Population-Based Study of Acute Respiratory Infections in Children, Greenland

Acute respiratory infections (ARI) are frequent in Inuit children, in terms of incidence and severity. A cohort of 294 children <2 years of age was formed in Sisimiut, a community on the west coast of Greenland, and followed from 1996 to 1998. Data on ARI were collected during weekly visits at home and child-care centers; visits to the community health center were also recorded. The cohort had respiratory symptoms on 41.6% and fever on 4.9% of surveyed days. The incidence of upper and lower respiratory tract infections was 1.6 episodes and 0.9 episodes per 100 days at risk, respectively. Up to 65% of the episodes of ARI caused activity restriction; 40% led to contact with the health center. Compared with studies from other parts of the world, the incidence of ARI appears to be high in Inuit children

The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial:study protocol for a randomized controlled trial

SPIRIT 2013 Checklist. (DOCX 61 kb

Mellemørebetændelse

Infectious middle ear disease By Niels Lynnerup, Morten Qvist and Preben Homøe Evaluation of general health is important in order to reconstruct the life conditions of earlier populations. This is usually done by analysing the skeletal remains of such populations. However, only few diseases leave their mark on the skeletons – indeed the most&nbsp;widespread and common diseases, such as pneumonia and gastrointestinal infections, which probably also accounted for the vast majority of deaths, do not leave any signs at all on the skeleton. Chronic conditions, on the other hand, such as tuberculosis and leprosy, do leave their mark, but the picture one gains by focusing on these diseases says more about the hardiness of a population (namely that individuals endured a lifelong disease) than about the general health. Palaeopathologists have sought for such markers, e.g. osteoporosis, Harris’ lines, dental enamel hypoplasia and porotic hyperostosis, but many of these methods either suffer from biased scoring methods, or the link to modern medical clinical observations is tenuous. We present a new method to evaluate general living conditions in earlier populations. Our method relates to the occurrence of chronic middle ear disease in childhood, and we think it has several advantages: correspondence between chronic infectious middle ear disease (IMED) and general living conditions is affirmed in modern medical epidemiological observations, the bone changes brought about by IMED occur in childhood, and the skeletal element used to evaluate the occurrence of IMED is the petrous part of the temporal bone in the skull, one of the sturdiest bones in the skeleton. We applied this method to three medieval skeletal materials from Nordby, an early medieval rural parish churchyard (function period approximately AD 1050-1250), Tirup, also a country parish churchyard, but from the later medieval period (function period approximately AD 1150-1350), and finally a monastic churchyard, used as parish churchyard for the citizens of Aalborg, one of the larger cities of medieval Denmark (function period approximately AD 1240-1530). The intact skulls from these churchyards were X-rayed from each side, and the area of the so-called pneumatic cells in the occipital bone was measured. From earlier studies we have proved the relationship between cell size as seen on X-ray photographs and occurrence of IMED earlier in life. Also, this relationship has been expressed mathematically, so that the left and right side cell area size may denote the risk of the individual having had or not having had IMED in childhood. The results showed that there was a pronounced rise in the frequency of IMED from the early to later medieval period. This seems to reflect the well-known agrarian crisis between the early and later medieval period: probably mainly due to land overuse and climatic changes, the population levels fell, and, as observed at&nbsp;Tirup, childhood mortality rose. Also, at this point in time, plague hit Denmark, further stressing population health. Our results also showed that the highest frequency was found in Aalborg, which may be explained by increased pathogen load in a more densely populated urban centre

Does drinking water influence hospital-admitted sialolithiasis on an epidemiological level in Denmark?

OBJECTIVES: Sialolithiasis, or salivary stones, is not a rare disease of the major salivary glands. However, the aetiology and incidence remain largely unknown. Since sialoliths are comprised mainly of calcium phosphate salts, we hypothesise that drinking water calcium levels and other elements in drinking water could play a role in sialolithiasis. Owing to substantial intermunicipality differences in drinking water composition, Denmark constitutes a unique environment for testing such relations. DESIGN: An epidemiological study based on patient data extracted from the National Patient Registry and drinking water data from the Geological Survey of Denmark and Greenland retrieved as weighted data on all major drinking water constituents for each of the 3364 waterworks in Denmark. All patient cases with International Statistical Classification of Diseases 10th Revision (ICD-10) codes for sialolithiasis registered between the years 2000 and 2010 were included in the study (n=3014) and related to the drinking water composition on a municipality level (n=98). PRIMARY AND SECONDARY OUTCOME MEASURES: Multiple regression analysis using iterative search and testing among all demographic and drinking water variables with sialolithiasis incidence as the outcome in search of possible relations among the variables tested. RESULTS: The nationwide incidence of hospital-admitted sialolithiasis was 5.5 cases per 100 000 citizens per year in Denmark. Strong relations were found between the incidence of sialolithiasis and the drinking water concentration of calcium, magnesium and hydrogen carbonate, however, in separate models (p<0.001). Analyses also confirmed correlations between drinking water calcium and magnesium and their concentration in saliva whereas this was not the case for hydrogen carbonate. CONCLUSIONS: Differences in drinking water calcium and magnesium may play a role in the incidence of sialolithiasis. These findings are of interest because many countries have started large-scale desalination programmes of drinking water

Infected “Mycotic” Aneurysm of the Common Carotid Artery—A Differential Diagnosis to Tumor of the Neck

Introduction: Infected “mycotic” Aneurysm (IA) of the extracranial carotid artery is a rare condition that can be fatal if mistaken for other pathology. An 83-year-old man presented with a mass on the neck initially suspected malignant. Weeks later it grew rapidly and was found to be an IA, thus requiring acute surgery. Via this case report, we discuss diagnostics and approach when diagnosing masses in relation to vessels of the neck not readily explained.Case Report: After diagnostic imaging and clinical assessment an unknown primary tumor of the neck was suspected. Fine needle aspiration was inconclusive. The patient did not present with any signs of infection or neurological symptoms—only discomfort and pain. Approximately two weeks later, the mass grew and the patient became dysphagic, febrile, and confused. Computed tomography angiography revealed an IA of the right common carotid artery. The patient underwent acute surgery consisting of ligation of the internal and external carotid arteries and resection of the internal jugular vein. The pathogen found was E. coli, supposedly from the bladder after surgical intervention due to polyposis.Conclusion: IA is a very rare entity and can have many etiologies. Since it can be fatal, it is necessary to keep IA in mind when diagnosing masses in relation to vessels of the neck. As shown in this case of a E. coli-induced IA, patients can present with atypical symptoms, on diagnostic imaging it can be mistaken for other pathology, and pathogenesis can be unclear