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PubMed1993

Myocardial infarction in Girona, Spain: attack rate, mortality rate and 28-day case fatality in 1988. Regicor Study Group.

This study was conducted to establish the attack rate, mortality rate and 28-day case-fatality rates of acute myocardial infarction (AMI) occurring in Girona, Spain, between October 1987 and September 1988. The study was carried out using a population register of AMI, and took place in one central hospital, and eight county hospitals in Girona (in the autonomous community of Catalonia, northeast Spain). Subjects comprised 222 fatal cases selected from 4069 death certificates, and 210 non-fatal cases from hospital records, among subjects aged between 25 and 74 years (reference population 263,778). The age standardized attack rate was 105.6 per 100,000 inhabitants in the age group 35-64 (193.6 in men and 17.6 in women). The age standardized mortality rate was 36.3 per 100,000 inhabitants in the age group 35-64 (63.1 among men and 9.9 among women). The age standardized 28-day case-fatality was 34.6% in men and 50.1% in women in this same age group. Attack and mortality rates of AMI in a region of Spain are presented for the first time. These rates are lower than in other developed countries, nevertheless the 28-day case-fatality is similar to that of these countries.

Adult↗
PubMed1989

Risk factors for heart failure in the general population: the study of men born in 1913.

In 1963 a sample of 973 men, all 50 years old, was drawn from the population register of Gothenburg, Sweden. These men have been followed up for 17 years with repeated examinations regarding a number of variables possibly related to cardiovascular disease. The latest examination, at the age of 67 years, focused on congestive heart failure (CHF). The incidence rate of manifest CHF varied from 1.5 to 10.2 cases (1000 population)-1 yr-1, depending on which age group was being studied. For the age group 50-67 years the incidence of manifest CHF was 5.5 (1000)-1 yr-1. A large number of factors associated with the risk of acquiring CHF were identified. In multivariate regression analyses, hypertension and smoking were the major independent risk factors. Body weight, heart volume, T-wave abnormalities, heart rate variability, peak expiratory flow rate, psychological stress and Fy-antigen (a genetic marker?) were also independent risk factors. Possible strategies for prevention are discussed.

Aged↗
PubMed2000

Evidence of sex-linked effects on the inheritance of human longevity: a population-based study in the Valserine valley (French Jura), 18-20th centuries.

A long-standing puzzle in gerontology is the sex dependence of human longevity and its inheritance. We have analysed the sex-linked pattern of inheritance of longevity from 643 nuclear families on the historical population register of a French valley. We have focused on mean conditional life expectancy at a minimum age of 50 years, thus, in the present study, longevity refers to late or post-reproductive survival. A comparison of parents' and offspring's longevity has shown the existence of a heritable component of late survival in this population. We have found that the heritable component was substantially larger for daughters compared to sons. Moreover, this result appeared to be specific to late survival, that is, when only post-reproductive mortality for parental and offspring generations is taken into account. The stronger resemblance of parents to their daughters was no longer observed when considering younger ages at death for the offspring. This observation explains the hitherto unaccountable diversity of data in previous studies.

Female↗
PubMed2005

Determinants of non-participation, and the effects of non-participation on potential cause-effect relationships, in the PART study on mental disorders.

OBJECTIVE: The study had two objectives: (i) to analyse determinants of non-participation in a general population study of mental disorder in Stockholm, and (ii) to determine whether associations between mental disorder and some potential determinants were different among participants and non-participants in the study. METHODS: The study was based on a questionnaire including potential risk factors for mental disorder and symptom scales. The study group was a random sample of the Stockholm County population aged 20-64 years (19,742 persons). Replies were obtained from 10,441 participants, i. e. the response rate was 53%. The symptom scales were used to identify a group with increased likelihood of mental disorder, screening-positive, and a group with low likelihood of mental disorder, screening-negative. Random samples of the screening-positive and screening-negative respondents were summoned for interview concerning psychiatric symptoms. The database of respondents and non-respondents was linked to several population registers. RESULTS: The participation was higher in females, among older persons, married persons, among persons with higher income and education and among those born in the Nordic countries. There seemed to be little further risk indicator based selection to interview participation. The associations between in-patient psychiatric care and register variables were strong and similar among participants and non-participants. CONCLUSIONS: The occurrence of mental disorders is likely to be underestimated in studies with this design and with substantial dropout rates. However, the study participants can most likely be a base for generalising risk indicators for, or social consequences of,mental disorder, to the general population.

Adult↗
PubMed2004

The Danish Renal Biopsy Register.

The Danish Renal Biopsy Register, created in 1985, is a comprehensive national register of all renal biopsies performed in Denmark. It includes light microscopy diagnoses, immunofluorescence information, disease localization, and clinical information. The number of registered biopsies has remained constant since inception at 570/year, 200 of which are from renal allografts. Biopsy analysis is performed in five regional specialist renal pathology departments, resulting in a high degree of compliance. Diagnosis intercenter reproducibility has been analyzed. The existence of a unique personal identity number permits easy linkage to other national databases, including the national population register, the dialysis and transplantation register, and the cancer register. Studies concerning the relationship of glomerulonephritis to cancer incidence, and the incidence and prognosis of glomerulonephritis and diabetic glomerulopathy have been published. The database is available for international studies on approval by the executive chairman.

Biopsy↗
PubMed1978

Reproductive history and risk of breast cancer: a case-control study in an unselected Swedish population.

Variables in reproductive histories were studied in 179 consecutively detected, unselected breast cancer patients and age-matched controls selected from a computerized population register. The comparison between patients and controls showed no significant difference in age at meanarche, age at first birth, age at menopause or number of children. A subdivision into pre- and post-menopausal women yielded no further information. These results are at variance with most earlier reports, possible because the controls here were selected from the whole female population instead of hospitalized patients. Our data do not support the view that it is possible to define groups at high risk for breast cancer on the basis of productive histories.

Adult↗
PubMed2003

Prevalence of nasal septal perforation: the Skövde population-based study.

BACKGROUND: Patients with nasal septal perforation appear from time to time in Ear, Nose, and Throat (ENT) practices, but the prevalence in a general population is not known. OBJECTIVE: The objective was to investigate the prevalence of nasal septal perforation in an adult Swedish population, and to relate septal perforation to possible risk factors, such as age, gender, diabetes mellitus, nasal polyps, and smoking. METHODS: A random sample of 1,900 inhabitants over the age of 20, stratified for age and gender, was drawn from the municipal population register in Skövde, Sweden, in December 2000. Subjects were called to clinical visits that included questions about diabetes and smoking habits. Nasal endoscopy was performed and, when a perforation was observed, the size was measured. RESULTS: In total, 1,387 volunteers (73% of the sample) were investigated. The sample size was adequate, with a good fit to the whole population. The prevalence of nasal septal perforation was 0.9% [95% CI 0.5-1.6%]. Nasal polyps was a possible risk factor, odds ratio of 11.5 [95% CI 3.0-43.5], but not age, gender, diabetes, or smoking. CONCLUSION: The prevalence of nasal septal perforation was found to be less than 1% in an adult population.

Adult↗
PubMed1986

The effect of BCG-vaccination and tuberculosis on the risk of leukaemia.

The information concerning leukaemia in the Cancer Register in Finland was matched with a BCG vaccination index (FVI) constructed in 1946-49. Male birth year cohorts 1926-41 were analyzed by comparing observed/expected ratios. There were 422 cases of leukaemia (A59) in these cohorts during 1949-78 which was the follow-up period. The expected values were counted on the basis of experience of the whole population of included cohorts. There were approximately 533,000 persons in the cohorts studied. About 315,000 participated in the mass BCG vaccination campaign. 115,000 were tuberculin positive, 200,000 were negative and BCG vaccinated. The cohort analysis techniques were applied and the findings presented as Lexis diagrams. A sample of the population register was used in order to check the matching errors in FVI. Obviously, the presented number of participants is not quite reliable. This is understandable because the register had not been in use from 1953-77 and contact with the organizers is no longer possible. With correction factors the errors can be adjusted, at least to some extent. The register is functioning as expected in relation to general mortality and tuberculosis. The results indicate that there is no marked difference between naturally T. B. infected and BCG vaccinated persons. The participants seem to have considerably less cases of leukaemia than the non-participants of which a great deal are not infected or vaccinated. Structural weaknesses in the FVI do not allow firm conclusions to drawn. There is in any case so much evidence by age, by calendar year and by cohort that a hypothesis of the diminishing long term effects on leukaemia is justified. The interrelationships are long standing and were noticeable during the whole follow-up period about 30 years. It seems that there is no difference in the possible effect between different types of leukaemia. The structural weaknesses, like the real number of participants in the register can be corrected. The analysis can be broadened to cover females as well, which will also facilitate analysis by different types of leukaemia. The possible long standing effect of mycobacterial infections are discussed. Some strategies of further research are outlined.

BCG Vaccine↗
PubMed1995

[Use of rheumatoid factor IgM analysis. A questionnaire study among the users].

The aim of this study was to describe who orders the rheumatoid factor analysis (RF-IgM) and the clinical indication compared to the result of the analysis. All analyses over a one month period were registered. The doctor who had ordered the analysis was contacted in order to answer a questionnaire asking about the clinical symptoms, results of other analyses and whether this analysis were the first or more. Four hundred and sixty-seven analyses were registered (population: about 300,000), 21% with a positive ELISA result (cut-off: 6 IU/ml). Thirty-one percent of the patients had clinical symptoms associated with rheumatoid arthritis. Sixty-seven percent of the analyses were ordered by the general practitioner. If we changed the cut-off to 15 or 20 IU/ml only 14 or 12 analyses were registered as having a positive result. We conclude that the analysis is often used for case-finding, perhaps the frequency could be reduced if the analysis were used more specifically and that the doctor who receives the answer has to be aware of the influence of the cut-off used by the local laboratory.

Adult↗
PubMed1990

Randomized double-blind trial of injectable heptaminol for controlling spontaneous or bromocriptine-induced orthostatic hypotension in parkinsonians.

Heptaminol is a molecule with experimental cardiovascular analeptic properties. In this double-blind vs placebo trial, the potency, so far unproven, of the injectable form of a 626 mg dose of heptaminol chlorhydrate on spontaneous or induced orthostatic hypotension (OH), was assessed. Nineteen patients were included in the study: 7 displayed spontaneous OH, and in the other 12 OH was induced by bromocriptine, as monitored 103 min/after an oral intake of 6.6 mg on average. Neither spontaneous nor induced OH were recorded in 32% of the Parkinsonian population registered, with no obvious distinctive characteristics. Potency tilt-trials, performed 15, 30 and 45 min after parenteral administration of heptaminol, revealed a significant and expressive potency of the molecule on the systolic blood pressure after 15 min (P less than 0.05). Clinical and biological tolerance was excellent. Low plasma renin activity and the absence of response to orthostatism indicated, in this population of Parkinsonian extrapyramidal syndromes, a loss in positive tonus likely to be of sympathetic origin. The anti-hypotensive action of heptaminol does not seem to be related to any renal or even sympathetic interaction.

Blood Pressure↗
PubMed2003

Maternal herpesvirus infections and risk of acute lymphoblastic leukemia in the offspring.

A critical role for infection in the etiology of childhood leukemia has repeatedly been suggested. The authors undertook a case-control study nested within national maternity cohorts with altogether 7 million years of follow-up to assess the relative role of three maternal herpesvirus infections in childhood acute lymphoblastic leukemia (ALL). Offspring of 550,000 mothers in Finland and Iceland formed the joint study cohort that was followed up for cancer in the offspring before age 15 years during 1975-1997 through national cancer registries. For each index mother-case pair, three or four matched control mother-control pairs were identified from national population registers. First-trimester sera were retrieved from mothers of 342 ALL and 61 other leukemia cases and from 1,216 control mothers and were tested for antibodies to cytomegalovirus, Epstein-Barr virus (EBV), and human herpesvirus 6. Serum EBV DNA was also analyzed. Conditional logistic regression-based estimates of relative risk (odds ratio) adjusted for birth order and sibship size, and population attributable fractions, were calculated. Only EBV immunoglobulin M positivity in EBV-immunoglobulin-G-positive mothers was associated with a highly significant increased risk of ALL in the offspring (adjusted odds ratio = 2.9, 95% confidence interval: 1.5, 5.8). Results indicate that reactivation of maternal EBV infection is probably associated with childhood ALL.

Adult↗
PubMed2005

Survival of patients with amyotrophic lateral sclerosis in a population-based registry.

OBJECTIVE: To evaluate the survival of patients with amyotrophic lateral sclerosis (ALS) in an Italian population and to assess the effects of selected prognostic indicators on survival. BACKGROUND: Median survival of ALS patients has been reported to range between 12 and 23 months from diagnosis and between 23 and 36 months from onset of symptoms. Although several negative prognostic factors have been identified, the overall picture still needs clarification. METHODS: We included patients enrolled in an Italian ALS Regional Register (population 4,529,003) during the calendar year 1998. The diagnosis was confirmed by an ad hoc committee using the original El Escorial criteria. Each case was regularly followed up until death or December 31, 2002, whichever came first. Survival was assessed with the Kaplan-Meier method in the whole sample, by level of diagnostic certainty, and by selected prognostic indicators (age, sex, bulbar or spinal onset, and disease duration). Multivariate analysis was done with the Cox proportional hazard function. RESULTS: The sample comprised 79 patients (33 female; 46 male) aged 28-85 years (mean age 64.4 years). Onset of symptoms was bulbar in 30% of cases. Mean symptom duration at diagnosis was 13.3 months. ALS was definite in 43%, probable in 29%, possible in 6%, and suspected in 22%. By December 31, 2002, 56 cases (71%) had died. The cumulative probability of surviving after diagnosis was 78% at 12 months, 56% at 24 months, and 32% at 48 months. Median survival from onset was 39.2 months and from diagnosis 30.6 months. Multivariate analysis confirmed definite ALS at diagnosis and older age as adverse prognostic factors. CONCLUSIONS: Survival of ALS patients in the present sample was slightly longer than previously reported. Better palliative care and supportive treatment may explain the difference. Older age and the presence of definite ALS at diagnosis are poor prognostic predictors.

Adult↗
PubMed2005

Germ-cell testicular cancer in offspring of Finnish immigrants to Sweden.

Variation in testicular cancer incidence can be used to assist in identification of risks. Finland has a significantly lower germ-cell testicular cancer risk than Sweden. Finns who immigrate to Sweden maintain their lower risk irrespective of age at immigration. We investigated difference in risk between Finland and Sweden by examining germ-cell testicular cancer incidence in males born in Sweden to Finnish immigrant parents. Swedish general population registers were used to identify 11,662 males born in Sweden where both Finnish parents immigrated to Sweden from Finland from 1969 or afterward. All of these offspring were at least 15 years old by final follow-up in 2001. Some six offspring (all diagnosed between ages 20 and 24 years) had a diagnosis of germ-cell testicular cancer. Comparison with the Swedish population rate produced standardized incidence ratios [SIR (95% confidence interval)] of 0.85 (0.31-1.84) for all the men and 1.75 (0.64-3.81) for the 20- to 24-year age group. SIRs calculated using the Finnish population rates produced an overall SIR (95% confidence interval) of 1.11 (0.41-2.41) and 2.95 (1.08-6.42) for the 20- to 24-year age group. Although the substantially reduced risk of testicular cancer previously observed in Finnish immigrant to Sweden was not found, this study had insufficient statistical power to conclude that environmental exposures explain the difference in germ-cell testicular cancer risk between Finland and Sweden.

Adolescent↗
PubMedDate not supplied

[Epidemiology of falls among the elderly].

INTRODUCTION: Falls among the elderly have important physical and psychological consequences. Interventions of proven effectiveness exist at individual and population level for their prevention. Studies conducted in other countries have estimated the prevalence and identified the health and environmental risk factors associated with falls, while in Italy, the information available is limited to elderly living in protected residences. To estimate therefore the prevalence of falls and to estimate the association between these events and different risk factors, a series of questions on falls and their possible determinants were included in Studio Argento, a cross-sectional survey of the state of health of the non-institutionalized population > or = 65 years of age that was conducted in 2002 in 11 Italian Regions. METHODS: In each region, two-stage cluster sampling was used to sample 210 individuals. In the first phase, 30 communes were selected, with the probability of selection proportionate to their population; in the second phase, simple random sampling using the communal population register to select the persons to be interviewed. Interviews were conducted in the homes of the study subjects using a standardized questionnaire. Data from the 11 regions were merged for purposes of the analysis, and the C-sample routine of Epi-Info version 2002 was used to conduct the analysis, taking into account of the survey design and the size of the total population > or = 65 years in the various Regions. SUDAAN, an application of SAS was used for the calculation of the rate ratios (R.R.) and 95% confidence intervals (95% CI) and the population-attributable fractions, taking into account potentially confounding variables. RESULTS: A total of 2,273 persons were included in the study. During the previous 12 months, 651 (28.6%; 95% CI = 26.4%-30.7%) had fallen; of these 43.1% (95% IC = 38.6%-47.7%) had fallen 2 or more times. Sixty percent (95% CI = 55,6%-64,2%) of those who had fallen reported having fallen at home. Risk factors for falls included stroke (adjusted RR = 1.4 (95% CI = 1.03-1.8)). diabetes (adjusted RR = 1.7 (95% CI = 1.2-2.1)). visual difficulties (adjusted RR = 1.3 (95% CI = 1.02-1.6)). urinary incontinence (adjusted RR = 1.3 (95%CI= 1.1-1.5) and physical inactivity (adjusted RR = 1.3 (95% CI = 1.03-1.5)). In addition, the consumption of anti-anxiety drugs was also associated with a greater risk of falls. The highest population-attributable fractions were seen for urinary incontinence (9.4%) and lack of physical activity (10.0%). CONCLUSIONS: Falls are common in Italian elderly and are linked with the fragility of aging. To prevent falls, it is necessary to intervene on factors associated with fragility. Methods include encouraging regular physical activity to improve equilibrium and muscle strength and the continuous monitoring of health status to prevent further deterioration. Moreover studies carried out in other countries have demonstrated that the multidisciplinary interventions targeted at persons who have already experienced a fall reduces their risk of further falls. These interventions consist of evaluations of visual acuity, balance, and gait and a review of clinical history with eventual modifications of drug therapy and the environmental risks in the home.

Accidental Falls↗
PubMed1995

Mortality after gynaecologic operations in Finland, 1986-1991.

OBJECTIVE: To study the current in-hospital, 30-day and 42-day mortality after conventional gynaecologic procedures in Finland, with special reference to hysterectomy. DESIGN: Nationwide six-year annual study. SETTING: Data were from the Finnish Population Register Centre, the Finnish Cause-of-Death and Hospital Discharge Register, and the Register for Legal Abortions and Sterilisations. SUBJECTS: Gynaecologic operations (n = 299,257) performed between January 1986 and December 1991. MAIN OUTCOME MEASURES: The overall and age-adjusted mortality rates during the initial hospitalisation, as well as 30 and 42 days after the operations. Age-adjusted probability of dying within 42 days after hysterectomy compared with the overall probability of age-matched Finnish female control population. RESULTS: Overall mortality rates per 10,000 hysterectomies increased gradually from 6.0 during initial hospitalisation to 9.1 and 12.9 when calculated 30 and 42 days post-operatively. The overall 42-day mortality rates of radical hysterectomy, curettage and laparoscopy (other than sterilisation) exceeded the post-hysterectomy mortality rate, while the rates after caesarean section, legal abortion and laparoscopic sterilisation did not. No deaths occurred after laparoscopic sterilisation (n = 40,346). The patients who died after radical hysterectomy, curettage and for other laparoscopy than sterilisation were old, and the great majority of them died of cancer. CONCLUSIONS: The mortality rates after gynaecologic procedures in Finland are currently very low and have clearly decreased in recent decades. Patients may be reassured that conventional gynaecologic operations are safe.

Adolescent↗
PubMed2001

Periodontal conditions in 70-year-old women with osteoporosis.

The aim of the present study was to examine the periodontal conditions in an age cohort of 70-year-old women and compare an osteoporosis group with a control group with normal bone mineral density. 210 women 70 years old and randomly sampled from the population register of the community of Linköping were examined. Bone mineral density (BMD) of the hip was measured by dual energy X-ray absorptiometry. 19 women were diagnosed with osteoporosis (BMD below 0.640 g/cm2 in total hip). 15 of them accepted to participate in the study. As a control group 21 women with normal bone mineral density (BMD exceeding 0.881 g/cm2) were randomly selected from the initial population. The clinical examination included registration of the number of remaining teeth, dental plaque and periodontal conditions. The radiographic examination included a dental panorama and vertical bite-wing radiographs. The subjects also answered a questionnaire about their general health, age at menopause, concurrent medication, smoking and oral hygiene habits. The results from this study showed no statistically significant differences in gingival bleeding, probing pocket depths, gingival recession and marginal bone level between the women with osteoporosis and the women with normal bone mineral density. In conclusion, the present randomly selected and controlled study of osteoporotic and non-osteoporotic women, showed no statistically significant differences in periodontal conditions or marginal bone level. As periodontitis as well as osteoporosis are associated with age, our study of a well-defined age cohort is of interest, but the results should be interpreted with caution since the compared groups are small.

Absorptiometry, Photon↗
PubMedDate not supplied

[The evaluation of noncompliance in an anti-influenza vaccination program].

The article presents an evaluation of an anti-influenza vaccination programme in a population at risk, with a special study of the general characteristics of the group of non-complying patients, and the possible relation of these characteristics with their conduct. Moreover, a study was made of the possible motives for not complying with the vaccination programme by means of a survey carried out by post and telephone in a representative sample of 108 individuals. A 34.77% of the registered population did not receive the anti-influenza vaccine, corresponding largely with the youngest age group (15 to 44 years) and there were no significant differences determined by sex or risk factor or doctor. A positive response was received from 75% of those surveyed, and the basic conclusions drawn were a low proportion of information error attributable to the programme (2.94%), and patient refusal as the principal cause of non-compliance (54.41%), followed by "other reasons" (hospitalisation, absence from home, etc.) (32.35%). The strategies that may be followed in the face of this problem require definition of the group of non-compliers, further understanding of the motives for their conduct, and educational measures to change their attitude. 95.9%). Incidence of hypertension and hyperlipemia was 56.2% and 47.3%. Late vascular events varied between 2.6% (nephropathy) and 19.5% (retinopathy). A total of 101 patients (44.6%) were unaware of the existence of diabetic health education programmes. Moreover, 68 (30.3%) declared that they had never received any previous information about their diabetes. Practical skills were evaluated on an individual basis.

Age Factors↗
PubMed1985

Migration patterns during Italian urbanization, 1865-1921.

This study examines patterns of male migration in central Italy during its transformation from an agrarian to an urban-industrial society. The Italian population registers provide data on the extent and type of emigration among more than 3,500 men (ages 10 and over) who immigrated to the commune of Casalecchio di Reno, bordering the city of Bologna, from 1865 to 1915. Demographic and social differentials in overall rates of emigration and their relation to places of origin and destination are measured. The implications of these results for an understanding of population mobility are discussed.

Female↗