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- Carlsson, Lena M S, 1957, et al.
(author)
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Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects.
- 2012
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In: The New England journal of medicine. - : Massachusetts Medical Society. - 1533-4406 .- 0028-4793. ; 367:8, s. 695-704
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Journal article (other academic/artistic)abstract
- Weight loss protects against type 2 diabetes but is hard to maintain with behavioral modification alone. In an analysis of data from a nonrandomized, prospective, controlled study, we examined the effects of bariatric surgery on the prevention of type 2 diabetes.
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| 3. |
- Sjöström, Lars, et al.
(author)
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Bariatric surgery and long-term cardiovascular events.
- 2012
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In: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598. ; 307:1, s. 56-65
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Journal article (peer-reviewed)abstract
- Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking.
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| 4. |
- Sjöström, Lars, et al.
(author)
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Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial.
- 2009
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In: The lancet oncology. - 1474-5488. ; 10:7, s. 653-62
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Journal article (peer-reviewed)abstract
- BACKGROUND: Obesity is a risk factor for cancer. Intentional weight loss in the obese might protect against malignancy, but evidence is limited. To our knowledge, the Swedish Obese Subjects (SOS) study is the first intervention trial in the obese population to provide prospective, controlled cancer-incidence data. METHODS: The SOS study started in 1987 and involved 2010 obese patients (body-mass index [BMI] >or=34 kg/m(2) in men, and >or=38 kg/m(2) in women) who underwent bariatric surgery and 2037 contemporaneously matched obese controls, who received conventional treatment. While the main endpoint of SOS was overall mortality, the main outcome of this exploratory report was cancer incidence until Dec 31, 2005. Cancer follow-up rate was 99.9% and the median follow-up time was 10.9 years (range 0-18.1 years). FINDINGS: Bariatric surgery resulted in a sustained mean weight reduction of 19.9 kg (SD 15.6 kg) over 10 years, whereas the mean weight change in controls was a gain of 1.3 kg (SD 13.7 kg). The number of first-time cancers after inclusion was lower in the surgery group (n=117) than in the control group (n=169; HR 0.67, 95% CI 0.53-0.85, p=0.0009). The sex-treatment interaction p value was 0.054. In women, the number of first-time cancers after inclusion was lower in the surgery group (n=79) than in the control group (n=130; HR 0.58, 0.44-0.77; p=0.0001), whereas there was no effect of surgery in men (38 in the surgery group vs 39 in the control group; HR 0.97, 0.62-1.52; p=0.90). Similar results were obtained after exclusion of all cancer cases during the first 3 years of the intervention. INTERPRETATION: Bariatric surgery was associated with reduced cancer incidence in obese women but not in obese men. FUNDING: Swedish Research Council, Swedish Foundation for Strategic Research, Swedish Federal Government under the LUA/ALF agreement, Hoffmann La Roche, Cederoths, AstraZeneca, Sanofi-Aventis, Ethicon Endosurgery.
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| 5. |
- Sjöström, Lars, et al.
(author)
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Effects of bariatric surgery on mortality in Swedish obese subjects.
- 2007
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In: The New England journal of medicine. - 1533-4406. ; 357:8, s. 741-52
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Journal article (peer-reviewed)abstract
- BACKGROUND: Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality. In fact, many observational studies suggest that weight reduction is associated with increased mortality. METHODS: The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group). We report on overall mortality during an average of 10.9 years of follow-up. At the time of the analysis (November 1, 2005), vital status was known for all but three subjects (follow-up rate, 99.9%). RESULTS: The average weight change in control subjects was less than +/-2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. There were 129 deaths in the control group and 101 deaths in the surgery group. The unadjusted overall hazard ratio was 0.76 in the surgery group (P=0.04), as compared with the control group, and the hazard ratio adjusted for sex, age, and risk factors was 0.71 (P=0.01). The most common causes of death were myocardial infarction (control group, 25 subjects; surgery group, 13 subjects) and cancer (control group, 47; surgery group, 29). CONCLUSIONS: Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.
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| 8. |
- Aleman, Soo, et al.
(author)
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A Risk for Hepatocellular Carcinoma Persists Long-term After Sustained Virologic Response in Patients With Hepatitis C-Associated Liver Cirrhosis
- 2013
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In: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1537-6591 .- 1058-4838. ; 57:2, s. 230-236
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Journal article (peer-reviewed)abstract
- Background. The long-term effect of sustained virologic response (SVR) to antiviral therapy on the risk of developing hepatocellular carcinoma (HCC), liver complications, liver-related death, and overall death in hepatitis C virus (HCV)-infected patients with liver cirrhosis is not fully known. Methods. These risks were evaluated during long-term follow-up in 351 patients with HCV-related cirrhosis. One hundred ten patients with SVR, 193 with non-SVR, and 48 who were untreated were included in a multicenter cohort that was initiated in 2001 and prospectively followed up for a mean of 5.3 (SD, 2.8) years. Complementary follow-up data from national registries were used to minimize the loss of patients during follow-up. Results. Six patients with SVR developed HCC at 0.04, 0.64, 2.4, 7.4, 7.4, and 7.6 years, respectively, after achieving SVR. The incidences of HCC, any liver complication, liver-related death, and overall death per 100 person-years were significantly lower in SVR time with 1.0, 0.9, 0.7, and 1.9, compared to 2.3, 3.2, 3.0, and 4.1 in non-SVR and 4.0, 4.9, 4.5, and 5.1 in untreated time. The long-term consequences did not decline significantly after >3 years versus during the first 3 years of follow-up. Conclusions. The risk for HCC, liver decompensation, and death in patients with liver cirrhosis related to HCV was markedly reduced after SVR, but a long-term risk of developing HCC remains for up to 8 years. Cirrhotic patients with HCV who achieve SVR should therefore maintain long-term surveillance for HCC. Future studies aimed to better identify those with remaining long-term risk for HCC are needed.
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| 10. |
- Andersson, Hans, et al.
(author)
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Kungahällaprojektet - en bakgrundsteckning
- 2002
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In: Kungahälla. Problem och forskning kring stadens äldsta historia. Skrifter utgivna av Bohusläns museum och Bohusläns hembygdsförbund nr 70, Lund Studies in Medieval Archaeology nr 28. - 0280-4174 .- 0283-6874. - 9176861376 - 9176861376 - 9122019316 - 9122019316 ; , s. 9-28
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Book chapter (other academic/artistic)abstract
- Kungahälla was the southernmost town in medieval Norway. The site, now in Sweden, is about 2 kmwest of today's Kungälv. Kungahälla occupies a significant place in the oldest written sources, the Norse sagas, where we have a glimpse of the important role that the town played in early medieval Norwegian society. Opinions have been divided as to how far back this role can he taken, but there is no certain written information before the first half of the twelfth century. The written sources nevertheless tell us that royal influence over the town was considerable. Kungahälla is first mentioned as one of six civitates in Norway in 1130, by the English historian Ordericus Vitalis. Kungahalla was the site of the first monastery to be founded in Bohuslan, Kastellekioster, an Augustinian house in all probability founded in the 1160s under the auspices of Archbishop Eystein. In the latter half of the thirteenth century a Franciscan friary was also built, mentioned for the first time in 1272. An important structure is the fortress on Ragnhildsholmen in Nordre Älv, completed by 1257 At the end of the nineteenth century, Wilhelm Berg investigated the ruins of the RagnhiIdsholmen fortress and a few years later the Augustinian friary, as well as parts of the town. A small-scale investigation of the Augustinian friary also took place in 1942. In the 1950s there were excavations of the Franciscan friary, when parts of a churchyard withthe remains of a surrounding wall were documented. In addition, parts of yet another churchyard with its wall remains were investigated in 1958. There was no concerted picture of the archaeological history of the place until publication no. 29 of the Medieval Town Project. During the 1980s the possibility of conducting new archaeological investigations within the area ofthe old town arose once again. After trial digs in 1985, a programme was drawn up for a project, the main aim of which was to determine the character of Kungahälla in the period up to the thineenth-century expansion. It is reasonable to regard the investigations of Kungahälla as part of the broad range of urban investigations geared to the Early Middle Ages in Scandinavia. What makes the Kungahälla Project particularly interesting is, of course, the geographical location of the town, along with the problems associated with the concept of urbanization that the archaeological findings have clearly demonstrated.There are several circumstances in the early development which, in our opinion, make it very interesting to formulate a more ambiguous concept of urbanization than scholars have previously workedwith. Ordericus mentions a civitas in the mid-1130s, but what did it look like, and what functions did it have? Was it a town in whatever sense we mean by the concept of town? Or is it the case that urbanization can stand for a much broader process, or be a narrow part of a much broader process for which we should use some other term? In the book we present the results of the investigations, also including a couple of more analytical sections (chapters 9 and 10) which sum up the findings and try to put them in a broader context, while also providing a point of departure for continued discussion.
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