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M Osler

Publications and source records attributed to M Osler.

At least 37 records · Page 2Linked to original sources
PubMed2001

Survival and cause of death after myocardial infarction: the Danish MONICA study.

As part of the Danish WHO MONICA study, a register of patients with myocardial infarction was established in 1982, covering 11 municipalities in the western part of Copenhagen County, Denmark. During the period 1982-91, all cases of myocardial infarction among citizens aged 25-74 years were registered and validated according to the criteria set up for the WHO MONICA project. Short-term (28 days) and long-term (up to 15 years) survival in three periods were compared. The rate of mortality after a non-fatal myocardial infarction was compared with that of the general population, and causes of death were analyzed. Short-term survival did not change during the study period, whereas long-term survival improved for men but did not change for women. The excess mortality rate among female patients over that of the general population was due to ischemic heart disease, other cardiovascular diseases, cancer and other diseases. The excess mortality among male patients was due only to cardiovascular diseases.

Adult↗
PubMed2001

Trends in incidence, case-fatality and recurrence of myocardial infarction in the Danish MONICA population 1982-1991.

BACKGROUND: Growing awareness of risk factors for myocardial infarction (MI), continuous mass campaigns on lifestyle factors, increasing use of heart rehabilitation and improved treatment should imply decreases in the incidence, case-fatality and recurrence rates of MI. The purpose of the study was to assess trends in the incidence, case-fatality and recurrence rate of MI and to analyse whether any changes seen were due to a period or a cohort effect. METHODS: The Danish MONICA population comprises all men and women aged 25-74 years in the period 1982-1991 living in a suburban area of Copenhagen, Denmark. Fatal and non-fatal attacks classified as definite MI and non-fatal attacks classified as possible MI were included. The incidence rate was analysed by Poisson regression, the case-fatality rate by logistic regression, and the rate of recurrence by Cox regression. Age-period-cohort analyses were carried out according to a method described by Clayton and Schifflers. RESULTS: During the 10-year period a significant decrease in the incidence rate of MI was seen for men and women and for the rate of recurrent MI. The decrease in incidence and recurrence could not unambiguously be ascribed to a period or cohort effect. The rate of case-fatality after a first MI was not changed significantly during the period, whereas men and women had different trends in case-fatality after recurrent MI. CONCLUSIONS: In accordance with results from other Western countries we found a decline in the incidence and recurrence rate of MI. Contrary, the lack of a decrease in the case-fatality rate after a first MI was unexpected and difficult to explain.

Adult↗
PubMed2001

Food intake patterns and body mass index in observational studies.

OBJECTIVE: To review studies of patterns of food intake, as assessed by diet index, factor analysis or cluster analysis, and their associations with body mass index or obesity (BMI/Ob). DESIGN: Systematic literature review MEDLINE search with crosscheck of references. STUDIES: Thirty observational studies relating food intake patterns to anthropometric information were identified and reviewed. Food intake patterns were defined using a diet index, factor or cluster analysis in 12, nine and nine studies, respectively. Measures of body mass were made concurrently with the diet assessment in all studies, and only in a few cases were the primary outcomes related to BMI/Ob. RESULTS: The food intake patterns identified could, in most factor or cluster analysis studies, be categorised as: (a) meat, fatty, sweet or energy dense foods; (b) vegetables, fruit, whole grain and low-fat foods; or (c) by high alcohol consumption. The diet indexes were designed to capture a high diversity and/or food combinations matching the recommendations. The relationships with BMI/Ob were inconsistent-ten studies found that intake patterns, which we categorised as fatty, sweet or energy dense were positively associated with BMI/Ob, while similar patterns in four other studies were negatively associated with BMI. The significant associations between diet index score and BMI/Ob were consistently negative, while the associations between factor scores or cluster membership and BMI/Ob were less clear in terms of food intake pattern. Men and women had similar food intake patterns, but food intake patterns were less often positively associated with BMI/Ob in women. In 11 studies, there were no significant associations between food intake pattern and BMI/Ob. CONCLUSION: This review showed that no consistent associations could be identified between BMI or Ob and food intake patterns, derived from diet index, factor analysis or cluster analysis. However, the heterogeneity of food intake patterns identified by such analyses and the lack of gold standards for the application of these techniques hampers consistent analysis of a relation between food intake patterns and health.

Adolescent↗
PubMed2001

Dietary patterns and mortality in Danish men and women: a prospective observational study.

The analysis of dietary patterns emerged recently as a possible approach to examining diet-disease relation. We analysed the risk of all-cause and cardiovascular mortality associated with dietary patterns in men and women, while taking a number of potential confounding variables into account. Data were from a prospective cohort study with follow-up of total and cause-specific mortality. A random sample of 3698 men and 3618 women aged 30-70 years and living in Copenhagen County, Denmark, were followed from 1982 to 1998 (median 15 years). Three dietary patterns were identified from a twenty-eight item food frequency questionnaire, collected at baseline: (1) a predefined healthy food index, which reflected daily intakes of fruits, vegetables and wholemeal bread, (2) a prudent and (3) a Western dietary pattern derived by principal component analysis. The prudent pattern was positively associated with frequent intake of wholemeal bread, fruits and vegetables, whereas the Western was characterized by frequent intakes of meat products, potatoes, white bread, butter and lard. Among participants with complete information on all variables, 398 men and 231 women died during follow-up. The healthy food index was associated with reduced all-cause mortality in both men and women, but the relations were attenuated after adjustment for smoking, physical activity, educational level, BMI, and alcohol intake. The prudent pattern was inversely associated with all-cause and cardiovascular mortality after controlling for confounding variables. The Western pattern was not significantly associated with mortality. This study partly supports the assumption that overall dietary patterns can predict mortality, and that the dietary pattern associated with the lowest risk is the one which is in accordance with the current recommendations for a prudent diet.

Adult↗
PubMed2001

Social influences and low leisure-time physical activity in young Danish adults.

BACKGROUND: Many youths and adults maintain a sedentary life style and a better understanding of the factors which influence physical activity is needed. This study analyses the association between social factors and low leisure-time physical activity in young adults. METHODS: Three hundred and seventeen children aged 6-18 years participated in a health survey in 1979 and again 13 years later. In this cohort the influence of family factors during childhood on the subsequent risk of low leisure-time activity was analysed using multiple logistic regression. RESULTS: Young women were significantly less physically active during leisure time if over 25 years of age, poorly educated and smokers. In multivariate analysis, childhood smoking was the only variable significantly related to low leisure-time physical activity (OR = 5.6 and 95% CI: 1.4-23.6) in young women. In young men, low leisure-time physical activity was associated with parental work activity. Men whose parents had reported high physical activity during work at the examination in 1976-1978 were less often physically inactive during leisure time (OR = 0.2 and 95% CI: 0.1-0.6) at the follow-up in 1992. CONCLUSIONS: Young smoking girls seem to be a key group in the prevention of both smoking and a sedentary life style.

Adolescent↗
PubMed2001

Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study.

OBJECTIVE: To examine whether self rated health confounds or modifies the relation between a prudent food intake pattern and mortality and to study whether the prudent food intake pattern predicts subsequent changes in self rated health. DESIGN: A prospective cohort study with follow up of total mortality and changes in self rated health. Food intake patterns were identified by principal component analysis from a 28 item food frequency questionnaire, collected at baseline. SETTING: MONICA surveys, Copenhagen County, Denmark. PARTICIPANTS: A random sample of 3698 men and 3618 women aged 30-70 years were followed up from 1982 to 1998 (median 15 years). MAIN RESULTS: Among participants with complete information on all variables 18% had rated their health as poor (average or bad) at the baseline examination. Poor self rated health was related to a low score on the prudent food intake pattern, which was characterised by a frequent intake of wholemeal bread, fruit and vegetables. Three hundred and seventy six men and 210 women died during follow up. Poor self rated health and a low prudent food score were associated with increased mortality in both men and women. Self rated health did not modify the relation between diet and mortality. Of the 1098 men and 1048 women with good self rated health at baseline, 243 men and 297 women reported poor health during follow up. Low prudent food score, smoking, and high BMI increased the risk of developing poor health in both men and women, but in multivariate analysis the associations attenuated and were only significant for BMI. CONCLUSION: Both prudent food intake pattern and self reported health are independent predictors of mortality. Self rated health does not seem to modify the relation between diet and mortality.

Adult↗
PubMed2001

Socioeconomic status and trends in alcohol drinking in the Danish MONICA population, 1982-92.

AIMS: To examine trends in alcohol drinking in different educational groups. METHODS: Data from three cross-sectional WHO MONICA surveys conducted in 1982-84, 1987, and 1991-92 were analysed to estimate trends in abstention, moderate, heavy, and sporadic heavy alcohol use in relation to level of education, age and smoking. In total, 6,695 Danish men and women aged 30, 40, 50, and 60 years were included. RESULTS: Alcohol drinking decreased in both men and women during the study period, but changes were only significant among the highest educated. In the highest educated men the prevalence of moderate alcohol use increased from 77 to 82%, while heavy alcohol use declined from 19 to 12%. In the highest educated women the prevalence of abstention increased from 15 to 22%, while moderate alcohol use declined from 78 to 68%. CONCLUSION: During the 1980s, alcohol drinking decreased among the highest educated men and women and an educational gradient in alcohol drinking widened in men and attenuated in women.

Adult↗
PubMed2001

Changes in smoking habits and risk of asthma: a longitudinal population based study.

A common statement from exsmokers is that symptoms of asthma develop shortly after smoking cessation. This study, therefore, investigated the relationship between smoking cessation and development of asthma in a large cohort from the Copenhagen City Heart Study (CCHS). The CCHS is a longitudinal, epidemiological study of the general population from the capital of Denmark, conducted between 1976 and 1994. The study population involved the 10,200 subjects who provided information on self-reported asthma and smoking habits from the first two examinations (baseline and 5-yr follow-up), and the 6,814 subjects who also attended the third and last examination (10-yr follow-up). The point-prevalence of smoking cessation as well as the asthma incidence between examinations was estimated, and a multivariate logistic regression model was used to examine the relationship between changes in smoking habits and development of asthma. During the study period, asthma incidence increased from 1.2-4.2%. Between examinations 1,316 subjects quit smoking. Smoking cessation between examinations was significantly related to reported asthma at follow-up. With never-smokers as the reference group and following adjustment for sex, age, chronic bronchitis, level of forced expiratory volume in one second and pack-yrs of smoking, the odds ratio (OR) for developing asthma when quitting smoking between examinations was 3.9 (95% confidence interval (CI) 1.8-8.2) from baseline to first follow-up and 3.1 (95% CI 1.9-5.1) from first to second follow-up. Continuing smoking also increased the risk of asthma significantly (OR 2.6 and 2.0, respectively). The results indicate that exsmokers have a higher incidence of self-reported asthma than never-smokers. It is likely that subjects perceive chronic obstructive pulmonary disease as asthma, hence the relationship between smoking cessation and asthma might be due to misclassification rather than causality.

Aged↗
PubMed2001

Socioeconomic position and smoking behaviour in Danish adults.

AIMS: The associations between smoking and various socioeconomic indicators may have different implications and causes, which may also vary according to sex and birth cohort. This study analyses how two dimensions of socioeconomic position, an individual (education) and a structural (occupation) indicator, are associated with ever, current and ex-smoking. METHODS: Data on smoking behaviour were collected in five cross-sectional surveys of random samples of the general Danish population aged 20 years or more at intervals between 1982 and 1994. In total, 8,054 men and 8,281 women participated. Logistic regression was used to analyse the influence of education and occupation on smoking behaviour controlling for sex and birth cohort. RESULTS: In cohorts born after 1930 ever and current smoking were related to years of school education and current occupation. The prevalences of ever and current smoking were highest among the least educated, unskilled workers, unemployed persons and persons who received welfare benefits. A significant interaction between birth cohort and education indicated that the educational difference in ever and current smoking increased significantly with increasing year of birth. In multivariate analysis controlling for sex and birth cohort, ex-smoking seemed to be more strongly associated with education than occupation. Those with 12 or more years of school education had twice as high a chance of being ex-smokers as those with 7 years of school or less. CONCLUSION: Smoking behaviour is strongly associated with both individual and structural indicators of socioeconomic position in Danish adults in all cohorts except for those born before 1930.

Adult↗
PubMed2000

[A quantitative assessment of the impact of diet on the mortality of heart disease in Denmark. Estimation of etiologic fraction].

INTRODUCTION: The aim of the present study was to quantify the impact of different dietary factors on the mortality from ischaemic heart disease in Denmark. METHODS: Relative risks and knowledge on the distribution of different dietary factors were used to estimate etiological fractions. RESULTS: It is estimated that an intake of fruit and vegetables and saturated fat as recommended would prevent 12 and 22%, respectively, of deaths from ischaemic heart disease in Denmark. An intake of fish among those at high risk for ischaemic heart disease, would lead to a 26% lower mortality, while alcohol intake among abstainers would have no significant quantitative effect. DISCUSSION: These results suggest that changes in dietary habits according to current recommendations would have an impact on public health in Denmark.

Alcohol Drinking↗
PubMed2000

[Epidemiology].

Explore the source record for details and available documents.

Epidemiology↗
PubMed2000

Prevention of secondary cases of meningococcal disease in Denmark.

Close contacts of cases of meningococcal disease are at increased risk of disease themselves. We identified household-like contacts of index cases, to investigate whether relevant target groups are informed, receive and follow recommended chemoprophylaxis and vaccination, and to ascertain the time delay for implementation of these measures. A telephone interview of 172 households of index cases and a questionnaire survey among 634 parents of contacts of cases in institutions were carried out. Results were compared with reports from Medical Officers of Health. In 21% of the cases, Medical Officers reported fewer household-like contacts than were identified in this study. Written information was effective. However, 59% of households, and 36% of parents of contacts in institutions felt a lack of information about how the disease is acquired, the risk and signs of illness. For household-like contacts the coverage rate for chemoprophylaxis with an appropriate drug was 90% and for vaccination 59%. No secondary cases occurred among those treated with chemoprophylaxis, but among those not treated, there were two secondary cases. The study design provided a useful audit methodology to evaluate the completeness of implementation and the success of prophylactic measures for meningococcal disease.

Adolescent↗
PubMed2000

Do we eat less fat, or just report so?

OBJECTIVE: To examine secular trends in diet reporting error. METHODS: Dietary information was obtained from 228 Danish men and women in 1987-88, and from 122 men and women in 1993-94. RESULTS: Bias in dietary reporting of energy and protein intake was assessed by comparing reported intake with intake data, estimated from 24 h nitrogen output, validated by administering P-aminobenzoic acid, and estimated 24 h energy expenditure. Total energy was under-reported more than energy from protein at both surveys, suggesting that energy from other nutrients, like fat and/or carbohydrate, must have been under-reported too. There was a greater under-reporting for energy than for protein in 1993-94 (29%) than in 1987-88 (15%). Obesity was positively associated with under-reporting, both in 1987-88 and in 1993-94. CONCLUSION: The higher macro-nutrient specific error in 1993-94 compared to 1987-88 may reflect a trend to increasingly omitting fat and/or carbohydrate-rich foods in dietary reporting. This may be a consequence of increased awareness of diet intake, which, in turn, may be related to intensified public health campaigns to reduce intake of fat and/or simple carbohydrate. These results may have consequences for our understanding of the apparent decline in dietary fat and associated health benefits.

4-Aminobenzoic Acid↗
PubMed2000

Socioeconomic status and trends in risk factors for cardiovascular diseases in the Danish MONICA population, 1982-1992.

STUDY OBJECTIVE: The decline in cardiovascular mortality in Denmark during the 1980s has been greatest in the highest socioeconomic groups of the population. This study examines whether the increased social inequality in cardiovascular mortality has been accompanied by a different trend in cardiovascular risk factors in different educational groups. DESIGN: Data from three cross sectional WHO MONICA surveys conducted in 1982-84, 1987, and 1991-92, were analysed to estimate trends in biological (weight, height, body mass index, blood pressure, and serum lipids) and behavioural (smoking, physical activity during leisure, and eating habits) risk factors in relation to educational status. SETTING: County of Copenhagen, Denmark. PARTICIPANTS: 6695 Danish men and women of ages 30, 40, 50, and 60 years. MAIN RESULTS: The prevalence of smoking and heavy smoking decreased during the study but only in the most educated groups. In fact, the prevalence of heavy smoking increased in the least educated women. There was no significant interaction for the remaining biological and behavioural risk factors between time of examination and educational level, indicating that the trend was the same in the different educational groups. However, a summary index based on seven cardiovascular risk factors improved, and this development was only seen in the most educated men and women. CONCLUSION: The difference between educational groups in prevalence of smoking increased during the 1980s, and this accounted for widening of an existing social difference in the total cardiovascular risk.

Adult↗
PubMed1999

[Control of medical practitioners' prescription of flunitrazepam preparations in the County of Copenhagen and municipality of Frederiksberg].

Aiming to limit the misuse of Flunitrazepam medicaments, these were made subject to registered prescription from 11.3.1996. At the same time, The National Board of Health informed every medical practitioner of the recommended daily dose and duration of treatment. A systematic superintendence was established in the region. Medical practitioners prescribing more than four times the recommended dose were identified and applied to one respectively two years after implementation of the prescription registration. In most regions of Denmark the superintendence of the Medical Officers has been occasional. Consumption development was surveyed in the period of 1.1.1996-30.6.1998. At the end of the period the consumption was reduced with 90% in the region and with 85% in the rest of Denmark. The consumption level was at the end of the period significantly lower in this region compared to the rest of Denmark.

Anti-Anxiety Agents↗
PubMed1999

[Smoking and life expectancy among Danish men and women].

Studies reporting increased mortality in smokers are abundant, but only few have included large numbers of heavily smoking women. Based on three large Danish population studies we calculated median survival in smokers and never-smokers and compared the impact of smoking in men and women. Seventeen thousand six hundred and sixty-nine men and 13,525 women were followed for up to 30 years for all-cause mortality. During follow-up there were 8644 deaths. Large differences in tobacco-exposure between men and women were found, in particular in older birth-cohorts. Despite a smaller accumulated exposure, the impact smoking had on median survival was similar in men and women. Female inhaling heavy smokers (> or = 15 cig./day) lost 9.4 and inhaling light smokers 7.4 years in comparison with female never-smokers. Corresponding loss of life-expectancy in males was 9.2 years and 6.0 years, respectively. In conclusion, this study shows survival prospects in relation to smoking in both men and women in a way that is easily communicated. The results indicate that women who smoke as much as men run a relatively higher risk in terms of reduced life expectancy.

Adult↗