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Biomedical subjects

T Klaukka

Publications and source records attributed to T Klaukka.

At least 19 recordsLinked to original sources
PubMed1992

Resistance to erythromycin in group A streptococci.

BACKGROUND: The use of erythromycin in Finland nearly tripled from 1979 to 1989. In 1988, we observed an unusually high frequency of resistance to erythromycin in group A streptococci in one geographic region. Because routine testing does not detect the sensitivity of these organisms to antibiotics, we initiated a national study to evaluate the extent of this resistance. METHODS: We studied 272 isolates of group A streptococci obtained from blood cultures from 1988 through 1990. In 1990 we collected from six regional laboratories 3087 consecutive isolates from throat swabs and 1349 isolates from pus samples. Resistance was indicated by growth on blood agar containing 2 micrograms of erythromycin per milliliter after incubation in 5 percent carbon dioxide. We also evaluated the clinical importance of erythromycin resistance in a retrospective study of consecutive patients with pharyngitis. RESULTS: The frequency of resistance to erythromycin in group A streptococci from blood cultures increased from 4 percent in 1988 to 24 percent in 1990. From January to December 1990, the frequency of resistance in isolates from throat swabs increased from 7 percent to 20 percent, and resistance in isolates from pus increased from 11 percent to 31 percent. In four communities within 50 km of each other, the frequency of erythromycin resistance ranged from 2 to 5 percent to 26 to 44 percent. Several distinct DNA restriction profiles and serotypes were found among resistant isolates from the same area, suggesting a multiclonal origin. The treatment of pharyngitis with erythromycin failed in 9 of 19 patients infected with erythromycin-resistant group A streptococci, as compared with 1 of 26 patients with erythromycin-susceptible isolates (47 percent vs. 4 percent, P = 0.008). CONCLUSIONS: In Finland since 1988 there has been a rapid and substantial increase in resistance to erythromycin in group A streptococci. The extent of this resistance is particularly serious since there are only a few alternative antibiotics available for peroral treatment of group A streptococcal infections.

Blood↗
PubMed1991

Changes in the prevalence and incidence of diabetes mellitus in Finnish adults, 1970-1987.

Prevalence and incidence of known diabetes mellitus in Finnish subjects aged 30 years or over in 1970-1987 were investigated using a nationwide register of drug recipients and four population surveys. On the basis of the drug-register data, the prevalence of drug-treated diabetes in men increased from 1.5% in 1970 to 2.8% in 1987. In women, the prevalence increased from 2.1% in 1970 to 3.0% in 1979 and declined thereafter slightly to 2.7% in 1987. The increase in the prevalence of drug-treated diabetes was mainly due to the increase of diabetes in the age groups 60 years and older. The prevalence of all known diabetic subjects in the population studies increased from 2.1% in the health examination survey of 1966-1972 (n = 38,676) to 3.5% in the interview survey of 1976 (n = 10,657) and to 4.5% in the health examination survey of 1979-1980 (n = 7,217) but decreased to 3.3% in the interview survey in 1987 (n = 9,522). The increased prevalence of obesity in men and better survival may be important factors contributing to the increasing prevalence rates of diabetes in Finnish subjects aged 30 years and over.

Adult↗
PubMed1991

Consumption of analgesics and anti-inflammatory drugs in the nordic countries between 1978-1988.

Comparative wholesale statistics from the five Nordic countries show an increase of 15-42% in the total consumption of analgesics and anti-inflammatory drugs (including antirheumatics) in the period 1978-1988. Denmark had the highest total consumption (112 DDD/1000 inhab/day in 1988) and Norway had the lowest (61 DDD/1000 inhab/day). Iceland and Finland, with the highest increases in total consumption (45% and 35%), overtook Norway in the early to mid 1980's. Division of total consumption into subgroups showed that Denmark had the highest consumption of analgesics (90 DDDs) and that Finland and Iceland had the lowest figure. The latter countries, however, had the highest consumption of nonsteroidal anti-inflammatory drugs (NSAID), 35 and 30 DDDs, respectively, in 1988. The increase in NSAID consumption was 57% in Finland and 54% in Iceland, while Denmark had only an 18% increase. The new NSAIDs introduced in the 1970's appear to have increased the overall consumption of pain relievers in the Nordic countries, especially in Finland and Iceland.

Analgesics↗
PubMed1991

Why has the utilization of antiasthmatics increased in Finland?

The sales of antiasthmatics have increased rapidly in the Nordic countries during the 1980s. The causes for this growth in Finland were studied. Four nationwide population surveys show that the prevalence of self-reported asthma has risen, a larger proportion of asthmatic patients are under medication, the number of antiasthmatics per patient has increased, and the dosage recommendations of inhalation glucocorticoids and beta-agonists have grown. The average cost of medical treatment of an asthmatic patient was FIM 1848 (approximately U.S. $510.00) in 1990. The highest average expenses in the 21 districts studied were FIM 2171 and the lowest FIM 1535. To identify the consequences of these variations, the frequency of symptomatic periods as well as the quality of life of the asthmatic patients should be studied.

Adolescent↗
PubMed1991

Use of hormone replacement therapy in 1976-89 by 45-64 year old Finnish women.

STUDY OBJECTIVE: The aim was to describe changes in the use of hormone replacement therapy (HRT) in Finland during the period 1976-1989. DESIGN: The study involved four separate cross sectional population surveys in the years 1976, 1978-1980, 1987, and 1989. Three of them involved interviews and one a questionnaire. Sales figures of hormones in 1981-1989 were used. PARTICIPANTS: Participants were national samples of non-institutionalized Finnish women 45-64 years of age. Participation rates ranged from 85% to 96%. MEASUREMENTS AND MAIN RESULTS: Current reported hormone use in the surveys of 1976, 1978-1980, and 1987 was assessed, together with reported hormone use in the last month in the 1989 survey. During the study period the proportion of HRT users increased fivefold. In 1989, 20% of women reported current use of HRT, and the highest rate of use was found among 50-54 year old women in the Helsinki area. In 1976, users were mainly women around the age of menopause, those living in the capital area, and those having a rather high level of education. By 1989 use had spread to postmenopausal women, those in rural areas, and those with less education. CONCLUSIONS: Use of HRT has increased in Finland. It is difficult to evaluate whether the level of current use is too high, optimal, or too low, because recommendations are contradictory and the long term effects of HRT are unkown.

Age Factors↗
PubMed1991

Back pain and arthrosis in Finland. How many patients by the year 2000?

Four Finnish interview surveys from the years 1964, 1968, 1976, and 1987 show a rapid increase in the occurrence of self-reported chronic musculoskeletal disorders. The expected number of such patients by the year 2000 will be one fifth more than in 1987 when the changes in the age structure of the population are taken into consideration. This would amount to 850,000 cases in the year 2000, the total population at that time being 5 million inhabitants. This would be a relative increase of 131 percent as compared with 1964. Half of the cases suffer from back disorders and one quarter from arthrosis. Musculoskeletal disorders now make up the most prevalent group of chronic diseases in the Finnish adult population.

Age Factors↗
PubMed1989

Fatal poisonings with antidepressants in Finland 1985-1987.

In Finland the majority of the users of antidepressants are women and old age people. In the 80's the number of fatal poisonings has increased. During the years 1985-1987 58% of these poisonings were women who belonged to the younger age group of the users. The older tricyclic drugs are known to be more toxic, at least in overdose, than the newer antidepressants especially when they are compared to mianserin. Of the latter, however, lately more serious side effects have been reported. For this reason the use of the different kinds of antidepressants in Finland had changed: the sales of doxepin and amitriptyline have increased and those of maprotiline and mianserin have decreased. To study the role of antidepressants in sudden and unexpected deaths the fatality ratio (defined as fatalities divided by defined daily doses per 1000 inhabitants/day) was calculated for four most prescribed antidepressants. As to the sales, amitriptyline has to be considered to be the leading antidepressant followed by doxepin, mianserin and maprotiline. As a detection in the forensic toxicological screening the sales related ratios showed that maprotiline was most commonly found followed by doxepin, amitriptyline and mianserin. When an antidepressant was the cause of death the fatality ratio was highest for doxepin (6.4) followed by maprotiline (4.3), amitriptyline (4.0) and mianserin (1). In cases of established suicides the order was the same again.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Users of prescription drugs in Finnish primary care.

This study investigates the users of prescription drugs in primary care in Finland in 1976. The data are derived from a national health interview survey, the sample of which represented the whole non-institutionalized population of Finland (N = 21,018). Thirty-two per cent of people 15 years of age or over and 13% of children were using prescription drugs at the time of interview. Women used drugs more than men in all drug categories except for respiratory agents. Children used drugs mainly for respiratory or skin diseases, or for allergic disorders. Cardiovascular agents and analgesics were the most frequently used drugs among the adults. The elderly used all drugs more than other adults except for analgesics, which were used most by the late middle-aged. Characteristics of users of cardiovascular drugs were studied in exploratory multivariate analyses. By far the best predictor of their use was cardiovascular morbidity. In stepwise analyses other significant predictors were age, the visiting to a primary care physician, sex, and work status. Marital status, family income and region appeared not to be statistically significant predictors to the use of cardiovascular drugs.

Adolescent↗
PubMed1985

Use of vitamin supplements in Finland.

Nationwide interview studies have shown that the use of non-prescribed vitamin supplements in Finland increased during the late 1970s, whereas the use of prescribed vitamins and other non-prescribed medicines did not change. Non-prescribed vitamins were taken by 11% of adults 30 years of age or older during the 2 days before the interview, i.e. by 14% of the women and 8% of the men. Prescribed vitamins were used by only 1% of the men and women. Users of non-prescribed vitamins were those who had a high education, metropolitan residency and who reported psychiatric symptoms. Amongst men use was related to a healthy life-style but amongst women with somewhat less healthy behaviour. Prescribed vitamins were taken by the elderly, the chronically ill, those who reported psychiatric symptoms and poor health status. Health behaviour was not associated with the use of prescribed vitamins. Two types of use of vitamin supplements were found: one was related to medical need, and another was inversely related to the medical need for these preparations.

Adult↗
PubMed1985

Does beta-blockade provoke intermittent claudication?

Intermittent claudication has been claimed to be a side-effect of beta-adrenoceptor blocking drugs. The confounding effect of coronary heart disease has not been controlled in earlier studies. In this case-control study, the cases were selected from a hospital material of patients with verified intermittent claudication and the controls from a nationwide health survey. The pool of potential cases and controls consisted of persons who had been treated with antihypertensives, but did not have coronary heart disease. The controls and cases were matched for age, sex, place of residence and time of examination. Comparison of current or previous use of beta-blocking drugs among our 55 case-control pairs revealed no association between intermittent claudication and beta-blockade. beta-Blockade is not a risk factor for intermittent claudication.

Adrenergic beta-Antagonists↗