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Chronic otitis media sequelae in skeletal material from medieval Denmark.

OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in archaeological skeletal materials from various ages. COMS reflecting episodes of upper respiratory tract infection may be used as a paleopathological indicator of general health. Estimation of the frequency of COMS may be useful in the gross evaluation of general standard of living. MATERIALS AND METHODS: Temporal bones and auditory ossicles from 659 individuals from two Danish medieval rural parish cemeteries, dated to 1050-1200 and 1150-1350, respectively, were examined otomicroscopically. RESULTS: Osseous fistulae from mastoid abscesses, remodelling of the hypotympanon, and erosion of the incus were among the convincing indications of COMS. A minimum frequency of COMS of 1% to 7% was found. The youngest material displayed the highest frequency of pathological changes. CONCLUSION: Indications of a rising incidence of infectious middle ear disease in early medieval Denmark were found. This may reflect a deterioration of living conditions from the 11th through the 14th centuries.

Bone Diseases↗

In vitro susceptibility of Neisseria gonorrhoeae to cefuroxime, penicillin, and tetracycline in Denmark-1979.

In vitro susceptibility to cefuroxime, penicillin, and tetracycline of 963 strains of Neisseria gonorrhoeae strains isolated in Denmark in 1979 was tested. If penicillinase-producing strains of N. gonorrhoeae were excluded from the analysis, a significant positive correlation between the 50% inhibitory concentrations (IC50) of cefuroxime and penicillin was observed (r = 0.87). Among strains exhibiting IC50 of penicillin of greater than or equal to 0.30 microgram/ml, 80% (106/133) had an IC50 of cefuroxime of greater than or equal to 0.088. Ninety-six per cent (106/110) of strains exhibiting an IC50 of cefuroxime of greater than or equal to 0.088 microgram/ml were less susceptible to penicillin (IC50, greater than or equal to 0.30 microgram/ml). The IC50 values of tetracycline were positively correlated with those of cefuroxime. There was no apparent difference between the level of antimicrobial susceptibility of strains (623) isolated from urogenital sites and that of strains (109) from the pharynx.

Cefuroxime↗

Patterns and trends of sexual behavior, HIV testing, and HIV prevalence among all sexually transmitted disease clinic attenders in Denmark.

BACKGROUND AND OBJECTIVES: Persons attending a sexually transmitted disease (STD) clinic have shown to be at a higher risk for HIV infection than the population in general. We evaluate the patterns of HIV prevalence and testing in relation to reported risk behavior. STUDY DESIGN: Data have been collected on all new attenders at the Danish STD clinics. The study period was January 1, 1990 through March 1992. RESULTS: Testing for HIV was accepted by 74% and more often by women than men and more outside Copenhagen than in the city itself. Acceptance was lowest among homo/bisexual men seen in Copenhagen. The HIV prevalence was highest among homo/bisexual men with drug use (10.0%) and lowest among heterosexual men (0.3%) and women (0.2%). Among heterosexuals the test activity increased over time, and the test activity increased and the prevalence of HIV antibodies decreased with the number of reported sex partners. Among heterosexuals HIV infection was associated with not being born in Denmark and age (> or = 30 years old in women and > or = 35 years old in men). CONCLUSION: These results are relevant for the national HIV surveillance programs and campaigns, and stress the importance of offering HIV testing to all persons attending for an STD examination.

AIDS Serodiagnosis↗

Occurrence of trichomoniasis in women in Denmark, 1967-1997.

BACKGROUND: The Neisseria Unit at Statens Serum Institut (SSI), Copenhagen, Denmark administers laboratory surveillance systems for gonorrhea and chlamydia, however, no similar system has been available for trichomoniasis. OBJECTIVES: To describe changes in the occurrence of trichomoniasis in women and in the distribution according to age, and to compare these changes with those observed in women with gonorrhea or chlamydia. STUDY DESIGN: Data on the epidemiology of trichomoniasis were based on the annual laboratory records at the Neisseria Unit at SSI. Data on gonorrhea (1967-1997) and chlamydia (1994-1997) originated from the National Laboratory Surveillance Systems. RESULTS: During the period 1967 to 1997, the percentage of Trichomonas vaginalis-positive specimens showed a constant decrease from 19 to fewer than 2. The annual number of specimens received varied between a maximum of 31,626 in 1975 and a minimum of 3,291 in 1997. The median age of women with trichomoniasis increased from 31 to 39 years as compared with a change from 21 to 24 years in women with gonorrhea (1967-1997) and a median age of 22 years in women with chlamydia (1994-1997). CONCLUSIONS: A significant decline in the occurrence of trichomoniasis in women concurrent with a significant rise in the median age of women with the disorder was observed. During the periods investigated, women with trichomoniasis were significantly older than women with gonorrhea or chlamydia.

Adolescent↗

The intrauterine origin of male breast cancer: a birth order study in Denmark.

First pregnancies are known to have higher oestrogen levels than later ones and first-born women are at increased breast cancer risk compared with later-born women. We hypothesized that a birth order effect might be even more evident in male breast cancer patients, in whom oestrogens in adult life are generally low. In a population-based study in Denmark involving 77 male breast cancer patients and 288 population controls, first-born men compared with later-born men had a relative risk of 1.71 for the disease (95% confidence interval (CI) 1.00-2.92). This result is in line with that seen in female breast cancer cases and indicates that male breast cancer may have roots in the intrauterine life, oestrogens being a likely mediator.

Birth Order↗

A population-based cohort study of mortality among users of ibuprofen in Denmark.

Using the population-based Pharmacoepidemiologic Prescription Database of North Jutland County, Denmark, we identified 113,538 persons who filled prescriptions for ibuprofen during 1989 through 1995 and determined subsequent mortality through 1996. Standardized mortality ratios [SMRs] for 25 specific causes of death were computed compared with the general population. SMRs were elevated for most causes of death, with an overall SMR of 1.21 (95% confidence interval 1.19-1.24) among persons who filled prescriptions for ibuprofen. There was a nearly threefold increase in the number of deaths from gastrointestinal bleeding within 1 year of ibuprofen prescription but no concomitant increase in hemorrhagic stroke. Elevated SMRs were seen for several cancer types, although the mortality ratios were highest within 1 year of prescription and declined with longer follow-up. For colon cancer, SMRs were below 1.0 three or more years after ibuprofen prescription. For hypertensive disease, nonhemorrhagic stroke, and diabetes, we observed slight but significant elevations of the SMRs that persisted beyond the fifth year of follow-up. Our findings indicate a slight increase in overall mortality among persons receiving ibuprofen on prescription. This excess was greatest within the first year, due partially to ibuprofen-related gastrointestinal bleeding but mostly to elevated cancer mortality among ibuprofen users. This temporal pattern is characteristic of an effect of confounding by indication, with ibuprofen being used for pain relief by patients with imminent fatal illnesses such as cancer. The slight excess mortality that persisted beyond the first few years was largely due to elevated death from hypertensive disease and diabetes, which may be explained in part by increased prescription of ibuprofen to patients with long-standing medical problems.

Adolescent↗

Cauda equina syndrome in lumbar spinal stenosis: case report and incidence in Jutland, Denmark.

BACKGROUND: Cauda equina syndrome in spinal stenosis is a rare complication. During a 5-year period (1996-2000), 340 cases of spinal stenosis were diagnosed in the County of South Jutland, Denmark. The annual incidence of spinal stenosis was 272 per million inhabitants. During that period, only one patient with acute cauda equina syndrome in spinal stenosis was diagnosed: that is, the patient described herein. METHODS AND RESULTS: A 74-year-old woman appeared with urinary retention and fecal incontinence for the previous 24 hours. Computed tomography scan showed spinal stenosis from L2 to L4. She underwent an urgent operation and recovered within 5 days from her anal sphincter paresis and within 5 weeks from her bladder paresis.

Aged↗

Birth cohort effect on the obesity epidemic in Denmark.

BACKGROUND: In Denmark, the obesity epidemic has developed in phases. To investigate if this has been a birth cohort phenomenon, we explored the secular trend in the prevalence of obesity among boys and young men. METHODS: We calculated body mass index (BMI; kg/m) over time for 163,835 Danish boys examined at ages 7-11 years and for 708,342 male draftees examined at age 19 years. Obesity was defined according to age-specific criteria for boys and as BMI >or=31 kg/m for men. We examined trends in the prevalence of obesity from 1930 through 1999, expressing time as the subjects' year of measurement and as year of birth. RESULTS: When expressed by year of measurement, 4 phases in the prevalence of obesity emerged for the boys and the young men, but they occurred at different times. However, when expressed by year of birth, the 2 stable periods and the 2 periods with sharp increases in obesity occurred in the same birth years. An increased prevalence of obesity was identified for birth cohorts from the early 1940s to the mid-1950s and from the late 1960s onward. CONCLUSIONS: The trends in the prevalence of obesity were similar in boys and young men only when expressed by year of birth, which suggests that early life may be a susceptible period for developing obesity. Specifically, the increased prevalence of obesity observed for birth cohorts from the early 1940s to the mid-1950s and from the late 1960s onward suggests that changes in the early life of these cohorts resulted in an increase in obesity at later ages.

Adolescent↗

Molecular evolution of puumala hantavirus in Fennoscandia: phylogenetic analysis of strains from two recolonization routes, Karelia and Denmark.

Like other members of the genus HANTAVIRUS: in the family BUNYAVIRIDAE:, Puumala virus (PUUV) is thought to be co-evolving with its natural host, the bank vole Clethrionomys glareolus. To gain insight into the evolutionary history of PUUV in northern Europe during the last post-glacial period, we have studied wild-type PUUV strains originating from areas along two postulated immigration routes of bank voles to Fennoscandia. Full-length sequences of the S RNA segment and partial sequences (nt 2168-2569) of the M segment were recovered by RT-PCR directly from bank vole tissues collected at three locations in Russian Karelia and one location in Denmark. Phylogenetic analysis showed that strains from Karelia and Finland belong to the same genetic lineage, supporting the hypothesis that PUUV spread to present Finland via a Karelian land-bridge. The Danish PUUV strains showed no particularly close relatedness to any of the known PUUV strains and formed a distinct phylogenetic lineage on trees calculated for both S and M segment sequences. Although no direct link between the Danish PUUV strains and those of the southern Scandinavian lineage was found, within the S segment of Danish PUUV strains, two regions with higher similarity to either northern Scandinavian or - to a less extent - southern Scandinavian genetic lineages were revealed, suggesting evolutionary connections of their precursors.

Amino Acid Sequence↗

Lectin typing of methicillin-resistant Staphylococcus aureus from Singapore, England and Wales, and Denmark.

Methicillin-resistant Staphylococcus aureus (MRSA) isolates from a possible outbreak in Singapore (84) were examined together with all MRSA isolated in Denmark in 1986-1990 (58) and 14 distinct epidemic and 10 distinct single hospital strains from England and Wales. All 84 Singapore isolates were phage typed routinely and 52 isolates were further analysed together with the Danish isolates with an additional set of experimental phages and by lectin typing. The British strains, previously phage typed in the same way, were lectin typed. The following lectins were used: wheat-term agglutinin, soy-bean agglutinin, tomato lectin and Concanavalin-A. Routine phage typing of the Danish isolates showed that 41 isolates belonged to 19 different types; 17 isolates were non-typable (NT). Addition of experimental phage typing and lectin typing enhanced discrimination to 47 types. The 24 British strains could be divided into eight [corrected] "lectin types". Sixty-one of the isolates from Singapore were non-typable by phage typing; the remaining 23 strains belonged to five types. Further examination of 52 isolates with the experimental set of phages and by lectin typing gave 14 closely related types; 48% of these isolates belonged to only two types.

Bacterial Typing Techniques↗

Tenacibaculum skagerrakense sp. nov., a marine bacterium isolated from the pelagic zone in Skagerrak, Denmark.

A number of bacteria were isolated from sea water in Skagerrak, Denmark, at 30 m depth. Two of the isolates, strains D28 and D30(T), belonged to the Flavobacteriaceae within the Cytophaga-Flavobacterium-Bacteroides group. Sequencing of 16S rRNA genes of the two strains indicated strongly that they belonged to the genus Tenacibaculum and that they showed greatest similarity to the species Tenacibaculum amylolyticum and Tenacibaculum mesophilum. DNA-DNA hybridization values, DNA base composition and phenotypic characteristics separated the Skagerrak strains from the other species within TENACIBACULUM: Thus, it is concluded that the strains belong to a novel species within the genus Tenacibaculum, for which the name Tenacibaculum skagerrakense sp. nov. is proposed, with strain D30(T) (=ATCC BAA-458(T)=DSM 14836(T)) as the type strain.

Base Composition↗

Methanobacterium aarhusense sp. nov., a novel methanogen isolated from a marine sediment (Aarhus Bay, Denmark).

Strain H2-LR(T), a 5-18 micro m long and 0.7 micro m wide filamentous, mesophilic, moderately halophilic, non-motile hydrogenotrophic methanogen, was isolated from marine sediment of Aarhus Bay, Denmark, 1.7 m below the sediment surface. On the basis of 16S rRNA gene comparison with sequences of known methanogens, strain H2-LR(T) could be affiliated to the genus Methanobacterium. The strain forms a distinct line of descent within this genus, with Methanobacterium oryzae (95.9 % sequence identity) and Methanobacterium bryantii (95.7 % sequence identity) as its closest relatives. The 16S rRNA-based affiliation was supported by comparison of the mcrA gene, which encodes the alpha-subunit of methyl-coenzyme M reductase. Strain H2-LR(T) grew only on H(2)/CO(2). The DNA G+C content is 34.9 mol%. Optimum growth temperature was 45 degrees C. The strain grew equally well at pH 7.5 and 8. No growth or methane production was observed below pH 5 or above pH 9. Strain H2-LR(T) grew well within an NaCl concentration range of 100 and 900 mM. No growth or methane production was observed at 1 M NaCl. At 50 mM NaCl, growth and methane production were reduced. Based on 16S rRNA gene sequence analysis, the isolate is proposed to represent a novel taxon within the genus Methanobacterium, namely Methanobacterium aarhusense sp. nov. The type strain is H2-LR(T) (=DSM 15219(T)=ATCC BAA-828(T)).

Base Composition↗

Clonal relationship of recent invasive Haemophilus influenzae serotype f isolates from Denmark and the United States.

Surveillance performed after the introduction of general Haemophilus influenzae serotype b (Hib) vaccination in Denmark identified 13 cases of invasive bacteraemic H. influenzae serotype f (Hif) disease in adults over a period of 7 years. Bacteraemic respiratory tract infections accounted for 61 % of cases, but meningitis, epiglottitis and osteoarthritis were also seen. Recent Danish isolates were compared to recent American isolates, historical Hif strains and non-Hif invasive strains. Results of conventional serotyping were confirmed by PCR detection of the serotype-f-specific cap and bexA gene sequences. Multilocus enzyme electrophoresis typing revealed that recent Danish and American isolates belonged to a single Hif clone, which may be undergoing expansion. The need for accurate serotyping of H. influenzae to enable reliable monitoring for Hib replacement by other capsular types is emphasized.

ATP-Binding Cassette Transporters↗

Nitrogen cycling in a Norway spruce plantation in Denmark--a SOILN model application including organic N uptake.

A dynamic carbon (C) and nitrogen (N) circulation model, SOILN, was applied and tested on 7 years of control data and 3 years of manipulation data from an experiment involving monthly N addition in a Norway spruce ( Picea abies, L. Karst) forest in Denmark. The model includes two pathways for N uptake: (1) as mineral N after mineralisation of organic N, or (2) directly from soil organic matter as amino acids proposed to mimic N uptake by mycorrhiza. The model was parameterised and applied to the data from the control plot both with and without the organic N uptake included. After calibration, the models performance was tested against data from the N-addition experiment by comparing model output with measurements. The model reproduced well the overall trends in C and N pools and the N concentrations in soil solutions in the top soil layers whereas discrepancies in soil-solution concentrations in the deeper soil layers are seen. In the control data, the needle-N concentration was well reproduced except for small underestimations in some years because of drought effects not included in the model. In the N-addition experiment, SOILN reproduces the observed changes; in particular, the changes in needle-N concentrations and the overall distribution within the ecosystem of the extra added 3.5 g N m(-2) year(-1) parallel the observations. When organic N uptake is included, the simulations indicate that in the control plot receiving c. 1.9 g N m(-2) year(-1), the organic N uptake in average supplies 35% of the total plant N uptake. By addition of an extra 35 kg N ha(-1) year(-1), the organic N uptake is reduced to 16% of the total N uptake. Generally, inclusion of the pathway for organic N uptake improves model performance compared with observations for both C and N. This is because mineral N uptake alone implies a larger mineralisation rate, leading to bigger concentrations of N in the soil and soil water, bigger N losses, and net loss of c. 100 kg C ha(-1) year(-1), thereby causing depletion of the organic soil layer.

Biomass↗

Adverse reactions to H2-receptor antagonists in Denmark before and after transfer of cimetidine and ranitidine to over-the-counter status.

The H2-receptor antagonists cimetidine and ranitidine were transferred from prescription only to over-the-counter (OTC) status in Denmark on March 27, 1989. Reports to the Danish Committee on Adverse Drug Reactions, a voluntary reporting system, have been evaluated to detect possible changes in frequency and pattern of adverse drug reactions (ADRs) caused by the altered delivery status. From the introduction of cimetidine in 1977 and until March 31, 1990, the Committee received 494 reports of 612 suspected adverse reactions to anti-ulcer drugs. The H2-receptor antagonists (mainly cimetidine and ranitidine) were responsible for 548 (90%) of the ADRs. The study, which presents experience with these drugs from more than a decade and a total consumption corresponding to 65 million treatment days, confirms their excellent safety record. Serious reactions were rare, and when they occurred, reversible. During the first year with cimetidine and ranitidine available OTC no changes were seen in reporting frequency or ADR pattern which could be ascribed to OTC transfer. Only one ADR report concerning OTC cimetidine was received. This may be caused by several factors: the safety of these drugs, the fact that only very little was actually sold OTC, and a relatively low sensitivity of the voluntary reporting system.

Adverse Drug Reaction Reporting Systems↗

A survey of occupational hand eczema in Denmark.

Occupational hand eczema (OHE) is the most frequently recognized work-related disease in Denmark and the annual cost to society is high. Understanding of the epidemiology of OHE is essential to be able to give appropriate recommendations for its prevention. The study comprised 758 persons, 490 females and 268 males with recognized OHE in the period October 2001 to November 2002. Data were obtained prospectively from the National Board of Industrial Industry Registry and from a self-administered questionnaire (response rate, 82%). The most frequently recognized diagnosis was irritant contact dermatitis (ICD), mainly caused by wet occupations. The proportion of occupational ICD was equal for males and females, 59.7% and 63.1%, respectively. The estimated rates of OHE were high for bakers, hairdressers and dental surgery assistants, and a high proportion of apprentices were found among hairdressers. The prevalence of atopic dermatitis was low (16.4%) compared to previous studies among hand eczema patients. The prevalence of occupational allergic contact dermatitis in the study population was substantially higher among males than females, and the most frequent causes among males were allergy to chromium (leather exposure), rubber additives (gloves) and nickel due to exposure from work tools and metalworking industry.

Adult↗

Asthma, ear problems, and dental anxiety among 6- to 8-yr-olds in Denmark: a population-based cross-sectional study.

The aim of this study was to examine the association between asthma, ear problems, and dental anxiety in children in a population-based cross-sectional study. The population included four municipalities in the County of North Jutland, Denmark, in 2001. A total of 1235 children aged 6-8 yr, and their parents, were identified. Data were obtained from a prescription database, from parental-answered questionnaires, and from dental records. Children with asthma were defined as children that had received prescriptions for both inhaled beta2-agonists and corticosteroids during the past year. Data on ear problems and dental anxiety were obtained from the questionnaires. Dental anxiety was measured using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Use of asthma-drugs was associated with dental anxiety (odds ratio = 1.70; 95% confidence interval 0.90-3.22). A history of often ear problems was also associated with dental anxiety (odds ratio = 1.83; 95% confidence interval 1.20-2.80). It is concluded that asthma and ear problems may be risk factors for dental anxiety in children.

Adrenergic beta-Agonists↗

Becker's rational addiction theory: An empirical test with price elasticities for distilled spirits in Denmark 1911-31.

AIM: To test an implication of Becker's rational addiction theory, namely that price changes will lead both to simultaneous consumption changes as well as lagged changes (and potentially also immediate changes if future changes in prices are anticipated). DESIGN: Time-series analysis, first of aggregate sales of distilled spirits and prices, controlled for gross national product (GNP), and secondly of deaths from delirium tremens. SETTING: Denmark 1911-31. Price changes were very large in the period 1916-18 due to shortages during World War I, and the Danish case can be conceived as a natural experiment. FINDINGS: No evidence for lagged price effects in the expected direction was found. On the contrary, the evidence pointed in the opposite direction. The immediate reduction in sales following rising prices are, to some degree, counteracted by an adjustment in the opposite direction the following year. The delirium tremens data confirm this pattern. CONCLUSION: Becker's theory is not confirmed. Several possible explanations are discussed. If the pattern observed in these data is representative of a more general mechanism, current price elasticity estimates may be too high, by ignoring lagged compensatory effects.

Alcohol Drinking↗