Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SWEDEN”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources
PubMed2004

Incidence of breast cancer in Norway and Sweden during introduction of nationwide screening: prospective cohort study.

OBJECTIVE: To determine whether any increase in the incidence of breast cancer in women detected by mammography is compensated for by a drop in the incidence after age 69, years when women are no longer invited for screening. DESIGN: Population based cohort study of incidence of breast cancer during the introduction of nationwide screening programmes. SETTING: Norway and Sweden. PARTICIPANTS: All women aged above 30 years (1.4 and 2.9 million, respectively, in 2000). MAIN OUTCOME MEASURES: Changes in age specific incidence rates of invasive breast cancer associated with the introduction of the screening programmes. RESULTS: As a result of screening the recorded incidence of breast cancer in women aged 50-69 years increased by 54% in Norway and 45% in Sweden. There was no corresponding decline in incidence after the age of 69 years. CONCLUSIONS: Without screening one third of all invasive breast cancers in the age group 50-69 years would not have been detected in the patients' lifetime. This level of overdiagnosis is larger than previously reported.

Adult↗
PubMed1983

Similar prevalence of coeliac disease in children and middle-aged adults in a district of Sweden.

Coeliac disease in children and adults is considered to be a variety of the same disorder. This gains epidemiological support in the present study, which reports on the observed prevalence of coeliac disease in an area of Sweden (population, 140 500). On 1 July 1981, the prevalence rate was found to be 104/100 000 (1:960) among children, and the same figure, 106/00 000 (1:950), was found for coeliac disease unaccompanied by dermatitis herpetiformis in the middle-aged population. The figures were obtained in patients seeking medical are and thus represent minimum rates, and it is likely that the actual prevalence of coeliac disease in Sweden will prove still higher.

Adolescent↗
PubMed1999

Appropriateness of referral of coronary angiography patients in Sweden. SECOR/SBU Project Group.

OBJECTIVE: To evaluate the appropriateness of referral following coronary angiography in Sweden. DESIGN: Prospective survey and review of medical records. PATIENTS: Consecutive series of 2767 patients who underwent coronary angiography in Sweden between May 1994 and January 1995 and were considered for coronary revascularisation. MAIN OUTCOME MEASURES: Percentage of patients referred for coronary artery bypass graft surgery (CABG) and percutaneous transluminal coronary angioplasty (PTCA) for indications that were judged necessary, appropriate, uncertain, and inappropriate by a multispecialty Swedish national expert panel using the RAND/University of California Los Angeles (UCLA) appropriateness method, and the percentage of patients referred for continued medical management who met necessity criteria for revascularisation. RESULTS: Half the patients were referred for CABG, 25% for PTCA, and 25% for continued medical therapy. CABG was judged appropriate or necessary for 78% of patients, uncertain for 12% and inappropriate for 10%. For PTCA the figures were 32%, 30% and 38%, respectively. Two factors contributed to the high inappropriate rate. Many of these patients did not have "significant" coronary artery disease (although all had at least one stenosis > 50%) or they were treated with less than "optimal" medical therapy. While 96% of patients who met necessity criteria for revascularisation were appropriately referred for revascularisation, 4% were referred for continued medical therapy. CONCLUSIONS: Using the RAND/UCLA appropriateness method and the definitions agreed to by the expert panel, which may be considered conservative today, it was found that 19% of Swedish patients were referred for coronary revascularisation judged inappropriate. Since some cardiovascular procedures evolve rapidly, the proportion of patients referred for inappropriate indications today remains unknown. Nevertheless, physicians should actively identify those patients who will and will not benefit from coronary revascularisation and ensure that they are appropriately treated.

Adult↗
PubMed1995

The Lidköping Accident Prevention Programme--a community approach to preventing childhood injuries in Sweden.

OBJECTIVES: In Sweden about 100 children 0-14 years die from accidental injuries every year, roughly 40 girls and 60 boys. To reduce this burden the Safe Community concept was developed in Falköping, Sweden in 1975. Several years later a second programme was initiated in Lidköping. The objectives of this paper are to describe the programme in Lidköping and to relate it to changes in injury occurrence. SETTING: The Lidköping Accident Prevention Programme (LAPP) was compared with four bordering municipalities and to the whole of Skaraborg County. METHODS: The programme included five elements: surveillance, provision of information, training, supervision, and environmental improvements. Process evaluation was based mainly on notes and reports made by the health planners, combined with newspaper clippings and interviews with key people. Outcome evaluation was based on information from the hospital discharge registry. RESULTS: In Lidköping there was an on average annual decrease in injuries leading to hospital admissions from 1983 to 1991 of 2.4% for boys and 2.1% for girls compared with a smaller decline in one comparison area and an increase in the other. CONCLUSION: Because the yearly injury numbers are small there is a great variation from year to year. However, comparisons over the nine year study period with the four border municipalities and the whole of Skaraborg County strengthen the impression that the programme has had a positive effect. The findings support the proposition that the decrease in the incidence of childhood injuries after 1984 could be attributed to the intervention of the LAPP. Nevertheless, several difficulties in drawing firm conclusions from community based studies are acknowledged and discussed.

Accident Prevention↗
PubMed2005

Temporal trends, gender, and geographic distributions in child and youth injury rates in Sweden.

OBJECTIVE: Sweden has the lowest child injury mortality rate in the world, 5.2/100 000 for children under 15. This paper describes temporal trends in Sweden, as well as gender related and geographic differences. DESIGN: The Swedish Cause-of-Death Register (1987-2001) and the Hospital Patient Register (1987-2002) were used to compare rates for the country as a whole and for discharges aged 0-20 by municipality, using the SEATS time series analysis program. RESULTS: There was a decrease in the rate of fatal unintentional injuries from 7 to 4 per 100 000 for girls and from 16 to 10 per 100 000 for boys since 1987. The gap between girls and boys was reduced and boys now have almost the same mortality rate as girls for violence related deaths. Road and other unintentional injuries show a general decrease whereas the pattern for falls varies by age and sex. Self inflicted injuries increased for both sexes, but more for girls. Substantial differences in injury rates between municipalities were also found-up to six times for girls and eight times for boys. CONCLUSION: Substantial declines in injury fatalities over time were found, but these were different for boys and girls. There remain substantial differences between municipalities. These data, published in a child injury atlas, have prompted substantial interest among media and the authorities.

Accidents↗
PubMed2004

Geographical mapping of type 1 diabetes in children and adolescents in south east Sweden.

STUDY OBJECTIVE: As earlier studies have shown space-time clusters at onset of type 1 diabetes in the south east region of Sweden we investigated if there also has been any geographical clusters of diabetes in this region. DESIGN: The place of residence (coordinates) at the time of diagnosis were geocoded in a geographical information system (GIS). All children diagnosed with type 1 diabetes up to 16 years of age at diagnosis between 1977-1995 were included. The population at risk was obtained directly from the population registry for the respective years and geographical area levels. SETTING: South east region of Sweden containing 5 counties, 49 municipalities, and 525 parishes. MAIN RESULTS: A significant geographical variation in incidence rate were found between the municipalities (p<0.001) but not between the counties. The variation became somewhat weaker when excluding the six largest municipalities (p<0.02). In municipalities with increased risk (>35.1/100 000) the major contribution comes from children in age group 6-10 years of age at diagnosis. There were no obvious differences between the age groups in municipalities with decreased risk (<20.1/100 000). Boys and girls had about the same degree of geographical variation. CONCLUSIONS: Apart from chance, the most probable explanation for the geographical variation in the risk for children and adolescents to develop type 1 diabetes between the municipalities in the region is that local environmental factors play a part in the process leading to the disease.

Adolescent↗
PubMed2004

Unintentional and violent injuries among pre-school children of teenage mothers in Sweden: a national cohort study.

STUDY OBJECTIVE: This study investigates the risk and mediating mechanisms of unintentional and violent injuries in pre-school children of teenage mothers. DESIGN: Cohort study based on Swedish national registers. Cox analyses of proportional hazard were used to estimate the relative risk of hospital admission and death attributable to injuries in analyses of data from national registers. PARTICIPANTS: The study population was a national cohort of 800,192 children born in Sweden during 1987-93 who were followed up prospectively from birth to their 7th birthday. MAIN RESULTS: Children of teenage mothers had higher relative risks (RRs) of hospital admissions for violent as well as unintentional injuries; age adjusted RRs of 2.7 (95% CI 1.2 to 6.1) and 1.6 (1.4 to 1.8), respectively, for children of mothers under 18 years of age and 2.5 (1.6 to 3.8) and 1.5 (1.4 to 1.6) of mothers aged 18-19 are compared with those with mothers aged at least 32 at the birth of the child. When the models were adjusted to socioeconomic variables and indicators of parental substance misuse and psychiatric illness the risk decreased slightly but remained well above that of children with older mothers. In addition, children of teenage mothers had an increased risk of death attributable to violent injuries (RR 6.7 (2.6 to 16.0), as well as to unintentional injuries (RR 3.5 (2.0 to 6.1). CONCLUSIONS: Maternal age is an important determinant of injuries in pre-school children in Sweden and the children of teenage mothers are at particular risk. Young parents should be given priority in injury prevention programmes.

Accidents↗
PubMed1989

Cryptorchidism: a registry based study in Sweden on some factors of possible aetiological importance.

STUDY OBJECTIVE: To examine the epidemiological characteristics of boys with cryptorchidism. DESIGN: Cohort survey using the Swedish personal identification code and Medical Birth Registry to link cryptorchid boys with their pregnancy and delivery data. They were compared with the total population of male births during the same period. SUBJECTS: 2861 cryptorchid boys born in Sweden between 1973 and 1982 were identified. Of these 437 could not be linked with their Medical Birth Registry information for various reasons, or were excluded because they were under 1 year of age at the end of 1982, leaving 2424 cases for study. The reference population comprised all boys born in Sweden during the same period (n = 458,601). MEASUREMENTS AND MAIN RESULTS: For each study variable, the observed number of cases among boys with cryptorchidism was compared with the expected number calculated from the whole population. A significant increase in intensity ratio for cryptorchidism was found with the first birth, caesarean section, toxaemia of pregnancy, and certain congenital abnormalities (hypospadias and subluxation of the hip). It was also more common in small for dates infants. There was a seasonal variation in cryptorchidism, with increased incidence in January-March. CONCLUSIONS: Cryptorchidism may be caused by hormonal influences during pregnancy, which could be affected by utero-placental factors involving placental dysfunction or by daylight hours, through pineal activity.

Birth Certificates↗
PubMed1992

Trends in "avoidable" mortality in Sweden, 1974-1985.

STUDY OBJECTIVE: The aim was to analyse trends in "avoidable" mortality in Sweden, and to contribute to the methodology of avoidable mortality as an index of the quality of care. SETTING AND PARTICIPANTS: All deaths of Swedish citizens and other residents in Sweden during the period 1974-1985 were analysed as to causes of death between ages 0 and 64 years. MEASUREMENTS AND MAIN RESULTS: Total mortality delined during the 12 year period studied. Avoidable causes of death were grouped into preventable and treatable causes according to Rutstein's classification. In men, treatable diseases declined more during the 12 year period studied than did total mortality. When lung cancer was excluded, preventable diseases declined for both sexes. Certain avoidable causes of death decreased compared to total mortality, while some others showed an increase. The death rate increased for some avoidable causes of death such as pneumonia other than viral. In women death rates increased for chronic bronchitis and emphysema as well as for malignant neoplasms of trachea, bronchus, and lung, while for boys aged 1-14 years bronchitis NOS and asthma showed an increasing death rate. CONCLUSIONS: The study indicates that the avoidable mortality method is sensitive enough to describe important changes in the mortality pattern. The explicit definition of treatable and preventable causes of death constitutes a methodological development in epidemiological analysis of this type. Further studies on the quality of care should combine this method with other methods examining the structure and process of health care.

Adolescent↗
PubMed1995

Components of small area variation in death rates: a method applied to data from Sweden.

STUDY OBJECTIVES: The study aimed to develop and evaluate a method for small area analysis of different non-random components of the variation in death rates. The method was applied to incidence and mortality data for selected malignant neoplasms in 26 administrative health areas in Sweden. DESIGN: Variation in mortality and incidence rates for malignant neoplasms of the trachea, bronchus, and lung; colon; rectum; and cervix uteri in the 26 health areas were analysed after standardisation for age. In addition, the systematic and random components of variance were estimated. The systematic component of variance in mortality was divided into two additive components-one component was dependent on the variation in the corresponding incidence rates and the other remained after adjustment for incidence. SETTING AND PARTICIPANT: All cases diagnosed between 1972 and 1983 and all deaths between 1974 and 1985 for selected malignant neoplasms in Swedish citizens and other residents in Sweden, aged between 0 and 64 years, were analysed. MAIN RESULTS: Much of the observed variation in mortality was explained by the estimated random variation. For malignant neoplasms of the trachea, bronchus, and lung the systematic variation in mortality was mainly explained by the variation in incidence. For cancer of the cervix uteri, alone, there was significant systematic variation of moderate magnitude that was not explained by the incidence rates. CONCLUSIONS: These methods made it possible to divide the observed variance in mortality into different components. Random effects and variance in incidence rates were found to be of great importance when analysing the variance in death rates between health areas. By studying different systematic components of variation it is possible to identify fields for in depth studies on the quality of prevention and treatment.

Adolescent↗
PubMed1996

Psychosocial resources and persistent smoking in early pregnancy--a population study of women in their first pregnancy in Sweden.

STUDY OBJECTIVE: To test the stress hypothesis by characterising women during their first pregnancy who continue to smoke in early pregnancy in comparison with women who quit smoking, with special reference to psychosocial factors like social network, social support, demands, and control in work and daily life. DESIGN: The study is based on a cohort of primigravidas followed during pregnancy. Data were collected by self administered questionnaires during the pregnant womens' first antenatal visit at about 12 weeks. SETTING: The study was performed in the antenatal clinics in the city of Malmö, Sweden. PARTICIPANTS: The participants were all primigravidas living in the city of Malmö, Sweden, over a one year period, 1991-92. A total of 872 (87.7%) of the 994 invited women agreed to participate. The population of this study on smoking includes all primigravidas who at the time of conception were smoking (n = 404, 46.3%). MAIN RESULTS: At the first antenatal visit (63.6% (n = 257) of the prepregnancy smokers were still smoking (a total smoking prevalence of 29.5%). The pregnant smokers were on average younger and had a lower educational level. The highest relative risk (RR) of continued smoking was found among unmarried women RR 2.7 (95% confidence interval) (1.5, 4.8), women having unplanned pregnancies RR 2.2 (1.2, 4.0) and those with a low social participation RR 1.6 (1.0, 2.7), low instrumental support RR 2.6 (1.2, 6.0), low support from the child's father RR 2.1 (1.0, 4.2) and those exposed to job strain RR = 2.3 (1.1, 4.8). The associations were independent of potential confounders such as age, educational level, nationality, cohabiting status, passive smoking, and previous years of smoking. CONCLUSIONS: This study supports the stress hypothesis. Smoking can be one way women handle stress when demands become too great. In order to reduce smoking among pregnant women, maternity centre resources need to be focused more on women with low psychosocial resources who are at highest risk for continued smoking. It is also important to involve actively the woman's partner or other important people in the woman's social network.

Adolescent↗
PubMed2001

Evaluation of "Live for Life", a health promotion programme in the County of Skaraborg, Sweden.

STUDY OBJECTIVE: To evaluate a health promotion programme, combining a population and individual based strategy, in the County of Skaraborg, Sweden, with special attention to outcome. DESIGN: The evaluation was subdivided into structure, process and outcome. The evaluation procedure as a total is described here, but the results presented refer only to outcome. In order to study the potential effect of the individually based health examination, 35 year old subjects who had participated five years previously were in 1994-1996 compared with 35 year old subjects who had not participated before, and compared with their own values five years earlier. The results during 1995-1996 were compared with those of 1989-1990 for corresponding ages in order to study the effect of, particularly, the population based strategy. SETTING: The County of Skaraborg in the south western part of Sweden with about 270 000 inhabitants. In addition to population strategy, involving the total county, men and women aged 30 and 35 years were invited to an individually based examination. MAIN RESULTS: Factors related to body weight increased during the study period, while other factors mostly changed in the direction wanted. As a whole the changes were rather modest. There were favourable changes in lifestyle variables, for example, concerning smoking and dietary habits. CONCLUSIONS: There were beneficial effects from the health promotion programme, but there is a need for continuous improvement of methods of intervention referred to lifestyle.

Adult↗
PubMed2004

Country of birth, socioeconomic position, and healthcare expenditure: a multilevel analysis of Malmö, Sweden.

STUDY OBJECTIVE: The principle of equity aims to guarantee allocation of healthcare resources on the basis of need. Therefore, people with a low income and persons living alone are expected to have higher healthcare expenditures. Besides these individual characteristics healthcare expenditure may be influenced by country of birth. This study therefore aimed to investigate the role of country of birth in explaining individual healthcare expenditure. DESIGN: Multilevel regression model based on individuals (first level) and their country of birth (second level). SETTING: The city of Malmö, Sweden. PARTICIPANTS: All the 52 419 men aged 40-80 years from 130 different countries of birth, who were living in Malmö, Sweden, during 1999. MAIN RESULTS: At the individual level, persons with a low income and persons living alone showed a higher healthcare expenditure, with regression coefficients (and 95% confidence intervals) being 0.358 (0.325 to 0.392) and 0.197 (0.165 to 0.230), respectively. Country of birth explained a considerable part (18% and 13%) of the individual differences in the probability of having a low income and living alone, respectively. However, this figure was only 3% for having some health expenditure, and barely 0.7% with regard to costs in the 74% of the population with some health expenditure. CONCLUSIONS: Malmö is a socioeconomically segregated city, in which the country of birth seems to play only a minor part in explaining individual differences in total healthcare expenditure. These differences seem instead to be determined by individual low income and living alone.

Adult↗
PubMed1990

Occupation and malignant melanoma: a study based on cancer registration data in England and Wales and in Sweden.

An analysis of the incidence of malignant melanoma according to occupation is presented using data from two national cancer registries. The data relate to 3991 cases of cutaneous malignant melanoma, 662 cases of ocular melanoma, and 179 cases of noncutaneous, non-ocular melanoma in subjects aged 15-64 in England and Wales diagnosed from 1971 to 1978 and to 5003 cases of cutaneous malignant melanoma diagnosed from 1961 to 1979 in Sweden in subjects born between 1896 and 1940. Professional workers of both sexes in both countries experienced an excess incidence of cutaneous malignant melanoma. An excess of ocular melanoma and of non-cutaneous, non-ocular melanoma also existed for this group in England and Wales. Pharmacists, medical doctors, and dentists had a high incidence of cutaneous melanoma in both countries and were represented three times when listing the top 20 occupations in both countries and both genders. Combining the data from cutaneous malignant melanoma over both sexes and both registries the occupations with the highest incidence ratios (expressed as a percentage) were: airline pilots, incidence ratio (IR) = 273, (95% confidence limits 118-538); finance and insurance brokers IR = 245 (140-398); professional accountants IR = 208 (134-307); dentists IR = 207 (133-309); inspectors and supervisors in transport IR = 206 (133-304); pharmacists IR = 198 (115-318); professionals not elsewhere classified IR = 196 (155-243); judges IR = 196 (126-289); doctors IR = 188 (140-248); university teachers IR = 188 (110-302); and chemists IR = 188 (111-296). No particular exposure in the workplace seemed to link these groups and only a few worked in high technology environments. Many of the highest risk groups have in common a high level of education. In England and Wales and in Sweden this might correlate particularly with foreign travel abroad was more unusual than it is now, but evidence on present and past exposure to sun by occupation is needed to clarify the reasons for the association.

England↗
PubMed1996

Myocardial infarction among male bus, taxi, and lorry drivers in middle Sweden.

OBJECTIVES: The aim of the present case-referent study was to investigate the incidence of myocardial infarction among male professional drivers, taking the type of vehicles and area of residence into account. METHODS: The study base comprised all men aged 30-74 in five counties in middle Sweden during 1976-81 or 1976-84. Incident cases of the first episode of myocardial infarction were identified from registers of hospital admissions and causes of deaths. Referents were selected randomly from the study base. Information about occupation was obtained from the national censuses in 1970 and 1975. The possible impact from tobacco smoking and overweight were evaluated by simulations in combination with indirect data on these factors. RESULTS: The incidence of myocardial infarction was increased among bus drivers in Stockholm (relative risk (RR) = 1.53, 95% confidence interval (95% CI) 1.15-2.05), and among taxi drivers both in Stockholm (RR 1.65, 95% CI 1.30-2.11) and in the surrounding rural counties (RR 1.82, 95% CI 1.17-2.82). A smaller increase was found among long distance lorry drivers, whereas the relative risk among short distance lorry drivers was close to unity. Indirect comparisons make it unlikely that the excess among bus drivers in Stockholm could be explained by uncontrolled confounding from tobacco smoking or overweight. A very high proportion (more than 80%) of urban bus drivers in Sweden report a combination of high psychological demands and low control at work. CONCLUSIONS: Different types of drivers are at different risk of myocardial infarction. Bus drivers in urban areas seem to be at an increased risk, which is unlikely to be explained by uncontrolled confounding from tobacco smoking or overweight. Psychosocial work conditions may play a part in the increased incidence of myocardial infarction among urban bus drivers and should be investigated further.

Adult↗
PubMed1999

Pleural mesothelioma in Sweden: an analysis of the incidence according to the use of asbestos.

OBJECTIVE: To investigate if the preventive measures taken to reduce the occupational exposure to asbestos have resulted in a decreased incidence of pleural mesothelioma in Sweden. METHODS: The incidence of pleural mesothelioma between 1958 and 1995 for birth cohorts born between 1885 and 1964 was investigated. The cases of pleural mesothelioma were identified through the Swedish Cancer Register. RESULTS: In 1995, around 80 cases of pleural mesothelioma could be attributed to occupational exposure to asbestos. There is an increasing incidence in more recent birth cohorts in men. The incidence was considerably higher in the male cohort born between 1935 and 1944 than in men born earlier. CONCLUSIONS: The annual incidence of pleural mesothelioma attributable to occupational exposure to asbestos is today larger than all fatal occupational accidents in Sweden. The first asbestos regulation was adopted in 1964 and in the mid 1970s imports of raw asbestos decreased drastically. Yet there is no obvious indication that the preventive measures have decreased the risk of pleural mesothelioma. The long latency indicates that the effects of preventive measures in the 1970s could first be evaluated around 2005.

Adult↗
PubMed2002

Work related symptoms among sewage workers: a nationwide survey in Sweden.

AIMS: To assess the risk for work related symptoms among sewage workers in Sweden using a postal questionnaire. METHODS: All municipalities in Sweden were contacted and asked to provide addresses of sewage workers and controls. Controls were recruited among other municipal workers not exposed to sewage, such as workers in drinking water plants and gardeners. A questionnaire was sent to the subjects and after two reminders, the response rate was 74% among sewage workers and 59% among controls. RESULTS: Significantly increased risks for airway symptoms, chronic bronchitis, and toxic pneumonitis, as well as central nervous system symptoms such as headache, unusual tiredness, and concentration difficulties were found among the sewage workers compared with controls. Furthermore, an increased risk for non-specific work related gastrointestinal symptoms was found among the sewage workers; an increased risk for joint pains, related to pains in more than four joints but not with loading, was also found. CONCLUSIONS: The results of this questionnaire survey show an increased risk for airway, gastrointestinal, and general symptoms such as joint pains and central nervous system symptoms among sewage workers. Clinical investigations are needed to determine the cause of the reported symptoms among sewage workers, and further field studies are required to assess the causal agents.

Central Nervous System Diseases↗
PubMed1978

Changes in the incidence of acute gonococcal and nongonococcal salpingitis. A five-year study from an urban area of central Sweden.

The incidence of acute gonococcal and nongonococcal salpingitis for a five-year-period (1970--74) was studied retrospectively in an urban area of central Sweden. The investigation was undertaken to see if the reported decrease of gonorrhoea in Sweden had been followed by a change in the incidence of gonococcal salpingitis--the most common complication of gonorrhoea. The study showed that the relative incidence of acute gonococcal salpingitis had decreased even more than urogenital gonorrhoea and these findings thus indicate a real decrease of gonorrhoea. At the same time there were more patients with nongonococcal salpingitis. During the period of the study the gonococcal complement-fixation test (GCFT) gave positive results in 40% to 80% of the patients with gonococcal salpingitis. The yield with this test was only 4% in patients with nongonococcal salpingitis during 1970 but it increased successively and was 23% in 1974. This increase was statistically highly significant (P less than 0.001).

Acute Disease↗