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Biomedical subjects

A Reunanen

Publications and source records attributed to A Reunanen.

At least 19 recordsLinked to original sources
PubMed1996

Seasonality in the clinical onset of insulin-dependent diabetes mellitus in Finnish children. Childhood Diabetes in Finland (DiMe) Study Group.

Seasonal patterns in the incidence of insulin-dependent diabetes based on 2,062 cases diagnosed at age 14 years or under in Finland are described for the years 1987-1992. Seasonal patterns were estimated presenting the data as short Fourier series up to three harmonics together with a possible linear trend. This method allows an arbitrary shape for the seasonal effect. Likelihood ratio tests and Akaike's information criterion were used to determine the number of harmonics necessary to model the seasonal pattern and to test differences among age- and sex-specific subgroups in the population. Seasonal patterns in incidence were compared between sexes and between the three 5-year age groups with each controlling for the other's effect. A significant seasonal pattern in the incidence of insulin-dependent diabetes was found for the sexes combined and for two age groups (0-9 and 10-14 years). A statistically significant seasonal pattern could be confirmed for males, but not for females. During a calendar year, one cycle with a decreased incidence of insulin-dependent diabetes in June was found among younger boys. Among older boys, there were two distinct cycles with a decreased incidence, the first in June and the second during November-December. The most visible seasonal pattern was a lower number of cases diagnosed in June, while during the rest of the year the incidence remained relatively stable and high. The average annual incidence was 35.6 per 100,000 persons without any upward peaks.

Adolescent↗
PubMed1995

Cardiovascular morbidity in relation to ovarian function after hysterectomy.

OBJECTIVE: To determine if removal of the uterus with ovarian preservation is associated with cardiovascular morbidity and risk factors. METHODS: Self-reported histories of gynecologic surgery of 3895 women from 40 regions in Finland, 30-95 years old, were collected in 1977-1980, and 78% of hysterectomies were confirmed from the hospital records. Cardiovascular risk factors (total- and high-density lipoprotein cholesterol, education, body mass index [BMI], blood glucose, and triglycerides), parity, and current use of hormone replacement therapy were used to adjust the risk of hypertension (less than 60 years old and diastolic blood pressure [BP] at least 95 mmHg, or 60 years older and diastolic BP at least 100 mmHg), coronary heart disease, and heart failure. The women with unconfirmed hysterectomies and missing information on cardiovascular risk factors were excluded. Thereafter, the final number of subjects included in the analysis was 3780. RESULTS: One or no ovary was removed in 163 hysterectomies, and in 55 cases, both ovaries were removed. Women with hysterectomy and preservation of at least one ovary had significantly higher diastolic BP and higher BMI than those who had not undergone hysterectomy. Women with hysterectomy and ovarian preservation also had a significantly increased risk of hypertension (odds ratio 2.2, 95% confidence interval 1.5-3.1). The risks of other heart diseases (angina pectoris, myocardial infarction, and heart failure) were not significantly increased. CONCLUSION: Hysterectomy with ovarian preservation is associated with increased risk of high diastolic BP, diagnosis of hypertension, and increased BMI, but not with other heart diseases. Either hysterectomy increases the risk of hypertension or the increase of BP and the development of myomas, which often lead to hysterectomy, are explained by a common pathogenetic mechanism.

Adult↗
PubMed1995

Parity and risk of rheumatoid arthritis in Finnish women.

Several recent case-control studies have suggested that nulliparity is a risk factor for rheumatoid arthritis (RA). We studied parity for its association with the incidence of RA in a cohort of adult Finnish women examined by the Mobile Clinic of the Social Insurance Institution in 1966-72. The 15,441 women were > or = 30 yr of age and had neither arthritis nor a history of it at the time of the baseline examination. They were followed up by examining records kept at the population register of the institution, to identify patients entitled to free anti-rheumatic medication. Up to late 1989, 269 women had developed RA. Of the incident cases, 176 were rheumatoid factor (RF)-positive. Compared with nulliparous women, the age-adjusted relative risks (95% confidence intervals) of parous women developing RF-positive RA, RF-negative RA or either type were 1.26 (0.82-1.92), 0.80 (0.48-1.32) and 1.06 (0.77-1.46), respectively. The number of childbirths presented an n-shaped relationship with the risk of RF-positive RA, but there were distinct differences between subpopulations. In female farmers the association was inverse, but in housewives and in other occupational groups (mainly employees) it was clearly positive. The results challenge the view that there is a causal relation between parity status and the development of RA.

Adult↗
PubMed1995

Body iron stores, dietary iron intake and coronary heart disease mortality.

OBJECTIVES: To assess whether increased body iron stores and dietary iron intake are associated with an increased risk of coronary heart disease mortality. DESIGN: A prospective population study with a mean mortality follow-up time of 14 years. SETTING: Participants attending a health screening examination carried out in several localities in Finland. SUBJECTS: All 6086 men and 6102 women aged from 45 to 64 years at the baseline examination without known heart disease, who had had serum iron and total iron binding capacity (TIBC) assessed. In a random fifth of these people, dietary iron intake was assessed by a dietary history. INTERVENTIONS: The study was observational without any interventions. MAIN OUTCOME MEASURES: Mortality from coronary heart disease. RESULTS: Altogether, 739 of the men and 245 of the women died from coronary heart disease. No relationship between TIBC and coronary mortality was observed in the men; in the women, an inverse although not significant association was found. Transferrin saturation was inversely but not significantly associated with coronary mortality in men; in women, the relationship was U-formed with a higher mortality at both the lower and higher ends of the distribution. Adjustment for other risk factors did not alter the results. No association was found with dietary iron intake and coronary mortality. CONCLUSIONS: The results do not corroborate earlier findings that excess body iron stores and increased iron intake are associated with an elevated risk of coronary heart disease.

Coronary Disease↗
PubMed1995

Rheumatoid factor, chronic arthritis and mortality.

OBJECTIVE: To investigate chronic arthritis and rheumatoid factor (RF) for their prediction of premature total and cardiovascular mortality. METHODS: In 1978-80, a representative population sample of 8000 Finns aged 30 or more was invited to participate in a comprehensive health examination; 90% complied. Arthritis was diagnosed on the basis of medical history, symptoms, and physical examination. Serum RF was determined by the sensitised sheep cell agglutination test. RESULTS: By the end of 1992 1597 of the subjects had died from all causes, including 876 deaths from cardiovascular diseases. When adjusted for age, gender and smoking, the relative risk of persons with RF positive arthritis dying from any cause was 1.61 (95% confidence interval (CI) 1.03 to 2.51); RF negative non-erosive arthritis was not associated with mortality (relative risk 1.03; 95% CI 0.72 to 1.49). In the absence of arthritis, 'false positive' RF titres > or = 128 predicted cardiovascular deaths with a relative risk of 1.74 (95% CI 1.06 to 2.86). CONCLUSION: Both RF positive arthritis and false positive RF reactions predict mortality, but through different disease patterns.

Adult↗
PubMed1995

Prevalence and risk factors of varicose veins in lower extremities: mini-Finland health survey.

OBJECTIVE: To study the prevalence and risk factors of clinically important varicose veins in the lower extremities. DESIGN: Cross-sectional study with self-administered questionnaire. SETTING: A national health examination survey, Finland. SUBJECTS: 8000 people from 40 geographical areas representing the adult population aged 30 years and over. RESULTS: The prevalence of varicose veins diagnosed by a physician was 25% in women and 7% in men. Twenty-nine per cent of the men and 53% of the women with diagnosed varicose veins had been treated surgically. Age, height, body mass index (weight/height2), standing at work, and the number of births were expected risk factors associated with varicosities. Unexpectedly, signs of osteoarthrosis were positively, and diabetes negatively, associated with varicose veins. Urban dwelling and high income correlated positively with varicose veins treated surgically in women. CONCLUSIONS: Varicose veins in the lower extremities are common, and demand considerable health service resources. The aetiology of varicose veins is still incompletely understood and more research is needed to develop possible preventive measures.

Adult↗
PubMed1994

Antioxidant vitamin intake and coronary mortality in a longitudinal population study.

Oxidation of lipoproteins is hypothesized to promote atherosclerosis and, thus, a high intake of antioxidant nutrients may protect against coronary heart disease. The relation between the intakes of dietary carotene, vitamin C, and vitamin E and the subsequent coronary mortality was studied in a cohort of 5,133 Finnish men and women aged 30-69 years and initially free from heart disease. Food consumption was estimated by the dietary history method covering the total habitual diet during the previous year. Altogether, 244 new fatal coronary heart disease cases occurred during a mean follow-up of 14 years beginning in 1966-1972. An inverse association was observed between dietary vitamin E intake and coronary mortality in both men and women with relative risks of 0.68 (p for trend = 0.01) and 0.35 (p for trend < 0.01), respectively, between the highest and lowest tertiles of the intake. Similar associations were observed for the dietary intake of vitamin C and carotenoids among women and for the intake of important food sources of these micronutrients, i.e., of vegetables and fruits, among both men and women. The associations were not attributable to confounding by major nondietary risk factors of coronary heart disease, i.e., age, smoking, serum cholesterol, hypertension, or relative weight. The results support the hypothesis that antioxidant vitamins protect against coronary heart disease, but it cannot be excluded that foods rich in these micronutrients also contain other constituents that provide the protection.

Adult↗
PubMed1994

Body iron stores and risk of cancer.

A high level of available tissue iron may increase the risk of cancer through its contribution to the production of free oxygen radicals. Serum iron, total iron-binding capacity (TIBC) and transferrin saturation levels were studied for their prediction of different cancers in a cohort of 41,276 men and women aged 20-74 years and initially free from cancer. During a mean follow-up of 14 years, 2,469 primary cancer cases were diagnosed. Excess risks of colorectal and lung cancers were found in subjects with transferrin saturation level exceeding 60%. The relative risks, adjusted for age, sex and smoking, were 3.04 for colorectal cancer and 1.51 for lung cancer, in comparison with subjects having lower levels. The risk of lung cancer was inversely related to serum TIBC, with a relative risk between the highest and lowest quartiles of 0.69 for men and 0.19 for women. For the risk of stomach cancer, we detected inverse relationships with serum iron and with transferrin saturation and a positive relationship with TIBC, but these associations weakened when the cancer cases occurring during the 5 first years of follow-up were excluded. High iron stores may increase the risk of colorectal cancer, whereas low iron stores may be an early sign of occult stomach cancer.

Adolescent↗
PubMed1994

Depression and cardiovascular diseases.

We first review the associations between depression and cardiovascular diseases (CVDs). Then we examine them in the nationally representative Mini-Finland Health Survey, which covers 8,000 persons. Chronic somatic diseases and mental disorders were diagnosed using standardized methods. Cross-sectionally, CVDs and neurotic depression were associated both before and after adjustment for covariates. The strongest associations were observed in the case of severe CVDs. During a 6.6 year follow-up, the risk of CVD death and coronary death was elevated in depressed persons both with and without CVDs at entry. Much of the cross-sectional association is probably due to depression caused by CVDs. The outcome of CVD may be poorer in depressed persons. The hypothesis that depression is a cause of CVDs requires further study.

Adult↗
PubMed1994

Antioxidant vitamins in the diet: relationships with other personal characteristics in Finland.

STUDY OBJECTIVE: The study aimed to reveal associations between dietary antioxidant vitamins and other personal characteristics. DESIGN: Population based, cross sectional survey. SETTING: Twenty seven rural, industrial, and semiurban communities in six different regions of Finland. PARTICIPANTS: Subjects included 5304 men and 4750 women aged 15 years or older, who were interviewed about their dietary habits at the baseline study of the Finnish Mobile Clinic Health Examination Survey, 1967-72. MAIN RESULTS: Intakes of carotenoids and vitamins A, E, and C were estimated from dietary history interviews covering the subjects' food consumption in the preceding year. In older age groups intakes of all the vitamins studied were low. Occupation had a profound effect on dietary antioxidant vitamins: intakes were highest in white collar workers and lowest in farmers; those classified as service workers, industrial workers, or housewives came in between. Current smoking was inversely associated with dietary carotenoids and vitamin C, especially in men. The vitamin intakes of ex-smokers were equal to or even slightly higher than those of never smokers. Married men had higher intakes of carotenoids and vitamin C than men living alone. Body mass index was not an important determinant of the intake of antioxidant vitamins. CONCLUSIONS: The associations of dietary antioxidant vitamins with sociodemographic characteristics and smoking were strong enough to exert a confounding or modifying effect in studies on diet and diseases.

Adolescent↗
PubMed1994

Hospital use among diabetic patients and the general population.

OBJECTIVE: This register-based linkage study compared hospital use among diabetic and nondiabetic populations. The study focused on overall use, use by disease categories, and inpatient care caused by complications. RESEARCH DESIGN AND METHODS: The patient data were derived from the Hospital Discharge Register and the Central Drug Register in Finland. All drug-treated diabetic patients and discharges of patients in a 3-year period were included in the study. Hospital use was measured by inpatient days, mean length of stay, and discharge rate. RESULTS: Among diabetic patients were eligible for drug reimbursement, 14.2% had at least one hospital stay because of diabetes in a year, while 50.7% had at least one hospital stay for any cause. Only 12.4% of the nondiabetic population was hospitalized annually. Patients with diabetes as the principal diagnosis consumed about 3% of all inpatient days; patients who had diabetes either as the principal or as a subsidiary diagnosis used 8.3%; and people who were eligible for antidiabetic drug reimbursement used 13.3% of total inpatient days. Among diabetic children, the risk for hospitalization was 6.5 times higher than among nondiabetic children. With advancing age, causes other than diabetes increasingly dominated hospitalization among diabetic patients. Inpatient days because of cardiovascular diseases were 1.6-18 times more common among diabetic patients than among nondiabetic patients, depending on gender and age-group. Diabetic patients used many more hospital inpatient days than did the nondiabetic population for a number of other disease categories that are usually not related to diabetes. CONCLUSIONS: Hospital use among diabetic patients is substantially greater than that among the nondiabetic population, mainly because of cardiovascular and microvascular complications, but also because of diseases unrelated to diabetes.

Adolescent↗
PubMed1994

Health-based reference values of the Mini-Finland Health Survey: 2. Cholesterol in total serum and in different lipoprotein fractions.

The reference values for cholesterol concentrations in the whole serum and in its VLDL, LDL and HDL fractions have been produced based on the data obtained in the Mini-Finland Health Survey. The lipoprotein fractions were separated with ultracentrifugation. The aim was to obtain reference values for the apparently healthy, ambulatory population. Two health-derived criteria were used to select subjects for reference populations: those based on the literature available and those based on the recommendations published by the Committee on Reference Values of the Scandinavian Society for Clinical Chemistry and Clinical Physiology, with slight modifications. The 95% inner reference intervals of total serum cholesterol in all the subjects and in the two selection groups were 4.2-9.0, 4.2-8.4, and 4.2-8.5 mmol l-1 for men, and 4.2-9.4, 4.1-8.6, and 4.2-9.0 mmol l-1 for women, respectively. The corresponding medians were 6.3, 6.2 and 6.2 mmol l-1 in men, and 6.4, 6.0 and 6.1 mmol l-1 in women, respectively. Frequency distribution curves showed clear skewness to the right in VLDL cholesterol and slight skewness in LDL and HDL cholesterol. In women there was a clear rise in total, VLDL and LDL cholesterol after the early middle age, whereas HDL cholesterol was lower in the older age groups. In men the age dependency was not as prominent; total cholesterol levels showed lower levels in older men. Of the background lifestyle factors alcohol consumption, smoking, obesity and physical exercise had negligible associations with total, VLDL, LDL and HDL cholesterol reference intervals.

Adult↗
PubMed1994

Health-based reference values of the Mini-Finland Health Survey: 3. Triglycerides in total serum and in different lipoprotein fractions.

The reference values for triglyceride concentrations in total serum and in its VLDL, LDL and HDL fractions have been produced based on the data obtained in the Mini-Finland Health Survey. The lipoprotein fractions were separated with ultracentrifugation. Efforts were made to obtain reference values for the healthy ambulatory population. Two health-derived selection criteria were used for inclusion of persons into the reference population: those based on the literature available and those based on the recommendations published by the Committee on Reference Values of the Scandinavian Society for Clinical Chemistry and Clinical Physiology, with minor modifications. The frequency distributions of triglycerides especially in total serum and in VLDL fraction were very skewed. Because of that the data were transformed before the calculation of the reference ranges according to the method of Box and Cox [1]. This transformation method appeared to be the best one of many tested methods in obtaining the distributions closer to the normal ones. The 95% inner reference intervals of total serum triglycerides in all subjects and in the two selection groups were 0.5-4.0, 0.5-2.8, and 0.5-3.2 mmol l-1 for men and 0.5-3.4, 0.5-2.3, and 0.5-2.4 mmol l-1 for women, respectively. The age dependence of triglyceride level was prominent in women after the early middle age. The distribution and age dependence of VLDL triglycerides resembled those of total triglycerides. In LDL and HDL fractions the skewness was not as clear as in the whole serum or in VLDL fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults.

Falls are the most common cause of nonfatal injuries and a major cause of injury death. In order to identify risk factors for injuries from falls, 19,518 persons aged 20-92 years from four regions of Finland were examined and followed up from between 1973 and 1977 to 1984 for 8 to 11 years by identifying hospital admissions or deaths due to fall injuries. During 187,405 person-years, 628 injuries from falls were documented. The risk for injuries from falls was significantly and independently of other factors associated with alcohol intake in all age and sex groups. After adjustment for all the other risk determinants, the relative risks (RR) (95% confidence intervals (CI)) in persons with monthly ethanol intake of 100-499 g, 500-999 g, and > or = 1,000 g were 1.43 (1.13-1.82), 2.32 (1.71-3.17), and 3.05 (2.05-4.55), respectively, compared with abstainers. Body mass index (kg/m2) > or = 30 was associated with an increased risk among women aged < 45 years (RR = 2.8, 95% CI 1.28-5.89), whereas in persons aged > or = 65 years it seemed to be a protective factor both among men (RR = 0.3, 95% CI 0.06-1.19) and women (RR = 0.5, 95% CI 0.30-0.76). Also single marital status, smoking, heavy physical activity during leisure time, use of psychopharmacologic agents, diabetes mellitus, and cardiovascular diseases other than stroke were found to carry independent predictive significance in at least one subgroup of sex and age. In conclusion, alcohol consumption, relative weight, and use of psychopharmacologic agents were seen to be the most relevant risk determinants. Intervention trials based on the predictive factors and on high-risk groups are needed.

Accidental Falls↗
PubMed1993

Decline of mumps antibodies in type 1 (insulin-dependent) diabetic children and a plateau in the rising incidence of type 1 diabetes after introduction of the mumps-measles-rubella vaccine in Finland. Childhood Diabetes in Finland Study Group.

A nationwide mumps-measles-rubella vaccination was introduced in 1982 in Finland to children aged 1.5 to 6 years and since then mumps has virtually disappeared in the country. We investigated whether this rapid epidemiological change had any impact on antibody activity against mumps virus in Type 1 (insulin-dependent) diabetic children or on the incidence of Type 1 diabetes in Finland. Two case-control series were collected before (series I and II) and three series after (series III-V) the introduction of the vaccination. IgA class mumps antibody levels were significantly higher in Type 1 diabetic children than in matched control children in the first two but not in the three later series. IgG class antibody levels were similar in patients and control subjects in the first two series but significantly lower in patients than in control subjects in the three later series. The overall incidence of Type 1 diabetes in 0-14-year-old children increased until 1987 but remained about the same during 1988-1990. In 5-9-year-old children no further increase in Type 1 diabetes was seen since 1985, whereas in 0-4-year-old children the incidence continued to rise until 1990. The results suggest that the elimination of natural mumps by mumps-measles-rubella vaccination may have decreased the risk for Type 1 diabetes in Finland; a possible causal relationship is substantiated by the observed concomitant decrease in mumps antibody levels in diabetic children. However, further studies are required to determine if the vaccine virus, like natural mumps, could trigger the clinical onset of Type 1 diabetes in young children.

Adolescent↗
PubMed1993

Effect of heliotherapy on skin and joint symptoms in psoriasis: a 6-month follow-up study.

The effect of heliotherapy on psoriasis skin lesions and arthritis was studied in a trial comprising 4 weeks of therapy in the Canary Islands and a 6-month follow-up period. A total of 373 patients participated in the heliotherapy and 361 patients completed the follow-up period. The severity of skin lesions was evaluated using a psoriasis severity index (PSI), and that of the arthropathy by using an arthritis index (AI). During heliotherapy, the PSI decreased significantly from the initial median value of 4.5 to the final value of 0.2. A reduction in the PSI of at least 75% was achieved in 84% of the patients. Guttate psoriasis improved significantly better than plaque-type or erythrodermic psoriasis. There was no correlation between skin type and improvement. Initially, 129 patients had symptoms of arthritis. During heliotherapy, the AI decreased significantly from the initial median value of 6 to the final value of 2. The median time until starting another treatment after heliotherapy was 80 days, and the PSI had returned to its original value in 49% of the patients in 6 months. In patients with joint symptoms the AI returned to the pretreatment level within 6 months. A 4-week heliotherapy period effectively cleared psoriasis, alleviated joint symptoms, and reduced both morbidity and treatment requirement to a considerable extent in the ensuing 6-month period.

Adolescent↗
PubMed1993

Supervised four-week heliotherapy alleviates the long-term course of psoriasis.

The long-term effects of psoriasis heliotherapy were studied in a randomized cross-over trial with a 2-year follow-up. We allocated 95 patients randomly to receive a 4-week heliotherapy course, either at the onset or in the middle of the follow-up period. After a highly significant immediate alleviation of psoriasis about 50% of the patients still had a reduction of psoriasis 6 months later and about 25% one year later. A favourable carry-over treatment effect was still observed during the second follow-up year. Taking advantage of the cross-over design, the effect of heliotherapy was calculated to be statistically significant during the first follow-up year, and the apparent long-term alleviation of psoriasis after the heliotherapy was reflected in a significant period effect. The alleviation of psoriasis was accompanied by a significant decrease in the use of antipsoriatic treatments.

Adult↗