Swedish Population Research Articles

Uncovering sociodemographic disparities in temporal trends of osteoarthritis incidence and age-at-diagnosis, 2006-2019.

To describe sociodemographic disparities in temporal trends of incidence and age distributions of first registered osteoarthritis (OA) diagnosis in southern Sweden. We identified all Skåne residents aged 35+ who had lived in the region at any point during the period 2006-2019 with no previous OA diagnosis (ICD-10 codes M15-M19) for 8 years prior to inclusion in the study (n = 849,061). We calculated person-years from inclusion until OA diagnosis, death, emigration, or 31 December 2019, whichever occurred first. Combining sex (female, male), education (low, medium, high) and nativity (Swedish, immigrant), we created a variable with 12 strata. Average annual percent changes in age-standardized incidence rates were estimated using joinpoint regression. Changes in the median age-at-diagnosis (year of diagnosis minus birth year), weighted to the mid-2005 Swedish population, were explored. Cumulative age-standardized incidence rates ranged from 116 (95% CI: 111, 121) per 10,000 person-years for immigrant males with low education to 205 (95% CI: 200, 210) for immigrant females with medium education. The estimated average annual percent changes (ranging from 3.4% to 6.1%) were generally similar, with slightly greater variations among immigrants than Swedes. The weighted median age-at-diagnosis was higher for Swedes and low educated people. Immigrant females with low education were the only stratum with a reduction (3 years) in the weighted median age-at-diagnosis over time. Sociodemographic patterns in knee OA incidence were different from patterns for hip OA. There were few sociodemographic disparities in temporal trends of OA incidence and age-at-diagnosis, suggesting persistent sociodemographic disparities in OA burden in southern Sweden.

Plasma carotenoids are independently associated with circulating granulocytes and systemic inflammatory markers in a Swedish middle-aged population

Plasma carotenoids are independently associated with circulating granulocytes and systemic inflammatory markers in a Swedish middle-aged population

Overall and cause-specific mortality among patients diagnosed with gastric precancerous lesions in Sweden between 1979 and 2014: an observational cohort study

BackgroundThe Correa’s cascade, encompassing chronic non-atrophic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia, represents the well-recognized pathway for the development of non-cardia gastric cancer. Population-based studies on all-cause and cause-specific mortalities among patients with gastric lesions in Correa’s cascade are scarce.MethodsWe compiled a cohort of 340 744 eligible patients who had undergone endoscopy with biopsy for non-malignant indications during the period 1979–2011, which was followed up until 2014. Standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) provided estimation of the relative risk, using the general Swedish population as reference. Cox regression model was used to estimate hazard ratios (HRs) of death for internal comparison.ResultsA total of 306 117 patients were included in the final analysis, accumulating 3,049,009 person-years of follow-up. In total 106,625 deaths were observed during the study period. Compared to the general population, excess risks of overall mortality were noted in all subgroups, with SMRs ranging from 1.11 (95% CI 1.08–1.14) for the normal mucosa group to 1.54 (95% CI 1.46–1.62) for the dysplasia group. For cause-specific mortalities, mortality from gastric cancer gradually increased along Correa’s cascade, with excess risk rising from 105% for patients with chronic gastritis to more than 600% for the dysplasia group. These results were confirmed in the comparison with the normal mucosa group. For non-cancer conditions, increased death risks were noted for various diseases compared to the general population, especially among patients with more severe gastric precancerous lesions. But the results were confirmed only for “infectious diseases and parasitic diseases”, “respiratory system diseases”, and “digestive system disease”, when using the normal mucosa group as reference.ConclusionsIncreased mortality from gastric cancer suggests that early recognition and intervention of gastric precancerous lesions probably benefit the patients. Excess mortality due to non-cancer conditions should be interpreted with caution, and future studies are warranted.

Acral Melanoma Incidence and Survival Trends in 1990-2020: A Nationwide, Population-based Study.

Acral melanoma is a clinical subtype of melanoma with high mortality, on which research is limited in scope. This study aimed to assess incidence trends and melanoma-specific survival rates for acral melanoma in the Swedish population from 1990 to 2020.This cross-sectional study included patients with an acral melanoma diagnosis from 1990 to 2020 from the nationwide, population-based Swedish Melanoma Registry. Analyses on acral melanoma melanoma-specific survival rates were adjusted for age, sex, histopathological subtype, and tumour thickness. Clinicopathological features and melanoma-specific survival rates were compared between diagnostic periods: 1990-1999, 2000-2009, and 2010-2020, respectively. Changes in standardized incidence rates in 1996-2020 were evaluated separately for males and females. In total, 1,000 acral melanomas in 999 patients were included in the study. No significant yearly change in standardized incidence rates for either males or females was observed, even though the absolute number of cases increased. Factors such as male sex, age ≥ 70 years, and Breslow thickness > 1.0 were independently linked to lower melanoma-specific survival. The 5-year melanoma-specific survival across the studied period ranged from 75.8% to 77.9% for females, and from 62.4% to 71.7% for males.

Epidemiology of Spinal Cord Injury in Adults in Sweden, 2016-2020: A Retrospective Registry-Based Study.

We conducted a retrospective, descriptive register study. The aim of the study was to present the epidemiological and demographic characteristics of the Swedish spinal cord injury (SCI) population. Rehabilitation units in Sweden were connected to the National Quality Register for Rehabilitation Medicine (Svenskt Register för Rehabiliteringsmedicin: SveReh). The registry includes data from 26 units around the country. Information was extracted from SveReh for patients who underwent rehabilitation for a new onset SCI between January 1, 2016, and December 31, 2020. Data regarding gender, age, aetiology, level of injury, neurogenic bowel and/or bladder dysfunction, complications during the primary rehabilitation, and the need for bi-level positive airway pressure, continuous positive airway pressure, or ventilator were analysed. Mean age at onset was 56 years, and men were overrepresented (66%). Tetraplegia was more common among traumatic SCI (TSCI) than non-traumatic SCI (NTSCI). The incidence was 11.9-14.8 per million for TSCI and 8.9-11.8 per million for NTSCI. At discharge, 8% of patients needed a breathing aid. Of those who were ventilator-dependent at discharge, 75% had a TSCI. Disturbed bowel and bladder functioning was noted in 58% of patients at discharge. The median time spent at the unit was 40 days, but it was approximately 2 weeks longer for those with a TSCI. Systematic and updated data on the Swedish SCI population show a pattern similar to Scandinavian countries with high age at onset and falls being the main cause of TSCI. The TSCI incidence was lower than in previous studies, and the results for NTSCI were novel.

The association between taurine concentrations and dog characteristics, clinical variables, and diet in English cocker spaniels: The Canine taURinE (CURE) project.

Occurrence of low blood taurine concentrations (B-TauC) and predisposing factors to taurine deficiency in English Cocker Spaniels (ECS) are incompletely understood. Investigate the occurrence of low B-TauC in a Swedish population of ECS and evaluate the association between B-TauC and dog characteristics, clinical variables, and diet composition. One-hundred eighty privately owned ECS. Dogs were prospectively recruited and underwent physical examination, blood analyses, and echocardiographic and ophthalmic examinations. Dogs with clinical signs of congestive heart failure (CHF) also underwent thoracic radiography. Taurine concentrations were analyzed in plasma (EDTA and heparin) and whole blood. Diets consumed by the dogs at the time of the examination were analyzed for dietary taurine- (D-TauC), cysteine- (D-CysC), and methionine concentrations (D-MetC). Fifty-three of 180 dogs (29%) had low B-TauC, of which 13 (25%) dogs had clinical and radiographic signs of CHF, increased echocardiographic left ventricular (LV) dimensions and volumes, and impaired LV systolic function. Five (9%) dogs with low B-TauC had retinal abnormalities. Dietary MetC, dietary animal protein source (red/white meat), and age were associated with B-TauC in the final multivariable regression model (P < .001, R2 adj = .39). Low B-TauC suggests that taurine deficiency may play a role in the development of myocardial failure and CHF in ECS. Low D-MetC and diets with red meat as the animal protein source were associated with low B-TauC. Dogs with B-TauC below the normal reference range were older than dogs with normal concentrations.

Chronic Airflow Limitation, Emphysema and Impaired Diffusing Capacity in Relation to Smoking Habits in a Swedish Middle-Aged Population.

Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity for carbon monoxide (DLCO) are present, but characteristics and symptoms vary with smoking exposure. To study the prevalence of CAL, emphysema and impaired DLCO in relation to smoking and respiratory symptoms in a middle-aged population. We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, DLCO, high-resolution computed tomography (HRCT) and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced expiratory volume (FEV1/FVC)<0.7. The overall prevalence was for CAL 8.8%, for impaired DLCO (DLCO<LLN) 5.7% and for emphysema 8.8%, with a higher prevalence in current smokers than in ex-smokers and never-smokers. The proportion of never-smokers among those with CAL, emphysema and impaired DLCO was 32%, 19% and 31% respectively. Regardless of smoking habits, the prevalence of respiratory symptoms was higher among people with CAL and impaired DLCO, compared to those with normal lung function. Asthma prevalence in never-smokers with CAL was 14%. In this group, asthma associated with lower FEV1 and more respiratory symptoms. In this large population-based study of middle-aged people, CAL and impaired DLCO were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).

Impact of cancer on the mortality of patients with idiopathic inflammatory myopathies by flexible parametric multistate modelling.

Patients with idiopathic inflammatory myopathies (IIM) have an increased risk of cancer, but their cancer-related disease burden remains unclear. To explore how cancer might impact the mortality of patients with IIM and examine the associated prognostic factors for cancer and death. We identified patients with IIM diagnosed between 1998 and 2020 and ascertained their cancer and death records via linkage to the Swedish healthcare and population registers. Transition hazards from IIM diagnosis to cancer and death were estimated in multistate models using flexible parametric methods. We then predicted the probability of having cancer or death, and the duration of staying alive at a given time from IIM and cancer diagnoses from a crude model. We also explored prognostic factors for progression to cancer and death in a multivariable model. Of 1826 IIM patients, 310 (17%) were diagnosed with cancer before and 306 (17%) after IIM diagnosis. In patients diagnosed with cancer after IIM, the 5-year probability of death from cancer and from other causes was 31% and 18%, respectively, compared to 7% and 15% in patients without cancer after IIM. We reported several factors associated with risk of progression to cancer and death. Specifically, patients with first cancer after IIM who were older at IIM diagnosis, had cancer history, dermatomyositis and a cancer diagnosis within 1 year following IIM faced a greater cancer-specific mortality. We observed a substantial increase in mortality from cancer, compared to before, rather than other causes after a cancer diagnosis following IIM, suggesting an unmet medical need for effective cancer management in IIM patients. This finding, along with the identified prognostic factors, provides useful insight into future research directions for improving cancer management in IIM patients.

Trend, disparities, and projection analysis of public data on foot fractures in Sweden: a retrospective analysis of 179 129 fractures

IntroductionOrthopedic injuries to the foot constitute a significant portion of lower extremity injuries, necessitating an understanding of trends for effective preventive strategies and resource allocation. Demographic shifts, improved traffic safety, and lifelong physical activity may alter incidence rates, trauma mechanisms, and fracture distribution. This study explores the prevalence of foot fractures in Sweden using publicly available data.MethodsUtilizing data from the Swedish National Board of Health and Welfare (SNBHW) spanning 2008–2022, retrospective study focuses on foot fractures in Sweden. Analysis includes calculating annual incidence rates per 100,000 person-years, assessing temporal trends, and exploring seasonal variations. Poisson regression analysis was used for projections into 2035.ResultsBetween 2008–2022, the average annual foot fracture incidence was 11,942, with notable fluctuations influenced by the COVID-19 pandemic. Age and sex disparities impact rates, and seasonal variance highlights increased incidence in summer. By 2035, foot fractures will decreasae amongst several demographic groups.ConclusionThis study provides insights into temporal trends, sex differences, and seasonal variations foot fracture patterns in Sweden. The identified trends suggest the utilization of targeted preventive strategies, efficient resource allocation, and informed healthcare planning. Despite limitations, this research offers valuable insights into foot fractures within the Swedish population, utilizing publicly aggregated data.

Correlation between environmental pollutant exposure and cardiopulmonary health by serum biomarker analysis in the Swedish elderly population

ABSTRACT Persistent organic pollutants (POPs) affect human health through the aryl hydrocarbon receptor (AhR) pathway and are implicated in mitochondrial dysfunction. Using data from the PIVUS study, we investigated the associations of serum AhR ligand (POP)-mediated luciferase activity (AhRL), mitochondrial ATP production inhibiting substances (MIS-ATP), and those affecting reactive oxygen species (MIS-ROS) with several metabolic syndrome (MetS) and cardiopulmonary function parameters. These include insulin resistance (HOMA-IR), inflammation, oxidative stress, and cardiopulmonary variables (FVC, FEV1, LV-EF, CCA distensibility). MIS-ATP showed significant correlations with HOMA-IR and pulmonary functions, indicating its direct impact of MIS-ATP on metabolic and pulmonary health. MIS-ROS correlated with oxidative stress markers and CCA distensibility, suggesting a role in systemic inflammatory responses. This study highlights the intricate relationships between environmental pollutant mixture and cardiopulmonary health in MetS as indicated by biomarkers of POP exposure in the elderly population, suggesting POP exposure may influence MetS onset and progression through mitochondrial dysfunction.

Individualized treatment effects of a digital alcohol intervention and their associations with participant characteristics and engagement.

Conditional average treatment effects are often reported in intervention studies, in which assumptions are made regarding how effects are similar across a heterogeneous sample. Nonetheless, differing factors, such as genetics, age, and sex, can impact an intervention's effect on outcomes. The study aimed to estimate the individualized effects of a digital alcohol intervention among individuals looking online to reduce their drinking. We used data from a randomized controlled trial (RCT), including 2129 adults from the Swedish general population. The RCT concerned a text message-based alcohol intervention that sought to engender change through increasing knowledge on how to change and instilling confidence in changing behaviour. Outcomes were total weekly alcohol consumption and monthly heavy episodic drinking. Individualized treatment effects were modelled using baseline characteristics (age, gender, alcohol consumption, and psychosocial variables) and engagement with the intervention content. We found evidence that the effects of the digital alcohol intervention were heterogeneous concerning participants' age, baseline alcohol consumption, confidence, and importance. For heavy episodic drinking, there was evidence that effects were heterogeneous concerning age, sex, and baseline alcohol consumption. Overall, women, older individuals, and heavier drinkers benefitted more from the intervention in terms of effect size. In addition, participants who engaged more with the goal-setting and screening content reported better outcomes. The results highlight how different individuals respond differently to a digital alcohol intervention. This allows insight into who benefits the most and least from the intervention and highlights the potential merit of designing interventions adapted to different individuals' needs.

Incidence of cerebral small vessel disease-related MR markers in the Swedish general population ‘Good Aging in Skåne’(GÅS) study

Background and objectivesCerebral small vessel disease (CSVD) is associated to cognitive decline and dementia. Neuroimaging changes of CSVD are highly prevalent above 80 years. Only few studies report on incidence of CSVD in high age. We have investigated the incidence and prevalence of magnetic resonance imaging (MRI) markers of CSVD and risk factors in the general older population.MethodsAs part of the general population Good Aging in Skåne cohort study (GÅS), 241 persons (mean age 76.3 years) underwent two brain MRI, 3-T scanner with a mean interval of 5.9 years. The incidence of white matter hyperintensities (WMH), lacunar infarction, cerebral atrophies and cerebral microbleeds (CMB) were calculated and the relationship to risk factors analysed by a multivariate regression analysis. Medial temporal lobe atrophy (MTA) was graded according to Scheltens’18 scale and CMB were defined as having > 1 small (0.2–0.5 cm) hypointense lesion.ResultsThe 6-year incidence of CMB, WMH and MTA were, 19%, 17% and 13% respectively, corresponding to 170/1,000 py., 172/1,000 py., and respectively 167/1,000 py. The incidence of CSVD according to the modified STRIVE score was 33%, 169/1,000 py and the prevalence at baseline was 73%. Moderate to high intake of alcohol was related to increased incidence of MTA and higher STRIVE score. Exposure to smoking was related to higher incidence of CMB and higher STRIVE score, adjusted for other known risk factors.ConclusionCSVD is highly prevalent in the general older population and the 6-year incidence of WMH, CMB and MTA ranges from 13 to 19 percent. The modifiable lifestyle factors: smoking, and moderate alcohol intake are related to incident CSVD.

PARENTAL OVER-INDEBTEDNESS AND YOUTH CRIME IN SWEDEN: A NATIONWIDE REGISTER-BASED STUDY

Very little is known about whether a child’s delinquency can be related to a parent’s economic problems in terms of financial indebtedness. This would seem to be an important research gap, not least at a time when the repercussions of the 2008 global financial crisis are still being felt by many people. This study concerned boys and girls born in 2002 who had a parent with a registration date for a debt in the Swedish Enforcement Authority register between 2016 and 2017 (n = 3,284). We determined whether the adolescents had been convicted of a crime during the 3-year period when they were 15 to 17 years old, and compared their records with a sample from the general Swedish population (n = 16,435). Results from logistic regressions show that children who, at age 15 to 17, had a parent with debt problems were approximately one and a half times more likely to be convicted of a crime than children who were unexposed to registered debts of parents (OR = 1.55), irrespective of other well-established criminogenic risk factors observed prior to the parent’s date of registration at the Enforcement Authority. The results provide support for the notion that financial challenges and problems with creditors may be an important proximate risk factor of delinquency.

“Ideology and Religion” how left‐right ideology plays a key role in attitudes toward Israel and Palestine in Sweden

AbstractThis research underscores the key role of ideology in shaping the Swedish public's stance towards Israel and Palestine. With the help of a survey conducted by the Surveyinstitute in 2020, this paper studies the Swedish population's attitudes toward the actions of Israel and Palestine in the Israel‐Palestine conflict. The findings reveal a distinct ideological divide along the left‐right scale in the attitudes of the Swedish population towards Israel and Palestine's actions. This ideological chasm extends to additional actors, such as Sweden, the United States, and the EU, in the Israel‐Palestine conflict. While religion does exert influence, particularly among practicing individuals, the study concludes that ideology is the most relevant factor in attitudes toward the actions of Israel and Palestina from a Swedish perspective.

Changes in Sleep Quality, Sleep Duration, and Sickness Absence: A Longitudinal Study with Repeated Measures.

Sickness absence has been linked to short and long, as well as poor, sleep in a few studies. Such studies have started from a baseline measurement and followed up on subsequent sickness absence. In the present study, however, we focused on the change in biennial reports of sickness absence and sleep measures (using work-related variables as possible modifiers). We also searched for an interaction between predictors and gender since women report more sleep problems. A total of 5377 individuals (random sample from the Swedish working population) participated across five biennial points of measurement. Data were analyzed using mixed-model logistic regression. The multivariable analysis of variation across the five time points showed that the significant sleep-related predictors of sickness absence (at least one occurrence during the preceding year) were sleep duration during days off (OR = 1.16, 95% Cl = 1.08;1.24) and sleep problems (OR = 1.42, 95% CI = 1.33;1.51). These also remained significant after the addition of psychosocial work factors. Sensitivity analyses indicated that a 9 h sleep duration during days off may represent a critical level in terms of increased sickness absence and that late rising contributed to the association between sickness absence and long sleep duration during days off. Women reported a higher sickness absence than men (OR = 2.16, 95% CI = 1.74;2.68) and had a higher probability of sickness absence for long sleep during days off and during the workweek than men. It was concluded that increases in sleep problems and sleep duration during days off are longitudinally associated with changes in sickness absence and that women have a closer link between the two. This suggests that treatment for sleep problems may reduce the risk of sickness absence.

Long-term health outcomes from inbreeding in a historical Swedish population: longevity, fertility, and impairments

Background Inbreeding, arising from consanguinity between related parents, has been observed to impact the health of individuals, typically attributed to biological factors. Nevertheless, these effects may be influenced by the social and environmental conditions. The prevalence of consanguineous marriages increased in certain parts of Sweden after it became legal in 1844, which offers a unique opportunity to study and understand the effects of inbreeding on health. Aim The objective of this study is to explore the potential impact of inbreeding on the longevity, fertility, and impairments of individuals born in the Skellefteå region, Sweden, between 1890 and 1905, with a follow-up period extending until 1950. Subjects and methods The level of inbreeding is calculated using micro-level parish register data and related to longevity, fertility, and impairments using regression analysis. Results Inbreeding is shown to be associated with longevity, fertility, and impairments. It seems to affect the risk of stillbirth and impairments and male longevity and fertility. Conclusion Inbreeding seems to have had a detrimental effect on some health outcomes in this historical population under study.

Increased risk of hip and major osteoporotic fractures in 8463 patients who have undergone stem cell transplantation, a Swedish population-based study

SummaryIn this retrospective cohort study of adult stem cell transplanted patients (n = 8463), a significant increased risk of both MOF and hip fractures was seen compared with the Swedish population and occurred in mean more than 2 years after stem cell transplantation.PurposeTo explore the risk for osteoporotic fracture in patients who have undergone hematopoietic stem cell transplantation (HSCT) compared with the Swedish population.MethodsThe risk of osteoporotic fractures was determined in a retrospective population cohort study of adult (≥ 18 years) Swedish patients (n = 8463), who were transplanted with HSCT 1997–2016 and compared with all adults living in Sweden during the same period.ResultsIn the total study group (n = 8463), 90 hip fractures (1.1% both in males and females) and 361 major osteoporotic fractures (MOF) (3.2% in men and 6.0% in women) were identified. In the total study population, the ratio of observed and expected number of hip fracture for women was 1.99 (95% CI 1.39–2.75) and for men 2.54 (95% CI 1.91–3.31). The corresponding ratio for MOF in women was 1.36 (CI 1.18–1.56) and for men 1.61 (CI 1.37–1.88). From 2005 onwards, when differentiation in the registry between allo- and auto-HSCT was possible, the observed number of hip fracture and MOF in allo-HSCT (n = 1865) were significantly increased (observed/expected hip fracture 5.24 (95% CI 3.28–7.93) and observed/expected MOF 2.08 (95% CI 1.63–2.62)). Fractures occurred in mean 2.7 (hip) and 2.5 (MOF) years after allo-HSCT. Graft-versus-host disease (GVHD) was not associated with an increased risk of fracture.ConclusionPatients who underwent HSCT had an increased risk of both hip and major osteoporotic fracture compared with the Swedish population and occurred in 4.3% of patients. GVHD was not statistically significantly associated with fracture risk.

Heart failure in patients with congenital heart disease after a cancer diagnosis.

Individuals with congenital heart disease (CHD) are at an increased risk for cancer. As cancer survival rates improve, the prevalence of late side effects, such as heart failure (HF), is becoming more evident. This study aims to evaluate the risk of developing HF following a cancer diagnosis in patients with CHD, compared with those without CHD and with CHD patients who do not have cancer. CHD patients (n=69799) and randomly selected non-CHD controls (n=650406), born in Sweden between 1952 and 2017, were identified from the Swedish National Health Registers and Total Population Register (excluding those with syndromes and transplant recipients). CHD patients who developed cancer (n=1309) were propensity score-matched with non-CHD patients who developed cancer (n=9425), resulting in a cohort of 1232 CHD patients with cancer and 2602 non-CHD controls with cancer (after exclusion of individuals with HF prior to cancer diagnosis). In a separate analysis, CHD patients with cancer were propensity score-matched with CHD patients without cancer (n=68490). A total of 1233 CHD patients with cancer and 2257 CHD patients without cancer were included in the study. Among CHD patients with cancer, 73 (5.9%) developed HF during a mean follow-up time of 8.5±8.7. Comparatively, in the propensity-matched control population, 29 (1.1%) non-CHD cancer patients (mean follow-up time of 7.3±7.5) and 101 (4.5%) CHD patients without cancer (mean follow-up time of 9.9±9.2) developed HF. CHD patients exhibited a significantly higher risk of HF post-cancer diagnosis compared with the non-CHD control group [hazard ratio (HR) 4.39, 95% confidence interval (CI) 2.83-6.81], after adjusting for age at cancer diagnosis and comorbidities. In the analysis between CHD patients with cancer and those without cancer, the results indicated a significantly higher risk of developing HF in CHD patients with cancer (HR 1.53, 95% CI 1.13-2.07). CHD patients face a more than four-fold increased risk of developing HF after a cancer diagnosis compared with cancer patients without CHD. Among CHD patients, the risk of HF is only modestly higher for those with cancer than for those without cancer. This suggests that the increased HF risk in CHD patients with cancer, relative to non-CHD cancer patients, may be more attributable to CHD itself than to cancer treatment-related side effects.

Bioelectrical impedance and lung function—associations with gender and central obesity: results of the EpiHealth study

BackgroundObesity is a major public health concern associated with various health problems, including respiratory impairment. Bioelectrical impedance (BIA) is used in health screening to assess body fat. However, there is no consensus in healthcare on how body fat should be assessed in relation to lung function. In this study, we aimed to investigate how BIA in relation to waist circumference contribute, using data from a large Swedish population study.MethodsA total of 17,097 participants (aged 45–75 years) were included in the study. The relationships between fat mass, waist circumference, and lung function were analysed using weighted quantile sum regression.ResultsIncreased fat mass was significantly associated with decreased lung function (FEV1, FVC) in both sexes. Also, the influence of trunk fat and waist circumference on FVC and FEV1 differed by sex: in males, waist circumference and trunk fat had nearly equal importance for FVC (variable weights of 0.42 and 0.41), whereas in females, trunk fat was significantly more important (variable weights 0.84 and 0.14). For FEV1, waist circumference was more important in males, while trunk fat was more significant in females (variable weights male 0.68 and 0.28 and 0.23 and 0.77 in female).ConclusionsOur results suggest that trunk fat should be considered when assessing the impact of adipose tissue on lung function and should potentially be included in the health controls.

Establishment of the Patient Acceptable Symptom State (PASS) for the Achilles Tendon Total Rupture Score in a Swedish Population.

As the use of patient-reported outcome measures (PROMs) is increasing in orthopaedic research, there is also a growing need for a standardized interpretation of these scores, such as the Patient Acceptable Symptom State (PASS), defined as the value beyond which patients consider themselves well. The Achilles tendon Total Rupture Score (ATRS) is the only PROM specific for Achilles tendon ruptures. To establish the PASS for the ATRS in a Swedish population. Cross-sectional study; Level of evidence, 3. Patients treated for an acute Achilles tendon rupture at a single institution in Sweden (injured between July 1, 2018, and December 31, 2020) were asked to participate in this study. The patients completed a questionnaire consisting of the ATRS and an anchor question: "How satisfied are you with the result of your treatment?" Receiver operating characteristic curve analysis was performed to calculate the PASS threshold for a positive response to the anchor question. Of 516 eligible patients, 316 (61%) were included. The time from injury to completion of the questionnaire ranged from 12 to 27 months. The PASS threshold for the ATRS was found to be 75. The median ATRS of all patients was 80; 66% of patients reached an ATRS ≥75. Overall, 79% of patients were satisfied with the results of their treatment. The estimated PASS for the ATRS was 75 in the general Swedish population at 12 to 27 months after an acute Achilles tendon rupture.