Anabolic-androgenic steroid use among young Finnish males.

The aim of the present study was to describe the lifetime occurrence and associated factors of anabolic-androgenic steroids (AAS) among young Finnish males. Of the 10 829 male conscripts (median age 19), 10 396 (96%) answered a questionnaire during the first days of their conscription in the years 2001-2007. The main outcome was lifetime AAS use. We also studied associations between 13 socioeconomic, health, and health behavioral background variables and AAS use by logistic regression. Eighty-nine (0.9%) respondents reported having used AAS. In addition, 26 (0.3%) respondents reported that they would use AAS if they could obtain them. In multivariate analysis, which included all significant variables and age, the strongest associated factors were weight training at fitness centers more than three times a week [odds ratio (OR) 11.8; 95% confidence interval (CI): 7.1-19.6], low educational status (OR 3.7; 95% CI: 2.0-7.0), and weekly drunkenness as drinking style (OR 2.4; 95% CI: 1.4-4.5). Sports other than weight training were not associated with AAS in our sample. The use of AAS is relatively uncommon among Finnish males. It is strongly associated with weight training at fitness centers but also with lower educational status and a drunkenness-oriented lifestyle. Prevention should be targeted at those males participating in weight training.

An association between socioeconomic, health and health behavioural indicators and fractures in young adult males.

UNLABELLED: The aim of this survey study with 7,083 male respondents was to examine the association between socioeconomic, health and health behavioural risk indicators and fractures. In the multivariate regression model, fractures were associated strongest with frequency of drunkenness, regular sports training, frequent use of health care services and obesity. INTRODUCTION: Little is known about the risk factors for fractures in young adults. Our aim was to identify the association between socioeconomic background, health and health behaviours and fractures. METHODS: The survey sample comprised 7,378 conscript males (median age 19), of which 7,083 (96%) answered. The outcome was self-reported fracture. Associations between 20 background variables and fractures were analysed with logistic regression. RESULTS: Altogether 2,456 (34.7%) participants reported fracture(s) during their lifetime. The most common anatomical locations of fracture were the forearm, the hand and the ankle. The strongest risk indicators for fractures were frequent drunkenness (OR 1.7; 95% CI: 1.3-2.0), regular sports training (OR 1.6; 95% CI: 1.3-1.9), frequent use of health care services (OR 1.5; 95% CI: 1.3-1.8) and obesity (OR 1.5; 95% CI: 1.2-1.9). CONCLUSIONS: This is among the first studies to describe risk indicators for fractures in young adults. The strongest risk factors for fractures were associated with health damaging behaviour, high-intensity physical activity and use of health care services. Of socioeconomic background factors, only living in the capital city area was associated with fractures. Preventive measures should be targeted at the males frequently using health care services or actively participating in sports.

Physicians' database searches as a tool for early detection of epidemics.

We analyzed retrospectively the use of Physician Desk Reference Database searches to identify epidemics of tularemia, nephropathy, Pogosta disease, and Lyme disease and compared the searches with mandatory laboratory reports to the National Infectious Diseases Register in Finland during 1995. Continuous recording of such searches may be a tool for early detection of epidemics.

The risk of Guillain-Barré syndrome following infection with Campylobacter jejuni.

To estimate the incidence of Guillain-Barré syndrome (GBS) following Campylobacter jejuni infection (CI) we studied three populations where outbreaks of CI had occurred involving an estimated 8000 cases. No case of GBS was detected in the 6 months following the outbreaks in the local populations. The point estimate for the risk of GBS following CI estimated in this study was 0 in 8000 (95% confidence interval 0-3).

The unchanging incidence of hospitalization for diabetic nephropathy in a population-based cohort of IDDM patients in Finland.

OBJECTIVE: Finland has the highest documented incidence of childhood IDDM in the world, but the incidence of diabetic nephropathy in Finland is unknown. The aim of the present study was to determine the incidence of hospitalization for diabetic nephropathy in a population-based cohort of Finnish IDDM patients and to analyze the prognostic effect of sex, age at diagnosis, and calendar year of diagnosis of IDDM. RESEARCH DESIGN AND METHODS: We included all Finnish patients who had onset of IDDM before age 18 years, were diagnosed between January 1965 and December 1979 (n = 5,149), and were traced for hospitalizations between January 1970 and the end of December 1989 in the Hospital Discharge Register, using the unique personal identification code given to all Finnish citizens. The development of diabetic nephropathy was defined as the first hospitalization with a diagnosis of nephropathy (International Classification of Diseases-8th Revision [ICD-8] 250.04, or 9th Revision [ICD-9] 2503B/2503X). RESULTS: Among the 5,149 patients included, we identified 446 cases of diabetic nephropathy. The incidence of hospitalization for diabetic nephropathy was very low during the first 8 years of diabetes duration, and after that increased to a maximum of 1.6-2.0% per year. Female subjects developed nephropathy slightly earlier than male subjects, but the cumulative risk was independent of sex. Patients diagnosed at ages 5-14 years had the highest risk of hospitalization for diabetic nephropathy. We observed no effect of calendar year of diagnosis. CONCLUSIONS: We found a 20% cumulative incidence of hospitalization for diabetic nephropathy during a total 24 years of IDDM duration. This finding is compatible with the cumulative incidence of hospitalization for diabetic nephropathy found in other European populations. The incidence of hospitalization for diabetic nephropathy did not decrease during the 20-year observation period.

Therapeutic traditions in type 2 diabetes--are they changing?

The utilisation of antidiabetic drugs reflects both the prevalence of diabetes and the different therapeutic traditions of physicians. A questionnaire survey to study attitudes to the use of oral antidiabetic drugs amongst physicians and possible changes in treatment habits was carried out in a representative sample of Finnish physicians (n = 454) in 1992 and the results were compared with those of a similar survey carried out in 1985, and with drug utilisation statistics. The mean fasting blood glucose level at which a physician would start pharmacological treatment was 8.7 mmol.l-1, which was significantly lower than in the 1985 survey. The responses to various case histories suggested a more active approach to pharmacological treatment compared to the 1985 survey. Insulin treatment especially seems to have gained in popularity. This change in attitude was paralled by an increase in the consumption of antidiabetic drugs in Finland during the observation period. The increase in use of oral drugs was steeper in Finland than in Norway and Sweden. Whether this active approach will improve the metabolic control and prognosis of patients with Type 2 diabetes, remains to be demonstrated.