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Biomedical subjects

P Magnus

Publications and source records attributed to P Magnus.

At least 19 recordsLinked to original sources

Psoriasis in Norway as observed in a population-based Norwegian twin panel.

BACKGROUND: Psoriasis is a chronic T-cell-mediated immunological skin disease. The occurrence of the disease appears to differ with geography and ethnicity. There is a need for epidemiological data obtained from defined population-based studies, and the sex-specific differences observed in the natural history of the disease require more attention. OBJECTIVES: To describe the occurrence and risk of psoriasis in Norway by age and sex. PATIENTS/METHODS: A population-based health survey was conducted in 1998 in Norwegian twins aged 19-31 years. The present study is based upon the self-reported history of psoriasis among the 8045 questionnaire responders. RESULTS: Altogether, 334 (4.2%) reported a positive history of psoriasis. There were no sex differences in the overall prevalence rates, but significantly higher point-prevalences emerged in females in the teenage-year intervals. A fairly linear increase in incidence rates by every 4-year age-interval peaked at a lower age in females. The mean age at onset was also significantly lower in females (14.8 years) than in males (17.3 years). The absolute risk of developing psoriasis appeared higher for females across the entire age range. However, by the age of 31 the cumulative risks were similar in females and males (0.056 and 0.053, respectively). CONCLUSIONS: In this historical cohort of Norwegian twins, we find a high prevalence of psoriasis in congruence with previously reported data among whites in north-western Europe. We have found sex-specific characteristics in point-prevalences and incidence rates which may contribute to the understanding of the earlier age at onset of the disease in females.

Adult↗

Cesarean delivery and cow milk allergy/intolerance.

The present study provides support for a positive association between cesarean delivery and persistent cow milk allergy/cow's milk intolerance. Correspondingly, a negative association was seen between cesarean delivery and early outgrown cow milk allergy/intolerance. A possible explanation is that cesarean delivery, rather than increasing the overall risk of food allergy, increases the risk of persistency of disease among food allergic children.

Cesarean Section↗

Day care center characteristics and children's respiratory health.

UNLABELLED: Day care centers provide an important exposure arena with potential harmful health effects for children. This study has linked health effect data from a survey among 942 3-5-year-old Oslo children with information on day care center characteristics collected during inspection of the 175 day care centers these children attended. The aim of the study was to estimate associations between dampness problems and other building characteristics and several respiratory health outcomes. Dampness problems (sign of molds, water leakage, damage to floor/wall) were observed in 51% of the day care centers. In multiple logistic regression analyses none of the studied symptoms and diseases (nightly cough, blocked or runny nose without common cold, wheeze, heavy breathing or chest tightness, the common cold, tonsillitis/pharyngitis, otitis media, bronchitis, pneumonia, asthma, and allergic rhinitis) were systematically associated with dampness problems or type of ventilation in day care centers. None of the studied indicators of day care center exposures were found to have a clear effect on day care children's respiratory health. Even so this study does not rule out negative health effects of day care center exposures. The study demonstrates that population-based studies of these relations are demanding with regard to assessment of exposure and health outcomes. PRACTICAL IMPLICATIONS: Simple and easy-to-register indicators of exposures like dampness problems and type of ventilation assessed in 175 day care centers were not related to respiratory health among 3-5-year-old Norwegian children attending the day care centers. The study does not rule out negative health effects of day care center exposures, but demonstrates methodological challenges needed to be addressed in studies of health effects of the day care environment.

Air Pollution, Indoor↗

Baby swimming increases the risk of recurrent respiratory tract infections and otitis media.

AIM: To estimate the association between baby swimming and recurrent respiratory tract infections and otitis media in the first year of life in children of parents without and with atopy. METHODS: Norwegian schoolchildren (n = 2862) was enrolled in a cross-sectional study of asthma and allergy using the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC). The outcomes were parental retrospective report of recurrent respiratory tract infections and otitis media diagnosed by a physician in the first year of life. The exposure was baby swimming during the same period. Parental atopy reflects a history of maternal or paternal asthma, hayfever or eczema. RESULTS: The prevalence of recurrent respiratory tract infections was higher (12.3%) among children who took part in baby swimming than among those who did not (7.5%). The prevalence of recurrent respiratory tract infections during the first year of life was 5.6% and 10.5%, respectively, in children of parents without and with atopy, whereas the prevalence of baby swimming was 5.6% and 5.1%, respectively, in the two groups. Stratified analysis using parental atopy as strata showed that the increased risk of recurrent respiratory tract infections was only present among children of parents with atopy [adjusted odds ratio (aOR) 2.08, 95% confidence interval (95% CI) 1.08-4.031. A similar trend was present for otitis media (aOR 1.77, 95% CI 0.96-3.25). CONCLUSION: The results of this study suggest that baby swimming and infant respiratory health may be linked. The findings need to be examined in a longitudinal study.

Child↗

A placebo-controlled study of high dose buprenorphine in opiate dependents waiting for medication-assisted rehabilitation in Oslo, Norway.

AIMS: To evaluate whether buprenorphine. even without additional control and psychosocial treatment and support, alleviates the problems faced by patients waiting for medication assisted rehabilitation (MAR). DESIGN: A randomized, double-blind, 12-week study of Subutex versus placebo without additional support as an interim therapy. PARTICIPANTS: One hundred and six patients, 70 males and 36 females, waiting for MAR in Oslo. The average age was 38 years with an average history of heroin use of 20 years. Fifty-five patients were assigned to buprenorphine and 51 to a placebo. INTERVENTION: Subutex or placebo sublingual tablets were given under supervision in a daily dose of 16 mg with the exception of a double dose on Saturday and no dose on Sunday. MEASUREMENT: Retention, compliance, self-reported drug-abuse, wellbeing and mental health. FINDINGS: The average number of days of participation was significantly higher in the buprenorphine group, 42 (median: 29) compared to 14 (median: 11) for the placebo group (P < 0.001). The retention of patients after 12 weeks was 16 patients in the buprenorphine group and one patient in the placebo group. The buprenorphine group had a larger decrease in reported opioid use (p < 0.001) and in reported use of other drugs, tablets and alcohol abuse (p < 0.01). The group also showed a stronger increase in wellbeing (p < 0.01) and life satisfaction (p < 0.05). None of the participants died. CONCLUSION: The patients waiting for MAR benefited significantly from the buprenorphine as an interim therapy according to retention, self-reported use of drugs and wellbeing. However, the patients had difficulties in remaining in treatment over time without psychosocial support.

Adult↗

Maternal and paternal age at delivery, birth order, and risk of childhood onset type 1 diabetes: population based cohort study.

OBJECTIVE: To estimate the associations of maternal and paternal age at delivery and of birth order with the risk of childhood onset type 1 diabetes. DESIGN: Cohort study by record linkage of the medical birth registry and the national childhood diabetes registry in Norway. SETTING: Norway. SUBJECTS: All live births in Norway between 1974 and 1998 (1.4 million people) were followed for a maximum of 15 years, contributing 8.2 million person years of observation during 1989-98. 1824 cases of type 1 diabetes diagnosed between 1989 and 1998 were identified. MAIN OUTCOME MEASURES: Incidence of type 1 diabetes. RESULTS: There was no association between maternal age at delivery and type 1 diabetes among firstborn children, but among fourth born children there was a 43.2% increase in incidence of diabetes for each five year increase in maternal age (95% confidence interval 6.4% to 92.6%). Each increase in birth order was associated with a 17.9% reduction in incidence (3.2% to 30.4%) when maternal age was 20-24 years, but the association was weaker when maternal age was 30 years or more. Paternal age was not associated with type 1 diabetes after maternal age was adjusted for. CONCLUSIONS: Intrauterine factors and early life environment may influence the risk of type 1 diabetes. The relation of maternal age and birth order to risk of type 1 diabetes is complex.

Adult↗

Birth weight and childhood onset type 1 diabetes: population based cohort study.

OBJECTIVE: To assess the associations between birth weight or gestational age and risk of type 1 diabetes. DESIGN: Population based cohort study by record linkage of the medical birth registry and the National Childhood Diabetes Registry. SETTING: Two national registries in Norway. PARTICIPANTS: All live births in Norway between 1974 and 1998 (1 382 602 individuals) contributed a maximum of 15 years of observation, a total of 8 184 994 person years of observation in the period 1989 to 1998. 1824 children with type 1 diabetes were diagnosed between 1989 and 1998. MAIN OUTCOME MEASURES: Estimates of rate ratios with 95% confidence intervals for type 1 diabetes from Poisson regression analyses. RESULTS: The incidence rate of type 1 diabetes increased almost linearly with birth weight. The rate ratio for children with birth weights 4500 g or more compared with those with birth weights less than 2000 g was 2.21 (95% confidence interval 1.24 to 3.94), test for trend P=0.0001. There was no significant association between gestational age and type 1 diabetes. The results persisted after adjustment for maternal diabetes and other potential confounders. CONCLUSION: There is a relatively weak but significant association between birth weight and increased risk of type 1 diabetes consistent over a wide range of birth weights.

Adolescent↗

[Day care centers, infections and asthma].

BACKGROUND: Our objective was to use a causal model for childhood asthma to determine whether the effect of day care attendance on asthma was mediated by recurrent respiratory tract infections. MATERIAL AND METHODS: The study is based on a cross-sectional survey among 1,447 children aged 6-16 years in Oslo. Their parents completed written questionnaires. A recursive logit model was used to estimate direct effects in terms of adjusted odds ratios (aOR). RESULTS: Year of birth, number of siblings and length of maternal education were significantly associated with after-school care attendance. Attendance increased the risk of early infections, aOR = 1.8 (1.3-2.5), and infections were associated with asthma, aOR = 4.9 (3.4-7.3). The crude association between after-school care and asthma was cOR = 1.5 (1.0-2.2), whereas the estimated direct effect was small and non-significant, aOR = 1.2 (0.8-1.9). The results may be influenced by over-reporting of infections among parents with children with asthma. INTERPRETATION: Our results suggest that children who attend day care have an increased risk of asthma, with early infections as a mediator of risk.

Adolescent↗

Value focused rationality in AIDS policy.

A health policy analysis to contain the effects of the HIV epidemic in Norway has been carried out. It was performed as a Multi Criteria Decision Analysis where participants in a decision panel used personal values to weight benefits and costs of alternative policies. The analysis is of particular interest since Norway afterwards adopted a controversial HIV policy: the authorities warned the general population against sexual relations with immigrants from countries south of Sahara. The policy might reap benefits, but a certain cost was to stigmatise that group. This paper describes the analysis and defends the underlying consequentialistic ethics against other approaches involving rule-based ethics and benefit-cost analysis. The main argument is based on Hume's insight that reason alone does not prompt action; values will always be involved and should therefore be more explicitly focused on. The paper concludes that we need an extended notion of rationality that includes well-foundedness of values. Decision-makers should try to reach an emotional equilibrium where their values concerning the issue at hand become stable. The paradigm of decision analysis provides useful methods to approach this situation, although it must be considered only an input to policy rather than something producing a final answer.

Communicable Disease Control↗

Exposure to pets and atopy-related diseases in the first 4 years of life.

BACKGROUND: It is still unclear how early-life exposure to pets is related to children's risk of developing atopy-related diseases. We estimated associations between early-life exposure to pets and atopy-related diseases at 0-4 years of life in a cohort of Norwegian children. METHODS: A population-based cohort of 2531 children born in Oslo, Norway, was followed from birth to the age of 4 years. Information on early-life exposure to pets, a number of possible confounders, and atopy-related diseases was mainly collected by questionnaire. RESULTS: In logistic regression analysis adjusting for potential confounders, the odds ratio for being exposed to pets in early life (reference category: not exposed) was, for bronchial obstruction at 0-2 years of life, 1.2 (95% confidence interval 0.9, 1.8); for asthma at the age of 4 years, 0.7 (0.5, 1.1); for allergic rhinitis at the age of 4 years, 0.6 (0.4, 1.0); and for atopic eczema at 0-6 months of life, 0.7 (0.5, 0.9). CONCLUSIONS: The results indicate that early-life exposure to pets or lifestyle factors associated with exposure to pets reduce the risk of developing atopy-related diseases in early childhood. However, these findings might also be explained by selection for keeping pets.

Animals↗

The prevalence of CMA/CMPI in young children: the validity of parentally perceived reactions in a population-based study.

BACKGROUND: The present study aimed to estimate the prevalence of adverse reactions to milk, as population-based prevalence estimates based on objective diagnostic procedures are rare. METHODS: Children with parentally reported reactions to milk were selected for further examination from a population-based cohort of 2721 children. At the age of 2(1/2) years, they underwent a stepwise diagnostic procedure that included diet trials at home, skin prick tests, and open and double-blind, placebo-controlled food challenges. A sample of children with symptoms not attributed to milk was selected for assessment of unrecognized reactions. RESULTS: The estimated point prevalence of cow's milk allergy and cow's milk protein intolerance (CMA/CMPI) in children with parentally perceived reactions at the age of 2(1/2) years was estimated to be 1.1% (CI 0.8-1.6). However, this was an underestimate, as unrecognized reactions were detected. Most reactions were not IgE-mediated. The positive predictive value of a parentally perceived reaction depended on the number of times it had been reported and was good for reactions reported three times (at 12, 18, and 24 months of age). CONCLUSION: The present study confirms previous findings that parents overestimate milk as a cause of symptoms in their children; however, it also indicates that unrecognized reactions may be a problem as well.

Age Distribution↗

The prevalence of allergy to egg: a population-based study in young children.

BACKGROUND: The aim of the present study was to estimate the prevalence of adverse reactions to egg, as population-based prevalence estimates based on objective diagnostic procedures are lacking. METHODS: The parents of 2721 children in a population-based birth cohort completed questionnaires on the occurrence of any reaction to food at 12, 18, and 24 months of age. Children with parentally reported reactions to eggs at the age of 2 years were selected for further examination. A stepwise diagnostic procedure was developed that included diet trials at home, skin prick tests, and open and double-blind, placebo-controlled food challenges. The mean age of the children at the time of the examination was 2.5 years (CI 2.5-2.6). A sample of children without perceived reactions to egg was also selected for assessment of unrecognized reactions. RESULTS: The estimated point prevalence of allergy to egg in children aged 2(1/2) years was 1.6% (CI 1.3-2.0%), with an upper estimate of the cumulative incidence by this age calculated roughly at 2.6% (CI 1.6-3.6). Almost all reactions were IgE mediated. In general, two-thirds of the parentally perceived reactions were verified. However, the positive predictive value of a parentally perceived reaction depended on the number of times it had been reported, and increased from 50% to 100%, for reactions reported one and three times, respectively. Unrecognized reactions were infrequent. CONCLUSION: This study confirms that allergy to egg is frequent in a child population.

Age Distribution↗

Gender differences in syringe exchange program use in Oslo, Norway.

AIMS: To examine gender differences in syringe exchange program (SEP) use, particularly frequent SEP use, within and across survey years. DESIGN: Three consecutive, anonymous cross-sectional surveys. SETTING: The SEP in Oslo, Norway. PARTICIPANTS: Two hundred and eighty-eight, 449 and 523 SEP participants interviewed during comparable 1-week periods in 1992, 1994 and 1997, respectively. MEASUREMENTS: Brief structured questionnaires assessed SEP use, HIV risk behaviors and self-reported HIV status. Chi square statistics, t-tests and analysis of variance were used to identify gender differences; logistic regression was used to identify independent correlates of frequent SEP use. FINDINGS: Women reported injecting more frequently than men, but neither reported more frequent SEP use nor acquiring more syringes during an exchange. Although syringe sharing decreased significantly over time, in 1997, 51% of SEP participants continued to share. HIV prevalence remained low (3-5%) over time. After controlling for gender, age and HIV risk factors, frequent SEP use was significantly correlated with frequent injection for both women (OR = 1.4) and men (OR = 1.5). A lack of income or benefits independently increased the likelihood of being a frequent SEP user (OR = 3.0), while having shared a syringe at last injection independently decreased this likelihood (OR = 0.5). CONCLUSIONS: Gender was not associated with frequent SEP use; rather, the single most important correlate of frequent SEP use was injection frequency. Women's need for sterile syringes may not be fully addressed, despite the existence of a well-established and well-utilized SEP.

Adolescent↗

Risk behaviour among blood donors who give blood in order to be tested for the human immunodeficiency virus.

BACKGROUND AND OBJECTIVES: There has been concern that some individuals may donate blood primarily motivated by the easy access to human immunodeficiency virus (HIV) testing, and that such donors may represent a risk to the transfusion service. In this article we focus on the risk behaviour of donors who reported that they gave blood in order to be HIV tested. MATERIALS AND METHODS: Anonymous questionnaires were given to 5859 blood donors. The response rate was 70%. RESULTS: Of the responders, 2.8% reported to have donated blood in order to be HIV tested. However, 87% of the donation-for-test group did not have any identified risk behaviour. CONCLUSIONS: The proportion who donated blood in order to be HIV tested was higher than expected, but the majority of the group did not have any identifiable HIV risk.

AIDS Serodiagnosis↗

Risk behavior in Norwegian blood donors.

BACKGROUND: Blood banks ensure the safety of blood components by testing them for a set of known infectious agents and by careful selection of donors based on a self-administered questionnaire and an interview. The purpose of this study is to describe the risk behavior for sexually transmitted diseases in Norwegian blood donors. STUDY DESIGN AND METHODS: A survey of the sexual habits of 5,859 blood donors in the capital of Norway was performed by using anonymous questionnaires. The results were compared with a previous survey of 10,000 randomly selected Norwegian subjects aged 18 to 60 years. The response rates were 70.3 percent and 48.4 percent, respectively. RESULTS: Blood donors had considerably more education than the general population. Their general sexual behavior was similar to that of the rest of the population, although the blood donors had later sexual debut, fewer new partners per year, and a lower frequency of intercourse. In addition, homosexual experience among males was much lower in the donor group. Blood donors were less likely to engage in risk behavior for sexually transmitted diseases than were the general population. Nevertheless, 1.5 percent of the donors reported behavior that would have led to deferral had the behavior been disclosed at the predonation interview. Deferrable donors were more likely to be male and young and to have had many partners. CONCLUSION: Anonymous questionnaires reveal information that is not given at the time of blood donation.

Adolescent↗

Changing paternity and time since last pregnancy; the impact on pre-eclampsia risk. A study of 547 238 women with and without previous pre-eclampsia.

BACKGROUND: Long time interval between pregnancies has been found to increase the risk of pre-eclampsia in second pregnancy. Our aim was to investigate whether this effect is influenced by a history of pre-eclampsia or a change in paternity. METHODS: We studied 547 238 women with a first and second pregnancy registered in the Medical Birth Registry of Norway, 1967-1998. The relative risk of pre-eclampsia in the second delivery according to time interval between deliveries was estimated as odds ratios (OR) in logistic regression models, controlling for changing paternity, maternal age and calendar time period in women with and without previous pre-eclampsia. RESULTS: A change of paternity for the second pregnancy was associated with a reduced risk of pre-eclampsia after controlling for the time since first delivery (adjusted OR = 0.80, 95% CI : 0.72-0.90), but the interaction between change in paternity and time between deliveries was significant only for women with no previous pre-eclampsia. The interaction between history of pre-eclampsia and time interval between the two deliveries was highly significant, and for women with no previous pre-eclampsia the risk of pre-eclampsia in second pregnancy increased with increasing time interval (for intervals longer than 15 years the adjusted OR was 2.11, 95% CI : 1.75-2.53). For women with previous pre-eclampsia the risk tended to decrease with increasing time interval between deliveries. CONCLUSIONS: The protective impact of a new father for the second pregnancy challenges the hypothesis of primipaternity, and implies that the increase in pre-eclampsia risk ascribed to new father by others is due to insufficient control for interpregnancy interval.

Adult↗