Objective To study the lifetime occurrence of prostatitis in Finnish men and their exposure to the disease. Subjects and methods A population-based cross-sectional survey was conducted in the two most northerly provinces of Finland (Oulu and Lapland). Altogether, 2500 male residents aged 20±59 years were chosen at random to complete a questionnaire on prostatitis. The data were collected between June 1996 and October 1997. Replies were received from 1832 men, giving a response rate of 75%. Results The overall lifetime prevalence of prostatitis was 14.2%. The risk of having or having had prostatitis increased with age, being 1.7 times greater in men aged 40±49 years than in those aged 20±39 years, and 3.1 times greater in those aged 50±59 years. The overall incidence was 37.8/10 000 person years. More than a quarter of the 261 men who had or had had prostatitis symptoms (27%) suffered from them at least once a year, while 16% suffered from persistent symptoms; 63% of the men with prostatitis had their worst symptoms during the winter (November-March). Neither education nor profession had much in¯uence on the occurrence of prostatitis, but divorced and single men had a lower risk than married men. Most patients felt they had not received enough information about the disease at their ®rst visit to a general practitioner. Conclusions The results of this survey showed that the occurrence of prostatitis symptoms in men living in northern Finland is higher than that reported in other parts of the world. This could be partly caused by the cold climate.

Objective To determine the occurrence of mental distress related to prostatitis in Finnish men. Subjects and methods A population-based cross-sectional survey was conducted of 2500 men aged 20±59 years living in the two northernmost provinces of Finland (Oulu and Lapland). The ®nal response rate was 75% (1832 men). Results The fear of undetected prostate cancer was reported by 17% of the men in the population who had had prostatitis, a value signi®cantly higher (P<0.001) than in healthy men. Fears of having a sexually transmitted disease and suicidal thinking were also slightly more common. The men who had had prostatitis preferred to be alone in a public toilet during voiding (58% vs 44%, P<0.001). Erectile dysfunction was reported by 43% of the men with symptomatic prostatitis and decreased libido by 24%. Self-assessment of personality, adjusted for age, showed that the men with prostatitis were more often busy and nervous than the healthy controls (P<0.001), and that they had a more meticulous attitude to life and its problems. Marital dif®culties were reported by 17% of the men who had had prostatitis at some point in their lives, and 4% were convinced that their illness had caused their divorce. Socio-economic status and social well-being had no apparent in¯uence on the occurrence of prostatitis. Conclusions This survey showed that psychological stress is common in men with prostatitis. Urologists and general practitioners should consider that a consultation with a psychiatrist may be appropriate for selected men with prostatitis.

No abstract

The occurrence and determinants of preterm delivery were studied in two population-based birth cohorts from northern Finland. In the first cohort of 1966 there were 11,475 singleton deliveries and in the later cohort of 1985-1986, 8,888. The overall incidence (percentage) of preterm deliveries fell from 9.1 to 4.8, including a reduction from 8.8 to 3.4 for spontaneous preterm deliveries. For iatrogenic ones, however, there was an increase from 0.3 to 1.4. The relative risks, associated with such known maternal determinants as unmarried status, smoking, low educational level, age over 34 years, unwantedness of the pregnancy, and poor earlier obstetric history, had about the same level in these two series. However, despite a favorable change in the distribution of most of these determinants over the 20 years, only a small part of the decrease of the total incidence of preterm delivery could be attributed to these changes, as a consistent and substantial reduction occurred in the incidence of spontaneous preterm birth in all categories of each single determinant. The increase in the proportion of iatrogenic preterm deliveries was accompanied by these being more common at lower than at higher socioeconomic levels in 1985-1986, whereas the social gradient appeared to be reversed in 1966.

The authors' previous study showed the presence of follicular dendritic cell (FDC) networks--though altered--in neoplastic areas, not only in the nodular lymphocyte predominance type, but also in other types of Hodgkin's disease. The present retrospective study was performed on 102 patients to determine whether the presence or absence of FDC networks, or parts of them, in neoplastic areas has prognostic relevance in Hodgkin's disease. Follicular dendritic cells were visualized with the monoclonal antibody Ki-FDC1P, which selectively stains FDCs in paraffin-embedded tissues. Univariate statistical analysis, in which nodular sclerosis (NS) and mixed cellularity (MC) types were combined, showed three prognostically different groups: the best prognosis was associated with nodular lymphocyte predominance cases; the worst with FDC-negative NS or MC cases; and an intermediate prognosis with FDC-positive NS or MC cases. In the NS group, the prognosis of FDC-positive cases was better than that of FDC-negative cases. After multivariate analysis, stepwise modeling identified three prognostic factors at diagnosis: stage (P = .001), FDC status (P = .001), and age (P = .06). The authors conclude that in the most common types of Hodgkin's disease (nodular lymphocyte predominance, NS, and MC), FDC status in the neoplastic area(s) bears prognostic relevance, a positive FDC status predicting a favorable prognosis and a negative FDC status an unfavorable one.