Bone Mineral Accrual in Physically Active Girls. With Special Reference to Reduction in Physical Activity Level and Use of Oral Contraceptives

Adolescence is an important time for acquiring high peak bone mass. Physical activity is known to be beneficial to bone development. The effect of estrogen-progestin contraceptives (EPC) is still controversial. Altogether 142 (52 gymnasts, 46 runners, and 42 controls) adolescent women participated in this study, which is based on two 7-year (n =142), one 6-year (n =140) and one 4-year (n =122) follow-ups. Information on physical activity, menstrual history, sexual maturation, nutrition, living habits and health status was obtained through questionnaires and interviews. The bone mineral density (BMD) and content (BMC) of lumbar spine (LS) and femoral neck (FN) were measured by dual- energy X-ray absoptiometry. Calcaneal sonographic measurements were also made. The physical activity of the athletes participating in this study decreased after 3-year follow-up. High-impact exercise was beneficial to bones. LS and FN BMC was higher in gymnasts than in controls during the follow-up. Reduction in physical activity had negative effects on bone mass. LS and FN BMC increased less in the group having reduced their physical activity more than 50%, compared with those continuing at the previous level (1.69 g, p=0.021; 0.14 g, p=0.015, respectively). The amount of physical activity was the only significant parameter accounting for the calcaneal sonography measurements at 6-year follow-up (11.3%) and reduced activity level was associated with lower sonographic values. Long-term low-dose EPC use seemed to prevent normal bone mass acquisition. There was a significant trend towards a smaller increase in LS and FN BMC among long-term EPC users. In conclusion, this study confirms that high-impact exercise is beneficial to bones and that the benefits are partly maintained even after a clear reduction in training level at least for 4 years. Continued exercise is needed to retain all acquired benefits. The bone mass gained and maintained can possibly be maximized in adolescence by implementing high-impact exercise for youngsters. The peak bone mass of the young women participating in the study may be reached before the age of 20. Use of low-dose EPCs seems to suppress normal bone mass acquisition.Siirretty Doriast

Occurrence and mortality of vasospastic angina pectoris hospitalised patients in Finland : a population-based registry cohort study

Objectives The occurrence and mortality of vasospastic angina pectoris (VAP) is largely unknown in western countries. Our objective was to darify the occurrence, gender-distribution and mortality of VAP in Finland using a population-based hospital registry. Methods We studied consecutive patients aged >= 18 years hospitalized with VAP as the primary cause of admission in Finland during 2004-2014. The data were collected from obligatory nationwide registries. During the study period 1762 admissions were recorded. Results Majority of all VAP patients were male (59.7%) and mean age was 65.7 +/- 12.0 years. Annual admission rate for VAP was 2.29/100 000 person-years. Men were in higher risk for VAP than women (admission rate 3.00/100 000 vs 1.68 / 100 000; RR 1.70; p Conclusions Men have higher risk for vasospastic angina caused admissions. Likelihood of vasospastic angina admission was highest in aged population. The 3-year all-cause mortality was 15.5%. Mortality was associated with increasing age, comorbidities and non-obstructive VAP diagnosis but was similar between genders.Peer reviewe

Occurrence and Features of Childhood Myocarditis : A Nationwide Study in Finland

Background-Epidemiology of myocarditis in childhood is largely unknown. Men are known to have a higher incidence of myocarditis than women in adults aged Methods and Results-Data of all hospital admissions with myocarditis in Finland occurring in patients aged Conclusions-Myocarditis leading to hospital admission is relatively uncommon in children, but occurrence of myocarditis increases with age. There is no sex difference in the risk of myocarditis during the first 6 years of life, but boys have a significantly higher risk at ages 6 to 15 years.Peer reviewe

Occurrence and mortality of vasospastic angina pectoris hospitalised patients in Finland: a population-based registry cohort study

OBJECTIVES: The occurrence and mortality of vasospastic angina pectoris (VAP) is largely unknown in western countries. Our objective was to clarify the occurrence, gender-distribution and mortality of VAP in Finland using a population-based hospital registry.METHODS: We studied consecutive patients aged ≥18 years hospitalized with VAP as the primary cause of admission in Finland during 2004-2014. The data were collected from obligatory nationwide registries. During the study period 1762 admissions were recorded.RESULTS: Majority of all VAP patients were male (59.7%) and mean age was 65.7±12.0 years. Annual admission rate for VAP was 2.29/100 000 person-years. Men were in higher risk for VAP than women (admission rate 3.00/100 000 vs 1.68/100 000; RR 1.70; p<0.0001). Gender difference was not modified by age. Likelihood of VAP was highest in population aged 70-84 years. Admission rate for VAP decreased notably during the study period. One-year all-cause mortality was 8.0% and 3-year mortality was 15.5% (cardiac mortality 11.1%). Mortality was associated with increasing age, comorbidity burden and lack of detected coronary artery obstruction, but was similar between genders and during the study period.CONCLUSIONS: Men have higher risk for vasospastic angina caused admissions. Likelihood of vasospastic angina admission was highest in aged population. The 3-year all-cause mortality was 15.5%. Mortality was associated with increasing age, comorbidities and non-obstructive VAP diagnosis but was similar between genders.</p

Yield of elective coronary angiography; gender differences, patient history, risk factors and angiographic findings in a primary care population

ObjectiveTo assess yield of elective coronary angiography and gender differences in primary care patients suspected to have stable coronary artery disease (SCAD).DesignInformation was gathered from an angiography registry, referral texts of the general practitioners and medical records made by the cardiologists in secondary care.SettingAngiography registry data analyses of the Turku University Hospital, Finland, in the year 2011.SubjectsTwo hundred forty-six patients who were referred from primary care to secondary care and underwent coronary angiography for suspected SCAD symptoms.Main outcome measuresGender differences and diagnostic yield of coronary angiography for obstructive CAD.ResultsObstructive CAD was identified in 73%, more often in males than in females (51% vs. 84%, p < 0.001). Thirteen per cent of the patients were over 80 years of age, and 94% of them had obstructive CAD. The prevalence of hypertension was 60%, treatment goal was achieved by 25%.ConclusionThe diagnostic yield of elective coronary angiography was low in women compared to men although there were no substantial differences in evidence-based medication, risk factors or anticipated angina symptoms between genders

Quantitative myocardial perfusion response to adenosine and regadenoson in patients with suspected coronary artery disease

Background The aim of the present study was to compare the quantitative flow responses of regadenoson against adenosine using cardiac O-15-water PET imaging in patients with suspected or known coronary artery disease (CAD). Methods Hyperemic myocardial blood flow (MBF) after adenosine and regadenoson was compared using correlation and Bland-Altman analysis in 21 patients who underwent rest and adenosine O-15-water PET scans followed by rest and regadenoson O-15-water PET scans. Results Global mean (+/- SD) MBF values at rest and stress were 0.92 +/- 0.27 and 2.68 +/- 0.80 mL center dot g center dot min for the adenosine study and 0.95 +/- 0.29 and 2.76 +/- 0.79 mL center dot g center dot min for the regadenoson study (P = 0.55 and P = 0.49). The correlations between global and regional adenosine- and regadenoson-based stress MBF were strong (r = 0.80 and r = 0.77). The biases were small for both global and regional MBF comparisons (0.08 and 0.09 mL center dot min center dot g), but the limits of agreement were wide for stress MBF. Conclusion The correlation between regadenoson- and adenosine-induced hyperemic MBF was strong but the agreement was only moderate indicating that established cut-off values for (15)0-water PET should be used cautiously if using regadenoson as vasodilator

Uuden liiketoiminnan kehittäminen-Case Korpikakut Oy

Tämän opinnäytetyön aiheena on uuden liiketoiminnan kehittäminen – Case Korpikakut Oy. Opinnäytetyön päätavoite on liiketoiminnan kehittämissuunnitelman laatiminen perustettavalle uudelle Korpikakut Oy:lle. Opinnäytetyön tuotoksena työn tekijä perustaa yrityksen, jonka vuoksi sen viitekehyksessä käsitellään myös uuden yrityksen perustamiseen liittyviä asioita. Opinnäytetyöllä ei ole ulkopuolista toimeksiantajaa, vaan sen tekijä on itse toimeksiantaja ja opin-näytetyö tehdään apuvälineeksi oman yrityksen perustamista varten. Opinnäytetyön avulla on tarkoitus saada lisää tietoa yrityksen perustamiseen liittyvistä asioista ja päästä punnitsemaan erilaisia liiketoimintamuotoilun työkaluja yritystä perustettaessa, ja sitä mistä työkaluista on erityisesti hyötyä. Yritystä perustettaessa liiketoimintamuotoilu on uusi käsite, jonka kimppuun tässä opinnäytetyössä tullaan käymään selvittäen, mitkä liiketoimintamuotoilu-prosessin vaiheista ja apuvälineistä ovat hyödyllisiä ja mitkä taas eivät niin hyödyllisiä yrityksen perustamisessa. Opinnäytetyön tavoite on perustaa uusi yritys Kajaaniin. Yrityksen perustamisessa käytetään apuna liiketoimintamuotoiluprosessin menetelmiä. Samalla saadaan testattua, onko prosessin työkaluista hyötyä yritystä perustettaessa. Yrityksen perustamiseen liittyy paljon asioita, jotka yritystä perustavan tulee taitaa. Tavoite on löytää perustettavalle yritykselle sopivin yritysmuoto, laatia toimiva liiketoimintasuunnitelma, hyödyntää liiketoimintamuotoiluprosessin työkaluja perustamisen eri vaiheissa, esimerkiksi laatien kyselyn potentiaalisille asiakkaille, sekä käydä läpi kaikki yrityksen perustamiseen liittyvät asiat, jonka jälkeen yrityksen voi perustaa. Opinnäytetyön teoriaosuudet perustuvat yrityksen perustamiseen ja sen käytännön toimiin, yritysmuodon valintaan sekä liiketoimintamuotoiluun ja sen prosessin eri vaiheisiin kuin myös yritykseni liiketoimintasuunnitelman laatimiseen. Ensin käydään läpi tarvittavaa teoriaa yrityksen perustamisesta, jota sovelletaan varsinaisessa tutkimustyössä, eli yrityksen perustamisessa liiketoimintamuotoilun keinoin. Yritystä perustettaessa tulee tietää, miten se tapahtuisi teoreettisesti. Tämän vuoksi, yrityksen perustamiseen tarvittavat tärkeimmät teoriat ovat kirjoitettu auki tässä opinnäytetyössä, joita ovat esimerkiksi liikeidea, liiketoimintasuunnitelma, markkinat, markkinointi, yritysmuodot, yrityksen perustamisen käytännön toimet ja elintarvikeyrityksen perustamistoimet. Opinnäytetyössä käydään läpi useita eri liiketoimintamuotoilun menetelmiä yrityksen perustamiseen liittyen, joita ovat muun muassa kyselyn laatiminen, asiakasprofiilit, asiakaspolun määritteleminen, vertailuanalyysi, negatiiviinen aivoriihi, fiktiivinen mainostus sekä tulevaisuuden skenaariot. Nämä kaikki liiketoimintamuotoiluun liittyvät työkalut auttavat omalta osaltaan, kun aletaan perustaa yritystä. Opinnäytetyön johtopäätöksissä laaditaan perustettavalle yritykselle liiketoiminnan kehittämissuunnitelma, joka on tärkeä työvälinen yritystä perustettaessa. Liike-toiminnan kehittämissuunnitelmassa, toisin sanoen liiketoimintasuunnitelmassa, käydään läpi perustettavan yrityksen perustiedot, liikeidea, osaaminen, SWOT-analyysi, tuotteet sekä palvelut, hinnoittelu, asiakkaat, markkinat ja kilpailijat, markkinointi sekä tavoitteet liiketoiminnalle. Lisäksi liiketoimintasuunnitelmassa käydään tarkasti läpi yrityksen riskien hallintaa, viranomaisilmoituksia sekä kirjanpitoa ja taloushallintoa

Quantitative myocardial perfusion response to adenosine and regadenoson in patients with suspected coronary artery disease

BACKGROUND: The aim of the present study was to compare the quantitative flow responses of regadenoson against adenosine using cardiac 15O-water PET imaging in patients with suspected or known coronary artery disease (CAD). METHODS: Hyperemic myocardial blood flow (MBF) after adenosine and regadenoson was compared using correlation and Bland-Altman analysis in 21 patients who underwent rest and adenosine 15O-water PET scans followed by rest and regadenoson 15O-water PET scans. RESULTS: Global mean (± SD) MBF values at rest and stress were 0.92 ± 0.27 and 2.68 ± 0.80 mL·g·min for the adenosine study and 0.95 ± 0.29 and 2.76 ± 0.79 mL·g·min for the regadenoson study (P = 0.55 and P = 0.49). The correlations between global and regional adenosine- and regadenoson-based stress MBF were strong (r = 0.80 and r = 0.77). The biases were small for both global and regional MBF comparisons (0.08 and 0.09 mL·min·g), but the limits of agreement were wide for stress MBF. CONCLUSION: The correlation between regadenoson- and adenosine-induced hyperemic MBF was strong but the agreement was only moderate indicating that established cut-off values for 150-water PET should be used cautiously if using regadenoson as vasodilator

Sleep apnoea is a risk factor for severe COVID-19

Background Obstructive sleep apnoea (OSA) is associated with higher body mass index (BMI), diabetes, older age and male gender, which are all risk factors for severe COVID-19.We aimed to study if OSA is an independent risk factor for COVID-19 infection or for severe COVID-19.Methods OSA diagnosis and COVID-19 infection were extracted from the hospital discharge, causes of death and infectious diseases registries in individuals who participated in the FinnGen study (n=260 405). Severe COVID-19 was defined as COVID-19 requiring hospitalisation. Multivariate logistic regression model was used to examine association. Comorbidities for either COVID-19 or OSA were selected as covariates. We performed a meta-analysis with previous studies.Results We identified 445 individuals with COVID-19, and 38 (8.5%) of them with OSA of whom 19 out of 91 (20.9%) were hospitalised. OSA associated with COVID-19 hospitalisation independent from age, sex, BMI and comorbidities (p-unadjusted=5.13×10−5, OR-adjusted=2.93 (95% CI 1.02 to 8.39), p-adjusted=0.045). OSA was not associated with the risk of contracting COVID-19 (p=0.25). A meta-analysis of OSA and severe COVID-19 showed association across 15 835 COVID-19 positive controls, and n=1294 patients with OSA with severe COVID-19 (OR=2.37 (95% 1.14 to 4.95), p=0.021).Conclusion Risk for contracting COVID-19 was the same for patients with OSA and those without OSA. In contrast, among COVID-19 positive patients, OSA was associated with higher risk for hospitalisation. Our findings are in line with earlier works and suggest OSA as an independent risk factor for severe COVID-19

Evidence of a causal effect of genetic tendency to gain muscle mass on uterine leiomyomata

Uterine leiomyomata (UL) are the most common tumours of the female genital tract and the primary cause of surgical removal of the uterus. Genetic factors contribute to UL susceptibility. To add understanding to the heritable genetic risk factors, we conduct a genome-wide association study (GWAS) of UL in up to 426,558 European women from FinnGen and a previous UL meta-GWAS. In addition to the 50 known UL loci, we identify 22 loci that have not been associated with UL in prior studies. UL-associated loci harbour genes enriched for development, growth, and cellular senescence. Of particular interest are the smooth muscle cell differentiation and proliferation-regulating genes functioning on the myocardin-cyclin dependent kinase inhibitor 1A pathway. Our results further suggest that genetic predisposition to increased fat-free mass may be causally related to higher UL risk, underscoring the involvement of altered muscle tissue biology in UL pathophysiology. Overall, our findings add to the understanding of the genetic pathways underlying UL, which may aid in developing novel therapeutics.Peer reviewe