Publications by authors named "Mikael Koskela"

Article Synopsis
  • Childhood cancer treatments can lead to long-term health issues and earlier death, particularly in male survivors who received conventional therapies from 1964 to 2000.
  • A study involving 200 male childhood cancer survivors (CCS) and 1,000 matched controls found that CCS experienced higher rates of hospital admissions for cardiovascular diseases and increased mortality after age 40.
  • Specific treatments, like heart radiation, were linked to significant health risks, while most survivors did not show excessive use of certain mental health medications, highlighting the importance of ongoing health monitoring for these individuals.
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Background: Childhood cancer therapy may cause subfertility. This study correlated cancer therapy exposures with testicular volumes from puberty to adulthood, spermatogenesis, and paternity outcomes in adulthood.

Methods: The study population comprised 255 male childhood cancer survivors (CCS) (survival ≥5 years, diagnosed in 1964-2000 at the Helsinki Children's Hospital) whose testicular volume was measured at ages 12 years (n = 38), 14 years (n = 57), 16 years (n = 63), 18 years (n = 105), and in adulthood (n = 43; median age, 27 years).

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The aim of this study was to identify pitfalls in ovarian tissue cryopreservation protocol from referral to surgical procedure and to analyze factors associated with chemotherapy exposure of the cryopreserved tissue and decreased ovarian function in a cohort of young girls at high risk of infertility. The study population comprised 200 girls eligible for ovarian tissue cryopreservation between 2002 and 2020 at the Children's Hospital of the University Central Hospital of Helsinki (Finland). Analyses included evaluation of the proportion of patients who underwent ovarian tissue cryopreservation, factors associated with patient selection and timing of ovarian tissue cryopreservation, and ovarian function during long-term follow-up in relation to oncological treatments.

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Background: Testicular volume is a marker of male pubertal development. Various clinical conditions and their treatments may influence testicular growth.

Objectives: To create ruler-based age-dependent pubertal testicular volume references that enable calculation of standard deviation (SD) scores.

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Background: Nephritis is a common manifestation of IgA vasculitis and is morphologically indistinguishable from IgA nephropathy. While MEST-C scores are predictive of kidney outcomes in IgA nephropathy, their value in IgA vasculitis nephritis has not been investigated in large multiethnic cohorts.

Methods: Biopsies from 262 children and 99 adults with IgA vasculitis nephritis ( N =361) from 23 centers in North America, Europe, and Asia were independently scored by three pathologists.

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Article Synopsis
  • Immunoglobulin A vasculitis with nephritis (IgAVN) is the most common vasculitis in children, and this study aimed to analyze clinical outcomes, treatments, and risk factors in a large cohort of 1148 children diagnosed with the condition.
  • The retrospective analysis revealed that poorer outcomes were associated with factors like older age, lower kidney function at onset, hypertension, and certain kidney damage features, but no specific treatment was found to be more effective than others.
  • The study concluded that there is a need for further research and clinical trials to determine effective treatments and improve health outcomes for children with IgAVN.
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Background: Childhood cancer therapy may cause long-term effects. This cross-sectional study evaluated adulthood milestones in male childhood cancer survivors (CCS).

Methods: The study population comprised 252 male CCS with 6 to 42 years of survival diagnosed at the Children's Hospital in Helsinki (1964-2000) at the age of 0 to 17 years.

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Background: The pathophysiology of Henoch-Schönlein purpura (HSP) is still unclear, but several findings suggest that genetic factors may influence disease susceptibility. We aimed to perform a genome-wide association study (GWAS) in pediatric HSP patients with an emphasis on severe HSP nephritis.

Methods: The study included 46 HSP patients, 42 of whom had undergone kidney biopsy.

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Background: In Henoch-Schönlein nephritis (HSN), a risk factor for unfavorable outcome is prolonged proteinuria, but the value of renal biopsies in prognosis assessment is debatable.

Methods: We evaluated serial renal biopsies from 26 HSN patients. Follow-up biopsy occurred at median 2.

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Background: Optimal treatment of Henoch-Schönlein purpura nephritis (HSN) remains unclear. We evaluated outcome of pediatric HSN patients treated initially with either methylprednisolone (MP) or cyclosporine A (CyA) in Finland between 1996 and 2011.

Methods: Outcome of 62 HSN patients was evaluated by screening urine and blood samples (n = 51) or by collecting clinical parameters from medical charts until last follow-up visit (n = 11).

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Background: Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch-Schönlein nephritis (HSN) patients.

Methods: Primary kidney biopsies from 53 HSN patients were re-evaluated using the ISKDC (International Study of Kidney Disease in Children) classification and a modified semiquantitative classification (SQC) that scores renal findings and also takes into account activity, chronicity and tubulointerstitial indices. The ISKDC and SQC classifications were evaluated comparatively in four outcome groups: no signs of renal disease (outcome A, n = 27), minor urinary abnormalities (outcome B, n = 18), active renal disease (outcome C, n = 3) and renal insufficiency, end-stage renal disease or succumbed due to HSN (outcome D, n = 5).

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