Rinnekoti Research Center

Espoo, Finland

Rinnekoti Research Center

Espoo, Finland

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Maatta J.,University of Oulu | Tervo-Maatta T.,University of Oulu | Taanila A.,University of Oulu | Kaski M.,Rinnekoti Research Center | And 2 more authors.
Journal of Intellectual and Developmental Disability | Year: 2011

Background Medical problems are described in a population of persons with Down syndrome. Health surveillance is compared to the recommendations of national guidelines. Method Case records from the specialised and primary healthcare and disability services were analysed. Results A wide spectrum of age-specific medical and surgical problems was described. Congenital heart defects and middle ear infections were mostly experienced by younger people, while thyroid disease, epilepsy, and Alzheimer's disease were frequent among older people. Psychiatric disorders and behavioural problems were frequent in all age groups. Conclusions Health surveillance remained insufficient, despite the guidelines available. A joint effort by healthcare and disability service providers is required to ensure that the medical needs of people with Down syndrome are adequately met across their entire lifespan. An active provision of healthcare and monitoring for this vulnerable group is needed. © 2011 Australasian Society for the Study of Intellectual Disability, Inc.


Westerinen H.,University of Helsinki | Kaski M.,Rinnekoti Research Center | Virta L.J.,Social Insurance Institution | Almqvist F.,University of Helsinki | Iivanainen M.,University of Helsinki
Journal of Intellectual Disability Research | Year: 2014

Background: In the national study of multiple registers in 2000, the average prevalence of intellectual disability (ID) was 0.70%, with marked differences by age group (range 0.38-0.96%) - what are these differences in detail, and can they be understood? Method: This study was based on two national health registers and six social benefit registers. Prevalence of ID was calculated by 1-year age cohorts. Results: The multiple register prevalence of ID increased steadily from 0.20% in the first life year to 0.74% (male: 0.90%, female: 0.58%) at 10 years. For boys, the rate fell to 0.71% at 11 years. For both sexes, a steady increase was noted in the distribution up to 40 years (male: 0.84%, female: 0.73%), followed by a sharper increase to the maximum prevalence (male: 1.19% at 48 years, female: 1.05% at 50 years). At the pension age of 66 years, a sudden drop to 0.49% occurred for men and women. Different registers gave very different age distributions. Conclusions: By examining the data by 1-year age cohorts, and by understanding the role of each register, it could be deduced that a proportion of cases in younger age groups is lacking, and a remarkable proportion of elderly ID persons is missing from the pooled data. The findings were more difficult to interpret, if the data were grouped into bigger age groups. © 2013 John Wiley & Sons Ltd, MENCAP & IASSIDD.


Leger D.,University of Paris Descartes | Partinen M.,Rinnekoti Research Center | Hirshkowitz M.,Sleep Disorders and Research Center | Chokroverty S.,New Jersey Neuroscience Institute | And 2 more authors.
Sleep Medicine | Year: 2010

Objective: To assess the daytime consequences in outpatients suffering from different insomnia symptoms in primary care practice. Methods: An international cross-sectional survey was conducted in 5293 outpatients complaining of sleep disturbances in primary care practice. A sleep questionnaire addressing daytime consequences, insomnia symptoms, socio-demographic characteristics, and other sleep variables was administered by 647 physicians in 10 countries. Results: Overall, 20-33% of subjects reported " severe" daytime impairments associated with sleep disturbances. Approximately 45% of patients complaining of sleep disturbances in primary care practice suffered from a combination of insomnia symptoms. Patients suffering from all insomnia symptoms reported the most severe daytime functioning impairments compared with patients suffering from initiation or maintenance insomnia only. Conversely, the majority of patients suffering from non-restorative sleep reported little daytime functioning impairments compared to the patients suffering from other combinations of insomnia symptoms. The strongest risk factor associated with " severe" daytime functioning impairments was sleep quality perception. Conclusions: Primary insomnia disturbs subjective daytime functioning. A report of combined insomnia symptoms reflected the most damaging insomnia subtype and had a negative impact on a wide range of daytime functioning consequences. © 2010 Elsevier B.V.


Leger D.,University of Paris Descartes | Partinen M.,Rinnekoti Research Center | Hirshkowitz M.,Sleep Disorders and Research Center | Chokroverty S.,New Jersey Neuroscience Institute | Hedner J.,Sahlgrenska University Hospital
Sleep Medicine | Year: 2010

Objective: To describe the characteristics of insomnia in primary care physicians' (PCPs') practices in 10 countries and to understand how the difficulty of maintaining sleep (DMS) was or was not associated with other insomnia symptoms such as difficulty initiating sleep (DIS), early morning awakenings (EMA) or nonrestorative sleep (NRS) in PCPs patients with insomnia. Methods: International, noninterventional, cross-sectional, observational survey conducted in a primary care setting in subjects complaining of sleep disturbances in 10 countries. A questionnaire based on DSM-IV and ICSD criteria was administered. Results: Thirteen thousand one hundred twenty-four subjects were enrolled by 647 physicians; 5293 of them (32.6%) had insomnia and were surveyed. The population was predominantly female (63.9%) with a mean age of 47.8 ± 15.3. years; 39.9% of these patients have already been treated for sleep difficulties. Combination of all types of insomnia symptoms (DIS. +. DMS. +. EMA. +. NRS) was the most frequently reported combination (38.6% of the subjects), while the percentage of subjects presenting with only one type of insomnia symptom (DIS, DMS, EMA or NRS) was very low: 3%, 1.8%, 0.9% and 1.4% respectively. DMS was on average the most commonly reported insomnia symptom (80.2%). Multiple logistic regression showed that DMS, EMA and NRS symptoms were significantly linked with each other and also to other insomnia criteria (sleep satisfaction, sleep quality, sleep duration, number of hours of sleep, frequency of insomnia symptoms, wake up rested / unrested and non restorative sleep). Conclusions: Patients visiting PCPs with insomnia are likely to present with severe and poly-symptomatic insomnia. © 2010 Elsevier B.V.


Partinen M.,Finnish Narcolepsy Research Center | Partinen M.,University of Helsinki | Partinen M.,Rinnekoti Research Center | Saarenpaa-Heikkila O.,University of Tampere | And 15 more authors.
PLoS ONE | Year: 2012

Background: Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002-2010. Methods: All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference. Findings: Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002-2009 giving an annual incidence of 0.79 per 100 000 inhabitants (95% confidence interval 0.62-0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12-0.51) per 100 000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100 000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100 000, which equals that in 2002-2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy. Interpretation: A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children. © 2012 Partinen et al.


Sahlman J.,Kuopio University Hospital | Miettinen K.,Kuopio University Hospital | Peuhkurinen K.,Kuopio University Hospital | Seppa J.,Kuopio University Hospital | And 9 more authors.
Journal of Sleep Research | Year: 2010

It is widely accepted that obstructive sleep apnoea (OSA) is linked with cardiovascular diseases. The relationship is complex and remains still poorly understood. The presence of chronic systemic inflammation has been connected with pathogenesis of both OSA and cardiovascular diseases. While atherogenesis is believed to be a process of many years, little is known about the potential impact of the largest OSA subgroup, mild OSA, on the development of cardiovascular diseases. The aim of the present study was to assess whether untreated mild OSA is associated with an activation of inflammatory cytokine system. The adult study population consisted of two groups: 84 patients with mild OSA [apnoea-hypopnoea index (AHI) 5-15 h-1] and 40 controls (AHI <5 h-1). Serum concentrations of pro- and anti-inflammatory cytokines were measured before any interventions. After adjustments for age, sex, body mass index, fat percentage, most important cardiometabolic and inflammatory diseases, and non-steroidal anti-inflammatory medication, the mean level of tumour necrosis factor-α was significantly elevated (1.54 versus 1.17 pg mL-1, P = 0.004), whereas the level of interleukin-1β (IL-1β) was reduced (0.19 versus 0.23 pg mL-1, P = 0.004) in patients with mild OSA compared with controls. The concentrations of the protective anti-inflammatory cytokines, interleukin-10 (1.28 versus 0.70 pg mL-1, P < 0.001) and interleukin-1 receptor antagonist (478 versus 330 pg mL-1, P = 0.003) were elevated in the OSA group. The concentrations of C-reactive protein increased, but IL-1β decreased along with the increase of AHI. Mild OSA was found to be associated not only with the activation of the pro-inflammatory, but also with the anti-inflammatory systems. © 2009 European Sleep Research Society.


Heikkila K.,University of Helsinki | Vuoksimaa E.,University of Helsinki | Oksava K.,University of Helsinki | Saari-Kemppainen A.,University of Helsinki | And 2 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2011

Objectives To determine whether exposure to prenatal ultrasound increases non-right-handedness in boys. Methods The association between exposure to prenatal ultrasound and handedness was tested, using logistic regression analysis, in the Helsinki Ultrasound Trial data. We applied an intention-to-treat approach in this analysis of a subset of 4150 subjects whose parents answered a follow-up questionnaire on handedness when the children were aged 13-15 years. Results The odds ratio for non-right-handedness of children who had been exposed to prenatal ultrasound was 1.16 (0.98-1.37) for all subjects, 1.12 (0.89-1.41) for boys and 1.24 (0.97-1.58) for girls. Conclusions We could not confirm the hypothesis that prenatal ultrasound exposure and handedness are associated. Our findings were independent of the particular definition of handedness used, whether it was considered according to the writing hand alone or defined using a laterality quotient. © 2011 ISUOG. Published by John Wiley & Sons, Ltd.


Ounjaijean S.,University of Helsinki | Ounjaijean S.,Chiang Mai University | Westermarck T.,Rinnekoti Research Center | Partinen M.,University of Helsinki | And 6 more authors.
International Journal of Clinical Pharmacology and Therapeutics | Year: 2011

Objective: This study aims to investigate the alteration of iron homeostasis and oxidative stress status in epilepsy patients treated with valproic acid (VPA) monotherapy. Materials: 24 epilepsy patients receiving VPA monotherapy (12 men, 12 women, age 27.5 ± 7.2 y) and 24 sex- and age-matched healthy volunteers were included in the study. Methods: The level of iron status parameters; serumiron, ferritin, transferrin saturation, non-transferrin bound iron (NTBI), serum level of trace elements (copper, zinc and selenium), concentration of antioxidant parameters, activities of antioxidant enzymes and level of lipid peroxidation product were determined. Results: NTBI was found in the patients although their other iron status parameters were normal. Levels of antioxidant parameters were decreased while activities of antioxidant enzymes were increased. Levels of serum MDA were significantly increased in patientswith epilepsy. The daily dose of valproic acid associatedwas statistically significant: serumconcentration of NTBI (r = 0.579; p = 0.003) and MDA (r = 0.465; p = 0.022).Apositive correlation existed between NTBI and zinc (r = 0.522; p = 0.009). Conclusion: According to our results, VPA treatment in patients with epilepsy contributes to themetabolism of iron, leading to the formation of NTBI and an increase in oxidative stress. ©2011 Dustri-Verlag Dr. K. Feistle.


PubMed | Clanet Oy, Rinnekoti Research Center and University of Helsinki
Type: Journal Article | Journal: Lipids in health and disease | Year: 2016

Oxidative stress plays an important role in the pathogenesis of disease, and the antioxidant physiological effect of omega-3 from fish oil may lead to improvement of canine spontaneous osteoarthritis (OA).In this prospective randomized, controlled, double-blinded study, we assessed haematological and biochemical parameters in dogs with OA following supplementation with either a concentrated omega-3 deep sea fish oil product or corn oil. Blood samples from 77 client-owned dogs diagnosed as having OA were taken before (baseline) and 16weeks after having orally ingested 0.2ml/Kg bodyweight/day of deep sea fish oil or corn oil. Circulating malondialdehyde (MDA), glutathione (GSH), non-transferrin bound iron (NTBI), free carnitine (Free-Car), 8-hydroxy-2-deoxyguanosine (8-OH-dG), and serum fatty acids, haemograms and serum biochemistry were evaluated. Differences within and between groups from baseline to end, were analysed using repeated samples T-test or Wilcoxon rank test and independent samples T-test or a Mann-Whitney test.Supplementation with fish oil resulted in a significant reduction from day 0 to day 112 in MDA (from 3.411.34 to 2.430.92mol/L; P<0.001) and an elevation in Free-Car (from 18.189.78 to 21.199.58mol/L; P=0.004) concentrations, whereas dogs receiving corn oil presented a reduction in MDA (from 3.411.34 to 2.411.01mol/L; P=0.001) and NTBI (from -1.252.17 to -2.311.64mol/L; P=0.002). Both groups showed increased (albeit not significantly) GSH and 8-OH-dG blood values. Dogs supplemented with fish oil had a significant reduction in the proportions of monocytes (from 3.842.50 to 1.771.92%; P=0.030) and basophils (from 1.471.22 to 0.620.62%; P=0.012), whereas a significant reduction in platelets counts (from 316.1393.83 to 288.41101.6810(9)/L; P=0.029), and an elevation in glucose (from 5.180.37 to 5.320.47mmol/L; P=0.041) and cholesterol (from 7.131.62 to 7.732.03mmol/L; P=0.011) measurements were observed in dogs receiving corn oil.In canine OA, supplementation with deep sea fish oil improved diverse markers of oxidative status in the dogs studied. As corn oil also contributed to the reduction in certain oxidative markers, albeit to a lesser degree, there was no clear difference between the two oil groups. No clinical, haematological or biochemical evidence of side effects emerged related to supplementation of either oil. Although a shift in blood fatty acid values was apparent due to the type of nutraceutical product given to the dogs, corn oil seems not to be a good placebo.


PubMed | Rinnekoti Research Center, University of Helsinki, Jagiellonian University and Voivodship Clinical Hospital No 2
Type: Journal Article | Journal: Pharmacological reports : PR | Year: 2016

We aimed to demonstrate the relationship between the valproate (VPA) treatment versus lipid and serum free fatty acids (FFAs) profiles to be the potential atherosclerosis risk factor in epileptic patients.Fasting blood samples were taken from 21 adult VPA-treated patients and 21 controls. The profiles of lipids, FFAs, clinical parameters and body mass index (BMI) were evaluated.No significant differences between the study group and controls were found for any of the studied parameters. However, significant differences in the total cholesterol (CHOL), low-density-lipoprotein cholesterol (LDL), triglycerides, the CHOL/HDL (high-density-lipoprotein cholesterol) ratio, and Atherogenic Index of Plasma were observed for overweight patients when compared to those of normal weight. Patients with uncontrolled epilepsy tended to have significantly lower palmitic acid level than seizure-free patients. Oleic acid was found to be positively correlated with VPA concentration for patients with uncontrolled epilepsy, and with the dose corrected VPA concentration for all the patients. The acid was however negatively correlated with stearic acid for both the controls and the patients with uncontrolled epilepsy. PLS method revealed CHOL, LDL, triglycerides and myristic acid to be positively interrelated for the whole group under the study, whereas these parameters were found to be negatively correlated with VPA concentration, and positively with BMI. Furthermore, high sensitivity C-reactive protein was found to be negatively correlated with palmitic acid levels.Overweight VPA-treated patients are exposed to higher risk of atherosclerosis. Alterations in FFAs are likely to depend on seizures control, and on VPA levels.

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