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Biomedical subjects

G Eklund

Publications and source records attributed to G Eklund.

At least 73 records · Page 4Linked to original sources
PubMed1987

Indoor exposure to radon from the ground and bronchial cancer in women.

A case-referent study on the possible association between radon emanating from the ground and bronchial cancer was carried out on 292 female lung cancer cases and 584 matched population referents. Both groups had lived for at least 30 years in the city of Stockholm, Sweden. The cases were diagnosed during 1972 to 1980 with oat-cell and other types of anaplastic pulmonary carcinomas. A sample of about 10% of the dwellings where cases and referents had lived was selected for measurements of radon and radon daughters. There was a relative risk of 2.2 (P = 0.01) for lung cancer associated with living in dwellings close to the ground in areas with an increased risk of radon emanation. Smoking habits did not appear to be a major confounding factor for this association, although a detailed evaluation was not possible. The measurements indicated increased radon daughter concentrations in ground level dwellings within radon risk areas where lung cancer cases had lived, suggesting that this exposure was of etiologic importance.

Adult↗
PubMed1987

Analysis of interval breast carcinomas in a randomized screening trial in Stockholm.

In the interval between screening examinations, some cases of breast cancer are invariably detected clinically in patients whose mammogram was considered to be normal at the earlier screening. During the first interval in the Stockholm study, 60 interval cancers were detected, giving a rate of 1.8 cases/1000 examinations/24 months. About half of these interval cases (31/60) were true interval tumours in that no sign of them could be found on the first mammogram; the other half, non-true, were possible to trace on the first mammogram. It is mainly women under 50 who feature in the interval group, above all in the sub-group of true interval cancers (p less than 0.05). The incidence of interval cancer rises, as expected, with the length of the interval (Fig. 1). In the final six months of the 2-year interval the incidence of interval cancers had risen to 88 per cent of the cancers detected in the control group in the same period of time. The cumulative incidence of interval cancers supports the hypothesis that the distribution of sojourn time in the interval 0-2 years is approximately rectangular. This means that shortening the interval by one-half would halve the number of interval cases. If mammography becomes a wide spread screening method for early detection of breast cancer, the number of non-true interval cancers could be a feed back on the effectiveness of the screening.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Photosensitive psoriasis. An epidemiologic study.

In this study of photosensitivity among psoriasis patients, a questionnaire was mailed to 2000 psoriasis patients living within the service area of Karolinska Hospital, Stockholm. Of the 88% patients who replied, 4.4% stated that their psoriasis always worsened after sun exposure, and 7.3% stated that this was sometimes so. After telephone interviews with an 80% sample of these allegedly photosensitive patients, half of them were considered nonphotosensitive. Thus an estimated prevalence of 5.5% photosensitivity was obtained. Forty-three percent of the light-sensitive patients had a history of polymorphous light eruption with secondary exacerbation of psoriasis lesions. Comparison between the photosensitive and the nonphotosensitive patients concerning background factors and symptoms showed a statistically significant increase (p less than or equal to 0.001) in the photosensitive group concerning skin type I, psoriasis affecting hands, heredity for photosensitivity, and advanced age.

Adolescent↗
PubMed1987

Perinatal origin of adult self-destructive behavior.

The study was undertaken to test whether obstetric procedures are of importance for eventual adult behavior of the newborn, as ecological data from the United States seem to indicate. Birth record data were gathered for 412 forensic victims comprising suicides, alcoholics and drug addicts born in Stockholm after 1940, and who died there in 1978-1984. The births of the victims were unevenly distributed among six hospitals. Comparison with 2,901 controls, and mutual comparison of categories, showed that suicides involving asphyxiation were closely associated with asphyxia at birth, suicides by violent mechanical means were associated with mechanical birth trauma and drug addiction was associated with opiate and/or barbiturate administration to mothers during labor. Irrespective of the mechanism transferring the birth trauma to adulthood--which might be analogous to imprinting--the results show that obstetric procedures should be carefully evaluated and possibly modified to prevent eventual self-destructive behavior.

Adult↗
PubMed1987

Mortality in relation to cigarette and pipe smoking: 16 years' observation of 25,000 Swedish men.

In a random sample of 25,129 Swedish men who responded to a questionnaire on smoking habits in 1963 the cause specific mortality was followed through 1979. In the cohort, 32% smoked cigarettes, 27% a pipe, and 5% cigars. There were clear covariations (p less than 0.001) between the amount of tobacco smoked and the risk of death due to cancer of the oral cavity and larynx, oesophagus, liver, pancreas, lung, and bladder as well as due to bronchitis and emphysema, ischaemic heart disease, aortic aneurysm, and peptic ulcer. Pipe smokers showed similar risk levels to cigarette smokers. There was a close to linear increase in lung cancer risk in relation to the amount of tobacco smoked for cigarette, pipe, and cigar smokers, respectively. An increasing risk of ischaemic heart disease with amount smoked was seen among both cigarette and pipe smokers. A similar fraction of inhalers in Swedish cigarette and pipe smokers may explain the similarity in risks.

Coronary Disease↗
PubMed1987

Smoking and the increased risk of contracting spontaneous pneumothorax.

The relation between smoking habits and the occurrence of spontaneous pneumothorax (SP) was studied in a Swedish population, predominantly urban. The study group consisted of a consecutive series of 138 patients admitted to Huddinge University Hospital over ten years for treatment of their first spontaneous pneumothorax. Their smoking habits were routinely analyzed. The sample consisted of 15,204 persons domiciled in the same circumscribed area (County of Stockholm). The annual incidence of first SP in the admission area is 6/100,000 for women and 18/100,000 for men. The study showed that smoking increased the relative risk of contracting a first spontaneous pneumothorax approximately ninefold among women and 22-fold among men and that there is a striking, statistically significant (p less than 0.001) dose-response relationship between smoking and the occurrence of SP. The life span risk of contracting SP among lifelong heavily smoking men is roughly estimated to be 12 percent but only 1/1,000 among never smokers.

Adolescent↗
PubMed1986

Incidence of malignant skin tumors in 14,140 patients after grenz-ray treatment for benign skin disorders.

During the years 1949 to 1975, 14,237 patients received therapeutic doses of grenz rays for the treatment of benign skin disorders such as chronic eczema, psoriasis, and warts. The records of 14,140 of these patients (99.3%) formed the basis for an epidemiologic study of the incidence of skin malignancies in this population. Information about the patients, diagnoses, doses, and sites of treatment was obtained from separate records. The follow-up time was 15 years on the average. We searched the Swedish Cancer Registry, Stockholm, for records reporting the incidence of malignant skin tumors in the study population (incidences of basal cell carcinoma are not registered). The expected number of malignancies was calculated on the basis of age- and sex-standardized incidence data from the Swedish Cancer Registry. In 58 patients, a malignant skin tumor was diagnosed more than five years after grenz-ray therapy had first been administered. Nineteen patients had malignant melanomas, and 39 patients had other malignant skin tumors. The expected number of melanomas was 17.8, and that of other malignant skin tumors was 26.9. None of the patients with melanomas, and only eight of the patients with other malignant skin tumors, had received grenz-ray therapy at the site of the tumor. Six of these eight patients had also been exposed to other known carcinogens. Four hundred eighty-one patients had received an accumulated high dose of grenz rays (greater than or equal to 10 000 rad [greater than or equal to 100 Gy]) on one and the same area. No malignancies were found on those areas. Although we cannot exclude grenz-ray therapy as a risk factor in the development of nonmelanoma skin malignancies, this risk, if any, is small, if recommendations for therapy are followed.

Adolescent↗
PubMed1986

Measures of continuity of care. A register-based correlation study.

In an empirical study using data from a health center in Sweden, correlation coefficients were computed among nine different measures of continuity of care, five of them visit-based and four individual-based. Generally, the correlations were high. This may be due, in part, to the similar behavior of the measures for people making few visits. The correlations were also quite high, however, when the sample was restricted to people with many visits. Several measures display a significant dependence on utilization level. The results suggest that, for general purposes, the measure COC should be preferred among the individual-based measures and fraction-of-care continuity among the visit-based measures. On grounds of flexibility and ease of interpretation, the authors recommend fraction-of-care measures.

Continuity of Patient Care↗
PubMed1986

Early feeding problems in an affluent society. II. Determinants.

The aim of this investigation was to identify different factors of importance for the occurrence of feeding problems during the first year of life. Forty-two infants, 3-12 months old, with feeding problems without any obvious medical explanation were matched to 42 controls with respect to age, sex and Child Health Centre (CHC) affiliation. Information was obtained by interviewing the parents and from medical records. Four factors emerged as being highly significant, namely "feeding problems presented by the parents during their own infancy" (p less than 0.001), "great anxiety experienced by the mother during the pregnancy" (p less than 0.02), "breast-feeding problems experienced by the mother" (p less than 0.001) and "ill-health in the mother" (p less than 0.001). A special study in which the maternal and paternal grandparents were interviewed, corroborated the parents' information on their own early feeding difficulties. This finding could explain a large proportion of the feeding problems that have no obvious medical origin.

Analysis of Variance↗
PubMed1986

The risk of endometrial neoplasia and treatment with estrogens and estrogen-progestogen combinations. First results of a cohort study after one to four completed years of observation.

This prescription-based cohort investigation was undertaken in order to study whether climacteric estrogen treatment of women in a Swedish population might be associated with an increased risk of endometrial cancer, and whether added progestogens can afford any protection from developing estrogen-related endometrial neoplasia. Some 23 000 women who had been prescribed estrogens were followed up regarding the outcome of neoplastic lesions of the endometrium. The results are based on an observation period of one to four completed years, corresponding to 89 000 person-years. Among those cohort members exposed to estrogens alone, regardless of the duration, the relative risk of endometrial cancer was 1.3 (95% confidence interval 0.9 to 1.7). The inclusion of premalignant endometrial changes resulted in a significantly increased relative risk of 1.6 (1.2-2.1). The relative risk estimates in association with estrogen-progestogen combinations were 0.6 (0.2-1.4) for endometrial cancer and 0.8 (0.4-1.5) when including premalignant lesions. These data indicated a possible protective effect of progestogens against the development of endometrial neoplasia. It was concluded that estrogens were - within an observation period of 4 years - associated with an increased risk of premalignant endometrial lesions.

Adult↗
PubMed1985

Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare.

A randomised controlled trial to investigate the efficacy of mass screening with single-view mammography in reducing mortality from breast cancer was started in Sweden in 1977. 162 981 women aged 40 years or more and living in the counties of Kopparberg and Ostergötland were enrolled in the study and divided at random into 2 groups. Each woman in the study group was offered screening every 2 or 3 years depending on age. Women in the control group were not offered screening. This report is confined to the 134 867 women aged 40-74 years at date of entry. The results to the end of 1984 show a 31% reduction in mortality from breast cancer and a 25% reduction in the rate of stage II or more advanced breast cancers in the group invited to screening. 7 years after the start of the study the excess of stage I cancers in the study group largely outweighs the deficit of advanced cancers.

Aged↗
PubMed1985

Screening for intrauterine growth retardation in late pregnancy.

A prospective study was performed on an unselected area-based population in order to improve the antenatal diagnosis of intrauterine growth retardation (IUGR). The clinical importance of simple clinical tests to follow fetal growth (measurements of the symphysis-fundus (SF) distance and recordings of maternal pregnancy weight gain) was investigated. Risk factors for IUGR, appearing in late pregnancy (vaginal bleeding, non-proteinuric pregnancy hypertension and pre-eclampsia) were also studied. A pathological SF curve (frequency 3.5%) was found to be valuable, but mainly as a screening instrument rather than a diagnostic tool for IUGR. Pre-eclampsia was the only risk factor appearing in late pregnancy that could be associated with IUGR. Previously we have recommended early pregnancy screening for the following high risk factors for IUGR: smoking, previous birth of a low birth weight infant, low pre-pregnancy weight, renal disease and addiction. When also screening for pre-eclampsia, 22% of the population exhibited at least one screening factor. Retrospectively we identified all severely growth-retarded infants (birth weight for gestational age less than or equal to -2 S.D.) born in 1980 (n = 27). 23 of these infants were delivered to mothers exhibiting high-risk factors for IUGR or a pathological SF curve. In this way a high-risk group for IUGR can be identified, which should be monitored more carefully during the last period of pregnancy.

Body Weight↗
PubMed1985

Early neonatal deaths in geographically defined populations with different organization of medical care.

A comparison of early neonatal deaths was performed in fourteen Swedish referral districts over six years (1973-1978). Two populations of newborn infants were compared: those born of mothers resident in referral districts of general hospitals with specialized obstetric service but without own neonatal wards; and those born of mothers living in districts of central hospitals with specialized obstetric and neonatal care in the same hospital. The early neonatal death rates of these two populations did not differ significantly. However, a tendency was observed indicating a lower mortality in the former group, necessitating further analysis.

Female↗
PubMed1985

Smoking, maternal age, and fetal growth.

In a prospective clinical study from an unselected area-based population, the influence on birth weight for gestational age (standardized birth weight) was studied with special respect to risk factors for intrauterine growth retardation. Smoking was the most important risk factor: 16% of the mothers smoked at least ten cigarettes per day, and the influence of smoking on standardized birth weight was highly significant (P less than .001). Maternal age in itself had no effect on standardized birth weight. However, among smokers the reduction in standardized birth weight became more pronounced with increasing maternal age (P less than .001). Longterm smoking has been reported to increase the risk of severe placental complications. This study emphasizes that elderly smokers also must be considered to be at a higher risk than younger smokers for developing fetal growth disturbances.

Aging↗
PubMed1984

Papanicolaou smear screening and cervical cancer. What can you expect?

More than 90% of the total female population of three Swedish counties between the ages of 30 and 59 years, 53% of women between 60 and 69 years, and 25% of women older than 70 years were screened for cervical cancer with the Papanicolaou smear over a ten-year period. The uniqueness of the study is that in Sweden it is possible to follow up the entire population during their lifetimes via a population register, which has its roots in the 17th century, natural to Swedes but almost incomprehensible in the United States or United Kingdom. Every Papanicolaou smear taken was computer recorded and linked on an individual level to the cancer registry. There were 207,455 women followed up for ten years. No women were lost to follow-up. There was a 75% decrease in invasive cervical cancer incidence among women who had smears taken at least once during the ten-year period. Among those women who had never had smears taken, the incidence of invasive cervical cancer was four times as great as among those women who had been examined at least once. We estimate that the system proposed by Swedish Medical Board (at least one smear every three years) for cervical cancer screening can reduce the incidence of invasive cervical cancer to a level between one and five cases per 100,000 women per year in a completely screened population.

Adult↗
PubMed1984

Early pregnancy screening for intrauterine growth retardation.

In a prospective clinical study from Uppsala County, Sweden, in 1980, all pregnancies were screened early in pregnancy for 15 previously reported risk factors for intrauterine growth retardation (IUGR). This risk group (n = 639) was then compared with a randomly selected control group (n = 539). In the risk group, there were increased risks for the delivery of growth retarded infants, low birthweight infants and infants spontaneously delivered as prematures. 30% of the population exhibited risk factors. Smoking was the most important risk factor, 16% of the mothers smoked at least ten cigarettes per day and smoking was the main risk factor in the majority of cases with IUGR.

Birth Weight↗
PubMed1984

Factors influencing birthweight for gestational age, with special respect to risk factors for intrauterine growth retardation.

In a prospective clinical study from an unselected, area-based population, the influence on birthweight for gestational age of different factors was studied, with special respect to 15 risk factors for intrauterine growth retardation (IUGR) recognizable in early pregnancy. In the multiple regression analyses performed, birthweight for gestational age was used as the dependent variable. Only 10% of the variance in birthweight for gestational age could be explained. A correlation was found between the number of risk factors and birthweight for gestational age. Four risk factors had a significant negative influence on birthweight for gestational age: smoking, previous birth of a low birthweight infant, a low prepregnancy weight and addiction. No single risk factor influenced birthweight for gestational age as much as parity. When a risk factor was present the expected increase in birthweight for gestational age with increasing parity did not appear.

Birth Weight↗