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Biomedical subjects

O Impivaara

Publications and source records attributed to O Impivaara.

14 recordsLinked to original sources
PubMed1992

Later development of asthma in patients with a negative methacholine inhalation challenge examined for suspected asthma.

A negative methacholine inhalation challenge (MIC) in a patient with suspected bronchial asthma is generally considered to make this diagnosis unlikely. Nevertheless, the patient may later develop asthma. To estimate the proportion that eventually becomes asthmatic, a 10 year follow-up study was carried out on 334 consecutive MIC-negative patients aged 14-80 years. The development of asthma among these patients was assessed on the basis of entitlement to preferential refund from the cost of antiasthmatic therapy granted for them under national health insurance. During the follow-up 30 patients (9%) were granted the refund. There was no significant difference between men and women in this respect. Patients who developed asthma were somewhat older than those who did not. A family history of allergy, allergic rhinitis, and positive reactions to skin prick tests were significantly more common in patients with future asthma. These patients also had a lower mean forced expiratory volume in 1 sec (FEV1) (% of predicted) and a higher mean increase in PEF after an inhaled sympathomimetic than those remaining free from asthma. In multivariate analyses with a logistic model, 3 risk indicators proved independent predictors of future asthma: age, positive family history of allergy, and FEV1 (% of predicted).

Adolescent↗
PubMed1992

Prevalence and characteristics of symptomatic gastroesophageal reflux disease in the elderly.

OBJECTIVE: To study prevalence and characteristics of symptomatic gastroesophageal reflux disease in the elderly. DESIGN: Survey by questionnaire of stratified random sample. SETTING: City of Turku, Finland. SUBJECTS: Population-based random sample consisting of non-institutionalized subjects aged 65 years or over. A questionnaire was sent to 559 subjects. The response rate was 92%. Twenty-nine incompletely filled forms were rejected. Thus, the questionnaires from 487 subjects, representing 87% of the original number, constitute the basis for the study. MEASUREMENTS: The questionnaire inquired about the following symptoms: heartburn, regurgitation, chest pain, dysphagia, dyspepsia, respiratory symptoms, vomiting, and belching. RESULTS: The age-adjusted prevalence of daily symptoms suggestive of gastroesophageal reflux disease was 8% in men and 15% in women (P < 0.05). Fifty-four percent of men and 66% of women reported that they had symptoms at least once a month (P < 0.05). The prevalence of symptoms was roughly the same across age groups. The occurrence of chest pain, dyspepsia, vomiting, belching, dysphagia, chronic cough, hoarseness, and wheezing were associated with symptoms suggestive of gastroesophageal reflux disease. CONCLUSIONS: Symptoms suggestive of gastroesophageal reflux disease are common in elderly subjects. Women suffer from these symptoms more frequently than men. Typical reflux symptoms are often associated with atypical complaints, such as abdominal symptoms, chest pain, or respiratory symptoms.

Aged↗
PubMed1991

Prevalence, determinants, and consequences of chronic neck pain in Finland.

Chronic neck pain is a relatively mild musculoskeletal condition, but common enough to be a possible public health problem. The distribution, determinants, and consequences of chronic neck pain have hitherto been described inadequately. In the Mini-Finland Health Survey, a representative population sample of 8,000 Finns aged greater than or equal to 30 years was invited to participate in a comprehensive health examination comprising an interview and a clinical examination; 90.2% complied. Predetermined criteria were used to diagnose major cardiovascular, musculoskeletal, respiratory, mental, and other disorders, regardless of other simultaneous disorders. Chronic neck syndrome was diagnosed in 9.5% of the men and 13.5% of the women. When adjusted for age and sex, the prevalence of the neck syndrome was associated with a history of injury to the back, neck, or shoulder and with mental and physical stress at work. Among those aged 30 to 64 years, overweight and parity were also significant determinants. Other musculoskeletal and mental disorders were associated with neck syndrome, and the association persisted after working conditions, injuries, overweight, and parity were adjusted for. There was some independent association between neck syndrome and disabilities, use of physician services, and use of pain killers.

Adult↗
PubMed1991

Risk factors for subarachnoid hemorrhage in a longitudinal population study.

The known risk factors of atherosclerotic diseases may be involved in the development of a subarachnoid hemorrhage. We studied the morbidity and mortality due to subarachnoid hemorrhage among 42,862 men and women aged 20-69 years who had participated in a large health survey in Finland. During a mean follow-up of 12 years, 102 non-fatal and 85 fatal cases of subarachnoid hemorrhage were observed. The total incidence was 37 per 100,000 person-years. Smoking and hypertension were positively associated and body mass index was inversely associated with the risk of subarachnoid hemorrhage. These associations were not confounded by age or each other. No statistically significant association with risk was detected for serum cholesterol level, hematocrit content, known heart disease, or diabetes. The risk was especially elevated among lean hypertensive subjects and lean smoking subjects. The age-adjusted relative risks of subarachnoid hemorrhage for lean, hypertensive smokers were 18.3 (95% confidence interval (CI), 7.8-42.7) among women and 6.7 (95% CI, 2.3-19.7) among men as compared to the risk among subjects without these risk factors. We conclude that modifiable risk factors are predictive of subarachnoid hemorrhage, for which reason subarachnoid hemorrhage may in part be preventable. Leanness combined with arterial hypertension and/or smoking, in particular, poses a substantially elevated risk.

Adult↗
PubMed1991

Determinants of sciatica and low-back pain.

Several factors were studied for their association with the prevalence of chronic low-back syndromes, sciatica, and unspecified low-back pain (LBP) in 2,946 women and 2,727 men (age range, 30-64 years) participating in the Mini-Finland Health Survey, a project aimed at comprehensive evaluation of the population's health. On the basis of a standardized clinical examination, a physician diagnosed sciatica in 5.1% and LBP in 11.6% of the subjects. Those with a previous traumatic back injury had a 2.5-fold risk of having sciatica or LBP. The fractions of sciatica and LBP attributable to such back injuries were estimated to be 16.5% and 13.7%, respectively. Sum indices of both physical and mental stress at work were found to be directly proportional to the prevalence of sciatica and LBP. Smokers had an increased risk of LBP, and body height was related positively to the prevalence of sciatica. These associations, however, were inconsistent between sex and age subgroups. In the presence of osteoarthritis in the knee, hip, or hand, LBP was prevalent (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 4.1-6.9), but sciatica was not (OR, 1.1; 95% CI, 0.7-1.7). Diabetics were found to have a significantly decreased prevalence of LBP (OR, 0.4; 95% CI, 0.3-0.8). Many factors, independent of each other, determine the occurrence of chronic low-back syndromes. The determinants of sciatica and LBP are different to some extent.

Adult↗
PubMed1990

New ergometric reference values for clinical exercise tests.

A group of 301 apparently healthy men and women were studied using bicycle ergometry in order to obtain generally applicable reference values for clinical exercise testing. The subjects, aged 30-67 years, were derived from a comprehensive health survey carried out on a population sample representative of adult Finns. The exercise test was a standardized heart rate conducted programme in which workload was regulated so as to increase heart rate by 5 beats/min every min up to subjective maximum. Three indicators of exercise capacity are presented: maximal workload (Wmax), mean workload attained during the last 4 min of the test (Wlast4') and hypothetical maximal workload sustainable for 6 min (Wmax6'). All showed wide inter-individual variation even when related to age and body weight. The ergometric results depended significantly on age and height in men and on age and weight in women. We present formulas for the calculation of expected values of Wlast4' and Wmax6' on the basis of sex, age, height and weight. We suggest that the measured values be given in percentages of those expected.

Adult↗
PubMed1989

Descriptive epidemiology and public health aspects of low back pain.

The prevalence of low back syndrome and its consequences in terms of disability, handicap, and need for medical care were studied as part of "the Mini-Finland Health Survey". A sample of 8000 persons representative of the Finnish population aged 30 or over was invited for examination, and 7217 (90%) participated. At interview 75% of the participants reported that they had experienced at least one episode of low back pain. Six or more episodes were reported by half of the population, and about 20% had suffered from pain during the previous month. On the basis of a standardised clinical examination, a physician diagnosed low back syndrome in 17.5% of men and 16.3% of women. The prevalence was highest in those aged 55-64 years. The use of health services was frequent among those suffering from low back pain. Nevertheless, their need for care was commonly unmet. Some disability was found in almost 60% of the subjects with low back pain, although severe functional limitations were rare. It was estimated that of the work disability the reduced capacity for everyday duties apart from work, and the reduced capacity for leisure time activities, in the population 18%, 16%, and 17%, respectively, were attributable to the low back syndrome. Thus low back syndrome has a strong impact on individuals and on society as a whole.

Adult↗
PubMed1987

Lumbar disc syndrome in Finland.

The prevalence of lumbar disc syndrome (herniated disc or typical sciatica) and its consequences in terms of disability, handicap, and need for medical care were studied as part of the Mini-Finland Health Survey. A sample of 8000 persons representative of the Finnish population aged 30 or over was asked to come for examination, and 7217 (90%) participated. A diagnosis of lumbar disc syndrome based on medical history, symptoms, and standardised physical examination was made for 5.1% of the men and for 3.7% of the women. Half of these patients were assessed to be in need of medical care, over 80% of which was considered to be adequately met. One third of all patients with lumbar disc syndrome had been previously hospitalised for that syndrome, and one fifth of the patients had undergone lumbar surgery. At least slight disability was found in almost 60% of the patients, though severe functional limitations were rare. About 6% of the population's work disability was estimated to be attributable to lumbar disc syndrome.

Adult↗
PubMed1987

Type A behaviour pattern in Finland.

The prevalence of coronary prone behaviour, type A, was investigated in a population sample of 1,958 men and 2,224 women aged 30-64 years representative for all people of that age actively employed in Finland. Type A behaviour was assessed by the Jenkins Activity Survey. The mean values of the standardized AB scale were -5.6 in men and -5.8 in women. Type A behaviour was strongly associated with the level of education, occupational group and the socio-economic status achieved. However, it was not related to the conventional cardiovascular risk factors. The prevalence of coronary heart disease was statistically significantly associated with type A behaviour.

Adult↗
PubMed1987

Practice and control of digitalis therapy in Finland.

In order to assess the adequacy of digitalis therapy in Finland we studied its practice and control in 747 patients who were receiving it regularly. The patients were derived from a sample (n = 8000) representative of the adult Finnish population. More than 90% of the patients were receiving digoxin, mostly 125 micrograms or 250 micrograms, once daily. Few patients were taking digitalis as the sole drug prescribed. The mean number of prescribed drugs for each patient (including digitalis) was 4.2 for men and 4.6 for women. 85% of the patients generally visited their "own" doctor. About 90% of the patients had seen a doctor at least once during the previous 12 months. In spite of this, the control of the therapy was generally considered poor, since almost half the patients were uncertain when the next visit to the doctor would be. Inadequately low serum digitalis concentrations, suggesting inadequate or questionable use of the drug, were observed in 30% of the patients. In 15% of the patients the therapy was considered especially questionable. Probably due to variable prescribing habits in general practice, the proportions of patients on poorly controlled, inadequate or questionable digitalis therapy varied remarkably between regions within the country. The results suggest that digitalis therapy in Finland is often inappropriate. We conclude that the practice and control of digitalis therapy need careful reappraisal in this country.

Adult↗
PubMed1986

Overprescription and underprescription of digitalis.

As part of a health examination of a representative sample (n = 8,000) of the adult Finnish population, cardiac state was assessed in the 747 digitalis users and the 6,329 non-users who participated in the survey. Ninety per cent of the digitalis users were in sinus rhythm and 50% were in sinus rhythm and had a normal roentgenographic heart volume. About 20% of those in sinus rhythm had a normal heart volume and a "subtherapeutic" serum digitalis concentration. The age-adjusted prevalence of digitalis therapy in the presence of sinus rhythm was 8% in men and 10% in women. The total number of these patients in Finland was estimated at 246,000 (95% confidence limits 225,000-267,000). Half of the men and two thirds of the women on digitalis received concomitant diuretic therapy. Atrial fibrillation and/or markedly enlarged heart were observed in 1.5% of the men and 0.9% of the women not receiving digitalis. Their total number in the Finnish population was estimated at 23,000 (+/- 7,000). The results suggest that questionable digitalis therapy is very common since several authors have reported successful withdrawal of maintenance digitalis therapy in at least half of the patients in sinus rhythm. On the other hand, underprescription of digitalis seems to be uncommon.

Adult↗
PubMed1985

Serum digoxin concentrations in a representative digoxin-consuming adult population.

As part of health examination of a representative sample of an adult population (n = 8000) serum digoxin concentration was measured in 661 patients on continuous digoxin therapy. The prescribed mean daily dose of digoxin was significantly higher in men (223 micrograms) than in women (201 micrograms); the dose significantly decreased with increasing age. The mean serum digoxin concentration was the same in men and women and it differed insignificantly between age groups, although older persons tended to have a higher concentration. The age - adjusted mean steady state digoxin concentration was 1.02 ng/ml in men and 0.98 ng/ml in women; in about 60% the concentration was within the "therapeutic" range (0.80-2.00 ng/ml). The concentrations were clearly related to daily dose of digoxin. At equal dose levels old persons tended to have higher concentrations than younger persons. The interindividual variation in serum digoxin concentrations was very wide. However, when digoxin measurements in the same subjects were repeated about three months later, a good correlation between the two measurements was found. The interval between the last dose of digoxin and the collection of blood (up to 41 h) had relatively little effect on individual serum digoxin concentrations. Patients on concomitant thiazide or loop diuretic therapy had the same mean serum digoxin concentration as those not-receiving a diuretic. The mean concentration was significantly higher in patients taking a thiazide or loop diuretic combined with triamterene. The difference may have been due to an interaction between triamterene and digoxin.

Adult↗
PubMed1985

Use of cardiac glycosides in Finland.

The prevalence and number of persons receiving cardiac glycosides were estimated in connection with a general health survey. A population sample (n = 8000) representative of the adult Finnish population was studied. According to a questionnaire and an interview, about 10% of men and 11% of women were receiving cardiac glycosides. The total number of glycoside users in Finland was estimated at 311 000 (95% confidence limits 289 000-333 000). A significant serum digitalis concentration definitely indicating digitalis use was observed in about 9% of men and 10% of women. By this method the minimum number of persons receiving digitalis therapy was estimated at 248 000 (95% confidence limits 227 000-269 000). About 90% of all glycoside consumption appeared to take place outside institutions. The prevalence of glycoside use increased greatly with advancing age and tended to be higher in women than in men. The prevalence varied significantly between regions within the country. Further research is required to explain the unusually prevalent and geographically variable use of cardiac glycosides in Finland.

Adult↗