An association of serum vitamin D concentrations < 40 nmol/L with acute respiratory tract infection in young Finnish men

BACKGROUND: The effects of vitamin D in regulating bone mineralization are well documented. The action of vitamin D as a key link between Toll-like receptor activation and antibacterial responses in innate immunity has recently been shown. The data suggest that differences in the ability of human populations to produce vitamin D may contribute to susceptibility to microbial infection. OBJECTIVE: We aimed to explore whether an association exists between vitamin D insufficiency and acute respiratory tract infection in young Finnish men. DESIGN: Young Finnish men (n = 800) serving on a military base in Finland were enrolled for this study. Their serum 25-hydroxyvitamin [25(OH)D] concentrations were measured in July 2002. They were followed for 6 mo, and the number of days of absence from duty due to respiratory infection were counted. RESULTS: The mean (+/- SD) serum 25(OH)D concentrations were 80.2 +/- 29.3 nmol/L (n = 756). Subjects with serum 25(OH)D concentrations < 40 nmol/L (n = 24) had significantly (P = 0.004) more days of absence from duty due to respiratory infection (median: 4; quartile 1-quartile 3: 2-6) than did control subjects (2; 0-4; n = 628; incidence rate ratio 1.63; 95% CI: 1.15, 2.24). We found a significant (P = 0.004) association between serum 25(OH)D concentrations and the amount of physical exercise before induction into military service. We also found significantly (P < 0.001) lower serum 25(OH)D concentrations in subjects who smoked (72.8 +/- 26.6 nmol/L; n = 192) than in control subjects (82.9 +/- 29.7 nmol/L; n = 537). CONCLUSION: Clinical trials of vitamin D supplementation are needed to investigate whether it enhances immunity to microbial infections.     

Cost-effectiveness analysis of guidelines for antihypertensive care in Finland

Background  

Hypertension is one of the major causes of disease burden affecting the Finnish population. Over the last decade, evidence-based care has emerged to complement other approaches to antihypertensive care, often without health economic assessment of its costs and effects. This study looks at the extent to which changes proposed by the 2002 Finnish evidence-based Current Care Guidelines concerning the prevention, diagnosis, and treatment of hypertension (the ACCG scenario) can be considered cost-effective when compared to modelled prior clinical practice (the PCP scenario).     

Comparison of hardwood and softwood dust-induced expression of cytokines and chemokines in mouse macrophage RAW 264.7 cells

Numerous epidemiological studies have shown that occupational exposure to wood dust can induce several respiratory diseases such as allergic rhinitis, chronic bronchitis, asthma, and sino-nasal adenocarcinoma. However, comparison of the harmful potential of different wood dust species on the basis of epidemiological studies is complicated because in the occupational environment workers are usually exposed to several wood dust species simultaneously. In the present study, we have characterized and compared the effects of two hardwood dusts, beech and teak, and two softwood dusts, pine and spruce, on cytokine and chemokine expression utilizing an in vitro model, murine macrophage cell line RAW 264.7. The expression patterns of selected cytokines and chemokines were assessed by real-time quantitative PCR and by ELISA. All the tested hardwood and softwood dusts induced TNF-alpha expression and inhibited IL-1beta expression. Similarly, all the wood dusts induced the expression of CCL2, CCL3, CCL4, and CXCL2/3 chemokines and inhibited CCL24 expression. Our results indicate that both hardwood and softwood dusts influence the cytokine and chemokine expression of RAW 264.7 cells. Although some differences could be detected in the magnitude of responses to different wood dust species, the two tested wood dust groups, hardwoods and softwoods, have quite similar effects on cytokine and chemokine expression in RAW 264.7 cell line.     

补充维生素C与感冒的关系:对某些文章中错误之处的分析

1971年，Linus Pauling对4个安慰剂对照试验组进行了meta分析，他认为，维生素C组感冒整体发病率的下降绝不可能是一种偶然的现象（P＜0.00003)。在pauling之后，又有许多试验发现维生素C（≥1克／天）可显降低感冒症状，这都说明维生素C具有一定的抗感冒的生理功能。但是，维生素C对感冒无效论仍然普遍存在。支持这种观点的理论依据来自3篇有影响的章。RDA营养推荐表中引用其中的两篇，用以证明维生素C不具有抗感冒功能。本对上述3篇综述章的错误和缺点进行了分析，推翻了他们的错误的结论。本的第二个目的，是对维生素C感冒无效论的成因进行了分析。尽管许多安慰剂对照实验均已证实维生素C的确可以减轻感冒症状，但仍有许多重要的问题需要探讨。     

Randomized Controlled Trial of Back School With and Without Peer Support

The aim of this trial was to determine whether social interaction between patients with long-lasting nonspecific back pain reduces subjective or objective disability. The participants were selected from persons visiting an occupational health care unit because of back pain. After a clinical examination in a university clinic, subjects without a specific diagnosis and having no disabilities preventing active rehabilitation were selected for study. The subjects (n = 108) were randomized into treatment (n = 54) and control groups (n = 54). Altogether 18 study groups, 9 treatment groups and 9 groups for controls, were formed. Before starting the back schools altogether 15 subjects dropped out. Both the treatment groups (n = 47) and the controls (n = 46) attended a back school consisting of 10 lessons and demonstrations supervised by a physiotherapist. The participants in treatment groups, but not the controls, had physical exercise and social intercourse with other members within the group. The clinical examination was repeated after 6 and 12 months. Both the treatment groups and the controls showed improvement in perceived functional capacity (assessed with Oswestry disability questionnaire) and in perceived life quality (assessed with 15D score). At the 6-month follow-up life quality had improved statistically significantly more among the participants in treatment groups than among the controls, and at the 12-month follow-up the Oswestry index showed corresponding improvement. Among subjects suffering from nonspecific back pain, social support improves the results of active rehabilitation.     

Occupational well-being of school staff members: a structural equation model

This study aimed to develop a theoretical basis for the promotion of school staff's occupational well-being. The 'Content Model for the Promotion of School Community Staff's Occupational Well-being' describes the four aspects of the promotion of occupational well-being ('working conditions', 'worker and work', 'working community' and 'professional competence') as well as the functionality and structure of the model. The content model was examined empirically by means of a structural equation model. The project was developed with school staff and occupational health nurses and implemented in 2001-2004. The target group consisted of the staff of 12 comprehensive schools in Eastern Finland in 2002 (n = 211) and 2004 (n = 266). The data were collected using a 'well-being at your work index' questionnaire at both times. A structural equation model for the school staff's occupational well-being, i.e. the 'Occupational Well-being of School Staff Model' (baseline OWSS Model: Study I in the year 2002), was produced. The model was tested with the 2004 data. Based on this, the model was further developed into the final OWSS Model (Study II). The theoretical Content Model for the Promotion of School Community Staff's Occupational Well-being can be used as a framework for planning, implementing and evaluating school staff's occupational well-being.     

Incremental cost‐effectiveness of double‐reading mammograms

Background. Double reading is a widely used criterion standard in breast cancer screening despite a lack of evidence of the costeffectiveness of the second reading. This study evaluates the incremental costeffectiveness of such a strategy.Design. Costeffectiveness analysis: Nationwide populationbased semiannual screening program for women aged 50–59 in Finland. Participation rate was 91%. All mammograms (95,423) performed during 1990–1995 in three screening centers of the Finnish Cancer Society were read by two radiologists with gradings recorded. The effectiveness of the double reading was the difference in cancers detected in the double compared to that of the single reading. Incremental costs of the double reading for the health care and nonhealth care and the time costs were estimated. The main outcome measure was the incremental cost per additional cancer found as a result of the doublereading strategy.Results. The total number of cancers detected with the double and single reading were 290 and 261, respectively. A significantly higher ratio of carcinoma in situ was the causative pathology in cancers detected only by the second reader. The cost per cancer detected with a single reading was US$ 18,340. The incremental cost of any additional cancer found was US$ 25,523, that is, a 39% higher cost per additional cancer found by double reading.Conclusions. The additional cost per cancer detected by double reading is not drastically higher than with single reading. However, the additional cost per life year saved may be much higher.     

Sentinel lymph node biopsy or elective neck dissection for patients with oral squamous cell carcinoma?

Sentinel lymph node biopsy (SNB) seems to be a promising method for staging clinically N0 neck in patients with oral squamous cell carcinoma (OSCC). In the present study, SNB was performed on 46 patients having elective neck dissection (END; six bilateral dissections) for T1–T3N0 OSCC. Sentinel lymph nodes (SLN) were first examined according to only slightly modified standard histopathologic protocol including sections at 1–2 mm intervals and H&E staining. SLN that appeared false negative (i.e. metastatic non-SLN without metastasis in a SLN) after the initial histopathologic examination were further assessed by step sectioning at 150 μm intervals and immunohistochemistry. Of the 47 neck sides with at least one SLN identified, nine contained metastasis in nine patients. After the initial histopathologic examination, SLNs were negative for malignant cells in four out of the nine metastatic neck sides. In one neck side, two metastatic SLNs were detected after the additional meticulous histopathologic work-up of the initially false negative SLNs. Therefore, in three neck sides the SLN did not contain metastasis although there was a metastasis in a non-SLN. In all these three cases with a false negative SLN, only one SLN had been identified. The sensitivity of the method (employing extensive histopathologic work-up) for detection of occult cervical metastasis was 67% (6/9 neck sides). The sensitivity of SNB for detection of occult metastasis seems to be poor in cases where only one SLN can be identified. The results of this study do not entitle us to entirely replace END by SNB in patients with OSCC.     

Progesterone metabolism by rat oral mucosa. III. Participation of granulation tissue and fibroblasts

The metabolism of progesterone by rat granulation tissue was studied. Experimental granulation tissue was produced by implanting viscose-cellulose sponges beneath the dorsal skin of female and male rats for 21 days. The granuloma capsules and fibroblasts in the sponges were homogenized, and mitochondrial, microsomal and soluble fractions were prepared with differential centrifugation. The subcellular Preparations were incubated with 4-¹⁴C-progesterone and NADPH for 30 min at PH 7.4 and 37°C. The metabolites were identified with column and multiple thinlayer chromatography and radioautography and quantitated with liquid scintillation counting. The granulation tissue and fibroblasts showed much less activity in metabolizing progesterone than the gingival tissue of either sex. As reported earlier, gingival tissues contain Δ⁴-5α- and,Δ⁴-5β-steroid hydrogenases and 3α-, 3β-, 20α- and 20β-hydroxysteroid dehydrogenases. The granulation tissue and fibroblasts lack 3 β-hydroxysteroid dehydrogenase activity. In addition, the fibroblasts show no 20 β-hydroxysteroid dehydrogenase activity. The enhanced metabolism of progesterone during gingival inflammation is thus probably not due to the formation of granulation tissue.     

The improvement in quality of life after breast reduction is comparable to that after major joint replacement

The loss of health-related quality of life (QoL) associated with symptomatic breast hypertrophy has been well documented. Measuring QoL with a generic, single index, instrument enables comparisons between different diseases, conditions, and specialities. The aim of this study was to measure the health-related QoL of patients before and after reduction mammaplasty, and to compare it to that of the age-standardised female population, and patients treated by total joint replacement. Health-related QoL was measured using the 15D score from 82 patients at baseline, and at six months after breast reduction surgery from 29 patients who had been randomised to the procedure. At baseline those who had had reduction mammaplasty had significantly lower health-related QoL than the age-standardised female population, but by six months it had improved to the same level with population. The preoperative health deficit of symptomatic breast hypertrophy was equal to that of symptomatic major joint arthrosis. The effect of intervention of reduction mammaplasty was comparable to that of hip and more than knee total joint replacement.