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Fish consumption in relation to myocardial infarction, stroke and mortality among women and men with type 2 diabetes: A prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature303254
Source
Clin Nutr. 2018 04; 37(2):590-596
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-2018
Author
Alice Wallin
Nicola Orsini
Nita G Forouhi
Alicja Wolk
Author Affiliation
Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden. Electronic address: alice.wallin@ki.se.
Source
Clin Nutr. 2018 04; 37(2):590-596
Date
04-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Animals
Cohort Studies
Diabetes Mellitus, Type 2 - epidemiology
Diet - methods
Female
Fishes
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology
Proportional Hazards Models
Prospective Studies
Retrospective Studies
Stroke - epidemiology
Sweden - epidemiology
Abstract
The accumulated evidence supports an inverse association of fish consumption with cardiovascular disease and mortality, but data among patients with type 2 diabetes are sparse. We aimed to assess fish consumption in relation to myocardial infarction (MI), stroke and mortality among individuals with type 2 diabetes.
Women and men with diagnosed type 2 diabetes (n = 2225; aged 45-84 years) within two population-based cohorts (the Swedish Mammography Cohort and the Cohort of Swedish Men) were followed from 1998 through 2012. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).
We identified 333 incident MI events, 321 incident stroke events and 771 deaths (154 with coronary heart disease [CHD] as underlying cause) during follow-up of up to 15 years. The multivariable HRs comparing >3 servings/week with =3 servings/month were 0.60 (95% CI, 0.39-0.92) for MI and 1.04 (95% CI, 0.66-1.64) for stroke. HRs for total mortality were lowest for moderate fish consumption of 1-
PubMed ID
28185684 View in PubMed
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Spillover improved survival in non-invited patients of the colorectal cancer screening programme.

https://arctichealth.org/en/permalink/ahliterature303248
Source
J Med Screen. 2018 09; 25(3):134-140
Publication Type
Journal Article
Date
09-2018
Author
Joonas Miettinen
Nea Malila
Matti Hakama
Janne Pitkäniemi
Author Affiliation
1 Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
Source
J Med Screen. 2018 09; 25(3):134-140
Date
09-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Colorectal Neoplasms - diagnosis - mortality
Early Detection of Cancer
Female
Finland - epidemiology
Health Services Research
Humans
Incidence
Male
Mass Screening - methods
Middle Aged
Patient Participation
Proportional Hazards Models
Randomized Controlled Trials as Topic
Registries
Treatment Outcome
Abstract
Objectives In colorectal cancer screening, randomized clinical trials have shown a 16% mean reduction in colorectal cancer mortality, but the Finnish randomized health services study showed no effect. We quantified spillover (the total indirect effect caused by the programme on the non-invited) and corrected the effectiveness estimate of the Finnish programme. Methods We retrieved from the Finnish Cancer Registry data on all non-invited colorectal cancer patients diagnosed in 1999-2013 in municipalities that adopted screening ( n?=?18,948). Patients were stratified by three 5-year diagnostic periods and two calendar periods of programme adoption in the municipality of residence. Follow-up ended on 31 December 2013. We measured the spillover effect in patient survival, based on differences of adjusted estimates of the colorectal cancer-related hazard of death between pairs of consecutive diagnostic periods. Results The spillover effect was estimated as 9 percentage points (95% confidence interval: -1 to 19 percentage points). It was 13 percentage points in men (-1 to 26 percentage points) and 5 percentage points in women (-9 to 20 percentage points). The corrected effect estimate of implementing screening in Finland was 5 percentage points. Conclusions The corrected Finnish effectiveness estimate was consistent with estimates from randomized trials. Indirect effects (spillover) bias the invitee-control contrast. In this case, spillover was an inherent benefit of the Finnish programme.
PubMed ID
28782403 View in PubMed
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The Origin of Spousal Resemblance for Alcohol Use Disorder.

https://arctichealth.org/en/permalink/ahliterature303229
Source
JAMA Psychiatry. 2018 03 01; 75(3):280-286
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
03-01-2018
Author
Kenneth S Kendler
Sara Larsson Lönn
Jessica Salvatore
Jan Sundquist
Kristina Sundquist
Author Affiliation
Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond.
Source
JAMA Psychiatry. 2018 03 01; 75(3):280-286
Date
03-01-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adult
Alcoholism - diagnosis - epidemiology - psychology
Causality
Female
Humans
Longitudinal Studies
Male
Marriage - psychology - statistics & numerical data
Prevalence
Proportional Hazards Models
Registries
Risk
Spouses - psychology - statistics & numerical data
Sweden
Abstract
Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear.
To examine longitudinally, in first marriages, the association of a first registration for AUD in one spouse with risk of registration in his or her partner and to explore changes in the risk for AUD registration in individuals with multiple marriages as they transition from a spouse with AUD to one without or vice versa.
Population-wide Swedish registries were used to identify individuals born in Sweden between 1960 and 1990 who were married before the end of study follow-up on December 31, 2013. The study included 8562 marital pairs with no history of AUD registration prior to their first marriage and an AUD registration in 1 spouse during marriage and 4891 individuals with multiple marriages whose first spouse had no AUD registration and second spouse did or vice versa. Final statistical analyses were conducted from August 15 to September 1, 2017.
A spousal onset or history of AUD registration.
Alcohol use disorder registration in national medical, criminal, or pharmacy registries.
Among the 8562 marital pairs (5883 female probands and 2679 male probands; mean [SD] age at marriage, 29.2 [5.7] years) in first marriages, the hazard ratio of AUD registration in wives immediately after the first AUD registration in their husbands was 13.82, which decreased 2 years later to 3.75. The hazard ratio of AUD registration in husbands after the first AUD registration in their wives was 9.21, which decreased 2 years later to 3.09. Among the 4891 individuals with multiple marriages (1439 women and 3452 men; mean [SD] age at first marriage, 25.5 [4.2] years), when individuals transitioned from a first marriage to a spouse with AUD to a second marriage to a spouse without AUD, the hazard ratio for AUD registration was 0.50 (95% CI, 0.42-0.59) in women and 0.51 (95% CI, 0.44-0.59) in men. After a first marriage to a spouse without AUD, the hazard ratio for AUD with a second marriage to a spouse with AUD was 7.02 (95% CI, 5.34-9.23) in women and 9.06 (95% CI, 7.55-10.86) in men. These patterns were modestly attenuated when moving from second to third marriages. Controlling for AUD registration prior to first marriage or between first and second marriages produced minimal changes in risk.
The increase in risk for AUD registration in a married individual following a first AUD registration in the spouse is large and rapid. When an individual with serial spouses is married, in either order, to partners with vs without an AUD registration, the risk for AUD registration is substantially increased when the partner has an AUD registration and decreased when the partner does not have an AUD registration. These results suggest that a married individual's risk for AUD is directly and causally affected by the presence of AUD in his or her spouse.
PubMed ID
29417130 View in PubMed
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Atrial fibrillation in patients undergoing coronary artery surgery is associated with adverse outcome.

https://arctichealth.org/en/permalink/ahliterature303151
Source
Ups J Med Sci. 2019 Jan; 124(1):70-77
Publication Type
Journal Article
Date
Jan-2019
Author
Gorav Batra
Anders Ahlsson
Bertil Lindahl
Lars Lindhagen
Anders Wickbom
Jonas Oldgren
Author Affiliation
a Uppsala Clinical Research Center , Uppsala , Sweden.
Source
Ups J Med Sci. 2019 Jan; 124(1):70-77
Date
Jan-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Atrial Fibrillation - epidemiology - therapy
Cardiovascular Diseases - epidemiology - therapy
Coronary Artery Bypass - methods
Coronary Vessels - surgery
Female
Follow-Up Studies
Heart Failure - epidemiology - therapy
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - therapy
Myocardial Ischemia - epidemiology - therapy
Outcome Assessment, Health Care
Preoperative Period
Proportional Hazards Models
Recurrence
Registries
Risk
Sweden - epidemiology
Treatment Outcome
Abstract
The aim was to determine the association between atrial fibrillation (AF) and outcome in patients undergoing coronary artery bypass grafting (CABG).
All patients undergoing CABG between January 2010 and June 2013 were identified in the Swedish Heart Surgery Registry. Outcomes studied were all-cause mortality, cardiovascular mortality, myocardial infarction, congestive heart failure, ischemic stroke, and recurrent AF. Patients with history of AF prior to surgery (preoperative AF) and patients without history of AF but with AF episodes post-surgery (postoperative AF) were compared to patients with no AF using adjusted Cox regression models.
Among 9,107 identified patients, 8.1% (n?=?737) had preoperative AF, and 25.1% (n?=?2,290) had postoperative AF. Median follow-up was 2.2?years. Compared to no AF, preoperative AF was associated with higher risk of all-cause mortality, adjusted hazard ratio with 95% confidence interval (HR) 1.76 (1.33-2.33); cardiovascular mortality, HR 2.43 (1.68-3.50); and congestive heart failure, HR 2.21 (1.72-2.84). Postoperative AF was associated with risk of all-cause mortality, HR 1.27 (1.01-1.60); cardiovascular mortality, HR 1.52 (1.10-2.11); congestive heart failure, HR 1.47 (1.18-1.83); and recurrent AF, HR 4.38 (2.46-7.78). No significant association was observed between pre- or postoperative AF and risk for myocardial infarction and ischemic stroke.
Approximately 1 in 3 patients undergoing CABG had pre- or postoperative AF. Patients with pre- or postoperative AF were at higher risk of all-cause mortality, cardiovascular mortality, and congestive heart failure, but not of myocardial infarction or ischemic stroke. Postoperative AF was associated with higher risk of recurrent AF.
PubMed ID
30265179 View in PubMed
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Repeated measures of body mass index and waist circumference in the assessment of mortality risk in patients with myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature303156
Source
Ups J Med Sci. 2019 Jan; 124(1):78-82
Publication Type
Journal Article
Observational Study
Date
Jan-2019
Author
Lars Berglund
Ulf Risérus
Kristina Hambraeus
Author Affiliation
a Uppsala Clinical Research Center , Uppsala University , Uppsala , Sweden.
Source
Ups J Med Sci. 2019 Jan; 124(1):78-82
Date
Jan-2019
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Aged
Anthropometry
Body mass index
Cohort Studies
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - diagnosis - mortality
Patient Discharge
Proportional Hazards Models
Prospective Studies
Registries
Risk factors
Sweden - epidemiology
Waist Circumference
Abstract
Weight loss is recommended for myocardial infarction (MI) patients with overweight or obesity. It has, however, been suggested that obese patients have better prognosis than normal-weight patients have, but also that central obesity is harmful. The aim of this study was to examine associations between repeated measures of body mass index (BMI) and waist circumference (WC), and all-cause mortality.
A total of 14,224?MI patients aged
PubMed ID
30256695 View in PubMed
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Intake of fermented and non-fermented dairy products and risk of incident CHD: the Kuopio Ischaemic Heart Disease Risk Factor Study.

https://arctichealth.org/en/permalink/ahliterature303138
Source
Br J Nutr. 2018 12; 120(11):1288-1297
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-2018
Author
Timo T Koskinen
Heli E K Virtanen
Sari Voutilainen
Tomi-Pekka Tuomainen
Jaakko Mursu
Jyrki K Virtanen
Author Affiliation
Institute of Public Health and Clinical Nutrition,University of Eastern Finland,P.O. Box 1627,70211 Kuopio,Finland.
Source
Br J Nutr. 2018 12; 120(11):1288-1297
Date
12-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Cohort Studies
Cultured Milk Products - adverse effects
Dairy Products
Diet
Diet Records
Dietary Fats
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Ischemia - diagnosis - epidemiology
Proportional Hazards Models
Prospective Studies
Risk factors
Abstract
Recent dairy product studies have suggested that fermented rather than non-fermented dairy products might provide benefits on cardiovascular health, but the evidence is inconclusive. Therefore, we investigated whether fermented and non-fermented dairy products have distinct associations with the risk of incident CHD in a population with high dairy product intake. The present study included a total of 1981 men, aged 42-60 years, from the Kuopio Ischaemic Heart Disease Risk Factor Study, with no CHD at baseline. Dietary intakes were assessed with instructed 4-d food records. We used Cox's proportional hazards regression model to estimate the associations with the risk of CHD. Fatal and non-fatal CHD events were ascertained from national registries. During a mean follow-up of 20·1 years, 472 CHD events were recorded. Median intakes were 105 g/d for fermented (87 % low-fat products) and 466 g/d for non-fermented dairy products (60 % low-fat products). After adjusting for potential confounders, those in the highest (v. lowest) intake quartile of fermented dairy products had 27 % (95 % CI 5, 44; P-trend=0·02) lower risk of CHD. In contrast, those in the highest intake quartile of non-fermented dairy products had 52 % (95 % CI 13, 104; P-trend=0·003) higher risk of CHD. When analysed based on fat content, low-fat (
PubMed ID
30370878 View in PubMed
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Rationale for a Swedish cohort consortium.

https://arctichealth.org/en/permalink/ahliterature303123
Source
Ups J Med Sci. 2019 Jan; 124(1):21-28
Publication Type
Journal Article
Date
Jan-2019
Author
Johan Sundström
Cecilia Björkelund
Vilmantas Giedraitis
Per-Olof Hansson
Marieann Högman
Christer Janson
Ilona Koupil
Margareta Kristenson
Ylva Trolle Lagerros
Jerzy Leppert
Lars Lind
Lauren Lissner
Ingegerd Johansson
Jonas F Ludvigsson
Peter M Nilsson
Håkan Olsson
Nancy L Pedersen
Andreas Rosenblad
Annika Rosengren
Sven Sandin
Tomas Snäckerström
Magnus Stenbeck
Stefan Söderberg
Elisabete Weiderpass
Anders Wanhainen
Patrik Wennberg
Isabel Fortier
Susanne Heller
Maria Storgärds
Bodil Svennblad
Author Affiliation
a Department of Medical Sciences , Uppsala University , Uppsala , Sweden.
Source
Ups J Med Sci. 2019 Jan; 124(1):21-28
Date
Jan-2019
Language
English
Publication Type
Journal Article
Keywords
Biomedical Research - methods
Cohort Studies
Ethics, Medical
Genetic Association Studies
Humans
International Cooperation
Outcome Assessment, Health Care
Pilot Projects
Proportional Hazards Models
Prospective Studies
Registries
Research Design
Risk factors
Subarachnoid Hemorrhage - diagnosis - epidemiology
Sweden - epidemiology
Abstract
We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.
PubMed ID
30618330 View in PubMed
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Sex-specific associations between body mass index and death before life expectancy: a comparative study from the USA and Sweden.

https://arctichealth.org/en/permalink/ahliterature302973
Source
Glob Health Action. 2019; 12(1):1580973
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2019
Author
Melissa Scribani
Margareta Norberg
Kristina Lindvall
Lars Weinehall
Julie Sorensen
Paul Jenkins
Author Affiliation
a Bassett Healthcare Network, Bassett Research Institute , Cooperstown , NY , USA.
Source
Glob Health Action. 2019; 12(1):1580973
Date
2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Factors
Aged
Body mass index
Cause of Death
Cohort Studies
Female
Global health
Humans
Life expectancy
Male
Middle Aged
Mortality, Premature - trends
New York - epidemiology
Obesity - epidemiology - mortality
Proportional Hazards Models
Sex Factors
Sweden - epidemiology
Abstract
Understanding the impact of obesity on premature mortality is critical, as obesity has become a global health issue.
To contrast the relationship between body mass index (BMI) and premature death (all-cause; circulatory causes) in New York State (USA) and Northern Sweden.
Baseline data were obtained between 1989 and 1999 via questionnaires (USA) and health exams (Sweden), with mortality data from health departments, public sources (USA) and the Swedish Death Register. Premature death was death before life expectancy based on sex and year of birth. Within country and sex, time to premature death was compared across BMI groups (18.5-24.9 kg/m2 (reference), 25-29.9 kg/m2, 30.0-34.9 kg/m2, =35.0 kg/m2) using Proportional Hazards regression. Absolute risk (deaths/100,000 person-years) was compared for the same stratifications among nonsmokers.
60,600 Swedish (47.8% male) and 31,198 US subjects (47.7% male) were included. Swedish males with BMI=30 had increased hazards (HR) of all-cause premature death relative to BMI 18.5-24.9 (BMI 30-34.9, HR = 1.71 (95% CI: 1.44, 2.02); BMI=35, HR = 2.89 (2.16, 3.88)). BMI=25 had increased hazards of premature circulatory death (BMI 25-29.9, HR = 1.66 (1.32, 2.08); BMI 30-34.9, HR = 3.02 (2.26, 4.03); BMI=35, HR = 4.91 (3.05, 7.90)). Among US males, only BMI=35 had increased hazards of all-cause death (HR = 1.63 (1.25, 2.14)), while BMI 30-34.9 (HR = 1.83 (1.20, 2.79)) and BMI=35 (HR = 3.18 (1.96, 5.15)) had increased hazards for circulatory death. Swedish females showed elevated hazards with BMI=30 for all-cause (BMI 30-34.9, HR = 1.42 (1.18, 1.71) and BMI=35, HR = 1.61 (1.21, 2.15) and with BMI=35 (HR = 3.11 (1.72, 5.63)) for circulatory death. For US women, increased hazards were observed among BMI=35 (HR = 2.10 (1.60, 2.76) for all-cause and circulatory HR = 3.04 (1.75, 5.30)). Swedish males with BMI=35 had the highest absolute risk of premature death (762/100,000 person-years).
This study demonstrates a markedly increased risk of premature death associated with increasing BMI among Swedish males, a pattern not duplicated among females.
PubMed ID
30947624 View in PubMed
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Oral contraceptives, hormone replacement therapy and breast cancer risk: a cohort study of 16 928 women 48 years and older.

https://arctichealth.org/en/permalink/ahliterature302807
Source
Acta Oncol. 2014 Jun;53(6):752-8. doi: 10.3109/0284186X.2013.878471. Epub 2014 Jan 24.
Publication Type
Article
Date
2014
Author
Thorbjarnardottir T
Olafsdottir EJ
Valdimarsdottir UA
Olafsson O
Tryggvadottir L
Source
Acta Oncol. 2014 Jun;53(6):752-8. doi: 10.3109/0284186X.2013.878471. Epub 2014 Jan 24.
Date
2014
Language
English
Geographic Location
Iceland
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Breast Neoplasms
Epidemiology
Cohort Studies
Contraceptives, Oral, Hormonal
Estrogen Replacement Therapy
Methods
Statistics & numerical data
Estrogens
Therapeutic use
Female
Humans
Iceland
Middle Aged
Progesterone
Proportional Hazards Models
Reproductive history
Risk factors
Time Factors
Abstract
BACKGROUND: Findings on potential interactive effects of oral contraceptives (OCs) and hormone replacement therapy (HRT) on breast cancer risk have been inconsistent. We aimed to use population-based cohort data to determine whether former use of OCs affects breast cancer risk among HRT users, taking into account regimens of HRT, duration and currency of use.
METHODS: The cohort consisted of 16 928 Icelandic women who visited the Icelandic Cancer Detection Clinic in 1979-2006 and provided information on use of OCs and HRT when they were 48 years or older. By record linkage to the Icelandic Cancer Registry, all breast cancer diagnosed during follow-up was identified. Using Cox regression, hazard ratios (HRs) for breast cancer according to hormone use were estimated, adjusting for menstrual and reproductive risk factors. Also, interaction analyses were carried out.
RESULTS: Breast cancer risk was significantly increased among ever users of combined estrogen and progestin (EP-HRT) preparations (HR=2.61; 95% CI 2.00-3.41) and not among users of estrogen-only regimens (E-only HRT) (HR=1.13; 95% CI 0.85-1.49). Ever users of both OCs and HRT had higher breast cancer risk than users of only one of the two (HR=2.19; 95% CI 1.67-2.87). After restricting the analysis to EP-HRT and focusing on long-term and current use, there was an indication of a negative interaction with ever OC use (p=0.06); HR=2.87; 95% CI 1.79-4.60 for never OC users and HR=2.24; 95% CI 1.51-3.34 for former OC users.
CONCLUSION: After taking HRT regimen, duration and currency of use into account, the results of our population-based cohort study do not support the notion that former OC use increases breast cancer risk among HRT users, on the contrary there was an indication of a slightly lower risk in former OC users, restricted to current, long-term EP-HRT users.
PubMed ID
24460068 View in PubMed
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The association of potentially inappropriate medication use on health outcomes and hospital costs in community-dwelling older persons: a longitudinal 12-year study.

https://arctichealth.org/en/permalink/ahliterature302779
Source
Eur J Health Econ. 2019 Mar; 20(2):233-243
Publication Type
Journal Article
Date
Mar-2019
Author
Virva Hyttinen
Johanna Jyrkkä
Leena K Saastamoinen
Anna-Kaisa Vartiainen
Hannu Valtonen
Author Affiliation
Department of Health and Social Management, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. virva.hyttinen@uef.fi.
Source
Eur J Health Econ. 2019 Mar; 20(2):233-243
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Accidental Falls
Aged
Aged, 80 and over
Cause of Death
Female
Finland - epidemiology
Fractures, Bone - epidemiology - etiology
Hospital Costs - statistics & numerical data
Humans
Longitudinal Studies
Male
Medication Errors
Mortality
Potentially Inappropriate Medication List - statistics & numerical data
Proportional Hazards Models
Registries
Abstract
To determine (1) whether potentially inappropriate medication (PIM) use defined by the Meds75?+?database is associated with fracture-specific hospitalisations and all-cause mortality, and (2) the association between PIM use and all-cause hospitalisation costs in a 12-year follow-up of a nationwide sample of people aged?=?65 years in Finland.
This is a longitudinal study of 20,666 community-dwelling older persons with no prior purchases of PIMs within a 2-year period preceding the index date (1 Jan 2002), who were followed until the end of 2013. Data were obtained from the Finnish Prescription Register, and it was accompanied by information on inpatient care, causes of deaths and socioeconomic status from other national registers. Propensity score matching (PSM) analysis was used to account for potential selection effect in PIM use. Cox proportional hazards regression was used to identify the time to the first fracture or death by comparing PIM-users (n?=?10,333) with non-users (n?=?10,333). The association between PIM use and hospital costs was analysed with a fixed effects linear model.
PIM use was weakly associated with an increased risk of fractures and death. The association was stronger in the first PIM-use periods. Hospitalised PIM-users had 15% higher hospital costs compared to non-users during the 12-year follow-up.
PIM initiation was associated with an increased risk of fracture-specific hospitalisation and mortality and PIM-users had higher hospital costs than non-users. Health care providers should carefully consider these issues when prescribing PIM for older persons.
PubMed ID
29978444 View in PubMed
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Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer.

https://arctichealth.org/en/permalink/ahliterature302781
Source
Mol Oncol. 2018 09; 12(9):1639-1655
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Jarle Bruun
Anita Sveen
Rita Barros
Peter W Eide
Ina Eilertsen
Matthias Kolberg
Teijo Pellinen
Leonor David
Aud Svindland
Olli Kallioniemi
Marianne G Guren
Arild Nesbakken
Raquel Almeida
Ragnhild A Lothe
Author Affiliation
Department of Molecular Oncology, Institute for Cancer Research, the Norwegian Radium Hospital, Oslo University Hospital, Norway.
Source
Mol Oncol. 2018 09; 12(9):1639-1655
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Biomarkers, Tumor - genetics
CDX2 Transcription Factor - genetics
Chemotherapy, Adjuvant
Colorectal Neoplasms - drug therapy - genetics - mortality - pathology
Disease-Free Survival
Female
Gene Expression
Hospitals, University
Humans
Kaplan-Meier Estimate
Male
Microsatellite Instability
Multivariate Analysis
Mutation
Neoplasm Staging
Norway
Pharmacogenomic Testing
Prognosis
Proportional Hazards Models
Proto-Oncogene Proteins B-raf - genetics
Registries
Retrospective Studies
Survival Analysis
Abstract
We aimed to refine the value of CDX2 as an independent prognostic and predictive biomarker in colorectal cancer (CRC) according to disease stage and chemotherapy sensitivity in preclinical models. CDX2 expression was evaluated in 1045 stage I-IV primary CRCs by gene expression (n = 403) or immunohistochemistry (n = 642) and in relation to 5-year relapse-free survival (RFS), overall survival (OS), and chemotherapy. Pharmacogenomic associations between CDX2 expression and 69 chemotherapeutics were assessed by drug screening of 35 CRC cell lines. CDX2 expression was lost in 11.6% of cases and showed independent poor prognostic value in multivariable models. For individual stages, CDX2 was prognostic only in stage IV, independent of chemotherapy. Among stage I-III patients not treated in an adjuvant setting, CDX2 loss was associated with a particularly poor survival in the BRAF-mutated subgroup, but prognostic value was independent of microsatellite instability status and the consensus molecular subtypes. In stage III, the 5-year RFS rate was higher among patients with loss of CDX2 who received adjuvant chemotherapy than among patients who did not. The CDX2-negative cell lines were significantly more sensitive to chemotherapeutics than CDX2-positive cells, and the multidrug resistance genes MDR1 and CFTR were significantly downregulated both in CDX2-negative cells and in patient tumors. Loss of CDX2 in CRC is an adverse prognostic biomarker only in stage IV disease and appears to be associated with benefit from adjuvant chemotherapy in stage III. Early-stage patients not qualifying for chemotherapy might be reconsidered for such treatment if their tumor has loss of CDX2 and mutated BRAF.
PubMed ID
29900672 View in PubMed
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Excess body weight, weight gain and obesity-related cancer risk in women in Norway: the Norwegian Women and Cancer study.

https://arctichealth.org/en/permalink/ahliterature302770
Source
Br J Cancer. 2018 08; 119(5):646-656
Publication Type
Journal Article
Date
08-2018
Author
Marisa da Silva
Elisabete Weiderpass
Idlir Licaj
Lauren Lissner
Charlotta Rylander
Author Affiliation
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway. marisa.e.silva@uit.no.
Source
Br J Cancer. 2018 08; 119(5):646-656
Date
08-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Body Weight
Cohort Studies
Female
Humans
Middle Aged
Neoplasms - epidemiology - etiology
Norway
Obesity - complications - epidemiology
Overweight - complications - epidemiology
Postmenopause
Proportional Hazards Models
Prospective Studies
Risk assessment
Self Report
Weight Gain
Abstract
Excess body weight and weight gain have been reported to independently increase the risk of several cancers. There are few published studies in nationally representative populations of women on specific, 'obesity-related' cancers in relation to prior weight change and relevant confounders.
Based on self-reported anthropometry, we prospectively assessed body mass index (BMI), weight change over 6 years and subsequent obesity-related cancer risk in the Norwegian Women and Cancer study. We used Cox proportional hazard models to calculate hazard ratios and restricted cubic splines to model potential non-linear dose-response relationships.
Excess body weight increased the risk of overall obesity-related cancer, postmenopausal breast, colorectal, colon, endometrial and kidney cancer, with endometrial cancer showing a threefold elevated risk. High weight gain (?=?10?kg) increased the risk of overall obesity-related cancer, postmenopausal breast, endometrial and pancreatic cancer. The association between high weight gain and pancreatic cancer was strong, with 91% increased risk.
Maintaining stable weight in middle adulthood, irrespective of BMI category at baseline, and avoiding excess body weight are both important in the prevention of several obesity-related cancers in women. Our finding of increased risk of pancreatic cancer in women with moderate and high weight gain is novel.
PubMed ID
30202086 View in PubMed
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Sauna Bathing and Risk of Psychotic Disorders: A Prospective Cohort Study.

https://arctichealth.org/en/permalink/ahliterature302771
Source
Med Princ Pract. 2018; 27(6):562-569
Publication Type
Comparative Study
Journal Article
Date
2018
Author
Tanjaniina Laukkanen
Jari A Laukkanen
Setor K Kunutsor
Author Affiliation
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Source
Med Princ Pract. 2018; 27(6):562-569
Date
2018
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Adult
Finland - epidemiology
Humans
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Psychotic Disorders - epidemiology - etiology
Risk factors
Steam Bath - adverse effects - psychology - statistics & numerical data
Surveys and Questionnaires
Abstract
Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study.
Baseline sauna bathing habits were assessed in 2,138 men aged 42-61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2-3, and 4-7 times per week).
During a median follow-up of 24.9 years, 203 psychotic disorders were recorded. A total of 537, 1,417, and 184 participants reported having a sauna bath once a week, 2-3 times, and 4-7 times per week, respectively. In Cox regression analysis adjusted for age, compared to men who had 1 sauna session per week, the hazard ratio (95% confidence intervals) of psychosis for 4-7 sauna sessions per week was 0.23 (0.09-0.58). In a multivariable model adjusted for several risk factors and other potential confounders, the corresponding hazard ratio was 0.21 (0.08-0.52). The association was similar after further adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein (0.22 [0.09-0.54]) and was unchanged on additional adjustment for duration of a sauna session and temperature of the sauna bath (0.23 [0.09-0.57]).
Our study suggests a strong inverse and independent association between frequent sauna bathing and the future risk of psychotic disorders in a general male population.
PubMed ID
30173212 View in PubMed
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Tumor Necrosis Factor Inhibitors and Cancer Recurrence in Swedish Patients With Rheumatoid Arthritis: A Nationwide Population-Based Cohort Study.

https://arctichealth.org/en/permalink/ahliterature302775
Source
Ann Intern Med. 2018 09 04; 169(5):291-299
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-04-2018
Author
Pauline Raaschou
Jonas Söderling
Carl Turesson
Johan Askling
Author Affiliation
Karolinska Institutet, Stockholm, Sweden (P.R., J.S.).
Source
Ann Intern Med. 2018 09 04; 169(5):291-299
Date
09-04-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Algorithms
Antirheumatic Agents - adverse effects
Arthritis, Rheumatoid - complications - drug therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Staging
Neoplasms - diagnosis - pathology
Neoplasms, Second Primary - diagnosis
Proportional Hazards Models
Recurrence
Risk factors
Sweden
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Abstract
Use of tumor necrosis factor inhibitors (TNFi) in patients with a history of cancer remains a clinical dilemma.
To investigate whether TNFi treatment in rheumatoid arthritis (RA) is associated with increased risk for cancer recurrence.
Population-based cohort study based on linkage of nationwide registers.
Sweden.
Patients with RA who started TNFi treatment between 2001 and 2015, after being diagnosed with cancer, and matched patients with RA and a history of the same cancer who had never received biologics.
The primary outcome was the first recurrence of cancer. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs), taking into account time, cancer type, and whether the cancer was invasive or in situ (or tumor, node, metastasis [TNM] classification system stage in a subset of patients).
Among 467 patients who started TNFi treatment (mean time after cancer diagnosis, 7.9 years), 42 had cancer recurrences (9.0%; mean follow-up, 5.3 years); among 2164 matched patients with the same cancer history, 155 had recurrences (7.2%; mean follow-up, 4.3 years) (HR, 1.06 [95% CI, 0.73 to 1.54). Hazard ratios were close to 1 in analyses of patient subsets matched on cancer stage or with similar time from index cancer diagnosis to the start of TNFi treatment, as well as in unmatched analyses. Several CIs had upper limits close to 2.
The outcome algorithm was partly nonvalidated, and channeling bias was possible if patients with a better index cancer prognosis were more likely to receive TNFi.
The findings suggest that TNFi treatment is not associated with increased risk for cancer recurrence in patients with RA, although meaningful risk increases could not be ruled out completely.
ALF (an agreement in Stockholm County Council concerning medical education and research in health and medical care), the Swedish Cancer Society, the Swedish Foundation for Strategic Research, and the Swedish Research Council.
PubMed ID
30105374 View in PubMed
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Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial.

https://arctichealth.org/en/permalink/ahliterature302651
Source
Ann Intern Med. 2018 06 05; 168(11):775-782
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
06-05-2018
Author
Øyvind Holme
Magnus Løberg
Mette Kalager
Michael Bretthauer
Miguel A Hernán
Eline Aas
Tor J Eide
Eva Skovlund
Jon Lekven
Jörn Schneede
Kjell Magne Tveit
Morten Vatn
Giske Ursin
Geir Hoff
Author Affiliation
Sørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
Source
Ann Intern Med. 2018 06 05; 168(11):775-782
Date
06-05-2018
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Cause of Death
Colorectal Neoplasms - diagnosis - epidemiology - mortality
Early Detection of Cancer - methods
Female
Follow-Up Studies
Humans
Incidence
Male
Mass Screening - methods
Norway - epidemiology
Occult Blood
Proportional Hazards Models
Registries
Risk Reduction Behavior
Sex Factors
Sigmoidoscopy
Abstract
The long-term effects of sigmoidoscopy screening on colorectal cancer (CRC) incidence and mortality in women and men are unclear.
To determine the effectiveness of flexible sigmoidoscopy screening after 15 years of follow-up in women and men.
Randomized controlled trial. (ClinicalTrials.gov: NCT00119912).
Oslo and Telemark County, Norway.
Adults aged 50 to 64 years at baseline without prior CRC.
Screening (between 1999 and 2001) with flexible sigmoidoscopy with and without additional fecal blood testing versus no screening. Participants with positive screening results were offered colonoscopy.
Age-adjusted CRC incidence and mortality stratified by sex.
Of 98 678 persons, 20 552 were randomly assigned to screening and 78 126 to no screening. Adherence rates were 64.7% in women and 61.4% in men. Median follow-up was 14.8 years. The absolute risks for CRC in women were 1.86% in the screening group and 2.05% in the control group (risk difference, -0.19 percentage point [95% CI, -0.49 to 0.11 percentage point]; HR, 0.92 [CI, 0.79 to 1.07]). In men, the corresponding risks were 1.72% and 2.50%, respectively (risk difference, -0.78 percentage point [CI, -1.08 to -0.48 percentage points]; hazard ratio [HR], 0.66 [CI, 0.57 to 0.78]) (P for heterogeneity = 0.004). The absolute risks for death from CRC in women were 0.60% in the screening group and 0.59% in the control group (risk difference, 0.01 percentage point [CI, -0.16 to 0.18 percentage point]; HR, 1.01 [CI, 0.77 to 1.33]). The corresponding risks for death from CRC in men were 0.49% and 0.81%, respectively (risk difference, -0.33 percentage point [CI, -0.49 to -0.16 percentage point]; HR, 0.63 [CI, 0.47 to 0.83]) (P for heterogeneity = 0.014).
Follow-up through national registries.
Offering sigmoidoscopy screening in Norway reduced CRC incidence and mortality in men but had little or no effect in women.
Norwegian government and Norwegian Cancer Society.
Notes
CommentIn: Ann Intern Med. 2018 Jun 5;168(11):824-825 PMID 29710347
CommentIn: Ann Intern Med. 2018 Nov 6;169(9):663 PMID 30398635
CommentIn: Ann Intern Med. 2018 Nov 6;169(9):663-664 PMID 30398636
PubMed ID
29710125 View in PubMed
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Antihypertensive drugs and prostate cancer risk in a Finnish population-based cohort.

https://arctichealth.org/en/permalink/ahliterature302616
Source
Scand J Urol. 2018 Oct - Dec; 52(5-6):321-327
Publication Type
Journal Article
Author
Aino Siltari
Teemu J Murtola
Kirsi Talala
Kimmo Taari
Teuvo L J Tammela
Anssi Auvinen
Author Affiliation
a Faculty of Medicine, Pharmacology , University of Helsinki , Helsinki , Finland.
Source
Scand J Urol. 2018 Oct - Dec; 52(5-6):321-327
Language
English
Publication Type
Journal Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antihypertensive Agents - therapeutic use
Cohort Studies
Diuretics - therapeutic use
Finland - epidemiology
Humans
Hypertension - drug therapy - epidemiology
Male
Middle Aged
Proportional Hazards Models
Prostatic Neoplasms - epidemiology
Risk factors
Abstract
The etiology of prostate cancer (PCa) involves environmental and genetic factors. Understanding the role of medication use on PCa risk may clarify the pathophysiological changes and mechanisms in development of cancer.
This study investigated PCa risk in relation to overall use of anti-hypertensive drugs and those with specific mechanisms of action. The study cohort (78,615 men) was linked to the prescription database to obtain information on medication use during 20-year follow-up. Information was obtained on PCa diagnoses, causes of deaths, and for a sub-set on B.M.I. and use of non-prescription drugs. Time-dependent drug use variables hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression analyses.
Use of antihypertensive drugs slightly increased PCa risk (HR = 1.16, 95% CI = 1.11-1.22). The risk increase was clearest for metastatic PCa (HR = 1.36, 95% CI = 1.14-1.62). ACE inhibitors, beta-blockers, and diuretics were all separately associated with a small excess risk (HR = 1.10, 95% CI = 1.01-1.19, HR = 1.14, 95% CI = 1.06-1.21, and HR = 1.16, 95% CI = 1.07-1.27, respectively). None of the other groups showed a clear association with PCa risk.
The use of antihypertensive drugs was associated with increased prostate cancer risk. Similar risk association for multiple drug groups suggests that the findings may not reflect a direct medication effect, but may be due to underlying hypertension.
PubMed ID
30698056 View in PubMed
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Higher mortality of adults with asthma: A 15-year follow-up of a population-based cohort.

https://arctichealth.org/en/permalink/ahliterature302555
Source
Allergy. 2018 Jul; 73(7):1479-1488
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
Jul-2018
Author
R E Lemmetyinen
J V Karjalainen
A But
R L O Renkonen
J R Pekkanen
S K Toppila-Salmi
J K Haukka
Author Affiliation
Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland.
Source
Allergy. 2018 Jul; 73(7):1479-1488
Date
Jul-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Asthma - epidemiology - mortality
Case-Control Studies
Cause of Death
Female
Finland - epidemiology
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Morbidity
Mortality
Population Surveillance
Proportional Hazards Models
Risk assessment
Risk factors
Abstract
Higher all-cause mortality in asthmatics has been shown previously. Polysensitization is associated with higher morbidity among asthmatic children, and allergic rhinitis and/or allergic conjunctivitis (AR/AC) are associated with higher morbidity in adult asthmatics. Little is known about the effect of AR/AC and other factors on mortality among adult asthmatics. The aim was to study mortality and its risk factors in adults with and without asthma.
We randomly selected 1648 asthmatics with age over 30 years from national registers and matched the asthma sample with one or two controls. Baseline information was obtained by a questionnaire in 1997, and the study population was linked with the death certificate information of Statistics Finland from 1997 to 2013. Overall and cause-specific survival between the groups was compared in several adjusted models.
During a mean follow-up period of 15.6 years, 221 deaths among 1052 asthma patients and 335 deaths among 1889 nonasthmatics were observed. Cardiovascular diseases were the main cause of death in both groups. Asthma was associated with increased all-cause mortality (adjusted HR 1.25; 95% CI 1.05-1.49, P = .011) as well as mortality from chronic obstructive pulmonary disease (HR 12.0, 4.18-34.2, P
PubMed ID
29461632 View in PubMed
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Suicide risk among native- and foreign-origin persons in Sweden: a longitudinal examination of the role of unemployment status.

https://arctichealth.org/en/permalink/ahliterature302516
Source
Soc Psychiatry Psychiatr Epidemiol. 2019 May; 54(5):579-590
Publication Type
Journal Article
Date
May-2019
Author
Andrea C Dunlavy
Sol Juárez
Susanna Toivanen
Mikael Rostila
Author Affiliation
Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, Sveaplan, 106 91, Stockholm, Sweden. andrea.dunlavy@su.se.
Source
Soc Psychiatry Psychiatr Epidemiol. 2019 May; 54(5):579-590
Date
May-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Emigrants and Immigrants - psychology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Proportional Hazards Models
Registries
Suicide - ethnology - psychology
Sweden - epidemiology - ethnology
Unemployment - psychology
Young Adult
Abstract
Prior research has documented an association between unemployment and elevated suicide risk. Yet, few Swedish studies have explicitly considered how such risk may vary by different migration background characteristics among persons of foreign-origin, who often experience diverse forms of labor market marginalization. This study examines the extent to which unemployment status may differentially influence suicide risk among the foreign-origin by generational status, region of origin, age at arrival, and duration of residence.
Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25-64 years) from 1993 to 2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models.
Elevated suicide risk observed among foreign-origin unemployed groups was generally of a similar or lower magnitude than that found in unemployed native-origin, although unemployed second-generation Swedish men demonstrated significantly greater (p?
PubMed ID
30421040 View in PubMed
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Serum phthalate levels and time to pregnancy in couples from Greenland, Poland and Ukraine.

https://arctichealth.org/en/permalink/ahliterature302420
Source
PLoS One. 2015 Mar 18;10(3):e0120070. doi: 10.1371/journal.pone.0120070. eCollection 2015.
Publication Type
Article
Date
2015
Author
Specht IO
Bonde JP
Toft G
Lindh CH
Jönsson BA
Jørgensen KT
Source
PLoS One. 2015 Mar 18;10(3):e0120070. doi: 10.1371/journal.pone.0120070. eCollection 2015.
Date
2015
Language
English
Geographic Location
Greenland
Russia
Publication Type
Article
Keywords
Adult
Cohort Studies
Diethylhexyl Phthalate
Blood
toxicity
Endocrine Disruptors
Environmental Exposure
Environmental Pollutants
Family Characteristics
Female
Greenland
Humans
Male
Phthalic Acids
Poland
Pregnancy
Proportional Hazards Models
Semen Analysis
Testosterone
Time-to-Pregnancy
Ukraine
Abstract
Phthalates are ubiquitous industrial chemicals that have been associated with altered reproductive function in rodents. Several human studies have reported an inverse association between male testosterone and phthalate levels. Our aim was to investigate time to pregnancy (TTP) according to serum levels of diethylhexyl phthalate (DEHP) and diisononyl phthalate (DiNP) metabolites in both partners. In 2002-2004 we enrolled 938 pregnant women and 401 male spouses from Greenland, Poland and Ukraine. Six oxidized metabolites of DEHP and DiNP were summarized for each of the two parent compounds to provide proxies of the internal exposure. We used Cox discrete-time models to estimate fecundability ratios (FR) and 95% confidence intervals (95% CIs) for men and women according to their proxy-DEHP or -DiNP serum levels adjusted for a fixed set of covariates. The FR was slightly elevated among women with high levels of DEHP (FR=1.14, 95% CI 1.00;1.30) suggesting a shorter TTP in these women. The FR was unrelated to DiNP in women, whereas the results for men were inconsistent pointing in opposite directions. First-time pregnant women from Greenland with high serum DiNP levels had a longer TTP. This study spanning large contrast in environmental exposure does not indicate adverse effects of phthalates on couple fecundity. The shorter TTP in women with high levels of DEHP metabolites is unexplained and needs further investigation.
PubMed ID
25786246 View in PubMed
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Do Cervical Cancer Patients Diagnosed with Opportunistic Screening Live Longer? An Arkhangelsk Cancer Registry Study.

https://arctichealth.org/en/permalink/ahliterature302344
Source
Int J Environ Res Public Health. 2017 Nov 26;14(12). pii: E1500. doi: 10.3390/ijerph14121500.
Publication Type
Article
Date
2017
Author
Roik EE
Nieboer E
Kharkova OA
Grjibovski AM
Postoev VA
Odland JØ
Source
Int J Environ Res Public Health. 2017 Nov 26;14(12). pii: E1500. doi: 10.3390/ijerph14121500.
Date
2017
Language
English
Geographic Location
Russia
Publication Type
Article
Keywords
Adult
Aged
Carcinoma, Squamous Cell
Diagnosis
Female
Humans
Longevity
Mass Screening
Middle Aged
Mortality
Neoplasm Staging
Prognosis
Proportional Hazards Models
Registries
Risk factors
Uterine Cervical Neoplasms
Abstract
The aim of the current study was to compare cervical cancer (??) patients diagnosed with and without screening in terms of: (i) sociodemographic and clinical characteristics; (ii) factors associated with survival; and (iii), and levels of risk. A registry-based study was conducted using data from the Arkhangelsk Cancer Registry. It included women with newly diagnosed malignant neoplasm of the uterine cervix during the period of 1 January 2005 to 11 November 2016 (N = 1548). The Kaplan-Meier method, the log-rank test, and Cox regression were applied. Most participants who were diagnosed by screening were at stage I and died less frequently from CC than those diagnosed without screening. The latter group was also diagnosed with ?? at a younger age and died younger. Younger individuals and urban residents diagnosed with stage I and II, squamous cell carcinoma had longer survival times. Cox regression modeling indicated that the hazard ratio for death among women with CC diagnosed without screening was 1.61 (unadjusted) and 1.37 (adjusted). CC diagnosed by screening, cancer stage, patient residence, histological tumor type, and age at diagnosis were independent prognostic variables of longer survival time with CC. Diagnosis of CC made within a screening program improved survival.
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