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1.
Why is the age-standardized incidence of low-trauma fractures rising in many elderly populations? 总被引:4,自引:0,他引:4
Pekka Kannus Seppo Niemi Jari Parkkari Mika Palvanen Ari Heinonen Harri Siev?nen Teppo J?rvinen Karim Khan Markku J?rvinen 《Journal of bone and mineral research》2002,17(8):1363-1367
Low-trauma fractures of elderly people are a major public health burden worldwide, and as the number and mean age of older adults in the population continue to increase, the number of fractures is also likely to increase. Epidemiologically, however, an additional concern is that, for unknown reasons, the age-standardized incidence (average individual risk) of fracture has also risen in many populations during the recent decades. Possible reasons for this rise include a birth cohort effect, deterioration in the average bone strength by time, and increased average risk of (serious) falls. Literature provides evidence that the rise is not due to a birth cohort effect, whereas no study shows whether bone fragility has increased during this relatively short period of time. This osteoporosis hypothesis could, however, be tested if researchers would now repeat the population measurements of bone mass and density that were made in the late 1980s and the 1990s. If such studies proved that women's and men's age-standardized mean values of bone mass and density have declined over time, the osteoporosis hypothesis would receive scientific support. The third explanation is based on the hypothesis that the number and/or severity of falls has risen in elderly populations during the recent decades. Although no study has directly tested this hypothesis, a great deal of indirect epidemiologic evidence supports this contention. For example, the age-standardized incidence of fall-induced severe head injuries, bruises and contusions, and joint distortions and dislocations has increased among elderly people similarly to the low-trauma fractures. The fall hypothesis could also be tested in the coming years because the 1990s saw many research teams reporting age- and sex-specific incidences of falling for elderly populations, and the same could be done now to provide data comparing the current incidence rates of falls with the earlier ones. 相似文献
2.
Markku Walamies Vesa Virtanen Matti Koskinen Arto Uusitalo 《European journal of nuclear medicine and molecular imaging》1994,21(9):968-972
The decrease in mortality among patients receiving thrombolytic therapy for myocardial infarction is greater than would be expected from the improvement in left ventricular contractile function alone; thus some additional advantage of recanalization of the infarctrelated coronary artery probably exists. Changes in the post-infarction myocardial metabolic state with respect to artery patency have not been studied with a gamma camera previously. A single-photon emission tomography scan using the fatty acid analogue para-123I-iodophenylpentadecanoic acid was performed at rest before hospital discharge on nine patients with first anterior myocardial infarction. All patients had received intravenous thrombolytic therapy at the beginning of the insult. The semiquantitative analysis of the left ventricle included a total of 44 segments in each patient. The test was repeated 3 months later, with the patients divided into two groups: six patients had an angiographically patent left anterior descending coronary artery (group A), and three an occluded artery (group B). In group A the number of myocardial segments with abnormal (<70% of maximum) fatty acid uptake was initially 20.2±4.7 (mean±SD) and was reduced to 11.3±6.1 during the follow-up (95% confidence interval of the decrease 16.0–1.7 segments). In group B the number of these aberrant segments was fairly constant (21.7±13.1, initial test, and 21.3±13.3, retest). Our preliminary results suggest that even when thrombolytic therapy fails to prevent myocardial infarction, myocardial fatty acid metabolism has a better change of recovering if the relevant coronary artery has regained its patency. This finding emphasizes the need for further study to establish whether a direct link exists between myocardial metabolic state and patient survival after infarction. 相似文献
3.
Markku Leino MD Kalevi Pyörälä Seppo Lehto Arto Rantala 《Documenta ophthalmologica. Advances in ophthalmology》1992,80(4):309-315
Lens opacity studies were performed using an electronic Lens Opacity Meter (Interzeag Opacity Lensmeter 701) in a population (n = 321) with ischaemic heart disease. These patients are participating in a trial targetting at the reduction of mortality and incidence of myocardial infarction using a cholesterol-lowering drug, simvastatin. A separate study to evaluate the reliability of the method showed good reproducibility. Repeated measurements after a short time-interval (2–10 days) gave statistically lower opacity values either due to a change in lens transparency or perhaps a change in pigment and cell dispersion in the acqueous caused by repeated mydriasis. Lens opacity values showed a highly significant positive correlation to age. Serum cholesterol, systolic blood pressure and smoking habits showed no significant correlations to the levels of lens opacity when adjustments for age were made.Abbreviations HMG-CoA
hydroxy-methylglutarylcoenzyme A
- 4S
Scandinavian Simvastatin Survival Study
- LOM
lens opacity meter 相似文献
4.
Saara Tyry Raija Kalimo Markku rimaa Juhani Juntunen Markku Seuri Kimmo Rsnen 《Stress and health》2004,20(4):213-221
The aim of this study was to analyse the influence of gender and children on physicians' stress and burnout and to obtain information on the compromises physicians make between family and work. The study was based on a nationwide survey of 3313 Finnish physicians. The results showed that work was the commonest reason for stress for both male and female physicians. If physicians had children, combining work and family was the commonest reason for stress among the women, but work still remained the commonest reason for stress among the men. The female physicians had made compromises between family and work more often than the male physicians (limited the number of children, delayed having children, given up postgraduate or continuing medical education, worked part‐time because of family, and given up a job because of a spouse's need to move). The female physicians—with or without children—were more likely than the male physicians to experience severe or moderate exhaustion and less likely than the male physicians to experience cynicism as components of burnout. Among both genders of physicians, having children was associated with less cynicism and reduced personal accomplishment, but the children did not affect exhaustion. In conclusion, having children is associated with a lower level of some burnout symptoms. Additional studies are needed to explain the health effects of work–family balance for physicians. Copyright © 2004 John Wiley & Sons, Ltd. 相似文献
5.
Depression-executive dysfunction syndrome in stroke patients. 总被引:6,自引:0,他引:6
Risto Vataja Tarja Pohjasvaara Riitta M?ntyl? Raija Ylikoski Maarit Leskel? Hely Kalska Marja Hietanen Hannu Juhani Aronen Oili Salonen Markku Kaste Antero Lepp?vuori Timo Erkinjuntti 《The American journal of geriatric psychiatry》2005,13(2):99-107
OBJECTIVE: It has been suggested that executive dysfunction could be the core defect in patients with geriatric or vascular depression, and that this depression-dysexecutive syndrome (DES) might be related to frontal-subcortical circuit dysfunction. The authors tested this hypothesis in 158 poststroke patients, of whom 21 had both depression and executive dysfunction. Methods: In this cross-sectional cohort study, a neurological, psychiatric, and neuropsychological examination was carried out 3 months after ischemic stroke, and brain infarcts, white-matter changes, and brain atrophy were recorded by MRI. RESULTS: The 21 patients with DES had significantly more brain infarcts affecting their frontal-subcortical circuit structures than the 137 patients without DES, or the 41 patients with depression but without executive dysfunction. Patients with DES also had more severe depressive symptoms and worse psychosocial functioning, and they coped less well in complex activities of daily living. CONCLUSIONS: DES is a valid concept and may define a subgroup of poststroke patients with frontal-subcortical pathology and with distinct prognosis and treatment options. 相似文献
6.
7.
Aaro Leinonen Topi Siniluoto Markku Päivänsalo Ari Karttunen Matti I. Kairaluoma Ilkka Suramo 《European radiology》1993,3(3):213-218
Nineteen patients with 49 symptomatic non-neoplastic non-parasitic simple hepatic cysts were subjected to ultrasonographically guided percutaneous aspiration and temporary injection of 99% ethanol into the cyst. Small cysts were treated twice, the large ones three times at the same sitting. The volume of alcohol per injection varied from 20 to 100 ml, depending on the size of the cyst. A cure was usually achieved with one ethanol sclerotherapy treatment. Only minor side effects such as transient pain and temperature elevation occurred. Forty-seven of the 49 cysts could be treated adequately, and did not recur during a follow-up period af 12–40 months. The results indicate that aspiration an and ethanol sclerotherapy is the treatment of choice in patients with symptomatic non-neoplastic simple hepatic cysts or polycystic liver disease.
Correspondence to: A. Leinonen 相似文献
8.
Markku Kankaanp Willy N. Colier Simo Taimela Christoph Anders Olavi Airaksinen Satu-Mari Kokko-Aro Osmo Hnninen 《Pathophysiology》2005,12(4):267-273
The purpose of this study was to assess if chronic low back pain patients have impaired paraspinal muscle O2 turnover and endurance capacity as compared to healthy control subjects during dynamic exercise. Middle-aged healthy male subjects (n = 12, control) and male patients with chronic low back pain (n = 17, CLBP) participated in the study. L4–L5 level paraspinal muscle fatigue was objectively assessed during earlier validated 90 s dynamic back endurance test (spectral EMG, MPFslope). Also EMG amplitude (EMGamplitude) and initial MPF (MPFinitial) were assessed from the initial 5 s of the endurance contraction. Simultaneously near infrared spectroscopy (NIRS) was used for quantitative measurement of local L4–L5 paraspinal muscle O2 consumption. Subcutaneous tissue thickness (ATT) was measured from the EMG and NIRS recording sites. The results indicated that control and CLBP groups were compatible as regarding anthropometric variables, paraspinal muscle activation levels (EMGamplitude), initial MPF (MPFinitial) and ATT. When the ATT was used as a covariate in the ANOVA analysis, CLBP group did not show significantly greater paraspinal muscle fatigability (right MPFslope – 12.2 ± 10.7%/min, left right MPFslope – 12.6 ± 13.3%/min) or O2 consumption (right NIRSslope – 52.8 ± 79.6 μM/l/s) as compared to healthy controls (right MPFslope – 11.9 ± 7.6%/min, left MPFslope – 12.7 ± 8.6%/min, right NIRSslope – 53.7 ± 95.2 μM/l/s). As a conclusion, these CLBP male patients did not show any impaired rate of paraspinal muscle oxygen consumption or excessive paraspinal muscle fatigability during dynamic exercise as compared with healthy controls. Subcutaneous tissue thickness has a strong influence on the NIRS and EMG amplitude measurements and, if unchecked, it could result in the false interpretation of the results. 相似文献
9.
Diagnosis of gastrointestinal stromal tumors: A consensus approach 总被引:258,自引:0,他引:258
Fletcher CD Berman JJ Corless C Gorstein F Lasota J Longley BJ Miettinen M O'Leary TJ Remotti H Rubin BP Shmookler B Sobin LH Weiss SW 《Human pathology》2002,33(5):459-465
As a result of major recent advances in understanding the biology of gastrointestinal stromal tumors (GISTs), specifically recognition of the central role of activating KIT mutations and associated KIT protein expression in these lesions, and the development of novel and effective therapy for GISTs using the receptor tyrosine kinase inhibitor STI-571, these tumors have become the focus of considerable attention by pathologists, clinicians, and patients. Stromal/mesenchymal tumors of the gastrointestinal tract have long been a source of confusion and controversy with regard to classification, line(s) of differentiation, and prognostication. Characterization of the KIT pathway and its phenotypic implications has helped to resolve some but not all of these issues. Given the now critical role of accurate and reproducible pathologic diagnosis in ensuring appropriate treatment for patients with GIST, the National Institutes of Health convened a GIST workshop in April 2001 with the goal of developing a consensus approach to diagnosis and morphologic prognostication. Key elements of the consensus, as described herein, are the defining role of KIT immunopositivity in diagnosis and a proposed scheme for estimating metastatic risk in these lesions, based on tumor size and mitotic count, recognizing that it is probably unwise to use the definitive term "benign" for any GIST, at least at the present time. 相似文献
10.
Jane M Olson Sompong Vongpunsawad Helena Kuivaniemi Antti Ronkainen Juha Hernesniemi Markku Ryynänen Lee-Lian Kim Gerard Tromp 《BMC medical genetics》2002,3(1):7-7