Biomedical subjects

Reijo Sund

Publications and source records attributed to Reijo Sund.

9 recordsLinked to original sources

PubMed2007

Parity, tubal sterilization, hysterectomy and risk of primary fallopian tube carcinoma in Finland, 1975-2004.

We studied the possible relationship among parity, female sterilization, hysterectomy and the risk of primary fallopian tube carcinoma (PFTC) in a case-control study in Finland in cases occurring between 1975 and 2004. A total of 573 PFTC cases were identified from the Finnish Cancer Registry, and 10 age-matched controls per case were randomly selected from the Finnish Central Population Registry. In multivariate analysis (including 189 PFTC cases and 1764 controls) parity was protective: the odds ratio (OR) for 1-2 deliveries was 0.63 (95% CI 0.44-0.91) and for > or =3 deliveries, 0.32 (95% CI 0.19-0.52). The OR for sterilization was 0.74 (95% CI 0.42-1.30) and for hysterectomy 1.27 (95% CI 0.73-2.21). Our findings suggest a possible hormonal background as regards the development of PFTC.

Carcinoma↗

PubMed2006

Cancer incidence of persons with Down syndrome in Finland: a population-based study.

Individuals with Down syndrome (DS) have a predisposition to leukaemia and testicular cancer, but data on the incidence of cancers are yet sparse. A cohort of 3,581 persons with DS was identified from a National Registry of Finnish persons with intellectual disability collected between 1978 and 1986 and followed-up for cancer incidence until 2002. Standardised incidence ratios (SIRs) were defined as ratios of observed number of cancer cases to those expected from the national cancer incidence rates, by age and sex. The overall cancer risk was equal to that of the general population, but a significantly high risk of leukaemia (SIR 10.5, CI 95% 6.6-15.8) and testicular cancer (SIR4.8, CI 95% 1.8-10.4) was found.

Adolescent↗

PubMed2006

Intrahepatic cholestasis of pregnancy as an indicator of liver and biliary diseases: a population-based study.

Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder, thought to be specific for pregnancy and to spontaneously resolve after delivery. Increased rates of gallstone formation and hepatitis C have previously been associated with ICP. However, there are no longitudinal studies to determine its significance as an indicator of subsequent liver or biliary diseases. In this retrospective cohort study with cases and controls we assessed the risk of liver and biliary diseases in 21,008 women, 10,504 with a history of ICP during the years 1972-2000 (cases) and 10,504 with a normal pregnancy (controls). Cases and controls were matched for age, time of delivery, and place of delivery. The diagnoses of liver and biliary disease were traced from the Finnish Hospital Discharge Register with an almost 100% coverage. Several liver and biliary diseases were found to have a significantly higher incidence in patients with ICP than in controls. The rate ratio for hepatitis C was 3.5 (CI 1.6-7.6; P < .001), for nonalcoholic liver cirrhosis 8.2 (CI 1.9-35.5; P < .05), for gallstones and cholecystitis 3.7 (CI 3.2-4.2; P < .001) and for nonalcoholic pancreatitis 3.2 (CI 1.7-5.7; P < .001). In conclusion, there is an association of ICP with several liver and biliary diseases. Some patients with ICP are at risk of the subsequent development of cirrhosis and other severe chronic diseases. Contrary to what has been previously thought, follow-up may need to be considered for these patients.

Biliary Tract Diseases↗

PubMed2006

[Not Available].

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Journal Article↗

PubMed2005

The mortality of young offenders sentenced to prison and its association with psychiatric disorders: a register study.

BACKGROUND: We studied the nationwide mortality in Finland of young offenders sentenced to prison, with the advantage of a long-term follow-up in an unselected population. In addition, we aimed to clarify the relationship between psychiatric disorders requiring hospital treatment and early death in young offenders sentenced to prison. METHODS: All offenders sentenced to prison between 1984 and 2000 in Finland and aged 15-21 years when the crime was committed were selected for this study. The mortality of the young offenders was compared with the age- and sex-matched mortality data of the general population, obtained from Statistics Finland. Information on hospital treatment periods for psychiatric diagnoses was collected from the Finnish Health Care Register and linked to the mortality data. RESULTS: The study population consisted of 3,743 young male and 89 young female offenders. Of these, 435 (11.4%) had died by the end of the follow-up period, including 3 girls. The standardized mortality ratio for young male prisoners was 7.4 (95% confidence interval 6.7-8.1). There was a higher mortality rate among young offenders convicted in the later years of the study period. The causes of death were mostly unnatural and often violent. Hospitalization for a psychiatric disorder or substance abuse was significantly associated with the risk of death. However, hospitalization for emotional disorders with an onset specific to childhood and adolescence were associated with a lower death risk. CONCLUSION: The mortality rate in the population of young offenders sentenced to prison is alarmingly high. The high mortality in this group is associated with substance abuse and psychiatric disorders, but not with emotional disorders with an onset specific to childhood and adolescence.

Adolescent↗

PubMed2005

Only modest resources are needed to improve treatment of hospitalised patients with chest pain or heart failure: rapid assessment is a safe and efficient strategy.

BACKGROUND: The objective of this study was to evaluate the safety and efficacy of rapid assessment using modest resources in hospitalised chest pain and heart failure patients. METHODS: We evaluated 81 patients hospitalised for chest pain or heart failure in a prospective rapid assessment group and 162 patients in a retrospective usual care group with 6 months' follow-up. Main outcome measures were length of hospital stay at index observation, number of days spent in hospital for all causes, chest pain or heart failure, and number of visits to the doctor. RESULTS: Chest pain patients: Length of hospital stay was significantly shorter in the rapid assessment group (1.3 vs. 3.7 days, P<0.0001). Days spent in hospital over 6 months were fewer in the rapid assessment group (2.9 vs. 8.8 days, P<0.005). Furthermore, the number of days spent in the hospital for chest pain or heart failure decreased (2.5 vs. 8.0 days, P<0.01). Heart failure patients: The length of hospital stay (8.7 vs. 9.7 days, P=ns) or days spent in the hospital over 6 months did not differ (25.7 vs. 23.1 days, P=ns). However, there were fewer days (10.5 vs. 16.7 days, P<0.01) spent in the hospital for chest pain or heart failure in the rapid assessment group. CONCLUSIONS: Rapid assessment of hospitalised chest pain and heart failure patients on the next working day is a safe strategy in a medium-sized hospital. In 6 months, rapid assessment effectively reduces days spent in the hospital in chest pain patients, but not in heart failure patients. It can easily be integrated into standard care using modest resources.

Aged↗

PubMed2004

Impact of service supply, need, and municipal factors on the use of residential services for people with intellectual disabilities.

We examined the use of residential services for people with intellectual disabilities in Finland from a regional perspective. Our aims were to investigate how service supply and need, as well as municipal factors, impact the use of residential services and to analyze whether the available information in registers and databases can be effectively utilized in studies of this kind. According to the model based on the register data, after age adjustment the most important factors determining service use were service supply, the prevalence of intellectual disabilities, the municipality's level of urbanization, the number of persons granted long-term care as a percentage of all care recipients, and the percentage of middle-class and managerial households in a given municipality.

Finland↗

PubMed2003

Risk of multiple reoperations after lumbar discectomy: a population-based study.

STUDY DESIGN: Retrospective follow-up study of patients undergoing multiple (two or more) reoperations after initial lumbar discectomy using an administrative database. OBJECTIVES: To identify the population-based risk of multiple reoperations after lumbar discectomy and to analyze factors associated with the risk. SUMMARY OF BACKGROUND DATA: Although multiple reoperations after initial lumbar discectomy are likely uncommon, research to better understand reasons for and outcomes of reoperations is needed because of the large number of discectomies performed. METHODS: Data on all lumbar spine operations during 1987-1998 were obtained from the Finnish Hospital Discharge Register. The patient's initial disc operation during the study period was linked to subsequent operations, and patients with two or more reoperations were analyzed further. The risk of multiple reoperations was determined using the methods of event history analysis. RESULTS: Among 35,309 patients undergoing an initial discectomy, 4943 (14.0%) had at least one reoperation and 803 (2.3%) had two or more reoperations. A total of 63% of the second reoperations were discectomies, 14% were fusions, and the remaining 23% were decompressions. Patients with one reoperation after lumbar discectomy had a 25.1% cumulative risk of further spinal surgery in a 10-year follow-up. Reduced risk was seen when the first reoperation took place more than 1 year after the initial discectomy (relative risk 0.83, 95% confidence interval 0.72-0.96), in patients for whom the first reoperation had been a fusion (relative risk 0.27, 95% confidence interval 0.12-0.61), and in patients 50-64 years of age (relative risk 0.62, 95% confidence interval 0.48-0.79). CONCLUSION: Patients with one reoperation after lumbar discectomy are at considerable risk of further spinal surgery.

Adult↗

PubMed2003

Comparing the financial risk of bed-day and DRG based pricing types using parametric and simulation methods.

The extent of random financial risk involved in the Finnish bed-day and Diagnosis Related Groups (DRG) based hospital pricing systems were estimated and compared using parametric and simulation methods. DRG based payment schemes were found to provide significantly better protection against financial risk for municipalities, but municipality's size was the main determinant of financial risk. Small municipalities should use longer contracts between hospitals or form bigger purchaser-organisations for risk pooling. In addition, the current risk management system proved to be ineffective in decreasing the random variation in total costs.

Benchmarking↗