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PubMed1989

Some characteristics of patients given dental treatment under general anesthesia.

The attitude to treatment of dental diseases under general anesthesia has been rather restricted in the dental profession in Scandinavia. Yet, some patients with certain medical conditions and patients haunted by anxiety may not be able to have conventional dental treatment. During the period 1975-1983, 1067 patients were treated in a group practice in Oslo. These patients are described with regard to gender, age, reasons for treatment, place of residence, source of referral, and type of treatment given. Some of the data are related to the year of treatment. The profile of patients changed during the observation period. At the beginning most of the patients came from Oslo and were less than 6 years old, whereas at the end most of the patients were more than 15 years old, lived outside Oslo, and had more conservative than radical treatment. It is concluded that there will probably always be a small group for whom dental treatment under general anesthesia will be necessary.

Adolescent↗
PubMed1994

Dental caries and microbial and salivary conditions in Uruguayan children from two different socioeconomic areas.

Dental caries, microbial and salivary conditions, dietary habits, and socioeconomic conditions were studied in 100 12- to 13-year-old children from 2 different socioeconomic areas in Montevideo: Pocitos and Piedras Blancas. The residents of Pocitos had a higher educational level, better housing conditions, and occupations involving higher earnings than those of Piedras Blancas. The caries prevalence in the two areas was about the same, but the children in Piedras Blancas had more decayed surfaces and fewer filled surfaces than the children in Pocitos. The mean values for caries in Piedras Blancas and Pocitos were, DMFT, 4.2 and 4.2; DMFS, 8.1 and 7.8; DS, 4.7 and 2.5; and FS, 1.7 and 4.7, respectively. The differences in DS and FS were statistically significant. The frequency of sugar intake and the salivary secretion rate were similar, but the buffer capacity was significantly higher in Pocitos than in Piedras Blancas. The plaque index was the same, but the distribution of cariogenic microorganisms differed significantly. Fifty-eight per cent of the children in Piedras Blancas had more than 10(6) CFU of mutans streptococci per milliliter saliva, compared with 17% of the children in Pocitos. Similar differences were found with regard to the lactobacilli. The percentage of children with high numbers of mutans streptococci was higher in Piedras Blancas and lower in Pocitos than in previous epidemiologic studies in Scandinavia. It was, however, higher than that recently noted in Finland.

Adolescent↗
PubMed1995

Caries incidence, effect of preventive measures, and caries prediction in Uruguayan children.

In 1988, 100 12- to 13-year-old children from two neighborhoods in Montevideo with different standards of living were examined. Twenty-three children with large numbers of mutans streptococci, lactobacilli, or decayed surfaces or a combination of these factors were considered to be at high risk of developing caries. Twelve of these 23 children were selected for special preventive measures. A second examination was made 18 months later, at which 81 of the originally 100 children were studied. The clinical and microbiologic variables were tested for their ability to predict caries by calculating their sensitivity, specificity, the positive and negative predictive values. The incidence of new DMFS was significantly higher in the children from the low than in those from the high socioeconomic area. It was also significantly higher in the children considered being at high risk than in those at low risk at the start of the study. Preventive measures reduced the caries risk. The highest sensitivity was obtained with the clinical test, whereas the highest specificity was obtained with the combined clinical and microbiologic tests. The findings indicate that methods for identifying children at risk which started to be used in Scandinavia 20 years ago could be applied in the Uruguayan population of today. It is valuable to know this, as the resources for both treatment and prevention are very limited.

Adolescent↗
PubMed1987

Prevalence of gallstones in a Norwegian population.

A population sample of 2464 persons between 20 and 70 years of age was invited to participate in a screening study designed for establishing gallstone prevalence rates. The diagnosis of gallstones was based on an ultrasonographic examination. The overall response rate after the primary invitation was 55.6%. Gallbladder stones were diagnosed in 300 persons, giving a crude prevalence of 21.9%. Total age-adjusted prevalence rates were 17.7% in men and 21.2% in women. From age group 20-29 years to age group 60-69 years the prevalence rates increased from 4.9% to 37.0% in men and from 6.0% to 41.3% in women. The age- and sex-specific rates are comparable to those of more recent studies from Scandinavia but are markedly higher than prevalence rates in a Norwegian study from 1960.

Adult↗
PubMed1996

Incidence of Crohn's disease in four counties in southeastern Norway, 1990-93. A prospective population-based study. The Inflammatory Bowel South-Eastern Norway (IBSEN) Study Group of Gastroenterologists.

BACKGROUND: Standardized criteria for Crohn's disease (CD) have only recently been developed, and prospective community-based incidence studies have been performed only during the past 3 decades. Geographic variations in incidence may therefore be due to differences in study design. METHODS: From 1 January 1990 to 31 December 1993 all new cases of CD in four counties in southeastern Norway were prospectively registered. RESULTS: A total of 225 new cases yielded an annual incidence of 5.8/10(5), with the highest incidence in mixed rural-urban areas. A peak of 11.2/10(5) in the annual incidence was found for the age group 15 to 24 years, with no significant differences in the overall annual incidence by gender. An average duration of 6 months of disease before diagnosis was unchanged during the 4 years. About half of the patients had isolated colonic disease, and one-quarter had isolated small-bowel disease. CONCLUSIONS: This study confirms the high incidence figures for Scandinavia, with a particularly high incidence in mixed rural-urban areas. Ileocolonoscopy improves the accuracy of the diagnosis and of the determination of disease extent, which may have therapeutic implications for the treatment and follow-up of patients.

Adolescent↗
PubMed1996

Acute pancreatitis in Buskerud County, Norway. Incidence and etiology.

BACKGROUND: Data on the incidence of acute pancreatitis in Norway are sparse. Danish studies have shown incidence rates increasing to about 35/100,000 (26-65% alcohol-induced), higher than found in American and British studies. METHODS: We have prospectively registered all cases of acute pancreatitis during 1 year in the county of Buskerud, with a population of 224,000. RESULTS: The incidence of acute pancreatitis was 41.5 per 100,000. The median age of the patients was 63 years (range, 21-96 years). The main etiologic factors were gallstone disease (51%) and alcohol abuse (15%), whereas 10% of the cases were classified as idiopathic. Pseudocysts or abscesses developed in 8.8%. The mortality was 6.5%. CONCLUSION: The incidence of acute pancreatitis in this population is comparable to what has been found elsewhere in Scandinavia, but the relative frequency of alcoholic pancreatitis is substantially less.

Acute Disease↗
PubMed1996

Prevalence of Crohn's disease and simultaneous occurrence of extraintestinal complications and cancer. An epidemiologic study in adults.

BACKGROUND: Very dissimilar prevalence figures for Crohn's disease (CD) have been reported from different regions of Scandinavia. There are few reports on the occurrence of liver, joint, skin, and eye disease and gastrointestinal cancer in CD. METHODS: All patients > or = 16 years old with CD living in a well-defined catchment area on 1 March 1990 were identified from the previous 10 years' registers of inpatients and outpatients. The records were screened for evidence of extraintestinal complications and fistulas. RESULTS: The prevalence of CD was 94/10(5) (95% confidence interval, 84-104) inhabitants > or = 16 years old. Signs of liver disease were encountered in 1 of 10 patients, and other extraintestinal complications and intestinal cancer occurred in 1-3%. The true prevalence of primary sclerosing cholangitis could not be assessed. CONCLUSION: The prevalence of CD was midway between recent figures from Orebro and Copenhagen. Fistulas and pathologic liver laboratory test results were more prevalent when CD involved both the large and small bowel.

Adolescent↗
PubMed1997

Absence of LKM-1 antibody reactivity in autoimmune and hepatitis-C-related chronic liver disease in Sweden. Swedish Internal Medicine Liver club.

BACKGROUND: Type-2 autoimmune hepatitis is a subgroup of chronic hepatitis characterized by the presence of liver/kidney microsomal autoantibodies type 1 (LKM-1). A frequent association with chronic hepatitis C suggests that hepatitis virus might trigger autoimmune reactivity. LKM-1-positive chronic hepatitis is not uncommon in southern Europe but is rarely seen in the USA and the UK. The prevalence in Scandinavia is hitherto unknown. METHODS: We used an automated prototype LKM-1 immunometry-based assay (IMx) to detect LKM-1 antibodies in sera from 350 Swedish patients with chronic liver diseases (100 with primary biliary cirrhosis, 80 with primary sclerosing cholangitis, 100 with hepatitis C, and 70 patients with various forms of chronic hepatitis, including 36 autoimmune cases), and from 17 children with autoimmune hepatitis. Sera reactive in the IMx assay were subjected to immunofluorescence testing. RESULTS: No clearly LKM-reactive sera were detected. Serum samples from 29 patients were borderline reactive in the IMx assay but tested negative in the confirmatory immunofluorescence test. Positive tests in the former assay were likely caused by reactivity against microsomal antigens other than LKM-1/cytochrome P450IID6. CONCLUSIONS: LKM-1-positive type-2 autoimmune hepatitis is very rare in Sweden. Furthermore, chronic hepatitis C did not trigger this type of autoimmune reactivity in our patients, probably owing to genetic insusceptibility.

Adolescent↗
PubMed1986

Prevalence and clinical effects of delta agent. Infections in Norwegian population subgroups.

The distribution of antibodies against the delta agent was studied in different groups of hepatitis B patients in Norway. Such antibodies were detected only in drug addicts, predominantly among chronic HBsAg carriers. The results support the notion that the delta agent was introduced into Scandinavia in 1970-75. Although the proportion of anti-delta positive individuals among chronic HBsAg carriers increased, the annual increase of new anti-delta carriers was essentially stable. One death caused by hepatic failure was registered among 43 anti-delta negative and none among 21 anti-delta positive chronic HBsAg carrier addicts.

Adult↗
PubMed1987

Primary meningococcal arthritis.

Arthritis in meningococcal disease is not uncommon and can be caused by either septic invasion of joints or allergic manifestations. Primary meningococcal arthritis (PMA) is, on the other hand, a rare form of meningococcal disease presenting as an isolated septic arthritis without other signs of meningococcal disease. We describe here the first two cases of PMA reported from Scandinavia. The patients were males, 3 and 47 years old, both with arthritis in an ankle joint. PMA is most commonly seen among male infants. Large joints, mainly knee joints, are most often involved and not seldom is the disease polyarthritic. PMA may appear with a previous or on-going upper respiratory tract infection and/or a maculopapular skin rash. If properly treated the prognosis is good.

Arthritis, Infectious↗
PubMed1989

Disseminated histoplasmosis in a Danish patient with AIDS.

We present the first case of disseminated histoplasmosis in an AIDS patient in Europe, a 33-year-old Danish homosexual man, and recommend a detailed travel history in HIV-positive patients presenting with fever, weight loss and organomegaly. In Scandinavia disseminated histoplasmosis is rare but should be kept in mind as the disease is a major opportunistic infection in patients with AIDS. Treatment with amphotericin B followed by fluconazole was effective.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Serogroup A Neisseria meningitidis of clone III-1 present in western Norway as early as 1969-73.

A clone of serogroup A Neisseria meningitidis recognized by multilocus enzyme electrophoresis and designated as clone III-1, has caused major epidemics of meningococcal disease in various parts of the world since the 1970s. In Norway, serogroup B meningococci have been responsible for an epidemic since the mid-1970s. We have studied a sample of 53 meningococci isolated from patients in western Norway prior to the serogroup B epidemic. 22/35 meningococcal isolates collected 1969-73 represented clone III-1, whereas this clone was not found in the 18 isolates from 1962-68. It has been speculated that the epidemic of meningococcal disease in Finland caused by clone III-1 in 1973-75 had spread from an epidemic in USSR that began in 1969. Our findings demonstrate, however, that the clone III-1 was present in Scandinavia in 1969.

Clone Cells↗
PubMed1991

Viral haemorrhagic fever in Sweden: experiences from management of a case.

The first recognized case in Scandinavia with potential man to man transmission of viral haemorrhagic fever occurred in Linköping, Sweden, in January 1990. Following a visit to Kenya a 21-year-old male student suffered a very severe illness including extremely prolonged high grade fever, rash, disseminated intravascular coagulation with thrombocytopenia and severe bleedings. This necessitated one month of intensive care support including respirator treatment. The patient was discharged after 2 1/2 months in good condition, with a partial femoral nerve paresis. About 100 medical personnel were exposed to aerosol or blood before a strict containment regimen was established. No secondary cases occurred.

Adult↗
PubMed1991

A Swedish fatal case of nephropathia epidemica.

A previously healthy 55-year-old man with nephropathia epidemica (NE) developed disseminated intravascular coagulation, anuria and shock and died on day 6 of his disease. By use of indirect immunofluorescence technique and ELISA, specific serum IgM antibodies against Puumala virus could be detected, thus confirming the clinical diagnosis. This case demonstrates that NE in Scandinavia is a potentially lethal disease.

Antibodies, Viral↗
PubMed1993

First cases of microsporidiosis in Scandinavian patients with AIDS.

The first 2 cases of infection with Enterocytozoon bieneusi in Denmark and Scandinavia are reported. Both patients were women and to the best of our knowledge this is the first report of E. bieneusi in female AIDS patients. Both had late stage AIDS, and both had complained of intermittent diarrhoea for more than 1 year. At the time microsporidiosis was diagnosed, no other pathogens causing diarrhoea were found. Immunodeficient patients with chronic unexplained diarrhoea should be investigated for intestinal microsporidiosis, especially as treatment is now available.

AIDS-Related Opportunistic Infections↗
PubMed1994

Stomatococcus mucilaginosus septicemia in two bone marrow transplanted patients.

A 44-year-old man with chronic myeloid leukemia and a 10-year-old boy with adrenoleukodystrophy, both admitted for bone marrow transplantation in December 1992, developed clinical signs of septicemia within 2 weeks after transplantation. Three strains of Stomatococcus mucilaginosus were isolated from blood cultures. These were among the first cases of S. mucilaginosus infection diagnosed at our Laboratory and the first reported from Scandinavia. S. mucilaginosus is part of the endogenous oral flora. Both patients had signs of oral mucositis. All 3 strains were isolated earlier with the Laboratory's present blood culture system, compared with the one in use before spring 1992.

Adult↗
PubMed1982

The fate of kidney-transplanted patients with a previous history of malignancy. The Scandinavian material.

Between 1956 and 1978, 4820 kidney transplantations were performed in 3959 patients in Scandinavia. In 18 cases the transplantation was performed in patients with a prior malignant tumour. There were 11 cases of tumours of the urinary tract. 3 cases of skin cancer and 4 of tumours in other organs. The observation period was 1-108 months before transplantation and 3-77 months after transplantation. In 14 cases it was possible to make a paired prognostic evaluation between the tumour patient and the recipient of the contralateral kidney from the same donor. On this basis, it was concluded that provided the recipient is observed for about 1 year after the treatment of a tumour and no signs of metastases are seen before transplantation, the previous malignancy does not seem to vitiate the prognosis for the course of the transplantation.

Adult↗
PubMed1983

Chronic antigenic stimulation from the graft as a possible oncogenic factor after renal transplant.

In the period 1956-1976, 3 649 kidney transplantations were performed on 3 040 patients in Scandinavia. In the same period 67 primary malignant tumours were detected in these patients. In comparisons using age and sex-specific incidence in a background population, the observed tumour incidence was significantly higher than expected. Analyses were made in regard to a number of factors with potential influence on oncogenesis. The interval from transplantation to appearance of tumour was significantly longer in the recipients of grafts from living relatives than in cadaver kidney recipients. Significant correlation of tumour incidence was found with HLA mismatch in recipients of necrokidneys. Chronic interstitial nephritis as underlying kidney disease and blood transfusion showed correlation with tumour incidence. From these observations the hypothesis is proposed that a chronic antigen effect is a dominant factor among the numerous possible oncogenic mechanisms in patients with transplants.

Adolescent↗