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Biomedical subjects

S Sarna

Publications and source records attributed to S Sarna.

At least 55 records · Page 3Linked to original sources
PubMed2000

Cancer incidence among Finnish world class male athletes.

A cohort of 2269 male world class athletes from the years 1920-65 was followed up through the Finnish Cancer Registry for cancer incidence during 1967-95. There were 331 cases of cancer while the expected number based on the national cancer incidence rates was 404; the standardized incidence ratio (SIR) was 0.82 and its 95% confidence interval (CI) 0.73-0.91. There was a decreased risk of cancers of the lung (SIR 0.35, 95% CI 0.25-0.48), especially among endurance athletes (0.12, 0.01-0.41). This fits well with the low prevalence of smoking among the athletes. The SIR for kidney cancer was also significantly low (0.43, 0.16-0.93), possibly partly due to the better diet (more vegetables, less fat). Incidence of cancers not related to smoking was not reduced. None of the cancer sites showed a significant excess in the whole cohort but hurdlers had a significantly high relative risk of sarcomas of the bone and soft tissue which according to suggested causal mechanisms might be related e.g. to injuries during their active sport period. This as well as other observations without sound a priori hypotheses needs to be confirmed in more detailed analyses and in other data sets before final conclusions.

Adolescent↗
PubMed2000

Cure of Helicobacter pylori infection after failed primary treatment: one-center results from 120 patients.

BACKGROUND: Treatment with a proton pump inhibitor (PPI) and antimicrobials cures Helicobacter pylori infection in about 90% of patients. This is a retrospective overview of our studies aiming to cure the infection in all compliant patients with failed initial therapy. METHODS: We retreated 120 (19% of 644) H. pylori-infected patients whose initial therapy had failed. The retreatments included (i) triple therapy (TT): colloidal bismuth subcitrate, metronidazole, amoxicillin (or tetracycline); (ii) quadruple therapy (QT): TT and a PPI; or (iii) high doses of both a PPI and clarithromycin combined with a further 1-3 individually selected antimicrobials. The eradication results were determined after 6-12 months. RESULTS: The 1st retreatment was successful in 70 of 120 patients. The 2nd retreatment cured 25 of the remaining 42 patients, the 3rd 13 of 17, and the 4th the last 4 patients. The cumulative eradication rate (ITT) was 93% (95% CI: 88.9%-97.9%; 8 patients withdrew after a failed 1st retreatment) and the rate was 100% in the remaining 112 patients who accepted several retreatments. The 1st retreatment with TT cured 23% (95% CI: 12%-34%) of 57 patients and QT 85% (95% CI: 74%-96%) of 41 patients who had initially undergone a failed metronidazole-based treatment. All retreatments were well tolerated. CONCLUSIONS: In this study, high doses of a PPI and clarithromycin combined with 1-3 antimicrobials according to susceptibility data proved to be the best drug combination in the cure of H. pylori infection after failed primary treatment. Giving imidazole- and bismuth-based QT (without clarithromycin) as the first-line treatment of H. pylori infection ensures that the number of failures remains low.

Anti-Bacterial Agents↗
PubMed2000

Evaluation of blood tests to predict normal gastric mucosa.

BACKGROUND: To determine the accuracy of blood tests in predicting normal gastric mucosa confirmed by histological examination of gastric biopsy specimens. METHODS: In total, 207 consecutive patients referred for upper endoscopy were included. Two biopsy specimens each from the antrum and corpus were assessed histologically for the presence of Helicobacter pylori, gastritis, and atrophy. Serum samples were studied for H. pylori antibodies by enzyme immunoassay (Pyloriset EIA-G and EIA-A) and by a rapid latex agglutination test (Pyloriset Dry); pepsinogen I was measured by an immunoenzymometric assay (Gastroset PGI), gastrin by radioimmunoassay, and parietal cell antibodies by indirect immunofluorescence. RESULTS: In 101 (49%) of 207 patients, the gastric mucosa on histologic examination was normal. In the 63 patients aged 45 years or less, H. pylori IgG serology was negative in all 47 patients with normal gastric mucosa and none had low serum pepsinogen I levels. Among 144 patients over age 45 years, 72 had negative H. pylori IgG serology. Combining the serum pepsinogen I assay with the results of H. pylori IgG serology, 12 patients with normal serology but low serum pepsinogen I were found. Thus, 60 patients, 52 of whom showed normal gastric histology, had normal IgG serology and serum pepsinogen 1. In the remaining eight patients with normal blood tests, the histologic changes were very mild. CONCLUSIONS: Although negative H. pylori IgG serology alone in younger patients, and in combination with normal serum pepsinogen I levels in older patients, reliably predicted the presence of normal gastric mucosa, gastroscopy is still recommended for patients over 45 years.

Adult↗
PubMed2000

Interferon-alpha and 13-cis-retinoic acid as maintenance therapy after high-dose combination chemotherapy with growth factor support for small cell lung cancer--a feasibility study.

This randomized phase II multi-center study was designed to determine the time to progression, duration of response and the feasibility of an intensified maintenance regime consisting of a combination of interferon (IFN)-alpha and retinoic acid after high-dose combination chemotherapy and radiotherapy in patients with small cell lung cancer. The patients received four courses of combination chemotherapy consisting of ifosfamide, carboplatin and etoposide, with higher doses of ifosfamide and carboplatin given in the first course, with routine growth factor support. Responding patients were then randomly assigned to one of three maintenance therapy arms. All patients with limited disease (LD) were given thoracic radiotherapy before maintenance therapy and those who had also achieved a complete response (CR) or minimal residual disease (MRD) received prophylactic cranial irradiation. In Arm 1 patients received IFN-alpha-2a, 6 MIU s.c. TIW for 4 weeks, followed by 3 MIU s.c. TIW, and 13-cis-retinoic acid 1 mg/kg/day p.o. BID daily. In Arm 2 patients received trophosphamide 100-150 mg/day p.o. BID. No maintenance treatment was given in Arm 3, the control group. Maintenance therapy was continued for 1 year. Eighty-five patients were treated according to the protocol. Twenty-one patients achieved CR, four achieved MRD and forty-two achieved partial responses to chemotherapy and radiotherapy. Sixty patients (71%) were randomly assigned for maintenance treatment. Median survival was 17.1 months in the IFN-alpha-retinoic acid arm, 12.4 months in the trophosphamide arm and 13.5 months in the control arm. One-year survival rates were 82, 56 and 55%, respectively. Duration of response was 6.5, 5.5 and 4.7 months, respectively. Time to progression was 8.6, 8.0 and 6.8 months, respectively The differences were not statistically significant. The IFN-alpha-retinoic acid maintenance treatment was well tolerated. Patients who received IFN-alpha-retinoid maintenance therapy lived longer after the onset of progressive disease. The treatment regime was effective, feasible and well tolerated.

Administration, Oral↗
PubMed2000

Factors associated with hip joint rotation in former elite athletes.

OBJECTIVES: To study factors associated with passive hip rotation range of motion (ROM) in former elite male athletes. METHODS: Athletes were interviewed about hip pain, disability, lifetime occupational loading, and athletic training. The passive hip rotation was measured with a Myrin inclinometer in 117 former elite male long distance runners, soccer players, weight lifters, and shooters aged 45-68 years. Magnetic resonance imaging was used to detect hip osteoarthritis. RESULTS: There were no differences in passive hip rotation ROM between the four athlete groups nor between diverging lifetime loading patterns associated with occupational or athletic activities. Among the subjects without hip osteoarthritis, hip pain, and hip disability according to a stepwise linear regression analysis, the only factor that was associated with the passive hip rotation ROM was body mass index (BMI), explaining about 21% of its variation. Subjects with high BMI had lower passive hip rotation ROM than those with low BMI. There was no right-left difference in the mean passive hip rotation ROM in subjects either with or without hip osteoarthritis as determined by magnetic resonance imaging. Nevertheless, hip rotation ROM was clearly reduced in a few hips with severe caput deformity. CONCLUSIONS: Long term loading appears to have no association with passive hip rotation ROM. On the other hand, the hip rotation value was lower in subjects with high BMI than in those with low BMI. A clear right-left difference in hip rotation was found only in those subjects who, according to our magnetic resonance imaging criteria, had severe hip osteoarthritis. These findings should be taken into account when hip rotation ROM is used in the clinical assessment of hip joints.

Aged↗
PubMed2000

Natural selection to sports, later physical activity habits, and coronary heart disease.

OBJECTIVES: To investigate the associations between natural selection to sports at a young age, continuity of physical activity, and occurrence of coronary heart disease. DESIGN: Prospective cohort study. SETTING: Finland. PARTICIPANTS: Former top level male athletes participating at a young age (1920-1965) in different types of sport (endurance (n = 166), power speed (n = 235), "other" (n = 834)) and controls healthy at the age of 20 years (n = 743). MAIN OUTCOME MEASURES: Data on the occurrence of coronary heart disease were obtained from death certificates, three nationwide registers, and questionnaire studies in 1985 and 1995, and data on later physical activity were obtained from the questionnaires. RESULTS: In 1985 all groups of former athletes were more physically active than controls (p<0.001). Despite similar total volumes of physical activity, compared with power speed athletes, former endurance athletes participated more often in vigorous activity (p = 0.006) and had less coronary heart disease (adjusted odds ratio 0.34, 95% confidence interval 0.17 to 0.73; p = 0.004). In 1985 and 1995, both endurance and other athletes had less coronary heart disease than controls. From 1986 to 1995, the incidence of new coronary heart disease was lower among those who participated in vigorous physical activity in 1985. CONCLUSIONS: Both a previous aptitude for endurance athletic events and continuity of vigorous physical activity seem to be associated with protection against coronary heart disease, but an aptitude for power speed events does not give protection against coronary heart disease.

Adult↗
PubMed2000

Atrophic gastritis and Helicobacter pylori infection in outpatients referred for gastroscopy.

BACKGROUND: Atrophic gastritis has been shown to be one of the long term sequelae of Helicobacter pylori infection. AIMS: To determine the prevalence of atrophic gastritis in outpatients, to study the accuracy of serological methods for revealing atrophy, and to define the association of H pylori infection with atrophic gastritis in these patients. PATIENTS/METHODS: A total of 207 consecutive outpatients referred for gastroscopy were included. Biopsy specimens from the antrum and corpus were assessed histologically according to the Sydney system. Serum samples were studied for H pylori IgG and IgA antibodies by enzyme immunoassay, CagA antibodies by immunoblot, pepsinogen I by an immunoenzymometric assay, gastrin by radioimmunoassay, and parietal cell antibodies by indirect immunofluorescence. RESULTS: Histological examination revealed atrophic gastritis in 52 (25%) of 207 patients. H pylori and CagA antibodies were strongly associated with atrophic antral gastritis but poorly associated with atrophic corpus gastritis. Low serum pepsinogen I was the most sensitive and specific indicator of moderate and severe atrophic corpus gastritis. All six patients with moderate atrophic corpus gastritis had H pylori infection but eight of 10 patients with severe atrophic corpus had increased parietal cell antibodies and nine had no signs of H pylori infection. CONCLUSIONS: Atrophic antral gastritis was strongly associated with CagA positive H pylori infection. Severe atrophic corpus gastritis was not determined by H pylori tests but low serum pepsinogen I, high gastrin, and parietal cell antibodies may be valuable in detecting these changes.

Adult↗
PubMed2000

alpha-Tocopherol enhances tumour growth inhibition by cis-dichlorodiammine platinum (II).

Present studies indicate that alpha-tocopherol enhances the efficacy of cisplatin as demonstrated by inoculation of Dalton's lymphoma cells incubated with either cisplatin (5 or 10 microg/ml) alone or cisplatin + alpha-tocopherol (25 or 50 microg/ml) into C3H/He mice. Tumour cells (3 x 10(6) cells/mouse) incubated with cisplatin grow slowly in syngeneic mice as indicated by the late appearance of tumour. However, mice failed to develop tumour when inoculated with tumour cells incubated with cisplatin + alpha-tocopherol. When the animals were challenged with tumour cells (3 x 10(6) cells/mouse) on the 15th day after the initial inoculation, 30-50% survived more than 60 days, with 10% tumour-free survivors being observed in some groups. Antitumour activity was higher in mice receiving lymphoma cells (3 x 10(6) cells/mouse) preincubated with cisplatin + alpha-tocopherol compared to cisplatin alone. Tumour-bearing mice receiving cisplatin in combination with different concentrations of alpha-tocopherol exhibited significantly higher (P<0.001) intratumour platinum content (123-306%) but without any change in the kidney platinum content as compared to those receiving cisplatin (5 or 10 microg/ml) alone. Enhancement of cisplatin-induced tumour growth inhibition is probably due to the modulation of tumour cell membrane permeability by alpha-tocopherol. alpha-Tocopherol might increase the influx of cisplatin into tumour cells, causing the DNA repair machinery to be less efficient due to increased efficiency of adduct formation in the DNA molecule. This effect of alpha-tocopherol can render cisplatin more effective as an antitumour agent.

Animals↗
PubMed2000

Human cytomegalovirus seroprevalence in three socioeconomically different urban areas during the first trimester: a population-based cohort study.

BACKGROUND: To re-evaluate the impact of socioeconomic status and human cytomegalovirus (HCMV) seroprevalence during pregnancy, we carried out a population-based cohort study. METHODS: IgG and IgM antibodies to HCMV and IgG avidity were studied by enzyme-linked immunosorbent assay (ELISA) in three different socioeconomic areas (SEA) in the 9-12th week of pregnancy of 1088 consecutive mothers. RESULTS: The overall IgG seropositivity was 70.7%, ranging from 60.9 to 76.4% in 'upper' to 'lower' SEA (P = 0.0004). The HCMV IgM seropositivity was 4.0%, ranging from 3.8% in the 'upper' and 'intermediate' SEA to 4.6% in the 'lower' SEA. Serologically acute cases, defined by low avidity of IgG, represented 1.7% of the pregnancies in the 'upper' SEA compared with 1.0 and 1.1% in the other two areas. In the 'lower' SEA there were twice as many recurrent infections as in the others, 3.6 versus 1.7%. The low impact of age did not increase after elimination of the effects of SEA and parity. Miscarriages were associated neither with IgG nor with IgM positivity, although the percentage of >/=2 miscarriages was 8.8% in seronegative women compared with 11.2% and 13.6% in IgG- and IgM-positive women. CONCLUSIONS: Social environment seems to be the most powerful factor, predicting both IgG seroprevalence and recurrences during pregnancy.

Adolescent↗
PubMed1999

Jumping height in former elite athletes.

To evaluate lower-limb explosive strength with respect to lifetime athletic activity, we measured vertical jumping height on a contact mat in former male runners (n = 28). soccer players (n = 31), weightlifters (n = 29) and shooters (n = 29) (age range 45 68 years). There were no statistically significant age-adjusted sport-group differences in jumping height, but differences by sport were evident among the subgroup of athletes without hip or knee osteoarthritis (n = 65) (P < 0.05). Thus, sports that increased jumping height also predisposed to lower-limb osteoarthritis. After adjustment for age and sport, the subjects without osteoarthritis jumped higher than those with osteoarthritis (n = 33) (P < 0.01). In a multiple linear regression analysis, age, reported hip and knee disability, and knee pain reduced jumping height. Hours spent in team-training during the past 12 months and the hours spent during their lifetime in power training were associated with improved vertical jumping height and together explained 41% of the difference among the subjects. The ability to jump even among athletes with hip or knee osteoarthritis would suggest that former elite athletes possess advanced lower limb muscle function.

Aged↗
PubMed1999

Concomitant chemotherapy and IFN-alpha for small cell lung cancer: a randomized multicenter phase III study.

Patients with any stage of small cell lung cancer were given low-dose interferon-alpha (IFN-alpha) from the first day of treatment as long as possible irrespective of changes in treatment dictated by disease progression. All patients received 6 cycles of the chemotherapy (CT): cisplatin 70 mg/m2 i.v. day 1 and etoposide 100 mg/m2 i.v. days 1, 2, 3 every 28 days. Seventy-eight patients were assigned to arm 1: CT alone, 75 patients to arm 2: CT + natural IFN-alpha (3 MU three times a week i.m.), and 66 patients to arm 3: CT + recombinant IFN alpha-2a (3 MU three times a week i.m.). There was no difference in median survival between the arms (10.2 months, 10.0 months, 10.1 months, respectively), p = 0.32. The 2-year survival rates were 15%, 3%, and 11%, respectively. Grade 3 and 4 leukopenia occurred more frequently in the IFN arms than in the CT alone arm and resulted in dose reductions. Antibodies occasionally developed to recombinant IFN. We conclude that IFN-alpha can be administered concomitantly with chemotherapy but is probably better kept for maintenance therapy so that optimal full doses of induction CT can be given.

Adult↗
PubMed1999

Heart attacks and lower-limb function in master endurance athletes.

PURPOSE: Whether very vigorous physical activity bestows on the participant more health benefits or more adverse effects is unclear: we investigated whether men participating in competitive endurance sports in middle and old age are at increased risk of heart attacks as well as of lower-limb osteoarthritis and disability. METHODS: In our cohort study with an 11-yr follow-up, we studied 269 male orienteering runners (mean age 48.6 yr at baseline; range 37-61), who in 1984 were placed among the 60 best in their master orienteer age-class in Finland, and 188 male nonsmoking controls (mean age 50.4 yr; range 39-61) classified as healthy at 20 yr of age and without overt ischemic heart disease up until 1985. We followed mortality and studied the prevalence of questionnaire-reported physician-diagnosed diseases and disabilities at the end of the follow-up in late 1995. RESULTS: Two (0.7%) of the 269 runners and 10 (5.3%) of the 188 controls had suffered myocardial infarctions during the follow-up, the age-adjusted odds ratio (95% confidence interval) being 0.15 (0.03-0.67) in runners compared with controls (P = 0.0059). At follow-up, orienteering runners reported knee osteoarthritis and knee pain more often than did the controls, whereas the occurrence of hip osteoarthritis and hip pain did not differ. Disability due to hip or knee pain after the same everyday activities tended to be less in the runners. CONCLUSION: In top-level master endurance athletes having a long-term training background and participating in competitive endurance sports, the risk both of heart attack and of lower-limb disability is low.

Adult↗
PubMed1999

Speed performance and long-term functional and vocational outcome in a group of young patients with moderate or severe traumatic brain injury.

We studied specific aspects of speed performance in neuropsychological tests and functional and vocational long-term outcome among moderate or severe traumatic brain injury (TBI) patients admitted to a rehabilitation programme. A group of 140 patients with mild, moderate or severe TBI was followed up for a minimum of 5 years in a rehabilitation programme. Severity of TBI was estimated using the Glasgow Coma Scale (GCS) scores on emergency hospital admission. The patients, grouped by age at injury into the categories: 7 or younger, 8-16 and 17 years of age or older, were tested five or more years post-injury with comprehensive neuropsychological tests, including a speed performance test with the Stroop material, the Purdue Pegboard (PB) test and simple visual and auditive reaction times. The outcome variables were functional outcome, as measured by the Glasgow Outcome Scale (GOS) score, and capacity for employment at the end of follow-up, i.e. on average 12 years post-injury. The patients with mild TBI were excluded from further analysis of outcome. The study was carried out at the Kauniala outpatient neurological clinic. In the Stroop test, patients with a GOS score of 3 and patients who were incapable of employment were slower (P = 0.0046 and P = 0.0015, respectively) than those with a GOS score of 1 or 2 and those capable of independent or subsidized employment, respectively. The PB test also differentiated significantly between the patients with a GOS score of 3 and those with a GOS score of 1 or 2 at the end of follow-up (P = 0.0413), and predicted incapacity for employment (P = 0.032), those with worse outcome being slower. Simple reaction times did not differ significantly between the GOS scores at the end of follow-up, and neither did they predict capacity or incapacity for employment. Our data suggest that the Stroop and PB tests can help estimate functional outcome, as measured by the GOS, among patients with initially moderate or severe TBI and who were referred to a rehabilitation programme. The same tests could also be useful in predicting long-term vocational outcome.

Adolescent↗
PubMed1999

Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome.

PURPOSE: To demonstrate risk factors involved in the origin of late posttraumatic seizures (LPTSs) in civilian traumatic brain injury (TBI) rehabilitation patients and the occurrence of LPTSs in this population, as well as the time of the first late seizures, and influence of these seizures on functional and occupational long-term outcome. METHODS: A consecutive sample of 490 patients (age range, 0.8-71 years) with TBI, and with postinjury problems in their education and employment, were followed up for > or =5 years from the time of injury in a rehabilitation and reemployment program. The study was carried out at the outpatient neurologic clinic of the Kauniala Hospital, which specializes in brain injuries in Finland and works in close cooperation with the Department of Clinical Neurosciences at the Helsinki University Central Hospital. Main outcome measures were functional outcome, as measured on the Glasgow Outcome Scale (GOS), and the capacity for employment at the end of follow-up. Outcomes were studied separately among patients with late seizures and for the nonseizure group. RESULTS: Children age 7 years or younger at time of injury more often had early posttraumatic seizures (EPTSs), than did adolescents or adults. The time elapsed between brain injury and the first late seizure also was longer in older age groups. EPTSs and depressed skull fracture had a statistically significant relation to the origin of LPTSs. Permanent posttraumatic neurologic deficit, linear skull fracture, and permanent local brain lesion documented on a computed tomography (CT) scan appeared clinically important as risk factors. Late seizures did worsen the functional outcome but had no significant influence on reemployment at the end of follow-up. CONCLUSIONS: Young children are more prone to early seizures, and adolescents and adults, to late seizures. The main risk factors for LPTSs are early seizures and depressed skull fracture. Severity of brain injury, as measured by a low GCS score, prolonged unconsciousness, and posttraumatic amnesia (PTA) without local brain lesion, should not be considered risk factor for LPTSs. Thorough follow-up of patients with TBI with seizures and adequate antiepileptic therapy may help attain rehabilitation goals and reemployment.

Adolescent↗
PubMed1999

Future hospital care in a population-based series of twin pairs discordant for physical activity behavior.

OBJECTIVES: This study investigated the association between physical activity behavior and morbidity, taking into account genetic selection. METHODS: Hospitalizations were followed from the beginning of 1977 to the end of 1986 in 710 same-sex healthy twin pairs discordant for leisure-time physical activity and in 151 pairs discordant for all physical activity at base-line in 1975. RESULTS: During the follow-up, among twin pairs discordant for leisure activity, the active member spent, on average, 43% fewer days in the hospital than the inactive member; the corresponding percentage was 55% among pairs discordant for all activity. CONCLUSIONS: Physically inactive behavior is associated with increased need for hospital treatments, even after genetic and other confounding factors are taken into account.

Adult↗
PubMed1999

Associations of isometric and isoinertial trunk muscle strength measurements and lumbar paraspinal muscle cross-sectional areas.

The relationships of dynamic and static trunk muscle strength measurements and muscle geometry are studied. Physiologically, isometric muscle strength is directly related to muscle cross-sectional area. We measured isometric and isoinertial trunk muscle strength of 111 former elite male athletes, aged 45-68, by Isostation B-200. Paraspinal muscle cross-sectional areas were measured from axial magnetic resonance images at the L3-L4 level. Isometric and isoinertial torques were closely related, but angular velocities were not predicted by isometric maximal torque. The area of the psoas muscles correlated with isometric maximal flexion, as well as with isoinertial maximal torque. angular velocity, and power in flexion (r = 0.24-0.27). The area of the extensor group correlated with isometric maximal extension and with isoinertial maximal torque and power in extension (r = 0.24-0.25). We conclude that dynamic and static strength measurements are closely related, with angular velocity giving additional information on muscle function. Paraspinal muscle cross-sectional area is one determinant of isometric and isoinertial trunk muscle strength.

Aged↗