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T Tuuponen

Publications and source records attributed to T Tuuponen.

28 records · Page 2Linked to original sources
PubMed1996

Seasonal variation in hospital admissions for chronic obstructive pulmonary disease in Finland.

BACKGROUND: Hospital admissions in general are characterised by a marked seasonal variation. We studied the periodicity in hospital treatment for chronic obstructive pulmonary disease (COPD) in Finland where the unfavourable climate with great climatic differences between summer and winter may play an important role in causing the seasonality in COPD hospitalisation. METHODS: Data by month were obtained for the years 1972-92 from the National Discharge Register, which contains information on patients treated in all hospitals in Finland. The search was concentrated on principal diagnoses conforming to International Classification of Diseases codes 491, 492 and 496. There were 182, 723 admissions of COPD patients aged 55 years or over during the period in question. Time series analysis was carried out on retrospective data over a 21 year period and analysed by two age groups (55-74 years or > 74 years) and gender. The autoregressive integrated moving average (ARIMA) model was used to analyse seasonality. RESULTS: The seasonality pattern showed a peak in winter (13.4% excess mean monthly admissions in January) and a trough in summer (10.0% deficit in below mean monthly admissions in July). This pattern was more prominent in women and in those aged 75 years or over. CONCLUSION: The cold winter together with an increased incidence of respiratory infections may be the most probable cause of the periodicity noted here. Due to the unfavourable northern climate even a greater seasonal variation was expected.

Aged↗
PubMed1993

Trends in hospitalization among asthmatic children in Finland from 1972 to 1986.

Trends in hospitalization among asthmatic children were examined over a period of 15 years on the basis of a hospital discharge register covering all hospitals in Finland. The annual mean population under 15 years of age, 992,994, had a total of 37,965 hospitalization periods on account of asthma during the interval studied. Examination in 5 year age groups showed treatment periods for boys under 5 years to have increased by 1.8% annually relative to the total population (95% confidence interval +0.6(-)+3.1) and those for girls by 22% (95% CI +0.7(-)+3.7), whereas the changes in the older age groups were insignificant. First admissions decreased annually in all age groups in the case of both boys and girls. The numbers of hospitalization periods due to asthma were significantly higher for boys than for girls. The use of hospital services by asthmatic children was appropriate during the period concerned, which may partly be explained by the fact that child health care is well organized in Finland and the treatment of childhood asthma entirely in the hands of paediatricians.

Adolescent↗
PubMed1993

Hospital admissions for asthma in Finland during 1972-86 of adults aged 65 years and over.

The aim of this investigation was to examine the use of hospital services, on account of asthma, among adults aged 65 and over in 1972-86. According to the discharge records maintained by the National Board of Health, asthma caused a total of 710,187 hospitalization days and 62,342 periods of hospital treatment among elderly people during the 15 years concerned. The annual number of hospitalization days per 100,000 persons, standardized for age and sex, was 8438 and that of treatment periods 731. The figures were higher in the case of patients under 75 years than with older age groups, but it was in the oldest age groups that the numbers of treatment periods increased most. The mean duration of a treatment period decreased from 15.4 days to 9.6 days in the course of the 15 years, but became longer with increasing age. The 15 years of consistently recorded data on asthma patients point to an increase in the use of hospital services by elderly people and suggest that the diagnosis and treatment of asthma in this sector of the population will pose a challenge for the health service in the future.

Aged↗
PubMed1993

Regional distribution of asthma-related hospital treatment periods in Finland in 1972-86.

We examined the use of asthma-related hospital services in geographically different areas of Finland in 1972-86, using data obtained from hospital discharge registers. A total of 254,402 cases diagnosed as asthma was identified (diagnosis 493, International Classification of Diseases, 8th Revision), information on the patient's place of residence enabling comparison of the southern, western, eastern, and northern parts of the country. Annual hospitalizations and the occurrence of new cases were calculated relative to the population, the former being found to increase throughout the country during the period studied, the most marked rise being 8.8% in Northern Finland (95% confidence interval 6.4-11.3%), and the smallest, 1.1%, in Western Finland (-0.2 to +2.5). A corresponding trend was also noted in the annual occurrence of new cases, which increased most in Northern Finland, i.e. by 4.8% (3.0-6.6), and decreased in Western Finland by 2.9% (-3.6 to -2.1). The change in asthma and the organization of treatment and factors related to the cold environment may, in combination, contribute to difficulties in the treatment of asthma in Northern Finland.

Asthma↗
PubMed1993

Asthma related hospital treatment in Finland: 1972-86.

BACKGROUND: The number of asthma related treatment periods in hospital has increased in many countries, particularly among children. The aim of the present investigation was to describe the use made of hospital services by asthmatic patients over a wide range in Finland. METHODS: A total of 255,387 treatment periods for asthma that had occurred between 1972 and 1986 was collected from the discharge register maintained by the National Board of Health (diagnosis 493, International Classification of Diseases). The numbers of admissions, days in hospital, and new occurrences of asthma were calculated by sex and age in relation to the total population at the end of each year. RESULTS: Asthma induced treatment periods in hospital in Finland were 12,860 (277 treatment periods per 100,000 inhabitants) in 1972 and 20,000 (406 per 100,000 inhabitants) in 1986. The annual increase in the number of such periods was 4.7% for men (95% confidence interval (95% CI) 3.5 to 5.9%) and 3.4% for women (2.1 to 4.7%) in relation to population. The most pronounced change was found in those aged 65 years and over, in which the number of treatment periods was found to increase annually by 7.5% (6.0 to 9.0%) for men and 4.9% (3.4 to 6.5%) for women, whereas the smallest increase was found among persons under 15 years with an annual change of 1.3% (0.2 to 2.3%) for boys and 1.1% (-0.1 to 2.4%) for girls. Although the number of asthma related treatment periods increased, that of new patients with asthma did not. An average of 114 new male asthmatic patients per 100,000 men were treated in hospitals annually between 1977 and 1986, whereas the figure for women was 115; the annual change during this 10 year period was 0.2% (-0.8 to 1.2%) for men and -0.8% (-1.8 to 0.2%) for women. CONCLUSIONS: The increase in the number of asthma related hospital treatment periods seemed attributable to the frequent treatment of the same patients. Treatment periods for persons aged 40 years or over were found to increase most, suggesting that the treatment of these asthmatic patients should be optimised and its organisation improved.

Adolescent↗
PubMed1986

Bronchial changes in airborne tularemia.

We describe seven typhoidal tularemia patients without ulcers or lymphadenopathy, who underwent diagnostic bronchoscopy. Four patients had had obvious airborne exposure to F. tularensis during farming activities, and the remaining three had respiratory symptoms also. Bronchoscopical findings were pathological in all cases, varying from local to diffuse haemorrhagic inflammation; in one case a granulomatous tumour was seen. Early histopathological changes in three biopsies consisted of haemorrhagic oedema progressing to a non-specific inflammatory reaction, which could still be found 45 days after the onset of symptoms. Granulomatous inflammation, indistinguishable from tuberculosis or sarcoidosis, was seen in four biopsies from two patients, three to seven months after the onset. Most patients had radiographic hilar enlargement. We conclude that transmission of typhoid tularemia usually occurs through inhalation leading to bronchial changes, which correspond skin ulcerations in ulcero-glandular tularemia, the hilar enlargement corresponding to the lymph node component. We emphasize that usage of the term 'typhoidal' tularemia should be discontinued. Instead, tularemia transmitted through inhalation should be called pulmonary or respiratory.

Adult↗
PubMed1983

Pulmonary fibrosis, with sarcoid granulomas and angiitis, associated with handling of mouldy lichen.

We report a case of extrinsic allergic bronchiolo-alveolitis associated with handling of mouldy lichen. The patient had periodic dyspnoea, cough and mucoid sputum, and a micronodular infiltration of both lungs with slight restrictive ventilatory insufficiency. An open lung biopsy showed interstitial inflammation and fibrosis with sarcoid granulomas and angiitis. The symptoms disappeared during long term corticosteroid therapy, but reappeared every year when the patient participated in the handling of lichen (Cladonia alpestris). Precipitating antibodies against Aspergillus fumigatus, A. umbrosus, and Thermoactinomyces vulgaris, were detected in the patient's serum, and against a mixture of fungi including A. terreus, Rhizopus spp., Cladosporium spp., and Penicillium spp., isolated from mouldy lichen storage boxes. After she retired, her symptoms disappeared and the lung function tests showed a slight improvement. In Northern Finland, farmers generally participate in lichen collection. Antigens from mouldy hay and from mouldy lichen may represent a double occupational hazard for them.

Adult↗