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Biomedical subjects

E Valkeila

Publications and source records attributed to E Valkeila.

5 recordsLinked to original sources

Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study.

Efficacy of drugs for the acute treatment of migraine in children has not so far been studied in well controlled trials. We conducted a study to evaluate the efficacy of acetaminophen and ibuprofen. Eighty-eight children, aged 4.0 to 15.8 years, with migraine participated in a double-blind crossover study. Three attacks per child were treated in random order with single oral doses of 15 mg/kg acetaminophen, 10 mg/kg ibuprofen, and placebo at home. The primary end point, reduction in severe or moderate headache (grade > or = 3 on a scale of 1 to 5) by at least two grades after 2 hours, was reached twice as often with acetaminophen and three times as often with ibuprofen as with placebo. Ibuprofen was twice as likely as acetaminophen to abort migraine within 2 hours. In the intent-to-treat analysis, children improved twice as often with ibuprofen and acetaminophen as with placebo. Both ibuprofen and acetaminophen are effective and economical treatments for severe or moderate migraine attacks in children. Ibuprofen gave the best relief.

Acetaminophen↗

Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children.

The clinical signs, symptoms and host responses (erythrocyte sedimentation rate, white blood cell count and C-reactive protein) were studied to distinguish bacterial from viral acute lower respiratory infection (ALRI) in 121 children hospitalized for ALRI. Etiologic diagnosis was based on blood culture, antibody assays and antigen detection. Children with bacterial involvement only were older than those with viral involvement alone (mean, 5.1 vs. 2.5 years), and their duration of respiratory symptoms had lasted longer (mean, 4.6 vs. 3.3 days). Children with unknown etiology had a shorter duration of fever before hospitalization than those with etiology identified with the methods used (mean, 1.6 vs. 2.9 days). The host response ranged widely within etiologic groups. The mean erythrocyte sedimentation rate did not differ significantly between the bacterial and viral ALRI (38 vs. 28 mm/hour); neither did white blood cell count (13.2 vs. 13.6 x 10(9)/liter) or C-reactive protein (68 vs. 49 mg/liter). No combination of clinical signs and host responses or any cutoff values could be shown to differentiate reliably bacterial from viral ALRI.

Acute Disease↗

Serum selenium and risk of cancer. A prospective follow-up of nine years.

The association between serum selenium concentration and the risk of cancer was studied in 1110 men aged 55 to 74 years in two rural areas of Finland. The men were followed-up prospectively for 9 years and there were 109 new cases of cancer, with the cases of the first follow-up year excluded. The serum selenium concentrations were adjusted for age, area, smoking, serum cholesterol, and alcohol intake. The patients had a slightly lower adjusted mean serum selenium than the subjects without cancer at the end of the follow-up (+/- standard error of mean) 53.9 +/- 1.5 and 55.3 +/- 0.5 micrograms/l, respectively. The relative risks of cancer were essentially the same when these were calculated in the tertiles of the serum selenium distribution. Thirty-seven men had a history of cancer at baseline or had cancer diagnosed during the first follow-up year and their adjusted mean serum selenium was 49.4 +/- 2.6 micrograms/l, which was significantly lower (P less than 0.05) than that of the subjects without cancer during the follow-up.

Aged↗

Serum selenium and the risk of coronary heart disease and stroke.

The association between serum selenium concentration and five-year risk of cardiovascular disease was studied in 1,110 men aged 55 to 74 years in two rural areas of Finland. In the total cohort, all-cause and cardiovascular deaths were associated significantly with serum selenium of less than 45 micrograms/liter, an adjusted relative risk of 1.4 (95% confidence interval (Cl), 1.0-2.0, p less than 0.05) and 1.6 (95% Cl, 1.1-2.3, p less than 0.05), respectively. Among men free of coronary heart disease at the outset, these associations were of similar magnitude but did not attain statistical significance. Among men free of stroke at the outset, low serum selenium was associated significantly with stroke mortality, an adjusted relative risk of 3.7 (95% Cl, 1.0-13.1). The associations of coronary deaths and myocardial infarctions with low serum selenium were nonsignificant.

Aged↗

Thyroid autoimmunity and cardiovascular diseases.

The relationship of thyroid autoantibodies and elevated TSH level to indices of cardiovascular diseases was studied in two population series monitored for 5 years and in a cross-sectional hospital series. In a cohort of 1105 males, initially 55-74 years of age, deaths due to cardiovascular causes occurred in 19% of subjects with thyroid autoantibodies and in 11% of controls matched for age (P less than 0.05). In another cohort of 1045 males and 1223 females, initially 40-64 years of age, no difference emerged in males, while 6 out of 20 females who died of cardiovascular causes had thyroid autoantibodies, compared with 18% in the whole series. In a series of 97 hospital patients with myocardial infarction, 7 patients had thyroid autoantibodies as opposed to 12 antibody-positive subjects among controls matched for age and sex. Elevated TSH level appeared to be no better an indicator of cardiovascular morbidity or mortality than thyroid autoantibodies. It is concluded that thyroid autoimmunity may act as a cardiovascular risk factor under certain circumstances, but it does not have any general significance and the mechanism of action remains unclear.

Adult↗