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Iodine in drinking water varies by more than 100-fold in Denmark. Importance for iodine content of infant formulas.

The iodine intake level of the population is of major importance for the occurrence of thyroid disorders in an area. The aim of the present study was to evaluate the importance of drinking water iodine content for the known regional differences in iodine intake in Denmark and for the iodine content of infant formulas. Iodine in tap water obtained from 55 different locations in Denmark varied from <1.0 to 139 microg/l. In general the iodine content was low in Jutland (median 4.1 microg/l) with higher values on Sealand (23 microg/l) and other islands. Preparation of coffee or tea did not reduce the iodine content of tap water with a high initial iodine concentration. A statistically significant correlation was found between tap water iodine content today and the urinary iodine excretion measured in 41 towns in 1967 (r=0.68, P<0.001). The correlation corresponded to a basic urinary iodine excretion in Denmark of 43 microg/24h excluding iodine in water and a daily water intake of 1.7 l. The iodine content of infant formulas prepared by addition of demineralized water varied from 37 to 138 microg/l (median 57 microg/l, n=18). Hence the final iodine content would depend heavily on the source of water used for preparation. We found that iodine in tap water was a major determinant of regional differences in iodine intake in Denmark. Changes in water supply and possibly water purification methods may influence the population iodine intake level and the occurrence of thyroid disorders.

Adult↗

Prevalence and incidence of precocious pubertal development in Denmark: an epidemiologic study based on national registries.

OBJECTIVE: To our knowledge, no population-based epidemiologic studies on the incidence and prevalence of precocious pubertal development have been published. Danish national registries provide sufficient data for estimating the prevalence and incidence of this condition. The aim of this study was to estimate the prevalence and incidence of precocious pubertal development in Denmark in a 9-year period. METHODS: The age- and gender-specific incidence rates as well as prevalence rates of precocious pubertal development in Denmark were estimated using data from the Danish National Patient Registry and Statistics Denmark from 1993 to 2001. RESULTS: Overall, 670 children with precocious pubertal development were registered with a diagnosis of precocious puberty (PP) from 1993 to 2001, corresponding to 50 to 70 new cases of PP per year in Denmark. The incidence of PP was constant during the study period from 1993 to 2001. The incidence of PP subdivided by gender and age at diagnosis was approximately 0.5 per 10000 in girls who were younger than 2 years, decreasing to levels below 0.05 per 10000 in girls aged 2 to 4 years, thereafter gradually rising to 8 per 10000 for girls aged 5 to 9 years. For boys who were younger than 8 years, the incidence was very low (<1 per 10000) and increased only slightly to 1 to 2 per 10000 in boys aged 8 to 10 years. The prevalence of PP was approximately 20 to 23 per 10000 in girls, whereas the prevalence was fivefold lower for boys (<5 per 10000). CONCLUSIONS: From this first epidemiologic study based on national registries, we estimated that 0.2% of all Danish girls and <0.05% of Danish boys had some form of precocious pubertal development.

Age Distribution↗

Intrapartum death of nonmalformed fetuses in Denmark and Sweden in 1991. A perinatal audit.

BACKGROUND: In 1991 the rate of intrapartum death of non-malformed fetuses was higher in Denmark than in Sweden (4.2 vs. 1.9 per 10,000, OR 2.24). However, it is not clear whether this difference reflects potentially avoidable cases and/or suboptimal care. MATERIAL AND METHODS: Short descriptions were made from medical records of all 50 intrapartum deaths in Denmark and Sweden in 1991. Ten obstetricians, two from each of the Nordic countries, reviewed the cases to determine whether (1) intra-uterine death might have occurred before admission, (2) surveillance and intervention were insufficient, (3) fetal death was potentially avoidable by improved obstetric care; and, if so, to suggest ways of improved health care. RESULTS: There was a statistically higher rate of insufficient care (surveillance and intervention) (high or less degree) in the Danish cases (66% vs. 55%). The proportion of potentially avoidable fetal deaths was also higher in Denmark (59% vs. 52%) although the difference was not statistically significant. CONCLUSION: The significantly higher rate of intrapartum death of non-malformed infants in 1991 in Denmark compared to Sweden might be reduced by improved intrapartum surveillance and interventions.

Adult↗

Minimum inhibitory concentrations for selected antimicrobial agents against organisms isolated from the mammary glands of dairy heifers in New Zealand and Denmark.

Minimum inhibitory concentrations were determined for selected antimicrobial agents against 872 bacteria isolated from intramammary infections in heifers in New Zealand (n = 401) and Denmark (n = 471). These values were reported in micrograms per milliliters. Antimicrobial agents tested against isolates from New Zealand were penicillin, cloxacillin, cephapirin, ceftiofur, novobiocin, enrofloxacin, erythromycin, and pirlimycin. The minimum inhibitory concentrations that inhibit 90% of the strains tested for these antimicrobial agents with Staphylococcus aureus were 4.0, 0.5, 0.5, 2.0, 1.0, 0.25, 0.5, and 1.0, respectively. The minimum inhibitory concentration values that inhibit 90% of the strains tested against the Staphylococcus spp. ranged from 0.5 to 1.0 for all antimicrobics. The minimum inhibitory concentrations against streptococci were < or = 0.06, 0.5, 0.13, 0.13, 4.0, 1.0, 0.13, and < or = 0.06, respectively. Antimicrobial agents tested against isolates from Denmark included penicillin, ampicillin, oxacillin, cephalothin, ceftiofur, penicillin plus novobiocin, erythromycin, and pirlimycin. Against S. aureus, the minimum inhibitory concentrations were 0.13, 0.5, 0.5, 0.5, 1.0, 0.25, 0.5, and 0.5, respectively. The minimum inhibitory concentrations against Staphylococcus spp. were 0.25, 0.25, 0.5, 0.5, 1.0, < or = 0.06, 0.13, 1.0, and 0.5, respectively. The minimum inhibitory concentrations against the streptococci were < or = 0.06, 0.13, 0.5, 0.5, 1.0, < or = 0.06, 0.13, 0.5, and 0.5, respectively. Minimum inhibitory concentration values for staphylococci from New Zealand and Denmark were similar to values reported for US isolates. Streptococci from New Zealand and Denmark had lower minimum inhibitory concentration values than did US isolates. Only ceftiofur and enrofloxacin were active against the Gram-negative bacilli.

Ampicillin↗

Diabetes among Inuit migrants in Denmark.

OBJECTIVES: The study aimed to estimate the prevalence of diabetes and impaired glucose intolerance (IGT) among Inuit migrants living in Denmark, and to compare with findings from Greenland. Further, we analyzed determinants for diabetes and impaired glucose metabolism. STUDY DESIGN: Cross-sectional, population-based epidemiological study. METHODS: This cross-sectional study included randomly selected Inuit migrants in Denmark aged 34 years and above. Diabetes and IGT were diagnosed using the oral glucose tolerance test. Body mass index (BMI) and waist circumference were measured, and blood samples were taken from each subject. Socio-demographic characteristics were investigated using a questionnaire. For comparison, data from the Greenland Population Study were used (n = 917). RESULTS: Of 506 eligible subjects, 256 (51%) participated. Twenty-six subjects had diabetes (10.2%) and twenty-eight had IGT (10.9%). Of those with diabetes, 64% had not been previously diagnosed. The prevalences of diabetes and IGT were not significantly different from those among Inuit in Greenland. Significant predictors of diabetes and impaired glucose metabolism (IGM) were found to be age, waist circumference and physical inactivity. The association between waist circumference and diabetes was significantly stronger among Inuit migrants in Denmark than among Inuit in Greenland. CONCLUSIONS: The prevalence of diabetes is high among the Inuit migrants in Denmark. However, unlike that reported in most studies, the prevalence was not significantly higher in the migrant population compared with the population of origin.

Adult↗

[Trends in dietary habits in Denmark and Sweden since the 1960s].

Dietary habits in Denmark and Sweden are compared during the period 1965-1998 based on data from Food Balance Sheets. Common trends are an increase in consumption of vegetables, fruits, berries and meat and a decrease in consumption of fats. In the latest ten years percentage of energy from fat has also decreased. Denmark has a higher consumption of fats and meat and a lower consumption of fruits, berries and fish. These differences contribute to a higher percentage of energy from fat in the Danish diet compared to the Swedish. Data consequently indicate that dietary habits in Sweden are healthier than in Denmark. Differences in dietary habits may have contributed to differences in life expectancy between the countries. Disparities in dietary habits are seen in both countries. The tendency is greater social differences in Denmark.

Denmark↗

[Cases of measles in Denmark are caused by reintroduction of virus from abroad].

Measles vaccination was implemented in the child vaccination programme in Denmark in 1987 and produced a rapid decline in the incidence. Few cases were recorded annually until 1999. The measles virus isolated in Denmark during 1997-1998 was compared by partial sequencing of the haemagglutinin-coding region with Danish strains from the prevaccination era collected in 1965-1983, as well as with representatives of globally circulating strains of today. The dissimilarity of the prevaccination era strains identified in Denmark in 1997-1998 along with the similarity of these five strains with globally circulating strains at present, substantiate the conclusion that there is no persistent circulation of the measles virus in Denmark.

Child↗

[Risk of disease transmission via donor blood in Denmark at the turn of the century].

INTRODUCTION: Published results of donor blood screening in Denmark were used to calculate the risks of window phase donations. METHODS: The main parameter was the frequencies of a confirmed positive donation from regular donors per 100,000 donations are: 0.34, for HIV; 0.47 for hepatitis C virus; 0.53 for hepatitis B virus; and nil for HTLVI/II. The mean interdonation interval between donations from regular donors is six months year. Window phase duration were estimated to be 22 days for anti-HIV; 10 weeks for anti-HCV; and 56 days for HBsAg. Blood from candidate donors is not used in Denmark. Thus, the risk of a window phase donation equals the risk of a window phase donation in donations from regular donors. RESULTS: The risks of window phase donations in Denmark are: 1 in 2,000,000 for HIV; 1 in 500,000 for hepatitis C; 1 in 250,000 for hepatitis B; and immeasurably low for HTLVI/II. DISCUSSION: The measures taken nowadays to prevent infection from allogeneic blood transfusion have resulted in a risk reduction of HIV transmission by a factor 50 and of HCV transmission by a factor 400, compared with the risks prevailing in Denmark in the early 1980s. The present very low risk renders obsolete predeposited autologous blood solely on the indication to prevent infection. Zero risk of transmission of HIV and HCV might be approached by introducing NAT screening for these viruses.

Biomarkers↗

The prevalent use of contraception among teenagers in Denmark and the corresponding low pregnancy rate.

In Denmark the number of births and induced abortions among teenagers has reduced and teenage parenthood is now rare. This paper evaluates the correlation between this observed fertility and reported sexual and contraceptive behaviour. In 1989 a sample of 16-20-year-olds in Denmark was selected at random and personally interviewed about sexual and contraceptive behaviour. Ninety-five per cent of the young women who had experienced sexual intercourse used contraception at the most recent sexual intercourse. In order to support the validity of this finding a model was developed to estimate an expected number of conceptions in the age groups concerned. The model included both the information on coital frequency and use of contraception from the questionnaire and available efficacy rates on contraception. The estimates derived by the model were compared with the registered number of births and induced abortions derived from public registers. The analysis revealed a high accordance between the estimated number of conceptions and the registered number of births and induced abortions for each age group. This underlines the validity of the data on sexual and contraceptive behaviour sampled among teenagers in Denmark. The findings indicate that contraceptive failure is a much greater problem than non-use of contraception for teenagers in Denmark.

Abortion, Induced↗

Papillary thyroid carcinoma in Denmark 1943-68. I. Incidence and clinical features.

On the basis of nation-wide Danish data on 1691 cases of thyroid carcinoma during the years 1943-1968, the author reports on 416 cases of papillary thyroid carcinoma reported to the Danish Cancer Registry. Diagnosis was made prior to surgery in about 40% of the cases, in accordance with previous experience. Papillary thyroid carcinoma tends to be less frequent in Denmark than elsewhere, contrary to the assumption of an increased occurrence in areas where goitre is not endemic. For thyroid carcinoma age-adjusted male incidence rates are lowest in Denmark and Great Britain, while female rates for Denmark are second lowest, being lower only in Great Britain. On the other hand, age-adjusted mortality rates are higher in Denmark than in any other country. These findings are discussed. In the past decade the annual number of reported cases has been constant, indicating that the incidence is stationary, although interest in a knowledge of C.T. is on the increase.

Adolescent↗

[An analysis of the demand of endoscopic ultrasonography in Denmark].

INTRODUCTION: Endoscopic ultrasonography (EUS) has been available in Denmark for about 10 years. Capacity problems can occur, because only a few departments perform this procedure. The aim of the present study was to analyse the demand for EUS in Denmark. METHODS: Questionnaires (140) were sent out to departments in Denmark, which were presumed to refer patients for EUS on a regular basis. RESULTS: One-hundred and seventeen questionnaires (84%) were returned. Twenty-three (20%) of the departments that returned the questionnaire stated that they never referred patients for EUS. The main reason was that patients, for whom EUS was considered necessary, were rarely treated in these departments (15 departments). Seventy departments (74%) referred 0-2 patients for EUS monthly. Twenty-one departments (22%) had problems in obtaining the number of investigations needed. There were significantly fewer problems in obtaining the desired number of investigations, if EUS was performed in the home county (p = 0.012). Thirty-eight per cent of the departments stated that more patients would be referred for EUS, if the procedure became more available in the future. DISCUSSION: There seems to be too small a capacity for EUS in Denmark. Whether the capacity should be increased by establishing new centres or by extending the present ones is unknown. Both solutions have benefits and drawbacks.

Denmark↗

[Electroconvulsive therapy in Denmark 1999. A nation-wide questionnaire study].

INTRODUCTION: The use of ECT in Denmark has not been systematically evaluated since 1979. Many changes have since taken place in the organisation of psychiatric care and the number of new drugs for the treatment of affective disorders has grown. We wanted to see whether the frequency of treatments and the technical standard of ECT had undergone changes in the same period. MATERIAL AND METHODS: A questionnaire was sent to all psychiatric departments in Denmark concerning the number of ECT sessions and ECT patients in 1999, and technical aspects and organisation of this treatment-modality. RESULTS: The percentage of replies was 100, all departments used ECT, and 86% of the departments adequately reported the number of ECT sessions and ECT-treated patients. The total number of sessions and patients treated was estimated from these answers. We found that the number of ECT sessions had fallen from 19,564 in 1979 to 16,306 in 1999 and the number of ECT patients from 2,332 in 1979 to 1,710 in 1999. ECT is thus given to an average of 5% of all hospitalised psychiatric patients. The number of sessions per patient had increased slightly. The technical quality of treatment with regard to the ECT devices used had improved considerably during the period. DISCUSSION: The use of ECT in Denmark shows a decline since the last evaluation in 1979. However, it still plays an important role in the treatment of hospitalised patients with depression in Denmark.

Denmark↗

Medical graduates (candidates) 1972-2001 from the University of Southern Denmark, Odense 2nd ed. Geographical supply and distribution, length of study, postgraduate education, specialties and main occupation.

AIM: The aim has been to create and maintain a list of all medical candidates from the University of Southern Denmark, Odense. MATERIALS AND METHODS: All medical graduates from 1972 to 2001 are included. Surveys have been performed 1997 (25) and 2000. Appr. 50% came from grammar schools in the County of Funen, 20-25% from other counties in Southern Denmark, i.e. Southern Jutland, and 15% from Copenhagen or from Northern Jutland. In the 1990'es more came from Northern Jutland. RESULTS: The duration of the medical study increased from a modus of 6-7 years in the 1970'es to a modus of 7-8 years since 1980. About 45% became general practitioners after four to 25 years (median 14 years), one third of them in the County of Funen, and another third in Southern Jutland. In the 1997 survey 25% became consultants after 11-17 years (median 14 years), in the 2000 survey it increased to 35% after 11-25 years (median still 14 years). The cumulated death rate was 7% for the ages 30-58 years, significantly lower than that of the general population. At twenty years after graduation 85% were medical specialists, at ten years the rate was 40%. Education in anaesthesiology, ophthalmology, oto-rhino-laryngology, and oncology took less than ten years, general medicine 12 years, and 15 years for internal medicine and even longer for surgery, paediatrics, and psychiatry. CONCLUSION: The medical school, Odense, recruits 82% of its students from Southern Denmark. Of the graduates since 1975 who became general practitioners two thirds have settled in Southern Denmark, of the consultants one half. It is not yet possible to predict when new surveys will be feasible. This article is a continuation of the study of the first survey published in Ugeskr Laeger 2000;162:1547-51 (25).

Career Choice↗

Sarcoidosis in Denmark 1980-1994. A registry-based incidence study comprising 5536 patients.

BACKGROUND AND AIM: To evaluate the incidence of sarcoidosis in Denmark 1980-1994. METHODS: Patients with a diagnosis of sarcoidosis were identified from the Danish National Patient Registry. The file contained information about the year in which the diagnosis was reported, gender, age, and residential county. RESULTS: 5536 persons (2816 men) with sarcoidosis were registered. Median age in men was 38 years, in women 45 years. The male/female incidence ratio was 1.06. The incidence (per 100,000 person years) declined gradually from 8.1 in 1980-1984 to 6.4 in 1990-1994. The overall incidence in 1980-1994 was 7.2. Incidence rates 1980-1994 increased from eastern to western parts of Denmark: Zealand 5.7, Funen 6.8, and Jutland 8.4. The peak incidence in men occurred at 30-34 years of age (14.8). Women displayed two similar peak incidences at 25-29 years of age (10.5) and at 65-69 years of age (11.0). CONCLUSION: Incidence rates in the present study are lower compared with previous mass-screening surveys showing an incidence rate of 13.8 (in persons examined). Peak incidences occurred at higher ages in both men and women. Previous surveys showed peak incidences at 20-25 years in men and at 25-30 years and 50 years in women. The overall incidence of sarcoidosis in Denmark ranges from 7-10 per 100,000 person years. With 5,500,000 residents, the expected number of new cases of sarcoidosis in Denmark is between 385 and 550 per year.

Adult↗

Rubella in Denmark.

An average of 20,000 rubella cases were recorded annually in Denmark until 1987. In 1989, however, only 1006 cases were reported, and the true current incidence of rubella infection in Denmark is unknown but considered to be very low and <1 per 100,000 population. The significant decrease in the incidence of rubella mirrors the success of vaccination of rubella seronegative women of childbearing age, which was initiated in Denmark in 1980. From 1982 and onwards the national health security scheme also refunded vaccination of children and the MMR vaccine was introduced in the Danish child-hood vaccination program in 1987. The low incidence has been sustainable due to these interventions, and since 1994 congenital rubella syndrome and rubella in pregnancy have been listed as notifiable infectious diseases in Denmark. Nevertheless, in order to meet the WHO goal of control of rubella in the Region, the introduction of mandatory reporting of all laboratory diagnosed rubella cases is now being considered.

Denmark↗

[The use of free maternal preventive services among immigrant pregnant women in Denmark during 1983-1987].

As part of an investigation of immigrants' living conditions in Denmark, we have investigated how pregnant immigrant women utilize the possibility of free examinations during pregnancy. The study is based on data on all deliveries in Denmark in the years 1983-1987, retrieved from the Danish Medical Birth Registry concerning parturient women with permanent address in Denmark and who were born in either one of the Scandinavian countries, Yugoslavia, Turkey, Pakistan, Marocco, Iran of Vietnam. The women born outside Scandinavia gave birth to about 6,500 infants during the study period; roughly half of these were borne by Turkish women. The largest percentage of young parturients were found among women from Turkey and Yugoslavia. Pakistani and Maroccan mothers had higher parity. These two groups were especially concentrated in the municipality of Copenhagen, where half of the parturient women lived. A few lived in the remainder of the country while a total of 85% lived in the metropolitan area. Four out of ten pregnant Turkish or Pakistani women had been examined by a midwife less than the five times recommended. Among those living in the metropolitan area. Danish women have an average total of almost 11 examinations compared to 8.2-8.9 among immigrants. The conclusion of the study is that the immigrant women have less contact with the free antenatal care system during their pregnancies than the Scandinavian women and that the differences are greatest when examinations by the midwife were concerned. Further discussion on antenatal care in Denmark, is required.

Adult↗

A comparison between the organization of obstetrics in Denmark and The Netherlands.

A comparison was made between two types of obstetric organization: total hospitalization as in Denmark, and a system that allows a choice between hospital and home delivery, provided there are no medical contra-indications, as in The Netherlands. Until the end of the 1950s, the current Dutch view prevailed in Denmark; Denmark changed its organization in the late 1960s and followed the international preference for total hospitalization. This change was not caused by disappointing obstetric results, nor was it the result of strong pressure from pregnant women. The change was associated with a considerable increase in instrumental deliveries. In both countries the perinatal mortality rate decreased continuously but in Denmark the improvement in early neonatal mortality was slightly faster. This difference may have occurred because of insufficient referral in The Netherlands of high-risk pregnancies and deliveries to the fully equipped obstetric departments. The Dutch acceptance of a high proportion of home-confinements is unlikely to be the explanation.

Delivery, Obstetric↗

[On-duty medical service regulation in Norway, Sweden, Finland and Denmark].

Out of hours services are under discussion in the Nordic countries, and their organisations in Norway, Sweden, Finland and Denmark are compared in the article. Only in Denmark all such services are free of charge. In Denmark and in most parts of Norway, the patient must first phone a call-in service manned by a physician who acts as receptionist cum dispatcher. House calls are very rarely made in Sweden and Finland but account for approximately 20 percent of the out of hours workload in Norway and Denmark.

Denmark↗