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Abdominal and gynoid adipose distribution and incident myocardial infarction in women and men.

https://arctichealth.org/en/permalink/ahliterature143340
Source
Int J Obes (Lond). 2010 Dec;34(12):1752-8
Publication Type
Article
Date
Dec-2010
Author
P. Wiklund
F. Toss
J-H Jansson
M. Eliasson
G. Hallmans
A. Nordström
P W Franks
P. Nordström
Author Affiliation
Department of Surgical and Perioperative Sciences, Sports Medicine Unit, Umeå University, Umeå, Sweden.
Source
Int J Obes (Lond). 2010 Dec;34(12):1752-8
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Adipose Tissue - anatomy & histology - radionuclide imaging
Blood Glucose - physiology
Body Composition
Body mass index
Female
Humans
Hypertension - etiology
Hypertriglyceridemia - complications
Male
Middle Aged
Myocardial Infarction - etiology
Obesity - complications
Prospective Studies
Risk assessment
Risk factors
Sex Factors
Smoking - adverse effects
Sweden
Abstract
The relationships between objectively measured abdominal and gynoid adipose mass with the prospective risk of myocardial infarction (MI) has been scarcely investigated. We aimed to investigate the associations between fat distribution and the risk of MI.
Total and regional fat mass was measured using dual-energy X-ray absorptiometry (DEXA) in 2336 women and 922 men, of whom 104 subsequently experienced an MI during a mean follow-up time of 7.8 years.
In women, the strongest independent predictor of MI was the ratio of abdominal to gynoid adipose mass (hazard ratio (HR)=2.44, 95% confidence interval (CI) 1.79-3.32 per s.d. increase in adipose mass), after adjustment for age and smoking. This ratio also showed a strong association with hypertension, impaired glucose tolerance and hypertriglyceridemia (P
PubMed ID
20498655 View in PubMed
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Abdominal and gynoid adiposity and the risk of stroke.

https://arctichealth.org/en/permalink/ahliterature136783
Source
Int J Obes (Lond). 2011 Nov;35(11):1427-32
Publication Type
Article
Date
Nov-2011
Author
F. Toss
P. Wiklund
P W Franks
M. Eriksson
Y. Gustafson
G. Hallmans
P. Nordström
A. Nordström
Author Affiliation
Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
Source
Int J Obes (Lond). 2011 Nov;35(11):1427-32
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Abdominal Fat - pathology - radiography
Absorptiometry, Photon
Adult
Age Distribution
Aged
Body Fat Distribution
Body mass index
Cardiovascular Diseases - epidemiology - pathology
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension - epidemiology - pathology
Incidence
Male
Middle Aged
Obesity - complications - epidemiology - pathology - radiography
Proportional Hazards Models
Risk factors
Stroke - epidemiology - etiology - pathology
Sweden - epidemiology
Abstract
Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke.
A cohort of 2751 men and women aged =40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg?m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age.
During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR)=1.66, 95% confidence interval (CI)=1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR=0.72, 95% CI=0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR=1.49, 95% CI=1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR=1.80, 95% CI=1.06-3.07; HR=1.71, 95% CI=1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension.
Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors.
PubMed ID
21343905 View in PubMed
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The Accuracy of the Computed Tomography Diagnosis of Acute Appendicitis: Does the Experience of the Radiologist Matter?

https://arctichealth.org/en/permalink/ahliterature294920
Source
Scand J Surg. 2018 Mar; 107(1):43-47
Publication Type
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Date
Mar-2018
Author
E Lietzén
P Salminen
I Rinta-Kiikka
H Paajanen
T Rautio
P Nordström
M Aarnio
T Rantanen
J Sand
J-P Mecklin
A Jartti
J Virtanen
P Ohtonen
N Ånäs
J M Grönroos
Author Affiliation
1 Division of Digestive Surgery and Urology, Department of Acute and Digestive Surgery, Turku University Hospital, Turku, Finland.
Source
Scand J Surg. 2018 Mar; 107(1):43-47
Date
Mar-2018
Language
English
Publication Type
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Keywords
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Appendectomy - methods
Appendicitis - diagnostic imaging - drug therapy - surgery
Clinical Competence
Female
Finland
Humans
Male
Middle Aged
Prognosis
Prospective Studies
Radiologists
Risk assessment
Tomography, X-Ray Computed - methods
Treatment Outcome
Young Adult
Abstract
To assess the accuracy of computed tomography in diagnosing acute appendicitis with a special reference to radiologist experience.
Data were collected prospectively in our randomized controlled trial comparing surgery and antibiotic treatment for uncomplicated acute appendicitis (APPAC trial, NCT01022567). We evaluated 1065 patients who underwent computed tomography for suspected appendicitis. The on-call radiologist preoperatively analyzed these computed tomography images. In this study, the radiologists were divided into experienced (consultants) and inexperienced (residents) ones, and the comparison of interpretations was made between these two radiologist groups.
Out of the 1065 patients, 714 had acute appendicitis and 351 had other or no diagnosis on computed tomography. There were 700 true-positive, 327 true-negative, 14 false-positive, and 24 false-negative cases. The sensitivity and the specificity of computed tomography were 96.7% (95% confidence interval, 95.1-97.8) and 95.9% (95% confidence interval, 93.2-97.5), respectively. The rate of false computed tomography diagnosis was 4.2% for experienced consultant radiologists and 2.2% for inexperienced resident radiologists (p?=?0.071). Thus, the experience of the radiologist had no effect on the accuracy of computed tomography diagnosis.
The accuracy of computed tomography in diagnosing acute appendicitis was high. The experience of the radiologist did not improve the diagnostic accuracy. The results emphasize the role of computed tomography as an accurate modality in daily routine diagnostics for acute appendicitis in all clinical emergency settings.
PubMed ID
28929862 View in PubMed
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Active commuting reduces the risk of wrist fractures in middle-aged women-the UFO study.

https://arctichealth.org/en/permalink/ahliterature125017
Source
Osteoporos Int. 2013 Feb;24(2):533-40
Publication Type
Article
Date
Feb-2013
Author
U. Englund
P. Nordström
J. Nilsson
G. Hallmans
O. Svensson
U. Bergström
U. Pettersson-Kymmer
Author Affiliation
Division of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden. undis.englund@germed.umu.se
Source
Osteoporos Int. 2013 Feb;24(2):533-40
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Case-Control Studies
Exercise - physiology
Female
Humans
Life Style
Middle Aged
Motor Activity - physiology
Osteoporotic Fractures - epidemiology - physiopathology - prevention & control
Risk factors
Seasons
Sweden - epidemiology
Transportation - methods
Wrist Injuries - epidemiology - physiopathology - prevention & control
Abstract
Middle-aged women with active commuting had significantly lower risk for wrist fracture than women commuting by car/bus.
Our purpose was to investigate whether a physically active lifestyle in middle-aged women was associated with a reduced risk of later sustaining a low-trauma wrist fracture.
The Umeå Fracture and Osteoporosis (UFO) study is a population-based nested case-control study investigating associations between lifestyle and fragility fractures. From a cohort of ~35,000 subjects, we identified 376 female wrist fracture cases who had reported data regarding their commuting habits, occupational, and leisure physical activity, before they sustained their fracture. Each fracture case was compared with at least one control drawn from the same cohort and matched for age and week of reporting data, yielding a total of 778 subjects. Mean age at baseline was 54.3?±?5.8 years, and mean age at fracture was 60.3?±?5.8 years.
Conditional logistic regression analysis with adjustments for height, body mass index, smoking, and menopausal status showed that subjects with active commuting (especially walking) were at significantly lower risk of sustaining a wrist fracture (OR 0.48; 95 % CI 0.27-0.88) compared with those who commuted by car or bus. Leisure time activities such as dancing and snow shoveling were also associated with a lower fracture risk, whereas occupational activity, training, and leisure walking or cycling were unrelated to fracture risk.
This study suggests that active commuting is associated with a lower wrist fracture risk, in middle-aged women.
PubMed ID
22525983 View in PubMed
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Are suicide trends among the young reversing? Age, period and cohort analyses of suicide rates in Sweden.

https://arctichealth.org/en/permalink/ahliterature68484
Source
Acta Psychiatr Scand. 1996 Jan;93(1):43-48
Publication Type
Article
Date
Jan-1996
Author
P. Allebeck
L. Brandt
P. Nordstrom
U. Asgard
Author Affiliation
Department of Social Medicine, University of Goteborg Vasa Hospital, Gothenburg.
Source
Acta Psychiatr Scand. 1996 Jan;93(1):43-48
Date
Jan-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cause of Death
Cohort Studies
Cross-Sectional Studies
Female
Humans
Incidence
Male
Middle Aged
Research Support, Non-U.S. Gov't
Sex Factors
Suicide - trends
Sweden - epidemiology
Abstract
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.
PubMed ID
8919328 View in PubMed
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Attempted suicide predicts suicide risk in mood disorders.

https://arctichealth.org/en/permalink/ahliterature46483
Source
Acta Psychiatr Scand. 1995 Nov;92(5):345-50
Publication Type
Article
Date
Nov-1995
Author
P. Nordström
M. Asberg
A. Aberg-Wistedt
C. Nordin
Author Affiliation
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Source
Acta Psychiatr Scand. 1995 Nov;92(5):345-50
Date
Nov-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bipolar Disorder - diagnosis - mortality
Cause of Death
Depressive Disorder - diagnosis - mortality - psychology
Female
Hospitals, University
Humans
Male
Middle Aged
Patient Admission - statistics & numerical data
Psychiatric Department, Hospital
Research Support, Non-U.S. Gov't
Risk
Suicide - prevention & control - psychology - statistics & numerical data
Suicide, Attempted - prevention & control - psychology - statistics & numerical data
Survival Analysis
Sweden - epidemiology
Abstract
Suicide risk was studied in a sample of 346 mood disorder inpatients, 92 of whom were admitted after a current suicide attempt. The overall suicide mortality after a mean observation period of 6 years was 8%. The potential of attempted suicide to predict suicide risk in hospitalized patients with mood disorders was studied by survival analysis after subgrouping on the basis of whether a current suicide attempt had occurred or not. The suicide risk the first year after attempting suicide was 12% (11/92), compared with 2% (4/254) in the mood disorder subgroup with no current suicide attempt. The long-range suicide risk after a current suicide attempt in depression was 15% (14/92) as compared with 5% (13/254) among those without a current suicide attempt. It is concluded that a current suicide attempt in mood disorder inpatients predicts suicide risk particularly within the first year and should be taken very seriously.
PubMed ID
8619338 View in PubMed
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Birth cohort analysis of changing suicide risk by sex and age in Sweden 1952 to 1981.

https://arctichealth.org/en/permalink/ahliterature68638
Source
Acta Psychiatr Scand. 1987 Oct;76(4):456-63
Publication Type
Article
Date
Oct-1987
Author
U. Asgård
P. Nordström
G. Råbäck
Author Affiliation
Department of Psychiatry, Karolinska Institute, Huddinge University Hospital, Sweden.
Source
Acta Psychiatr Scand. 1987 Oct;76(4):456-63
Date
Oct-1987
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Female
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Risk factors
Sex Factors
Suicide - epidemiology
Abstract
The study aims at exploring the sex and age shift in suicide in Sweden. Data from the Causes of Death Register comprising suicides occurring in 1952 to 1981 among persons born in 1877 to 1966 were included. Analysis of linear regression of cumulative suicide incidence in successive birth cohorts yielded a shift toward younger ages and a general increase in female suicide risk. The statistical suicide risk in the 20 to 24 male age group has increased 3.6 times. The male to female suicide risk sex ratio has decreased for those older than 45, while it has increased among young adults. There is an urgent need of explanatory studies.
PubMed ID
3425373 View in PubMed
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Combining the Suicide Intent Scale and the Karolinska Interpersonal Violence Scale in suicide risk assessments.

https://arctichealth.org/en/permalink/ahliterature272925
Source
BMC Psychiatry. 2015;15:226
Publication Type
Article
Date
2015
Author
J. Stefansson
P. Nordström
B. Runeson
M. Åsberg
J. Jokinen
Source
BMC Psychiatry. 2015;15:226
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Aggression - psychology
Cohort Studies
Female
Humans
Male
Middle Aged
Psychiatric Status Rating Scales
Risk Assessment - methods
Risk factors
Suicidal ideation
Suicide - prevention & control - psychology
Suicide, Attempted - psychology
Sweden
Violence - psychology
Abstract
High suicide intent, childhood trauma, and violent behavior are risk factors for suicide in suicide attempters. The aim of this study was to investigate whether the combined assessment of suicide intent and interpersonal violence would provide a better prediction of suicide risk than an assessment of only suicide intent or interpersonal violence.
This is a cohort study involving 81 suicide attempters included in the study between 1993 and 1998. Patients were assessed with both the Suicide Intent Scale (SIS) and the Karolinska Interpersonal Violence Scale (KIVS). Through the unique personal identification number in Sweden, patients were linked to the Cause of Death Register maintained by the Swedish National Board of Health and Welfare. Suicides were ascertained from the death certificates.
Seven of 14 patients who had died before April 2013 had committed suicide. The positive predictive value for the Suicide Intent Scale alone was 16.7 %, with a specificity of 52 % and an area under the curve of 0.74. A combined assessment with the KIVS gave higher specificity (63 %) and a positive predictive value of 18.8 % with an AUC of 0.83. Combined use of SIS and KIVS expressed interpersonal violence as an adult subscale gave a sensitivity of 83.3 %, a specificity of 80.3 %, and a positive predictive value of 26 % with an AUC of 0.85. The correlation between KIVS and SIS scores was not significant.
Using both the the SIS and the KIVS combined may be better for predicting completed suicide than using them separately. The nonsignificant correlation between the scales indicates that they measure different components of suicide risk.
Notes
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PubMed ID
26400812 View in PubMed
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Definite and undetermined forensic diagnoses of suicide among immigrants in Sweden.

https://arctichealth.org/en/permalink/ahliterature68497
Source
Acta Psychiatr Scand. 1995 Feb;91(2):130-5
Publication Type
Article
Date
Feb-1995
Author
M. Ferrada-Noli
M. Asberg
K. Ormstad
P. Nordström
Author Affiliation
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Source
Acta Psychiatr Scand. 1995 Feb;91(2):130-5
Date
Feb-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Comparative Study
Emigration and Immigration
Employment
Female
Finland
Humans
Male
Marital status
Middle Aged
Research Support, Non-U.S. Gov't
Sex Factors
Social Isolation
Suicide - statistics & numerical data
Sweden - epidemiology - ethnology
Abstract
A total of 707 cases of violent death (suicide, undetermined mode or accident) occurring in 1990 were investigated at the Department of Forensic Medicine in Stockholm. The catchment area of the Department includes about 1.9 million people. Fourteen percent of the population in the area are immigrants. The largest single immigrant group was the 91,015 Finnish-born inhabitants, who represented 33% of the overall immigrant population. Thirty percent of all undetermined deaths and 20% of the suicides were among people born outside Sweden. A significant overrepresentation of the largest immigrant group (Finnish-born) was found in both the definite and undetermined suicide categories. There was also an overall overrepresentation of immigrants among the undetermined cases and a trend towards overrepresentation among definite suicides. Also, there was a significant overall overrepresentation of immigrants in the total cases of undetermined and definite suicide. Some psychosocial factors found predominant among the immigrant sample were social isolation, low social class and poor social network. The findings in this study indicates that immigrant status should be considered as a risk factor for suicide in Sweden. Previous reports on the high suicide rates among immigrants in Australia, Canada, Great Britain and the United States suggest that the overrepresentation of immigrants found in our study could represent a worldwide epidemiological trend related to voluntary and forced migration. Possible hypotheses that could explain this phenomenon are discussed.
PubMed ID
7778471 View in PubMed
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Economic evaluation of antibiotic therapy versus appendicectomy for the treatment of uncomplicated acute appendicitis from the APPAC randomized clinical trial.

https://arctichealth.org/en/permalink/ahliterature285317
Source
Br J Surg. 2017 Sep;104(10):1355-1361
Publication Type
Article
Date
Sep-2017
Author
S. Sippola
J. Grönroos
R. Tuominen
H. Paajanen
T. Rautio
P. Nordström
M. Aarnio
T. Rantanen
S. Hurme
P. Salminen
Source
Br J Surg. 2017 Sep;104(10):1355-1361
Date
Sep-2017
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Anti-Bacterial Agents - economics - therapeutic use
Appendectomy - economics
Appendicitis - drug therapy - surgery
Cost-Benefit Analysis
Finland
Humans
Length of Stay - economics
Levofloxacin - economics - therapeutic use
Metronidazole - economics - therapeutic use
Middle Aged
Recurrence
Sick Leave - economics
Treatment Outcome
Young Adult
beta-Lactams - economics - therapeutic use
Abstract
An increasing amount of evidence supports antibiotic therapy for treating uncomplicated acute appendicitis. The objective of this study was to compare the costs of antibiotics alone versus appendicectomy in treating uncomplicated acute appendicitis within the randomized controlled APPAC (APPendicitis ACuta) trial.
The APPAC multicentre, non-inferiority RCT was conducted on patients with CT-confirmed uncomplicated acute appendicitis. Patients were assigned randomly to appendicectomy or antibiotic treatment. All costs were recorded, whether generated by the initial visit and subsequent treatment or possible recurrent appendicitis during the 1-year follow-up. The cost estimates were based on cost levels for the year 2012.
Some 273 patients were assigned to the appendicectomy group and 257 to antibiotic treatment. Most patients randomized to antibiotic treatment did not require appendicectomy during the 1-year follow-up. In the operative group, overall societal costs (€5989·2, 95 per cent c.i. 5787·3 to 6191·1) were 1·6 times higher (€2244·8, 1940·5 to 2549·1) than those in the antibiotic group (€3744·4, 3514·6 to 3974·2). In both groups, productivity losses represented a slightly higher proportion of overall societal costs than all treatment costs together, with diagnostics and medicines having a minor role. Those in the operative group were prescribed significantly more sick leave than those in the antibiotic group (mean(s.d.) 17·0(8·3) (95 per cent c.i. 16·0 to 18·0) versus 9·2(6·9) (8·3 to 10·0) days respectively; P
PubMed ID
28677879 View in PubMed
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17 records – page 1 of 2.