First Report of Streptomyces europaeiscabiei Causing Common Scab on Potato in Finland.

Common scab is an important disease in potato (Solanum tuberosum) caused by Streptomyces spp. In Finland, morphological and physiological characterization (5) and comparison of the 16S rRNA gene sequences have suggested that Streptomyces scabies and S. turgidiscabies are the main causal species (2), but occurrence of S. europaeiscabiei has not been previously studied. In September 2011, potato tubers of cvs. Fambo, Melody, Puikula, Rosamunda, Victoria, and Van Gogh showing symptoms of common scab were collected from 10 fields in southern (Lammi), eastern (Liperi), and western Finland (Isokyrö, Kalajoki, Tyrnävä). Symptoms included superficial, raised, and pitted corky lesions ranging from 3 to 10 mm in diameter. Isolations were made from scab lesions on water agar. Colonies phenotypically characteristic of Streptomyces were transferred to glucose yeast malt extract agar (GYM) after 7 days. Pure cultures were obtained through subsequent transfers to fresh GYM medium, on which the strains produced golden brown colonies and white to grey spores. DNA was extracted from bacteria using the E.Z.N.A. SP Plant DNA Mini Kit (Omega Bio-Tek, Inc.). Primers developed for the 16S rRNA gene sequences (4) were used to detect S. scabies and S. turgidiscabies by PCR. Of the 14 strains recovered, nine were assigned to S. scabies, three to S. turgidiscabies, and two remained unidentified. However, S. scabies and S. europaeiscabiei cannot be distinguished by the 16S rRNA gene sequence, but the ITS1 region of the 16S operon sequence amplified by PCR is cleaved by Hpy99I in S. scabies but not in S. europaeiscabiei (1). Altogether, 18 strains were tested, including nine obtained in 2011 and seven Finnish and two Swedish strains isolated and assigned to S. scabies in the mid-1990s (2,4,5). The ITS1 sequence of S. scabies type strain, ATCC49173, was cleaved with Hpy99I, in contrast to all other strains that were consequently assigned to S. europaeiscabiei. To further confirm the identity of the Finnish strains, sequences of atpD, recA, and rpoB genes from three strains (one from 1995, two from 2011) (GenBank Accession Nos. KJ802471 to 79) were found to be 100, 99.8, and 100% identical, respectively, to corresponding S. europaeiscabiei type strain CFBP 4497 sequences (3). Pathogenicity of the S. europaeiscabiei strains isolated in 2011 was confirmed using radish seedling assay (1). All strains prevented or reduced the growth of radish seedlings (cv. French Breakfast) or caused severe necrosis in repeated experiments. No symptoms were observed on the seedlings grown on oat meal agar without bacteria. The pathogenicity of the S. europaeiscabiei strains isolated in the mid-1990s was confirmed using minituber assays (4,5). In addition, two of these strains were tested in a glasshouse experiment and two in a radish seedling assay and shown to be pathogenic. The results suggest that S. europaeiscabiei is an important cause of potato common scab in Finland. In the earlier studies, S. europaeiscabiei may have been mistaken for S. scabies, as the restriction analysis of the ITS1 region was not done. References: (1) R. Flores-Gonzáles et al. Plant Pathol. 57:162, 2008. (2) J. F. Kreuze et al. Phytopathology 89:462, 1999. (3) D. P. Labeda. Int. J. Syst. Evol. Microbiol. 61:2525, 2011. (4) M. J. Lehtonen et al. Plant Pathol. 53:280, 2004. (5) P. Lindholm et al. Plant Dis. 81:1317, 1997.

Caesarean section and allergic manifestations: insufficient evidence of association found in population-based study of children aged 1 to 4 years.

AIM: To provide evidence on the association between caesarean section and allergic manifestations in an unselected child population. METHODS: Research focused on all children aged from one to 4 years (N = 4779), born between April 2001 and March 2005 and living in the province of South Karelia, Finland. They were identified from the nationwide population register. Questionnaire data on 3181 participants were individually merged with allergy test results (skin prick tests, IgE antibodies and open food challenges) from all patient records. RESULTS: Compared with vaginal delivery, the adjusted relative incidence of positive allergy tests (with 95% confidence intervals, CI) in children born by caesarean section was 1.14 (0.79, 1.65) for food, 1.16 (0.66, 2.05) for animals, 0.94 (0.46, 1.92) for pollen and 1.19 (0.87, 1.63) for any allergens. The corresponding adjusted prevalence odds ratios (with 95% CI) of physician-diagnosed allergic manifestations were 1.15 (0.80, 1.63) for food allergy, 0.90 (0.47, 1.59) for pollen allergy or hay fever, 1.00 (0.75, 1.31) for atopic eczema, 0.96 (0.53, 1.65) for asthma and 1.08 (0.85, 1.38) for any allergic manifestation. CONCLUSION: Insufficient evidence was found in our population for any association between birth by caesarean section and allergic manifestations. Further evidence from unselected populations, with longer follow-up periods, is needed.

Factor V Leiden as a risk factor for preterm birth--a population-based nested case-control study.

BACKGROUND: Preterm birth is a major cause of neonatal morbidity and mortality, occurring in 5-13% of deliveries in developed countries. Genetic thrombophilia can theoretically contribute to the induction of preterm delivery, but the role of thrombophilia as risk factor is unclear. OBJECTIVES: To assess factor V Leiden, FII G20210A and other selected inherited and acquired variables as risk factors for preterm birth. PATIENTS/METHODS: We performed a population-based nested case-control study of 100,000 consecutive pregnancies in Finland. Cases and controls were identified by combining national registers. Clinical data were obtained from medical records and standardized questionnaires. We studied 324 cases with preterm delivery at or after 22 and before 37 completed weeks of gestation, and 752 controls. RESULTS: FV Leiden was associated with a 2.4-fold risk (95% confidence interval [CI] 1.3-4.6) of preterm birth in all pregnancies, and a 2.6-fold risk (95% CI 1.4-5.1) in singleton pregnancies. FV Leiden was especially associated with late preterm birth at or after 32 weeks of pregnancy, with an odds ratio (OR) of 2.9 (95% CI 1.5-5.6) in all pregnancies and an OR of 3.1 (95% CI 1.6-6.2) in singleton pregnancies. FII G20210A was not associated with preterm birth. Twin pregnancy (OR 12.0, 95% CI 6.0-24.1) and a history of venous thrombosis (OR 3.8, 95% CI 1.4-9.8) were associated with increased risk. High educational level and modest overweight (body mass index 25-29.9 kg m(-2) ) had protective effects. CONCLUSIONS: Maternal carriage of FV Leiden was associated with increased risk of late but not early preterm birth. FII G20120A was not associated with preterm birth.

Prevalence and associated factors of restless legs in a 57-year-old urban population in northern Finland.

OBJECTIVE: We examined the prevalence and associated factors of restless legs syndrome (RLS) in a 57-year-old unselected urban population in northern Finland. METHODS: A health survey was conducted in 2002 that targeted persons born in 1945 and residing in the city of Oulu on 31 December, 2001. Their history of RLS, coronary heart disease (CHD), daytime sleepiness, depressive symptoms and snoring was assessed by means of questionnaires. RESULTS: Altogether 995 of 1332 eligible subjects (74%) participated (556 women, 439 men). The overall prevalence of RLS > or = 1 per week was 20% in women and 15% in men. In the fitted multiple logistic regression model, RLS was found to be associated with female gender (OR 1.64, 95% CI 0.98-2.72), CHD (OR 2.92, 95% CI 1.18-7.23), daytime sleepiness (OR 2.12, 95% CI 1.32-3.41), moderately elevated (31-45) or high (46-65) Zung sum scores (OR 1.95, 95% CI 1.09-3.48 and OR 3.67, 95% CI 1.71-7.90, respectively), antidepressant medication (OR 2.10, 95% CI 1.06-4.19) and arthropathy (OR 1.69, 95% CI 1.04-2.72). Insufficient evidence was found of an association between RLS and type 2 diabetes or impaired glucose regulation. CONCLUSIONS: Restless legs syndrome is fairly common in subjects aged 57 years. A particularly strong positive association was observed between RLS and depressive symptoms and CHD.

ROCK2 allelic variants are not associated with pre-eclampsia susceptibility in the Finnish population.

The rho-associated coiled-coil protein kinase 2 (ROCK2) gene has been suggested to associate with general hypertension and is therefore a plausible functional candidate gene for pre-eclampsia. ROCK2 maps to chromosome 2p25, which we have implicated previously in a linkage study of pre-eclampsia. We have re-sequenced exons and putative promoter region of ROCK2 in up to 30 pre-eclampsia patients and 22 controls and genotyped putative functional single-nucleotide polymorphisms (SNPs) as well as tagging SNPs from HapMap in a Finnish case-control data set-340 affected and 357 matched control individuals-for a genetic association study of ROCK2 in pre-eclampsia. Even though several new SNPs were discovered, we did not detect significant allelic or haplotypic association between ROCK2 and pre-eclampsia. We assessed ROCK2 expression in placentas by microarray analysis, but no significant expression differences were observed when comparing preeclamptic and normotensive pregnancies. We conclude that common genetic variation in ROCK2 is unlikely to make a major contribution to the risk of pre-eclampsia, but cannot exclude the possibility of having missed non-coding functional variants or rare coding variants.

Interactions and biocontrol of pathogenic Streptomyces strains co-occurring in potato scab lesions.

AIMS: To test interactions between pathogenic strains of Streptomyces turgidiscabies, S. scabies and S. aureofaciens. To study biological control of S. turgidiscabies and S. scabies using the nonpathogenic Streptomyces strain (346) isolated from a scab lesion and a commercially available biocontrol agent (S. griseoviridis strain K61; 'Mycostop'). METHODS AND RESULTS: Pathogenic strains of S. turgidiscabies and S. aureofaciens inhibited growth of S. scabies in vitro, whereas strain 346 and S. griseoviridis inhibited the pathogenic strains and were subsequently tested for control of scab in the greenhouse and field. Strains 346 and K61 suppressed development of common scab disease caused by S. turgidiscabies in the greenhouse. Strain 346 reduced incidence of S. turgidiscabies in scab lesions on potato tubers in the field. CONCLUSIONS: Streptomyces turgidiscabies shows antagonism against S. scabies that occurs in the same scab lesions and shares the ecological niche in the field. Biocontrol of S. turgidiscabies is possible with nonpathogenic Streptomyces strains but interactions may be complicated. SIGNIFICANCE AND IMPACT OF THE STUDY: Streptomyces turgidiscabies may have potential to displace S. scabies under the Scandinavian potato growing conditions. Biological control of the severe potato scab pathogen, S. turgidiscabies, is demonstrated for the first time. The results can be applied to enhance control of common scab.

Are there associations between coffee consumption and glucose tolerance in elderly subjects?

OBJECTIVE: To describe the associations between coffee consumption and glucose tolerance among elderly subjects. DESIGN: A survey among an unselected non-institutionalized elderly population. Diabetes was assessed on the basis of self-reports and 2-h oral glucose tolerance test for the subjects on diet treatment or with normal glucose tolerance (NGT). Coffee consumption was assessed by a questionnaire. SETTING: Three municipalities in Northern Finland Subjects: All non-institutionalized subjects with baseline normal glucose tolerance or impaired glucose tolerance (IGT) aged 70 years or over. MAIN OUTCOME MEASURES: Incidence, persistence or impairment of abnormal glucose tolerance (AGT). RESULTS: Forty-two percent of those with NGT and 0-5 cups of coffee daily developed AGT, whereas the corresponding figure was 25% for those who drank more than five cups coffee daily. Fifty-five percent of the subjects with IGT or NGT who drank 0-5 cups coffee daily either persisted in IGT or developed AGT. The corresponding figure was 30% for those drinking more than five cups coffee daily. After adjustment for age, body mass index, cardiovascular disease, smoking, alcohol consumption and physical exercise, among those with NGT, the odds ratio (OR) for developing AGT was 2.3 for those drinking 0-5 cups compared to those drinking more than five cups of coffee daily (95% confidence interval (CI) 0.7-7.2). Correspondingly, low coffee consumption was the most powerful predictor associated with the persistence of IGT or the development of AGT (OR 2.9; 95% CI 1.2-6.9). CONCLUSIONS: Low coffee consumption predicts impairment of AGT or persistence of IGT among elderly subjects.

Are there associations between socio-economic status and known diabetes in an elderly Finnish population?

The aim of the study was to describe the associations between socio-economic status and type 2 diabetes in a non-institutionalised population aged 70 years or over. Diabetes was assessed on the basis of self-reports and additionally 2-h oral glucose tolerance test for the subjects on diet treatment. Socio-economic status was assessed by questions on marital status, number of residents in household, basic education, self-rated income and economic status. In the population of 379 subjects (141 men), 14% (n = 19) of men and 19% (n = 46) of women had known diabetes. Known diabetes was less common among married compared to unmarried, widowed or divorced subjects. Diabetes was also more common among men with higher compared to lower level of basic education, while a reverse trend was seen among women. Women, who had been engaged in manual labour, had diabetes more often compared to those engaged in administrative work. Diabetes was more common among men who rated their income as good, but the opposite was true of women. Higher income among men and lower income among women were the most powerful variables associated with known diabetes. Known diabetes was more common in elderly women with lower socio-economic status, whereas the opposite was true of men. This finding suggests that the impact of the socio-economic changes that have taken place in Finland in the 20th century on the risk factors for diabetes has been greater among men with higher and women with lower socio-economic status.

Does hyperglycaemia cause symptoms in elderly people?

The aim of the present study was to describe the associations between glucose tolerance and symptoms in an unselected non-institutionalised elderly population aged 73 years or over (n = 259, of whom 93 were men). Diabetes was assessed on the basis of self-reports and 2-h oral glucose tolerance tests (1985 WHO criteria). Symptoms were measured with a modified diabetes symptom checklist (DSC-Type 2). The previously diagnosed diabetic patients reported to have more symptoms in all the six dimensions of the symptom checklist than the other study groups. According to the responses to twenty out of 34 items, more of the previously diagnosed diabetic women had symptoms than the other female study groups; the corresponding figure for the previously diagnosed diabetic men being 16/34. The following hyperglycaemic symptoms: "dry mouth", "increasing fatigue in the course of the day", "numbness in the hands", were either weakly or significantly associated with undiagnosed diabetes. Men with IGT reported to have "dry mouth" and "tingling or pricking in the legs or feet" more often than men with NGT. Symptoms of "moodiness" increased along with the deterioration of glucose tolerance, and it seems that depression is associated with type 2 diabetes in elderly people, too. Although the study covered a wide range of symptoms, it did not clearly reveal such symptoms that could be used as potential indicators of undiagnosed diabetes or especially IGT among elderly patients.

Functional ability after hip fracture among patients home-dwelling at the time of fracture.

The aim of the study was to assess the change in function and residential status four months after hip fracture in patients over 50 years of age and living independently at home at the time of fracture. All consecutive hip fracture patients treated at Oulu University Hospital during 1989--1999 were followed up. Data collection was done on standardized hip fracture forms, which were filled in at admission and at four months postoperatively. The forms included demographic data, place of residence, locomotor ability, use of walking aids, data on the fracture and its treatment, hospital stay, place of discharge and pain. At four months, 16.0% of the men and 14.3% of the women were permanently institutionalized. Preoperatively, 81.1% of the patients had been able to walk out of doors either alone or accompanied, while at 4 months, less than half of the patients (149 men, 391 women) were able to do so. Two thirds of the hip fracture patients had been able to walk without walking aids before the fracture, the corresponding proportion being one fifth at four months after the fracture. Cumulative mortality at 4 months was 9.9%, being higher among the male (15.5%, n=53) than the female patients (7.9%, n=75). The original study population was also divided into two subgroups operated at different period of time (1989--92 and 1993--99), the functional results seemed to improve with time. Hip fracture leads to the institutionalization of every seventh patient able to live at home at the time of fracture and impairs markedly one's functional capacity. To restore the pre-fracture status as well as possible and to reduce the burden of the consequences of hip fracture, it might be beneficial to evaluate and improve the existing rehabilitation system.

Risk factors for cryptogenic ischaemic stroke.

This case-control study was designed to identify risk factors for cryptogenic brain infarction. We assessed the frequency of prothrombotic states, homocysteine, lipoprotein (a) [Lp(a)] and other lipids and the apolipoprotein E phenotype together with conventional risk factors in 46 patients (19 women and 27 men) with cryptogenic brain infarction aged from 15 to 60 years and in 104 community-based controls. Multivariate odds ratios (ORs) for risk factors and 95% CIs were calculated by logistic regression. Hypertension (OR 4.5; 95% CI, 1.5-13.2; P = 0.006), current smoking (OR 2.9; 95% CI, 1.2-6.8; P = 0.012), low HDL cholesterol (HDL-C) (OR 5.4; 95% CI, 1.1-25.5; P = 0.035) and high clotting factor VIII activity (OR 3.6; 95% CI, 1.1-12.2; P = 0.041) were variables associated with cryptogenic brain infarction. These risk factors were not equally frequent in women and men. Low HDL-C and high factor VIII activity in the women, and hypertension, current smoking and a low level of plasma folate in the men were risk factors for cryptogenic stroke. Several of the observed risk factors for cryptogenic brain infarction were lifestyle-associated, which emphasizes the role of health education in addition to pharmacological treatment in the prevention of stroke.

Glucose tolerance and cognitive impairment in an elderly population.

We investigated the associations between abnormal glucose tolerance and cognitive impairment in elderly subjects, taking into account some other known determinants of cognitive function. The study population consisted of community-living northern Finnish subjects aged 70 y or over (n=379, of whom were 141 men). Thirty-one percent of the men and women (n=43 for the men and n=75 for the women) scored 23 or less in the Mini Mental State Examination. A low level of basic education and high age were the most powerful predictors of impaired cognition. When adjusted for age, gender, educational level, presence of cardiovascular disease (or hypertension), use of alcohol, number of depressive symptoms and poor vision, abnormal glucose tolerance (including IGT) was also weakly associated with impaired cognitive function among these elderly subjects.

Increased risk of intraventricular hemorrhage in preterm infants with thrombophilia.

The multifactorial etiology of cerebral intraventricular hemorrhage (IVH) may involve coagulation disturbances and venous infarction. We tested whether coagulation abnormalities associated with adult venous thrombosis would constitute a risk factor for IVH in newborn infants. In 22 infants (gestational age 24.3--39.9 wk, median 28.0 wk) with neonatal IVH grade II to IV, the frequencies of congenital resistance to activated protein C due to a point mutation in the factor V gene (Gln506-FV) and a polymorphism in the prothrombin gene (G20210A-FII) were assessed and compared with those observed in 29 premature newborn infants without IVH and in 302 (Gln506-FV) or 526 (G20210A-FII) healthy adults. In infants with IVH, four (18%) heterozygous carriers of Gln506-FV and one (5%) heterozygous carrier of G20210A-FII were found. One infant without IVH was heterozygous for Gln506-FV (3%). When compared with the frequency of Gln506-FV in the general population, the odds ratio for being a carrier of Gln506-FV for patients with IVH was 5.9 (95% confidence interval 1.7--20.3, p = 0.013) and for patients without IVH 0.9 (95% confidence interval 0.1--7.6, p > 0.99). The absolute risk of IVH in a newborn infant with heterozygous Gln506-FV and born before 30 wk of gestation was estimated at 80%, whereas the corresponding risk for all infants born before 30 wk was 14%. Gln506-FV was more common in newborn infants with IVH than in the general population, whereas there was no difference in the frequencies of Gln506-FV in infants without IVH and in the general population. Thus, Gln506-FV may be a risk factor of IVH. The risk of IVH in a premature infant with Gln506-FV or other established thrombophilic coagulation abnormality may be considerable.

Does glucose tolerance affect elderly persons' balance, gait or muscle strength?

The aim of this study was to find out if there are associations between the deterioration of glucose tolerance and balance, gait or muscle strength among non-institutionalised northern Finnish subjects aged 70 years or over. 79% of the eligible 483 subjects participated in the study (n = 379; of whom 141 were men). 14 % (n = 19) of the men had previously diagnosed diabetes, 9% had undiagnosed diabetes, and 32% had impaired glucose tolerance (IGT). The corresponding figures for the women were 19% (n = 46), 9% (n = 21) and 35% (n = 84). The proportion of the female subjects with good balance tended to decrease along with the deterioration of the glucose tolerance status and there was a trend that disturbances in gait (walking speed, step length among the women) increased along with the deterioration of glucose tolerance. A greater proportion of the previously diagnosed diabetic subjects had decreased thenar (p = 0.09), interosseus (p = 0.00), tibialis anterior (p = 0.003), tibialis posterior (p = 0.07) and peroneus (p = 0.03) muscle strength and decreased or missing biceps (p = 0.019) and quadriceps (p = 0.010) tendon reflexes. More of the subjects with abnormal glucose tolerance had weakening of the abdominal muscles compared to the persons with normal glucose tolerance (NGT) (p = 0.001). A greater proportion of the previously diagnosed diabetic subjects had abnormal vibration sense in the sternum compared to the subjects with NGT (p = 0.028) and the tendency was similar for undiagnosed diabetes. As a majority of the abnormal findings in this study were made among the previously diagnosed diabetic patients, the long duration of hyperglycemia probably contributes to the development of these disturbances. Therefore, early detection and active treatment of hyperglycemia might prevent or at least delay the development of signs of diabetic neuropathy among elderly subjects.

Effects of the WHO 1985 criteria and the proposed new diagnostic criteria on the prevalence of diabetes in an elderly population.

Population data suggest that a fasting blood glucose level of > or = 6.1 mmol/l corresponds best to a two-hour blood glucose level of > or = 11.1 mmol/l, which is associated with an increased risk of developing microvascular complications. The proposed new criteria, and the WHO 1985 criteria for diabetes, were applied in an elderly population, which underwent a two-hour oral glucose tolerance test. The prevalence of diabetes was higher when the proposed new criteria were used than when the old criteria were used. In calculating the prevalence of diabetes, the fasting blood glucose > or = 6.1 mmol/l corresponded better to the combination of fasting and/or two-hour values than did fasting blood glucose > or = 6.7 mmol/l. The prevalence obtained by using either of these fasting values alone or in combination with two-hour values corresponded poorly to that obtained by using mere two-hour blood glucose values.

Changes in glucose tolerance during three years' follow-up in an elderly population.

The aim of this study was to describe changes in glucose tolerance over 3 y and to establish the prevalence of diabetes and impaired glucose tolerance in an unselected non-institutionalised elderly population aged 70 y or over at the beginning of the study. Diabetes was assessed on the basis of self-reports and 2 h oral glucose tolerance tests which were classified according to the 1985 WHO criteria. At the end of the follow-up period, 15% (n=14) of the men were diagnosed as having previously diagnosed diabetes, 8% (n=7) as having previously undiagnosed diabetes, 36% (n=33) as having IGT and the remaining 41% (n=38) as having normal glucose tolerance. The corresponding figures for the women were: 22% (n=37), 8% (n=13), 37% (n=61) and 34% (n=56), respectively. More than one third of the people with baseline normal glucose tolerance (NGT) had progressed to impaired glucose tolerance (IGT) or diabetes mellitus (DM) (n=44). Almost one third of those with baseline IGT had reverted to NGT (n=24), half had persisting IGT (n=41) and one fifth had progressed to DM (n=14). Almost one fifth of the subjects with baseline DM had reverted to IGT (n=12), and only one had reverted to NGT. In conclusion, a comparatively high proportion of both previously diagnosed diabetes, previously undiagnosed diabetes and IGT were found in the follow-up examinations of this elderly study population. The rate of deterioration of glucose tolerance during 3 y follow-up was also moderately high among these elderly subjects.

Does glucose tolerance affect quality of life in an elderly population?

The aim of the present study was to describe the associations between glucose tolerance and quality of life in an unselected non-institutionalised elderly population aged 73 years or over (n = 259, of whom 93 were men). Diabetes was assessed on the basis of self-reports and 2-h oral glucose tolerance tests (1985 WHO criteria). Quality of life was evaluated with the Nottingham Health Profile instrument (NHP). A greater proportion of the previously diagnosed diabetic patients reported to have problems on all the three energy items, on nearly all the physical mobility items and on half of the pain items compared to the subjects with undiagnosed diabetes, impaired glucose tolerance or normal glucose tolerance. The results of the second part of the NHP were in line with those of the first part, showing that more of the persons with previously diagnosed diabetes had problems on the following items: jobs around the house, hobbies and holidays compared to the other study groups. As for the six quality of life dimensions in the first part of the NHP, the previously diagnosed diabetic persons scored clearly higher on the energy, pain and physical mobility dimensions of the NHP compared to all the other subjects. To conclude, elderly subjects with previously diagnosed diabetes had a poorer quality of life compared to those with undiagnosed diabetes, impaired glucose tolerance or normal glucose tolerance.