Browsing by Subject "OLDER"

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  • Buettner, Ralf; Le Xuan Truong Nguyen; Kumar, Bijender; Morales, Corey; Liu, Chao; Chen, Lisa S.; Pemovska, Tea; Synold, Timothy W.; Palmer, Joycelynne; Thompson, Ryan; Li, Ling; Dinh Hoa Hoang; Zhang, Bin; Ghoda, Lucy; Kowolik, Claudia; Kontro, Mika; Leitch, Calum; Wennerberg, Krister; Yu, Xiaochun; Chen, Ching-Cheng; Horne, David; Gandhi, Varsha; Pullarkat, Vinod; Marcucci, Guido; Rosen, Steven T. (2019)
    Nucleoside analogs represent the backbone of several distinct chemotherapy regimens for acute myeloid leukemia (AML) and combination with tyrosine kinase inhibitors has improved survival of AML patients, including those harboring the poor-risk FLT3-ITD mutation. Although these compounds are effective in killing proliferating blasts, they lack activity against quiescent leukemia stem cells (LSCs), which contributes to initial treatment refractoriness or subsequent disease relapse. The reagent 8-chloro-adenosine (8-Cl-Ado) is a ribose-containing, RNA-directed nucleoside analog that is incorporated into newly transcribed RNA rather than in DNA, causing inhibition of RNA transcription. In this report, we demonstrate antileukemic activities of 8-Cl-Ado in vitro and in vivo and provide mechanistic insight into the mode of action of 8-Cl-Ado in AML. 8-Cl-Ado markedly induced apoptosis in LSC, with negligible effects on normal stem cells. 8-Cl-Ado was particularly effective against AML cell lines and primary AML blast cells harboring the FLT3-ITD mutation. FLT3-ITD is associated with high expression of miR-155. Furthermore, we demonstrate that 8-Cl-Ado inhibits miR-155 expression levels accompanied by induction of DNA-damage and suppression of cell proliferation, through regulation of miR-155/ErbB3 binding protein 1(Ebp1)/p53/PCNA signaling. Finally, we determined that combined treatment of NSG mice engrafted with FLT3-ITD (+) MV4-11 AML cells with 8-Cl-Ado and the FLT3 inhibitor AC220 (quizartinib) synergistically enhanced survival, compared with that of mice treated with the individual drugs, suggesting a potentially effective approach for FLT3-ITD AML patients.
  • Seppala, Jussi; Koponen, Hannu; Kautiainen, Hannu; Eriksson, Johan G.; Kampman, Olli; Leiviska, Jaana; Mannisto, Satu; Mantyselka, Pekka; Oksa, Heikki; Ovaskainen, Yrj; Viikki, Merja; Vanhala, Mauno; Seppala, Jussi (2013)
  • Sillanpää, Elina; Laakkonen, Eija K.; Vaara, Elina; Rantanen, Taina; Kovanen, Vuokko; Sipilä, Sarianna; Kaprio, Jaakko; Ollikainen, Miina (2018)
    Background: Biomarkers of biological aging - DNA methylation age (DNAm age) and leukocyte telomere length (LTL)-correlate strongly with chronological age across the life course. It is, however, unclear how these measures of cellular wear and tear are associated with muscle strength and functional capacity, which are known to decline with older age and are associated with mortality. We investigated if DNAm age and LTL were associated with body composition and physical functioning by examining 48 monozygotic twin sisters. Methods: White blood cell DNAm age (predicted years) was calculated from Illumina 450 k BeadChip methylation data using an online calculator. DNAm age acceleration was defined from the residuals derived from a linear regression model of DNAm age on chronological age. LTL was measured by qPCR. Total body percentage of fat and lean mass were estimated using bioimpedance. Physical functioning was measured by grip strength, knee extension strength and by 10 m maximal walking speed test. Results: In all participants, DNAm age (58.4 +/- 6.6) was lower than chronological age (61.3 +/- 5.9 years). Pairwise correlations of monozygotic co-twins were high for DNAm age (0.88, 95% CI 0.79, 0.97), age acceleration (0.68, 95% CI 0.30, 0.85) and LTL (0.77, 95% CI 0.60, 0.94). Increased age acceleration i.e. faster epigenetic aging compared to chronological age was associated with lower grip strength (beta = -5.3 SE 1.9 p = 0.011), but not with other measures of physical functioning or body composition. LTL was not associated with body composition or physical functioning. Conclusions: To conclude, accelerated DNAm age is associated with lower grip strength, a biomarker known to be associated with physiological aging, and which predicts decline in physical functioning and mortality. Further studies may clarify whether epigenetic aging explains the decline in muscle strength with aging or whether DNAm age just illustrates the progress of aging.
  • Pasanen, S.; Halonen, J.I.; Gonzalez-Inca, C.; Pentti, J.; Vahtera, J.; Kestens, Y.; Thierry, B.; Brondeel, R.; Leskinen, T.; Stenholm, S. (2022)
    This study examined the changes in accelerometer-measured physical activity by GPS-measured contexts among Finnish retirees (n = 45 (537 measurement days)) participating in a physical activity intervention. We also assessed whether residential greenness, measured with Normalized Difference Vegetation Index, moderated the changes. Moderate-to-vigorous physical activity (MVPA) increased at home by 7 min/day, (P < 0.001) and during active travel by 5 min/day (P = 0.03). The participants with the highest vs. lowest greenness had 25 min/ day greater increase in MVPA over the follow-up (P for Time*Greenness interaction = 0.04). In conclusion, retirees participating in the intervention increased their MVPA both at home and in active travel, and more so if they lived in a greener area.
  • European Soc Blood Marrow Transpla; HOVON-SAKK (2018)
    Background. Disease recurrence remains the major cause of death in adults with acute myeloid leukaemia (AML) treated using either intensive chemotherapy (IC) or allogenic stem cell transplantation (allo-SCT). Aims. The timely delivery of maintenance drug or cellular therapies represent emerging strategies with the potential to reduce relapse after both treatment modalities, but whilst the determinants of overall relapse risk have been extensively characterized the factors determining the timing of disease recurrence have not been characterized. Materials and Methods. We have therefore examined, using a series of sequential landmark analyses, relapse kinetics in a cohort of 2028 patients who received an allo-SCT for AML in CR1 and separately 570 patients treated with IC alone. Results. In the first 3 months after allo-SCT, the factors associated with an increased risk of relapse included the presence of the FLT3-ITD (P <0.001), patient age (P = 0.012), time interval from CR1 to transplant (P <0.001) and donor type (P = 0.03). Relapse from 3 to 6 months was associated with a higher white cell count at diagnosis (P = 0.001), adverse-risk cytogenetics (P <0.001), presence of FLT3-ITD mutation (P <0.001) and time interval to achieve first complete remission (P = 0.013). Later relapse was associated with adverse cytogenetics, mutated NPM1, absence of chronic graft-versus-host disease (GVHD) and the use of in vivo T-cell depletion. In patients treated with IC alone, the factors associated with relapse in the first 3 months were adverse-risk cytogenetics (P <0.001) and FLT3-ITD status (P = 0.001). The factors predicting later relapse were the time interval from diagnosis to CR1 (P = 0.22) and time interval from CR1 to IC (P = 0.012). Discussion and Conclusion. Taken together, these data provide novel insights into the biology of disease recurrence after both allo-SCT and IC and have the potential to inform the design of novel maintenance strategies in both clinical settings.
  • Auraen, Henrik; Durheim, Michael Thomas; Dellgren, Göran; Hammainen, Pekka; Larsson, Hillevi; Geiran, Odd; Schultz, Hans Henrik Lawaetz; Leuckfeld, Inga; Iversen, Martin; Fiane, Arnt; Holm, Are Martin (2019)
    Background. Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors 55 years or older stratified by recipient diagnosis and compares outcomes with transplantations from younger donors. Methods. All BLTx recipients (excluding retransplantation) at 5 Scandiatransplant centers between 2000 and 2013 were included (n = 913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and "other." Intensive care unit (ICU) length of stay (LOS) and survival were assessed. Results. Overall, there was no difference in survival among patients transplanted from donors 55 years or older compared with younger donors. However, in CF recipients, donor age 55 years or older was associated with inferior survival (P = 0.014), and this remained significant in a multivariate model (hazard ratio, 5.0; 95% confidence interval, 1.8-14.1; P = 0.002). There was no significant effect of donor age on survival in recipients with COPD, ILD, or in the "other" group in multivariate models. Utilization of older donors was associated with increased ICU LOS for recipients with CF and ILD, but not in the COPD or "other" group. Conclusions. The BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors 55 years or older. Recipients with COPD, ILD, or in the "other" group did not have inferior survival in multivariate models.
  • MRIGENIE GISCOME Invest Int Stroke; Hong, Sungmin; Giese, Anne-Katrin; Schirmer, Markus D.; Strbian, Daniel; Tatlisumak, Turgut; Wu, Ona (2021)
    Objective: To personalize the prognostication of post-stroke outcome using MRI-detected cerebrovascular pathology, we sought to investigate the association between the excessive white matter hyperintensity (WMH) burden unaccounted for by the traditional stroke risk profile of individual patients and their long-term functional outcomes after a stroke. Methods: We included 890 patients who survived after an acute ischemic stroke from the MRI-Genetics Interface Exploration (MRI-GENIE) study, for whom data on vascular risk factors (VRFs), including age, sex, atrial fibrillation, diabetes mellitus, hypertension, coronary artery disease, smoking, prior stroke history, as well as acute stroke severity, 3- to-6-month modified Rankin Scale score (mRS), WMH, and brain volumes, were available. We defined the unaccounted WMH (uWMH) burden via modeling of expected WMH burden based on the VRF profile of each individual patient. The association of uWMH and mRS score was analyzed by linear regression analysis. The odds ratios of patients who achieved full functional independence (mRS < 2) in between trichotomized uWMH burden groups were calculated by pair-wise comparisons. Results: The expected WMH volume was estimated with respect to known VRFs. The uWMH burden was associated with a long-term functional outcome (beta = 0.104, p < 0.01). Excessive uWMH burden significantly reduced the odds of achieving full functional independence after a stroke compared to the low and average uWMH burden [OR = 0.4, 95% CI: (0.25, 0.63), p < 0.01 and OR = 0.61, 95% CI: (0.42, 0.87), p < 0.01, respectively]. Conclusion: The excessive amount of uWMH burden unaccounted for by the traditional VRF profile was associated with worse post-stroke functional outcomes. Further studies are needed to evaluate a lifetime brain injury reflected in WMH unrelated to the VRF profile of a patient as an important factor for stroke recovery and a plausible indicator of brain health.
  • Narusyte, Jurgita; Ropponen, Annina; Silventoinen, Karri; Alexanderson, Kristina; Kaprio, Jaakko; Samuelsson, Asa; Svedberg, Pia (2011)
  • Kaivola, Karri; Jansson, Lilja; Saarentaus, Elmo; Kiviharju, Anna; Rantalainen, Ville; Eriksson, Johan G.; Strandberg, Timo E.; Polvikoski, Tuomo; Myllykangas, Liisa; Tienari, Pentti J. (2018)
    Biallelic loss-of-function mutations in TYROBP and TREM2 cause a rare disease that resembles early-onset frontotemporal dementia with bone lesions called polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL). Some PLOSL-causing variants in TREM2 have also been associated with Alzheimer's disease when heterozygous. Here, we studied the PLOSLFIN TYROBP deletion that covers 4 of the gene's 5 exons. We genotyped 3220 older Finns (mean age 79, range 58-104) and found 11 deletion carriers (mean age 78, range 60-94). The carrier prevalence was 0.0034 (1 in 293) that matches previous findings in younger cohorts suggesting no significant early mortality. By comparing Mini-Mental State Examination (MMSE) scores and diagnoses of dementia, we did not find any significant differences between TYROBP deletion carriers and noncarriers (all p-values >0.5). Neuropathological analysis of 2 deletion carriers (aged 89 and 94 years) demonstrated only minimal beta amyloid pathology (Consortium to Establish a Registry for Alzheimer's Disease (CERAD) score 0). Collectively these results suggest that heterozygous carriership of the TYROBP deletion is not a major risk factor of cognitive impairment. (C) 2017 Elsevier Inc. All rights reserved.
  • INTERACT2 Investigators; Kaste, Markku; Tatlisumak, Turgut (2017)
    Objective: To clarify associations between intracerebral hemorrhage (ICH) location and clinical outcomes among participants of the main phase Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Methods: Associations between ICH sites and poor outcomes (death [6] or major disability [3-5] of modified Rankin Scale) and European Quality of Life Scale (EQ-5D) utility scores at 90 days were assessed in logistic regression models. Results: Of 2,066 patients included in the analyses, associations were identified between ICH sites and poor outcomes: involvement of posterior limb of internal capsule increased risks of death or major disability (odds ratio [OR] 2.10) and disability (OR 1.81); thalamic involvement increased risks of death or major disability (OR 2.24) and death (OR 1.97). Involvement of the posterior limb of the internal capsule, thalamus, and infratentorial sites were each associated with poor EQ-5D utility score ( Conclusion: Poor clinical outcomes are related to ICH affecting the posterior limb of internal capsule, thalamus, and infratentorial sites. The highest association with death or major disability and poor EQ-5D utility score was seen in ICH encompassing the thalamus and posterior limb of internal capsule.
  • Ganse, Bergita; Ganse, Urs; Dahl, Julian; Degens, Hans (2018)
    Master athletes maintain high physical activity levels and have better health than age-matched non-athletes. World records show accelerated declines after age 70 in swimming, long-distance running and sprint performance. However, less is known about age-related performance declines in the general master athlete population and whether decline rates differ between disciplines and genders. We interrogated a dataset including all track and field athletes of North Rhine from 2001 to 2014 to assess age-related changes in performance. 27,088 results of athletes between 11 and 89 years of age in 12 disciplines were analysed by regression statistics. The analyses showed an accelerated decline beyond the age of 70 in sprint, middle- and long-distance running, while in throwing and jumping disciplines the performance continued a linear decline. Patterns of decline differed between men and women. The steepest declines were observed in javelin throw and 400m (women), and in pole vault and 800m (men). In conclusion, performance declines in ageing depend more on the specific profile of requirements than previously assumed.
  • Wickberg, Asa; Liljegren, Goran; Killander, Fredrika; Lindman, Henrik; Bjöhle, Judith; Carlberg, Michael; Blomqvist, Carl; Ahlgren, Johan; Villman, Kenneth (2018)
    Purpose: The aim of this study was to verify if radiotherapy (RT) safely can be omitted in older women treated for estrogen-receptor positive early breast cancer with breast-conserving surgery (BCS) and endocrine therapy (ET). Patients and Methods: Eligibility criteria were: consecutive patients with age >= 65 years, BCS + sentinel node biopsy, clear margins, unifocal T1N0M0 breast cancer tumor, Elston-Ellis histological grade 1 or 2 and estrogen receptor-positive tumor. After informed consent, adjuvant ET for 5 years was prescribed. Primary endpoint was ipsilateral breast tumor recurrence (IBTR). Secondary endpoints were contralateral breast cancer and overall survival. Results: Between 2006 and 2012, 603 women were included from 14 Swedish centers. Median age was 71.1 years (range 65-90). After a median follow-up of 68 months 16 IBTR (cumulative incidence at five-year follow-up; 1.2%, 95% CI, 0.6% to 2.5%), 6 regional recurrences (one combined with IBTR), 2 distant recurrences (both without IBTR or regional recurrence) and 13 contralateral breast cancers were observed. There were 48 deaths. One death (2.1%) was due to breast cancer and 13 (27.1%) were due to other cancers (2 endometrial cancers). Five-year overall survival was 93.0% (95% CI, 90.5% to 94.9%). Conclusion: BCS and ET without RT seem to be a safe treatment option in women >= 65 years with early breast cancer and favorable histopathology. The risk of IBTR is comparable to the risk of contralateral breast cancer. Moreover, concurrent morbidity dominates over breast cancer as leading cause of death in this cohort with low-risk breast tumors. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
  • Mazumder, Atiqul Haq; Barnett, Jennifer; Isometsä, Erkki Tapio; Lindberg, Nina; Torniainen-Holm, Minna; Lähteenvuo, Markku; Lahdensuo, Kaisla; Kerkelä, Martta; Ahola-Olli, Ari; Hietala, Jarmo; Kampman, Olli; Kieseppä, Tuula; Jukuri, Tuomas; Häkkinen, Katja; Cederlöf, Erik; Haaki, Willehard; Kajanne, Risto; Wegelius, Asko; Männynsalo, Teemu; Niemi-Pynttäri, Jussi; Suokas, Kimmo; Lönnqvist, Jouko; Tiihonen, Jari; Paunio, Tiina; Vainio, Seppo Juhani; Palotie, Aarno; Niemelä, Solja; Suvisaari, Jaana; Veijola, Juha (2021)
    The purpose of this study was to explore the association of cognition with hazardous drinking Polygenic Scores (PGS) in 2649 schizophrenia, 558 schizoaffective disorder, and 1125 bipolar disorder patients in Finland. Hazardous drinking PGS was computed using the LDPred program. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: the 5-choice serial reaction time task, or Reaction Time (RT) test, and the Paired Associative Learning (PAL) test. The association between hazardous drinking PGS and cognition was measured using four cognition variables. Log-linear regression was used in Reaction Time (RT) assessment, and logistic regression was used in PAL assessment. All analyses were conducted separately for males and females. After adjustment of age, age of onset, education, household pattern, and depressive symptoms, hazardous drinking PGS was not associated with reaction time or visual memory in male or female patients with schizophrenia, schizoaffective, and bipolar disorder.
  • Pirkkalainen, Juha-Matti; Jääskeläinen, Anna-Stina; Halonen, Päivi (2022)
    Background Incidence of glioblastoma (GBM) increases with age and the prognosis is worse among the elderly. This was shown in a Finnish population-based register study evaluating GBM patients diagnosed between 2000 and 2013. The median overall survival (OS) was poor among the elderly (4.5 months), despite the OS increase during that period. We conducted a study to see if the OS has increased in our hospital area with current therapies. Methods One hundred and ninety-eight patients over 65 years at the time of diagnosis, with malignant glioma diagnosed January 1, 2014 to December 31, 2018 at the Helsinki Comprehensive Cancer Center were included. In addition to grade IV gliomas, grade III gliomas with nonmutated R132HIDH1 and only radiographically diagnosed gliomas were included. The demographics and treatment data were collected with performance status evaluated retrospectively. The Kaplan-Meier method and the multivariate Cox proportional hazard model were used for the statistical analysis. Results One hundred and seventy-seven patients with grade IV glioma, 6 with grade III glioma with nonmutated IDH1 and 15 radiologically diagnosed patients were included. One hundred and sixteen patients received chemoradiation, 59 only radiotherapy, 3 only temozolomide, and 27 patients did not receive oncological treatments. In the age group 65-70 years the OS was 9.95 months, 70-75 years 10.12 months, and >75 years 5.54 months. Lower WHO status correlated with longer survival independently of the age of the patient. Also methylated O(6)-methylguanine-DNA-methyltransferase and tumor resection correlated with better survival. Conclusions The performance status of elderly patients is the most important prognostic factor. When choosing treatment protocols for patients in this age group, the performance status not calendar age should be considered.
  • Mäkinen, Anna; Nawaz, Ali; Mäkitie, Antti; Meurman, Jukka H. (2018)
    Purpose: This study examined the prevalence of Candida species in the saliva of oral squamous cell carcinoma patients and its effect on the mortality rate. Materials and Methods: One hundred patients with oral cavity squamous cell carcinoma undergoing protocol treatment at Helsinki University Hospital were recruited into the study from March 2011 through 2014. For comparison, 75 age-matched controls with no current or previously treated oral cancer were recruited. Paraffin-stimulated whole saliva samples were collected and cultivated on CHROMagar Candida medium (CHROMagar, Paris, France) to establish possible Candida growth. The API ID 32C yeast identification kit (bioMerieux, Lyon, France) and Bichro-Dubli Fumouze latex agglutination test (Fumouze Diagnostics, Levallois-Perret, France) were used for further identification of different Candida species. Patients' medical records were studied for information on their health habits and general health status, as well as tumor-related data. The patients' status regarding being alive and cancer free was checked at a follow-up point in December 2017. Descriptive statistics and cross tabulation were carried out, and the P value was set at .05. Results: Candida species were detected in 74% of the oral cancer patients' samples, with C. albicans being the most common species (84%). Other species identified were C. dubliniensis (8%), C. tropicalis (4%), C. glabrata (3%), C. parapsilosis (3%), C. sake (3%), C. krusei (1%), and C. guilliermondii (1%). After the follow-up period, 63% of the patients were alive and 86% of them were cancer free. Harboring Candida species in the saliva was not associated with any increase in the mortality rate. Conclusions: C. albicans was common in the oral cavity of the oral squamous cell carcinoma patients. However, in this patient population, we did not observe a statistically significant effect of the yeast on the mortality rate. (C) 2018 American Association of Oral and Maxillofacial Surgeons
  • Ahmadi-Abhari, Sara; Guzman-Castillo, Maria; Bandosz, Piotr; Shipley, Martin J.; Muniz-Terrera, Graciela; Singh-Manoux, Archana; Kivimaki, Mika; Steptoe, Andrew; Capewell, Simon; O'Flaherty, Martin; Brunner, Eric J. (2017)
    OBJECTIVE To forecast dementia prevalence with a dynamic modelling approach that integrates calendar trends in dementia incidence with those for mortality and cardiovascular disease. DESIGN Modelling study. SETTING General adult population of England and Wales. PARTICIPANTS The English Longitudinal Study of Ageing (ELSA) is a representative panel study with six waves of data across 2002-13. Men and women aged 50 or more years, selected randomly, and their cohabiting partners were recruited to the first wave of ELSA (2002-03). 11392 adults participated (response rate 67%). To maintain representativeness, refreshment participants were recruited to the study at subsequent waves. The total analytical sample constituted 17 906 people. Constant objective criteria based on cognitive and functional impairment were used to ascertain dementia cases at each wave. MAIN OUTCOME MEASURES To estimate calendar trends in dementia incidence, correcting for bias due to loss to follow-up of study participants, a joint model of longitudinal and time-to-event data was fitted to ELSA data. To forecast future dementia prevalence, the probabilistic Markov model IMPACT-BAM (IMPACT-Better Ageing Model) was developed. IMPACT-BAM models transitions of the population aged 35 or more years through states of cardiovascular disease, cognitive and functional impairment, and dementia, to death. It enables prediction of dementia prevalence while accounting for the growing pool of susceptible people as a result of increased life expectancy and the competing effects due to changes in mortality, and incidence of cardiovascular disease. RESULTS In ELSA, dementia incidence was estimated at 14.3 per 1000 person years in men and 17.0/1000 person years in women aged 50 or more in 2010. Dementia incidence declined at a relative rate of 2.7% (95% confidence interval 2.4% to 2.9%) for each year during 2002-13. Using IMPACT-BAM, we estimated there were approximately 767 000 (95% uncertainty interval 735 000 to 797 000) people with dementia in England and Wales in 2016. Despite the decrease in incidence and age specific prevalence, the number of people with dementia is projected to increase to 872 000, 1 092 000, and 1 205 000 in 2020, 2030, and 2040, respectively. A sensitivity analysis without the incidence decline gave a much larger projected growth, of more than 1.9 million people with dementia in 2040. CONCLUSIONS Age specific dementia incidence is declining. The number of people with dementia in England and Wales is likely to increase by 57% from 2016 to 2040. This increase is mainly driven by improved life expectancy.
  • Raudasoja, L.; Vastamäki, H.; Raatikainen, T. (2018)
    Background and Aims: Whether or not radiological results correlate with functional outcome after operative treatment of distal radius fractures still remains controversial. We carried out a retrospective study to analyse the long-term (6.5year) outcome of radius fractures treated by means of surgery in our hospital. The aim of the study was to explore whether step-off on radius joint surface, shortening of the radius versus ulnar height and dorsal or volar tilt of the radius correlate with long-term Patient-Rated Wrist Evaluation or Quick Disability of the Arm, Shoulder and Hand scores among 100 consecutive patients after surgical treatment. Materials and Methods: Of these, 60 patients (63 wrists) participated. They were examined radiologically, clinically and by means of a questionnaire. Results: Shortening of the radius correlated significantly with both Patient-Rated Wrist Evaluation and Quick Disability of the Arm, Shoulder and Hand scores. Step-off on the radius joint surface correlated significantly with worse PRWE scores, with no difference in Quick Disability of the Arm, Shoulder and Hand evaluation. Dorsal or volar tilt showed no statistical correlation (though it was mild in this group). The age of the patients (below 60years vs 60years or above) did not affect the PRWE or Quick Disability of the Arm, Shoulder and Hand results. Conclusion: Our results indicate that when it comes to conserving the radial height and congruence of the joint surface, the more precise the reduction of the fracture achieved by surgical means, the better the functional outcome.
  • Wedenoja, Juho; Kalsi, Juhani; Salenius, Salla; Parkkari, Kalle; Kaarniranta, Kai; Tervo, Timo (2021)
    Purpose To evaluate the significance of vision-related problems in fatal motor vehicle accidents (FMVAs) based on a systematic investigation process by multidisciplinary road accident investigation teams (RAITs). Methods Retrospective registry-based study of all FMVAs during the years 2012-2016 in Finland in which driver causing the accident had a valid Finnish driving licence and the operated motor vehicle required having a driving licence. Results There were a total of 968 FMVAs. In only 1.3% of all the accidents, a vision-related problem was considered to have contributed to the FMVA, while an observational failure of 23.6% was the leading cause of all the FMVAs. Conclusions Eye-originating vision problems are rarely a causative risk for FMVAs in Finland. Making current visual standards more stringent would unlikely to be effective in FMVA prevention.
  • Lont, Tonis; Nieminen, Jyrki; Reito, Aleksi; Pakarinen, Toni-Karri; Pajamäki, Ilari; Eskelinen, Antti; Laitinen, Minna K. (2019)
    Background and purpose Low-energy acetabulum fractures are uncommon, and mostly occur in elderly patients. Determining the optimal operative treatment for such fractures is challenging. Here we investigated whether acutely performed total hip arthroplasty plus posterior column plating (THA) reduced complications and reoperations compared with open reduction and internal fixation (ORIF) in elderly patients with acetabular fractures.Patients and methods We retrospectively reviewed the records of 59 patients, > 55 years of age, with complex acetabular fractures, caused by low-energy trauma, treated between January 2008 and September 2017. Of these patients, 34 underwent acute THA, and 25 ORIF alone. Patient and implant survival were compared between groups using Kaplan-Meier survival analysis and Cox multiple regression. Functional outcomes assessed by Oxford Hip Score (OHS) were compared between the THA patients and those 9 ORIF patients who underwent secondary THA due to posttraumatic hip osteoarthritis (OA) during follow-up.Results Overall patient survival was 90% (95% CI 82-98) at 12 months, and 64% (CI 47-81) at 5 years. Of 25 ORIF patients, 9 required secondary THA due to posttraumatic OA. Large fragments on the weight-bearing acetabular dome upon imaging predicted ORIF failure and secondary THA. The acute THA group and secondary THA group had similar 12-month OHS.Interpretation Acute THA including a reinforcement ring resulted in fewer reoperations than ORIF alone in elderly patients with acetabular fractures. These findings support acute THA as first-line treatment for complex acetabular fractures in elderly patients.