SEARCH · Search PubMed
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.
We analyzed 224 and 163 serum samples from individuals in Sweden and Honduras, respectively, for the presence of the hepatitis G virus (HGV or GB virus-C) RNA. HGV infection in both Sweden and Honduras was related to common risk factors for blood-borne infections, despite a surprisingly high frequency in groups without known risk factors.
Inflammation has been implicated as an etiological factor in several human cancers. Growing evidence suggests that chronic inflammation may also play a role in the etiology of prostate cancer. Considering that genetic susceptibility is a major risk factor for this disease, we hypothesize that sequence variants in genes that regulate inflammation may modify individual susceptibility to prostate cancer. The lipopolysaccharide receptor Toll-like receptor 4 (TLR4) is a central player in the signaling pathways of the innate immune response to infection by Gram-negative bacteria and is an important candidate inflammatory gene. We performed a systematic genetic analysis of TLR4 sequence variants by evaluating eight single-nucleotide polymorphisms that span the entire gene among 1383 newly diagnosed prostate cancer patients and 780 age- and residence-matched controls in Sweden. We found an association between a sequence variant (11381G/C) in the 3'-untranslated region of the TLR4 gene and prostate cancer risk. The frequency of the variant genotypes (CG or CC) was significantly higher in the patients (24.1%) than in the controls (19.7%; P = 0.02). The frequency of risk genotypes among patients diagnosed before the age of 65 years was even higher (26.3%). Compared with men who had the wild-type genotype of this single-nucleotide polymorphism (GG), those with GC or CC genotypes had a 26% increased risk for prostate cancer (odds ratio, 1.26; 95% confidence interval, 1.01-1.57) and 39% increased risk increased risk for early onset prostate cancer (before age 65 years; odds ratio, 1.39; 95% confidence interval, 1.02-1.91). The risk attributable to this variant for prostate cancer in Sweden was estimated to be 4.9%. Although the biological mechanism of the observed association remains to be elucidated, our finding supports a role for a bacteria-associated response pathway, possibly acting via inflammation, in the development of prostate cancer.
BACKGROUND: Patients with impaired glucose tolerance (IGT) have an increased risk of cardiovascular disease (CVD) that is independent of traditional risk factors. Hence, slightly elevated glucose levels, even in the non-diabetic range, might be associated with increased macrovascular disease. METHODS: Within the Northern Sweden MONICA project a population survey was performed in 1986. Electrocardiograms (ECG's) were recorded for half of the survey (n = 790) and oral glucose test was carried out in 78 % of those. The association between subjects with ECG's indicating previously unknown myocardial infarction (ukMI), IGT and conventional risk factors were analyzed by logistic regression for men and women separately, adjusting for age, smoking, hypercholesterolemia and hypertension. RESULTS: Impaired glucose tolerance was significantly more common among women with ukMI, but not in men, compared to the group with normal ECG. In men, no variable was significantly associated with ukMI although the odds ratio (OR) for hypercholesterolemia was of borderline significance, 3.2 (95% confidence interval (CI) 0.9 to 11). The OR of having ukMI was 4.1 (CI 1.1 to 15) in women with IGT compared to women with normal glucose tolerance after multiple adjustment. The OR for hypertension was of borderline significance; 3.3 (CI 0.97 to 11). CONCLUSION: We found that IGT was associated with ECG findings indicating silent myocardial infarction in women in a middle-aged general population in northern Sweden. The results persisted even after adjusting for known risk factors.
The occurrence of the delta (delta) agent was analyzed in 89 patients with acute hepatitis B infection during 1976-1979 in Gothenburg, Sweden, and in 46 patients (16 drug addicts) with chronic HBsAg-positive liver disease. Four of the patients with acute hepatitis B had transiently detectable anti-delta antibodies in serum. At least three of these four cases were associated with intravenous drug abuse. Eleven of the HBsAg carriers (24%) were anti-delta-positive, and all of them were drug addicts. One of the drug addicts transmitted hepatitis B infection without detectable anti-delta in serum to two other non-addicts via parenteral routes. Apparently, in Sweden today delta-infection is mostly restricted to drug addicts and seldom found in other groups of hepatitis B patients.
The aim of this study was to investigate the hearing threshold levels (HTL) of an otologically unscreened population in Sweden. The results are compared to other studies of otologically unscreened populations, and a new mathematical model of hearing threshold levels as a function of age is presented. The subjects were males and females aged from 19 to 81 years, selected from the province of Ostergötland in Sweden. The test battery included otoscopy, tympanometry, pure-tone audiometry, and a questionnaire. Subjects exposed to occupational noise were excluded, and in total 603 persons were included in the analysis. The regression analysis resulted in different hyperbolic tangent functions with four parameters: HTL=A+B x tanh(C x age+D).
PURPOSE: The aim was to study variation in views on long-term goals expressed by members in a project concerning rehabilitation of individuals in an area in mid Sweden. The organisations participating were the municipal social services, the county council's health care organisation, the governmental social insurance office, the national employment service and the national labour market institute. THEORY: A number of different meanings of the concept of integration are accounted for and the background of inter-organisational rehabilitation in Sweden is described. METHODS: Qualitative interviews using a semi-structured interview guide with altogether 20 leading representatives of the various organisations, all members of the Steering Committee of the project. The analysis consisted of two parts: an in-depth analysis using a phenomenographically inspired approach and qualitative content analysis. RESULTS: Two main views regarding the goal of inter-organisational integration were identified in the in-depth analysis: Category A, which regards integration as a new approach to rehabilitation, and Category B, which regards integration as a way of rendering the existing organisations more efficient. The content analysis showed a wide variation in spontaneously mentioned topics e.g. on the task of the group. CONCLUSIONS AND DISCUSSION: There exists a risk that divergent views in the Steering Committee concerning the future direction of the collaboration may send mixed messages providing uneven support for the professionals within the different organisations. The study points to the importance of having a common vision and common, well-defined goals at the outset of a collaborative project in order to support micro-level cooperation.
In contrast to the other Nordic countries Sweden has long had a favourable position as regards meningococcal disease. In the last 10 year period the annual incidence has been only about one case per 100,000 inhabitants. The treatment once the cause is confirmed is conventional and no different from that in the other Nordic countries but varies somewhat in the event of unknown etiology. Cortisone therapy also seems to be more frequent in treatment of meningitis. Two strategies for antibiotic prophylaxis are used in Sweden.
IL-3, IL-5, and GM-CSF are related hematopoietic cytoines that are important for allergic inflammation. The receptors for human IL-5, IL-3, and GM-CSF are members of the hematopoietin receptor superfamily and are comprised of a cytokine-specific alpha chain and the common beta chain that is shared among these cytokines for signaling. Each of these cytokines contributes to the differentiation and function of leukocyte subpopulations and have clinical importance in protective immunity and in the pathophysiology of a spectrum of immunologic diseases that are as diverse as allergy and asthma, pulmonary alveolar proteinosis, neurodegenerative diseases, and malignancies. Delineating the biology of these cytokines is enabling the development of new strategies for diagnosing and treating these diseases and modulating immune responses.
OBJECTIVES: To establish the prevalence of remaining beta-cell function 8 years after diagnosis of diabetes in young adults and relate the findings to islet antibodies at diagnosis and 8 years later. DESIGN: Population-based cohort study. SETTING: Nationwide from all Departments of Medicine and Endocrinology in Sweden. SUBJECTS: A total of 312 young (15-34 years old) adults diagnosed with diabetes during 1987-88. MAIN OUTCOME MEASURE: Plasma connecting peptide (C-peptide) 8 years after diagnosis. Preserved beta-cell function was defined as measurable C-peptide levels. Three islet antibodies - cytoplasmic islet cell antibodies (ICA), glutamic acid decarboxylase antibodies and tyrosine phosphatase antibodies - were measured. RESULTS: Amongst 269 islet antibody positives (ab+) at diagnosis, preserved beta-cell function was found in 16% (42/269) 8 years later and these patients had a higher body mass index (median 22.7 and 20.5 kg m-2, respectively; P = 0.0003), an increased frequency of one islet antibody (50 and 24%, respectively; P = 0.001), and a lower prevalence of ICA (55 and 6%, respectively; P = 0.007) at diagnosis compared with ab+ without remaining beta-cell function. Amongst the 241 patients without detectable beta-cell function at follow-up, 14 lacked islet antibodies, both at diagnosis and at follow-up. CONCLUSIONS: Sixteen per cent of patients with autoimmune type 1 diabetes had remaining beta-cell function 8 years after diagnosis whereas 5.8% with beta-cell failure lacked islet autoimmunity, both at diagnosis and at follow-up.
BACKGROUND: The prevalence of chronic obstructive pulmonary disease (COPD) according to guidelines of today seems considerably higher than has been reported also in recent literature. AIM: To estimate the prevalence of COPD as defined by British Thoracic Society (BTS) criteria and the recent global initiative for chronic obstructive lung disease (GOLD) criteria. Further aims were to assess the proportion of underdiagnosis and of symptoms in subjects with COPD, and to study risk factors for COPD. METHODS: In 1996, 5892 of the Obstructive Lung Disease in Northern Sweden (OLIN) Study's first cohort could be traced to a third follow-up survey, and 5189 completed responses (88%) were received corresponding to 79% of the original cohort from December 1985. Of the responders, a random sample of 1500 subjects were invited to a structured interview and a lung function test, and 1237 of the invited completed a lung function test with acceptable quality. RESULTS: In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, while it was 14% according to the GOLD criteria. The absolutely dominating risk factors were increasing age and smoking, and approximately a half of elderly smokers fulfilled the criteria for COPD according to both the BTS and the GOLD criteria. Family history of obstructive airway disease was also a risk factor, while gender was not. Of those fulfilling the BTS criteria for COPD, 94% were symptomatics, 69% had chronic productive cough, but only 31% had prior to the study been diagnosed as having either chronic bronchitis, emphysema, or COPD. The corresponding figures for COPD according GOLD were 88, 51, and 18%. CONCLUSIONS: In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, and it was 14% according to the GOLD criteria. Fifty percent of elderly smokers had developed COPD. The large majority of subjects having COPD were symptomatic, while the proportion of those diagnosed as having COPD or similar diagnoses was small.
We mapped the genetic influences for type 1 diabetes (T1D), using 2,360 single-nucleotide polymorphism (SNP) markers in the 4.4-Mb human major histocompatibility complex (MHC) locus and the adjacent 493 kb centromeric to the MHC, initially in a survey of 363 Swedish T1D cases and controls. We confirmed prior studies showing association with T1D in the MHC, most significantly near HLA-DR/DQ. In the region centromeric to the MHC, we identified a peak of association within the inositol 1,4,5-triphosphate receptor 3 gene (ITPR3; formerly IP3R3). The most significant single SNP in this region was at the center of the ITPR3 peak of association (P=1.7 x 10(-4) for the survey study). For validation, we typed an additional 761 Swedish individuals. The P value for association computed from all 1,124 individuals was 1.30 x 10(-6) (recessive odds ratio 2.5; 95% confidence interval [CI] 1.7-3.9). The estimated population-attributable risk of 21.6% (95% CI 10.0%-31.0%) suggests that variation within ITPR3 reflects an important contribution to T1D in Sweden. Two-locus regression analysis supports an influence of ITPR3 variation on T1D that is distinct from that of any MHC class II gene.
During the 17-year period 1972 through 1988, a total of seven cases of agranulocytosis associated with the use of dapsone for the treatment of dermatitis herpetiformis were reported in Sweden. The median age of the patients involved was 61 years; three of them were male. The median duration of dapsone treatment was 7 weeks and the daily prescribed dose was 100 mg. Based on sales and prescription data, the crude relative risk of agranulocytosis during dapsone treatment of dermatitis herpetiformis was 50, and the total risk was one case per 3000 patient years of exposure to dapsone. In relation to the number of new cases of dermatitis herpetiformis, agranulocytosis was estimated to develop in 1 of 240 to 425 patients receiving dapsone therapy. Patients should be instructed to seek medical care immediately in case of fever.
The age-standardized mortality from motor neuron disease in Sweden doubled from 1961 to 1985. The average annual rate during the period was 1.9 per 100,000 population. The male to female ratio was 1.2:1. The age-specific mortality rates had a peak at 70 to 79 years of age. When each birth cohort was followed up separately over time, the peak was less clear and in some cohorts the mortality rates increased continuously with advancing age. A significant increase of motor neuron disease among men was found in one Swedish county.
OBJECTIVE: To study the prevalence of tuberous sclerosis in children and adolescents. DESIGN: Previously published diagnostic criteria for tuberous sclerosis were used. All physicians likely to encounter young patients with tuberous sclerosis were contacted by way of a screening questionnaire. SETTING: The study was performed in a circumscribed geographic area (western Sweden). PATIENTS AND OTHER PARTICIPANTS: The sample was population based. However, only patients with such severe and early symptoms that referral to a physician had been considered necessary and relatives of these patients with tuberous sclerosis could be included. This was because there is currently no diagnostic marker for tuberous sclerosis that could be used as a screening tool. RESULTS: The peak prevalence (one in 6800 individuals) for tuberous sclerosis was found in the 11- to 15-year-old age group. For the whole age cohort, 0 to 20 years, the prevalence was one in 12,900 individuals. CONCLUSIONS: The prevalence for the school-age group was the highest ever reported in the literature on tuberous sclerosis. However, it is likely that the true prevalence of tuberous sclerosis in the general population is even higher.
OBJECTIVES: To describe the time and space patterns of patients with monosymptomatic optic neuritis (MON) in Stockholm County, Sweden, and to explore the role of environmental factors in the etiology of MON and multiple sclerosis. DESIGN: Population-based and prospective incidence survey. SETTING: Census based on referrals from 1.68 million inhabitants of Stockholm County. PATIENTS: One hundred forty-seven new patients with MON were consecutively referred by ophthalmologists and neurologists from January 1, 1990, through December 31, 1995. A standardized questionnaire was used for data collection. MAIN OUTCOME MEASURES: Evaluations consisted of annual incidence, statistical significance of temporal aggregation, Knox test, likelihood score test applied to the ratio of the highest to lowest seasonal proportion of registered events, and standardized morbidity ratio for municipalities. RESULTS: We observed a seasonal pattern of MON incidence, with the highest incidence (31%) in the spring and the lowest (17%) in the winter (ratio of highest to lowest seasonal proportion, 1.84; 95% confidence interval, 1.13-3.01; P = .007). The seasonal monthly incidences were correlated with the average number of sunny hours and the temperature. The presence of positive immune activity markers (i.e., mononuclear pleocytosis and oligoclonal IgG bands in the cerebrospinal fluid) seemed to be linked to the onset of MON in winter. No aggregation by time, space, or month of birth was detected. CONCLUSIONS: Monosymptomatic optic neuritis in Stockholm County occurred at an uneven frequency across the seasons, with the highest incidence in spring and the lowest in winter. This seasonal pattern is compatible with that described in most previous reports. Environmental and probable infectious factors unevenly distributed by season may play a role in the etiology and early clinical course of MON.
BACKGROUND: Selected groups of patients with bipolar and unipolar disorder have an increased mortality rate from suicide and natural causes of death. However, there has been no population-based study of mortality of patients followed up from the onset of the illness. METHODS: All patients with a hospital diagnosis of bipolar (n = 15 386) or unipolar (n = 39 182) disorder in Sweden from 1973 to 1995 were identified from the inpatient register and linked with the national cause-of-death register to determine the date and cause of death. Overall and cause-specific standardized mortality ratios (SMRs) and numbers of excess deaths were calculated by 5-year age classes and 5-year calendar periods. RESULTS: The SMRs for suicide were 15.0 for males and 22.4 for females with bipolar disorder, and 20.9 and 27.0, respectively, for unipolar disorder. For all natural causes of death, SMRs were 1.9 for males and 2.1 for females with bipolar disorder, and 1.5 and 1.6, respectively, for unipolar disorder. For bipolar disorder, most excess deaths were from natural causes, whereas for unipolar disorder, most excess deaths were from unnatural causes. The SMR for suicide was especially high for younger patients during the first years after the first diagnosis. Increasing SMR for suicide during the period of study was found for female patients with unipolar disorder. CONCLUSIONS: This population-based study of patients treated in the hospital documented increased SMRs for suicide in patients with bipolar and unipolar disorder. The SMR for all natural causes of death was also increased, causing about half the excess deaths.
In order to study the prevalence of antibody to hepatitis E virus (HEV) among hemodialysis patients and to evaluate whether chronic hemodialysis is associated with an increased risk of exposure to HEV in developed countries, the IgG anti-HEV was determined in serum samples obtained from 182 patients on chronic hemodialysis and 349 statistically selected, healthy Swedish control subjects. Serum specimens from 11 of the 182 (6.0%) hemodialysis patients and from 18 of the 349 (5.2%) control subjects were repeatedly positive for HEV antibodies (the difference was not significant: P = .67). Analysis of serial serum samples obtained at the initiation of hemodialysis and consecutively during follow-up periods of several years demonstrated no IgG anti-HEV seroconversion during chronic hemodialysis. The seroprevalence of anti-HEV antibody in the adult Swedish population was associated significantly with age. In persons younger than 40 years, the percentage of seropositive individuals was 2.5%, whereas the seroprevalence rate of anti-HEV was 7.4% in subjects older than 40 years (P < .05). This study indicates that nosocomial transmission of HEV to patients on maintenance hemodialysis was non-existent in three dialysis centers in Sweden (a developed country) and that chronic hemodialysis is not associated with an increased risk of exposure to HEV infection in this region.
BACKGROUND: Although prostate carcinoma is not widely recognized as a familial cancer, familial aggregation of this disease has been shown in some retrospective case-control studies. To study familial prostate cancer in Sweden, a population-based cohort study was performed, that attempted to avoid possible bias connected with some earlier studies of familial prostate cancer. METHODS: A nationwide register cohort study was conducted using an unselected study population. The study cohort of 5496 sons of Swedish men found to have prostate cancer between 1959 and 1963 was identified through parish offices. All prostate cancer patients reported between 1958 and 1990 in this cohort were identified through linkage to the Swedish Cancer Register. The expected number of prostate cancer patients was calculated using incidence rates obtained from the same register. RESULTS: A highly significant increased overall standardized incidence ratio (SIR) of 1.70 (95% confidence interval, 1.51-1.90) was obtained for prostate cancer in this cohort, with 302 observed cases compared with 178 expected prostate cancers. The SIR was 3.38 among patients aged 45-49 years at diagnosis, with the risk gradually decreasing to a SIR of 1.35 among patients older than 80 years (trend, P = 0.013). Among sons with a father whose prostate cancer was diagnosed at an early age (< 70 years), a significant trend (P = 0.01) for prostate cancer risk was observed due to early onset of the disease. CONCLUSIONS: This cohort study provides further evidence that a positive family history of prostate cancer is a risk factor for developing the disease in an unselected population. The increased risk was found for all ages, but was more pronounced in younger men.