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PubMed1998

[Prolapsed cervical intervertebral disk in professional drivers in Denmark 1981-1990].

The aim of this study was to estimate the risk of being hospitalized due to prolapsed cervical interverteral disc among male professional drivers in Denmark. A cohort consisting of all economically active persons in Denmark, identified January 1981, gives information on the most important occupation during 1980. The cohort was followed for ten years. Additional data on occupational exposures were extracted from a national survey. Occupational groups such as bus and taxi-cab drivers were found to have an increased risk, of cervical prolapse as did the group of professional drivers as a whole.

Automobile Driving↗

PubMed1998

[Organization of obstetric ultrasonography in Denmark 1995--description of the development since 1990].

With the aim to provide an overview of the current organisational status of obstetric ultrasound in Denmark and to describe the development since 1990, a questionnaire was sent in spring 1995 to all 49 departments responsible for the hospital antenatal care program. In addition a questionnaire was sent to the 14 imaging diagnostic departments providing ultrasound services for those of the 49 departments that had either insufficient or no ultrasound facilities. The response rate was 100. Since 1986 the National Board of Health in Denmark has recommended not to screen. At the time of the study the issue was under consideration as part of a general revision of the antenatal care program. Obstetric ultrasound was performed in 30 obstetric, 11 surgical, 12 radiological, 1 image diagnostic and 1 ultrasound department. In total approx. 140,000 obstetric ultrasound examinations were performed in 1994 in contrast to approx. 120,000 in 1989. Fifty-one point four percent of the pregnant population was routinely offered an ultrasound scan in the 10-20th week of gestation (1990: 39.9%). For 19.5% the offer included screening for foetal malformations (1990: 16.5%). In total 34 departments, responsible for the antenatal care of 86.3% of the pregnant population, wanted to continue or start giving an offer of ultrasound screening. The study documents a significant technology diffusion process of ultrasound into the specialty of obstetrics and gynaecology.

Denmark↗

PubMed1998

[Ultrasonography of pregnant women in Denmark 1994-1995--description of its development since 1989-1990].

During a two-week period in May 1995 all delivery departments in Denmark (n = 49) participated in a study with the purpose of describing number, type, time and place for all obstetric ultrasound examinations (OUL) that the women who delivered in the period had during their pregnancies. Further, the purpose was to compare the results with a similar study performed in 1990. The material consisted of 2,315 women; approximately 3.4% of all deliveries in Denmark in 1995. Of all OUL, 96% took place in hospitals. Seven percent of the women had no OUL during their pregnancies (1990: 20.3%). The mean number of OUL was 1.9 for all women and 2.1 for women who had at least one ultrasound examination. In total, 53.9% of the women were offered a screening examination (1990: 40.3%). Women with an offer of screening had a mean number of 1.96 OUL during pregnancy in contrast to 1.88 OUL for women without a screening offer (t-test, non-significant). In the subgroup of women from OB/GYN departments, women with an offer of one screening examination had a mean number of 1.94 OUL during pregnancy in contrast to 1.98 OUL for women without an offer (t-test, non-significant). In conclusion, the study has shown that in comparison with the study performed in 1990, an increasing number of women are given an offer of ultrasound screening and that there in general has been an increase in use of ultrasound examinations in obstetrics during the five-year period.

Denmark↗

PubMed1998

[Emergency echocardiography in Denmark].

In spring 1997, all medical departments in Denmark and the Faroe Islands, not including cardiological centers, were asked to reply to a questionnaire concerning their ability to perform echocardiography at hours different from normal daytime. The response rate was 94.5%. In 21 (30.4%) of 69 departments none of the senior doctors on duty were able to perform echocardiography. In only eight (11.6%) of the departments were more than 50% of the senior doctors on duty able to perform echocardiography (M-mode/2D). Echocardiography is the most informative investigation for patients with suspected acute heart failure or with acute dyspnoea of unknown cause. In these cases acutely performed echocardiography will often be of critical diagnostic value and thereby deciding for correct and rapid therapy. This investigation shows that only a very small fraction of the medical departments in Denmark are able to perform acute echocardiography on a 24-hour basis.

Cardiovascular Diseases↗

PubMed1999

[The effect of transdermal nicotine patches in smoking cessation. A randomized trial in pharmacy customers in Denmark].

The aim of the study was to examine the effect of 24-hour nicotine patches in smoking cessation among over-the-counter customers in Denmark based on a randomized, double-blind, placebo-controlled trial. Participants were consecutive customers to whom nicotine patches were offered free of charge and as the only treatment. Forty-two pharmacies in the areas of Aarhus and Copenhagen in Denmark participated in the trial, and 522 customers who smoked 10 or more cigarettes per day were randomized to either nicotine or placebo patches from January to March 1994. Twenty-four-hour patches were offered for a three-month period. Those smoking 20 or more cigarettes per day started on 21 mg/day patches. Customers who smoked less started on 14 mg/day patches and all the participants were gradually reduced to 7 mg/day patches during the study period. Smoking behaviour and compliance were recorded by means of self-administered question-naires and telephone interviews. Smoking status was recorded following each four-week treatment period, and 26 weeks after inclusion. There was a significant increase in smoking cessations rates, but only among smokers who started on 21 mg/day patches after eight weeks of follow-up. No significant differences in smoking cessation rates were seen among smokers who started with the low dose nicotine or placebo patches.

Administration, Cutaneous↗

PubMed1998

Visual outcomes of cataract surgery in the United States, Canada, Denmark, and Spain. Report From the International Cataract Surgery Outcomes Study.

OBJECTIVE: To compare visual outcomes obtained following cataract surgery in 4 sites in North America and Europe where considerable differences in the organization of care and patterns of clinical practice have been previously described. METHODS: Patients scheduled for first eye-cataract surgery and aged 50 years or older were enrolled consecutively in a prospective multicenter study that collected clinical and patient interview data preoperatively and postoperatively. From the United States, 772 patients were enrolled; from the Province of Manitoba (Canada), 159; from Denmark, 291; and from the City of Barcelona (Spain), 200. Preoperative and 4-month postoperative visual acuity was obtained for 92% of the patients (n = 1291). RESULTS: The mean 4-month postoperative visual acuity of eyes operated on varied significantly across the 4 sites (P < .001) and had the following Snellen decimal fraction measurements: 0.49 in Barcelona, 0.65 in Denmark, 0.66 in Manitoba, and 0.74 in the United States. However, while crude visual acuity outcome figures varied significantly, no significant difference was observed across the 4 sites regarding the risk of poorer visual outcome after controlling for differences in age, preoperative visual acuity, and general health status for patients with no ocular comorbidity. Older age, poorer preoperative visual acuity, poorer preoperative general health status, and coexisting ocular comorbidity were predictors of a poorer visual outcome. CONCLUSION: A previously identified variation in treatment modalities across the 4 sites did not seem to affect patients' visual acuity outcomes.

Aged↗

PubMed2006

Seasonality of suicides with and without psychiatric illness in Denmark.

This paper studied the seasonality of suicides among persons with and without psychiatric illness in Denmark from 1970 to 1999. A non-homogenous Poisson process was used to examine the data. The seasonality of suicides was shown to be associated with gender and their psychiatric histories with a declining trend of suicide incidence noted over the captured period. A mild seasonal component was reported in the period of the late 70s to early 80s (1975-1984) among females who did not have any psychiatric treatment history, while in the 80s the significant seasonality was mainly contributed by male suicides without a psychiatric history. Another mild possible invoked seasonality in the 90s was in males who suffered from psychiatric illness. The rest could be treated as random events. Apparently, the seasonality among suicides with psychiatric illness exists but its effect could vary in different periods of time and among genders in Denmark.

Analysis of Variance↗

PubMed2000

Quinolone resistance among Salmonella enterica from cattle, broilers, and swine in Denmark.

This study was conducted to determine the susceptibility to nalidixic acid and fluoroquinolones of Salmonella Dublin, S. Enteritidis, and S. Typhimurium isolates from cattle, broilers, and pigs over time in Denmark and to characterise the gyrA, gyrB, and parC genes in quinolone-resistant isolates. A total of 584 S. Typhimiurium and 573 S. Dublin isolates from cattle during 1984 through 1999, and 241 S. Enteritidis and 131 S. Typhimurium from broilers and 452 S. Typhimurium from pigs isolated during 1997-1999 were tested. All isolates from cattle from the period 1984 through 1992 were susceptible to quinolones. A single (1.1%) S. Typhimurium isolate from 1995 and three (5.9%) from 1998 were resistant to nalidixic acid. Six (9.0%) S. Dublin isolates from 1996, four (4.2%) from 1997, and one (1.7%) from 1998 were resistant to nalidixic acid. Resistance was not observed among isolates from cattle in 1999. All broiler isolates from 1997 except for one were susceptible to nalidixic acid, whereas seven (6.2%) S. Enteritidis and two (6.3%) of the S. Typhimurium isolates from 1998 and 9 S. Enteritidis (26.5%) from 1999 were resistant. Among isolates from pigs, four isolates from 1997, three from 1998, and one from 1999 were resistant to nalidixic acid. All the nalidixic acid-resistant isolates had reduced susceptibility to fluoroquinolones. Sequence analysis of the gyrA gene in 37 nalidixic-resistant isolates identified two different base substitutions at codon serine-83 and two at aspartate-87. The base substitutions in serine-83 were TCC (Ser)-->TAC (Tyr), and TCC (Ser)-->TTC (Phe). The base substitutions in aspartic-87 were GAC (Asp)-->AAC (Asn), and GAC (Asp)-->GGC (Gly). Sequence analysis of the gyrB and parC genes revealed no mutations in 27 selected isolates. This study showed that quinolone-resistant isolates have emerged in recent years among food-producing animals, especially among S. Enteritidis from broilers in Denmark, and that the resistance mainly is associated with mutations in gyrA.

4-Quinolones↗

PubMed1997

Epidemiology of Staphylococcus aureus bacteremia in Denmark from 1957 to 1990.

OBJECTIVE: To investigate the changes in epidemiology of Staphylococcus aureus (SA) bacteremia in Denmark over a 30-year period, where the population has remained stable. METHODS: Bacteriologic and clinical data were generated on 17 712 SA strains from virtually all SA bacteremia cases in Denmark from 1957 to 1990 submitted to our laboratory for phage typing. The data were related to information about population, hospital activity and blood-culturing activity during that period. RESULTS: SA bacteremia cases increased from 3 to 20/100 000 inhabitants per year, with the largest increases in incidence rates for the <1-year and >50-year age groups. While blood-culturing activity increased three-fold during the period, the rate of SA bacteremias actually decreased relative to the number of blood cultures taken. The increase in SA bacteremia cases was mainly due to increases in nosocomial infections for all age groups and was related to the increasing admission rates to Danish hospitals. Major shifts in antibiotic resistance patterns and phage types took place during the period, i.e. a marked reduction in multiresistant (including methicillin-resistant) strains, but could not explain the change in the epidemiology of the infections. CONCLUSIONS: The data indicate that increases in SA bacteremia rates correlated significantly with increasing numbers of admissions to hospitals. The main increase in SA bacteremia rates was represented by nosocomial infection, although increasing blood-culturing activity during the period may have contributed.

Journal Article↗

PubMed1998

Caries preventive services for children and adolescents in Denmark, Iceland, Norway and Sweden: strategies and resource allocation.

According to the dental acts of Denmark, Iceland, Norway and Sweden, emphasis is placed on preventive dental care. The purpose of this study was to describe and compare two aspects of the caries preventive services: the strategies and the resource allocation for preventive dental care of children and adolescents in Denmark, Iceland, Norway and Sweden. Questionnaires were sent to samples of dentists and other dental personnel who provided preventive care to children during 1995 and 1996. Comparisons between the countries showed significant differences in recall routines and in implementation of risk-based and population-based preventive strategies. Multivariate analyses showed that the time used for preventive care varied by country and was not associated with the DMFT of the children. More time was allocated for prevention when more operating dental auxiliaries were available at the clinic, when the recall interval was shorter, when the time used for routine examination was longer and when the clinician was an auxiliary rather than a dentist. In conclusion, resource allocation and strategies used for prevention were not consistent between the countries.

Adolescent↗

PubMed1989

Changing incidence of cancer of the tongue, oral cavity, and pharynx in Denmark.

The present paper describes the trend in incidence of oral and pharyngeal carcinomas in Denmark in the period 1943-1985, and provides an illustration of the effect of birth cohort on the overall trend. The results are discussed in relation to changes in consumption of alcoholic beverages and tobacco, and to changes in dietary habits in this century. The incidence of these cancers appear to be increasing rapidly in response to the increasing level of alcohol consumption in Denmark.

Adolescent↗

PubMed1990

The clinical value of the haemoglobin concentration analysis (g/L) and the calculation of oxyhaemoglobin saturation (%) in an automatic blood gas analyser (ABL2, Radiometer A/S, Denmark).

This study was aimed to evaluate the accuracy and thereby the clinical value of the haemoglobin concentration (g/L) analysis and of the calculation of oxyhaemoglobin saturation (%) in a commonly used automatic blood gas analyser (ABL2, Radiometer A/S, Denmark). The measured and calculated values (ABL2) were compared to the readings obtained in a last generation haemoximeter (OSM3, Radiometer A/S, Denmark), which served as reference. The haemoglobin concentration measurements performed in the ABL2 apparatus showed an increasing underestimation of the true haemoglobin value at larger haemoglobin concentration values. This together with a poor correlation makes the analysis unsuitable for clinical use. The oxyhaemoglobin saturation values (%) obtained using the ABL2, however, had a good correlation to the corresponding values measured in the OSM3. It is suggested that the oxyhaemoglobin saturation value obtained in the ABL2 can be used clinically, e.g., for invasive control of pulsoximeters.

Arteries↗

PubMed1975

Environmental Radioactivity in Denmark in 1974.

The present report deals with the measurement of fall-out radioactivity in Denmark in 1974. Strontium-90 was determined in samples from all over the country of precipitation, soil, ground water, sea water, grass, dried milk, fresh milk, grain, bread, potatoes, vegetables, fruit, total diet, drinking water, and human bone. Furthermore, 90Sr was determined in local samples of air, rain water, grass, sea plants, fish, and meat. Caesium-137 was determined in soil, sea water, milk, grain products, potatoes, vegetables, fruit, total diet, fish, and meat. It was also measured by wholebody-counting of a control group at Tisø. Estimates of the mean contents of radiostrontium and radiocaesium in the human diet in Denmark during 1974 are given. The gamma-background was measured regularly at locations around Risø, at ten of the State experimental farms, in one area in Zealand, one in Jutland, and along the shores of the Great Belt. Finally the report includes routine surveys of environmental samples from the Risø area.

Air Pollution, Radioactive↗

PubMed2005

[Screening for skin cancer in organ transplant recipients in Denmark].

INTRODUCTION: Non-melanoma skin cancer (NMSC) is a serious cause of morbidity and mortality in organ transplant recipients. The necessary immunosuppressive therapy is linked to an increased number of biologically more aggressive acting skin tumours. Preventing disease and providing early diagnosis and treatment is thus essential. This is done through repetitive patient education and regular examination of the skin performed by a trained specialist, i.e., a dermatologist. We investigated the routine level of monitoring for NMSC in organ transplant recipients in Denmark. MATERIALS AND METHODS: A questionnaire survey was conducted on how hospital departments educate patients in NMSC prevention, the frequency of full-body skin examination and where patients are treated when a tumour is found. The questionnaire was sent to 28 medical departments in Denmark that follow up organ transplant recipients. Twenty-five departments returned the questionnaire. RESULTS: A full-body skin examination was routinely done in six (24%) of the departments. Fifteen (60%) of the departments informed patients about the risk factors for developing skin cancer, but only five (20%) provided written information. DISCUSSION: There appears to be considerable scope for improvement in the follow-up of organ transplant recipients. Providing thorough and repeated information to organ transplant patients, in addition to early diagnosis and treatment carried out by trained specialists according to standard guidelines, can minimize the morbidity and mortality caused by non-melanoma skin cancer in these patients. We suggest that written guidelines be provided in order to improve these patients" treatment and prognosis. A corresponding survey done in the United Kingdom produced almost the same conclusions.

Follow-Up Studies↗

PubMed2006

[Length of stay after primary total hip and knee arthroplasty in Denmark, 2001-2003].

INTRODUCTION: We studied length of stay (LOS) after operation with total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Denmark from 2001 to 2003 to determine whether experiences from published accelerated tracks had been implemented in Denmark, resulting in reduced LOS. MATERIALS AND METHODS: Through the National Patient Registry (Landspatientregistret) we obtained information on numbers, sex, age and LOS for each year during the period 2001-2003, inclusive. RESULTS: In 2003 the male-female sex ratios for THA and TKA were 1:1.4 and 1:1.7, respectively. In 2003, the mean age at operation with THA was 66.0 years for men and 69.9 years for women; 66.9 years for men and 69.0 years for women operated on with TKA. During the period studied, LOS was reduced for both operations: 16% for THA, to a mean of 8.1 days, and 17% for TKA, to a mean of 8.6 days, in 2003. LOS increased with age for both THA and TKA. Men had shorter LOS than women. DISCUSSION: The LOS shows that accelerated tracks - with accompanying shorter LOS in the area of 4 to 6 days - have not been implemented on a nationwide basis, and we find a need to review the principles for rehabilitation after operation with THA and TKA in the direction of accelerated tracks. This could be expected not only to generate large savings in LOS but also to reduce the need for rehabilitation and possibly reduce morbidity.

Aged↗

PubMed2006

Acute lymphoblastic leukemia in adolescents between 10 and 19 years of age in Denmark--secondary publication.

INTRODUCTION: Data seem to indicate that young adults with acute lymphoblastic leukemia (ALL) have a better survival when treated with pediatric protocols compared with adult ALL protocols. The purpose of the study was to report the clinical characteristics and outcome of all children and young adults 10-19 years of age diagnosed with ALL in Denmark between 1992 and 2001. MATERIAL: The study includes 99 patients 10-19 years of age with ALL in Denmark during a ten year period found in the complete NOPHO (Nordic Society of Pediatric Hematology and Oncology) registry and through the Danish Cancer Registry and local pathology databases. Data were retrieved by reviewing medical charts of the patients. A total of 61 children (10-14 years) treated on pediatric protocols and 38 young adults (15-19 years) were diagnosed with ALL. Data were reported as of January 1st 2005. RESULTS: There were no difference with respect to the distribution of T-ALL, CNS-leukemia, total white blood count and high risk chromosomal abnormalities between the two groups. There was a statistical significant lower event free survival (p<0.01) and lower overall survival (p<0.01) in young adults compared with 10-14 year-old children (0.38 vs 0.60 and 0.47 vs 0.67). There were more transplant-related deaths in the young adults. Higher treatment intensity in children may be an additional explanatory factor. Children received more prednisone, vincristine and high-dose methotrexate than young adults. CONCLUSION: Young adult patients with ALL might benefit from therapy with pediatric NOPHO ALL protocols.

Adolescent↗

PubMed2003

Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark.

A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly will also be presented. Antidepressants and antipsychotics are beyond the scope of the report, but due to the mood-stabilizing properties of at least some of the atypical antipsychotics, these agents will be brought into some focus in connection with the overall treatment guidelines for the different phases of bipolar disorder given at the end of this report.

Adolescent↗

PubMed1999

Clinical features of Staphylococcus aureus endocarditis: a 10-year experience in Denmark.

BACKGROUND: Both morbidity and mortality resulting from Staphylococcus aureus endocarditis are known to be high, and the incidence of this disease seems to increase. The Statens Serum Institut, Copenhagen, Denmark, made it possible for us to analyze the clinical features of S aureus endocarditis in a nation-wide population of non-drug addicts. METHODS: Almost all Danish cases of bacteremia due to S aureus are reported to the Staphylococcus laboratory, Statens Serum Institut. The medical records were reviewed in cases reported from 1982 to 1991 in which the diagnosis of endocarditis was reported or suspected. RESULTS: A total of 260 patients, 145 males and 115 females, fulfilled the diagnostic criteria. The median age was 67.5 years. In 83 patients, the diagnosis of endocarditis was not suspected clinically. The overall mortality rate among those patients whose disease was diagnosed clinically was 46%. Among the subset of patients who received medical therapy only and appropriate antistaphylococcal treatment, mortality was significantly associated with late congestive heart failure, age, and involvement of the central nervous system. CONCLUSIONS: A raised awareness of the paucity of clinical findings and a more frequent use of echocardiography as a screening method seem essential to improve the prognosis of patients with S aureus endocarditis. Involvement of the central nervous system constitutes a relative indication of early valve replacement.

Adolescent↗