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Effects of Cognitive Training on Cognition and Quality of Life of Older Persons with Dementia.

https://arctichealth.org/en/permalink/ahliterature302899
Source
J Am Geriatr Soc. 2018 04; 66(4):664-670
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
04-2018
Author
Eeva-Liisa Kallio
Hannareeta Öhman
Marja Hietanen
Helena Soini
Timo E Strandberg
Hannu Kautiainen
Kaisu H Pitkälä
Author Affiliation
Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
Source
J Am Geriatr Soc. 2018 04; 66(4):664-670
Date
04-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Aged, 80 and over
Cognition - physiology
Cognitive Behavioral Therapy - methods
Dementia - therapy
Female
Finland
Humans
Independent living
Male
Neuropsychological Tests - statistics & numerical data
Quality of Life - psychology
Single-Blind Method
Abstract
To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia.
Single-blind randomized controlled trial with 3- and 9-month follow-up.
Adult day care centers in Helsinki, Finland.
Older individuals with mild to moderate dementia living at home and attending adult day care twice a week (N = 147; mean age 83, 72% female, 63% at mild stage of dementia).
A systematic 12-week training program focused on subskills of executive function: attention, working memory, cognitive flexibility, and planning. The intervention group (n = 76) underwent cognitive training twice a week for 45 minutes, and the control group (n = 71) attended day care as usual.
Primary outcomes were the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) for global cognition and the 15-dimensional instrument (15D) for HRQoL. The outcomes were measured at baseline and 3 and 9 months.
Both groups deteriorated in global cognition and HRQoL during follow-up, and there were no differences between the two groups in change on the ADAS-Cog (P = .43) or 15D (P = .61) over time (adjusted for age and sex). At 3 months, changes were 0.8 (95% confidence interval (CI) = -0.2-1.8) for the intervention group and 1.7 (95% CI = 0.6-2.7) for the control group on the ADAS-Cog and -0.040 (95% CI = -0.058 to -0.021) for the intervention group and -0.037 (95% CI = -0.056 to -0.018) for the control group on the 15D.
Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.
Notes
CommentIn: J Am Geriatr Soc. 2018 Apr;66(4):645-647 PMID 29345742
PubMed ID
29345724 View in PubMed
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Feasibility of a checklist in treating hypertension in primary care - base line results from a cluster-randomised controlled trial (check and support).

https://arctichealth.org/en/permalink/ahliterature302619
Source
BMC Cardiovasc Disord. 2018 12 19; 18(1):240
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
12-19-2018
Author
Aapo Tahkola
Päivi Korhonen
Hannu Kautiainen
Teemu Niiranen
Pekka Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. aapo.tahkola@jkl.fi.
Source
BMC Cardiovasc Disord. 2018 12 19; 18(1):240
Date
12-19-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Checklist - standards
Feasibility Studies
Female
Finland
Guideline Adherence
Humans
Hypertension - diagnosis - drug therapy - physiopathology
Male
Medication Adherence
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians' - standards
Primary Health Care - methods - standards
Quality Improvement
Quality Indicators, Health Care
Time Factors
Treatment Outcome
Abstract
Most patients with antihypertensive medication do not achieve their blood pressure (BP) target. The most important factor behind this failure is poor medication adherence. However, non-adherence to therapy does not concern only patients. Clinicians also tend to lack adherence to hypertension guidelines, overestimate BP control and be satisfied with inadequate BP control. The aim of this non-blinded, cluster-randomised, controlled study was to investigate if using a checklist would improve the quality of care in the initiation of new antihypertensive medication and help reduce non-adherence.
The study was conducted in eight primary care study centres in Central Finland, randomised to function as either intervention (n?=?4) or control sites (n?=?4). We included patients aged 30-75?years who were prescribed antihypertensive medication for the first time. Initiation of medication in the intervention group was carried out with a 9-item checklist, filled in together by the treating physician and the patient. Hypertension treatment in the control group was managed by the treating physician without a study-specific protocol.
In total, 119 patients were included in the study, of which 118 were included in the analysis (n?=?59 in the control group, n?=?59 in the intervention group). When initiating antihypertensive medication, an adequate BP target was set for 19% of the patients in the control group and for 68% in the intervention group. Shortly after the appointment, only 14% of the patients in the control group were able to remember the adequate BP target, compared with 32% in the intervention group. The use of the checklist was also related to more regular agreement on the next follow-up appointment (64% in the control group versus 95% in the intervention group). No adverse events or side effects were related to the intervention.
Even highly motivated new hypertensive patients in Finnish primary care have significant gaps in their informational and behavioural skills. The use of a checklist for initiation of antihypertensive medication was related to significant improvement in these skills. Based on our findings, the use of a checklist might be a practical tool for addressing this problem.
NCT02377960 . Date of registration: February 26th, 2015.
PubMed ID
30567497 View in PubMed
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Regular physical exercise before entering military service may protect young adult men from fatigue fractures.

https://arctichealth.org/en/permalink/ahliterature301920
Source
BMC Musculoskelet Disord. 2019 Mar 25; 20(1):126
Publication Type
Journal Article
Date
Mar-25-2019
Author
Harri Pihlajamäki
Mickael Parviainen
Heikki Kyröläinen
Hannu Kautiainen
Ilkka Kiviranta
Author Affiliation
Department of Orthopaedics and Traumatology, Seinäjoki Central Hospital, Seinäjoki and University of Helsinki, Helsinki, Finland. harri.pihlajamaki@helsinki.fi.
Source
BMC Musculoskelet Disord. 2019 Mar 25; 20(1):126
Date
Mar-25-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Cohort Studies
Exercise - physiology
Finland - epidemiology
Follow-Up Studies
Fractures, Stress - diagnosis - epidemiology - prevention & control
Humans
Male
Military Medicine - methods
Military Personnel
Random Allocation
Young Adult
Abstract
Bone stress fractures are overuse injuries commonly encountered in sports and military medicine. Some fatigue fractures lead to morbidity and loss of active, physically-demanding training days. We evaluated the incidence, anatomical location, risk factors, and preventive measures for fatigue fractures in young Finnish male conscripts.
Five cohorts of 1000 men performing military service, classified according to birth year (1969, 1974, 1979, 1984, 1989), were analysed. Each conscript was followed for his full military service period (180?days for conscripts with rank and file duties, 270?days for those with special training, 362?days for officers and highly trained conscripts). Data, including physical activity level, were collected from a standard pre-information questionnaire and from the garrisons' healthcare centre medical reports. Risk factor analysis included the conscripts' service class (A, B), length of military service, age, height, weight, body mass index, smoking, education, previous diseases, injuries, and subjective symptoms, as well as self-reports of physical activity before entering the service using a standard military questionnaire.
Fatigue fractures occurred in 44 (1.1%) of 4029 men, with an incidence of 1.27 (95% confidence interval: 0.92-1.70) per 1000 follow-up months, and mostly (33/44, 75%) occurred at the tibial shaft or metatarsals. Three patients experienced two simultaneous stress fractures in different bones. Most fatigue fractures occurred in the first 3?months of military service. Conscripts with fatigue fractures lost a total of 1359 (range 10-77) active military training days due to exemptions from duty. Conscripts reporting regular (>?2 times/week) physical activity before entering the military had significantly fewer (p?=?0.017) fatigue fractures. Regular physical activity before entering the service was the only strong explanatory, protective factor in the model [IRR?=?0.41 (95% CI: 0.20 to 0.85)]. The other measured parameters did not contribute significantly to the incidence of stress fractures.
Regular and recurrent high-intensity physical activity before entering military service seems to be an important preventive measure against developing fatigue fractures. Fatigue fractures should be considered in conscripts seeking medical advice for complaints of musculoskeletal pain, and taken into consideration in planning military and other physical training programs.
PubMed ID
30909910 View in PubMed
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Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture - protocol of a randomized controlled trial (HIPFRA study).

https://arctichealth.org/en/permalink/ahliterature301757
Source
BMC Geriatr. 2018 10 01; 18(1):232
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
10-01-2018
Author
Paula Soukkio
Sara Suikkanen
Sanna Kääriä
Hannu Kautiainen
Sarianna Sipilä
Katriina Kukkonen-Harjula
Markku Hupli
Author Affiliation
Rehabilitation, South Karelia Social and Health Care District, Valto Käkelän katu 3, FI-53130, Lappeenranta, Finland. paula.soukkio@eksote.fi.
Source
BMC Geriatr. 2018 10 01; 18(1):232
Date
10-01-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Female
Finland - epidemiology
Frail Elderly - psychology
Hip Fractures - epidemiology - psychology - rehabilitation
Home Care Services - trends
Humans
Independent Living - psychology - trends
Male
Nutrition Assessment
Physical Therapy Modalities - psychology - trends
Quality of Life - psychology
Surveys and Questionnaires
Time Factors
Treatment Outcome
Abstract
Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture.
This is a non-blinded, parallel group, randomized controlled trial performed in South Karelia Social and Health Care District, Finland (population 131,000). Three hundred community-dwelling older persons with signs of frailty (age?=?65) and 300 persons with a recent hip fracture (age?=?60) will be recruited. Frailty is screened by FRAIL questionnaire and verified by modified Fried's frailty criteria. Both patient groups will be randomized separately to a physiotherapy and a usual care arm. Individualized, structured and progressive physiotherapy will be carried out for 60 min, twice a week for 12 months at the participant's home. The primary outcome at 24 months is duration of living at home. Our hypothesis is that persons assigned to the physiotherapy arm will live at home for six months longer than those in the usual care arm. Secondary outcomes are functional capacity, frailty status, health-related quality-of-life, falls, use and costs of social and health care services, and mortality. Assessments, among others Short Physical Performance Battery, Functional Independence Measure, Mini Nutritional Assessment, and Mini-Mental State Examination will be performed at the participant's home at baseline, 3, 6, and 12 months. Register data on the use and costs of social and health care services, and mortality will be monitored for 24 months.
Our trial will provide new knowledge on the potential of intensive, long-term home-based physiotherapy among older persons at risk for disabilities, to enhance functional capacity and thereby to postpone the need for institutional care, and diminish the use of social and health care services.
ClinicalTrials.gov Identifier: NCT02305433 , Registered Nov 28, 2014.
PubMed ID
30285645 View in PubMed
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Increasing incidence and shifting profile of idiopathic inflammatory rheumatic diseases in adults during this millennium.

https://arctichealth.org/en/permalink/ahliterature300331
Source
Clin Rheumatol. 2019 Feb; 38(2):555-562
Publication Type
Journal Article
Date
Feb-2019
Author
Paula Muilu
Vappu Rantalaiho
Hannu Kautiainen
Lauri Juhani Virta
Johan Gunnar Eriksson
Kari Puolakka
Author Affiliation
Department of Medicine, Tampere University Hospital, PL 2000, 33521, Tampere, Finland. paula.muilu@pshp.fi.
Source
Clin Rheumatol. 2019 Feb; 38(2):555-562
Date
Feb-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Antirheumatic Agents - economics - therapeutic use
Female
Finland - epidemiology
Humans
Incidence
Insurance, Health, Reimbursement - statistics & numerical data - trends
Male
Middle Aged
Rheumatic Diseases - classification - drug therapy - epidemiology
Sex Distribution
Young Adult
Abstract
To explore the trends in the incidence of idiopathic inflammatory rheumatic diseases (IIRDs) after the turn of the millennium. From a nationwide register maintained by the Social Insurance Institution of Finland, we collected all adult patients with IIRDs granted a new special reimbursement for anti-rheumatic drugs between 2000 and 2014. Temporal trends in the incidences of various IIRDs were estimated in three 5-year intervals. A total of 58,405 adult patients were identified. Between 2000-2004 and 2010-2014, the age-adjusted incidence rate of IIRDs increased from 114 to 116/100000 [incidence rate ratio (IRR) 1.03 (95% CI 1.01 to 1.06)] in women and from 67 to 69/100,000 [IRR 1.10 (95% CI 1.06-1.14)] in men. The incidence of seropositive rheumatoid arthritis (RA) remained stable while that of seronegative RA decreased. For other diagnoses, the incidences either increased (unspecified arthritis, psoriatic arthritis, spondyloarthritis), remained stable (reactive arthritis), or decreased (SLE and the group of diseases with the ICD-10 code M35). The gender difference in spondyloarthritis leveled as the incidence in women increased at a higher rate than in men. Mean age at IIRD diagnosis decreased among women. The total age-adjusted incidence of IIRDs has gradually increased, due to the increase in unspecified arthritis, psoriatic arthritis, and spondyloarthritis. This, in addition to the ascending number of individuals at risk in the population, translates into a growing burden to the health care system.
PubMed ID
30259249 View in PubMed
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Determinants of sickness absence rate among Finnish municipal employees.

https://arctichealth.org/en/permalink/ahliterature300292
Source
Scand J Prim Health Care. 2019 Mar; 37(1):3-9
Publication Type
Journal Article
Date
Mar-2019
Author
Tiina Vuorio
Sakari Suominen
Hannu Kautiainen
Päivi Korhonen
Author Affiliation
a Department of Family Medicine, Institute of Clinical Medicine , University of Turku and Turku University Hospital , Turku , Finland.
Source
Scand J Prim Health Care. 2019 Mar; 37(1):3-9
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Absenteeism
Adult
Chronic Disease
Cross-Sectional Studies
Educational Status
Female
Finland
Humans
Male
Middle Aged
Multivariate Analysis
Occupations
Risk factors
Sick Leave
Surveys and Questionnaires
Abstract
In addition to acute health problems, various aspects of health behavior, work-related and sociodemographic factors have been shown to influence the rate of sickness absence. The aim of this study was to concomitantly examine factors known to have an association with absenteeism. We hypothesized the prevalence of chronic diseases being the most important factor associated with sickness absence.
A cross-sectional study.
Occupational health care in the region of Pori, Finland.
671 municipal employees (89% females) with a mean age of 49 (SD 10) years. Information about the study subjects was gathered from medical records, by physical examination and questionnaires containing information about physical and mental health, health behavior, work-related and sociodemographic factors. The number of sickness absence days was obtained from the records of the city of Pori.
The relationship of absenteeism rate with sociodemographic, health- and work-related risk factors.
In the multivariate analysis, the mean number of chronic diseases (IRR 1.24, 95% CI 1.13 to 1.36), work ability (IRR 0.83, 95% CI 0.76 to 0.91), and length of years in education (IRR 0.90, 95% CI 0.85 to 0.95) remained as independent factors associated with absenteeism.
According to our results, chronic diseases, self-perceived work ability and length of years in education are the most important determinants of the rate of sickness absence. This implies that among working-aged people the treatment of chronic medical conditions is also worth prioritizing, not only to prevent complications, but also to avoid sickness absences. KEY POINTS Various sociodemographic, health- and work- related risk factors have been shown to influence sickness absence. The study aimed to find the most important determinants of absenteeism among several known risk factors in Finnish municipal employees. Chronic diseases, self-perceived work ability and education years remained as the most important determinants of sickness absence rates. Treatment of chronic medical conditions should be prioritized in order to reduce sickness absence rate.
PubMed ID
30689483 View in PubMed
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The mortality rate and causes of death among juvenile idiopathic arthritis patients in Finland.

https://arctichealth.org/en/permalink/ahliterature300281
Source
Clin Exp Rheumatol. 2019 May-Jun; 37(3):508-511
Publication Type
Journal Article
Author
Minna Susanna Kyllönen
Hannu Kautiainen
Kari Puolakka
Paula Vähäsalo
Author Affiliation
Department of Internal Medicine and Medical Research Centre, University of Oulu and Oulu University Hospital; and PEDEGO Research Unit, University of Oulu, Finland. mikyllon@student.oulu.fi.
Source
Clin Exp Rheumatol. 2019 May-Jun; 37(3):508-511
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Arthritis, Juvenile - mortality
Case-Control Studies
Cause of Death
Child
Female
Finland
Humans
Male
Proportional Hazards Models
Registries
Young Adult
Abstract
To explore mortality rates and causes of death in juvenile idiopathic arthritis (JIA) patients in Finland compared with the general population.
All incident patients with JIA (age
PubMed ID
30767877 View in PubMed
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Psychiatric diagnosis in primary care patients with increased depressive symptoms.

https://arctichealth.org/en/permalink/ahliterature300018
Source
Nord J Psychiatry. 2019 Apr; 73(3):195-199
Publication Type
Journal Article
Date
Apr-2019
Author
Satu Kotiaho
Katariina Korniloff
Mauno Vanhala
Hannu Kautiainen
Hannu Koponen
Tiina Ahonen
Pekka Mäntyselkä
Author Affiliation
a School of Medicine, General Practice , University of Eastern Finland , Kuopio , Finland.
Source
Nord J Psychiatry. 2019 Apr; 73(3):195-199
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Comorbidity
Depressive Disorder - diagnosis - psychology
Female
Finland
Humans
Male
Mental Disorders - psychology
Middle Aged
Primary Health Care - statistics & numerical data
Psychiatric Status Rating Scales
Abstract
Screening of depression has been recommended in primary care and Beck's 21-item Depression Inventory (BDI-21) is a commonly used tool for screening. Depression has been shown to be frequently accompanied by comorbidities.
This study aimed to analyze the characteristics, psychiatric diagnoses, and psychiatric comorbidity of primary care patients who have been screened for depression and referred to a depression nurse.
The study subjects were primary care patients aged = 35 years with depressive symptoms (BDI-21?>?9). Their psychiatric diagnosis were based on a diagnostic interview (Mini-International Neuropsychiatric Interview; M.I.N.I.) conducted by a trained study nurse.
Of the 705 study subjects, 617 (87.5%) had at least one and 66.1% had at least two psychiatric diagnoses. The most common diagnosis was depression (63.4%). The next most common diagnoses were generalized anxiety disorder (GAD) (48.1%) and panic disorder (22.8%). Only 8.8% of the study subjects had depression without other psychiatric disorders. Ten percent of the subjects had both depression and a generalized anxiety disorder (GAD). Also other psychiatric comorbidities were common. Age was inversely associated with the psychiatric diagnosis in the M.I.N.I.
This study suggests that most of the primary care patients with increased depressive symptoms have a psychiatric disorder. Although depression is the most common diagnosis, there are several other concurrent psychiatric comorbidities. Therefore, diagnostic assessment of primary care patients with a screening score over 9 in the BDI-21 should be reconsidered.
PubMed ID
30929594 View in PubMed
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Body surface area at birth and later risk for gestational diabetes mellitus among primiparous women.

https://arctichealth.org/en/permalink/ahliterature299848
Source
Acta Diabetol. 2019 Apr; 56(4):397-404
Publication Type
Journal Article
Observational Study
Date
Apr-2019
Author
Senja Masalin
Kristiina Rönö
Hannu Kautiainen
Mika Gissler
Johan G Eriksson
Merja K Laine
Author Affiliation
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. senja.lindholm@helsinki.fi.
Source
Acta Diabetol. 2019 Apr; 56(4):397-404
Date
Apr-2019
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adolescent
Adult
Birth Weight - physiology
Body mass index
Body surface area
Cohort Studies
Diabetes, Gestational - epidemiology
Female
Finland - epidemiology
Humans
Infant, Newborn
Parity - physiology
Parturition - physiology
Pregnancy
Risk factors
Young Adult
Abstract
To assess the relationship between body surface area (BSA) at birth and future risk for gestational diabetes mellitus (GDM).
This is an observational cohort study from Vantaa, Finland. The cohort included 1548 Finnish primiparous women, aged 15-28 years, without pre-existing diabetes, who gave birth 2009-2015. All women were born full-term and had complete information about their birth weight and length, from the Finnish Medical Birth Register. Additional data for the study were provided by individual patient health records and Statistics Finland. Study participants were divided into five levels (I-V) according to BSA at birth, based on normal distribution.
There was an inverse association between BSA at birth and risk for GDM (p?=?0.015 for linearity, after adjustments for age, educational attainment, pre-pregnancy BMI and smoking). The odds ratio (OR) for GDM in level V, with the largest BSA at birth, compared with level I, with the smallest BSA at birth, was 0.43 [95% confidence interval (CI) 0.22-0.83]; adjusted for age, educational attainment, pre-pregnancy body mass index and smoking. The OR for GDM was 0.8 (95% CI 0.68-0.95, p?=?0.009) for each one standard deviation increase in BSA at birth, adjusted for the same confounders. BSA at birth correlated with adult anthropometry: correlation coefficients were r?=?0.16 (95% CI 0.11-0.21) for weight, r?=?0.31 (95% CI 0.26-0.35) for height, and r?=?0.06 (95% CI 0.01-0.11) for BMI.
Body surface area at birth is inversely associated with future risk for GDM in primiparous women.
PubMed ID
30430243 View in PubMed
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Tanning dependence and seasonal affective disorder are frequent among sunbathers but are not associated.

https://arctichealth.org/en/permalink/ahliterature299829
Source
Psychiatry Res. 2019 02; 272:387-391
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2019
Author
Anna Toledo
Emmi Yli-Uotila
Hannu Kautiainen
Sami Pirkola
Timo Partonen
Erna Snellman
Author Affiliation
Tampere University, Faculty of Medicine and Health Technology, 33521 Tampere, Finland; Tampere University Hospital, Department of Dermatology and Venereology, 33521, Tampere, Finland. Electronic address: jussila.anna.k@student.uta.fi.
Source
Psychiatry Res. 2019 02; 272:387-391
Date
02-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Female
Finland - epidemiology
Humans
Male
Middle Aged
Seasonal Affective Disorder - diagnosis - epidemiology - psychology
Sunbathing - psychology - trends
Surveys and Questionnaires
Ultraviolet Rays - adverse effects
Abstract
Ultraviolet radiation (UVR) is a known risk factor for skin cancers. Those who are tanning dependent seek out UVR exposure. Many tanners have expressed symptoms of seasonal affective disorder (SAD), but conclusive evidence of a connection with tanning dependence is lacking. We evaluated the frequency of tanning dependence or abuse and symptoms of SAD among Finnish sunbathers and analysed whether phenomena are associated which could indicate a common biological mechanism. Sunbathing related tanning dependence/abuse among Finnish sunbathers were assessed using the Structured Interview for Tanning Abuse and Dependence measure (SITAD), and symptoms of SAD were assessed with the Seasonal Pattern Assessment Questionnaire (SPAQ). Of 229 sunbathers, 8% (n?=?18) were classified as tanning-dependent, and 26% (n?=?59) were classified as tanning abusers. Additionally, 16% (n?=?37) met the criteria for SAD, and 26% (n?=?60) met the criteria for subsyndromal seasonal affective disorder (S-SAD), but there was no significant association between tanning dependence or abuse and SAD or S-SAD. Sunbathing dependence or abuse and SAD/S-SAD were frequent among sunbathers, and they may promote sun-seeking risk behaviour. However, within this sample, tanning dependence and SAD/S-SAD were not associated.
PubMed ID
30605797 View in PubMed
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Impact of maternal height and gestational diabetes mellitus on offspring birthweight.

https://arctichealth.org/en/permalink/ahliterature299281
Source
Diabetes Res Clin Pract. 2019 Feb; 148:110-118
Publication Type
Journal Article
Observational Study
Date
Feb-2019
Author
Senja Masalin
Merja K Laine
Hannu Kautiainen
Mika Gissler
Marko Raina
Pirjo Pennanen
Johan G Eriksson
Author Affiliation
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: senja.lindholm@helsinki.fi.
Source
Diabetes Res Clin Pract. 2019 Feb; 148:110-118
Date
Feb-2019
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Birth Weight - physiology
Body Height - physiology
Body mass index
Cohort Studies
Delivery, obstetric - statistics & numerical data
Diabetes, Gestational - diagnosis - epidemiology - etiology
Female
Finland - epidemiology
Gestational Age
Humans
Infant, Newborn
Male
Mothers
Pregnancy
Risk factors
Young Adult
Abstract
To evaluate the impact of gestational diabetes mellitus (GDM) and maternal height on offspring birthweight.
This is an observational cohort study, encompassing 4 111 Finnish primiparous women from Vantaa city, Finland, with singleton deliveries between 2009 and 2015. Data were obtained from the Finnish Medical Birth Register. The study population was divided into five groups according to maternal height. Cut-offs for height levels were I?=?158?cm, II 159-163?cm, III 164-167?cm, IV 168-172?cm, V?=?173?cm. The main outcome measure was offspring birthweight, expressed as Z-scores according to sex and gestational age.
Independently, both maternal height and GDM increased offspring birthweight (p?
PubMed ID
30641170 View in PubMed
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Older persons with signs of frailty in a home-based physical exercise intervention: baseline characteristics of an RCT.

https://arctichealth.org/en/permalink/ahliterature299053
Source
Aging Clin Exp Res. 2019 Apr 02; :
Publication Type
Journal Article
Date
Apr-02-2019
Author
Sara Suikkanen
Paula Soukkio
Kaisu Pitkälä
Sanna Kääriä
Hannu Kautiainen
Sarianna Sipilä
Katriina Kukkonen-Harjula
Markku Hupli
Author Affiliation
Rehabilitation, South Karelia Social and Health Care District, Valto Käkelän katu 3, 53130, Lappeenranta, Finland. sara.suikkanen@eksote.fi.
Source
Aging Clin Exp Res. 2019 Apr 02; :
Date
Apr-02-2019
Language
English
Publication Type
Journal Article
Abstract
Increasing the level of physical activity among persons with signs of frailty improves physical functioning. There is a lack of long-term supervised physical exercise intervention studies including a validated definition of frailty.
To present baseline characteristics of persons with signs of frailty participating in a randomized long-term home-based physical exercise trial (HIPFRA), and to study associations between the severity of frailty, functional independence and health-related quality-of-life (HRQoL).
Three hundred persons,?=?65 years old and with signs of frailty (assessed by Fried´s phenotype criteria) were recruited from South Karelia, Finland and randomized to a 12-month physiotherapist-supervised home-based physical exercise program (n?=?150), and usual care (n?=?150). Assessments at the participants' homes at baseline, and after 3, 6 and 12 months included the Short Physical Performance Battery (SPPB), the Functional Independence Measure (FIM), HRQoL (15D) and the Mini-Mental State Examination (MMSE).
Eligibility was screened among 520 persons; 300 met the inclusion criteria and were randomized. One person withdrew consent after randomization. A majority (75%) were women, 182 were pre-frail and 117 frail. The mean age was 82.5 (SD 6.3) years, SPPB 6.2 (2.6), FIM 108.8 (10.6) and MMSE 24.4 (3.1) points, with no significant differences between the study groups. Inverse associations between the severity of frailty vs. FIM scores and HRQoL (p?
PubMed ID
30941731 View in PubMed
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Anticholinergic drug use and its association with self-reported symptoms among older persons with and without diabetes.

https://arctichealth.org/en/permalink/ahliterature298928
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Publication Type
Journal Article
Date
Apr-2019
Author
Niina-Mari Inkeri
Merja Karjalainen
Maija Haanpää
Hannu Kautiainen
Juha Saltevo
Pekka Mäntyselkä
Miia Tiihonen
Author Affiliation
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus - epidemiology
Female
Finland
Humans
Independent living
Male
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care
Self Report
Surveys and Questionnaires
Abstract
Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes.
The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older. Persons with diabetes were identified according to the ICD-10 diagnostic codes from electronic patient records. Two controls adjusted by age and gender were selected for each person with diabetes. This cross-sectional study was based on electronic primary care patient records and a structured health questionnaire. The health questionnaire was returned by 430 (81.6%) persons with diabetes and 654 (73.5%) persons without diabetes. Data on prescribed drugs were obtained from the electronic patient records. Anticholinergic drug use was measured according to the Anticholinergic Risk Scale. The presence and strength of anticholinergic symptoms were asked in the health questionnaire.
The prevalence of anticholinergic drug use was 8.9% in the total study cohort. There were no significant differences in anticholinergic drug use between persons with and without diabetes. There was no consistent association between anticholinergic drug use and self-reported symptoms.
There is no difference in anticholinergic drug use in older community-dwelling persons with and without diabetes. Anticholinergic drug use should be considered individually and monitored carefully.
PubMed ID
30315583 View in PubMed
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Comorbid opioid use is undertreated among forensic patients with schizophrenia.

https://arctichealth.org/en/permalink/ahliterature297569
Source
Subst Abuse Treat Prev Policy. 2018 11 06; 13(1):39
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
11-06-2018
Author
Kristiina Kivimies
Eila Repo-Tiihonen
Hannu Kautiainen
Jari Tiihonen
Author Affiliation
Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Niuvankuja 65, FI-70240, Kuopio, Finland. kristiina.kivimies@niuva.fi.
Source
Subst Abuse Treat Prev Policy. 2018 11 06; 13(1):39
Date
11-06-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Comorbidity
Diagnosis, Dual (Psychiatry) - statistics & numerical data
Female
Finland - epidemiology
Forensic Psychiatry - statistics & numerical data
Humans
Male
Opiate Substitution Treatment - statistics & numerical data
Opioid-Related Disorders - drug therapy - epidemiology
Registries
Retrospective Studies
Schizophrenia - epidemiology
Young Adult
Abstract
Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our aim was to study whether patients with schizophrenia have received opioid replacement therapy for their opioid use disorder.
The study sample consisted of 148 individuals diagnosed with schizophrenia who were in involuntary psychiatric treatment as forensic patients in Finland in 2012. The proportion of the study sample with comorbid opioid use disorder having received opioid replacement therapy prior to their forensic psychiatric treatment was compared to the available information of opioid dependent patients in general. The data were collected from forensic examination statements, patient files and other medical registers retrospectively.
Of the study sample, 15.6% (23/148) had a history of opioid use disorder, of whom 8.7% (2/23) had received opioid replacement treatment (95% confidence interval (Cl): 1.1-28.0), even though opioid use disorder had been diagnosed in the treatment system. According the available information the corresponding proportion among patients with opioid use disorder and using substance use disorder services was 30.4% (565/1860, 95% Cl: 28.3-32.5). The fraction of patients receiving opioid replacement therapy was significantly lower among patients with schizophrenia (p =?0.022).
Opioid replacement therapy was seldom used among schizophrenia patients who were later ordered to involuntary forensic psychiatric treatment. More attention should be paid to the possible use of opioids when planning treatment for patients with schizophrenia.
Our study is not a randomized controlled trial (but a register-based study); thus the trial registration is not applicable.
PubMed ID
30400965 View in PubMed
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Gestational diabetes in primiparous women-impact of age and adiposity: a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature295727
Source
Acta Obstet Gynecol Scand. 2018 02; 97(2):187-194
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Merja K Laine
Hannu Kautiainen
Mika Gissler
Marko Raina
Ilkka Aahos
Kajsa Järvinen
Pirjo Pennanen
Johan G Eriksson
Author Affiliation
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Source
Acta Obstet Gynecol Scand. 2018 02; 97(2):187-194
Date
02-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Factors
Body mass index
Cohort Studies
Comorbidity
Diabetes, Gestational - diagnosis - epidemiology
Female
Finland - epidemiology
Humans
Maternal Age
Obesity - epidemiology
Parity
Pregnancy
Prenatal Care - methods
Prenatal Diagnosis - methods
Risk factors
Young Adult
Abstract
Data on risk factors for gestational diabetes mellitus (GDM) in primiparous women is limited. The aim of this study was to assess the prevalence of GDM and simultaneously evaluate the impact of age and adiposity in primiparous women at risk of GDM risk.
This observational register-based cohort study from the city of Vantaa, Finland, included all 7750 primiparous women giving birth between 2009 and 2015 without previously diagnosed diabetes mellitus.
In primiparous women the prevalence of GDM was 16.5% and mean age was 28.2 years (5.2 SD). Primiparous women aged =35 years had a significantly higher risk for GDM than women aged
PubMed ID
29194561 View in PubMed
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Reliability and validity of the Finnish version of the prosthesis evaluation questionnaire.

https://arctichealth.org/en/permalink/ahliterature295643
Source
Disabil Rehabil. 2018 08; 40(17):2081-2087
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-2018
Author
Jussi Petteri Repo
Kirsi Piitulainen
Arja Häkkinen
Risto Paavo Roine
Hannu Kautiainen
Paju Becker
Erkki Juhani Tukiainen
Author Affiliation
a Department of Plastic Surgery , Helsinki University Hospital, University of Helsinki , Helsinki , Finland.
Source
Disabil Rehabil. 2018 08; 40(17):2081-2087
Date
08-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Amputation - psychology - rehabilitation
Amputees - psychology - rehabilitation
Female
Finland
Humans
Lower Extremity - surgery
Male
Middle Aged
Patient Reported Outcome Measures
Prosthesis Fitting - methods - psychology
Psychometrics - methods - standards
Quality of Life
Reproducibility of Results
Surveys and Questionnaires
Translations
Abstract
Thus far there have been no specific patient-reported outcome instrument in Finnish for health-related quality of life (HRQoL) assessment after major lower extremity amputation and successful prosthesis fitting.
The prosthesis evaluation questionnaire (PEQ) was translated and cross-culturally adapted into Finnish. Participants completed a questionnaire package including the Finnish version of the PEQ and the 15?D HRQoL instrument. Scales (n?=?10) were tested for internal consistency, floor-ceiling effect, and reproducibility for which participants completed the PEQ twice within a 2-week interval. Validity was tested by estimating the correlation between the 15?D index and the scales. The authors included 122 participants who had completed the questionnaire on two separate occasions in the final analysis.
Mean scale scores of the 10 scales varied from 52 to 83. Cronbach's alphas ranged from 0.67 to 0.96. The total score showed no floor-ceiling effect. Reproducibility of the scales was good (intraclass correlation coefficient, 0.78-0.87; coefficient of repeatability, 19-36). Significant correlations were observed between the 15?D index and the scales for ambulation, social burden, usefulness, and well-being.
This study provided evidence of the reliability and validity of the Finnish version of the PEQ in assessing the HRQoL among major lower extremity amputated patients who have been fitted with prosthesis. Implications for rehabilitation Measurement of quality of life during rehabilitation can provide important information on patients' well-being. The prosthesis evaluation questionnaire (PEQ) is a valid instrument for assessing health-related quality of life (HRQoL) after major lower extremity amputation. This study provided evidence of the reliability and validity of the Finnish version of the PEQ for assessing HRQoL among patient who have undergone major lower extremity amputation.
PubMed ID
28486856 View in PubMed
Less detail

Results of lumbar spine surgery: A postal survey.

https://arctichealth.org/en/permalink/ahliterature295475
Source
Scand J Pain. 2015 Jan 01; 6(1):9-13
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
Jan-01-2015
Author
Voitto Järvimäki
Lotta Juurikka
Merja Vakkala
Hannu Kautiainen
Maija Haanpää
Author Affiliation
Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
Source
Scand J Pain. 2015 Jan 01; 6(1):9-13
Date
Jan-01-2015
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Cohort Studies
Cross-Sectional Studies
Decompression, Surgical
Female
Finland
Humans
Lumbar Vertebrae - surgery
Male
Middle Aged
Orthopedic Procedures
Pain - epidemiology - etiology - surgery
Spinal Diseases - complications - epidemiology - surgery
Surveys and Questionnaires
Treatment Outcome
Young Adult
Abstract
Background and aim No studies have been published regarding the results of lumbar spine surgery a in population-based setting in Finland. Our objective was to investigate functional capacity and quality of life after lumbar spine surgery in a population-based cohort in Northern Finland, focusing on working-age patients. Methods This was a cross-sectional postal survey. Three questionnaires (a self-made questionnaire, the Oswestry Low Back Disability Questionnaire and the SF-36) were sent the patients aged 18-65 years who had undergone lumbar spine surgery due to disc herniation, instability or spinal stenosis in the Oulu University Hospital between June 2005 and May 2008. Results The postal survey was sent to 814 patients, of whom 537 patients (66%) replied. Of these, 361 (67%) underwent disc surgery, 85 (16%) stabilizing surgery and 91 (17%) decompression. Pain was absent or present only occasional in 51% in the disc surgery group, whereas it was present daily in 59% in the stabilizing surgery group and in 58% in the decompression group (P
Notes
CommentIn: Scand J Pain. 2017 Dec 29;6(1):7-8 PMID 29911583
PubMed ID
29911585 View in PubMed
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Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture - protocol of a randomized controlled trial (HIPFRA study).

https://arctichealth.org/en/permalink/ahliterature295229
Source
BMC Geriatr. 2018 Oct 01; 18(1):232
Publication Type
Journal Article
Date
Oct-01-2018
Author
Paula Soukkio
Sara Suikkanen
Sanna Kääriä
Hannu Kautiainen
Sarianna Sipilä
Katriina Kukkonen-Harjula
Markku Hupli
Author Affiliation
Rehabilitation, South Karelia Social and Health Care District, Valto Käkelän katu 3, FI-53130, Lappeenranta, Finland. paula.soukkio@eksote.fi.
Source
BMC Geriatr. 2018 Oct 01; 18(1):232
Date
Oct-01-2018
Language
English
Publication Type
Journal Article
Abstract
Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture.
This is a non-blinded, parallel group, randomized controlled trial performed in South Karelia Social and Health Care District, Finland (population 131,000). Three hundred community-dwelling older persons with signs of frailty (age?=?65) and 300 persons with a recent hip fracture (age?=?60) will be recruited. Frailty is screened by FRAIL questionnaire and verified by modified Fried's frailty criteria. Both patient groups will be randomized separately to a physiotherapy and a usual care arm. Individualized, structured and progressive physiotherapy will be carried out for 60 min, twice a week for 12 months at the participant's home. The primary outcome at 24 months is duration of living at home. Our hypothesis is that persons assigned to the physiotherapy arm will live at home for six months longer than those in the usual care arm. Secondary outcomes are functional capacity, frailty status, health-related quality-of-life, falls, use and costs of social and health care services, and mortality. Assessments, among others Short Physical Performance Battery, Functional Independence Measure, Mini Nutritional Assessment, and Mini-Mental State Examination will be performed at the participant's home at baseline, 3, 6, and 12 months. Register data on the use and costs of social and health care services, and mortality will be monitored for 24 months.
Our trial will provide new knowledge on the potential of intensive, long-term home-based physiotherapy among older persons at risk for disabilities, to enhance functional capacity and thereby to postpone the need for institutional care, and diminish the use of social and health care services.
ClinicalTrials.gov Identifier: NCT02305433 , Registered Nov 28, 2014.
Notes
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PubMed ID
30285645 View in PubMed
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Impact of early systemic lupus erythematosus on work disability-results from the Finnish nationwide register 2000-2007.

https://arctichealth.org/en/permalink/ahliterature294999
Source
Clin Rheumatol. 2018 May; 37(5):1413-1416
Publication Type
Journal Article
Date
May-2018
Author
Pia Elfving
Kari Puolakka
Vappu Rantalaiho
Hannu Kautiainen
Lauri J Virta
Oili Kaipiainen-Seppänen
Author Affiliation
Department of Medicine, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Kuopio, Finland. pia.elfving@kuh.fi.
Source
Clin Rheumatol. 2018 May; 37(5):1413-1416
Date
May-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Female
Finland - epidemiology
Humans
Incidence
Lupus Erythematosus, Systemic - epidemiology
Male
Middle Aged
Registries
Sick Leave - statistics & numerical data
Young Adult
Abstract
Objectives of this study were to examine work disability (WD) and its leading causes in incident SLE patients. Data were derived from the Finnish nationwide registries to identify all non-retired, 18 to 64-year-old incident SLE patients between 2000 and 2007. Sick benefits and WD pensions and the causes for them were monitored until the end of 2008. A total of 446 working-aged, incident SLE patients available for work force (mean age 42?±?13 years, 89% females) were found. During the follow-up (median 5.3 years), WD pension was granted to 27 patients. The most common cause was SLE itself (14 patients, 52%), with cumulative incidence of 3.4% (95% CI 1.9 to 5.8) in 5 years and 5.0% (95% CI 3.0 to 8.5) in 8 years, followed by musculoskeletal and psychiatric causes. The age- and sex- adjusted incidence ratio for WD pension in SLE patients due to any cause was 5.4 (95% CI 3.7 to 7.9) compared to the Finnish population. The mean number of WD days was 32 (95% CI 28 to 35) per patient-year among all SLE patients during the follow-up. The study concludes that SLE patients have an increased risk for WD already in early course of the disease.
Notes
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PubMed ID
29541950 View in PubMed
Less detail

Hemoglobin level and lipoprotein particle size.

https://arctichealth.org/en/permalink/ahliterature294299
Source
Lipids Health Dis. 2018 Jan 10; 17(1):10
Publication Type
Journal Article
Date
Jan-10-2018
Author
Päivi Hämäläinen
Juha Saltevo
Hannu Kautiainen
Pekka Mäntyselkä
Mauno Vanhala
Author Affiliation
Department of Internal Medicine, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland. Paivi.o.hamalainen@pshp.fi.
Source
Lipids Health Dis. 2018 Jan 10; 17(1):10
Date
Jan-10-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Body mass index
Cross-Sectional Studies
Diabetes Mellitus - diagnosis
Female
Finland
Hemoglobins - metabolism
Humans
Insulin Resistance
Lipoproteins, HDL - blood
Lipoproteins, LDL - blood
Lipoproteins, VLDL - blood
Male
Metabolic Syndrome - diagnosis
Middle Aged
Particle Size
Risk factors
Triglycerides - blood
Abstract
Alterations in lipoprotein size are associated with increased cardiovascular disease risk. Higher hemoglobin levels may indicate a higher risk of atherosclerosis and was previously associated with obesity, metabolic syndrome, and insulin resistance. No previous studies have investigated an association between hemoglobin concentration and lipoprotein particle size.
We conducted a population-based, cross-sectional study of 766 Caucasian, middle-aged subjects (341 men and 425 women) born in Pieksämäki, Finland, who were categorized into five age groups. The concentrations and sizes of lipoprotein subclass particles were analyzed by high-throughput nuclear magnetic resonance (NMR) spectroscopy.
Larger very low density lipoprotein (VLDL) particle diameter was associated with higher hemoglobin concentrations in men (p = 0.003). There was a strong relationship between smaller high density lipoprotein (HDL) particle size and higher hemoglobin concentration in both men and women as well as with smaller low density lipoprotein (LDL) particle size and higher hemoglobin concentration in men and women (p 
Notes
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Cites: J Am Coll Cardiol. 2007 Feb 6;49(5):547-53 PMID 17276177
PubMed ID
29321013 View in PubMed
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