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New articles - Uudet artikkelit 5.6.2009 - ISI Web of Knowledge & PubMed Search Alert
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Maintenance treatment received by patients with bipolar I and II disorders - A naturalistic prospective study
Arvilommi, P., Suominen, K., Mantere, O., Leppämäki, S., Valtonen, H. M. and Isometsä, E. J Affect Disord. 2009. IF 3.144 BACKGROUND: We investigated the adequacy of maintenance phase pharmacotherapy received by psychiatric in- and outpatients with bipolar I or II disorder, including patients both with and without a clinical diagnosis of bipolar disorder (BD). METHODS: In the Jorvi Bipolar Study (JoBS), a naturalistic prospective 18-month study representing psychiatric in- and outpatients with DSM-IV BD I and II in three Finnish cities, we studied the adequacy of pharmacological treatment received by 154 patients during the first maintenance phase after index episode. Information on treatments prescribed during the follow-up was gathered in interviews and from psychiatric records. RESULTS: Of the patients with a maintenance phase in follow-up, adequate maintenance treatment was received by 75.3% for some time, but by only 61.0% throughout the maintenance phase and for 69.3% of the time (783/1129 patient months) indicated. Uninterrupted adequate maintenance treatment received was most strongly independently associated with having a clinical diagnosis of BD; other associations included inpatient treatment, rapid cycling and not having a personality disorder. LIMITATIONS: Adequacy of dosage, duration or serum concentrations were not estimated. Findings represent an upper limit for adequate treatment within the cohort. CONCLUSIONS: Provision or continuity of maintenance treatment was found to be compromised in more than one-third of BD patients during their first follow-up maintenance phase. As expected, clinical diagnosis of BD has a decisive role in determining adequacy of maintenance treatments. However, also rapid cycling may facilitate provision of adequate maintenance treatment, whereas outpatients and those with comorbid personality disorders may be disadvantaged subgroups. Bernabe, E., Tsakos, G., Watt, R. G., Suominen-Taipale, A. L., Uutela, A., Vahtera, J. and Kivimäki, M. Quality of Life Research. 2009; 18(5): 629-636. Article. IF 2.466 To examine the structure of the sense of coherence (SOC) scale in a general population. This study analysed the responses of 6,217 subjects aged 30 years and over who participated in the Finnish Health 2000 survey (response rate 77.4%). Participants completed an abbreviated 12-item version of the SOC scale. Two alternative structures were tested using confirmatory factor analysis: a one-factor model, with all scale items loaded onto a single latent factor representing the SOC construct, versus a second-order factor model, with scale items loaded onto their corresponding latent factors representing the three SOC components (comprehensibility, manageability and meaningfulness), which are, in turn, dependent on one single higher-order SOC construct. The one-factor model was fitted to the data after allowing the errors of comprehensibility item 5 and manageability item 6 to correlate, as was done in previous studies among Finnish adults. The comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA) for the one-factor model were, respectively, 0.97-0.98, 0.96-0.97 and 0.05-0.09 across both sexes and three age groups. The second-order factor model had correlations between latent factors higher than 1, even after alternative model modifications, casting doubts on this more complex structure. These data suggest that the components of comprehensibility, manageability and meaningfulness should be merged when measuring SOC with the 12-item SOC scale in the Finnish general population. Cheng, F., Weidner-Glunde, M., Varjosalo, M., Rainio, E. M., Lehtonen, A., Schulz, T. F., Koskinen, P. J., Taipale, J. and Ojala, P. M. Plos Pathogens. 2009; 5(3). Article. IF 9.336 Host signal-transduction pathways are intimately involved in the switch between latency and productive infection of herpes viruses. As with other herpes viruses, infection by Kaposi's sarcoma herpesvirus (KSHV) displays these two phases. During latency only few viral genes are expressed, while in the productive infection the virus is reactivated with initiation of extensive viral DNA replication and gene expression, resulting in production of new viral particles. Viral reactivation is crucial for KSHV pathogenesis and contributes to the progression of KS. We have recently identified Pim-1 as a kinase reactivating KSHV upon over-expression. Here we show that another Pim family kinase, Pim-3, also induces viral reactivation. We demonstrate that expression of both Pim-1 and Pim-3 is induced in response to physiological and chemical reactivation in naturally KSHV-infected cells, and we show that they are required for KSHV reactivation under these conditions. Furthermore, our data indicate that Pim-1 and Pim-3 contribute to viral reactivation by phosphorylating the KSHV latency-associated nuclear antigen (LANA) on serine residues 205 and 206. This counteracts the LANA-mediated repression of the KSHV lytic gene transcription. The identification of Pim family kinases as novel cellular regulators of the gammaherpesvirus life cycle facilitates a deeper understanding of virus-host interactions during reactivation and may represent potential novel targets for therapeutic intervention. Crohns, M., Liippo, K., Kankaanranta, H., Moilanen, E., Alho, H. and Kellokumpu-Lehtinen, P. Lung Cancer. 2009; 64: S65-S65. Meeting Abstract. IF 3.455 Depression and C-Reactive Protein: Population-Based Health 2000 Study Elovainio, M., Aalto, A. M., Kivimäki, M., Pirkola, S., Sundvall, J., Lönnqvist, J. and Reunanen, A. Psychosomatic Medicine. 2009; 71(4): 423-430. Article. IF 3.109 Objective: To test whether depression is independently associated with elevated levels of C-reactive protein (CRP) in a large nationwide population-based sample. Methods: Depression and CRP were assessed in 6005 Finns aged > 30 years, as part of the ongoing population-based Health 2000 Study. Depression was determined by responses to the Beck's Depression Inventory (BDI-21) and by Composite International Diagnostic Interview (CIDI). Results: Higher scores on BDI-21 were related to higher CRP levels (beta = 0.12, p < .001) in men and (beta = 0.08, p < .001) in women. In men, but not in women, this relationship persisted after adjustment for a number of other known risk factors. In men, the more recent dysthymic disorder or at least moderate depressive episode defined using CIDI was related to elevated CRY levels (beta = 0.06, p = .006). Conclusions: Depressive symptoms may be partly responsible for inflammatory processes, and inflammatory processes may induce depressive symptoms in men. Impinen, A., Rahkonen, O., Karjalainen, K., Lintonen, T., Lillsunde, P. and Ostamo, A. Traffic Injury Prevention. 2009; 10(3): 220-226. Article. Background: Recidivism is a major problem in the prevention of DUI offenses. It is suggested that impairing substances used by drivers may relate to a higher risk of recidivism. This study aims to determine rearrest rates in different groups of arrested drivers focusing on different substances found in the blood. Material and Methods: The data utilized were obtained from the register of suspected DUI offenders maintained by the Finnish National Institute for Health and Welfare (THL). Data were available for the 15-year period between 1993 and 2007. The number of rearrests was traced from the individuals' ID codes. The mean blood alcohol concentration (BAC) of the DUI offenders was studied as well as their age at the time of the first arrest. Rearrest rates according to alcohol and drug findings were estimated using survival analysis methods. Results: At the time of the first arrest, the drivers with a single DUI arrest were older and had a lower BAC than those who had a later arrest. The proportion of female drivers decreased as the number of rearrests increased. Drivers with drugs only or a combination of drugs and alcohol had a significantly higher rearrest rate than drivers with alcohol alone. Drivers with amphetamines only had the highest rearrest rates. Findings of benzodiazepine and opioids alone did not increase the risk of rearrest in the long run. Young age, male sex, high blood alcohol level, and arrest during the nighttime and during weekdays constituted a higher risk for rearrest. Conclusions: A third of those suspected of driving under the influence of alcohol and/or drugs are rearrested within 15 years. Drugs, especially amphetamines, are a risk factor for faster rearrest. These results show that the groups at risk of recidivism can be pinpointed. Interventions to prevent recidivism should be developed particularly for drugged drivers. Substance abuse beginning in adolescence seems to be a greater risk. Neuronal ceroid lipofuscinoses Jalanko, A. and Braulke, T. Biochim Biophys Acta. 2009; 1793(4): 697-709. IF 4.374 The neuronal ceroid lipofuscinoses (NCL) are severe neurodegenerative lysosomal storage disorders of childhood, characterized by accumulation of autofluorescent ceroid lipopigments in most cells. NCLs are caused by mutations in at least ten recessively inherited human genes, eight of which have been characterized. The NCL genes encode soluble and transmembrane proteins, localized to the endoplasmic reticulum (ER) or the endosomal/lysosomal organelles. The precise function of most of the NCL proteins has remained elusive, although they are anticipated to carry pivotal roles in the central nervous system. Common clinical features in NCL, including retinopathy, motor abnormalities, epilepsia and dementia, also suggest that the proteins may be functionally linked. All subtypes of NCLs present with selective neurodegeneration in the cerebral and cerebellar cortices. Animal models have provided valuable data about the pathological characteristics of NCL and revealed that early glial activation precedes neuron loss in the thalamocortical system. The mouse models have also been efficiently utilized for the evaluation of therapeutic strategies. The tools generated by the accomplishments in genomics have further substantiated global analyses and these have initially provided new insights into the NCL field. This review summarizes the current knowledge of the NCL proteins, basic characteristics of each disease and studies of pathogenetic mechanisms in animal models of these diseases. Community-associated methicillin-resistant Staphylococcus aureus, 2004-2006, Finland Kanerva, M., Salmenlinna, S., Vuopio-Varkila, J., Lehtinen, P., Möttönen, T., Virtanen, M. J. and Lyytikäinen, O. J Clin Microbiol. 2009. IF 3.708 A nationwide population-based study on community-associated MRSA (CA-MRSA) in Finland during 2004-2006 showed that both incidence (1.9/100,000 population) and strain variation increased in comparison to years 1997-1999. There were seven community-associated epidemic and 25 sporadic MRSA strain types. Half of these had Panton Valentine Leukocidin (PVL) genes. Kylaniemi, M. K., Haveri, A., Vuola, J. M., Puolakkainen, M. and Lahesmaa, R. Microbial Pathogenesis. 2009; 46(5): 235-242. Article. IF 2.064 in this study experimental mouse model for Chlamydia pneumoniae infection was used to elucidate the nature of immune response developing during primary and secondary infection. First we examined the mononuclear cells from different lymphoid organs in BALB/c mice during C. pneumoniae infection and detected a strong lymphocyte influx into mediastinal lymph nodes (MLN). To further characterize the C pneumoniae induced immune response the gene expression profiles of MLN derived lymphocytes was studied. To identify genes characteristic for reinfection we compared gene expression profiles during reinfection and primary infection and found 148 genes to be differentially regulated in CD19+ cells, 7 in CD4+ cells and 12 in CD8+ cells. A panel of these genes was selected to be confirmed by real-time RTPCR. Genes related to interferon signaling like Ifit1, Ifit3, Gbp2, Irf7 and Usp18 were found to be upregulated when reinfection was compared to primary infection. In our study we were able to identify 8 genes that were differentially expressed between reinfection and primary infection in lymphocytes. These novel gene expression signatures provide new insights and clues to the nature of protective immunity established during experimental C pneumoniae immunity. (C) 2009 Elsevier Ltd. All rights reserved. Linder, M. D., Mäyränpää, M. I., Peränen, J., Pietilä, T. E., Pietiäinen, V. M., Uronen, R. L., Olkkonen, V. M., Kovanen, P. T. and Ikonen, E. Arteriosclerosis Thrombosis and Vascular Biology. 2009; 29(6): 883-U259. Article. IF 7.221 Objective-ATP-binding cassette transporter A1 (ABCA1) is thought to lipidate apolipoprotein A-I (apoA-I) at the plasma membrane, with endosomal cholesterol contributing as substrate. The mechanisms of ABCA1 surface delivery are not well understood. We have shown that Rab8 regulates endosomal cholesterol removal to apoA-I in human fibroblasts. Here, we investigated whether Rab8 plays a role in ABCA1 plasma membrane expression and cholesterol removal in primary human macrophages. Methods and Results-We found that Rab8 was abundantly expressed in human atherosclerotic lesional macrophages and upregulated on lipid loading of macrophages in vitro. Adenoviral overexpression of Rab8 increased ABCA1 protein levels and reduced cholesterol deposition in macrophage foam cells incubated with apoA-I. Depletion of Rab8 decreased the fraction of ABCA1 at the plasma membrane and inhibited the efflux of lipoprotein-derived endosomal cholesterol to apoA-I. In Rab8-depleted cells, ABCA1-GFP localized in beta 1 integrin and transferrin receptor containing recycling organelles. Conclusion-Rab8 reduces foam cell formation by facilitating ABCA1 surface expression and stimulating endosomal cholesterol efflux to apoA-I in primary human macrophages. (Arterioscler Thromb Vasc Biol. 2009;29:883-888.) Ljungman, P., Bellander, T., Nyberg, F., Lampa, E., Jacquemin, B., Kolz, M., Lanki, T., Mitropoulos, J., Muller, M., Picciotto, S., Pistelli, R., Rucker, R., Koenig, W. and Peters, A. Thrombosis Research. 2009; 124(1): 57-64. Article. IF 2.038 Introduction: Increased levels of interleukin 6 (IL-6), a marker for systemic inflammation, have been associated with cardiovascular morbidity and mortality. Materials and Methods: We investigated the influence of IL6 gene polymorphisms on mean level and variability of plasma IL-6 in a population of myocardial infarction survivors recruited in six European cities as part of the AIRGENE study. DNA from each individual was collected and genotyped for eight functional and tagging single nucleotide polymorphisms (SNPs) in the IL6 gene. Results: We analyzed 946 subjects with 5520 repeated plasma samples for IL-6 levels. For four IL6 SNPs in high linkage disequilibrium, heterozygous and homozygous minor allele genotypes were associated with an increase in mean plasma IL-6 levels. SNP rs1800795 was associated with a 6.3% increase in IL-6 (95% confidence interval [CI] 1.7-11.2%) For these SNPs, we found that genotypes associated with higher IL-6 levels also tended to be associated to higher between-individual variability of IL-6 levels on the log-scale than other genotypes. Variability over time within individuals varied little by genotype. Conclusions: We found four genetic polymorphisms in the IL6 gene associated with mean level and variability of plasma IL-6 between individuals in myocardial infarction survivors. (C) 2008 Elsevier Ltd. All rights reserved. Lou, H., Yeager, M., Li, H. C., Bosquet, J. G., Hayes, R. B., Orr, N., Yu, K., Hutchinson, A., Jacobs, K. B., Kraft, P., Wacholder, S., Chatterjee, N., Feigelson, H. S., Thun, M. J., Diver, W. R., Albanes, D., Virtamo, J., Weinstein, S., Ma, J., Gaziano, J. M., Stampfer, M., Schumacher, F. R., Giovannucci, E., Cancel-Tassin, G., Cussenot, O., Valeri, A., Andriole, G. L., Crawford, E. D., Anderson, S. K., Tucker, M., Hoover, R. N., Fraumeni, J. F., Thomas, G., Hunter, D. J., Dean, M. and Chanock, S. J. Proceedings of the National Academy of Sciences of the United States of America. 2009; 106(19): 7933-7938. Article. IF 9.598 Two recent genome-wide association studies have independently identified a prostate cancer susceptibility locus on chromosome 10q11.2. The most significant single-nucleotide polymorphism (SNP) marker reported, rs10993994, is 57 bp centromeric of the first exon of the MSMB gene, which encodes beta-microseminoprotein (prostatic secretory protein 94). In this study, a fine-mapping analysis using HapMap SNPs was conducted across a approximate to 65-kb region (chr10: 51168330-51234020) flanking rs10993994 with 13 tag SNPs in 6,118 prostate cancer cases and 6,105 controls of European origin from the Cancer Genetic Markers of Susceptibility (CGEMS) project. rs10993994 remained the most strongly associated marker with prostate cancer risk [P = 8.8 x 10(-18); heterozygous odds ratio (OR) = 1.20, 95% confidence interval (CI): 1.11-1.30; homozygous OR = 1.64, 95% CI: 1.47-1.86 for the adjusted genotype test with 2 df]. In follow-up functional analyses, the T variant of rs10993994 significantly affected expression of in vitro luciferase reporter constructs. In electrophoretic mobility shift assays, the C allele of rs10993994 preferentially binds to the CREB transcription factor. Analysis of tumor cell lines with a CC or CT genotype revealed a high level of MSMB gene expression compared with cell lines with a TT genotype. These findings were specific to the alleles of rs10993994 and were not observed for other SNPs determined by sequence analysis of the proximal promoter. Together, our mapping study and functional analyses implicate regulation of expression of MSMB as a plausible mechanism accounting for the association identified at this locus. Further investigation is warranted to determine whether rs10993994 alone or in combination with additional variants contributes to prostate cancer susceptibility. Lucero, M. G., Nohynek, H., Williams, G., Tallo, V., Simoes, E. A., Lupisan, S., Sanvictores, D., Forsyth, S., Puumalainen, T., Ugpo, J., Lechago, M., de Campo, M., Abucejo-Ladesma, E., Sombrero, L., Nissinen, A., Soininen, A., Ruutu, P., Riley, I. and Makela, H. P. Pediatr Infect Dis J. 2009; 28(6): 455-62. IF 3.086 BACKGROUND: Pneumococcus is a leading cause of childhood pneumonia worldwide. Pneumococcal conjugate vaccines (PCV) have demonstrated efficacy against childhood invasive pneumococcal disease (IPD) and pneumonia in the United States and Africa. No information is available from Asia on the impact of PCV on childhood pneumonia. METHODS: We conducted a randomized, placebo-controlled, double-blind trial in Bohol, the Philippines (ISRCTN 62323832). Children 6 weeks to <6 months of age were randomly allocated to receive 3 doses of either an 11-valent PCV (11PCV, sanofi pasteur, Lyon, France) or a saline placebo, with a minimum interval of 4 weeks between doses to determine vaccine efficacy (VE) against the primary outcome of a child experiencing first episode of community-acquired radiologically defined pneumonia in the first 2 years of life. Secondary end points were clinical pneumonia, IPD, safety, and immunogenicity. RESULTS: Twelve thousand one hundred ninety-one children were enrolled. By per protocol (PP) analysis, 93 of 6013 fully vaccinated 11PCV recipient children had a first episode of radiologic pneumonia compared with 120 of 6018 placebo recipients. VE against radiologically defined pneumonia for the PP cohort of children 3 to 23 months old was 22.9% (95% CI: -1.1, 41.2; P = 0.06), for the prespecified subgroups of children 3 to 11 months of age, 34.0% (95% CI: 4.8, 54.3; P = 0.02), and of those 12 to 23 months old, 2.7% (95% CI: -43.5, 34.0; P = 0.88). By intent-to-treat (ITT) analysis, 119 of 6097 11PCV recipient children had an episode of radiologic pneumonia compared with 141 of 6094 placebo recipients. VE against radiologic pneumonia for the ITT cohort of children <2 years old was 16.0% (95% CI -7.3, 34.2; P = 0.16), for a subgroup of children <12 months of age, 19.8% (95% CI: -8.8, 40.8; P = 0.15). VE against clinical pneumonia by PP was not significant (VE 0.1%; 95% CI -9.4, 8.7; P = 0.99). IPD was rare: only 3 cases of IPD due to vaccine serotypes were observed during the study. 11PCV was immunogenic and well tolerated. Among 11PCV recipients, a small excess of serious adverse respiratory events was observed in the first 28 days after the first and second dose of vaccine, and of nonrespiratory events after the first dose. An excess of pneumonia episodes in 11PCV recipients in the month following the second dose of vaccination was the principal reason for lower VE by ITT analysis than by PP analysis. CONCLUSIONS: In PP analysis, a 22.9% reduction of community-acquired radiologically confirmed pneumonia in children younger than 2 years of age in the 11-valent tetanus-diphtheria toxoid-conjugated PCV vaccinated group was observed; a reduction similar as observed in other PCV trials. We could not demonstrate any VE against clinical pneumonia. Our finding confirms for the first time that in a low-income, low-mortality developing country in Asia, at least one-fifth of radiologically confirmed pneumonia is caused by pneumococcus, and thus preventable by PCV. Whether PCV should be included in national program in such settings, however, depends on careful country specific disease burden measurement and cost-effectiveness calculation. Health effects of trans-fatty acids: experimental and observational evidence Mozaffarian, D., Aro, A. and Willett, W. C. European Journal of Clinical Nutrition. 2009; 63: S5-S21. Review. IF 2.326 Background/Objectives: Growing evidence indicates that trans-fatty acids (TFA) adversely affect cardiovascular health. As part of the World Health Organization (WHO) Scientific Update on TFA, we reviewed the evidence for effects of TFA consumption on coronary heart disease (CHD). Subjects/Methods: We searched Medline publications examining TFA consumption and CHD risk factors or outcomes, emphasizing results of studies in humans. We evaluated and synthesized evidence from both controlled feeding trials evaluating risk factors and long-term observational studies evaluating risk factors or clinical outcomes, each of which have complementary strengths and limitations, to enable the most robust and reliable inferences of effects. Results: The effects of TFA consumption on risk factors most consistently seen in both controlled trials and observational studies included adverse lipid effects (for example up arrow low-density lipoprotein cholesterol, down arrow high-density lipoprotein cholesterol (HDL-C), up arrow total/HDL-C ratio), proinflammatory effects (for example up arrow tumor necrosis factor-alpha activity, up arrow interleukin-6, up arrow C-reactive protein) and endothelial dysfunction. These effects were most prominent in comparison with cis unsaturated fats; adverse effects on total/HDL-C and endothelial function were also seen in comparison with saturated fatty acids (SFA). TFA may also worsen insulin sensitivity, particularly among individuals predisposed to insulin resistance; possible effects on weight gain and diabetes incidence require further confirmation. Five retrospective case-control studies and four prospective cohort studies demonstrated positive associations between TFA consumption and CHD events. A meta-analysis of prospective studies indicated 24, 20, 27 and 32% higher risk of myocardial infarction (MI) or CHD death for every 2% energy of TFA consumption isocalorically replacing carbohydrate, SFA, cis monounsaturated fatty acids and cis polyunsaturated fatty acids, respectively. The differential effects of specific TFA isomers may be important but are less well established. The available evidence indicates that trans-18: 1 and particularly trans-18: 2 isomers have stronger CHD effects than trans-16: 1 isomers. The limited data suggest that the experimental effects of ruminant and industrial TFA are similar when consumed in similar quantities, but very few persons consume such high levels of ruminant TFA, and observational studies do not support adverse CHD effects of ruminant TFA in amounts actually consumed. Conclusions: Controlled trials and observational studies provide concordant evidence that consumption of TFA from partially hydrogenated oils adversely affects multiple cardiovascular risk factors and contributes significantly to increased risk of CHD events. The public health implications of ruminant TFA consumption appear much more limited. The effects of specific TFA isomers require further investigation. European Journal of Clinical Nutrition (2009) 63, S5-S21; doi:10.1038/sj.ejcn.1602973 Muhonen, L. H., Lönnqvist, J., Lahti, J. and Alho, H. Psychiatry Research. 2009; 167(1-2): 115-122. Article. IF 2.298 The aim of this study was to determine predictors of the response to escitalopram, a selective serotonin re-uptake inhibitor antidepressant and memantine, a non-competitive glutamate NMDA receptor blocker, for the treatment of major depression comorbid with alcohol dependence. Eighty alcohol dependent treatment-seeking adult patients with comorbid major depressive disorder were randomized to receive either memantine 20 mg or escitalopram 20 mg for 26 weeks. In both treatment groups, depression was reduced significantly. Comparisons were made between patients in remission (final Montgomery-Asberg Depression Rating Scale (MADRS) <= 12) and non-responding patients (MADRS decrease <50%). The age at onset of the first major depressive episode significantly correlated with the treatment response in the escitalopram group; the mean age at onset of depression among patients on the non-responders group was 13.7 +/- 4.0 years and 31.9 +/- 11.9 years in remission. These results are significantly different from those with memantine. Our study provides evidence that the onset of the first major depressive episode might be a clinically relevant predictor of a response to escitalopram treatment in patients with major depression and comorbid alcohol dependence. (C) 2008 Elsevier Ireland Ltd. All rights reserved. Estimation of vaccine efficacy against acquisition of pneumococcal carriage Rinta-Kokko, H., Dagan, R., Givon-Lavi, N. and Auranen, K. Vaccine. 2009; 27(29): 3831-7. IF 3.377 Evaluation of the effect of new conjugate vaccines on nasopharyngeal carriage of Streptococcus pneumoniae (pneumococcus) has been based on simple comparisons of the prevalence of carriage in vaccinees and controls. However, the definition and measurement of vaccine efficacy should be based on knowledge of the actual mechanism of the vaccine's effect. According to current knowledge, conjugate vaccines affect acquisition. We propose a simple-to-use method to measure vaccine efficacy against serotype-specific acquisition that needs only cross-sectional measurements of carriage. We demonstrate the use of the method by application to a data set where it is also possible to estimate efficacy against acquisition from longitudinal measurements. Personal Goals of Older Female Twins Genetic and Environmental Effects Salmela-Aro, K., Read, S., Nurmi, J. E., Koskenvuo, M., Kaprio, J. and Rantanen, T. European Psychologist. 2009; 14(2): 160-167. Article. IF 1.105 This study examined genetic and environmental influences on older women's personal goals by using data from the Finnish Twin Study on Aging. The interview for the personal goals was completed by 67 monozygotic (MZ) pairs and 75 dizygotic (DZ) pairs. The tetrachoric correlations for personal goals related to health and functioning, close relationships, and independent living were higher in MZ than DZ twins, indicating possible genetic influence. The pattern of tetrachoric correlations for personal goals related to cultural activities, care of others, and physical exercise indicated environmental influence. For goals concerning health and functioning, independent living, and close relationships, additive genetic effect accounted for about half of the individual variation. The rest was the result of a unique environmental effect. Goals concerning physical exercise and care of others showed moderate common environmental effect, while the rest of the variance was the result of a unique environmental effect. Personal goals concerning cultural activities showed unique environmental effects only. Time Trends in Allergic Sensitisation and Helicobacter pylori Prevalence in Finnish Pregnant Women Seiskari, T., Viskari, H., Kaila, M., Haapala, A. M., Koskela, P. and Hyoty, H. International Archives of Allergy and Immunology. 2009; 150(1): 83-88. Article. IF 2.160 Background: An increase in the prevalence of allergic conditions has been documented in Finland, correlating with the diminishing prevalence of Helicobacter pylori infections. We investigated whether the increase of allergic sensitisation still continues and correlates with the prevalence of H. pylori infections. Methods: The sera from 958 pregnant women in 1983, 1989, 1995 and 2001 were analysed for the presence of antibodies against H. pylori. In addition, allergen-specific IgE antibodies and total levels of IgE antibodies were measured. Results: A clear birth cohort effect was found in the prevalence of allergic sensitization: allergen-specific IgE was more frequent among recent birth cohorts than earlier ones (p = 0.001). The frequency of H. pylori antibodies followed the opposite trend (p < 0.001) and the increase in allergic sensitisation was only seen among H. pylori-negative women. A modest increase was also seen in allergic sensitisation between the 4 time series among the H. pylori-negative subjects (p = 0.04). Total IgE levels did not differ between birth cohorts or time series. Conclusion: The results suggest that hygiene-related environmental factors have played a role in the increase of allergic sensitisation during the last decades. Copyright (C) 2009 S. Karger AG, Basel Physical work load factors and carpal tunnel syndrome: a population-based study Shiri, R., Miranda, H., Heliövaara, M. and Viikari-Juntura, E. Occupational and Environmental Medicine. 2009; 66(6): 368-373. Article. IF 2.817 Objective: Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. Studies on selected occupational populations suggest an association of CTS with forceful repetitive work and vibration. Only few population-based studies have addressed the role of physical load factors in CTS. The aim of this study was to investigate the relations between exposures to a single or a combination of physical work load factors and CTS. Methods: The target population consisted of people aged 30 years or older residing in Finland during 2000-2001. Of the 7977 eligible subjects, 6254 (78.4%) were included in the study. Occupational physical load factors were assessed by interview and CTS by physical examination. Results: The prevalence of possible or probable CTS was 2.1% in men and 5.3% in women. Work tasks with vibrating tools (adjusted odds ratio (OR) 1.9, 95% CI 1.2 to 2.9) and handgrip with high forces (OR 1.7, 95% CI 1.2 to 2.5) were related to an increased prevalence of CTS. There were joint effects between work tasks requiring handgrip with high forces and the use of vibrating tools (adjusted OR 3.3, 95% CI 2.0 to 5.4), between forceful activities (handgrip with high forces or handling of loads) and repetitive movements of the hands (OR 2.1, 95% CI 1.5 to 2.9), and between repetitive movements of the hands and the use of vibrating tools (OR 2.8, 95% CI 1.6 to 4.8). Only exposure in the most recent job was associated with CTS. Conclusions: Work tasks demanding handgrip with high forces or the use of vibrating tools are associated with CTS. The association is stronger if these work tasks are accompanied by repetitive movements of the hand or wrist. Soderberg, K. C., Kaprio, J., Verkasalo, P. K., Pukkala, E., Koskenvuo, M., Lundqvist, E. and Feychting, M. European Journal of Cancer. 2009; 45(7): 1232-1238. Article. IF 4.454 Background: Obesity is related to an increased risk of several forms of cancer. However, findings from studies on haematological malignancies are inconsistent. Methods: We used prospectively collected data from two Swedish twin cohorts and the Finnish Twin Cohort (in total 70,067 persons) to study the effects of overweight and obesity on the development of leukaemia, non-Hodgkin lymphoma, Hodgkin's lymphoma and myeloma. The cohorts were followed from baseline through 2002 (Sweden) and through 2004 (Finland). Results: We found a risk increase of myeloma with a relative risk (RR) of 2.1 (95% confidence interval [CI] 1.1-3.7) among obese persons, a RR of 2.5 (1.0-6.2) for chronic myeloid leukaemia and a RR of 2.7 (0.8-9.6) for acute lymphoblastic leukaemia among overweight persons as compared to normal-weighted ones. Conclusions: Our results add further evidence suggesting that over-weight and obesity may have an impact on some haematological malignancies, in particular myeloma. (C) 2008 Elsevier Ltd. All rights reserved. Tarkkanen, A. M., Heinonen, T., Jogi, R., Mentula, S., van der Rest, M. E., Donskey, C. J., Kemppainen, T., Gurbanov, K. and Nord, C. E. Antimicrobial Agents and Chemotherapy. 2009; 53(6): 2455-2462. Article. IF 4.390 Ipsat P1A is a recombinant beta-lactamase which degrades antibiotic residue in the gastrointestinal tract. In an open-label, single- center controlled trial, 36 healthy subjects were randomized to receive (i) ampicillin (1 g intravenously [i.v.] every 6 h [q6h]), (ii) oral P1A recombinant beta-lactamase (8.2 mg q6h), or (iii) ampicillin (1 g i.v. q6h) in combination with oral P1A recombinant beta-lactamase (8.2 mg q6h) for 5 days. Fecal samples were collected before treatment, during treatment (days 3 to 5), and at follow-up (day 12). The primary end points were (i) changes in gastrointestinal microflora (determined by temperature gradient gel electrophoresis [TGGE]) and (ii) emergence of bacterial resistance (determined by conventional microbiology and PCR of TEM beta-lactamase genes). Thirty-five subjects completed the study. The mean similarity percentages of TGGE profiles between baseline and each treatment day sample were significantly lower for the ampicillin group than for the group receiving ampicillin plus P1A recombinant beta-lactamase on days 3, 4, and 5 (P<0.001). Compared with the ampicillin group, subjects receiving ampicillin plus P1A recombinant beta-lactamase had significantly fewer ampicillin-resistant coliforms on days 3, 4, and 5 and at follow-up (P<0.001) and fewer TEM beta-lactamase genes on days 3, 4, and 5 (P<0.02). P1A recombinant beta-lactamase was safe and well tolerated. In healthy subjects, P1A recombinant beta-lactamase prevents ampicillin-induced alterations in intestinal microflora, emergence of resistance, and the number of TEM genes. Taskinen, M. R., Sullivan, D. R., Ehnholm, C., Whiting, M., Zannino, D., Simes, R. J., Keech, A. C. and Barter, P. J. Arteriosclerosis Thrombosis and Vascular Biology. 2009; 29(6): 950-U436. Article. IF 7.221 Objective-The purpose of this study was to determine fenofibrate-induced changes in plasma high-density lipoprotein cholesterol (HDL-C), apoliprotein (apo) A-I, and apolipoprotein (apo) A-II and how they relate to changes in plasma homocysteine and creatinine. Methods and Results-FIELD was a double-blind placebo-controlled trial done in Australia, New Zealand, and Finland. All FIELD subjects were included except those who started statin therapy or permanently discontinued fenofibrate. Patients were randomized to receive daily micronised fenofibrate ( 200 mg) or matching placebo and were followed up for a median of 5 years. Plasma HDL-C, apoA-I, apoA-II, homocysteine, and creatinine were measured. There was an inverse relationship between baseline homocysteine levels and HDL-C in the placebo (P = 0.07 for linear trend) and fenofibrate groups ( P < 0.0001) and apoA-I (P < 0.001, both groups). The increases in homocysteine and creatinine in the fenofibrate group correlated positively ( P < 0.0001). The greater the increase in homocysteine induced by fenofibrate, the smaller the increases in HDL-c and apoA-I (P < 0.0001 for linear trends). There was a highly significant and positive relationship between fenofibrate-induced changes in homocysteine and apoA-II levels. Conclusions-PPAR alpha agonists that have a more robust effect on HDL-C and apoA-I would be desirable. (Arterioscler Thromb Vasc Biol. 2009; 29: 950-955.) WHO Scientific Update on trans fatty acids: summary and conclusions Uauy, R., Aro, A., Clarke, R., Ghafoorunissa, R., L'Abbe, M., Mozaffarian, D., Skeaff, M., Stender, S. and Tavella, M. European Journal of Clinical Nutrition. 2009; 63: S68-S75. Review. IF 2.326 The purpose of the WHO scientific review on trans fatty acids (TFAs) was to examine the evidence generated since the 1993 Joint FAO/WHO Expert Consultation on Fats and Oils in Human Nutrition, and to inform member countries on the health consequences of TFAs consumption that have emerged since the last report was released. The new information was deemed sufficient to recommend the need to significantly reduce or to virtually eliminate industrially produced TFA from the food supply in agreement with the implementation of the 2004 WHO Global Strategy on Diet, Physical Activity and Health. This goal has been accomplished in some countries and cities, by the virtual elimination of partially hydrogenated vegetable oils in the human food supply, replacing them with healthy cis-unsaturated fatty acids. The document provides the evidence base to promote discussion between the international scientific community related to nutrition and health as well as between agriculturalists, food producers, relevant health professionals, national and international food regulatory agencies, civil society and the private sector to achieve the stated goal. European Journal of Clinical Nutrition (2009) 63, S68-S75; doi:10.1038/ejcn.2009.15 |