Background and Purpose-Declining trends in the incidence and mortality of stroke have been observed in Finland since the beginning of the 1980s until 1997.

These results suggest that genetic variation in the IL-1 gene family is associated with measures of glucose homeostasis and prevalent diabetes.

Our study showed that the evidence-based use of medications after acute coronary syndrome was suboptimal in Finland, particularly in elderly and diabetic patients. Consistent use of these medications, however, was associated with a better prognosis.

No abstract

Background: The ankle blood pressure is commonly used as a ratio to the brachial blood pressure, called ankle-brachial index (ABI). Very few studies have considered the independent value of the ankle blood pressure without indexing it to the brachial blood pressure. We examined the value of ankle blood pressure, together with the exercise blood pressure, as a predictor of cardiovascular (CVD) and total mortality.

Aims/hypothesis We analysed whether the prognosis of a first acute coronary syndrome (ACS) in patients treated for type 2 diabetes has improved. We also compared the trends in patients with and without diabetes. Methods We used national registers to identify all patients with clinically known type 2 diabetes in Finland during the years 1988 to 2002 (n=222,940). All first-ever ACS events (n=43,412) among these patients were identified using the Hospital Discharge Register and the Causes of Death Register. From the National Cardiovascular Disease Register we identified all first ACS attacks (n=191,403) among non-diabetic patients in the country. Finally, we calculated annual age-standardised case fatality rates for ACS for three time periods: prehospital, days 0 to 27 and days 28 to 364 after the first ACS. Results The case fatality rate of first ACS declined significantly in both sexes at all time points considered. The declining trends were not different between patients with type 2 diabetes and those without. Among men aged 35 to 74 years, 58.5% (95% CI 57.6-59.4%) with type 2 diabetes and 44.1% (95% CI 43.8-44.5%) without diabetes had died from cardiovascular causes 1 year after their first ACS. Among women of the same age, the corresponding figures were 54.2% (95% CI 53.0-55.4%) and 36.5% (95% CI 35.9-37.1%). Men generally had higher case fatality rates than women. However, except for prehospital deaths, diabetic women had the same or even higher case fatality rates than non-diabetic men. Conclusions/interpretation The case fatality rates for first ACS show similar improving trends in patients with type 2 diabetes and in those without. However, case fatality rates have remained higher in patients with type 2 diabetes.

Elevated ankle blood pressure (ABP) may be one of the earliest signs of subclinical atherosclerosis. However, its behavior in different degrees of atherosclerotic vascular damage has not been well characterized. We examined the association of ABP and brachial exercise blood pressure with the incidence of future coronary events. A cohort of 3808 consecutive ambulatory persons (mean age 50 years, 34% women), referred to a symptom-limited exercise test and free of cardiovascular events at baseline, was prospectively followed up for 15 years. Altogether, 383 (80 fatal and 303 non-fatal) incident coronary events occurred. Cox proportional hazards models, adjusting for several conventional risk factors, were used to analyse the independent association of ABP with the risk of an incident coronary heart disease (CHD) event. Persons with normal ankle, brachial resting and brachial exercise blood pressures were taken as the reference group. Other groups were formed on the basis of ankle and exercise blood pressures and compared with the reference group. Even in persons among whom the elevated ABP was the only abnormal finding, the multivariate adjusted hazard ratio (HR) of a future CHD event was significantly elevated (HR ¼ 1.60, 95% confidence interval 1.20-2.14, Po0.0001). In general, the HRs were higher for fatal events than for non-fatal events. The measurement of ABP could be an inexpensive and non-invasive tool to detect elevated risk of a CHD event.

Research questions:The purpose of the study was to reveal new aspects of interpreters' memory and executive control. Design: The memory and executive control of simultaneous and consecutive interpreters were compared to those of foreign language teachers and non-linguistic experts in two experiments: free recall and cocktail-party dichotic listening. Data: Volunteers were 94 participants (22 to 26 participants in each group) with a minimum of 10 years of professional experience. Findings: Simultaneous interpreters outperformed the non-linguistic experts in free recall. Though most of them detected their name in the cocktail-party test, they made no errors in the first and second word after it. In contrast, consecutive interpreters exceeded the performance of non-linguistic experts in seldom detecting their name in the cocktail-party test, as well as in making just a few errors in the first word after it. The results seem to indicate expertisedependent differences between the two interpreter groups, as well as between foreign language teachers and non-linguistic experts. For simultaneous interpreters, the findings can be explained by conditions at work which demand the continuous dividing of attention between listening to the source text, formulating and speaking the target text, and even monitoring and comparing the equivalence of the two. With consecutive interpreters, the results could reflect high demands for resisting external distractions at work. Originality: The results seem to point to expertise-dependent differences in memory and executive control between different foreign language expert groups achieved as a result of thorough experience in their field of expertise.