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ABSTRACT: Injuries are an important public health problem as well as the leading cause of death and disability among children. Our aim was to longitudinally explore the incidence of in-hospital treated traumas, their operative treatment and related mortality among pediatric patients in Finland.
The National Hospital Discharge Register and the Official Cause-of-Death Statistics data of in-hospital treated pediatric trauma patients between 1997 and 2006 in Finland were evaluated for hospitalizations, treatment modality and mortality.
Fractures (69%) and head injuries (28%) were the most common in-hospital treated traumas (477/100,000 persons/year). These were followed by injuries of intra-abdominal (1.4%), thoracic (1.2%) and urological organs (0.6%). Head traumas constituted 67% of injury-related deaths. During the ten-year follow-up period, the annual incidence (per 100,000 persons) of head injuries decreased by 13.6% (152 in 1997 vs. 131 in 2006, p < 0.0001) mainly contributing to a 30% decrease in overall injury-related mortality incidence (from 5.7 in 1997 to 4.0 in 2006, p = 0.0519). The overall trauma incidence, and incidence of fractures and abdominal injuries significantly increased by 5.0% (p < 0.0001), 13.5% (p < 0.0001) and 37% (p < 0.05), respectively, while the incidence of thoracic and urological injuries remained unchanged. Up to 15% of spleen injuries lead to splenectomy.
Although overall and head trauma-related mortality is decreasing, the increasing incidence of fractures and abdominal injuries has amplified the overall incidence of severe injuries among children in Finland. A significant number of unnecessary splenectomies are still performed among children.
Scandinavian journal of surgery: SJS: official organ for the Finnish Surgical Society and the Scandinavian Surgical Society 01/2011; 100(2):129-35. · 1.03 Impact Factor
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ABSTRACT: Severe vertebral fractures strongly predicted subsequent hip fracture in this population-based study. Such high-risk patients should be provided with clinical evaluation and care for osteoporosis.
Vertebral fractures are commonly osteoporotic and known to predict hip fracture. The aim of this study was to evaluate associations between the severity of vertebral fractures and the risk of subsequent hip fracture.
Chest radiographs were obtained of 7,095 Finnish men and women aged 30 years or over in the Mini-Finland Health Survey in 1978-1980. Record linkage to the National Hospital Discharge Register identified 182 subjects from the survey who had subsequently been hospitalized for primary treatment of hip fracture by the end of 1994. A nested case-control setting was adopted, where three controls individually matched for age, gender, and place of residence were drawn for 169 subjects with hip fracture from the same cohort. Baseline vertebral fractures were identified at levels T3 to T12, and their morphology was categorized to mild, moderate, or severe according to Genant's classification.
Severe vertebral fracture (>40% reduction in vertebral body height) strongly predicted hip fracture. After controlling for education, physical activity, smoking, alcohol consumption, and self-rated general health, the adjusted relative odds was 12.06 (95% confidence interval, 3.80-38.26). Mild to moderate fracture grades and the number of compressed vertebral bodies showed no prediction for hip fracture.
The presence of a severe vertebral fracture in the thoracic spine strongly predicts subsequent hip fracture. Such high-risk patients should be clinically evaluated and provided with care for osteoporosis and measures to reduce the risk of falling as required.
Osteoporosis International 02/2010; 22(1):63-8. · 4.58 Impact Factor
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LMJ Helenius,
D Hallikainen, I Helenius,
JH Meurman,
S Koskimies,
P Tervahartiala,
L Kivisaari,
J Hietanen,
R Suuronen,
C Lindqvist,
M Leirisalo‐Repo
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ABSTRACT: Objective: To investigate the association between HLA antigens and temporomandibular joint (TMJ) erosion, salivary composition, and focal sialadenitis in patients with rheumatic diseases. Methods: Eighty‐four patients, 24 with rheumatoid arthritis (RA), 19 with mixed connective tissue disease (MCTD), 19 with ankylosing spondylitis (AS), and 22 with spondyloarthropathy (SPA) were studied. Each patient underwent clinical examination of the masticatory system, unstimulated and stimulated saliva collection, and minor salivary gland biopsy. Radiographs (OPTG) of the TMJ were obtained, and HLA allele (A, B, C and DRB1*) analysis was performed. Erosion in OPTG was scored from 0 (no erosion) to 4 (condyles totally eroded). In the analysis, scores 0–2 were grouped as normal or mild changes, and scores 3–4 as distinct erosions. One hundred healthy blood donors served as controls for HLA typing. Results: Distinct erosion of the TMJ in OPTG was observed in 22 (27%) patients. It affected four (17%) of the 24 patients with RA, three (17%) of the 18 with MCTD, seven (37%) of the 19 patients with AS and eight (38%) of the 21 with SPA non‐significant (NS). The mean erosion scores were 1.7 for RA, 1.3 for MCTD, 2.5 for SPA, and 1.6 for AS patients [probability (p)=0.04]. The frequency of HLA‐B27 antigen was higher in the AS and SPA patients, and that of HLA‐DRB1*04 allele higher in RA patients than in control subjects. In the whole patient population, HLA‐DRB1*01 allele was significantly associated with erosions 16/36 (44%) versus 6/46 (13%) (p=0.0014). In the SPA group, patients with HLA‐DRB1*01 allele had a significantly higher occurrence of distinct erosions than patients without this allele [8/10 (80%) versus 0/11 (0%) (p=0.0002)], whereas DRB1*06 was protective [0/8 (0%) versus 8/13 (62%) (p=0.018)]. HLA‐DRB1*04 was associated with increased salivary IgG in the RA patients. Conclusion: HLA antigens are significantly associated with the development of destructive lesions in the TMJ, as well as composition of saliva in patients with various rheumatic diseases.
07/2009; 33(1):24-29.
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ABSTRACT: Hand function was evaluated in 105 patients who had been operated on in early infancy for brachial plexus birth palsy. The mean follow-up after surgery was for 13.4 years (5.0 to 31.5). Fine sensation, stereognosis, grip and pinch strength and the Raimondi scale were recorded. Fine sensation was normal in 34 of 49 patients (69%) with C5-6 injury, 15 of 31 (48%) with C5-7 and in 8 of 25 (32%) with total injury. Loss of protective sensation or absent sensation was noted in some palmar areas of the hand in 12 of 105 patients (11%). Normal stereognosis was recorded in 88 of the 105 patients (84%), whereas only 9 of the 105 (9%) had normal grip strength. The mean Raimondi scale scores were 4.57 (3 to 5) (C5-6), 4.26 (1 to 5) (C5-7) and 2.16 (0 to 5) in patients with total injury. The location of impaired sensation was related to the distribution of the root injury. Avulsion type of injury correlated with poor recovery of hand function.
Journal of Bone and Joint Surgery - British Volume 04/2008; 90(3):349-55. · 2.83 Impact Factor
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ABSTRACT: Long-term complications related to immunosuppressive medication are an important problem after liver transplantation (OLT). This study was carried out to evaluate the bone health and risk factors for osteoporosis and fractures in 40 pediatric liver transplant recipients. The results of 208 longitudinal bone mineral density (BMD) measurements were analyzed retrospectively. In addition, a dual-energy X-ray absorptiometry was performed to assess the bone mineral content more precisely and to detect subclinical vertebral fractures (VF). The median age of the patients was 14 years and mean postoperative follow-up 7.0 years. The results showed that over half (58%) had lumbar spine (LS) Z-score </=-1.0 and one-fifth (18%) had asymptomatic VF. LS Z-score tended to increase from the first year after OLT, but during puberty the bone mass gain was suboptimal and Z-scores decreased in some subjects. Patients with VF were older at the time of OLT (p = 0.002) and their LS Z-score was lower (p = 0.001). Children transplanted before 10 years of age had less VF (p = 0.004) and higher LS Z-score (p = 0.005) than older patients. In conclusion, adolescent liver recipients are prone to osteoporosis and prevention should be targeted especially to this age group.
American Journal of Transplantation 01/2008; 8(1):150-7. · 6.39 Impact Factor
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ABSTRACT: The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and 18 with spondyloarthropathy (SPA). They were clinically examined, and panoramic tomography, lateral panoramic radiography and MRI of the TMJ were performed. MRI showed reduced articular cartilage in 25% (4/16) of RA, 0% (0/15) of MCTD, 17% (3/18) of AS and 17% (3/18) of SPA patients. Condylar changes included erosion, osteophytes and abnormal shape. Disc alterations included perforation, abnormal anterior position and decreased movement. These abnormalities were most frequent in RA patients, and least frequent in MCTD and SPA patients. Crepitation and reduced maximum opening of the mouth correlated with abnormalities of the disc and articular cartilage as shown by MRI. Severe condylar erosion in panoramic tomograms significantly correlated with MRI findings of condylar erosion (P<0.01), diminished thickness of condylar cartilage, abnormal condylar shape, and abnormal shape of the temporal surface of the TMJ (P< or =0.001). The presence of crepitation, limited mandibular movement and/or pain on movement of the jaw often indicated structural damage to the TMJ. Panoramic radiographs provide an alternative method to MRI but, to obtain a more detailed anatomic picture, MRI is recommended for patients with acute unexplained pain or as part of preoperative work up. A panoramic recording is not indicated when MRI is planned.
International Journal of Oral and Maxillofacial Surgery 12/2006; 35(11):983-9. · 1.51 Impact Factor
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ABSTRACT: The present study aimed at determining the use of physician-prescribed medication in a large number of elite athletes compared with a representative control sample of the general population. Of all the athletes (N = 494) financially supported by the National Olympic Committee, 446 completed a structured questionnaire (response rate 90.3 %) in 2002. A control group (N = 1503, response rate 80.1 %) comprised an age-matched sample from the population-based study collected by the National Public Health Institute. Any prescribed medication was used by 34.5 % of the athletes and 24.9 % of the controls during the past seven days. The most frequently reported physician-prescribed medications among athletes during the previous seven days were anti-allergic medicines (12.6 % of the respondents), non-steroidal anti-inflammatory drugs (NSAIDs; 8.1 %), anti-asthmatic medicines (7.0 %), and oral antibiotics (2.7 %). The adjusted odds ratios (95 % CI) for the physician-prescribed medications used during the previous seven days was 2.42 (1.69 - 3.46), 3.63 (2.25 - 5.84), 3.42 (2.05 - 5.70), and 2.15 (1.03 - 4.45) for use of anti-allergic medication, NSAIDs, anti-asthmatic medication, and oral antibiotics, respectively, in the athletes compared with controls. Every fifth athlete reported some NSAID-related adverse effect. In conclusion, the athletes used NSAIDs, antibiotics, anti-asthmatic and anti-allergic medication significantly more often than a representative sample of age-matched controls. All these medicines have potential adverse effects that may have a deleterious impact on the maximum exercise performance of elite athletes. Adverse effects were commonly reported in connection with NSAID use.
International Journal of Sports Medicine 12/2006; 27(11):919-25. · 2.43 Impact Factor
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ABSTRACT: Although athletes' beliefs and values are known to influence whether or not an athlete will use banned drugs, little is known about the athletes' beliefs and attitudes in different sports. The aim of this study was to clarify the beliefs and attitudes of elite athletes towards banned substances and methods in sports. A total of 446 athletes (response rate 90.3 %; 446/494) financially supported by the National Finnish Olympic Committee completed a structured questionnaire during their national team camps in 2002. More than 90 % of the athletes reported to believe that banned substances and methods have performance enhancing effects, and 30 % reported that they personally know an athlete who uses banned substances. Of the male athletes 35 %, and 23 % of females reported they personally know an athlete using banned substances. A total of 15 % of the athletes reported that they had been offered banned substances: 21 % of the speed and power athletes, 14 % of the team sport athletes and of the athletes in motor skills demanding events, and 10 % of the endurance athletes. Stimulants were the most often offered substance group (to 7 % of all the athletes) followed by anabolic steroids (4 %). Subjects who regarded doping as a minor health risk seemed to be more often associated with doping users than those regarding doping as a significant health risk. Athletes in different sports have a different approach to doping. Risk of doping appears to be highest in speed and power sports and lowest in motor skills demanding sports. Males are at higher risk than females. Controlling doping only by tests is not sufficient. A profound change in the attitudes is needed, which should be monitored repeatedly.
International Journal of Sports Medicine 11/2006; 27(10):842-6. · 2.43 Impact Factor
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ABSTRACT: This study aimed to assess the prevalence of smoking and snuff use in Finnish elite athletes. Of all the athletes (n = 494) financially supported by the National Olympic Committee, 446 completed a structured questionnaire (response rate 90.3 %) in 2002. A control group (n = 1504, response rate 80.2 %) comprised an age-matched sample from the population-based sample collected by the National Public Health Institute. Any smoking was reported by 11.4 % of the athletes (3.6 % daily and 7.8 % occasionally) and by 38.3 % of the controls (28.1 % and 10.2 %). After adjusting for age, sex, and education, OR (95 % CI) for any smoking was highest 0.42 (0.23 - 0.77) for athletes in skill-based events and lowest 0.06 (0.02 - 0.17) for endurance athletes as compared with controls. Snuff use was reported by 24.6 % of the athletes (9.6 % daily and 15.0 % occasionally) and by 3.7 % of the controls (1.8 % and 1.9 %). The adjusted OR (95 % CI) for any snuff use was highest 15.6 (9.55 - 25.6) for team-sport athletes and lowest 3.33 (1.54 - 7.21) for endurance athletes as compared with controls. Although snuff use in the general female population is rare, also female athletes did use snuff. Though prevalence of daily smoking among athletes was one-seventh of the respective figure for the general population, prevalence of daily snuff use was five-fold that of controls. Tobacco free elite athletes are valuable in health counselling because athletes are considered role models influencing their peers and the sport. Sport associations are challenged to ban all forms of tobacco.
International Journal of Sports Medicine 08/2006; 27(7):581-6. · 2.43 Impact Factor
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I Helenius,
H Jalanko,
V Remes,
H Sairanen,
S Salminen,
C Holmberg,
P Palmu,
P Tervahartiala,
H Valta,
S Sarna,
M Helenius,
O Mäkitie,
J Peltonen
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ABSTRACT: The occurrence of scoliosis in children after solid organ transplantation is not known. A total of 196 children, which is 93% of patients surviving kidney, liver and heart transplantation in our country, participated in a cross-sectional survey. All children were screened for rib hump, and those with clinically significant hump (over 6 degrees ) underwent radiographs of the spine. The occurrence of scoliosis was compared to data obtained from a previously published comparison group. Forty-three (21.9%) of the patients had scoliosis greater than 10 degrees , and 21 (10.7%) of them had curves greater than 20 degrees . The RR (95% CI) for scoliosis needing treatment (over 20 degrees ) was 17.0 (6.75-42.7) in the patients as compared with control population. The occurrence of scoliosis was 17.9% of the kidney, 13.6% of the liver and 51.7% of the heart transplant patients (p < 0.001). In a logistic regression model, heart transplantation (OR (95% CI) 7.27 (2.62-20.2)) and growth hormone treatment (3.98 (1.77-8.94)) were most significant risk factors for scoliosis. The risk of scoliosis is increased in patients with solid organ transplantation. Pediatricians treating these patients should be aware of this increased risk to diagnose early curves and to refer these patients to an orthopedic surgeon.
American Journal of Transplantation 03/2006; 6(2):324-30. · 6.39 Impact Factor
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ABSTRACT: Patients with atopic dermatitis (AD) often have symptoms suggestive of asthma or rhinitis. The prevalence and signs of respiratory disease in AD patients have been studied to a limited extent.
To assess the prevalence and clustering of respiratory symptoms, bronchial hyper-responsiveness (BHR), and eosinophilic airway inflammation in patients with moderate-to-severe AD.
Eighty-six consecutive patients with moderate-to-severe AD and 49 randomly selected control subjects without AD were studied by questionnaire, flow volume spirometry, histamine challenge to detect BHR, induced sputum test to detect eosinophilic airway inflammation, and skin prick tests (SPTs) and total serum immunoglobulin (Ig)E measurements to detect atopy.
The patients with AD showed increased risk of physician-diagnosed asthma (36% vs. 2%, odds ratio (OR) 10.1, confidence interval (CI) 1.3-79.7, P=0.03), physician-diagnosed allergic rhinitis (AR) (45% vs. 6%, OR 4.5, CI 1.2-16.7, P=0.02), BHR (51% vs. 10%, OR 5.5, CI 1.5-20.1, P=0.01), and sputum eosinophilia (81% vs. 11%, OR 76.1, CI 9.3-623.5, P<0.0001) compared with the control subjects. In AD patients, elevated s-IgE and positive SPTs were associated with the occurrence of physician-diagnosed asthma and AR, BHR, and the presence of sputum eosinophilia.
BHR and eosinophilic airway inflammation are more common in patients with AD than in control subjects. The highest prevalences were seen in patients with AD who were SPT positive and had high IgE levels. Longitudinal studies are needed to assess the outcome of patients with signs of airway disease, in order to identify those who need early initiation of asthma treatment.
Clinical & Experimental Allergy 02/2006; 36(2):192-7. · 5.03 Impact Factor
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L M J Helenius,
D Hallikainen, I Helenius,
J H Meurman,
S Koskimies,
P Tervahartiala,
L Kivisaari,
J Hietanen,
R Suuronen,
C Lindqvist,
M Leirisalo-Repo
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ABSTRACT: To investigate the association between HLA antigens and temporomandibular joint (TMJ) erosion, salivary composition, and focal sialadenitis in patients with rheumatic diseases.
Eighty-four patients, 24 with rheumatoid arthritis (RA), 19 with mixed connective tissue disease (MCTD), 19 with ankylosing spondylitis (AS), and 22 with spondyloarthropathy (SPA) were studied. Each patient underwent clinical examination of the masticatory system, unstimulated and stimulated saliva collection, and minor salivary gland biopsy. Radiographs (OPTG) of the TMJ were obtained, and HLA allele (A, B, C and DRB1*) analysis was performed. Erosion in OPTG was scored from 0 (no erosion) to 4 (condyles totally eroded). In the analysis, scores 0-2 were grouped as normal or mild changes, and scores 3-4 as distinct erosions. One hundred healthy blood donors served as controls for HLA typing.
Distinct erosion of the TMJ in OPTG was observed in 22 (27%) patients. It affected four (17%) of the 24 patients with RA, three (17%) of the 18 with MCTD, seven (37%) of the 19 patients with AS and eight (38%) of the 21 with SPA non-significant (NS). The mean erosion scores were 1.7 for RA, 1.3 for MCTD, 2.5 for SPA, and 1.6 for AS patients [probability (p) = 0.04]. The frequency of HLA-B27 antigen was higher in the AS and SPA patients, and that of HLA-DRB1*04 allele higher in RA patients than in control subjects. In the whole patient population, HLA-DRB1*01 allele was significantly associated with erosions 16/36 (44%) versus 6/46 (131%1) (p = 0.0014). In the SPA group, patients with HLA-DRBI*01 allele had a significantly higher occurrence of distinct erosions than patients without this allele [8/10 (80%) versus 0/11 (0%) (p = 0.0002)], whereas DRB1*06 was protective [0/8 (0%) versus 8/13 (62%) (p = 0.018)]. HLA-DRB1*04 was associated with increased salivary IgG in the RA patients.
HLA antigens are significantly associated with the development of destructive lesions in the TMJ, as well as composition of saliva in patients with various rheumatic diseases.
Scandinavian Journal of Rheumatology 02/2004; 33(1):24-9. · 2.47 Impact Factor
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ABSTRACT: Controlled clinical trials on the effects of leukotriene antagonists on asthma-like symptoms, bronchial hyperresponsiveness and airway inflammation have not been performed in elite athletes.
In 2001, we examined 88 of 102 (86%) players from three junior, national league ice hockey teams in Helsinki. Athletes were included in the intervention if they reported at least two exercise-induced bronchial symptoms (wheeze, cough, shortness of breath) weekly during the previous month on a previously validated respiratory-symptom questionnaire. Sixteen male ice hockey players fulfilled the study criteria. A double-blind, randomized, cross-over, placebo-controlled study included 4-week active treatment (10 mg oral montelukast, bedtime), 1-week washout period, and 4-week placebo treatment. Before entering the study, all patients were clinically examined, skin prick tested, filled in a respiratory symptom questionnaire, performed a spirometry and a histamine challenge test, and gave induced sputum samples. Exhaled NO was measured. These measures were repeated after both treatment periods. During the treatment the athletes kept daily diary on lower respiratory tract symptoms on a scale from 0 (no symptoms) to 10 (most severe symptoms), morning peak expiratory flow (PEF), training amount, and use of study medication. Primary end-point was daily lower respiratory tract symptom score.
Montelukast had no effect on daily lower respiratory symptom scores, spirometry parameters [forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, PEF], bronchial hyperresponsiveness, sputum eosinophil or neutrophil cell counts, exhaled NO measurements, or morning PEF. Nine subjects were atopic in skin prick test, but their results did not differ from the nonatopic subjects.
A leukotriene antagonist, montelukast, was of no benefit in the treatment of asthma-like symptoms, increased bronchial hyperresponsiveness or a mixed type of eosinophilic and neutrophilic airway inflammation in highly-trained ice hockey players.
Allergy 02/2004; 59(1):39-44. · 6.27 Impact Factor
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ABSTRACT: Background: Controlled clinical trials on the effects of leukotriene antagonists on asthma-like symptoms, bronchial hyperresponsiveness and airway inflammation have not been performed in elite athletes.Methods: In 2001, we examined 88 of 102 (86%) players from three junior, national league ice hockey teams in Helsinki. Athletes were included in the intervention if they reported at least two exercise-induced bronchial symptoms (wheeze, cough, shortness of breath) weekly during the previous month on a previously validated respiratory-symptom questionnaire. Sixteen male ice hockey players fulfilled the study criteria. A double-blind, randomized, cross-over, placebo-controlled study included 4-week active treatment (10 mg oral montelukast, bedtime), 1-week washout period, and 4-week placebo treatment. Before entering the study, all patients were clinically examined, skin prick tested, filled in a respiratory symptom questionnaire, performed a spirometry and a histamine challenge test, and gave induced sputum samples. Exhaled NO was measured. These measures were repeated after both treatment periods. During the treatment the athletes kept daily diary on lower respiratory tract symptoms on a scale from 0 (no symptoms) to 10 (most severe symptoms), morning peak expiratory flow (PEF), training amount, and use of study medication. Primary end-point was daily lower respiratory tract symptom score.Results: Montelukast had no effect on daily lower respiratory symptom scores, spirometry parameters [forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, PEF], bronchial hyperresponsiveness, sputum eosinophil or neutrophil cell counts, exhaled NO measurements, or morning PEF. Nine subjects were atopic in skin prick test, but their results did not differ from the nonatopic subjects.Conclusion: A leukotriene antagonist, montelukast, was of no benefit in the treatment of asthma-like symptoms, increased bronchial hyperresponsiveness or a mixed type of eosinophilic and neutrophilic airway inflammation in highly-trained ice hockey players.
Allergy 12/2003; 59(1):39 - 44. · 6.27 Impact Factor
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ABSTRACT: Data concerning the determinants of sputum eosinophilia and bronchial hyper-responsiveness (BHR) in large cohorts of individuals with normal lung function are limited. Here, we assessed the occurrence of sputum eosinophilia and BHR and identified the risk factors for these variables in two populations living in North Karelia, Finland, and in Pitkäranta, the Republic of Karelia, Russia. These areas are geographically adjacent, but differ, however, fundamentally in major cultural, socioeconomical and lifestyle aspects. The study population comprised 790 Finns and 387 Russian, aged 25-54 years, who were randomly enrolled from the population registers. A methacholine challenge test to measure BHR was successfully performed in 581 (74%) Finns and 307 (79%) Russians with virtually normal lung function (FEV1 > 70% of predicted). Of these, induced sputum samples were obtained from 41% of the Finns and from 67% of the Russians. The proportion of current smokers was 27% among the former and 42% among the latter. Sputum eosinophilia was assessed using a semi-quantitative method, and total concentrations of sputum eosinophilic cationic protein (ECP) and myeloperoxidase (MPO) were measured using an immunoassay. Risk factors for BHR and sputum eosinophilia were identified with a regression analysis. The prevalence of sputum eosinophilia was 22% among the Finns and 19% among the Russians, and the respective figures for BHR were 14% and 13%. The median ECP concentration in sputum was significantly higher among the Russians as compared with the Finns (P<0.001), whereas for MPO, the difference did not achieve significance. Current smoking was significantly associated with both sputum eosinophilia and BHR in Russia (OR 3.1, 95% CI 1.2-7.6 for sputum eosinophilia, 2.8, 1.3-6.1 for BHR) and with BHR in Finland (2.1, 1.3-3.7). Atopy showed a tendency to be another risk factor for BHR in Finland (1.6, 0.98-2.6). In conclusion, sputum eosinophilia and BHR occurred commonly among the Finns and the Russians with normal lung function. Current smoking was significantly associated with BHR in both countries and additionally with sputum eosinophilia in Russia. Atopy was identified as a risk factor, albeit of borderline significance, for BHR in Finland only, suggesting that there may be differences in the aetiology and nature of BHR between the two countries.
Respiratory Medicine 09/2003; 97(8):947-54. · 2.47 Impact Factor
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ABSTRACT: There is little information of lower respiratory symptoms, bronchial hyperresponsiveness and airway inflammation in elite ice hockey players. A total of 88 highly trained ice hockey players and 47 control subjects were studied. All the subjects were subjected to skin-prick tests, resting spirometry examinations and histamine-challenge tests. Adequate induced sputum samples were obtained from 68 of the ice hockey players and from 18 symptom-free control subjects on a separate day. Bronchial hyperresponsiveness in a histamine-challenge test was found in 21 (24%) of the athletes and in five (11%) of the controls. Current asthma (current asthmatic symptoms and increased bronchial responsiveness) was observed in 13 (15%) of the athletes and in one (2%) of the control subjects. Total asthma (current asthma or previously physician-diagnosed asthma) occurred in 19 (22%) of the athletes and in two (4%) of the controls. Atopy, according to skin-prick tests, was observed in 51 (58%) of the athletes and 17 (36%) of the control subjects. The differential cell counts of eosinophils (2.6 versus 0.2%) and neutrophils (80.9 versus 29.9%) in the sputum samples of the ice hockey players were significantly higher than in those of the control subjects. Asthma is common in elite ice hockey players and they show signs of a mixed type of neutrophilic and eosinophilic airway inflammation. Inhalation of cold air associated with exposure to indoor pollutants during intensive training is a possible causative factor.
European Respiratory Journal 08/2003; 22(1):113-7. · 5.89 Impact Factor
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ABSTRACT: Exercise-induced changes in postexercise pulmonary function have not been studied in healthy elite athletes in normal training conditions. Twelve healthy elite runners volunteered. They showed normal resting spirometry and bronchial responsiveness to histamine, and were non-atopic. They performed free running exercise challenge tests (ECT) at subzero temperature and immediately after highest birch pollen season. The mean maximal postexercise changes in FEV(1), PEF, FVC, and FEV(1)/FVC did not differ between the cold air and pollen season ECTs. Compared with pre-exercise values, FEV(1)increased significantly at 10 min (p = 0.028) and 20 min (p = 0.033) postexercise in the cold air ECT, as well as at 10 min (p = 0.024) and 20 min (p = 0.010) postexercise in the pollen season ECT. The mean (SEM) maximal postexercise change in FEV(1) was mostly small + 2.6 (0.6)% in the winter and + 2.7 (0.9)% in the pollen season. In contrast, significant decreases in PEF, compared with baseline, were found at 10 min (p = 0.071) and 20 min (p = 0.0029) postexercise in the cold air ECT, as well as at 10 min (p = 0.060) and 20 min (p = 0.010) postexercise in the pollen season ECT (p = 0.0076). The mean (SEM) maximal postexercise fall in PEF was 5.9 (1.0)% in the winter and 6.0 (1.8)% in the pollen season. Heavy exercise challenge tests in extreme conditions increased FEV(1) post-exercise, while PEF decreased as compared with pre-exercise values. Thus, even small postexercise falls in FEV(1) may be considered as deviate exercise responses in elite athletes.
International Journal of Sports Medicine 06/2002; 23(4):252-61. · 2.43 Impact Factor
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ABSTRACT: To investigate the occurrence of and risk factors for focal sialadenitis in patients with rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), ankylosing spondylitis (AS), and spondyloarthropathy (SpA).
A total of 85 patients (25 with RA, 19 with MCTD, 19 with AS, 22 with SpA) participated in the study. Each patient filled out a questionnaire for eye and oral symptoms and for the use of medication, and was interviewed; other tests included Schirmer's test, laboratory tests, collection of unstimulated and stimulated whole saliva, and minor salivary gland biopsy. A focus score of > or =1 was regarded as an indicator of focal sialadenitis.
Focal sialadenitis was observed in 68% (57/84) of all patients. It affected 80% (20/25) of the patients with RA, 94% (17/18) of those with MCTD, 58% (11/19) of those with AS, and 41% (9/22) of those with SpA (chi(2) test, p=0.0013). Salivary secretion correlated negatively with the focus scores-that is, severity of focal sialadenitis. Patients with focal sialadenitis had both decreased salivary secretion and decreased tear secretion significantly more often than did patients without (chi(2) test, p=0.0074 and p=0.048 respectively). Patients with positive rheumatoid factor (RF), antinuclear antibodies (ANA), or SSA or SSB antibodies had sialadenitis significantly more often than did patients with negative antibodies. In the subgroup of patients with AS or SpA, no associations were found between focal sialadenitis and the presence of these antibodies.
In addition to patients with RA or MCTD, focal sialadenitis also affects a very high proportion of patients with AS or SpA. Focus scores are significantly higher in patients with RA or MCTD than in those with AS or SpA. A significant association exists between focal sialadenitis and RF, ANA, SSA and SSB. However, in the subgroup of patients with AS or SpA, no associations were found between focal sialadenitis and serological markers or clinical symptoms.
Annals of the Rheumatic Diseases 09/2001; 60(8):744-9. · 8.73 Impact Factor
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Duodecim; lääketieteellinen aikakauskirja 02/2001; 117(7):722-4.
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ABSTRACT: A few studies have investigated therapeutic effect of hip arthroscopy in osteoarthritis, and therefore the use of hip arthroscopy in osteoarthritis has remained controversial. The aim of this study was to evaluate diagnostic and therapeutic aspects of hip arthroscopy in primary osteoarthritis.
During a time period from 1995 to 1999, a total of 68 patients had an arthroscopic evaluation of primary hip osteoarthritis at the Päijät-Häme Central Hospital, Lahti, Finland. The mean (range) follow-up was 1.3 (0.3 to 4) years. Arthroscopy was diagnostic in 38 (56%), while six (9%) patients received either long-lasting anaesthetic or prednisolone, and in 24 (35%) debridement was possible. Partial synovectomy was performed in two (3%).
Three months after the arthroscopy, 49 (72%) patients reported that their hip pain had decreased. One year after the arthroscopy, 18 (26%) patients stated that their hip pain was less pronounced than before the arthroscopy. The severity of hip osteoarthritis in preoperative x-rays correlated significantly (p = 0.035) with the subjective result: the milder the osteoarthritis, the more often patients reported that their hip pain had decreased after arthroscopy. No association was observed between age, sex, modified Outerbridge grade of chondropathy, or whether a debridement was done or not and the symptomatic relief after the arthroscopy.
Hip arthroscopy with or without debridement of loose cartilage may, at least temporarily, reduce the pain of mild or moderate osteoarthritis of the hip. Still, repeated arthroscopies had no therapeutic effect.
Annales chirurgiae et gynaecologiae 02/2001; 90(1):28-31.
