Mortality pattern in Greenland. An analysis of potential years of life lost 1968-83.
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Biomedical subjects
Publications and source records attributed to P Bjerregaard.
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24 hour ambulatory electrocardiography was performed in a representative group of people born in 1897. Out of 73 people included in the study, 22 were without known heart disease, 15 had definite ischaemic heart disease (IHD) and 36 symptoms of possible cardiac origin. An R-R interval in excess of 2000 ms was seen in only 3 subjects and Wenckebach A-V block in only one. One subject without a history of syncope had a nocturnal episode of complete A-V block with an escape interval of 8000 ms. The most striking difference between healthy subjects and patients with IHD was the higher number of patients with more than 1000 ventricular premature beats (VPBs) per 24 hour and ventricular couplets compared with the number of healthy subjects with such findings. At follow-up two years later 11% had died, with the highest mortality in patients with IHD (33%), and out of 8 patients with IHD who had more than 1000 VPBs per 24 hour, 4 (50%) had died compared with only one (14%) of those with less than 1000 VPBs. Our results seem to indicate that more than 1000 VPBs per 24 hour is a very unusual finding in healthy 85 year old individuals. When it occurs in very old people, it is usually in connection with IHD, and in this setting it signifies a poor prognosis.
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The effects of lethal mercury concentrations on regulation of hemolymph electrolytes in the shore crab Carcinus maenas were investigated. In most experiments mercury exposure reduced hemolymph osmolality and Na+, Cl- and K+ levels to 55-90% of controls in 48 hr. Mercury exposure augmented calcium levels to 120-300% of controls. The effect of mercury on all of the electrolytes varied during the year, especially on magnesium levels which showed significant increases or decreases, or remained unaffected in different experiments.
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During one year, 1979-80, all the contacts between the 836 inhabitants of Upernavik town and the local medical officers were recorded. In the 737 native Greenlanders 1006 contacts (41%) were caused by infectious diseases, representing 705 episodes of disease. The number of contacts per episode of disease was similar in all age groups. Of these contacts 26% were caused by acute upper respiratory tract infections, 8% by other acute respiratory infections, 10% by chronic respiratory infections, 24% by non-traumatic skin infections, 7% by post-traumatic skin infections, 8% by sexually transmitted diseases, and 17% by other infections. Skin infections were most common in males, whereas all other infections were most common in females. The patterns of age specific contact rates were similar in males and females, except regarding "other infections". A peak of respiratory infections in July and of skin infections during winter was noted. The contact rate for all infectious diseases together was slightly higher than in Danish general practice, and infectious diseases also accounted for a larger proportion of all registered contacts. Contacts due to chronic respiratory infections, skin infections and sexually transmitted diseases were notably more frequent in Upernavik.
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Nine patients (mean age 32 years, range 9-58) with a secundum atrial septal defect (ASD) were investigated by intracardiac electrography before and, on an average, 14 months after circumclusion of the defect. Postoperatively, four patients developed atrial fibrillation or flutter requiring treatment. After the repair, sinus node recovery time and the H-V interval increased significantly. The P-A interval, the A-H interval, sinoatrial conduction time, and the effective refractory period of the atrium (ERPA) remained unchanged. In the patients who developed atrial tachyarrhythmias, the mean preoperative ERPA was significantly longer than in the remaining patients; in patients with ERPA less than 220 ms, no atrial arrhythmias occurred. Our findings suggest that circumclusion of a secundum ASD has a sustained deleterious effect on sinus node function and His-Purkinje conduction. Preoperative determination of ERPA might be of value for the prediction of postoperative atrial arrhythmias in patients submitted to ASD repair.
Hypertrophic cardiomyopathy and juvenile amaurotic idiocy (one of the ceroid lipofuscinoses ) were diagnosed in a 29 year old man. This combined finding may be one of pure coincidence, but hypertrophic cardiomyopathy like changes of the myocardium are known to occur in Friedreich's ataxia and lentiginosis . The occurrence may, therefore, indicate some fundamental interrelation.
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