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Martikainen M.H.,University of Turku | Martikainen M.H.,Medical Research Center Oulu | Ronnemaa T.,University of Turku | Majamaa K.,University of Oulu
Diabetes and Vascular Disease Research | Year: 2015

We investigated whether mitochondrial (mtDNA) haplogroups and maternal family history of diabetes mellitus were associated with vascular diabetes mellitus complications in a population-based cohort of 299 Finnish diabetes mellitus patients with disease onset in young adult age. We found that haplogroup U was more prevalent among patients with no vascular diabetes mellitus complications than among those with at least one complication (p=0.038). Haplogroup U was also more prevalent among the patients who reported maternal family history of diabetes mellitus than among those who did not (p=0.0013). Furthermore, haplogroup U was more prevalent among patients with maternal family history of diabetes mellitus but no vascular diabetes mellitus complications than among those with at least one vascular diabetes mellitus complication but no maternal family history of diabetes mellitus (p=0.0003 for difference). These findings suggest that different mtDNA-related factors may influence the risk of diabetes mellitus per se and the risk of vascular diabetes mellitus complications. Further studies are, however, warranted to replicate and elaborate on these results. © 2015 The Author(s). Source

Jansson M.M.,University of Oulu | Jansson M.M.,Medical Research Center Oulu | Ala-Kokko T.I.,University of Oulu | Ohtonen P.P.,University of Oulu | And 3 more authors.
American Journal of Infection Control | Year: 2014

Background Knowledge among critical care nurses and their adherence to evidence-based guidelines for preventing ventilator-associated pneumonia is reported to be low. The aim of our study was to evaluate the effectiveness of human patient simulation (HPS) education in the nursing management of patients requiring mechanical ventilation. Methods A prospective, parallel, randomized controlled trial with repeated measurements was conducted in a 22-bed adult mixed medical-surgical intensive care unit in Finland from February-October 2012. Thirty critical care nurses were allocated evenly to intervention and control groups (n = 15 each). The effectiveness of HPS education was evaluated through the validated Ventilator Bundle Questionnaire and Ventilator Bundle Observation Schedule at baseline and repeated twice-after the clinical and simulation settings, respectivley. Results After HPS education, the average skill scores (Ventilator Bundle Observation Schedule) in the intervention group increased significantly (46.8%-60.0% of the total score) in the final postintervention observation. In the average skill scores, a linear mixed model identified significant time (Pt <.001) and group (Pg =.03) differences and time-group interactions (Pt*g =.02) between the study groups after the HPS education. In contrast, the model did not identify any significant change over time (Pt =.29) or time-group interactions (Pt =.69) between groups in average knowledge scores (Ventilator Bundle Questionnaire). Conclusions Our study identified significant transfer of learned skills to clinical practice following HPS education but no influence on the level of participants' factual knowledge. Copyright © 2014 Published by Elsevier Inc. Source

Perjes A.,University of Oulu | Perjes A.,University of Pecs | Skoumal R.,University of Pecs | Tenhunen O.,University of Oulu | And 8 more authors.
PLoS ONE | Year: 2014

Background: Apelin, the endogenous ligand for the G protein-coupled apelin receptor, is an important regulator of the cardiovascular homoeostasis. We previously demonstrated that apelin is one of the most potent endogenous stimulators of cardiac contractility; however, its underlying signaling mechanisms remain largely elusive. In this study we characterized the contribution of protein kinase C (PKC), extracellular signal-regulated kinase 1/2 (ERK1/2) and myosin light chain kinase (MLCK) to the positive inotropic effect of apelin. Methods and Results: In isolated perfused rat hearts, apelin increased contractility in association with activation of prosurvival kinases PKC and ERK1/2. Apelin induced a transient increase in the translocation of PKCε, but not PKCα, from the cytosol to the particulate fraction, and a sustained increase in the phosphorylation of ERK1/2 in the left ventricle. Suppression of ERK1/2 activation diminished the apelin-induced increase in contractility. Although pharmacological inhibition of PKC attenuated the inotropic response to apelin, it had no effect on ERK1/2 phosphorylation. Moreover, the apelin-induced positive inotropic effect was significantly decreased by inhibition of MLCK, a kinase that increases myofilament Ca 2+ sensitivity. Conclusions: Apelin increases cardiac contractility through parallel and independent activation of PKCε and ERK1/2 signaling in the adult rat heart. Additionally MLCK activation represents a downstream mechanism in apelin signaling. Our data suggest that, in addition to their role in cytoprotection, modest activation of PKCe and ERK1/2 signaling improve contractile function, therefore these pathways represent attractive possible targets in the treatment of heart failure. © 2014 Perjés et al. Source

Tseveenjav B.,Dental Health Care | Tseveenjav B.,University of Oulu | Pesonen P.,University of Oulu | Virtanen J.I.,University of Oulu | Virtanen J.I.,Medical Research Center Oulu
Tobacco Induced Diseases | Year: 2015

Background: The relationship between the use of snus and lifestyle-related habits - especially in adolescence, when these behaviours begin and become established - is not widely studied. Our aim was to analyse associations between snus use and habits of and attitudes towards smoking and alcohol consumption among Finnish adolescents. Methods: The study is a part of the National School Health Promotion Study in Finland. The study population consisted of a representative sample of Finnish adolescents (n∈=∈183 226). A questionnaire enquired about pupils' use of snus, habits of and attitudes towards smoking and alcohol consumption, as well as their (age, gender, school type) and their parents' (education and smoking) background factors. Chi-square tests and logistic regression models served in the statistical analyses. Results: Of the adolescents, 18 % had used snus (2 % daily, 16 % experimented) while 82 % never had. Snus use was more common among boys than girls (p∈<∈0.05). Concerning smoking, 19 % were daily and 15 % occasional smokers. Regarding alcohol, 11 % consumed it weekly and 57 % monthly or less frequently. More than two thirds of the adolescents held positive attitudes towards smoking (71 %), and alcohol (67 %). Male gender (OR∈=∈9.9; 95 % CI 9.4-10.4), current (OR∈=∈32.8; 95 % CI 26.1-41.1) or former (OR∈=∈10.1; 95 % CI 8.0-12.9) smoking, weekly consumption of alcohol (OR∈=∈27.4; 95 % CI 21.0-35.8), positive attitude towards smoking (OR∈=∈1.4; 95 % CI 1.3-1.6), and higher parental education (OR∈=∈1.4; 95 % CI 1.3-1.4) associated significantly with adolescents' current snus use, whereas parental smoking did not. Conclusion: Current snus use among adolescents may signal an accumulation of other lifestyle-related risky behaviours such as current or past smoking and alcohol consumption as well as a positive attitude towards smoking. In addition to these possible co-existing health-related risk factors, health promotion activities should take into account gender and school differences in order to target preventive messages to youth more effectively. © 2015 Tseveenjav et al. Source

Tarkiainen M.,University of Helsinki | Tynjala P.,University of Helsinki | Vahasalo P.,Medical Research Center Oulu | Vahasalo P.,University of Oulu | Lahdenne P.,University of Helsinki
Rheumatology (United Kingdom) | Year: 2015

Objective. The aim of this study was to carry out a safety evaluation of biologic agents in patients with JIA and associated uveitis. Methods. In three tertiary centres in Finland, all adverse events (AEs) in 348 consecutive patients were collected. AEs were classified according to the Common Terminology Criteria for AEs. Results. A total of 1516 patient-years (py) were included: 710 on etanercept, 591 on infliximab, 188 on adalimumab, 8 on rituximab, 5 on anakinra, 6 on tocilizumab, 6 on abatacept and 1 on golimumab. The median follow-up of an individual patient was 51 months (range 1-155). The most common of the 2902 AEs (191/100 py) observed were mild infections, infusion or injection site reactions and alanine aminotransferase elevations. At least one AE occurred in 319 (92%) patients and 121 (35%) had at least one serious AE (SAE). The rate of SAEs was 11.4/100 py on etanercept, 11.8 on infliximab, 10.1 on adalimumab, 15.7 on abatacept, 31.2 on tocilizumab and 87.5 on rituximab, higher than with most anti-TNF agents (P = 0.005). No cases of malignant neoplasms or tuberculosis were detected. New-onset uveitis occurred in 9 patients, psoriasis or psoriasiform lesions in 13 and IBD in 6. Conclusion. Mild and moderate AEs in patients with JIA treated with biologics were more frequent than previously reported. SAEs were observed in one-third of the patients, but SAEs seldom led to drug discontinuation. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Source

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