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Jyväskylä, Finland

Erkkila J.,University of Jyvaskyla | Punkanen M.,University of Jyvaskyla | Fachner J.,University of Jyvaskyla | Ala-Ruona E.,University of Jyvaskyla | And 6 more authors.
British Journal of Psychiatry | Year: 2011

Background: Music therapy has previously been found to be effective in the treatment of depression but the studies have been methodologically insufficient and lacking in clarity about the clinical model employed. Aims: To determine the efficacy of music therapy added to standard care compared with standard care only in the treatment of depression among working-age people. Method: Participants (n = 79) with an ICD-10 diagnosis of depression were randomised to receive individual music therapy plus standard care (20 bi-weekly sessions) or standard care only, and followed up at baseline, at 3 months (after intervention) and at 6 months. Clinical measures included depression, anxiety, general functioning, quality of life and alexithymia. Trial registration: ISRCTN84185937. Results: Participants receiving music therapy plus standard care showed greater improvement than those receiving standard care only in depression symptoms (mean difference 4.65, 95% CI 0.59 to 8.70), anxiety symptoms (1.82, 95% CI 0.09 to 3.55) and general functioning (-4.58, 95% CI -8.93 to -0.24) at 3-month follow-up. The response rate was significantly higher for the music therapy plus standard care group than for the standard care only group (odds ratio 2.96, 95% CI 1.01 to 9.02). Conclusions: Individual music therapy combined with standard care is effective for depression among working-age people with depression. The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practices. Source

Saaristo T.,Pirkanmaa Hospital District | Moilanen L.,Kuopio University Hospital | Korpi-HYOVALTI E.,South Ostrobothnia Hospital District | Vanhala M.,Unit of Family Practice | And 9 more authors.
Diabetes Care | Year: 2010

OBJECTIVE - To investigate 1-year outcomes of a national diabetes prevention program in Finland. RESEARCH DESIGN AND METHODS - Altogether 10,149 individuals at high risk for diabetes were identified with the Finnish Diabetes Risk Score (FINDRISC; scoring ≥15 points), by a history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), cardiovascular disease, or gestational diabetes mellitus in 400 primary health care centers. One-year follow-up data were available for 2,798 participants who were nondiabetic at baseline (919 men and 1,879 women, aged 56.0 ± 9.9 and 54.0 ± 10.7 years [mean ± SD] with BMI 30.9 ± 4.6 and 31.6 ± 5.4 kg/m2). RESULTS - The incidence of diabetes was 2.0 and 1.2% in men and women with normal glucose tolerance at baseline, 13.5 and 7.4% in those with IFG, and 16.1 and 11.3% in those with IGT, respectively. Altogether 17.5% of the subjects lost ≥5% weight with no sex difference. The relative risk of diabetes was 0.31 (95% CI 0.16-0.59) in the group who lost ≥5% weight, 0.72 (0.46-1.13) in the group who lost 2.5-4.9% weight, and 1.10 (0.77-1.58) in the group who gained ≥2.5% compared with the group who maintained weight. CONCLUSIONS - The FIN-D2D was the first national effort to implement the prevention of diabetes in a primary health care setting. Methods for recruiting high-risk subjects were simple and easy to use. Moderate weight loss in this very high-risk group was especially effective in reducing risk of diabetes among those participating in the program. © 2010 by the American Diabetes Association. Source

Turpeinen A.M.,Valio Ltd. | Jarvenpaa S.,Medcare Oy | Kautiainen H.,Unit of Family Practice | Kautiainen H.,Kuopio University Hospital | And 2 more authors.
Annals of Medicine | Year: 2013

A meta-analysis of possible antihypertensive effects of small doses of bioactive tripeptides isoleucine-proline-proline and valine-proline-proline in commercial milk products or tablets was carried out. A random effects model was used on 19 randomized, placebo-controlled clinical intervention trials (published 1996-October 2010) consisting of about 1500 prehypertensive or mildly hypertensive subjects.The overall blood pressure lowering for systolic blood pressure was -4.0 mmHg (95% CI -5.9 to -2.1 mmHg, P < 0.001) and for diastolic blood pressure -1.9 mmHg (95% CI -3.1 to -0.8 mmHg, P < 0.001). However, a positive effect was not reported in all the studies. The results suggest that rather small daily doses of the lactotripeptides in different functional food products may offer a valuable option as a non-pharmacological treatment of prehypertension or mild hypertension as part of life-style advice. © 2013 Informa UK, Ltd. Source

Takala J.H.,University of Helsinki | Kautiainen H.,Unit of Family Practice | Kautiainen H.,Rehabilitation Unit | Leirisalo-Repo M.,University of Helsinki
Scandinavian Journal of Rheumatology | Year: 2010

Objective: To determine the survival of and contributing factors in patients diagnosed with Wegener's granulomatosis (WG) between 1981 and 2000 in Finland. Methods: A retrospective cohort study using hospital discharge registers with a review of hospital case records. Analysis of causes of death in Finland up to 30 July 2005. Results: A total of 492 patients received a verified diagnosis of WG between 1981 and 2000. Of these, 203 died before the end of June 2005. The overall 1-year survival rate was 83.3% and the 5-year survival rate was 74.2%. The standardized mortality ratio (SMR) for all WG patients was 3.43 [95% confidence interval (CI) 2.983.94], for women 4.38 (95% CI 3.595.61) and for men 2.80 (95% CI 2.283.41). The most frequent causes of death were WG or another connective tissue disease, cardiovascular events and neoplasms. The prognosis did not change markedly over the 20-year period. Older age and elevated creatinine level at presentation were associated with poorer prognosis, whereas primary ear, nose, and throat (ENT) involvement and prompt treatment with cyclophosphamide predicted longer survival. Conclusions: WG patients had increased mortality compared with the rest of the population. Older age and elevated creatinine level at diagnosis predicted poor prognosis, but ENT involvement initially and cyclophosphamide treatment resulted in a better outcome. © 2010 Informa UK Ltd. Source

Salmi T.T.,University of Tampere | Hervonen K.,University of Tampere | Kautiainen H.,Unit of Family Practice | Kautiainen H.,Kuopio University Hospital | And 2 more authors.
British Journal of Dermatology | Year: 2011

Background Dermatitis herpetiformis (DH) is an external manifestation of coeliac disease presenting with blistering rash and pathognomonic cutaneous IgA deposits. Better knowledge of subclinical forms and serological testing has resulted in a sharp increase in the incidence and prevalence of coeliac disease. Objectives To investigate the prevalence of DH and analyse whether the incidence of DH changed when the occurrence of coeliac disease increased. Methods All 477 patients with DH diagnosed from 1970 onwards at the Tampere University Hospital were analysed for prevalence in 2009. The incidence of DH was calculated in three 10-year periods from the year 1980. Results The prevalence of DH was 75·3 per 100 000 which is eight times lower than the prevalence of coeliac disease in our area. The annual incidence of DH in the whole period was 3·5 per 100 000, and in the three 10-year periods 5·2, 2·9 and 2·7 per 100 000, respectively. The decrease in incidence between the first and second 10-year period was significant (P < 0·001). The male to female ratio of DH was 1·1: 1. The mean age at diagnosis increased significantly during the study, in men from 35·3 to 51·1 years and in women from 36·3 to 45·8 years. Conclusions The present study shows the highest prevalence of DH reported to date. Although the overall incidence of DH was also high, a significant decrease occurred in the 1990s, which is in contrast to the incidence of coeliac disease. © 2011 British Association of Dermatologists. Source

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