Second primary cancers among 109 000 cases of non-Hodgkin's lymphoma

An analysis of other primary cancers in individuals with non-Hodgkin's lymphoma (NHL) can help to elucidate this cancer aetiology. In all, 109 451 first primary NHL were included in a pooled analysis of 13 cancer registries. The observed numbers of second cancers were compared to the expected numbers derived from the age-, sex-, calendar period- and registry-specific incidence rates. We also calculated the standardised incidence ratios for NHL as a second primary after other cancers. There was a 47% (95% confidence interval 43-51%) overall increase in the risk of a primary cancer after NHL. A strongly significant (P<0.001) increase was observed for cancers of the lip, tongue, oropharynx*, stomach, small intestine, colon*, liver, nasal cavity*, lung, soft tissues*, skin melanoma*, nonmelanoma skin*, bladder*, kidney*, thyroid*, Hodgkin's lymphoma*, lymphoid leukaemia* and myeloid leukaemia. Non-Hodgkin's lymphoma as a second primary was increased after cancers marked with an asterisk. Patterns of risk indicate a treatment effect for lung, bladder, stomach, Hodgkin's lymphoma and myeloid leukaemia. Common risk factors may be involved for cancers of the lung, bladder, nasal cavity and for soft tissues, such as pesticides. Bidirectional effects for several cancer sites of potential viral origin argue strongly for a role for immune suppression in NHL.     

Comparison of Swanson and Sutter metacarpophalangeal arthroplasties in patients with rheumatoid arthritis: a prospective and randomized trial

PURPOSE: To perform a prospective and randomized comparison of the clinical outcome of patients with rheumatoid arthritis who had Swanson or Sutter implant replacement arthroplasty of the metacarpophalangeal joints. METHODS: There were 45 patients (3 men, 42 women) and 49 hands; a total of 75 Swanson and 99 Sutter implants were inserted. The mean time between surgery and the final follow-up control visit was 58 months (range, 37-80 mo). Preoperative and postoperative measurements were performed including active extension and flexion, correction of ulnar deviation, and strength. RESULTS: There was no statistically significant difference between groups with regard to active extension deficit correction. Mean active flexion decreased less in the Sutter group than in the Swanson group but difference between the groups was statistically significant in only the index finger. At the final follow-up examination no significant differences existed between the groups in the correction of ulnar deviation or arc of motion. Grip strengths, chuck pinch, and thump-to-fingertip grip strengths did not improve in either of the groups. CONCLUSIONS: In this study clinical results showed no significant difference between the groups with the single exception of the amount of index finger metacarpophalangeal joint flexion.     

Occupational class inequalities across key domains of health: results from the Helsinki Health Study

BACKGROUND: Studies comparing socioeconomic inequalities in health using several health indicators are scarce. Therefore, this study aims to compare the shape and magnitude of occupational class inequalities across key domains of health, i.e. the subjective, functional and medical domains. Additionally, we examine whether physical or mental workload will affect these inequalities, and whether these effects are specific to particular health indicators. METHODS: Cross-sectional survey data from the Helsinki Health Study in 2000 and 2001 were used. Each year employees of the City of Helsinki, reaching 40, 45, 50, 55 and 60 years received a mailed questionnaire. 6243 employees responded (80% women, response rate 68%). The socioeconomic indicator was occupational social class. Nine health indicators were included: self-rated health, pain or ache, GHQ-12 mental well-being, limiting long-standing illness, SF-36 physical and mental health functioning, Rose angina symptoms, circulatory diseases and mental problems. Prevalence percentages, odds ratios and inequality indices from logistic regression analysis were calculated. RESULTS: Occupational class inequalities were found for self-rated health, pain or ache, limiting long-standing illness, physical health functioning, angina symptoms, and circulatory diseases. Physical or mental workload did not account for these inequalities. Inequalities were non-existent or slightly reversed for GHQ-12 mental well-being, SF-36 mental health functioning and mental problems. CONCLUSION: Expected occupational class inequalities in health among both women and men were found for global and physical health but not for mental health. The observed inequalities could not be attributed to physical or mental workload.     

Survival of the AGC total knee arthroplasty is similar for arthrosis and rheumatoid arthritis. Finnish Arthroplasty Register report on 8,467 operations carried out between 1985 and 1999

We report the survival of AGC knee endoprosthesis from the Finnish Arthroplasty Register for 2 indications, osteoarthrosis (OA, 6 306 knees) and rheumatoid arthritis (RA, 2 161 knees) during 1985- 1999. Survivorship analysis was performed with revision as an endpoint. We found similar survival rates. In the OA group, survival after 5 years was 97% and it was 94% after 10 years. In the RA group the corresponding figures were 97% and 96%, respectively. There was no significant difference in survival whether or not cement was used for fixation. The revision rates were higher in men and in younger patients.     

Breast cancer risk among Finnish cabin attendants: a nested case-control study

Background: Earlier studies have found increased breast cancer risk among female cabin crew. This has been suggested to reflect lifestyle factors (for example, age at first birth), other confounding factors (for example, age at menarche), or occupational factors such as exposure to cosmic radiation and circadian rhythm alterations due to repeated jet lag.     

Comparison of Electrocardiographic Changes during Microlaryngoscopy under Halothane Anaesthesia induced by Althesin® or Thiopentone

The incidences of electrocardiographic (ECG) changes during microlaryngoscopy under halothane anaesthesia were compared by using Althesin® and thiopentone as induction agents.
During the procedure the most common ECG change in both groups was junctional rhythm, which occurred in 37% of the patients in the Althesin group and in 29% of the patients in the thiopentone group. The next most common changes in the Althesin group were: ventricular ectopic beats (22%), ischaemic S-T segment depression (14%), and T wave flattening or inversion (14%); those in the thiopentone group were ventricular ectopic beats (18%) and rapidly ascending S-T segment depression (12%). As well as during the procedure, some ECG changes were registered in both groups during intubation. ECG changes disappeared without any special treatment after manipulation of the vocal cords or after intubation.
There was no statistically significant difference in the total incidence of dysrhythmias between the Althesin and thiopentone groups, but the types of dysrhythmias were different in the two groups. There were more lower nodal rhythms, less serious ectopic beats and more ischaemic S-T segment depression in the Althesin group than in the thiopentone group.
The results suggest that Althesin is useful and superior to thiopentone in patients with a tendency to develop serious ventricular ectopic beats, whereas in patients with heart and coronary arterial disease, Althesin is inferior to thiopentone and should be used with care.     

Recurrent persistent occipito-posterior position in subsequent deliveries

A nine year follow up study of the delivery pattern of 119 women after delivery in the persistent occiput posterior position and their occipito-anterior controls. The studied parameters were: number of deliveries, number of repeated cases of persistent occiput posterior position and operative deliveries. Deliveries in the occipito-posterior position were more common in the study group than in the controls ( P = 0.031). Except for this, no statistically significant differences were found between the groups. According to the results, recurrence of the persistent occiput posterior position is common. A history of delivery in the persistent occiput posterior position does not seem to have any major impact on future childbearing.     

A randomized intervention since infancy to reduce intake of saturated fat: calorie (energy) and nutrient intakes up to the age of 10 years in the Special Turku Coronary Risk Factor Intervention Project

OBJECTIVE: To evaluate the longitudinal impact of dietary counseling on children's nutrient intake. DESIGN: A prospective, randomized, clinical trial. PARTICIPANTS: Children were recruited to the study between December 1, 1989, and May 30, 1992. At the age of 7 months, children were randomized to the intervention group (n = 540) or the control group (n = 522) and were followed up until the age of 10 years.Intervention Families in the intervention group have, since randomization, received regularly individualized counseling about how to modify the quality and quantity of fat in the child's diet, the goal being an unsaturated-saturated fat ratio of 2:1. MAIN OUTCOME MEASURES: Nutrient intakes between the ages of 4 and 10 years based on annual 4-day food records. RESULTS: The fat intake of the intervention children was constantly around 30% of the calorie (energy) intake, while that of the control children was 2 to 3 calorie percentage units higher (P<.001). The intervention children received 2 to 3 calorie percentage units less saturated fats and 0.5 to 1.0 calorie percentage unit more polyunsaturated fats than the control children (P<.001 for both). However, neither group reached the 2:1 goal set for the unsaturated-saturated fatty acid ratio. The vitamin and mineral intakes of the intervention and control children closely resembled each other despite the marked differences in fat intake. CONCLUSION: Individualized, biannually given, fat intake-focused dietary counseling that began at the child's age of 8 months continued to influence favorably the diet of 4- to 10-year-old intervention children without disadvantageous dietary effects, but the 2:1 goal for unsaturated-saturated fat ratio was not reached.     

Epidemiology of choriocarcinoma in Finland, 1953 to 1999

OBJECTIVE: Choriocarcinoma is a rare tumor with remarkable differences in the incidence in various parts of the world. The available data do not elucidate recent time trends in the incidence of the disease in Western countries. We studied the epidemiology of choriocarcinoma in Finland over a period of 47 years. METHODS: Incidence rates for choriocarcinoma from 1953 to 1999, according to the population-based Finnish Cancer Registry, were calculated per number of deliveries, obtained from the National Research and Development Center for Welfare and Health. Standardized incidence ratios (SIRs) for the years 1971 through 1995 for women born between 1906 and 1945 were calculated by occupation taken from the 1970 Population Census. RESULTS: The incidence of choriocarcinoma was 40/10(6) deliveries for the study period 1953-1999 as a whole. The respective incidence rate calculated per female population and adjusted for age to the world standard population was 1.3/10(6). The incidence, per number of deliveries, was remarkably higher in women above 40 years as compared to younger women. There was a decline in the incidence of the disease in women between 25 and 39 years of age from 53/10(6) deliveries in 1953-1984 to 26/10(6) deliveries in 1985-1999. High occupation-specific risks were observed for nurses (SIR 7.8; 95% confidence interval 2.1-20) and agricultural workers (SIR 11; 95% confidence interval 1.4-40). CONCLUSION: The incidence of choriocarcinoma in Finland is similar to that reported earlier for other Western countries. The recent decline in the incidence of the disease, the enormous increase in the risk among old fertile women, and clustering of cases to certain occupations should be targets of future studies.