In a population study of 4,763 middle-aged men, the 120-min responses of blood glucose as well as plasma IRI in OGTTs were studied in subgroups of the screening population with different levels of gamma-glutamyl transferase (GGT) and/or defined alcohol consumption levels. In the group with low GGT (below the median, n - 2,196), both 120-min blood glucose and plasma IRI tended to be lower than in the whole screening cohort and there was a significantly smaller number of cases with 120-min blood glucose greater than or equal to 7.0 mmol/l. In a group of ideological alcohol abstainers the values of fasting as well as 120-min blood glucose were largely the same as in the average middle-aged men. In members of the study population with increased screening GGT, however, both fasting and especially, 120-min values of blood glucose and plasma IRI were higher than in the average males, particularly in the cases in which the interview revealed chronic heavy alcohol consumption as the predominant underlying factor associated with elevated GGT. In these individuals, the prevalence of 120-min screening OGTT blood glucose values greater than or equal to 7.0 mmol/l was 26%, in comparison with 13% in the average men and 9% in the individuals with screening GGT left of the median. This indicates that GGT and alcohol consumption are of clinical importance both for the results and interpretation of OGTTs.

Adult↗

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The influence of GGT, COHb% and body weight on the 2-h glucose and insulin response after a standardized oral glucose load.

Relative body weight (A/I weight) serum gamma-glutamyl-transferase (GGT) and carboxyhemoglobin (COHb%) were related to glucose and insulin values at 0 and 120 min in a sizable, consecutive series of oral glucose tolerance tests (OGTTs) in middle-aged males. Partial and multiple correlation coefficients were calculated, and the squared stepwise multiple correlation coefficient was used to estimate how much of the variability of glucose and insulin could be accounted for by the three factors. No less than 14% of the glucose variability and 25% of the insulin variability at 2 h could be attributed to them, emphasizing the importance of keeping these three factors in mind when interpreting the results of OGTTs.

Blood Glucose↗

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Chronic effects of gastroduodenal surgery on glucose and insulin response to oral glucose tolerance test in a population study.

Oral glucose tolerance test (OGTT) results were compared between 4,667 middle-aged males attending a preventive medical screening and intervention program in Malmö and the subjects in this sample who reported a history of previous operation for gastric or duodenal ulcer (n = 158, or 3.4%). 76% of the operated subjects were smokers in comparison with 50% in the general cohort of males of the same age. The glucose and insulin responses in the OGTT in both the smoking and non-smoking operated cases showed higher early peak values and a subsequent rapid drop of the levels with lower 120-min values of both glucose and insulin compared to the average screening cohort. This type of response to an oral glucose load had previously been well known in the acute and immediate postoperative stages of gastric and duodenal resection, but it had not been shown before that it seems to be a permanent effect and may chronically influence the results of OGTTs in the population. Gastro-duodenal surgery should be included among the factors which may significantly affect the chronic results and thereby also the clinical interpretation of the OGTTs in the population.

Blood Glucose↗

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Prevention of alcohol-related problems in urban middle-aged males.

More than 30,000 individuals have been investigated in the continuous screening and intervention study in Malmö. Large subsamples of individuals with different levels of GGT (gamma-glutamyltransferase) have been characterized. GGT has proven to be a useful and simple tool in tracing, identifying, treating and controlling heavy drinkers. Furthermore, GGT seems to be a new and strong indicator of alcohol-related disabilities and short term mortality in the male population. Individuals with GGT in the tenth deecentile of the GGT distribution have been randomly selected for treatment or control. Results and follow-up for 60 months in the intervention study with randomized controls in middle-aged heavy drinkers indicate a significant reduction in alcohol consumption, sick absence, hospitalization and mortality. Thus, the intervention program seems to be effective in preventing complications of alcoholism on an individual basis.

Absenteeism↗

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Following the thread of Ariadne to the health of women.

The health of women has risen to a priority position in medical research. Comparative studies of female morbidity are called for as an intermediary stage for generation of hypotheses and design of deeper studies of determinants, such as social, ecological, and individual factors. In previous studies, we have noted differences in female hospitalization between Heraklion in Greece and Linköping in Sweden. They were related to age and to urban versus rural dwelling, and fit projections for a more archaic and a more technocratic society, respectively. This paper aims at showing how the study of women's health may proceed from relevant hospitalization observations to the next level, of exploring already available indicators of self-perceived health in elderly females.

Age Factors↗

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Malignant lymphogranulomatosis and anticonvulsant therapy.

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Aged↗

PubMedDate not supplied

Influence of carboxyhemoglobin, gamma-glutamyl-transferase, body weight, and heart rate on blood pressure in middle-aged men.

Carboxyhemoglobin (COHb%) and gamma-glutamyl-transferase (GGT) are indicators of tobacco and alcohol consumption; similarly, body weight broadly reflects dietary habits. Relationships between COHb%, GGT, relative body weight, heart rate and blood pressure were studied in 242 48-year-old men attending a general health screening program in Malmö, Sweden. All were without treatment for high blood pressure. Positive correlations were found between blood pressure and body weight, GGT, and pulse, and a reciprocal correlation between blood pressure and COHb%. Use of objective markers for known or suspected risk factors, such as alcohol consumption, smoking, or overweight, were studied to elucidate their usefulness for further prospective studies.

Alcohol Drinking↗

PubMedDate not supplied

Arylhydrocarbonhydroxylase inducibility and smoking habits in patients with laryngeal carcinomas.

There is considerable evidence that the inducible enzyme aryl hydrocarbon hydroxylase (AHH) plays an important role in the activation of polycyclic aromatic hydrocarbons (PAH) to ultimate carcinogens. In man, a genetic heterogeneity of AHH inducibility has been demonstrated, and correlated to susceptibility to bronchogenic carcinomas following exposure to PAH. We assessed AHH inducibility in a control group of 102 healthy Swedish citizens and in 41 patients with laryngeal carcinomas. Frequencies of the three phenotypes of high, intermediate and low AHH inducibility in our control group; 8.8%, 42.2% and 49%, respectively, did not differ significantly from frequencies found in a white US population. In the laryngeal carcinoma group, there was a statistically highly significant overrepresentation of patients with high AHH inducibility, 36.6%, whereas 43.9% had an intermediate and 19.5% a low level. Most of the patients were heavy smokers. These findings add further support to the concept that susceptibility to PAH-induced carcinomas is associated with high levels of inducible AHH activity.

Aged↗

PubMedDate not supplied

Cross-sectional assessment and subgroup comparison of functional disability in patients with rheumatoid arthritis in a Swedish health-care district.

A cross-sectional study was undertaken on 222 patients with rheumatoid arthritis (RA) within a Swedish health-care district. An exploratory analysis of functional status, according to a Swedish version of the Health Assessment Questionnaire (HAQ), was carried out in order to explore the extent and pattern of functional disability in an unselected group of individuals with RA. The mean score of functional disability according to HAQ increased with more clinical manifest disease. There were no significant differences between the mean score in men and women. Most functional disability was related to hand-grip function and the ability to take care of personal hygiene. Increased functional disability was significantly associated with increasing age and disease duration. There was no significant relation between functional status and housing condition and educational level. A strong correlation was found between pain and functional disability. Multiple regression analysis was performed and predictive functional scores were tabulated based upon sex, age at onset and duration of RA disease.

Activities of Daily Living↗

PubMedDate not supplied

An interactive computer program for retrieving and processing multiphasic health screening data.

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Computers↗

PubMedDate not supplied

MCHS: an application software for family welfare programmes.

At the level of first contact, a primary health care centre, information management is an unwieldy task, therefore health information systems are reported to be inadequate and weak. Microcomputers could improve information management at this level, but there is little success due to a lack of specialized application software. In this paper we describe software developed after a multi-centre systems analysis study, on an essential data set, to support the delivery of the public health programmes for family welfare, i.e. maternal health care, family planning and immunization programmes. The modular approach was taken to develop a common application software for information management use at multiple sites. The software is tested in a laboratory mode by retrospective data entry from sites in Sweden and in India. All the information could be entered and site-specific reports that were generated are compared. The software provided a common data collection format, an essential platform for outcomes research.

Adolescent↗

PubMedDate not supplied

Towards an essential data set for ambulatory otorhinolaryngological care in general practice.

In order to optimize otorhinolaryngological ambulatory care provision and quality assurance in the general practice services there is a need for interdisciplinary consensus on the conditions, the quantitative and qualitative criteria of diagnosis and outcome as well as other standards that apply to such a partnership. We report on the core, or essential set, of data involved herein, as derived from an information modelling study of the literature and a formalized agreement between the public primary health care and specialist otorhinolaryngology organizations in Sweden. We find that the identified essential data set constitutes a compact common taxonomy, term register, or thesaurus, an ordered survey of which provides the necessary performance and quality assurance support. This points to a computerized method of mediation. The essential data set for otorhinolaryngology in general practice thus corresponds to the notion of a basic minimal data set as outlined by the World Health Organization to be one of the requisites for the successful realization of the distinct components of the Health for All by the Year 2000 programme at the local level.

Data Collection↗

PubMedDate not supplied

Essential data set for computer management of distributed primary care services.

Reported here is a personal computer-based registration program of medical consultations in general practice that has been implemented in six communities ('primary health care districts'; total population 112623) in the county of Jönköping, southern Sweden. The program enabled decentralized monitoring and management of the primary health care organization in the communities. The objective of the present paper is to give, from one year's experience of about 137000 recorded visits, a broad overview of the program structure, briefly considering the questions associated with routine registration of medical consultations, to discuss how the system is used for decision and steering support as well as to summarize its overall performance, results and costs in relation to the general utility of accurate information on health service delivery and consumption in the population.

Computer Communication Networks↗