| 1. |
- Pesonen, Erkki, et al.
(författare)
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Elevated infection parameters and infection symptoms predict an acute coronary event.
- 2008
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Ingår i: Therapeutic Advances in Cardiovascular Disease. - : SAGE Publications. - 1753-9447 .- 1753-9455. ; 2:6, s. 419-424
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The etiology and significance of flu-like symptoms often appearing before myocardial infarction should be clarified. METHODS: In a case-control study of 323 matched controls and a random sample of 110 out of 351 cases the presence of infection symptoms during the preceding four weeks before admission were asked and blood samples taken. RESULTS: Enterovirus (EV), herpes simplex virus (HSV), and Chlamydia pneumoniae IgA titers were significantly higher in cases than in controls (p<0.001, 0.008 and 0.046, respectively). Flu-like symptoms appeared significantly more often in patients than in controls the most common one being fatigue (p<0.001). In controls with fatigue, EV and HSV titers showed a trend to be higher (1.50 vs 1.45 and 4.29 vs 3.73) than in controls without fatigue but only HSV titers were statistically significantly higher (3.47 vs 3.96, p = 0.02). Even CRP and amyloid A concentrations (3.49 vs 2.08, p<0.0001 and 5.70 vs 3.77 mg/l, p = 0.003, respectively) as well as C4 (0.40 vs 0.44, p = 0.02) were higher in controls with fatigue. CONCLUSIONS: Odds ratios for a coronary event in a logistic regression model were 4.79 for fatigue and 2.72 for EV antibody levels in their fourth quartile. A linear-by-linear association test showed increasing number of single symptoms with higher EV titer quartiles (p = 0.004).
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| 2. |
- Pesonen, Erkki, et al.
(författare)
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Mannose-binding lectin as a risk factor for acute coronary syndromes.
- 2009
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 1365-2060 .- 0785-3890. ; 41, s. 591-598
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Tidskriftsartikel (refereegranskat)abstract
- Background. Mannose-binding lectin (MBL) is a multifunctional protein involved in innate immunity. We tested whether MBL and elevated viral and bacterial antibodies were risk factors for acute coronary events. Design. Controlled cohort study. Methods. A total of 354 patients with unstable angina pectoris (UA) or acute myocardial infarction (AMI) were compared with 334 paired controls. Results. Enterovirus titres were associated with increased risk of UA (odds ratio 10.04, P<0.001) and AMI (odds ratio 3.18, P=0.003), but titres did not correlate with either MBL concentration or genotype. Chlamydia pneumoniae heat shock protein 60 IgG concentrations were also associated with increased risk of UA (odds ratio 1.63, P=0.049). Compared to asymptomatic controls, patients had lower complement C3 serum concentrations (P<0.001), higher MBL serum concentration, and more frequently had MBL genotypes that determined high MBL levels (P<0.001). High MBL genotypes had odds ratios of 1.16 (P=0.010) for UA and 1.12 (P=0.007) for AMI. The elevation of MBL concentrations in the acute phase correlated with MBL concentrations after recovery (r=0.85, P<0.001). Conclusions. Elevated microbial titres, indicating an on-going inflammation, were associated with cardiovascular events. MBL might have a dual role both decreasing susceptibility to infections and increasing the risk of acute coronary syndromes.
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| 3. |
- Ruotsalainen, Tarja M., et al.
(författare)
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Concomitant chemotherapy and IFN-alpha for small cell lung cancer : a randomized multicenter phase III study
- 1999
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Ingår i: Journal of Interferon and Cytokine Research. - : Mary Ann Liebert Inc. - 1079-9907 .- 1557-7465. ; 19:3, s. 253-9
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 4. |
- Albrecht, Eva, et al.
(författare)
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Telomere length in circulating leukocytes is associated with lung function and disease
- 2014
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 43:4, s. 983-992
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Tidskriftsartikel (refereegranskat)abstract
- Several clinical studies suggest the involvement of premature ageing processes in chronic obstructive pulmonary disease (COPD). Using an epidemiological approach, we studied whether accelerated ageing indicated by telomere length, a marker of biological age, is associated with COPD and asthma, and whether intrinsic age-related processes contribute to the interindividual variability of lung function. Our meta-analysis of 14 studies included 934 COPD cases with 15 846 controls defined according to the Global Lungs Initiative (GLI) criteria (or 1189 COPD cases according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria), 2834 asthma cases with 28 195 controls, and spirometric parameters (forced expiratory volume in is (FEV1), forced vital capacity (PVC) and FEV1/FVC) of 12 595 individuals. Associations with telomere length were tested by linear regression, adjusting for age, sex and smoking status. We observed negative associations between telomere length and asthma (beta= -0.0452, p= 0.024) as well as COPD (beta= -0.0982, p=0.001), with associations being stronger and more significant when using GLI criteria than those of GOLD. In both diseases, effects were stronger in females than males. The investigation of spirometric indices showed positive associations between telomere length and FEV1 (p=1.07 x 10(-7)), FVC (p=2.07 x 10(-5)), and FEV1/FVC (p =5.27 x 10(-3)). The effect was somewhat weaker in apparently healthy subjects than in COPD or asthma patients. Our results provide indirect evidence for the hypothesis that cellular senescence may contribute to the pathogenesis of COPD and asthma, and that lung function may reflect biological ageing primarily due to intrinsic processes, which are likely to be aggravated in lung diseases.
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| 5. |
- Feodoroff, Benjamin, et al.
(författare)
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Campylobacter jejuni isolates in Finnish patients differ according to the origin of infection
- 2010
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Ingår i: Gut Pathogens. - : Springer Science and Business Media LLC. - 1757-4749. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Campylobacter jejuni is a significant cause of bacterial enteritis worldwide. Very little is known about the pathogenicity mechanisms and virulence factors of this important enteropathogen. C. jejuni isolates from 166 Finnish patients, collected from July to December in 2006, were studied for the presence of putative virulence factors and susceptibility to antimicrobials. Isolates were tested for production of gamma-glutamyltransferase (GGT) as well as the presence of genes ceuE, cgtB, ciaB, cj0486, pldA, virB11, wlaN, and the gene cluster cdtABC. Bacterial characteristics were compared to information on foreign travel history as well as information on the course and the symptoms of disease obtained from questionnaires returned by patients. RESULTS: Except for one domestic isolate, antimicrobial resistance was only detected in isolates of foreign origin. Univariate analyses showed association between bloody stools and both GGT production (p=0.025) and the presence of cgtB (p=0.034). Multivariate analysis verified that GGT production was more prevalent in domestic isolates (p<0.0001), while the genes cj0486 (p<0.0001) and ceuE (p<0.0001) were associated with C. jejuni isolates of foreign origin. CONCLUSIONS: The results indicate that imported and domestic C. jejuni isolates differ significantly in several aspects from each other.
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| 6. |
- Feodoroff, Benjamin, et al.
(författare)
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Clonal Distribution and Virulence of Campylobacter jejuni Isolates in Blood
- 2013
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 19:10, s. 1653-1655
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Tidskriftsartikel (refereegranskat)abstract
- Campylobacter jejuni bacteria are highly diverse enteropathogens. Seventy-three C. jejuni isolates from blood collected in Finland were analyzed by multilocus sequence typing and serum resistance. Approximately half of the isolates belonged to the otherwise uncommon sequence type 677 clonal complex. Isolates of this clonal complex were more resistant than other isolates to human serum.
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| 7. |
- Juusela, Maria, et al.
(författare)
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Bronchial hyperresponsiveness in an adult population in Helsinki: decreased FEV(1) , the main determinant.
- 2013
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Ingår i: The clinical respiratory journal. - 1752-699X. ; 7:1, s. 34-44
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Bronchial hyperresponsiveness (BHR) elevates the risk for development of respiratory symptoms and accelerates the decline in forced expiratory volume in the first second (FEV(1) ). We thus aimed to assess the prevalence, determinants and quantity of BHR in Helsinki. Objectives: This study involved 292 randomly selected subjects age 26-66 years, women comprising 58%. Methods: Following a structured interview, a spirometry, a bronchodilation test, and a skin-prick test, we assessed a bronchial challenge test with inhaled histamine using a dosimetric tidal breathing method. Results included the provocative dose inducing a decrease in FEV(1) by 15% (PD(15) FEV(1) ) and the dose-response slope. For statistical risk factor-analyses, the severity of BHR was considered; PD(15) values ≤1.6 mg (BHR) and ≤0.4 mg [moderate or severe BHR (BHR(ms) )] served as cut-off levels. Results: BHR presented in 21.2% and BHR(ms) in 6.2% of the subjects. FEV(1) < 80% of predicted [odds ratio (OR) 4.09], airway obstruction (FEV(1) /forced vital capacity < 88% of predicted) (OR 4.33) and history of respiratory infection at age <5 (OR 2.65) yielded an increased risk for BHR as ORs in multivariate analysis. For BHR(ms) , the determinants were decreased FEV(1) below 80% of predicted (OR 27.18) and airway obstruction (OR 6.16). Respiratory symptoms and asthma medication showed a significant association with BHR. Conclusions: Of the adult population of Helsinki, 21% showed BHR to inhaled histamine. The main determinants were decreased FEV(1) and airway obstruction. Quantitative assessment of BHR by different cut-off levels provides a tool for characterization of phenotypes of airway disorders in epidemiologic and clinical studies. Please cite this paper as: Juusela M, Pallasaho P, Sarna S, Piirilä P, Lundbäck B and Sovijärvi A. Bronchial hyperresponsiveness in an adult population in Helsinki: decreased FEV(1) , the main determinant. Clin Respir J 2012; DOI:10.1111/j.1752-699X.2011.00279.x.
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| 8. |
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| 9. |
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| 10. |
- Kainu, Annette, et al.
(författare)
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Responses of FEV6, FVC, and FET to inhaled bronchodilator in the adult general population.
- 2009
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Ingår i: Respiratory research. - : Springer Science and Business Media LLC. - 1465-993X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The assessment of bronchodilator-induced change in forced vital capacity (FVC) is dependent on forced expiratory time (FET) in subjects with airflow limitation. Limited information is available on the concurrent responses of FVC, forced expiratory volume in six seconds (FEV6), and FET in the bronchodilation test among patients with obstructive airways disease or in the general population. The aim of this study was to assess the changes in FEV6, FVC, and FET, and their relationships in a standardized bronchodilation test in the general population. METHODS: We studied bronchodilation response in a general adult population sample of 628 individuals (260 men, 368 women) with flow-volume spirometry. The largest FVC, the corresponding FET and the largest FEV6 both at the baseline and after 0.4 mg of inhaled salbutamol were selected for analysis. RESULTS: After administration of salbutamol FEV6 decreased on average -13.4 (95% CI -22.3 to -4.5) ml or -0.2% (-0.4% to 0.0%) from the baseline. The 95th percentile of change in FEV6 was 169.1 ml and 5.0%. FVC decreased on average -42.8 (-52.4 to -33.3) ml or -1.0% (-1.2% to -0.7%). Concurrently FET changed on average -0.2 (-0.4 to 0.0) seconds or 0.4% (-1.4% to 2.3%). There were four subjects with an increase of FVC over 12% and only one of these was associated with prolonged FET after salbutamol. Changes in FEV6 and FVC were more frequently positive in subjects with reduced FEV1/FVC in baseline spirometry. CONCLUSION: In general adult population, both FEV6 and FVC tended to decrease, but FET remained almost unchanged, in the bronchodilation test. However, those subjects with signs of airflow limitation at the baseline showed frequently some increase of FEV6 and FVC in the bronchodilation test without change in FET. We suggest that FEV6 could be used in assessment of bronchodilation response in lieu of FVC removing the need for regulation of FET during bronchodilation testing.
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