A cohort of 4 475 Finnish men was followed up during 1964-80 in order to study regional differences in mortality from cardiovascular diseases, especially ischaemic heart disease (IHD). The west/east gradient in cardiovascular mortality recorded in several previous studies was greatly age-dependent. The excess eastern risk was a feature of younger age groups; with increasing age the risk pattern was reversed. The risk factors in IHD in eastern Finland have an element which somehow accelerates the process of this disease.
Research has demonstrated a bidirectional relationship between physical function and depression, but studies on their association in migrant populations are scarce. We examined the association between mental health symptoms and mobility limitation in Russian, Somali and Kurdish migrants in Finland.
We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The participants comprised 1357 persons of Russian, Somali or Kurdish origin aged 18-64 years. Mobility limitation included self-reported difficulties in walking 500?m or stair climbing. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25) and symptoms of somatization using the somatization subscale of the Symptom Checklist-90 Revised (SCL-90-R). A comparison group of the general Finnish population was selected from the Health 2011 study.
Anxiety symptoms were positively associated with mobility limitation in women (Russians odds ratio [OR] 2.98; 95% confidence interval [CI] 1.28-6.94, Somalis OR 6.41; 95% CI 2.02-20.29 and Kurds OR 2.67; 95% CI 1.41-5.04), after adjustment for socio-demographic factors, obesity and chronic diseases. Also somatization increased the odds for mobility limitation in women (Russians OR 4.29; 95% CI 1.76-10.44, Somalis OR 18.83; 95% CI 6.15-57.61 and Kurds OR 3.53; 95% CI 1.91-6.52). Depressive symptoms were associated with mobility limitation in Russian and Kurdish women (Russians OR 3.03; 95% CI 1.27-7.19 and Kurds OR 2.64; 95% CI 1.39-4.99). Anxiety symptoms and somatization were associated with mobility limitation in Kurdish men when adjusted for socio-demographic factors, but not after adjusting for obesity and chronic diseases. Finnish women had similar associations as the migrant women, but Finnish men and Kurdish men showed varying associations.
Mental health symptoms are significantly associated with mobility limitation both in the studied migrant populations and in the general Finnish population. The joint nature of mental health symptoms and mobility limitation should be recognized by health professionals, also when working with migrants. This association should be addressed when developing health services and health promotion.
Balanced chromosomal rearrangements occasionally have strong phenotypic effects, which may be useful in understanding pathobiology. However, conventional strategies for characterising breakpoints are laborious and inaccurate. We present here a proband with a thoracic aortic aneurysm (TAA) and a balanced translocation t(10;11) (q23.2;q24.2). Our purpose was to sequence the chromosomal breaks in this family to reveal a novel candidate gene for aneurysm.
Intracranial aneurysm (IA) and TAAs appear to run in the family in an autosomal dominant manner: After exploring the family history, we observed that the proband's two siblings both died from cerebral haemorrhage, and the proband's parent and parent's sibling died from aortic rupture. After application of a genome-wide paired-end DNA sequencing method for breakpoint mapping, we demonstrate that this translocation breaks intron 1 of a splicing isoform of Neurotrimin at 11q25 in a previously implicated candidate region for IAs and AAs (OMIM 612161).
Our results demonstrate the feasibility of genome-wide paired-end sequencing for the characterisation of balanced rearrangements and identification of candidate genes in patients with potentially disease-associated chromosome rearrangements. The family samples were gathered as a part of our recently launched National Registry of Reciprocal Balanced Translocations and Inversions in Finland (n=2575), and we believe that such a registry will be a powerful resource for the localisation of chromosomal aberrations, which can bring insight into the aetiology of related phenotypes.
Long-term survival of patients with basal cell (BCC) and squamous cell carcinoma (SCC) of the skin and site distribution of the lesions were studied using ample nationwide cancer registry data. The material consisted of 23,975 patients with BCC and 2,927 patients with SCC diagnosed in Finland from 1967 to 1981. The proportion of patients with lesions in the head and neck region was 77.5% in men and 81.4% in women for BCC and, 75.7% in men and 75.8% in women for SCC. The 5- and 10-year relative survival rates (RSRs) of patients with BCC were very close to 100%. The 5-year RSR of patients with SCC diagnosed from 1974 to 1981 was 87.7% in men and 84.0% in women. In patients with SCC the worst prognosis was for lesions of the scalp and neck in men (80.2%) and for those of the ears in women (73.2%).
The risk of smoking-related secondary cancers developing in bladder cancer patients was studied. The study population consisted of 10,014 bladder cancer patients reported to the Finnish Cancer Registry between 1953 and 1989. The risk of contracting a new primary cancer was estimated as a standardized incidence ratio, defined as the ratio of the observed and expected numbers of cases. Of 660 secondary cancers (6.6%) observed (standardized incidence ratio 0.96) 44% were considered to be smoking-related. Lung cancer was the most common secondary cancer (30% overall), and it occurred significantly more often than expected (standardized incidence ratio 1.31, 95% confidence interval 1.13 to 1.50). Also, larynx cancer among men (standardized incidence ratio 1.67, 95% confidence interval 0.95 to 2.79) and kidney cancer among women (standardized incidence ratio 3.55, 95% confidence interval 1.84 to 6.20) were found more often than expected. These excess risks were observed up to 20 years after diagnosis of bladder cancer. Therefore, bladder cancer patients experience an excess risk of smoking-related new tumors, which must be acknowledged during the initial evaluation and regular followup of such patients.
Two nationwide registers, the Finnish Cancer Registry and a register of persons entitled to free drugs for hypertension, were linked in a case-control study of the association of breast cancer and use of rauwolfia. Cases were all hypertensive patients in whom breast cancer was diagnosed in 1973. To test the association specifically with rauwolfia, controls were hypertensive women matched with the cases for age and geographic area and approximately matched for duration of treatment for hypertension. There were 109 case-control pairs. Use of any physician-prescribed drugs during the year prior to diagnosis of breast cancer was ascertained from original prescriptions. In the first set of analyses the patients were classified according to the drug used during most days of the year ("main antihypertensive agent"). In the second set a person qualified as a user of the respective drug regardless of the amount taken. The relative risks in the use of rauwolfia, methyldopa, another synthetic antihypertensive or a diuretic as main antihypertensive agent all ranged between 0.90 and 1.11. The results based on use of a drug in any amount were similar. Next, pairs in which duration of treatment for hypertension was different for cases and controls were excluded. The relative risk associated with use of rauwolfia as main antihypertensive agent then increased from 1.00 to 1.30 and the risk associated with use of any amount of rauwolfia from 1.16 to 2.14. Simultaneously, the relative risk in the use of digitalis was raised from 1.33 to 2.67 and of nitroglycerin from 1.00 to 1.71. Cases also used more types of antihypertensive agents simultaneously than controls. There was no association between rauwolfia-use and breast cancer in analyses limited to pairs in which neither case nor control used digitalis. Thus, there was not a consistent drug-specific association between rauwolfia-use and breast cancer in hypertensive patients. An underlying association of hypertension, heart disease or its treatment (digitalis) and breast cancer may have confounded some of the results of this and earlier studies. In conclusion, it is unlikely that use of rauwolfia increases the risk of breast cancer.
OBJECTIVES: This study analyzed cancer incidence among man-made vitreous fiber workers. METHODS: A cancer incidence follow-up was conducted among 3685 rock-slag wool (RSW) and 2611 glass wool (GW) production workers employed for > or =1 year in Denmark, Finland, Norway, or Sweden, and the standardized incidence ratios (SIR) were calculated on the basis of national incidence rates. RESULTS: Overall cancer incidence was close to expectation. Lung cancer incidence was increased among the RSW [SIR 1.08, 95% confidence interval (95% CI) 0.85-1.36] and GW (SIR 1.28, 95% CI 0.91-1.74) workers. For both subcohorts, a trend was suggested for time since first employment (P-value for linear trend 0.1 and 0.2, respectively). Neither subcohort showed an association with employment during the early technological phase, when fiber exposure was high. The incidence of oral, pharyngeal, and laryngeal cancer was increased among the RSW (SIR 1.46, 95% CI 0.99-2.07) and the GW (SIR 1.41, 95% CI 0.80-2.28) subcohorts. Despite a trend in risk for these neoplasms among the GW workers with time since first employment, the lack of a positive relation with other indirect indicators of fiber exposure points against a causal interpretation. No association between RSW or GW exposure and the risk of other neoplasms was suggested. CONCLUSIONS: These lung cancer results are similar to those of a mortality study that included a larger number of factories. For other cancers there was no suggestion of an association with RSW or GW exposure.
The purpose of the study was to find out whether there is an association between use of enzyme-inducing antiepileptic medicines and cancer.
: A cohort of 14,487 male and 13,932 female patients who received reimbursement for antiepileptic drugs (AEDs) in 1979-1981 in Finland was followed for subsequent cancers up to 1997 through the Finnish Cancer Registry.
During the follow-up, 2242 cancer cases were observed, while the expected number based on national incidence rates was 1743. Over 40% of the excess was attributable to cancer of the brain and nervous system [standardised incidence ratio (SIR) 4.30, 95% confidence interval (CI) 3.81, 4.82]. The relative risk of meningiomas was very high (SIR 46.6, 95% CI 22.3, 85.6) only during the first year of reimbursement, while the risk of gliomas remained tenfold or higher for 7 years and was significantly increased for 19 years in patients taking AEDs. Also cancers of the larynx (SIR 1.77), liver (1.71), pancreas (1.35), colon (1.32), stomach (1.30) and lung (1.29) showed statistically increased risks.
As epilepsy can be a symptom of cancers of the nervous system, the role of AEDs in their occurrence is speculative albeit possible. The excess of some cancers might be attributable to enzyme-inducing antiepileptic drugs, but the excess is not very high compared with the benefits obtained with these drugs.