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PubMed2005

Trends in incidence and mortality in the hospital diagnosis of atrial fibrillation or flutter in Denmark, 1980-1999.

BACKGROUND: The incidence of diagnosed atrial fibrillation is increasing in the USA, England, Wales, Scotland and Denmark, and the mortality rate in patients with diagnosed atrial fibrillation has been reported to be declining in Scotland and Denmark. We undertook this study to examine recent trends in incidence and mortality in subjects with a hospital diagnosis of atrial fibrillation or flutter in Denmark from 1980 to 1999 by sex, 10-year age group and conditions of comorbidity. METHODS: We identified all individuals, aged 40-89 years, with an incident hospital diagnosis of atrial fibrillation or flutter in the Danish National Registry of Patients, and subjects were followed in the Danish Civil Registration System. We used multivariate Cox proportional hazard models to estimate trends in mortality. RESULTS: Atrial fibrillation or flutter was diagnosed in 131,728 subjects (68,660 men and 63,068 women), and the incidence of a hospital diagnosis of atrial fibrillation or flutter more than doubled during the study period. The hazard ratios for mortality adjusted for 10-year age group, conditions of comorbidity and mortality trend in the Danish population in the last 5-year period compared to the first 5-year period were 0.80 (95% confidence interval 0.78-0.82) in men, and 0.82 (95% confidence interval 0.80-0.84) in women. CONCLUSIONS: The incidence of a hospital diagnosis of atrial fibrillation or flutter more than doubled, and the 10-year age group- and comorbidity- and general population-adjusted mortality decreased, equally, from the first to the last 5-year period by 20% in men and 18% in women.

Adult↗

PubMed2003

Iodine-129 in thyroid and urine in Ukraine and Denmark.

Human thyroids collected from Gomel in Belarus, sheep thyroid from Jutland and human urine from Zealand in Denmark were analysed for 129I and 127I concentrations. The ratios of 129I/127I in human thyroid in Gomel are 2.65-11.0 x 10(-9) with an average of 7.21 x 10(-9), which is one order of magnitude higher than those from Asia and South America (10(-10)), but significantly lower than those observed in west Europe (10(-8)). A weak negative correlation (P < 0.05) between 129I/127I ratio in human thyroid and the age of the subjects was observed in Gomel. The average ratio of 129I/127I in sheep thyroids from Jutland of Denmark is 1.81 x 10(-7), which is two orders of magnitude higher than those in south hemisphere, and Asia. It is also significantly higher than those observed in other west European countries before 1984 and that in human thyroid in Gomel. The high thyroid 129I level in Jutland is attributed to the release of reprocessing plants in France and UK. The 129I/127I ratios in human urine in Zealand of Denmark are 0.86-2.86 x 10(-8). The possibility of using urine 129I to evaluate the thyroid exposure to 129I is investigated.

Adolescent↗

PubMed1998

Diffusion of laparoscopic technologies in Denmark.

It has been predicted that minimally invasive therapy will have dramatic consequences for the specialty of general surgery, as demonstrated by the diffusion of laparoscopic cholecystectomy. To investigate the determinants of the diffusion in Denmark of five laparoscopic technologies (cholecystectomy, appendicectomy, surgery for colon cancer, surgery for inguinal hernia and fundoplication), questionnaires on seventeen factors' influence on the adoption (stimulating or impeding) were sent to fifty-nine hospitals. Fifty hospitals (85%) responded. Overall, 98% adopted laparoscopic cholecystectomy in Denmark between 1991 and 1995, whereas the remainder of the technologies were adopted by 7-65% of hospitals performing these operations. Large and specialized hospitals were the earliest adopters. The factors, nature of technology (minimally invasive versus conventional), training (appropriate training courses), competition (between specialties and between hospitals) and media attention have stimulated the diffusion, whereas three budget factors (budget for investment, budget for operation and public regulation) usually had an impeding effect. Stimulating factors prevail for all laparoscopic technologies indicating that some guidance of the adoption and use of new health technologies might be necessary. In Denmark, one of the suggested health policies to secure timely guidance is the establishment of an early warning system.

Denmark↗

PubMed2000

Incidence of lung cancer in Denmark: historical and actual status.

This is a registry-based analysis of 97,281 lung cancer patients diagnosed in Denmark during the period 1943-1994. The development of lung cancer incidence in Denmark in the study period is described and this information is used to predict the future trends in lung cancer in Denmark. Since 1960, lung cancer has been the most frequent type of cancer in Danish men, excluding skin cancer. The incidence in men reached its maximum in 1985, when it was 100 new cases per 100,000 inhabitants, whereafter the incidence began to level off and was 83 per 100,000 inhabitants in 1994. During the study period, the incidence of lung cancer in Danish women was somewhat lower than in men. The incidence in women has been steadily increasing since 1960 by approximately 20% per each 5-year period, and was 46 per 100,000 inhabitants in 1994. Adenocarcinoma is the most frequent histological subtype in women and the only subtype increasing in incidence in men. Taking the actual development into account, the incidence of lung cancer will continue to fall among men and rise among women, leading to a reversal of the classical gender ratio in about 15 years.

Adenocarcinoma↗

PubMed2003

Hedgerow planting analysed as a social system--interaction between farmers and other actors in Denmark.

In a number of European countries, including Denmark, the practice of planting hedgerows has a long tradition, and hedgerows form significant structures of semi-natural elements in a matrix of arable land. In Denmark an institutionalised framework has developed in relation to a subsidy scheme encouraging farmers to plant hedgerows. This article analyses the planting practice as a social system; giving emphasis to the interactions between actors and how this affects the current planting activity. Combining an overall description of the nationwide network with a detailed case study in Jutland, Denmark enables an understanding of how the local planting practice is influenced by the local context and the nationwide network, and at the same time contributes to the reproduction of the entire network. It is concluded that the planting activity is characterised by routines, professionalism and division of labour. The local actors involved perceive the activity as a success, and do not question current practise. However, the actors are not aware of the potential consequences of the planting practice at the landscape scale. Even though hedgerows are planted through so-called planting associations related to defined local areas the placement of hedgerows is not co-ordinated and evaluated at a landscape scale. In addition, the composition of hedgerows is standardised at a national level, and the individual farmer makes few adjustments. Thus, the sense of local landscape identity may become blurred. The increasing public attention towards a multiplicity of functions in the agricultural landscape implies further development of the potential positive landscape effects of hedgerows in a local context. This may induce changes in the relationships between actors and eventually the planting practice.

Agriculture↗

PubMed2005

No evidence of time trends in the urban-rural differences in schizophrenia risk among five million people born in Denmark from 1910 to 1986.

BACKGROUND: There have been conflicting reports on time trends in urban-rural differences in the incidence of schizophrenia. This study explored the potential time trends in these differences with regard to birth cohort and age at onset. METHOD: Linking data from the Danish Civil Registration system with data from the Danish Psychiatric Central Register, a cohort born in Denmark from 1910 to 1986 was established (5.05 million people). Overall, 23051 people were classified with schizophrenia in 1970-2001. RESULTS: Urban-rural differences in schizophrenia risk may have existed for people born in Denmark since 1910, and have existed at a constant level for people born from 1945 to 1986. Males aged <20 years had a risk of 3.90 [95% confidence interval (CI) 3.28-4.65] associated with urban birth while males >or=20 years had a risk of 2.12 (1.98-2.27). Females <20 years had a risk of 2.49 (95% CI 2.01-3.09) associated with urban birth while females >or=20 years had a risk of 1.90 (95% CI 1.74-2.08). At age 46, 1.84% (95% CI 1.76-1.93) of males and 1.05% (95% CI 0.99-1.12) of females born in the capital area had developed schizophrenia, while 0.81% (95% CI 0.75-0.86) of males and 0.56% (95% CI 0.51-0.60) of females born in the rural area had developed schizophrenia. CONCLUSIONS: There was no evidence of time trends in the urban-rural differences in the incidence of schizophrenia in Denmark, suggesting that the cause(s) responsible for these differences were not related to exposures that became more prevalent in urban areas over time. This finding is in contrast to findings from Finland and The Netherlands.

Adolescent↗

PubMed2002

Acromegaly and cancer risk: a cohort study in Sweden and Denmark.

OBJECTIVE: Several studies have suggested that patients with acromegaly have an increased risk of benign and malignant neoplasms, especially of the colon. To further investigate this relationship we evaluated cancer risk in population-based cohorts of acromegaly patients in Sweden and Denmark. METHODS: Nationwide registry-based cohorts of patients hospitalized for acromegaly (Denmark 1977-1993; Sweden 1965-1993) were linked to tumor registry data for up to 15-28 years of follow-up, respectively. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated to estimate cancer risk among 1634 patients with acromegaly. RESULTS: The patterns of cancer risk in Sweden and Denmark were similar. After excluding the first year of follow-up, 177 patients with acromegaly had a diagnosis of cancer compared with an expected number of 116.5 (SIR = 1.5. 95% CI = 1.3-1.8). Increased risks were found for digestive system cancers (SIR = 2.1, 95% CI = 1.62.7), notably of the small intestine (SIR = 6.0, 95% CI = 1.2-17.4), colon (SIR = 2.6, 95% CI = 1.6-3.8), and rectum (SIR = 2.5, 95% CI= 1.3-4.2). Risks were also elevated for cancers of the brain (SIR = 2.7, 95% CI= 1.2-5.0). thyroid (SIR = 3.7, 95% CI = 1.8-10.9), kidney (SIR = 3.2, 95% CI = 1.6-5.5), and bone (SIR= 13.8, 95% CI= 1.7-50.0). CONCLUSIONS: The increased risk for several cancer sites among acromegaly patients may be due to the elevated proliferative and anti-apoptotic activity associated with increased circulating levels of insulin-like growth factor-1 (IGF-1). Pituitary irradiation given to some patients may have contributed to the excess risks of brain tumors and thyroid cancer. Our findings indicate the need for close medical surveillance of patients with acromegaly, and further studies of the IGF-I system in the etiology of various cancers.

Acromegaly↗

PubMed2002

Mortality among anesthesiologists in Denmark, 1973-95.

BACKGROUND: Preliminary data from Sweden indicating that anesthesiologists have a high mortality risk has caused a lot of concern in Denmark. The aim of this study therefore was to compare mortality between consultant anesthesiologists and other consultants in Denmark. METHODS: A historical prospective cohort study based on the membership register of the Danish Medical Association from 1973 to 1992. The study population consisted of 6854 consultants who were members of the Association of Medical Specialists, 406 of whom were anesthesiologists. The all-cause mortality between the two groups was compared during the period 1972-95 using Cox's proportional hazard regression model. RESULTS: The study covered approximately 86000 person-years. A total of 1205 deaths occurred within the period studied, 41 of whom were anesthesiologists. The relative risk for all-cause mortality among the anesthesiologists compared with all the other consultants was 1.0 (95% confidence limit: 0.7-1.4). CONCLUSION: In Denmark there is no evidence of a high mortality risk in consultant anesthesiologists compared with other consultants.

Adult↗

PubMed2002

Histopathologically verified non-vascular optic nerve lesions in Denmark 1940-99.

PURPOSE: To evaluate the distribution in Denmark of histologically verified optic nerve lesions according to histological diagnosis, gender and age during a period of 60 years and to calculate frequency and possible changes in frequency during the observation period. METHODS: All optic nerve lesions reported at the Eye Pathology Institute, University of Copenhagen, during the period 1940-99 were investigated. All similar lesions reported at all pathological departments in Denmark during 1974-99 were also investigated. RESULTS: The number of optic nerve lesions identified totalled 313 in 298 patients. The frequency of histopathological optic nerve lesions was seen to have increased significantly over the last 25 years, and at present, an average of 12 lesions per year are recorded. Lesions in children represented 42% (130). The percentage of lesions suffered by children remained constant throughout the observation period. Benign tumours constituted 33% (44) of the total number of tumours in adults and 61% (62) in children. Frequencies of glioma and optic nerve sheath meningioma increased significantly during the last 25 years. Subjects presenting with optic nerve sheath meningioma exhibited a significant difference in age at presentation: the mean age of women at presentation was seen to be 48.8 years, while the mean age of men at presentation was seen to be 29.7 years. The most frequent lesion seen in children was glioma and in adults invasion from malignant uveal melanoma. CONCLUSION: Histologically diagnosed optic nerve lesions are rare and consist primarily of tumours. The increase in frequency of optic nerve lesions in Denmark during the last 25 years is due to an increase in the number of benign tumours.

Adolescent↗

PubMed2001

Therapeutic and economic implications of traumatic dental injuries in Denmark: an estimate based on 7549 patients treated at a major trauma centre.

AIM: To analyse the type and extent of injuries presented by patients seeking treatment for traumatic dental injuries at a major trauma centre. Furthermore, to analyse acute and subsequent treatment demands and treatment costs. METHODS: A therapeutic and economic analysis was performed of 7549 patients treated for traumatic dental injuries in a major trauma centre located at the University Hospital in Copenhagen, Denmark. Cases were divided into uncomplicated (concussion, subluxation, enamel and enamel-dentine fractures) and complicated cases (crown fractures with exposed pulps and crown-root fractures, luxation injuries with displacement of the tooth and bone fractures). RESULTS: Primary tooth injuries were found in 2874 patients, involving 5443 teeth, among which 62.8% had complicated injuries. Permanent tooth injuries were found in 4525 patients, involving 10,673 teeth, among which 40.4% had complicated injuries. The cost of treatment (including acute trauma service, follow-up and subsequent restoration) was estimated to be 0.6-1 mill USD a year for the patients treated in this trauma centre. If this figure is transferred to the estimated trauma population in Denmark, a yearly cost of traumatic dental injuries appears to range from 2 to 5 mill USD per 1 mill inhabitants per year according to the treatment scenario. CONCLUSION: Thus, treatment of traumatic dental injuries comprises an expensive part of the health services in Denmark.

Adolescent↗

PubMed2003

The provision of pharmaceutical care in Denmark: a cross-sectional survey.

BACKGROUND: Pharmaceutical care was a concept initially defined in the early 1990s. It had its roots within clinical pharmacy, in the USA. In Denmark, pharmaceutical care has been part of the professional standards of practice for community pharmacy since 1995. OBJECTIVE: The objective of the present study was to investigate the provision of pharmaceutical care in community practice in Denmark. A focus of the study was the estimation of the frequency of medicine-related problem identification and the process of problem management in the Danish pharmacies. METHODS: A cross-sectional questionnaire-based survey of all Danish community pharmacies was conducted (n = 288). The variables included: detection and identification of medicine-related problems, goal-setting for solving medicine-related problems, and documentation of efforts to solve these. The response rate was 75.7%. A non-respondent analysis was performed. RESULTS: On average three medicine-related problems per pharmacy were found within the working week prior to the survey. For two-thirds of those cases the type of problem involved was identified. For the other third, goals had been set to resolve the problem. Minimal documentation of these activities was reported. The primary collaborators in problem management were general practitioners and patients. CONCLUSION: Pharmaceutical care, in its fullest sense, as defined in policy documents in Denmark, was not evident in practice. While some aspects of pharmaceutical care were being performed, almost no documentation of efforts was taking place in community pharmacy.

Adult↗

PubMed1997

Trend in cerebral palsy birth prevalence in eastern Denmark: birth-year period 1979-86.

To investigate changes in cerebral palsy birth prevalence and perinatal mortality rate by different gestational age groups, 1979-86, cerebral palsy cases in eastern Denmark were identified from the Danish Cerebral Palsy Register, and information on birth and mortality rates was sought in the Danish Medical Birth Register. From 1979-82 to 1983-86, the birth prevalence of cerebral palsy increased from 2.6 to 3.0 per 1000 (P < 0.05). The rate for infants of 31 weeks' gestation or more did not change, whereas a significant increase was observed in infants below 31 weeks (85-123 per 1000, P < 0.05). In the same periods, perinatal mortality in eastern Denmark decreased significantly from 8.6 to 7.8 per 1000. The decrease in stillbirth rate was significant in all subgroups of gestational ages except in those of 28-30 weeks' gestation. The early neonatal mortality rate decreased significantly only in infants below 31 weeks (282-239 per 1000, P < 0.05). Thus, in eastern Denmark, cerebral palsy birth prevalence has increased from birth-year period 1979-82 to 1983-86 because of an increased rate in preterm infants below 31 weeks, who at the same time had a reduced risk of early neonatal death.

Cerebral Palsy↗

PubMed2003

Quality of diabetes management in children and adolescents in Denmark.

AIM: To describe the management of children and adolescents with Type 1 diabetes mellitus in Denmark. METHODS: Quality indicators with standards of childhood diabetes management were chosen based on international and national guidelines. Data originated from the nation-wide Danish Registry for Childhood Diabetes and two questionnaires: one questionnaire was sent to all children with diabetes (response rate 78%, n=1335) and the other was sent to the 19 centres in Denmark treating these children (response rate 100%). Simultaneously, the children were asked to take a blood sample for central HbA1c-analysis (normal range 4.3-5.8, mean 5.1%). RESULTS: Most children were managed at centres which complied with the standards for the process indicators for good diabetes management, but not with the standards for most structure and outcome indicators. Only one third of the children reached the treatment target for HbA1c. Their mean HbA1c-level increased gradually from ages 4-14 without significant difference between genders. The youngest children had the lowest HbA1c (mean 8.2%) and the lowest rate of severe hypoglycaemic events (4.6 events per 100 patient years). The subgroup of children without any hypoglycaemic events had the significantly lowest mean HbA1c-level (8.6%, P=0.028). CONCLUSIONS: The Danish Registry for Childhood Diabetes provided useful data for quality improvement, but had to be supplemented with data from questionnaires on the structure and process indicators. Outcome of paediatric diabetes management in Denmark was unsatisfactory. Centres need feedback on ways to improve care to lower the children's risk of developing severe diabetes complications.

Adolescent↗

PubMedDate not supplied

Prevalence of Bartonella infection in domestic cats in Denmark.

Whole blood and serum from 93 cats (44 pets and 49 shelter/stray cats) from Denmark were tested for the presence of feline Bartonella species by culture and for the presence of Bartonella antibodies by serology. Bartonella henselae was isolated from 21 (22.6%) cats. Bacteremia prevalence was not statistically different between shelter/stray cats (13/49, 26.5%) and pet cats (8/44, 18.2%), but varied widely by geographical origin of the cats, even after stratification for cat origin or age (p < 0.001). All isolates but one were B. henselae type II. The only cat bacteremic with B. henselae type I was not co-infected with B. henselae type II. None of the cats was harboring either B. clarridgeiae or B. koehlerae. Almost half (42/92, 45.6%) of the cats were seropositive for B. henselae and antibody prevalence was similar in shelter/stray cats (23/49, 46.9%) and pet cats (19/43, 44.2%). This is the first report of isolation of B. henselae from domestic cats in Denmark. This study also indicates that domestic cats, including pet cats, constitute a large Bartonella reservoir in Denmark.

Animals↗

PubMedDate not supplied

Chiropractic patients in Denmark: a short description of basic characteristics.

BACKGROUND: The vast majority of information on chiropractic and chiropractic patients originates from English-speaking countries. Lately, however, reports describing chiropractic patients and practice in other European countries have emerged. OBJECTIVE: To describe basic characteristics of Danish chiropractic patients. DESIGN: Survey questionnaire. All chiropractic clinics in Denmark were asked to collect information on new patients during 1 randomly assigned week in 1999. SETTING: Private chiropractic practice and a nonprofit research institution. OUTCOME MEASURES: Age and sex, location and duration of chief complaint, pain intensity, limitation of activities of daily living from chief complaint, and mode of referral. RESULTS: Eighty-eight percent of all chiropractic clinics in Denmark participated in the study. Out of 2020 patients from the participating clinics, 1897 (94%) filled out a self-administered questionnaire. The mean age of participants was 42 years, and slightly more women than men returned the questionnaire. By far the most frequent area of complaint was pain related to the lower back (50%) followed by pain related to the neck (15%). The majority of patients had complaints in the subacute or chronic category (duration 1-6 months). Patients with sciatica had significantly higher pain scores and limitation in activities of daily living (ADL) than any other group, whereas patients with neck pain tended to score lower. Patients in the subacute category had the highest pain scores and limitation in ADL. For complaints lasting more than 6 months, limitation in ADL remained constant at a low level. Twenty-three percent of all patients were referred to the chiropractor, most frequently by a general medical practitioner. More than half of all patients had previously been treated for the same or similar problems, most frequently by a chiropractor. Fifty-one percent had also received chiropractic care for other types of problems. CONCLUSIONS: Most Danish chiropractic patients complain of pain related to the low back or neck of between 1 and 6 months' duration. This study confirms that chiropractic is fairly well integrated in the Danish primary health care system. There are differences between the chiropractic patient population in Denmark compared with that of Sweden and Holland.

Adolescent↗

PubMed2003

Twenty-year survey of the epidemiology of hepatitis B in Denmark: effect of immigration.

Implementation of hepatitis B virus (HBV) vaccination is being considered in Denmark. Therefore, a 20 y survey on the epidemiology of HBV infection was performed. All notified cases of acute HBV infection in Denmark from 1982 to 2002 were reviewed retrospectively and all available data from 1970 to 2001 on the prevalence of hepatitis B surface antigen (HBsAg) in different groups of the Danish population were studied. The notified annual incidence of acute HBV infection has declined from more than 200 cases to fewer than 50 cases in 2001. In the indigenous population there has been a similar decline in prevalence of HBsAg carriers, from 0.15 to 0.03%, but owing to immigration of new HBsAg carriers from developing countries the overall number of carriers has not changed. The small effect of immigration on the incidence of acute HBV infections as well as the decreasing prevalence of HBsAg carriers among Danes should be taken into account when planning new vaccination strategies in Denmark.

Adolescent↗

PubMed2005

Demographics of HIV-1 infection in Denmark: results from the Danish HIV Cohort Study.

We used a population-based cohort study design to describe the demographic characteristics of the HIV-infected population in Denmark and their variation over time. HIV treatment in Denmark is restricted to 9 centres, and all 3941 HIV-1 infected patients more than 15 y old seen at these centres in 1995-2003 were included. We found an estimated HIV prevalence of 70 per 100,000, and a mean annual incidence rate of 5.1 per 100,000 persons. The number of newly infected individuals was stable with a median of 231 per y (period 1995-2002), whereas the number of deaths decreased from 166 in 1995 to 50 in 2000 (p=0.000) and remained stable thereafter. Of the enrolled patients, 75% were males, 80% were Caucasian, 13% were black African, and the primary risk behaviour was male-to-male sexual contact (44%), heterosexual contact (36%), and injection drug use (11%). During the y 1995-2003 we found an increase in age at diagnosis (p=0.000), and no major changes in gender, race, mode of infection, or baseline CD4+ cell count and viral load, neither overall not within subgroups of patients. In this period 14.5% had AIDS at the time of HIV diagnosis. Our data do not confirm concerns about unmonitored evolution in the HIV epidemic in Denmark.

Adult↗

PubMed2005

Demographics in HIV-infected children in Denmark: results from the Danish Paediatric HIV Cohort Study.

We present the demographic data on HIV-infected children from the Danish Paediatric HIV Cohort Study, an observational database on HIV in Denmark. Up to 1 July 2003 a total of 89 children had been diagnosed with HIV infection before the age of 16 y, of which 12 (13.5%) had died, 2 (2.2%) had emigrated from Denmark, and 13 had reached the age of 16 y. Estimates of prevalence and incidence of HIV infection in the area were 5.77/100,000 and 0.39/100,000 respectively, which are lower than in the adult population. After 1993 the number of newly diagnosed HIV infected children remained quite constant with an average of 4.2 diagnoses per y. Of the enrolled patients only 15.7% had both their parents of Danish origin, while 58.5% had at least 1 of the parents from an African country. Of the entire cohort, 20% were Caucasians, 51% were males and 76% were infected perinatally. There has been a shift in the HIV epidemic in children over recent y, with a higher proportion of newly diagnosed HIV patients having contracted the infection perinatally, a higher proportion being of non-Caucasian race, and the newly diagnosed individuals being younger. Even since 1995, a major part of the newly diagnosed children was born in Denmark by mothers from high-endemic areas and we therefore suggest that HIV-testing should actively be offered to all pregnant women coming from these high-risk areas.

Adolescent↗