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Biomedical subjects

V Fønnebø

Publications and source records attributed to V Fønnebø.

At least 19 recordsLinked to original sources
PubMed2006

Carotid plaque echogenicity and risk of nonvertebral fractures in women: a longitudinal population-based study.

Atherosclerosis and osteoporosis appear to be related, but prospective studies on the relationship are sparse. In order to examine whether carotid artery plaques with different morphology predict nonvertebral fractures, we followed 2,733 women, aged 55-74 years (75% of the eligible population in Tromsø, Norway), for 6 years. At baseline, plaque morphology in terms of ultrasound echogenicity was categorized into three groups, ranging from low echogenicity (echolucent plaques with a high content of soft tissue) to strong echogenicity (echogenic plaques with a high content of dense fibrous tissue and calcified material). We found that the age-adjusted relative risk (RR) of fracture was significantly higher among women with echogenic plaques than among women without plaques: 1.7 (95% confidence interval [CI] 1.0-2.7). After adjustment for bone mineral density at baseline in addition to age, the RR was 1.6 (95% CI 1.0-2.6), and further adjustments for body mass index, body height, high-density lipoprotein cholesterol, smoking status, and muscle strength did not influence the association. Subjects with other plaque types were not at an increased risk compared to subjects without plaques: RR < or = 1.1, after multiple adjustments. We conclude that in the general population elderly women with echogenic carotid plaques are at higher risk of nonvertebral fractures than women without plaques.

Aged↗
PubMed2005

Features of the metabolic syndrome and the risk of non-vertebral fractures: the Tromsø study.

INTRODUCTION: We wanted to examine whether the features of the metabolic syndrome carried an increased risk of non-vertebral fracture. METHODS: This is a population-based, 6-year follow-up of 27,159 subjects from the municipality of Tromsø, followed from 1994 until 2001. Age range was 25-98 years. Non-fasting serum levels of high-density lipoprotein (HDL), triglycerides and glucose, blood pressure (BP), weight and height were measured at baseline. All non-vertebral fractures were registered by computerised search in radiographic archives. RESULTS: A total of 1,249 non-vertebral fractures were registered. Increasing number of metabolic syndrome features was associated with significantly reduced fracture risk in both men and women, p= 0.004 and p<0.0001, respectively. High BP was protective against fracture in men [relative risk (RR) 0.89; 95% confidence interval (CI) 0.8-0.99)] while increased body mass index (BMI) was protective in women (RR 0.91; 95% CI 0.84-0.98). Increasing non-fasting serum levels of HDL increased fracture risk in women (RR 1.12; 95% CI 1.05-1.21). BMI modified the effect of HDL in men. Accordingly, high HDL increased fracture risk in men with high BMI (RR 1.51; 95% CI 1.2-1.9). CONCLUSIONS: Increasing burden of metabolic syndrome features protects against non-vertebral fractures. Reduced non-vertebral fracture risk was associated with high BP in men and increased body mass in women. Lower non-fasting serum levels of HDL protect against fractures in women and obese men.

Adult↗
PubMed2005

Longitudinal changes in forearm bone mineral density in women and men aged 25-44 years: the Tromsø study: a population-based study.

The aim of this study was to describe and compare bone mineral density (BMD) development in Norwegian women and men aged 25-44 years in a population-based, longitudinal study. BMD was measured twice at distal and ultradistal forearm sites by single x-ray absorptiometry in 258 women and 147 men (mean follow-up time, 6.4 (standard deviation, 0.6) years). At the distal site, a small annual gain of approximately 0.1% became a small loss beginning at age 34 years in men and age 36 years in women. At the ultradistal site, BMD change was predicted by age in women only, and bone loss started at age 38 years. A high degree of tracking of BMD measurements was observed for both sexes and both sites, r > 0.93. Depending on total BMD change, participants were grouped into "losers", "nonlosers", and "gainers", and more than 6% lost more than the smallest detectable amount of BMD: > or =3.46% at the distal site and > or =5.14% at the ultradistal site. In both sexes, bone mineral content (grams) decreased, whereas area (centimeters squared) increased significantly in "losers" compared with "gainers". This finding might represent physiologic compensation preserving bone strength. No cohort effects were observed when 1994 and 2001 measures from similar age groups were compared.

Absorptiometry, Photon↗
PubMed2005

Bone mineral density measures in longitudinal studies: the choice of phantom is crucial for quality assessment. The Tromsø study, a population-based study.

Determination of change in bone mineral density (BMD) requires high-precision densitometry techniques. The purpose of the study is to investigate to what degree different densitometer phantoms reflect observed changes in human BMD and to investigate to what degree fluctuations in densitometers' measurement level influence bone loss estimates. Densitometer influence was assessed using the aluminum forearm phantom (AFP) provided by the manufacturer, the European forearm phantom (EFP) of semi-anthropomorphic calcium-hydroxyapatite, and repeated population measurements on different densitometer combinations. The mean follow-up time was 6.4 years (SD 0.6). Measured population bone loss varied from 4.6%/year to 3.2%/year, depending on densitometer combinations. These variations could not be explained by differences in sex, age, height, weight and baseline BMD. They were predicted by EFP measurements, but not AFP measurements. The EFP measurements indicate that X-ray tube replacement changed the densitometers' measurement level in one of three instances, whereas "wear and tear" did not. We used the EFP data for adjustment of the densitometers' measurement levels. After adjustment, the overall crude bone loss was reduced from 4.14% to 3.92%. Mean annual loss was reduced from 0.64% or 0.61%. We conclude that densitometer performance might influence the accuracy of bone loss estimates. Changes in performance are not detected by aluminum phantoms. Quality control of BMD measurements in longitudinal studies should be performed with anthropomorphic calcium-hydroxyapatite phantoms in order to detect possible differences between the participating densitometers' measurement levels.

Absorptiometry, Photon↗
PubMed2004

Long-term mental distress, bone mineral density and non-vertebral fractures. The Tromsø Study.

The purpose of this study was to examine, prospectively, the risk of non-vertebral fractures and low bone mineral density in a population-based cohort with respect to indicators of subjective mental distress. In 1979-1980 all males born 1925-1959 and all females born 1930-1959 living in Tromsø were invited (21,441; response rate, 78%). The same individuals were invited to the subsequent studies in 1986-1987 and 1994-1995 (74% attended the first two, and 71% attended all three surveys). Non-vertebral fractures were registered by linkage to the hospital X-ray register for the period 1988-1995, and forearm bone mineral density (BMD) was available in a subsample of 4,690 who had attended three times. Questions about mental distress (depression, insomnia and coping problems) were repeated three times and analyzed as cumulated exposure. Women who reported being depressed at two time points had an adjusted odds ratio (OR) =2.5 (95% confidence interval [CI] 1.3-4.9) for sustaining a non-vertebral fracture and OR=3.1 (95% CI 1.3-7.2) for sustaining an osteoporotic fracture, compared with those without depression on any occasion. The corresponding odds ratios for those with coping problems at two time points were slightly higher, whereas sleeping problems seem only to be weakly associated with non-vertebral fractures. The pattern of associations and the magnitude of OR estimates were mainly the same in women younger than 50 years and those 50 years and older. Women using nerve medicine and reporting depression twice had an odds ratio of 4.4 (95% CI 1.1-17.7) for sustaining a non-vertebral fracture, and those using nerve medicine and reporting coping problems twice had a corresponding OR 4.7 (95% CI 1.2-18.4). Among men no significant associations were found for either fracture type. No association was found between mean BMD and number of times reporting depression, insomnia or coping problems, in women or men. Long-term mental distress is associated with risk of all non-vertebral fractures and osteoporotic fractures in middle-aged women, but not in men. Mental distress itself seems to be more important than the use of nerve medicine.

Absorptiometry, Photon↗
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↗
PubMed2003

Users of homeopaths in Norway in 1998, compared to previous users and GP patients.

AIM: Homeopathy is the form of complementary medicine most frequently used in Norway. This study describes complaints and characteristics of patients who visited Norwegian homeopaths in 1998, comparing them with those who visited homeopaths in 1985 and general practice patients. METHODS: We conducted a survey of 1097 patients visiting 80 Norwegian homeopaths in 1998 and compared them with a similar survey in 1985 (1072 consultations) and a 1989 survey of general practice patients (90,458 consultations). RESULTS: One in four of patients visiting homeopaths in 1998 were children between 0 and 9 years of age, compared to one in ten in 1985 and in general practice. Almost half of the patients in 1998 had used prescription drugs provided by a medical doctor the previous month for the same complaints they presented to the homeopath. In 1998 patients sought homeopathy most often because of respiratory and skin complaints. In 1985 the most common reasons were musculo-skeletal and digestive problems. Four of the five commonest reasons for encounter in homeopathic practice in 1998 were also found among the five commonest reasons for general practice consultations. CONCLUSION: Patients currently visiting homeopaths differ in age and to some extent in complaints compared to previous users of homeopathy and general practice patients.

Adolescent↗
PubMed2002

Attitudes to the contribution of placebo in acupuncture--a survey.

Interest in placebo is increasing, and recent research suggests that the therapeutic consequence of placebo is generated through mental processes in which attitudes are important. The aim of this study is therefore to explore attitudes and beliefs concerning placebo effect in acupuncture therapy, among doctors, patients and acupuncturists. From February 1994 until June 1995, four anonymous questionnaires were distributed among 1135 randomly selected doctors, 294 medical students, 432 acupuncturists and a random sample of 653 in the general population in Norway. Fifty-seven percent indicated the treatment effect seen in acupuncture as mainly a genuine acupuncture effect, 30% indicated that half of the effect in acupuncture comes from placebo, while 13% indicated that the treatment effect in acupuncture is mainly based on placebo. Doctors and students express a more skeptical view than the others, and having tried acupuncture for one's own disease is significantly associated with a less skeptical view within all study groups. Attitudes to the use of acupuncture for cancer patients are associated with attitudes to placebo for doctors and medical students, but not for the general population or acupuncturists.

Acupuncture Therapy↗
PubMed2001

[Acupressure against morning sickness].

BACKGROUND: Although stimulation of certain acupressure points for long has been claimed to alleviate nausea, previous research has left contradictory results. The aim of our study was to find out if acupressure can alleviate nausea and vomiting in early pregnancy. MATERIAL AND METHODS: 97 women with mean gestational length between 8 and 12 weeks were randomized to use either active acupressure or placebo acupressure bands. Symptoms were recorded before they entered the study, during the use of the wristbands, and after the end of the study, according to the intensity, duration and nature of complaints. RESULTS: 71% of the women in the intervention group reported both less intensive morning sickness and shorter duration of symptoms. The same tendency was seen in the placebo group, with 59% reporting less intensity and 63% shorter duration of symptoms, However, significance levels of 5% were reached regarding duration of symptoms, which was reduced by 2.74 hours in the intervention group compared to 0.85 hours in the placebo group (p = 0.0018). INTERPRETATION: Acupressure wristband might be an alternative for morning sickness in early pregnancy, especially before pharmaceutical treatment is considered.

Acupressure↗
PubMed2001

Forearm bone mineral density by age in 7,620 men and women: the Tromsø study, a population-based study.

Population-based studies of adult forearm bone mineral density (BMD) by age are scarce, and standardized reference values are lacking. In this cross-sectional study, men aged 55-74 years, women aged 50-74 years, and representative 5-10% samples of remaining age groups between 25 and 84 years living in Tromsø, Norway, were invited for forearm BMD measurement in 1994-1995. The authors measured 3,062 men and 4,558 women (response rate, 78%) by single x-ray absoptiometry at distal and ultradistal forearm sites. Up to age 50, the mean BMD difference was -0.1% per 1-year age group in both sexes. After age 50, the mean BMD difference per 1-year age group was -0.6% in men and -1.3% (distal) and -1.5% (ultradistal) in women. The BMD by age curve was linear for men throughout senescence, but women had a slope change to -0.7% (distal) and -0.8% (ultradistal) per 1-year age group from the 65- to 69-year age group. BMD levels and BMD by age association in the general population (n = 7,620) and in the population without bone-threatening diseases or medication (n = 5,179) were similar. Only longitudinal studies can clarify whether cohort effects or longitudinal BMD development patterns explain these cross-sectional results.

Absorptiometry, Photon↗
PubMed2001

[Vertebral fractures--a big health problem for elderly women?].

BACKGROUND: The term osteoporosis often conjures up an image of deformed spines,--small stooping ladies burdened with back pain. Most modern medication against osteoporosis has documented effect first and foremost against vertebral fractures. However, are vertebral fractures a public health issue, and are they frequent and serious enough to warrant aggressive and expensive preventive measures? MATERIAL AND METHODS: Through search in Medline with the terms "osteoporosis", "vertebral fracture*" and "vertebral deformities", we identified and reviewed a total of 222 scientific articles on vertebral fractures. RESULTS: Incident vertebral deformities entail temporary complaints, and the consequences of prevalent deformities are minute unless there are several deformities. Less than 8% of back pain among the elderly can be attributed to vertebral deformities. A large double-blind, randomised clinical trial demonstrates that treatment that halves the risk of new vertebral deformities barely affects the occurrence of back pain or disability. INTERPRETATION: Even if some patients' suffering is attributable to vertebral deformities, we conclude that vertebral deformities represent a minor public health problem. As a consequence, studies exploring predictors of painful vertebral fractures are warranted; furthermore, more documentation on prevention of non-vertebral fractures is needed.

Aged↗
PubMed2001

The Tromsø study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register?

In order to compare different methods of fracture registration, we sought all nonvertebral fractures suffered during 8 years (1988-95) among 21,441 persons invited to a survey in 1979/80. We registered a total of 54 hip fracture cases through three separate sources (self-report, computer linkage to the local radiographic archives, discharge register), whereas forearm fractures (a total of 291 cases) were registered through two separate sources (self-report, computer linkage to the radiographic archives). The registration of fractures at other sites (a total of 1321 cases) were from one source (computer linkage to the local radiographic archives), and we have compared three ways of obtaining data from this single source (no ascertainment, ascertainment of records coded as fracture, ascertainment of all records). Ninety-three percent of all hip fractures and 97% of all wrist fractures in the entire study population were found by computer linkage to the radiographic archives, whereas the discharge register detected 87% of all the hip fractures. Computer linkage with ascertainment gave no overreporting of fractures. Among the 11,626 persons who answered a follow-up questionnaire in 1994/95, 97% (CI 84-100%) of all hip fractures and 72% (CI 66-78%) of all wrist fractures were self-reported. We conclude that a computerized search of radiographic archives is a viable method of fracture registration.

Adult↗
PubMed2001

Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study.

OBJECTIVE: To find out whether acupressure wristband can alleviate nausea and vomiting in early pregnancy. DESIGN: Double-blind, placebo-controlled study. SUBJECTS: 97 women with mean gestational length completed 8-12 weeks. MAIN OUTCOME MEASURES: Symptoms were recorded according to intensity, duration and nature of complaints. RESULTS: 71% of women in the intervention group reported both less intensive morning sickness and reduced duration of symptoms. The same tendency was seen in the placebo group, with 59% reporting less intensity and 63% shorter duration of symptoms. However, a significance level of 5% was reached only in the case of duration of symptoms, which was reduced by 2.74 hours in the intervention group compared to 0.85 hours in the placebo group (p = 0.018). CONCLUSIONS: Acupressure wristband might be an alternative therapy for morning sickness in early pregnancy, especially before pharmaceutical treatment is considered.

Acupressure↗
PubMed2000

Hormone replacement therapy: knowledge, attitudes, self-reported use - and sales figures in Nordic women.

OBJECTIVES: To evaluate knowledge about, attitudes towards and use of hormone replacement therapy (HRT) in Norwegian women - and to compare self-reported use with sales statistics of HRT in the Nordic countries during recent years. MATERIAL AND METHODS: Random samples of Norwegian women age 16-79 were interviewed by the Central Bureau of Statistics in 1994 (n=737), in 1996 (n=665) and in 1998 (n=680). Statistics on the sale of estrogen were provided by the Norwegian Medical Depot and Nordic Council on Medicines. RESULTS: One in three women had received information about HRT during the last 2 years (1994), mainly through weekly magazines and physicians. The proportion answering in accordance with the prevailing view of HRT's effects ('correct knowledge') varied from 36.4 to 47.2%. Those informed by a physician possessed correct knowledge, had positive attitudes towards HRT and were willing to use HRT more often than women informed through other channels. Women with a high level of education had received information and had correct knowledge more often than others, but they were still less willing to use HRT and did not use HRT more often than the less educated. In the age group 45-69 years the use of HRT was 16.3% in 1994, 19.1% in 1996 and 19. 1% in 1998 (P=0.421, trend). In addition to received information, attitudes towards and knowledge about estrogen were the most important factors predicting use of HRT after adjusting for other variables. According to sales figures, the use of systemic estrogen in Norway has increased more than 360% since 1990. Although no other Nordic country has experienced a corresponding increase, Iceland had the highest sales figures in 1997. CONCLUSIONS: Based on the limited proportion of women receiving information on HRT and the ambivalence found in groups of educated women, we suggest that more and better information should be given middle-aged women to make them better able to make informed choices regarding use of HRT.

Adolescent↗
PubMed2000

The Tromsø study: determinants of precision in bone densitometry.

Studies of precision determinants in bone densitometry are scarce. A total of 111 subjects recruited from the population-based multipurpose Tromsø Study (Norway), 27-75 years of age, had repeated forearm bone single X-ray absorptiometry (SXA) measurements. Measurement conditions were systematically varied in series up to eight scans. Median coefficients of variation (CV) for two scans performed 1 week apart, by two different operators were 0.79% and 0.98% at distal and ultradistal sites, respectively. The CV distribution was skewed: 5% of the subjects had individual CVs above 2.2% (distal) and 3.4% (ultradistal). Age (P = 0.0097) and repositioning were important determinants of precision. The SXA bone mineral density (BMD)-measurement method is sufficiently precise to establish BMD level. The minimal individual percentage BMD change that can be detected with 95% certainty was 2% and 3% at distal and ultradistal sites, respectively. Detection of BMD changes less than this should rely on multiple repeat measurements at each point in time.

Absorptiometry, Photon↗
PubMed2000

A survey of acupuncture patients: results from a questionnaire among a random sample in the general population in Norway.

The objective of this study is to survey attitudes to, and use of acupuncture in the general Norwegian population. An anonymous questionnaire was dispatched to a random sample of 1100 in the general population, and 653 responded (60.7%). Nineteen per cent of the general population, most often suffering from musculo-skeletal pain, had tried acupuncture treatment. Lack of effect of conventional medicine was most often given as the reason to try acupuncture. Acupuncture patients had tried other kinds of alternative medicine twice as often as others, most often homeopathy (P<0.01). Acupuncture patients visit their GP more often (P<0.01), and are more concerned about own health (P<0.01) than patients who have not tried acupuncture. Sixty-six per cent say they benefited from acupuncture, and 7% report that the acupuncture treatment had adverse effects. Fifty-six per cent of those with experience of acupuncture felt that doctors should recommend acupuncture for migraine patients, and 34% of those never having tried acupuncture agreed (P<0.01). Both patients who had tried acupuncture and those who had not, felt that the doctor should not interfere in the cancer patient's wish to try acupuncture.

Acupuncture Therapy↗