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PubMed2003

What can morphology and isozymes tell us about the history of the Dryas integrifolia-octopetala complex?

An earlier study of the morphological variation in the circumpolar genus Dryas in Greenland revealed that populations in east Greenland are highly variable and this variation was interpreted as a hybrid zone between D. octopetala and D. integrifolia. It was proposed that populations of Dryas in east Greenland immigrated postglacially from Svalbard. The purpose of our study was to investigate the population structure of the Dryas integrifolia-octopetala complex using a combination of morphological and genetic characters. Populations of Dryas were sampled in Greenland, Svalbard, Iceland and north Scandinavia (Sweden). The morphological traits clearly separated west Greenland from Svalbard, Iceland and north Scandinavia. A large number of individuals from east Greenland and some from north Greenland could be interpreted as hybrids between the morphs. The genetic pattern was, however, partly different as the greatest amount of differentiation among regions was found between west and north Greenland (FRT = 0.65). The highest degree of genetic variation appeared within east Greenland. This was in accordance with the putative hybrid origin of the populations, as concluded based on the morphological results. The total amount of genetic differentiation found among the six regions (FRT = 0.61) was larger than between the two species (FRT = 0.44). The genetic pattern matched the proposed postglacial migration routes.

Climate↗
PubMed2003

Cryptic population structure in a large, mobile mammalian predator: the Scandinavian lynx.

The Eurasian lynx (Lynx lynx) is an example of a species that has gone through a severe bottleneck, leading to near extinction in Scandinavia around 1930-- a pattern shared with several other large carnivorous mammals. Here we extend previous genetic analyses of northern European lynx, confirming that lynx from the Scandinavian Peninsula represent a distinct clade differing clearly from European conspecifics. Furthermore, and despite a recent bottleneck and subsequent range expansion, we detect marked genetic differentiation within Scandinavia. This differentiation is largely manifested as a north-south gradient, with a linear increase in the quantity FST/(1 - FST). Aided by computer simulations we find that this pattern is unlikely to have arisen by random genetic drift in the short time since lynx started to expand in the 1950s, suggesting that the spatial structure may predate the bottleneck. Individual-based analyses indicate that, instead of a continuous gradient, Scandinavian lynx may be structured into three more or less distinct groups, possibly corresponding to northern, central and southern subpopulations. The presence of such structuring was unknown previously and was unexpected from general considerations on the mobility of the species, historical data and the absence of geographical barriers. Our study demonstrates how molecular markers may be used to detect cryptic population structure, invisible using traditional methods.

Animals↗
PubMed2001

Marchiafava-Bignami disease: two cases with favourable outcome.

Marchiafava-Bignami disease (MBD) is a rare disorder of an unknown aetiology but strongly associated with alcoholism. MBD primarily affects the corpus callosum leading to confusion, dysarthria, seizures and frequently to death. Over 250 cases from all races and from almost all nationalities have been reported, most cases being alcoholics. We report two cases with a favourable outcome. Magnetic resonance imaging (MRI) demonstrated a typical lesion of the corpus callosum, in both patients. The patients, a 44-year-old male and a 40-year-old female, presented with depressed consciousness and a variety of other symptoms, but finally made a reasonably good recovery leading to home discharge. To the best of our knowledge, only one additional case of MBD from Scandinavia has been published. As alcoholism is a major public health problem in Scandinavia, we assume that MBD is underdiagnosed and/or under-reported. Non-specific general symptoms and encephalopathy in an alcoholic may harbour undiagnosed MBD. We suggest that the incidence of MBD may be higher and its prognosis may be milder than generally believed.

Adult↗
PubMed2001

Correlation between 8-methoxypsoralen bath-water concentration and photosensitivity in bath-PUVA treatment.

BACKGROUND: Bath-PUVA treatment, originally established in Scandinavia, offers several advantages over oral PUVA and has become increasingly popular in recent years. Outside Scandinavia 8-methoxypsoralen (8-MOP) is the prevailing photosensitizer for this PUVA modality and is used arbitrarily in a wide range of concentrations. Up to the present, data are lacking on the impact of 8-MOP bath-water concentration on UVA dosimetry. OBJECTIVE: We investigated the influence of increasing 8-MOP bath-water concentrations on photosensitivity in bath-PUVA treatment. METHODS: Fifteen healthy volunteers without abnormal photosensitivity or recent exposure to ultraviolet radiation were included in an intraindividually controlled comparison study. In all volunteers the minimal phototoxic dose (MPD) was determined on the volar side of their forearms after immersion for 20 minutes in 4 different 8-MOP bath-water concentrations (0.5, 1, 2.5, and 5 mg/L). The correlation between 8-MOP concentration and photosensitivity (defined as the reciprocal value of the MPD) was analyzed by linear regression analysis. In addition, the time course of erythema formation and the UVA dose-erythema response curve was assessed for each psoralen concentration. RESULTS: The median MPD and the 25%-75% interquartile were 5.7 J/cm(2) (5.7-8), 4 J/cm(2) (4-5.7), 2.8 J/cm(2) (2.8-5.7), and 2 J/cm(2) (2-2.8) at an 8-MOP concentration of 0.5, 1, 2.5, and 5 mg/L, respectively. Linear regression analysis revealed a significant correlation between 8-MOP bath-water concentration and photosensitivity (r = 0.98; P =.019). Bath-PUVA-induced erythema peaked after a median time interval of 3 days, with a range of 2 to 4 days. The slope of the UVA dose-erythema response curve was similar for all psoralen concentrations. CONCLUSION: UVA dose requirements in bath-PUVA treatment decrease linearly with increasing 8-MOP concentrations. A single MPD assessment at 72 hours after the UVA exposure is inappropriate for accurate determination of the patients' photosensitivity. The hazard of wrong UVA dosimetry is comparable at all psoralen concentrations.

Adult↗
PubMed1999

Therapy and diagnostic tests used for Helicobacter pylori infection in the Scandinavian countries in 1998.

BACKGROUND: We wanted to ascertain how Helicobacter pylori infection is managed in Scandinavia. METHODS: A one-page questionnaire with seven questions was mailed in April 1998 to 1718 gastroenterologists in Finland, Denmark, Norway, and Sweden (excluding Swedish surgeons). RESULTS: The questionnaire was returned by 36%. Antimicrobials were used by 99% for peptic ulcer associated with H. pylori, by 67% for mucosa-associated lymphoid tissue lymphoma, by 27% before long-term therapy with a proton-pump inhibitor (PPI), by 16% for non-ulcer dyspepsia, by 11% for reflux disease, and by 11% for other indications. In Finland several conditions other than ulcer were treated more frequently than in the other countries. The commonest primary therapy is PPI triple therapy (94%), followed by bismuth-based (11%), 'other' (2%), and PPI dual therapy (0.2%). Primary bismuth-based therapy was almost completely limited to Norway. The commonest secondary therapy for failures was also PPI triple therapy (71%), followed by bismuth-based (41%), 'other' (10%), and PPI dual therapy (1%). Clarithromycin for primary therapy was used much less frequently in Finland than in the other countries. Follow-up to ascertain whether eradication is successful was done always or often by 90% in Finland, 63% in Norway, 62% in Sweden, and 21% in Denmark and by 61% of the internists and 42% of the surgeons. The commonest method to confirm eradication was gastroscopy (69%), followed by the breath test (52%) and serology (11%). CONCLUSIONS: In Scandinavia H. pylori associated with peptic ulcer disease is treated with antimicrobials by virtually all gastroenterologists. PPI triple therapy is the commonest regimen for primary and secondary eradication. PPI dual therapy has essentially disappeared. Fifty-four per cent confirm eradication always or often, with gastroscopy being the commonest method.

Antacids↗
PubMed1999

Deletions of the heavy neurofilament subunit tail in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron degeneration resulting in paralysis and death, usually within 3 years of onset. Pathological and animal studies implicate neurofilament involvement in ALS, but whether this is primary or secondary is not clear. The heavy neurofilament subunit (NFH) tail is composed of a repeating amino acid motif, usually X-lysine-serine-proline-Y-lysine (XKSPYK), where X is a single amino acid and Y is one to three amino acids. There are two common polymorphic variants of 44 or 45 repeats. The tail probably regulates axonal calibre, with interfilament spacing determined by phosphorylation of the KSP motifs. A previous study suggested an association between sporadic cases of ALS and NFH tail deletions, but two subsequent studies have found none. We have analysed samples from two different populations (UK 207, Scandinavia 323) with age-matched controls for each group (UK 219, Scandinavia 228) and have found four novel NFH tail deletions, each involving a whole motif. These were found in three patients with sporadic ALS and a family with autosomal dominant ALS, although another was also found in two young controls. In all cases motif deletions were only associated with disease when paired with the long NFH allele. The deletions all occurred within a small region of the NFH tail. This has allowed us to propose a structural organization of the tail as well as allowing observed deletions both from this study and previous reports to be organized into logical groups. These results strongly suggest that NFH motif deletions can be a primary event in ALS but that they are not common.

Adult↗
PubMed2002

A fusidic acid-resistant clone of Staphylococcus aureus associated with impetigo bullosa is spreading in Norway.

OBJECTIVE: To investigate the possibility that the increased prevalence of fusidic acid-resistant Staphylococcus aureus in Norway is caused by clonal spread. METHODS: Fusidic acid-resistant and -susceptible clinical isolates of S. aureus from patients with skin infections in the Norwegian county of Telemark and fusidic acid-resistant isolates from other parts of Scandinavia were compared. MICs of fusidic acid for bacterial isolates and pulsed-field gel electrophoresis (PFGE) patterns were investigated. Prevalence data for fusidic acid-resistant S. aureus for the period 1992-2001 were obtained. RESULTS: The prevalence of fusidic acid resistance in S. aureus increased from 1992 to 2001. Eighty per cent of the resistant isolates investigated shared an identical PFGE pattern. The same pattern was found in fusidic acid-resistant isolates from other parts of Scandinavia. Fusidic acid-resistant S. aureus was typically found in impetigo bullosa-like skin disease in children mostly in the summer months. CONCLUSIONS: Fusidic acid resistance among S. aureus is increasing in Norway and is predominantly caused by one clone of S. aureus. The clone may spread further to other countries, and dissemination may be facilitated by extensive use of topical fusidic acid.

Clone Cells↗
PubMed2005

Ultraviolet radiation and the risks of cutaneous malignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and American adolescents.

The highest prevalence rates of skin malignancy in the northern hemisphere occur in Scandinavia and the United States (USA). Most Danes and Americans receive 50% of their lifetime ultraviolet (UV) radiation before the age of 21, making it important to address sun exposure risks with adolescents. The project was undertaken to determine differences between Danish and American adolescents in knowledge of sun exposure and skin malignancy, activities accounting for sun exposure, and means used for sun protection. Questionnaires regarding skin cancer and sun exposure were distributed to 674 secondary school age students in Hilleroed, Denmark, and to 483 similarly aged students in Winston-Salem, North Carolina, USA. Differences in responses between and within groups were compared. American adolescents had more knowledge of the characteristics and malignant potential of melanoma than did Danish adolescents. Danish youth and females from both countries were significantly more likely to engage in sunbathing and tanning bed use. Black Danish students reported significantly more sunburn and were more likely to sunbathe or use a tanning bed than were black American students. Danish students were more likely than Americans to use sunscreen, however, Americans were more likely to apply sun protective factor (SPF) 15 or greater. In conclusion, given that sunbathing and tanning bed use are associated with the development of precancerous lesions and skin malignancy, Danish teens are at increased risk. The rates of skin malignancy are relatively high in Scandinavia and efforts to improve understanding of exposure and cancer risks should be undertaken in adolescents.

Adolescent↗
PubMed1984

Evaluation and consequences of teaching competence: Scandinavian developments.

Provision of health care, research and teaching are three major activities common to all medical schools. In spite of the fact that most medical schools emphasize the importance of basic education in their programme, both teachers and students point out that in reality teaching ability and experience are of little significance when academic positions are filled. A common objection to attaching a higher value to teaching competence is that teaching skills cannot be systematically and reliably evaluated. However, experience throughout the world shows that there are various methods of evaluating and considering teaching ability. Activities initiated in Scandinavia highlight concrete methods of considering the qualitative aspects of teaching skills with the basic point of view that there are great similarities between the processes of evaluating scientific and teaching competence. In this article the results of a survey of medical schools in Scandinavia on the relative importance of scientific and teaching merit are reported. Subsequent developments are provided from a task force working under the auspices of the Nordic Federation for Medical Education as well as from the Karolinska Institute in Stockholm. Suggestions are included for evaluation of teaching skills, including qualitative and subjective considerations. Arguments for increasing the value accorded to such skills are advanced and discussed.

Education, Medical, Undergraduate↗
PubMed2006

Divergence and diversity: lessons from an arctic-alpine distribution (Pardosa saltuaria group, Lycosidae).

The relationship of interpopulation genetic divergence and within-population diversity has been studied for many temperate species in Europe, but not for the cold-adapted fauna. Here we present the first European-wide phylogeographical study of an arctic-alpine distribution in invertebrates, focusing on wolf spiders of the Pardosa saltuaria group. One hundred twenty-seven (127) specimens from 14 populations were examined. Within Europe, these populations were distributed among six high mountain ranges and Scandinavia. We sequenced the whole 921 base pair mitochondrial (mt) ND1 gene. The resulting 55 unique haplotypes form three monophyletic phylogroups of deep divergence: a Pyrenean, a Balkan and a 'northern' clade. Genetic distances (3.6-4.0%) between the major clades indicate that the arctic-alpine range disjunction was initiated by vicariance events, which precede the four major Alpine glaciations. However, low divergence and incomplete lineage sorting within the 'northern clade' suggest a late Pleistocene separation of the Alpine, Scandinavian, Carpathian and Sudetian populations. Thus, we provide evidence for a multiglacial origin of arctic-alpine distributions in Europe, i.e. the current disjunction results from range fragmentation in several glacial cycles. The pattern of genetic diversity within populations seems predominantly determined by historical factors, but is modified by contemporary aspects. Overall, diversity and divergence are negatively correlated. We suggest that low diversity values might result from (i) ancient bottlenecking during warm interglacial periods, as seen in the Pyrenees and Balkans; (ii) recent bottlenecking in small modern areas, as seen in the Giant Mountains and Bohemian Forest; and (iii) dispersal bottlenecking in northern Scandinavia.

Animals↗
PubMed1975

Renal transplantation and cancer. The Scandia transplant material.

Between 1965 and 1973, 30 malignant tumours were found in patients transplanted in Scandinavia. Of these tumours, 24 were found in the 1,254 patients transplanted in Scandinavia as part of the Scandia Tranplant Programme between 1969 and 1972. Using the information recorded in the programme, 418 Danish patients who received their first and only transplant between 1969 and 1972 were selected and followed until 31/12 1973. Twelve tumours occurred in these patients. A comparison with the expected age, sex and time-specific incidence rates from the Danish Cancer Register was made and the observed tumour incidence was found to be significantly (P less than 0.001) greater than expected. Tumour incidence was found to be associated with incompatibility in the FOUR series, but was unrelated to number of rejections, the presence of HL-A antibodies and sex difference between donor and recipient. Apart from certain special forms of immunosuppression which could be oncogenic, the cause of tumour development appears to be multifactorial, both the allograft itself and immunosuppressive treatment playing a role.

Adolescent↗
PubMed1988

Transfusion transmitted human T-lymphotropic virus infections.

Human immunodeficiency virus (HIV) type 1 has emerged during the 1980s as an important transfusion transmitted agent. The impact of HIV depends on the epidemiology and characteristics of the virus, serological response to infection and efficacy of serological tests to identify infected blood units. These factors will be described in the present article. The risk to acquire HIV today, by transfusion of anti-HIV screened blood, is extremely small in Scandinavia and the Western world. The risk can be further minimized by more sensitive screening tests and an improved donor information. The epidemiology in Scandinavia of other members of the human T-lymphotrophic viruses, HTLV-1 and HIV-2, has to be further investigated.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Biological UV-doses and the effect of an ozone layer depletion.

Effective UV-doses were calculated based on the integrated product of the biological action spectrum (the one proposed by IEC, which extends to 400 nm, was adopted) and the spectral irradiance. The calculations include absorption and scattering of UV-radiation in the atmosphere, both for normal ozone conditions as well as for a depleted ozone layer. For Scandinavian latitudes the effective annual UV-dose increases by approximately 4% per degrees of latitude towards the Equator. An ozone depletion of one percent increases the annual UV-dose by approximately 1% at 60 degrees N (increases slightly at lower latitudes). A large depletion of 50% over Scandinavia (60 degrees N) would give these countries an effective UV-dose similar to that obtained, with normal ozone conditions, at a latitude of 40 degrees N (California or the Mediterranean countries). The Antarctic ozone hole increases the annual UV-dose by 20 to 25% which is a similar increase as that attained by moving 5 to 6 degrees of latitude nearer the Equator. The annual UV-dose at higher latitudes is mainly determined by the summer values of ozone. Both the ozone values and the effective UV-doses vary from one year to another (within +/- 4%). No positive or negative trend is observed for Scandinavia from 1978 to 1988.

Ozone↗
PubMed2006

Prevalence of xerostomia in population-based samples: a systematic review.

The consequences of xerostomia on oral health have been studied for decades; however, the actual prevalence of this disorder on the general population remains controversial. The purpose of this systematic review was to determine the prevalence of xerostomia in population-based samples. Electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. Thirteen articles meeting the final inclusion criteria were identified. Based on the definition of xerostomia used in this review, only publications including a subjective diagnosis of the disorder were included. All of the self-reported diagnoses were achieved through a questionnaire either by mail, telephone, interview or self-administered by the patient. There was a variation across papers regarding number and content of the questions as well as guidelines for the diagnosis of xerostomia (i.e. answer yes to one or more than one question). The prevalence of xerostomia in the selected articles ranged from 0.9% to 64.8%. The majority of these studies were performed in Scandinavia. In 9 of the articles, the studied samples were 50 years and older. None of the studies evaluated the prevalence xerostomia among individuals younger than 18 years. Based on these observations, it can be concluded that there is a need for population-based studies on prevalence of xerostomia in regions other than Scandinavia. A standardized protocol to diagnose xerostomia needs to be developed. Patient-perceived treatment needs and impact on quality of life should be included to have a complete picture of public health implications of the disease.

Age Distribution↗
PubMed1997

Serological diagnosis of hantavirus infections by an enzyme-linked immunosorbent assay based on detection of immunoglobulin G and M responses to recombinant nucleocapsid proteins of five viral serotypes.

Worldwide, hantaviruses cause more than 100,000 human infections annually. Rapid and accurate methods are important both in monitoring acute infections and for epidemiological studies. We and others have shown that the amino termini of hantavirus nucleocapsid proteins (Ns) are sensitive tools for the detection of specific antibodies in hantavirus disease. Accordingly, we expressed truncated Ns (amino acids 1 to 117) in Escherichia coli from the five hantaviruses known to be pathogenic to man; Hantaan (HTN), Seoul (SEO), Dobrava (DOB), Sin Nombre (SN), and Puumala (PUU) viruses. In order to obtain pure antigens for use in an enzyme-linked immunosorbent assay (ELISA), the recombinant proteins were purified by polyhistidine-metal chelate affinity chromatography. Polyclonal animal antisera and a panel of serum specimens from hantavirus-infected individuals from Scandinavia, Slovenia, Russia, Korea, China, and the United States were used to evaluate the usefulness of the method. With both human and animal sera, it was possible to designate the antibody response into two groups: those with HTN, SEO, and DOB virus reactivity on the one hand and those with SN and PUU virus reactivity on the other. In sera from Scandinavia, European Russia, and the United States, the antibody response was directed mainly to the PUU and SN virus group. The sera from Asia reacted almost exclusively with the HTN, SEO, and DOB types of viruses. This was true for both the immunoglobulin M (IgM) and IgG antibody responses, indicating that this type of discrimination can be done during the acute phase of hantavirus infections. Both the HTN, SEO, and DOB virus and the PUU and SN virus types of antibody response patterns were found in patients from the Balkan region (Solvenia).

Animals↗
PubMed1984

Permissible starting age for drinking in four Scandinavian countries.

Data on the age at which it is considered permissible to start drinking alcoholic beverages in Finland, Iceland, Norway and Sweden with peers and with family are analyzed and compared with similar data from California, Mexico, the Netherlands, Ontario, Scotland and Zambia. Of the Swedish population, 63% felt that drinking should be permitted for a 16-year-old girl whereas only 5% of the Zambian population felt similarly. The egalitarian sex norms in industrial countries contrast with the normative expectations in Zambia and Mexico, where the sex of the drinker has a considerable impact on the responses. By international comparison, the current norms about drinking by youth in Scandinavia are quite permissive. This permissiveness is of recent origin, and older age groups are still much less permissive. The normative distance between drinking with peers and with the family is used as an indicator of the integration of drinking with family life. Compared with older respondents, younger respondents accept drinking with the family at a clearly lower age than drinking with peers. Drinking per se is no longer associated with independence, and alcoholic beverages may be becoming culturally integrated with family life in Scandinavia.

Adult↗
PubMed1990

Sex and cultural differences in lefthandedness.

Sex differences are presented for the students of architecture and music, and the distribution of sex in the tested sample, and the population is discussed. The results are related to other studies in Scandinavia, which give comparable results. A genetic/cultural model is used to discuss the differences between results from Scandinavia, USA, and other parts of the world.

Adult↗
PubMed1991

Optimal treatment of hip fractures.

At the orthopedic departments in Sweden, the hip fracture patients continuously occupy up to one third of the bed resources. Hip fractures in Sweden consume more hospital days than all the cancer patients together. In the middle of the 1980s, the annual number of hip fractures amounted to 6,500 in Denmark, 4,500 in Finland, 260 in Iceland, 6,000 in Norway and 14,000 in Sweden. The calculated number of hip fractures in the year 2000 is dependent on if the prognosis is based solely on the increasing number of elderly in the population or if also the increasing incidence during the last decades is included. An increase up to the year 2000 of 50-100 percent is prognosticated for Scandinavia. The proportions cervical/trochanteric fractures varies. In Norway and Sweden it is close to 1/1, whereas Iceland and Finland have more cervical than trochanteric fractures. In Iceland, however, trochanteric fractures are increasing. Finally, in all of Scandinavia, 3 out of 4 hip fracture patients are women.

Activities of Daily Living↗