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Dental students at the University of Helsinki answered a 25-item questionnaire during spring 2008 that investigated their alcohol consumption, smoking habits and knowledge about the risk factors of smoking and alcohol consumption. This allows one to estimate how well future oral health care professionals would follow the recommendations they give and how hazardous they consider the risk factors of smoking and alcohol consumption to be. In addition, their attitudes towards tobacco use cessation and their opinions on who is responsible for education on tobacco use cessation were elicited to determine how anti-tobacco counselling might work in the future. Current smoking was reported by 17% of the participants and current alcohol consumption by 90% of participants. The majority of dental students (92%) considered education on tobacco use cessation to be the responsibility of dentists/doctors. Fairly high number of participants (43%) reported receiving inadequate information on tobacco cessation during their studies. Dental students should be taught and encouraged early on to routinely discuss with smokers the impacts of smoking on health.

Soft tissue sarcoma (STS) is a rare neoplasm consisting of approximately 50 different histologic subtypes treated similarly. The median patient age is 60 years, and there’s a slight male predominance. There are no known predisposing factors apart from ionizing radiation. STS is diagnosed with core needle biopsy of a suspicious lump, most commonly a palpable, painless mass. Surgery with adequate margins is the only curative treatment of STS. Adjuvant radiation therapy (RT) improves local control rates (LC) and is offered for patients with positive surgical margins. However, there is no consensus on which surgical margin is wide enough. Adjuvant chemotherapy yields rather poor survival benefit with significant risk of toxicity and is therefore offered for minority of the patients. Prognostic factors for local recurrence include patient age, tumor grade and surgical margin. Due to disease rarity, complex diagnostics, need for surgical treatment, adjuvant radiation therapy and critical evaluation of patient selection to receive chemotherapy, centralization of treatment is effective. Specialist centers adhere to treatment guidelines more strictly than non-tertiary centers. Adequate preoperative imaging methods are more often used, adequate surgical margins are more often achieved, patients undergo fewer operations, adequate adjuvant RT is more often offered and local control rates are better in specialist centers compared to non-tertiary centers. However, there is still a lack of adherence to referral policies with only 63 percent of STSs referred before surgical intervention. The aim of this study was to quality control treatment received in Soft Tissue Sarcoma Group at Helsinki University Hospital (HUH) during its first 25 years, with special interest in 1) adherence to treatment protocol, 2) metastases-free survival (MFS) and overall survival (OS) of STS patients and 3) treatment and survival of radiation-associated STS. We used a 1327-patient series from 1987-2012 consisting of patients referred to STS Group at HUH. Patients were treated according to treatment protocol based on 1987 Scandinavian Sarcoma Group recommendations. 1182 (79 %) patients had only primary tumor at presentation. Only 411 (35 %) patients referred for a primary tumor were referred untouched. However, the proportion increased by time from 13 to 47 percent. Of the 1115 patients treated with a curative intent, 680 (61 %) patients underwent only one procedure, proportion of which increased by time. Only 64 and 62 percent of patients with intralesional (tumor tissue in resection margin) and marginal margins (smallest margin under 2.5 cm) received adjuvant RT. Overall survival rates for patients treated with curative intent were 68 percent and 55 percent in 5-year and 10-year follow-up, respectively. No improvement in OS was recorded. 59 patients were referred for a radiation-associated sarcoma, and 52 of them were treated with a curative intent. Tumor appeared in the radiation field of an invasive breast cancer in 77 percent of the patients. Local control rates for patients treated with curative intent were 73 percent and 58 percent in 5-year and 10-year follow-up, respectively. Adherence to treatment protocol in STS group at HUH has improved over time in 1987-2012. To increase the percentage of patients referred for primary tumor without preceding biopsy, increasing soft tissue sarcoma knowledge in district hospitals is vital. All exceptions from treatment protocol should be discussed and reported in patient files.

Tutkielmassa perehdytään soluterapioiden käyttöön palovammojen hoidossa. Siihen kuuluvat kirjallisuuskatsaus sekä kokeellinen osa kahden biomateriaalin vertailusta laboratorio-olosuhteissa. Tarkasteltavia menetelmiä ovat ihmisen viljellyt ja viljelemättömät autologiset ja allogeeniset keratinosyytit, ihosiirteet, eläinperäiset ihon korvikkeet sekä ihon korvikkeina käytettävät biomateriaalit. Kutakin menetelmää on käytetty maailmalla kliinisissä tutkimuksissa jo usean vuosikymmenen ajan, mutta läpimurto tekniikoiden osalta edelleen puuttuu. Saadut tulokset ovat osaltaan ristiriidassa keskenään ja lisäksi tutkimusten potilasaineistot ovat vaihtelevia ja pieniä. Menetelmien osalta tarvittaisiin vielä lisätutkimuksia erityisesti niiden teknisestä toteuttamisesta ja hoidon pitkäaikaistuloksista. Parhaimmillaan ne ovat kuitenkin mahdollisuus osana henkeä pelastavaa hoitoa erityisesti laajoissa ja hankalissa palovammoissa.

Maahanmuutto Suomeen on viime vuosikymmenten aikana lisääntynyt ja monipuolistunut. Tavallisimmin muutetaan työllistymisen johdosta tai humanitaarisista syistä, ja lähtömaat ovat nykyisin entistä etäämpänä. Suun terveydentila ja suunhoitotottumukset eroavat eri kulttuureissa, mikä on otettava huomioon suunniteltaessa kasvavan maahanmuuttajaväestön suun terveydenhoitoa. Somalitaustainen väestöryhmä on alkujaan saapunut Suomeen 1990-luvun alussa. Se on kuudenneksi suurin vieraskielinen ryhmä. Tämän hetken nuoret ovat useimmiten toisen ja kolmannen sukupolven edustajia. Tutkimuksissa on todettu suunterveyden olevan heikompaa maahanmuuttajaväestössä, johon vaikuttavat usein sosioekonomiset erot. Suomen suun terveydenhuollossa on havaittu maahanmuuttajataustaisten nuorten asiakasprofiilin kasvua, eritoten päivystyksellisessä hoidossa. Tutkielman tavoitteena oli selvittää somalitaustaisten nuorten suun terveydentilaa, terveystottumuksia ja niissä ilmeneviä haasteita. Asenteet ja mallit suunterveyden käytänteissä siirtyvät usein vanhemmilta lapsilla. Vanhemmille toteutetussa kyselytutkimuksessa pyrimme tunnistamaan epäsuotuisia terveyskäytänteitä ja pohtimaan vanhempien vaikutusta nuorten suunhoidon tottumuksiin. Tämän lisäksi pyrimme tarjoamaan kohderyhmälle yksilöityjä kehitysideoita kehittämään ennaltaehkäisevää suun terveydenhuoltomallia. Kyselytutkimus toteutettiin keväällä 2023. Siinä tuli esille erityisen hyvä suuhygienian toteuttamien. Toisaalta huolenaihe kohdentui runsaaseen sokerituotteiden käyttöön, mikä oli merkittävin suunterveyteen vaikuttava tekijä. Huomionarvoista oli lisäksi vanhempien vähäinen valvonta nuorten napostelutavoissa. Terveysneuvonta kuuluu olennaisena osana suunterveyden edistämisen keinoihin väestötasolla. Siihen sisältyy myös yksilö-, yhteisö- ja elinympäristökohtaisten taustatekijöiden huomioonottaminen. Saatuja tutkimustuloksia voidaan hyödyntää eri tilanteissa annettavassa terveysneuvonnassa, niin suun terveydenhuollon ammattilaisten vastaanottokäyntien yhteydessä, tai terveydenhoitajien neuvolakäynneissä.

The role of somatic mutations in cancer development is undisputable, but our knowledge of the prevalence and function of somatic mutations in healthy cells is yet unresolved question. In immune-mediated bone-marrow failure (such as aplastic anemia and hypoplastic myelodysplastic syndromes) hematopoietic stem cells are destroyed by cytotoxic T cells, which have been shown to be oligoclonal and in some cases harbor STAT3 mutations. We addressed clonality of non-malignant T cells by investigating somatic mutations with a custom- made gene panel of 2533 genes. We sequenced CD4+ and CD8+ cells of 29 patients with immune-mediated bone marrow failure and compared the results to 20 healthy controls as well as previously published data on patients with aplastic anemia. Somatic variants in lymphocytes were common both in patients and healthy controls, but especially enriched in aplastic anemia patients and CD8+ T cells. CD8+ T cells of aplastic anemia patients accumulated most mutations on JAK-STAT and MAPK pathways. The number of somatic mutations was associated with CD8+ T cell clonality, assessed by T cell receptor beta sequencing. To further understand the role of mutations in T cells, we performed single-cell RNA sequencing from 6 longitudinal samples of 2 aplastic anemia patients with STAT3, KRAS, NFATC2 and PTPN22 mutations in CD8+ T cell clones. Mutated clones showed cytotoxic phenotype, which was altered by successful immunosuppressive treatment. Our results suggest that somatic mutations in T cells are common, associate with clonality and may alter T cell phenotype. The role of somatic mutations in the initiation and persistence of autoreactive clones needs to be further investigated.

Målet med studien är att undersöka ifall det finns ett samband mellan sömn och metabola störningar hos tidigare toppidrottare och deras kontroller. Kombinationen av sömn- och hälsodata från tidigare toppidrottare och kontroller gör det möjligt att undersöka både sömnen och motionens inverkan på hälsan. Fysisk aktivitet gör att man sover bättre. För kort (under sex timmar) eller för lång (över nio timmar) sömn ökar risken för övervikt. Metabola störningar är associerade med fysisk inaktivitet och sömnstörningar. Studien innefattar 392 tidigare manliga toppidrottare som representerat Finland mellan åren 1920 och 1965 minst en gång i Olympiska spelen, världs- eller europamästerskap eller landskamper och 207 friska kontroller som motsvarar idrottarna till hemort och ålder. De undersökta deltog år 2008 i en hälsokartläggning där de fyllde i ett frågeformulär och genomgick en hälsogranskning. I denna studie undersöks prevalensen av metabolt syndrom, blodtryckssjukdom och störningar i glukosmetabolin. Av de undersökta var idrottarna äldre men friskare och motionerade mer jämfört med kontrollerna. Bland alla idrottargrupper var också prevalensen av de undersökta sjukdomarna lägre än hos kontrollerna. Prevalensen av metabolt syndrom och störningar i glukosmetabolin var minst hos dem som sov över sex och under nio timmar. Slutsatsen är att tillräcklig sömn och motion skulle skydda mot metabola störningar.

Objectives. According to previous research heavy social media use is associated with poor psychosocial well-being in adolescents. The direction of this association is not, however yet clear. The majority of previous studies are cross-sectional and there are not many studies focusing on early adolescents. The objective of this study was to investigate longitudinal associations between social media use and psychosocial well-being in 10–15-year-old boys and girls. In addition, the study tested whether the associations are age dependent. Methods. The participants (n=6422) of this study were a part of Understanding Society: The UK Household Longitudinal Study (2009-). The data came from 3 waves (2011-2013, 2013-2015 and 2015-2017) of the study and participants were 10–15-year-olds in every wave. Social media use was assessed through the daily amount (hours) spent chatting or interacting on social media websites and apps. Psychosocial well-being was measured by the Strengths and Difficulties Questionnaire. The study was conducted with repeated measurements method and by using multilevel modeling. The associations between social media use and psychosocial well-being were examined with linear regression analysis and ordinal logistic regression analysis. Results and conclusions. Gender differences were found in the longitudinal association between social media use and psychosocial well-being. Among girls, even less than an hour of social media use predicted higher total and externalizing symptoms, and among 10–11-year-old girls over 4 hours of social media use predicted higher internalizing symptoms. Social media use did not predict later psychosocial well-being among boys. Higher externalizing symptoms predicted heavier social media use among both boys and girls, and higher total symptoms also predicted heavier use but only among boys. This study found that social media use predicted later declines in psychosocial well-being among girls, but not among boys. Poor psychosocial well-being, mainly higher externalizing symptoms, predicted later heavier social media use among both boys and girls. These effects were however relatively small.

Objectives: Previous studies have shown that psychotic-like experiences (PLE) have harmful effects on people's lives, but there is no information on possible protecting effects of social support. The purpose of the current study was to examine in general population if social support protects against psychotic symptoms' harmful effects. This study focused on the positive ones of psychotic symptoms whereas problems of daily living (ADL = activities of daily living) were selected to describe the harmful effects. Hypothesis was that the perceived social support decreases the risk of daily living problems, when sex, age, psychotic symptoms and the size of primary support group were controlled. Method: The data was obtained with face-to-face interviews in 2000 by the office for National Statistics (ONS). The name of the survey was The Second National Survey of Psychiatric Morbidity in Great Britain. Respondents were people living in private households, and aged between 16 and 74 years. The final sample size was 8464. Daily living problems were assessed from respondents' answers to seven questions on difficulties in daily living. Psychotic symptoms were assessed using the Psychosis Screening Questionnaire (PSQ). The perceived social support was assessed from respondents' answers to seven questions in the Health and Lifestyle Survey. The primary group size was assessed with three questions in the Interview Measure for Social Relationships (IMSR). Findings: It was found that the perceived social support predicted lower amount of daily living problems (OR: 0.91) after sex, age, psychotic symptoms, the size of the primary support group and interactions of these variables were controlled. Perceived social support is more important as a protecting factor against the psychotic symptoms' harmful effects i.e. problems of daily living, than the size of the primary support group. Because this study wasn't longitudinal, there is however not certainty of the perceived social support's and the primary support group size's protecting roles. Nevertheless, along this study it is now known that for general population's part psychotic symptoms increase risk of daily living problems. Thus it should be important to survey the status of social support also for people with mild psychotic-like experiences, because it impacts their wellbeing in future.

Tutkimuksen tavoitteena oli selvittää, millaisia harjoituksia puremalihaksille löytyy sosiaalisen median alustoilta ja voiko niillä julkaistun kirjallisuuden perusteella olla vaikutuksia purentaelimistön terveyteen terveillä tai TMD-oireista kärsivillä henkilöillä. Tutkimus koostui netnografisesta osuudesta ja kirjallisuuskatsauksesta. Netnografiseen osuuteen kerättiin materiaaliksi sosiaaliseen mediaan julkaistuja leuan alueen harjottamiseen tarkoitettuja videoita. Kirjallisuuskatsaus tehtiin julkaisuista, joissa tutkittiin puremalihasten vapaaehtoisten harjoitteiden vaikutusta puremalihaskipuun. Tutkimukseen kerättiin 71 videota, joista 37 oli naisten ja 34 miesten tekemiä. Suurin osa netnografialla löydetyistä lihasharjoitteista perustui masseter-lihasten isometriseen harjoittamiseen. Videoista noin 69 % sisälsi lihasharjoitteita ilman apuvälineitä ja noin 31 % apuvälineellä. Miesten tekemissä videoissa noin 53 %:ssa käytettiin apuvälineitä ja naisten videoista noin 89 % tehtiin ilman apuvälineitä. Harjoitteiden toivottu tulos kohdistui kaksoisleuan pienentämiseen, leukalinjan terävöittämiseen tai molempiin. Naisten tekemistä videoista yli 60 %:ssa tavoitteena oli kaksoisleuan pienentäminen. Miesten tekemistä videoista yli 90 % tavoitteli leukalinjan terävöittämistä. Julkaistun kirjallisuuden perusteella todettiin, että terveiden vapaaehtoisten henkilöiden hampaiden yhteen pureminen saattaa aiheuttaa lihaskipua ja väsymistä. Terveisiin verrokkeihin verrattuna TMD-potilaat väsyvät rasituksessa usein helpommin. Ilman apuvälineitä tehtävät harjoitteet olivat yleisempiä koko materiaalissa. Leukalinjan terävöittäminen oli yleisempää kuin kaksoisleuan pienentäminen. Miehet keskittyivät huomattavasti enemmän leukalinjan terävöittämiseen ja naiset puolestaan kaksoisleuan pienentämiseen. Tulokset sopivat hyvin tutkittuun tietoon sukupuolten kauneuskäsityksestä. Videoita julkaisevat etenkin maallikot, eivätkä ne perustu tieteelliseen näyttöön. Puremalihaksia vahvistavien harjoitusten tekeminen saattaa aiheuttaa kipua ja väsymystä purentaelimistöön, etenkin, jos yksilöllä on jo aikaisemmin purentaelimistön toimintahäiriöitä ja kipua.

Anxiety disorders typically onset in adolescence, often resulting in significant impairment. Social anxiety disorder (SAD) and generalized anxiety disorder (GAD) are among the clinically most important anxiety disorders in adolescents and may have a significant effect on schoolwork. The aim of this study was to explore the associations of perceived difficulties in schoolwork with SAD and GAD. It also aimed at determining if the comorbidity between SAD and GAD is associated with higher rates of school difficulties than seen in SAD or GAD without comorbidity. The study also assessed if the associations are different for boys and girls, and whether parental education level, parental unemployment, family structure, and school performance explain the possible associations. The study data was based on the School Health Promotion Study of 2015 and included survey data from 37 905 Finnish upper secondary school students. Exploratory factor analysis was used to determine indicators for academic and social difficulties in school. Logistic regression analysis was used to examine the multivariate associations between anxiety symptoms and perceived difficulties in schoolwork, conducted separately for both genders. Three different logistic models were formed for each association, academic and social difficulties each being the dependent variable in turn. Each model had 1, 4, or 5 independent background variables, in addition to self-reported anxiety symptoms. The main finding of this study was that both social anxiety and general anxiety were associated with perceived difficulties in schoolwork in upper secondary school students. Adolescents with SAD or GAD had a significantly increased risk for difficulties in schoolwork. The comorbidity between SAD and GAD was associated with significantly higher rates of social difficulties than non-comorbid SAD or GAD. In academic difficulties, GAD especially increased the risk significantly whether or not it was comorbid with SAD. The associations were for the most part similar for boys and girls. Parental unemployment, low parental education level, other than nuclear family structure, and poor school performance were associated with school difficulties. However, those variables only explained a small proportion of the association between anxiety symptoms and school difficulties. This study showed that adolescents with anxiety symptoms face challenges that they probably need support for in the school environment.