The prevalence of abuse in Swedish female psychiatric users, the perpetrators and places where abuse occurred.

The aims of the study were to investigate self-reported physical, sexual, emotional and economical abuse in Swedish female users of psychiatric services, who the perpetrators were and in which places abuse occurred. An anonymous self-administrated questionnaire was answered in the waiting room of the services. The drop-out rate was 21% and n=1382 women completed the questionnaire. Fifty-three per cent of the women had been abused during childhood, 63% during adulthood and 31% during past year. Seventy-four per cent of those exposed during childhood were also exposed later in life. Women subjected to abuse reported longer contact with psychiatric care. Regardless of life period, the majority reported multiple and frequent abuse. Emotional abuse was most frequent reported in both childhood and adulthood followed by physical and sexual abuse. The reported perpetrators were mainly male persons to whom the woman had an intimate relationship. Mostly the abuse occurred in the women's own home. However, other women, strangers, acquaintances and relatives were also stated as perpetrator and abusive acts also took place in other homes, outdoors or down town. The high prevalence of abuse and its multiplicity point to the necessity for the care and support system to prioritize abuse against women with psychiatric illness.

Ruptured thoracic aortic aneurysms: a study of incidence and mortality rates.

PURPOSE: The purpose of this study was to determine the incidence and mortality rate of ruptured thoracic aortic aneurysm (TAA) in a well-defined population. METHODS: Retrospective analysis of complied data from multiple registries in Stockholm, Sweden was performed. RESULTS: Eighty-two and 76 cases were identified from 1980 and 1989, respectively, for an equal incidence of 5 per 100,000. Forty-one percent of the patients were alive on arrival at an emergency hospital, but the overall mortality rate was 97% to 100%. CONCLUSIONS: The mortality rate of ruptured TAA is high. To decrease this high mortality rate, efficient screening methods for the diagnosis of TAA must be worked out, characteristics indicating high risk of rupture must be identified, and efforts should be made to increase the number of operations for ruptured TAA.

Clinical and hemodynamic effects of stepwise lowering of hemoglobin concentration in patients with intermittent claudication.

This study evaluates the effect of stepwise lowering of the hemoglobin (Hb) concentration on maximal walking distance (MWD) and hemodynamics in patients with intermittent claudication. The results in a study group (n = 6) were compared with those of a control group (n = 6) whose members were not subjected to venesections. An average decrease of Hb concentration from 151 +/- 4 to 121 +/- 3 g/L did not significantly influence MWD, the result being 282 +/- 62 meters before venesections and 255 +/- 54 meters after three to five (mean four) repeated venesections. Transcutaneous oxygen pressure was measured at the dorsum of the foot before and after exercise and did not change with a gradual decrease of the Hb concentration. Maximal heart rate, painfree walking distance, ankle pressure, and blood lactate concentration were also unchanged. An average venesection volume of about 1.4 liters whole blood within fourteen days, without isovolemic replacement, did not change the blood volume, which was 5.1 +/- 0.4 liters before and 5.0 +/- 0.5 liters after venesections. In conclusion, hemodilution accomplished by venesections did not have a clinically or physiologically beneficial effect in patients with severe intermittent claudication. However, hemodynamics and clinical symptoms were not affected by a considerable decrease in the arterial oxygen content within the normal Hb concentration range.