Biomedical subjects

E Taimela

Publications and source records attributed to E Taimela.

9 recordsLinked to original sources

PubMed2004

The generic 15D instrument is valid and feasible for measuring health related quality of life in Parkinson's disease.

OBJECTIVES: To test the validity and feasibility of the generic 15D health related quality of life (HRQoL) instrument in Parkinson's disease (PD) and compare parkinsonian patients with the general population. Much effort has gone into developing disease specific HRQoL measures for PD, but only generic measures allow comparisons with the general population. New HRQoL tools are needed for PD because earlier ones have low feasibility in elderly patients. METHODS: The study comprised 260 patients with idiopathic PD and age and sex matched controls. HRQoL was evaluated using the disease specific questionnaire PDQ-39 and the 15D generic instrument. PD severity was assessed by Hoehn and Yahr staging, and the activities of daily living (ADL) and motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). RESULTS: The mean 15D score (scale 0-1; overall HRQoL) was lower in PD (0.77) than in controls (0.86). Patients with PD had significantly lower scores than controls in 13 of the 15 dimensions of 15D. Scores of the corresponding dimensions of PDQ-39 and 15D correlated significantly, confirming the convergent validity of 15D. In multiple stepwise regression analysis, the UPDRS ADL score explained 55% of the variation in the 15D score. CONCLUSIONS: 15D is a valid, feasible, and sensitive tool to assess quality of life in PD. PD has a major impact on HRQoL, which is related to disease progression. Mobility, eating, speech, and sexual functions are most affected. The ADL measure of the UPDRS and the 15D provide an easily assessable view of HRQoL in PD.

Aged↗

PubMed2003

Economic burden and quality of life impairment increase with severity of PD.

PURPOSE: To define the interrelationship between cost-of-illness, quality of life (QoL) and Parkinson's disease (PD) severity in a common patient management setting in Finland.Scope. Two hundred and sixty consecutive outpatients with idiopathic PD participated. UPDRS, motor fluctuations, QoL, and the use of health care resources were measured. Direct and indirect costs were calculated. CONCLUSIONS: There is a strong relationship between QoL or cost-of-illness on the one hand, and severity of PD on the other. Treatment policies capable of reducing or delaying motor fluctuations would be expected to increase QoL and reduce some of the economic burden of PD.

Aged↗

PubMed1997

Reference intervals for serum thyrotropin, free thyroxine and free triiodothyronine in healthy adults in Finland, measured by an immunoautomate based on time-resolved fluorescence (AutoDELFIA).

We have established reference intervals for healthy adults of serum thyrotropin, free thyroxine and free triiodothyronine using the AutoDELFIA (Wallac, Finland) automatic measuring device. The determination of reference intervals in a proper manner is costly, and many laboratories adopt reference ranges from the literature rather than determining them alone. This is the first report on reference values in thyroidology where this automatic system based on time-resolved fluorescence has been used. The reference intervals for thyrotropin, free thyroxine and free triiodothyronine were 0.6-4.3 mIU/l, 9.6-17.1 pmol/l and 4.3-7.5 pmol/l, respectively.

Adult↗

PubMed1995

Third generation time-resolved immunofluorometric TSH assay for automatic immunoassay system evaluated.

We evaluated a new, third generation assay for serum thyrotropin (TSH) based on time-resolved fluorescence (AutoDelfia hTSH Ultra) for the 1235 AutoDelfia automatic immunoassay system. The functional sensitivity of the TSH assay was 0.007 mIU l-1 (between-assay CV, 20%). The between-assay imprecision was CV 4.1-7.7%, between TSH concentrations of 0.026 and 23.8 mIU l-1. The within-assay imprecision was CV 1.2-1.5% between TSH concentrations of 0.5 and 12 mIU l-1. The degree of agreement between the AutoDelfia hTSH Ultra assay and a second generation TSH-IRMA was studied. The mean difference was -0.04 (SD 0.28) mIU l-1 at concentrations between 0.22 and 52 mIU l-1. Serum TSH concentrations of euthyroid subjects, hypothyroid and hyperthyroid patients as well as those of patients with non-thyroidal illness, and thyroid carcinoma patients with TSH suppressive thyroxine treatment were analysed. The AutoDelfia automatic immunoassay system offers many benefits in sensitivity, precision, speed, output rate, time and convenience. Overnight runs are possible, and the system is easy to operate.

Fluorescence Polarization Immunoassay↗

PubMed1995

Free thyroid hormones and a third-generation TSH assay in the detection of hyperthyroidism during long-term thyroxine treatment in thyroid carcinoma patients.

We evaluated the value of serum-free thyroid hormone and thyrotropin (TSH) concentrations in the detection of peripheral hyperthyroidism during thyroxine suppression therapy. A total of 57 patients on a stable thyroxine dose and 70 controls participated in the study. Serum-free thyroxine (FT4), free triiodothyronine (FT3) and TSH were measured by immunoassays based on time-resolved fluorescence (Delfia). The assay for TSH was a modification of a third generation Delfia hTSH Ultra method. The patients were classified into euthyroid and hyperthyroid subgroups based on clinical signs and symptoms (Wayne index). Systolic time intervals (STI) were measured. The Wayne indices were higher among patients than controls (p < 0.0001). The STI results were similar in patients and controls. Only FT4 had the discriminatory power for classifying euthyroid and hyperthyroid patients according to discriminant analyses. The diagnostic value of FT4 was further assessed by calculating the area under the relative operating characteristic (ROC) curve. The area was 0.707 (SE 0.0918), which was significantly different from an area of 0.5, i.e. the area of a test of no value (p = 0.032). In conclusion, a high serum FT4 concentration indicates hyperthyroidism during long-term thyroxine treatment among thyroid carcinoma patients. Although the degree of TSH suppression can now be exactly monitored with new third generation TSH assays, hyperthyroidism cannot be defined using TSH concentration in thyroid carcinoma patients. Therefore, additional serum FT4 concentration assays are needed in the assessment of hyperthyroidism associated with TSH suppression therapy in thyroid carcinoma patients.

Adult↗

PubMed1994

Accelerated bone degradation in thyroid carcinoma patients during thyroxine treatment, measured by determination of the carboxyterminal telopeptide region of type I collagen in serum.

We studied the effects of long-term suppressive thyroxine treatment on serum markers of bone collagen synthesis and degradation in thyroid carcinoma patients, and the relationship of these effects to the serum concentrations of thyrotropin, free thyroxine and free triiodothyronine were investigated. Thirty-seven thyroid carcinoma patients receiving a stable thyroxine dose, and thirty-five controls participated in a cross-sectional study. Bone collagen synthesis and degradation were measured by using specific radioimmunoassays to determine the serum concentrations of carboxyterminal propeptide of type I procollagen, and carboxyterminal telopeptide region of type I collagen, respectively. Serum thyrotropin, free T4 and free T3 were measured by time-resolved fluoroimmunoassays (Delfia). Serum carboxyterminal telopeptide region of type I collagen concentrations of thyroid carcinoma patients were significantly higher than those of the controls (p = 0.0012). Serum carboxyterminal propeptide of type I procollagen concentrations did not differ significantly between the patients and controls (p = 0.85). Significant associations between age or physical activity, and carboxyterminal propeptide of type I procollagen or carboxyterminal telopeptide region of type I collagen were found in the controls, but not in the patients. Thyrotropin, free T4 or free T3 were not significantly associated with carboxyterminal propeptide of type I procollagen or carboxyterminal telopeptide region of type I collagen in either the control or patient group. From these results it is concluded that long-term suppressive thyroxine treatment seems to accelerate bone degradation, but not bone formation, and therefore carries a risk for osteoporosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Time-resolved immunofluorometric assay for thyrotropin improved for enhanced functional sensitivity and clinical discrimination.

Modification of a new commercial time-resolved immunofluorometric assay for thyrotropin (DelfiaR hTSH Ultra) by prediluting samples, reducing tracer concentration, and increasing total reaction volume offered improved functional sensitivity of 0.005 mIU l-1 (20% between-assay CV) over the functional sensitivity limit of 0.014 mIU l-1 of the unmodified TSH assay. Serum TSH concentrations of 50 hyperthyroid patients and 24 clinically euthyroid patients with serum TSH < 0.1 mIU l-1 by a second generation immunoradiometric assay were analysed by both the original and modified TSH-IFMA method. The discrimination was better with the modified method, according to ROC-analysis (p = 0.027). In conclusion, these modifications enhanced functional sensitivity and improved the discriminatory power of the assay in separating hyperthyroid patients from euthyroid subjects with low TSH concentrations.

Adolescent↗

PubMed1994

Ability of two new thyrotropin (TSH) assays to separate hyperthyroid patients from euthyroid patients with low TSH.

We evaluated the ability of new thyrotropin (TSH) assays to separate hyperthyroid (n = 50) patients from clinically euthyroid subjects with low TSH values (nodular goiter, n = 20, and nonthyroidal illness, n = 22). Only patients whose serum TSH was < 0.1 mIU/L by immunoradiometric assay were included. We used a new immunofluorometric method based on time-resolved fluorescence (TR-IFMA) and a new immunochemiluminometric assay (ICMA) to measure TSH in serum. Although the differences between the hyperthyroid patients and the euthyroid patients differed from each other by both methods (P = 0.0012 for TR-IFMA and P < 0.0001 for ICMA), there was no cutoff point that could definitely separate the groups. Thus, it is not possible to draw any definite conclusions on whether a patient is hyperthyroid or not, solely on the basis of TSH concentration measured with these new TSH assays.

Adult↗

PubMed1993

Clinical and laboratory studies of time-resolved fluorescence immunoassays of thyrotropin and free triiodothyronine.

We evaluated a new time-resolved immunofluorometric assay (TR-IFMA) for thyrotropin (TSH) and a time-resolved fluoroimmunoassay (TR-FIA) for free triiodothyronine (FT3) in serum. Delfia hTSH Ultra is a solid-phase two-site TR-IFMA involving three monoclonal antibodies directed against different antigenic sites on the human TSH molecule. It offers improved analytical (+3 SD of zero) and functional (10% between-assay CV) detection limits of 0.001 and 0.016 mlU/L, respectively. Results of the assay agreed closely with those of a second-generation immunoradiometric assay (TSH-IRMA) for samples with TSH > 0.2 mlU/L (n = 114). The nonparametric reference interval for TSH in euthyroid men and women was 0.5-4.7 mlU/L (n = 200). The TSH concentrations of hyperthyroid subjects (n = 29) were < 0.016 mlU/L (median; range < 0.016-0.063 mlU/L). The Delfia FT3 assay, a solid-phase TR-FIA, is based on the back-titration principle and second-antibody separation. The parametric reference interval for FT3 in euthyroid men and women was 4.2-7.6 pmol/L (n = 320). The FT3 concentration in hyperthyroidism (n = 29) was 23 +/- 22 pmol/L (mean +/- SD; range 7.9-85 pmol/L). These methods offered rapid results (2-4 h for the whole procedure) and were simple to run.

Adult↗