Browsing by Subject "Neoplasms"

Sort by: Order: Results:

Now showing items 1-20 of 54
  • 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.
  • Hui, David; Mori, Masanori; Meng, Yee-Choon; Watanabe, Sharon M.; Caraceni, Augusto; Strasser, Florian; Saarto, Tiina; Cherny, Nathan; Glare, Paul; Kaasa, Stein; Bruera, Eduardo (2018)
    Palliative care referral is primarily based on clinician judgment, contributing to highly variable access. Standardized criteria to trigger automatic referral have been proposed, but it remains unclear how best to apply them in practice. We conducted a Delphi study of international experts to identify a consensus for the use of standardized criteria to trigger automatic referral. Sixty international experts stated their level of agreement for 14 statements regarding the use of clinician-based referral and automatic referral over two Delphi rounds. A consensus was defined as an agreement of ae70% a priori. The response rate was 59/60 (98%) for the first round and 56/60 (93%) for the second round. Twenty-six (43%), 19 (32%), and 11 (18%) respondents were from North America, Asia/Australia, and Europe, respectively. The panel reached consensus that outpatient palliative care referral should be based on both automatic referral and clinician-based referral (agreement = 86%). Only 18% felt that referral should be clinician-based alone, and only 7% agreed that referral should be based on automatic referral only. There was consensus that automatic referral criteria may increase the number of referrals (agreement = 98%), facilitate earlier palliative care access, and help administrators to set benchmarks for quality improvement (agreement = 86%). Our panelists favored the combination of automatic referral to augment clinician-based referral. This integrated referral framework may inform policy and program development.
  • Kansikas, Minttu; Nyström, Minna; Peltomäki, Päivi (2017)
  • Isoherranen, Kirsi; Salmi, Teea; Tasanen, Kaisa (2020)
    Epätyypilliset haavat ovat merkittävä haavatyyppi, johon haavaklinikoiden aineistoissa jopa 10-20 % kroonisista haavoista lukeutuu. Epätyypilliseen haavaan viittaavia tunnusmerkkejä ovat haavan epätyypillinen ulkonäkö tai sijainti, huomattava kipu haavan kokoon nähden, poikkeava hypergranulaatio tai pigmentaatio ja huono hoitovaste. Kliinisen kuvan ja histologisen löydöksen lisäksi diagnosoinnissa tulee huomioida epätyypillisten haavojen liitännäissairaudet. Hoito määräytyy diagnoosin mukaan. Monen epätyypillisen haavaan diagnoosi viivästyy, mikä heikentää potilaan ja haavan paranemisennustetta.
  • Koskenvuo, Laura; Pöyhönen, Minna; Lepistö, Anna (2020)
  • Seppälä, Toni; Meretoja, Tuomo (2019)
  • Juteau, Susanna; Koljonen, Virve; Kytölä, Soili (2019)
  • Vesanen, Kari (Helsingfors universitet, 2016)
    Studies have shown that there is a familial risk in developing lymphomas. This thesis aimed to find candidate predisposing mutations for inherited non-Hodgkin lymphoma susceptibility in a Finnish pedigree. Exome sequences were available from two individuals in the pedigree, and common mutations were sought from exomes using bioinformatical tools. The validity and uniqueness of these common mutations were verified, and variation segregation was assessed by sequencing variation areas from all lymphoma patients in the pedigree. After filtering, 13 common variations were found, but due to variation's presence also in healthy control samples or the lack of segregation in the kindred, no candidate variation explaining non-Hodgkin lymphoma clustering in the pedigree was found. However, this study proved a group of mutations that probably do not need further studies as candidate variations for inheritable non-Hodgkin lymphoma. This study also provided rough comparison data for two different DNA sequence analysis programs.
  • Global Burden of Disease Cancer Collaboration; Fitzmaurice, C.; Doku, D.T.; Hadkhale, K.; Meretoja, T.J.; Neupane, S. (2019)
    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.
  • Sutinen, Jussi; Leppä, Sirpa; Tarkkanen, Maija (2016)
  • Heikinheimo, Oskari; Apter, Dan (2018)
  • Utriainen, Meri; Rämet, Mika (2016)
  • Kellokumpu-Lehtinen, Pirkko-Liisa; Bono, Petri (2016)
  • Havunen, Riikka; Heiniö, Camilla; Hemminki, Akseli (2019)
  • Kaprio, Jaakko; Pukkala, Eero (2016)
  • Barner-Rasmussen, Nina (2019)
  • Munne, Pauliina M.; Savelius, Mariel; Juopperi, Iiris; Räty, Iiris; Klefström, Juha (2018)