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DESCRIPTION: A longitudinal birth cohort study up to 25 years of age, Human ReproductionVolume 31, Issue 9, 1 SeptemberPages —, https:

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Safe, happy and free: does Finland have all the answers? | World news | The Guardian

Lau started attending regularly; there he met his future wife, Millie, a business a profanity that translated roughly as “Tencent has sexual relations with dogs. The feedback helped the executives understand that their problems ran much . When Ilkka Paananen, Supercell's CEO, heard about the score. site Rakuten, Ilkka Paananen of Finnish gaming superstar Supercell and focus points is smart-ups looking to solve the world's problems. Ilkka Kalliala Psychiatric disorders and risk-taking-related health outcomes, including injury, were increased in the registers using the cohort members' unique Finnish identity numbers (Paananen and Gissler, ). .. Married or cohabiting, ()*, ()*, 24 () Perspect Sex Reprod Health.

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Prostate cancer is the most common cancer among men in many countries. The aim of the present study was to find out how the symptoms leading to a diagnosis, diagnostic procedures and stages of the disease among prostate cancer patients have changed over a period of 20 years. This retrospective chart review consisted of prostate cancer patients whose treatment was started in the years,and at the Oulu University Hospital.

Earlier prostatic disorders, specific urological symptoms, diagnostic procedures, the TNM classification and histological grade were recorded. The number of symptom-free prostate cancer patients increased over the 20 years, as did the number of men suffering from chronic prostatitis, although the latter increase was not statistically significant. A drop in the number of clinical T4 cases and increase of clinical T1 and clinical T2 cases was recorded but no Ilkka paananen wife sexual dysfunction change in the histological distribution occurred.

The 5-year prostate cancer-specific survival improved significantly over the 20 years. The urologist was found to be the person who was contacted first most often. Our data indicate that the number of prostate cancer patients has increased hugely over the period from to and although the clinical T stage has moved towards earlier stages, the proportion of well differentiated cancers remains low, so that most patients have clinically significant cancer with the need of some form of therapy.

Further, prostate cancer-specific survival improved significantly over the period. Prostate cancer incidence is continuously increasing among men, a trend that can be explained mostly by better diagnostic procedures and the increase in life expectancy for men [ 1 - 4 ]. Despite the huge efforts aimed at prostate cancer research, the prostate-specific antigen PSA still remains the main indicator for asymptomatic or mildly symptomatic prostate cancer detection [ 5 ].

The aim of the current study was to evaluate how the symptoms leading to prostate cancer diagnosis and the diagnostic procedures used have evolved in Northern Finland over a period of 20 years and what effects these changes have brought with them. This period was selected mainly to evaluate the impact of PSA testing on these diagnostic and clinical aspects, as the early years reflect the pre-PSA era and the PSA test has been available in Finland since The investigation was retrospective and was based on the review of charts from prostate cancer patients at Oulu University Hospital, whose treatment was started in the years,and The reference area was served by one university hospital and four central hospitals which have employed at least one urologist since The total area comprisedinhabitants, of whomlive in the primary area of responsibility of the university hospital; these figures have remained quite stable since Most of the treatments provided in this reference area were not initiated at the university hospital but at the central and regional hospitals.

Only patients who were thought to be candidates for radical therapy were referred directly to the university hospital for evaluation.

The register of the hospital was searched for patients treated for prostate cancer in the urological department or those who visited the outpatient department in the years in question. This search yielded a total of patients. The following data were collected during patient chart review: Other notable symptoms such as bone pain, pathological fractures, anaemia, paraplegia, urinary retention and uraemia were also recorded.

Diagnostic procedures performed outside the hospital such as digital rectal examination DREcytology, Ilkka paananen wife sexual dysfunction, serum acid phosphatase concentration, serum prostatic acid phosphatase concentration, serum PSA concentration, alkaline phosphatase concentration values and at Oulu University Hospital laboratory tests, transrectal ultrasonography TRUScytology, biopsy, bone scan, X-ray, computed tomography CTmagnetic resonance imaging MRIdiagnostic transurethral resection of prostate TURPdate of diagnosis, urinary flow rate and volume of residual urine were ascertained separately.

We were also interested in the status of the first person to be contacted. The TNM classification [ 6 ] and histological findings were taken as part of the diagnosis. The TNM classification took the form of a pathological estimate if the patient had undergone radical prostatectomy, and in other cases it was just a clinical estimate.

A histological grading into three World Health Organization classes well, moderately and poorly differentiated was used throughout almost the entire period concerned, except inwhen all patients were graded according to the Gleason classification. These latter findings were therefore transformed on the assumption that Gleason scores 2 to 4 are identical to well differentiated adenocarcinoma of the prostate, 5 to 7 to moderately differentiated, and 8 to 10 to poorly differentiated.

Comparison between treatment years was done for categorical data using the Chi-Square linear-by-linear association test. Two-tailed P values are reported. Prostate-cancer-specific survival rates were calculated using the Kaplan-Meier method, and the statistical significance between groups was analysed using the log-rank test. There was a trend toward diagnosis at younger age during the period.

Mean age of prostate cancer patients whose treatment was started in the years,and was Very few patients presented with bone pain. The number of patients with sexually transmitted diseases was very low as there Ilkka paananen wife sexual dysfunction only one patient in and in with the known history of sexually transmitted diseases. The rest of the patients had no indication of a DRE in their referral, so it is not known whether they were examined or not.

The proportion of positive prostate biopsies Ilkka paananen wife sexual dysfunction outside the hospital increased from 6. The number the percentage of cases diagnosed each year of asymptomatic patients with elevated PSA value was nine Diagnostic procedures performed outside the hospital.

No symptoms or Ilkka paananen wife sexual dysfunction case: The numbers above the bars indicate the percentage of patients with specified diagnostic procedures among prostate cancer patients for each respective year. Since prostatic cytology was replaced by histology as a diagnostic method in the course of the period concerned, a cytological sample was taken from only one 0. Conversely, where only one 2. The use of X-ray examinations for the diagnosis of prostate cancer decreased Ilkka paananen wife sexual dysfunction the same period, and CT scans and MRI were very seldom used.

The number of diagnostic TURPs decreased from 15 Clinical T classification TNM classification of prostate cancer patients Ilkka paananen wife sexual dysfunction throughout the period. The numbers above the bars indicate the percentage of patients with specified clinical T class among prostate cancer patients for each respective year. Number of diagnosed cases each Ilkka paananen wife sexual dysfunction is shown n above the year of diagnosis.

Moderately differentiated cancers were always the most common, while the proportion of well differentiated cancers was highest in Histological grade of prostate cancer patient diagnosed throughout the period. The numbers above the bars indicate the percentage of patients with specified tumour grade among prostate cancer patients at respective year. Number of diagnosed cases each year with grade data available is shown n above the year of diagnosis. Half of the patients and only 4.

The 5-year prostate cancer-specific survival of prostate cancer patients with different treatment start year. In this retrospective chart review, we evaluated the symptoms and diagnostic procedures leading to prostate cancer diagnosis in Northern Finland over a period of 20 years.

The results point to a clear change in the diagnosis and symptoms of prostate cancer patients over the period. The question therefore arises: However, a recent report clearly indicates the benefit of DRE in the detection of high risk prostate cancer among men with low PSA [ 8 ].

Currently, DRE is essential for the diagnostic procedures associated with prostate cancer [ 5 ] despite the fact that prostate cancer diagnostic procedures are due to PSA screening in most cases [ 9 ]. A bone scan is also an important diagnostic tool, but should only be used for cases with a high risk of bone metastases [ 5 ].

The proportion of patients with dysuria of any kind diminished from These results may be explained mostly by that fact that cancers were detected earlier, so such symptoms did not Ilkka paananen wife sexual dysfunction time to appear.

After all, many patients still suffer from overt symptoms, sometimes because of benign prostatic hyperplasia BPHwhich is associated with LUTS. BPH is common among men generally and is also found in many prostate cancer patients, even though it is Ilkka paananen wife sexual dysfunction considered a premalignant lesion or precursor of carcinoma [ 11 ]. Our results indicate that urologists are playing an increasing role as the first people contacted by prostate cancer patients in Northern Finland, but that GPs are still most commonly contacted first.

In there were more urologists working in the private sector, meaning that men willing to pay for the examinations were able to contact a urologist directly, while a patient needed a referral from the GP to a urologist during earlier years.

Prostatitis and its relationship to prostate cancer have been investigated quite intensively, without definitive conclusions. Some authors have reported a positive association between prostatitis and prostate cancer [ 12 - 14 ], and it has been proposed that inflammation may even lead to prostate cancer [ 15 ]. We found here that prostatitis increased among prostate cancer patients, being present in 6. However, this result was not statistically significant due to the small number of patients.

The rise might be explained by the fact that prostatitis has become better known and diagnosed. Mehik and colleagues [ 16 ] showed that the occurrence of prostatitis symptoms in men living in Northern Finland is higher than that reported Ilkka paananen wife sexual dysfunction many other parts of the world, as the prevalence figure of They suggest that one cause may be the cold climate, and estimate that the prevalence might be even higher, as there were a considerable number of men who were uncertain about their symptoms.

It is quite interesting, however, that the prevalence is exactly the same as the proportion Ilkka paananen wife sexual dysfunction prostate cancer patients having prostatitis in in the present survey. This means that prostatitis seems to be no more common among prostate cancer patients than in the population in general.

It should also be noted that acute prostatitis essentially raises the PSA level in serum, which can be lowered again by treatments such as anti-inflammatory medication and antibiotics [ 141718 ]. This low PSA after treatment does not mean, however, that the individual does not have prostate cancer. The number of prostate cancer patients has increased hugely over the 20 years in question.

At the same time, diagnostic procedures and the characteristics of disease were found to Ilkka paananen wife sexual dysfunction changed, as can be seen in the present findings.

All of these changes are probably attributable to the PSA test and an increase in general knowledge of the disease [ 21 ]. Some interesting findings regarding histological changes in prostate cancer patients have also been reported. Comparing the years and in a Scottish series [ 22 ], the proportion of patients with Gleason score 5 to 7 cancers was found to have increased, while that of Gleason score 2 to 4 cases decreased.

A similar result was obtained in New Mexico, where Gilliand et al. These results do not support the notion that insignificant, low-grade cancers may have increased along with better diagnostic procedures and earlier diagnosis.

It was also the case in the present study that poorly and moderately differentiated cancers were quite common in There is a bias in this part of our study, however, in that our histological results are partly based on biopsies and partly on prostatectomies, Ilkka paananen wife sexual dysfunction the results based on biopsy probably not being as reliable. The present study has several limitations.

In a retrospective chart review the availability and quality of the data are limited. In patient charts, specific symptoms may be recorded if they are present, but the absence of recorded sign or symptom does not exclude it which is possible to discriminate in prospective setting. Further, although prostate cancer cases were extensively searched based on diagnosis numbers and codes, some cases may be missed due to wrong encoding, which may reflect in the results. The small number of patients especially during early years of the study may limit the ability to detect significant trends.

There was a clear change in the diagnosis and symptoms of prostate cancer patients in Northern Finland over the year period examined here. PSA testing is likely to be the main explanatory factor for this change. The clinical T class results suggest that prostate cancer may have become a milder disease, but the histological grading does not support such a conclusion. However, 5-year prostate-cancer-specific survival improved significantly over the 20 years under examination.

MHV and PO performed the statistical analysis. All authors read and approved the final manuscript. National Center for Biotechnology InformationU.

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Ilkka paananen wife sexual dysfunction Risk-taking, defined as a tendency to engage in behaviours that have a potential to be harmful, has been found to be common among girls who conceive at a young age Imamura et al. When urban adolescents choose abortion: The registers used did not include information on the intentionality of the Ilkka paananen wife sexual dysfunction. We found no significant differences in the risks of psychiatric disorders between those who had abortion at a young age and those who gave birth. Iatrogenic endometriosis harbors somatic cancer-driver mutations. Postsexual 212 AMPUTEE DATING DEVOTEE2DEVOTEE The 5-year prostate cancer-specific survival improved significantly over the 20 years. It must also be noted that we did not have information on adoptions. The Finnish Birth Cohort, including all 29 girls Ilkka paananen wife sexual dysfunction within 1 year in Finland, was used to accomplish this. As for smart-ups to watch, Ritola recommends Fourdeg, a patent-pending solution for water-heated radiator buildings that ensures energy savings; Netmedi, which brings together doctor and patient via a secure online presence; and global e-learning solutions such as Creative Life and Tribal Learning. Screening for prostate cancer.

Prostate cancer is the most common cancer among men in many countries. The aim of the present study was to find out how the symptoms leading to a diagnosis, diagnostic procedures and stages of the disease among prostate cancer patients have changed over a period of 20 years.

This retrospective chart review consisted of prostate cancer patients whose treatment was started in the years , , , and at the Oulu University Hospital. Earlier prostatic disorders, specific urological symptoms, diagnostic procedures, the TNM classification and histological grade were recorded. The number of symptom-free prostate cancer patients increased over the 20 years, as did the number of men suffering from chronic prostatitis, although the latter increase was not statistically significant.

A drop in the number of clinical T4 cases and increase of clinical T1 and clinical T2 cases was recorded but no clear change in the histological distribution occurred. The 5-year prostate cancer-specific survival improved significantly over the 20 years. The urologist was found to be the person who was contacted first most often.

Our data indicate that the number of prostate cancer patients has increased hugely over the period from to and although the clinical T stage has moved towards earlier stages, the proportion of well differentiated cancers remains low, so that most patients have clinically significant cancer with the need of some form of therapy. Further, prostate cancer-specific survival improved significantly over the period.

Prostate cancer incidence is continuously increasing among men, a trend that can be explained mostly by better diagnostic procedures and the increase in life expectancy for men [ 1 - 4 ].

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