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31 records – page 1 of 4.

A 10-year survey of inflammatory bowel diseases-drug therapy, costs and adverse reactions.

https://arctichealth.org/en/permalink/ahliterature71979
Source
Aliment Pharmacol Ther. 2001 Apr;15(4):475-81
Publication Type
Article
Date
Apr-2001
Author
P. Blomqvist
N. Feltelius
R. Löfberg
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Paul.Blomqvist@mep.ki.se
Source
Aliment Pharmacol Ther. 2001 Apr;15(4):475-81
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adult
Adverse Drug Reaction Reporting Systems
Aged
Anti-Inflammatory Agents - adverse effects - economics - therapeutic use
Drug Costs - statistics & numerical data
Female
Health Surveys
Humans
Inflammatory Bowel Diseases - drug therapy - economics
Male
Middle Aged
Nutritional Support
Physician's Practice Patterns
Prescriptions, Drug - economics
Retrospective Studies
Steroids
Sweden
Abstract
BACKGROUND: Drug therapy for Crohn's disease and ulcerative colitis is based on anti-inflammatory and immunodulating drugs, nutritional support and surgical resection. Recently, new drugs have been introduced. AIM: To report drug prescriptions, costs and adverse reactions among inflammatory bowel disease patients in Sweden between 1988 and 1997. METHODS: Drug use was calculated from the national Diagnosis and therapy survey and drug costs from prescriptions and drug sales. Adverse drug reactions were obtained from the Medical Products Agency's National Pharmacovigilance system. RESULTS: The annual drug exposure for Crohn's disease was 0.55 million daily doses per million population, mainly supplementation and aminosalicylic acids. Mesalazine and olsalazine had 61% within this group. For ulcerative colitis patients, drug exposure was 0.61 million daily doses per million per year and aminosalicylic acids fell from 70% to 65%. For inflammatory bowel disease patients, corticosteroids and nutritional supplementation were common. The annual average cost for inflammatory bowel disease drugs was 7.0 million US dollars. Annually, 32 adverse drug reactions were reported, mainly haematological reactions such as agranulocytosis and pancytopenia (60%), followed by skin reactions. Only two deaths were reported. Aminosalicylic acids were the most commonly reported compounds. CONCLUSIONS: Drug use for inflammatory bowel disease in the pre-biologic agent era rested on aminosalicylic acid drugs and corticosteroids with stable levels, proportions and costs. The level of adverse drug reactions was low but haematological reactions support the monitoring of inflammatory bowel disease patients.
PubMed ID
11284775 View in PubMed
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Appendectomy in Sweden 1989-1993 assessed by the Inpatient Registry.

https://arctichealth.org/en/permalink/ahliterature33696
Source
J Clin Epidemiol. 1998 Oct;51(10):859-65
Publication Type
Article
Date
Oct-1998
Author
P. Blomqvist
H. Ljung
O. Nyrén
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Source
J Clin Epidemiol. 1998 Oct;51(10):859-65
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Analysis of Variance
Appendectomy - adverse effects - statistics & numerical data - utilization
Appendicitis - diagnosis - epidemiology - surgery
Child
Child, Preschool
Female
Humans
Incidence
Infant
Infant, Newborn
Inpatients - statistics & numerical data
Length of Stay - trends
Linear Models
Male
Middle Aged
Patient Admission - statistics & numerical data - trends
Population Surveillance
Registries
Seasons
Sweden - epidemiology
Abstract
We analyzed all appendectomies in Sweden 1989-1993 (n = 60,306) recorded in the national Inpatient Registry. Our focus was on diagnostic accuracy, incidence rate of appendicitis, perforative appendicitis, and length of stay by day of admission and hospital category. The incidence rate of appendectomy decreased by 9.8% in women compared to 4.1% in men. Since the number of patients with an end diagnosis of appendicitis remained almost constant, diagnostic accuracy increased each year. This was more pronounced in women than men, seen in all hospital categories, and was higher for those admitted during periods of low capacity (weekends/ holidays). Perforated appendicitis did not increase. Duration of hospital stay decreased continuously, especially among the oldest. We found no indications of an increased frequency of complications, such as increases in the incidence rate of perforations or in the length of stay.
PubMed ID
9762879 View in PubMed
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Benign prostatic hyperplasia in Sweden 1987 to 1994: changing patterns of treatment, changing patterns of costs.

https://arctichealth.org/en/permalink/ahliterature75051
Source
Urology. 1997 Aug;50(2):214-9; discussion 219-20
Publication Type
Article
Date
Aug-1997
Author
P. Blomqvist
A. Ekbom
P. Carlsson
C. Ahlstrand
J E Johansson
Author Affiliation
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
Source
Urology. 1997 Aug;50(2):214-9; discussion 219-20
Date
Aug-1997
Language
English
Publication Type
Article
Keywords
Aged
Ambulatory Care - statistics & numerical data
Costs and Cost Analysis
Cross-Sectional Studies
Health Care Costs - trends
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Prostatic Hyperplasia - economics - therapy
Sweden
Abstract
OBJECTIVES: To assess health care use and costs for benign prostatic hyperplasia (BPH) in Sweden from 1987 to 1994 when minimal invasive procedures, including transurethral microwave therapy (TUMT) and drugs, were introduced, in addition to conventional surgery. METHODS: Cross-sectional annual data on health care utilization based on national information systems and surveys were used for calculation of direct 1994 cost. RESULTS: The total number of men in the age group at risk for BPH was virtually constant, and the total direct health care costs for BPH treatment increased from 1987 to 1992. A slight decrease was evident for the years 1993 and 1994, notwithstanding the introduction of new ambulatory procedures in 1991 and of new drugs in 1992. The number of physician office visits changed little during the study period, although this estimate may be low. TUMT procedures were introduced rapidly but decreased; nevertheless, their share was never more than 3% of total costs. Drug sales were 15-fold those in 1992 and accounted for 12% of the total costs in 1994. Conventional transurethral resection of the prostate (TURP) operations decreased markedly after the introduction of the new treatments. CONCLUSIONS: The new treatments were adopted differently. TUMT procedures decreased as rapidly as they were introduced. Three years after the introduction of the new drugs, drug sales indicated that the number of men receiving drug treatment was greater than the annual number of men receiving TURP operations and TUMT procedures combined. Yet the total costs showed a slight decrease, mainly due to the decreasing numbers of TURP operations.
PubMed ID
9255291 View in PubMed
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Brain tumours in Sweden 1996: care and costs.

https://arctichealth.org/en/permalink/ahliterature20129
Source
J Neurol Neurosurg Psychiatry. 2000 Dec;69(6):792-8
Publication Type
Article
Date
Dec-2000
Author
P. Blomqvist
J. Lycke
P. Strang
H. Törnqvist
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Paul.Blomqvist@mep.ki.se
Source
J Neurol Neurosurg Psychiatry. 2000 Dec;69(6):792-8
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Brain Neoplasms - economics - epidemiology
Delivery of Health Care - utilization
Female
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Sensitivity and specificity
Sweden - epidemiology
Abstract
OBJECTIVES: Brain tumours cause considerable concern due to a high mortality and there are increasing efforts to provide adequate care, sometimes outside hospitals. Health care utilisation, direct costs of care, and the indirect social cost of morbidity and early mortality caused by brain tumours in Sweden in the year 1996 was analysed. METHODS: Quantification of ambulatory care, care in hospital, long term and palliative/terminal care, drug consumption, temporary as well as long term morbidity, and mortality from comprehensive national data sources. Direct costs were calculated using 1996 charges. Indirect costs were calculated by sex and age specific salaries. A sensitivity analysis considered the impact of alternative estimates of each item. RESULTS: Indirect costs were 75% of the total and were caused mainly by early mortality. Direct costs were predominantly for care in hospital, long term care, and home health care. Among direct costs, astrocytomas III-IV and meningiomas accounted for 42% and 30% respectively. CONCLUSIONS: The cost of illness from brain tumours reflects the characteristics of these malignancies. Despite their low incidence rate, the economic impact caused by high mortality among young persons is a predominant trait. Costs of acute hospital care and also long term care and home care are considerable.
PubMed ID
11080235 View in PubMed
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Cancer incidence among patients with ankylosing spondylitis in Sweden 1965-95: a population based cohort study.

https://arctichealth.org/en/permalink/ahliterature13858
Source
Ann Rheum Dis. 2003 Dec;62(12):1185-8
Publication Type
Article
Date
Dec-2003
Author
N. Feltelius
A. Ekbom
P. Blomqvist
Author Affiliation
Unit of Rheumatology, Department of Medicine at Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden. Nils.Feltelius@mpa.se
Source
Ann Rheum Dis. 2003 Dec;62(12):1185-8
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Cohort Studies
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Middle Aged
Neoplasms - complications - epidemiology
Poisson Distribution
Risk factors
Spondylitis, Ankylosing - complications - epidemiology
Sweden - epidemiology
Abstract
BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory joint disease which may lead to extra-articular complications. The disease associated cancer risk has been poorly explored. Recently, tumour necrosis factor alpha blockers have been found to be efficacious in AS, but their long term risk is unknown. OBJECTIVE: To analyse a large national cohort of patients with AS to determine the overall cancer risk in AS as a background to the future introduction of new treatments. METHODS: All patients with AS admitted to Swedish hospitals 1965-95 were linked through individual national registration numbers to the Swedish Cancer Register and National Death Register. Standardised incidence ratio (SIR) of cancer risk was calculated in 6621 people, monitored during 67 885 person-years. RESULTS: No overall increase in cancer risk was found (SIR 1.05, 95% CI 0.94 to 1.17). Rectal cancer was less common (SIR 0.41, 95% CI 0.15 to 0.89) while unspecified kidney cancer was more common (SIR 5.90, 95% CI 1.61 to 15.1). Risks for colon, renal parenchymal, and renal pelvic cancer were not significantly increased. Laryngeal cancer was more common than expected, while lung cancer was not. Risks of haematopoietic malignancies were not increased. CONCLUSIONS: No overall increase in cancer risk was found. The decreased risk of rectal cancer might be due to local application of NSAIDs, and the increased risk of unspecified kidney cancer to frequent radiological pelvic examinations. If information on disease characteristics, including HLA-B27, was available for individual patients with cancer, risk-benefit analysis of long term effects of new immunomodulation treatment might be improved.
PubMed ID
14644856 View in PubMed
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Cholecystectomy in Sweden 1989 and 1994: long admissions assessed by the inpatient registry.

https://arctichealth.org/en/permalink/ahliterature52428
Source
J Clin Epidemiol. 2000 Nov;53(11):1174-80
Publication Type
Article
Date
Nov-2000
Author
P. Blomqvist
H. Ljung
E. Nilsson
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Box 281, SE-171 77 Stockholm, Sweden. Paul.Blomqvist@mep.ki.se
Source
J Clin Epidemiol. 2000 Nov;53(11):1174-80
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cholecystectomy - statistics & numerical data
Cholecystectomy, Laparoscopic - statistics & numerical data
Confidence Intervals
Female
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Multivariate Analysis
Postoperative Complications - epidemiology
Registries
Risk
Sweden - epidemiology
Abstract
The purpose of this study was to compare cholecystectomy in Sweden (pop. 8.9 million) 1989 to 1994 when the diffusion of laparoscopic cholecystectomy (LC) was completed, focusing on long hospital admissions as a proxy indicator of adverse events. This was an observational study of all patients operated on with cholecystectomy in 1989 and 1994 (n = 19,432) from the National Inpatient Registry. The risk of a long admission was analyzed by multivariate analyses. Odds ratios of long admissions were computed considering gender, age groups, acute or chronic gallstone disease, 1989 and 1994, county level of operations per 1000 inhabitants, and hospital categories. Stratified analyses were performed by acuteness of disease, and year. Long admissions were defined as lasting longer than 20 days in 1989 and 14 days in 1994. Odds ratios of a long admission increased steeply with age and acute gallstone disease. The county level of operations per 1000 inhabitants had no influence on risk nor did hospital category. The absolute number of those operated on with an acute gallstone disease changed little between 1989 and 1994, whereas operations for chronic disease increased significantly. Stratification revealed that their risk of a long admission was increased both in 1989 and 1994, particularly for women. Those with chronic gallstone disease had no increased risk. After the introduction of the laparoscope and a rise in the number of cholecystectomies, patients with chronic gallstone disease seem to have a constant risk of long hospital stay. However, because patients with acute disease had an increased risk in both 1989 and 1994, further longitudinal analyses are needed to analyze the level of complications in this group.
PubMed ID
11106893 View in PubMed
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Colorectal cancer detection by colonoscopy in a Swedish county, 1979-95.

https://arctichealth.org/en/permalink/ahliterature18089
Source
Scand J Gastroenterol. 2003 Oct;38(10):1059-67
Publication Type
Article
Date
Oct-2003
Author
G. Dafnis
P. Blomqvist
F. Granath
L. Påhlman
A. Ekbom
Author Affiliation
Dept. of Surgery, University Hospital, Uppsala, Sweden. george.dafnis@telia.com
Source
Scand J Gastroenterol. 2003 Oct;38(10):1059-67
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Aged
Colonoscopy
Colorectal Neoplasms - complications - diagnosis - epidemiology
Female
Humans
Male
Research Support, Non-U.S. Gov't
Sensitivity and specificity
Sweden - epidemiology
Abstract
BACKGROUND: Colorectal cancer is the third most common cancer in Sweden, and incidence is increasing. We analysed colorectal cancer detection by colonoscopy in a defined population in Sweden. METHODS: All colonoscopy records for the period 1979-95 in one Swedish county (population 258,000) were retrieved. Information was obtained about patient demographics, date of examination, endoscopists, indications, findings, colonoscopy type and completion level. Records were linked to the Swedish Cancer Register and the Cause of Death Register. RESULTS: The majority of 2214 colorectal cancers were detected by means other than colonoscopy. In total, 192 were diagnosed and 6 were not detected by colonoscopy, with no significant differences in gender, age, indications, presence of polyps or diverticulosis, time-period or experience of the endoscopist. The mean completion rate of the endoscopist was lower in patients with undetected cancers. Coexisting inflammatory bowel disease was more common in patients with late diagnosis. Sensitivity was 97.0%, and higher when the indication was bleeding, cancer or unclear X-ray findings. CONCLUSIONS: Sensitivity in detecting colorectal cancer was high, and the proportion detected by colonoscopy increased over time. Mean completion rate was lower in patients with undetected cancers. Coexisting IBD was more common in patients with a late diagnosis.
PubMed ID
14621281 View in PubMed
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Complications of diagnostic and therapeutic colonoscopy within a defined population in Sweden.

https://arctichealth.org/en/permalink/ahliterature193491
Source
Gastrointest Endosc. 2001 Sep;54(3):302-9
Publication Type
Article
Date
Sep-2001
Author
G. Dafnis
A. Ekbom
L. Pahlman
P. Blomqvist
Author Affiliation
Department of Surgery, University Hospital, Uppsala, Sweden.
Source
Gastrointest Endosc. 2001 Sep;54(3):302-9
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Colon - injuries
Colonic Diseases - diagnosis - therapy
Colonoscopy - adverse effects - statistics & numerical data
Female
Gastrointestinal Hemorrhage - epidemiology - etiology
Humans
Intestinal Perforation - epidemiology - etiology
Male
Middle Aged
Morbidity
Rectal Diseases - diagnosis - therapy
Registries - statistics & numerical data
Sweden
Time Factors
Abstract
Colonoscopy, introduced in the late 1960s, has become the principal method for diagnosis, treatment, and follow-up of colorectal diseases. Being invasive, colonoscopy is associated with a risk of complications. The aim of this study was to analyze the rate of complications of diagnostic and therapeutic colonoscopy in a population-based setting.
All colonoscopy records for 1979 to 1995 in 1 Swedish county (population 258,000) were retrieved. Information was obtained about patients' demographics, date of examination, endoscopist, indications, findings, colonoscopy type, completion level, and complications. Records were linked to the Cause of Death Register and the Swedish Hospital Discharge Register to ascertain mortality and morbidity.
In 6066 colonoscopies, the overall morbidity was 0.4% (diagnostic 0.2%, therapeutic 1.2%). The most frequent complications were bleeding (0.2%) and perforation (0.1%), with no colonoscopy-related mortality. Bleeding was confined to therapeutic colonoscopy and occurred immediately, mainly after removal of large polyps with thick stalks. Perforations at diagnostic colonoscopy occurred in the left colon; they were diagnosed sooner than perforations associated with therapeutic colonoscopy where the cecum was the most frequent site. The bleeding rate was correlated to the experience of the endoscopists.
Colonoscopy is a safe procedure, and the rate of adverse events in this population-based setting was low.
PubMed ID
11522969 View in PubMed
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Diverticular disease and the risk of colon cancer - a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature132681
Source
Aliment Pharmacol Ther. 2011 Sep;34(6):675-81
Publication Type
Article
Date
Sep-2011
Author
J. Granlund
T. Svensson
F. Granath
F. Hjern
A. Ekbom
P. Blomqvist
P T Schmidt
Author Affiliation
Department of Medicine, Solna, Unit of Gastroenterology and Hepatology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. johan.granlund@ki.se
Source
Aliment Pharmacol Ther. 2011 Sep;34(6):675-81
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Case-Control Studies
Colonic Neoplasms - etiology - mortality
Diverticulum - complications
Female
Humans
Male
Odds Ratio
Risk factors
Sweden
Abstract
Colon cancer and diverticular disease are most common in the Western world and their incidences tend to increase with advancing age. The association between the diseases remains unclear.
To analyse the risk of colon cancer after hospitalisation for diverticular disease.
Nationwide case-control study. A total of 41,037 patients with colon cancer during 1992-2006, identified from the Swedish Cancer Register were included. Each case was matched with two control subjects. From the Swedish Inpatient Register, cases and control subjects hospitalised for diverticular disease were identified. Odds ratios (OR) and confidence intervals for receiving a diagnosis of colon cancer after hospital discharge for diverticular disease were calculated. Colon cancer mortality was compared between patients with or without diverticular disease.
Within 6months after an admission due to diverticular disease, OR of having a colon cancer diagnosis were up to 31.49 (19.00-52.21). After 12 months, there was no increased risk. The number of discharges for diverticular disease did not affect the risk. Colon cancer mortality did not differ between patients with and without diverticular disease.
Diverticular disease does not increase the risk of colon cancer in the long term, and a history of diverticular disease does not affect colon cancer mortality. The increased risk of colon cancer within the first 12months after diagnosing diverticular disease is most likely due to surveillance and misclassification. Examination of the colon should be recommended after a primary episode of symptomatic diverticular disease.
PubMed ID
21790681 View in PubMed
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Efficacy of once- and twice-daily administration of budesonide via Turbuhaler as initial therapy in patients with mild persistent asthma.

https://arctichealth.org/en/permalink/ahliterature15644
Source
Respir Med. 1999 Apr;93(4):230-5
Publication Type
Article
Date
Apr-1999
Author
I. Herjavecz
P. Blomqvist
A. Serrano
Author Affiliation
Országos Korányi TBC és Pulmonológiai Intézet, Budapest, Hungary.
Source
Respir Med. 1999 Apr;93(4):230-5
Date
Apr-1999
Language
English
Publication Type
Article
Keywords
Administration, Topical
Adolescent
Adult
Aged
Anti-Inflammatory Agents - administration & dosage - adverse effects
Asthma - drug therapy
Budesonide - administration & dosage - adverse effects
Dose-Response Relationship, Drug
Double-Blind Method
Female
Glucocorticoids
Humans
Male
Middle Aged
Nebulizers and Vaporizers
Treatment Outcome
Abstract
Inhaled glucocorticosteroids such as budesonide have an important role in the management of asthma. Although these agents have traditionally been given twice daily, evidence is accumulating that once-daily treatment may be as effective as twice-daily administration. The efficacy of budesonide Turbuhaler (Astra, Lund, Sweden), 400 micrograms once daily in the evening or 200 micrograms twice daily, was compared in a randomized, double-blind study involving 181 patients (75 men, 106 women; mean age 30.8 years) with mild asthma [mean forced expiratory volume in 1 s (FEV1) 92.8% pred.] who had not previously been treated with inhaled glucocorticosteroids. After a 2-week run-in period, patients were randomized to either regimen and treated for 6 weeks. This was followed by two 8-week open treatment periods, during which all patients received budesonide Turbuhaler, 200 micrograms once daily during the first period and 100 micrograms once daily during the second period. The mean change in morning peak expiratory flow (PEF) during the double-blind treatment period was 16.9 l min-1 in patients receiving once-daily treatment and 17.2 l min-1 in those receiving twice-daily treatment. Similarly, there were no significant differences in evening PEF, symptom scores, bronchodilator use or spirometry data between patients receiving once- and twice-daily treatments. The improvements in morning PEF, symptom scores and bronchodilator use seen during the double-blind treatment period were maintained during the two open treatment periods. It is concluded that once-daily treatment with budesonide Turbuhaler is as effective as an initial therapy twice-daily treatment in patients with mild persistent asthma and that the initial dose can be reduced to maintenance levels (including 100 micrograms) without loss of asthma control.
PubMed ID
10464886 View in PubMed
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31 records – page 1 of 4.