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Biomedical subjects

G Tibblin

Publications and source records attributed to G Tibblin.

At least 73 records · Page 4Linked to original sources
PubMed1991

Prevalence and incidence of diabetes in a Swedish community 1972-1987.

The prevalence and incidence of diabetes mellitus were studied from 1972 to 1987 in Laxå, a rural community with 8500 inhabitants located in mid-Sweden. Data were collected from clinical records at the primary health care centre in Laxå, from departments of internal medicine and paediatrics and from a general practitioner's office in the area. In addition, a case finding procedure involving 85% of the residents aged 35-79 years was performed in 1983-1987. The age-standardized prevalence of diabetes rose significantly (p less than 0.001) from 26 per 1000 in 1972 to 43 per 1000 in 1987. The largest rise in prevalence for males occurred in the age group 45-54 years and for females in the age group 65-74 years. The age-standardized mean annual incidence of diabetes was 3.46 per 1000 population. A small (non-significant) increase in incidence of Type 2 diabetes over time was seen in men which may in part be an effect of the case finding strategy. The overall incidence rates thus appeared to be rather stable while the prevalences tended to increase, probably mainly due to earlier detection of diabetic individuals in recent years, leaving a larger number of patients with a longer duration of diabetes to be cared for in the future.

Age Factors↗
PubMed1991

Are geographical differences in cardiovascular mortality due to morbidity differences or to methodological differences? The project "myocardial infarction in Mid-Sweden".

Geographical variations in cardiovascular mortality have been reported from Mid-Sweden. IHD mortality for men aged 45-64 was 60% higher in the western part than in the east. Mortality from stroke for men aged 45-74 was 73% higher on the west. Similar differences were found for women. One possible explanation could be that there are no incidence differences but that the mortality differences are due to different survival rates or to differences certifying the cause of death. These two possible explanations were tested in this study. Data for all patients hospitalised during the 10-year period 1972-1981 for myocardial infarction or stroke in a high mortality area, the County of Värmland in the west, and a low mortality area, the County of Uppsala in the east, were collected. In addition, a substudy was performed where the basis for the death certificate diagnosis was studied. The western area generally had a higher case fatality rate than the eastern. However, a larger proportion of the deaths the eastern area, occurred outside hospital, so that the net effect would be that the differences found were not large enough to explain the mortality differences. The autopsy rate in the western part was lower than in the east but since a larger proportion of the deaths occurred in hospital the rank order for IHD and stroke mortality between east and west was the same whether all IHD or stroke deaths were counted or only those considered the most well documented.

Aged↗
PubMed1991

Triglycerides, a major coronary risk factor in elderly men. A study of men born in 1913.

We examined two 'cohorts' of elderly men, 60 and 67 years old. The two 'cohorts' overlapped to a large extent in terms of numbers but not in the follow-up periods. The mean have been followed-up for 7 and 8 years respectively. Among the 748 60-year-old men without prior myocardial infarction the 7-year incidence of coronary heart disease was 8%. The incidence was related to blood pressure, smoking habits and serum triglycerides (but not serum cholesterol) both in univariate and multivariate analyses. The incidence of coronary heart disease increased 5-fold from the lowest to the highest quintile of triglycerides. Among the 595 67-year-old men without prior myocardial infarction the 8-year incidence of coronary heart disease was 11%. Both serum cholesterol and triglycerides were significant risk factors in univariate analyses but only triglycerides in multivariate analyses. The incidence of coronary heart disease increased almost three-fold from the lowest to the highest quintile of triglycerides. Increased serum triglycerides is a major coronary risk factor in elderly men.

Aged↗
PubMed1990

Non-pharmacological treatment of hypertension: differences between health centres in patients' blood pressure and success at withdrawal from drugs.

Four hundred patients from eight health centres were recruited for this two-year study on the possibility of replacing antihypertensive drugs by non-pharmacological therapy. This consisted of monthly check-ups and blood pressure measurements at home by the patients plus advice about changes of lifestyle--salt restriction, weight reduction, physical activity, and reduction of alcohol and tobacco. The non-pharmacological treatment was effective and 44% had discontinued drugs after two years without any increase in diastolic blood pressure. Twenty-five per cent reduced their weight by 4% or more. There were no changes in sodium or potassium output. Thirty-five per cent increased their physical activity and 20% decreased it. When the results for each health centre were compared, striking differences in hypertensive characteristics of patients and the outcome of antihypertensive drug treatment were found. In one health centre 69% of patients were not taking drugs after two years. In some health centres the non-pharmacological treatment was quite successful, but in others the attempt failed. A prerequisite for successful use of pharmacological treatment is that the problem of non-compliance should be solved.

Adult↗
PubMed1990

Symptoms by age and sex. The population studies of men and women in Gothenburg, Sweden.

Symptoms by age and sex were studied in two population studies from Gothenburg, Sweden. In general, men and women showed the same age-related pattern. The prevalence of the following symptoms increased with age--sleeping disturbances, pain in the joints, pain in the legs, breathlessness, and impaired hearing. Six symptoms decreased with age--general fatigue, abdominal pain, nausea, diarrhoea, cough, and headache. A group of symptoms showed a curvilinear shape with a peak at the age of 50. In general, women presented more symptoms than men. This was especially true for symptoms of depression and tension. A possible explanation is that women are more attentive to their internal state. A more probable explanation, supported by our study, is that the mental symptoms are related to the woman's situation in life with double work (responsible for both work and family).

Adult↗
PubMed1990

Optimal felodipine dose when combined with metoprolol in arterial hypertension: a Swedish multicenter study within primary health care. Swedish General Practitioner Felodipine Study Group.

In a multicenter study comprising 23 Swedish primary health care centers, felodipine extended-release (ER) tablets in doses of 5, 10, and 20 mg were compared double-blind with placebo when given in addition to metoprolol controlled-release (CR) tablets 100 mg. All medication was given once daily in the morning. Altogether, 251 hypertensive patients with a diastolic blood pressure greater than 95 mm Hg after 4 weeks of treatment with placebo in combination with metoprolol CR 100 mg were randomized to four parallel groups. After 4 weeks of treatment, there were significantly greater reductions in blood pressure with all doses of felodipine ER than with placebo, both 2 and 24 h after intake of the tablets. Twelve patients were withdrawn because of adverse reactions. Of these, one patient was taking placebo, one 5 mg of felodipine ER, four 10 mg of felodipine ER, and six patients 20 mg of felodipine ER. When combined with metoprolol, 5 mg of felodipine ER seemed to be less effective than higher doses, but was very well tolerated. Adding 10 mg of felodipine ER to the basal metoprolol appeared to be optimal if both the effect and adverse reactions were taken into consideration.

Adult↗
PubMed1990

"The Göteborg quality of life instrument"--an assessment of well-being and symptoms among men born 1913 and 1923. Methods and validity.

"The Göteborg quality of life instrument" (GQL-instrument) has been used to assess the quality of life of men born in 1913 and 1923. On a population basis, it was possible to show that the well-being variables were stable over time and that excellent well-being showed a great variation. A high level of well-being was common in variables such as family and housing but more uncommon in variables such as fitness, vision, hearing and memory. Symptoms were often significantly related to biomedical variables such as body mass index, blood pressure, lung function, blood lipids, fasting blood sugar and fasting insulin. The GQL-instrument seems to provide a reliable and stable assessment of well-being and symptoms and is useful both as a descriptive tool, and as a help in evaluating treatment, and it also has predictive power.

Aged↗
PubMed1990

Göteborg quality of life study of men born in 1913 and 1923--age, sex, job satisfaction and cardiovascular diseases.

To see whether well-being and symptoms are affected by age, job satisfaction, and cardiovascular diseases a quality of life assessment of men born in 1913 and 1923 and living in Göteborg was performed. Age influenced both well-being and symptoms in different ways. Many well-being variables declined and many symptoms decreased with age. Symptoms were strongly related to both global health and job satisfaction--more symptoms were found in participants with low global health or low job satisfaction. Participants with cardiovascular disease and diabetes mellitus showed considerable variation in their quality of life. Hypertensive and diabetic patients showed only small deviations in the well-being and symptom profile. Congestive heart failure patients generally had a low quality of life. It was not possible to decide if the lack of well-being was caused by the diseased state, the treatment, or the patients' awareness of having a specific disease.

Adult↗
PubMed1990

Is quality of life affecting survival? The study of men born in 1913.

In this study the prognostic significance of a set of quality of life measures was tested with regard to mortality regardless of its cause, cardiovascular mortality, cancer mortality and mortality from other causes. From the population register of Gothenburg, Sweden, a sample was drawn consisting of one third of all 60-year-old men. The 945 men who met the criteria were invited to a medical examination. Information on the occurrence of 30 symptoms and 15 measures of well-being was obtained by questionnaire. Mortality data were obtained through official registers, death certificates and medical records. Of the symptoms at 60, breathlessness, cough, depression, bad appetite and feeling cold, all were significantly related to mortality during 15 years of follow-up. Of the well-being variables, the same was true of perceived health, physical fitness and appetite. This means that the quality of life has a strong bearing not only on the present life situation for these men but also for their future health.

Age Factors↗
PubMed1989

Obesity, adipose tissue distribution and health in men--the study of men born in 1913.

Recent studies suggest that cardiovascular disease is associated with abdominal distribution of adipose tissue rather than obesity in terms of total body fat. A number of other variables, known to be associated with obesity, were therefore examined in a cohort of randomly selected middle-aged men in relation to abdominal distribution of adipose tissue, measured as the ratio of the circumferences of the waist and hips (WHR), as well as to degree of obesity, measured as body mass index (BMI). These variables included anthropometric variables, cardiovascular risk factors as well as socioeconomic factors and physical health. Increased WHR, independent of BMI, was negatively associated with height, and hip circumference. Positive associations were found with blood pressure, cholesterol, triglycerides, fibrinogen and smoking. In addition positive associations were found with low social class and social group, illness in terms of sick leave, frequent use of health facilities such as X-rays, as well as diseases such as peptic ulcer. In sharp contrast to this, BMI, independent of WHR, was not associated with physical health variables or social class. Generalized obesity seemed to be associated with good health in the variables measured. There were positive associations to various anthropometric variables, including lean body mass. High BMI was also associated with elevated blood pressure and triglycerides. Several of the indicators of poor health traditionally associated with obesity thus do not seem to be characteristic for obesity in middle-aged men selected at random from the population but rather for an abdominal fat distribution, independent of obesity.

Abdomen↗
PubMed1989

Effect of patients' expectations on recovery from acute tonsillitis.

To investigate whether the personal attention paid to a patient can affect his or her subjective recovery from acute tonsillitis, a controlled study was performed on 100 patients consulting a doctor for this disease. At the consultation a randomly assigned experimental group (n = 50) was given more detailed information about the diagnosis, treatment and prognosis and also a more extensive physical examination than a control group (n = 50). At a follow-up interview two days later significantly more of the experimental group felt that their symptoms had improved (P less than 0.005) than the control group, significantly more felt that the treatment had helped them (P less than 0.005) and significantly more felt they had received sufficient information about their illness and treatment (P less than 0.001). A deliberate attempt to maximize the expectation effect was thus shown to influence the clinical course of acute tonsillitis, recorded as the degree of subjective improvement.

Adult↗
PubMed1989

Validity of a postal questionnaire with regard to the prevalence of myocardial infarction in a general population sample.

In order to evaluate the possibility of finding persons who have suffered a myocardial infarction (MI) by postal questionnaire, a self-administered questionnaire was sent to a random sample of 4400 men aged 45-64 years, drawn from the general population. The response rate was 95%. 176 men indicated that they had been hospitalized for MI, out of which 124 cases could be verified from medical records. Of the remaining men, 33 had evidence of cardiovascular disease (CVD) in their records but no MI, and 19 men had no evidence of CVD. The sensitivity (estimated from a subsample) was 100% and the specificity 98.7%. The predictive value was 100% for a negative response and 70.5% for a positive response. The 33 positive responders whose MI could not be verified but who had evidence of CVD had characteristics fairly similar to the responders with verified MIs. However, the 19 positive responders whose MI could not be verified and who had no evidence of CVD had characteristics that were dissimilar from the MI group as well as from the negative responders. The questionnaire thus identified all the MI cases. The need for validation can be limited to the relatively small group of positive responders.

Cardiovascular Diseases↗
PubMed1989

Risk factors for heart failure in the general population: the study of men born in 1913.

In 1963 a sample of 973 men, all 50 years old, was drawn from the population register of Gothenburg, Sweden. These men have been followed up for 17 years with repeated examinations regarding a number of variables possibly related to cardiovascular disease. The latest examination, at the age of 67 years, focused on congestive heart failure (CHF). The incidence rate of manifest CHF varied from 1.5 to 10.2 cases (1000 population)-1 yr-1, depending on which age group was being studied. For the age group 50-67 years the incidence of manifest CHF was 5.5 (1000)-1 yr-1. A large number of factors associated with the risk of acquiring CHF were identified. In multivariate regression analyses, hypertension and smoking were the major independent risk factors. Body weight, heart volume, T-wave abnormalities, heart rate variability, peak expiratory flow rate, psychological stress and Fy-antigen (a genetic marker?) were also independent risk factors. Possible strategies for prevention are discussed.

Aged↗
PubMed1989

Addition of non-pharmacological methods of treatment in patients on antihypertensive drugs: results of previous medication, laboratory tests and life quality.

Four hundred patients from eight health centres were recruited for this 2-year study on the possible replacement of antihypertensive drugs by non-pharmacological therapy. All the patients were given a device to measure their blood pressure at home and had monthly checks at a health centre. Two hundred patients on antihypertensive drugs (G1) started additional non-pharmacological therapy after 1 year in the study, while the rest (G2) had used it from the beginning. Antihypertensive drugs were withdrawn according to predetermined criteria. The drop-out rate was 1.5% each year. Medication was withdrawn completely from 42.7% of G1, and in 21.5% it was withheld for at least 18 months. The corresponding figures for G2 were 46.4% and 25.5% respectively. Most of the medication withdrawal in G1 occurred during the first year, when the group's management consisted solely of blood pressure measurements at home and frequent visits to the health centre. Serum triglycerides decreased on non-pharmacological treatment in both sexes in both groups. Life quality improved, particularly for the group (n = 173) that had the drugs withdrawn.

Adult↗
PubMed1989

Colonization with potentially pathogenic respiratory tract bacteria. A household study.

A group of 235 persons (180 adults and 55 children 0-15 years old) recorded symptoms of upper respiratory tract infection daily during two three-month periods (autumn 1986 and spring 1987). Samples for culture were taken from the nasopharynx and throat once during each period. Fifteen per cent of asymptomatic subjects harboured respiratory pathogens in the nasopharynx, as did 28% of those subjects with minor respiratory tract infections and 46% of those with more severe respiratory tract infections. Of children up to seven years of age, 58% were colonized with potential respiratory pathogens, which is important to keep in mind when evaluating culture reports from young children. Adults living with young children were colonized significantly more often than other adults. Branhamella catarrhalis was the most common pathogen.

Adolescent↗
PubMed1989

High alcohol consumption, liver toxic drugs and brain damage--a population study.

Computed tomography (CT) of the brain was performed in a random sample of 195 men to investigate the relationship between alcohol drinking and brain damage. This sample from the general population was divided into subsamples on the basis of their self-reported loss of control over drinking, morning drinks and blackouts. Three groups with different degrees of alcohol consumption were distinguished and the only differences in CT findings were a significantly higher frequency of frontal lobe atrophy with increasing alcohol consumption. The consumption of hepatotoxic drugs was also investigated and the following were the types of drug used: antiarrhythmics, antiepileptics, antibiotics, antiphlogistics, mixed analgetics, sulphonamides, benzodiazepines and derivatives of phenothiazines, all of which are metabolized by way of the liver. The material was divided into four groups with regard to both alcohol consumption and use of hepatotoxic drugs: Group IA, low or moderate alcohol consumption and no use of such drugs; IB, low or moderate alcohol consumption with use of such drugs; IIA, high alcohol consumption with no use of such drugs; and IIB, high alcohol consumption with use of such drugs. Group IIB was found to have a higher incidence of cortical and subcortical changes than group IA. The results indicate that drug use influences the incidence of cortical and subcortical aberrations. It is concluded that there is a typical frontal lobe atrophy associated with alcohol abuse; thus with increasing alcohol ingestion there is accelerated shrinkage of the brain, the frontal lobe being the first part affected. The groups with alcohol abuse who used hepatotoxic drugs show a picture of cortical changes and also of subcortical aberrations, expressed as an increased anterior horn index and widening of the third ventricle.

Adult↗