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Objectives: To study the effect of vitamin D supplementation and the impact of summer season on serum 25-hydroxyvitamin (S-25(OH)D) in Finnish 9-15-y-old girls. Design: Three-year follow-up study with vitamin [D.sub.2] supplementation using [D.sub.2] 10 [micro]g daily from October to January for the first and from October to February for the second winter as well as 20 [micro]g daily from October to March for the third winter. Setting: Paavo Nurmi Centre, University of Turku, Turku, Finland. Subjects: A total of 171 female volunteers aged 9-15y. Methods: Vitamin D and calcium intakes were estimated by a semi-quantitative food frequency questionnaire (FFQ). S-25(OH)D was measured by radioimmunoassay. Results: The median daily dietary intakes of vitamin D and calcium were 3.8 [micro]g (interquartile range (IQR) 2.7-5.0) and 1451 mg (IQR 1196-1812), respectively, over 3y. The prevalence of severe hypovitaminosis D (S-25(OH)D < 20 nmol/l) was 14% and of moderate hypovitaminosis D (20 nmol/l [less than or equal to] S-25(OH)D [less than or equal to] 37.5 nmol/l) 75% at baseline in winter. None of the participants had severe hypovitaminosis D in summer. The effect of 10 [micro]g of [D.sub.2] daily was insufficient to raise S-25(OH)D from baseline. The daily supplementation of 20 [micro]g of [D.sub.2] increased S-25(OH)D significantly in wintertime compared with the nonsupplement users (to 45.5 vs 31.8 nmol/l; P Conclusion: Vitamin D supplementation daily with 20 [micro]g is needed to prevent hypovitaminosis D in peripubertal Finnish girls in winter. Sunlight exposure in summer is more effective than approximately 20 [micro]g of [D.sub.2] supplementation daily in winter to raise S-25(OH)D. Both the daily supplementation with 20 [micro]g of [D.sub.2] and summertime sunlight exposure had more effect on those who had severe hypovitaminosis D than those who had a normal vitamin D status. Sponsorship: Supported by the Yrjo Jahnsson Foundation and the Medical Research Foundation of the Turku University Central Hospital. DOI: 10.1038/sj/ejcn/1601330 Keywords: dietary intakes; hypovitaminosis D; serum 25-hydroxyvitamin D; supplementation of vitamin [D.sub.2], Introduction Adequate vitamin D stores are essential for normal skeletal mineralization and growth. Vitamin D may be important not only for the skeleton, since, in addition to its known influence [...]

Daily dietary intake of vitamin D is insufficient in most Finnish girls aged between nine and 15, according to research undertaken among 191 girls in Turku, Finland, and the surrounding area. Only 22% of the participants took vitamin supplementation at least four times a week. In the period Feb 1997 to Mar 1997, the prevalence of severe hypovitaminosis D was 13.4%, with the prevalence of moderate hypovitaminosis at 67.7%. A year later, after three months of vitamin D supplementation, 63.4% of the participants still had hypovitaminosis D.

The association of the amount and type of physical activity with bone mineral acquisition was studied in 191 peripubertal Caucasian girls aged 9-16 years (66 gymnasts, 65 runners, and 60 nonathletic controls). Weight, height, stage of puberty, the amount of leisure-time physical activity, and years of training were recorded, and dietary calcium and vitamin D were assessed by a semi-quantitative questionnaire. The bone area, the bone mineral density (BMD), and the bone mineral content (BMC) of the femoral neck, lumbar spine and antebrachium were measured by dual-energy x-ray absorptiometry. The unadjusted mean values of BMD at the femoral neck were 15.2%, higher in the pubertal gymnasts than ia the controls (P< 0.001). Compared with the controls, the mean BMC adjusted for hone area of the pubertal gymnasts at the femoral neck and lumbar spine was 16.4% and 10.8% higher, respectively. When comparing the association of the type of physical activity among the pubertal athletics by multiple regression analysis, height, physical activity, gymnastics, and Tanner stage emerged as significant variables and accounted for 54.7%, and 63.4% of the total variation in BMD of the femoral neck and lumbar spine, respectively. These results indicate that physical activity is associated with bone mineral acquisition in peripubertal girls and that high-impact weight-hearing exercise seems to be particularly associated with tile increase of the BMD al the femoral neck. [ABSTRACT FROM AUTHOR]

Presents information on a study which determined the prevalence of hypovitaminosis D, the effect of vitamin D supplementation on serum-25-hydroxyvitamin D. Intakes of vitamin D and calcium in Finnish athletic and non-athletic girls; Research design and methods; Results and discussion; Conclusion.

Background: The treatment of rheumatoid arthritis should aim at clinical remission. This multicentre, randomised trial with 2-year follow-up sought evidence on the efficacy and tolerability of combination therapy (sulphasalazine, methotrexate, hydroxychloroquine, and prednisolone) compared with treatment with a single disease-modifying antirheumatic drug, with or without prednisolone, in the treatment of early rheumatoid arthritis.Methods: 199 patients were randomly assigned to two treatment groups. 195 started the treatment (97 received combination and 98 single drug therapy). Single-drug therapy in all patients started with sulphasalazine; in 51 patients methotrexate was later substituted. Oral prednisolone was required by 63 patients. The primary outcome measure was induction of remission. Analyses were intention to treat.Findings: 87 patients in the combination group and 91 in the single-therapy group completed the trial. After a year, remission was achieved in 24 of 97 patients with combination therapy, and 11 of 98 with single-drug therapy (p=0.011). The remission frequencies at 2 years were 36 of 97 and 18 of 98 (p=0.003). Clinical improvement (American College of Rheumatology criteria of 50% clinical response) was achieved after 1 year in 68 (75%) patients with combination therapy, and in 56 (60%) using single-drug therapy (p=0.028), while at the 2-year visit 69 and 57 respectively (71% vs 58%, p=0.058) had clinically improved. The frequencies of adverse events were similar in both treatment groups.Interpretation: Combination therapy was better and not more hazardous than single treatment in induction of remission in early rheumatoid arthritis. The combination strategy as an initial therapy seems to increase the efficacy of the treatment in at least a proportion of patients with early rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the utility of the Stanford Health Assessment Questionnaire (HAQ) in the estimation of loss of productivity due to early rheumatoid arthritis (RA) and to develop a simple model for analysis of the cost-benefit of therapies., Methods: In the Finnish Rheumatoid Arthritis Combination Therapy (FIN-RACo) trial, 162 patients with recent-onset RA who were available for the workforce were randomized to receive either a combination of three disease-modifying anti-rheumatic drugs (DMARDs) or a single DMARD for 2 years and were followed up for 5 years. No biological drugs were used. Data on sick leave and RA-related disability pensions came from official register records. Loss of productivity was computed by both the human capital approach (HCA) and the friction cost approach (FCA). Functional capacity was assessed by the HAQ at baseline and at 6 months., Results: Over 5 years, mean loss of productivity per year was EUR 8344 by the HCA and EUR 1928 by the FCA. The level of the HAQ index at 6 months, but not the change in HAQ from baseline, determined productivity costs. With the HCA, a monotonous association between annual loss of productivity and the 6-month HAQ was found: EUR 2087 [95% confidence interval (CI) 1340-2903] per one step (0.13) on the HAQ scale from 0 to 1.88. With the FCA, the increase in loss of productivity was cut at the HAQ level of 0.5 to 0.75 (EUR 17 740 in 5 years)., Conclusion: The HAQ index at 6 months may serve as a determinant of long-term RA-related indirect costs in economic analyses in early RA.