Publications by authors named "Kalle Mattila"

18 Publications

  • Page 1 of 1

A three-feature prediction model for metastasis-free survival after surgery of localized clear cell renal cell carcinoma.

Sci Rep 2021 Apr 21;11(1):8650. Epub 2021 Apr 21.

Department of Oncology and Radiotherapy, Fican West Cancer Centre, University of Turku and Turku University Hospital, Hämeentie 11, Post Box 52, 20521, Turku, Finland.

After surgery of localized renal cell carcinoma, over 20% of the patients will develop distant metastases. Our aim was to develop an easy-to-use prognostic model for predicting metastasis-free survival after radical or partial nephrectomy of localized clear cell RCC. Model training was performed on 196 patients. Right-censored metastasis-free survival was analysed using LASSO-regularized Cox regression, which identified three key prediction features. The model was validated in an external cohort of 714 patients. 55 (28%) and 134 (19%) patients developed distant metastases during the median postoperative follow-up of 6.3 years (interquartile range 3.4-8.6) and 5.4 years (4.0-7.6) in the training and validation cohort, respectively. Patients were stratified into clinically meaningful risk categories using only three features: tumor size, tumor grade and microvascular invasion, and a representative nomogram and a visual prediction surface were constructed using these features in Cox proportional hazards model. Concordance indices in the training and validation cohorts were 0.755 ± 0.029 and 0.836 ± 0.015 for our novel model, which were comparable to the C-indices of the original Leibovich prediction model (0.734 ± 0.035 and 0.848 ± 0.017, respectively). Thus, the presented model retains high accuracy while requiring only three features that are routinely collected and widely available.
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http://dx.doi.org/10.1038/s41598-021-88177-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060273PMC
April 2021

Kinetic analysis and optimisation of F-rhPSMA-7.3 PET imaging of prostate cancer.

Eur J Nucl Med Mol Imaging 2021 Apr 12. Epub 2021 Apr 12.

Clinical Research Services Turku - CRST Ltd, Turku, Finland.

Purpose: This phase 1 open-label study evaluated the uptake kinetics of a novel theranostic PET radiopharmaceutical, F-rhPSMA-7.3, to optimise its use for imaging of prostate cancer.

Methods: Nine men, three with high-risk localised prostate cancer, three with treatment-naïve hormone-sensitive metastatic disease and three with castration-resistant metastatic disease, underwent dynamic 45-min PET scanning of a target area immediately post-injection of 300 MBq F-rhPSMA-7.3, followed by two whole-body PET/CT scans acquired from 60 and 90 min post-injection. Volumes of interest (VoIs) corresponding to prostate cancer lesions and reference tissues were recorded. Standardised uptake values (SUV) and lesion-to-reference ratios were calculated for 3 time frames: 35-45, 60-88 and 90-118 min. Net influx rates (K) were calculated using Patlak plots.

Results: Altogether, 44 lesions from the target area were identified. Optimal visual lesion detection started 60 min post-injection. The F-rhPSMA-7.3 signal from prostate cancer lesions increased over time, while reference tissue signals remained stable or decreased. The mean (SD) SUV (g/mL) at the 3 time frames were 8.4 (5.6), 10.1 (7) and 10.6 (7.5), respectively, for prostate lesions, 11.2 (4.3), 13 (4.8) and 14 (5.2) for lymph node metastases, and 4.6 (2.6), 5.7 (3.1) and 6.4 (3.5) for bone metastases. The mean (SD) lesion-to-reference ratio increases from the earliest to the 2 later time frames were 40% (10) and 59% (9), respectively, for the prostate, 65% (27) and 125% (47) for metastatic lymph nodes and 25% (19) and 32% (30) for bone lesions. Patlak plots from lesion VoIs signified almost irreversible uptake kinetics. K, SUV and lesion-to-reference ratio estimates showed good agreement.

Conclusion: F-rhPSMA-7.3 uptake in prostate cancer lesions was high. Lesion-to-background ratios increased over time, with optimal visual detection starting from 60 min post-injection. Thus, F-rhPSMA-7.3 emerges as a very promising PET radiopharmaceutical for diagnostic imaging of prostate cancer.

Trial Registration: NCT03995888 (24 June 2019).
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http://dx.doi.org/10.1007/s00259-021-05346-8DOI Listing
April 2021

Inflammatory bowel disease-related economic costs due to presenteeism and absenteeism.

Scand J Gastroenterol 2021 Jun 7;56(6):687-692. Epub 2021 Apr 7.

Department of Internal Medicine, Turku University Hospital, University of Turku, Turku, Finland.

Background: Inflammatory bowel disease (IBD), consisting of Crohn's disease and ulcerative colitis, can be a lifelong burden generating high costs to an economic system. Data regarding the cost of workplace presenteeism and absenteeism in workers with IBD are limited. Our objective was to assess these costs in employed adults.

Methods: A structured questionnaire, hospital records and national registers were combined to assess the economic costs involved with workplace presenteeism and absenteeism in employed patients. Our final sample comprised 320 IBD patients. The costs were calculated as productivity-loss costs by using a Human Capital Approach.

Results: Due to IBD, the mean annual economic costs of workplace presenteeism were €643.90/patient, and mean annual absenteeism costs were €740.90/patient. Women had higher costs (€955/patient/year) from absenteeism compared to men (€531/patient/year) especially when working blue-collar jobs. These findings were also evident in presenteeism. CD and UC patients had similar total costs due to presenteeism and absenteeism. The use of biologics did not have a major impact on these costs.

Conclusion: IBD patients had moderate economic costs from workplace presenteeism and absenteeism. Interestingly, women, working blue-collar jobs, had higher costs than men.
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http://dx.doi.org/10.1080/00365521.2021.1908416DOI Listing
June 2021

Teaching limited compression ultrasound to general practitioners reduces referrals of suspected DVT to a hospital: a retrospective cross-sectional study.

Ultrasound J 2021 Feb 2;13(1). Epub 2021 Feb 2.

Emergency Department, South Savo Central Hospital, Mikkeli, Finland.

Background: The aim of this study was to retrospectively determine whether teaching limited compression ultrasound (LCUS) to general practitioners (GP) would reduce the number of patients with a suspected lower extremity DVT referred to a hospital for ultrasound (US) examination. According to the current literature, an LCUS protocol is a safe way to diagnose or exclude lower extremity deep venous thrombosis (DVT) and a good option to radiologist-performed whole-leg ultrasound (US), especially in remote health care units where there may be a limited availability of radiological services.

Methods: Between 2015 and 2016, altogether 13 GPs working in the same primary care unit were trained in LCUS for DVT diagnostics. The number of annual referrals due to a suspected DVT from Saarikka primary care unit to the closest hospital was evaluated before and after training. The incidence of DVT was considered to be constant. Thus, the reduction of referrals was attributed to the fact that these patients were diagnosed and treated in primary health care. Incidence rate ratio of hospital referrals was calculated. As a measure of safety, all patients diagnosed with a pulmonary embolism in the nearest hospital were evaluated to determine if they had undergone LCUS by a GP in primary care.

Results: Before training in 2014, there were 60 annual referrals due to a suspected DVT; in 2017, after training, the number was reduced to 16, i.e., a 73.3% decrease. The incidence of referrals decreased from 3.21 to 0.89 per 1000 person-years. (IRR 3.58, 95% CI 2.04-6.66, p < 0.001). No patient with a pulmonary embolism diagnosis had LCUS performed previously, indicating that there were no false negatives, resulting in pulmonary embolism.

Conclusions: Teaching LCUS to GPs can safely reduce the number of patients with a suspected DVT referred to a hospital substantially.
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http://dx.doi.org/10.1186/s13089-021-00204-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851247PMC
February 2021

Is there a role for lumbar puncture in early detection of subarachnoid hemorrhage after negative head CT?

Intern Emerg Med 2019 04 24;14(3):451-457. Epub 2018 Nov 24.

Emergency Department, Turku University Hospital, Turku, Finland.

To investigate the role of lumbar puncture (LP) after a negative head computed tomography (CT) when ruling out subarachnoid hemorrhage (SAH) within 24 h of symptom onset. In a single-center, retrospective cohort study, we studied a consecutive series of patients from 2011 to 2015. All patients underwent CT or CT following LP to rule out SAH. Patients were categorized into four groups depending on the time of symptom onset to initial head CT: 0-6 h, 6-12 h, 12-24 h, and over 24 h. Experienced radiologists interpreted all CT scans. We investigated the sensitivity, specificity, and negative predictive value (NPV) of noncontrast CT in detecting SAH. Of 539 patients with suspected SAH and negative CT, 280 (51.9%) had their CT performed within 24 h of symptom onset. None of these patients had SAH. Five (1.9%) out of 259 patients with CT performed after 24 h of symptom onset had SAH diagnosed, and two turned out to be aneurysmal. When CT was performed within 24 h of symptom onset it had a sensitivity of 100% (95% CI 95-100%), specificity of 98% (95% CI 96-99.7%), and NPV of 100% (95% CI 98-100%) in detecting SAH. Modern CT scanners seem to have high sensitivity and specificity in the diagnosis of SAH when performed within 24 h of symptom onset. Beyond this point, CT seems to lack sensitivity and further investigation with LP is required.
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http://dx.doi.org/10.1007/s11739-018-1982-zDOI Listing
April 2019

Long-term Survival of Stage IV Melanoma Patients Treated with BOLD Combination Chemotherapy and Intermediate-dose Subcutaneous Interferon-alpha.

Anticancer Res 2018 Nov;38(11):6393-6397

Department of Oncology and Radiotherapy, University of Turku and Turku University Hospital and FICAN West Cancer Centre, Turku, Finland.

Background: Immune checkpoint and serine/threonine-protein kinase inhibitors have become a standard of care for advanced cutaneous melanoma, but dacarbazine-based chemotherapies are occasionally used. This study assessed the long-term efficacy of chemoimmunotherapy (bleomycin, vincristine, lomustine and dacarbazine with/without subcutaneous interferon-alpha: BOLD-INF-α) as real-world data in patients with metastatic melanoma not eligible for clinical trials.

Patients And Methods: Medical data of 146 patients with stage IV melanoma who had received BOLD/BOLD-INFα regimen during 1991-2010 were analyzed.

Results: The median overall survival was 8.9 months (95% confidence intervaI=7.5-10.4 months). The 1-year survival rate was 36%, 2-year 18%, and 5-year 13%. The 5-year survival rates in the M1a, M1b and M1c subgroups were 28%, 10% and 6%, respectively. Overall, 7% (n=11) of the patients were alive at the end of the follow-up.

Conclusion: Our study showed similar overall survival among patients with stage IV cutaneous melanoma treated with BOLD/BOLD-INFα as noted previously with chemotherapy.
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http://dx.doi.org/10.21873/anticanres.12999DOI Listing
November 2018

The Finnish Prehospital Stroke Scale Detects Thrombectomy and Thrombolysis Candidates-A Propensity Score-Matched Study.

J Stroke Cerebrovasc Dis 2018 Mar 21;27(3):771-777. Epub 2017 Nov 21.

Emergency Division, Tampere University and Tampere University Hospital.

Background: Prehospital stroke triage is challenged by endovascular treatment for large vessel occlusion (LVO) being available only in major stroke centers. Conjugate eye deviation (CED) is closely related to LVO, whereas common stroke signs (face-arm-leg-speech-visual) screen stroke. We hypothesized that combining CED with common stroke signs would yield a prehospital stroke scale for identifying both LVO and stroke in general.

Methods And Results: We retrospectively analyzed consecutive patients (n = 856) with prehospital Code Stroke (recanalization candidate). The National Institutes of Health Stroke Scale (NIHSS) and computed tomography were administered to patients on arrival. Computed tomography angiography was performed on patients with NIHSS score of 8 or greater and considered to benefit from endovascular treatment. With random forest analysis and deviance analysis of the general linear model we confirmed the superiority of the NIHSS "Best Gaze" over other NIHSS items in detecting LVO. Based on this and commonly used stroke signs we presented the Finnish Prehospital Stroke Scale (FPSS) including dichotomized face drooping, extremity weakness, speech difficulty, visual disturbance, and CED. FPSS detected LVO with a sensitivity of 54%, specificity of 91%, positive predictive value of 48%, negative predictive value of 93%, and likelihood ratio of 6.2.

Conclusions: Based on CED and universally used stroke signs, FPSS recognizes stroke in general and additionally, LVO as a stroke subtype comparably to other scales intended to detect LVO only. As the FPSS items are dichotomized, it is likely to be easy for emergency medical services to implement.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.10.015DOI Listing
March 2018

Emergency medicine residents in the implementation of thrombolysis for acute ischemic stroke.

Duodecim 2016;132(24):2342-48

Background: Traditionally, neurologists have been in charge of thrombolytic treatment of ischemic stroke. In 2013, emergency medicine residents started working in the frontline at the Central Hospital of Central Finland (CHCF). They were trained to evaluate and give thrombolytic treatment to acute ischemic stroke patients out of hours, with the possibility of consulting a neurologist.

Matherials And Methods: Retrospective study of acute stroke patients in CHCF, who received thrombolytic therapy during 2012 and 2014. In 2012 thrombolytic treatment was initiated by neurologists only, In 2014 emergency medicine registrars initiated thrombolytic therapy out of hours.

Results: The annual number of tissue plasminogen activator treatment (tPA) increased and door-to needle time significantly decreased from 2012 to 2014. There were no significant differences in complications and overall functional capacity at 3 months.

Conclusions: This study indicated that training of emergency medicine physicians to give thrombolytic treatment to acute ischemic stroke is feasible and may shorten in-hospital delays.
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January 2018

Influence of rheumatoid arthritis-related morning stiffness on productivity at work: results from a survey in 11 European countries.

Rheumatol Int 2015 Nov 26;35(11):1791-7. Epub 2015 May 26.

Department of Public Health, University of Turku, Turku, Finland.

The objective of this study was to evaluate the influence of morning stiffness on productivity at work and to estimate the work-related economic consequences of morning stiffness among patients with RA-related morning stiffness in 11 European countries. The original sample comprised 1061 RA patients from 11 European countries (Belgium, Denmark, Finland, France, Germany, Italy, Norway, Poland, Spain, Sweden and UK). They had been diagnosed with RA and experience morning stiffness three or more times per week. Data were collected by interviews. Women comprised 77.9 % of the sample, the average age was 50.4 years, and 84.3 % had RA diagnosed for more than 2 years. Overall costs of RA-related morning stiffness was calculated to be 27,712€ per patient per year, varying from 4965€ in Spain to 66,706€ in Norway. On average, 96 % of the overall production losses were attributed to early retirement, with a markedly lower level (77 %) in Italy than in other countries (p < 0.0001). The proportion of patients who reported retirement due to morning stiffness and productivity losses due to late work arrivals and working while sick showed considerable variation across the countries represented in the study. Overall, the average annual cost of late arrivals (0.8 % of the total costs) was approximately half of the costs attributed to sick leave (1.7 %) and working while sick (1.5 %). Morning stiffness due to RA causes significant production losses and is a significant cost burden throughout Europe. There seem to be notable differences in the impact of morning stiffness on productivity between European countries.
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http://dx.doi.org/10.1007/s00296-015-3275-4DOI Listing
November 2015

Influence of Psoriasis on Household Chores and Time Spent on Skin Care at Home: A Questionnaire Study.

Dermatol Ther (Heidelb) 2015 Jun 5;5(2):107-16. Epub 2015 May 5.

Department of Dermatology, Turku University Hospital and University of Turku, Turku, Finland,

Introduction: Previous studies have shown that psoriasis has a significant effect on patients' health-related quality of life. The impact of psoriasis on household chores and the need for assistance with such tasks are not well documented. The aim of this study was to estimate the impact of psoriasis on the ability to carry out household chores, the time spent on skin care at home and the assistance that patients with psoriasis require with these activities.

Methods: In a questionnaire study 262 patients with moderate-to-severe psoriasis, visiting a tertiary level dermatological clinic during a 1-year study period, listed household chores which they considered were particularly affected by psoriasis. This was done without a predefined list of chores. Questions on their ability to perform household chores as well as time spent on skin care at home were asked. The need for outside assistance with household chores and help received were also determined.

Results: More than half of the patients (57.8%) reported difficulties with household chores because of psoriasis. Psoriasis affected a wide range of everyday household activities, with physically demanding tasks and those involving contact with water mentioned most often. Most of the patients (84.6%) reported that they have increased the time spent on skin care because of psoriasis, on average by 87 min per week. A quarter of patients received assistance in household chores. Women received more assistance than men (p < 0.01). The need for additional assistance was reported by a fifth of patients, women more often than men (p < 0.05).

Conclusion: When estimating the overall burden of psoriasis, considering only the economic and productivity consequences may underestimate the impact of the disease. The impact on everyday life events such as the ability to perform household chores should also be taken into account.

Funding: This study was supported by unconditional grants from the research funds of the Hospital District of Southwest Finland. Hospital District of Southwest Finland's research permission K44/10/EVO13043.
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http://dx.doi.org/10.1007/s13555-015-0076-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470958PMC
June 2015

How much of the productivity losses among psoriasis patients are due to psoriasis.

BMC Health Serv Res 2015 Mar 4;15:87. Epub 2015 Mar 4.

Department of Public Health, University of Turku and Primary Health Care Unit, Hospital District of Southwest Finland, Turku, Finland.

Background: In previous studies, productivity losses have been measured specifically due to psoriasis or generally due to health problems in psoriasis patients. There is no information on the proportion of health related productivity losses that are due to psoriasis. The aim of this study was to estimate the proportion of productivity losses due to psoriasis and due to other medical problems among employed psoriasis patients.

Methods: Patients visiting a tertiary level dermatological clinic during a one-year period due to psoriasis or psoriasis arthritis, who were employed, were selected to the study. A questionnaire was used to assess productivity losses during the previous month.

Results: Psoriasis accounted for 38% of the total lost productivity costs. One fifth of patients had been on sick leave (absenteeism) due to psoriasis and a third of patients worked despite being sick with psoriasis (presenteeism). Men had higher costs of presenteeism, but the costs of absenteeism due to psoriasis were lower for men than for women.

Conclusions: Productivity losses should be assessed disease specifically to avoid overestimations of the role of the disease on indirect costs. Our study shows that about a third of the lost productivity costs are due to psoriasis.
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http://dx.doi.org/10.1186/s12913-015-0752-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352284PMC
March 2015

Treatment costs of psoriasis in a tertiary-level clinic.

BMC Health Serv Res 2014 Aug 15;14:344. Epub 2014 Aug 15.

Department of Dermatology, Turku University Hospital and University of Turku, Turku, Finland.

Background: The costs of psoriasis to a tertiary-level clinic vary considerably depending on the country of study and methods used. Hospitalisation and phototherapy have been significant cost components. This study was performed to estimate the distribution and relative magnitude of the costs of psoriasis to a tertiary-level clinic.

Methods: Based on 233 patients, outpatient and phototherapy visits and the days hospitalised were collected from the treatment provider's records. The visit costs represented true costs, used to charge the final payers. Patients were analysed according to their treatment modalities.

Results: On average, hospitalised patients (3.4%) had 31-fold higher total costs than non-hospitalised patients (p < 0.0001). The costs of hospitalisations formed 45% of all the treatment costs to the entire study population. Phototherapy accumulated 19% of the overall treatment costs. Patients receiving biological drugs or both phototherapy and traditional systemic therapy had the highest costs of treatment.

Conclusions: The current study indicates that a small percentage of all psoriasis patients generate a large proportion of the overall costs to a tertiary-level hospital. Treatment modality has a significant effect on the costs to a tertiary-level hospital.
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http://dx.doi.org/10.1186/1472-6963-14-344DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141106PMC
August 2014

Impact of morning stiffness on working behaviour and performance in people with rheumatoid arthritis.

Rheumatol Int 2014 Dec 29;34(12):1751-8. Epub 2014 May 29.

Department of Public Health, University of Turku, Lemminkäisenkatu 1, 20014, Turku, Finland,

Work disability remains a considerable problem for many patients with rheumatoid arthritis (RA). Morning stiffness is a symptom of RA associated with early retirement from work and with impaired functional ability. We aimed to explore the patient's perception of the impact of morning stiffness on the working life of patients with RA. A survey was conducted in 11 European countries. Patients of working age, with RA for ≥6 months and morning stiffness ≥3 mornings a week, were interviewed by telephone using a structured questionnaire. Responses were assessed in the total sample and in subgroups defined by severity and duration of morning stiffness and by country. A total of 1,061 respondents completed the survey, 534 were working, 224 were retired and the rest were, i.e. homemakers and unemployed. Among the 534 working respondents, RA-related morning stiffness affected work performance (47 %), resulted in late arrival at work (33 %) and required sick leave in the past month (15 %). Of the 224 retired respondents, 159 (71 %) stopped working earlier than their expected retirement age, with 64 % giving RA-related morning stiffness as a reason. There was a differential impact of increasing severity and increasing duration of morning stiffness on the various parameters studied. There were notable inter-country differences in the impact of RA-related morning stiffness on ability to work and on retirement. This large survey showed that from the patient's perspective, morning stiffness reduces the ability to work in patients with RA and contributes to early retirement.
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http://dx.doi.org/10.1007/s00296-014-3040-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237915PMC
December 2014

Perceived impact of psoriasis on leisure-time activities.

Eur J Dermatol 2014 Mar-Apr;24(2):224-8

Department of Public Health, University of Turku and Primary Health Care Unit, Hospital District of Southwest Finland, Lemminkäisenkatu 1, PO BOX 20014, Turku, Finland.

Background: Psoriasis has an influence on various aspects of patients' everyday life. When estimating the total burden of the disease, the influence on leisure-time should also be taken into account.

Objectives: To evaluate the perceived impact of psoriasis on leisure-time activities.

Material And Methods: The questionnaire study was based on 262 patients with psoriasis. The patients were asked to list their leisure-time activities, any activities they had reduced or given up completely because of psoriasis, the time spent on current leisure-time activities and the time they would have spent in a hypothetical situation if they did not have psoriasis. Using a visual analogue scale (VAS) of 0-100, the patients assessed how well they could currently perform their leisure-time activities and how well in a hypothetical situation without psoriasis. The difference between the VAS scores depicted the level of disadvantage caused by psoriasis.

Results: More than half the patients (51.9%) had reduced or completely given up at least one leisure-time activity. The disadvantage score (VAS) of psoriasis was 16.9. Younger age was associated with higher disadvantage (r = 0.154, p<0.05). Sports activities were completely given up by 30.2% and reduced by 23.7%. Social activities and those which could be expected to cause embarrassment were given up by 29.0% and reduced by 21.4% of the patients.

Conclusion: A majority of patients with psoriasis reduce or give up leisure-time activities because of their condition, so the influence of psoriasis on leisure-time is considerable.
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http://dx.doi.org/10.1684/ejd.2014.2282DOI Listing
July 2015

The costs of psoriasis medications.

Dermatol Ther (Heidelb) 2013 Dec 13;3(2):169-77. Epub 2013 Dec 13.

Department of Dermatology, Turku University Hospital, University of Turku, Lemminkäisenkatu 1, 20014, Turku, Finland,

Introduction: Psoriasis is a chronic disease, which contributes to the economic burden on health care. The distribution of psoriasis medication costs and the quality of life in these patients has been estimated to be around 20% of total costs.

Objectives: To estimate the economic distribution of medications and the impact of multiple treatment options on a patient's quality of life.

Materials And Methods: The study was based on 236 Finnish psoriasis patients. The Finnish Social Insurance Institution had databases for all psoriasis related medications purchased. Each purchase, during the 1-year study period (1 October 2009-30 September 2010), was recorded and analyzed. The dermatological quality-of-life index was collected from the medical records.

Results: Total medication costs were 1,083 per year per patient. Topical treatments were the most often purchased medication and they comprised 18% of the total medication costs. Ten percent of the patients needed 3 or more medication changes during the 1-year study period. Biologics were used only by 5% of patients, but they produced 67% of total medication costs. Patients needing various treatments had higher medication costs and a poorer quality of life.

Conclusion: A small number of patients generated a great sum of medication costs partly due to the need to change medications. These patients had the worst quality-of-life index scores. Biologics formed a major cost component.
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http://dx.doi.org/10.1007/s13555-013-0040-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3889304PMC
December 2013

Influence of psoriasis on work.

Eur J Dermatol 2013 Apr;23(2):208-11

Department of Dermatology, Turku University Hospital, University of Turku, Lemminkäisenkatu 1, 20014 University of Turku, Turku, Finland.

Background: Previous research indicates that psoriasis has an impact on early retirement, sick leave days and reduced work performance.

Objectives: To evaluate the disadvantages at work caused by psoriasis.

Material And Methods: The sample was based on patients visiting the dermatology outpatient clinic in Turku University Hospital. 262 returned a mailed questionnaire. The subjects were asked how many hours they were on a sick leave (absenteeism) and working while sick (presenteeism) due to psoriasis and other health reasons.

Results: Of the retired, 17.0% felt they were retired due to psoriasis. Those in the active work force reported on average 4.5 hours absenteeism and 8.3 hours of presenteeism due to psoriasis during the last 4 weeks. Psoriasis caused 27.0% of the total absenteeism and 39.0% of presenteeism. More than a quarter (28.9%) had been forced to modify their work due to psoriasis, most frequently to make the work less irritating for the skin.

Conclusion: Psoriasis has a negative effect on patients' work in many ways, causing early retirement from work, sick leave days, change of occupation and work modifications.
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http://dx.doi.org/10.1684/ejd.2013.1969DOI Listing
April 2013

Perceived disadvantages caused by low back pain.

J Rehabil Med 2011 Jul;43(8):684-8

Department of Physical and Rehabilitation Medicine, Turku University Hospital, Turku, Finland.

Objective: To evaluate the perceived disadvantages caused by low back pain in work, household chores and leisure-time activities, as expressed by patients themselves.

Design And Subjects: Structured telephone interviews, carried out among a sample of 39 physician referrals (29 women and 10 men) for non-specific chronic low back pain to University Hospital, Turku, covered how low back pain affected their daily living, with separate sections for work, household chores and leisure time. Disadvantages in daily activities were measured using numeric rating scales (0-100). The differences between scores for ability to perform with low back pain and for expected performance if the subject did not have low back pain were used to depict the disadvantage in each activity.

Results: Men reported a greater disadvantage than women in work, household chores and leisure-time activities. The ability to perform in any of the 3 daily activities was associated with an ability to perform in the others. Good performance at work was reported by 81.0% of the women and 42.9% of the men. Because of low back pain, leisure-time activities had been reduced by 82.1% of the patients and, out of them, 64.1% had completely given up at least one leisure-time activity.

Conclusion: When estimating the overall burden of low back pain, the measure of work-related loss of productivity should be complemented by measures of performance in household chores and limitations to leisure-time activities. To depict extensively the burden to the patients, such measures should be based on the activities the patients consider important. These are best determined by using the phrasings and expressions the patients themselves use.
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http://dx.doi.org/10.2340/16501977-0835DOI Listing
July 2011