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PubMed1996

Epidemiology of osteoporotic ankle fractures in elderly persons in Finland.

BACKGROUND: Although osteoporotic or minimal trauma fractures among elderly persons are a major public health problem worldwide, epidemiologic information on these fractures is limited. OBJECTIVE: To determine the current trend in the number and incidence of osteoporotic ankle fractures in the elderly. A fracture was defined as osteoporotic only if it occurred as a result of minimal trauma in a person 60 years of age or older. DESIGN: National hospital discharge register. SETTING: Finland, a country with approximately 5 million inhabitants. PARTICIPANTS: All patients 60 years of age or older who were admitted to hospitals in Finland for primary treatment of first osteoporotic ankle fracture in 1970 to 1972, 1974, 1975, 1978 to 1980, 1983 to 1985, 1988 to 1989, and 1991 to 1994. MEASUREMENTS: The number and the age-specific and age-adjusted incidence of osteoporotic ankle fractures in each year of the study. RESULTS: For the study period, the number and incidence (per 100,000 persons) of osteoporosis-related ankle fractures in Finnish persons 60 years of age or older increased considerably (370 and 57, respectively, in 1970 compared with 1243 and 130, respectively, in 1994). The age-adjusted incidence of these fractures also increased in women, from 66 in 1970 to 162 in 1994, and in men, from 38 in 1970 to 82 in 1994. CONCLUSION: The number of osteoporotic ankle fractures in Finland is increasing at a rate that cannot be explained simply by demographic changes. Vigorous preventive measures are needed to control the increasing burden of this type of fracture.

Aged↗
PubMed1999

Leucocytozoonosis and trypanosomiasis in redstarts in Finland.

Leucocytozoon spp. and Trypanosoma spp. blood parasites in the redstart (Phoenicurus phoenicurus) were studied during spring migration 1994 in southern Finland (53 individuals) and the breeding season 1992-1994 in northern Finland (69). Parasite prevalence was higher during the breeding season (48%) than during the migration period (13%), with no age or sex differences in the breeding site birds. In both periods, redstarts were infected by the same blood parasites Leucocytozoon shaartusicum (46% prevalence at the breeding site and 71% during the migration period) and Trypanosoma avium, complex (58% and 43%, respectively). One individual at the breeding site had contracted L. dubreuili and one at the stop-over site had T. everetti. Our results may support the assumption that tissue-hidden parasites relapse during the breeding season when birds may have diminished immune response related to egg production and brood rearing. Another explanation could be that the high abundance of ornithophilic vectors enhance parasite transmission during breeding season in northern Finland.

Animals↗
PubMed1999

Eclampsia in Finland in 1990-1994.

BACKGROUND: Eclampsia is a serious threat to both maternal and fetal well-being. We started the present study because no recent data are available on the incidence of eclampsia and the outcome of patients with this serious disorder in Finland. METHODS: The incidence of eclampsia in Finland in 1990-1994 was studied retrospectively. The data were retrieved from the National Birth Register and the Finnish Hospital Discharge Register. Patient records were reviewed. RESULTS: Seventy-seven cases of eclampsia were found in the hospital records, which gave an eclampsia incidence of 2.4 per 10,000 deliveries (95% confidence intervals 1.9 to 2.9). Eclampsia was preceded by severe pre-eclampsia in 84% and by mild pre-eclampsia in 8% of the patients. Ten mothers suffered from severe eclampsia-related complications but, fortunately, none of the mothers died. Perinatal mortality was 5%, and 33% of the newborns were small for gestational age. CONCLUSIONS: Eclampsia is rare in Finland. Its low incidence is probably due to improved neonatal care that allows earlier deliveries before the progress of preeclampsia to eclampsia.

Adolescent↗
PubMed2000

Single founder mutation (W380G) in type II protein C deficiency in Finland.

The present study investigated the genetic basis for type II protein C deficiency in Finland, where this form has an unusually high incidence. We demonstrated that, first, a single novel mutation W380G in the protein C gene (PROC) explained 25/26 index patients, estimated to represent two thirds of all families with type II deficiency in Finland. Second, extended chromosomal conservation, i.e. a specific haplotype, around the W380G mutation was indicated in unrelated patients. Third, a local geographical origin for the W380G mutation was suggested by genealogical data. These results are in contrast to the heterogeneity in type II protein C deficiency elsewhere, but closely parallel disorders of the Finnish disease heritage. The high frequency of the type II disease can be explained by founder effect and subsequent enrichment of a single mutation in Finland. The present study also provided a simple means for genetic diagnosis of this disease and the genetic test can be included in the routine screenings in this population.

Chromosome Mapping↗
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

Structural changes and social inequalities in health in Finland, 1986-1994.

BACKGROUND: This paper seeks to examine changes in health inequalities in Finland from the mid-1980s to the mid-1990s. To improve our understanding of the contribution of employment status changes to class and educational differences in health within the context of changing labour market conditions, we examined the differences in ill health among social classes, educational groups, and employment status groups. METHODS: The data was derived from nation-wide Finnish Surveys on Living Conditions from 1986 and 1994. Analyses included the age range 25-64 years. Health was measured using limiting long-standing illness and perceived health as below good. Results are presented as age-standardized prevalence percentages and odds ratios from logistic regression analyses. RESULTS: The pattern and size of relative social inequalities in ill health have remained generally stable during the eight-year study period in Finland. Differences between social classes have changed only slightly. Differences between educational groups have declined somewhat among men, but have remained stable among women. Compared with the employed, health among the unemployed, housewives, and pensioners has improved for both men and women. Analysing social class differences within both the employed and the non-employed showed only negligible changes. CONCLUSIONS: Changes in social inequalities in health as indicated by class and educational differentials among Finnish men and women have mostly been negligible. The observed changes are likely to have been affected by the 1990s' labour market crisis in Finland. The rapidly increasing mass unemployment is unlikely to have been very individually selective in the short run. However, in the longer run, to the extent that unemployment remains high, this trend can be expected to change as re-entry to paid employment is likely to be more individually selective.

Adult↗
PubMed1990

[Geographical differences in the mortality of the elderly in Finland since the 1850s].

Mortality data for the elderly in Finland are compared for geographical differences between the east and the west. The author utilizes simulated data from 1853 to 1878 to evaluate mortality in the past and compare it to the present, which indicates high levels of male mortality from heart disease in eastern Finland. "The historical evidence is compatible with the view that the causes of the high premature mortality in Finland are to be found in diet and smoking and perhaps also in genetics." (SUMMARY IN ENG)

Adult↗
PubMed1993

[Marriage trends in Finland and Hungary].

"The study compares marriage trends of Finland and Hungary, using marriage tables of Finnish males and females born between 1939 and 1965 as well as those of Hungarian males and females born between 1939 and 1968." A major change in marriage behavior in Finland during the 1960s is attributed to changing social and economic conditions, particularly migration to the major cities. "Due to the changes a new marriage pattern is being shaped in Finland's population which is typical of postindustrial societies. In the youngest cohorts of Finnish females the average age at first marriage is likely to exceed 26 years, and at least 25 per cent of them remain ultimately unmarried. In the younger Hungarian cohorts significant decrease in first marriages can similarly be pointed out." (SUMMARY IN ENG AND RUS)

Cohort Studies↗
PubMed1992

Surveillance of human immunodeficiency virus (HIV) antibodies in medicolegal autopsies in Finland--monitoring early changes in HIV-seropositivity among risk groups and average population.

In order to cooperate with voluntary screening programs aimed at the surveillance of the HIV epidemic in Finland, we have studied medicolegal autopsies for HIV antibodies since 1986 using an enzyme immunoassay on postmortem sera. The investigation covered 47.4% and 39.2%, respectively, of all deaths under the age of 65 years in the metropolitan areas of Helsinki and Turku--two cities on the densely populated southern coast of Finland from which most HIV infections have thus far been detected. Nine HIV-positive cases (0.12%) were detected among the 7305 medicolegal autopsies tested in 1986 to 1990. This figure is higher than the prevalence of 0.01 to 0.03% in voluntary screening programs for the general population would suggest. Seven of our cases had previously tested positive, and two were previously unknown cases, indicating that people at high risk are clustered in the medicolegal autopsy series. Of the six cases in an early stage of infection, three committed suicide suggesting the importance of HIV-screening in suicide cases in tracing symptomless HIV carriers. Five of the cases were detected in 1990, a year when the number of new HIV infections had more than doubled compared to the previous two years. This suggests that testing of medicolegal autopsies as surrogate tests for the population gives useful information even in low-prevalence areas like Finland. Such testing has none of the ethical problems of many other back-up surveys, and may be particularly sensitive to early changes in epidemiology.

Adult↗
PubMed1992

Epidemiology of invasive pneumococcal infections in children in Finland.

OBJECTIVE: To study the epidemiologic characteristics of invasive infections in children caused by Streptococcus pneumoniae to provide background data for vaccination programs. DESIGN: A nationwide laboratory-based prospective surveillance of all invasive pneumococcal infections in children during 1985 through 1989. SETTING: A network of all microbiologic laboratories and pediatric wards in Finland. PATIENTS: Children aged 0 to 15 years who were admitted to a hospital with S pneumoniae isolated from blood, cerebrospinal fluid, or deep aspirate sample. RESULTS: Four hundred fifty-two invasive pneumococcal infections were diagnosed in 1985 through 1989. The annual incidence rate was 8.9 per 100,000 children less than 16 years of age (24.2 per 100,000 among children less than 5 years of age and 45.3 per 100,000 among those less than 2 years of age). The most common clinical entities were bacteremia without focus (310 cases), pneumonia (66 cases), and meningitis (51 cases), with other focal infections seen in 25 cases. The pneumococcal groups/types 14, 6, 19, 7, 18, and 23 comprised 78% of all invasive infections. CONCLUSIONS: Streptococcus pneumoniae is a common cause of invasive infections in children in Finland. A pneumococcal conjugate vaccine containing the six most common groups/types could prevent up to 70% of invasive pneumococcal infections of children in Finland if fully protective in infancy.

Adolescent↗
PubMed1992

[Morbidity and social class in Finland, Sweden and Norway].

Investigations of living standards in Norway, Sweden and Finland in 1986-1987 yielded new comparative data on public health and disease as related to social class. Long-term troublesome illness was less common in Sweden than in Finland and Norway. In all three countries the jobless category and skilled working women accounted for the highest morbidity. Among men, morbidity was greatest for agricultural workers in Finland and Norway, and lowest for Swedes of social class 1--i.e., highly placed and highly educated white collar workers.

Adult↗
PubMed2005

The core data elements of electronic health record in Finland.

Delivery of good care, ability to communicate effectively about patient care and the decision-making during the care process depends on the quality of the information available to all professions and between sectors. The main purpose of an electronic health record is to support the multidisciplinary communication, cooperation and decision-making in the patient's care process. In addition, the data in electronic health records are used, e.g. in clinical research, health system management, the planning of health services and government reporting. A nationwide electronic health record will be introduced in Finland by the end 2007. Reaching this target has been a special part of the national health project. In a subproject of the introduction of a national electronic health record, core data elements of electronic health record have been defined through a consensus-based approach. The main elements are the patient identification information, the provider's identification information, care episode, risk factors, health patterns, vital signs, health problems and diagnosis, nursing minimum data set, surgical procedures, tests and examinations, information about medication, preventive measures, medical statements, functional status, technical aids, living will, tissue donor will, discharge summary, follow-up care plan and consent information. Furthermore, existing vocabularies, nomenclatures, classifications and codes were clarified. The HL7 Finland has defined the manner in which this information is expressed in the CDA R2 structure. The core information elements will be implemented in regional development projects which are partly funded by the Ministry of Social Affairs and Health. This paper presents the defining process of the national core data elements of electronic health record systems in Finland.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Declining trend in the incidence of rheumatoid factor-positive rheumatoid arthritis in Finland 1980-2000.

OBJECTIVE: To investigate trends in the incidence of rheumatoid arthritis (RA) in Finland. METHODS: We studied all the subjects entitled to receive drug reimbursement for chronic inflammatory joint diseases in 5/21 central hospital districts (population base about 1 million adults) in Finland during 2000. The incidence rates and the mean age at disease onset were compared with those from 1980, 1985, 1990, and 1995. RESULTS: A total of 714 subjects were entitled to drug reimbursement for chronic inflammatory joint disease that had started at the age of 16 or over. Of them, 321 satisfied the American College of Rheumatology classification criteria for RA, 198 had spondyloarthropathy, and 195 had undifferentiated oligo- or polyarthritis. The incidence of RA was 29.1/100,000 (95% CI 26.0-32.5); the figures for rheumatoid factor (RF)-positive RA and RF-negative RA were 18.2 (95% CI 15.8-21.0) and 10.8 (95% CI 9.0-12.9)/100,000, respectively. The incidence of RA was 36.9 (95% CI 32.1-42.2)/100,000 among women and 20.8 (95% CI 17.2-25.1)/100,000 among men. The age- and sex-adjusted incidence rate ratio declined from 1.00 in the referent year 1980 to 0.55 (95% CI 0.46-0.66) in 2000. A declining trend was evident for the incidence of RF-positive RA (p < or = 0.001). CONCLUSION: We verified the declining trend for the incidence of RF-positive RA in both sexes in Finland. Although the etiology of RA remains unknown, public health measures may reduce the risk of RA in the general population.

Adult↗
PubMedDate not supplied

Mortality, cardiovascular risk factors, and diet in China, Finland, and the United States.

Mortality, cardiovascular risk factors, and diet were compared in Tianjin province, People's Republic of China; in North Karelia Province, Finland; and in the United States as a whole. People in Tianjin received 7 percent of their energy intake from saturated fats, whereas people in the United States received 13 percent and those in North Karelia received 20. The mean blood cholesterol levels for men were 158 milligrams per deciliter (mg per dl) for Tianjin, 216 mg per dl for the United States, and 241 mg per dl for North Karelia. The smoking prevalence among men was highest in Tianjin (66 percent), followed by the United States (42 percent) and Finland (36 percent). The differences among mortality rates for the three locales were less pronounced among women than among men. Age-standardized total mortality for women was highest for Tianjin and lowest in North Karelia. The reverse was true for men. Age-standardized total mortality for men was lowest in Tianjin and highest in North Karelia. Age-standardized ischemic heart disease mortality for men was lowest in Tianjin (99 per 100,000) and highest in North Karelia (730 per 100,000). For women, the corresponding figures were 83 per 100,000 in Tianjin and 164 per 100,000 in North Karelia. Although salt intake was higher in Tianjin than in North Karelia, the blood pressure was on average lower in persons from Tianjin than in those from North Karelia. The stroke mortality rate in Tianjin, however, was much higher than in either Finland or the United States. The strong discrepancy in stroke mortality relative to prevalence of hypertension and salt intake raises the issue of the etiology of stroke in Tianjin. Recently it has been reported that hemorrhagic stroke may be more common among people whose blood cholesterol level is very low and blood pressure level high. This joint condition may be relatively common in Tianjin and calls for longitudinal and case-control studies to clarify the relationships among these factors in Tianjin.

Adult↗
PubMed1987

Community periodontal index of treatment needs in Finland.

WHO and FDI introduced in 1984 a simplified periodontal examination system for dental practitioners utilizing the CPITN. Finland was among the first countries to adopt the newly developed index nationwide. The process of introducing the CPITN was a tough and time-consuming task. Close co-operation between the administration, the educational system and the dental association was needed. The National Board of Health for Finland initiated the monitoring of periodontal diseases in 1981. The University of Helsinki was invited to provide the scientific basis for the monitoring process. The CPITN was then tested in a dozen municipal health centres. Testing of the index took one year and the results led to the adoption of the CPITN nationwide. In 1984 instructions for the use of CPITN were issued by the National Board of Health to all dentists in Finland. The role of the Finnish Dental Association was essential in launching a national training programme on the practical use of the index. The first national data on CPITN indicate that the index is suitable and useful in the monitoring of the periodontal health of the population. It is noteworthy that the national introduction of this index took several years in a fairly well developed small country. Much co-operation, testing and training were required until the first national results using CPITN were available.

Adolescent↗
PubMed1986

Endemic goitre in Finland and changes during 30 years of iodine prophylaxis.

Endemic goitre of moderate severity was mainly found in the East of Finland still in the 1950s but the whole country was moderately iodine deficient. The daily iodine intake determined both from food consumption and from the urinary excretion in population samples was 50-70 micrograms being lower in the East. The main iodine sources were milk products, about 50% of the daily intake being derived from these. Iodized salt was available but its use was very low and the iodine content insufficient so that only about 20% came from this source. In the late 1950s iodine prophylaxis was activated and since then only salt containing 25 mg KI/kg has been imported. However, during the last decades the consumption of salt has declined from 7-8 g to less than 4 g per day. Today the iodine intake in Finland is about 300 micrograms per day, the highest in Europe. The main sources are milk products and eggs which provide about 2/3 of the daily iodine intake due to an active iodine prophylaxis of house animals and only 20% comes from iodized salt. The origin of endemic goitre in Finland has obviously been multifactorial autoimmunity, natural goitrogens and possibly genetic factors being superimposed upon the basic iodine deficiency. The iodine supply is now adequate and there is no more goitre in neonates and no endemic goitre in school children in whom the prevalence is usually below 1%. Concomitantly, the nosology of hyperthyroidism has changed. Whereas more than 80% of hyperthyroid patients in the 1950s had nodular goitre the main type of hyperthyroidism today is Graves' disease proper with a small or normal-sized thyroid gland without nodules obviously due to disappearance of the endemic nodular goitre.

Adult↗
PubMed1987

Incidence of clinically confirmed farmer's lung in Finland and its relation to meteorological factors.

In Finland, data about the incidence of clinically confirmed (according to predefined criteria) farmer's lung have been collected in successive years since 1980. All special hospitals for pulmonary diseases and departments of pulmonary diseases in other hospitals (23 clinical units throughout Finland) took part in the study. This report deals with the results collected from 1980 to 1982 (inclusive), during which 512 new cases of farmer's lung were recorded, 186 in 1980, 153 in 1981, and 173 in 1982. The mean age of the patients was 47 years (range 14-75), 45 years for men and 48 years for women. About two-thirds of the patients were women. The mean annual incidence of farmer's lung among the entire farming population (standardized for age and sex to the total population in Finland in 1975) was 44 per 100,000 persons in farming. Both the standardized mean annual incidence (range 8-60 per 100,000 persons in farming) and the female/male ratio of the standardized incidence showed distinct regional differences. Most cases of farmer's lung occurred during the indoor feeding season for cattle. The highest frequency of new cases was observed in April and the lowest in October. The incidence of farmer's lung was positively correlated with measures of daily rainfall and negatively correlated with days without rainfall and with sunshine during the haymaking period preceding the diagnosis. A rainy haymaking period calls for artificial drying of hay in order to reduce the incidence of farmer's lung.

Adult↗
PubMed1987

Trends in stroke mortality and in antihypertensive treatment in Finland from 1972 to 1984 with special reference to North Karelia.

Trends in antihypertensive treatment and stroke mortality were analysed in the province of North Karelia where the first systematic hypertension control programme in Finland was started in 1972. Surveys carried out in random samples of the middle-aged population of North Karelia showed that the control of hypertension was better than in the reference area, especially from 1972 to 1977. From 1972 to 1984, mortality from stroke fell on average 6.3% and 7.6% per annum, in North Karelian men and women aged 35-64 years. These declines were steeper than those observed in the rest of Finland. In the age group of 65-74 years the decline in stroke mortality was also steeper in North Karelia. From 1978 to 1984 the self-reported awareness of hypertension and the proportion of people receiving antihypertensive drug treatment decreased in the middle-aged population in Finland, suggesting lesser efforts at detection and treatment. During the same period, the steep national decline in stroke mortality levelled off, but the mortality rate remained higher than in the USA and in other Western European countries. Prevention of stroke through hypertension control in the community still remains a major challenge for health care.

Adult↗