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1.
Sci Rep ; 7(1): 6543, 2017 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-28754972

RESUMO

It is controversial if global warming will result into increased crime and conflict rate, and no causal neurobiological mechanisms have been proposed for the putative association between ambient temperature and aggressive behavior. This study shows that during 1996-2013, ambient temperature explained 10% of variance in the violent crime rate in Finland, corresponding to a 1.7% increase/degree centigrade. Ambient temperature also correlated with a one month delay in circannual changes in peripheral serotonin transporter density among both offenders and healthy control subjects, which itself correlated strongly with the monthly violent crime rate. This suggests that rise in temperature modulates serotonergic transmission which may increase impulsivity and general human activity level, resulting into increase in social interaction and risk of violent incidents. Together, these results suggest that the effect of ambient temperature on occurrence of violent crime is partly mediated through the serotonergic system, and that a 2 °C increase in average temperatures would increase violent crime rates by more than 3% in non-tropical and non-subtropical areas, if other contributing factors remained constant.


Assuntos
Crime/estatística & dados numéricos , Criminosos/estatística & dados numéricos , Temperatura , Violência/estatística & dados numéricos , Adulto , Humanos , Masculino , Serotonina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismo
2.
Int J Clin Pharm ; 33(5): 849-58, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21858727

RESUMO

OBJECTIVE: The aim was to describe parental attitudes towards medicine use in children, and the factors associated with them. SETTING: A cross-sectional population survey of a random sample of children under 12 years of age (n = 6,000) was carried out in Finland in the spring of 2007, with a response rate of 67%. METHOD: A questionnaire was sent to their parents. A Principal Component Analysis was conducted for the attitudinal scale to determine parental attitudes. MAIN OUTCOME MEASURE: An attitudinal scale including 21 items on five-point Likert scale was used to determine parental attitudes towards medicines. RESULTS: Five principal components with 18 statements explained parental attitudes: General attitude towards medicines, Attitude towards prescription medicines, Attitude towards OTC medicines, Attitude towards the risks of medicines, and Attitude towards long-term use of pain-killers. These components were internally consistent and explained 54.7% of the total variance. Of the respondents, 15% were cautious towards medicine use, 84% agreed that prescription medicines are safe and effective, whereas 49% thought so about OTC medicines. Of the respondents, 69% were worried about the risks of medicines, especially parents older than 46 years, with a low level of education, who used medicinal herbs themselves, and had a child with a long-term illness. Moreover, 46% of the respondents were worried about the long-term use of pain-killers. CONCLUSION: This population based study showed that the parental attitudes toward prescription medicines and toward OTC medicines are different: many parents consider prescription medicines as safe and effective, less think so of OTC medicines. A considerable proportion of parents had worries about side effects and interactions. This stresses the need to address these topics in encounters with parents.


Assuntos
Atitude Frente a Saúde , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Medicamentos sem Prescrição , Pais/psicologia , Medicamentos sob Prescrição , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Finlândia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal
3.
Ann Intern Med ; 153(11): 703-9, 2010 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-21135293

RESUMO

BACKGROUND: Current guidelines recommend ß-blockers as the first-line preventive treatment of atrial fibrillation (AF) after cardiac surgery. Despite this, 19% of physicians report using amiodarone as first-line prophylaxis of postoperative AF. Data directly comparing the efficacy of these agents in preventing postoperative AF are lacking. OBJECTIVE: To determine whether intravenous metoprolol and amiodarone are equally effective in preventing postoperative AF after cardiac surgery. DESIGN: Randomized, prospective, equivalence, open-label, multicenter study. (ClinicalTrials.gov registration number: NCT00784316) SETTING: 3 cardiac care referral centers in Finland. PATIENTS: 316 consecutive patients who were hemodynamically stable and free of mechanical ventilation and AF within 24 hours after cardiac surgery. INTERVENTION: Patients were randomly assigned to receive 48-hour infusion of metoprolol, 1 to 3 mg/h, according to heart rate, or amiodarone, 15 mg/kg of body weight daily, with a maximum daily dose of 1000 mg, starting 15 to 21 hours after cardiac surgery. MEASUREMENTS: The primary end point was the occurrence of the first AF episode or completion of the 48-hour infusion. RESULTS: Atrial fibrillation occurred in 38 of 159 (23.9%) patients in the metoprolol group and 39 of 157 (24.8%) patients in the amiodarone group (P = 0.85). However, the difference (-0.9 percentage point [90% CI, -8.9 to 7.0 percentage points]) does not meet the prespecified equivalence margin of 5 percentage points. The adjusted hazard ratio of the metoprolol group compared with the amiodarone group was 1.09 (95% CI, 0.67 to 1.76). LIMITATIONS: Caregivers were not blinded to treatment allocation, and the trial evaluated only stable patients who were not at particularly elevated risk for AF. The withdrawal of preoperative ß-blocker therapy may have increased the risk for AF in the amiodarone group. CONCLUSION: The occurrence of AF was similar in the metoprolol and amiodarone groups. However, because of the wide range of the CIs, the authors cannot conclude that the 2 treatments were equally effective. PRIMARY FUNDING SOURCE: The Finnish Foundation for Cardiovascular Research and the Kuopio University EVO Foundation.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Metoprolol/uso terapêutico , Antagonistas Adrenérgicos beta/efeitos adversos , Idoso , Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Feminino , Finlândia , Humanos , Infusões Intravenosas , Masculino , Metoprolol/efeitos adversos , Pessoa de Meia-Idade , Estudos Prospectivos
4.
Pharmacoepidemiol Drug Saf ; 19(4): 400-7, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19937988

RESUMO

PURPOSE: The goal was to determine the prevalence of medicine use and to provide population-based information on factors associated with medicine use, including prescribed and over-the-counter (OTC) medicines, in children aged under 12 years. METHODS: A cross-sectional population survey of a random sample of children aged under 12 years (n = 6000) was carried out in Finland in spring 2007, with a response rate of 67%. A questionnaire was sent to their parents. Current use of medicines prescribed by a physician and use of OTC medicines during the preceding two days were the main outcome measures. RESULTS: The prevalence of current prescribed medicine use was 17%, and the 2-day prevalence of OTC medicine use 17% (vitamins excluded). The use of prescribed medicines was higher among children with illnesses diagnosed by a physician. Additionally, predictors for the use of prescribed medicines were young age among boys, health status worse than good, and the use of any prescribed medicines by a parent. The predictors for the use of OTC medicines by the child were young age and fairly good to poor health status, and the use of OTC medicines by a parent. However, children with any illnesses diagnosed by a physician were less likely to use OTC medicines. CONCLUSIONS: A considerable proportion of children use prescription and OTC medicines in Finland. Young age and health-related factors, morbidity and health status, and parental medicine use predicted children's medicine use. Further studies are needed to examine the association between parents' and children's medicine use.


Assuntos
Revisão de Uso de Medicamentos/estatística & dados numéricos , Medicamentos sem Prescrição/uso terapêutico , Vigilância da População , Medicamentos sob Prescrição/uso terapêutico , Criança , Pré-Escolar , Estudos Transversais , Finlândia , Humanos , Lactente , Medicamentos sem Prescrição/administração & dosagem , Padrões de Prática Médica/estatística & dados numéricos , Medicamentos sob Prescrição/administração & dosagem , Análise de Regressão , Inquéritos e Questionários
5.
JAMA ; 297(14): 1562-7, 2007 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-17426275

RESUMO

CONTEXT: Atrial fibrillation (AF) is the most common arrhythmia to occur after cardiac surgery. An exaggerated inflammatory response has been proposed to be one etiological factor. OBJECTIVE: To test whether intravenous corticosteroid administration after cardiac surgery prevents AF after cardiac surgery. DESIGN, SETTING, AND PATIENTS: A double-blind, randomized multicenter trial (study enrollment August 2005-June 2006) in 3 university hospitals in Finland of 241 consecutive patients without prior AF or flutter and scheduled to undergo first on-pump coronary artery bypass graft (CABG) surgery, aortic valve replacement, or combined CABG surgery and aortic valve replacement. INTERVENTION: Patients were randomized to receive either 100-mg hydrocortisone or matching placebo as follows: the first dose in the evening of the operative day, then 1 dose every 8 hours during the next 3 days. In addition, all patients received oral metoprolol (50-150 mg/d) titrated to heart rate. MAIN OUTCOME MEASURE: Occurrence of AF during the first 84 hours after cardiac surgery. RESULTS: The incidence of postoperative AF was significantly lower in the hydrocortisone group (36/120 [30%]) than in the placebo group (58/121 [48%]; adjusted hazard ratio, 0.54; 95% confidence interval, 0.35-0.83; P = .004; number needed to treat, 5.6). Compared with placebo, patients receiving hydrocortisone did not have higher rates of superficial or deep wound infections, or other major complications. CONCLUSION: Intravenous hydrocortisone reduced the incidence of AF after cardiac surgery. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00442494.


Assuntos
Anti-Inflamatórios/uso terapêutico , Fibrilação Atrial/etiologia , Fibrilação Atrial/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Hidrocortisona/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/administração & dosagem , Valva Aórtica , Ponte Cardiopulmonar , Ponte de Artéria Coronária , Método Duplo-Cego , Feminino , Implante de Prótese de Valva Cardíaca , Humanos , Hidrocortisona/administração & dosagem , Injeções Intravenosas , Estimativa de Kaplan-Meier , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos
6.
Clin Physiol Funct Imaging ; 27(3): 162-72, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17445067

RESUMO

The earlier studies using phantom models and human subjects concerning warming effects during cellular phone use have been controversial, partly because radiofrequency (RF) exposures have been variable. In this randomized, double-blind, placebo-controlled crossover trial, 30 healthy subjects were submitted to 900 MHz (2W) and 1800 MHz (1W) cellular phone RF exposure, and to sham exposure in separate study sessions. Temperature signals were recorded continuously in both ear canals before, during and after the 35-min RF exposure and the 35-min sham exposure sessions. Temperature was measured by using small-sized NTC thermistors placed in the ear canals through disposable ear plugs. The mean temperature changes were determined during a set cardiovascular autonomic function studies: during a 5-min controlled breathing test, during a 5-min spontaneous breathing test, during 7-min head-up tilting, 1-min before, during and after two consecutive Valsalva manoeuvres and during a deep breathing test. Temperatures in the exposed ear were significantly higher during RF exposures compared with sham exposure in both 900 and 1800 MHz studies with maximum differences of 1 x 2 +/- 0 x 5 degrees C (900 MHz exposure) and 1 x 3 +/- 0 x 7 degrees C (1800 MHz exposure). Temperatures in the RF-exposed ear were also significantly higher during the postexposure period compared with post-sham exposure period with maximum differences of 0 x 6 +/- 0 x 3 degrees C for 900 MHz and 0 x 5 +/- 0 x 5 degrees C for 1800 MHz. The results of this study suggest that RF exposure to a cellular phone, either using 900 or 1800 MHz with their maximal allowed antenna powers, increases the temperature in the ear canal. The reason for the ear canal temperature rising is a consequence of mobile phone battery warming during maximal antenna power use. The earlier published articles do not indicate that temperature rising in the ear canal has any significant contribution from the RF fields emitted from mobile phones.


Assuntos
Temperatura Corporal/fisiologia , Telefone Celular , Meato Acústico Externo/fisiologia , Adulto , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ondas de Rádio
7.
Scand J Prim Health Care ; 25(1): 27-32, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17354156

RESUMO

OBJECTIVE: To study people's views on the accessibility and continuity of primary medical care provided by different providers: a public primary healthcare centre (PPHC), occupational healthcare (OHC), and a private practice (PP). DESIGN: A nationwide population-based questionnaire study. SETTING: Finland. SUBJECTS: A total of 6437 (from a sample of 10,000) Finns aged 15-74 years. MAIN OUTCOME MEASURES: Period of time (in days) to get an appointment with any physician was assessed via a single structured question. Accessibility and continuity were evaluated with a five-category Likert scale. Values 4-5 were regarded as good. RESULTS: Altogether 72% had found that they could obtain an appointment with a physician within three days, while 6% had to wait more than two weeks. Older subjects and subjects with chronic diseases perceived waiting times as longer more often than younger subjects and those without chronic diseases. The proportion of subjects who perceived access to care to be good was 35% in a PPHC, 68% in OHC, and 78% in a PP. The proportion of subjects who were able to get successive appointments with the same doctor was 45% in a PPHC, 68% in OHC, and 81% in a PP. A personal doctor system was related to good continuity and access in a PPHC. CONCLUSIONS: Access to and continuity of care in Finland are suboptimal for people suffering from chronic diseases. The core features of good primary healthcare are still not available within the medical care provided by public health centres.


Assuntos
Continuidade da Assistência ao Paciente , Medicina de Família e Comunidade , Acessibilidade aos Serviços de Saúde , Satisfação do Paciente , Atenção Primária à Saúde , Adolescente , Adulto , Idoso , Doença Crônica/terapia , Centros Comunitários de Saúde/normas , Centros Comunitários de Saúde/estatística & dados numéricos , Medicina de Família e Comunidade/normas , Medicina de Família e Comunidade/estatística & dados numéricos , Finlândia , Humanos , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador/normas , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/estatística & dados numéricos , Setor Privado , Setor Público , Inquéritos e Questionários
8.
Scand J Caring Sci ; 20(4): 439-47, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17116153

RESUMO

Adolescents' health is today threatened by the use of alcohol and other psychoactive substances. It is therefore important to develop interventions related to substance use in school health care. The aim of this study was to examine the empowering or risk background factors related to substance use among adolescents, and the ability of school nurses (PHN) to identify these factors and to provide needed individual early intervention. The data were collected by semistructured questionnaires completed by 14- to 18-year-old adolescents (n = 326, response rate 79) and PHNs (n = 10) in 2004. The adolescent questionnaire consisted of items related to the respondents' background and Adolescents' Substance Use Measurement (ADSUME). Following individual consent, adolescents' ADSUME responses were sent to the PHNs for intervention. The PHNs assessed the adolescents' empowering background factors and intervention using the questionnaire, and 70% (n = 228) of their answers matched the adolescents' answers. The data were analysed with the SPSS software using the chi-squared test, Fisher's exact test, kappa coefficient and agreement percentages. Substance use among adolescents was associated with parental support, mother's education and smoking, the adolescents' knowledge about substances, peer support and hobbies. The PHNs' assessments regarding supportive background were not in agreement with the assessments of adolescents who were using hazardous substances. One-fifth of the adolescents received the brief intervention, although many of them might have needed extra support and follow-up on the basis of their ADSUME results. The research findings can be generalized only for alcohol use, because only 3% of the study informants used substances other than alcohol. Further research is warranted concerning PHNs' ability to identify hazardous substance use and to ensure preventive early intervention and requisite support among substance-using adolescents in order to improve evidence-based health promotion.


Assuntos
Serviços de Enfermagem Escolar , Transtornos Relacionados ao Uso de Substâncias/enfermagem , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Aconselhamento , Finlândia , Humanos , Fatores de Risco , Meio Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários
9.
Scand J Public Health ; 34(4): 437-44, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16861195

RESUMO

AIMS: Little is known about changes in lifestyle and socioeconomic characteristics among physical activity subgroups over time. This study aimed at assessing whether the lifestyle and the socioeconomic profile of people with either low total physical activity (TPA) or high TPA changed during 1972-97. METHODS: Six independent cross-sectional surveys were carried out among a middle-aged population at five-year intervals in Eastern Finland, 1972-97. The participation rates varied from 71% to 95% (n = 33,712). Physical activity during leisure time (LTPA) and occupational physical activity (OPA) were determined by a self-administered questionnaire. TPA was calculated by combining LTPA and OPA. RESULTS: Men with low TPA were older, smoked more, and had a higher BMI than men with high TPA. The increase in BMI was almost fourfold in sedentary men (trend 0.4%/5 years, p = 0.023 for trend) than in highly active men (trend 0.1%/5 years, p = 0.044 for trend). Education no longer accounted for the socioeconomic difference after 1977. Sedentary women had a higher BMI and smoking prevalence than those with high TPA. The difference in age, education, and marital status disappeared between those two groups after 1977. CONCLUSIONS: The lifestyle and the socioeconomic profiles of people with both low TPA and high TPA have changed during 1972-97.


Assuntos
Promoção da Saúde/tendências , Inquéritos Epidemiológicos , Estilo de Vida , Fatores Socioeconômicos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Estudos Transversais , Exercício Físico , Feminino , Finlândia/epidemiologia , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de Risco
10.
Circulation ; 114(1 Suppl): I1-4, 2006 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-16820555

RESUMO

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia to occur after cardiac surgery, with an incidence of 20% to 40%. AF is associated with postoperative complications, including increased risk of stroke and need of additional treatment, as well as prolonged hospital stay and increased costs. It has been shown that prophylactic oral administration of beta-blocker therapy reduces the incidence of postoperative AF after cardiac surgery. However, it is possible that absorption of drugs is impaired after cardiopulmonary perfusion associated with cardiac surgery. The purpose of this prospective, controlled, randomized trial was to study compare intravenous and per oral metoprolol administration in the prevention of AF after cardiac surgery. METHODS AND RESULTS: 240 consecutive patients who were scheduled to undergo their first on-pump coronary artery bypass graft (CABG), aortic valve replacement, or combined aortic valve replacement and CABG were randomized to receive 48-hour infusion of metoprolol or oral metoprolol starting on the first postoperative morning. Patients were excluded if they had contraindications for beta-blocker or had to stay >1 day in the intensive care unit. Dosage of metoprolol was adjusted according to heart rate. The dosage was 1 to 3 mg/h in the intravenous group and from 25 mg twice per day to 50 mg 3 times per day in the oral group. The incidence of postoperative AF was significantly lower in the intravenous group than in the oral group (16.8% versus 28.1%, P=0.036). No serious adverse effects were associated with intravenous metoprolol therapy. CONCLUSIONS: Our study suggests that intravenous metoprolol is well-tolerated and more effective than oral metoprolol in the prevention of AF after cardiac surgery.


Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Valva Aórtica/cirurgia , Fibrilação Atrial/prevenção & controle , Ponte de Artéria Coronária , Implante de Prótese de Valva Cardíaca , Metoprolol/administração & dosagem , Complicações Pós-Operatórias/prevenção & controle , Administração Oral , Antagonistas Adrenérgicos beta/uso terapêutico , Idoso , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/etiologia , Eletrocardiografia , Feminino , Humanos , Infusões Intravenosas , Masculino , Metoprolol/uso terapêutico , Pessoa de Meia-Idade , Monitorização Fisiológica
11.
J Am Geriatr Soc ; 54(6): 912-8, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16776785

RESUMO

OBJECTIVES: To investigate the association between blood pressure and mortality in people aged 85 and older. DESIGN: Population-based prospective study with 9-year follow-up. SETTING: Department of Neuroscience and Neurology and Department of Public Health and General Practice, University of Kuopio, and Department of Clinical Neurosciences, Helsinki University Hospital. PARTICIPANTS: Of all 601 people living in the city of Vantaa born before April 1, 1906, whether living at home or in institutions and alive on April 1, 1991, 521 were clinically examined and underwent blood pressure measurement. MEASUREMENTS: Blood pressure was measured using a standardized method in the right arm of the subject after resting for at least 5 minutes. Information on medical history for each participant was verified from a computerized database containing all primary care health records. Death certificates were obtained from the National Register; the collection of death certificates was complete. RESULTS: After adjusting for age, sex, functional status, and coexisting diseases (earlier-diagnosed myocardial infarction, congestive heart failure, dementia, cancer, stroke, or hypertension), low systolic blood pressure (BP) was associated with risk of death. CONCLUSION: Low systolic BP may be partially related to poor general health and poor vitality, but the very old may represent a select group of individuals, and the use of BP-lowering medications needs to be evaluated in this group.


Assuntos
Envelhecimento/fisiologia , Pressão Sanguínea , Atividades Cotidianas , Fatores Etários , Idoso de 80 Anos ou mais , Monitorização Ambulatorial da Pressão Arterial , Feminino , Finlândia/epidemiologia , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Inquéritos e Questionários , Taxa de Sobrevida/tendências , População Urbana/estatística & dados numéricos
12.
Eur Neuropsychopharmacol ; 16(8): 552-60, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16626947

RESUMO

We measured cortical dopamine transporter (DAT) in Cloninger type 1 and 2 alcoholics by using [(125)I]PE2I as a radioligand in human postmortem whole hemispheric autoradiography, and evaluated the putative correlations of DAT between cortical areas and nucleus accumbens. There was a low, but distinct cortical binding in the cryosections. The mean binding was generally higher in both groups of alcoholics compared to controls, and the results reached statistical significance with a large effect size (1.25) in the temporal cortex of type 2 alcoholics. This is surprising, because several studies have reported lower DAT densities in the striatum among alcoholics compared to controls. Moreover, the density of DAT had a statistically significant positive correlation between temporal cortex and nucleus accumbens in controls, whereas among type 2 alcoholics the correlation was statistically significantly negative, which may suggest some pathology relating to the antisocial behaviour of these alcoholics.


Assuntos
Alcoolismo/diagnóstico por imagem , Alcoolismo/metabolismo , Alcoolismo/patologia , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Adulto , Alcoolismo/classificação , Análise de Variância , Autorradiografia/métodos , Feminino , Humanos , Radioisótopos do Iodo/farmacocinética , Masculino , Pessoa de Meia-Idade , Nortropanos/farmacocinética , Mudanças Depois da Morte , Radiografia , Estatística como Assunto , Ultrassonografia
13.
Eur Heart J ; 27(5): 582-8, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16399774

RESUMO

AIMS: The objective is to study whether a heart rate (HR) response during exercise test independently predicts cardiovascular disease (CVD) mortality. METHODS AND RESULTS: The subjects were a representative sample of 1378 men, 42-61 years of age, from eastern Finland with neither prior coronary heart disease (CHD) nor use of beta-blockers at baseline. HR was measured at rest and during a maximal, symptom-limited exercise test at 20, 40, 60, 80, and 100% of maximal workload. During an average follow-up of 11.4 years, there were 56 deaths due to CVD. The slope of HR increase during exercise test was steeper in survivors when compared with those who died due to CVD during follow-up (P<0.001), and the difference in the steepness of HR slope between the groups was the strongest at interval 40-100% (P<0.001). In Cox-multivariable models, maximal HR-HR at 40% workload as a continuous variable was inversely associated with CVD (P=0.04), CHD (P=0.004), and all-cause (P=0.002) mortality after adjustment for known risk factors for CVD death. CONCLUSION: By considering an HR response throughout an exercise test, we found that a blunted HR increase at 40-100% of maximal workload was associated with increased CVD mortality.


Assuntos
Doenças Cardiovasculares/mortalidade , Exercício Físico/fisiologia , Adulto , Análise de Variância , Doenças Cardiovasculares/fisiopatologia , Causas de Morte , Eletrocardiografia , Teste de Esforço , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco
14.
Pediatr Res ; 59(2): 320-4, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16439600

RESUMO

Ambulatory blood pressure (ABP) monitoring offers a reliable method for determining blood pressure (BP) in children. The aim of this cohort study was to examine whether maternal preeclampsia is associated with elevated BP in an offspring. The study population consisted of 57 children born to preeclamptic mothers (PRE) and their 57 age- and sex-matched control subjects born to normotensive mothers (non-PRE). We examined the 24-h ABP at 12 y of age in the PRE and non-PRE children. Within the two groups, the association of anthropometric measures, plasma catecholamine (epinephrine [E], norepinephrine [NE]) concentrations, and ABP was examined. The PRE children had significantly higher mean 24-h systolic and diastolic ABPs than the non-PRE children. The same was true for the mean daytime and nighttime systolic and diastolic ABPs. The PRE boys had higher 24-h systolic ABP than the PRE girls. In the PRE children, high plasma E concentration and being born small for gestational age (SGA) predicted high systolic 24-h ABP in logistic regression analysis. In the non-PRE children, high current body mass index (BMI) and high plasma E concentration was associated with high systolic 24-h ABP. In conclusion, systolic and diastolic ABP values were elevated in the PRE children. High plasma E concentration and being born SGA were associated with high systolic 24-h ABP in the PRE children. Presumably maternal preeclampsia affects offspring via several mechanisms, including genetic ones and metabolic consequences of restricted intrauterine growth.


Assuntos
Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Pré-Eclâmpsia/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal , Criança , Feminino , Humanos , Gravidez
15.
Scand Cardiovasc J ; 39(3): 177-81, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16146981

RESUMO

OBJECTIVE: To determine the impact of diabetes on outcome after coronary artery bypass surgery. DESIGN: We matched 866 diabetic patients with non-diabetic controls in regards to gender, age, left ventricular ejection fraction, body mass index, presence of unstable angina and history of myocardial infarction, and day of surgery. The 30-d mortality and morbidity were evaluated with univariate analysis and survival and freedom from cardiac death were assessed with the Kaplan-Meier method. RESULTS: Follow-up time was 69+/-37 months. The 30-d mortality was 2.0% in the diabetic group and 1.0% in the non-diabetic group (p=0.15). Postoperative morbidity did not differ between groups. Cumulative 5- and 10-year survival rates were 89 and 71% in diabetics and 94 and 84% in non-diabetics (p=0.001). During follow-up, there was no difference between groups in regards to repeat revascularization. CONCLUSIONS: The 30-d mortality was equally low in diabetic and non-diabetic patients with severe coronary artery disease. However, long-term survival was significantly lower in the diabetic group than in the non-diabetic group.


Assuntos
Ponte de Artéria Coronária/efeitos adversos , Diabetes Mellitus/fisiopatologia , Resultado do Tratamento , Estudos de Casos e Controles , Ponte de Artéria Coronária/mortalidade , Feminino , Finlândia/epidemiologia , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Sobrevida , Fatores de Tempo
16.
Hum Psychopharmacol ; 20(7): 467-72, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16158448

RESUMO

Monthly binding densities (B(max)) of [3H]citalopram to the platelet serotonin transporter (SERT) was measured longitudinally over 1 year in a control group of 18 healthy Finnish male volunteers. Single platelet samples were also analysed from 33 men who were incarcerated for violent crimes during the same calendar year. A statistically significant seasonal variation in SERT B(max) was observed in both data sets, and bi-monthly floating averages for SERT B(max) were calculated and then fit to an annual sinusoidal curve for both groups. The B(max) for platelet [3H]citalopram binding showed a statistically significant (p = 0.001) seasonal variance between a winter (January-February) maximum of 1590 fmol/mg protein and a summer (July-August) minimum of 1216 fmol/mg protein for the control group, with an R2 of 70% for the annual sinusoidal curve fit. A statistically significant (p = 0.007) seasonal variance was also observed between a winter (January-February) maximum of 1980 fmol/mg protein and an autumnal (August-September) minimum of 1234 fmol/mg protein for the violent offenders, again with an R2 of 70% for the annual sinusoidal curve fit. This observation lends additional support to the idea that violent human behavior and impulsivity may be directly linked to values of SERT B(max), which can be affected by various psychoactive drugs and also varies with the natural change of seasons.


Assuntos
Plaquetas/metabolismo , Citalopram/sangue , Crime/psicologia , Inibidores Seletivos de Recaptação de Serotonina/sangue , Violência/psicologia , Adulto , Proteínas Sanguíneas/metabolismo , Crime/estatística & dados numéricos , Finlândia/epidemiologia , Humanos , Masculino , Valores de Referência , Estações do Ano , Violência/estatística & dados numéricos
17.
Pediatr Res ; 58(3): 467-71, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16148058

RESUMO

Intrauterine growth restriction (IUGR) may influence adrenocortical function, lipid metabolism and glucose tolerance in later life. Both cortisol (F) synthesis and metabolism contribute to serum F concentrations. 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) enzyme converts F to biologically inactive cortisone (E). Decreased 11beta-HSD2 activity has been suggested for a reason to IUGR and to its metabolic consequences. Our aim was to develop a specific liquid chromatography - tandem mass spectrometry (LC-MS/MS) method for analysing serum F and E concentrations, to determine the F/E ratios, and to correlate them with serum lipid concentrations, insulin resistance index (HOMA-IR), and catch-up growth in children born small for gestational age (SGA). The mean serum F and E concentrations, and F/E ratios did not differ between the SGA and their control children at 12 y age. The SGA children in the highest F/E ratio quartile had poorer gain in height between 0-12 y, and higher serum total and LDL cholesterol levels than those with lower F/E ratios. In logistic regression analysis, high LDL cholesterol, high HOMA-IR, and early pubertal stage associated with high F/E ratio in the SGA children. In conclusion, our LC-MS/MS method enables a reliable measurement of both F and E concentrations from a single serum sample. High serum F/E ratio may be associated with IUGR, its metabolic consequences, and poor catch-up growth in a subset of SGA children.


Assuntos
Cromatografia Líquida/métodos , Cortisona/sangue , Hidrocortisona/sangue , Recém-Nascido Pequeno para a Idade Gestacional , Resistência à Insulina , Lipídeos/sangue , Espectrometria de Massas/métodos , Antropometria , Humanos , Recém-Nascido
18.
J Clin Psychiatry ; 66(8): 1012-5, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16086616

RESUMO

OBJECTIVE: We tested the hypothesis that topiramate is more effective than placebo in reducing symptoms in patients with treatment-resistant schizophrenia when combined with ongoing antipsychotic medication. METHOD: Twenty-six hospitalized treatment-resistant patients with chronic DSM-IV-diagnosed schizophrenia participated in a randomized, double-blind, placebo-controlled trial in which 300 mg/day of topiramate was gradually added to their ongoing treatment (clozapine, olanzapine, risperidone, or quetiapine) over two 12-week crossover treatment periods. Data were collected from April 2003 to November 2003. RESULTS: In intention-to-treat analysis, topiramate was more effective than placebo in reducing Positive and Negative Syndrome Scale general psychopathologic symptoms (effect size = 0.7, p = .021), whereas no significant improvement was observed in positive or negative symptoms. CONCLUSION: Glutamate antagonist topiramate may be an effective adjuvant treatment in reducing general psychopathologic symptoms in patients with schizophrenia resistant to treatment with second-generation antipsychotics.


Assuntos
Anticonvulsivantes/uso terapêutico , Antipsicóticos/uso terapêutico , Frutose/análogos & derivados , Esquizofrenia/tratamento farmacológico , Adulto , Estudos Cross-Over , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Frutose/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Escalas de Graduação Psiquiátrica , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Topiramato , Resultado do Tratamento
19.
J Dermatolog Treat ; 16(2): 87-94, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16019622

RESUMO

BACKGROUND: Hempseed oil is a rich and balanced source of omega-6 and omega-3 polyunsaturated fatty acids (PUFAs). Anecdotal evidence indicated that dietary hempseed oil might be useful in treating symptoms of atopic dermatitis. PATIENTS AND METHODS: Dietary hempseed oil and olive oil were compared in a 20-week randomized, single-blind crossover study with atopic patients. Fatty acid profiles were measured in plasma triglyceride, cholesteryl and phospholipid fractions. A patient questionnaire provided additional information on skin dryness, itchiness and usage of dermal medications. Skin transepidermal water loss (TEWL) was also measured. RESULTS: Levels of both essential fatty acids (EFAs), linoleic acid (18:2n6) and alpha-linolenic acid (18:3n3), and gamma-linolenic acid (GLA; 18:3n6) increased in all lipid fractions after hempseed oil, with no significant increases of arachidonic acid (20:4n6) in any lipid fractions after either oil. Intra-group TEWL values decreased (p=0.074), qualities of both skin dryness and itchiness improved (p=0.027) and dermal medication usage decreased (p=0.024) after hempseed oil intervention. CONCLUSIONS: Dietary hempseed oil caused significant changes in plasma fatty acid profiles and improved clinical symptoms of atopic dermatitis. It is suggested that these improvements resulted from the balanced and abundant supply of PUFAs in this hempseed oil.


Assuntos
Cannabis , Dermatite Atópica/dietoterapia , Gorduras Insaturadas na Dieta/administração & dosagem , Óleos de Plantas/administração & dosagem , Adulto , Estudos Cross-Over , Dermatite Atópica/metabolismo , Ácidos Graxos Essenciais/sangue , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Azeite de Oliva , Método Simples-Cego , Perda Insensível de Água/fisiologia
20.
Eur J Endocrinol ; 152(3): 335-40, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15757848

RESUMO

OBJECTIVES: Our aim was to determine whether markers of growth hormone and insulin action differ between children born small for gestational age (SGA) and those born of an appropriate size for gestational age (AGA). DESIGN: Fifty-five SGA children and their 55 age- and sex-matched AGA control subjects were studied in a case-control setting at 12 years of age. METHODS: We examined serum concentrations of insulin-like growth factor (IGF)-I, IGF-II, IGF-binding protein (IGFBP)-1 and IGFBP-3, sex hormone binding globulin (SHBG), leptin, fasting insulin, and blood glucose. Insulin sensitivity was evaluated by the homeostasis model assessment for insulin resistance (HOMA-IR). RESULTS: The body mass index (BMI), sex, and puberty-adjusted mean serum IGF-I concentration was higher in the SGA than in the AGA children (303.4 vs 282.3 microg/l, P = 0.006). The mean serum concentrations of IGF-II, IGFBP-I, IGFBP-3, SHBG, fasting insulin, blood glucose and HOMA-IR did not differ between the SGA and the AGA group. The BMI, sex, and puberty-adjusted mean serum leptin concentration was lower in the SGA than in the AGA children (7.9 vs 10.1 microg/l, P = 0.037). In multiple logistic regression analysis, high HOMA-IR predicted high serum IGF-I levels in the SGA children (odds ratio 8.3; 95% confidence interval 1.7-41; P = 0.010), whereas in the AGA group HOMA-IR did not associate with the serum IGF-I level. CONCLUSIONS: The BMI, sex, and puberty-adjusted mean serum IGF-I concentration was significantly higher and the leptin concentration was lower in the SGA than in the AGA children. No differences were found in the indices of insulin action or sensitivity between the SGA and AGA children at 12 years of age. However, HOMA-IR strongly associated with serum IGF-I levels in the SGA children.


Assuntos
Biomarcadores/sangue , Hormônio do Crescimento Humano/fisiologia , Recém-Nascido Pequeno para a Idade Gestacional/sangue , Insulina/fisiologia , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Feminino , Homeostase , Humanos , Recém-Nascido , Resistência à Insulina , Fator de Crescimento Insulin-Like I/metabolismo , Leptina/sangue , Modelos Logísticos , Masculino , Concentração Osmolar , Puberdade/sangue , Fatores Sexuais
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