ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies.
We used the SCANDAT2 (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987 and 2012 were followed up for diagnosis of thromboembolism and arterial events. Poisson regression models were used to estimate incidence rate ratios as measures of relative risk. A total of 9170 venous and 24 653 arterial events occurred in 1 112 072 individuals during 13.6 million person-years of follow-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis (incidence rate ratio, 1.92; 95% confidence interval, 1.80-2.05), and pulmonary embolism (incidence rate ratio, 1.80; 95% confidence interval, 1.71-1.88).
In this healthy population of blood donors, non-O blood groups explain >30% of venous thromboembolic events. Although ABO blood groups may potentially be used with available prediction systems for identifying at-risk individuals, its clinical utility requires further comparison with other risk markers.
OBJECTIVES--To describe parent-reported morbidity in relation to the psycho-social conditions of the families and to characterize families whose children are frequently ill. DESIGN--The parent-reported morbidity in a two-month prospective period, and the psychosocial conditions of the families were registered by means of a questionnaire. The conditioned probability of parents' reporting an episode of illness was estimated by means of logistic regression analysis, taking the psycho-social conditions into consideration. SETTING--18,949 families with at least one child under the age of 8 years, resident in the County of Ringkjøbing in western Denmark at 1 March 1988. SUBJECTS--An age-stratified random sample of 1982 families was entered in the study. 1588 (82%) families returned the questionnaire. RESULTS--The parents reported considerable morbidity in their children. The cumulative incidence proportion (CIP) for the period was 48%. The multivariate analysis of the parent-reported morbidity led to the following main results: 1) the morbidity was greatest for children aged 6 to 18 months, after which it decreased with age, 2) there was interaction between the care conditions and the child's age--CIP for children up to two years was largest for the children who were cared for in daycare, while the CIP for the older children was largest for the children who were cared for at home, 3) if the parents reported that the child's siblings suffered from chronic or frequently recurring morbidity, the child's morbidity rate was significantly increased, 4) mothers with higher education reported more morbidity in their children than mothers without this education, and 5) parents with a high perception of the general health threat ("worried" parents) reported more morbidity than did parents with a low perception. CONCLUSIONS--The results made it possible to characterize families whose children were frequently reported ill.
There are presently few international studies that examine adolescents' own experience of both triggering and the underlying reasons behind their suicide attempts.
To present the rates, triggering factors, and underlying reasons for such behavior.
The 23-year (1984-2006) surveillance study reported includes all general hospital-treated suicide attempters aged between 13 and 19 years (n = 254) living in the municipality of Bærum, a suburb on the outskirts of Oslo, Norway.
Suicide attempt rates for both sexes decreased during the period of study. The female suicide attempt rate was on average 3.5 times higher than the male rate. An average of 8.2% of the suicide attempters made a repeat attempt within the following year. Overall, the most commonly reported trigger was a relational conflict (50.2%), and the most commonly reported underlying reason was a dysfunctional family situation (43.6%), followed by mental health problems (22.8%). The main gender difference for both triggers and underlying reasons was that relational conflicts were reported significantly more often by girls than by boys as triggers (55.0% versus 32.7%), and dysfunctional family issues were reported significantly more often by girls than by boys (47.1% versus 30.8%) as underlying reasons for the attempt. Mental health problems were reported less frequently as an underlying reason by girls than boys (21.2% versus 28.8%).
A family-oriented intervention embracing the extended family system seems warranted in a majority of the cases in our study.
Non insulin dependent diabetes mellitus (NIDDM) and essential hypertension (EH) are two of several manifestations of the insulin resistance syndrome. Although subjects with NIDDM and subjects with EH share a common defect in carbohydrate metabolism, only diabetics are advised to avoid sugar. We tested the theory that an adverse effect of diuretics treatment in men with EH with respect to risk of ischaemic heart disease (IHD) would depend on the intake of dietary sugar using sugar in hot beverages as a marker. The cohort consisted of 2,899 men from the Copenhagen Male Study aged 53-74 years (mean 63) who were without overt cardiovascular disease. Potential confounders were: age, alcohol,smoking, physical activity, body mass index, blood pressure, fasting lipids, cotinine, NIDDM,and social class. A total of 340 men took antihypertensives; 211 took diuretics (95% thiazides and related agents), and 129 used other antihypertensives. During 6 years, 179 men (6.2%) had a first IHD event. Among the 340 men taking antihypertensives, the incidence rate was 11%. Diuretics use was associated with a high risk of IHD in hypertensive men with a relatively high intake of dietary sugar; the cumulative incidence rate was 22%; in diuretics treated men with a low intake of sugar, the rate was 7%. After controlling for potential confounders, relative risk (95% ci.) was 3.1(1.3-7.6), p = 001. Among the 129 men who took other forms of antihypertensive drugs, the IHD incidence rate was 8%, and independent of the intake of sugar. The results indicate that the risk of IHD in hypertensives using diuretics is associated with intake of dietary sugar, which may explain at least some of the discouraging effects of antihypertensive agents on the reduction of risk of IHD.
Age at first intercourse among Norwegian adolescents was studied by means of survival analysis. The data stemmed from a nation-wide survey of 3000 Norwegian adolescents aged 17-19, yielding a response rate of 61.8%. Median age at first intercourse was 17.3 years among girls and 18.0 years among boys. By means of Cox regression analysis associations between age at onset of intercourse and some correlates were estimated. Age at first intercourse was significantly associated with educational aspirations, smoking behaviour, alcohol consumption, peer affiliation, and frequency of visiting a discotheque. These inter-relationships confirm that age at onset of intercourse comprise an important indicator of the lifestyle of an individual. In order to influence sexual behaviour of adolescents it may thus be appropriate to employ health promotion activities focusing upon environmental and structural factors, as a supplement to traditional methods of sex education.
BACKGROUND: The objective of this study was to estimate the risk of severe osteoarthritis, with the need for arthroplasty, in the knee and/or hip according to body mass index (BMI) both within a normal range and in persons with high BMI. Furthermore, we wanted to study the significance of smoking. METHODS: This study identifies male construction workers participating in a national health control program (n = 320,192). The incidence rate for joint replacement was found by matching with the Swedish hospital discharge register between 1987 and 1998. BMI and smoking habit was registered at the time of the health examination. RESULTS: In total 1495 cases of osteoarthritis of the hip and 502 cases of osteoarthritis of the knee were identified and included in this analysis. The incidence rate was found to increase linearly to the BMI even within low and 'normal' BMI. The relative risk for osteoarthritis of the hip was more than two times higher in persons with a BMI of 20-24 than in men with a BMI 17-19. There was almost a doubling of the risk of severe knee osteoarthritis with an increase in BMI of 5 kg/m2. Smoker had a lower risk of osteoarthritis than non-smokers and ex-smokers. CONCLUSIONS: BMI is an important predictor of osteoarthritis even within normal BMI. A decreased risk of osteoarthritis of the hip was found in smokers, but the effect was weak compared to that of BMI or age. Contrary to studies of radiographic osteoarthritis our study indicates higher risk of hip than of knee osteoarthritis.
An 18-year addiction career, 1985-2003, for 157 heroin dependent subjects (73% men; 49% human immunodeficiency virus seropositive) admitted for the first time to Stockholm's Methadone Maintenance Treatment program during 1989 to 1991 was analyzed with data from seven official registers and patient records. Regression analyses and incidence rates for various outcomes were calculated for subjects in first methadone maintenance treatment at the end of the observation period, discharged from first methadone maintenance treatment, in second methadone maintenance treatment, and discharged from second methadone maintenance treatment. Being human immunodeficiency virus positive (HR = 3.8), lodging (HR = 1.9) and prison sentence (HR = 1.7) predicted mortality for the 45% deceased. Approximately 70% of living subjects participated in methadone maintenance treatment at some period each year. Subjects in first or second methadone maintenance treatment had less criminality and had spent more time in methadone maintenance treatment (70% to 100%) than those discharged from first or from second methadone maintenance treatment (50%). Efforts and interventions should be intensified to increase time in treatment also for those with high problem severity.
Since most studies of caries decline are descriptive time-trend analyses, the purpose of this article was to identify factors statistically associated with the caries decline among Norwegian adolescents after 1985. The DMFT scores for the age groups 12 and 18 years reported annually by 19 counties were analysed. The average caries-free proportions of 18-year-olds increased from 2% to 15% between 1985 and 2000, while the DMFT declined by 49%; 10.2 +/- 0.75 to 5.2 +/- 0.78. The decline for the 12-year-olds was 53%. The mean DT at the dentinal level remained at about 0.8 for 12-year-olds and 1.5 for 18-year-olds throughout the observation period. There was no significant difference in DMFT increment from age 12 to 18 between the birth cohorts 1973 (3.8 +/- 0.46) and 1982 (3.0 +/- 0.52) when controlling for counties. The variables migration and children per dentist were significantly associated with the DMFT decline in multivariate analyses. The caries decline for 18-year-olds was significantly steeper before than after 1990. The decline among the 18-year-olds may be attributed to fluoride and more restrictive criteria for placement of fillings in teenagers in the 1980s and fewer filled teeth before the age of 12 years in the 1990s.
Based on a population-based cohort study, Olsson et al.  found significant evidence for elevated incidence of breast and ovarian cancers among female first-degree relatives of men with breast cancer. Using an extension of logistic regressive models we investigate whether, after allowing for multifactorial familial correlations, single locus segregation could be the cause of the elevated incidence in these families. The logit for a given sib in the class D logistic regressive model depends on the order in which affected sibs occur in a sibship. That makes the model less appropriate for the situation where a polygenic component or a common sibling environment may be present, as well as being computationally cumbersome. In this paper, we propose to use the proportion of siblings in a sibship who are affected to quantify a sibling correlation. That not only relaxes the interchangeability problem but also makes the model computationally efficient. We then use this modified class D logistic regressive model for our segregation analysis. Using the proportion of siblings in a sibship who are affected as a covariate resulted in a significantly higher likelihoods in all the models we investigated. We found evidence for a dominant Mendelian gene leading to early age of onset of breast and/or ovarian cancer. This could either be a germline mutation of BRCA2 or a mutation in a gene different from BRCA2.
Cancer incidence data for the Ontario Public Health Units in 1980-91 were examined to investigate regional patterns and the existence of outlier values after adjustment for known risk factors. Candidate risk factors were derived from the Ontario Health Survey and the census. Weighted regressions were fit to the data, and the spatial pattern of the residuals was analyzed. The number of outlier data points with significant elevations or reductions in risk was close to that expected by chance. They were dispersed geographically, and occurred in a variety of cancer types. We conclude that, in general, most of the geographic variation in cancer risk can be associated with variation in known risk factors, and that there appear to be no broad regional effects remaining after adjustment for these factors. A few cancer sites provide limited evidence of regional effects that may warrant further investigation.