Browsing by Subject "PREDICTIVE-VALUE"

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  • Joensuu, Eveliina; Munck, Petriina; Setänen, Sirkku; Lipsanen, Jari; Huhtala, Mira; Lapinleimu, Helena; Stolt, Suvi K. J. (2021)
    Preterm children (born
  • Almangush, Alhadi; Bello, Ibrahim O.; Keski-Santti, Harri; Mäkinen, Laura; Kauppila, Joonas H.; Pukkila, Matti; Hagstrom, Jaana; Laranne, Jussi; Tommola, Satu; Nieminen, Outi; Soini, Ylermi; Kosma, Veli-Matti; Koivunen, Petri; Grenman, Reidar; Leivo, Ilmo; Salo, Tuula (2014)
  • Stolt, Suvi; Lind, Annika; Matomäki, Jaakko; Haataja, Leena; Lapinleimu, Helena; Lehtonen, Liisa (2016)
  • Sánez Tähtisalo, Heini; Hiltunen, Timo P.; Kenttä, Tuomas; Junttila, Juhani; Oikarinen, Lasse; Virolainen, Juha; Kontula, Kimmo K.; Porthan, Kimmo (2020)
    Background T-wave area dispersion (TW-Ad) is a novel electrocardiographic (ECG) repolarization marker associated with sudden cardiac death. However, limited data is available on the clinical correlates of TW-Ad. In addition, there are no previous studies on cardiovascular drug effects on TW-Ad. In this study, we examined the relation between TW-Ad and left ventricular mass. We also studied the effects of four commonly used antihypertensive drugs on TW-Ad. Methods A total of 242 moderately hypertensive males (age, 51±6 years; office systolic/diastolic blood pressure during placebo, 153±14/100±8 mmHg), participating in the GENRES study, were included. Left ventricular mass index was determined by transthoracic echocardiography. Antihypertensive four-week monotherapies (a diuretic, a beta-blocker, a calcium channel blocker, and an angiotensin receptor antagonist) were administered in a randomized rotational fashion. Four-week placebo periods preceded all monotherapies. The average value of measurements (over 1700 ECGs in total) from all available placebo periods served as a reference to which measurements during each drug period were compared. Results Lower, i.e. risk-associated TW-Ad values correlated with a higher left ventricular mass index (r = −0.14, p = 0.03). Bisoprolol, a beta-blocker, elicited a positive change in TW-Ad (p = 1.9×10−5), but the three other drugs had no significant effect on TW-Ad. Conclusions Our results show that TW-Ad is correlated with left ventricular mass and can be modified favorably by the use of bisoprolol, although demonstration of any effects on clinical endpoints requires long-term prospective studies. Altogether, our results suggest that TW-Ad is an ECG repolarization measure of left ventricular arrhythmogenic substrate.
  • Thelin, Eric Peter; Nelson, David W.; Vehvilainen, Juho; Nystrom, Harriet; Kivisaari, Riku; Siironen, Jari; Svensson, Mikael; Skrifvars, Markus B.; Bellander, Bo-Michael; Raj, Rahul (2017)
    Background Traumatic brain injury (TBI) is a major contributor to morbidity and mortality. Computerized tomography (CT) scanning of the brain is essential for diagnostic screening of intracranial injuries in need of neurosurgical intervention, but may also provide information concerning patient prognosis and enable baseline risk stratification in clinical trials. Novel CT scoring systems have been developed to improve current prognostic models, including the Stockholm and Helsinki CT scores, but so far have not been extensively validated. The primary aim of this study was to evaluate the Stockholm and Helsinki CT scores for predicting functional outcome, in comparison with the Rotterdam CT score and Marshall CT classification. The secondary aims were to assess which individual components of the CT scores best predict outcome and what additional prognostic value the CT scoring systems contribute to a clinical prognostic model. Methods and findings TBI patients requiring neuro-intensive care and not included in the initial creation of the Stockholm and Helsinki CT scoring systems were retrospectively included from prospectively collected data at the Karolinska University Hospital (n = 720 from 1 January 2005 to 31 December 2014) and Helsinki University Hospital (n = 395 from 1 January 2013 to 31 December 2014), totaling 1,115 patients. The Marshall CT classification and the Rotterdam, Stockholm, and Helsinki CT scores were assessed using the admission CT scans. Known outcome predictors at admission were acquired (age, pupil responsiveness, admission Glasgow Coma Scale, glucose level, and hemoglobin level) and used in univariate, and multivariable, regression models to predict long-term functional outcome (dichotomizations of the Glasgow Outcome Scale [GOS]). In total, 478 patients (43%) had an unfavorable outcome (GOS 1-3). In the combined cohort, overall prognostic performance was more accurate for the Stockholm CT score (Nagelkerke's pseudo-R-2 range 0.24-0.28) and the Helsinki CT score (0.18-0.22) than for the Rotterdam CT score (0.13-0.15) and Marshall CT classification (0.03-0.05). Moreover, the Stockholm and Helsinki CT scores added the most independent prognostic value in the presence of other known clinical outcome predictors in TBI (6% and 4%, respectively). The aggregate traumatic subarachnoid hemorrhage (tSAH) component of the Stockholm CT score was the strongest predictor of unfavorable outcome. The main limitations were the retrospective nature of the study, missing patient information, and the varying follow-up time between the centers. Conclusions The Stockholm and Helsinki CT scores provide more information on the damage sustained, and give a more accurate outcome prediction, than earlier classification systems. The strong independent predictive value of tSAH may reflect an underrated component of TBI pathophysiology. A change to these newer CT scoring systems may be warranted.
  • Kleemola, Katri; Hyytinen, Heidi (2019)
    As Finnish university admissions are reformed, more information is needed on the relationship between performance in prior education and later academic achievement. Transition to university is a critical period, and low performance in prior education is associated with challenges in later study. In the present study, law students' (n = 426) performance in the National Matriculation Examination was investigated in relation to later academic achievement at university. Quantitative methods were used. Findings showed that prior performance was not only associated with study success but also with study progress. The results also showed that law students who had grades in the advanced mathematics course were faster and more successful at university. This work contributes to the existing knowledge of university admissions ahead of the Finnish reform by providing new insights into prior performance and how it is related to academic achievement at university.
  • Antinmaa, Jaana; Lapinleimu, Helena; Salonen, Jaakko; Stolt, Suvi; Kaljonen, Anne; Jääskeläinen, Satu (2020)
    Aim: To study whether auditory function measured with brainstem auditory evoked potential and brainstem audiometry recordings in the neonatal period associates with language development 1 year later in preterm infants.Methods: This retrospective study included 155 preterm infants (birthweight ≤1500 g and/or birth ≤32 gestational weeks) born between 2007 and 2012 at the Turku University Hospital. Auditory function was recorded in neonatal period. Information of language development was gathered at the mean corrected age of 1 year by using the Finnish version of the MacArthur Communicative Development Inventory.Results: Slower auditory processing (longer interpeak interval, IPI I-V) in the right ear in the neonatal brainstem auditory evoked potential recording associated with smaller receptive lexicon size at 1 year (P = .043). Infants with longer IPI I-V were more likely to have a deviant (≤17 words) receptive lexicon size (P = .033). The ab-sence of a contralateral response with right ear stimulation increased the risk for deviant lexicon size (P = .049).Conclusion: The results suggest that impaired auditory function in the neonatal pe-riod in preterm infants may lead to a poorer receptive language outcome 1 year later. Auditory pathway function assessment provides information for the identification of preterm children at risk for weak language development.
  • Schmidt, Marcus; Weyer-Elberich, Veronika; Hengstler, Jan G.; Heimes, Anne-Sophie; Almstedt, Katrin; Gerhold-Ay, Aslihan; Lebrecht, Antje; Battista, Marco J.; Hasenburg, Annette; Sahin, Ugur; Kalogeras, Konstantine T.; Kellokumpu-Lehtinen, Pirkko-Liisa; Fountzilas, George; Wirtz, Ralph M.; Joensuu, Heikki (2018)
    Background: The clinical importance of tumor-infiltrating cluster of differentiation 4 (CD4) T cells is incompletely understood in early breast cancer. We investigated the clinical significance of CD4, forkhead box P3 (FOXP3), and B cell attracting chemokine leukocyte chemoattractant-ligand (C-X-C motif) 13 (CXCL13) in early breast cancer. Methods: The study is based on the patient population of the randomized FinHer trial, where 1010 patients with early breast cancer were randomly allocated to adjuvant chemotherapy containing either docetaxel or vinorelbine, and human epidermal growth factor receptor 2 (HER2)-positive patients were also allocated to trastuzumab or no trastuzumab. Breast cancer CD4, FOXP3, and CXCL13 contents were evaluated using quantitative real-time polymerase chain reaction (qRT-PCR), and their influence on distant disease-free survival (DDFS) was examined using univariable and multivariable Cox regression and Kaplan-Meier estimates in the entire cohort and in selected molecular subgroups. Interactions between variables were analyzed using Cox regression. The triple-negative breast cancer (TNBC) subset of the HE10/97 randomized trial was used for confirmation. Results: High CXCL13 was associated with favorable DDFS in univariable analysis, and independently in multivariable analysis (HR 0.44, 95% CI 0.29-0.67, P Conclusions: The results provide a high level of evidence that humoral immunity influences the survival outcomes of patients with early breast cancer, in particular of those with TNBC.
  • Bally, Michele; Dendukuri, Nandini; Rich, Benjamin; Nadeau, Lyne; Helin-Salmivaara, Arja; Garbe, Edeltraut; Brophy, James M. (2017)
    OBJECTIVE To characterise the determinants, time course, and risks of acute myocardial infarction associated with use of oral non-steroidal anti-inflammatory drugs (NSAIDs). DESIGN Systematic review followed by a one stage bayesian individual patient data meta-analysis. DATA SOURCES Studies from Canadian and European healthcare databases. REVIEW METHODS Eligible studies were sourced from computerised drug prescription or medical databases, conducted in the general or an elderly population, documented acute myocardial infarction as specific outcome, studied selective cyclo-oxygenase-2 inhibitors (including rofecoxib) and traditional NSAIDs, compared risk of acute myocardial infarction in NSAID users with non-users, allowed for time dependent analyses, and minimised effects of confounding and misclassification bias. EXPOSURE AND OUTCOMES Drug exposure was modelled as an indicator variable incorporating the specific NSAID, its recency, duration of use, and dose. The outcome measures were the summary adjusted odds ratios of first acute myocardial infarction after study entry for each category of NSAID use at index date (date of acute myocardial infarction for cases, matched date for controls) versus non-use in the preceding year and the posterior probability of acute myocardial infarction. RESULTS A cohort of 446 763 individuals including 61 460 with acute myocardial infarction was acquired. Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations. CONCLUSIONS All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses.
  • Vehkavuori, Suvi-Maria; Stolt, Suvi (2018)
    Early screening of children at risk for language difficulties is challenging. This study aimed to analyze the specificity and sensitivity of two screening methods at 2;0 years of age. In addition, the matter of what kind of information the use of word combinations and parental concern provide for screening was analyzed. The subjects were 78 children. The screening methods used were the Finnish versions of the short-form version of the MacArthur Communicative Development Inventories (FinCDI-SF) and the Communication and Symbolic Behavior Scales, Developmental Profile, Infant-Toddler Checklist (FinCSBS). The specificity and sensitivity of the screening methods were analyzed based on result of the Reynell Developmental Language Scales III. Both screening methods had high specificity but only moderate sensitivity. The use of word combinations and parental concern provided relevant information on early language development. The results imply that it is important to take into consideration receptive language development in early screening.