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PubMed1981

Heavy drug abuse in Sweden 1979 - a national case-finding study.

An investigation was carried out as a case-finding study to estimate the scale of heavy drug abuse in Sweden. Just over 8200 persons were reported as heavy drug abusers, 80% of these as injecting. For the majority of those reported more than one type of drug was indicated. There was concurrent abuse of alcohol by a majority of the heavy drug abusers. After correction of non-response with a modified capture-recapture technique and for erroneous classification, the scale of heavy drug abuse was estimated at 10000 - 14000 persons.

Adult↗
PubMed1986

Relative abuse of diazepam and oxazepam: prescription forgeries and theft/loss reports in Sweden.

Results of previous laboratory studies in humans suggest that the benzodiazepine diazepam has greater abuse liability than the benzodiazepine oxazepam. The validity of these laboratory-based experimental data were examined by analyzing Swedish data on drug abuse. Sales and prescription data showed that use of diazepam was somewhat lower than oxazepam, but of the same general order of magnitude (0.8:1). Prescription data showed that the drugs were prescribed for the same diagnostic indications. After adjustment for differences in use, 'prescription forgeries' and 'mentions in theft and loss reports' were found to be more frequent for diazepam than for oxazepam (2.3:1 and 2.5:1 for forgeries and theft/loss reports, respectively). This effect was consistent for each year examined (1982, 1983, 1984) and occurred when the data were recalculated to exclude Valium, the original and most widely known brand of diazepam. Finally, this pattern with prescription forgeries occurred across different geographical regions in Sweden (1982, 1983).

Cross-Sectional Studies↗
PubMedDate not supplied

Occurrence of barbiturate, benzodiazepine, meprobamate, methaqualone and phenothiazine in car occupants killed in traffic accidents in the south of Sweden.

An investigation of the following psychoactive drugs: barbiturate, benzodiazepine, meprobamate, methaqualone and phenothiazine, was performed on all automobile occupants killed in accidents in southern Sweden during 1977 and 1978. Of 122 drivers and 55 passengers analysed, low concentrations of these drugs were found in nine drivers and in five passengers. Thus, 7.3% of the drivers were driving under the influence of drugs and, of these, two drivers (1.6% of all analysed drivers) were also inebriated. Twenty-three per cent of the drivers were inebriated only. According to the circumstances in the accidents and the number of drivers whose analyses proved positive, drug influence seldom seems to be the cause of fatal traffic accidents.

Accidents, Traffic↗
PubMedDate not supplied

Explosion-related deaths in Sweden--a forensic-pathologic and criminalistic study.

All cases of death caused by explosions of explosive solids, fluids and gases in Sweden during the 6-year period 1979-1984 were analyzed. Among the total of 61 fatalities 33 (54%) were due to accidents (2/3 of them occupational and 1/3 miscellaneous accidents), 25 (41%) were suicides, and only 3 (5%) were associated with terrorist activity. About one half of the occupational accidents were caused by deficient safety devices or defective equipment, while the other half was due to transgression of regulations. All suicides were males, relatively elderly, the majority of them burdened with somatic and mental diseases, alcoholism, social or economical problems, most of them being familiar with explosives. The anatomical localization of suicidal explosive injuries was regular and symmetric, while the accidental and terrorist injuries showed great variations. The terrorist-associated deaths had common features different from all other death cases, strongly suggesting the same type of bomb and the same terrorist group. Explosives caused only superficial burns or singes. Symmetric hemorrhages of the vocal folds and fracture of the laryngeal skeleton were found, as well as ruptures of trachea and lungs. When not ruptured, the lungs showed to different types of injury: hyperinflation, probably due to the blast-induced barotrauma to the respiratory passages, or lung contusions. In cases of suspected terrorist explosions close collaboration between the forensic pathologists and police investigators is mandatory since the bodies of victims protect parts of the bomb from fire or from being spread over a larger area and thus constitute a part of the crime scene.

Accidents↗
PubMed1993

Lipoprotein (a) in a randomly selected 25-64 year old population: the Northern Sweden Monica Study.

Lipoprotein (a) (Lp (a)) was determined in 1527 individuals participating in the Northern Sweden WHO MONICA project for monitoring of cardiovascular risk factors in the general population. Subjects were randomly selected and stratified according to sex and age. A weak but significant relation between Lp (a) and increasing age was found in both sexes (p < 0.01). Menopausal status was the strongest independent predictor of Lp (a) level in women (p = 0.010). Fibrinogen was independently related to Lp (a) in both men and women (p < 0.05). An inverse relation between waist-to-hip ratio and Lp (a) was found in men (p < 0.01). Hypertensive subjects treated with diuretics had significantly higher Lp (a) than hypertensives on other agents (p < 0.05). Only a minor proportion of Lp (a) variance could be explained by lifestyle factors, which supports the contention that genetic factors primarily control Lp(a) level.

Adult↗
PubMed1995

Prescribing patterns for elderly community-dwelling heavy medicinal drug users in Manitoba, Canada and Jämtland, Sweden.

Patterns of drugs prescribed for elderly community-dwelling heavy medicinal drug users were determined from random samples of data bases and compared between Manitoba, Canada and Jämtland, Sweden for the year 1981. Qualitatively, there was 80% concordance between the 20 most frequently prescribed drugs in Manitoba and in Jämtland. Gender differences were rare, but there were notable quantitative differences for prescription of specific drugs between the two jurisdictions. Drugs to treat cardiovascular diseases were prominent in both groups with thiazides, triamterene and alpha-methyldopa more frequently prescribed for Manitoba patients, and furosemide, potassium supplements and digoxin more frequently prescribed for patients from Jämtland. The frequent prescribing of codeine in combination analgesics in Manitoba and phenothiazines in Jämtland appears to represent geographically disparate approaches to the use of these drugs. Overall, the concordance of prescribed drugs for elderly heavy medicinal drug users from these two jurisdictions appears to outweigh the differences. These results indicate that data from studies of heavy medicinal drug users, at least in the industrialized world, may be more widely applicable than to the geographical location from where they were obtained.

Aged↗
PubMed1994

Are geographical differences and time trends in myocardial infarction incidence in Sweden real? Validity of hospital discharge diagnoses.

In Sweden, acute myocardial infarction (AMI) incidence has been found to differ considerably between the neighboring counties of Stockholm and Gävleborg, with an increase in Stockholm during the 1970s. We estimated the AMI incidence in Stockholm in 1973 and in both areas in 1981. To determine if there were differences in the validity of hospital discharge diagnoses, random samples of AMI patients were examined for diagnostic criteria for AMI. In both genders, AMI incidence was higher in Gävleborg than in Stockholm (relative risk (RR) 1.34 for men and 1.21 for women) and increased in Stockholm from 1973 to 1981 (RR 1.21 for men and 1.29 for women). The proportion of patients fulfilling the diagnostic criteria for AMI was similar in both areas in 1981 but 10% less in Stockholm in 1981 than in 1973. These results suggest that differences in the validity of hospital discharge diagnoses cannot explain the geographical differences in AMI incidence, but that this may have contributed to the increasing incidence seen in Stockholm county.

Adult↗
PubMed1993

Increasing survival of patients with urinary bladder cancer. A nationwide study in Sweden 1960-1986.

Survival rates were analysed in 29,055 patients with urinary bladder cancer diagnosed in Sweden from 1960 to 1986 and followed up until 1987. The 2-, 5- and 10-year relative survival rates were 79, 70 and 64% for men and 75, 68 and 63% for women, respectively. Patients with a history of bladder cancer for at least 15 years ran a negligible risk of dying from their disease. Prognosis was consistently better in younger than in older patients; below 50 years of age the 5-year relative survival rate was 90%, as compared with 60% in patients aged 70-79 years. Patients diagnosed between 1960 and 1964 had a 60% 5-year relative survival, as compared to 71% in those diagnosed between 1980 and 1984. Multivariate analyses further confirmed that age but not sex is an important prognostic factor in bladder cancer and, further, that a substantial improvement in survival rates took place during the 1960-1986 period. Compared with 1960-1964 the risk of dying of bladder cancer within 5 years in patients diagnosed between 1980 and 1984 was 51% lower in men [relative risk (RR) = 0.49; 95% confidence interval (C.I.) 0.42-0.57] and 44% lower in women (RR = 0.56; 95% C.I. 0.45-0.70).

Age Distribution↗
PubMed1994

Epidemiology of respiratory symptoms, lung function and important determinants. Report from the Obstructive Lung Disease in Northern Sweden Project.

SETTING: Cross-sectional epidemiological study based on a representative sample of the general population in northern Sweden. OBJECTIVES: To assess the prevalence of respiratory symptoms, the role of respiratory symptoms as indicators of impairment of lung function, and to define risk factors for respiratory symptoms and lung function impairment. DESIGN: The 1340 subjects of 6610 who reported respiratory symptoms suggestive of asthma or chronic bronchitis in a postal questionnaire study were invited to a structured interview and lung function tests. A control group of 315 subjects was also invited. Risk factors were assessed from the postal questionnaire. RESULTS: 400 subjects in the symptomatic group had attacks of breathlessness and wheezing, while none in the control group had them, corresponding to 7% of the original study population. Chronic productive cough was present in 537 subjects, of whom 13 were from the control group, suggesting that 12% of the original study population had this symptom. Persistent wheeze was the symptom that predicted the greatest proportion of cases of impaired lung function. Attacks of breathlessness, wheezing, long-standing cough and sputum production were all related to age, smoking and a family history of asthma. Both chronic productive cough and impaired lung function correlated strongly with smoking and age, and their prevalences differed in different socio-economic groups. CONCLUSION: Impaired lung function can be predicted from respiratory symptoms. Data collected in postal questionnaires suffice for the identification of risk factors. Combinations of symptoms gave greater odds ratios than individual symptoms.

Adult↗
PubMed2005

The social patterning of injury repetitions among young car drivers in Sweden.

A national register-based cohort study was conducted to explore whether the social patterning of car drivers suffering injury repetitions differs from that of once-injured drivers in a cohort of young persons in Sweden (aged 18-26). Injury repeaters were defined as individuals sustaining injuries as a car driver on more than one occasion over an 8-year period. Only subjects obtaining a driver's licence before the age of 27 were included in the study. The social variables considered were, in turn, gender, socioeconomic position of origin, and own educational attainment. Attention was also paid to age at licensing. Two types of comparisons were made, using odds ratios with 95% confidence intervals. First, the odds of injury repeaters were computed using the once-injured car drivers as a reference group. Second, odds were compiled for once, twice, and three or more times injured people, using the non-injured at all as a comparison group. The results show that, by and large, the injury-risk distribution of car drivers with injury repetition does not differ from that of one-injury drivers with regard to gender, education, or socioeconomic group. However, drivers from self-employed households show greater odds of injury repetition (OR 1.65, CI 1.02-2.67) than of one injury compared with drivers from the families of non-manual employees. Since the number of injury repeaters is low and their socioeconomic distribution is very similar to that of the once injured, there is no need to regard them as a group at excess risk or different from the one-time injured. Reducing risk levels and risk differentials for the one time injured should therefore receive priority with regard to traffic-injury prevention.

Accidents, Traffic↗
PubMed2006

Short-term effects of countermeasures for improved safety and mobility at marked pedestrian crosswalks in Borås, Sweden.

The Swedish code concerning car drivers' responsibility to give way to pedestrians was strengthened in 2000. The primary aim of this study is to evaluate the short-term effects of the change in code. Another goal is to look at the effects of the reconstruction of four sites in Borås, Sweden. One site had changes made prior to the change of code, two test sites had countermeasures implemented during the study, and one comparison site was left unchanged. All the sites were chosen because schools were situated nearby. The focus of the evaluation was on children and elderly as pedestrians and cyclists. The goal of traffic calming of a 90 percentile driving speed below 30 km/h was not fulfilled at any of the test sites. A conclusion is that the height of a speed cushion is important. After the speed cushions were lowered from 70 mm to 55 mm, the 90 percentile speed increased from 34 km/h to 41 km/h. Sites with no speed cushions had much higher speeds. The design of an intersection influences road users' behavior. At the site where one crosswalk was removed, pedestrians that were using the remaining marked crosswalk were given way to less frequently than at the other sites. At intersections where most pedestrians used marked crosswalks, the children benefited the most in mobility. At the intersection where pedestrians used marked crosswalks to a lower extent after reconstruction, children and the elderly had the smallest increase in frequency of being given way to. After reconstruction to a court-yard street, the pedestrians were given way to a lower extent compared with the other sites, though the vehicle speeds were the lowest observed at this study. At the sites were no physical changes were made, the change of code improved driver yield behavior, but no more towards children than other age groups.

Accident Prevention↗
PubMed2006

Assignment of the gene locus for severe congenital neutropenia to chromosome 1q22 in the original Kostmann family from Northern Sweden.

Autosomal recessive severe congenital neutropenia (SCN) or Kostmann syndrome is characterised by reduced neutrophil counts and subsequent recurrent bacterial infections. The disease was originally described in a large consanguineous pedigree from Northern Sweden. A genome-wide autozygosity scan was initiated on samples from four individuals in the original pedigree using high density single nucleotide polymorphism (SNP) genotyping arrays in order to map the disease locus. Thirty candidate regions were identified and the ascertainment of samples from two additional patients confirmed a single haplotype with significant association to the disorder (p<0.01) on chromosome 1q22. One affected individual from the original Kostmann pedigree was confirmed as a phenocopy. The minimal haplotype shared by affected individuals spans a candidate region of 1.2 Mb, containing several potential candidate genes.

Chromosome Mapping↗
PubMed2004

Early breast cancer deaths in women aged 40-74 years diagnosed during the first 5 years of organised mammography service screening in north Sweden.

The aim of this study was to analyse individual cases of lethal breast cancer and not to evaluate the screening programme. Women aged 40-74 years who were diagnosed with breast cancer in 1990-94 and died on or before 31 December 1998, during the gradual introduction of organised mammography service screening in north Sweden, were included in the study. Out of 342 breast cancer deaths, 280 (82%) were in symptomatic patients whose cancers were clinically detected. Most breast cancers that proved fatal were already in an advanced stage and/or of high histological grade at the time of detection. A shift towards a lower stage was seen among screen-detected and interval-detected fatal cases. In a few of the cases with fatal outcome, in patients primarily presenting with histological grade I tumours of various sizes or small screen-detected tumours less than 10mm in size, early diagnosis by mammography followed by state-of-the-art treatment did not seem to have been enough to prevent death.

Adult↗
PubMed2006

Levels of chlorinated compounds (CPs, PCPPs, PCDEs, PCDFs and PCDDs) in soils at contaminated sawmill sites in Sweden.

Soil samples from five contaminated sawmill sites in Sweden were characterized with respect to chlorophenols (CP), chlorinated phenoxy phenols (PCPP, hydroxylated chlorinated diphenyl ethers), chlorinated diphenyl ethers (PCDE), chlorinated dibenzofurans (PCDF) and chlorinated dibenzo-p-dioxins (PCDD). The composition of chlorinated compounds in the soil samples was compared to the composition of two preservatives commonly used in the Scandinavian wood impregnation industry: the 2,3,4,6-tetrachlorophenol preservative called Ky-5 and the pentachlorophenol preservative Dowicide G. The levels of CPs in the soil samples ranged from 0.1 to 4500 mgkg-1 d.w., PCPPs from <0.15 to 940 mgkg-1 d.w., PCDEs from <38 to 6800 microgkg-1 d.w., PCDFs from 7.4 to 18000 microgkg-1 d.w. and PCDDs from 9.9 to 35000 microgkg-1 d.w. The resulting WHO-TEQ of PCDD/Fs in the soil samples ranged from 0.14 to 3000 microgkg-1 d.w. Despite a wide range of concentrations the congener compositions were similar within tetrachlorophenate and pentachlorophenate contaminated soils respectively. The contamination at each sawmill site may be linked to the use of either a tetrachlorphenol preservative, e.g. Ky-5, or a pentachlorophenol preservative, e.g. Dowicide G. Best-fit calculations were used to compare the chlorinated phenol contents of the preservatives to those of the soil samples. This revealed a positive correlation between the hydrophobicity (logKow) of contaminants and the ratio of their levels in soil to preservatives. The relative abundance of the chlorinated compounds varied greatly between the five sites studied, suggesting that their transport parameters differ substantially.

Benzofurans↗
PubMed2004

Outcomes of family group conferencing in Sweden. A 3-year follow-up.

OBJECTIVE: Between 1995 and 1997, the Swedish Association of Local Authorities implemented Family Group Conferences (FGC) in 10 local authorities throughout Sweden. This study reports on client outcomes of this implementation. METHOD: 97 children involved in 66 FGCs between November 1996 and October 1997 were compared with 142 children from a random sample of 104 traditional child protection investigations by the Child Protective Services (CPS). All children were followed for exactly 3 years for future child maltreatment events reported to CPS. Effects were modeled using multiple regressions, controlling for the child's age, gender, family background, and type and severity of problems. RESULTS: After controlling for initial differences, FGC-children experienced higher rates of re-referral to CPS compared to the group that had been processed in traditional investigations. They were more often re-referred due to abuse, were more often re-referred by the extended family, were longer in out-of-home placements, but tended over time to get less intrusive support from the CPS. FGCs were not related to re-referrals of neglect, of case-closure after 3 years or number of days of received services. The results suggest that the impact of the FGC was scant, accounting for 0-7% of the statistical variance of outcome variables. CONCLUSIONS: The findings did not support the alleged effectiveness of the FGC model compared to traditional investigations in preventing future maltreatment cases. If these results are confirmed in future research, they serve as a reminder of the necessity to evaluate models based on untested theories or on extrapolations from other countries/cultures, before these models are widely spread in a national practice context.

Adolescent↗
PubMed2004

Patients with type 2 diabetes aged 35-64 years at four primary health care centres in Stockholm County, Sweden. Prevalence and complications in relation to gender and socio-economic status.

This study estimates the prevalence of known diabetes, and complications of type 2 diabetes, among subjects aged 35-64 years, in relation to socio-economic factors and gender at four primary health care centres (PHCCs) in Stockholm County, Sweden. A total of 685 diabetic subjects aged 35-64 years of age were identified in primary care by diagnosis using electronic patient records. Data were supplied from medical records, and postal questionnaires. The prevalence of known diabetes among subjects aged 35-65 years differed between the PHCCs, with standardised rates between 1.7 and 3.6%, with the highest figure at the PHCC in an underprivileged area. The prevalence was higher among men (2.8% versus 1.7%). A subgroup of the patients, i.e. 389 subjects aged 35-64 years with type 2 diabetes, was studied with regard to complications. Higher education level was protective for microvascular complications (OR 0.50; CI 0.25-1.00). In addition, microvascular complications were predicted by male sex, duration, HbA(1c), and hypertension, and macrovascular complications by male sex, age, and hypertension. Prevalence of known diabetes and microvascular complications in type 2 diabetes, are associated with lower socio-economic status and male sex.

Adult↗
PubMed2006

Seasonal variation in the diagnosis of type 1 diabetes in south-east Sweden.

With the aim to survey the seasonal pattern of diagnosis of type 1 diabetes we included all 1903 children <16 years of age and who had been diagnosed with type 1 diabetes between 1977 and 2001 in the south-east of Sweden. To investigate the seasonal pattern a mixture of two cosine functions was included in a logistic regression model. There was a clear seasonal variation over the years (p<0.001). Children in the oldest age group (11-15 years) showed the most obvious seasonal variation (p<0.001). Children with a short duration of symptoms had about the same seasonal variation as children with a long duration. Both children with and without an infection 3 months prior to diagnosis showed significant seasonal variation (p<0.001) although the seasonal pattern differed between the two groups (p<0.001). As the incidence of diabetes increased during the 25 years the study period was divided into periods of 5 years and it was only during the two last periods that significant seasonal variation occurred. There is a clear seasonal variation in diagnosis of type 1 diagnosis in children and the results suggest that children with a less aggressive disease process at diagnosis were most responsible for this variation. Children with and without prior infection showed a different seasonal pattern.

Adolescent↗
PubMed2005

Eating disorders and disordered eating among patients seeking non-surgical weight-loss treatment in Sweden.

The aim of this cross-sectional descriptive study of 194 Swedish men and women seeking non-surgical weight-loss treatment was to investigate the presence of eating disorders and binge eating symptoms and to compare these two groups of patients with a group without eating disorder- or binge eating symptoms. The groups were compared in regard to co-morbid psychopathology, Health Related Quality of Life (HRQL) and anthropometric data. Of the total sample, 9.8% fulfilled criteria for any eating disorder. An additional 7.2% indicated binge eating symptoms without having an eating disorder. The three groups were significantly different in regard to psychopathology scales and most HRQL items. Eating disorders and binge eating symptoms are common among patients seeking non-surgical weight-loss treatments in Sweden and both groups showed elevated levels of co-morbid psychopathology and lower HRQL compared to patients without disordered eating. These findings point to the importance of assessing the full range of eating disorder symptoms and disorders as well as HRQL and co-morbid psychopathology before weight-loss treatment, as these factors might affect treatment outcome.

Adult↗