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Biomedical subjects

M Klockars

Publications and source records attributed to M Klockars.

At least 19 recordsLinked to original sources
PubMed1999

Bioactive glasses induce chemiluminescence by human polymorphonuclear leukocytes.

The effect of bioactive glasses on human polymorphonuclear leukocytes (PMNLs) were studied in vitro by a chemiluminescence (CL) assay. Eight different glasses were chosen. All glasses induced a rapid CL response by human PMNLs, which proved to be dose dependent. The CL response also seemed to depend on the durability of the glasses. The least durable glass caused the highest CL response, and highly durable glasses caused only low CL responses by the cells.

Bone Substitutes↗
PubMed1999

Health reasons for leaving the profession as determined among Finnish hairdressers in 1980-1995.

BACKGROUND: Selection into and out of a profession is a known phenomenon in jobs such as hairdressing, in which the workers are exposed to agents and conditions capable of causing work-related symptoms and diseases. OBJECTIVE: To assess the risk for departure from the profession due to health and other reasons among hairdressers as compared with women engaged in commercial work. METHODS: We used a self-administered questionnaire to provide data on 3484 female hairdressers and 3357 referents with regard to their reasons for leaving the profession during the 15-year follow-up period of 1980 1995, for which the relative risks (RR) and 95% confidence intervals (CI) were calculated. The data were collected in August 1995. RESULTS: Of the reasons studied, only the concern for health increased the risk of leaving the profession (RR 1.33; 95% CI 1.16-1.52) among hairdressers. The risk of hairdressers having to leave the profession (1) because of asthma or hand eczema was 3.5 times as great as that found among the control group, (2) because of a strain injury of the wrist or elbow was 2.7 times as great, and (3) because of diseases of the neck or shoulders was 1.7 times as great. The risk of leaving the profession was approximately 20% higher for hairdressers who had suffered at some point in their lives from an atopic disease. CONCLUSIONS: Hairdressers suffering from atopic diseases, hand eczema, and strain injuries of the elbow and wrist are at higher risk of leaving the profession. Active modes of intervention are needed to maintain their working ability. The tools available in the occupational health service are: information on hazards, optimization of working conditions, personal protection, and timely medical care and rehabilitation.

Adult↗
PubMed1999

Computer-assisted telephone interview (CATI) in primary care.

OBJECTIVES: We aimed to study the prevalence of cardiovascular disease (CVD) risk factors among 11,000 inhabitants in Northern Helsinki, and to identify high-risk individuals in the area and direct them to the local primary-health-care-centred CVD-risk-factor prevention programme. METHOD: We conducted a computer-assisted telephone interview (CATI), a descriptive survey and primary care unit searching for CVD risk factors within the population under its responsibility. Six hundred and sixty-seven individuals aged 18-65 years out of 1000 randomly chosen inhabitants were interviewed using CATI. We measured the prevalence of self-reported CVD risk factors: smoking, blood pressure, last measured total serum cholesterol, body mass index (BMI), alcohol consumption, diabetes, physical exercise habits, positive family history of CVD/diabetes and personal history of CVD. RESULTS: Sixty-seven per cent of the sample was interviewed. Nineteen per cent did not have a telephone and 3% refused to be interviewed. Eleven per cent did not respond. Persons with high cardiovascular risk scores were observed mainly in the oldest age group. In the total sample, 23% of women and 28% of men were estimated to be at high risk of coronary artery disease. Gender differences were seen only in one age-group: 45-54-year-old men reporting higher risk-factor scores. The results were analysed using the Statistical Analysis System (SAS). CONCLUSIONS: The CATI-method is a useful tool in screening of high-CVD-risk patients and in guiding them to local CVD primary prevention programmes.

Adolescent↗
PubMed1998

Follow-up of asbestosis patients and predictors for radiographic progression.

OBJECTIVE: We followed a group of 85 Finnish asbestosis patients radiographically for an average of 6.5 (range 2-10) years to examine the progression of the disease and to assess possible explanations for the progression. METHODS: The examinations included full-size chest radiographs and a blood specimen analysis. The radiographs were classified according to the 1980 International Labor Office (ILO) classification. Progression was accepted if the second or third radiography was estimated (in a side-by-side comparison) to have more profusion of small opacities qualitatively than the first, even if the radiographs were classified into the same profusion category. RESULTS: In all, 38% of the patients showed progression during the follow-up period. The average progression of small opacities ranged from ILO 1/1 to ILO 2/2 (0.4 minor ILO categories/year). The asbestosis was progressive more often among the sprayers than among the insulators and asbestos factory workers [cross-tabulation, odds ratio (OR) 5.0, 95% confidence interval (95% CI) 1.2-20]. In the logistic regression model the ILO classification category at the beginning of the follow-up (OR 1.54; 95% CI 0.96-2.47), the fibronectin (OR 1.01; 95% CI 1.00-1.01) and angiotensin-converting enzyme (ACE; OR 1.10; 95% CI 1.00-1.20) levels, and the erythrocyte sedimentation rate (ESR; OR 1.05; 95% CI 1.00-1.10) were statistically associated with the radiographic progression of small opacities. Abnormalities of the pleura were found to progress more often among the patients with progressive parenchymal opacities. CONCLUSION: For the progression of small-opacity profusion the significant predictors in the logistic regression model were the ILO profusion category at the beginning of the follow-up period, the fibronectin level, the ACE value, and the ESR. The model correctly classified 94% of the patients with progression and 65% of those without progression. The differences in the mean values recorded for the biomarkers between the progressors and nonprogressors, however, were small and may therefore not be of any importance to the clinician.

Adult↗
PubMed1998

Progression of asbestosis predicts lung cancer.

STUDY OBJECTIVES: To explore whether the progression of asbestosis correlates with the risk of lung cancer among patients with asbestosis. DESIGN: A group of 85 asbestosis patients (78 men and 7 women) were radiographically followed up between 1979 and 1987. Two or three posteroanterior radiographs taken from each patient in 1978 to 1979, 1983 to 1984, and 1986 to 1987 were classified according to the International Labour Office 1980 classification and were used to divide the patients into progressors and nonprogressors. Follow-up for cancer was done automatically through the files of the Finnish Cancer Registry from the time of determination of the progression status to December 31, 1994. Predictors of lung cancer risk were studied with a logistic regression model, and the standardized incidence ratio (SIR) was calculated for lung cancer. RESULTS: Of the 24 male patients with progressive small opacity profusion, 11 (46%) developed lung cancer, as opposed to 5 (9%) of the 54 male patients without progression. The SIR for lung cancer was 37 (95% confidence interval, 18 to 66) for the progressors and 4.3 (1.4 to 9.9) for the nonprogressors. In both groups, all the lung cancer cases occurred among smokers or ex-smokers. None of the seven female patients showed progressive small opacity profusion. One of them developed lung cancer. In the logistic regression model including all 85 asbestosis patients, radiographic progression of small opacity profusion (p=0.0009) and current smoking (0.0021) were significant predictors of lung cancer morbidity. CONCLUSIONS: Asbestosis patients with radiographic progression of small opacity profusion over a few years are at a higher risk of lung cancer than those with a less aggressive course of the disease. The progression of pulmonary fibrosis may be an independent risk factor that, in addition to smoking history and the intensity of asbestos exposure, could be used to estimate lung cancer risk.

Adult↗
PubMed1998

[Hospital-based advanced home-care, models from Ekenäs, Finland].

In 1995, advanced home treatment services were introduced at Västra Nyland district hospital in Finland. For selected patients the new services constitute an alternative where hospitalisation would otherwise be necessary. Some of the hospital bed resources were moved to the patients' homes together with a trained team with immediate responsibility for the patients and providing 24-hour care, backed up by access to hospital resources in terms of specialised knowledge and sophisticated technology. Two years' experience of 500 patients so treated showed their diseases to have represented the complete spectrum of specialists fields. The most common diagnoses were oncological and infectious diseases. Although preliminary assessment suggests advanced home care to be a cheaper alternative than hospitalised care, the preeminent advantage from the patients' point of view was improved quality of life.

Finland↗
PubMed1997

Finnish research project on aging workers in 1981-1992.

The objective of this follow-up study of aging workers was to determine changes in the work, life-style, health, functional capacity, and stress symptoms of Finnish municipal employees from 1981 to 1992. In addition, factors that predict improvement or decline in the ability to work were studied. With the use of this information, attempts were made to produce practical measures to decrease the work-related health risks of elderly workers and increase factors promoting work ability. Along with the stress-strain model applied in the study, the reference frame of the World Health Organization (WHO) was used. The WHO model emphasizes the interaction between work, life-style, aging, and health. Work, life-style, health, work ability, and stress symptoms were studied through the use of comprehensive questionnaire surveys in 1981, 1985 and 1992. Initially, all the subjects (N = 6257) were employed in municipal occupations. During the follow-up, the data were supplemented by information on disability to work and mortality. The changes in work, life-style, health, work ability, and stress symptoms were examined among employees who worked in the same job (N = 924) during the entire follow-up period.

Adult↗
PubMed1997

Aging and changes in health.

OBJECTIVES: The study explored changes in the health of aging workers from 1981 to 1992. METHODS: Municipal workers [age 55 to 69 (mean 61.6) years in 1992] who filled out questionnaires in both 1981 and 1992 (N = 4534) were studied. The changes in disease prevalence and perceived health were tested with Pearson's chi-square independence test. Improvement and decline in perceived health were analyzed by logistic regression models. RESULTS: In 1992, significantly more diseases were reported than in 1981; the musculoskeletal disease rate rose from 38% in 1981 to 53% in 1992 for the women and from 35% to 49% for the men and the cardiovascular disease rate rose from 15% in 1981 to 28% in 1992 for the women and from 19% to 37% for the men. The age differences diminished during the follow-up. Self-assessed health improved in all the age groups among both those still working in 1992 and those retired. The association between illnesses and perceived health changed during the follow-up, 11% of those with no diseases experiencing their health as good in 1981 and over 40% in 1992. The most important factors explaining the improvement appeared to be a low number of physical illnesses and the absence of cardiovascular and musculoskeletal disease. Nonphysical work, frequent physical exercise, and satisfaction with life situation were also significant contributors to good perceived health. CONCLUSIONS: The improvement in perceived health during the follow-up may mean that older people have lower criteria for good perceived health than younger people do. The associations between self-assessed health and the presence of disease need further study.

Adult↗
PubMed1997

Changes in the work ability of active employees over an 11-year period.

OBJECTIVES: Changes in the work ability of active employees were followed over a period of 11 years. METHODS: Men and women in the same occupation (N = 818) in 1981-1992 assessed their work ability according to an index on current work ability, physical and mental work demands, diagnosed diseases, work impairment from disease, sickness absence, work ability prognosis, and psychological resources. Their mean initial age was 46.9 (range 44-51) years. The means and standard deviations of the work ability index and the prevalence rates of 4 work ability categories were followed with respect to age, gender, and job content. RESULTS: The mean work ability index declined significantly in 11 years for both genders. Its association with age and work was strong. Age of > or = 51 years and physical work load were critical factors affecting the work ability of both genders. At the mean age of 58 years, at least 25% of the installation, auxiliary, or transport workers had a poor work ability rating, as did the women doing kitchen supervision, auxiliary, and home care work. The annual rate of decline in work ability was highest for women aged 51 years at the onset of the study. Female teachers showed a less dramatic decline in work ability than male teachers. CONCLUSIONS: Work does not seem to prevent a decline in the work ability of men and women as they age. Therefore, measures to promote work ability should be started before the age of 51 years, especially for workers in physically demanding jobs.

Adaptation, Psychological↗
PubMed1997

Aging, work, life-style and work ability among Finnish municipal workers in 1981-1992.

OBJECTIVES: This study was designed to explain changes in work ability through occupational and life-style factors. METHODS: Work ability was measured by an index describing workers' health resources in regard to their work demands. The work factors mainly included physical and mental demands, social organization and the physical work environment. The life-style factors covered smoking, alcohol consumption, and leisure-time physical exercise. The first questionnaire study was done in 1981 and it was repeated in 1992. The subjects (N = 818) were workers in the 44- to 51-year-old age group in the beginning of the study who were active during the entire follow-up. The improvement and, correspondingly, the decline in work ability were analyzed by logistic regression models. RESULTS: Both the improvement and the decline in work ability were associated more strongly with changes in work and life-style during the follow-up than with their initial variation. The model for improved work ability included improvement of the supervisor's attitude, decreased repetitive movements at work, and increased amount of vigorous leisure-time physical exercise. Deterioration in work ability was explained by a model which included a decrease in recognition and esteem at work, decrease in workroom conditions, increase in standing at work, and decrease in vigorous leisure-time physical exercise. CONCLUSIONS: Social relations at work can promote or impair the work ability of elderly workers. Although the work ability of elderly workers generally declined with aging, both older and younger workers were also able to improve their work ability.

Adult↗
PubMed1996

Neurone-specific enolase levels in pleural effusions in patients with rheumatoid arthritis.

BACKGROUND: High pleural fluid levels of neurone-specific enolase (NSE) have been reported, not only in patients with small cell lung cancer but also in those with chronic inflammatory diseases. METHODS: NSE concentrations were determined in pleural fluid and serum from 342 patients with pleural effusions including 17 with rheumatoid arthritis. RESULTS: The median NSE concentration in pleural fluid was higher in rheumatoid effusions than in any other condition studied. The median pleural fluid:serum NSE ratio was highest in patients with rheumatoid arthritis (11.6) and about unity in all other diseases including small cell lung cancer (0.9). In patients with rheumatoid arthritis pleural fluid concentrations of NSE correlated inversely with pleural fluid glucose concentrations and the pH of the pleural fluid. CONCLUSIONS: A high pleural fluid:serum NSE ratio was found consistently in pleural effusions from patients with rheumatoid disease.

Arthritis, Rheumatoid↗
PubMed1996

Pleural fluid beta-2-microglobulin and angiotensin-converting enzyme concentrations in rheumatoid arthritis and tuberculosis.

Concentrations of beta 2-microglobulin (B2M) and angiotensin-converting enzyme (ACE) were measured in pleural fluid (Pf) and serum (S) of 364 patients with pleural effusions. Eleven patients had rheumatoid arthritis (RA), 36 verified tuberculosis (TB), 15 suspected TB, 120 cancer, 21 empyema, 34 pneumonia, 33 various defined diseases, 67 effusions of unknown aetiology and 27 congestive heart failure. The median concentrations of Pf-B2M and Pf-ACE were significantly higher in patients with RA than in patients with any other disease (p < 0.005). Tuberculous effusions contained higher Pf-ACE concentrations than any other type of non-rheumatoid effusion (p < 0.05). With sensitivities of 91%, the specificity of Pf-B2M and Pf-ACE for the diagnosis of RA was 86% and 55%, respectively. Local cellular immune events probably account for the abundance of B2M and ACE in rheumatoid and tuberculous pleural effusions. Pf-B2M and Pf-ACE determinations may aid in the differentiation of rheumatoid and tuberculous pleurisy from other types of pleural disease.

Arthritis, Rheumatoid↗
PubMed1996

Pleural fluid interferon-gamma and tumour necrosis factor-alpha in tuberculous and rheumatoid pleurisy.

Tuberculous and rheumatoid pleural effusions show features suggesting a strong local cellular immune response. Pleural fluid (Pf) from patients with tuberculosis, rheumatoid arthritis (RA) and other diseases were compared with respect to interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha). Immunoassays were used to determine Pf-IFN-gamma and Pf-TNF-alpha in 102 patients, including 11 with RA, 31 with verified tuberculosis, 23 with suspected tuberculosis, 11 with pneumonia, 14 with lung cancer and 12 with congestive heart failure. Measurable Pf-IFN-gamma occurred exclusively in patients with verified (median 1.8 ng x mL-1; 95% confidence interval (95% CI) 0.63-4.0 ng x mL-1) or suspected (0.37 ng x mL-1; 95%CI 0-0.7 ng x mL-1) tuberculosis. The highest median Pf-IFN-gamma was observed in those patients who showed a positive pleural fluid culture for Mycobacterium tuberculosis. In pleural effusions due to other diseases, including RA, IFN-gamma was undetectable. The highest Pf-TNF-alpha occurred in verified tuberculosis (median 198 ng x L-1; 95% CI 169-222 ng x L-1) and RA (210 ng x L-1; 95% CI 147-231 ng x L-1). Pleural fluid interferon-gamma is a highly useful marker for diagnosing tuberculous pleurisy. Although tuberculous and rheumatoid pleural effusions share several biochemical features, they are strikingly different with respect to interferon-gamma.

Arthritis, Rheumatoid↗
PubMed1995

Different contributions of cytochrome P450 2E1 and P450 2B1/2 to chloroform hepatotoxicity in rat.

The contribution of cytochrome P450 isozymes CYP2E1 and CYP2B1/2 to chloroform-induced hepatotoxicity taken at 18 hr after the treatment was investigated in rats treated with n-hexane as an inducer of CYP2E1, 2-hexanone as an inducer of CYP2E1 and CYP2B1/2, and phenobarbital (PB) as an inducer of CYP2B1/2. Hepatic damage was evaluated by gross measurement of plasma alanine aminotransferase activity and histopathological examination. All treatments potentiated chloroform-induced hepatic damage. In n-hexane-pretreated rats, the damage was maximal with the middle dose of chloroform (0.2 ml/kg), whereas the damage increased with dose in rats treated with 2-hexanone or PB. The degree of hepatic damage induced with the three pretreatments was in the following order: n-hexane > 2-hexanone = PB with the middle dose of chloroform and PB >> 2-hexanone > n-hexane with the high dose (0.5 ml/kg); little difference among the pretreatments was seen with the low dose (0.1 ml/kg). These findings suggest that CYP2E1 is a low Km isoform and CYP2B1/2 a high Km isoform for chloroform activation. CYP2E1-dependent hepatic damage was characterized by ballooned hepatocytes, which were restricted to the centrilobular area; with CYP2B1/2, more necrotic than ballooned hepatocytes were seen and the necrotic hepatocytes were found not only in the centrilobular but also in the midzonal and periportal areas. Chloroform treatment did not affect the activity of N-nitrosodimethylamine N-demethylase in pretreated rats; the high dose increased the activity in control rats. In contrast, the high dose of chloroform decreased the activity of 7-pentoxyresorufin O-depentylase in all induced rats but not in controls. Immunoinhibition and immunoblot analyses showed that the high dose of chloroform induced CYP2E1 in control rats but decreased CYP2B1/2 in all pretreated rats. These results suggest that although both CYP2E1 and CYP2B1/2 contribute to chloroform-induced hepatic damage, they do so quite differently.

Alanine Transaminase↗
PubMed1995

Neutrophil and asbestos fiber-induced cytotoxicity in cultured human mesothelial and bronchial epithelial cells.

This study investigates reactive oxygen species generation and oxidant-related cytotoxicity induced by amosite asbestos fibers and polymorphonuclear leucocytes (PMNs) in human mesothelial cells and human bronchial epithelial cells in vitro. Transformed human pleural mesothelial cells (MET 5A) and bronchial epithelial cells (BEAS 2B) were treated with amosite (2 micrograms/cm2) for 48 h. After 24 h of incubation, the cells were exposed for 1 h to nonactivated or amosite (50 micrograms) activated PMNs, washed, and incubated for another 23 h. Reactive oxygen species generation by the PMNs and the target cells was measured by chemiluminescence. Cell injury was assessed by cellular adenine nucleotide depletion, extracellular release of nucleotides, and lactate dehydrogenase (LDH). Amosite-activated (but also to a lesser degree nonactivated) PMNs released substantial amounts of reactive oxygen metabolites, whereas the chemiluminescence of amosite-exposed mesothelial cells and epithelial cells did not differ from the background. Amosite treatment (48 h) of the target cells did not change intracellular adenine nucleotides (ATP, ADP, AMP) or nucleotide catabolite products (xanthine, hypoxanthine, and uric acid). When the target cells were exposed to nonactivated PMNs, significant adenine nucleotide depletion and nucleotide catabolite accumulation was observed in mesothelial cells only. In separate experiments, when the target cells were exposed to amosite-activated PMNs, the target cell injury was further potentiated compared with the amosite treatment alone or exposure to nonactivated PMNs. In conclusion, this study suggests the importance of inflammatory cell-derived free radicals in the development of amosite-induced mesothelial cell injury.

Adenine Nucleotides↗
PubMed1994

Bacillus Calmette-Guérin (BCG) and immunoglobulins synergistically enhance mineral dust-induced production of reactive oxygen metabolites by human monocytes.

The modulating effect of BCG and polyclonal immunoglobulin on mineral dust-induced production of reactive oxygen metabolites (ROM) by human monocytes was studied using luminol-dependent chemiluminescence. BCG and immunoglobulin synergistically amplified the ROM production induced by chrysotile asbestos and quartz particles, and BCG caused a sharper dose response for poly-immunoglobulin added to the mineral dusts. Immunoglobulins did not affect zymosan yeast-induced ROM production, which was enhanced strongly by BCG. As there is evidence that phagocyte-derived ROM are of importance in mineral dust-induced lung injury, we suggest that the observed synergism between host response inflammatory mediators (poly-immunoglobulin) and exogenic irritants (BCG) may contribute to the outcome of exposure of mineral dusts, and thus in part explain the individual variations in susceptibility to mineral dust-induced diseases.

Asbestos↗