Biomedical subjects

C Bengtsson

Publications and source records attributed to C Bengtsson.

At least 37 records · Page 2Linked to original sources

PubMed2001

Helicobacter pylori infection in Swedish school children: lack of evidence of child-to-child transmission outside the family.

BACKGROUND & AIMS: Helicobacter pylori infection is mainly acquired in early childhood, but the exact routes of transmission remain elusive. To distinguish between risks of intrafamilial and extraneous child-to-child transmission, we studied H. pylori seroprevalence among Swedish school children with varying family backgrounds. METHODS: In a cross-sectional study, 695 of 858 (81%) 10-12-year-olds in 36 school classes in Stockholm donated blood and answered a questionnaire. Infection was detected by enzyme-linked immunosorbent assay and confirmed by immunoblot and urea breath test. RESULTS: Overall, 112 (16%) children were infected. The seroprevalence was 2% among 435 children with Scandinavian parents and 55% among 144 children with origin in high prevalence areas (Middle East and Africa). Among children born in Scandinavia, the odds ratios (adjusted for gender, socioeconomic status, and family size) for being seropositive were 39.1 (95% confidence interval, 16.7-91.3) and 5.6 (1.8-17.3) when having parents born in high and medium prevalence areas, respectively, relative to children with Scandinavian parents. Importantly, the prevalence of infection among the classmates was not a risk factor for H. pylori infection. CONCLUSION: Our data indicate that intrafamilial transmission is far more important than child-to-child transmission outside the family. The H. pylori prevalence in the parental generation may be a crucial determinant for the child's risk of contracting the infection.

Child↗

PubMed2001

Refinement of the 14C-urea breath test for detection of Helicobacter pylori.

BACKGROUND: Helicobacter pylori is recognized as the main etiological factor for chronic gastritis, peptic ulcer and possibly also gastric malignancies. A 14C-urea breath test was successively refined to correctly diagnose the presence of H. pylori. METHODS: After intake of a 14C-urea cocktail, 14CO2 in breath was trapped in benzethoniumhydroxide/ethanol. Serology by ELISA, followed by Western blot, was used as reference method for confirmation of presence or absence of H. pylori. RESULTS: Breath measurements at 10 and 20 min were determined to be optimal for diagnostic purposes. With 2.5 microCi of 14C-urea, a sensitivity of 86% and specificity of 100% was obtained for the 10-min values. Corresponding data for the 20-min values were 86% and 99%, respectively. When 50 mmol L(-1) citric acid was added to the 2.5 microCi 14C-urea cocktail, separation between positive and negative results became more distinct along with improved sensitivity of 91% and specificity of 100%. As the isotope amount was reduced to 1.0 microCi in the citric acid-containing cocktail, a sensitivity of 93% and specificity of 100% were obtained at both 10 and 20 min. CONCLUSION: Diagnostic urea breath test has a high concordance with H. pylori serology, combining ELISA and Western blot. Stepwise refinements proved the optimal urea breath test cocktail to include 1.0 microCi 14C-urea in citric acid solution with breath measurement at 10 min.

Adult↗

PubMed2001

Microproteinuria and long-term prognosis with respect to renal function and survival in normotensive and hypertensive women--a 24-year follow-up of a representative population sample of women in Gothenburg, Sweden.

OBJECTIVE: This study aimed to assess albuminuria and subclinical proteinuria, their association with hypertension and their role as predictors of hypertension, impaired renal function and mortality. MATERIAL AND METHODS: A baseline population study comprising 1462 women in five different age groups in Gothenburg, Sweden, was carried out in 1968-69. Comprehensive clinical examinations and laboratory tests were performed, including blood pressure measurement and an Albustix test. A systematic subsample of women additionally collected a 24 h urine sample for quantitative protein analysis. Values of urinary protein (u-protein) excretion between 80 and 300 mg/24 h were defined as microproteinuria. The results described in this paper are based on a 24-year follow-up. RESULTS: The baseline Albustix test was positive in 6.8% of 1458 women, from whom a urine sample was obtained. Of 741 baseline urine collections for u-protein excretion, 16.9% were in the microproteinuric range (80-300 mg/24 h), 1.1% in the macroproteinuric range (> 300 mg/24 h) and 82.1% in the normoproteinuric range (< 80 mg/24 h). Hypertension was more common in Albustix-positive women than in those with negative Albustix, and hypertension was also more prevalent in women with microproteinuria than in women with normoproteinuria. Neither positive Albustix nor microproteinuria was related to later renal impairment. Hypertension was associated with increased mortality in both Albustix-positive and Albustix-negative women, and in women with both normoproteinuria and microproteinuria at baseline. The mortality ratio during the follow-up period was, however, not significantly influenced by positive Albustix or by microproteinuria at baseline, in either hypertensive or non-hypertensive women. CONCLUSIONS: This study demonstrated that both a positive Albustix test and microproteinuria were associated with hypertension. Hypertension at baseline increased the risk for death during the follow-up period, while neither albuminuria, defined as a positive Albustix test, nor microproteinuria was associated with an impaired long-term prognosis with respect to renal function or survival in this cohort of Swedish middle-aged women during 24 years of follow-up. Microproteinuria in otherwise healthy normotensive or hypertensive women does not appear to impair the long-term prognosis.

Adult↗

PubMed2001

Socioeconomic status and mortality in Swedish women: opposing trends for cardiovascular disease and cancer.

We examined relations between socioeconomic status and cardiovascular disease, cancer, and diabetes mellitus in a 24-year prospective study of 1,462 Swedish women. Two socioeconomic indicators were used: the husband's occupational category for married women and a composite indicator combining women's educational level with household income for all women. The husband's occupational category was strongly associated with cardiovascular disease and cancer mortality in opposite directions, independent of age and other potential confounders. Women with husbands of lower occupational categories had an increased risk of cardiovascular disease mortality [relative risk (RR) = 1.60; 95% confidence interval (95% CI) = 1.09-2.33] while experiencing lower rates of all-site cancer mortality (RR = 0.69; 95% CI = 0.50-0.96). A similar relation was seen with the composite variable: women with low socioeconomic status had an increased risk of cardiovascular disease (RR = 1.37; 95% CI = 1.01-1.84) but a somewhat lower risk for cancer of all sites (RR = 0.86; 95% CI = 0.66-1.11). Finally, morbidity data (diabetes mellitus, stroke, and breast cancer) yielded results that were consistent with the mortality trends, and breast cancer appeared to account for a major part of the association between total cancer and high socioeconomic status. In summary, higher socioeconomic status was associated with decreased cardiovascular disease mortality and excess cancer mortality, in such a way that only a weak association was seen for all-cause mortality.

Adult↗

PubMed2001

Evaluation of "Live for Life", a health promotion programme in the County of Skaraborg, Sweden.

STUDY OBJECTIVE: To evaluate a health promotion programme, combining a population and individual based strategy, in the County of Skaraborg, Sweden, with special attention to outcome. DESIGN: The evaluation was subdivided into structure, process and outcome. The evaluation procedure as a total is described here, but the results presented refer only to outcome. In order to study the potential effect of the individually based health examination, 35 year old subjects who had participated five years previously were in 1994-1996 compared with 35 year old subjects who had not participated before, and compared with their own values five years earlier. The results during 1995-1996 were compared with those of 1989-1990 for corresponding ages in order to study the effect of, particularly, the population based strategy. SETTING: The County of Skaraborg in the south western part of Sweden with about 270 000 inhabitants. In addition to population strategy, involving the total county, men and women aged 30 and 35 years were invited to an individually based examination. MAIN RESULTS: Factors related to body weight increased during the study period, while other factors mostly changed in the direction wanted. As a whole the changes were rather modest. There were favourable changes in lifestyle variables, for example, concerning smoking and dietary habits. CONCLUSIONS: There were beneficial effects from the health promotion programme, but there is a need for continuous improvement of methods of intervention referred to lifestyle.

Adult↗

PubMed2000

Poor agreement between self-reported birth weight and birth weight from original records in adult women.

Data from an ongoing prospective population study of women in Göteborg, Sweden, were used to assess agreement between self-reported birth weight and birth weight obtained from original delivery records of women aged 44-60 years. Of the eligible population with traced delivery records (n = 693), only 28% (n = 192) could report their own birth weight. Spearman correlation between self-reported birth weight and birth weight from original records was r = 0.76. However, a difference plot, with limits of agreement at -1,028 to 1,038 g (95% confidence limits: lower limit, -1,157 to -901 g, upper limit, 910 to 1,166 g) revealed poor agreement between methods. Of the self-reported birth weights, 53% were in error by 250 g or more, and 31% were positively or negatively discordant by 500 g or more. Application in an analysis of cardiovascular risk factors in adulthood found conflicting results between self-reported and recorded birth weights. Low reporting rate, poor reporting accuracy, and misleading findings in application led to the conclusion that self-reported birth weights from middle-aged women would not be a satisfactory replacement for birth weights from original records.

Adult↗

PubMed2000

Population studies of diet and obesity.

Population-based research on diet, obesity and the metabolic syndrome is faced with accumulating evidence of biases that may profoundly affect results. One potential source of bias, which is often neglected in nutritional epidemiology, arises from self-selected study populations. Subjects who agree to participate in surveys may be at less risk of metabolic syndrome than those who refuse. Analogous to observations in adult populations, studies of schoolchildren have also yielded clear evidence of self-selection. Whether such selection patterns influence analytical results depends on how the biases relate to the dependent and independent variables being studied. Systematic dietary reporting error is another source of bias in studies of nutritional risk factors for disease. While obesity-related under-reporting bias is now well documented, less is known about whether specific foods and nutrients are disproportionately affected. However, two studies employing biomarkers for protein have suggested that obese subjects under-reported the proportion of energy from fat plus carbohydrate. This should alert epidemiologists to the possibility that a dual reporting bias may be present in studies of diet and disease: general under-reporting among obese subjects compounded by food-specific errors. In summary, biases due to self-selection and selective dietary under-reporting may produce consequences in epidemiological studies that are both unpredictable and complex. We conclude this review with recent findings involving dietary fat intake and regional adiposity in a population-based study of women. These preliminary results may have etiological relevance to the development of metabolic syndrome, but multiple biases of the type described previously may also be operating.

Anthropometry↗

PubMed2000

Blood pressure and hypertension in middle-aged women in relation to weight and length at birth: a follow-up study.

OBJECTIVES: To examine the relationship between indicators at birth and adult blood pressure and risk for developing hypertension at two age levels. DESIGN: Original midwife records of 438 women born at term participating in a prospective population study in Göteborg, Sweden with blood pressure and hypertension assessment at both 50 and 60 years of age. RESULTS: Systolic blood pressure at both age levels showed a U-shaped relationship to weight and length at birth. Hypertension prevalence at 60 years was significantly and inversely related to both weight and length at birth, but not at 50 years. Significantly higher risk for hypertension was found in the lowest birth weight quintile [odds ratio (OR) = 2.0, 95% confidence interval (CI) 1.1-3.8] and lowest birth length tertile (OR = 1.8, 95% CI 1.1-3.0), in relation to the middle quintile/tertile, with or without adjustment for adult body size (as body mass index), at 60 years but not at 50 years. At 50 years, hypertension risk decreased by 3% (95% CI 0.92-1.01) for every 100 g increase in birth weight and 6% (95% CI 0.83-1.05) per cm birth length. At age 60 years, hypertension risk decreased by 4% (95% CI 0.92-0.99) per 100 g birth weight and 10% (95% CI 0.81-0.99) per cm length. CONCLUSIONS: Size at birth was a predictor of hypertension risk in women at 60 years but not 50 years. This study supports the hypothesis that poor fetal growth, as measured by low weight or length at birth, may contribute to the development of hypertension in later life and that this relationship became stronger with age.

Birth Weight↗

PubMed2000

Sociodemographic characteristics influencing birth outcome in Sweden, 1908-1930. Birth variables in the Population Study of Women in Gothenburg.

STUDY OBJECTIVE: To identify variables available in early Swedish delivery records and their relation to birth outcomes for home and hospital deliveries in Gothenburg at the early part of this century. DESIGN: A retrospective recovery of original delivery records and social variables in a cross sectional population. SETTING: Gothenburg, Sweden. PARTICIPANTS: 851 fullterm singleton female births with known gestational age born into five birth cohorts on selected dates (1908, 1914, 1918, 1922 and 1930). MAIN RESULTS: Delivery site, maternal parity, gestational age, and social group were significant factors influencing birth outcome as birth weight and length. The mean birth weight and length of hospital born infants was consistently lower than for home deliveries across all cohorts. Site of delivery changed significantly during the period of births under study, 1908-1930. CONCLUSIONS: In this study, which was based on original delivery records from the early part of this century, it was found that delivery site was an important factor influencing birth outcome across five birth cohorts. Utilisation of delivery services changed during the period of study. Thus, to avoid selection bias, the application of delivery records should reflect the birthing practice of the time period in question.

Adult↗

PubMed1999

Pre-existing risk factor profiles in users and non-users of hormone replacement therapy: prospective cohort study in Gothenburg, Sweden.

OBJECTIVE: To assess whether risk factor profiles for cardiovascular disease differed, before starting treatment, between women who would subsequently use hormone replacement therapy and those who would remain untreated. DESIGN: Prospective population study, initiated in 1968-9, with follow ups in 1974, 1980, and 1992. SETTING: Gothenburg, Sweden. PARTICIPANTS: 1201 women born in 1918, 1922, and 1930, representative of women of the same age in the general population. MAIN OUTCOME MEASURES: Hormone replacement therapy as a function of initial systolic and diastolic blood pressure, waist and hip circumference, waist to hip ratio, body mass index, serum concentrations of cholesterol and triglycerides, smoking status, education, leisure time activity, and socioeconomic group. RESULTS: 179 of the 1202 women (14.9%) used hormone replacement therapy sometime during the 24 year follow up period. Age adjusted models indicated that these women had significantly lower blood pressure, had less obesity, and belonged to a higher social group before the start of treatment than women who would remain untreated [corrected]. CONCLUSION: Women who would subsequently use hormone replacement therapy were already at lower cardiovascular risk before the start of treatment than women who would remain untreated. Some of the claimed beneficial effects of treatment may thus be explained by women who would use hormone replacement therapy representing a healthier cohort than women who would remain untreated.

Adult↗

PubMed1999

Birth weight, adulthood BMI, and subsequent weight gain in relation to leptin levels in Swedish women.

OBJECTIVE: Leptin seems to be involved in the regulation of energy balance, although little is known about the epidemiology of leptin with respect to prediction of weight gain and incidence of obesity-related diseases. The dual aim of this study is to document characteristics of leptin after long-term storage, and to describe its relation to body weight, from birth to old age, in an ongoing prospective study. RESEARCH METHODS AND PROCEDURES: A population-based sample of Swedish women was first examined at the ages of 38 to 60 and re-examined 24 years later. This study used 1358 frozen serum samples that had been stored 29 years for analysis of leptin concentrations and their relation to body weight history. RESULTS: Leptin values obtained from stored samples showed the same correlation with relative weight as that seen in a contemporary sample with similar demographic characteristics. Lower self-reported birth weight was associated with higher leptin levels in adulthood (p = 0.01), controlling for age and adult BMI. Prospective analyses revealed that high leptin in 38 to 46-year-olds predicted subsequent long-term weight gain (p = 0.003), although no significant associations were seen in women initially aged 50 or older. DISCUSSION: It is feasible to use frozen serum for studying leptin in relation to obesity and related developments many years later. High leptin level was a risk factor for subsequent weight gain in 38- and 46-year-old women. Retrospective analyses involving birth weight suggest that leptin resistance in adulthood might have fetal origins.

Adult↗

PubMed1999

Evaluation of an educational programme for the early detection of cancer.

Avoiding patient's and doctor's delay is important for the detection of cancer. In order to study the possibilities for shortening the delay, without causing anxiety, an educational programme for early detection of cancer (EPEDC) was worked out, aimed to be evaluated at the community level. A community with 77,100 inhabitants, was informed about cancer symptoms in a letter. Participants who observed the cancer symptoms, described in the letter, were invited to visit the health centres, where they were interviewed and examined according to a specially designed schedule. Guidelines for taking care of these participants were also worked out. Fifteen previously unknown cancers were detected. By means of a telephone interview and a questionnaire the reactions to the EPEDC were studied. The results indicate that it is possible to inform and educate the population about cancer symptoms without causing anxiety on condition that there is an organisation which can be contacted without delay by subjects with potential cancer symptoms.

Adult↗

PubMed1999

Dental status of women in a 24-year longitudinal and cross-sectional study. Results from a population study of women in Göteborg.

The aim of the study was to describe dental health status among middle-aged and elderly women over a 24-year period. Because of the design of the study it was possible to make both longitudinal and cross-sectional comparisons. The study started in 1968-69 with a combined medical and dental examination of women aged between 38 and 60 years. New dental examinations of these same women were performed in 1980-81 and again in 1992-93, and included new cohorts of 38-year-old women on both occasions. In the cross-sectional perspective, it was shown that the number of edentate individuals decreased significantly during the 24-year period. Among dentate women, the number of remaining teeth and restored teeth increased significantly cross-sectionally. However, the youngest age group, women of 38 years, showed a lower number of restored teeth in the latest study (in 1992-93). There was also a lower number of crowns, root-fillings, and pontics in the latest study for the youngest age group. The two older age groups studied cross-sectionally showed similar numbers in all studies. In the longitudinal study, there was a decrease with time in incidence of edentulism. Among the dentate women in the longitudinal study the number of restored teeth related to those remaining was high (range 76-90%) and did not change much between the studies in the different age groups. There was a clear tendency during the 24-year period in all age groups for more teeth to be restored with crowns rather than different fillings. In conclusion, this population study, with a follow-up of 24 years, shows that dental status improved in that fewer individuals lost all their teeth and younger age groups have more remaining teeth and fewer restorations than previously.

Adult↗

PubMed1999

Serum mercury concentration in relation to survival, symptoms, and diseases: results from the prospective population study of women in Gothenburg, Sweden.

A prospective population study of women in Gothenburg, Sweden was started in 1968-69 and comprised 1462 women aged 38, 46, 50, 54, or 60 years at baseline. Follow-up studies were carried out in 1974-75, 1980-81, and 1992-93. The baseline study included an extensive medical and dental examination. Serum mercury concentration (beta-HG) was determined in deep-frozen samples from all participants in 1968-69 and in a random subsample of sera from participants in 1980-81, about 20 years after the baseline examination. S-Hg was statistically significantly correlated with number of amalgam fillings at both examinations. Of 30 defined symptoms and 4 different clusters of symptoms, no one was independently correlated with S-Hg measured in the samples from 1968-69, while there was a negative statistically significant correlation with over-exertion and poor appetite in 1980-81. Blood hemoglobin and serum B-12 concentrations in 1968-69 were statistically significantly and positively correlated with S-Hg, while erythrocyte sedimentation rate and the serum concentrations of potassium and triglycerides were significantly and negatively correlated with S-Hg, also after including potential confounders. Blood hematocrit examined in 1980-81 was negatively correlated with S-Hg. When including potential confounders, serum IgA was also statistically significantly correlated with S-Hg, but not in univariate analysis. No statistically significant correlation was observed between S-Hg, on the one hand, and the incidence of diabetes, myocardial infarction, stroke, or cancer on the other, while a statistically significant negative correlation was observed with overall mortality when age and education were included as background variables. There were some correlations between biological variables and S-Hg, probably of no negative clinical significance, and we conclude that there is no association between disease and S-Hg on a population basis in middle-aged and older women.

Adult↗

PubMed1999

One doctor's 25-year experience of beta-blocker treatment to the same group of hypertensive women.

OBJECTIVE: To assess the importance of long-term doctor-patient relationship, and to assess the effect of long-term treatment with beta-blockers of hypertensive women. DESIGN: A 25-year follow-up study of hypertensive women, compared with participants in a prospective population study of women of the same age. SETTING: Gothenburg, Sweden. SUBJECTS: 57 hypertensive women and 1462 participants in the population study. RESULTS: The women's blood pressure was well-controlled over the years, and no serious side-effects occurred. There was no increased mortality in these groups of hypertensive women compared with women in the general population of the same age. CONCLUSIONS: The favourable effects over the years with respect to the management of blood pressure and survival indicate the beneficial effect of a stable doctor-patient relationship and the beneficial long-term effect of beta-blockers as a base for antihypertensive treatment.

Adrenergic beta-Antagonists↗

PubMed1999

How often is the diagnosis bronchial asthma correct?

BACKGROUND: There are studies indicating that bronchial asthma is often underdiagnosed, while only a little research has been conducted as concerns overdiagnosing asthma. OBJECTIVE: We aimed to estimate the number of patients who have been given the wrong diagnosis of asthma. METHODS: All patients aged above 18 years who had visited two GPs during 1994 or 1995, with the diagnosis of bronchial asthma confirmed in the medical register, were examined by a specialist in allergies. RESULTS: One hundred and twenty-three patients fulfilled the criteria for being included in the study. Eighty-six patients (70%) attended the examination. Of these, 51 (59%) had bronchial asthma, six (7%) asthma in combination with chronic obstructive pulmonary disease (COPD) and 29 (34%) no asthmatic disease. CONCLUSION: The study indicates that more accuracy is needed when diagnosing bronchial asthma.

Adult↗

PubMed1999

Variations in dental anxiety among middle-aged and elderly women in Sweden: a longitudinal study between 1968 and 1996.

Cross-sectional studies have shown that older individuals are significantly less dentally anxious than younger ones. However, research has not been able to show if this is a cohort effect or an effect of fear declining with age. If it is a cohort effect, dental anxiety among the elderly may pose a greater-than-expected problem for the providers of dental services. With the exception of longitudinal studies in children and a three-year follow-up on adults, no truly longitudinal epidemiological studies concerning dental anxiety have been performed. The aim of this project was to investigate how dental anxiety changes with aging. In a longitudinal population study of women in Göteborg, Sweden, starting in 1968, 1462 women aged 38 to 54 participated. A representative subsample of 778 women took part in a psychiatric examination where an investigation of dental anxiety was included. The same questions were also included when these women were re-examined in 1974, 1992, and 1996. Three hundred seventy-five women were still eligible for investigation in 1996. In 1968-69, 48 (12.8%) of the participating women assessed themselves as "very afraid" or "terrified" when visiting the dentist, and in 1996 the frequency was 21 (5.6%) among the same women. In 1968-69, 180 women (48%) reported no dental anxiety when visiting the dentist, and 28 years later the frequency was 230 (61%). In the three youngest age groups, dental anxiety decreased significantly (p < 0.001) over the 28-year period. Older compared with younger women reported significantly less dental anxiety, and this was an age effect rather than a cohort effect. Thus, this longitudinal study supported the hypothesis that dental fear, like many other general and specific phobias, declines with age.

Age Distribution↗

PubMed1999

The prevalence of urinary incontinence and its influence on the quality of life in women from an urban Swedish population.

OBJECTIVES: To assess the prevalence of urinary incontinence and its influence on the quality of life. MATERIAL AND METHODS: A random sample of every fourth woman aged > or =20 years resident in a primary health care district of the city of Göteborg was obtained from the population register (n=2911). The women were invited by letter to complete a questionnaire concerning urinary incontinence. The women were also requested to assess their quality of life using a visual analogue scale. RESULTS: The overall response rate was 77%. The prevalence of urinary incontinence increased (p<0.001) in a linear fashion from 3% in the cohort 20-29 years to 32 % in the cohort of women aged > or =80 years. The proportion of women suffering from stress incontinence decreased (p<0.001) with increasing age, while the proportion of women suffering from urge and mixed incontinence increased (p<0.01) with increasing age. Women with stress incontinence had a greater body weight and had given birth to a greater number of children compared to continent women. There was, however, in this respect no difference between women with urge incontinence and continent women. Women with urinary incontinence reported a poorer quality of life compared to continent women (p<0.01). Women with urge incontinence and women with mixed incontinence reported a poorer quality of life compared to women with stress incontinence (p<0.05). Only 6% of the women from this population had sought medical attention for urinary incontinence. CONCLUSIONS: Although urinary incontinence was a prevalent condition, particularly among the elderly and had a negative influence on the quality of life, only a small number of women had sought medical care.

Adult↗