Alcohol consumption in Estonia and Finland: Finbalt survey 1994-2006

Background  

Alcohol consumption has been regarded as an important contributor to the high premature mortality rates. The objective of this paper was to provide an overview and comparison of alcohol consumption and its socio-demographic determinants among adults in Estonia and Finland.     

Bianca in the neighborhood: moving beyond the ‘reach paradigm’ in public mental health

This article offers a critical analysis of how to address social inequalities in mental health. In public mental health, inequalities are commonly construed as a problem of reach, implying that existing mental health expertise often fails to reach low-income groups. We discuss two critiques on the ‘reach-paradigm’ in mental health promotion: the impoverishment of idioms of distress and the tendency to transform complex political issues into clinical ones that are assumed to be backed by evidence. Furthermore, we present the findings of our ethnographic research of an alternative approach to mental health promotion that used media storytelling focused on local knowledge and social context. Our analysis is guided by anthropological research on idioms of distress and sociological literature on health promotion and social inequalities.     

Association analysis of juvenile idiopathic arthritis genetic susceptibility factors in Estonian patients

Clinical Rheumatology - Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition of childhood. Genetic association studies have revealed several JIA susceptibility loci...     

Expression of CD11c and EMR2 on neutrophils: potential diagnostic biomarkers for sepsis and systemic inflammation

There is a need for cellular biomarkers to differentiate patients with sepsis from those with the non‐infectious systemic inflammatory response syndrome (SIRS). In this double‐blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)‐like molecule containing mucin‐like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non‐infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0·001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0·05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively.     

Evaluation of correlation of articular cartilage staining for DDR2 and proteoglycans with histological tissue damage and the results of radiographic assessment in patients with early stages of knee osteoarthritis

Objective: To determine, if staining of articular cartilage for proteoglycans (natural element of healthy and functioning cartilage) and discoidin domain receptor 2 (DDR2) (a protein associated with articular cartilage degradation) is correlated with histological tissue damage or radiographic assessment score in patients with early stages of knee osteoarthritis (OA). Method: 40 patients, with early stage OA were enrolled, from whom the biopsies for histological and immunohistochemical studies were obtained from edge of the femoral condyle during the arthroscopy. Semi-quantitative computer based analysis was used to evaluate the proportion of staining in histological sections. Results: No correlation was shown between the proportion of tissue stained for DDR2 and histological score or the results of radiographic assessment of tibiofemoral (TF) joint. There was a negative correlation between the proportion of tissue stained for DDR2 and radiographic grade of patellofemoral (PF) OA (Spearman r=-0.34; 95% CI -0.60 to -0.02; P=0.03). No correlation was shown between the proportion of tissue stained for proteoglycans and histological score or the results of radiographic assessment of TF and PF joints. A negative correlation was found between proportion of tissue stained for DDR2 and proteoglycans. Spearman r=-0.43; 95% CI=-0.66 to -0.12; P=0.006. Conclusion: Production of DDR2 in articular cartilage could be related to early stages of OA, as it is significantly correlated to decrease of staining for cartilage proteoglycans. The role of production of DDR2 in cartilage may be decreased in stages, where higher grades of OA are detected on the radiographs.     

Multi-detector row CT scanner angiography in the evaluation of living kidney donors

Renal vascular anomalies are frequent and are not usually problematic, especially when they have been identified and localised with preoperative imaging; computed tomography angiography is a fast and minimally invasive procedure that may afford accurate visualisation of arterial and venous anatomy. We report on our experience with the utilisation of multi-detector row angiography in the preoperative evaluation of living kidney donors. Nineteen living kidney donors underwent multidetector row scan angiography with 3D post-processing. The subjects were 12 male and 7 female donors with a mean age of 60 years. Renal vascular anomalies were identified in 52.6% of donors. A total of 10 supernumerary arteries were identified. Surgical correlation was available for 19 kidneys (17 left and 2 right). The donated kidneys were selected on the basis of CT scan and renal function. CT scan identified all 29 arteries including 10 double right or left arteries (100% specificity and sensitivity). Dual multi-phase multi-detector row CT angiography is a minimally invasive and highly accurate method for preoperative evaluation of renal donors. It affords comprehensive depiction of the arterial and venous anatomy of the kidney, which is particularly critical for planning and performing the donor nephrectomy, especially via a laparoscopic approach.     

Time-divided ingestion pattern of casein-based protein supplement stimulates an increase in fat-free body mass during resistance training in young untrained men

We hypothesized that during prolonged resistance training, time-divided ingestion pattern of casein-based protein supplement is of superior efficiency in comparison with the ingestion of the same supplement immediately before each training session. In a crossover study, 13 men aged 18 to 19 years were evaluated during 2 well-controlled, 8-week training and supplementation periods. In the time-focused supplementation regimen (TFR), the subjects consumed the supplement in the morning and in the afternoon, immediately before the training session. Time-divided supplementation regimen (TDR) included 1 morning dose, whereas the second dose was ingested in the evening, 5 hours after training. The daily dose of the supplement contained approximately 70 g of protein (82% casein) and less than 1 g of carbohydrate and fat. Body mass, body composition (dual-energy x-ray absorptiometry scanned), and one-repetition maximum (1RM) for bench press and squat were determined at the beginning and at the end of both 8-week training and supplementation periods. Training produced a significant increase in 1RM strength both in the bench press (9.4% and 7.2%) and the squat exercise (10.7% and 17.8%) in the TFR and TDR, respectively, with no differences between the supplementation regimens. Fat-free mass increased from 62.4 ± 1.2 to 63.5 ± 1.3 kg (P = .046) with TDR, whereas no change was evident with TFR. The increase in 1RM strength in the squat exercise was related to the increase in fat-free mass in TDR (r = 0.569; P = .041). These findings may have practical implications for the timing of ingestion of protein supplements to enhance the efficacy of resistance training.