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PubMed2000

The effects of bovine viral diarrhoea virus on cattle reproduction in relation to disease control.

Bovine viral diarrhoea virus (BVDV) is a major reproductive pathogen in cattle. Infection of the bull can lead to a fall in semen quality and the isolation of infectious virus in the ejaculate, while infection in the cow leads to poor conception rates, abortions and congenital defects. BVDV also reduces the animal's resistance to other respiratory and enteric pathogens. The prevalence of BVDV is primarily due to the efficiency with which the virus crosses the placenta of susceptible females. Calves that survive infection during the first trimester of pregnancy are born with a persistent and lifelong infection. These persistently infected (PI) animals represent between 1.0% and 2.0% of the cattle population and continuously shed infectious virus. The availability of reliable diagnostic ELISA and PCR techniques, which can test milk or serum samples for virus or antibodies, has simplified BVDV surveillance and improved the prospects for control. Although PI animals are the principal vectors within and between herds, they can be readily identified and removed. By contrast, cows carrying a PI foetus are particularly problematic. These animals have been compared to 'Trojan Horses' because they are virus-negative and antibody-positive but they deliver PI calves. In general, acutely infected cattle are much less efficient vectors but infections at the onset of puberty have resulted in a localised and persistent infection within the testes. Under these circumstances, virus shedding into the semen may remain undetected. Transmission of BVDV can be controlled through vaccination or eradication. BVDV vaccine technology has been developing over the past 30 years, but currently available vaccines are still of the conventional inactivated or attenuated sort. In general, vaccination has not been applied with sufficient rigor to make a significant impact on the level of circulating virus, unlike the national and regional eradication programmes established in areas such as Scandinavia, Austria, the Netherlands and Scotland. Eradication confers the added advantage of improved herd health; however, it also creates a susceptible cattle population that needs to be protected by stringent biosecurity. In this article, we discuss how BVDV influences reproductive function, the potential for viral transmission during breeding and the measures that must be taken to avoid the spread of infection to susceptible cattle populations via semen, embryos, culture fluids and infected cows.

Abortion, Veterinary↗
PubMed2000

Reproduction in female reindeer.

Reindeer are either wild or kept under very extensive farming systems. They are seasonal breeders, with mating coinciding with the decreasing photoperiod in the autumn, and with calving in the spring. Little is known regarding the factors that influence reproduction in reindeer or of their reproductive physiology. Studies carried out to date have mainly focused on issues related to the population dynamics of wild populations and semi-domestic herds, and to a limited extent on the reproductive physiology of the female. Nor is much known about reproductive disorders and their medical treatment, or of the possibilities to manipulate or control reproduction by the use of hormones. Modern reproductive techniques such as artificial insemination and in vitro fertilisation, maturation and transfer of embryos have so far received scant attention.In the future, it is possible that reindeer under certain conditions might be kept in more intensive production systems. Limited access to high-quality winter pastures and increased demands for productivity have resulted in artificial feeding becoming a common practice in various reindeer herding areas in Scandinavia. In efforts to enhance the productivity of reindeer herds, attention has been focused on factors affecting reproduction in the female and survival of the offspring. Further knowledge on these issues seems necessary when developing strategies for optimalization of meat production in domestic herds and the harvesting of wild populations. This paper puts a broad focus on various aspects of reproduction, including factors influencing the fecundity of reproductively active females. In order to understand these effects it is important also to have a basic understanding of the reproductive physiology of these animals.

Animals↗
PubMed2002

Research for improving the autopsy rate for infant death--medical economic assessment of the forensic autopsy system in Japan.

The rate at which autopsies are performed in Japan for cases of infant death is not adequate for diagnosing sudden infant death syndrome (SIDS). In Japan, it will be necessary to increase the autopsy rate at the time of infant deaths in order to improve the certainty of diagnosing SIDS and improving the accuracy of determining the cause of death with respect to infant death. The objective of this research is to provide basic documentation required for administrative implementation of this objective. In Japan, the Medical Examiner System and its related Approved Autopsy System are not deployed nationwide. The estimated budget in the case of deploying the Medical Examiner System nationwide for the purpose of improving the infant death autopsy rate is in excess of 5 trillion yen, and that in the case of deploying the Approved Autopsy System nationwide is estimated at roughly 130 million US dollars. However, since the rate of autopsies performed for SIDS has not changed following the implementation of approved autopsies, the efficacy of the Approved Autopsy System has come to be viewed questionably. In addition, it is also necessary to enact legislation that mandates the conducting of autopsies for all cases of infant death as is done in Scandinavia. The required cost in the case of performing autopsies for all cases of abnormal infant death is estimated at 200,000-700,000 US dollars and is considered to be within a range that could be implemented through local government regulations. In addition, the cost per body of an autopsy performed at the State Crime Laboratory in the State of Arkansas in the US in 1999 was about 6000 US dollars. In contrast, the same cost at the Tokyo Medical Examiner Office is much less at only about 4000 US dollars.

Autopsy↗
PubMedDate not supplied

Molecular mechanisms of cefoxitin resistance in Escherichia coli from the Toronto area hospitals.

Escherichia coli may become resistant to cephamycines and oxyimino cephalosporins by virtue of promotor and attenuator mutations or because they have acquired mobilized beta-lactamases from other gram-negative bacilli. This study examined Canadian strains to determine how often promotor and/or attenuator mutations account for this mechanism of resistance and the extent to which clonal spread of these organisms has occurred. We sequenced the promotor and attenuator region of 30 strains resistant to cefoxitin. Twenty-two strains had promotor mutations, 26 had attenuator mutations. Most promotor mutations resulted either in a change in the -35 promotor region towards the E. coli sigma 70 consensus sequence or in the creation of a new consensus hexamer upstream. Eight strains had mutations that increased the typical ampC 16-nucleotide spacer region to the consensus 17- or an 18-nucleotide sequence. Of the attenuator mutations, most did not substantially affect the attenuator loop. Several of the mutations have previously been described in South Africa, Scandinavia, and France. There was evidence that strains bearing certain mutations were clonally disseminated; however, the 11 strains bearing a complex set of attenuator mutations were not. The majority of cephamycin resistant E. coli strains in Toronto have attenuator and/or promotor mutations upstream of the chromosomal ampC gene.

Cefoxitin↗
PubMed1993

Equine influenza.

Influenza continues to be one of the most important diseases of horses despite the availability and widespread use of equine influenza vaccines for almost 30 years. In recent years, infection with the influenza A/equine/2 subtype has become endemic in the equine populations of North America, Europe, and Scandinavia. Continued antigenic drift of field virus has compromised the efficacy of vaccines, most of which contain antigens prepared from influenza viruses isolated more than 10 years ago. This article reviews the history, virology, epidemiology, pathogenesis, immunology, clinical presentation, diagnosis, treatment, control, and prevention of influenza in horses and emphasizes recent developments in diagnostic methods and vaccine technology.

Animals↗
PubMed2005

[Chewing tobacco. An emerging habit among adolescents].

INTRODUCTION: In France, unlike in the United States and Scandinavia, the use of "smokeless tobacco" (also called "chewing tobacco") was rare, but this habit is starting to expand, especially in the world of sports. At ski championships, for example, it is used as a doping agent. Adolescents in mountain areas are now imitating their competitive-skiing peers. CASE: A 16-year-old girl living in a ski resort became addicted to the tobacco paste, "Snuss", and consumed 15-20 doses of Snuss daily, together with a dozen cigarettes. DISCUSSION: "Smokeless tobacco" is emerging as a habit in France, its use encouraged by its discretion, low cost, and rapid induction of addiction. Its growth in Alpine areas requires the urgent development of impact studies to facilitate the organization of information campaigns to treat and prevent its use.

Adolescent↗
PubMed2003

PACS developments in Europe.

Although the concept of picture archiving and communications systems (PACS) was developed in Europe during the latter part of the 1970s, no working system was completed at that time. The first PACS implementations took place in the United States in the early 1980s, e.g. at Pennsylvania University, UCLA, and Kansas City University. Some more or less successful PACS developments also took place in Europe in the 1980s, particularly in the Netherlands, Belgium, Austria, the United Kingdom, France, Italy, Scandinavia, and Germany. Most systems could be characterized by their focus on a single department, such as radiology or nuclear medicine. European hospital-wide PACS with high visibility evolved in the early 1990s in London (Hammersmith Hospital) and Vienna (SMZO). These were followed during the latter part of the 1990s by approximately 10-20 PACS installations in each of the major industrialized countries of Europe. Wide-area PACS covering several health care institutions in a region are now in the process of being implemented in a number of European countries. Because of limitations of space, some countries, for i.e. Switzerland, Denmark, Finland, Spain, Greece, as well as Eastern European countries, etc. could not be appropriately represented in this paper.

Diffusion of Innovation↗
PubMed2001

Antibiotic sensitivity still prevails in Norwegian blood culture isolates.

We describe the antimicrobial susceptibility of bacteraemia isolates from Norway. From March 1998 to February 1999, four university hospitals covering all parts of Norway collected their first 10 isolates each month. Minimal inhibitory concentrations were determined for: Enterobacteriaceae (n=192), staphylococci (n=89) and Streptococcus pneumoniae (n=69) using the Etest. NCCLS breakpoints were used. About 20% of all blood culture isolates in Norway in this period were investigated. Compared with countries outside Scandinavia antibiotic sensitivity still prevails. Only minor differences in resistance were found between participating hospitals, between hospital departments and between hospital- and community-acquired pathogens. The prudent use of antibiotics in Norway may contribute to the fact that antibiotic resistance still remains low in the most common bacterial pathogens causing bloodstream infections.

Anti-Bacterial Agents↗
PubMed2001

Antibiotic usage in Nordic countries.

The consumption of antibacterials has remained relatively stable in Scandinavia and is low compared with most other countries. Measured as "Defined Daily Doses" (DDD), the highest consumption is found in Iceland and Finland, and the lowest in Denmark and Norway. The consumption in Iceland, Finland and Sweden is about twice that in Norway. The distribution of different classes of antimicrobials shows striking differences. Phenoxymethyl and benzylpenicillin make up about 55% of the DDDs in Sweden and 40% of the DDDs in Denmark and Norway, whereas the narrow-spectrum penicillins represent 20% of the DDDs in Iceland. Fluoroquinolones are little used except in Sweden where they account for about 10% of DDDs. The use of cephalosporins ranges from 1% (in Denmark) to 15% (in Finland) and between 3 and 5% in the other countries. The policy that narrow-spectrum penicillins may be used when necessary but broad-spectrum compounds should be avoided has the positive effect that there is greater susceptibility in the Nordic countries to these antibiotics than elsewhere.

Anti-Bacterial Agents↗
PubMed1997

Intrathecal IgM, IgA and IgG antibody response in tick-borne encephalitis. Long-term follow-up related to clinical course and outcome.

BACKGROUND: Tick-borne encephalitis (TBE) of western subtype causes long-term morbidity and is considered a health problem in Scandinavia, eastern and central parts of Europe and Russia. The pathophysiology is not fully elucidated. As TBE RNA is rarely demonstrable in cerebrospinal fluid (CSF) the kinetics of the CSF antibody response to the disease has attracted attention. OBJECTIVES: To investigate the intrathecal TBE-specific antibody response and to correlate its intensity and persistence to the clinical course. To compare indirect, commercially-based ELISA methods indexed against albumin ratio or IgG ratio with the capture ELISA method for the establishment of CSF response. STUDY DESIGN: The specific IgM, IgG and IgA antibody responses in serum and CSF were analysed in 69 Swedish patients included in a prospective study of TBE from the acute phase up to 11-13 months after onset. RESULTS: Antibody response by all three classes was demonstrable in serum and CSF. All methods were useful, but capture technique was the most sensitive and results were easiest to interpret. Peak IgM activity was seen early during the disease and persisted after 6 weeks. Maximum IgG levels were encountered in late convalescent samples (median 6 weeks). Intrathecal antibody production was demonstrable in nearly all patients: in 41% days 0-6, in 97% days 7-19, in 98% days 21-61 and-at lower levels-in 84% of the patients after 1 year (50/52 of CSF-serum sampled in the interval 11-61 days). Day 9 after onset, patients with dominating encephalitic symptoms showed significantly lower intrathecal IgM activity. The persistence of serum and CSF antibodies did not correlate to severity of disease. CONCLUSIONS: Capture IgM and IgG assays were superior to indirect ELISA. Low early CSF IgM response correlated to encephalitic symptoms, otherwise the intensity and duration of intrathecal antibody response were of limited value for the prediction of clinical course and long-term outcome.

Adolescent↗
PubMed1999

Inhibitory effect of andrographolide from Andrographis paniculata on PAF-induced platelet aggregation.

Andrographolide, an active principle of the Chinese drug Andrographis paniculata, used for prevention and treatment of common cold in Scandinavia and known as an antiinflammatory, antiviral, antithrombotic, hypotensive and antiatherosclerotic drug, was investigated for its suggested influence on the biosynthesis of eicosanoids and the platelet-activating factor (PAF). Whereas in isolated human polymorph-nuclear leukocytes (PMNL) no influence on the biosynthesis was found, it could be shown that andrographolide inhibits PAF-induced human blood platelet aggregation in a dose dependent manner (IC50-5 microM). These results indicate that andrographolide has a mechanism of action different from that of non-steroidal antiinflammatory drugs (NSAID) and most likely associated with the cardiovascular and antithrombotic activity described of Andrographis paniculata.

Adult↗
PubMed1998

Traditional analgesic agents: are parenteral narcotics passé and do inhalational agents still have a place in labour?

Systemic labour pain treatment with opioids and inhaled nitrous oxide has for many decades frequently been used in medically developed countries. Self-administered nitrous oxide (50% in oxygen) has never gained the same popularity in the USA as in the UK or Scandinavia but the use of opioids, mainly pethidine, has generally been widespread in spite of well-known negative effects on the postnatal adaptation of the newborn. Since the often very intense labour pain seems to respond very poorly even to highly sedating doses of parenteral opioids, their frequent use during delivery and parturition has to be questioned. Self-administered inhalation of nitrous oxide 50% in oxygen also has a limited efficacy for relieving labour pain but because it is mainly devoid of adverse effects on the baby or on the parturient its future use in obstetrics can be defended more easily, either as a sole agent in women with low labour pain scores or in early labour preceding epidural analgesia.

Administration, Inhalation↗
PubMed1991

Relation of giant cell arteritis to polymyalgia rheumatica.

Polymyalgia rheumatica and temporal arteritis appear to be separate syndromes rather than two manifestations of an underlying giant cell arteritis. Polymyalgia rheumatica is a synovitis that may be persistent or recurrent, while temporal arteritis is almost always a single episode; documented recurrences are rare. The two syndromes frequently occur in the same patient although not necessarily at the same time and they may be separated by a long interval. In some patients with polymyalgia rheumatica, giant cell arteritis is found on biopsy of an asymptomatic temporal artery. The frequency of this concurrence is variable in different populations. It is high in Scandinavia, low in Israel and intermediate between these extremes in other populations that have been studied.

Giant Cell Arteritis↗
PubMed1997

A double-blind, parallel-group, placebo-controlled, dose-ranging, multicenter study of intravenous granisetron in the treatment of postoperative nausea and vomiting in patients undergoing surgery with general anesthesia.

STUDY OBJECTIVE: To compare the effectiveness of granisetron with placebo in the treatment of established postoperative nausea and vomiting (PONV). DESIGN: Randomized, placebo-controlled study. SETTING: 34 hospitals in Europe, Scandinavia, and South Africa. PATIENTS: 519 ASA physical status I, II, and III patients who developed PONV within 4 hours of the end of surgery performed with general anesthesia. INTERVENTIONS: Patients received a single intravenous dose of granisetron 0.1 mg, 1 mg, or 3 mg, or placebo when symptoms of nausea or vomiting were experienced. Additional rescue medication could be given at the investigator's discretion if nausea and vomiting were not controlled. MEASUREMENTS AND MAIN RESULTS: At all doses investigated, granisetron was significantly more effective (p < or = 0.001) than placebo in controlling vomiting: 38%, 46%, and 49% of patients receiving granisetron, 0.1 mg, 1.0 mg, and 3.0 mg, respectively, experienced no vomiting in the first 24 hours following drug administration, compared with 20% receiving placebo. There was a statistically significant linear relationship between vomiting control and granisetron dose (p < 0.001). Survival distributions of time to resolution of vomiting confirmed the statistically significant difference between patients receiving granisetron and those receiving placebo. Granisetron was well tolerated: the most common adverse experiences were pain, constipation, anemia, and headache, and the incidence of adverse experiences was not statistically significantly higher in any of the granisetron groups than in the placebo group. CONCLUSION: Granisetron was significantly more effective than placebo in all groups. Further studies in specific subgroups may be warranted.

Adolescent↗
PubMed1998

Prevalence of obstructive lung diseases and respiratory symptoms in southern Sweden.

The prevalence of obstructive lung diseases is increasing in Scandinavia and worldwide. The reasons for this are not known. The prevalence varies between countries but also between different areas within the same country. In northern Europe a north-south gradient and also an east-west gradient have been proposed. To our knowledge this is the first comprehensive epidemiological study concerning obstructive lung diseases and respiratory symptoms in the southern part of Sweden. The prevalence of bronchial asthma, chronic bronchitis/emphysema, respiratory symptoms, smoking habits and medication in a random sample of 12,071 adults aged 20-59 years was assessed in a postal survey with a slightly modified questionnaire previously used in central and northern Sweden (the OLIN Studies). The questionnaire was based on the British Medical Research Council (BMRC) questionnaire. We also compared the prevalence figures of asthma found in the postal survey with those reported in the medical records in a part of the study area. After two reminders, the response rate was 70.1% (n = 8469); 33.8% of the responders were smokers. Among younger (20-39 year age group) individuals, smoking was most common in women, whereas in those aged 40-59 years, smoking was more common in men. In all, 469 subjects (5.5%) stated that they had asthma, 41.6% of whom reported a family history of asthma compared to 15.9% of the study sample not reporting asthma. Of all subjects reporting asthma, 60.1% (n = 282) answered that they used asthma drugs. Inhaled steroids were used by 20.7%. Chronic bronchitis and/or emphysema was reported by 4.6% (n = 392), 28.6% of whom reported a family history of chronic bronchitis or emphysema compared to 6.8% of the study sample not reporting chronic bronchitis. The most common respiratory symptom in the study population was 'phlegm when coughing' reported by 15.1% (n = 1279). Our data show a prevalence of self-reported asthma of 5.5% compared with 7% reported by Lunbäck et al. in northern Sweden, which indicates a north-south gradient.

Adult↗
PubMed1998

Alpha 1-antitrypsin deficiency in Europe: geographical distribution of Pi types S and Z.

alpha 1-Antitrypsin (AT) is the principal serum inhibitor of proteolytic enzymes such as neutrophil elastase. AT can exist as over 90 different genetically determined variants known as the Pi system; the three most important variants are type M (90% of population) and types S and Z, two of the commoner abnormal variants. Homozygotes of type Z have a severe reduction in the serum AT concentration and may develop pulmonary emphysema or hepatic cirrhosis. Heterozygotes of type SZ have a less severe reduction in serum AT concentration and the association with clinical disease is less clear. The S and Z variants are found mainly among those of European stock. The gene frequency for Pi type Z is highest on the north-western seaboard of the continent and the mutation seems likely to have arisen in southern Scandinavia. The distribution of type S is quite different; the gene frequency is highest in the Iberian peninsula and the mutation is likely to have arisen in that region. A population survey for determining the number of type Z homozygotes in a given community is important for planning purposes now that AT replacement therapy is potentially available.

Europe↗
PubMed2001

Variation in survival of European children with acute lymphoblastic leukaemia, diagnosed in 1978--1992: the EUROCARE study.

The aim of this study was to provide a comparative description of geographical variations and time trends in the population-based survival of European children with acute lymphoblastic leukaemia (ALL). Data on 13344 newly diagnosed children (0--14 years) with ALL were included in the EUROCARE study and were collected were collected by 34 population-based cancer registries (four comprising only childhood malignancies), operating in 17 countries (four in Scandinavia, two in Southern Europe, three in Eastern Europe, six in Continental Europe and two in the UK). Age-specific crude survival rates were estimated for boys and girls according to country for the period 1985--1989 and in adjusted form to attain comparability. Overall pooled and weighted rates were estimated as European standards. Children dead at diagnosis or diagnosed only through a death certificate were excluded. Geographical variation was also estimated by calculating the relative death rate with respect to the pooled overall European rate. After adjustment for age, gender and country, a Cox regression analysis was used to estimate time trends in survival. Survival was compared with that in the USA, Japan, Canada and Australia. During 1985--1989, the 1-year survival rate varied from 99 to 79%, the 5-year survival rate from over 80 to 56% (with the exception of Estonia; 34%; 95% confidence interval (CI) 20--52) among the various countries; the European weighted means were 90 (95% CI 87--93) and 72% (95% CI 69--75), respectively. Survival was particularly favourable in (south) Sweden, Finland, Germany and The Netherlands and rather unfavourable in Estonia and (surprisingly) France, where only 4% of its population was covered by the participating registries. Compared with the period 1978--1981, the hazard ratio for the period 1986--1989 decreased to 0.59 (95% CI 0.54--0.64) and -- in a smaller set of registries -- to 0.49 (0.45--0.55) for 1990-1992, an annual decrease in this rate of approximately 3.5%. During 1985--1989, the 5-year survival rates for European children were largely similar to those found in the USA, Canada and Australia, but markedly better than those in Japan. Higher survival rates were found for countries with 'good' access to centrally organised diagnostic and treatment facilities which stimulated 'aggressive' treatments according to a protocol. However, a subdivision according to risk profiles, e.g. according to the initial white blood cell count at diagnosis, could not be made and this might have explained partially the geographical differences in survival, because a positive association appeared between incidence at age 1--4 years and 5-year survival in most countries.

Adolescent↗
PubMed1998

Variation in survival for adults with nasopharyngeal cancer in Europe, 1978-1989. EUROCARE Working Group.

During the period 1978-1989, 2,054 new patients with nasopharyngeal carcinoma (NPC) were registered in the EUROCARE study, which, during 1985-1989 involved 45 population-based cancer registries in 17 countries. The follow-up time was at least 5 years. 48% of all cases were squamous cell carcinomas and 39% undifferentiated carcinomas, which were more frequent in males. The overall relative 1- and 5-year survival rates (data included from 8 countries with complete data) were 75 and 34%, respectively, for males, and 72 and 32%, respectively, for females, but in a multivariate analysis, there was no significant difference in risk between males and females (0.93 (0.84-1.01), hazard ratio (HR) with 95% confidence interval (95% CI) for females). The overall relative 5-year survival (data included from nine countries with complete data) declined with age, from 53% for patients aged 15-44 years to 31% for patients aged 65-74 years. For patients with undifferentiated tumours, higher survival rates were observed in Scandinavia, Slovakia and Mediterranean countries, with lower rates for patients from the U.K. and Estonia. Survival for patients with squamous cell carcinoma was lowest in Scotland, England and Estonia. In a multivariate analysis, there was a significant difference in risk of death between those with squamous cell carcinomas and those with undifferentiated (HR 0.82, 95% CI 0.74-0.90). Between 1978 and 1989, the prognosis did not change.

Adolescent↗