The present study investigated the association between 24-h urinary sodium excretion and heart rate in the determination of blood pressure (BP) levels in a large random population sample from eastern Finland. Three independent risk factor surveys were performed in 1979, 1982 and 1987 using the same methodology. Data from each survey was pooled for subjects aged 25-64 years who reported a complete 24-h urine collection and were not on the current antihypertensive treatment (1640 men and 1686 women). The effect of urinary sodium excretion and heart rate was examined by regressing BP on urinary sodium excretion and pulse rate, together with age and body mass index (BMI). Analyses stratified by quintiles of heart rate were also performed. There was no association between urinary sodium and BP either in men or in women. There was a significant correlation between heart rate and both systolic and diastolic BP in both men and women. A significant interaction between age and BMI with heart rate was also found in both sexes. Interaction between urinary sodium and heart rate was found neither in men nor in women. Among men, after adjustment for age and BMI, there was a curvilinear relation between 24-h urinary excretion of sodium and diastolic BP (P = 0.054) in the lowest quintile of heart rate (
We studied the association of glucose intolerance with total and cause-specific mortality during a 5-year follow-up of 637 elderly Finnish men aged 65 to 84 years. Total mortality was 276 per 1000 for men aged 65 to 74 years and 537 per 1000 for men aged 75 to 84 years. Five-year total mortality adjusted for age was 364 per 1000 in diabetic men, 234 per 1000 in men with impaired glucose tolerance and 209 per 1000 in men with normal glucose tolerance. The relative risk of death among diabetic men was 2.10 (95% confidence interval 1.26 to 3.49) and among men with impaired glucose tolerance 1.17 (95% confidence interval 0.71 to 1.94) times higher compared with men with normal glucose tolerance. Cardiovascular disease was the most common cause of death in every glucose tolerance group. The multivariate adjusted relative risk of cardiovascular death was increased (1.55) in diabetic patients, albeit non-significantly (95% confidence interval 0.84 to 2.85). Diabetes resulted in an increased risk of cardiovascular mortality among men aged 65-74 years but not among the 75- 84-year-old men. Relative risk of death from non-cardiovascular causes was slightly increased among diabetic subjects. In conclusion, diabetes mellitus is a significant determinant of mortality among elderly Finnish men.
To investigate the role of diet as a predictor of glucose intolerance and non-insulin-dependent diabetes mellitus (NIDDM).
At the 30-year follow-up survey of the Dutch and Finnish cohorts of the Seven Countries Study, in 1989/1990, men were examined according to a standardized protocol including a 2-h oral glucose tolerance test. Information on habitual food consumption was obtained using the cross-check dietary history method. Those 338 men in whom information on habitual diet was also available 20 years earlier were included in this study. Subjects known as having diabetes in 1989/1990 were excluded from the analyses.
Adjusting for age and cohort, the intake of total, saturated, and monounsaturated fatty acids and dietary cholesterol 20 years before diagnosis was higher in men with newly diagnosed diabetes in the survey than in men with normal or impaired glucose tolerance. After adjustment for cohort, age, past body mass index, and past energy intake, the past intake of total fat was positively associated with 2-h postload glucose level (P
Section of Pediatric Hematology and Oncology, Pediatric Clinic II, Juliane Marie Center, University Hospital, Rigshospitalet and Institute of Gynecology, Obstetrics and Pediatrics, Medical Faculty, University of Copenhagen, Copenhagen, Denmark. firstname.lastname@example.org
Many childhood cancer survivors have psychosocial late effects. We studied the risks for cohabitation and subsequent separation. Through the Danish Cancer Register, we identified a nationwide, population-based cohort of all 1877 childhood cancer survivors born from 1965 to 1980, and in whom cancer was diagnosed between 1965 and 1996 before they were 20 years of age. A sex-matched and age-matched population-based control cohort was used for comparison (n=45,449). Demographic and socioeconomic data were obtained from national registers and explored by discrete-time Cox regression analyses. Childhood cancer survivors had a reduced rate of cohabitation [rate ratio (RR) 0.78; 95% confidence interval (CI): 0.73-0.83], owing to lower rates among survivors of both noncentral nervous system (CNS) tumors (RR 0.88; 95% CI: 0.83-0.95) and CNS tumors (RR 0.52; 95% CI: 0.45-0.59). Male CNS tumor survivors had a nonsignificantly lower rate (RR 0.47; 95% CI: 0.38-0.58) than females (RR 0.56; 95% CI: 0.47-0.68). The rates of separation were almost identical to those of controls. In conclusion, the rate of cohabitation was lower for all childhood cancer survivors than for the population-based controls, with the most pronounced reduction among survivors of CNS tumors. Mental deficits after cranial irradiation are likely to be the major risk factor.
We investigated the risk of, prognosis of and symptoms of multiple sclerosis (MS) among all Danish residents who owned a mobile phone subscription before 1996. Using the Danish Multiple Sclerosis Registry and Civil Registration System, study subjects were followed up for MS through 2004. Poisson models were used to calculate incidence rate ratios (IRR, age range: 18-64 years) and mortality rate ratios (MRR, age range: 18+) and to compare presenting symptoms among subscribers and all non-subscribers. A total of 405 971 subscription holders accrued four million years of follow up, with men accounting for 86% of the observation time. Among subscription holding men, the IRR of MS was close to unity, overall as well as 13+ years after first subscription (IRR 1.02, 95% CI: 0.48-2.16). Among women, the IRR was 3.43 (95% CI: 0.86-13.72) 13+ years after first subscription, however, based on only two cases. Presenting symptoms of MS differed between subscribers and non-subscribers (p = 0.03), with slightly increased risk of diplopia in both genders (IRR: 1.38, 95% CI: 1.02-1.86), an increased risk of fatigue among women (IRR: 3.02, 95% CI: 1.45-6.28), and of optic neuritis among men (IRR: 1.38, 95% CI: 1.03-1.86). Overall the MRR was close to one (MRR: 0.91, 95%CI 0.70-1.19) among MS-patients with a subscription and although we observed some increased MRR estimates among women, these were based on small numbers. In conclusion, we found little evidence for a pronounced association between mobile phone use and risk of MS or mortality rate among MS patients. Symptoms of MS differed between subscribers and nonsubscribers for symptoms previously suggested to be associated with mobile phone use. This deserves further attention, as does the increased long-term risk of MS among female subscribers, although small numbers and lack of consistency between genders prevent causal interpretation.
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The International Agency for Research on Cancer has classified radiofrequency radiation as possibly carcinogenic. Previous studies have focused on intracranial tumors, although the skin receives much radiation. In a nationwide cohort study, 355,701 private mobile phone subscribers in Denmark from 1987 to 1995 were followed up through 2007. We calculated incidence rate ratios (IRRs) for melanoma, basal cell carcinoma, and squamous cell carcinoma by using Poisson regression models adjusted for age, calendar period, educational level, and income. Separate IRRs for head/neck tumors and torso/leg tumors were compared (IRR ratios) to further address potential confounders. We observed no overall increased risk for basal cell carcinoma, squamous cell carcinoma, or melanoma of the head and neck. After a follow-up period of at least 13 years, the IRRs for basal cell carcinoma and squamous cell carcinoma remained near unity. Among men, the IRR for melanoma of the head and neck was 1.20 (95% confidence interval: 0.65, 2.22) after a minimum 13-year follow-up, whereas the corresponding IRR for the torso and legs was 1.16 (95% confidence interval: 0.91, 1.47), yielding an IRR ratio of 1.04 (95% confidence interval: 0.54, 2.00). A similar risk pattern was seen among women, though it was based on smaller numbers. In this large, population-based cohort study, little evidence of an increased skin cancer risk was observed among mobile phone users.
Socioeconomic position and lifestyle often affect participation in scientific studies. The authors investigated differences in overall and cause-specific mortality between participants and non-participants in the prospective Danish cohort study "Diet, Cancer and Health" and the association between non-participation and mortality by socioeconomic position. A total of 80,996 men and 79,729 women aged 50-64 years, were invited. The authors obtained register data on education, income, death and cause-specific mortality for participants and non-participants and used survival curves to examine differences in overall mortality. Poisson regression models were used to estimate the mortality rate ratio (MRR) by socioeconomic group and by cause of death of participants and non-participants. After a median follow-up of 13 years (5-95 percentiles, 5-14 years), the MRRs for overall mortality among non-participants were 2.09 (95% CI 1.99-2.14) and 2.29 (95% CI 2.19-2.40) among men and women, respectively compared with participants. After adjusting for socioeconomic position, the MRRs changed to 1.73 (95% CI 1.66-1.79) and 2.10 (95% CO 2.01-2.20) among men and women, respectively. The MRRs did not level out after up to 15 years of follow-up. The MRRs were all significantly increased and ranged from 1.51 to 4.28 for men, depending on the cause of death, and from 1.60 to 3.99 for women. Clear differences in mortality from all investigated causes of death were found between participants and non-participants, which persisted after up to 15 years of follow-up. Socioeconomic position had little effect on this result.
Factors predicting disability in late life were studied in 716 men from eastern or southwestern Finland in connection with the 25-year follow-up of the East-West Study, which is part of the Seven Countries Study, in 1984. In middle-aged men, low forced vital capacity, occurrence of diabetes, presence of intermittent claudication, high diastolic blood pressure, higher age and lower educational level showed the greatest predicting power for future disability 15-25 years later. In later middle age, low forced vital capacity, presence of intermittent claudication, cerebrovascular disease or coronary heart disease and higher age were the most powerful predictors for disability 10 years later. In order to lower disability in old age, it is important to prevent deterioration of ventilatory function and cardiovascular diseases in middle-aged populations and to treat chronic diseases adequately.
The epsilon 4 allele of the apolipoprotein E (apoE) is associated with Alzheimer's disease (AD) and also with elevated serum total cholesterol and low-density lipoprotein levels. However, the interrelationships between apoE genotype, plasma cholesterol levels and AD risk have been studied very little. We examined the possible role of serum total cholesterol in the pathogenesis of AD in a population-based sample of 444 men, aged 70-89 years, who were survivors of the Finnish cohorts of the Seven Countries Study. Previous high serum cholesterol level (mean level > or = 6.5 mmol/l) was a significant predictor of the prevalence of AD (odds ratio = 3.1; 95% confidence interval = 1.2, 8.5) after controlling for age and the presence of apoE epsilon 4 allele. In men who subsequently developed AD the cholesterol level decreased before the clinical manifestations of AD. We conclude that high serum total cholesterol may be an independent risk factor for AD and some of the effect of the apoE epsilon 4 allele on risk of AD might be mediated through high serum cholesterol.
The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here.
The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011-2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73% and 81% of eligible students, and 22% of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period.
Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention.
ISRCTN57822968. Date of registration: 16/01/2013.
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