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This cohort study uses Swedish Medical Birth Register data to investigate risk of birth defects in infants born to women who had Roux-en-Y bariatric surgery between 2007 and 2014. [ABSTRACT FROM AUTHOR]

The article presents information about a research conducted for assessing the health care use over 20 years in obese patients who have been treated conventionally or with bariatric surgery. The research employed the Swedish obese subjects study in an ongoing, prospective, nonrandomized, controlled intervention study at the Swedish health care system which included 2010 adults who underwent bariatric surgery. The inclusion criteria were age 37 to 60 years of age and body mass index of 34 or higher in men and 38 or higher in women.

Background: Sick-leave is an important source of productivity losses to society. The objective of this study was to investigate the association between body mass index (BMI) status in young adulthood and future sick-leave. Methods: A nation-wide cohort of 43 989 Swedish men (18.7 ± 0.5 years) performing military conscription tests in 1969–70 were followed between 1986 and 2005 regarding sick-leave. BMI was used to define underweight (<18.5), normal weight (18.5–24.9), overweight (25.0–29.9) and obesity (&geq;30.0). Relative risks of sick-leave were estimated with Cox proportional hazards models adjusted for smoking, socio-economic index and muscular strength, using normal weight as the reference. Results: During 803 684 person-years of follow-up, 488 570 sick-leave episodes were recorded. On average, one short-term (&leq;7 days) episode occurred every eight person-months, one intermediate-term (8–30 days) every five person-years and one long-term (>30 days) episode every 15 person-years. Overweight was associated with 20% and obesity with >30% risk elevation for episodes ranging from 8 to 30 days [hazard ratio (HR) 1.20; 95% CI 1.15–1.24 and HR 1.35; 95% CI 1.24–1.47, respectively] as well as for episodes >30 days (HR 1.19; 95% CI 1.15–1.23 and HR 1.34; 95% CI 1.24–1.47, respectively) compared to normal weight. Obesity was also associated with an increased risk of sick-leave episodes &leq;7 days (HR 1.13; 95% CI 1.09–1.16), but the corresponding risk increase for overweight was very small (HR 1.02; 95% CI 1.00–1.03). Underweight showed increased risk only for short-term episodes (HR 1.05; 95% CI 1.04–1.07). Discussion: Overweight and obesity are associated with increased risk for sick-leave compared to normal weight, especially for sick-leave episodes of longer duration. [ABSTRACT FROM PUBLISHER]

The article discusses research which investigated perinatal outcomes in women with history of bariatric surgery. It acknowledges increased risk of women who previously undergone bariatric surgery for preterm and small for gestational age births. It offers brief details about study procedures which include selection of participants and data analysis. A chart listing information on preterm birth and fetal growth outcomes recorded is also presented.

Objectives To compare trajectories of marriage and parenthood in individuals with JIA vs the general population. Methods Patients with JIA (n  = 4399) were identified in the Swedish National Patient Register (2001–2016) and individually matched to up to five general population comparators on birthyear, sex and residence county (n  = 21 981). Marriage and parenthood data were retrieved from the Total Population Register from age 18 y, and parenthood from the Multigeneration Register from age 15 y, respectively. Hazard ratios (HRs) were estimated using Cox regression adjusted for parental education, parental marital status and number of siblings. Results During a median of 6.3 years of follow-up, 362 patients with JIA and 1744 comparators got married (12.9 vs. 12.5 per 1000 person-years; HR 1.03, 95%CI 0.93-1.15). During a median of 8.8 years of follow-up, 680 patients with JIA and 3477 matched comparators became parents (17.1 vs 17.8 per 1000 person-years; HR 0.94, 95%CI 0.87-1.01). In the subgroup of patients with systemic onset JIA (SJIA), the adjusted hazard ratios for marriage and parenthood were 0.79 (95%CI 0.53-1.17) and 0.73 (95%CI 0.55-0.97), respectively. Conclusion The times to first marriage and first parenthood are similar for patients with JIA and the general population, suggesting that adolescents with JIA transition into family life along a trajectory resembling their community peers. One exception is the subgroup of patients with systemic onset JIA, who become parents for the first time at a lower rate than general population comparators. [ABSTRACT FROM AUTHOR]

Abstract: Previous research has been inconclusive as to whether high peak bone mineral density (BMD, g/cm2) resulting from previous physical activity is retained with reduced activity later in life. The aim of this 12-year longitudinal study was to investigate the association between BMD loss and reduced physical activity (h/wk) at trabecular and cortical bone sites in men. Three groups with a mean age of 17 years at baseline were investigated: i) 51 athletes who discontinued their active careers during the follow-up period (former athletes), ii) 16 athletes who were active throughout the follow-up period (active athletes), and iii) 25 controls. BMD loss at the hip, spine, and pelvis (mainly trabecular bone) was compared to BMD loss at femur, humerus, and legs (mainly cortical bone) during a 12-year follow-up period. Across the total follow-up period in the total cohort, reduced physical activity was more strongly associated with changes at trabecular BMD sites, i.e. hip, spine, and pelvis (B =0.008–0.005 g/cm2 per weekly hour physical activity (h), p <0.001), than at cortical bone sites, i.e. humerus, legs (B =0.002–0.003 g/cm2/h, p <0.05), and femur (p >0.05). At the final follow-up, former athletes showed higher BMD than controls only at the cortical bone sites of the humerus, legs, and femur (difference 0.05–0.10 g/cm2, p <0.05). In conclusion, this study indicates that predominantly trabecular bone is lost with reduced physical activity levels in young men. Benefits were still evident at the more cortical sites eight years after the discontinuation of an active sports career. [Copyright &y& Elsevier]

Objective. To compare work-loss in RA patients starting their first biologic with high vs moderate disease activity. Methods. We identified all RA patients aged 20-63 years in the Swedish Biologics Register who started their first biologic 2007-09 with high disease activity (DAS28 >5.1; n = 868) or moderate disease activity (DAS28 3.2-5.1; n = 854). Work days lost, defined as sick leave and disability pension days from the Swedish Social Insurance Agency, were assessed over 5 years after first bio-start. We estimated be-tween-group mean differences adjusted for age, sex, calendar year, education level, disease duration, comorbidities and work-loss the month before bio-start. Results. During 5 years after anti-TNF start, mean monthly work days lost declined from 16.0 to 9.2 (42%; P< 0.001) in patients with high disease activity at baseline and from 12.0 to 7.2 (40%; P< 0.001) in patients with moderate disease activity, with no between-group difference (adjusted mean difference 0.81; 95% CI-0.44, 2.05). Accumulated 5-year work-loss was, however, higher in the high activity group (724 vs 548 days; adjusted mean difference 70; 95% CI 20, 120), but after stratification on baseline disability pension status, no differences in accumulated work-loss were detected. Conclusion. Substantial work-loss was seen in both patients with high and patients with moderate disease activity at anti-TNF start, with a 5-year decline in mean monthly work days lost by ~40% in both groups and no between-group difference. Accumulated work-loss over 5 years was higher in the high-activity group, which may be explained by differences in baseline disability pension status. [ABSTRACT FROM AUTHOR]

Purpose.To investigate if testicular cancer survivors (TCSs) have a higher incidence of work loss compared with the population, accounting for stage, treatment and relapse. Material and methods.A cohort of 2146 Swedish TCSs diagnosed 1995–2007 (seminoma n = 926, non-seminoma n = 1220) was identified in the SWENOTECA (Swedish-Norwegian Testicular Cancer Group) register, and matched 1:4 to population comparators. Prospectively recorded work loss data (both before and after diagnosis) were obtained from national registers through September 2013. Adjusted relative risks (RR) and 95% confidence intervals (CI) of sick leave and/or disability pension were calculated annually and overall with Poisson- and Cox regression, censoring at relapse. The mean number of annual work days lost was also estimated. Results.TCSs were at a modestly increased annual risk of work loss up to the third year of follow-up (RR3rd year1.25, 95% CI 1.08, 1.43), attributed to a more pronounced risk among extensively treated patients (4 chemotherapy courses: RR3rd year1.60, 95% CI 1.19, 2.15; > 4 courses: RR3rd year3.70, 95% CI 2.25, 6.11). Patients on surveillance or limited treatment (radiotherapy, 1–3 chemotherapy courses) did not have an increased risk of work loss beyond the first year. TCSs receiving > 4 chemotherapy courses had higher mean number of annual days of work loss up to the 10th year post-diagnosis, and a five-fold risk of disability pension (RR 5.16, 95% CI 2.00, 10.3). Conclusion.Extensively treated TCSs, but not those on surveillance or limited treatment, are at increased risk of work loss long-term, not explained by relapse. These patients may benefit from early rehabilitation initiatives. [ABSTRACT FROM PUBLISHER]

This pharmacoepidemiology study uses Norwegian registry data to investigate associations between fluconazole use during pregnancy and subsequent stillbirth and neonatal death. [ABSTRACT FROM AUTHOR]

Objective: To investigate the associations of exercise capacity and muscle strength in late adolescence with risk of vascular disease and arrhythmia.Design: Cohort study.Setting: General population in Sweden.Participants: 1.1 million men who participated in mandatory military conscription between 1 August 1972 and 31 December 1995, at a median age of 18.2 years. Participants were followed until 31 December 2010.Main Outcomes: Associations between exercise capacity and muscle strength with risk of vascular disease and subgroups (ischaemic heart disease, heart failure, stroke, and cardiovascular death) and risk of arrhythmia and subgroups (atrial fibrillation or flutter, bradyarrhythmia, supraventricular tachycardia, and ventricular arrhythmia or sudden cardiac death). Maximum exercise capacity was estimated by the ergometer bicycle test, and muscle strength was measured as handgrip strength by a hand dynamometer. High exercise capacity or muscle strength was deemed as above the median level.Results: During a median follow-up of 26.3 years, 26 088 vascular disease events and 17 312 arrhythmia events were recorded. Exercise capacity was inversely associated with risk of vascular disease and its subgroups. Muscle strength was also inversely associated with vascular disease risk, driven by associations of higher muscle strength with lower risk of heart failure and cardiovascular death. Exercise capacity had a U shaped association with risk of arrhythmia, driven by a direct association with risk of atrial fibrillation and a U shaped association with bradyarrhythmia. Higher muscle strength was associated with lower risk of arrhythmia (specifically, lower risk of bradyarrhythmia and ventricular arrhythmia). The combination of high exercise capacity and high muscle strength was associated with a hazard ratio of 0.67 (95% confidence interval 0.65 to 0.70) for vascular events and 0.92 (0.88 to 0.97) for arrhythmia compared with the combination of low exercise capacity and low muscle strength.Conclusions: Exercise capacity and muscle strength in late adolescence are independently and jointly associated with long term risk of vascular disease and arrhythmia. The health benefit of lower risk of vascular events with higher exercise capacity was not outweighed by higher risk of arrhythmia. [ABSTRACT FROM AUTHOR]

The article focuses on a randomised controlled trial that studied the effect of low energy diet on obstructive sleep apnoea in men. It says that weight loss programme was found to be effective in both moderate and severe sleep apnoea after one year follow-up of 63 obese men aged 30-65 participated in the study. The main outcome measure of the study was apnoea-hypopnoea index.