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7. epiflows : an R package for risk assessment of travel- related spread of disease [version 1; referees: 2 approved with reservations]

Author

Moraga, P, Dorigatti, I, Kamvar, Z, Piatkowski, P, Toikkanen, S, Nagraj, VP, Donnelly, C, Jombart, T, Medical Research Council (MRC), and National Institute for Health Research

Abstract

As international travel increases worldwide, new surveillance tools are needed to help identify locations where diseases are most likely to be spread and prevention measures need to be implemented. In this paper we present epiflows, an R package for risk assessment of travel-related spread of disease. epiflows produces estimates of the expected number of symptomatic and/or asymptomatic infections that could be introduced to other locations from the source of infection. Estimates (average and confidence intervals) of the number of infections introduced elsewhere are obtained by integrating data on the cumulative number of cases reported, population movement, length of stay and information on the distributions of the incubation and infectious periods of the disease. The package also provides tools for geocoding and visualization. We illustrate the use of epiflows by assessing the risk of travel-related spread of yellow fever cases in Southeast Brazil in December 2016 to May 2017.

Published
2018

13. Aggressiveness of breast cancers found with and without screening

Author

Klemi, P.J., Joensuu, H., Toikkanen, S., Tuominen, J., Rasanen, O., Tyrkko, J., and Parvinen, I.

Subjects
Evaluation, Medical examination, Mammography -- Evaluation, Breast cancer, Pathology, Breast examination -- Medical examination
Abstract

Introduction Mass screening for breast cancer by mammography has been found to reduce mortality from breast cancer,[1-3] but the reduction has not been significant in all trials.[4-6] A plausible explanation [...]

Published
1992

18. Increased incidence of Mycoplasma pneumoniae infection in Finland, 2010-2011

Author

University of Helsinki, Department of Virology, Polkowska, A., Harjunpaa, A., Toikkanen, S., Lappalainen, M., Vuento, R., Vuorinen, T., Kauppinen, J., Flinck, H., Lyytikainen, O., University of Helsinki, Department of Virology, Polkowska, A., Harjunpaa, A., Toikkanen, S., Lappalainen, M., Vuento, R., Vuorinen, T., Kauppinen, J., Flinck, H., and Lyytikainen, O.

Published
2012

23. Raw grated beetroot linked to several outbreaks of sudden-onset gastrointestinal illness, Finland 2010

Author

JACKS, A., primary, TOIKKANEN, S., additional, PIHLAJASAARI, A., additional, JOHANSSON, T., additional, HAKKINEN, M., additional, HEMMINKI, K., additional, HOKKANEN, P., additional, KÄPYAHO, A., additional, KÄRNÄ, A., additional, VALKOLA, K., additional, NISKANEN, T., additional, TAKKINEN, J., additional, KUUSI, M., additional, and RIMHANEN-FINNE, R., additional

Published
2012
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25. Bcl-2 protein expression and long-term survival in breast cancer

Author

Joensuu, H., Pylkkänen, L., and Toikkanen, S.

Subjects
Adult, Aged, 80 and over, Carcinoma, Breast Neoplasms, DNA, Neoplasm, Middle Aged, Flow Cytometry, Prognosis, Survival Analysis, Immunoenzyme Techniques, Proto-Oncogene Proteins c-bcl-2, Proto-Oncogene Proteins, Biomarkers, Tumor, Humans, Female, Longitudinal Studies, Tumor Suppressor Protein p53, Research Article, Aged, Follow-Up Studies
Abstract

Bcl-2 gene product functions to prevent apoptosis in a variety of in vitro and in vivo experiments. The prognostic significance of Bcl-2 protein expression was investigated by immunocytochemistry from paraffin-embedded tissue in a series of 174 women with breast cancer, treated with radical surgery with or without regional radiotherapy, and who had been followed up for the median of 31 years or until death. A minority (25%) of cancers were entirely negative for Bcl-2 protein. Moderate to strong Bcl-2 protein expression (present in 46%) was strongly associated with several favorable prognostic features, such as a low mitotic count, high histological grade of differentiation, and lack of p53 protein expression (P < 0.0001 for each). It was also significantly associated with lack of tumor necrosis, a low S-phase fraction size, low cathepsin D expression, DNA diploidy, and the lobular histological type, but not with the primary tumor size or the axillary nodal status. Women with cancer with moderate to strong Bcl-2 protein expression had more favorable short-term (69% versus 46% alive at 5 years) but similar long-term (29% versus 33% alive at 30 years) disease-specific survival as those with cancer with weak or lacking expression. Bcl-2 protein expression did not have independent prognostic value in a multivariate survival analysis. We conclude that Bcl-2 protein is frequently expressed in breast cancer, and its expression is associated with favorable clinicopathological features.

Published
1994

27. Cryptosporidium parvum Caused a Large Outbreak Linked to Frisée Salad in Finland, 2012.

Author

Åberg, R., Sjöman, M., Hemminki, K., Pirnes, A., Räsänen, S., Kalanti, A., Pohjanvirta, T., Caccio, S. M., Pihlajasaari, A., Toikkanen, S., Huusko, S., and Rimhanen‐Finne, R.

Subjects
CRYPTOSPORIDIUM parvum, FOOD microbiology, FOOD consumption, CONSUMERS
Abstract

Over 250 individuals fell ill in five outbreaks caused by Cryptosporidium parvum in Finland, October-November 2012. The cases were connected by lunch meals at restaurants in four different cities. In two outbreaks, the same C. parvum IIdA17G1 subtype was found in patients' stool samples which supports a single source of infection. Frisée salad was the only common food item served at the restaurants, and consumption of lunch salad containing the frisée salad was associated with the illness. Lunch customers who responded that they had eaten lunch salad were three times more likely to have become ill than those who had not answered whether they had eaten the salad or not (RR 2.66; 95% Cl 1.02-6.9, P-value <0.01). Cryptosporidiosis should be considered as a causal agent in long-lasting watery diarrhoea combined with abdominal cramps, and clinical samples should be tested for Cryptosporidium at the same time bacteria and viruses are tested. Measures to prevent contamination of 'ready-to-eat vegetables' with Cryptosporidium oocysts and methods to test frozen food samples should be developed. [ABSTRACT FROM AUTHOR]

Published
2015
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33. Standardized Mitotic Counts in Breast Cancer Evaluation of the Method

Author

Collan, Y.U.I., primary, Kuopio, T., additional, Baak, J.P.A., additional, Becker, R., additional, Bogomoletz, W.V., additional, Deverell, M., additional, Van Diest, P., additional, Van Galen, C., additional, Gilchrist, K., additional, Javed, A., additional, Kosma, V.-M., additional, Kujari, H., additional, Luzi, P., additional, Mariuzzi, G.M., additional, Matze, E., additional, Montironi, R., additional, Scarpelli, M., additional, Sierra, D., additional, Sisti, S., additional, Toikkanen, S., additional, Tosi, P., additional, Whimster, W.F., additional, and Wisse, E., additional

Published
1996
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48. Pure and mixed mucinous breast carcinomas: DNA stemline and prognosis.

Author

Toikkanen, S, Eerola, E, and Ekfors, T O

Abstract

The DNA stemline of 45 mucinous breast carcinomas was determined by flow cytometry using paraffin embedded archival tissue sections. The material consisted of 26 pure mucinous and 19 mixed mucinous carcinomas. The patients were followed up for at least 15 years or until death. Nearly all pure mucinous carcinomas had a normal DNA stemline (25 of 26) with only one aneuploid tumour. Mixed mucinous carcinomas had a DNA content resembling that of common ductal carcinoma with 11 aneuploid tumours. Aneuploid tumours tended to be of higher grade and stage than diploid tumours. The survival of patients with pure mucinous carcinoma was better than that of patients with mixed mucinous carcinoma. Mucinous carcinoma should be classified as such only if it is a pure mucinous carcinoma. [ABSTRACT FROM PUBLISHER]

Published
1988
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