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PubMed1999

The rise in incidence of lymphomas in Europe 1985-1992.

A collaborative study was carried out of the descriptive epidemiology of the lymphomas from seven countries across Europe in the period 1985-1992. Careful attention was paid to sources of information and the data quality in close collaboration with expert histopathologists. The data were classified as non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD). An attempt was made to put the data into a modified version of the Revised European American Lymphoma (REAL) classification. We observed an overall rise in total NHL throughout the time period in all European countries but no such trend in HD. The increase in NHL overall being 4.2% per annum, representing an increase of 4.8% in males and 3.4% in females per annum, was only marked in middle and old age. Such increases were observed in all participating areas except in Burgundy. Different countries, however, have different base rates, the rates being highest in Scandinavia and the Netherlands. The analysis by subcategory classification suggested that the increase in NHL was confined to the follicle centre cell type, extranodal B-cell, nodal T-cell and nodal lymphomas not otherwise specified, categories. These new observations present a picture of real increase in case incidence with no obvious explanation. The increases in NHL do not appear to be due solely to better diagnoses. Pending other explanations or refutation, these present a compelling picture of an inexorable rise in incidence of this disease.

Adolescent↗
PubMed2002

Phytoestrogens and breast cancer.

The role of phytoestrogens and consumption of phytoestrogen-rich foods such as soy containing isoflavones and whole grain products with lignans for the prevention of breast cancer is reviewed. It is concluded that soy-containing diet in adult women is not or only slightly protective with regard to breast cancer, but that it may be beneficial if consumed in early life before puberty or during adolescence supporting results of immigrant and epidemiological studies. No negative effects of soy on breast cancer have been observed. On the other hand, a diet low in lignans, resulting in a low plasma enterolactone concentration, increases risk both in a case-control and a prospective study, but some controversial results have also been obtained. Some of these results may be explained by the fact that the determinants of plasma or urinary enterolactone concentration are very different in different countries. In Scandinavia, the main determinants are whole grain cereal food, vegetables and berries. Whether the protective effect is caused by the phytoestrogens in the diet or whether they are only biomarkers of a healthy diet has not been established.

Animals↗
PubMed1997

Primary idiopathic chylopericardium--a case report and review of the literature.

Primary idiopathic chylopericardium is a rare entity with obscure etiology. In recent years, a few reports have been published where the lymphatic leak and fistula were identified by combined lymphangiography and computed tomography or intraoperative thoracic ductogram. Here we report a case occurring in a previously healthy 51 year old woman, to our knowledge the first case described in Scandinavia. She presented with cough and dyspnea of about 1 year duration. Chest X-ray demonstrated enlargement of the cardiac silhouette. Echocardiography revealed pericardial effusion and at puncture pericardiocentecis 760 ml of chylous fluid was evacuated. There was no history of trauma, infection or neoplasm. She underwent extensive investigations but no apparent cause of the chylous effusion could be determined. Conservative treatment with pericardial drainage and low fat (medium chain triglyceride) diet failed. The patient was cured by surgical ligature of the thoracic duct and partial pericardectomy through a left anterolateral thoracotomy. At 12 months post operation she was doing well and echocardiography did not reveal any signs of recurrence. A brief review of the literature is presented.

Echocardiography↗
PubMed2001

The bicalutamide Early Prostate Cancer Program. Demography.

BACKGROUND: The optimal treatment for early prostate cancer has yet to be established. A well-tolerated hormonal therapy such as bicalutamide could be a useful treatment option in this setting, either as adjuvant or immediate therapy. A major collaborative clinical trials program was set up to investigate bicalutamide as a treatment option for local prostate cancer (localized or locally advanced disease). METHODS: The bicalutamide Early Prostate Cancer program comprises three randomized, double-blind, placebo-controlled trials of similar design that are being conducted in distinct geographical areas (North America; Australia, Europe, Israel, South Africa and Mexico; and Scandinavia). Men with T1b-4N0-1M0 (TNM 1997) prostate cancer have been randomized on a 1:1 basis to receive bicalutamide 150 mg daily or placebo. Recruitment to the program closed in July 1998, and follow-up is ongoing. Study endpoints include time to clinical progression, overall survival and tolerability. RESULTS: 8113 men aged 38 to 93 years (mean 66.9) were randomized over a 3-year period. 67.4% of the enrolled patients had localized disease (T1-2) and 66.4% had a Gleason score </=6 at study entry, while the majority of patients had node-negative (N0) disease; only 3.1% in two of the studies and none in the third study had confirmed N+ disease. Overall, 71.8% of the patients received therapy of primary curative intent within 16 weeks of randomization; the remainder received watchful waiting as their primary approach. Across the program, the two randomized groups are well balanced. CONCLUSION: This is the largest randomized clinical trial program to date in local prostate cancer and is expected to provide critical information on the role of bicalutamide as an addition to standard care for patients with local prostate cancer who have received a therapy of curative intent or are candidates for watchful waiting.

Journal Article↗
PubMed2003

Idiopathic lenticular mucocutaneous pigmentation (Laugier-Hunziker syndrome): a report of a case.

Laugier-Hunziker syndrome (LHS) is an acquired, benign, macular hyperpigmentation of the lips and oral mucosa, often associated with pigmentation of the nails. It is a rare disorder thought to be more common than the number of reported cases would suggest. It is important to include this condition in the differential diagnosis of diffuse oral pigmentation. Here we report the first case of the Laugier-Hunziker syndrome in Scandinavia. Other conditions causing diffuse or multifocal pigmented oral lesions are discussed.

Diagnosis, Differential↗
PubMedDate not supplied

A European allele map of the C282Y mutation of hemochromatosis: Celtic versus Viking origin of the mutation?

The aim of this new meta-analysis (to the end of 2002) is to compile the Y allele frequencies of the C282Y mutation of hereditary hemochromatosis (HFE gene) for 63 European populations, representing a total of 10,708 unrelated people concerning control samples. A new allele map of C282Y frequencies in Europe was constructed. The highest European frequencies are observed in the Celtic populations in Ireland, in the United Kingdom, and in France, but elevated frequencies are also observed in Scandinavia.

Cysteine↗
PubMed2003

Further evidence for sexual reproduction in Rhynchosporium secalis based on distribution and frequency of mating-type alleles.

Rhynchosporium secalis, the causal agent of scald on barley, is thought to be exclusively asexual because no teleomorph has been found. Partial sequences of the HMG-box and alpha-domain of Rhynchosporium secalis isolates were identified and used to develop a PCR assay for the mating-type locus. PCR amplification of only one of these two domains was possible in each strain, suggesting that R. secalis has a MAT organization that is similar to other known heterothallic fungi. A multiplex PCR with primers amplifying either a MAT1-1- or MAT1-2-specific amplicon was used to determine the distribution of mating types in several R. secalis populations. In total, 1101 isolates from Australia, Switzerland, Ethiopia, Scandinavia, California, and South Africa were included in the analysis. Mating types occurred in equal frequencies for most of these populations, suggesting frequency-dependent selection consistent with sexual reproduction. In addition, both mating types were frequently found occupying the same lesion or leaf, providing opportunities for isolates of opposite mating type to interact and reproduce sexually. We propose that R. secalis should be considered a sexual pathogen, although the sexual cycle may occur infrequently in some populations.

Ascomycota↗
PubMed1999

Late stages of epidemiological transition: health status in the developed world.

Drawing on the example of twentieth century Europe, this paper examines themes in the spatial development of the late stages of epidemiological transition in developed countries. A preliminary analysis of mortality trends for sample countries in four European regions (north, Scandinavia, south and east) suggests that, as the epidemiological transition progressed to its later stages during the period 1901-1975, spatial variability in the importance of classical infectious diseases increased. This trend was countered by a spatial convergence in the importance of disease groupings that typify late transition. An apparently new epidemiological phase in late transition, linked to the emergence and re-emergence of infectious and parasitic diseases, is illustrated with reference to tuberculosis and the acquired immunodeficiency syndrome (AIDS).

Communicable Diseases↗
PubMed2002

Predicting the risk of tick-borne diseases.

This brief review focuses on the value of predictive risk mapping and the question of how to test predictions of the spatial and temporal variation in risk of tick-borne diseases, specifically as caused by tick-borne encephalitis virus (TBEv). Predictions of the present distribution of TBEv, driven by satellite data, match the mapped records of TBE cases with 90% accuracy in the Baltic region and 81% accuracy in central Europe. Many of the apparently false predictions of TBE presence coincide with recent records of new or reactivated foci, and highlight regions for active surveillance. Predictions of the changes in TBEv distribution under the influence of climate change suggest that TBEv may be driven into increasingly high latitude and high altitude regions, until by the 2080s it is confined to parts of Scandinavia. This is consistent with the fact that enzootic TBEv cycles are inherently fragile and depend for their existence on specific seasonal temperature profiles and moisture conditions, which may be disrupted by climate change. Changes in the incidence of TBE in many countries since the 1990s are also consistent with these predictions, although there is evidence that local non-biological factors also play an important role in determining the incidence of disease.

Animals↗
PubMed2002

How to treat hydrosalpinges: IVF as the treatment of choice.

Two treatment options are available for patients suffering from tubal infertility due to hydrosalpinges. Surgical distal tubal repair is appropriate only for patients with preserved tubal mucosa, otherwise the subsequent intrauterine pregnancy rate is unacceptably low and the ectopic pregnancy rate too high. The alternative treatment, IVF, has also demonstrated low success rate in patients with untreated hydrosalpinges, possibly due to leakage of fluid into the uterus. Salpingectomy has been suggested as a method to overcome the negative influence of the hydrosalpingeal fluid on implantation and embryo development. A randomized controlled trial in Scandinavia has demonstrated a benefit of salpingectomy in patients with hydrosalpinges that were large enough to be visible on ultrasound. If only the first cycle was considered, patients having undergone salpingectomy expressed significantly higher clinical pregnancy (46% versus 22%) and birth (40% versus 17%) rates. It is concluded that patients with large hydrosalpinges and without prospect of spontaneous conception should be recommended salpingectomy, which truly increases their chances of a successful IVF treatment.

Embryo Implantation↗
PubMed2003

The pain of childbirth: perceptions of culturally diverse women.

The pain experiences of culturally diverse childbearing women are described based on a secondary analysis of narrative data from phenomenologic studies of the meaning of childbirth. Study participants were interviewed in the hospital after giving birth or in their homes within the first weeks after having a baby. Transcripts of interviews with childbearing women who lived in North and Central America, Scandinavia, the Middle East, the People's Republic of China, and Tonga were analyzed. Participants described their attitudes toward, perceptions of, and the meaning of childbirth pain. Culturally bound behavior in response to childbirth pain was also articulated. A variety of coping mechanisms were used by women to deal with the pain. Understanding the meaning of pain, women's perceptions of pain, and culturally bound pain behaviors is fundamental in order for nurses to facilitate satisfying birth experiences for culturally diverse women.

Adaptation, Psychological↗
PubMed1993

Aquatic pollution: effects on the health of fish and shellfish.

As there is little evidence of pollution affecting the health of fish and shellfish on a global scale, this paper attempts to put into perspective the pollution/fish disease relationship by reviewing examples of studies and reports in the historic and current literature. Although there is no dispute that pollution can affect the aquatic organisms under laboratory conditions and may be responsible for the decline of populations of such animals in some inland waters and some estuaries, most of the evidence for pollution causing or increasing disease in fish in open waters is circumstantial. Historical data proves that almost all fish and shellfish diseases known today have been described since the end of the last century. However, it is also known that water pollution, especially in inland waters, has for the past 400-500 years been the result of urbanization and industrialization. This has resulted in some major rivers becoming devoid of or deficient in fish stocks. The concern that pollution may influence the health status of fish and shellfish stocks has increased over the past 20 years. Initial attention was paid to epidermal diseases, including fin-rot in demersal fish, and protozoan diseases in molluscs in the heavily polluted bays and estuaries in North America. As the interest in this subject spread, it became political, and often controversial, especially amongst the North Sea countries. The disagreements have largely been settled amongst scientists because international bodies, such as the International Council for Exploration of the Sea (ICES), established workshops to investigate sampling methods and disease-reporting techniques. Recommendations from those workshops have contributed to some form of standardization for field work and the subject, although largely subjective, has some objective approaches which are described. As there are variable, interacting biological and physical influences in the aquatic environment, it is difficult to establish the background prevalences of diseases in populations of fish and shellfish. Examples of the influences of climatic changes are presented, and these show that short-term catastrophes can be directly related. However, a more long-term problem is water acidification resulting largely from anthropogenic activities. In parts of Scandinavia this has, and is, leading to decimation of fish stocks in inland waters. In general, diseases in fish and shellfish are very localized, but there is concern amongst scientists that certain cancers, especially liver tumours, occurring in demersal fish inhabiting polluted estuarine and coastal waters, are related to the release of chemicals, e.g. hydrocarbons, pesticides and heavy metals.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2004

Definition and estimation of an actual reproduction number describing past infectious disease transmission: application to HIV epidemics among homosexual men in Denmark, Norway and Sweden.

Prevalence and incidence measures are the common way to describe epidemics. The reproduction number supplies information on the potential for growth or decline of an epidemic. We define an actual reproduction number for infectious disease transmission that has taken place. An estimator is suggested, based on the number of new infections observed in a given time-interval, the number of those infected at the start of the interval, and the length of the infectious period. That estimator is applied to HIV among men having sex with other men over the period, 1977-1995, in Scandinavia. The actual reproduction number was estimated with acceptable certainty from the period, 1981-1982, yielding a value of 15 secondary cases. A value of less than one secondary case was assessed for the period, 1988-1995, in Denmark and Sweden. The actual reproduction number gives us some additional understanding of the dynamics of epidemics, compared with prevalence and incidence curves.

Adult↗
PubMed2004

North American populations of Entoleuca mammata are genetically more variable than populations in Europe.

Entoleuca mammata (syn. Hypoxylon mammatum) is a damaging pathogen of Populus tremuloides and P. grandidentata in North America and P. tremula in Europe, where the fungus occurs only sporadically in alpine regions and Scandinavia. It has been hypothesized that E. mammata was introduced to Europe from North America. In this study, E. mammata isolates collected from Europe and North America were compared by a sequence analysis of two DNA markers derived from DNA fingerprints. The objective of the study was to elucidate the relationship between North American and European E. mammata populations by testing two hypotheses: (1) North American and European isolates are conspecific; and (2) the fungus was introduced between continents causing both a founder effect and a genetic bottleneck. North American populations were found to be more polymorphic, but no major phylogenetic differences between fungal isolates collected from different continents were found. This result combined with the historical observations of the disease in Europe implies that E. mammata was introduced to Europe several centuries ago.

Alleles↗
PubMed2003

Factors governing the atmospheric deposition of polycyclic aromatic hydrocarbons to remote areas.

Polycyclic aromatic hydrocarbons (PAH) were measured in bulk atmospheric deposition collected in three remote areas of Europe during 1997-1998. Mean total PAH fluxes over a period of 18 months were 1560 +/- 750 and 1150 +/- 630 ng m(-2) mo(-1) in the Pyrenees and the Alps, respectively. In the Caledonian mountains (Scandinavia) the observed mean fluxes were 1900 +/- 940 ng m(-2) mo(-1) (6 month collection). Similar qualitative PAH compositions (p values <0.05) in the bulk atmospheric deposition have been observed between sites, which are dominated by the more volatile parent compounds. The main differences between lakes are related to the high molecular weight compounds. Atmospheric deposition of PAH to these remote sites appears to be independent of their concentrations in the atmosphere, which are similar between sites (in the range of 1.8-3.0 ng x m(-3)), being controlled mainly by particle deposition, followed by precipitation and air temperature. A multilevel regression model including these three variables accounted for 74% of the total variability in total PAH bulk deposition; however, the contribution of each variable in the model is compound and site-dependent. The deposition of high molecular weight PAH depends more on particle deposition and precipitation, whereas air temperature is the main factor controlling the deposition fluxes of the low molecular weight PAH.

Air Movements↗
PubMed2005

Endosperm structure affects the malting quality of barley (Hordeum vulgare L.).

Twenty-seven barley (Hordeum vulgare L.) samples collected from growing sites in Scandinavia in 2001 and 2002 were examined to study the effect of endosperm structure on malting behavior. Samples were micromalted, and several malt characteristics were measured. Samples were classified as having a mealier or steelier endosperm on the basis of light transflectance (LTm). Because endosperm structure is greatly dependent on protein content, three barley sample pairs with similar protein contents were chosen for further analysis. During malting, the steelier barley samples produced less root mass, but showed higher respiration losses and higher activities of starch-hydrolyzing enzymes. Malts made from steelier barley had a less friable structure, with more urea-soluble D hordein and more free amino nitrogen and soluble protein. The reason for these differences may lie in the structure or localization of the hordeins as well as the possible effects of endosperm packing on water uptake and movement of enzymes.

Cell Wall↗
PubMed2001

Cancer risk in the reindeer breeding Saami population of Sweden, 1961-1997.

The Saami people are the natives of northern Scandinavia and the Kola Peninsula. In a cohort of 2033 Swedish reindeer breeding Saamis, the cancer risks between 1961 and 1997 were studied. In total, 193 cases of cancer were observed versus 322 expected in the general Swedish population and 249 in a geographically matched reference population of non-Saamis. In comparison to non-Saamis living in the same area, the reindeer breeding Saamis showed a statistically significant lower risk of developing cancer of the prostate and of malignant lymphoma, whereas the risk of stomach cancer was significantly higher. Although there were no statistically significant changes of cancer risks over time, temporal trends were indicated towards a decreased risk of cancer in the stomach and the prostate. The results suggest that the explanations of the low cancer risk of the reindeer breeding Saamis, in relation to the non-Saamis in the same environment, are to be found among lifestyle and/or genetic factors.

Age Distribution↗
PubMed1997

Epitope analysis of birch pollen allergen in Japanese subjects.

Birch pollen is a very common cause of nasal allergy (pollinosis) not only in Scandinavia, Europe, Canada, and the northern part of the United States but also in Hokkaido, Japan. We have previously reported a positive association between the HLA-DR9 phenotype and the development of birch pollen allergy in Japanese subjects. However, there is little information about T cell epitopes of birch pollen which are presented by HLA class II molecules other than HLA-DR9. Therefore, we analyzed the difference in T cell epitope usage in patients who had HLA-DR9 versus those who did not. Seven Japanese patients with birch pollinosis were studied. Some groups of peptides representing T cell epitopes (Betula verrucosa; Bet VI peptides, p7-33, p23-46, p138-160) appeared to be shared by the majority, while another peptide (Bet VI p72-95) was recognized predominantly by patients who expressed HLA-DR9 and/or HLA-DQ3 molecules. Moreover, seven T cell clones and eight T cell lines were generated from two patients who did not have HLA-DR9 or HLA-DQ3. Using some of these T cell clones/lines, we investigated the relationship between HLA class II molecules and antigenic peptides. One of these T cell clones recognized antigenic peptides in the context of the HLA-DQ1 molecule. To our knowledge, this is the first indication that the epitope on Bet VI can be presented by the HLA-DQ molecule.

Allergens↗