myös Suomessa.
  • Esser, Andrea Marlen (Helsinki Collegium for Advanced Studies, 2015)
    COLLeGIUM: Studies across Disciplines in the Humanities and Social Sciences ; 19
  • Hakola, Outi (Helsinki Collegium for Advanced Studies, 2015)
    COLLeGIUM: Studies across Disciplines in the Humanities and Social Sciences ; 19
    COLLeGIUm’s 19th volume discusses mortality at the communal and personal levels of experience. The volume “Death and Mortality” emerges from the Human Mortality project (Helsinki Collegium for Advanced Studies 2011-2013), which provided a framework for discussing death, dying and mortality in an interdisciplinary network. This volume brings together, in particular, anthropological, philosophical, theological and historical perspectives. The writers - including Douglas Davies, Jeff McMahan, Kathryn Edwards and many others - discuss how (good/bad) death can be defined, understood and experienced in different cultural, political, social and historical contexts.
  • Koski, Kaarina; Moilanen, Ulla (Gaudeamus, 2019)
  • Koski, Kaarina (2019)
  • Vuola, Jyrki (2016)
    Ääriolosuhteissa saunavammoja voi aiheutua kontaktin ja kuuman ilman lisäksi myös vesihöyryn syrjäyttäessä hapen. Saunomisen MM-kisoissa vuonna 2010 oletettavasti nimenomaan hapenpuute esti vaarallisten merkkien havaitsemisen ja saunojat jäivät saunaan kriittisiksi viimeisiksi minuuteiksi.
  • Lindberg, Nina; Miettunen, Jouko; Heiskala, Anni; Kaltiala-Heino, Riittakerttu (2017)
    Background: The mortality rate of young offenders is high. Furthermore, mortality in young offenders is associated with psychiatric and substance use disorders. The primary aim of this national register-based follow-up study was to investigate the mortality rate of Finnish delinquents who underwent a forensic psychiatric examination between 1980 and 2010. As delinquency is not a solid entity, we further aimed to compare the risk of premature death among different subgroups of the delinquents; violent versus non-violent offenders, offenders with alcohol use disorders versus those with no such diagnoses, offenders with schizophrenia spectrum disorders versus conduct-and personality-disordered offenders, under-aged versus young adult offenders, and, finally, boys versus girls. Methods: We collected the forensic psychiatric examination reports of all 15- to 19-year-old offenders who were born in Finland and had undergone the examination between 1.1.1980 and 31.12.2010 (n = 606) from the archives of the National Institute of Health and Welfare and retrospectively reviewed them. For each delinquent, four age-, gender- and place of birth-matched controls were randomly selected from the Central Population Register (n = 2424). The delinquents and their controls were followed until the end of 2015. The median follow-up time was 23.9 years (interquartile range 15.3-29.5). We obtained the mortality data from the causes of death register. Deaths attributable to a disease or an occupational disease were considered natural, and those attributable to an accident, suicide or homicide were considered unnatural. Results: By the end of the follow-up period, 22.1% (n = 134) of the delinquents and 3.4% (n = 82) of their controls had died (OR 8.11, 95% CI 6.05-10.86, p <0.001). Among boys, 22.0% (n = 121) of the delinquents and 3.7% (n = 81) of the controls had died (OR 7.38, 95% CI 5.46-9.95, p <0.001). Male delinquents' risk of unnatural death was almost 11-fold, of natural death more than twofold, and of unclear death more than fourfold compared to that of their controls. No girls had natural or unclear deaths, but 23.6% (n = 13) of the delinquents and 0.5% (n = 1) of the controls had died due to unnatural causes (OR 67.79, 95% CI 8.63-532.00, p <0.001). The violent delinquents' risk of premature death was twice that of the non-violent delinquents. The other comparisons demonstrated no statistically significant differences between subgroups. Conclusions: Even though the Finnish correction system prefers psychiatric treatment and rehabilitation over criminal sanctions, and the national health care system offers developmental-phase-specific psychiatric care, the mortality rate of delinquents, especially of those with a history of violent offences, is high. The excess mortality of offenders can be regarded as a specific public-health inequity that calls for more effective intervention procedures than those used thus far.
  • Mroueh, R.; Haapaniemi, A.; Saarto, T.; Grönholm, L.; Grénman, R.; Salo, T.; Mäkitie, A. A. (2019)
    PurposeLate-stage OTSCC is associated with poor overall survival (OS). Non-curative treatment approach aims to improve quality of life and prolong survival of patients deemed incurable. The purpose of this study was to investigate the used non-curative treatment modalities for OTSSC and patient survival.MethodsAll patients diagnosed with OTSCC and treated with non-curative intent at the HUS Helsinki University Hospital (Helsinki, Finland) during the 12-year period of 2005-2016 were included. Survival analysis after the non-curative treatment decision was conducted using the Kaplan-Meier method in this population-based study.ResultsEighty-two patients were identified. A non-curative treatment decision was made at presentation without any previous treatment in 26 patients (7% of all patients diagnosed with OTSCC during the study period). Palliative radiotherapy was administered to 24% of all patients. The average survival time after the non-curative treatment decision was 3.7months (median 2 and range 0-26).ConclusionsDue to the short mean survival time after decision for treatment with non-curative intent, and the notable symptom burden in this patient population, a prompt initiation of all non-curative measures is warranted.
  • Wüest, Julia (Helsingin yliopisto, 2022)
    The goal of this thesis is to show the ways in which C. S. Lewis’ The Chronicles of Narnia and Philip Pullman’s His Dark Materials depict Biblical themes, and to illustrate the worldview and moral values they represent by making use of these Biblical themes. I discuss the differences and similarities of the two series in their portrayal of themes like temptation, sin, morality, death and the afterlife. For my theoretical background and secondary material, I draw on theological literary criticism and thematics, as well as previous research on both Lewis’ and Pullman’s work. Using these as my background, I analyse the primary material through close reading. I show that the two series make use of a variety Biblical references and themes to create a moral framework and present their respective views on these themes. My main result is that their portrayal of morality and the other ideologies that they portray vary drastically, but that their overall goal is very similar. Both The Chronicles of Narnia and His Dark Materials aims to provide young readers with ideas about what is moral, how to live a morally good life, and where this life ultimately leads. In their own ways, both series also provide reassurance to their young audience when it comes to the topic of death. In their work, both Lewis and Pullman treat existential questions about what it means to be human, and they give different answers to these questions that I present in this thesis. I also demonstrate the relevance of this topic by discussing some of the critical opinions on both series, pointing to the underlying issue of deciding what is appropriate for young audiences to read. This is an important and ongoing cultural and societal discussion, in which our moral values and the ideologies we want to pass on to the next generation are constantly re-negotiated. Analysing the ways in which these values are represented on a textual level can give us an increased understanding of the issues at stake. With this thesis, I hope to be able to contribute to this discussion.
  • Roinila, Markku (RIA, 2016)
    According to Leibniz, there is no death in the sense that the human being or animal is destroyed completely. This is due to his metaphysical pluralism which would suffer if the number of substances decreased. While animals transform into other animals after “death”, human beings are rewarded or punished of their behavior in this life. This paper presents a comprehensive account of how Leibniz thought the “death” to take place and discusses his often unclear views on the life after death. I will also present a new, naturalistic reading of Leibniz’s views on afterlife.
  • Junno, Juho-Antti; Pakanen, Lasse; Oura, Petteri (2021)
    The Finnish population has a long life expectancy but ranks high in unnatural deaths on the European scale. Mortality has historical regional discrepancy in Finland, as Northern Finns are overrepresented in both natural and unnatural deaths. This study aimed to characterize the age- and sex-related trends in unnatural mortality among Northern Finns. Altogether 12 143 individuals, constituting >95% of births in Northern Finland in 1966, were followed up for a median of 52 years. The mortality patterns of this population were studied using death record data. Crude annual mortality rates were calculated and graphed for 10-year age strata (all-cause, natural-cause, and unnatural-cause mortality, as well as accident, suicide, and homicide mortality). Cox regression was used to analyze the sex discrepancy in mortality. A total of 874 deaths (7.2%) occurred during the follow-up period. Women had 47% and 73% lower risks of any death and unnatural death than men, respectively. From the second decade of life onwards, the unnatural mortality of men was 3–5 times that of women. Accident and suicide mortality rates of men were 2–13 and 2–3 times those of women, respectively. Homicides were rare among either sex. We conclude that Northern Finnish women have a substantially lower risk of all-cause mortality and unnatural mortality than men. To aid the development of preventive strategies, future studies should aim to identify the underlying factors behind unnatural mortality. Primarily, emphasis should be placed on the increased mortality of men from the second decade of life onwards.
  • Hemilä, Harri (2013)
    In their meta-analysis, Bjelakovic et al. (2013) calculated that vitamin E in doses above the RDA (>15 mg) may slightly increase mortality by 3%. This estimate was based on the pooling of the results of 44 studies. However, study-level analyses can lead to different conclusions than do corresponding individual-level analysis, a difference which is called the “ecological fallacy”. ... Given the mainly negative findings in the antioxidant trials, it seems justified to discourage the general population from taking supplements until we have better knowledge of the groups of people who may benefit. However, a single vitamin E effect estimate, such as +3%, does not apply to all people over the globe since, at least, a substantial proportion of Finnish men in the ATBC study are inconsistent with such an effect. The individual-level analysis of the ATBC Study suggests that trials on vitamins E and C for men older than 70 years are warranted.