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PubMed1978

Serum genetic markers in a Newfoundland isolate with a familial aggregate of Hodgkin's disease.

Inherited genetic markers on the immunoglobulins and three other serum proteins were investigated in members of an isolated Newfoundland community. The frequencies found were compared with those from Europe. Whilst the incidence of the commonest variant forms were typically 'European', the occurrence of rare phenotypes pointed towards specific admixture from American Indians and Scandinavia. A possible contribution of these rare alleles, and of others, to pathogenesis in a familial aggregate of Hodgkin's disease within this community is discussed.

Gene Frequency↗
PubMedDate not supplied

Low frequency of the delta F508 mutation in Finno-Ugrian and Baltic populations.

The frequency of carriers of the delta F508 mutation at the cystic fibrosis (CF) locus was studied in population samples of Finns, Lithuanians, Saamis (Lapps) and Swedes from northern Sweden. The carrier frequencies in northern Sweden (1:200) and in Lithuanians (1:143) were significantly lower than in southern Scandinavia (Denmark; 1:38). No delta F508 carriers were found in Finns (n = 171) and Saamis (n = 151). The results indicate that the frequency of delta F508 is low in Finno-Ugrian and Baltic populations, and the decreased frequency of delta F508 in northern Sweden may be due to Finnish and Saamish admixture.

Baltic States↗
PubMed1989

ACE inhibitors in hypertension: a European viewpoint.

The introduction of angiotensin-converting enzyme (ACE) inhibitors has had an appreciable impact upon the treatment of hypertension in Europe, although acceptance of these new agents has not been uniform in all countries. In order to arrive at an understanding of the place of ACE inhibitors in the management of the hypertensive patient, the attitudes of four parties must be considered: the prescriber, the patient, the manufacturer, and the regulatory agency. Physicians in Britain, Germany, and Scandinavia have lagged behind their counterparts in France and Italy in prescribing ACE inhibitors, due to restrictions placed by national regulatory agencies on the first-line use of these agents in hypertension therapy.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1978

Hereditary lecithin cholesterol acyltransferase deficiency. Report of a new family with two afflicted sisters.

One case of lecithin cholesterol acyltransferase (LCAT) deficiency is discovered by renal biopsy. Through the study of a French family, native to Brittany, one sister is found to be carrier of the trait. This finding suggests that the gene defect hitherto reported from Scandinavia is not restricted to this region. The patient shows typical signs of the disease, corneal opacities, anemia with a hemolytic component and lack of plasma LCAT activity. She has proteinuria, HTA, hematuria, no renal insufficiency. Signs previously unreported were noted: sensorineural hearing loss and platelet environment disorder. Histological abnormalities of two types are found: foam cells and subendothelial deposits, of which the tinctorial characteristics indicate a lipid composition. The lack of glomerular fluorescent staining observed is not in favor of an immune complex nephropathy. The study of this case suggests the determining role of lipid abnormalities in the genesis of anemia and of the vascular depositions in the induction of renal failure encountered in several cases of LCAT deficiency.

Adult↗
PubMed1977

Preoperative facial paralysis in malignant parotid tumours.

Preoperative paralysis of the facial nerve was found in 145 of 1,029 patients with malignant parotid tumours (14%) treated at nine university clinics in Scandinavia. The incidence of facial paralysis varied between the different clinics. A parellelism between the incidence of the facial paralysis and the impairment of the prognosis of the different tumour types is shown. The presence of preoperative facial nerve paralysis in malignant parotid tumours implies a very poor prognosis but the situation is not as hopeless as has been suggested and therefore one must rely on very radical surgery.

Adenoma↗
PubMed1986

Coecocystoplasty: an evaluation of operative results.

Coecocystoplasty for substituting or augmenting the bladder is a relatively common operation in the United States, but not in Scandinavia. In order to focus the attention on this voiding-preserving operation we evaluated the late postoperative results of 8 patients. Median follow-up was 5 years. Seven of the patients had symptoms from a contracted bladder and 1 patient with epispadias was undiverted from a ureteroileocutaneostomy. There were some early postoperative complications. Two patients had a revision of the coecocystoplasty, 1 patient ended up with a ureteroileocutaneostomy and 1 patient needed a nephrectomy because of a perirenal abscess. The patient with epispadias later had an artificial urinary sphincter because of persisting incontinence. At follow-up time all patients found that they had a better life than prior to operation since the invalidating symptoms from the contracted bladder had disappeared. One patient with residual urine had chronic urinary tract infection. All patients were continent at daytime, 3 patients had nocturnal incontinence. Urodynamic studies showed no infravesical obstruction and bladder capacity between 75 and 380 ml H2O. Three patients had decreased renal function. Based on our limited material we conclude that coecocystoplasty is a reasonable, though not unproblematic, treatment in patients with severe symptoms from a small contracted bladder and a therapeutical alternative in patients with a previously defunctionalised bladder and that this method should always be taken into consideration before a urinary diversion.

Adult↗
PubMed1987

Problems concerning the concept of reactive psychoses.

The problems of reactive psychoses are discussed from the following perspectives: terminology, prevalence, psychogenesis and trauma, predisposition and vulnerability, as well as outcome. Four definitions of reactive psychoses, which are used in Scandinavia, are presented and discussed. Each of them is beset with problems. The authors argues that the term 'reactive psychoses' should be limited to those functional psychoses which are not typically schizophrenic, manic-depressive or paranoid.

Adjustment Disorders↗
PubMed1983

Disseminated intravascular coagulation in Korean hemorrhagic fever.

To investigate the nature and role of coagulation and complement alterations in the pathogenesis of Korean hemorrhagic fever (KHF), the profiles from the early stages in 27 male patients were serially evaluated. Evidence of disseminated intravascular coagulation (DIC) was observed in 14 of the 27 patients (51.8%) sometime during the course of the disease. The earlier the coagulation tests were performed, the more frequently the evidence of DIC was found. The mean serum C3 concentration was significantly decreased during the early stages, while serum C4 concentrations revealed no significant variation. A significant decrease of the serum C3 concentration, however, was found only in the group with DIC. Korean hemorrhagic fever (KHF) is an acute, systemic disease characterized by fever, hemorrhagic manifestations, and renal failure. This disease has been known to occur from the Pacific Ocean to the Baltic Sea under various synonyms and toponyms including epidemic hemorrhagic fever, hemorrhagic nephrosonephritis and hemorrhagic fever with renal syndrome. Recent investigations demonstrated the identity of these conditions described from Korea, the Soviet Union, Japan, and China. Nephropathia epidemica of Scandinavia was also revealed to have a close serological relation to this disease, but with antigenic differences. The etiologic agent was identified in 1978 by Lee et al., who isolated a viral antigen from a field mouse, Apodemus agrarius coreae, which is the natural reservoir of this disease in Korea. The KHF or Hantaan virus has been propagated in cell cultures and observed electronmicroscopically. In thin sections, the virus was detected within the cytoplasmic granular matrices (viroplasms) of the infected cells. Virus particles were spherical and had an extremely electron-dense core. Negative-contrast staining showed that the virus had an icosahedral structure and annular surface capsomeres. The morphology and morphogenesis of the virus were similar to those of the orbiviruses. The characteristic pathologic findings observed in fatal cases of KHF are congestion and hemorrhage of the renal medulla, hemorrhage in the right atrial wall of the heart, and hemorrhage and necrosis in the anterior lobe of the pituitary gland. The microscopic characteristics of these lesions consist of hemorrhage, coagulation necrosis, and mononuclear cell infiltration. The clinical course of typical KHF may be divided into five phases, each designated for a characteristic physiologic aberration; febrile, hypotensive, oliguric, diuretic, and convalescent.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1989

Conservative drug treatment in patients with moderately severe chronic occlusive peripheral arterial disease. Scandinavian Study Group.

A double-blind, parallel group, multicenter clinical trial of pentoxifylline compared with placebo enrolled 150 patients with moderately severe chronic occlusive arterial disease (COAD) at three centers in Scandinavia. The study consisted of a 4-6 week single-blind, placebo-controlled run-in phase, during which the stabilization of the initial claudication distance of all patients was assessed before randomization to a 6-month double-blind observation period. The diagnosis of COAD was established by clinical findings, conventional angiography, and noninvasive peripheral Doppler pressure assessment at rest and after exercise. The results of the overall intention-to-treat analysis of the study population show statistically significant superiority of pentoxifylline over placebo for all absolute claudication distance summary and end point measures. By using two clinically relevant parameters, which are a resting ankle/arm pressure ratio 0.8 or less and a duration of COAD for greater than 1 year, a target population could be defined in whom trial results became highly significant. For nontarget patients with mild COAD, we conclude that basic therapeutic measures should include the treatment of risk factors and the initiation of physical training. For target patients, however, a multifactorial therapeutic approach, including the use of pentoxifylline, is justified.

Aged↗
PubMed1998

Characteristics of 9194 patients with left ventricular hypertrophy: the LIFE study. Losartan Intervention For Endpoint Reduction in Hypertension.

-Losartan was the first available orally administered selective antagonist of the angiotensin II type 1 receptor developed for the treatment of hypertension. The Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study is a double-blind, prospective, parallel group study designed to compare the effects of losartan with those of the beta-blocker atenolol on the reduction of cardiovascular morbidity and mortality. Patients with essential hypertension, aged between 55 and 80 years, and ECG-documented left ventricular hypertrophy (LVH) were included. Altogether, 9223 patients in Scandinavia, the United Kingdom, and the United States were randomized from June 1995 through April 1997, and 9194 remain after exclusion of a study center at which irregularities were discovered. This population of hypertensives (mean systolic/diastolic blood pressure, 174.4/97.8 mm Hg) with LVH comprises women (54.1%) and men, mostly retired from active work (mean age, 66.9 years), with a high prevalence of overweight (mean body mass index, 28.0 kg/m2), diabetes mellitus (12.3%), lipid disorders (18.0%), and symptoms or signs of coronary heart disease (15.1%). There were fewer current smokers (<17%) than in the general population, and approximately 7% were nonwhite. Almost 30% of participants had been untreated for at least 6 months when screened for the study. Only 1557 persons who entered the placebo run-in period of 14 days were excluded, predominantly because of sitting blood pressures above or below the predetermined range of 160-200/95-115 mm Hg and ECG-LVH criteria not met. By application of simple 12-lead ECG criteria for LVH (Cornell voltage QRS duration product formula plus Sokolow-Lyon voltage read by a core laboratory), hypertensive patients with LVH with an average 5-year coronary heart disease risk of 22.3% according to the Framingham score were identified. This population is now being treated (goal, <140/90 mm Hg) in adherence with the protocol for at least 4 years after final enrollment (ie, through April 2001) and until at least 1040 patients suffer myocardial infarction, stroke, or cardiovascular death.

Aged↗
PubMed1975

Season of birth in schizophrenia and neurosis.

National studies in Scandinavia and in England and Wales have shown that schizophrenic patients are born significantly more often in the early months of the year than would be expected from comparison with the general population. The author examines additional evidence from England and Wales and discusses possible sources of technical error. Although there is currently no evidence of a causal association between season of birth and schizophrenia, he suggests that this possibility should be given consideration.

England↗
PubMed1984

Psychotherapy in Sweden: historical background, current status, and future projections.

From medieval times, care of the emotionally disturbed in Sweden has shifted between moralistic and enlightened approaches. In this century through the 1960s, organic methods have predominated, with emphasis on description and precise diagnosis. Psychodynamic treatment has been only reluctantly accepted until the past decade, with child psychiatrists and psychologists at the forefront. Norway has typically been most progressive in the establishment of psychoanalytic and other psychodynamic movements in Scandinavia, with Sweden following and Denmark often lagging behind. In 1970, Norway became the first Scandinavian country to require training in psychotherapy for psychiatrists. Sweden remained more conservative for years, both in adherence to the organic model at one extreme, and in supporting one of the most orthodox psychoanalytic movements in the world, at the other. During the 1970s, however, it became increasingly more common for psychiatrists in Sweden to seek training in psychotherapy through a variety of organizations, established since the early 1930s and operating independently of each other. In 1978, a uniform state program in psychotherapy was developed with theoretical and practical requirements, and is scheduled in the near future to become obligatory for psychiatrists, psychologists, and various other mental health professionals. The paramedical personnel has become increasingly more involved in mental health care during the past decade. In delivery of care, the "sectorization" principle has become central, and is likely to set the tone for the future. With the entire country divided into local catchment areas, the direction will be toward psychodynamic approaches integrated with traditional organic models, open care, decentralization, planned prophylaxis, and full collaboration of all mental health professionals and social agencies.

Child Psychiatry↗
PubMed1976

Multiple lead ECG submaximal treadmill exercise tests in angiographically documented coronary heart disease.

One hundred patients underwent submaximal exercise tolerance testing and coronary cineangiography. Sixty-six percent of the exercise tests were diagnostic including 48 positive and 18 negative tests; 34 patients had indeterminate test results. The occurrence of exercise induced ventricular premature beats was not related to significant coronary artery disease. Ventricular asynergy was significantly more frequent in patients with positive exercise tests (p less than .0001). Application of the age-adjusted target heart rate criterion recommended from Scandinavia and Myrtle Beach to patients with indeterminate results due to failure to reach target heart rate resulted in six false negative tests and lowered sensitivity. The number of positive diagnostic responses achieved using a multiple electrocardiographic lead system was compared with positive diagnostic responses detected in a single lead (V5) and the number of positive tests identified by the additional leads was highly significant (p less than .0001). A high incidence of indeterminate test results due to failure to achieve target heart rate is noted.

Adolescent↗
PubMed1980

Reactive arthritis following asymptomatic yersinia infection.

A case of an acute asymmetrical polyarthritis occurring in a teenage boy is described. This was shown by serological tests to be secondary to a recent infection with Yersinia enterocolitica. Reactive arthritis following infection by this organism is well recognised in Scandinavia. Only recently have two cases been reported in the U.K. (1,2). This is the first reported case in Scotland and is unusual in that the initial infection was asymptomatic. Clinical improvement was associated with falling Y. enterocolitica titres and a reduction in the E.S.R. The patient was HLA B27 positive. It is suggested that all patients presenting with an acute asymmetrical polyarthritis predominantly affecting the lower limbs should be screened by stool culture and serology for recent Y. enterocolitica infection.

Adolescent↗
PubMed1985

Epidemiology of dietary fibre and colorectal cancer: current status of the hypothesis.

The hypothesis that lack of dietary fibre in the diet is responsible for a variety of large bowel problems, including cancer, has stimulated much discussion and research over the past 15 years. However, the epidemiological examination of this hypothesis has been hampered by the absence of data on the fibre content of most of the world's foods. In Scandinavia and Britain where the consumption of the major chemical fraction of dietary fibre, the non-starch polysaccharides, has been measured using accurate methods, significant negative associations have been shown with colon cancer occurrence. These studies suggest that non-starch polysaccharides may be protective in populations at otherwise high risk of colon cancer from an excess of meat and fat. However, methodological problems in the assessment of non-starch polysaccharide consumption in individuals preclude the use of case control studies in verifying these associations within a single homogeneous population.

Colonic Neoplasms↗
PubMedDate not supplied

Histopathology and epidemiology of breast cancer in the Padua area.

The histologic epidemiology of all breast cancer cases that had been diagnosed in the Padua area over an 11-year period was studied, and the absolute and relative distribution of breast cancer, location indices according to histologic types, 5-yr distribution and annual age-specific incidences of infiltrating and noninfiltrating cancers, as well as noncancerous disease were calculated. The results suggest that the Padua area should be considered a medium-high risk area along with England and Scandinavia.

Adult↗
PubMed1992

Dental amalgam--environmental aspects.

Increasing knowledge about the risk of toxic effects caused by anthropogenic mercury accumulation in ecosystems has resulted in a growing pressure for reduction of the discharge of mercury waste. Consequently, the mercury waste problems of dental clinics have been given increased attention, and restrictions on handling and discharge of contaminated waste have been established in several countries. Major amalgam particles from trituration surplus of those produced during the carving and burnishing of new amalgam restorations are generally collected in coarse filters and sold for refinement. Minor amalgam particles released by production of new fillings or by removal of old restorations partly sediment in tubes and drains. The remaining particles are carried with the waste water stream to the local purifying plant. In Scandinavia, the industrial discharge of mercury-contaminated waste water has been reduced to a minimum. According to recent investigations, dental clinics appear to be responsible for the major amount of mercury collected in the sludge generated in purifying plants. If threshold values for heavy metal content, including mercury, are exceeded, the sludge is not allowed to be recycled as fertilizer. Installation of an approved amalgam-separating apparatus in dental clinics is now mandatory in several countries--for example, Switzerland, Germany, Sweden, and Denmark. Approval of amalgam separators is based on national testing programs, including clinical or laboratory tests demanding 95-99% separating efficiency.

Biological Availability↗
PubMed1996

Population screening for haemochromatosis: a unifying analysis of published intervention trials.

OBJECTIVES: To examine the efficacy of population screening for haemochromatosis by analysing the screening performance of seven intervention trials, and to compare this with the expected performance derived from family studies. SETTING: Seven population intervention trials carried out between 1983 and 1995 in Australia, Scandinavia, Iceland, and the United State. METHODS: Seven of 23 English language trials identified were suitable for the meta-analysis. Transferrin saturation and serum ferritin measurements derived from family studies were used to predict detection and false positive rates for each trial. RESULTS: The seven trials used various screening and diagnostic criteria. A total of 18,396 men and 12,254 women were screened. Because some cases were not detected by screening, and some screen positive individuals did not complete diagnostic testing, the prevalence of homozygous individuals was underestimated in all the trials. The reported and predicted percentages of screen positive individuals nearly always agreed. The homozygote prevalence was estimated to be 34 men and 40 women per 10,000 (prevalence predicted from family studies is 53 per 10,000). Clinical manifestations were present in 50% of male and 44% of female homozygotes. CONCLUSIONS: False positive rates, homozygote prevalences, and frequency of clinical manifestations were in general agreement with predictions from family studies. However, incomplete understanding about a number of issues requires that further pilot trials be carried out before screening can be considered part of routine medical practice.

Adult↗