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Promising initial studies on vitamin D (VD) supplementation as an adjunct treatment for major depressive disorder (MDD) require rigorously designed randomized controlled trials (RCTs). We aim to investigate the effects of augmenting standard MDD treatment with VD supplementation and examine factors influencing the treatment outcome. This article describes the study design, measures, and baseline characteristics. This multicenter RCT compares the efficacy of a six‐month VD intervention at 100 micrograms/day versus 10 micrograms/day (μg/day) (4000 IU (international units)/day vs. 400 IU/day) added to a standard treatment in outpatients aged 20–61 years with MDD. The primary outcome is change in the Montgomery–Åsberg Depression Rating Scale (MADRS) score. Secondary outcomes are other indicators of mental health and functionality (BDI, SOC, 15‐D, PSS10, LS‐4, LOT‐R, YSQ‐S2‐extended, CORE‐OM, TAS‐20, BRCS, TADS, SCL‐90, DIAD, GAF), and circulating biomarkers. Intervention assessments are conducted at baseline, 3, and 6 months, and follow‐ups at 18 months and 6 years post‐baseline. The baseline sample had 319 subjects (74% women; median age 31 (inter‐quartile range (IQR) 15), mean MADRS score 21.38 (SD 6.04)), with 281 assigned to the RCT. At present, the study continues as a follow‐up study. DepFuD project will provide extensive information regarding the potential benefits of VD and enables to identify various biopsychosocial depression‐associated risk factors. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examined differences in detailed body composition in subtypes of depression. It found that subjects with dysthymia were usually obese and had greater fat percentage and fat mass than the reference group. It concluded that subtypes of depression, particularly dysthymia, should be considered and studied separately when examining associations between depressive disorders, obesity and metabolic adversities.

Lehto SM, Huotari A, Niskanen L, Tolmunen T, Koivumaa-Honkanen H, Honkalampi K, Ruotsalainen H, Herzig K-H, Viinamäki H, Hintikka J. Serum adiponectin and resistin levels in major depressive disorder. Objective: To examine the role of the adipose-tissue-derived low-grade inflammation markers adiponectin and resistin in major depressive disorder (MDD) in a population-based sample. Method: Serum levels of adiponectin and resistin were measured from 70 DSM-IV MDD subjects and 70 healthy controls. Depression severity was assessed with the 29-item Hamilton Depression Rating Scale. Results: The MDD group had lowered serum adiponectin levels. Regression modelling with adjustments for age, gender, overweight, several socioeconomic and lifestyle factors, coronary heart disease and metabolic syndrome showed that each 5.0 μg/ml decrease in serum adiponectin increased the likelihood of MDD by approximately 20% ( P = 0.01). The resistin levels correlated with atypical ( P = 0.02), but not with typical depressive symptoms ( P = 0.12). Conclusion: Our findings suggest that the lowered adiponectin levels in MDD are depression-specific and not explained by conventional low adiponectin-related factors such as such as coronary heart disease and metabolic disorders. [ABSTRACT FROM AUTHOR]

Background and purpose:To further assess the clinical potential of the blockade of metabotropic glutamate receptors (mGluR1) for the treatment of pain.Experimental approach:We characterized the effects of A-841720, a novel, potent and non-competitive mGluR1 antagonist in models of pain and of motor and cognitive function.Key results:At recombinant human and native rat mGluR1 receptors, A-841720 inhibited agonist-induced calcium mobilization, with IC50 values of 10.7±3.9 and 1.0±0.2 nM, respectively, while showing selectivity over other mGluR receptors, in addition to other neurotransmitter receptors, ion channels, and transporters. Intraperitoneal injection of A-841720 potently reduced complete Freund's adjuvant-induced inflammatory pain (ED50=23 μmol kg−1) and monoiodoacetate-induced joint pain (ED50=43 μmol kg−1). A-841720 also decreased mechanical allodynia observed in both the sciatic nerve chronic constriction injury and L5-L6 spinal nerve ligation (SNL) models of neuropathic pain (ED50=28 and 27 μmol kg−1, respectively). Electrophysiological studies demonstrated that systemic administration of A-841720 in SNL animals significantly reduced evoked firing in spinal wide dynamic range neurons. Significant motor side effects were observed at analgesic doses and A-841720 also impaired cognitive function in the Y-maze and the Water Maze tests.Conclusions and implications.The analgesic effects of a selective mGluR1 receptor antagonist are associated with motor and cognitive side effects. The lack of separation between efficacy and side effects in pre-clinical models indicates that mGluR1 antagonism may not provide an adequate therapeutic window for the development of such antagonists as novel analgesic agents in humans.British Journal of Pharmacology (2006) 149, 761–774. doi:10.1038/sj.bjp.0706877; published online 3 October 2006 [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the hypothesis that coronary heart disease (CHD) mortality in diabetic subjects without prior evidence of CHD is equal to that in nondiabetic subjects with prior myocardial infarction or any prior evidence of CHD.Research Design and Methods: During an 18-year follow-up total, cardiovascular disease (CVD) and CHD deaths were registered in a Finnish population-based study of 1,373 nondiabetic and 1,059 diabetic subjects.Results: Adjusted multivariate Cox hazard models indicated that diabetic subjects without prior myocardial infarction, compared with nondiabetic subjects with prior myocardial infarction, had a hazard ratio (HR) of 0.9 (95% CI 0.6-1.5) for the risk of CHD death. The corresponding HR was 0.9 (0.5-1.4) in men and 1.9 (0.6 -6.1) in women. Diabetic subjects without any prior evidence of CHD (myocardial infarction or ischemic electrocardiogram [ECG] changes or angina pectoris), compared with nondiabetic subjects with prior evidence of CHD, had an HR of 1.9 (1.4-2.6) for CHD death (men 1.5 [1.0-2.2]; women 3.5 [1.8-6.8]). The results for CVD and total mortality were quite similar to those for CHD mortality.Conclusions: Diabetes without prior myocardial infarction and prior myocardial infarction without diabetes indicate similar risk for CHD death in men and women. However, diabetes without any prior evidence of CHD (myocardial infarction or angina pectoris or ischemic ECG changes) indicates a higher risk than prior evidence of CHD in nondiabetic subjects, especially in women. [ABSTRACT FROM AUTHOR]

The fate of hexanal added to flours of five different grain varieties was studied. All the flours appeared to be capable in decreasing hexanal concentration, but the abilities of oat flours were clearly the best. Depending on the oat flour used, the rate of hexanal decrease was 2.45–2.73 μg hexanal min−1 g−1 flour when 100 μg of hexanal was added to 1 g flour. This ability was highest amongst oat flour fractions rich in protein and fiber, which originated from the aleurone layers. The time course of hexanal decrease followed typical first order kinetics and the reaction was susceptible to heat inactivation. Hexanoic acid was identified as the predominant product correlating with hexanal decrease. These observations suggested the presence of aldehyde dehydrogenase type activity in oat. Hexanal was also absorbed to oat matrix to some extent, but it became saturated relatively quickly. It was concluded that the aldehyde dehydrogenase type activity present in oat efficiently prevents the accumulation of short chain aldehydes that lead to off odours in oat products. [Copyright &y& Elsevier]

Six Joint European Torus (JET) divertor tiles were coated with tungsten marker stripes for erosion/deposition studies. The average thickness was 3.4 μm and the film was uniform within 5% across and within 10% along the stripe. Small amounts of impurities C, Fe, Ni and Cr were found and the in-plane stress was 965 MPa. Resistance to high heat loads was tested in the Neutral Beam Test-bed at JET where a coated carbon fibre composite block was exposed to a total of 113 pulses with a maximum peak power density of 15.7 MW m-2 and a maximum surface temperature of 1280 °C. No visible changes as a result of thermal cycling nor sputtering of the film by deuterium could be detected. [Copyright &y& Elsevier]

At the end of C4 campaign at JET, a 1% SiH4/99% D2 mixture and pure 13CH4 were injected into the torus from the outer divertor wall and from the top of the vessel, respectively, in order to study material transport and scrape-off layer (SOL) flows. A set of MkIIGB tiles was removed during the 2001 shutdown for surface analysis. The tiles were analysed with secondary ion mass spectrometry (SIMS) and time-of-flight elastic recoil detection analysis (TOF-ERDA). 13C was detected in the inner divertor wall tiles implying material transport from the top of the vessel. Silicon was detected mainly at the outer divertor wall tiles and very small amounts were found in the inner divertor wall tiles. Si amounts in the inner divertor wall tiles were so low that rigorous conclusions about material transport from divertor outboard to inboard cannot be made. [Copyright &y& Elsevier]

Objective: To study the prevalence of depression at least 6 months after various coronary heart disease (CHD) events (bypass grafting, coronary angioplasty, myocardial infarction, myocardial ischaemia without infarction) and the associations between depression and clinical variables.Design: In the course of the study 414 (284 males, 130 females) patients younger than 71 years (mean age for men 60.9 years and for women 63.6 years) were interviewed and examined. Smoking habits, body mass index, lipid levels and diabetic status were recorded. The New York Heart Association (NYHA) class was assessed. Depression was screened using a self-rated depression scale.Results: In the four diagnostic categories, one-sixth of the patients (14-19%) suffered from depression. Depression was associated with smoking (OR 1.7, 95% CI 1.2; 2.4) and poor NYHA class (OR 1.9, 95% CI 1.4; 2.6).Conclusion: Depression is common after CHD events, and is associated with smoking and poor NYHA class. The identification and treatment of depression should be one of the elements in the rehabilitation of cardiac patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate cardiovascular disease (CVD) and total mortality associated with thoracoabdominal calcifications. RESEARCH DESIGN AND METHODS Thoracoabdominal calcifications of native radiograms were evaluated in 833 subjects with type 2 diabetes and 1,292 subjects without diabetes, aged 45-64 years, without prior evidence of CVD. The type 2 diabetic and nondiabetic study cohorts were followed up for 18 years. RESULTS After adjustment for conventional risk factors, marked thoracoabdominal calcifications predicted CVD/total mortality with hazard ratio (HR) (95% CI) of 1.5 (0.8-3.0)/1.8 (1.1-2.9) in type 2 diabetic men, 3.0 (1.6-5.7)/3.1 (1.9-5.0) in type 2 diabetic women, 5.0 (2.2-12)/4.0 (2.2-7.4) in nondiabetic men, and 7.8 (1.8-34)/3.0 (1.3-7.0) in nondiabetic women and in the presence of C-reactive protein below/over 3 mg/l with HR of 2.4 (1.3-4.4)/3.0 (1.4-6.1) in type 2 diabetic subjects and 4.0 (1.5-10.8)/6.6 (2.7-16.0) in nondiabetic subjects. CONCLUSIONS Thoracoabdominal calcifications in native radiograms are significant predictors of CVD and total mortality, especially in type 2 diabetic and nondiabetic women with elevated high-sensitivity C-reactive protein level. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between several indicators of depression and metabolic syndrome (MetS). Method: A population-based sample with high (HMS group) or low (LMS group) levels of mental symptoms, including those of depression, in three follow-ups participated in a clinical examination in 2005 ( n = 223). MetS was determined according to the NCEP criteria. Results: The prevalence of MetS was 49% in men and 21% in women. Men with MetS had higher rates of major depressive disorder than other men. They also displayed higher Hamilton Rating Scale for Depression (HDRS) scores and more often signs of suicidality. In logistic regression analyses, higher HDRS scores (OR 1.31, 95% CI 1.04–1.64) and belonging to the HMS group (OR 10.1, 95% CI 1.98–51.3) were independent associates for MetS but only in men. Conclusion: The results highlight that there is an association between long-term depressive symptoms and the emergence of MetS, especially in men. [ABSTRACT FROM AUTHOR]

Abstract: A January 1966 accident dispersed Pu and other nuclear bomb materials in the vicinity of Palomares, a village in southeastern Spain. Radioactive particles were identified in a soil sample collected in 1998 and analytical results obtained from one of the isolated particles are presented here. Isolation of the particle was performed using gamma-ray spectrometry and imaging plates. Scanning electron microscopy with X-ray microanalysis revealed the presence of U and Pu as well as Pb and Fe in the particle of ∼ 10μm diameter. Radioisotopes of U, Pu, and Am were quantified using radiometric methods, inductively coupled plasma mass spectrometry and secondary ion mass spectrometry. The elevated 235U/238U atom ratio indicates enriched U, and the Pu atom ratios are consistent with weapons-grade material. This work demonstrates that the analysis of individual particles provides information not available through bulk sample analysis. [Copyright &y& Elsevier]

Recapitulating human disease pathophysiology using genetic animal models is a powerful approach to enable mechanistic understanding of genotype--phenotype relationships for drug development. NaV1.7 is a sodium channel expressed in the peripheral nervous system with strong human genetic validation as a pain target. Efforts to identify novel analgesics that are nonaddictive resulted in industry exploration of a class of sulfonamide compounds that bind to the fourth voltage-sensor domain of NaV1.7. Due to sequence differences in this region, sulfonamide blockers generally are potent on human but not rat NaV1.7 channels. To test sulfonamide-based chemical matter in rat models of pain, we generated a humanized NaV1.7 rat expressing a chimeric NaV1.7 protein containing the sulfonamide-binding site of the human gene sequence as a replacement for the equivalent rat sequence. Unexpectedly, upon transcription, the human insert was spliced out, resulting in a premature stop codon. Using a validated antibody, NaV1.7 protein was confirmed to be lost in the brainstem, dorsal root ganglia, sciatic nerve, and gastrointestinal tissue but not in nasal turbinates or olfactory bulb in rats homozygous for the knock-in allele (HOM-KI). HOM-KI rats exhibited normal intraepidermal nerve fiber density with reduced tetrodotoxin-sensitive current density and action potential firing in small diameter dorsal root ganglia neurons. HOM-KI rats did not exhibit nociceptive pain responses in hot plate or capsaicin-induced flinching assays and did not exhibit neuropathic pain responses following spinal nerve ligation. Consistent with expression of chimeric NaV1.7 in olfactory tissue, HOM-KI rats retained olfactory function. This new genetic model highlights the necessity of NaV1.7 for pain behavior in rats and indicates that sufficient inhibition of NaV1.7 in humans may reduce pain in neuropathic conditions. Due to preserved olfactory function, this rat model represents an alternative to global NaV1.7 knockout mice that require time-intensive hand feeding during early postnatal development. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Thermoregulatory side effects hinder the development of transient receptor potential vanilloid‐1 (TRPV1) antagonists as new painkillers. While many antagonists cause hyperthermia, a well‐studied effect, some cause hypothermia. The mechanisms of this hypothermia are unknown and were studied herein. Methods: Two hypothermia‐inducing TRPV1 antagonists, the newly synthesized A‐1165901 and the known AMG7905, were used in physiological experiments in rats and mice. Their pharmacological profiles against rat TRPV1 were studied in vitro. Results: Administered peripherally, A‐1165901 caused hypothermia in rats by either triggering tail‐skin vasodilation (at thermoneutrality) or inhibiting thermogenesis (in the cold). A‐1165901‐induced hypothermia did not occur in rats with desensitized (by an intraperitoneal dose of the TRPV1 agonist resiniferatoxin) sensory abdominal nerves. The hypothermic responses to A‐1165901 and AMG7905 (administered intragastrically or intraperitoneally) were absent in Trpv1−/− mice, even though both compounds evoked pronounced hypothermia in Trpv1+/+ mice. In vitro, both A‐1165901 and AMG7905 potently potentiated TRPV1 activation by protons, while potently blocking channel activation by capsaicin. Conclusion: TRPV1 antagonists cause hypothermia by an on‐target action: on TRPV1 channels on abdominal sensory nerves. These channels are tonically activated by protons and drive the reflectory inhibition of thermogenesis and tail‐skin vasoconstriction. Those TRPV1 antagonists that cause hypothermia further inhibit these cold defences, thus decreasing body temperature. Significance: TRPV1 antagonists (of capsaicin activation) are highly unusual in that they can cause both hyper‐ and hypothermia by modulating the same mechanism. For drug development, this means that both side effects can be dealt with simultaneously, by minimizing these compounds’ interference with TRPV1 activation by protons. [ABSTRACT FROM AUTHOR]

Objectives: The representativeness of the data is one of the main issues in evaluating the significance of research findings. Dropping out is common in adolescent mental health research, and may distort the results. Nevertheless, very little is known about the types of systematic bias that may affect studies in a) the informed consent phase and b) later in follow-up phases. Study design: The authors addressed this gap in knowledge in a five-year follow-up study on a sample of adolescents aged 13-18 years. Methods: The data were collected using self-report questionnaires. The baseline sample consisted of 4171 adolescents, 1827 (43.8%) of whom gave consent to be contacted for a follow-up survey, but only 797 (19.1%) participated in the follow-up. Binary logistic regression models were used to explain the participation. Results: Young age, female gender, a high number of hobbies, good performance at school in the native language and general subjects, family disintegration such as divorce, high parental employment, and symptoms of depression and anxiety were associated with both consent and participation. However, the effect of mental health aspects was smaller than the effect of age and gender. Conclusions: This study confirmed the possibility of systematic selection bias by adolescents' sociodemographic characteristics. The representativeness of the study sample might have been improved by more intense recruitment strategies. [ABSTRACT FROM AUTHOR]

Accessible summary Health-related quality of life ( HRQL) measures subjects perceived well-being and functioning in physical, mental and social domains of life. In mental health nursing there is a need for improving knowledge of how life dissatisfaction, as an indicator of poor mental health, is associated and impacts on HRQL., In the present study, both long-term and concurrent life dissatisfaction (Life satisfaction scale; LS-4) were found to have a strong adverse impact on HRQL in the general population., Screening of life dissatisfaction with only four items may help mental health nurses to identify service users with poor HRQL or those at risk of it, and then investigating HRQL particularly among the dissatisfied service users would provide information on the domains and factors that most require intervention., Monitoring of life satisfaction and HRQL in mental health nursing practice or in primary care can help nurses to cooperate with service users in promoting their mental, physical or social well-being and functioning and in alleviating adverse consequences of disease., Abstract The aim of this population-based study ( n = 329) was to explore how long-term life dissatisfaction ( LS burden) and concurrent life dissatisfaction are associated with the concurrent health-related quality of life ( HRQL) ( RAND-36), and how long-term life dissatisfaction predicts HRQL in the general population. The sum of the life satisfaction scores in 1998, 1999, 2001 ( LS burden) and the concurrent life satisfaction score ( LS) in 2005 were used to categorize the study participants into satisfied, intermediate and dissatisfied groups. Differences in RAND-36 dimensions in 2005 were investigated with respect to the LS burden and concurrent life dissatisfaction. The predictive power of the LS burden for HRQL dimensions was assessed with logistic regression models. Both a high LS burden and concurrent life dissatisfaction were strongly associated with HRQL and were risk factors for poor HRQL, regardless of its dimensions. The LS burden predicted all of the RAND-36 dimensions, except for physical functioning. Screening of life dissatisfaction can be used to identify service users whose HRQL should be further investigated. Assessment of HRQL provides information on the domains and factors that require mental health nursing intervention. This knowledge could assist mental health nurses in both the alleviation of disease consequences and promotion of well-being of service users. [ABSTRACT FROM AUTHOR]

Objectives Hypertension and proteinuria are major risk factors for cardiovascular disease ( CVD) mortality in patients with type 2 diabetes. Blood pressure ( BP) targets have been progressively lowered in these patients to prevent or delay the progression of nephropathy. However, no long-term population-based studies have been reported on the interaction between BP and proteinuria with respect to total and CVD mortality in patients with type 2 diabetes. Design We prospectively followed 881 middle-aged type 2 diabetic patients, free of CVD events at baseline, for up to 18 years. Participants were categorized into four groups according to baseline systolic BP (<130, 130-139, 140-159 and ≥160 mm Hg) and further stratified by proteinuria (≤150 or >150 mg L−1). Cox proportional hazards model was used to estimate the joint association between systolic BP and proteinuria and the risk of mortality. Results During follow-up, 607 patients died including 395 because of CVD. After adjustment for confounding factors, total and CVD mortality were significantly higher in patients with proteinuria and systolic BP <130 mm Hg compared with those with systolic BP between 130 and 160 mm Hg. The prognosis was similar in patients with systolic BP <130 mm Hg or ≥160 mm Hg. Among patients without proteinuria, systolic BP <130 mm Hg was associated with a nonsignificant reduction in mortality. Conclusions Type 2 diabetic patients with proteinuria and with systolic BP <130 mm Hg may have an increased risk of CVD mortality. The presence of proteinuria should be taken into account when defining the target systolic BP level for the prevention of fatal CVD events in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: Diabetic patients with moderate renal impairment (estimated glomerular filtration rate [eGFR] 30-59 mL/min/1.73 m(2)) are at particular cardiovascular risk. Fenofibrate's safety in these patients is an issue because it may elevate plasma creatinine. Furthermore, guidelines regarding fenofibrate dosing in renal impairment vary internationally. We investigated fenofibrate's effects on cardiovascular and end-stage renal disease (ESRD) events, according to eGFR, in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study.Research Design and Methods: Type 2 diabetic patients (aged 50-75 years) with eGFR ≥30 mL/min/1.73 m(2) were randomly allocated to a fixed dose of fenofibrate (200 mg daily) (n = 4,895) or placebo (n = 4,900) for 5 years. Baseline renal function (Modification of Diet in Renal Disease equation) was grouped by eGFR (30-59, 60-89, and ≥90 mL/min/1.73 m(2)). The prespecified outcome was total cardiovascular events (composite of cardiovascular death, myocardial infarction, stroke, and coronary/carotid revascularization). Serious adverse events and instances of ESRD (plasma creatinine >400 μmol/L, dialysis, renal transplant, or renal death) were recorded. Analysis was by intention to treat.Results: Overall, fenofibrate reduced total cardiovascular events, compared with placebo (hazard ratio 0.89 [95% CI 0.80-0.99]; P = 0.035). This benefit was not statistically different across eGFR groupings (P = 0.2 for interaction) (eGFR 30-59 mL/min/1.73 m(2): 0.68 [0.47-0.97], P = 0.035; eGFR ≥90 mL/min/1.73 m(2): 0.85 [0.70-1.02], P = 0.08). ESRD rates were similar between treatment arms, without adverse safety signals of fenofibrate use in renal impairment.Conclusions: Patients with type 2 diabetes and moderate renal impairment benefit from long-term fenofibrate, without excess drug-related safety concerns compared with those with no or mild renal impairment. Fenofibrate treatment should not be contraindicated in moderate renal impairment, suggesting that current guidelines may be too restrictive. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To analyse the risk of coronary heart disease (CHD) events and total mortality among patients who had coronary artery bypass graft (CABG) surgery during 1988–1992. Methods: A population-based myocardial infarction (MI) register included data on invasive cardiac procedures among residents of the study area. The subjects aged 35–64 years were followed-up for 12 years for non-fatal and fatal CHD events and all-cause mortality, excluding events within 30 days of the CABG operation. CABG was performed on 1158 men and 215 women. Results: The overall survival of men who underwent CABG was similar to the survival of the corresponding background population for about ten years but started to worsen after that. At twelve years of follow-up, 23% (n =266, 95% CI 234–298) of the men who had undergone the operation had died, while the expected proportion, based on mortality in the background population, was 20% (n =231, 95% CI 226–237). The CHD mortality of men who had undergone the operation was clearly higher than in the background population. Among women, the mortality after CABG was about twice the expected mortality in the corresponding background population. In Cox proportional hazards models age, smoking, history of MI, body mass index and diabetes were significant predictors of mortality. Conclusions: The prognosis of male CABG patients did not differ from the prognosis of the corresponding background population for about ten years, but started to deteriorate after that. History of MI prior to CABG and major cardiovascular risk factors was a predictor of an adverse outcome. [Copyright &y& Elsevier]

Objective: To identify risk factors for fear of childbirth (FOC) according to parity and socioeconomic status, and to evaluate associations between FOC and adverse perinatal outcomes.Design: A cohort study.Setting: The Finnish Medical Birth Register.Population: All 788 317 singleton births during 1997-2010 in Finland.Methods: Fear of childbirth was defined according to the International Classification of Diseases code O99.80, and its associations with several risk factors and perinatal outcomes were analysed by multivariable logistic regression.Main Outcome Measures: Prevalence of, risk factors for and outcomes of FOC.Results: Fear of childbirth was experienced by 2.5% of nulliparous women and 4.5% of multiparous women. The strongest risk factors for FOC in nulliparous women were depression [adjusted odds ratio (aOR), 6.35; 95% confidence interval (CI), 5.25-7.68], advanced maternal age (aOR, 3.78; 95% CI, 3.23-4.42) and high or unspecified socioeconomic status. In multiparous women, the strongest risk factors for FOC were depression (aOR, 5.47; 95% CI, 4.67-6.41), previous caesarean section (CS) (aOR, 3.02; 95% CI, 2.93-3.11) and high or unspecified socioeconomic status. Among both nulliparous and multiparous women, FOC was associated with higher rates of CS (3.3-fold and 4.5-fold higher, respectively) and a lower incidence of low birthweight (<2500 g), small for gestational age babies, preterm birth and low Apgar scores at 1 minute.Conclusions: High and unspecified socioeconomic status, advanced maternal age and depression are predisposing factors for FOC regardless of parity. Among multiparous women, a previous CS increases vulnerability to FOC. FOC is associated with increased rates of CS, but does not adversely affect other pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate in a follow-up study whether high-sensitivity C-reactive protein (hs-CRP) predicts coronary heart disease (CHD) events in subjects with type 2 diabetes.Research Design and Methods: The original study population consisted of 1,059 patients with type 2 diabetes (age 45-64 years). Mean duration of diabetes was 8 years. CRP values were available from 1,045 subjects, of whom 878 were free of myocardial infarction (MI) at baseline. CHD mortality and the incidence of nonfatal MI were assessed in a 7-year follow-up.Results: Altogether, 157 patients died from CHD and 254 had a nonfatal or fatal CHD event. Patients with hs-CRP >3 mg/l had a higher risk for CHD death than patients with hs-CRP < or =3 mg/l (19.8 and 12.9%, respectively, P = 0.004). In Cox regression analysis, patients with high hs-CRP had a relative risk of 1.72 for CHD death even after the adjustment for confounding factors (P = 0.002). Among subjects who were free from MI at baseline, those with a high hs-CRP level had relative risks of 1.83 (P = 0.003) and 1.84 (P = 0.004) for CHD death in univariate and multivariate analyses, respectively.Conclusions: In this large cohort of type 2 diabetic patients, hs-CRP was an independent risk factor for CHD deaths. [ABSTRACT FROM AUTHOR]

Aim To investigate the incidence of clinical diabetes as determined by the incidence of diabetes drug reimbursements within a 5-year period after the first myocardial infarction (MI) in patients who were non-diabetic at the time of their first MI. Research design and methods A population-based MI register, FINMONICA/FINAMI, recorded all coronary events in persons of 35–64 years of age between 1988 and 2002 in four study areas in Finland. These records were used to identify subjects sustaining their first MI ( n = 2632). Participants of the population-based risk factor survey FINRISK (surveys 1987, 1992, 1997 and 2002), who did not have diabetes or a history of MI, served as the control group ( n = 7774). The FINMONICA/FINAMI study records were linked with the National Social Security Institute's drug reimbursement records, which include diabetes medications, using personal identification codes. The records were used to identify subjects who developed diabetes during the 5-year follow-up period ( n = 98 in the MI group and n = 79 in the control group). Results Sixteen per cent of men and 20% of women sustaining their first MI were known to have diabetes and thus were excluded from this analysis. Non-diabetic men having a first MI were at more than twofold {hazard ratio (HR) 2.3 [95% confidence interval (CI) 1.6–3.4]}, and women fourfold [HR 4.3 (95% CI 2.4–7.5)], risk of developing diabetes mellitus during the next 5 years compared with the control population without MI. Conclusions Many patients who do not have diabetes at the time of their first MI develop diabetes in the following 5 years. [ABSTRACT FROM AUTHOR]

Abstract Background There has been no previous study to determine the severity and extent of coronary artery disease (CAD) in subjects with no diagnosis or symptoms of CAD at the time of the angiography. Methods Fifty-three subjects, who were siblings of patients with early onset CAD, underwent coronary angiography. Indices to describe per-patient characteristics of CAD were calculated, based on computer-aided quantitative coronary angiography. Clinical and laboratory characteristics were correlated to the angiographic parameters. Results Serum total homocysteine (ρ = 0·29, P < 0·05) and creatinine (ρ = 0·47, P = 0·001) levels were related to the global atheroma burden index. The median of the atheroma burden index was two times higher in the top homocysteine quartile compared to the lowest quartile. The overall atheroma burden index correlated significantly with the fasting blood glucose level in all subjects. Diabetes, especially when albuminuria was present, was a powerful risk factor. In a multivariate analysis, only age and sex were independent predictors of atheroma burden. Conclusions Serum homocysteine and creatinine concentrations, and diabetes with albuminuria were found to be markers of the severity and extent of CAD in subjects of high-risk families without symptoms of CAD. [ABSTRACT FROM AUTHOR]

Objective: Elevated HDL cholesterol and its principal carrier protein apolipoprotein a1 [apo(a1)] are associated with reduced risk of coronary heart disease (CHD). No studies are available on the impact of the -75-bp and/or +83-bp polymorphisms of the apo(a1) gene on HDL cholesterol and apo(a1) levels in patients with type 2 diabetes.Research Design and Methods: We determined the prevalence of the: -75-bp and +83-bp polymorphisms of the apo(a1) gene by restriction fragment length polymorphism analysis among 308 unrelated nondiabetic subjects with CHD and among 251 unrelated patients with type 2 diabetes with CHD and in randomly selected 82 healthy men (CHD-).Results: The rare M1- and M2- allele frequencies of the apo(a1) gene were 23 and 1.8%, respectively, among control subjects; 20 and 1.5%, respectively, among nondiabetic subjects with CHD; and 22 and 2.6%, respectively, among patients with type 2 diabetes and CHD (NS). Nonsmoking nondiabetic subjects with CHD having the M2+- genotype had higher HDL cholesterol (1.48 +/- 0.19 vs. 1.23 +/- 0.02 mmol/l, P < 0.01) and apo(a1) (1.43 +/- 0.10 vs. 1.36 +/- 0.02 g/l, P < 0.05) levels than subjects with the M2++ genotype, even after adjustment for confounding factors. This association was not found among patients with type 2 diabetes and CHD.Conclusions: We conclude that the +83-bp polymorphism of the apo(a1) gene is associated with elevated HDL cholesterol and apo(a1) levels in Finnish nondiabetic subjects but not in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: The aim was to examine the concordance of diet with the recommended cholesterol lowering diet in Coronary Heart Disease (CHD) patients receiving usual care.Design: CHD patients were selected for a survey from hospital records at least six months after hospitalization. Four patient groups divided according to the severity of disease were examined in cross-sectional setting. Food records and fatty acid composition of serum lipids were used to assess dietary intake.Subjects: The study population consisted of 109 patients with coronary bypass grafting, 106 patients with balloon angioplasty, 101 patients with acute myocardial infarction and 99 patients with acute myocardial ischemia.Results: Concordance of the diet with the cholesterol lowering diet was similar in the patient groups. One third of the patients achieved the recommended fat intake and only one fourth achieved the recommended saturated fat intake. Concordance was better in the patients who also used lipid lowering drugs, but previous myocardial infarction did not affect dietary intake of fat and saturated fat. Diabetic or obese patients tended to have a higher intake of saturated fat. Myristic acid in cholesterol esters, triglycerides and phospholipids and also palmitic and linoleic acids in triglycerides were markers of dietary saturated fat intake.Conclusions: Concordance of the diet with the recommended cholesterol lowering diet in CHD patients was moderate. Concordance was not affected by disease severity or previous myocardial infarction and was slightly worse in CHD patients who had diabetes or were obese or did not use lipid lowering drugs. [ABSTRACT FROM AUTHOR]

Presents a study which was conducted to examine the concordance of diet with the recommended cholesterol lowering diet in coronary heart disease (CHD) patients receiving usual care. Methodology used in this study; Characteristics of the patients examined; Results of this study.

Introduction Modulators of the brain renin-angiotensin system (RAS) have been shown to improve cognitive functioning in several animal models of neuropsychiatric disorders. Moreover, the brain RAS has been considered a new target for the treatment of Alzheimer's disease (AD). However, there are no population-based follow-up studies supporting this hypothesis. Objectives Cross-sectional and prospective relationships between cognitive decline and ARB treatment were examined in the population-based Kuopio Ischemic Heart Disease Risk Factor Study. Aims To evaluate procognitive/antidementia capacity of orally delivered angiotensin II receptor blockers (ARB). Methods The study was conducted on a sample of 1774 subjects (920 females, 854 males; age range at baseline: 42–61 years) from Eastern Finland. An established cutoff score of at least 2-point decrease in the Mini Mental State Examination over a 9-year follow-up was used to detect age-related cognitive decline in the cross-sectional setting. In the prospective setting, a hospital discharge diagnosis of dementia/AD was used as outcome variable. Cross-sectional relationships were determined with logistic regression and prospective analyses were conducted with the Cox proportional hazards model (both adjusted for relevant background variables). Results Cross-sectional analysis displayed a decrease of the odds of cognitive decline ( n = 87; 4.9% of participants) in those with ARB treatment; OR = 0.445, 95% CI: 0.22–0.90, P = 0.024. Furthermore, in the prospective setting, the risk of dementia/AD diagnosis ( n = 149; 8.4% of participants) was significantly reduced in ARB treated participants; HR = 0.621, 95% CI: 0.40–0.98, P = 0.038. Conclusions ARB treatment is associated with a decreased risk for age-related cognitive decline and dementia/AD manifestation. [ABSTRACT FROM AUTHOR]

Diabet. Med. 29, e126-e132 (2012) Abstract Aims To assess the effect of lifestyle intervention on depressive symptoms during a 36-month randomized clinical trial designed to prevent Type 2 diabetes. Methods A total of 522 middle-aged participants, who were overweight or obese and had impaired glucose tolerance, were randomized to the lifestyle intervention or control group in the Finnish Diabetes Prevention Study. The intervention group received individualized counselling aimed at reducing weight and increasing physical activity. Depressive symptoms were measured using the Beck Depression Inventory among a subgroup of 140 participants. Results On study entry, the mean Beck Depression Inventory scores ± sd were 6.8 ± 5.6 in the intervention group and 6.7 ± 5.5 in the control group. Beck Depression Inventory scores reduced during the intervention study: the mean ± sd (95% CI) reduction was 0.90 ± 4.54 (−1.99 to −0.19) scores in the intervention group and 0.75 ± 4.47 (−1.80 to 0.31) in the control group, with no difference between the groups. In a stepwise linear multivariate regression analysis, the variables with the strongest associations with the change in Beck Depression Inventory scores were baseline Beck Depression Inventory scores, marital status, weight change and change of total energy intake ( R2 = 0.209, P < 0.001). Conclusions Participation in the study lowered depression scores, with no specific group effect. Among the lifestyle changes, particularly successful reduction of body weight was associated with the greater reduction of depressive symptoms. Thus, regardless of the intensity of the treatment, the success in executing alterations in one's lifestyle and behaviour is associated with beneficial changes in mood. [ABSTRACT FROM AUTHOR]

Diffusion of As into Ge from a GaAs overlayer deposited on p-type Ge substrates has been studied by means of secondary ion mass spectrometry. A concentration-dependent diffusion of As atoms was observed in addition to the concentration-independent diffusion of Ga and As atoms. The concentration dependence is explained by a Fermi-level-dependent diffusion model. Arsenic atoms are shown to diffuse through Ge vacancies with the charge states 2- and 0. No presence of the singly negatively charged vacancies was observed, indicating that Ge vacancy could be a negative U center. © 2000 American Institute of Physics. [ABSTRACT FROM AUTHOR]