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Biomedical subjects

P Fredlund

Publications and source records attributed to P Fredlund.

At least 19 recordsLinked to original sources
PubMed2005

A 6-month study of the efficacy and safety of tadalafil in the treatment of erectile dysfunction: a randomised, double-blind, parallel-group, placebo-controlled study in Australian men.

The efficacy and safety of tadalafil for the treatment of erectile dysfunction (ED) were assessed in a 6-month, randomised, double-blind, placebo-controlled study. Australian men with mild, moderate or severe ED of organic, psychogenic or mixed aetiology were randomised to tadalafil 20 mg as needed (n = 93) or placebo (n = 47). Efficacy assessments included the international index of erectile function (IIEF) and the sexual encounter profile (SEP) diary. Tadalafil significantly improved erectile function compared with placebo (p < 0.001, all measures). At the end of the study, the mean per-patient proportion of successful sexual intercourse attempts (SEP question three) was 73.5% for patients treated with tadalafil and 26.8% for placebo-treated patients. Improved erections were reported by 78% of tadalafil-treated patients compared to 12.8% of placebo-treated patients. The most common treatment-emergent adverse events--headache and dyspepsia--were generally mild or moderate. Tadalafil was effective and well tolerated in Australian men with mild to severe ED.

Adult↗
PubMed2004

Impact of diabetes mellitus on the severity of erectile dysfunction and response to treatment: analysis of data from tadalafil clinical trials.

AIMS/HYPOTHESIS: A retrospective analysis of pooled data from twelve placebo-controlled trials was conducted to characterise the efficacy and safety of tadalafil for the treatment of erectile dysfunction in men with diabetes compared with that in men without diabetes. METHODS: Patients were randomly allocated to tadalafil 10 mg, 20 mg, or placebo, taken as needed for 12 weeks. The study population comprised 637 men with diabetes (mean age 57 years) and 1681 men without diabetes (mean age 56 years). RESULTS: At baseline, patients with diabetes had more severe erectile dysfunction than patients without diabetes, with mean International Index of Erectile Function (IIEF) erectile function domain scores of 12.6 and 15.0 respectively (p<0.001). Compared with placebo, tadalafil 10 mg and 20 mg improved all primary efficacy outcomes in both patient groups (p<0.001). Men with diabetes receiving tadalafil 20 mg experienced a mean improvement of 7.4 in their IIEF erectile function domain score against baseline versus 0.9 for placebo (p<0.001). This group reported on average that 53% of their attempts at intercourse were successful, compared with 22% for placebo (p<0.001 for the change from baseline). Baseline IIEF erectile function domain scores correlated inversely with baseline HbA(1)c levels. The responses to tadalafil were similar regardless of levels of baseline glycaemic control, diabetic therapy received, or previous use of sildenafil. CONCLUSIONS/INTERPRETATION: Despite more severe baseline erectile dysfunction in men with diabetes, tadalafil was efficacious and well tolerated in this population. As reported for other phosphodiesterase 5 inhibitors, the response to tadalafil was slightly lower in men with diabetes than in men without diabetes.

Blood Glucose↗
PubMed2002

A prospective study of fatal occupational accidents -- relationship to sleeping difficulties and occupational factors.

Very little is known about the association between sleep and (fatal) occupational accidents. This study investigated this relationship using register data of self-rated sleep difficulties, together with occupational and demographic characteristics. The variables were related to subsequent occupational fatal accidents. A national sample of 47,860 individuals was selected at regular intervals over a period of 20 years, and interviewed over the phone on issues related to work and health. The responses were linked to the cause of death register (suicides excluded) and the data set was subjected to a (multivariate) Cox regression survival analysis. One hundred and sixty six fatal occupational accidents occurred, and the significant predictors were: male vs. female: relative risk (RR)=2.30 with a 95% confidence interval (CI) of 1.56-3.38; difficulties in sleeping (past 2 weeks): RR=1.89 with CI=1.22-2.94; and non-day work: RR=1.63 with CI=1.09-2.45. No significant effect was seen for age, socio-economic group, hectic work, overtime (>50 h per week), or physically strenuous work. It was concluded that self-reported disturbed sleep is a predictor of accidental death at work, in addition to non-day work and male gender.

Accidents, Occupational↗
PubMed2001

Self rated health: Is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes?

STUDY OBJECTIVE: To analyse the predictive power of self rated health for mortality in different socioeconomic groups. DESIGN, SETTING, PARTICIPANTS: Analysis of mortality rates and risk ratios of death during follow up among 170 223 respondents aged 16 years and above in the Swedish Survey of Living Conditions 1975-1997, in relation to self rated health stated at the interview, by age, sex, socioeconomic group, chronic illness and over time. MAIN RESULTS: There was a strong relation between poor self rated health and mortality, greater at younger ages, similar among men and women and among persons with and without a chronic illness. The relative relation between self rated health and subsequent death was stronger in higher than in lower socioeconomic groups, possibly because of the lower base mortality of these groups. However, the absolute mortality risk differences between persons reporting poor and good self rated health were similar across socioeconomic groups within each sex. The mortality risk difference between persons reporting poor and good self rated health was considerably higher among persons with a chronic illness than among persons without a chronic illness. The mortality risk among persons reporting poor health was increased for shorter (<2 years) as well as longer (10+ years) periods of follow up. CONCLUSIONS: The results suggest that poor self rated health is a strong predictor of subsequent mortality in all subgroups studied, and that self rated health therefore may be a useful outcome measure.

Adolescent↗
PubMed1998

Decision latitude, job strain, and myocardial infarction: a study of working men in Stockholm. The SHEEP Study Group. Stockholm Heart epidemiology Program.

OBJECTIVES: This study examined the role of decision latitude and job strain in the etiology of a first myocardial infarction. METHODS: Eligible case patients were all full-time working men 45 to 64 years of age who suffered a first myocardial infarction during the period January 1992 to January 1993 in the greater Stockholm region. Referents were selected from the general population. Participation rates were 82% (case patients) and 75% (referents). RESULTS: Both inferred and self-reported low decision latitude were associated with increased risk of a first myocardial infarction, although this association was weakened after adjustment for social class. A decrease in inferred decision latitude during the 10 years preceding the myocardial infarction was associated with increased risk after all adjustments, including chest pain and social class. The combination of high self-reported demands and low self-reported decision latitude was an independent predictor of risk after all adjustments. CONCLUSIONS: Both negative change in inferred decision latitude and self-reported job strain are important risk indicators in men less than 55 years of age and in blue-collar workers.

Decision Making↗
PubMed1996

Long-term psychosocial work environment and cardiovascular mortality among Swedish men.

OBJECTIVES: This study examined the effect of cumulative exposure to work organization--psychological demands, work control, and social support on prospectively measured cardiovascular disease mortality risk. METHODS: The source population was a national sample of 12517 subjects selected from the Swedish male population by Statistics Sweden in annual surveys between 1977 and 1981. Over a 14-year follow-up period, 521 deaths from cardiovascular disease were identified. A nested case-control design was used. Work environment exposure scores were assigned to cases and controls by linking lifetime job histories with a job exposure matrix. RESULTS: Conditional logistic regression analysis was used in examining cardiovascular mortality risk in relation to work exposure after adjustment for age, year last employed, smoking, exercise, education, social class, nationality, and physical job demands. In the final multi-variable analysis, workers with low work control had a relative risk of 1.83 (95% confidence interval [CI] = 1.19, 2.82) for cardiovascular mortality. Workers with combined exposure to low control and low support had a relative risk of 2.62 (95% CI=1.22, 5.61). CONCLUSIONS: These results indicate that long-term exposure to low work control is a risk factor for cardiovascular disease mortality.

Adult↗
PubMed1994

Lipid lowering through work stress reduction.

Swedish civil servants, who reported considerable stress while working in larger government authorities, were randomized into either a work stress reduction intervention or a control group. Four work units constituted the intervention group (n = 94). and one unit formed the control group (n = 35). Participants in the two groups were of similar age and two thirds were women. Psychosocial, lifestyle, and physiological assessments were made before, during, and after the 8-month intervention period. A significant decrease in apolipoprotein B/apolipoprotein A I ratio (p < 0.05) occurred in the intervention group but not in the control group. No changes were seen in either group in smoking, eating. exercise, relative weight, or other lifestyle factors. which could explain the lipid profile changes. Stimulation from and autonomy over work increased in the intervention group (p < 0.01) hut remained the same in the control group. Results have implications for the efficacy of work stress interventions in decreasing coronary risk.

Journal Article↗
PubMed1987

Surveillance colonoscopy and biopsy in patients with ureterosigmoidostomy.

Colonoscopy with biopsy was included in the surveillance of 19 patients with ureterosigmoidostomy, because of the high incidence of colonic carcinoma reported in such cases. The patients were examined 1-6 times, at intervals of 1-2 years, 4-36 years after the urinary diversion. Random biopsies from the distal colon and rectum showed only discrete changes, and no dysplasia. Polyps with dysplastic changes were found close to ureteral anastomoses in three patients. For routine check-up of the rectosigmoid region and the ureteral implantation sites, examination with a flexible sigmoidoscope seems to be adequate and preferable, giving easy access to the risk zone for the development of cancer. Caution should be exercised, however, when performing biopsy close to the ureteral orifices.

Adult↗
PubMed1987

Continent ileostomy. A follow-up study of 60 patients.

Sixty patients underwent proctocolectomy and received a continent ileostomy because of ulcerative colitis (50 cases) familial polyposis (7) or Crohn's disease (3), with no deaths at surgery or during follow-up (mean 4.5 years, range 3 months-10 years). Early complications were few and insignificant. Late complications (nipple-valve sliding and pouch ileitis) were more common, and 15 patients with valve sliding causing leakage had to undergo altogether 22 reoperations. Three reservoirs had to be removed because of refractory pouch ileitis. Modifications in nipple-valve construction in the last 40 cases diminished the problem of sliding. More than 90% of the patients reported improved quality of life after conversion of conventional to continent ileostomy. Continent ileostomy remains an excellent alternative to ileoanal anastomosis with proximal reservoir for patients who cannot accept conventional ileostomy or when an ileoanal anastomosis with reservoir functions unsatisfactorily or is otherwise unsuitable.

Adenomatous Polyposis Coli↗
PubMed1983

Protective colostomy in low anterior resection of the rectum using the EEA stapling instrument. A randomized study.

The need for protective transverse colostomy in low anterior resection using the EEA stapler was tested in a randomized series of 50 patients, half of whom received peroperative protective colostomy. Gastrografin enema on the tenth postoperative day showed a leakage frequency of 30 per cent in both groups. Clinical leakage was noted in 4 per cent (one patient) in the colostomy group and 12 per cent (three patients) in the noncolostomy group. Protective colostomy was followed by stenosis in nine instances, compared with only two in the noncolostomy group (2 alpha = 0.05). Routine protective colostomy should not be used in low anterior resection when the EEA stapling instrument is used. The occasional clinical leakage, which may appear in the postoperative period, can be revealed by close observation and successfully treated by an emergency colostomy. The majority of patients with anterior resection of the rectum, therefore, can be spared the inconvenience and cost of temporary colostomy.

Aged↗
PubMed1981

Angiography after temporary inhibition of blood flow followed by intraarterial 5-FU infusion in the treatment of liver metastases.

Temporary inhibition of the blood flow to the liver was performed in 20 patients with metastases by tightening slings around the hepatic artery for 16 hours. Infusion of 5-FU started two days later through a catheter in the gastroduodenal artery. The response to the treatment as revealed by angiography was swelling of the liver and necrosis of the metastases. Thirteen patients responded favourably to the treatment. Complications such as abscess formation, 5-FU leakage, thrombosis of the hepatic artery and development of aneurysm at the entry of the infusion catheter occurred in some patients.

Adult↗
PubMed1980

Evaluation of aggressive surgery for carcinoma of the extrahepatic bile ducts.

The records of 80 consecutive patients with extrahepatic bile duct cancer, 45 women and 35 men, median age 70 years (33-89 years), were reviewed. The histologic diagnoses were adenocarcinoma in 45 patients, 34 cholangiocarcinoma and one squamous cell carcinoma. In 34 patients the tumor was located to the confluence, the right or left hepatic duct, in 16 to the middle and in four to the distal portion of the bile duct. In the remaining 26 patients the tumor comprised more than one of these locations (mixed location). Twenty-seven of the 80 patients (34%) were operated on with resection of the tumor. Among patients 70 years of age and younger the resectability rate was 57%. In nine patients the main surgical procedure was bile duct resection, in 15 patients bile duct resection and liver lobe resection, in 2 patients total pancreatectomy and in one local excision were performed. The resection of the tumor was regarded as radical in 12 patients and palliative in 15. The mortality rate was 11% after resection as compared to 30% in patients with nonresectable tumors. The most common postoperative complication was insufficiency of the anastomosis which occurred in seven patients. Three of these patients required reoperation. The median survival time in patients operated on with radical resection was 20 months, palliative resection 7(1/2) months and in patients with nonresectable tumors 2(1/2) months. The quality of life was estimated according to a special schedule and was found to be improved after resection as compared to nonresection. Patients operated with radical resection spent significantly less of their remaining life at hospital as compared to palliatively resected patients or patients with nonresectable tumors.

Adenocarcinoma↗
PubMed1978

Roentgen stereophotogrammetry for evaluation of liver volume and shape.

Model experiments and tests on 2 patients were performed to probe the feasibility of roentgen stereophotogrammetry for evaluating variations in shape and volume of the liver. The surface of the object was marked with indicators, and the three-dimensional marker coordinates were determined. The model experiments demonstrate a good correlation between true volume and the volumes defined by the indicators, and also demonstrate the possibility of localizing an expansivity. The variability of the volume of a polyhedron defined by 15 liver indicators with stage of breathing is discussed.

Computers↗