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Biomedical subjects

L R Knuts

Publications and source records attributed to L R Knuts.

At least 19 recordsLinked to original sources
PubMed2000

Feasibility of, and success in adopting a low-fat diet in coronary patients.

The aim of this study was to evaluate the feasibility of dietary counselling and the predictability of success in reducing fat intake to less than 20% of total energy in patients with symptomatic coronary heart disease. Forty-seven patients with coronary heart disease attended a 2-week in-house cardiac rehabilitation course with the main emphasis on individual dietary counselling by a nutritionist. Patients were followed up at 3 and 6 months. The dietary data were collected by means of 3-7 days food diaries. Mean fat intake decreased from 33.6 +/- 6.2% to 24.7 +/- 5.5% of total energy intake at 3 months and to 27.0 +/- 6.9% (p < 0.001) at 6 months. Only 13% of the patients were able to reduce their dietary fat intake as recommended. Thus, reduction of > or = 20% was considered a good response, while reduction of < 20% was classified as poor. Forty-seven percent (n = 22) of the patients were good and 53% (n = 25) poor responders. It was not possible to predict the success rate from the baseline data. After a 2-week intensive counselling period at the rehabilitation centre, half of the coronary patients were able to comply with a low-fat diet at home for 6 months. Long-term compliance requires further investigation.

Adult↗
PubMed1999

A health promotion programme for oil refinery employees: changes of health promotion needs observed at three years.

The main aim of this three-year follow-up study was to evaluate the long-term effects of a workplace health promotion intervention programme offered by the Neste Oyj corporation's occupational health service. Another aim was to study factors associated with changes in health promotion needs. These were assessed using information obtained by means of questionnaires and laboratory measurements. The target areas assessed were physical activity, musculoskeletal problems, dietary habits, obesity, blood pressure, serum lipids, smoking, quality of sleep and mental well-being. Participants from one oil refinery were offered special health promotion counselling, while those from the other oil refinery studied received only their personal results, written information and instructions. Evaluation of the changes in needs was mainly based on comparison of the results of two examinations performed with an interval of three years. Effects of special health promotion counselling were observed in the target area of physical activity. Elimination of certain health promotion needs was seen in both groups in all of the target areas. The most extensive changes were seen in the target areas of musculoskeletal symptoms, dietary habits, blood pressure and mental well-being. Basic education, occupational status and age-group, as well as the value of tending health were frequent variables explaining the reduction in the need for health promotion activities. Worker participation in health promotion counselling activities provided by occupational health services can be high, as in this study in which the participation rate was 90% and the drop-out rate during the three years only 10%.

Adult↗
PubMed1998

Life-style related health promotion needs in oil refinery employees.

This report describes the screening procedure used in the assessment of health promotion needs in a group of oil refinery employees (n = 885). The aim of the study was to assess the life-style related health promotion needs before initiating an intervention programme study. The frequency of different health promotion needs and their distribution according to age, gender and employee group were examined, as well as the factors explaining different health promotion needs. The assessment was based on laboratory tests and questionnaires covering the target areas of physical activity and fitness, dietary habits, overweight, blood pressure, serum lipids, smoking, alcohol consumption, sleep, mental health, and musculoskeletal symptoms. Life-style related health promotion needs were frequent. Self-assessed health was strongly associated with health promotion needs in most of the ten target areas and also with the total number per person of areas with health promotion needs. Health promotion needs were also associated with such demographic variables as age, gender, basic education, and vocational training. If health promotion activities are provided to employees in a company, assessment of individual needs is necessary to find the employees with the greatest need of health promotion actions. This study presents one method of screening, although certain simplification is needed to make it fit into the daily routines. The contents of health promotion activities could also vary according to the differences related to age and gender observed in health promotion needs of the target population.

Adult↗
PubMed1997

Subjective quality of sleep and use of hypnotics in an elderly urban population.

To investigate the characteristics and subjective quality of sleep, the use of hypnotics and their correlates in an urban elderly population, a structured interview was administered to a stratified random sample of 600 elderly subjects in five age groups. Interrupted sleep and napping were common; nonetheless, 88% of the subjects considered their sleep at least satisfactory. According to specific criteria, 17% were good, 72% moderate and 11% poor sleepers. Habitual insomnia was reported by 12% of the subjects. Quality of sleep did not differ between age groups or genders. Hypnotics were habitually used by 8% of the men and 25% of the women. Consumption increased with age in both sexes, and 77% of the hypnotics were benzodiazepines. In multivariate regression analyses, insomnia and habitual use of hypnotics were associated with poor health, but only the latter with age and gender. As a conclusion, most of the subjects considered their sleep satisfactory, and aging itself did not seem to have an effect on the quality of sleep. The use of hypnotics was common, more prevalent in women and increased with age. Aging and poor health were independently associated with the use of hypnotics, but not with poor quality of sleep or insomnia.

Age Factors↗
PubMed1995

Reduction in sudden deaths and coronary mortality in myocardial infarction patients after rehabilitation. 15 year follow-up study.

The study was set up to evaluate the long-term effects on mortality of a comprehensive rehabilitation and secondary prevention programme lasting 3 years after acute myocardial infarction. The study group consisted of 375 consecutive, non-selected patients under 65 years of age randomly allocated to an intervention group (188 patients) or a control group (187 patients). After 15 years follow-up significantly lower incidence of sudden death (16.5% vs 28.9%, P = 0.006) and coronary mortality (47.9% vs 58.5%, P = 0.04) were seen in the intervention group compared with controls. Total mortality was 64.4% and 66.8%, respectively (ns). The incidence of cancer death was 16 in the intervention group and three in the controls. Cardiac failure, enlarged heart, New York Heart Association functional class II or more and membership in the control group were significantly associated with coronary mortality during the first 3 years, and after 3 years enlarged heart, diabetes and reinfarction were associated with late coronary death. Thus, comprehensive multifactorial intervention after acute myocardial infarction had favourable long-term effects on coronary mortality and sudden death but no effect on total mortality.

Adult↗
PubMed1994

Cardiac rehabilitation and return to work after coronary artery bypass surgery.

The work situation of 66 male patients who underwent elective coronary artery bypass surgery (CABS) and who had been randomly allocated to receive cardiac rehabilitation (group R) was compared with the work situation of 59 similar patients allocated to receive only standard care (group H). The follow-up time was one year. The proportions of subjects working in groups R and H were 26% and 20% (p = ns) before the CABS, 45% and 34% (p = ns) 6 months and 56% and 38% (p = ns) 12 months after the CABS, respectively. The increase in proportion of subjects who worked was significant in both groups at both 6 and 12 months after the CABS (p < 0.05 for all changes). The increases were not significantly different between the whole groups, but in patients younger than 55 years of age, return to work was more frequent in group R than in group H (at 12 months 60% vs. 35%, p for the difference in change = 0.02). Stepwise logistic regression analysis of the factors influencing return to work showed that a patient's judgement of his own working capacity as good 6 months after CABS (odds ratio (OR) 8.5, confidence interval (CI) 2.3-32.0), functional class I 6 months after the CABS (OR 6.7, CI 1.8-24.5), his desire to work (OR 6.4, CI 1.6-26.0) and absence from work of less than 3 months before the CABS (OR 4.9, CI 1.2-20.2) were significant positive predictors of return to work 1 year after the CABS.

Coronary Artery Bypass↗
PubMed1994

Chronic illness and subjective quality of sleep in the elderly.

The effect of chronic illness on the subjective quality of sleep, and the use of hypnotics was studied in a stratified random sample of elderly people. Six hundred subjects aged 65 years or over were included in the study. A structured interview on the quality of sleep and medical history was carried out. In addition, the majority of diagnoses were confirmed from the national health insurance documents of the subjects. Logistic regression analysis disclosed that only perceived poor health and peptic ulcer or esophagitis were associated with perceived poor sleep. Age did not contribute to the quality of sleep. Age over 80 years and the presence of peptic ulcer or esophagitis, heart failure, cholelithiasis, and, in particular, depression were associated with the habitual use of hypnotics. The results stress the importance of perceived poor general health status, and acid-related gastrointestinal diseases as the determinants of subjective poor sleep, rather than age or many specific somatic diseases as such. On the other hand, depression is a major determinant for the habitual use of hypnotics.

Aged↗
PubMed1993

Determinants of symptoms suggestive of gastroesophageal reflux disease in the elderly.

The study material consisted of 487 subjects from a stratified random sample of the non-institutionalized population of Turku aged 65 years or more (n = 24,937). The study was based on a population study on health status and sleeping habits of the elderly. Information on health status and medications was obtained by means of interviews and from the national health insurance records of the subjects. A postal questionnaire inquired about symptoms suggestive of gastroesophageal reflux disease (GERD). In univariate analyses, perceived poor health, insomnia, disability, depression, previous peptic ulcer, cholelithiasis, and bronchial asthma were associated with daily symptoms suggestive of GERD. Moreover, the symptoms were associated with the use of beta-blocking agents, benzodiazepines, and neuroleptic agents. In multivariate analyses, previous peptic ulcer, perceived poor health, insomnia, and use of benzodiazepines were independently associated with symptoms suggestive of GERD. In conclusion, the determinants of symptoms suggestive of GERD in the elderly differ from those reported in young and middle-aged subjects.

Aged↗
PubMed1992

Quality of life during rehabilitation after coronary artery bypass surgery.

The effect of a three-phase comprehensive rehabilitation programme on the quality of life during the first postoperative year after coronary artery bypass surgery was studied in 205 male patients randomly allocated into a rehabilitation (R) and a hospital-based treatment (H) group. The rehabilitation programme included physical exercise, relaxation training, psychological group sessions, dietary advice and discussions about postoperative treatment of coronary disease. There was no difference between R and H groups in the frequency of postoperative complaints, number of hospital admissions and satisfaction of sexual life. An almost significantly greater number of subjects in R group than in H group perceived their health as good 12 months after surgery. The Beck Depression Index score decreased significantly in R group but not in H group during follow-up. A greater increase in hobby activities was observed in R group than in H group. More subjects in R group than in H group considered rehabilitation important for recovery, whereas more patients in H group considered support by the spouse and family, the subjective mental strength and a secure income as important.

Adult↗
PubMed1992

Coronary heart disease risk factors before and after bypass surgery: results of a controlled trial on multifactorial rehabilitation.

The effect of a three-phase multifactorial institution-based rehabilitation programme on coronary heart disease (CHD) risk factors was studied in an open randomised trial comprising 228 patients undergoing coronary artery bypass surgery allocated into a rehabilitation (R) group (n = 119) and a hospital (H = control) group (n = 109). Follow-up examinations were performed at 6 and 12 months. Serum total cholesterol and triglyceride levels decreased significantly in both groups during follow-up. These decreases were not significantly different between the R and H groups. Serum high density lipoprotein (HDL) cholesterol level increased significantly at 6 and 12 months in the R group, but not in the H group. The differences in the changes between the groups were not significant. The ratio of serum HDL cholesterol to total cholesterol increased significantly in the R group from the preoperative value of 0.154 to 0.179 (P less than 0.001) at 6 months and to 0.180 (P less than 0.001) at 12 months. In the H group these values were 0.152, 0.166 (P less than 0.001) and 0.168 (P less than 0.001), respectively. The significance of the differences in the changes between the groups were P = 0.01 at 6 months and 0.06 at 12 months. These differences were more obvious in patients aged 55 years or under. There was a significant decrease (P = 0.005) in the proportion of smokers in the R group and a significant increase in the proportion of patients taking regular exercise in both groups as assessed by questionnaire.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1992

Exercise habits and physical performance during comprehensive rehabilitation after coronary artery bypass surgery.

The effects of training as part of a comprehensive rehabilitation programme on exercise capacity and habits was studied in 171 male coronary artery bypass surgery patients randomized into a rehabilitation (R) (n = 93) and a reference, hospital-based treatment (H), group (n = 78). The rehabilitation programme started with a 2-day informative course before surgery and continued with a 3-week exercise-based course 2 months after surgery followed by a 2-day refresher 8 months post-operatively. The percentages of subjects having regular exercise were 22% and 10% pre-operatively, 42% and 38% 6 months and 46% and 38% 12 months after surgery in the R and H groups, respectively. The changes in the proportions observed in R and H groups were not significantly different. Total work during a bicycle exercise test increased from 38.9 +/- 24.3 kJ pre-operatively to 64.0 +/- 31.4 kJ 6 months (P less than 0.001) and to 70.0 +/- 35.7 kJ 12 months (P less than 0.001) post-operatively in group R and from 40.8 +/- 25.6 kJ to 57.3 +/- 26.6 kJ (P less than 0.001) and to 60.4 +/- 30.8 kJ (P less than 0.001) in group H, respectively. The increase from the pre-operative value was greater in group R than in group H both 6 (P = 0.03) and 12 months (P = 0.02) after surgery. Respective changes occurred in maximal work load, but the increase was significantly greater in group R than in group H only 12 months post-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Validity of the estimated food diary: comparison of 2-day recorded and observed food and nutrient intakes.

We assessed the validity of the estimated food diary by comparing recorded and observed food and nutrient intakes for 121 subjects (71 men and 50 women) aged 15 to 65 years. We obtained observed intake by unobtrusively recording the amounts of foods, preweighed or measured when served, at the four meals on each of the two study days. At the same time, subjects kept an estimated food diary. In general, the mean food intake recorded in the food diaries deviated from the observed intake by 15% at most. The deviation exceeded 20% for only a few food items. With the exception of calcium (-11%), starch (+10%) and thiamin (+8%), there was no difference or only a few percent difference in the means for energy and the 16 nutrients calculated. The validity of the food diary was equally high for men and women in the 15 to 34, 35 to 44, and 45 to 65 age groups. Product-moment correlation coefficients ranged from 0.68 to 0.97 for food intake and from 0.75 to 0.92 for nutrient intake. We conclude that validity is very satisfactory on the group level and is probably acceptable on the individual level.

Adolescent↗
PubMed1991

The proportion of patients with cognitive impairment after coronary artery bypass surgery: an 8-month follow-up study.

The aim of this study was to investigate cognitive function after coronary artery bypass surgery and the association of this with surgical variables. All male patients scheduled for elective surgery, aged 40-64 years, mean age 54 +/- 6 (n = 104), and participating in a randomized rehabilitation study, were included. A comprehensive psychodiagnostic examination was conducted preoperatively, 2, and 8 months postoperatively. The assessment of change was conducted using tertiles, defined according to population norms. More patients revealed improvement than impairment, and practically no significant associations with surgical variables were found.

Adult↗
PubMed1990

A prospective study of patients with sciatica. A comparison between conservatively treated patients and patients who have undergone operation, Part I: Patient characteristics and differences between groups.

Based on a prospective study on 342 sciatica patients examined with rhizography, the aim was to determine which factors others than the rhizography finding and the grade and duration of symptoms were related to the selection of patients to undergo operation. Compared with surgically treated patients, conservatively treated patients who did not undergo operation and who had pathologic rhizography findings had pessimistic attitudes to possible surgery, often expressed a desire to retire, and considered their work as physically stressful. The women in this group were older and had lower pain indices than women who underwent operation. Conservatively treated patients with negative rhizography had more severe occupational handicaps, minor expectations of possible surgery, physically more strenuous jobs requiring difficult physical positions, and lower indices for pain and ADL than did the operated patients. The social and ergonomic background problems are emphasized in sciatica patients conservatively treated after rhizography.

Adult↗
PubMed1990

A prospective study of patients with sciatica. A comparison between conservatively treated patients and patients who have undergone operation, Part II: Results after one year follow-up.

The prospective study included 122 sciatica patients who had not undergone operation (NOPs) and 220 sciatica patients who had undergone operation (OPs); all had been examined by rhizography. The follow-up study was done on 110 (90%) of the NOPs and 212 (96%) of the OPs. The NOPs were divided into two groups: 30 patients with pathologic rhizography (PR) and 80 patients with negative rhizography (NR). Pain-, ADL-, and occupation-handicap indices showed that after the 1 year follow-up the OP group had the best result and the NR group the lowest result. The PR group had nearly as good a result as the OP group. Thus, sciatica patients are candidates for conservative therapy, even though they have pathologic findings in rhizography, if the symptoms are mild. To improve therapeutic outcome, more accurate diagnostic tools are needed to develop specific therapy especially for those sciatica patients with negative rhizography.

Adult↗
PubMed1989

Long-term reduction in sudden deaths after a multifactorial intervention programme in patients with myocardial infarction: 10-year results of a controlled investigation.

Three-hundred and seventy-five unselected patients below 65 years of age and with acute myocardial infarction participated in a controlled investigation aimed at studying the effects of a multifactorial intervention programme on morbidity, mortality and risk factor control. After ten years' follow-up the significantly lower sudden death and coronary mortality observed three years after myocardial infarction still persisted in the intervention group (188 patients) compared with the control group (187 patients). The incidence of sudden death in the intervention group was 12.8% compared with 23.0% in the controls (P = 0.01). The incidence of coronary mortality was 35.1% and 47.1%, respectively (P = 0.02). No significant difference was found in the number of patients with clinical non-fatal reinfarctions (25.6% and 19.3%, respectively). During the first year, when the mortality difference was most marked, the use of beta blockers was not significantly different between the groups. The results suggest that with a multifactorial intervention programme which starts early after the infarction and lasts for years a significant long-term reduction in sudden deaths and coronary mortality can be attained.

Adrenergic beta-Antagonists↗
PubMed1989

Prognostic value of an exercise test one year after myocardial infarction.

An exercise test was performed in 306 patients who had had acute myocardial infarction one year previously. The five year cumulative coronary heart disease mortality was 40.0%, when the test had to be discontinued because of ventricular arrhythmias but only 13.0% if discontinued because of fatigue (P less than 0.05). If the maximum work load was less than 80 W the mortality was 30.7% compared with 16.6% in patients who exercised at least 80 W (P less than 0.01). If maximum systolic blood pressure was less than or equal to 150 mmHg mortality was 40.3% compared with 8.5% in patients with greater than 200 mgHg (P less than 0.001). The mortality was 38.2% in patients having single monoform ventricular ectopic beats at a rate of three or more per minute or multiform, paired or early cycle ventricular ectopic beats or ventricular tachycardias: this compared with 14.1% (P less than 0.001) in patients having no or only single monoform ventricular ectopic beats at a rate of less than three per minute. ST-segment depression in univariate testing had no prognostic value. When both exercise test and clinical variables were used in survival analysis (Cox's regression) the most important variable was heart volume and after that ventricular arrhythmias. In multivariate regression analysis ST segment depression also had additional prognostic value. Thus ventricular arrhythmias turned out to be the most important prognostic factor measured during exercise test.

Aged↗