Search PubMed⌕ Search

Biomedical subjects

H Aberg

Publications and source records attributed to H Aberg.

At least 37 records · Page 2Linked to original sources
PubMed1997

Asthma education for Swedish primary care physicians--a study on the effects of "academic detailing" on practice and patient knowledge.

OBJECTIVE: To assess the effect of an intervention on general practitioners' (GPs) knowledge about the diagnosis and treatment of asthma, including the prescribing of anti-asthmatic drugs, and asthmatic patients' knowledge about their disease. METHODS: The study took place in the south-west region of Stockholm County. In the area where the intervention took place (area 1), 44 GPs at 21 health centres were visited by a clinical pharmacologist and a pharmacist presenting oral and written information. The basic messages were: (1) the central role of inhaled glucocorticoids; (2) the use of peak expiratory flow (PEF) meters; and (3) the use of reversibility tests. In the control area (area 2), there were 19 GPs at nine health centres. The GPs knowledge about the intervention message was evaluated by a questionnaire pre- and post-intervention. The ratios of prescribed inhaled be beta-adrenoceptor agonists to inhaled glucocorticoids were determined. At the 26 local pharmacies, all asthmatic patients who presented a prescription for anti-asthmatic drugs, issued at the 30 health centres, were given a questionnaire before and after the intervention regarding their knowledge of asthma and its treatment. RESULTS: GPs in area 1 showed significantly more knowledge about item numbers 2 and 3 in the above-described intervention message than did the GPs in the control area 2. The data on prescriptions showed lower ratios of beta-adrenoceptor agonists to glucocorticoids in area 1 than in area 2. The difference, however, between area 1 and area 2 was not significant. After the GP intervention, the patients' knowledge about asthma had increased in area 1, as assessed by the questionnaire filled in by the patients. However, there was no significant difference from that in area 2. CONCLUSIONS: The study shows differences between the intervention and control areas regarding the knowledge and practice of GPs after the intervention. We found changes in knowledge, attitudes and actual practice, the latter being measured by the prescriptions.

Asthma↗
PubMed1997

Oral contraceptives and back pain in women in a Swedish community.

BACKGROUND: Female back pain is a clinical problem-especially low back pain with symptoms from the pelvic posterior region-that is often aggravated in connection with pregnancy and childbirth. Hormones have been suggested as an aetiologic factor. This study is aimed to determine whether additional hormone preparations, i.e. oral contraceptives (OC), may contribute to the increased frequency of such pain. METHODS: A register study was conducted to investigate the use of drugs and health care use in a female population with known OC consumption. Specifically, we registered the number of primary health care visits for low back pain, comparing OC users with non-OC using age-matched women with otherwise equal circumstances. RESULTS: OC users recorded a significantly higher incidence of low back symptoms during the study period compared to non-users. Pregnancy was not found to be a confounding factor. CONCLUSIONS: The intriguing association between OC use and a higher incidence of low back pain, does not enable us to conclude that there is a causal connection, but it should lead to further studies.

Adolescent↗
PubMed1997

Quality of life among patients with glaucoma in Sweden.

PURPOSE: To assess the health-related quality of life (HRQOL) in an unselected sample of patients with glaucoma. METHODS: The HRQOL was studied in a cross-sectional survey in 270 patients from two departments of ophthalmology in different parts of Sweden by using the Swedish Health-Related Quality of Life Survey, a generic HRQOL-instrument adapted from the Medical Outcomes Study. RESULTS: Compared to a random Standard Population Sample, the glaucoma patients showed lower mean score only in the scale of 'Pain' (p < 0.05, effect size 0.17), but higher mean score in 'Sexual functioning' (p < 0.01, effect size 0.35). Significant factors correlated to a lower score on HRQOL-scales were decreased visual acuity and visual field, and comorbidity of cardiovascular and non-vascular systemic diseases. Regarding the topical medications, beta-blockers with or without miotic agents had no negative impact on the HRQOL. CONCLUSION: Our findings indicate that health-related quality of life in glaucoma patients in general is good, especially when vision is intact, and that topical beta-blockers do not have any negative influence.

Aged↗
PubMed1997

Psychic and socioeconomic consequences with diabetes compared to other chronic conditions.

The present study relies on data for the years 1988 and 1989 from the Swedish continuous Surveys of Living Conditions (SLC), which are based on random samples from the population among individuals aged 16 through 84 years. We compared the rates of self-reported mental health for subjects reporting diabetes (n = 361), a musculoskeletal condition but without diabetes (n = 2187), hypertension but without diabetes (n = 980), and healthy free from any medical condition (n = 6664). Comparisons are based on age- and gender-standardized rates, using the diabetes group as standard. The results show that more diabetic respondents had psychic symptoms and long-standing psychiatric disorders than the healthy respondents, with otherwise no differences compared to the other chronic conditions. The diabetic respondents had lower mean disposable income, and a higher rate of disability pension than the respondents with hypertension, and than the healthy. They also reported more sick leave days than the healthy respondents.

Adolescent↗
PubMed1997

Quality of life in diabetic patients registered with primary health care services in Sweden.

OBJECTIVE: To evaluate the health-related quality of life in diabetic subjects in primary health care. DESIGN: A cross-sectional, questionnaire survey of diabetic patients registered with primary health services, compared with a standard population sample. SETTING: Three community health centres in the Metropolitan Stockholm area. SUBJECTS: 341 diabetic individuals aged 21-84 years, with 229 respondents, i.e. 67%. Matched controls of the same age and sex from a standard population sample of 2366 individuals. MAIN OUTCOME MEASURES: Quality of life was assessed by the Swedish Health-Related Quality of Life Survey (SWEDQUAL), adopted from the Medical Outcomes Study and consisting of 61 items covering aspects of physical, mental, social, and general health. Medical data were extracted from the medical records. RESULTS: Diabetic patients had significantly lower scores on all scales (p < 0.001 for ten, and p < 0.01 for one), except for social health, when compared with the standard population sample. Outcomes were correlated with vascular and non-vascular comorbidity, age, and income, but not with level of metabolic control. CONCLUSIONS: Diabetic patients in primary health care have a markedly lower health-related quality of life, compared with a standard population.

Adult↗
PubMed1996

Nocturnal micturition, sleep and well-being in women of ages 40-64 years.

OBJECTIVE: To study the relationship between sleep and nocturnal micturition in women 40-64 years old. METHODS: A questionnaire study was carried out in 3669 (6000 invited) randomly selected women in the County of Jämtland in Sweden. Questions were asked about the general state of health, nocturnal micturition, sleep, menstruation and menopausal symptoms, and also about visits to doctors and the use of sleeping pills and hormone preparations. RESULTS: The subjective evaluation of the general state of health and of a feeling of contentedness and of confidence in the future worsened with increasing numbers of nocturnal voiding episodes. Sleep was more strongly correlated to the number of nocturnal voiding episodes (R2 = 0.099; P < 0.0001) than to age (R2 = 0.021; P < 0.0001) or the menopause (R2 = 0.017; P < 0.0001). Daytime sleepiness was three times more common among women with three or more nocturnal voiding episodes than among those with no nocturnal micturition. Women who voided three or more times in the night consulted a doctor twice as frequently as those without nocturnal micturition and were treated with drugs 2.5 times as often. The corresponding figures for sick-listing were 75 and 15 days per year, respectively. CONCLUSION: Frequent nocturnal micturition is common in 40-64-year-old women and impair sleep with subsequent decrease in daytime performance and general well-being.

Activities of Daily Living↗
PubMed1996

Drug use in patients with diabetes.

OBJECTIVE: To describe the use of pharmaceutical medications by patients with diabetes in Sweden. RESEARCH DESIGN AND METHODS: We analyzed the computerized Surveys of Living Conditions (SLC), performed regularly in Sweden, for the years 1988 and 1989, among individuals aged 16-84 years. Drug use (during a 2-week period) and the use of health services (during a 3-month period) were registered for subjects with diabetes (n = 361) and compared with age- and gender-standardized figures (using the diabetes group as the standard) in subjects with hypertension but without diabetes (n = 980), in subjects with a musculoskeletal condition but without diabetes (n = 2,187), in healthy subjects free from any medical condition (n = 6,664), and in the general population sample (n = 12,717). RESULTS: The reported use of medication was higher for subjects with diabetes compared with the general population regarding overall use (92.5 vs. 71.9%; P < 0.001), the use of cardiovascular drugs (52.2 vs. 36.3%; P < 0.001), all use of analgesics (43.8 vs. 36.5%; P < 0.05), and use of psychoactive drugs (23.5 vs. 15.3%; P < 0.01). Compared with the hypertension group, the use was lower regarding cardiovascular drugs (52.2 vs. 93.3%; P < 0.001), and compared with the musculoskeletal group, the use was lower regarding all use of analgesics (43.8 vs. 56.5%; P < 0.01) and the use of herbal products (6.8 vs. 11.8%; P < 0.05), but was higher regarding cardiovascular drugs (52.2 vs. 37.8%; P < 0.001). The use was higher compared with the healthy individuals, regarding all groups of drugs with the exception of vitamins and herbal products. CONCLUSIONS: Diabetic subjects have a higher overall use of drugs compared with the general population. Compared with other chronic illnesses, the differences are small except for disease-specific drugs (cardiovascular drugs in the hypertension group and analgesics in the musculoskeletal group). The main difference concerns the comparison with healthy subjects who had a markedly higher drug rate among diabetic subjects, thus signifying a greater impact on health.

Adolescent↗
PubMed1995

The mouse proteinase-activated receptor-2 cDNA and gene. Molecular cloning and functional expression.

We have reported the cloning from mouse genomic DNA of a fragment encoding a G-protein-coupled receptor related to the receptor for the blood clotting enzyme thrombin. Like the thrombin receptor this receptor is activated by proteolytic cleavage of its extracellular amino terminus. Because the physiological agonist at the receptor was unknown, we provisionally named it proteinase-activated receptor 2 (PAR-2). Here we present a PAR-2 cDNA of 2729 nucleotides that differs from the published genomic sequence at the 5' end, including a part of the protein coding region. The differences do not affect the peptide sequence of the activating proteinase cleavage site proper, but may include amino acid residues important for enzyme-substrate recognition. Analysis of the PAR-2 gene structure showed that the cDNA 5' end is derived from a separate exon located about 10 kilobases away from the 3' exon. Results from a primer extension experiment indicate that transcription starts at a unique site around nucleotide -203 respective to the translation initiation ATG. Chinese hamster ovary cells transfected with either the PAR-2 cDNA or a construct made from the published PAR-2 genomic sequence responded with intracellular calcium mobilization to stimulation with 1 nM trypsin, 10 microM PAR-2-activating peptide (SLIGRL), or 1 microM thrombin receptor-activating peptide (SFLLRN). Untransfected cells responded only to stimulation with thrombin receptor activating peptide. Only transcripts corresponding to the PAR-2 cDNA could be detected in three mouse tissues examined.

Amino Acid Sequence↗
PubMed1995

Quality of life is not negatively affected by diet and exercise intervention in healthy men with cardiovascular risk factors.

Health-related quality of life was assessed in a diet and exercise intervention study among 157 healthy men aged 35-60 years (mean +/- s.d.; 46.2 +/- 5.0) with moderately raised cardiovascular risk factors. The men were randomized to four groups, diet (D, n = 40), exercise (E, n = 39), diet plus exercise (DE, n = 39), and no active intervention (controls (C) n = 39). Quality of life was measured with two self-administered questionnaires; Subjective Symptoms Assessment Profile and Minor Symptom Evaluation Profile, at baseline and after 1.5, 3 and 6 months. Cardiovascular risk factors were investigated at baseline and after 6 months. As a result of changes in dietary habits and physical exercise in the three intervention groups, several important cardiovascular risk factors were significantly reduced. The quality of life/well-being did not differ between the four groups and did not change significantly in any of the groups during the study. There was, however, a tendency towards fewer gastrointestinal symptoms in group D and fewer cardiac symptoms in group DE. We conclude that advice on lifestyle changes in the form of diet and exercise reduce risk factors in middle-aged men without negative effects on their quality of life.

Adult↗
PubMed1995

The costs and effects of two different lipid intervention programmes in primary health care.

OBJECTIVE: To compare the costs and effects of two different intervention strategies for the nonpharmacological treatment of hypercholesterolaemia. DESIGN: Randomized, controlled trial. Subjects were randomly allocated to one of two intervention models and followed up for 1 year. SETTING: Vårby Health Centre, a primary care practice located in a suburb of Stockholm. SUBJECTS: Subjects with a total serum cholesterol in the range 7.0-7.8 mmol L-1 and no signs of ischaemic heart disease or diabetes mellitus, randomized to a low-intensity (n = 35) or medium-intensity (n = 41) intervention. INTERVENTION: Two strategies were used, one labelled medium-intensity strategy which followed national current guidelines for nonpharmacological treatment of hypercholesterolaemia, the other was a low-intensity strategy. MAIN OUTCOME MEASURES: Total serum cholesterol and intervention costs. RESULTS: Both intervention strategies resulted in small (mean 3.5%) decreases in total cholesterol with no significant difference between the groups. The cost per subject in the low-intensity group was SEK 753 and in the medium-intensity group SEK 3614. CONCLUSIONS: Because the effect of the two intervention programmes did not differ, the low-intensity programme is to be preferred from a cost-effectiveness point of view. If only one-third of the population in Stockholm county with cholesterol levels > or = 6.5 mmol L-1 are discovered by the primary health care system, and follow the treatment advice, the net savings in the low-intensity model compared to the current guidelines here presented as the moderate-intensity model, would be SEK 93 million.

Adult↗
PubMed1995

Seasonal changes in the levels of antidiuretic hormone and melatonin in the elderly.

Antidiuretic hormone (ADH) and melatonin in plasma were measured every 4 hr during a 24-hr period in 69 elderly volunteers (42 males and 27 females) aged 75.6 +/- 8.8 years (+/- SD) and 73.5 +/- 9.5 years, respectively. The population was divided into three groups, which were examined February 27-28, April 25-26, and November 14-15. For the males, the mean ADH level during 24 hr was lowest in April and highest in November with a level five times higher than in April. The ADH level in February was about three times higher that in April. Females did not show any seasonal variation in the ADH system. The melatonin levels were lowest in November, higher in February, and even higher in April in both male and female volunteers. The ADH increased with age in males (R2 = 0.13; P < 0.05) but not in females (R2 = 0.07; NS). The melatonin concentration decreased with age for the whole group, aged 60-98 years.

Aged↗
PubMed1995

Serum levels of relaxin during the menstrual cycle and oral contraceptive use.

Serum relaxin levels were analysed in 12 healthy women every other day during the menstrual cycle and during a second cycle on oral contraceptives. Relaxin levels in 7 women with posterior pelvic and lumbar pain were also measured. Relaxin was detected during both the follicular and luteal phases of the menstrual cycle in some of the healthy women. Serum levels were further increased during the use of oral contraceptives. Oestradiol levels in the untreated women correlated to the relaxin levels. Women with posterior pelvic and lumbar pain had higher relaxin levels than did healthy women, a finding that needs to be further explored. Our data indicate the existence of sources for relaxin production other than the corpus luteum in the non-pregnant woman. Endogenous and exogenous oestrogens may stimulate the production of relaxin.

Contraceptives, Oral↗
PubMed1995

The public view on cardiovascular risk factors and changes in lifestyle.

OBJECTIVE: To investigate the public knowledge of cardiovascular risk factors including hyperlipidaemia, and attitudes to changes in lifestyle and to the role of the primary health care in preventive work. DESIGN: Postal questionnaire. SETTING: A physically defined area in south-western Stockholm. SUBJECTS: 1000 randomly selected individuals of both sexes 40 to 64 years, stratified into 5-year groups. MAIN OUTCOME MEASURES: Knowledge of and attitudes to cardiovascular risk factors. Contact with the primary health care and expectancy of physicians' interest in patients' lifestyles. RESULTS: Response rate was 75%. The awareness of cardiovascular risk factors was high, but only 51% knew what constitutes healthy food, and two thirds doubted that they could change their eating habits. Forty-eight percent had visited the primary health care during the previous year. Eighty-four percent thought that the physicians should know about their patients' smoking, 83% about drinking habits, and 75% about eating habits. Physicians were expected to spend 40% of their time on preventive work. Only 26% believed that press information about hyperlipidaemia and heart disease did more good than harm. CONCLUSION: Knowledge was good about causative cardiovascular risk factors, but poor about healthy eating. Physicians were expected to have an interest in patients' lifestyle and in prevention. This type of knowledge is important for preventive work.

Adult↗
PubMed1995

Different long-term metabolic effects of enalapril and atenolol in patients with mild hypertension. EGTA Group.

The primary objective in this multicentre, double-blind randomised, parallel study was to compare the metabolic effects of 12 months of treatment with an ACE inhibitor (enalapril) with those of a selective beta-blocker (atenolol) in patients with mild hypertension. The patients (35-69 years of age) were included if they were without antihypertensive drugs and after six months of nonpharmacological treatment had supine DBPs between 90 and 104 mmHg; 220 patients were randomised to enalapril (20 or 40 mg/day) and 218 to atenolol (50 or 100 mg/day). After 12 months of treatment, atenolol significantly increased the glucose concentrations at 60, 90 and 120 minutes after an oral intake of 75 g glucose (P < 0.01), while enalapril did not. Atenolol significantly increased fasting blood glucose and insulin concentration 120 minutes after glucose intake, while enalapril did not. Plasma total cholesterol and triglycerides increased significantly in patients having atenolol but not in those having enalapril. HDL cholesterol decreased significantly in the atenolol group but not in the enalapril group. The proportions of patients with clinical adverse experiences were similar in both treatment groups. These results indicate that enalapril does not influence either glucose tolerance or lipoprotein metabolism while atenolol does. These findings are consistent over the 12 month treatment period and confirm earlier short-term study results.

Adult↗
PubMed1994

The concentration of magnesium in erythrocytes in female patients with primary Raynaud's phenomenon; fluctuation with the time of year.

The magnesium (Mg) concentration was measured in erythrocytes of 30 women with pronounced primary Raynaud's phenomenon (PRP) and of 33 age-matched healthy control women. The measurements were made at three different times, six months apart. The mean Mg concentration in the PRP group and the control group differed significantly at each measurement. The values for the two groups were, respectively, 1.64 +/- 0.21 and 2.02 +/- 0.21 mmol/L (P < 0.001) in February, 1988; 2.16 +/- 0.21 and 1.85 +/- 0.21 mmol/L (P < 0.001) in August, 1988; and 2.01 +/- 0.21 and 2.37 +/- 0.20 mmol/L (P < 0.001) in January, 1989. The erythrocyte Mg level varied significantly with the time of year in both groups. In the PRP group the mean value was significantly higher in August than in the two winter months, but in the control group it was significantly lower in August. The authors conclude that women with PRP have a significantly lower magnesium concentration in erythrocytes during winter than the healthy controls and that this concentration varied with the season of the year in both groups.

Adult↗
PubMed1994

Risk factors for cardiovascular disease--a comparison between Swedes and immigrants.

OBJECTIVE: To explore and compare risk factors for cardiovascular disease in Swedes and immigrants. DESIGN: Descriptive analysis of data obtained by personal interview, laboratory investigations, and clinical examination by a trained nurse. SETTING: Vårby Health Centre, located in a suburb of Stockholm. The health centre has 32 percent immigrants in its catchment area. SUBJECTS: 2238 participants aged 25-54 years who attended for a health check in 1989-90. MAIN OUTCOME MEASURES: Ethnicity, age, sex, smoking habits, body mass index(BMI), serum-cholesterol, blood glucose, and blood pressure. RESULTS: 30 different nationalities participated and were classified as Swedish, Finnish, Mediterranean and "Other". Mediterraneans had a higher BMI in spite of the fact that their blood pressures were significantly lower. The Finns had the highest mean cholesterol values. Smoking rates among Mediterranean men were high (58%). 40% of the Swedish men smoked. Only 14% of the Mediterranean women aged 45-54 years smoked. The smoking rates increased in age groups 35-44 years (29%) and 25-34 years (46%). CONCLUSIONS: We found important ethnic differences in risk factor patterns. On the basis of our findings, Finnish immigrants should fare the worst. Special efforts should be directed at Finns, focusing on diagnosis and treatment of hypertension and hypercholesterolemia, and at Mediterraneans on overweight and smoking.

Adult↗
PubMed1994

24-hour ambulatory blood pressure monitoring in elderly normotensive individuals and its reproducibility after one year.

To study ambulatory blood pressure (ABP) and its reproducibility in healthy normotensive elderly subjects, 34 individuals were randomly selected. Their ages were 65 years (n = 10), 70 years (n = 10), 75 years (n = 8) and 80 years (n = 6). SpaceLabs 90207 system was used and one initial and a follow-up measurement after one year was performed. It was found that 24h ABP easily could be recorded in elderly subjects. A mean of 97% of the measurements were successful and only two of 34 subjects dropped out because of measurement failures. Nocturnal blood pressures were lower in all age groups and in both sexes. The standard deviations of the differences between the baseline and one year measurements were for the daytime period 8/4 mmHg and for the nighttime period 12/8 mmHg. In conclusion, ABP is easily accepted as a clinical method in normotensive elderly subjects. In all subjects there is a reduction of the nocturnal blood pressure and the reproducibility of ABP after one year is good.

Aged↗