Olli-Pekka Alho

Malignant epithelial salivary gland tumors in northern Finland: incidence and clinical characteristics

Abstract A population-based survey was conducted in Northern Finland to evaluate the incidence rate as well as the patient and tumor characteristics of malignant epithelial salivary gland tumors diagnosed between 1988 and 1998. A total of 40 new cases of malignant epithelial salivary gland tumors were diagnosed and separately evaluated. The age-standardized incidence rates (per 100,000 years) were 0.51 among men and 0.35 among women, giving an overall incidence rate of 0.43. About half of the patients suffered from pain, which was the most common symptom along with palpable resistance, but the duration of symptoms varied widely (median: 11 months). Of all the malignant epithelial salivary gland tumors analyzed in our study, fine-needle aspiration cytology correctly indicated malignancy in only 28% of the cases.

Effect of antimicrobial treatment of acute otitis media on the daily disappearance of middle ear effusion: a placebo-controlled trial.

IMPORTANCE Antimicrobial treatment reduces the symptoms of acute otitis media (AOM). The effect of antimicrobial treatment on the duration of middle ear effusion (MEE) and concomitant hearing impairment is not known. OBJECTIVE To determine whether the antimicrobial treatment of AOM reduces the duration of MEE. DESIGN, SETTING, AND PARTICIPANTS This randomized, double-blind, placebo-controlled trial involved a total of 84 children with AOM between 6 months and 15 years of age. Participants were recruited from September 14, 1999, to January 4, 2000; October 10, 2005, to December 16, 2005; and September 22, 2009, to June 4, 2012, from among children attending an AOM prevention trial and children visiting local outpatient clinics in Oulu, Finland. INTERVENTIONS Children were randomly allocated to receive either 40 mg/kg of amoxicillin-clavulanate or a placebo mixture per day for 7 days. MAIN OUTCOMES AND MEASURES The primary outcome measure was the time to the disappearance of MEE as defined by a normal tympanogram finding (A curve) from both ears on 2 consecutive measurement days. Parents performed daily tympanometry at home. The study physician performed tympanometry and otoscopy at study entry, after 3 and 7 days, and then weekly until both ears were healthy. The main secondary outcome measures were the time to normal otoscopy findings and the proportion of children without persistent MEE at 14 days and 2 months. RESULTS Middle ear effusion disappeared 2.0 weeks (13.7 days) earlier (P = .02) in the antimicrobial group (mean time, 2.7 weeks; 95% CI, 1.7-3.7) than in the placebo group (4.7 weeks; 95% CI, 3.6-5.7). Normal otoscopy findings were observed 1.4 weeks sooner in the antimicrobial group than in the placebo group (P = .02). On day 14, 69% of children in the antimicrobial group and 38% in the placebo group had normal tympanometry findings (number needed to treat, 3.2; 95% CI, 2.0-10.5). On day 60, 2 children (5%) in the antimicrobial group and 10 children (24%) in the placebo group had persistent MEE (P = .01). CONCLUSIONS AND RELEVANCE Antimicrobial treatment effectively reduced the duration of MEE and possible concomitant hearing impairment in children with AOM. Antimicrobial treatment also reduced the risk for persistent MEE. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01244581.

Predictive factors for quality of life after tonsillectomy among adults with recurrent pharyngitis: a prospective cohort study

To assess health‐related quality of life (QoL) and clinical factors predicting it after tonsillectomy among adult patients with recurrent pharyngitis.

Diagnostic accuracy of history and physical examination in bacterial acute rhinosinusitis

To evaluate the diagnostic accuracy of symptoms, the symptom progression pattern, and clinical signs in identifying bacterial acute rhinosinusitis (ARS).

Characteristics and medical-care-seeking of head and neck cancer patients: a population-based cross-sectional survey.

OBJECTIVES Well-known risk factors, such as smoking and alcohol consumption, easily denounce head and neck cancer patients as smokers, alcohol abusers, and persons who are socially excluded and have low socioeconomic status. To diagnose these patients as early as possible, we should not have a prejudiced assumption of their characteristics. MATERIALS AND METHODS We collected detailed data on patient characteristics and health behavior and explored whether these traits had any effect on seeking medical advice in a population-based cross-sectional study involving 85 patients with head and neck cancer diagnosed between January 2003 and December 2007, residing in two health care districts (population 1,600,000) in Finland. The data were gathered from patient charts and questionnaires. The questionnaire data were compared with the general population in Finland. RESULTS We found these patients to be ordinary elderly people whose demographic and social features resembled those of the general population. They smoked more often, but otherwise had a rather healthy lifestyle. Only half were aware that smoking and alcohol consumption were risk factors of head and neck cancer. In a multivariate analysis, fear of physicians (adjusted odds ratio 11.0; 95% confidence interval 1.2-103), medical-care-seeking for symptoms other than pain (18.5; 2.2-156), and not suspecting cancer (11.2; 1.7-75.1) were independent risk factors for delayed consultation (combined appraisal and help-seeking interval over 3 months). CONCLUSION Head and neck cancer patients deviated from the same-aged general population only in excessive smoking. Fear of doctors, having no pain, and no suspicion of cancer resulted in delayed medical-care-seeking.

Accurate measurement of respiratory airflow waveforms using depth data

Respiratory disorders are a very common and growing health problem. Signal waveforms of respiratory airflow and volume may indicate pathological signs of several diseases and, thus, it would be important to measure them accurately. Currently, devices used in respiration measurements are mostly obtrusive in nature interfering with the natural respiration patterns. We used a depth camera for the continuous measurement of respiratory function without contact on a subject. We propose a novel calibration method which enables accurate estimates of the respiratory airflow waveforms from the depth camera data. Eight subjects were measured with the depth camera and spirometer at the same time using different breathing styles. Results show that not only the respiratory volume and respiratory rate (RR) can be computed precisely from the estimated respiratory airflow, but also the respiratory airflow waveforms are very accurate. This offers interesting opportunities, e.g. in pulmonary and critical care medicine, when objective measurements are required.

Inflammatory Biomarkers During Bacterial Acute Rhinosinusitis

Purpose of ReviewDiagnosis of bacterial acute rhinosinusitis is difficult. Several attempts have been made to clarify the diagnostic criteria. Inflammatory biomarkers are easily obtainable variables that could shed light on both the pathophysiology and diagnosis of bacterial acute rhinosinusitis. The purpose of this review article is to assess literature concerning the course of inflammatory biomarkers during acute rhinosinusitis and the use of inflammatory biomarkers in diagnosing bacterial acute rhinosinusitis.Recent FindingsWe included C-reactive protein, erythrocyte sedimentation rate, white blood cell counts, procalcitonin, and nasal nitric oxide in this review and found that especially elevated C-reactive protein and erythrocyte sedimentation rate are related to a higher probability of a bacterial cause of acute rhinosinusitis. Still, normal levels of these two biomarkers are quite common as well, or the levels can be heightened even during viral respiratory infection without suspicion of bacterial involvement.SummaryElevated levels of C-reactive protein or erythrocyte sedimentation rate support diagnosis of bacterial acute rhinosinusitis, but due to a lack of sensitivity, they should not be used to screen patients for bacterial acute rhinosinusitis.

Respiratory Effort Belts in Postoperative Respiratory Monitoring: Pilot Study with Different Patients

Respiratory complications are common in patients after the general anaesthesia. Respiratory depression often occurs in association with postoperative opioid analgesia. Currently, there is a need for a continuous non-invasive respiratory monitoring of spontaneously breathing postoperative patients. We used calibrated respiratory effort belts for the respiratory monitoring pre- and postoperatively. Used calibration method enables accurate estimates of the respiratory airflow waveforms. Five different patients were measured with the spirometer and respiratory effort belts at the same time. Preoperative measurements were done in the operating room just before the operation, whereas postoperative measurements were done in the recovery room after the operation. We compared three calibration models pre- and postoperatively. Postoperative calibration produced more accurate respiratory airflows. Results show that not only the tidal volume, minute volume and respiratory rate can be computed precisely from the estimated respiratory airflow, but also the respiratory airflow waveforms are very accurate. The method produced accurate estimates even from the following challenging respiratory signals: low airflows, COPD, hypopneic events and thoracoabdominal asynchrony. The presented method is able to produce estimates of postoperative respiratory airflow waveforms to enable accurate, continuous, non-invasive respiratory monitoring postoperatively.