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[Aerobic capacity in children and adolescents--Nordic results over the past 45 years].

The aim of this study was to reveal whether today's children and adolescents have lower aerobic capacity compared with earlier studies. Aerobic capacity may be defined as the highest amount of oxygen a subject is able to consume per unit of time. Peak oxygen uptake (VO2peak) is often used as a measure of aerobic capacity in children. VO2peak in 196 healthy children and adolescents of both sexes, aged 8-16 years, was measured on a graded treadmill test. The mean results of VO2peak (l.min-1) showed only small differences compared with previous studies in Scandinavia. There was, however, greater dispersion in the present study when the VO2peak-values were corrected for weight (ml.kg-1.min-1) than in the earlier studies. When compared to other countries in Europe, Norwegian subjects achieved higher values. The reason may be due to either genetic differences or to a higher level of physical activity among the Norwegian subjects.

Adolescent↗

Familial defective apolipoprotein B-100.

Abnormal interaction between low density lipoprotein receptors (LDLR) and their ligands, apolipoprotein E and B, causes decreased catabolism of lipoproteins which carry these apolipoproteins (VLDL, IDL and/or LDL) and thereby increased plasma concentrations of these. In familial hypercholesterolemia (FH), abnormal interaction is due to mutations in the LDLR gene, and in type III hyperlipidemia due to mutations in the apo E gene. A few mutations in the apolipoprotein B (apo B) gene have been described, of which the apo B-3,500Arg-Gln seems by far the most frequent, that causes defective binding to normal LDLR. The metabolic disorder associated with these mutations has been named familial defective apolipoprotein B-100 (FDB). The frequency of the apo B-3,500Arg-Gln mutation is particularly high in Central Europe (Switzerland) with lower frequencies south of the Alpes, in Russia and in Scandinavia. We found an incidence of 1/1250 of the mutation in Denmark (III), employing a DNA based assay optimized to allow detection of the mutation in very small amounts of DNA (I). Since other mutations in the receptor binding domain of the apo B-100 have been described, we developed another DNA based assay, employing DGGE technique, to screen for other mutations in the region of amino acid 3,456 to 3,553 (II). However, no other mutations but the apo B-3,500Arg-Gln have so far been detected in Danish hypercholesterolemic patients. In a study of 5 Danish families with FDB (46 heterozygous FDB patients and 57 unaffected relatives) we found that FDB patients had significantly increased mean cholesterol and LDL cholesterol concentrations, but with a wide range of variation and with approximately 30% having cholesterol concentrations below the 95th percentile for the general population (IV). This was confirmed in a compilation of data on 205 FDB patients from the Netherlands, Germany and Denmark (V). In this study we also compared the biochemical and clinical features of FDB with those of 101 Danish FH patients in whome FDB had been ruled out. Our data support, that the LDL cholesterol elevation is less pronounced in FDB than in FH and that the age-specific prevalence of atherosclerotic cardiovascular disease (CVD) is lower in FDB than in FH. In the compiled study of 205 FDB heterozygotes (V), we found that age, gender and genetic variation in the LDLR gene explained a considerable part of the between-individual variation in total and LDL cholesterol. We conducted a prospective study of the lipid lowering effect of pravastatin and gemfibrozil in 30 Danish FDB patients (VI). Together with other, retrospective, studies, we conclude that the cholesterol lowering effect of HMG-coA-reductase inhibitors, anion binding resins and nicotinic acid is fully comparable to that observed when treating FH patients and type IIa hypercholesterolemic patients, without clinical signs of FH.

Animals↗

[Food and food additives hypersensitivity in adult asthmatics. II. Oral allergy syndrome in adult asthmatic with or without Japanese cedar hay fever].

OBJECTS: The aim of this study was to investigate whether oral allergy syndrome (OAS) in Japan has a particular association with Japanese cedar (JC) hay fever and which kinds of food allergen cause OAS. SUBJECTS AND METHOD: The questionnaire was answered by 463 adult asthmatics. Each patient was submitted to skin scratch tests with fresh foods and commercial food extracts. RESULTS: Of the 463 patients 45 (9.7%) were diagnosed as OAS. The foods, which most often provoked a reaction, were in order of frequency, melon, kiwi, crab and shrimp. The prevalence of OAS was higher in patients with JC hay fever than without JC hay fever. However, a higher prevalence of OAS was also found in house dust mite antibody positive patients than negative patients. There was no difference in the prevalence of OAS between JC hay fever and house dust mite antibody positive patients. CONCLUSION: It is suggested that OAS has no particular association with JC hay fever. OAS in Japan is associated with different foods from other countries such as Scandinavia where apple is frequently associated with OAS.

Adult↗

Eradication therapy of Helicobacter pylori. A review. Report from a workshop organized by the Swedish and Norwegian Medical Products Agencies, September 1995.

An expert meeting was organized by the Swedish and Norwegian Medical Products Agencies in September 1995 in order to review the current literature and opinions on detection and treatment of Helicobacter pylori. Ten people from these Agencies and 23 experts participated in the workshop and all were involved in the final manuscript, summarizing the background data and the conclusions (Info Läkemedelsverket 1:96). This report is limited to the therapeutic issues. Therapeutic effect on H. pylori is shown for tetracyclines, nitroimidazoles, clarithromycin, and amoxicillin. Acid inhibitory drugs or bismuth salts increase the antibacterial activity. In vitro resistance to metronidazole is reported in cultures of 10%-40% of H. pylori-infected patients in Scandinavia. Primary resistance to clarithromycin and tetracyclines is rare and no resistance to amoxicillin is confirmed. The clinical significance of resistance is unclear when effective triple combinations are used in previously untreated patients, but should be considered in treatment failures. Recommended therapeutic regimens should achieve a more than 90% cure rate. Important factors when choosing therapy are efficacy, side-effects, ecological factors, duration of therapy, and cost-benefit. Four triple regimens are effective and relatively well documented: omeprazole/amoxicillin/metronidazole for 1 week, omeprazole/clarithromycin/metronidazole for 1 week, omeprazole/clarithromycin/amoxicillin for 1 week, or bismuth subnitrate or bismuth citrate/tetracycline/metronidazole for 10 days. Side-effects are less pronounced in the combinations without bismuth. Dual therapy is not recommended. Eradication therapy should be considered for patients with peptic ulcer disease, MALT-lymphoma and Menetriéré's disease. Triple combinations, including two antimicrobials and a potent acid inhibitory drug or bismuth, are recommended.

Antacids↗

Moroxydine: the story of a mislaid antiviral.

A review is presented which began as a literature survey listing verbatim over fifty abstracts and references to the use of moroxydine in the treatment of a number of viral disorders throughout Europe and Scandinavia between 1960 and 1985. The list was first circulated in 1990 and was revised six times as new information became available. The sources are unusual in their diversity and originally appeared in several other languages besides English. Moroxydine may be effective against a number of DNA and RNA viruses, influenza being the original application of the substance when it emerged in the late 1950's. The drug received some attention around 1960, and the introduction of thalidomide at around the same time (1961) is one likely explanation for its current obscurity. Side-effects are reported to be mild and infrequent, and evidence exists that the substance possesses other characteristics which plead for further investigation.

Antiviral Agents↗

Head and neck cancer: a global perspective on epidemiology and prognosis.

Head and neck cancers (ICD-9 categories 140-149 and 161) are common in several regions of the world where tobacco use and alcohol consumption is high. The age standardized incidence rate of head and neck cancer (around 1990) in males exceeds 30/100, 000 in regions of France, Hong Kong, the Indian sub-continent, Central and Eastern Europe, Spain, Italy, Brazil, and among US blacks. High rates (> 10/100,000) in females are found in the Indian sub-continent, Hong Kong and Philippines. The highest incidence rate reported in males is 63.58 (France, Bas-Rhin) and in females 15.97 (India, Madras). The variation in incidence of cancers by subsite of head and neck is mostly related to the relative distribution of major risk factors such as tobacco or betel quid chewing, cigarette or bidi smoking, and alcohol consumption. Some degree of misclassification by subsites is a clear possibility in view of the close proximity of the anatomical subsites. While mouth and tongue cancers are more common in the Indian sub-continent, nasopharyngeal cancer is more common in Hong Kong; pharyngeal and/or laryngeal cancers are more common in other populations. While the overall incidence rates show a declining trend in both sexes in India, Hong Kong, Brazil and US whites, an increasing trend is observed in most other populations, particularly in Central and Eastern Europe, Scandinavia, Canada, Japan and Australia. The overall trends are a reflection of underlying trends in cancers of major subsites which seem to be related to the changing prevalence of risk factors. The five year relative survival varies from 20-90% depending upon the subsite of origin and the clinical extent of disease. While primary prevention is the potential strategy for long term disease control, early detection and treatment may have limited potential to improve mortality in the short term.

Age Factors↗

Coercion in psychiatric care: what have we learned from research?

The use of coercion to assure that people with a mental illness receive treatment has been the focus one of the longest running controversies among mental health professionals. Until quite recently, however, this debate has been almost entirely based on abstract principles. Empirical research concerning coercion was quite limited. Recently, however, research in this field has blossomed. The development of a validated measure of perceived coercion has spawned a variety of new studies. A five-nation study in Scandinavia has begun the difficult task of assessing the impact of different legal systems and systems of care on perceived coercion. Two new studies have used random assignment designs to study the impact of outpatient commitment. This article reviews these and other studies and describes what they do, and do not, tell us about coercion in mental health treatment.

Ambulatory Care↗

[Drug prescriptions for the elderly].

The assessment od drugs taken by elderly people remains a difficult subject since epidemiological data on drug intake in this population is very limited. In a study undertaken in the context of the PAQUID project, drug use was screened in a group of 3,777 elderly people living at home in the Gironde and Dordogne regions of south-west France. In this group, 89.1% of subjects take at least one drug per day, with an average daily intake of 4.1 drugs by 41% of the group. One third of these elderly people take a benzodiazepine drug. Excessive intake of drugs by elderly people is a phenomenon encountered in Scandinavia and Italy but not in the United Kingdom.

Age Factors↗

[Diseases caused by hantaviruses].

Hantaviruses are RNA viruses that belong to the genus Hantavirus, family Bunyaviridae. The main reservoir of hantaviruses are rodents. Humans become infected by inhaling particles of dust contaminated with faeces of rodents, that are found In Europe and Asia hantaviruses named: Hantaan, Seoul and Dobrava-Belgrade causing haemorrhagic fever with renal syndrome (HFRS) are prevalent. Typical clinical picture of HFRS consists of renal insufficiency (primarily anuria and then polyuria with disturbances of water and electrolytic balance), hypotension, shock and disseminated intravascular coagulation and fibrynolisis (DIC). The mild form of this disease caused by Puumala virus is found in Scandinavia. North and South America are the regions where the prevalence of viruses: Sin Nombre, Black Creek Canal, Bayou, and New York causing hantavirus pulmonary syndrome (HPS) has been noted. In the course of this disease non-cardiogenic pulmonary oedema requires immediate hospitalisation at intensive care ward with artificial ventilation. Mortality in HPS due to hypotension, hypoxia and shock ranges up to 40%.

Hantavirus Infections↗

The role of reproductive factors and use of oral contraceptives in the aetiology of breast cancer in women aged 50 to 74 years.

It is unclear whether age at menarche is causally involved in breast-cancer aetiology, or serves a correlate of other early-life exposures. Other aspects of reproductive life, including cycle length and regularity, climacteric symptoms, reproductive history and oral contraceptive use, are also incompletely investigated. We examined these issues in a population-based case-control study, including 3,016 women aged 50 to 74 years with invasive breast cancer, and 3,263 controls of similar age. Mailed questionnaires and telephone interviews were used to collect information on menstrual and reproductive characteristics as well as use of oral contraceptives. We found a statistically significant negative association between increasing age at menarche and breast-cancer risk in women born before 1925 but not after. Length of the menstrual cycle at age 30 seemed to be adversely related to breast-cancer risk, with OR for women with cycle lengths < 24 days and > 30 days being 0.76 and 1.18, as compared with women with a cycle length of 28 days. There was a strong trend of decreasing breast-cancer risk with increasing parity (OR per borne child 0.85, 95% CI 0.80-0.90). Lactation, menopausal symptoms or past use of oral contraceptives did not appear associated with breast-cancer risk. Our findings provide some evidence of a role of environmental correlates of early menarche in breast-cancer aetiology, and underline the importance of childbirth, especially early in life, in the prevention of breast cancer. Our data are not readily compatible with an important influence of former oral contraceptive use on post-menopausal breast-cancer risk.

Aged↗

Mixture models for cancer survival analysis: application to population-based data with covariates.

The interest in estimating the probability of cure has been increasing in cancer survival analysis as the curability of many cancer diseases is becoming a reality. Mixture survival models provide a way of modelling time to death when cure is possible, simultaneously estimating death hazard of fatal cases and the proportion of cured case. In this paper we propose an application of a parametric mixture model to relative survival rates of colon cancer patients from the Finnish population-based cancer registry, and including major survival determinants as explicative covariates. Disentangling survival into two different components greatly facilitates the analysis and the interpretation of the role of prognostic factors on survival patterns. For example, age plays a different role in determining, from one side, the probability of cure, and, from the other side, the life expectancy of fatal cases. The results support the hypothesis that observed survival trends are really due to a real prognostic gain for more recently diagnosed patients.

Age Factors↗

The spatial mobility of two generations of young adults in Norway.

"This article presents results from a longitudinal study using data from the Norwegian population register, combined with data from the 1970 and 1980 censuses. For two generations, those born in 1948 and 1958, successive migrations are considered and the effects of various sociodemographic characteristics on migratory behaviour are explored....Event-history analysis is used to examine the duration of stay at the place reached at age 22, and the effects of individual characteristics on this duration. Since a distinction is made between intra- and inter-regional migration, it has been possible to show that these effects vary significantly depending on whether we are dealing with short- or long-distance migration."

Demography↗

Contribution of the demographic factor to the migration turnarounds in Japan, Sweden and Canada.

"It is well known that similar changes of migration pattern occurred during recent decades in most developed countries; core regions recorded a greatly decreased net in-migration in the 1970s, but increased net in-migration in the 1980s. Based on shift-share analysis of the migration data of Japan, Sweden and Canada, this paper reveals that changing cohort size, especially related to the fertility fluctuation of baby boom and bust, has played an important role in the turnarounds. Furthermore, it is elucidated from a series of correlation analyses that this demographic factor was closely linked with labour-market restructuring in terms of industrial/occupational employment changes."

Americas↗

Investigating the effect of clustering of the urban field on sustainable population growth of centrally located and peripheral towns.

In a previous study (Portnov and Erell, 1998a), an Index of Clustering was defined, which allowed an analysis of the combined effect of spatial isolation and remoteness of peripheral towns on the long-term patterns of their population growth. In the present paper, the analysis of the effect of clustering of the urban field on the patterns of population growth is extended to centrally located urban places, and the validity of this index is tested in two unevenly populated countries--Israel and Norway. In both countries, the effect of clustering of the urban field on the patterns of urban growth is twofold. In sparsely populated areas, the presence of neighboring towns appears to increase their chances of attracting potential migrants due to inter-urban exchanges, while in more densely populated areas, increasing clustering tends to reduce migration influx to a given locality due to inter-town competition. Following this conclusion, a strategy of "redirecting priorities" leading to the formation of urban clusters is proposed, which may enhance the potential of urban growth in geographical areas where this is desirable.

Asia↗

Age at menarche in Iceland.

The purpose of this study was to elucidate the mean age at menarche in Icelandic girls and compare it with results from other Scandinavian populations as well as in other ethnic groups. The study was performed during the school year 1972-1973 on a cross-sectional sample of 682 girls (aged 8.5 to over 17 years), constituting 9.5% of the girls from the third to eleventh forms in all the primary and secondary schools of Reykjavik. The mean age at menarche in Iceland, elicited by the status quo method, proved to be 13.06 +/- 0.10 years (S.D. 1.17 years). According to the information given by the girls (recall method), the earliest time of menstruation was 9.83 years and the latest 15.17 years, at which age all but one of the girls were menstruating.

Adolescent↗

The Danish case-control study of cutaneous malignant melanoma. III. Hormonal and reproductive factors in women.

The relationship between cutaneous malignant melanoma in women and reproductive and hormonal factors was investigated in a population-based case-control study including a total of 280 cases and 536 controls from East Denmark. Patients with lentigo maligna melanoma were not included. No association was found between risk of melanoma and age at menarche, duration of menstrual life, age at natural menopause, age at first pregnancy, or number of pregnancies, live births or miscarriages. There was no evidence of an association between melanoma and use, duration of use or type of oral contraceptives. The use of menopausal replacement therapy was not a risk factor for melanoma. There was no difference in risk associated with hormonal factors between superficial spreading melanoma and nodular melanoma. Our findings suggest that neither reproductive nor hormonal factors increase the risk of melanoma in women in Denmark.

Contraceptives, Oral↗

Risk factors for cervical cancer in Greenland and Denmark: a population-based cross-sectional study.

The incidence of cervical cancer in Greenlandic women aged 20-39 years is nearly 6 times higher than in Danish women of the same age. Possible determinants of cervical cancer incidence were investigated in a population-based cross-sectional study. From Nuuk (Greenland) and Nykøbing Falster (Denmark) a sample of 800 women aged 20-39 years was drawn at random. A total of 586 and 661 women were studied in Greenland and Denmark, respectively. All underwent a personal interview. In Greenland, 13% of the women reported first intercourse before the age of 14 in contrast to 3.5% in Denmark, and nearly 85% of the Greenlanders had their sexual debut before the end of the 16th year of age whereas this applied to only 45% of the Danish women. The prevalence of women with 0-1 lifetime sexual partner was 20.4% in Denmark, and only 1.7% in Greenland. In contrast, 53.2% of the Greenlandic women reported more than 20 partners and 22.4% more than 40 partners. The corresponding figures for Denmark were 3.6% and 0.3%, respectively. In Greenland the most common contraceptive method was the use of intra-uterine devices (73.6%), whereas, in Denmark, oral contraceptive use was most frequent (87.9%). Few Greenlanders had ever used "barrier" contraceptives (diaphragm: 1.4%; condom: 18.1%) compared to Denmark (diaphragm: 10.1%; condom: 53.9%). As many as 87.4% were current smokers in Greenland (Denmark: 53.6%) and 5.6% claimed to have never smoked, whereas this applied to 35.3% in Denmark. The indications of a higher sexual activity (multiple partners, early age at first intercourse) in Greenland compared to Denmark are in line with the observed higher rates of sexually transmitted diseases and with the hypothesis that differences in cervical cancer incidence between Greenland and Denmark are determined by aspects of sexual background.

Adult↗

The long-term influence of vasectomy on prostatic volume and morphology in man.

During the past two decades several papers have described the changes in prostatic secretory capacity following vasectomy. Based upon results indicating a reduction of secretory function, it was suggested that even prostatic size and the incidence of benign prostatic hyperplasia (BPH) might be altered after the operation. In this study, which included 56 males who had been vasectomized 8 years previously and 56 age-matched control persons, transrectal ultrasonic scanning of the prostate was used for exact measurements of the prostatic volume and for the investigation of intraprostatic echo pattern. The total prostatic volume, the volume of the periurethral gland, and the volume of the peripheral zone were not influenced by the vasectomy; nor was the growth rate of these zones affected. In the vasectomy group, the frequency of adenomatous prostates was 19.6%, whereas 30.3% of prostates in the control group had ultrasonic signs of BPH. However, this is not a statistically significant difference. Subdividing the material according to age did not reveal altered BPH frequency in any age group when vasectomized and controls were compared.

Humans↗