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PubMed1979

Cultivable mycobacteria in sphagnum vegetation of moors in South Sweden and coastal Norway.

Intact sphagnum vegetation from moors in south Sweden and coastal areas of west Norway contained cultivable mycobacteria in 32% and 30% of the specimens, respectively. This frequency of specimens is lower than the 50% previously found in the partly altered moors of northwestern Germany, but the Scandinavian moors contained a larger variety of species. On both intact and altered moors M. chelonei and M. sphagni sp. nov. were found, the latter a homologous group of 151 strains. In south Sweden the highest frequency was found in S. balticum, S. recurvum. S. tenellum and S. compactum & molle. (40-65%). In coastal Norway the highest frequency was found in S. rubellum (48%) which offers favourable conditions for the accumulation of solar energy due to the red brown colour in the upper parts. Combined with a high humidity in coastal Norway in summer, this may contribute to the growth of mesophilic mycobacteria. A significant affinity of M. chelonei to S. tenellum was stated.

Mycobacterium↗
PubMed2002

Subjective need for implant treatment among middle-aged people in Sweden and Denmark.

BACKGROUND: The use of oral implants in prosthodontics has become widespread and regarded as a predictable treatment modality. However, there is a lack of knowledge among the general population about the prevalence and need for implant treatments. PURPOSE: This study was undertaken to register and compare the prevalence of dental implants and the subjective need for implant treatment among people in Sweden and Denmark. MATERIALS AND METHODS: Random samples taken from the national population registers in Sweden and Denmark comprised 1001 Swedish subjects aged 55 to 79 years and 1175 Danish subjects aged 45 to 69 years. Subjects were requested to fill out questionnaires regarding dental conditions, subjective need for implant treatment, whether they had received treatment with dental implants during the previous 10 years, and so on. RESULTS: Of the Swedes, 4.8% reported that they had dental implants, compared with 2.5% of the Danes. In the Swedish sample, age was significantly associated with subjective need for implant treatment. In the Danish sample, women showed a significantly higher subjective need for implant treatment than did men. CONCLUSIONS: Compared with the Swedish sample, the subjective need for treatment with dental implants was higher in the Danish sample, although the patient fees were substantially higher in Denmark.

Age Factors↗
PubMed1999

A field survey on the distribution of strongyle infections of horses in Sweden and factors affecting faecal egg counts.

Faecal egg counts were performed during the first quarter of 1995 on samples from 1183 horses of varying breeds, ages and gender on 110 farms in 3 regions of Sweden. The majority of the horses had been treated with ivermectin or pyrantel when stabled the previous autumn. The risk of reinfection with strongyles between treatment and sampling was therefore considered to be minimal. Consequently, the results reflect primarily the occurrence of worms originating from inhibited strongyle larvae refractory to anthelmintic treatment. A total of 922 (78%) individuals were found to shed strongyle eggs, and 15 (14%) of the farms studied had at least one horse infected with Strongylus vulgaris. There was a significant, gradual decrease in faecal egg output in horses originating from the southern to the northern part of Sweden. Horses from studfarms showed significantly higher numbers of strongyle eggs/g faeces (EPG) as compared to those on other types of farms, such as riding-schools and boarding stables. However, there was no correlation between herd size and mean herd EPG. The output of strongyle eggs was highest in horses aged 2 and 3 years. EPG values then declined with increasing age of the horse. Horses treated with ivermectin in the previous autumn showed significantly lower EPG values than untreated horses and those treated with pyrantel pamoate.

Animals↗
PubMed1992

Antimicrobial susceptibilities of Campylobacter jejuni and Campylobacter coli isolated in Sweden: a 10-year follow-up report.

Resistance to erythromycin and doxycycline and more recently to fluoroquinolones has been reported to occur in Campylobacter spp. both in vitro and in patients treated with these antibiotics. The frequency of resistance to 14 antimicrobial agents in Campylobacter jejuni and Campylobacter coli isolated from patients infected in Sweden or abroad is described. For some agents, a comparison of susceptibility in strains of Campylobacter spp. isolated in 1978 with those isolated in 1988 is made. No general increase in in vitro resistance to antibiotics commonly used for the treatment of human gastroenteritis caused by C. jejuni or C. coli has occurred during the last 10 years in Sweden, which might be a consequence of strict antibiotic control. The numbers of strains from 1988 to 1989 resistant to ciprofloxacin and to norfloxacin included in this study (0.7 and 1.4%, respectively) are still fewer than those that were resistant to erythromycin (7.3%) or doxycycline (12.4%). There is, however, since 1989 to 1990 an indication of increasing resistance to these antibiotics.

Anti-Bacterial Agents↗
PubMed1980

Ochratoxin A in blood from slaughter pigs in Sweden: use in evaluation of toxin content of consumed feed.

Samples of pig blood, intended for ochratoxin A analysis, were collected from pigs of 279 randomly selected herds. The samples were obtained at nine different slaughterhouses from different areas of Sweden. Pigs from 47 herds (16.8% of the total) exhibited ochratoxin A in amounts of greater than or equal to 2 ng of ochratoxin A per ml of blood. One sample each from a single pig per herd identified herds contaminated with ochratoxin A in amounts exceeding three times the detection limit of the method (3 x 2 ng of ochratoxin A per ml of blood = 6 ng of ochratoxin A per ml of blood). There was a good agreement between ochratoxin A concentrations in the blood from different pigs within the same herd (correlation coefficient = 0.80). The ochratoxin A concentration in pig blood was used as an estimate of the ochratoxin A content of the consumed feed. This method showed that feed from grain produced on-farm contained higher concentrations of ochratoxin A than commercial feed preparations. No geographical variation of ochratoxin A occurrence within Sweden was detected.

Animal Feed↗
PubMed1998

Comparison of membrane filtration and multiple-tube fermentation by the colilert and enterolert methods for detection of waterborne coliform bacteria, Escherichia coli, and enterococci used in drinking and bathing water quality monitoring in southern sweden.

A total of 338 water samples, 261 drinking water samples and 77 bathing water samples, obtained for routine testing were analyzed in duplicate by Swedish standard methods using multiple-tube fermentation or membrane filtration and by the Colilert and/or Enterolert methods. Water samples came from a wide variety of sources in southern Sweden (Skåne). The Colilert method was found to be more sensitive than Swedish standard methods for detecting coliform bacteria and of equal sensitivity for detecting Escherichia coli when all drinking water samples were grouped together. Based on these results, Swedac, the Swedish laboratory accreditation body, approved for the first time in Sweden use of the Colilert method at this laboratory for the analysis of all water sources not falling under public water regulations (A-krav). The coliform detection study of bathing water yielded anomalous results due to confirmation difficulties. E. coli detection in bathing water was similar by both the Colilert and Swedish standard methods as was fecal streptococcus and enterococcus detection by both the Enterolert and Swedish standard methods.

Bacteriological Techniques↗
PubMed1979

Phage heterogeneity of coagulase-negative staphylococci isolated in the United States and Sweden from bovine milk.

A Swedish bovine and a Dutch human phage set for coagulase-negative staphylococci were used to phage type coagulase-negative staphylococci isolated from bovine milk from Minnesota dairy herds. A comparison was also made of the deoxyribonuclease activity of coagulase-negative staphylococci isolated from bovine milk in Sweden and Minnesota. Of 133 Minnesota isolates, only one could be typed with the Swedish set and one by the Dutch set, whereas of 218 Swedish strains, 49 could be typed with the Swedish set and 7 by the Dutch set. A larger number of coagulase-negative isolates from Sweden were deoxyribonuclease positive (35%) than were the similar isolates from Minnesota (12%). These findings substantiate the marked heterogeneity of coagulase-negative staphylococci isolated from bovine udders. Results presented point to the usefulness of establishing regional phage sets for epidemiological investigations of coagulase-negative staphylococci in cattle. It is anticipated that at a later stage the regional phage sets will be coordinated internationally.

Animals↗
PubMed2001

Characterization of Lyme borreliosis isolates from patients with erythema migrans and neuroborreliosis in southern Sweden.

Southern Sweden is an area of Lyme borreliosis (LB) endemicity, with an incidence of 69 cases per 100,000 inhabitants. The most frequent clinical manifestations are erythema migrans (77%) and neuroborreliosis (16%). There was no record of human Borrelia strains being isolated from patients in this region before the prospective study reported here. Borrelia spirochetes were isolated from skin and cerebrospinal fluid (CSF) from LB patients living in the region. A total of 39 strains were characterized by OspA serotype analysis, species-specific PCR, and signature nucleotide analysis of the 16S rRNA gene. Of 33 skin isolates, 31 (93.9%) were Borrelia afzelii strains and 2 (6.1%) were Borrelia garinii strains. Of six CSF isolates, five (83.3%) were B. garinii and one (16.7%) was B. afzelii. Neither Borrelia burgdorferi sensu stricto strains nor multiple infections were observed. The B. afzelii isolates were of OspA serotype 2. Three B. garinii strains were of OspA serotype 5, and the remaining four strains were of OspA serotype 6. All of the B. garinii strains belonged to the same 16S ribosomal DNA ribotype class. Our findings agree with earlier findings from other geographic regions in Europe where B. afzelii and B. garinii have been recovered predominantly from skin and CSF cultures, respectively. To further study the possible presence in Sweden of the genotype B. burgdorferi sensu stricto, which is known to be present in Europe and to occur predominantly in patients with Lyme arthritis, molecular detection of Borrelia-specific DNA in synovial samples from Lyme arthritis patients should be performed.

Antigens, Surface↗
PubMed2001

Comparison of serogroup W-135 meningococci isolated in Sweden during a 23-year period and those associated with a recent hajj pilgrimage.

An outbreak of serogroup W-135 meningococcal disease was reported among pilgrims returning from the annual hajj (pilgrimage to Mecca) in mid-March 2000. Molecular characterization was used to investigate the similarity of the hajj-associated W-135 strains with those isolated in Sweden during a 23-year period (1978 to 2000). The same hajj-associated genosubtype, genosubtype P1.5,2,36b, has been documented in Sweden since 1979, while pulsed-field gel electrophoresis and the sulfadiazine resistance of the W-135 isolates indicated that the outbreak was probably due to a new clone of W-135 meningococci.

Disease Outbreaks↗
PubMed2004

Molecular epidemiology of Mycobacterium tuberculosis in western Sweden.

The genetic diversity of Mycobacterium tuberculosis isolates among patients from Sweden was determined by a combination of two PCR-based techniques (spoligotyping and variable number of tandem repeats analysis). It resulted in a clustering of 23.6% of the isolates and a rate of recent transmission of 14.1%. The clustered isolates mainly belonged to the Haarlem family (23.2%), followed by the Beijing (9.8%), Latin American and Mediterranean (LAM; 8%), and East African-Indian (EAI; 6.2%) families. A comparison of the spoligotypes with those in the international spoligotyping database showed that 62.5% of the clustered isolates and 36.6% of all isolates typed were grouped into six major shared types. A comparison of the spoligotypes with those in databases for Scandinavian countries showed that 33% of the isolates belonged to an ill-defined T family, followed by the EAI (22%), Haarlem (20%), LAM (11%), Central Asian (5%), X (5%), and Beijing (4%) families. Both the highest number of cases and the proportion of clustered cases were observed in patients ages 15 to 39 years. Nearly 10% of the isolates were resistant to one or more drugs (essentially limited to isoniazid monoresistance). However, none of the strains were multidrug resistant. Data on the geographic origins of the patients showed that more than two-thirds of the clustered patients with tuberculosis were foreign-born individuals or refugees. These results are explained on the basis of both the historical links within specific countries and recently imported cases of tuberculosis into Sweden.

Adolescent↗
PubMed1990

Acute epiglottitis in children and adults in Sweden 1981-3.

In a retrospective study of the incidence of acute epiglottitis in Sweden, 485 children and 356 adults fulfilled the following criteria: (a) red and swollen epiglottis visualised at laryngoscopy; (b) stridor or difficulties in swallowing own saliva or water; and (c) temperature greater than or equal to 38 degrees C. The age specific incidence in children (0-14 years) was 10 and in adults (greater than or equal to 15 years) 1.8/100,000/year. These incidence rates were higher than the incidence of Haemophilus influenzae meningitis in the same population. Blood cultures were obtained from 290 children (60%) and 185 adults (52%). H influenzae was isolated from 267 blood cultures (92%) from children and 98 blood cultures from adults (53%). Other organisms were isolated from six adults (3%). An artificial airway was established in 352 children (73%) and in 68 adults (19%); the remainder were treated conservatively. Six children and two adults died. Sweden has a high incidence of acute epiglottitis in children and the disease also occurs in adults. The importance of H influenzae in the aetiology of epiglottitis in all age groups is confirmed, but in adults many cases occur without septicaemia. The mortality is currently very low.

Acute Disease↗
PubMed2001

Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996.

BACKGROUND: From the early 1970s to the early 1990s, there was a significant rise in the incidence of sudden infant death syndrome (SIDS) in Scandinavia. Following the risk reducing campaign, the incidence has fallen to about the same level as in 1973. AIMS: To identify the changes that have occurred in the epidemiology of SIDS. METHODS: We compared the Swedish part of the Nordic Epidemiological SIDS Study (NESS), covering the years 1992-1995, with two earlier, descriptive studies during this period. To assess the changing effects of risk factors, we analysed data from the Medical Birth Registry of Sweden, covering the years 1973-1996. RESULTS: There was a predominance of deaths during weekends in the 1970s and 1990s. The seasonal variation was most notable in the 1980s. The proportion of young mothers decreased from 14% to 5%. Cohabitation (living with the biological father) was as frequent in the 1990s as in the 1970s. The prevalence of high parity, admissions to neonatal wards, low birth weight, prematurity, and multiple pregnancies were all increased in the 1990s compared to the 1970s. No significant change in the prevalence of previous apparent life threatening events was found. Deaths occurring in cars diminished from 10% to below 2%. In the data from the Medical Birth Registry of Sweden, there were significantly increased odds ratios after the risk reducing campaign of the risk factors smoking during early pregnancy and preterm birth. We could find no increased effects of maternal age, parity, or being small for gestational age over time. The rate of deaths at weekends remained increased; the median age at death fell from 90 to 60 days. Seasonal variation was less notable in the periods of low incidence.

Age Distribution↗
PubMed2004

Results from a nationwide postmarketing cohort study of patients in Sweden treated with etanercept.

OBJECTIVES: To describe a nationwide system for postmarketing follow up of new antirheumatic drugs in Sweden, and to analyse safety and effectiveness in an etanercept treated patient cohort. METHODS: Etanercept became available in Sweden for prescribing on a named patient basis in 1999. All patients treated were included in a follow up of intensified adverse event reporting and recording of clinical outcome during 24 months, according to the EULAR core set. RESULTS: The mean (SD) disease activity score (DAS 28) value at inclusion among 820 patients recruited on a named patient basis during year 1 was 5.99 (1.19). After two years, 21% (n = 172) of these patients had discontinued the treatment. Of the remaining 648 patients, 68% (n = 442) responded to the treatment. However, in 55% of the responders, the disease activity was intermediate or high (mean DAS 28, 3.37 (1.20)). In all, 540 adverse events were reported in 421 adverse drug reaction (ADR) reports, in 294 patients. The events in 80 reports (19%) were serious. Twenty two per cent of the events were infections, of which 24% (n = 29) were serious. The incidence of serious adverse events remained constant over time. CONCLUSIONS: At start of etanercept treatment, patients had high disease activity. Activity remained high in a large proportion of the responding patients. Although serious ADRs occurred during late phases of treatment, no unexpected safety problems arose. No specific indicators of ADR risk were found. The monitoring system that was established may be useful in future postmarketing surveillance.

Adult↗
PubMed2002

Annual incidence of inflammatory joint diseases in a population based study in southern Sweden.

OBJECTIVE: To estimate the annual incidence of inflammatory joint diseases in a population based prospective referral study in an adult population in Kronoberg County in southern Sweden. METHODS: The patients were referred from primary healthcare centres to the rheumatology department in Växjö Central Hospital or to the one private rheumatologist in Växjö participating in the study. Additionally, the hospital records for patients with joint aspirates during the inclusion period were checked. The patients were registered as incident cases if the onset of the joint inflammation was between 1 May 1999 and 1 May 2000. A systematic follow up of incoming referrals was conducted up to 31 January 2001. Children under the age of 16 and patients with septic arthritis, crystal arthropathies, and osteoarthritis were excluded from the study. RESULTS: A total of 151 new cases with inflammatory joint diseases were identified during one year, corresponding to a total annual incidence of 115/100 000. Of these, 31 patients (21%) had rheumatoid arthritis, the annual incidence being 24/100 000 (for women 29/100 000, and for men 18/100 000). Reactive arthritis was diagnosed in 37 patients (24%, annual incidence 28/100 000) and 54 patients had undifferentiated arthritis (36%, annual incidence 41/100 000). Eleven patients presented with psoriatic arthritis (7%, annual incidence 8/100 000). The incidence of Lyme arthritis was small in this non-endemic area, and the incidence of sarcoid arthritis corresponded to that in earlier studies. CONCLUSION: This is the first prospective population based annual incidence study of early arthritis in Sweden. In this population, 36% of the incident cases had undifferentiated arthritis, whereas rheumatoid arthritis and reactive arthritis accounted for 45% of the cases. The incidence figures compare well with figures reported from other countries.

Adolescent↗
PubMed1982

Adverse reactions to nitrofurantoin in the United Kingdom, Sweden, and Holland.

A study was carried out comparing the reporting of adverse reactions to nitrofurantoin in Sweden, Holland, and the United Kingdom. The Swedish drug regulatory authorities receive more reports of adverse reactions to nitrofurantoin than to any other drug, and the annual reporting rate is increasing despite a steady fall in the prescription of nitrofurantoin. In the United Kingdom the total number of adverse reaction to nitrofurantoin reported to the Committee on Safety of Medicines has been steadily falling for many years, as has the number of prescription. Lung reactions and liver damage are more commonly reported in Sweden than in the UK, where gastrointestinal symptoms and peripheral neuropathy are more common. Such figures as were available in Holland showed an intermediate picture. The incidences of blood dyscrasias and allergic reactions are similar in the three countries. The causes for such differences are unresolved, but it is disturbing that the incidence and range of adverse reactions to such a common drug as nitrofurantoin reported to the national authorities can differ so much in countries that have close ethnic, dietary, and economic similarities. Thus great caution must be observed when data on adverse drug reactions from the country are extrapolated to another.

Chemical and Drug Induced Liver Injury↗
PubMed1983

Mass vaccination programme aimed at eradicating measles, mumps, and rubella in Sweden: first experience.

General vaccination with a combined measles, mumps, and rubella vaccine was introduced in Sweden in 1982. The immunisation schedule comprises two vaccine injections, given at 18 months and 12 years of age, respectively. A controlled field study was carried out in 150 children aged 18 months using two different batches of the vaccine. Seroconversion was seen in 96% against measles, 93% against mumps, and 99% against rubella--the same rates with both vaccine lots. Nevertheless, a difference was noted between the two batches with respect to postvaccination reactions. Fever and rash were recorded mainly five to 12 days after vaccination. Moderate fever (38.5-39.4 degrees C) was observed in 22 children, high fever (greater than or equal to 39.5 degrees C) in 33, and rash in 35. Preliminary results obtained by follow up of routinely vaccinated schoolchildren aged 12 indicated considerably lower rates of fever and rash during the postvaccination period, occurring in 3-10% of cases only. These findings show that complete eradication of measles, mumps, and rubella in Sweden is entirely practicable by the mass vaccination programme and that side effects of vaccination are likely to be few and mild.

Child↗
PubMed1994

Choice of antidepressants: questionnaire survey of psychiatrists and general practitioners in two areas of Sweden.

OBJECTIVE: To identify factors that affect physicians' choice of specific antidepressant drugs in order to evaluate the validity of epidemiological studies of the risks (particularly suicide) and benefits of different compounds. DESIGN: Questionnaire survey of 264 psychiatrists and general practitioners in an urban area and a rural area of Sweden with validation of data by independent prescription surveys. SETTING: Urban area of greater Stockholm and rural county of Jämtland, Sweden. SUBJECTS: 228 physicians (86%) who answered the questionnaire. MAIN OUTCOME MEASURES: The drugs used as first line drugs of choice, as drugs of choice in particularly severe depression, and as drugs of choice for disorders other than depression. RESULTS: Amitriptyline was the most common first line drug of choice among both psychiatrists and general practitioners. The patterns of choice of antidepressants in the two areas accorded with prescribing patterns in two independent prescription surveys. Amitriptyline was chosen even more frequently for severe depression and depression with severe insomnia. Clomipramine was chosen comparatively more often for depression with severe anxiety. Low toxicity compounds (mainly lofepramine, mianserin, and moclobemide) were more often the drug of choice in depression associated with overt risk of suicide. Amitriptyline and clomipramine were used extensively for disorders other than depression (40% and 54% of prescriptions, compared with 13-19% for some other major antidepressants). CONCLUSION: Patient groups treated with different antidepressant compounds may not be comparable with respect to diagnoses and severity of disease. In particular, lofepramine, mianserin, and moclobemide, and possibly amitriptyline, seem to be chosen more often for patients prone to suicide.

Antidepressive Agents↗
PubMed1996

Pet birds and risk of lung cancer in Sweden: a case-control study.

OBJECTIVE: To investigate the association between keeping birds and the risk of lung cancer in Sweden. DESIGN: Case control study based on cases of lung cancer and community controls. Interviews were performed by two nurses specially trained for this project. SETTING: Three major referral hospitals located in southwest Sweden. SUBJECTS: All patients aged 75 and under with newly diagnosed lung cancer and of Scandinavian birth who lived in one of 26 municipalities in Gothenburg and Bohus county or Alvsborg county. Potential control subjects matched on county of residence, sex, and closest date of birth were selected from population registries. In the context of a larger case-control study, information on pet birds was obtained from 380 patients with lung cancer (252 men) and 696 controls (433 men). MAIN OUTCOME MEASURES: Odds ratios for lung cancer in relation to whether or not pet birds were kept and the duration of keeping pet birds. RESULTS: The adjusted odds ratio for ever versus never exposed to pet birds at home was 0.94 (95% confidence interval 0.64 to 1.39) for men and 1.10 (0.64 to 1.90) for women. There was no evidence of a trend for increased risk of lung cancer with duration of bird ownership. CONCLUSION: Bird keeping does not seem to confer any excess risk of lung cancer to Swedish men or women.

Adult↗