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Biomedical subjects

E Trell

Publications and source records attributed to E Trell.

143 records · Page 8Linked to original sources
PubMedDate not supplied

Influence of carboxyhemoglobin, gamma-glutamyl-transferase, body weight, and heart rate on blood pressure in middle-aged men.

Carboxyhemoglobin (COHb%) and gamma-glutamyl-transferase (GGT) are indicators of tobacco and alcohol consumption; similarly, body weight broadly reflects dietary habits. Relationships between COHb%, GGT, relative body weight, heart rate and blood pressure were studied in 242 48-year-old men attending a general health screening program in Malmö, Sweden. All were without treatment for high blood pressure. Positive correlations were found between blood pressure and body weight, GGT, and pulse, and a reciprocal correlation between blood pressure and COHb%. Use of objective markers for known or suspected risk factors, such as alcohol consumption, smoking, or overweight, were studied to elucidate their usefulness for further prospective studies.

Alcohol Drinking↗
PubMedDate not supplied

Arylhydrocarbonhydroxylase inducibility and smoking habits in patients with laryngeal carcinomas.

There is considerable evidence that the inducible enzyme aryl hydrocarbon hydroxylase (AHH) plays an important role in the activation of polycyclic aromatic hydrocarbons (PAH) to ultimate carcinogens. In man, a genetic heterogeneity of AHH inducibility has been demonstrated, and correlated to susceptibility to bronchogenic carcinomas following exposure to PAH. We assessed AHH inducibility in a control group of 102 healthy Swedish citizens and in 41 patients with laryngeal carcinomas. Frequencies of the three phenotypes of high, intermediate and low AHH inducibility in our control group; 8.8%, 42.2% and 49%, respectively, did not differ significantly from frequencies found in a white US population. In the laryngeal carcinoma group, there was a statistically highly significant overrepresentation of patients with high AHH inducibility, 36.6%, whereas 43.9% had an intermediate and 19.5% a low level. Most of the patients were heavy smokers. These findings add further support to the concept that susceptibility to PAH-induced carcinomas is associated with high levels of inducible AHH activity.

Aged↗
PubMedDate not supplied

Cross-sectional assessment and subgroup comparison of functional disability in patients with rheumatoid arthritis in a Swedish health-care district.

A cross-sectional study was undertaken on 222 patients with rheumatoid arthritis (RA) within a Swedish health-care district. An exploratory analysis of functional status, according to a Swedish version of the Health Assessment Questionnaire (HAQ), was carried out in order to explore the extent and pattern of functional disability in an unselected group of individuals with RA. The mean score of functional disability according to HAQ increased with more clinical manifest disease. There were no significant differences between the mean score in men and women. Most functional disability was related to hand-grip function and the ability to take care of personal hygiene. Increased functional disability was significantly associated with increasing age and disease duration. There was no significant relation between functional status and housing condition and educational level. A strong correlation was found between pain and functional disability. Multiple regression analysis was performed and predictive functional scores were tabulated based upon sex, age at onset and duration of RA disease.

Activities of Daily Living↗
PubMedDate not supplied

MCHS: an application software for family welfare programmes.

At the level of first contact, a primary health care centre, information management is an unwieldy task, therefore health information systems are reported to be inadequate and weak. Microcomputers could improve information management at this level, but there is little success due to a lack of specialized application software. In this paper we describe software developed after a multi-centre systems analysis study, on an essential data set, to support the delivery of the public health programmes for family welfare, i.e. maternal health care, family planning and immunization programmes. The modular approach was taken to develop a common application software for information management use at multiple sites. The software is tested in a laboratory mode by retrospective data entry from sites in Sweden and in India. All the information could be entered and site-specific reports that were generated are compared. The software provided a common data collection format, an essential platform for outcomes research.

Adolescent↗
PubMedDate not supplied

Towards an essential data set for ambulatory otorhinolaryngological care in general practice.

In order to optimize otorhinolaryngological ambulatory care provision and quality assurance in the general practice services there is a need for interdisciplinary consensus on the conditions, the quantitative and qualitative criteria of diagnosis and outcome as well as other standards that apply to such a partnership. We report on the core, or essential set, of data involved herein, as derived from an information modelling study of the literature and a formalized agreement between the public primary health care and specialist otorhinolaryngology organizations in Sweden. We find that the identified essential data set constitutes a compact common taxonomy, term register, or thesaurus, an ordered survey of which provides the necessary performance and quality assurance support. This points to a computerized method of mediation. The essential data set for otorhinolaryngology in general practice thus corresponds to the notion of a basic minimal data set as outlined by the World Health Organization to be one of the requisites for the successful realization of the distinct components of the Health for All by the Year 2000 programme at the local level.

Data Collection↗
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Essential data set for computer management of distributed primary care services.

Reported here is a personal computer-based registration program of medical consultations in general practice that has been implemented in six communities ('primary health care districts'; total population 112623) in the county of Jönköping, southern Sweden. The program enabled decentralized monitoring and management of the primary health care organization in the communities. The objective of the present paper is to give, from one year's experience of about 137000 recorded visits, a broad overview of the program structure, briefly considering the questions associated with routine registration of medical consultations, to discuss how the system is used for decision and steering support as well as to summarize its overall performance, results and costs in relation to the general utility of accurate information on health service delivery and consumption in the population.

Computer Communication Networks↗
PubMedDate not supplied

Unwinding Ariadne's thread: some methodological and interpretative considerations on international hospital admission comparisons, with special reference to cancer.

Hospital utilisation rates comprise the main available source of information on morbidity patterns and the need for health care in a number of developing countries. On the basis of the findings of a Greek-Swedish comparison of somatic hospital admission (presented per the 18 principal head groups of the International Classification of Diseases) between two regional University hospitals, a number of important findings and methodological questions are considered. Factors that can explain the large variations of hospital admission found are examined; in particular those related to disease definition, classification and coding, hospital services supply, professional behavior and practices, illness behavior of patients, and demographic and socio-economic characteristics but especially a true difference in morbidity. An additional statistical elaboration of the hospitalization data in the form of a logistic regression analysis is suggested, in particular at the district or regional level. However, after rigorous scrutiny, our data point to persistent remarkable differences at the respective sites in the major "welfare-related" population diseases, notably, cancer and cardiovascular diseases.

Accidents↗
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Relation between aryl hydrocarbon hydroxylase inducibility, serum gamma-glutamyltransferase and serum cholesterol in middle-aged smokers and non-smokers.

Aryl hydrocarbon hydroxylase (AHH) inducibility, carbon monoxide in expired air (CO), serum gammaglutamyl-transferase (GGT), and total cholesterol were compared in equal-sized, age-matched samples of healthy middle-aged males born in 1921, 1934-1936, and 1946 attending the ongoing preventive medical population program in Malmö. AHH did not differ in various age - and smoking or non-smoking groups, and there were no correlations between AHH, GGT, and cholesterol. The findings provide evidence against the recent hypothesis that low cholesterol may mediate or reflect a carcinogenic mechanism through a state of general enzyme induction in the body.

Aryl Hydrocarbon Hydroxylases↗
PubMedDate not supplied

Smoking, carboxyhaemoglobin, carbon monoxide in expired air and aryl hydrocarbon hydroxylase inducibility. A cross-sectional study and anti-smoking applications in middle-aged men.

In this cross-sectional study we report on the distributions of carboxyhaemoglobin in blood (COHb%), carbon monoxide in expired air (CO), and aryl hydrocarbon hydroxylase (AHH) inducibility in age-matched samples of males born 1934-36 and 1921, attending our ongoing preventive medical health screening program in Malmö. Both COHb% and CO showed great interindividual variations in the smokers; potentially of value as a complement to smoking history to identify smokers at high risk of tobacco-related diseases. They also provide powerful arguments for quitting smoking. Therefore, CO is now measured and discussed by the nurses as part of the screening investigation in all smokers. Neither COHb% nor CO showed correlations to the AHH induction levels. There were no associations between the latter and the smoking category, which supports that AHH inducibility is under genetic control. However, high AHH induction in smokers implies an increased risk of smoking-induced carcinogenesis. Smokers with high AHH inducibility identified in the screening have, therefore, been invited to antismoking information and counselling.

Aryl Hydrocarbon Hydroxylases↗
PubMedDate not supplied

Low cholesterol level as risk factor for noncoronary death in middle-aged men.

Eighty-six deaths occurred zero to five years (mean, 2.5 years) after the screening investigation in 10,000 middle-aged men in Malmö, Sweden. The men were 47 to 50 years old at the time of the screening and represented 75% of their total birth-year cohorts in Malmö. The mortality showed two peaks, one at the higher end of the cholesterol distribution and the other and more pronounced one at the lower end of the cholesterol distribution. The first peak corresponded to the cardiovascular deaths while the second peak corresponded to the noncoronary death causes, including alcohol-related deaths.

Accidents↗
PubMedDate not supplied

Hospital admissions for different cancer diagnosis: a comparison between two European landscapes.

Cancer frequency has been studied in a Department of Crete and a Department of Sweden, using in-patient data collected in the Departmental Hospitals, for a two-year period. The results of the study suggest that similar trends exist in the prevalence of different forms of cancer between the two areas studied, as well as some significant differences. The differences observed concern mainly the frequency of cancers of the lung, prostate, bladder and large bowel among men and breast and large bowel among women. These findings could to a great extent be explained by life-style and environmental differences between the two areas and are consistent with data concerning the cancer mortality in the two countries.

Adolescent↗
PubMedDate not supplied

Differential cancer morbidity towards year 2000 in a population disease outlook across Europe.I. The female gender.

Modern health system research emphasises the transition from mortality statistics via morbidity and risk factors observations to comparative site explorations in defined areas. The health of women from the perspective of their gender has become a priority in medical research over the last decade. Studies of morbidity have been called for as necessary intermediary stage for hypothesis generation, and the formulation and inception of epidemiological projects which are recognized as essential for attaining knowledge on the factors and circumstances that determine diseases and wellbeing in the general population. This applies especially to cancer, where the importance of seeing disease, from a ecological, cultural as well as gender context is evident. We made a comparative analysis of the hospitalization for somatic diseases during 1986-1987 at the Heraklion University Hospital on Crete, and the commensurable Linköping University Hospital in the country of Ostergötland, Sweden. They are representative of their complementary Europian situations and comprise the total hospital admissions in their regions. Large differences were found, notably regarding both cardiovascular diseases and cancer, with lower morbidity in the more 'arcadian', rural circumstances. The results provide unique data on traits and patterns intermediate to the pioneering observations of the Seven Countries survey on the rapidly changing European scene. In the field of cancer the data are effectively unmatched both as raw data and as a platform for further investigation, which we are presently pursuing under the emblem of 'Ariadne's thread'. From a salutogenetic point of view the elderly rural women on Crete, and from a pathogenetic point of view the elderly urban women in Linköping warrant particular attention.

Adolescent↗
PubMedDate not supplied

Differential cancer morbidity towards year 2000 in a population disease outlook across Europe. II. The male gender.

The conception of new, 'avoidable' life style diseases in affluent Western societies is largely based upon observations in groups of middle-aged urban males with mortality as the major end-point. This applies to cancer, too, and studies of morbidity, where cancer is put within the overall disease spectrum, are called for as a necessary intermediary stage for hypothesis generation and initiation of evaluative and interventive epidemiological projects in the community. Here also the conditions and circumstances that determine health and well being, that is, salutogenetic factors, come increasingly into focus. We made a comparative analysis of the total hospitalization for somatic diseases during 1986-1987 at the Linköping University Hospital in the county of Ostergötland, Sweden and the both complementary and commensurable Heraklion University Hospital on Crete. They are representative of their respective European situations, and are the only somatic hospitals in their regions. Large differences were found with lower morbidity in the more 'Arcadian', rural settings. The results provide valuable data on traits and patterns between earlier surveys such as the Seven Countries study and today. We have earlier reported on the findings from the female group of the two populations, and here wish to concentrate on the males. In particular, cancer is compared with the both prominent and 'archetypical' forms of male ill-health that are comprised by cardiovascular diseases and accidents. We discuss some of the salutogenetic as well as pathogenetic factors that call for closer study in the next stage of our project, whose emblem of Ariadne's thread we feel also has a strong bearing on the masculine gender.

Adolescent↗