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PubMed1999

[The prevalence of pain in the German population: results of population-based studies with the Giessen Subjective Complaints List (Giessener Beschwerdebogen GBB)].

OBJECTIVE: Pain is one of the most frequent physical complaints worldwide. Empirical data on the prevalence of chronic pain is considerable. However, compared with the large number of epidemiological studies published in North America, Great Britain and particularly in Scandinavia, there has been relatively little equivalent research in Germany to date. METHODS: In two separate population-based cross-sectional studies conducted in 1975 (n=1.597, 18-60 years) and 1994 (n=2.148, 18-60 years) using the Giessen Subjective Complaints List (Giessener Beschwerdebogen GBB), data was collected on current pain in various parts of the body (limbs, back, neck, head, stomach). RESULTS: The frequency scores for pain varied according to localization between 32.4% (stomach pains 1975) and 67.3% (headaches 1994). Between the two measurement dates there was an increase in overall prevalence particularly for pains in the neck, head and limbs. At the same time we found a decrease in the proportion of severe pain symptoms. There were also considerable variations in pain experience according to age and gender: the frequency of pain increases with age (especially in limbs, back and neck). Women register more pain than men (particularly in head and neck), although the influence of gender decreases from 1975 to 1994. There are other sociodemographic variables like marital status, educational level, occupation or living in East/West Germany which influence the pain prevalence. CONCLUSIONS: Pain in differing parts of the body is a serious problem in the German population. However, the prevalence of pain is strongly dependent on sociodemographic factors (especially age, gender and living in East/West Germany), the localization of pain in the body and the grading of pain. Future epidemiological research should take these differential aspects into account.

English Abstract↗
PubMed2006

Changes in stomatal conductance and net photosynthesis during phenological development in spring wheat: implications for gas exchange modelling.

Gas exchange was measured from 1 month before the onset of anthesis until the end of grain filling in field-grown spring wheat, Triticum aestivum L., cv. Vinjett, in southern Sweden. Two g ( s ) models were parameterised using these data: one Jarvis-type multiplicative g ( s ) model (J-model), and one combined stomatal-photosynthesis model (L-model). In addition, the multiplicative g ( s ) model parameterisation for wheat used within the European Monitoring and Evaluation Programme (EMEP-model) was tested and evaluated. The J-model performed well (R (2)=0.77), with no systematic pattern of the residuals plotted against the driving variables. The L-model explained a larger proportion of the variation in g ( s ) data when observations of A (n) were used as input data (R (2)=0.71) compared to when A (n) was modelled (R (2)=0.53). In both cases there was a systematic model failure, with g (s) being over- and underestimated before and after anthesis, respectively. This pattern was caused by the non-parallel changes in g ( s ) and A (n) during plant phenological development, with A (n) both peaking and starting to decline earlier as compared to g ( s ). The EMEP-model accounted for 41% of the variation in g ( s ) data, with g ( s ) being underestimated after anthesis. We conclude that, under the climatic conditions prevailing in southern Scandinavia, the performance of the combined stomatal-photosynthesis approach is hampered by the non-parallel changes in g ( s ) and A (n), and that the phenology function of the EMEP-model, having a sharp local maximum at anthesis, should be replaced by a function with a broad non-limiting period after anthesis.

Carbon Dioxide↗
PubMed2001

Incidence of respiratory syncytial virus-positive hospitalizations in Germany.

Epidemiological data, especially population-based data, on respiratory syncytial virus (RSV)-related hospitalizations in Germany have been lacking to date. Since Palivizumab (Synagis, Abbott, USA) is already available and new vaccines for active immunization are under development, these data are urgently needed. From July 1996 to June 1999, nasopharyngeal aspirates of children hospitalized in Kiel with an acute respiratory tract infection were tested by multiplex reverse transcriptase polymerase chain reaction. Of 1,241 patients, 150 (12.1%) were RSV positive. RSV was the predominant pathogen detected through the end of the second year. In 37 (25%) children an underlying condition was present. For the city of Kiel and close surroundings, the cumulative incidence of RSV-positive hospitalizations in infants was 1,214/10(5) (725/10(5) in children less than 2 years). For those children less than 2 years old born with a gestational age of less than 32 weeks or 32-37 weeks, the cumulative incidence was 2,025/10(5) and 1,202/10(5), respectively (dose-effect response). For the group less than 32 weeks of age, bronchopulmonary dysplasia (BPD) as an underlying condition carried a relative risk of 17.8. The RSV season began between the end of September and January and ended between March and July. The population-based incidence of RSV-positive hospitalizations in Kiel is close to that reported from the UK and Scandinavia. Throughout Germany, approximately 10.000 RSV-related hospitalizations in infants can be expected annually. Prematurity is an effect modifier and BPD a strong risk factor for RSV-positive hospitalization in population-based studies. There is considerable variation in the start and end of the yearly epidemic.

Acute Disease↗
PubMed2004

[How dangerous are patients with mental disorders?].

The question of potential violence on the part of people with a mental disease has caused considerable controversy in recent decades. While in the eighties the prevailing opinion was that they have no increased risk of aggression, recent studies, especially from Scandinavia and Canada, show a moderate but reliable coherence between violent crime and paranoid and schizophrenic diseases. The danger of people with a mental disease is assessed essentially through the following five study-approaches: Studies to assess the criminal rate of hospitalised patients, the prevalence of mental disorder, studies on prisoners who are committed to a psychiatric facility, and long-term analyses of cohorts. Special emphasis is attached to investigations on homicides. Other investigative questions are concerned with the influence of psychopathological symptoms, the importance of comorbid disturbances and sociological aspects. The studies agree that the risk of violence is decisively increased in people who suffer from schizophrenia, through additional substance abuse, comorbidity with personality disorders, absence of treatment and social desintegration. An unprejudiced approach to this sensitive theme of aggression in people with schizophrenia with regard to further effective prevention and therapy is required.

Aggression↗
PubMed2005

Isolation and metabolite production by Penicillium roqueforti, P. paneum and P. crustosum isolated in Canada.

Penicillium roqueforti, P. crustosum and P. paneum grow on ensiled grain and recycled feed unless properly treated. The former two species occur also on cut lumber in Canada. These are known to produce a number of secondary metabolites including roquefortine. In cooler dairy production areas, including Scandinavia and North America, cattle toxicosis has been associated with silage contaminated by these fungi. We collected strains associated with cow or cattle toxicoses. The principal metabolites were determined making use of a new extraction method and analysis combining HPLC, LC/MS/MS, and LC/NMR. Penicillium roqueforti and P. crustosum required amino acid nitrogen for metabolite formation and their toxins were formed under conditions of low oxygen (20-30% saturation). Production of roquefortine C occurred on depletion of the available nitrogen and penitrem A on depletion of carbon source. Yield was reduced by excess carbon. Medium osmotic tension (aw) affected metabolite production by the two species differently. Penicillium paneum was associated with ill-thrift of dairy cows and P. roqueforti was associated with more serious symptoms. Our data suggest a physiological basis for the common occurrence of roquefortine C in silage without serious consequences and the alternative, the presence of roquefortine C and toxicoses. The strain isolated from lumber was the best producer of the toxins studied. This is the first report of the toxigenic potential of P. roqueforti and P. paneum from Canada.

Animals↗
PubMed2001

Reactive psychosis and other brief psychotic episodes.

Modern classification systems have ignored the reactive psychoses, and little has been published using this concept during the last years. Nevertheless, the term is of interest in clinical practice where its presence is dependent on clinical skills and empathy. It is also important for a general understanding of the development of psychosis. The delineation from other acute psychoses needs clarification. Studies on reliability and validity are promising, but need extension. Traditionally, the concept of reactive psychosis has hardly been used outside Scandinavia, and it is encouraging that interest in brief psychoses seems growing in other cultures as well.

Humans↗
PubMed2003

Meningitis due to multiple-resistant penicillin- and cefotaxime-intermediate Streptococcus pneumoniae in a German child after bone marrow transplantation.

The incidence of infection with penicillin-non-susceptible Streptococcus pneumoniae is increasing rapidly worldwide. Spain and France are highly affected, whereas the level of penicillin resistance in Germany, Italy, The Netherlands and Scandinavia is low. We report a lethal episode of meningitis due to penicillin- and cefotaxime-intermediate S. pneumoniae in a 7-year-old, allogene bone marrow transplanted German boy, 5 weeks after a holiday in Spain. Three days prior to the infection the patient showed good performance status. He was in complete remission without signs of graft-versus-host disease (GVHD). He died on day 341 post bone marrow transplant (BMT), 2 days after the onset of meningitis. Penicillin-non-susceptible S. pneumoniae should be regarded as a potential infectious agent even in countries with a low prevalence of resistance.

Bone Marrow Transplantation↗
PubMed1993

The effect of daytime running lights on crashes between two vehicles in Saskatchewan: a study of a government fleet.

Keeping vehicle lights on to increase vehicle conspicuity during daytime hours has been found to reduce crashes in Scandinavia and the United States. Crashes of vehicles with and without daytime running lights owned by the Central Vehicle Agency of the Province of Saskatchewan were compared to a random selection of crashes drawn from provincial crash files involving vehicles without daytime running lights for the years 1982 through 1989. Daytime two-vehicle crashes involving vehicles approaching from the front or side were reduced by about 28% for the daytime running-light equipped vehicles. A 28% reduction in daytime running-light relevant daytime two-vehicle crashes corresponds to a 15% reduction in all daytime two-vehicle crashes.

Accidents, Traffic↗
PubMed1994

Safety implications of bicycle paths at signalized intersections.

This paper presents a quantitative meta-analysis of studies evaluating, by means of the Bayesian method, the safety effectiveness of different bicycle facilities at road junctions. This is preceded by a discussion of background theories and an up-to-date presentation of today's knowledge of the cyclist's safety at intersections; alternative layouts in Scandinavia, and Sweden in particular, are shown. The project consists of a literature survey as well as interviews with experts and cyclists, and an attempt to weave together these different sources in estimating the effect of a particular layout. In summary, few studies from the Scandinavian countries exist that have treated this area with an acceptable methodology. Combined results, with the Bayesian technique, are therefore presented for only one layout comparison: accident risks for cyclists at signalized intersections with and without a cycle path. The results of this aggregation may be unreliable as well, due to deficiencies in the studies. New field studies should be initiated. The "experts'" prior opinion was that the introduction of the cycle path would, on average, increase the risk by about 20%, while interviewed cyclists considered that a cycle path would decrease the risk by about 20%. The conclusion that can be drawn so far from combining results shows that the most likely effect of introducing a cycle path is that the risk will increase by about 40% for a passing cyclist. The probability that the effect will be the opposite, i.e. that the risk will decrease, is very small (about 2%). These combined results are based primarily on cross-section studies, where the layouts have not been "randomly allotted". It is therefore likely that the risk increase may have been overestimated. The probability that the "real" effect is accident reduction is therefore somewhat greater than 2%. How much greater cannot be estimated from these studies.

Accidents, Traffic↗
PubMed1990

Effects of enalapril and neuroendocrine activation on prognosis in severe congestive heart failure (follow-up of the CONSENSUS trial). CONSENSUS Trial Study Group.

This study enrolled 253 patients with severe heart failure (New York Heart Association functional class IV) from 35 centers in Scandinavia, randomly assigned to treatment with placebo or enalapril, in addition to their usual treatment for heart failure. After an initial titration period, the daily doses of enalapril ranged from 2.5 to 40 mg. At the end of the trial, 46% of the placebo-treated patients and 61% of the enalapril-treated patients were alive (p = 0.003); the survival figures at 8 months after completion of the trial were 32 and 48%, respectively (p = 0.001); and 21 and 30%, respectively (p = 0.006) at the 2-year follow-up. In the placebo group, there was a significant positive association between mortality and baseline levels of norepinephrine, epinephrine, angiotensin II, aldosterone and atrial natriuretic peptide; no such association was found in the enalapril-treated patients. The results suggest that the effects of enalapril on mortality are related to a counteraction of the neuroendocrine activation in general and to the renin-angiotensin system in particular.

Enalapril↗
PubMed1993

Design and baseline results of the Scandinavian Simvastatin Survival Study of patients with stable angina and/or previous myocardial infarction.

The Scandinavian Simvastatin Survival Study is a clinical trial of patients with coronary artery disease (CAD) and mild or moderate hypercholesterolemia. The primary objective is to investigate whether long-term treatment with the serum lipid-lowering agent simvastatin in patients with serum total cholesterol levels between 5.5 and 8.0 mmol/liter (212 to 309 mg/dl) will reduce overall mortality. The secondary objective is to investigate whether simvastatin treatment reduces the incidence of major CAD events (fatal and nonfatal myocardial infarction and sudden death). This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. Patients of both sexes, aged 35 to 69 years, with stable angina pectoris or previous myocardial infarction were recruited at 94 clinical centers throughout Scandinavia. Dietary advice was given to 7,027 patients who were followed for 2 months. Of these, 4,444 met the eligibility criteria and were subsequently randomized to receive simvastatin or similar placebo tablets. The patients will be followed for a minimum of 3 years and until total mortality reaches 440 deaths. This report presents certain design features of this study such as methods of recruitment and follow-up of patients, adjustment procedures for the test drug dose, sample size and power calculations, and organization of the study. Baseline results are summarized and ethical aspects of the study are also discussed.

Adult↗
PubMed1985

The prevalence and the etiology of the initial dummy- and finger-sucking habit.

The prevalence of dummy- and finger-sucking habits, or malocclusions of the type that may be associated with sucking habits, was examined in three different groups: Group A--415 small children from Mnene, Zimbabwe; group B--20 skulls from the Schreiner Collections, Anatomical Institute, Oslo, exhibiting intact deciduous dentitions. The skulls are mainly from the period A.D. 1000 to 1500 and were found in Scandinavia. Group C consisted of 280 young Swedish children. The study indicates that dummy- and finger-sucking habits occur infrequently among the African children other than as a symptom of a disturbance in the normal feeding and/or care in other respects. The investigation of the medieval skull material supports a similar situation among these Scandinavian children. In Sweden most infants are dummy- or finger-suckers. The authors introduce an explanation for the development of the initial sucking habits.

Breast Feeding↗
PubMed1977

Comparative determinations of aminotransferase activities in serum with so-called "optimised" methods.

Comparative determinations of aspartate aminotransferase and alanine aminotransferase activities were made with so-called "optimised" methods introduced in the G.D.R., G.F.R. and Scandinavia. By means of the paired t-test significant differences could be established. These differences are partly due to different reaction conditions. For practical clinical aspects these differences should be of little relevance. In comparison with above-mentioned activites determined at 37 degrees C, aspartate aminotransferase activities measured with the IFCC reference method are lower by about 30 percent.

Alanine Transaminase↗
PubMedDate not supplied

Convergence of American and Scandinavian diagnoses of functional psychoses.

One hundred ninety-nine case summaries of a consecutive sample of functional psychoses, which had been classified by Odegård, were diagnosed independently using DSM-III-R criteria by four experienced psychiatrists. Odegård's classification and DSM-III-R showed high concordance for schizophrenia and affective psychoses. Odegård's concept of reactive psychoses had high concordance with atypical psychoses in DSM-III-R. These findings imply that the results of genetic and follow-up studies from Scandinavia might be relevant for these diagnostic categories in DSM-III-R.

Affective Disorders, Psychotic↗
PubMed1987

Pattern of cadmium contamination in the liver and kidneys of moose and white-tailed deer in Québec.

Samples of moose (N = 431) and white-tailed deer (N = 225) liver and kidneys were collected during the 1985 hunting season from 14 zones south of the 50 degree latitude in Québec. Regional differences in cadmium level in the liver were detected and three homogeneous areas were delineated for each species. Uptake was greater for moose than for deer: in the liver, mean concentrations were 2.9-15.9 mg kg-1 (dry weight) for moose and 0.8-2.6 for deer, depending on the area and sex; in kidneys, means ranged between 31.8-100.5 and 20.9-39.0 mg kg-1, respectively. Female moose had lower levels than bulls. Less affected moose, in eastern Québec, contained cadmium concentrations comparable to the highest values measured in Scandinavia. Cadmium uptake in deer was on the same level or higher than in the United States. Our results indicate a widespread presence of this heavy metal in the environment that may be linked to acid precipitation. We do not recommend consuming wild cervid liver or kidneys in Québec for the moment. Further research is needed on the overall mechanisms involved in the cadmium contamination of the environment and on the actual intake of this metal in the human diet.

Animals↗
PubMed1988

Cadmium levels in Ontario moose and deer in relation to soil sensitivity to acid precipitation.

This study examines the influence of buffering capacity of the soil on the levels of cadmium in the kidney, liver and muscle of moose and white-tailed deer from nine sampling sites (four buffered and five non-buffered) in Ontario, Canada. Tissues collected from hunter-killed moose and deer during 1984 and 1985 were analysed for cadmium. Tissue from moose in the non-buffered Algonquin Park site (21.9 +/- 1.1 mg/kg wet weight) and the buffered St. Joseph Island site (12.7 +/- 3.2 mg kg-1) had the highest mean levels of kidney cadmium compared with other sites sampled in Ontario. The highest mean levels of kidney cadmium in deer were found in the non-buffered Loring site (15.1 +/- 0.8 mg kg-1) adjacent to Algonquin. From all sites, the level of cadmium was highest in kidney, lower in liver and was often undetectable in muscle. Cadmium level increased with animal age (p less than 0.05). Levels of cadmium in Ontario moose from some regions are comparable to those found in Quebec and Manitoba and are considerably higher than those of Maine and Scandinavia. Levels of cadmium in kidneys and livers of white-tailed deer in parts of Ontario are considerably lower than those in Pennsylvania. As a result of this study, the Ontario Ministry of Natural Resources, in consultation with the Ontario Ministry of Health, has recommended that the public not consume kidneys or livers of Ontario moose and deer.

Age Factors↗
PubMed1996

Health implications for Faroe islanders of heavy metals and PCBs from pilot whales.

In the Faroe Islands marine food constitutes a considerable part of the diet. In addition to fish, both meat and blubber from pilot whales are included in the diet. Muscle tissue of pilot whales caught in the Faroe Islands contains an average mercury concentration of 3.3 micrograms/g (16 nmol/g), about half of which is methylmercury. In some years an evenly distributed annual catch of pilot whales would make the average dietary intake of mercury close to an excess of the Provisional Temporary Weekly Intake of 0.3 mg recommended by WHO. In one out of eight consecutive births, the mercury concentration in maternal hair exceeded a limit of 10 micrograms/g where a risk of neurobehavioral dysfunction in the child may occur; the maximum was 39.1 micrograms/g. Mercury concentrations in umbilical cord blood showed a similar distribution with a maximum of 351 micrograms/l. The large variation in mercury exposure is associated with differences in the frequency of whale dinners. The average PCB concentration in pilot whale blubber is very high, i.e. about 30 micrograms/g. With an estimated daily consumption of 7 g of blubber, the average daily PCB intake could therefore exceed 200 micrograms, i.e. close to the Acceptable Daily Intake. In Scandinavia, the average daily PCB intake is about 15-20 micrograms. To obtain an improved scientific basis for public health action, two major prospective studies have been initiated. A birth cohort of 1000 children has been examined at approximately 7 years of age for neurobehavioral dysfunctions associated with prenatal exposure to mercury and PCB. Preliminary analyses of the data show that several neurobehavioral tests are associated with mercury exposure parameters. With emphasis on prenatal exposures to PCB, another cohort has been generated during 1994-95, and this cohort will be followed closely during the next years.

Animals↗
PubMed1992

Descriptive epidemiology of ovarian cancer in Europe.

Trends in ovarian cancer mortality over the period 1955-1989 were analyzed for 25 European countries (excluding the Soviet Union and a few small countries) on the basis of the official death certification data from the World Health Organization database. The overall variation in age-standardized ovarian cancer mortality at all ages declined appreciably, from over 17-fold during the period 1955-1959 (i.e., between 10.5/100,000 in Denmark and 0.6/100,000 in Spain, world standard) to 3.4-fold (i.e., between 9.9/100,000 in Denmark and 2.9/100,000 in Spain) in the late 1980s. When a comparison was made between the late 1950s and the 1980s, ovarian cancer mortality increased in most European countries, except Denmark, Sweden, and Switzerland, where certified mortality was already elevated in the late 1950s, although also in these countries the peak rate around or over 10/100,000 was reached during the 1960s. However, when the changes over the last decade were considered, ovarian cancer mortality trends were downward in all Nordic countries, Germany, Switzerland, Austria, and Czechoslovakia. Mortality was rising somewhat, though to a smaller extent, in Ireland, Britain, and Southern Europe. Trends were more favorable in middle-aged women (35 to 64 years), and, to an even greater extent, in young women (aged 20 to 44), among whom substantial declines, particularly over the last decade, were observed in most European countries, approaching 50% in Britain and Scandinavia. These trends are discussed in terms of changes in risk factor exposure (i.e., trends in average parity and oral contraceptive use), diagnostic and therapeutic improvements, ovariectomy, and changes in case ascertainment and certification.

Adult↗