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Biomedical subjects

I Persson

Publications and source records attributed to I Persson.

At least 145 records · Page 8Linked to original sources
PubMed1989

Risk of cancer in women receiving hormone replacement therapy.

Cancer risk following treatment with non-contraceptive estrogens was studied in a population-based cohort of 23,244 women. Complete follow-up for an average of 6.7 years revealed 1,087 incident cancers versus 962.5 expected (relative risk/RR/ = 1.13; 95% confidence interval 1.10-1.20). We confirmed the recent findings of a more detailed analysis of the same cohort, based on a 1-year shorter follow-up period, namely: a markedly increased risk of endometrial cancer (RR = 1.8; 1.5-2.1), notably in women receiving potent estrogens, i.e., conjugated estrogens or estradiol (RR = 2.0; 1.6-2.4), and a slightly increased risk of breast cancer (RR = 1.1; 1.0-1.2). A slightly decreased risk of invasive cervical cancer (RR = 0.8; 0.5-1.2) is most likely due to more frequent smear taking than in the background population. There was no increase in the risk of cancer of ovary (RR = 1.0; 0.8-1.2), pancreas (RR = 0.8; 0.5-1.2), large bowel (RR = 1.0; 0.8-1.2) or kidney (RR = 1.0; 0.7-1.4). The risk of developing cancer in liver or biliary tract was lower than expected (RR = 0.4; 0.2-0.7), particularly in women who had used potent estrogens (RR = 0.3; 0.1-0.6), an unexpected finding which warrants further studies. Increased risks of malignant melanoma (RR = 1.5; 1.0-2.1) and lung cancer (RR = 1.3; 0.9-1.7) need cautious interpretation because of their low magnitude, the absence of a biological gradient when subgroups were analyzed and the slightly higher prevalence of smokers in the cohort than in the background population.

Climacteric↗
PubMed1989

The risk of breast cancer after estrogen and estrogen-progestin replacement.

To examine the risk of breast cancer after noncontraceptive treatment with estrogen, we conducted a prospective study of 23,244 women 35 years of age or older who had had estrogen prescriptions filled in the Uppsala region of Sweden. During the follow-up period (mean, 5.7 years) breast cancer developed in 253 women. Compared with other women in the same region, the women in the estrogen cohort had an overall relative risk of breast cancer of 1.1 (95 percent confidence interval, 1.0 to 1.3). The relative risk increased with the duration of estrogen treatment (P = 0.002), reaching 1.7 after nine years (95 percent confidence interval, 1.1 to 2.7). Estradiol (used in 56 percent of the treatment periods in the cohort) was associated with a 1.8-fold increase in risk after more than six years of treatment (95 percent confidence interval, 0.7 to 4.6). No increase in risk was found after the use of conjugated estrogens (used in 22 percent of the treatment periods) or other types, mainly estriols (used in 22 percent of the treatment periods). Although the numbers of women were smaller, the risk of breast cancer was highest among the women who took estrogen and progestin in combination for extended periods. The relative risk was 4.4 (95 percent confidence interval, 0.9 to 22.4) in women who used only this combination for more than six years. Among women who had previously used estrogens alone, the relative risk after three years or more of use of the combination regimen was 2.3 (95 percent confidence interval, 0.7 to 7.8). We conclude that in this cohort, long-term perimenopausal treatment with estrogens (or at least estradiol compounds) seems to be associated with a slightly increased risk of breast cancer, which is not prevented and may even be increased by the addition of progestins.

Adult↗
PubMed1989

Risk of endometrial cancer after treatment with oestrogens alone or in conjunction with progestogens: results of a prospective study.

OBJECTIVE: To determine the relative risk of developing endometrial neoplasia after treatment with oestrogens alone or in conjunction with progestogens. DESIGN: Prospective cohort follow up study, average observation period 5.7 years for each patient. To have a 90% chance of detecting a relative risk of 2.0 with 95% significance the study required 78,000 person years of observation. SETTING: Community based cohort. PATIENTS: Women aged over 35 who were prescribed non-contraceptive oestrogens in the Uppsala health care region during April 1977 to March 1980 were identified from pharmacy records. Of all prescriptions issued, 95% were identified. Patients from the cohort who developed endometrial neoplasia were identified from the cancer registry of the Uppsala health care region. Compliance, sociodemographic data, and lifetime exposures to oestrogen and cyclically added progestogen were assessed by questionnaire in a sample of the cohort. The final cohort consisted of 23,244 patients (133,373 person years). The prevalence of university education, oophorectomy, and hysterectomy was higher in the cohort than the general population; no other confounding factors were identified. MEASUREMENTS: The total number of person years was divided into exposure groups by inference from the data from the questionnaire. Compensation was made for the excess of hysterectomies. Specimens from all cases of endometrial neoplasia in the cohort and 90% of cases in the general population were studied blind histopathologically. Characteristics of treatment of all women who had endometrial neoplasia were assessed by questionnaire. Relative risks and 95% confidence intervals were calculated. RESULTS: Seventy four cases of carcinoma and 33 cases of premalignant lesions occurred in the cohort. The relative risk of endometrial carcinoma was 1.8 (95% confidence interval 1.1 to 3.2) after exposure to any oestrogen compound without progestogen for more than six years; 2.2 (1.2 to 4.4) after more than three years' exposure to conjugated oestrogens without progestogen; and 2.7 (1.4 to 5.1) after more than three years' exposure to oestradiol compounds without progestogen. When carcinoma and premalignant lesions were considered together the results were similar but the relative risk was higher. Risk of carcinoma did not increase when progestogens were cyclically added to oestrogens for the entire treatment period (relative risk 0.9 (0.4 to 2.0]. CONCLUSIONS: Use of oestrogens without progestogens is associated with a twofold to threefold increase in risk of endometrial neoplasia. Use of progestogens either removes this increased risk or delays its onset. A further follow up of the cohort is essential to analyse the risks with greater statistical power.

Adult↗
PubMed1989

Comparative antibacterial activity of the new cephalosporin cefcanel against anaerobic bacteria.

The activity of cefcanel against anaerobic cocci, Clostridium perfringens, Bacteroides fragilis, Bacteroides spp. and fusobacteria was determined by the agar dilution method and compared with the activity of cefaclor, cephalexin, cefadroxil, phenoxymethylpenicillin and ampicillin. Cefcanel showed good activity against Clostridium perfringens, Bacteroides spp. and fusobacteria (MIC90 = 1-4 mg/l). Against anaerobic cocci its MIC90 value was 16 mg/l, and against Bacteroides fragilis, 32 mg/l. Cefcanel has an antibacterial activity that warrants investigation in clinical trials.

Ampicillin↗
PubMed1989

Susceptibility of anaerobic bacteria to the new streptogramin RP 59500 in vitro.

The activity of the new streptogramin RP 59500 in vitro was determined against 380 strains of anaerobic bacteria by an agar dilution method and compared with that of pyostacine, piperacillin, cefoxitin, imipenem, clindamycin, metronidazole and chloramphenicol. RP 59500 and imipenem were the most active agents tested. On the basis of these results, RP 59500 appears to be a promising antimicrobial agent for treatment of anaerobic infections, further clinical investigations being warranted.

Anti-Bacterial Agents↗
PubMed1989

Susceptibility of anaerobic bacteria to meropenem.

The activity of meropenem was determined against 350 strains of anaerobic bacteria by an agar dilution method. It was compared with those of piperacillin, cefoxitin, imipenem, clindamycin, metronidazole and chloramphenicol. Meropenem and imipenem were the most active agents tested. On the basis of these results, meropenem appears to be a promising antimicrobial agent for anaerobic infections and warrants further clinical investigation.

Anti-Bacterial Agents↗
PubMed1989

Prognosis after breast cancer diagnosis in women exposed to estrogen and estrogen-progestogen replacement therapy.

The association between survival in breast cancer and menopausal hormone treatment prior to diagnosis was analyzed by comparing 261 women who developed the disease in a population-based cohort of estrogen-treated women with 6,617 breast cancer patients without any recorded estrogen treatment drawn from the same population. Complete follow-up was achieved during the 0-9 years of observation. The relative survival rate was significantly higher (p = 0.02), by about 10 percentage points at eight years, in patients who had received estrogen treatment--corresponding to an approximately 40% reduction in excess mortality. The more favorable course could be confirmed only in patients aged 50 years or more at diagnosis (p less than 0.01) and was most pronounced in recent users, that is, in women whose treatment was ongoing (p less than 0.01) or had been discontinued within one year prior to diagnosis. The time from first use to diagnosis and the total duration of estrogen medication were virtually unrelated to survival when the effect of recency was taken into account in multivariate analyses. The authors were unable to examine the effect of stage at diagnosis on the results. Several factors, particularly selection bias and surveillance bias, might have affected the results in favor of the women receiving hormone replacement therapy, but there is a possibility that exogenous female sex hormones affect survival in women with breast cancer.

Adult↗
PubMed1989

Time trends in incidence rates of first hip fracture in the Uppsala Health Care Region, Sweden, 1965-1983.

Time trends from 1965 through 1983 for age-specific and age-standardized rates of first hospital admission for a proximal femur fracture were studied in the Uppsala Health Care Region, Sweden, using a centralized register for inpatient care. During the 19-year study period, 29,277 hospital admissions for a first hip fracture were recorded in this population of about 1.5 million persons. The total number of first hip fracture admissions per year increased for both sexes. Age-standardized admission rates for both cervical and trochanteric fractures increased in men (average change per year of 1.8% and 2.6%, respectively) in contrast to the decreased admission rate for cervical fractures (-1.6% per year) and a stable rate for trochanteric fractures (0.4% per year) in women. The cumulative rate of cervical or trochanteric fracture at ages 30-79 years increased 46% in men (from 42/1,000 population in 1965 to 61.5/1,000 population in 1983) in contrast to a 24% decrease in women (from 134/1,000 population in 1965 to 101.5/1,000 population in 1983). The female:male ratio of age-standardized incidence rates decreased for both types of fracture during the study period. This finding of stable or decreasing rates of hip fracture in women contrasts with the findings of most previous studies.

Adult↗
PubMed1989

Mammographic parenchymal patterns in women receiving noncontraceptive estrogen treatment.

Two population-based registers, one of women with at least one estrogen prescription, and the other of women who had undergone mammographic screening, were linked by means of the national registration number, revealing 3,436 estrogen-treated women who had attended the mammography screening program. Their mammographic parenchymal pattern was classified according to the criteria of Wolfe into two groups, one with a low risk and the other with a high risk of development of breast cancer. Estrogen replacement therapy was more common in women with a high risk than in those with a low risk mammographic parenchymal pattern (standardized morbidity ratio = 1.3). The increased probability of receiving noncontraceptive estrogen treatment in women with a high risk mammographic parenchymal pattern remained when the impact of several possible confounding factors had been taken into account in a logistic regression analysis (odds ratio = 1.36, 95% confidence interval 1.24-1.49). No evidence was found of a shift toward the unfavorable mammographic parenchymal pattern during treatment, which suggests that the treatment itself was not responsible for the high proportion of P2 and DY patterns. The mammographic parenchymal pattern must therefore be looked upon as a confounder in the context of studying breast cancer risk after estrogen treatment.

Adult↗
PubMed1989

Non-contraceptive hormones and rheumatoid arthritis: possibilities of using a Swedish population-based cohort.

We report the possibility of, and the methodological problems associated with, using a large population-based cohort of 23,000 Swedish women, ascertained from a drug prescription database to have received non-contraceptive oestrogens; to further investigate the relationship between such therapy and the postulated protection against development of rheumatoid arthritis (RA). Although this study was primarily designed to look at cancer risk, it should be possible to study the relationship with RA.

Adult↗
PubMed1989

Susceptibility of anaerobic bacteria to ALP 201.

The activity of ALP 201 against 350 strains of anaerobic bacteria was determined by an agar dilution method. Its activity was compared with those of piperacillin, cefoxitin, imipenem, clindamycin, metronidazole, and chloramphenicol. ALP 201 and imipenem were the most active agents tested. Based on these results, ALP 201 appears to be a promising antimicrobial agent for anaerobic infections and warrants further clinical investigations.

Anti-Bacterial Agents↗
PubMed1989

Increased fracture risk in hypercalcemia. Bone mineral content measured in hyperparathyroidism.

In the present study, 39 women with mild hypercalcemia, which had been detected 18 years earlier during a health survey, and presumably caused by primary hyperparathyroidism (HPT), were investigated together with 34 age-matched controls. The bone mineral content (BMC) of the nondominant distal forearm was measured by single-photon absorptiometry, and the occurrence of fractures was recorded. Among women up to the age of 70 years, those with hypercalcemia had lower BMC than the controls (P less than 0.05), whereas among the older women, there was no difference. Twelve of the women with probable primary HPT had suffered a distal radius fracture as compared with 3 of the controls (P less than 0.05). Thus, also mild hypercalcemia is a risk factor for bone loss and distal forearm fractures. The findings constitute arguments in favor of early detection and treatment of primary HPT.

Aged↗