Disability pension in Norway

In this paper we study the system of disability pension in Norway. We present an overview of its recipients, and how cost cutting and policy changes effect these and new applicants. While there is an improvement of people's health in Norway, the number of people granted this disability pension has inexorably increased each year. Our source of data is a registry of the entire Norwegian population, including information on disability pension (“FD trygd”). We focus on those granted and denied this pension in 1993 and 1997, presenting their differences and similarities. Compared to the general Norwegian population aged 18 to 66 in 2004, the recipients of disability pension are more likely to be women, have an income below the median, and be more than 55 years old. 30 % have a mental illness and 15 % have a musculoskeletal disorder. However, over the last years the mean age for new recipients has been decreasing, and there has been an increase in percentage granted disability pension on the grounds of mild mental illness, whereas the self-reported psychiatric health in the population has become better. For both years, 1993 and 1997, we find an odds ratio of about 1.5 of being denied disability pension if your income is below the median. While the diagnosis is of importance, this seems to be a result of recent policy changes and trends only, as one was more likely to be denied disability pension with a musculoskeletal disorder in 1993, and more likely to be granted it in 1997 with the same diagnosis

Autoimmune Thyroid Disorders in Autoimmune Addison Disease

Context: Autoimmune thyroid disease is the most common endocrine co-morbidity in autoimmune Addison's disease (AAD), but detailed investigations of prevalence and clinical course is lacking. Objective: Provide comprehensive epidemiological and clinical data on autoimmune thyroid disorders in AAD. Design and patients: A nationwide registry-based study including 442 patients with AAD and autoimmune thyroid disease, identified through the Norwegian National Registry of Autoimmune Diseases. Results: Of 912 registered AAD patients, 442 (48%) were diagnosed with autoimmune thyroid disease. Three hundred and eighty (42%) had autoimmune hypothyroidism. Of the 302 with available thyroid function tests at time for diagnosis, 20% had overt hypothyroidism, 73% had subclinical hypothyroidism and 7% had thyroid levels in the normal range. Negative thyroid peroxidase antibodies was found in 32%. Ninety-eight percent were treated with levothyroxine, 5% with combination therapy with liothyronine or thyroid extracts, and 1% were observed without treatment. Seventy-eight patients (9%) were diagnosed with Graves' disease (GD), of whom 16 (21%) were diagnosed with autoimmune hypothyroidism either before onset or after remission of GD. At the end of follow-up 33% had normal thyroid hormone levels without antithyroid-drugs or levothyroxine treatment. The remaining had either active disease (5%), had undergone ablative treatment (41%), or had developed autoimmune hypothyroidism (21%). Conclusion: The true prevalence of hypothyroidism in AAD is lower than reported in current literature. Careful consideration of the indication to start thyroxin therapy is warranted. Long-term remission rates in GD patients with AAD are comparable to recent reports on long-term follow-up of patients without AAD.publishedVersio

Domestic endotoxin exposure and clinical severity of asthma

Endotoxins are potent pro-inflammatory substances present in several natural environments and in commercial house dust extracts. To investigate the possible effect of chronic endotoxin exposure on asthma, 28 patients with perennial chronic asthma (20 allergic to house dust mite and eight intrinsic asthmatics) were evaluated during a 4-month period (lung function, clinical and immunological criteria). At the same time, two house dust samples were collected from each patient's home to determine total house dust weight (mg/m2), endotoxin concentration and house dust mite antigen content (evaluated indirectly by guanine content with HPLC method). The mean (± s. d.) endotoxin concentration, as measured by quantitative Limulus assay was 2.59 (± 3.41) ng/mg house dust, ranging from 0.12 to 20 ng/mg. The mean guanine content was 0.13 (± 0.16) mg/100 mg house dust. There was no correlation between endotoxin and house dust mite concentrations. Patients were compared according to the low or high grade exposure to dust, endotoxins and guanine. Compared with patients with low grade (≤ 5.6 ng/ml) exposure, subjects exposed to high endotoxin concentrations (> 5.6 ng/ml) showed a significant increase in dyspnea (median 2.6 vs 3.3; P<0.05) and treatment (median 14 vs 44.3; P<0.01) scores, oral corticosteroid (median 0.0 vs 13.5 mg/24 hr; P<0.01) and β2-mimetics (median four vs eight puffs/day; P<0.01) intake, and a significant decrease in FEV1/FVC (median 84.5 vs 67% of predicted value; P<0.01). In contrast, no differences were found between the two groups exposed to low (< 0.07 mg/100 mg house dust) and high (≥ 0.07 mg/100 mg house dust) concentrations of guanine, respectively. We conclude that endotoxins are present in normal domestic environment and could have a deleterious effect on the chronic asthmatic disease.SCOPUS: cp.jFLWNAinfo:eu-repo/semantics/publishe

Autoimmune Thyroid Disorders in Autoimmune Addison Disease

Context: Autoimmune thyroid disease is the most common endocrine co-morbidity in autoimmune Addison's disease (AAD), but detailed investigations of prevalence and clinical course is lacking. Objective: Provide comprehensive epidemiological and clinical data on autoimmune thyroid disorders in AAD. Design and patients: A nationwide registry-based study including 442 patients with AAD and autoimmune thyroid disease, identified through the Norwegian National Registry of Autoimmune Diseases. Results: Of 912 registered AAD patients, 442 (48%) were diagnosed with autoimmune thyroid disease. Three hundred and eighty (42%) had autoimmune hypothyroidism. Of the 302 with available thyroid function tests at time for diagnosis, 20% had overt hypothyroidism, 73% had subclinical hypothyroidism and 7% had thyroid levels in the normal range. Negative thyroid peroxidase antibodies was found in 32%. Ninety-eight percent were treated with levothyroxine, 5% with combination therapy with liothyronine or thyroid extracts, and 1% were observed without treatment. Seventy-eight patients (9%) were diagnosed with Graves' disease (GD), of whom 16 (21%) were diagnosed with autoimmune hypothyroidism either before onset or after remission of GD. At the end of follow-up 33% had normal thyroid hormone levels without antithyroid-drugs or levothyroxine treatment. The remaining had either active disease (5%), had undergone ablative treatment (41%), or had developed autoimmune hypothyroidism (21%). Conclusion: The true prevalence of hypothyroidism in AAD is lower than reported in current literature. Careful consideration of the indication to start thyroxin therapy is warranted. Long-term remission rates in GD patients with AAD are comparable to recent reports on long-term follow-up of patients without AAD