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Adverse effects of delayed treatment for perforated peptic ulcer.

https://arctichealth.org/en/permalink/ahliterature217583
Source
Ann Surg. 1994 Aug;220(2):168-75
Publication Type
Article
Date
Aug-1994
Author
C. Svanes
R T Lie
K. Svanes
S A Lie
O. Søreide
Author Affiliation
Department of Surgery, Haukeland University Hospital, Bergen, Norway.
Source
Ann Surg. 1994 Aug;220(2):168-75
Date
Aug-1994
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Bacterial Infections - epidemiology
Cause of Death
Duodenal Ulcer - complications - surgery
Female
Follow-Up Studies
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Norway - epidemiology
Odds Ratio
Peptic Ulcer Perforation - complications - mortality - surgery
Postoperative Complications - epidemiology
Risk factors
Stomach Ulcer - complications - surgery
Survival Rate
Time Factors
Treatment Outcome
Abstract
The authors assessed the consequences of delayed treatment for ulcer perforation with regard to short-term and long-term survival, complication rates, and length of hospital stay.
Important adverse effects of delayed treatment have not been studied previously. Conflicting results have been given with regard to short-term survival.
One thousand two hundred ninety-two patients operated on for perforated peptic ulcer in the Bergen area between 1935 and 1990 were studied. The effect of delay on postoperative lethality and complications adjusted for age, sex, ulcer site, and year of perforation was analyzed by stepwise logistic regression. The effect of delay on duration of hospital stay adjusted for potential confounding factors was analyzed by Cox proportional hazards regression. Observed survival was estimated by the Kaplan-Meier method, and expected survival was calculated from population mortality data.
Adverse effects increased markedly when delay exceeded 12 hours. Delay of more than 24 hours increased lethality sevenfold to eightfold, complication rate to threefold, and length of hospital stay to twofold, compared with delay of 6 hours or less. The reduced long-term survival for patients treated more than 12 hours after perforation could be attributed entirely to high postoperative mortality.
Delayed treatment after peptic ulcer perforation reduced survival, increased complication rates, and caused prolonged hospital stay. To improve outcome after ulcer perforation, an effort should be made to keep delay at less 12 hours, particularly in elderly patients.
Notes
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PubMed ID
8053739 View in PubMed
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Age and sex distribution of intestinal type and diffuse gastric carcinoma.

https://arctichealth.org/en/permalink/ahliterature24916
Source
APMIS. 1991 Jan;99(1):78-82
Publication Type
Article
Date
Jan-1991
Author
C W Janssen
H. Maartmann-Moe
R T Lie
R. Matre
Author Affiliation
Department of Surgery, University of Bergen, Norway.
Source
APMIS. 1991 Jan;99(1):78-82
Date
Jan-1991
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Carcinoma - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Sex Factors
Stomach Neoplasms - epidemiology
Abstract
A twelve-year series of 375 patients with gastric carcinoma has been studied. Primary tumours were classified as intestinal type (58%) or diffuse (26%), whereas 16% were unclassifiable. The relative age and sex incidence rates of intestinal type and diffuse gastric carcinoma were estimated using the age and sex distribution of individuals in Norway as the basis for calculation. There was no difference in the rates of diffuse gastric carcinoma between the sexes. On the other hand, the rate of men with intestinal type carcinoma was more than twice as high as that of women. This difference was consistent within each age group from adolescence to senescence. The findings indicate that Laurén's two types of gastric carcinoma are aetiologically different. The rates of both types increased with age up to the 70-79 age group, whereas the rates in octogenarians tended to be lower than in septuagenarians. A comparison of our data with the data of incidence of gastric cancer in Norway indicates that some of the older patients do not come for surgery.
PubMed ID
1993119 View in PubMed
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[Apparent decrease in the occurrence of anencephalus in Norway 1967-90]

https://arctichealth.org/en/permalink/ahliterature59454
Source
Tidsskr Nor Laegeforen. 1993 Oct 20;113(25):3126-8
Publication Type
Article
Date
Oct-20-1993
Author
M. Bulajic-Kopjar
P. Magnus
R T Lie
Author Affiliation
Avdeling for Samfunnsmedisin, Statens Institutt for Folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 1993 Oct 20;113(25):3126-8
Date
Oct-20-1993
Language
Norwegian
Publication Type
Article
Keywords
Anencephaly - epidemiology
English Abstract
Gestational Age
Humans
Infant, Newborn
Norway - epidemiology
Registries
Abstract
The occurrence of anencephalus as reported to the Norwegian Medical Birth Registry has fallen from 4.9 per 10,000 births in 1967-71 to 2.7 in 1987-90. The decrease is particularly noticeable for births with a gestational length of 28 weeks or more. On the other hand, there has been a significant increase in the number of cases of anencephalus with a gestational age less than 28 weeks. The occurrence of meningomyelocele has remained relatively stable throughout the same period. Ascertainment error could explain these contrasting trends, since cases of anencephalus detected on ultrasound screening may lead to early termination of pregnancy without notification to the Medical Birth Registry. Better routines for notification of malformations are needed to improve the basis for surveillance in Norway.
PubMed ID
8273032 View in PubMed
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Assessing quality of obstetric care for low-risk deliveries; methodological problems in the use of population based mortality data.

https://arctichealth.org/en/permalink/ahliterature58752
Source
Acta Obstet Gynecol Scand. 2000 Jun;79(6):478-84
Publication Type
Article
Date
Jun-2000
Author
D. Moster
T. Markestad
R T Lie
Author Affiliation
Medical Birth Registry of Norway, Locus of Registry-based Epidemiology, University of Bergen, Department of Pediatrics, Haukeland University Hospital.
Source
Acta Obstet Gynecol Scand. 2000 Jun;79(6):478-84
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Adult
Bias (epidemiology)
Delivery, Obstetric
Female
Fetal Death
Humans
Infant, Newborn
Middle Aged
Norway - epidemiology
Obstetrics - standards
Population Surveillance
Pregnancy
Quality of Health Care
Registries
Research Support, Non-U.S. Gov't
Risk factors
Sample Size
Sensitivity and specificity
Abstract
BACKGROUND: Studies evaluating safety of different birth settings for low-risk deliveries are often difficult to interpret because of great methodological problems. OBJECTIVE: To assess potential bias in comparisons of mortality between maternity institutions with different size and level of care, particularly when using various definitions of low-risk delivery and when studying stillbirth rates. DESIGN: Population-based study. POPULATION: The population of 1.74 million births in Norway from 1967 to 1996 recorded in The Medical Birth Registry of Norway. METHODS: First we explored the problems of properly identifying low-risk deliveries from population-based data and calculated adjusted perinatal mortality rates in sub-populations by excluding different risk factors. Then we measured the difference in apparent low-risk deliveries between institutions of different size and level of care. Finally we explored bias by using stillbirths and discuss the loss of statistical power by studying only livebirths. RESULTS: The occurrence of a whole spectrum of risk factors differed between small and large institutions, even after adjustment for birthweight. Although the majority of births were from low-risk deliveries, only 1/10th of all perinatal deaths occurred in this group after admission to a maternity unit. There was a systematic difference in the reporting of time of death for stillbirths between types of institutions; the rate of stillbirths occurring during delivery was higher among small institutions, while large institutions were more often uncertain in classifying time of death for stillbirths. CONCLUSIONS: Adjustments for a large number of different risk factors, large sample-sizes and caution in including stillbirth as outcome measure are needed when comparisons of safety between different sizes of delivery units are made for low-risk pregnancies.
PubMed ID
10857872 View in PubMed
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Association between inhibited binding of folic acid to folate receptor alpha in maternal serum and folate-related birth defects in Norway.

https://arctichealth.org/en/permalink/ahliterature134465
Source
Hum Reprod. 2011 Aug;26(8):2232-8
Publication Type
Article
Date
Aug-2011
Author
A L Boyles
J L Ballard
E B Gorman
D R McConnaughey
R M Cabrera
A J Wilcox
R T Lie
R H Finnell
Author Affiliation
Epidemiology Branch, NIEHS/NIH, Durham, NC 27709, USA. boylesa@niehs.nih.gov
Source
Hum Reprod. 2011 Aug;26(8):2232-8
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Autoantibodies - analysis
Case-Control Studies
Cleft Lip - etiology
Cleft Palate - etiology
Female
Folate Receptor 1 - blood - immunology
Folic Acid - metabolism
Folic Acid Deficiency - complications
Humans
Neural Tube Defects - etiology
Norway
Pregnancy
Abstract
Folic acid intake during pregnancy can reduce the risk of neural tube defects (NTDs) and perhaps also oral facial clefts. Maternal autoantibodies to folate receptors can impair folic acid binding. We explored the relationship of these birth defects to inhibition of folic acid binding to folate receptor a (FRa), as well as possible effects of parental demographics or prenatal exposures.
We conducted a nested case-control study within the Norwegian Mother and Child Cohort Study. The study included mothers of children with an NTD (n = 11), cleft lip with or without cleft palate (CL/P, n= 72), or cleft palate only (CPO, n= 27), and randomly selected mothers of controls (n = 221). The inhibition of folic acid binding to FRa was measured in maternal plasma collected around 17 weeks of gestation. On the basis of prior literature, the maternal age, gravidity, education, smoking, periconception folic acid supplement use and milk consumption were considered as potential confounding factors.
There was an increased risk of NTDs with increased binding inhibition [adjusted odds ratio (aOR) = 1.4, 95% confidence interval (CI) 1.0-1.8]. There was no increased risk of oral facial clefts from inhibited folic acid binding to FRa (CL/P aOR = 0.7, 95% CI 0.6-1.0; CPO aOR = 1.1, 95% CI 0.8-1.4). No association was seen between smoking, folate supplementation or other cofactors and inhibition of folic acid binding to FRa.
Inhibition of folic acid binding to FRa in maternal plasma collected during pregnancy was associated with increased risk of NTDs but not oral facial clefts.
Notes
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PubMed ID
21576080 View in PubMed
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The association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants.

https://arctichealth.org/en/permalink/ahliterature32149
Source
J Pediatr. 2001 Jun;138(6):798-803
Publication Type
Article
Date
Jun-2001
Author
D. Moster
R T Lie
L M Irgens
T. Bjerkedal
T. Markestad
Author Affiliation
Department of Pediatrics, Haukeland University Hospital, Barneklinikken, N-5021 Bergen, Norway.
Source
J Pediatr. 2001 Jun;138(6):798-803
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Apgar score
Cerebral Palsy - diagnosis
Child
Child, Preschool
Comparative Study
Humans
Infant
Infant, Newborn
Infant, Newborn, Diseases - mortality
Predictive value of tests
Research Support, Non-U.S. Gov't
Risk
Abstract
OBJECTIVE: To estimate the risk of adverse outcomes for newborns with a low Apgar score.Study design: Population-based cohort study. All 235,165 children born between 1983 and 1987 in Norway with a birth weight of at least 2500 g and no registered birth defects were followed up from birth to age 8 to 12 years by linkage of 3 national registries. Outcomes were death and cerebral palsy (CP). RESULTS: Five-minute Apgar scores of 0 to 3 were recorded for 0.1%, and scores of 4 to 6 were recorded for 0.6% of the children. Compared with children who had 5-minute Apgar scores of 7 to 10, children who had scores of 0 to 3 had a 386-fold increased risk for neonatal death (95% CI: 270-552) and an 81-fold (48-138) increased risk for CP. If Apgar scores at both 1 and 5 minutes were 0 to 3, the risks for neonatal death and CP were increased 642-fold (442-934) and 145-fold (85-248), respectively, compared with scores of 7 to 10. CONCLUSION: The strong association of low Apgar scores with death and CP in this population with a low occurrence of low scores shows that the Apgar score remains important for the early identification of infants at increased risk for serious and fatal conditions.
Notes
Comment In: J Pediatr. 2001 Jun;138(6):791-211391316
PubMed ID
11391319 View in PubMed
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Birth defects and parental consanguinity in Norway.

https://arctichealth.org/en/permalink/ahliterature34355
Source
Am J Epidemiol. 1997 Mar 1;145(5):439-48
Publication Type
Article
Date
Mar-1-1997
Author
C. Stoltenberg
P. Magnus
R T Lie
A K Daltveit
L M Irgens
Author Affiliation
National Institute of Public Health, Oslo, Norway.
Source
Am J Epidemiol. 1997 Mar 1;145(5):439-48
Date
Mar-1-1997
Language
English
Publication Type
Article
Keywords
Abnormalities - ethnology
Comparative Study
Confidence Intervals
Consanguinity
Educational Status
Emigration and Immigration - statistics & numerical data
Female
Humans
Incidence
Maternal Age
Morocco - ethnology
Norway - epidemiology
Pakistan - ethnology
Parity
Research Support, Non-U.S. Gov't
Risk assessment
Turkey - ethnology
Abstract
The study compares frequencies of birth defects between immigrant groups and the rest of the Norwegian population in Norway and estimates the influence of consanguinity and socioeconomic factors on these frequencies. The authors studied all 1.56 million births in Norway from 1967 to 1993. Of these, 7,494 children had two Pakistani parents, 84,688 had one Norwegian and one immigrant parent, and 25,891 had two immigrant parents from countries other than Pakistan. The risk of birth defects relative to the Norwegian group was 0.98 (95% confidence interval 0.92-1.03) in the group with one foreign and one Norwegian parent, 1.39 (95% confidence interval 1.22-1.60) in the group with two Pakistani parents, and 1.04 (95% confidence interval 0.95-1.14) in the group with two parents from other foreign countries; 0.1% of the Norwegian and 30.1% of the Pakistani children had parents who were first cousins. There was no difference in risk between children of nonconsanguineous Pakistani parents and the other groups. The relative risk of birth defects among children whose parents were first cousins was about 2 in all groups. Among the Pakistani, 28% of all birth defects could be attributed to consanguinity. Low paternal educational level was associated with a slightly increased risk in the Norwegian group, while independent effects of parental educational levels were not found in any other groups.
Notes
Erratum In: Am J Epidemiol 1997 May 15;145(10):957
PubMed ID
9048518 View in PubMed
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Birth defects in Norway by levels of external and food-based exposure to radiation from Chernobyl.

https://arctichealth.org/en/permalink/ahliterature59591
Source
Am J Epidemiol. 1992 Aug 15;136(4):377-88
Publication Type
Article
Date
Aug-15-1992
Author
R T Lie
L M Irgens
R. Skjaerven
J B Reitan
P. Strand
T. Strand
Author Affiliation
Medical Birth Registry of Norway, University of Bergen, Norway.
Source
Am J Epidemiol. 1992 Aug 15;136(4):377-88
Date
Aug-15-1992
Language
English
Publication Type
Article
Keywords
Abnormalities, Radiation-Induced - epidemiology - etiology
Accidents
Dose-Response Relationship, Radiation
Down Syndrome - epidemiology
Environmental Exposure - adverse effects - analysis
Female
Food Contamination, Radioactive - analysis
Humans
Hydrocephalus - epidemiology - etiology
Infant, Newborn
Male
Norway - epidemiology
Nuclear Reactors
Research Support, Non-U.S. Gov't
Ukraine
Abstract
In Norway, external doses of radiation resulting from fallout from the Chernobyl nuclear accident were estimated from detailed measurements, including soil deposition patterns. Internal doses were estimated from measurements of radioactive cesium in meat and milk supplies. The doses were calculated as average monthly doses for each of 454 municipalities during 36 consecutive months after the accident in spring 1986. Prospectively collected data on all newborns listed in the Medical Birth Registry of Norway who were conceived in the period May 1983-April 1989 were used to assess possible dose-response relations between estimated external and food-based exposures and congenital malformations and some other conditions. A positive association was observed between total radiation dose (external plus food-based) and hydrocephaly, while a negative association was observed for Down's syndrome. However, an important conclusion of the study was that no associations were found for conditions previously reported to be associated with radiation, i.e., small head circumference, congenital cataracts, anencephaly, spina bifida, and low birth weight. Potential sources of bias, including exposure misclassification and incomplete ascertainment of cases, are discussed.
PubMed ID
1415157 View in PubMed
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Birth weight and childhood onset type 1 diabetes: population based cohort study.

https://arctichealth.org/en/permalink/ahliterature32247
Source
BMJ. 2001 Apr 14;322(7291):889-92
Publication Type
Article
Date
Apr-14-2001
Author
L C Stene
P. Magnus
R T Lie
O. Søvik
G. Joner
Author Affiliation
Section of Epidemiology, Department of Population Health Sciences, National Institute of Public Health, Nydalen, N-0403 Oslo, Norway. lars.christian.stene@folkehelsa.no
Source
BMJ. 2001 Apr 14;322(7291):889-92
Date
Apr-14-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Birth weight
Child
Child, Preschool
Cohort Studies
Diabetes Mellitus, Type 1 - epidemiology - etiology
Female
Gestational Age
Humans
Incidence
Infant
Male
Norway - epidemiology
Regression Analysis
Research Support, Non-U.S. Gov't
Risk factors
Sex Distribution
Abstract
OBJECTIVE: To assess the associations between birth weight or gestational age and risk of type 1 diabetes. DESIGN: Population based cohort study by record linkage of the medical birth registry and the National Childhood Diabetes Registry. Setting: Two national registries in Norway. PARTICIPANTS: All live births in Norway between 1974 and 1998 (1 382 602 individuals) contributed a maximum of 15 years of observation, a total of 8 184 994 person years of observation in the period 1989 to 1998. 1824 children with type 1 diabetes were diagnosed between 1989 and 1998. MAIN OUTCOME MEASURES: Estimates of rate ratios with 95% confidence intervals for type 1 diabetes from Poisson regression analyses. RESULTS: The incidence rate of type 1 diabetes increased almost linearly with birth weight. The rate ratio for children with birth weights 4500 g or more compared with those with birth weights less than 2000 g was 2.21 (95% confidence interval 1.24 to 3.94), test for trend P=0.0001. There was no significant association between gestational age and type 1 diabetes. The results persisted after adjustment for maternal diabetes and other potential confounders. CONCLUSION: There is a relatively weak but significant association between birth weight and increased risk of type 1 diabetes consistent over a wide range of birth weights.
PubMed ID
11302899 View in PubMed
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Causes of death in patients with peptic ulcer perforation: a long-term follow-up study.

https://arctichealth.org/en/permalink/ahliterature21222
Source
Scand J Gastroenterol. 1999 Jan;34(1):18-24
Publication Type
Article
Date
Jan-1999
Author
C. Svanes
S A Lie
R T Lie
O. Søreide
K. Svanes
Author Affiliation
Dept. of Surgery, Haukeland Hospital, University of Bergen, Norway.
Source
Scand J Gastroenterol. 1999 Jan;34(1):18-24
Date
Jan-1999
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - mortality
Cause of Death
Cohort Studies
Female
Follow-Up Studies
Humans
Lung Diseases, Obstructive - mortality
Male
Mortality - trends
Neoplasms - mortality
Peptic Ulcer Perforation - complications - mortality - surgery
Research Support, Non-U.S. Gov't
Smoking - adverse effects
Abstract
BACKGROUND: Survival is lower in ulcer perforation patients than in the general population. This study assesses the causes of death in patients treated for peptic ulcer perforation. METHODS: Cause-specific mortality in a population-based cohort of 817 patients treated for ulcer perforation in western Norway during the period 1962-1990 was compared with cause-specific population death rates. Analyses were based on observed and expected mortality curves for major causes of death and on standardized mortality rates (SMRs). Cox regression models were used to analyse possible differences on the basis of sex, birth cohort, surgical procedure, and ulcer location. RESULTS: Ulcer perforation patients experienced increased mortality from neoplasms (SMR = 1.8; 95% confidence interval (CI) = 1.4-2.1), lung cancer (SMR = 3.6; 95% CI = 2.3-4.9), circulatory diseases (SMR = 1.3; 95% CI = 1.1-1.6), ischaemic heart disease (SMR = 1.3; 95% CI = 1.03-1.6), and respiratory diseases (SMR = 1.9; 95% CI = 1.3-2.6). Postoperative deaths accounted for 38% of all excess deaths. Death from recurrent peptic ulcer was increased also in subjects who survived the 1st year after the perforation (SMR = 5.8; 95% CI = 1.2-10.4) but accounted for only a few deaths. The increase in mortality from lung cancer was higher in subjects born after 1910 than in patients of older generations. Excess mortality from lung cancer and from circulatory diseases was higher in male than in female patients. CONCLUSIONS: Increased mortality in ulcer perforation patients could mainly be attributed to smoking-related diseases. This is indirect evidence that smoking may be an important aetiologic factor for ulcer perforation.
PubMed ID
10048727 View in PubMed
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50 records – page 1 of 5.