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PubMed2004

Intestinal and extra-intestinal cancer in Crohn's disease: follow-up of a population-based cohort in Copenhagen County, Denmark.

AIM: To determine the long-term risk of intestinal and extra-intestinal malignancies in Crohn's disease patients in Copenhagen County, Denmark. METHODS: In Copenhagen County, a strictly population-based cohort of 374 patients with Crohn's disease diagnosed between 1962 and 1987 was followed until 1997 in order to determine the long-term risk of intestinal and extra-intestinal malignancies. Information on cancer occurrence was provided by the Danish National Cancer Registry and confirmed by the examination of hospital files. The observed number of cases was compared with the expected number, calculated from individually computed person-years at risk and 1995 cancer incidence rates for the background population. RESULTS: The risk of small bowel adenocarcinoma was significantly increased, independent of age and gender (standardized morbidity ratio, 66.7; 95% confidence interval, 18.1-170.7). The risk of colorectal cancer was not increased, either in the total group of patients or in patients with colonic Crohn's disease exclusively (standardized morbidity ratio, 1.64; 95% confidence interval, 0.20-5.92). Extra-intestinal cancer did not occur more frequently than expected. CONCLUSIONS: This population-based study of patients with Crohn's disease revealed no increase in colorectal cancer risk, possibly due to maintenance treatment with 5-aminosalicylic acid preparations and surgery in treatment failure. In contrast, the risk of small bowel cancer was increased more than 60-fold, but the numbers were small. The risk of extra-intestinal cancer was not increased and no lymphomas were observed.

Adenocarcinoma↗
PubMed1986

Sparteine oxidation polymorphism in Greenlanders living in Denmark.

Sparteine oxidation appeared to be polymorphic in 185 healthy Greenlanders living in Denmark. Six subjects (3.2%) were phenotyped as poor metabolizers (PM) and 179 subjects as extensive metabolizers (EM). The metabolic ratio (MR) between sparteine and 2- + 5-dehydrosparteine in a 12 h urine sample ranged from 0.06-3.12 in EM and from 30-480 in PM. The excretion of dehydrosparteines accounted for less than 2.2% of the dose in PM and ranged from 5.6%-63% in EM. The urinary recovery (% of dose) of sparteine, 2-dehydrosparteine and total sparteine + dehydrosparteines was lower in Greenlander EM than in Danish EM (Brøsen et al., 1985). Incomplete urine collection in a substantial proportion of the Greenlanders could explain these discrepancies.

Adolescent↗
PubMed1993

Proguanil metabolism is determined by the mephenytoin oxidation polymorphism in Vietnamese living in Denmark.

1. A sparteine/mephenytoin phenotyping test was carried out in 37 Vietnamese living in Denmark. By visual inspection the urinary S/R-mephenytoin ratio appeared to show a bimodal frequency distribution. Eight putative poor metabolizers of mephenytoin, PMm (22%), had S/R-mephenytoin ratios from 0.79 to 1.12 and 29 putative extensive metabolizers of mephenytoin, EMm, had S/R-mephenytoin ratios < or = 0.55. All of the subjects were extensive metabolizers of sparteine with urinary metabolic ratios from 0.15 to 2.4. 2. The metabolism of the antimalarial prodrug proguanil was studied in 34 of the subjects after a single oral dose of 100 mg. The median 12 h urinary recoveries of the active metabolite cycloguanil and the minor metabolite 4-chlorphenylbiguanide were 5.8 and 1.9% of the dose, respectively, in 26 EMm compared with 1.6 and 0.4%, respectively, in 8 PMm (P < 0.001, Mann-Whitney U-test). 3. There was no statistically significant correlation (Spearmans rs) between any index of proguanil metabolism and the sparteine metabolic ratio.

Administration, Oral↗
PubMed2005

Statin use after acute myocardial infarction: a nationwide study in Denmark.

AIMS: To study outpatient statin use after first acute myocardial infarction (AMI) in Denmark between 1995 and 2002 and to determine the predictors of statin use. METHODS: This is a nationwide population-based study using administrative registries. Patients with first AMI between 1995 and 2002 older than 30 years of age and alive 6 months after discharge (n = 45 219) were identified through the National Patient Registry. The statins purchased by these patients within 6 months after discharge were determined using the Registry of Medicinal Product Statistics, a nationwide prescription database. RESULTS: Statin use following AMI increased from 13% in 1995 to 61% in 2002. In 2002, 81% of patients aged 30-64 years used statins. Older patients used fewer statins, but use increased more among patients aged 75-84 years: from 1.3% to 43%. Use in elderly patients did not differ according to gender in 2000-02, but young men used more than younger women. In 2000-02, patients with diabetes (odds ratio (OR): 0.84; 95% confidence interval (CI): 0.74-0.95) and with heart failure (OR: 0.70; 95% CI: 0.64-0.76) were undertreated; this trend was present throughout the period. CONCLUSIONS: In this nationwide study, younger patients after AMI had high statin use in 2002, but high-risk patients such as those with diabetes and heart failure were still being undertreated.

Adult↗
PubMed1978

Human infections with Microsporum gypseum in Denmark.

Ninety cases of Microsporum gypseum infection in Denmark during the period 1933-1977 are reviewed. The sex ratio, age distribution, and anatomical sites are started. A case of onychomycosis in a 1-year-old child is reported, and the cases of M. gypseum onychomycosis in the literature are reviewed.

Adolescent↗
PubMed1991

Skin cancer as a cause of death in Denmark.

Denmark has a well-established nation-wide registration system for cancer incidence and mortality. In 1984, 2984 new cases of non-melanoma skin cancer were notified to the Danish Cancer Registry and 40 deaths were attributed to this cause. An evaluation and validation of the death certificates indicate that the true number of deaths caused by non-melanoma skin cancer was 18. Basal cell and squamous cell carcinoma accounted for three and 15 of the deaths, respectively. The estimated lethality is 4.3% for squamous cell carcinoma and 0.12% for basal cell carcinoma.

Basal Cell Carcinoma↗
PubMedDate not supplied

Services for the mentally handicapped in Denmark.

This paper, based on a recent visit to Denmark, outlines some aspects of the Danish system of delivering services to the mentally handicapped that contrast sharply wtih the United Kingdom system. It attempts to review some of the implications of putting into practice a philosophy of normalization, viewed from both the administrative and client standpoints.

Adolescent↗
PubMed2006

Root canal treatment in Denmark is most often carried out in carious vital molar teeth and retreatments are rare.

AIM: To study the reasons given by a representative sample of Danish general dental practitioners (GDPs) for undertaking root canal treatment and, to investigate their confidence in performing root canal treatment on molar teeth. METHODOLOGY: A questionnaire was sent to 600 Danish GDPs randomly selected from the roster of the Danish Dental Association. They were asked to recall various factors about their experience of the last root filling they completed, including the reason for treatment and the pulp diagnosis. Self-assessments on 100-mm visual analogue scales (VAS) were reported concerning the confidence in performing root canal treatment of a molar. End-point definitions were 'very easy' (0) and 'very difficult' (100), respectively. Time reports of molar treatments were given in categorized groups. RESULTS: The most frequent reason for performing root canal treatment was caries within the tooth involved (55%). The majority of treatments involved teeth with vital pulps (54%). Retreatments were carried out in 2% of the cases. The confidence in performing root canal treatment varied but was relatively high, expressed as VAS-values below 50. The creation of an aseptic working field was regarded as the most difficult procedure followed by root canal preparation. Fifty-six percent of the responders stated a time frame of 46-75 min to complete root filling in a molar tooth. CONCLUSIONS: Root canal treatment in Denmark was reported to be undertaken most often because of caries. Treatment was typically performed in molar teeth with vital pulp. Even though apical periodontitis was frequently noted in root filled teeth, retreatments were rare. From a subjective perspective root canal treatment was not considered to be very difficult and was carried out relatively rapidly.

Analysis of Variance↗
PubMed1987

Incidence of bilateral testicular germ cell cancer in Denmark, 1960-84: preliminary findings.

The incidence of a second primary testicular germ cell cancer in the contralateral testicle among 2338 men with a first primary testicular germ cell cancer diagnosed in the years 1960-79 in Denmark was established in this preliminary report. The material represents 83% of the total cohort followed until 31 December 1984. The relative risk for a patient with testicular cancer to get yet another testicular cancer was studied, taking into account the histology of the first primary testicular germ cell cancer. Based on fifty-eight nonsimultaneous contralateral testicular cancer cases and 19,995 'person-years at risk', the overall relative risk of invasive germ cell cancer in the contralateral testicle following a first germ cell testicular cancer was found to be 23.3 (95% confidence interval: 18-30). Among men with nonseminoma the risk was higher (relative risk = 27.5) than among men with seminomas (relative risk = 20.1). Overall, sixty-two (2.7%) patients developed a second cancer. In four of these patients bilateral tumours occurred simultaneously.

Denmark↗
PubMed2006

Transmission routes of Salmonella Typhimurium DT 104 between 14 cattle and pig herds in Denmark demonstrated by molecular fingerprinting.

AIMS: Salmonella Typhimurium DT 104 is generally assumed to be spread by contact between live animals, e.g. by trading. The aim of the present study was to assess the importance of other routes of transmission in the dissemination of this bacterium. METHODS AND RESULTS: An outbreak among 14 cattle and pig herds located in a geographically narrow area in Denmark was investigated. Epidemiological information and disease history of the herds was obtained through interviews. Based on this, the hypothesis for horizontal spread was proposed, and these were confirmed by comparison of the pulsed field gel electrophoresis (PFGE) and the plasmid profiles of isolates obtained by continuous sampling over a period of almost 3 years. CONCLUSIONS: The study indicated that other routes might play an important role, than the trading of live animals, in the spread of S. Typhimurium DT 104 among livestock. SIGNIFICANCE AND IMPACT OF THE STUDY: Salmonella Typhimurium DT 104 infected herd might pose a significant risk to herds located within the same geographic area. In advising on how to avoid the spread of this bacterium, factors like person contacts, sharing of equipment and contaminated slurry should be focussed on in addition to infected animals.

Animal Husbandry↗
PubMed2006

Nursing documentation audit--the effect of a VIPS implementation programme in Denmark.

AIM AND OBJECTIVES: The aim of this paper is to present a study describing nurses' adherence to the VIPS model by evaluating the quality of nursing assessment, and the quantity of completed nursing care plans. BACKGROUND: Numerous efforts have been made over the years to improve nursing documentation in Denmark. Hospitals have traditionally based nurses' charting on a rudimentary version of the nursing process and on Virginia Henderson's theory of human needs. In 2002-2004 the Copenhagen University Hospital, Rigshospitalet, introduced the Swedish VIPS model for nursing documentation. VIPS is an acronym for well being, integrity, prevention and safety, all of which are seen as major goals for nursing care. The model organizes nursing data according to a system of keywords, which facilitates storage and retrieval of data. DESIGN AND METHODS: The design in this part of the study was retrospective, wherein 50 journals from each of the departments of cardiology, neurology, oncology and urology were audited annually for three years using the Cat-ch-Ing instrument (n=600). All nursing journals were randomly selected by including the first 50 journals at each site given a specific date. RESULTS: The nursing documentation significantly improved during the course of the study. After the second year the participants used the keywords appropriately and correctly according to the VIPS model. Application of primary nursing increased during the study. Initial, ongoing and discharge patient status improved. The nurses' familiarity with nursing diagnoses, goals and interventions increased. CONCLUSIONS: The structured implementation programme significantly improved nursing documentation, and the simultaneous training of the entire nursing staff shows promise. The VIPS model has prepared the nurses for more complex computerized taxonomies and classification systems in the future by improving the nurses' analytical skills. Relevance to clinical practice. New strategies for improving nursing documentation have been demonstrated.

Adult↗
PubMed1991

High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland.

Little is known about the optimum level of iodine intake for iodine supplementation programmes, or about the effects of the high levels of iodine intake that are found in some countries. We compared the incidence of different types of hyperthyroidism in East-Jutland Denmark with a low average iodine intake but no endemic goitre, and the incidence in Iceland with a relatively high iodine intake. Hyperthyroidism was more common in East-Jutland than in Iceland, due to a much higher incidence of multinodular toxic goitre and also of single toxic adenoma. Most of the patients with these diseases were over 50 years of age. By contrast, the incidence of Graves' disease was significantly higher in Iceland than in East-Jutland. This difference was most marked in the younger age groups, in which hyperthyroidism was more than twice as common in Iceland as in East-Jutland. These results demonstrate that even mild iodine deficiency has a significant effect on population health, since it leads to a high incidence of autonomous thyroid nodules with hyperthyroidism in the elderly population. However, population iodine intake probably should not exceed a level much higher than that necessary to avoid iodine deficiency, otherwise Graves' disease may be induced in the young population.

Adolescent↗
PubMed2006

Rising incidence and persistently high mortality of hospitalized pneumonia: a 10-year population-based study in Denmark.

BACKGROUND: Little is known about temporal trends in the incidence and mortality of pneumonia in the general population. METHODS: We conducted a population-based cohort study in three Danish counties (population 1.4 million) to examine changes in the incidence and 30- and 90-day mortality associated with hospitalized pneumonia between 1994 and 2004. All adults hospitalized with a first-time diagnosis of pneumonia (n = 41 793) were identified in hospital discharge registries and followed for mortality through the Danish Civil Registry System. We determined age-standardized incidence rates and adjusted mortality rates associated with calendar year, gender, age and comorbidity. RESULTS: Between 1994 and 2003, the incidence of hospitalized pneumonia amongst adults increased from 288 per 100 000 person-years to 442 per 100 000 person-years, equivalent to an age-standardized incidence rate ratio of 1.50. The cumulative mortality within 30 and 90 days of admission was 15.2% and 21.9%, respectively, ranging from a 90-day mortality of 2.5% in patients aged 15-39 years to 34.7% in those aged 80 and over. Advanced age was the most important poor prognostic factor, followed by a high comorbidity score and male gender. The adjusted mortality rate ratios amongst patients with hospitalized pneumonia in 1999-2004, when compared with 1994-1998, were 0.89 (95% CI 0.85-0.94) after 30 days and 0.91 (95% CI 0.88-0.95) after 90 days. CONCLUSIONS: The incidence of hospitalized pneumonia in Denmark has increased considerably during the last 10 years and, combined with persistently high mortality rates, is of clinical and public health concern.

Adolescent↗
PubMed1983

Death caused by wasp and bee stings in Denmark 1960-1980.

During a 21-year period in Denmark a total of 26 deaths were caused by wasp or bee stings (according to the National Health Service). The deaths might be classified, with some overlapping, as caused by either anaphylactic/anaphylactoid shocks (between 65% and 80%), suffocation after stings in the airways (about 15%) or preexisting diseases, especially arteriosclerotic heart disease (approx. 20%). Characteristically, in most persons with shock reactions unconsciousness and death occurred very shortly after the sting (within 45 min), while the interval between sting and death was longer (30 min to a couple of hours) when death was caused by suffocation. In more than 21 of the 26 cases it seemed reasonable to assume that insect allergy might have contributed to the fatal outcome. Six of these cases had a previous history of abnormal reactions to insect venom, thus only a small group would have benefited from the prophylactic effect of hyposensitisation. There was no known previous history of reactions to insect stings in the other cases, but it is likely that more than six persons had had severe reactions to insect stings on other occasions. Presumably many deaths where insect stings have been involved--through not verified as causal--are classified as inexplicable or accidental, thus the real number of deaths caused by wasp or bee stings could be substantially greater. Consequently hyposensitisation after severe insect sting reactions of verified allergic genesis can still be advised.

Adolescent↗
PubMed1984

Diagnosing of chromosome abnormalities in Denmark.

A survey of how frequent chromosome abnormalities are diagnosed in Denmark prenatally as well as postnatally compared with the expected incidence in an 11-year period 1970-1980 has been made from the Danish Cytogenetic Central Register. Ten percent of the expected number of Klinefelter's syndrome, 41% of Turner's syndrome and 10% of other sex chromosome abnormalities in children born between 1970 and 1980 have been diagnosed until January 1, 1983. The total frequency of diagnosed cases with sex chromosome abnormalities is 13% of the expected number. Induced abortion was made in 62% of the cases with sex chromosome abnormalities diagnosed prenatally. Ninety percent of all cases with Down's syndrome were diagnosed by chromosome examination, and 10% were diagnosed prenatally and aborted. During the last part of the period from 1977-1980 this had increased to 20%. Thirty-seven percent of cases with other chromosome abnormalities were diagnosed. Among the expected 4,396 children with chromosome abnormalities to be born between 1970 and 1980, a total of 39% were diagnosed postnatally until January 1, 1983, and 10% were diagnosed prenatally. It is concluded that there is a great need for training consultants in clinical genetics, expansion and further decentralization of cytogenetic service with more cytogenetic laboratories and employment of clinical geneticists in all 14 Danish counties.

Chromosome Aberrations↗
PubMed1988

Rates and survival of individuals with trisomy 13 and 18. Data from a 10-year period in Denmark.

Rates and survival figures for trisomy 13 and trisomy 18 have been calculated for Denmark (DK) based on a 10-year period (1977-86). The data have been ascertained through The Danish Central Cytogenetic Register, all cytogenetic laboratories in DK, paediatric departments throughout the country. The Medical Birth Register and The Register of Causes of Death in DK. Nineteen liveborn probands with trisomy 13 and 76 liveborn probands with trisomy 18 were found. No stillborn cases with trisomy 13 but 6 with trisomy 18 were found. By prenatal diagnosis 19 probands with trisomy 13 and 46 with trisomy 18 were found. Based on liveborn and stillborn probands, the prevalence at birth was 1 per 29,374 for trisomy 13 and 1 per 6806 for trisomy 18. The median survival for trisomy 13 was 2.5 days, while the same figure for trisomy 18 was 6.0 days. The rates calculated seem rather low compared to earlier studies.

Adolescent↗
PubMed1990

A cost-benefit analysis of prenatal diagnosis by amniocentesis in Denmark.

A cost-benefit analysis of amniocentesis has been performed using both the excess-cost- and the replacement methods and several replacement and discount rates. In Denmark, amniocentesis is offered free of charge to various groups of pregnant women at risk for genetic disorders of the foetus. Most important is age greater than or equal to 35 years. The analysis is based on incidence and survival rates for Down syndrome (trisomy 21), Patau's syndrome (trisomy 13) and Edward's syndrome (trisomy 18), and on incidence and survival rates of children with neural tube defects. If amniocentesis were offered to all pregnant women independent of age, with a supposed participation rate of 75% and if only tangible costs and benefits were included, the analysis shows a benefit:cost ratio greater than 1.0 using discount rates of 4% and 7% (both for the excess-cost- and replacement method); a benefit:cost ratio less than 1.0 is found using 10%. The ratio is approximately 1.0, if pregnant women aged 15-19 and 20-24 years are excluded, using the discount rate 10%. Calculations for other participation rates have also been performed. If intangible costs and benefit are included, the results are uncertain.

Adult↗