PubMed Health⌕ Search

Biomedical subjects

I Branehög

Publications and source records attributed to I Branehög.

At least 19 recordsLinked to original sources
PubMed1998

Hypertension and long-term cancer incidence and mortality among Swedish men.

OBJECTIVE: To examine incidence of cancer and cancer mortality in relation to high blood pressure. DESIGN: A longitudinal study of middle-aged men from a random population sample. SETTING: Göteborg, Sweden. SUBJECTS: We studied 7396 men aged 47-55 years without diagnosed cancer at baseline (1970-1973). MAIN OUTCOME MEASURES: Incidence of cancer and mortality from cancer. RESULTS: By the end of December 1992, 1401 men had been diagnosed with cancer at any site and 651 had died from cancer. Of the men in the highest fifth of the systolic blood pressure distribution (above 166 mmHg) 126 per 10000 observation years were diagnosed with cancer at any site, compared with 91 per 10000 in the lowest fifth [below 130 mmHg; relative risk after adjustment for age, smoking, body mass index, treatment for hypertension and leisure time physical activity 1.41 (95% confidence interval 1.19-1.68); P for trend 0.0001]. Of men in the highest fifth, 55 per 10000 observation years died from cancer, compared with 42 in the lowest [adjusted relative risk 1.41 (1.09-1.82); P for trend 0.01]. Several types of tumour tended to be more common among men with hypertension, but only genito-urinary cancers [age-adjusted relative risk 1.39 (1.04-1.85)] and non-melanoma skin cancer [age-adjusted relative risk 1.98 (1.12-3.51)] were significantly so. Findings were similar for diastolic blood pressure and if data for the first 5 years of follow-up were excluded. There was an increase in risk of cancer also during the first 5 years [adjusted relative risk 1.80 (1.10-2.92) for systolic blood pressure and 1.77 (1.05-2.99) for diastolic blood pressure]. CONCLUSIONS: We found an excess risk of cancer and of death from cancer for men with high blood pressure. Although the increase in risk was comparatively modest, the findings are of public health importance, insofar as both hypertension and cancer are common conditions.

Aged↗
PubMed1997

Infradiaphragmatic Hodgkin's disease: the Swedish National Care Programme experience. The Swedish Lymphoma Study Group.

A Swedish national care programme has provided guidelines for staging, treatment and follow-up of all patients with Hodgkin's disease (HD) since 1985. Between January 1985 and December 1992, 920 patients were reported and followed prospectively. Of a total of 533 patients with stage I and II disease, 484 presented with supradiaphragmatic HD and 49 (9%) with infradiaphragmatic HD. The median follow-up time was 4.3 yr (3.3-10 yr). Significant differences in average age (45 +/- 21 yr and 55 +/- 19 yr), male:female ratio (1.1:1 and 2.8:1) and B-symptoms (25% and 47%) were observed in patients with supra- and infradiaphragmatic HD, respectively. Forty-six patients with infradiaphragmatic HD were treated with a curative intention and 40 (87%) achieved a complete response. Eleven (28%) of the 40 patients have recurred and 8 patients have died of HD. Complete response rates and recurrence frequencies did not differ from those observed in patients with supradiaphragmatic HD. Mortality was, however, significantly higher (p = 0.001) in the infradiaphragmatic group; this was due mainly to poorer effects of salvage treatment in a elderly population. In this population-based study, patients with peripheral disease in stage IA respond well to inverted Y irradiation alone, whereas it appears to be important to give stage II patients chemotherapy or a combined modality treatment in order to avoid unacceptably high recurrence rates.

Adult↗
PubMed1996

Lung cancer in West Sweden 1976-1985. A study of trends and survival with special reference to surgical treatment.

We reviewed 3 285 consecutive cases of lung cancer diagnosed in West Sweden during the period 1976-1985. Data were collected from the regional cancer registry, the Swedish National Population Registry, and medical records. During the study period, the annual female/male ratio increased from 0.29 to 0.42. In females, there was an increase primarily in the incidence of tobacco-related morphologic tumour types (i.e. squamous and small cell lung cancers). In males, a moderate increase of adenocarcinomas was seen, although squamous cell cancer remained the most common tumour type. The overall 5-year survival rate was 8.3%. In 641 patients (20%) a surgical tumour resection was carried out. The 5-year survival rate following resection was 38%, and the probability of 10-year survival was estimated at 25%. In a multifactorial model including gender, age, histology, pTNM stage and extent of resection, pTNM stage and, to a lesser degree, age were statistically significant independent predictors of postoperative survival. The five-year survival was 57% in stage 1, 21-27% in stage II and IIIa, and 10% in stage IIIb. Of all resected patients, 4.2% died within two months after resection. In males, early postoperative mortality was predicted by preoperative bicycle ergometry. The prognosis in non-resected patients was poor, with only 2% surviving 5 years or longer. In conclusion, the results indicate that some progress has been made with regard to surgical management of lung cancer, but they also point to the fact that the vast majority of patients are not amenable to curative treatments, and that the overall survival in lung cancer has improved only marginally during the last decades.

Age Distribution↗
PubMed1994

Treatment of early and intermediate stages of supradiaphragmatic Hodgkin's disease: the Swedish National Care Programme experience. Swedish Lymphoma Study Group.

PURPOSE: Since 1985 a Swedish National Care Programme has provided tailored principles for the staging, treatment and follow-up of patients with Hodgkin's disease (HD). This report presents treatment results for all patients below 60 years of age who were diagnosed with early and intermediate stages, between 1985 and 1989. PATIENTS AND TREATMENT: During that period, 210 patients with supradiaphragmatic HD in clinical (CS) and pathological (PS) stages IA+IIA, PS IB+IIB, and PS III1 A were diagnosed in five Health Care Regions in Sweden. In patients with CS IA, staging laparotomy was not recommended provided that the radiological assessment of the abdomen was adequate, whereas this procedure was recommended in stages CS IB, IIA and IIB in order to minimize treatment. In the absence of bulky mediastinal disease, patients with CS+PS IA and PS IIA were treated with mantle (occasionally mini-mantle) irradiation alone, while patients with bulky disease, as well as those with stages PS IB+IIB+III1 A, were treated with one cycle of MOPP/ABVD prior to mantle (PS III1 A sub-total nodal) irradiation. Full chemotherapy followed by radiotherapy to initial sites with bulky disease was recommended for patients with CS IIA who did not undergo laparotomy. RESULTS: After a median follow-up in excess of five years, treatment results are 'favourable' for all stages, provided the recommendations were followed. In patients with CS+PS IA treated according to the recommendations, recurrence rates were 14% (9/65) with all but one patient (64/65, 98%) remaining in continuous first or second remission. These figures were worse in patients treated inadequately (9/26 [35%] and 22/26 [85%], respectively). In PS IIA, adequately-treated patients had a recurrence rate of 13% (7/52) whereas 5/7 (71%) of those with bulky disease who received only mantle irradiation developed recurrences. Similar patterns also emerged in patients with CS IIA, PS IB+IIB and PS III1 A. CONCLUSIONS: The tailored principles, which usually entail less staging and/or treatment than is generally the case, produced favourable results when applied to an entirely unselected group of patients with early and intermediate stages of HD.

Adolescent↗
PubMed1992

Association of ploidy and cell proliferation, Dukes' classification, and histopathological differentiation in adenocarcinomas of colon and rectum.

OBJECTIVES: To find out if there is an association between DNA indexes and DNA synthesis (S) phase measurements and Dukes' classification and histopathological differentiation in colorectal cancers, and to investigate the interrelationship between DNA indexes and S phase measurements. DESIGN: Prospective open study. MATERIAL: 182 colorectal carcinomas in 181 consecutive patients. INTERVENTION: Tumours biopsied immediately after resection or at rectoscopy or colonoscopy. RESULTS: One or more aneuploid cell populations were found in 113 of 182 carcinomas (62%). There was no correlation between Dukes' stage and either degree of differentiation or S phase measurements, but there were significant correlations between S phase measurements and histological grading (p less than 0.05), and between the percentage of cells in the S phase and the DNA index when values for both diploid and aneuploid tumours were included (p less than 0.001). CONCLUSION: The degree of aneuploidy indicates how far tumour cells have progressed in their cellular disarrangement, and information about a tumour's proliferative capacity is given by the S phase measurements.

Adenocarcinoma↗
PubMed1992

Energy and macronutrient intake in relation to cancer incidence among Swedish women.

Two dietary reporting methods were used to examine associations between macronutrient intake and subsequent cancer incidence in a cohort of Swedish women born between 1908 and 1930. 1361 subjects gave 23-h dietary recalls at their baseline examinations in 1968-1969, and 412 of them also provided detailed dietary histories. The cohort was followed up 19 years later by means of linkages with the National Cancer and Death Registries. Both dietary methods indicated that subjects who were ranked in the highest tertile of energy intake, relative to the lowest, were at significantly greater risk of developing cancer (all-site). Relative risks across energy intake tertiles were 1, 1.15 and 2.04, respectively, using the dietary history method and 1, 1.02 and 1.55 using the 24-h recall data. Examination of specific macronutrient energy sources indicated that dietary fat and carbohydrate are likely to have made the largest contribution to this association. However, after adjustment for total energy, none of the individual macronutrients was significantly associated with all-site cancer, by either dietary reporting method. When expressed as a percentage of total energy, low protein density of the diet was associated with increased cancer risk, by both dietary methods. However, this appeared to be a function of high energy intake rather than low protein intake. Simultaneous statistical adjustment for seven potential confounders of the association between energy intake and cancer was performed using both the 24-h recall and the dietary history data.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Psychosocial problems and needs of cancer patients].

A Swedish-American epidemiological study of the psychosocial problems and needs of cancer patients have shown that the personal needs of such individuals are frequently ignored. The Swedish patients requested psychological support more often than the Americans, who instead reported a need for financial assistance. Swedish patients were very rarely offered psychiatric or psychological counselling, while many Americans felt that they had received good support from physicians and other medical personnel. Fourteen per cent of the Swedes and 2.7 per cent of the American patients had no-one to whom to turn for help. The article gives concrete recommendations for better psychosocial care of cancer patients.

Counseling↗
PubMed1982

The relation of platelet kinetics to bone marrow megakaryocytes in chronic granulocytic leukaemia.

The relation of thrombokinetics to quantitative determinations of megakaryocytes (mgkc) in bone marrow sections was studied in 11 consecutive cases of untreated Ph1-positive chronic granulocytic leukaemia (CGL). The results were compared with controls and with previously obtained data in polycythaemia vera (PV), primary thrombocythaemia (PT) and in idiopathic thrombocytopenic purpura (ITP). Platelet survival was significantly reduced in CGL. Platelet production was 5.8 x normal and the mgkc number and volume/microliter bone marrow were significantly increased as compared to controls. The increase in mgkc volume was not in proportion to that of number due to a significant decrease of mgkc size. Platelet production was strongly related to mgkc number/mm2 and to the mgkc volume/microliter bone marrow. The platelet production rate in relation to a unit of mgkc volume/microliter bone marrow was, however, greater in CGL than in controls, PV, PT and ITP. The chief reason for this is most probably the greater expansion of the total bone marrow mass in CGL.

Adult↗
PubMed1977

On the analysis of platelet survival curves and the calculation of platelet production and destruction.

Platelet survival, platelet production and megakaryocyte quantifications were studied in control subjects and in patients with idiopathic thrombocytopenic purpura (ITP) and primary thrombocythaemia (PT). A platelet death probability function (DPF), which gives the expected probability of a randomly chosen platelet to be destroyed within the nextcoming short time interval, was constructed on the basis of the present knowledge of platelet function and the factors that influence its survival. Starting from this function platelet age and life span distributions and the function for the survival curve were derived. Platelet mean life span (MLS) was in controls 6.9d, in PT 5.2Dd and in ITP 0.44d. Determinations of platelet life span and platelet age distributions revealed a considerable variation in platelet life spans about these means and a great difference in platelet age compositions between the 3 groups of subjects studied. The function for the platelet survival curve, derived from the DPF, was employed in the calculation of platelet production and there was a highly significant relationship between platelet production and megakaryocyte volume per microliter bone marrow giving mutual confirmation to the 2 determinations and to the correctness of the death probability function.

Adolescent↗
PubMed1976

The ultrastructure of the megakaryocytes in idiopathic thrombocytopenic purpura (ITP) in relation to thrombokinetics.

The ultrastructure of megakaryocytes was examined in eight patients with idiopathic thrombocytopenic purpura (ITP) and the results were compared with those obtained from controls and with data obtained from platelet kinetic studies. Platelet production was significantly increased in (ITP) and related to the megakaryocyte number and volume. In all cases of ITP megakaryocytes containing tubular demarcation membranes were found. The granular content and the distribution of the demarcation membrane system in these megakaryocytes from cases of ITP were similar to those features seen in normal cells of the same degree of maturity. In three cases of ITP an increased content of a dilated demarcation membrane system was found in promegakaryocytes and granular megakaryocytes, in one of these cases with the additional formation of large membrane complexes. The ultrastructural findings lend support to the results obtained from the thrombokinetic studies namely that the megakaryocytes in the bone marrow react to thrombocytopenia with an increased production of platelets.

Adult↗
PubMed1975

Platelet kinetics in idiopathic thrombocytopenic purpura (ITP) before and at different times after splenectomy.

Platelet kinetics were studied in 18 patients with idiopathic thrombocytopenic purpura (ITP) before splenectomy, 1 month and 8 months after splenectomy. A gamma function was used for the calculation of platelet mean life span (MLS). Before splenectomy platelet MLS was greatly reduced and platelet production was 2.8 times normal. The peripheral platelet count and platelet recovery were significantly related to platelet MLS. One month after splenectomy platelet MLS increased appreciably while platelet production decreased but continued to be significantly above normal. These changes together with the removal of the splenic platelet pool resulted in a peripheral platelet count significantly higher than normal and a total platelet mass not differing from normal. Eight months after splenectomy platelet MLS increased slightly but was not significantly different from that found 1 month after splenectomy. Platelet production, however, decreased significantly and became normal. This resulted in a normal peripheral platelet count and a decreased total platelet mass which was significantly lower than in non-splenectomized control subjects. The results suggest that platelet production is regulated by a feed-back mechanism that is governed by the peripheral platelet count. The high platelet count encountered 1 month after splenectomy is due to a sluggishness of this regulatory mechanism.

Adolescent↗
PubMed1975

Megakaryocyte quantifications in relation to thrombokinetics in primary thrombocythaemia and allied diseases.

Megakaryocyte morphology was studied quantitatively in primary thrombocythaemia (PT) and in chronic myelogenous leukaemia (CML). The relation of thrombokinetics to megakaryocyte quantifications was evaluated in PT and compared to previously obtained results in polycythaemia vera (PV) and idiopathic thrombocytopenic purpura (ITP). Megakaryocyte area, number and volume per mul bone marrow were significantly higher in PT as compared to controls. The nuclear lobe number was significantly increased and the megakaryocytes were shifted towards more mature forms, suggesting a prolonged megakaryocyte generation time. In CML the megakaryocyte number and volume per mul bone marrow were also significantly above normal, but the megakaryocyte area, number of lobes and degree of megakaryocytic maturation were significantly below normal. Platelet production was in PT 6.2 times normal and proportional to the increase in megakaryocyte volume which was 6.8 times normal. In PV with major splenomegaly the mean platelet production rate was higher (9.5 times normal) although their peripheral platelet count was lower than in PT. This discrepancy is explained by the greatly enlarged splenic platelet pool in the PV patients. In ITP the mean platelet production rate was 2.2 to 3 times normal and was significantly lower than in PT and PV.

Adult↗
PubMed1975

The relation of thrombokinetics to bone marrow megakaryocytes in idiopathic thrombocytopenic purpura (ITP).

In 23 patients with untreated idiopathic thrombocytopenic purpura (TP), the relation of thrombokinetics to quantitative determinations of megakaryocytes in bone marrow sections was studied. The megakaryocytes were classified into maturation stages, and platelet sizes were determined. Megarkaryocyte number and volume per microliter of bone marrow were significantly higher in ITP as compared to controls. The megakaryocyte number and volume were inversely related to the peripheral platelet count. Platelet production rate was significantly increased in ITP and related to the megakaryocyte number and volume. The megakaryocytes were shifted towards more immature forms in ITP, suggesting an increased turnover rate of the expanded recognizable metakaryocyte compartment. Platelet size was significantly increased in ITP, and the mean platelet diameter was 1.6 times normal. There was a significant relationship between platelet size and platelet production rate, as well as an inverse relationship between platelet size and platelet mean life-span (MLS). There was also a significant correlation between platelet size and the proportion of young megakaryocytes.

Adolescent↗