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PubMed1990

Policies on iron in Denmark.

The mounting evidence on the adverse effects of increasing iron stores raises the question of the appropriateness of existing national policies on iron fortification of foods and iron supplementation in the development countries. A pilot study on the pattern of iron supplementation during pregnancy was implemented in one county of Denmark. The results of the study suggest that there is inappropriate use of iron and laboratory investigation for haemoglobin during pregnancy. For recommendations to be made at national level similar studies should be performed in other counties of Denmark.

Contraindications↗

PubMed1990

Sex chromosome abnormalities found among 34,910 newborn children: results from a 13-year incidence study in Arhus, Denmark.

A 13-year incidence study of sex chromosome abnormalities in Arhus, Denmark of 34,910 newborn children showed that 1 per 448 had a sex chromosome abnormality. The incidences of the most common sex chromosome abnormalities were Klinefelter syndrome, 1 per 576 boys; XYY, 1 per 851 boys; triple X, 1 per 897 girls; Turner syndrome, 1 per 2130 girls. Follow-up of children with autosomal abnormalities is not included in this study. None of the 78 surviving children with sex chromosome abnormalities was mentally retarded. All children above school age attended regular schools. Seventy-seven percent of Klinefelter, triple X, and XYY children aged 15-19 had received remedial teaching, 29% were receiving remedial teaching at the last follow-up, 32% had been in special classes at a regular school due to learning problems, and 24% were still in such classes at the last time of follow-up. There was no increased frequency of criminal activity or behavior disorders, nor was there any increased frequency of mental or physical disorders. The distribution of planned training or occupation for the 25 youths with sex chromosome abnormalities between 15 and 19 years of age was similar to that of their sibs. Testosterone undecanoate treatment has been given to Klinefelter boys from puberty and growth hormone treatment to Turner girls from the age of 7, and very small doses of estrogen were given to these girls from around the age of 12 when FSH was increasing to postmenopausal levels. Prevention or reduction of deviations in mental development from the normal range in children with sex chromosome abnormalities is possible if educational and social resources are available and the parents are well informed and counseled regularly. Information in Denmark has been given in part by publishing four booklets about triple X, XYY, Turner, and Klinefelter syndrome. Information, support, and stimulation to self-help have, to a certain extent, been given through contact groups. Parents having a child with a sex chromosome abnormality need information, counseling, and assistance. The type and magnitude of this assistance depend on the individual child, the specific sex chromosome abnormality, and the parents' own resources, psychologically, socially, and otherwise.

Aneuploidy↗

PubMed1990

[Fatal accidents at train intersections in Denmark].

Material was collected concerning fatal level-crossing accidents in Denmark during the period 1.1.1980 to 31.12.1987. The epidemiological and traumatic circumstances are illustrated. A total of 51 fatal level-crossing accidents occurred which corresponds to 1% of all the annual traffic deaths in Denmark. The majority of the accidents occurred in good weather conditions and between 12 noon and 3.59 pm. Single-person accidents constituted 75%. The majority of the persons killed belonged to the local population and were familiar with the local conditions. The majority of the accidents were the local conditions. The majority of the accidents were due to poor visual conditions and lack of attention. In level-crossings with a keeper, the commonest causes were blinding by the sun and fog. The majority of the accidents occurred in level-crossings marked by light and sound signals. The risk for accidents in these crossings is six times as great as in crossings with half barriers. Private cars were most frequently involved and the persons killed in these died of head and cerebral injuries because the train buffers hit them at head height. Derailing of the trains was only seen on three occasions where the obstructing vehicles were heavy lorries. The fact that more derailings did not occur must be due to the low rate of the trains in the railway sidings where the majority of accidents occurred. A few proposals are made for prophylactic measures.

Accidents, Traffic↗

PubMed1990

[Whooping cough epidemiology in Denmark prior to and after the introduction of whooping cough vaccination. Protective effect of the vaccine and herd immunity].

The epidemiology of whooping cough in Denmark is described on the basis of the notified cases of the disease. The frequency of whooping cough has decreased to approximately one sixteenth of the previous level in children following the introduction of vaccination for whooping cough in 1961. Following change to a programme with only three vaccinations with a weaker, non-aluminium-adsorbed pure whooping cough vaccine in 1970, whooping cough became again slightly more frequent in the nineteen seventies and eighties. No definite reduction in the proportion of cases of whooping cough among infants could be detected although this was what the 1970 programme was particularly aimed at. Isolated deaths from whooping cough still occurred in the eighties, all of these among unvaccinated infants. The risk of whooping cough in an unvaccinated child is approximately one sixth of the risk prior to introduction of vaccination. In a vaccinated child, the risk, as judged from the notified cases, is one twentieth of the risk during the time prior to introduction of vaccination. In all age groups "herd immunity" is considered to have contributed considerably to the reduced incidence. The incidence in Denmark is, however, high compared with the incidence in some other industrialized countries. A vaccination programme with more numerous whooping cough vaccinations and possibly with a more immunogenic vaccine may be recommended on the basis of the strategy aimed at keeping the incidence of whooping cough, and thus the risk of exposure, as low as possible.

Cross-Sectional Studies↗

PubMed1990

[Frequency of causes of death related to sudden infant death syndrome in Denmark during the period 1972-1983].

Differences in the incidence of infant mortality due to sudden infant death syndrome between the regions of the three Institutes of Forensic Medicine in Denmark are known to exist. To investigate whether these could be due to differences in incidence of causes of death such as suffocation and respiratory infections, the rates and types of autopsy were analysed regarding these death causes. The number of deaths due to these causes and the development in the incidence cannot explain the variation of the incidence of SIDS, in the areas observed. For each of the three periods under consideration (1972-1975, 1976-1979, 1980-1983) the variation between institutes in SIDS-rate is relatively larger than the variation in the total rate of deaths due to these three groups of death causes. In the latest period the total rate is 1.93, 1.77 and 1.27 per 1,000 liveborn in Cophenhagen, Odense and Arhus areas, respectively. The study suggests different evaluations of the results of autopsy. A higher incidence of deaths due to congenital heart defects is seen in Arhus, where the lowest incidence of SIDS is observed. A prospective study (1987-1988) of all cases of sudden infant death in Denmark was initiated by the three forensic Institutes with the aim of evaluating possible time and regional incidence variations using identical diagnostic criteria.

Cause of Death↗

PubMed1990

[Vascular surgery in Denmark].

This report presents vascular surgical operations performed in Denmark 1983-1987, the first five years after the establishment of the speciality. The number of vascular surgical operations increased by 18 per cent during the five years to nearly 2,000 operations in 1987. Approximately 50 per cent of all vascular procedures were intraabdominal operations, while 30 per cent were peripheral reconstructions. In 1987 40 operations/100,000 inhabitants were made, a level considerably below the activity performed in the other Scandinavian countries. We conclude that vascular surgical activity will increase in Denmark in the years to come.

Denmark↗

PubMed1990

[Consensus on the treatment and control of border-line tumors of the ovary in Denmark].

In order to obtain an impression of the consensus in Denmark of the treatment and control of border-line tumours of the ovary (BTO), a questionnaire was sent to all 43 departments of gynaecology/obstetrics and of surgery with gynaecology/obstetrics. Thirty-seven (86%) departments replied. The results of the investigation are presented. It is concluded that about 75% (87% in stage Ia and 65% in stage Ib) perform restrictive surgery on younger patients in the early stages. Indication for chemotherapy is found only in patients with more advanced stages. Very few find an indication for radiotherapy. Treatment and control of BTO in Denmark are in agreement with current international principles.

Adult↗

PubMed1990

[Femoro-crural reconstruction in Denmark 1983-1987].

From 1983 to 1987, 293 femoro-crural bypasses were performed in eight centers for vascular surgery in Denmark. The activity increased in the period from 15 to 135 bypasses per year. The increase took place particularly 1986, when the in situ saphenous vein bypass was introduced in Denmark. A total of 203 bypasses were performed at the University Hospital of Copenhagen, Rigshospitalet: 108 in situ bypasses, 51 bypasses with arterial protheses and 44 bypasses using reversed vein. The cumulated graft patency after one year was 76% for the in situ bypasses, 26% for the bypasses with arterial protheses and 32% for reversed vein. The cumulated limb survivals after one year were 90%, 66% and 63%, respectively.

Adult↗

PubMed1990

[Extrauterine pregnancy in Denmark in 1981-1986].

A uniform increase has been observed in the incidence of extrauterine pregnancies in Denmark from 11.7 per 1,000 known conceptions in 1981 to 16.9 per 1,000 known conceptions in 1986. This increase is significant. The incidence of extrauterine pregnancies increases with increasing maternal age until the age of 40 years. The main increase occurred in the age group 20-39 years, where the increase is significant. The same age-related tendency has been demonstrated regionally and in Denmark as a whole. Where all Danish counties are concerned, an increasing frequency of extrauterine pregnancies was demonstrated from 1981 to 1986. The risks are greater in urban regions than in the rural regions. The etiology of the increase at a national level and the age-related and regional variations are unknown.

Adult↗

PubMedDate not supplied

Pneumocystis carinii Delanoë & Delanoë, 1912 found in lungs of freeliving animals in Denmark at autopsy.

Stained imprints made from autopsy lung biopsies from hares, foxes, badgers, stone martens, one hedgehog, roe deer from Denmark and from caribou from Greenland were examined microscopically for Pneumocystis carinii. Pneumocysts were found in the lungs of 3 out of 28 hares, 3 out of 18 foxes and 1 out of 6 roe deer. This is the first report of Pneumocystis carinii in hares, foxes, and roe deer in Denmark. It seems to be the first report of Pneumocystis carinii in roe deer.

Animal Population Groups↗

PubMed1989

[Preventive health examinations of pregnant women in Denmark. Structure and organization].

In Denmark, pregnant women are offered antenatal care in a nationwide programme. This programme is organized around health examinations in general practice, midwives centres and hospital outpatient departments. During the winter 1986/87 a nationwide investigation of antenatal care was carried out in Denmark. A random sample of approximately 1/3 of the general practitioners, all of the midwives who had antenatal consultations and the medical staffs of 26 departments of obstetrics and gynaecology with more than 100 deliveries in 1985 received a questionnaire about the content of a definite antenatal examination and certain conditions of organization. The obstetricians could describe three different types of antenatal examinations depending upon the place and arrangement of work. The percentage replies received were 62 for general practice, 86 for the midwives and 62, 69 and 55 from the doctors in the place of delivery. 50% of the pregnant women had been attached to the same practice for at least five years. 70% of the general practitioners performed approximately one antenatal examination weekly. Only few hospital districts had attempted to have the first examination by the midwife at the 12th week of pregnancy. 25% of the places for examination by midwives were outside hospitals, which, according to the guidelines for antenatal care, do not entirely fulfill the intentions concerning situation in the patient's immediate surroundings. All of the obstetric departments offered routine examinations in the 16th-18th weeks and a number of these also routine examinations in the third trimester.(ABSTRACT TRUNCATED AT 250 WORDS)

Denmark↗

PubMed1989

Effect of organized screening on incidence and mortality of cervical cancer in Denmark.

Pap smears were used only on a limited scale in Denmark until the late 1960s. Since then smears have been taken both in organized screening programs and outside the programs by general practitioners, private gynecologists, and hospital wards. The present smear-taking activity is equivalent to an average of one smear every second year per woman. As the responsibility for health care rests with the counties in Denmark, differences are found between the counties both concerning organization of screening programs, and concerning the overall level of the smear-taking activity. An analysis using multiplicative Poisson models on county-based incidence and mortality data for women aged 30-59 years in 1963-1982 showed a statistically significant effect of organized screening in reducing both the incidence (RR = 0.67; 95% CI, 0.61-0.73), and the mortality (RR = 0.68; 95% CI, 0.59-0.78) of cervical cancer from 5 years after introduction of an organized screening program. The level of overall smear-taking activity was found to be of limited importance when organized screening was taken into account.

Adult↗

PubMed1989

[Regional distribution of birth weights in Denmark during the period 1979-1983].

We investigated the geographical distribution of birthweights among liveborn infants in Denmark for the years 1979-1983, using the Medical Birth Register of the Danish National Board of Health. The investigation includes 272,361 liveborn children. The birthweight varies with the sex of the child, and with the age and parity of the mother. In the analysis of geographical variation of birthweight correction was made for these factors. We found an association between birthweight and urbanization, the lowest average birthweight being found in the capital, and the highest in the rural areas. Further, the average birthweight was higher in the western than in the eastern part of Denmark, especially in Northern Jutland and in Aarhus County. Geographical variation in gestational age explains part of the geographical variation in birthweight, but part of the variation must be explained by variation in the growth of fetuses. The role of genetic variation, variation in living conditions, and variation in the conduct of the health services is discussed. We found an unexpected association between the average birthweight in the counties, and neonatal mortality; the counties with high average birthweights also had a significantly increased neonatal mortalities.

Birth Weight↗

PubMed1989

[Abnormalities among newborn children born to immigrants in Denmark in the period 1983-1987].

It has recently been discussed whether there was a higher incidence of congenital malformations among newborns of immigrant mothers than among Danish infants. The study is based on information retrieved from two registries in the Danish National Board of Health, both with national coverage: The Medical Birth Register and the Register of Congenital Malformations. All livebirths in Denmark, born to women from Denmark, Scandinavia, Yugoslavia, Turkey, Pakistan, Morocco, Iran and Vietnam in the years 1983-1987, more than 240,000 infants, were included. When comparing the birth prevalence of congenital malformations in the various groups, the observed rate is corrected for maternal age and parity distribution, fathers' occupation (indicating the social position) and county of delivery, as ascertainment varies between hospitals. This part of the analysis did not support the observation of an increased incidence among offspring of immigrant women. A more detailed analysis, based on a multiplicative Poisson-model, compares the three largest groups: Danish, Turkish and Pakistani mothers. Evaluating the influence of maternal age, father's occupation and county of delivery, the result is that the differences observed can, to a large degree, be explained by these three factors, especially the county of delivery. The remaining differences are no larger than can be explained as random. We were thus unable to support the debated observation on a higher incidence of congenital malformations among infants born to immigrant mothers.

Congenital Abnormalities↗

PubMed1989

[Fatal gunshot injuries in East Denmark].

All of the fatal gunshot lesions in East Denmark during the period 1984-1987 were investigated. A total of 276 cases were found corresponding to an annual frequency of approximately 3.0 per 100,000 live population. The majority were cases of suicide (86%) and the majority of these were men. Only four accidents were found. Two of these were due to "Russian roulette"). No hunting accidents were encountered. In the middle of the period investigated, new and more restrictive legislation concerning firearms was introduced in Denmark. No specific effect in the form of reduction in the number of cases with smooth barrelled shot guns resulting from this could be demonstrated but there was, possibly, a general prophylactic effect. As compared with previous Danish investigations, the absolute number of cases of suicide with firearms has increased during the period investigated here while not only the absolute but also the relative number of homicides have increased. Increased information and further attempts to limit the number of firearms in the population are recommended.

Adolescent↗

PubMed1988

Fatal intoxications in Denmark following intake of morphine from opium poppies.

In Denmark it is legal to grow opium poppies for the production of poppy seeds and until 1986 for decoration purposes, too. Danish poppy capsules contain 0.3-5 mg morphine per capsule and the content of morphine in opium exuded from the capsules may amount to 24%. This has resulted in misuse as both fresh and dried poppy capsules have been used for the production of "opium tea". During the period 1982-1985, seven casualties occurred among drug addicts in Denmark which were solely or partly caused by these opium poppies.

Adolescent↗

PubMed1986

Prevalence of diabetes mellitus treated with insulin and oral hypoglycemic agents in Denmark.

During a period of 12 months all diabetics treated with insulin or oral hypoglycemic agents (OHA) were registered by collection of prescriptions on the island of Falster, Denmark, with 44,498 inhabitants. The overall prevalence of diabetes mellitus was 12.4 per 1,000 (553 diabetics). Insulin-treated diabetics comprised 231 persons (prevalence rate 5.2 per 1,000) and OHA-treated diabetics comprised 322 persons (prevalence rate 7.2 per 1,000). The prevalence of insulin-treated diabetes especially with an age less than 30 yr was significantly higher than the prevalence in 2 other areas in Denmark. 50% of the insulin-treated diabetics with an onset age greater than or equal to 30 yr were overweight in contrast to 6% of insulin-treated diabetics with an onset age less than 30 yr (p less than 0.01). Among OHA-treated diabetics, 65% were overweight.

Age Factors↗

PubMed1986

Influence of smoking habits and place of residence on the risk of lung cancer among workers in one rock-wool producing plant in Denmark.

Cancer incidence was studied among 5,317 employees in one rock-wool production plant in Denmark. During the period 1943--1982 a marginally significant excess of 240 cancer cases was observed versus 211.0 cases expected. Among the subgroup of male workers an increasing risk with time since first employment was observed for cancer of the buccal cavity and pharynx, cancer of the respiratory system, and cancer of the bladder, of which only the excess of the first-mentioned reached significance. The increased risk of lung cancer among male workers with 20 or more years since first employment, which was not significantly in excess of 1.0, although still compatible with a two- to threefold increase according to conventional 95% confidence limits, could not be explained by deviations in local lung cancer incidence, place of residence among the rock-wool male workers, or smoking habits prevailing among unskilled workers in the eastern part of Denmark. The number of cases, however, was too small to exclude the effect of chance in this single investigation.

Adult↗