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New articles - Uudet artikkelit 28.7.2008 - ISI Web of Knowledge & PubMed Search Alert
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The factorial structure of the Suicide Intent Scale: a comparative study in clinical samples from 11 European regions
Antretter, E., Dunkel, D., Haring, C., Corcoran, P., De Leo, D., Fekete, S., Hawton, K., Kerkhof, A., Lönnqvist, J., Renberg, E. S., Schmidtke, A., Van Heeringen, K. and Wasserman, D. International Journal of Methods in Psychiatric Research. 2008; 17(2): 63-79. Article. Although the Suicide Intent Scale (SIS) is a widely used instrument in research on suicidal behavior, comparative research on the latent structure of the SIS has been neglected. To determine whether a general factor model of the SIS is supported, alternative factor models of the SIS were evaluated comparatively in I I clinical samples. The SIS was applied as part of a structured clinical interview to patients after an episode of non-fatal suicidal behavior. The samples were drawn from I I study centers within the frame of the WHO/EURO multicenter study on suicidal behavior. Three different two-factor and two three-factor models of the SIS were examined in each sample using principal component analysis with orthogonal Procrustes rotation. The factorial structure of the 'subjective part' of the SIS (items 9-14) was strongly supported, whereas an acceptable model fit for the 'objective part' was not found. Possible future revisions of 'objective' SIS items may be worth consideration. As a limitation, the results of the study might not generalize to other samples that use different definitions of non-fatal suicidal behavior. Copyright (C) 2008 John Wiley & Sons, Ltd. Modulation of voluntary ethanol consumption by beta-arrestin 2 Björk, K., Rimondini, R., Hansson, A. C., Teräsmaa, A., Hyytiä, P., Heilig, M. and Sommer, W. H. Faseb Journal. 2008; 22(7): 2552-2560. Article. IF 6.791 Beta-arrestin 2 is a multifunctional key component of the G protein-coupled receptor complex and is involved in mu-opiate and dopamine D2 receptor signaling, both of which are thought to mediate the rewarding effects of ethanol consumption. We identified elevated expression of the beta-arrestin 2 gene (Arrb2) in the striatum and the hippocampus of ethanol-preferring AA rats compared to their nonpreferring counterpart ANA line. Differential mRNA expression was accompanied by different levels of Arrb2 protein. The elevated expression was associated with a 7-marker haplotype in complete linkage disequilibrium, which segregated fully between the lines, and was unique to the preferring line. Furthermore, a single, distinct, and highly significant quantitative trait locus for Arrb2 expression in hippocampus and striatum was identified at the locus of this gene, providing evidence that genetic variation may affect a cis-regulatory mechanism for expression and regional control of Arrb2. These findings were functionally validated using mice lacking Arrb2, which displayed both reduced voluntary ethanol consumption and ethanol-induced psychomotor stimulation. Our results demonstrate that beta-arrestin 2 modulates acute responses to ethanol and is an important mediator of ethanol reward. Bradley, E. L., Honkalampi-Hamalainen, U., Weber, A., Andersson, M. A., Bertaud, F., Castle, L., Dahlman, O., Hakulinen, P., Hoornstra, D., Lhuguenot, J. C., Maki-Paakkanen, J., Salkinoja-Salonen, M., Speck, D. R., Severin, I., Stammati, A., Turco, L., Zucco, F. and von Wright, A. Food and Chemical Toxicology. 2008; 46(7): 2498-2509. Article. IF 2.186 Nineteen food contact papers and boards and one non-food contact board were extracted following test protocols developed within European Union funded project BIOSAFEPAPER. The extraction media were either hot or cold water, 95% ethanol or Tenax, according to the end use of the sample. The extractable dry matter content of the samples varied from 1200 to 11,800 mg/kg (0.8-35.5 mg/dm(2)). According to GC-MS the main substances extracted into water were pulp-derived natural products such as fatty acids, resin acids, natural wood sterols and alkanols. Substances extracted into ethanol particularly, were diisopropylnaphthalenes, alkanes and phthalic acid esters. The non-food contact board showed the greatest number and highest concentrations of GC-MS detectable compounds. The extracts were subjected to a battery of in vitro toxicity tests measuring both acute and sublethal cytotoxicity and genotoxic effects. None of the water or Tenax extracts was positive in cytotoxicity or genotoxicity assays. The ethanol extract of the non-food contact board gave a positive response in the genotoxicity assays, and all four ethanol extracts gave positive response(s) in the cytotoxicity assays to some extent. These responses could not be pinpointed to any specific compound, although there appeared a correlation between the total amount of extractables and toxicity. (C) 2008 Elsevier Ltd. All rights reserved. Donner, J., Pirkola, S., Silander, K., Kananen, L., Terwilliger, J. D., Lönnqvist, J., Peltonen, L. and Hovatta, I. Biol Psychiatry. 2008. IF 8.456 BACKGROUND: Human anxiety disorders are complex diseases with largely unknown etiology. We have taken a cross-species approach to identify genes that regulate anxiety-like behavior with inbred mouse strains that differ in their innate anxiety levels as a model. We previously identified 17 genes with expression levels that correlate with anxiety behavior across the studied strains. In the present study, we tested their 13 known human homologues as candidate genes for human anxiety disorders with a genetic association study. METHODS: We describe an anxiety disorder study sample derived from a Finnish population-based cohort and consisting of 321 patients and 653 carefully matched control subjects, all interviewed to obtain DSM-IV diagnoses. We genotyped altogether 208 single nucleotide polymorphisms (SNPs) (all non-synonymous SNPs, SNPs that alter potential microRNA binding sites, and gap-filling SNPs selected on the basis of HapMap information) from the investigated anxiety candidate genes. RESULTS: Specific alleles and haplotypes of six of the examined genes revealed some evidence for association (p </= .01). The most significant evidence for association with different anxiety disorder subtypes were: p = .0009 with ALAD (delta-aminolevulinate dehydratase) in social phobia, p = .009 with DYNLL2 (dynein light chain 2) in generalized anxiety disorder, and p = .004 with PSAP (prosaposin) in panic disorder. CONCLUSIONS: Our findings suggest that variants in these genes might predispose to specific human anxiety disorders. These results illustrate the potential utility of cross-species approaches in identification of candidate genes for psychiatric disorders. Urban air pollution, and asthma and COPD hospital emergency room visits Halonen, J. I., Lanki, T., Yli-Tuomi, T., Kulmala, M., Tiittanen, P. and Pekkanen, J. Thorax. 2008; 63(7): 635-41. IF 6.226 BACKGROUND: There is little previous information of the effects of size fractioned particulate air pollution and source specific fine particles (PM(2.5); <2.5 microm) on asthma and chronic obstructive pulmonary disease (COPD) among children, adults and the elderly. OBJECTIVES: To determine the effects of daily variation in levels of different particle size fractions and gaseous pollutants on asthma and COPD by age group. METHODS: Levels of particulate air pollution, NO(2) and CO were measured from 1998 to 2004 at central outdoor monitoring sites in Helsinki, Finland. Associations between daily pollution levels and hospital emergency room visits were evaluated for asthma (ICD10: J45+J46) in children <15 years old, and for asthma and COPD (ICD10: J41+J44) in adults (15-64 years) and the elderly (>or=65 years). RESULTS: Three to 5 day lagged increases in asthma visits were found among children in association with nucleation (<0.03 microm), Aitken (0.03-0.1 microm) and accumulation (0.1-0.29 microm) mode particles, gaseous pollutants and traffic related PM(2.5) (7.8% (95% CI 3.5 to 12.3) for 1.1 microg/m(3) increase in traffic related PM(2.5) at lag 4). Pooled asthma-COPD visits among the elderly were associated with lag 0 of PM(2.5), coarse particles, gaseous pollutants and long range transported and traffic related PM(2.5) (3.9% (95% CI 0.28 to 7.7) at lag 0). Only accumulation mode and coarse particles were associated with asthma and COPD among adults. CONCLUSIONS: Among children, traffic related PM(2.5) had delayed effects, whereas among the elderly, several types of particles had effects that were more immediate. These findings suggest that the mechanisms of the respiratory effects of air pollution, and responsible pollutants, differ by age group. Circadian phenotype in patients with the co-morbid alcohol use and bipolar disorders Hätönen, T., Forsblom, S., Kieseppä, T., Lönnqvist, J. and Partonen, T. Alcohol Alcohol. 2008. IF 2.092 AIMS: Alcohol misuse is associated with bipolar disorder. Abnormalities in the circadian clockwork play a role in the pathogenesis of bipolar disorder. Alcohol intake is likely to affect the circadian phenotype. We aimed at analysing the behavioural trait of the preference to morning or evening hours for the daily activities in bipolar disorder patients with or without the co-morbid alcohol use. METHODS: Our nationwide sample of families included patients with bipolar disorder born during 1940-1969 having at least one hospitalization due to bipolar disorder during 1969-1991 and their first-degree relatives. All the 148 participants were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders and assessed using the Morningness-Eveningness Questionnaire whose factor matrix applying for the maximum likelihood principle was calculated for the first time. RESULTS: Patients with the co-morbid alcohol use disorder were more of the morning type as compared with patients with bipolar disorder only. CONCLUSIONS: Co-morbid patients preferred more the morning hours for their daily activities, indicative of alcohol consumption having an effect on the circadian clock. Hemminki, E., Heikkilä, K., Sevon, T. and Koponen, P. BMC Health Services Research. 2008; 8. Article. IF 1.358 Background: Evaluating complex interventions in health services faces various difficulties, such as making practice changes and costs. Ways to increase research capacity and decrease costs include making research an integral part of health services and using routine data to judge outcomes. The purpose of this article is to report the feasibility of a pilot trial relying solely on routinely collected register data and being based on ordinary health services. Methods: The example intervention was education to public health nurses (PHN) (childbirth classes) to reduce caesarean section rates via pre-delivery considerations of pregnant women. 20 maternity health centers (MHC) were paired and of each 10 pairs, one MHC was randomly allocated to an intervention group and the other to a control; 8 pairs with successful intervention were used in the analyses (1601 mothers). The women visiting to the study maternity centers were identified from the Customer Register of Helsinki City. A list of the study women was made using the mother's personal identification number, visit date, the maternity center code, birth date and gestation length. The mode of delivery and health outcomes were retrieved from the Finnish Medical Birth Register (MBR). Process data of the intervention are based on observations, written feedback and questionnaires from PHNs, and project correspondence. Results: It took almost two years to establish how to obtain permissions and to actually obtain it for the trial. Obtaining permissions for the customer and outcome data and register linkages was unproblematic and the cluster randomization provided comparable groups. The intervention did not succeed well. Had the main aim of the trial been to cause a change in PHNs behavior, we would have very likely intensified the intervention during the trial. Conclusion: Our experiences encourage the use of trials that obtain their outcomes from registers. Changing the behavior of ordinary health service providers is a challenging intervention. Kajantie, E., Hovi, P., Räikkönen, K., Pesonen, A. K., Heinonen, K., Järvenpää, A. L., Eriksson, J. G., Strang-Karlsson, S. and Andersson, S. Pediatrics. 2008; 122(1): E62-E72. Article. IF 4.473 OBJECTIVE. Although most children and adults who are born very preterm live healthy lives, they have, on average, lower cognitive scores, more internalizing behaviors, and deficits in social skills. This could well affect their transition to adulthood. We studied the tempo of first leaving the parental home and starting cohabitation with an intimate partner and sexual experience of young adults with very low birth weight (< 1500 g). METHODS. In conjunction with the Helsinki Study of Very Low Birth Weight Adults, 162 very low birth weight individuals and 188 individuals who were born at term (mean age: 22.3 years [range: 18.5-27.1]) and did not have any major disability filled out a questionnaire. For analysis of their ages at events which had not occurred in all subjects, we used survival analysis (Cox regression), adjusted for gender, current height, parents' ages at the birth, maternal smoking during pregnancy, parental educational attainment, number of siblings, and parental divorce/death. RESULTS. During their late teens and early adulthood, these very low birth weight adults were less likely to leave the parental home and to start cohabiting with an intimate partner. In gender-stratified analyses, these hazard ratios were similar between genders, but the latter was statistically significant for women only. These very low birth weight adults were also less likely to experience sexual intercourse. This relationship was statistically significant for women but not for men; however, very low birth weight women and men both reported a smaller lifetime number of sex partners than did control subjects. CONCLUSIONS. Healthy young adults with very low birth weight show a delay in leaving the parental home and starting sexual activity and partnerships. Koistinen, J., Kiviranta, H., Ruokojärvi, P., Parmanne, R., Verta, M., Hallikainen, A. and Vartiainen, T. Environmental Pollution. 2008; 154(2): 172-183. Article. IF 3.135 Organohalogen contaminants were investigated in Baltic herring caught from three catchment areas in the Baltic Sea, off the coasts of Finland. Pools of both small and large herring were analysed for polychlorinated biphenyls (PCB), dibenzo-p-dioxins, dibenzofurans, naphthalenes, camphenes (toxaphene), polybrominated diphenyl ethers and the pesticide DDT and its metabolites. PCB concentrations per fresh weight in small herring were at the same level in all catchment areas, i.e. the Bothnian Bay, the Bothnian Sea and the Gulf of Finland, revealing no hot spots and reflecting most likely long term emissions and atmosheric deposition. Differences in the levels and/or congener profiles of other p contaminants between catchment areas may be explained by point sources. Similar concentrations in small and large herring in the Gulf of Finland were possibly due to their common nutrition. In the other areas, differences between small and large herring most likely reflected their different food sources. (C) 2007 Elsevier Ltd. All rights reserved. Kroneman, A., Verhoef, L., Harris, J., Vennema, H., Duizer, E., van Duynhoven, Y., Gray, J., Iturriza, M., Bottiger, B., Falkenhorst, G., Johnsen, C., von Bonsdorff, C. H., Maunula, L., Kuusi, M., Pothier, P., Gallay, A., Schreier, E., Hohne, M., Koch, J., Szucs, G., Reuter, G., Krisztalovics, K., Lynch, M., McKeown, P., Foley, B., Coughlan, S., Ruggeri, F. M., Di Bartolo, I., Vainio, K., Isakbaeva, E., Poljsak-Prijatelj, M., Grom, A. H., Mijovski, J. Z., Bosch, A., Buesa, J., Fauquier, A. S., Hernandez-Pezzi, G., Hedlund, K. O. and Koopmans, M. J Clin Microbiol. 2008. IF 3.708 The Food-borne viruses in Europe network has developed integrated epidemiological and virological outbreak reporting with aggregation and sharing of data through a joint database. We analyzed data from reported outbreaks of NoV gastroenteritis from 13 European countries (July 2001-July 2006) for trends in time and indications of different epidemiology of genotypes and variants. Of the 13 countries participating in this surveillance network, 11 were capable of collecting integrated epidemiological and virological surveillance data and 10 countries reported outbreaks throughout the entire period. Large differences in the numbers and rates of reported outbreaks per country were observed, reflecting the differences in the focus and coverage of national surveillance systems. GII.4 strains predominated throughout the 5 year surveillance period, but the proportion of outbreaks associated with GII.4 rose remarkably during years in which NoV activity was particularly high. Spring and summer peaks indicated the emergence of genetically distinct variants within GII.4 across Europe and were followed by increased NoV activity during the 2002/2003 and 2004/2005 winter seasons. GII.4 viruses predominated in health care settings and in person to person transmission. The consecutive emergence of new GII.4 variants is highly indicative of immune driven selection. Their predominance in health care settings suggests properties that facilitate transmission in settings with a high concentration of people such as higher virus loads in excreta, or a higher incidence of vomiting. Understanding the mechanisms driving the changes in epidemiology and clinical impact of these rapidly evolving RNA viruses is essential to design effective intervention and prevention measures. Lajunen, T., Vikatmaa, P., Ikonen, T., Lepantalo, M., Lounatmaa, K., Sormunen, R., Rantala, A., Leinonen, M. and Saikku, P. Diagn Microbiol Infect Dis. 2008; 61(2): 156-64. IF 2.448 Chlamydia pneumoniae has been associated with cardiovascular diseases and has been shown by different methods to be present in atherosclerotic lesions. However, not all studies have found C. pneumoniae in atherosclerotic tissues. We compared polymerase chain reaction (PCR) methods, in situ hybridization (ISH), and measurement of chlamydial lipopolysaccharide (cLPS) by enzyme immunoassay (EIA) from homogenized atherosclerotic tissue in the detection of C. pneumoniae. In a study population of 110 patients with carotid artery disease, cLPS was found in 22.2%, and DNA by PCR was found in 34.3% and by ISH in 39.4% of the samples. Poor repeatability was shown to complicate PCR, and the technical problems inherent in ISH were not insignificant. In contrast, the cLPS EIA test was fast and easy to perform. If the sensitivity could be increased, for example, by testing multiple tissue pieces, cLPS EIA might provide a standardized commercial method for the detection of chlamydia in tissue samples, and it, thus, merits further characterization and validation in different patient populations. Drug testing in oral fluid-evaluation of sample collection devices Langel, K., Engblom, C., Pehrsson, A., Gunnar, T., Ariniemi, K. and Lillsunde, P. J Anal Toxicol. 2008; 32(6): 393-401. IF 2.068 Nine different oral fluid (OF) collection devices were studied to evaluate their suitability for collecting samples for drug analysis. The devices were Greiner Bio-One, Orasure Intercept(R), Immunalysis Quantisaltrade mark, StatSure Saliva.Samplertrade mark, Cozart(R), Sarstedt Salivette(R), Malvern Medical OraCol, Acro Biotech Salicule, and Varian OraTubetrade mark. For comparison, OF was also collected into plastic tubes. The volume of collected OF was quantified for samples collected both in vitro and from volunteers. Drug recovery was studied by collecting OF fortified at 1000 ng/mL with amphetamine, 3,4-methylenedioxymethamphetamine, cocaine, Delta(9)-tetrahydrocannabinol, morphine, codeine, diazepam, and alprazolam with the devices in vitro and analyzing the samples with gas chromatography-mass spectrometry. Recovery of ethanol was measured from 0.2% in OF by headspace gas chromatography-flame-ionization detection. The stability of drugs in the samples was studied by analyzing the samples after 0, 14, and 28 days storage. The study shows that there are substantial differences between the OF collection devices on the market. Some are well suited for collecting samples for toxicological analysis, but some give quite poor results. Malignancy in unrecognized celiac disease: Population based cohort study Lohi, S., Maki, M., Laurila, K., Montonen, J., Bravi, E., Gasparin, M., K-Nekt, P., Reunanen, A. and Kaukinen, K. Journal of Pediatric Gastroenterology and Nutrition. 2007; 44: 22-22. Meeting Abstract. IF 2.102 Perinatal factors and the risk of asthma in childhood - A population-based register study in Finland Metsala, J., Kilkkinen, A., Kaila, M., Tapanainen, H., Klaukka, T., Gissler, M. and Virtanen, S. M. American Journal of Epidemiology. 2008; 168(2): 170-178. Article. IF 5.285 The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma. Body fat and mobility are explained by common genetic and environmental influences in older women Ortega-Alonso, A., Sipila, S., Kujala, U. M., Kaprio, J. and Rantanen, T. Obesity. 2008; 16(7): 1616-1621. Article. IF 1.520 In older adults, mobility limitations often coexist with overweight or obesity, suggesting that similar factors may underlie both traits. This study examined the extent to which genetic and environmental influences explain the association between adiposity and mobility in older women. Body fat percentage (bioimpedance test), walking speed over 10 m, and distance walked in a 6-min test were evaluated in 92 monozygotic (MZ) and 104 dizygotic (DZ) pairs of twin sisters reared together, aged 63-76 years. Genetic and environmental influences on each trait were estimated using age-adjusted multivariate genetic modeling. The analyses showed that the means ( and s.d.) for body fat percentage, walking speed, and walking endurance were 33.2 +/- 7.3%, 1.7 +/- 0.3 m/s and 529.7 +/- 75.4 m, respectively. The phenotypic correlation between adiposity and walking speed was -0.32 and between adiposity and endurance it was -0.33. Genetic influences explained 80% of the association between adiposity and speed, and 65% of adiposity and walking endurance. Cross-trait genetic influences accounted for 12% of the variability in adiposity, 56% in walking speed, and 34% in endurance. Trait-specific genetic influences were also detected for adiposity (54%) and walking endurance (13%), but not speed. In conclusion, among community-living older women, an inverse association was found between adiposity and mobility that was mostly due to the effect of shared genes. This result suggests that the identification of genetic variants for body fat metabolism may also provide understanding of the development of mobility limitations in older women. Hydrolethalus Syndrome: Neuropathology of 21 Cases Confirmed by HYLS1 Gene Mutation Analysis Paetau, A., Honkala, H., Salonen, R., Ignatius, J., Kestilä, M. and Herva, R. J Neuropathol Exp Neurol. 2008. IF 4.718 ABSTRACT: Hydrolethalus syndrome is a lethal malformation syndrome with a severe brain malformation, most often hydrocephaly and absent midline structures. Other frequent findings are micrognathia, polydactyly, and defective lobation of the lungs. Hydrolethalus syndrome is inherited in an autosomal recessive manner and is caused by a missense mutation in the HYLS1 gene. Here, we report the neuropathologic features of 21 genetically confirmed cases. Typically, 2 separated cerebral hemispheres could be identified, but they lacked midline and olfactory structures and were situated basally with a massive accumulation of cerebrospinal fluid. Temporal and occipital lobes were hypoplastic, and normally developed hippocampi were not found. Primitive thalami and basal ganglia were fused in the midline. A hypothalamic hamartoma was a frequent finding, and brainstem and cerebellum were hypoplastic. Three cases were hydranencephalic, and 1 was anencephalic. A midline "keyhole" defect in the skull base was a constant finding. Histologically, the cortex was dysplastic. This pattern of brain pathology, clearly belonging to the midline patterning defects, seems to be unique for the hydrolethalus syndrome and combines features of disturbed neurulation, prosencephalization, and migration. Despite variation in the clinicopathologic phenotype, all cases in the series carried the same homozygous missense mutation in HYLS1. Puisto, V., Rissanen, H., Heliövaara, M., Knekt, P. and Helenius, I. Ann Epidemiol. 2008; 18(8): 595-601. IF 2.353 PURPOSE: Vertebral fractures and scoliosis, unlike Scheuermann's disease, have been associated with increased mortality. Total and cause-specific mortalities of these spinal deformities were studied to produce epidemiologic knowledge. METHODS: A population of 16,010 Finnish men and women 20 to 92 years of age participated in a health examination from 1973-1976. Their spinal deformities were assessed from chest radiographs by two radiologists. Logistic regression and Cox's model were used to estimate risk ratios and to control confounding. The follow-up period was 30 years. RESULTS: Vertebral fracture significantly predicted total mortality, and this increase in mortality was due to an excess of cancer and respiratory deaths. The increased risk of cancer death persisted even when those subjects with a history of cancer and the first 5 years of follow-up were excluded to avoid the effect of metastatic fractures, and when confounding was controlled. In this analysis the relative risk of cancer death in subjects with a baseline vertebral fracture was 2.02 (95% confidence interval: 1.23-3.31). CONCLUSION: Vertebral fracture significantly predicted increased mortality from cancer. To clarify the mechanism, the fractures should be studied further for their associations with defined and site-specific cancer types. Rintamaki, H., Salo, H., Vaarala, O. and Kolho, K. L. Scandinavian Journal of Gastroenterology. 2008; 43: 39-39. Meeting Abstract. IF 1.758 Trends of socioeconomic differences in daily vegetable consumption, 1979-2002 Roos, E., Talala, K., Laaksonen, M., Helakorpi, S., Rahkonen, O., Uutela, A. and Prättälä, R. European Journal of Clinical Nutrition. 2008; 62(7): 823-833. Article. IF 2.326 Background: Studies from different time periods have shown that consumption of vegetables is more common in higher socioeconomic groups and among women. However, there are only few studies of changes of socioeconomic differences in vegetable consumption over time. Our aim was to determine whether socioeconomic differences, measured by educational level and household income, in daily vegetable consumption have increased, decreased or been stable over the last two decades among Finnish men and women. Methods: Data on daily consumption of fresh vegetables were derived from repeated annual cross-sectional surveys performed among representative samples of Finnish working aged ( 15-64 years) population. Data from the years 1979-2002 were linked with data on education and household income from Statistics Finland. Those under 25 years and all students were excluded, giving a total of 69 383 respondents. The main analyses were conducted with logistic regression. Results: Daily consumption of fresh vegetables became overall more prevalent during the study period. Daily consumption of fresh vegetables was more common among those with higher education and higher income during the whole study period. Both educational level and household income differences in daily vegetable consumption slightly narrowed since 1979 among men and women. Conclusions: Women with high socioeconomic position have been initial trend setters, but the prevalence of daily consumers of vegetables in these groups has not increased since the early 1990s. The prevalence of daily consumption of fresh vegetables has increased more in lower educational and income groups during the 1980s and 1990s along with narrowing socioeconomic differences. Prospective study of coffee consumption and risk of Parkinson's disease Sääksjärvi, K., Knekt, P., Rissanen, H., Laaksonen, M. A., Reunanen, A. and Männistö, S. European Journal of Clinical Nutrition. 2008; 62(7): 908-915. Article. IF 2.326 Objective: To examine the prediction of coffee consumption on the incidence of Parkinson's disease. Subjects and methods: The study population comprised 6710 men and women, aged 50-79 years and free from Parkinson's disease at the baseline. At baseline, enquiries were made about coffee consumption in a self-administered questionnaire as the average number of cups per day. During a 22-year follow-up, 101 incident cases of Parkinson's disease occurred. Parkinson's disease cases were identified through a nationwide registry of patients receiving medication reimbursement, which is based on certificates from neurologist. Results: After adjustments for age, sex, marital status, education, community density, alcohol consumption, leisure-time physical activity, smoking, body mass index, hypertension and serum cholesterol, the relative risk for subjects drinking 10 or more cups of coffee per day compared with non-drinkers was 0.26 (95% confidence interval 0.07-0.99, P-value for trend 0.18). The association was stronger among overweight persons and among persons with lower serum cholesterol level (P-value for interaction=0.04 and 0.03, respectively). Conclusions: The results support the hypothesis that coffee consumption reduces the risk of Parkinson's disease, but protective effect of coffee may vary by exposure to other factors. The patatin-like lipase family in Gallus gallus Saarela, J., Jung, G., Hermann, M., Nimpf, J. and Schneider, W. J. BMC Genomics. 2008; 9. Article. IF 4.180 Background: In oviparous species, genes encoding proteins with functions in lipid remodeling, such as specialized lipases, may have evolved to facilitate the assembly and utilization of yolk lipids by the embryo. The mammalian gene family of patatin-like phospholipases (PNPLAs) has received significant attention, but studies in other vertebrates are lacking; thus, we have begun investigations of PNPLA genes in the chicken (Gallus gallus). Results: We scanned the draft chicken genome using human PNPLA sequences, and performed PCR to amplify and sequence orthologous cDNAs. Full-length cDNA sequences of galline PNPLA2/ATGL, PNPLA4, -7, -8, -9, and the activator protein CGI-58, as well as partial cDNA sequences of avian PNPLA1, -3, and -6 were obtained. The high degree of sequence identities (similar to 50 to 80%) between the avian and human orthologs suggests conservation of important enzymatic functions. Quantitation by qPCR of the transcript levels of PNPLAs and CGI-58 in 21 tissues indicates that expression patterns and levels diverge greatly between species. A particularly interesting tissue in which certain PNPLAs may contribute to physiological specialization is the extraembryonic yolk sac. Conclusion: Knowledge about the exact in-vivo functions of PNPLAs in any system is still sparse. Thus, studies about the temporal expression patterns and functions of the enzymes identified here, and of other already known extracellular lipases and co-factors, in the yolk sac and embryonic tissues during embryogenesis are called for. Based on the information obtained, further studies are anticipated to provide important insights of the roles of PNPLAs in the yolk sac and embryo development. Ethically problematic treatment decisions in different medical specialties Saarni, S. I., Halila, R., Palmu, P. and Vänskä, J. J Med Ethics. 2008; 34(4): 262-7. IF 1.103 BACKGROUND: Ethical dilemmas are an integral part of medicine. Whether physicians actually feel that they have made ethically problematic treatment decisions or choices in their work is largely unknown. Identifying physicians with ethical problems, and the types of problems and underlying factors, might benefit organisational and educational efforts to help physicians solve ethical dilemmas in a constructive way. We investigated how the frequency and types of ethically difficult treatment decisions vary by specialty. METHOD: A mail survey of all non-retired Finnish physicians (n = 17,172, response rate 75.6%) was conducted in 2004. Of those who had made any ethically problematic treatment decisions, the types of decisions and reasons given for these decisions were asked for. Factor analysis was used to investigate clustering of ethically problematic treatment decisions, and logistic regression to investigate the effect of specialty, adjusted for age and gender. RESULTS: Psychiatrists experienced ethically problematic treatment decisions most frequently, followed by pulmonologists, internists and neurologists. Problems were reported least often by pathologists, laboratory physicians and ophthalmologists. Overtreatment was more common than undertreatment in most specialties, with the exception of psychiatrists who emphasised undertreatment and patient rights issues. CONCLUSION: Physicians of different specialties differ significantly regarding frequency and types of ethically problematic treatment decisions they have made. Psychiatrists differ from all other specialists in reporting more undertreatment and patient rights issues. Experiencing ethically problematic decisions might affect the quality of care and physician well-being in many ways. The findings could be useful for both under- and postgraduate ethics education. Systemic inflammation, genetic susceptibility and lung function Sunyer, J., Pistelli, R., Plana, E., Andreani, M., Baldari, F., Kolz, M., Koenig, W., Pekkanen, J., Peters, A. and Forastiere, F. European Respiratory Journal. 2008; 32(1): 92-97. Article. IF 5.349 Local inflammation in airway diseases is well recognised, but less is known about the association between low-grade systemic inflammatory processes and lung function. The aim of the present study was to assess the association between inflammatory markers and lung function, taking into account polymorphisms in genes coding for inflammatory markers. In 134 post-myocardial infarction patients, six repeated measurements of C-reactive protein (CRP), interleukin (IL)-6 and fibrinogen in peripheral blood were assayed using high-sensitivity tests. Spirometry was conducted at baseline. Genotyping of single nucleotide polymorphisms was performed in genes coding for the inflammatory markers. CRP and IL-6 levels were negatively associated with forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and mean forced expiratory flow between 25 and 75% of FVC (FEF25-75%). In the CRP gene, both the polymorphism rs1205 and the haplotype 2 showed a protective association with FEV1 and FEF25-75%, and, to a lesser extent, with FVC. rs1205 and haplotype 2 were both negatively associated with CRP levels in peripheral blood. Analysis with instrumental variables also showed a protective effect between these CRP gene polymorphisms and lung function. Results are very suggestive that heritability of lung function is at least partly controlled by the CRP gene. Applying a Mendelian randomisation approach, the study supports a causal association between low-grade general inflammation and airway diseases. Tiittanen, M., Westerholm-Ormio, M., Verkasalo, M., Savilahti, E. and Vaarala, O. Clin Exp Immunol. 2008; 152(3): 498-507. IF 2.599 Because the role of regulatory T cells in the intestinal inflammation is unknown in coeliac disease (CD) and type 1 diabetes (T1D), the expression of forkhead box P3 (FoxP3), CD25, transforming growth factor-beta, interferon (IFN)-gamma, interleukin (IL)-4, IL-8, IL-10, IL-15 and IL-18 was measured by quantitative reverse transcription-polymerase chain reaction in the small intestinal biopsies from paediatric patients with active or potential CD, T1D and control patients. The numbers of FoxP3- and CD25-expressing cells were studied with immunohistochemistry. Enhanced intestinal expressions of FoxP3, IL-10 and IFN-gamma mRNAs were found in active CD when compared with controls (P-values < 0.001, 0.004, <0.001). In potential CD, only the expression of IFN-gamma mRNA was increased. The numbers of FoxP3-expressing cells were higher in active and potential CD (P < 0.001, P = 0.05), and the ratio of FoxP3 mRNA to the number of FoxP3-positive cells was decreased in potential CD when compared with controls (P = 0.007). The ratio of IFN-gamma to FoxP3-specific mRNA was increased in active and potential CD (P = 0.001 and P = 0.002). Patients with T1D had no changes in regulatory T cell markers, but showed increased expression of IL-18 mRNA. The impaired up-regulation of FoxP3 transcripts despite the infiltration of FoxP3-positive cells in potential CD may contribute to the persistence of inflammation. The increased ratio of IFN-gamma to FoxP3 mRNA in active and potential CD suggests an imbalance between regulatory and effector mechanisms. The increased intestinal expression of IL-18 mRNA in patients with T1D adds evidence in favour of the hypothesis that T1D is associated with derangements in the gut immune system. Toropainen, M., Raitolehto, A., Henckaerts, I., Wauters, D., Poolman, J., Lestrate, P. and Käyhty, H. Infect Immun. 2008. IF 3.996 Haemophilus influenzae (Hi) outer membrane protein D (PD) is a glycerophosphodiester phosphodiesterase (GlpQ) activity possessing virulence factor and a promising vaccine antigen, providing 35.3% efficacy against acute otitis media caused by nontypeable Hi (NTHi) when used as a carrier protein in a novel pneumococcal PD conjugate (Pnc-PD) vaccine. To study if PD-induced protection against NTHi could be due to antibodies that inhibit, or neutralize, its enzymatic activity, a GlpQ enzyme-inhibition assay was developed and serum samples collected from Finnish infants before and after Pnc-PD vaccination were analyzed for enzyme inhibition and anti-PD immunoglobulin G (IgG) antibody concentration. Before vaccination at age 2 months, the majority (84%) of infants (n=69) had no detectable anti-PD IgG antibodies and all were enzyme inhibition assay negative (inhibition index < 20). At age 13-16 months, all infants receiving 3 or 4 doses of Pnc-PD had detectable anti-PD IgG antibodies and 36% (8/22) of the infants receiving 3 doses and 26% (6/23) of the infants receiving 4 doses of Pnc-PD were inhibition assay positive (inhibition index >/=20). No significant rise in anti-PD IgG antibodies or enzyme inhibition among control vaccinees (n=24) receiving three doses of hepatitis B vaccine was detected. A modest correlation (rs approximately 0.66) between anti-PD IgG concentration and enzyme inhibition was detected; however, their kinetics were clearly different. These data suggest that measurement of antibody responses that inhibit PD's enzymatic activity could be a useful tool for assessing Pnc-PD vaccine induced protective immunity against NTHi. Dioxin Cancer Risk - Example of Hormesis? Tuomisto, J., Pekkanen, J., Kiviranta, H., Tukiainen, E., Vartiainen, T., Viluksela, M. and Tuomisto, J. T. Dose Response. 2006; 3(3): 332-341. IF A recent case-control study implied an inverse correlation between the measured body burden of dioxins (polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans, PCDD/F) and the risk of soft tissue sarcoma in normal population exposed to dioxins mainly via food. The surprising result could not be explained by biases or confounding. There is no a priori confounding by occupational chemicals in a random sample from general population, but exposures to other lipid soluble chemicals with similar sources might be expected to associate with that of dioxins. One such group is polychlorinated biphenyls (PCB). Therefore three most relevant dioxin-like PCB compounds PCB 77, PCB 126, and PCB 169 were now analyzed from the same patients. Cases were 110 soft-tissue sarcoma patients undergoing surgery for their disease, and referents were 227 patients operated for appendicitis. Dioxin and PCB concentrations were analyzed from subcutaneous fat samples by high-resolution gas chromatography-mass spectrometry and TCDD equivalent concentrations (WHO-TEq) were calculated by using toxicity equivalency factors of WHO. The highest risk of sarcoma was found in the septile with the lowest body burden of sum WHO-TEq, and the differences of septiles 2 and 6 from septile 1 were statistically significant. If soft sarcoma risk is true at high occupational levels of dioxins, the provocative result suggests that a possibility of a J-shaped dose-response curve should be taken into consideration and studied further. This is also supported by the similar J-shaped dose responses in animal studies. |