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PubMed2001

Three cases of bacteraemia caused by Aeromonas veronii biovar sobria.

Septicaemia caused by Aeromonas species is a life-threatening condition, arising primarily in immunocompromised patients, which has rarely been reported in Scandinavia. Herein we describe 3 cases of Aeromonas sobria bacteraemia from Denmark. All the patients were male and all 3 cases occurred during the summer. Two patients had acute leukaemia and HIV infection, respectively, while the third patient had colorectal cancer diagnosed several years later. The clinical presentation in all patients was chest and/or abdominal pain with fever developing into sepsis without any known infectious focus. All patients responded well to antibiotic therapy.

Adult↗
PubMed2002

CMV disease in AIDS patients: incidence of CMV disease and relation to survival in a population-based study from Oslo.

CMV disease is an important cause of morbidity and mortality in patients with AIDS. The purpose of this study was to investigate the incidence of CMV disease in a well-defined population of AIDS patients with a high rate of autopsy. No such study has previously been published from Scandinavia. A total of 248 patients who developed clinical AIDS in Oslo during the period 1 January, 1983 to 31 December, 1995 were included. Autopsy was performed in 152 of 213 deaths (71.3%). CMV disease was diagnosed in 95 patients. In the autopsy group, 73 patients (48%) had CMV disease, and in 52 of these patients CMV disease was first detected at autopsy. Retinitis was the most frequent manifestation, followed by adrenalitis, pneumonitis, encephalitis and gastrointestinal disease. No intravenous drug users (IVDUs) were diagnosed alive with CMV disease. All patients diagnosed with CMV disease before death had evidence of CMV disease at autopsy despite anti-CMV treatment. CMV disease was associated with increased risk of death. We conclude that CMV disease was frequent in patients with AIDS during the study period, was associated with increased mortality and was often diagnosed too late for the administration of appropriate therapy.

AIDS-Related Opportunistic Infections↗
PubMed2001

Rapid laboratory diagnosis of ulceroglandular tularemia with polymerase chain reaction.

Tularemia is a zoonotic disease which, in Scandinavia, is usually acquired through a mosquito bite. As the infecting organism, Francisella tularensis, is highly virulent the culturing of F. tularensis has generally been avoided. PCR offers a safe way to rapidly confirm diagnosis of tularemia. The case of a 9-y-old boy with ulceroglandular tularemia is presented. The diagnosis was made rapidly with DNA amplification from a pus specimen. The efficacy of ciprofloxacin treatment of tularemia in children is also discussed.

Child↗
PubMed2002

A Scandinavian case of domestically acquired human fascioliasis.

A 30-y-old farmhand was admitted to our clinic in September 2000 with a 6-week history of increasing fatigue and polydipsia/polyuria after an initial short spell of gastroenteritis. No evidence of disease was discovered. During follow-up he developed leucocytosis with prominent eosinophilia, leading to the discovery of multiple liver abscesses and subsequently to the diagnosis of human fascioliasis of domestic origin. Although not uncommon in Europe, the infestation has hitherto not been reported from Scandinavia. The patient was successfully treated with praziquantel.

Adult↗
PubMed2003

Death from the Nile crosses the Atlantic: the West Nile Fever story.

The present paper reviews the American epidemic of West Nile Fever (WNF), which is the largest recorded outbreak ever. The epidemiological consequences of introducing a novel and immunologically unknown pathogen in a previously unexposed population and the possible evolution of a more pathogenic viral strain are discussed. In view of recent reports of imported cases in Denmark the issue of possible disease spread to Scandinavia is likewise addressed. However, the main scope of the article is to provide the clinician with an overview of the natural history, epidemiology and clinical characteristics of the disease.

Communicable Disease Control↗
PubMed2004

Mycoplasma pneumoniae and Legionella pneumophila in community-acquired lower respiratory tract infections among hospitalized children: diagnosis by real time PCR.

Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important agents of community-acquired lower respiratory tract infections (LRTI). Mycoplasma pneumoniae has been also recognized as a cause of nosocomial infections. The aim of this study was to investigate the role of real time polymerase chain reaction (PCR) for the rapid diagnosis of these infections among hospitalized children with community-acquired LRTI. During 2001, 65 children were prospectively studied. Microbiological investigation consisted of capillary PCR with a LightCycler for M. pneumoniae and L. pneumophila in induced sputum or throat swab specimens, IgM enzyme immunoassay for M. pneumoniae and immunofluorescence for L. pneumophila in paired sera. Serology testing showed acute M. pneumoniae infection in 18 (27.5%) patients and L. pneumophila in 1 (1.5%). M. pneumoniae was also detected in sputum specimen by capillary PCR in 9 (50%) serologically diagnosed cases, including 4 (22%) with non-diagnostic IgM levels in the acute phase. Capillary PCR and IgM enzyme immunoassay diagnosed together 15 (83%) M. pneumoniae cases in the acute phase. It is concluded that M. pneumoniae is an important cause of LRTI necessitating hospitalization among children in Greece. Capillary PCR in sputum may diagnose M. pneumoniae LRTI in the acute setting and direct therapy and isolation of patients.

Adolescent↗
PubMed1999

Saquinavir hard gel suppresses viral load insufficiently in HIV-infected patients naive to anti-retroviral therapy: a retrospective cohort study.

Protease inhibitors are important components in anti-retroviral regimens. In this retrospective study 29 HIV-infected patients treated with a regimen of zidovudine, lamivudine and saquinavir hard gel in 1 centre in Denmark were compared with 58 patients treated with zidovudine, lamivudine and ritonavir or indinavir followed at 5 other centres in Scandinavia. All patients were naive to anti-retroviral therapy prior to institution of the actual anti-retroviral regimen and were followed for a median of 1.3 and 1.4 y respectively. The 2 groups did not differ significantly with respect to age, gender, route of infection, ethnic background, viral load, CD4 count, AIDS at baseline or frequency of clinical controls. Six and 12 months after initiating anti-retroviral therapy, 31% and 34% of the patients on the saquinavir regimen obtained HIV-RNA < or = 500 compared with 76% and 73% in the control group (p < 0.001). In contrast to viral load, the increase in CD4 count did not differ significantly between the 2 groups. In conclusion, we found that with respect to suppression of viral load a regimen of saquinavir, zidovudine and lamivudine seemed to be inferior to a regimen of zidovudine, lamivudine and ritonavir or indinavir.

Adult↗
PubMed1998

Variations in the diagnostic process among urologists in one region recorded using an interactive computer program.

To analyse how male cases suffering from lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are handled within a well-defined health-care region in Scandinavia, an interactive computer program containing 20 cases suffering from LUTS due to BPH was used for recording the diagnostic process and the treatment decisions; 37 out of a total of 50 urologists practicing within a small health region participated. The diagnostic process varied considerably due to a varying choice of diagnostic tests and the large differences in interpreting the qualities described by the tests. The probability that a patient would be offered a treatment within the region was analysed. For many patients the probability that a treatment was chosen was in the vicinity of 50%. No treatment probability was correlated to the symptom score of the patients. While the probability that a transurethral prostatic resection would be offered to the patients within the region was correlated significantly to urodynamic variables, residual urine and to cystoscopy findings, the probability that transurethral microwave or finasteride therapy would be offered was not correlated to any of the described qualities. The costs of the diagnostic process in all the patients incurred by each of the urologists varied by up to 500%. It was estimated that approximately 40% of the costs involved diagnostic tests that did not influence the decision to offer or not to offer treatment. In conclusion, the enormous variations in the handling of the cases recorded in the study stress the need that a management formula should be used in the handling of patients with LUTS.

Decision Making, Computer-Assisted↗
PubMed1999

The use of ethanol to monitor fluid absorption during transurethral resection of the prostate.

Ethanol monitoring is a method for assessing fluid absorption during transurethral resection of the prostate. The method is based on the principle that absorption can be measured by expired-breath tests provided that an irrigating fluid containing ethanol 1% is used. A nomogram for transformation of the ethanol data into meaningful indices of fluid absorption, such as the volume of irrigant absorbed and the degree of hyponatraemia, has been approved for routine use within the European Union. To make a correct interpretation, however, one must learn how to distinguish the pattern of breath ethanol changes typical of absorption of fluid directly into the blood from the pattern associated with the rare intraoperative events in which fluid is deposited in a pool in the retro- or intraperitoneal space. The ethanol method is well documented, but it is still sparsely used outside Scandinavia, due to its lack of a patent and differing opinions concerning the need for measuring fluid absorption.

Absorption↗
PubMed2006

Worldwide regional variations in home advantage in association football.

Home advantage plays an important part in determining the result of a game of football. Its existence and magnitude is well documented in England, but its causes are still not completely understood. In this study, reliable estimates of home advantage are calculated for the domestic leagues of all countries of Europe and South America, as well as a selection of countries from other continents. The results of all games during the last six seasons are used for each of these 72 countries. In Europe, home advantage in the Balkan countries, especially Bosnia and Albania, is much higher than average. It is generally lower than average in northern Europe, from the Baltic republics, through Scandinavia to the British Isles. In South America, home advantage is high in the Andean countries and lower elsewhere, especially in Uruguay. Home advantage is not unusually high or low in any of the countries from other continents. A multiple regression model for the 51 European countries, which included variables for geographical location, crowd effects and travel, accounted for 76.7% of the variability in home advantage. The large geographical variations can be interpreted in terms of territoriality being a contributing factor to home advantage.

Competitive Behavior↗
PubMed2005

Quality of life of patients with diabetes mellitus. An overview of research in primary health care in the Nordic countries.

OBJECTIVE: A review of articles on health-related quality of life (HRQoL) among diabetes patients in primary health care in the Nordic countries. DESIGN: Search in PubMed and related sources. Used MeSH terms were: "Diabetes Mellitus", "Quality of Life", "Primary Health Care", and "Scandinavia" or "Denmark", "Finland", "Iceland", "Norway", or "Sweden". RESULTS: In total, 19 relevant articles were found, 9 from Finland and 10 from Sweden. HRQoL questionnaires used were from the Medical Outcomes Study, i.e. the SWED-QUAL in seven, SF-20 in four and SF-36 in one, NHP in two, GQL in two, GHQ in one, and own questionnaires in two. HRQoL was moderately affected in diabetic patients, with macrovascular diseases, especially coronary heart disease, and non-vascular diseases as the most consistently found and strongest predictors. Weaker predictors were microvascular complications, age, sex, metabolic level, and education. Other groups at higher risk of worse HRQoL were diabetes patients with psychiatric disorders, especially depression, and foreign-born patients. Good continuity of care was associated with better HRQoL. CONCLUSION: Diabetes affects the HRQoL through macrovascular complications and associated non-vascular comorbidity, and also by adding to the total burden of disease. Future research areas include transcultural and ethnic aspects, and effects of lifestyle interventions.

Adolescent↗
PubMed2004

Magnetic resonance imaging findings and outcome in severe tick-borne encephalitis. Report of four cases and review of the literature.

PURPOSE: To describe the magnetic resonance imaging (MRI) findings of four patients with proven tick-borne encephalitis (TBE). These are the most northern cases reported from Scandinavia. Experience of turbo fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) has not previously been published in this context. MATERIAL AND METHODS: The MRI findings of four consecutive patients with TBE treated in our hospital during the year 2002 were evaluated. MRI was done during the first week of illness, and follow-up scans were available in three cases. RESULTS: In T2-weighted and turbo FLAIR images, thalamic hyperintensity was equally evident in three of the four patients. One of them also showed hyperintensity in the left putamen and the internal capsule and another patient in the peduncles and the hypothalamus. T1-weighted images without contrast were normal in all patients, and leptomeningeal enhancement was detected in only one patient. The two patients who underwent DW images did not show any restricted diffusion. Follow-up MR images showed no atrophy or necrotic foci, and the signal abnormalities disappeared during 16-34 weeks of follow-up. CONCLUSION: T2-weighted and turbo FLAIR sequences proved equally effective in detecting and delineating the thalamic, brainstem, and basal ganglia pathologies. According to our results, mechanisms other than cytotoxic edema contribute to the signal pathology. Radiologists should be familiar with the MR findings of TBE even in non-endemic areas.

Adult↗
PubMedDate not supplied

Prevalence of primary adult lactose malabsorption in Poland.

Lactose-absorption capacity was examined in 275 apparently healthy Polish adolescents and adults (214 females and 61 males with an average age of 29.1 years) using a field version of the lactose-tolerance test with breath hydrogen determination. In the total group, 172 lactose absorbers (62.5%) and 103 lactose malabsorbers (37.5%) were identified. Reported milk intolerance and symptoms of lactose intolerance were significantly more frequent in lactose malabsorbers. Subdivision according to the birthplaces of the probands' grandparents did not reveal significant regional differences. The unexpectedly high frequency of lactose malabsorption is further evidence for concentric genetic clines of lactase gene frequencies extending from southern Scandinavia, the area with the lowest observed frequencies of selective adult hypolactasia, to the south and the east.

Adolescent↗
PubMed1990

Endurance capacity and longevity in women.

The aim of our study was to compare the cardiovascular and metabolic adjustments of 8 female and 8 male subjects to similar situations of physical stress, which involved muscle contractions at various intensities, and to link the results with the fact that in Scandinavia, women survive men by an average of 5-10 years. The mean age of subjects was 25 years old, and all were in good health. It was concluded that the cardiovascular and metabolic reactions to comparable regimens of physical stress differ markedly between female and male subjects: The women demonstrated the healthier adjustments, with lesser blood pressure elevation and a higher degree of lipid utilization. Both reactions are linked to protective mechanisms with respect to developing ischemic heart disease. We suggest that these adjustments are linked to longevity in women, and that part of the explanation of the sex differences in physiological adjustments to physical stress and in longevity lies in the fact that women through life are subjected to a higher degree of physical activity.

Adult↗
PubMed2005

Epidemiology and diagnosis of Lyme borreliosis.

The multisystem disease Lyme borreliosis is the most frequent tick-transmitted disease in the northern hemisphere. In Europe Lyme borreliosis is most frequent in Central Europe and Scandinavia (up to 155 cases per 100,000 individuals) and is caused by the species, B. burgdorferi sensu stricto, B. afzelii and B. garinii. The recently detected genospecies A14S may also play a role in skin manifestations. Microbiological diagnosis in European patients must consider the heterogeneity of borreliae for development of diagnostic tools. According to guidelines of the USA and Germany, serological diagnosis should follow the principle of a two-step procedure (enzyme-linked immunosorbent assay (ELISA) as first step, if reactive; followed by immunoblot). The sensitivity and standardization of immunoblots has been considerably enhanced by use of recombinant antigens (p100, p58, p41i, VlsE, OspC, DbpA) including those expressed primarily in vivo (VlsE and DbpA) instead of whole cell lysates. VlsE is the most sensitive antigen for IgG antibody detection, OspC for IgM antibody detection. At present, detection rates for serum antibodies are 20%-50% in stage I, 70%-90% in stage II, and nearly 100% in stage III Lyme disease. Detection of the etiological agent by culture or polymerase chain reaction (PCR) should be confined to specific indications and specialized laboratories. Recommended specimens are skin biopsy specimens, cerebrospinal fluid (CSF) and synovial fluid. The best results are obtained from skin biopsies with culture or PCR (50%-70%) and synovial tissue or fluid (50%-70% with PCR). CSF yields positive results in only 10%-30% of patients except when the duration of symptoms is shorter than 2 weeks (50% sensitivity). Methods which are not recommended or adequately documented for diagnosis are antigen tests on body fluids, PCR of urine, and lymphocyte transformation tests.

Animals↗
PubMed2003

Industrial and agricultural pollution: a threat to the health of children living in the Arctic region.

UNLABELLED: Various environmental pollutants of industrial or agricultural origin such as persistent organic pollutants (POCs) are causing great concern owing to their toxicity to humans and animals. At the Stockholm Convention on POCs in 2001, 12 of these pollutants, i.e. dioxins, PCBs (polychlorinated biphenyls) and DDT were referred to as "the dirty dozen". CONCLUSION: Collaborative studies by scientists from Canada, Russia, Scandinavia and other countries representing different fields such as environmental chemistry, ecology and medical sciences may increase our knowledge about the present threat of toxic chemicals to ecology and human health in the Arctic region. It is hoped that improved understanding will promote preventive political decisions.

Agriculture↗
PubMed2006

Secular change in adult stature has come to a halt in northern Europe and Italy.

AIM: To investigate whether the increase in adult stature in European countries is continuing. METHODS: The secular trend in growth after 1990 for various European countries was assessed by national conscript data. RESULTS: In Scandinavia and the Netherlands, the height has reached a plateau at 179-181 cm, and in Italy a plateau at 174 cm. In Belgium, Portugal and Spain, height continued to increase. CONCLUSION: Only in the northern European countries and Italy height has ceased to increase.

Adolescent↗
PubMed2002

The prevalence of chronic fatigue syndrome in Iceland - a national comparison by gender drawing on four different criteria.

The study was carried out to estimate the prevalence of chronic fatigue syndrome (CFS) in Iceland. No previous prevalence studies known to us have been undertaken in Iceland or in Scandinavia. A 95-item custom-made questionnaire was sent to 4000 randomly selected people. The response rate was 63%. The questionnaire was constructed to include questions on all the items found in the four most common criteria for diagnosing CFS; the criteria being Australian, British and American. Results show very different prevalences according to the criteria used. The prevalence ranged from 0 to 4.9%, with the most established criteria yielding a prevalence of 1.4%. Re-test validity of the questionnaire was good, the following results are based on the selection criteria by Fukuda et al. (Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Int Med 1994;121:953-9). Women were in a majority (78%); their mean age was 44, they were fully employed and worked long hours. They believed that the onset of their symptoms was stress related. The type of work was unskilled in the majority of cases. A significant proportion of the males felt a constant buzzing in their ears (P < 0.05). Food suppliants were used daily by significantly more women than men (P < 0.01). Men had more frequently phobic symptoms (P < 0.001) than did women. Differences were found in the prevalence of phobia and panic (P < 0.001) between women in the CFS group compared to healthy ones. A positive correlation was found in the prevalence of phobia between women in the CFS group and those with Iceland Disease.

Adult↗