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E Arnesen

Publications and source records attributed to E Arnesen.

At least 19 recordsLinked to original sources

The South Asian cataract management study: complications, vision outcomes, and corneal endothelial cell loss in a randomized multicenter clinical trial comparing intracapsular cataract extraction with and without anterior chamber intraocular lens implantation.

OBJECTIVE: To determine clinical outcomes of primary intracapsular cataract surgery with and without implantation of anterior chamber lenses. DESIGN: A multicenter randomized clinical trial. PARTICIPANTS: One thousand two hundred twenty-nine male and female patients 40-75 years of age with senile cataract. METHODS: Study patients were recruited from screening eye camps and outpatient clinics. Randomization to the two treatment groups was performed after screening for predetermined inclusion and exclusion criteria. Demographics, visual acuity, intraocular pressures, and corneal endothelial cell data were recorded before surgery and at 6 weeks, 12 months, and 24 months after surgery. Monitoring of the study was secured by a standardized image documentation procedure on all patients using the IMAGEnet digital imaging system. Analysis of corneal endothelial cell images was performed with the Cell Soft software (Topcon Corporation, Japan). MAIN OUTCOME MEASURES: Visual acuity and central corneal endothelial cell loss. RESULTS: The patients were randomized to intraocular lens (IOL; n = 616) and no IOL (n = 613) implantation. Surgical complications were reported in 177 (14.4%) patients (IOL = 14.8%; no IOL = 14.0%). The most frequent complication observed was vitreous loss which occurred in 10.3% of eyes (IOL = 11.2%; no IOL = 9.5%). At the final examination (2 years after surgery), 88% of the operated eyes had a best corrected vision of 6/18 or better (IOL = 88.8%; no IOL = 86.6%). Analysis of corneal endothelial cell data showed a small but significantly greater cell loss 6 weeks after surgery in eyes with IOL compared with those without IOL, but no overall difference was found between the treatment groups in the long term follow-up. CONCLUSIONS: The findings indicate that there is a rationale for the use of anterior chamber intraocular lenses in primary intracapsular cataract surgery.

Adult↗

Can single-lead computerized electrocardiography predict myocardial infarction in young and middle-aged men? The Tromsø study.

BACKGROUND: In epidemiological studies, the electrocardiogram has often been interpreted by means of a categorical classification. Computerized recording offers the possibility of analysing electrocardiographic measurements as continuous variables. OBJECTIVE: To test the hypothesis that duration of QRS complex and T-wave inversion would be independent predictors of myocardial infarction. METHODS: In a population-based study, we prospectively investigated the risk of developing myocardial infarction according to duration of ORS complex and peak-to-peak T-wave amplitude measured from lead I of the 12-lead electrocardiogram by computerized electrocardiography. In total 6628 men aged 25-61 years who had not previously suffered a myocardial infarction were followed up for 3.9 years. RESULTS: Eighty-two first myocardial infarctions (55 non-fatal and 24 fatal myocardial infarctions and three sudden deaths) were identified. The risk of myocardial infarction increased with duration of ORS complex and with decreasing T-wave amplitude. A proportional hazards model with adjustment for possible confounders yielded a relative risk of myocardial infarction of 3.74 (P for linear trend 0.015) for duration of QRS complex > or = 120 ms compared with duration of QRS complex <80 ms. The multivariate relative risk for T-wave amplitude > or = 0.35 mV compared with T-wave amplitude < 0.20 mV was 0.55 (P for linear trend 0.036). When both duration of ORS complex and T-wave amplitude were included in the multivariate model, T-wave amplitude retained its predictive power, whereas duration of ORS complex became marginally no longer significant (P=0.067). CONCLUSIONS: Peak-to-peak T-wave amplitude from lead I is an independent predictor of myocardial infarction in men who have not previously suffered a myocardial infarction. Greater duration of ORS complex clearly indicates a higher risk of myocardial infarction. However, when T-wave amplitude is included as a covariate, the predictive power of duration of QRS complex does not remain significant. Single-lead electrocardiography is a feasible method for improving the assessment of the relative risk of myocardial infarction.

Adult↗

Preinfarction blood pressure and smoking are determinants for a fatal outcome of myocardial infarction: a prospective analysis from the Finnmark Study.

BACKGROUND: Serum cholesterol levels, blood pressure, and smoking are the classic coronary risk factors, but what determines whether a myocardial infarction will be fatal or not? OBJECTIVE: To investigate cardiovascular risk factors that may influence survival in subjects with coronary heart disease (myocardial infarction and sudden death). SUBJECTS AND METHODS: All inhabitants aged 35 to 52 years in Finnmark County, Norway, were invited to a cardiovascular survey in 1974-1975 and/or 1977-1978. Attendance rate was 90.5%. A total of 6995 men and 6320 women were followed up for 14 years with regard to incident myocardial infarction and sudden death. Predictors for 28-day case fatality rate after first myocardial infarction were analyzed. RESULTS: During 186 643 person-years, 635 events among men and 125 events among women were registered. The case fatality rate was 31.6% in men and 28.0% in women (P =.50). Among men (women) with baseline systolic blood pressure lower than 140 mm Hg, the 28-day case fatality rate was 24.5% (22.6%), among those with systolic blood pressure of 140 through 159 mm Hg, the case fatality rate was 35.6% (28.2%), and among those with systolic blood pressure of 160 mm Hg or higher, the case fatality rate was 48.2% (41.7%). Of the 760 subjects with myocardial infarction, 348 died during follow-up. In Cox regression analysis, systolic blood pressure at baseline was strongly related to death (relative risk per 15 mm Hg, 1.22; 95% confidence interval, 1.13-1.31). Daily smoking at baseline (relative risk, 1.40; 95% confidence interval, 1.07-1.85) and age at time of event (relative risk per 5 years, 1.12; 95% confidence interval, 1.01-1.24) were additional significant risk factors, while total serum and high-density lipoprotein cholesterol levels were unrelated to survival. Similar results were obtained with diastolic blood pressure in the model. CONCLUSIONS: Preinfarction blood pressure was an important predictor of case fatality rate in myocardial infarction. Daily smoking and age were additional significant predictors.

Adult↗

Sex differences in risk factors for clinical diabetes mellitus in a general population: a 12-year follow-up of the Finnmark Study.

The associations among obesity, height, cardiovascular risk factors, and the incidence of clinical diabetes mellitus were investigated in the Norwegian population-based Finnmark Study of 11,654 men and women aged 35-52 years at baseline in 1977-1978. A total of 87 cases of diabetes among men and 75 cases among women were registered during 12 years of follow-up. The incidence of diabetes was 1.1 per 1,000 person-years in women and 1.2 per 1,000 person-years in men, but sex-related differences in risk factors were noted. Body mass index was the dominant risk factor in men and predicted diabetes in a dose-response relation in both sexes. However, in women, the association between body mass index and diabetes was greatly attenuated after multivariable adjustment. Serum lipid concentrations were similar in prediabetic men and women; thus, prediabetic women had a relatively more adverse metabolic risk profile as compared with nondiabetics of the same sex. In multivariable analysis, high density lipoprotein cholesterol was inversely related to diabetes in women (relative risk per 0.3 mmol/liter, 0.53; 95% confidence interval 0.41-0.70) but not in men (relative risk, 0.97; 95% confidence interval 0.78-1.19). Serum glucose was a highly significant predictor in both sexes, while height was inversely related to diabetes only in women (relative risk per 5 cm, 0.71; 95% confidence interval 0.58-0.87).

Adult↗

Cardiovascular diseases and diabetes mellitus in different ethnic groups: the Finnmark study.

The mortality from coronary and cerebrovascular diseases is higher in Finnmark County than in other Norwegian counties. In a population-based cohort study, we compared the incidence of myocardial infarction, stroke, and diabetes mellitus in different ethnic groups in Finnmark. A total of 10,622 subjects of Norse, Sami, and Finnish origin were followed for 14 years. During approximately 150,000 person-years, we identified 509 and 84 cases of myocardial infarction, 107 and 75 cases of stroke, and 96 and 73 cases of clinical diabetes mellitus among men and women, respectively. A total of 533 men and 199 women died. Norse subjects born outside of Finnmark had the most favorable risk factor levels and, in general, the lowest incidence of disease. Men of Finnish origin had a higher incidence rate of all endpoints than other men, and Finnish women had a higher incidence rate of myocardial infarction than other women. Sami women were more obese but did not have a higher diabetes mellitus incidence than other women. After adjustment for major cardiovascular risk factors and height, most ethnic differences were attenuated.

Adult↗

Experimental expression in mice and spontaneous expression in human SLE of polyomavirus T-antigen. A molecular basis for induction of antibodies to DNA and eukaryotic transcription factors.

We have previously demonstrated that experimental expression of the polyomavirus transcription factor T-antigen has the potential to induce anti-DNA antibodies in mice. Two sets of independent evidences are presented here that demonstrate a biological relevance for this model. First, we describe results demonstrating that mice inoculated with T-antigen-expressing plasmids produced antibodies, not only to T-antigen and DNA, but also to the DNA-binding eukaryotic transcription factors TATA-binding protein (TBP), and to the cAMP-response-element-binding protein (CREB). Secondly, we investigated whether polyomavirus reactivation occurs in SLE patients, and whether antibodies to T-antigen, DNA, and to TBP and CREB are linked to such events. Both within and among these SLE patients, frequent polyomavirus reactivations were observed that could not be explained by certain rearrangements of the noncoding control regions, nor by corticosteroid treatment. Linked to these events, antibodies to T-antigen, DNA, TBP, and CREB were detected, identical to what we observed in mice. Antibodies recognizing double-stranded DNA were confined to patients with frequent polyomavirus reactivations. The results described here indicate that cognate interaction of B cells recognizing DNA or DNA-associated proteins and T cells recognizing T antigen had taken place as a consequence of complex formation between T ag and DNA in vivo in the context of polyomavirus reactivations.

Adrenal Cortex Hormones↗

Total mortality in people admitted to a psychiatric hospital.

BACKGROUND: The aim was to document the mortality of psychiatric patients within a service system characterised by a low beds-to-population ratio. METHOD: All patients admitted to one psychiatric hospital were followed from date of first admission after 31 July 1980 until 31 December 1992 with regard to death, by linkage to the Norwegian Central Register of Persons. Age-adjusted total mortality rates and standardised mortality ratios (SMRs) compared with the general population were computed. RESULTS: Mortality rates were highest in men, and increased with age in both sexes. SMRs were highest in the younger age-groups, and the overall SMR was significantly higher for men than for women. Mortality was highest during the first year after admission for both sexes and was higher than in the general population in all diagnostic groups. CONCLUSIONS: The mortality of psychiatric patients is still unsatisfactorily high, and men constitute a special high-risk group.

Adolescent↗

Body height, cardiovascular risk factors, and risk of stroke in middle-aged men and women. A 14-year follow-up of the Finnmark Study.

BACKGROUND: Geographical differences in stroke mortality are not fully explained by population variations in blood pressure and antihypertensive treatment. Some studies have suggested that factors connected with health and nutrition in early life may be related to stroke morbidity and mortality. Body height is a sensitive marker for socioeconomic conditions, but results are conflicting as to whether height is associated with stroke. METHODS AND RESULTS: In a population-based study, we investigated stroke incidence in relation to height and classic cardiovascular risk factors. A total of 13,266 men and women 35 to 52 years of age were followed for 14 years, and 241 first events of stroke were registered. Stroke incidence was 36% higher in men. Height was inversely related to stroke in a dose-response manner. Per 5-cm increase in height, the age-adjusted risk of stroke was 25% lower in women (P < .0001) and 18% lower in men (P = .0007). Systolic blood pressure and daily smoking were positively associated with stroke in both sexes, while serum triglyceride level was a significant risk factor in women only (relative risk per 1 mmol/L, 1.3; 95% CI, 1.1 to 1.5). The associations remained after adjustment for possible confounders and were also observed in certain subtypes of stroke. CONCLUSIONS: The results are consistent with the theory that factors influencing early growth as well as adult lifestyle factors contribute to cerebrovascular disease in adult age.

Adult↗

Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark Study.

BACKGROUND: Few epidemiological studies have investigated the relative importance of major coronary risk factors in the two sexes within the same study population. In particular, it is not clear whether smoking carries a similar risk of coronary heart disease in men and women. METHODS AND RESULTS: The associations between smoking, serum lipids, blood pressure, and myocardial infarction were examined in a population-based prospective study of 11,843 men and women aged 35 to 52 years at entry. During 12 years, 495 cases of first myocardial infarction among men and 103 cases among women were identified. Myocardial infarction incidence was 4.6 times higher among men. The incidence was increased sixfold in women and threefold in men who smoked at least 20 cigarettes per day compared with never-smokers, and the rate in female heavy smokers exceeded that of never-smoking men. Multivariate analysis identified current smoking as a stronger risk factor in women (relative risk, 3.3; 95% confidence interval [CI], 2.1 to 5.1) than in men (relative risk, 1.9; 95% CI, 1.6 to 2.3). Among those under 45 years old at entry, the smoking-related sex difference was more pronounced (in women: relative risk, 7.1; 95% CI, 2.6 to 19.1) (in men: relative risk, 2.3; 95% CI, 1.6 to 3.2). Serum total cholesterol, HDL cholesterol, and systolic blood pressure were also highly significant predictors in both sexes. CONCLUSIONS: Smoking was a stronger risk factor for myocardial infarction in middle-aged women than in men. Relative risks associated with serum lipids and blood pressure were similar despite large sex differences in myocardial infarction incidence rates.

Adult↗

Pregnancy related changes in some cardiovascular risk factors.

BACKGROUND: Certain risk factors for development of ischemic heart disease are influenced by pregnancy related changes of female sex hormone levels. METHODS: As a part of the cardiovascular risk factor studies in Finnmark county, Norway, 1974-75 and 1977-78, cross-sectional clinical and non-fasting laboratory data were obtained prior to conception (n = 463), during pregnancy (n = 335), and following delivery (n = 451). RESULTS: Compared with prepregnancy values, total cholesterol was on average 7% lower in the first trimester (p < 0.001), and 30% higher at the end of gestation (p < 0.001). High density lipoprotein cholesterol was 38% higher at mid-pregnancy (p < 0.001), but only 14% higher in the last trimester (p < 0.01). Serum triglycerides were 18% lower in the first (p < 0.001) and 123% higher in the third trimester (p < 0.001). Blood glucose was 5% lower than baseline in mid-pregnancy (p < 0.001). Except for the second trimester, when only 27% of women smoked, more than 40% of the women examined were smokers. Postpartum values were similar to prepregnancy levels, except serum triglycerides which remained 35% higher (p < 0.001) and blood glucose (p < 0.05). CONCLUSIONS: The major serum lipid fractions, and blood glucose, were significantly different during pregnancy and postpartum, which may influence the risk of cardiovascular disease development in women.

Adult↗

Serum total homocysteine and coronary heart disease.

BACKGROUND: Several studies have observed high plasma levels of homocysteine among patients with coronary heart disease (CHD). The only prospective study was based on US physicians, and concluded that homocysteine was associated with subsequent myocardial infarction (MI). However, the association was limited to those above a threshold level of homocysteine. METHODS: We conducted a nested case-control study among the 21,826 subjects, aged 12-61 years, who were surveyed in the municipality of Tromsø, Norway. Among those free from MI at the screening, 123 later developed CHD. Four controls were selected for each case. RESULTS: Level of homocysteine was higher in cases than in controls (12.7 +/- 4.7 versus 11.3 +/- 3.7 mumol/l (mean +/- SD); P = 0.002). The relative risk for a 4 mumol/l increase in serum homocysteine was 1.41 (95% confidence interval (CI): 1.16-1.71). Adjusting for possible confounders reduced the relative risk to 1.32 (95% CI: 1.05-1.65). There was no threshold level above which serum homocysteine is associated with CHD events. CONCLUSIONS: In the general population serum total homocysteine is an independent risk factor for CHD with no threshold level.

Adolescent↗

Association between heart rate and atherogenic blood lipid fractions in a population. The Tromsø Study.

BACKGROUND: Prospective epidemiological studies indicate that elevated heart rate may carry increased risk for coronary heart disease. Little is known about the relation between heart rate and serum lipid and lipoprotein concentrations in the general population. METHODS AND RESULTS: We assessed anthropometric and life-style determinants of heart rate and examined the association between heart rate and serum lipid and lipoprotein concentrations in a cross-sectional study of 9,719 men and 9,433 women 12-59 years old. Stratified and multivariate analyses were used to detect possible modification of effect and to control for confounding variables. Heart rate was positively associated with male sex and smoking, decreased with body height and physical activity, and showed a U-shaped relation to body mass index. In both sexes, there was a significant progressive increase in age-adjusted levels of total cholesterol, non-high density lipoprotein (HDL) cholesterol, and triglycerides and a decrease in HDL cholesterol with heart rate. Men with heart rate greater than 89 beats per minute had 14.5% higher non-HDL cholesterol and 36.3% higher triglyceride levels than men with heart rate less than 60 beats per minute. The corresponding differences in women were 12.5% and 22.2%. The associations remained significant when anthropometric and life-style factors were controlled for. The slopes relating total and non-HDL cholesterol level to heart rate were steeper with advancing age. CONCLUSIONS: Increases in heart rate correlate with higher levels of atherogenic serum lipid fractions in the general population. Alterations in aortic impedance and/or autonomic influences may underlie these associations.

Adolescent↗

Pattern of childbearing and mortality in married women--a national prospective study from Norway.

STUDY OBJECTIVE: The aim of the study was to investigate the effect of different pattern of childbearing on total mortality. DESIGN: A cohort study with all currently married women aged 25 years or more at the Norwegian census in 1970 with follow up to the end of 1985. Information on childbearing was obtained by questionnaires collected by enumerators. Follow up on death was found by a linkage based on the unique Norwegian identification number, between census information and the death register in the Central Bureau of Statistics. SETTING: The study was a national population survey. PARTICIPANTS: A total of 822,593 women with 11.5 million years of follow up and 112,023 deaths. MAIN RESULTS: Nulliparous women had higher mortality than parous women in all age groups. Parity showed a weak association with increasing mortality among high parous women. Lowest mortality was found for parous women with 2-4 children and a late first and last birth, adjusted for socioeconomic group by level of women's education. CONCLUSION: The findings indicate that postponed childbearing may benefit the health of women.

Adult↗

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Humans↗