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Roos E, Heikkinen S, Seppä K, Pietiläinen O, Ryynänen H, Laaksonen M, Roos T, Knekt P, Männistö S, Härkänen T, Jousilahti P, Koskinen S, Eriksson JG, Malila N, Rahkonen O, Pitkäniemi J. Pairwise association of key lifestyle factors and risk of solid cancers - A prospective pooled multi-cohort register study. Prev Med Rep 2024; 38:102607. [PMID: 38298822 PMCID: PMC10828451 DOI: 10.1016/j.pmedr.2024.102607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Smoking, alcohol consumption, obesity, and physical inactivity are key lifestyle risk factors for cancer. Previously these have been mostly examined singly or combined as an index, assuming independent and equivalent effects to cancer risk. The aim of our study was to systematically examine the joint pairwise and interactive effects of these lifestyle factors on the risk of a first solid primary cancer in a multi-cohort prospective setting. We used pooled data from seven Finnish health survey studies during 1972-2015, with 197,551 participants diagnosed with 16,373 solid malignant primary tumors during follow-up. Incidence of any cancer was analyzed separately without and with lung cancers using Poisson regression with main and interaction effects of key lifestyle factors. When excluding lung cancer, the highest risk of any cancer in men was observed for smokers with a BMI of ≥25 kg/m2 (HR 1.36, 95 % CI 1.25-1.48) and in women for smokers consuming alcohol (HR 1.22, 1.14-1.30). No statistically significant interactions between any studied risk factor pairs were observed. When including lung cancer, the highest HRs among men were observed for smokers who consume alcohol (HR 1.72, 1.57-1.89) and among women for smokers who were physically inactive (HR 1.38, 1.27-1.49). Smoking combined with other lifestyle factors at any exposure level resulted in highest pairwise risks, both in men and women. These results highlight the importance of smoking prevention, but also the importance of preventing obesity and reducing alcohol consumption.
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Affiliation(s)
- Eira Roos
- Department of Public Health, University of Helsinki, Finland
| | - Sanna Heikkinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Karri Seppä
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | | | - Heidi Ryynänen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Maarit Laaksonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- School of Mathematics and Statistics, University of New South Wales, Sydney, Australia
| | - Teemu Roos
- Department of Computer Science, University of Helsinki, Finland
| | - Paul Knekt
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Johan G. Eriksson
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
| | - Janne Pitkäniemi
- Department of Public Health, University of Helsinki, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Finland
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Seppä K, Heikkinen S, Ryynänen H, Albanes D, Eriksson JG, Härkänen T, Jousilahti P, Knekt P, Koskinen S, Männistö S, Rahkonen O, Rissanen H, Malila N, Laaksonen M, Pitkäniemi J. Every tenth malignant solid tumor attributed to overweight and alcohol consumption: A population-based cohort study. Eur J Cancer 2024; 198:113502. [PMID: 38181631 DOI: 10.1016/j.ejca.2023.113502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Recent studies have shown that some four in ten cancers are attributable to a few key risk factors. The aim of this study was to estimate cohort-based population attributable fractions (PAFs) in Finland for potentially modifiable cancer risk factors. METHODS Data from eight health studies including 253,953 subjects with 29,802 incident malignant solid tumors were analysed using Bayesian multivariate regression model with multiplicative risk factor effects. We estimated the effects of smoking, excess body weight, alcohol consumption, physical activity, parity and education on cancer incidence and related PAFs by cancer site, accounting for competing mortality. RESULTS PAF for all cancer sites and exposures combined was 34% (95% credible interval 29%-39%) in men and 24% (19%-28%) in women. In men, 23% (21%-27%) and in women 8% (6%-9%) of all cancers were attributed to smoking. PAF related to excess body weight was 4% (2%-6%) in men and 5% (2%-7%) in women, to alcohol 7% (3%-10%) in men and 4% (0%-7%) in women, and to excess body weight and alcohol combined 10% (6%-15%) in men and 9% (4%-13%) in women. CONCLUSION Smoking was the most important factor contributing to cancer burden in Finnish men and women over the last 40 years. The contribution of excess body weight and alcohol consumption together outweighed the role of smoking in women. As the prevalence of overweight is expected to increase, more efficient public health measures supporting adherence to healthy weight are essential to reduce cancer burden.
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Affiliation(s)
- Karri Seppä
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
| | - Sanna Heikkinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Heidi Ryynänen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Johan G Eriksson
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tommi Härkänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Paul Knekt
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
| | - Harri Rissanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Maarit Laaksonen
- School of Mathematics and Statistics, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland; Department of Public Health, University of Helsinki, Finland; Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Finland
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Tolonen S, Juonala M, Fogelholm M, Pahkala K, Laaksonen M, Kähönen M, Sievänen H, Viikari J, Raitakari O. Dietary Saturated Fat and Bone Health in Young Adults: The Young Finns Cohort. Calcif Tissue Int 2022; 111:419-429. [PMID: 35896727 PMCID: PMC9474366 DOI: 10.1007/s00223-022-01008-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/06/2022] [Indexed: 11/15/2022]
Abstract
Previous studies suggest that saturated fat (SFA) intake may negatively impact on bone. However, few human studies on the topic exist. Women and men aged 31-46 years from the Cardiovascular Risk in Young Finns study attended the peripheral quantitative computed tomography and ultrasound bone measurements in 2008 (n = 1884-1953, ~ 56% women). In addition, fracture diagnoses in 1980-2018 were searched for the national health care registers and 431 participants had at least one fracture. Food consumption was gathered with the 48-h dietary recall interviews and food frequency questionnaire in 1980-2007. In the present study, radial, tibial, and calcaneal bone traits, and fractures were examined relative to the long-term intake of SFA. No consistent associations were seen between bone outcomes and SFA intake that would have replicated in both women and men. The only evidence for differential distributions was seen in cortical density and cortical-to-total area ratio at the radial shaft, and speed of sound at the calcaneus, which were 0.1-0.4% higher in women in the lowest tertile of SFA intake compared with the highest tertile. In addition, among men, the odds ratio (OR) of fractures was greater in the second (OR 1.86, 95% confidence interval (CI) 1.03-3.33) and third tertile of SFA intake (OR 2.45, 95% CI 1.38-4.36) compared with the lowest tertile, independently of many risk factors of osteoporosis. In this observational study, we found no robust evidence of the associations of dietary long-term SFA intake with bone outcomes. Therefore, additional studies are needed to confirm the association of dietary SFA with bone health in humans.
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Affiliation(s)
- S Tolonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - M Juonala
- Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - M Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - K Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - M Laaksonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - M Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - H Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - J Viikari
- Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - O Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Roos E, Seppä K, Pietiläinen O, Ryynänen H, Heikkinen S, Eriksson JG, Härkänen T, Jousilahti P, Knekt P, Koskinen S, Laaksonen M, Männistö S, Roos T, Rahkonen O, Malila N, Pitkäniemi J. Pairwise association of key lifestyle factors and risk of colorectal cancer: a prospective pooled multicohort study. Cancer Rep (Hoboken) 2022; 5:e1612. [PMID: 35243812 PMCID: PMC9675367 DOI: 10.1002/cnr2.1612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/03/2021] [Accepted: 02/16/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Several lifestyle factors are associated with an increased risk of colorectal cancer (CRC). Although lifestyle factors co-occur, in most previous studies these factors have been studied focusing upon a single risk factor or assuming independent effects between risk factors. AIM To examine the pairwise effects and interactions of smoking, alcohol consumption, physical inactivity, and body mass index (BMI) with risk of subsequent colorectal cancer (CRC). METHODS AND RESULTS We used METCA cohort data (pooled data from seven population-based Finnish health behavior survey studies during years 1972-2015) consisting of 171 063 women and men. Participants' smoking, alcohol consumption, physical inactivity and BMI measures were gathered, and participants were categorized into those exposed and those not exposed. The incidence of CRC was modeled by Poisson regression with main and interaction effects of key lifestyle factors. The cohort members were followed-up through register linkage to the Finnish Cancer Registry for first primary CRC case until the end of 2015. Follow-up time was 1715, 690 person years. The highest pairwise CRC risk was among male smokers who had overweight (BMI ≥ 25 kg/m2 ) (HR 1.75, 95% CI 1.36-2.26) and women who had overweight and consumed alcohol (HR 1.45, 95% CI 1.14-1.85). Overall, among men the association of lifestyle factors and CRC risk was stronger than among women. In men, both having overweight and being a smoker combined with any other adverse lifestyle factor increased CRC risk. Among women, elevated CRC risks were observed for those who were physically inactive and who consumed alcohol or had overweight. No statistically significant interactions were detected between pairs of lifestyle factors. CONCLUSIONS This study strengthens the evidence of overweight, smoking, and alcohol consumption as CRC risk factors. Substantial protective benefits in CRC risk can be achieved by preventing smoking, maintaining BMI to <25 kg/m2 and not consuming alcohol.
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Affiliation(s)
- Eira Roos
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Karri Seppä
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
| | - Olli Pietiläinen
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Heidi Ryynänen
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
| | - Sanna Heikkinen
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
| | | | - Tommi Härkänen
- The Finnish Institute for Health and Welfare (THL)HelsinkiFinland
| | - Pekka Jousilahti
- The Finnish Institute for Health and Welfare (THL)HelsinkiFinland
| | - Paul Knekt
- The Finnish Institute for Health and Welfare (THL)HelsinkiFinland
| | - Seppo Koskinen
- The Finnish Institute for Health and Welfare (THL)HelsinkiFinland
| | - Maarit Laaksonen
- The Finnish Institute for Health and Welfare (THL)HelsinkiFinland,School of Mathematics and StatisticsUniversity of New South WalesSydneyAustralia
| | - Satu Männistö
- The Finnish Institute for Health and Welfare (THL)HelsinkiFinland
| | - Teemu Roos
- Department of Computer ScienceUniversity of HelsinkiHelsinkiFinland
| | - Ossi Rahkonen
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Nea Malila
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
| | - Janne Pitkäniemi
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland,School of Health SciencesUniversity of TampereTampereFinland
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Abstract
BACKGROUND Seafarers are exposed to many occupational risk factors. AIMS To study whether there are differences in mortality between seafarers and other employees, whether there are variations in seafarers' mortality between different seafaring occupations and whether these differences can be explained by sociodemographic factors. METHODS A register-based study of all seafarers aged 25-64 years, resident in Finland in 2000 with minimum 5 years of cumulative seafaring experience on Finnish vessels and other employees, followed for mortality 2001-13. Analysis methods included age standardized death rates, mortality ratios (SMR) and Cox proportional hazard model. RESULTS During the follow-up period 2001-13, there were 81,035 person years and 382 deaths in the cohort of seafarers. Seafarers had 1.3 times higher risk of death (men SMR 132, 95% confidence intervals [CI] 118-147, women SMR 125, 95% CI 99-157) than other employees. Mortality was especially high in alcohol-related causes (men SMR 172, 95% CI 126-233, women SMR 262, 95% CI 131-525) and causes related to smoking. Controlling for sociodemographic characters strengthened the risk compared to other occupations. Mortality was high among male deck and engine crew and among male and female galley personnel. The mortality differences between different seafaring occupations were partly explained by adjustments of sociodemographic characters. CONCLUSIONS Seafarers still have increased mortality among men after adjustment of sociodemographic characters. Results by causes of death suggest that changing practices to enable healthy behaviour are important.
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Affiliation(s)
- H Rinne
- Rehabilitation Foundation, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Kirjurinkatu, Helsinki, Finland
| | - V Notkola
- Rehabilitation Foundation, Helsinki, Finland
| | - R Shemeikka
- Rehabilitation Foundation, Helsinki, Finland
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Pirkola S, Nevalainen J, Laaksonen M, Fröjd S, Nurmela K, Näppilä T, Tuulio-Henriksson A, Autio R, Blomgren J. The importance of clinical and labour market histories in psychiatric disability retirement: analysis of the comprehensive Finnish national-level RETIRE data. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1011-1020. [PMID: 31807792 PMCID: PMC7394924 DOI: 10.1007/s00127-019-01815-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/28/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Despite the stable incidence of mental disorders in Finland and Europe, mental health-related occupational disability has been increasing. We unveiled the paths to permanent psychiatric disability, recovery, or death, by analysing sequences of labour market participation. METHODS The RETIRE register database includes information regarding all persons (n = 42,170) awarded an ICD-10 psychiatric disability pension between 2010 and 2015 in Finland. We identified clusters of typical paths of pre-retirement labour market history. Controlling for major mental disorders, age, and sex, we evaluated factors associated with returning to work (RTW), or death, over a 5-year follow-up period. RESULTS Only 10.5% of the disabled subjects returned to work within the follow-up. Half of them ended up with a permanent disability pension. Seven distinguishable paths to disability were identified. Subjects in the cluster characterized by steady employment were relatively often females, lost their work ability due to affective disorders, and had the highest rate of returning to work (16.3%). Mortality was highest (9%) among the cluster characterized by long-term unemployment. Distributions of major diagnostic groups, as well as age and sex, differed between clusters. After their adjustment in the analysis of RTW or death, the identified labour market history paths prior to losing work ability remained as important independent prognostic factors for both outcomes. CONCLUSIONS The complex retirement process involves identifiable clinical and contextual associating factors. Labour market history patterns associate with varying prognoses after psychiatric retirement. Prolonged unemployment appears as a predictor of relatively poor prognoses, whereas employment indicates the opposite.
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Affiliation(s)
- S Pirkola
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland.
- Department of Psychiatry, Tampere University Central Hospital, Tampere, Finland.
| | - J Nevalainen
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - M Laaksonen
- The Finnish Centre for Pensions, Helsinki, Finland
| | - S Fröjd
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - K Nurmela
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - T Näppilä
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - A Tuulio-Henriksson
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R Autio
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
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Polvinen A, Laaksonen M. How often do partial disability pensioners end up on a full disability pension? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Extending working lives and deferring retirement have been important topics of discussion in recent years. Full disability pensioners seldom work, but most partial disability pensioners continuing working while receiving a pension. However, very little is known about how often partial disability pensioners end up on a full disability pension. The aims of this study were to investigate to what degree partial disability pensions become full disability pensions, and how age, gender, marital status, education, unemployment or a disability diagnosis are associated with that.
Methods
The register data included 2,969 Finns who were aged 18-59 years and whose partial disability retirement started in 2010. The follow-up period ranged from 2010 to the end of 2015. Cox models were used to estimate hazard ratios for full disability retirement.
Results
Approximately 40 per cent of the partial disability pensioners ended up on a full disability pension during the follow-up period. Partial disability pensioners who were older, had a lower educational level or a history of unemployment, or who suffered from mental disorders ended up on a full disability pension more often than others. The risk of full disability retirement was 1.5-fold among those with mental disorders compared to those with musculoskeletal diseases.
Conclusions
Partial disability pensioners with a low education, a history of unemployment or who suffer from mental disorders experience a higher risk of ending up on a full disability pension. More focus should be paid to improving education, preventing mental health problems and unemployment in order to help the disabled work longer.
Key messages
Preventing partial disability pensioners from ending up on a full disability pension can extend their working lives. Partial disability pensioners with a low education, a history of unemployment or poor mental health more often stop working altogether. More focus should be paid to improving these issues.
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Affiliation(s)
- A Polvinen
- The Finnish Centre for Pensions, Helsinki, Finland
| | - M Laaksonen
- The Finnish Centre for Pensions, Helsinki, Finland
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Perhoniemi R, Blomgren J, Laaksonen M, Tuulio-Henriksson A. Psychotropic drug purchases among Finnish disability pension applicants with mental disorders. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
Trajectories of psychotropic drug purchases around disability pension process have only been studies among awarded applicants. The aim was to follow and compare psychotropic drug purchases between awarded and rejected applicants before and after the application ruling, and to analyse whether such differences are affected by diagnostic group and sociodemographic background.
Methods
A representative 70% sample of Finnish adults applying disability pension due to mental or behavioral disorder in 2009-2011 (N = 18,087) were followed for four eight years in three-month periods. Registers of purchased psychotropic drugs measured in defined daily doses (DDDs), gender, age, occupational class, unemployment history, and diagnostic group were used. The DDD levels and trends were analysed using growth curve models.
Results
The average purchased DDDs of psychotropic drugs increased before the application ruling and decreased gradually thereafter among both awarded and rejected applicants. Before the application ruling the DDD level was higher for the rejected applicants. However, the increase in DDDs was steeper for awarded applicants. The inversed U-curve of purchase amount was most prominent awarded applicants in diagnostic groups of bipolar disorders, depression, anxiety disorders and schizophrenia. The results partly varied between sociodemographic groups.
Conclusions
The early high level of psychotropic drug purchases of rejected disability pension applicants signals long running ill-health, calling for earlier measures to uphold their functional ability. Respectively, for awarded applicants, the steep DDD increase before the ruling may reflect accurate identification of worsening condition but also access to precise treatment.
Key messages
Rejected disability pension applicants with mental disorders suffer from long-running mental ill-health, calling for earlier measures to uphold their mental health and prevent the pension process. Awarded disability pension applicants with mental disorders may have access to more precise treatment, but their worsening condition appear to be accurately identified by Finnish system.
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Affiliation(s)
- R Perhoniemi
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
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9
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Rinne H, Laaksonen M, Notkola V. High mortality in manual occupations and the role of alcohol in 2001-2015 in Finland. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High mortality is concentrated in low socioeconomic positions which may largely be explained by excessive use of alcohol. The aim was to identify specific manual occupations with high mortality and to examine whether there are differences in the role of alcohol in explaining the excess mortality among manual occupations with high all-cause mortality.
Methods
A register-based study of employees aged 30-64, followed for mortality 2001-2015. Age standardized mortality ratios (SMR) were calculated to compare the mortality rates of manual occupations. The contribution of alcohol related mortality to excess mortality was obtained by comparing the excess mortality in all deaths and deaths not related to alcohol.
Results
Men had 31 and women 11 manual occupations with SMR statistically significantly over 120 compared to all employees. Mortality rates were highest among building construction labourers (SMR 180, 95% CI 163-199) among men and building caretakers (SMR 155, 95% CI 135-179) among women. With few exceptions, high mortality was a combination of high alcohol-related and high non-alcohol-related mortality. Among men, the contribution of alcohol-related mortality to the excess all-cause mortality compared to all employees was over 10% in half of the high mortality occupations. Among women excluding the alcohol-related deaths had a minor effect on all-cause mortality.
Conclusions
Diminishing the alcohol-related mortality would level excess mortality of high mortality manual occupations but not eliminate it. Targeting the improvement of working conditions and occupational health care to certain occupations would diminish the mortality differences between occupations and social classes.
Key messages
To prevent the high mortality of manual occupations, improvements should be targeted to several different aspects of working conditions. Occupational health care of manual occupations with high mortality should be improved and provide with early interventions towards risky alcohol behaviour.
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Affiliation(s)
- H Rinne
- Rehabilitation Foundation, Finland, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
| | - V Notkola
- University of Eastern Finland, Kuopio, Finland
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Laaksonen M, Rantala J, Liukko J, Polvinen A, Varis J, Kesälä M, Kuivalainen S. Individual- and company level determinants of vocational rehabilitation: a multilevel study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Backround
Vocational rehabilitation (VR) is considered an important means to combat work ability problems and enable people to continue working despite health problems. We examined the magnitude of company level variation in VR and determined which individual- and company level characteristics are associated with access to VR due to mental disorders, musculoskeletal diseases, and other somatic diseases.
Methods
A 30% random sample of all Finnish private sector companies with more than 10 employees aged 25-62 years at the end of 2010 (5.567 companies with 300.601 employees) was followed up for incident VR for six years. Company size and industry, as well as gender, age, education, social class and sickness absence measured both at the individual- and company level, were used as explanatory variables in multilevel logit models.
Results
After controlling for the individual level covariates, companies accounted for 12% of the variance in VR. The proportion was largest in VR due to musculoskeletal diseases. VR was more common among women, older employees (except the very oldest age group), those with low education (particularly due to musculoskeletal diseases), low social class, and previous sickness absence. VR was more common in larger companies, and in construction and in health and social work, and less common in professional activities. VR was more common in companies with low proportion of highly educated employees and with higher sickness absence rates.
Conclusions
Company level variation in VR was substantial after controlling for individual level characteristics of the employees. The employer may have an important role in the prevention of work disability through vocational rehabilitation.
Key messages
Company level variation in vocational rehabilitation was substantial after controlling for individual level characteristics of the employees. The employer may have an important in the prevention of work disability through vocational rehabilitation.
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Affiliation(s)
- M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Rantala
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Liukko
- Finnish Centre for Pensions, Helsinki, Finland
| | - A Polvinen
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Varis
- Finnish Centre for Pensions, Helsinki, Finland
| | - M Kesälä
- Finnish Centre for Pensions, Helsinki, Finland
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11
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Laaksonen M, Blomgren J. Levels and trends in unemployment before disability retirement: a register-based case-control study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
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12
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Salonen L, Blomgren J, Laaksonen M. From sickness absence to disability retirement: Diagnostic and occupational class differences. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - J Blomgren
- Social Insurance Institution of Finland, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
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13
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Perhoniemi R, Blomgren J, Laaksonen M. Sources of subsistence after a rejected disability pension in Finland: a sequence analysis study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Perhoniemi
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
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14
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Leinonen T, Solovieva S, Husgafvel-Pursiainen K, Laaksonen M, Viikari-Juntura E. Work participation trajectories before and after vocational rehabilitation in Finland. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - S Solovieva
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
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15
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Blomgren J, Laaksonen M. Do changes in unemployment affect disability benefit rates? A municipality-level panel study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Blomgren
- The Social Insurance Institution of Finland (Kela), Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions (ETK), Helsinki, Finland
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16
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Laaksonen M, Rantala J, Järnefelt N, Kannisto J. Educational differences in years of working life lost due to disability retirement. Eur J Public Health 2017; 28:264-268. [DOI: 10.1093/eurpub/ckx221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Laaksonen
- Research Department, Finnish Centre for Pensions, Helsinki, Finland
| | - J Rantala
- Research Department, Finnish Centre for Pensions, Helsinki, Finland
| | - N Järnefelt
- Research Department, Finnish Centre for Pensions, Helsinki, Finland
| | - J Kannisto
- Research Department, Finnish Centre for Pensions, Helsinki, Finland
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17
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Laaksonen M, Liukko J, Rantala J, Polvinen A, Kesälä M, Varis J, Kuivalainen S. Workplace level differences in the risk of disability retirement. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Liukko
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Rantala
- Finnish Centre for Pensions, Helsinki, Finland
| | - A Polvinen
- Finnish Centre for Pensions, Helsinki, Finland
| | - M Kesälä
- Finnish Centre for Pensions, Helsinki, Finland
| | - J Varis
- Finnish Centre for Pensions, Helsinki, Finland
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18
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Blomgren J, Laaksonen M, Niemelä M, Salonen L. Sickness absence as a predictor of disability retirement in different occupational classes. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - M Laaksonen
- The Social Insurance Institution (ISS), Helsinki, Finland
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19
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Leinonen T, Viikari-Juntura E, Husgafvel-Pursiainen K, Virta L, Laaksonen M, Autti-Rämö I, Solovieva S. Labour market segregation and gender differences in sickness absence: trends in 2005–2013 in Finland. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | - L Virta
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
| | - I Autti-Rämö
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - S Solovieva
- Finnish Institute of Occupational Health, Helsinki, Finland
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20
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Perhoniemi R, Blomgren J, Laaksonen M. Sickness allowance, unemployment and rehabilitation after a rejected disability pension application. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Perhoniemi
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - M Laaksonen
- Finnish Centre for Pensions, Helsinki, Finland
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21
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Merikukka M, Ristikari T, Laaksonen M, Gissler M, Tuulio-Henriksson A. Parental risk factors related to circumstances of childhood for psychiatric disability pension. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw166.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Veskimäe K, Staff S, Grönholm A, Pesu M, Laaksonen M, Nykter M, Isola J, Mäenpää J. Assessment of PARP protein expression in epithelial ovarian cancer by ELISA pharmacodynamic assay and immunohistochemistry. Tumour Biol 2016; 37:11991-11999. [PMID: 27155850 DOI: 10.1007/s13277-016-5062-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 05/01/2016] [Indexed: 01/02/2023] Open
Abstract
Targeting Poly (ADP-ribose) polymerase 1 (PARP-1) involved in base excision repair (BER) has been shown to be a clinically effective treatment strategy in epithelial ovarian cancer (EOC) defective in homologous recombination (HR). The aim of this study was to evaluate fresh EOC tumor tissue in regard to PAR (Poly (ADP-ribose)) concentration as a surrogate marker for PARP activity and PARP protein expression in archival samples by immunohistochemistry (IHC). The prospective study cohort consisted of 57 fresh tumor samples derived from patients undergoing primary (n = 38) or interval debulking surgery (n = 19) for EOC and parallel archival paraffin-embedded tumor samples. PARP activity in fresh frozen tumor tissue was assessed by an enzymatic chemiluminescence assay and PARP protein expression in paraffin-embedded tumor tissue by IHC. No correlation was detected between PARP enzyme activity and PARP staining by IHC (p = 0.82). High PARP activity was associated with platinum sensitivity both in the entire study cohort (p = 0.022) and in the high-grade subgroup (p = 0.017). High PARP activity was also associated with improved progression-free survival (PFS) (32 vs 14 months, log-rank p = 0.009). However, PARP immunostaining pattern was not predictive of patient survival. In conclusion, we present a novel finding of high PARP activity associated with platinum sensitivity and improved PFS in EOC. There was no association between PARP IHC and pharmacodynamic assay, and the correlation of PARP IHC with clinico-pathological characteristics and patient survival was poor. Pharmacodynamic assay rather than IHC seems to reflect better biologically significant PARP.
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Affiliation(s)
- K Veskimäe
- Department of Gynecology and Obstetrics, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.
| | - S Staff
- Department of Gynecology and Obstetrics, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.,Laboratory of Cancer Biology, Institute of Biomedical Technology, BioMediTech, University of Tampere, Tampere, Finland
| | - A Grönholm
- Immunoregulation, Institute of Biosciences and Medical Technology, BioMediTech, University of Tampere, Tampere, Finland
| | - M Pesu
- Immunoregulation, Institute of Biosciences and Medical Technology, BioMediTech, University of Tampere, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - M Laaksonen
- Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland
| | - M Nykter
- Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland
| | - J Isola
- Laboratory of Cancer Biology, Institute of Biomedical Technology, BioMediTech, University of Tampere, Tampere, Finland
| | - J Mäenpää
- Department of Gynecology and Obstetrics, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.,School of Medicine, University of Tampere, Tampere, Finland
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23
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Laaksonen M, Rantala J, Järnefelt N, Kannisto J. The burden of disability retirement due to different diagnoses. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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24
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Tolonen S, Sievänen H, Mikkilä V, Telama R, Oikonen M, Laaksonen M, Viikari J, Kähönen M, Raitakari OT. Adolescence physical activity is associated with higher tibial pQCT bone values in adulthood after 28-years of follow-up--the Cardiovascular Risk in Young Finns Study. Bone 2015; 75:77-83. [PMID: 25697084 DOI: 10.1016/j.bone.2015.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 01/30/2015] [Accepted: 02/09/2015] [Indexed: 11/16/2022]
Abstract
High peak bone mass and strong bone phenotype are known to be partly explained by physical activity during growth but there are few prospective studies on this topic. In this 28-year follow-up of Cardiovascular Risk in Young Finns Study cohort, we assessed whether habitual childhood and adolescence physical activity or inactivity at the age of 3-18 years were associated with adult phenotype of weight-bearing tibia and the risk of low-energy fractures. Baseline physical activity and data on clinical, nutritional and lifestyle factors were assessed separately for females and males aged 3-6-years (N=395-421) and 9-18-years (N=923-965). At the age of 31-46-years, the prevalence of low-energy fractures was assessed with a questionnaire and several tibial traits were measured with pQCT (bone mineral content (BMC; mg), total and cortical cross-sectional areas (mm(2)), trabecular (for the distal site only) and cortical (for the shaft only) bone densities (mg/cm(3)), stress-strain index (SSI; mm(3), for the shaft only), bone strength index (BSI; mg(2)/cm(4), for the distal site only) and the cortical strength index (CSI, for the shaft only)). For the statistical analysis, each bone trait was categorized as below the cohort median or the median and above and the adjusted odds ratios (OR) were determined. In females, frequent physical activity at the age of 9-18-years was associated with higher adulthood values of BSI, total and cortical areas, BMC, CSI and SSI at the tibia independently of many health and lifestyle factors (ORs 0.33-0.53, P≤0.05; P-values for trend 0.002-0.05). Cortical density at the tibial shaft showed the opposite trend (P-value for trend 0.03). Similarly in males, frequent physical activity was associated with higher values of adult total and cortical areas and CSI at the tibia (ORs 0.48-0.53, P≤0.05; P-values for trend 0.01-0.02). However, there was no evidence that childhood or adolescence physical activity was associated with lower risk of low energy fractures during the follow-up. In conclusion, frequent habitual physical activity in adolescence seems to confer benefits on tibial bone size and geometry in adulthood.
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Affiliation(s)
- S Tolonen
- Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland; Vaasa Central Hospital, Vaasa, Finland.
| | - H Sievänen
- The UKK-institute for Health Promotion Research, Tampere, Finland
| | - V Mikkilä
- Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - R Telama
- LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | - M Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - M Laaksonen
- Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland
| | - J Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Finland
| | - M Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - O T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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25
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Polvinen A, Laaksonen M, Gould R, Lahelma E, Leinonen T, Martikainen P. Socioeconomic inequalities in cause-specific mortality after disability retirement due to different diseases. Scand J Public Health 2014; 43:159-68. [DOI: 10.1177/1403494814562597] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: Socioeconomic inequalities in both disability retirement and mortality are large. The aim of this study was to examine socioeconomic differences in cause-specific mortality after disability retirement due to different diseases. Methods: We used administrative register data from various sources linked together by Statistics Finland and included an 11% sample of the Finnish population between the years 1987 and 2007. The data also include an 80% oversample of the deceased during the follow-up. The study included men and women aged 30-64 years at baseline and those who turned 30 during the follow-up. We used Cox regression analysis to examine socioeconomic differences in mortality after disability retirement. Results: Socioeconomic differences in mortality after disability retirement were smaller than in the population in general. However, manual workers had a higher risk of mortality than upper non-manual employees after disability retirement due to mental disorders and cardiovascular diseases, and among men also diseases of the nervous system. After all-cause disability retirement, manual workers ran a higher risk of cardiovascular and alcohol-related death. However, among men who retired due to mental disorders or cardiovascular diseases, differences in social class were found for all causes of death examined. For women, an opposite socioeconomic gradient in mortality after disability retirement from neoplasms was found. Conclusions: The disability retirement process leads to smaller socioeconomic differences in mortality compared with those generally found in the population. This suggests that the disability retirement system is likely to accurately identify chronic health problems with regard to socioeconomic status.
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Affiliation(s)
| | | | - R. Gould
- Finnish Centre for Pensions, Finland
| | - E. Lahelma
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
| | - T. Leinonen
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
| | - P. Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
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26
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Siggberg L, Ala-Mello S, Linnankivi T, Avela K, Scheinin I, Kristiansson K, Lahermo P, Hietala M, Metsähonkala L, Kuusinen E, Laaksonen M, Saarela J, Knuutila S. Erratum to: High-resolution SNP array analysis of patients with developmental disorder and normal array CGH result. BMC Med Genet 2014; 15:124. [PMID: 25928284 PMCID: PMC4429685 DOI: 10.1186/s12881-014-0124-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Linda Siggberg
- Department of Pathology, Haartman Institute, University of Helsinki, and Laboratory of Helsinki and Uusimaa University Hospital, Helsinki, Finland.
| | - Sirpa Ala-Mello
- Rinnekoti Foundation, Rehabilitation Home for Children, Espoo, Finland.
| | - Tarja Linnankivi
- Department of Pediatric Neurology, Helsinki University Central Hospital, Helsinki, Finland.
| | - Kristiina Avela
- Department of Medical Genetics, Väestöliitto, The Family Federation of Finland, Helsinki, Finland.
| | - Ilari Scheinin
- Department of Pathology, Haartman Institute, University of Helsinki, and Laboratory of Helsinki and Uusimaa University Hospital, Helsinki, Finland. .,Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands. .,Institute for Molecular Medicine Finland FIMM, University Helsinki, Helsinki, Finland.
| | - Kati Kristiansson
- Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. .,Institute for Molecular Medicine Finland FIMM, University Helsinki, Helsinki, Finland.
| | - Päivi Lahermo
- Institute for Molecular Medicine Finland FIMM, University Helsinki, Helsinki, Finland.
| | - Marja Hietala
- Department of Clinical Genetics, Turku University Hospital and Department of Medical Biochemistry and Genetics, University of Turku, Turku, Finland.
| | - Liisa Metsähonkala
- Department of Pediatric Neurology, Helsinki University Central Hospital, Helsinki, Finland.
| | - Esa Kuusinen
- Department of Pediatrics, Satakunta Hospital District, Pori, Finland.
| | - Maarit Laaksonen
- Population Health Unit, Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, P.O. Box 21, 00014, Helsinki, Finland.
| | - Janna Saarela
- Institute for Molecular Medicine Finland FIMM, University Helsinki, Helsinki, Finland.
| | - Sakari Knuutila
- Department of Pathology, Haartman Institute, University of Helsinki, and Laboratory of Helsinki and Uusimaa University Hospital, Helsinki, Finland.
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27
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Kenttä T, Porthan K, Tikkanen JT, Väänänen H, Oikarinen L, Viitasalo M, Karanko H, Laaksonen M, Huikuri HV. Sensitivity and specificity of automated detection of early repolarization in standard 12-lead electrocardiography. Ann Noninvasive Electrocardiol 2014; 20:355-61. [PMID: 25367676 DOI: 10.1111/anec.12226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Early repolarization (ER) is defined as an elevation of the QRS-ST junction in at least two inferior or lateral leads of the standard 12-lead electrocardiogram (ECG). Our purpose was to create an algorithm for the automated detection and classification of ER. METHODS A total of 6,047 electrocardiograms were manually graded for ER by two experienced readers. The automated detection of ER was based on quantification of the characteristic slurring or notching in ER-positive leads. The ER detection algorithm was tested and its results were compared with manual grading, which served as the reference. RESULTS Readers graded 183 ECGs (3.0%) as ER positive, of which the algorithm detected 176 recordings, resulting in sensitivity of 96.2%. Of the 5,864 ER-negative recordings, the algorithm classified 5,281 as negative, resulting in 90.1% specificity. Positive and negative predictive values for the algorithm were 23.2% and 99.9%, respectively, and its accuracy was 90.2%. Inferior ER was correctly detected in 84.6% and lateral ER in 98.6% of the cases. CONCLUSIONS As the automatic algorithm has high sensitivity, it could be used as a prescreening tool for ER; only the electrocardiograms graded positive by the algorithm would be reviewed manually. This would reduce the need for manual labor by 90%.
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Affiliation(s)
- Tuomas Kenttä
- Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kimmo Porthan
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Jani T Tikkanen
- Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Heikki Väänänen
- Department of Biomedical Engineering and Computational Science, Aalto University, Helsinki, Finland
| | - Lasse Oikarinen
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Matti Viitasalo
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Hannu Karanko
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Heikki V Huikuri
- Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
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29
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Salonsalmi A, Rahkonen O, Lahelma E, Laaksonen M. Working conditions and subsequent drinking habits. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Roos E, Laaksonen M, Rahkonen O, Lahelma E, Lallukka T. Weight change and sickness absence--a prospective study among middle-aged employees. Eur J Public Health 2014; 25:263-7. [DOI: 10.1093/eurpub/cku087] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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31
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Avery CL, Sitlani CM, Arking DE, Arnett DK, Bis JC, Boerwinkle E, Buckley BM, Ida Chen YD, de Craen AJM, Eijgelsheim M, Enquobahrie D, Evans DS, Ford I, Garcia ME, Gudnason V, Harris TB, Heckbert SR, Hochner H, Hofman A, Hsueh WC, Isaacs A, Jukema JW, Knekt P, Kors JA, Krijthe BP, Kristiansson K, Laaksonen M, Liu Y, Li X, Macfarlane PW, Newton-Cheh C, Nieminen MS, Oostra BA, Peloso GM, Porthan K, Rice K, Rivadeneira FF, Rotter JI, Salomaa V, Sattar N, Siscovick DS, Slagboom PE, Smith AV, Sotoodehnia N, Stott DJ, Stricker BH, Stürmer T, Trompet S, Uitterlinden AG, van Duijn C, Westendorp RGJ, Witteman JC, Whitsel EA, Psaty BM. Drug-gene interactions and the search for missing heritability: a cross-sectional pharmacogenomics study of the QT interval. Pharmacogenomics J 2014; 14:6-13. [PMID: 23459443 PMCID: PMC3766418 DOI: 10.1038/tpj.2013.4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 12/07/2012] [Accepted: 01/03/2013] [Indexed: 01/18/2023]
Abstract
Variability in response to drug use is common and heritable, suggesting that genome-wide pharmacogenomics studies may help explain the 'missing heritability' of complex traits. Here, we describe four independent analyses in 33 781 participants of European ancestry from 10 cohorts that were designed to identify genetic variants modifying the effects of drugs on QT interval duration (QT). Each analysis cross-sectionally examined four therapeutic classes: thiazide diuretics (prevalence of use=13.0%), tri/tetracyclic antidepressants (2.6%), sulfonylurea hypoglycemic agents (2.9%) and QT-prolonging drugs as classified by the University of Arizona Center for Education and Research on Therapeutics (4.4%). Drug-gene interactions were estimated using covariable-adjusted linear regression and results were combined with fixed-effects meta-analysis. Although drug-single-nucleotide polymorphism (SNP) interactions were biologically plausible and variables were well-measured, findings from the four cross-sectional meta-analyses were null (Pinteraction>5.0 × 10(-8)). Simulations suggested that additional efforts, including longitudinal modeling to increase statistical power, are likely needed to identify potentially important pharmacogenomic effects.
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Affiliation(s)
- C L Avery
- Department of Epidemiology, Bank of America Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C M Sitlani
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - D E Arking
- McKusick-Nathans Institute of Genetic Medicine and Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D K Arnett
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - J C Bis
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - E Boerwinkle
- Division of Epidemiology and Center for Human Genetics, The University of Texas Health Science Center, Houston, TX, USA
| | - B M Buckley
- Department of Pharmacology and Therapeutics, University College Cork, Cork, UK
| | - Y-D Ida Chen
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - A J M de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Eijgelsheim
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D Enquobahrie
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - D S Evans
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - I Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - M E Garcia
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
| | - V Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
| | - T B Harris
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
| | - S R Heckbert
- 1] Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA [2] Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - H Hochner
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - A Hofman
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands
| | - W-C Hsueh
- Department of Medicine, University of California, San Francisco, CA, USA
| | - A Isaacs
- 1] Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Centre for Medical Systems Biology, Leiden, The Netherlands
| | - J W Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - P Knekt
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - J A Kors
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - B P Krijthe
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands
| | - K Kristiansson
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - M Laaksonen
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Y Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA
| | - X Li
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - P W Macfarlane
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - C Newton-Cheh
- 1] Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA [2] Center for Human Genetic Research, Cardiovascular Research Center, Harvard Medical School, Boston, MA, USA [3] Massachusetts General Hospital, Boston, MA, USA
| | - M S Nieminen
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - B A Oostra
- 1] Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Centre for Medical Systems Biology, Leiden, The Netherlands
| | - G M Peloso
- 1] National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA [2] Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - K Porthan
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - K Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - F F Rivadeneira
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands [3] Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J I Rotter
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - V Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - N Sattar
- BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, Glasgow, UK
| | - D S Siscovick
- 1] Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA [2] Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - P E Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A V Smith
- Icelandic Heart Association, Kopavogur, Iceland
| | - N Sotoodehnia
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - D J Stott
- Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - B H Stricker
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands [3] Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands [4] Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - T Stürmer
- Department of Epidemiology, Bank of America Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A G Uitterlinden
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands [3] Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - C van Duijn
- 1] Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Centre for Medical Systems Biology, Leiden, The Netherlands
| | - R G J Westendorp
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - J C Witteman
- 1] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands [2] Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands
| | - E A Whitsel
- 1] Department of Epidemiology, Bank of America Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Departments of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - B M Psaty
- 1] Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA [2] Department of Epidemiology, University of Washington, Seattle, WA, USA [3] Departments of Medicine, University of Washington, Seattle, WA, USA [4] Department of Health Services, University of Washington, Seattle, WA, USA [5] Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
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Abuhusain H, Matin A, Qiao Q, Shen H, Daniels B, Laaksonen M, Teo C, Don A, McDonald K, Jahangiri A, De Lay M, Lu K, Park C, Carbonell S, Bergers G, Aghi MK, Anand M, Tucker-Burden C, Kong J, Brat DJ, Bae E, Smith L, Muller-Greven G, Yamada R, Nakano-Okuno M, Feng X, Hambardzumyan D, Nakano I, Gladson CL, Berens M, Jung S, Kim S, Kiefer J, Eschbacher J, Dhruv H, Vuori K, Hauser C, Oshima R, Finlay D, Aza-Blanc P, Bessarabova M, Nikolsky Y, Emig D, Bergers G, Lu K, Rivera L, Chang J, Burrell K, Singh S, Hill R, Zadeh G, Li C, Chen Y, Mei X, Sai K, Chen Z, Wang J, Wu M, Marsden P, Das S, Eskilsson E, Talasila KM, Rosland GV, Leiss L, Saed HS, Brekka N, Sakariassen PO, Lund-Johansen M, Enger PO, Bjerkvig R, Miletic H, Gawrisch V, Ruttgers M, Weigell P, Kerkhoff E, Riemenschneider M, Bogdahn U, Vollmann-Zwerenz A, Hau P, Ichikawa T, Onishi M, Kurozumi K, Maruo T, Fujii K, Ishida J, Shimazu Y, Oka T, Chiocca EA, Date I, Jain R, Griffith B, Khalil K, Scarpace L, Mikkelsen T, Kalkanis S, Schultz L, Jalali S, Chung C, Burrell K, Foltz W, Zadeh G, Jiang C, Wang H, Kijima N, Hosen N, Kagawa N, Hashimoto N, Chiba Y, Kinoshita M, Sugiyama H, Yoshimine T, Klank R, Decker S, Forster C, Price M, SantaCruz K, McCarthy J, Ohlfest J, Odde D, Kurozumi K, Onishi M, Ichikawa T, Fujii K, Ishida J, Shimazu Y, Chiocca EA, Kaur B, Date I, Huang Y, Lin Q, Mao H, Wang Y, Kogiso M, Baxter P, Man C, Wang Z, Zhou Y, Li XN, Liang J, Piao Y, de Groot J, Lu K, Rivera L, Chang J, Bergers G, McDonell S, Liang J, Piao Y, Henry V, Holmes L, de Groot J, Michaelsen SR, Stockhausen MT, Hans, Poulsen S, Rosland GV, Talasila KM, Eskilsson E, Jahedi R, Azuaje F, Stieber D, Foerster S, Varughese J, Ritter C, Niclou SP, Bjerkvig R, Miletic H, Talasila KM, Soentgerath A, Euskirchen P, Rosland GV, Wang J, Huszthy PC, Prestegarden L, Skaftnesmo KO, Sakariassen PO, Eskilsson E, Stieber D, Keunen O, Nigro J, Vintermyr OK, Lund-Johansen M, Niclou SP, Mork S, Enger PO, Bjerkvig R, Miletic H, Mohan-Sobhana N, Hu B, De Jesus J, Hollingsworth B, Viapiano M, Muller-Greven G, Carlin C, Gladson C, Nakada M, Furuta T, Sabit H, Chikano Y, Hayashi Y, Sato H, Minamoto T, Hamada JI, Fack F, Espedal H, Obad N, Keunen O, Gotlieb E, Sakariassen PO, Miletic H, Niclou SP, Bjerkvig R, Bougnaud S, Golebiewska A, Stieber D, Oudin A, Brons NHC, Bjerkvig R, Niclou SP, O'Halloran P, Viel T, Schwegmann K, Wachsmuth L, Wagner S, Kopka K, Dicker P, Faber C, Jarzabek M, Hermann S, Schafers M, O'Brien D, Prehn J, Jacobs A, Byrne A, Oka T, Ichikawa T, Kurozumi K, Inoue S, Fujii K, Ishida J, Shimazu Y, Chiocca EA, Date I, Olsen LS, Stockhausen M, Poulsen HS, Plate KH, Scholz A, Henschler R, Baumgarten P, Harter P, Mittelbronn M, Dumont D, Reiss Y, Rahimpour S, Yang C, Frerich J, Zhuang Z, Renner D, Jin F, Parney I, Johnson A, Rockne R, Hawkins-Daarud A, Jacobs J, Bridge C, Mrugala M, Rockhill J, Swanson K, Schneider H, Szabo E, Seystahl K, Weller M, Takahashi Y, Ichikawa T, Maruo T, Kurozumi K, Onishi M, Ouchida M, Fuji K, Shimazu Y, Oka T, Chiocca EA, Date I, Umakoshi M, Ichikawa T, Kurozumi K, Onishi M, Fujii K, Ishida J, Shimazu Y, Oka T, Chiocca EA, Kaur B, Date I, Sim H, Gruenbacher P, Jakeman L, Viapiano M, Wang H, Jiang C, Wang H, Jiang C, Parker J, Dionne K, Canoll P, DeMasters B, Waziri A. ANGIOGENESIS AND INVASION. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Salonsalmi A, Laaksonen M, Lahelma E, Rahkonen O. Associations between alcohol drinking and mental health – a prospective study among ageing employees. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pietiläinen O, Rahkonen O, Laaksonen M, Lahelma E. Occupational Class Inequalities in Sickness Absence after Hospitalization. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Polvinen A, Laaksonen M, Gould R, Lahelma E, Martikainen P. The contribution of different diseases to socioeconomic inequalities in disability retirement. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Laaksonen M, Blomgren J, Gould R. Sickness absence history before disability retirement: a register based case-control study. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lallukka T, Arber S, Laaksonen M, Lahelma E, Partonen T, Rahkonen O. Work–family conflicts and subsequent sleep medication among women and men: A longitudinal registry linkage study. Soc Sci Med 2013; 79:66-75. [DOI: 10.1016/j.socscimed.2012.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 04/18/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022]
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Kaasinen E, Aavikko M, Vahteristo P, Patama T, Li Y, Saarinen S, Kilpivaara O, Pitkänen E, Knekt P, Laaksonen M, Artama M, Lehtonen R, Aaltonen LA, Pukkala E. Nationwide registry-based analysis of cancer clustering detects strong familial occurrence of Kaposi sarcoma. PLoS One 2013; 8:e55209. [PMID: 23365693 PMCID: PMC3554690 DOI: 10.1371/journal.pone.0055209] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 12/23/2012] [Indexed: 11/18/2022] Open
Abstract
Many cancer predisposition syndromes are rare or have incomplete penetrance, and traditional epidemiological tools are not well suited for their detection. Here we have used an approach that employs the entire population based data in the Finnish Cancer Registry (FCR) for analyzing familial aggregation of all types of cancer, in order to find evidence for previously unrecognized cancer susceptibility conditions. We performed a systematic clustering of 878,593 patients in FCR based on family name at birth, municipality of birth, and tumor type, diagnosed between years 1952 and 2011. We also estimated the familial occurrence of the tumor types using cluster score that reflects the proportion of patients belonging to the most significant clusters compared to all patients in Finland. The clustering effort identified 25,910 birth name-municipality based clusters representing 183 different tumor types characterized by topography and morphology. We produced information about familial occurrence of hundreds of tumor types, and many of the tumor types with high cluster score represented known cancer syndromes. Unexpectedly, Kaposi sarcoma (KS) also produced a very high score (cluster score 1.91, p-value <0.0001). We verified from population records that many of the KS patients forming the clusters were indeed close relatives, and identified one family with five affected individuals in two generations and several families with two first degree relatives. Our approach is unique in enabling systematic examination of a national epidemiological database to derive evidence of aberrant familial aggregation of all tumor types, both common and rare. It allowed effortless identification of families displaying features of both known as well as potentially novel cancer predisposition conditions, including striking familial aggregation of KS. Further work with high-throughput methods should elucidate the molecular basis of the potentially novel predisposition conditions found in this study.
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Affiliation(s)
- Eevi Kaasinen
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Mervi Aavikko
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Pia Vahteristo
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Toni Patama
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Yilong Li
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Silva Saarinen
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Outi Kilpivaara
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Esa Pitkänen
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Paul Knekt
- National Institute of Health and Welfare, Helsinki, Finland
| | | | - Miia Artama
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Rainer Lehtonen
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Lauri A. Aaltonen
- Genome-Scale Biology Research Program, and Department of Medical Genetics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
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Piha K, Laaksonen M, Martikainen P, Rahkonen O, Lahelma E. Socio-economic and occupational determinants of work injury absence. Eur J Public Health 2012; 23:693-8. [DOI: 10.1093/eurpub/cks162] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Siggberg L, Ala-Mello S, Sirpa AM, Linnankivi T, Tarja L, Avela K, Kristiina A, Scheinin I, Ilari S, Kristiansson K, Kati K, Lahermo P, Päivi L, Hietala M, Marja H, Metsähonkala L, Liisa M, Kuusinen E, Esa K, Laaksonen M, Maarit L, Saarela J, Janna S, Khuutila S, Sakari K. High-resolution SNP array analysis of patients with developmental disorder and normal array CGH results. BMC Med Genet 2012; 13:84. [PMID: 22984989 PMCID: PMC3523000 DOI: 10.1186/1471-2350-13-84] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 09/05/2012] [Indexed: 12/02/2022]
Abstract
Background Diagnostic analysis of patients with developmental disorders has improved over recent years largely due to the use of microarray technology. Array methods that facilitate copy number analysis have enabled the diagnosis of up to 20% more patients with previously normal karyotyping results. A substantial number of patients remain undiagnosed, however. Methods and Results Using the Genome-Wide Human SNP array 6.0, we analyzed 35 patients with a developmental disorder of unknown cause and normal array comparative genomic hybridization (array CGH) results, in order to characterize previously undefined genomic aberrations. We detected no seemingly pathogenic copy number aberrations. Most of the vast amount of data produced by the array was polymorphic and non-informative. Filtering of this data, based on copy number variant (CNV) population frequencies as well as phenotypically relevant genes, enabled pinpointing regions of allelic homozygosity that included candidate genes correlating to the phenotypic features in four patients, but results could not be confirmed. Conclusions In this study, the use of an ultra high-resolution SNP array did not contribute to further diagnose patients with developmental disorders of unknown cause. The statistical power of these results is limited by the small size of the patient cohort, and interpretation of these negative results can only be applied to the patients studied here. We present the results of our study and the recurrence of clustered allelic homozygosity present in this material, as detected by the SNP 6.0 array.
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Affiliation(s)
- Linda Siggberg
- Department of Pathology, Haartman Institute, University of Helsinki, Finland.
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Uusi-Rasi K, Laaksonen M, Mikkilä V, Tolonen S, Raitakari OT, Viikari J, Lehtimäki T, Kähönen M, Sievänen H. Overweight in childhood and bone density and size in adulthood. Osteoporos Int 2012; 23:1453-61. [PMID: 21850549 DOI: 10.1007/s00198-011-1737-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 06/23/2011] [Indexed: 10/17/2022]
Abstract
UNLABELLED We evaluated the adult bone structural traits in relation to childhood overweight in 832 men and women. Childhood overweight was associated with larger cross-sections at long bones in both sexes. Excess weight in childhood may also lead to higher trabecular density in females and somewhat lower cortical density in men. INTRODUCTION Excess body weight in childhood may impose more loading on growing skeleton and thus lead to more robust structure in adulthood. METHODS This prospective cohort study evaluated the adult bone structural traits in relation to childhood overweight in a subgroup of 456 women and 376 men from the population-based cohort of Cardiovascular Risks in Young Finns Study. Between-group differences were evaluated with analysis of covariance. RESULTS According to established body mass index (BMI) criterion at the age of 12 years, 31 women and 34 men were classified overweight in childhood. At the mean age (SD) of 36.1 (2.7) years, total cross-sectional (ToA) and cortical area (CoA) at the distal and shaft sites and cortical (shaft CoD) and trabecular (distal TrD) bone density of the nonweight-bearing radius and weight-bearing tibia were evaluated with pQCT. Despite being taller in adolescence, the adult body height of overweight children was similar. In both sexes, childhood overweight was consistently associated with 5-10% larger ToA at all bone sites measured in adulthood. CoA did not show such a consistent pattern. Women, who were overweight in childhood, had ~5% denser TrD with no difference in CoD. In contrast, TrD in men who were overweight in childhood was not different but their CoD was ~1% lower. CONCLUSIONS Childhood overweight was consistently associated with larger long bone cross-sections in both sexes. Excess weight in childhood may also lead to higher trabecular density in women and somewhat lower cortical density in men. Specific mechanisms underlying these associations are not known.
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Affiliation(s)
- K Uusi-Rasi
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
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Laaksonen M, Kärki J, Ailio E. Uniforming information management in Finnish Social Welfare. Stud Health Technol Inform 2012; 180:922-926. [PMID: 22874327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper describes the phases and methods used in the National project for IT in Social Services in Finland (Tikesos). The main goals of Tikesos were to unify the client information systems in social services, to develop electronic documentation and to produce specifications for nationally organized electronic archive. The method of Enterprise Architecture was largely used in the project.
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Affiliation(s)
- Maarit Laaksonen
- National Institute for Health and Welfare, Information department, Finland.
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Knekt P, Lindfors O, Sares-Jäske L, Laaksonen M. [The effectiveness of psychotherapy on depression in the long term]. Duodecim 2012; 128:267-274. [PMID: 22428380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Different short-term therapies, mainly with short follow-ups, seem equally effective treatments of mood disorders. The Helsinki Psychotherapy Study is the only published randomized trial on the effectiveness of short-term and long-term therapies during a longer follow-up. During a 5-year follow-up, patients' recovery from symptoms and improvement in work ability were greater in long-term therapy than in two, equally effective, short-term therapies. The short-term therapies were, however, more cost-effective, but many patients in them did not recover. More randomized clinical trials and cohort studies with long follow-ups on the efficacy, sufficiency and suitability of short- and long-term therapy are thus needed.
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Affiliation(s)
- Paul Knekt
- Terveyden ja hyvinvoinnin laitos, Väestön terveydentila -yksikkö
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Miettinen A, Mykkänen J, Laaksonen M. Method for modeling social care processes for national information exchange. Stud Health Technol Inform 2012; 180:906-910. [PMID: 22874324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Finnish social services include 21 service commissions of social welfare including Adoption counselling, Income support, Child welfare, Services for immigrants and Substance abuse care. This paper describes the method used for process modeling in the National project for IT in Social Services in Finland (Tikesos). The process modeling in the project aimed to support common national target state processes from the perspective of national electronic archive, increased interoperability between systems and electronic client documents. The process steps and other aspects of the method are presented. The method was developed, used and refined during the three years of process modeling in the national project.
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Affiliation(s)
- Aki Miettinen
- University of Eastern Finland, School of Computing, HIS R&D, Finland.
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Kääriä S, Laaksonen M, Rahkonen O, Lahelma E, Leino-Arjas P. Risk factors of chronic neck pain: A prospective study among middle-aged employees. Eur J Pain 2011; 16:911-20. [DOI: 10.1002/j.1532-2149.2011.00065.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2011] [Indexed: 11/06/2022]
Affiliation(s)
- S. Kääriä
- Department of Public Health; Hjelt Institute; University of Helsinki; Helsinki; Finland
| | - M. Laaksonen
- Department of Public Health; Hjelt Institute; University of Helsinki; Helsinki; Finland
| | - O. Rahkonen
- Department of Public Health; Hjelt Institute; University of Helsinki; Helsinki; Finland
| | - E. Lahelma
- Department of Public Health; Hjelt Institute; University of Helsinki; Helsinki; Finland
| | - P. Leino-Arjas
- Finnish Institute of Occupational Health; Helsinki; Finland
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Laaksonen M, Ramseier A, Rovó A, Jensen S, Raber-Durlacher J, Zitzmann N, Waltimo T. Longitudinal Assessment of Hematopoietic Stem Cell Transplantation and Hyposalivation. J Dent Res 2011; 90:1177-82. [DOI: 10.1177/0022034511414156] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Hyposalivation is a common adverse effect of anti-neoplastic therapy of head and neck cancer, causing impaired quality of life and predisposition to oral infections. However, data on the effects of hematopoietic stem cell transplantation (HSCT) on salivary secretion are scarce. The present study determined stimulated whole-saliva flow rates in HSCT recipients in comparison with a healthy control group. Stimulated whole-saliva flow rates of 228 allogeneic HSCT recipients (134 males, 94 females; mean age, 43 yrs) were examined pre-HSCT and 6, 12, and 24 months post-HSCT. Healthy individuals (n = 144; 69 males, 75 females; mean age, 46 yrs) served as the control group. Stimulated saliva flow rates (mL/min) were measured and analyzed statistically, stratifying for hematological diagnoses and conditioning therapy. Hyposalivation (≤ 0.7 mL/min) was found in 40% (p < 0.00001), 53% (p < 0.00001), 31% (p < 0.01), and 26% (n.s.) of the recipients pre-HSCT, and 6, 12, and 24 months post-HSCT, respectively, whereas 16% of the control individuals had hyposalivation. Severe hyposalivation (≤ 0.3 mL/min) was found in 11%, 18%, 4%, and 4% of the recipients pre-HSCT, and 6, 12, and 24 months post-HSCT, respectively. Additionally, conditioning regimen and sex had an impact on saliva flow. In conclusion, hyposalivation was observed to be a common but generally reversible complication among HSCT recipients.
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Affiliation(s)
- M. Laaksonen
- Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland
| | - A.M. Ramseier
- Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland
| | - A. Rovó
- Department of Hematology, University Hospital Basel, Switzerland
| | - S.B. Jensen
- Department of Oral Medicine, Clinical Oral Physiology, Oral Pathology & Anatomy, University of Copenhagen, Denmark
| | | | - N.U. Zitzmann
- Department of Periodontology, Endodontology and Cariology, School of Dentistry, University of Basel, Switzerland
| | - T. Waltimo
- Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland
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Laaksonen M, Salo T, Vardar-Sengul S, Atilla G, Han Saygan B, Simmer JP, Baylas H, Sorsa T. Gingival crevicular fluid can degrade Emdogain and inhibit Emdogain-induced proliferation of periodontal ligament fibroblasts. J Periodontal Res 2010; 45:353-60. [DOI: 10.1111/j.1600-0765.2009.01244.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
OBJECTIVES To compare associations of health-related behaviours with self-certified and medically confirmed sickness absence, and to examine whether these associations can be explained by psychosocial and physical working conditions and occupational social class. METHODS The study included 5470 female and 1464 male employees of the City of Helsinki surveyed in 2000-2002. These data were linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression analysis was used to examine associations of smoking, alcohol use, physical activity, dietary habits and relative weight (body mass index) with self-certified (1-3 days) and medically confirmed (> or =4 days) absence spells. Population attributable fractions (PAFs) were calculated to quantify the sickness absence burden related to the behaviours. RESULTS Smoking and high relative weight were most strongly associated with sickness absence, while the associations of other studied health-related behaviours were weaker. The associations were stronger for medically confirmed sickness absence spells for which heavy smoking and obesity more than doubled the risk of sickness absence in men and nearly doubled it in women. Adjusting for psychosocial working conditions had little or no effect on the associations. Physical working conditions and social class somewhat attenuated the associations, especially for smoking and relative weight. In self-certified sickness absence the PAF for smoking (16.4 in men, 10.3 in women) was largest, while in medically confirmed absence relative weight had the largest PAF (23.5 in men, 15.0 in women). CONCLUSIONS Health-related behaviours, smoking and high relative weight in particular, were associated with subsequent sickness absence independently of psychosocial and physical working conditions and social class. Decreasing smoking and relative weight is likely to provide important gains in work ability and reduce sickness absence.
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Affiliation(s)
- M Laaksonen
- Department of Public Health, FIN-00014 University of Helsinki, Helsinki, Finland.
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Laaksonen M, Piha K, Rahkonen O, Martikainen P, Lahelma E. Explaining occupational class differences in sickness absence: results from middle-aged municipal employees. J Epidemiol Community Health 2009; 64:802-7. [DOI: 10.1136/jech.2009.093385] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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