Biomedical subjects

S Friis

Publications and source records attributed to S Friis.

At least 73 records · Page 4Linked to original sources

PubMed1998

Risk of liver and other types of cancer in patients with cirrhosis: a nationwide cohort study in Denmark.

Cancer risk in patients with cirrhosis could be modified by factors such as changes in hormonal levels, impaired metabolism of carcinogens, or alteration of immunological status. We investigated the risk of liver and various forms of cancer in patients with cirrhosis in a follow-up study. We identified 11,605 1-year survivors of cirrhosis from the files of the Danish National Registry of Patients (NRP) from 1977 to 1989. Occurrence of cancer through 1993 was determined by linkage to the Danish Cancer Registry. For comparison, the expected number of cancer cases was estimated from national age-, sex-, and site-specific incidence rates. Overall, 1,447 cancers were diagnosed among the study subjects, as compared with 708.1 expected, to yield a standardized incidence ratio (SIR) of 2.0 (95% CI: 1.9 to 2.2). In all diagnostic subgroups of cirrhosis, the risk of primary liver cancer, mainly hepatocellular carcinoma, was markedly elevated, with 245 observed cases and an overall 36-fold elevated risk (59.9-fold elevated for hepatocellular carcinoma and 10-fold for cholangiocarcinoma). Substantial and persistent excesses during follow-up were seen for all types of cancer associated with tobacco and alcohol habits (cancer of the lung, larynx, buccal cavity, pharynx, pancreas, urinary bladder, and kidney), while moderate excesses were seen for cancers of the colon and breast. The latter, however, were not complemented by any decrease in the risk of prostate cancer (SIR: 1.0; 95% CI: 0.7 to 1. 3). A slightly increased risk was seen for testis cancer, but disappeared after 10 years. We found evidence of an increased risk for liver and several extrahepatic cancers in patients with cirrhosis. Although part of this increase is likely attributable to alcohol and tobacco consumption, our study opens up the possibility that cirrhosis plays a role in the carcinogenesis of types of cancer other than liver cancer.

Adult↗

PubMed1998

Prostate cancer in Denmark: a 50-year population-based study.

OBJECTIVES: To review the trends in prostate cancer (PC) incidence and mortality rates in Denmark during a 50-year period. METHODS: A population-based register study was performed of all new cases of PC recorded in the Danish Cancer Registry from 1943 to 1992. RESULTS: The age-standardized incidence rate for PC increased from 11.5/100,000 in 1943 to 1947 to 30.9/100,000 in 1988 to 1992. Age-specific incidence rates increased in all age groups over 50 years of age. Mortality rates increased from 13.5/100,000 in 1953 to 1957 to 17.8/100,000 in 1988 to 1992. No major changes in the distribution of age, stage at the time of diagnosis, or in diagnostic procedures were found, indicating that the observed change in incidence rates was not caused by attempted early detection or changes in diagnostic strategy. CONCLUSIONS: Our data suggest that the increased PC incidence observed during the period of cancer registration in Denmark represents a true increase in the number of patients with clinical PC.

Age Distribution↗

PubMed1998

Risk of breast cancer in men with liver cirrhosis.

OBJECTIVE: Liver cirrhosis is associated with increased levels of estrogens, which may be causally related to breast cancer. Because background estrogen levels are lower in men than in women, an estrogen-mediated link between liver cirrhosis and breast cancer would be easier to detect in men. METHODS: Men hospitalized with liver cirrhosis in Denmark from January 1, 1977, to December 31, 1989, were followed up, through record linkage, until the end of December 1993 for the possible occurrence of breast cancer. RESULTS: A total of 11,642 men with liver cirrhosis were identified and were followed for a mean period of 4.3 yr, for a total of 49,687 person-years. Three cases of male breast cancer were observed whereas 0.75 was expected, for a standardized incidence ratio of 4.0 (95% confidence interval, 0.8-11.7). CONCLUSIONS: Cirrhosis, possibly via high levels of endogenous estrogens, increases the risk of breast cancer in men.

Breast Neoplasms, Male↗

PubMed1998

Chronic patients in psychiatric institutions: psychopathology, level of functioning and need for care.

A total of 107 chronic in-patients in a catchment area of 106,000 inhabitants were rated for psychopathology on the Brief Psychiatric Rating Scale expanded version (BPRS-E), for level of functioning on the Rehabilitation Evaluation Hall And Baker (REHAB), and for geriatric problems on the Geriatric Rating Scale (GRS). The results showed low levels of severe psychopathology and low to moderate levels of functioning, indicating that the main obstacle to community placement was the lack of functioning. Global assessment by ward nurses with regard to the future level of care needed divided the patients into three categories: 40 patients in need of a psychiatric nursing home, 30 patients in need of a general nursing home, and 37 patients who could potentially be discharged to apartments with community support. This study indicates that the REHAB may help to identify patients who are potential candidates for community placement, while the BPRS-E may help to identify patients who are still in need of care in a psychiatric institution.

Activities of Daily Living↗

PubMed1998

The fate of chronic in-patients after closure of psychiatric nursing homes in Norway: a personal follow-up 6 years later.

We evaluated all 107 chronic in-patients in a catchment area before and 6 years after a planned reduction in the number of psychiatric institution beds was implemented. At follow-up, 32 of the patients had died. One had probably committed suicide, while the others were elderly people who had died of natural causes. In the remaining patients the level of functioning was low, and below that which could be deduced from their level of symptoms, which was also low. The majority of the patients still lived in institutions, mostly in general nursing homes. Among those who had moved out, there were non-significant trends towards a reduction in symptoms and an increase in functioning. In general, the patients were satisfied with their new accommodation. Most of them needed extensive help and support to establish an acceptable standard of living in the community.

Aged↗

PubMed1998

Outcomes of poorly functioning patients with personality disorders in a day treatment program.

OBJECTIVE: Rates of completion, complications, and outcome were examined in a sample of poorly functioning patients who participated in a group-oriented day treatment program for patients with personality disorders. METHODS: The study was a naturalistic prospective study of 183 patients admitted to a day treatment program in Oslo, Norway. The program consists of a combination of group analytically oriented groups and cognitive-behavioral groups. The Global Severity Index (GSI) of the Symptom Check List, the circumplex version of the Inventory of Interpersonal Problems (IIP-C), and the Global Assessment of Functioning (GAF) were administered at admission and discharge. RESULTS: A total of 138 [corrected] patients (77 percent) completed the day treatment program. Few patients experienced treatment complications. Effect sizes for GAF, GSI, and IIP-C scores for treatment completers were in the medium-to-high range, indicating a fair level of improvement. Patients' rating of benefit was positive. CONCLUSIONS: The results are promising as a first step toward development of a cost-efficient comprehensive long-term treatment program for patients with severe personality disorders.

Adult↗

PubMed1998

Neurologic disease among women with breast implants.

OBJECTIVE: To investigate the risk of neurologic disease among women with silicone breast implants. BACKGROUND: Since 1992, several case series reported an association between silicone breast implants and neurologic diseases. METHODS: Between 1977 and 1992, 1,135 women received cosmetic silicone breast implants, and 7,071 women had breast reduction surgery, as identified by the Danish National Register of Patients (NRP). NRP files provided information on numbers and types of subsequent neurologic disorders at hospital discharge, which were compared with expected numbers, calculated on the basis of national hospital discharge rates. RESULTS: In the two study cohorts, hospital discharge rates for neurologic diseases were raised by some 60% to 70% compared with Danish women in general. Among women with silicone breast implants, 13 subsequently developed a neurologic disorder compared with 7.7 expected; whereas in the comparison group, 63 observed versus 39.1 expected disorders were recorded. These results indicate that relative to the comparison cohort, women with implants had no excessive levels of definite neurologic disease. Furthermore, medical record reviews revealed that the majority of women with implants discharged with a neurologic diagnosis had either symptoms before implant surgery or neurologic symptoms secondary to degenerative diseases. CONCLUSIONS: Our findings do not support the hypothesis of silicone-induced neurologic disease. The reasons for the elevated rates of neurologic disease in both the exposed and comparison cohorts remain unclear, but may reflect selection processes associated with these women seeking medical care more often than the general population.

Adult↗

PubMed1998

Health outcomes in offspring of mothers with breast implants.

OBJECTIVE: To examine the occurrence of esophageal disorders, connective tissue diseases, and congenital malformations in children of mothers with breast implants. METHODS: Nationwide register-based follow-up study of all offspring born during 1977 to 1992 to a cohort of 1135 women with breast implants for cosmetic reasons and to a comparison cohort of 7071 women who underwent breast reduction surgery. Cause-specific hospi-talization rates among offspring, relative to those of the general population, were calculated from the Danish National Registry of Patients. RESULTS: Among the 939 children of mothers with breast implants, higher rates of esophageal disorders were observed, but the excess was similar for those born before versus after the implant surgery. Higher than expected hospitalization rates for these conditions were also observed among 3906 children of women who underwent breast reduction surgery. No significant increases in connective tissue diseases or congenital malformations were observed in either the breast implant or breast reduction cohorts. CONCLUSIONS: This first epidemiologic cohort study provides no evidence that silicone breast implants affect risks of esophageal or other disorders in children of the implantees. Rather, the observed risk pattern suggests that a lower threshold exists among both groups of women who have undergone cosmetic breast surgery in seeking professional medical care for problems normally solved outside the hospital.

Adolescent↗

PubMed1997

Breast implants and cancer risk in Denmark.

Although millions of women worldwide have received breast implants for cosmetic or medical reasons, possible late effects (in particular cancer) have not been well studied. To provide quantitative information on cancer occurrence among women undergoing breast implant surgery, 1,135 women treated for cosmetic reasons in Denmark were evaluated. Patients were identified using the nationwide Hospital Discharge Registry with linkage to the nationwide Danish Cancer Registry to determine subsequent cancer incidence. The average age of the women at implant surgery was 31 years, and the average follow-up was 8.4 years, up to a maximum of 17 years. Overall, 27 cancers developed after implant surgery compared with 24.7 expected based on incidence rates from the general population (standardized incidence ratio [SIR] = 1.1; 95% CI: 0.7-1.6). Eight breast cancers were observed vs. 7.8 expected (SIR = 1.0; 95% CI: 0.4-2.0). No evidence was found to link breast implants with increased cancer risk in the decade after surgery. While the results are encouraging, longer follow-up into later life will be necessary to assess fully any possible adverse effects.

Adolescent↗

PubMed1997

[Involuntary admissions in emergency psychiatric institutions. A comparison between the county of Hedmark and the Ullevål sector in Oslo].

In this paper we compare the acute psychiatric wards in Hedmark county and the catchment area of Ullevål hospital with regard to involuntary hospitalizations and admission rates for psychosis during the period 1989-94. In the former area the percentage of involuntary admissions decreased from 58% to 48% during the period, but in the Ullevål catchment area it remained fairly stable at 85%. The latter area showed a higher percentage of involuntary hospitalizations for both psychotic and non-psychotic patients. The admission rate for psychotic patients was higher in the Ullevål catchment area and tended to increase in the course of the study period. We relate our findings primarily to a higher incidence of psychiatric disorders in a city like Oslo. Structural differences in psychiatric and primary care, especially for long-term patients may also be a contributory factor.

Commitment of Persons with Psychiatric Disorders↗

PubMed1997

[Prostatic cancer men under age 65. Occurrence and need for study].

Based on information from the nationwide Danish Cancer Registry, the development in prostate cancer incidence among Danish men under 65 years is reviewed. Changes in incidence rate, clinical stage and the number of possible candidates for radical treatment are discussed.

Adult↗

PubMed1997

[Silicone breast implants and breast cancer].

Sarcomas have been shown to develop next to foreign body implants, silicone included, in animal experiments. However, this carcinogenesis is not believed to have any human relevance. A review of the existing epidemiological studies suggests that women with silicone breast implants have a reduced risk for developing breast cancer. However, the presence of breast implants does obscure mammographic visualization as well as palpation of mammary tissue. This has led to the assumption that breast cancer detection could be compromised in women with breast implants. In the few studies that have dealt with this issue, women with breast implants were diagnosed with the same stage of disease as women without implants. However, the percentage of false negative mammographies was increased in one study. In conclusion, there is currently no evidence of an association between breast implants and cancer or postponed breast cancer detection.

Breast Implants↗

PubMed1997

Internal consistency of the Seasonal Pattern Assessment Questionnaire (SPAQ).

We examined the consistency reliability of the widely used Seasonal Pattern Assessment Questionnaire (SPAQ). In total, 587 questionnaires from a random sample of the general population were analysed. The 6 items of the Seasonality Scale Index (SSI) correlated fairly well, and consequently this scale proved to have a high internal consistency (alpha = 0.82). Items from the SSI that measure seasonal variations in sleep and weight were consistent with other SPAQ scales that also measure these dimensions. Since the questionnaires analysed were from an epidemiological study, the high consistency reliability shows that the symptoms probed for by the SSI, tend to cluster in susceptible individuals in the general population.

Adolescent↗

PubMed1997

Reproducibility and relative validity of a self-administered semiquantitative food frequency questionnaire applied to younger women.

We have evaluated the reproducibility and relative validity of a semiquantitative food frequency questionnaire (FFQ) used in a prospective study of risk factors for cervical neoplasia. The questionnaire is a modified version of one developed and evaluated in a middle-aged Danish population. In the present study, 122 women from the general population of Copenhagen, aged 20-29 years, completed the FFQ twice at a 1-year interval, and provided three 4-day dietary records during the intervening year. The mean nutrient intakes calculated from the first and second questionnaire were similar and, for most nutrients, close to those obtained from the dietary records. The Pearson correlation coefficients between the mean nutrient intakes from the two questionnaires ranged from 0.53 (95% CI, 0.39-0.65) for vitamin E to 0.76 (95% CI, 0.67-0.83) for vitamin B12 (median, 0.67 [95% CI, 0.56-0.76]). In comparisons between the second FFQ and the dietary records, the correlations ranged from 0.24 (95% CI, 0.07-0.40) for vitamin D to 0.63 (95% CI, 0.51-0.73) for sucrose (median, 0.42 [95% CI, 0.26-0.561). The correlations between FFQ and dietary records were generally higher after adjustment for energy intake (median, 0.53 [95% CI, 0.39-0.65]) and within-person variability (median, 0.64 [95% CI, 0.52-0.73]). On average, 71% of the women were classified in the same (+/- 1) quintile in the second FFQ and the dietary records. An average of 3.8% of the women were grossly misclassified into the highest and lowest quintiles by the dietary records. The relative validity of the FFQ in this population was similar to that reported earlier. It is concluded that the FFQ is reproducible and provides a useful scale for categorizing individuals according to their intake of energy and nutrients.

Adult↗

PubMed1997

Cancer following breast reduction surgery in Denmark.

Intuitively, breast tissue mass should be directly related to a woman's risk of breast cancer, simply because having more cells at risk would seem to increase the potential for malignant transformation. However, studies attempting to link breast size with breast cancer risk have been inconsistent. Limitations include crude measures of breast size, the inability to distinguish glandular from adipose tissue, and the confounding influence of co-factors such as obesity. A nationwide study in Denmark was undertaken to investigate the effect of breast reduction surgery on the subsequent risk of breast cancer, including an evaluation of the patterns of risk by age and time since surgery. The Danish Hospital Discharge Registry was used to identify women who underwent reduction mammaplasty between 1977 and 1992. Linkage based on personal identification numbers with the Danish Cancer Registry provided information on cancer incidence. Expected numbers of cancers were calculated from rates in the general population. Among 7,720 women whose breasts were surgically reduced, 182 cancers were subsequently observed cf 209 expected (standardized incidence ratio [SIR] = 0.9;95 percent confidence interval [CI] = 0.7-1.0). Breast cancer was significantly reduced by nearly 50 percent (29 observed cf 53.9 expected, SIR = 0.5, CI = 0.4-0.8), and accounted for the overall deficit in cancer. The risk reductions were related inversely to age at surgery, with significant deficits apparent only among women 40 years of age and older at surgery and especially among those over age 50 (SIR = 0.3). No clear trend was apparent with increasing years post-surgery. The findings indicate that breast reduction surgery among women over age 40 is associated with a lower subsequent risk of breast cancer, but the surgery and presumably glandular mass appear less closely related to breast cancer risk among younger women.

Adolescent↗

PubMed1997

Cervical intraepithelial neoplasia, anogenital cancer, and other cancer types in women after hospitalization for condylomata acuminata.

To investigate the possible association between condylomata acuminata and anogenital neoplasia, a cohort of 9552 women recorded as having condylomata acuminata in the Danish Hospital Discharge Register during 1977-1989 was followed through 1991 for the occurrence of cancer and cervical intraepithelial neoplasia grade III (CIN III) by linkage to the Danish Cancer Registry. Eleven cases of vulvar cancer were identified, with 0.3 expected (standardized incidence ratio [SIR], 40.1; 95% confidence interval [CI], 20.0-71.7), and there were increased risks for cervical cancer (SIR, 2.0; 95% CI, 1.3-3.0), anal cancer (SIR, 8.5; 95% CI, 0.9-30.5), and CIN III (SIR, 2.6; 95% CI, 2.3-2.9). Risks were also elevated for non-anogenital cancers, notably lung cancer (SIR, 3.8; 95% CI, 2.2-6.0). Although confounding by smoking and other factors may exist, these results support the view that condylomata acuminata are associated with an increased risk of anogenital neoplasias, particularly vulvar cancer, and emphasize that women hospitalized with these lesions should undergo thorough anal and gynecologic examinations at regular intervals.

Adolescent↗

PubMed1997

Connective tissue disease and other rheumatic conditions following breast implants in Denmark.

To investigate the risks of connective tissue diseases (CTDs) following breast implants we used the nationwide Danish Hospital Discharge Register (HDR) to identify 2,570 women who received breast implants, either for cosmetic reasons (N = 1,135) or for breast reconstruction (N = 1,435), between 1977 and 1992. Two additional cohorts of women having either breast reduction surgery (N = 7,071) or breast cancer without implants (N = 3,952) were identified for comparison. Observed-to-expected (O/E) cases of CTDs and other rheumatic conditions were calculated based on national hospital discharge rates. The calculated O/E ratio for definite CTDs was 1.1 (95% confidence interval [CI], 0.2-3.4) among women with cosmetic breast implants, and 1.3 (95% CI, 0.5-2.6) among women receiving implants for breast reconstruction. No CTD excesses were seen in the breast reduction or breast-cancer-without-implant cohorts. Statistically significant risks for muscular rheumatism (a nonspecific discharge diagnosis) were observed in all four patient cohorts: cosmetic (O/E ratio, 2.5; 95% CI, 1.7-3.6), breast reconstruction (O/E ratio, 2.5; 95% CI, 1.7-3.4), breast reduction (O/E ratio, 2.0; 95% CI, 1.6-2.3), and breast cancer without implants (O/E ratio, 1.4; 95% CI, 1.0-1.9). In conclusion, breast implants showed little association with definite CTDs. Breast surgery per so, however, was associated with an apparent increase in muscular rheumatism.

Adult↗

PubMed1997

Cancer risk in users of calcium channel blockers.

Ca2+ channel blockers may cause cancer by inhibiting apoptosis or reducing intracellular Ca2+ in certain tissues. Recent findings suggest that drug users are at increased risk for cancer in general and for colon cancer in particular. We conducted a study in one Danish county of 17911 patients who received at least one prescription of Ca2+ channel blockers between 1 January 1991 and 31 December 1993. The patients were identified from records in the National Health Insurance Program, which refunds part of the price of such drugs. Cancer occurrence and rate were determined by use of the files of the Danish Cancer Registry and compared with county-specific incidence rates for various categories of cancer. During the follow-up period of up to 3 years, 412 cancers were observed among users of Ca2+ channel blockers, compared with 414 expected, to yield an age- and sex-standardized incidence ratio (SIR) of 1.00 (95% confidence interval, 0.90 to 1.10). There was no indication of an excess risk in the subgroup of likely long-term users or users of specific drugs. The SIR of colon cancer, a site of a priori interest, was 0.8 (95% confidence interval, 0.5 to 1.1) on the basis of 34 cases. Although the results are reassuring, the lack of association could reflect the relatively short follow-up after registration in the prescription database. Continued monitoring of cancer risk is planned.

Aged↗