Joint associations of leisure time physical activity and screen sitting time with long-term sickness absence due to mental and musculoskeletal diseases: a registry linked follow-up study.

OBJECTIVES: To examine joint associations of leisure-time physical activity (LTPA) and screen sitting time with subsequent sickness absence among the adult population. STUDY DESIGN: Registry linked follow-up study. METHODS: A representative sample of Finnish adults (n = 10,300) were asked to fill out a questionnaire for the FinHealth 2017 survey. Self-reported LTPA was classified into three groups: inactive, moderately active, and active, and screen sitting time into two groups: 3 h or less and over three hours a day, yielding a six-category variable for the joint analyses. Questionnaire data were linked to the Finnish Social Insurance Institution's register data on sickness benefits (over 9 days), including diagnoses (follow-up 2.9 years). The analytical samples were restricted to working age (18-64 years), which included 5098 participants. Associations were examined using logistic regression analysis adjusting for covariates with SPSS 29. RESULTS: The inactive and high sitting time had a higher risk for sickness absence due to mental disorders (OR 2.07, 95% CI 1.03-4.18) compared with the physically active, low-sitting time group. Additionally, the inactive and low sitting time (OR 1.69 95% CI 1.12-2.55) and the moderately active and high-sitting time groups (OR 2.06 95% CI 1.15-3.67) had a higher risk. No significant associations were found for all-cause and musculoskeletal diseases sickness absence. CONCLUSION: Employers and policymakers could support reducing sitting in front of a screen and increase LTPA outside working hours to prevent mental health problems and related sickness absences.

Clindamycin resistant emm33 Streptococcus pyogenes emerged among invasive infections in Helsinki metropolitan area, Finland, 2012 to 2013.

In 2012, blood, skin and soft tissue infections caused by clindamycin resistant Streptococcus pyogenes (group A streptococcus; GAS) appeared to be increasing in the Helsinki metropolitan area. We compared monthly percentages of clindamycin resistant isolates in the area between 2012 and 2013, with those in 2010 and 2011. Resistance frequency in terms of patient age was also studied. We reviewed the medical records of bacteraemic cases in 2012 and 2013 and linked the data to emm types. To inform on the emm distribution among GAS isolated from skin and soft tissue infections during the epidemic, GAS isolates of one month (March 2013) were emm typed. For GAS blood, skin, and soft tissue isolates taken together, the proportions of clindamycin resistant isolates were significantly higher in 2012 and 2013 (23% and 17%, respectively) compared with the two previous years (3%, p<0,001). The erythromycin resistance percentages were almost equal to clindamycin (22% and 17%) in 2012 and 2013, respectively. Clindamycin resistance was most frequent in GAS isolates of 40 to 60 year-old patients (148/417; 36%). Among clindamycin resistant isolates, 12 of 14 blood isolates from 2012 to 2013, and 11 of 13 skin and soft tissue isolates from March 2013, were emm33. Emm33 GAS bacteraemia was associated with clindamycin and erythromycin resistance (odds ratio (OR): 7.0; 95% confidence interval (CI): 1.9-25.3). Infection focus was mainly the skin; either cellulitis (7/12) or necrotising fasciitis (3/12). All emm33 GAS isolates harboured the ermTR resistance gene with constitutive macrolides, lincosamides and streptogramines B (MLS(B)) phenotype. Emm33 GAS was responsible for the higher proportion of clindamycin resistance in skin, soft tissue, and blood isolates locally in 2012 and 2013.

Multinational outbreak of Salmonella Enteritidis infection during an international youth ice hockey competition in Riga, Latvia, preliminary report, March and April 2015.

A multinational outbreak of salmonellosis linked to the Riga Cup 2015 junior ice-hockey competition was detected by the Finnish health authorities in mid-April and immediately notified at the European Union level. This prompted an international outbreak investigation supported by the European Centre for Disease Prevention and Control. As of 8 May 2015, seven countries have reported 214 confirmed and suspected cases, among which 122 from Finland. The search for the source of the outbreak is ongoing.

Exercise for fitness does not decrease the muscular inactivity time during normal daily life.

The time spent in sedentary behaviors has been shown to be independent of exercise in epidemiological studies. We examined within an individual whether exercise alters the time of muscular inactivity within his/her normal daily life. Quadriceps and hamstring muscle electromyographic activities and heart rate were measured during 1 to 6 days of normal daily living of ordinary people. Of 84 volunteers measured, 27 (15 men, 12 women, 40.7 years ± 16.5 years) fulfilled the criteria of having at least 1 day with and 1 day without exercise for fitness (total of 87 days analyzed, 13.0 h ± 2.5 h/day). Reported exercises varied from Nordic walking to strength training and ball games lasting 30 min-150 min (mean 83 min ± 30 min). Exercise increased the time spent at moderate-to-vigorous muscle activity (6% ± 4% to 9% ± 6%, P < 0.01) and energy expenditure (13% ± 22%, P < 0.05). Muscular inactivity, defined individually below that measured during standing, comprised 72% ± 12% of day without and 68% ± 13% of day with exercise (not significant). Duration of exercise correlated positively to the increase in moderate-to-vigorous muscle activity time (r = 0.312, P < 0.05) but not with inactivity time. In conclusion, exercise for fitness, regardless of its duration, does not decrease the inactivity time during normal daily life. This is possible by slight modifications in daily nonexercise activities.

Relationship between habitual physical activity and gross motor skills is multifaceted in 5- to 8-year-old children.

Adequate motor skills are essential for children participating in age-related physical activities, and gross motor skills may play an important role for maintaining sufficient level of physical activity (PA) during life course. The purpose of this study was to examine the relationship between gross motor skills and PA in children when PA was analyzed by both metabolic- and neuromuscular-based methods. Gross motor skills (KTK--Körperkoordinationstest für Kinder and APM inventory--manipulative skill test) of 84 children aged 5-8 years (53 preschoolers, 28 girls; 31 primary schoolers, 18 girls) were measured, and accelerometer-derived PA was analyzed using in parallel metabolic counts and neuromuscular impact methods. The gross motor skills were associated with moderate-to-high neuromuscular impacts, PA of vigorous metabolic intensity, and mean level of PA in primary school girls (0.5 < r < 0.7, P < 0.05), and with high impacts in preschool girls (0.3 < r < 0.5, P < 0.05). In preschool boys, moderate impacts, light-to-vigorous PA, and mean level of PA were associated with gross motor skills (0.4 < r < 0.7, P < 0.05). In conclusion, the result emphasizes an important relationship between gross motor skills and PA stressing both metabolic and neuromuscular systems in children. Furthermore, PA highly stressing neuromuscular system interacts with gross motor proficiency in girls especially.

Responsiveness of electromyographically assessed skeletal muscle inactivity: methodological exploration and implications for health benefits.

Prolonged sedentary behaviour is detrimental to health due to low contractile activity in large lower extremity muscle groups. This muscle inactivity can be measured with electromyography (EMG), but it is unknown how methodological factors affect responsiveness longitudinally. This study ranks 16 different EMG inactivity thresholds based on their responsiveness (absolute and standardized effect size, responsiveness) using data from a randomized controlled trial targeted at reducing and breaking up sedentary time (InPact, ISRCTN28668090). EMG inactivity duration and usual EMG inactivity bout duration (weighted median of bout lengths) were measured from large lower extremity muscle groups (quadriceps, hamstring) with EMG-sensing shorts. The results showed that the EMG inactivity threshold above signal baseline (3 µV) provided overall the best responsiveness indices. At baseline, EMG inactivity duration of 66.8 ± 9.6% was accumulated through 73.9 ± 36.0 s usual EMG inactivity bout duration, both of which were reduced following the intervention (-4.8 percentage points, -34.3 s). The proposed methodology can reduce variability in longitudinal designs and the detailed results can be used for sample size calculations. Reducing EMG inactivity duration and accumulating EMG inactivity in shorter bouts has a potential influence on muscle physiology and health.

Agreement between heart rate deflection point and maximal lactate steady state in young adults with different body masses.

We examined the agreement between heart rate deflection point (HRDP) variables with maximal lactate steady state (MLSS) in a sample of young males categorized to different body mass statuses using body mass index (BMI) cut-off points. One hundred and eighteen young males (19.9 ± 4.4 years) underwent a standard running incremental protocol with individualized speed increment between 0.3 and 1.0 km/h for HRDP determination. HRDP was determined using the modified Dmax method called S.Dmax. MLSS was determined using 2-5 series of constant-speed treadmill runs. Heart rate (HR) and blood lactate concentration (La) were measured in all tests. MLSS was defined as the maximal running speed yielding a La increase of less than 1 mmol/L during the last 20 min. Good agreement was observed between HRDP and MLSS for HR for all participants (±1.96; 95% CI = -11.5 to +9.2 b/min, ICC = 0.88; P < 0.001). Good agreement was observed between HRDP and MLSS for speed for all participants (±1.96; 95% CI = -0.40 to +0.42 km/h, ICC = 0.98; P < 0.001). The same findings were observed when participants were categorized in different body mass groups. In conclusion, HRDP can be used as a simple, non-invasive and time-efficient method to objectively determine submaximal aerobic performance in nonathletic young adult men with varying body mass status, according to the chosen standards for HRDP determination.

Possibilities, limitations, and technique for the study of regional myocardial perfusion in man by Xenon-133.

The theoretical possibilities and the practical limitations of the Xenon-133 (133Xe) method for the study of regional myocardial perfusion in man are discussed. The techniques for data acqusition and processing developed over the past 5 years are described in detail. Illustrative examples of experimental findings are reported. The practical interpretation of the data, at the light of the influence of injection site, initial tracer distribution, constancy of counting geometry, spatial resolution, and Xenon retention in fat, is presented.

Systemic and coronary haemodynamic effects of the new hypotensive drug L 6150.

The acute systemic and coronary haemodynamic effects of a new hypotensive drug L 6150 (3-hydrazino-6-[N,N-bis(2-hydroxyethyl)amino]pyridazine) have been studied in six patients with renal or essential hypertension. The drug, administered intravenously at a dose of 2-9 mg, caused a marked hypotension and increase of cardiac output in five cases. Though left ventricular work was reduced or unchanged after the drug, myocardial blood flow increased markedly, coronary resistance decreased and coronary A-V oxygen difference decreased by about 50% indicating coronary vasodilation. When compared with the available data on the effects of hydrazinophthalazine, L 6150 appeared to have qualitatively similar effects, but a somewhat greater direct coronary vasodilator effect.

[Prevalence of hepatitis C virus infection in a population of drug addicts and their heterosexual partners]. / Prevalenza della infezione da virus C della epatite in una popolazione di tossicodipendenti e dei loro partner eterosessuali.

This study reports data concerning the prevalence of anti HCV in a population of 166 drug addicts and 25 partners (14 drug addicts and 11 with no history of substance abuse) of subjects proven anti HCV positive. The study was carried out in order to evaluate the importance of the haematic and sexual modes of transmission of HCV. The results obtained showed a prevalence of HCV infection in drug addicts with substantial statistic significance when compared with the prevalence in a population of donors. There is no evidence of statistically significant differences in prevalence between non-addicted partners and blood donors or between addicted partners and the general population of drug addicts. From these comparisons it is clear that haematic contact is an important source of contagion, whereas sexual contact appears to be of minor importance.

[Role of ambulatory ECG in a cardiology department]. / Ruolo dell'ECG dinamico in un Servizio di Cardiologia.

Ambulatory electrocardiographic monitoring has become an important clinical tool for the diagnosis and management of patients with symptoms suggesting cardiac arrhythmias or ischemic heart disease. Holter monitoring (H) is widely used in the evaluation of patients with recent myocardial infarction, angina pectoris, hypertrophic cardiomyopathy, dilated cardiomyopathy, long QT syndrome, sinus node dysfunction. The role of H monitoring in defining prognosis in many of these heart disease is not well established. Holter monitoring is also used to evaluate the results of antiarrhythmic and antianginal drug therapy. Application of quantitative H monitoring to define drug efficacy has revealed that antiarrhythmic drugs may have a proarrhythmic effect and that a withdrawal syndrome can follow the abrupt cessation of antianginal and antiarrhythmic drugs. There are no consistent data about the optimal duration of monitoring to detect and quantify ventricular arrhythmias and ischemic attacks. We think that the appropriate duration of monitoring must be adjusted to the single patient, considering: a) the frequency and severity of symptoms; b) the cardiac lesion (s) and functional class; c) the goal of H. When used appropriately H can be a cost-effective tool and may prevent hospitalizations.

Transient transmural reduction of myocardial blood flow demonstrated by thallium-201 scintigraphy, as a cause of variant angina.

In previous studies we demonstrated that variant angina could not be attributed to increased myocardial demands. In order to investigate whether a reduction of regional myocardial blood supply could be responsible for these ischemic episodes, we studied regional myocardial perfusion in six patients admitted to our coronary care unit. Myocardial scintigrams, obtained 5-7 min following i.v. injection of 1 mCi of thallium-201, performed during an episode of ST-segment elevation, showed transmural deficits of tracer uptake in the heart wall corresponding to the leads showing ST-segment elevation. These regional deficits ahd disappeared by 2 hours because of late uptake in previously ischemic myocardium. One week later, following injections performed in the absence of acute ischemia, no deficit was apparent. Tracer uptake in ischemic areas was 60% to 85% of that observed a week later. After adjusting for thallium-201 kinetics and counting geometry promblems., these scintigrams actually represent large underestimations of actual flow reduction. Thus variant angina appears to be caused by massive transmural reduction of myocardial blood supply.

Lung disease associated with amiodarone treatment.

A case of pneumonitis and pulmonary fibrosis occurring during long term treatment with amiodarone hydrochloride is described. The patient, a 68 year old woman, presented with severe dyspnoea and weakness 13 months after the institution of amiodarone therapy, 200 mg. bid 6 days/week. Chest x-ray showed patchy infiltrates involving the parahilar and medullary areas of both upper lobes. The clinical symptoms and the pulmonary signs improved only after amiodarone discontinuation and steroid treatment. Radiographic abnormalities gradually cleared over 45 days except for residual lines of fibrosis in the zones of previous alveolar consolidation still present 4 months later.

Efficacy of diltiazem in variant angina. Results of a double-blind crossover study in CCU by Holter monitoring. The possible occurrence of a withdrawal syndrome.

The short and long term efficacy of diltiazem, a calcium-entry blocker, has been evaluated in a group of ten patients with Prinzmetal's variant angina admitted to a CCU. In the short term part of the study, after a run-in period, diltiazem 60 mg tid and placebo were administered alternatively during 4 randomized 72 hour periods. Response was assessed using continuous Holter monitoring, measuring the frequency of transient ischemic attacks. During the run-in period the number of episodes/day/patient was 16.1. No episodes of transient ST segment elevation were recorded during both periods of diltiazem treatment in 3 patients and during one of the two periods in 4. For the group as a whole the number of episodes during the first placebo period was not statistically different from that during the run-in period (208 versus 161). No statistically significant difference was also found in 8 patients comparing the number of episodes during the second placebo period and the run-in period (166 versus 101). During each period of diltiazem treatment an highly significant reduction in the number of episodes was observed (43 and 5, p = .006 and p = .02). Two patients did not complete the study protocol. Both patients had a worsening of angina during the first placebo period following diltiazem treatment. One of them developed an acute myocardial infarction. The possible occurrence of a rebound phenomenon after withdrawal of diltiazem seems to be indicated, in 6 patients, by a significant increase in the number of ischemic episodes recorded during the placebo period following active treatment in respect to the number during the first placebo period (159 versus 73, p = .04).(ABSTRACT TRUNCATED AT 250 WORDS)