PubMed Health⌕ Search

Biomedical subjects

Anssi Auvinen

Publications and source records attributed to Anssi Auvinen.

At least 19 recordsLinked to original sources

The Childhood Cancer and Leukemia International Consortium (CLIC): Expanding global collaboration in pediatric cancer etiology research.

Childhood cancers are rare, but incidence has risen modestly in countries with robust registration, partly reflecting improved diagnosis. In high-income countries, cancer is the leading cause of disease-related death in children. Marked inequities in incidence, survival, and research capacity underscore the need for large-scale collaboration to identify environmental, genetic, and contextual determinants of risk. The Childhood Cancer and Leukemia International Consortium (CLIC) was established in 2007 to study the etiology of childhood leukemia and later expanded in 2019 to include other childhood cancers, principally solid tumors. CLIC pools harmonized, individual-level data from case-control and cohort studies, obtained through interviews, record linkage (insurance claims, registries), or geographic information systems, and integrates germline genomic data where available. Membership has grown from 13 studies in 9 countries to 57 studies in 21 countries; recruitment spans the early 1960s to the present and encompasses approximately 150,000 cases across all tumor types and 300,000 controls with clinical, demographic, and exposure data, centralized via harmonized data dictionaries at the Data Coordination Center, established in 2014 at the International Agency for Research on Cancer, and supported by a secure analysis platform. Pooled analyses across diverse populations have implicated parental age, prenatal vitamin or folic acid use, mode of delivery, fetal growth, selected congenital anomalies, occupational or household exposures (e.g., pesticides), paternal smoking, and markers of early-life immune modulation (e.g., breastfeeding, daycare attendance) in leukemia risk, informing carcinogen evaluation and prevention. The integration of genetic ancestry and germline susceptibility data is clarifying ancestry-related differences in leukemia biology and outcomes, while confirming risk loci with population-specific effects. CLIC is now adding polygenic risk scores and exposomic data to refine etiologic subtyping and identify modifiable pathways, while broadening representation from underserved regions through partnership-building and capacity-strengthening.

Humans↗

Mobile phone use and risk of glioma in 5 North European countries.

Public concern has been expressed about the possible adverse health effects of mobile telephones, mainly related to intracranial tumors. We conducted a population-based case-control study to investigate the relationship between mobile phone use and risk of glioma among 1,522 glioma patients and 3,301 controls. We found no evidence of increased risk of glioma related to regular mobile phone use (odds ratio, OR = 0.78, 95% confidence interval, CI: 0.68, 0.91). No significant association was found across categories with duration of use, years since first use, cumulative number of calls or cumulative hours of use. When the linear trend was examined, the OR for cumulative hours of mobile phone use was 1.006 (1.002, 1.010) per 100 hr, but no such relationship was found for the years of use or the number of calls. We found no increased risks when analogue and digital phones were analyzed separately. For more than 10 years of mobile phone use reported on the side of the head where the tumor was located, an increased OR of borderline statistical significance (OR = 1.39, 95% CI 1.01, 1.92, p trend 0.04) was found, whereas similar use on the opposite side of the head resulted in an OR of 0.98 (95% CI 0.71, 1.37). Although our results overall do not indicate an increased risk of glioma in relation to mobile phone use, the possible risk in the most heavily exposed part of the brain with long-term use needs to be explored further before firm conclusions can be drawn.

Adolescent↗

Bidirectional relationship between depression and erectile dysfunction.

PURPOSE: We specified the interrelationship between depressive mood and erectile dysfunction. MATERIALS AND METHODS: The target population consisted of men who were 50, 60 or 70 years old and residing in the study area in Finland in 1994. Questionnaires were mailed to 3,143 men in 1994 and to 2,837 men 5 years later. The followup sample consisted of 1,683 men who responded to the baseline and followup questionnaires. RESULTS: Erectile dysfunction was strongly associated with untreated and treated depressive symptoms. The prevalence OR adjusted for potential confounders was 2.6 (95% CI 1.8-3.8) for untreated and 3.3 (95% CI 1.6-7.1) for treated depressive symptoms at the beginning of followup. The incidence of erectile dysfunction was 59/1,000 person-years (95% CI 39-90) in men with depressive mood and 37/1,000 person-years (95% CI 32-43) in those free of the disorder. Compared with men free of depressive symptoms who did not use medication for psychological disorders at study entry the adjusted incidence density ratio of erectile dysfunction was 4.5 (95% CI 2.2-9.2) in men with treated depressive symptoms and 1.2 (0.7-2.1) in those with untreated depressive symptoms. The incidence of depressive mood was 20/1,000 person-years in men with erectile dysfunction and 11/1,000 person-years in those free of erectile dysfunction. The adjusted incidence density ratio of depressive mood was 1.9 (95% CI 1.1-3.3) in men with erectile dysfunction compared with those free of it at entry. CONCLUSIONS: Moderate or severe depressive mood or antidepressant medication use may cause erectile dysfunction and erectile dysfunction independently may cause or exacerbate depressive mood.

Aged↗

Genetic variation in p53 and ATM haplotypes and risk of glioma and meningioma.

BACKGROUND: P53 and ATM are central checkpoint genes involved in the repair of DNA damage after ionising irradiation, which has been associated with risk of brain tumours. Therefore, we tested the hypothesis that polymorphisms and haplotypes in p53 and ATM could be associated with glioma and meningioma risk. MATERIAL AND METHODS: Six hundred and eighty glioma cases (298 glioblastoma (GBM)), 503 meningioma cases, and 1555 controls recruited in the Nordic-UK Interphone study, were analysed in association with three polymorphisms in p53 (rs2287499, rs1042533, rs1625895) and five polymorphisms in ATM ( rs228599, rs3092992, rs664143, rs170548, rs3092993). Haplotypes were constructed using the HAPLOSTAT program. RESULTS: The global statistical test of glioblastoma and p53 haplotypes was p = 0.02. The haplotype analysis on glioblastoma revealed the 1-2-2 haplotype (promotor-codon72-intron 6) had a frequency of 6.1% in cases compared with 9.8% in controls (p = 0.003). The 1-2-1 haplotype was significantly more frequent in GBM cases, 10.2%, than in controls, 7.3% (p = 0.02). The haplotype analysis in ATM revealed an increased frequency of the 1-1-1-2-1 haplotype in meningioma cases (33.8%) compared with controls (30.3%) (p = 0.03). The 2-1-2-1-1 haplotype had a lower frequency in meningioma cases (36.1%) than controls (40.7%) (p = 0.009). CONCLUSIONS: This study found both positive and negative associations of haplotypes in p53 for glioblastoma and ATM for meningioma. This study provides new data that could add to our understanding of brain tumour susceptibility.

Adult↗

Smoking causes erectile dysfunction through vascular disease.

OBJECTIVES: To investigate whether smoking either directly or through vascular disease causes erectile dysfunction (ED) and to determine whether ED is an early marker of vascular disease in smokers. METHODS: The target population consisted of all men 50, 60, or 70 years old who resided in the study areas in Finland in 1994. Questionnaires were mailed to 3143 men in 1994, to 2837 men in 1999, and to 2510 men in 2004. A total of 1368 men (55% of those alive) responded to the three surveys. RESULTS: Men who smoked in 1994 and developed a vascular disease during 1994 to 1999 had a three times (adjusted incidence density ratio [IDR] 3.1, 95% confidence interval [CI] 1.3 to 7.5) greater risk of ED during 1999 to 2004 compared with those who had never smoked who did not develop vascular disease. In contrast, smokers without episodes of vascular disease were not at an increased risk of ED (adjusted IDR 1.0, 95% CI 0.5 to 1.8). Among men who were exsmokers and had ED in 1994, the incidence of vascular disease was greater than among those who had never smoked who were free of ED at entry (IDR 1.5, 95% CI 1.0 to 2.2). No greater risk of vascular disease owing to ED was found in smokers (IDR 1.1, 95% CI 0.6 to 2.0) or those who had never smoked (IDR 1.1, 95% CI 0.6 to 1.9) at entry. CONCLUSIONS: The results of this study have shown that smoking may cause ED because it can cause vascular disease, and ED may be a marker of silent vascular disease in exsmokers.

Aged↗

KLF6 IVS1 -27G>A variant and the risk of prostate cancer in Finland.

OBJECTIVES: A recent report demonstrated that KLF6 IVS1 -27G>A substitution increases the transcription of alternatively spliced isoforms; this action was suggested to be associated with prostate cancer (pCA). To evaluate these findings among the Finnish population, a total of 3348 samples were analysed. METHODS: The variant was genotyped in 164 patients with familial pCA, 852 patients with unselected pCA, 459 patients with benign prostate hyperplasia (BPH), 923 male population controls, and 950 men from a Finnish prostate-specific antigen (PSA) screening trial with PSA levels less than 1.0ng/ml. Odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) were calculated by using logistic regression to estimate pCA risk. RESULTS: Association testing revealed no significant differences between familial prostate cancer patients and population controls (OR: 0.84; 95%CI, 0.56-1.28; p=0.42), unselected cases and controls (OR: 0.95; 95%CI, 0.76-1.19; p=0.63), or BPH cases and controls (OR: 1.12; 95%CI, 0.86-1.46; p=0.39). pCA and BPH cases were also compared with PSA-screened controls. None of these analyses revealed any significant associations. CONCLUSIONS: Our results do not support the suggested association of KLF6 IVS1 -27G>A germline polymorphism with pCA risk and also suggest that the variant is not a risk allele for BPH in the Finnish population.

Adenine↗

Cancer risk among Chernobyl cleanup workers in Estonia and Latvia, 1986-1998.

Two cohorts of Chernobyl cleanup workers from Estonia (4,786 men) and Latvia (5,546 men) were followed from 1986 to 1998 to investigate cancer incidence among persons exposed to ionizing radiation from the Chernobyl accident. Each cohort was identified from various independent sources and followed using nationwide population and mortality registries. Cancers were ascertained by linkage with nationwide cancer registries. Overall, 75 incident cancers were identified in the Estonian cohort and 80 in the Latvian cohort. The combined-cohort standardized incidence ratio (SIR) for all cancers was 1.15 (95% confidence interval (CI) = 0.98-1.34) and for leukemia, 1.53 (95% CI = 0.62-3.17; n = 7). Statistically significant excess cases of thyroid (SIR = 7.06, 95% CI = 2.84-14.55; n = 7) and brain cancer (SIR = 2.14, 95% CI = 1.07-3.83; n = 11) were found, mainly based on Latvian data. However, there was no evidence of a dose response for any of these sites, and the relationship to radiation exposure remains to be established. Excess of thyroid cancer cases observed may have been due to screening, the leukemia cases included 2 unconfirmed diagnoses, and the excess cases of brain tumors may have been a chance finding. There was an indication of increased risk associated with early entry to the Chernobyl area and late follow-up, though not statistically significant. Further follow-up of Chernobyl cleanup workers is warranted to clarify the possible health effects of radiation exposure.

Adolescent↗

Impact of LUTS using bother index in DAN-PSS-1 questionnaire.

OBJECTIVES: To quantify the bothersomeness of urinary symptoms in males with lower urinary tract symptoms (LUTS). METHODS: A population-based postal survey of urinary symptoms among 2837 men aged 55, 65, or 75 years was conducted. The response rate was 75%, and data of both symptom and bother questions were eligible for 1803-2046 men, depending on the question. Bothersomeness of each urinary symptom was measured with a bother index (BI) as a ratio of the number of men with a bother score higher than a symptom score to that with a bother score lower than a symptom score. The BI was compared with the relative risk (RR), the prevalence of men with bother to those with symptom. RESULTS: Urgency (46%) and postmicturition dribble (42%) were the most common symptoms. Any type of incontinence was considered highly bothersome (BI: 1.79-3.70). In light of the BI, most voiding and postmicturition symptoms except weak stream (BI: 1.14) were well tolerated. The variation of the BI (0.06-3.70) was substantially larger than that of RR (0.53-0.89) of the urinary symptoms. CONCLUSIONS: Bothersomeness of a symptom is an independent contribution in the assessment of LUTS. The BI may be a useful indicator of bothersomeness of urinary symptoms. The greater variation of the BI than that of RR indicates that the BI provides information on LUTS that cannot be described by prevalence or prevalence ratio only.

Aged↗

Female predominance in meningiomas can not be explained by differences in progesterone, estrogen, or androgen receptor expression.

The female predominance in meningioma incidence and association between meningioma and breast cancer suggest that growth of meningiomas is hormone-dependent. There are several discrepancies in literature about the proliferative effect of sex hormones on meningiomas. This study aims to evaluate the hormone receptor status of meningiomas and assess its relation to age, sex, histological grade, recurrence, and proliferation activity. The material was based on consecutive patients operated for meningioma at Tampere University Hospital in 1989-1999. The occurrence of progesterone, estrogen and androgen receptor in patients with primary and recurrent meningiomas was studied immunohistochemically by using specific monoclonal antibodies. Hormonal status was determined in 510 tumor samples. 443 samples were from primary meningiomas and 67 from recurrent tumors. Of the samples, 455 were benign (WHO grade I), 49 atypical (grade II), and 6 malignant (grade III). Of the primary tumor samples, 88% were progesterone receptor positive, 40% were positive for estrogen and 39% for androgen receptors. Grade I meningiomas had significantly higher incidence for estrogen and androgen receptors than higher grade meningiomas. Estrogen positive tumor samples had significantly higher proliferation index than estrogen negative samples. No difference in expression of sex hormone receptors was observed by sexes or age group. Estrogen and androgen receptors may have more influence on the pathogenesis of meningiomas than earlier thought. The higher incidence of meningiomas in women can not be explained by differences of sex hormone receptor expression.

Age Factors↗

No increase in thyroid cancer among children and adolescents in Finland due to Chernobyl accident.

The aim of the study was to assess whether radioactive fallout from the Chernobyl accident in 1986 influenced thyroid cancer incidence among children and adolescents in Finland. The population was divided into two: those with thyroid doses less than 0 6 mSv and above 0.6 mSv. Cumulative incidence of thyroid cancer was identified from the Finnish Cancer Registry from a population aged 0-20 years in 1986 with a total of 1,356,801 persons. No clear difference in underlying thyroid cancer incidences rates were found during the pre-Chernobyl period (1970-1985) (rate ratio RR 0.95, 95% confidence interval CI 0.81-1.10). During the post-Chernobyl period (1991-2003), thyroid cancer incidence was lower in the more exposed population than in the less exposed population (RR 0.76, 95% CI 0.59-0.98). Our results did not indicate any increase in thyroid cancer incidence related to exposure to radiation from the Chernobyl accident.

Adolescent↗

Nocturia and obesity: a population-based study in Finland.

The authors' aim in this study was to analyze the association of nocturia with overweight and obesity. In 2003-2004, a questionnaire was mailed to 6,000 randomly selected Finns aged 18-79 years who were identified from the Finnish Population Register Centre. Information on nocturia was collected through questionnaires using the Danish Prostatic Symptom Score and the American Urological Association Symptom Index. Self-reported body weight and height were used to calculate body mass index (BMI; weight (kg)/height (m)2). Subjects were classified on the basis of BMI as nonoverweight (BMI<25), overweight (BMI 25-29.9 kgm2), or obese (BMI>or=30). Of the 6,000 subjects, 62.4% participated. Among men, the age-standardized prevalence of nocturia, defined as at least one void per night, was 33.4% (95% confidence interval (CI): 28.5, 38.3) in the nonoverweight, 35.8% (95% CI: 31.4, 40.1) in the overweight, and 48.2% (95% CI: 38.8, 57.6) in the obese. Among women, the corresponding figures were 37.2% (95% CI: 33.0, 41.5) in the nonoverweight, 48.3% (95% CI: 42.5, 54.2) in the overweight, and 53.6% (95% CI: 43.9, 63.2) in the obese. The associations remained similar when nocturia was defined as two or more voids per night. The age-standardized attributable fraction (population) of increased BMI for nocturia was 17.7% for men and 18.5% for women, corresponding to an 8.5% increase in the crude prevalence of nocturia in men and a 13.9% increase in women. The authors conclude that obesity is associated with increased nocturia, more strongly among women than among men.

Adolescent↗

Incidence of bone and soft tissue sarcoma after radiotherapy: a cohort study of 295,712 Finnish cancer patients.

Radiotherapy is commonly used for treatment of malignant disease. As a consequence of radiotherapy, an increased risk of developing a second malignant neoplasm has been shown. However, little is known about the effects of radiation on developing sarcoma. The aim of this study was to examine the risk of developing a bone or soft tissue sarcoma after radiotherapy for a first primary cancer. The study population included all the patients with primary cancers of breast, cervix uteri, corpus uteri, lung, ovary, prostate, rectum and lymphoma diagnosed during 1953-2000 and identified from the Finnish Cancer Registry. Patients were followed up for subsequent sarcomas. The follow-up yielded 1.5 million person-years at risk and 147 sarcomas. Compared to the national incidence rates, after 10 years of follow-up sarcoma risk was increased among patients who had received neither radiotherapy nor chemotherapy (standardised incidence ratio (SIR) 2.0, 95% CI 1.3-3.0), radiotherapy without chemotherapy (SIR 3.2, 95% CI 2.3-4.3), chemotherapy without radiotherapy (SIR 4.9, 95% CI 1.0-14.4), as well as combined radiotherapy and chemotherapy (SIR 3.4, 95% CI 0.4-12.5). For radiotherapy in ages below 55 the SIR was 4.2 (95% CI 2.9-5.8). In the adjusted regression analysis the rate ratio was 1.5 (95% CI 0.9-2.6) for the radiotherapy group. In conclusion, radiotherapy appears to be associated with an increased risk of developing sarcoma especially among younger patients. Further investigation is needed to clarify the dose-response of the preceding ionizing radiation.

Adult↗

Well water radioactivity and risk of cancers of the urinary organs.

Water from bedrock frequently contains higher concentrations of natural radionuclides than water from other sources. Bladder and kidneys receive a radiation dose when radioactive isotopes are excreted into urine. The subjects for this case-cohort study were selected from all drilled wells users in Finland. The study comprised 61 bladder cancer and 51 kidney cancer cases diagnosed between 1981 and 1995, as well as a random sample of 274 reference persons, stratified by age and sex. The median activity concentrations of radon in drilled wells used by bladder and kidney cancer cases and the reference cohort were 170, 140, and 130 Bq/L, respectively. The radium concentration was 0.01 Bq/L for all groups and the uranium concentrations were 0.08, 0.07, and 0.06 Bq/L, respectively. The bladder cancer risks associated with radon, radium, and uranium activity concentrations in drinking water were 1.02 (0.68-1.54) per log(100 Bq of radon/L), 0.73 (0.21-2.50) per log(0.1 Bq of radium/L), and 0.77 (0.32-1.89) per log(1 Bq of uranium/L). The corresponding figures for kidney cancer were 0.81 (0.47-1.37), 0.12 (0.01-1.10), and 0.92 (0.36-2.35), respectively. In conclusion, even though ingested radionuclides from drilled wells are a source of radiation exposure, they are not associated with a substantially increased risk of bladder or kidney cancers in concentrations occurring in drilled wells.

Case-Control Studies↗

Risk factors for traumatic and non-traumatic lower limb pain among preadolescents: a population-based study of Finnish schoolchildren.

BACKGROUND: The child's lower limb is the most commonly reported musculoskeletal location with pain and also the most commonly injured site in sports. Some potential risk factors have been studied, but the results are inconsistent. We hypothesized that distinction of traumatic from non-traumatic pain would provide a clearer picture of these factors. The aim of this study is to assess factors associated with lower extremity pain and its impact on preadolescents in a population-based cohort. METHODS: A structured pain questionnaire was completed by 1756 schoolchildren of third and fifth grades to assess musculoskeletal pain, psychosomatic symptoms, subjective disabilities, school absence and frequency of exercise. In addition, hypermobility and physical fitness were measured. RESULTS: The knee was the most common site of pain followed by the ankle-foot and thigh. Of the children who reported pain in their lower extremity, approximately 70% reported at least one disability and 19% reported school absence attributed to their pain during the previous three-month period. Children with traumatic pain had a higher subjective disability index than those with non-traumatic pain (P = 0.02). Age less than 11 years, headache, abdominal pain, depressive feelings, day tiredness, and vigorous exercise were more common in children with lower limb pain than those free of it. In the stratified analysis, younger age was related to both traumatic and non-traumatic pain groups. Vigorous exercise was positively associated with traumatic pain, while subjects with non-traumatic pain had more frequent psychosomatic symptoms. CONCLUSION: Risk factors and consequences of traumatic and non-traumatic lower limb pain are not similar. Traumatic lower limb pain is associated with practicing vigorous exercise and high level of physical fitness, while non-traumatic pain is more correlated with psychosomatic symptoms. These differences might be one of the reasons for the discrepancy of previous research conclusions. The two conditions need to be treated as different disorders in future studies.

Age Factors↗

Incidence of nocturia in 50 to 80-year-old Finnish men.

PURPOSE: We estimated the incidence and natural course of nocturia in an unselected Finnish male population. MATERIALS AND METHODS: A mail interview of a cohort of 3,143 randomly selected men 50 to 70 year old at study entry was done in Finland in 1994, 1999 and 2004. The questionnaire included questions on sociodemographic status, overall health and disease, urinary symptoms, sexual functioning and symptom bother. The overall response rate was 70% on the 1994 survey, 75% on the 1999 survey and 76% on the 2004 survey. A response to nocturia questions was obtained from 1,633 men at the 1994 to 1999 followup and from 1,618 at the 1999 to 2004 followup. RESULTS: The overall prevalence of 1 or more nocturnal voidings was 56% at baseline and 74% 10 years later. The crude incidence rate for nocturia was 75 new cases per 1,000 men annually (95% CI 66 to 85) during the first 5-year followup period and 126/1,000 (95% CI 113 to 140) during the second period. The incidence of moderate or severe nocturia was 9/1,000 (95% CI 7 to 11) and 14/1,000 men (95% CI 12 to 17), respectively. Incidence and prevalence increased clearly with age but also by calendar time, which was most prominent for the mild nocturia incidence. The incidence of moderate to severe symptoms increased, especially in the oldest cohort (incidence density ratio 5.6 to 5.7/5 years). CONCLUSIONS: Every year 10% more males older than 50 years start to void during the night. The incidence of mild nocturia increases, especially in men when they age from 50 to 60 years. In older men mild symptoms are more stable but the incidence of severe nocturia increases strongly after age 75 years.

Age Distribution↗

Is nocturia equally common among men and women? A population based study in Finland.

PURPOSE: We assessed the prevalence of nocturia and its association with sociodemographic factors. MATERIALS AND METHODS: Information was collected with a questionnaire mailed to a random sample of 6,000 subjects 18 to 79 years old, identified from the Finnish Population Register Centre. Nocturia was defined as 1 or more, or 2 or more voids per night. Information was collected using the DAN-PSS questionnaire with an additional question from the AUA-SI questionnaire. Age standardized prevalence was calculated using the European standard population. Logistic regression was used for multivariate analysis. RESULTS: Of the 6,000 subjects 62.4% responded and 97.9% of the participants provided information on all nocturia questions. The age standardized prevalence of nocturia (1 or more voids per night) was 37% (95% CI 34%-40%) among men and 43% (95% CI 40%-46%) among women. With criterion of 2 or more voids per night prevalence was 12% (95% CI 10%-14%) for men and 13% (95% CI 11%-14%) for women. Women 18 to 49 years old had more nocturia than men. At 50 to 59 years old half of men and women reported nocturia. In older age groups nocturia was more frequent among men than women. The prevalence of nocturia increased at a constant rate with age. It increased twice as rapidly in men as among women (increase in OR 7.3% [95% CI 6.5%-8.2%] and 3.5% [95% CI 2.9%-4.1%] per year among men and women, respectively). CONCLUSIONS: The age standardized prevalence of nocturia (1 or more voids per night) was approximately 40% for both genders. In men the prevalence of nocturia increases more rapidly with age than in women. Nocturia is more common among women at a younger age but the differences disappear by middle age. In the elderly nocturia is more frequent among men.

Adolescent↗

Kidney toxicity of ingested uranium from drinking water.

BACKGROUND: In experimental settings, uranium is toxic to kidneys, but effects on humans are unclear. Ingestion of water from drilled wells is a source of high uranium exposure in some populations. METHODS: Uranium exposure was measured in 95 men and 98 women aged 18 to 81 years who had used drinking water from drilled wells for an average of 16 years. Urinary N-acetyl-gamma-d-glucosaminidase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyltransferase, and glutathione-S-transferase; serum cystatin C; and urinary and serum calcium, phosphate, glucose, and creatinine were measured to evaluate possible toxic effects of uranium on kidney cells and renal function. In addition, supine blood pressure was measured. Associations between uranium exposure and the outcome variables were modeled by using linear regression with adjustment for age, sex, body mass index, smoking, and analgesic use. RESULTS: Median uranium concentration in drinking water was 25 microg/L (interquartile range, 5 to 148 microg/L; maximum, 1,500 microg/L). Indicators of cytotoxicity and kidney function did not show evidence of renal damage. No statistically significant associations with uranium in urine, water, hair, or toenails was found for 10 kidney toxicity indicators. Uranium exposure was associated with greater diastolic and systolic blood pressures, and cumulative uranium intake was associated with increased glucose excretion in urine. CONCLUSION: Continuous uranium intake from drinking water, even at relatively high exposures, was not found to have cytotoxic effects on kidneys in humans.

Adolescent↗

Incidence of inflammatory bowel disease in Finnish children, 1987-2003.

BACKGROUND: The incidence of inflammatory bowel disease (IBD) has been increasing in Western countries. In younger people, Crohn's disease (CD) predominates over ulcerative colitis (UC), but the finding is not universal. The present study aimed to characterize not only the incidence but also the clinical picture of IBD from 1987 to 2003 in a large pediatric population in Finland. MATERIALS AND METHODS: Data were collected from the patient discharge and medical records at the 2 largest university hospitals in Finland. The study population covered a total of 619,340 children, representing 56% of the children <18 years old in the country. All of the cases diagnosed with IBD from 1987 to 2003 were reviewed. Clinical, endoscopic, and histological data were collected. Incidence rates were estimated based on statistical assumptions. RESULTS: A total of 604 cases with IBD were diagnosed during the 17-year period. All of the patients had undergone endoscopy. The diagnosis was CD in 203 (34%) cases, UC in 317 (52%) cases, and indeterminate colitis (IC) in 83 (14%) cases. The mean annual incidence rate increased from 3.9/100,000 (95% confidence interval [CI] 2.5-5.8) in 1987 to 7.0/100,000 (CI 5.0-9.4) in 2003 (P < 0.001). The majority of cases were 12 to <15 years old (n = 200, 33%). Of the patients, 5.1% were <3 years old and 14% were <6 years old. IC was most common in young children; 29% of all IBD patients <3 years of age had IC. Of the patients, 97% had been followed up until the age 18 in the hospitals after initial diagnosis (median follow-up 3.1 years). Of the patients, 45.2% were initially treated with steroids, whereas 17.8% received immunosuppressive agents at the end of the follow-up. Operations had been performed in 21% of the cases before age 18. The median time interval from the diagnosis to the first operation was 1.8 (range 7.8) years. CONCLUSIONS: The incidence of pediatric IBD almost doubled in Finland from 1987 to 2003. Surgical intervention was common early in the disease course.

Adolescent↗