Publications by authors named "Lehto J"

Background: After percutaneous coronary intervention (PCI), patients at high bleeding risk (HBR) according to The Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria have increased risk for ischemic complications. The underlying cause is not well documented. The aim of this study was to assess the ischemic risk among ST-elevation myocardial infarction (STEMI) patients classified as HBR according to the ARC-HBR and to identify individual risk factors.

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Objective: Iron supplementation may reduce postoperative anemia, blood transfusions, and infections in patients undergoing surgery. We sought to assess efficacy and safety of prophylactic intravenous iron supplementation in patients without anemia undergoing cardiac surgery.

Methods: In this investigator-initiated industry-sponsored single-center randomized double-blind parallel group trial, we enrolled patients undergoing coronary bypass, aortic or mitral valve or ascending aortic surgery who fulfilled prespecified iron blood test safety criteria.

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Background: Patients with chronic nonmalignant pulmonary disease and lung cancer both need palliative care, but palliative care services may be better adjusted to serve cancer patients. We compared the timing and clinical practice of palliative care and acute hospital usage during the last year of life in patients with nonmalignant pulmonary disease or lung cancer.

Methods: This was a retrospective study of all patients in a palliative care phase (palliative goal of care) with nonmalignant pulmonary disease or lung cancer who were treated at Tampere University Hospital, Finland, during the years 2018-2020.

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Background And Aims: The Academic Research Consortium for High Bleeding Risk Criteria (ARC-HBR) are recommended by guidelines for bleeding risk assessment in ST-elevation myocardial infarction (STEMI). The aim of this study was to identify possible other risk factors and adjust the original ARC-HBR criteria for confounders.

Methods: All consecutive STEMI patients managed in a Finnish tertiary hospital between 2016-2022 were identified using a database search.

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Background: PET imaging of activated microglia has improved our understanding of the pathology behind disability progression in MS, and pro-inflammatory microglia at 'smoldering' lesion rims have been implicated as drivers of disability progression. The P2X R is upregulated in the cellular membranes of activated microglia. A single-tissue dual-input model was applied to quantify P2X R binding in the normal appearing white matter, perilesional areas and thalamus among progressive MS patients, healthy controls and newly diagnosed relapsing MS patients.

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Nutrient-rich product fractions were produced from abundant, yet currently chemically under-utilized nutrients-containing feedstock, residual digestate formed during anaerobic digestion (AD). The objective of this research was to experiment individually three sub-processes, i.e.

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Article Synopsis
  • The study investigates the long-term prognosis of patients suspected of having pulmonary embolism (PE), focusing on various biomarkers' predictive performance.
  • Among 1,001 patients, about 22% were diagnosed with PE, and both groups exhibited a high mortality rate over nearly four years of follow-up.
  • Key findings indicate that elevated NT-proBNP and C-reactive protein levels at hospital admission are linked to higher mortality in PE patients, while several biomarkers also predict mortality in patients without PE, emphasizing the need for careful risk assessment and alternative diagnoses.*
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Background: Integration of palliative care has been shown to be beneficial and is therefore recommended. However, the specific methods for arranging such care remain unclear. Systematic referral and regular visits with a multi-professional palliative care team have appeared most beneficial.

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Background: Health-related quality of life (HRQoL) assessments and estimates of prognosis are needed for comprehensive care and planning of subsequent treatment in patients with idiopathic pulmonary fibrosis (IPF). We investigated HRQoL and its association with survival using a disease-specific tool in patients with IPF.

Methods: The patients were recruited from the real-life FinnishIPF study in 2015.

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Objectives: The primary aim was to investigate if frozen embryo transfer (FET) without a corpus luteum increases the risk of hypertensive disorders of pregnancy (HDP). The secondary aim was to investigate other adverse maternal and perinatal outcomes.

Methods: This was a retrospective cohort study of 1168 singleton pregnancies and live births following a FET with either an artificial cycle (AC-FET) (n = 631) or a natural/modified natural/stimulated cycle (CL-FET) (n = 537) between 2012 and 2020.

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Background: Paramedics are often involved in treating palliative care patients with difficulties regarding symptom control. They report minimal training in palliative care and find decision-making difficult. This often leads to overtreatment and unnecessary transportation to the emergency department.

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Objectives: To compare whether the clinical features of preeclampsia (PE) or gestational hypertension (GH) were different in pregnancies after a frozen embryo transfer (FET), depending on the FET regimen used.

Study Design: A retrospective study including 58 pregnancies with PE and 64 pregnancies with GH, all with singleton live births. Pregnancies were stratified according to the presence or absence of a corpus luteum (CL).

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The primary tumor location (PTL) is associated with the phenotype, metastatic sites, mutations, and outcomes of metastatic colorectal cancer (mCRC) patients, but this has mostly been studied according to sidedness (right vs. left sided). We studied right colon vs.

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Objectives: Cardiac surgery induces systemic inflammatory response syndrome (SIRS), leading to higher morbidity and mortality. There are no individualized predictors for worse outcomes or biomarkers for the multifactorial, excessive inflammatory response. The interest of this study was to evaluate whether a systematic use of the SIRS criteria could be used to predict postoperative outcomes beyond infection and sepsis, and if the development of an exaggerated inflammation response could be observed preoperatively.

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Objective: Patients undergoing heart surgery are at high risk of postoperative fluid accumulation due to long procedures and cardiopulmonary bypass. In the present study, we sought to investigate the prevalence of postoperative fluid accumulation and its relation to adverse events in patients undergoing cardiac surgery.

Methods: CAREBANK is prospective, single-center cohort study focusing on the adverse events after cardiac surgery.

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Patients with mechanical aortic valve replacement (AVR) require lifelong vitamin K antagonist (VKA) therapy for stroke and systemic embolism prevention. However, VKA treatment predisposes patients to various types of bleeding. In the present study, we sought to assess the success of antithrombotic therapy and the occurrence and timing of strokes and bleeding events after mechanical AVR.

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Background: As cancer incidences are increasing, the means to provide effective palliative care (PC) are called for. There is evidence, that PC may prevent futile treatment at the end of life (EOL) thus implicating that PC decreases resource use at the EOL, however, the effects of outpatient PC units remain largely unknown. We surveyed the national use of Finnish tertiary care PC units and their effects on resource use at the EOL in real-life environments.

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Background/aim: Appropriate decision-making is essential for end-of-life (EOL) care without futile therapies. However, these decisions might vary in cases of cancer and other advanced diseases according to physicians' experience, education, and values. This study aimed to compare the decisions in EOL care of advanced cancer and dementia and the factors that influence them in medical students, general practitioners (GPs), and physicians with special competence in palliative medicine (cPM).

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Article Synopsis
  • Research on health-related quality of life (HRQoL) in idiopathic pulmonary fibrosis (IPF) is necessary for improving palliative care, particularly in understanding how dyspnea affects patients over time.
  • A study involving 246 IPF patients revealed that their HRQoL scores were significantly lower than those of the general population, with notable impairment in various dimensions related to daily living activities and breathing, especially in patients experiencing higher levels of dyspnea (MMRC ≥2).
  • Despite a decline in HRQoL scores during follow-up for both dyspnea categories, patients' mental health remained stable, highlighting the need for integrated palliative care to address the complex challenges faced by those with IPF.
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Mouthpiece ventilation (MPV) reduces hypoventilation, but its efficacy in relieving dyspnea in patients with acute chronic obstructive pulmonary disease exacerbation (AECOPD) is unclear. To assess the feasibility of MPV in relieving dyspnea among patients with AECOPD. In this prospective single-arm pilot study, the change in dyspnea on numeric rating scale (NRS) after using MPV and side effects of the treatment were studied in 18 patients with AECOPD.

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Article Synopsis
  • This study aimed to investigate the activation of brain innate immune cells in patients with relapsing-remitting multiple sclerosis who were treated with teriflunomide for six months.
  • Researchers used advanced imaging techniques, including TSPO-PET and MRI, to assess microglial activity, lesion load, and brain volume in 12 patients compared to 12 healthy controls.
  • Results showed that treated patients had slightly higher innate immune cell activation but no significant changes over time, suggesting minimal inflammation related to lesions and highlighting the study's novel approach in using both imaging methods for evaluation.
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The ROR1 receptor tyrosine kinase is expressed in embryonic tissues but is absent in normal adult tissues. ROR1 is of importance in oncogenesis and is overexpressed in several cancers, such as NSCLC. In this study, we evaluated ROR1 expression in NSCLC patients (N = 287) and the cytotoxic effects of a small molecule ROR1 inhibitor (KAN0441571C) in NSCLC cell lines.

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Background: Few patients with chronic nonmalignant pulmonary diseases receive specialist palliative care consultation, despite their high symptom burden in end of life.

Objectives: To study palliative care decision making, survival, and hospital resource usage in patients with nonmalignant pulmonary diseases with or without a specialist palliative care consultation.

Methods: A retrospective chart review of all patients with a chronic nonmalignant pulmonary disease and a palliative care decision (palliative goal of therapy), who were treated in Tampere University Hospital, Finland, between January 1, 2018 and December 31, 2020.

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