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PubMed1996

Infant fussing and crying patterns in the first year in an urban community in Denmark.

Infant crying amounts and patterns in 590 1- to 12-month-old infants in an urban community in Denmark were studied using the Crying Patterns Questionnaire. The impact of the crying on parents and the primary health services was also assessed. The results showed that Danish mothers leave their infants to "cry out" substantially less than mothers in the UK and North America. Despite this difference, mean crying amounts, crying patterns and the incidence of persistent crying were similar to those reported in earlier western studies. The findings support the view that the infant crying peak in the first 3 months is due to normal maturational and developmental processes.

Age Factors↗
PubMed2000

Epidemiology of invasive pneumococcal infections in children aged 0-6 years in Denmark: a 19-year nationwide surveillance study.

UNLABELLED: The impact of the new pneumococcal conjugate vaccines on invasive disease burden in Danish children was evaluated by analysing the results from the last 19 years of a nationwide surveillance of invasive pneumococcal infections. During 1981-1999, the Streptococcus Unit at Statens Serum Institut, Copenhagen, received 1123 invasive pneumococcal isolates from children aged 0-6 years. Nearly 72% (71.8%) of the pneumococcal isolates were from children aged <2 y. The median ages of children with pneumococcal meningitis and bacteraemia were 10.2 mo and 15.9 mo, respectively. The incidence of pneumococcal meningitis remained stable during the study period. The mean annual incidence rates of pneumococcal meningitis among children aged <1, <2, and <7 years were 17.4, 12.4, and 4.3 per 100,000, respectively, during 1981-1999 (overlapping age groups are used throughout this article to facilitate the comparison of incidence data from different countries or among different studies). The annual incidence of pneumococcal bacteraemia increased from 1981 to 1996, after which a slight fall was noted. During the last six years of the study period, the mean annual incidence rates of bacteraemia were 30.1, 32.5, and 14.0 per 100,000 children aged < 1, < 2, and < 7 years. In the 1990s, pneumococcal isolates with reduced sensitivity to penicillin (0-5% each year) and erythromycin (7.4% in 1999) emerged as a cause of invasive infections in children aged 0-6 years in Denmark. During 1981-1999, 10 serotypes (1, 4, 6A, 6B, 7F, 9V, 14, 18C, 19F, 23F) caused 82% of invasive infections in Danish children. Importantly, no significant temporal changes in overall serotype distribution or differences in serotype distributions between girls and boys could be documented during the study period. CONCLUSION: According to the Kaiser Permanente trial, the 7-, 9-, and 11-valent pneumococcal conjugate vaccines will probably cover around 60%, 70%, and 80%, respectively, of all invasive pneumococcal infections in Danish children aged 0-6y, corresponding to 12-14 episodes of meningitis and 40-60 episodes of bacteraemia per year.

Age Distribution↗
PubMed2005

Extreme hyperbilirubinaemia in term and near-term infants in Denmark.

AIM: To determine the incidence amongst infants born at term or near-term of extreme hyperbilirubinaemia, i.e., with a serum concentration of unconjugated bilirubin exceeding the limit above which an exchange transfusion was indicated according to the authorized guidelines. METHOD: The investigation period covered 2 y, 1 January 2000 to 31 December 2001, and included all infants born alive at term or near-term in Denmark. All infants with extreme hyperbilirubinaemia admitted to paediatric departments were recorded. RESULTS: Thirty-two infants developed extreme hyperbilirubinaemia, i.e., an incidence of 25 per 100 000. The maximum total serum bilirubin concentration (TSB) was 492 (385-689) micromol/I (median (range)). The median value of the exchange transfusion limits was 450 micromol/l. Twelve infants had signs and symptoms of central nervous system involvement; 11 had acute bilirubin encephalopathy phase-1 symptoms; and one had phase-2 symptoms. Nineteen infants developed extreme hyperbilirubinaemia during primary admission to the maternity ward or neonatal department; the others after having been discharged. There was no difference in maximum TSB between those infants not discharged from hospital and those infants admitted to hospital from home. Maximum TSB appeared latest amongst those infants admitted from home (p < 0.01), and these more often had signs and symptoms of central nervous system involvement (p < 0.05). Ten infants were of non-Caucasian extraction. Less than half of all Danish mothers receive both verbal and written information after birth on jaundice in the infant. CONCLUSION: Twenty-five per 100 000 infants born at term or near-term developed extreme hyperbilirubinaemia, the majority of them whilst in hospital. Infants admitted from home more often had signs and symptoms of central system involvement.

Bilirubin↗
PubMed1979

Electron microscopy of a filamentous, segmented bacterium attached to the small intestine of mice from a laboratory animal colony in Denmark.

A filamentous, segmented bacterium was observed in the small intestine of the SSC:AH stock of mice from the Statens Seruminstitut (Denmark) animal colony but was absent in golden hamsters and guinea pigs from the same colony. The bacterium is attached to the epithelial cell by a special segment (holdfast) and causes specific changes in the epithelial cell at the site of attachment. Once attached the bacterium appears to undergo a complex life cycle which involves the development of a long filament divided into a number of segments within which holdfasts or spores are formed. This organism is morphologically identical to a bacterium found in mice and rats in the USA, but this is the first report of such an infection in Europe.

Animals↗
PubMed1987

Epidemiology of sinonasal cancer in Denmark, 1943-1982.

Long-term trends in the incidence of cancer of the nasal cavity and paranasal sinuses were studied on the basis of notifications of cancer cases in Denmark over 40 years. A total of 1436 cases of sinonasal cancer were reported in 1943-1982, giving steady annual incidences of 0.8 per 100,000 males and 0.5 per 100,000 females. These contrast with the simultaneous increases in risk for cancers of the middle and lower respiratory tract, and indicate that cigarette smoking does not play any significant role in the aetiology of sinonasal cancer. Since this tumour type has many occupational aetiologies, the stable time trends observed further indicate that all the major risk factors have been present in work places in a relatively unchanged form for more than half a century. A curious time-dependent distribution of cases according to subsite of the tumour, however, leaves open for possibility that some of the environmental carcinogens may have changed.

Adolescent↗
PubMed1988

Primary squamous cell carcinoma of the rectum in Denmark.

Only a limited number of cases of primary squamous cell carcinoma (SCC) developed in the colon and rectum have been described in the world literature. This study represents the first population-based study of this rare cancer. Sixteen patients with primary SCC of the rectum diagnosed in the period 1978-1983 were identified from the Danish Cancer Registry. Eleven patients were excluded after revision of the histological specimens because the SCC in these cases were in connection with the squamous epithelium of the anal canal. SCC of the rectum in Denmark in the period 1978-1983 thus constituted 0.06% and 0.11% of the histologically verified rectal tumours in men and women, respectively. Case reports on these cases are given. One of the two males was homosexual and the other had never been married or lived with a woman. It is concluded that our findings support the hypothesis proposed by Austin that there may be an association between the frequency of anal intercourse and occurrence of squamous cell carcinoma of the rectum.

Adult↗
PubMed1988

Trends in cutaneous malignant melanoma in Denmark 1943-1982 by anatomic site.

Time trends in the incidence of cutaneous malignant melanoma were examined by analysing data from the Danish Cancer Registry, 1943-1982, by sex and subsite for 3509 male and 5305 female cases. The age-standardized incidence rate for cutaneous malignant melanoma for men and women in Denmark increased by five- to six-fold between 1943 and 1982. The increase varied by site; a particularly pronounced elevation was seen for tumours of the trunk in both men and women and of the leg in women. A statistical analysis of the effects of age, time and cohort showed steep increases in risk for progressively younger birth cohorts. This association was particular pronounced for sites other than the face, scalp and neck; for the latter sites, there was a much smaller increase for younger cohorts.

Adolescent↗
PubMed1989

Molecular epidemiology of antibiotic resistant Haemophilus influenzae isolated in Denmark 1981-87.

The molecular basis of antibiotic resistance was studied in 32 epidemiologically unrelated Danish clinical isolates of Haemophilus influenzae. Both non-encapsulated and capsulated type b strains were represented as well as four different biotypes. Plasmid DNA was found in 11 strains, all of which were antibiotic resistant. Antibiotic resistance was transferred to an Rd Haemophilus influenzae recipient from 5 of 6 prospective donors. Ampicillin and chloramphenicol resistance were linked markers while tetracycline resistance--when unselected--was lost in 18% of the transconjugants. Loss of Tcr was associated with loss of a plasmid DNA segment. Restriction enzyme profiles of plasmid DNA lead to the conclusion that the drug resistance plasmids are derivatives of a common, not too distant, ancestor. There is evidence of both clonal spread and horizontal transmission of related drug resistance plasmids in H. influenzae in Denmark.

Ampicillin Resistance↗
PubMed1994

Salmonella typhimurium phage types from human salmonellosis in Denmark 1988-1993.

A total of 989 isolates of Salmonella enterica ssp. enterica serovar Typhimurium from cases of human salmonellosis were investigated by phage typing. The isolates comprised all isolates recovered during the month of August in each of the years from 1988 to 1993. Phage typing assigned 82.6% of the strains to 36 different definitive types, 11.9% of the strains belonged to types of unknown lysis pattern (RDNC), and 5.5% could not be typed by the phages used (NT). Three phage types (12, 66 and 110) made up approximately 50% of the isolates in each of the years investigated. During the period in question these types showed major changes in prevalence: phage type 12 increased from 4.0% in 1988 to a maximum of 55.2% in 1992, and phage type 66 and phage type 110 were reduced from 40.1% and 27.8% to a minimum of 3.9% and 4.8% in 1993 and 1992, respectively. The increasing prevalence of phage type 12 among isolates from human salmonellosis most likely reflects the increasing significance of pork as a source of human salmonellosis. The reduction in phage types 66 and 110 is paralleled by a reduction in S. Typhimurium in Danish poultry. Some phage types were associated with travel, namely 17, 193 and 194. It is concluded that phage typing, although here performed retrospectively, produces valuable epidemiological information regarding changes in the relative importance of different sources of infection in humans. It is suggested that phage typing be performed prospectively on both human and animal S. Typhimurium isolates in Denmark.

Bacteriophage Typing↗
PubMed1996

Vancomycin-resistant enterococci at a large university hospital in Denmark.

Enterococci are part of the normal human fecal flora and also part of the fecal flora of many animals. Vancomycin- and ampicillin-resistant enterococci give rise to infections that may virtually be untreatable with antibiotics. Antibiotic use in humans is a risk factor for development or selection of vancomycin-resistant enterococci. In animals the related glycopeptide avoparcin is used, especially in poultry, as a food additive to promote growth. Selective pressures for vancomycin-resistant enterococci are high in Denmark with the production of 105 million poultry and the use of 24,000 kg avoparcin per year. The possible impact on vancomycin resistance among human isolates of enterococci remains to be defined. Furthermore, there has been a 3-fold increase in vancomycin usage during the last 5 years at our hospital, from 2.4 to 7 kg/year. We examined 91 stool specimens from 67 patients in risk units at our hospital. Using a selective medium (KAA agar), 17 strains of Enterococcus faecium grew on the selective medium and 3 (18%) were vancomycin-resistant (MIC > 256 mg/l). Using PCR and an internal probe, vanA was found in the vancomycin-resistant enterococci. No association between vancomycin therapy and carriage of VRE was demonstrated in these patients.

Cross Infection↗
PubMed1997

Restriction pattern variability of respiratory syncytial virus during three consecutive epidemics in Denmark.

A PCR-based assay was used to distinguish between respiratory syncytial virus (RSV) group A and B in order to analyze their prevalence in Denmark in three consecutive epidemics during the winters of 1992/93, 1993/94 and 1994/95. A total of 96 RSV strains isolated from hospitalized children were examined, showing alternation of group prevalence. Furthermore, the genetic variability of the RSV isolates was illustrated by restriction enzyme analysis of PCR products originating from a part of the F and G proteins that has been reported to be highly variable. We found that, in general, different genome types predominated each year, some types being present in consecutive epidemics, indicating a contribution of strains circulating unattended between outbreak seasons, while others seemed to disappear or became undetectable, being replaced by emerging types. Some of the genome types found seemed related to strains isolated up to more than two decades ago in other parts of the world. This indicates that the temporal fluctuation in predominance of genome types presumably caused by selective pressure exerted by host immunity is due to the favoring of strains from a pool of globally circulating, genetically relatively stable genome types, rather than a molecular evolution in strains induced or directed by immunoselective pressure.

Animals↗
PubMed1998

The 1994 human parvovirus B19 epidemic in Denmark: diagnostic and epidemiological experience.

In 1994 the first human parvovirus B19 (B19) epidemic to be documented in Denmark was recorded from February 2 to September 30. In total, 10,333 serum samples were tested for specific B19 IgM and IgG antibodies, using IDEIA Parvovirus B19 IgM and IgG kits. The prevalence of B19 IgM positivity was 11% for the whole period and 29% at the peak of the epidemic in week 14, declining from week 39 and onwards to 1-3%. The prevalence of B19 IgG (IgM-negative samples) was 60%, indicating an earlier infection, and the same for men and women. The gender distribution of tested patients was the same at the beginning of the epidemic as at the end of the epidemic and a year after its peak, i.e. 86% of samples were from women and only 14% from men. Age distribution for women was the same for the three periods (median age 34 years). For men the median age was 32 years, 39 years and 31 years, respectively. Only a few samples from children were tested. No change in test pattern was observed during the three periods. Approximately 75% of all samples tested were from women of childbearing age (18-45 years old), suggesting a fear of fetal complications in an actual or future pregnancy, rather than a serological verification of clinical symptoms. From the sparse clinical information that accompanied the serum sample we were not able to demonstrate that women were more likely than men to have a symptomatic B19 infection. With reservations we estimate that 14% of adverse pregnancy outcome is correlated with a B19 infection.

Adolescent↗
PubMed2004

Changing dentate status of adults, use of dental health services, and achievement of national dental health goals in Denmark by the year 2000.

OBJECTIVES: This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. METHODS: Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self-administered questionnaires. RESULTS: In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65-74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35-44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65-74-year-olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. CONCLUSIONS: Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably over time. The WHO goals for better dental health by the year 2000 were achieved for 35-44-year-olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. It remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.

Adolescent↗
PubMed1982

Malignant melanomas of the human uvea: 25-year follow-up of cases in Denmark, 1943--1952.

All cases (302) of malignant intraocular melanomas in Denmark between 1943--1952 were followed up and evaluated 25 years after enucleation, which was the treatment used immediately after diagnosis during that period. The follow-up percentage was 99, 82% of the total being dead at the time of follow-up, bringing the real course of the malignant uveal melanoma in a traditionally treated series nearer to the truth. The same series was analysed in 1963 and 1970. Three-quarters of the patients were hospitalized immediately before and/or in the process of dying. In the series of choroidal and/or ciliary body melanoma the autopsy frequency was 36. Death with metastases took place in 51% (150). Orbital recurrence was found in 2.5% and 8--12% of cases with extrascleral extension had orbital recurrence. This appeared at an average of 2 years after enucleation and 10% of metastases appeared within the first 6 months post-operatively, more than half within 3 years. The peak incidence was during the first year after enucleation. No second peak was observed. However, metastases appeared even after 23 years. The probability of being alive without metastases after 25 years was found to be 40%, assuming that the patient did not die of another cause. The prognosis was estimated using various clinical and histopathological parameters. Women below the age of 40 had a better prognosis than women above that age. Small tumours, spindle shaped cells, no invasion and low pigment content of tumour were all in favour of a good prognosis. Of the iris melanomas from the period dealt with, only one died with metastasis. The present lively discussion on early enucleation or conservative management is reported and finally the attitude of the Ophthalmic Tumour Centre towards therapy is indicated.

Adolescent↗
PubMed1983

The prevalence of glaucoma and ocular hypertension in type 1 and 2 diabetes mellitus. An epidemiological study of diabetes mellitus on the island of Falster, Denmark.

The prevalence of glaucoma and ocular hypertension was investigated in an epidemiological study of diabetics traced by registration of prescriptions on insulin and oral hypoglycaemic agents (OHA) on the island of Falster (inhabitants 44 498), Denmark. Among 533 diabetics (227 insulin- and 306 OHA-treated) the prevalence rate of primary open angle glaucoma and ocular hypertension was 6.0% and 3.0%, respectively. Neovascular glaucoma occurred in 2.1% of all diabetics and in 21.3% of diabetics with proliferative retinopathy. Open angle glaucoma was more prevalent (P less than 0.01) in type 2 diabetes mellitus compared with type 1 diabetes mellitus. No difference in the prevalence of neovascular glaucoma was found between type 1 and type 2 diabetics. The occurrence of open angle glaucoma correlated positively (P less than 0.01) to the current age (greater than 65 years) in both groups and the diabetes onset age (greater than 40 years) in insulin-treated diabetics. Neovascular glaucoma correlated positively (P less than 0.05) with diabetic macrovascular complications in total (myocardial infarction, ischemic heart disease, arterial hypertension, cerebrovascular stroke, gangrene/amputation), neuropathy and severe microvascular complications (proliferative retinopathy, retinovascular occlusion). Diabetics with open angle glaucoma and ocular hypertension showed a higher frequency (P less than 0.05) of ischemic heart disease, arterial hypertension and retinovascular occlusion compared with diabetics without glaucoma or ocular hypertension.

Adult↗
PubMed1986

Endothelial cell density after penetrating keratoplasty using long-time banked donor material after long distance transportation (Denmark-Sweden).

Central corneal cell density was evaluated from photographs obtained by a clinical non-contact specular microscope (Zeiss) in 48 patients at a mean post-operative time of 7 1/2 months after penetrating keratoplasty for a number of different causes, keratoconus being the most frequent indication. Cell density decrease on this occasion was compared to pre-operative data from the Eye Bank in Arhus, Denmark, which supplied corneo-scleral preparations transported by ferry and train to Linköping, Sweden. A mean decrease in cell density of 4.4% was recorded during bank time (11-27 days). A further mean decrease from final preparation to post-operative photography of 36.5% was found. Mean total cell density decrease amounted to 39.4%, which compares well with results found in other studies. Among several factors studied, the only one associated with significantly (P less than 0.02) greater cell density decrease than other factors was long post-mortal time periods (death to bank preparation). Mean final endothelial cell density was 1899 cells/mm2, which should correspond to a good functional reserve of donor endothelium. Neither the long bank time, nor the transportation seemed to be of major importance with respect to donor material quality. Foreign material supply can be a good solution to local corneal shortage.

Cell Count↗
PubMed1992

Glaucoma blindness in Denmark.

In order to evaluate the prevalence and the incidence of glaucoma blindness in Denmark, all registration forms of persons greater than or equal to 50 years of age at admission, admitted to the Danish Association of the Blind (DAB) between 1955 and 1987 with glaucoma as main cause of blindness, were examined. In 1987 6.7% of DAB-members greater than or equal to 50 years of age suffered from blindness caused at least partially by glaucoma, equivalent to an estimated prevalence of 45 per 100,000 of the Danish population greater than or equal to 50 years. The estimated annual incidence of blindness due to glaucoma was 7 per 100,000 greater than or equal to 65 years, and in an equal number of patients glaucoma was a contributory cause of blindness. The incidence of blindness due to glaucoma was decreasing in the young age groups (less than 65 years) throughout the study period. Glaucoma blindness seems to occur at a later age now than earlier, leaving the patients blind for a shorter time. This pattern may be explained by improved health services but could also be due to a change in the spontaneous course of glaucoma. The proportion of glaucoma blindness in the glaucoma population was estimated to be 4-5%.

Age Factors↗
PubMed1992

Prevalence of retinitis pigmentosa and allied disorders in Denmark. II. Systemic involvement and age at onset.

A population survey of retinitis pigmentosa and allied disorders in the Danish population disclosed 1301 cases prevalent in Denmark per January 1, 1988. Crude prevalence rates and World Standardized prevalences of systemic and non-systemic RP are presented. Sixty-four per cent of all RP-cases were non-systemic. A preponderance of males was encountered in both systemic and non-systemic RP. Usher disease was diagnosed in 12%, Bardet-Biedl syndrome constituted 5%, and the frequency of Spielmeyer-Vogt disease was 1% of all prevalent RP-cases. Other defined syndromes occurred in 1% of the cases. The Danish figures with respect to Usher disease are compared with standardized prevalence rates from Sweden and Finland. Nineteen per cent of patients affected by non-systemic RP had an onset later than 30 years of age. In patients affected by systemic RP the eye disease tended to an earlier debut with only a few per cent beginning after the age of 30 years.

Adolescent↗