So far aflatoxin has not been detected in crops grown in Sweden but only in imported feedstuffs or in feed mixtures containing imported products. During the survey for other mycotoxins in Swedish crops a compound was detected in oats which, by further analysis, was identified as aflatoxin B1. Quantitative evaluation showed concentrations as high as 2.6 ppm. The fungal population in this highly contaminated sample consisted almost entirely of Aspergillus flavus.
To investigate if advanced maternal age at first birth increases the risk of psychological distress during pregnancy at 17 and 30 weeks of gestation and at 6 and 18 months after birth.
National cohort study.
A total of 19 291 nulliparous women recruited between 1999 and 2008 from hospitals and maternity units.
Questionnaire data were obtained from the longitudinal Norwegian Mother and Child Cohort Study, and register data from the national Medical Birth Register. Advanced maternal age was defined as = 32 years and a reference group of women aged 25-31 years was used for comparisons. The distribution of psychological distress from 20 to = 40 years was investigated, and the prevalence of psychological distress at the four time-points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced maternal age and psychological distress.
Psychological distress measured by SCL-5.
Women of advanced age had slightly higher scores of psychological distress over the period than the reference group, also after controlling for obstetric and infant variables. The youngest women had the highest scores. A history of depression increased the risk of distress in all women. With no history of depression, women of advanced age were not at higher risk. Changes over time were similar between groups and lowest at 6 months.
Women of 32 years and beyond had slightly increased risk of psychological distress during pregnancy and the first 18 months of motherhood compared with women aged 25-31 years.
A population-based, randomized breast cancer screening project was undertaken using mammography alone. Of 17,447 invited women aged 50-69, 12,765 (73%) attended the screening. On the basis of the screening films, malignancy was suspected in 405 women (3.2%) who were recalled for complete mammography. Additional films showed that the suspicion of malignancy was false in 194 women. The remaining 211 women (1.7%) were referred for clinical and cytological examination. Of these, 159 had surgery. Breast cancer was proved in 97 women, corresponding to a prevalence rate of 7.6/1000. Fifty-three (55%) of the carcinomas were either in situ or invasive with a diameter of less than or equal to 1 cm. Axillary metastases were found in 19 patients (19.6%). Cancers detected at screening were significantly less advanced than those in the control group. There was a remarkably high frequency of tubular carcinoma among cancers detected at screening.
Summary. The spread of hepatitis C virus (HCV) in Sweden in the 1970s indicated that serious liver complications (SLC) would increase in the 2000s. The aim of this study was to analyse the burden of HCV-associated inpatient care in Sweden, to demonstrate the changes over time and to compare the findings with a noninfected population. The HCV-cohort (n: 43 000) was identified from the national surveillance database 1990-2006, and then linked to national registers to produce an age-, sex-, and region-matched noninfected comparison population (n: 215 000) and to obtain information on demographics, cancers, inpatient care and prescriptions. Cox regression was used to estimate the likelihood (hazard ratios) for admission to hospital in the HCV compared with the noninfected cohort. The hazard ratios were 4.03 (95% CI: 3.98-4.08) for all care, 77.52 (71.02-84.60) for liver-related care and 40.74 (30.58-54.27) for liver cancer care. The admission rate in the HCV-cohort compared with the noninfected cohort, the rate ratio (age- and sex-adjusted) for all inpatient care was 5.91 (95% CI: 5.87-5.94), and the rate ratio for liver-related care was 70.05 (66.06-74.28). In the HCV-cohort, 45% of all episodes were for psychiatric, mostly drug-related, care. Inpatient care for SLC increased in the 2000s. To conclude, drug-related care was common in the HCV-infected cohort, the demand for liver-related care was very high, and SLC increased notably in the 2000s, indicating that the burden of inpatient care from serious liver disease in HCV-infected individuals in Sweden is an increasing problem.
A self-administered hand test was used to screen 5262 persons aged 40-70 living in a rural district in southern Sweden. It revealed evidence of hand impairment in 13%. The prevalence of RA was 1.1%. At the screening procedure a subgroup of 48 previously unrecognized individuals with inflammatory joint disease was identified. They were assessed by a rheumatologist, who established the following diagnoses: four definite RA, eight probable RA, three psoriatic arthritis, one unclassifiable arthritis, 10 osteoarthritis and 22 non-specific arthralgia. No advanced RA was detected. Two were seropositive and another was erosive. One with RA, one with psoriatic arthritis and three with arthralgic symptoms were unable to work. Most had only a minor need for further medical aid. The test was thus able to identify persons with hand impairment. Follow-up studies will address the practical implications of the screening procedure.
OBJECTIVES: To review long-term prophylactic factor treatment in young patients with severe haemophilia A and B, focusing on the orthopaedic and radiological outcome. DESIGN: We received 34 patients with severe haemophilia A (n = 29) and B (n = 5), aged 7-22 years. Age at start of treatment was 1-4.5 years. Dosages of factor concentrate (F VIII and F IX, respectively) were 25-40 IU/kg body weight, three times a week for haemophilia A and twice a week for haemophilia B. The patients had been checked annually over a 5-year period (1990-95). Orthopaedic and radiological joint scores were evaluated according to recommendations by the World Federation of Haemophilia. SETTING: All results were obtained at the Department for Coagulation Disorders, University of Lund, Malm? University Hospital, Malm?, Sweden. RESULTS: Orthopaedic and radiological joint scores were found to have remained unchanged during follow-up in almost all patients and to be still zero (i.e. no unaffected joints) in 79% (n = 27) of the patients. CONCLUSION: There is a growing international consensus haemophilic arthropathy can be prevented by administering early high-dose prophylaxis. The results of the present investigation strongly support this opinion.
Nivalenol has been analysed in Swedish cereals between 1987 and 1990 and it was found in oats (35% of all samples), barley (13%) and wheat (4%), with a high yearly variation. The highest concentration was 4700 micrograms/kg. Nivalenol-producing strains of Fusarium poae were isolated from contaminated samples. Feeding nivalenol to chicks produced no toxic effects at concentrations below 5 mg/kg and only small effects at 6 and 12 mg/kg.
More women in reproductive ages are entering occupations where exposure to whole body vibrations (WBV) is common (e.g. in transportation and construction). Previous studies based on self-assessed exposure suggest increased risks of adverse birth outcomes, but it is unclear at what exposure levels and if the current exposure guidelines are appropriate during pregnancy.
To investigate whether occupational WBV-exposure increases the risk of preterm birth, low birth weight, and/or small-for-gestational age, in a large, nationwide, prospective, cohort study.
The Fetal Air Pollution Exposure cohort (FAIR) was formed by merging data from multiple, national registers, and the present study includes singletons born 1994-2014 to working women in Sweden (n?=?1,091,080 births). WBV-exposure was assessed quantitatively using a job-exposure matrix based on measurements, and calculated odds ratios were adjusted for potential confounders such as smoking and BMI, and other occupational exposures like noise, combustion particles, and physically and psychologically strenuous work. Data on absence from work (full-/part time, sick leave, parental leave, etc.) was also used.
Exposure to WBV during pregnancy, among women with low absence from work (n?=?476,419), was associated with an increased risk of preterm birth, below the occupational exposure limit (1.15?m/s2). Compared to unexposed mothers, the OR was 1.38 (95% CI: 1.05, 1.83) for exposure =0.5?m/s2, corresponding to an increase from 47/1000 cases to 65/1000 cases. No increased risk was found for small-for-gestational age.
Exposure to WBV was associated with an increased risk of preterm birth. The results suggest that the current permissible exposure and action levels for WBV-exposure do not adequately protect pregnant women with continuous exposure.