We investigated cancer risk among mothers of 2365 children who were diagnosed with cancer between 1973 and 1989 in Sweden. From the date of birth of the child until 31 December 1989, 38 cases of cancer were diagnosed among the mothers. The expected number of cases, according to national rates, was 30.9. Cancer of the thyroid was the only site showing a significantly increased risk among the mothers (observed = 6, expected = 1.2, P
Among 424 HLA identical siblings undergoing stem cell transplantation, 364 were Scandinavians and 60 represented other ethnic groups. The cumulative probabilities of acute graft-versus-host disease grades II-IV were similar in both groups, 17% in Scandinavians and 12% in the others, p = 0.4. In a multivariate analysis, less effective immune suppression with cyclosporine or methotrexate alone (p = 0.001), recipient seropositive for three to four herpes viruses (p = 0.004), CMV-seropositive recipient (p = 0.05) and early engraftment (before day 15) (p = 0.05) were independent risk-factors for acute GVHD grades II-IV. The cumulative probabilities of chronic GVHD were 47% and 68% in the two ethnic populations, respectively (p = 0.004). In multivariate analysis, higher patient age (p
Since 1989 the reporting of chlamydia infections is regulated by the Contagious Diseases Act, which stipulates that a physician who detects chlamydia is obliged to trace the patient's sexual partner(s). Up to 1994 the annual decrease in the number of chlamydia cases was 20 percent, which did not meet the goal stipulated by the County Council. A questionnaire study was carried out concerning diagnosis, treatment and public health intervention in chlamydia patients seen by general and private practitioners. While the clinical management was seen to adhere to the recommendations of the National Board of Health, adequate tracing of sexual contacts was not carried out in 20-45 per cent of the cases. In a major urban area, such as the County of Stockholm, referral of all chlamydia cases to specialist clinics could possibly improve not only the care of the patients but also the success rate in reaching their sex partners.
Because of a very high mortality in ischaemic heart disease in Kiruna, Sweden, a case-control study was undertaken to study risk factors (e.g. life style, hypertension, psycho-social factors, and diet and serum lipids). As part of this study the dietary habit, lipoproteins and composition of fatty acids in cholesterol esters in serum and adipose tissue triglycerides were studied in Kiruna and in an age-matched reference cohort in Uppsala. There were small, non-significant differences in these variables between cases and controls in Kiruna and between the Kiruna cohort and a reference cohort in Uppsala. Main differences in the inter-city comparison were low levels of gamma tocopherol in serum, high levels of palmitic acid (16:0) and low levels of linoleic acid (18:2 n-6) in serum cholesterol esters and adipose tissue triglycerides in Kiruna which suggest dietary differences and different anti-oxidative status in the two populations.
This investigation was designed to study to what extent dysphagia in the elderly is accompanied by other chest symptoms and if it leads to a reduction in body weight and quality of life. To this end 796 persons, randomly taken from a population register, replied to a questionnaire concerning swallowing difficulties and other chest symptoms. Chest pain, heartburn, and regurgitation occurred significantly more frequently in subjects who admitted feelings of obstruction in the throat or chest during the ingestion of food (p less than 0.001) than in the rest, as did so-called heart problems (p less than 0.05). People with dysphagia had more often gained weight over the last 5 years than people without dysphagia (p less than 0.05). Psychosocial problems in those with dysphagia were given as anxiety at mealtimes and the wish to eat alone. Of those with dysphagia, 40% had consulted a physician, but despite this these patients had as many problems as those who had not seen a doctor. It is apparent that difficulty in swallowing in the elderly leads to physical and psychosocial problems that may reduce their quality of life.
OBJECTIVE--To evaluate a model for dietary treatment of hyperlipidaemia in primary health care. DESIGN--The participating men received their initial dietary instructions from a dietitian, in a group, together with their wives. Thereafter the nurses used a checklist to evaluate dietary compliance throughout the year. The participants completed a simplified food frequency questionnaire six times during the study period. RESULTS--Throughout the year the total body weight, body mass index (BMI), total cholesterol, LDL cholesterol and LDL/HDL cholesterol ratio decreased significantly. HDL cholesterol was significantly increased after one year. SETTING--The Industrial Health Care Centre, Ovansiljans Företagshälsovård AB in Mora, Sweden. PARTICIPANTS--35 men, aged 39-63 years (mean 51), with hyperlipidaemia, discovered at a health survey of persons attending an industrial health care centre. CONCLUSION--A simplified model for treatment of hyperlipidaemic patients can improve the dietary habits in the long term.
We have examined 645 recorded cases of childhood acute lymphatic leukaemia (ALL) in Sweden during 1973-89 to identify space-time clustering by using the close-pair method of Knox. The records included date of birth and of diagnosis as well as addresses at birth and at diagnosis. There was a significant excess of case pairs close in date of birth and place of birth in the 5- to 15-year age group.