Search PubMed⌕ Search

Biomedical subjects

J Carstensen

Publications and source records attributed to J Carstensen.

At least 19 recordsLinked to original sources

Seasonal variation in the diagnosis of type 1 diabetes in south-east Sweden.

With the aim to survey the seasonal pattern of diagnosis of type 1 diabetes we included all 1903 children <16 years of age and who had been diagnosed with type 1 diabetes between 1977 and 2001 in the south-east of Sweden. To investigate the seasonal pattern a mixture of two cosine functions was included in a logistic regression model. There was a clear seasonal variation over the years (p<0.001). Children in the oldest age group (11-15 years) showed the most obvious seasonal variation (p<0.001). Children with a short duration of symptoms had about the same seasonal variation as children with a long duration. Both children with and without an infection 3 months prior to diagnosis showed significant seasonal variation (p<0.001) although the seasonal pattern differed between the two groups (p<0.001). As the incidence of diabetes increased during the 25 years the study period was divided into periods of 5 years and it was only during the two last periods that significant seasonal variation occurred. There is a clear seasonal variation in diagnosis of type 1 diagnosis in children and the results suggest that children with a less aggressive disease process at diagnosis were most responsible for this variation. Children with and without prior infection showed a different seasonal pattern.

Adolescent↗

Long germanium nanowires prepared by electrochemical etching.

Germanium (Ge) nanowires have been produced by electrochemical etching of single-crystalline n-type Ge [100] in a HCl-containing aqueous electrolyte. Macropores could be etched at various etching currents after an optimized procedure for homogeneous pore nucleation was used. Because of the narrow band gap of Ge (0.66 eV), the leakage current through pore walls is much higher than that, for example, in Si, leading to a constant dissolution of the pore walls. At sufficiently high current densities, it is then possible to form nanowires with diameters determined by the width of the space charge region, ranging from roughly 50 to 500 nm, and a length of several hundred micrometers. The role of the space charge region for stabilizing pore formation and in the formation of nanowires will be discussed.

Electrochemistry↗

Attitude towards remission induction for elderly patients with acute myeloid leukemia influences survival.

Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking. The remission intention (RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown. The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries. Among 506 treated and untreated patients aged 70-79 years with AML (non-APL), there was a direct correlation between the RI rate in each health region (range 36-76%) and the two-year overall survival, with no censored observations (6-21%) (chi-squared for trend=11.3, P<0.001; r2=0.86, P<0.02, nonparametric). A 1-month landmark analysis showed significantly better survival in regions with higher RI rates (P=0.003). Differences could not be explained by demographics, and was found in both de novo and secondary leukemias. The 5-year survival of the overall population aged 70-79 years was similar between the regions. Survival of 70-79-year-old AML patients is better in regions where more elderly patients are judged eligible for remission induction.

Acute Disease↗

Intergenerational effects of preterm birth and reduced intrauterine growth: a population-based study of Swedish mother-offspring pairs.

OBJECTIVE: To estimate the intergenerational effects of preterm birth and reduced intrauterine growth. DESIGN: Population-based cohort study. SETTINGS: Mother-first-born offspring pairs recorded in the Swedish Medical Birth Registry. POPULATION: Children born before 2001 to 38 720 women born in 1973-75. METHODS: The relationships between the mother's and the child's birth characteristics were estimated using logistic regression analysis. Adjustments were made for smoking habits, body mass index (BMI), and current and childhood socio-economic conditions. Analyses were performed on all mother-offspring pairs and on the pairs for which information on neither of the included background variables was missing (n= 24 520). MAIN OUTCOME MEASURES: Preterm birth (<37 weeks of gestation) and small for gestational age (SGA) (<-2 SD of the Swedish standard). RESULTS: Mothers who themselves had been born preterm were not significantly more likely to deliver their own children preterm, compared with those who had been born at term (adjusted OR 1.24, 95% CI 0.95-1.62). Also, preterm birth in the mothers did not influence the occurrence of SGA in the children. However, the odds ratio for giving birth to SGA and preterm children, respectively, was higher among SGA mothers (OR 2.68, 95% CI 2.11-3.41 and OR 1.30, 95% CI 1.05-1.61). Mothers whose intrauterine growth was moderately reduced but who did not meet the criterion of being born SGA were also at higher risk of giving birth to both preterm and SGA children, respectively. CONCLUSIONS: The present study showed evidence of intergenerational effects of reduced intrauterine growth even when socio-economic factors as well as BMI and smoking were adjusted for. There was, however, no consistent intergenerational effect of preterm birth.

Adult↗

MEAD: an interdisciplinary study of the marine effects of atmospheric deposition in the Kattegat.

This paper summarises the results of the EU funded MEAD project, an interdisciplinary study of the effects of atmospheric nitrogen deposition on the Kattegat Sea between Denmark and Sweden. The study considers emissions of reactive nitrogen gases, their transport, transformations, deposition and effects on algal growth together with management options to reduce these effects. We conclude that atmospheric deposition is an important source of fixed nitrogen to the region particularly in summer, when nitrogen is the limiting nutrient for phytoplankton growth, and contributes to the overall eutrophication pressures in this region. However, we also conclude that it is unlikely that atmospheric deposition can, on its own, induce algal blooms in this region. A reduction of atmospheric nitrogen loads to this region will require strategies to reduce emissions of ammonia from local agriculture and Europe wide reductions in nitrous oxide emissions.

Agriculture↗

Serum cholesterol and testicular cancer incidence in 45,000 men followed for 25 years.

In a 25-year follow-up study of 44,864 men with measured serum cholesterol levels, the testicular cancer hazard ratios for the serum cholesterol categories 5.7-6.9 and > or = 7.0 mmol l(-1) vs the reference category (<5.7 mmol l(-1)) were 1.3 and 4.5, respectively; P-value for trend=0.005. This highly significant association suggests that high-serum cholesterol is a risk factor for testicular cancer.

Adolescent↗

The probability of giving birth among women who were born preterm or with impaired fetal growth: a Swedish population-based registry study.

The primary aim of this study was to investigate whether women born prematurely or with impaired fetal growth have a reduced probability of giving birth. Using Swedish population-based registries, the authors identified 148,281 women born in 1973-1975 for follow-up until 2001. Of these women, 4.1% were born preterm and 0.32% very preterm, 0.29% were born with a very low birth weight, and 5.4% were small for gestational age. Outcome measures were the hazard ratios for giving birth during the study period. Adjustments were made for socioeconomic factors. Very-low-birth-weight women displayed a reduced probability of giving birth (hazard ratio = 0.74, 95% confidence interval: 0.60, 0.91), most apparent among women aged 25 or more years. There were also tendencies of reduced hazard ratios of giving birth among women born preterm or very preterm in this age interval. Women born small for gestational age (below -2 standard deviations) seemed to be more likely to have given birth (hazard ratio = 1.09, 95% confidence interval: 1.04, 1.14), but when a more extreme group of small-for-gestational-age women (below -3 standard deviations) was defined, the association was less evident (hazard ratio = 1.04, 95% confidence interval: 0.94, 1.16). The results suggest that very-low-birth-weight women and, possibly, women born preterm or very preterm have a reduced probability of giving birth, while the results regarding small for gestational age are less clear.

Adult↗

Identification of characteristic regions and representative stations: a study of water quality variables in the Kattegat.

Gradients in nutrient distributions and the effects of eutrophication are common features in most coastal marine areas. These structures occur in aquatic systems due to spatial differences in hydrography, nutrient loading and key biogeochemical processes. Two statistical methods, cluster analysis and probability mapping, have been used in the present study to determine characteristics and patterns in water quality variables. Combined, these two methods provide a useful tool to statistically determine spatial homogeneity and representativity of areas and stations. A case study is presented here in which water quality variables (salinity, dissolved inorganic nitrogen, dissolved inorganic phosphorus and chlorophyll) in surface waters of the Kattegat are analysed for the time period 1993-1997. It was found that morphology, the proximity to sources of nutrient loading from land, nutrient uptake and the infrequent water exchange between the Baltic Sea in the south and the Skagerrak in the north all contribute to create distinct regions of water quality. Regions with concentrations significantly different from the overall mean are identified. In addition to identification of regions with similar characteristics, representative stations (as well as not representative stations) for the respective regions were made. This type of information can be used to design new or revise old monitoring programs.

Animal Nutritional Physiological Phenomena↗

Space-time clustering of childhood lymphatic leukaemias and non-Hodgkin's lymphomas in Sweden.

BACKGROUND: The discussion concerning clusters of childhood leukaemia has mainly been focused on their relation to the time and place of diagnosis. Recently some studies have indicated clustering not only at diagnosis, but also around time and place of birth. Space-time clustering at time of birth could be of special interest if the aetiological agent is of infectious origin and the induction of leukaemia either occurs pre- or perinatally or an infection at that time favours a poor subsequent immune response to the agent. METHODS: To identify possible space-time clustering we have used the close-pair method of Knox. One-thousand-twenty recorded cases (0-14 years) of childhood acute lymphatic leukaemia and 293 cases (0-14 years) of malignant non-Hodgkin's lymphoma from Sweden between 1973-1996 were analysed. The records include date of birth and of diagnosis as well as addresses at birth and at diagnosis. RESULTS: A significant excess of case-pairs (25 observed, 14.9 expected, p = 0.01) was observed close in date and place of birth in the 4-14 year age group with acute lymphatic leukaemia (ALL). However there was no statistically significant clustering found around time of diagnosis. When the cases of leukaemia and the non-Hodgkin's lymphomas were combined no statistically significant clustering was obtained neither at birth nor at diagnosis. CONCLUSIONS: This study strengthens the evidence of space-time clustering around the birth date in children whom later developed ALL. This observation is in support of the hypothesis that pre- or perinatal infections can induce a process leading to ALL.

Adolescent↗

Changes in sexual behavior after orthopedic replacement of hip or knee in elderly males--a prospective study.

The aim of this study was to investigate two questions: Does arthroplastic surgery affect the patient's status as being sexually active; and if patients are sexually active, does surgery affect their erectile function? The study was designed prospectively and the patients filled in a questionnaire concerning sexuality and erectile function before and 6 months after alloplastic hip-or knee surgery. Ninety-nine males were included, mean age 70.6 y. The results demonstrate that 17% of patients lost a sexual activity that they had preoperatively, and no one regained sexual activity after surgery. A correlation between increasing age and risk of losing sexual activity was demonstrated. 26.1% lost a normal erectile function they had preoperatively, while 6.7% regained normal erections. A similar correlation between increasing age and increased risk was demonstrated. From this study of elderly males undergoing orthopaedic alloplastic surgery it is concluded that the risk of losing sexual activity and erectile capability is increased after surgery, and especially in the group where sexual functions are already impaired.

Aged↗

A moderate intake of wine is associated with reduced total mortality and reduced mortality from cardiovascular disease.

OBJECTIVE: The aim of this study was to investigate the effects of the consumption of wine, beer and distilled spirits on total mortality and on mortality from cardiovascular disease. METHOD: The consumption of wine, beer and distilled spirits was assessed in 1,828 individuals by a psychiatrist. Subjects were selected according to expected level of need for health services, from a random sample of 24,043 individuals aged 18-65 years. Mortality was recorded after 22 years and the results related to those for the individuals not exposed to the factor examined. The results were adjusted for age, expected level of need for health services, total alcohol consumption, gender, body-mass index, tobacco use and social class. RESULTS: Intake of wine once a week or more (compared with intake of wine less than once a week or not at all) was associated with a relative risk ratio of 0.58 for total mortality (95% CI: 0.40-0.84) and a relative risk ratio of 0.49 for mortality from cardiovascular disease (95% CI: 0.27-0.90). The risk reduction seemed to be confined to those consumers of wine who had an intake of less than 140 grams of alcohol per week and consumed the beverage once a week. Ex-drinkers had an increased relative risk ratio in total mortality compared with lifelong abstainers and individuals who consumed less than 50 grams of alcohol per week (relative risk ratio = 2.64; 95% CI: 1.56-4.49). CONCLUSIONS: A low to moderate intake of wine seems, unlike the consumption of distilled spirits and beer, to be associated with reduced total mortality and reduced mortality from cardiovascular disease.

Adolescent↗

Glutathione S-transferase T1 and M1 genotypes in normal mucosa, transitional mucosa and colorectal adenocarcinoma.

Gene codings for glutathione S-transferase T1 (GSTT1) and M1 (GSTM1) are polymorphic in humans with null genotypes present in approximately 20 and 50%, respectively. A significant excess of homozygous null GSTT1 and GSTM1 genotypes has been demonstrated among individuals with certain types of cancers. This finding suggests that GSTT1 and GSTM1 may play a role in tumour susceptibility. However, reports concerning colorectal cancer susceptibility are controversial. In the present study, we used a multiplex polymerase chain reaction (PCR) approach to identify and analyze simultaneously the genotypes of both the genes in 99 patients with colorectal cancer and 109 healthy controls. Compared with the control group, a significant excess of homozygous null genotypes for GSTT1 was found in normal mucosa among the cancer patients, but not for GSTM1. Both genes were more frequently deleted in tumours than in corresponding normal mucosa. Furthermore, GSTT1 null genotype in tumour tissue, was significantly related to old age and to poor differentiation of tumours. GSTM1 null genotype in tumour was more frequent in the rectal tumours compared with tumours of left colon and right colon. Our results suggest that individuals with GSTT1 null genotype may be genetically predisposed for an increased risk of developing colorectal cancer. Allele loss in tumour tissue, which reflects genetic instability, may be considered as a marker for evaluating clinico-pathological characteristics of the cancer patients.

Aged↗

Evidence of space-time clustering of childhood acute lymphoblastic leukaemia in Sweden.

We have examined 645 recorded cases of childhood acute lymphatic leukaemia (ALL) in Sweden during 1973-89 to identify space-time clustering by using the close-pair method of Knox. The records included date of birth and of diagnosis as well as addresses at birth and at diagnosis. There was a significant excess of case pairs close in date of birth and place of birth in the 5- to 15-year age group.

Adolescent↗

Validity of two questions on alcohol use in a health survey questionnaire.

The aim of this study was to investigate whether consumers of high and low levels of alcohol could be identified by two questions about alcohol use in a postal questionnaire survey. A sample of 2,300 persons aged 18 64 years from Stockholm county were sent a masked postal questionnaire comprising 30 questions about their health and functioning. Two questions concerned their alcohol consumption. One year later the subjects underwent a psychiatric health examination, which included an assessment of their alcohol use. The two questions about alcohol consumption identified high alcohol consumers with a relatively high sensitivity and specificity, of 64% and 87%, respectively, and thus are useful for identifying high alcohol consumers in health surveys using questionnaires.

Adult↗

Effects of an assessment of needs for medical and social services on long-term mortality: a randomized controlled study.

BACKGROUND: The aim of this study was to investigate the long-term effects of one general health screening on mortality. METHOD: After stratification and randomization of a population of 450,000 inhabitants, two groups were formed, an intervention group of 3064 people and a control group of 29,122 people. From the National Cause of Death Register, data were collected as regards death and causes of deaths for 1970-1990. RESULTS: Multivariate analysis was used to correct for known confounders. We then found no differences between the groups regarding deaths from all causes, cardiovascular diseases, cancer or accidents and poisoning. CONCLUSIONS: One general health screening seems to have little, if any value in preventing fatal diseases.

Adolescent↗

Trend of psychological distress in a Swedish population from 1989 to 1995.

The economic recession which began in Sweden in 1991 was followed by a large increase in the unemployment rate, especially in the younger labour force. The main purpose of the present study was to examine whether this recession has resulted in an increase in psychological distress in the population. Self-reported symptoms of anxiety, anguish, depression and sleeplessness have been analysed in repeated cross-sectional surveys conducted every other year from 1989 to 1995 in the County of Ostergötland. The study was confined to the 20-39 years age group and includes 3122 male and 3440 female respondents. The analysis was restricted to symptoms reported as occurring often or constantly. There was a significant increase in the 12-month prevalence of psychological distress among both men and women. At the beginning of the period 5% of the men in the 20-29 years age group reported frequent symptoms of psychological distress. By 1995 this had increased to 10%. The largest increase in prevalence, however, was found in men in the 30-39 years age group and women in the 20-29 years group Interestingly, when the non-employed groups were excluded from the analysis, the increasing trends of reported distress remained statistically significant with the exception of women aged 30-39 years.

Adult↗

Heat shock protein 72/73 in relation to cytoplasmic p53 expression and prognosis in colorectal adenocarcinomas.

Heat shock proteins (hsp) are molecular chaperones that are increased by various environmental and patho-physiological stimuli. Hsp can bind to mutant/wild-type p53 in tumors and, consequently, could not only regulate p53 accumulation or localization but also modulate its biological effects on cells. However, there is little information available on the significance of hsp expression in colorectal cancer. The aim of our study was to investigate the relationship of hsp to p53 expression, clinico-pathological factors and prognosis in a series of 256 patients with colorectal adenocarcinomas, using immuno-histochemistry. Seventy-five cases exhibited hsp expression in the cytoplasm, with 11 presenting both cytoplasmic and nuclear staining. Hsp expression was related positively to cytoplasmic p53 expression but not to nuclear p53 expression. In the subgroup of rectal tumors, hsp over-expression appeared to predict unfavorable survival, though its prognostic value diminished using multivariate analysis. There were no significant relationships of hsp with patient sex or age, tumor site, Duke's stage, growth pattern or differentiation.

Adenocarcinoma↗