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Sven-Erik Johansson

Publications and source records attributed to Sven-Erik Johansson.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence of oesophageal eosinophils and eosinophilic oesophagitis in adults: the population-based Kalixanda study.

BACKGROUND: Eosinophilic oesophagitis may be increasing but the prevalence in the general population remains unknown. Our aim was to assess this and the presence of eosinophils in the distal oesophageal epithelium in the community. METHODS: Oesophagogastroduodenoscopy was performed in a random sample (n = 1000) of the adult Swedish population (mean age 54 years, 49% men). Oesophageal biopsy samples were obtained from 2 cm above, and at, the Z-line. Any eosinophil infiltration of the epithelium was defined as "eosinophils present". Definite eosinophilic oesophagitis was defined as > or =20, probable as 15-19, and possible as 5-14 eosinophils/high-power field (HPF, at magnification x 40) in oesophageal biopsy specimens. RESULTS: Eosinophils were present in 48 subjects (4.8%, 95% CI 3.5 to 6.1%, mean age 54 years, 63% men), in 54% without troublesome reflux symptoms. Definite eosinophilic oesophagitis was present in four subjects (0.4%, 95% CI 0.01 to 0.8%, mean age 51 years, 75% men) and probable eosinophilic oesophagitis in seven subjects (0.7%, 95% CI 0.2 to 1.2%, mean age 58 years, 43% men). Erosive oesophagitis (OR = 2.99, 95% CI 1.58 to 5.66) and absence of dyspepsia (OR = 0.23, 95% CI 0.07 to 0.75) and Helicobacter pylori infection (OR = 0.41, 95% CI 0.19 to 0.92) were independent predictors for "eosinophils present". Definite eosinophilic oesophagitis was associated with dysphagia (2/66 vs 2/926, p = 0.025), and probable eosinophilic oesophagitis with narrowing of the oesophageal lumen (2/15 vs 5/978, p = 0.005). CONCLUSIONS: Oesophageal eosinophils were present in nearly 5% of the general population; approximately 1% had definite or probable eosinophilic oesophagitis. Oesophageal eosinophils may be a manifestation of reflux disease in adults, but the condition is as likely to be asymptomatic and go unrecognised.

Adult↗
PubMed2006

Differential CSF biomarker levels in APOE-epsilon4-positive and -negative patients with memory impairment.

OBJECTIVES: To investigate the relationships between episodic memory, APOE genotype, CSF markers (total tau, T-tau; phospho-tau, P-tau; beta-amyloid, Abeta42) and longitudinal cognitive decline. METHODS: 124 memory clinic patients were retrospectively divided into 6 groups based on (i) episodic memory function (Rey Auditory Verbal Learning Test, RAVLT): severe, moderate or no impairment (SIM, MIM or NIM), and (ii) APOE genotype (epsilon4+ or epsilon4-). CSF marker levels and cognitive decline were compared across groups. RESULTS: Episodic memory function, according to RAVLT scores, was significantly correlated with CSF marker levels only among epsilon4+ subjects and not among epsilon4- subjects. When comparing the 6 subgroups, SIM epsilon4+ and MIM epsilon4+ groups showed significantly lower Abeta42 levels than the other groups. T-tau and P-tau levels were significantly increased in SIM epsilon4+ when compared to all the other groups, including the SIM epsilon4- group. However, both SIM epsilon4+ and SIM epsilon4- declined cognitively during the follow-up. CONCLUSION: It remains to be determined whether APOE genotype affects the expression of biomarkers in CSF, or whether the different biomarker patterns reflect different types of disease processes in patients with progressive cognitive dysfunction.

Amyloid beta-Protein Precursor↗
PubMed2006

Recovered? Association between self-perceived recovery and the SF-36 after minor musculoskeletal injuries.

OBJECTIVE: Recovery after minor musculoskeletal injuries is often disproportionately protracted. Our aim was to relate Short Form-36 (SF-36), to self-perceived recovery assessed with the question" Do you feel recovered". We hypothesized that restitution of physical factors would be reported at least as often as improvement of symptoms or impairments and that social and mental factors would dominate over physical as determinants for recovery. We followed 318 patients with minor traffic-related injuries for up to 6 months. RESULTS: For all SF-36 subscores more than 60% of the recovered patients had returned to their pre-injury levels. The subscores with the highest proportions (> 80%) were all mainly reflecting disability. For no subscore, however, was the proportion 100%. Normalizations in the SF-36 subscores for "Bodily Pain" (BP) (Odds Ratio, OR = 7.2), "Role limitations due to physical function" (OR = 5.3) were associated with self-perceived recovery. CONCLUSION: Abolition of pain appears to be paramount for the self-perceived recovery, but it is neither a sufficient nor a necessary prerequisite. Contrary to our expectation, physical aspects of functional health status were more strongly associated with recovery than were emotional or social aspects.

Adult↗
PubMed2006

Familial risks for epilepsy among siblings based on hospitalizations in Sweden.

PURPOSE: Epilepsy is a common disabling condition, with high heritability according to twin studies. Characterization of familial risks for common subtypes of epilepsy will advance the search for the heritable causes of these conditions and their underlying mechanisms. We aim at defining familial risks for siblings to be hospitalized because of epilepsy. METHODS: A nationwide ad hoc epilepsy database was constructed by linking the Multigeneration Register on 0- to 69-year-old siblings to the Hospital Discharge Register for data on epilepsies covering the years 1987-2001. Standardized risk ratios (SIRs) were calculated for affected sibling pairs by comparing them to those whose siblings had no epilepsy. RESULTS: Among a total of 26,799 hospitalized cases, 598 affected siblings were identified with a familial SIR of 2.35; the SIR was highest at ages 0-4 years (6.82). Infantile spasms showed the highest risk for any subtype (10.45), when a co-sibling was diagnosed with any epilepsy. When both siblings were diagnosed with a concordant (same) subtype of epilepsy, the SIRs were high, i.e. 8.43 for generalized idiopathic epilepsy, 2.56 for partial epilepsy, 24.72 for status epilepticus and 24.39 for other epilepsies. Generalized idiopathic epilepsy was also associated with grand mal (4.06) and other epilepsies (7.61). The numbers of cases were small but concordant diagnoses always showing higher SIRs compared with discordant diagnoses. CONCLUSIONS: Within the limits of the present sample size, our results suggest high familial aggregation for certain subtypes of epilepsy for which distinct genetic mechanisms may underlie.

Adolescent↗
PubMed2006

Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations.

BACKGROUND: Mortality from cardiovascular diseases is higher among immigrants than native Swedes. It is not clear whether the high mortality persists from the country of birth or is a result of migration. The purpose of the present study was to analyse whether all-cause and coronary heart disease mortality differ between immigrants in Sweden and in the country of birth. METHODS: Two cohorts including the total population from Swedish national registers and WHO were defined. All-cause and CHD mortality are presented as age-adjusted incidence rates and incidence density ratios (IDR) in eight immigrant groups in Sweden and in their country of birth. The data were analysed using Poisson regression. RESULTS: The all-cause mortality risk was lower among seven of eight male immigrant groups (IDR 0.39-0.97) and among six of eight female immigrant groups (IDR 0.42-0.81) than in their country of birth. The CHD mortality risk was significantly lower in male immigrants from Norway (IDR = 0.84), Finland (IDR = 0.91), Germany (IDR = 0.84) and Hungary (IDR = 0.59) and among female immigrants from Germany (IDR = 0.66) and Hungary (IDR = 0.54) than in their country of birth. In contrast, there was a significantly higher CHD mortality risk in male immigrants from Southern Europe (IDR = 1.23) than in their country of birth. CONCLUSION: The all-cause mortality risk was lower in the majority of immigrant groups in Sweden than in their country of birth. The differences in CHD mortality risks were more complex. For countries with high CHD mortality, such as Finland and Hungary, the risk was lower among immigrants in Sweden than in their country of birth. For low-risk countries in South Europe, the risk was higher in immigrants in Sweden than in South Europe.

Age Distribution↗
PubMed2006

Identifying patients at high and low risk of cognitive decline using Rey Auditory Verbal Learning Test among middle-aged memory clinic outpatients.

OBJECTIVES: To investigate whether application of cutoff levels in an episodic memory test (Rey Auditory Verbal Learning Test, RAVLT) is a useful method for identifying patients at high and low risk of cognitive decline and subsequent dementia. METHODS: 224 patients with memory complaints (mean age = 60.7 years, mean MMSE = 28.2) followed-up at a memory clinic over approximately 3 years were assigned retrospectively to one of three memory groups from their baseline results in RAVLT [severe (SIM), moderate (MIM) or no impairment (NIM)]. These groups were investigated regarding cognitive decline. RESULTS: Patients assigned to SIM showed significant cognitive decline and progressed to dementia at a high rate, while a normal performance in RAVLT at baseline (NIM) predicted normal cognition after 3 years. Patients with MIM constituted a heterogeneous group; some patients deteriorated cognitively, while the majority remained stable or improved. CONCLUSIONS: The application of cutoff levels in RAVLT at baseline showed that patients with severely impaired RAVLT performance were at a high risk of cognitive decline and progression to dementia, while patients with normal RAVLT results did not show cognitive decline during 3 years. Furthermore, the initial degree of memory impairment was decisive in the cognitive prognosis 3 years later.

Acoustic Stimulation↗
PubMed2006

Country of birth and suicide: a follow-up study of a national cohort in Sweden.

The aim of this study was to examine whether the hypothesized association between country of birth and suicide rates remains after adjustment for age, marital status, socioeconomic status, and hospitalization due to psychiatric disorders or substance abuse. A Swedish cohort of 4.4 million individuals aged 25-64 years was followed from January 1, 1994, to December 31, 1999 for suicide. Suicide rates varied according to country of birth. Among men the highest risk of suicide was found among men from Finland. Among women the highest risk of suicide was found among women from Finland, Poland, and Eastern Europe. Key factors to prevent suicide include early detection and treatment of psychiatric disorders and/or substance abuse, especially among certain population groups.

Adult↗
PubMed2006

East-west health divide and east-west migration: Self-reported health of immigrants from Eastern Europe and the former Soviet Union in Sweden.

AIM: Research on the east-west health divide has provided extensive evidence of poorer health in Eastern Europe and the former Soviet Union than in Western Europe. This study focuses on immigrants from Eastern to Western Europe and analyses whether they have an increased risk of self-reported poor health compared with the host population and what determines that. METHODS: This cross-sectional study is based on 373 immigrants from Poland, other East European countries, and the former Soviet Union, aged 25-84, who arrived in Sweden after 1944 and were interviewed during 1993-2000 along with their 35,711 Swedish counterparts. RESULTS: Age- and sex-adjusted unconditional logistic regression showed in general a 92% higher risk of reporting poor health among immigrants than among Swedish-born respondents. The risk also persisted after adjustment for several potential confounders (living singly, having a poor social network, low socioeconomic status, and smoking) and after an additional adjustment for acculturation (language at home), and years in Sweden. CONCLUSIONS: Being born in Eastern Europe or the former Soviet Union was an independent risk factor for reporting poor health. It is therefore suggested that it is important for primary and public care services to be aware of the health status and needs of immigrants from these countries.

Adult↗
PubMed2006

Neighborhood deprivation and cardiovascular disease risk factors: protective and harmful effects.

AIMS: To determine whether neighborhood-level deprivation is independently associated with cardiovascular disease (CVD) health behaviors/risk factors in the Swedish population. METHODS: Pooled cross-sectional data, Swedish Annual Level of Living Survey (1996-2000) linked with indicators of neighborhood-level (i.e. Small Area Market Statistics areas) deprivation (1997), to examine the association between neighborhood-level deprivation and individual-level smoking, physical inactivity, obesity, diabetes, and hypertension among women and men, aged 25-64 (n = 18,081). Data were analyzed with a series of logistic regression models that adjusted for individual-level age, gender, marital status, immigration status, urbanization, and a comprehensive measure of socioeconomic status (SES). Interactions were tested to determine whether neighborhood effects varied by SES or length of neighborhood exposure. RESULTS: Living in a neighborhood with low deprivation was protective (i.e. lower odds) for smoking, while living in a neighborhood with high deprivation was harmful (i.e. higher odds) for smoking, physical inactivity, and obesity (compared with living in a neighborhood with moderate deprivation). These associations were significant after adjustment for individual-level characteristics. There was no evidence that the neighborhood deprivation associations varied by individual-level SES or length of neighborhood exposure. CONCLUSIONS: Neighborhood-level deprivation exerted important protective and harmful associations with health behaviors/risk factors related to CVD. The significance to public health is substantial because of the number of persons at risk as well as the serious health consequences of CVD. These results suggest that interventions focusing on changing contextual aspects of neighborhoods, in addition to changing individual behaviors, may have a greater impact on CVD than a sole focus on individuals.

Adult↗
PubMed2006

Familial risks of aortic aneurysms among siblings in a nationwide Swedish study.

PURPOSE: Aortic aneurysms have a high fatality rate that could be reduced with control of risk factors and use of available screening methods for detection of early changes in aortic walls. The available data on familial risks, a potential indication for screening, are mainly limited to abdominal aortic aneurysms. METHODS: A nationwide Swedish cohort was constructed by linking the Multigeneration Register on 0- to 69-year-old siblings to the Hospital Discharge Register and the Cause of Death Register for data on aortic aneurysms from years 1987 to 2001. Standardized incidence ratios (SIRs) were calculated for affected siblings by comparing with those whose siblings had no aneurysm. RESULTS: A total of 71 affected siblings were identified with a familial SIR of 8.71; when one sibling was diagnosed before age 50 years, the SIR was 19.69. For concordant thoracic or concordant abdominal aneurysms, the SIRs were 21.68 and 13.06, respectively. For brothers, the risk of abdominal aneurysms was 14.63, and 49.50 for diagnosis before age 50 years. Familial risks and the effects of early diagnostic age were shared by the anatomic subtypes of aneurysms. Within limits of the sample size, no gender differences could be observed. Affected siblings constituted 2.2% of all diagnosed patients. CONCLUSIONS: A family history of any aortic aneurysms and age groups younger than 50 years should be considered in recommendations for screening. The high familial risks are likely to be the result of heritable genes, the identification of which would allow gene testing and preventive counseling.

Adult↗
PubMed2006

Incidence of schizophrenia or other psychoses in first- and second-generation immigrants: a national cohort study.

The main aims of this study were to investigate whether the increased risk of psychotic disorders among certain immigrant groups is present in the next generation and whether having one parent born in Sweden has a protective effect on the risk of psychotic disorders among second-generation immigrants. In total, 2,243,546 individuals were followed from January 1, 1992, until December 31, 1999, for first hospital admission for schizophrenia or other psychoses. Cox regression was used to estimate hazard ratios. The highest risks of psychotic disorders were found among first-generation and second-generation Finns, after adjustment for socioeconomic status. Having one parent born in Sweden had no protective effect on the risk of being hospitalized for psychotic disorders among second-generation immigrants. The disabling symptoms of psychotic disorders call for increased awareness among clinicians and public health planners involved in the treatment and prevention of psychotic disorders, especially among certain immigrant groups.

Adult↗
PubMed2006

Working conditions and cultural competence when interacting with children and parents of foreign origin--Primary Child Health Nurses' opinions.

BACKGROUND: Interaction with children and parents of foreign origin is an important part of Primary Child Health Care (PCHC) services. Cultural competence among Primary Child Health Nurses' (PCHNurses') must therefore be regarded as essential. Cultural competence has been described as a process with different steps through which an individual must proceed. AIM: The present study investigates PCHNurses' opinions regarding their working conditions and cultural competence. The focus will be placed on their interaction with children and parents of foreign origin. METHODS: A total of 270 PCHNurses working in the PCHC services in Stockholm County responded to a questionnaire (response rate 70%). The association between experiences of difficulties and nine explanatory variables were analysed with logistic regression. RESULTS: Many of the PCHNurses reported inadequate working conditions and dissatisfaction with the quality of their healthcare work and said that they lacked written guidelines, support and help. A majority (84%) experienced difficulties in their interactions with children and parents of foreign origin, although to different degrees. The odds of experiencing difficulties were increased when nurses were responsible for a high proportion of children of foreign origin, when nurses had long professional experience and when they worked more than 50% on child-health-services assignments. Many nurses had no formal training in cultural competence and the majority felt that their formal and clinical cultural competence was insufficient. CONCLUSIONS: Deficiencies were found regarding the PCHNurses' working conditions and cultural competence when interacting with children and parents of foreign origin. Improvements are needed to facilitate the nurses' healthcare work and to enable high quality health care on equal terms for all children and parents visiting the PCHC services.

Adult↗
PubMed2006

Poor self-reported health and sleeping difficulties among Kurdish immigrant men in Sweden.

This study explores the association between ethnicity and poor self-reported health and psychological distress, sleeping difficulties, and use of psychotropic drugs among immigrant Kurdish men and native Swedish men, based on data from the first Swedish National Survey of Immigrants and the Swedish Level-of-Living Surveys collected in 1996 by Statistics Sweden. The age-adjusted odds of poor self-reported health and sleeping difficulties among Kurdish men was about 3.5 times higher than among Swedish men. The odds ratio decreased to 2.1 and 2.7 respectively in a model adjusted for age and the other explanatory variables. Yearning for the home country, perceived discrimination and unemployment in the host country seem to be possible explanations for the higher levels of distress among Kurdish immigrants to Sweden.

Adult↗
PubMed2005

Familial risks for migraine and other headaches among siblings based on hospitalizations in Sweden.

Migraine and other headaches are common disabling conditions, reducing the quality of life in the affected individuals. The unambiguous definition of familial risk for subtypes of migraine and other headaches will advance the search for the heritable causes of these conditions and their underlying mechanisms. We aim at defining familial risks for siblings to be hospitalized because of migraine or other headaches. An ad hoc migraine database was constructed by linking the Multigeneration Register on 0- to 69-year-old siblings to the Hospital Discharge Register for data on migraines of all hospitalized patients in Sweden from years 1987 to 2001. Standardized incidence ratios (SIRs) were calculated for affected sibling pairs by comparison with those whose siblings had no migraine. Among a total of 14,123 hospitalized patients, 205 affected siblings were identified, with a familial SIR of 2.84. SIRs for migraine with and without aura were 3.08 and 2.67, respectively. The highest familial risk of 3.71 was noted for unspecified migraine. The risk tended to be higher for concordant (both siblings sharing the migraine subtype, ranging from 4.0 to 6.0) than discordant subtypes, but even many discordant SIRs were significant. The SIR for spouse correlation was 1.14 for husbands and 1.22 for wives, far from being significant. All subtypes of hospitalized migraines and other headaches show an increased familial risk, at least in specific age groups. The different subtypes appear to share susceptibility, which may imply common disease mechanisms.

Adolescent↗
PubMed2005

Neighborhood violent crime and unemployment increase the risk of coronary heart disease: a multilevel study in an urban setting.

Little is known about the association between neighborhood social disorganization and coronary heart disease (CHD). This study used the theoretical frameworks of the Chicago school and the Stirling County group in order to analyze the impact of neighborhood violent crime and neighborhood unemployment on CHD in an urban setting, the capital of Sweden. The entire population of Stockholm County aged 35-64 years on January 1, 1998 was included in the study. All individuals were followed for CHD until December 31, 1998. Small area neighborhood units were used to define neighborhoods. The neighborhood-level variables were calculated as rates of violent crime or unemployment in the small area neighborhood units, categorized in quintiles. Multilevel logistic regression was used to estimate odds ratios and neighborhood-level variance in three different models. When rates of neighborhood violent crime or neighborhood unemployment increased, the risk of CHD increased among both women and men. In neighborhoods with the highest rates of violent crime (quintile 5), the odds ratios were 1.75 (CI=1.37-2.22) and 1.39 (CI=1.19-1.63) for women and men, respectively. In neighborhoods with the highest unemployment rates, the corresponding odds ratios were 2.05 (CI=1.62-2.59) and 1.50 (CI=1.28-1.75). These average neighborhood effects on CHD (fixed effects) remained almost unaltered after inclusion of the individual-level variables. The neighborhood-level variance indicated significant differences in CHD between neighborhoods, and the neighborhood-level and individual-level variables partly explained the variance between neighborhoods (random effects). Public safety and social stability in socially disorganized neighborhoods need to be improved in order to promote cardiovascular health.

Adult↗
PubMed2005

Low linking social capital as a predictor of coronary heart disease in Sweden: a cohort study of 2.8 million people.

This study investigated the association between the recently minted concept of linking social capital and incidence of coronary heart disease (CHD). A follow-up study of 1,358,932 men and 1,446,747 women in Sweden aged 45-74 years was conducted between 1 January 1998 and 31 December 1999. Neighbourhood linking social capital was conceptualised as proportions of individuals voting in local government elections at neighbourhood level. The neighbourhood- and individual-level factors were analysed within a multilevel framework. Linking social capital was associated with CHD in both men and women beyond individual-level factors: in neighbourhoods with low linking social capital the odds ratios were 1.19 (CI = 1.14-1.24) and 1.29 (CI = 1.21-1.38) for men and women, respectively, after adjustment for age, country of birth, education, marital status, and housing tenure. The significant between-neighbourhood variance (i.e. the random intercept) showed significant differences in CHD incidence between neighbourhoods. Even in a relatively egalitarian society, as exemplified by the Swedish Welfare State, individual health is affected by differences between neighbourhoods in linking social capital. The use of linking social capital represents a novel conceptual advance in research on the association between CHD, one of the major causes of death in Western countries, and the multidimensional aspects of social capital.

Aged↗
PubMed2005

Psychological illness is commonly associated with functional gastrointestinal disorders and is important to consider during patient consultation: a population-based study.

BACKGROUND: Some individuals with functional gastrointestinal disorders (FGID) suffer long-lasting symptoms without ever consulting their doctors. Our aim was to study co-morbidity and lifestyle differences among consulters and non-consulters with persistent FGID and controls in a defined adult population. METHODS: A random sample of the general adult Swedish population was obtained by a postal questionnaire. The Abdominal Symptom Questionnaire (ASQ) was used to measure GI symptomatology and grade of GI symptom severity and the Complaint Score Questionnaire (CSQ) was used to measure general symptoms. Subjects were then grouped for study by their symptomatic profiles. Subjects with long-standing FGID (n = 141) and subjects strictly free from gastrointestinal (GI) symptoms (n = 97) were invited to attend their local health centers for further assessment. RESULTS: Subjects with FGID have a higher risk of psychological illness [OR 8.4, CI95(4.0-17.5)] than somatic illness [OR 2.8, CI95(1.3-5.7)] or ache and fatigue symptoms [OR 4.3, CI95(2.1-8.7)]. Subjects with psychological illness have a higher risk of severe GI symptoms than controls; moreover they have a greater chance of being consulters. Patients with FGID have more severe GI symptoms than non-patients. CONCLUSION: There is a strong relation between extra-intestinal, mental and somatic complaints and FGID in both patients and non-patients. Psychological illness increases the chance of concomitantly having more severe GI symptoms, which also enhance consultation behaviour.

Adult↗