Browsing by Subject "Cardiovascular diseases"

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  • Virtanen, Eunice; Nurmi, Tapio; Soder, Per-Osten; Airila-Mansson, Stella; Soder, Birgitta; Meurman, Jukka H. (2017)
    Background: Periodontal disease associates with systemic diseases but corresponding links regarding apical periodontitis (AP) are not so clear. Hence our aim was to study association between AP and the prevalence of systemic diseases in a study population from Sweden. Methods: The subjects were 150 patients from a randomly selected epidemiological sample of 1676 individuals. 120 accepted to participate and their basic and clinical examination data were available for these secondary analyses where dental radiographs were used to record signs for endodontic treatments and AP. Periapical Index and modified Total Dental Index scores were calculated from the x-rays to classify the severity of AP and dental infection burden, respectively. Demographic and hospital record data were collected from the Swedish National Statistics Center. T-test, chi-square and univariate analysis of covariance (ANCOVA) and regressions analyses were used for statistics. Results: Of the 120 patients 41% had AP and 61% had received endodontic treatments of which 52% were radiographically unsatisfactory. AP patients were older and half of them were smokers. AP and periodontitis often appeared in the same patient (32.5%). From all hospital diagnoses, cardiovascular diseases (CVD) were most common, showing 20.4% prevalence in AP patients. Regression analyses, controlled for age, gender, income, smoking and periodontitis, showed AP to associate with CVD with odds ratio 3.83 (95% confidence interval 1.18-12.40; p = 0.025). Conclusions: The results confirmed our hypothesis by showing that AP statistically associated with cardiovascular diseases. The finding that subjects with AP also often had periodontitis indicates an increased oral inflammatory burden.
  • Virtanen, Eunice; Nurmi, Tapio; Söder, Per-Östen; Airila-Månsson, Stella; Söder, Birgitta; Meurman, Jukka H. (BioMed Central, 2017)
    Abstract Background Periodontal disease associates with systemic diseases but corresponding links regarding apical periodontitis (AP) are not so clear. Hence our aim was to study association between AP and the prevalence of systemic diseases in a study population from Sweden. Methods The subjects were 150 patients from a randomly selected epidemiological sample of 1676 individuals. 120 accepted to participate and their basic and clinical examination data were available for these secondary analyses where dental radiographs were used to record signs for endodontic treatments and AP. Periapical Index and modified Total Dental Index scores were calculated from the x-rays to classify the severity of AP and dental infection burden, respectively. Demographic and hospital record data were collected from the Swedish National Statistics Center. T-test, chi-square and univariate analysis of covariance (ANCOVA) and regressions analyses were used for statistics. Results Of the 120 patients 41% had AP and 61% had received endodontic treatments of which 52% were radiographically unsatisfactory. AP patients were older and half of them were smokers. AP and periodontitis often appeared in the same patient (32.5%). From all hospital diagnoses, cardiovascular diseases (CVD) were most common, showing 20.4% prevalence in AP patients. Regression analyses, controlled for age, gender, income, smoking and periodontitis, showed AP to associate with CVD with odds ratio 3.83 (95% confidence interval 1.18–12.40; p = 0.025). Conclusions The results confirmed our hypothesis by showing that AP statistically associated with cardiovascular diseases. The finding that subjects with AP also often had periodontitis indicates an increased oral inflammatory burden.
  • Liljestrand, John M.; Paju, Susanna; Pietiäinen, Milla; Buhlin, Kåre; Persson, G. Rutger; Nieminen, Markku S.; Sinisalo, Juha; Mäntylä, Päivi; Pussinen, Pirkko J. (2018)
  • Smidtslund, Patrik (Helsingin yliopisto, 2021)
    Personer med typ 1-diabetes har en ökad risk att insjukna i en akut hjärtinfarkt. Studiens mål är att undersöka prognosen efter första hjärtinfarkten vid typ 1-diabetes samt att utreda hur olika diabetesrelaterade och hjärtinfarktrelaterade faktorer påverkar prognosen. Studien består av 132 personer som deltog i nationella FinnDiane-studien mellan åren 1995– 2011 och insjuknade i sin första hjärtinfarkt under uppföljningstiden. Information om hjärtinfarkten och diabetesrelaterade faktorer samlades från sjukjournaler. För bedömning av prognosen erhölls information om tidpunkt för eventuell död från Statistikcentralen. Under medianuppföljningstiden om 2,5 (0,0–7,2) år efter hjärtinfarkten dog 91 (68,9 %) av personerna i studien. I studien hade personer med kronisk njursjukdom den sämsta överlevnadsprognosen efter hjärtinfarkten och ju sämre njurfunktionen var, desto sämre blev prognosen. Personer med diabetesnefropati hade också en klart sämre prognos, speciellt om de var i dialysvård. De personer till vilka subakuta revaskularisering gjordes hade en betydligt bättre prognos medan akuta vården inte påverkade prognosen. I vår studie påverkade inte ålder, kön, durationen av diabetes, tidigare medicinering, lipidprofilen eller blodsockerbalansen prognosen. Resultaten i vår studie tyder på att för att förhindra hög mortalitet bland de personer som insjuknar i hjärtinfarkt måste vi förebygga utvecklingen av kronisk njursjukdom vid typ 1- diabetes. (197 ord)
  • Lindroos, Emil (Helsingin yliopisto, 2019)
    Denna uppföljningsstudie är en del av FinnDiane-studien som initierades 1997 för att identifiera riskfaktorer hos typ 1-diabetiker som bidrar till utveckling av olika diabetesrelaterade komplikationer. Eftersom det tidigare rått oklarheter vad beträffar adiponektinets samband med det metabola syndromet samt deras gemensamma inverkan för typ 1-diabetiker utan nefropati att insjukna i kardiovaskulära sjukdomar, är denna studies målsättning att undersöka detta. Under en ca 15 års uppföljningstid samlades information i form av anamnestiska uppgifter, klinisk grundundersökning samt blodprov från 1444 typ 1-diabetiker utan nefropati. Medelåldern vid det första FinnDiane-studiebesöket var 34 år och 32 % hade metabolt syndrom. Vi såg ett klart samband mellan adiponektinkoncentrationen och det metabola syndromet, där en lägre adiponektinkoncentraton associerades inte endast med metabolt syndrom, utan även med ökat midjemått, lågt HDL och höga triglycerider. Personer med samtidigt metabolt syndrom och låg adiponektinkoncentration hade en 2,6-faldig risk att insjukna i kardiovaskulär sjukdom jämfört med jämförelsegruppen. Sammanfattningsvis kan vi konstatera att det i framtiden skulle vara skäl att identifiera de personer som lider av det metabola syndromet, samt att bestämma deras adiponektinkoncentration, för att kunna initiera en möjligast effektiv primärprevention.
  • Collins, Brendan; Kypridemos, Chris; Cookson, Richard; Parvulescu, Paula; McHale, Philip; Guzman-Castillo, Maria; Bandosz, Piotr; Bromley, Helen; Capewell, Simon; O'Flaherty, Martin (2020)
    Distributional cost effectiveness analysis is a new method that can help to redesign prevention programmes by explicitly modelling the distribution of health opportunity costs as well as the distribution of health benefits. Previously we modelled cardiovascular disease (CVD) screening audit data from Liverpool, UK to see if the city could redesign its cardiovascular screening programme to enhance its cost effectiveness and equity. Building on this previous analysis, we explicitly examined the distribution of health opportunity costs and we looked at new redesign options co-designed with stakeholders. We simulated four plausible scenarios: a) no CVD screening, b) ‘current’ basic universal CVD screening as currently implemented, c) enhanced universal CVD screening with ‘increased’ population-wide delivery, and d) ‘universal plus targeted’ with top-up delivery to the most deprived fifth. We also compared assumptions around whether displaced health spend would come from programmes that might benefit the poor more and how much health these programmes would generate. The main outcomes were net health benefit and change in the slope index of inequality (SII) in QALYs per 100,000 person years. ‘Universal plus targeted’ dominated ‘increased’ and ‘current’ and also reduced health inequality by −0.65 QALYs per 100,000 person years. Results are highly sensitive to assumptions about opportunity costs and, in particular, whether funding comes from health care or local government budgets. By analysing who loses as well as who gains from expenditure decisions, distributional cost effectiveness analysis can help decision makers to redesign prevention programmes in ways that improve health and reduce health inequality.