Publications by authors named "Tuomo J Meretoja"

Background: The economic crisis that began in 2008 has severely affected Southern (Greece, Italy, Portugal, Spain) Western European (SWE) countries of Western Europe (WE) and may have affected ongoing efforts to eliminate viral hepatitis. This study was conducted to investigate the impact of the economic crisis on the burden of HBV and HCV disease.

Methods: Global Burden of Diseases 2019 data were used to analyse the rates of epidemiological metrics of HBV and HCV acute and chronic infections in SWE and WE.

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Background: Combining cytotoxic chemotherapy or novel anticancer drugs with T-cell modulators holds great promise in treating advanced cancers. However, the response varies depending on the tumor immune microenvironment (TIME). Therefore, there is a clear need for pharmacologically tractable models of the TIME to dissect its influence on mono- and combination treatment response at the individual level.

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Purpose: The purpose of this study was to evaluate if it is possible to completely remove small breast cancer tumours with vacuum-assisted excision (VAE) under ultrasound guidance.

Methods: Women ≥ 50 years old with a biopsy proven invasive cancer ≤ 10 mm were selected between October 2021 and November 2021 based on referrals and enrolled in this prospective study. The patients underwent VAE within six weeks following biopsy to remove the tumour.

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Article Synopsis
  • HIV/AIDS remains a significant public health issue in sub-Saharan Africa, with current efforts falling short of global targets for eradication set by UNAIDS and the SDGs.
  • The study utilized extensive data from various HIV prevalence surveys to estimate localized HIV infection rates across 43 African countries, focusing on specific age and sex groups from 2000 to 2018.
  • Findings revealed wide disparities in HIV prevalence within countries and districts, indicating that age and sex stratification provides more nuanced insights into the epidemic, which can help tailor prevention and treatment efforts more effectively.
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Introduction: Human epidermal growth factor receptor 2 (HER2) expression is considered an unfavourable prognostic factor in early breast cancer when the patients are not treated with HER2-targeted therapy. However, the long-term prognostic importance of HER2 expression in small (≤1 cm, stage pT1a-b), node-negative HER2* breast cancer is still incompletely known.

Methods: A retrospective analysis was performed based on a prospectively collected database including patients with pT1 breast cancer operated at the Helsinki University Hospital, Finland, between March 2000 and April 2006.

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Background: Surgical planning depends on precise preoperative assessment of the radiological extent of ductal carcinoma in situ (DCIS). Despite different modalities used, reoperation rates for DCIS due to involved margins are high.

Purpose: To evaluate the impact of additional imaging views (spot magnification, tomosynthesis) on surgical reoperation rate of DCIS.

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Purpose: This study aims to compare the feasibility of VAE and BLES in the treatment of intraductal papillomas.

Material And Methods: Patients with a suspected intraductal papilloma who underwent a BLES or a VAE procedure were included in this retrospective study. The BLES procedures were performed between November 2011 and June 2016 and the VAE procedures between May 2018 and September 2020 at the Department of Radiology of Helsinki University Hospital (HUH).

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Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation.

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Article Synopsis
  • Injuries significantly impact global health, with the number of injury deaths rising from approximately 4.26 million in 1990 to about 4.48 million in 2017, despite a decline in age-standardized mortality rates.
  • The Global Burden of Disease study measured both fatal and non-fatal injuries through years of life lost (YLLs) and years lived with disability (YLDs), which were combined into disability-adjusted life years (DALYs).
  • While overall injury incidence increased, age-standardized DALYs decreased, indicating a need for ongoing research focused on injury prevention, better data collection, and improving access to medical care in high-burden areas.
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Background: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period.

Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017.

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Introduction: Falls in older aged adults are an important public health problem. Insight into differences in fall-related injury rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to compare Global Burden of Disease (GBD) 2017 estimates on incidence, mortality and disability-adjusted life years (DALYs) due to fall-related injury in older adults across 22 countries in the Western European region and to examine changes over a 28-year period.

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Background: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.

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Article Synopsis
  • - The study investigates how sociodemographic factors relate to injury-related health outcomes worldwide, specifically analyzing disability-adjusted life years (DALYs) from injuries across 195 countries from 1990 to 2017.
  • - Findings show that while most injury causes display a trend of decreasing DALY rates with higher Socio-demographic Index (SDI), certain injuries like road injuries, interpersonal violence, and self-harm deviate from this trend, indicating complex underlying factors.
  • - The research highlights the importance of understanding these injury patterns to improve health strategies and intervention efforts at both national and global levels, especially since not all injuries follow the same developmental trajectory.
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  • Past research highlights that fires and hot substances are significant global health risks, causing morbidity and mortality that necessitate better preventative strategies and healthcare access.
  • Using the Global Burden of Disease 2017 framework, the study calculated various health metrics related to fire-related injuries across 195 countries from 1990 to 2017.
  • Findings indicate that while global mortality rates from these injuries have declined, there is considerable regional variation, with middle and lower-income areas being more affected and requiring improved safety resources and healthcare infrastructure.*
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Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends.

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Article Synopsis
  • Cancer and other noncommunicable diseases (NCDs) pose a significant threat to global development, with slow progress in addressing these issues highlighted by the recent UN meeting; key barriers include a lack of situational analyses and prioritization for effective action against NCDs.* -
  • The study aims to provide comprehensive data on cancer burden across 29 cancer types in 195 countries from 1990 to 2017, utilizing the Global Burden of Disease (GBD) methods to analyze cancer incidence, mortality, and disability metrics.* -
  • In 2017, there were 24.5 million new cancer cases globally, with significant variations based on socio-demographic factors; the majority of cancer-related disabilities stemmed
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Objectives: The aim of this retrospective study is to compare surgical margins, reoperation rates and local recurrences after breast conserving surgery (BCS) using radioguided occult lesion localization (ROLL) or radioactive seed localization (RSL).

Materials And Methods: We reviewed 744 consecutive patients with impalpable primary invasive breast cancer who underwent BCS at Helsinki University Hospital between 2010 and 2012. ROLL was used in our unit until October 31st, 2011; from November 1st we changed localization method to RSL.

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Background: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques.

Material And Methods: We reviewed 1800 consecutive patients with primary invasive breast cancer (N = 1707) or ductal carcinoma in situ (N = 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012.

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Background: The aim of this study was to investigate outcome of treatment in patients over 80 years of age with early breast cancer at the time of the diagnosis with special interest in surgical treatment.

Materials And Methods: Breast cancer patients older than 80 years of age, treated at the Breast Surgery Unit of Helsinki University Hospital in 2005-2010 were identified from electronic patient records. Patients were followed-up until the end of 2014.

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Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions.

Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.

Design, Setting, And Participants: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location.

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Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required.

Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus.

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Background: The prognostic significance of isolated tumour cells (ITCs) in the sentinel nodes (SNs) is controversial in early breast cancer, and some centres have abandoned immunohistochemistry to detect ITCs.

Methods: Patients with unilateral pT1N0 breast cancer, operated between February 2001 and August 2005 at a university hospital were included in this prospective, population-based cohort study. Survival of 936 patients with or without isolated tumour cells (ITC) in their SNs were compared with the log-rank test and Cox regression analysis.

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Objectives: This study aims to evaluate the feasibility of Breast Lesion Excision System (BLES) in the treatment of intraductal papillomas.

Material And Methods: All patients with a needle biopsy -based suspicion of an intraductal papilloma who consequently underwent a BLES procedure at Helsinki University Hospital between 2011 and 2016 were included in this retrospective study. The purpose of the BLES procedure was either to excise the entire lesion or in few cases to achieve better sampling.

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Purpose Persistent pain after breast cancer surgery is a well-recognized problem, with moderate to severe pain affecting 15% to 20% of women at 1 year from surgery. Several risk factors for persistent pain have been recognized, but tools to identify high-risk patients and preventive interventions are missing. The aim was to develop a clinically applicable risk prediction tool.

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The aim of this study was to identify clinical risk factors for unfavorable pain trajectories after breast cancer surgery, to better understand the association between pain expectation, psychological distress, and acute postoperative pain. This prospective study included 563 women treated for breast cancer. Psychological data included questionnaires for depressive symptoms and anxiety.

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