Browsing by Author "Karhu, Elisa"
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Karhu, Elisa (2016)Gastrointestinal symptoms such as diarrhea, cramping, nausea and gastric pain occur frequently in runners during training and competitions. The mechanisms leading to the distress are not fully understood, nor the reason why some remain asymptomatic. However, hyperthermia induced by exercise elevation of core temperature and oxidative damage due to reduced gastric blood flow have been postulated to affect the intestinal epithelial cells. Both sources of stress disrupt the binding of the epithelial tight junction proteins and increase permeability of the membrane to luminal endotoxins. Endotoxins reaching the blood stream through leaky tight junctions lead to an inflammatory response mediated by cytokines. These mechanisms may underlie the gastrointestinal symptoms often experienced by endurance athletes. The aim of this study was to measure running-induced changes in intestinal permeability and inflammatory markers and investigate their association with gastrointestinal symptoms. A secondary objective was to inspect possible correlations between gastrointestinal symptom occurrence and intake of certain nutrients. A total of 17 active runners were allocated into a control group (asymptomatic) or a symptomatic group based on a symptom history questionnaire and completed a 90-minute running test. Intestinal permeability at baseline and after the run were assessed via urine recovery of orally administered Iohexol . LPS (endotoxin) and zonulin concentrations were determined from serum samples. Participants kept a food diary for three days before each measurement and filled out a symptom questionnaire after the run. No significant difference was found in intestinal permeability between symptomatic and asymptomatic runners either at rest or following strenuous exercise. However, both groups experienced a significant increase in intestinal permeability from baseline to after running. LPS concentrations were significantly higher at baseline in the symptomatic group. This may explain the higher symptom occurrence in the symptomatic group. Zonulin levels were higher in control group than symptom group after the run. Zonulin concentration was also higher in the control group after the run compared to baseline. The symptom group reported more stomach pain and stool changes after running compared to controls. Comparison of average intake of various nutrients between the two groups showed no significant differences, indicating an individual predisposition as the cause of symptoms rather than diet alone. The lack of difference in intestinal permeability between the groups combined with the difference in symptom occurrence indicates that intestinal permeability changes alone do not account for symptom development. A possible factor may be individual differences in intestinal mucosa repair ability or some underlying pathology.
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Karhu, Elisa (2021)Objectives. Prematurely born (<37 gestational weeks) children are at increased risk for difficulties in language development and literacy skills, including pre-reading skills, reading and writing. Previous studies investigating full-term populations suggest that language skills are strongly correlated with reading acquisition. This connection is not widely studied in preterm sample and the findings of previous investigations have incongruity. The aim of this study is to examine the language development and literacy skills of children born extremely preterm (ELGA, born <28 gestational weeks) and/or with extremely low birth weight (ELBW, birth weight <1000 grams) at seven years of age. This thesis also investigates the possible association between language abilities and literacy skills in the sample of preterm children and a full-term born comparison group (born >37 gestational weeks). This study is part of the multidisciplinary cohort study of prematurely born children called PIPARI (the Development and Functioning of Very Low Birth Weight Infants from Infancy to School Age). Methods. The sample of this Master´s thesis includes 63 ELGA/ELBW children and 107 full-term born children who participated in the PIPARI study and were living in monolingual Finnish-speaking families. The language skills were assessed using the Five to Fifteen parent questionnaire (subdomains Comprehension, Expressive language skills, Verbal Communication) and the Peabody Picture Vocabulary Test-Revised. Pre-reading and reading skills were measured with the Jyväskylä First Steps study test material (phonological awareness, letter knowledge, rapid automized naming, single word reading, single word writing) and with the Five to Fifteen parent questionnaire (subdomains Reading and writing, General learning). Results and conclusion. The language and literacy skills at seven years of age were statistically significantly weaker in children born ELGA/ELBW when compared to the full-term controls. The Five to Fifteen questionnaire subdomain Verbal communication was the only skill that did not differ significantly between the groups. There was a clear and significant association between language and literacy skills with both preterm and full-term groups. In the preterm group the connection between language and literacy skills were stronger and appeared wider among the different language components. The results of this study support the previous findings that preterm children have an elevated risk for difficulties in language and literacy skills. In addition, this study provides further evidence for the associations between language abilities and literacy skills in school age in children born ELGA/ELBW. It is important that preterm children get the appropriate developmental follow-ups and support still at school age.
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