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PubMed | Central Hospital of Seinajoki, University of Turku and Finnish National Institute for Health and Welfare
Type: | Journal: Acta obstetricia et gynecologica Scandinavica | Year: 2016

Sleep disturbances are common during pregnancy, yet underdiagnosed and under-investigated. We evaluated sleep quality during pregnancy and assessed associated factors, especially depressive and anxiety symptoms.A total of 78 healthy pregnant women from the FinnBrain Birth Cohort Study were studied twice prospectively during pregnancy (in mid-pregnancy and late pregnancy). Sleep quality was evaluated by the Basic Nordic Sleep Questionnaire, depressive symptoms by the Edinburgh Postnatal Depression Scale, and anxiety symptoms by the State-Trait Anxiety Inventory.Poor general sleep quality, difficulty falling asleep, the number of nocturnal awakenings per night, and too-early morning awakenings increased in late pregnancy compared with mid-pregnancy (all p-values < 0.020). The total insomnia score (p < 0.001) and sleep latency increased (p = 0.005), but sleep duration and preferred sleep duration did not change. Women tended to snore more often in late pregnancy, but apneas remained rare. Almost one-fourth of the women reported both morning and daytime sleepiness, but the frequencies did not increase during the follow up. In late pregnancy, depressive and anxiety symptoms were cross-sectionally related to sleep disturbances, but depressive or anxiety symptoms in mid-pregnancy were not associated with sleep disturbances in late pregnancy.We found deterioration in sleep quality across pregnancy. However, no increase in negative daytime consequences was found, presumably indicating a compensatory capacity against sleep impairment. Additionally, depressive and anxiety symptoms and sleep disturbances were only cross-sectionally associated. Our study calls for further research on the factors that influence sleep disturbances during pregnancy.


Mustila T.,Central Hospital of Seinajoki | Raitanen J.,UKK Institute for Health Promotion | Raitanen J.,University of Tampere | Keskinen P.,University of Tampere | And 4 more authors.
BMJ Open | Year: 2012

Objective: To investigate the effect of intensified lifestyle counselling targeting infants' mothers on offspring weight development during the first 4 years of life. Design and setting: Follow-up of a clusterrandomised controlled trial in primary care child health clinics during 2004-2006 in Finland. Participants received a follow-up survey during 2010 concerning weight and height measurements of their offspring. Number of clusters was six and the response rate to the follow-up 71.9% (N=64/89). Participants: The participants (N=89) were mothers of infants aged 2-10 months. Intervention: The intervention included individual counselling on diet and physical activity when the infant was 2-10 months of age and an option to attend supervised group exercise sessions. Primary and secondary outcome measures: The authors analysed the secondary outcome of the intervention study: the weight development of the offspring. The primary outcome was the proportion of women returning to their prepregnancy weight by 10 months post partum, reported earlier. Results: Multilevel mixed effect non-linear regression models included group, age of the child and interaction between group and age of the child. The increase of BMI z-score between 24 and 48 months was slower among the intervention group offspring (-0.034 to -0.002, p=0.028) as compared with control group. Z-scores for weight-for-length/height did not differ between groups when the period 0-48 months was analysed (p=0.23) but for the period of 24-48 months, between-group differences were significant (p=0.012). Conclusions: Lifestyle counselling targeting mothers during the child's first year may be effective in slowing offspring weight gain until 4 years of age. However, larger studies are needed to confirm the findings which may have the potential in combatting the obesity epidemic.


Pauniaho S.-L.,University of Tampere | Pauniaho S.-L.,Central Hospital of Seinajoki | Heikinheimo O.,University of Helsinki | Vettenranta K.,University of Helsinki | And 6 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2013

Aim The birth prevalence of sacrococcygeal teratoma (SCT) has been reported to range from 1:27 000 to 1:40 000. We assessed the population-based prevalence and clinical presentation of SCT over 22 years. Methods We identified all cases of SCT, including live births, stillbirths and terminations of pregnancy (TOPs), in the Finnish Register of Congenital Malformations, covering 1987-2008. Data on prenatal diagnoses, pregnancy outcomes, infant deaths and associated anomalies were collected. Results One hundred and twenty four SCT cases were identified among 1 331 699 pregnancies. There were 89 (72%) live births, 13 (10%) stillbirths and 22 (18%) TOPs. The total prevalence of SCT was 1:10 700. Tumours were detected in utero in 55% of the pregnancies with SCT. The proportion of perinatal deaths among all SCT births was 28%. Thirty percentage of the cases had associated abnormalities (mainly of the urinary tract and various syndromes). Conclusion This nationwide, population-based study on SCT shows that the total and birth prevalence of SCT in Finland is markedly higher than previously reported. This may reflect true differences between populations, but may also be explained by accurate nationwide registration of SCTs. The high perinatal mortality rate has an impact on counselling of families and planning of deliveries. ©2013 Foundation Acta Pædiatrica. Published by Blackwell Publishing Ltd.


Rantanen T.,Privatix Clinic | Rantanen T.,Central Hospital of Seinajoki | Telaranta T.,Privatix Clinic
Surgical Endoscopy and Other Interventional Techniques | Year: 2013

Background: Endoscopic thoracic sympathectomy has been used successfully in the treatment of blushing, excessive sweating, and social phobia. However, the adverse effects of endoscopic thoracic sympathectomy are more severe and frequent than the adverse effects of endoscopic sympathetic block (ESB). The use of different blocking levels for different indications in ESB according to the Lin-Telaranta classification further decreases the postoperative adverse effects. However, there are few data on the long-term results of ESB performed using the Lin-Telaranta classification. Methods: Ninety-five patients (55 men, 40 women) were interviewed by before the surgery using our routine questionnaire, and the same questionnaire was answered postoperatively by the patients. In addition, a long-term follow-up questionnaire was sent to all patients whose address was known. Forty-seven patients (24 men, 23 women) answered to this questionnaire. The Davidson brief social phobia scale and the Liebowitz quality of life scale were used. Patients were divided to 3 categories: category 1, patients with sweating problems; category 2, patients with blushing; and category 3, and patients with symptoms other than sweating or blushing. Results: Among patients in category 1, social phobia decreased from 12.43 to 6.71 (p = 0.004), in category 2 from 13.97 to 7.69 (p < 0.001), and in category 3 from 13.18 to 9.64 (p = 0.007) during long-term follow-up. Among patients with severe sweating problems preoperatively, sweating decreased from 2.50 to 1.29 (p = 0.003) among patients in category 1 and from 1.86 to 1.16 (p < 0.001) among patients in category 2. Among patients with unbearable blushing, blushing decreased from 4 to 1.80 (p < 0.001). Conclusions: Patients got a clear help from ESB performed using the Lin-Telaranta classification to treat blushing, excessive sweating, and social phobia with and without physical symptoms. In addition, compensatory sweating increased only slightly. © 2013 Springer Science+Business Media New York (outside the USA).


Isohanni P.,University of Helsinki | Linnankivi T.,University of Helsinki | Buzkova J.,University of Helsinki | Lonnqvist T.,University of Helsinki | And 9 more authors.
Journal of Medical Genetics | Year: 2010

Background: Leucoencephalopathy with brain stem and spinal cord involvement and high brain lactate (LBSL) was first defined by characteristic magnetic resonance imaging and spectroscopic findings. The clinical features include childhood or juvenile onset slowly progressive ataxia, spasticity, and dorsal column dysfunction, occasionally accompanied by learning difficulties. Mutations in DARS2, encoding mitochondrial aspartyltRNA synthetase, were recently shown to cause LBSL. The signs and symptoms show some overlap with the most common leucoencephalopathy of young adults, multiple sclerosis (MS). Objective: To clarify the molecular background of LBSL patients in Finland, and to look for DARS2 mutations in a group of MS patients. Methods: Clinical evaluation of LBSL patients, DARS2 sequencing and haplotype analysis, and carrier frequency determination in Finland. Results: All eight LBSL patients were compound heterozygotes for DARS2 mutations: all carried R76SfsX5 change, seven had M134-K165del, and one had C152F change. Axonal neuropathy was found in five of the eight patients. The carrier frequencies of the R76SfsX5 and M134-K165del mutations were 1:95 and 1:380, respectively. All patients shared common European haplotypes, suggestive of common European LBSL ancestors. No enrichment of the two common DARS2 mutations was found in 321 MS patients. Conclusion: All LBSL patients were compound heterozygotes, which suggests that DARS2 mutation homozygosity may be lethal or manifest as a different phenotype. The authors show here that despite identical mutations the clinical picture was quite variable in the patients. Axonal neuropathy was an important feature of LBSL. DARS2 mutations cause childhood-to-adolescence onset leucoencephalopathy, but they do not seem to be associated with MS.


Pauniaho S.-L.,University of Tampere | Pauniaho S.-L.,Central Hospital of Seinajoki | Salonen J.,University of Helsinki | Helminen M.,University of Tampere | And 4 more authors.
Cancer Causes and Control | Year: 2012

Purpose: Germ cell tumors (GCTs) comprise a heterogeneous group of tumors derived from primordial germ cells. The incidence of malignant testicular GCTs has increased in recent decades, but little is known about possible changes in malignant female GCTs. Population-based data covering all malignant GCTs in both sexes remain limited. Methods: All cases of malignant GCTs in 1969-2008 were collected from the Finnish Cancer Registry and their age-adjusted annual incidences calculated. Results: The overall incidence of malignant GCTs was 2.56 per 100,000 person-years in males and 0.34 per 100,000 in females. The incidence of gonadal GCTs increased from 2.27 to 8.36 per 100,000 in males between 15 and 44 years of age. Moreover, the incidence of all histological subtypes of gonadal GCTs increased in males. In females, the only increase was seen in the incidence of ovarian non-dysgerminoma (from 0.07 to 0.29/100,000). The incidence of extragonadal GCTs did not change during the study period, being 0.18 and 0.10 per 100,000 in males and females, respectively. Conclusions: The incidence of gonadal GCTs in males increased significantly during the 40-year study period, whereas in females, no such change was observed. There were significant gender differences regarding the distribution of histological subtypes and patients' ages. However, the incidence of extragonadal GCTs remained low in both sexes. The differences in the incidences of gonadal GCTs derived from the same population suggest that the risk factors of these malignancies differ between the two sexes. © 2012 Springer Science+Business Media Dordrecht.


Rantanen T.,Central Hospital of Seinajoki | Rantanen T.,University of Tampere | Kauttu T.,University of Helsinki | Akerla J.,University of Tampere | And 5 more authors.
Medical Oncology | Year: 2013

CIP2A is overexpressed in many cancers, including esophageal squamous cell carcinoma. The regulation of c-MYC and CIP2A expression is characterized by a positive feedback mechanism facilitating the expression of both of them and accelerating cancer cell proliferation in gastric cancer. Increased CIP2A expression is a predictor of poor survival in some cancers. The incidence of positive CIP2A immunostaining and its association with c-MYC and its predictive value in esophageal adenocarcinoma are unknown. All esophageal adenocarcinoma patients from 1990 to 2007 with sufficient material for analysis of CIP2A and c-MYC in two university hospitals were included in the study. In addition, biopsies from Barrett's epithelium from the cancer patients and control tissue from normal esophageal mucosa adjacent to the tumor were included. CIP2A was moderately or strongly positive in 77.9 %, and c-MYC in 93.8 % of the cancer specimens. These frequencies were statistically different from the expression in normal esophageal epithelium. In addition, there was a positive correlation between CIP2A and c-MYC expression (p = 0.018). According to adjusted Cox regression survival analysis, CIP2A and c-MYC had no effect on survival. However, among patients with stage IVA-IVB cancer, there was a trend toward poor prognosis in CIP2Apositive patients. The expression of CIP2A and c-MYC was associated with each other, and their overexpression was found in most cases of esophageal adenocarcinoma. However, CIP2A and c-MYC had no effect on survival. © Springer Science+Business Media New York 2013.


Petaja T.,University of Tampere | Petaja T.,Central Hospital of Seinajoki | Pedersen C.,University of Southern Denmark | Poder A.,University of Tartu | And 5 more authors.
International Journal of Cancer | Year: 2011

Vaccination against oncogenic human papillomavirus (HPV) types is one key intervention for cervical cancer prevention. This follow-up study assessed the persistence of the systemic and mucosal immune responses together with the safety profile of the HPV-16/18 AS04-adjuvanted vaccine administered to young women aged 10-25 years. Serum and cervicovaginal secretion (CVS) samples were collected at prespecified time-points during the 48-month follow-up period. Anti-HPV-16/18 antibody levels in serum and CVS were measured by enzyme-linked immunosorbent assay (ELISA). At Month 48, all subjects remained seropositive for serum anti-HPV-16 and -18 antibodies. As previously observed, anti-HPV-16 and -18 antibodies levels (ELISA Units/mL) were higher in subjects vaccinated at the age of 10-14 years (2862.2 and 940.8) compared to subjects vaccinated at the age of 15-25 years (1186.2 and 469.8). Moreover, anti-HPV-16 and -18 antibodies in CVS were still detectable for subjects aged 15-25 years (84.1% and 69.7%, respectively). There was a strong correlation between serum and CVS anti-HPV-16 and -18 antibodies levels (correlation coefficients = 0.84 and 0.90 at Month 48, respectively) supporting the hypothesis of transudation or exudation of serum immunoglobulin G antibodies through the cervical epithelium. The HPV-16/18 AS04-adjuvanted vaccine had a clinically acceptable safety profile. In conclusion, this follow-up study shows that the HPV-16/18 AS04-adjuvanted vaccine administered to preteen/adolescents girls and young women induces long-term systemic and mucosal immune response and has a clinically acceptable safety profile up to 4 years after the first vaccine dose. © 2010 UICC.


PubMed | Central Hospital of Seinajoki
Type: Journal Article | Journal: Molecular imaging and biology : MIB : the official publication of the Academy of Molecular Imaging | Year: 2014

6-[(18)F]fluoro-L-3,4-dihydroxyphenyl alanine ([(18)F]FDOPA) positron emission tomography (PET) is a diagnostic tool which can detect malignancies of the pancreas. We aimed to study whether the manipulation of the [(18)F]FDOPA metabolic pathway would change the (18)F-behavior to provide a biochemical foundation for PET imaging of rat pancreas with [(18)F]FDOPA.Inhibitors of aromatic amino acid decarboxylase, catechol-O-methyltransferase, monoamine oxidases A and B, or their combinations on [(18)F]FDOPA uptake, metabolism, and the regional distribution in the rat pancreas was evaluated using in vivo PET/computed tomography imaging, chromatographic metabolite analyses, and autoradiography.Enzyme inhibition generally increased the uptake of [(18)F]FDOPA derived (18)F-radioactivity in rat pancreas. Dependent on which enzymatic pathway is blocked (or a combination of pathways), different radiolabeled metabolites in pancreas are responsible for this increase in uptake.Altering the metabolism of [(18)F]FDOPA by using various enzymatic inhibitors increased the radioactivity uptake and changed the radiometabolic profile in the pancreas allowing better discrimination between pancreas and surrounding tissues of rat. However, these manipulations did not separate islets from the exocrine pancreas. Elucidating the metabolic behavior of [(18)F]FDOPA provides a biochemical foundation of PET imaging of the rat pancreas.


PubMed | Central Hospital of Seinajoki
Type: Clinical Trial | Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A | Year: 2014

The lack of correlation between the symptomatic outcome after fundoplication and the results of objective measurements has been demonstrated. Therefore, subjective tools are needed to measure the outcomes of the treatment. Long-term results concerning health-related quality of life (HRQoL) after laparoscopic Nissen fundoplication (LNF) performed in a community-based hospital are lacking. The objective of this study was to describe HRQoL of an LNF cohort 10 years after surgery performed in a community-based hospital.In 1997-1999, 107 LNFs were performed. The 15D questionnaire was mailed to all patients, and consent to participate in the study was requested. The patients who agreed to participate were interviewed. The resulting 15D profile and single index scores were compared with those of a sample of age-standardized general population (n=6053).Of the 107 patients, 64 (59.8%) participated in the study (40 men; mean age, 61.9 years; range, 28-85 years). The mean 15D score for our patient group was 0.860 versus 0.888 for the age-standardized general population (P=.030). The mean 15D score of the patients who were satisfied with the surgical results was 0.870 (median, 0.890), which is clinically the same as that of the general population. Among the patients, dissatisfaction with the results of surgery decreased the mean 15D score by 0.069 (P=.023).Our long-term follow-up study suggests that, in the majority of patients, HRQoL after LNF performed in a community-based hospital is similar to that of the general population, while the subjective failure of surgery leads to suboptimal results. The multidimensional 15D instrument seems a promising HRQoL instrument also when applied to gastroesophageal reflux disease patients.

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