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At least 379 records · Page 21Linked to original sources
PubMed1988

Incidence and geographic distribution of serologically verified cases of nephropathia epidemica in Sweden.

A nationwide survey of hospitalized, serologically verified adult nephropathia epidemica cases in Sweden from 1978 to 1981 was performed. Serum was collected from 1,063 patients with a diagnosis of nephropathia epidemica or one of 10 other renal diseases with related symptoms. Sera were analyzed by indirect immunofluorescence technique for the presence of immunoglobulin G antibodies to Hantaan virus, causative agent of Korean hemorrhagic fever that cross-reacts with the nephropathia epidemica agent. Antibodies were present in 368 patients, 355 of whom also fulfilled four or more of six criteria for clinical diagnosis of nephropathia epidemica. The male:female ratio was 2.7:1. The total number of cases in Sweden varied between 26 and 144 per year, which coincided with the fluctuations in small rodent populations. The highest incidence was found in Västerbotten County, with a maximum crude incidence rate of 23.5 cases per 100,000 inhabitants per year. Mean crude incidence in Sweden during the study period was 1.3 cases per 100,000 inhabitants per year. The southernmost cases lived in proximity to the 59th parallel. Thus, nephropathia epidemica was found to be prevalent south of the 60th parallel, which was previously assumed to be its southern boundary.

Adolescent↗
PubMed1997

Survival after colon cancer 1973-1990 in Sweden. Convergence between catchment areas.

OBJECTIVE: The objective of the study is to analyze the temporal trends in relative survival among patients with colon cancer in catchment areas of hospitals of different categories and regions in Sweden. BACKGROUND: In Sweden, cancer of the colon is the second most common type of cancer in women and the third most common in men, afflicting approximately 3000 individuals annually. During the past decades, survival has improved, but it is not clear what factors have contributed to this development. Changes in the natural history of the disease, altered alimentary habits, advances in diagnosis, and treatment have been suggested. The effects of centralized care still are debated. METHOD: Longitudinal observational study of relative survival of all patients with colon cancer from 1973 to 1993 in Sweden (n = 41,700) by period of diagnosis and hospital category of primary catchment area was conducted. Multivariate analyses of relative hazards of any interaction between length of follow-up, period of diagnosis, hospital category of the primary catchment area, age at diagnosis, and region were performed. RESULTS: Relative survival in patients with colon cancer improved substantially from 1973 through 1990. The prognosis in patients from primary catchment areas of regional-university hospitals did not change during this period, and the prognostic improvement was noted only in county and local hospital areas, where survival approached that of regional hospitals. Although new management regimens may have been introduced unevenly, improved perioperative care best explains this convergence. Low-incidence regions showed the lowest survival, but this improved with time, although not significantly. CONCLUSIONS: Although survival in patients with colon cancer improved and convergence between different catchment area categories was seen, a large initial gap as well as a remaining difference may warrant future monitoring to ensure equal prognosis, irrespective of domicile.

Aged↗
PubMed2000

Inflammatory bowel disease in children and adolescents in Sweden, 1984-1995.

BACKGROUND: A prospective study of inflammatory bowel disease (IBD) in Sweden was performed to investigate whether the incidence and morbidity have changed from 1984 through 1995. METHODS: Children 15 years of age or less with IBD were included--i.e., those with a definite diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and those classified as having indeterminate colitis (IC) and probable Crohn's disease (PCD). The study covered 56.5% of the pediatric population of Sweden. RESULTS: The diagnosis of IBD was made in 639 children, which corresponds to a mean annual incidence of 5.8 per 100,000. The incidence increased from 4.6 per 100,000 per year from 1984 through 1986 to 7.0 from 1993 through 1995. It reflected an increase in UC from 1.4 to 3.2 per 100,000 per year, which is a significant yearly percentage of increase (8%; confidence interval, 2-14%; P < 0.05). In contrast, no change occurred in the incidence of CD (1.2-1.3 per 100,000). The incidence of IC and PCD also remained fairly stable. The percentages of children who underwent surgery decreased from 17.3% in the first 6 years to 4.6% in the last 6 years (P < 0.001). Surgery was performed in 27.7% of CD and 5.3% of UC cases. The median age at diagnosis was 12.2 years for UC, 13.0 years for CD, 11.2 for IC, and 11.2 for PCD. At diagnosis, 48 children (7.5%) were 5 years of age or less, whereas most of the patients were 11 years of age or more (398 children, 62.3%). CONCLUSIONS: In Sweden, the incidence of UC has increased, whereas that of CD remains the same. A significant number of children were classified with IC and PCD. In most children, IBD was diagnosed when they were 11 years old or more, but some cases were detected even in those below 6 years of age. A decrease in the frequency of surgery occurred during the study.

Adolescent↗
PubMed2001

A review of serious injuries and deaths from bicycle accidents in Sweden from 1987 to 1994.

BACKGROUND: Injured cyclists are often seen in emergency departments. The aims of this study were to determine the long-term incidence of injuries, age and gender distributions, mortality rates, and geographic differences among all patients admitted to hospitals because of bicycle accidents in Sweden. METHODS: Between 1987 and 1994, 34,606 persons (39,183 admissions) were injured in bicycle accidents in Sweden (19,978 men and 14,628 women). RESULTS: The annual frequency of hospital admissions ranged from 4,585 to 5,212. Fifty-seven patients were admitted with bicycle-related injuries per 100,000 population each year. Children between 5 and 14 years of age, especially boys, and men older than 70 were more commonly involved. Injuries to the head and brain were very frequent (46%). The survival rate was poorest in persons of older age, male gender, and cyclists involved in collisions with motor vehicles. CONCLUSION: About 4,900 cyclists have been hospitalized each year after bicycle accidents in Sweden. Young children were affected very often, with injuries of the brain and various types of fractures of the extremities being common. Significant factors for a poor survival outcome included old age, male gender, and collisions with motor vehicles.

Accidents, Traffic↗
PubMed2001

Complications of epilepsy surgery after 654 procedures in Sweden, September 1990-1995: a multicenter study based on the Swedish National Epilepsy Surgery Register.

OBJECTIVE: To present the first national multicenter study on complications after epilepsy surgery procedures to include all epilepsy surgery centers in Sweden: Göteborg, Linköping, Lund, Stockholm, Umeå, and Uppsala. METHODS: Every epilepsy surgery procedure in Sweden is reported to the Swedish National Epilepsy Surgery Register. The report includes relevant social and medical items and complications. A complication is defined as minor if it resolves within 3 months and major if it affects activities of daily living and lasts longer than 3 months. Follow-up data are recorded for 2 years after the operation. Intrinsic checkpoints and external revision validate the register data. RESULTS: During the inclusion period (September 1990-December 1995), 654 surgical procedures were performed (age range, 6 mo-67 yr). Of these, 205 were invasive electrode procedures (182 first investigations and 23 reinvestigations), and 449 were therapeutic procedures (375 first operations and 74 reoperations). After invasive electrode procedures, only minor complications were reported (6.3%). For all 449 therapeutic procedures (including reoperations), minor complications were reported in 8.9% and major complications in 3.1 %. Only one major complication was reported in a patient under the age of 35 years. CONCLUSION: This is the first national multicenter study on complications after epilepsy surgery. It demonstrates that these procedures as performed at six different centers in Sweden are safe, but also that risk is related to age. In patients younger than age 35 years, the risk for a major complication after invasive subdural strip electrode investigation and epilepsy surgery is low.

Adolescent↗
PubMed1999

Epiglottitis in Sweden before and after introduction of vaccination against Haemophilus influenzae type b.

BACKGROUND: Acute epiglottitis is an important manifestation of invasive Haemophilus influenzae type b (Hib) infection. In 1992 and 1993 Hib vaccination was introduced in the general childhood vaccination program in Sweden. The aim of the present investigation was to study the impact of Hib vaccination on the diagnosis of epiglottitis in Sweden in children as well as adults. METHODS: A retrospective national population-based study on the incidence of epiglottitis in Sweden was performed for the 10-year period 1987 to 1996. The incidence calculations were based on figures from the national register of all patients treated at Swedish hospitals. The incidence (cases/100,000/year) for the prevaccination period 1987 to 1991 was compared with the incidence after Hib vaccination was introduced. RESULTS: In children a substantial decrease was found after introduction of large scale vaccination against Hib. Below 5 years of age the annual incidence decreased from 20.9 in 1987 to 0.9 in 1996. In adults a tendency toward a decrease in incidence was evident. CONCLUSIONS: Introduction of Hib vaccination in a general childhood program was followed not only by a >90% reduction in the incidence in the youngest age group but also by a reduction in the incidence in the older age groups and among adults.

Adult↗
PubMed2002

Evidence for environmental influence on CYP2D6-catalysed debrisoquine hydroxylation as demonstrated by phenotyping and genotyping of Ethiopians living in Ethiopia or in Sweden.

Black Africans show lower rates of CYP2D6- and CYP2C19-dependent drug metabolism compared to Caucasians of the same apparent genotype. To determine if environmental factors are responsible for this difference, the genotypes and phenotypes of CYP2D6 and CYP2C19 among Ethiopians living in Sweden (n = 70) were assessed and compared to our previously published data from Ethiopians living in Ethiopia (n = 114) and Swedish Caucasians (n = 134). There was no significant difference in CYP2C19 genotype or phenotype as assessed by mephenytoin between Ethiopians in Sweden or in Ethiopia. However, Swedes were significantly more rapid for CYP2C19 activity than both Ethiopian groups (P < 0.01). A comparison of the debrisoquine MR among individuals of the same CYP2D6 genotype revealed that Swedes exhibited the highest rate of debrisoquine metabolism, followed by Ethiopians in Sweden and Ethiopians in Ethiopia. The difference between the Ethiopian groups was significant (P < 0.02 using a univariate test ANOVA) and amounted to approximately 50% of the magnitude of the MR difference between Swedes and Ethiopians in Ethiopia. It is tempting to speculate that inhibitory dietary factors may explain the differences seen between the two Ethiopian groups and that these components in the past might have contributed to dietary stress-mediated selection of duplicated and multiduplicated active CYP2D6 genes, as frequently seen in Ethiopians. In conclusion, the results indicate a significant influence of environmental factors as an explanation for the difference in capacity for CYP2D6, but not CYP2C19 metabolism between Caucasians and Black Africans. Additional factors remain to be elucidated to fully explain the interethnic differences in CYP2D6 activity.

Adult↗
PubMed2005

Changes in demographic factors and mortality after out-of-hospital cardiac arrest in Sweden.

OBJECTIVE: To describe changes between 1992 and 2003 in age, sex, factors at resuscitation and survival among patients suffering from out-of-hospital cardiac arrest in Sweden. METHODS: This was a prospective observational study including various ambulance organizations in Sweden. Patients suffering from out-of-hospital cardiac arrest between 1992 and 2003 included in the Swedish Cardiac Arrest Registry were followed for survival to 1 month. RESULTS: In all 19 791 cases took part in the survey. There was a slight increase in mean age from 68 to 70 years (P = 0.025) and an increase of females from 29 to 32% (P = 0.0001). There was a change in witnessed status (P < 0.0001) with an increase in crew-witnessed cases and a decrease in non-witnessed cases. There was a decrease in cases of a cardiac etiology from 75 to 61% (P < 0.0001) and a decrease in the percentage found in ventricular fibrillation from 36 to 25% (P < 0.0001). When crew-witnessed cases were excluded the proportion receiving bystander cardiopulmonary resuscitation (CPR) increased from 30 to 42% (P < 0.0001). There was a slight increase in the overall proportion of patients hospitalized alive from 16 to 20% (P = 0.032). There was no significant change in the overall proportion of survivors at 1 month after cardiac arrest (4.5% in 1992 and 5.0% in 2003). CONCLUSIONS: Among patients suffering from out-of-hospital cardiac arrest in Sweden some changes took place. The most important ones were a decrease in the proportion of patients found in ventricular fibrillation and an increase in the proportion of patients receiving bystander CPR. The proportion of patients admitted alive to hospital increased moderately, whereas the proportion of patients alive after 1 month remained unchanged.

Age Distribution↗
PubMed1996

A survey of treatment routines and educational level of health care providers in the initial phase of suspected acute myocardial infarction in Sweden in 1994. Swedish Working Group on Early Heart Attack Care.

The aim of this survey was to explore treatment routines with regard to early heart attack care at various hospitals in Sweden. All the hospitals in Sweden with a coronary care unit or its equivalent were sent a postal enquiry about early heart attack care including use of various medications and educational level of health care providers. In all, 84 of 86 hospitals (98%) answered the enquiry. Prior to hospital admission, 10% of the hospitals used thrombolytic agents, 10% used beta-blockers and 55% used aspirin. In only 4% of hospitals was thrombolytic treatment initiated in the emergency department and in 17% beta-blockers were initiated. The proportion of acute myocardial infarction (AMI) patients who received thrombolytic treatment varied from 10% to more than 80%, with a mean value of 41%. The proportion of AMI patients who received intravenous beta-blockade varied from 0 to 93%, with a mean value of 24%. This survey indicates that the vast majority of hospitals in Sweden use thrombolytic agents in more than 30% of AMI patients and aspirin in more than 80% of AMI patients. The use of intravenous beta-blockade is lower than expected. Considering the strong association between the delay before instituting therapy and outcome, it is surprising that treatment is not initiated more frequently outside hospital or in the emergency department.

Adrenergic beta-Antagonists↗
PubMed1994

The annualized incidence of contact lens induced keratitis in Sweden and its relation to lens type and wear schedule: results of a 3-month prospective study.

All cases of contact lens induced keratitis (epithelial defects with an underlying infiltrate or ulcer) among cosmetic wearers in Sweden were collected in a 3-month prospective study and analyzed for risk factors in relation to lens type and wear schedule. Every ophthalmologist in Sweden was invited to participate and 100% responded. Viral cases were excluded. The number of lens wearers in Sweden, subdivided by lens type and wear schedule, was obtained in a parallel 3-month study among 71% of the lens fitters, who counted all their wearers, recording lens type and wear schedule as well as revisit and replacement schedules. The annualized incidence per 10,000 wearers was 1.48 for daily wear of rigid gas permeable lenses, 2.16 for daily wear and 10.00 for extended wear of disposable soft lenses, and 2.17 for daily wear and 13.33 for extended wear of conventional soft lenses. Thus, extended wear was associated with a significantly (P < 0.01-0.001) higher (5-6 times) risk of keratitis than daily wear. There were no other significant differences between the incidence figures. The Swedish incidence figures were approximately half as high as those reported in the U.S. Of the lesions, only 12% were located within the pupillary area and only 8% were corneal ulcers. Only three patients (12%) suffered a decrease in visual acuity. Severe keratitis was significantly (P < 0.01) more common among conventional soft lens wearers (accounting for all ulcers, all lesions within the pupillary area, and all decreases in visual acuity) than among wearers of disposable lenses.

Adult↗
PubMed2005

Burden of illness of chronic low back pain in Sweden: a cross-sectional, retrospective study in primary care setting.

STUDY DESIGN: Cross-sectional survey of patients with chronic low back pain in primary care setting. OBJECTIVES: To analyze the health care resource use, productivity loss, and health-related quality of life of patients with chronic low back pain in Sweden. SUMMARY OF BACKGROUND DATA: Despite the clinical and economic importance of chronic LBP, the overall burden of the disease is not well documented. METHODS: Cross-sectional data on patients' socio-demographics, disease-related healthcare resource use during the past 6 months, inability to work during the previous 3 months, and quality of life at the time of the study visit were collected using questionnaires completed during an outpatient visit. Patient recruitment and data collection was performed at 14 primary care centers in Sweden. Patients over 18 years of age with chronic LBP present at least 50% of the days during the previous 3 months were included. Regression analysis was used to investigate factors associated with variation in costs. RESULTS: Based on a sample of 302 patients, the total annual direct costs for chronic LBP per patient were estimated at 3,100 Euros, or 2,900 United States dollars, in 2002 prices, constituting 15% of the total annual LBP costs per patient. The indirect costs (mainly productivity loss because of lost work days) were estimated at 17,600 Euros (16,600 United States dollars) per patient, or 85% of the total LBP costs per patient. Direct and indirect costs were positively correlated with disease severity, disease duration, and female gender. The mean Roland & Morris score was 12.2, and the Medical Outcomes Study 8-Item Short Form physical and mental summary component scores were 35.2 and 41.6, respectively. CONCLUSIONS: In Sweden, the indirect costs for chronic LBP appear to be substantially higher than the direct costs for pharmaceuticals, medical visits, physiotherapy, andhospitalizations. The high indirect costs indicate that more effective treatments for chronic LBP could potentially lead to cost savings even if the therapy costs were higher.

Activities of Daily Living↗
PubMed1987

Genomic comparison of herpes simplex virus type 1 isolates from Japan, Sweden and Kenya.

One-hundred and seventy-two epidemiologically unrelated herpes simplex virus type 1 (HSV-1) strains isolated in Japan (104 strains) and Sweden (68 strains) were compared by analysis of their genome structures using four restriction endonucleases, BamHI, KpnI, SalI and HindIII. In addition, 32 Kenyan HSV-1 isolates previously compared to Japanese isolates were included for further comparison with the Swedish isolates. Remarkable and statistically significant differences were found between the HSV-1 isolates from the three countries. One-hundred and thirty cleavage sites were examined, and it was shown that isolates from two of the three countries were statistically distinguishable at 27 of these loci. Pairwise comparison between isolates from Japan and Sweden, Kenya and Sweden, and Japan and Kenya revealed variation in 18, 16 and 23 sites, respectively. By considering gains and losses of 19 sites, the total of 204 strains could be classified into 92 distinct cleavage patterns. Isolates from the three countries could be distinguished from each other by the pattern, except for one Swedish and two Kenyan isolates which shared a pattern. Twenty-one fragments that were present or absent only in individual isolates from one or other of the three countries could be detected. These results show that HSV-1 strains from geographically separate countries or anthropologically different races have distinct distributions of endonuclease recognition sites.

DNA Restriction Enzymes↗
PubMed1996

Distribution and genetic heterogeneity of Puumala virus in Sweden.

Small mammals trapped in Sweden were analysed for specific antibody responses against three hantavirus serotypes and for the presence of viral antigen. To determine the genetic identity of viral RNA in lungs of seropositive bank voles (Clethrionomys glareolus), polymerase chain reactions and subsequent partial sequencing of both the M and S segments were employed. The sequences obtained were all identified as Puumala (PUU) virus, with a high degree of heterogeneity between the different geographical localities. Alignment of nucleotide and deduced amino acid sequences, together with phylogenetic analysis, showed that PUU viruses circulating in central Sweden were distinct from those in the northern region. The localization of the two distinct PUU virus genotypes was shown to correlate with the postglacial recolonization of Sweden by bank voles.

Animals↗
PubMed2005

Preterm birth in Sweden 1973-2001: rate, subgroups, and effect of changing patterns in multiple births, maternal age, and smoking.

BACKGROUND: The objectives of this report are to evaluate changes in the preterm birth rate in Sweden 1973-2001. Furthermore, describe the proportion of spontaneous and indicated preterm births and assess risk factors for the subgroups of preterm birth during the period from 1991 to 2001. METHODS: A population-based register study of all births occurring in Sweden from 1973 to 2001 registered in the Swedish Medical Birth Register was designed. The analysis of subgroups was restricted to the period 1991-2001. Gestational age was calculated using last menstrual period and best estimate. Odds ratio for preterm birth related to risk factors was calculated for the subgroups' spontaneous and indicated preterm birth. RESULTS: After an increase in the beginning of the 1980s, the preterm birth rate has decreased from 6.3% in 1984 to 5.6% in 2001 (P < 0.0001). The proportion of multiple births born preterm of the total birth rate increased from 0.34% in 1973 to 0.71% in 2001 (P < 0.0001). Spontaneous preterm births account for 55.2% and iatrogenic preterm births for 20.2% of all preterm births. The strongest association with maternal smoking in early pregnancy was found at gestational age <28 weeks and spontaneous preterm birth [odds ratio (OR) smoking versus no smoking: 1.55, 95% confidence intervals (CI): 1.42-1.69]. The strongest association for maternal age was found between gestational age <28 weeks and indicated preterm birth (OR 5-year increase: 1.34, 95% CI: 1.21-1.47). CONCLUSIONS: The preterm birth rate in Sweden has decreased since the mid 1980s. The composition of different subtypes of preterm birth in a Scandinavian low-risk population seems to be similar to populations with higher incidence of preterm birth and perinatal infections.

Adult↗
PubMed1985

Regional differences in the idiopathic hemochromatosis gene frequency in Sweden.

Screening for idiopathic hemochromatosis (IH) in 941 men, 55 years of age, did not reveal any individual with both biochemical abnormalities and liver iron content compatible with homozygosity for the IH gene. In a large autopsy series of 8 834 males representative of southern Sweden, we found classical hemochromatosis in 0.1%. The results are in contrast with the high frequency of homozygous IH found in the county of Jämtland in central Sweden. We suggest that the difference in gene frequency is a result of enrichment of the recessive IH gene in the Jämtland population by the mechanisms of sampling and drift. We conclude that population screening for early IH in southern Sweden is not worthwhile.

Autopsy↗
PubMed1990

Moist snuff in Sweden--tradition and evolution.

Snuff-dipping was already widespread in Sweden in the 19th century. After the 1920s snuff sales went down, but Sweden still kept its position as world leader in per capita consumption of moist snuff. Following a major advertising campaign snuff consumption began rising again in the late 1960s. The Swedish Tobacco Company claims that Swedish snuff is a 'less harmful' alternative to cigarettes. Swedish epidemiological studies indicate that there is a cancer risk from snuff-dipping, but it is low compared with smoking. Accordingly, the STC claims to "do a good job replacing cigarettes with snuff". However, an analysis of the trends in tobacco usage patterns in Sweden during the last few decades does not support this claim. The marketing of moist snuff has not primarily attracted older smokers who would seek help in order to stop smoking, but young people. The use of snuff is no prerequisite and no guarantee for a decrease of smoking. On the contrary, taking up snuff must be seen as an introduction to the tobacco habit and possibly a first step towards taking up cigarettes.

Adolescent↗
PubMed2006

What drug policies cost: estimating drug policy expenditures in Sweden, 2002: work in progress.

AIM: To estimate drug policy expenditures in Sweden for 2002. DATA AND METHOD: The various governmental agencies with drug policy responsibilities were identified and then requested to provide information on their actual spending on these activities. For most agencies additional information was obtained from special studies or expert opinion. FINDINGS: Drug policy expenditures are not easily identified in Swedish official statistics. The results have a very wide range between 500 and 1,400 million Euros during 2002, with 950 million Euros as a baseline estimate. Two items each account for almost 60% of the total-police (including customs and courts) and corrections-whereas treatment expenditures and income support represent about one-fifth, respectively. Comparison with the most recent previous estimate (1991) shows a substantial higher level in 2002. CONCLUSIONS: The findings suggest that a great deal of money is invested in drug policy measures in Sweden today and that it has most probably increased since the early 1990s. This development probably reflects the increase in number of problematic drug users in Sweden as well as increasing attention paid to the drug problem, foremost in the criminal justice system. More work is needed in developing a drug budget that is more easily available and in producing more reliable estimates both across sectors and across time. The need to develop the conceptualization of drug policy measures is also discussed.

Costs and Cost Analysis↗
PubMed2006

Trends in alcohol-related mortality in Sweden 1969-2002: an age-period-cohort analysis.

AIM: To study the effects of age, period and cohorts on alcohol-related mortality trends in Sweden. DESIGN: The study comprises an age-period-cohort analysis. SETTING AND PARTICIPANTS: The analysis was based on all deaths in the Swedish population between 1969 and 2002. MEASUREMENTS: Data on alcohol-related deaths in Sweden from 1969 to 2002 excluding accidental injury and homicide were used. The analysis covered 43 021 deaths. FINDINGS: Time period and birth cohort both influenced alcohol-related mortality. Male cohorts born in the 1930-40s exhibited the highest alcohol-related mortality, while for females those born in the 1940-50s had the highest alcohol-related mortality. For both men and women, those born in the 1960-70s had the lowest age-adjusted alcohol-related mortality. High-risk cohorts were young or in early adulthood during the periods that alcohol became more available in Sweden. The low-risk cohorts of the 1960-70s were brought up during a period when society was concerned with increasing alcohol problems and more emphasis was placed on issuing alcohol awareness information in schools. CONCLUSIONS: Cohort effects were found suggesting that the link between alcohol consumption and non-accident alcohol-related mortality at the population level is dependent on other factors that may change over time. One such factor may be that restrictive alcohol policies have a greater effect on drinking in those who are younger at the time they are put into effect.

Adolescent↗