BACKGROUND: The role of TNF-alpha in Crohn disease is now well established and anti-TNF-alpha is frequently used as a second- or third-line treatment. Tumor necrosis factor-alpha (TNF-alpha) is traditionally associated with macrophages but has recently also been found in mast cells of the ileal wall in patients with Crohn disease. As it is well known that mast cells and TNF-alpha play important roles in atopic manifestations like asthma, allergic rhinitis; and eczema the aim of this study was to investigate whether these are seen more commonly in Crohn patients than in the general population. METHODS: Patients with Crohn disease (n = 308), aged 18-50 years, living in the Linköping region in southeast Sweden, were asked to answer a questionnaire regarding the presence of any kind of atopic manifestations. The questionnaire was also sent to 930 controls collected from the Southeastern Region Population Registry. The controls were matched according to age, sex, and place of residence. RESULTS: The response rate among the Crohn patients was 91% (280/308) and among controls 84% (779/930). Eczema was a significantly more frequent manifestation, being almost twice as common in Crohn patients (27%) as in the general population (16%). Adjustment by logistic regression for place of residence, gender, age and coexistence of any other atopic manifestation did not change the odds ratios significantly. CONCLUSION: Atopic manifestations as a group, and eczema as a single manifestation, are significantly more frequent in Crohn patients than in the general population.
All men born in even-numbered months in 1914 and domiciled in Malmö were invited in 1969 to participate in an investigation regarding risk factors for cardiovascular disease. Individuals with a blood pressure of 165/110 and over were treated and a sub-sample of heavy smokers were later invited to take part in a quit-smoking project. During the following five year period total and cause-specific mortality in the examined group was compared with corresponding data for men born in uneven months in 1914. Mortality in the examined cohort was lower than among controls and differed significantly from that in the control group with regard to cardiovascular mortality.
In 1969 a cohort of 703 men born in 1914 was screened to determine the prevalence of cardivascular and pulmonary diseases among middle-aged men. Smoking habits and other cardiovascular risk factors were registered. Hypertension was treated. The disability pension rate among non-smokers was considerably lower than that for smokers. Also the proportion of individuals who had been admitted to hospital and the proportion of individuals who had reported sick was lower in non-smokers than in smokers. The ex-smokers showed an intermediate position both in terms of disability pension rate and in proportion of individuals admitted to hospital. High systolic blood pressure, high cholesterol level and high triglyceride values in 1969 were not associated with increased disability pension rate, hospitalization rate or with increased sick leave.
In a five-year follow-up of a random sample of men aged 55 the association between risk factors and premature death was analysed. The overall mortality in five years was 5.8%. The mortality among the smokers was 8%; among non-smokers 2%. Of 16 cancer deaths all were smokers except one who was an ex-smoker. In spite of treatment of hypertension (greater than 165/110 mmHg) there was an association between high blood pressure and premature death, particularly when cause of death was cardiovascular disease. There was no association between premature death and serum cholesterol, serum triglycerides or physical activity. The study is based on 703 men, of whom 41 died. The autopsy frequency was 93%. Only 3 men (0.4%) were lost to follow-up.