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Abuse of alcohol in sudden out-of-hospital deaths in Finland.

https://arctichealth.org/en/permalink/ahliterature218488
Source
Alcohol Clin Exp Res. 1994 Apr;18(2):255-60
Publication Type
Article
Date
Apr-1994
Author
M. Perola
E. Vuori
A. Penttilä
Author Affiliation
Department of Forensic Medicine, University of Helsinki, Finland.
Source
Alcohol Clin Exp Res. 1994 Apr;18(2):255-60
Date
Apr-1994
Language
English
Publication Type
Article
Keywords
Accidents - mortality
Adolescent
Adult
Aged
Alcoholism - complications - mortality
Cause of Death
Death Certificates
Death, Sudden - epidemiology - etiology
Death, Sudden, Cardiac - epidemiology - etiology
Ethanol - pharmacokinetics
Female
Finland - epidemiology
Homicide - statistics & numerical data
Humans
Liver Diseases, Alcoholic - complications - mortality
Male
Middle Aged
Risk factors
Suicide - statistics & numerical data
Abstract
Alcoholism is known to be greatly underdiagnosed in death certificates, a fact that biases in estimates of alcohol-related mortality. An autopsy series of 1658 cases (920 with natural cause of death and 738 nonnatural) was reviewed to evaluate the extent of this bias, and also to see how well different sources of information served as indicators of alcoholism when alcohol-related disease diagnosed at autopsy was considered as a gold standard. A stepwise logistic regression model adjusted by age and sex showed police reports of individual's alcohol usage and blood alcohol concentration (BAC) of > 2.9/1000 at autopsy to be the two most significant predictors of chronic alcohol abuse (p 2.9/1000), due to its high specificity, as particularly suggestive of chronic heavy drinking. However, it is wise to use these parameters only as an aid in decision-making, not as sole indicators of alcoholism. Deaths associated with chronic heavy drinking were frequent, 50.5% of the total series (male 56.4%, female 37.1%). For all but one age-group (male 45-64 years), however, death certificates mentioned alcohol-related diseases in less than half of these cases. Especially evident underdiagnosis was found for female and males 65 years and older. These results indicate that alcoholism is frequent in such a highly selected population as a series of forensic autopsies and suggest that estimates of prevalence of alcoholism based only on review of death certificates are to be considered with great caution.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
8048723 View in PubMed
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[Accidents with fatal outcome in Finnish leisure boating 1986-1988].

https://arctichealth.org/en/permalink/ahliterature103579
Source
Beitr Gerichtl Med. 1990;48:185-91
Publication Type
Article
Date
1990
Author
A. Penttilä
J. Pikkarainen
Author Affiliation
Institut für Rechtsmedizin, Universität Helsinki.
Source
Beitr Gerichtl Med. 1990;48:185-91
Date
1990
Language
German
Publication Type
Article
Keywords
Cause of Death
Cross-Sectional Studies
Drowning - mortality
Finland - epidemiology
Humans
Incidence
Leisure Activities
Risk factors
Ships - legislation & jurisprudence
Abstract
All 291 fatal accidents (510 persons on board, 318 drowned) in water traffic in Finland in 1986-1988 were investigated by specific teams. Only some data of this extensive investigation are presented in this study. Staggering and falling in boat because of drunkenness, falling over and sinking of boat were the main causes of getting into water of the people aboard. Only 3.5% of the drowned had used life jackets and 9.7% of them could not swim. The reduced ability to swim because of alcohol and the exhaustion were in about half of the drowned the actual cause and the cold water in one third the background factor for drowning. The results indicate that fatal accidents in water traffic are a major problem of males (95.9%) and give important information for countermeasures.
PubMed ID
2241787 View in PubMed
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Age-dependent association of apolipoprotein E genotype with coronary and aortic atherosclerosis in middle-aged men: an autopsy study.

https://arctichealth.org/en/permalink/ahliterature201193
Source
Circulation. 1999 Aug 10;100(6):608-13
Publication Type
Article
Date
Aug-10-1999
Author
E. Ilveskoski
M. Perola
T. Lehtimäki
P. Laippala
V. Savolainen
J. Pajarinen
A. Penttilä
K H Lalu
A. Männikkö
K K Liesto
T. Koivula
P J Karhunen
Author Affiliation
Medical School, University of Tampere, Tampere University Hospital, Finland. ei46478@uta.fi
Source
Circulation. 1999 Aug 10;100(6):608-13
Date
Aug-10-1999
Language
English
Publication Type
Article
Keywords
Age Factors
Alcoholism - mortality
Alleles
Aorta, Abdominal - pathology
Aorta, Thoracic - pathology
Aortic Diseases - epidemiology
Apolipoprotein E3
Apolipoprotein E4
Apolipoproteins E - genetics
Arteriosclerosis - epidemiology - genetics - pathology
Autopsy
Body mass index
Cardiovascular Diseases - mortality
Cause of Death
Comorbidity
Coronary Artery Disease - epidemiology - genetics - pathology
Finland - epidemiology
Gene Frequency
Genetic Predisposition to Disease
Genotype
Heterozygote
Humans
Male
Middle Aged
Obesity - epidemiology
Violence
Abstract
Apolipoprotein E (apoE) polymorphism is one of the genetic determinants of serum cholesterol values. The apoE epsilon4 allele has been associated with advanced coronary heart disease (CHD) diagnosed by angiography, but the role of the apoE genotype in atherosclerosis has not been confirmed at vessel-wall level, nor is any age-dependent effect of the apoE genotype on the development of CHD known.
The right and left anterior descending coronary arteries (RCA and LAD) and the aorta from 700 male autopsy cases (Helsinki Sudden Death Study) in 1981-1982 and 1991-1992 (average age 53 years, range 33 to 70 years) were stained for fat, and all areas covered with fatty streaks, fibrotic plaques, and complicated lesions were measured. In the RCA and LAD, the apoE genotype was significantly associated with the area of total atherosclerotic lesions in men
PubMed ID
10441097 View in PubMed
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[Alcohol consumption in males with sudden unexpected death in Helsinki].

https://arctichealth.org/en/permalink/ahliterature231454
Source
Beitr Gerichtl Med. 1989;47:361-8
Publication Type
Article
Date
1989
Author
A. Penttilä
P J Karhunen
Source
Beitr Gerichtl Med. 1989;47:361-8
Date
1989
Language
German
Publication Type
Article
Keywords
Accidents - legislation & jurisprudence
Adult
Aged
Alcoholism - mortality
Cause of Death
Death, Sudden
Finland
Homicide - legislation & jurisprudence
Humans
Male
Middle Aged
Risk factors
Suicide - legislation & jurisprudence
Abstract
The consumption of alcohol during the preceding year before death was investigated in 400 consecutive sudden and unexpected natural and non-natural out-of-hospital deaths in males aged 35-69 years in Helsinki. Information about the consumption of alcohol was obtained by interviewing the next kind or a good friend of the deceased (84.5%), or only from the police protocols (13.3%). In the whole material the consumption of alcohol was as follows; the proportion of teetotallers was 6.8%, that of moderate users 35.0% and that of heavy users/alcoholics 56.0%. In addition, there were few undefined cases (2.3%). In general, the consumption of alcohol was heavy in all categories of deaths. However, it was not so heavy among the deceased with a heart disease as the cause of death (the proportion of heavy users/alcoholics 42.9%) as in the other groups of deceased (63.0-85.4%). The results indicate that the heavy chronic consumption of alcohol is common in a large proportion of males who die suddenly and suggest that in addition to the acute consumption also the chronic use of alcohol is an important risk factor in many deaths among middle-aged Finns.
PubMed ID
2818504 View in PubMed
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An international comparison of mortality in middle-aged men from cardiovascular diseases during 1970--1974.

https://arctichealth.org/en/permalink/ahliterature75281
Source
Forensic Sci Int. 1979 May-Jun;13(3):221-37
Publication Type
Article
Author
A. Penttilä
A. Ahonen
Source
Forensic Sci Int. 1979 May-Jun;13(3):221-37
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - mortality
Comparative Study
Humans
Male
Middle Aged
World Health Organization
Abstract
An international comparison of mortality rates in middle-aged men (35--54 years) from cardiovascular diseases (CVD) during the period 1970--1974 was made. The material for this study was obtained from the statistics of the WHO (World Health Statist. Ann. 1970--1974, Vol. I, Vital Statistics of Causes of Death. WHO, Geneva, 1973--1976). The mean death rate of middle-aged men from all CVD and ischaemic heart diseases was clearly higher in Finland than in any other country in the world during the 5-year period. The mortality rates according to all ICD (International Classification of Diseases) main groups of diseases were determined for a selected group of countries containing all the Scandinavian countries, the United States, Canada, Hungary, Australia, Scotland, and Czechoslovakia. The death rates of all natural (ICSI-XVI) and unnatural causes (ICDXVII) were higher in Finland than in the other selected countries. Also the proportion of cardiovascular deaths as a percentage of all natural deaths was clearly higher in Finland than in any of the above countries, whereas in these countries proportionally more deaths were due to neoplasms than in Finland, especially in men aged 35--44. Only in Hungary did infectious diseases account for about 4.5% of all natural deaths; in the other countries they accounted for only about 1--2%. In the United States, Sweden, Czechoslovakia and Canada a clearly higher relative number of deaths (about 9--13%) were due to diseases of the digestive system than in the other countries (about 3--9%), whereas the relative numbers of deaths from respiratory and genitourinary diseases were uniform among all selected countries. Only in Denmark and Norway was a prominent proportion of the deceased (3.5--9.5%) certified as having died due to some symptom or ill-defined condition. About 90% of all middle-aged men died in each country from various diseases of the above six main ICD categories. As a whole, the above single deviations from the general trend were so small that the present results do not support the view that the differences in certifying and coding practices could explain the significant differences found in cardiovascular mortality of middle-aged men between various countries.
PubMed ID
456963 View in PubMed
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Arteriosclerotic and other degenerative heart diseases in Finland. I. A death certificate study of the frequency of degenerative heart diseases among males and females.

https://arctichealth.org/en/permalink/ahliterature252673
Source
Scand J Soc Med. 1975;3(2):61-7
Publication Type
Article
Date
1975
Author
A. Penttilä
A. Ahonen
Source
Scand J Soc Med. 1975;3(2):61-7
Date
1975
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Arteriosclerosis - mortality
Female
Finland
Heart Diseases - mortality
Humans
Male
Middle Aged
Population Surveillance
Residence Characteristics
Sex Factors
Abstract
All available information recorded on the death certificates of 12973 Finnish persons who, according to the official Finnish mortality statistics, died in 1968 from arteriosclerotic and other degenerative heart diseases (ADHD, rubrics 420-422 in ICD) comprised the material of the present study. The mortality of males from ADHD analysed by age and place of residence was very high when compared with various national rates of international WHO statistics. The degree of urbanization of the domicile did not have any statistically significant effect on the mortality from ADHD. Significant differences between various provinces were found in the mortality of males from ADHD. The male population living in the eastern provinces of Finland showed a highly significantly higher mortality from degenerative heart diseases than the male population living on the west coast. A highly significant difference was found in mortality between various subgroups of the Finnish male and female populations analysed by age, place of residence, and type of community. The uniform difference between the mortality of various male and female subgroups of the Finnish population, which was obtained using the present statistical survey of death certificates, and the fairly uniform distribution of high rate of mortality of males from degenerative heart diseases in most regions of the country lend further support to the reliability of cause-of-death statistics, since certification of deaths can then be regarded to occur uniformly and with about the same accuracy in different parts of the country.
PubMed ID
1179186 View in PubMed
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Arteriosclerotic and other degenerative heart diseases in Finland. II. A death certificate study of the examination of the cause of death from degenerative heart diseases.

https://arctichealth.org/en/permalink/ahliterature252672
Source
Scand J Soc Med. 1975;3(2):69-74
Publication Type
Article
Date
1975
Author
A. Penttilä
A. Ahonen
Source
Scand J Soc Med. 1975;3(2):69-74
Date
1975
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Arteriosclerosis - mortality - pathology
Autopsy
Female
Finland
Heart Diseases - mortality - pathology
Humans
Male
Middle Aged
Population Surveillance
Rural Population
Sex Factors
Urban Population
Abstract
A statistical survey of death certificates was made to analyse the ante-mortem and post-mortem medical and medico-legal examinations used in the determination of the cause of death of 12973 decedents who were recorded officially to have died of arteriosclerotic and other degenerative heart diseases in Finland in 1968. The relationship between the regional autopsy rate and the rate of mortality from degenerative heart diseases was studied in particular. The survey indicated that there was no systematic relationship between the type of ante-mortem and post-mortem cause-of-death examinations, including medical and medico-legal autopsies, and the rate of mortality from arteriosclerotic and other degenerative heart diseases in various groups of the Finnish population analysed by age, sex and domicile. This was concluded to be an indication of the reliability of Finnish cause-of-death statistics of degenerative heart diseases which show a generally high rate of mortality and prominent regional differences in the rate of deaths from those diseases among the Finnish male population.
PubMed ID
1179187 View in PubMed
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Asbestos exposure and pulmonary fiber concentrations of 300 Finnish urban men.

https://arctichealth.org/en/permalink/ahliterature218962
Source
Scand J Work Environ Health. 1994 Feb;20(1):34-41
Publication Type
Article
Date
Feb-1994
Author
A. Karjalainen
E. Vanhala
P J Karhunen
K. Lalu
A. Penttilä
A. Tossavainen
Author Affiliation
Finnish Institute of Occupational Health, Helsinki.
Source
Scand J Work Environ Health. 1994 Feb;20(1):34-41
Date
Feb-1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Asbestos - isolation & purification
Asbestosis - mortality - pathology
Cause of Death
Electron Probe Microanalysis
Finland - epidemiology
Humans
Lung - pathology
Male
Microscopy, Electron, Scanning
Middle Aged
Occupational Exposure - adverse effects
Risk factors
Urban Population - statistics & numerical data
Abstract
The aim of the study was to determine the pulmonary concentrations of mineral fibers in the Finnish male urban population and to evaluate the analysis of pulmonary fiber burden by scanning electron microscopy (SEM) as an indicator of past fiber exposure.
The pulmonary concentration of mineral fibers was determined by SEM and compared with occupational history for a series of 300 autopsies of urban men aged 33 to 69 years.
The concentration of fibers (f) longer than 1 micron ranged from
PubMed ID
8016597 View in PubMed
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Association of FXIII Val34Leu with decreased risk of myocardial infarction in Finnish males.

https://arctichealth.org/en/permalink/ahliterature203068
Source
Atherosclerosis. 1999 Feb;142(2):295-300
Publication Type
Article
Date
Feb-1999
Author
U. Wartiovaara
M. Perola
H. Mikkola
K. Tötterman
V. Savolainen
A. Penttilä
P J Grant
M J Tikkanen
E. Vartiainen
P J Karhunen
L. Peltonen
A. Palotie
Author Affiliation
Department of Clinical Chemistry and Biomedicine, Helsinki University Central Hospital, Finland.
Source
Atherosclerosis. 1999 Feb;142(2):295-300
Date
Feb-1999
Language
English
Publication Type
Article
Keywords
Alleles
DNA - analysis
DNA Primers - chemistry
Factor XIII - genetics
Fibrinolysis - genetics
Finland - epidemiology
Genetic markers
Genotype
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology - genetics
Plasminogen Activator Inhibitor 1 - genetics
Polymorphism, Genetic
Prevalence
Risk factors
Abstract
Factor XIII is a transglutaminase that crosslinks fibrin in the last steps of the coagulation process. A few polymorphic sites have been identified in this gene, one of them being a point mutation (FXIII Val34Leu), leading to an amino acid change of valine to leucine. Recently, in British patients, FXIII 34Leu allele was suggested to be associated with a decreased incidence of myocardial infarction (MI). PAI-1 4G/4G genotype seemed to lessen the beneficial effect of FXIII 34Leu allele. The aim of our study was to further investigate the possible protective role of the FXIII 34Leu allele against MI and its suggested interaction with the PAI-1 4G/5G polymorphism. We carried out genotype analyses for FXIII Val34Leu using solid-phase minisequencing in two independent Finnish study groups. In our study, the FXIII 34Leu allele was associated with a lower risk of MI (P = 0.009), however, the PAI-1 4G allele showed no interaction with this polymorphism. To establish the population frequency of the FXIII 34Leu allele and to study the possible variations in Finland four DNA pools from different geographical areas of Finland were genotyped. No significant differences in the allele frequencies were observed (21-28%) except in the Eastern Kainuu area (13%), an area with an increased risk of mortality from coronary artery disease (CAD), supporting the results presented above. The association of FXIII 34Leu variant with a lower incidence of myocardial infarction suggests a new role for FXIII in a polygenic thrombotic disease.
PubMed ID
10030380 View in PubMed
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55 records – page 1 of 6.