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PubMed2001

Antibacterial drugs prescribed for dogs and cats in Sweden and Norway 1990-1998.

The usage of veterinary antibacterial drugs in dogs and cats in Sweden and Norway for the period 1990-1998 was investigated by use of drug wholesalers' statistics. Additionally, usage of human antibacterial drugs in these species in Sweden was investigated by use of prescription data for the period 1996-1998. On average, more than 50% of the prescribed veterinary antibacterials in Sweden were beta-lactam antibiotics. In Norway, about 75% of the preparations prescribed for dogs and cats contained sulfonamides and trimethoprim. Furthermore, the prescription data from Sweden showed a reduced usage of human antibacterials prescribed for dogs and cats since the beginning of the 1980s. Approximately 20% of the prescribed packages for dogs in the years 1996-1998 were human approved drugs. The corresponding figure for cats was 13%. The differences between the countries in the choice of antibacterial drugs can be explained by differences in the availability of approved preparations during the study period. The consumption of veterinary antibacterials in dogs and cats in Sweden during the period was in the range of 3% to 8% of the total use of veterinary antibacterials. The corresponding figures in Norway were in the range of 3% to 7%. It is of vital importance to study usage patterns of antibacterial drugs in dogs and cats in surveillance and control of bacterial resistance, but also in discussions of therapeutic appropriateness. Therefore, further research is needed in this area.

Animals↗
PubMed2004

Hepatic cobalt and copper levels in lambs in Norway.

Cobalt and copper concentrations were measured in 599 lamb livers collected at slaughter from 58 sheep flocks in 6 different parts of Norway in 1993. Information about pasture, additional feeding and mineral supplements in the flocks was obtained through a questionnaire. Average hepatic levels of cobalt in the lamb flocks varied from < 0.003 to 0.22 microg/g ww, and of copper from 5 to 240 microg/g ww. Flocks with deficient or marginal cobalt status were found in all parts of southern Norway, but primarily in the west and south-west. Some flocks with marginal copper status were found in the south-west, while flocks with signs of excessive hepatic copper concentrations were found mainly in inner parts of central and northern Norway. Hepatic copper concentrations were significantly higher in lambs that had grazed mountain pastures than in those that had grazed lowland pastures in the summer.

Animal Husbandry↗
PubMed2006

A 50-year follow-up of the incidence of multiple sclerosis in Hordaland County, Norway.

OBJECTIVE: To assess longitudinal follow-up of the incidence of multiple sclerosis (MS) through five decades and estimate the prevalence rate in Hordaland County, Norway, on January 1, 2003. METHODS: All patients with MS diagnosed from 1953 to 2003 were identified in the patient records of the Department of Neurology, Haukeland University Hospital, Bergen, Norway. The diagnostic criteria of Poser et al. were applied and only patients with definite and probable MS were included. The study comprises 912 patients, and 666 patients with MS were living in Hordaland on January 1, 2003. The annual incidence rates for the years 1953 to 2003 were calculated. RESULTS: The total crude prevalence rate on January 1, 2003, was 150.8 per 100,000 population: 191.3 per 100,000 among women and 109.8 per 100,000 among men. The annual incidence of MS increased from 1.8 per 100,000 in 1953 to 1957 to 6.0 per 100,000 in 1993 to 1997. CONCLUSIONS: Hordaland County, Norway, has changed from a low-risk to a high-risk area for multiple sclerosis (MS) during the last 50 years. During the last 25 years, the incidence of MS has been stable rather than increasing. Systematic longitudinal follow-up studies are essential to calculate reliable prevalence and incidence rates in MS. The results suggest that both methodologic and environmental factors are essential in determining the distribution of MS.

Adult↗
PubMed1991

Epidemiologic trends in multiple sclerosis in Møre and Romsdal, Norway: a prevalence/incidence study in a stable population.

The western part of Norway has been a low-to medium-frequency area for multiple sclerosis (MS). The prevalence of definite/probable MS on January 1, 1961, was 24.3/100,000 in the county of Møre and Romsdal, western Norway. Based on the same diagnostic criteria, the prevalence of definite/probable MS increased to 75.4/100,000 on January 1, 1985. The average annual incidence rate increased from 1.94/100,000 in the period 1950-1954 to 3.78/100,000 from 1975-1979. Remitting MS in the younger age groups of both sexes increased the most. We consider this increase of MS to be due to alteration in exogenous factors as variation in genetic susceptibility cannot account for the increase in the stable western Norwegian population. The rise in prevalence/incidence over the last 20 to 25 years in western Norway supports the theory that MS is a disease influenced by exogenous factors that show variation over time.

Adolescent↗
PubMed2000

Increasing mortality from amyotrophic lateral sclerosis in Norway?

OBJECTIVE: To investigate a possible increase in incidence of ALS in Norway. METHODS: Death certificate data from all deaths in Norway in the period 1961 to 1994 for ALS, PD, and MG were obtained from Statistics Norway and related to population statistics. Data on ALS was obtained on sex, age, and place of death and compared with mortality data in PD and MG for the same period. Data were standardized using the 1990 population as standard population. Poisson regression was used to test for trends in mortality. The data from the death certificates were related to a clinical study performed on ALS in one of the counties during the same period. RESULTS: The annual mortality of ALS almost doubled during the period studied, rising from 1.38 to 2.54 per 100,000 inhabitants at the end of the study. The increased mortality appeared solely in the population older than 60 years of age, with a peak in mortality in the age group 80 to 84 years. The increase was larger in women than in men, and the ratio between the sexes was 1.32 (men-women, age-adjusted at the end of the study). The mortality in patients with PD showed a similar increase to that seen in ALS, whereas no increase in mortality was observed in patients with a diagnosis of MG. There were considerable differences in ALS mortality in different counties, but no clear regional trends were observed. CONCLUSION: The authors report increasing ALS mortality. Although the increase in mortality is restricted to the population aged 65 years or older, it cannot be explained by increasing age of the general population alone.

Adolescent↗
PubMed1996

Videoconferencing in psychiatry: a survey of use in northern Norway.

A survey of the use of videoconferencing in mental health care was carried out in northern Norway. A questionnaire was distributed to all user institutions in northern Norway at the same time that ISDN became available, in mid-1995. The questionnaire completion rate for locations recorded as participants in videoconferencing sessions was 62%. Within six months, a total of 1028 persons had participated in 140 videoconferencing sessions from 35 institutions. The purposes of videoconferencing included meetings (50%), supervision, training and teaching (31%), clinical consultations (14%) and tests or demonstrations (5%). The alternative forms of contact which videoconferencing replaced included travel (59%), no contact (25%), telephone (14%), and mail or fax (2%). No problems were reported in 55% of the sessions; in 19% there were audio problems, in 14% there were picture problems, in 5% attempts to connect failed and in 5% disconnection occurred. The majority of users (87%) reported that they were satisfied or very satisfied with the facility; 8% were uncertain and 5% were less satisfied or totally dissatisfied. Continued surveying will provide longitudinal data on the diffusion of telepsychiatry in northern Norway.

Attitude of Health Personnel↗
PubMed1994

Harsh social conditions and perinatal survival: an age-period-cohort analysis of the World War II occupation of Norway.

OBJECTIVES: The hypothesis was tested that unfavorable social conditions are associated with poor perinatal survival through direct effects on pregnancy or, more indirectly, through effects on mothers born under such conditions. The occupation of Norway by Nazi Germany was used as a period of social hardship. METHODS: Data from Norwegian vital statistics and the Medical Birth Registry were used to describe perinatal mortality during World War II and also a generation later, among babies born to mothers who had themselves been born during the war. Logistic regression was used to identify a possible cohort effect among mothers born in 1940 through 1944 compared with mothers born before or after that period. RESULTS: Harsh conditions in Norway during the occupation increased childhood mortality. However, perinatal mortality declined during that period. Likewise, no adverse effect was seen on the survival of babies born to mothers who had themselves been born during the war (odds ratio = 1.00; 95% confidence interval = 0.96, 1.04). CONCLUSIONS: We find no evidence that wartime conditions in Norway impaired perinatal survival, either directly or through an effect on women born during the war. These data underscore how little is known about the ways that social conditions influence perinatal mortality.

Adolescent↗
PubMed2006

Lipid management and cholesterol goal attainment in Norway.

OBJECTIVE: To document prescribing patterns of lipid-modifying therapies in hypercholesterolemic patients, cholesterol goal attainment, and factors associated with cholesterol goal attainment in Norway. METHOD: This was a retrospective, observational study using existing computerized patient records at 11 primary healthcare centers in Norway and the Norwegian Patient Register of hospital data. The study population was 3111 patients identified in the primary care database who were prescribed a lipid-modifying therapy between the dates of July 1987 and May 2003 and who were > or = 18 years of age at the time of the first prescription. Of these patients, 1337 patients had uncontrolled lipid measures at baseline. In the analysis of goal attainment, data were available for 877 (28% of the total study population) and 1144 (37%) patients with baseline and follow-up total cholesterol (TC) and/or low-density lipoprotein-cholesterol (LDL-C) levels after 4 and 12 months' treatment, respectively. OUTCOME MEASURES: Initial lipid-modifying therapy (drug and dosage), changes in initial lipid-modifying therapy, cholesterol goal attainment, and factors related to cholesterol goal attainment. Cholesterol treatment goals were defined as LDL-C <3.0 mmol/L and/or TC <5.0 mmol/L (as per the Second Joint Task Force of European Societies on the Prevention of Cardiovascular Disease). RESULTS: The initial lipid-modifying therapy was a HMG-CoA reductase inhibitor (statin) in 98% of patients, most often simvastatin (42%; mean initial dosage = 18.4 mg/day) or atorvastatin (34%; 12.7 mg/day). The median year of treatment initiation was 1999 and the mean duration of follow-up was 39 months. The initial prescription remained unchanged at year 1 for most patients (69%), whereas 17% discontinued drug treatment. Mean TC levels decreased from 7.36 mmol/L at baseline (n = 1337) to 5.31 mmol/L at 12 months (n = 1144; p < 0.05), whereas mean LDL-C levels decreased from 4.98 (n = 847) to 3.08 mmol/L at 12 months (n = 713; p < 0.05). These mean reductions occurred within 3 months of the initial prescription and did not change subsequently. A total of 32.9% of patients who were not at goal at baseline achieved cholesterol goal 12 months after initiating treatment. The factors related to cholesterol goal attainment at 12 months were: baseline TC level (odds ratio [OR] 0.64; 95% CI 0.58, 0.71), treatment with a statin (OR 8.60; 95% CI 1.13, 65.4), diagnosis of diabetes mellitus (OR 2.91; 95% CI 2.01, 4.21), and age (OR 1.02; 95% CI 1.01, 1.03). CONCLUSIONS: Lipid-modifying therapy in Norway is dominated by statin monotherapy. In this analysis of primary-care patients, maximal reductions in cholesterol levels were seen within the first 3-4 months after therapy initiation. After 12 months of treatment, 67% of patients remained above recommended cholesterol levels. More effective and well tolerated treatment strategies are needed to improve the probability of patients achieving cholesterol treatment goals.

Aged↗
PubMed1989

Changes in frequency and indications for cesarean section in Norway 1967-1984.

We have studied the cesarean section frequencies and changing spectrum of indications in Norway during six consecutive 3-year periods from 1967 to 1984. The data set consists of 1,046,162 births notified to the Medical birth registry of Norway, of which 52,426 were specified as cesarean sections, the frequency rising from 1.9% in 1967-69 to 9.7% in 1982-84. A check for completeness of cesarean section notification was made against the birth protocols of the largest obstetrical unit in Norway. The error rate was about 3%. Information on the indication for performing cesarean section was missing in 11.4% of the cases. We grouped thirty-one specified indications under seven headings. In 1967-69 the operation was most often performed for 'maternal' reasons, followed by 'mechanical', 'abnormalities of fetal presentation' and 'acute placental' conditions. Throughout the study period, 'mechanical' (which can also be labelled 'dystocia') accounted for about one third of the indications for cesarean section, while 'maternal' (including high maternal age and pre-eclampsia) and 'acute placental' (placenta praevia and placental abruption) decreased in relative importance. 'Fetal presentation' (including twins) doubled its relative share, while increasing from 2.4 per 1000 births in 1967-69 to 24.8 per 1000 births in 1982-84. A steep rise in the group 'fetal asphyxia' corresponded to the period when the mass of electronic monitoring devices was introduced, in the early 1970s. 'Fetal asphyxia' had a higher relative share of the indications among para 0 mothers than in the total birth population.

Cesarean Section↗
PubMed1996

Academic dissertations by dentists in Finland, 1891-1991, and in Finland, Norway, and Sweden, 1984-93.

Dental education in the Nordic countries was founded in the late 1800s, but the doctor's degree in dentistry (Ph.D.) was established somewhat later. Since the first dissertation in Finland in 1891, a total of 204 doctoral dentist candidates had defended their Ph.D. theses by 1991, 50% of them during the most recent 12 years. Over the 100-year period, 54% of the dentists' Ph.D. theses in Finland were defended at the University of Helsinki, 27% at Turku, 14% at Kuopio, and 5% at Oulu. Women constituted a minority of the candidates (23%) during the first 90 years but 54% from 1982 to 1991. From 1984 to 1993 a total of 374 dentist candidates in Finland, Norway, and Sweden defended their Ph.D. theses. The mean ages of the candidates ranged from 37.7 to 41.7 years for men and from 40.6 to 43.2 years for women. In the 10-year period on average 53 doctor's degrees were received per institute in Sweden, compared with 28 in Finland and 27 in Norway. In all three countries about 6 of 100 graduates in 1980s received a doctor's degree in dentistry. Almost all of these Ph.D. theses were written in English and based on collections of articles. Female candidates dominated in Finland (56%), compared with 34% in Sweden and 26% in Norway, where, however, women's contribution increased most rapidly, being tripled from early 1980s to 1990s.

Academic Dissertations as Topic↗
PubMed1997

Regional differences in hospital admission rates for suspected and verified myocardial infarction in Nord-Trøndelag county, Norway.

OBJECTIVE: To investigate differences in the occurrences of hospitalized suspected and verified acute myocardial infarction (AMI) between the two hospital regions, Namdal and Innherred, within a single county in Norway. DESIGN: A descriptive epidemiological study. SETTING: The county of Nord-Trøndelag in the central part of Norway (131,000 inhabitants). SUBJECTS: Patients admitted for suspected AMI 13 March-11 June 1995. MAIN OUTCOME MEASURES: Proportion of verified AMI among patients admitted. Regional incidence rates for AMI. RESULTS: Among 347 patients admitted to hospitals with suspected AMI, AMI was verified in 120 (35%), corresponding to an annual incidence rate of 509 and 294 per 100,000 (p < 0.001). CONCLUSIONS: Among patients admitted with suspicion of AMI, approximately one third had AMI. The study revealed substantial differences for AMI between two neighbouring hospital regions within one county in Norway. This difference may have implications for the planning and cost of hospital care.

Aged↗
PubMed2004

First human cases of tickborne encephalitis, Norway.

The first reported case of tickborne encephalitis (TBE) in Norway occurred in 1997. From 1997 to 2003, from zero to two cases of human TBE have been diagnosed per year in Norway, for a total of eight cases. Clinical TBE cases in dogs are not reported in Norway.

Adult↗
PubMed1996

Population decline and plague in late medieval Norway.

Norwegian scholars have engaged in considerable research over the last half century in an attempt to assess the impact of the Black Plague of 1349 on population and society in Norway. Evidence has been put forward relating the incidence of plague to a continuance of population decline over the two centuries following its initial introduction. Estimates of population decline in Norway between 1350 and 1550 indicate a reduction by as much as 65%. Two directions of study have emerged, one concentrating on land abandonment known as the "Ødegard Project." The other is represented by the recent works of Ole Jørgen Benedictow presenting epidemiological and osteo-archaeological research. An examination of the available literature raises questions concerning the degree to which plague, and its recurrence, directly affected population decline in Norway during the Late Middle Ages. While evidence of the virulence of the plague and the degree of farm abandonment is compelling, a direct relationship to population decline may not be as great as implied by the research. Other explanatory factors, especially social and economic responses to plague, have been given limited attention.

Disease Outbreaks↗
PubMed1999

[Telepathology in Mid-Norway].

Telepathology can provide frozen section service to hospitals without a pathology service of their own. Using a dynamic-robotic system with 6 ISDN B-channels (Telemed A200, AM Elektronikk A/S, Oslo, Norway), the pathologists at the University Hospital in Trondheim, Norway during a three-year period from 1995 successfully performed 116 diagnostic sessions for two rural Norwegian hospitals. In 90% of the cases a diagnosis was provided. There was no false positive diagnosis and only 3% false negative cases without clinical consequence. Deferred cases (10%) were mainly due to poor quality of the frozen sections and a conservative attitude among the pathologists. It is concluded that the diagnostic accuracy is good, but for safety reasons telepathology should be offered on a regular basis, so that the skills of the technicians and pathologists involved are kept up. In Mid-Norway, five more hospitals will be included in a telemedicine network comprising eight hospitals in the region.

Attitude of Health Personnel↗
PubMed1975

[Drug abuse in Norway (author's transl)].

The author gives a review of the problems of drug dependences in Norway. The rate of use of and dependency to drugs is discussed with special reference to adolescent drug habits, as registered yearly since 1968. About 18 percent of adolescents in Oslo have tried cannabis once or several times (1972, 1973). Although, the situation seems to have stabilized during the last two or three years. In other big towns in Norway the percentage is about half of that in Stockholm and Copenhagen. The attitude of young people to the use of drugs, including cannabis, is strongly negative. Tendencies in adolescent use of and dependency on drugs are described. In adults dependency on benzodiazepines seems to be the most common type of dependency. The methods used in treatment of drug dependents in Norway are described, as are also the prophylactic measures.

Adolescent↗
PubMed1999

Influence of prescription patterns in general practice on anti-microbial resistance in Norway.

BACKGROUND: The global pandemic of antibiotic resistance is causing considerable concern, and a major reason for the growing world-wide resistance problem is the overuse of anti-infective drugs, especially the use of broad spectrum antibiotics. This is still a relatively minor problem in most of the Nordic countries where the consumption of antibiotics is less than half of that reported from southern Europe and the United States of America (USA). AIM: To describe the resistance pattern among common respiratory tract pathogens in Norwegian general practice, the national consumption of antibiotics, and GPs' prescription patterns for respiratory tract infections. To offer some suggestions as to why Norway has maintained a favourable situation regarding resistant microbes during the past 10 years. METHODS: An analysis of the prescription patterns in Norwegian general practice. RESULTS: There is a low total prescription volume of antibiotics compared with other countries. Penicillin V is the most commonly used antibiotic for the most common airway diseases in general practice in Norway. CONCLUSION: Although there is a low prevalence of antibiotic resistance in Norway, there is still a great potential for reducing the unnecessary antibiotic prescribing for the most common respiratory illnesses.

Anti-Bacterial Agents↗
PubMed2000

[Hepatitis C virus infection among pregnant women and their children in Norway].

Estimates indicate the births of 6 to 78 children vertically infected with hepatitis C virus infection each year in Norway. There is insufficient knowledge of the magnitude of this health problem and the National Institute of Public Health commissioned the authors to approach issues relating to vertical transmission of hepatitis C virus (HCV) infection in Norway. The risk of vertical transmission of HCV appears to be associated with the titre of the maternal viral load. Vertical transmission from nonviraemic mothers has not been demonstrated. No postexposure prophylaxis exists. There is a lack of association between vertical HCV transmission and delivery mode and no association with breast feeding. Universal screening for HCV infection among pregnant women is not recommended. Children born to women known to be HCV-positive should be followed up with antibody and polymerase chain reaction investigations in order to clarify their HCV status. More studies of HCV infection among pregnant women and their children in Norway are needed.

Communicable Disease Control↗
PubMed2000

[Is the benefit of organized mass screening for cervix cancer and breast cancer in Norway scientifically justified?].

BACKGROUND: It has been argued that mass screening may reduce mortality from cervical cancer and breast cancer in Norway by 50% and 39%, respectively. However, some authors doubt that mass screening for breast cancer is justifiable. This article discusses whether mass screening for cervical cancer in Norway is more effective than opportunistic screening. MATERIAL AND METHODS: The scientific methods used to justify organised mass screening for cervical cancer are reviewed and discussed, as are the randomised trials used to justify screening by mammography. The author is especially critical of the use of descriptive statistics to justify screening, on the assumption that there is a basic constant incidence or mortality rate. RESULTS: The incidence rates of pre-malignant conditions and cervical cancer in Norway are presented. There is no essential increase in the number of pre-malignant conditions after three years of organised mass screening compared to the previous three-year of unorganized screening. However, the number of pre-malignant conditions did increase from 1987 to 1992 due to a national recommendation for testing every three years. By contrast, incidence rates for cervical cancer remained almost constant in the 1987-97 period. INTERPRETATION: There is no scientific proof of organised mass screening for cervical cancer being preferable to unorganized screening. The author warns against only comparing observed rates with historic rates and rates in other countries; alternatively, rates among those who participate in the screening might be compared in a simultaneous analysis to rates among those who do not respond to the invitation. The author also suggests estimating correlation coefficients between individual test results to identify high-risk individuals.

Breast Neoplasms↗