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Article ; Online: Large lungs may predict increased air trapping in navy divers.

Wuorimaa, Tomi / Haukka, Jari / Tikkinen, Janne / Parkkola, Kai / Piirilä, Päivi

2022 Volume 10, Issue 4, Page(s) e15153

Abstract: ... in the controls (p = 0.006) and TLCb 8.9 L in the divers versus 8.1 L in the controls (p = 0.002). No difference ...

Abstract	Navy divers tend to have large lungs and low expiratory flow rates in the terminal portion of a spirogram. We examined Finnish Navy divers for the presence of air trapping, airway obstruction, and functional airway compression, and their association with lung volumes. Divers (n = 57) and non-diving men (n = 10) underwent a variety of pulmonary function tests. The amount of trapped air was calculated as the subtraction of the total lung capacity (TLC) measured in a single-breath helium dilution test from the TLC in body plethysmography (TLCb). Mean vital capacity (VC) was 6.4 L in the divers versus 5.8 L in the controls (p = 0.006) and TLCb 8.9 L in the divers versus 8.1 L in the controls (p = 0.002). No difference existed between them in the amount of trapped air. However, we found break points in a linear regression model (Davies test) between trapped air and several pulmonary parameters. Those individuals above the break points had lower ratio of forced expiratory volume in first second to forced vital capacity, lower resistance of airways, and higher reactance than those below the break points. In conclusion, navy divers had larger lungs than controls. Large lung volumes (VC >7.31 L or >122% of predicted value) were associated with air trapping. Furthermore, large volumes of air trapping (>1.1 L) were associated with increased residual volume (RV) and RV/TLCb. Despite no concurrent obstruction, functional airway compression, or reduced diffusing capacity, this slowly ventilated trapped air might remain disadvantageous for divers.
MeSH term(s)	Forced Expiratory Volume ; Humans ; Lung ; Male ; Respiratory Function Tests ; Total Lung Capacity ; Vital Capacity
Language	English
Publishing date	2022-02-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2724325-4
ISSN	2051-817X ; 2051-817X
ISSN (online)	2051-817X
ISSN	2051-817X
DOI	10.14814/phy2.15153
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Article ; Online: Lactate and ammonia measurements during cardiopulmonary exercise testing and its recovery phase-Consideration of age and sex in its interpretation.

Ratia, Nadja / Lantto, Hanna / Rotgers, Emmi / Kouri, Vesa-Petteri / Auranen, Mari / Luukkonen, Ritva / Piirilä, Päivi

Clinical physiology and functional imaging

2023 Volume 43, Issue 4, Page(s) 278–290

Abstract: ... 10, 20 and 30 min into recovery.: Results: The lactate (p = 0.021-0.044) and ammonia values (p = 0 ... 50-year-groups (lactate p = <0.001-0.040, ammonia p = 0.002-0.03). In the linear model, the yearly ...

Abstract	Background: Cardiopulmonary exercise testing with lactate and ammonia samples is used in the diagnostics of metabolic myopathies. As the effect of age and sex on the exercise lactate and ammonia levels are incompletely characterized for clinical associations, our aim was to assess the effects of these factors on healthy subjects to improve the test's interpretation. Methods: Seventy-three subjects (34 men and 39 women; age < 35 years, n = 26, 35-50 years, n = 23 and >50 years, n = 24) performed cardiopulmonary exercise tests with venous blood gases, plasma lactate and ammonia analyses at rest, during exercise, and 2, 4, 6, 10, 20 and 30 min into recovery. Results: The lactate (p = 0.021-0.044) and ammonia values (p = 0.002-0.038) differed between men and women measured during recovery and between three age groups point-by-point in maximal exercise and the recovery phase and also longitudinally, most notably between <35- and >50-year-groups (lactate p = <0.001-0.040, ammonia p = 0.002-0.03). In the linear model, the yearly reduction of lactate was maximally -0.119 mmol/L and that of ammonia -1.514 µmol/L. The yearly reduction of lactate was greater in women than in men (-0.131 vs.-0.099 2 min into recovery), but for ammonia, the results were not as clear. Conclusions: Plasma lactate and ammonia concentrations measured during cardiopulmonary exercise were lower in older age groups, and their yearly reduction was also influenced by sex. These data give new information on lactate and ammonia levels and the effect of aging on them during exercise and recovery and may help assess cardiopulmonary exercise testing results.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Adult ; Lactic Acid ; Ammonia ; Exercise Test ; Exercise
Chemical Substances	Lactic Acid (33X04XA5AT) ; Ammonia (7664-41-7)
Language	English
Publishing date	2023-03-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2071203-0
ISSN	1475-097X ; 1475-0961
ISSN (online)	1475-097X
ISSN	1475-0961
DOI	10.1111/cpf.12817
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Article ; Online: Occupational exposure to vapors, gasses, dusts, and fumes in relation to causes of death during 24 years in Helsinki, Finland.

Jalasto, Juuso / Luukkonen, Ritva / Lindqvist, Ari / Langhammer, Arnulf / Kankaanranta, Hannu / Backman, Helena / Rönmark, Eva / Sovijärvi, Anssi / Piirilä, Päivi / Kauppi, Paula

International archives of occupational and environmental health

2023 Volume 97, Issue 2, Page(s) 145–154

Abstract: Purpose: Environmental particulate matter (PM) exposure has been shown to cause excess all-cause and disease-specific mortality. Our aim was to compare disease-specific mortality by estimated occupational exposure to vapors, gasses, dusts, and fumes ( ... ...

Abstract	Purpose: Environmental particulate matter (PM) exposure has been shown to cause excess all-cause and disease-specific mortality. Our aim was to compare disease-specific mortality by estimated occupational exposure to vapors, gasses, dusts, and fumes (VGDF). Methods: The data source is the Helsinki part of the population-based FinEsS study on chronic obstructive pulmonary diseases including information on age, education level, main occupation, sex, and tobacco smoking combined with death registry information. We compared estimated VGDF exposure to mortality using adjusted competing-risks regression for disease-specific survival analysis for a 24-year follow-up. Results: Compared to the no-exposure group, the high occupational VGDF exposure group had sub-hazard ratios (sHR) of 1.7 (95% CI 1.3-2.2) for all cardiovascular-related and sHR 2.1 (1.5-3.9) for just coronary artery-related mortality. It also had sHR 1.7 (1.0-2.8) for Alzheimer's or vascular dementia-related mortality and sHR 1.7(1.2-2.4) for all respiratory disease-related mortality. Conclusion: Long-term occupational exposure to VGDF increased the hazard of mortality- to cardiovascular-, respiratory-, and dementia-related causes. This emphasizes the need for minimizing occupational long-term respiratory exposure to dust, gasses, and fumes.
MeSH term(s)	Humans ; Dust/analysis ; Cause of Death ; Finland/epidemiology ; Occupational Diseases/etiology ; Occupational Exposure/adverse effects ; Occupational Exposure/analysis ; Pulmonary Disease, Chronic Obstructive/etiology ; Gases/analysis ; Risk Factors
Chemical Substances	Dust ; Gases
Language	English
Publishing date	2023-12-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	129038-1
ISSN	1432-1246 ; 0340-0131 ; 0367-9977
ISSN (online)	1432-1246
ISSN	0340-0131 ; 0367-9977
DOI	10.1007/s00420-023-02031-1
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Article: Lowered oxidative capacity in spinal muscular atrophy, Jokela type; comparison with mitochondrial muscle disease.

Ratia, Nadja / Palu, Edouard / Lantto, Hanna / Ylikallio, Emil / Luukkonen, Ritva / Suomalainen, Anu / Auranen, Mari / Piirilä, Päivi

Frontiers in neurology

2023 Volume 14, Page(s) 1277944

Abstract: Introduction: Spinal muscular atrophy, Jokela type (SMAJ) is a rare autosomal dominantly hereditary form of spinal muscular atrophy caused by a point mutation c.197G>T in : Methods: Eleven patients with genetically verified SMAJ, 26 subjects with ... ...

Abstract	Introduction: Spinal muscular atrophy, Jokela type (SMAJ) is a rare autosomal dominantly hereditary form of spinal muscular atrophy caused by a point mutation c.197G>T in Methods: Eleven patients with genetically verified SMAJ, 26 subjects with mitochondrial myopathy (MM), and 28 healthy volunteers underwent a cardiopulmonary exercise test with lactate and ammonia sampling. The effect of the diagnosis group on the test results was analysed using a linear model. Results: Adjusted for sex, age, and BMI, the SMAJ group had lower power output ( Conclusion: In cardiopulmonary exercise test, subjects with SMAJ showed a similar decrease in power output and oxidative capacity as subjects with mitochondrial myopathy but did not exhibit findings typical of mitochondrial disease.
Language	English
Publishing date	2023-11-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1277944
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Article ; Online: Agreement between self-reported and registered age at asthma diagnosis in Finland.

Nurmi, Elias / Vähätalo, Iida / Ilmarinen, Pinja / Andersén, Heidi / Tuomisto, Leena E / Sovijärvi, Anssi / Backman, Helena / Lehtimäki, Lauri / Hedman, Linnea / Langhammer, Arnulf / Nwaru, Bright I / Piirilä, Päivi / Kankaanranta, Hannu

BMC pulmonary medicine

2024 Volume 24, Issue 1, Page(s) 133

Abstract: Introduction: In epidemiological studies, the age at asthma onset is often defined by patients' self-reported age at diagnosis. The reliability of this report might be questioned. Our objective was to evaluate the agreement between self-reported and ... ...

Abstract	Introduction: In epidemiological studies, the age at asthma onset is often defined by patients' self-reported age at diagnosis. The reliability of this report might be questioned. Our objective was to evaluate the agreement between self-reported and registered age at asthma diagnosis and assess features contributing to the agreement. Methods: As part of the FinEsS respiratory survey in 2016, randomly selected population samples of 13,435 from Helsinki and 8000 from Western Finland were studied. Self-reported age at asthma diagnosis was compared to age at asthma diagnosis registered in the Finnish register on special reimbursement for asthma medication. The reimbursement right is based on lung function criteria according to GINA and Finnish guidelines. If the difference was less than 5 years, self-reported diagnosis was considered reliable. Features associated with the difference between self-reported and registered age at asthma diagnosis were evaluated. Results: Altogether 197 subjects from Helsinki and 144 from Western Finland were included. Of these, 61.9% and 77.8%, respectively, reported age at diagnosis reliably. Median difference between self-reported and registered age at diagnoses was - 2.0 years (IQR - 9.0 to 0) in Helsinki and - 1.0 (IQR - 4.3 to 0) in Western Finland indicating earlier self-reported age at diagnosis. More reliable self-report was associated with non-allergic subjects and subjects who reported having asthma diagnosis more recently. Conclusions: Agreement between self-reported and registered age at asthma diagnosis was good especially with adult-onset asthma patients. Poor agreement in early-onset asthma could be related to delay in registration due to reimbursement criteria.
MeSH term(s)	Adult ; Humans ; Self Report ; Finland/epidemiology ; Reproducibility of Results ; Prevalence ; Asthma/diagnosis ; Asthma/epidemiology
Language	English
Publishing date	2024-03-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2059871-3
ISSN	1471-2466 ; 1471-2466
ISSN (online)	1471-2466
ISSN	1471-2466
DOI	10.1186/s12890-024-02949-3
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Article ; Online: Is there still a social gradient in respiratory symptoms? A population-based Nordic EpiLung-study.

Andersén, Heidi / Bhatta, Laxmi / Bashir, Muwada / Nwaru, Bright / Langhammer, Arnulf / Krokstad, Steinar / Piirilä, Päivi / Hisinger-Mölkänen, Hanna / Backman, Helena / Kankaanranta, Hannu / Hedman, Linnea

Respiratory medicine

2024 Volume 223, Page(s) 107561

Abstract: Background: Respiratory symptoms are a common public health issue that can partly be attributed to preventable risk factors, such as tobacco smoking and occupational exposure, which are more common in individuals with lower socioeconomic status.: ... ...

Abstract	Background: Respiratory symptoms are a common public health issue that can partly be attributed to preventable risk factors, such as tobacco smoking and occupational exposure, which are more common in individuals with lower socioeconomic status. Objective: Our aim was to evaluate the social gradient in respiratory symptoms in Nordic countries. Methods: This study included participants aged 30-65 years from five cross-sectional population-based questionnaire surveys in 2016 in Finland and Sweden (N = 25,423) and in 2017-2019 in Norway (N = 27,107). Occupational skill levels 1 and 2 (occupations requiring compulsory education) were combined and compared to skill levels 3 and 4 (occupations requiring upper secondary and tertiary education). Meta-analysis was conducted to obtain pooled age- and sex adjusted odds ratios (aORs) of associations between occupational skill and the respiratory symptoms including recurrent wheeze, dyspnoea, and productive cough. Results: In the meta-analysis, recurrent wheeze, dyspnoea, and productive cough showed a social gradient. The participants with occupational skill 1 and 2 had higher risk for recurrent wheeze (aOR 1.78, 95% CI 1.34-2.22) and dyspnoea (aOR 1.59, 95% CI 1.29-1.90) compared to occupational skill 3 and 4 in Sweden and Finland. Similarly increased risk was observed for combined assessment of dyspnoea and wheeze (aOR 1.05, 95% CI 1.03-1.07) in Norway. In a meta-analysis including all three countries, the aOR for productive cough was 1.31 95% CI 1.07-1.56. Conclusions: Occupations with lower, compared to higher, skill levels were associated with an increased risk of recurrent wheeze, dyspnoea, and productive cough.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Dyspnea ; Norway/epidemiology ; Respiratory Sounds/etiology ; Social Class ; Cough/epidemiology ; Cough/etiology
Language	English
Publishing date	2024-02-08
Publishing country	England
Document type	Meta-Analysis ; Journal Article
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2024.107561
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Article ; Online: Mortality Associated With Occupational Exposure in Helsinki, Finland-A 24-Year Follow-up.

Jalasto, Juuso / Luukkonen, Ritva / Lindqvist, Ari / Langhammer, Arnulf / Kankaanranta, Hannu / Backman, Helena / Rönmark, Eva / Sovijärvi, Anssi / Kauppi, Paula / Piirilä, Päivi

Journal of occupational and environmental medicine

2022 Volume 65, Issue 1, Page(s) 22–28

Abstract: Objectives: Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort.: Methods: We divided the participants based on ... ...

Abstract	Objectives: Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort. Methods: We divided the participants based on the answers to asthma and chronic obstructive pulmonary disease (COPD) diagnoses and occupational exposure and used a combined effects model and compared the results to no asthma or COPD with no occupational exposure. Results: High exposure had a hazards ratio (HR) of 1.34 (1.11-1.62) and asthma and COPD coexistence of 1.58 (1.10-2.27). The combined effects of intermediate exposure and coexistence had an HR of 2.20 (1.18-4.09), high exposure with coexistence of 1.94 (1.10-3.42) for overall mortality, and sub-HR for respiratory-related mortality of 3.21 (1.87-5.50). Conclusions: High occupational exposure increased overall but not respiratory-related mortality hazards, while coexisting asthma and COPD overall and respiratory-related hazards of mortality.
MeSH term(s)	Humans ; Asthma/etiology ; Asthma/mortality ; Finland/epidemiology ; Follow-Up Studies ; Occupational Diseases/epidemiology ; Occupational Exposure/adverse effects ; Pulmonary Disease, Chronic Obstructive/etiology ; Pulmonary Disease, Chronic Obstructive/mortality ; Risk Factors
Language	English
Publishing date	2022-10-06
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1223932-x
ISSN	1536-5948 ; 1076-2752
ISSN (online)	1536-5948
ISSN	1076-2752
DOI	10.1097/JOM.0000000000002718
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Article ; Online: Self-Reported Physician Diagnosed Asthma with COPD is Associated with Higher Mortality than Self-Reported Asthma or COPD Alone - A Prospective 24-Year Study in the Population of Helsinki, Finland.

Jalasto, Juuso / Kauppi, Paula / Luukkonen, Ritva / Lindqvist, Ari / Langhammer, Arnulf / Kankaanranta, Hannu / Backman, Helena / Rönmark, Eva / Sovijärvi, Anssi / Piirilä, Päivi

COPD

2022 Volume 19, Issue 1, Page(s) 226–235

Abstract: Asthma and COPD are common chronic obstructive respiratory diseases. COPD is associated with increased mortality, but for asthma the results are varying. Their combination has been less investigated, and the results are contradictory. The aim of this ... ...

Abstract	Asthma and COPD are common chronic obstructive respiratory diseases. COPD is associated with increased mortality, but for asthma the results are varying. Their combination has been less investigated, and the results are contradictory. The aim of this prospective study was to observe the overall mortality in obstructive pulmonary diseases and how mortality was related to specific causes using postal questionnaire data. This study included data from 6,062 participants in the FinEsS Helsinki Study (1996) linked to mortality data during a 24-year follow-up. According to self-reported physician diagnosed asthma, COPD, or smoking status, the population was divided into five categories: combined asthma and COPD, COPD alone and asthma alone, ever-smokers without asthma or COPD and never-smokers without asthma or COPD (reference group). For the specific causes of death both the underlying and contributing causes of death were used. Participants with asthma and COPD had the highest hazard of mortality 2.4 (95% CI 1.7-3.5). Ever-smokers without asthma or COPD had a 9.5 (3.7-24.2) subhazard ratio (sHR) related to lower respiratory tract disease specific causes. For asthma, COPD and combined, the corresponding figures were 10.8 (3.4-34.1), 25.0 (8.1-77.4), and 56.1 (19.6-160), respectively. Ever-smokers without asthma or COPD sHR 1.7 (95% CI 1.3-2.5), and participants with combined asthma and COPD 3.5 (1.9-6.3) also featured mortality in association with coronary artery disease. Subjects with combined diseases had the highest hazard of overall mortality and combined diseases also showed the highest hazard of mortality associated with lower respiratory tract causes or coronary artery causes.
MeSH term(s)	Asthma/diagnosis ; Finland/epidemiology ; Humans ; Physicians ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/complications ; Risk Factors ; Self Report ; Smoking/epidemiology
Language	English
Publishing date	2022-04-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171107-0
ISSN	1541-2563 ; 1541-2555
ISSN (online)	1541-2563
ISSN	1541-2555
DOI	10.1080/15412555.2022.2061935
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Article ; Online: Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation.

Pyykkönen, Henri / Rahkonen, Otto / Ratia, Nadja / Lähteenmäki, Sini / Tikkanen, Heikki / Piirilä, Päivi / Pitkänen-Argillander, Olli

Pediatric cardiology

2022 Volume 43, Issue 5, Page(s) 969–976

Abstract: A modified Fontan procedure is performed to palliate single ventricle malformations. This hemodynamic arrangement sets systemic venous pressure unphysiologically high which predisposes the patient to severe long-term complications. As a means of self- ... ...

Abstract	A modified Fontan procedure is performed to palliate single ventricle malformations. This hemodynamic arrangement sets systemic venous pressure unphysiologically high which predisposes the patient to severe long-term complications. As a means of self-care, exercise may ease transpulmonary flow. We investigated the effects of 6-month exercise prescription on pediatric Fontan patients. Eighteen stable Fontan patients (14 ± 2.6 years, 160.4 ± 11.3 cm, and 51.4 ± 14.4 kg) were recruited. Baseline fitness was assessed by physical activity questionnaire, body composition, cardiorespiratory performance, and muscle fitness tests. Exercise prescription was individually tailored for a 6-month training period at home. At entrance to the study, Fontan patients had lower than normal maximal oxygen uptake (VO
MeSH term(s)	Anaerobic Threshold ; Cardiovascular Abnormalities ; Child ; Exercise Test ; Exercise Therapy/methods ; Exercise Tolerance ; Fontan Procedure ; Heart Defects, Congenital/surgery ; Humans ; Oxygen ; Oxygen Consumption ; Prescriptions
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-021-02806-8
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Article ; Online: Correction to: Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation.

Pyykkönen, Henri / Rahkonen, Otto / Ratia, Nadja / Lähteenmäki, Sini / Tikkanen, Heikki / Piirilä, Päivi / Pitkänen-Argillander, Olli

Pediatric cardiology

2022 Volume 43, Issue 4, Page(s) 922

Language	English
Publishing date	2022-03-17
Publishing country	United States
Document type	Published Erratum
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-022-02871-7
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