Non-specific Health complaints and self-rated health in pre-adolescents:impact on primary health care use

Abstract The objective of the present study was to explore past and future primary health care use in preadolescents reporting frequent non-specific health complaints or a low self-rated health compared to that of preadolescents with no frequent health complaints or with good self-rated health. The study was conducted as a cohort study based within the Danish National Birth Cohort (1996–2002). Information on non-specific health complaints and self-rated health was obtained by an 11-year follow-up questionnaire. Information about number of general practitioner (GP) contacts was obtained from the Health Insurance Service Register. A total of 44,877 pre-adolescents gave complete exposure information. Pre-adolescents who reported frequent non-specific health complaints had a higher use of GP compared to pre-adolescents without complaints across the five years following the index date (somatic complaints: IRR = (1.46 [1.38; 1.55], mental complaints: IRR = 1.16 [1.12; 1.19], both complaints: IRR = 1.58 [1.47; 1.69]). The same pattern was found for the association between low self-rated health and number of GP contacts (IRR = 1.41 (1.36; 1.46)). Non-specific health complaints and a poor self-rated health in pre-adolescents was associated with a higher past and future use of GP, indicating a need for development of early interventions with help for symptom management

Dietary glycemic index during pregnancy is associated with biomarkers of the metabolic syndrome in offspring at age 20 years.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Growing evidence indicates that metabolic syndrome is rooted in fetal life with a potential key role of nutrition during pregnancy. The objective of the study was to assess the possible associations between the dietary glycemic index (GI) and glycemic load (GL) during pregnancy and biomarkers of the metabolic syndrome in young adult offspring.Dietary GI and GL were assessed by questionnaires and interviews in gestation week 30 and offspring were clinically examined at the age of 20 years. Analyses based on 428 mother-offspring dyads were adjusted for maternal smoking during pregnancy, height, pre-pregnancy body mass index (BMI), education, energy intake, and the offspring's ambient level of physical activity. In addition, possible confounding by gestational diabetes mellitus was taken into account.Waist circumference, blood pressure, HOMA insulin resistance (HOMA-IR) and plasma levels of fasting glucose, triglycerides, HDL cholesterol, LDL cholesterol, total cholesterol, insulin, and leptin were measured in the offspring.Significant associations were found between dietary GI in pregnancy and HOMA-IR (the relative increase in HOMA-IR per 10 units' GI increase was 1.09 [95% CI: 1.01, 1.16], p = 0.02), insulin (1.09 [95% CI: 1.02, 1.16], p = 0.01) and leptin (1.21 [95% CI: 1.06, 1.38], p = 0.01) in the offspring; whereas no associations were detected for GL.Our data suggests that high dietary GI in pregnancy may affect levels of markers for the metabolic syndrome in young adult offspring in a potentially harmful direction.Danish Council for Strategic Research/ 09-067124 09-063072 2101-06-000

Temporal and regional differences in the incidence of hospital-diagnosed endometriosis:a Danish population-based study

INTRODUCTION: Due to diagnostic challenges, normalization of symptoms and an overall lack of awareness among both patients and physicians, endometriosis is an underdiagnosed disease. This can result in delayed treatment and potentially worsening of the disease. Despite initiatives, such as patients' support organizations and specialized endometriosis referral centers, differences in awareness, socioeconomic factors and lifestyle, combined with varying distances to specialized referral centers, could result in regional differences in the degree of underdiagnosing. This study aims to explore temporal and regional variations in the incidence of endometriosis based on the Danish hospital discharge register, and shed light on the degree of underdiagnosing of endometriosis in Denmark. MATERIAL AND METHODS: This registry‐based cohort study included all women aged 15–55 living in Denmark from 1990–2017. Participants were identified through the Danish Civil Registration system and endometriosis diagnoses received at a hospital were obtained from the Danish National Patient Registry. Incidence rates of diagnosed endometriosis were calculated for each year of the study period and for each municipality in Denmark. A Cox regression analysis, stratified by calendar time and adjusted for ethnic origin, household composition, highest educational level and family socioeconomic status, was performed to estimate the association between residence and likelihood of receiving a hospital‐based diagnosis of endometriosis. RESULTS: The nationwide incidence rate of hospital‐diagnosed endometriosis was 7.89 (95% confidence interval [CI] 7.80–7.99) per 10 000 person‐years and the prevalence in 2017 was 1.63%. The results showed an overall increase in the incidence of diagnosed endometriosis of 46.8% (95% CI 32.9–62.2) during the study period and also displayed significant regional differences. After adjustments, women living in northern Jutland had the highest probability of receiving a hospital‐based diagnosis of endometriosis (hazard ratio 1.13, 95% CI 1.09–1.18), whereas women living in northern Zealand had the lowest probability (hazard ratio 0.63, 95% CI 0.60–0.67) compared with eastern Jutland. These regional differences have become more evident over time. CONCLUSIONS: Our results reveal significant regional differences in the incidence of hospital‐diagnosed endometriosis, suggesting that a significant number of women may be left behind without a diagnosis. Further studies are needed to assess the underlying reasons for the significant regional differences

No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageThe intake of marine n-3 PUFA has been shown to decrease the risk of CVD in a number of studies. Since the development of CVD is often a lifelong process, marine n-3 PUFA intake early in life may also affect the development of later CVD. The aim of the present study was to investigate the association between maternal intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring. The study was based on the follow-up of the offspring of a Danish pregnancy cohort who participated in a study conducted from 1988 to 1989. A total of 965 pregnant women were originally included in the cohort and detailed information about the intake of marine n-3 PUFA during the second trimester was collected. In 2008-9, the offspring were invited to participate in a clinical examination including anthropometric, blood pressure (BP) and short-term heart rate variability measurements. Also, a fasting venous blood sample was drawn from them. Multiple linear regression modelling, using the lowest quintile of marine n-3 PUFA intake as the reference, was used to estimate the association with all outcomes. A total of 443 offspring participated in the clinical examination. No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and offspring adiposity, glucose metabolism, BP or lipid profile was found. In conclusion, no association between the intake of marine n-3 PUFA during the second trimester of pregnancy and the factors associated with cardiometabolic risk in the 20-year-old offspring could be detected.Danish Council for Strategic Research 09-067124 2101-07-0025 2101-06-000

Prenatal Exposure to Perfluorooctanoate and Risk of Overweight at 20 Years of Age: A Prospective Cohort Study

Background: Perfluoroalkyl acids are persistent compounds used in various industrial -applications. Of these compounds, perfluorooctanoate (PFOA) is currently detected in humans worldwide. A recent study on low-dose developmental exposure to PFOA in mice reported increased weight and elevated biomarkers of adiposity in postpubertal female offspring

Ændrede stuegangsrutiner på de akutte sengeafsnit på Aalborg Universitetshospital har medført hurtigere afvikling af stuegangen og reduceret crowding trods samme antal læger - Et organisatorisk studie

Titel: Ændrede stuegangsrutiner på de akutte sengeafsnit på Aalborg Universitetshospital har medført hurtigere afvikling af stuegangen og reduceret crowding trods samme antal læger - Et organisatorisk studie Baggrund: Det stigende antal akutte patienter i Danmark har medført vanskeligheder med at få afviklet stuegang i Akutafdelingerne. På Kolding Sygehus har man med succes ændret stuegangsorganiseringen, så stuegangen afvikles hurtigere og lægerne derefter kan hjælpe med modtagelse af nye patienter.   Formål: at undersøge, om erfaringerne fra Kolding kan overføres til andre akutmodtagelser.   Metode: I to uger blev næsten alle læger i Akutafdelingen sat til at gå stuegang. Efterhånden som nye patienter ankom i Modtagelsen op ad dagen, blev lægerne kaldt fra stuegang ned til Modtagelsen en ad gangen. Der blev sendt spørgeskemaer ud til alle sygeplejersker i de to akutmedicinske sengeafsnit og alle læger mhp. at måle effekten.  Resultat: Ud af 51 besvarelser svarede 84 % ”Ja” (43, heraf 25 læger) til at arbejdsgangene fra projektugerne skulle indføres permanent. Andelen af dage, hvor sengeafsnittene var afviklet før kl. 13, steg fra 48% til 79 % (p=0.03). Andelen af læger, der ”ofte” eller ”altid” kunne nå stuegang inden lægekonference øgedes fra 14% til 82 % selvom konferencen blev rykket fra kl. 12 til kl. 11 (p< 0.001). Andelen af læger, der efter stuegang kunne hjælpe med i Modtagelsen med nye patienter øgedes fra 38 % til 77 % (p<0.001). Af koordinerende læger i Modtagelsen vurderede 64 % at varigheden af crowding blev nedsat.   Konklusion: Selvom projektugerne medførte en stor organisatorisk forandring, viste det sig at være en fordel for både læger og sygeplejersker. Forbedring sås både ved hurtig afvikling af stuegang og flere læger i Modtagelsen i crowding perioder. Metoden har potentiale og kan med fordel afprøves i andre Akutafdelinger med tilsvarende organisation.

Fish Oil Supplementation During Late Pregnancy Does Not Influence Plasma Lipids or Lipoprotein Levels in Young Adult Offspring

Nutritional influences on cardiovascular disease operate throughout life. Studies in both experimental animals and humans have suggested that changes in the peri- and early post-natal nutrition can affect the development of the various components of the metabolic syndrome in adult life. This has lead to the hypothesis that n-3 fatty acid supplementation in pregnancy may have a beneficial effect on lipid profile in the offspring. The aim of the present study was to investigate the effect of supplementation with n-3 fatty acids during the third trimester of pregnancy on lipids and lipoproteins in the 19-year-old offspring. The study was based on the follow-up of a randomized controlled trial from 1990 where 533 pregnant women were randomized to fish oil (n = 266), olive oil (n = 136) or no oil (n = 131). In 2009, the offspring were invited to a physical examination including blood sampling. A total of 243 of the offspring participated. Lipid values did not differ between the fish oil and olive oil groups. The relative adjusted difference (95% confidence intervals) in lipid concentrations was −3% (−11; 7) for LDL cholesterol, 3% (−3; 10) for HDL cholesterol, −1% (−6; 5) for total cholesterol,−4% (−16; 10) for TAG concentrations, 2%(−2; 7) for apolipoprotein A1, −1% (−9; 7) for apolipoprotein B and 3% (−7; 15) in relative abundance of small dense LDL. In conclusion, there was no effect of fish oil supplementation during the third trimester of pregnancy on offspring plasma lipids and lipoproteins in adolescence