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PubMed1987

The impact of dietary fat and fiber on intestinal carcinogenesis.

The effect of dietary fiber on intestinal carcinogenesis in animals is controversial. Some find that the addition of wheat bran or cellulose inhibits intestinal cancer in rats, while others report no effect. Such mixed results often are due to differences in the design of experiments. One important aspect in this regard is the amount of fat in the diet. Some fiber supplements inhibit cancer formation when the fat content is normal but not when it is high. However, a recent epidemiological study in Scandinavia showed a lower cancer incidence in a rural population compared with an urban area, in spite of the fact that the dietary fat content was high in both regions. There was a modest difference in the amount of fiber, and this may not have accounted completely for the variation in cancer incidence. Other dietary factors might have added inhibitory response to help overcome the promotional effect of an excessive amount of fat. The interaction among dietary components must be considered when designing animal experiments to assess the effect of fiber on cancer development.

Animals↗
PubMed1991

Rapid diagnosis of hantavirus disease with an IgG-avidity assay.

Nephropathia epidemica (NE), due to Puumala virus, is endemic in eastern Europe and Scandinavia. Serodiagnosis of NE relies on conventional indirect immunofluorescence to detect IgG against Puumala virus. However, in conventional serology, most patients with acute NE have raised but stable non-diagnostic antibody titres. For better serodiagnosis of NE, we have developed a test that measures the avidity (functional affinity) of IgG antibodies against Puumala virus. This new assay was highly specific and sensitive; a diagnosis of NE could be confirmed or excluded rapidly from an early single serum sample. With this test we have now verified the diagnosis of NE in more than 1300 Finnish patients during 22 months in 1989-91. Our findings point to an incidence of confirmed hantavirus disease much higher than previously shown.

Antibodies, Viral↗
PubMed1995

Home application of EMLA cream prior to venipuncture. Is it feasible in pediatric ENT day care surgery?

EMLA (Eutectic Mixture of Local Anaesthetics) cream is an emulsion made from lidocaine and prilocaine. The cream is well known among parents in Scandinavia, and it has become most popular in preventing pain during venipuncture in children. To be fully effective the cream must be applied at least 60 min before the painful stimulus, which is a major drawback in outpatient practice. Could this problem be eliminated by home application of EMLA cream? To answer this we performed a study comprising 228 consecutive patients (1-15 years of age) planned for outpatient surgery. All parents received a letter with detailed information about the procedure and a prescription of EMLA cream. Parents and anaesthesiology nurses answered questionnaires after the operation. Twenty-three children were excluded from the study due to failure in registration or they were called in to fill vacancies. One hundred and eighty out of 205 children had EMLA cream applied. Home application of EMLA cream reduced the waiting time at the ENT outpatient clinic by at least 60 min, and the study showed that home application of EMLA cream is safe, easy to perform and a well-tolerated procedure.

Adolescent↗
PubMed1981

The epidemiology of Paget's disease.

Paget's disease is commoner in men and its prevalence increases with age. It has a remarkable geographical localisation. Britain has the highest recorded prevalence. Somewhat lower rates have been recorded in North America, Australia and Western Europe. The disease is rare in Scandinavia. Within Britain there is a localised area of high prevalence in Lancashire. In North America prevalence is markedly higher in New York than in Atlanta. Rates in American blacks and whites are similar although the disease is rare in Africa. In Australia the prevalence among British born immigrants is intermediate between the British rate and that of native born Australians. There is evidence of a decline in incidence of the disease in Britain and North America. The epidemiological characteristics of the disease suggest that environmental influences are important in its aetiology. They provide data against which new hypotheses on causation must be tested.

Age Factors↗
PubMed1993

Strategies for immunization against hepatitis B in western Europe.

In western Europe there has been a striking decline in the incidence of hepatitis B virus infection during the second half of the 1980s. Only a minor part of this decrease is the effect of vaccination, since rather limited vaccination programmes have been introduced in most west European countries. The policies for recommendation of hepatitis B vaccination have differed from north to south in Europe due to different risks of exposure to hepatitis B virus. In Scandinavia, vaccination has mainly been recommended for health-care workers with frequent blood contact, while in Germany and in France vaccination has been recommended for all health-care workers with patient contact. Further south, as in Italy, all health-care workers have been considered a risk group, and vaccination is recommended for all newly recruited workers and students.

Europe↗
PubMed1995

Overview of epidemiology and disease burden of hepatitis B in the European region.

The European Regional Office of the World Health Organization (WHO) carried out a survey to collect the available surveillance data on hepatitis B and to determine the preventive strategies and policies in 50 countries in the European region. A questionnaire was sent to every country to obtain data on acute hepatitis B incidence over the past five years as well as estimates of the prevalence of hepatitis B carriage and infection in the general population. Although the surveillance systems vary in their methods and completeness, the pattern of disease is clear. In western Europe, rates vary from north to south. Southern countries have incidence rates of about 6 per 100,000 per year whereas northern countries such as Scandinavia, Ireland and the UK have much lower rates of about 1 per 100,000. Central Europe has markedly higher rates of about 20 per 100,000 per year. The highest rates are found in the Central Asian Republics, where the rates are close to 100 per 100,000 per year. Mortality data on cancer liver diseases are also available. These, together with data on the prevalence of hepatitis B in the general population of each country, provide estimates of the number of deaths attributable to hepatitis B for each country. These estimates, in comparison with other preventable causes of death, illustrate the importance of hepatitis B in Europe. Most countries have some form of selective vaccination policy, although the risk groups targeted vary markedly from country to country. Only Albania, Bulgaria, France, Israel, Italy, Portugal and Spain have implemented national universal hepatitis B vaccination programmes.

Europe↗
PubMed1988

Reduction of net photosynthesis in oats after treatment with low concentrations of ozone.

Oats (Avena sativa L. cv Titus) were exposed to low concentrations of O3 in an assimilation chamber system. Net photosynthesis (net CO2 uptake), measured before and after O3 fumigation, showed significantly different responses for leaves of different age. The oldest active leaf was the most sensitive to O3. Net photosynthesis was depressed after 2 h with 0.075 ppm (150 microg m(-3)) O3. For leaves exposed to 0.150 ppm (300 microg m(-3)) O3 for 2 h, net photosynthesis was reduced significantly for 4 h, after which recovery occurred, nearly reaching the preexposure level 19 h after the exposure. Dark respiration was initially more than doubled after exposure to 0.130 ppm (260 microg m(-3)) O3. There was no visible injury after any of the experiments. The results indicate that O3 may cause crop losses through effects on photosynthesis even in Scandinavia, where a typical O3 episode lasts 1 to 2 h, and the concentration seldom exceeds 0.150 ppm.

Journal Article↗
PubMed1991

Contaminant trends in soils and crops.

The evidence for long-term changes in the contaminant content of soils and crops is reviewed. Heavy metals, acidification and trace organic contaminants are each considered separately, with the emphasis placed on changes brought about by inputs from long-term atmospheric deposition. It is argued that effectively all soils in industrialised countries have become contaminated with selected trace substances (notably Pb, Cd, polynuclear aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and -furans) above their true (historical) background level by aerial inputs. In the case of Pb, for example, cumulative deposition inputs over several centuries have probably roughly doubled the Pb burden of contemporary UK surface soils. Despite this, there is little evidence for a concomitant rise in the contaminant content of UK crops through the twentieth century. In fact, the burden of many contaminants in vegetation may well be somewhat lower than in earlier decades of this century because (1) crop composition is strongly influenced by direct deposition onto the above-ground portion of the plant, (2) root uptake and translocation of soil-borne heavy metals and recalcitrant organic contaminants are inefficient processes, and (3) UK air quality has generally improved over the last 10-20 years. Acidification of soils is of considerable regional significance. The evidence for changes in soil pH over this century is reviewed, and it is concluded that atmospheric inputs have enhanced the rate of soil acidification over large areas of Scandinavia and elsewhere.

Journal Article↗
PubMed1991

Factors determining the uptake of persistent pollutants in an eel population (Anguila anguilla L.).

The distribution of persistent pollutants in an eel population from a eutrophic lake of southern Scandinavia was examined. The origin of PCBs, DDT, DDE and lindane found in the fish was most likely the atmosphere. The most important factors for uptake of the chlorinated hydrocarbons was age (exposure time), growth rate and fat content. The life cycle of the eel is unique with a stage in freshwater when energy reserves (fat stored in muscular tissue) and lipophilic pollutants are accumulated. This stage is followed by a long migration to the spawning areas in the Sargasso Sea when pollutants are released from the fat deposits. These two stages followed by a once-in-a-lifetime spawning behaviour, makes the eel especially vulnerable to persistent pollutants. The effects of persistent pollutants combined with the eel's unusual life cycle may explain the decline in the eel population in northern Europe in recent decades.

Journal Article↗
PubMed1995

The risk epidemic in medical journals.

Searches in MEDLINE databases show a rapid increase in the number of articles with the term 'risk(s)' in the title and/or abstract in the period from 1967 to 1991. This trend is found in medical journals giving a general coverage of medicine and journals covering obstetrics and gynaecology in U.S.A., Britain and Scandinavia. The most rapid increase is, however, found in epidemiological journals. Comparisons of the developments in the occurrence of such terms as risk, hazard, danger and uncertainty show that the increasing frequency of the term risk in the medical literature can not be explained as a change in terminology alone. It is hypothesized that the ongoing trend, which resembles an epidemic, is a result of developments in science and technology, that has changed our beliefs about the locus of control from factors outside human control to factors inside our control. The origins of the epidemic may be traced to the development of such disciplines as probability statistics, increased focus on risk management and health promotion, with recent developments in computer technology as the factor responsible for the escalation seen in the past decade. With the cultural selection of risks in mind, the social construction of risk is discussed. Potentially harmful effects of such an epidemic are discussed, exemplified through controversies over current epidemiological risk construction and strategies for coronary risk reduction. It is finally argued that the risk epidemic reflects the social constructions of a particular culture at a particular time in history.

Attitude to Health↗
PubMed1990

Caries in the preschool child: international trends.

Most studies on the prevalence and incidence of dental caries are carried out on schoolchildren and data on preschool children are comparably few. In most of the developing countries in South East Asia, children have a high prevalence of dental caries in the primary dentition, often in contrast to the situation in the permanent dentition. The reasons for this difference are not obvious, but may be linked to differences in diet. In Africa, dental caries prevalence in the preschool child seems to be increasing somewhat in countries or parts of countries where there is an increase in sugar intake, while it stays low in countries where a poor economy restricts sugar intake. The prevalence does not seem to be as high as in South East Asia. In most industrialized countries in northern Europe, in North America, in Australia and New Zealand, dental caries is decreasing, often linked to an increasing use of fluorides, to various types of dental health education programmes, etc. In many European countries, the prevalence in preschool children is, however, still high and caries in primary teeth is often left untreated. In Scandinavia, where all preschool children are included in an organized dental care programme, dental caries has been decreasing markedly during the 1970s and at the beginning of the 1980s. While the mean values for d.m.f.t. at present appear to be largely unchanged, there seems to be a change in the distribution of the disease. More and more children are totally free of the disease, while the group with high d.m.f. values has a tendency to increase.

Child↗
PubMed1996

Epidemiology of hip fractures.

There were an estimated 1.66 million hip fractures world-wide in 1990. According to the epidemiologic projections, this worldwide annual number will rise to 6.26 million by the year 2050. This rise will be in great part due to the huge increase in the elderly population of the world. However, the age-specific incidence rates of hip fractures have also increased during the recent decades and in many countries this rise has not leveled off. In the districts where this increase has either showed or leveled off, the change seems to especially concern women's cervical fractures. In men, the increase has continued unabated almost everywhere. Reasons for the age-specific increase are not known: increase in the age-adjusted incidence of falls of the elderly individuals with accompanying deterioration in the age-adjusted bone quality (strength, mineral density) may partially explain the phenomenon. The growth of the elderly population will be more marked in Asia, Latin America, the Middle East, and Africa than in Europe and North America, and it is in the former regions that the greatest increments in hip fracture are projected so that these regions will account for over 70% of the 6.26 million hip fractures in the year 2050. The incidence rates of hip fractures vary considerably from population to population and race to race but increase exponentially with age in every group. Highest incidences have been described in the whites of Northern Europe (Scandinavia) and North America. In Finland, for example, the 1991 incidence of hip fractures was 1.1% for women and 0.7% for men over 70 years of age. Among elderly nursing home residents, the figures can be as high as 6.2% and 4.9%. The lifetime risk of a hip fracture is 16%-18% in white women and 5%-6% in white men. At the age of 80 years, every fifth woman and at the age of 90 years almost every second woman has suffered a hip fracture. Since populations are aging worldwide, the mean age of the hip fracture patients are increasing rapidly, too. Between 1970 and 1991, the mean age of male Finnish patients increased dramatically from 52.9 years to 69.0 years. In women, the corresponding figures were 71.6 and 78.9 years. This change is likely to cause increasing problems in the treatment and rehabilitation of the patients. In 1990, 72% of the hip fractures worldwide occurred in women. All over the world, the hip fracture incidences are about two times higher in women than in men. Women's overrepresentation has been explained by women's lower bone mass and density and higher frequency of falling. Epidemiologic studies show that trochanteric fractures are an increasing problem since compared with cervical fractures their relative number increases progressively with age in women after the age of 60 years and since their incidence has been shown to increase in both sexes and all age groups during the recent decades. This may have direct public health implication since mortality, morbidity, and costs caused by trochanteric fractures are higher than those of the cervical fractures. Reduced bone density (strength) by age and over the recent decades has been the most frequently mentioned reason for the increase of trochanteric fractures. Also, the fall characteristics of the elderly may have changed during the recent decades resulting in increasing numbers of this type of hip fractures since the type of the hip fracture (cervical or trochanteric) also depends on the impact angle of the greater trochanter at the moment of the floor contact.

Aged↗
PubMed2004

Cutaneous malignant melanoma in Europe.

Cutaneous malignant melanoma is on the rise in fair skinned societies. Both its incidence and mortality rates have been increasing in Europe over the past decades, the latter seem to stabilise in Scandinavia. The main cause of melanoma is intermittent exposure to ultraviolet radiation, especially in combination with endogenous factors like skin type and genetic predisposition. Evidence on an association between sunbed use and melanoma is inconclusive, but seems to point to a slightly increased risk associated with sunbed use. Within Europe, considerably variation in patterns of melanoma incidence and mortality existed. In this paper, we discuss the possible explanations for the observed trends and options for primary and secondary prevention. Early detection seems the most promising way to combat the relatively poor survival rates in Southern and Eastern Europe.

Adult↗
PubMed2006

Inhibitory effect of Andrographis paniculata extract and its active diterpenoids on platelet aggregation.

Andrographis paniculata has been widely used for the prevention and treatment of common cold especially in Asia and Scandinavia. The three active diterpenoids from this plant, including aqueous plant extracts, were investigated for the inhibitory effect on platelet aggregation in vitro. The results indicated that andrographolide (AP(1)) and 14-deoxy-11,12-didehydroandrographolide (AP(3)) significantly inhibited thrombin-induced platelet aggregation in a concentration-(1-100 microM) and time-dependent manner while neoandrographolide (AP(4)) had little or no activity. AP(3) exhibited higher antiplatelet activity than AP(1) with IC(50) values ranging from 10 to 50 microM. The inhibitory mechanism of AP(1) and AP(3) on platelet aggregation was also evaluated and the results indicated that the inhibition of extracellular signal-regulated kinase1/2 (ERK1/2) pathway may contribute to antiplatelet activity of these two compounds. In addition, standardized aqueous extracts of A. paniculata containing different amounts of AP(3) inhibited thrombin-induced aggregation to different degrees. The extracts significantly decreased platelet aggregation in a concentration-(10-100 microg/ml) and time-dependent manner. However, the extract with high level of AP(3) (Extract B) (IC(50) values=50-75 microg/ml) showed less inhibitory activity against thrombin than the extract with lower level of AP(3) (Extract A) (IC(50) values=25-50 microg/ml). These results indicate that the standardized A. paniculata extract may contain other antiplatelet compounds rather than AP(1) and AP(3), which contribute to high antiplatelet activity. Therefore, the consumption of A. paniculata products may help to prevent or treat some cardiovascular disorders i.e. thrombosis; however, it should be used with caution by patients with bleeding disorders.

Andrographis↗
PubMed2006

Levels of brominated flame retardants in blood in relation to levels in household air and dust.

Levels of tri- to decabrominated diphenyl ethers (BDEs), 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE) and 1,2-bis(pentabromophenyl)ethane (DeBDethane) were determined in air, sedimentary dust and human plasma from five households in Sweden. The levels of the individual BDEs in the plasma samples were in the same order of magnitude as in other studies of the general population in Scandinavia, and varied between non-detectable (<0.41 ng g(-1) l.w.) to 17 ng g(-1) (l.w.). BDE#28 and #47 were present in all air samples, with mean values of 0.015 and 0.12 ng m(-3), respectively, except for one sample where the BDE#47 concentration was below the limit of detection (<0.17 ng m(-3)). BDE#209 was found in one of the five air samples at a concentration of 0.26 ng m(-3). DeBDethane was also detected in one sample, in which the BDE#209 level was below LOD (<0.021 ng m(-3)), at a level of 0.023 ng m(-3). All the target compounds were found in the sedimentary dust samples at levels from 0.51 to 1600 ng g(-1), the highest concentration representing BDE#209. The most abundant components in plasma, air and dust were BDE#47, #99 and #209. In the plasma samples BDE#207 and #206 were also present at similar concentrations as BDE#47. In the sedimentary dust samples, DeBDethane was also among the most abundant BFRs. A positive relationship was found for the sumBDE concentrations in dust and plasma, although the relationship was strongly dependent on one of the five observations. BFR levels in dust and air were not dependent on the house characteristics such as living area, floor material or number of electronic devices.

Air Pollution, Indoor↗
PubMed2004

Distribution of some organochlorine compounds in pine needles from Central and Northern Europe.

Levels of selected organochlorine compounds in pine needles were measured in two sampling series. The first series collected in 1989 covered Southern Germany to Northern Scandinavia, and the second collected in 1990 covered Czechoslovakia to Estonia. The levels of alpha-hexachlorocyclohexane (alpha-HCH) and hexachlorobenzene (HCB) were relatively uniform throughout Europe, while the levels of gamma-hexachlorocyclohexane (gamma-HCH) and the DDT group show higher levels in the southern parts of the investigated area. The deposition patterns of all compounds except alpha-HCH indicate a dependence on fresh release from diffuse or point sources rather than global fractionation. The analytes accumulate in the needles until senescence starts and, generally, the oldest needles have the highest concentrations. The accumulation rate of the analytes in mountain pine needles is about half that of Scots pine needles indicating the importance of species differences.

Air Pollutants↗
PubMed2006

Regional differences among the Finns: a Y-chromosomal perspective.

Twenty-two Y-chromosomal markers, consisting of fourteen biallelic markers (YAP/DYS287, M170, M253, P37, M223, 12f2, M9, P43, Tat, 92R7, P36, SRY-1532, M17, P25) and eight STRs (DYS19, DYS385a/b, DYS388, DYS389I/II, DYS390, DYS391, DYS392, DYS393), were analyzed in 536 unrelated Finnish males from eastern and western subpopulations of Finland. The aim of the study was to analyze regional differences in genetic variation within the country, and to analyze the population history of the Finns. Our results gave further support to the existence of a sharp genetic border between eastern and western Finns so far observed exclusively in Y-chromosomal variation. Both biallelic haplogroup and STR haplotype networks showed bifurcated structures, and similar clustering was evident in haplogroup and haplotype frequencies and genetic distances. These results suggest that the western and eastern parts of the country have been subject to partly different population histories, which is also supported by earlier archaeological, historical and genetic data. It seems probable that early migrations from Finno-Ugric sources affected the whole country, whereas subsequent migrations from Scandinavia had an impact mainly on the western parts of the country. The contacts between Finland and neighboring Finno-Ugric, Scandinavian and Baltic regions are evident. However, there is no support for recent migrations from Siberia and Central Europe. Our results emphasize the importance of incorporating Y-chromosomal data to reveal the population substructure which is often left undetected in mitochondrial DNA variation. Early assumptions of the homogeneity of the isolated Finnish population have now proven to be false, which may also have implications for future association studies.

Alleles↗
PubMed2006

Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial.

BACKGROUND: Most patients with malignant common bile duct strictures are suited only for palliation of jaundice by placement of a polyethylene (PE) stent using an endoscopic retrograde cholangiographic technique. Occlusion of these stents occurs after 3 to 4 months, whereas uncovered self-expanding metal stents (SEMS) remain open twice as long. The initial higher cost of the latter might be balanced by a decreased need for repeat intervention. OBJECTIVE: To compare the patency of 10F PE stents and covered 30F steel SEMS (Wallstent; Boston Scientific Nordic AB, Helsingborg, Sweden). DESIGN: Single-center, prospective, randomized, controlled trial. SETTING: General hospital in Stockholm, Sweden, which has a catchment area of 0.6 million people. PATIENTS: Non-referred, unresectable malignant common bile duct strictures. INTERVENTIONS: Endoscopic retrograde cholangiography with plastic stents or covered SEMS. MAIN OUTCOME MEASUREMENTS: Time to stent failure, requiring a new stent. LIMITATIONS: Similar setting and patients, and costs in Scandinavia. RESULTS: Fifty-one and 49 patients were allocated to the PE stent and SEMS groups, respectively. Fifty-six patients died without stent failure within 10 months (median, 2.6 months). Twenty-two PE stent and 9 SEMS patients (P = .009) developed failure after a median of 1.1 and 3.5 months, respectively (P = .007). Median patency times were 1.8 and 3.6 months in the PE and SEMS groups, respectively (P = .002). Median survival was 4.5 months; in 35 patients with distant metastases, the median survival was 2.5 months (P = .002)(PE group, 1.9 months). CONCLUSIONS: The more-effective SEMS are recommended in unresectable patients with malignant common bile duct strictures, who survive a median of 4.5 months. Less costly plastic stents are preferable in the one third of patients who have distant metastases. In our study, the cost was equal.

Aged↗