Diseases In Finland Research Articles

Diagnoses and prescription patterns among users of medications for obstructive airway diseases in Finland

BackgroundAsthma and chronic obstructive pulmonary disease (COPD) are common diseases mostly treated in primary care. However, the usage patterns of drugs for obstructive airway diseases (R03 drugs) at the national level are not known.ObjectiveThe aims of this study were to describe (1) for which diagnoses each class of R03 drugs were used, (2) the usage pattern of different drug classes for asthma and COPD, and (3) how often these medications were used without a diagnosis of asthma or COPD in Finland.MethodsWe sent questionnaires that included questions on physician-diagnosed asthma and COPD to a random sample of 2000 Finnish subjects who had been dispensed R03 medications in the previous year. Details of R03 medications dispensed were retrieved from national registries.ResultsAltogether, 803 subjects (40.6%) responded. Of these, 61.6% had asthma, 5.7% had both asthma and COPD, 5.1% had COPD, and 27.5% had neither asthma nor COPD. Among subjects with asthma or asthma and COPD, inhaled corticosteroids (ICS) were the most frequently dispensed class of drugs (93.7% and 97.8%, respectively). Even among subjects with COPD, ICS were dispensed as frequently (68.3%) as long-acting bronchodilators (70.7%). Antileukotrienes were dispensed mainly to asthmatic individuals only (18.4%) but far less frequently than ICS. The use of theophylline and roflumilast was rare.ConclusionsR03 medications are dispensed far more frequently for asthma than for COPD and often also for subjects without asthma or COPD. In line with guidelines, asthma is treated mainly with ICS, but there seems to be overuse of ICS for COPD.

Genetic findings of individuals with inherited retinal diseases in Finland

Genetic research can benefit from population isolates like Finland, as they tend to have a high concentration of deleterious alleles on a small number of low‐frequency variants. To investigate gene findings from the patients with inherited retinal disorders (IRD) in Finland, retrospectively collected data from the patients with IRDs treated between January 1st of 2012, and December 31st of 2020 at the Department of Ophthalmology, Helsinki University Hospital. Of the 638 patients that underwent genetic testing, 79% received a likely genetic diagnosis (504/638). The genetic findings corresponded to autosomal recessive (AR) inheritance in 242 patients, X‐linked (XL) in 158, autosomal dominant (AD) in 94, and mitochondrial inheritance in 22 patients. The most common genetic diagnosis was X‐linked retinoschisis as 17% (84/504) harboured pathogenic variants in RS1. The most common retinitis pigmentosa genes with causative variants were CERKL (8.5%, 43/504), RPGR (5.8%, 24/504), and EYS (5%, 25/504). CERKL variant c.375C>G, p.(Cys125Trp) and EYS c.1155T>A, p.(Cys385Ter) are frequent founder mutations. The Stargardt disease is less common than in other Western countries, the pathogenic variants in the ABCA4 gene were found in 24 patients. Pathogenic variants were also found in CHM (26), and CLRN1 (16). The genetic landscape of IRDs in Finland differs from other Western countries due to its specific isolated population history. The high yield of genetic findings is possibly explained by the enriched founder mutations in the population. One‐fifth of the patients are lacking genetic diagnosis, which might be due to shortages in the testing methods, i.e., non‐coding variants and complex structural genomic variants are missing. To address this problem, we have been utilizing the whole genome and long‐read sequencing methods to uncover new pathogenic variants. In two families with IRDs, we have found large structural variants in the RP1 and PRPH2 genes using Nanopore long‐read sequencing. In the future, we try to utilize the advantages of the population isolate to find unknown genes causing IRDs.

Association between food control inspection grades and regional incidence of infectious foodborne diseases in Finland

ABSTRACT We studied regional food control inspection grades and their relation to regional incidence of domestically acquired foodborne diseases (caused by Campylobacter spp. Salmonella spp. enterohemorrhagic Escherichia coli (EHEC), and Listeria monocytogenes) using food control inspection data of local food business operators and infectious disease data from 2014 to 2019 from Finland. We observed that inferior overall inspection grades were associated with increased incidence of Salmonella infections (p=0.02). Specifically, inferior grades on cleanliness of facilities, surfaces, and equipment were associated with increased incidence of Salmonella infections (p=0.04). For this topical inspection area, a high effect size was also seen for Campylobacter infections (p=0.06). Of the individual inspection items, an association between increased incidence of Campylobacter infections and inferior grades on storage of foodstuffs (p=0.01) and verification of hygiene proficiency (p=0.03) was observed. These results suggest that food control recognizes non-compliances that may predispose to foodborne diseases.

‘Small’ data, isolated populations, and new categories of rare diseases in Finland and Poland

Health policy and academic discourses on rare diseases and people with rare conditions frequently employ terms such as ‘low prevalence’ and ‘unique’ to characterize the smallness of the population under consideration and to justify targeted action toward these patient groups. This paper draws from recent anthropological scholarship on smallness and data, ethnographic research in Finland and Poland, as well as document and media analysis to examine how data is utilized in the context of isolated populations that are considered sites of rare diseases in these two countries. Specifically, this paper juxtaposes the notion of Finnish Disease Heritage (FDH) with that of a ‘Kashubian gene’ in Poland. The concept of FDH was developed by Finnish researchers in the 1970s; it encompasses almost forty rare hereditary diseases that are significantly more prevalent in Finland than elsewhere globally. On the other hand, the notion of the ‘Kashubian gene’ was first utilized by the media and some members of the Polish medical community around 2008. Based on ‘unstable’ data gathered during genetic research, the term referred to the high prevalence of a rare metabolic disorder (Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase (LCHAD) deficiency) among Kashubians, an ethnic minority that resides in Northern Poland’s Pomerania region. Whereas FDH facilitated the production and branding of ‘a unique Finnish genetic identity’ (Tupasela 2016b, 61), the notion of the ‘Kashubian gene’ has engendered health policy interventions targeting members of this ethnic minority and has contributed to stigmatizing practices carried out against Kashubians.

Gambling disorder and chronic diseases in Finland: a nationwide register study

Abstract Background Previous register-based studies on comorbidity have mainly focused on gambling disorder (GD) and psychiatric disorders. However, knowledge on somatic health of persons with GD is also needed. This nationwide register-based study aims to examine the gender-specific prevalence rates of chronic diseases and conditions among the Finnish adults with GD. Methods This study utilizes aggregated data of persons aged 18 and over with GD diagnosis (corresponding to pathological gambling, ICD-10; F63.0) in 2011-2020. The data were retrieved from the Finnish nationwide health registers: Register of Primary Health Care visits and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient social care. All diagnostic groups were included. Corresponding figures for the total population with same age range were presented as reference numbers. Results The preliminary results showed that 2,617 persons with the median age of 33.5-36.0 were diagnosed with GD (men n = 1,858; women n = 759). Despite the fact that the prevalence rates of the general population were not age-adjusted, many chronic diseases and conditions were more prevalent among persons with GD compared with the general population. The prevalence rates of psychiatric disorders (87.5% vs 29.2%) and nervous system diseases (23.9% vs 15.2%) were particularly high. Musculoskeletal diseases (61.6% vs 55.8%) and digestive diseases (30.2% vs 27.6%) were also slightly more prevalent. Memory disorders (1.1% vs 5.3%), cardiovascular diseases (25.3% vs 41.0%), and cancer (15.6% vs 24.4%) were less prevalent. Among persons with GD, all comorbid diseases were more prevalent among women than among men. Conclusions Psychiatric disorders and nervous system diseases are exceptionally prevalent in persons with GD. These findings highlight the need for health and social care professionals to recognize that persons with GD may additionally have other disorders that need attention. Key messages • Mental disorders are the most common comorbidity among persons with GD, however, many somatic chronic diseases are also common. • Comorbidities are more common among women with GD than among men with GD.

The impact of the COVID-19 pandemic on incident cases of chronic diseases in Finland.

The COVID-19 pandemic has caused changes in the availability and use of health services, and disruptions have been reported in chronic disease management. We aimed to study the impact of the pandemic on the incidence of chronic diseases in Finland using register-based data. Incident cases of chronic diseases decreased, except cases of anxiety disorders. The annual reductions ranged from 5% in cases of cancers to over 16% in cases of type 2 diabetes. These findings may be due to diagnostic delays and highlight the importance to ensuring access to health care and the continuity of care in all circumstances.

Overview of Control Programs for Cattle Diseases in Finland

Animal disease control has a long tradition in Finland. The country is free of all EU-regulated cattle diseases of categories A and B. Infectious bovine rhinotracheitis, enzootic bovine leucosis, bovine viral diarrhea, bluetongue, bovine genital campylobacteriosis, and trichomoniasis do not currently exist in the country. The prevalence of paratuberculosis, Mycoplasma bovis, salmonella infection, and Q-fever is low. The geographic location, cold climate, low cattle density, and limited animal imports have contributed to the favorable disease situation. Besides screening for selected regulated diseases, the national disease-monitoring program includes periodic active monitoring of non-regulated diseases, which allows assessment of the need for new control measures. The detection of diseases through efficient passive surveillance also plays an important part in disease monitoring. The Finnish cattle population totals 850,000 animals kept on 9,300 cattle farms, with 62,000 suckler cows in 2,100 herds and 260,000 dairy cows in 6,300 herds. Animal Health ETT, an association owned by the dairy and meat industry, keeps a centralized cattle health care register. Animal Health ETT supervises cattle imports and trade within the country and runs voluntary control programs (CP) for selected diseases. Active cooperation between authorities, the cattle industry, Animal Health ETT, and herd health experts enables the efficient planning and implementation of CPs. CPs have been implemented for cattle diseases such as salmonella, Mycoplasma bovis, ringworm, and Streptococcus agalactiae. The CP for salmonellosis is compulsory and includes all Salmonella serotypes and all cattle types. It has achieved the goal of keeping the salmonella prevalence under 1% of cattle herds. CPs for M. bovis, ringworm, and S. agalactiae are on a voluntary basis and privately funded. The CP for Mycoplasma was designed in collaboration with national experts and has been implemented since 2013. The CP includes observation of clinical signs, nasal swab sampling from calves, and bulk tank milk and clinical mastitis samples for M. bovis. M. bovis-negative herds gradually achieve lower status levels for M. bovis infection. The general challenge facing voluntary CPs is getting farms to join the programs.

Trends in occupational diseases in Finland, 1975–2013: a register study

ObjectivesThe objective was to investigate trends in the incidence of recognized and suspected cases of occupational diseases in Finland from 1975 to 2013, including variations by industry – and describe...

Incidence of inflammatory joint diseases in Finland: results from a population-based epidemiological study

The objective of the study was to assess the incidence of inflammatory joint diseases and possible environmental factors contributing to their occurrence in a defined population in Finland. All rheumatologists practising in the Northern Savo rheumatological outpatient departments collected data on their newly diagnosed patients with an inflammatory joint disease in 2010. Antibodies to Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) were determined from patients with various arthritides. The incidence of all arthritis cases was 141.8/100,000 (95% CI 126.1-159.1). Eighty-six patients, 43 men and 43 women, satisfied the ACR/Eular 2010 classification criteria for rheumatoid arthritis (RA) yielding an annual incidence of 41.6/100,000 (33.3-51.4), 42.5 (30.8-57.3) for men and 40.8 (29.9-56.1) for women. The incidence of chronic spondyloarthritides was 36.3 (28.6-45.5), reactive arthritis 7.8 (4.4-12.6), undifferentiated arthritis 38.7 (30.7-48.2), and crystalline arthritis 15.0 (10.2-21.3). Immunoglobulin A (IgA) antibody levels to Pg were higher among men, patients with anti-cyclic citrullinated peptide antibodies (ACPA) or missing teeth and AaIgA antibody levels in patients with missing teeth. In RA, 67 % of men and 35% of women had a smoking history, p=0.012. There was no difference between the genders in the incidence of RA, which might be explained by a higher carriage of periodontal bacteria and a higher smoking rate among men. In other disease categories, the incidences were comparable to those earlier reported. By influencing behavioral and environmental factors, it might be possible to reduce the burden of ACPA-positive RA.

The risk of colorectal cancer in patients with inflammatory bowel diseases in Finland: A follow-up of 20 years

Background and aimsData on the relative risk of colorectal cancer in inflammatory bowel diseases (IBD) are inconsistent. To prevent the development of cancer, endoscopic facilities should be targeted correctly. We report here the results of a 20-year follow-up in Finland and evaluate the efficacy of endoscopic surveillance in cancer prevention. MethodsThe data were based on an IBD register in our catchment area in 1986–2007. The population-based cohort comprised 1915 patients, 1254 with ulcerative colitis, 550 with Crohn's disease and 111 with inflammatory bowel unclassified. Colorectal cancer cases were obtained from the IBD register; the colorectal cancer figures in the respective population were obtained from the Finnish Cancer Registry. ResultsColorectal cancer was found in 21 patients, the standardized incidence ratio (SIR) being 1.83 (95% confidence interval (CI) 1.13–2.79) for IBD. Colorectal cancer risk was 3.09 (CI 1.50–5.75) for extensive UC, and 3.62 (CI 2.00–11.87) for Crohn's disease affecting the colon. Eleven (52%) of the colorectal cancer cases were TNM stage 3 or 4. In the same observation period 10 colectomies with ileoanal anastomosis were performed with the indication of cancer risk in ulcerative colitis; of these 10 patients only two had no additional risk factors for colorectal cancer, for example primary sclerosing cholangitis, pseudopolyposis or active disease. ConclusionsThe risk of colorectal cancer in the cohort was only moderately increased. In the absence of additional risk factors, endoscopic surveillance was of limited benefit. We therefore suggest intensive endoscopy surveillance to be targeted on patients with definite risk factors.

Global Estimates of Fatal Work-Related Diseases by Region and Disease Group, 2002

Work-related and occupational diseases are multifactorial diseases among the working population that have a heavy impact on workers, enterprises, and society. We calculated estimates for 2002, using global regional estimates of disease mortality, and adjusted attributable fractions produced for work-related diseases in Finland. The estimated number of fatal work-related diseases is about 2 million worldwide. The most common fatal work-related disease groups are cancers (25%), circulatory diseases (21%), and communicable diseases (28%). Though estimates of fatal work-related diseases have some limitations, they are needed for prevention.

The epidemiology of inflammatory bowel diseases in Finland

Objective. There is evidence that the incidence of inflammatory bowel diseases is increasing, but the data are inconsistent. For appropriate allocation of health care resources, knowledge of the actual occurrence of diseases is important. We here conducted an epidemiological survey using a population-based register in a well-defined area representative of the whole Finnish population. Material and methods. The collection of cases took place in 1986–1999 in the Tampere region, which comprised 363,000 adults in 1999. All municipal centers detecting and managing inflammatory bowel diseases participated in the study. Particular effort was made to register all cases. Results. The total number of patients was 1691. The prevalence per 100,000 inhabitants in 1986 was 119 for ulcerative colitis (UC), 40 for Crohn's disease (CD) and 9 for inflammatory bowel disease unclassified (IBDU); in 1999 the respective figures were 291, 124 and 27. During the study period, the annual incidence of UC increased from 13.3 to 19.6 per 100,000, and that of CD from 5.0 to 9.4, whereas the incidence of IBDU decreased from 1.2 to 0.3. The extent of the diseases remained by and large unaltered over the time of survey. Conclusions. An increasing trend was observed in the number of patients with inflammatory bowel disease, and the frequency was higher than that reported in most surveys. This increase constitutes a challenge for the health care system.

Scientific rationale for the Finnish Allergy Programme 2008–2018: emphasis on prevention and endorsing tolerance

In similarity to many other western countries, the burden of allergic diseases in Finland is high. Studies worldwide have shown that an environment rich in microbes in early life reduces the subsequent risk of developing allergic diseases. Along with urbanization, such exposure has dramatically reduced, both in terms of diversity and quantity. Continuous stimulation of the immune system by environmental saprophytes via the skin, respiratory tract and gut appears to be necessary for activation of the regulatory network including regulatory T-cells and dendritic cells. Substantial evidence now shows that the balance between allergy and tolerance is dependent on regulatory T-cells. Tolerance induced by allergen-specific regulatory T-cells appears to be the normal immunological response to allergens in non atopic healthy individuals. Healthy subjects have an intact functional allergen-specific regulatory T-cell response, which in allergic subjects is impaired. Evidence on this exists with respect to atopic dermatitis, contact dermatitis, allergic rhinitis and asthma. Restoration of impaired allergen-specific regulatory T-cell response and tolerance induction has furthermore been demonstrated during allergen-specific subcutaneous and sublingual immunotherapy and is crucial for good therapeutic outcome. However, tolerance can also be strengthened unspecifically by simple means, e.g. by consuming farm milk and spending time in nature. Results so far obtained from animal models indicate that it is possible to restore tolerance by administering the allergen in certain circumstances both locally and systemically. It has become increasingly clear that continuous exposure to microbial antigens as well as allergens in foodstuffs and the environment is decisive, and excessive antigen avoidance can be harmful and weaken or even prevent the development of regulatory mechanisms. Success in the Finnish Asthma Programme was an encouraging example of how it is possible to reduce both the costs and morbidity of asthma. The time, in the wake of the Asthma Programme, is now opportune for a national allergy programme, particularly as in the past few years, fundamentally more essential data on tolerance and its mechanisms have been published. In this review, the scientific rationale for the Finnish Allergy Programme 2008-2018 is outlined. The focus is on tolerance and how to endorse tolerance at the population level.

The emergence of cereal fungal diseases and the incidence of leaf spot diseases in Finland

Fungal plant pathogens causing cereal diseases in Finland have been studied by a literature survey, and a field survey of cereal leaf spot diseases conducted in 2009. Fifty-seven cereal fungal diseases have been identified in Finland. The first available references on different cereal fungal pathogens were published in 1868 and the most recent reports are on the emergence of Ramularia collo-cygni and Fusarium langsethiae in 2001. The incidence of cereal leaf spot diseases has increased during the last 40 years. Based on the field survey done in 2009 in Finland, Pyrenophora teres was present in 86%, Cochliobolus sativus in 90% and Rhynchosporium secalis in 52% of the investigated barley fields. Mycosphaerella graminicola was identified for the first time in Finnish spring wheat fields, being present in 6% of the studied fields. Stagonospora nodorum was present in 98% and Pyrenophora tritici-repentis in 94% of spring wheat fields. Oat fields had the fewest fungal diseases. Pyrenophora chaetomioides was present in 63% and Cochliobolus sativus in 25% of the oat fields studied.;

Communicable disease policy development in response to changing European political frontiers in Finland, Norway and Sweden

The European Union (EU) enlargement of 2004 brings both opportunities and challenges for public health. It is believed that further integration will bring direct health benefits, mainly through improved socioeconomic conditions, but there are also risks associated with the EU expansion, in particular cross-border health risks, such as the impact of the internal EU market policy of free movement and migration on communicable disease patterns. Against this background, this article examines communicable disease policy development in Finland, Norway and Sweden in response to changing European political frontiers, in particular the EU accession of the Baltic States. The emphasis is on HIV/AIDS and tuberculosis. The study is based on a qualitative and quantitative approach, using two complementary methods: documentary analysis and stakeholder analysis. The article identifies a distinct pattern in communicable disease policy development between 1990 and 2005. The turn of the new millennium saw a sharp increase in national attention and the priority assigned to communicable diseases in Finland, Norway and Sweden. The article argues that this development is likely to be related to the rising national, regional and European awareness of the public health challenges associated with communicable diseases in today's borderless Europe. It also shows that the Baltic health situation is a particular concern for Finland. Although there is increasing national and regional activity within the communicable disease area, there is a need for a more effective European approach to tackle the future communicable disease challenges that may follow in an increasingly interdependent and integrated Europe.

Hereditary urea cycle diseases in Finland

To estimate the incidence of urea cycle diseases (UCDs) in Finland and determine the course of the various disorders as well as the outcome. The original data were collected in the years 1998-2001. The diagnoses made after 2001, as well as the current status of the patients, were updated by surveys in the spring of 2007. We found a total of 55 cases of UCDs in Finland by 2007: 30 cases of ornithine transcarbamylase (OTC) deficiency, 20 of argininosuccinate lyase (ASL) deficiency, 3 of carbamyl phosphate synthetase (CPS-I) deficiency, 1 of type 1 citrullinaemia and 1 of argininaemia. The estimated total incidence of UCDs was 1:39 000. The incidences of individual disorders were: OTC deficiency 1:62 000, ASL deficiency 1:144 000, CPS deficiency 1:539 000 and citrullinaemia 1:1 616 000. Eighteen (33%) of the patients with a diagnosis of UCD have died, most during their first hyperammonaemic crisis. One patient with OTC deficiency has had a liver transplant. Neurological symptoms of varying severity are common among these patients, particularly those with ASL deficiency. The first survey on the incidence of UCDs in Finland shows some differences in the occurrence rates compared to other countries. Hyperammonaemia, and the neurological symptoms caused by it, can be avoided in most patients with late-onset UCDs with a standard treatment. However, in patients with ASL deficiency, the development of neurological symptoms seems to be inevitable in spite of careful treatment and avoidance of hyperammonaemia.

Global estimates of fatal work‐related diseases

Work-related mortality is a relatively new concept which aims to widen occupational health and safety; to take into account not only recognized fatal occupational accidents and diseases but also other work-related deaths. Few countries in the world have a register for work-related diseases. Estimates are calculated using baseline world mortality scenarios of all diseases for the year 2000 and attributable fractions made for work-related diseases in Finland, as adjusted. It is estimated that about 2 million work-related deaths take place annually. Men suffer two thirds of those deaths. The biggest groups of work-related diseases are cancers, circulatory diseases and communicable diseases. Information about work-related diseases is needed for prevention, as people in developed countries are working longer, and the age of retirement is being raised in many countries. As a result, workers are being exposed to different kinds of substances and working conditions for a longer time. In developing countries, work exposures may already start in infancy. Due to industrialization, workers in developing countries are facing new conditions with a lack of relevant knowledge and skills. With the help of information, nations can direct resources and skills for appropriate purposes such as regulatory measures on health and safety at work.

What lies behind relief and worsening of asthma symptoms? A register-based study of adults with asthma and other chronic obstructive pulmonary diseases in Finland

To examine how subjects with relief or worsening of asthma symptoms differ in terms of gender, age, severity and duration of asthma, comorbidity, and difficulties with medication and daily life. A postal inquiry among a sample of 6000 adults with clinically diagnosed asthma and/or other chronic obstructive pulmonary diseases. Relief of asthma symptoms over a 12-month period was associated with a recent asthma diagnosis, within five years, in both sexes. Lack of current smoking and lack of problems in using anti-asthmatic treatment were associated with a positive outcome in men, and mild asthma and living alone associated with a positive outcome in women. Severe and moderate asthma predicted worse symptoms in both sexes, as did other obstructive pulmonary diseases, living alone, and medication problems amongst men. Patients with asthma should be cared for comprehensively, requiring consideration of both clinical and psychosocial factors that can modify the course of the disease.

Subpopulation difference scanning: a strategy for exclusion mapping of susceptibility genes

Background: Association mapping is a common strategy for finding disease-related genes in complex disorders. Different association study designs exist, such as case-control studies or admixture mapping. Methods: We propose a...

Costs of Work-Related Musculoskeletal Disorders (MSDs) in Developing Countries: Colombia Case

The real burden of occupational diseases, specifically work-related musculoskeletal disorders (MSDs), and its impact on workers’ productivity is not known. The situation is critical in developing countries where only cases that cause workers’ disability are recorded. In this study, the incidence of MSDs in Colombia was estimated by using the age and gender specific double incidence rate of repetitive strain injuries diseases in Finland for 2002. The results showed that the estimated number of MSDs recorded in Colombia during 2005 was 23,477 cases at the rate of 11.6 cases per 10,000 workers. The estimated total cost of these MSD cases relative to workers’ productivity was US $171.7 million, representing around 0.2% of Colombia’s Gross Domestic Product for 2005. The systematic appraisal of the incidence of MSDs and their associated cost on workers’ productivity are necessary in developing countries to reduce the costly impact on productivity and to increase workers’ well-being.