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- Lindahl, B Ingemar B
(författare)
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Selection of the principal cause of death : studies on the basis of mortality statistics for rheumatoid arthritis
- 1985
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The official statistics of Sweden for 1971-75 show a 2.7-fold increase in mortality for men and a 3.0-fold increase for women attributed to rheumatoid arthritis (RA) as the underlying cause of death. In order to investigate the basis of this observed increase, all death certificates for 1971 and 1975 with a diagnosis of RA (N=1224) were studied. All information was re-coded according to the original entry on the death certificates. The aims of the study were to seek an explanation of the observed increase by investigating the National Central Bureau of Statistics' (NCBS) registration procedure, and to identify inadequacies in the completion of death certificates and major interpretation problems facing the certifiers and coders in the reporting and registration of the causes of death. The investigation showed that the observed increase was due to changes in the NCBS' registration procedure: An increased tendency by the NCBS to favour RA in the registration of the underlying cause of death even when RA was not reported as the underlying cause on the death certificates. Physicians had reported a slight decrease for men and practically no change at all for women between the years when RA was considered the underlying cause of death. The major inadequacies identified on the certificates were (1) an inadequate causal sequence, (2) diagnoses making the conditions difficult or impossible to code, (3) more than one diagnosis for each link in the causal sequence leading to death, and (4) an underlying condition not stated in accordance with other provisions of the official WHO instructions. The NCBS was found to have registered RA as the underlying cause instead of physicians' stated underlying condition (i) when RA was likely to have caused the stated underlying condition, (ii) when the non-RA diagnosis was the only entry in part I of the certificate and rendered an incomplete description of the fatal course of events, (iii) when the non-RA condition could only be classified by a rest-category code of the International Classification of Diseases (ICD), and (iv) when the non-RA condition was considered 'trivial'. The NCBS' increased registration of RA as the underlying cause of death in the period examined could not be explained by inadequately made out death certificates, nor by a strict application of the rules for coders on selection of the underlying cause of death issued in the ICD. Several interpretation problems were identified of significance to cause-of-death statistics in general and different interpretations were discussed. Some of these problems were caused by inadequacies on the certificates. Others concerned incompleteness, ambiguities, and manifold meanings of the basic concepts and rules governing the reporting and registration of causes of death.
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- Lindahl, G, et al.
(författare)
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Receptor for IgA in group A streptococci : cloning of the gene and characterization of the protein expressed in Escherichia coli
- 1989
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Ingår i: Molecular Microbiology. - : Wiley. - 0950-382X .- 1365-2958. ; 3:2, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- The gene for an IgA-binding protein from a group A streptococcal strain was cloned and expressed in Escherichia coli. The IgA-binding protein, called protein Arp, was purified on IgA-Sepharose, allowing complete purification in a single step. Analysis of protein Arp by Western immunoblotting demonstrated a major IgA-binding band, with an apparent molecular weight of 42 kD. The purified protein was shown to bind serum IgA and secretory IgA, as well as monoclonal IgA of both subclasses. There was no binding to IgM, IgD or IgE, but a weak binding to IgG. Inhibition experiments with whole bacteria indicated that IgA and IgG bind at separate sites. Experiments with immunoglobulin fragments showed that protein Arp binds to the Fc region of both IgA and IgG. The equilibrium constant of the reaction between protein Arp and polyclonal human IgA was determined to be 5.6 x 10(8) M-1. Amino acid sequencing of protein Arp demonstrated a direct repeat of 7 amino acids in the NH2-terminal region, a feature previously found in several streptococcal M proteins. This suggests that protein Arp, like M proteins, may be a streptococcal virulence factor.
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- Olsson, H., et al.
(författare)
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Permanent alterations induced in plasma prolactin and estrogen receptor concentration in benign and malignant tissue of women who started oral contraceptive use at an early age
- 1987
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Ingår i: Anticancer research. - 0250-7005. ; 7:4 B, s. 853-856
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Tidskriftsartikel (refereegranskat)abstract
- In 65 young women undergoing curettage for benign utrine disorders a signicicant relationship was found between early oral contraceptive use (starting age<25 years) and a high ratio of ln plasma prolactin versus ln estrogen receptor concentration of the uterine mucosae (p<0.047, Mann-Whitneys U-test). Year of birth, age at menarche, age at first full term pregnancy, parity, menstrual cycle phase and duration of oral contraceptive use could not explain the results. Because similar results have previously been found for breast cancer patients using plasma prolactin and breast tumour estrogen receptor concentration, the findings indicate that early oral contraceptive use permanently alters plasma prolactin levels and estrogen receptor concentration, both in benign uterine tissue and in malignant breast tumours.
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