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Biomedical subjects

V Kallio

Publications and source records attributed to V Kallio.

At least 37 records · Page 2Linked to original sources
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

Psychologists' role in functional assessment of rehabilitation patients.

In this study attention was paid to the psychological criteria that clinicians may use when assessing global functioning of rehabilitation patients. Global functioning was understood to be determined by physical, psychological and social factors and was operationally defined as performance in three different areas of life: work, daily activities and human relations. The psychological factors whose relationships to global functioning were studied were three components of personality dynamics:--mental health, cognitive skills and motivation. Patients' mental health, cognitive abilities, motivation and global functioning were clinically rated on the basis of data given by psychological interview, psychological test-results and other information. Correlation analysis showed that the clinicians tend to use the mental health state, the level of cognitive performance and the degree of motivation as criteria when assessing the functioning of rehabilitation patients during the rehabilitation examination. However, multiple regression analysis showed that these psychological variables explained as little as 32% of the variance in follow-up functioning. This is in agreement with the biopsychosocial view that psychological factors are only one class of events manifesting in illness, functioning and behavior.

Activities of Daily Living↗
PubMed1989

Factors associated with fasting and postglucagon plasma C-peptide levels in middle-aged insulin-treated diabetic patients.

We studied fasting and postglucagon plasma C-peptide levels and factors associated with them in two representative studies of middle-aged insulin-treated diabetic patients whose diabetes had been diagnosed after the age of 30 yr. Altogether, 75 men and 79 women from East Finland and 83 men and 62 women from West Finland aged 45-64 yr were studied. Of these patients, 44.4% had undetectable fasting and 38.5% undetectable postglucagon C-peptide concentrations. The phi-coefficient expressing the concordance of fasting and postglucagon C-peptide concentrations in the classification of diabetic patients into nonresponders and responders was .75 in men and .91 in women. In multiple stepwise regression analyses, body mass index (BMI) and the period between diabetes diagnosis and the initiation of insulin treatment were positively and duration of diabetes inversely associated with fasting and postglucagon C-peptide levels in both sexes. We concluded that 1) insulin deficiency is not uncommon in middle-aged insulin-treated diabetic patients whose diabetes has been diagnosed after the age of 30 yr; 2) fasting C-peptide levels contain basically the same information as postglucagon C-peptide levels; and 3) a low BMI, a need for insulin treatment soon after the diagnosis of diabetes, and a long duration of diabetes are predictive of insulin deficiency.

C-Peptide↗
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↗
PubMed1989

Urinary mercury concentrations in Finnish dentists.

During the past few years the safety of amalgam as a dental filling material has been the subject of general public discussion. So far there has been no agreement of whether micromercurialism, a term for the symptoms caused by minute amounts of mercury released from dental fillings, exists or not. Dentists may take mercury into their bodies from amalgam in their dental fillings and from handling it while working. We therefore included determination of urinary mercury concentrations in a comprehensive medical examination programme involving 136 dentists from South-Western Finland. We investigated factors possibly related to observed levels of mercury. The factor most closely related to high urinary mercury levels was use of amalgam by the dentist. Dentists who did not use amalgam had urinary mercury concentrations similar to those in Finns not occupationally exposed to mercury. Their "normal" excretion of mercury into the urine reflected the numbers of their dental fillings made from amalgam. The urinary concentrations of mercury of the dentists who used amalgam in their work were statistically highly significantly elevated. None of the values observed was close to the upper level for safety set by the WHO. However, since only one dentist in eight who used amalgam in their work had urinary mercury levels similar to those in Finns non-exposed to mercury at work, our findings suggest that every dentist should constantly take due care when using amalgam.

Adult↗
PubMed1988

Atherosclerotic vascular disease and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects in Finland.

A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondiabetic population. A total of 510 diabetic and 649 nondiabetic subjects aged 45-64 yr were examined in East Finland and 549 diabetic and 724 nondiabetic subjects of the same age in West Finland. In both areas and in both sexes the prevalence of coronary heart disease (CHD), stroke, and intermittent claudication was higher in diabetic than in nondiabetic subjects. Both in diabetic and nondiabetic subjects the prevalence of ASVD was higher in East Finland than in West Finland. In men, the East-West difference in the prevalence of symptomatic CHD and claudication was greater in diabetic than in nondiabetic subjects. In both areas and in both sexes the serum lipid pattern was more atherogenic and hypertension was more frequent in diabetic than in nondiabetic subjects. In both diabetic and nondiabetic subjects, serum total-cholesterol level was somewhat higher and hypertension was more frequent in East Finland than in West Finland. The East-West difference in serum total-cholesterol was greater in diabetic than in nondiabetic subjects. In multiple logistic analyses including cardiovascular risk factors, diabetes status, and area of residence, residence in East Finland was found to be, in addition to diabetes, a strong independent factor associated with CHD, particularly in men.

Arteriosclerosis↗
PubMed1987

Assessment of exercise tolerance of cardiac patients by bicycle, treadmill and treadmill plus isometric exercise with and without nifedipine.

Seventeen post-myocardial infarction patients experiencing angina on effort performed 6 different exercise tests until they reached symptom-limited maximal level, 3 after placebo and 3 after oral administration of 10 mg of the Calcium antagonist, nifedipine, in a randomized, double blind, cross-over controlled study. Four of the tests were conventional bicycle and treadmill tests with stepwise increasing load. In 2 of the tests an isometric exercise of carrying a weight averaging 6 kg and corresponding to about 30% of maximal grip strength was added to the treadmill walking. When the exercise was stopped because of moderately severe angina, the product of heart rate and systolic blood pressure did not show any statistically significant difference between the tests. However, in the treadmill plus isometric test the work time was shorter and the slope of the treadmill was less than in the treadmill test. The difference was caused partly by non-cardiac factors, namely fatigue of the hand muscles. In routine exercise tests of coronary patients the addition of an isometric to a dynamic load did not give substantially more information than dynamic exercise alone. Nifedipine caused a modest increase of exercise tolerance in all tests, the increase being greatest in the treadmill plus isometric test. The increase in exercise tolerance was seen also in patients receiving beta-blocking agent.

Aged↗
PubMed1986

Insulin-like growth factor-I in type 2 (non-insulin-dependent) diabetics with myocardial infarction and without macroangiopathy.

In order to evaluate whether insulin-like growth factor-I (IGF-I) is associated with the development of diabetic macroangiopathy, we measured its plasma concentration in type 2 diabetics with definite myocardial infarction (MI), in type 2 diabetics without macroangiopathy (MA), and in non-diabetic healthy controls. We also compared plasma IGF-I concentration in non-diabetics with definite MI to that in non-diabetics without MA. There was a large interindividual variation in plasma IGF-I concentration in all groups of subjects studied. The median values were as follows: 0.60 IU/ml in diabetics with MI, 0.59 IU/ml in diabetics without MA, 0.48 IU/ml in non-diabetics with MI and 0.76 IU/ml in non-diabetic healthy controls. The only statistically significant difference between the groups was that between non-diabetics with MI and non-diabetics without MA. In diabetics, irrespective of MA, no significant correlation existed between plasma IGF-I level and the degree of glycemic control, renal function or various risk factors for atherosclerosis. The results of this study suggest that the high prevalence of macroangiopathy in type 2 diabetics cannot be imputed to IGF-I.

Diabetes Mellitus, Type 2↗
PubMed1986

Rehabilitation after surgery for lumbar disc herniation: results of a randomized clinical trial.

The aim of this prospective study was to examine the one-year postoperative results in patients operated on for lumbar disc herniation randomized in two groups: one with comprehensive rehabilitation and the other taken care of by normal care facilities. A total of 212 patients without any previous spinal operations comprised the final study group. The physiatrist, the surgeon, the social worker, and the psychologist performed the handicap evaluation according to the occupation handicap scales of the WHO. The handicap was evaluated for two phases: before the onset of acute sciatica leading to operation and one year after operation. No significant differences in handicap distribution between the intervention and normal care groups were seen. The postoperative handicap correlated highly significantly with preoperative handicap for both groups. More than half (57%) of all the patients returned to work within two months of the operation. The amount of sick leaves did not differ significantly between the intervention and normal care groups. A total of 15 persons (7%) retired during the postoperative year.

Absenteeism↗
PubMed1986

A controlled randomized study on the effect of long-term physical exercise on the metabolic control in type 2 diabetic patients.

The effects of 4 months' physical exercise on the metabolic control in non-insulin-dependent diabetes were studied in 25 patients divided randomly into exercise (n = 13) and control (n = 12) groups. In the exercise group glycosylated hemoglobin A1 fell from 9.6-8.6% (p less than 0.01) and the 2 hour plasma glucose in oral glucose tolerance test decreased from 19.7-16.5 mmol/l (p less than 0.01). The mean fall in fasting plasma glucose from 11.8-10.5 mmol/l was not statistically significant. The responses of plasma insulin and C-peptide to oral glucose increased significantly during the exercise period. However, patients with initially poorest metabolic control were not able to improve their physical fitness and did not show significant improvement in metabolic control. In the control group no changes occurred in any parameter of glucose metabolism. The results suggest that physical exercise is beneficial for the glycemic control in patients with mild and moderate non-insulin-dependent diabetes. Increased insulin response is at least one main mechanism of the action of exercise.

Blood Glucose↗
PubMed1986

Community phase of cardiac rehabilitation.

Although their effects cannot be shown to statistically alter coronary heart disease mortality or morbidity, voluntary health organizations throughout the world clearly play an important role in bringing about favorable changes in the natural history of this disease and in the community phase of its management. In particular, voluntary organizations are able to conduct research surveys and field trials and by so doing favorably influence state health administration. They are able to correct temporary deficiencies in health services, particularly in the form of psychosocial support and cardiac health education. Observers note that the major change in community phase management has occurred with the wider use of coronary bypass surgery since 1975. More objective data, especially relating to psychosocial factors, can be expected when further research (especially the MONICA Study) is completed. Throughout the world, however, existing voluntary health organizations could be more active in the community phase of cardiac rehabilitation. It would seem an area where such organizations could well do more. A challenging question that should be constantly reviewed is 'Can we do more to reduce the effects of invalidism in cardiac patients?'

Australia↗
PubMed1986

Beta-blockers, diuretics and physical fitness as determinants of serum lipids in myocardial infarction patients.

Serum lipid levels were followed in myocardial infarction patients for one year after the infarction and related to their drug use and physical performance. Serum triglyceride concentrations were significantly elevated in patients using diuretics or diuretics and beta-blockers together both 3 and 12 months after the infarction when compared to patients not having drugs. The beta-blockers alone did not change triglycerides. No differences were found in total cholesterol concentration between any of the drug groups. The HDL cholesterol levels were significantly lower in all the drug groups 12 months after the infarction in comparison with the group using no drugs, but 3 months after the infarction these differences were not present. Total work in the exercise stress test correlated negatively with serum triglycerides and total cholesterol and positively with HDL/total cholesterol ratio in the group using no drugs 12 months after the infarction. In beta-blocker users, total work correlated negatively with triglyceride and total cholesterol concentrations. In all drug groups no correlation between total work and HDL/total cholesterol ratio could be found. These data suggest that despite differences in the physical working capacity between the groups, the drugs themselves are major determinants of differences in serum lipids.

Adrenergic beta-Antagonists↗
PubMed1986

The concept of consequences of disease in patients with low back pain.

This paper is based on 212 patients operated on 1 year earlier for lumbar disc herniation. We should have liked to find severity scales for impairment in the ICIDH. The severity scale for disability was not practical for use with low back pain patients. Assignment to the different scale categories of occupation handicap was relatively easy. As a theoretical model of the process of an individual's illness we found it helpful to use that proposed by Purola. The ICIDH concepts seem like a bridge between the medical (internal system) and social connexions (external system) of illness.

Activities of Daily Living↗