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At least 343 records · Page 19Linked to original sources
PubMed2003

Population-based study of prostate-specific antigen testing and prostate cancer detection in clinical practice in northern Sweden.

OBJECTIVE: The pattern of prostate-specific antigen (PSA) testing in clinical practice is largely unknown; it may be used either in asymptomatic men or in the work-up of men with urinary or other symptoms. The aim of this study was to investigate the pattern of PSA testing in clinical practice for men diagnosed with stage T1c prostate cancer in a region with no formal screening programme. MATERIAL AND METHODS: Using the Primary Prostate Cancer Register for Northern Sweden, all cases of stage T1c prostate cancer diagnosed between 1992 and 1999 in the city of Umeå were identified. The cause of PSA testing was assessed by examining the medical records. Men were categorized as asymptomatic, having lower urinary tract symptoms (LUTS) or having symptoms other than LUTS. Prospective registration of the cause of PSA testing in the entire region of Northern Sweden started in 2000. RESULTS: We found that in Umeå only 32/213 (15%) cases diagnosed with T1c prostate cancer were asymptomatic at the time of PSA testing, 55% of men had a PSA test as part of a work-up for LUTS and 30% had other symptoms. In 2000, 126 cases of stage T1c prostate cancer were diagnosed in the entire region and 20/126 (16%) of these men were asymptomatic. CONCLUSIONS: PSA testing was mostly used as a tool in the work-up of symptomatic patients in Umeå and also in the region of Northern Sweden. Further studies in other populations are needed.

Age Distribution↗
PubMed2006

CHEK2*1100delC is not an important high-risk gene in families with hereditary prostate cancer in southern Sweden.

OBJECTIVE: CHEK2*1100delC is a frame-shifting germ-line mutation which abolishes the function of cell-cycle-checkpoint kinase 2 (chk2) and hence impairs the cells' response to DNA damage. This variant occurs in 1% of the general Western population but has been reported to be more common among patients with breast and prostate cancer. The aim of this study was to investigate the significance of CHEK2*1100delC as a possible high-risk gene for hereditary prostate cancer in the population of southern Sweden. MATERIAL AND METHODS: We screened for the CHEK2*1100delC variant in 419 men diagnosed with prostate cancer in southern Sweden, 145 of whom were sporadic cases that were divided into two subgroups depending on whether they were diagnosed before (n=64) or after (n=81) the age of 55 years. A further 126 men were classified as familial prostate cancer cases and 148 as hereditary prostate cancer cases. The control group consisted of 305 military conscripts aged 18 years (range 18-21 years). RESULTS: The CHEK2*1100delC variant was found in 1.2% of the cases (sporadic: 0.7%; familial: 1.6%; hereditary: 1.4%) and in 1.0% of the controls. CONCLUSION: The CHEK2 1100delC mutation is not a clinically important high-risk gene for hereditary prostate cancer susceptibility in the population of southern Sweden.

Aged↗
PubMed2005

Geographical variation in incidence of prostate cancer in Sweden.

OBJECTIVE: To investigate the geographical variation in prostate cancer incidence in Sweden, in particular the incidences of screening-detected tumours and curative treatment of prostate cancer. MATERIAL AND METHODS: Data were retrieved from the National Prostate Cancer Register of Sweden for all cases of prostate cancer diagnosed in the year 2000-01. There were a total of 14 376 cases of prostate cancer and the mean total annual age-adjusted incidence was 197/100 000 men. There were 3318 cases in tumour category T1c, i.e. non-palpable tumours diagnosed during work-up for an elevated serum level of prostate-specific antigen, 1006 of which (30%) were asymptomatic and detected at a health check-up. RESULTS: The difference between the counties with the lowest and highest age-adjusted incidences per 100 000 men of total prostate cancer was almost twofold (128 vs 217). The corresponding variation in incidence of category T1c tumours was more than fourfold (13 vs 60); the difference in incidence of T1c tumours detected in asymptomatic men was up to 10-fold (2 vs 20); and there was more than a fourfold variation in incidence of curative treatment between counties (13 vs 67). Measured incidences were mostly highest in urban regions and in counties with university hospitals. CONCLUSION: There are large geographical variations in prostate cancer incidence and in the frequency of curative treatment for prostate cancer in Sweden and there appear to be large geographical variations in the uptake of prostate cancer screening.

Aged↗
PubMed1999

From teaching to learning. Experiences of small CME group work in general practice in Sweden.

OBJECTIVE: To describe the experiences of learning in small groups and the impact of small group continuing medical education (CME). DESIGN: Literature review, personal communication and critical reflection. SETTING: General practice in Sweden. SUBJECTS: Small CME groups. MAIN OUTCOME MEASURES: Occurrence, themes and impact of small CME groups. RESULTS: In 1998, there were approximately 230 small CME groups in Sweden, which means that nearly half of Swedish general practitioners (GPs) participated in such activities. Although widely used in Sweden, small CME groups are less practised than "traditional" CME activities, such as lectures. Group work might enhance knowledge development, enable the assessment of individual learning needs and facilitate the adoption of national guidelines and agreements between primary and secondary care. A competent group leader is crucial. CONCLUSION: A transition from passive to interactive learning in small groups is recommended.

Education, Medical, Continuing↗
PubMed1999

Adverse reactions to food and food allergy in young children in Iceland and Sweden.

OBJECTIVE: To investigate the prevalence of adverse reactions to food and food allergy in Icelandic and Swedish 18-month-old children. DESIGN: Prospective multicentre comparative study. SETTING: Primary health care centres in Sweden and Iceland. SUBJECTS: A total of 324 children in Iceland and 328 in Sweden who attended for regular 18-month check-up. MAIN OUTCOME MEASURES: Adverse reaction to food according to questionnaire, and food allergy according to skin prick tests and double blind food challenge tests. RESULTS: Adverse reactions to food were reported in 27% of children in Iceland and 28% in Sweden. Food allergy was confirmed in 2.0% in both countries. Allergy among other family members was reported in 45% of the Icelandic children and 62% in the Swedish (p < 0.001). Indoor smoking was reported by 30% of the Icelandic families and 3% of the Swedish. Respiratory infections were reported significantly more often in Icelandic children than Swedish. CONCLUSION: Adverse reactions to food and food allergy were similar in Icelandic and Swedish children. At the age of 18 months one can expect to confirm food allergy in approximately one out of 15 children with reported adverse reactions to food.

Food Hypersensitivity↗
PubMed2003

Radiotherapy practices in Sweden compared to the scientific evidence.

A systematic assessment of radiotherapy for cancer was conducted by The Swedish Council on Technology Assessment in Health Care (SBU) in 2001. The assessment included a critical review of the literature on radiotherapy for cancer published in 1994-2001 and a prospective survey of radiotherapy practice in Sweden during 12 weeks in the autumn of 2001. The results of the survey were compared with the evidence derived from the scientific literature, and the following conclusions could be drawn: Radiotherapy is currently given to approximately 47% of new cancer cases This figure is on a par with rates reported from other countries. For most tumour types, curative radiotherapy practices in Sweden are generally supported by the literature. Interstitial brachytherapy has been included in the treatment of non-gynaecological malignancies, and prostate cancer is now the most common indication. Palliative radiotherapy has increased and is today given in a more rational way using single or few fractions However, it still seems to be under-utilized in Sweden. The need for radiotherapy can be expected to increase until the year 2010.

Biopsy, Needle↗
PubMed2005

Homozygosity mapping of familial glioma in Northern Sweden.

About 5% of glioma cases are familial. Most glioma families are not ascribed to the well-known glioma predisposing syndromes. One segregation analysis has supported an autosomal recessive gene in glioma families, which could be studied by homozygosity mapping. The ancestors of seven glioma families from the northern region of Sweden were traced through genealogical databases. A common ancestor and inbreeding were traced to give support to an autosomal recessive gene. Homozygosity mapping was performed with a genome-wide scan of 811 markers with linkage calculations. The families were geographically mapped to see if familial glioma was more common in northern compared with southern Sweden. Three of the seven families were remotely related. Homozygosity mapping did not reveal any allele homozygous for all three families. However, there was a geographical clustering of glioma families in the northern region of Sweden. A non-parametric analysis showed an allele-sharing LOD score of 1.05 for marker D1S196 on chromosome 1q23. Genealogical studies linking glioma families might be a tool for linkage in a small set of families. This study did not support an autosomal recessive gene, implicating a low penetrant dominant gene as a possible explanation to the glioma family clustering.

Brain Neoplasms↗
PubMed2004

Appropriate prophylaxis with restrictive palivizumab regimen in preterm children in Sweden.

AIM: Palivizumab (Synagis) was registered in Sweden in 1999 for prophylaxis against respiratory syncytial virus (RSV) in premature infants. The high costs and the limited knowledge of the efficacy of this substance have led to debate about how and when it should be used. National guidelines for the use of palivizumab in Sweden were constructed in the year 2000. The aim of this study was to evaluate the guidelines. METHODS: A nation-wide prospective study was conducted during the two RSV seasons of the years 2000-2002. The paediatric departments in Sweden reported the use of palivizumab, the indication for its use, and the number of infants born preterm before 36 wk of gestation and less than 2 y old who were admitted to hospital for RSV infection. RESULTS: During the two seasons, 218 (3.8%) children who were born before 36 wk of gestation, and 97 (5.4%) who were born before 33 wk, were hospitalized because of RSV infection. Five children were treated with mechanical ventilation. No death caused by RSV was reported. A total of 390 children were treated with palivizumab, and 16 (4.1%) of those who received prophylactic treatment were admitted to hospital with RSV infection. CONCLUSION: We consider the comparatively restrictive Swedish recommendations to be safe and recommend that palivizumab should also be used very restrictively in the future. In our opinion, palivizumab in preterm children could be recommended only for those with chronic lung disease younger than 1 y of age, and with active treatment for their disease.

Antibodies, Monoclonal↗
PubMed2006

Growth from birth to age 19 for children in Sweden born in 1981: descriptive values.

AIM: To describe Swedish children's growth (i.e. height, weight and body mass index) from birth to age 19 y. METHODS: Every infant born on the 15th of any month in 1981 and living in Sweden as of 31 December 1989 was sampled. Longitudinal data were collected from childhood and school health records, and analysis by piecewise linear regression gave statistical descriptions of height, weight and body mass index for every age group. RESULTS: The data include measurements of 3107 of 3158 sampled children; 1.6% of individuals are missing, so non-response bias is minimal. Thus, statistical descriptions and comparisons with similar data sets can be based on data with unusually high national representativeness. Selected subgroups (i.e. individuals born outside Sweden, suffering from chronic disease causing major growth impairment, or with birthweight <2500 g) deviate in growth pattern, and exclusion of these subgroups increases means and decreases SD for height but only slightly influences summary statistics for weight and body mass index. CONCLUSION: This study represents, without selection bias, the current growth situation among children and adolescents in Sweden, enabling both epidemiological comparisons over time and comparisons with other national surveys.

Adolescent↗
PubMed1999

Trends in overweight and obesity among 18-year-old males in Sweden between 1971 and 1995.

The aims of the study are to analyse Swedish trends in overweight and obesity-as measured by body mass index (BMI)-between 1971 and 1995, and to examine socioeconomic and geographic differences between groups of individuals on the basis of information on 18-y-old military conscripts. The study population comprises all males born in 1953, 1958, 1963, 1968, and between 1973 and 1977, reported to be living in Sweden at 17 y of age according to nationwide population registers (RTPs). Utilizing the unique personal ID number, sociodemographic data in the RTPs and in Population and Housing censuses were linked to data on BMI in the national Military Service Conscription Registry for the years 1971 to 1995. These data were obtained from compulsory medical examinations held at military induction at 18 y of age. BMI data were available for 448 732 (89%) of a total of 503 689 subjects. Mean BMI increased by 6.6% over the study period-from 21.1 kg/m2 in 1971 to 22.4 kg/m2 in 1995. Unadjusted trend analyses showed a 2.4 times increase in the prevalence of overweight among 18-y-old males over the period-from 6.9% in 1971 to 16.3% in 1995. Over the same years, the prevalence of obesity increased 3.5 times-from 0.9% to 3.2%. After adjustment for muscle power, demographic factors, and living area, the prevalence of overweight was found to have increased 1.4 times, and obesity 1.7 times between 1971 and 1993. The prevalence of overweight was considerably higher among 18-y-old males from low-educated families than among those from high-educated families in both 1971 and 1995. The prevalence of overweight was also found to be higher in both 1971 and 1995 among young men from rural and/or sparsely populated areas than among those living in Sweden's largest cities. Mean BMI, and the prevalence of overweight and obesity have increased among 18-y-old males in Sweden over the last 24 y. The increased risk of overweight among young men from low-educated families and those from rural and/or sparsely populated areas detected in 1971 was still evident in 1995.

Adolescent↗
PubMed2001

Life situation and posttraumatic symptoms: a follow-up study of refugees from the former Yugoslavia living in Sweden.

Posttraumatic symptoms were assessed by means of the Harvard Trauma Questionnaire among 27 severely traumatized refugees from the former Yugoslavia in psychiatric treatment and then 3 years later, after an average of 5.5 years in Sweden. At follow-up the subjects also answered a questionnaire about their life situations. No significant change in average symptom level had taken place at follow-up. Seventeen subjects met the DSM IV criteria for posttraumatic stress disorder (PTSD) at both times. However, five subjects who met the PTSD criteria in the first study did not at follow-up, and the opposite was true for another five subjects. Fifteen subjects reported contact with psychiatric care during the past year. Unemployment and dependence on social welfare were high at follow-up. The unemployment rate of 32% was almost six times greater than that for the regular Swedish labor force but comparable to that of the whole Bosnian labor force in Sweden. Social contacts with the majority population were as common as with compatriots, but two-thirds of the subjects expressed a wish for more social contacts outside the family. Positive factors in the subjects' life situations were the housing situation and the fact that most subjects had at least reasonable knowledge of the majority language. However, a minority of the group still had no formal competence in Swedish, with negative consequences for labor market integration and social contact with Swedes. Two-thirds of the group had made no definite decision to stay in Sweden.

Adult↗
PubMed2005

Mental health services provided for physically abused children in Sweden. A 4-year follow-up of child and adolescent psychiatric charts.

As there has been a considerable increase regarding the number of police reports on physical child abuse in Sweden since the mid-1980s, there should be an increased number of children in need of trauma-focused mental health treatment. During 1986-1996, there were 126 children reported as being physically abused by a parent or equivalent and reported to the police in a police district in Sweden. Fifty-seven of these children (45%) had been the objects of interventions from Child and Adolescent Psychiatric Services (CAPS). The aim of this study was to investigate the extent and content of this. Questions addressed were: when did the children receive interventions, were these trauma-focused and could this be reflected in their charts? This group of children was referred to CAPS for different reasons and 35/122 referrals were made under the label of child physical abuse. Overall, interventions were mainly directed toward the parents. Six of 126 physically abused children received individual therapy. Abuse was not mentioned in the charts for 23 of the children, even though eight of them had been referred due to abuse. The results of this study indicate that physically abused children have often been in contact with mental health services prior to the abuse for different reasons, initially due to individual problems and later on regarding family conflict. Individual interventions for physically abused children were rare due to for instance CAPS workloads, poor motivation among parents and children, and maybe due to professionals' lack of knowledge regarding effective treatment. The introduction of a routine checklist is recommended early on to find indications of abuse, as is the need of exploring methods working with physically abused children in Sweden.

Adolescent↗
PubMed1998

HIV testing for HIV prevention: a comparative analysis of policies in Britain, Hungary and Sweden.

This paper compares policies on named HIV testing in the context of HIV prevention in Britain, Hungary and Sweden, and considers the extent to which these policies are based on evidence of effectiveness or on other, more contextual, factors. In Britain, testing has not featured significantly as a prevention strategy, and named testing has generally been carried out only with the voluntary, informed consent of individuals. In Hungary, testing is central to HIV prevention, and is required by law of certain groups. HIV testing is carried out mainly on a voluntary basis in Sweden, but, unlike in Britain, it has been actively promoted by public health authorities. The paper contrasts the 'right not to know' one's HIV status which is widely respected in Britain, with the 'responsibility to find out' which is more pervasive in Hungary and Sweden. Although policy makers in all three countries appear convinced that their's is the right approach, there appears to be as yet a dearth of convincing evidence to support their arguments.

Communicable Disease Control↗
PubMed2000

Trends in the incidence and severity of stab wounds in Sweden 1987-1994.

OBJECTIVE: To evaluate the incidence, types of injury, medical consequences, and mortality of patients with stab wounds in Sweden. DESIGN: Retrospective case study. SETTING: The Swedish National Hospital Discharge Register (SNHDR) and the Register of Causes of Death, Statistics Sweden (RCDSS) SUBJECTS: 1315 patients with stab wounds. All 1507 episodes were treated in Swedish hospitals from 1987-1994. MAIN OUTCOME MEASURES: Incidence of stab wounds in Sweden, mortality, types of injuries and medical consequences. RESULTS: From 1987 to 1994, 1315 people were admitted to Swedish hospitals with stab wounds, which corresponds to 2.1 injuries/100,000 population/year. In all, 1507 episodes were treated in hospital. There were 1121 men (85%) and 194 women (15%), with a median age of 32 years (range 1-88). The annual incidence was relatively constant during this period. The total number of deaths was 45/1315 (3.4%). Among these, 13 (29%) had thoracic, 9 (21%) abdominal, 7 (16%) head/neck and 7 (15%) extremity injuries. Twenty percent of those admitted to hospital had to spend more than one week there. CONCLUSIONS: The incidence of stab wounds was low and the annual incidence stable. Young men in urban areas were the commonest victims. Injuries of the trunk were commonest, followed by injuries to the head and neck and limbs, 80% of the patients were discharged from hospital within a week, and 3% of those treated in hospital for stab wounds died.

Abdominal Injuries↗
PubMed2001

Pedestrians who required admission to hospital after collisions with motor vehicles in Sweden from 1987 to 1994.

OBJECTIVES: To report the incidence, range of injury, medical consequences, and mortality of pedestrians in collisions with motor vehicles in Sweden. DESIGN: Retrospective case study. SETTING: The Swedish Hospital Discharge Register (SHDR). SUBJECTS: 8684 pedestrians in collisions with motor vehicles had a total of 12,036 episodes treated in Swedish hospitals from 1987-1994. INTERVENTIONS: Statistical analysis of the Register. MAIN OUTCOME MEASURES: Incidence of pedestrians in collisions with motor vehicles in Sweden, mortality, range of injuries, and medical consequences. RESULTS: From 1987 to the end of 1994, a total of 8684 pedestrians were admitted to Swedish hospitals after collisions with motor vehicles. A mean of 17.6 persons were admitted/100,000 population/year. In all there were 12,036 admissions of injured pedestrians. There were 4593 men (53%) and 4091 women (47%), with a median age of 47 (range 1-100) years. The annual incidence of injured pedestrians (both men and women) decreased significantly during this period. Injuries to the extremities were commonest (39% fractures), followed by injuries to the head and neck (34%). The total number of deaths in our series of patients was 444 (5%). Of these, more than half had head injuries, 22% had fractures, and 5% abdominal or thoracic injuries. CONCLUSION: The number of pedestrians in collisions with motor vehicles is low in Sweden. Injuries to the extremities were commonest, followed by injuries to the head and neck. Old people were most likely to be injured and 5% of the patients treated in hospital died.

Accidents, Traffic↗
PubMed2002

Injured moped riders who required admission to hospital in Sweden from 1987 to 1994.

OBJECTIVES: To find out the incidence, extent of injury, medical consequences, and mortality rate of moped riders involved in crashes in Sweden. DESIGN: Retrospective case study. SETTING: The Swedish Hospital Discharge Register (SHDR). SUBJECTS: 4716 moped riders, a total of 5857 admissions to Swedish hospitals from 1987-94. INTERVENTIONS: Statistical analysis of the Register. MAIN OUTCOME MEASURES: Incidence of injured moped riders in Sweden, mortality rate, types of injuries, and medical consequences. RESULTS: From 1987 to 1994, Swedish hospitals admitted 4716 moped riders (5857 admissions) injured in crashes, which corresponds to a mean of 8.5 injured/100 000 population a year. Of these 3993 were male (85%) and 723 female (15%), with a median age of 16 years (range 3-93). Twenty-four percent of those admitted to hospital spent more than a week there. The annual number of injured moped riders did not change significantly during this period. The total number of deaths in hospital was 59 (1%). Among those who died in hospital, 32 (54%) had head injuries, 16 (27%) fractures, and 5 (9%) abdominal or thoracic injuries. CONCLUSION: The number of injured moped riders in Sweden is low. Fractures of the extremities were most common, followed by injuries to the head and brain. The usual victim was a teenager or young man. Of the patients treated in hospital few died, most of whom were elderly men.

Accidents, Traffic↗
PubMed1998

A survey of surgical treatment of gallstone disease and the diffusion of laparoscopic surgery in Sweden 1992-93.

OBJECTIVE: To study the diffusion of laparoscopic biliary surgery in Sweden, 1992-93. DESIGN: A prospective survey of all biliary surgery for gallstone disease recorded for 8 weeks in 1992 and the same period in 1993. SETTING: All surgical departments in Sweden. SUBJECTS: A consecutive series of 1938 patients in 1992 and 1748 patients in 1993. MAIN OUTCOME MEASURES: The changing indications, diffusion, morbidity, mortality, postoperative and hospital stay after laparoscopic cholecystectomy (LC) in Sweden in 1992 compared with 1993. RESULTS: Despite the spread of LC, the indications did not change between 1992 and 1993 (p=0.31). The total number of cholecystectomies decreased from 1938 in 1992 to 1748 in 1993. The overall percentage of laparoscopic cholecystectomies (LCs) increased from 74.7% to 81.2% (p <0.001) between 1992 and 1993. Postoperative morbidity and mortality after LC did not differ between 1992 and 1993, but the total morbidity was 9.0% in 1992 and 7.0% in 1993 (p=0.02). Mortality for all cholecystectomies did not change over the periods, being 0.6% in 1992 and 0.2% in 1993 (p=0.07). The numbers of LCs done in any hospital were divided in two groups, 20 or fewer and 21-80. In the smaller group, the postoperative morbidity was 7.1% and in the larger group it was 7.0%, (p=0.9). The postoperative mortality was 0.1% in both groups. The postoperative and total hospital stays of all cholecystectomies decreased from 3.4 days in 1992 to 2.9 days in 1993 (p=0.001) and from 5.0 in 1992 to 4.4 days in 1993 (p < 0.001), respectively. The postoperative and total hospital stays of LCs decreased from 2.0 in 1992 to 1.8 days in 1993 (p=0.009) and from 3.3 in 1992 to 2.9 days in 1993 (p=0.007), respectively. CONCLUSION: Despite the introduction and diffusion of the new technology, LC, the indications for surgery did not change and the number of cholecystectomies did not increase from 1992 to 1993. The morbidity and mortality of LC and the mortality of all cholecystectomies were unchanged between 1992 and 1993, but the morbidity for all cholecystectomies decreased. The number of LC or all cholecystectomies done in any particular hospital were not related to morbidity or to mortality.

Cholecystectomy, Laparoscopic↗
PubMed2001

High use of sedatives and hypnotics in ethnic minorities in Sweden.

OBJECTIVE: To study use of analgesics, and psychotropic drugs in relation to health indicators in four ethnic minorities in Sweden in comparison with Swedish-born. DESIGN: Cross-sectional study based on data from the Survey of Living Conditions and Immigrant Survey of Living Conditions in Sweden in 1996. STUDY POPULATION: Random samples of 1890 Swedish residents, in the age range 27-60 years, born in Chile, Poland, Turkey and Iran and 2452 age-matched Swedish-born residents. RESULTS: A two fold higher use of prescribed analgesics and antidepressants and a five to sixfold higher use of hypnotic and sedative drugs was demonstrated in members of ethnic minorities in Sweden in comparison with Swedish-born. In a multivariate analysis the higher use of prescribed analgesics and antidepressants was explained almost entirely by a higher morbidity in the minority study groups. A twofold higher use of sedatives and hypnotics was demonstrated in the minority study populations compared to the Swedish-born sample even after adjustment for extensive indicators of psychiatric and physical health in the multivariate analysis. CONCLUSIONS: The higher use of sedatives and hypnotics in relation to health in the minority samples in the present study indicates a differential treatment of minor psychiatric disorders of members of ethnic minorities in Swedish health services. Further studies that yield more qualitative data regarding the interaction of Swedish physicians with migrant patients are needed to explain these differences and to create a basis for intervention.

Adult↗