Incidence rates for cervical cancer were analyzed for Finland in 1953 to 1974. The age-specific incidence rates fit an age-incidence curve based on the assumption of two epidemiological components. The time trends give support to the hypothesis that one of the components occurs at a lower age and is preceded by a carcinoma in situ stage. The risk of cervical cancer originating from the component occurring in younger women showed a decreasing trend which correlated with the organized mass screening programme. The other component occurred later in life and was not influenced by the screening programme. It was estimated that the proportion of the cases in the earlier category decreased from 53% in the 1950s to 17% in 1973 to 1974 of all cases of cervical cancer diagnosed in the Finnish population.
The Kuopio Regional Institute of Occupational Health, in collaboration with the Social Insurance Institution and the National Board of Health, conducted and evaluated a national model for the farmers' occupational health services. In January 1985 the National Board of Health instructed the Finnish municipal health centers to start the provision of farmers' occupational health services based on the recommendation given by the research group. The service was evaluated by experiments carried out during 1982, 1985, and 1986. The main problem in function of the services was that the health hazards (exposures) were difficult to observe and evaluate. The system of how the occupational health nurse evaluates the working conditions should be further developed. The efficiency of the services was studied by postal inquiries in 1982 and 1986. Farmers' knowledge about the appropriate means of reducing hazardous exposures had increased significantly due to the occupational health services. At the local level, the main problem in providing services for occupational farmers is that health centers do not have the resources to offer services for all farmers at the same time. Altogether by the end of 1986, about 30% of all active farmers in Finland (45,000 farmers) were willing to have occupational health services, which is voluntary for self-employed farmers.
Ovarian granulosa cell tumor lung metastases regressed, and symptoms were relieved, during gonadotropin-releasing hormone (GnRH) agonist analog therapy after the failure of operative treatment and cytotoxic chemotherapy, indicating the hormone dependence of the malignancy. The response was transient, but the largest metastasis did not relapse. This case report suggests that GnRH analogs may offer a new approach to the treatment of ovarian stromal cell malignancies.
OBJECTIVE: To evaluate the bleeding patterns and clinical compliance associated with postmenopausal amenorrhea-inducing forms of hormone replacement therapy using either percutaneous estradiol-gel and a levonorgestrel-releasing intrauterine device or an oral/vaginal natural progesterone. METHODS: Sixty postmenopausal women with an intact uterus were followed over 12 months in this open, non-randomised, parallel group study. All patients continuously received a gel containing 1.5 mg of estradiol daily. The women were divided into three groups on the basis of progestin administration. Twenty women (group I) had a levonorgestrel-releasing device (LNG-IUD) inserted at the beginning of the study. Twenty-one women (group II) received oral natural micronised progesterone (oral P) 100 mg daily during 25 calendar days each month, and 19 women (group III) used vaginal natural micronised progesterone (vaginal P) 100-200 mg daily during 25 calendar days each month (higher dose if spotting occurred). Clinic visits were at 0, 3, 6 and 12 months. Bleeding patterns were recorded by the patient in a diary and clinical compliance was evaluated at control visits during the treatment. Symptoms were recorded using a modified Kuppermann index. The serum estradiol concentration was determined at the 0, 6 and 12 month control visits. RESULTS: 80% (n = 16) of the patients in the LNG-IUD group, 67% (n = 14) in the oral P group II and 53% (n = 10) in the vaginal P group were without bleeding at 12 months. Spotting was common during the first 3 months. Symptom relief was good in each group. The LNG-IUD did not cause any serious side-effects. Compliance was good for LNG-IUD and oral progesterone but not for vaginal progesterone. CONCLUSIONS: Percutaneous estradiol-gel associated with LNG-IUD is an appropriate method of hormone replacement therapy. The combination of oral natural progesterone with estradiol-gel is also useful, although bleeding episodes complicated the treatment in one third of the patients. The vaginal administration of natural progesterone was impractical due to bleeding disorders.
This study determined whether people visiting a doctor because of infection had an increased risk of myocardial infarction.
For 83 case patients and 249 matched control patients nested in a cohort of 3172 Finnish male farmers, comparisons were made on the basis of visits to a doctor because of infection.
Infections of the upper respiratory tract were statistically significantly associated with coronary artery disease. The odds ratio was 3.2 (95% confidence interval = 1.2, 8.5) for patients visiting a doctor four or more times because of infection of upper respiratory tract compared with patients with three or fewer visits.
Men in this sample with recurrent or chronic infections of the upper respiratory tract exhibited a pronounced risk for myocardial infarction.
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Cites: Am J Cardiol. 1984 Feb 1;53(4):481-26695777
A nested case-control study was made to analyze the correlation between back trouble and myocardial infarction.
The purpose of the present study was to determine whether individuals visiting a doctor because of back trouble have an increased risk for myocardial infarction.
According to previous results, back pain precedes myocardial infarction in young and middle-aged male farmers. There are no previous results concerning the risk of myocardial infarction among patients visiting a doctor because of back pain.
The basic cohort includes 3172 Finnish farmers. Those having myocardial infarction from February 1, 1980 through December 31, 1992 were considered case studies. Three matched control subjects were selected for every case subject. The final group had 83 case subjects and 249 matched control subjects. Case subjects and control subjects were compared according to doctor visits because of back complaint during the follow-up period, which began February 1, 1980 and ended on the date of myocardial infarction of each case subject.
Fewer case subjects than control subjects visited a doctor because of back disorders during the follow-up period. This was especially true for nonspecific back pain (odds ratio = 0.51; confidence interval = 0.25-1.05).
Atherosclerosis is not a probable cause of any kind of back pain among individuals visiting a general practitioner because of back complaint.