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Bordetella pertussis, Finland and France
Caro, V., Elomaa, A., Brun, D., Mertsola, J., He, Q. S. and
Guiso, N.
Emerging Infectious Diseases. 2006; 12(6): 987-989. IF
5.308
We used pulsed-field gel electrophoresis analysis and genotyping to
compare clinical isolates of Bordetella pertussis recovered since
the early 1990s in Finland and France, 2 countries with similar
histories of long-term mass vaccination with whole-cell pertussis
vaccines. Isolates from both countries were similar genetically but
varied temporally.
Molecular and phenotypic profiling of sorbitol-fermenting
Escherichia coli O157:H human isolates from Finland
Eklund, M., Bielaszewska, M., Nakari, U. M., Karch, H. and
Siitonen, A.
Clin Microbiol Infect. 2006; 12(7): 634-41. IF 2.679
This study investigated the occurrence of virulence-associated
genes, including stx1, stx2, stx2c, stx2d, stx2e, eae and its
subtypes (alpha, beta, gamma, epsilon), efa1, cdt-V cluster,
enterohaemorrhagic Escherichia coli (EHEC)-hlyA, katP, espP, etpD,
sfpA and the flagellar fliC gene, in nine sorbitol-fermenting (SF),
beta-glucuronidase-positive E. coli O157:H(-) (non-motile) isolates
obtained from humans in Finland between 1997 and 2001. In addition,
the production of Shiga toxin (Stx), cytolethal distending toxin
(CDT)-V and EHEC haemolysin (EHEC-Hly) was studied, and the phage
type (PT) and pulsed-field gel electrophoresis (PFGE) types were
determined. All nine isolates carried eae-gamma, efa1, EHEC-hlyA,
etpD, sfpA and fliC; eight also harboured the cdt-V gene cluster
and five were positive for stx2. None of the isolates harboured
stx1, stx2c, stx2d, stx2e, katP or espP. All isolates harbouring
the corresponding genes also produced Stx2 and CDT-V in titres
ranging from 1:32 to 1:128 and from 1:2 to 1:4, respectively. None
of the isolates expressed EHEC-Hly on enterohaemolysin agar. Seven
isolates belonged to PT88 and two had a PT88 variant pattern. Seven
isolates showed a close genetic relationship, with a PFGE
similarity index (SI) of 92-98%. Two isolates, temporally the first
and last, obtained 5 years apart, were the most divergent (SI of
71% and 85%, respectively). The study demonstrated that SF E. coli
O157:H(-) isolates from Finland are closely related and show a
close relationship with SF E. coli O157 strains isolated in
Germany. This finding suggests a clonality of SF E. coli O157:H(-)
isolates from different geographical regions.
Field evaluation of the chessboard modification for serotyping of
Streptococcus pneumoniae in a small laboratory in
Bangladesh
Herva, E., Granat, S., Mia, Z., Ollgren, J., Piirainen, L.
and Makela, P. H.
Am J Trop Med Hyg. 2006; 74(5): 863-7. IF 2.482
The chessboard modification of the quellung method for serotyping
Streptococcus pneumoniae (Pneumococcus) was introduced in the
Gonoshasthaya Vaccine Research Laboratory, a small laboratory in
Bangladesh. We applied initial bench-side training and subsequent
continuous surveillance and quality assurance as approaches for
good laboratory practice. Results obtained a this laboratory on
1,101 consecutive isolates had satisfactory sensitivity (85.1-100%)
and specificity (97.9-99.9%) for serotyping the 10 most common
serogroups/types of pneumococci when compared with the results
obtained in the Finnish reference laboratory for pneumococcal
serotyping at the National Public Health Institute. We conclude
that serotyping of pneumococci by the chessboard method can be
introduced into a small laboratory by providing basic bacteriologic
skills, adequate initial training, and continuous external
support.
Association of low-insulin sensitivity measured by quantitative
insulin sensitivity check index with hair loss in 55-year-old men.
A Finnish population-based study
Hirsso, P., Rajala, U., Hiltunen, L., Laakso, M., Koskela,
P., Harkonen, P. and Keinanen-Kiukaanniemi, S.
Diabetes Obesity & Metabolism. 2006; 8(4): 466-468. IF
2.496
Current comorbidity among consecutive adolescent psychiatric
outpatients with DSM-IV mood disorders
Karlsson, L., Pelkonen, M., Ruuttu, T., Kiviruusu, O., Heila,
H., Holi, M., Kettunen, K., Tuisku, V., Tuulio-Henriksson, A.,
Torronen, J. and Marttunen, M.
European Child & Adolescent Psychiatry. 2006; 15(4):
220-231. IF 1.367
Objective: To compare selected characteristics (age, sex, age of
onset for depression, impairment, severity of depression, somatic
comorbidity, and treatment status) of adolescents with currently
comorbid and non-comorbid depression.
Method: A sample of 218 consecutive adolescent (13-19 years)
psychiatric outpatients with depressive disorders, and 200 age- and
sex-matched school-attending controls were interviewed for DSM-IV
Axis I and Axis II diagnoses.
Results: Current comorbidity, most commonly with anxiety disorders,
was equally frequent (> 70%) in outpatients and depressed
controls. Younger age (OR 0.20; 95% CI 0.08, 0.51) and male gender
(OR 0.02; 95% CI 0.09, 0.55) were associated with concurrent
disruptive disorders. Current comorbidity with substance use
disorders (SUD) was independent of age (OR 1.13; 95% CI 0.51, 2.49)
and sex (OR 0.51; 95% CI 0.22, 1.17). Personality disorders
associated with older age (OR 2.06; 95% CI 1.10, 3.86). In
multivariable logistic regression analysis, impairment (GAF <=
60) was associated with current comorbidity (OR 3.13; 95% CI 1.53,
6.45), while severity of depression and lifetime age of onset for
depression were not.
Conclusion: Adolescent depression presents with age- and
sex-dependent patterns of multiple co-occurring problem areas.
While many clinical characteristics of adolescent depression are
not affected by comorbidity, comorbidity associates with increased
impairment.
Differences in Axis I and II comorbidity between bipolar I and II
disorders and major depressive disorder
Mantere, O., Melartin, T. K., Suominen, K., Rytsala, H. J.,
Valtonen, H. M., Arvilommi, P., Leppamaki, S. and Isometsa, E.
T.
J Clin Psychiatry. 2006; 67(4): 584-93. IF 5.038
OBJECTIVE: To obtain a comprehensive view of differences in current
comorbidity between bipolar I and II disorders (BD) and (unipolar)
major depressive disorder (MDD), and Axis I and II comorbidity in
BD in secondary-care psychiatric settings.
METHOD: The psychiatric comorbidity of 90 bipolar I and 101 bipolar
II patients from the Jorvi Bipolar Study and 269 MDD patients from
the Vantaa Depression Study were compared. We used DSM-IV criteria
assessed by semistructured interviews. Patients were inpatients and
outpatients from secondary-care psychiatric units. Comparable
information was collected on clinical history, index episode,
symptom status, and patient characteristics.
RESULTS: Bipolar disorder and MDD differed in prevalences of
current comorbid disorders, MDD patients having significantly more
Axis I comorbidity (69.1% vs. 57.1%), specifically anxiety
disorders (56.5% vs. 44.5%) and cluster A (19.0% vs. 9.9%) and C
(31.6% vs. 23.0%) personality disorders. In contrast, BD had more
single cluster B personality disorders (30.9% vs. 24.6%). Bipolar I
and bipolar II were similar in current overall comorbidity, but the
prevalence of comorbidity was strongly associated with the current
illness phase.
CONCLUSIONS: Major depressive disorder and BD have somewhat
different patterns in the prevalences of comorbid disorders at the
time of an illness episode, with differences particularly in the
prevalences of anxiety and personality disorders. Current illness
phase explains differences in psychiatric comorbidity of BD
patients better than type of disorder.
Incorporating serotypes into family based association studies using
the MFG test
Minassian, S. L., Palmer, C. G. S., Turunen, J. A., Paunio,
T., Lonnqvist, J., Peltonen, L., Woodward, J. A. and Sinsheimer, J.
S.
Annals of Human Genetics. 2006; 70: 541-553. IF 3.192
Family based association tests are widely used to detect genetic
effects. The focus of this paper is the maternal-fetal genotype
(MFG) incompatibility test, a family based association test which
can be used to detect genetic effects that contribute to disease,
including alleles in the child that increase disease risk, maternal
alleles that increase disease risk in the child, and maternal-fetal
genotype incompatibilities. Consideration of incomplete data
resulting from using serotypes could expand the power of the MFG
test for detecting genetic effects. Serotypes may be all that are
available in certain families, or preferred because of convenience
or low cost, and thus a modification of the MFG test will allow
optimal use of such data. The modified MFG likelihood can
accommodate the incomplete data that result from using serotypes
rather than the corresponding codominant genotypes. The modified
MFG test was evaluated with serotypes and genotypes from families
with members affected with schizophrenia. In addition, simulation
studies were performed. Results of the data analyses and simulation
studies showed that serotypes can be used to augment genotypes
within a sample, to increase power to detect effects when the
candidate gene produces serotypes.
Adaptive changes of myosin isoforms in response to long-term
strength and power training in middle-aged men
Puhke, R., Aunola, S., Ailanto, P., Alev, K., Venojarvi, M.,
Rusko, H. and Seene, T.
Journal of Sports Science and Medicine. 2006; 5(2):
349-358.
The purpose of the study was to examine the adaptive changes in
myosin heavy chain (MHC) and light chain (MLC) isoforms in human
vastus lateralis muscle caused by long-term strength and power
training (54 weeks, approximately 3 times a week) in untrained
middle-aged men (16 in the training and 6 in the control group).
Muscular MHC and MLC isoforms were determined by means of SDS-PAGE
gel electrophoresis. During the training period, maximal anaerobic
cycling power increased by 64 W (p < 0.001) and the maximal
jumping height by 1.5 cm (p < 0.05) in the training group, but
no significant changes were found in the control group. However,
the group by time effect was not significant. In the training
group, the increase of the maximal jumping height correlated with
the number of strength and power training sessions (r = 0.56; p
< 0.05). The change of the proportion of MHC IIa isoform from
52.6 +/- 12.2% to 59.4 +/- 11.6% did not reach statistical
significance (p = 0.070 for group by time; within training group p
= 0.061) and neither did the change of the proportion of MHC IIx
isoform from 18.1 +/- 11.4% to 11.1 +/- 9.1% (p = 0.104 for group
by time; within training group p = 0.032). The degree of change of
MHC IIx isoform correlated with the amount of earlier recreational
sports activity (r = 0.61; p < 0.05). In the training group, the
changes of MLC1s isoform correlated negatively with the changes of
MLC1f isoform (r = -0.79; p < 0.05) as well as with the changes
in maximal anaerobic cycling power (r = -0.81; p < 0.05), and
positively with those of MHC I isoform (r = 0.81; p < 0.05). In
conclusion, the long-term strength and power training similar to 3
times a week seemed to have only slight effects on fast MHC
isoforms in the vastus lateralis muscle of untrained middle-aged
men; the proportion of MHC IIa tended to increase and that of MHC
IIx tended to decrease. No changes in MLC isoform profile could be
shown.
Management of pain in acute otitis media in Finnish primary
care
Pulkki, J., Huikko, S., Rautakorpi, U. M., Honkanen, P.,
Klaukka, T., Makela, M., Palva, E., Roine, R., Sarkkinen, H.,
Varonen, H. and Huovinen, P.
Scand J Infect Dis. 2006; 38(4): 265-7. IF 1.308
Most treatment recommendations for acute otitis media favour active
use of pain relief medication. These data comprised 3059 Finnish
primary care acute otitis media patients. We found that 10.4% of
the patients were prescribed or recommended analgesics, which is in
contrast to treatment recommendations.
Effects of External Light Loading in Power-type Strength Training
on Muscle Power of the Lower Extremities in Middle-aged
Subjects
Surakka, J., Alanen, E., Aunola, S., Karppi, S. L. and
Pekkarinen, H.
Int J Sports Med. 2006; 27(6): 448-55. IF 1.433
The purpose of this study was to evaluate and compare the effects
of training either with a light load or without any load in a
16-week power-type strength training intervention in sedentary
middle-aged subjects. A total of 85 subjects participated in the
study. In a supervised 22-week training intervention, including 16
weeks of power-type strength training, 42 subjects (Light Load
group = LL group) trained with a 1.1 kg weight on each ankle and 43
subjects (No Load group = NOL group) trained without any external
load. Subjects were comparable concerning their training
attendance, and anthropometric and physiological characteristics.
Training effects were evaluated by measuring Vertical Squat Jump
(VSJ), 20-metre Running Time (20 mRT), Maximal Anaerobic Cycling
Power of leg muscles (MACP), and Maximal Oxygen Uptake (V.O (2max))
before and after the intervention. The LL group improved VSJ and
MACP significantly (p < 0.05), compared with the NOL group. No
difference between the groups was observed in 20 mRT or in V.O
(2max). To conclude, the external loads of 2.2 kg, in total,
increased the efficiency of power-type strength training in
vertical jumps and in anaerobic power in leg muscles, but not in
sprint running.
Soluble adhesion molecules in young children with signs of
beta-cell autoimmunity - prospective follow-up from
birth
Toivonen, A. M., Kimpimaki, T., Kupila, A., Korhonen, S.,
Hyoty, H., Virtanen, S. M., Ilonen, J., Simell, O. and Knip,
M.
Diabetes-Metabolism Research and Reviews. 2006; 22(3): 176-183.
IF 2.453
Background: This study aimed at evaluating the relationship between
the circulating concentrations of soluble intercellular adhesion
molecule-1 (sICAM-1) and sL-selectin and the appearance of
beta-cell autoimmunity, and at assessing whether these molecules
could assist in the identification of environmental factors
implicated in the immune process damaging the pancreatic
beta-cells.
Methods: Serum levels of soluble adhesion molecules were measured
with enzyme-linked immunosorbent assays over the first 2 years of
life in 65 children seroconverting to positivity for autoantibodies
and 65 control children, all with HLA-conferred susceptibility to
type 1 diabetes (T1D).
Results: The total integrated concentrations of soluble adhesion
molecules were comparable between the two groups. The
autoantibody-positive children tended to have higher sL-selectin
concentrations during the 3-month seroconversion (SC) period than
did the control children during the corresponding period (P =
0.07), the difference being significant (P = 0.03) after excluding
subjects with signs of a concurrent enterovirus infection. Auto
antibody-positive children had higher concentrations of sL-selectin
in the 3-month period when an enterovirus infection was detectable
than did the control children (P = 0.018). No significant
difference could, however, be seen after excluding the children
with concomitant seroconversion to autoantibody positivity.
Conclusions: Elevated concentrations of sL-selectin are temporally
associated with seroconversion to autoantibody positivity
suggesting that leukocyte activation might coincide with the
appearance of beta-cell autoimmunity. Early-onset progressive
beta-cell autoimmunity, on the other hand, is not reflected in
overall increased concentrations of soluble adhesion molecules in
the peripheral circulation during the first 2 years of life in
children carrying increased HLA-conferred disease susceptibility.
Enterovirus infections (EVIs) are not independently associated with
increased circulating sL-selectin concentrations in young children
with enhanced HLA-conferred susceptibility to T1D. Copyright (c)
2005 John Wiley & Sons, Ltd.
Assessing the quality of risk factor survey data: lessons from the
WHO MONICA Project
Tolonen, H., Dobson, A. and Kulathinal, S.
Eur J Cardiovasc Prev Rehabil. 2006; 13(1): 104-14. IF
2.333
BACKGROUND AND PURPOSE: Survey data quality is a combination of the
representativeness of the sample, the accuracy and precision of
measurements, data processing and management with several
subcomponents in each. The purpose of this paper is to show how, in
the final risk factor surveys of the WHO MONICA Project,
information on data quality were obtained, quantified, and used in
the analysis.
METHODS AND RESULTS: In the WHO MONICA (Multinational MONItoring of
trends and determinants in CArdiovascular disease) Project, the
information about the data quality components was documented in
retrospective quality assessment reports. On the basis of the
documented information and the survey data, the quality of each
data component was assessed and summarized using quality scores.
The quality scores were used in sensitivity testing of the results
both by excluding populations with low quality scores and by
weighting the data by its quality scores.
CONCLUSIONS: Detailed documentation of all survey procedures with
standardized protocols, training, and quality control are steps
towards optimizing data quality. Quantifying data quality is a
further step. Methods used in the WHO MONICA Project could be
adopted to improve quality in other health surveys.
Suicidal ideation, deliberate self-harm behaviour and suicide
attempts among adolescent outpatients with depressive mood
disorders and comorbid axis I disorders
Tuisku, V., Pelkonen, M., Karlsson, L., Kiviruusu, O., Holi,
M., Ruuttu, T., Punamaki, R. L. and Marttunen, M.
European Child & Adolescent Psychiatry. 2006; 15(4):
199-206. IF 1.367
Objective: We aimed to analyse and compare prevalence and
associated clinical features of suicidal ideation, self-harm
behaviour with no suicidal intent and suicide attempts among
adolescent outpatients with depressive mood disorders with or
without comorbidity.
Method: A sample of 218 consecutive adolescent outpatients aged
13-19 years with depressive mood disorders was interviewed using
K-SADS-PL for DSM-IV Axis I diagnoses. They filled out self-report
questionnaires assessing depressive and anxiety symptoms. Suicidal
behaviour was assessed by K-SADS-PL suicidality items.
Results: Half of the subjects reported suicidal ideation or
behaviour. There was no difference in prevalence of suicidal
behaviour between non-comorbid and comorbid mood disorder groups.
Multivariate logistic regression analyses produced the following
associations: (1) suicidal ideation with self-reported depressive
symptoms and poor psychosocial functioning, (2) deliberate
self-harm behaviour with younger age and poor psychosocial
functioning, and (3) suicide attempts with self-reported depressive
symptoms and poor psychosocial functioning.
Conclusion: Depressed mood disorders, whether comorbid or not, are
associated with suicidal ideation and suicide attempts. Diagnostic
assessment should be supplemented by self-report methods when
assessing suicidal behaviour in depressed adolescents.
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