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PubMed1996

Cleft-twin sets in Finland 1948-1987.

Extensive review of the literature since 1884 on cleft-twin sets yielded 364 cleft-twin sets. Of these, 118 were monozygotic (MZ) and 246 dizygotic (DZ) sets. In addition, Danish material on cleft twins, like our Finnish material, reflects the total number of clefts and cleft twins on a well-defined population during a well-defined time interval. Both sets of material also contain slightly over 100 pairs of twins. The Danish material and the literature review were compared to the Finnish material. The hospital records of all Finnish patients with operated clefts who were born between 1948 and 1987 were reviewed. Information was gathered regarding each patient, his parents, the pregnancy, and his twin or triplet siblings and other siblings. This search produced 105 sets of twins and three sets of triplets with clefts, 15 sets of twins being concordant regarding clefting. This resulted in a total of 120 cleft siblings, and the corrected cleft incidence of 1.72 promille, close to the overall cleft incidence rate in Finland between 1948 and 1975. Twinning was found to be associated neither with an increased nor with a decreased risk of clefting, and clefting could not be seen to increase twinning. Zygosity could be verified in 88 sets of twins; the total number of MZ sets was 17, and of DZ was 71, a 19% MZ rate. Although a higher incidence of clefting in MZ-twin sets has been proposed, no such higher or lower incidence could be found in our material. Recognized syndromes were found in 15 sets (14%), slightly higher than found in a large Finnish study on cleft probands (8.4%). Of these, three sets were monozygotic (MZ), all of them cleft palate (CP) and male sets, whereas eight sets were dizygotic (DZ). All 15 sets were CP only, with no one set with cleft lip and palate [CL(P)]. In our total Finnish-twin material of 105 sets, we found the CL(P)/CP ratio to be 39/66 (37%/63%). In all of the 120 affected siblings, the ratio was 35%/65%. The very high rate of 63% of CP twins is about two to three times higher than that reported in the literature of 364 sets where the CP ratio is 23%; compared to the Danish material with a CP ratio of 17%, it is almost four-fold. The overall CP rate in all clefts (not restricted to twins) in Finland compared to the rate in our neighboring Scandinavian countries was very much in line with this very big difference seen in the CP rate in our twin material. The CL(P) incidence in our Finnish material is 0.61 promille and the CP incidence 1.11 promille. For MZCL(P), the incidence was 0.38 promille; for MZCP, 0.91 promille; for DZCL(P), 0.52 promille, and for DZCP, 0.99 promille. Compared to the Danish figures both the MZCP and DZCP incidence figures are nearly four-fold, with the MZCL(P) somewhat lower, and DZCL(P) less than half that number. The sex distribution of all cleft patients in our material was 44% male/56% female. Both in the Danish material and in the literature, it was the reverse. This difference is probably due mostly to the higher ratio of CP in the Finnish material. The CP group has a higher proportion of females in all these materials. The concordance (C) of the whole Finnish-twin material is 14%, compared to 16.5% reported in the literature and 8% for the Danish twins. The concordance for CL(P) in our material is many times lower (2.6%) than in the literature (17.1%) and in the Danish material (8%). In the Finnish twins, the C for CP is higher (17%) than that for the Danish (6%) and for the literature cleft-twin populations (14.3%). This is also true for the MZ and DZ subgroups. The heritability index (H) in CL(P) is lower for the Finns (17%) than for the Danish (45%) and for the literature materials (43%), and higher for CP (Finns 49%, Danish 33%, literature 36%). All of these data strongly suggest the quite different genetic behavior of both CL(P) and CP in Finland, with a much lower genetic component in the CL(P) and a higher in the CP.

Cleft Lip↗
PubMedDate not supplied

Isolation and characterization of a reovirus from common eiders (Somateria mollissima) from Finland.

Samples of brain, intestine, liver, lung, spleen, and bursa of Fabricius were collected from five common eider (Somateria mollissima) duckling carcasses during a die-off in the western Gulf of Finland (59 degrees 50'N, 23 degrees 15'E) in June 1996. No viral activity was observed in specific-pathogen-free chicken embryos inoculated with tissue suspensions, but samples of bursa of Fabricius from three birds were positive when inoculated into Muscovy duck (Cairina moschata) embryo fibroblasts. The isolates were characterized as nonenveloped RNA viruses and possessed several characteristics of the genus Orthoreovirus. Virus particles were icosahedral with a mean diameter of 72 nm and were stable at pH 3.0; their genome was separated into 10 segments by polyacrylamide gel electrophoresis. Mallard (Anas platyrhynchos) ducklings experimentally infected with the eider reovirus showed elevated serum activities of aspartate aminotransferase, creatine kinase, and lactate dehydrogenase enzymes and focal hemorrhages in the liver, spleen, and bursa of Fabricius. During 1997-99, the prevalence of neutralizing antibodies to the isolated virus ranged from 0 to 86% in 302 serum samples collected from incubating eider hens at three nesting areas along coastal Finland. The highest seroprevalence was found in Hanko in 1999, just weeks before reports of an uninvestigated mortality event resulting in the death of an estimated 98% of ducklings at that location. These findings raise the question of potential involvement of the virus in poor duckling survival and eider population declines observed in several breeding areas along coastal Finland since the mid-1980s.

Animals↗
PubMed2004

Aspects of the ecology and natural history of Paraergasilus rylovi (Copepoda, Ergasilidae) parasitic in unionids of Finland.

The distribution of Paraergasilus rylovi in 17 populations of unionids was investigated. In 1 unionid population, the parasite was studied regarding host age, size, sex, and the reproductive period (occurrence of egg sacs). Results from pooled material from the years 1987--1989 and 1996 (southern Finland, 11 populations) indicated that Anodonta piscinalis (n = 1,359) is the main host (total mean prevalence 71% and intensity +/-SE of infection 16.4+/-0.6). Pseudanodonta complanata (n = 106) was infected occasionally (3% and 1.3+/-0.3), whereas Unio pictorum (n = 108) and U. tumidus (n = 17) were not infected. Results from 17 A. piscinalis populations showed that P. rylovi occurs in southern Finland but not in northern Finland. In A. piscinalis, the mean intensity of infection was higher in lake populations than in river populations. Both host age and length had a negative relationship with the intensity of P. rylovi infection. Host sex did not affect the intensity of infection. Egg sacs of P. rylovi were found from June to August. There was a tendency for higher intensities of infection in autumn. Infection by the digenean Rhipidocotyle fennica had no effect on the intensity of P. rylovi infection.

Analysis of Variance↗
PubMed2001

Smoking during pregnancy in Finland: determinants and trends, 1987-1997.

OBJECTIVES: This study examined determinants of and trends in smoking during pregnancy in Finland from 1987 through 1997. METHODS: A repeated cross-sectional investigation of 694,926 women was conducted. RESULTS: The prevalence of smoking during pregnancy remained similar from 1987 through 1997 (at 15%). In 1997, prevalences of smoking were alarmingly high among young (37%), single (30%), and less educated (25%) women and among women living in northern (20%) and eastern (19%) Finland. These determinants were persistent over time, with the exception of an increase in regional differences. CONCLUSIONS: Despite increasing knowledge of adverse effects, smoking during pregnancy has not declined in Finland over the past decade.

Adult↗
PubMed1997

Does licensing of drugs in industrialized countries guarantee drug quality and safety for Third World countries? The case of norplant licensing in Finland.

Norplant implantable contraceptives were developed mainly for use in Third World countries, but first were approved for marketing in Finland in 1983 and in Sweden in 1985. Since then Norplant has been approved in more than 40 countries, most of them in the Third World. The authors analyzed the clinical documentation submitted to the Finnish and Swedish drug control authorities, and the assessments made of the data. The Finnish review process lasted for three years, and the number of data increased substantially during that time. The authors have not been allowed to publish the clinical data submitted in Finland, but a reconstruction from the Swedish data showed that the clinical data were of poor quality and were mainly focused on assessing efficacy. Side effects, acceptability, and requirements of the health care system for proper use of Norplant were poorly studied. This example of Norplant licensing in Finland shows that licensing of drugs in industrialized countries is insufficient for guaranteeing their safety in Third World countries.

Contraceptive Agents, Female↗
PubMed1999

A point mutation inactivating the sulfonylurea receptor causes the severe form of persistent hyperinsulinemic hypoglycemia of infancy in Finland.

Mutations in genes encoding the ATP-regulated potassium (K(ATP)) channels of the pancreatic beta-cell (SUR1 and Kir6.2) are the major known cause of persistent hyperinsulinemic hypoglycemia of infancy (PHHI). We collected all cases of PHHI diagnosed in Finland between 1983 and 1997 (n = 24). The overall incidence was 1:40,400, but in one area of Central Finland it was as high as 1:3,200. Haplotype analysis using polymorphic markers spanning the SUR1/Kir6.2 gene cluster confirmed linkage to the 11p region. Sequence analysis revealed a novel point mutation in exon 4 of SUR1, predicting a valine to aspartic acid change at amino acid 187 (V187D). Of the total cases, 15 affected individuals harbored this mutation in heterozygous or homozygous form, and all of these had severe hyperinsulinemia that responded poorly to medical treatment and required subtotal pancreatectomy. No K(ATP) channel activity was observed in beta-cells isolated from a homozygous patient or after coexpression of recombinant Kir6.2 and SUR1 carrying the V187D mutation. Thus, the mutation produces a nonfunctional channel and, thereby, continuous insulin secretion. This unique SUR1 mutation explains the majority of PHHI cases in Finland and is strongly associated with a severe form of the disease. These findings provide diagnostic and prognostic utility for suspected PHHI patients.

ATP-Binding Cassette Transporters↗
PubMed1999

Glycemic control in patients with diabetes in Finland.

OBJECTIVE: To evaluate the quality of diabetes care at a national level in Finland, using level of glycemia as a determinant of success in treatment. RESEARCH DESIGN AND METHODS: Physicians and diabetes nurses in 76 randomly selected clinics (59 primary care units and 17 hospitals) evenly covering the whole of Finland were asked to fill in a questionnaire asking for data based on the 1993 medical records of a random sample of 50 diabetic patients from each center (total n = 3,800). HbAlc was used as an index of glycemic control. RESULTS: Information on 3,195 (84%) diabetic patients was received. HbAlc was measured in 67% of the patients in 1993. The mean HbAlc in the whole population was 8.6 +/- 1.9% (normal range 4-6%). Some 25% of patients had HbAlc < or = 7.3%, while 25% had HbAlc > or = 9.7%. The mean HbAlc was 8.8 +/- 1.9% in type 1 and 8.5 +/- 1.9% in type 2 diabetic patients. There was no sex difference in the HbAlc level in type 1 diabetic patients. However, male type 2 diabetic patients had better glycemic control than female patients (8.3 +/- 1.9 vs. 8.8 +/- 1.9%, P < 0.0001). The sex difference was independent of the type of therapy. The mean level of glycemic control was lowest among individuals with the shortest duration of diabetes. After 7-9 years after the diagnosis, there was no change in the mean level of glycemia. CONCLUSIONS: Average glycemic control is poor in a majority of the diabetic patients in Finland. Better treatment strategies and methods should be used to improve glycemic control and to reduce long-term complications.

Adult↗
PubMed1975

Strontium content of deciduous teeth in northern and southern Finland.

A possible connection has been suggested between strontium and a low prevalence of dental caries. An investigation of this subject was initiated by measuring the strontium content of deciduous teeth by atomic absorption spectrophotometry in different regions in Finland. The material analysed consisted of a total of 2,482 tooth crowns and 392 tooth roots. The results showed that the Sr content of the tooth crowns in northern Finland was about two-fold that in the south, about 400 and 200 mug/gCa, respectively. The difference was apparently caused by corresponding differences in dietary strontium. The tooth roots contained much more Sr than the crowns, about 600 and 200 mug/gCa, respectively, in southern Finland, presumably owing to changes occurring in the dietary habits of the child during the development of the crowns and roots of the deciduous teeth.

Dental Caries↗
PubMed1997

Hunting guns in homes and suicides in 15-24-year-old males in eastern Finland.

OBJECTIVE: The aim of this study was to investigate the associations between firearm ownership, the presence of guns in homes, the use of psychiatric services and suicides in 15-24-year-old males in Eastern Finland. METHOD: Police and medicolegal records of all suicides (n = 68) performed by 15-24-year-old males in the Kuopio province, Eastern Finland, in 1988-1995 were studied. Information was sought about firearm ownership, legality and purposes of use. Information was also sought about recent contacts with psychiatric services. Firearm suicides were compared with suicides by other methods. RESULTS: The annual suicide rate for 15-24-year-old males was 51/100 000. Sixty-two percent of suicides were committed by shooting. In 74% of these, licensed hunting guns were used. The proportion of suicides committed by legal hunting guns stored in the homes of victims was 60% of all firearm suicides. Sixty-two percent of firearm suicides were committed in homes of victims or in someone else's residence where guns were present. Only 2% of those who shot themselves were seen in psychiatric consultation during the 3 months prior to death. CONCLUSIONS: The presence of hunting guns in homes means easy access to a most lethal suicide method and is associated with a high suicide rate for 15-24-year-old males in Eastern Finland.

Adolescent↗
PubMed1987

Decreased incidences of intestinal and diffuse types of gastric carcinoma in Finland during a 20-year period.

The incidence of gastric carcinoma (GCA) has decreased throughout the world. This decrease is attributed to a decline in incidence of the intestinal type of GCA (IGCA), whereas the diffuse (DGCA) type of GCA is considered to be endemic in nature and more stable in incidence. In the present study we have estimated how much the incidences of IGCA and DGCA have decreased in percentage in Finland from 1952-61 to 1972-81. Our calculations are based on the Finnish Cancer Registry data of new GCA cases, on population statistics in Finland, and on the percentage distribution of GCA subtypes in three consecutive samples of GCA patients collected in the time periods 1952-61 (reference series) and 1972-81 (two separate samples: series A and B). The samples totaled 1837 GCA cases. We calculated that the incidence of IGCA had decreased from 1952-61 to 1972-81 by 62-71% (reference series versus series A - reference series versus series B) among men and by 69-70% among women. Correspondingly, the incidence of DGCA was calculated to have decreased by 30-39% among men and 37-42% among women. We conclude that not only has the incidence of IGCA decreased in percentage approximately twice as much as the incidence of DGCA but DGCA has also distinctly decreased in incidence in Finland from 1952-61 to 1972-81.

Adult↗
PubMed1997

Incidence of antireflux surgery in Finland 1988-1993. Influence of proton-pump inhibitors and laparoscopic technique.

BACKGROUND: The advent of proton-pump inhibitors, and subsequently of the laparoscopic technique, can be assumed to have influenced the use of antireflux surgery in gastro-oesophageal reflux disease. METHODS: Data on antireflux operations carried out in Finland in 1988-93 were obtained from national statistics, and the number of operations performed laparoscopically in 1993 was ascertained by a questionnaire to all relevant units. The rates per 100,000 population in the catchment areas were calculated. RESULTS: Antireflux surgery almost always implied fundoplication. During 1993, 784 fundoplications and 43 other antireflux procedures were performed in Finland (total population around 5 million). The fundoplication rate per 100,000 population rose from 8.8 to 15.4 between 1988 and 1993. The increase was minimal (8.1-8.2) in 1990-91 when the first proton-pump inhibitor, omeprazole, was introduced, but remarkably greater (12.8-15.4) in 1992-93, when the laparoscopic technique became popular. Differences in fundoplication rates were six to tenfold between health service districts and even larger between hospitals. CONCLUSIONS: The numbers of antireflux operations in Finland were almost static when proton-pump inhibitors were introduced, but rapidly increased after the advent of the laparoscopic technique. Remarkable discrepancies were found in the incidence of fundoplication between different areas and hospitals.

Adolescent↗
PubMed1984

Rapid decline of hepatitis A in Finland.

Infectious hepatitis, based on clinical diagnosis, has been reported by practicing doctors in Finland to the National Board of Health since 1943. Two epidemics of infectious hepatitis have been recorded. The first one with more than 16000 cases occurred in 1948 and the second one in 1954-57 with a peak of more than 7000 cases in 1956. After that infectious hepatitis has declined rapidly. In 1966 only 363 cases were reported. Although the figures are incomplete they reflect the changes that have taken place in the frequency of infectious hepatitis in Finland. The statistics are supported by serological studies. 24% of the sera collected in 1970 from 20-24-yr-old Finns, born in 1946-50, contained antibodies of the IgG class to hepatitis A while only 0.3% of the sera collected in 1982-83 from the same age group, born in 1958-63, contained these antibodies. Only 3.2% of the sera sent to our laboratory for hepatitis A diagnosis in 1980-82 contained antibodies of the IgM class to hepatitis A, and at least 68% of these infections were connected with travel in foreign countries. This paper shows that the prevalence of hepatitis A is low in Finland and that a rapid decline in its frequency has taken place during the last 25 years.

Adult↗
PubMed1989

Sero- and subtypes of group B meningococci causing invasive infections in Finland in 1976-87.

Neisseria meningitidis group B (MenB) strains isolated from 1976 to 1987 in Finland in 339 patients with invasive infection were sero/subtyped by whole cell enzyme immunoassay using monoclonal antibodies to class 1 and 2/3 outer membrane proteins. 66.7% of the strains could be serotyped (class 2/3) and 70.2% subtyped (class 1). No single phenotype was clearly predominant. The most common serotypes were 4 (18.6%) and 14 (17.4%) and the most common subtypes P1.16 (20.1%) and P1.2 (12.1%). The Norwegian phenotype B:15:P1.16 was seen only rarely (a total of 18 strains). Strains from Northern Finland did not differ from those from Southern Finland: no single phenotype caused the slight increase seen in the incidence of MenB infections in the end of 1970s in the North.

Antibodies, Monoclonal↗
PubMed1995

General practice consultations in central and northern Finland.

OBJECTIVE: To examine general practice consultations in health centres in central and northern parts of Finland. DESIGN: A questionnaire concerning all general practice consultations during one week. SETTING: Central and northern parts of Finland in a region comprising 72% of the area of the country and one-third of its population. PARTICIPANTS: 851 health centre doctors. OUTCOME MEASURES: Consultation rates by age and sex of the patients and by characteristics of doctors and their practices. RESULTS: The average consultation rate per 1,000 female inhabitants was 43 and per 1,000 male inhabitants 34 per week. For total contacts, a J-shaped association with increasing age was demonstrated for both sexes. The average number of consultations per doctor in a week was 72. Consultation rates were lowest among physicians over 45 years of age. A low consultation rate was also found among general practitioners not participating in the personal doctor programme and among those who worked in municipalities with over 30,000 inhabitants. CONCLUSION: In Finland, consultation rates per 1,000 inhabitants, as well as per general practitioner, are remarkably lower than in most European countries. The personal doctor programme with defined lists of patients seems to be associated with high consultation rates.

Adolescent↗
PubMed1991

Resources and productivity in radiation oncology in Denmark, Finland, Iceland, Norway and Sweden during 1987.

Data concerning megavoltage equipment and use of megavoltage external beams in cancer management during 1987 in Denmark, Finland, Iceland, Norway, and Sweden were collected from all 37 centres serving a population of 23 million in these countries. Population per Linear Accelerator Equivalent (LAE) unit ranged from 0.30 million/LAE unit (Denmark) to 0.19 million/LAE unit (Sweden). The number of field treatments were 227,548 (Denmark), 259,917 (Finland), 10,426 (Iceland), 147,960 (Norway) and 490,126 (Sweden). The number of field treatments per million population per year ranged from 35,229 (Norway) to 58,438 (Sweden). The number of field treatments per LAE unit/year ranged from 13,192 (Denmark) to 9,546 (Norway). The fraction of cancer patients receiving megavoltage radiotherapy in 1987 out of all newly diagnosed cancer patients during 1987 was 24% in Denmark, 37% in Iceland, 25% in Norway, and 34% in Finland and Sweden. We conclude that Denmark and Norway probably did not provide adequate levels of radiotherapy for their cancer patients during 1987.

Denmark↗
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↗
PubMed1981

Drinking habits in Finland and Scotland: a comparison of survey results.

An unusual opportunity to compare drinking habits in two countries in a technically satisfying way is offered by two surveys, one conducted in Scotland in 1972 by Dight and the other in Finland in 1976 by this author. Both Scotland and Finland represent ambivalent sociocultural attitudes toward alcohol, and the total alcohol consumption per capita is approximately the same in both countries. In Finland the distribution of alcoholic beverages is controlled by a state alcohol monopoly whereas in Scotland the distribution is in private hands and controlled by a very different system. Moreover, the dominating beverage type in Scotland is beer in spite of the famous whisky tradition, while the Finns prefer distilled spirits to other beverages. Thus there exist notable similarities as well as interesting dissimilarities in the general framework of drinking habits in these two countries. In this paper only the shares of drinkers and abstainers in demographic groups, the number of problem drinkers, as well as some results concerning the attributes of drinking occasions are considered. The results reveal interesting differences in the sociocultural sphere of drinking. The problem to be further discussed is whether these differences arise from the deeply noted traditions or from the influence of control systems. These two are, of course, complexly connected.

Adolescent↗
PubMed2002

Incidence of frostbite and ambient temperature in Finland, 1986-1995. A national study based on hospital admissions.

OBJECTIVES: The association of frostbite with ambient temperature in Finland is not known. The present study determined the incidence of frostbite and its association with sex, age and ambient temperature in a nationwide sample. STUDY DESIGN: The first admissions of all patients (n=1,275) admitted to hospital in Finland during the period 1986-1995 with frostbite as a principal or secondary diagnosis were associated with ambient temperature on the day of admission. RESULTS: The incidence of frostbite was 2.5 per 100,000 inhabitants, it was higher in males than females and increased linearly with age. The annual incidence of frostbite started to rise at below -15 degrees C and was considerable at under -20 degrees C, particularly in northern Finland. However, the daily incidence increased most in the urban area of Helsinki. CONCLUSION: In the north, the main factor is the large number of cold days in the year. The daily incidence may be affected by urban lifestyle, possibly fashion, and inability to protect oneself against the cold.

Adolescent↗