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Biomedical subjects

S Forsmo

Publications and source records attributed to S Forsmo.

12 recordsLinked to original sources
PubMed2004

Higher bone mineral density in rural compared with urban dwellers: the NOREPOS study.

Norway has a very high incidence of osteoporotic fractures, with substantial regional differences in fracture incidence. The present study evaluated whether there are differences in bone mineral density (BMD) between regions in Norway with differences in fracture incidence. The authors used data collected in four large, population-based, multipurpose studies performed in four regions of Norway during 1994-2001. Distal forearm BMD was measured by single energy x-ray absorptiometry in 10,667 participants aged 40-75 years. Cross-calibration was performed by using the European Forearm Phantom. Mean distal forearm BMD was lower in the urban populations of Tromso, Oslo, and Bergen compared with the rural county of Nord-Trondelag, whereas there was no difference between the rural part of Tromso and Nord-Trondelag. For women, body mass index explained some of these differences. The prevalence of low BMD (z score < or = -1) in Oslo, Bergen, and urban Tromso, compared with Nord-Trondelag, was 1.6-1.7 times higher in men and 1.5-2.0 times higher in women, whereas no significant difference was found between rural Tromso and Nord-Trondelag. In this study, higher BMD was found in rural compared with urban areas of Norway, which might help explain the differences in fracture incidence. There was no apparent north-south gradient in BMD.

Absorptiometry, Photon↗
PubMed2001

How do reproductive and lifestyle factors influence bone density in distal and ultradistal radius of early postmenopausal women? The Nord-Trøndelag Health Survey, Norway.

In a population-based health survey, densitometry was performed at the distal and ultradistal radius with single-energy X-ray absorptiometry. Bone mineral density (BMD) data and self-reported reproductive and lifestyle data from 1652 randomly selected peri- and postmenopausal women aged 50-59 years were analyzed. A total of 893 (54.1%) postmenopausal women reported no prior use of hormone replacement therapy (HRT) and constituted the principal group of study. These women were more frequently smokers, consumed less alcohol, more coffee and had made less use of oral contraceptives (OC) than women in the HRT group. The strongest association with both distal and ultradistal radius bone densities was found for age, weight, time since menopause and a history of bilateral oophorectomy. Among reproductive factors, nulliparous women had lower BMD than parous women; however, no linear relationship was found between parity and bone density. A weak, positive relationship was found for OC and BMD in bivariate, but not in multivariate analyses. A history of hysterectomy was positively associated with BMD, stronger at the ultradistal than distal radius. A positive relationship between alcohol consumption and BMD was found at the ultradistal radius. Present or prior smokers had lower BMD than never smokers. In the multivariate model, interaction between pack-years of smoking and daily coffee intake was observed at the distal radius, and both factors had a stronger negative influence on distal than ultradistal radius bone density. In perimenopausal women, most reproductive and lifestyle risk factors found to be associated with BMD of the radius may be explained by different levels of estrogen.

Absorptiometry, Photon↗
PubMed1998

[The murder at Grünerløkken--a centenary].

In December 1898, a five year old boy was found murdered and sexually abused at Grünerløkka in Oslo. The crime was reported to the police by a 19 year old boy, who soon after was detained and charged with the misdeed. In spring 1899 he was found guilty and sentenced to life imprisonment with hard labour. This article is based on a long and detailed forensic medical and psychiatric report from the investigation and trial, published in this Journal in 1899, and on the Oslo press coverage of the crime. It shows that much has changed during these 100 years regarding both the privacy of the victim, the accused and their families, and factors paid attention to in the psychiatric assessment of the accused.

Adult↗
PubMed1997

Treatment of pre-invasive conditions during opportunistic screening and its effectiveness on cervical cancer incidence in one Norwegian county.

Norway had until recently no organized screening programme for cervical cancer, but opportunistic screening was common. This study focuses on the effectiveness of treatment of pre-malignant cervical conditions (CIN III) on cervical-cancer incidence in the county of Sør-Trøndelag in Norway, prior to the introduction of organized mass screening. The study is based on cervical-cancer incidence rates during the years 1965-92 and treatment data for CIN III. The expected number of cervical-cancer cases prevented due to early intervention was expressed in a regression model with 2 unknown parameters: the probability, p, of cancer development in case of CIN III, and the time lag, t, between treatment and when clinical cancer would otherwise have been diagnosed. The estimated probability that a patient treated for CIN III would have developed cervical cancer if not treated was found to be approximately 20%, and the mean time delay was around 16 years. In the last period of study (1988-92), the incidence was reduced by nearly 40% of what would have been expected without early intervention. Based on equal treatment rates as in 1990, parameter estimates were used to predict future incidence reduction. Maximum effectiveness will be achieved around the year 2005, with a nearly 70% reduction. Opportunistic screening and treatment of CIN III seems to have had considerable influence on cervical-cancer incidence. The costs, however, are substantial over-treatment, since our results indicate that 4 of 5 women treated for CIN III would not progress into the invasive state.

Adult↗
PubMed1996

Cervical neoplasia in pap smears: risk of cervical intra-epithelial neoplasia (CIN) after negative or no prior smears in a population without a mass screening programme.

BACKGROUND: The aim of this study was to examine, in a population not submitted to mass screening, the risk of cancer and cervical intra-epithelial neoplasia (CIN) in Pap smears from women without previously reported positive smears. METHODS: In a logistic regression model consisting of 58,271 smears from 40,536 Norwegian women the risk of cytologically indicated CIN was studied according to age and time elapsed since last smear. RESULTS: The risk of CIN was highest in smears from women with no previously registered smears and in smears taken after an interval of > or = 5 years. Odds ratio for CIN I-II adjusted for age was highest in first time smears and in smears taken after an interval of 5 years. Odds ratio for CIN III was highest in first registered smears. No difference in risk of CIN III was found in smears taken within one year or 2-3 years after the last smear. The increased risk of CIN III in first smears was most pronounced in postmenopausal women ( > 50 years). Nine of 16 cases with cytological indication of cancer were found in women having a smear taken for the first time. All cases with malignancy in smears were > 50 years. CONCLUSIONS: The risk of cytologically diagnosed premalignant cervical conditions increases with time since the previous smear, but more than 5 years have to elapse before the risk is comparable with that in first smears taken. Postmenopausal women without previous smears run the highest risk of serious cervical premalignancies and cancer.

Adolescent↗
PubMed1996

Pregnancy outcome after laser surgery for cervical intraepithelial neoplasia.

BACKGROUND: Little is published about obstetrical problems after treatment of cervical intraepithelial neoplasia with the C02-laser. The aim of this study was to determine the risk of low birth weight in the subsequent pregnancy after laser conization or vaporization in a follow-up study of women treated for cervical intraepithelial neoplasia (CIN). Methods. Of 319 women treated for CIN with the C02-laser in the Department of Obstetrics and Gynecology, University Hospital of Tromsø, Norway and followed for pregnancy outcome, 87 women had given birth (after 24th week) four to nine years after treatment. Sixty-five women had undergone conization and 22 women had been treated with vaporization. For each delivery, two controls matched for parity, age (+/- 3 years) and place of delivery were identified. The material was analyzed as a matched cohort study. RESULTS: A strong relationship was found between conization and low birth weight. Mean birth weight after conization was 3185 g vs 3473 g,in the control women (p=0.03). Thirteen (20%) infants from women subject to conization had birth weight less than 2500 g. Relative risk of birth weight<2500 g was 2.2 (1.04-4.5) after conization, for<2000 g and< 1500 g the risk was 3.5 (1.02-12.0) and 10.0 (1.2-85.6), respectively. Four women (6.2%) with normal deliveries prior to conization experienced one or several stillbirths after treatment. No difference in birth weight was observed for women after vaporization compared to their controls. CONCLUSION: Excisional surgery on the cervix increases the risk for low birth weight in subsequent pregnancies. Pregnant women with prior conization need careful antenatal care.

Adult↗
PubMed1994

Use of pap-smears in a population without a mass screening program.

STUDY OBJECTIVE: To analyze the use of Pap-smears in a population where a screening program was not offered. DESIGN: Retrospective analysis of pathology registry data on women resident in two counties of Norway. SETTING: Evaluation of opportunistic screening by age and year of birth. Proportion of population tested during successive 3-year periods. MATERIAL: 353,665 smears from 88,048 women examined since 1973. For this purpose we concentrated on 257,951 smears from 77,431 women examined during the period 1981-90. RESULTS: Between 62 and 67% of women examined during each 3-year period were 20-39 years old, 14-16% were 50-69 years of age. Throughout the ten-year period the frequency of Pap-smear testing of women over 60 and under 20 increased slightly whereas it decreased for women 20-39 years old. Follow-up of positive or atypical smears comprised about 25% of all smears. The highest proportion of follow-ups was found among women 30-49 years old. About one third of women aged 20-59 years had more than one smear taken in a 3-year period, follow-up smears excluded. CONCLUSION: More than half of the women aged 50 and above have no smears or smears less than one every third year. This proportion increases with age. The use and distribution of smears by age is still far from the situation expected in an organized screening program although a slight amelioration was observed through the study period.

Adult↗
PubMed1992

[Cervical intraepithelial neoplasms. Persistency and recurrence after laser surgery].

Between 1983 and 1988, 402 women, with ages ranging from 18 to 73 years were treated for cervical intraepithelial neoplasia using the CO2-laser. 89 patients underwent vaporization and 313 conization. Preoperative biopsy examination showed CIN III in 214 patients. Five cases of invasive cancer were diagnosed, either preoperatively (two cases), after conization (two cases) or on both occasions (one case). At the first postoperative examination residual disease was found in 21 patients of the vaporization group (23.6%) and in 13 patients of the conization group (4.3%). Later examinations (after 5-70 months) revealed recurrence in 10 patients in the vaporization group (11%) and in 13 patients in the conization group (4.3%). Median time for recurrence was 11 months. 30 patients were treated twice or more. No case of invasive cancer was diagnosed after treatment.

Adolescent↗