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Biomedical subjects

A M Koivisto

Publications and source records attributed to A M Koivisto.

At least 19 recordsLinked to original sources

Are there differences in the attitudinal body image between adolescent anorexia nervosa and bulimia nervosa?

OBJECTIVE: Body image dissatisfaction is as well a risk factor for eating disorders (ED) and a central feature of ED. The exact nature of body image in adolescent ED is still debated. This study examined attitudinal body image in adolescent anorexia nervosa (AN) and bulimia nervosa (BN), and the association of age, maturational timing, duration of eating disorder, actual weight and general psychological distress with the attitudinal body image in ED. METHODS: The study group consisted of an outpatient clinical sample of adolescents attending for assessment because of eating disorders. The attitudinal body image of 57 adolescents (girls) aged 14-21 years was studied at the beginning of the treatment. The attitudes to body shape, body size, appearance, tone and femininity were studied by a Likert format scale and by the body dissatisfaction (BD) and drive for thinness scales (DT) from EDI-2 inventory. RESULTS: Bulimics reported more body image dissatisfaction than anorectics. In multivariate analyses BN and higher general psychological distress had strong associations with body image dissatisfaction. Longer duration of ED and earlier menarche were also associated with negative body image. DISCUSSION: Attitudinal body image differs between adolescent AN and BN. The psychological distress has a great impact on body image in ED, which should be taken into account in assessment and in treatment interventions.

Adolescent↗

Possible association of nicastrin polymorphisms and Alzheimer disease in the Finnish population.

The authors previously reported that genetic variation in the gene coding for nicastrin (NCSTN) modified risk for familial early-onset Alzheimer disease (AD) in a Dutch population-based sample. Risk was highest in patients without an APOE epsilon4 allele. Here, they evaluated if NCSTN polymorphisms increased risk of AD in the eastern Finnish population. A significant difference in one haplotype was observed in AD patients without the APOE epsilon4 allele.

Aged↗

Polymorphisms in neprilysin gene affect the risk of Alzheimer's disease in Finnish patients.

OBJECTIVES: Neprilysin (NEP) is an amyloid beta-peptide (Abeta) degrading enzyme expressed in the brain, and accumulation of Abeta is the neuropathological hallmark in Alzheimer's disease (AD). In this study we investigated whether polymorphisms in the NEP gene have an effect on the risk for AD. METHODS: The frequencies of seven single nucleotide polymorphisms (SNPs) and apolipoprotein E (APOE) were assessed in 390 AD patients and 468 cognitively healthy controls. Genotypes of the study groups were compared using binary logistic regression analysis. Haplotype frequencies of the SNPs were estimated from genotype data. RESULTS: Two SNPs, rs989692 and rs3736187, had significantly different allelic and genotypic frequencies (uncorrected p = 0.01) between the AD and the control subjects and haplotype analysis showed significant association between AD and NEP polymorphisms. CONCLUSION: Taken together, these findings suggest that polymorphisms in the NEP gene increase risk for AD and support a potential role for NEP in AD.

Aged↗

Frequency of and risk factors for necrotizing enterocolitis in infants born before 33 weeks of gestation.

AIM: To investigate the frequency of and risk factors for necrotizing enterocolitis (NEC) among infants of <33 wk of gestation. METHODS: Prospective follow-up of 140 inpatients. RESULTS: 26 (18.6%) subjects developed NEC stage I-III and 12 (8.6%) severe NEC (stage II-III). Breast milk fortifier and duration of morphine infusion emerged as the statistically significant factors associated with NEC stage I-III, but only the latter had a significant association with severe NEC. CONCLUSION: Future studies are needed to be established whether morphine is a causative factor in NEC.

Ductus Arteriosus, Patent↗

Isolated ultrafiltration affects dynamic vectorcardiographic ischemia monitoring parameters.

AIMS: The present study was undertaken to assess the role of isolated ultrafiltration (UF phase) and hemodialysis with minimal ultrafiltration (HD phase) in changes in parameters reflecting myocardial ischemia: QRS vector difference (QRS-VD), ST change vector magnitude (STC-VM) and ST vector magnitude (ST-VM6) registered by MIDA (myocardial infarction dynamic analysis). PATIENTS AND METHODS: Twelve patients on maintenance hemodialysis were first ultrafiltrated for 2.5 h without dialysis (UF) followed by a 2.5-hour session of hemodialysis with minimal ultrafiltration (HD). Computerized vectorcardiography (VCG) was used for on-line dynamic analysis of ST segment and QRS complex changes. Blood volume (BV) changes were monitored non-invasively and continuously with the CRIT-LINE instrument. Whole-body bioelectric impedance analysis (BIA) was used for extracellular water (ECW) estimation. RESULTS: During the UF phase QRS-VD and STC-VM showed a statistically significant increasing linear trend (time effect for both QRS-VD and STC-VM p < 0.0001, while no changes were noted in ST-VM6; time effect p = 0.986). During the HD phase none of these parameters changed (time effect for QRS-VD p = 0.855, for STC-VM p = 0.275 and for ST-VM6 p = 0.976). During the UF, phase changes in QRS-VD were in close relation to those in ECW. CONCLUSION: Isolated ultrafiltration leads to an increase in the VCG ischemia monitoring parameters QRS-VD and STC-VM. The increase of QRS-VD is related to changes in ECW. Hemodialysis with minimal ultrafiltration has no effect on VCG ischemia monitoring parameters.

Adult↗

Genome-wide linkage disequilibrium mapping of late-onset Alzheimer's disease in Finland.

BACKGROUND: AD is a complex neurodegenerative disorder comprising several disease-associated chromosome loci. To find novel susceptibility genes for late-onset AD, a population-based genome-wide search using linkage disequilibrium (LD) mapping approach has been performed. METHOD: Forty-seven patients with late-onset AD and 51 age-matched control subjects were carefully chosen from the same geographic area in eastern Finland, where the population is descended mainly from a small group of original founders. These subjects were initially genotyped with 366 polymorphic microsatellite markers, and a follow-up analysis was performed with additional microsatellite markers for those chromosome loci found to be associated with AD. RESULTS: Initial genome-wide screening revealed 21 chromosomal loci significantly associated with AD in addition to the 13q12 locus described previously. Subsequent comparison of single-allele frequencies of the microsatellite markers in the AD and control groups indicated the presence both of possible risk alleles (odds ratio [OR] > 1) and of possible protective alleles (OR < 1). Screening of the LD regions with additional microsatellite markers revealed seven chromosomal loci where more than one microsatellite marker was associated with AD (1p36.12, 2p22.2, 3q28, 4p13, 10p13, 18q12.1, and 19p13.3) in addition to the 13q12 locus. CONCLUSIONS: These genome-wide LD screening data suggest that several AD-associated chromosomal loci exist, which may encompass novel susceptibility genes for late-onset AD. Therefore, extensive screening of the genes located in the vicinity of these LD regions is necessary to elucidate their role in AD.

Age of Onset↗

To be or not to be married--that is the question of quality of life in men with schizophrenia.

BACKGROUND: The association of gender and marital status with quality of life (QoL) was studied in a representative national sample of long-term schizophrenia patients. METHODS: The study sample consisted of 1,750 male and 1,506 female 15- to 64-year-old schizophrenia patients discharged from mental hospitals in 1986, 1990 and 1994 in Finland. Comprehensive data were collected from hospital and out-patient case records and the psychiatric teams carried out a structured interview regarding the patients' socio-demographic background, living places, living situation, psycho-social state and functioning and life satisfaction three years after the index discharge. RESULTS: Female patients were older, more often married, had been ill for a longer time and had moved after discharge from hospital to live alone or with their spouse more often than men. Women and married patients had migrated more often than men and single patients, but single men had more often remained living in a remote rural area than others. The QoL of single men was poorer than others in almost all the areas in which it was measured: housing conditions, working, daily functioning, number of confidants and psycho-social state. Differences between single women and married men or women were much smaller. Women, independently of their marital status, were more satisfied with their life, had more close interpersonal relationships and had done useful work more often than men. CONCLUSIONS: Single male patients with schizophrenia seem to have dropped out of the development of society. They remain living in their birthplace and are more dependent than other patients. Single women migrate more consistently into urban areas, which may be favourable for their QoL. Married patients with schizophrenia, possibly partly helped by their spouse, can best follow changes in the society. Female gender also seems to have an independent association with life satisfaction and interpersonal aspects of the QoL. The results of this study strongly emphasise that the associations between gender, marital status and QoL to a great extent depend on the study sample and may also vary by study area.

Adolescent↗

Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing.

We analyzed data from 87 patients who had displaced closed or open grade I simple or spiral wedge tibial shaft fractures caused by low-energy impact. Fifty-four patients were treated with plaster cast and 33 with intramedullary locking nail (IMLN). Delayed union only occurred in 8 patients after plaster cast treatment. Forty-two patients in the IMLN group and one in the plaster cast group suffered from anterior knee pain. Final treatment outcome, healing time, hospitalization time and duration of sick leave were assessed on the basis of 25 matched pairs of patients. Mean healing time, hospitalization time and sick leave in the plaster cast and IMLN groups were 19 (SD 6.7) and 12 (SD 4.4) weeks (P<0.001); 8 (SD 4.8) and 7 (SD 2.7) days (P=0.686); and 195 (SD 81) and 106 (SD 31) days (P=0.001), respectively. No difference was found between plaster cast and IMLN groups when the outcome was evaluated using the criteria of Johner and Wruhs.

Adult↗

Predictors of discharge to home during the first year after right hemisphere stroke.

OBJECTIVES: The aim of this study was to explore predictive factors of the length of hospital stay at the acute stage of right hemisphere stroke. Special attention was paid to the possible role of anosognosia for hemiparesis and anosognosia for neglect in this prediction. PATIENTS AND METHODS: A consecutive series of 57 patients having their first right hemisphere stroke were examined at the acute phase. Forty-nine patients were included in this study and followed-up for 12 months. The examinations were conducted within 2 weeks of onset. The outcome variable was the time (days) from stroke to discharge to home. The predictors were age, gender, size of infarct, neglect, hemiparesis, verbal memory, unawareness of illness, anosognosia for neglect, anosognosia for hemiparesis and presence of a relative at home. RESULTS: Hemiparesis and unawareness of illness lengthened the duration of the hospital stay, the presence of a relative reduced it. Neglect was the best single predictor of poor outcome, but it had no additional value in the combination of the three predictors above. Neither anosognosia for hemiparesis nor anosognosia for neglect were important predictors. CONCLUSION: Hemiparesis, unawareness of illness and presence of a relative at home were the best predictors of the time from right hemisphere stroke to discharge to home.

Activities of Daily Living↗

Alarming wear of the first-generation polyethylene liner of the cementless porous-coated Biomet Universal cup: 107 hips followed for mean 6 years.

Wear of the socket liner and resulting osteolysis are the major causes of failure in cementless hip arthroplasties. We report alarming wear of the first-generation polyethylene liner of the cementless porous-coated Biomet Universal cup. Radiographs of 107 primary hip arthroplasties were analyzed retrospectively. The mean follow-up time was 74 (47-91) months. The linear wear of the polyethylene liners was assessed using a modification of the Livermore method. The median linear wear was 1.0 (0-6.2) and the median linear wear rate was 0.17 mm/year. There was a statistically significant difference between the 28 mm and 32 mm femoral head groups both in the volumetric wear and in the volumetric wear rate. The median linear wear was 0.28 mm/year and 0.14 mm/year for the 32 mm and 28 mm heads, respectively. So far, 14 revisions have been performed or have been scheduled because of excessive wear of the polyethylene liner. In regression analysis, the factors related to the wear rate were the 32 mm size of the femoral head and screw fixation of acetabular shell. We found that the cases with calcar rounding were associated with significantly greater wear. Possible reasons for increased wear of the Hexloc liner may be the cylindrical design, thin polyethylene, and poor quality of the polyethylene. Regular clinical and radiographic follow-ups are recommended especially for hips with 32 mm femoral heads or with screw fixation. If progressive wear of the liner is observed, revision must be considered.

Adult↗

Polymorphism of the cytokine genes in hospitalized patients with Puumala hantavirus infection.

BACKGROUND: Nephropathia epidemica (NE) is a mild type of haemorrhagic fever with renal syndrome caused by Puumala (PUU) hantavirus. The clinical course of NE varies from asymptomatic to fatal. The aim of this study was to establish whether polymorphisms in the cytokine genes are associated with susceptibility to and outcome of NE. METHODS: The genotypes of the genes of tumour necrosis factor alpha (TNFalpha), interleukin-1alpha (IL-1alpha), IL-1beta and IL-1 receptor antagonist (IL-1RA) were analysed by polymerase chain reaction in 87 subjects, all hospital-treated for serologically confirmed acute NE. The control group comprised 400 healthy blood donors. Nineteen out of these 400 (5%) controls were PUU virus-seropositive. RESULTS: IL-1RA allele 2 and IL-1beta (base exchange polymorphism at position -511) allele 2 were strongly associated with each other in both groups. NE patients were more often IL-1RA-2 negative/IL-1beta-2 negative than PUU-seronegative blood donors (38 vs 27%, odds ratio 1.65, 95% confidence interval 1.0-2.7). However, there were no differences in the clinical severity of NE between the IL-1RA-2 negative/IL-1beta-2 negative and the other patients. The other allele frequencies studied evinced no statistically significant differences between the groups. Thirty-three out of 87 (38%) patients and 121 out of 381 (32%) seronegative controls were carriers of the high-producer genotype TNF2 allele. Several parameters showed the clinical course of NE to be more severe in TNF2 carriers than in non-carriers. CONCLUSIONS: These data suggest that non-carriage of the IL-1RA allele 2 and IL-1beta (-511) allele 2 may contribute to susceptibility to NE. Furthermore, TNFalpha polymorphism seems to be associated with the outcome of NE.

Adolescent↗

Genetic determinants of bone mineral content in premature infants.

Genetic determinants of bone mineral content in prematurely born children at 3 months and 9-11 years of age were studied. The findings suggest that multiple genes are involved in the regulation of site specific bone mass accumulation during childhood.

Absorptiometry, Photon↗

Wellbeing of professionals at entry into the labour market: a follow up survey of medicine and architecture students.

STUDY OBJECTIVE: Knowledge about changes in wellbeing during the passage from professional studies to working life is scarce and controversial. This study examined these changes among university graduates with good and poor employment prospects. DESIGN: A longitudinal study with four postal questionnaire surveys of a closed cohort. SETTING: Cohorts of graduating Finnish physicians and architects were followed up from 1994 to 1998. In 1994 Finland's national economy was still struggling to break loose from a period of severe recession, and unemployment rates were high even among educated professionals. As economic growth eventually got under way the unemployment situation began to ease for physicians but not for architects. PARTICIPANTS: Architecture students (n = 189) from Finland's three technical universities and medical students (n = 638) from Finland's five medical faculties. Both had started their studies in 1989. RESULTS: In the first questionnaire survey there were no differences between the professions in strain resistance resources, as indicated by Sense of Coherence (SOC), or in psychological distress, as indicated by General Health Questionnaire (GHQ). Profession emerged as a significant between subject factor in analysis of variance for repeated measures of both SOC and GHQ. Physicians' scores on the 13 item SOC questionnaire improved during the follow up from 62.6 to 67.5 and on the 12 item GHQ questionnaire from 24.2 to 22.2. Among architects the corresponding scores remained unchanged (62.5-62.2 and 23.1-22.6). The significance of profession remained unchanged when gender and individuals' graduation and total work experience were introduced to the statistical models as between subject factors. CONCLUSIONS: Improved SOC in physicians but not in architects supports the hypothesis that good employment prospects are important to employee wellbeing. Although less consistent, indicating fluctuations in day to day psychological distress, GHQ findings are also in line with the hypothesis. In both professions the indicators studied were independent of individuals' graduation and career. It is concluded that rather than individually, the mechanisms that connect employment prospects with wellbeing operate collectively within the whole profession. Highly educated professionals do not complete their studies until almost 30, and if for reasons of insecure employment they are unable to develop their SOC to the optimum level at that age, their resources for resisting health endangering strain may remain permanently poor.

Adult↗

Association of smoking with urgency in older people.

OBJECTIVE: To evaluate the association of smoking with urgency in older people. METHODS: A population-based survey involving 1,059 people aged 60-89 years. A stratified sampling method was used and data were collected by interviews. The response rate was 82%. The indicators were urgency, former and current smoking, alcohol and coffee drinking. Prevalences of urgency were calculated for 15-year age groups of the two genders. Logistic regression models were used to analyse the age-adjusted association of urgency with smoking, use of alcohol and coffee drinking in the whole study population and separately in the two gender groups. RESULTS: The prevalence of urgency was lowest among younger men (6.6%) and highest among older women (19.5%). In the whole study population including both genders the current smokers were at greater risk of suffering from urgency [OR (odds ratio) 2.76; 95% CI (confidence interval) 1.43-5.32] than the never-smokers while the OR of urgency for former smokers was 1.63 (95% CI 0.97-2.74). In the separate models for the two genders the current male smokers (OR 2.55; 95% CI 1.13-5.73) and the former female smokers (OR 2.62; 95% CI 1.14-6.0) were at greater risk. The OR for current female smokers was 2.54 (95% CI 0.79-8.22), but the group was very small. Alcohol use and coffee drinking were not associated with urgency. CONCLUSION: Smoking is associated with urgency in older people. Especially current smokers are at greater risk than never-smokers. The prevalence of urgency is higher among women and is increased in both genders with advancing age. The study material being cross-sectional the causal relationship cannot be confirmed.

Age Factors↗

Gestational health and predictors of newborn weight amongst pregnant women in rural Malawi.

This study was conducted to provide community-based data on maternal health and predictors of newborn weight in rural Malawi. Data were obtained prospectively from a community-based cohort of 581 pregnant women who attended an antenatal clinic and delivered a term, live-born, singleton infant in Lungwena, rural Malawi. Morbidity from infectious diseases and anaemia was common. Maternal weight gain in rural Malawi was slower but fundal height gain was comparable to that of an affluent western population. The mean +/- SD weight of term newborns was 3.2 +/- 0.5 kilograms. A regression model including data from all routine investigations explained only 24% of the variance in newborn weights, suggesting that routine antenatal measurements had a limited power to predict the size of term live-born babies. Maternal parity, initial weight, the duration of pregnancy and gestational weight gain were associated with newborn weights and should, therefore, be systematically recorded in rural Malawian antenatal clinics.

Adult↗

Is the presenilin-1 E318G missense mutation a risk factor for Alzheimer's disease?

Nearly all of the presenilin-1 (PSEN-1) mutations are missense mutations leading to Alzheimer's disease (AD). The role of the mutation E318G (a substitution of glutamic acid to glycine) in the PSEN-1 is controversial. It has been found both in AD patients and in non-demented control individuals. Using the polymerase chain reaction and the restriction fragment length polymorphism method, we screened for E318G mutation in a total of 16 familial (FAD) cases, in 64 sporadic neuropathologically confirmed AD cases and in 270 non-demented controls including 35 neuropathologically confirmed individuals. We detected the E318G mutation in four FAD cases, seven sporadic AD cases and 10 control individuals with highly varying onset-ages. Odds ratios for carrying the mutation were 7.6 and 3 in FAD and sporadic AD cases, respectively. Our results suggest that this mutation could be a risk factor in the Finnish FAD and sporadic AD population. It may be in linkage disequilibrium with a pathogenic change somewhere else in the PSEN-1 gene or in close proximity to the PSEN-1 gene.

Aged↗