Search PubMed⌕ Search

Biomedical subjects

G Eklund

Publications and source records attributed to G Eklund.

At least 19 recordsLinked to original sources
PubMed1992

Socio-economic versus obstetric risk factors for drug addiction in offspring.

Two possible risk factors for drug addiction were weighed against each other: (1) perinatal factors associated with obstetric medication at time of birth; and (2) factors associated with familial socio-economic conditions at time of birth. The subjects comprised 200 amphetamine addicts and 200 opiate addicts born in Stockholm 1945-1966. In a matched case control study, addicts were compared to their siblings with regard to possible obstetric risk factors by means of conditional logistic regression controlling for socio-economic level and civil status. Administration of opiates, barbiturates and nitrous oxide to mothers during labour was associated with drug addiction in offspring, hence confirming results from earlier studies. In a cohort study the risk associated with birth at a given hospital and familial socio-economic level was analysed by means of log-linear analysis using 7100 controls from the general population. For amphetamine addicts, a low socio-economic level at time of birth might be of importance for the infant subsequently becoming an addict. This could not be demonstrated for the opiate addicts. An uneven distribution of births among the hospitals, most pronounced for the amphetamine addicts, is in agreement with the hypothesis that obstetric practices may be risk factors for adult drug addiction.

Adolescent↗
PubMed1992

Bilateral bronchial anomaly. A pathogenetic factor in spontaneous pneumothorax.

Flexible fiberoptic bronchoscopy (FFB) was performed in 26 never-smokers with healed spontaneous pneumothorax (SP) with the aim of detecting and localizing any bronchial obstruction, including congenital anomaly. In a case-control study these patients were compared with a consecutive, randomly sampled, control group of 41 patients who were undergoing FFB for respiratory symptoms but who had not had a SP. In both groups the endobronchial anatomy with respect to such anomalies, which could be classified as disproportionate bronchial anatomy, an accessory bronchus, and/or a missing bronchus, was compared with normal anatomy. All except one of the 26 patients with SP but only four of the 41 control patients without SP had such bronchial anomalies bilaterally. This corresponds to an odds ratio of 231 (95% confidence interval, 24 to 880; p < 0.001). The significantly higher frequency of bilateral bronchial anomalies in never-smokers with SP suggests that a virtual prerequisite for the occurrence of SP has been found. However causal links between the probably congenital bronchial anomalies and SP have not yet been identified.

Adolescent↗
PubMed1991

Response bias in a case-control study: analysis utilizing comparative data concerning legal abortions from two independent Swedish studies.

Independent reports of legal abortions in two Swedish epidemiologic studies of breast cancer in young women, covering the same women and overlapping the same time period, have been compared in order to estimate a putative response bias. One study used case-control methods and obtained data by retrospective interviews from 317 cases and 512 controls. The other study was based on objectively documented information froma nationwide registry covering legally induced abortions. Analysis demonstrated a ratio between the odds ratios from the two studies of 1.5 (95 percent confidence interval 1.1-2.1) and an observed ratio of 22.4 (p less than 0.007) between underreporting of previous induced abortions among controls relative to overreporting among cases. This response bias may explain the tendency toward increased risk of breast cancer which, according to several case-control studies, appears to be associated with induced abortion.

Abortion, Legal↗
PubMed1991

Condylomata acuminata and risk of cancer: an epidemiological study.

OBJECTIVE: To determine whether patients with condylomata acuminata have an increased risk of developing cancer. DESIGN: Prospective cohort study on patients diagnosed as having condylomata acuminata. The number of malignant tumours in the cohort was compared with national incidences obtained from the Swedish Cancer Registry. SETTING: Dermatology department of the Karolinska Hospital, Stockholm, Sweden. SUBJECTS: 3260 patients (2549 males and 711 females, median (range) age 23 (1-80) years) seen during 1969-84, with a mean follow up of 7.8 years. MAIN OUTCOME MEASURES: Number of malignant tumours observed in the cohort during the study period and expected number from national incidence. RESULTS: There were 27 malignancies in the study group. There was no significant increase genital cancer in females compared with the national incidence. Only one patient had invasive cervical cancer (relative risk = 1.8; 95% confidence interval 0 to 10.1). Seventeen women had cervical carcinoma in situ (1.5; 0.9 to 2.5) compared with an expected number of 11.5; this increase was not significant. For males 22 cancers were observed at all sites (1.6; 1.0 to 2.5). The number of genitourinary cancers observed in males was almost three times higher than expected (2.6; 1.2 to 5.0). CONCLUSION: The results indicate that the risk of developing cervical carcinoma in situ or invasive cervical cancer after a genital human papillomavirus infection is less than previously thought. The implications of increase in the genitourinary malignancies in males are uncertain.

Adult↗
PubMed1991

Randomized study of mammography screening--preliminary report on mortality in the Stockholm trial.

In March 1981, 40,318 women in Stockholm, aged 40-64, entered a randomized trial of breast cancer screening by single-view mammography alone versus no intervention in a control group of 20,000 women. The attendance rate during the first screening round was 81 per cent and the cancer detection rate was 4.0 per 1000 women. The detection the rate fell to 3.1 per 1000 in the second round, which was completed in October 1985. During 1986 the controlled design of the study was broken and the control women were invited once to screening which was completed the same year. A total of 428 cases of breast cancer were thus diagnosed in the study group and 439 in the adjusted control group. After a mean follow-up of 7.4 years the number of breast cancer deaths in the study and control groups was 39 and 30 respectively. The relative risk of breast cancer death (screening versus control) was 0.71 (95 per cent confidence interval: 0.4-1.2). Among women older than 50 years at entry the relative risk was 0.57 (95 percent confidence interval: 0.3-1.1). Cancer deaths among women under 50 were few and perhaps because of this no mortality reduction was seen in this age group. The estimate of mortality reduction lies between the results from two earlier Swedish randomized controlled trials.

Adult↗
PubMed1991

Occurrence of other malignancies in 1973 patients with basal cell carcinoma.

To evaluate the possible association of other malignancies with basal cell carcinoma, we reviewed 1973 consecutive patients with basal cell carcinoma. We searched the Swedish Cancer Registry for records reporting malignancies in the study population (1958-1984) and the expected number of malignancies was calculated on the basis of age- and sex-standardized incidence data. In 452 patients with basal cell carcinoma another malignancy was diagnosed. The expected number was 323 (relative risk = 1.4; 95% confidence interval = 1.3 to 1.5). A significant association with basal cell carcinoma was found in four cancer types for men and in three for women. For skin malignancies other than malignant melanoma there was more than a sixfold increased risk for men (relative risk = 6.8; 95% confidence interval = 4.8 to 9.4) and more than a threefold increased risk for women (relative risk = 3.1; 95% confidence interval = 1.4 to 5.9) during the period after the diagnosis of basal cell carcinoma. During the period before the diagnosis of basal cell carcinoma, there were also increased risks (men: relative risk = 5.0; 95% confidence interval = 3.1 to 7.5; women: relative risk = 4.0; 95% confidence interval = 1.9 to 7.4). This was in contrast to the risks of malignant melanoma. Before the diagnosis of basal cell carcinoma there was no significant increased risk of malignant melanoma but after the diagnosis there was more than a sixfold increased risk for men (relative risk = 6.8; 95% confidence interval = 4.8 to 9.4) and more than a fourfold increased risk for women (relative risk = 4.2; 95% confidence interval = 1.5 to 9.2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Acute leukemia in professional drivers exposed to gasoline and diesel.

The environmental exposure to the petroleum products gasoline, diesel, and their motor exhausts was studied in a case-control interview of 125 patients with acute leukemia and 1 matched control per patient. Odds ratios were calculated by comparing discordant matched patient-control pairs. An excess risk for developing acute leukemia was found for the professional drivers, and odds ratio was determined to be 3.0 (95% CI: 1.1-9.2/p less than or equal to 0.02). For those who were exposed for more than 5 years in their life-time, or more than 1 yr during the 5-20 yr period prior to diagnosis, the odds ratio was 5.0 (p less than 0.05). This finding remains after consideration is given to exposures to organic solvents, smoking and therapeutic x-ray treatment. No excess risk was observed for persons professionally exposed to motor oil and machine oil without exposure to fuels and exhausts. No preferential type of acute leukemia was found to be associated with exposure to fuels and their exhausts. The results indicate an etiological relationship between the development of acute leukemia and exposure to petroleum products as fuels and exhaust.

Acute Disease↗
PubMed1991

Mortality among Swedish reindeer breeding Lapps in 1961-85.

We analyzed the mortality pattern among Swedish reindeer breeding Lapps, a unique group with a carefully preserved culture and a lifestyle that differs considerably from that of the rest of the population. The cohort consisted of 2,034 Lapps who were recorded in the 1960 Population and Housing census as members of a household where someone were occupied in reindeer breeding. The cohort was followed-up in the Swedish Cause-of-Death Register from January 1, 1961 until death or December 31, 1985. The total mortality was similar to that of the entire population. Four hundred and twenty eight deaths occurred and the standardized mortality ratio (SMR) was 0.95. Ischemic heart disease was the most frequent cause-of-death and the mortality was the same as in the general population (SMR = 0.95). Significantly lower mortality than expected was observed for malignant tumors (SMR = 0.70), diseases of the circulatory system (SMR = 0.68 and for diseases of the digestive system (SMR = 0.42). Significantly increased SMR was found for external causes of injury (SMR = 1.83) and among female Lapps for cerebrovascular diseases (SMR = 1.70). Female Lapps had a significantly higher mortality of diseases of the circulatory system (SMR = 1.19) in relation to males (SMR = 0.48).

Animal Husbandry↗
PubMed1990

Opiate addiction in adult offspring through possible imprinting after obstetric treatment.

OBJECTIVE: To test the hypothesis that opiate addiction in adults might stem partly from an imprinting process during birth when certain drugs are given to the mother. DESIGN: Retrospective study by logistic regression of opiate addicts with siblings as controls. SETTING: Stockholm, Sweden. SUBJECTS: 200 Opiate addicts born in Stockholm during 1945-66, comprising 41 identified during interviews of probands for an earlier study; 75 patients whose death from opiate addiction had been confirmed during 1978-88; and 84 accepted for the methadone programme. 262 Siblings (controls) born in Stockholm during the same period, 24 of whom were excluded for drug addiction or being brought up outside the family. Birth records were unavailable for eight, leaving 230 siblings and 139 corresponding probands. MAIN OUTCOME MEASURES: Administration of opiates, barbiturates, and nitrous oxide (for greater than 1 h) to mothers of all subjects during labour within 10 hours before birth as a risk factor for adult opiate addiction. RESULTS: In subjects who had subsequently become addicts a significant proportion of mothers had received opiates or barbiturates, or both, compared with unmatched siblings (25% v 16%, chi 2 = 5.83, df = 1, p = 0.02), and these mothers had received nitrous oxide for longer and more often. After controlling for hospital of birth, order of birth, duration of labour, presentation other than vertex, surgical intervention, asphyxia, meconium stained amniotic fluid, and birth weight the relative risk for offspring subsequently becoming an adult opiate addict increased with the number of administrations of any of the three drugs. When the addicts were matched with their own siblings the estimated relative risk was 4.7 (95% confidence interval 1.8 to 12.4, p for trend = 0.002) for three administrations compared with when no drug was given. CONCLUSIONS: The results are compatible with the imprinting hypothesis. Therefore, for obstetric pain relief methods are preferable that do not permit substantial passage of drugs through the placenta.

Analgesia, Obstetrical↗
PubMed1990

Pemphigoid and cancer.

To evaluate the significance of the association of malignant disease with bullous pemphigoid, we reviewed 497 consecutive cases with positive immunofluorescence tests for circulating antibodies to basement membrane. We searched the Swedish Cancer Registry, Stockholm, Sweden, for records reporting malignancies in the study population (1958 to 1985), and the expected number of malignancies was calculated on the basis of age- and sex-standardized incidence data. In 61 patients, a total of 69 malignancies were diagnosed. The expected number of malignancies was 82.6. In 25 patients, a total of 27 malignancies appeared during the same year as the onset of pemphigoid, or later. The expected number was 35.8. The median titer of circulating antibodies in the 497 patients, in the 61 patients with malignancy, and in the 25 patients with malignancy preceded by the pemphigoid, were not significantly different. We conclude that pemphigoid is not statistically associated with malignancy, and that the former hypothesis of such an association was based on age only.

Adult↗
PubMed1990

Prospective evaluation of serum CA 125 levels in a normal population, phase I: the specificities of single and serial determinations in testing for ovarian cancer.

To determine the potential efficacy of the CA 125 assay as one component of a strategy for early detection of ovarian malignancy, serum CA 125 levels were determined in 1082 women 40 years of age or older in Stockholm. Initial serum CA 125 levels exceeded 35 U/ml in 36 women (3.3%) and 65 U/ml in 11 women (1.0%), placing the exact 95% upper confidence limits on false positive rates for a single screen at 4.3 and 1.7%, respectively. Follow-up CA 125 levels were obtained for those women with initially elevated levels and a group of age-matched controls. Mean CA 125 levels declined significantly for women with initially elevated levels (P = 0.0014). Interindividual variation and variation within individual subjects over the entire follow-up period were 52 and 35%, respectively. Of the 36 subjects with initially elevated serum CA 125 levels, only 2 showed a doubling of these levels; in only 1 of these 2 was this increase sustained. Intensive clinical follow-up with pelvic examination and ultrasonography, with investigators blinded to CA 125 results, led to the diagnosis of Stage III ovarian cancer in the latter individual. Diagnosis was made 21 months after the initially elevated serum CA 125 measurement and 15 months after the first measured doubling of that level. Because no other malignancies were identified at entry or during the follow-up period (median 560 days) in the women with elevated CA 125 levels, the specificity of the assay over that time period would have been 99.9% using the doubling of an initially elevated value as the criterion for determining positivity and 100% using as the criterion a sustained increase in level for those with initially elevated levels that doubled. These results support the continued investigation of longitudinally collected CA 125 levels to identify individuals at high risk for ovarian malignancy.

Adult↗
PubMed1990

The prevalence of malignant tumors in patients with psoriasis.

A possible association between psoriasis and cancer was investigated by linking the Swedish Psoriasis Association's membership registry to the Swedish Cancer Registry. The population studied was 20,328 living persons. Since 1958 a cancer was recorded in 520 of them. The expected number, based on the prevalence of cancer in Sweden, was 540. Among 43 cancer sites for men and 46 for women selected primarily for analysis, a significant association with psoriasis was found only in two types of cancer. For male breast cancer the observed number was 4 and the expected number was 0.58, and for female kidney cancers the observed number was 17 and the expected number was 6.1. The statistically significant excess risk found for these two forms of cancer may be the result of multiple statistical testing rather than a phenomenon of true biologic significance. Thus psoriasis patients seem not to deviate from the general population with regard to cancer prevalence.

Adolescent↗
PubMed1990

Cancer risks in Swedish Lapps who breed reindeer.

Cancer risks during the period 1961-1984 were studied in a cohort of 2,034 Swedish reindeer-breeding Lapps, a unique group whose culture and life-style differ considerably from those in the rest of the Swedish population. A total of 100 cases of cancer were observed versus 163 expected. Statistically significantly decreased risks were found for cancers of the colon, respiratory organs, female breast, male genital organs, and kidneys, and for malignant lymphomas. The stomach was the only site with a significantly increased risk. Reindeer-breeding Lapps have ingested fallout products via the lichen-reindeer-man food chain since the 1950s. However, no increased risk was found for the cancer sites considered to be most sensitive to radiation.

Adult↗
PubMed1990

Chronic urticaria and cancer: an epidemiological study of 1155 patients.

To evaluate the possible association of malignant disease with chronic urticaria 1155 consecutive cases with chronic urticaria were reviewed. The Swedish Cancer Registry, Stockholm, was searched for records reporting malignancies in the study population (1958-84), and the expected number of malignancies was calculated on the basis of age- and sex-standardized incidence data. A malignancy was diagnosed in 36 patients with urticaria and the expected number of malignancies was 41. In 23 patients the malignancy appeared during the same year as the onset of urticaria or later. The expected number was 25.6. We conclude that chronic urticaria is not statistically associated with malignancy in general.

Adolescent↗
PubMed1990

Malignant tumours in Swedish dental personnel: a comparative study with the total population as well as with some specific occupational groups.

By linking the records between the Swedish census of 1970 and the cancer register for the period 1971-1984 the question was investigated as to whether an increased risk of, in the first hand, tumours of the liver, the kidneys or the nervous system could be found among dental personnel, and if so, whether it could be correlated with age. No significant higher risk could be demonstrated for any of these sites of tumours, neither for dentists, nor for dental nurses, dental technicians, nor for dental personnel collectively in comparison to the risk in the general Swedish population. For dental personnel the SIR value for primary liver tumours was 1.3, 95% CI: 0.6-2.4, for tumours of the kidneys the SIR was 1.0, 95% CI: 0.6-1.5, and for tumours of the nervous system the SIR was 1.1, 95% CI: 0.8-1.6. When these groups of tumours were taken together, a significantly increased risk (p less than was found only for male dentists, where 33 cases were observed against 22 expected. This increased risk does not seem to have any counterpart in any other category of dental personnel, and therefore the significant figures may be interpreted as a chance result. The noticeably increased and decreased risk levels which were found in other sites of tumours for dentists could also be demonstrated in other groups with university education with one exception: haemo-lymphatic malignancies for which male dentists display a significantly lower risk. For all types of malignant tumours of dental personnel there was a nonsignificantly increased risk, the SIR = 1.07, 95% CI: 0.99-1.15.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Risk of cancer of the breast after legal abortion during first trimester: a Swedish register study.

An increase in induced abortions in Sweden has been accompanied by an increase in the incidence of breast cancer of about 40% in women aged 20-44. To assess whether the apparent risk is real the risk of breast cancer was investigated in practically all Swedish women with a history of a legal abortion in the first trimester before the age of 30 during 1966-74 (n = 49,000). The cohort was followed up in the Swedish cancer register to identify cases of breast cancer diagnosed more than five years after the abortion until the end of 1984. The number of observed cases of breast cancer was 65 compared with an expected number of 84.5, estimated from the contemporary Swedish population with due consideration to age, giving a relative risk of 0.8 (95% confidence interval 0.58 to 0.99). Contrary to most earlier reports, this study did not indicate any overall increased risk of breast cancer after an induced abortion in the first trimester in young women.

Abortion, Legal↗