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Biomedical subjects

J Suni

Publications and source records attributed to J Suni.

At least 19 recordsLinked to original sources

Self-guided brisk walking training with or without poles: a randomized-controlled trial in middle-aged women.

Walking with poles (Nordic walking, NW) has become popular. We compared training responses of brisk walking (W) or NW on cardiorespiratory and neuromuscular fitness. We randomized 121 non-obese sedentary women (aged 50-60) to an NW or W group (NWG, WG), to train 40 min four times weekly for 13 weeks. Intensity was based on subjective perception of exertion. Cardiorespiratory performance was assessed in four levels corresponding to 50%, 65%, 80% and 100% of peak VO(2). Fifty-four NWG and 53 WG subjects completed the study. The mean intensity was about 50% of heart rate (HR) reserve. The baseline peak VO(2) was 25.8 (SD 3.9) mL/min/kg. Both groups improved peak VO(2) similarly (NWG 2.5 mL/min/kg, 95% confidence interval (CI) 1.9-3.3; WG 2.6, CI 1.9-3.3). In the submaximal stages while walking with or without poles, HR and lactate decreased after training in both groups, but the changes were not statistically significantly different between the groups. Of the neuromuscular tests after training, the only significant difference between the groups was in the leg strength in the one-leg squat, favoring WG. In conclusion, both training modes improved similarly health-enhancing physical fitness, and they were feasible and safe.

Cross-Sectional Studies↗

Waist circumference and BMI are independently associated with the variation of cardio-respiratory and neuromuscular fitness in young adult men.

OBJECTIVE: To test two hypotheses: (1) cardiorespiratory (CRF) and neuromuscular (NMF) fitness is associated with body mass index (BMI) and waist circumference (WC), independent of each other and of leisure-time physical activity; (2) individuals with high CRF and NMF have lower WC for a given BMI, compared with those with low CRF and NMF. DESIGN: Cross-sectional study. SETTING: Men participating in refresher training organized by the Finnish Defence Forces. PARTICIPANTS: A total of 951 men (mean age 29.1, s.d. 4.2 years; BMI 25.3 kg/m(2), s.d. 3.8; WC 91, s.d. 11 cm). MAIN OUTCOME MEASURES: Body mass index, WC, maximal oxygen uptake (VO(2)max), height of vertical jump, number of push-ups and sit-ups during a 1-min test, static back extension endurance, isometric grip strength, self-reported leisure-time vigorous physical activity. Multiple linear regressions were used to explain the variation in fitness. RESULTS: Waist circumference had significant (P<0.001) negative association with all test results (standardized beta coefficients from -0.23 to -0.77), except for grip strength. Body mass index had significant negative association with VO(2)max (-0.12; P<0.05), but positive association (P<0.01) with grip strength (0.28), vertical jump (0.21) and push-ups (0.55). For a given BMI, the estimated WC was highest among those with the poorest results for VO(2)max, vertical jump, sit-ups and push-ups. CONCLUSIONS: Despite stronger isometric grip strength, the functional muscle fitness of the upper body, trunk and lower extremities is impaired in individuals with abdominal obesity. Although the known loss of CRF is a serious consequence of obesity, the deterioration of NMF deserves increased attention.

Adult↗

Quantitative PCR in the diagnosis of CMV infection and in the monitoring of viral load during the antiviral treatment in renal transplant patients.

Cytomegalovirus (CMV) infection is a significant problem in transplantation. In this study, a quantitative PCR test was compared with the CMVpp65 antigenemia assay not only in the diagnosis CMV infections but especially in the monitoring of viral loads during ganciclovir treatment of CMV disease in individual renal transplant patients. Altogether 342 blood specimens were obtained from 116 patients. Blood specimens were used for Cobas Amplicor Monitor plasma PCR and for the pp65 assay. Also shell vial culture was performed. The patients with a positive pp65 finding were monitored for CMV weekly during ganciclovir treatment and/or until the antigenemia subsided. CMV was detected in 31/116 (27%) patients, of whom 14 (12%) developed CMV disease and were treated with ganciclovir. CMV was found by shell vial culture in 13/14 cases, but by PCR and pp65 test in all 14 patients. CMV was detected in 156 (45%) samples; by PCR in 121/156 (range 344-103,000 copies/ml) and by pp65 test in 138/156 (range 1-1,000 positive cells/50,000 leukocytes) and by culture in 59/156 (38%) only. The peak viral loads were significantly (P<0.0001) higher in CMV disease than in untreated infections (19,650 vs. 379 copies/ml, and 100 vs. 5pp65 positive cells). In the monitoring of individual patients, the time-related CMV-DNAemia and pp65 antigenemia correlated well during the treatment of CMV disease. In conclusion, Cobas Amplicor Monitor plasma PCR and CMVpp65 antigen assays can be equally used in the diagnosis CMV infection and in the monitoring of viral load during antiviral treatment.

Antigens, Viral↗

CMV infection is usually associated with concurrent HHV-6 and HHV-7 antigenemia in liver transplant patients.

Human herpesvirus 6 and 7 (HHV-6, HHV-7) have been recently reported in liver transplant patients. HHV-6 may cause fever, neurological disorders and hepatitis. The clinical significance of HHV-7 is less clear. HHV-6 and -7 are closely related to cytomegalovirus (CMV), and interactions between the viruses have also been suggested. In this study, we investigated the post transplant HHV-6 and -7 antigenemia was in relation to symptomatic CMV disease after liver transplantation. Consecutive 34 adult liver allograft recipients transplanted during 1999-2000 were included in the study. CMV infections were diagnosed by the frequent monitoring of pp65-antigenemia and by viral cultures. HHV-6 and -7 were demonstrated, by using immunoperoxidase staining and monoclonal antibodies against the virus specific antigens, in the mononuclear cells from the same blood specimens which were obtained for CMV pp65 monitoring. Altogether 322 blood specimens were analyzed. CMV disease was diagnosed in 12 (35%) patients during the first 3 months (first pp65 positive specimen mean 25 days, range 8-61 days) after transplantation. Concurrent HHV-6 antigenemia was detected in 10/12 (mean 14 days, range 6-22 days) and HHV-7 antigenemia in 9/12 patients (mean 25 days, range 10-89 days) after transplantation. HHV-6 usually appeared slightly before CMV. All CMV infections were successfully treated with ganciclovir and the CMV-antigenemia subsided. HHV-6 and -7 antigenemia also responded to the antiviral treatment, but more slowly than CMV. In conclusion, CMV infection was usually associated with HHV-6 and -7 antigenemia in liver transplant patients. The results support the suggestion that CMV, HHV-6 and -7 may have interactions. The clinical symptoms of CMV infection, may also be linked with HHV-6 or -7.

Adult↗

Improved sensitivity and specificity of enzyme immunoassays with P1-adhesin enriched antigen to detect acute Mycoplasma pneumoniae infection.

An in-house P1-enriched (168-kDA protein) Mycoplasma pneumoniae antigen preparation was compared in IgG, IgA and IgM enzyme immunoassays (EIAs) to the respective EIAs employing crude antigen lysate, antigen prepared by Triton X-114 partition and two commercial antigens, one of which was an ether-extracted antigen and the other a P1-enriched antigen. In addition, three commercial kits from Sanofi Pasteur, Novum Diagnostica and Savyon Diagnostics were also assessed for comparison. Diagnostic sensitivity was studied with paired samples from adults (n=37) with acute respiratory illness interpreted as acute, recent or past infection to M. pneumoniae on the basis of the results of complement fixation test (CFT). If the consensus of at least two methods is taken as the true positive for acute infection, the diagnostic sensitivities of combined IgG and IgM EIAs were 100% for the Platelia(R), Sero MP and in-house EIAs whereas for the Novum EIAs and CFT- 97% and 74%, respectively. Moreover, the sensitivity of the P1-enriched antigen was proven superior on the basis of systematically highest OD(405 nm) ratios between convalescent and acute serum samples. Analytical specificity was studied by screening serum samples from 92 Finnish blood donors and 111 serum samples from cord blood. Diagnostic specificity was studied in a blind testing of 30 paired serum samples from infants with pneumonia of variable etiology. No single misinterpretation of acute infection from the group of samples with other respiratory diseases did occur. The present study confirmed and extended the earlier observations of the usefulness of P1-enriched antigen for reliable serologic diagnosis of acute M. pneumoniae infection.

Acute Disease↗

Multicenter evaluation of the novel enzyme immunoassay based on P1-enriched protein for the detection of Mycoplasma pneumoniae infection.

The aim of the study was to evaluate new Mycoplasma pneumoniae IgG, IgA and IgM EIA methods based on the enrichment of P1-protein (ThermoLabsystems, Helsinki, Finland) (L) for the detection of acute infection. This evaluation was performed in two independent routine clinical microbiology laboratories. The first laboratory used samples preselected by IgG and IgM Platelia enzyme immunoassay (P) and the second used samples preseleced by Serion ELISA Classic M. pneumoniae IgG, IgM (V). The L method was also compared to the FDA approved method of ImmunoWell M. pneumoniae IgG and IgM (G). When the agreement of two methods was applied as a serologic criteria for an acute infection, the following ratios of acute to nonacute infection were calculated 32/86 (totally 118) in the first and 20/72 (totally 92) in the second laboratory. In the first laboratory, the corresponding ratios by methods were 35/83 (sensitivity 100%, specificity 96.5%), 31/87 (sensitivity 97%, specificity 100%), and 55/63 (sensitivity 100%, specificity 79%) for the L, P and G methods, respectively. In the second laboratory, the ratios were 21/71 (sensitivity 100%, specificity 99%), 16/76 (sensitivity 83%, specificity 100%), and 53/39 (sensitivity 100, specificity 69%) for the L, V and G methods, respectively. Taking into account that the tested sample material was preselected by the P and V methods, which may have introduced some bias in their favor, the newly developed L method utilizing P1-enriched protein was found reliable for serodiagnosis of acute M. pneumoniae infection. The method G was the least specific in detection of acute infection.

Adhesins, Bacterial↗

Comparison of plasma polymerase chain reaction and pp65-antigenemia assay in the quantification of cytomegalovirus in liver and kidney transplant patients.

BACKGROUND: Cytomegalovirus (CMV) is a significant problem in transplantation. The antiviral treatment is based on the clinical symptoms and the rapid laboratory diagnosis. Although polymerase chain reaction (PCR) methods have already been widely used, the clinical correlation of the findings is not clear. OBJECTIVE: The objective of this study was to investigate the usefulness of a quantitative plasma PCR test and compare it with the pp65-antigenemia test in the detection of clinically significant CMV infections in liver and kidney transplant patients. STUDY DESIGN: The clinical material consisted of 253 consecutive blood samples was tested using a quantitative polymerase chain reaction test, Cobas Amplicor CMV Monitor (Roche) and pp65 antigenemia assay. Plasma was used for PCR and leucocytes were used for the antigenemia test. RESULTS: CMV was detected in 89 out of 253 blood samples by one or both methods. PCR detected 78 (range 274-165000 copies/ml) and pp65 antigenemia test 79 (range 1-1500 positive cells/50000) of the positive findings. The sensitivity and specificity of PCR test was 86 and 94%, respectively. The PCR detected all clinically significant CMV infections (>10 positive cells in pp65 test) and infections which required antiviral treatment. In addition, the correlation between the two tests was almost linear. CONCLUSIONS: The quantitative PCR appears to be a suitable alternative to diagnose and monitor CMV infections in transplant patients.

Antiviral Agents↗

HHV-6 reactivation is often associated with CMV infection in liver transplant patients.

Human herpesvirus 6 (HHV-6) infection has been recently reported in liver transplant patients. HHV-6 is closely related to cytomegalo-virus (CMV), and some interaction between the viruses has been suggested. In this study, the post-transplant HHV-6 antigenemia was investigated in relation to symptomatic CMV infections in adult liver transplant patients. CMV infections were diagnosed by the pp65 antigenemia test and by viral cultures. HHV-6 infections were demonstrated by the HHV-6 antigenemia test and by serology. Significant symptomatic CMV infection was diagnosed in 42 of 75 patients during the first 6 months after transplantation. All CMV infections were successfully treated with ganciclovir. Concurrent HHV-6 antigenemia was detected in 21 (50%) of 42 patients with CMV infection. All HHV-6 infections were reactivations. HHV-6 also responded to the antiviral treatment, but with less clear effect. In conclusion, HHV-6 reactivation is often associated with CMV infection in liver transplant patients. The results support the suggestion that CMV and HHV-6 may have interactions.

Adult↗

Tooth and tooth surface survival rates in birth cohorts from 1965, 1970, 1975, and 1980 in Lahti, Finland.

Differences in the tooth and tooth surface survival rates between four cohorts born in 1965, 1970, 1975, and 1980 were analysed in a historical cohort study including data on the permanent teeth of children aged 5-7 years at baseline and 19 years at the end of the study. A statistically significant reduction in caries occurrence in fissured surfaces in the three oldest cohorts was seen during the 3 years after the eruption of the teeth. Caries occurrence in the cohorts born in 1975 and 1980 did not differ from each other. The occurrence of caries in smooth surfaces was low in all age cohorts. Therefore, despite a systematic decrease in caries occurrence towards the younger cohorts, no significant differences were found between the cohorts in smooth surface decay. After the 3 first posteruptive years, practically no differences in survival rates between the cohorts were observed. In the two youngest cohorts, the figures during the 3 first years after eruption did not differ from the figures for the later years. Throughout the study, caries occurrence was symmetric and no gender differences were observed. No postponement of decay was found by the end of the follow-up time.

Adolescent↗

Hepatitis A outbreak amongst intravenous amphetamine abusers in Finland.

This article describes a widespread outbreak of hepatitis A virus (HAV) infection amongst drug abusers in Finland. Although attempts to demonstrate the virus in amphetamines failed, the infection was assumed to be linked to intravenous use of the drug. The unusual mode of transmission prompted us to analyse possible atypical clinical features as well as the spread of the virus to the general population, nowadays practically without protective immunity. Serologically verified cases that occurred in Helsinki were interviewed, their hospital records were analysed and their contacts were serology tested. Amphetamine lots, as well as faecal samples from patients, were examined with RT-PCR. Detailed information was obtained from 238 subjects, among whom 131 admitted drug abuse and 67 cases were classified as secondary cases. Phylogenetic analysis of virus strains from HAV-infected cases suggested a common origin, and epidemiological observations linked it with particular lots of amphetamine. Three cases died, and 3 presented with severe clinical disease. Icterus was more common among i.v. drug abusers than others. Infection with hepatitis A virus was probably related to the faecal contamination of amphetamine associated with the transportation of the drugs in the gastrointestinal tract.

Adult↗

Correlation between mobility restrictions and radiologic changes in ankylosing spondylitis.

STUDY DESIGN: In 151 adult patients with ankylosing spondylitis who participated in an inpatient rehabilitation program of 3-4 weeks, 10 different range of motion (ROM) values were measured, and their lumbar spine and sacroiliac joints were radiographed. OBJECTIVES: To determine whether a correlation obtained between restriction of ROM and progression of radiologic findings in ankylosing spondylitis, together with a high enough reliability level in measurements. SUMMARY OF BACKGROUND DATA: A significant correlation was observed between the restriction of eight ROMs: the Schober test, thoracolumbar rotation, thoracolumbar flexion, cervical rotation, occiput-wall distance, chin-chest distance, chest expansion, finger-floor distance, and overall radiologic changes in both lumbar spine and sacroiliac joints; straight leg raise did not correlate, and vital capacity only with sacroiliac joint changes. Spearman's correlation coefficients for ROMs were slightly higher to lumbar spine changes than to sacroiliac joint changes. A corresponding correlation was also observed between spinal mobility restrictions and six detailed changes in lumbar roentgenogram: syndesmophytes, apophyseal arthritis, sclerotic anterior borders of vertebrae, straightened anterior surface of vertebrae, and ossification of interspinous and anterior longitudinal ligaments. Other detailed lumbar spine findings did not correlate. As assessed by erythrocyte sedimentation rate values the disease activity increased in the course of radiologic progression, decreasing again, however, to the end stage. METHODS: Conventional methods with a tape and (Myrin) inclinometer were used to measure thoracolumbar flexion, cervical rotation, occiput-wall distance, chin-chest distance, finger-floor distance, chest expansion, vital capacity, and straight leg raise. In addition, a new method of thoracolumbar rotation and a new modification of the Schober test were introduced. Thirty-nine patients were randomized for a reliability assessment using repeated measurements of ROMs. Radiologic changes were evaluated (in a masked fashion) using the method of Dale and Vinje. RESULTS: The reliability of all ROMs was good (except for interrater intraclass correlation coefficients of chest expansion: 0.53). CONCLUSIONS: The clear correlation between radiologic sacroiliac joint and lumbar spine progression and eight ROMs showed that these are useful noninvasive measurements of disease progression and severity in ankylosing spondylitis that can be used in daily practice.

Adult↗