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61.
Anu Muraja‐Murro Antti Kulkas Mikko Hiltunen Salla Kupari Taina Hukkanen Pekka Tiihonen Esa Mervaala Juha Töyräs 《Journal of sleep research》2013,22(6):663-669
Obstructive sleep apnea (OSA) is linked to an increased mortality rate. However, the severity of individual obstruction events is rarely considered quantitatively in clinical practice. We hypothesized that OSA with especially severe obstruction events would predispose a patient to greater health risks than OSA with a similar apnea–hypopnea index (AHI), but lower severity of individual events. This hypothesis was tested in a follow‐up (198.2 ± 24.7 months) of a population of 1068 men referred for ambulatory polygraphic recording due to suspected OSA. The recordings were analysed according to the guidelines of the American Academy of Sleep Medicine. Furthermore, a novel obstruction severity parameter was determined; this was defined as the product of duration of the individual obstruction event and area of the related desaturation event. Patients treated with continuous positive airway pressure (CPAP) were omitted. We identified 125 deceased patients from our original population and for 113 of these a matching alive patient with similar AHI, age, body mass index (BMI), smoking habits and follow‐up time could be found. The deceased patients with severe OSA (based on conventional AHI) showed higher obstruction severity values than their AHI‐matched alive controls. Based on the multivariate logistic regression analysis, obstruction severity was the only parameter which was related statistically significantly to mortality in the severe OSA category. Furthermore, 59% of all deceased patients and 83% of those who had severe OSA displayed higher obstruction severity than the AHI‐matched alive counterparts. To conclude, the obstruction severity parameter provided valuable prognostic information supplementing AHI. The obstruction severity parameter might improve recognition of the patients with the highest risk. 相似文献
62.
Metsälä Riku Ala-Korpi Solja Rannikko Juha Helminen Merja Renko Marjo 《European journal of clinical microbiology & infectious diseases》2021,40(7):1427-1431
European Journal of Clinical Microbiology & Infectious Diseases - Polymerase chain reaction (PCR)-based diagnostics for Mycoplasma pneumoniae (M. pneumoniae) from the respiratory tract has... 相似文献
63.
Anne S. Koponen Juha E. Peltonen Marja K. Päivinen Jyrki M. Aho Harriet J. Hägglund Arja L. Uusitalo Harri J. Lindholm Heikki O. Tikkanen 《European journal of applied physiology》2013,113(5):1181-1188
Blood O2 carrying capacity affects aerobic capacity (VO2max). Patients with type 1 diabetes have a risk for anaemia along with renal impairment, and they often have low VO2max. We investigated whether total haemoglobin mass (tHb-mass) and blood volume (BV) differ in men with type 1 diabetes (T1D, n = 12) presently without complications and in healthy men (CON, n = 23) (age-, anthropometry-, physical activity-matched), to seek an explanation for low VO2max. We determined tHb-mass, BV, haemoglobin concentration ([Hb]), and VO2max in T1D and CON. With similar (mean ± SD) [Hb] (144 vs. 145 g l?1), T1D had lower tHb-mass (10.1 ± 1.4 vs. 11.0 ± 1.1 g kg?1, P < 0.05), BV (76.8 ± 9.5 vs. 83.5 ± 8.3 ml kg?1, P < 0.05) and VO2max (35.4 ± 4.8 vs. 44.9 ± 7.5 ml kg?1 min?1, P < 0.001) than CON. VO2max correlated with tHb-mass and BV both in T1D (r = 0.71, P < 0.01 and 0.67, P < 0.05, respectively) and CON (r = 0.54, P < 0.01 and 0.66, P < 0.001, respectively), but not with [Hb]. Linear regression slopes were shallower in T1D than CON both between VO2max and tHb-mass (2.4 and 3.6 ml kg?1 min?1 vs. g kg?1, respectively) and VO2max and BV (0.3 and 0.6 ml kg?1 min?1 vs. g kg?1, respectively), indicating that T1D were unable to reach similar VO2max than CON at a given tHb-mass and BV. In conclusion, low tHb-mass and BV partly explained low VO2max in T1D and may provide early and more sensitive markers of blood O2 carrying capacity than [Hb] alone. 相似文献
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66.
Homocysteine and carotid atherosclerosis in chronic renal failure--the confounding effect of renal function 总被引:4,自引:0,他引:4
Leskinen Y Lehtimäki T Loimaala A Huhtala H Salenius JP Oja SS Saha H 《Atherosclerosis》2004,175(2):315-323
Since total homocysteine (tHcy) level is markedly elevated in patients with chronic renal failure (CRF), it has been presented as a potential factor contributing to the high risk of cardiovascular disease (CVD) in CRF. Our aim was to examine the significance of elevated tHcy level and other cardiovascular risk factors for carotid atherosclerosis in patients with CRF. In this cross-sectional study, 135 study patients with CRF (52 +/- 11 years) included 58 patients with moderate to severe predialysis CRF, 36 dialysis patients and 41 renal transplant recipients. In addition, 58 control subjects were examined. The association of tHcy level and classic risk factors for atherosclerosis with common carotid artery intima-media thickness (IMT) or carotid artery plaque score was examined. We found no association between tHcy and carotid IMT or a high carotid plaque score in the CRF patient groups. No consistent association was found between elevated tHcy and coronary artery disease, cerebrovascular disease or peripheral arterial disease. Renal function, described as creatinine clearance, was the strongest determinant for tHcy level. Significant predictors of carotid atherosclerosis were age, duration of hypertension and elevated low-density lipoprotein cholesterol level. In conclusion, the present study shows no apparent association between tHcy level and atheromatous carotid findings in patients with CRF. However, because of the changing renal function in the course of renal disease, the strong confounding effect of renal function may not be adequately controlled for the analysis of the significance of elevated tHcy level for CVD in patients with CRF. 相似文献
67.
Juha Paloneva 《Acta orthopaedica》2015,86(2):220-224
Background and purpose — An increased incidence rate of acromioplasty has been reported; we analyzed data from the Finnish National Hospital Discharge Register.Patients and methods — During the 14-year study period (1998–2011), 68,877 acromioplasties without rotator cuff repair were performed on subjects aged 18 years or older.Results — The incidence of acromioplasty increased by 117% from 75 to 163 per 105 person years between 1998 and 2007. The highest incidence was observed in 2007, after which the incidence rate decreased by 20% to 131 per 105 person years in 2011. The incidence declined even more at non-profit public hospitals from 2007 to 2011. In contrast, it continued to rise at profit-based private orthopedic clinics.Interpretation — We propose that this change in clinical practice is due to accumulating high-quality scientific evidence that shows no difference in outcome between acromioplasty and non-surgical interventions for rotator cuff disease with subacromial impingement syndrome. However, the exact cause of the declining incidence cannot be defined based solely on a registry study. Interestingly, this change was not observed at private clinics, where the number of operations increased steadily from 2007 to 2011. 相似文献
68.
Markku J. Ikäheimo Ilkka J. Palatsi Juha T. Takkunen 《The American journal of cardiology》1979,44(1):24-30
To evaluate possible differences in the cardiac effects of different types of running training, 22 competing male runners--10 sprinters and 12 endurance runners--were studied with a physical examination, electrocardiography, chest X-ray film and echocardiography. Thirteen sedentary men served as control subjects. There were no differences between the athletic groups in physical findings. However, left ventricular hypertrophy in the electrocardiogram was more apparent in the endurance runners (P less than 0.05), whose relative heart size on chest X-ray examination was also greater than in the sprinters (P less than 0.02). On echocardiography the left ventricular end-diastolic volume was equally greater than normal in both groups of athletes (P less than 0.005), but in the endurance runners the percent chance of the minor axis diameter in systole was greater than in the sprinters or control subjects (P less than 0.02). Values for left ventricular wall thickness and mass were greater than normal in both groups of athletes but were higher in the endurance runners than in the sprinters (P less than 0.001). The left atrial diameter was apparently greater in the endurance runners than in the sprinters or control subjects (P less than 0.001), whereas that of the sprinters did not differ from normal. Thus, intensive sprinter training seems to dilate the left ventricle but causes less increase in wall thickness and mass than training for endurance running and no change in left ventricular function or left atrial size. Endurance running causes left ventricular dilatation equal to that of sprinter training, greater wall hypertrophy and improved systolic emptying of the left ventricle, and it also dilates the left atrium perhaps because of decreased left ventricular compliance. 相似文献
69.
Ulla R. Korhonen Antti J. Jounela Arto J. Pakarinen Pertti J. Pentikäinen Juha T. Takkunen 《The American journal of cardiology》1979,44(6):1190-1194
The effects of acute myocardial infarction on the pharmacokinetics of digoxin were studied. Digoxin, 0.75 mg, was given orally to 12 patients with left-sided cardiac failure due to acute myocardial infarction and to 9 healthy control subjects. Serum concentration of digoxin in the first 4 hours and the area under the serum concentration-time curve in the first 12 hours after administration of the drug were lower in patients with infarction than in control subjects (P less than 0.01). The 24 hour area under the concentration curve, the amount excreted in urine and the renal clearance did not differ between the groups. The 24 hour area under the concentration curve correlated with the predigoxin pulmonary capillary wedge pressure and with heart rate (P less than 0.01). The decrease of renal clearance of digoxin was related to the serum activity of MB isoenzyme of creatine kinase (P less than 0.001). Morphine reduced and delayed the peak serum concentrations of digoxin (P less than 0.001). Thus, the absorption of oral digoxin was slower and the peak concentrations remained lower in patients with acute myocardial infarction than in healthy control subjects. However, the total amount of digoxin absorbed was unchanged. 相似文献
70.
Brett Duce Antti Kulkas Christian Langton Juha Töyräs Craig Hukins 《Sleep & breathing》2018,22(1):57-64