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Metsna V.,East Tallinn Central Hospital | Metsna V.,University of Tartu | Vorobjov S.,National Institute for Health Development | Ma rtson A.,University of Tartu
Medicina (Lithuania)

Background and objective:: Anterior knee pain (AKP) may compromise the results of total knee arthroplasty in more than quarter of cases. The aim of the current work was to determine the prevalence of AKP and the severity of patellofemoral symptoms among patients who received a total knee arthroplasty with non-replaced patella in East-Tallinn Central Hospital from January 1, 2000 to December 31, 2009. Materials and methods: We carried out a retrospective study involving 1778 consecutive total knee arthroplasties with non-replaced patella. Mean follow-up time was 68 months. We collected data by two patient-reported measures: the knee pain questionnaire and the Kujala score. Results: We diagnosed AKP among 20.2% of patients, 33.6% had pain in the knee from a source other than patellofemoral joint and 46.2% were pain free. In 87.3% of AKP cases the pain emerged within the first five years of knee replacement. AKP was more prevalent among patients with osteoarthritis compared to rheumatoid arthritis and among patients below 60 years. There was no difference in the prevalence of AKP in terms of gender or mobile and fixed bearing implants. The severity of patellofemoral symptoms in case of AKP was moderate. Conclusions: AKP is a frequent complication of total knee arthroplasty with non-replaced patella and patients undergoing this procedure should be apprised of the high probability of experiencing pain in the anterior part of the replaced knee. © 2014 Lithuanian University of Health Sciences. Source

Kuusik A.,Competence Center | Nomm S.,Tallinn University of Technology | Ovsjanski S.,Tallinn University of Technology | Orunurm L.,East Tallinn Central Hospital | Reilent E.,Competence Center
IEEE EMBS Special Topic Conference on Point-of-Care (POC) Healthcare Technologies: Synergy Towards Better Global Healthcare, PHT 2013

In this paper we describe an extendable point of care system for simultaneous motor rehabilitation (post-stroke and -arthroscopy) patient condition assessment and patient safety observations. Electronic linear and angular accelerometer sensors attached to the human upper or lower limbs gather information about performed therapeutic exercises. The measurement data processing of the vital sign sensors and accelerometers is done in the health hub device in real time with the patient feedback. The movement correctness evaluation and gait analysis is done with ANARX neural network based models. The system is implemented and tested. The evaluation of the test results is presented. © 2013 IEEE. Source

Jurisson M.,University of Tartu | Vorobjov S.,East Tallinn Central Hospital | Vorobjov S.,National Institute for Health Development | Kallikorm R.,University of Tartu | And 2 more authors.
Osteoporosis International

Summary: The incidence of hip fractures among individuals aged over 50 in Estonia and trends over time were assessed for 2005–2012. The incidence among women is relatively low, with the declining trend, but the rate among men is among the highest in Eastern and Central Europe.Introduction: The aim of this study was to assess the incidence and trends of hip fractures among individuals over 50 years in Estonia in 2005–2012 and to increase understanding of the incidence of hip fractures in Eastern Europe.Methods: We identified all patients aged 50 years or older with hip fracture (ICD-10 codes S72.0, S72.1 and S72.2) in 2005–2012 using medical claims data from the Estonian Health Insurance Fund. Crude and age-specific incidence rates were calculated for men and women using the population of Estonia in 2005–2012. To adjust for age differences in the population, standardized incidence rates (SIR) were estimated.Results: The SIR per 100,000 for the entire observation period was 209.2 (95 % CI 204.2 to 214.2) in women and 215.6 (95 %CI 208.2 to 223.1) in men, resulting in a female to male rate ratio of 0.97 (95 % CI 0.84 to 1.11). Over the period of 2005–2012 the estimated SIR/100,000 ranged from 211.5 (95 % CI 196.8–226.3) in 2005 to 183.7 (95 % CI 170.8–196.7) in 2012 in women, and from 238.5 (95 % CI 215.4–261.7) in 2005 to 187.9 (95 % CI 169.0–206.8) in 2012, in men. For women, the decrease in SIR for the study period approached statistical significance (p = 0.058), and for the period of 2009–2012, we observed an accelerated 16 % decrease (p = 0.008).Conclusions: The incidence of hip fractures among Estonian women is relatively low, whereas the rate among men is among the highest in Eastern and Central Europe. In line with many countries, we found a recent decline in incidence among women. © 2014, International Osteoporosis Foundation and National Osteoporosis Foundation. Source

Kuusik A.,Technology Competence Center | Reilent E.,Technology Competence Center | Loobas I.,Technology Competence Center | Parve M.,East Tallinn Central Hospital
Advances in Information Sciences and Service Sciences

Results of several research groups indicate that modern home telehealth care systems should support patient personalization and context awareness. To deal with accompanying increase of data amount and processing complexity, a semantic reasoning approach is proposed. However, so far there are no practical, system level software architectures proposed to address all related issues within one complete solution. We describe a developed RDF blackboard based data processing solution for smart home telecare supporting off-the-self reasoning tools and existing ontologies. Source

Papp K.A.,Probity Medical Research | Langley R.G.,Dalhousie University | Sigurgeirsson B.,University of Iceland | Abe M.,Gunma University | And 6 more authors.
British Journal of Dermatology

Background Conventional systemic therapies for plaque psoriasis have not fully met the needs of patients, and although current biologic treatments are generally well tolerated, concerns exist with respect to long-term safety. Interleukin (IL)-17A is believed to be an important effector cytokine in the pathogenesis of psoriasis and is produced by Th17 cells, a class of helper T cells that act outside the established Th1/Th2 paradigm for regulation of innate and adaptive immunity. Objectives To assess the efficacy and safety of different doses of secukinumab, a fully human anti-IL-17A IgG1κ monoclonal antibody, in patients with moderate-to-severe plaque psoriasis. Methods Patients (n = 125) were randomized 1: 1: 1: 1: 1 to receive subcutaneous doses of placebo (n = 22) or secukinumab [1 × 25 mg (n = 29), 3 × 25 mg (n = 26), 3 × 75 mg (n = 21) or 3 × 150 mg (n = 27)] at weeks 0, 4 and 8. After the 12-week treatment period, patients entered a follow-up period of 24 weeks. The primary efficacy outcome was at least 75% improvement from baseline in the Psoriasis Area and Severity Index score (PASI 75); secondary outcomes included the Investigator's Global Assessment (IGA) and PASI 90 and 50 response rates. Results After 12 weeks of treatment, secukinumab 3 × 150 mg and 3 × 75 mg resulted in significantly higher PASI 75 response rates vs. placebo (82% and 57% vs. 9%; P < 0·001 and P = 0·002, respectively). Higher PASI 75 response rates compared with placebo were maintained throughout the follow-up period with these dosages [week 36, 26% (n = 7) and 19% (n = 4) vs. 4% (n = 1), respectively], with a gradual decline of PASI 75 response over time after the dosing period. IGA response rates were significantly higher in the 3 × 150 mg group vs. placebo at week 12 (48% vs. 9%; P = 0·005) and were consistently higher for the 3 × 150 mg and 3 × 75 mg groups vs. placebo at all time points from week 4 onward. The PASI 90 response rate was significantly higher in the 3 × 150 mg group vs. placebo (52% vs. 5%) at week 12 and remained higher during the follow-up period. Secukinumab was well tolerated. Two cases of neutropenia (≤ grade 2) were reported in the 3 × 150 mg cohort. Conclusions Treatment with subcutaneous secukinumab 3 × 75 mg and 3 × 150 mg met the primary outcome of PASI 75 response achievement after 12 weeks, demonstrating efficacy in moderate-to-severe psoriasis. © 2012 The Authors. BJD © 2012 British Association of Dermatologists. Source

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