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Now showing items 1 - 16 of 54

  • Response to Dr Holmes and Dr Angus

    Poikolainen, Kari  

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  • Response to Dr Holmes and Dr Angus

    Poikolainen, Kari  

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  • A Note on the Statistical Power of Regression Analysis

    Poikolainen, Kari  

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  • Response to Dr Holmes and Dr Angus

    Poikolainen, Kari  

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  • The Weakness of Stern Alcohol Control Policies

    Poikolainen, Kari  

    To test the total consumption model claiming that alcohol-related ill health can best be diminished by a policy of severe restrictions and high price. The associations between an index measuring the severity of the alcohol policy, total alcohol consumption and number of disability-adjusted life years (DALYs) lost due to alcohol were compared in 30 OECD countries in 2005. No significant correlations were found between alcohol policy index, alcohol consumption and the number of DALYs due to alcohol use. In regression analysis, alcohol policy index and alcohol consumption were not related to alcohol-related DALYs. Excise tax rate was not related to alcohol-related DALYs (25 countries with tax rate data). These findings suggest that the total consumption model fails. Alcohol-related ill health seems to be mainly due to alcohol dependence, both clinical and subclinical, not to moderate drinking.
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  • Healthy Former Drinkers Have Higher Mortality Than Light Drinkers: Table 1.

    Poikolainen, Kari  

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  • Alcohol consumption and all-cause mortality among elderly in Finland

    Halme, Jukka T.   Seppa, Kaija   Alho, Hannu   Poikolainen, Kari   Pirkola, Sami   Aalto, Mauri  

    Aims: To estimate the gender-specific prevalences of alcohol consumption levels and to investigate the association between heavy drinking and all-cause mortality among elderly males. Design: A cohort derived from a nationally representative sample of Finns aged >65 years was followed for six years. Number of subjects was 1569 (72.7% of the original sample, 65.3% females, weighted n = 1357). Measurements: Alcohol consumption was retrospectively measured by beverage-specific quantity and frequency over a 12-month period. Mortality data were obtained from the official Cause-of-Death Register. Cox proportional hazards models were used to analyse the relative risks (RRs) of death. Findings: The prevalence of heavy drinking (>8 standard drinks per week) was 20.3% in males and 1.2% in females. Over one-tenth (11.4%) of males reported drinking :l 5 standard drinks per week. Relative death risks suggested a J-curved relationship between alcohol consumption levels and mortality. However, significant curvilinear relationship was not found, when using alcohol consumption as continuous variable. The multivariate adjusted RR of death among moderate drinkers (1-7 drinks per week) vs. abstinent subjects was 0.41 (95% CI=.23-.72). Males drinking >= 15 standard drinks per week had a two-fold multivariate adjusted risk of death (RR = 2.11, 95% CI = 1.19-3.75) compared with abstinent males. The level of alcohol consumption by females was too low for analysis. Conclusions: Heavy drinking is common among Finnish elderly males but not among females. The present study shows an increased all-cause mortality risk for males drinking, on average, more than two standard drinks per day. (c) 2009 Elsevier Ireland Ltd. All rights reserved.
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  • Level of Alcohol Response Is Not a Risk Factor For Alcohol Dependence

    Poikolainen, Kari  

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  • Binge drinking and depressive symptoms: a 5-year population-based cohort study

    Paljarvi, Tapio   Koskenvuo, Markku   Poikolainen, Kari   Kauhanen, Jussi   Sillanmaki, Lauri   Makela, Pia  

    Only few prospective population studies have been able so far to investigate depression and drinking patterns in detail. Therefore, little is known about what aspect of alcohol consumption best predicts symptoms of depression in the general population. In this prospective population-based two-wave cohort study, a cohort of alcohol-drinking men and women (n = 15 926) were followed-up after 5 years. A postal questionnaire was sent in 1998 (response proportion 40%) and again in 2003 (response proportion 80% of the baseline participants) to Finnish adults aged 20-54 years at baseline. Alcohol consumption was measured by average intake (g/week) and by measures of binge drinking (intoxications, hangovers and alcohol-induced pass-outs). Depressive symptoms were assessed with the 21-item Beck Depression Inventory. In addition, information from hospital discharge register for depression and alcohol abuse were linked to the data. This study found a positive association between baseline binge drinking and depressive symptoms 5 years later. Adjustment for several possible confounders attenuated the observed relationships only slightly, suggesting that binge drinking contributes independently to the occurrence of depressive symptoms. Binge drinking was related to symptoms of depression independently of average intake. This study supports the hypothesis that heavy drinking, and in particular a binge pattern involving intoxications, hangovers or pass-outs, produces depressive symptoms in the general population. The frequency of hangovers was the best predictor for depressive symptoms.
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  • Increased Stroke Risk Is Related to a Binge Drinking Habit

    Sundell, Laura   Salomaa, Veikko   Vartiainen, Erkki   Poikolainen, Kari   Laatikainen, Tiina  

    Background and Purpose-Heavy alcohol consumption increases the risk for all strokes, whereas moderate regular alcohol consumption is associated with a lower risk for ischemic stroke. The purpose of this study was to evaluate the effect of different drinking patterns on stroke risk, independent of average alcohol intake. Methods-A prospective cohort study of 15 965 Finnish men and women age 25 to 64 years who participated in a national risk factor survey and had no history of stroke at baseline were followed up for a 10-year period. The first stroke event during follow-up served as the outcome of interest (N=249 strokes). A binge drinking pattern was defined as consuming 6 or more drinks of the same alcoholic beverage in men or 4 or more drinks in women in 1 session. Cox proportional-hazards models were adjusted for average alcohol consumption, age, sex, hypertension, smoking, diabetes, body mass index, educational status, study area, study year, and history of myocardial infarction. Results-Binge drinking was an independent risk factor for total and ischemic strokes. Compared with non-binge drinkers, the hazard ratio for total strokes among binge drinkers was 1.85 (95% CI, 1.35 to 2.54) after adjusting for average alcohol consumption, age, and sex; the association was diluted after adjustment for other risk factors. Compared with non-binge drinkers, the risk for ischemic stroke was 1.99 (95% CI, 1.39 to 2.87) among binge drinkers; the association remained statistically significant after adjustment for potential confounders. Conclusions-This study found that a pattern of binge drinking is an independent risk factor for all strokes and ischemic stroke. (Stroke. 2008;39:3179-3184.)
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  • Magnesium treatment in alcoholics: A randomized clinical trial

    Poikolainen, Kari   Alho, Hannu  

    Background: Magnesium (Mg) deficiency is common among alcoholics. Earlier research suggests that Mg treatment may help to normalize elevated enzyme activities and some other clinically relevant parameters among alcoholics but the evidence is weak. Methods: The effect of Mg was studied in a randomized, parallel group, double-blind trial. The patients were first treated for alcohol withdrawal symptoms and then received for 8 weeks either 500 mg of Mg divided into two tablets or matching placebo. Measurements were made at the beginning and in the end of the Mg treatment period. The primary outcome was serum gammaglutamyltransferase (S-GGT) activity; secondary outcomes included aspartate-aminotransferase (SAST) and alanine-aminotransferase (S-ALT) activity. Results: The number of randomized patients (completers) was 64 (27) in the treatment and 54 (31) in the control group. In intention-to-treat-analyses and in most analyses of study completers, there were no significant differences between the Mg-treated and placebo groups in the outcome variables. When baseline serum Mg level, coffee intake, and the number of unused Mg tablets were controlled for in a multivariate regression model, after-treatment serum Mg levels were found to be higher among the Mg-treated group than in the placebo group (t-test 3.334, df = 53, p = 0.002). After controlling for age, body weight, baseline alcohol intake, subsequent change in alcohol intake and baseline S-AST, the after-treatment S-AST levels were found to be lower among the Mg-treated group than in the placebo group (t-test 2.061, df = 49, p = 0.045). Conclusion: Mg treatment may speed up the S-AST decrease in compliant patients. This might decrease the risk of death from alcoholic liver disease. Trial Registration: ClinicalTrials.gov ID NCT00325299
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  • Childhood and current determinants of heavy drinking in early adulthood

    Kestila, Laura   Martelin, Tuija   Rahkonen, Ossi   Joutsenniemi, Kaisla   Pirkola, Sami   Poikolainen, Kari   Koskinen, Seppo  

    Aims: To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations. Method: The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >= 280 g/week and for women >= 140 g/week). Results: 8% of young adult men and 5% of women were heavy drinkers. In both genders, parental alcohol problems and other childhood adversities, poor own education, and unemployment status increased the risk of heavy drinking. The impact of childhood on heavy drinking was partly independent and partly mediated by adult characteristics, in particular, for both genders, low level of education. Conclusions: Childhood adversities are associated with heavy drinking in early adulthood among both genders. Childhood social circumstances as well as low educational level and unemployment should be taken into account in planning preventive policies to tackle the harms caused by excessive alcohol use at the individual and population level.
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  • Do the protective effects fade away?

    Poikolainen, Kari  

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  • Hazardous drinking: Prevalence and associations in the Finnish general population

    Halme, Jukka T.   Seppa, Kaija   Alho, Hannu   Pirkola, Sami   Poikolainen, Kari   Lonnqvist, Jouko  

    Background: Hazardous drinking, defined as consuming alcohol on a risky level and not meeting the diagnostic criteria of alcohol use disorders (AUDs), has been suggested for a new complementary nondependence diagnosis. This study aimed to investigate the prevalence and associations of hazardous drinking in comparison to AUDs, moderate drinking, and abstinence.Methods: A national representative sample of Finns was examined in the Health 2000 Survey. For 4477 subjects aged 30 to 64 years (76%, 2341 females), both the quantity frequency data about alcohol consumption and Composite International Diagnostic Interview (CIDI) data concerning AUD diagnoses were available. The nationally recommended limits for hazardous dinking were used (males: 24 drinks, females: 16 drinks/wk). Logistic regression models were used to analyze associations.Results: The prevalence of hazardous drinking was 5.8%. Hazardous drinking was more prevalent among males than females (8.5% vs. 3.1%). It was most prevalent among the subjects aged 40 to 49 years (7.3%), divorced or separated (8.3%), unemployed (8.2%) and subjects living in the southern (Helsinki) region (7.5%). AUDs versus hazardous drinking were more likely to be in males versus females and in the unemployed versus employed. Subjects aged 40 and over had higher odds for hazardous drinking versus AUDs. The odds for hazardous versus moderate drinking were higher for males versus females (adjusted odds ratio = 3.24), for subjects aged over 40 years, unemployed versus employed and cohabiting, divorced/separated or unmarried subjects versus married subjects.Conclusion: The high prevalence of hazardous drinking makes it an important public health concern. Hazardous drinkers have different sociodemographic characteristics as compared to people in other alcohol use categories.
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  • Magnesium treatment in alcoholics: a randomized clinical trial (vol 3, art no 1, 2008)

    Poikolainen, Kari   Alho, Hannu  

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  • Book Review: SBU lyckades inte bringa reda i missbrukarvården

    Poikolainen, Kari  

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