Validation of Obesity Surgery Data in the Swedish National Patient Registry and Scandinavian Obesity Registry (SOReg)

Background and Aim

Swedish health registries are common sources of data for studies on the effects of obesity surgery, and there is a need to assess the quality of data in these registries. The aim of this study was to validate the registration of obesity surgery in the National Patient Registry (NPR) and the Scandinavian Obesity Surgery Registry (SOReg).

Method

We randomly selected 962 out of 8501 registrations of obesity surgery in 2011 from the NPR and SOReg. Registered surgical procedures in the NPR and SOReg were compared to the medical records, and concordance was analyzed by calculating positive predictive value (PPV) with 95 % confidence interval (CI).

Results

We received 938 (98 %) medical records for manual review. The overall PPV for obesity surgery was high in the NPR (PPV 97.0; 95 % CI 95.6–98.4) and even higher in SOReg (PPV 99.7; 95 % CI 99.3–100). Accuracy was higher for gastric bypass surgery than for other types of obesity surgery. Registrations that were misclassified as obesity surgery (n?=?44) included reoperations due to complications or reconstruction to normal anatomy after previous obesity surgery (n?=?11) and endoscopic procedures (n?=?10).

Conclusion

Obesity surgery registrations in the NPR and SOReg have high accuracy and are reliable sources of data to identify patients having undergone obesity surgery. When it is of importance to distinguish between specific surgical procedures, non-gastric bypass surgeries in the NPR should ideally be supplemented with data from other sources.

     

Isolation and partial characterization of proteins with vasodegenerative and proinflammatory properties from the egg-nests of Hylesia metabus (Lepidoptera: Saturniidae)

The Hylesia genus comprises a group of Neotropical moths ubiquitous in the Americas from Arizona to Argentina. One of the species of the Hylesia genus in Venezuela, French Guyana, and Trinidad has been identified as Hylesia metabus (Cramer 1775) (Lepidoptera: Saturniidae). In Venezuela, these moths are found in abundance in the mangrove (Avicennia spp.) swamps surrounding the Gulf of Paria and the Orinoco Delta in the eastern part of the country. During the mating season, the female adults shed copious amounts of urticating setae in the air, producing a severe papulovesicular dermatitis among the population in the affected areas. The females also use their urticating setae to protect the eggs during the hatching period. In the current study, we have isolated and partially characterized proteins with proinflammatory properties from the urticating setae in the egg-nests by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and anionic exchange-high-performance liquid chromatography (HPLC). We also have studied the biological response of the egg-nest extract and the HPLC purified fractions by inoculation in guinea pigs; and, analyzing the tissue samples by means of histopathological methods. The results of this study show that the extracted venom and HPLC purified subcomponents give rise to an intense inflammatory reaction characterized by massive infiltration of inflammatory cells, echymoses, and vascular degeneration. Chromatographic separation showed that the venom was made up of proteins having selectively vasodegenerative-fibrinolytic or proinflammatory-quimotactic properties.     

Experiences of fatigue and self-management of Thai Buddhist cancer patients undergoing radiation therapy

The purpose of this study was to describe (a) the subjective feelings of fatigue of Thai Buddhist cancer patients undergoing radiation therapy (RT) and identify possible gender differences, (b) their beliefs about the main cause of fatigue, and (c) their ways of self-management for relief of fatigue. One hundred thirty-three voluntary and randomly selected patients, 55 men and 78 women, completed a questionnaire with a Thai version of the Revised Piper Fatigue Scale. After 1 week of treatment, the largest group (42.1%) of the patients had felt fatigue during the last few hours (from 1 to 5 hours). The patients perceived a mild level of fatigue, but the sensory/cognitive fatigue scores were high. Five categories of beliefs about the main cause of fatigue emerged: (a) receiving RT; (b) feelings of anxiety, depression, and fright/fear; (c) cancer; (d) long travel to hospital and long waiting time for RT; and (e) difficulty with sleep and weak body. For relief of fatigue, 5 categories of self-management emerged: (1) getting moral support from family and friends; (2) practicing religion, reciting prayers, doing merit, and meditating; (3) practicing self-care for symptomatic problems; (4) accepting the situation and doing the best of one's life; and (5) consulting with doctor and nurse. In conclusion, healthcare providers need to be concerned about RT patients' symptoms of fatigue, beliefs about causes of fatigue, and ways of self-management for relief of fatigue. They also need understanding of cultural and religious beliefs to plan holistic care.     

Acute Toxicity of Eight Oil Spill Response Chemicals to Temperate,Boreal, and Arctic Species

The objectives of this study were to (1) determine the acute toxicity of selected shoreline washing agents (SWA) and dispersants, and (2) assess interspecies differences in sensitivity to the products. Eight shoreline washing agents (Hela saneringsvæske, Bios, Bioversal, Absorrep K212, and Corexit 9580) and chemical dispersants (Corexit 9500, Dasic NS, and Gamlen OD4000) were tested on five marine species, algae Skeletonema costatum, planktonic copepod species Acartia tonsa (temperate species), Calanus finmarchicus (boreal species) and Calanus glacialis (Arctic species), and benthic amphipod Corophium volutator. For most products, A. tonsa was the most sensitive species, whereas C. volutator was the least sensitive; however, these species were exposed through different media (water/sediment). In general, all copepod species displayed a relatively similar sensitivity to all products. However, A. tonsa was somewhat more sensitive than other copepods to most of the tested products. Thus, A. tonsa appears to be a candidate species for boreal and Arctic copepods for acute toxicity testing, and data generated on this species may be used as to provide conservative estimates. The benthic species (C. volutator) had a different sensitivity pattern relative to pelagic species, displaying higher sensitivity to solvent-based SWA than to water-based SWA. Comparing product toxicity, the dispersants were in general most toxic while the solvent-based SWA were least toxic to pelagic species.     

Work Control, Work Demands, and Work Social Support in Relation to Alcoholism Among Young Men

Objectives : The aim of the study was to estimate the impact of psychosocial work-environment factors, such as low work control, on alcoholism among young men. Methods : Data on circumstances during childhood and adolescence, such as on risk use of alcohol, were collected for 49,323 young men, born 1949 to 1951 at time of enlistment for compulsory military training in 1969/1970. On the basis of census data on occupation in 1975, all individuals were classified into groups with regard to psychosocial work-environment factors in accordance with a job-exposure matrix. Follow-up for alcoholism diagnoses from inpatient care registers (1976 to 1983) was undertaken for each of the groups. A number of potential confounding factors were taken into account. Results : Low work control and also low job demands and low workplace social support were found to be related to later alcoholism. On separate analysis, the pattern among blue-collar workers was found to be similar to that of the entire population. When the analyses were extended to include indicators of risk use of alcohol and other relevant background factors, the relative risks decreased, but were still significantly high in the cases of low work control and low work social support. A combination of low demands and low control, what might be called a "passive" work environment, was related to an increased relative risk of psychiatric alcoholism diagnosis after controlling for relevant background factors. Conclusions : Low work control, in particular in combination with low work demands, and low work social support are related to later alcoholism even after controlling for previously known risk factors (including risk use of alcohol). The results suggest that young men may respond to an undemanding occupational environment by increasing their alcohol consumption.     

Elevation of plasma neuropeptide Y-like immunoreactivity and noradrenaline during myocardial ischaemia in man

Plasma levels of neuropeptide Y-like immunoreactivity (NPY-LI) and noradrenaline were studied for 25 h in 22 patients with acute ischaemic heart disease. On admission, NPY-LI levels were above normal in 16 patients, and 20 patients had increased noradrenaline levels. The initial plasma NPY-LI did not differ between patients with acute myocardial infarction (AMI) and angina pectoris. Initial plasma noradrenaline levels were higher in patients with AMI than in those with angina pectoris. Plasma levels of noradrenaline remained elevated in AMI patients, but decreased towards normal values in patients with angina pectoris. Levels of NPY-LI returned to normal within 25 h in all patients. Tachycardia and left ventricular failure were related to high NPY-LI and noradrenaline levels. A positive correlation was found between noradrenaline and NPY-LI in plasma. It is suggested that neuropeptide Y (NPY), an endogenous vasoconstrictor peptide, should be considered as one of the mediators involved in the cardiovascular response to sympathetic activation induced by myocardial ischaemia.