| 1. |
- Bergh, Cecilia, 1972-, et al.
(författare)
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Severe infections and subsequent delayed cardiovascular disease
- 2017
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 24:18, s. 1958-1966
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe infections in adulthood are associated with subsequent short-term cardiovascular disease. Whether hospital admission for sepsis or pneumonia is associated with persistent increased risk (over a year after infection) is less well established.Design: The design of this study was as a register-based cohort study.Methods: Some 236,739 men born between 1952-1956 were followed from conscription assessments in adolescence to 2010. All-cause cardiovascular disease ( n = 46,754), including coronary heart disease ( n = 10,279) and stroke ( n = 3438), was identified through national registers 1970-2010 (at ages 18-58 years).Results: Sepsis or pneumonia in adulthood (resulting in hospital admission) are associated with increased risk of cardiovascular disease in the years following infection. The risk is highest during the first year after the infection, with an adjusted hazard ratio (and 95% confidence intervals) of 6.33 (5.65-7.09) and a notably increased risk persisted with hazard ratios of 2.47 (2.04-3.00) for the second and 2.12 (1.71-2.62) for the third year after infection. The risk attenuated with time, but remained raised for at least five years after infection; 1.87 (1.47-2.38). The results are adjusted for characteristics in childhood, cardiovascular risk factors and medical history in adolescence. Similar statistically significant associations were found for coronary heart disease and stroke.Conclusions: Raised risks of cardiovascular disease following hospital admission for sepsis or pneumonia were increased for more than five years after the infection, but with the highest magnitude during the first three years following infection, suggesting a period of vulnerability when health professionals and patients should be aware of the heightened risk for cardiovascular disease.
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| 2. |
- Kennedy, Beatrice, 1982-, et al.
(författare)
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Stress resilience and cancer risk : a nationwide cohort study
- 2017
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Ingår i: Journal of Epidemiology and Community Health. - London, UK : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 71:10, s. 947-953
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stress resilience is recognised as a determinant of both psychiatric and somatic health, but the potential link between stress resilience and cancer development has not been explored.Methods: In this nationwide cohort study, we examined the association between stress resilience in adolescence and subsequent cancer risk. We identified a cohort of 284 257 Swedish men, born 1952-1956, who underwent compulsory military enlistment examinations including measures of psychological stress resilience (median age 18 years). The resulting score was categorised as low, moderate and high stress resilience. Individuals diagnosed with cancer during the follow-up time were identified through data linkage to the Swedish Cancer Register.Results: Lowest stress resilience, compared with the highest, was associated with increased risks of liver (HR: 4.73, 95% CI 2.73 to 8.19) and lung (HR: 2.75, 95% CI 2.02 to 3.74) cancer after adjusting for markers of socioeconomic circumstances in childhood (p for trend <0.001 for both cancer types). Further adjustment for cognitive and physical fitness at conscription assessment had a marginal influence. In contrast, men with low stress resilience had a decreased risk of being diagnosed with prostate cancer (HR: 0.65, 95% CI 0.56 to 0.76) and malignant melanoma (HR: 0.65, 95% CI 0.55 to 0.76).Conclusion: We conclude that adolescent stress resilience, plausibly by influencing behavioural choices and social patterns, constitutes an important determinant of adult cancer occurrence. Increased awareness of longterm consequences in susceptible individuals may help direct future efforts to reduce cancer burden in adults.
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| 3. |
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| 4. |
- Montgomery, Scott, 1961-, et al.
(författare)
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Sex of older siblings and cognitive function
- 2017
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Konferensbidrag (refereegranskat)abstract
- Background : Number of older siblings is associated with lower cognitive function, possibly as marker of material disadvantage. Sex differences may signal an influence of inter-sibling interactions.Methods: The study used a national Swedish register-based cohort of men (n=644,603), born between 1970 and 1992 who undertook military conscription assessments in adolescence that included cognitive function measured on a normally-distributed scale of 1-9. Associations with siblings were investigated using linear regression.Results: After adjustment for numbers of younger siblings, year of conscription assessment, age/year of birth, sex, European socioeconomic classification for parents and maternal age at delivery; the regression coefficients (and 95% confidence intervals) for cognitive function are -0.26 (-0.27, -0.25), -0.42 (-0.44, -0.40), and -0.72 (-0.76, -0.67) for one, two and three or more male older siblings, respectively, compared with none; and -0.22 (-0.23, -0.21), -0.39 (-.41, -0.37), -0.62 (-0.67, -0.58) for one two and three or more female older siblings, respectively, compared with none. A larger number of younger siblings is not associated with lower cognitive function in the adjusted model.Conclusions: Family size is associated with cognitive function: older male siblings may have greater implications than females due to their demands on familial resources or through inter-sibling interactions.
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| 5. |
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| 6. |
- Mota Garcia, Teresa, et al.
(författare)
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Acne in late adolescence is not associated with a raised risk of subsequent malignant melanoma among men
- 2017
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Ingår i: Cancer Epidemiology. - : Elsevier. - 1877-7821 .- 1877-783X. ; 51, s. 44-48
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To evaluate the association of acne in late adolescence with the risk for subsequent malignant melanoma (MM) in men.METHODS: Swedish register-based cohort study of 242,096 males born between 1952 and 1956, who took part in compulsory assessments for Swedish military conscription in late adolescence between 1969 and 1975, with subsequent diagnoses of MM (n=1,058) up to December 31, 2009. Covariates included measures of childhood circumstances and information from adolescence on presence of acne, physical fitness, cognitive function, body mass index (BMI), and a summary of diagnoses. Cox regression was used for the analysis.RESULTS: In total 1,058 men were diagnosed with MM. Acne was not associated with subsequent MM, with an adjusted hazard ratio (and 95% confidence interval) of 0.95 (0.61 to 1.49). Men with parents who were agricultural workers, and men who lived in northern Sweden, had lower physical fitness, or lower cognitive function had a lower risk of MM. Overweight and obesity was associated with a raised risk, with an adjusted hazard ratio of 1.39 (1.14, 1.71).CONCLUSIONS: Acne in late adolescence is unlikely to represent a raised risk for subsequent MM in men. Overweight or obesity was identified as a raised risk for MM, possibly due to the associated increased skin surface area.
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| 7. |
- Sundin, Per-Ola, 1971-, et al.
(författare)
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Measured glomerular filtration rate does not improve prediction of mortality by cystatin C and creatinine
- 2017
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Ingår i: Nephrology, Dialysis and Transplantation. - : Oxford University Press. - 0931-0509 .- 1460-2385. ; 32:4, s. 663-670
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cystatin C may add explanatory power for associations with mortality in combination with other filtration markers, possibly indicating pathways other than glomerular filtration rate (GFR). However, this has not been firmly established since interpretation of associations independent of measured GFR (mGFR) is limited by potential multicollinearity between markers of GFR. The primary aim of this study was to assess associations between cystatin C and mortality, independent of mGFR. A secondary aim was to evaluate the utility of combining cystatin C and creatinine to predict mortality risk.Methods: Cox regression was used to assess the associations of cystatin C and creatinine with mortality in 1157 individuals referred for assessment of plasma clearance of iohexol.Results: Since cystatin C and creatinine are inversely related to mGFR, cystatin C - 1 and creatinine - 1 were used. After adjustment for mGFR, lower cystatin C - 1 (higher cystatin C concentration) and higher creatinine - 1 (lower creatinine concentration) were independently associated with increased mortality. When nested models were compared, avoiding the potential influence of multicollinearity, the independence of the associations was supported. Among models combining the markers of GFR, adjusted for demographic factors and comorbidity, cystatin C - 1 and creatinine - 1 combined explained the largest proportion of variance in associations with mortality risk ( R 2 = 0.61). Addition of mGFR did not improve the model.Conclusions: Our results suggest that both creatinine and cystatin C have independent associations with mortality not explained entirely by mGFR and that mGFR does not offer a more precise mortality risk assessment than these endogenous filtration markers combined.
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| 8. |
- Udumyan, Ruzan, 1971-, et al.
(författare)
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Beta-Blocker Drug Use and Survival among Patients with Pancreatic Adenocarcinoma
- 2017
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Ingår i: Cancer Research. - : American Association for Cancer Research Inc.. - 0008-5472 .- 1538-7445. ; 77:13, s. 3700-3707
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Tidskriftsartikel (refereegranskat)abstract
- Preclinical studies have suggested that beta-adrenergic signaling is involved in pancreatic cancer progression. Prompted by such studies, we investigated an association between beta-blocker drug use with improved cancer-specific survival in a large, general population-based cohort of patients with pancreatic ductal adenocarcinoma (PDAC). All patients diagnosed with a first primary PDAC in Sweden between 2006 and 2009 were identified through the Swedish Cancer Register (n = 2,394). We obtained information about use of beta-blockers and other medications through linkage with the national Prescribed Drug Register. Cancer-specific mortality was assessed using the Swedish Cause of Death Register. We used multivariable Cox regression adjusted for sociodemographic factors, tumor characteristics, comorbidity score, and other medications to estimate HRs and 95% confidence intervals (CI) for cancer-specific mortality associated with beta-blocker use during the 90-day period before cancer diagnosis. A total of 2,054 (86%) died, with pancreatic cancer recorded as the underlying cause of death during a maximum of 5-year follow-up (median 5 months). Patients who used beta-blockers (n = 522) had a lower cancer-specific mortality rate than nonusers (adjusted HR, 0.79; 95% CI, 0.70-0.90; P < 0.001). This observed rate reduction was more pronounced among patients with localized disease at diagnosis (n = 517; adjusted HR, 0.60; 95% CI, 0.43-0.83; P = 0.002), especially for users with higher daily doses (HR, 0.54; 95% CI, 0.35-0.83; P = 0.005). No clear rate differences were observed by beta-blocker receptor selectivity. Our results support the concept that beta-blocker drugs may improve the survival of PDAC patients, particularly among those with localized disease.
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| 9. |
- Ugge, Henrik, 1987-, et al.
(författare)
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Asthma and allergy in adolescence and risk of prostate cancer
- 2017
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 51:Suppl. 220, s. 20-20
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The role of inflammation in prostate cancer has been widely discussed [1]. Exploring the association between immunological or inflammatory conditions, that reflect immune response profile, and prostate cancer risk may provide clues to the type of inflammatory processes involved in the etiology of prostate cancer. Asthma and allergic conditions have been suggested to reduce the risk of prostate cancer, but data from large studies are currently scarce and results are conflicting [2,3].Objectives: To test if asthma, hay fever, or any allergic condition present in adolescence is associated with a decreased risk of prostate cancer later in life.Methods: This study is based on a cohort of 243,309 men born in Sweden between 1952 and 1956 who underwent mandatory conscription assessments for military service around ages 18-19 years. At this time, a thorough assessment of the men’s health was performed, and conditions such as asthma, hay fever, and allergies were recorded. The cohort was followed for incident prostate cancer through linkage with the Swedish cancer- and population registers. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the selected conditions and prostate cancer incidence.Results: A total of 1,654 men were diagnosed with prostate cancer during a maximum of 40.3 years of follow-up (median 36.7 years). At the time of conscription assessment, there were 11,754 men with hay fever, 4,943 with an asthma-diagnosis and 16,112 with any allergic condition. We observed no difference in prostate cancer risk for men with asthma (HR: 0.91, 95% CI: 0.63-1.3), hay fever (HR: 1.03, 95% CI: 0.82-1.28) or any allergic condition (HR: 0.98, 95% CI: 0.8-1.19) compared with men without these diagnoses. Small numbers precluded separate analyses of men with advanced or lethal prostate cancer (n¼6 andn¼3, respectively).Conclusion: Our results do not support the hypothesis that presence of asthma or allergic conditions in late adolescence reduces the risk of prostate cancer later in life. If inflammatory processes are involved in the pathogenesis of prostate cancer, the immune response profiles likely differ from those reflected in clinical diagnoses of asthma or allergic conditions. The possibility that different risk patterns may be observed among older men with advanced or lethal prostate cancer, however, cannot be excluded.
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