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Biomedical subjects

E Trell

Publications and source records attributed to E Trell.

At least 37 records · Page 2Linked to original sources
PubMed1985

A risk factor approach to the alcohol-related diseases.

Alcohol-related disorders belong to the spectrum of major non-infectious diseases in Western societies which are capable of prevention by means that have not yet been fully implemented. The mortality in a population of 10,353 middle-aged males invited to a preventive medical population program in Malmö was assessed for 1.5-6.5 years (mean 4.5 years) after the time of invitation and analysed in relation to participation or non-participation. The characteristics at entry of the 7948 males who participated in screening were compared in order to evaluate risk factor patterns for the major categories of premature death during the follow-up period. Among the non-participants for screening the mortality rate was twice as high, and the death rate due to alcohol-related diseases was five times higher than among the participants. There were no significant differences between participants and non-participants in the other death causes. The autopsy rate was high, at 87.8%. Even in the males participating in the screening, alcohol-related deaths constituted a major mortality category, comprising 55 of 218 cases, whereas cancer comprised 61 and coronary heart disease 50 of the premature deaths in this group. In these three main categories of male premature mortality, significant and distinctly differential risk factor patterns were found. Risk factors for coronary heart disease involved smoking, serum cholesterol, triglycerides and systolic blood pressure, and for alcohol-related deaths involved gamma-glutamyltransferase, an alcoholism screening questionnaire and, inversely, serum cholesterol and serum creatinine. In both groups of diseases, these risk factors could be combined into a highly predictive multiple logistic risk factor function. The discriminative power of this instrument was higher for the alcohol-related deaths than for the coronary heart disease deaths. Malignant and alcohol-related diseases constituted at least equally prominent categories as the cardiovascular disorders among the deaths that occurred within middle age in these cohorts. All of these conditions are potentially avoidable and are associated with significant and distinctive risk factor patterns. Risk factors may be applied to the alcohol-related disorders as signals for preventive measures in analogy with tested methods for the regulation of blood pressure and serum lipids.

Alcoholism↗
PubMed1984

Aryl hydrocarbon hydroxylase induction levels in patients with malignant tumors associated with smoking.

The levels of aryl hydrocarbon hydroxylase (AHH) inducibility were assessed in 173 patients with cancers statistically associated with smoking, i.e., squamous cell and transitional cell carcinomas, at various sites. In 34 patients with carcinomas of the oral cavity, 41 patients with laryngeal carcinomas, and 22 patients with pulmonary carcinomas there was a highly significant overrepresentation of high inducers, whereas 30 patients with carcinomas of the renal pelvis and ureter and 46 patients with urinary bladder carcinomas did not differ significantly in this respect from a control population comprising 92 subjects with no history of neoplastic disease. The results add further support to the concept of AHH as a major activator of carcinogens belonging to the group of polycyclic aromatic hydrocarbons (PAH) when these affect the oral cavity and/or the respiratory tract. The role of AHH in urothelial carcinogenesis seems to be less explicit.

Adult↗
PubMed1984

Premature death and associated risk factors in urban middle-aged men.

The full range of premature mortality and associated risk factors was analyzed for a follow-up period of three and a half to eight years in a uniform group of 7,935 middle-aged males (46 to 48 years old at screening) participating between the years 1975 and 1979 in the preventive population program in Malmö (participation rate 76.7 percent). Of the 218 deaths that occurred, necropsy was performed in 181 (83.0 percent). Three major causes of death were established: cancer (61/218), alcohol-related deaths (55/218), and coronary heart disease (50/218). In these three main categories of male premature mortality, significant and distinctly differential risk factor patterns were found. In coronary heart disease, smoking (p = 0.0062), serum cholesterol level (p = 0.00014), serum triglyceride level (p = 0.00013), systolic blood pressure (p = 0.000012), and diastolic blood pressure (p = 0.0021) were the strongest single determinants, but the independent role of the diastolic blood pressure disappeared in a multivariate analysis whereas all the others could be combined in a highly predictive logistic model. In the alcohol-related group, equal or stronger risk factor associations were present for serum gamma-glutamyltransferase level (p less than 0.0001), questionnaire alcoholism screening response (p less than 0.0001) and, inversely, serum cholesterol level (p = 0.0046) and serum creatinine level (p less than 0.0001), all of which were independent and could be combined in an even more predictive logistic model than in the coronary heart disease group. In the cancer deaths, significant associations were found for serum urate level (p = 0.023) and, inversely, serum cholesterol level (p = 0.056 - 0.031). Malignant and alcohol-related diseases constituted at least equally prominent groups as the cardiovascular disorders of the total premature deaths that occurred during middle age in these cohorts of Malmö males. All of these conditions are potentially avoidable and seem to be associated with significant and distinctive risk factor patterns. It seems possible that these factors may be applied, in current alcohol-related disorders and in future malignant diseases, both as indicators of the respective risks and as signals and instruments for directed preventive measures like the previously well established and tested methods for the regulation of blood pressure, serum lipids levels, and so on.

Age Factors↗
PubMed1984

Mutagen sensitivity, smoking habits and enzyme induction in healthy middle-aged men.

Unscheduled DNA synthesis (UDS) (excision-repair) of N-acetoxy-2-acetylaminofluorene (NA-AAF) damage to the DNA of human lymphocytes and levels of 3H-labeled NA-AAF bound to the DNA (carcinogen binding) of lymphocytes after 18 hr of culturing were measured in a consecutive subsample of healthy middle-aged males attending a multiphasic health screening program at the Department of Preventive Medicine in Malmö during 3 weeks in November-December 1981, and compared relative to their smoking habits, body weight, serum cholesterol, and gamma-glutamyltransferase levels as well as aryl hydrocarbon hydroxylase inducibility. This study group numbered 66 males and was uniform in sex, age, and investigation time. No case of significant arterial hypertension was present. The UDS and carcinogen binding results showed no correlation with the other factors measured, with the exception of smoking which was strongly (P less than 0.01) associated with increasing levels of both the UDS and carcinogen binding values. It is concluded that under ordinary circumstances smoking may represent the most important exogenous factor which may modulate risk to cardiovascular disease and cancer by influencing individual mutagen sensitivity.

Acetoxyacetylaminofluorene↗
PubMed1984

Major determinants of premature mortality in middle-aged urban males. Alcohol-related deaths and degree of participation in a preventive population program against alcohol and its complications.

The total, consecutive mortality in a population of 10,353 middle-aged males invited to participate in a preventive medical population program in Malmö was followed up 1.5-6.5 years, mean 4.5 years, after the time of invitation and analyzed in relation to participation or nonparticipation, forensic or in-hospital autopsy and possible intervention effects. The total mortality was twice as high in the nonparticipants as in the participants, and the death rate due to alcohol-related diseases was five times higher. There were no significant differences in other causes of death, including cancer and cardiovascular diseases. In the nonparticipants autopsied at the Forensic Department the proportion of alcohol-related deaths was 60.5%, compared with 10.0% in participants autopsied in hospital. A history of alcohol abuse was present in 45.2% of the total sample, and in 61.0% of the group autopsied at the Forensic Department. In participants with increased screening gamma-glutamyltransferase, mortality at 48-72 months' follow-up was lower in an intervention group in comparison with a control group matched for sex, age and gamma-glutamyltransferase. The results support findings that alcohol-related deaths, nonparticipation in a preventive population program, and intervention effects in a public health strategy against alcohol and its complications are major determinants of premature mortality in middle-aged urban males.

Age Factors↗
PubMed1984

Alcohol-related death and associated risk factors in urban middle-aged males.

Alcohol-related disorders belong to the spectrum of major non-infectious diseases in Western societies which can be prevented by means that have not yet been fully implemented. Total consecutive mortality in a population of 10353 middle-age males invited to take a part in a preventive medical population program in Malmö was followed up for 3.5-8.5 years (mean 4.5) after the time of invitation and analysed in relation to participation or non-participation and forensic or in-hospital autopsy. Entry characteristics in the 7935 males who attended the screening were compared in order to evaluate risk factor patterns for the major categories of premature death during the follow-up period. Even in the males participating in the screening, alcohol-related deaths (ARD) constituted a major mortality category, comprising 55 of 218 cases, whereas cancer comprised 61 and coronary heart disease (CHD) 50 of the premature deaths in this group. Both in the ARD and CHD categories of male premature mortality, significant and distinctly differential risk factor patterns were found; in CHD for smoking, cholesterol, serum triglycerides and systolic blood pressure, and in ARD for gamma-glutamyltransferase, questionnaire alcoholism screening test and, inversely, serum cholesterol and serum creatinine. In both groups of diseases, these risk factors could be combined into highly predictive multiple logistic risk factor functions. The discriminative power of this instrument was even higher in ARD than in CHD deaths. In consequence, these factors may be applied both as indicators of the ARD risk and as signals and instrument for directed preventive measures in analogy with previously well established and tested methods for the regulation of blood pressure, serum lipids, etc. in the conquest of the cardiovascular diseases.

Alcohol Drinking↗
PubMed1984

Alcohol-related problems in middle-aged men with elevated serum gamma-glutamyltransferase: a preventive medical investigation.

In an ongoing population study in Malmö, Sweden, serum gamma-glutamyltransferase (GGT) was used both as an indicator of alcohol-related problems and as an aid in further investigation and treatment. The study group was consecutively selected from six middle-aged male birth-year cohorts of 8859 screening attenders (76.1% attendance), and comprised a random one-half (N = 317) of the individuals with screening GGT in the top decentile of the distribution. Alcohol consumption was the main cause of GGT elevation in 76% of the study group. Symptoms of alcoholism were frequent in these subjects but were rare in those with normal GGT levels. Marital and occupational measures were similar to those in the general population for subjects who were still in treatment but differed for subjects who had dropped out within 2 yr. Comparisons of medical and social data, the questionnaire results and other screening measures between the study group and the other subjects with screening GGT in the top decentile showed equivalence between the two groups and indicated that the study group was representative of the entire group with significantly elevated GGT values in the screening investigation.

Age Factors↗
PubMed1984

Self-reported family history of hypertension in healthy middle-aged men.

A self-reported first-degree family history of hypertension was obtained by questionnaire in two consecutive subsamples of middle-aged male attenders to a multi-phased health screening program in Malmö. This corresponded to 2739 men in lower (36-39 years) and 6597 in upper (46-48 years) middle age. Reported first-degree family history of hypertension was very frequent, about 26-27% in both groups. It was predominantly confined to the parental generation and was twice as common in mother as in father. Furthermore, the reported family histories showed marked interrelations. Thus, hypertension was much more frequently reported when both parents had the condition than if it only concerned one of them. It is proposed that these findings may reflect an increased awareness, investigation, diagnosis and treatment of hypertension rather than the genetic occurrence of the disease per se in modern society.

Adult↗
PubMed1984

Blood pressure and other risk factors in healthy middle-aged men in relation to self-reported first-degree family history of hypertension.

In a questionnaire-assessed first-degree family history of hypertension obtained in a sizable subsample of middle-aged male attenders to a multiphasic health screening programme in Malmö, the actual blood pressure distributions and other risk factors are compared in the different heredity groups. Both mean values and frequencies of borderline and hypertensive levels of the systolic and diastolic blood pressures were significantly higher in groups with a family history of hypertension in particular biparental, than in those without. Reported paternal hypertension was less frequent than reported maternal hypertension but resembled more the biparental history group in terms of the recorded blood pressure levels. Several biochemical and physiological variables were compared between the groups, but there were no differences in associated risk factors, including blood lipids, except for higher serum urate in the biparental history group than in the others. Only part of the overrepresentation of increased blood pressure levels that was present appeared to be of the genuine idiopathic variety of hypertension, and the genotype for this disorder did not appear to be associated with other risk factors for hypertension in the population.

Blood Pressure↗
PubMed1984

The prevalence of thyroid disorders in a middle-aged female population, with special reference to the solitary thyroid nodule.

A survey of thyroid disease was conducted in 477 middle-aged women selected at random in an urban area where goiter is not endemic. The overall occurrence of thyroid disease was estimated to be 16.2%. Previously known disease was reported by 6.7% of those surveyed, and an additional 9.5% were diagnosed in the present study. The prevalence of all goiter was 11.3%, and of a palpable solitary nodule, 6.5%. Women with goiter were examined by thyroid scintigraphy and fine-needle aspiration cytology. The results of these examinations combined with the conventional clinical examination were considered a sufficient basis for benign diagnosis in all cases except one, a woman with a solitary nodule who was surgically treated because the cytologic report indicated follicular neoplasm; histopathology, however, revealed colloid goiter. The accumulated incidence of hyperthyroidism was 2.3% and of hypothyroidism 0.8%. It is concluded that goiter is a common disorder among women living in non-endemic areas, and that most goiter, including palpable solitary nodules, can be classified after evaluation as multinodular goiter.

Age Factors↗
PubMed1984

[Carcinoma and leukoplakia in the oral cavity in relation to AHH induction, smoking and dental status].

Smoking habits, dental status and aryl-hydrocarbonhydroxylase (AHH) inducibility were studied in a series of 52 oral leucoplakias and 20 oral cancers. There was an obvious association between leucoplakia, cancer and smoking. A significant overrepresentation of high AHH and a corresponding underrepresentation of low AHH inducibility were found among the smokers with leucoplakia and in the oral carcinoma group. In both groups, however, the dental status was largely normal.

Adult↗
PubMed1983

Premature mortality in middle-aged men: serum cholesterol as risk factor.

Serum cholesterol as risk factor for premature mortality; 0--6, mean 3 years after a screening investigation in 10,000 middle-aged men (46--48 years at screening) was studied with respect to category of death. Serum cholesterol was reciprocally correlated to cancer deaths and to alcohol-related deaths, and strongly positively correlated to deaths in coronary heart disease. The men who died of cancer did not have lower body weight, nor was there any association with serum triglycerides. The inverse correlation to serum cholesterol did not differ between the cancer deaths occurring early, and those occurring later after screening. Part of the cholesterol/cancer death relationship may be explained by the presence of an otherwise occult malignancy at screening, but it cannot be excluded that the development of some cancers may be associated with a state of low serum cholesterol.

Age Factors↗