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PubMed1998

Indoor allergen levels and other environmental risk factors for sensitization in Estonian homes.

The prevalence of allergic disease is low in Eastern Europe for reasons that are poorly understood. Our study aimed to investigate the levels of exposure to indoor allergens and living conditions among Estonian infants in relation to sensitization. Dust samples were collected during four winter months in 1993/94 from the homes of 197 infants participating in a prospective study of sensitization. Information about living conditions was collected through a home visit and interviewing the mothers when the children were 6 weeks old. Three dust samples were collected from each home; i.e., from the infant's mattress, bedroom floor, and living-room carpet. The levels of allergens were determined by ELISA with monoclonal antibodies. The highest allergen level in a home was regarded as the peak value. The peak geometric mean values (+/-SD) of Der p 1 and Der f 1 were 0.3 (0.07-1.4) microg/g dust, of Can f 1, 0.86 (0.23-3.12) microg/g dust, and of Fel d 1, 0.1 (0.01-0.9) microg/g dust. In 12 homes (9%), the peak value of house-dust mite (HDM) allergens exceeded 2 microg/g dust, with Der p 1 as the dominating allergen. Multivariate analyses indicated that high levels of HDM allergens were more common in apartments that were on the ground floor or first floor, that were heated with stoves, and/or that had a dampness problem. The mean allergen levels at home were similar in children sensitized to HDM (n=17, 0.29 vs 0.3 microg/ g dust), dog (n=5, 0.55 vs 1.06 microg/g dust, and cat (n=18, 0.21 vs 0.09 microg/g dust) and in children who were not sensitized to these allergens. Most of the sensitized children were exposed to relatively low allergen levels at home; i.e., below 1 microg/g dust. This level was exceeded in the homes of 4/17 mite-, 5/18 cat-, and 0/5 dog-sensitized children. The similar levels of the major indoor allergens in Estonia and in Scandinavia indicate that the large differences in atopy prevalence among children and young adults in the two regions are not due to differences in allergen exposure. No allergen threshold level for sensitization was identified.

Air Pollution, Indoor↗
PubMed1998

Taxonomy and identification of dust mites.

Taxonomy provides the basis for the identity of species, allowing the construction of keys and the reliable, reproducible identification of dust mites for ecologic purposes and other studies. Details are given of nomenclatorial conventions in taxonomy as applied to dust mites, and taxonomically problematic entities are highlighted, such as Blomia kulagini and the sibling species Dermatophagoides farinae and D. microceras. Current keys to dust mites and advances in interactive computer keys are reviewed. An hypothesis of the phylogeny of the family Pyroglyphidae is presented, based on habitat specificity, geographic distribution, and association with birds. The value of predictive classifications based on phylogenies is stressed. Finally, a pictorial key is presented to the mites found in house dust in Scandinavia.

Animals↗
PubMed1996

RYR mutation G1021A (Gly341Arg) is not frequent in Danish and Swedish families with malignant hyperthermia susceptibility.

Malignant hyperthermia (MH) is a pharmacogenetic disorder. Susceptibility to MH (MHS) is presumed to be inherited in an autosomal dominant way. MH crises are triggered by halogenated inhalational anaesthetics and suxamethonium, and may be lethal if not treated early and adequately. Until now, eight mutations in the RYR1 gene have been described as causes of MHS phenotype in various MH families. The mutation RYR1 G1021A (Gly341Arg) has been reported to account for approximately 10% of Caucasian MHS cases. However, in our study this mutation was discovered in only 1 out of 89 Scandinavian families, indicating that this mutation may be the cause of MHS in only about 1% of MHS families in those populations. The mutation may have been brought to Scandinavia by an immigrant.

Calcium Channels↗
PubMed1996

Dandy-Walker malformation and polydactyly: a possible expression of hydrolethalus syndrome.

Hydrolethalus syndrome consists of hydrocephalus, polydactyly, micrognathia, midcranial malformations, visceral abnormalities and perinatal lethality. It was first described in Finland, and only a few other cases outside Scandinavia are known. We report the first Hungarian patient who displayed many signs of the syndrome but had no cleft lip and visceral abnormalities. This observation suggests the existence of oligosymptomic hydrolethalus syndrome, and suggests that Dandy-Walker malformation with polydactyly may be a manifestation of the hydrolethalus syndrome.

Adult↗
PubMed1989

Possible effect of medically administered antibiotics on the mutans streptococci: implications for reduction in decay.

The decline in dental caries in children in North America, Scandinavia, Britain, Ireland and many Commonwealth nations is well documented. The multiple uses of fluoride can account for most, but not all, of this reduction. In this investigation, data are provided which suggest a relationship between antibiotic usage for medical purposes and a decline in both mutans streptococci (MS) and caries. Children attending Grades 1 and 2 in the Coldwater, Michigan school system and who reportedly never received antibiotics had significantly higher proportions of MS in the fissure plaques of first molars than subjects who received antibiotics. The level of decay in the primary dentition was inversely related to the reported usage of antibiotics. The frequent usage of antibiotics could reduce the incidence of dental caries by delaying the colonization of the teeth by the MS. This was evaluated by a prospective study in infants to determine what effect reported antibiotic usage would have on the colonization of newly erupting primary teeth. Only 2 of 10 infants cultured at 2 to 3 week intervals for periods up to 1 year after tooth eruption became colonized by the MS. One had never received antibiotics and the second had been on antibiotics for a single 5-day period. Seven of the 8 non-colonized infants had received antibiotic therapy for periods ranging from 10 to 181 days. Both the Coldwater study and the prospective study of infants suggested a relation between frequency of antibiotic usage for medical purposes and the MS levels on the teeth.

Anti-Bacterial Agents↗
PubMed1985

Long-term parenteral nutrition using a mixture of fat, amino acids and carbohydrates in a single three-litre bag.

Long-term parenteral nutrition is today an established therapy, both in hospitals and at home. A variety of patients with chronic intestinal dysfunction, leading to malnutrition, are candidates for this treatment. There are however several problems related to this therapy, some of which can be attributed to the infusion system. In Scandinavia most patients receiving parenteral nutrition are given separate bottles of aminoacids, fat-emulsions and carbohydrates. This method has several disadvantages. A new system which includes premixing of all nutrients in a single bag is discussed. Nutrients are mixed in three litre bags in the hospital pharmacy, under optimal conditions, and can be stored refrigerated for several days.

Amino Acids↗
PubMed1998

Patients' desire for information about anaesthesia: Danish attitudes.

BACKGROUND: Patients' desire for information about anaesthesia has been examined in a number of Commonwealth countries but not in Scandinavia. A questionnaire was distributed to form a basis for giving Danish patients more appropriate preoperative information. METHODS: 201 preoperative patients in Denmark were asked to complete a questionnaire. The patients were divided into subgroups according to: age, gender, residential origin, ASA group, educational level, type of anaesthesia planned and number of previous anaesthetics. RESULTS: Patients from a city area required significantly more information than patients from a rural/urban area about premedication drugs, drips/catheters, pain/pain relief and complications. Men more than women preferred to know about dangerous complications. Information about pain/pain relief, duration of anaesthesia, and influence of anaesthesia on daily activities such as eating, drinking, mobilisation was given the highest priority, while unpleasant information such as about complications and needles was given the lowest priority. Meeting the anaesthetist and information about alternative methods of anaesthesia and premedication drugs were given only moderate priority. Ranking information in Denmark was significantly correlated with Scotland, Canada and Australia, despite profound differences in priority. More often than Danish patients, Australian patients felt they had right to know, and especially about complications. CONCLUSION: Patients from a city area required more information than patients from a rural/urban area. Information about the influence on daily activities was preferred to unpleasant information. Ranking information in Denmark was correlated with a number of Commonwealth countries.

Activities of Daily Living↗
PubMed2006

Central venous catheter infections at a county hospital in Sweden: a prospective analysis of colonization, incidence of infection and risk factors.

BACKGROUND: Catheter-related infection (CRI) is one of the most serious complications of the use of central venous catheters (CVCs), with an incidence of 2-30/1000 days in different studies. No major prospective study has evaluated the rate of CRI in Scandinavia. Since 1999, we have had a thorough programme for the insertion and care of all CVCs used at our hospital and its outpatient clinics. The purpose of this survey was to study the incidence of catheter tip colonization and CRI and their risk factors, and to compare these data with previous non-Scandinavian studies. METHODS: We studied prospectively 605 CVCs in 456 patients in relation to insertion data, patient and catheter characteristics, catheterization time and microbiological cultures. Risk factors were analysed by multivariate analysis. RESULTS: Four hundred and ninety-five (82%) of all CVCs were assessed completely. The total catheterization time was 9010 days. The incidence of positive tip culture was 7.66/1000 days, and the predominant microorganism was coagulase-negative staphylococci. The incidence of CRI was 1.55/1000 days, and the only significant risk factor was the duration of catheterization with a relative risk of 1.009 per day [95% confidence interval (CI), 1.003-1.015]. Of the 14 cases with CRI, six were associated with candida species, and five of these were diagnosed in the intensive care unit. CONCLUSION: In comparison with non-Scandinavian studies, our practice of strict basic hygiene routines for CVC insertion and care is associated with a low incidence of CRI. However, there was a high proportion of candida species amongst these infections. The only risk factor for CRI was the duration of catheterization.

Adolescent↗
PubMed1998

Requirements for the electronic crossmatch.

With the integration of laboratory information systems into transfusion services, it is now possible to develop standard operating procedures (SOPs) for an electronic crossmatch (EXM) to replace the immediate-spin crossmatch for detecting ABO incompatibility between the blood sample submitted for pre-transfusion testing and the donor unit selected for transfusion. Essential to the safety of an EXM are requirements that: 1) the computer contains logic to prevent assignment and release of ABO incompatible blood; 2) no clinically significant antibodies are detected in the recipient's serum/plasma and there is no record of previous detection of such antibodies; 3) there are concordant results of at least two determinations of the recipient's ABO type on record, one of which is from a current sample; 4) critical elements of the system have been validated on-site; and, 5) there are mechanisms to verify the correct entry of data prior to release of blood. EXM procedures are in use in at least 10 North American facilities, Scandinavia, Hong Kong and Australia. Some provide blood at remote sites lacking laboratory services. Experience has shown that a combination of properly programmed computer software and carefully developed SOPs can provide a safe and efficient means of detecting ABO incompatibility without performing a serological crossmatch.

Algorithms↗
PubMed1994

Living kidney donation in Europe: legal and ethical perspectives--the EUROTOLD Project.

The demand for organ replacement by transplantation continues to outstrip supply, leading to unnecessary morbidity and health care costs. "Space capacity" (i. e. cadaver organs not currently harvested for transplant) has been tackled within Western Europe in particular by many strategies--medical, social, educational and legal--but with varying degrees of success. Despite this, the use of living donors has not been fully exploided in many European countries to fill this gap. The total picture is, however, one of marked differences between countries and between centres within countries. In Turkey and Greece, living donors generally account for 60-90% of all renal donors. Countries within Scandinavia also have a high rate of living donor use, especially Norway. By contrast the percentage is far more modest, for example in Spain, Ireland, France and Germany. In the United Kingdom the rate is only 6% with a range of between 0 and 20%. Sources of living donors also show substantial variations between countries, notably the extent to which non-genetically related donors are used. A European Commission sponsored study has been established to acquire a broad understanding of the interaction of ethical values, cultural traditions and social customs on willingness to donate. It will also aim to assess the effect of national laws on professional attitudes to living donor transplantation. This is a collaborative project between the University Department of Surgery, Leicester General Hospital, the Department of Law, De Montfort University and the Department of Mathematics, Newcastle University. Transplant units throughout Europe, including France, Germany, Switzerland, Norway, The Netherlands, Eire and Turkey are collaborating to exchange information and views on living donor transplantation.

Bioethics↗
PubMed1989

Seronegative arthritis associated with serological evidence of Yersinia infection in Australia.

Infection due to yersinia enterocolitica is a common antecedent illness in patients with reactive arthritis in Scandinavia, but appears to be less frequent in other countries. In order to examine the frequency of yersinia infection in patients with seronegative arthritis in Australia we examined 22 patients, 15 with ankylosing spondylitis (AS) and seven with Reiter's syndrome (RS). A sensitive ELISA assay was used to detect serum antibodies to the most common serotypes. Six patients (29%) had positive yersinia serology, all were HLA B27 and four had a history of diarrhea preceding the onset of their disease. Four patients with positive yersinia serology had AS and two had RS. Antibodies were directed against Y. enterocolitica biotype 0:3 in three cases, Y. enterocolitica 0:9 in two cases and Y. enterocolitica 0:8 in one subject. Twenty-nine control subjects (13 HLA B27) had no serum antibodies to yersinia. The results of this study indicate that preceding yersinia infection occurs in a significant (p less than 0.05; compared to controls) proportion of patients with HLA B27 related seronegative arthropathies.

Adult↗
PubMed2006

The Pelican Cancer Foundation and The English National MDT-TME Development Programme.

The formation of The Pelican Cancer Foundation in 2000 was based around the pioneering work of Professor Bill Heald and colleagues, and the development of Total Mesorectal Excision (TME) for rectal cancer. A series of surgical workshops in Scandinavia in the mid 1990s and, later, six further workshops in the Trent region culminated in the commissioning of the fully multidisciplinary National MDT-TME Development Programme by the National Cancer Director, Professor Mike Richards, in March 2003.

Charities↗
PubMed1988

Adenine phosphoribosyltransferase deficiency: 2,8-dihydroxyadenine urolithiasis in a 48-year-old woman.

We report the first patient in Finland and Scandinavia with a deficiency of adenine phosphoribosyltransferase (APRT). About 30 clinically affected patients have been reported in the literature. APRT deficiency is an enzyme disorder which is inherited autosomally in a recessive manner. The use of adenine in purine metabolism is disturbed and it accumulates in the body, where it is oxidised to poorly insoluble 2,8-dihydroxyadenine by xanthine oxidase. The dihydroxyadenine forms stones which can be mistaken for uric acid stones. Our patient had had frequent episodes of urolithiasis and the diagnosis was finally made after pyelolithotomy and stone analysis. The total APRT deficiency was detected in the haemolysate of erythrocytes. Partial deficiency of APRT in the patient's relatives showed heterozygosity of the enzyme defect. The only clinical manifestation of the defect is the formation of urinary stones. This can be prevented by diet and allopurinol.

Adenine↗
PubMed2006

Children of divorce in a Scandinavian welfare state: are they less affected than US children?

A fairly common view holds that children's risks of negative outcomes associated with family dissolution are generally small or even nonexistent in Scandinavia, and clearly smaller than what is usually found in the United States. This view was empirically examined in a recent large-scale study of 4,127 12-15-year-old children in Norway, of whom 623 had experienced parental divorce and lived in a single-mother family. The somewhat paradoxical pattern of findings was as follows: (a) The negative associations between parental divorce and various outcomes were found to be generally very similar in Norway and the United States in spite of the great differences in family policy and welfare benefits for single mothers (at the macro level); and (b) Mediational effects of family economic resources were in both countries most marked for the academic achievement area, and the predictive power of such variables was quite similar, again in spite of the great differences in absolute level of the economic resources available to single-mother families in the two countries. The results cast some doubt on the value of the absolute economic deprivation perspective in explaining the results, and the many Norwegian welfare benefits do not seem to mitigate the association between divorce and negative outcomes for the children involved. Also policy implications derived from the economic deprivation perspective are questioned. Alternative interpretations of the findings involving relative deprivation and economic resources as a partial proxy for other non-economic factors are briefly discussed.

Adaptation, Psychological↗
PubMed1997

Ear infections with Shewanella alga: a bacteriologic, clinical and epidemiologic study of 67 cases.

OBJECTIVE: To present bacteriologic and clinical data on 67 patients from the island of Funen, Denmark, with Shewanella alga, a bacterium rarely seen in Scandinavia, isolated from ear swabs. Included in the study is an examination of the occurrence of S. alga in sea water around the island. METHODS: Bacteriologic examination and antibiotic susceptibility testing of 67 clinical isolates, 11 sea-water isolates and two reference strains were conducted. Clinical information was obtained from the referring physicians. RESULTS: During 6 months S. alga was isolated from 67 patients, in 33 cases in pure culture. Seventy per cent of the patients were children between 3 and 15 years old who had clinical symptoms of acute or chronic otitis media. Previous ear disease was common (76%). Most of the cases (85%) occurred in August or September, and 47 of 55 patients reported contact with sea water shortly before symptoms developed. From seven of the patients, S. alga was isolated more than once. The species was also isolated from five of 10 bathing areas around the island of Funen. CONCLUSIONS: The patients were probably infected with S. alga during sea-water bathing in the unusually warm summer of 1994. Infections with marine bacteria are possible in countries with a temperate climate; patients with previous ear disease are at special risk.

Journal Article↗
PubMed1977

Bioassay of kinship in northwestern Europe.

Kinship of Barra (Outer Hebrides) is bioassayed as 0.0096 relative to northwestern Europe, in reasonable agreement with prediction of 0.008 relative to Britain. The exponential decline of kinship with distance is similar to Scandinavia. Kinship of larger populations is consistent with predictions from isolates. Kinship is largely due to local drift rather than Norse admixture, the estimate of which is obscured by drift and appears highly unreliable. Other populations in northwest Europe, including Iceland, Lewis and Orkney, give estimates of kinship which reflect drift and geography, but also do not provide reliable estimates of admixture. Bioassay of kinship from gene frequencies gives observations to be explained in terms of migration and drift, but contributes nothing to the question of whether polymorphism in the species is maintained by neutral mutation or selection. Although the latter is on various grounds more likely, no calculations based on gene frequency distribution can provide critical evidence.

Emigration and Immigration↗
PubMed2006

Two mire species respond differently to enhanced ultraviolet-B radiation: effects on biomass allocation and root exudation.

Increased ultraviolet-B (UV-B) radiation arising from stratospheric ozone depletion may influence soil microbial communities via effects on plant carbon allocation and root exudation. Eriophorum angustifolium and Narthecium ossifragum plants, grown in peatland mesocosms consisting of Sphagnum peat, peat pore water and natural microbial communities, were exposed outdoors to enhanced UV-B radiation simulating 15% ozone depletion in southern Scandinavia for 8 wk. Enhanced UV-B increased rhizome biomass and tended to decrease the biomass of the largest root fraction of N. ossifragum and furthermore decreased dissolved organic carbon (DOC) and monocarboxylic acid concentration, which serves as an estimate of net root exudation, in the pore water of the N. ossifragum mesocosms. Monocarboxylic acid concentration was negatively related to the total carbon concentration of N. ossifragum leaves, which was increased by enhanced UV-B. By contrast, enhanced UV-B tended to increase monocarboxylic acid concentration in the rhizosphere of E. angustifolium and its root : shoot ratio. Microbial biomass carbon was increased by enhanced UV-B in the surface water of the E. angustifolium mesocosms. Increased UV-B radiation appears to alter below-ground biomass of the mire plants in species-specific patterns, which in turn leads to a change in the net efflux of root exudates.

Analysis of Variance↗
PubMed1993

Social networks--the metaphor that became a research approach--a research approach in the field of nursing?

This article discusses whether the concept of social networks can be an effective approach for use in nursing research in Norway and Scandinavia. It also describes areas which may be especially well suited for this approach. The article does not answer the question as to whether nursing research should make use of social network studies, but it is concluded that this is one of the approaches which must be considered closely in connection with nursing research.

Humans↗