Hannu Salmea onnittelemassa

Blogikirjoitus akatemiaprofessori Hannu Salmen onnitteluista ja 60-vuotisjuhlinnasta lähinnä Zoomissa. Kulttuurihistorian Nyt! -blogi. 14.5.2021.</p

Flow-Mediated Vasodilation Is Not Attenuated in Hypertensive Pregnancies Despite Biochemical Signs of Inflammation

Background. Our objective was to evaluate endothelial function and markers of inflammation during and after pregnancy in normal pregnancies compared to pregnancies complicated with hypertension or preeclampsia (PE). Methods and Results. We measured endothelium-dependent brachial artery flow-mediated vasodilation (FMD) and high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α) in 32 women with normal pregnancy and in 28 women whose pregnancy was complicated with hypertensive disorder in the second half of pregnancy and minimum 3-month postpartum. Enhancement of endothelial function was greater in hypertensive than normal pregnancies, the mean FMD% being 11.0% versus 8.8% during pregnancy (P = 0.194) and 8.0% versus 7.9% postpartum (P = 0.978). Concentrations of markers of inflammation were markedly increased in pregnant hypertensive group compared to those after delivery (hsCRP 4.5 versus 0.80 mg/L, P = 0.023, IL-6 2.1 versus 1.2 pg/mL, P = 0.006; TNF-α 1.9 versus 1.5 pg/mL, P = 0.030). There were no statistically significant associations between the markers of inflammation and FMD. Conclusions. Brachial artery FMD was not attenuated in the third trimester hypertensive pregnancies compared to normal pregnancies, whereas circulating concentrations of hsCRP and IL-6 and TNF-α reacted to hypertensive complications

Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study

BACKGROUND: The aims were to evaluate the effect of pregnancy on carotid artery elasticity and determine the associations between maternal lipids, endothelial function and arterial elasticity during pregnancy. METHODS: We examined 99 pregnant and 99 matched non-pregnant control women as part of a population-based prospective cohort study. Carotid artery elasticity indexes; carotid artery distensibility (CAD), Young's elastic modulus (YEM) and stiffness index (SI) as well as brachial artery flow-mediated dilation (FMD) were assessed using ultrasound; serum lipid levels were also determined. RESULTS: SI was 57% and YEM 75% higher and CAD 36% lower in the third trimester group than the corresponding values in the first trimester group. Serum cholesterol and triglyceride levels were significantly higher in women at the end of the pregnancy than at the beginning of pregnancy (P < 0.001) and in controls (P < 0.001). In multivariate analysis, gestational age was the only independent correlate of arterial elasticity in pregnant women. In controls, age (P ≤ 0.001) and common carotid diameter (P = 0.001-0.029) were associated with SI, YEM and CAD. CONCLUSIONS: The present study revealed that carotid artery elasticity declined towards the end of the pregnancy; this neither is straight correlating with maternal hyperlipidemia or the diameter of the carotid artery nor is it associated with changes in endothelial function.BioMed Central open acces

"... Ja ne uivat ja uivat sen uskotte!" : päihteitä käyttävien äitien ja heidän lastensa varhaisen vuorovaikutuksen tukeminen ryhmässä toiminnallisin menetelmin

Opinnäytetyön tavoitteena oli raportoida Keski-suomen avopalveluyksikkö Ainon päihteitä käyttävien äitien ja heidän lastensa muodostamassa äiti – lapsi – ryhmässä käytettyjen toimintojen merkitystä varhaisen vuorovaikutuksen sekä riittävän hyvän vanhemmuuden tukemisessa. Opinnäytetyössä pyrittiin selvittämään, mitä on riittävän hyvä vanhemmuus, mitkä varhaisen vuorovaikutuksen ongelmat nousivat esiin ryhmässä sekä millaisilla toiminnallisilla keinoilla voidaan tukea riittävän hyvää vanhemmuutta äiti – lapsi – ryhmässä. Opinnäytetyössä lähestytään ensimmäistä tutkimuskysymystä kirjallisuuskatsauksen avulla ja kahta seuraavaa tutkimuskysymystä laadullisen tutkimuksen keinoin. Opinnäytetyö on toteutettu toimintatutkimuksen omaisesti, osallistuen itse ryhmän toteutukseen. Tarkoituksena oli tuoda olemassa olevan ryhmän toimintoihin jotakin uutta. Tärkeäksi asiaksi nousi myös toimintojen tarkoituksenmukaisuuden ja merkityksellisyyden analysointi ja näiden toimintojen entistä syvempi ymmärtäminen. Tutkimuksen taustateoriana käytettiin Kielhofnerin Inhimillisen toiminnan mallia. Ryhmän ohjaus toteutui keväällä 2007, aineiston purku ja raportointi syksyllä 2007 ja keväällä 2008. Kirjallisuuskatsauksen myötä riittävän hyvän vanhemmuuden määritelmiksi muodostuivat äidin kyky tuntea itsensä äidiksi, huolehtijaksi, kyvykkääksi olemaan vuorovaikutuksessa lapsen kanssa, sosiaalisten verkostojen olemassa olo, elämän säännöllisyys, turvallisuus ja taloudellisen elämäntilanteen tasapaino. Opinnäytetyö osoitti, että päihteitä käyttävillä äideillä on vaikeus suhtautua lapseen ja lapsen tarpeisiin asianmukaisella tavalla. Tästä syystä kiintymyssuhteen muodostuminen ja varhainen vuorovaikutus ovat uhattuina. Esiin nousi myös pitkään päihteitä käyttäneiden äitien päivittäisissä perustoiminnoissa tarvittavien taitojen puutteellisuus. Äidit kokivat ryhmän tarpeellisena; ryhmästä he saivat vertaistukea ja konkreettisia neuvoja kokeakseen riittävän hyvää vanhemmuutta. Opinnäytetyön myötä nousi esille kyseisen asiakasryhmän kanssa käytettävien toimintojen vaikuttavuuden perustuvan niiden arkipäiväisyyteen ja yksinkertaisuuteen. Tällaisen kuntouttavan ryhmän tarve näyttäisi olevan suuri. Usealle äidille ryhmä voi olla ainut mahdollisuus oppia äitiyteen liittyviä asioita.The purpose of this thesis was to report on the success of the occupational methods used in a group that consisted of mothers with alcohol- and drug problems and their children. The group congregated at the Central-Finnish AVOPALVELUYKSIKKÖ Aino. The objective was to improve early interaction and to support and clarify the concept of good-enough parenting. The thesis aimed to find out what good-enough parenting is, what early interaction problems came up in the group and what occupational methods are suitable for supporting goodenough parenting in a mother-child group. The thesis approaches the first research question with the help of a literature review and the two further questions by the means of qualitative research methods. The thesis has been done as an action research, by taking part in the execution of the group. The purpose was to bring something new to the functions of an existing group. One of the key topics was analyzing the meaningfulness and appropriateness of the functions and understanding these functions on an even deeper level. The background theory of the study was Kielhofner´s Model of Human Occupation. The group took place in spring 2007, unpacking the data and reporting fall 2007-spring 2008. Good-enough parenting was defined based on the literature review as follows: the ability of the mother to feel like a mother, a care taker, to feel herself competent to interact with her child, the existence of social networks, the regularity of life in general, safety and economical balance. The thesis showed that drug and alcohol-abusing mothers have difficulties relating to the child and responding to her needs in appropriate manner. For this reason, the formation of attachmenttheory and early interaction are threatened. A topic that also came to attention was the lack of knowledge and skill in everyday routines with mothers that had endured drug and alcohol-related problems for a long time. Mothers found the group useful. They got peer support and tangible advice to experience good-enough parenting. The thesis showed that the occupational methods used with this client group are based on simplicity and everydayness. There seems to be great demand for a rehabilitational group like this. For several mothers, the group may very well be the only opportunity to learn motherhood-related skills

Need for insulin to control gestational diabetes is reflected in the ambulatory arterial stiffness index

<p>Abstract</p> <p>Background</p> <p>The aim was to evaluate the metabolic profile in conjunction with vascular function using the ambulatory arterial stiffness index (AASI) in women with uncomplicated pregnancies and in women with gestational diabetes mellitus (GDM).</p> <p>Methods</p> <p>Plasma glucose, lipids, HOMA –IR (homeostasis model assessment of insulin resistance) and AASI, as obtained from 24-hour ambulatory blood pressure monitoring in third trimester pregnancy and at three months postpartum, were measured in three groups of women: controls (N = 32), women with GDM on diet (N = 42) and women with GDM requiring insulin treatment (N = 10).</p> <p>Results</p> <p>Women with GDM had poorer glycemic control and higher HOMA-IR during and after pregnancy and their total and LDL (low density lipoprotein) cholesterol levels were significantly higher after pregnancy than in the controls. After delivery, there was an improvement in AASI from 0.26 ± 0.10 to 0.17 ± 0.09 (P = 0.002) in women with GDM on diet, but not in women with GDM receiving insulin whose AASI tended to worsen after delivery from 0.30 ± 0.23 to 0.33 ± 0.09 (NS), then being significantly higher than in the other groups (P = 0.001-0.047).</p> <p>Conclusions</p> <p>Women with GDM had more unfavorable lipid profile and higher blood glucose values at three months after delivery, the metabolic profile being worst in women requiring insulin. Interestingly, the metabolic disturbances at three months postpartum were accompanied by a tendency towards arterial stiffness to increase in women requiring insulin.</p