Publications by authors named "T Nieminen"

321 Publications

Non-invasive home telemonitoring in patients with decompensated heart failure: a systematic review and meta-analysis.

ESC Heart Fail 2021 Jun 24. Epub 2021 Jun 24.

Päijät-Häme Joint Authority for Health and Well-being, Lahti, Finland.

We planned this systematic review and meta-analysis to study an estimate of the effect of non-invasive home telemonitoring (TM) in the treatment of patients with recently decompensated heart failure (HF). A systematic literature search was conducted in the Medline, Cinahl, and Scopus databases to look for randomized controlled studies comparing TM with standard care in the treatment of patients with recently decompensated HF. The main outcomes of interest were all-cause hospitalizations and mortality. Eleven original articles met our eligibility criteria. The pooled estimate of the relative risk of all-cause hospitalization in the TM group compared with standard care was 0.95 (95% CI 0.84-1.08, P = 0.43) and the relative risk of all-cause death was 0.83 (95% CI 0.63-1.09, P = 0.17). There was significant clinical heterogeneity among primary studies. HF medication could be directly altered in three study interventions, and two of these had a statistically significant effect on all-cause hospitalizations. The pooled effect estimate of TM interventions on all-cause hospitalizations and all-cause death in patients with recently decompensated heart failure was neutral.
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http://dx.doi.org/10.1002/ehf2.13475DOI Listing
June 2021

RSV Specific Antibodies in Pregnant Women and Subsequent Risk of RSV Hospitalization in Young Infants.

J Infect Dis 2021 Jun 15. Epub 2021 Jun 15.

Helsinki University Hospital and University of Helsinki, Children's Hospital, Helsinki, Finland.

Background: The fusion (F) glycoprotein of respiratory syncytial virus (RSV) represents the major neutralizing antigen, and antibodies against the pre-F conformation have the most potent neutralizing activity. This study aimed to assess the correlation between maternal antibody (Ab) titers against the pre-F, post-F and G glycoproteins and the child's risk of developing severe RSV bronchiolitis early in infancy.

Methods: We identified previously healthy term infants less than 3 months of age hospitalized with RSV bronchiolitis from December 2015 to March 2016. We measured IgG Ab titers to pre-F, post-F, and G proteins in maternal sera obtained at 9-12 weeks of pregnancy of these hospitalized infants' mothers (n=94) and compared them with serum Ab titers of control pregnant mothers (n=130), whose children were not hospitalized.

Results: All maternal samples (n= 224) had detectable pre-F Abs. Pre-F Ab titers were significantly lower in mothers whose infants were hospitalized with RSV bronchiolitis compared with those mothers whose infants were not (23.9 [1.4-273.7] vs 30.6 [3.4-220.0] ug/l; p=0.0026). There were no significant differences in maternal post-F and G Ab titers between hospitalized versus non-hospitalized infants.

Conclusions: Our findings indicate that maternal pre-F antibodies are fundamental for providing immune protection to the infant.
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http://dx.doi.org/10.1093/infdis/jiab315DOI Listing
June 2021

Clinical characteristics and evaluation of the incidence of cryptococcosis in Finland 2004-2018.

Infect Dis (Lond) 2021 Sep 11;53(9):684-690. Epub 2021 May 11.

HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Background: Cryptococcosis is one of the major causes of mortality among HIV patients worldwide. Though most often associated with late stage HIV infection/AIDS, a significant number of cases occur in other immunocompromised patients such as solid organ transplant recipients and patients with hematological malignancies. Immunocompromised patients are a heterogeneous group and their number increases constantly. Since little is known about the incidence and the clinical features of cryptococcosis in Northern Europe, our aim was to investigate the clinical characteristics of cryptococcosis patients in Finland.

Methods: We retrospectively reviewed the laboratory confirmed cryptococcosis cases in Finland during 2004-2018. Only those who were treated for cryptococcosis were included in the study. Initial laboratory findings and medical records were also collected.

Results: A total of 22 patients with cryptococcosis were included in our study. The annual incidence of cryptococcosis was 0.03 cases per 100,000 population. Ten patients were HIV-positive and 12 out of 22 were HIV-negative. Hematological malignancy was the most common underlying condition among HIV-negative patients.

Conclusions: To our knowledge, this is the first study of the clinical presentation and incidence of cryptococcosis in Finland. We demonstrate that invasive cryptococcal infection occurs not only in HIV/AIDS patients or otherwise immunocompromised patients but also in immunocompetent individuals. Even though cryptococcosis is extremely rare in Finland, its recognition is important since the prognosis depends on rapid diagnostics and early antifungal therapy.
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http://dx.doi.org/10.1080/23744235.2021.1922753DOI Listing
September 2021

Hydroxychloroquine reduces interleukin-6 levels after myocardial infarction: The randomized, double-blind, placebo-controlled OXI pilot trial.

Int J Cardiol 2021 Aug 4;337:21-27. Epub 2021 May 4.

Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland. Electronic address:

Objectives: To determine the anti-inflammatory effect and safety of hydroxychloroquine after acute myocardial infarction.

Method: In this multicenter, double-blind, placebo-controlled OXI trial, 125 myocardial infarction patients were randomized at a median of 43 h after hospitalization to receive hydroxychloroquine 300 mg (n = 64) or placebo (n = 61) once daily for 6 months and, followed for an average of 32 months. Laboratory values were measured at baseline, 1, 6, and 12 months.

Results: The levels of interleukin-6 (IL-6) were comparable at baseline between study groups (p = 0.18). At six months, the IL-6 levels were lower in the hydroxychloroquine group (p = 0.042, between groups), and in the on-treatment analysis, the difference at this time point was even more pronounced (p = 0.019, respectively). The high-sensitivity C-reactive protein levels did not differ significantly between study groups at any time points. Eleven patients in the hydroxychloroquine group and four in the placebo group had adverse events leading to interruption or withdrawal of study medication, none of which was serious (p = 0.10, between groups).

Conclusions: In patients with myocardial infarction, hydroxychloroquine reduced IL-6 levels significantly more than did placebo without causing any clinically significant adverse events. A larger randomized clinical trial is warranted to prove the potential ability of hydroxychloroquine to reduce cardiovascular endpoints after myocardial infarction.
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http://dx.doi.org/10.1016/j.ijcard.2021.04.062DOI Listing
August 2021

Feasibility of preoperative adrenalectomy risk score in center with low operation-specific volume.

Minerva Surg 2021 May 4. Epub 2021 May 4.

Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.

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http://dx.doi.org/10.23736/S2724-5691.21.08892-4DOI Listing
May 2021