PK#x89cx3x3refs.MYD34|?Heliovaara, M.2008<Health in Finland according to national surveys in 1975-20005-5$Scandinavian Journal of Rheumatology37Meeting Abstract://000253952900004Heliovaara, Markku Suppl. 123 0300-9742ISI:00025Q?3L|?1Saila, H. Larva, K. Savolainen, A. Tuomilehto, J.2008&Genome wide association studies in JIA10-10$Scandinavian Journal of Rheumatology37Meeting Abstract://000253952900017NSaila, Hanna Larva, Katariina Savolainen, Anneli Tuomilehto, Jaakko Suppl. 123 0300-9742ISI:00025wg2|?!Broms, U. Korhonen, T. Kaprio, J.2008^Smoking reduction predicts cessation: Longitudinal evidence from the Finnish adult twin cohort423-427Nicotine & Tobacco Research103Article(The aim of the study was to examine whether smoking reduction over a 6-year period (1975-1981) predicted smoking cessation 9 years later by 1990. The longitudinal data from three surveys over 15-year period among the Finnish adult twin cohort were used. The data were collected by postal surveys in 1975, 1981, and 1990, and the sample comprised 11,015 participants, of whom 2,443 were persistent current smokers in 1975 and 1981. Smoking cessation by 1990 was examined as the outcome measure. Nineteen percent reported having stopped smoking by 1990, corresponding to an approximate annual rate of smoking cessation of 2%. Those who had quit smoking by 1990 had larger decreases in smoking between 1975 and 1981. The odds ratio for quitting by 1990 increased with increasing levels of reduction in amount smoked between 1975 and 1981. This was found in both categorical and trend analyses, and when adjusting for age, sex and for amount of baseline smoking. The model among twin pairs discordant for cessation indicated that the association of smoking reduction with increased likelihood of cessation was independent of genetic or early shared family influences on smoking behavior. We conclude that smokers who are able to decrease the number of cigarettes smoked per day by at least 25% are more likely to quit later.://000253763400005-Broms, Ulla Korhonen, Tellervo Kaprio, Jaakko 1462-2203ISI:0002537J;2d|?QSokero, P. Melartin, T. Rytsala, H. Leskela, U. Lestela-Mielonen, P. Isometsa, E.2008iAdequacy of, attitudes toward, and adherence to treatments by suicidal and nonsuicidal depressed patients223-229%Journal of Nervous and Mental Disease1963ArticleMarrWe examined differences in treatments received, and attitudes and adherence to them between suicidal and nonsuicidal patients with major depressive disorder (MDD). Psychiatric MDD patients with no suicidal behavior (N = 92), suicidal ideation (N = 92), or attempts (N = 34) were compared during 6 months of follow-up in the Vantaa Depression Study (VDS). Patients with suicidal behavior received antidepressants or adequate antidepressant treatment significantly more often, bad more frequent appointments with psychiatrists, more psychotherapeutic support, and more favorable attitudes toward antidepressant treatment than nonsuicidal patients. However, after adjusting for the confounding severity of depression, the significance of these differences was lost. Adherence to treatment was similar in the patient groups. Overall, among psychiatric patients with MDD, those known to be suicidal have higher suicide risk and should receive more intensive treatment. However, suicidal behavior per se does not seem to markedly influence treatments provided nor should it be associated with negative attitudes or poor adherence to treatments.://000253999000007jSokero, Petteri Melartin, Tarja Rytsaelae, Heikki Leskelae, Ulla Lestelae-Mielonen, Paula Isometsae, Erkki 0022-3018ISI:00025399rc2PF|?RHuizink, A. C. Bartels, M. Rose, R. J. Pulkkinen, L. Eriksson, C. J. P. Kaprio, J.2008ZChernobyl exposure as stressor during pregnancy and hormone levels in adolescent offspring,Journal of Epidemiology and Community Health624ArticleAprBackground: Animal research suggests a programming effect of prenatal stress in the fetal period, resulting in disruptions in behavioural and neuromotor development. Physiological changes that mediate these effects include alterations in the hypothalamic-pituitary-adrenal axis and in testosterone levels. This human study focuses on changes related to these physiological systems after prenatal stress exposure. Methods: We examined the potential effect of prenatal stress associated with the Chernobyl disaster in an ongoing genetic epidemiological study in Finland. One birth cohort of twins (n = 121 twin pairs) was exposed in utero to maternal stress, and their saliva cortisol and testosterone levels at age 14 were compared with twins (n = 157 twin pairs) born one year later. Results: Cortisol levels in both sexes and testosterone levels among females were significantly elevated after prenatal exposure to maternal stress from the second trimester onwards, compared to reference groups of non-exposed adolescents. Exposure explains 3% of variance (p < 0.05) in cortisol levels and 18% of variance in testosterone levels (p < 0.001). No significant differences were found for exposure from either first or third trimester onwards. Conclusion: Our results suggest that prenatal exposure to maternal stress in the second trimester of pregnancy may have resulted in prenatal programming of physiological systems relating to cortisol and testosterone levels.://000253989600023RHuizink, A. C. Bartels, M. Rose, R. J. Pulkkinen, L. Eriksson, C. J. P. Kaprio, J. 0143-005XISI:0002539896000232.82<|?<Ylostalo, P. Suominen-Taipale, L. Reunanen, A. Knuuttila, M.20089Association between body weight and periodontal infection297-304"Journal of Clinical Periodontology354ArticleAprYBackground: Besides being a risk factor for cardiovascular diseases, certain cancers and type II diabetes, obesity has been suggested to be a risk factor for periodontitis. A number of epidemiological studies have studied the association between obesity and periodontitis, but the results have been partly inconclusive. The aim of this study was to examine the association of body weight with periodontal infection. Material and Methods: The association between body weight and periodontal infection was examined using a nationally representative Health 2000 Health Examination Survey. The study was based on a subpopulation of dentate non-diabetic subjects aged 30-49 (n=2841). Periodontal infection was measured by the number of teeth with periodontal pockets of 4 mm or deeper and 6 mm or deeper. Body weight was measured using body mass index (BMI). Results: We detected a weak exposure-response association of BMI with teeth with deepened periodontal pockets after controlling for smoking habits by restricting the sample to subjects who have never smoked and for other potential confounders by including them in the multivariate models. Conclusions: The results showed an association between body weight and periodontal infection among the non-diabetic, non-smoking population aged 30-49. Additional research is needed to determine the nature of this association.://000254055100003HYlostalo, Pekka Suominen-Taipale, Liisa Reunanen, Antti Knuuttila, Matti 0303-6979ISI:00025405UC2$|?bHu, G. Lindstrom, J. Jousilahti, P. Peltonen, M. Sjoberg, L. Kaaja, R. Sundvall, J. Tuomilehto, J.2008YThe increasing prevalence of metabolic syndrome among finnish men and women over a decade832-836.Journal of Clinical Endocrinology & Metabolism933ArticleMardObjective: Our objective was to assess a 10-yr change in the prevalence of the metabolic syndrome defined by the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) among Finnish men and women. Design and Subjects: Two cross-sectional population surveys were performed in Finland in 1992 and 2002. A total of 3495 participants aged 45-64 yr were included in the analysis. Results: In both years the metabolic syndrome was more common among men than women. In men the prevalence of the metabolic syndrome tended to increase slightly between 1992 and 2002, from 48.8-52.6% (P = 0.139) based on the NCEP definition, and from 51.4-55.6% based on the IDF definition (P = 0.102). In women the prevalence of the metabolic syndrome increased significantly from 32.2-39.1% based on the NCEP definition (P = 0.003), and from 38.0-45.3% based on the IDF definition (P = 0.002). In both sexes the prevalence of high blood pressure decreased, but the abnormalities in glucose metabolism increased between 1992 and 2002. The prevalence of central obesity increased in women between 1992 and 2002. Conclusions: In Finland the prevalence of the metabolic syndrome, based both on the NCEP and IDF definitions, is higher in men than women. However, the increase in the prevalence of the metabolic syndrome, from 1992-2002, was significant only among women.://000253822700028zHu, Gang Lindstrom, Jaana Jousilahti, Pekka Peltonen, Markku Sjoberg, Lena Kaaja, Risto Sundvall, Jouko Tuomilehto, Jaakko 0021-972XISI:000251|?Yan, D. G. Konen, V. M.2008-Characteristics of oxysterol binding proteins253-+CInternational Review of Cytology: A Survey of Cell Biology, Vol 265265Protein families characterized by a ligand binding domain related to that of oxysterol binding protein (OSBP) have been identified in eukaryotic species from yeast to humans. These proteins, designated OSBP-related (ORP) or OSBP-like (OSBPL) proteins, have been implicated in various cellular functions. However, the detailed mechanisms of their action have remained elusive. Data from our and other laboratories suggest that binding of sterol ligands may be a unifying theme. Work with Soccharomyces cerevisiae ORPs suggests a function of these proteins in the nonvesicular intracellular transport of sterols, in secretory vesicle transport from the Golgi complex, and in the establishment of cell polarity. Mammals have more ORP genes, and differential splicing substantially increases the complexity of the encoded protein family. Functional studies on mammalian ORPs point in different directions: integration of sterol and sphingomyelin metabolism, sterol transport, regulation of neutral lipid metabolism, control of the microtubule-dependent motility of endosomes/lysosomes, and regulation of signaling cascades. We envision that during evolution, the functions of ORPs have diverged from an ancestral one in sterol transport, to meet the increasing demand of the regulatory potential in multicellular organisms. Our working hypothesis is that mammalian ORPs mainly act as sterol sensors that relay information to a spectrum of different cellular processes.://0002538887000079International Review of Cytology-a Survey of Cell Biology#Yan, Daoguang Konen, Vesa M. Review 0074-7696ISI:000251|? MSilventoinen, K. Hammar, N. Hedlund, E. Koskenvuo, M. Ronnemaa, T. Kaprio, J.2008VSelective international migration by social position, health behaviour and personality150-155!European Journal of Public Health182ArticleAprBackground: Immigrants is an important minority in many countries, but little is known how they are self-selected. We analysed differences in psycho-social and health behavioural factors between international migrants and non-migrants prior to migration in a large cohort of Finnish twins. Methods: A questionnaire was sent to Finnish twins in 1975 (response rate 89, N = 26555 twin individuals). Follow-up data on migration and mortality were derived from population registries in Finland and Sweden up to 31 March 2002. In 1998, another questionnaire was sent to Finnish twins migrated to Sweden and their co-twins (response rate 71%, N = 1534 twin individuals). The data were analysed using Cox and conditional logistic regression models. Results: Life dissatisfaction, higher alcohol use and smoking at baseline predicted future migration. In men additionally, unemployment, neuroticism and extroversion increased the probability to migrate. Similar associations were found for alcohol use in men and smoking in men and women within twin pairs discordant for migration. Twins also reported retrospectively that prior to migration the migrated twin had been less satisfied with his/her educational institution or job and was generally less satisfied with life, used more alcohol (men) and smoked more (women) than the co-twin stayed in Finland. Conclusion: Migrants are self-selected by health behavioural and personality factors, which may compromise their health. The special requirements of migrants should be recognized in health care.://000254007400012bSilventoinen, Karri Hammar, Niklas Hedlund, Ebba Koskenvuo, Markku Ronnemaa, Tapani Kaprio, Jaakko 1101-1262ISI:00025400 1|? %Korppi, M. Leinonen, M. Ruuskanen, O.2008:Pneumococcal serology in children's respiratory infections167-175?European Journal of Clinical Microbiology & Infectious Diseases273ReviewMarNThe role of Streptococcus pneumoniae in the etiology of respiratory tract infections has been studied serologically using microbe-specific antibody and immune complex assays. Serological methods are sensitive in the bacteremic pneumococcal pneumonia of adults. In children, however, pneumococcal pneumonia is seldom bacteremic, and, thus, in the absence of a gold standard for the detection of pneumococcal infection, serological methods are still insufficiently validated. We report here indirect evidence for the sensitivity and specificity of pneumococcal serology in children. Serological evidence of pneumococcal infection has been found in 27% to 38% of children with radiologically confirmed pneumonia, in 7% to 8% of children with viral wheezy bronchitis, and in <1% to 5% of children and young adults with viral upper respiratory infection. Serological findings for pneumococcal infection have been dependent on the study venue, whether in hospital or ambulatory subjects, and on the test panel used. Where both antibody and immune complex assays have been available, the proportion of children with pneumococcal infection has been 32% to 37% in inpatients and 27% to 28% in outpatients. The respective rates have been 10% to 18% by antibody assays alone. Pneumococcal acute otitis media, when present with pneumonia, may confound findings in pneumococcal serology, but pure nasopharyngeal carriage of S. pneumoniae has little effect. In contrast, carriage acquisition of a new serotype may induce significant antibody production. Thus, understandably, significant rises between paired sera in antibodies to pneumococcal capsular polysaccharides and pneumococcal pneumolysin have been found in <1% to 3% of non-symptomatic children and young adults. Findings from the last 20 years indirectly suggest that pneumococcal antibody and immune complex assays are sensitive and specific enough for the detection of pneumococcal infection in children. However, the methods are too complex for routine clinical practice, and, so far, serological methods for S. pneumoniae infections have only been used for research purposes.://000253994000001%Korppi, M. Leinonen, M. Ruuskanen, O. 0934-9723ISI:00025399!1d|? ORoutti, H. Nyman, M. Jenssen, B. M. Backman, C. Koistinen, J. Gabrielsen, G. W.2008cBone-related effects of contaminants in seals may be associated with vitamin D and thyroid hormones873-880&Environmental Toxicology and Chemistry274ArticleAprOThe high levels of polychlorinated biphenyls (PCBs) and DDT in gray seal (Halichoerus grypus) and ringed seal (Phoca hispida botnica) in the Baltic Sea have been associated with pathological disruptions, including bone lesions and reproductive failures. The underlying environmental and toxicological mechanisms leading to these pathological changes are not yet fully understood. The present study investigated the relationship between the individual contaminant load and bone- and thyroid-related effects in adult gray seals (n = 30) and ringed seals (n = 46) in the highly contaminated Baltic Sea and in reference areas (Sable Island, Canada, and Svalbard, Norway). In the gray seals, multivariate and correlation analyses revealed a clear relationship between circulating 1,25-dihydroxyvitamin D-3 (1,25(OH)(2)D), calcium, phosphate, and thyroid hormone (TH) levels and hepatic PCB and DDT load, which suggests contaminant-mediated disruption of the bone and thyroid homeostasis. Contaminants may depress 1,25(OH)(2)D levels or lead to hyperthyroidism, which may cause bone resorption. In the ringed seals, associations between circulating 1,25(OH)(2)D, THs, and hepatic contaminants were less prominent. These results suggest that bone lesions observed in the Baltic gray seals may be associated with contaminant-mediated vitamin D and thyroid disruption.://000253950500014lRoutti, Heli Nyman, Madeleine Jenssen, Bjorn Munro Backman, Christina Koistinen, Jaana Gabrielsen, Geir Wing 0730-7268ISI:000251<|? bGronroos, P. Raitakari, O. T. Kahonen, M. Hutri-Kahonen, N. Marniemi, J. Viikari, J. Lehtimaki, T.2008Association of high sensitive C-reactive protein with apolipoprotein E polymorphism in children and young adults: The Cardiovascular Risk in Young Finns Study179-186*Clinical Chemistry and Laboratory Medicine462ArticleBackground: A relation between apolipoprotein E (APOE) genotypes and high sensitive C-reactive protein (hsCRP) has been observed in some studies with elderly subjects and different patient groups. We studied whether serum hsCRP levels are linked with common APOE (epsilon 2, epsilon 3, epsilon 4) polymorphism already in children and young adults. Methods: The study cohort included 1221 subjects participating in the Cardiovascular Risk in Young Finns Study at age 3-18 years at baseline in 1980. These subjects were reexamined at the 21-year follow-up at age 24-39 years in 2001. APOE phenotypes were examined in 1986, serum hsCRP was measured from fresh samples in 2001 and baseline hsCRP (in 1980) was measured from frozen samples in 2005. Results: Serum hsCRP was significantly associated with APOE phenotypes in children and young adults using multivariate analysis adjusted for age, body mass index, smoking, total cholesterol and low-density lipoprotein cholesterol. Male epsilon 4 carriers had significantly lower hsCRP levels both in childhood (p=0.003) and in adulthood (p=0.013). hsCRP increased in both phenotype classes (epsilon 4+ and epsilon 4-) during the 21-year follow-up. Female epsilon 4 carriers had lower hsCRP levels in childhood (p=0.032) but not in adulthood (p=0.995). An interaction effect between time and APOE phenotype (p=0.045) in relation to hsCRP was observed in females during the 21-year follow-up. Conclusions: Common APOE polymorphism affects the level of circulating hsCRP already in children and young adults. Male APOE epsilon 4 carriers have consistently lower hsCRP levels. In females, APOE epsilon 4 carriers had lower hsCRP levels in childhood but not in adulthood.://000253902500006zGroenroos, Paula Raitakari, Olli T. Kaehoenen, Mika Hutri-Kaehoenen, Nina Marniemi, Jukka Viikari, Jorma Lehtimaeki, Terho 1434-6621ISI:000253901 F|? sMatee, M. Mtei, L. Lounasvaara, T. Wieland-Alter, W. Waddell, R. Lyimo, J. Bakari, M. Pallangyo, K. Von Reyn, C. F.2008XSputum microscopy for the diagnosis of HIV-associated pulmonary tuberculosis in TanzaniaBMC Public Health8ArticleFebBackground: In many resource poor settings only sputum microscopy is employed for the diagnosis of HIV-associated pulmonary tuberculosis; sputum culture may not be available. Methods: We determined the diagnostic accuracy of sputum microscopy for active case finding of HIV-associated pulmonary tuberculosis using TB culture as the reference standard. Results: 2216 potential subjects screened for a TB vaccine trial submitted 9454 expectorated sputum specimens: 212 (2.2%) were sputum culture positive for Mycobacterium tuberculosis (MTB), 31 (0.3%) for non-tuberculous mycobacteria, and 79 (0.8%) were contaminated. The overall sensitivity of sputum microscopy was 61.8% (131/212) and specificity 99.7% (9108/9132). Sputum microscopy sensitivity varied from 22.6% in specimens with < 20 colony forming units (CFU)/specimen to 94.2% in patients with > 100 CFU/specimen plus confluent growth. The incremental diagnostic value for sputum microscopy was 92.1%, 1.8% and 7.1% for the first, second and third specimens, respectively. The positive predictive value and negative predictive values for sputum microscopy were 84.5% and 99.1%, respectively. The likelihood ratio (LR) of a positive sputum microscopy was 235.1 (95% CI 155.8-354.8), while the LR of a negative test was 0.38 (95CI 0.32-0.45). The 212 positive sputum cultures for MTB represented 103 patients; sputum microscopy was positive for 57 (55.3%) of 103 patients. Conclusion: Sputum microscopy on 3 expectorated sputum specimens will only detect 55% of culture positive HIV-infected patients in active screening for pulmonary tuberculosis. Sensitivity is higher in patients with greater numbers of CFUs in the sputum. Culture is required for active case finding of HIV-associated pulmonary tuberculosis.://000253871100001Matee, Mecky Mtei, Lillian Lounasvaara, Tarja Wieland-Alter, Wendy Waddell, Richard Lyimo, Johnson Bakari, Muhammad Pallangyo, Kisali Von Reyn, C. Fordham 1471-2458ISI:000253871100001H70F|?2Lahti, T. A. Haukka, J. Lonnqvist, J. Partonen, T.2008[Daylight saving time transitions and hospital treatments due to accidents or manic episodesBMC Public Health8ArticleFebBackground: Daylight saving time affects millions of people annually but its impacts are still widely unknown. Sleep deprivation and the change of circadian rhythm can trigger mental illness and cause higher accident rates. Transitions into and out of daylight saving time changes the circadian rhythm and may cause sleep deprivation. Thus it seems plausible that the prevalence of accidents and/or manic episodes may be higher after transition into and out of daylight saving time. The aim of this study was to explore the effects of transitions into and out of daylight saving time on the incidence of accidents and manic episodes in the Finnish population during the years of 1987 to 2003. Methods: The nationwide data were derived from the Finnish Hospital Discharge Register. From the register we obtained the information about the hospital-treated accidents and manic episodes during two weeks before and two weeks after the transitions in 1987-2003. Results: The results were negative, as the transitions into or out of daylight saving time had no significant effect on the incidence of accidents or manic episodes. Conclusion: One-hour transitions do not increase the incidence of manic episodes or accidents which require hospital treatment.://000253871300001<Lahti, Tuuli A. Haukka, Jari Lonnqvist, Jouko Partonen, Timo 1471-2458ISI:0002538713000011#|?AVaughan, C. Kilkkinen, A. Heistaro, S. Laatikainen, T. Dunbar, J.2007gThe dietary, physical activity and sedentary behaviours of Victorian regional secondary school students81-88$Australian Journal of Primary Health131ArticleAprThe aim of this study was to investigate the dietary, physical activity and sedentary behaviours of adolescents from four secondary schools in Warrnambool, regional Victoria. In 2004, a random sample of students (n=712), stratified by school year level, was generated from school enrolment databases and 443 students completed a lifestyle questionnaire. Twenty per cent of students were physically active for 60 minutes or more per day; 28 per cent used electronic media in free time for a maximum of two hours per day. Only seven per cent of students met these two Australian physical activity recommendations. Fruit, vegetables and dairy products were consumed every day by 39 per cent, 40 per cent and 71 per cent of students respectively; three serves per day of each of these foods are recommended for Australian adolescents. Compared with boys, girls were less physically active (p<0.001), consumed more fruit (p=0.011) and vegetables (p<0.001), but fewer dairy products (p<0.024). Seventeen per cent of students were overweight or obese; these students were less physically active than normal weight peers (p<0.018). The dietary, physical and sedentary behaviours of regional Victorian secondary school students in this study were inadequate when compared with Australian recommendations. Dietary and physical activity habits are still evolving in adolescence and unhealthy habits can still be changed.://000253726000011RVaughan, Clare Kilkkinen, Annamari Heistaro, Sami Laatikainen, Tiina Dunbar, James 1448-7527ISI:000253726000011q_0|?~Eklund, C. Kivimaki, M. Islam, M. S. Juonala, M. Kahonen, M. Marniemi, J. Lehtimaki, T. Viikari, J. Raitakari, O. T. Hurme, M.2008C-reactive protein genetics is associated with carotid artery compliance in men in The Cardiovascular Risk in Young Finns Study841-848Atherosclerosis1962ArticleFebPAlthough C-reactive protein (CRP) is known to predict cardiovascular events, its status as a causal risk factor is still controversial. CRP gene single nucleotide polymorphisms (SNPs) have been shown to associate with CRP concentration, but no direct independent effect on early atherosclerotic changes has been demonstrated. We aimed to determine if CRP gene polymorphisms or haplotypes are associated with CRP concentration or carotid artery compliance (CAC), an indicator of subclinical atherosclerosis: We genotyped CRP gene polymorphisms - 717 > AG, - 286C > T > A, +10596 > C, +1444C > T and +18466 > A and measured CRP concentration and CAC in 2283 young adults participating in The Cardiovascular Risk in Young Finns Study. A strong association was found between CRP genotypes and CRP concentration, which was also seen at the haplotype level. Linear regression analysis showed an independent effect of each SNP on CRP concentration after adjustment for risk factors, except for +1444 in males. Moreover, - 286C > T > A, +1444C > T and +18466 > A were associated with CAC in males, but not in females. Men carrying the SNP -286 allele C had increased CAC after adjusting for risk factors. These data suggest that the presence of high producer CRP genotype is deleterious to carotid elasticity in men. (c) 2007 Elsevier Ireland Ltd. All rights reserved.://000253743800045Eklund, C. Kivimaki, M. Islam, Md. Shaheenul Juonala, M. Kahonen, M. Marniemi, J. Lehtimaki, T. Viikari, J. Raitakari, O. T. Hurme, M. 0021-9150ISI:00025M;0|?YLarsson, S. C. Virtanen, M. J. Mars, M. Mannisto, S. Pietinen, P. Albanes, D. Virtamo, J.2008TMagnesium, calcium, potassium, and sodium intakes and risk of stroke in male smokers459-465Archives of Internal Medicine1685ArticleMarBackground: A high intake of magnesium, calcium, and potassium and a low intake of sodium have been hypothesized to reduce the risk of stroke. However, prospective data relating intake of these minerals to risk of stroke are inconsistent. Methods: We examined the relationship of dietary magnesium, calcium, potassium, and sodium intake with risk of stroke in a cohort of 26 556 Finnish male smokers, aged 50 to 69 years, who were free from stroke at baseline. Dietary intake was assessed at baseline using a detailed and validated food frequency questionnaire. During a mean follow-up of 13.6 years (1985-2004), 2702 cerebral infarctions, 383 intracerebral hemorrhages, and 196 subarachnoid hemorrhages were identified in the national registries. Results: After adjustment for age and cardiovascular risk factors, a high magnesium intake was associated with a statistically significant lower risk of cerebral infarction but not with intracerebral or subarachnoid hemorrhages. The multivariate relative risk of cerebral infarction was 0.85 (95% confidence interval, 0.76-0.97; P for trend = .004) for men in the highest quintile of magnesium intake compared with those in the lowest quintile. The inverse association between magnesium intake and cerebral infarction was stronger in men younger than 60 years (relative risk, 0.76; 95% confidence interval, 0.64-0.89; P for interaction = .02). Calcium, potassium, and sodium intake was not significantly associated with risk of any subtype of stroke (P for trend > .05). Conclusion: These findings in male smokers suggest that a high magnesium intake may play a role in the primary prevention of cerebral infarction.://000253881400003tLarsson, Susanna C. Virtanen, Mikko J. Mars, Monica Mannisto, Satu Pietinen, Pirjo Albanes, Demetrius Virtamo, Jarmo 0003-9926ISI:00025 0t|?Holl, K. Lundin, E. Kaasila, M. Grankvist, K. Afanasyeva, Y. Hallmans, G. Lehtinen, M. Pukkala, E. Surcel, H. M. Toniolo, P. Zeleniuch-Jacquotte, A. Koskela, P. Lukanova, A.2008Effect of long-term storage on hormone measurements in samples from pregnant women: The experience of the Finnish Maternity Cohort406-412Acta Oncologica473ArticleQValidity of biobank studies on hormone associated cancers depend on the extent the sample preservation is affecting the hormone measurements. We investigated the effect of long-term storage (up to 22 years) on immunoassay measurements of three groups of hormones and associated proteins: sex-steroids [estradiol, progesterone, testosterone, dihydroepiandrosterone sulphate (DHEAS), sex hormone-binding globulin (SHBG)], pregnancy-specific hormones [human chorionic gonadotropin (hCG), placental growth hormone (pGH), alpha-fetoprotein (AFP)], and insulin-like growth factor (IGF) family hormones exploiting the world largest serum bank, the Finnish Maternity Cohort (FMC). Hormones of interest were analyzed in a random sample of 154 Finnish women in the median age (29.5 years, range 25 to 34 years) of their first pregnancy with serum samples drawn during the first trimester. All hormone measurements were performed using commercial enzyme-linked- or radio-immunoassays. Storage time did not correlate with serum levels of testosterone, DHEAS, hCG, pGH and total IGFBP-1. It had a weak or moderate negative correlation with serum levels of progesterone (Spearman's ranked correlation coefficient (r(s))=- 0.36), IGF-I (r(s)=-0.23) and IGF binding protein (BP)-3 (r(s)=-0.38), and weak positive correlation with estradiol (r(s)=0.23), SHBG (r(s)=0.16), AFP (r(s)=0.20) and non-phosphorylated IGF binding protein (BP)-1 (r(s)=0.27). The variation of all hormone levels studied followed the kinetics reported for early pregnancy. Bench-lag time (the time between sample collection and freezing for storage) did not materially affect the serum hormone levels. In conclusion, the stored FMC serum samples can be used to study hormone-disease associations, but close matching for storage time and gestational day are necessary design components of all related biobank studies.://000254069300012Holl, Katsiaryna Lundin, Eva Kaasila, Marjo Grankvist, Kjell Afanasyeva, Yelena Hallmans, Goeran Lehtinen, Matti Pukkala, Eero Surcel, Helja-Marja Toniolo, Paolo Zeleniuch-Jacquotte, Anne Koskela, Pentti Lukanova, Annekatrin 0284-186XISI:0002540|?NKekkonen, R. A. Kajasto, E. Miettinen, M. Veckman, V. Korpela, R. Julkunen, I.2008uProbiotic Leuconostoc mesenteroides ssp cremoris and Streptococcus thermophilus induce IL-12 and IFN-gamma production 1192-1203!World Journal of Gastroenterology148ArticleFebAIM: To investigate the capacity of potentially probiotic strains from six bacterial genera to induce cytokine production alone or in combinations in order to identify potential enhancing or synergistic effects in order to select probiotic bacteria for in vivo purposes. METHODS: Cytokine production in human peripheral blood mononuclear cells (PBMC) in response to stimulation with eleven different potentially probiotic bacterial strains from streptococcus, Lactobacillus, Bifidobacterium, Lactococcus, Leuconostoc and Propionibacterium genera was analysed. Production and mRNA expression of TNF-alpha, IL-12, IFN-gamma and IL-10 were determined by ELISA and Northern blotting, respectively. RESULTS: All tested bacteria induced TNF-alpha production. The best inducers of Th1 type cytokines IL-12 and IFN-gamma were Streptococcus and Leuconostoc strains. All Bifidobacterium and Propionibacterium strains induced higher IL-10 production than other studied bacteria. Stimulation of PBMC with any bacterial combinations did not result in enhanced cytokine production suggesting that different bacteria whether gram-positive or gram-negative compete with each other during host cell interactions. CONCLUSION: The probiotic S. thermophilus and Leuconostoc strains are more potent inducers of Th1 type cytokines IL-12 and IFN-gamma than the probiotic Lactobacillus strains. Bacterial combinations did not result in enhanced cytokine production. (c) 2008 WJG. All rights reserved.://000253599100007aKekkonen, Riina A. Kajasto, Elina Miettinen, Minja Veckman, Ville Korpela, Riitta Julkunen, Ilkka 1007-9327ISI:000253599100007P?3 |?$Leino, O. Tainio, M. Tuomisto, J. T.2008XComparative risk analysis of dioxins in fish and fine particles from heavy-duty vehicles127-140 Risk Analysis281ArticleFeb Dioxins and airborne fine particles are both environmental health problems that have been the subject of active public debate. Knowledge on fine particles has increased substantially during the last 10 years, and even the current, lowered levels in the Europe and in the United States appear to be a major public health problem. On the other hand, dioxins are ubiquitous persistent contaminants, some being carcinogens at high doses, and therefore of great concern. Our aim was to (a) quantitatively analyze the two pollutant health risks and (b) study the changes in risk in view of the current and forthcoming EU legislations on pollutants. We performed a comparative risk assessment for both pollutants in the Helsinki metropolitan area (Finland) and estimated the health effects with several scenarios. For primary fine particles: a comparison between the present emission situation for heavy-duty vehicles and the new fine particle emission standards set by the EU. For dioxins: an EU directive that regulates commercial fishing of Baltic salmon and herring that exceed the dioxin concentration limit set for fish meat, and a derogation (= exemption) from the directive for these two species. Both of these two decisions are very topical issues and this study estimates the expected changes in health effects due to these regulations. It was found that the estimated fine particle risk clearly outweighed the estimated dioxin risk. A substantial improvement to public health could be achieved by initiating reductions in emission standards; about 30 avoided premature deaths annually in the study area. In addition, the benefits of fish consumption due to omega-3 exposure were notably higher than the potential dioxin cancer risk. Both regulations were instigated as ways of promoting public health.://000253637700010,Leino, Olli Tainio, Marko Tuomisto, Jouni T. 0272-4332ISI:000253P?2|?+Raulio, S. Roos, E. Mukala, K. Prattala, R.2008SCan working conditions explain differences in eating patterns during working hours?258-270Public Health Nutrition113ArticleMarObjective: The aim of this study was to examine whether there are associations between working conditions and the use of staff canteen or packed meals among Finnish employees. Setting: Data were obtained from cross-sectional surveys on working conditions, conducted triennially (1997, 2000, 2003) since 1997. Subjects: In each survey, the subjects were 25-64-year-old employed Finnish employees: 3096 men and 3273 women. Results: Employees at large workplaces used canteens far more often than those at smaller workplaces. Working conditions played a different role in canteen use at small and large workplaces, as well as among the different sexes. At small workplaces, physically demanding jobs held by female employees and low job control encouraged employees to use the canteen. on the other hand, at large workplaces, low social support at work encouraged the use of canteens among men whereas high mental strain at work meant they used the canteen less. Among women, eating packed meals was not related to working conditions, but among men, low social support and high mental strain at work were associated with more frequent use of packed meals. Conclusions: The use of a staff canteen is largely determined by the size of the workplace and by employee education. The underlying factor could be the availability of canteens, a question which must be confirmed in further studies, since well-planned mass catering at workplaces has major effects on public health, well-being and the nutrition education of employees.://000253637800009;Raulio, Susanna Roos, Eva Mukala, Kristiina Prattala, Ritva 1368-9800ISI:000253 2|?3Haukka, J. Suvisaari, J. Hakkinen, L. Lonnqvist, J.2008(Growth pattern and risk of schizophrenia63-70Psychological Medicine381ArticleJanBackground. Foetal nutrition and growth seem to affect the risk of developing schizophrenia. Exposure to famine during foetal development and low birthweight increase the risk. However, few studies have investigated the association between schizophrenia and adult height and weight or patterns of growth. Method. The study population consisted of two subpopulations: families with at least one member with schizophrenia, and families of offspring of mothers with psychotic disorder, and controls. Using a seven-parameter model of height growth curves, we compared the parameters of persons who later developed schizophrenia and their unaffected siblings from the same families. We also studied how growth curve parameters differed in children with genetic risk for schizophrenia and controls, and whether weight, height and body mass index (BMI) at different ages predicted later development of schizophrenia. Results. The predicted growth curves based on a parametric model were nearly identical for persons with schizophrenia and their unaffected siblings. Adult height of daughters of mothers with psychoses was borderline significantly (p=0.0536) lower compared to controls, while no difference was detected among sons (p=0.3283). Conclusions. No association between growth characteristics and schizophrenia in families with at least one member with schizophrenia was found. Family-related factors should be taken into account as possible confounders in future studies on growth and schizophrenia.://0002536661000063Haukka, J. Suvisaari, J. Hakkinen, L. Lonnqvist, J. 0033-2917ISI:00025 < +2|?TStenholm, S. Sainio, P. Rantanen, T. Koskinen, S. Jula, A. Heliovaara, M. Aromaa, A.2007oHigh body mass index and physical impairments as predictors of walking limitation 22 years later in adult finns859-865IJournals of Gerontology Series a-Biological Sciences and Medical Sciences628ArticleAug9Background. Our aim was to study the effects of high body mass index (BMI) and physical impairments in midlife on later life walking limitation. Methods. Primarily middle-aged persons (aged 32-72 Years) with no walking limitation at baseline (n = 840) were followed-up for 22 years as a part of the Mini-Finland Follow-up Survey. Incident walking limitation (walking speed < 1.2 m/s or difficulty in walking 0.5 km) was predicted by measured BMI, handgrip strength, squatting test, and self-reported running difficulties. Results. Twenty-one percent of the participants developed walking limitation. After adjustment for multiple potential confounders, high BMI, low handgrip strength, impaired squatting, and running difficulties were significant predictors of incident walking limitation. The odds ratio (OR) of walking limitation was 4.55 (95% confidence interval [CI], 1.32-15.74) for squatting difficulties and 2.39 (95% CI, 1.26-4.55) for major running difficulties as compared to participants with no difficulties. The corresponding ORs for handgrip strength and BMI were 0.56 (95% CI, 0.38-0.81) and 1.39 (95% CI, 1.10-1.75) per an increment of I standard deviation. For persons in the highest BMI tertile who had two or more physical impairments, the adjusted risk of walking limitation was 4.5 times higher in comparison to normal weight persons with no physical impairments. Conclusions. In primarily middle-aged persons, BMI and simple tests of physical impairment strongly predicted the development of walking limitation 22 years later. In addition, physical impairments coexisting with high BMI predisposed to later life walking limitation more than high BMI alone. Therefore, increasing physical fitness by physical activity and promoting weight loss in middle age may prevent mobility limitation and subsequent disability in old age.://000253828900008iStenholm, Sari Sainio, Paeivi Rantanen, Taina Koskinen, Seppo Jula, Antti Heliovaara, Markku Aromaa, Arpo 1079-5006ISI:000253 N ?2|?5Stenholm, S. Rantanen, T. Heliovaara, M. Koskinen, S.2008eThe mediating role of C-reactive protein and handgrip strength between obesity and walking limitation462-469*Journal of the American Geriatrics Society563ArticleMarOBJECTIVES: To study the association between different obesity indicators and walking limitation and to examine the role of C-reactive protein (CRP) and handgrip strength in that association. DESIGN: A cross-sectional, population-based study. SETTING: The Health 2000 Survey with a representative sample of the Finnish population. PARTICIPANTS: Subjects aged 55 and older with complete data on body composition, CRP, handgrip strength, and walking limitation (N = 2,208). MEASUREMENTS: Body composition, anthropometrics, CRP, medical conditions, handgrip strength, and maximal walking speed were measured in the health examination. Walking limitation was defined as maximal walking speed less than 1.2 m/s or difficulty walking half a kilometer. RESULTS: The two highest quartiles of body fat percentage and CRP and the two lowest quartiles of handgrip strength were all significantly associated with greater risk of walking limitation when chronic diseases and other covariates were taken into account. In addition, high CRP and low handgrip strength partially explained the association between high body fat percentage and walking limitation, but the risk of walking limitation remained significantly greater in persons in the two highest quartiles than in those in the lowest quartile of body fat percentage (odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.19-2.57 and OR = 2.80, 95% CI 1.89-4.16). The prevalence of walking limitation was much higher in persons who simultaneously had high body fat percentage and low handgrip strength (61%) than in those with a combination of low body fat percentage and high handgrip strength (7%). Using body mass index and waist circumference as indicators of obesity yielded similar results as body fat percentage. CONCLUSION: Low-grade inflammation and muscle strength may partially mediate the association between obesity and walking limitation. Longitudinal studies and intervention trials are needed to verify this pathway.://000253628200010AStenholm, Sari Rantanen, Taina Heliovaara, Markku Koskinen, Seppo 0002-8614ISI:00025362 5 #2x|?Kronholm, E. Partonen, T. Laatikainen, T. Peltonen, M. Harma, M. Hublin, C. Kaprio, J. Aro, A. R. Partinen, M. Fogelholm, M. Valve, R. Vahtera, J. Oksanen, T. Kivimaki, M. Koskenvu, M. Sutela, H.2008Trends in self-reported sleep duration and insomnia-related symptoms in Finland from 1972 to 2005: a comparative review and re-analysis of Finnish population samples54-62Journal of Sleep Research171ArticleMar1A hypothesis concerning habitual sleep reduction and its adverse consequences among general population in modern societies has received wide publicity in the mass media, although scientific evidence supporting the hypothesis is scarce. Similarly, there is an extensively distributed belief, at least in Finland, that the prevalence of insomnia-related symptoms is increasing, but evidence for this is even sparser. These issues are important because of the known increased risk of mortality and health risks associated with sleep duration deviating from 7 to 8 h. To reveal possible trends in self-reported sleep duration and insomnia-related symptoms, we reanalyzed all available data from surveys carried out in Finland from 1972 to 2005. The main results were that a minor decrease of self-reported sleep duration has taken place in Finland, especially among working aged men. However, the size of the reduction (about 4%) was relatively small, approximately 5.5 min per each 10 years during the 33 years' time interval under study. The proportion of 7 h sleepers has increased and, correspondingly, the proportion of 8 h sleepers has decreased, but the extreme ends of the sleep duration distribution remained unchanged. Tentative evidence suggesting an increase in insomnia-related symptoms among working aged population during the last 10 years was found. In conclusion, the Finnish data during the past 33 years indicate a general decrease in self-reported sleep duration of about 18 min and an increase of sleep complaints, especially among the employed middle-aged population.://000253719600010Kronholm, Erkki Partonen, Timo Laatikainen, Tiina Peltonen, Markku Harma, Mikko Hublin, Christer Kaprio, Jaako Aro, Arja R. Partinen, Markku Fogelholm, Mikael Valve, Raisa Vahtera, Jussi Oksanen, Tuula Kivimaki, Mika Koskenvu, Markku Sutela, Hanna 0962-1105ISI:00025  0|?nRaikkonen, K. Pesonen, A. K. Heinonen, K. Kajantie, E. Hovi, P. Jarvenpaa, A. L. Eriksson, J. G. Andersson, S.20085Depression in young adults with very low birth weight290-296Archives of General Psychiatry653ArticleMar<Context: Little is known about the mental health outcomes of very low-birth-weight ( VLBW) ( < 1500 g) infants in young adulthood. Objective: To test whether young adults aged 18 to 27 years with VLBW differ from term control subjects in depressive symptoms, current use of antidepressant medication, and the rate of depression diagnosed by a physician. Design: Retrospective longitudinal study. Setting: Academic research. Participants: A total of 162 VLBW young adults ( response rate, 65.1%) and 172 term control subjects ( response rate, 54.8%) born between February 22, 1978, and November 8, 1985, in Helsinki, Finland. Main Outcome Measures: Antidepressant use, history of physician-diagnosed depression, Beck Depression Inventory score, and Center for Epidemiologic Studies Depression Scale score. Results: The VLBW participants reported 20.1% ( 95% confidence interval [ CI], -40.8% to -5.1%) lower CES-D scores than the controls ( P=.02). However, this finding was confined to 110 VLBW participants who were born appropriate for gestational age ( birth weight >=-2 SDs according to Finnish birth weight charts), whose Center for Epidemiologic Studies Depression Scale scores were 29.1% ( 95% CI, - 53.7% to -8.4%) lower than those of the controls ( P=.004). Furthermore, VLBW participants born appropriate for gestational age were 4.8 ( 95% CI, 1.3-10.0) times less likely to report a depression diagnosis than controls ( P=.02). In contrast, 52 VLBW participants born small for gestational age ( birth weight <-2 SDs according to Finnish birth weight charts) reported 36.2% ( 95% CI, 1.1%-83.5%) higher Beck Depression Inventory scores ( P=.04), were 4.0 ( 95% CI, 1.1-14.3) times more likely to use antidepressants ( P=.03), and were 2.5 ( 95% CI, 1.0-6.3) times more likely to report a depression diagnosis ( P=.04) compared with controls. Conclusions: This is the first study ( to our knowledge) to show that intrauterine growth pattern may modify associations between VLBW and depression. Intrauterine growth retardation rather than VLBW per se may pose a risk of depression in young adulthood.://000253672200006Raikkonen, Katri Pesonen, Anu-Katriina Heinonen, Kati Kajantie, Eero Hovi, Petteri Jarvenpaa, Anna-Liisa Eriksson, Johan G. Andersson, Sture 0003-990XISI:00025360|?7Havulinna, A. S. Paakkonen, R. Karvonen, M. Salomaa, V.2008oGeographic patterns of incidence of ischemic stroke and acute myocardial infarction in Finland during 1991-2003206-213Annals of Epidemiology183ArticleMarPURPOSE: To examine geographic variation in the incidence of ischemic stroke (IS) and acute myocardial infarction (AMI) in Finland during 1991-2003. METHODS: Data included all cases of first IS (n = 115,383) and AMI (n = 205,213) in persons aged 3584 years. We used full Bayesian spatial shared component disease models for mapping the geographic risk patterns. RESULTS: The risk component shared by IS and AMI explained 73% (95% credible interval [CI]; 59%, 87%) of the geographic variation in IS risk and 68% (41%, 91%) in AMI risk. The spatial variation was similar in men and women. In the northeastern part of Finland, annual age-adjusted IS incidence was 356-4/100,000 (95% CI; 350.3, 362.6) in men and 231.2 (226.9, 235.4) in women. Annual AMI incidence was 855.6 (846.1, 865.2) in men and 351.4 (346.2, 356.5) in women. In the southwestern part of the country, annual IS incidence was 334.7 (331.6,337.8) in men and 210.6 (208.5, 212.6) in women. Annual AMI incidence was 707.3 (702.8, 711.8) in men and 278.3 (276.0, 280.7) in women. CONCLUSION: A marked part of the spatial variation in IS and AMI incidence was disease specific, even though these diseases share a similar atherosclerotic background. Further studies are warranted for understanding the reasons for the different geographic variation.://000253699100006EHavulinna, Aki S. Paakkonen, Rauni Karvonen, Marjatta Salomaa, Veikko 1047-2797ISI:00025%1||7QSokero, P. Melartin, T. Rytsala, H. Leskela, U. Lestela-Mielonen, P. Isometsa, E.2008iAdequacy of, attitudes toward, and adherence to treatments by suicidal and nonsuicidal depressed patients223-9J Nerv Ment Dis1963 2008/03/15MarrWe examined differences in treatments received, and attitudes and adherence to them between suicidal and nonsuicidal patients with major depressive disorder (MDD). Psychiatric MDD patients with no suicidal behavior (N = 92), suicidal ideation (N = 92), or attempts (N = 34) were compared during 6 months of follow-up in the Vantaa Depression Study (VDS). Patients with suicidal behavior received antidepressants or adequate antidepressant treatment significantly more often, had more frequent appointments with psychiatrists, more psychotherapeutic support, and more favorable attitudes toward antidepressant treatment than nonsuicidal patients. However, after adjusting for the confounding severity of depression, the significance of these differences was lost. Adherence to treatment was similar in the patient groups. Overall, among psychiatric patients with MDD, those known to be suicidal have higher suicide risk and should receive more intensive treatment. However, suicidal behavior per se does not seem to markedly influence treatments provided nor should it be associated with negative attitudes or poor adherence to treatments.Sokero, Petteri Melartin, Tarja Rytsala, Heikki Leskela, Ulla Lestela-Mielonen, Paula Isometsa, Erkki United States The Journal of nervous and mental disease J Nerv Ment Dis. 2008 Mar;196(3):223-9.1539-736X (Electronic)183402581.957fDepartment of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.A10.1097/NMD.0b013e31816634f5 [doi] 00005053-2008030002F|72Haukka, J. Tiihonen, J. Harkanen, T. Lonnqvist, J.2008Association between medication and risk of suicide, attempted suicide and death in nationwide cohort of suicidal patients with schizophreniaPharmacoepidemiol Drug Saf 2008/03/11Mar 10PURPOSE: Mortality among schizophrenia patients is substantially higher than in the general population. The aim of this study was to investigate, in a nationwide cohort of suicidal schizophrenic individuals, how the risks of suicide, severe suicide attempts and death are associated with usage of antidepressant or antipsychotic treatment. METHODS: The study population included all individuals in Finland who were hospitalised with a diagnosis of attempted suicide between 1 January 1997 and 31 December 2003, who also had at least one hospitalisation due to schizophrenia diagnosis (ICD-10 F20), and were at least 16 years old when the index hospitalisation began. Cox's proportional hazards modelling and Bayesian intensity estimation were used in the analysis. RESULTS: There were 1611 patients with a mean follow-up time of 4.3 years. Current use of antipsychotics was associated with decreased mortality due to suicide (HR 0.52, 95% CI 0.34-0.81, p = 0.004), but no significant decrease in mortality was observed during current use of antidepressants (0.66, 0.41-1.08, p = 0.099), when compared to past use. In more detailed analysis when current users were compared to non-users, olanzapine, and mixed use of antipsychotics, were associated with reduced all-cause mortality, and mixed use also with reduced risk of suicide mortality. Current use of citalopram was associated with decreased all-cause and suicide mortality. CONCLUSIONS: In a population of suicidal schizophrenic individuals antipsychotic medication, treatment was associated with lower mortality from suicide and all-causes. Antidepressive medication was associated with lower all-cause mortality when used in combination with antipsychotics. Copyright (c) 2008 John Wiley & Sons, Ltd.NPharmacoepidemiology and drug safety Pharmacoepidemiol Drug Saf. 2008 Mar 10;.1053-8569 (Print)183278692.155pDepartment of Mental Health and Alcohol Research, National Public Health Institute, FIN-00300 Helsinki, Finland.10.1002/pds.3d||7rLyytikainen, E. Kaasila, M. Koskela, P. Lehtinen, M. Patama, T. Pukkala, E. Tasanen, K. Surcel, H. M. Paavonen, J.2008?Chlamydia trachomatis seroprevalence atlas of Finland 1983-200319-22Sex Transm Infect841 2007/10/04 Adult Antibodies, Bacterial/blood Chlamydia Infections/ epidemiology/immunology Chlamydia trachomatis/immunology Female Finland/epidemiology Humans Immunoglobulin G/blood Pregnancy Pregnancy Complications, Infectious/ epidemiology/immunology Seroepidemiologic StudiesFebOBJECTIVES: To study Chlamydia trachomatis seroprevalence trends and geographical distribution over time in Finland. MATERIALS AND METHODS: First pregnancy serum samples were retrieved from the Finnish Maternity Cohort serum bank for the subcohort of 8000 women stratified by calendar years (1983-1989, 1990-1996, 1997-2003) and age at time of sample withdrawal (14-22 and 23-28 years). C trachomatis antibodies were determined using standard major outer membrane protein peptide ELISA. The spatiotemporal variation of C trachomatis seroprevalence rates was visualised by a series of maps. RESULTS: A decreasing C trachomatis seroprevalence trend from 1983 to 2003 was seen for both women under 23 years of age (20.8% to 10.6%) and 23-28-year-old women (19.1% to 12.5%). Constant clusters were seen around the largest cities and in eastern Finland although seroprevalence rates were generally decreasing throughout the country. CONCLUSIONS: Only a few population-based serological studies have been undertaken on C trachomatis epidemiology over time. In Finland the seroprevalence of C trachomatis is decreasing all over the country, albeit with small clusters remaining.Lyytikainen, E Kaasila, M Koskela, P Lehtinen, M Patama, T Pukkala, E Tasanen, K Surcel, H-M Paavonen, J Research Support, Non-U.S. Gov't England Sexually transmitted infections Sex Transm Infect. 2008 Feb;84(1):19-22. Epub 2007 Oct 2.1472-3263 (Electronic)179111352.5770National Public Health Institute, Oulu, Finland.3sti.2007.027409 [pii] 10.1136/sti.2007.0273 ||7\Kerttula, A. M. Lyytikainen, O. Virolainen, A. Finne-Soveri, H. Agthe, N. Vuopio-Varkila, J.2007_Staphylococcus aureus colonization among nursing home residents in a large Finnish nursing home996-1001Scand J Infect Dis3911-12 2007/09/14Aged, 80 and over Anti-Bacterial Agents/pharmacology Carrier State Female Finland/epidemiology Humans Male Methicillin Resistance Nursing Homes Staphylococcal Infections/epidemiology/ microbiology Staphylococcus aureus/drug effects/ isolation & purificationWe studied colonization with methicillin-resistant and -sensitive Staphylococcus aureus (MRSA, MSSA) in the second largest nursing home in Finland, in which the residents volunteered had their nostrils, throats, perineums, skin lesions, and catheter exit sites swabbed, and catheter urines cultured. The specimens were cultured onto non-selective and selective agar, with or without enrichment in salt-containing trypticase soy broth (TSB). S. aureus was identified by routine methods, methicillin resistance was detected by oxacillin and cefoxitin disk diffusion and MIC E-tests, and GenoType MRSA -test was used for mecA gene confirmation. A total of 663 cultures were obtained from 213 residents. Of those, 165 specimens (25%) from 94 residents (44%) were positive for S. aureus, and 3 specimens (0.4%) from 2 (0.9%) residents were positive for MRSA. Of the 165 S. aureus isolates, 31 (19%) from 25 (27%) residents were found only from sites other than nostrils (30 MSSA and 1 MRSA). TSB enrichment detected additional 33 (5%) S. aureus isolates (32 MSSA and 1 MRSA), resulting in 8 (5%) additional residents. None of the MRSA strains would have been found if only nostrils and throat had been screened, and no enrichment broth had been used.Kerttula, Anne-Marie Lyytikainen, Outi Virolainen, Anni Finne-Soveri, Harriet Agthe, Niina Vuopio-Varkila, Jaana Research Support, Non-U.S. Gov't Sweden Scandinavian journal of infectious diseases Scand J Infect Dis. 2007;39(11-12):996-1001. Epub 2007 Jun 21.0036-5548 (Print)178529351.560Department of Bacterial and Inflammatory Diseases, National Public Health Institute, Mannerheimintie, Helsinki, Finland. anne-marie.kerttula@ktl.fi/779753839 [pii] 10.1080/003655407014 1||7 NLehtola, M. J. Miettinen, I. T. Hirvonen, A. Vartiainen, T. Martikainen, P. J.2007Estimates of microbial quality and concentration of copper in distributed drinking water are highly dependent on sampling strategy725-32Int J Hyg Environ Health2106 2007/01/16Biofilms Colony Count, Microbial Copper/analysis Environmental Monitoring/ methods Finland Polyethylene Research Design Water Microbiology Water Movements Water Pollutants/analysis Water Supply/ analysisDecThe numbers of bacteria generally increase in distributed water. Often household pipelines or water fittings (e.g., taps) represent the most critical location for microbial growth in water distribution systems. According to the European Union drinking water directive, there should not be abnormal changes in the colony counts in water. We used a pilot distribution system to study the effects of water stagnation on drinking water microbial quality, concentration of copper and formation of biofilms with two commonly used pipeline materials in households; copper and plastic (polyethylene). Water stagnation for more than 4h significantly increased both the copper concentration and the number of bacteria in water. Heterotrophic plate counts were six times higher in PE pipes and ten times higher in copper pipes after 16 h of stagnation than after only 40 min stagnation. The increase in the heterotrophic plate counts was linear with time in both copper and plastic pipelines. In the distribution system, bacteria originated mainly from biofilms, because in laboratory tests with water, there was only minor growth of bacteria after 16 h stagnation. Our study indicates that water stagnation in the distribution system clearly affects microbial numbers and the concentration of copper in water, and should be considered when planning the sampling strategy for drinking water quality control in distribution systems.Lehtola, Markku J Miettinen, Ilkka T Hirvonen, Arja Vartiainen, Terttu Martikainen, Pertti J Research Support, Non-U.S. Gov't Germany International journal of hygiene and environmental health Int J Hyg Environ Health. 2007 Dec;210(6):725-32. Epub 2007 Jan 16.1438-4639 (Print)172233871.733Laboratory of Environmental Microbiology, National Public Health Institute, Department of Environmental Health, FI-70701, Kuopio, Finland. markku.lehtola@ktl.fi=S1438-4639(06)00120-9 [pii] 10.1016/j.ijheh.2006.1 @ /1|||7!PPrattala, R. Paalanen, L. Grinberga, D. Helasoja, V. Kasmel, A. Petkeviciene, J.2007sGender differences in the consumption of meat, fruit and vegetables are similar in Finland and the Baltic countries520-5Eur J Public Health175 2006/12/30#Adult Age Factors Attitude to Health/ethnology Baltic States Cross-Sectional Studies Educational Status Female Finland Food Habits/ ethnology Fruit Health Behavior/ ethnology Humans Life Expectancy Male Meat Middle Aged Questionnaires Rural Population Sex Factors Urban Population VegetablesOct BACKGROUND: Women's diets are healthier than men's. Finnish women eat more fruits and vegetables but less meat than men. Gender differences may be larger in the Baltic countries, which represent Eastern European transition societies than in Finland, a society characterized by the Scandinavian welfare ideology and a high degree of gender equality. METHODS: The data are based on questionnaires to random samples of adults in Finland, Estonia, Latvia and Lithuania. The data provide a way of addressing gender differences at the turn of the century in the economically and culturally different countries. The purpose is to explore whether the consumption of foods classified as masculine or feminine-meat, fruits and vegetables-follow a similar gender pattern in Finland and the Baltic countries. RESULTS: Men ate meat more often while women ate fruits and vegetables. A high educational level was associated with frequent consumption of fruits and vegetables. Educational differences in the consumption of meat were few and inconsistent. The consumption of fruits and vegetables was more common in urban areas except in Finland. Gender differences were similar in all countries throughout age and educational groups and in rural and urban areas. CONCLUSION: The consistent association of gender and food and the similarity of gender patterning in population subgroups point to the stability of masculine versus feminine food habits. The similarity suggests that food habits contribute equally to the gender gap in health in the Baltic countries as they do in Finland.Prattala, Ritva Paalanen, Laura Grinberga, Daiga Helasoja, Ville Kasmel, Anu Petkeviciene, Janina Comparative Study Research Support, Non-U.S. Gov't England European journal of public health Eur J Public Health. 2007 Oct;17(5):520-5. Epub 2006 Dec 27.1101-1262 (Print)171947101.481National Public Health Institute, Department of Health Promotion and Chronic Disease Prevention, Helsinki, Finland. ritva.prattala@ktl.fi(ckl265 [pii] 10.1093/eurpub/c \ K1|7".Muhonen, L. H. Lonnqvist, J. Juva, K. Alho, H.2008Double-Blind, Randomized Comparison of Memantine and Escitalopram for the Treatment of Major Depressive Disorder Comorbid With Alcohol Dependencee1-e8J Clin Psychiatry 2008/03/20Feb 6 OBJECTIVE: The aim of the study was to evaluate possible new treatments for major depressive disorder in patients with comorbid alcohol dependence in a municipal alcohol treatment unit. The efficacy of memantine, a noncompetitive glutamate N-methyl-D-aspartate (NMDA)-receptor blocker used for the treatment of moderate to severe Alzheimer's disease, was compared with that of escitalopram, a selective serotonin reuptake inhibitor antidepressant. METHOD: Eighty alcohol-dependent outpatients with major depressive disorder (DSM-IV criteria) seeking treatment from municipal alcohol treatment clinics in Helsinki, Finland, were randomly assigned 1:1 to receive memantine 20 mg/day or escitalopram 20 mg/day. During the study period, patients continued their routine treatment at the clinics. Abstinence was not required. Concomitant interventions or imposed treatment goals were not offered by the study physician. The patients returned to the treatment clinics at weeks 1, 2, 4, 12, and 26 for data collection and for medication checking and dispensing. Outcome measures were the Montgomery-Asberg Depression Rating Scale (MADRS) and Beck Depression Inventory-II for depression, Hamilton Rating Scale for Anxiety (HAM-A) and Beck Anxiety Inventory for anxiety, Consortium to Establish a Registry for Alzheimer's Disease test battery for cognitive functions, and Social and Occupational Functioning Assessment Scale for social and occupational functions and quality-of-life measures. Twenty-nine patients in each group completed the study. All primary and secondary outcome statistical analyses were performed by an independent source for intent-to-treat populations, which included all patients randomly assigned to treatment. The study was conducted from December 2004 to May 2006. RESULTS: Both treatments significantly reduced the baseline level of depression and anxiety according to MADRS and HAM-A, which were the primary measures (p < .0001). There was no significant difference between the memantine and escitalopram groups. Assessed cognitive functioning scores were primarily within the normative range and were unchanged in both groups. Quality-of-life outcomes equally improved in both treatment groups. CONCLUSIONS: These data provide new evidence for the safety and potential efficacy of memantine and escitalopram for major depressive disorder in patients with comorbid alcohol dependence. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier NCT00368862.HThe Journal of clinical psychiatry J Clin Psychiatry. 2008 Feb 6;:e1-e8.1555-2101 (Electronic)183485975.533From the Department of Mental Health and Alcohol Research, National Public Health Institute (Drs. Muhonen, Lonnqvist, and Alho); and the Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital (Drs. Lonnqvist and Juva), Helsinki, Finland.ej07mzk0F|7#2Haukka, J. Suominen, K. Partonen, T. Lonnqvist, J.2008`Determinants and Outcomes of Serious Attempted Suicide: A Nationwide Study in Finland, 1996-2003Am J Epidemiol 2008/03/18Mar 14Suicide is among the 10 leading causes of death. Attempted suicide is 10-40 times more frequent than completed suicide and is the strongest single predictor of subsequent suicide. The current study population included all persons in Finland who were hospitalized with a diagnosis of attempted suicide between 1996 and 2003 (N = 18,199). Information on background variables and mortality was obtained by register linkage. The risk of repeated attempted suicide was 30% and the risk of suicide was 10%. The risks of repeated attempted suicide, completed suicide, and death from any cause were high immediately after discharge from the hospital. Analysis of competing causes of death revealed that while alcohol-related disorder was not associated with suicide, it markedly increased the risk of other violent death: The subdistribution hazards rate (SHR) was 2.61 (95% confidence interval (CI): 2.12, 3.21). Schizophrenia-related disorders (SHR = 1.87, 95% CI: 1.57, 2.21) and mood disorders (SHR = 1.72, 95% CI: 1.47, 2.01) were associated with the risk of suicide. The risks of suicide and all-cause mortality were extremely high immediately after hospitalization for attempted suicide.>American journal of epidemiology Am J Epidemiol. 2008 Mar 14;.1476-6256 (Electronic)183438815.241fDepartment of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.%kwn017 [pii] 10.1093/aje/kwn / 2||7$_Ovaskainen, M. L. Torronen, R. Koponen, J. M. Sinkko, H. Hellstrom, J. Reinivuo, H. Mattila, P.2008FDietary intake and major food sources of polyphenols in Finnish adults562-6J Nutr1383 2008/02/22Adult Biological Availability Diet Eating Female Finland Flavonoids/ administration & dosage Food Food Analysis Humans Male Phenols/ administration & dosageMarPhenolic acids, flavonoids, proanthocyanidins, and ellagitannins are polyphenols that may have beneficial effects on human health and provide protection against chronic diseases. To date, limited data exist on quantitative intake of polyphenols. The aims of this study were to estimate the quantitative intakes of polyphenols by using analyzed concentrations together with individual food consumption records and to determine major dietary sources. Analyzed concentrations of phenolic acids, anthocyanidins, and other flavonoids, proanthocyanidins, and ellagitannins (44 total polyphenol compounds) were entered into the national food composition database, Fineli. The absolute intakes of the polyphenols and the corresponding food sources were calculated on the basis of 48-h dietary recalls of 2007 Finnish adults. The mean total intake of polyphenols was 863 +/- 415 mg/d. Phenolic acids comprised the dominant group of polyphenols (75% of total intake) followed by proanthocyanidins (14%) and anthocyanidins and other flavonoids (10%). Due to their high consumption and high concentrations of phenolic acids, coffee and cereals were the main contributors to total polyphenol intake. Berries and berry products were the main source for anthocyanidins, ellagitannins, and proanthocyanidins, and fruits were the main source for flavonols, flavones, and flavanones. The results give additional support to the recommendations for a varied diet with fruits, berries, cereals, and vegetables.Ovaskainen, Marja-Leena Torronen, Riitta Koponen, Jani M Sinkko, Harri Hellstrom, Jarkko Reinivuo, Heli Mattila, Pirjo Research Support, Non-U.S. Gov't United States The Journal of nutrition J Nutr. 2008 Mar;138(3):562-6.1541-6100 (Electronic)182873674.009Department of Health Promotion and Chronic Disease Prevention, Nutrition Unit, National Public Health Institute, FI-00300 Helsinki, Finland. marja-leena.ovaskainen@ktl.fi138/3 1$||7%ySiljander, T. Karppelin, M. Vahakuopus, S. Syrjanen, J. Toropainen, M. Kere, J. Vuento, R. Jussila, T. Vuopio-Varkila, J.2008OAcute bacterial, nonnecrotizing cellulitis in Finland: microbiological findings855-61Clin Infect Dis466 2008/02/12Acute Disease Adult Aged Aged, 80 and over Blood/microbiology Carrier State/microbiology Case-Control Studies Cellulitis/epidemiology/ microbiology Culture Media Electrophoresis, Gel, Pulsed-Field Family Characteristics Female Finland/epidemiology Humans Male Middle Aged Pharynx/microbiology Streptococcal Infections/epidemiology/ microbiology Streptococcus/ classification/genetics/ isolation & purificationMar 15BACKGROUND: Bacterial, nonnecrotizing cellulitis is a localized and often recurrent infection of the skin. The aim of this study was to identify the beta-hemolytic streptococci that cause acute nonnecrotizing cellulitis infection in Finland. METHODS: A case-control study of 90 patients hospitalized for acute cellulitis and 90 control subjects was conducted during the period of April 2004-March 2005. Bacterial swab samples were obtained from skin lesions or any abrasion or fissured toe web. Blood culture samples were taken for detection of bacteremia. The patients, their household members, and control subjects were assessed for pharyngeal carrier status. beta-Hemolytic streptococci and Staphylococcus aureus were isolated and identified, and group A and G streptococcal isolates were further analyzed by T serotyping and emm and pulsed-field gel electrophoresis typing. RESULTS: beta-Hemolytic streptococci were isolated from 26 (29%) of 90 patients, 2 isolates of which were blood-culture positive for group G streptococci, and 24 patients had culture-positive skin lesions. Group G Streptococcus (Streptococcus dysgalactiae subsp. equisimilis) was found most often and was isolated from 22% of patient samples of either skin lesions or blood, followed by group A Streptococcus, which was found in 7% of patients. Group G streptococci were also carried in the pharynx of 7% of patients and 13% of household members but was missing from control subjects. Several emm and pulsed-field gel electrophoresis types were present among the isolates. Six patients (7%) had recurrent infections during the study. In 2 patients, the group G streptococcal isolates recovered from skin lesions during 2 consecutive episodes had identical emm and pulsed-field gel electrophoresis types. CONCLUSIONS: Group G streptococci, instead of group A streptococci, predominated in bacterial cellulitis. No clear predominance of a specific emm type was seen. The recurrent nature of cellulitis became evident during this study.TSiljander, Tuula Karppelin, Matti Vahakuopus, Susanna Syrjanen, Jaana Toropainen, Maija Kere, Juha Vuento, Risto Jussila, Tapio Vuopio-Varkila, Jaana Research Support, Non-U.S. Gov't United States Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Clin Infect Dis. 2008 Mar 15;46(6):855-61.1537-6591 (Electronic)182607536.186~Department of Bacterial and Inflammatory Diseases, National Public Health Institute, Helsinki, Finland. tuula.siljander@ktl.fi10.1086/ D 31P||7&QSalonen, R. O. Pennanen, A. S. Vahteristo, M. Korkeila, P. Alm, S. Randell, J. T.2008DHealth risk assessment of indoor air pollution in Finnish ice arenas51-7 Environ Int341 2007/08/25*Adolescent Adult Air Pollutants/analysis Air Pollution, Indoor/ analysis Carbon Monoxide Poisoning/ epidemiology/physiopathology Child Female Finland/epidemiology Humans Male Nitrogen Dioxide/ toxicity Prevalence Public Facilities Respiration Disorders/ epidemiology/physiopathology Risk AssessmentJan|Poor indoor air quality and epidemic carbon monoxide (CO) and nitrogen dioxide (NO(2)) poisonings due to exhaust emissions from ice resurfacers have been continuously reported from enclosed ice arenas for over 30 years. The health risks in users of Finnish ice arenas were analysed in three ways: (1) evaluation of four cases of epidemic CO poisonings, (2) modelling the association between NO(2) exposure and respiratory symptoms among junior ice hockey players, and (3) estimation of the number of arena users at risk of breathing poor quality air due to non-compliance of ice arenas with recommended abatement measures. The common causes for the CO poisonings involving over 300 subjects were large emissions from propane-fuelled ice resurfacer, small arena volume, negligible ventilation, and very recent opening of the arena. Rhinitis (prevalence 18.3%) and cough (13.7%) during or after training or game were significantly associated with the estimated personal NO(2) exposure of young hockey players (n=793) to average concentrations ranging from 21 to 1176 microg/m(3) in their home arena. During a 6-year follow-up of an intensive information campaign the portion of electric resurfacers increased from 9% to 27%, and that of emission control technology on propane-fuelled resurfacers increased from 13% to 84%. The portion of inadequately ventilated arenas decreased from 34% to 25%. However, 48% of the investigated Finnish ice arenas (n=125) did not fully comply with the non-regulatory recommendations. Consequently, 20000 daily users of ice arenas were estimated to remain in 2001 at risk of breathing poor quality air. Modern small and inadequately ventilated ice arenas pose their users (mostly children and young adults) at risk of breathing poor quality air and suffering from acute adverse health effects. Governmental regulations are needed worldwide to ensure safe sports in enclosed ice arenas.Salonen, Raimo O Pennanen, Arto S Vahteristo, Mikko Korkeila, Petri Alm, Sari Randell, Jukka T Research Support, Non-U.S. Gov't United States Environment international Environ Int. 2008 Jan;34(1):51-7. Epub 2007 Aug 22.0160-4120 (Print)177167322.626kNational Public Health Institute, Department of Environmental Health, Kuopio, Finland. raimo.salonen@ktl.fi>S0160-4120(07)00128-6 [pii] 10.1016/j.envint.2007.0 693000121.856 017 [doi]Eng 36991000062.2107220000613.936 38814000037.920 37438000453.811.603 74 Artn 74 1.603 68 Artn 68 527388 [doi]eng 25000061.7256.012 [doi]eng 39505000142.202kl265 [doi]eng 40000012.330 74000121.4811.011 [doi]eng 38887000075.98803113 [pii]Eng -00007 [pii]eng /562 [pii]eng 38227000285.799 51000032.380 05 e5 ARTN e5 90000071.957 37196000103.458 82000103.3318289000082.861 634000052.299.1579 [doi]Eng 36661000063.8166378000092.1236377000101.93866207 [doi]eng 39529000042.273 39529000172.273 409 [doi]engPKUd|8I/**refs.FRM 0B< !// !HPRIMARYyearIndex 6ByP/) idreference_type text_stylesauthoryear title pages secondary_title volume numbernumber_of_volumessecondary_authorplace_published publishersubsidiary_authoredition keywords type_of_workdate2)  abstractlabelurltertiary_titletertiary_author notes isbn custom_1 custom_2 custom_3 custom_4alternate_titleaccession_number call_number short_title custom_5 custom_6sectionoriginal_publicationH) reprint_editionreviewed_itemauthor_addressimagecaption custom_7 electronic_resource_number link_to_pdf translated_author translated_titlename_of_databasedatabase_providerresearch_notes language access_datelast_modified_date !! 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