Biomedical subjects

H Helenius

Publications and source records attributed to H Helenius.

At least 19 recordsLinked to original sources

PubMed2001

Customer fee and participation in breast-cancer screening.

Until 1997, breast screening by mammography was free for all women living in Turku, Finland. After this date, women born in certain years had to pay to be screened. We did a retrospective study, using data obtained from Statistics Finland, to ascertain whether or not the introduction of a fee affected attendance. We also assessed the effect of socioeconomic status on attendance. Our findings show that people who had to pay for mammography attended less often than women who were entitled to free screening, irrespective of their socioeconomic status.

Adolescent↗

PubMed2001

Feasibility of prolonged use of interferon-alpha in metastatic kidney carcinoma: a phase II study.

BACKGROUND: Interferon-alpha has proven effective in the treatment of metastatic renal cell carcinoma. However, the optimal schedule has not yet been determined. The authors have studied the efficacy and toxicity of prolonged use interferon-alpha2a (IFN-alpha) in metastatic renal cell carcinoma (RCC). Interferon-alpha was administered intermittently for outpatients. METHODS: Seventy-five patients with metastatic RCC without prior biochemotherapy were treated. During the first month, the IFN-alpha dose was increased from 4.5 to 18 million units (MU) 3 times a week to define the individual maximal tolerated dose for each patient. The treatment was continued at the maximal tolerated dose with a 1-week pause each month until either progression or intolerable toxicity was observed or up to 2 years. RESULTS: The overall response rate (5 complete response [CRs] and 8 partial responses [PRs]) was 17% (95% confidence interval, 10-28%). Stable disease was observed in 32 patients (43%). Three late objective responses (4%) occurred after 12 months treatment. The median progression free time of all patients was 12.3 months, and median survival time was 19.3 months. The median duration of response in CR/PR patients was 16 months. In multivariate analysis independent prognostic factors were poor performance status (P = 0.004), presence of bone metastases (P = 0.001), and time to metastases less than 24 months (P = 0.003), which predicted poor survival. Six patients (8%) discontinued the treatment because of fatigue, elevation of liver enzymes, or cardiac arrhythmias. No life-threatening side effects were observed. CONCLUSIONS: Prolonged and intermittently administered IFN-alpha2a three times per week in 3 weekly cycles in metastatic RCC is a feasible and effective therapy. A prolonged treatment duration of more than 12 months for stable and responding patients is beneficial and may improve the outcome of patients with RCC.

Adult↗

PubMed2001

Stress of daily activities and risk of breast cancer: a prospective cohort study in Finland.

The belief that life stress enhances breast cancer is common, but there are few prospective epidemiological studies on the relationship of life stress and breast cancer. We have investigated the association between stress of daily activities (SDA) and breast-cancer risk in a prospective cohort study of 10,519 Finnish women aged 18 years or more. SDA measures a subject's own appraisal of daily stress. It was assessed in 1975 and 1981 by a self-administered questionnaire, which also provided information on subject characteristics and other known breast-cancer risk factors. Follow-up data for breast cancer from 1976 to 1996 were attained through record linkage to the Finnish Cancer Registry. Study subjects were divided into 3 groups based on their SDA scores in 1975: no stress (23% of subjects), some stress (68%) and severe stress (9%). Hazard ratios (HRs) and respective 95% confidence intervals (CIs) for incidence of breast cancer by level of SDA were obtained from the Cox proportional hazards model. We identified 205 incident breast cancers in the cohort. Multivariable-adjusted HRs for breast-cancer risk were 1.00 (reference), 1.11 (95% CI 0.78-1.57) and 0.96 (95% CI 0.53-1.73) by increasing level of stress. Neither shifting of the SDA cut-off points nor restricting the analysis to women who reported the same level of SDA in 1975 and 1981 materially altered the results. We found no evidence of an association between self-perceived daily stress and breast-cancer risk.

Activities of Daily Living↗

PubMed2001

The Schizophrenia Suicide Risk Scale (SSRS): development and initial validation.

BACKGROUND: Estimations about the lifetime risk of suicide in schizophrenia vary between 4 and 10%. At present, there does not exist a suicide risk scale developed particularly for schizophrenic patients. The aims of the present study were to: (1) develop a clinically useful semi-structured scale for the estimation of short-term suicide risk among schizophrenic patients, and (2) to carry out an initial validation of the scale. METHODS: A 25-item Schizophrenia Suicide Risk Scale (SSRS) was constructed on the base of the literature. The SSRS scores of 69 living schizophrenic patients (LS group) were compared with the scores of 69 schizophrenic suicides (SS group) whose data had been collected previously from The Finnish nationwide and representative psychological autopsy study. Internal consistency of the SSRS was evaluated with Cronbach alpha. The most important SSRS items predicting suicide were identified with a logistic regression analysis. Sensitivity, specificity, positive predictive value, and negative predictive value of the SSRS in predicting suicide with various cut-off scores were calculated. RESULTS: In the final logistic regression model, the following SSRS items significantly predicted suicide: suicide plans communicated to someone during the past 3 months; one or more previous suicide attempts; loss of professional skills demanding job; depression observed during an interview; and suicide plans communicated during an interview. With high cut-off scores the specificity of the SSRS became satisfactory, but the sensitivity dropped below 32%. Internal consistency of the anamnestic history of the SSRS was low, which suggests that anamnestic risk factors for suicide in schizophrenia are multifactorial. Internal consistency of the interview-based items was high, and present state risk factors seemed to consist of two separate factors, depression-anxiety and irritability. CONCLUSIONS: The SSRS may be clinically useful in identifying schizophrenic patients with a particularly high risk for suicide. However, the SSRS seems not to be a practical screening instrument for suicide risk in schizophrenia, and it is probably impossible to construct a suicide risk scale with both high sensitivity and high specificity in this disorder.

Adolescent↗

PubMed2001

Cognitive functions of adolescent childhood cancer survivors assessed by event-related potentials.

BACKGROUND: Neurophysiological methods were applied to examine subtle central nervous system (CNS) adverse effects for adolescent childhood cancer survivors. We analyzed auditory event-related potentials (ERPs)-P300 and MMN/P3a complex-to find out whether there was impaired attention orientation in asymptomatic cancer survivors, and whether these ERP methods could be used as more objective tools in detecting those survivors who might need academic testing. Previous clinical studies of P300 have focused on leukemia survivors. MMN for cancer survivors has not been reported. PROCEDURE: The subjects were survivors of childhood leukemia (n=11) and solid tumors (n=8), as well as healthy controls (n=10). The mean age was 15.5 years for survivors and 15.9 years for controls. Pure sine-wave tones (500 and 553 Hz, 100 ms) were used as stimuli in an oddball paradigm. The ERPs to frequency change were measured. MMN recordings were performed in a passive non-attended situation where the subject was watching a voiceless video cartoon. P300 was produced thereafter, but in an active attend situation, by the same auditory oddball paradigm as MMN. RESULTS: A significant difference was detected between the groups for the latency of P300 at electrodes Cz (P = 0.03) and C4 (P = 0.05). The cancer survivors had prolonged P300 latencies as an indication of prolonged short-term memory processing. The area and latency parameters of MMN did not differ significantly between the study groups, but in cancer survivors, the area and the mean amplitude of the subsequent P3a wave were diminished. The results indicate that the discrimination process was not as easy for the survivors as for the controls. However, it seems that in cancer survivors the basic mechanism starting attention shift to novel stimuli is not impaired. CONCLUSIONS: These results indicate that it is important to carefully evaluate the proper methods for the teaching of children who are survivors of malignancies. The auditory information may not always lead to the best possible learning results.

Achievement↗

PubMed2001

Child and adolescent mental health service use in Finland.

BACKGROUND: The study examines the associations of parent, teacher and self-report evaluations of child psychopathology, help-seeking variables and family factors with the use of child mental health services. METHOD: The study comprised an 8-year follow-up of the Epidemiological Child Psychiatry Study in Finland. Children were evaluated at age 8 with Rutter parent and teacher scales and with the Child Depression Inventory, and at age 16, with the Child Behavior Checklist and the Youth Self Report. Information was obtained from about 70% of the follow-up sample (n=857). RESULTS: About 7% of the sample had been in contact with child mental health services during the follow-up. The most potent predictors at age 8 of later referral were total problem behaviours and antisocial problems in parental evaluation, teacher's evaluation of the child's need for referral and living in other than a biological two-parent family. At age 16, externalizing and internalizing problems, total competence and family composition were independently associated with service use. CONCLUSIONS: Both child psychopathology and family disruption were associated with service use. Only a minority of children at risk of psychiatric disorders had used child mental health services.

Adolescent↗

PubMed2001

Choline acetytransferase activity and striatal dopamine receptors in Parkinson's disease in relation to cognitive impairment.

Brain tissue from 44 patients with Parkinson's disease (PD) and 36 age-matched controls was examined for choline acetyltransferase (ChAT) activity, and for densities of D1 and D2 dopamine receptors. Brain samples were examined for Alzheimer' disease (AD) type changes and for Lewy bodies (LBs), and for apolipoprotein E genotype. Patients were evaluated for the stage of cognitive impairment using Reisberg's global deterioration scale. ChAT activity in PD was reduced in all brain areas examined, being 51% of the control mean in the hippocampus (P<0.001), 57% in the prefrontal cortex (P< 0.001) and 64% in the temporal cortex (P<0.001). The number of LBs had a significant negative correlation with ChAT activity in both prefrontal (r=-0.33, P<0.05) and temporal cortex (r=-0.32, P<0.05). The reduction in ChAT activity in the prefrontal cortex had a significant negative correlation (r=-0.38, P=0.012) with the extent of cognitive impairment. When the CERAD class 'C' was excluded, cognitive impairment correlated significantly with both prefrontal ChAT activity (r=-0.52, P=0.0051) and the density of D1 dopamine receptors in the caudate nucleus (r=-0.40, P=0.037). The number of D1 and D2 dopamine receptors was reduced in both caudate nucleus and putamen in PD patients without neuroleptics as compared to controls. An increased D2 receptor number was found in the caudate nucleus and putamen in PD patients treated with neuroleptics. The present study showed that cognitive decline in PD is associated with reduced ChAT activity in the prefrontal cortex and the D1 dopamine receptor number in the caudate nucleus, even in the absence of AD-type pathology.

Aged↗

PubMed2001

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults.

UNLABELLED: A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.

Adolescent↗

PubMed2001

Antenatal depression, substance dependency and social support.

BACKGROUND: The purpose of this study was to explore the prevalence of depression and factors associated with depressive mood among pregnant women. METHOD: 391 women who were 14-37 weeks pregnant were evaluated with the Edinburgh Postnatal Depression Screen (EPDS), which has also been validated for prenatal use. Four questionnaires were used in order to explore associated factors: a questionnaire on background and pregnancy data, the Substance Abuse Subtle Screening Inventory (SASSI) and two Social Support Questionnaires (SSQ1 and 2). RESULTS: 7.7% of the total sample screened positive on the EPDS with a cut-off point of 12/13 recommended. Substance dependency and experienced difficulties in social environment had an independently significant association with maternal depression. LIMITATION: The caseness was defined with a self-report instrument. CONCLUSION: Substance dependency and experienced difficulties, especially in relation to friends, partner and own mother, are associated with antenatal depression. It is important to be aware of this when developing interventions in maternity care primary units.

Adult↗

PubMed2001

An early report on the mother-baby interactive capacity of substance-abusing mothers.

OBJECTIVE: Examination of maternal interactive behavior and psychosocial situation of substance-abusing mothers in treatment. METHOD: Twelve mothers with an alcohol or drug abuse problem and 12 control mothers were assessed in random order with the Parent-Child Early Relational Assessment, for the analysis of videotaped mother-infant interactions at 3 and 6 months' postpartum. Depressive symptoms were assessed with Edinburgh Postnatal Depression Scale and aspects of social support with two Social Support Questionnaires. RESULTS: Substance-abusing mothers tended to have more problematic areas in their interactive behavior, a tendency which increased during the study period. As was expected, they were more often depressive, and experienced more social environment difficulties and less social support. CONCLUSIONS: Mothers with alcohol and drug abuse problems need intensive professional support in early motherhood, and are seen to be particularly motivated to strive for abstinence and accept help at this stage of life.

Adolescent↗

PubMed2001

Familial occurrence of Parkinson's disease in a community-based case-control study.

Purpose: To study the occurrence of Parkinson's disease (PD) in the relatives of parkinsonian patients (n=119), and of their matched controls (n=238).Scope: More patients reported a positive family history of PD in their first degree relatives, compared to their controls (OR 2.7, 95% CI 1.3-5.9), and the incidence of PD among those relatives was also significantly higher (OR 1.4, 95% CI 1.1-1.8).Conclusions: Familial occurrence of PD is not necessarily a sign of genetic mechanisms in the etiology of PD. Shared environment with common risk factors might be even more important.

Journal Article↗

PubMed2001

Validation of a new questionnaire on asthma, allergic rhinitis, and conjunctivitis in young adults.

BACKGROUND: Epidemiologic data on asthma and allergies among adults are mainly based on questionnaires: this study validates the questions on asthma, allergic rhinitis, and conjunctivitis of a new Finnish questionnaire. METHODS: To validate questions used in a country-wide study among university students aged 18-25 years, we examined 150 subjects who had ever reported asthma or wheezing, and 140 without asthma symptoms. Questions were validated in relation to current diseases including 1) symptoms detected during the preceding year at the physician's interview 2) objective measurements, such as methacholine challenge, skin prick tests, and specific IgE. Data were adjusted for original proportions of "asthmatics" and"nonasthmatics" in the questionnaire study. RESULTS: Questions on "reported asthma" and "doctor-diagnosed asthma" had good positive predictive value (PPV) and specificity in diagnosing current asthma. The question on "attacks of shortness of breath with wheezing", and especially the question on "cough with wheezing" were most sensitive. Questions on "allergic nasal symptoms" and "allergic eye symptoms" that were "related to pollen or animals" were sensitive, but a further question on doctor's diagnosis yielded higher specificity and PPV. CONCLUSION: Diagnosis-based questions were found suitable for risk-factor studies, because of their good specificity and PPV, and symptom-based questions for screening, because they were highest in sensitivity.

Adolescent↗

PubMed2001

Prevalence of nickel allergy among Finnish university students in 1995.

Nickel allergy was studied in a sample of 1st-year university students starting their studies in 1995. A total of 296 subjects (72%) of 413 invited participated in the clinical examination, and 284, 96 male and 188 female, were patch tested (69%). A history of nickel sensitization was enquired for. Prick tests and serum specific IgE levels were determined. Occurrence of atopic dermatitis, hand eczema, and current exposure to metals were recorded. Nickel allergy was encountered in 39% of all female students, in 42% of females with pierced skin, and in 14% of females without pierced skin. The corresponding figures for males were 3%, 7% and 3%. In the multiple regression analysis, the risk factors for nickel allergy were female sex (OR 8.1, p<0.01), current metal exposure at examination (OR 4.1, p<0.01) and skin piercing (OR 3.6, p<0.05). Positive prick tests or elevated IgE levels to common allergens were not significantly associated with nickel allergy. In female students, the prevalence of nickel allergy has increased from 13% in 1986 to 39%. The prevalence among males has remained low at 3%. The results indicate that, in addition to skin piercing, current metal contacts are important risk factors for nickel allergy. This finding gives support to the EU Nickel Directive.

Adult↗

PubMed2001

Long-term reproducibility of ambulatory blood pressure in unselected elderly subjects.

The aim of this study was to evaluate the long-term reproducibility and validity of 24-h ambulatory blood pressure measurements (ABPM) in an unselected elderly population. In a rural Finnish community 503 randomly chosen invited persons over 65 years of age participated and went through 24-h ABPM. As part of the validation of the methodology, the reproducibility study was conducted in 26 persons (age 65-76 years). Two identical sets of measurement were performed at 4-12 (median 8) month intervals. The agreement between measurements was assessed by correlation coefficients and standard deviation (SD) of the differences. There were no significant differences in 24-h, daytime and night-time average diastolic blood pressure (DBP) and daytime average systolic blood pressure (SBP) between the two measurements. During the second measurement, 24-h SBP and night-time average SBP were slightly higher than those obtained by the first monitoring. Average 24-h SBP and DBP were 18 and 7 mmHg lower, respectively, than office blood pressure averages. The correlation coefficients were significantly higher for 24-h ambulatory blood pressure than for office blood pressure. The SD of the mean difference between visits was significantly lower for 24-h ambulatory blood pressure than for office blood pressure measurements. These findings show that the long-term reproducibility of ambulatory blood pressure is good in an elderly unselected population and better than the office blood pressure reproducibility.

Age Factors↗

PubMed2001

Asthma and gastro-oesophageal reflux: can the response to anti-reflux therapy be predicted?

The aim of the study was to investigate which features predict favourable response to omeprazole therapy in asthmatics with gastro-oesophageal reflux (GER). The study population consisted of 52 outpatient asthmatics with GER who had completed an intervention where they were randomized to receive omeprazole 40 mg once a day or placebo for 8 weeks. After a 2-week washout period the patients were crossed over. Asthma symptoms were found to be relieved > or = 20% in 18 (35%) patients who were thus regarded as responders. A logistic regression analysis was performed in order to identify which features separate the responders from the non-responders. More responders were found among the patients whose body mass index (BMI) was higher (P = 0.02) or whose distal esophageal reflux was more severe [total time (%) pH < 4 (P = 0.01) or time (%) pH < 4 in upright position (P = 0.04)]. Adding other predictors to the total time (%) pH < 4, which was the most significant predictor for response in multi-variate analysis, did not further increase the prediction for favourable outcome. It is concluded that severe distal oesophageal reflux and obesity predict amelioration in asthma symptoms after 8-week omeprazole treatment in asthmatics with GER. Adding more than one predictor does not seem to further increase prediction for favourable asthma response.

Adult↗

PubMed2001

Wood stove heating, asthma and allergies.

In two German studies household wood or coal stove use was negatively associated with atopic sensitization and allergic rhinitis in childhood. Wood stove heating is strongly related to 'traditional lifestyle and therefore subjected to confounding factors possibly yet not known. The study was conducted to study these factors and the independent impact of early exposure to wood stove heating on subsequent asthma and atopic disease. In a questionnaire survey among 10667 Finnish university students aged 18-25 years, we investigated the association between wood stove heating at age 0-6 years and asthma and allergies up to young adulthood. Adjustment was made for factors related to the heating system and atopic disorders by using multivariate regression. Unadjusted lifetime prevalence rates for physician-diagnosed asthma, allergic rhinoconjunctivitis, atopic dermatitis and self-reported wheezing were lower among subjects with wood stove heating compared to other heating systems. There was a significant negative association between childhood wood stove heating and allergic rhinitis or conjunctivitis in the univariate model (OR 0.61, 95% CI 0.61-0.91), but not for the other diseases. The significant association disappeared in the multivariate analysis after adjusting for various family indoor and outdoor (adjusted OR 0.96, 95% CI 0.77-1.20) factors. The association between wood stove heating and allergic rhinoconjunctivitis was mainly confounded by childhood residential environment, especially the farm environment. Farm environment was found to be the main confounding factor related to association between wood stove heating and asthma, and atopic diseases.

Adolescent↗

PubMed2001

Comorbidity of other pains in schoolchildren with migraine or nonmigrainous headache.

OBJECTIVE: To compare the occurrence of pain other than headache in prepubertal children with migraine and those with nonmigrainous headache. STUDY DESIGN: An unselected population-based prospective follow-up study on the occurrence of headache in school-aged children was carried out in 1290 children aged 8 to 9 years. The children (n = 725) who reported headache during the preceding 6 months were sent a more detailed questionnaire concerning the occurrence of pain other than headaches; 622 children (86%) returned an acceptably completed second questionnaire. Of them, 53 (8.5%) had migraine. Nonmigrainous headache was found in 460 children (74%). RESULTS: Children with migraine reported neck-shoulder pain, abdominal pain, back pain, and otalgia significantly more often than those with nonmigrainous headache. The median of the sum of other pains in children with migraine was significantly higher than that in children with nonmigrainous headache. The sum of other pains correlated positively with the frequency of nonmigrainous headache episodes (r =.40; 95% CI.31-.47), but there was no correlation between the sum of other pains and frequency of migraine attacks (r = -0.09; 95% CI -0.36-0.20). CONCLUSION: Children with migraine are more likely to report types of pain other than headaches, regardless of the frequency of attacks. Children with frequent nonmigrainous headaches also report higher frequencies of other types of pain.

Child↗

PubMed2001

Maternal magnesium sulfate treatment is associated with reduced brain-blood flow perfusion in preterm infants.

OBJECTIVE: To examine the influence of antenatally administered magnesium sulfate (MgSO4) and ritodrine on cerebral blood flow and systemic hemodynamics in preterm infants. DESIGN: Prospective, observational study. SETTING: Neonatal intensive care unit of a university central hospital. PATIENTS: Fifty-five preterm infants age <33 wks of gestation. INTERVENTIONS: Serial Doppler examinations of the brain circulation, heart rate, systemic blood pressure, and echocardiographic assessment of ductus arteriosus shunting were performed during the first week of life in infants exposed antenatally to maternal MgSO4 (n = 19) or ritodrine treatment (n = 17), and in 19 nonexposed preterm controls. MEASUREMENTS AND MAIN RESULTS: Cerebral blood flow velocity measurements were obtained from the anterior cerebral artery and internal carotid artery. Perfusion pressure and indices of resistance and blood flow in both vessels were subsequently derived. Maternal MgSO4 had no effect on neonatal cerebral blood flow velocity or resistance, but was associated with decreased (p <.05) perfusion pressure and blood flow in the anterior cerebral artery and internal carotid artery during the first day of life. Systolic blood pressure and pulse pressure were also lower (p <.05) during the whole study period in the MgSO4-exposed infants when compared with the controls. Maternal ritodrine treatment, on the other hand, had no consistent effects on either neonatal cerebral or systemic hemodynamics. CONCLUSIONS: Our data indicate that maternal MgSO4 treatment, in contrast to antenatal ritodrine, is associated with lowered cerebral perfusion in preterm infants on the first day of life.

Analysis of Variance↗