Search PubMed⌕ Search

Biomedical subjects

H Helenius

Publications and source records attributed to H Helenius.

At least 73 records · Page 4Linked to original sources
PubMed2000

The quality of life in Parkinson's disease.

The objective of this study was to examine the quality of life in patients with Parkinson's disease (PD) in a community-based sample (n = 228 patients) using a Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) as a measure. Associations to the variables age, age at onset, duration, clinical stage (Hoehn and Yahr), depression (Zung), and dementia (MMSE) were studied. Women scored significantly lower on five of the eight dimensions of SF-36. Depression, as measured in this study, was more common among parkinsonian women than men. Depression was the factor that was associated most significantly with the experienced quality of life, according to SF-36. With physical functioning, only the clinical stage had a more significant association than depression. To improve the quality of life in patients with PD, it is necessary to make every effort to recognize and relieve the depression of patients with PD.

Activities of Daily Living↗
PubMed2000

Alpha-synuclein-immunoreactive cortical Lewy bodies are associated with cognitive impairment in Parkinson's disease.

Amygdala, hippocampus and six cortical gyri were examined for the Lewy body (LB) degeneration and Alzheimer's disease (AD) type changes in 45 patients with Parkinson's disease (PD). For detection of LBs, the brain areas were stained with an antibody against alpha-synuclein. The extent of neuropathological lesions was investigated in relation to cognitive dysfunction and apolipoprotein E (apoE) epsilon4 allele dosage. At least one cortical LB was found in 95% of cases (43/45). Furthermore, 40% of cases (18/45) had histological findings of definite AD (CERAD class C). Those PD cases with the apoE epsilon4 allele had a significantly greater number of cortical LBs than those without the apoE epsilon4 allele, but this was statistically significant only in precentral, angular and temporal gyri. The LB density correlated better with the number of plaques than with the density of tangles. The number of LBs in several cortical areas correlated significantly with the cognitive impairment. In stepwise linear regression analysis, the number of LBs in the cingulate gyrus and the amount of tangles in the temporal cortex remained statistically significant. When the CERAD class C was excluded, the correlation between cognitive decline and the number of LBs in cortical areas became even more pronounced. A stepwise linear regression analysis in these cases found the number of LBs in the frontal gyrus to be the statistically most significant predictor of cognitive impairment. This study shows, for the first time, that in PD, alpha-synuclein-positive cortical LBs are associated with cognitive impairment independent of AD-type pathology.

Aged↗
PubMed2000

The effect of hormone replacement therapy on salivary calcium concentrations in menopausal women.

Hormone replacement therapy in menopausal women is known to affect the general calcium turnover of the body. No information is available about the effects of hormone therapy on salivary electrolytes and on calcium in particular. A group of 16 healthy peri- and postmenopausal women, all recommended to start hormone replacement therapy, were studied longitudinally for 5 months. Paraffin-stimulated whole saliva was collected at baseline, at 3 and at 5 months after the onset of therapy, and analysed for calcium, sodium and potassium concentrations. In response to hormone replacement therapy, calcium concentration decreased (p = 0.037), that of sodium increased (p = 0.019), while no change was observed in the potassium concentrations during the follow-up period.

Analysis of Variance↗
PubMed2000

Cardiac decompensation during an ischemic event weakens the predictive power of myocardial injury markers.

Our objection was to find determinants of long-term outcome in routine data collected for differential diagnosis of suspected acute myocardial infarction. Study population consisted of 263 discharged patients who were initially hospitalized for differential diagnosis of suspected acute myocardial infarction between October 1992 and January 1993. Follow-up time for all cause and cardiac mortality was 5 years. The variables studied as predictors of outcome were computerized ECG, peak creatine kinase isoenzyme MB, peak troponin I, radiographic evidence of pulmonary congestion (cardiac decompensation), treatment for hyperlipidemia, hypertension or diabetes, smoking, previous myocardial infarction, age and gender. Total mortality was 32% at 5 years, of which 77% (64/83) was of cardiac origin. Pulmonary congestion in chest X-ray was the most powerful predictor of outcome (RR=3.3, 95% CI=2.0-5.2, P<0.001). In multivariate analysis congestion (RR=3.3, CI=2.0-5.2) was the only independent predictor of 5-year total mortality in addition to age (RR=1.06, CI=1.04-1.08). These two variables together with previous myocardial infarction (RR=1.9, CI=1.2-3.1) and hyperlipidemia (RR=2. 0, CI=1.1-3.5) were independent predictors of cardiac mortality. Radiographic evidence of cardiac decompensation during hospitalization is a strong and independent predictor of long-term outcome in unselected patients with suspected AMI. The predictive power of cardiac markers is confined to patients without pulmonary congestion.

Aged↗
PubMed2000

Prolonged endocrine responses to medroxyprogesterone in postmenopausal women with respiratory insufficiency.

OBJECTIVE: To evaluate the endocrinologic changes associated with, and possibly responsible for, prolonged ventilatory improvement after short-term medroxyprogesterone acetate (MPA) in chronic respiratory failure. METHODS: Fourteen postmenopausal women with permanent or previous episodic hypercapnic or hypoxemic respiratory failure were enrolled in a placebo-controlled, 12-week, single-mask trial including 14-day treatment periods with placebo and MPA (60 mg daily) and a 6-week follow-up. We evaluated the duration of MPA-induced alterations on serum concentrations of progesterone, estradiol, testosterone, FSH, LH, sex hormone-binding globulin (SHBG), and prolactin. Hormones were measured four times: at baseline, after 14 days with MPA, and during the washout on days 21 and 42. RESULTS: With MPA, FSH decreased 42.7% (P <.001, 95% confidence interval [CI] -54.2, -31.6), LH 62.1% (P <.01; 95% CI -81. 0, -32.6), and SHBG 58.1% (P <.001; 95% CI -63.0, -43.9). Luteinizing hormone remained decreased (-28.7%; P <.01; 95% CI -42.0, -14.2) at the 3-week washout, whereas FSH and SHBG were back to pretreatment levels. Prolactin had a borderline initial increase of 23.5% (P =.097; 95% CI -3.5, 50.5) with MPA and a significant increase at the 3-week (31.9%; P <.05; 95% CI 1.0, 62.9) and 6-week (26.4%; P <.05; 95% CI 4.4, 48.3) washouts. CONCLUSION: Medroxyprogesterone acetate 60 mg daily for 2 weeks has both immediate (FSH, LH, and SHBG), prolonged (LH), and rebound endocrinologic (prolactin) effects up to 6 weeks after treatment. The MPA-induced widespread endocrine aftereffects could explain the earlier reported prolonged ventilatory improvement.

Chronic Disease↗
PubMed2000

Persistence of bullying from childhood to adolescence--a longitudinal 8-year follow-up study.

OBJECTIVE: To examine factors associated with bullying and victimization from age 8 to 16. METHOD: An 8-year longitudinal study included questions about bullying and victimization at age 8 and 16. Children were evaluated with Rutter scales by parents and teachers and with the Child Depression Inventory filled in by the children at age 8. When the children were at the age of 16 parents filled in the CBCL and adolescents the YSR. RESULTS: About 15% of boys and 7% of girls were bullied and 12% of girls and 13% of boys were victimized at age 16. Both bullying and victimization at age 16 were associated with a wide range of psychological problems at age 8 and 16, and with referral to child mental health services. Bullying at age 8 was associated with bullying at age 16, while victimization at age 8 was associated with victimization 8 years later. CONCLUSIONS: Bullying and victimization are often persistent and associated with severe emotional and behavior problems. Preventive efforts should be focused, and targeted at those children who are characterized by both psychological disturbance and bullying.

Adolescent↗
PubMed2000

Advanced dental maturity in children with juvenile rheumatoid arthritis.

The subjects of the investigation comprised 95 girls and 73 boys with juvenile rheumatoid arthritis (JRA), and 102 girls and 66 boys representing healthy controls, all with a chronological age from 6.3 to 14.4 yr. The dental development was assessed from panoramic radiographs using a seven-tooth model. The radiographs were evaluated on three separate occasions with a minimum interval of one month in a randomized order, and blind with respect to absence or presence of JRA. In both JRA patients and healthy controls, dental maturity was ahead of chronological age. In addition, dental maturity was significantly advanced in JRA patients with 0.26 yr in girls and 0.28 yr in boys. It is tentatively suggested that the advanced dental development in JRA patients compared with healthy children was partly an effect of treatment with cortisone, while the influence of the disorder per se remains to be elucidated.

Adolescent↗
PubMed2000

Farm environment in childhood prevents the development of allergies.

BACKGROUND: A protective effect of infections in early life might explain the firmly reported finding of an inverse association between atopic disorders and large sibships. OBJECTIVE: To study the effect of childhood farm, rural non-farm and urban environment, as well as family size and other factors on the occurrence of asthma, wheezing and atopic disorders up to young adulthood. METHODS: Data on lifetime prevalence of physician-diagnosed asthma, allergic rhinitis and/or allergic conjunctivitis, atopic dermatitis, as well as self-reported episodic wheezing from 10 667 Finnish first-year university students aged 18-24 years were collected by a postal questionnaire. Associations of lifetime prevalence of the diseases with living on a farm, in a rural non-farm and urban environment during childhood were estimated by logistic regression analysis. Adjustment was made for potential confounding by gender, parental atopy, parental education, number of older siblings, day care outside the home and passive smoking. RESULTS: The childhood farm environment independently reduced the risk for physician-diagnosed allergic rhinitis and/or allergic conjunctivitis (adjusted odds ratio 0.63, 95% CI 0.50-0.79, P < 0.001), and for diagnosed asthma and episodic wheezing analysed together (OR 0.71, 95% CI 0.54-0.93, P < 0.05), but not for atopic dermatitis during lifetime. Urban childhood environment did not show independent increased risk when compared with rural non-farm residence. The inverse association of sibship size with the occurrence of allergic rhinitis and/or allergic conjunctivitis was found among subjects with one (OR 0.86, 95% CI 0.77-0.96, P < 0.01) or at least four older siblings (OR 0.47, 95% CI 0.26-0.84, P < 0.05). CONCLUSION: Childhood farm environment seems to have a protective effect against allergic rhinitis and/or conjunctivitis, and more weakly against asthma and wheezing irrespective of family size. Environmental exposure to immune modulating agents, such as environmental mycobacteria and actinomycetes, favouring manifestation of a nonatopic phenotype could explain the finding.

Adolescent↗
PubMed2000

Predisposing and provoking factors in childhood headache.

OBJECTIVE: To study the differences in predisposing and provoking factors between childhood migraine and nonmigrainous headache. BACKGROUND: Information on the predisposing and provoking factors of headache could help to find ways to prevent it. Differences in predisposing and provoking factors between migraine and nonmigrainous headache are largely unknown. METHODS: An unselected, population-based, prospective, follow-up study on the occurrence of headache in schoolchildren was carried out in 1290 children aged from 8 to 9 years. The children who had reported headache during the 6 months prior to the study (n = 725) were sent a more detailed questionnaire about factors that might give rise to headache. Six hundred twenty-two (86%) children returned questionnaires that were completed to an acceptable degree. RESULTS: The occurrence of familial paroxysmal headache and unhappiness in the family independently predicted the occurrence of migraine in children, but this was not the case for nonmigrainous headache. CONCLUSIONS: In particular, the family occurrence of paroxysmal headache increases the risk of migraine in a child. The risk is still greater if their living conditions are experienced as unsatisfactory by the family.

Causality↗
PubMed2000

A reply

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

Fungal colonization of haematological patients receiving cytotoxic chemotherapy: emergence of azole-resistant Saccharomyces cerevisiae.

Fungal colonization during cytotoxic chemotherapy was studied in 42 patients with a recent diagnosis of a haematological malignancy. In total, 2759 surveillance cultures were taken from the nostrils, throat, urine, stool and perineal region. Seven hundred and ninety-six positive surveillance cultures (28.9%) yielded 968 fungal isolates. The rate of fungal colonization did not differ between patients with acute leukaemia, patients with other haematological malignancies and control patients in the same ward at admission (71% vs. 67% vs. 80%). Patients with acute leukaemia were colonized at a significantly lower rate in samples from the throat (32%), urine (10%), stool (45%) and perineum (29%) taken during hospitalization when compared with other haematological patients (respective values 58%, 21%, 67% and 45%; P-values 0.001). This could be attributed to differences in the use of antifungal drugs. Although 21/42 (50%) of our patients had multiple-site fungal colonization at the end of follow-up, only one systemic Candida infection was diagnosed. Extensive use of antifungal treatment may have influenced the low incidence of systemic fungal infections during the follow-up. In addition to Candida species, Malassezia furfur, Geotrichum candidum and Saccharomyces cerevisiae were frequently isolated. The rate of S. cerevisiae isolation increased significantly over time after admission (1%, vs. 18% of isolates, P<0.001), suggesting hospital-acquired transmission. These isolates were highly resistant to azole antifungals (MIC90 128 microg/mL for fluconazole and 16 microg/ml, for itraconazole), and caused persistent multiple site colonization in 12 patients. Extensive use of antifungal agents in a haematological ward may keep the incidence of invasive fungal infections low in spite of heavy fungal colonization. However, there may be a risk of emergence of resistant fungal strains.

Amphotericin B↗
PubMed2000

IGF-I and ventilation after short-term progestin in postmenopausal women with chronic respiratory insufficiency.

Progestins stimulate respiration. We have previously shown prolonged ventilatory improvement in chronic respiratory failure with short-term medroxyprogesterone acetate (MPA). The mechanism of the sustained respiratory effect is unknown. Insulin-like growth factor-I (IGF-I) and insulin have anabolic effects which could also improve ventilation in the long-term. To better understand the interactions between hormones and control of breathing, we evaluated the degree and duration of changes in IGF-I, insulin and cortisol after short-term MPA therapy in chronic respiratory insufficiency. Fourteen postmenopausal women with permanent or episodic hypercapnic or hypoxaemic respiratory failure were recruited for a placebo-controlled single-blind trial. After 14 days of placebo treatment and 7 days of washout, a daily dose of 60 mg MPA was administered for 14 days. Serum IGF-I, insulin and cortisol were measured five times at 3-week intervals: at baseline, after 14 days on placebo, after 14 days on MPA, and during the washout, on days 21 and 42. Serum IGF-I levels were 15.2 (SD 4.6), 20.8 (SD 6.8) and 17.2 (SD 6.4) at baseline, on MPA and after a 3-week washout. Serum insulin levels did not change [12.5 mU l(-1) (SD 4.1), 12.2 mU l(-1) (SD 4.8) and 14.5 mU l(-1) (SD 3.6), respectively]. Serum cortisol did not change. On MPA, IGF-I increased on average by 5.6 nmol l(-1) [95% confidence interval (95% CI) 1.4 to 9.9] or 42.0% (95% CI 6.3 to 77.8) from baseline. The IGF-I response coincided with the previously reported ventilatory improvement. MPA 60 mg daily for 2 weeks increases serum IGF-I in postmenopausal women with chronic respiratory insufficiency. During follow-up after MPA, there was a trend towards increased IGF-I and insulin levels. The role of these two hormones to induce prolonged ventilatory stimulation could not be excluded and further studies in larger populations are warranted.

Age Factors↗
PubMed2000

Craniofacial growth of immature rats following administration of vincristine and doxorubicin.

The aim of the present study was to investigate the possible short-term effect of two anti-neoplastic drugs, vincristine and doxorubicin, on the craniofacial skeleton in young rats. On the basis of findings from pilot experiments, one dose of 0.0375 mg/kg vincristine or 1.0 mg/kg doxorubicin was given parenterally to inbred Long-Evans/Turku rats at 10 or 30 days of age, and followed up until 30 or 50 days, respectively. Some 30-day-old rats received two additional doses of the drugs, 3 and 6 days after the first injection. Controls were given physiological saline. A total of 310 rats were used: 40 for the pilot study, 180 medicated, and 90 control animals for the experiment itself. The weights of the rats were recorded, a number of craniofacial dimensions were measured, and the neurocranial volume determined in the case of the most severely affected rats. The weight gain of the younger rats was retarded, as was that of the older rats that received repeated drug injections. Most dimensions of the craniofacial skeleton were significantly smaller in the vincristine-treated young animals, and following multiple injections of vincristine or doxorubicin also in the older ones when compared with the controls. Contrary to the general pattern, the measurements of the foramen magnum increased in the older rats, a feature associated with the decrease in brain cavity volume observed in those that received vincristine. These findings indicate that anti-neoplastic agents can have a short-term adverse effect on the craniofacial growth and that the morphological changes are differential, rather than uniform.

Age Factors↗
PubMed2000

Distribution and characterization of proliferative cells in the rat mandibular condyle during growth.

Distribution of proliferative cells and localization of types I and II collagen were examined in the rat mandibular condylar cartilage of 36 long-Evans/Turku strain rats during normal postnatal growth using an immunohistochemical method combined with histomorphometry. There were considerable differences in the thickness of the proliferative cell layer in the condylar head, with most mitoses occurring in the postero-superior area. It was found that the extracellular matrix of the proliferative cells does not stain for type II collagen in 20-day-old and older rats, and that besides the subchondral bone, the strongest intensity for type I collagen stain was always localized in the articular surface of the condylar head. Statistically significant overlapping of the proliferative cell layer and the one secreting type II collagen occurred during the earlier stages of development, particularly in the postero-superior area of the condylar head. As type II collagen is considered to be a marker for identification of typical cartilage cells, the findings indicate that, in addition to undifferentiated cells, a portion of the proliferative cells can be characterized as chondroblasts during the early postnatal period in rats, but not in the later stages of development. The developmental phase of the condylar cartilage should therefore be taken into consideration when the effect of various biomechanical and humoral/hormonal factors on growth of the condylar cartilage is examined.

Animals↗
PubMed2000

Correlation properties and complexity of perioperative RR-interval dynamics in coronary artery bypass surgery patients.

BACKGROUND: Dynamic measures of heart rate variability (HRV) may uncover abnormalities that are not easily detectable with traditional time and frequency domain measures. The purpose of this study was to characterize changes in RR-interval dynamics in the immediate postoperative phase of coronary artery bypass graft (CABG) surgery using traditional and selected newer dynamic measures of HRV. METHODS: Continuous 24-h electrocardiograph recordings were performed in 40 elective CABG surgery patients up to 72 h postoperatively. In one half of the patients, Holter recordings were initiated 12-40 h before the surgery. Time and frequency domain measures of HRV were assessed. The dynamic measures included a quantitative and visual analysis of Poincaré plots, measurement of short- and intermediate-term fractal-like scaling exponents (alpha1 and alpha2), the slope (beta) of the power-law regression line of RR-interval dynamics, and approximate entropy. RESULTS: The SD of RR intervals (P < 0.001) and the ultra-low-, very-low-, low-, and high-frequency power (P < 0.01, P < 0.001, P < 0.001, P < 0.01, respectively) measures in the first postoperative 24 h decreased from the preoperative values. Analysis of Poincaré plots revealed increased randomness in beat-to-beat heart rate behavior demonstrated by an increase in the ratio between short-term and long-term HRV (P < 0.001) after CABG. Average scaling exponent alpha1 of the 3 postoperative days decreased significantly after CABG (from 1.22 +/- 0.15 to 0.85 +/- 0.20, P < 0.001), indicating increased randomness of short-term heart rate dynamics (i.e., loss of fractal-like heart rate dynamics). Reduced scaling exponent alpha1 of the first postoperative 24 h was the best HRV measure in differentiating between the patients that had normal (</= 48 h, n = 33) or prolonged (> 48 h, n = 7) intensive care unit stay (0.85 +/- 0.17 vs. 0.68 +/- 0.18; P < 0.05). In stepwise multivariate logistic regression analysis including typical clinical predictors, alpha1 was the most significant independent predictor (P < 0.05) of long intensive care unit stay. None of the preoperative HRV measures were able to predict prolonged intensive care unit stays. CONCLUSIONS: In the selected group of patients studied, a decrease in overall HRV was associated with altered nonlinear heart rate dynamics after CABG surgery. Current results suggest that a more random short-term heart rate behavior may be associated with a complicated clinical course. Analysis of fractal-like dynamics of heart rate may provide new perspectives in detecting abnormal cardiovascular function after CABG.

Aged↗
PubMed2000

Pain experience of children with headache and their families: A controlled study.

OBJECTIVE: This study reports the pain sensitivity of children with headache and their family members, as well as the prevalence of recurring aches, psychosocial life, and family environment of children with headache at preschool age. DESIGN: A representative population-based sample of 1443 families expecting their first child were followed over 7 years. A screening questionnaire relating to the child's headache was sent to parents of a representative sample of 1132 6-year-old children. Of 144 children suffering from headache, 106 (76%) were examined and interviewed clinically. Ninety-six children with primary headache (58 migraine and 38 tension-type headache children) and matched controls (n = 96) were included in further examinations. RESULTS: Children with headache were more often extremely sensitive to pain according to their parents, were more excited about physical examinations, cried more often during blood sampling or vaccination, avoided play or games more often because they were afraid of hurting themselves, and had recurring abdominal and growing pains more often than did control children. The fathers of children with headache were more often extremely sensitive to pain. Children with headache reacted with somatic symptoms, usually with pain and functional intestinal disorders in stress situations, felt more tired, and had more ideations of death during the previous month. They had also had more problems in day care and fewer hobbies such as scout or club meetings than did control children. More mothers of tension-type headache children than those of migraine children reported that they were considerably sensitive to pain. Tension-type headache children also had a poorer family environment; the family atmosphere was more often unhappy and the relationship between the parents was more often distant than in the families of children with migraines. CONCLUSIONS: In addition to somatic factors, it is important to consider the child's pain sensitivity, reaction to various stress situations, and family functioning when studying childhood headache. The child's coping mechanisms can be supported by information given by the parents. School entry can be considered a suitable period for careful investigation into possible occurrence of headache and also for giving information about headache and its management.

Child↗
PubMed2000

Prediction of short-term outcome in patients with suspected myocardial infarction.

STUDY OBJECTIVE: Although specific cardiac injury markers have enhanced early patient classification, the ECG remains a necessary investigation in the acute phase of chest pain. Combined use of both tests could further improve the diagnostic and prognostic accuracy. METHODS: We studied 311 consecutive patients who came to the emergency department of a regional referral hospital for the differential diagnosis of acute chest discomfort. The admission ECG was classified using an automated interpretation program and tested together with elevated admission creatine kinase isoform MB (CK-MB) and cardiac troponin I (TnI) concentration for prediction of final myocardial injury (44%) and in-hospital mortality (14%). RESULTS: Combining the information from the admission ECG and cardiac markers, the sensitivity for becoming final myocardial injury (maximal CK-MB >/=11 microg/L) was 90% and specificity 61%. The proportion of false-negative results (10%) was independent of symptom duration. Age, positive ECG findings, and increased admission TnI levels were predictive for in-hospital mortality. CONCLUSION: The commonly available biochemical and ECG criteria allow risk stratification of patients with a suspected acute ischemic event. The data analysis can easily be automated and is independent of patient delay.

Adult↗