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PubMed1990

Frequency of the delta F508 mutation on cystic fibrosis chromosomes in Denmark.

We have investigated the frequency of the delta F508 mutation on cystic fibrosis (CF) chromosomes in Denmark. Of 304 chromosome tested, 86.8% have the delta F508 mutation. The majority of the chromosomes with this mutation are found on chromosomes with the XV2c/KM19 haplotype B (97.3%), whereas 15/16 chromosomes with haplotype C have another mutation, confirming that only very few mutations will account for the majority of CF genes in the Danish population.

Cystic Fibrosis↗

PubMed2002

Preventive home visits to older people in Denmark: methodology of a randomized controlled study.

BACKGROUND AND AIMS: Preventive home visits were introduced by legislation in Denmark in 1998. This ongoing randomized controlled intervention study introduces a model where preventive home visits to elderly people are carried out in a standardized way, focusing on early signs of disability and on physical activity. The study includes general practitioners (GPs) in relevant parts of the assessment and endeavors coordinated interdisciplinary follow-up. Our main aim was to investigate whether this model gives enhanced active life expectancy, but the focus of the present paper is the design of the study. METHODS: The design was a prospective, controlled, follow-up study conducted over a 3-year period (1999-2001) with randomization and intervention at the community level, and outcomes measured at an individual level among people living in those communities. The study included 17 pairs of intervention and control communities (34 in total), including 2104 persons aged 75-80 years in the intervention communities (participation rate, 70.8%) and 1956 persons in the control communities (p.r. 70.3%). The main outcome measure is change in functional ability after 1.5 and 3 years. Other outcomes are mortality, and hospital and nursing home admissions. Intervention communities received systematic education and written materials; two key representatives from each community also attended bi-annual follow-up meetings. Control communities did not receive any intervention but were allowed to conduct a preventive program completely on their own. RESULTS: Baseline characteristics were similar in the intervention and control communities with regard to size, rural and urban characteristics and geriatric services, and the individual characteristics of participating persons living in these communities were also comparable. The intervention was well accepted and feasible. CONCLUSIONS: When results become available, the study should reveal the most important factors for preventive home visits to elderly people.

Aged↗

PubMed2006

Increased prevalence of Down's syndrome in individuals with type 1 diabetes in Denmark: A nationwide population-based study.

AIMS/HYPOTHESIS: In patients with Down's syndrome, dogma has long held that the prevalence of diabetes is increased. The aim of the present study was to determine the actual prevalence of Down's syndrome among type 1 diabetic patients. SUBJECTS, MATERIALS AND METHODS: The background population included all children born in Denmark between 1981 and 2000. Registry-validated and clinical data on type 1 diabetes and Down's syndrome diagnoses were obtained from the National Disease Register and Danish Cytogenetic Central Register, respectively. RESULTS: The prevalence of Down's syndrome in the background population was 0.09%, whereas we identified a prevalence of Down's syndrome in type 1 diabetes patients of 0.38% (95% CI 0.17-0.75), corresponding to a 4.2-fold increased prevalence compared with the background population (p = 7.3 x 10(-5)). CONCLUSIONS/INTERPRETATION: To the best of our knowledge this is the first population-based study addressing the prevalence of Down's syndrome among verified type 1 diabetes patients. A more than fourfold increased prevalence of Down's syndrome among type 1 diabetes patients supports the notion that genes on chromosome 21 may confer risk for type 1 diabetes, probably also in the general population.

Adolescent↗

PubMed2006

Progression from impaired fasting glucose and impaired glucose tolerance to diabetes in a high-risk screening programme in general practice: the ADDITION Study, Denmark.

AIMS/HYPOTHESIS: To estimate the 1-year progression rates from both IFG and IGT to diabetes in individuals identified in a pragmatic diabetes screening programme in general practice (the ADDITION Study, Denmark [Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care]). METHODS: Persons aged 40-69 years were screened for type 2 diabetes based on a high-risk, stepwise strategy. At baseline, anthropometric measurements, blood samples and questionnaire data were collected. A total of 1,160 persons had IFG or IGT at baseline: 811 (70%) accepted re-examination after 1 year. Glucose tolerance classification was based on the 1999 WHO definition. At follow-up, diabetes was based on one diabetic glucose value of fasting blood glucose or 2-h blood glucose. RESULTS: At baseline, 308 persons had IFG and 503 had IGT. The incidence of diabetes was 17.6 and 18.8 per 100 person-years in the two groups, respectively. CONCLUSIONS/INTERPRETATION: IFG and IGT identified in general practice during a stepwise, high-risk screening programme for type 2 diabetes have high 1-year progression rates to diabetes. Consequently, intensive follow-up and intervention strategies are recommended for these high-risk individuals.

Adult↗

PubMed2000

High resolution inductively coupled plasma mass spectrometry (HR-ICPMS) determination and multivariate evaluation of 10 trace elements in mussels from 7 sites in Limfjorden, Denmark.

The contents of V, Cr, Co, Ni, Cu, Ga, Rb, Cd, Ba, and Pb in the soft tissue of blue mussel (Mytilus edulis) were determined by a high resolution inductively coupled plasma mass spectrometry (HR-ICPMS) method. Sample digestions were performed in closed microwave vessels using nitric acid and hydrogen peroxide. Using HR-ICPMS it is possible to resolve the analytical peaks from otherwise interfering polyatomic ions with a mass resolution setting of 4,000 (Cr, Ni, Cu). The proposed method was validated using a mussel tissue reference material (NIST SRM 2974). The proposed method was applied to real samples of blue mussel from seven sites in the inlet "Limfjorden", Denmark, and the levels of trace elements found were compared with the levels found in an earlier study. For the mussel samples large inter-regional differences in trace element concentrations in the tissues were recorded. The mussels from the different sites could be separated using principal component analysis (PCA). Comparison with the levels of trace elements in mussels found in 1982 showed that the trace elemental contamination has increased during the last 15 years. From the data obtained, mussel tissue appears to be good bio-indicator for identification of coastal areas exposed to metallic contaminants.

Animals↗

PubMed2001

Spontaneous reports on drug-induced pancreatitis in Denmark from 1968 to 1999.

OBJECTIVES: To present an update on drug-induced pancreatitis reported to the Danish Committee on Adverse Drug Reactions. DESIGN: Retrospective study of spontaneous case reports to the Danish reporting system on adverse drug reactions. METHODS: All cases of suspected drug-induced pancreatitis reported to the Danish Committee on Adverse Drug Reactions from 1968 to 1999 were analysed. Three cases were excluded leaving 47 cases for analysis. RESULTS: Drug-induced pancreatitis made up 0. 1% of all the reports to the committee from 1968 to 1999. The proportion seemed to increase and was 0.3% during the last 8 years. The 47 cases corresponded to 0.1% of the number of patients discharged due to pancreatic disease (without cancers) per year in Denmark. Serious courses were frequent as indicated by death and hospitalisation being reported in 4 (9%) and 32 (68%) cases, respectively. Death occurred after valproate (two cases), clomipramine (one case) and azathioprine (one case). Definite relationship was stated for mesalazine (three cases), azathioprine (two cases) and simvastatin (one case) on the basis of re-challenge. A possible or probable causality was considered for a further 30 drugs including 5-acetylsalicylic acid agents, angiotensin-converting enzyme inhibitors, estrogen preparations, didanosine, valproate, codeine, antiviral agents used in acquired immunodeficiency syndrome therapy, various lipid-reducing agents, interferon, paracetamol, griseofulvin, ticlopine, allopurinol, lithium and the MMR (measles" mumps/rubella) vaccination. CONCLUSION: Drug-induced pancreatitis is rarely reported. The incidence may be increasing and the course is often serious. This is the first report on definite simvastatin-induced pancreatitis. Further studies on the pancreotoxic potential of drugs are warranted.

Adverse Drug Reaction Reporting Systems↗

PubMed2003

Increased mortality in patients hospitalized with primary hyperparathyroidism during the period 1977-1993 in Denmark.

The aim of the present study was to determine whether patients with the incident hospital diagnosis of primary hyperparathyroidism (PHPT) in Denmark during the period 1977-1993 had an increased mortality from cardiovascular disease and cancer compared to the rest of the Danish population. In a random sample of half of the Danish population, all patients with an incident hospital diagnosis of PHPT were identified in the National Hospital Patients Register. The mortality in the cohort was analyzed and compared with the background population. A cohort of 1578 patients was identified. Follow-up of 1179 women and 376 men, who did not die in the same month as the incident PHPT diagnosis, was made through 1993. Of these, 312 (20%) died within the follow-up period. The standard mortality ratio (SMR) for women was 1.7 (95% confidence interval [95% CI]: 1.5-1.9). SMR for men was 1.6 (95% CI: 1.3-2.0). In women an increased mortality from ischemic heart disease, cerebrovascular disease, and cancer was found. In men an increased mortality from cerebrovascular disease and cancer was found.

Cardiovascular Diseases↗

PubMed2005

Preventive home visits to elderly people in Denmark.

During the last 20 years several randomised controlled trials have been published about preventive home visits to old people, but the benefit of the visits is still controversial and under debate. Based on a state law from the Ministry of Social Affairs in 1998, the municipalities in Denmark are obliged to offer home visits twice a year to all citizens 75 years and older. After six years with this law, there is still variation of how the law is managed and implemented. About 60% of the elderly people accept and receive the visits. Less than 50% of the municipalities have made specific guidelines and quality assurance indicators. More than the half have systematically used the visits to collect information of community needs and older people' wishes to be used for administrative and political purposes. In a prospective, controlled, feasibility study conducted over a 3-year period we found that a brief, manageable and ongoing educational intervention towards professionals working with preventive home visits is feasible and improves older people's functional mobility.

Aged↗

PubMed2006

Incidence and prognosis of non-typhoid Salmonella bacteraemia in Denmark: a 10-year county-based follow-up study.

The aim of this study was to examine the incidence and prognosis of non-typhoid Salmonella bacteraemia in a well-defined population in which complete follow-up investigations had been performed. All patients with non-typhoid Salmonella bacteraemia from 1994 through 2003 in North Jutland County, Denmark, were eligible for the study. Annual incidence rates were calculated for 10-year age groups. The North Jutland County Bacteraemia Database (inclusion of subjects), medical hospital records, the Prescription Registry (redemption of prescription drugs), and the Central Population Registry (deaths) were used as data sources. The outcomes were mortality within 30 and 180 days of the first non-typhoid-Salmonella-positive blood sample. Cox proportional-hazards regression analysis was performed, first with age and comorbidity as evidenced by Charlson index scores, and second with selected clinical and laboratory prognostic variables potentially related to non-typhoid Salmonella bacteraemia per se. A total of 111 non-typhoid Salmonella bacteraemia patients were included in the study. The incidence rate (mean 2.3/100,000 person-years) increased steadily from 1.9/100,000 person-years in the 40-49-year age group to 14.6/100,000 person-years in those >90 years. Twelve (11%) and 24 (22%) patients died within 30 and 180 days, respectively. Cox regression analyses showed that increasing age and, to a higher degree, increasing levels of comorbidity were independently associated with an unfavourable outcome, whereas none of the clinical or laboratory variables studied were strong independent prognostic factors. In conclusion, the presence of comorbid diseases and old age were independently associated with mortality, whereas clinical and laboratory variables were less important.

Adolescent↗

PubMed1998

Trend in incidence and case fatality of meningococcal disease over 16 years in Northern Denmark.

The incidence and case fatality rates of meningococcal disease were assessed in the county of Northern Jutland, Denmark, during the 16-year period from 1980 to 1995. A total of 320 patients were identified from the Meningococcal Research Database, which comprises information from the following sources: (i) the Department of Public Health, to whom notification of meningococcal disease is obligatory; (ii) the Regional Hospital Discharge Registry; and (iii) the register of the regional department of clinical microbiology. In order to assess prognostic indicators assessable at admission, information was collected for each patient from hospital records regarding contacts, symptoms and signs on arrival, laboratory data, and course of disease. The mean incidence was 4.3 cases per 100000 persons per year (range, 2.7-7.7). The incidence increased slightly during the period studied. Overall, the case fatality rate was 9.7%, with a significant rise occurring during the period (P=0.016) and a peak occurring in 1992. Advanced age (> or = 50 years), seizures, impaired consciousness, and skin bleeding on arrival at hospital were predictors of death.

Adolescent↗

PubMed2004

Reimbursement of glitazones in treatment of type 2 diabetes patients in Denmark in the context of a voluntary system for submitting pharmacoeconomic studies.

In 1998, guidelines for pharmacoeconomic evaluation were issued in Denmark. It was left to the discretion of the industry for which products to submit a pharmacoeconomic study. The impact of this voluntary system is illustrated by a case study on reimbursement of two types of glitazones. A review is presented of the evidence on safety, effectiveness and cost-effectiveness of glitazones that was available in the public domain at the time of reimbursement decision making, which was matched to the Danish criteria for general reimbursement of new pharmaceuticals. The study concludes that the voluntary system has not supported the inclusion of efficiency considerations in reimbursement decision making on glitazones. The decision-making process may be improved by mandatory pharmacoeconomic evaluations for selected products such as glitazones, which potentially represent a benefit to patients and potentially improve the cost-effectiveness of care, while at the same time having a considerable budget impact.

Cost-Benefit Analysis↗

PubMed2005

The "Health Benefit Basket" in Denmark: a description of entitlements, actors, and decision-making processes in the curative health sector.

Until 2007, when the new legislation on health care becomes effective, the right to receive free health care services in Denmark, or "health benefits," are described in a comprehensive set of legislation, including laws, executive orders and legal guidelines. This contribution provides an overview of the current main legislation regulating the Danish "health benefit basket" and describes the regulatory mechanisms for the provision of curative care at Danish hospitals and primary health care offices. Although the services are both financed and planned by the counties, they differ substantially in the way that benefits are regulated.

Denmark↗

PubMed2005

Five decades of tick-man interaction in Denmark--an analysis.

The tick Ixodes ricinus (L.) is a known vector of several zoonotic diseases such as Tick Borne Encephalitis (TBE), Lyme borreliosis and ehrlichiosis. The interaction between humans and ticks are at the very core of our understanding of the epidemiology of tick borne zoonoses, but only few experimental studies have been performed. Hence our understanding of the epidemiology of tick-borne disease has to rest on the assumption that the potential tick activity, which is reflected in tick samples from the vegetation or samples from animals, corresponds with tick-human interaction. Observations which may reflect the long term tick-human contact are available in Denmark. These observations are records of requests for information on I. ricinus forwarded to the Danish Pest Infestation Laboratory (DPIL). This article was based on the assumption that the request could be seen as a measure of tick-human interaction reflecting the tick densities in relative terms. The perceived tick densities given by the number of requests on I. ricinus divided by the total number of requests to DPIL was fairly stable from 1965 to 1985, while it doubled during the late 1980's reaching a higher level in the beginning of the 1990's. The perceived density was well explained by the variation in temperature, solar radiation (monthly measurement) and deer abundance (yearly assessments). The measure of deviation, i.e. the ratio between observed requests + 1 and modelled requests + 1, for the individual years varied between 0.91 and 1.20, with considerable within-year variation. A gradual change in periodicity of the residual might suggest gradually changing tick population dynamics. In conclusion, the perceived tick densities appear to be consistent with the current knowledge of tick ecology and tick-transmitted diseases.

Animals↗

PubMed2005

Are mortality differences and trends by education any better or worse in New Zealand? A comparison study with Norway, Denmark and Finland, 1980-1990s.

UNLABELLED: During the 1980s and early 1990s New Zealand experienced major social and economic change, decreasing all-cause mortality rates for the majority ethnic group, and high (but falling) cardiovascular disease (CVD) mortality rates. This paper explores whether inequalities in mortality by education were greater, and increased more, in New Zealand than in Nordic countries (Denmark, Finland, Norway), and determines the contribution of CVD to these differences and trends. METHODS: We used mortality rates for 30-59 year olds by education, and slope (SII) and relative (RII) indices of inequality, calculated from comparable linked census mortality data. RESULTS: Mortality inequalities in New Zealand were at the high end of the Nordic range when standardised by age only, but were mid-range when also standardised by ethnicity. Over time, relative inequalities in all-cause mortality increased similarly in all countries. In New Zealand a large increase in inequality for cardiovascular disease (CVD) mortality was the major contributor. In contrast both CVD and other causes of death were important drivers of increasing inequalities in Nordic countries. Absolute inequalities in all-cause mortality were stable over time among males across all countries, and increased modestly among females. The contribution of CVD to absolute inequality was stable or decreasing over time in all countries. CONCLUSION: Overall, inequalities in mortality in New Zealand did not widen more rapidly than in northern European countries. However, rapid social and economic change may have affected trends in CVD mortality among low educated men and women, and especially the ethnic minority groups.

Adult↗

PubMed2006

Women's patterns of participation in mammography screening in Denmark.

The objective of the study is to analyse individual women's participation patterns in mammography screening in Denmark. The study is set in the capital of Copenhagen and the county of Fyn representing around 95,000 women aged 50-69. The Central Population Register (CPR) was used to define the total target group, and supply information on migrations and deaths. Invitation and participation data came from the mammography screening programmes in Copenhagen (1991-1999) and Fyn (1993-2001), containing personal identification number, data on invitation date, participation and examination date for each screening round. In Copenhagen the coverage went from 70.5% in the first round to 63.1% in the fourth round, and the equivalent data for Fyn is 84.6% in the first round and 82.8% in the fourth round. Of the women eligible for at least three invitation rounds, 52.6% in Copenhagen and 76.4% in Fyn were faithful users, i.e. had participated in all screenings they were invited to. The conclusion is that the programme participation rates tend to overestimate the protection of the individual women covered by the programme. Behind the urban-rural gradient in programme participation is an even greater gradient in programme protection.

Aged↗

PubMed2006

Long-term trends and short-term variability of water quality in Skive Fjord, Denmark - nutrient load and mussels are the primary pressures and drivers that influence water quality.

Nineteen years of monitoring data from the eutrophic Skive Fjord, Denmark were examined for linkages to external pressures and drivers, including nutrient inputs, meteorology and stocks of blue mussels. Linkages were examined by: 1) time-series analysis to document effects of nutrient reduction programs, 2) Pearson Rank correlations, 3) multivariate statistical analysis (PLS) to identify water quality variables with high predictability and their linkages to pressures, and 4) regression analysis to quantify relationships between pressures and water quality. Freshwater input, nitrogen load and phosphorus load showed decreasing trends through the period 1984-2002. The load reductions were only partially translated into trends in water quality: phosphorus decreased in most seasons, while total nitrogen decreased during winter and spring only. Phosphorus concentration had the highest predictability (explained by seasonal temperature variation) followed by transparency, silicate, tot-N, chlorophyll-a, primary productivity, phytoplankton diversity and phytoplankton turnover. The variation in pressures other than nutrient input confounded the relations between loads and water quality. High biomass of mussels led to reduced chlorophyll-a and increased transparency, while short-term variability in water column mixing led to changes in chlorophyll-a due to nutrient entrainment and coupling to benthic mussels.

Animals↗

PubMed1994

Family dynamics during the third trimester of pregnancy in Denmark.

Family dynamics in Danish families during the third trimester of pregnancy were explored in relation to family structure, parity, mother-father differences, and normative versus delayed childbearing. There were differences between married and cohabiting families, first- and second-time expectant parents, mothers and fathers, and between normative and delayed first-time expectant parents. For married couples to have better family dynamics than cohabiting couples is surprising for Denmark where both marriage and cohabitation are examples of a nuclear family lifestyle. A dual-path model is conceptualized as a nursing strategy to support the couples' interrelationship during their role transition.

Adolescent↗

PubMed1996

The Trp23-Stop and Trp66-Gly mutations in the LDL receptor gene: common causes of familial hypercholesterolemia in Denmark.

Mutations in the gene for the low density lipoprotein (LDL) receptor cause the autosomal dominant disease familial hypercholesterolemia (FH), the prevalence of which is about 0.2% in most populations. By PCR-SSCP analysis and direct sequencing, we identified the receptor-negative Trp23-Stop LDL receptor mutation (FH Cincinnati-5) in 10 of 63 FH probands and the receptor-defective Trp66-Gly LDL receptor mutation (FH French Canadian-4) in another 10 of the 63 FH probands. These two mutations thus account for 30% of diagnosed FH families in Denmark. Comparison of the mean lipid concentrations (unadjusted and adjusted for age), including serum total cholesterol and LDL-cholesterol, showed no significant differences between the two groups of FH heterozygote probands (cholesterol: 10.7 mmol/l vs. 10.7 mmol/l) and between the probands and 16 and 22 non-proband family members with the Trp23-stop (cholesterol: 10.1 mmol/l) ad Trp66-Gly (cholesterol: 10.7 mmol/l) mutations, respectively.

Adult↗