| New articles - Uudet artikkelit
29.1.2007 - ISI Web of Knowledge & PubMed Search Alert |
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Use of health services for major depressive and anxiety disorders
in Finland
Hamalainen, J., Isometsa, E., Sihvo, S., Pirkola, S. and Kiviruusu, O. Depress Anxiety. 2007. Journal article. IF 1.975 Factors associated with people suffering from major depressive disorder (MDD) or anxiety disorders seeking or receiving treatment are not well known. In the Health 2000 Study, a representative sample (n=6005) of Finland's general adult (>/=30 years) population was interviewed with the M-CIDI for mental disorders and health service use for mental problems during the last 12 months. Predictors for service use among those with DSM-IV MDD (n=298) or anxiety disorders (n=242) were assessed. Of subjects with MDD, anxiety disorders, or both, 34%, 36%, and 59% used health services, respectively. Greater severity and perceived disability, psychiatric comorbidity, and living alone predicted health care use for MDD subjects, and greater perceived disability, psychiatric comorbidity, younger age, and parent's psychiatric problems for anxiety disorder subjects. The use of specialist-level mental health services was predicted by psychiatric comorbidity, but not characteristics of the disorders per se. Perceived disability and comorbidity are factors influencing the use of mental health services by both anxiety disorder and MDD subjects. However, still only approximately one-half of those suffering from even severe and comorbid disorders use health services for them. Depression and Anxiety 0:1-11, 2007. (c) 2007 Wiley-Liss, Inc. Type 2 diabetes and the risk of Parkinson's disease Hu, G., Jousilahti, P., Bidel, S., Antikainen, R. and Tuomilehto, J. Diabetes Care. 2007. Journal article. IF 7.844 Objective: The aim of this study was to evaluate whether type 2 diabetes at baseline is a risk factor for Parkinson's disease. Research design and methods: We prospectively followed 51 552 Finnish men and women of 25 to 74 years of age without a history of Parkinson's disease at baseline. History of diabetes and other study parameters were determined at baseline using standardized measurements. Ascertainment of the Parkinson's disease status was based on the nationwide Social Insurance Institution's Drug Register data. Hazards ratios of incident Parkinson's disease associated with the history of type 2 diabetes were estimated. Result: During a mean follow up period of 18.0 years, 324 men and 309 women developed incident Parkinson's disease. Age-and study year-adjusted hazard ratios of incident Parkinson's disease among subjects with type 2 diabetes, compared to those without it, were 1.80 (95% CI 1.03-3.15) in men, 1.93 (95% CI 1.05-3.53) in women, and 1.85 (95% CI 1.23-2.80) in men and women combined (adjusted also for sex), respectively. Further adjustment for body mass index, systolic blood pressure, total cholesterol, education, leisure time physical activity, smoking, alcohol drinking, coffee and tea consumption affected the results only slightly. The multivariate adjusted association between type 2 diabetes and the risk of Parkinson's disease was also confirmed in stratified subgroup analysis. Conclusion: These data suggest that type 2 diabetes is associated with an increased risk of Parkinson's disease. Surveillance bias might account for higher rates in diabetes. The mechanism behind this association between diabetes and Parkinson's disease is not known. Hu, G., Tuomilehto, J., Borodulin, K. and Jousilahti, P. Eur Heart J. 2007. Journal article. IF 7.341 AIMS: To determine joint associations of different kinds of physical activity and the Framingham risk score (FRS) with the 10-year risk of coronary heart disease (CHD) events. METHODS AND RESULTS: Study cohorts included 41 053 Finnish participants aged 25-64 years without history of CHD and stroke. The multivariable-adjusted 10-year hazard ratios (HRs) of coronary events associated with low, moderate, and high occupational physical activity were 1.00, 0.66, and 0.74 (P(trend) < 0.001) for men, and 1.00, 0.53, and 0.58 (P(trend) < 0.001) for women, respectively. The multivariable-adjusted 10-year HRs of coronary events associated with low, moderate, and high leisure-time physical activity were 1.00, 0.97, and 0.66 (P(trend) = 0.002) for men, and 1.00, 0.74, and 0.54 (P(trend) = 0.003) for women, respectively. Active commuting had a significant inverse association with 10-year risk of coronary events in women only. The FRS predicted 10-year risk of coronary events among both men and women. The protective effects of occupational, commuting, or leisure-time physical activity were consistent in subjects with a very low ( < 6 % ), low (6-9 % ), intermediate (10-19 % ), or high ( >/= 20 % ) risk of the FRS. CONCLUSION: Moderate or high levels of occupational or leisure-time physical activity among both men and women, and daily walking or cycling to and from work among women are associated with a reduced 10-year risk of CHD events. These favourable effects of physical activity on CHD risk are observed at all levels of CHD risk based on FRS assessment. Kajantie, E., Phillips, D. I., Osmond, C., Barker, D. J., Forsen, T. and Eriksson, J. G. J Clin Endocrinol Metab. 2006; 91(12): 4953-6. Journal Article. IF 6.020 Research Support, Non-U.S. Gov't. BACKGROUND: The relationships of early growth with coronary heart disease and type 2 diabetes have received considerable attention. It is not known whether fetal or childhood growth is linked with autoimmune disorders. OBJECTIVE: Our objective was to assess whether the risk of adult-onset spontaneous hypothyroidism is predicted by body size at birth and during childhood. DESIGN AND SETTING: We conducted a birth cohort study in Helsinki, Finland. PARTICIPANTS: A total of 293 women who were born between 1934 and 1944 and had their heights and weights recorded at birth and during childhood participated in the study. MEASUREMENTS: We measured spontaneous hypothyroidism, defined as: 1) a disease history confirmed from medical records, or 2) previously undiagnosed hypothyroidism (TSH > 10 mU/liter). RESULTS: Twenty women (6.8%) had spontaneous hypothyroidism; 18 had been diagnosed previously, between 43 and 65 yr of age, and two had undiagnosed subclinical hypothyroidism. In addition, 59 women were thyroid peroxidase antibody positive. Compared with the 214 thyroid peroxidase antibody-negative women with no thyroid disorder, those with spontaneous hypothyroidism had on average 252 g [95% confidence interval (CI), 61 to 443 g; P = 0.01] lower birth weight and 1.2 cm (95% CI, 0.5 to 2.0 cm; P = 0.002) shorter length at birth. The odds of developing hypothyroidism increased 4.4-fold per kilogram decrease in birth weight (95% CI, 1.4 to 14.1). Hypothyroid subjects had been shorter in early childhood and had lower body mass index during later childhood. CONCLUSIONS: Small body size at birth and during childhood increases the risk of spontaneous hypothyroidism in adult women. Kaprio, J. Twin Res Hum Genet. 2006; 9(6): 772-7. Journal Article Research Support, Non-U.S. Gov't. In studies on the Finnish Twin Cohorts, genetic and environmental determinants of common, complex diseases, and their behavioral risk factors have been investigated in Finland. In 1974, the older twins were identified, with a total of 13,888 like-sexed pairs of known zygosity. They have participated since 1975 in mail surveys, clinical examinations for subsamples, have been used to recruit families, and have been followed up for morbidity using national medical registers. Opposite twin pairs were added later. Two longitudinal studies of adolescent twins and their families, known as the FinnTwin12 and FinnTwin16 studies, have focused on determinants of health-related behaviors and disease in adolescents and young adults. This article describes current, ongoing data collection and analyses. Novel conjugate vaccine decreases incidence of otitis media Kilpi, T. J Pediatr. 2006; 149(1): 142-3. Comment. IF 3.837 Investigation of KIR gene frequencies in type 1 diabetes mellitus Middleton, D., Halfpenny, I., Meenagh, A., Williams, F., Sivula, J. and Tuomilehto-Wolf, E. Human Immunology. 2006; 67(12): 986-990. Article. IF 2.467 The frequency of killer immunoglobulinlike receptors (KIR) genes was examined in type 1 diabetes metlitus patients and controls from Finland. The KIR gene 2DS5 was significantly decreased in patients versus controls, but this was no longer significant after correction for the number of comparisons made. (c) American Society for Histocompatibility and Immunogenetics, 2006. Published by Elsevier Inc. Penttinen, P., Pelkonen, J., Huttunen, K. and Hirvonen, M. R. Toxicology and Applied Pharmacology. 2006; 217(3): 342-351. Article. IF 3.148 We have recently shown that the actinobacterium Streptomyces californicus and the fungus Stachybotrys chartarum originating from moisture damaged buildings possess both immunotoxic and immunostimulatory characteristics, which are synergistically potentiated by microbial interaction. In the search for the causative agent(s) behind the immunotoxicity, the cytostatic effects of the co-cultivated spores of S. calfornicus and S. chartarum were compared to those caused by widely used cytostatic agents produced by streptomycetes. The RAW264.7 macrophages were exposed to four doses of doxorubicin (DOX), actinomycin D (AMD), mitomycin C (MMC) or phleomycin (PHLEO) for 24 h. Kinetics of the spores of the co-cultivated and the separately cultivated microbes (1 x 10(6) spores/ml) was compared to DOX (0.15 mu M). Apoptotic responses were analyzed by measuring DNA content and mitochondria membrane depolarization with flow cytometer, and by the fluorometric caspase-3 assay. The present data indicate that interactions during co-cultivation of S. californicus and S. chartarum stimulate the production of an unidentified cytostatic compound(s) capable of inducing mitochondria mediated apoptosis and cell cycle arrest at S-G(2)/M. The spores of co-cultivated microbes caused a 4-fold collapse of mitochondrial membrane potential and an almost 6-fold caspase-3 activation and DNA fragmentation when compared to control. Similar responses were induced by DNA cleaving compounds, especially DOX and AMD, at the relatively low concentrations, but not the spores of the same microbes when they were grown separately. These data suggest that when growing in the same habitat, interactions between S. calfornicus and S. chartarum stimulates the production of an unknown cytostatic compound(s) which evoke immunotoxic effects similar to those by chemotherapeutic drugs. (c) 2006 Elsevier Inc. All rights reserved. Pietila, T. E., Veckman, V., Lehtonen, A., Lin, R. T., Hiscott, J. and Julkunen, L. Journal of Immunology. 2007; 178(1): 253-261. Article. IF 6.387 CCL19 chemokine has a central role in dendritic cell (DC) biology regulating DC traffic and recruitment of naive T cells to the vicinity of activated DCs. In this study, we have analyzed the regulation of CCL19 gene expression in human monocyte-derived DCs. DCs infected with Salmonella enterica or Sendai virus produced CCL19 at late times of infection. The CCL19 promoter was identified as having two putative NF-kappa B binding sites and one IFN-stimulated response element (ISRE). Transcription factor binding experiments demonstrated that Salmonella or Sendai virus infection increased the binding of classical p50+p65 and alternative p52+RelB NF-kappa B proteins to both of the CCL19 promoter NF-kappa B elements. Interestingly, Salmonella or Sendai virus infection also increased the binding of multiple IFN regulatory factors (IRFs), STAT1, and STAT2, to the ISRE element. Enhanced binding of IRF1, IRF3, IRF7, and IRF9 to the CCL19 promoter ISRE site was detected in Salmonella or Sendai virus-infected cell extracts. The CCL19 promoter in a luciferase reporter construct was activated by the expression of NF-kappa B p50+p65 or p52+RelB dimers. IRF1, IRF3, and IRF7 proteins also activated CCL19 promoter in the presence of Sendai virus infection. CCL19 promoter constructs mutated at NF-kappa B and/or ISRE sites were only weakly activated. Ectopic expression of RIG-I (Delta RIG-1, CARDIF) or TLR3/4 (TRIF, MyD88, IKK epsilon, or TBK1) signaling pathway components induced CCL19 promoter activity, suggesting that these pathways are important in CCL19 gene expression. Our experiments reveal that expression of the CCL19 gene is regulated by a combined action of several members of the NF-kappa B, IRF, and STAT family transcription factors. Saarni, S. I., Harkanen, T., Sintonen, H., Suvisaari, J., Koskinen, S., Aromaa, A. and Lonnqvist, J. Qual Life Res. 2006; 15(8): 1403-14. Journal Article. IF 1.915 Research Support, Non-U.S. Gov't. BACKGROUND: Health-related quality of life (HRQoL) is an essential outcome of health care, but there is no gold standard of HRQoL measurement. We investigated the impact of major chronic conditions on HRQoL using 15D and EQ-5D in a representative sample of Finns. METHODS: Information on chronic somatic conditions was obtained by interviews. Psychiatric disorders were diagnosed using a structured interview (M-CIDI). Tobit and CLAD regression analysis was used to estimate the impact of conditions on HRQoL at the individual and population level. MAIN RESULTS: Adjusted for other conditions and sociodemographic variables, Parkinson's disease had the largest negative impact on HRQoL at the individual level, followed by anxiety disorders, depressive disorders and arthrosis of the hip and knee. Based on prevalence, arthrosis of the hip or knee, depression, back problems and urinary incontinence caused the greatest loss of HRQoL at the population level. The results obtained with the two HRQoL measures differed markedly for some conditions and the EQ-5D results also varied with the regression method used. CONCLUSIONS: Musculoskeletal disorders are associated with largest losses of HRQoL in the Finnish population, followed by psychiatric conditions. Different HRQoL measures may systematically emphasize different conditions. |