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PubMed2005

Small changes in United Kingdom cardiovascular risk factors could halve coronary heart disease mortality.

BACKGROUND AND OBJECTIVE: The U.K. government recently called for a 40% reduction in cardiovascular disease mortality by 2010. We examined the potential for cardiovascular risk factor changes to achieve that target. METHODS: We applied a previously validated mortality model, IMPACT, to an England and Wales population (37.1 million, aged 25-84). The model integrates information on trends in all the major cardiovascular risk factors, plus the uptake and effectiveness of all medical and surgical treatments. The potential reductions in coronary heart disease mortality from the base year, 2000, were calculated for two contrasting scenarios: (a) if recent risk factor trends simply continued to 2010 and (b) if further small reductions in risk factors were achieved, as in Scandinavia and the United States. RESULTS: Continuation of recent risk factor trends should result in approximately 10,685 fewer coronary deaths in 2010 (minimum estimate 10,110; maximum 16,460) than in 2000. Modest additional reductions in cholesterol and smoking could potentially achieve 51,270 fewer deaths (minimum 39,435; maximum 71,510). Optimistic changes in obesity, diabetes, and physical activity, however, would have relatively small effects. CONCLUSION: Modest additional risk factor reductions in cholesterol and smoking already achieved in the United States and Scandinavia could prevent or postpone > 50,000 deaths by 2010, halving current coronary mortality.

Adult↗
PubMed2004

Amalgam to tooth-coloured materials--implications for clinical practice and dental education: governmental restrictions and amalgam-usage survey results.

OBJECTIVES: To review governmental guidelines on amalgam use worldwide and to assess trends in the usage of amalgam and composite materials in restoration of posterior teeth. METHODS: A letter was sent to 24 government health agencies or representative organisations requesting details of regulations pertaining to amalgam use. A literature search was carried out in order to identify papers in which the incidence of amalgam and composite restorations was stated. RESULTS: Ten replies were received, indicating few restrictions on the use of amalgam. Results obtained from published work appear to indicate that amalgam use is declining, but at rates which are unclear in many countries because of the paucity of published data. Amalgam use has been found to be decreasing in the USA, Australia and Scandinavia, with lesser decreases being apparent in the UK. CONCLUSIONS: There are few restrictions to the use of amalgam worldwide. In countries where data are available, such as USA, Australia and Scandinavia, amalgam use has been found to be decreasing, with smaller decreases being apparent in the UK.

Adolescent↗
PubMed2006

Analysis of MAdCAM-1 and ICAM-1 polymorphisms in 365 Scandinavian patients with primary sclerosing cholangitis.

BACKGROUND/AIMS: Mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) has been implicated in the aberrant homing of intestinal lymphocytes to the liver in primary sclerosing cholangitis (PSC). Intercellular adhesion molecule-1 (ICAM-1) has also been implicated in the pathogenesis of PSC and the E/E genotype of the K469E polymorphism has been reported to be associated with PSC susceptibility. The aims of this study were to determine if MAdCAM-1 polymorphisms or the K469E polymorphism of ICAM-1 are associated with PSC in Scandinavia. METHODS: Seven single nucleotide polymorphisms (SNPs) in MAdCAM-1 and the G421R and K469E ICAM-1 SNPs were genotyped in 365 PSC patients from Norway and Sweden. 327 Norwegian ulcerative colitis (UC) patients and 368 Norwegian bone marrow donors served as controls. RESULTS: No significant association with PSC was found for any of the MAdCAM-1 or ICAM-1 SNPs. Allele frequencies for these polymorphisms were not significantly different between PSC patients with UC, UC patients and healthy controls. CONCLUSIONS: Polymorphisms in MAdCAM-1 are not likely to significantly affect PSC susceptibility. In addition, the E/E genotype of the K469E in ICAM-1 does not influence PSC susceptibility in Scandinavia.

Case-Control Studies↗
PubMed1979

Innovation in medical diagnosis--the Scandinavian curiosity.

Fine-needle aspiration biopsy is a major diagnostic tool in Scandinavia, where 8000 such biopsies may be done in a large metropolitan hospital each year. The procedure is rapid, inexpensive, and technologically simple, yet it has found only limited, albeit increasing, acceptance in medical practice outside Scandinavia. Although the differences between Scandinavian and other medical systems may explain why the technique is not used more widely, there seems to be an underlying reluctance among medical communities to accept subjective types of innovation compared with objective innovation.

Biopsy, Needle↗
PubMed2001

Comparison of nitrate tolerance between different populations of the common frog, Rana temporaria.

Euthrophication-associated changes in the physical and biological environment of lakes and ponds are potentially a source of major stress for many aquatic organisms. In Scandinavia, the nitrate concentrations in lakes and ponds decrease towards north due to a naturally lower productivity of the habitats, but also due to lower supplementation of anthropogenic nitrogen. A chronic experiment using ecologically relevant concentrations of sodium nitrate (0-5000 micro gl(-1)) was used to test whether common frog (Rana temporaria L.) larvae from northern parts of Scandinavia are less well adapted to cope with high nitrate concentrations than those from the southern parts. Slight, but significant differences in nitrate tolerance, as measured in terms of growth rate and size at metamorphosis, between the two regions were found. High concentrations of nitrate reduced the growth rates and metamorphic size in north, but not in south. However, there was no clear-cut impact of high nitrate concentrations on developmental rate or on mortality until metamorphosis. The general lack of large effects of nitrate treatment on the response variables suggests that nitrates per se do not pose any significant threat to the development of R. temporaria tadpoles under a natural range of concentrations. This was confirmed in an acute test where results suggest that ammonia and nitrite, compounds seldom found in high concentrations in Fennoscandian lakes, are possibly responsible for the larger negative effects of "nitrate" observed in previous studies of amphibians.

Animals↗
PubMed1998

Why the Scandinavian countries have not implemented universal vaccination against hepatitis B.

Within the 50 member states of the WHO European region, HBsAg carriage rates vary from a high of approximately 20% to a low of 0.05%. The Scandinavian countries have the lowest carriage rates in the region (0.05%). The situation in Sweden is representative of the situation throughout Scandinavia: although a substantial number of immigrants to Sweden are HBsAg-positive, acute cases of hepatitis B continue to be seen mainly in drug addicts and their contacts and to a certain extent, in male homosexuals with multiple partners. Public health officials and governments in Scandinavia are unwilling to introduce universal vaccination of infants because hepatitis B infection is viewed as a limited public health problem that does not justify the expense and other efforts of universal immunization.

Acute Disease↗
PubMed1998

Report from Working Group 3 (the Czech Republic, Denmark, Finland, Norway, The Netherlands, Slovakia, Sweden and the UK).

The Czech Republic, Denmark, Finland, Norway, the Netherlands, Slovakia, Sweden and the UK all have very low HBsAg carrier rates; in the Scandinavian countries, for instance, carrier rates are on the order of 0.05%. Most countries in this group are unconvinced that the carrier rates and the burden of disease caused by new hepatitis infections warrant the expense of universal childhood immunization. In Scandinavia and the UK hepatitis B prevention programmes are based on immunization of high-risk groups. In Scandinavia (excepting Denmark), the UK and the Netherlands, pregnant women are screened and newborns of carrier mothers vaccinated. Only the Czech Republic and Slovakia--both of which now employ high-risk group strategies of hepatitis B prevention--have expressed interest in implementing programmes of universal hepatitis B vaccination of infants and/or adolescents.

Czech Republic↗
PubMed2002

Atmospheric transport patterns and possible consequences for the European North after a nuclear accident.

The main purpose of this study is to examine possible impacts and consequences of a hypothetical accident at the Kola nuclear plant in north-west Russia on different geographical regions: Scandinavia, central Europe, European FSU and Taymyr. The period studied is 1991-1996. An isentropic trajectory model has been used to calculate forward trajectories that originated over the nuclear accident region. Atmospheric transport patterns were identified using the isentropic trajectories and a cluster analysis technique. From the trajectory model results, a number of cases were chosen for examination in detail using more complete transport models. For this purpose, the models MATHEW/ADPIC, DERMA and a newly developed FOA Random Displacement Model have been used to simulate the radionuclide transport and contamination in the case of a nuclear accident and their results have been compared with those of the trajectory modelling. Estimation of the long-term consequences for populations after an accident has been performed for several specific dates by empirical models and correlation between fallout and doses to humans on the basis of the Chernobyl accident exposures in Scandinavia.

Air Movements↗
PubMed2000

The teaching of Class I and Class II direct composite restorations in European dental schools.

OBJECTIVES: The purpose of this descriptive study was to provide updated data on the teaching of Class I and Class II direct composite restorations in Europe as part of a survey of this aspect of the primary dental curriculum in Europe and North America. METHODS: Data on the teaching of posterior composite restorations and related matters were collected by means of a postal questionnaire sent to 185 dental schools known to exist in Europe. Non-respondents were sent a second questionnaire after two months. Further information pertaining to student requirements was sought after six months from all respondents. RESULTS: The response ranged from 92% for dental schools in Scandinavia to 40% from dental schools in Southern Europe with an overall response of 56%. All but four of the 104 participating schools were found to teach the use of composites in Class I and Class II, two-surface situations in at least premolar teeth. Contraindications and techniques taught for posterior composites varied within and between the country groupings of Northern and Central Europe. Scandinavia, Southern Europe and Eastern Europe. However, certain consensus views were identified. The experience of adverse biological reactions to the use of resin-based restoratives in European dental schools was found to be limited. CONCLUSIONS: Notwithstanding the variation in the response from the four geographic regions investigated and the relatively low overall response to the questionnaire, it is concluded that the data reported indicates that most dental schools in Europe teach the use of composites in selected Class I and Class II situations. However, considerable variation exists both within and between the regions investigated in relation to this teaching. Further research and consensus conferences should be planned to reduce variability across Europe in relation to the contraindications and techniques taught for posterior composites.

Composite Resins↗
PubMed2002

Genotypic analysis at multiple loci across Kaposi's sarcoma herpesvirus (KSHV) DNA molecules: clustering patterns, novel variants and chimerism.

BACKGROUND: The genomes of human Kaposi's sarcoma-associated herpesvirus (KSHV) display several levels of DNA sequence heterogeneity and subgrouping that show distinctive clustering patterns in related human populations. The four major subtype patterns for the hypervariable ORF-K1 protein correlate closely with the principal diasporas resulting from the migration of modern humans out of East Africa and suggest that KSHV is an ancient human virus that is transmitted primarily in a familial fashion with consequent very low recombination rates. However, chimeric genomes have also been detected, especially with regard to the presence of P versus M alleles of the ORF-K15 gene. OBJECTIVES: To understand further the genetic organization and evolutionary history of KSHV, especially with regard to possible new subtypes, recombinant genomes, constant region loci and clustering in particular ethnic groups or among classic versus epidemic cases in the same geographic area. STUDY DESIGN: Direct PCR DNA sequencing was carried out on the ORF-K1 and ORF-K15 genes at the extreme left and right hand sides, as well as on six other internal loci of diagnostic samples collected from 70 new KSHV-positive patients in Israel, South Korea, Sicily, Scandinavia, Brazil, Uganda, South Africa and the US. RESULTS AND CONCLUSIONS: Our overall results from more than 135 KSHV genomes from many different human population groups now provides evidence for seven distinct subtypes of KSHV genomes (referred to as A/P, B/P, C/P, D/P, M, N and Q). However, the two most closely related subtypes (A/P and C/P) are only differentiated at the LHS side of the genome, and the three most distantly related forms (M, N and Q) appear to exist only as small chimeric segments that are remnants from the RHS of more ancient forms of the virus. By analyzing multiple conserved loci across the B subtype genomes that predominate in sub-Saharan Africa, we can also now recognize three to four distinct B genome subgroups with varying patterns of inter and intratypic mosaicism. Analysis of classic KS genomes from Israel has revealed that the ORF-K1 clade referred to as A1' predominates in Ashkenazi Jewish immigrants from Russia, whereas C2 and C6 variants predominate in North African Sephardi Jews. A variety of chimeric genomes containing C2 or C3 ORF-K1 genes are disseminated among classic KS cases throughout Europe and Asia including Israel, Sicily, Scandinavia, South Korea, and Taiwan. Comparison of the genomes from classic versus AIDS-associated KSHV in the US indicates that it was derived originally by reactivation and spread of a subset of the endogenous viruses carried by descendants of immigrants from endemic areas of Northern and Eastern Europe, the Mediterranean and sub-Saharan Africa.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Human granulocytic ehrlichiosis in Europe.

Human granulocytic ehrlichiosis (HGE) is a tick-borne zoonosis caused by Anaplasma phagocytophilum. A MEDLINE literature search revealed that the European story of HGE began in 1995 with an article on the presence of serum antibodies to A. phagocytophilum. At present, there is seroepidemiological information indicating the presence of infection with HGE agent(s) for several European countries; seroprevalence rates range from zero or very low to up to 28%. The proportion of seropositive persons increases with age and is higher in persons exposed to ticks. Knowledge of the causative agent of HGE and of animal reservoirs in Europe is limited. Ixodes ricinus is a recognized vector of A. phagocytophilum in Europe. Prevalence of the agent in questing I. ricinus is usually higher in adult ticks than in nymphs and ranges from zero or very low to > 30%. Pronounced differences between countries and marked variability by localities were established. Up to March 2003 about 65 human patients (all but one were adults) with confirmed HGE and several patients fulfilling criteria for probable HGE had been reported. The majority of them came from Central Europe (Slovenia) and Scandinavia (Sweden) but there are individual reports from several other European countries. The patients presented with an acute febrile illness that as a rule occurred after a tick bite; the majority had leukopenia and/or thrombocytopenia, elevated concentration of C-reactive protein and mild abnormalities of liver function test results. A small number of patients does not permit reliable conclusions on the clinical features of European HGE; however, there is an impression that at least in central Europe (but maybe not in Scandinavia) the disease is, from the clinical angle, only mild to moderately severe and (most likely) self-limited. The relatively high proportion of the population with HGE serum antibodies and the presence of A. phagocytophilum (like) agent(s) in ticks, small mammals and deer as found in several European countries are discordant with the rather low number of patients with proven HGE. The discordance may indicate inadequate awareness among European physicians, limited recording and reporting of the disease, and/or the presence of and the infection of humans with nonpathogenic A. phagocytophilum (like) strains present in ticks. Additional studies are needed to better define the biological and public health significance of HGE in Europe.

Anaplasma phagocytophilum↗
PubMed2003

The repair of direct composite restorations: an international survey of the teaching of operative techniques and materials.

This article reports the findings of a study on the aspects of the teaching of repair as a conservative alternative to the replacement of failing direct composite restorations (DCRs) in primary dental degree curricula in the UK and Ireland, Germany and Scandinavia. Data on teaching, including operative techniques applied in the repair of DCRs, were collected by means of a questionnaire sent to 58 dental schools in the surveyed countries. Based on the overall response rate of 83%, the findings indicate that the majority (59%) of the schools in the countries surveyed may be found to teach the repair of DCRs. However, marked variations were observed in respect of this teaching and the expected longevity of repaired DCRs. Where the repair of DCRs was not taught, views differed as to the intentions, if any, to include this teaching in the curriculum. It is concluded that the teaching of DCRs may be found to be widespread in dental schools in the UK and Ireland, Germany and Scandinavia, with this teaching being subjected to considerable variation within and between countries.

Composite Resins↗
PubMed2001

International prevalences of reported food allergies and intolerances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991-1994.

OBJECTIVE: The aim of this study was to report the prevalence, type and reported symptoms associated with food intolerance. DESIGN: A cross-sectional epidemiological study involving 15 countries using standardized methodology. Participants answered a detailed interviewer-administered questionnaire and took part in blood, lung function and skin prick tests to common aeroallergens. SETTING: Randomly selected adults who took part in the second phase of the European Community Respiratory Health Survey (ECRHS). SUBJECTS: The subjects were 17280 adults aged 20-44 y. RESULTS: Twelve percent of respondents reported food allergy/intolerance (range 4.6% in Spain to 19.1% in Australia). Atopic females who had wheezed in the past 12 months, ever had asthma or were currently taking oral asthma medications were significantly more likely to report food allergy/intolerance. Participants from Scandinavia or Germany were significantly more likely than those from Spain to report food allergy/intolerance. Respondents who reported breathlessness as a food-related symptom were more likely to have wheezed in the past 12 months, to have asthma, use oral asthma medications, be atopic, have bronchial hyperreactivity, be older and reside in Scandinavia. CONCLUSION: Self-reported food allergy/intolerance differed significantly across multiple countries. The reasons for these differences were not explored in this study, but are likely to be largely due to cultural differences.

Adult↗
PubMed2003

Genetic variation in caribou and reindeer (Rangifer tarandus).

Genetic variation at seven microsatellite DNA loci was quantified in 19 herds of wild caribou and domestic reindeer (Rangifer tarandus) from North America, Scandinavia and Russia. There is an average of 2.0-6.6 alleles per locus and observed individual heterozygosity of 0.33-0.50 in most herds. A herd on Svalbard Island, Scandinavia, is an exception, with relatively few alleles and low heterozygosity. The Central Arctic, Western Arctic and Porcupine River caribou herds in Alaska have similar allele frequencies and comprise one breeding population. Domestic reindeer in Alaska originated from transplants from Siberia, Russia, more than 100 years ago. Reindeer in Alaska and Siberia have different allele frequencies at several loci, but a relatively low level of genetic differentiation. Wild caribou and domestic reindeer in Alaska have significantly different allele frequencies at the seven loci, indicating that gene flow between reindeer and caribou in Alaska has been limited.

Animals↗
PubMed2001

Population structure and genetic diversity of the amphiatlantic haploid peatmoss Sphagnum affine (Sphagnopsida).

Nineteen populations of Sphagnum affine were included in a study of genetic diversity and structure in fragmented and less fragmented landscapes, and differentiation at intercontinental and three regional levels. Isozyme electrophoresis of eight enzyme systems revealed 12 variable loci, which could be used for haplotype identification. A hierachical analysis of variance (AMOVA) revealed no significant intercontinental differentiation, and very limited differentiation among European regions. A trend of decreasing diversity with increasing latitude was apparent. Gametic phase disequilibria was high, suggesting nonrandom mating and regionally high incidences of inbreeding. The partitioning of genetic variation within and among populations in each region varied among regions, the northernmost populations having 86% of the total variation among populations, the southernmost in Scandinavia having 25% of the variation among populations, whereas the American populations displayed 89% of the variation within populations. Fifteen alleles at eight loci occurred in the U.S.A. which were not encountered in Europe, whereas only three European alleles at one locus in three populations were not encountered in U.S.A. The differences in diversity between North America and Europe may result from loss of genetic diversity caused by founder effects during postglacial recolonization of northern Europe. In Europe, the main mountain ranges extend E-W, posing severe barriers to northwards migration of lowland species, compared to the N-S trend of mountain ranges in North America. The decline in genetic diversity and increase in population differentiation and gametic phase disequilibria towards the north in Scandinavia may be caused by a series of founder effects during postglacial migration. These may have corresponded to minor climatic oscillations that influenced the migration front/leading edge in the suboceanic lowlands of Norway. According to this model random genetic drift will be an increasingly important structuring factor with latitude.

Analysis of Variance↗
PubMed1999

Preclinical endodontology: an international comparison.

AIM: The aim of this study was to compare preclinical endodontic teaching in Europe, Scandinavia and North America, and to place recent UK data in an international context. METHODOLOGY: A postal questionnaire was sent to all undergraduate dental schools in North America, Scandinavia, and Europe. Data were requested on a range of issues relating to endodontic teaching. RESULTS: Forty-three percent of the 170 schools surveyed returned completed questionnaires. There was considerable international consensus on the content of preclinical courses, with most schools advocating preflaring canal preparation techniques, sodium hypochlorite for irrigation, and cold lateral condensation as the standard obturation method. There was little consensus on the standard use of intracanal medicaments, though calcium hydroxide was universally popular. The practice of single visit treatment was advocated by at least 70% of schools in all geographical areas. A number of innovations appear to be gaining acceptance in preclinical teaching, with more than 20% of schools teaching the use of electronic apex locators, and a quarter of Western European, Scandinavian and North American schools embracing nickel-titanium instrumentation. Regional differences in the priority and resource given to endodontic teaching were striking. On average, UK schools had the worst staff:student ratios for preclinical endodontic teaching, and allocated substantially less time allocation for this teaching compared with Western European, Scandinavian and North American schools. CONCLUSIONS: It was concluded that although teachers in the UK were broadly advocating techniques recommended elsewhere, the academic infrastructure and priority given for endodontic teaching in the UK was limited in the international context. This may have some impact on the quality of endodontic provision within the UK General Dental Services.

Curriculum↗
PubMed2000

Nuclear DNA microsatellite analysis of genetic diversity and gene flow in the Scandinavian brown bear (Ursus arctos).

In the 1930s, the Scandinavian brown bear was close to extinction due to vigorous extermination programmes in Norway and Sweden. Increased protection of the brown bear in Scandinavia has resulted in the recovery of four subpopulations, which currently contain close to 1000 individuals. Effective conservation and management of the Scandinavian brown bear requires knowledge of the current levels of genetic diversity and gene flow among the four subpopulations. Earlier studies of mitochondrial DNA (mtDNA) diversity revealed extremely low levels of genetic variation, and population structure that grouped the three northern subpopulations in one genetic clade and the southernmost subpopulation in a second highly divergent clade. In this study, we extended the analysis of genetic diversity and gene flow in the Scandinavian brown bear using data from 19 nuclear DNA microsatellite loci. Results from the nuclear loci were strikingly different than the mtDNA results. Genetic diversity levels in the four subpopulations were equivalent to diversity levels in nonbottlenecked populations from North America, and significantly higher than levels in other bottlenecked and isolated brown bear populations. Gene flow levels between subpopulations ranged from low to moderate and were correlated with geographical distance. The substantial difference in results obtained using mtDNA and nuclear DNA markers stresses the importance of collecting data from both types of genetic markers before interpreting data and making recommendations for the conservation and management of natural populations. Based on the results from the mtDNA and nuclear DNA data sets, we propose one evolutionarily significant unit and four management units for the brown bear in Scandinavia.

Animals↗
PubMed2001

Genetic variation and population structure in Scandinavian wolverine (Gulo gulo) populations.

Wolverine (Gulo gulo) numbers in Scandinavia were significantly reduced during the early part of the century as a result of predator removal programmes and hunting. Protective legislation in both Sweden and Norway in the 1960s and 1970s has now resulted in increased wolverine densities in Scandinavia. We report here the development of 15 polymorphic microsatellite markers in wolverine and their use to examine the population sub-structure and genetic variability in free-ranging Scandinavian wolverine populations as well as in a sample of individuals collected before 1970. Significant subdivision between extant populations was discovered, in particular for the small and isolated population of southern Norway, which represents a recent recolonization. Overall genetic variability was found to be lower than previously reported for other mustelids, with only two to five alleles per locus and observed heterozygosities (H(O)) ranging from 0.269 to 0.376 across the examined populations, being lowest in southern Norway. Analysis of the mitochondrial DNA control region revealed no variation throughout the surveyed populations. As the historical sample did not show higher levels of genetic variability, our results are consistent with a reduction in the genetic variation in Scandinavian wolverines that pre-dates the demographic bottleneck observed during the last century. The observed subdivision between populations calls for management caution when issuing harvest quotas, especially for the geographically isolated south Norwegian population.

Animals↗