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Biomedical subjects

M Uhari

Publications and source records attributed to M Uhari.

At least 127 records · Page 7Linked to original sources
PubMed1991

Obesity in children, adolescents and young adults.

The prevalence of obesity in Finnish children, adolescents and young adults aged three to 24 years was estimated in three surveys performed within the multicentre project, "Cardiovascular Risk in Young Finns" (1980, 1983, 1986). Obesity was defined as either body mass index (weight/height) or skinfold thickness (triceps or subscapular) or both greater than 90th percentiles of age and sex-specific reference data for white children. Its mean prevalences among 9- to 18-year old boys and girls in three surveys (95% confidence limits) were 3.6% (3.1-4.2) and 2.1% (1.7-2.6) as estimated in terms of body mass index and triceps skinfold thickness or 4.3% (3.9-4.9) and 2.6% (2.2-3.1) according to body mass index and subscapular skinfold thickness. Thus the 9- to 18-year old boys were on average more often obese than the girls, but no statistically significant changes in the prevalence of obesity were observed over the period 1980-1986. Body mass index and triceps or subscapular skinfold thicknesses vary in sensitivity as indicators of obesity.

Adolescent↗
PubMed1991

Blood pressure in children, adolescents and young adults.

The question of whether blood pressure is one of the main risk factors for cardiovascular diseases in childhood has been evaluated in a Study of Cardiovascular Risk in Young Finns. In the second follow-up study, carried out in 1986, blood pressure was successfully measured in 2500 individuals aged nine to 24 years using a random zero sphygmomanometer. The mean systolic blood pressure in girls rose from 102 mmHg (95th percentile 119 mmHg) at age nine to 116 mmHg (138 mmHg) at age 24 and that in boys from 102 mmHg (95th percentile 121 mmHg) to 128 mmHg (148 mmHg). Diastolic blood pressure was more often measurable using Korotkoff's 5th than the 4th phase. The values observed were similar to those reported by the Second Task Force on Blood Pressure Control in Children, but owing to differences in the methods used to measure blood pressure it cannot be reliably concluded that the blood pressures were similar in the two series. Even in childhood blood pressure measurement is important, and since it changes with the physical size of the child, observations should be compared with normal values such as those reported here. No data are yet available to suggest that children with blood pressure values in the high normal range would benefit from interventions. Thus normal blood pressure value curves should be applied with caution when assessing children.

Adolescent↗
PubMed1991

Serum lipids and lipoproteins in children, adolescents and young adults in 1980-1986.

A multicentre study on atherosclerosis precursors in young Finns aged three to 18 years was started in 1980 (3596 subjects) serum lipid concentrations (cholesterol, HDL (high density lipoprotein) cholesterol and triglycerides) were determined (n = 3554) and the apolipoproteins A-I and B measured (n = 1355). Two follow-up studies were carried out in 1983 (n = 2851) and 1986 (n = 2489), when HDL-subfractions (HDL-2-cholesterol and HDL-3-cholesterol) were also determined. Apolipoproteins A-I and B were measured again in 1986 (n = 1202). Serum total cholesterol concentration has fallen by about 1% annually during the 1980's from 5.07 mmol/l (1980) to 4.79 mmol/l (1986) in 9- to 18-year old children and adolescents. Mean values of serum triglycerides have slightly increased during the follow-up from 0.79 mmol/l to 0.84 mmol/l, respectively. In children and young adults (3-24 years) the mean cholesterol concentration was highest at the age of six and lowest during puberty. Concentrations of serum cholesterol, LDL (low density lipoprotein) cholesterol apoprotein B and triglycerides were higher in eastern than in western Finland in 1980 and 1983, but these differences were smaller in 1986, with the exception of serum triglycerides. Both in 1983 and in 1986 HDL-2-cholesterol was lower in the west than in the east, whereas HDL-3-cholesterol was higher in the former. The favourable changes in lipid levels should be reflected in future morbidity and mortality rates from coronary heart disease in Finland.

Adolescent↗
PubMed1991

Regional differences in apolipoprotein E polymorphism in Finland.

Apolipoprotein E (apoE) polymorphism is a genetic determinant of plasma lipid levels and of coronary heart disease risk. We determined apoE phenotypes and plasma lipid levels in 1564 subjects aged three to 18 years, living in five geographical areas of Finland in 1980. ApoE phenotyping was performed directly from plasma by isoelectric focusing and immunoblotting. The serum concentrations of total cholesterol, low density lipoprotein cholesterol and apolipoprotein B varied with apoE phenotype, and there were increases in all three variables (all P less than 0.001) of the order of E2/2 less than E3/2 less than E4/2 less than E3/3 less than E4/3 less than E4/4. These differences were present in all five areas. The mean levels of high density lipoprotein cholesterol, apolipoprotein A-I and triglyceride in the subjects did not differ between the apoE phenotypes or between their areas of residence. The apoE phenotype dependency of serum total and LDL cholesterol remained significant in all five areas during the six year follow-up from 1980 to 1986, when the mean level of serum total cholesterol fell by 5.8% in east (P less than 0.05) and by 4.4% in west Finland (P less than 0.05); the fall was steeper (P less than 0.01) in the east than the west. In all subjects, particularly those in west Finland, the size of the falls of serum total and LDL cholesterol concentrations depended on the apoE phenotype in the order of E3/2 less than E3/3 less than E4/3, but this effect was not seen in the east.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Serum insulin and other cardiovascular risk indicators in children, adolescents and young adults.

We wanted to determine the levels of fasting serum insulin during growth, the tracking of serum insulin, and the correlation of serum insulin with other coronary heart disease risk indicators in children and young adults. In 1986 2433 subjects, aged nine to 24 were studied, and insulin data were available from the same population in 1980 and 1983. Serum insulin levels showed a peak during puberty in both sexes and the decline in insulin continued after the age of 21. Tracking of serum insulin was only moderate, especially in females and young boys. Serum insulin correlated positively with body mass index, concentrations of serum triglycerides, and blood pressure, and inversely with the concentration of high density lipoprotein cholesterol. High triglycerides, high systolic blood pressure, and low level of high density lipoprotein cholesterol clustered among subjects within the highest insulin quartile. Our results suggest that the insulin resistance phenomenon, caused mainly by obesity and leading to unfavourable levels of other coronary heart disease risk indicators, is already developing in children and young adults. This suggests that preventing obesity in early life is important.

Adolescent↗
PubMed1991

Composition of the diet of young Finns in 1986.

The aim was to describe the energy intake and composition of the diet of 1200 9-, 12-, 15-, 18-, 21- and 24-year-old Finns in 1986 and changes in their diet from 1980 to 1986. Data on food consumption were collected using the 48 h recall method. In 1980 protein accounted for 14%, fat for 38% and carbohydrates for 48% of total energy intake, and in 1986 for 15%, 38% and 47%, respectively. The mean P/S ratio increased from 0.24 to 0.31 while the regional differences in the intakes of fatty acids remained unchanged, the P/S ratio being higher in urban than in rural areas and higher in western than in eastern Finland. In 1986 the diet of 15-, 18- and 24-year-old males contained more fat, saturated fatty acids and monounsaturated fatty acids but less sucrose than that of females. The difference in the diet between young men and women, if continued, might increase the male/female ratio at risk for coronary heart disease, which is already pronounced in Finland.

Adolescent↗
PubMed1991

Venous patch aortoplasty for correction of experimental coarctation.

Experimental chronic aortic coarctation in eight beagle dogs was repaired with a free autogenous vein patch graft. Seven sham-operated dogs were controls. One year later the aortic resting blood pressure proximal to the aortoplasty was 122/77 (SD 10/8) mmHg in the aortoplasty group and 112/76 (SD 11/10) in the control group. The strength of the venous patch was tested with intravenous infusion of phenylephrine 0.01 mg/kg/min for 10 min (total dose 0.1 mg/kg). The aortic blood pressure after this infusion was 240/167 (38/26) and 271/179 (27/19) mmHg, respectively. The systolic gradient across the aortoplasty site was 3.9 (6.9) mmHg at rest and 7.7 (16.6) after the phenylephrine infusion. The aortic cross-sectional area at the aortoplasty site was 46.8 (2.7) mm2 in the aortoplasty group and 43.7 (3.7) in the control group. Focal intimal smooth muscle cell hyperplasia was found in the venous patch and in the aortic wall beside the sutures, and the medial layer of the patch was fibrotic. A venous patch may be an option for treatment of coarctation.

Animals↗
PubMed1991

[Treatment of obesity in children and adolescents].

Weight development was compared in 48 obese children, 6-15 years of age, who during a 12-month period underwent treatment either individually, in groups, or as part of the school health services. Those treated intensively by groups or individually manifested a relative weight reduction of 10-14 per cent at the 12-month follow-up, as compared with seven per cent in those treated by the school health services, but at five-year follow-up relative weight reduction was much the same in all three categories. Thus, group treatment of childhood obesity would appear to be the best alternative as it yields fairly rapid relative weight reduction with beneficial metabolic changes, and entails less investment in personnel resources.

Adolescent↗
PubMed1990

Viral infections and recurrences of febrile convulsions.

To determine whether complicated febrile seizures occur more often in children with a proven viral infection, we performed viral examinations on 144 children with febrile convulsions, of whom 112 had simple and 32 had complicated seizures. A diagnosis of virus infection was verified in 46% of the former patients and 53% of the latter. Three adenoviruses, one parainfluenza virus type 2 and one type 3, one respiratory syncytial virus, one echovirus type 11, one herpes simplex virus type 2, and one influenza B virus were isolated from the cerebrospinal fluid. A simple febrile convulsion occurred in seven children with a positive cerebrospinal fluid viral isolation, and two had a complex febrile seizure. In a follow-up of 2 to 4 years (mean 3.3 years), 21 of the 107 children with simple seizures (19.6%) and 3 of the 32 children with complicated seizures (9.4%) had recurrent febrile seizures. The children with positive evidence for a viral infection, even with a virus isolated from the cerebrospinal fluid, had no more recurrences than those without any proven viral infection. We conclude that children with a proven viral infection have no worse prognosis than those without.

Cerebrospinal Fluid↗
PubMed1990

Tularemia in children caused by Francisella tularensis biovar palaearctica.

Existing data on tularemia infections in children caused by the biovar Francisella tularensis palaearctica (type B) are limited. The case histories of all patients younger than the age of 16 years in northern Finland who had tularemia, based on the antibody response, during the years 1967 to 1986 are reviewed. A total of 67 children, 28 girls and 39 boys, were identified as having had tularemia. The occurrence of the disease varied greatly among years. Most of the cases occurred in July, August and September. The epidemiology differed significantly from that reported for F. tularensis biovar tularensis (type A). This is most probably attributable to the different vector, which was the mosquito in our series, but the tick in areas where type A is common. There were also clear differences in the clinical picture. The ulceroglandular clinical type was the most common. The clinical symptoms and signs were usually quite benign, but the symptoms lasted for a median duration of 26 days. The patients were treated with different antibiotics and there were no differences in the outcome related to the treatment given. Prospective comparative investigations of antibiotic therapy given for tularemia are needed. It is also important to try to identify which strain is causing the disease in each case.

Adolescent↗
PubMed1990

Metabolic and hematologic effects and immune complex formation related to pertussis immunization.

Selected metabolic, hematologic, and immunologic functions were evaluated in 3- to 6-mo-old Finnish infants who received whole-cell pertussis-component diphtheria and tetanus toxoids and pertussis vaccine, adsorbed (DTP) vaccine, and in 4- to 6-y-old Los Angeles children who received either a licensed DTP vaccine or an acellular pertussis component DTP vaccine. One d after immunization, there was an increase in total leukocytes and neutrophils and a decrease in lymphocytes in all vaccinees. In 4- to 6-y-old children the leukocytosis and neutrophilia were greater in recipients who received the standard DTP vaccine than in vaccinees who received an acellular pertussis component DTP vaccine. In infants there was an increase in the mean plasma insulin concentration but no change in the glucose concentration 24 h after immunization; no increase in the mean plasma insulin was noted in the 4- to 6-y-old children. Three 4- to 6-y-old vaccinees had higher circulating immune complex concentrations after immunization and two of these children had high clinical reaction scores. The etiology of adverse reactions after DTP immunization is multifactorial. In contrast with findings in animals, our findings do not demonstrate a clinically significant effect due to lymphocytosis-promoting factor on glucose metabolism in vaccinated children. Neutrophilia in vaccinees is probably due to endotoxin, and some reactions may be due to circulating immune complexes.

Antigen-Antibody Complex↗
PubMed1989

Poliovaccine virus in the cerebrospinal fluid after oral polio vaccination.

In February-March 1985 an oral poliovirus vaccine campaign was launched in Finland in a population vaccinated earlier with inactivated poliovaccine. During this campaign a strain of poliovirus was isolated from the cerebrospinal fluid (CSF) of a 7-year-old girl 34 days after she had received oral poliovirus vaccine. She had long-lasting headache, vomiting and fever but no paralysis. This case demonstrates that poliovaccine virus can invade the central nervous system even after a complete course of inactivated poliovirus vaccine if the inactivated vaccine has been poorly antigenic against one of the three types of virus.

Cerebrospinal Fluid↗
PubMed1989

Mixed bacterial and viral infections are common in children.

Acute phase and convalescent sera from 51 pediatric patients who had a documented viral infection and no obvious culture-confirmed bacterial infection such as meningitis, otitis media or urinary tract infection were tested by enzyme immunoassay for antibodies to Haemophilus influenzae and Branhamella catarrhalis and by the latex agglutination test for pneumococcal antigens to evaluate the frequency of mixed bacterial and viral infections. A mixed bacterial and viral infection was documented in 19 patients (37%). Seven patients (14%) showed a diagnostic rise in antibodies to H. influenzae and 8 patients (16%) showed an antibody elevation to B. catarrhalis in their paired sera; pneumococcal antigen was detected in acute phase serum from 4 patients (8%). The rate of mixed infections in patients having respiratory symptoms was 52%. High serum C-reactive protein values and white blood cell counts were found significantly more often in those with mixed infections than in those who had viral infections. The results indicate that mixed bacterial and viral infections occur more frequently in children than one could anticipate on the basis of the earlier reports. Mixed bacterial and viral etiology is highly probable in a child who has a defined viral infection with high C-reactive protein and white blood cell count values, especially in the presence of respiratory symptoms.

Adolescent↗
PubMed1989

Ultrasonic features of the congenital nephrotic syndrome of the Finnish type.

Ultrasonic features of the kidneys of seven infants with congenital nephrotic syndrome of the Finnish type under active conservative treatment are described. In all cases the kidney were enlarged an the cortex more echogenic than the liver and spleen parenchyma. The pyramids were small with hazy borders resulting in an indistinct or lost corticomedullary border. At follow-in the echogenity of the renal cortex increased still further in four infants and the pyramids became invisible. The differential diagnosis is discussed.

Diagnosis, Differential↗
PubMed1989

Cardiovascular risk in young Finns, results from the second follow-up study.

A comprehensive study of coronary heart disease (CHD) risk factors and their determinants in children and adolescents in Finland was initiated in the late 1970's. The main cross-sectional study was undertaken in 1980, with 3596 subjects aged from 3 to 18 years participating. The first follow-up study was carried out in 1983, and the second in 1986. The present report describes briefly some findings in 2746 children and young adults, aged 9, 12, 15, 18, 21 and 24 years, participating in 1986. Serum total cholesterol concentrations, mean (SD), ranged between 4.31 (0.73) and 4.91 (0.81) mmol/l in boys, and between 4.73 (0.85) and 5.09 (0.82) mmol/l in girls, respectively. Mean serum cholesterol values had fallen from 1980 to 1986 by 5.4% in such age cohorts, which had been included in all three studies. Fat content in the diet remained unchanged (38 E %), whereas the mean P/S ratio increased from 0.24 in 1980 to 0.31 in 1986. Young Finns from East Finland had a higher somatic risk index than those from West Finland (P greater than 0.001). The clustering of somatic risk factors was stable between 1980 and 1986. Further follow-up of the cohorts will, we hope, provide the tools for implementing primary prevention of CHD in Finland.

Adolescent↗