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PubMed2002

Rapid increase in macrolide resistance among penicillin non-susceptible pneumococci in Finland, 1996-2000.

The aims of this study were to evaluate the resistance patterns and serotypes/groups of penicillin non-susceptible pneumococci (PNSP) in Finland, and to determine phenotypes and resistance mechanisms of the erythromycin-resistant isolates. A total of 1190 PNSP were collected during 1996-2000 in Finland. The MICs of 18 antimicrobials were determined by the agar plate dilution method, and PCR was used to study the resistance mechanisms of the macrolide-resistant isolates. For serotyping, counterimmunoelectrophoresis and latex agglutination were used. Erythromycin resistance increased from 32% in 1996 to 62% in 2000 among PNSP in Finland. Multiresistance (co-resistance to erythromycin, tetracycline and co-trimoxazole) was present in 22% of the isolates in 1996 and in 40% in 2000. The most common macrolide resistance phenotype was the MLS(B) phenotype (72%), 25% had the M phenotype and 3% the MS phenotype. The MLS(B) and M phenotypes increased in the same proportion during the study period. All the MLS(B) isolates had the erm(B) gene, the M isolates the mef(A) gene, and in 11 MS isolates, ribosomal mutations were the cause of resistance. The most common serotypes/groups were 14, 19 and 6. We found a significant increase in multiresistance among PNSP within a short period of time in Finland. Although pneumococcal resistance to erythromycin was 11% in 2000, the same figure was 50% among the PNSP. The rise in erythromycin resistance is worrying, as macrolides are commonly used as first- and second-line drugs in pneumococcal infections.

Anti-Bacterial Agents↗
PubMed1982

Contrasting patterns of familiality for cholesterol and triglyceride in Finland according to type of coronary manifestations and locations.

A descriptive genetic analysis (offspring between parent plot) was applied to serum cholesterol and triglyceride levels of 1044 Finnish subjects who were parents, siblings, spouses, and offspring of 204 male probands with angina pectoris or nonfatal myocardial infarction before age 55 years. The same analysis was also applied to 511 relatives of 106 control men matched to the probands for age and location (northeastern Finland or southern Finland). Striking differences in the plot results for triglyceride data suggest that male probands with angina pectoris as first evidence of coronary disease had different familial characteristics than those with nonfatal myocardial infarction at the onset. Further plot contrasts suggest stronger major gene effects for cholesterol and triglyceride levels in northeastern Finland, both in case and control families. Genetic makeup may help explain why men in northeastern Finland have the world's highest rate of early coronary heart disease.

Adult↗
PubMed1978

The prevalence of chronic diseases in children in out-hospital care in Finland.

The records of public health nurses have been used for an estimate of the prevalence of children in domestic care and suffering from various kinds of chronic diseases. This estimate provided a basis for computation of the number of chronically ill children in out-hospital care in Finland. The research was carried out as a sample research and this inquiry resulted in the information of the anamnesis of 12,721 chronic children under 16 years of age taken care of at home. We have counted as chronics those children whose disease is lingering either due to its mechanism of origin or to its nature or known to be such from experience. The total prevalence was 53% of the child population in Finland which corresponds to 59,000 chronically sick children. The geographical distributions of the groups of the diseases were not quite alike in the different parts in our land. The greater prevalences were found on the other hand in Northern Finland and in the wide archipelago of Southwestern Finland. The most common types of the chronic diseases of children were found to be those of sense organs (the total prevalence was 18%). The prevalence of allergic diseases varies between 6--12% and the disease group of endocrinic glands 1.0--3.4%. The prevalence of the neurological diseases was 2.3% and the biggest group consists of the convulsive. The prevalence of the other groups of diseases were: the psychiatric diseases 2.2%, the urological diseases 1.4% and the hematological diseases 0.8%.

Adolescent↗
PubMed2006

Trends in hypertension care in eastern and south-western Finland during 1982-2002.

OBJECTIVE: To assess the trends in blood pressure (BP) levels and the control of hypertension in eastern and south-western Finland during 1982-2002. DESIGN: Five independent cross-sectional population surveys conducted in 1982, 1987, 1992, 1997 and 2002. SETTING: The provinces of North Karelia and Kuopio in eastern Finland and the region of Turku-Loimaa in south-western Finland. PARTICIPANTS: Stratified random samples of men and women aged 25-64 years were selected from the national population register. The total number of participants was 29 127. MAIN OUTCOME MEASURES: Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), the prevalence and control of hypertension. The distribution of all subjects with no antihypertensive drug treatment in 2002 according to the modified risk stratification scheme introduced in 2003 European Society of Hypertension-European Society of Cardiology guidelines. RESULTS: Mean SBP and DBP and the prevalence of hypertension decreased significantly in all areas. The proportion of treated hypertensive subjects with adequately controlled BP (SBP < 140 mmHg and DBP < 90 mmHg) increased from 13.7 to 33.3% in men (P < 0.001) and from 11.4 to 32.0% in women (P < 0.001). The unsatisfactory treatment of hypertension was mainly a result of the lack of control of high SBP. According to the 2003 guidelines, 35.9% of the entire population currently not on antihypertensive drug treatment should have been prescribed such treatment within a year. CONCLUSIONS: Hypertension care has improved significantly in Finland during 1982-2002. However, the difference between the actual situation at the population level and the treatment goals presented by the hypertension guidelines remains vast.

Adult↗
PubMed1977

Regional coffee consumption and mortality from ischemic heart disease in Finland.

In Finland the mortality from ischemic heart disease is highest in North Karelia and lowest in Southwest Finland. In this study the consumption of coffee has been measured from the total sales in the different areas of Finland to see if it correlates with the mortality from heart disease. North Karelia had higher coffee sales per inhabitant than Southwest Finland. This finding reinforces the view that carefully controlled dietary studies are needed to establish the role of coffee in the mortality from ischemic heart disease.

Adolescent↗
PubMed1987

Comparison of the levels of cardiovascular risk factors between eastern and south-western Finland in 1982.

Altogether 6,523 persons aged 25-64 years were studied in eastern and south-western Finland to determine their cardiovascular risk factor levels. Among men, smoking was more prevalent in the south-western area (41 vs. 37%), serum cholesterol levels were higher in the eastern area (6.2 vs. 6.0 mmol/l) and blood pressure levels were the same in both areas (145/86 in the east vs. 144/86 in the south-west). Among women, smoking was also more common in the south-western area (24 vs. 16%) and serum cholesterol levels were higher in the eastern area (6.1 vs. 6.0 mmol/l) as well as blood pressure levels (142/84 vs. 138/81 mmHg). Among both genders, prevalence of hypertension and proportion of persons on antihypertensive drug therapy was higher in eastern Finland. The comparison of these findings with the results from previous studies carried out among men in these two areas indicates that the risk factor levels have been decreasing in both areas and that the previously observed differences in risk factor levels between eastern and south-western Finland (the levels used to be higher in the east) have levelled off. The favourable development in eastern Finland may be a result of the North Karelia Project.

Adult↗
PubMed2005

Agents causing occupational asthma in Finland in 1986-2002: cow epithelium bypassed by moulds from moisture-damaged buildings.

BACKGROUND: Occupational asthma is an avoidable form of asthma. In Finland, the diagnosis of occupational asthma entitles substantial compensation to the employee. The diagnostics are based on symptoms, exposure assessment, allergologic investigations, follow-up of peak expiratory flow (PEF) at work and at home and, in many cases, specific challenge tests. OBJECTIVE: To study the causative agents of occupational asthma in Finland. METHODS: The causative agents and the numbers of new occupational asthma cases notified to the Finnish Register of Occupational Diseases (FROD) during 1986-2002 are reported. RESULTS: The number of occupational asthma cases increased from 1986 until 1995, after which a downward trend, stabilizing during the last few years, has been observed. The majority of the cases (59%) in the beginning of the period (1986-1990) were associated with agriculture, but the percentage has fallen thereafter (42% of the cases in 1998-2002) along with the fall in the total number of cases. Since 1995, indoor moulds from water-damaged buildings have caused an increasing number of cases and have become the most important causative agents (0.5% cases, in 1986-1990 and 18% of the cases in 1998-2002). Chemicals have caused 10-30% of the cases, a decreasing number since 1990. The most important chemicals causing occupational asthma have been diisocyanates and welding fumes, followed by hairdressing chemicals and formaldehyde. CONCLUSIONS: The number of occupational asthma cases in Finland reached its height in the mid-1990s. The decrease in the number of total cases is because of the decrease in agriculture-associated cases, reflecting the number of employees in agriculture-associated occupations, which has greatly decreased since Finland joined the EU in 1995. An epidemic of mould-induced asthma, affecting mostly white-collar employees working in moisture-damaged buildings, has taken place since 1995.

Adult↗
PubMed1995

Phenotypic and molecular characteristics of Aeromonas salmonicida subsp. salmonicida isolated in southern and northern Finland.

Aeromonas salmonicida subsp. salmonicida causes outbreaks of furunculosis in salmonid fish. Furunculosis was first detected in Finland in 1986 on fish farms located on the Finnish coast of the Bothnian Bay. Molecular methods, SDS-PAGE, ribotyping, randomly amplified polymorphic DNA (RAPD) and plasmid profile analysis as well as phenotypic characteristics (biochemical characteristics, maximum growth temperature, pigment and elastase production) were used both for typing the strains and to study the possible routes of transmission of the organism to Finland and the spread of infection within Finland from 1986 to 1993. Ribopattern analysis of chromosomal DNA digested with SmaI, BglI, PstI and ClaI of 28 Finnish strains and eight foreign strains (Denmark, Sweden, Norway or Canada) showed that all Finnish strains and the Swedish strain originating from the Swedish coast of the Bothnian Bay had identical ribopatterns. All other foreign strains had distinct, unique ribotypes except for the second Swedish strain studied, the ribotype of which was identical with that of one Danish strain. RAPD typing, based on the results of two arbitrary primers, yielded 15 types for the Finnish strains. Except for both Danish strains, which had the RAPD type which was identical with that of one Finnish strain, the foreign strains had RAPD patterns differing from those of the Finnish strains. Plasmid profile typing and RAPD profile typing did not correlate. Ribotyping with four different enzymes proved to be the most sensitive method for studying genetically homogeneous Aer. salmonicida subsp. salmonicida. Ribopattern analysis showed that the infection which first started in 1984/1985 on the Swedish coast of the Bothnian Bay may have been transmitted to Finland where the first outbreaks occurred in 1986. The strains infecting Finnish fish farms were very homogeneous, with most differences seen, for example, in maximum growth temperature, plasmid profiles and the RAPD profiles of the strains.

Aeromonas↗
PubMed1986

Pollen seasons: forecasts of the most important allergenic plants in Finland.

Occurrence of airborne pollen in Finland has been studied for 10 years in Turku (southern Finland), 8 years in Oulu, 4 years in Kuopio (central Finland) and 7 years at Kevo (northern Lapland). Observations on the pollen seasons of alder, birch, grasses and mugwort are presented. All these pollens occur in south and mid- Finland in quantities capable of causing allergy symptoms. Except for birch pollen, allergenic pollens occur in far lower concentrations than in central Europe. In northern Lapland only birch and pine pollen concentrations are high. Pollens may occur without signs of local flowering when there are southerly winds. This finding suggests that long-distance transport is an essential contributing factor to the occurrence of pollens. There are wide year-to-year variations in the start of pollen seasons and the quantities of pollens. The variations in the start of birch and grass pollen seasons could very much depend on the mean temperature in April. However, a forecasting model based on this and other spring-time temperature parameters often fails to give sufficiently accurate forecasts.

Finland↗
PubMed1993

Isolation of Mycobacterium avium complex from water in the United States, Finland, Zaire, and Kenya.

Disseminated infection with organisms of the Mycobacterium avium complex (MAC) is a common complication of AIDS in the United States and other developing countries, but it is rare or absent in sub-Saharan Africa. To assess the comparative likelihood of exposure to MAC in these geographic areas, we used a standard protocol to culture 91 water samples from environmental sites and piped water supply systems in the United States, Finland, Zaire, and Kenya. MAC was isolated from all geographic areas and from 22 of 91 (24%) samples. Isolation rates were 13 of 47 (28%) for environmental samples and 9 of 44 (20%) for water supply samples. Overall isolation rates were 18 of 52 (35%) samples in the United States and Finland, whereas they were 4 of 39 (10%) samples in Zaire and Kenya (P = 0.015). MAC isolation rates from water supply systems were 8 of 25 (32%) samples in the United States and Finland and 1 of 19 (5%) samples in Zaire and Kenya (P = 0.056). MAC was isolated from hospital water in the United States and Finland but not in hospital water in Zaire and Kenya. Serovar determinations showed that six of eight isolates from the United States were serovar 4 or 8. One MAC isolate from Zaire was identified as an "X" mycobacterium. These data suggest that exposure to MAC in water is likely in diverse areas of the world, but that the likelihood of human exposure to the organism in water may be slightly less in sub-Saharan Africa than in developed countries in the Northern Hemisphere.

AIDS-Related Opportunistic Infections↗
PubMed1994

Fallout from Chernobyl and incidence of childhood leukaemia in Finland, 1976-92.

OBJECTIVE: To assess effects of fallout from Chernobyl on incidence of childhood leukaemia in Finland. DESIGN: Nationwide cohort study. External exposure measured for 455 Finnish municipalities with instruments driven 19,000 km throughout the country. Values specific to municipalities corrected for shielding due to houses and fallout from A bomb testing. Internal exposure estimated from whole body measurements on a random sample of 81 children. Mean effective dose for two years after incident calculated from these measurements. Data on childhood leukaemia obtained from Finnish cancer registry and verified through hospitals treating childhood cancers. SETTING: Finland, one of the countries most heavily contaminated by the Chernobyl accident; the population was divided into fifths by exposure. SUBJECTS: Children aged 0-14 years in 1976-92. MAIN OUTCOME MEASURES: Standardised incidence ratio of childhood leukaemia and relative excess risk of childhood leukaemia per mSv. From incidence data of Finnish cancer registry for 1976-85, expected numbers specific to sex and age group (0-4, 5-9, and 10-14 years) were calculated for each municipality for three periods (1976-85, 1986-8, and 1989-92) and pooled as exposure fifths. Dose response was estimated as regression slope of standardised incidence ratios on mean doses for fifths for each period. RESULTS: Population weighted mean effective doses for first two years after the accident were 410 microSv for the whole country and 970 microSv for the population fifth with the highest dose. In all Finland the incidence of childhood leukaemia did not increase 1976-92. The relative excess risk 1989-92 was not significantly different from zero (7% per mSv; 95% confidence interval -27% to 41%). CONCLUSIONS: An important increase in childhood leukaemia can be excluded. Any effect is smaller than eight extra cases per million children per year in Finland. The results are consistent with the magnitude of effect expected.

Accidents↗
PubMed1996

Socioeconomic differences in mortality among diabetic people in Finland: five year follow up.

OBJECTIVE: To compare socioeconomic differences in mortality (by cause of death) among diabetic people with those in the rest of the population. DESIGN: Five year follow up of mortality in the population of Finland, comparing people with diabetes and those without diabetes. SETTING: Finland. SUBJECTS: All residents of Finland aged 30 to 74 included in the 1980 census. Subjects were classified as diabetic (230,000 person years) or other (12,400,000 person years) according to whether they were exempted from charges for medication for diabetes. During 1981-5 there were 114,058 deaths, of which 11,215 were in people with diabetes. MAIN OUTCOME MEASURES: Age standardised mortality by sex, social class, and cause of death for the diabetic and non-diabetic populations. RESULTS: No significant social class differences in mortality were found among women with diabetes. Among diabetic men there was a slight increasing trend in mortality from the upper while collar group to the unskilled blue collar workers but it was much less steep than that of non-diabetic men. CONCLUSIONS: Among people with diabetes in Finland the quality of treatment and compliance with treatment probably do not vary by socioeconomic status. Health education for diabetic people seems to be effective in all socioeconomic strata; in people from the lower strata this leads to greater changes because their health behavior was originally less good.

Adult↗
PubMed1980

Cervical cancer in Finland and South Wales: implications of end results data on the natural history.

The population-based cancer registry data on patients with cervical cancer in Finland and South Wales in 1960--69 were analysed for survival. Patients with carcinoma-in-situ experienced essentially the normal life expectancy. Those with invasive carcinoma experienced 75% of normal post-registration life expectancy in Finland but only 45% in South Wales. The difference was due to higher frequency and to better survival of patients with localised carcinoma in Finland, which was attributed to the fact that in Wales the mean age of the population is higher than that in Finland, and also to the longer delya in Wales from first symptoms to diagnosis among women with localised cancer. The differences in mean age by clinical stage and in survival combined with the duration of symptoms support the hypothesis that speed of tumour growth is a major determinant of clinical stage at diagnosis.

Adult↗
PubMed1990

Geographical variation in cancer patient survival in Finland: chance, confounding, or effect of treatment?

STUDY OBJECTIVE: The aim was to determine whether survival of cancer patients in Finland varies with their place of residence, and if so, what proportion of the variation might be due to health services rather than to confounding variables. DESIGN: Patients with breast and prostatic cancer diagnosed in Finland between 1970 and 1981 were classified by place of residence (from 21 hospital districts), and area specific 5 year relative survival rates were estimated. SETTING: This was a population based survey of the whole of Finland. PATIENTS: 16,754 cases of breast cancer and 9483 cases of prostatic cancer were identified. Of these, 0.5% of breast cancers and 4.1% of prostatic cancers were excluded because diagnosis was based only on necropsy findings or because the only information available was from the death certificate. MEASUREMENTS AND MAIN RESULTS: There was a large variation in rates, ranging from 59% to 76% for breast cancer, and from 30% to 65% for prostatic cancer. However, after accounting for age of patient and extent of disease, the standardised differences for prostatic cancer closely followed random distribution, indicating equal results of treatment in different areas. For breast cancer there was more variation than expected by chance and patients resident in any of the university central hospital districts with modern radiotherapy equipment survived better than other patients. CONCLUSIONS: There is little indication that large variations in crude mortality rates from these two cancers in different parts of Finland are due to inequalities of medical care, though a small effect on breast cancer survival which might be care related was shown.

Aged↗
PubMed2002

Liberal fortification of foods: the risks. A study relating to Finland.

STUDY OBJECTIVE: The free circulation of goods in the European Union (EU) has increased the number of fortified foods available to consumers in Finland. Fortification of foodstuffs with calcium is currently widespread. To assist decision making relating to fortification, the object of this study was to determine whether there might be a risk of excessive levels of calcium. The study was done using the dietary data of adult population by sex and calcium intake deciles, taking account of intakes of calcium from normal diets and from fortified foods. STUDY DESIGN: Calcium intakes for deciles were calculated from dietary data of the population involved in the 1992 FINDIET survey. Calcium fortification was evaluated by considering foodstuffs to which calcium has already been added or which producers might wish to fortify and market in Finland. Situations in which a fortified product replaced its unfortified equivalent were envisaged. Daily calcium intakes (mg) from particular foodstuffs were calculated based on known amounts of calcium (mg) per 100 g of each foodstuff and amounts of each product consumed per day. Total calcium intakes of people in different deciles were calculated by adding amounts of calcium contributed by each fortified product to normal dietary intakes. Calcium intakes were also calculated for consumption by persons of all foodstuffs that are or intended to be fortified with calcium. STUDY PARTICIPANTS: Adults aged 25 to 64 representing populations in four regions of Finland, who recorded food consumption over three day periods in spring 1992. STUDY SETTING: North Karelia, Kuopio Province, Turku-Loimaa, and the capital area Helsinki-Vantaa, Finland. MAIN STUDY RESULTS: The results indicate that the highest 10% of Finnish adult men receive on average 2315 mg calcium per day from diets that do not include fortified foodstuffs. These people whose energy consumption was high consumed substantial amounts of dairy products. Consumption of fortified foods would increase the calcium intake further to levels exceeding the tolerable upper intake level (2500 mg/d). CONCLUSIONS: Liberal addition of calcium to various groups of foodstuffs could increase the calcium intake in the highest decile to levels with potentially untoward health effects. In assessing benefits and possible disadvantages of fortification of foodstuffs, the dietary habits of the population concerned, probable consumption of fortified products and nutritional intakes, especially at extremes, need to be taken into account, by total risk assessment.

Adult↗
PubMedDate not supplied

Differences in the location and multiplicity of mandibular fractures in Kuwait, Canada and Finland during the 1990s.

OBJECTIVE: To compare the location and multiplicity of mandibular fractures in Kuwait, Canada and Finland during the 1990s. SUBJECTS AND METHODS: Data were collected from several hospitals in Kuwait (1991-2000), Toronto General Hospital in Canada (1995-2000) and Oulu University Hospital in Finland (1990-1999). The data were analyzed statistically using chi-square test, ANOVA, t test and logistic regression. RESULTS: Condylar fractures were more common in Finnish patients (41%) than Canadian (35%) or Kuwaiti patients (21%). Condylar fractures caused by falls were about 3.4 times more common in Kuwait and Finland compared to Canada. In Finland the risk of road traffic accidents caused by condylar fracture was about 4 times higher than those caused by other etiologies. In Canada male gender was about 2 times higher for the condylar fracture than female gender. Female patients often had more multiple injuries than men in all three countries and multiple fractures were observed especially in traumas caused by falling. CONCLUSION: Differences in location and multiplicity of mandibular fractures are due to differences in etiologies and demographic patterns.

Accidental Falls↗
PubMed1985

Trends in coronary heart disease mortality and morbidity and related factors in Finland.

A marked increase in the coronary heart disease (CHD) mortality of working-age men and women occurred in Finland from the 1950s until the 1960s. Around the year 1970, CHD mortality started to decline and this decline still continues. In the age group 35-64 years the average annual decline of CHD mortality in the 1970s was 1.8% for men and 3.4% for women. Limited data available on trends in CHD morbidity show that the decline in CHD mortality is accompanied by a decline in the incidence of non-fatal myocardial infarction. CHD mortality and incidence are higher in east Finland than in west Finland and this east-west difference has so far persisted during the declining trend. The decline in CHD mortality and incidence in the 1970s has been preceded and paralleled by changes into favourable direction in dietary fat consumption and population mean levels for serum cholesterol, prevalence of smoking among adult Finnish men, control of hypertension by antihypertensive drug therapy, and management of patients with symptomatic CHD. Both the changes in life-styles and CHD risk factor levels, as well as changes in the management of patients with CHD, appear to have been contributing to the decline in CHD mortality and incidence in Finland.

Adrenergic beta-Antagonists↗
PubMed1984

Fish tapeworm, a disappearing health problem in Finland.

The occurrence of the tapeworm (Diphyllobothrium latum) in eastern Finland in 1975-81 was studied and findings were compared with previous results. The fish tapeworm has previously been shown to be a common health problem, especially in these parts of Finland. The prevalence rates of fish tapeworm eggs in large consecutive routine series of hospital laboratories have decreased to a level of 1-4% among the population. The results also indicate some possible differences in the rates and trends between different provinces in eastern Finland. The reasons for the occurrence and changing trends of the fish tapeworm in eastern Finland are discussed.

Diphyllobothriasis↗