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81.
  • Modig, Karin, et al. (författare)
  • Stable or improved health status in the population 65 years and older in Stockholm, Sweden - an 8-year follow-up of self-reported health items
  • 2016
  • Ingår i: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; 44:5, s. 480-489
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Previous studies have reached different conclusions about whether health is improving in the ageing population. More studies with narrow age groups analyzed separately for men and women will contribute to the literature. Aim: To describe trends in self-reported indicators of health and health-related quality of life between 2002 and 2010, focusing on differences between gender and age groups. A population-based survey of individuals 65+ in the Stockholm County was used. Results: Prevalence of health problems increased with age both among men and women. Men generally reported having no health problems to a larger extent than women, but the proportions reporting severe problems were similar. The larger picture is one of stability in health-related quality of life, even if several items developed for the better, especially among women. While the proportions reporting no health/functional problems increased for many items, the proportions reporting severe problems remained unchanged among men and improved only for two items among women. Conclusions: Overall, improvements were seen in many of the health-related quality of life items as well as for self-rated health among women. The proportions reporting long-term illness or persistent health problems increased, but fewer seem to be limited in their daily activities by these problems. The stable proportions of poor self-rated health indicates that while health and functioning seem to be improving for the majority of the older population, some groups may be lagging behind. Future studies should pay attention to changes both in the upper and lower ends of the health spectrum.</p>
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82.
  • Modig, Karin, et al. (författare)
  • The Aging Population in Sweden – Can Declining Incidence Rates in MI, Stroke and Cancer Counterbalance the Future Demographic Challenges?
  • 2012
  • Ingår i: Stockholm University SIMSAM Node for Demographic Research (SUNDEM). - Springer Netherlands.
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>It is often taken for granted that an ageing population will lead to an increased burden for the health care sector. However, for several diseases of big public health impact the rates have actually come down for a substantial period of time. In this study we investigate how much the incidence rates for myocardial infarction (MI), stroke, and cancer will have to decline in order to counterbalance future demographic changes (changes in population size and age structure) and compare these figures with observed historical trends. Information on incidence rates were obtained from the National Board of Health and Welfare and referred to the total Swedish population. Population projections were obtained from Statistics Sweden. We projected the number of MI events to increase 50–60% between 2010 and 2050. The decline in incidence rates that is required to keep the number of events constant over time is, on average, 1.2%/year for men and 0.9%/year for women, somewhat higher than the trend for the past 10 years. For stroke the corresponding figures were 1.3% (men) and 1% (women), well in line with historical trends. For cancer the results indicate an increasing number of events in the future. Population ageing is more important than population growth when projecting future number of MI, stroke and cancer events. The required changes in incidence rates in order to counterbalance the demographic changes are well in line with historical figures for stroke, almost in line regarding MI, but not in line regarding cancer. For diseases with age dependence similar to these diseases, a reduction of incidence rates in the order of 1–2% is sufficient to offset the challenges of the ageing population. These are changes that have been observed for several diseases indicating that the challenges posed by the ageing population may not be as severe as they may seem when considering the demographic component alone.</p>
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83.
  • Monge, Patricia, et al. (författare)
  • Parental occupational exposure to pesticides and the risk of childhood leukemia in Costa Rica
  • 2007
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 33:4, s. 293-303
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>OBJECTIVES: Parental exposure to pesticides and the risk of leukemia in offspring were examined in a population-based case-control study in Costa Rica. METHODS: All cases of childhood leukemia (N=334), in 1995-2000, were identified at the Cancer Registry and the Children's Hospital. Population controls (N=579) were drawn from the National Birth Registry. Interviews of parents were conducted using conventional and icon-based calendar forms. An exposure model was constructed for 25 pesticides in five time periods. RESULTS: Mothers' exposures to any pesticides during the year before conception and during the first and second trimesters were associated with the risk [odds ratio (OR) 2.4, 95% confidence interval (95% CI) 1.0-5.9; OR 22, 95% CI 2.8-171.5; OR 4.5, 95% CI 1.4-14.7, respectively] and during anytime (OR 2.2, 95% CI 1.0-4.8). An association was found for fathers' exposures to any pesticides during the second trimester (OR 1.5, 95% CI 1.0-2.3). An increased risk with respect to organophosphates was found for mothers during the first trimester (OR 3.5, 95% CI 1.0-12.2) and for fathers during the year before conception and the first trimester (OR 1.5, 95% CI 1.0-2.2 and OR 1.6, 95% CI 1.0-2.6, respectively), and benzimidazoles during the first, second, and third trimesters of pregnancy (OR 2.2, 95% CI 1.0-4.4; OR 2.2, 95% CI 1.0-5.0; OR 2.2, 95% CI 1.0-5.2, respectively). There was a suggestion of an exposure-response gradient for fathers as regards picloram, benomyl, and paraquat. Age at diagnosis was positively associated with fathers' exposures and inversely associated with mothers' exposures. CONCLUSIONS: The results suggest that parental exposure to certain pesticides may increase the risk of leukemia in offspring.</p>
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84.
  • Mukamal, Kenneth J, et al. (författare)
  • Coffee consumption and mortality after acute myocardial infarction : the Stockholm Heart Epidemiology Program
  • 2009
  • Ingår i: American Heart Journal. - 0002-8703 .- 1097-6744. ; 157:3, s. 495-501
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>BACKGROUND</p><p>Cohort studies have suggested little effect of coffee consumption on risk of acute myocardial infarction. The effect of coffee consumption on prognosis after myocardial infarction is uncertain.</p><p>METHODS</p><p>In a population-based inception cohort study, we followed 1,369 patients hospitalized with a confirmed first acute myocardial infarction between 1992 and 1994 in Stockholm County, Sweden, as part of the Stockholm Heart Epidemiology Program. Participants reported usual coffee consumption over the preceding year with a standardized questionnaire distributed during hospitalization and underwent a health examination 3 months after discharge. Participants were followed for hospitalizations and mortality with national registers through November 2001.</p><p>RESULTS</p><p>A total of 289 patients died during follow-up. Compared with intake of &lt;1 cup per day, coffee consumption was inversely associated with mortality, with multivariable-adjusted hazard ratios of 0.68 (95% confidence interval [CI] 0.45-1.02) for 1 to &lt;3 cups, 0.56 (95% CI 0.37-0.85) for 3 to &lt;5 cups, 0.52 (95% CI 0.34-0.83) for 5 to &lt;7 cups, and 0.58 (95% CI 0.34-0.98) for &gt; or =7 cups per day (P trend .06). Coffee intake was not associated with hospitalization for congestive heart failure or stroke. Candidate lipid and inflammatory biomarkers did not appear to account for the observed inverse association with mortality.</p><p>CONCLUSIONS</p><p>Self-reported coffee consumption at the time of hospitalization for myocardial infarction was inversely associated with subsequent postinfarction mortality in this population with broad coffee intake. If confirmed in other settings, identification of relevant mechanisms could lead to an improved prognosis for survivors of acute myocardial infarction.</p>
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85.
  • Möller, Jette, et al. (författare)
  • Work related stressful life events and the risk of myocardial infarction : Case-control and case-crossover analyses within the Stockholm heart epidemiology programme (SHEEP)
  • 2005
  • Ingår i: Journal of Epidemiology and Community Health. - 0143-005X .- 1470-2738. ; 59:1, s. 23-30
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>STUDY OBJECTIVES:</strong></p><p>Recent changes in labour market conditions and in the organisation of work in developed societies have increased exposure to work related stress. The question is whether this also implies an increased risk of myocardial infarction, either through the triggering effect of acute stress, or through accumulation of stress over several months.</p><p><strong>DESIGN:</strong></p><p>A case-control and a case-crossover study design was applied.</p><p><strong>SETTING:</strong></p><p>The Stockholm heart epidemiology programme (SHEEP), in Stockholm County during 1992 to 1994.</p><p><strong>PARTICIPANTS:</strong></p><p>Patients with a first episode of non-fatal acute myocardial infarction, a total of 1381 men and women, responded to questionnaires and participated in interviews and health examinations.</p><p><strong>MAIN RESULTS:</strong></p><p>The case-crossover analysis showed triggering effects of sudden, short term situations of increased work load or work competition. Having "had a high pressure deadline at work" entailed a sixfold increase in risk of myocardial infarction (OR = 6.0 95% CI (1.8 to 20.4)) during the next 24 hours. The importance of work related life events as risk factors for myocardial infarction was supported by the case-control analysis. However, no support was found for the hypothesis that an accumulation of stressful life events over a period of 12 months increases the risk of myocardial infarction.</p><p><strong>CONCLUSION:</strong></p><p>Specific work related stressful life events seem to be potential triggers of the onset of myocardial infarction.</p>
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86.
  • Olsson, Lisa, et al. (författare)
  • Mortality in Adult-Onset Autoimmune Diabetes Is Associated With Poor Glycemic Control Results from the HUNT Study
  • 2013
  • Ingår i: Diabetes Care. - 0149-5992 .- 1935-5548. ; 36:12, s. 3971-3978
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>OBJECTIVEKnowledge on mortality in autoimmune diabetes with adult onset is limited. We compared mortality in adult-onset autoimmune diabetes and type 2 diabetes, taking into account metabolic risk factors, HbA(1c), lifestyle, and socioeconomic factors.RESEARCH DESIGN AND METHODSParticipants of the population-based HUNT2 Study (second survey of the Norwegian HelseUndersOkelsen i Nord-TrOndelag Study; n = 64,264) were followed up prospectively for mortality in the Cause of Death Registry (1995-2009). Diabetes with onset 35 years was classified as autoimmune diabetes in adults if anti-GAD was positive (n = 208) and as type 2 diabetes if anti-GAD was negative (n = 2,425). Hazard ratios (HRs) of mortality from all-causes, cardiovascular disease (CVD), and ischemic heart disease (IHD) were calculated using the Cox proportional hazards model.RESULTSPrevalence of the metabolic syndrome was lower in autoimmune diabetes than in type 2 diabetes (55 vs. 77%, P &lt; 0.001). Still, autoimmune diabetes was associated with an increased risks of mortality from all-causes (HR 1.55 [95% CI 1.25-1.92]), CVD (1.87 [1.40-2.48]), and IHD (2.39 [1.57-3.64]), equally high as in type 2 diabetes in analyses where individuals without diabetes were used as the reference group. The increased risk was not explained by overweight, lifestyle, socioeconomic position, or presence of the metabolic syndrome. Excess mortality was primarily observed in individuals with elevated HbA(1c).CONCLUSIONSMortality in autoimmune diabetes was as high as in type 2 diabetes, despite a more favorable baseline metabolic risk profile. Excess risk was associated with poor glycemic control. The results from this study, the largest so far on mortality in autoimmune diabetes in adults, underscore the importance of optimal treatment modalities to improve survival in adult-onset autoimmune diabetes.</p>
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87.
  • Pyshchyta, Ganna, et al. (författare)
  • Tea consumption, incidence and long-term prognosis of a first acute myocardial infarction : The SHEEP study
  • 2012
  • Ingår i: Clinical Nutrition. - 0261-5614 .- 1532-1983. ; 31:2, s. 267-272
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>BACKGROUND &amp; AIMS: Results of previous studies on tea consumption and incidence or prognosis of acute myocardial infarction (AMI) are conflicting. The aim of the present study was to examine the potential role of tea consumption in the previous 12 months in primary and secondary prevention of AMI.</p> <p>METHODS: We studied a total of 1340 individuals with a first non-fatal AMI and 2303 frequency matched control participants on age, gender and hospital catchment area including querying their tea consumption over the previous 12 months. The cohort of AMI cases was then followed for total and cardiac mortality and for non-fatal cardiovascular events with national registers over 8 years. Estimates of relative risks for a first AMI were based on odds ratios from unconditional logistic regression and Cox proportional hazards models were used to examine the prognostic importance of tea consumption in the cohort of cases.</p> <p>RESULTS: The prevalence of daily tea consumption was 20.5% among cases and 21.5% among controls. Tea consumption was associated with a lower risk for a first AMI with adjustment for matching criteria alone, with an odds ratio of 0.78 (95% confidence interval, 0.64-0.95) comparing those who consumed tea daily to those never consuming tea. However, in multivariable adjusted model there was no evidence for an association, the corresponding odds ratio was 1.08(0.86-1.36). There was also no association between tea consumption and cardiac mortality and non-fatal cardiovascular events, with a corresponding adjusted hazard ratio of 0.99(0.77-1.27).</p> <p>CONCLUSIONS: In this epidemiological study, greater tea consumption in the previous year was associated with a lower risk of AMI. However, a clear association between tea consumption and the incidence or prognosis of AMI was not demonstrated, probably because of tea drinkers having a healthier lifestyle.</p>
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88.
  • Rajaraman, Preetha, et al. (författare)
  • Genome-wide association study of glioma and meta-analysis
  • 2012
  • Ingår i: Human Genetics. - 0340-6717 .- 1432-1203. ; 131:12, s. 1877-1888
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Gliomas account for approximately 80 % of all primary malignant brain tumors and, despite improvements in clinical care over the last 20 years, remain among the most lethal tumors, underscoring the need for gaining new insights that could translate into clinical advances. Recent genome-wide association studies (GWAS) have identified seven new susceptibility regions. We conducted a new independent GWAS of glioma using 1,856 cases and 4,955 controls (from 14 cohort studies, 3 case-control studies, and 1 population-based case-only study) and found evidence of strong replication for three of the seven previously reported associations at 20q13.33 (RTEL), 5p15.33 (TERT), and 9p21.3 (CDKN2BAS), and consistent association signals for the remaining four at 7p11.2 (EGFR both loci), 8q24.21 (CCDC26) and 11q23.3 (PHLDB1). The direction and magnitude of the signal were consistent for samples from cohort and case-control studies, but the strength of the association was more pronounced for loci rs6010620 (20q,13.33; RTEL) and rs2736100 (5p15.33, TERT) in cohort studies despite the smaller number of cases in this group, likely due to relatively more higher grade tumors being captured in the cohort studies. We further examined the 85 most promising single nucleotide polymorphism (SNP) markers identified in our study in three replication sets (5,015 cases and 11,601 controls), but no new markers reached genome-wide significance. Our findings suggest that larger studies focusing on novel approaches as well as specific tumor subtypes or subgroups will be required to identify additional common susceptibility loci for glioma risk.</p>
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89.
  • Ranstam, Jonas, et al. (författare)
  • ORAL CONTRACEPTIVES AND BREAST CANCER
  • 1986
  • Ingår i: The Lancet. - Elsevier. - 0140-6736. ; 328:8512, s. 922-923
  • Tidskriftsartikel (refereegranskat)
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90.
  • Romelsjö, Anders, et al. (författare)
  • Abstention, alcohol use and risk of myocardial infarction in men and women considering social anchorage and working conditions : the SHEEP case control study
  • 2003
  • Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 98:10, s. 1453-1462
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Aims </strong> Very few studies indicating that low–moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers.</p><p><strong>Design </strong> Data came from a case–control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45–70 years old.</p><p><strong>Setting </strong> Stockholm County 1992–94.</p><p><strong>Participants </strong> There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population.</p><p><strong>Measurement </strong> Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls.</p><p><strong>Findings </strong> In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50–69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1–5 g 100% ethanol/day). Men who were abstainers during the previous 1–10 years and with an earlier average consumption of 5–30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations.</p><p><strong>Conclusion </strong> Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1–10-year-long abstainers influenced the risk of MI.</p>
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