Browsing by Subject "FEASIBILITY"

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  • Bonaros, Nikolaos; Kofler, Markus; Frank, Derk; Cocchieri, Riccardo; Jagielak, Dariusz; Aiello, Marco; Lapeze, Joel; Laine, Mika; Chocron, Sidney; Muir, Douglas; Eichinger, Walter; Thielmann, Matthias; Labrousse, Louis; Bapat, Vinayak; Rein, Kjell Arne; Verhoye, Jean-Philippe; Gerosa, Gino; Baumbach, Hardy; Deutsch, Cornelia; Bramlage, Peter; Thoenes, Martin; Romano, Mauro (2018)
    Objective: It has been reported that balloon aortic valvuloplasty immediately before transfemoral or transapical transcatheter aortic valve implantation has mostly little to no clinical value. We aimed to provide data on the need for balloon aortic valvuloplasty in patients undergoing transaortic transcatheter aortic valve implantation. Methods: Patients undergoing transaortic transcatheter aortic valve implantation with the Edwards SAPIEN XT (Nyon, Switzerland) or 3 transcatheter heart valve were prospectively included at 18 sites across Europe. In the present analysis, we compare the periprocedural and 30-day outcomes of patients undergoing conventional (thorn balloon aortic valvuloplasty) versus direct (-balloon aortic valvuloplasty) transaortic transcatheter aortic valve implantation. Results: Of the 300 patients enrolled, 222 underwent conventional and 78 underwent direct transaortic transcatheter aortic valve implantation. Peak and mean transvalvular gradients were improved in both groups with no significant difference between groups. Procedural duration, contrast agent volume, and requirement for postdilation were also comparable. A trend toward fewer periprocedural complications was evident in the direct group (3.9% vs 11.3%; P = .053), with significantly lower rates of permanent pacemaker implantation (0% vs 5.0%; P = .034). Balloon aortic valvuloplasty omission had no significant effect on any of the 30-day safety and efficacy outcomes, including Valve Academic Research Consortium-2 composite end points (early safety events: 22.7% vs 17.4%, odds ratio, 1.17, 95% confidence interval, 0.53-2.62; clinical efficacy events: 20.5% vs 18.7%, odds ratio, 1.14, 95% confidence interval, 0.51-2.55). Conclusions: For many patients, balloon aortic valvuloplasty predilation seems to have little clinical value in transaortic transcatheter aortic valve implantation using a balloon expandable transcatheter valve and may result in a higher rate of periprocedural complications, particularly in terms of permanent pacemaker implantation.
  • Almada-Correia, Inês; Neves, Pedro Miguel; Mäkitie, Antti; Ravasco, Paula (2019)
    Introduction: Head and neck cancer (HNC) patients show a high risk of malnutrition due to the lifestyle habits adopted prior to the diagnosis as well as to the compromising impact of both the anatomical location of the tumor and the treatment modalities on food intake. Weight change, measurement of skinfold thickness, biochemical parameters, bioelectrical impedance analysis (BIA), computed tomography (CT), magnetic resonance (MRI), or dual-energy x-ray absorptiometry (DXA) are available techniques to evaluate nutritional status and/or body composition in the clinical practice. Evaluating body composition alterations in HNC patients is essential to be able to offer the best therapeutical interventions. In this paper, we review the existing literature regarding body composition evaluation in HNC patients to determine, which is the most suitable method for this population, regarding availability in the day-to-day practice, patient burden, cost, sensibility, and specificity.Methodology: A literature search for relevant papers indexed in MEDLINE, Cochrane Library and Scielo was conducted, with no publication date restriction and for all published articles until the 31 January, 2019. All the papers written in English, with interventions in humans, exclusively considering HNC patients were selected.Results: A total of 41 studies with different methodologies were included in this review. In 15 studies BIA was the used assessment method and three of them also evaluated skinfold thickness and one was a bioelectric impedance vector analysis (BIVA). Body composition assessment was made with DXA in eight studies, one of which also included muscle biopsies. In two studies the chosen method was both BIA and DXA. CT/ positron emission tomography-CT was applied in 11 studies and one also included MRI. In two studies body composition was assessed with skinfold measurements alone and one study only used BIVA.Conclusions: Despite the different existing body composition assessment tools, it seems that skeletal muscle mass (SMM) measurement at the level of cervical spine C3 vertebra may be a reliable method for SMM assessment as it strongly correlates with cross-sectional area measures at the level of L3 and it allows a cost-effective body composition assessment without the need for additional radiation exposure.
  • Pöhö, Päivi; Vaikkinen, Anu; Haapala, Markus; Kylli, Petri; Kostiainen, Risto (2019)
    This is the first report on capillary photoionization (CPI) interfacing a liquid chromatograph (LC) and mass spectrometer (MS). A new heated CPI ion source was developed, including a heated transfer capillary, a wide oval-shaped and low-depth ionization chamber with a vacuum ultraviolet (VUV) transparent magnesium fluoride (MgF2) window to increase the photoionization efficiency and thus the sensitivity. As both analytes and eluent are first vaporized and then photoionized inside the CPI ion source between the atmosphere and the vacuum of MS, the ion transfer efficiency into the MS and thus the sensitivity is improved. The effect of the most important operation parameters, the eluent flow rate and temperature of the CPI source, on the signal intensity was studied with selected steroids. The feasibility of LC-CPI-MS/MS for the quantitative analysis of steroids was also studied in terms of linearity, repeatability, and limits of detection. The method showed good quantitative performance and sensitivity down to the low femto-mole level.
  • Vuorinen, Anna-Leena; Erkkola, Maijaliisa; Fogelholm, Mikael; Kinnunen, Satu; Saarijärvi, Hannu; Uusitalo, Liisa; Näppilä, Turkka; Nevalainen, Jaakko (2020)
    Background: To date, the evaluation of diet has mostly been based on questionnaires and diaries that have their limitations in terms of being time and resource intensive, and a tendency toward social desirability. Loyalty card data obtained in retailing provides timely and objective information on diet-related behaviors. In Finland, the market is highly concentrated, which provides a unique opportunity to investigate diet through grocery purchases. Objective: The aims of this study were as follows: (1) to investigate and quantify the selection bias in large-scale (n=47,066) loyalty card (LoCard) data and correct the bias by developing weighting schemes and (2) to investigate how the degree of loyalty relates to food purchases. Methods: Members of a loyalty card program from a large retailer in Finland were contacted via email and invited to take part in the study, which involved consenting to the release of their grocery purchase data for research purposes. Participants' sociodemographic background was obtained through a web-based questionnaire and was compared to that of the general Finnish adult population obtained via Statistics Finland. To match the distributions of sociodemographic variables, poststratification weights were constructed by using the raking method. The degree of loyalty was self-estimated on a 5-point rating scale. Results: On comparing our study sample with the general Finnish adult population, in our sample, there were more women (65.25%, 30,696/47,045 vs 51.12%, 2,273,139/4,446,869), individuals with higher education (56.91%, 20,684/36,348 vs 32.21%, 1,432,276/4,446,869), and employed individuals (60.53%, 22,086/36,487 vs 52.35%, 2,327,730/4,446,869). Additionally, in our sample, there was underrepresentation of individuals aged under 30 years (14.44%, 6,791/47,045 vs 18.04%, 802,295/4,446,869) and over 70 years (7.94%, 3,735/47,045 vs 18.20%, 809,317/4,446,869), as well as retired individuals (23.51%, 8,578/36,487 vs 31.82%, 1,414,785/4,446,869). Food purchases differed by the degree of loyalty, with higher shares of vegetable, red meat & processed meat, and fat spread purchases in the higher loyalty groups. Conclusions: Individuals who consented to the use of their loyalty card datafor research purposes tended to diverge from the general Finnish adult population. However, the high volume of data enabled the inclusion of sociodemographically diverse subgroups and successful correction of the differences found in the distributions of sociodemographic variables. In addition, it seems that food purchases differ according to the degree of loyalty, which should be taken into account when researching loyalty card data. Despite the limitations, loyalty card data provide a cost-effective approach to reach large groups of people, including hard-to-reach population subgroups.
  • Köykkä, Laura Katariina; Absetz, Pilvikki; Araújo-Soares, Vera; Knittle, Keegan Phillip; Sniehotta, Falko F.; Hankonen, Nelli Elisa (2019)
    Creating active classroom environments and reducing excessive student sitting requires changes in teachers' behaviours. This study examines a teacher training intervention, which aimed to increase the extent to which teachers use strategies to interrupt prolonged periods of students' sitting, as well as strategies to reduce total sitting time. The training was part of the Let's Move It (LMI) multi-level school-based intervention that aimed to reduce sedentary behaviour and increase physical activity among older adolescents, drawing on insights from social psychological theories, such as the reasoned action approach, self-regulation approaches and habit formation. We explore (1) whether the intervention increased teachers' use of sitting reduction strategies, (2) whether theoretical mechanisms mediated these changes, and (3) how teachers utilized habit formation. This pragmatic experimental study of vocational school teachers (n = 234) was embedded within a cluster-randomized controlled trial evaluating LMI, in which schools were randomized to intervention or no-treatment control arms. Three intervention workshops targeted skills and motivation to use sitting reduction strategies in class (e.g., active teaching methods, activity breaks). Participants self-reported sitting reduction activities, theoretical mediators, and use of behaviour change techniques (BCTs) at baseline and 8-weeks follow-up. Compared to controls, intervention schools' teachers increased breaks to interrupt sitting, but not their outcome expectations, perceived behavioural control or intentions - potentially due to ceiling effects. Effects were mediated by BCT use and perceived behavioural control. Descriptive norms mediated the effects of the intervention on intention, which in turn mediated the intervention effects on BCT use. BCT use and intention were positively related to reducing students' sitting.
  • Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja (2018)
    Background: The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients >= 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Methods: Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. Discussion: The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources.
  • Grasbeck, Thomas C.; Grasbeck, Sophia V.; Miettinen, Päivi J.; Summanen, Paula A. (2016)
    PURPOSE: To determine the success rate of the initial fundus photography session in producing gradable images for screening diabetic retinopathy in children <18 years of age with type 1 diabetes (T1D), and to analyze outcome-associated factors. DESIGN: Retrospective observational cohort study. METHODS: Mydriatic red-free monochromatic 60 degree digital fundus images centered on the macula and optic disc of 213 patients were graded. Photography success was classified as "complete" if both images of both eyes were gradable, "partial" if both images of 1 eye were gradable, "macula-centered image(s) only" if only the macula-centered image of one or both eyes was grad able, and "unsuccessful" if neither macula-centered image was gradable. RESULTS: Complete success was reached in 97 (46%; 95% confidence interval [CI], 39-52) patients, at least partial success in 153 (72%; 95% CI, 65-78) patients, success of macula-centered image(s) only in 47 (22%; 95% CI, 17-28) patients, and in 13 (6%; 95%CI, 3-10) patients fundus photography was unsuccessful. Macula centered images were more often gradable in both eyes than optic disc-centered images (P <.001). Success, of photography did not differ between right and left eye. Sex, age at diagnosis of T1D, and the duration of diabetes, age, and glycemic control at the time of initial photography were unassociated with complete success. Partial success tended to decrease with increasing age category (P = .093), and the frequency of gradable macula-centered image(s) only increased with increasing age (P = .043). CONCLUSIONS: Less than half of the children achieved complete success, but in only 6% initial fundus photography was unsuccessful, indicating its value in assessing retinopathy in the pediatric setting. (C) Elsevier Inc. All rights reserved.
  • Aspinen, Samuli; Karkkainen, Jari; Harju, Jukka; Juvonen, Petri; Kokki, Hannu; Eskelinen, Matti (2017)
    The assessment of the quality of life (QoL) in minilaparotomy cholecystectomy (MC) versus laparoscopic cholecystectomy (LC) with the ultrasonic dissection in both groups has not been addressed earlier. Initially, 109 patients with non-complicated symptomatic gallstone disease were randomized to undergo either MC (n = 59) or LC (n = 50). RAND-36 survey was conducted preoperatively and at 4 weeks and 6 months postoperatively. The end point of our study was to determine differences in health status in MC versus LC groups. QoL improved significantly in both groups, and the recovery was similar in the two groups, except from the higher score in 'health change' subscale at 4 weeks in MC group [MC score 75.0 (25.0) vs. LC score 56.5 (23.2), p = 0.008]. The MC and LC groups combined, RAND-36 scores increased significantly in 'physical functioning' [combined mean (SD) preoperative score 80.5 (23.9) vs. 6-month postoperative score 86.5 (21.7), p = 0.015], 'vitality' [64.5 (19.2) vs. 73.5 (18.3), p = 0.001], 'health change' [43.0 (21.6) vs. 74.6 (25.4), p = 0.0001] and 'bodily pain' scores [57.7 (26.3) vs. 75.5 (25.5), p = 0.001], respectively. Four RAND-36 domains indicated statistically significant health status differences in comparing the preoperative and postoperative RAND-36 scores in LC and MC groups combined. Four RAND-36 domains indicated a significant positive change in QoL after cholecystectomy.
  • Puhakka, Jani; Afara, Isaac O.; Paatela, Teemu; Sormaala, Markus J.; Timonen, Matti A.; Viren, Tuomas; Jurvelin, Jukka S.; Toyras, Juha; Kiviranta, Ilkka (2016)
    Objective. Accurate arthroscopic evaluation of cartilage lesions could significantly improve the outcome of repair surgery. In this study, we investigated for the first time the potential of intra-articular ultrasound as an arthroscopic tool for grading cartilage defects in the human shoulder joint in vivo and compared the outcome to results from arthroscopic evaluation and magnetic resonance imaging findings. Design. A total of 26 sites from 9 patients undergoing routine shoulder arthroscopy were quantitatively evaluated with a clinical intravascular (40MHz) ultrasound imaging system, using the regular arthroscopy portals. Reflection coefficient (R), integrated reflection coefficient (IRC), apparent integrated backscattering (AIB), and ultrasound roughness index (URI) were calculated, and high-resolution ultrasound images were obtained per site. Each site was visually graded according to the International Cartilage Repair Society (ICRS) system. "Ultrasound scores" corresponding to the ICRS system were determined from the ultrasound images. Magnetic resonance imaging was conducted and cartilage integrity at each site was classified into 5 grades (0 = normal, 4 = severely abnormal) by a radiologist. Results. R and IRC were lower at sites with damaged cartilage surface (P = 0.033 and P = 0.043, respectively) and correlated with arthroscopic ICRS grades (r (s) = -0.444, P = 0.023 and r (s) = -0.426, P = 0.03, respectively). Arthroscopic ICRS grades and ultrasound scores were significantly correlated (rs = 0.472, P = 0.015), but no significant correlation was found between magnetic resonance imaging data and other parameters. Conclusion. The results suggest that ultrasound arthroscopy could facilitate quantitative clinical appraisal of articular cartilage integrity in the shoulder joint and provide information on cartilage lesion depth and severity for quantitative diagnostics in surgery.
  • De Fazio, Chiara; Skrifvars, Markus B.; Soreide, Eldar; Creteur, Jacques; Grejs, Anders M.; Kjaergaard, Jesper; Laitio, Timo; Nee, Jens; Kirkegaard, Hans; Taccone, Fabio Silvio (2019)
    BackgroundThe aim of this study was to explore the performance and outcomes for intravascular (IC) versus surface cooling devices (SFC) for targeted temperature management (TTM) after out-of-hospital cardiac arrest.MethodsA retrospective analysis of data from the Time-differentiated Therapeutic Hypothermia (TTH48) trial (NCT01689077), which compared whether TTM at 33 degrees C for 48h results in better neurologic outcomes compared with standard 24-h duration. Devices were assessed for the speed of cooling and rewarming rates. Precision was assessed by measuring temperature variability (TV), i.e., the standard deviation (SD) of all temperature measurements in the cooling phase. Main outcomes were overall mortality and poor neurological outcome, including death, severe disability, or vegetative status.ResultsA total of 352 patients had available data and were included in the analysis; of those, 218 (62%) were managed with IC. A total of 114/218 (53%) patients with IC and 61/134 (43%) with SFC were cooled for 48h (p=0.22). Time to target temperature (34 degrees C) was significantly shorter for patients treated with endovascular devices (2.2 [1.1-4.0] vs. 4.2 [2.7-6.0] h, p
  • Seitamaa-Hakkarainen, Pirita; Laamanen, Tarja-Kaarina; Viitala, Jemina; Mäkelä, Maarit (2013)
  • Sen, Partho; Dickens, Alex M.; Lopez-Bascon, Maria Asuncion; Lindeman, Tuomas; Kemppainen, Esko; Lamichhane, Santosh; Rönkkö, Tuukka; Ilonen, Jorma; Toppari, Jorma; Veijola, Riitta; Hyöty, Heikki; Hyötyläinen, Tuulia; Knip, Mikael; Oresic, Matej (2020)
    Aims/hypothesis Previous metabolomics studies suggest that type 1 diabetes is preceded by specific metabolic disturbances. The aim of this study was to investigate whether distinct metabolic patterns occur in peripheral blood mononuclear cells (PBMCs) of children who later develop pancreatic beta cell autoimmunity or overt type 1 diabetes. Methods In a longitudinal cohort setting, PBMC metabolomic analysis was applied in children who (1) progressed to type 1 diabetes (PT1D, n = 34), (2) seroconverted to >= 1 islet autoantibody without progressing to type 1 diabetes (P1Ab, n = 27) or (3) remained autoantibody negative during follow-up (CTRL, n = 10). Results During the first year of life, levels of most lipids and polar metabolites were lower in the PT1D and P1Ab groups compared with the CTRL group. Pathway over-representation analysis suggested alanine, aspartate, glutamate, glycerophospholipid and sphingolipid metabolism were over-represented in PT1D. Genome-scale metabolic models of PBMCs during type 1 diabetes progression were developed by using publicly available transcriptomics data and constrained with metabolomics data from our study. Metabolic modelling confirmed altered ceramide pathways, known to play an important role in immune regulation, as specifically associated with type 1 diabetes progression. Conclusions/interpretation Our data suggest that systemic dysregulation of lipid metabolism, as observed in plasma, may impact the metabolism and function of immune cells during progression to overt type 1 diabetes. Data availability The GEMs for PBMCs have been submitted to BioModels (), under accession number MODEL1905270001. The metabolomics datasets and the clinical metadata generated in this study were submitted to MetaboLights (), under accession number MTBLS1015.
  • Rönö, Kristiina; Stach-Lempinen, Beata; Klemetti, Miira M; Kaaja, Risto; Pöyhönen-Alho, Maritta; Eriksson, Johan G.; Koivusalo, Saila B.; Andersson, Sture; Huvinen, Emilia; Radiel Grp (2014)
  • Yrttimaa, Tuomas; Luoma, Ville; Saarinen, Ninni; Kankare, Ville; Junttila, Samuli; Holopainen, Markus; Hyyppä, Juha; Vastaranta, Mikko (2020)
    Terrestrial laser scanning (TLS) has been adopted as a feasible technique to digitize trees and forest stands, providing accurate information on tree and forest structural attributes. However, there is limited understanding on how a variety of forest structural changes can be quantified using TLS in boreal forest conditions. In this study, we assessed the accuracy and feasibility of TLS inquantifying changes in the structure of boreal forests. We collected TLS data and field reference from 37 sample plots in 2014 (T1) and 2019 (T2). Tree stems typically have planar, vertical, and cylindricalcharacteristics in a point cloud, and thus we applied surface normal filtering, point cloud clustering, and RANSAC-cylinder filtering to identify these geometries and to characterize trees and foreststands at both time points. The results strengthened the existing knowledge that TLS has the capacity to characterize trees and forest stands in space and showed that TLS could characterize structural changes in time in boreal forest conditions. Root-mean-square-errors (RMSEs) in the estimates for changes in the tree attributes were 0.99–1.22 cm for diameter at breast height (∆dbh), 44.14–55.49 cm2 for basal area (∆g), and 1.91–4.85 m for tree height (∆h). In general, tree attributes were estimated more accurately for Scots pine trees, followed by Norway spruce and broadleaved trees. At the forest stand level, an RMSE of 0.60–1.13 cm was recorded for changes in basal area-weighted meandiameter (∆Dg), 0.81–2.26 m for changes in basal area-weighted mean height (∆Hg), 1.40–2.34 m2 /ha for changes in mean basal area (∆G), and 74–193 n/ha for changes in the number of trees per hectare (∆TPH). The plot-level accuracy was higher in Scots pine-dominated sample plots than in Norway spruce-dominated and mixed-species sample plots. TLS-derived tree and forest structural attributes at time points T1 and T2 differed significantly from each other (p < 0.05). If there was an increase or decrease in dbh, g, h, height of the crown base, crown ratio, Dg, Hg, or G recorded in the field, a similar outcome was achieved by using TLS. Our results provided new information on the feasibility of TLS for the purposes of forest ecosystem growth monitoring.
  • Nelskylä, Annika; Nurmi, Jouni; Jousi, Milla; Schramko, Alexey; Mervaala, Eero; Ristagno, Giuseppe; Skrifvars, Markus (2017)
    Background and aim: We hypothesised that the use of 50% compared to 100% oxygen maintains cerebral oxygenation and ameliorates the disturbance of cardiac mitochondrial respiration during cardiopulmonary resuscitation (CPR). Methods: Ventricular fibrillation (VF) was induced electrically in anaesthetised healthy adult pigs and left untreated for seven minutes followed by randomisation to manual ventilation with 50% or 100% oxygen and mechanical chest compressions (LUCAS (R)). Defibrillation was performed at thirteen minutes and repeated if necessary every two minutes with 1 mg intravenous adrenaline. Cerebral oxygenation was measured with near-infrared spectroscopy (rSO(2), INVOS (TM) 5100C Cerebral Oximeter) and with a probe (NEUROVENT-PTO, RAUMEDIC) in the frontal brain cortex (PbO2). Heart biopsies were obtained 20 min after the return of spontaneous circulation (ROSC) with an analysis of mitochondrial respiration (OROBOROS Instruments Corp., Innsbruck, Austria), and compared to four control animals without VF and CPR. Brain rSO(2) and PbO2 were log transformed and analysed with a mixed linear model and mitochondrial respiration with an analysis of variance. Results: Of the twenty pigs, one had a breach of protocol and was excluded, leaving nine pigs in the 50% group and ten in the 100% group. Return of spontaneous circulation (ROSC) was achieved in six pigs in the 50% group and eight in the 100% group. The rSO(2) (p = 0.007) was lower with FiO(2) 50%, but the PbO2 was not (p = 0.93). After ROSC there were significant interactions between time and FiO(2) regarding both rSO(2) (p = 0.001) and PbO2 (p = 0.004). Compared to the controls, mitochondrial respiration was decreased, with adenosine diphosphate (ADP) levels of 57 (17) pmol s(-1) mg(-1) compared to 92 (23) pmol s(-1) mg(-1) (p = 0.008), but there was no difference between different oxygen fractions (p = 0.79). Conclusions: The use of 50% oxygen during CPR results in lower cerebral oximetry values compared to 100% oxygen but there is no difference in brain tissue oxygen. Cardiac arrest disturbs cardiac mitochondrial respiration, but it is not alleviated with the use of 50% compared to 100% oxygen (Ethical and hospital approvals ESAVI/1077/04.10.07/2016 and HUS/215/2016, 7 30.3.2016, Funding Helsinki University and others). (C) 2017 Elsevier B.V. All rights reserved.
  • Holopainen, Saila; Rautala, Elina; Lilja-Maula, Liisa; Lohi, Hannes; Rajamaki, Minna M.; Lappalainen, Anu K. (2019)
    Canine idiopathic pulmonary fibrosis is a chronic, progressive interstitial lung disease particularly prevalent in West Highland White Terriers. In the present prospective pilot study, we evaluated the feasibility of modified VetMousetrap (TM) device in high resolution CT to detect idiopathic pulmonary fibrosis in West Highland White Terriers. Twelve awake West Highland White Terriers with canine idiopathic pulmonary fibrosis and 24 clinically healthy West Highland White Terriers were scanned using a helical dual slice scanner utilizing VetMousetrap (TM) device without or with minimal chemical restraint with butorphanol. Three evaluators blindly assessed the images for image quality and the presence of canine idiopathic pulmonary fibrosis related imaging findings such as ground glass opacity and reticular opacities. Additionally, the attenuation of the lung was quantified with ImageJ software using histogram analysis of density over the lung fields. Computed tomography was successfully completed and motion artifact ranked in statistical analysis barely noticeable to mild in all dogs. The agreement between imaging findings and clinical status was very good with overall kappa value 0.91 and percentage of agreement of 94%. There was also very good intraobserver (kappa(range) = 0.79-0.91) and interobserver agreement (kappa = 0.94). Moderate to severe ground glass opacity was present in all affected dogs. In the ImageJ analysis, a significant difference in lung attenuation between the study groups was observed. We conclude that modified VetMousetrap (TM) device is applicable in diagnosing canine idiopathic pulmonary fibrosis in awake West Highland White Terriers avoiding anesthetic risk in these often severely hypoxic patients.
  • Mäkitie, Antti A.; Keski-Säntti, Harri; Markkanen-Leppänen, Mari; Bäck, Leif; Koivunen, Petri; Ekberg, Tomas; Sandström, Karl; Laurell, Göran; von Beckerath, Mathias; Nilsson, Johan S.; Wahlberg, Peter; Greiff, Lennart; Spaak, Lena Norberg; Kjaergaard, Thomas; Godballe, Christian; Rikardsen, Oddveig; Channir, Hani Ibrahim; Rubek, Niclas; von Buchwald, Christian (2018)
    Background: The five Nordic countries with a population of 27 M people form a rather homogenous region in terms of health care. The management of head and neck cancer is centralized to the 21 university hospitals in these countries. Our aim was to gain an overview of the volume and role of transoral robotic surgery (TORS) and to evaluate the need to centralize it in this area as the field is rapidly developing. Materials and Methods: A structured questionnaire was sent to all 10 Departments of Otorhinolaryngology-Head and Neck Surgery in the Nordic countries having an active programme for TORS in December 2017. Results: The total cumulative number of performed robotic surgeries at these 10 Nordic centers was 528 and varied between 5 and 240 per center. The median annual number of robotic surgeries was 38 (range, 5-60). The observed number of annually operated cases remained fairly low ( Conclusions: The present results showing a limited volume of performed surgeries call for considerations to further centralize TORS in the Nordic countries.
  • Raj, Rahul; Rautio, Riitta; Pekkola, Johanna; Rahi, Melissa; Sillanpää, Mikko; Numminen, Jussi (2019)
    BACKGROUND: The Woven EndoBridge (WEB) device is a new treatment modality developed for broad-necked unruptured intracranial aneurysms (IAs) but shows potential for the treatment of ruptured IAs as well. Our aim was to describe 6-month aneurysm obliteration rates, clinical outcomes, and procedure-related complications after WEB treatment for ruptured IAs from 2 academic centers. METHODS: We conducted a retrospective observational study, including all consecutive patients treated with the WEB device (WEB single layer and single-layer sphere) for a ruptured IA causing acute subarachnoid hemorrhage between 2014 (start of use) and 2017. Primary outcome was angiographic aneurysm obliteration (Beaujon Occlusion Scale Score) rate. Secondary outcomes were early re-bleedings, complications, and patient outcome (death and modified Rankin Scale). RESULTS: A total of 33 patients with ruptured IAs were treated 0-4 days from IA rupture. Of 27 survivors, 6-month angiographic follow-up was available for 26 patients, of whom 81% showed complete occlusion. Of the 27 survivors, 24 patients (89%) had a favorable neurologic outcome at 6 months after subarachnoid hemorrhage. Two aneurysms were retreated (8% of all). There was 1 fatal procedure-related complication. No early aneurysm re-bleedings were noted. CONCLUSIONS: For anatomically suitable ruptured IAs, WEB device treatment seems to be safe and results in acceptable occlusion rates. Still, larger studies with long-term results are needed before recommendations can be made.