Biomedical subjects

K Andersson

Publications and source records attributed to K Andersson.

At least 19 recordsLinked to original sources

PubMed2006

Characteristics of the K+-competitive H+,K+-ATPase inhibitor AZD0865 in isolated rat gastric glands.

The gastric H+,K+-ATPase of the parietal cell is responsible for acid secretion in the stomach and is the main target in the pharmacological treatment of acid-related diseases. Omeprazole and other benzimidazole drugs, although having delayed efficacy if taken orally, have high success rates in the treatment of peptic ulcer disease. Potassium competitive acid blockers (P-CAB) compete with K+ for binding to the H+,K+-ATPase and thereby they inhibit acid secretion. In this study, the in vitro properties of AZD0865, a reversible H+,K+-ATPase inhibitor of gastric acid secretion, are described. We used a digital-imaging system and the pH sensitive dye BCECF to observe proton efflux from hand-dissected rat gastric glands. Glands were stimulated with histamine (100 microM) and exposed to a bicarbonate- and Na+-free perfusate to induce an acid load. H+,K+-ATPase inhibition was determined by calculating pHi recovery (dpH/dT) in the presence of omeprazole (10-200 microM) or AZD0865 (0.01-100 microM). The efficacies of both drugs were compared. Our data show that acid secretion is inhibited by both the proton pump inhibitor omeprazole and the P-CAB AZD0865. Complete inhibition of acid secretion by AZD0865 had a rapid onset of activation, was reversible, and occurred at a 100-fold lower dose than omeprazole (1 microM AZD0865 vs. 100 microM omeprazole). This study demonstrates that AZD0865 is a potent, fast-acting inhibitor of gastric acid secretion, effective at lower concentrations than drugs of the benzimidazole class. Therefore, these data strongly suggest that AZD0865 has great potential as a fast-acting, low-dose inhibitor of acid secretion.

Animals↗

PubMed2006

Cloning, expression and immunological characterization of full-length timothy grass pollen allergen Phl p 4, a berberine bridge enzyme-like protein with homology to celery allergen Api g 5.

BACKGROUND: Timothy grass pollen is a common cause of respiratory allergy in the temperate regions. The major group 4 allergen, Phl p 4, has previously been purified and studied biochemically and immunologically, but has so far not been produced and characterized as a recombinant protein. OBJECTIVE: To clone and characterize timothy grass pollen allergen Phl p 4. METHODS: Full-length Phl p 4 cDNA was cloned using a PCR-based strategy including 3'-and 5'-RACE. Recombinant Phl p 4 was expressed in Escherichia coli and purified by immobilized metal ion affinity chromatography. Its immunological activity was investigated using experimental ImmunoCAP tests, sera from Phl p 4 sensitized individuals and Phl p 4 reactive polyclonal and monoclonal animal antibodies. RESULTS: Five full-length Phl p 4 cDNA clones were analysed. Sequence deviations between the clones were present at nine amino acid positions, and the consensus sequence comprised an open reading frame of 525 amino acids, including a predicted 25-residue signal peptide. The calculated molecular weight of the deduced mature protein was 55.6 kDa and the isoelectric point 9.9, both consistent with previously observed properties of purified nPhl p 4. Close sequence similarity was found to genomic clones from several other Pooideae grass species and to Bermuda grass pollen allergen BG60. Further, similarity was found to members of the berberine bridge enzyme (BBE) family, including celery allergen Api g 5. Recombinant Phl p 4 bound specific immunoglobulin (Ig)E from 31 of 32 nPhl p 4-reactive sera, and the IgE binding to rPhl p 4 could be inhibited by nPhl p 4 in a dose-dependent manner. CONCLUSIONS: Full-length Phl p 4 cDNA was cloned and showed sequence similarity to members of the BBE family. Recombinant Phl p 4 was produced and shared epitopes with natural Phl p 4.

Allergens↗

PubMed2006

A critical assessment of allergen component-based in vitro diagnosis in cherry allergy across Europe.

BACKGROUND: Food allergy to cherry occurs throughout Europe, typically with restricted oral reactions in the central and northern parts but with frequent systemic reactions in the Mediterranean region. Previous studies have demonstrated insufficient sensitivity of commercially available cherry extract reagents in the diagnosis of cherry allergy. OBJECTIVE: To assess the diagnostic performance of specific IgE tests based on recombinant cherry allergens in comparison with an extract-based assay and to skin prick test (SPT). A secondary objective was to analyse the frequency of systemic reactions in cherry-allergic subjects across Europe, including the largest population of LTP-sensitized subjects from central Europe studied to date. METHODS: A total of 186 subjects from central Europe and Spain were studied. Serum IgE was analysed with ImmunoCAP tests carrying rPru av 1, 3 and 4, combined and separately, and cherry extract. RESULTS: Among the central European cherry allergics, the mix of rPru av 1, 3 and 4 had a sensitivity of 95%, compared with 65% for cherry extract, and the IgE binding capacity of the recombinant mix was considerably higher. The sensitivity of the two tests was more comparable in the Spanish population, 95% and 86%, respectively. The recombinant allergen ImmunoCAP equalled SPT in terms of sensitivity and specificity. Consistent with previous reports, major geographic differences in sensitization pattern and prevalence of systemic reactions were found. A significantly higher rate of systemic reactions was found in Spanish patients sensitized to Pru av 3 whereas German patients sensitized to LTP only had oral allergy syndrome. CONCLUSIONS: The recombinant cherry allergen ImmunoCAP is a highly sensitive diagnostic tool, clearly superior to any diagnostic method based on cherry extract. Three cherry allergens are sufficient for detecting sensitization in 95% of cherry-allergic subjects. Systemic reactions are common in LTP-sensitized individuals but seem to require at least one additional causative factor.

Adolescent↗

PubMed2006

Refill adherence to repeat prescriptions of cancer drugs to ambulatory patients.

The objective was to study the refill adherence among ambulatory patients with prescribed cancer drugs. The study was based on copies of repeat prescriptions, which were collected at three large Swedish pharmacies during the last 3 months of 2004. Copies of 141 repeat prescriptions were analysed. There was no statistical significant difference between the number of patients with undersupply of cancer drugs (i.e. <80% of prescribed cancer drugs) and that of patients with undersupply of all other drugs, or between the number of patients with oversupply of cancer drugs (>120% of prescribed cancer drugs) and that of patients with oversupply of all other drugs. Undersupply of drugs was found among 14% of the patients. The median treatment gap for these patients was 39 (range 29-49 days) per 98-100 days of prescribed treatment time, meaning that the undersupply leads to treatment gaps that may jeopardize their therapeutic outcome. It is reasonable to expect that more seriously ill patients would be adherent to prescribed medication, and consequently that cancer patients would have high adherence. However, our data show that cancer patients on oral long-term treatment have a non-adherence similar to that of patients in general.

Ambulatory Care↗

PubMed2005

Beneficial effect from a cognitive training programme on children with acquired brain injuries demonstrated in a controlled study.

PRIMARY OBJECTIVE: To test the effectiveness of a cognitive training programme in children and adolescents with attention and memory deficits after acquired brain injury (ABI). RESEARCH DESIGN: Randomized controlled study. PARTICIPANTS: Thirty-eight children with ABI, 9-16 years of age. METHODS AND PROCEDURES: The treatment group trained with the cognitive programme for 30 minutes per day interactively with a teacher or parent for a period of 17 weeks. Children in the control group had a freely chosen interactive activity 30 minutes daily for 17 weeks. Pre- and post-training assessments were made using a neuropsychological test battery. MAIN OUTCOME AND RESULTS: Significant improvements in the majority of neuropsychological tests of sustained and selective attention as well as in memory performance were shown in the treatment group as compared to controls. CONCLUSIONS: The immediate effect of the training programme improved complex attention and memory functions, indicating that this method may be a valuable treatment option for improving cognitive efficiency in children after ABI. On the basis of these results, the next step will be to evaluate long-term effects and further ecological validity.

Adolescent↗

PubMed2004

Water dissociation on Ru(001): an activated process.

It is shown using x-ray photoelectron spectroscopy that water is adsorbed either nondissociatively or partially dissociatively on Ru(001) under ultrahigh vacuum conditions. We found an activated dissociation process with a barrier slightly larger than that of desorption. A difference in dissociation barriers is found between H2O and D2O that explains the anomalous isotope effects in the thermal desorption. Previous theoretical and experimental disagreements can be rationalized based on electron or x-ray beam-induced dissociation of the water overlayer and an earlier underestimation of the dissociation barrier.

Journal Article↗

PubMed2004

Inheritance and determinants of pulmonary oedema in swedish hunting dogs.

By using information derived from questionnaires sent to registered owners of drever dams and sires in Sweden with offspring born in 1992 and/or 1994, two groups of offspring were identified: one with one parent said to have had breathing difficulties after hunting, and another with both parents unaffected. Questionnaires were sent to the owners of these offspring, and multiple logistic regression was used to analyse the offspring data, with the status of their sire and dam with respect to breathing difficulties after hunting included as covariates. For the outcome 'breathing difficulties after hunting' in the 266 offspring, the odds ratio (OR) was 4.4 (95 per cent confidence interval [CI] 1.8 to 10.8) if the dam was affected and 3-9 (95 per cent CI 1.2 to 11.1) if the sire was affected. The OR for male offspring was 2.4 (95 per cent CI 1.1 to 5.7). The heritability of the condition was estimated to be 0.34 from the dogs born in 1992, and 0.28 from the dogs born in 1994.

Animal Husbandry↗

PubMed2004

Eye trigeminal sensitivity, tear film stability and conjunctival epithelium damage in 182 non-allergic, non-smoking Danes.

UNLABELLED: The population distributions of CO(2)-induced irritation sensitivity in the eyes (COI), tear film stability (break-up time, BUT), and epithelium damage (ED) and the relation of these to basic potential confounders were assessed in an age- and gender-stratified random sample of citizens in Aarhus County, Denmark. One hundred eighty-two non-allergic, non-smoking persons participated. A general health questionnaire and an indoor air questionnaire was filled out before the measurements. The BUT was non-normally distributed, as was COI at 16% CO(2) and single ED-scores. However, COI average for all levels was normally distributed and the total score for ED was only marginally deviating. BUT decreased, the threshold to CO(2) increased, and irritation intensity at CO(2) eye exposure decreased with increasing age. ED was increased among women. There were no internal relations between the three measures, but reduced BUT was seen among subjects rating high levels of exposure to dust, electrostatic fields, and dry air. ED decreased by perceived unpleasant odors and increased with experiences of high temperatures. CO(2) sensitivity increased by perceived draught, dry air, and noise exposure prior to measurements. Selection bias cannot be excluded and the results may therefore not be truly representative of the general population. However, the results may be used as reference data for future use of measurements of break-up time, epithelium defects, and CO(2) sensitivity of the eyes in the indoor air. PRACTICAL IMPLICATIONS: The most direct implication is that results can be used as reference level for measurements in problem buildings and for individual measurements. The reference can also be used in research and the other results as basis for future hypotheses and for support of existing hypotheses.

Adolescent↗

PubMed2004

Nasal histamine reactivity among adolescents in a remediated moisture-damaged school--a longitudinal study.

UNLABELLED: In a previous study, in the spring of 1995, we found that teachers, who had been working for several years in a moister-damaged school, 1 year after the renovation still reported a higher frequency of complaints and symptoms and showed significantly higher mucosal histamine reactivity compared with teachers in a control school, although the school seemed to be properly renovated. A longitudinal study of 90 randomly selected senior high school students entering the two schools was initiated to exclude or verify if the indoor air still exerted an irritant effect on the upper airways of an earlier unexposed group. The students went through a nasal histamine provocation test and answered a questionnaire on three occasions, in 1995, 1996 and 1997. No significant differences in the nasal histamine provocation curves for the students at the target school and those at the control school could be shown from start to endpoint of the study period. Neither was there any differences concerning perceived indoor air or mucosal symptoms between the target and the control group and technical measurements showed no noteworthy differences between the two schools. In conclusion, this study indicates that based on both technical and objective medical measures, the current indoor air in the remediated moisture-damaged school does not exert an irritant effect on the upper airway mucosa of the students. A 2-year follow-up of the teachers showed a decreased reactivity to histamine, giving further support to this statement. The increased mucosal reactivity observed among the teachers is probably a result of the previous long-term exposure to building dampness. No differences were seen between atopic and non-atopic students. PRACTICAL IMPLICATIONS: Persistent symptoms and increased nasal mucosal reactivity among personnel in a remediated damp building does not necessary imply an inadequate renovation. A longitudinal study with registration of subjective (questionnaires) and objective (nasal histamine reactivity) data of an earlier unexposed group residing in the same building further contributes to the evaluation whether the renovation was successful or not.

Adolescent↗

PubMed2004

Attitudes to and perceptions of oral health and oral care among community-dwelling elderly residents of Stockholm, Sweden: an interview study.

The aim of this study was to document perceptions of oral health of community-dwelling elderly people and how it had been affected through life. Twelve individuals (mean age 78.2 years) were gradually recruited to an interview study. The interviews were conducted as conversations, and the topics in a guide model were introduced only if they did not arise spontaneously. The interviews lasted 60-90 min and were tape-recorded and transcribed verbatim and analysed by the phenomenological-hermeneutic method. The interviews dealt with perceptions of growing old, life style, general health, former dental experiences, dental care in adult life, current oral health, general medical care, dental care, oral hygiene, dental hygienist care and the level of participation in treatment decisions. The interviewees were generally satisfied with their present oral health and often referred to their parents' oral problems as deterrents. Dental experiences from childhood, in association with the welfare state and personal financial security, were factors which influenced attitudes and perceptions of oral health and oral care. Although dental care was regarded as very expensive, it had been given priority over other expenses in adult life. The results confirm that the dental hygienist must take into account the importance of oral health to well being in old age and be aware that in elderly people, perception of personal oral health is multifactorial, influenced by life-long experience.

Aged↗

PubMed2003

Attention and memory training in children with acquired brain injuries.

AIM: To test the feasibility of the Amsterdam memory and attention training for children (Amat-c) in Swedish children with acquired brain damage. METHODS: Amat-c consists of structured exercises in specific attention and memory techniques. Three Swedish children aged 9-16 y with acquired brain injuries and related memory and attention deficits trained with the Amat-c method for half an hour a day in school or at home interactively with a teacher or parent for a period of 20 wk. RESULTS: All children and their coaches completed the training without interruption. The results showed an improvement in several neuropsychological tests of sustained and selective attention as well as in memory performance. Questionnaires filled in by parents and teachers indicate that, using the Amat-c method, the children learned strategies that improved their school achievement and self-image. CONCLUSIONS: The Amat-c is a valuable treatment option for improving cognitive efficiency in children with acquired brain injuries. The results indicate improved performance in several psychometric measurements. On the basis of these results, the second step will be to modify the complexity and duration of the method, as well as to integrate a reward system before further evaluating the efficacy in a larger controlled study.

Attention↗

PubMed2002

Nicotinamide prevents the long-term effects of perinatal asphyxia on basal ganglia monoamine systems in the rat.

Asphyxia during birth can cause gross brain damage, but also subtle perturbations expressed as biochemical or motor deficits with late onset in life. Thus, it has been shown that brain dopamine levels can be increased or decreased depending upon the severity of the insult, and the region where the levels are determined. In this study, perinatal asphyxia was evoked by immersing pup-containing uterus horns removed by hysterectomy in a water bath at 37 degrees C for various periods of time from 0 to 20 min. After the insult, the pups were delivered, given to surrogate mothers, treated with nicotinamide, further observed and finally, 4 weeks later, killed for monoamine biochemistry of tissue samples taken from substantia nigra, neostriatum and nucleus accumbens. The main effect of perinatal asphyxia was a decrease in dopamine and metabolite levels in nucleus accumbens, and a paradoxical increase in the substantia nigra. Nicotinamide (100 mg/kg i.p., once a day for 3 days, beginning 24 h after the perinatal asphyctic insult) prevented the effect of asphyxia in nucleus accumbens. Furthermore, striatal dopamine levels were increased by nicotinamide in asphyctic animals. No apparent changes were observed in substantia nigra. A prominent unexpected effect of perinatal asphyxia alone was on the levels of the metabolite of 5-hydroxytryptamine, 5-hydroxyindoleacetic acid (5-HIAA), which were increased in substantia nigra and decreased in both neostriatum and accumbens. However, nicotinamide increased 5-HIAA levels in all regions, which appeared to be related to the extent of the asphyctic insult. These results suggest that nicotinamide is a useful treatment against the long-term consequences produced by perinatal asphyxia on brain monoamine systems, and that there is a therapeutic window following the insult, providing a therapeutic opportunity to protect the brain.

Animals↗

PubMed2002

Ocular, nasal, dermal and general symptoms among commercial airline crews.

OBJECTIVE: To study symptoms among a commercial cabin crew, in relation to personal risk factors, perceived psychosocial work environment, occupation, and work on intercontinental flights, with exposure to environmental tobacco smoke (ETS). METHODS: A standardized questionnaire (MM 040 NA) was mailed in February-March 1997 to all Stockholm aircrew on duty in a Scandinavian flight company ( n=1,857), and office workers from the same company ( n=218). During this time, smoking was allowed only on intercontinental flights. The participation rate was 81% ( n=1,513) of the aircrew, and 77% ( n=168) of the office group. Statistical analysis was performed by multiple logistic regression analysis, keeping age, gender, atopy, current smoking, occupation, and perceived psychosocial work conditions simultaneously in the model. RESULTS: The most common symptoms among the aircrew were fatigue (21%), nasal symptoms (15%), ocular symptoms (11%), dry or flushed facial skin (12%), and dermal hand symptoms (12%). The aircrew had more nasal (odds ratio (OR) = 3.12), throat (OR=5.75), and dermal symptoms on the face (OR=2.03), and hands (OR=3.68), than the office workers. The aircrew with a history of atopy had an increase of most symptoms (OR=1.5-3.8), but age, gender, or smoking was not associated with symptoms. Perceived stress due to excess of work was associated with fatigue (OR=7.33), feeling heavy-headed (OR=9.52), headache (OR=5.10), and facial dermal symptoms (OR=3.75), while those crew with better work control and work satisfaction had less fatigue. For most symptoms, there were no differences between different categories onboard, but pilots had fewer ocular (OR=0.28) nasal (OR=0.52), and dermal hand symptoms (OR=0.39). Airline crew that had been on an intercontinental flight the previous week had more complaints of fatigue (OR=1.87), heavy-headedness (OR=1.89), and difficulties concentrating (OR=3.22). CONCLUSION: There was an association between symptoms and work stress, lack of influence on working conditions, atopy, and work on intercontinental flights where smoking was allowed. In view of the increase of civil aviation, the working conditions for aircrews need further attention.

Adult↗

PubMed2002

Nasal mucosal histamine reactivity among young students and teachers, having no or prolonged exposure to a deteriorated indoor climate.

BACKGROUND: In a study performed in the spring of 1995, we found a significantly greater nasal mucosal histamine reactivity among teachers, who had worked for several years in a recently renovated moisture-damaged school, than in those in a control school. In the present study we investigated the students who begun their high-school studies at both schools in the autumn of 1995 and compared them with the teachers as regards mucosal reactivity, atopy and symptoms. METHODS: Twenty-eight teachers in the target school, 18 teachers in the control school and 45 students from each school underwent a nasal histamine provocation test and a skin-prick test. They also answered a standardized questionnaire. RESULTS: The teachers in both schools had more marked nasal mucosal histamine reactivity at the lowest provocation concentrations than the students. The histamine provocation curve of the target school teachers had consistently higher values than that of the students (P = 0.0001), but its slope and shape were similar (P = 0.15), while the slope of the provocation curve of the control school teachers was flatter. However, there was only a borderline significance in this respect compared to the students (P = 0.07). Teachers with a dry and crusty appearance of the nasal mucosa on anterior rhinoscopy reacted more strongly to histamine provocation than those without this finding (P = 0.0004). There was a significantly higher frequency of skin-prick test positivity (SPT+) among the students (P = 0.03). There were no significant differences in nasal mucosal histamine reactivity between atopic and non-atopic subjects out of pollen season. CONCLUSIONS: Teachers had a significantly greater mucosal histamine reactivity than the students, whereas the latter had a significantly higher frequency of atopy. These results are compatible with an age-related pattern of mucosal reactivity. A crusty appearance of the nasal mucosa seems to predispose to an increase in histamine reactivity. There were no significant differences according to histamine reactivity between atopic and non-atopic subjects.

Adolescent↗

PubMed2002

Slowly decreasing mucosal hyperreactivity years after working in a school with moisture problems.

In our first study in 1995, teachers, who had worked in a water-damaged school for more than 5 years, were tested for nasal histamine reactivity by rhinostereometry. They were found to have significantly increased reactivity compared with teachers in a school without these indoor-climate problems. This finding could not be explained by differences in atopy or other personal characteristics. In this 2-year follow-up study (1995-97), 26 of 28 teachers in the target school and all 18 teachers in the control school, who participated in the initial study, accepted to take part. They were tested with the same histamine provocation procedure and answered the same questionnaire as 2 years earlier. Technical measurements of temperature, relative humidity, dust, carbon dioxide, formaldehyde and total volatile organic compounds (TVOC) were carried out in both schools during the time period between the two test occasions. In this provocation test, the teachers from the repaired water-damaged school still demonstrated an increased reactivity to histamine compared with the teachers in the control school, but the difference between the growth curves of the provocation tests was less than in 1995. Teachers in the target school still complained about the indoor air quality more than their colleagues, although the complaints were less common. No major differences were observed in the technical investigation between the two schools and the measurements were all within values usually seen in schools in northern countries. Our conclusion is that the observed nasal mucosal hyperreactivity among the teachers in the renovated water-damaged school seems to persist over years and only slowly decrease even after successful remedial measures have been taken.

Adult↗

PubMed2002

Drug-induced prevention of gastrectomy- and ovariectomy-induced osteopaenia in the young female rat.

Both ovariectomy (Ovx) and gastrectomy (Gx) induce osteopaenia in rats and humans. While the effect of Ovx has been ascribed to oestrogen deficiency, the underlying mechanism behind Gx is poorly understood. Alendronate, oestrogen and parathyroid hormone (PTH) are known to prevent the osteopaenia induced by Ovx in rats. The purpose of the present study was to determine whether alendronate, oestrogen or PTH could also prevent Gx-evoked osteopaenia. Rats were Ovx-, Gx-, or were sham-operated (Sham) and were then treated with alendronate (50 micro g/kg/day), oestrogen (10 micro g/kg/day) or PTH(1-84) (75 micro g/kg/day) for eight weeks. At sacrifice, serum PTH was unaffected by surgery (Ovx, 64+/-8 pg/ml; Gx, 75+/-13 pg/ml; Sham, 58+/-11 pg/ml). The bone mineral density (BMD) of the fifth lumbar vertebra (L5) was analysed. Ovx and Gx reduced the BMD (ash weight/Volume) of the L5 by 15+/-4% and 22+/-3% respectively. Trabecular BMD and the cortical bone mineral content (BMC) of the femur were assessed using peripheral computed tomography. Both Ovx and Gx markedly reduced trabecular BMD in the metaphyseal area of the distal femur (Ovx, -37+/-7%; Gx, -49+/-7%). The cortical BMC of the femur was only slightly reduced. Alendronate prevented trabecular bone loss after both Ovx and Gx, while oestrogen and PTH prevented trabecular bone loss after Ovx but not after Gx. In conclusion, the bisphosphonate alendronate prevented both Ovx- and Gx-induced trabecular bone loss. In contrast, PTH and oestrogen prevented Ovx-induced but not Gx-induced trabecular bone loss, suggesting that the mechanism behind the trabecular bone loss in Ovx rats differs from that in Gx rats. The results support the notion that the mechanism of action for the bone-sparing effect of these drugs differs. The ability of alendronate, and probably also other bisphosphonates, to prevent Gx-evoked osteopaenia in the rat might be of potential clinical interest when dealing with post-Gx osteopaenia in humans.

Alendronate↗

PubMed2001

Environmental tobacco smoke exposure and overtime work as risk factors for sick building syndrome in Japan.

Sick building syndrome (SBS) is an increasingly common health problem for workers in modern office buildings. It is characterized by irritation of mucous membranes and the skin and general malaise. The impact of environmental tobacco smoke (ETS) exposure and overtime work on these symptoms remains unclear. The authors examined these relations using data from a 1998 cross-sectional survey of 1,281 municipal employees who worked in a variety of buildings in a Japanese city. Logistic regression was used to estimate the odds ratio for symptoms typical of SBS while adjusting for potential confounders. Among nonsmokers, the odds ratio for the association between study-defined SBS and 4 hours of ETS exposure per day was 2.7 (95% confidence interval: 1.6, 4.8), and for most symptom categories, odds ratios increased with increasing hours of ETS exposure. Working overtime for 30 or more hours per month was also associated with SBS symptoms, but the crude odds ratio of 3.0 for SBS (95% confidence interval: 1.8, 5.0) was reduced by 21% after adjustment for variables associated with overtime work and by 49% after further adjustment for perceived work overload. These results suggest that both ETS exposure and extensive amounts of overtime work contribute to the development of SBS symptoms and that the association between overtime and SBS can be explained substantially by the work environment and personal lifestyle correlated with overtime.

Adult↗

PubMed2001

Knowledge, attitudes and management strategies in Scandinavia concerning hormone replacement therapy: a comparison between gynecologists in Denmark, Norway and Sweden.

OBJECTIVES: To describe and compare attitudes, knowledge and management strategies concerning the prescription of hormone replacement therapy (HRT) between gynecologists from three Scandinavian countries. DESIGN AND METHODS: In a cross-sectional study gynecologists in Denmark (n=386), Norway (n=475) and Sweden (n=1323) were invited by letter to complete and return an enclosed questionnaire. Then 1653 of the 2184 (76%) contacted gynecologists completed and returned the questionnaire. RESULTS: of the 1653 Scandinavian gynecologists, 42% offered HRT to all women provided there was no contraindication, while 58% recommended HRT to selected women after considering the advantages and disadvantages of HRT. In Norway and Sweden, the proportion of gynecologists routinely prescribing HRT for women without contraindications increased with age and in the oldest age group of gynecologists (>55 years) 49 and 56%, respectively, recommended HRT to all women. The gynecologists were unanimous in their choice of the type of HRT for perimenopausal women as 94% preferred cyclical or sequential combined (estrogen/progestogen) treatment or estrogen monotherapy (orally or transdermally) for hysterectomized women (95%). For postmenopausal women, 75% of the gynecologists offered continuous combined HRT while cyclical combined therapy was chosen by 15% of the gynecologists. No significant differences were found between physicians in the three countries regarding indications and contraindications to HRT. CONCLUSIONS: Scandinavian gynecologists are generally well informed concerning HRT and liberally recommend HRT for women without contraindications.

Adult↗