Teleradiology and teledermatology in Finnish military medicine.
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Bone and Bones↗
Biomedical subjects
T Sahi
Publications and source records attributed to T Sahi.
Body mass index, cigarette smoking, and other characteristics as predictors of self-reported, physician-diagnosed gallbladder disease in male college alumni.
Despite the high prevalence of gallbladder disease in industrialized countries, little is known about the predictors of the disease, especially in men. The authors prospectively studied 16,785 alumni of Harvard University, aged 15-24 years, who were followed for up to 61 years. The health characteristics of these men were ascertained from their college entrance physical examination done in 1916-1950, and updated via mailed questionnaires in 1962 or 1966 (1962/1966). Alumni subsequently self-reported physician-diagnosed gallbladder disease on further mailed questionnaires in 1972 or 1977. Between college time and 1962/1966, 371 gallbladder disease cases occurred. An additional 314 cases occurred after 1962/1966. With respect to college characteristics, after adjustment for potential confounders, the authors found that body mass index (BMI), smoking, physical activity, blood pressure, and consumption of alcohol, coffee, or tea were unrelated to risk. However, BMI in 1962/1966 was directly related to risk of subsequent gallbladder disease, as was BMI gain since college (p, trend = 0.002 and 0.013, respectively). Compared with men with BMI < 22.0, men with BMI > or = 27.0 had a rate ratio of 2.71 (95% confidence interval (CI) 1.57-4.66) for risk of contracting the disease. Men who gained > or = 6.0 BMI units since college had a rate ratio of 1.46 (95% CI 0.86-2.46) compared with men who gained -0.9 to +0.9 BMI units. Compared with never smokers, men who smoked pipes or cigars or < 1 pack of cigarettes daily in 1962/1966 had a rate ratio of 1.43 (95% CI 1.00-2.06), while heavier cigarette smokers had a rate ratio of 1.52 (95% CI 1.03-2.24). Neither physical activity nor physician-diagnosed hypertension or diabetes mellitus in 1962/1966 predicted risk.
Adolescent↗
Role of irritable bowel syndrome in subjective lactose intolerance.
It has been suggested that the symptoms of irritable bowel syndrome (IBS) may be wrongly attributed to lactose intolerance. We examined the relations among IBS, demographic factors, living habits, and lactose intolerance. On the basis of a lactose tolerance test with ethanol, 101 of the 427 healthy subjects studied were lactose maldigesters and 326 were lactose digesters. IBS was diagnosed by means of the Bowel Disease Questionnaire, according to the Rome criteria. The use of dairy products and symptoms experienced after their consumption were recorded. IBS was found in 15% of both the lactose maldigesters and lactose digesters. One-third of the subjects reported intolerance to dairy products containing < or = 20 g lactose. About half of this third were lactose maldigesters and about half were lactose digesters. As explanations for this subjective lactose intolerance, the logistic regression model estimated lactose maldigestion (odds ratio: 10.3; 95% CI: 5.2, 20.4), IBS (4.6; 2.1, 10.1), experience of symptoms other than gastrointestinal ones (2.3; 1.2, 4.5), and female sex (2.1; 1.1, 4.0). Characteristics common to both subjective lactose intolerance and IBS were female sex and the experience of abdominal pain in childhood (P < 0.01). Age, regularity of meals, and the amount of physical activity were not associated with either subjective lactose intolerance or IBS. Of the subjects with IBS, the percentage of lactose maldigesters was the same as in the whole study group (24%) but the number who reported lactose intolerance was higher (60% compared with 27%, P < 0.001). We showed a strong relation among subjective lactose intolerance, IBS, the experience of abdominal pain in childhood, and female sex.
Abdominal Pain↗
[Epidemiological relationship between owen-baked Baltic herring, homebrewed beer and gastroenteritis].
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Beer↗
Seasonal increase in human IgE and IgG4 antisaliva antibodies to Aedes mosquito bites.
BACKGROUND: Mosquito bite-sensitive subjects frequently have circulating IgE and IgG4 antibodies to Aedes mosquito saliva proteins. METHODS: In the present study we examined the antibody response during a mosquito season in 14 subjects living in Finnish Lapland. Immunoblotting was performed with Aedes communis saliva and the 22- and 36-kD antisaliva antibody bands were analyzed. RESULTS: The preseason sera showed IgE antibodies to the main saliva antigens in 12, IgG4 antibodies in all 14 and IgG1 antibodies in 12 subjects, and the postseason sera in all but 1 subject. The postseason sera showed significantly more intense IgE (p < 0.05), IgG4 (p < 0.001) and IgG1 (p < 0.01) antibody bands than the preseason sera. CONCLUSION: These results show that seasonal exposure to mosquito bites leads to an increased IgE, IgG4 and IgG1 antibody response, a phenomenon similar to that occurring e.g. in pollen allergy.
Adult↗
The effect of simvastatin treatment on natural antioxidants in low-density lipoproteins and high-energy phosphates and ubiquinone in skeletal muscle.
It has been hypothesized that treating hypercholesterolemic patients with statins will lead not only to a reduction in cholesterol, but also to inhibited synthesis of other compounds which derive from the synthetic pathway of cholesterol. In theory, this could further lead to ubiquinone deficiency in muscle cell mitochondria, disturbing normal cellular respiration and causing adverse effects such as rhabdomyolysis. Furthermore, ubiquinone is one of the lipophilic antioxidants in low-density lipoprotein (LDL), and therefore it has also been hypothesized that statin treatment will reduce the antioxidant capacity of LDL. We investigated the effect of 6 months of simvastatin treatment (20 mg/day) on skeletal muscle concentrations of high-energy phosphates and ubiquinone by performing biopsies in 19 hypercholesterolemic patients. Parallel assays were performed in untreated control subjects. The muscle high-energy phosphate and ubiquinone concentrations assayed after simvastatin treatment were similar to those observed at baseline and did not differ from the values obtained in control subjects at the beginning and end of follow-up. These results do not support the hypothesis of diminished isoprenoid synthesis or energy generation in muscle cells during simvastatin treatment. Furthermore, the results of analysis of antioxidant concentrations in LDL before and after simvastatin treatment indicate that the antioxidant capacity of LDL is maintained in simvastatin-treated patients.
Adenosine Triphosphate↗
Tolerance to small amounts of lactose in lactose maldigesters.
In this study we examined whether small doses of lactose induced symptoms in 39 lactose maldigesters and 15 lactose digesters in a randomized, crossover, double-blind design. The test doses were 200 mL fat-free, lactose-free milk to which 0, 0.5, 1.5, and 7 g lactose was added. Every third day of a lactose-free diet, after an overnight fast, the subjects drank one of the test milks in random order and registered the occurrence and severity of gastrointestinal symptoms in the next 12 h. During the study, the maldigesters reported significantly more abdominal bloating (P = 0.0003) and abdominal pain (P = 0.006) than the digesters. There was no difference in the mean severity of the reported symptoms between the test milks and the lactose-free milk in the group of lactose maldigesters, of whom one-third did not experience any symptoms from any of the test doses. The same proportion (64%) of the maldigesters experienced symptoms after both the lactose-free milk and the milk with 7 g lactose. However, the symptoms occurred inconsistently with the different test doses in 59% of the maldigesters. Thus, it can be concluded that the gastrointestinal symptoms in most lactose maldigesters are not induced by lactose when small amounts (0.5-7.0 g) of lactose are included in the diet.
Abdominal Pain↗
Decreases in serum ubiquinone concentrations do not result in reduced levels in muscle tissue during short-term simvastatin treatment in humans.
Statins, which are commonly used drugs for hypercholesterolemia, inhibit 3-hydroxy-3-methylglutaryl coenzyme A reductase, the rate-limiting enzyme in cholesterol synthesis. Important nonsterol compounds, such as ubiquinone, are also derived from the same synthetic pathway. Therefore it has been hypothesized that statin treatment causes ubiquinone deficiency in muscle cells, which could interfere with cellular respiration causing severe adverse effects. In this study we observed decreased serum levels but an enhancement in muscle tissue ubiquinone levels in patients with hypercholesterolemia after 4 weeks of simvastatin treatment. These results indicate that ubiquinone supply is not reduced during short-term statin treatment in the muscle tissue of subjects in whom myopathy did not develop.
Acyl Coenzyme A↗
Lactose malabsorption in Khants in western Siberia.
BACKGROUND: We wanted to estimate the prevalence of selective lactose malabsorption (SLM) in Khants, a small Finno-Ugric population living in Western Siberia who have traditionally consumed no milk in adulthood. METHODS: A total of 80 Khants, aged 8-57 years and living on the middle reaches of the River Ob, were studied. The diagnosis was based on a lactose tolerance test; general malabsorption was excluded by a glucose-galactose tolerance test whenever possible. In six subjects electronmicroscopic examination of the duodenal mucosa was performed. RESULTS: The prevalence of SLM in the Khants was 94%. CONCLUSION: This is the highest prevalence found in the previous Soviet Union.
Adult↗
[Where to get funds for research--the possibilities for getting funds as a young researcher].
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Finland↗
Adult hypolactasia, milk consumption, and age-specific fertility.
Beta-galactosidase (lactase) allows the digestion of lactose as its component sugars, galactose and glucose. Considerable variation exists worldwide in the prevalence of adults who lose the ability to digest lactose after infancy (hypolactasia) as well as in the amount of milk products they consume. Clearly, those populations in which hypolactasia is infrequent and milk consumption high will have greater dietary exposure to galactose. Because there is clinical and experimental evidence that galactose may be toxic to ovarian germ cells, the authors sought to determine whether age-specific fertility rates in various countries correlate with the prevalence of adult hypolactasia and per capita milk consumption by analysis of published data on these variables. The authors found significant correlations among these variables such that fertility at older ages is lower and the decline in fertility with aging is steeper in populations with high per capita consumption of milk and greater ability to digest its lactose component. These demographic data add to existing evidence that dietary galactose may deleteriously affect ovarian function.
Adolescent↗
Hypolactasia and lactase persistence. Historical review and the terminology.
Lactase (more precisely lactase-phlorizin hydrolase) is located in the brush border of the small intestinal enterocytes and is responsible for the hydrolysis of dietary lactose. The earliest studies on lactase activity in mammals were published around the turn of the century. In 1903, it was found that the dog had a very low lactase activity and therefore lactose remained unhydrolysed, causing diarrhoea. Human hypolactasia was demonstrated in 1963, and it was soon found that it is very common, commoner than lactase persistence in most parts of the world. In 1973, adult-type hypolactasia was shown to be inherited by an autosomal recessive single gene. This article reviews the early expansion of the knowledge on lactase and hypolactasia as well as the correct terminology.
Animals↗
Genetics and epidemiology of adult-type hypolactasia.
The prevalence of adult-type hypolactasia varies from less than 5% to almost 100% between different populations of the world. The lowest prevalence has been found in northwestern Europe, around the North Sea, and the highest prevalence in the Far East. The reason for the variation is that selective (primary) hypolactasia is genetically determined by an autosomal recessive single gene. It is assumed that thousands of years ago all people had hypolactasia in the same way as most mammals do today. At that time in cultures where milk consumption was started after childhood, lactase persistence had a selective advantage. Those people with lactase persistence were healthier and had more children than people with hypolactasia, and the frequency of the lactase persistence gene started to increase. The present prevalence of hypolactasia can be explained fairly well by this culture historical hypothesis. This article reviews the evidence for the inheritance of adult-type hypolactasia and the occurrence of hypolactasia in different countries and populations of the world.
Adult↗
Improved immunoturbidimetric method for rheumatoid factor testing.
The performance of two immunoturbidimetric modifications for rheumatoid factor (RF) testing, which differ with respect to the means of complement inactivation (heat treatment and inactivation with polyvinyl sulphonate), were compared in serum samples from 87 patients with rheumatoid arthritis (RA) and from 403 healthy subjects. IgM-rheumatoid factor titres were also measured with an enzyme linked immunosorbent assay (ELISA). Both immunoturbidimetric tests gave positive reactions (rheumatoid factor > or = 20 IU/ml) in 74 out of the 87 (85%) RA sera. In cases with high RF concentrations the results after chemical inactivation tended to be slightly higher compared with heat inactivation. In healthy subjects rheumatoid factor was detected in 19/403 (4.7%) sera using heat inactivation and in 22/403 (5.5%) sera with chemical inactivation of complement. Interrun coefficient of variation in the chemical inactivation assay was 4.4%; with the heat inactivation method it was 8.1%. In the ELISA, a marginally better correlation was noted in the results obtained using chemical inactivation. Inactivation of complement by means of polyvinyl sulphonate offers the advantage of easier test performance and better reproducibility, and the results may reflect more accurately true rheumatoid factor concentrations.
Adult↗
Increased life expectancy of world class male athletes.
Reliable data are scanty on the incidence of chronic diseases and life expectancy (LE) of highly trained athletes. We therefore studied Finnish male world class athletes to estimate the LE of athletes. Finnish team members in the Olympic games, World or European championships or intercountry competitions during 1920-1965 in track and field athletics, cross-country skiing, soccer, ice hockey, basketball, boxing, wrestling, weight lifting, and shooting were included (N = 2613 men). The reference cohort, 1712 men, was selected from the Finnish Defence Forces conscription register matched on age and area of residence. All referents were classified completely healthy at the time of induction to military service. The stratified Kaplan-Meier product limit method and the Cox proportional hazards model were used to estimate the life expectancies and the mortality odds ratios (OR) and their confidence limits. The mean LE adjusted for occupational group, marital status, and the age at entry to the cohort (and its 95% confidence limits) was in endurance sports (long distance running and cross-country skiing) 75.6 (73.6, 77.5) yr; in team games (soccer, ice hockey, basketball, as well as jumpers and short-distance runners from track and field (73.9 (72.7, 75.1) yr; in power sports (boxing, wrestling, weight lifting, and throwers from field athletics) 71.5 (70.4, 72.2) yr; and in the reference group 69.9 (69.0, 70.9) yr. The increased mean life expectancies were mainly explained by decreased cardiovascular mortality (endurance sports mortality odds ratio OR = 0.49 (95% CL 0.26, 0.93), team sports OR = 0.61 (0.41, 0.92) compared with referents). For maximum life span no differences between the groups were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Cohort Studies↗
Social, personality and environmental determinants of smoking in young Finnish men.
The study was based on 471 males, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. Of these subjects 48% smoked regularly and had smoked in the past three weeks. The correlation between the reported number of cigarettes smoked a day and serum thiocyanate was 0.60. Seventy-four per cent of the subjects whose best friend smoked, were current smokers compared with 24% of the others. Proportion of smokers was higher in urban areas than in rural areas. Among the 14 explanatory variables in the multivariate logistic analysis, family members' and friends' smoking, the place of residence, strenuousness of leisure-time physical activities, number of friends, rebelliousness, intelligence test score, and general pessimism were most strongly associated with the likelihood of being a current smoker. The model explained 87% of the smoking variance.
Adult↗
Relation of alcohol, physical activity, dietary fat and smoking to serum HDL and total cholesterol in young Finnish men.
The study was based on 471 men, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. The data were gathered by means of self-administered questionnaires. A fasting venous blood specimen was taken to determine serum HDL and total cholesterol, gamma-glutamyltransferase and thiocyanate. In this cross-sectional study a few variables based on the self-administered questionnaire explained 8% and 7% of the variation in serum HDL and total cholesterol, respectively. Our results show that easily measurable behavioural factors do contribute to serum HDL and total cholesterol levels in young men. In our study the impact of alcohol consumption on serum HCL cholesterol was greater than in most previous studies. Our findings give additional support to the hypothesis that even a very modest amount of regular physical exercise has the effect of increasing the serum HDL cholesterol level.
Adult↗
Etiology of mild acute infectious myocarditis. Relation to clinical features.
The etiology of mild myocarditis, diagnosed on the basis of serial ECG changes during an acute infection, was studied in 126 consecutive conscripts. A fourfold rise in the antibody titers in the paired serum samples was required for a positive etiologic diagnosis. An etiologic diagnosis was made probable in 47% of the patients. Adenovirus was incriminated in 19 patients, vaccinia in 12, influenza A in eight, beta-hemolytic Streptococcus in six, mononucleosis in five and Mycoplasma in three. Chlamydia, influenza B and Coxsackie B4 were each found in two patients; parainfluenza, mumps and adult Still's disease were each found in one patient. The incidence of vaccinia myocarditis was 1/10000 smallpox vaccinations. Clear-cut myopericarditis was usually noted during vaccinia, mononucleosis, Mycoplasma, Chlamydia and Coxsackie B4 infections. Adenovirus and influenza A myocarditis was most often subclinical, being mostly detected only because of ECG screening of patients without cardiac symptoms. Frequent recent ventricular extrasystoles were most often triggered by a beta-hemolytic Streptococcus infection. The etiology of infectious myocarditis seems to reflect the overall profile of viruses and other infective agents in the study population at that particular time. Cardiotrophic viruses such as Coxsackie B only rarely cause myocarditis outside epidemics.
Acute Disease↗