25 resultados para 402

em Doria (National Library of Finland DSpace Services) - National Library of Finland, Finland


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kuv., 14 x 22 cm

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Background: Measurement of serum cotinine, a major metabolite of nicotine, provides a valid marker for quantifying exposure to tobacco smoke. Exposure to tobacco smoke causes vascular damage by multiple mechanisms, and it has been acknowledged as a risk factor for atherosclerosis. Multifactorial atherosclerosis begins in childhood, but the relationship between exposure to tobacco smoke and arterial changes related to early atherosclerosis have not been studied in children. Aims: The aim of the present study was to evaluate exposure to tobacco smoke with a biomarker, serum cotinine concentration, and its associations with markers of subclinical atherosclerosis and lipid profile in school-aged children and adolescents. Subjects and Methods: Serum cotinine concentration was measured using a gas chromatographic method annually between the ages 8 and 13 years in 538-625 children participating since infancy in a randomized, prospective atherosclerosis prevention trial STRIP (Special Turku coronary Risk factor Intervention Project). Conventional atherosclerosis risk factors were measured repeatedly. Vascular ultrasound studies were performed among 402 healthy 11-year-old children and among 494 adolescents aged 13 years. Results: According to serum cotinine measurements, a notable number of the school aged children and adolescents were exposed to tobacco smoke, but the exposure levels were only moderate. Exposure to tobacco smoke was associated with decreased endothelial function as measured with flow-mediated dilation of the brachial artery, decreased elasticity of the aorta, and increased carotid and aortic intima-media thickness. Longitudinal exposure to tobacco smoke was also related with increased apolipoprotein B and triglyceride levels in 13-year-old adolescents, whose body mass index and nutrient intakes did not differ. Conclusions: These findings suggest that exposure to tobacco smoke in childhood may play a significant role in the development of early atherosclerosis. Key Words: arterial elasticity, atherosclerosis, children, cotinine, endothelial function, environmental tobacco smoke, intima-media thickness, risk factors, ultrasound

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In recent years, one important objective of cardiovascular research has been to find new markers that would improve the risk stratification and diagnosis of patients presenting with symptoms of acute coronary syndrome (ACS). Pregnancy-associated plasma protein A (PAPP-A) is a large metalloproteinase involved in insulin-like growth factor signalling. It is expressed in various tissues and seems to be involved in many physiological and pathological processes, such as folliculogenesis, bone formation, wound healing, pregnancy and atherosclerosis. The aim of this thesis was to investigate PAPP-A in ACS patients. Circulating concentrations of PAPP-A had been previously shown to be elevated in ACS. In this study it was revealed that the form of PAPP-A causing this elevation was the free noncomplexed PAPP-A. Thus, the form of PAPP-A in the circulation of ACS patients differed from the complexed PAPP-A form abundantly present in the circulation during pregnancy. A point-of-care method based on time-resolved immunofluorometric assays was developed, which enabled the rapid detection of free PAPP-A. The method was found to perform well with serum and heparin plasma samples as well as with heparinized whole blood samples. With this method the concentrations of free PAPP-A in healthy individuals were shown to be negligible. When the clinical performance of the method was evaluated with serum samples from ACS patients, it was shown that the free PAPP-A concentration in the admission sample was an independent predictor of myocardial infarction and death. Moreover, as a prognostic marker, free PAPP-A was revealed to be superior to total PAPPA, i.e. the combination of free and complexed PAPP-A, which has been measured by the other groups in this field. As heparin products are widely used as medication in ACS patients, the effect of heparin products on free PAPP-A molecule and circulating concentrations were also investigated in this study. It was shown that intravenous administration of low molecular weight or unfractionated heparin elicits a rapid release of free PAPP-A into the circulation in haemodialysis patients and patients undergoing angiography. Moreover, the interaction between PAPP-A and heparin was confirmed in gel filtration studies. Importantly, the patients included in the clinical evaluation of the free PAPP-A detection method developed had not received any heparin product medication before the admission sample and thus the results were not affected by the heparin effect. In conclusion, free PAPP-A was identified as a novel marker associated with ACS. The point-of-care methods developed enable rapid detection of this molecule which predicts adverse outcome when measured in the admission sample of ACS patients. However, the effect revealed of heparin products on circulating PAPP-A concentrations should be acknowledged when further studies are conducted related to free or total PAPP-A in ACS.

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Invocatio: D.O.D.

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Soitinnus: piano.

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Kommentti artikkeliin "Luonnollisten rajojen oppi ja David Alopaeuksen osuus Suomen suuriruhtinaskunnan rajojen synnyssä" / Kari Tarkiainen (HAik 4/2009, s. 379-402).

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Rauman alueella toteutettiin maa- ja metsätalousalueiden luonnon monimuotoisuuden ja kosteikkojen yleissuunnitelma vuonna 2010. Hankkeessa etsittiin maatalouden ympäristötuen erityistuella hoidettavaksi soveltuvia luonnon monimuotoisuuskohteita ja ei-tuotannollisella investointituella perustettavaksi sopivia kosteikkoja. Lisäksi tarkasteltiin suojavyöhykkeiden tarvetta erityisesti tulvahaitoista kärsivillä ja kaltevilla pelloilla. Alueelta löytyi runsaasti luonnon monimuotoisuuskohteita, joiden hoidolla seudun luontoarvot kohenisivat. Kosteikkoja alueelta löytyi aika vähän ja useimpiin niihin eivät maataloustuet sovellu. Kuitenkin kosteikkojen ja lisäksi myös tarpeellisten suojavyöhykkeiden toteuttaminen todennäköisesti parantaisivat jonkin verran Rauman alueen vesistöjen tilaa. Lisäksi hankkeessa kartoitettiin metsäluonnon monimuotoisuuskohteita, joita metsänomistaja voi halutessaan hoitaa ja suojella valtakunnallisen METSO-ohjelman keinoin. Sekä metsä- että maatalouskohteiden mukanaolo suunnitelmassa ei velvoita maanomistajia mihinkään, mutta tuo toivottavasti tarpeellista taustatukea ja tietoa, jos alueita suunnitellaan hoidettavan.