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PubMed1996

[The first case of Vibrio cholerae 0139 in Denmark].

We report the first case of V. cholerae O139 in Denmark. In 1994, a 61-year-old Vietnamese woman was admitted to Aalborg Hospital, Denmark due to severe diarrhoea. The diagnosis was confirmed by biochemical characterization and agglutination in O139 antiserum of a strain isolated from a stool specimen. The woman had stayed in Denmark after family reunion for nine months and had not travelled outside the country. She had not eaten any foods imported from Southeast Asia. The V. cholerae O139 isolate had similar antibiotic susceptibility pattern and contained genes encoding a virulence gene cassette previously identified in O139 isolates from Southeast Asia. Ribotyping showed a banding pattern similar to patterns exhibited by O139 isolates from Bangladesh, India and Thailand. However, the exact mode of transmission of this first Danish case of V. cholerae O139 infection was not determined.

Cholera↗

PubMed1997

Work in agriculture, childhood residence, nitrate exposure, and testicular cancer risk: a case-control study in Denmark.

A population-based case-control study in Denmark investigated the hypothesis that parental occupation in agriculture increases the risk of testicular cancer in the offspring. Other factors investigated were: childhood residence on a farm, in the country, or in an area with high nitrate concentration in ground water, and the subjects' own occupation in agriculture. The only association that emerged was with childhood residence in the high-nitrate area. The excess risk was, however, confined entirely to men who did not grow up on a farm or in the country. This makes it very unlikely that nitrate exposure per se should be responsible. Further analyses revealed that the excess risk was confined largely to men who grew up in nonrural areas within Arhus County, where Denmark's second largest city is located, and an excess risk was also seen among men who grew up in Copenhagen Municipality, which is the center of the most urban area in Denmark. The geographic pattern of incidence is stronger for the area of childhood residence than for the area of residence at the time of diagnosis. This supports indirectly the idea that testicular cancer is caused by unidentified factors early in life.

Agriculture↗

PubMed1997

[Incidence of juvenile-onset diabetes in Denmark. A prospective registration in the counties of Fyn, Ribe, Sønderjylland and Vejle].

To provide contemporary figures of the incidence of childhood onset diabetes mellitus in Denmark, a prospective routine registration system has been established. The present study covered the population of children aged 0-14 years in four Danish counties, observed during the calendar years 1989 through 1993 concerning new cases of the disease. A total of 201 cases (113 boys and 88 girls) were registered, corresponding with a sex- and age-adjusted incidence rate of 17.4 per 100,000 person-years. Based on a validation analysis the study material is considered virtually complete. Overall, the incidence among boys was slightly higher than among girls, but not statistically significantly so. The incidence rate increased with age for both boys and girls. The results confirm that the incidence of childhood onset diabetes in Denmark is relatively high. Compared with previous Danish studies there has been an increase of about 20-25% in the incidence during the last 20 years. Our study stresses the importance of a continuous registration of new cases of childhood diabetes in Denmark, thereby providing clues for further aetiological studies as well as providing reference values for the planning of the diabetes health care. Our results indicate that at least two independent ascertainment sources must be employed to ensure complete registration in studies that rely upon voluntary registration as the primary reporting source.

Adolescent↗

PubMed1997

[Occurrence of hepatitis A infection in Denmark].

Hepatitis A is a mandatory notifiable disease in Denmark. The number of notified cases of hepatitis A was compiled over a period of 16 years, 1980-1995. A total of 3790 were included in the study. The average incidence was 4.6 per 100,000 population per year, but the number of cases declined slightly through the period. Median age among Danes were 27 years and among immigrants seven years. The male to female ratio was 1.5 among Danes and 1.1 among foreigners. The incidence was highest in the capital area. Two-thirds of the notified persons were infected in Denmark, among whom the source of infection was unknown for half of the cases. The two most important sources of infection were household contracts and i.v. drug abuse. A total of 73 persons were infected in connection with their occupation in Denmark. Workers in day care centres, sewage workers and cleaners may be particularly at risk, although the risk is still low. The relevance of vaccination recommendations for special groups is considered.

Adolescent↗

PubMed1997

Induced abortions in Denmark.

BACKGROUND: A law on Induced Abortion on Request came into force in Denmark in 1973. During the first years the rate of abortion increased but since the early 1980s the rate has been rather constant. The paper reviews recent findings concerning induced abortion and discusses its role in controlling fertility. METHODS: Trends in induced abortion is described from routine statistics while information on the aborting women are taken both from a survey and from a register based study of fertility- and abortion-pattern among a cohort of women. RESULTS: Fertility trends in Denmark are characterized by an increasing age at first birth. Half of the aborters to day have no children before and 10% had given birth less than 18 months earlier. Among aborters a higher proportion than among parturients were still under education and a higher proportion were single with no steady partner. Half of the aborters became pregnant in spite of contraceptive use, indicating a need for better contraceptives. CONCLUSIONS: Induced abortion has become a generally accepted form of birth control in Denmark and the decision to terminate a pregnancy is influenced by many factors including the woman's conjugal--and educational situation. A strategy for prevention of induced abortion must take into consideration the social circumstances of women and for families with children.

Abortion, Induced↗

PubMed1997

Multidrug-resistant tuberculosis in Denmark 1993-1995.

SETTING: All bacteriologically confirmed new cases of tuberculosis and treatment relapses in Denmark are examined for drug resistance. In the years 1993-1995, nine cases of multidrug-resistant tuberculosis (MDR-TB), all acquired outside Denmark, were identified among 1354 cases of tuberculosis. OBJECTIVE: To examine incidence, treatment and prognosis for patients with tuberculosis due to MDR Mycobacterium tuberculosis. DESIGN: Retrospective evaluation of routine data. RESULTS AND CONCLUSION: Multidrug resistance was present in less than one present of patients with tuberculosis. One patient died from tuberculosis without revision of treatment, and eight patients responded favourably to a regimen of pyrazinamide, streptomycin or amikacin, ofloxacin and cycloserine. In two patients, this regimen was supplemented with para-aminosalicylic acid and thiacetazone respectively. All patients needed prolonged hospitalization and had observed treatment. It is possible to cure such patients, but it is a lengthy and expensive process. It is expected that similar cases will be imported into the country and that they will occur within Denmark in the future.

AIDS-Related Opportunistic Infections↗

PubMed1998

[Multiresistant tuberculosis in Denmark 1993-1996].

Infections with multiresistant tubercle bacilli have also become a problem in the rich part of the world. The reasons are lack of compliance in patients with life style problems and ineffectiveness of the health system due to lack of fundings. During a four year period, 1993-1996 ten patients were seen in Denmark with tuberculosis due to multiresistant Mycobacterium tuberculosis. Nine were infected abroad, one developed MDR-TB during treatment in Denmark. It is possible to cure these patients, but it is expensive and takes a long time. In the future more cases created within Denmark are likely to be seen due to lack of funding for the tuberculosis programme and, depending on immigration, further cases created abroad are expected.

Adult↗

PubMed1998

[Doping--a medical problem in Denmark?].

Misuse of drugs in relation to doping has been known for many years in Denmark. The Sports Confederation of Denmark carries out about 1000 doping controls every year on athletes at both competitions and training-sessions. In the period 1991-1996, 5084 doping controls were performed. Six athletes who refused to participate were excluded from organized sport for a period of two years. Forty-three athletes were found positive for drugs; 32 were positive for androgenic-anabolic steroids, 11 were positive for different stimulants including amphetamine, cocaine, caffeine and ephedrine. The misuse of drugs outside organized sport is considered to be a growing problem. Three percent of all persons between fifteen and fifty years have tried some kind of doping. The number of misusers of androgenic-anabolic steroids in Denmark is considered to be around 10,000. Side-effects are numerous and include cardiovascular side-effects, psychiatric disturbances and hepatotoxicity. It is important that all doctors be aware of the side-effects and health problems in misusers.

Denmark↗

PubMed1998

Detection of extended-spectrum beta-lactamases. The reliability of methods for susceptibility testing as used in Denmark.

The susceptibility testing methods used in Denmark were evaluated with respect to their ability to detect cephalosporin resistance with cefuroxime as indicator, especially resistance caused by extended-spectrum beta-lactamases (ESBLs). Two methods for determination of minimal inhibitory concentration (MIC), three agar diffusion methods, a disc approximation test and the ESBL-Etest were used against a panel of strains producing well-known beta-lactamases. The tablet diffusion test (Rosco Neo Sensitabs) as the most used in Denmark had the lowest detection rate of cefuroxime resistance among ESBL-producing strains. The prediffusion method, which is only used at one laboratory, was the most reliable method for such detection. The MIC methods were in good agreement, but the detection rate for resistance due to ESBLs was low and depended on the antibiotics used. The disc approximation test and the ESBL-Etest both resulted in an acceptable ESBL detection rate. The latter tests discriminated between isolates producing the frequent chromosome-mediated and the in Denmark probably very rare ESBL-mediated cephalosporin resistance. For the evaluation of susceptibility tests such strains require special attention.

Alcaligenes↗

PubMed1985

Subsidizing pharmaceutical prescriptions: the experience of Denmark, Finland, Norway and Sweden.

In 1980, drug consumption per capita was 455 Swedish crowns (SEK) in Sweden, SEK 452 in Denmark, SEK 384 in Finland and SEK 382 in Norway; actual figures for Denmark, Finland and Norway being converted into Swedish crowns using the mean 1980 exchange rates. To what extent can these differences be explained by differences in the drug reimbursement programmes of these four Nordic countries? For instance, is it the greater generosity of the Swedish system--in Sweden, the share of drug reimbursement expenditures to total drug consumption is 57%, as against 33% in Norway, 38% in Finland and 34% in Denmark--that makes drug consumption per capita so much higher in Sweden? If the demand for drugs were elastic and if all other influencing factors, besides the reimbursement system, were the same in all the four Nordic countries, then a definite conclusion would, obviously, be fairly easy to reach. However, a number of factors do differ: for instance, income per capita, physician remuneration schemes (and, hence, maybe, physician behaviour) and consumer charges for inpatient and outpatient care; and other factors such as morbidity and patterns of illness may differ. A complete analysis has to take all these factors into account. Too many factors seem to vary to make the sole use of cross-section data meaningful in this case. Time-series data are available and will be used in future analyses.

Cost Control↗

PubMed1999

Clonality of Vibrio anguillarum strains isolated from fish from the Scandinavian countries, Sweden, Finland and Denmark.

In order to investigate whether outbreaks of vibriosis in the Baltic region were caused by the spread of certain pathogenic clones, 291 Vibrio anguillarum isolates from Finland (n = 156), Sweden (n = 88) and Denmark (n = 47) were studied with respect to serogroup, ribotype, plasmid content, and biochemical phenotypes as expressed with the PhenePlate (PhP) typing system. For comparison, 54 V. anguillarum serogroup O1 from other countries worldwide were included. Most isolates from Finland, Sweden and Denmark belonged to serogroup O1 (255), followed by O2 (30). Four Finnish isolates cross-reacted strongly with antisera against two new serogroups VaNT2 and VaNT4, whereas two strains were non-typeable. The serogroup O1 isolates displayed ten different ribotype patterns, whereas the other strains were considerably more diverse with respect to ribotypes. Most of the O1 isolates carried the 67 kb virulence plasmid and a group of Finnish isolates, in addition, carried an 86 kb plasmid. Additional plasmids with molecular weights of 63, 76, 135 or 260-290 kb were found in single O1 isolates. With few exceptions, strains of serogroup O2 either had no plasmids or carried one or two small plasmids. PhenePlate typing revealed considerable diversity within the species, serogroup O1 being the most homogeneous. A few PhP types were dominant, whereas other types were observed only in one to four isolates. The prevalence of the different types changed significantly from one year to another but in Finland, one clonal lineage became increasingly important from 1992 (20% of isolates) to 1996 (80%). Remaining clones were mostly restricted to specific geographic areas. By cluster analysis, it was demonstrated that most of the isolates from Finland, Sweden and Denmark belonged to two clusters, and most of the strains from Southern Europe fell into two other, distinct clusters. Most isolates from the UK, North America, Chile and Tasmania grouped together in a distinct cluster. For the typing of V. anguillarum, O-serotyping should be the primary method. For isolates belonging to serogroups other than O1, plasmid profiling in combination with ribotyping gives a very good discrimination between strains, whereas for serogroup O1, another method is required. It is concluded that PhP typing is a tool that provides a good discrimination between O1 isolates.

Animals↗

PubMed1986

Annual number of intraoral radiographs in Denmark and other countries.

It has been demonstrated previously that in 1982, 2.4 million intraoral radiographs were taken in Denmark, or 0.47 radiograph per inhabitant. In the present study this frequency is compared to frequencies in other countries. The number of radiographs per inhabitant varied between 1.6 (Sweden) and 0.08 (Hungary). It is concluded that the frequency in Denmark is lower than in Sweden, USA, Norway, and Japan, but higher than in Great Britain, Finland, and Hungary. The increase in use of intraoral radiography was compared for five countries. The frequency curves exhibited nearly identical slopes, but the rates of increase for Great Britain and Denmark were approximately 15 yr delayed in comparison with Sweden, USA, and Japan.

Europe↗

PubMed1998

Surveillance of antimicrobial resistance in bacteria isolated from food animals to antimicrobial growth promoters and related therapeutic agents in Denmark.

This study was conducted to describe the occurrence of acquired resistance to antimicrobials used for growth promotion among bacteria isolated from swine, cattle and poultry in Denmark. Resistance to structurally related therapeutic agents was also examined. Three categories of bacteria were tested: 1) indicator bacteria (Escherichia coli, Enterococcus faecalis, Enterococcus faecium), 2) zoonotic bacteria (Campylobacter, Salmonella, Yersinia enterocolitica), and 3) animal pathogens (E. coli, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Staphylococcus hyicus, Actinobacillus pleuropneumoniae). All antimicrobials used as growth promoters in Denmark and some structurally related therapeutic agents (in brackets) were included: Avilamycin, avoparcin (vancomycin), bacitracin, carbadox, flavomycin, monensin, olaquindox, salinomycin, spiramycin (erythromycin, lincomycin), tylosin (erythromycin, lincomycin), and virginiamycin (pristinamycin). Bacterial species intrinsically resistant to an antimicrobial were not tested towards that antimicrobial. Breakpoints for growth promoters were established by population distribution of the bacteria tested. A total of 2,372 bacterial isolates collected during October 1995 to September 1996 were included in the study. Acquired resistance to all currently used growth promoting antimicrobials was found. A frequent occurrence of resistance were observed to avilamycin, avoparcin, bacitracin, flavomycin, spiramycin, tylosin and virginiamycin, whereas resistance to carbadox, monensin, olaquindox and salinomycin was less frequent. The occurrence of resistance varied by animal origin and bacterial species. The highest levels of resistance was observed among enterococci, whereas less resistance was observed among zoonotic bacteria and bacteria pathogenic to animals. The association between the occurrence of resistance and the consumption of the antimicrobial is discussed. The results show the present level of resistance to growth promoters in bacteria from food animals in Denmark. They will form the baseline for comparison with future prospective studies, thereby enabling the determination of trends over time.

Animals↗

PubMed1977

Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark.

The prevalence of vitiligo was 0.38% in 47,033 people in a representative region in Denmark. Both sexes were equally affected. No significant difference was found in the distribution of 179 patients with vitiligo among five municipalities or between urban and rural districts. The age-specific prevalence increased from 0.09% under the age of 10 years to 0.90% in the age group 60 to 69 years. After the age of 70, the prevalence declined. This fall might reflect an increased incidence of vitiligo during the past few decades. The number of new cases of vitiligo increased steadily with advancing age, its onset being most often between the ages of 40 and 60 years. It is assumed that the prevalence of vitiligo in Denmark applies also to the northwestern part of Europe.

Adolescent↗

PubMed1994

Mental illness in the biological and adoptive relatives of schizophrenic adoptees. Replication of the Copenhagen Study in the rest of Denmark.

BACKGROUND: Our previous investigation of the prevalence of mental illness among the biological and adoptive relatives of schizophrenic adoptees in Copenhagen, Denmark, showed a significant concentration of chronic schizophrenia (5.6%) and what Bleuler called "latent schizophrenia" (14.8%) in the biological relatives of chronic schizophrenic adoptees, indicating the operation of heritable factors in the liability for schizophrenic illness. METHODS: We now report the results of a replication of that study in the rest of Denmark (the "Provincial Sample"). RESULTS: In this sample, the corresponding prevalences were 4.7% and 8.2%. In the combined "National Sample" of adoptees with chronic schizophrenia, that disorder was found exclusively in their biological relatives and its prevalence overall was 10 times greater than that in the biological relatives of controls. CONCLUSIONS: This study and its confirmation of previous results in the Copenhagen Study speak for a syndrome that can be reliably recognized in which genetic factors play a significant etiologic role. These findings provide important and necessary support for the assumption often made in family studies: observed familial clustering in schizophrenia is an expression of shared genetic factors.

Adolescent↗

PubMed1996

Epidemiology of classic Kaposi's sarcoma in Denmark between 1970 and 1992.

BACKGROUND: Studies have suggested that the incidence of classic Kaposi's sarcoma (KS) varies considerably within Europe. The epidemiology of classic KS in Denmark was described for the period between 1970 and 1992 and association with marital status and country of origin were evaluated. METHODS: A descriptive epidemiology study was carried out using data from the Danish Cancer Registry and from all Danish pathology departments. The effects of marital status and of immigration were evaluated in a case-control study with sex- and age-matched controls for 50 cases of classic KS. RESULTS: A total of 59 patients with classic KS, 34 men, 25 women, were identified between 1970 and 1992, yielding world standardized incidence rates of 0.40 and 0.22 per 1,000,000 population among men and women, respectively. Among men, a larger proportion of the patients with classic KS were of non-Danish origin [odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.5-9.6]. No excess of foreign born persons was observed among women with KS. Never-married men were at a markedly increased risk for classic KS (OR = 2.8, 95% CI = 1.2-6.7). This risk was, however, restricted to men younger than 60 years (OR = 18.8, 95% CI 3.4-104.8), whereas no increased risk was observed in men age 60 years or older nor was there an increased risk in women. CONCLUSIONS: Classic KS is a rare disease in Denmark. However, men, immigrants and never-married men age 60 years or younger experienced an excess risk. Even though the latter finding might reflect an association with male homosexuality, the observation should be interpreted with caution due to the limited number of observations.

Case-Control Studies↗

PubMed1996

Cancer risk in fathers and brothers of testicular cancer patients in Denmark. A population-based study.

There are several reports of familial testicular cancer in the literature but few systematic attempts have been made to estimate the risk of testicular cancer in first-degree relatives of patients with this neoplasm, and the risk remains to be fully assessed in population-based studies. By means of data from the Danish Cancer Registry, we identified all testicular cancer patients (index cases) born and diagnosed during 1950-1993 in Denmark. Their fathers were identified from national registries, as were the brothers of a subcohort of these patients. Familial cancer occurrence was determined through linkage with the cancer registry and compared with the cancer incidence in the general male population in Denmark. The ratio of observed to expected cancers generated the measure used for the relative risk. Fathers of 2,113 index cases with testicular cancer experienced an almost 2-fold risk of developing testicular cancer themselves (RR = 1.96; 95% CI: 1.01-3.43). Overall, the fathers had a decreased relative cancer risk (RR = 0.84; 95% CI: 0.74-0.95) with a significantly decreased risk of cancers of the lung and digestive organs. Brothers of a subcohort of 702 index cases showed a markedly increased risk of testicular cancer (RR = 12.3; 95% CI: 3.3-3 1.5). In conclusion, we documented a significantly increased familial risk of testicular cancer which was relatively more pronounced between brothers than between fathers and sons. These findings support the possible involvement of a genetic component in the aetiology of testicular cancer, but also leave room for a hypothesized influence of in-utero exposures, such as specific maternal hormone levels, that might be shared by brothers.

Adult↗

PubMed1996

Colorectal cancer in asbestos cement workers in Denmark.

Recent data on the risk of colorectal cancer following exposure to chrysotile are conflicting. We report on colorectal cancer morbidity in a large cohort of asbestos cement workers from Denmark mainly exposed to chrysotile. The total cohort had an SIR of 1.23 (95% CI 1.01-1.48). With a latency period of 15 years, men employed in the early (1928-1950) production period had an SIR of 1.47 (95% CI 1.05-2.01). With the observation of excess risks of colorectal cancer morbidity among chrysotile exposed asbestos cement workers in both Sweden and Denmark the question on the role of chrysotile in the etiology of colorectal cancer remains open.

Air Pollutants, Occupational↗