Showing papers by "Stockholm County Council published in 1996"

A 10-Year Follow-Up Study of Tick-Borne Encephalitis in the Stockholm Area and a Review of the Literature: Need for a Vaccination Strategy

Abstract: 143 people treated for tick-borne encephalitis (TBE) were included in a retrospective follow-up study. Sequelae and epidemiological characteristics in 114 individuals were analysed. The case fatality rate and the prevalence of residual paresis were low, 1.4 and 2.7%, respectively. However, 40 (35.7%) individuals were found to have a postencephalitic syndrome after a median follow-up time of 47 months, and a majority (77.5%) of these were classified as moderate to severe. Various mental disorders, balance and co-ordination disorders and headache were the most frequently reported symptoms. Increasing age was correlated to a longer duration of hospital stay, longer convalescence and increased risk of permanent sequelae. Results from a neuropsychiatric questionnaire showed marked differences between the subjects with sequelae compared to controls. 57% had noticed a tick bite before admission, and 48% were aware of at least one person in their environment who previously had contracted TBE. 79% were permanent residents or visited endemic areas often and regularly. In conclusion, we have found that TBE in the Stockholm area has a low case fatality rate, but gives rise to a considerable number of different neurological and mental sequelae, which justifies vaccination of a defined risk population in endemic areas.

How to evaluate interaction between causes: a review of practices in cardiovascular epidemiology.

Abstract: To increase the knowledge of interaction or synergy between risk factors in an important task in medical research. Still, current literature in cardiovascular epidemiology reflects major misconceptions as how to evaluate interaction. This paper presents Rothman's model of causation from which strict empirical criteria of interaction can be derived. In principle, the method to apply consists of comparing risk differences for one risk factor of interest across strata of the other. Commonly used but incorrect approaches are exemplified and discussed. These include reporting risk of disease among those with combined exposure, comparing relative risks for one exposure after stratification by level of the other, and including an interaction term in the regression model and drawing conclusions from its P-value.

Root surface etching at neutral pH promotes periodontal healing

Abstract: The purpose of the present investigation was to examine whether an etching agent operating at neutral pH (EDTA) can enhance healing compared to a low pH etching agent (citric acid) in an animal model. Maxillary molars and premolars, in total 32 teeth, in 4 monkeys were divided between test (EDTA or citric acid treatment) and matched control groups. Periodontal surgery on both palatal and buccal roots using the dehiscence model was performed with or without root surface etching. Healing results were evaluated histomorphometrically after 8 weeks. The statistically significant differences between EDTA treated surfaces (n=15) and control surfaces (n=11) were approximately 10% less failure (gingival recession and periodontal pocket), 10 to 15% more total histological attachment (long epithelial junction, connective tissue and reparative cementum), approximately 20% less long epithelial junction and approximately 20% more connective tissue in roots etched with EDTA. The statistically significant differences between citric-acid-treated surfaces (n=14) and control surfaces (n=11) were approximately 10% more connective tissue and 15% less long epithelial junction in the citric acid etched roots. Thus, etching with EDTA appeared to improve healing, avoiding the superficial necrotizing effect on exposed periodontal tissues by citric acid documented in previous studies. Although etching at present is not routinely applied in conventional periodontal therapy, future potential applications of etching at neutral pH may include exposure of the collagenous matrix of dentin for retention of biologically active substances, such as growth factors. Such treatment may be argued to produce a biocompatible surface more conducive to periodontal membrane cell colonization after removal of root-surface- associated smear without compromising the vitality of the surrounding periodontium.

Radiographic evaluation of maddibular posterior implant sites; correlation between panoramic and tomographic determinations

Abstract: The purpose of the present study was to compare bone height determinations of implant sites by different radiographic techniques. Available bone height was measured in regions posterior to the mental foramen on panoramic radiographs, and on tomographs where the faciolingual dimensions was at least 5mm. The one heights were recorded at 401 edentulous and denate sites in 100 patients. The overall mean bone height ±SD) was 11.25±3.29mm on panoramic radiographs and 8.81±3.38mm on tomographs. The correlation between the two radiographic techniques ranged from 0.36 to 0.91 if the material was stratified according to factors such as height of available bone, age, gender and the presence of teeth. Gender was significantly correlated to panoramic and tomographic measurements in all regions. However, the precision of predicted tomographic measurements by using a linear regression model was not significantly increased by including gender as an explanatory variable. For evaluation of available bone height in mandibular regions posterior to the mental foramen, tomography is recommended for all prospective implant sites.

A search for association between schizophrenia and dopamine-related alleles.

Abstract: Dopamine receptor dysfunction and altered tyrosine hydroxylase activity have both been implicated in the pathophysiology of schizophrenia. Schizophrenic pationts and control subjects were examined for allele frequencies in the tyrosine hydroxylase and dopamine D2 and D4 receptor genes. No significant differences of allele or genotype frequencies were found between the two groups after adjustment for multiple comparison. Neither were any significant relationships observed between allele frequencies and a number of clinical variables within the schizoprenic subsample. When no adjustment was made for multiple testing a few significant tendencies were obtained which warrant further research in extended patient and control materials. The results are compatible with the view that the tyrosine hydroxylase, dopamine receptor D2 and D4 gene polymorphisms examined are not of major importance in the aetiology or pathophysiology of schizophrenia.

A repetition-prediction study on European parasuicide populations. Part II of the WHO/Euro Multicentre Study on Parasuicide in cooperation with the EC Concerted Action on Attempted Suicide.

Abstract: One of the aims of the inter-European study on parasuicide, which was initiated by WHO/Euro in the mid-1980s, was to try and identify social and personal characteristics predictive of future suicidal behavior A follow-up interview study (the Repetition-Prediction Study) was designed, and so far 1145 interviews have been carried out at nine research centers, representing seven European countries The study and the instrument used (the European Parasuicide Study Interview Schedules, EPSIS I and II) are described here Some basic characteristics of the material from the various centers are presented and compared, and the representativeness of the samples are discussed There were differences between the centers in several respects Results from analyses based on pooled data have to be treated with some caution because of the possible lack of representativeness

The WHO-EURO multicentre study: Risk of parasuicide and the comparability of the areas under study

Abstract: The 15 areas under study in the WHO/Euro Multicentre Study on Parasuicide vary considerably with regard to socio-economic factors, culture, life-styles, etc. In this paper, the authors discuss whether the traditional high risk factors for suicidal behavior (such as unemployment, abuse, divorce, etc.) take on different weights depending on local societal and cultural settings. Results from analyzing covariations between various background factors characteristic of the different areas under study and the frequency of attempted suicide showed weak or insignificant correlations, indicating that high-risk factors can only be identified from international pooled data with great care.

Living conditions of female suicide attempters: a case—control study

Abstract: A total of 51 hospitalized female suicide attempters (17-64 years old) were interviewed according to a questionnaire used by Statistics Sweden, SCB (ULF 88:1) for investigation of living conditions. Control subjects from similar geographical areas included in the ULF investigation in 1988, and matched for age and nationality, were identified through the SCB (n = 153). Odds ratios (OR) and 95% confidence limits were estimated. Correlation coefficients were used to study the relative importance of specific factors. Not less than 26 items reached the level of statistical significance, but only four of them (mental disorder, use of anxiolytics, unemployment at some time during the last 5 years, and no professional work during the past year) showed a considerable excess risk (lower 95% CI limit for OR > 3). Physical illness was relevant as an independent factor. Although of secondary importance, hospitalization during the previous 3 months was also a characteristic of suicide attempters.

Levels of personality organization and psychopathology among drug abusers in Sweden.

Abstract: In a case-finding sample of 1,824 drug abusers in the greater Stockholm area, personality organization (PO), according to Kernberg's theory, was assessed by using a standardized questionnaire, with the clients' contact persons as informants. Twenty percent of the sample were diagnosed as psychotic PO (PPO), 40% had a clear borderline PO (BPO), and 40% a high BPO or a neurotic PO (NPO). This distribution agreed closely with that found in a comparison sample of social service clients. However, in the NPO and BPO groups, the mean scores were higher for the social service clients than for the abusers. A clustering into nine sub-clusters revealed interesting differences within each PO. © 1996 John Wiley & Sons, Inc.

Stimulation of tumor necrosis factor-α release from lipopolysaccharide-activated human blood monocytes by prostaglandin J2 and metabolites of prostaglandin J2

Abstract: Prostaglandin (PG) J 2 and related compounds have anti-tumor effects in vivo. To investigate possible mechanisms for this we determined effects of PGD 2 , PGJ 2 and two PGJ 2 metabolites Δ 12 -PGJ 2 and 15-deoxy- Δ 12 , Δ 14 PGJ 2 on tumor necrosis factor-alpha (TNF-α) release from blood monocytes in vitro. All PGJ 2 compounds stimulated TNF-α-release from lipopolysaccharide-activated monocytes. By contrast, the parent prostaglandin PGD 2 had no stimulatory effect. We conclude that the stimulatory effect of PGJ compounds on TNF-α formation might contribute to the antineoplastic properties of these compounds.

Children's dental health in Europe Caries treatment need in 5- and 12-year-old children from eight EU countries

Abstract: The purpose of this study was to develop methods to evaluate treatment needs (TNEED) and previous treatment (TDONE) in different populations. In the collaborative study, 'Children's Dental Health in Europe', the methods were used in connection with a clinical examination to document and compare treatment needs in 200 5-year-olds and 200 12-year-olds from each of the 8 participating countries. The study comprised a total of 3200 children from Belgium, Germany, Greece, Ireland, Italy, Scotland, Spain, and Sweden. The method for calculating TNEED was validated by estimation of required time to meet the treatment needs (TNTIME). The calculated TNEED shows a clear relationship with the evaluated TNTIME, and the method is applicable to different population subgroups. The results revealed large differences in both TNEED and TDONE among the different countries and between the two age groups.