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Biomedical subjects

K Remes

Publications and source records attributed to K Remes.

18 recordsLinked to original sources

Diet in infancy and bronchial hyperreactivity later in childhood.

Sixty-seven atopy-prone children (atopic family group, AFG) and 52 children with no family history of atopy (NAFG) were followed for 10 years. During infancy, the mothers of the newborn AFG children were advised to adjust their infants' diet, with a view toward minimizing the risk of atopy, and not to keep pets. Pulmonary function tests, methacholine inhalation challenge (MIC), and skin prick tests (SPT) were done in order to evaluate the bronchial reactivity and skin reactivity in the two groups. A pathological result in MIC was found in 20 (30%) of the AFG children and in 10 (19%) of the NAFG children. Such results of MIC were more common in the children with positive SPT results than in those without (67% vs. 24%). In regard to the diet consumed in infancy, MIC was pathological in 23% of children with and in 36% without prophylactic diet in infancy. For MIC, using the new, Spira electro 2 dosimeter equipment, the sensitivity was 75% and specificity 97%, but the predictive value for diagnosing bronchial asthma was only 25%. The important advantage of our method is that the degree of bronchial reactivity can be estimated by responses to increasing provocative doses. Our observations confirm that the new method is suitable for detecting bronchial asthma in clinical practice but it seems not to be optimal for epidemiological studies. We concluded that later bronchial hyperreactivity can not be diminished by avoiding home pets or providing a hypoallergenic diet during infancy.

Age Factors

Infections and serum IgG levels in patients with chronic lymphocytic leukemia.

To review our policy of prophylactic treatment with intravenous immunoglobulin (i.v.IG) in chronic lymphocytic leukemia (CLL), we analyzed the infection history, serum IgG levels (S-IgG) and disease stage of 146 patients who were treated and followed at our institution in 1980-1989. S-IgG was available for 98 patients: 55% were hypogammaglobulinemic and 56% had had at least one severe infection. There were significant associations between S-IgG and the occurrence of infections (p less than 0.01) and disease stage (p less than 0.02). There was also a significant association between disease stage and occurrence of infections (p less than 0.001). Severe infections tended to accumulate in patients with subnormal S-IgG and advanced disease stage. Totally, 292 infections were recorded, and the incidence of moderate to severe infections was 0.47 per patient year. Infection mortality was high: 42 patients died of a severe infection (46% of all causes of death). Patients with a low S-IgG and advanced disease stage are the most susceptible to death from infection and would be most likely to benefit most from i.v.IG prophylaxis; however, the cost of this therapy is so high that strict individual consideration still remains crucial for treatment decisions.

Adult

Alpha interferon raises serum beta-2-microglobulin in patients with multiple myeloma.

Serum beta 2-microglobulin (beta 2m) levels were followed in eight patients with multiple myeloma who were treated with leucocyte alpha interferon (alpha IFN) 6 x 10(6) IU daily for 1-2 weeks before chemotherapy. Serial measurements of serum beta 2m were carried out regularly during the first week on alpha IFN. A rise in beta 2m was observed in all patients. with maximum increments ranging from 29% to 185% (mean 109%). The increase in beta 2m was most marked in patients with elevated pretreatment levels of serum beta 2m and creatinine. In six patients the peak value was reached between the third and the fifth day, after which the levels decreased. In two patients serum beta 2m remained elevated for 3 and 4 months, respectively. A marked increase in serum beta 2m can be induced by alpha IFN in myeloma, which should be taken into consideration when using beta 2m for the assessment of tumour response during alpha IFN therapy.

Aged

Asthma, allergic rhinitis and atopic eczema in Finnish children and adolescents.

The parents of 3649 Finnish children and adolescents were interviewed in 1980 to evaluate the prevalence of bronchial asthma, allergic rhinitis and atopic dermatitis. The same group was interviewed 6 years later to determine the incidence of new cases of bronchial asthma in the 1980s. Age- and sex-matched samples were taken from three areas, southern, eastern and northern Finland to allow assessment of possible regional differences in prevalences and incidences. The prevalences of atopic eczema, allergic rhinitis and asthma were 1.7%, 6.0% and 4.3%, respectively. These figures are similar to those found in previous studies in Scandinavia and Finland over 10 years ago. The prevalence of atopy was highest (6.4%) in southern Finland, which is the most urbanized area of our country. The prevalence of asthma was highest (3.3%) in northern Finland. This is still low when compared with the incidences in other European countries. THe prevalences of asthma and atopy were lowest in eastern Finland which is the most agrarian area. The incidence of asthma was 1.5 cases/1000 individuals/year, but regional differences were shown.

Adolescent

[Sports anemia].

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Anemia, Macrocytic

Atopy in children with and without a family history of atopy. I. Clinical manifestations, with special reference to diet in infancy.

The influence of a family history of atopy on atopic morbidity, and relationships between diet in infancy and allergic manifestations at the ages of one and five years were prospectively studied in 91 children. A control group consisted of 72 children with no family history of atopy. At the age of one year, atopic manifestations were found in 19% of 163 children, in 23% of those with a family history of atopy and in 14% of those with no such history. Skin problems were more common in children with a family history of atopy (43%) than in the control children (19%). Of the children with a family history of atopy, 23% had prolonged rhinorrhoea during infancy. The corresponding figure in children with no family history of atopy was 10%. Prolonged rhinorrhoea during infancy correlated with parental smoking only in children with a family history of atopy (47% vs. 18%). At the age of five years, atopic disease was found in 17% of 128 children, 24% of those with a family history of atopy and 9% of those with no such history. Atopic eczema was more common in children with a family history of atopy, irrespective of the diet consumed during infancy. Atopic signs were found in about half of all the children with a family history of atopy. If atopy had been present in the family, the child usually exhibited the same manifestation. Onset of atopic manifestations was not prevented or delayed.

Breast Feeding

Compliance with a dietary manipulation programme in families with infants prone to atopy.

The success of familial compliance with a dietary manipulation programme was studied prospectively in 91 newborn babies from atopic families for up to 12 months. The control group consisted of 72 infants from non-atopic families. The percentages of infants breast-fed at the age of six months were 58% and 38% in the study group and control group, respectively. The introduction of cow's milk based formulas was postponed until the age of three months in 63% of the infants in the study group and 47% of the infants in the control group. Solid food was avoided during the first three months in 76% and 45% of the infants in the study group and control group, respectively. Maternal age, smoking and low social class were associated with poor compliance. The existence of atopic dermatitis in any member of the family was associated with good compliance. The main advantages of our programme were the increased number of children breast-fed until the age of six months, and the reduced number of infants introduced to cow's milk based formulas or solid food before three months of age.

Adult

Effect of physical exercise and sleep deprivation on plasma androgen levels: modifying effect of physical fitness.

The responses of plasma testosterone (T), sex hormone-binding globulin (SHBG) binding capacity, androstenedione (A), and luteinizing hormone (LH) to 21 km of marching exercise and to sleep deprivation stress were studied in army recruits. The effect of physical fitness on the exercise responses was evaluated, cross-sectionally, by comparing the stress responses in 11 fit and 11 less fit subjects, and, longitudinally, in 11 subjects after 4 months of physical training. The submaximal marching exercise did not significantly alter the plasma hormone levels compared to the control day levels. The fit subjects had a tendency toward smaller decreases in the mean plasma T and T/SHBG ratio during both control and exercise days than the less fit subjects. After 4 months of conditioning, the mean plasma T and T/SHBG ratio tended to decrease less during both control and exercise days, which was more evident in the well-conditioned subjects. The exercise caused a decrease in mean plasma LH, especially in the less fit subjects. After sleep deprivation stress, the morning levels of plasma T, A, and LH were significantly depressed, as a result of which the normal diurnal variation of the hormones disappeared.

Androgens

Effect of long-term training and acute physical exercise on red cell 2,3-diphosphoglycerate.

A statistically significant 10% increase (p less than 0.005) in mean red cell 2,3-diphosphoglycerate (2,3-DPG) concentration, concomitantly with a mean 16% increase (p less than 0.001) in the predicted maximal oxygen uptake (VO2max) was observed in 29 recruits, who were studied during 6 months of physical training in military service. The increase in 2,3-DPG was higher, the lower the initial 2,3-DPG and VO2max levels. The mean initial 2,3-DPG level was higher in the subjects with a higher initial VO2max. A strenuous but highly aerobic 21-km marching exercise elicited a mean 9% increase (p less than 0.005) in red cell 2,3-DPG concentration. A significantly greater response of 2,3-DPG to marching exercise was observed in subjects with a lower pre-test VO2max than in those with a higher pre-test VO2max. During another more competitive march 2,3-DPG remained almost unchanged and was associated with a tendency towards a negative correlation with the acccompanying lactate response (r = -0.60, p less than 0.05). Red cell 2,3-DPG response to a standardized exercise is considered to be a suitable indicator for evaluating the effect of training on an individual.

Adult

Effect of long-term physical training on plasma testosterone, androstenedione, luteinizing hormone and sex-hormone-binding globulin capacity.

The effect of 6-months' physical training on plasma testosterone, androstenedione and luteinizing hormone levels and the binding capacity of sex-hormone-binding globulin (SHBG capacity) were studied in thirty-nine army recruits. Highly significant increases in mean plasma testosterone (21%), androstenedione (25%) and LH (25%) were observed during the training period and were associated with a mean 16% increase in the estimated maximal oxygen uptake. The mean increases in hormone levels tended to be greater in the well conditioned group than in the poorly conditioned group. The mean ratio of testosterone to SHBG capacity increased by 32% (P less than 0.05), which may be in relationship with the various training-induced effects.

Adult

Effect of long-term physical training on total red cell volume.

Six months of military training elicited a significant 4% mean increase in total red cell volume (TRC) measured by the 51Cr-labelled red cell method. This increase was associated with a mean 16% increase in predicted maximal oxygen uptake (VO2max). The increases in TRCV and predicted VO2max were inversely related to their initial levels. A statistically highly significant correlation between TRCV and predicted VO2max was observed (r = 0.59). The trained group had larger initial TRCVs than the sedentary group and the subjects who became well conditioned had a significant increase in TRCV, which contrasted with the unchanged TRCV in the subjects who did not become well conditioned. The greatest increase in TRCV (11%) was found in corporals, who had the hardest training. A statistically significant correlation between the changes in TRCV and estimated plasma volume was observed (r = 0.62), P less than 0.001). Owing the 1.8% increase in body weight the TRCV and predicted VO2max in terms relative to the body weight did not demonstrate the changes as clearly as did the absolute values. The factors affecting the TRCV increase are discussed.

Adult

Atopy in childhood and diet in infancy. A nine-year follow-up study. I. Clinical manifestations.

A national program for the prevention of atopy in children has been in progress in Finland since 1979. Its aim is to prevent or at least to reduce atopic symptoms in childhood. Since the start of the program we have followed a group of 119 children with and without a family history of atopy. Half the atopy-prone children kept to the diet intended to prevent atopy, i.e., breast-feeding prolonged up to age 3 months and introduction of solid food and formulae based on cow's milk after age 3 months. All children were examined at ages 5 and 10 years. In addition to clinical examination and interview, skin-prick tests using eight common inhalant allergens were performed. At age 9 to 10 years, 38 of the 119 children (32%) exhibited at least one atopic illness (bronchial asthma, allergic rhinitis, allergic conjunctivitis, atopic eczema or food allergy). Forty percent of children with family histories of atopy had atopic illness, independent of diet in infancy. The occurrence of atopic manifestations in the children of nonatopic families was 21%. Only half the children who had atopic symptoms at age 12 months had symptoms 9 years later. Asthma, allergic rhinitis, and positive skin-prick test results at age 5 years, however, correlated well with the subsequent occurrence of respiratory allergy. Our observations indicate that the preventive measures in early infancy intended to reduce the risk of atopy had no influence on atopic manifestations 9 years later.

Child