Biomedical subjects

R Bergström

Publications and source records attributed to R Bergström.

At least 181 records · Page 10Linked to original sources

PubMed1991

Complications after double and single stapling in rectal surgery.

Stapled anterior resections were carried out in 131 patients between October 1980 and July 1990. Double stapling was used in 87 cases and single stapling in 44. Clinical leaks occurred in 20 patients (15%) and subclinical leaks in 10 (8%) giving a total leak rate of 30/131 (23%). This proportion was similar after double (19/87, 22%) and single (11/44, 25%) stapling. Three fistulas to adjacent organs developed (two after double and one after single stapling). Stenoses occurred in 27 patients (21%), 15/87 (17%) after double, and 12/44 (27%) after single stapling. A permanent stoma was the outcome of an anastomotic complication in 9/87 (10%) patients after double and in 4/44 (9%) after single stapling. The main risk factors were: the number of blood transfusions was related to the risk of dehiscence (p = 0.01), a small cartridge size increased the risk of stenosis (p = 0.002) and previous radiotherapy increased the probability of a permanent stoma (p = 0.0005).

Adult↗

PubMed1991

Patients' perception of itch induced by histamine, compound 48/80 and wool fibres in atopic dermatitis.

Itch and flare responses were investigated in 32 patients with atopic dermatitis (AD) and in 32 healthy controls. Itch was induced chemically by intradermal injections of histamine (1, 3.3, 10 and 100 micrograms/ml) and compound 48/80 (10 micrograms/ml) into non-lesional skin and mechanically by wearing a woollen sweater. Continuous recording of itch intensity allowed the calculation of itch duration (ID), maximal itch intensity (Imax) and a "total itch index" (Tii). The itch responses were significantly increased in AD patients compared with controls for wool fibres and one of the histamine concentrations (10 micrograms/ml), but not for the remaining three histamine concentrations or compound 48/80. Conversely, the flare response was significantly smaller in AD patients than in controls for the two strongest histamine solutions and compound 48/80. Significant dose-response relationships were found between histamine concentration and each of ID, Imax, Tii and flare in both patients and controls. The slope of the flare-regression line was significantly steeper in controls than in AD patients, whereas the slopes of the itch-regression lines did not differ significantly between the two groups, i.e. their ability to discriminate between weak and strong histamine concentrations did not differ significantly. No increased skin mast cell releasability in vivo to compound 48/80 was shown in AD patients compared with controls. The itch and flare responses of AD patients did not correlate significantly with clinical itch intensity, eczema score or serum IgE level.

Adolescent↗

PubMed1990

Clinical and serologic markers of stage and prognosis in small cell lung cancer. A multivariate analysis.

The respective pretreatment prognostic impacts of the following markers were evaluated in 125 patients with small cell lung cancer (SCLC): lactic dehydrogenase (LDH), serum thymidine kinase (S-TK), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and tissue polypeptide antigen (TPA). More traditional clinical and serologic markers were also evaluated. Univariate analysis showed that all of the biochemical markers mentioned above, the Karnofsky index (KI) and the patient's sex were related to both the stage of disease (limited/extensive disease: LD/ED) and to survival. The strongest marker for the clinical stage was S-TK, whereas TPA showed the strongest relationship with survival. Multivariate analyses produced a model consisting of S-TK, CEA, NSE, and the patient's sex for determining the clinical stage. To compare the prognostic capacity of easily determined biochemical and simple clinical variables to the more resource-demanding variable of the clinical stage, three multivariate analyses in relation to survival were performed: (1) biochemical markers and simple clinical variables; (2) LD/ED and simple clinical variables; and (3) all available variables. The model obtained from the first analysis included TPA, KI, age, and the patient's sex; the model from the second analyses included LD/ED, patient's age, and KI; and the model from the third analysis, TPA, KI, age, sex, and LD/ED. Indices based on these three multivariate models were calculated for each patient and the prognostic capacity of these indices was compared. Pretreatment serum marker levels also had the capacity to predict both the grade and the duration of the response to therapy.

Adult↗

PubMed1990

Hormone replacement therapy and the risk for first hip fracture. A prospective, population-based cohort study.

OBJECTIVE: To determine the relative risk for sustaining a first hip fracture after hormone replacement therapy. DESIGN: Prospective population-based cohort study with an average observation period of 5.7 years. SETTING: A prescription-based cohort in the Uppsala health care region in Sweden. PARTICIPANTS: The cohort (23 246 women) comprised virtually all women of 35 years of age and older who received noncontraceptive estrogens from April 1977 through March 1980. Comparisons were made with women in the background population. MEASUREMENTS: Follow-up through 1983 was done with regard to hospital admissions for a first cervical or trochanteric hip fracture. The observed number of cases was compared with that expected on the basis of person-years of observation in the cohort and incidence rates in the background population. Analyses were made in exposure categories, based solely on prescription data. MAIN RESULTS: During 133 022 person-years of observation, 163 cases of first hip fracture occurred, compared with the 205.5 expected, yielding an overall relative risk of 0.79 (95% CI, 0.68 to 0.93). The greatest protective effect (relative risk, 0.37; CI, 0.13 to 0.79) was found against trochanteric fracture among women receiving potent estrogens who were under 60 years of age at cohort entry. This group also had the highest proportion of treatments with combinations of estrogens and progestogen (41%). Treatment with less potent estrogens, mainly estriols, had no protective effect. Data indicated that the baseline risk for hip fracture was not lower in the cohort women than in the background population. CONCLUSIONS: Treatment with potent estrogens, both alone and possibly when combined with progestogens, reduces the risk for both cervical and trochanteric hip fractures within the first decade after menopause.

Adult↗

PubMed1990

The effect of female sex hormones on cancer survival. A register-based study in patients younger than 20 years at diagnosis.

The hypothesis that the female survival advantage in many cancers is dependent on sexual maturity was tested in a population-based cohort. Complete follow-up through 1986 was achieved in virtually all 6262 individuals in Sweden who were diagnosed from 1960 through 1984 as having a malignant disease before the age of 20 years. Proportional hazards analysis revealed a 22% lower death rate overall in females than in males. The difference was unrelated to age at diagnosis for tumors arising in the nervous system and the hematopoietic system (lymphomas and leukemias) but strongly dependent on age for sarcomas and, notably, for all remaining cancers--mostly epithelial. Males and females had similar hazard rates for epithelial cancers before the age of 11 years. At ages 11 to 19 years, the rates in females were 55% to 65% lower than in males. One conceivable explanation for these findings is that female sex hormones prevent the establishment of distant metastases in certain malignant diseases.

Adolescent↗

PubMed1990

Nuclear DNA content and survival in medullary thyroid carcinoma. Swedish Medullary Thyroid Cancer Study Group.

In a nationwide study of medullary thyroid carcinoma, the relation between nuclear DNA content and survival was studied in 211 patients with complete follow-up of up to 27 years. Morphologically identified tumor cells were analyzed by an image cytometric method. The DNA histograms were classified (1) by an objective method in which the degree of aneuploidy was defined as the percentage number of tumor cells with DNA values exceeding the 90th percentile of diploid control cells (P90), and (2) according to a subjective evaluation of whether the DNA profiles represented a euploid or an aneuploid DNA pattern. Both classifications separated groups with marked differences (P less than 0.001) in survival. A multivariate proportional hazards analysis indicated that each method provided additional information when the other one was taken into account. In patients whose tumors were classified according to the objective P90 method 1, the relative hazards (with 95% confidence interval) in the groups with P90 values of 36% to 69% and greater than or equal to 70% were 1.6 (0.9-2.8) and 2.1 (1.1-4.0) respectively, compared with the reference group. With the subjective method 2 the corresponding figure for the group with aneuploid tumors was 1.7 (1.0-2.0) compared with the group with euploid tumors.

Adolescent↗

PubMed1990

Cesium-137 in moose diet; considerations on intake and accumulation.

An attempt was made to estimate the daily intake of 137Cs by moose during different months and seasons, and to compare this result with the 137Cs activity concentration in moose muscles. Plants representative of moose diet in central Sweden showed a high 137Cs activity concentration compared with plants from agricultural systems, and there appears to be very slow reduction of 137Cs activity concentration in these forest plants. It seems that the daily intake of 137Cs was low during the summer, but it exhibited a peak in the autumn, which corresponds to the 137Cs activity concentration in moose muscles and also coincides with the hunting season.

Animals↗

PubMed1990

Survival in women receiving hormone replacement therapy. A record-linkage study of a large population-based cohort.

Survival was studied in a population-based cohort of over 23,000 women who were prescribed hormone replacement therapy. Complete follow-up through 1986 revealed a total of 1472 deaths, which was somewhat lower than expected; the relative survival being 101.1% (95% CL, 100.8, 101.3) after 5 years and 102.4% (95% CL, 101.9, 102.8) after 10 years. The relative survival increased with increasing age at entry into the cohort, being 98.2% (95% CL, 96.6, 99.8) in the 40-44 and 105.2% (95% CL, 101.4, 109.1) in the 65-69 year age group after 10 years. Neither the type of compound (potent vs non-potent estrogens), nor the year of entry into the cohort seemed to affect survival, whereas survival advantage generally increased with years of follow-up. Multivariate analysis showed that age at time of first prescription was the only determinant that significantly affected the death risk. This pattern could be explained by confounding due to selection of healthy subjects receiving hormone replacement therapy and/or by the specific choice of estrogen compounds (and progestogens), related to age. It is concluded that hormone replacement therapy is associated with a survival which is similar to or--notably at ages above 50-60 years--slightly higher than that in the general population.

Adult↗

PubMed1990

The enterochromaffin cells in the mouse gastrointestinal tract after streptozotocin treatment.

Effects of 5 weeks streptozotocin treatment on the mouse gastrointestinal tract were studied with special emphasis on enterochromaffin (EC) cells. In the streptozotocin-treated animals the frequency of EC cells was reduced in the antral area and in the small intestine, but increased in the colon. The length of the intestinal tract and the mucosal thickness were increased in these animals. Possible mechanisms underlying these abnormalities of the EC cell system are discussed.

Animals↗

PubMed1990

Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway.

A population-based case-control study was conducted in Sweden and Norway to analyse possible associations between breast cancer occurring before the age of 45 and several different characteristics of the women's reproductive life. A total of 422 (89.2%) of all eligible patients, and 527 (80.6%) of all eligible controls were interviewed. In univariate analyses, different characteristics of child-bearing (parity, age at first birth, years between last birth and diagnosis, duration of breast-feeding, and number of induced and spontaneous abortions), measures of the fertile or ovulating period (age at menarche, years between menarche and first pregnancy, and estimates of the menstruation span) and symptoms of anovulatory cycles or infertility were all seemingly unrelated to, or at most weakly associated with breast cancer. Adjustment for possible confounding factors in multivariate analyses resulted in largely unaltered risk estimates with odds ratios close to unity and without any significant trends when the exposure variables were studied in categorised or in continuous form. We conclude that reproductive factors did not explain the occurrence of breast cancer before the age of 45 in this population.

Abortion, Spontaneous↗

PubMed1990

The incidence of ovarian cancer in Sweden, 1960-1984.

Trends in the incidence of ovarian cancer among 23,239 cases reported to the Swedish Cancer Registry from 1960 through 1984 were analyzed. Trends in age-standardized incidence rates were best described by a nonlinear model with a highly significant negative second-order term, which showed an initial increase followed by stabilization and, in later years, a decline. In multivariate models, both time period of diagnosis and birth cohort were found to have significant effects. These separate models provided consistent evidence for an increasing risk in women born during the last decades of the 19th century, and a slowly decreasing risk in recent years and in the youngest birth cohorts. The very high population exposure to oral contraceptives, which may protect against ovarian cancer, is one conceivable explanation for the decreasing trend.

Adult↗

PubMed1990

Trends in the incidence of malignant melanoma in Sweden, by anatomic site, 1960-1984.

This study was based on 15,376 patients in Sweden with cutaneous malignant melanoma diagnosed during the 25-year period 1960-1984. Trunk melanoma increased substantially during that period among men, with age-standardized rates rising from 1.1 to 7.0 per 10(5). Among women, the greatest increases occurred in melanoma of the upper extremity (rising from 0.4 to 2.3), lower extremity (rising from 1.6 to 4.4), and trunk (rising form 0.6 to 3.1), but the rates for the latter two sites seemed to level off after 1978. Multivariate analyses showed that models based on a common parameter ("drift"), including linear birth cohort and/or time periods effects, were significantly superior to simple age models for explaining incidence trends for each separate site. Further, in men with melanoma of the trunk and upper and lower extremities, birth cohort effects had significant effects compared with drift. In contrast, in women, time period effects were a significant improvement on drift for melanoma of the trunk and lower extremity. The relative risk of malignant melanoma among men leveled off in later-born cohorts for all separate sites. A similar trend was found in women, except for melanomas of the trunk, in which the increase in relative risk persisted. The results indicate sex-specific differences in temporal trends of exposure to factors causing malignant melanoma.

Adult↗

PubMed1990

The antipruritic effect of a sedative and a non-sedative antihistamine in atopic dermatitis.

A double-blind, randomized, cross-over study was carried out on the effect of a sedative and a non-sedative antihistamine on 25 adults with atopic dermatitis. Intensity of itch was recorded using a computerized method for self-assessment (Pain-Track) and using conventional visual analogue scales. The antipruritic effect of 3 days of treatment with the non-sedative H1 antagonist terfenadine (60 mg b.i.d.) and with the sedative antihistamine, clemastine (2 mg b.i.d.) did not differ from that found with the placebo. Our findings support the view that histamine is not of importance in the pathogenesis of itch in atopic dermatitis.

Adolescent↗

PubMed1990

Effects of prolonged adrenaline infusion and of mental stress on plasma minerals and parathyroid hormone.

The role of the sympatho-adrenal system for the secretion of PTH in humans is not established. Previous studies on the effects of adrenaline on plasma mineral homeostasis have focused on injections or short-term infusions of adrenaline, and conflicting results concerning calcium and parathyroid hormone (PTH) responses have been reported. We therefore infused adrenaline or placebo continuously for 3 h to 10 healthy volunteers and studied several plasma minerals, as well as PTH levels. Venous plasma adrenaline concentrations increased to the upper physiological range (5 nmol l-1) during adrenaline infusion. Another nine volunteers were exposed for 25 min to mental stress (a colour word conflict test; CWT), which causes marked circulatory changes and raises plasma catecholamine concentrations. Plasma ionized and total calcium, and magnesium concentrations were slowly and gradually reduced during infusion of adrenaline, but there was only a small increase in PTH. Plasma potassium was decreased by adrenaline within 30 min and thereafter did not change further during infusion. There was a marked but transient increase in the plasma free fatty acids concentration, which were not related to the reduction of the calcium or magnesium levels. The adrenaline-induced decrements in calcium, magnesium and potassium, and increases in heart rates persisted 30 min after the infusion, despite a rapid decrease in plasma adrenaline concentrations within 5 min of termination of the infusion. Plasma phosphate concentrations were lowered during the first 90 min of adrenaline infusion, but after 3 h they had returned to baseline despite continued infusion. CWT induced small increments of the plasma ionized calcium and PTH concentrations. Plasma potassium levels were raised despite increases in plasma adrenaline at the beginning of the stress test, while phosphate values were reduced at the end of the test. Thus, long-lasting elevations of circulating adrenaline lower plasma ionized and total calcium, phosphate, magnesium and potassium, but the time courses for these changes differed markedly. Despite the reduction of plasma ionized calcium there was only little increase in PTH and thus no indication that sustained elevations of circulating adrenaline stimulates the secretion of PTH in vivo in humans. Responses to acute mental stress and adrenaline infusion differed qualitatively, indicating that adrenaline responses to stress are of minor importance in this respect.

Adult↗

PubMed1990

Effects of exposure to welding fume: an experimental study in sheep.

Welding fume contains various metals and pulmonary effects from their inhalation are largely unknown. We have studied the effects of exposure to welding fume in sheep. The animals were exposed to either a bolus dose of welding fume solution or to five weeks daily exposure. Lung physiology parameters were studied and biopsies taken. Magnetopneumography was used to register the longterm exposure. Acutely exposed animals had elevated pulmonary arterial pressure. Arterial oxygen tension was reduced after fume instillation. These animals had accumulation of iron (Fe), magnesium (Mg) and manganese (Mn) in the lungs. Mn was elevated 40 times. Longterm exposed sheep increased the iron oxide accumulation significantly in lungs as seen with the magnetopneumographic technique. Following long term exposure, Mn was the metal most heavily retained in the lungs. Metals like Mn, Fe and Mg retained in the lungs can possibly give negative health effects. Besides this, the metals could be used for quantitation of welding fume exposure.

Air Pollutants, Occupational↗

PubMed1990

Clinical characteristics and surgical treatment of sporadic primary hyperparathyroidism with emphasis on chief cell hyperplasia.

In 570 patients with sporadic primary hyperparathyroidism, the age, sex, symptoms, and preoperative serum calcium values were related to the histopathologic diagnoses, operative findings, and the extent and outcome of parathyroid surgery. Renal stone formation was especially prevalent in younger patients with slight hypercalcemia and parathyroid chief cell hyperplasia, whereas neuromuscular and psychiatric disturbances were overrepresented among older women with higher serum calcium values. Serum calcium concentration was inversely correlated to the proportional incidence of chief cell hyperplasia and positively correlated to the glandular weight of both adenomas and hyperplasias. Glandular size was markedly irregular in chief cell hyperplasia, with increased gland weights of no more than two glands in 78% of patients. During follow-up, for as long as 27 years, normocalcemia was obtained in 91% of patients with adenomas, with failures mainly depending on difficulties in identifying the parathyroid glands. The rate of normocalcemia was lower (80%) among patients with hyperplasia, but an inability to visualize the glands was not a major cause of failure. In patients with hyperplasia with asymmetric and more markedly enlarged glands, it appeared sufficient to remove only the enlarged glands, whereas the findings advocated a subtotal 3- to 3.5-gland resection in patients with more symmetrically or less enlarged hyperplastic glands.

Adenoma↗

PubMed1990

Long-term survival in sporadic and familial medullary thyroid carcinoma with special reference to clinical characteristics as prognostic factors. The Swedish MTC Study Group.

All the 249 patients with medullary thyroid carcinoma (MTC) diagnosed during a 23-year period in Sweden were followed up completely for 4-27 years. The overall relative survival was 79.9% at 5 years after diagnosis and 68.6% at 10 years. After 5 years of follow-up, the relative survival rate was 5 percentage points higher in females than in males; 30 percentage points higher in patients aged less than 40 than in those 60-69 years at diagnosis; 24 percentage points higher in patients with familial disease detected at screening than in those with sporadic MTC; 20, 26 and 48 percentage points lower in patients with stage II, III, and IV, respectively, than in those with stage I; and almost 30 percentage points lower in the group of patients with a large tumor (greater than 3 cm) than in the group with a small one (less than 1 cm). In multivariate proportional hazards analyses of all these important determinants of outcome, the prognostic information provided by age and stage was still significant when several morphologic characteristics were taken into account (nuclear DNA content, calcitonin immunoreactivity, amyloid content, argyrophil reaction and state of the tumor capsule).

Adolescent↗

PubMed1989

Increasing survival trend after cancer diagnosis in Sweden: 1960-1984.

We analyzed the survival trend after cancer was diagnosed by complete follow-up through 1986 of 591,456 (99.4%) of all those patients in whom a first malignant disease was diagnosed in Sweden from 1960 to 1984. From 1960-1964 to 1980-1984, the 5-year relative survival increased from 34.2% to 47.1% in males and from 48.7% to 56.9% in females. The mean loss of expected life among cancer patients decreased from 9.6 to 7.0 years. During the first 5 years after diagnosis, the cancer-specific hazard rate decreased by 34% in males and 30% in females. Thus several analytical approaches revealed a substantial increase in cancer patient survival since 1960.

Adult↗