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Biomedical subjects

H Isomäki

Publications and source records attributed to H Isomäki.

At least 37 records · Page 2Linked to original sources
PubMed1995

Mortality from cancer in patients with rheumatoid arthritis.

Data in nationwide Finnish registers were used to study the relationship between rheumatoid arthritis (RA) and site-specific cancers as a cause of death. The study included in all 1,666 subjects who had died in 1989 and who were entitled, under the nationwide sickness insurance scheme, to specially reimbursed medication because of RA. There were 277 deaths from malignancies. The proportion of such deaths in relation to all deaths declined with the duration of RA (p < 0.05). There was an excess of hematopoietic malignancies, particularly in males (p < 0.05). Deaths due to these malignancies, in relation to all cancer deaths, accumulated in long-lasting RA (p < 0.05). This suggests that hematopoietic malignancies arise as a complication of either RA or its treatment and to some degree argues against the notion of a shared etiological agent for these diseases.

Aged↗
PubMed1995

Elevated cancer incidence in patients with dermatomyositis: a population based study.

OBJECTIVE: To study the relationship of polymositis (PM) and dermatomyositis (DM) and cancer in Finland. METHODS: The medical records of 175 patients with PM and 71 with DM diagnosed between 1969 and 1985 were reviewed. The patients were followed until death or until December 30, 1990 through the files of Statistics Finland and the Finnish Cancer Registry. RESULTS: Thirty-four cases of cancer were found [standardized incidence ratio (SIR) 2.1, 95% confidence interval 1.4-2.9]. In the PM group the SIR was 1.0 (95% CI 0.5-1.8), and in the DM group 6.5 (95% CI 3.9-10). The relative risk of cancer among DM cases was very high (SIR 26, 12-48) in the first year after DM diagnosis. CONCLUSION: DM is associated with cancer, but not PM. The risk is high among patients with DM older than 49. Cytotoxic drugs given to DM patients did not increase the risk of malignancies. DM and certain cancers seem to share etiological factors.

Adolescent↗
PubMed1995

Cardiovascular mortality in women with rheumatoid arthritis.

OBJECTIVE: To investigate the relationship of deaths from cardiovascular causes in mortality of women with rheumatoid arthritis (RA). There is increasing evidence that subjects with RA have increased mortality from cardiovascular causes, but little is known of its determinants. METHODS: Our study included all women subjects in Finland who died during 1989 and who were entitled to reimbursement for medication for RA under the national health insurance plan. Demographic data on the Finnish population and health insurance statistics were used for computations. RESULTS: Half of the 1186 deaths of women were due to cardiovascular causes. The distribution of specific diagnoses within this disease group did not differ appreciably from that in the female population as a whole. However, there was a 34% excess of deaths due to cardiovascular causes. The median age at death in women with RA was 2.5 years lower than that in the whole population with deaths due to cardiovascular causes. CONCLUSION: Deaths due to cardiovascular causes constitute and important determinant in the surplus of mortality associated with RA in women.

Adolescent↗
PubMed1995

[The detection of secondary amyloidosis in rheumatoid arthritis by aspiration biopsy of the subcutaneous fatty tissue].

81 rheumatoid arthritis patients were regularly and periodically examined in rheumatological department of Tartu University Clinic. Depending on the presence of amyloid in subcutaneous fat biopsies the patients were divided into two comparable groups: amyloid-positive (group 1 of 22 patients) and amyloid-negative (group 2 of 59 patients). Between the groups some differences were found: group 1 patients had more active and severe course of rheumatoid arthritis and higher level of rheumatoid factor and circulating immune complexes in the sera. Before biopsy secondary amyloidosis was diagnosed in 17.4% of the examines, biopsy of abdominal subcutaneous fat increased this rate to 27.2%. We could not ascertain any effect of previous treatment on secondary amyloidosis development except the connection with long-term use of corticosteroids. The analysis of 10379 autopsies showed that cases of RA with amyloidosis account for 30.9% of all amyloidosis cases. Multiple stepwise regression analysis determined predisposition factors to secondary amyloidosis as severity of locomotor system involvement, long-term use of corticosteroids, high level of rheumatoid factor and activity of rheumatoid process.

Abdomen↗
PubMed1995

Death attributed to antirheumatic medication in a nationwide series of 1666 patients with rheumatoid arthritis who have died.

OBJECTIVE: Most drugs used in rheumatoid arthritis (RA) can have fatal side effects, but there are no good data on the frequency of such complications. Our study was designed to obtain information on deaths attributable to different antirheumatic drugs. METHODS: The role of antirheumatic medication as a cause of death was studied in 1666 subjects who died in Finland in 1989 and had been entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for RA. RESULTS: Forty-seven deaths were attributed to antirheumatic medication. Thirty deaths were attributed to the use of nonsteroidal antiinflammatory drugs (NSAID) (17 from peptic ulcer, 11 perforation or hemorrhage of the lower intestinal tract, one renal failure, and one bone marrow depression) and 11 deaths to the use of glucocorticoids (2 from perforations of the lower intestinal tract, 5 osteoporotic fractures, 3 septicemias after intraarticular injections and one adrenal insufficiency after abrupt discontinuation of treatment). There were 2 cases of fatal bone marrow depression attributed to methotrexate and 2 to sulfasalazine, one case of lymphoma induced by azathioprine and one hydroxychloroquine intoxication. In spite of widespread use of injectable gold in Finland, there were no deaths attributed to side effects of gold. CONCLUSION: The data emphasize the frequent occurrence of fatal side effects from NSAID and from glucocorticoids and the relative safety of treatment with gold.

Aged↗
PubMed1994

Height loss rate as a marker of osteoporosis in postmenopausal women with rheumatoid arthritis.

The relation between the loss of height and bone mineral density (BMD) at the lumbar spine and proximal femur was determined in 61 women aged 56-70 years suffering from rheumatoid arthritis. Statistically highly significant negative correlations were found between the loss of height and the spinal and femoral BMD. A loss of 4 cm or more in height over 10 years seems to be associated with a significant decrease of BMD, and it can be recommended as a clinical marker of osteoporosis.

Aged↗
PubMed1994

Tolfenamic acid: clinical experience in rheumatic diseases.

Tolfenamic acid (TA) is an interesting drug for the treatment of rheumatic diseases because of its capacity to inhibit the synthesis of leukotrienes. It may have fewer upper gastrointestinal side effects than other NSAIDs which inhibit only the synthesis of prostaglandins. Several controlled and non-controlled studies on the clinical efficacy and side effects of TA have been carried out since the early seventies. These studies include about 900 patients suffering from different rheumatic diseases. The clinical efficacy of TA has proved to be at least as good as that of control drugs in all double-blind trials. We have compared the analgesic effect of ten NSAIDs in patients with rheumatoid arthritis, using a single-blind method by asking the patients which one of two drugs was the better. The study gave a rank order to the drugs favoured by the patients and the results showed that TA was among the four best drugs together with naproxen, indomethacin, and diclofenac. The side effect profile of TA is different from that of other NSAIDs. The number of upper gastrointestinal side effects during TA treatment was less than half the number during treatment with control NSAIDs in eight double-blind studies. On the other hand, dysuria was found only during TA treatment. In 1989 the official side effect registers of Denmark and Finland included a total of 462 side effect reports. The frequency of side effects per treatment day was about the same as for other NSAIDs according to these reports.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1994

Long-term outcome of rheumatoid arthritis has improved.

X-rays of 20 finger joints, 10 foot joints and 2 wrists of 50 female patients with seropositive rheumatoid arthritis of 10-15 years' duration from 1962, 1972, 1982 and 1992 were evaluated blindly for erosions. A highly significant decline was observed in erosions in finger joints. Erosions had also declined in wrists and in foot joints, though less than in fingers. This may indicate improvement in the long-term outcome of rheumatoid arthritis.

Aged↗
PubMed1994

Increased type I collagen degradation in early rheumatoid arthritis.

OBJECTIVE: To evaluate the serum concentration of the mature, crosslinked carboxy terminal telopeptide of type I collagen (ICTP) in patients with early onset rheumatoid arthritis (RA) and to assess its correlation with clinically relevant features of the disease. METHODS: The serum ICTP concentration was measured in 99 adult patients with RA with a duration of disease less than one year. The main clinical outcome measures were joint count, modified Lansbury index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Larsen index and number of erosions in peripheral joints. RESULTS: There was a strong positive correlation (p < 0.001) between the serum ICTP concentration and the Lansbury joint index and a weaker but still significant correlation (p < 0.01) between the serum ICTP concentration and the number of eroded hand and foot joints. CONCLUSION: Serum ICTP may have value as a marker of tissue destruction in patients with early RA.

Adolescent↗
PubMed1994

[Epidemiology of rheumatoid arthritis].

Although arthritis is a common disease in adults, only one in five new cases of arthritides is classifiable as rheumatoid arthritis (RA). The annual incidence of adult RA is about 0.05 per cent, and is ten times higher among women over fifty than among men under 50. The prevalence increases with age up to 70 years, after which it declines due to premature mortality. The high or low prevalences characteristic of certain populations may be explained by ethnic differences in genetic susceptibility.

Adult↗
PubMed1993

Frequency of amyloidosis in Estonian patients with rheumatoid arthritis.

Occurrence of secondary amyloidosis in hospitalized Estonian patients suffering from rheumatoid arthritis was studied using subcutaneous fat aspiration biopsies. Only 47 out of 59 samples included fat, and amyloidosis deposits were found in 11 of these (23%). The high frequency of amyloidosis may be due to selection of the most severe cases in the hospital.

Adipose Tissue↗
PubMed1993

Prospect for an additional laboratory criterion for rheumatoid arthritis.

The aim of the study was to establish the benefit of an additional hypothetical laboratory criterion for rheumatoid arthritis (RA), comprising positivity for antikeratin antibody (AKA) and/or antiperinuclear factor (APF). The tests were applied to a series of 308 hospital patients with various recent-onset inflammatory joint diseases who were followed for 3 years. The performance of APF and AKA was compared with rheumatoid factor (RF). The most sensitive (.72) but the least specific (.86) test for RA was the latex test. The most specific (.96) but the least sensitive (.33) test was AKA. Waaler-Rose and APF were intermediate. AKA and/or APF positive patients had significantly more erosions than patients negative for these autoantibodies. Despite the impressive performance characteristics of APF and AKA, the actual classification impact achieved, as compared to using RF as the sole laboratory criterion, turned out to be moderate. This is because the criteria proved to be interrelated. Unlike RF, AKA and APF are not suited to the general laboratory, at least not in their present form. Moreover they so far lack the broad data base of RF.

Antibodies↗
PubMed1993

Pain intensity in patients with fibromyalgia and rheumatoid arthritis.

Three times daily continuously during a three-week inpatient rehabilitation course a visual analogue scale (VAS) was used in the assessment of pain intensity in 20 female patients with primary fibromyalgia (PF) and 20 female patients with rheumatoid arthritis (RA). The pain intensity in PF patients was constantly twice as high as in RA patients. The effect of the rehabilitation course on pain intensity, as assessed by linear regression analysis, was significantly higher in RA than in PF (p < 0.001). In comparison of the first and the last two days, the pain intensity decreased significantly (P < 0.01) in RA, but not in PF. The patients with PF were more depressive than the RA patients, but a positive correlation between depression score and pain intensity was found only in RA patients. Depression was not able to explain the high pain intensity in PF patients. Continuous monitoring of pain by VAS seems to be a useful tool for assessing changes in pain intensity in patients with rheumatic disorders.

Adult↗
PubMed1993

Amyloidosis--incidence and early risk factors in patients with rheumatoid arthritis.

In a 15-year follow-up examination, reactive secondary amyloidosis (RSA) was found by subcutaneous fat biopsy in six out of 74 still living patients (8.1%) of an original population of 102 with erosive and seropositive rheumatoid arthritis (RA). Five of the 24 deceased patients had had RSA. Thus the 15-year incidence of RSA in RA was at least 10.9% (11/102). To study early prognostic aspects of RSA, comparison was made of 14 entry variables and the initial treatment in the RSA group (n = 11) and the control group (n = 81) respectively. At onset (< or = 6 months) of RA only serum orosomucoid, but after three years morning stiffness, ESR, serum CRP and orosomucoid were significantly worse in patients whom later developed RSA. Three out of 48 patients treated with gold sodium thiomalate and seven out of 30 treated with chloroquine developed RSA (p = 0.04). It is concluded that continuously active disease was the risk factor underlying RSA. The role of early chloroquine therapy is discussed.

Adult↗