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P Hakala

Publications and source records attributed to P Hakala.

7 recordsLinked to original sources
PubMed1992

A seven-year follow-up of a weight reduction programme in Finnish primary health care.

The study was carried out to assess the short- and long-term effects of a Finnish Social Insurance Institution (SII) weight reduction programme in overweight primary health care clients and the suitability of the programme for use in health centres. The treatment group consisted of 22 men and 71 women, mean body mass index (BMI) 34.3, divided into 8 subgroups. These subjects participated in a 6-week weight reduction course led by public health nurses. Afterwards, there were six follow-up sessions and weight measurements at about 2-month intervals. A control group of 20 men and 76 women, mean BMI 33.5, received no weight reduction instruction during the 1 year that they served as controls. The weights, serum and high-density lipoprotein (HDL) cholesterol levels as well as blood pressures of the subjects in both groups were measured at entry to the study and at the end of the 1-year period. At that time the treatment group showed a weight reduction of 10.9 kg in men and 5.4 kg in women. The control group showed a mean weight gain of 0.9 kg in men and 0.2 kg in women. HDL cholesterol increased in the treatment group. The blood pressure decreased significantly in the category of subjects with a weight loss exceeding 4 kg weight. At the end of the 7-year follow-up period the mean weight reduction in the treatment group was 8.7 kg in men and 3.5 kg in women. Of men 53% and of women 21% still weighed over 10 kg less than at baseline. Both the clients and public health nurses found the weight reduction programme useful and applicable to health centres, preferably with extended time. The programme has now been adopted nationwide in the Finnish primary health care system.

Adolescent↗
PubMed1990

Long-term effects on lipid metabolism of weight reduction on lactovegetarian and mixed diet.

The effects of two dietary weight reduction programmes (1200 kcal/day) on lipid metabolism were followed for one year in moderately obese subjects. The groups consisted of lactovegetarian (n = 31), mixed diet (n = 37) and control (n = 42) groups. Serum triglyceride levels decreased rapidly during the first two weeks (46 per cent on average) especially in the mixed diet group, and this change was still statistically significant at 6 and 12 months after the beginning of the study. Serum total cholesterol levels also decreased rapidly in the beginning, but at 6 and 12 months the change was no longer statistically significant. After a small initial decrease HDL cholesterol levels appeared to increase towards the end of the study year. This increase was more marked in men (18.6 per cent at 6 months) than in women, and in the mixed diet group than in the lactovegetarian group (P less than 0.05 between the groups). The HDL/total cholesterol ratio increased rapidly in the beginning of the weight reduction and practically remained at the elevated (12-16 per cent) level during the whole follow-up. This increase was also more apparent in men than in women, and in the mixed diet group than in the lactovegetarian group. The changes in HDL subfractions, HDL2 and HDL3, paralleled those seen in the HDL cholesterol levels. Similarly the alterations in apolipoproteins A-I and B resembled those of the HDL and total cholesterol levels. The activity of adipose tissue lipoprotein lipase decreased drastically (about 50 per cent) at the beginning of the weight reduction, while at 6 and 12 months the mean activities were higher than the initial levels. This was also seen in the LPL activity when measured in post-heparin plasma. The activity of post-heparin plasma hepatic lipase decreased clearly at both 6 (P less than 0.001) and 12 months (P less than 0.01) in the mixed diet group, whereas no change was found in the lactovegetarian group. The ratio of subscapular to triceps skinfold reduced significantly (P less than 0.01) in women but not in men during the intervention period. Our study shows that in moderately overweight subjects weight reduction with the aid of a low-calorie dietary programme results in favourable responses in lipid metabolism many months after the cessation of the weight reduction programme. These responses appear to be stronger in subjects following mixed diet than in those attempting to follow a lactovegetarian diet.

Adult↗
PubMed1989

Weight reduction on lactovegetarian and mixed diets. Changes in weight, nutrient intake, skinfold thicknesses and blood pressure.

The purpose of this study was to investigate whether a weight reduction programme based on a lactovegetarian diet has any beneficial effects on the weight, nutrient intake, blood pressure and skinfold thickness of overweight subjects compared with a programme based on a balanced mixed diet. The subjects consisted of three groups of moderately overweight persons, with a mean age of 38 years and a mean overweight of 38 per cent. Two groups had a weight reduction programme for 1 year; group 1 (n = 31) had a 1200 kcal lactovegetarian diet and group 2 (n = 37) had an isocaloric mixed diet. Group 3 (n = 42) served as a control group which had no intervention. During the 1-year study period, group 1 lost 9.2 kg in weight, group 2 lost 10.4 kg and group 3 gained 1.6 kg in weight. Weight loss in both weight reduction groups was accompanied by a reduction in blood pressure, skinfold thickness and arm circumference. The results were slightly more favourable in the mixed diet group than in the lactovegetarian group. In the lactovegetarian group 7 persons were not able to follow the lactovegetarian diet throughout the whole year but ate some meat, fish and eggs during the latter part of the study year. The intake of fibre, vitamin C and calcium was greater and the intake of fat lower in the lactovegetarian than in the mixed diet group during the 1-year weight reduction period. The intake of most nutrients was above the recommended level in both weight reduction groups. The intake was somewhat below recommendations for niacin in the lactovegetarian group, for calcium in the mixed diet group and for iron for women in both groups. It seems desirable to recommend a low-calorie nutritionally well-balanced mixed diet, based on familiar foods and rich in vegetables, instead of a lactovegetarian diet, for long-term weight reduction of overweight persons. In the long term some nutrients may need to be supplemented in both diets.

Adult↗
PubMed1988

Stopping insulin treatment in middle-aged diabetic patients with high postglucagon plasma C-peptide. Effect on glycaemic control, serum lipids and lipoproteins.

We studied the successfulness of stopping insulin treatment in middle-aged diabetic patients aged 45-64 with a high postglucagon C-peptide level and the effects of this change on glycaemic control, serum lipids and lipoproteins. Insulin treatment was successfully stopped in 15 of our 22 patients who satisfied the inclusion criteria for the study and were selected on the basis of a computer file including practically all diabetic patients treated with insulin in the Kuopio University Central Hospital region (population base 250,000 inhabitants). Insulin therapy was restarted in seven patients during the first 3 months after discharge. During the following 9 months insulin therapy was restarted in another three patients so that after a 1-year follow-up period half of the diabetic patients whose insulin therapy was stopped had been switched back to insulin. Insulin therapy was seldom successfully stopped if the postglucagon C-peptide value was under the limit of 1.0 nmol/l. Glycaemic control did not change during the follow-up, although there was a significant weight loss in diabetic patients. No changes were observed in serum lipids or lipoproteins with the exception of LDL cholesterol, which showed a significant reduction during the 3-month follow-up. In conclusion, insulin therapy can often be successfully stopped in patients with postglucagon C-peptide over the limit of 1.0 nmol/l without worsening of glycaemic control and without unfavourable changes in serum lipid and lipoprotein levels.

C-Peptide↗
PubMed1976

Apical curettage as a treatment of acute periapical inflammation.

In 16 incisors, one canine, and one premolar with an acute periapical infection which had perforated the cortical bone, an apical curettage was carried out. During the treatment and the following 5 days, the patients were protected with antibiotic therapy. The curettage was performed through a slightly arched incision, convex toward the gingival margin. At the same sitting, a guttapercha root filling was made in the conventional way. Irrespective of operation, which involved a somewhat larger than normal incision, no spread from local to general infection was found in any of the cases. The patients were free from pain and other symptoms of infection after one treatment. In the radiographic examinations carried out from 6 to 12 months and 3 years later, it was found that 50% of curetted roots showed complete healing, 33% were uncertain and 17% were unsatisfactory. Bone formation was most rapid during the first postoperative year, after which it decreased. The bone formation was also most rapid in larger lesions but decreased, even in these, when it advanced to the vicinity of the root.

Acute Disease↗