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Biomedical subjects

S Sarna

Publications and source records attributed to S Sarna.

At least 37 records · Page 2Linked to original sources
PubMed2002

Increase of allergen-specific immunoglobulin E antibodies from 1973 to 1994 in a Finnish population and a possible relationship to Helicobacter pylori infections.

BACKGROUND: The prevalence of atopic diseases--hayfever, asthma and eczema--has increased over the past decades. The increase may be associated with decreased rates of infections such as measles, hepatitis A, tuberculosis, toxoplasmosis, and, as recently suggested, Helicobacter pylori gastritis. OBJECTIVE: Since the increase of atopy has been mainly based on clinical studies, we wanted to study the prevalence of allergen-specific Immunoglobulin (Ig)E antibodies in two cross-sectional, adult population-based serum samples two decades apart. Since the sera had been tested for H. pylori antibodies, we also had a chance to look for a possible relationship between these two findings. METHODS: We determined the prevalence rate of allergen-specific serum IgE antibodies against birch and timothy pollen, and cat and dog epithelium allergens by the radioallergosorbent test in a 15-54-years-old Finnish population using 326 sera collected in 1973 and 319 sera collected in 1994 from randomly selected subjects. RESULTS: From 1973 to 1994 allergen-specific IgE prevalence rates and IgE antibody levels rose. In 1994, the prevalence rate of positive findings in 15-24-year-old population had increased from 11 to 38% (3.5-fold increase, P = 0.0001, OR 5.12, CI 95% 2.32-11.3). In older 10-year age groups similar trends did not reach significance, but the overall change was significant with all three cut-off levels of allergen-specific IgE analysed. The percentage of IgE-positive persons rose mainly in the subgroup with no H. pylori antibodies. In 1994 21% of the H. pylori-negative subjects had IgE antibodies compared with 5% of the H. pylori-positive subjects (in 1973 11% in both subgroups). CONCLUSIONS: IgE-based evidence for an increase in IgE-mediated allergy was uncovered. The increase occurred mainly in the subgroup with no antibodies to H. pylori, which support the hypothesis that H. pylori could be one of the microbes counteracting atopy.

Adolescent↗
PubMed2002

Short-term variability of exhaled nitric oxide in young male patients with mild asthma and in healthy subjects.

BACKGROUND: Exhaled nitric oxide (NOexp) is an indicator of eosinophilic airways inflammation. This study evaluated short-term variability of NOexp in 13 healthy subjects (19-41 years, eight males) and in 31 patients with asthmatic respiratory symptoms (19-21 years, all male) to obtain data for assessment of short-term changes of NOexp in clinical situations. METHODS: Mild asthma was confirmed in 10 patients (Group = asthma). Twenty-one patients with asthmatic respiratory symptoms did not fulfill the functional criteria of asthma (Group = respiratory symptoms). The procedure to determine NOexp followed the European Respiratory Society (ERS) guidelines; the mean expiratory flow used during sampling was 0.09-0.12 l/s. NOexp for each subject was determined as the mean of at least three successive measurements at the baseline, followed by determinations at 10 min, 6 h and 24 h after the baseline. RESULTS: At the baseline, the mean (SD) value of NOexp was 6.6 (2.3) parts per billion (ppb) in the healthy controls, and significantly higher both in patients with respiratory symptoms (14.6 (11) ppb, P = 0.0076) and in those with asthma (34.2 (43) ppb, P < 0.001). Intraclass correlation coefficient of NOexp measured at baseline and after an interval of 10 min was 0.959 in healthy subjects, 0.986 in patients with respiratory symptoms and 0.936 in asthma patients, respectively. Short-term variability in terms of coefficient of variation (CoV) of repeated measurements of NOexp at 10 min, 6 hand 24 h was 5.1, 10.8 and 11.7% in healthy subjects, 71, 16.4 and 22.2% in patients with respiratory symptoms and 13.5, 19.4 and 26.4% in asthma patients, respectively. CONCLUSIONS: Reproducibility of NOexp using standardized methods was good both in healthy subjects and in asthmatic patients. However, in asthmatics the short-term variation of NOexp was over two times as high as in healthy subjects. The level of NOexp was elevated, except in asthma, also in patients with asthmatic respiratory symptoms who did not fulfill the functional criteria of asthma.

Adult↗
PubMed2002

Long-term vigorous training in young adulthood and later physical activity as predictors of hypertension in middle-aged and older men.

500 and 69 male former elite athletes and 319 male controls completed a health questionnaire in 1985 and in 1995. Register data on the subjects were also collected. Subjects were aged 65 years or less and had no history of hypertension in 1985, and they had been healthy at the age of 20 years. The athletes were grouped into endurance and mixed sports (n = 386), and power sports (n = 183). The cumulative 10-year incidence of hypertension up to 1995 was significantly lower in the endurance and mixed sports group (23.6 %) compared to the power sports group (33.3 %) or the control group (32.0 %). The difference between the endurance and mixed sports group and the two other groups was still significant after adjustment for age, but not after further adjustment for body mass index, alcohol consumption, and later physical activity. However, the trend of reduced risk remained. In conclusion, a history of being an elite athlete in endurance or mixed sports predicts a lower risk of hypertension in working age men, while a history of being an elite athlete in power sports appears to confer no benefit. Later physical activity was also associated with lower risk.

Adult↗
PubMed2002

No support for endoscopic surveillance for gastric cancer in hereditary non-polyposis colorectal cancer.

BACKGROUND: The DNA mismatch repair gene mutations underlying hereditary non-polyposis colorectal cancer syndrome (HNPCC) also predispose, besides colorectal and endometrial cancer, to gastric cancer. usually of the intestinal type. The carcinogenetic pathway behind the elevated gastric cancer risk is largely unknown. METHODS: The aim of this study was to determine whether there are any premalignant lesions to search for in gastric surveillance in HNPCC by comparing gastric histopathology between mutation-positive and mutation-negative family members. We searched for differences in occurrence of Helicobacter pylori, inflammation, atrophy, intestinal metaplasia and dysplastic changes. Upper gastrointestinal endoscopy was performed for 73 mutation-positive and 32 mutation-negative family members. RESULTS: One case of duodenal cancer was detected in the mutation-positive group, but no gastric neoplastic lesions were seen in either group. There were no differences in the occurrence of polyps, H. pylori, inflammation, activity, atrophy nor intestinal metaplasia tested with binaric, logistic, regression analysis. CONCLUSIONS: We conclude that surveillance gastroscopy may not be beneficial in HNPCC, since neither cases of early cancer nor premalignant lesions could be detected in our series of 73 mutation-positive subjects.

Adult↗
PubMed2001

Complement C4 deficiency and HLA homozygosity in patients with frequent intraoral herpes simplex virus type 1 infections.

Three consecutive patients with no apparent immunodeficiency who had frequent intraoral herpes simplex type 1 recurrences, a rare complication of herpes simplex virus infection, were found to have a total deficiency of either the A or B isotype of the complement component C4 and to be homozygous for the studied HLA antigens. A combination of HLA homozygosity, which may lead to impaired T cell recognition of viral peptides, and deficiency in the classical complement pathway, which can compromise virus neutralization, may predispose to severe and frequent herpes simplex virus infections.

Adult↗
PubMed2001

Real-time PCR for detection and quantitation of hepatitis B virus DNA.

A sensitive and reproducible real-time PCR assay based on TaqMan technology was developed for the detection and quantitation of hepatitis B virus (HBV) DNA in serum, and compared with an "in-house" qualitative PCR assay. HBV DNA was measured in 125 serum samples from 76 hepatitis B patients, consisting of 22 patients with an acute infection, 20 patients with a previous history of hepatitis B infection, and 34 patients with a chronic hepatitis B. Four patients with a chronic infection were treated with either an IFN-alpha monotherapy or a combination of IFN-alpha and lamivudine. Twenty-nine sera from healthy individuals and non-hepatitis B patients served as negative controls. The assay was validated by using a 10-fold dilution series of the World Virological Quality Control (VQC) sample containing 3.73 x 10(7) genome equivalents per ml. The detection limit for the real-time PCR was 3.73 x 10(2) genome equivalents per ml (geq/ml), while it was 3.73 x 10(3) geq/ml for the in-house PCR. The real-time PCR assay had an 8-logarithm dynamic range spanning from 10(2) to 10(10) geq/ml. In clinical serum samples, the real-time PCR and the in-house PCR detected HBV DNA in 81% (101/125) and 66% (83/125) of samples, respectively. HBV DNA was not detected among the negative controls by either of these assays. In conclusion, real-time PCR is a sensitive, specific, and a reproducible approach for the detection and quantitation of HBV DNA in clinical serum samples, useful also for monitoring the efficacy of antiviral treatment.

Acute Disease↗
PubMed2001

Mechanical ventilation in children with severe asthma.

Hospital admissions for childhood asthma have increased during the past few decades. The aim of this study was to describe the need for mechanical ventilation for severe asthma exacerbation in children in Finland from 1976 to 1995. We reviewed medical records and collected data retrospectively from all 5 university hospitals in Finland, thus covering the entire population of about 5 million. The endpoints selected were the number of admissions and readmissions leading to mechanical ventilation, duration of stay in the hospital, and mortality. Moreover, asthma medications prescribed prior to admission and administered in the intensive care unit (ICU), as well as the etiology of the exacerbation associated with mechanical ventilation were examined. Mechanical ventilation was required in 66 ICU admissions (59 patients). This constituted approximately 10% of all 632 admissions for acute asthma to an ICU. The number of admissions decreased from 1976 to 1995: 41 admissions between 1976 and 1985 vs. 25 admissions during the next 10-year period. The mean age at admission to the ICU was 3.6 years, and 46% of the patients were boys. Prior to the index admission, 70% of the patients had used asthma medication such as oral bronchodilator (50%), inhaled bronchodilator (20%), theophylline (38%), inhaled glucocorticoid (18%), oral glucocorticoid (5%), and cromoglycate (7%). Respiratory infection was by far the most common cause of all the exacerbations (61%), followed by food allergy (8%) and gastroesophageal reflux (3%). In 28% of cases the cause of the severe asthma exacerbation could not be identified. In the mechanically ventilated patients readmissions occurred 38 times between 1976 and 1985 vs. 5 times between 1986 and 1995. Five of the patients who received mechanical ventilation died, and in 3 of these patients asthma was the event causing death. In conclusion, there has been decrease in the number of first and repeat ICU admission for asthma requiring mechanical ventilation between 1970 and 1995. This trend occurred despite a simultaneous 5% yearly increase in hospital admissions for childhood asthma during these 2 decades.

Adolescent↗
PubMed2001

Serologic diagnosis of Helicobacter pylori infection in outpatients aged 45 years or less.

The diagnostic accuracy of serological tests for Helicobacter pylori was studied in 145 consecutive outpatients aged 45 years or less referred for gastroscopy. Helicobacter pylori infection can be detected by serological tests, including rapid whole-blood tests. The low prevalence of the disease in young people may have a negative effect on the positive predictive value of a test. In this study, the presence of Helicobacter pylori was assessed by a biopsy urease test and histological examination, and by several serological tests: a rapid whole-blood test on fingerstick blood, a latex agglutination serum test, a commercial enzyme immunoassay (EIA) test, and an in-house EIA for detection of antibodies of both the IgG and IgA classes. Helicobacter pylori infection was diagnosed with invasive tests in 21 (14.5%) patients. The sensitivity, specificity, and positive and negative predictive values of the EIA-based tests, compared to histological examination, were 100%, 96-97%, 81-84%, and 100%, respectively. The positive predictive value of the latex agglutination test was 78%, whereas it was only 47% for the whole-blood rapid test used. Although the results of the whole-blood rapid test were unsatisfactory, the quantitative EIA-based tests could reliably detect Helicobacter pylori among young patients, in whom the prevalence of the infection is low.

Adult↗
PubMed2001

Factors affecting the cytology outcome of Pap smears--a brief approach to internal quality control in private cytopathology laboratory practice.

We evaluated the effect of intrauterine device (IUD), patient age and hormone replacement therapy (HRT) on cytology outcome in Pap smears together with the important IQC procedures: 1) manual double-screening by cytotechnologists, and 2) retrospective senior pathologist review during 1996-1999. The results from primary double-screening (119 of 87,409 Pap smears) showed an excellent inter-observer correlation. The estimation of hormonal effects showed higher incidence of disagreements (p=0.013) in patients <47 yr. Some individual trends were found in the assessments of both cellular atypia (p=0.012) and Papanicolaou classification (p=0.018). The IUD had no influence on the accuracy when the degree of inflammatory reaction was evaluated (p>0.050), but showed an adverse effect on the estimation of cellular atypia (p=0.001). HRT distinctly equalized the entire sample material, since fewer disagreements were found in the age groups <47 yr and >47 yr when estimating the hormonal effects (p=0.013), inflammatory reaction (p=0.044) or cellular atypia (p=0.006) compared to those without HRT. The continuous cytopathologist supervision had a positive impact on the accuracy of hormonal effect estimation during the 4 years. The senior cytopathologists' reviews (354 of 87,409 Pap smears) showed mutually good interobserver correlation, and diagnostic conclusions of the same specimens differed only slightly between the cytopathologists. We found these state-of-the-art cytopathological IQC procedures to be effective and fit-for-purpose when evaluating hormonal effects, inflammatory reaction and cellular atypia.

Adult↗
PubMed2001

Personality and mood of former elite male athletes--a descriptive study.

The purpose of this study was to describe the personality and mood of former athletes in middle and old age. The subjects were male athletes who represented Finland from 1920 to 1965 and male referents who were classified as healthy at 20 years of age. The athletes were classified into a total of five athlete groups (endurance, power/combat, power/individual, team, shooting) and one reference group. Four personality scales (extroversion, neuroticism, life satisfaction, and hostility) were used in a baseline questionnaire in 1985 (athletes N = 1040, referents N = 777). Anxiety and depression were assessed in a follow-up in 1995 (athletes N = 758, referents N = 578) with a shortened version of the BSI-53 symptom inventory. According to ANCOVA there were group differences in extroversion, neuroticism, and life satisfaction but not in hostility. Athletes who had participated in power/combat sports and team sports were more extroverted than referents. Endurance sport and shooting sport athletes had lower neuroticism scores than the referents. Endurance, power/combat, team and shooting sport athletes were more satisfied with their lives than were the referents. Discriminant analysis mainly supported these findings. Differences regarding depression were also statistically significant between the groups as referents were more depressed than endurance sport and team sport athletes. No group differences in anxiety were found. The subjects described in this study are unique in number of respects. Bearing in mind the limitations of the study subjects, it is concluded that former athletes differ from nonathletes in some personality characteristics and depression.

Adult↗
PubMed2001

Decreasing prevalence of helicobacter antibodies in Finland, with reference to the decreasing incidence of gastric cancer.

Time trends and geographical variation of Helicobacter pylori antibodies in Finland were investigated by enzyme immunoassay in 20- to 34-year-old randomly selected females from six localities during 1969-73 (n = 375), and 15- to 45-year-old females representing nine communities and four geographical areas in 1983 (n = 882) and 1995 (n = 842). In the six communities investigated at three different time points, the overall prevalence declined from 38 to 12%, with an emphasis on the latter 12 years. The regionally varying rate of decrease in helicobacter prevalence changed the pre-existing geographical variation, leaving northern Finland with the highest rate. A 10%-units higher local helicobacter prevalence seemed to predict a 23% (95% CI 3-44%) higher gastric cancer incidence 20 years later. The overall decline in helicobacter seropositivity is consistent with earlier reports from Finland and other developed countries, and supports the cohort theory as an explanation for the age-related increase in H. pylori seroprevalence.

Adolescent↗
PubMed2001

The role of alcohol in accident and violent deaths in Finland.

BACKGROUND: In Finland, the high rates of forensic autopsy and postmortem toxicology furnish a reliable base for nation-wide studies on alcohol-related violent deaths. MATERIAL AND METHODS: National mortality and population data within Finland, from 1987 to 1996, were used to analyze sex- and age-specific rates, proportions, and trends of violent deaths associated with alcohol. Deaths were defined as alcohol-related when alcohol was certified as a contributing factor to death. RESULTS: During the study period, 10,360 (23.3%) of the 45,544 violent deaths that occurred were alcohol-related. Among 15- to 64-year-olds, 28.6% of accidents, 30.5% of suicides, and 55.3% of homicides were associated with alcohol (alcohol-positive). Differences in epidemiologic patterns and trends for different types of violent death were observed between sexes and age groups. For instance, alcohol-positive accidents significantly decreased in males (-2.3%/year; CL95: -3.3, -1.2; p < 0.001), but not in females (+0.5%/year; CL95: -2.7, +3.7; p = 0.772), and alcohol-positive suicides increased slightly in females (+3.9%/year; CL95: +0.0, +7.9; p = 0.047), but not in males (-0.2%/year, CL95: -1.4, +1.0; p = 0.704). CONCLUSIONS: The victims of violent deaths have often consumed or abused alcohol before the fatal events. Especially in young adults, consumption of alcohol is likely one of the most serious risk factors in accidents and may decrease the threshold for suicide ideation and impulsive behaviors. Studies that explore the effects of sociodemographic and health factors on random populations with relevant control data will increase the understanding of the causal connection between alcohol and violent deaths.

Accidents↗
PubMed2000

Physical activity and osteoporotic hip fracture risk in men.

BACKGROUND: Physical activity has been related to reduced risk of osteoporotic hip fractures, but the evidence among men is weak. OBJECTIVE: To determine the association between baseline leisure physical activity and future risk of osteoporotic hip fracture in men. METHODS: At baseline in 1975 our prospective study cohort included 3,262 men who were 44 years or older and did not have chronic disease restricting their ability to exercise. At baseline, physical activity was assessed by a questionnaire. Hip fractures were followed for 21 years, or from the age of 50 years for subjects who were initially younger than 50 years. RESULTS: The hazard ratio of osteoporotic hip fracture, adjusted for other possible predictors (height, body mass index, baseline diseases, smoking, use of alcohol, work-related physical activity, and occupational group), in men participating in vigorous physical activity compared with men not participating was 0.38 (95% confidence interval, 0.16-0.91) (P = .03). CONCLUSION: These results provide further evidence that there is an inverse association between baseline physical activity and future hip fracture risk among men.

Accidental Falls↗
PubMed2000

Physical activity and other risk factors in male twin-pairs discordant for coronary heart disease.

BACKGROUND: Twin-pairs discordant for coronary heart disease (CHD) can be used to examine the possible contribution of genetic and other familial factors to the relationship between CHD risk factors, in particular physical inactivity at leisure, and CHD. METHODS AND RESULTS: In 1975 at baseline, 8205 men aged 25-69 years of the Finnish Twin Cohort without overt CHD responded to a questionnaire. The outcome measures were hospitalization for CHD or death from CHD before age 70 between 1977 to 1995 based on reliable nationwide registries. Among all men, the age-adjusted relative risk of CHD was 0.52 (95% confidence interval (CI) 0.39, 0.71) in men participating in conditioning exercise compared to sedentary men, based on their questionnaire responses. The age, and covariate (body-mass index, smoking, hypertension, diabetes) adjusted-relative risk was 0.68 (CI 0.50, 0.92). Among the twin-pairs discordant for CHD during follow-up (N=311), the odds ratio (OR) of having CHD was 0.54 (CI 0. 27, 1.09) for conditioning exercisers compared to sedentary men. The point estimates from discordant pairs analyses were of the same magnitude as obtained from the analyses of individuals, though statistically not significant due to smaller samples. In contrast, smoking (OR 3.21) and diabetes (OR 10.0) at baseline were also significant predictors of CHD. CONCLUSIONS: By studying twins we were able to examine genetic and other familial selection bias and found further supporting evidence that leisure conditioning physical exercise compared to sedentariness helps prevent CHD in men, but smoking was a stronger risk factor.

Adult↗
PubMed2000

Acute childhood asthma in Finland: a retrospective review of hospital admissions from 1976 to 1995.

The prevalence of childhood asthma has increased markedly in many Western societies during recent decades. We wanted to study whether the incidence and severity of childhood asthma in Finland had changed during the time-period 1976-95. Hospital admission rates from 1976 to 1995 were obtained from the National Hospital Discharge Register and the individual intensive care unit (ICU) registers of the five university hospitals in Finland. The number and length of treatment periods for childhood asthma in all Finnish hospitals and at the ICUs of the five university hospitals were analyzed. The number of children receiving special reimbursement for asthma medication costs was obtained from the central register of the Social Insurance Institution. The data showed that during the time-period investigated, hospital admissions as a result of asthma had increased by 2.8-fold, but the mean length of hospital stay had more than halved (from 7.3 to 2.6 days). The increase in hospital admissions showed greatest significance in the 0-4-year age-group among both sexes (p <0.001). In contrast, a significant reduction in hospital admissions was found among the 10-14-year age-group (p <0.001). No discernible change in admission to ICUs was seen. During the same time-period, the number of children receiving special reimbursement for asthma medication costs increased 7.5-fold. Hence, a major increase has occurred in the number of children diagnosed with asthma that has not been paralleled by a proportionate increase in the number of hospital admissions. While the prevalence of mild and moderate asthma has increased, the occurrence of severe asthma has remained essentially unchanged.

Acute Disease↗
PubMed2000

Predictors of weight change in middle-aged and old men.

OBJECTIVE: Studies on weight change and mortality have yielded inconclusive results. This 10-year prospective study was undertaken to improve understanding of factors affecting weight change. RESEARCH METHODS AND PROCEDURES: The subjects were 1,143 men, aged 36 to 88 years (mean, 53.3 years) at entry. A questionnaire was filled in at entry and at the end of the follow-up with queries on weight, height, weight at the age of 20, physician-diagnosed diseases, smoking, alcohol use, dietary habits, leisure physical activity, occupation, present occupational activity, living conditions (living alone or cohabiting), and former athletic status. Further information on morbidity was obtained from selected national registers. Factors predicting weight change during the study were identified by stepwise linear multiple regression analysis. RESULTS: The mean 10-year weight change was 0.8 (range, -29 to +24) kg. Age at entry (beta-coefficient, -0.17, SE 0.02), weight at entry (beta, -0.03, SE 0.01), diabetes at entry (beta, -3.55, SE 1.02), diabetes diagnosed after entry (beta, -3.94, SE 0.96), malignant cancer (beta, -1.60, SE 0.70), being a smoker (beta, - 1.59, SE 0.48), and increased physical activity (beta, - 1.27, SE 0.54) were significantly (p < 0.05) associated with weight loss in the final model. The model explained 13% of the variance of weight change. DISCUSSION: The results emphasize the complexity of weight change. Some factors associated with weight change are apparently negatively, and some positively, associated with health. This could explain the equivocal findings on weight change and mortality in the literature.

Adult↗
PubMed2000

Increased premature mortality of competitive powerlifters suspected to have used anabolic agents.

Misuse of supraphysiological doses of anabolic steroids is claimed to have serious side effects. The aim of the study was to determine the mortality, and the cause of premature deaths among a group of subjects who are strongly suspected to have used anabolic steroids for a non-medical purpose over several years. The mortality of 62 male powerlifters placed 1st-5th in weight series 82.5-125 kg in Finnish championships during 1977-1982 was compared with the mortality of population controls. The mortality during the 12-year follow-up was 12.9% for the powerlifters compared to 3.1% in the control population. By 1993 eight of 62 powerlifters and 34 of 1094 population controls had died, thus the risk of death among the powerlifters was 4.6 times higher (95% CI 2.04-10.45; p = 0.0002). The causes of premature death among the powerlifters were suicide (3), acute myocardial infarction (3), hepatic coma (1) and non-Hodgkin's lymphoma (1). These findings add to the growing amount of evidence of an association between anabolic steroid abuse and premature death, and support the view that measures to decrease AAS misuse among both competitive and amateur athletes are justified.

Adult↗