5.12.2005

Absetz, P., Heinonen, H., Valve, R., Talja, M., Uutela, A., Nissinen, A. and Fogelholm, M.

Psychology & Health. 2005; 20: 10-11. Meeting Abstract

Attenuation of cue-induced cocaine seeking by glutamate receptor antagonism in the nucleus accumbens core

Bäckstrom, P. and Hyytiä, R.

Behavioural Pharmacology. 2005; 16: S63-S63. Meeting Abstract

Differences in the frequency of minor substitutions between HIV-1 subtypes and their potential impact on the genetic barrier for resistance to protease inhibitors

de Vijver, D. V., Wensing, A. M. J., Angarano, G., Asjo, B., Balotta, C., Boeri, E., Camacho, R., Chaix, M. L., Costagliola, D., de Coul, E., de Luca, A., Maljkovic, I., de Mendoza, C., Derdelinckx, I., Grossman, Z., Hamouda, O., Hatzakis, A., Hoepelman, I. M., Hemmer, R., Horban, A., Korn, K., Kucherer, C., Leitner, T., Loveday, C., MacRae, E., Meyer, L., Nielsen, C., Ormaasen, V., Perrin, L., Paraskevis, D., Puchhammer-Stockl, E., Ruiz, L., Salminen, M., Schmit, J. C. C., Schneider, F., Schuurman, R., Soriano, V., Stanczak, G., Stanojevic, M., Vandamme, A. M., Van Laethem, K., Violin, M., Wilbe, K., Yerly, S., Zazzi, M. and Boucher, C. A. B.

Antiviral Therapy. 2005; 10: S145-S145. Meeting Abstract

European nutrition and health report 2004.

Elmadfa I, Weichselbaum E, Konig J, de Winter A-M R, Trolle E, Haapala I, Uusitalo U, Mennen L, Hercberg S, Wolfram G, Trichopoulou A, Naska A, Benetou V, Kritsellis E, Rodler I, Zajkas G, Branca F, D'Acapito P, Klepp KI, Ali-Madar A, De Almeida MD, Alves E, Rodrigues S, Sarra-Majem L, Roman B, Sjostrom M, Poortvliet E, Margetts B.

Forum Nutr 2005;(58):1-220.

New quinolone resistance phenomenon in Salmonella enterica: Nalidixic acid-susceptible isolates with reduced fluoroquinolone susceptibility

Hakanen, A. J., Lindgren, M., Huovinen, P., Jalava, J., Siitonen, A. and Kotilainen, P.

Journal of Clinical Microbiology. 2005; 43(11): 5775-5778.

We describe the emergence of a new quinolone resistance pattern in Salmonella enterica isolates from Southeast Asia. These isolates are susceptible to nalidixic acid but exhibit reduced susceptibility to ciprofloxacin. The increase of such strains may threaten the value of the nalidixic acid disk test to screen for reduced fluoroquinolone susceptibility in salmonellas.

Improved fibrinolysis by an intensive lifestyle intervention in subjects with impaired glucose tolerance. The Finnish Diabetes Prevention Study

Hämäläinen, H., Ronnemaa, T., Virtanen, A., Lindström, J., Eriksson, J. G., Valle, T. T., Ilanne-Parikka, P., Keinanen-Kiukaanniemi, S., Rastas, M., Aunola, S., Uusitupa, M. and Tuomilehto, J.

Diabetologia. 2005; 48(11): 2248-2253.

Aims/hypothesis: The aim of this study was to investigate the effects of lifestyle intervention on the levels of plasminogen activator inhibitor (PAI-1) and fibrinogen in subjects participating in the Finnish Diabetes Prevention Study (DPS).

Methods: In five DPS centres, 321 subjects with impaired glucose tolerance (intervention group, n=163; control group, n=158) had their PAI-1 and fibrinogen levels measured at baseline and at the 1-year follow-up. Additional 3-year follow-up assessments were carried out in a sample of 97 subjects in one of the DPS centres (Turku). The intervention programme included an intensive lifestyle intervention aiming at weight reduction, healthy diet and increased physical activity.

Results: During the first intervention year, PAI-1 decreased by 31% in the intervention group but showed no change in the control group (p < 0.0001). In the Turku subgroup, the decrease in PAI-1 persisted throughout the 3-year follow-up. Changes in PAI-1 were associated with the number of lifestyle changes made during the first year (p=0.008). Weight reduction was the most important factor explaining the decrease in PAI-1. Changes in fibrinogen levels did not differ between the groups.

Conclusions/interpretation: In addition to the previously reported reduction in the risk of type 2 diabetes in DPS participants with impaired glucose tolerance, the intensive dietary and exercise intervention had beneficial long-term effects on fibrinolysis as indicated by the reduced levels of PAI-1. These results suggest that elevated PAI-1 levels in obese subjects with impaired glucose tolerance are mostly reversible by lifestyle changes, especially those geared to weight reduction.

Major depressive episode related to long unemployment and frequent alcohol intoxication

Hämäläinen, J., Poikolainen, K., Isometsä, E., Kaprio, J., Heikkinen, M., Lindeman, S. and Aro, H.

Nord J Psychiatry. 2005; 59(6): 486-91.

We studied the association between two major problems - unemployment and major depressive episode - and the impact of different timing of periods of unemployment and risk factors, especially alcohol intoxication, for major depressive episode among the unemployed. Major depressive episode during the last 12 months, plus current and past employment status and frequency of alcohol intoxication, were assessed within the nationally representative, cross-sectional 1996 Finnish Health Care Survey, in which non-institutionalized individuals aged 15-75 years were interviewed by using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form).

Of the 5993 subjects interviewed, 3818 (64%) were occupationally active and included in the logistic regression analysis, showing that even after adjusting for other potentially confounding variables, current unemployment was associated with major depressive episode (odds ratio, OR = 1.78, 95% confidence interval, CI, 1.38-2.29). Further analysis revealed that the increased risk of major depressive episode was only related to long-term unemployment. Frequent alcohol intoxication (at least once a week) increased the risk of major depressive episode remarkably. Compared with the group "Constantly employed, no frequent alcohol intoxication", long-term unemployment with no frequent alcohol intoxication had moderately increased risk of major depressive episode (OR = 1.72 (95% CI 1.29-2.30) and those with frequent alcohol intoxication had highly increased risk [OR = 11.27 (95% CI 5.51-23.09) vs. OR = 1.72 (95% CI 1.29-2.30].

Long-term unemployment is associated with increased risk of major depressive episode. Frequent alcohol intoxication among long-term unemployed individuals greatly increases the risk of depression.

A case study in comparing therapies involving informative drop-out, non-ignorable non-compliance and repeated measurements

Härkänen, T., Knekt, P., Virtala, E. and Lindfors, O.

Stat Med. 2005; 24(24): 3773-87.

Virtually no comparisons of different psychotherapies with long follow-up times have been carried out until now. The Helsinki Psychotherapy Study is a randomized clinical trial, where patients were monitored for 12 months after the onset of study treatments, of which each lasted approximately 6 months. The patients' psychiatric status was measured at five pre-determined time points during the follow-up period. In general, the analyses of trials are complicated in cases where compliance with the given treatment is incomplete or the drop-out from the follow-up is non-ignorable. In the present study, the quality of the treatment deviated from the protocol for some patients and some patients took auxiliary treatments which had similar effects to the study treatment during the study treatment or follow-up period. This might have resulted in standard intention-to-treat analyses providing excessively conservative or liberal conclusions. Non-compliance may have been non-ignorable in some cases, so subject-specific latent factors may have influenced the outcome both directly and indirectly via compliance behaviour. The most and least healthy patients are the most likely to dropout from the follow-up a priori, so the missing data process is informative. The missing data can partly be augmented with surrogate information collected during interviews with patients who dropped out. A Bayesian hierarchical as-treated model, which uses random-effects-based selection models to account for non-ignorable missing data and non-compliance, was compared with different mixed effects models. Copyright (c) 2005 John Wiley & Sons, Ltd.

Predictors of successful and unsuccessful efforts, intentions and reluctance to health behaviour change among middle-aged and older individuals

Heinonen, H., Absetz, P., Valve, R., Uutela, A., Fogelholm, M. and Nissinen, A.

Psychology & Health. 2005; 20: 111-112. Meeting Abstract

Glutamatergic control of cue-induced reinstatement of alcohol- and cocaine-seeking behaviour

Hyytiä, R. and Bäckström, P.

Behavioural Pharmacology. 2005; 16: S3-S3. Meeting Abstract

A resampling test for the total independence of stationary time series: Application to the performance evaluation of ICA algorithms

Karvanen, J.

Neural Processing Letters. 2005; 22(3): 311-324.

This paper addresses the independence testing of stationary time series. We develop a resampling test based on the Kankainen-Ushakov test of total independence. The resampling test, contrary to the original test, can be also applied to the data with a time-structure. The simulation studies demonstrate the good performance of the proposed test even with strongly autocorrelated time series. As an application, we consider biomedical signal processing and independent component analysis (ICA). The independence test can be used as a performance criterion for ICA algorithms. The practical example of performance evaluation deals with the ICA of electroencephalogram (EEG) data.

Genome-wide scan in a family study on nicotine dependence

Loukola, A., Maunu, H., Salo, A., Widen, E., Broms, U., Siivola, M., Heikkila, K., Peltonen, L., Madden, P. A. F. and Kaprio, J.

Nicotine & Tobacco Research. 2005; 7(4): 655-655. Meeting Abstract

Comparison of F-18-FDG and Ga-68 PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus

Mäkinen, T. J., Lankinen, P., Pöyhönen, T., Jalava, J., Aro, H. T. and Roivainen, A.

European Journal of Nuclear Medicine and Molecular Imaging. 2005; 32(11): 1259-1268.

Purpose: Although positron emission tomography (PET) using 2-[F-18]fluoro-2-deoxy-D-glucose (F-18-FDG) is a promising imaging modality for bone infections, the technique may still give false-positive results due to unspecific uptake in healing bone. This experimental study compared F-18-FDG and Ga-68 in PET imaging of osteomyelitis and normal bone healing.

Methods: A diffuse osteomyelitis model of the tibia was applied in the rat (n=50). Two weeks after operation, PET imaging with F-18-FDG and Ga-68 was performed, followed by peripheral quantitative computed tomography (pQCT) and radiography. Osteomyelitis was verified by quantitative bacteriology. In addition to in vivo imaging, ex vivo measurements of tissue radioactivity were performed to verify uptake of the tracers.

Results: Compared with controls with normal bone healing, the osteomyelitic tibias showed increased SUV ratios (i.e. radioactivity ratios between the operated and non-operated sides) for both F-18-FDG (1.74 +/- 0.37) and Ga-68 (1.62 +/- 0.28) (P < 0.001). Ex vivo measurements also showed increased tracer accumulation in the infected bone (P=0.003 for F-18-FDG and P < 0.001 for Ga-68). The intensity of Ga-68 uptake reflected pathological changes of osteomyelitic bones measured by pQCT. The uptake of F-18-FDG, however, did not show as close a correlation with the anatomical changes. The healing bones without infection exhibited slightly elevated uptake of F-18-FDG (SUV ratio 1.16 +/- 0.06), but Ga-68 did not accumulate in the healing bone, as judged on the basis of both in vivo imaging (SUV ratio 1.02 +/- 0.05) and ex vivo measurements (SUV 0.92 +/- 0.21) (P=0.003 and P=0.022 compared with F-18-FDG uptake, respectively).

Conclusion: This study suggests the feasibility of Ga-68 PET imaging of bone infections. However, further studies are needed to clarify the value of Ga-68 PET for clinical purposes.

The striatal deltafosb expression after 4-day cocaine treatment in alcohol-preferring AA and alcohol-avoiding ANA rats

Marttila, K., Raattamaa, H., Piepponen, T. P., Kiianmaa, K. and Ahlee, L.

Behavioural Pharmacology. 2005; 16: S18-S18. Meeting Abstract

A Community-Wide Outbreak of Legionnaires Disease Linked to Industrial Cooling Towers--How Far Can Contaminated Aerosols Spread?

Nhu Nguyen, T. M., Ilef, D., Jarraud, S., Rouil, L., Campese, C., Che, D., Haeghebaert, S., Ganiayre, F., Marcel, F., Etienne, J. and Desenclos, J. C.

J Infect Dis. 2006; 193(1): 102-111.

A community-wide outbreak of legionnaires disease occurred in Pas-de-Calais, France, in November 2003-January 2004. Eighteen (21%) of 86 laboratory-confirmed cases were fatal. A case-control study identified smoking, silicosis, and spending >100 min outdoors daily as risk factors for acquiring the disease. Legionella pneumophila strain Lens was isolated from cooling towers, wastewater, and air samples from plant A. This unique strain matched all 23 clinical isolates, as assessed by pulsed-field gel electrophoresis subtyping. Modeling of atmospheric dispersion of aerosols emitted from plant A cooling towers showed good coverage of the communes where patients lived and showed that the dispersion extended over a distance of at least 6 km from plant A. No other aerosol-producing installation was identified as a plausible source, and no common source of indoor exposure was found. These findings implicate plant A as the most likely outbreak source and suggest that the distance of airborne transmission of L. pneumophila may be greater than previously reported.

Enhanced morphine-induced ethanol drinking in alcohol-preferring AA rats sensitized to morphine

Ojanen, S. P., Hyytiä, R. and Kiianmaa, K.

Behavioural Pharmacology. 2005; 16: S59-S59. Meeting Abstract

Snacks as an element of energy intake and food consumption

Ovaskainen, M. L., Reinivuo, H., Tapanainen, H., Hannila, M. L., Korhonen, T. and Pakkala, H.

Eur J Clin Nutr. 2005.

Background:An increasing frequency of snacks has been observed in meal pattern studies. Snacks can alter the diet because of their high-energy density and low-nutrient content or on the contrary.Objective:The prominence of snacks in energy intake and food consumption was assessed.

Design:Dietary data were collected for 2007 adults by using a computer-assisted 48-h dietary recall in the national FINDIET 2002 survey. Energy intakes and food consumption were aggregated for snacks and for main meals.

Results:Daily energy was mostly derived from main meals comprising traditional mixed dishes, milk and bread. However, a snack-dominating meal pattern was observed in 19% of men and 24% of women. This meal pattern was associated with urbanization in both genders and with physical work in men. Higher sucrose intake and lower intake of micronutrients were typical of the snack-dominating meal pattern compared to the others.

Conclusions:As snacks appear to have a higher energy density and a lower content of micronutrients than main meals, a snack-dominating meal pattern is inadvisable. However, further studies are needed to examine the association between meal pattern and health status.European Journal of Clinical Nutrition advance online publication, 30 November 2005; doi:10.1038/sj.ejcn.1602343.

Indicative oligodendrocyte dysfunction in spinal cords of human fetuses suffering from a lethal motoneuron disease

Pakkasjarvi, N., Gentile, M., Saharinen, J., Honkanen, J., Herva, R., Peltonen, L. and Kestilä, M.

Journal of Neurobiology. 2005; 65(3): 269-281.

Human spinal cord development is still poorly understood and detailed molecular analyses of human motoneuron diseases could improve our understanding of the normal developmental processes of the spinal cord. Lethal Congenital Contracture Syndrome (LCCS, MIM 253310) provides a human model to study the early motoneuronal development. A typical phenotype of LCCS fetuses consists of multiple joint contractures, distinct facial features, and hydrops. Tissue pathology is characterized by severe muscle atrophy, lung hypoplasia, and degeneration of the anterior horn of the spinal cord as the hallmark of the syndrome. In this study we performed a global transcript analysis of LCCS spinal cords. The RNA expression profiles of these spinal cords were compared to age-matched healthy control fetuses, aborted for nonrelated causes. In addition, we applied phylogenetic footprinting methods to decipher the mechanisms of transcriptional regulation in the affected transcripts. Changes in transcripts involved with the development of the CNS and oligoden-drocytes were obvious and the transcription factor PAX6 was identified as a key regulator during spinal cord development. In addition, transcript pathway analysis clearly indicated genes belonging to groups with neuronal functions to be affected. Our findings support the hypothesis that human motoneurons and oligoden-drocytes are dependent on each other during their development and are influenced by distinct transcription factors previously known to act during murine and chick motoneuron development. These data provide valuable information about the molecular pathways putatively active in motoneuron diseases. (c) 2005 Wiley Periodicals, Inc.

The P38 MAPK pathway modulates replication and elimination of Salmonella enteritidis in HLA-B27 positive human monocytic cells

Sahlberg, A., Penttinen, M. A., Colbert, R. A. and Granfors, K. M.

Arthritis and Rheumatism. 2005; 52(9): S642-S642. Meeting Abstract

Chemical composition, mass size distribution and source analysis of long-range transported wildfire smokes in Helsinki

Sillanpaa, M., Saarikoski, S., Hillamo, R., Pennanen, A., Makkonen, U., Spolnik, Z., Van Grieken, R., Koskentalo, T. A. and Salonen, R. O.

Science of the Total Environment. 2005; 350(1-3): 119-135.

Special episodes of long-range transported particulate (PM) air pollution were investigated in a one-month field campaign at an urban background site in Helsinki, Finland. A total of nine size-segregated PM samplings of 3- or 4-day duration were made between August 23 and September 23, 2002. During this warm and unusually dry period there were two (labelled P2 and P5) sampling periods when the PM2.5 mass concentration increased remarkably. According to the hourly-measured PM data and backward air mass trajectories, P2 (Aug 23-26) represented a single, 64-h episode of long-range transported aerosol, whereas P5 (Sept 5-9) was a mixture of two 16- and 14-h episodes and usual seasonal air quality. The large chemical data set, based on analyses made by ion chromatography, inductively coupled plasma mass spectrometry, X-ray fluorescence analysis and smoke stain reflectometry, demonstrated that the PM2.5 mass concentrations of biomass signatures (i.e. levoglucosan, oxalate and potassium) and of some other compounds associated with biomass combustion (succinate and malonate) increased remarkably in P2. Crustal elements (Fe, Al, Ca and Si) and unidentified matter, presumably consisting to a large extent of organic material, were also increased in P2. The PM2.5 composition in P5 was different from that in P2, as the inorganic secondary aerosols (NO3-, SO42-, NH4+) and many metals reached their highest concentration in this period. The water-soluble fraction of potassium, lead and manganese increased in both P2 and P5. Mass size distributions (0.035-10 mu m) showed that a large accumulation mode mainly caused the episodically increased PM2.5 concentrations. An interesting observation was that the episodes had no obvious impact on the Aitken mode.

Finally, the strongly increased concentrations of biomass signatures in accumulation mode proved that the episode in P2 was due to long-range transported biomass combustion aerosol. (c) 2005 Elsevier B.V All rights reserved.

Effect on trend estimates of the difference between survey respondents and non-respondents: Results from 27 populations in the WHO MONICA project

Tolonen, H., Dobson, A. and Kulathinal, S.

European Journal of Epidemiology. 2005; 20(11): 887-898.

Introduction: In the World Health Organization (WHO) MONICA (multinational MONItoring of trends and determinants in CArdiovascular disease) Project considerable effort was made to obtain basic data on non-respondents to community based surveys of cardiovascular risk factors. The first purpose of this paper is to examine differences in socio-economic and health profiles among respondents and non-respondents. The second purpose is to investigate the effect of non-response on estimates of trends.

Methods:Socio-economic and health profile between respondents and non-respondents in the WHO MONICA Project final survey were compared. The potential effect of non-response on the trend estimates between the initial survey and final survey approximately ten years later was investigated using both MONICA data and hypothetical data.

Results: In most of the populations, non-respondents were more likely to be single, less well educated, and had poorer lifestyles and health profiles than respondents. As an example of the consequences, temporal trends in prevalence of daily smokers are shown to be overestimated in most populations if they were based only on data from respondents.

Conclusions: The socio-economic and health profiles of respondents and non-respondents differed fairly consistently across 27 populations. Hence, the estimators of population trends based on respondent data are likely to be biased. Declining response rates therefore pose a threat to the accuracy of estimates of risk factor trends in many countries.

Monogenic autoimmune diseases - lessons of self-tolerance

Ulmanen, I., Halonen, M., Ilmarinen, T. and Peltonen, L.

Current Opinion in Immunology. 2005; 17(6): 609-615.

The molecular defects recently identified in the rare monogenic autoimmune diseases (AIDs) have pinpointed critical steps in the pathways that contribute to the development of normal immune responses and self-tolerance. Recent studies of autoimmune polyendocrinopathy syndrome type 1, autoimmune lymphoproliferative syndrome, immunodysregulation, polyendocrinopathy and enteropathy, X-linked, IL-2 receptor a-chain deficiency, and, in particular, their corresponding mouse models, have revealed the details of the molecular mechanisms of normal immune tolerance, and exposed how defects in these mechanisms result in human autoimmunity. In addition to a deeper understanding of the immune system, detailed molecular characterization of monogenic AIDs will help us to understand the mechanisms behind common polygenic AIDs and, furthermore, to develop novel therapies and intervention strategies to treat them.

Defective insulin receptor activation and altered lipid rafts in Niemann-Pick type C disease hepatocytes

Vainio, S., Bykov, I., Hermansson, M., Jokitalo, E., Somerharju, P. and Ikonen, E.

Biochemical Journal. 2005; 391: 465-472.

Niemann-Pick type C (NPC) disease is a neuro-visceral cholesterol storage disorder caused by mutations in the NPC-1 or NPC-2 gene. In the present paper, we studied IR (insulin receptor) activation and the plasma-membrane lipid assembly in primary hepatocytes from control and NPC1-/- mice. We have previously reported that, in hepatocytes, IR activation is dependent on cholesterol-sphingolipid rafts [Vainio, Heino, Mansson, Fredman, Kuismanen, Vaarala and Ikonen (2002) EMBO Rep. 3, 95-100]. We found that, in NPC hepatocytes, IR levels were up-regulated and the receptor activation was compromised. Defective IR activation was reproduced in isolated NPC plasma-membrane preparations, which displayed an increased cholesterol content and saturation of major phospholipids. The NPC plasma membranes were less fluid than control membranes as indicated by increased DPH (1,6-diphenyl-1,3,5-hexatriene) fluorescence anisotropy values. Both in NPC hepatocytes and plasma-membrane fractions, the association of IR with low-density DRMs (detergent-resistant membranes) was increased. Moreover, the detergent resistance of both cholesterol and phosphatidylcholine were increased in NPC membranes. Finally, cholesterol removal inhibited IR activation in control membranes but restored IR activation in NPC membranes. Taken together, the results reveal a lipid imbalance in the NPC hepatocyte, which increases lipid ordering in the plasma membrane, alters the properties of lipid rafts and interferes with the function of a raft-associated plasma-membrane receptor. Such a mechanism may participate in the pathogenesis of NPC disease and contribute to insulin resistance in other disorders of lipid metabolism.

Ambient air pollution is associated with increased risk of hospital cardiac readmissions of myocardial infarction survivors in five European cities

von Klot, S., Peters, A., Aalto, P., Bellander, T., Berglind, N., D'Ippoliti, D., Elosua, R., Hormann, A., Kulmala, M., Lanki, T., Lowel, H., Pekkanen, J., Picciotto, S., Sunyer, J. and Forastiere, F.

Circulation. 2005; 112(20): 3073-3079.

Background - Ambient air pollution has been associated with increases in acute morbidity and mortality. The objective of this study was to evaluate the short-term effects of urban air pollution on cardiac hospital readmissions in survivors of myocardial infarction, a potentially susceptible subpopulation.

Methods and Results - In this European multicenter cohort study, 22 006 survivors of a first myocardial infarction were recruited in Augsburg, Germany; Barcelona, Spain; Helsinki, Finland; Rome, Italy; and Stockholm, Sweden, from 1992 to 2000. Hospital readmissions were recorded in 1992 to 2001. Ambient nitrogen dioxide, carbon monoxide, ozone, and mass of particles < 10 mu m ( PM10) were measured. Particle number concentrations were estimated as a proxy for ultrafine particles. Short-term effects of air pollution on hospital readmissions for myocardial infarction, angina pectoris, and cardiac causes ( myocardial infarction, angina pectoris, dysrhythmia, or heart failure) were studied in city-specific Poisson regression analyses with subsequent pooling. During follow-up, 6655 cardiac readmissions were observed. Cardiac readmissions increased in association with same-day concentrations of PM10 ( rate ratio [ RR] 1.021, 95% CI 1.004 to 1.039) per 10 mu g/m(3)) and estimated particle number concentrations ( RR 1.026 [ 95% CI 1.005 to 1.048] per 10 000 particles/cm(3)). Effects of similar strength were observed for carbon monoxide ( RR 1.014 [ 95% CI 1.001 to 1.026] per 200 mu g/m(3) [ 0.172 ppm]), nitrogen dioxide ( RR 1.032 [ 95% CI 1.013 to 1.051] per 8 mu g/m(3) [ 4.16 ppb]), and ozone ( RR 1.026 [ 95% CI 1.001 to 1.051] per 15 mu g/m(3) [ 7.5 ppb]). Pooled effect estimates for angina pectoris and myocardial infarction readmissions were comparable.

Conclusions - The results suggest that ambient air pollution is associated with increased risk of hospital cardiac readmissions of myocardial infarction survivors in 5 European cities.