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PubMed1985

Second cancer following lymphatic and hematopoietic cancers in Denmark, 1943-80.

In Denmark, approximately 5% of all malignant neoplasms occur within the lymphatic and hematopoietic tissues. Between 1943 and 1980, 23,367 persons with these diseases fulfilled the criteria for entering the study. The risk of developing a second primary cancer was significantly increased only after Hodgkin's disease [relative risk (RR) = 1.6], whereas no increase was found after non-Hodgkin's lymphoma [(NHL); RR = 1.0] or leukemia (RR = 1.1), and a significant deficit occurred after multiple myeloma (RR = 0.8). All initial cancer sites showed a higher incidence of second primary cancers among males than females. Significant elevated risks for acute non-lymphocytic leukemia occurred after Hodgkin's disease (RR = 17), NHL (3.8), and multiple myeloma (9.1). Among persons initially diagnosed with leukemia, NHL was significantly elevated (RR = 2.6). However, these RR should be regarded as minimum figures due to the likelihood of serious underreporting of second primary hematologic cancers in Denmark. The secondary leukemias were likely induced by the treatment of the first primary cancer (chemotherapy, radiotherapy), but common etiologies, misclassification, or progression of the initial cancer cannot be ruled out entirely. Other second primary cancers found to be above expectation following Hodgkin's disease were cancers of the pancreas, lung, and urinary bladder. The risk for bladder cancer increased with time, which suggested a causal relation to radiation or chemotherapy, or both. Cancers of the colon and rectum following NHL and female breast cancer following leukemia occurred below expectation and remain unexplained.

Denmark↗

PubMed1984

Morbidity of peptic ulcer. Registration of hospital discharges in Denmark 1978-1980.

A descriptive investigation of the frequency of discharges and the frequency of complications for patients with ulcer disease on the basis of the National Patient Registry in Denmark covering the years 1978, 1979, and 1980 for the diagnoses gastric ulcer, duodenal ulcer, gastrojejunal ulcer, peptic ulcer, site unspecified, and gastritis-duodenitis is presented. The number of discharges was constant--12,000-13,000 annually, or 250 per 100,000 inhabitants--with a 4% increase for gastric ulcer and an 11% decrease for duodenal ulcer during the period. The frequency of discharges was of the same size as for comparable groups of diseases in Denmark in 1970-1977 but greater than in the United Kingdom. The number of patients discharged was 10,000 annually. The consumption of bed days fell from 126,000 to 106,000, implying a reduction in the average length of stay from 9.6 to 8.3 days. The total number of surgical operations and the number of elective operations was constant, around 2000 and 1400 annually, respectively. Of the patients discharged 20% had had a bleeding and 8% a perforation from their ulcer. During the period of examination cimetidine was introduced in the treatment, and this may have influenced the decrease in the consumption of bed days and the frequency of discharges for duodenal ulcer.

Adult↗

PubMed1995

[Mandatory anonymous HIV-surveillance in Denmark. Experience with the new notification system].

A newly implemented mandatory, anonymous HIV surveillance system in Denmark is described. The system is based on a serially numbered form that is circulated among the laboratories, the physicians, and the national surveillance unit. All laboratories doing confirmatory tests for HIV antibodies must send a report form along with any positive test result. Before forwarding the form to the physician, the laboratory is to fill in the top part of the form with its own name, the name and address of the requesting physician and the date of testing. The back copy must be send to the surveillance unit. The Danish physicians are by law mandated to fill in the form with data on the patient and then send the original to the surveillance unit. The two copies are for the patient's file and for the physicians' own centralized filing system. After a revision of the system in 1992, a response rate of 95% was obtained during the first year. An increasing number and proportion of first-time identified HIV-infections in Denmark are acquired heterosexually, many of these infections are identified among foreigners. The newly developed mandatory HIV surveillance system is based on anonymous reporting but it allows routine evaluation of the completeness of reporting as well as nonresponding physicians to be reminded of their duty to report. Also, the system allows nested studies to be carried out among selected HIV-infected subpopulations of special research interest without compromising the anonymity of the patient.

Confidentiality↗

PubMed1994

Phage types of Salmonella enterica ssp. enterica serovar typhimurium isolated from production animals and humans in Denmark.

S. Typhimurium is one of the 2 most common salmonella serotypes causing human salmonellosis in Denmark. In order to illustrate the significance of different production animals as a source of infection, 1461 isolates were characterized by phage typing. The isolates originated from human patients and from cattle, pigs and poultry. By phage typing the isolates could be separated in 35 different phage types. Five types (10, 12, 66, 110 and 135) predominated and comprised 78.8% of the isolates. In humans, 57.3% of the isolates were phage type 12. This phage type was also predominant in pig herds and, to a lesser degree, in cattle. Phage types 110, 120, 135 and 193 constituted 86.5% of the poultry isolates while these phage types only made up 12.9% of the human isolates. The investigation showed that pigs are probably a major source of S. Typhimurium infection in humans in Denmark today.

Animals↗

PubMed1995

[Poisonings due to analgesics during a period of 14 years in Denmark--a registry study of the period 1979-1992].

The study describes consumption of and poisoning by analgesic drugs in Denmark during the period 1979-1992. During this period, fatal poisonings from analgesics almost doubled to 200 deaths per year (40% of all drug related deaths in Denmark). The annual consumption of opioids increased at the beginning of the period, but during 1985-1992 it was relatively constant at 20 million defined daily doses (DDD) and associated with 600 hospital admissions and 150-170 deaths due to poisoning per year. Within the opioid group dextropropoxyphene consumption and poisonings decreased following a National Board of Health initiative in 1985-1987. As for the weak analgesics, consisting mainly of paracetamol or salicylates, the total consumption increased gradually and reached 145 million DDD in 1992, corresponding to 160 tablets per inhabitant per year. This consumption was associated with approximately 750 hospital admissions and 40 deaths due to poisoning. As judged from the mortality per dose the weak analgesics are 20-30 times safer than the opioids.

Analgesics↗

PubMed1994

[Cervical insufficiency and cerclage in Denmark 1980-1990. A registry-based epidemiological study].

The objective of this analysis was to assess the incidence rate of cervical incompetence diagnoses in Denmark 1980-1990 according to maternal age, to analyze regional variations, to investigate how often cervical cerclage is applied, and finally to estimate abortion rates among women with cervical incompetence with and without cervical cerclage. The design was a register-based retrospective cross sectional study, including all Danish gynaecological departments. Since 1977, all hospitalized patients in Denmark have been centrally recorded by diagnosis according to the ICD classification and by operation codes in The National Patient Register. From this database, all women with cervical incompetence (CI) and cerclage in the period 1980-1990 were identified. From the same database all cases of spontaneous abortions were registered. A total of 2756 cases of cervical incompetence were registered in the period 1980-1990, corresponding to an incidence rate of 4.6/1000 births. The risk of cervical incompetence increased from 2/1000 births among women 15-19 years old to 7.5/1000 births among women 35-39 years old. The incidence rate of the CI-diagnosis fell by 44% from 1980 to 1990. The incidence rates in different counties ranged from 1.7/1000 births to 10.0/1000 births. The average length of stay in hospital among patients with cervical incompetence was three weeks. Among patients with cervical incompetence, 61% were treated with cervical cerclage. This percentage increased from 29% among women 15-19 years old to 68% among women 35-39 years old. 13.5% of women with CI experienced spontaneous abortion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

[Mammographic examinations in Denmark, 1990-1991].

Diagnostic mammographic activity was studied in five regions in Denmark in 1990-1991. During this period there was only one organized mammography screening programme which started in the Copenhagen municipality on 1 April 1991. It is estimated that 49,000 diagnostic mammographic examinations were made in Denmark per year in the period 1990-1991. Almost two-thirds of these mammograms were taken in women below 50 years of age. It is important to monitor the diagnostic mammographic activity to ensure that this does not gradually develop into a screening activity. This is in particular important for women below 50 years for whom screening is not recommended.

Adult↗

PubMed1995

[Estimated consumption of anabolic steroids among athletes in Denmark].

In an attempt to ascertain the types and quantities of anabolic steroids used by athletes in Denmark, a questionnaire was distributed at nine weight-training centres during the winter of 1986-1987. By comparing the results of the non-representative questionnaire study with the overall consumption of anabolic steroids in the country as a whole, the annual consumption was estimated to be the equivalent of at least 6,500 10-week courses of anabolic steroids at daily dosages eight times the recommended therapeutic level. In addition, the not inconsiderable illegal use of anabolic steroids seems to increase. The annual consumption of anabolic steroids by athletes in Denmark is estimated to be 2 million daily doses.

Adolescent↗

PubMed1994

[Accidents and accident mortality in Denmark--a comparison with Scandinavia and Europe].

As the development in mean age of the population and life expectancy has been less favourable in Denmark than in the rest of Western Europe, the Ministry of Health decided to investigate statistics for the period, 1972-1990, for the main areas where Danish life expectancy was poorer. A sharp increase in the incidence of accidental poisoning with medical drugs and alcohol during the period was found to be a factor contributing to the poorer Danish statistics during the period. In the subcategory, death after a fall, there was an increase in incidence among the elderly, but the loss of life-years remained constant. The subcategory, fatal road accidents, manifested a marked reduction in incidence, despite the increase in traffic density during the period, and there was a reduction in the loss of life-years. Thus, in the category, accidental deaths, the increase in the incidence of accidental poisonings would appear to be the only factor contributing to the poorer development in mean age and life expectancy in Denmark.

Accidents↗

PubMed1994

[Extrapulmonary tuberculosis in Denmark. A review of the incidence, localization and therapy].

In Denmark, just under 20% of tuberculosis (TB) cases amongst Danes and 25-30% of cases amongst people of foreign nationalities are made up of isolated extrapulmonary (EP) TB. The incidence among Danes is falling, whereas an increasing amount of EP TB cases are found among foreigners due to continued immigration, and these now constitute 50% of all cases of EP TB. EP TB is found among older Danes and younger foreigners. The HIV/AIDS epidemic has not had any effect on the incidence of TB and EP TB in Denmark. EP TB is most frequently found in lymph nodes and the urogenital system. Since the disease is rare, it may be overlooked; it should be considered as a differential diagnosis in unresolved cases, particularly in immigrants from countries with a high prevalence of TB. Treatment is as for pulmonary TB, namely "four drug" therapy for six months. Surgical intervention is rarely required. Supplementation with oral steroids may be useful in very special cases.

Denmark↗

PubMed1994

Distribution of feline blood types detected in the Copenhagen area of Denmark.

The purpose of the present study was to make the first survey of the distribution of feline AB blood types in the Copenhagen area of Denmark. A total of 244 cats (139 purebred cats and 105 Domestic Shorthair cats) were tested. 93% of all tested cats had blood type A. Neither an AB nor an O type cat was detected and thus, the frequency of blood type B among all tested cats was 7%. Most type B cats were purebred cats (Birman, British Shorthair and Persian cats). No association between sex and blood type could be demonstrated among British Shorthair and Persian cats. Thus, the present study indicates that cats in Denmark predominantly have blood type A, and that blood type B cats are rare, except for certain breeds such as Birman and British Shorthair cats.

Animals↗

PubMed1994

[Kawasaki disease. Incidence in Denmark during the period 1981-1990].

The aim of the study was to estimate the incidence of Kawasaki's disease and to describe the clinical manifestations and the prognosis of the disease in children in Denmark during the period 1981-1990. In a register of all hospital admissions in Denmark, 99 patients were registered as having Kawasaki's disease. Of those, 89 patients fulfilled the clinical diagnostic criteria. The mean incidence of the ten year period was 1.0 per 100,000 children per year. The incidence of the disease decreased in the age group from zero to seven years after which it was rarely observed. Typical laboratory findings were hypersedimentation, leucocytosis and thrombocytosis. Eight children had cardiomegaly and three had electrocardiographic changes. Echocardiography was performed in 66 patients showing coronary artery aneurysms in nine patients (14%) (six boys and three girls). No further cardiac complications were found.

Adolescent↗

PubMed1994

Mandatory anonymous HIV surveillance in Denmark: the first results of a new system.

OBJECTIVES: This paper describes the principles and first results of the newly implemented anonymous mandatory human immunodeficiency virus (HIV) reporting system in Denmark. METHODS: The system is based on a serially numbered form that is circulated among the laboratories, the physicians, and the national surveillance unit. All laboratories doing confirmatory tests for HIV antibodies must send a report form along with any positive test results. Before forwarding the form, the laboratory is to fill in the top part with the name and address of the requesting physician and send the back copy to the surveillance unit. The physicians are mandated by law to fill in the form with data on the patient and to keep two copies for their own files before sending the original to the surveillance unit. RESULTS: After a revision of the system, a response rate of 95% was obtained. CONCLUSIONS: We have established an anonymous mandatory HIV surveillance system in Denmark that enables routine evaluation of the completeness of reporting and nonresponding physicians to be reminded of their duty to report. Also, the physicians can act as mediators between patients and researchers; therefore, nested studies can be done without breaking the anonymity of the patient.

AIDS Serodiagnosis↗

PubMed1994

[Treatment of subcapital fractures of the 4th and the 5th metacarpus. A clinical trial of the results after treatment without immobilization and reposition and a study of the treatment of these fractures at casualty departments in Denmark].

The aim of the study was to evaluate the results of treating subcapitular fractures of the fourth and fifth metacarpal bones with immediate mobilization and without splinting or reduction. Thirty-six such fractures were prospectively treated in this fashion and evaluated clinically. After four weeks only four patients (11.1%) had restricted movement of the metacarpal-phalangeal joint (less than 0-80 degrees of movement). The fracture was healed in 33 patients (91.7%) and 31 (86.1%) were fully satisfied. In order to investigate the types of treatment given in other accident and emergency departments in Denmark, a questionnaire was sent to all such departments. The results showed that most (90%) departments used plaster of Paris immobilization of the fracture. The average period of immobilization was 3.6 weeks (two to six). The indications given for reduction was an average volar angulation of 32 degrees (10-70). We conclude that treatment of subcapitular fractures of the fourth and fifth metacarpal bones without reduction and with a supporting bandage and mobilization to the pain-limit seems to secure a rapid restitution of function. These fractures are generally treated in Denmark with plaster immobilization and sometimes reduction, which appears to constitute overtreatment.

Adolescent↗

PubMed1994

[Occurrence of lung cancer in Denmark 1943-1986. Reliability of the cancer registry].

A rise in the number of adenocarcinomas of the lung and a fall in squamous cell carcinomas are seen in Denmark since 1978; a change based on a growing number of lung cancers among women with an excess of adenocarcinomas. A fall in the frequency of autopsies in Denmark will entail the loss of an essential control of the quality of diagnosis of lung cancer, primary or secondary, and make future descriptive studies difficult to interpret. The validity of morphologic diagnosis of lung cancer as recorded by the Danish Cancer Registry during 1943-1986 was assessed. We extracted a stratified random sample of 5% of all recorded cases prior to 1978, these were then recorded according to the ICD-O classification. Cases after 1978 were originally coded in the Registry according to ICD-O, here we checked the coding against the original reports. The information on morphology prior to 1978 was too inprecise to merit evaluation of trends and proportionate distributions by morphology. After 1978 data was adequate, and after 1983 very precise.

Adenocarcinoma↗

PubMed1994

Clozapine treatment in Denmark: concomitant psychotropic medication and hematologic monitoring in a system with liberal usage practices.

BACKGROUND: Clozapine has been utilized in Denmark since the early 1970s. This study examines doses, concomitant psychotropics, and leukocyte counts. METHOD: All psychiatric hospitals in Denmark were asked for copies of all their clozapine monitoring forms, which were then personally reviewed by the authors. RESULTS: Forms from 656 patients were collected from 32 hospitals. The male/female ratio was 2/1; the median age, 38 years (range, 18-80). Thirty-five percent received concomitant antipsychotics, 28% benzodiazepines, 19% anticholinergics, 11% antidepressants, 8% antiepileptics, (carbamazepine, valproate, and phenobarbital), and 2% lithium. While there were no gender differences with respect to concurrent psychotropics, women received lower doses of clozapine than men (median dose, women 300 mg/day and men 400 mg/day, p < .02). Ten percent had had a neutrophil count < 2000/microL (3.2% < 1500/microL). Five percent had repeated neutrophil counts < 2000/microL (1.5% < 1500/microL). There were two cases of agranulocytosis; both patients fully recovered upon withdrawal of clozapine. Clozapine was discontinued because of hematologic abnormalities in only five other cases (0.8%). CONCLUSION: While use of concomitant psychotropics during clozapine treatment should be limited because of an increased risk of complications, a totally restrictive policy might deprive certain patients of the benefits of clozapine treatment. There appears to be a benign form of granulocytopenia that does not always necessitate discontinuation, provided there is close follow-up.

Adolescent↗

PubMed1994

[Status of preventive screening for uterine cervix cancer in Denmark in 1994].

In 1986 The National Board of Health published guidelines for cervical cancer screening in Denmark. These guidelines recommend organized screening with personal invitations every three years to women in the age group 23-59 years, and in the years to come also invitation of women aged 60-74 years. We studied the organization of cervical cancer screening in Danish counties at the beginning of 1994. Organized screening programmes are running in 15 out of the 16 "counties" (this include the municipalities of København and Frederiksberg). Four counties completely follow the national guidelines. Eight counties follow these guidelines in general, but they do not invite women above the age of 60 years. In total, 72% of women aged 25-74 years are at present invited for cervical cancer screening in Denmark.

Adult↗

PubMed1994

[Acute pancreatitis in Denmark].

The incidence, etiology, severity and mortality of acute pancreatitis in Denmark were investigated by examining published material from Denmark from the period 1979-1992 and information from the central registry of diagnoses from the period 1981-1990. The incidence of acute pancreatitis increased from 26.8 to 35.4 per 100,000 inhabitants per year from 1981 to 1990. An increase in the incidence among males was solely responsible for this total increase in incidence. Acute pancreatitis is significantly more frequent in men than in women, in men the frequencies in the age-group 15-64 and the age-group > 65 were the same. In contrast, acute pancreatitis was nearly twice as common among women of 65 or older as it was among the 15-64 year-old women. Oedematous pancreatitis accounted for 95% of the total number of cases registered, with minimal yearly variations (94.0-96.0%). The total mortality was low, with no systematic variation in the period studied (3.2%, yearly variations between 2.6 and 4.2%). Hospitalization time decreased over the period from an average of 12.8 to nine days.

Acute Disease↗