OBJECTIVES: To study the prevalence of iron and vitamin deficiencies, endocrine disorders and immunological parameters in patients with primary Sjogren's syndrome (1 degree SS). DESIGN AND SUBJECTS: At the time of the establishment of the diagnosis of 1 degree SS in 43 consecutive patients, a clinical examination including haematological analyses was performed. The patients' medical records were also reviewed. SETTING: Patients referred for diagnosis to The University Hospital, Link?ping, a secondary or tertiary referral hospital serving the middle part of southern Sweden. RESULTS: In total, current or previously treated iron and vitamin deficiencies were registered for 63% of the 1 degree SS patients (iron 51%, vitamin B12 25%, folate 9%). Current low ferritin was noted in 24%, low iron saturation in 37%, decreased vitamin B12 in 13% and folate in 9%. Thyroid disease was found in a total of 33% and 30% had had autoimmune thyroiditis. Three patients (7%) had verified diabetes mellitus. Erythrocyte sedimentation rate (ESR) was raised in 65% of the patients and 84% had a polyclonal increase of Ig. Rheumatoid factor (RF) was detected in 85%, antinuclear antibody (ANA) in 74%, anti-SS-A in 88% and anti-SS-B in 73% of the patients. CONCLUSION: Iron and vitamin deficiencies and thyroid diseases are common in patients with 1 degree SS. Since these disorders often are treatable and may affect the patients' distress as well as their immune and exocrine function, an active, recurrent search for deficiencies, endocrine diseases and other frequently recorded disorders is recommended.
OBJECTIVE. To investigate an outbreak of S. enteritidis enterocolitis which occurred at a radiology symposium in Malmö, Sweden in March, 1990. METHODS: Questionnaires were mailed to the 126 participants after 1 and 6 months inquiring about enterocolitis, joint and eye symptoms and antibiotic treatment. Fifty-one delivered blood samples for serological studies. RESULTS. One hundred thirteen responded to the questionnaire. Enterocolitis was reported by 108 individuals (96%) and 17 (15%) developed reactive arthritis (ReA). Only 3 persons reported conjunctivitis. Antibody response did not differ between patients with uncomplicated enterocolitis or ReA. IgA antibodies had the highest sensitivity to detect infected individuals. Ten out of 65 patients treated with antibiotics (mean 9.1 days) for enterocolitis and 7 out of 48 nontreated reported joint symptoms. At 6 month followup 8 patients had persistent joint complaints. CONCLUSION. Following an outbreak of S. enteritidis dysentery, joint symptoms may be more frequent than previously thought and could not be prevented by early antibiotic treatment. Nor did antibiotics affect the duration of ReA over a 6 month followup period.
Section of Vascular Surgery, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
A population-based screening programme for abdominal aortic aneurysm (AAA) started in 2010 in Stockholm County, Sweden. This present study used individual data from Sweden's extensive healthcare registries to identify the reasons for non-participation in the AAA screening programme.
All 65-year-old men in Stockholm are invited to screening for AAA; this study included all men invited from July 2010 to July 2012. Participants and non-participants were compared for socioeconomic factors, travel distance to the examination centre and healthcare use. The influence of these factors on participation was analysed using univariable and multivariable logistic regression models.
The participation rate for AAA screening was 77·6 per cent (18?876 of 24?319 men invited). The prevalence of AAA (aortic diameter more than 2·9?cm) among participants was 1·4 per cent. The most important reasons for non-participation in the multivariable regression analyses were: recent immigration (within 5?years) (odds ratio (OR) 3·25, 95 per cent confidence interval 1·94 to 5·47), low income (OR 2·76, 2·46 to 3·10), marital status single or divorced (OR 2·23, 2·08 to 2·39), low level of education (OR 1·28, 1·16 to 1·40) and long travel distance (OR 1·23, 1·10 to 1·37). Non-participants had a higher incidence of stroke (4·5 versus 2·8 per cent; P?
The aim was internal vascular centre quality-control measures to compare single-centre results with the national perspective, as well as analysing the Swedish results from carotid artery stenting (CAS) and comparing a relatively high-volume single centre with the Swedish Vascular Registry (Swedvasc) data. The second aim was to compare CAS and carotid artery endarterectomy (CEA) outcomes for the same 7-year period.
Retrospective review of a single high-volume centre (Södersjukhuset (SÖS)) (approximately 30 CAS year(-1) approximately 90 CEA year(-1)) versus Swedvasc National data.
All consecutive selective patients treated with CAS at SÖS for a stenosis of the internal carotid artery (n = 208) or CEA (n = 552) between 2004 and 2011 were compared with all patients in Swedvasc registered for CAS (n = 258) and CEA (n = 6474). Primary outcome was 30-day frequency of stroke or death. Secondary outcome was stroke/death/acute myocardial infarction (AMI).
The 30-day frequency of any stroke or death after CAS at SÖS compared to the national data was 2.9% and 7.4%, respectively (P = 0.04). The 30-day AMI/stroke/death frequency was 3.4% and 9.5%, respectively (P = 0.01). After CEA during the same time period, the Swedvasc national data had a 4.4% frequency of 30-day stroke and death and 5.8% for AMI/stroke/death.
CAS is not as safe as CEA from a national perspective but our results indicate that a single centre can achieve acceptable results with CAS.
Screening for abdominal aortic aneurysms (AAAs) substantially reduces aneurysm-related mortality in men and is increasing worldwide. This cohort study compares post-operative mortality and complications in men with screening-detected vs. non-screening-detected AAAs.
Data were extracted from the Swedish National Registry for Vascular Surgery (Swedvasc) for all screening-detected men treated for AAA (n = 350) and age-matched controls treated for non-screening-detected AAA (n = 350).
There were no differences in baseline characteristics besides age, which was lower in the screening-detected group than in the non-screening-detected group (median 66 vs. 68, p