The historical background of aneurysmal subarachnoid hemorrhage is depicted with emphasis in the Scandinavian contribution to improvements in the treatment. It is concluded that an aneurysmal subarachnoid hemorrhage with all certainty was the cause of death of the prospective King of Sweden, Charles August, in the year 1810. Despite advances in management and surgical treatment of this devastating disease the outcome in this important patient--which led to a new royal dynasty in Sweden--would certainly have turned out as fatal today as became the case 174 years ago.
The role of social, behavioral, and psychological characteristics and other risk indicators for high alcohol consumption in young men was analyzed using a survey of 49,464 Swedish conscripts. A strong association between an increasing weight of adverse social and behavioral risk indicators on the one hand and high alcohol consumption on the other was found. Yet many high consumers had no or few risk indicators. In multivariate analysis, substance use and indicators of deviant behavior came out as the strongest risk indicators for high alcohol consumption. Indicators of poor social background generally had relatively low odds ratios. Poor home wellbeing, for instance, had an odds ratio of 0.9. Social group of father was nonsignificant. Very good family economy had a higher odds ratio, 1.7, than average or poor family economy. Psychosomatic symptoms had relatively low odds ratios. Among psychological variables, low emotional control had a significantly elevated odds ratio of 1.8. Increased odds ratios were found for conscripts who were never anxious or never felt insecure. In conclusion, although many high consumers of alcohol had no or few risk indicators, we identified a high-risk group characterized by high levels of alcohol consumption and several indicators of personality disturbances, early deviant behavior, and social maladjustment.
The purpose of this study was to find psychiatric, behavioral and social characteristics that predict subsequent anxiety syndromes in men. Questionnaire data were collected in a cohort of all 50,465 men in Sweden who were conscripted for military training. By record linkage with the national psychiatric inpatient register, we identified 68 probands with pure anxiety neurosis occurring in the cohort during a 13-year follow-up period. Baseline characteristics were categorized into 8 variables that were entered into logistic regression models. We found that reported treatment with psychoactive drugs and perceived mental health problems at baseline increased the odds of being admitted for anxiety neurosis by 1.9 and 1.8. Other predictors were family problems (odds ratio = 2.0) and having a family member being treated with psychoactive drugs (odds ratio = 1.7). Univariate relative risks were higher, and a psychiatric diagnosis at conscription conferred a relative risk of anxiety neurosis of 2.2. A similar profile was obtained for subjects admitted for a depressive neurosis, in support of the continuum hypothesis between anxiety and depression. We conclude that the necessity of admission for anxiety neurosis in young men originates in genuine mental symptoms in the family setting.
Seamen constitute a special group of international travellers who may run an increased risk of contracting hepatitis, because of visits to foreign ports and the particular environment on board ship. The purpose of the survey was to assess the prevalence of serological markers for hepatitis A, B and C virus infection among seamen and to identify present and previous risk factors for infection. 515 seamen were studied. The prevalence of antibodies against hepatitis A was 0.3% in subjects below 40 years of age, increasing with age above 40 years, and highest among those who had sailed in international trade. The prevalence of antibodies against hepatitis B was 2.7% in subjects below 40 years of age, increasing to 35.7% in the group above 60 years of age. Hepatitis C antibodies occurred in 1.2%. Vaccination of sailors against hepatitis A should follow the same recommendations as to other travellers. The prevalence of hepatitis B was higher than in reference groups of non-seamen but, because hepatitis B is only one of many blood-borne diseases, prevention should be directed towards changes in behaviour rather than vaccination, except for special groups. Young seamen in international trade were found to be most at risk of contracting sexually transmitted diseases.
A key issue in the debate on suicide prevention is the extent to which suicide rates are affected by the availability of means of committing suicide. The aim of this study was to analyse the changes in rates of suicides committed by poisoning in Sweden between 1969 and 1992, and to determine to what extent these were associated with changes in the prescribing of medicines. We compared suicide rates from 1969 to 1992 with trends in the sales of antidepressants, barbiturates, neuroleptics and analgesics during the same period. The incidence of suicide by poisoning decreased during the 1970s, especially in younger and middle-aged men. This was mainly due to a decrease in suicides by barbiturate poisoning, which closely followed a decrease in sales of barbiturates. Sales of analgesics and antidepressants increased during the study period, and so did the rates of suicide using these drugs. We conclude that the availability of medicines is an important factor influencing suicide rates, and that changes in the prescribing of medicines may influence suicide rates.
We analyzed suicide rates in Sweden 1952-1992 with the main purpose of following up the previously observed increasing suicide rate in young men, and applying age-period-cohort (APC) analyses to the trends in suicide mortality. APC analyses were performed by a graphical method and by multivariate log-linear regression. The suicide rate among 20-40 year-old men increased throughout the 1950s and 60s, but the increase has levelled off since the middle of the 1970s, and in some narrow age groups possibly even reversed. The suicide rate among men over 45 years has declined throughout the period. The suicide rate among women has remained more stable. APC analyses did not give clear evidence for a specific cohort or period effect, although addition of a cohort term in the analyses of men slightly improved the fit of the model. A longer follow-up of younger birth cohorts is needed to see whether the changes in male suicide rates will remain as a cohort effect.
The association between left-handedness, epilepsy, and hearing impairment with schizophrenia was investigated using data from a cohort of 50,000 male Swedish conscripts linked to the Swedish National Register of Psychiatric Care. Though epilepsy was rare in this cohort, no association with schizophrenia was found. Left-handedness was associated with neither schizophrenia nor other psychoses. The study shows that, when studied from a population base, the apparent increase in neurodevelopmental anomalies in schizophrenia may be an artefact of bias. However, schizophrenia was 1.81 (95% CI 1.2-2.7) times higher amongst those with severe hearing loss, which may be preventable.
In adults, impaired fasting glycemia (IFG) increases the risk for type 2 diabetes mellitus (T2DM). This study aimed to investigate to which extent children with obesity develop T2DM during early adulthood, and to determine whether IFG and elevated hemoglobin A1c (HbA1c) in obese children are risk markers for early development of T2DM.
In this prospective cohort study, 1620 subjects from the Swedish Childhood Obesity Treatment Registry - BORIS who were ?18 years at follow-up and 8046 individuals in a population-based comparison group, matched on gender age and living area, were included. IFG was defined according to both ADA (cut-off 5.6 mmol?l(-1)) and WHO (6.1 mmol?l(-1)). Elevated HbA1c was defined according to ADA (cut-off 39 mmol?l(-1)). Main outcome was T2DM medication, as a proxy for T2DM. Data on medications were retrieved from a national registry.
The childhood obesity cohort were 24 times more likely to receive T2DM medications in early adulthood compared with the comparison group (95% confidence interval (CI): 12.52-46). WHO-defined IFG predicted future use of T2DM medication with an adjusted hazard ratio (HR) of 3.73 (95% CI: 1.87-7.45) compared with those who had fasting glucose levels
Cites: BMJ. 2000 May 6;320(7244):1240-310797032
Cites: Int J Obes (Lond). 2014 Jan;38(1):40-523828099
In a case-control study of 280 out of 426 consecutive patients with a recent diagnosis of non-Hodgkin lymphoma (NHL) and 1827 control subjects, 53 (19%) and 230 (13%) respectively had received blood transfusions 1 year or more before the interview. Using an age- and sex-stratified analysis the odds ratio (OR) for transfusion was 1.74 (95% CI 1.24-2.44). ORs were also determined for transfusions received in the intervals 1-5, 6-15, 16-25 and > or = 26 years before diagnosis. In the interval 6-15 years, the OR for transfusion was 2.83 (95% CI 1.60-4.99) whereas ORs for transfusions received in other intervals were lower and not significantly elevated. Histological diagnoses (Kiel classification) and results of staging procedures were known for 185 patients. For low-grade NHL of nodal B-cell chronic lymphocytic leukaemia (B-CLL) or immunocytoma type, the OR for transfusions was 4.15 (95% CI 1.92-9.01). For low-grade nodal lymphomas of follicle centre cell type and high-grade nodal lymphomas, no relation to transfusions could be demonstrated. For high-grade extranodal lymphoma as sole manifestation, OR for transfusions was 3.27 (95% CI 1.30-8.24). It is concluded that blood transfusion may be a risk factor for NHLs especially those of B-CLL or immunocytoma type and for high-grade extranodal lymphoma.
BACKGROUND AND OBJECTIVES: Blood transfusion has been shown to be a risk factor for non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: In a cohort of 77,928 women with bleeding complications at delivery in the period of 1973-1986, subsequent NHL cases were identified and the number was compared with the number expected from national incidence rates. In a case-control study the proportion of transfused NHL cases was compared with the proportion of transfused controls. RESULTS: The observed number of NHL in the cohort was 18 versus 22.0 expected. Information on transfusion was obtained for 15 of the NHL cases and none (0%) was transfused versus 32 out of 136 controls (23%). CONCLUSIONS: Blood transfusion at delivery is not a risk factor for NHL. The immune tolerance induced by pregnancy may reduce the risk of NHL associated with the transfusion of allogeneic blood cells.