Search PubMed⌕ Search

Biomedical subjects

T Riise

Publications and source records attributed to T Riise.

At least 37 records · Page 2Linked to original sources

High mortality in patients with rheumatoid arthritis and atlantoaxial subluxation.

OBJECTIVE: To study relationships between atlantoaxial subluxation (AAS) and total mortality in patients with rheumatoid arthritis (RA). METHODS: Radiological reports and clinical files of patients with RA were reviewed for the presence of cervical spine involvement verified by cervical radiographs. RESULTS: Among 241 patients with cervical radiographs, anterior AAS > or = 4 mm was found in 5% [95% confidence interval (CI) 2-8] of patients. Vertical and posterior subluxations were found in 1.4 and 0.5%, respectively. The mean observation time from RA diagnosis to AAS was 3.9 years. Patients with AAS had 8 times higher mortality than patients without AAS (95% CI 3-25). According to the death certificate, the patients died from cancer, stroke, and myocardial infarction. Cervical spine disorder was not mentioned on the death certificate. However, an autopsy was not performed. CONCLUSION: We found high mortality in RA patients with AAS. AAS in the cervical spine developed relatively early in the course of the disease. Analyses adjusted for seropositivity, erosiveness, and glucocorticosteroids did not reduce the mortality rate ratio. Our results underline the need for careful evaluation of patients with RA with respect to development of AAS.

Adult↗

Quality of life as a predictor for change in disability in MS.

OBJECTIVE: To investigate the predictive value of quality of life on changes in disability measured by the Expanded Disability Status Scale (EDSS). BACKGROUND: There are few good prognostic factors for disease development in MS. Quality of life and self-rated health have been shown to be highly predictive of morbidity and disease development in heart disease and cancer. METHODS: Data on quality of life (SF-36 Health Survey) were ascertained at baseline for 97 relapsing-remitting patients with MS participating in a short-term clinical trial on interferon alpha-2a. These scores were correlated with change in EDSS scores 1 year later, 6 months after treatment ended. RESULTS: Low scores on the SF-36 mental health scale were correlated with increased (worsened) EDSS scores 1 year later (r = -0.29, p = 0.006). The results were not altered by adjusting for disease activity at baseline, which was measured by the number gadolinium-enhanced MRI lesions, relapse rate for the preceding 2 years, and baseline EDSS score. Similar results were found for self-rated health (according to the first question of the SF-36). CONCLUSIONS: These findings reinforce the importance of incorporating the patients' evaluation of their quality of life during treatment. Further, assessing such measures is important in evaluating effects in treatment trials in MS.

Adult↗

Heavy metals in human primary teeth: some factors influencing the metal concentrations.

Human primary teeth have been used as indicators of heavy metal exposure for several decades, but the knowledge about the influence of factors such as tooth type and the presence of caries and roots on metal concentrations is limited. Samples of tooth powder from more than 1200 Norwegian primary teeth without fillings have been analyzed for lead, zinc and cadmium content, and 554 of them for mercury. The material represents all groups of tooth types (incisors, canines and molars), carious and non-carious teeth, and teeth with and without roots. Here we investigate how tooth group and the presence of caries and roots are related to metal concentrations in the teeth. We find that carious teeth have higher metal concentrations than non-carious teeth; the difference was statistically significant for lead, mercury and zinc. Teeth with roots have higher lead and zinc concentrations than teeth without roots. We find differences in metal concentrations between the tooth groups for lead, mercury and zinc. Significant, positive correlations are found between lead and the three other metals and between mercury and zinc. We conclude that metal concentrations in primary teeth are affected by the presence of caries and roots and by tooth group.

Cuspid↗

MRI of cervical spine with flexion and extension used in patients with rheumatoid arthritis.

Patients with rheumatoid arthritis (RA) often have involvement of the cervical spine. The most common abnormality is atlanto-axial subluxation (AAS). The more serious vertical subluxation (VS) is thought to develop at a later stage. Direct cord compression may occur, but the symptoms may be vague and difficult to interpret. In addition to clinical follow up, RA patients undergo several conventional radiographs of the cervical spine, with addition of flexion and extension images. This, in spite of the fact that the cervical cord and soft tissue do not show. Magnetic resonance imaging (MRI), is the modality of choice to visualize soft tissue and the cervical medulla, but is rarely performed in the follow up of RA patients. Five patients with long-standing RA, episodes of neck pain, and known AAS were asked to volunteer for a MRI study of the cervical spine, consisting of sagittal T2 weighted images of the cervical spine during flexion and extension of the neck. Compared to clinical examinations and cervical radiographs, MRI gave valuable information not otherwise obtained. The importance of MRI with the neck in a flexed and extended position is stressed. This is possible to obtain within a conventional quadrature neck coil in many RA patients.

Aged↗

Systematic health, environment and safety activities: do they influence occupational environment, behaviour and health?

This study investigated the relationships between systematic health, environment and safety (HES) activities (as defined by Norway's Internal Control Regulation), the working environment, and workers' health-related behaviour and health. A questionnaire on systematic HES activities was answered by 237 managers of motor vehicle repair garages. A further questionnaire, on the working environment, health-related behaviour and health, was answered by workers (n = 2174) from the same garages. Using regression analysis, systematic HES activities were positively and significantly correlated with the following separate outcome variables, measured at an individual level: satisfaction with HES activities, physical working environment, social support, HES-related management support, health-related support, and control and workers' participation in activities related to occupational health. Workers at garages with systematic HES activities reported fewer musculoskeletal symptoms. Firm conclusions on the direction of causality are difficult to draw because of the cross-sectional design.

Accidents, Occupational↗

Prevalence of musculoskeletal symptoms among aluminium workers.

The aim of this study was to determine the prevalence of musculoskeletal symptoms (MSS) in workers in the aluminium industry, and to test the relationship with work by using the duration of employment as a measure of exposure. A total of 5654 workers (92%) answered a questionnaire. Operators, who were more exposed to physically demanding work, showed a greater incidence of MSS than did office workers. Among operators, the duration of employment was significantly correlated with MSS in nine out of ten areas of the body, when adjusted by multiple regression analyses for age, gender, height, weight, smoking and physical activity. Among office workers this relationship was weaker and was significant only for neck and lower back areas. The higher prevalence of MSS among operators and the association between their duration of employment and MSS suggests that a higher risk of MSS is related to the working environment.

Adolescent↗

Performance of the SF-36, SF-12, and RAND-36 summary scales in a multiple sclerosis population.

BACKGROUND: Multiple sclerosis (MS) patients accumulate both physical and mental health problems along with disease progression. Valid and sensitive outcome measures are important to measure disease effects and the effect of treatment. OBJECTIVE: The objective of this study was to test the performance of the physical and mental summary scales of SF-36, SF-12, and RAND-36. METHODS: The scales were evaluated by comparing the scores of a cohort of 194 MS patients with general population data and using the Expanded Disability Status Scale (EDSS) and the Incapacity Status Scale-mental as criterion variables for physical functioning and mental health. RESULTS: All 3 physical summary scales were markedly reduced and correlated highly with the EDSS. The SF-36 mental summary score was only slightly reduced among MS patients (0.2 SD) compared with the general population, despite significantly reduced scores on all 4 health scales being most related to mental health and despite a high prevalence of mental health problems. This results from the poor physical functioning (mean scale score, 2.3 SD below the general population) and the orthogonal factor rotation used to derive independent measures of physical and mental health. Similar results were found for the SF-12. The nonorthogonal RAND-36 physical and mental summary scores were both markedly reduced. This is more compatible with the disease progression in MS and the results of the other measures of physical and mental health used in the study. CONCLUSIONS: The SF-36 and SF-12 mental health summary scales appear to overestimate mental health in people with MS.

Activities of Daily Living↗

Compensation for occupational injury and disease in Norway: ranking of job groups.

The health risk of various job groups in Norway was estimated by ranking them according to the annual occupational insurance costs per capita. This was done by dividing the costs of work-related injury and disease from 1991 to 1996 in various job groups by the number of workers in these groups. Occupational groups were also ranked according to total annual costs. The five occupational groups with the highest total costs were metalworkers, woodworkers, nursing-related workers, fisheries workers, and teachers. The groups with the highest annual cost per worker were shoe and leather workers, oil and gas extractors, fisheries workers, miners and quarry workers, and ship's officers. Fisheries workers and ship's officers were ranked among the top 10 positions on both lists and deserve priority in preventive measures.

Accidents, Occupational↗

Incidence and prevalence of rheumatoid arthritis in the county of Troms, northern Norway.

OBJECTIVE: To investigate the population incidence and prevalence of rheumatoid arthritis (RA) in persons above the age of 20 in the county of Troms, northern Norway, during the period 1987-1996. METHODS: All records of patients with RA registered at the Department of Rheumatology at the University Hospital of Tromsø during the years 1987 to 1996 were reviewed. The diagnosis of RA was set in accordance with the 1987 American Rheumatism Association criteria, and the population data were based on the 1989 and 1994 census. Total and age-specific incidence rates were calculated as number of new cases per 100,000 inhabitants and year. Age adjusted incidence rates were obtained by the direct method. Prevalence rates of RA for January 1, 1989, and January 1, 1994, were estimated. RESULTS: The total annual incidence rate for the period 1987-1996 was 28.7/100,000 per year (36.0/100,000 in women and 21.4/100,000 in men). No significant difference in incidence rates was found between the periods 1987-1991 and 1992-1996. Total prevalence of RA was 0.39% in 1989 and 0.47% in 1994. The corresponding data for women and men were 0.54% and 0.24% in 1989, and 0.63% and 0.30% in 1994, respectively. CONCLUSION: We found a rather low incidence and prevalence of RA in the county of Troms in northern Norway. Females contracted RA significantly more often than males. There was no change in incidence rates during the observation period, lending no support to suggestions of a continuously decreasing occurrence of RA.

Adult↗

Quality of life in multiple sclerosis: measuring the disease effects more broadly.

OBJECTIVE: To compare the Expanded Disability Status Scale (EDSS) and self-rated quality of life scores (SF-36 Health Survey) as measures of disease impact in a representative sample of MS patients. BACKGROUND: The EDSS is the most common outcome measure of impairment/disability for MS patients but is heavily weighted toward mobility. Sensitive outcome measures are needed that also capture other aspects of the effects of MS. METHODS: The authors performed a cross-sectional study of the cohort of all individuals with onset of MS between 1976 and 1986 who were diagnosed before 1995 in Hordaland County, Norway. A total of 194 patients (94%) participated. RESULTS: The patients had lower mean scores for all eight SF-36 health dimensions compared with sex- and age-adjusted scores in a general population. EDSS scores correlated highly with physical functioning (r = -0.86, R2 = 0.73), and explained some of the variation in social functioning (r = -0.48, R2 = 0.23) and general health (r = -0.46, R2 = 0.21) but little for the other dimensions. CONCLUSIONS: The SF-36 captures the broad effects of MS, and the results showed that patients also are bothered frequently with health problems such as bodily pain and low vitality. These problems, which are not reflected in the Expanded Disability Status Scale, should be given more attention in the treatment of MS and when evaluating interventions.

Adult↗

Interferon-alpha2a reduces MRI disease activity in relapsing-remitting multiple sclerosis. Norwegian Study Group on Interferon-alpha in Multiple Sclerosis.

OBJECTIVE: To evaluate the efficacy and safety of interferon-alpha2a (IFN-alpha2a) in relapsing-remitting MS (RRMS). BACKGROUND: Several immune-modulating therapy regimens of IFN-alpha have shown varying results in MS. A recent pilot study suggested benefits from IFN-alpha2a. METHODS: Ninety-seven patients were randomized to receive subcutaneous injections of placebo (33 patients) or 4.5 million international units (mIU) (32 patients) or 9.0 mIU (32 patients) of IFN-alpha2a three times weekly for 6 months, with a further 6 months of follow-up. Monthly gadodiamide-enhanced MRI was the primary method of evaluating efficacy. RESULTS: IFN-alpha2a treatment resulted in fewer new MRI lesions during the treatment period (p < 0.003). The probability of no new lesions during treatment was >2.5 times higher with 9.0 mIU IFN-alpha2a than with placebo (p < 0.005). The median number of lesions at the end of treatment was lower with IFN-alpha2a treatment than with placebo (p = 0.0004), but the difference disappeared during follow-up. The total number of lesions (mean) increased by 4.78 with placebo, 0.86 with 4.5 mIU IFN-alpha2a, and 0.28 with 9.0 mIU IFN-alpha2a during treatment (p = 0.030). No treatment effect on exacerbation rate, progression of disability, or quality of life was detected. Nine patients discontinued treatment, five because of adverse events. CONCLUSIONS: IFN-alpha2a treatment significantly reduced disease activity as measured by MRI, but the efficacy disappeared within 6 months after discontinuation of treatment. A long-term study of more patients using disability as a primary outcome measure is needed to evaluate the clinical impact.

Adult↗

Zinc in primary teeth from children in Norway.

Human primary teeth have been used as indicators of exposure to several heavy metals both in Norway and elsewhere. Local dentists in all 19 counties of Norway collected 2747 primary teeth during 1990-1994. Samples of tooth powder from whole, ground teeth were analyzed for zinc concentration by flame atomic absorption spectrophotometry. The overall geometrical mean was 144.5 micrograms of Zn/g of tooth substance (S.D. = 1.6). The result represents a small increase (5.2%) compared with a similar investigation in the 1970s. However, the mean zinc concentrations in the geographically matching parts of the two materials did not differ significantly. The variation in tooth zinc concentrations between the different counties declined from the 1970s to the 1990s. We found no correlation between the tooth zinc concentration and available environmental data on zinc in drinking-water, discharge of zinc from industrial point sources or population density in the same geographical areas. The zinc concentrations varied significantly with caries status, tooth type and root length. Few samples had a zinc concentration below 90 micrograms/g, indicating that most children consume sufficient zinc. Some very high values could not immediately be explained, but may be caused by contamination from zinc-containing dental restorations.

Child↗

Influence of paternal exposure to oil and oil products on time to pregnancy and spontaneous abortions.

The objective of this study was to evaluate the influence of exposure to oil and oil products among men on the time taken for their wives to conceive and on the incidence of spontaneous abortion among them. A cross-sectional study was performed by posting questionnaires to 1,269 men employed as offshore mechanics, offshore operators, offshore drilling personnel, car mechanics (the 'exposed' occupations) and carpenters ('unexposed'). The married men were asked to give a separate questionnaire to their wives for details about their pregnancies. The time elapsed between the beginning of coitus without contraception and the wife becoming pregnant (time to pregnancy) was analyzed with Cox regression analysis by calculating fecundability ratios for the pregnancies for the men exposed to oil and oil products as compared with the men who were not exposed. Spontaneous abortions were analyzed with logistic regression by calculating odds ratios for the pregnancies in which the men were exposed vs. not exposed. A total of 741 (58%) men returned the questionnaires. A total of 301 pregnancies were analyzed for time taken to conceive and 580 for spontaneous abortion. The results were adjusted for variables that could significantly influence conception time (previous infections of the reproductive system and coffee drinking) or the incidence of spontaneous abortion (mother's age, parity and smoking). The outcomes between the exposed and unexposed pregnancies showed no significant differences. Car mechanics had a lower fecundability ratio before 1992 than after 1992. Paternal exposure to hydrocarbons in the occupations studied did not seem to have had a major influence on time to conception or the incidence of spontaneous abortion among the wives of the men exposed to oil products.

Abortion, Spontaneous↗

Occupational injuries reported to insurance companies in Norway from 1991 to 1996.

Occupational injuries represent a relatively high proportion of the total number of injuries in Norway and thereby deserve more attention than they are currently receiving. Occupational injury claims made to insurance companies in Norway from 1991 to 1996 were analyzed for determination of their patterns. The types of injury with the highest incidence rates among men were fractures; among women, the highest rates were for those for sprains. The injury rates were more than twice as high in young men as in young women; this difference declined with increasing age. Young men had an increased risk of finger injuries, compared with older age groups. The injury rates increased with increasing age, especially for fractures and contusions. A somewhat higher number of injuries per working day occurred in January and February than in the other months. Action should be taken to prevent fractures and contusions among older workers.

Adolescent↗

Type I interferons and the quality of life of multiple sclerosis patients. Results from a clinical trial on interferon alfa-2a.

The objective of the study was to examine whether the beneficial effect of treatment of interferon alfa-2a on multiple sclerosis seen by magnetic resonance imaging is reflected in a corresponding improvement in the quality of life (QoL) and to address the impact of adverse events related to this treatment on the QoL. The study was a randomised double-blinded placebo-controlled treatment trial including 97 relapsing-remitting multiple sclerosis patients. Thirty-two patients received 4.5 MIU recombinant interferon alfa-2a, 32 patients received 9.0 MIU recombinant interferon alfa-2a and 33 patients received placebo treatment for 6 months. All patients were followed up 6 months after end of treatment. QoL was assessed according to the eight scales of the SF-36 Health Survey and measured at baseline, month 3, 6 and 12. The effect found on MRI was not reflected in a corresponding change in the QoL. We found a relationship between the presence of new enhancing lesions and reduced QoL among the placebo patients, whereas this was not found among the patients treated with interferon. The presence of the adverse events fatigue, myalgia, headache and weakness were significantly negatively correlated to several of the QoL dimensions. Conclusively, the treatment with interferon alfa-2a does not seem to improve the patients' QoL after 6 months of treatment, in spite of a marked effect measured by MRI. The treatment is followed by adverse events that negatively affected the QoL.

Adult↗

Altered antibody pattern to Epstein-Barr virus but not to other herpesviruses in multiple sclerosis: a population based case-control study from western Norway.

OBJECTIVE: The prevalence of anti-EBV antibodies was studied in a group of 144 patients with multiple sclerosis and 170 age, sex, and area matched controls from the county of Hordaland, western Norway. The prevalence of three other herpesviruses, herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV), were also included. METHODS: Antibodies to various virus antigens were determined by enzyme linked immunosorbent assay (ELISA) and indirect immunfluorescence (IIF) in serum samples from 144 patients with multiple sclerosis and 170 controls. RESULTS: All of the 144 patients with multiple sclerosis had IgG antibodies to EBV compared with 162 of 170 controls (p=0.008). The frequency of IgG antibodies to EBV capsid antigen (VCA), nuclear antigen (EBNA), and early antigen (EA) was significantly higher in patients with multiple sclerosis compared with the controls (p<0.000001, p=0.01, and p<0.0001 respectively). The presence of antibodies was independent of the initial course of the disease and the disease activity at the time of blood sampling. The prevalence of IgG antibodies to HSV, CMV, and VZV did not differ between cases and controls. CONCLUSION: The results suggest a role for EBV in the aetiology of multiple sclerosis.

Adolescent↗

Lead in primary teeth from Norway: changes in lead levels from the 1970s to the 1990s.

Lead is one of the most important and widely distributed pollutants in the environment. In the human population children are particularly at risk. Local dentists in all 19 counties in Norway collected 2746 primary teeth from 1990 to 1994. Tooth substance from whole, ground teeth were analyzed for lead concentration by electrothermal atomic absorption spectrophotometry. The geometrical mean for the entire material was 1.27 micrograms lead/g tooth substance (S.D. 1.87). The mean lead levels in each of the counties were significantly lower than those obtained in a corresponding study in the 1970s. Two counties, Oslo and Vest-Agder, had significantly higher lead levels than the majority of the other counties. Tooth lead concentration and atmospheric deposition of lead in the same areas were significantly and positively correlated, as shown by analysis of naturally growing moss. We conclude that lead concentrations in primary teeth from children in Norway have been reduced by approx. 50% from the 1970s to the 1990s. The reduction probably reflects a decrease in the environmental lead burden in Norway.

Air Pollutants↗