The Danish polyposis register

A manual Danish register of patients with familial polyposis coli and their family members was established in 1971. The methods of collection of propositi, preparation of pedigrees, collection of call-up cases, and the organization of the register are described. A country-wide prophylactic proctosigmoidoscopic examination of first-degree relatives, aged 10 to 59 years, resulted in the detection of 42 call-up cases and by December 1982, 319 cases of polyposis were registered in 94 families. An evaluation of the number of collected propositi and call-up cases shows almost complete registration. Dr. Bülow has received grants from the Danish Cancer Society (809/71 and 87/80), “Max and Anna Friedmanns Legat,” and “Ferdinand og Ellen Hindsgauls Fond.”     

Incidence of gallstones in a Danish population

Five-year incidence of gallstone disease was assessed by ultrasonography in an age- and sex-stratified random population of Danish origin aged 30, 40, 50, and 60 years. The response rate was 82.8% (2987/3608). Nonrespondents did not differ from respondents regarding variables concerning gallstone disease. The 5-year incidence of gallstone disease in men aged 30, 40, 50, and 60 years was 0.3%, 2.9%, 2.5%, and 3.3%. Corresponding figures in women were 1.4%, 3.6%, 3.1%, and 3.7%. The incidence of gallstones was significantly higher in subjects aged 45 years or more compared with those aged 35 years. The sex difference in gallstone incidence decreased with increasing age. A significantly higher incidence of gallstone disease was found among subjects with former polyps in the gallbladder. Spontaneous disappearance of gallstones was seen in 4.5%.     

New Danish reference values for spirometry

Introduction: International recommendations state that reference values for lung function should derive from cross‐sectional studies of healthy nonsmokers and be renewed from time to time because of cohort effect and newer, more accurate, technical equipment. In 1986, the Danish Lung Society published reference values for spirometry based on 570 individuals aged 30–70 years. Objectives: To produce new reference values for lung function and to extend the existing values by including individuals between 20 and 30 years of age and older than 70 years of age. Methods: Two similar but independent studies was used: The 2001–2003 examination of the Copenhagen City Heart Study and the 2003–2010 examination of the Copenhagen General Population Study. Of a total of 69 822 individuals, we included 11 288 healthy never‐smoking white individuals to produce the reference values: 6307 women and 4981 men, 20 years of age or older with adequate lung function. Results: We used sex‐stratified multiple linear regression analysis to find prediction formulas for forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and FEV₁/FVC adjusted for age and height. The cutoff value of normal lung function was defined as the fifth percentile (also named the 5% quantile) according to gender, age and height. The robustness of the data was tested and validated in several ways. Conclusion: Compared with the 1986 data, our 2001–2010 material contributes with a substantial number of individuals in the more extreme groups of age and height, and in general, our dataset shows that in most subgroups, the lung function level has improved during the last two decades. Please cite this paper as: Løkke A, Marott JL, Mortensen J, Nordestgaard BG, Dahl M and Lange P. New Danish reference values for spirometry. Clin Respir J 2013; 7: 153–167.     

Drug abusers in Danish mental hospitals

The purpose of this study was to investigate trends in drug abuse among psychiatric inpatients in Denmark. The investigation was based on data collected from The Danish Psychiatric Case Register. The findings show that drug abusers occupy an increasing number of beds in Danish psychiatric hospitals and departments. Moreover, an increase in the number of patients with schizophrenic or borderline diagnoses combined with drug abuse was found. Furthermore, the drug abuse found among psychiatric patients now is frequently more serious than previously. Finally, an increased number of young males admitted with drug abuse was discovered. Young males are also more frequently diagnosed as illegal, or polydrug abusers, as opposed to older males and females.     

Antipolymer antibodies in Danish fibromyalgia patients

OBJECTIVE: To use a new immunologic assay to investigate antipolymer antibody (APA) levels in women with fibromyalgia (FM). METHODS: The study population consisted of 35 patients with FM and 129 controls. The controls were selected based on a prior history of breast surgery and the presence or absence of a prior hospital diagnosis of soft tissue rheumatism. Study subjects underwent blood sampling, including tests for antinuclear antibodies (ANA) and APA, a clinical examination, and an interview focusing on rheumatic complaints and self-reported disability. The severity of rheumatic symptoms/signs was scored from 1 (= none) to 5 (= severe) based on the clinical examination and the interview. RESULTS: FM patients in this study represented a broad spectrum of disease severity, with the majority having mild symptoms. FM patients had a higher symptom severity and myalgic scores than controls (p < 0.001 for both variables). Adjusting for symptom severity, a weak positive association between APA levels and FM was observed (p = 0.08). The APA level was inversely associated with age, i.e., decreasing APA levels were seen with increasing age (p = 0.008). CONCLUSION: FM patients tended to have slightly higher APA levels than controls when adjusted for symptom severity. APA levels declined with age, a finding that has not been reported previously. The APA test and its clinical relevance should be evaluated in future studies.     

Reflections on the Danish Revolution.

Cardiologists have for some time accepted that primary angioplasty,at least in the best hands, results in improved outcomes inpatients with ST segment elevation myocardial infarction whencompared to thrombolysis. An impasse had, however, arisen inthe cardiology community. Primary angioplasty was regarded asthe treatment that we would like to receive, and to offer, butthe results of the well conducted trials have been regardedas impossible to translate into routine clinical practice. Argumentsagainst the routine use of primary angioplasty had centred onthe assumption that these results were only achievable in highvolume centres manned by high quality staff. This year two landmarkpublications have forced us to radically reassess the role ofprimary angioplasty in the management of acute myocardial infarction. The first was a Lancet meta-analysis of 23 trials that demonstratedin the     

Changing epidemiology of HBV infection in Danish children

Hepatitis B continues to be a worldwide threat to human health, especially if infection occurs in childhood. Universal vaccination is recommended by WHO, but has not been implemented in the Scandinavian countries, Holland and UK, because of a low incidence rate. However, clinically overt infections are rare in childhood. We therefore performed a nation wide serosurvey for HBV markers in 2428 children aged primarily 6-16 years from 16 primary schools in Denmark. Anti-HBc was found in altogether 20 children (0.8%), 12 of whom were among 144 immigrant children (8.3%) compared to 8 (0.4%) in those born in Denmark. Three of the children, all immigrants, were HBsAg positive indicating chronic infection. At school level no relation of anti-HBc in Danish born children was found to schools with high number of immigrant children or schools with HBsAg positive children indicating a low risk of Hepatitis B transmission in this setting. The results do not support implementation of general vaccination, but stress the need for HBV screening in immigrants as it provides a mean for immunization of close contacts at risk and information on prevention.     

Semen quality among Danish and Finnish men attempting to conceive. The Danish First Pregnancy Planner Study Team

OBJECTIVE: To assess differences in semen quality between similar populations from Denmark and Finland. DESIGN: Comparison of semen quality between 221 Finnish men (of whom 115 had no proven fertility) and 411 Danish men with no proven fertility in two follow-up studies among normal couples trying to conceive. METHODS: In Finland male partners of couples without experienced infertility attempting to conceive were recruited through advertisements in local newspapers from 1984 to 1986. From 1992 to 1995 Danish men who lived with a partner and who had not attempted to achieve a pregnancy previously were recruited through their union when they discontinued birth control. All semen analyses were performed in accordance with the World Health Organization guidelines. RESULTS: Median sperm concentration, total sperm count and the percentage of morphologically normal spermatozoa were significantly higher among the Finnish men without proven fertility (104.0 million/ml, 304.0 million and 58% respectively) compared with the Danish men (53.0 million/ml, 140.8 million, and 41% respectively). Sperm concentration was 105.7% (95% confidence interval (CI) 58.1%-167.6%) and total sperm count was 127.4% (95% CI 71.4%-201.6%) higher among Finnish men without proven fertility than among Danish men after control for confounders. CONCLUSIONS: Some, but hardly all, of the observed difference in semen quality may be explained by differences in recruitment procedures, selection of the men and by methodological differences in semen analysis between the two countries. Also a birth cohort effect may explain some of the differences between countries as the Finnish men were recruited 11 years before the Danish men. Therefore, follow-up studies with identical recruitment and selection of men from the two countries are needed.     

Hepatitis B virus infections among Danish surgeons

Acute viral hepatitis B is considered to be an occupational risk to health-care workers worldwide. At the 1977 annual meeting of the Danish Society of Surgeons, 224 participants were examined for the presence of hepatitis B surface antigen (HGsAg) and antibody to HBsAg (anti-HBs) with use of a radioimmunoassay. None of the surgeons was HBsAg-positive, but 23% had anti-HBs. The prevalence of anti-HBs was five times higher among these surgeons than that in an age-matched control population. Hepatitis acquired during occupation as a surgeon was predominantly of type B, in contrast to hepatitis acquired before entering the surgical profession. Danish surgeons must be regarded as a group at high risk of hepatitis B infection.     

Gallstones and diet in a Danish population

A cross-sectional study of gallstone disease, ascertained by ultrasonography, comprised 4581 men and women of Danish origin, aged 30, 40, 50, and 60 years, of whom 3608 (79%) took part in the investigation. The prevalence was assessed in relation to alcohol intake and number of daily meals. A randomly chosen subgroup of 593 persons was interviewed about their dietary habits. Both in the univariate and the multivariate analysis, gallstone disease was significantly related to abstinence from alcohol but not to number of meals. There was a trend towards positive association between gallstones and intake of refined sugars and total fat, whereas a negative trend was found between gallstones and intake of fibres and polyunsaturated to saturated fat ratio. None of the associations were significant. The same relations were observed when gallstones less than 10 mm were used in the analysis. The problem of assessing diet in relation to gallstone prevalence is stressed.     

Hepatitis B virus infections among Danish dentists

Since type B hepatitis is generally regarded as an occupational risk for dentists, the participants at the 1976 annual meeting of the Danish Dental Association were examined for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). A total of 1,338 dentists (89% of the dentists at the meeting and 29% of all Danish dentists) were included in the study by completion of a questionnaire and by radioimmunoassay of a blood sample for HGsAg and anti-HBs. None of the dentists was HBsAg-positive, but 110 (8.2%) had anti-HBs. An increasing frequency of anti-HBs was found with increasing age, but the figures were similar to the findings in a control population. Evidence is presented that hepatitis found before admittance to or during the time at dental school was predominantly not of type B. In contrast, type B hepatitis predominated during the professional activity of the dentists. On the basis of the serological findings in 29% of all Danish dentists, it is concluded that dentists cannot be regarded as a high-risk group for hepatitis B.     

Employability and workability among Danish employees.

The study is based on a cross-sectional study of 5575 employees interviewed by telephone in 1995. The response rate was 80%. The purpose of the study was to examine the association between employability, workability, and age. The findings of this study support the hypothesis of a correlation between employability and workability. Furthermore, it shows a strong association between employability, age, and gender.     

Screening for celiac disease in Danish adults

Abstract

Objective. The prevalence of celiac disease (CD) as recorded in the Danish National Patient Registry is ～50/100,000 persons. This is much lower than the reported prevalence of CD in other Nordic countries and underdiagnosis is suspected. Our aim was to estimate the prevalence of CD in a population-based study of Danish adults. Methods. A total of 2297 adults aged 24–76 years living in the southwestern part of Copenhagen were screened for CD by immunoglobulin (Ig)A and IgG antibodies to transglutaminases and deamidated gliadin. IgA/IgG-positive participants were invited to a clinical evaluation, including biopsies, by a gastroenterologist. Results. Of the invited 56 participants, 40 underwent a full clinical evaluation and 8 persons were diagnosed with CD; 2 of the 16 persons, who did not complete the clinical evaluation, were considered by experts to have probable CD. None of the above 56 participants had a known history of CD or a recorded diagnosis of CD in National Patient Registry. By combining cases of biopsy-proven CD (n = 8), probable CD (n = 2), and registry-recorded CD (n = 1), the prevalence of CD was estimated to be 479/100,000 (11/2297) persons (95% CI: 197–761). Conclusion. In this general adult population, the prevalence of CD as estimated by screening and clinical evaluation was 10 times higher than the registry-based prevalence of CD. Of 11 participants diagnosed with CD in our screening study, 10 were unaware of the diagnosis prior to the study. Thus, our study suggests that CD is markedly underdiagnosed in Danish adults.     

Cerebral toxoplasmosis in Danish AIDS patients.

We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had the diagnosis confirmed but since 5 patients, who were never treated, were diagnosed at autopsy, the overall cumulated incidence was 8% (22/266 patients). The overall diagnostic accuracy was 59% (17/29 patients) showing some changes over time. Among patients diagnosed with AIDS in 1988 or later, the accuracy was 83% (10/12 patients) while among patients diagnosed in 1987 or earlier the accuracy was 41% (7/17 patients). Four patients were diagnosed with Pneumocystis carinii pneumonia (PCP) prior to the diagnosis of CNS toxoplasmosis, while among patients with toxoplasmosis as the AIDS-defining diagnosis, 3 later developed PCP. None of these 7 patients had received secondary prophylaxis with a drug containing sulfonamide.