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Biomedical subjects

A Reunanen

Publications and source records attributed to A Reunanen.

At least 91 records · Page 5Linked to original sources
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↗
PubMed1993

Smoking and risk of rheumatoid arthritis.

OBJECTIVE: To investigate smoking for its association with the incidence of seropositive and seronegative rheumatoid arthritis (RA). METHODS: A cohort of adult Finns was examined by the Social Insurance Institution's Mobile Clinic in 1966-72. The 24,445 women and 28,364 men who had neither arthritis nor a history of it at the start of the study were followed until the end of 1989 using record linkage with the Institution's population register to identify patients entitled to free antirheumatic medication. Sufficient information was obtained on 512 incident cases of RA, of whom 119 men and 229 women were seropositive and 42 men and 122 women seronegative. RESULTS: There was a close association between smoking and the incidence of seropositive RA in men. It was not due to confounding by age, geographical location of residence, marital status, social class, self-perceived general health, or body mass index, although these factors correlated with smoking history. As adjusted for these factors, the relative risk of seropositive RA was 2.6 (95% confidence interval, 1.3-5.3) in male ex-smokers and 3.8 (95% confidence interval, 2.0-6.9) in current smokers, in comparison with the men who had never smoked. The association persisted throughout the entire followup period, but it was most distinct after the first 14 years of followup. Smoking did not predict seropositive RA in women, nor was it predictive of seronegative RA in men or women. CONCLUSION: Exposure to tobacco smoke, or some factor or cluster of factors associated with smoking, may trigger the production of rheumatoid factors and, in interaction with the male sex, subsequently contribute to the development of clinically manifest RA.

Adolescent↗
PubMed1992

Serum ceruloplasmin level and the risk of myocardial infarction and stroke.

The associations between serum ceruloplasmin level and the subsequent incidence of myocardial infarction and stroke were studied in a nested case-control study in Finland (baseline examination 1968-1972). Ceruloplasmin levels were measured in stored serum samples from 104 myocardial infarction or stroke cases occurring during a median follow-up of about 11 years and from 104 individually matched controls. High serum ceruloplasmin levels were significantly associated with higher future odds of myocardial infarction but not of stroke. The odds ratios for myocardial infarction and stroke comparing the highest and lowest tertiles of serum ceruloplasmin, adjusted for smoking, serum cholesterol, body mass index, hematocrit, hypertension, and diabetes, were 3.1 and 0.7, respectively. The results of the present study support the hypothesis that a high serum ceruloplasmin level is a risk factor for myocardial infarction.

Adolescent↗
PubMed1992

Epidemiology of childhood diabetes mellitus in Finland--background of a nationwide study of type 1 (insulin-dependent) diabetes mellitus. The Childhood Diabetes in Finland (DiMe) Study Group.

A nationwide study of childhood Type 1 (insulin-dependent) diabetes mellitus was established in 1986 in Finland, the country with the highest incidence of this disease worldwide. The aim of the project called "Childhood Diabetes in Finland" is to evaluate the role of genetic, environmental and immunological factors and particularly the interaction between genetic and environmental factors in the development of Type 1 diabetes. From September 1986 to April 1989, 801 families with a newly-diagnosed child aged 14 years or younger at the time of diagnosis were invited to participate in this study. The vast majority of the families agreed to participate in the comprehensive investigations of the study. HLA genotypes and haplotypes were determined in 757 families (95%). Our study also incorporates a prospective family study among non-diabetic siblings aged 3-19 years, and two case-control studies among the young-onset cases of Type 1 diabetes. During 1987-1989, the overall incidence of Type 1 diabetes was about 35.2 per 100,000 per year. It was higher in boys (38.4) than in girls (32.2). There was no clear geographic variation in incidence among the 12 provinces of Finland. Of the 1,014 cases during these 3 years only six cases were diagnosed before their first birthday. The incidence was high already in the age group 1-4-years old: 33.2 in boys and 29.5 in girls. Of the 801 families 90 (11.2%) were multiple case families, of which 66 had a parent with Type 1 diabetes at the time of diagnosis of the proband.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Concordance for type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus in a population-based cohort of twins in Finland.

We studied the cumulative incidence, concordance rate and heritability for diabetes mellitus in a nationwide cohort of 13,888 Finnish twin pairs of the same sex. The twins were born before 1958 and both co-twins were alive in 1967. Data on diabetes were derived through computerized record linkage from death certificates, the National Hospital Discharge Register and the National Drug Register. Records were reviewed in order to assign a diagnostic category to the 738 diabetic patients identified. Of these patients 109 had Type 1 (insulin-dependent) diabetes, 505 Type 2 (non-insulin-dependent) diabetes, 46 gestational diabetes, 24 secondary diabetes, 38 impaired glucose tolerance and 16 remained unclassified. The cumulative incidence of diabetes was 1.4% in men and 1.3% in women aged 28-59 years and 9.3% and 7.0% in men and women aged 60 years and over, respectively. The cumulative incidence did not differ between monozygotic and dizygotic twins. The concordance rate for Type 1 diabetes was higher among monozygotic (23% probandwise and 13% pairwise) than dizygotic twins (5% probandwise and 3% pairwise). The probandwise and pairwise concordance rates for Type 2 diabetes were 34% and 20% among monozygotic twins and 16% and 9% in dizygotic twins, respectively. Heritability for Type 1 diabetes was greater than that for Type 2 where both genetic and environmental effects seemed to play a significant role.

Adult↗
PubMed1992

Incidence of heart failure in eastern Finland: a population-based surveillance study.

Heart failure is a frequent disorder, but there is little population-based data available on its incidence. We have studied the incidence of heart failure in 45-74-year-old inhabitants in four rural communities in eastern Finland (total population 37,600; 11,000 45-74 years of age). The aim was to identify all patients in whom symptoms had started and in whom a diagnosis of heart failure had been established during a 2-year study period. General physicians, working in community health centres in the study area, referred all their patients with suspected heart failure to the study. A register of drug reimbursement, hospital discharge and other health care registers were used to identify patients who had not been referred. The Boston criteria were used to verify the diagnosis. One hundred and thirteen subjects (51 men and 62 women) were enrolled, of whom 51 (38 men and 13 women) had definite heart failure. Age-adjusted incidence rate of heart failure (per 1000 . year-1) was 4.0 in men and 1.0 in women, and the incidence rates increased with age in both sexes. Coronary heart disease or hypertension was evident in 41 (80%) cases. The striking difference in the incidence rates between men and women is probably explained by the excessive occurrence of coronary heart disease among men in eastern Finland.

Age Factors↗
PubMed1991

Changes in the prevalence and incidence of diabetes mellitus in Finnish adults, 1970-1987.

Prevalence and incidence of known diabetes mellitus in Finnish subjects aged 30 years or over in 1970-1987 were investigated using a nationwide register of drug recipients and four population surveys. On the basis of the drug-register data, the prevalence of drug-treated diabetes in men increased from 1.5% in 1970 to 2.8% in 1987. In women, the prevalence increased from 2.1% in 1970 to 3.0% in 1979 and declined thereafter slightly to 2.7% in 1987. The increase in the prevalence of drug-treated diabetes was mainly due to the increase of diabetes in the age groups 60 years and older. The prevalence of all known diabetic subjects in the population studies increased from 2.1% in the health examination survey of 1966-1972 (n = 38,676) to 3.5% in the interview survey of 1976 (n = 10,657) and to 4.5% in the health examination survey of 1979-1980 (n = 7,217) but decreased to 3.3% in the interview survey in 1987 (n = 9,522). The increased prevalence of obesity in men and better survival may be important factors contributing to the increasing prevalence rates of diabetes in Finnish subjects aged 30 years and over.

Adult↗
PubMed1991

Increasing trend in type 1 (insulin-dependent) diabetes mellitus in childhood in Finland. Analysis of age, calendar time and birth cohort effects during 1965 to 1984.

The Central Drug Registry in Finland ascertained 5,920 incident cases of Type 1 (insulin-dependent) diabetes mellitus diagnosed under the age of 15 years, during 1965-1984. The incidence was higher for males 29.2/100,000 (95% confidence intervals 28.2-30.2/100,000) than for females 26.1/100,000 (25.1-27.1/100,000). A non-linear increase in incidence with age was confirmed, with peaks at ages 2, 9 and 14 years in males and at 3, 5-6 and 11 years in females. A significant temporal variation in incidence was found, adjusting for age and sex. During 1965 to 1984 the incidence rose by about 57% or by 2.4% annually. However, a non-linear curve with two incidence peaks in 1978 and 1983 would better describe the temporal pattern than a linear trend. There was no significant difference in the temporal variation between males and females. The changes in diabetes risk appeared to affect proportionally all age groups under 15 years. Two possible mechanisms were explored: a calendar period effect vs a birth cohort effect. The calendar time period effect was significant alone and also when adjusted for the birth cohort effect. One the contrary, the birth cohort effect was not significant, when adjusted for the calendar period effect. In conclusion, over the past two decades, the incidence of childhood Type 1 diabetes in Finland has increased by about 57%. The pattern of change was a steady rising background incidence superimposed by sudden outbreaks suggesting environmental causative factors.

Adolescent↗
PubMed1991

Risk factors for subarachnoid hemorrhage in a longitudinal population study.

The known risk factors of atherosclerotic diseases may be involved in the development of a subarachnoid hemorrhage. We studied the morbidity and mortality due to subarachnoid hemorrhage among 42,862 men and women aged 20-69 years who had participated in a large health survey in Finland. During a mean follow-up of 12 years, 102 non-fatal and 85 fatal cases of subarachnoid hemorrhage were observed. The total incidence was 37 per 100,000 person-years. Smoking and hypertension were positively associated and body mass index was inversely associated with the risk of subarachnoid hemorrhage. These associations were not confounded by age or each other. No statistically significant association with risk was detected for serum cholesterol level, hematocrit content, known heart disease, or diabetes. The risk was especially elevated among lean hypertensive subjects and lean smoking subjects. The age-adjusted relative risks of subarachnoid hemorrhage for lean, hypertensive smokers were 18.3 (95% confidence interval (CI), 7.8-42.7) among women and 6.7 (95% CI, 2.3-19.7) among men as compared to the risk among subjects without these risk factors. We conclude that modifiable risk factors are predictive of subarachnoid hemorrhage, for which reason subarachnoid hemorrhage may in part be preventable. Leanness combined with arterial hypertension and/or smoking, in particular, poses a substantially elevated risk.

Adult↗
PubMed1991

Weight and mortality in Finnish women.

Mortality in relation to body mass index (BMI) was studied in 17,159 healthy Finnish women aged 25-79 followed up for a median of 12 years. Mortality from all cases was related to BMI only in non-smokers aged 25-64, among whom the mortality pattern was "U"-shaped, with a minimum in the second quintile of BMI (the reference range), and about 1.5 times higher in quintiles I and V. Most of the excess risk of mortality among overweight women was due to cardiovascular diseases. During the first 7 years of follow-up, and high risk (relative risk (RR) = 1.7, 95% confidence interval (CI) = 1.0-2.9 for quintile V compared to quintile II) depended on the association of BMI with the initial blood pressure level, but in the later years, the relative risk of cardiovascular death, ranging from 1.6 (95% CI = 1.0-2.5) for women in quintile III up to 2.6 (95% Ci = 1.7-4.0) for those in quintile V, was largely independent of the baseline levels of the main biological risk factors. The excess mortality among thin women under the age of 65 was mainly due to non-cardiovascular diseases (RR = 1.7, 95% CI = 1.2-2.3 for quintile I compared to quintile II) and was not attributable to antecedent disease, smoking or the biological risk factors studied. Among women aged 65 and over, overall mortality varied little with BMI, but thinness seemed to predict deaths from cancers (RR = 1.6, 95% CI = 0.9-3.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Validity of clinical diagnosis of heart failure in primary health care.

Validity of heart failure (HF) diagnosis was studied in 88 patients (37 men and 51 women), aged 45-74 (mean 61) years, in whom HF diagnosis had been newly made by primary health care physicians. Boston criteria for HF and a supplementary classification, based on information from clinical examinations and a 6-month follow-up, were used to define HF diagnosis as 'definite', 'possible' or 'unlikely'. Twenty-eight (32%) patients (21 men and seven women) had 'definite' HF and 46 (52%) (28 men and 18 women) had either 'definite' or 'possible' HF by both classifications. In 30 (34%) patients (six men and 24 women) HF diagnosis was 'unlikely' by both classifications. In conclusion, false-positive diagnosis of HF was common in primary health care, and HF diagnosis was more difficult in women than in men. Obesity, unrecognized symptomatic myocardial ischaemia without HF and pulmonary diseases were the most important conditions leading to false-positive HF diagnosis.

Aged↗