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The 10-year COPD Programme in Finland: effects on quality of diagnosis, smoking, prevalence, hospital admissions and mortality.

https://arctichealth.org/en/permalink/ahliterature135938
Source
Prim Care Respir J. 2011 Jun;20(2):178-83
Publication Type
Article
Date
Jun-2011
Author
Vuokko L Kinnula
Tuula Vasankari
Eva Kontula
Anssi Sovijarvi
Olli Saynajakangas
Anne Pietinalho
Author Affiliation
Department of Medicine, Division of Pulmonary Medicine, University of Helsinki, Helsinki, Finland. vuokko.kinnula@helsinki.fi
Source
Prim Care Respir J. 2011 Jun;20(2):178-83
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Diagnostic Techniques, Respiratory System - standards
Female
Finland - epidemiology
Hospitalization - trends
Humans
Male
Middle Aged
Prevalence
Program Evaluation - methods
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - therapy
Quality Assurance, Health Care
Retrospective Studies
Smoking - adverse effects - epidemiology
Smoking Cessation - statistics & numerical data
Survival Rate - trends
Young Adult
Abstract
The Finnish National Programme for Chronic Bronchitis and Chronic Obstructive Pulmonary Disease (COPD) 1998-2007 was set up to reduce the prevalence of COPD, improve COPD diagnosis and care, reduce the number of moderate to severe cases of the disease, and reduce hospitalisations and treatment costs due to COPD. Over 900 events for 25,000 participating healthcare workers were arranged. The major strengths of this programme included multidisciplinary strategies and web-based guidelines in nearly all primary health care centres around the country.
Data from national registries, epidemiological studies and questionnaires were used to measure whether the goals had been reached.
The prevalence of COPD remained unchanged. Smoking decreased in males from 30% to 26% (p
Notes
Comment In: Prim Care Respir J. 2011 Jun;20(2):109-1021603847
PubMed ID
21431275 View in PubMed
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Airway obstruction and the risk of myocardial infarction and death from coronary heart disease: a national health examination survey with a 33-year follow-up period.

https://arctichealth.org/en/permalink/ahliterature297762
Source
Eur J Epidemiol. 2018 01; 33(1):89-98
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2018
Author
Tiina Mattila
Tuula Vasankari
Harri Rissanen
Paul Knekt
Pauli Puukka
Markku Heliövaara
Author Affiliation
Heart and Lung Center, Helsinki University Hospital, Meilahti Triangle Hospital, HUS, 6th Floor, PO Box 372, 00029, Helsinki, Finland. tiina.m.mattila@fimnet.fi.
Source
Eur J Epidemiol. 2018 01; 33(1):89-98
Date
01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Airway Obstruction - epidemiology
Cause of Death
Coronary Disease - mortality
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Hospitalization
Humans
Male
Middle Aged
Myocardial Infarction - mortality
Proportional Hazards Models
Risk factors
Abstract
Chronic obstructive pulmonary disease (COPD) has been associated with coronary mortality. Yet, data about the association between COPD and acute myocardial infarction (MI) remain scarce. We aimed to study airway obstruction as a predictor of MI and coronary mortality among 5576 Finnish adults who participated in a national health examination survey between 1978 and 1980. Subjects underwent spirometry, had all necessary data, showed no indications of cardiovascular disease at baseline, and were followed up through record linkage with national registers through 2011. The primary outcome consisted of a major coronary event-that is, hospitalization for MI or coronary death, whichever occurred first. We specified obstruction using the lower limit of normal categorization. Through multivariate analysis adjusted for potential confounding factors for coronary heart disease, hazard ratios (HRs) (with the 95% confidence intervals in parentheses) of a major coronary event, MI, and coronary death reached 1.06 (0.79-1.42), 0.84 (0.54-1.31), and 1.40 (1.04-1.88), respectively, in those with obstruction compared to others. However, in women aged 30-49 obstruction appeared to predict a major coronary event, where the adjusted HR reached 4.21 (1.73-10.28). In conclusion, obstruction appears to predict a major coronary event in younger women only, whereas obstruction closely associates with the risk of coronary death independent of sex and age.
PubMed ID
28688065 View in PubMed
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Association between all-cause and cause-specific mortality and the GOLD stages 1-4: A 30-year follow-up among Finnish adults.

https://arctichealth.org/en/permalink/ahliterature272552
Source
Respir Med. 2015 Aug;109(8):1012-8
Publication Type
Article
Date
Aug-2015
Author
Tiina Mattila
Tuula Vasankari
Merja Kanervisto
Tarja Laitinen
Olli Impivaara
Harri Rissanen
Paul Knekt
Pekka Jousilahti
Seppo Saarelainen
Pauli Puukka
Markku Heliövaara
Source
Respir Med. 2015 Aug;109(8):1012-8
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death - trends
Female
Finland - epidemiology
Follow-Up Studies
Forced expiratory volume
Forecasting
Humans
Male
Population Surveillance - methods
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive - mortality - physiopathology
Retrospective Studies
Risk Assessment - methods
Risk factors
Severity of Illness Index
Survival Rate - trends
Vital Capacity
Abstract
Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction.
We studied the association between all-cause and cause-specific mortality and GOLD stages 1-4 in a 30-year follow-up among 6636 Finnish men and women aged 30 or older participating in the Mini-Finland Health Study between 1978 and 1980.
After adjusting for age, sex, and smoking history, the GOLD stage of the subject showed a strong direct relationship with all-cause mortality, mortality from cardiovascular and respiratory diseases, and cancer. The adjusted hazard ratios of death were 1.27 (95% confidence interval (CI) 1.06-1.51), 1.40 (1.21-1.63), 1.55 (1.21-1.97) and 2.85 (1.65-4.94) for GOLD stages 1-4, respectively, with FEV1/FVC =70% as the reference. The association between GOLD stages 2-4 and mortality was strongest among subjects under 50 years of age at the baseline measurement. Cardiovascular mortality increased consistently for all GOLD stages.
Airway obstruction indicates an increased risk for all-cause mortality according to the severity of the GOLD stage. We found that even stage 1 carries a risk for cardiovascular death independently of smoking history and other known risk factors.
PubMed ID
26108990 View in PubMed
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Low socioeconomic status is associated with chronic obstructive airway diseases.

https://arctichealth.org/en/permalink/ahliterature135648
Source
Respir Med. 2011 Aug;105(8):1140-6
Publication Type
Article
Date
Aug-2011
Author
Merja Kanervisto
Tuula Vasankari
Tarja Laitinen
Markku Heliövaara
Pekka Jousilahti
Seppo Saarelainen
Author Affiliation
University of Tampere, Department of Nursing Science, Niittytie 1, FI-33470 Ylöjärvi, Finland. mkanervisto@hotmail.com
Source
Respir Med. 2011 Aug;105(8):1140-6
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Asthma - epidemiology
Body mass index
Educational Status
Female
Finland - epidemiology
Humans
Logistic Models
Male
Prevalence
Pulmonary Disease, Chronic Obstructive - epidemiology
Risk factors
Severity of Illness Index
Socioeconomic Factors
Spirometry
Abstract
Worldwide, asthma and COPD are common causes of disability or death. Few studies have been made concerning the association with socioeconomic status (SES) and these diseases.
The aim of this nationwide population-based study was to determine the association with educational and income levels (SES) and chronic airway diseases (CAD), i.e., asthma or COPD (FEV1/FVC 
PubMed ID
21459567 View in PubMed
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Lung function and respiratory diseases in people with psychosis: population-based study.

https://arctichealth.org/en/permalink/ahliterature271335
Source
Br J Psychiatry. 2015 Jul;207(1):37-45
Publication Type
Article
Date
Jul-2015
Author
Krista Partti
Tuula Vasankari
Merja Kanervisto
Jonna Perälä
Samuli I Saarni
Pekka Jousilahti
Jouko Lönnqvist
Jaana Suvisaari
Source
Br J Psychiatry. 2015 Jul;207(1):37-45
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Adult
Bronchitis, Chronic - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Female
Finland
Humans
Linear Models
Male
Middle Aged
Odds Ratio
Pneumonia - epidemiology
Schizophrenia - complications
Self Report
Smoking - epidemiology
Spirometry - statistics & numerical data
Abstract
There is little information on lung function and respiratory diseases in people with psychosis.
To compare the respiratory health of people with psychosis with that of the general population.
In a nationally representative sample of 8028 adult Finns, lung function was measured by spirometry. Information on respiratory diseases and symptoms was collected. Smoking was quantified with serum cotinine levels. Psychotic disorders were diagnosed utilising the Structured Clinical Interview for DSM-IV (SCID-I) and medical records.
Participants with schizophrenia and other non-affective psychoses had significantly lower lung function values compared with the general population, and the association remained significant for schizophrenia after adjustment for smoking and other potential confounders. Schizophrenia was associated with increased odds of pneumonia (odds ratio (OR) = 4.9), chronic obstructive pulmonary disease (COPD, OR = 4.2) and chronic bronchitis (OR = 3.8); and with high cotinine levels.
Schizophrenia is associated with impaired lung function and increased risk for pneumonia, COPD and chronic bronchitis.
PubMed ID
25858177 View in PubMed
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MDR-TB in Finland--still rare despite the situation in our neighbouring countries.

https://arctichealth.org/en/permalink/ahliterature134682
Source
Clin Respir J. 2012 Jan;6(1):35-9
Publication Type
Article
Date
Jan-2012
Author
Tuula Vasankari
Hanna Soini
Kari Liippo
Petri Ruutu
Author Affiliation
Epidemiologic Surveillance and Response Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland. tuula.vasankari@utu.fi
Source
Clin Respir J. 2012 Jan;6(1):35-9
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antitubercular Agents - therapeutic use
Bacterial Typing Techniques
DNA, Bacterial - genetics
Disease Outbreaks
Drug Therapy, Combination
Emigrants and Immigrants - statistics & numerical data
Female
Finland - epidemiology
Humans
Male
Middle Aged
Mycobacterium tuberculosis - genetics
Polymorphism, Restriction Fragment Length
Tuberculosis, Multidrug-Resistant - drug therapy - epidemiology
Abstract
The multidrug-resistant tuberculosis (MDR-TB) epidemic in Eastern Europe bordering Finland has raised worries concerning the risk of disease in near-frontier contacts.
Our aim was to find out the amount of multidrug resistance, characterise the resistance profiles and evaluate the outcome of treatment. In addition, we analysed the isolates by molecular genotyping methods in order to evaluate the origins of the resistant isolates.
All culture-verified new MDR-TB cases diagnosed during the years 1994-2005 were included. Treatment outcome categories of the World Health Organization collected 36 months from the beginning of the treatment were used for outcome monitoring. The IS6110 restriction fragment length polymorphism (RFLP) test and spoligotyping were carried out according to standard recommendations.
There were 19 culture-confirmed MDR-TB cases during the study period. The mean age was 39.9 years. The proportion of foreign-born patients was 73.7%. The outcome of the treatment was favourable in 14 cases (73.7%). When the spoligotypes were compared with the international spoligotype database, a corresponding spoligotype was found in 17 cases. Seven (36.8%) patients were infected by an isolate belonging to the Beijing genotype (SIT1).
It is very probable that cases of MDR-TB in Finland are mostly caught abroad. Risk of gaining disease in near-frontier contacts seems to be very low.
PubMed ID
21554562 View in PubMed
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Overt and cryptic miliary tuberculosis misdiagnosed until autopsy.

https://arctichealth.org/en/permalink/ahliterature181995
Source
Scand J Infect Dis. 2003;35(11-12):794-6
Publication Type
Article
Date
2003
Author
Tuula Vasankari
Kari Liippo
Eero Tala
Author Affiliation
Department of Pulmonary Diseases, Turku University Central Hospital, Preitilä, Finland. Tuula.Vasankari@tyks.fi
Source
Scand J Infect Dis. 2003;35(11-12):794-6
Date
2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antitubercular Agents - therapeutic use
Autopsy
Biopsy, Needle
Cohort Studies
Diagnostic Errors - statistics & numerical data
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Probability
Radiography, Thoracic
Registries
Severity of Illness Index
Tuberculosis, Miliary - diagnosis - drug therapy - mortality - pathology
Abstract
Autopsy confirmed deaths due to miliary tuberculosis in Finland were analysed in order to improve the diagnosis of the disease. Tuberculosis deaths from mortality statistics were examined in order to identify miliary tuberculosis deaths, and the medical records of the autopsied cases were studied. The deceased were divided into 2 groups, 'overt' disease and 'cryptic' disease, on the basis of chest X-ray findings. There were 114 overt (mean age 79 y) and 140 cryptic (mean age 78 y) miliary tuberculosis cases. The majority of patients in both groups were females. There was no difference between the groups in history of previous tuberculosis, in predisposing factors or in symptoms. Suspicion of tuberculosis was recorded before death in 86% in overt form and in 53% in cryptic form. In overt disease 50% of the patients received chemotherapy, but in cryptic form only a quarter were treated. In one third of cases autopsy had been carried out without suspicion of tuberculosis. Suspicion of tuberculosis had arisen too seldom, especially in the cryptic group. On the other hand, those suspected to have tuberculosis were not promptly treated with the appropriate chemotherapy. Absence of suspicion and delayed diagnosis mean increased risk in health care and at autopsy.
PubMed ID
14723351 View in PubMed
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[Recognize tuberculosis--prevent outbreak].

https://arctichealth.org/en/permalink/ahliterature273838
Source
Duodecim. 2016;132(7):654-60
Publication Type
Article
Date
2016
Author
Hanna Soini
Hannele Kotilainen
Harri Marttila
Jane Marttila
Risto Pietikäinen
Eeva Ruotsalainen
Pieter Smit
Kirsi Valve
Tuula Vasankari
Outi Lyytikäinen
Source
Duodecim. 2016;132(7):654-60
Date
2016
Language
Finnish
Publication Type
Article
Keywords
Disease Outbreaks - prevention & control
Emigrants and Immigrants
Finland - epidemiology
Health Surveys
Humans
Incidence
Tuberculosis - epidemiology - transmission
Tuberculosis, Multidrug-Resistant - epidemiology - transmission
Abstract
The number of tuberculosis cases in Finland has decreased. Cases among immigrants have, however, increased, and the disease may not be recognized early enough.
We describe four group exposures to tuberculosis that occurred in Finland, the index patient coming from a country with a high incidence rate of tuberculosis.
Over 900 persons were exposed to tuberculosis. Coordination of the surveys was hampered by the fact that several healthcare operators participated in the study. Three index patients had drug-resistant tuberculosis, one of which was multidrug resistant.
Extensive operations of tracking and prevention could have been avoided, if the symptoms would have been recognized earlier.
PubMed ID
27188090 View in PubMed
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Recurrent tuberculosis in Finland 1995-2013: a clinical and epidemiological cohort study.

https://arctichealth.org/en/permalink/ahliterature290053
Source
BMC Infect Dis. 2017 11 16; 17(1):721
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
11-16-2017
Author
Virve Korhonen
Hanna Soini
Tuula Vasankari
Jukka Ollgren
Pieter W Smit
Petri Ruutu
Author Affiliation
Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland. virve.korhonen@uta.fi.
Source
BMC Infect Dis. 2017 11 16; 17(1):721
Date
11-16-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Cohort Studies
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Recurrence
Registries
Risk factors
Tuberculosis - epidemiology
Young Adult
Abstract
We investigated the epidemiology and prevalence of potential risk factors of tuberculosis (TB) recurrence in a population-based registry cohort of 8084 TB cases between 1995 and 2013.
An episode of recurrent TB was defined as a case re-registered in the National Infectious Disease Register at least 360 days from the date of the initial registration. A regression model was used to estimate risk factors for recurrence in the national cohort. To describe the presence of known risk factors for recurrence, patient records of the recurrent cases were reviewed for TB diagnosis confirmation, potential factors affecting the risk of recurrence, the treatment regimens given and the outcomes of the TB episodes preceding the recurrence.
TB registry data included 84 patients, for whom more than 1 TB episode had been registered. After a careful clinical review, 50 recurrent TB cases (0.6%) were identified. The overall incidence of recurrence was 113 cases per 100,000 person-years over a median follow up of 6.1 years. For the first 2 years, the incidence of recurrence was over 200/100000. In multivariate analysis of the national cohort, younger age remained an independent risk factor at all time points, and male gender and pulmonary TB at 18 years of follow-up. Among the 50 recurrent cases, 35 patients (70%) had received adequate treatment for the first episode; in 12 cases (24%) the treating physician and in two cases (4%) the patient had discontinued treatment prematurely. In one case (2%) the treatment outcome could not be assessed.
In Finland, the rate of recurrent TB was low despite no systematic directly observed therapy. The first 2 years after a TB episode had the highest risk for recurrence. Among the recurrent cases, the observed premature discontinuation of treatment in the first episode in nearly one fourth of the recurrent cases calls for improved training of the physicians.
Notes
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PubMed ID
29145819 View in PubMed
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14 records – page 1 of 2.