The results of two studies, one in Finland and one in the U.S.A., raise the possibility that fetal damage previously attributed to phenytoin and other anticonvulsant drugs, principally phenobarbitone, may be due to epilepsy itself. In the U.S.A., drug-exposure information was collected before delivery in a cohort of 50 282 mother/child pairs. The total malformation rate in 305 children born to epileptic mothers was 10.5%, as against 6.4% in the remainder (p less than 0.01); corresponding rates for major malformations were 6.6% and 2.7%. When the fathers had epilepsy, the malformation-rates in their children were intermediate. The rates did not vary significantly according to maternal anticonvulsants therapy. Mental and motor scores as 8 months of age, and intelligence quotient scores at 4 years were lower in children of epileptic mothers, but not in children of epileptic fathers. The scores showed only random variation according to maternal anticonvulsant therapy. In Finland, 2784 children with craniofacial anomalies were compared with an equal number of normal children; 8 and 2 mothers, respectively, received anticonvulsants, while pregnant, for epilepsy. In that study, the separate effects of the disease and its treatmet could not be evaluated. Both studies did not find evidence of fetal damage when phenobarbitone was taken for indications other than epilepsy.
Association of alcohol consumption and Helicobacter pylori infection in young adulthood and early middle age among patients with gastric complaints. A case-control study on Finnish conscripts, officers and other military personnel.
There is growing evidence that Helicobacter pylori is responsible for a variety of gastric and duodenal changes which can eventually lead to stomach cancer. Little is known about risk factors for H. pylori infection. We re-analyzed the association of alcohol with H. pylori positivity in 451 conscripts, officers and other military personnel endoscoped due to gastric complaints in the Central Military Hospital of Finland in 1987 and 1988. Serology and culture were done in all patients. Alcohol consumption histories were obtained by use of a self-administered questionnaire. We observed a high odds ratio (OR) of H. pylori infection among young adults who were heavy alcohol consumers compared to non-drinkers (OR 5.32, 95% confidence interval: 1.09-25.95). There was evidence of a dose response when heavy and moderate drinkers were compared to non-drinkers (Mantel-Haenszel chi 2 for trend, p = 0.02) in young adulthood. A subgroup of young respondents who reported drinking all classes of alcohol (including hard liquor) showed an even stronger association and more significant dose-response. Multivariate techniques revealed a qualitative interaction of alcohol with H. pylori positivity in different age groups and among old people an inverse association of H. pylori and alcohol consumption was observed. These findings, if confirmed independently, might have implications for preventing a variety of gastric and duodenal lesions, since they allow identification of high risk groups.
The aim was to test the hypothesis that atopy increases the occurrence of chronic bronchitis. Relations between atopy, smoking, and chronic bronchitis were studied in farmers. The data were from two successive postal surveys and a skin prick tested subsample. The cross-sectional study consisted of 9017 farmers. Those 6899 farmers who did not have chronic bronchitis at the beginning and who continued farming were followed for three years. A sample of 150 farmers was skin-tested with 36 allergens. The prevalence of chronic bronchitis (rate per 1000), standardised for age and sex, was 41 in non-atopic non-smokers, 101 in atopic non-smokers, 106 in non-atopic smokers, and 257 in atopic smokers (effect of atopy: p less than 0.001; effect of smoking: p less than 0.001). The standardised incidence rates of chronic bronchitis (per 1000 farming years) were 14, 34, 36, and 50, respectively (atopy: p less than 0.001; smoking p less than 0.001). The relative risk of chronic bronchitis, calculated from the incidence data adjusting for the effects of age, sex, smoking or atopy by logistic regression analysis was 2.2 for atopy (95% confidence interval 1.8-2.7) and 2.3 for smoking (1.8-2.9). Only 20 farmers had chronic bronchitis in the skin-tested subjects; the results were consistent with the findings in the surveys but did not reach statistical significance for atopy. In conclusion, atopy and smoking have independent and additive effects on the occurrence of chronic bronchitis at least in dusty farming work.
Cites: Ann Intern Med. 1976 Feb;84(2):134-91252041
Cites: Am Rev Respir Dis. 1979 Feb;119(2):193-203434592
Cites: Am Rev Respir Dis. 1980 Feb;121(2):329-387362139
Eating disorders are often associated with regurgitation of gastric contents into the mouth and dental erosion. In this study the dental status was evaluated in bulimic patients. Thirty-five bulimics, diagnosed in the Outpatient Departments of Psychiatry and Adolescent Psychiatry of the University Central Hospital in Helsinki, and 105 controls matched for age, sex, and educational level were examined clinically, and the factors associated with dental erosion and caries were evaluated in an interview. Severe dental erosion and dental caries were significantly commoner among bulimics than controls. Bulimics commonly had a low salivary flow rate, but other apparent risk factors of dental erosion did not differ from those of controls. A feeling of dry mouth was commoner among bulimics than controls, and bulimics had an increased tooth sensitivity to cold and touch. More should be done to protect teeth from dental erosion among bulimics, because loss of tooth tissue remains even if the eating disorder disappears.
The possible effects of working with video display terminals (VDTs) during pregnancy on the occurrence of cardiovascular malformations in the offspring was studied in 500 cases and 1055 controls. The cases represented all registered cardiovascular malformations reported in Finland during 1982-84, excluding those with chromosomal anomaly or known genetic syndrome. The controls were randomly selected from all babies born during the same period. Both the case and control mothers were interviewed by midwives using a structured questionnaire approximately three months after delivery. In this interview the mother's occupation, job description and employer during the first trimester were noted, as were large number of other exposures to chemical and physical factors. An industrial hygienist examined all these records for information indicating exposure to VDTs, unaware of case/control status. Work with VDTs during the first trimester of pregnancy was ascertained for 30 case mothers (6.0%, 30/500) and 53 control mothers (5.0%, 53/1055). In logistic regression analysis maternal exposure to VDTs for at least 20h a week during the first trimester of pregnancy showed a point estimate of odds ratio of 1.4 with 95% confidence limits of 0.5 and 3.8, when adjusted for age and alcohol use. Maternal exposure to VDTs was not associated with indicators of fetal growth such as birthweight, placental weight or length of gestation.
In order to investigate the possible association between cardiovascular malformations and maternal exposure to organic solvents during the first trimester of pregnancy, 569 cases and 1,052 controls were retrospectively studied. The cases represented all infants with diagnosed cardiovascular malformations born in Finland in 1982-1984, and the controls were randomly selected from all normal births in the country during the same period. All mothers were interviewed approximately 3 months after delivery by a midwife using a structured questionnaire. Exposures to organic solvents at work during the first trimester of pregnancy were slightly more prevalent among the mothers of affected infants (10.4%) than among those of controls (7.8%). Logistic regression analysis of exposure to organic solvents showed an adjusted relative odds ratio of 1.3 (95% confidence interval, 0.8-2.2). In the analysis of ventricular septal defect, exposure to organic solvents showed an adjusted relative odds ratio of 1.5 (95% confidence interval, 1.0-3.7).
Temporal trends of caries frequency in 6-17-year-old children in Finland and its counties during 1975-79 are reported. Initially the attendance rate was 70%: during the 4-year follow-up it increased to 84%. The cross-sectional annual proportion of children needing curative treatment diminished from 80% to 67% at the age of 8 years; the changes among the 12- and 16-year-old children were 78-66% and 86-76%, respectively. The proportion of entirely caries-free children increased from 2.5% to 9.2% at the age of 8 years, only a slight increase was found in the older age groups. The mean DMFT value decreased continuously at all ages: in the 8-year-old children it decreased from 2.7% to 1.7%, in 12-year-olds from 6.7% to 5.2% and at the age of 16 from 13.4% to 11.6%. The caries scores decreased most in areas where the initial values were highest. In the county with high fluoride levels, where the initial caries scores were smallest, only slight improvement in the caries situation was found; this indicates no major change in recording of caries. Although a simultaneous improvement of the national attendance rate and the caries scores were observed, no consistent associations were found between the changes in the attendance rate and the changes in various caries indices when age and geographical area were considered in the analyses. It is concluded that the marked decrease in caries frequency is mainly due to preventive measures.
Nationwide and regional participation in the newly started dental care system, occurrence of caries and proportion of children registered to be in need of restorative treatment during 1974-1979 were studied in 3-5-year-old Finnish children. The data were collected from the annual reports of municipal dental health centers. The mean annual proportion of children participating in the care increased from 27% in 1974 to 71% in 1979. A clear improvement was noticed in each county, especially in areas where the earlier situation was poor. During the study period an average proportion of entirely cariesfree children increased from 24% at the beginning to 57% at the end of the study. The mean annual proportion of children recorded to be in need of restorative care decreased from 61% at the beginning to 32% at the end of the study period. The mean dmft value decreased from 3.7 in 1974 to 1.7 in 1979. A strong inverse relationship existed between the dental health at the beginning of the study period and the extent of changes in dental health during the 6-year-period. Thus regional differences having greatly diminished since the introduction of the public dental care system.
A random sample of 7-16-year-old children (n = 2778) who visited municipal dental clinics in fluoridated and non fluoridated areas were studied. Structured questionnaires were used to collect data on social class and fluoride exposure; caries diagnoses were made by local dentists in municipal dental clinics. Children from the highest social class had the lowest caries frequency in both fluoridated and nonfluoridated areas. Differences between middle and lower class children were small. Water fluoridation had a similar effect in all social classes.