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Biomedical subjects

D Mellström

Publications and source records attributed to D Mellström.

At least 55 records · Page 3Linked to original sources
PubMed1991

Cohort comparisons of dental status in the adult Swedish population between 1975 and 1981.

The aim was to describe and analyze changes in dental status in Sweden over a 6-yr period, and to establish a baseline for a subsequent investigation. Representative samples of the Swedish population in 1975, 1977, and 1981 were investigated by means of interviews. The participation rate varied between 81 and 86% and the number of participants between 11,582 and 14,964. Dental status, based on a question about natural teeth and/or removable denture(s), was analyzed in relation to demographic, socio-economic, social support and life style factors. The prevalence of edentulism in the age group 16-74 years decreased during the observation period from 12.7% to 9.9% in men and from 15.5% to 11.2 in women. Besides age, urbanization, occupation and tobacco smoking had the highest explanatory value for edentulism. The findings are discussed with respect to the increasing life expectancy and possible changes in the need and demand for dental care.

Adolescent↗
PubMed1991

Walking habits and health-related factors in a 70-year-old population.

Walking and other physical activities were studied in a representative population sample of 619 70-year-old people in the city of Gothenburg, Sweden. Walking was the most common physical activity declared, and two thirds of those without an obvious disability walked 30 min or more every day. Subjects who took a daily walk of at least 30 min had a significantly better climbing capacity, higher bone mineral content and lower concentration of blood triglycerides than subjects who walked less. Male 'walkers' had a significantly larger lung volume than 'non-walkers'. Walkers had a more positive attitude towards physical activity as well as a higher estimation of their own physical fitness than non-walkers.

Aged↗
PubMed1990

[The Svalebo program--successful rehabilitation of hip fracture patients].

The aim of the Svalebo programme is improved rehabilitation and increased home discharge of patients with hip fractures, and a better use of health care resources. The programme includes contact with the hip fracture patients at the orthopaedic clinic, a rehab programme on an outpatient basis 1-3 days a week. As a result of the programme, the role of the day hospital has become clearer and the flow of patients through the orthopaedic department has increased, the mean duration of hospitalisation having decreased by 30 per cent. In a one-year follow up of 42 patients, it was found that in many cases hip function was incompletely restored. In general, our view is that the Svalebo programme assures good care and rehabilitation of the hip fracture patient, and decreased consumption of institutional care facilities.

Activities of Daily Living↗
PubMed1990

[The standard hip--evaluation of physical function and health care utilization following hip fracture].

All 441 cases of hip fracture admitted to Sahlgrenska sjukhuset, Göteborg, during a one-year period were followed in accordance with a form developed by the Swedish Medical Research Council. Osteosynthesis was the method used in over 97 per cent of the cases. There were 336 women, mean age 80.0 (+/- 9.9) years, and 105 men, mean age 77.1 (+/- 11.8). A rehabilitation programme for non-institutionalised patients (68 per cent of the total of 441) reduced the length of stay at the orthopaedic department from 22 days to an average of 15 days in 1986, and the proportion of patients able to return home was increased from 81 per cent in 1982 to 90 per cent in 1987-88. Thus, the use of rehabilitation or nursing home facilities was reduced, and the length of stay there was reduced. The findings of the study also showed the rehabilitation to be time-consuming, and that few hip fracture patients ever regain complete pre-fracture function. Therefore it is suggested that the follow-up should be extended to cover a longer period than four months. Otherwise, the form is well designed, and its use improves the comparability of different studies.

Activities of Daily Living↗
PubMed1990

An epidemiological study of urinary incontinence and related urogenital symptoms in elderly women.

The prevalence of urinary incontinence (UI) and related urogenital symptoms (UGS) was investigated in a random sample (n = 4206) of women from the 1900-20 birth cohorts residing in the city of Göteborg. It was reported by 16.9% of the respondents that they currently had UI and by 22.7% that they had regularly suffered from this complaint at some time in their lives. The prevalence of UI increased (P less than 0.001) with rising age, from 13.9% in the 1920 birth cohort to 24.6% in the 1900 birth cohort. Over 50% of the sufferers reported daily incontinence. An objective assessment was performed in a subsample (n = 300) of the women complaining of UI. In 14 cases (4.6%) the diagnosis could not be confirmed, while in the remainder UI was classified by type as follows: stress incontinence 24%, urge incontinence 49% and mixed incontinence 27%. The number of urinary tract infections (UTI) reported by the respondents increased (P less than 0.001) with rising age. UGS such as pruritus, burning, pain and vaginal discharge were reported by 11% of the respondents. The reported frequency of local vaginal discomfort did not increase with age, unlike that of UI and UTI. Systemic or local oestrogen treatment was being received by 9.2% of the respondents.

Age Factors↗
PubMed1990

Effect of oral oestriol on vaginal flora and cytology and urogenital symptoms in the post-menopause.

The effect of oral oestriol (3 mg/day for 4 weeks followed by 2 mg/day for a further 6 weeks) on the vaginal bacterial flora, vaginal cytology and urogenital symptoms was assessed in a double-blind, placebo-controlled study in 35 women with symptoms of the urogenital oestrogen deficiency syndrome. No significant differences were observed with regard to the occurrence or severity of urogenital symptoms, vaginal pH, karyopyknotic index (KPI) or the baseline results of vaginal bacterial cultures in the 18 patients (mean age 71.6 +/- 1.0 years) treated with oestriol and the 17 women (mean age 72.6 +/- 1.4 years) who received placebo tablets. A decrease in both vaginal pH (P less than 0.001) and the proportion of faecal-type bacteria (P less than 0.05), and an increase in the KPI (P less than 0.01) and the proportion of lactobacilli (P less than 0.001) were recorded after 10 weeks of treatment with oral oestriol. At the end of the following 10 medication-free weeks all of these parameters except vaginal pH had returned to values that were not significantly altered from the corresponding baseline levels. In the patients treated with placebo no significant changes occurred in vaginal pH, KPI or the proportion of lactobacilli in vaginal cultures during the course of this study. Urogenital symptoms improved in both groups after medication (and even after the medication-free period) in relation to the baseline assessment, which reflects the latter's subjective nature.

Administration, Oral↗
PubMed1990

The prevalence of urinary incontinence and use of incontinence aids in 85-year-old men and women.

The prevalence of urinary incontinence and the use of incontinence aids was investigated in 85-year-old men and women resident in the city of Göteborg. The overall prevalence of urinary incontinence was 37.2%. Urinary incontinence was more prevalent (p less than 0.001) in women (43.2%) than men (24.0%), and in residents of a nursing home or hospital (83.9%) than in men and women living at home (29.4%). Urinary incontinence was more commonly encountered in men with neurological (p less than 0.001) and respiratory (p less than 0.05) illnesses, and in women suffering from cardiovascular (p less than 0.05), neurological (p less than 0.001) and urogenital (p less than 0.01) illnesses. Incontinence aids were used more often (p less than 0.001) by incontinent women (67.9%) then men (42.9%) living in the community, and were used by 86.4% of the incontinent men and 91.5% of the incontinent women living in an institution. Pads were the commonest form of incontinence aid used, irrespective of whether the men and women lived in the community or in an institution. Indwelling urinary catheters were used by only 2% of the 85-year-old men and women.

Aged↗
PubMed1990

Osteoporosis after long-term corticosteroid treatment of giant cell arteritis.

The mineral content of the heel bone, and signs of osteoporosis on X-ray of the spine, were evaluated in 26 patients (20 women and 6 men) with giant cell arteritis (GCA), treated with prednisolone for an average period of 5 years. The mean age was 78 years (range 66-95 years). These results were compared with those obtained from a large population study of individuals aged 72, 75, 82 and 85 years. An increase of obvious and severe spinal osteoporosis from 16 to 85% was observed in the women in the population study between the ages of 72 and 85. No additional osteoporosis that could be attributed to the cortisone treatment was found among the GCA patients. The bone mineral content was not reduced in the patients compared to the general population. We conclude that there is no justification for attempting non-steroid treatment in GCA on account of the risk of osteoporosis. Corticosteroids are the only safe treatment for prevention of complications of GCA.

Adrenal Cortex Hormones↗
PubMed1990

Dental health and functional ageing. A study of 70-year-old people.

Functional ageing, including dental health, was studied in the gerontological population study in Gothenburg. This study was based on three 70-yr-old cohorts, born in 1901-2, 1906-7, and 1911-12 (n = 1380). The Eichner index was used as a measurement of deterioration in dental state and dental functional impairment. This impairment was significantly associated with a lower capacity in cognition, visual ability, hearing ability, lung volume, heart volume, muscle strength, and bone mineral content as well as a lower self-assessment of health. A multiple regression model showed that an index of seven functional capacities was the most predictive factor for dental status independent of confounding factors such as socioeconomic factors, tobacco smoking, and the most incapacitating diseases. These associations were more marked in men and the survival rate between 70 and 79 years of age was higher among men with a well preserved dental state of the age of 70. The co-variation between impairment in dental function and other functional variables and survival indicate a common functional ageing.

Aged↗
PubMed1989

Incidence of peptic ulcer disease in Gothenburg, 1985.

OBJECTIVE: To determine the incidence and age distribution of peptic ulcer disease in adults in Gothenburg. DESIGN: Retrospective study of patients with symptoms over one year. SETTING: All gastroenterology and x ray departments. PATIENTS: Any patient found to have an active ulcer crater during 1985. MAIN OUTCOME MEASURES: Sex, age, past history of gastrointestinal ulcers, and smoking habit. RESULTS: In 1985, 1402 peptic ulcers were diagnosed in 1137 adults. Over half (403; 54%) of the ulcers in men and 393 (60%) ulcers in women were in patients aged over 60. All types of ulcer showed increasing incidence with age. The sex ratio of patients aged 40-50 with peptic ulcers was 1:1. Nearly half (109; 48%) of ulcers diagnosed for the first time in men and 129 (57%) of such ulcers in women were in patients aged over 60. Elderly men and women were also more likely to develop haemorrhage. CONCLUSIONS: In Gothenburg there is a surprisingly high incidence of peptic ulcer disease, which increases considerably with age, possibly explained by the availability of modern diagnostic techniques as 1121 (80%) ulcers had been diagnosed by gastroscopy. Compared with earlier studies there was no difference in the incidence between men and women aged 40-50.

Adult↗
PubMed1989

Neurological examination of elderly women under investigation for urinary incontinence.

A random sample of 6,000 women from the birth cohorts 1900-1920 were invited to participate in an investigation of urinary incontinence by completing and returning an enclosed questionnaire. Of the 4,206 women who returned the completed questionnaire, 677 (16.9%) complained of urinary incontinence and accepted an invitation to be examined and treated at our clinic. The first 150 consecutive patients recruited via this questionnaire who attended the clinic underwent a detailed neurological examination. The prevalence of neurological signs amongst this group of women was low, only 2% were considered to have a focal encephalopathy, 1% had an organic brain syndrome, 2% had a myelopathy and a further 1% were considered to have a polyneuropathy. There was no significant difference in the prevalence of neurological signs between the group of women with urinary incontinence and an age-matched control group from the total population. Thus, urinary incontinence in an unselected population of elderly women appears to be mainly dependent on other aetiological factors rather than neurological dysfunction.

Aged↗
PubMed1988

Special health services--an introduction to a programme for elderly women with urinary incontinence and related symptoms.

Urinary incontinence and related urogenital symptoms can be considered to constitute a concealed yet widespread disease amongst elderly women. The problems are to a large extent related to hormonal changes associated with the ageing process. The symptoms have been reported to occur in more than 50% of elderly women. Like severe angina pectoris, osteoarthrosis of the hip and cataract, urinary incontinence and related symptoms may negatively influence the quality of life and reduce the individual's degree of independency. A health care programme, based on an algorithmic model, for the investigation and treatment of urinary incontinence and related symptoms is described. A representative sample of elderly women aged 65-85 yr suffering from urogenital symptoms are currently participating in this programme. The aim is to cure or alleviate urogenital symptoms amongst the elderly women concerned and to assess the value of the programme from a cost-benefit point of view.

Aged↗
PubMed1988

Oral cancer after surgery for peptic ulcer.

Oral cancer was studied in a population of 3435 which constituted all persons who were operated upon because of peptic ulcer in Gothenburg 1952-61. This population formed a data base which was coordinated with the National Cancer Register and the Register of Causes of Deaths in Sweden. The expected number of oral cancers was 7.7 and the observed number was 17 (P less than 0.01). In gerontologic population studies of the elderly in Gothenburg it was shown that 70-yr-old men with a history of peptic ulcer surgery more often were tobacco smokers, edentulous and more often had sideropenic and megaloblastic anemia and also had a lower bone mineral content.

Aged↗
PubMed1988

Gallstones and previous cholecystectomy in 77- to 78-year-old women in an urban population in Sweden.

A randomly selected sample of 120 women, born in 1906-1907 and living in the city of Gothenburg, were invited to an ultrasound examination for gallstone disease. One hundred and nine subjects participated in the study, and among these, 24% gave a history of a previous cholecystectomy, 27% had gallstones, and 49% had no stones in the gallbladder. Among the women with stones in the gallbladder only 35% had associated symptoms. The design of the study enabled a comparison among women with no stones in the gallbladder, with gallstones, and with a previous cholecystectomy. Women with gallstones, previous or present, had a higher body weight, body mass index, skinfold thickness, and serum triglyceride level than subjects without gallstones.

Aged↗