Artikkelit: Äskettäin tallennettua

Näkyvissä 1-20 / 18500
  • Nyman, K.; Granér, M.; Pentikäinen, M.O.; Lundbom, J.; Hakkarainen, A.; Sirén, R.; Nieminen, M.S.; Taskinen, M.-R.; Lundbom, N.; Lauerma, K. (2018)
    AbstractBackground and aims Obesity and metabolic syndrome (MetS) are risk factors of atrial fibrillation (AF), but limited data exist on their effect on left atrial (LA) function. The aim of the study was to evaluate the effects of cardiac, hepatic and intra-abdominal ectopic fat depots and cardiometabolic risk factors on LA function in non-diabetic male subjects. Methods and results Myocardial and hepatic triglyceride contents were measured with 1.5T 1H-magnetic resonance spectroscopy and LA and left ventricular function, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), epicardial and pericardial fat by magnetic resonance imaging (MRI) in 33 men with MetS and 40 men without MetS. LA volumes were assessed using a novel three-chamber orientation based MRI approach. LA ejection fraction (EF) was lower in MetS patients than in the control group (44 ± 7.7 % in MetS vs. 49 ± 8.6 % in controls, p=0.013) without LA enlargement, indicating LA dysfunction. LA EF correlated negatively with waist circumference, body mass index, SAT, VAT, fasting serum insulin, and homeostasis model assessment of insulin resistance index, and positively with fasting serum high-density lipoprotein cholesterol. VAT was the best predictor of reduced LA EF. Conclusions MetS associates with subclinical LA dysfunction. Multiple components of MetS are related to LA dysfunction, notably visceral obesity and insulin resistance. Further studies are needed to elucidate the role of mechanical atrial remodeling in the development of AF.
  • Ahola, Aila J; Forsblom, Carol; Groop, Per-Henrik (2018)
    AbstractAims Depressive mood negatively affects self-care practices, and thereby increases the risk of long-term complications. Not much is known about the association between depressive symptoms and dietary intake in patients with type 1 diabetes, a population with high risk of cardiovascular disease. Methods Subjects (n=976, 41% men, age 48±14 years) were participants in the Finnish Diabetic Nephropathy Study. Depressive symptomatology was assessed with the Beck Depression Inventory (BDI). Dietary patterns were derived from food frequency questionnaire-entries by exploratory factor analysis. Energy and macronutrient intakes were calculated from food records. In the same record, participants also reported the results of their daily blood glucose monitoring. Associations between BDI score and self-care variables were analysed using generalized linear regression. For macronutrients, a substitution model was applied. Results Two dietary patterns (“Fish and vegetables”, and “Traditional”) negatively associated with the BDI score. Instead, an increase in the “Sweet” pattern score was positively associated with depressive symptomatology. Of the macronutrients, favouring protein over carbohydrates or fats associated with lower depression scores. Higher blood glucose self-monitoring frequency and higher variability of the measurements were positively associated with the BDI score. However, no association was observed between depressive symptoms and the mean of the blood glucose measurements. Conclusions Depressive symptoms are reflected in the dietary intake and the self-monitoring of blood glucose, in type 1 diabetes. Whether depression, via compromised self-care practices, negatively affect long-term outcomes in this patient group has to be the subject of future studies.
  • Leino, Sakari; Koski, Sini K.; Rannanpää, Saara; Salminen, Outi (2018)
    Abstract The treatment of Parkinson’s disease is often complicated by levodopa-induced dyskinesia (LID), and antidyskinetic treatment options are currently sparse. Nicotinic acetylcholine receptors have been suggested as potential targets for treatment of LID, as nicotinic agonists have been reported to alleviate LID in animal models. We aimed at the first independent replication of an antidyskinetic effect by nicotine using a mouse model of LID, and at investigation of its mechanisms by studying the release of [3H]dopamine from synaptosomes prepared from the dorsal and ventral striatum. Chronic nicotine treatment in drinking water inhibited the development of LID in mice lesioned unilaterally with 6-hydroxydopamine and treated chronically with levodopa and benserazide. The antidyskinetic nicotine treatment had no effect on [3H]dopamine release mediated by α4β2* nicotinic receptors, but decreased α6β2*-mediated [3H]dopamine release in the lesioned dorsal striatum and the ventral striatum. In addition, nicotine treatment restored [3H]dopamine release in the lesioned ventral striatum to intact levels. The results support a role for nicotinic receptors as drug targets for treatment of LID, and suggest that striatal presynaptic α6β2* receptors are important mediators of nicotine’s antidyskinetic effect.
  • Bertone-Johnson, Elizabeth R.; Virtanen, Jyrki K.; Nurmi, Tarja; Niskanen, Leo; Mursu, Jaakko; Voutilainen, Sari; Ronkainen, Kimmo; Kauhanen, Jussi; Tuomainen, Tomi-Pekka (2018)
    Recent studies of perimenopausal women suggest that follicle-stimulating hormone (FSH) levels may be associated with atherosclerosis, independent of estradiol. Whether FSH is related to atherosclerosis in older postmenopausal women, who have completed the menopausal transition, remains unknown. We assessed the relationship of serum FSH and estradiol levels with carotid artery intima-media thickness (IMT) among 587 postmenopausal participants in the Kuopio Ischemic Heart Disease Risk Factor Study (Kuopio, Finland). Participants were aged 53-73 years and not using hormone therapy at baseline (1998-2001). Mean IMT was measured via high-resolution ultrasonography. We observed a significant inverse association between FSH levels and IMT. Mean IMTs among women in quartiles 1-4 of FSH were 0.94 mm, 0.91 mm, 0.87 mm, and 0.85 mm, respectively (P-trend <0.001). After adjustment for age, estradiol, testosterone, body mass index (weight (kg)/height (m)(2)), lipids, and other factors, FSH levels remained significantly associated with IMT (regression coefficients for quartiles 2-4 vs. quartile 1 were -0.038, -0.045, and -0.062, respectively; P-trend = 0.01). Findings were strongest in women aged 64-73 years (P-trend = 0.006) and did not vary by body mass index. In contrast, estradiol levels were not related to IMT. In summary, high postmenopausal FSH levels were associated with a lower atherosclerotic burden, independent of estradiol, adiposity, and other factors. Our findings warrant replication and the further exploration of potential underlying mechanisms.
  • Ervasti, Jenni; Kivimaki, Mika; Head, Jenny; Goldberg, Marcel; Airagnes, Guillaume; Pentti, Jaana; Oksanen, Tuula; Salo, Paula; Suominen, Sakari; Jokela, Markus; Vahtera, Jussi; Zins, Marie; Virtanen, Marianna (2018)
    Aims: We examined differences in sickness absence in relation to at-risk drinking and abstinence, taking into account potential changes in consumption. Methods: We used individual-participant data (n = 46,514) from four prospective cohort studies from Finland, France and the UK. Participants responded to a survey on alcohol use at two time points 4-6 years apart, and were linked to records of sickness absence for an similar to 6-year follow-up after the latter survey. Abstainers were those reporting no alcohol use in either survey. At-risk drinkers at T1 were labelled as 'former', at-risk drinkers at T2 as 'current' and at-risk drinkers at both times as 'consistent' at-risk drinkers. The reference group was low-risk drinkers at both times. Study-specific analyses were stratified by sex and socioeconomic status (SES) and the estimates were pooled using meta-analysis. Results: Among men (n = 17,285), abstainers (6%), former (5%), current (5%) and consistent (7%) at-risk drinkers had an increased risk of sickness absence compared with consistent low-risk drinkers (77%). Among women (n = 29,229), only abstainers (12%) had a higher risk of sickness absence compared to consistent low-risk drinkers (74%). After adjustment for lifestyle and health, abstaining from alcohol was associated with sickness absence among people with intermediate and high SES, but not among people with low SES. Conclusions: The U-shaped alcohol use-sickness absence association is more consistent in men than women. Abstinence is a risk factor for sickness absence among people with higher rather than lower SES. Healthy worker effect and health selection may partly explain the observed differences. Short summary: In a pooled analysis from four cohort studies from three European countries, we demonstrated a U-shaped association between alcohol use and sickness absence, particularly among men. Abstinence from alcohol was associated with increased sickness absenteeism among both sexes and across socioeconomic strata, except those with low SES.
  • Olakivi, Antero Olavi (2017)
    Public care work organisations in Northern Europe often seek to increase their economic efficiency in ways that care workers criticise for reducing both their professional autonomy and the quality of care. Recently, the ideal of ‘enterprising nursing’ has emerged as a political belief according to which economic efficiency, care workers' autonomy and the quality of care can be improved in tandem by cultivating care workers' agential abilities. This article examines the reception of this belief among migrant care workers in Finland. Drawing on research interviews, the analysis demonstrates how migrant care workers may have difficulties in aligning themselves with the enterprising ideals but also in protesting them. Ethnicity, and the status of a migrant, can offer resources for both constructing enterprising subjectivities and reframing care workers' agency, and their organisational environment, in more critical terms.
  • Lindberg, A.; Holm, Are M.; Hilberg, O.; Harju, T.; Vestbo, Jorgen; Foronjy, Robert; Harju, Terttu; Nurmos, Ninni-Ingrid; Karvonen, Henna; Lappi-Blanco, Elisa; Skold, Magnus; Lehtonen, Siri; Kaarteenaho, Riitta; Backman, Helena; Christensen, V. L.; Rustoen, T.; Cooper, B. A.; Miaskowski, Christine; Henriksen, A. H.; Bentsen, S. B.; Holm, Are M.; Andersson, Mikael; Waatevik, Marie; Johannessen, Ane; Real, Francisco Gomez; Aanerud, Marianne; Hardie, Jon Andrew; Bakke, Per Sigvald; Eagan, Tomas Mikal Lind; Farver-Vestergaard, Ingeborg; Ottesen, Anders Lokke; Bendstrup, Elisabeth; O'Connor, Maja; Zachariae, Robert; Törölä, T.; Nieminen, P.; Ohlmeier, S.; Gao, J.; Toljamo, T.; Mazur, W.; Pulkkinen, V.; Andreassen, Siw L.; Christensen, Vivi L.; Rustoen, Tone; Klingenberg, Olav; Aarberge, Ingebord; Miaskowski, Christine; Holm, Are M.; Jarenback, Linnea; Kaasgaard, Mette (2017)
  • Int Injury Care Improvement Initia; Moore, Lynne; Champion, Howard; O'Reilly, Gerard; Leppäniemi, Ari; Cameron, Peter; Palmer, Cameron; Abu-Zidan, Fikri M.; Gabbe, Belinda; Gaarder, Christine; Yanchar, Natalie; Stelfox, Henry Thomas; Coimbra, Raul; Kortbeek, John; Noonan, Vanessa; Gunning, Amy; Leenan, Luke; Gordon, Malcolm; Khajanchi, Monty; Shemilt, Michele; Porgo, Valerie; Turgeon, Alexis F. (2017)
    Background: Injury represents one of the greatest public health challenges of our time with over 5 million deaths and 100 million people temporarily or permanently disabled every year worldwide. The effectiveness of trauma systems in decreasing injury mortality and morbidity has been well demonstrated. However, the organisation of trauma care varies significantly across trauma systems and we know little about which components of trauma systems contribute to their effectiveness. The objective of the study described in this protocol is to systematically review evidence of the impact of trauma system components on clinically significant outcomes including mortality, function and disability, quality of life, and resource utilization. Methods: We will perform a systematic review of studies evaluating the association between at least one trauma system component (e.g. accreditation by a central agency, interfacility transfer agreements) and at least one injury outcome (e. g. mortality, disability, resource use). We will search MEDLINE, EMBASE, COCHRANE central, and BIOSIS/Web of Knowledge databases, thesis holdings, key injury organisation websites and conference proceedings for eligible studies. Pairs of independent reviewers will evaluate studies for eligibility and extract data from included articles. Methodological quality will be evaluated using elements of the ROBINS-I tool and the Cochrane risk of bias tool for non-randomized and randomized studies, respectively. Strength of evidence will be evaluated using the GRADE tool. Discussion: We expect to advance knowledge on the components of trauma systems that contribute to their effectiveness. This may lead to recommendations on trauma systemstructure thatwill help policy-makersmake informed decisions as to where resources should be focused. The review may also lead to specific recommendations for future research efforts.
  • Puuskari, Varpu; Aalto-Setälä, Terhi; Komulainen, Erkki; Marttunen, Mauri (2017)
    Background: Increasing psychiatric disorders and alcohol intoxication challenge the pediatric emergency departments (PEDs) to which adolescents are referred owing to acute alcohol intoxication. Objective: This study examined the degree to which adolescents presenting to PED with alcohol intoxication or deliberate self-harm report symptoms of depression and how they differed from non-depressed patients in terms of alcohol use, perceived social support, psychological distress, self-esteem, and suicidal thoughts. Methods: In a sample of 138 adolescents, 12- to 16-years old (62 % females), we assessed the patients' psychiatric status using self-report scales and analyzed blood samples for alcohol. Before discharge, a consulting psychiatrist interviewed each patient to evaluate possible suicidality and organized aftercare when necessary. The mediating data-driven hypothesis was examined. Adolescents scoring >= 10 on the Beck Depression Inventory (BDI) were deemed as screening positive for depression. Results: In 55% of participants, intoxication was by alcohol consumption. Deliberate self-harm was found in 17% of the participants. Of the 138 adolescents, 39 % scored positive on the BDI for depressive symptoms, occurring more commonly in girls. Logistic regression showed that the most significant variables associated with depressive symptoms were female gender, high psychological distress, and low self-esteem. Symptoms of depression served as a mediator between gender and self-esteem and the blood alcohol level. Conclusions: Our findings underscore the importance of identifying mood disorders, suicidality, and self-esteem among adolescents with acute alcohol intoxication at the PED. Intensive psychiatric evaluation in an emergency department is necessary in order to detect those adolescents requiring additional treatment and support.
  • Kataja, Kati; Hakkarainen, Pekka; Koivula, Lauri Matti Petteri; Hautala, Sanna (2018)
    Purpose The purpose of this paper is to discuss what kinds of messages about the risks of polydrug use are mediated in YouTube video blogs and on what kinds of norms and values do the vloggers base these messages. Design/methodology/approach The data consist of 12 YouTube videos where vloggers share their own experiences of the risks and harms of polydrug use. In the analysis, the actantial model of Greimas' theory of structural semiotics was applied. Findings Two main types of videos were identified - sobriety and controlled use - where polydrug use has different meanings. In sobriety videos, polydrug use is presented as the heavy use of multiple substances. In the videos dealing with controlled use, polydrug use is taken as the combining of certain substances. Whereas the sobriety videos emphasized total abstinence from all substances due to their destructiveness, the videos about controlled use emphasized risk awareness when combining substances. Despite modern digital media and a new generation operating in this space, the messages of the risks of polydrug use mainly repeat those of familiar discourses. Originality/value This paper offers an analytical insight into the ways in which the risks of polydrug use are conceptualized in a YouTube context that is increasingly gaining a foothold among the youth. Greimas' actantial model offers a fruitful tool to find semiotic meanings that hide under the surface. The model has not been applied in previous drug research.
  • Ahlberg, Sara; Grace, Delia; Kiarie, Gideon; Kirino, Yumi; Lindahl, Johanna (2018)
    Aflatoxin M1 (AFM1), a human carcinogen, is found in milk products and may have potentially severe health impacts on milk consumers. We assessed the risk of cancer and stunting as a result of AFM1 consumption in Nairobi, Kenya, using worst case assumptions of toxicity and data from previous studies. Almost all (99.5%) milk was contaminated with AFM1. Cancer risk caused by AFM1 was lower among consumers purchasing from formal markets (0.003 cases per 100,000) than for low-income consumers (0.006 cases per 100,000) purchasing from informal markets. Overall cancer risk (0.004 cases per 100,000) from AFM1 alone was low. Stunting is multifactorial, but assuming only AFM1 consumption was the determinant, consumption of milk contaminated with AFM1 levels found in this study could contribute to 2.1% of children below three years in middle-income families, and 2.4% in low-income families, being stunted. Overall, 2.7% of children could hypothetically be stunted due to AFM1 exposure from milk. Based on our results AFM1 levels found in milk could contribute to an average of −0.340 height for age z-score reduction in growth. The exposure to AFM1 from milk is 46 ng/day on average, but children bear higher exposure of 3.5 ng/kg bodyweight (bw)/day compared to adults, at 0.8 ng/kg bw/day. Our paper shows that concern over aflatoxins in milk in Nairobi is disproportionate if only risk of cancer is considered, but that the effect on stunting children might be much more significant from a public health perspective; however, there is still insufficient data on the health effects of AFM1.
  • Blakey, Robert; Askelund, Adrian D.; Boccanera, Matilde; Immonen, Johanna; Plohl, Nejc; Popham, Cassandra; Sorger, Clarissa; Stuhlreyer, Julia (2017)
    Neuroscience has identified brain structures and functions that correlate with psychopathic tendencies. Since psychopathic traits can be traced back to physical neural attributes, it has been argued that psychopaths are not truly responsible for their actions and therefore should not be blamed for their psychopathic behaviors. This experimental research aims to evaluate what effect communicating this theory of psychopathy has on the moral behavior of lay people. If psychopathy is blamed on the brain, people may feel less morally responsible for their own psychopathic tendencies and therefore may be more likely to display those tendencies. An online study will provide participants with false feedback about their psychopathic traits supposedly based on their digital footprint (i.e., Facebook likes), thus classifying them as having either above-average or below-average psychopathic traits and describing psychopathy in cognitive or neurobiological terms. This particular study will assess the extent to which lay people are influenced by feedback regarding their psychopathic traits, and how this might affect their moral behavior in online tasks. Public recognition of these potential negative consequences of neuroscience communication will also be assessed. A field study using the lost letter technique will be conducted to examine lay people's endorsement of neurobiological, as compared to cognitive, explanations of criminal behavior. This field and online experimental research could inform the future communication of neuroscience to the public in a way that is sensitive to the potential negative consequences of communicating such science. In particular, this research may have implications for the future means by which neurobiological predictors of offending can be safely communicated to offenders.
  • Ding, Ming; Huang, Tao; Bergholdt, Helle K. M.; Nordestgaard, Borge G.; Ellervik, Christina; Qi, Lu; Frazier-Wood, Alexis C.; Aslibekyan, Stella; North, Kari E.; Voortman, Trudy; Graff, Mariaelisa; Smith, Caren E.; Lai, Chao-Qiang; Varbo, Anette; Lemaitre, Rozenn N.; de Jonge, Ester A. L.; Fumeron, Frederic; Corella, Dolores; Wang, Carol A.; Tjonneland, Anne; Overvad, Kim; Sorensen, Thorkild I. A.; Feitosa, Mary F.; Wojczynski, Mary K.; Kahonen, Mika; Ahmad, Shafqat; Renstrom, Frida; Psaty, Bruce M.; Siscovick, David S.; Barroso, Ines; Johansson, Ingegerd; Hernandez, Dena; Ferrucci, Luigi; Bandinelli, Stefania; Linneberg, Allan; Sandholt, Camilla Helene; Pedersen, Oluf; Hansen, Torben; Schulz, Christina-Alexandra; Sonestedt, Emily; Orho-Melander, Marju; Chen, Tzu-An; Rotter, Jerome I.; Allison, Mathew A.; Rich, Stephen S.; Sorli, Jose V.; Coltell, Oscar; Pennell, Craig E.; Mikkilä, Vera; Wang, Yujie (2017)
    OBJECTIVE To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. DESIGN Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable. SETTING CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium. PARTICIPANTS Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis. MAIN OUTCOME MEASURES The instrumental variable estimation was conducted using the ratio of coefficients approach. Using metaanalysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized. RESULTS Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P CONCLUSION The weak inverse association between dairy intake and systolic blood pressure in observational studies was not supported by a comprehensive instrumental variable analysis and systematic review of existing clinical trials.
  • Wang, Xin; Dalmeijer, Geertje W.; den Ruijter, Hester M.; Anderson, Todd J.; Britton, Annie R.; Dekker, Jacqueline; Engstrom, Gunnar; Evans, Greg W.; de Graaf, Jacqueline; Grobbee, Diederick E.; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kauhanen, Jussi; Kitagawa, Kazuo; Kitamura, Akihiko; Kurl, Sudhir; Lonn, Eva M.; Lorenz, Matthias W.; Mathiesen, Ellisiv B.; Nijpels, Giel; Okazaki, Shuhei; Polak, Joseph F.; Price, Jacqueline F.; Rembold, Christopher M.; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T.; Sitzer, Matthias; Stehouwer, Coen D. A.; Tuomainen, Tomi-Pekka; Peters, Sanne A. E.; Bots, Michiel L. (2017)
    Background The relation of a single risk factor with atherosclerosis is established. Clinically we know of risk factor clustering within individuals. Yet, studies into the magnitude of the relation of risk factor clusters with atherosclerosis are limited. Here, we assessed that relation. Methods Individual participant data from 14 cohorts, involving 59,025 individuals were used in this cross-sectional analysis. We made 15 clusters of four risk factors (current smoking, overweight, elevated blood pressure, elevated total cholesterol). Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) between clusters using those without any of the four risk factors as reference group. Results Compared to the reference, those with 1, 2, 3 or 4 risk factors had a significantly higher common CIMT: mean difference of 0.026 mm, 0.052 mm, 0.074 mm and 0.114 mm, respectively. These findings were the same in men and in women, and across ethnic groups. Within each risk factor cluster (1, 2, 3 risk factors), groups with elevated blood pressure had the largest CIMT and those with elevated cholesterol the lowest CIMT, a pattern similar for men and women. Conclusion Clusters of risk factors relate to increased common CIMT in a graded manner, similar in men, women and across race-ethnic groups. Some clusters seemed more atherogenic than others. Our findings support the notion that cardiovascular prevention should focus on sets of risk factors rather than individual levels alone, but may prioritize within clusters.
  • Hartman, Otto; Sinisalo, Juha; Kovanen, Petri T.; Lehtonen, Jukka; Eklund, Kari K. (2017)
  • Pippias, Maria; Kramer, Anneke; Noordzij, Marlies; Afentakis, Nikolaos; Alonso de la Torre, Ramon; Ambuhl, Patrice M.; Aparicio Madre, Manuel I.; Arribas Monzon, Felipe; Asberg, Anders; Bonthuis, Marjolein; Bouzas, Encarnacion; Bubic, Ivan; Caskey, Fergus J.; de la Nuez, Pablo Castro; Cernevskis, Harijs; Garcia Bazaga, Maria de los Angeles; des Grottes, Jean-Marin; Fernandez Gonzalez, Raquel; Ferrer-Alamar, Manuel; Finne, Patrik; Garneata, Liliana; Golan, Eliezer; Heaf, James G.; Hemmelder, Marc H.; Idrizi, Alma; Ioannou, Kyriakos; Jarraya, Faical; Kantaria, Nino; Kolesnyk, Mykola; Kramar, Reinhard; Lassalle, MathilDe; Lezaic, Visnja V.; Lopot, Frantisek; Macario, Fernando; Magaz, Angela; de Francisco, Angel L. Martin; Martin Escobar, Eduardo; Martinez Castelao, Alberto; Metcalfe, Wendy; Moreno Alia, Inmaculada; Nordio, Maurizio; Ots-Rosenberg, Mai; Palsson, Runolfur; Ratkovic, Marina; Resic, Halima; Rutkowski, Boleslaw; de Pablos, Carmen Santiuste; Seyahi, Nurhan; Roblero, Maria Fernanda Slon; Spustova, Viera; Stas, Koenraad J. F.; Stendahl, Maria E.; Stojceva-Taneva, Olivera; Vazelov, Evgueniy; Ziginskiene, Edita; Massy, Ziad; Jager, Kitty J.; Stel, Vianda S. (2017)
    Background: This article summarizes the European Renal Association - European Dialysis and Transplant Association Registry's 2014 annual report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2014 within 35 countries. Methods: In 2016, the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD, from 51 national or regional renal registries. Thirty-two registries provided individual patient level data and 19 provided aggregated patient level data. The incidence, prevalence and survival probabilities of these patients were determined. Results: In 2014, 70 953 individuals commenced RRT for ESRD, equating to an overall unadjusted incidence rate of 133 per million population (pmp). The incidence ranged by 10-fold; from 23 pmp in the Ukraine to 237 pmp in Portugal. Of the patients commencing RRT, almost two-thirds were men, over half were aged >= 65 years and a quarter had diabetes mellitus as their primary renal diagnosis. By day 91 of commencing RRT, 81% of patients were receiving haemodialysis. On 31 December 2014, 490 743 individuals were receiving RRT for ESRD, equating to an unadjusted prevalence of 924 pmp. This ranged throughout Europe by more than 10-fold, from 157 pmp in the Ukraine to 1794 pmp in Portugal. In 2014, 19 406 kidney transplantations were performed, equating to an overall unadjusted transplant rate of 36 pmp. Again this varied considerably throughout Europe. For patients commencing RRT during 2005-09, the 5-year-adjusted patient survival probabilities on all RRT modalities was 63.3% (95% confidence interval 63.0-63.6). The expected remaining lifetime of a 20-to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 21.9 and 44.0 years, respectively. This was substantially lower than the 61.8 years of expected remaining lifetime of a 20-year-old patient without ESRD.
  • Tuuminen, Tamara; Rinne, Kyösti Sakari (2017)
    The presence of toxic indoor molds with accompanying bacterial growth is clearly detrimental to human health. The pathophysiological and toxicological effects of toxins and structural components of molds and bacteria have been clarified in experiments conducted in tissue culture and animals, and there is convincing epidemiologic evidence; nonetheless their implications for human health are either ignored or denied, at least in Finland. In this communication, we describe two cohorts suffering severe sequelae to mold-related illness. One cohort is a nine-member family with pets that moved into a new house, which soon proved to be infested with pathogenic molds. The other cohort consists of 30 teachers and 50 students from a mold-infested school building. The first cohort experienced a plethora of mucosal irritation, neurological, skin, allergic, and other symptoms, with all family members ultimately developing a multiple chemical syndrome. In the second cohort, we detected a greatly elevated prevalence of autoimmune conditions and malignancies. We claim that mold-related illness exists in multiple facets; if not simply a transient mucosal irritation or even an increased risk of asthma onset or its exacerbation. We propose a scheme to explain the natural course of the mold-related illness. We recommend that future studies should combine data from, e.g., cancer, autoimmune, and endocrine disorder registers and neurological and mental health or neuropsychological registers with mold-exposed individuals being monitored for prolonged follow-up times.
  • Tiedemann, Jörg; Scherrer, Yves (Association for Computational Linguistics, 2017)
  • Tegelberg, Saara; Tomasic, Nikica; Kallijärvi, Jukka; Purhonen, Janne; Elmer, Eskil; Lindberg, Eva; Nord, David Gisselsson; Soller, Maria; Lesko, Nicole; Wedell, Anna; Bruhn, Helene; Freyer, Christoph; Stranneheim, Henrik; Wibom, Rolf; Nennesmo, Inger; Wredenberg, Anna; Eklund, Erik A.; Fellman, Vineta (2017)
    Background: Mitochondrial diseases due to defective respiratory chain complex III (CIII) are relatively uncommon. The assembly of the eleven-subunit CIII is completed by the insertion of the Rieske iron-sulfur protein, a process for which BCS1L protein is indispensable. Mutations in the BCS1L gene constitute the most common diagnosed cause of CIII deficiency, and the phenotypic spectrum arising from mutations in this gene is wide. Results: A case of CIII deficiency was investigated in depth to assess respiratory chain function and assembly, and brain, skeletal muscle and liver histology. Exome sequencing was performed to search for the causative mutation(s). The patient's platelets and muscle mitochondria showed respiration defects and defective assembly of CIII was detected in fibroblast mitochondria. The patient was compound heterozygous for two novel mutations in BCS1L, c.306A > T and c.399delA. In the cerebral cortex a specific pattern of astrogliosis and widespread loss of microglia was observed. Further analysis showed loss of Kupffer cells in the liver. These changes were not found in infants suffering from GRACILE syndrome, the most severe BCS1L-related disorder causing early postnatal mortality, but were partially corroborated in a knock-in mouse model of BCS1L deficiency. Conclusions: We describe two novel compound heterozygous mutations in BCS1L causing CIII deficiency. The pathogenicity of one of the mutations was unexpected and points to the importance of combining next generation sequencing with a biochemical approach when investigating these patients. We further show novel manifestations in brain, skeletal muscle and liver, including abnormality in specialized resident macrophages (microglia and Kupffer cells). These novel phenotypes forward our understanding of CIII deficiencies caused by BCS1L mutations.
  • Hemilä, Harri (2017)
    Antonic et al. reported the findings of a randomized trial on vitamin C and atrial fibrillation (AF). They wrote that “the sample size estimation was based on the assumption that the incidence of AF after CABG lies at about 25% and that the administration of ascorbic acid would result in a 20% decrease of AF. With a power of 80%, beta error of 0.2 and alpha of 0.05, about 50 patients were required in each group”. This sample size calculation does not seem to be correct.