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Biomedical subjects

H A Isomäki

Publications and source records attributed to H A Isomäki.

14 recordsLinked to original sources
PubMed1996

Increased risk of leukaemia in patients with juvenile chronic arthritis treated with chlorambucil.

Two cases of acute leukaemia have developed in a group of 77 patients treated with chlorambucil (Chl) because of severe juvenile chronic arthritis. The total follow-up from the beginning of Chl treatment in these patients was 560 years, indicating a highly increased risk of leukaemia. Despite favourable results, especially in patients with secondary amyloidosis, Chl should only be used in selected cases.

Antineoplastic Agents, Alkylating↗
PubMed1995

Mortality in rheumatoid arthritis.

Patients with rheumatoid arthritis (RA) have a substantially reduced life expectancy. The standardized mortality ratio in different studies has ranged from 1.13 to 2.98. This mainly applies to rheumatoid factor (RF)-positive cases, although there is a subgroup of RF-negative cases with an adverse long-term prognosis. Clinically based studies probably overestimate the true shortening of life span and population-based studies may underestimate it. Excess mortality from infection and from renal disease likely reflects the presence of severe disease, whereas most of the added mortality from gastrointestinal causes is treatment related. The reasons for the surplus of mortality from cardiovascular causes are not fully known. RF may have a direct role, and preillness factors such as smoking may predipose patients to RA and also render them susceptible to cardiovascular diseases. The excess mortality associated with RA is appreciably higher than is apparent from the cases in which RA is regarded as an underlying cause of death. The effect of treatment on mortality remains largely unknown.

Arthritis, Rheumatoid↗
PubMed1993

Decrease in the number of deaths from secondary amyloidosis in patients with juvenile rheumatoid arthritis.

OBJECTIVE: The analysis of the mortality rate and causes of death of all Finnish patients with juvenile rheumatoid arthritis (JRA) in 1969-1979 and 1980-1990. METHODS: Cases with JRA and deaths at the age of 24 years or younger were identified by using the nationwide register of persons entitled to free medication because of rheumatoid arthritis and allied diseases. Causes of death are based on autopsy in all but 4 of 47 cases. RESULTS: There were 24 deaths during 1969-1979 and 23 during 1980-1990. The expected numbers of deaths were 8.9 and 9.5, giving a standardized mortality rate of 2.7 and 2.4, respectively. Secondary amyloidosis was the direct cause of death in 10 patients during the earlier period and in 4 patients during the later period. CONCLUSIONS: The decrease in amyloidosis as a cause of death may be explained by an increased use of cytotoxic drug treatment for severe JRA in the early 1980s. Deaths from violence have increased.

Adolescent↗
PubMed1989

Ultrasonography of the adult hip joint.

The ultrasonographic distance between the hip joint capsule and femur was measured in 75 healthy adults. The mean distance was 5.1 (SD 0.7) mm. The shortest distance was 3.0 mm, the longest 7.0 mm. The difference between the right and left hip was 0.3 (SD 0.3, range 0-1.2) mm. No correlation was found between the ultrasonographic distance and the subjects' height, body weight, age or sex. The reproducibility of the measurement was good, and the interobserver correlation was 0.94. It is concluded that an ultrasonographic distance between the hip joint capsule and the femur of 7 mm or more, and a difference between the hips of 1 mm or more suggest an intracapsular effusion in the joint in adults.

Adolescent↗
PubMed1989

Rheumatoid arthritis as seen from official data registers. Experience in Finland.

Computerized public data registers are an important data base for bodies monitoring public health. They can also be used for epidemiological research. The main problems in the use of the registers are administrative and qualitative. The use, and especially the linking of different registers together, is strictly regulated by law. The trend seems to be towards more strict regulations. Another problem is the quality of the data. The registers were designed for administrative purposes and therefore, the classification of data is not always suitable for research. In addition, errors are possible at several stages of the production and filing of the data. International comparisons are difficult because of differences in legislation and administrative rules. However, despite these problems, public data registers are an important resource for research, and their importance will grow with time and improvements in the quality of the registers.

Adult↗
PubMed1987

An epidemiologically based follow-up study of recent arthritis. Incidence, outcome and classification.

Incidence and outcome of inflammatory joint disease (IJD) were studied by an epidemiologically based follow-up study of unselected adult arthritis patients. The annual incidence of all IJD together was 2.18% in the population of 16 years and older; 5.67% in the HLA B27 positive and 1.62% in the B27 negative population. Almost half of all arthritides were of non-specific nature. Incidence of definite rheumatoid arthritis was 0.42% per year. The outcome after 8 years was worst in seropositive rheumatoid arthritis and best in seronegative oligoarthritis of unknown etiology. Outcome of seronegative polyarthritis was bimodal: majority of patients with a favourable and minority with a poor outcome. In Yersinia arthritis, patients with a mainly IgA-class antibody response had a more severe clinical picture than those with a mainly IgG-class response. Diagnosis of rheumatoid arthritis at the early stage of the disease should be based on specific features like rheumatoid factor, radiological signs, symmetric peripheral polyarthritis and morning stiffness with a long duration. Erosive rheumatoid arthritis is almost always seropositive, at least at some stage of the disease.

Arthritis, Rheumatoid↗
PubMed1985

Multiple tumor incidence in patients with rheumatoid arthritis or allied disorders.

The incidence of multiple malignant neoplasms in 55,279 patients with rheumatoid arthritis (RA) or allied disorders was studied by linking two separate nationwide data registers covering the whole Finnish population. The linking of the Social Insurance Institution's Population Register and the Finnish Cancer Registry resulted in 2106 cancer patients in whom both cancer (diagnosed in 1967-1978) and rheumatoid arthritis or allied disorders (diagnosed before cancer) were diagnosed. In 1974, the allied disorders (ankylosing spondylitis or systemic connective tissue diseases) accounted for 3.9% of all the diagnoses in the Social Insurance Institution's Population Register. The incidence of multiple neoplasms was slightly but not significantly higher in cancer patients with RA or allied disorders than in the general population or in all cancer patients taken together. The risk of leukemia was four times higher in the rheumatoid or allied disease cancer patients than in all the cancer patients. The results are consistent with previous results showing that the leukemia incidence in RA patients is higher than expected.

Adult↗
PubMed1983

Prevalence and social impact of rheumatic diseases in Finland.

The prevalence and social impact of rheumatic diseases as established from interview surveys and disability pension statistics have markedly increased in Finland. This is probably due to a change in disease experience and social legislation rather than to an increase in the disability caused by these diseases. The prevalence of disability, rather than that of the disease, would be a preferable basis for monitoring the state of public health.

Adolescent↗
PubMed1975

Death rate and causes of death in patients with rheumatoid arthritis.

Patients with rheumatoid arthritis, 500 males and 500 females, aged 40 years or over, and an age- and sex-matched control population were observed over a 3-year period. During the follow-up, 122 RA patients and 69 controls had died. The most common causes of death in RA patients were cardiovascular diseases (57 patients), renal failure (27 patients), infections (19 patients), and malignant neoplasms (11 patients); in the controls, the respective data are: cardiovascular diseases (35 people), malignant neoplasms (21 people), accidents (7 people), and infections (5 people).

Adult↗