Biomedical subjects

L Vatten

Publications and source records attributed to L Vatten.

At least 19 recordsLinked to original sources

PubMed2002

Low socio-economic status is associated with increased risk of frequent headache: a prospective study of 22718 adults in Norway.

Prevalence studies exploring the relation between socio-economic status (SES) and headache have shown conflicting results. This is the first prospective study analysing the relation between SES and risk of headache. A total of 22685 adults not likely to suffer from headache were classified by SES at baseline in 1984-1986, and responded to a headache questionnaire in a follow-up 11 years later (1995-1997). SES at baseline was defined by educational level, occupation, and income. The risk of frequent headache and chronic headache (>6, and > or =15 days/month, respectively) at follow-up was estimated in relation to SES. When defining SES by educational level or type of occupation, low status was associated with increased risk of frequent and chronic headache at follow-up. The risk of frequent and chronic headache decreased with increasing individual income, but only among men. We conclude that individuals with low SES had higher risk of frequent and chronic headache than people with high SES.

Adult↗

PubMed2002

Blood pressure and risk of headache: a prospective study of 22 685 adults in Norway.

OBJECTIVES: Prevalence studies of the association between blood pressure and headache have shown conflicting results. The aim was to analyse the relation between blood pressure and risk of headache in a prospective study. METHODS: A total of 22 685 adults not likely to have headache, had their baseline blood pressure measured in 1984-6, and responded to a headache questionnaire at follow up 11 years later (1995-7). The relative risk of headache (migraine or non-migrainous headache) was estimated in relation to blood pressure at baseline. RESULTS: Those with a systolic blood pressure of 150 mm Hg or higher had 30% lower risk (risk ratio (RR)=0.7, 95% CI 0.6-0.8) of having non-migrainous headache at follow up compared with those with systolic pressure lower than 140 mm Hg. For diastolic blood pressure, the risk of non-migrainous headache decreased with increasing values, and these findings were similar for both sexes, and were not influenced by use of antihypertensive medication. For migraine, there was no clear association with blood pressure. CONCLUSION: In the first prospective study of blood pressure and the risk of headache, high systolic and diastolic pressures were associated with reduced risk of non-migrainous headache. One possible explanation may be the phenomenon of hypertension associated hypalgesia, which probably involves the baroreflex system influencing nociception in the brain stem or spinal cord.

Adult↗

PubMed2001

[Urinary problems and prostate-specific antigen in a Norwegian normal population].

BACKGROUND: Measurements of PSA in serum is crucial in the diagnostic work-up of prostatic diseases. MATERIAL AND METHODS: We have studied the distribution of PSA values in an unselected population of 609 men, and the relation between PSA level and urinary symptoms, age and prostate volume. RESULTS: 87 (14%) men had a PSA concentration at or above the reference value of 4.0 ng/ml. Prostate cancer was verified in 14 (16%) of these men. The probability of having PSA equal to or above 4.0 ng/ml was 12 times greater for men with a prostate volume of 40 cm3 or less than for men with a prostate volume less than 20 cm3. Mean PSA values were higher in men with severe than with mild urinary symptoms, but symptoms were poor predictors of PSA levels. Age was not associated with an increase in PSA level independent of prostate volume. INTERPRETATION: Absence of urinary symptoms does not exclude elevated PSA values and thus not cancer. Most men with PSA equal to or above 10.0 ng/ml will have prostate cancer, but enlarged prostate without cancer can also give elevated PSA values.

Aged↗

PubMed2001

Early diagnostic markers for neonatal sepsis: comparing C-reactive protein, interleukin-6, soluble tumour necrosis factor receptors and soluble adhesion molecules.

We compared six inflammatory mediators (C-reactive protein (CRP), interleukin-6 (IL-6), soluble tumour necrosis factor receptors (p55 and p75) and soluble adhesion molecules (ICAM-1, E-selectin)) as early diagnostic tests for neonatal sepsis, and studied the possible benefit of combining parameters. Blood samples were obtained from 166 consecutively admitted neonates, who were suspected to suffer from infection within the first week of life. Neonates were retrospectively classified as infected (sepsis, clinical sepsis or pneumonia), possibly infected, or non-infected. Twenty-four infected neonates had higher serum levels of all six mediators (all P < 0.05), and 18 possibly infected neonates had higher levels of CRP, IL-6, ICAM-1 and E-selectin (all P < 0.05), than neonates without infection (n = 124). Receiver operator characteristic plots showed that CRP was the single best diagnostic test. Multiple logistic regression modelling, including various combinations of two to six mediators, consistently showed that IL-6, in addition to CRP, predicted sepsis. With infected and possibly infected neonates as the reference standard, a combined test of CRP > or = 10 mg/l and/or IL-6 > or = 20 pg/ml had a sensitivity of 85%, specificity of 62%, and negative likelihood ratio of 0.24. Using infected neonates as reference standard alone, and including possibly infected as controls, sensitivity increased to 96%, whereas specificity decreased to 58%; a negative test result (CRP < 10 mg/l and IL-6 < 20 pg/ml) ruled out sepsis with high certainty (likelihood ratio = 0.07). CRP performed best as a diagnostic test for neonatal sepsis. Diagnostic accuracy was further improved by combining CRP and IL-6, whereas the other parameters (p55, p75, ICAM-1 and E-selectin) added no further diagnostic information.

Biomarkers↗

PubMed2001

No randomised trial of prostate-cancer screening in Norway.

The Norwegian Urological Cancer Group (NUCG) decided against participating in the European Randomised Study on Screening for Prostate Cancer, to which they had planned to contribute data from a population of 75 000 men aged between 50 and 65. The plan was abandonned for three main reasons: Norwegian doubts about the statistical power of the trial, the possible ethical implications of screening a large number of men with no symptoms, and the belief that the trial would not produce clinically important results. In this review, the NUCG's reasons for not participating in the trial are discussed in full.

Aged↗

PubMed2001

Low headache prevalence amongst women with high TSH values.

The aim of this large cross-sectional population-based study was to examine a possible positive or negative association between thyroid dysfunction and headache. Between 1995 and 1997, all 92 566 adults in Nord-Trøndelag County in Norway were invited to participate in a health survey. A total of 51 383 (56%) responded to a headache questionnaire, whereof thyroid-stimulating hormone (TSH) was measured in 28 058 individuals. These included 15 465 women and 8019 men above 40 years of age, 1767 randomly selected individuals between 20 and 40 years of age, and 2807 (97%) with thyroid dysfunction. Associations between thyroid dysfunction and headache were assessed in multivariate analyses, estimating prevalence odds ratios (OR) with 95% confidence intervals (CIs). High TSH values were associated with low prevalence of headache. This was most evident amongst women with no history of thyroid dysfunction. Amongst these, headache was less probable (OR=0.5, 95% CI 0.3-0.7) if TSH > or = 10 mU/l than in women with normal TSH (0.2-4 mU/l). In all age groups between 40 and 80 years, TSH was lower amongst headache sufferers, especially migraineurs, than in those without headache complaints.

Adult↗

PubMed2001

Blood pressure, smoking and body mass in relation to mortality from stroke and coronary heart disease in the elderly. A 10-year follow-up in Norway.

OBJECTIVES: To examine the association between blood pressure, smoking and body mass index (BMI) and cerebro- and cardiovascular mortality in a population of healthy elderly. DESIGN: Ten-year mortality follow-up of elderly men and women who participated in the Nord-Trøndelag Health Study 1984-86. SETTING: Nord-Trøndelag county, Norway. SUBJECTS: 3121 men and 3271 women aged 70 years and older, free from any diagnosed atherosclerotic diseases or diabetes at baseline. MAIN OUTCOME MEASURES: Relative risk of cerebro- and cardiovascular mortality and all-cause mortality according to blood pressure, smoking and BMI. RESULTS: There was a consistent, positive association between systolic and diastolic blood pressure and cerebro- and cardiovascular mortality. The association persisted after adjustment for potential confounding factors, and was strongest for cerebrovascular mortality; the adjusted relative risks for systolic blood pressure categories 160-179 mmHg and > or = 180 mmHg in men were 1.63 (95% confidence interval, CI 1.06-2.53) and 2.19 (95% CI 1.39-3.44) compared to blood pressure < 140 mmHg. In women, the corresponding relative risks were 1.54 (95% CI 0.93-2.56) and 2.12 (95% CI 1.29-3.50). For diastolic blood pressure the adjusted relative risks in categories 100-109 and > or = 110 mmHg in men were 1.88 (95% CI 1.19-2.95) and 3.06 (95% CI 1.79-5.21) compared to pressure <90 mmHg. The corresponding relative risks in women were 1.75 (95% CI 1.05-2.91) and 2.02 (95% CI 1.04-3.93). Current smoking increased cardiovascular mortality in both men and women, and among women, BMI was negatively associated with all-cause mortality. CONCLUSIONS: These findings add to the growing evidence that hypertension is a major risk factor for mortality from stroke and coronary heart disease among the elderly and the very old.

Aged↗

PubMed2001

Inflammatory mediators in umbilical plasma from neonates who develop early-onset sepsis.

OBJECTIVES: To study whether early-onset neonatal sepsis is associated with a prenatal immune response with elevated umbilical plasma levels of inflammatory mediators, and to study whether mediator levels may be helpful in identifying infected neonates. SETTING: Nested case-control study. METHODS: Cord blood was sampled from 7,073 consecutively delivered neonates. After review of the medical records, neonates suspected to suffer from infection were classified as infected (n = 52) or noninfected but sick controls (n = 33). We also included a group of healthy controls (n = 99). Umbilical plasma levels of tumour necrosis factor-alpha (TNFalpha), interleukin (IL)-1beta, IL-6, IL-8, soluble TNF receptors (p55 and p75), IL-1 receptor antagonist (IL-1RA) and C-reactive protein were measured by immunoassays. RESULTS: Infected neonates had higher levels of TNFalpha, IL-1beta, IL-6, IL-8, p55, p75 and IL-1RA than healthy controls (all p < 0.01). Among preterm infants (GA <37 weeks), those with infection (n = 11) had higher levels of IL-1beta, IL-6, IL-8, p55 and p75 than noninfected sick controls (n = 13) (all p < 0.05), but among term infants, the infected did not differ from the noninfected sick controls. Receiver operator characteristic plots showed that IL-1beta, IL-6 and IL-8 identified preterm infected neonates accurately. CONCLUSIONS: Early-onset neonatal sepsis is associated with a prenatal immune response with increased TNFalpha, IL-1beta, IL-6, IL-8, p55, p75 and IL-1RA levels in umbilical plasma. Among neonates who present symptoms suggestive of infection, cytokine levels may be helpful in identifying preterm, but not term infected individuals.

C-Reactive Protein↗

PubMed2001

Stability in incidence of acute appendicitis. A population-based longitudinal study.

UNLABELLED: BACKGROUND/AIM OF THE STUDY: During the past 50 years, a decrease in incidence of appendicitis has been reported. The various studies were retrospective and based on different data sources. In the present study, we analyze prospectively the incidence of acute appendicitis during a 10-year period in a well defined population of 265,000. METHODS: Prospective registration of all operations performed in patients with suspected acute appendicitis in the catchment area of a single institution. The diagnosis of acute appendicitis was based on histology in all cases. The annual incidence of acute appendicitis was calculated with regard to nonperforated and perforated acute appendicitis. MAIN RESULTS: Between 1989 and 1998, 2,861 patients underwent surgery for suspected acute appendicitis. In 2,232 (78%) patients, acute appendicitis was confirmed histologically. Mean annual incidence was 84/100,000 (95% confidence interval 80 to 88/100,000). Crude incidence remained stable during the study period, with the exception of a significant increase in 1991 followed by a significant decrease the next year. Nonperforated acute appendicitis showed a different incidence pattern as compared to perforated acute appendicitis. CONCLUSION: In our prospective study, the incidence of acute appendicitis remained stable in our well-defined study population during the study period of 10 years. This is in contrast to the majority of studies during the last decades.

Acute Disease↗

PubMed2001

Lower urinary tract symptoms, prostate volume and uroflow in norwegian community men.

OBJECTIVE: To describe lower urinary tract symptoms, prostate volume and peak urinary flow rate, and investigate the relationships among urological variables in a community sample of Norwegian men. MATERIALS AND METHODS: A cross-sectional study of 611 men, aged 55-70 years, who underwent a clinical urological examination including uroflowmetry, residual urine measurement, and transrectal ultrasonography of the prostate. All the men completed a questionnaire which included the International Prostate Symptom Score (IPSS). RESULTS: Severe symptoms were reported by 5%, while 23.6% reported moderate symptoms, and the overall median IPSS was 4 (q1 = 25th percentile, 1; q3 = 75th percentile, 9). The median peak flow rate was 15 ml/s (q1 = 11; q2 = 22) while median prostate volume was 30 cm(3) (q1 = 23; q3 = 38), with little variation evident across the narrow age range of 55-70 years. A positive modest correlation (r = 0.176) was found between IPSS and prostate volume, and a negative correlation between IPSS and peak flow rate (r = -0.278). There was a modest correlation between body mass index (BMI) and prostate size, but no significant correlation between BMI and IPSS. CONCLUSION: In this population-based study, moderate lower urinary tract symptoms were reported by 24% and severe symptoms by 5% of community men. The distribution of lower urinary tract symptoms, prostate volume and peak urinary flow rate in Norwegian men is comparable to that described in similar studies conducted in Spain, Holland and USA.

Aged↗

PubMed2000

Head-HUNT: validity and reliability of a headache questionnaire in a large population-based study in Norway.

We have assessed the validity and reliability of a self-administered headache questionnaire used in the 'Nord-Trøndelag Health Survey 1995-97 (HUNT)' in Norway, by blindly comparing questionnaire-based headache diagnoses with those made in a clinical interview of a sample of the participants. Restrictive questionnaire-based diagnostic criteria for migraine, assessed according to modified criteria of the International Headache Society, performed excellently in selecting 'definite' migraine patients (100% positive predictive value). The best agreement concerning migraine diagnoses was achieved by using a liberal set of criteria (kappa 0.59). Similar agreement was found evaluating patient status as headache sufferers, and as sufferers from frequent headaches (>6 days per month) (kappa 0.57 and 0.50, respectively). The kappa values of non-migrainous headache and chronic headache (> 14 days per month) were 0.43 and 0.44, respectively. The results suggest that our self-administered questionnaire may be suitable in identifying a population with 'definite' migraine, and the questionnaire is an acceptable instrument in determining the prevalence in Nord-Trøndelag of headache sufferers, migraine, non-migrainous headache, and frequent or chronic headache sufferers.

Confidence Intervals↗

PubMed2000

Prevalence of migraine and non-migrainous headache--head-HUNT, a large population-based study.

The objective of this study was to estimate the 1-year prevalence of the following categories of headache; migraine, non-migrainous headache, frequent headache (>6 days/month), and chronic headache (>14 days/month). Between 1995 and 1997, all 92,566 inhabitants 20 years and older in Nord-Trøndelag county in Norway were invited to a comprehensive health study. Out of 64,560 participants, a total of 51,383 subjects (80%) completed a headache questionnaire. The overall age-adjusted 1-year prevalence of headache was 38% (46% in women and 30% in men). The prevalence of migraine was 12% (16% in women and 8% in men), and for non-migrainous headache 26% (30% in women and 22% in men). For frequent headache (> 6 days per month) and for chronic headache (>14 days per month), the prevalence was 8% and 2%, respectively. Women had a higher prevalence than men in all age groups and for all headache categories. Prevalence peaked in the fourth decade of life for both men and women, except for 'frequent non-migrainous headache', which was nearly constant across all age groups in both genders. In accordance with findings in other western countries, we found that headache suffering, including migraine, was highly prevalent, especially in younger women.

Adult↗

PubMed2000

Wegener's granulomatosis: clinical course in 108 patients with renal involvement.

BACKGROUND: The aim of this study was to evaluate the clinical course of patients with Wegener's granulomatosis and renal involvement, with special reference to relapse rate, renal and patient survival and morbidity from serious infections. METHODS: A retrospective analysis was carried out of 108 patients presenting with Wegener's granulomatosis and active renal disease in eight hospitals in Norway between 1988 and 1998. Multivariate analysis was used to investigate whether selected variables predicted relapse, renal and patient survival and serious infections. RESULTS: Median follow-up was 41.5 months. Twenty-two patients (20.4%) were admitted with a need for dialysis. Complete remission was obtained in 81.5% after a median of 4 months, and 54.7% relapsed after a median of 22. 5 months. Two- and five-year renal survival was 86 and 75%, respectively, and 22.8% developed end-stage renal disease (ESRD). Two- and five-year patient survival was 88 and 74%, respectively, and the cumulative mortality was 3.8 times higher than expected. The relative risk of relapse increased with the use of intravenous pulse cyclophosphamide compared with daily oral cyclophosphamide. Initial renal function predicted renal survival, and low serum albumin and high age at treatment start increased the mortality risk. Thirty one per cent of the patients were hospitalized for serious infections during follow-up. Old age increased the risk of having an infection. CONCLUSIONS: The current treatment of Wegener's granulomatosis does not prevent relapse, development of ESRD and serious treatment-induced infections in a considerable fraction of the patients. Alternative strategies for the management of this disease will be an important objective for further studies.

Adolescent↗

PubMed2000

Male-pattern hair loss in Norwegian men: a community-based study.

BACKGROUND: A Norwegian community study was conducted as an add-on to a large general health survey in Trondlag County, Norway, to characterize the cross-sectional relationship of patient perceptions with the degree of hair loss. METHODS: All members of the community were invited to participate in the general health survey and male participants, aged 20-50 years (n = 7,250), regardless of their degree of hair loss, were asked to complete a mail-based questionnaire. The questionnaire measured satisfaction with hair appearance, self-reported degree of hair loss, self-assessment of Norwood/Hamilton hair pattern, bother due to hair loss as well as concern about getting older due to hair loss, and included the SF-12 general health status questionnaire. RESULTS: Respondents (n = 4, 101) rated their hair loss on a 7-point, textual scale that ranged from 'a full head of hair' to 'I am bald'. The majority (63%) of participants reported at least a little hair loss and 27% reported moderate to severe loss. Using the Norwood/Hamilton hair patterns, participants rated themselves as class II (25.5%), III (8.6%), IV (8. 8%) or V or worse (19.5%). Relative to men without hair loss, a greater proportion of men with hair loss reported being bothered (20. 5 vs. 2.3%), concerned about growing older (43.4 vs. 10.6%) and dissatisfied with overall hair appearance (22.6 vs. 94%, all p< or =0.001). Men with hair loss also reported greater levels of perceived noticeability of hair thinning to others. CONCLUSIONS: A high proportion of Norwegian men aged 26-50 years self-reported having at least some hair loss. Results suggest that men who perceive themselves as having greater hair loss are more bothered by their hair loss, more dissatisfied with the appearance of their hair and have greater concern about getting older and losing more hair.

Adult↗

PubMed2000

The history is important in patients with suspected acute appendicitis.

BACKGROUND/AIMS: The clinical diagnosis of acute appendicitis is incorrect in 20-30% of patients undergoing surgery. We analysed the clinical importance of nine commonly used symptoms and signs in 544 consecutive patients with regard to the correct diagnosis of acute appendicitis. METHODS: Open population-based prospective study. The degree of the surgeon's certainty of the preoperative diagnosis was assessed. The final diagnosis was based on histology. Logistic regression was used to analyze the independent value of nine symptoms and signs to predict acute appendicitis by calculating odds ratio (OR) with 95% confidence intervals (CI). RESULTS: In 434 of 544 patients (80%) acute appendicitis was confirmed. A history of nausea or vomiting (OR = 2.3; CI = 1.11 to 4.76) and pain migration to right iliac fossa (OR = 1.9; CI = 1.12 to 3.22) were significant predictors of acute appendicitis. Pain migration was found to be an independent predictor in females and nausea or vomiting in males. In the group of patients (29%) with an uncertain preoperative diagnosis, pain migration predicted a correct diagnosis in females (OR = 4.7; CI = 1.2 to 18), while tenderness over McBurney's point was a significant predictor in males (OR = 8.3; CI = 1.1 to 63). CONCLUSIONS: A history of pain migration and nausea or vomiting were independent predictors for the correct diagnosis of acute appendicitis in patients undergoing surgery. Thus, patient history is important in this patient group.

Acute Disease↗

PubMed2000

Physical activity and stroke mortality in women. Ten-year follow-up of the Nord-Trondelag health survey, 1984-1986.

BACKGROUND AND PURPOSE: Few studies have reported a protective effect of physical activity on stroke in women, particularly among elderly women. This study was conducted to examine the association between different levels of leisure-time physical activity and stroke mortality in a large prospective study of middle-aged and elderly women. METHODS: We conducted a 10-year mortality follow-up of women aged >/=50 years, free from stroke at baseline (n=14 101), who participated in the Nord-Trondelag Health Survey in Norway during 1984-1986. Main outcome measures were relative risk of stroke mortality according to increasing levels of physical activity, with the least active group used as reference. RESULTS: In groups aged 50 to 69, 70 to 79, and 80 to 101 years, the relative risk of dying decreased with increasing physical activity, after adjustment for potentially confounding factors. In groups aged 50 to 69 and 70 to 79 years, the most active women had an adjusted relative risk of 0. 42 (95% CI, 0.24 to 0.75) and 0.56 (95% CI, 0.36 to 0.88), respectively. In the group aged 80 to 101 years, there was a consistent negative association with physical activity; the adjusted relative risk for the most active was 0.57 (95% CI, 0.30 to 1.09). CONCLUSIONS: Physical activity was associated with reduced risk of death from stroke in middle-aged and elderly women. This association persisted after we excluded individuals with prevalent cardiovascular and cerebrovascular disease at baseline and women who died during the first 2 years of follow-up. These observations strengthen the evidence that physical activity should be part of a primary prevention strategy against stroke in women.

Adult↗

PubMed1999

Soluble tumor necrosis factor receptors in sera from patients with insulin-dependent diabetes mellitus: relations to duration and complications of disease.

Concentrations of soluble receptors for tumor necrosis factor (p55 and p75) strongly correlate with clinical stage and progression of infectious diseases, and may be useful in monitoring autoimmune diseases. However, the role of soluble TNF receptors in insulin-dependent diabetes mellitus (type 1 DM) is not clear. We have compared levels of p55 and p75 in sera from different groups of type 1 DM patients. Group 1: 18 patients with type 1 DM duration from 1/2 to 3 years, group 2: 17 patients with type 1 DM duration of more than 10 years, and less than 20 microg/min excretion of albumin in urine, group 3: 24 patients with type 1 DM for more than 10 years and albumin excretion in urine higher than 20 mg/min. Sera from 24 healthy blood donors constituted a control group. We found that patients in group 1 and 2 had lower p55 levels than among controls (20% and 16.7%, respectively, both P < 0.01). Serum levels of p75 did not differ between the groups. Both p55 and p75 increased with severity of type 1 DM complications (P < 0.00001). These results indicate that type 1 DM without complications is associated with lower serum levels of p55 than in healthy controls, and that type 1 DM complications increase the p55 and p75 levels. In addition, the results suggest that increased serum levels of p55 and p75 in type 1 DM patients may be early markers of type 1 DM complications.

Adult↗

PubMed1999

LPS mediated production of IL-1, PGE2 and PGF2alpha from term decidua involves tumour necrosis factor and tumour necrosis factor receptor p55.

Prostaglandins, with cytokines involved as intermediate factors, may have an essential role in premature labour when infection is present. We therefore wanted to study tumour necrosis factor (TNF), in cytokine and prostaglandin production in reproductive tissue. Decidual cell cultures were established and cells were stimulated with lipopolysaccharides (LPS). Media concentrations of TNF, interleukin-1 (IL-1), IL-6 and prostaglandin E2 and F2alpha were analysed, and involvement of LPS receptor CD14, TNF and TNF receptors (p55 and p75) were analysed, by studying effects after administration of specific antibodies. LPS induced an early peak elevation of TNF, with a subsequent release of IL-1, IL-6 and prostaglandins. Antibodies against CD14 inhibited these LPS effects. TNF antibodies reduced production of IL-1 and prostaglandins, whereas no significant influence on IL-6 production was observed. Antibodies against the TNF receptor p55 reduced all observed TNF effects. In contrast, p75 antibodies did not influence cytokine or prostaglandin production in this system. Our results suggest that increased TNF production is a prerequisite for LPS stimulated production of IL-1 and prostaglandins from decidual cells. LPS may directly stimulate IL-6 production. Of the two TNF receptors studied, only p55 seemed to be involved in the TNF signal transduction.

Antigens, CD↗