Transmitting genetic risk information in families: attitudes about disclosing the identity of relatives.
(57/3722)
Attitudes about disclosing the identities of family members to a physician to ensure diffusion of genetic risk information within affected families were examined in a questionnaire study of Danish patients with alpha1-antitrypsin deficiency (A1AD), their relatives, and a control group of Danish citizens. The questionnaires were returned by 1,761 (82%) of 2,146 recipients; 1,609 (75%) agreed to participate and completed the questionnaire. Only 2.8% objected to disclosing the identity of children, 9.1% objected to disclosing the identity of parents, and 6.7% objected to disclosing the identity of siblings. When genetic tests are offered to a sister, 75.4% of screened individuals with severe A1AD (phenotype "piZ") and 66.8% of piZ probands thought that the physician should say who is ill. Important reasons for informing a sister at risk were, for 58%, the opportunity to prevent disease and, for 41% of piZ-probands, the opportunity to maintain openness in the family and to avoid uncertainty. Stepwise logistic regression of background variables showed that relatives were those for whom most respondents approved the disclosure of the parents' and siblings' identities to enable the physician to examine them for the presence of A1AD. Women were less prone to disclose the identity of siblings. The results indicate that the genetic counselor should inquire about relatives' identities, to ensure that they are properly informed about the known risk of severe genetic disorder, such as A1AD, for which disability can be prevented by a change of lifestyle or by careful management. Disease prevention is essential, but openness and avoidance of uncertainty in affected families are also important. Our findings imply that fully informing all relatives about the disorder and about who is actually ill should be the principal rule. (+info)
Semen quality and sex hormones among organic and traditional Danish farmers. ASCLEPIOS Study Group.
(58/3722)
OBJECTIVES: To confirm or refute the hypothesis that organic farmers have higher sperm concentrations than traditional farmers. METHODS: Traditional and organic farmers were selected randomly from central registers, and 171 traditional farmers and 85 organic farmers delivered one semen sample before the start of the spraying season. The participation rate was 28.8% among traditional farmers and 42.9% among organic farmers. RESULTS: The median sperm concentration for traditional and organic farmers was 58 million/ml and 64 million/ml, respectively. After adjustment for several confounders, sperm concentration, total count, proportion of non-vital spermatozoa, sperm chromatin structure, and motility variables did not differ significantly between the two groups. The traditional farmers had a significantly lower proportion of normal spermatozoa, but this result was not confirmed in a second sample. Organic farmers had slightly higher inhibin B concentration and testosterone/sex hormone binding globulin ratio. CONCLUSION: Despite slight differences in concentrations of reproductive hormones, no significant differences in conventional measures of semen quality were found between organic and traditional farmers. (+info)
Declining physical abilities with age: a cross-sectional study of older twins and centenarians in Denmark.
(59/3722)
OBJECTIVE: To evaluate whether physical disability reaches a plateau in the oldest age groups. DESIGN: Cross-sectional survey. PARTICIPANTS: A total of 3351 individuals, which included all those living in Denmark who celebrated their 100th anniversary during the period from 1 April 1995 to 31 May 1996 (276 subjects) and all Danish twins aged 75-94 registered in the Danish Twin Register (3075 subjects). MAIN OUTCOME MEASURES: The ability to perform selected items of basic activities of daily living independently. RESULTS: The prevalence of independence in each of six selected activities of daily living was significantly lower in both men and women centenarians compared with octo- and septuagenarians. The sex difference in independence in all six selected activities of daily living was larger for each advancing age group, with women being most disabled (P < 0.001). In centenarians 20% of women and 44% of men were able to perform all selected activities of daily living independently. CONCLUSION: Compared with individuals aged 75-79 years, physical abilities of men and women gradually diminished in age groups 80-84, 85-90 and 90-94, with the lowest levels among 100-year-olds. Although women have lower mortality, they are more disabled than men, and this difference is more marked with advancing age. (+info)
The epidemiology and prognosis of glomerulonephritis in Denmark 1985-1997.
(60/3722)
BACKGROUND: The existence of a national renal biopsy register and a national terminal uraemia status register in Denmark provides an opportunity to study the prognosis of glomerulonephritis (GN), and factors influencing prognosis. METHODS: Multivariate analysis of 2380 renal biopsies with GN performed between 1985 and 1997 was done to determine the influence of clinical and histological factors on prognosis. RESULTS: The incidence of GN (39/mo/year) and individual diagnoses did not change during the period. After 10 years, 32%, were dead, 13% terminally uraemic, 5%, uraemic and 50% well. Older age increased mortality, but not the incidence of renal failure after the first year. Male sex increased both mortality and incidence of renal failure (34 vs 24% at 10 years, P < 0.001). The diagnoses could be divided into three prognostic groups compared with the general population: a good prognostic group (minimal change GN and membranous GN ), with a relative mortality of three and a combined renal and patient mortality of four; a poor prognostic group [crescentic GN, HUS/TTP, chronic GN] with relative mortalities of 8-19 and 13-33, respectively; and the remainder with mortalities of 4-7 and 6-12. The presence of multiple glomerular pathology, chronic GN, nephrosclerosis and chronic interstitial nephropathy worsened the prognosis, while the presence of immune deposits only worsened the prognosis of focal segmental glomerulopathy. Mortality was related to uraemia and co-morbidity at biopsy, and to the incidence of renal failure. Renal failure was correlated to uraemia and hypertension at biopsy but not to nephrotic syndrome or atherosclerosis. All vascular complications were increased and were positively related to hypertension and negatively correlated to the incidence of uraemia. Crescentric glomerulonephritis combined with anti-GBM disease had a worse prognosis than Wegener's granulomatosis, with microscopic polyangiitis and pauci-immune disease occupying an intermediate position. The prognosis of mesangioproliferative GN was unaffected by the presence of IgA nephropathy and systemic lupus erythematosus. (+info)
The safety of proton pump inhibitors in pregnancy.
(61/3722)
AIM: To assess the safety of proton pump inhibitors during pregnancy. METHODS: Fifty-one pregnant women exposed to proton pump inhibitors around the time of conception or during pregnancy were compared with 13 327 controls without exposure to any prescribed drug in a population-based study based on The Pharmaco-Epidemiological Prescription Database of North Jutland and the Danish Hospital Discharge Registry. RESULTS: Three babies with malformations were found among 38 women exposed to proton pump inhibitors from 30 days before conception to the end of the first trimester. No cases of stillbirth were recorded. Crude relative risks of malformation, low birth weight and preterm delivery were 1.6 (95% CI: 0.5-5.1), 1.8 (95% CI: 0.2-13.0) and 2.3 (95% CI: 0.9-6.0), respectively. CONCLUSIONS: In this population-based follow-up study, we found no substantially elevated risk in terms of malformations, low birth weight or number of preterm deliveries in pregnancies exposed to proton pump inhibitors. However, further monitoring is warranted in order to establish or rule out a potential association between the use of proton pump inhibitors and increased risk of either cardiac malformations or preterm birth. (+info)
Absence of human herpes virus 8 in semen from healthy Danish donors.
(62/3722)
Epidemiological data indicate a sexual route of transmission of acquired immune deficiency syndrome (AIDS) associated Kaposi's sarcoma. Recently human herpes virus 8 (HHV-8) has been proposed as the aetiological agent for development of Kaposi's sarcoma. Further the virus has been reported in semen obtained from healthy men. In Denmark strict biochemical and microbiological criteria are used in combination with an intensive interview to select semen donors. Despite these strict criteria, HHV-8 may be transmitted to a recipient and even the child by the use of donor semen. We used four different polymerase chain reaction (PCR) and one nested PCR to test semen from 100 Danish donors for the presence of HHV-8 DNA. All 100 samples were consistently negative for HHV-8 DNA, while only one sample (1%) was positive for cytomegalovirus DNA. As HHV-8 was not demonstrated in any of the semen samples, we conclude that the frequency of HHV-8 in semen from Danish donors is very low. (+info)
Shoulder impingement syndrome in relation to shoulder intensive work.
(63/3722)
OBJECTIVES: To analyse the risk of shoulder impingement syndrome relative to shoulder intensive work. METHODS: A cross sectional study of a historical cohort of 1591 workers employed between 1986 and 1993 at a slaughterhouse or a chemical factory. Workers not doing tasks in slaughtering or meat processing constituted the reference group. Intensity of shoulder work in meat processing tasks was assessed by video based observations. Information on shoulder disorders was collected by questionnaire and by physical examinations. Impingement syndrome was diagnosed when shoulder symptoms had been present for at least 3 months during the past year and there were signs of subacromial impingement in the corresponding shoulder at physical examination. Shoulder function was assessed at the same occasion with the Constant scoring technique. Prevalence of shoulder impingement syndrome was analysed according to job title and cumulative exposure. RESULTS: Prevalence ratio for shoulder impingement syndrome was 5.27 (95% confidence interval (95% CI), 2.09 to 12.26) among currently working and 7.90 (95% CI, 2.94 to 21.18) among former slaughterhouse workers. Transformed model based prevalence ratios according to years in slaughterhouse work showed an overall association between cumulative exposure and risk for shoulder impingement syndrome. CONCLUSIONS: This study supports the hypothesis that shoulder intensive work is a risk factor for impingement syndrome of the shoulder. Despite the historical cohort design healthy worker selection may have influenced the exposure-response relation found. (+info)
Occurrence of Shewanella algae in Danish coastal water and effects of water temperature and culture conditions on its survival.
(64/3722)
The marine bacterium Shewanella algae, which was identified as the cause of human cases of bacteremia and ear infections in Denmark in the summers of 1994 and 1995, was detected in seawater only during the months (July, August, September, and October) when the water temperature was above 13 degrees C. The bacterium is a typical mesophilic organism, and model experiments were conducted to elucidate the fate of the organism under cold and nutrient-limited conditions. The culturable count of S. algae decreased rapidly from 10(7) CFU/ml to 10(1) CFU/ml in approximately 1 month when cells grown at 20 to 37 degrees C were exposed to cold (2 degrees C) seawater. In contrast, the culturable count of cells exposed to warmer seawater (10 to 25 degrees C) remained constant. Allowing the bacterium a transition period in seawater at 20 degrees C before exposure to the 2 degrees C seawater resulted in 100% survival over a period of 1 to 2 months. The cold protection offered by this transition (starvation) probably explains the ability of the organism to persist in Danish seawater despite very low (0 to 1 degrees C) winter water temperatures. The culturable counts of samples kept at 2 degrees C increased to 10(5) to 10(7) CFU/ml at room temperature. Most probable number analysis showed this result to be due to regrowth rather than resuscitation. It was hypothesized that S. algae would survive cold exposure better if in the biofilm state; however, culturable counts from S. algae biofilms decreased as rapidly as did counts of planktonic cells. (+info)