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14.1.2008 - ISI Web of Knowledge & PubMed Search Alert |
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Enattah, N. S., Jensen, T. G., Nielsen, M., Lewinski, R., Kuokkanen, M., Rasinpera, H., El-Shanti, H., Seo, J. K., Alifrangis, M., Khalil, I. F., Natah, A., Ali, A., Natah, S., Comas, D., Mehdi, S. Q., Groop, L., Vestergaard, E. M., Imtiaz, F., Rashed, M. S., Meyer, B., Troelsen, J. and Peltonen, L. Am J Hum Genet. 2008; 82(1): 57-72. IF 12.629 The T(-13910) variant located in the enhancer element of the lactase (LCT) gene correlates perfectly with lactase persistence (LP) in Eurasian populations whereas the variant is almost nonexistent among Sub-Saharan African populations, showing high prevalence of LP. Here, we report identification of two new mutations among Saudis, also known for the high prevalence of LP. We confirmed the absence of the European T(-13910) and established two new mutations found as a compound allele: T/G(-13915) within the -13910 enhancer region and a synonymous SNP in the exon 17 of the MCM6 gene T/C(-3712), -3712 bp from the LCT gene. The compound allele is driven to a high prevalence among Middle East population(s). Our functional analyses in vitro showed that both SNPs of the compound allele, located 10 kb apart, are required for the enhancer effect, most probably mediated through the binding of the hepatic nuclear factor 1 alpha (HNF1alpha). High selection coefficient (s) approximately 0.04 for LP phenotype was found for both T(-13910) and the compound allele. The European T(-13910) and the earlier identified East African G(-13907) LP allele share the same ancestral background and most likely the same history, probably related to the same cattle domestication event. In contrast, the compound Arab allele shows a different, highly divergent ancestral haplotype, suggesting that these two major global LP alleles have arisen independently, the latter perhaps in response to camel milk consumption. These results support the convergent evolution of the LP in diverse populations, most probably reflecting different histories of adaptation to milk culture. South-to-North gradient in lipid peroxidation in men with stable coronary artery disease in Europe Grau, M., Guxens, M., Subirana, I., Fito, M., Covas, M. I., Jacquemin, B., Sunyer, J., Lanki, T., Picciotto, S., Bellander, T., Katsouyanni, K., Schneider, A., Peters, A. and Marrugat, J. European Heart Journal. 2007; 28(23): 2841-2849. Article. IF 7.286 Aims A South-to-North gradient across Europe exists for the incidence of coronary artery disease (CAD) rates. Low-density lipoprotein (LDL) oxidation is a hallmark of atherosclerosis and CAD development. The aim of our study was to determine whether differences exist in the degree of LDL oxidation in stable CAD patients from different regions of Europe. Methods and results A cross-sectional multicentre study included 790 stable CAD male subjects aged 35-79 years (61.4 +/- 9.5) from six European countries in three regions by latitude: Northern (Finland and Sweden), Central (Germany), and Southern (Greece, Spain, and Italy). Plasma oxidized LDL (oxLDL) levels were determined. Alcohol intake and lipid profile were significantly associated with oxLDL. The Italian participants had the highest oxLDL levels. A sensitivity analysis showed the models yielded higher adjusted oxLDL values in Northern (63.8 U/L) than in Central (57.6 U/L) and Southern populations (56.5 U/L), P < 0.001, after excluding Italian subjects. The probability of Southern Europe scoring the lowest oxLDL levels was > 71% in all fitted models. Conclusion Our findings suggest a gradient in LDL oxidation from Southern to Northern Europe that consistently holds for all levels of LDL, except for Italy; this country displays the highest levels in Europe, for unknown reasons. Coffee and tea consumption and the risk of Parkinson's disease Hu, G., Bidel, S., Jousilahti, P., Antikainen, R. and Tuomilehto, J. Movement Disorders. 2007; 22(15): 2242-2248. Article. IF 3.323 Several prospective studies have assessed the association between coffee consumption and Parkinson's disease (PD) risk, but the results are inconsistent. We examined the association of coffee and tea consumption with the risk of incident PD among 29,335 Finnish subjects aged 25 to 74 years without a history of PD at baseline. During a mean follow-up of 12.9 years, 102 men and 98 women developed an incident PD. The multivariate-adjusted (age, body mass index, systolic blood pressure, total cholesterol, education, leisure-time physical activity, smoking, alcohol and tea consumption, and history of diabetes) hazard ratios (HRs) of PD associated with the amount of coffee consumed daily (0, 1-4, and >= 5 cups) were 1.00, 0.55, and 0.41 (P for trend = 0.063) in men, 1.00, 0.50, and 0.39 (P for trend = 0.073) in women, and 1.00, 0.53, and 0.40 (P for trend = 0.005) in men and women combined (adjusted also for sex), respectively. In both sexes combined, the multivariate-adjusted HRs of PD for subjects drinking >= 3 cups of tea daily compared with tea nondrinkers was 0.41 (95% CI 0.20-0.83). These results suggest that coffee drinking is associated with a lower risk of PD. More tea drinking is associated with a lower risk of PD. (c) 2007 Movement Disorder Society. LOCAL IMMUNE RESPONSE IN UPPER URINARY TRACT INFECTION IN CHILDREN Kantele, A., Palkola, N., Arvilommi, H., Honkinen, O., Jahnukainen, T., Mertsola, J. and Kantele, J. M. Clin Vaccine Immunol. 2008. Vaccines are needed against urinary tract infections (UTI) in children, as episodes of pyelonephritis (PN) may cause renal scarring. Local immune mechanisms are regarded to confer protection, yet they have been poorly characterized in children. This study explores the local immune response in children by looking for newly activated pathogen-specific antibody-secreting cells (ASC) expected to be appearing transiently in the circulation as a response to UTI. Urinary tract-originating ASC specific to each patient's own pathogen or P fimbria were studied in 37 children with PN. The children were examined for recidives and renal scarring in a six-month follow-up. Pathogen-specific ASC were found in 33/37 children, the magnitude increasing with age. In contrast to adults with IgA-dominance, in 18/33 cases IgM dominated the response, more frequently in infants (63%) than in older children (30%). Most vigorous response was found to whole E.coli bacteria (geom. mean 63+/-2135 ASC/10(6) PBMC), yet, responses were found to P fimbria (13+/-33 ASC/10(6) PBMC), too. The response peaked at 1-2 weeks and was low/negligible after 3-7 weeks after the beginning of symptoms. Recidives were seen in seven and renal scarring in nine patients. In conclusion, a response of circulating ASC was found in children with UTI, the magnitude increasing with age. As IgM is not present in urine, the IgM-dominance of the response suggests that systemic immune mechanisms are more important in the immune defense in children than in adults. In 81% of patients, no recidives were seen suggesting a successful immune defense. Same genetic components underlie different measures of sweet taste preference Keskitalo, K., Tuorila, H., Spector, T. D., Cherkas, L. F., Knaapila, A., Silventoinen, K. and Perola, M. American Journal of Clinical Nutrition. 2007; 86(6): 1663-1669. Article. IF 6.562 Background: Sweet taste preferences are measured by several often correlated measures. Objective: We examined the relative proportions of genetic and environmental effects on sweet taste preference indicators and their mutual correlations. Design: A total of 663 female twins (324 complete pairs, 149 monozygous and 175 dizygous pairs) aged 17-80 y rated the liking and intensity of a 20% (wt/vol) sucrose solution, reported the liking and the use-frequency of 6 sweet foods (sweet desserts, sweets, sweet pastry, ice cream, hard candy, and chocolate), and completed a questionnaire on cravings of sweet foods. The estimated contributions of genetic factors, environmental factors shared by a twin pair, and environmental factors unique to each twin individual to the variance and covariance of the traits were obtained with the use of linear structural equation modeling. Results: Approximately half of the variation in liking for sweet solution and liking and use-frequency of sweet foods (49-53%) was explained by genetic factors, whereas the rest of the variation was due to environmental factors unique to each twin individual. Sweet taste preference-related traits were correlated. Tetravariate modeling showed that the correlation between liking for the sweet solution and liking for sweet foods was due to genetic factors (genetic r = 0.27). Correlations between liking, use-frequency, and craving for sweet foods were due to both genetic and unshared environmental factors. Conclusion: Detailed information on the associations between preference measures is an important intermediate goal in the determination of the genetic components affecting sweet taste preferences. Mixed bacterial-viral infections in septic children with leukemia Koskenvuo, M., Mottonen, M., Rahiala, J., Saarinen-Pihkala, U. M., Riikonen, P., Waris, M., Ziegler, T., Uhari, M., Ruuskanen, L. and Salmi, T. T. Pediatric Infectious Disease Journal. 2007; 26(12): 1133-1136. Article. IF 3.215 Backround: Febrile infections in children with leukemia are common. The occurrence of possible mixed bacterial-viral infections is unknown. Methods: We searched for viruses in leukemic children with blood culture-positive bacterial infections. The prospective multicenter survey included 156 febrile episodes in 51 children with acute leukemia. The mean follow-up time was 1.5 years per patient (27,743 patient-days at risk). Sixteen viruses were searched for from nasal swab and stool samples using virus culture, virus antigen detection, and polymerase chain reaction tests. Results: Bacterial blood cultures were positive in 19 (11%) febrile episodes among 17 children. In half of the septic episodes (11 of 19), a virus was also found. Rhinovirus and respiratory syncytial virus were the most common viruses detected. Conclusions: Our findings suggest that invasive bacterial infections are commonly associated with viral infections in children with leukemia. Lianou, M., Chalbot, M. C., Kotronarou, A., Kavouras, I. G., Karakatsani, A., Katsouyanni, K., Puustinnen, A., Hameri, K., Vallius, M., Pekkanen, J., Meddings, C., Harrison, R. M., Thomas, S., Ayres, J. G., ten Brink, H., Kos, G., Meliefste, K., de Hartog, J. J. and Hoek, G. Journal of the Air & Waste Management Association. 2007; 57(12): 1507-1517. Article. IF 1.441 The associations between residential outdoor and ambient particle mass, fine particle absorbance, particle number (PN) concentrations, and residential and traffic determinants were investigated in four European urban areas (Helsinki, Athens, Amsterdam, and Birmingham). A total of 152 nonsmoking participants with respiratory diseases, not exposed to occupational pollution, were included in the study, which comprised a 7-day intensive exposure monitoring period of both indoor and home outdoor particle mass and number concentrations. The same pollutants were also continuously measured at ambient fixed sites centrally located to the studied areas (fixed ambient sites). Relationships between concentrations measured directly outside the homes (residential outdoor) and at the fixed ambient sites were pollutant-specific, with substantial variations among the urban areas. Differences were more pronounced for coarse particles due to resuspension of road dust and PN, which is strongly related to traffic emissions. Less significant outdoor-to-fixed variation for particle mass was observed for Amsterdam and Birmingham, predominantly due to regional secondary aerosol. On the contrary, a strong spatial variation was observed for Athens and to a lesser extent for Helsinki. This was attributed to the overwhelming and time-varied inputs from traffic and other local sources. The location of the residence and traffic volume and distance to street and traffic light were important determinants of residential outdoor particle concentrations. On average, particle mass levels in suburban areas were less than 30% of those measured for residences located in the city center. Residences located less than 10 in from a street experienced 133% higher PN concentrations than residences located further away. Overall, the findings of this multi-city study, indicated that (1) spatial variation was larger for PN than for fine particulate matter (PM) mass and varied between the cities, (2) vehicular emissions in the residential street and location in the center of the city were significant predictors of spatial variation, and (3) the impact of traffic and location in the city was much larger for PN than for fine particle mass. Association of ADRB1 and UCP3 gene polymorphisms with insulin sensitivity but not obesity Mottagui-Tabar, S., Hoffstedt, J., Brookes, A. J., Jiao, H., Arner, P. and Dahlman, I. Horm Res. 2008; 69(1): 31-6. IF 1.385 BACKGROUND: The uncoupling proteins (UCPs) and beta-adrenoceptors (ADRBs) are important for energy balance and may be involved in the pathogenesis of insulin resistance. Obesity is strongly hunted by insulin resistance and susceptibility genes for the two conditions could be separate or common. Variations within the UCPs and ADRBs genes may give important clues to their involvement in disease. METHODS: A total of four single nucleotide polymorphisms (SNPs) in the genes UCP1, UCP2, UCP3, and ADRB1 were examined for association with obesity and insulin sensitivity (HOMA(IR)) in obese (n = 292) and healthy non-obese (n = 481) females. RESULTS: None of the SNPs was associated with obesity status or body mass index. However, ADRB1 (rs1801253) was nominally associated with serum insulin (nominal p = 0.034) and HOMA(IR) (nominal p = 0.022). UCP3 (rs1800006) was in post-hoc analysis nominally associated with serum insulin and HOMA(IR) (nominal p = 0.013 and 0.048, respectively). UCP1 and UCP2 showed no association with insulin sensitivity. CONCLUSION: Polymorphisms in ADRB1 and UCP3 may contribute to insulin resistance rather than obesity among Swedish women. Association of ADRB1 and UCP3 gene polymorphisms with insulin sensitivity but not obesity Mottagui-Tabar, S., Hoffstedt, J., Brookes, A. J., Jiao, H., Arner, P. and Dahlman, I. Hormone Research. 2008; 69(1): 31-36. Article. IF 1.385 Background: The uncoupling proteins (UCPs) and beta-adrenoceptors (ADRBs) are important for energy balance and may be involved in the pathogenesis of insulin resistance. Obesity is strongly hunted by insulin resistance and susceptibility genes for the two conditions could be separate or common. Variations within the UCPs and ADRBs genes may give important clues to their involvement in disease. Methods: A total of four single nucleotide polymorphisms ( SNPs) in the genes UCP1, UCP2, UCP3, and ADRB1 were examined for association with obesity and insulin sensitivity (HOMA(IR)) in obese (n = 292) and healthy non-obese ( n = 481) females. Results: None of the SNPs was associated with obesity status or body mass index. However, ADRB1 (rs1801253) was nominally associated with serum insulin ( nominal p = 0.034) and HOMA(IR) (nominal p = 0.022). UCP3 (rs1800006) was in posthoc analysis nominally associated with serum insulin and HOMA(IR) (nominal p = 0.013 and 0.048, respectively). UCP1 and UCP2 showed no association with insulin sensitivity. Conclusion: Polymorphisms in ADRB1 and UCP3 may contribute to insulin resistance rather than obesity among Swedish women. Copyright (C) 2007 S. Karger AG, Basel. Niiranen, T. J., Jula, A. M., Kantola, I. M., Karanko, H. and Reunanen, A. J Hum Hypertens. 2007; 21(10): 788-94. IF 2.960 Electrocardiographic evidence of left ventricular hypertrophy (ECG-LVH) has a grave prognostic significance in hypertensive patients. The purpose of our study was to assess whether ECG-LVH is more strongly associated with home-measured blood pressure (BP) than with clinic BP, and whether the correlation between home BP and ECG-LVH increases with the number of home measurements performed. We studied a representative sample of the general adult population (1989 subjects 45-74 years of age) in Finland. Subjects included in the study underwent a clinical interview, electrocardiography and measurement of clinic BP (mean of two clinic measurements) and home BP (mean of 14 duplicate home measurements performed during 1 week). Home BP correlated significantly better than clinic BP with the Sokolow-Lyon voltage (home/clinic systolic: r=0.23/0.22, P=0.60; diastolic: r=0.17/0.12, P=0.009), Cornell voltage (systolic: r=0.30/0.25, P=0.004; diastolic: r=0.21/0.12, P<0.001) and Cornell product (systolic: r=0.30/0.24, P=0.001; diastolic r=0.22/0.14, P<0.001) criteria of ECG-LVH. The correlation between home BP and ECG-LVH increased slightly with the number of home measurements, but even the mean of the initial two home BP measurements correlated equally well (systolic BP), or better (diastolic BP) with ECG-LVH than did clinic BP. In conclusion, home BP measurement allows us to obtain a large number of measurements that have a strong association with ECG-LVH. Our data support the application of home BP measurement in clinical practice. ADHD candidate gene study in a population-based birth cohort: association with DBH and DRD2 Nyman, E. S., Ogdie, M. N., Loukola, A., Varilo, T., Taanila, A., Hurtig, T., Moilanen, I. K., Loo, S. K., McGough, J. J., Jarvelin, M. R., Smalley, S. L., Nelson, S. F. and Peltonen, L. J Am Acad Child Adolesc Psychiatry. 2007; 46(12): 1614-21. IF 4.767 OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common childhood-onset disorder with a significant impact on public health. Although a genetic contribution to risk is evident, predisposing genetic determinants remain largely unknown despite extensive research. So far, the most promising candidate genes have been those involved in dopamine and serotonin pathways. This study tests a series of allelic variants within such candidate genes to determine their potential influence on ADHD susceptibility. METHOD: We used a population sample ascertained from a birth cohort of a subpopulation of Finland, characterized by founder effect and isolation, thus minimizing genetic heterogeneity. The subjects were systematically ascertained using DSM-IV diagnostic criteria for ADHD from the Northern Finland Birth Cohort 1986 of more than 9,000 individuals, resulting in the study sample of 188 ADHD cases and 166 controls. We genotyped markers in 13 candidate genes, including critical components of dopamine and serotonin pathways. RESULTS: We report evidence for association of ADHD with allelic variants of the dopamine beta-hydroxylase (DBH) and dopamine receptor D2 (DRD2) genes. CONCLUSIONS: Our study supports the involvement of the dopamine pathway in the etiology of ADHD; specifically the genes DBH and DRD2 deserve more attention in further studies. Heritability of intraocular pressure in older female twins Parssinen, O., Era, P., Tolvanen, A., Kaprio, J., Koskenvuo, M. and Rantanen, T. Ophthalmology. 2007; 114(12): 2227-2231. Article. IF 4.031 Purpose: To examine the heritability of intraocular pressure (IOP) among older women not diagnosed as having glaucoma. Design: Cross-sectional twin study. Participants: 94 monozygotic (MZ) and 96 dizygotic (DZ) female twin pairs aged 63-76 years and not diagnosed as having glaucoma. Methods: Intraocular pressure was measured using a noncontact tonometer. The contributions of genetic and environmental factors to individual differences in IOP were estimated by applying an independent pathway model to twin data. Main Outcome Measures: Contribution of genetic and environmental effects to the variation in IOP among MZ and DZ twins. Results: Mean IOP of the study population was 14.1 mmHg (+/- standard deviation 3.1) with no differences observed neither between the MZ and the DZ individuals, nor between the left and the right eyes. The pair-wise correlations for IOP of the right eye were .61 in MZ and .25 in DZ and for the left eye .63 and .42. The phenotypic correlation between the left and the right eye IOP was high (r = 0.81), suggesting that they were indices of a single trait. Quantitative genetic modeling revealed that for both eyes 64% (95% confidence interval [Cl], 53-71) of the variance in IOP was explained by additive genetic effects and 18% (95% Cl, 11-27) by nonshared environmental factors in common. In addition, 18% (95% Cl, 15-23) of the variance in IOP was explained by nonshared environmental factors specific to each eye. Conclusions: Additive genetic influences explained most of the individual differences in IOP among older women not diagnosed as having glaucoma. Because elevated IOP is an important risk factor for glaucoma, genetic factors underlying IOP may have a significant role in determining the risk for glaucoma, a complex progressive disease leading to death of ganglion cells. Peters, T. M., Berghold, C., Brown, D., Coia, J., Dionisi, A. M., Echeita, A., Fisher, I. S. T., Gatto, A. J., Gill, N., Green, J., Gerner-Smidt, P., Heck, M., Lederer, I., Lukinmaa, S., Luzzi, I., Maguire, C., Prager, R., Usera, M., Siitonen, A., Threlfall, E. J., Torpdahl, M., Tschape, H., Wannet, W. and Van der Zwaluw, W. K. Epidemiology and Infection. 2007; 135(8): 1274-1281. Article. IF 1.809 Salmonella is one of the most common causes of foodborne infection in Europe with Salmonella enterica serovar Enteritidis (S. Enteritidis) being the most commonly identified serovar. The predominant phage type for S. Enteritidis is phage type (PT) 4, although PT 8 has increased in incidence. Within these phage types, pulsed-field gel electrophoresis (PFGE) provides a method of further subdivision. The international project, Salm-gene, was established in 2001 to develop a database of PFGE profiles within nine European countries and to establish criteria for real-time pattern recognition. It uses DNA fingerprints of salmonellas to investigate outbreaks and to evaluate trends and emerging issues of foodborne infection within Europe. The Salm-gene database contains details of about 11700 S. Enteritidis isolates, demonstrating more than 65 unique PFGE profiles. The clonal nature of S. Enteritidis is evidenced by the high similarity and distribution of PFGE profiles. Over 56% (6603/11716) of the submitted isolates of several different phage types were profile SENTXB.0001, although this profile is most closely associated with PT 4. The next most common profiles, SENTXB.0002 and SENTXB.0005, were closely associated with PT 8 and PT 21 respectively. Studies to investigate the relationship of profile types with outbreaks and possible vehicles of infection suggest that the incidence of PFGE profile SENTXB.0002, and thus PT 8, in some countries may be due to importation of foods or food production animals from Eastern Europe, where PT 8 is amongst the most frequently identified phage types. Collation of subtyping data, especially in the commonly recognized phage types, is necessary in order to evaluate trends and emerging issues in salmonella infection. Yersinia pseudotuberculosis causing a large outbreak associated with carrots in Finland, 2006 Rimhanen-Finne, R., Niskanen, T., Hallanvuo, S., Makary, P., Haukka, K., Pajunen, S., Siitonen, A., Ristolainen, R., Poyry, H., Ollgren, J. and Kuusi, M. Epidemiol Infect. 2008: 1-6. IF 1.809 SUMMARY A large outbreak of Yersinia pseudotuberculosis O:1 infection affected over 400 children from 23 schools and 5 day-care centres in two municipalities in southern Finland in August-September, 2006. A retrospective cohort study conducted in a large school centre showed that the outbreak was strongly associated with the consumption of grated carrots served at a school lunch. The risk of illness increased with the amount of carrots eaten. Poor quality carrots grown the previous year had been delivered to the school kitchens in the two municipalities affected. In the patients' samples and in the environmental samples collected from the carrot distributor's storage facility, identical serotypes and genotypes of Y. pseudotuberculosis were found, but the original source and the mechanism of the contamination of the carrots remained unclear. Outbreaks of Y. pseudotuberculosis linked to fresh produce have been detected repeatedly in Finland. To prevent future outbreaks, instructions in improved hygiene practices on the handling of raw carrots have been issued to farmers, vegetable-processing plants and institutional kitchens. Ripatti, S. and Makela, P. Addiction. 2008; 103(1): 24-31. Article. IF 4.088 Aims To develop statistical methodology needed for studying whether effects of an acute-onset intervention differ by consumption group that accounts correctly for the effect of regression to the mean (RTM) in observational panel studies with three or more measurement waves. Design A general statistical modelling framework, based on conditional models, is presented for analysing alcohol panel data with three or more measurements, that models the dependence between initial drinking level and change in consumption controlling for RTM. The method is illustrated by panel data from Finland, southern Sweden and Denmark, where the effects of large changes in alcohol taxes and travellers' allowances were studied. Findings The suggested model allows for drawing statistical inference of the parameters of interest and also the identification of non-linear effects of an intervention by initial consumption using standard statistical software modelling tools. There was no evidence in any of the countries of the changes being larger among heavy drinkers, but in southern Sweden there was evidence that light drinkers raised their level of consumption. Conclusions Conditional models are a versatile modelling framework that offers a flexible tool for modelling and testing changes due to intervention in consumption by initial consumption while controlling simultaneously for RTM. Saarni, S. I., Suvisaari, J., Sintonen, H., Koskinen, S., Härkänen, T. and Lönnqvist, J. Journal of Clinical Epidemiology. 2007; 60(12): 1288-1297. Article. IF 2.440 Objective: To estimate the individual- and population-level impact of major chronic conditions on health-related quality of life (HRQoL) at different ages, to test whether the HRQoL impact of conditions varies with age, and to predict future changes of quality-adjusted life years (QALYs) lost due to morbidity. Study Design and Setting: HRQoL was measured using two preference-based instruments, the 15D and the EQ-5D, in a representative sample of 8,028 Finns. Information on chronic somatic conditions was obtained by interviews. Psychiatric disorders were diagnosed using a structured inter-view (Munich version of the Composite International Diagnostic Interview). Results: The impact of chronic conditions on HRQoL increased fourfold when comparing people aged 30-44 years to people over 75 years. This was mostly due to increase in prevalence, but the severity of some conditions also varied with age. Musculoskeletal disorders had the largest and rather stable impact across ages on the population level. Psychiatric disorders placed the largest burden on HRQoL at 30-44 years, but their impact declined after 55 years. The aging of the Finnish population was predicted to increase annual QALYs lost due to morbidity by one quarter by year 2040. Conclusion: The impact of conditions on HRQoL varied with age for each condition. (C) 2007 Elsevier Inc. All rights reserved. The association between carotid intima-media thickness and sciatica Shiri, R., Viikari-Juntura, E., Leino-Arjas, P., Vehmas, T., Varonen, H., Moilanen, L., Karppinen, J. and Heliovaara, M. Seminars in Arthritis and Rheumatism. 2007; 37(3): 174-181. Review. IF 3.440 Objective: Both clinical and epidemiologic studies have shown an association between atherosclerotic changes in the aorta or lumbar arteries and lumbar disc degeneration. However, the association between atherosclerosis and sciatica remains unknown. The aim of this study was to investigate the association between carotid intima-media thickness and sciatica. Methods: The target population consisted of people aged 45 to 74 years, who had participated in a Finnish nationwide population study during the period 2000 to 2001 and lived within 200 km of the 6 study clinics. Of the 1867 eligible subjects, 1386 (74%) were included in the study. We used high-resolution B-mode ultrasound imaging to measure intima-media thickness, and local or radiating low back pain was determined by a standard interview and clinical signs of sciatica through a physician's clinical examination. Results: Carotid intima-media thickness was associated with continuous radiating low back pain and with a positive unilateral clinical sign of sciatica among men only. After adjustment for potential confounders, each standard deviation (0.23 mm) increment in carotid intima-media thickness showed an odds ratio of 1.6 (95% confidence interval 1.1-2.3) for continuous radiating low back pain and 1.7 (95% confidence interval 1.3-2.1) for a positive unilateral clinical sign of sciatica. Carotid intima-media thickness was not associated with local low back pain. Conclusion: Sciatica may be a manifestation of atherosclerosis, or both conditions may share common risk factors. (c) 2007 Elsevier Inc. All rights reserved. Simell, B., Melin, M., Lahdenkari, M., Briles, D. E., Hollingshead, S. K., Kilpi, T. M. and Käyhty, H. J Infect Dis. 2007; 196(10): 1528-36. IF 5.363 BACKGROUND: Pneumococcal surface protein A (PspA) is a highly variable yet cross-reactive protein that exists as 2 major families. We assessed the development of human serum and salivary antibodies against the PspA families 1 (PspA1) and 2 (PspA2) in early childhood and their role in the prevention of pneumococcal acute otitis media (AOM). METHODS: Serum levels of IgG and salivary levels of IgA antibodies to PspA1 and PspA2 were measured by use of enzyme immunoassay from the samples from the Finnish Otitis Media Cohort Study obtained at the ages of 12 months (287 and 160 samples, respectively) and 18 months (258 and 131 samples, respectively). The Cox proportional hazard model was used to evaluate the relative risk (RR) of pneumococcal AOM during the 6 months after sampling relative to concentration of serum or presence of salivary anti-PspA in the samples. RESULTS: Anti-PspA1 and anti-PspA2 concentrations at 12 and 18 months were related to prior culture-confirmed pneumococcal exposure. The concentrations of serum anti-PspA were not significantly associated with the risk of pneumococcal AOM. At 18 months, the presence of salivary anti-PspA was significantly associated with a lower risk of pneumococcal AOM during the 6 months after sampling (RR, 0.27 [95% confidence interval, 0.11-0.69]). CONCLUSIONS: The lowered risk of pneumococcal AOM associated with the presence of salivary anti-PspA at 18 months suggests that mucosal anti-PspA antibodies have a role in the prevention of pneumococcal AOM. Stenholm, S., Rantanen, T., Heliövaara, M. and Koskinen, S. J Am Geriatr Soc. 2007. IF 3.331 OBJECTIVES: 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. MRI of hippocampus and entorhinal cortex in mild cognitive impairment: A follow-up study Tapiola, T., Pennanen, C., Tapiola, M., Tervo, S., Kivipelto, M., Hanninen, T., Pihlajamaki, M., Laakso, M. P., Hallikainen, M., Hamalainen, A., Vanhanen, M., Helkala, E. L., Vanninen, R., Nissinen, A., Rossi, R., Frisoni, G. B. and Soininen, H. Neurobiology of Aging. 2008; 29(1): 31-38. Article. IF 5.599 The concept of mild cognitive impairment (MCI) has been proposed to represent a transitional stage between normal aging and dementia. We studied the predictive value of the MRI-derived volumes of medial temporal lobe (MTL) structures, white matter lesions (WML), neuropsychological tests, and Apolipoprotein E (APOE) genotype on conversion of MCI to dementia and AD. The study included 60 subjects with MCI identified from population cohorts. During the mean follow-up period of 34 months, 13 patients had progressed to dementia (9 to Alzheimer's disease (AD)). In Cox regression analysis the baseline volumes of the right hippocampus, the right entorhinal cortex and CDR sum of boxes predicted the progression of MCI to dementia during the follow-up. In a bivariate analysis, only the baseline volumes of entorhinal cortex predicted conversion of MCI to AD. The Mini-Mental State Examination (MMSE) score at baseline, WML load, or APOE genotype were not significant predictors of progression. The MTL volumetry helps in identifying among the MCI subjects a group, which is at high risk for developing AD. (C) 2006 Elsevier Inc. All rights reserved. Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study Vasankari, T., Holmstrom, P., Ollgren, J., Liippo, K., Kokki, M. and Ruutu, P. BMC Public Health. 2007; 7. Article. IF 1.603 Background: We investigated the patient- and treatment-system dependent factors affecting treatment outcome in a two-year cohort of all treated culture-verified pulmonary tuberculosis (TB) cases to establish a basis for improving outcomes. Methods: Medical records of all cases in 1995-1996 were abstracted to assess outcome of treatment. Outcome was divided into three groups: favourable, death and other unfavourable. Predictors of unfavourable outcome were assessed in univariate and multivariate analysis. Results: Among 629 cases a favourable outcome was achieved in 441 (70.1%), 17.2% (108) died and other unfavourable outcome took place in 12.7% (80). Significant independent risk factors for death were male sex, high age, non-HIV-related immunosuppression and any other than a pulmonary specialty being responsible for stopping treatment. History of previous tuberculosis was inversely associated with the risk of death. For other unfavourable treatment outcomes, significant risk factors were pause(s) in treatment, treatment with INH+RIF+EMB/SM, and internal medicine specialty being responsible at the end of the treatment. Conclusion: We observed a significant association with unfavourable outcome for the specialty responsible for treatment being other than pulmonary, but not for the volume of cases, which has implications for system arrangements. Poor outcomes associated with immunosuppression and advanced age, with frequent comorbidity, stress a low threshold of suspicion, availability of rapid diagnostics, and early empiric treatment as probable approaches in attempting to improve treatment outcomes in countries with very low incidence of TB. Cerebral glucose metabolism in dizygotic twin pairs discordant for Alzheimer's disease Virta, J. J., Karrasch, M., Kaprio, J., Koskenvuo, M., Raiha, I., Viljanen, T. and Rinne, J. O. Dementia and Geriatric Cognitive Disorders. 2008; 25(1): 9-16. Article. IF 2.511 Positron emission tomography (PET) with 2-deoxy-2[F-18]-fluoro-D-glucose (FDG) can be used to estimate regional cerebral glucose metabolism (rCMRgluc). FDG-PET studies have shown rCMRgluc to be reduced especially in temporal and parietal cortices in Alzheimer's disease (AD). A previous study on monozygotic twins discordant for AD showed that the rCMRgluc of the non-demented twins is reduced significantly in the lateral temporal and parietal cortices compared to unrelated controls. In this study we examined 9 pairs of dizygotic twins discordant for AD with FDG-PET. The rCMRgluc of the demented twins was 16% lower in the prefrontal cortex (p = 0.04), 20% lower in the hippocampus (p = 0.002) and 15% lower in the lateral temporal cortex (p = 0.003) compared to controls. The non-demented twins showed no such reductions on any cortical region compared to unrelated control subjects. This implies that both genes and environment, and not genes alone, are causative in the pathogenesis of AD. Copyright (c) 2007 S. Karger AG, Basel. |