Children in Greenland: disease patterns and contacts to the health care system.

Background: Previous studies of Greenlandic children's disease pattern and contacts to the health care system are sparse and have focused on the primary health care sector.

Objective: We aimed to identify the disease pattern and use of health care facilities of children aged 0-10 in two Greenlandic cohorts.

Methods And Design: In a retrospective, descriptive follow-up of the Ivaaq (The Greenland Child Cohort) and the CLEAR (climate changes, environmental contaminants and reproductive health) birth cohorts (total n=1,000), we reviewed medical records of children aged 6-10 in 2012 with residence in Nuuk or Ilulissat (n=332).

Erythema nodosum and the risk of tuberculosis in a high incidence setting.

Objective: This study estimates the erythema nodosum (EN) incidence in a tuberculosis (TB) endemic setting and evaluates the likelihood of a subsequent TB diagnosis among individuals with infection (MTI) with or without EN.

Design: We estimated EN incidence rates (IRs) in East Greenland in 2010-2011 and conducted a cohort study following all individuals who tested positive for MTI from 1 January 2010 until 31 December 2012. A personal identifier allowed individual follow-up in the mandatory TB register.

Cervical cancer screening in Greenland, 1997-2011: Screening coverage and trends in the incidence of high-grade cervical lesions.

Objective: In spite of the high incidence of cervical cancer in Greenland, no assessment has been made of the impact of organized cervical screening, introduced in 1998, in relation to occurrence of high-grade cervical lesions. The objectives of the present study were to estimate coverage of the screening program and to examine possible changes in cervical intraepithelial neoplasia (CIN3) incidence in Greenland during 1997-2011 according to calendar period and age.

Methods: Using nationwide registries, we calculated age-standardized incidence rates for all women born and living in Greenland.

Tracing Mycobacterium tuberculosis transmission by whole genome sequencing in a high incidence setting: a retrospective population-based study in East Greenland.

In East Greenland, a dramatic increase of tuberculosis (TB) incidence has been observed in recent years. Classical genotyping suggests a genetically similar Mycobacterium tuberculosis (Mtb) strain population as cause, however, precise transmission patterns are unclear. We performed whole genome sequencing (WGS) of Mtb isolates from 98% of culture-positive TB cases through 21 years (n = 182) which revealed four genomic clusters of the Euro-American lineage (mainly sub-lineage 4.

Nasopharyngeal bacterial carriage in young children in Greenland: a population at high risk of respiratory infections.

The incidence of childhood respiratory infections in Greenland is among the highest globally. We performed a population-based study of 352 Greenlandic children aged 0-6 years aiming to describe rates and risk factors for carriage of four key bacteria associated with respiratory infections, their antimicrobial susceptibility and inter-bacterial associations. Nasopharyngeal swabs were tested for Streptococcus pneumoniae grouped by serotypes included (VT) or not included (NVT) in the 13-valent pneumococcal conjugate vaccine, non-typable Haemophilus influenzae (NTHi), Staphylococcus aureus and Moraxella catarrhalis.

Liver biochemistry and associations with alcohol intake, hepatitis B virus infection and Inuit ethnicity: a population-based comparative epidemiological survey in Greenland and Denmark.

Background: Hepatitis B virus (HBV) infection is common in Arctic populations and high alcohol intake has been associated with an increased risk of a number of diseases. Yet, a description of the influence of alcohol intake in persons with HBV infection on liver biochemistry is lacking.

Objective: We aimed to describe the association between reported alcohol intake and liver biochemistry taking into account also HBV infection, ethnicity, Inuit diet, body mass index (BMI), gender and age in an Arctic population.

Vitamin D-rich marine Inuit diet and markers of inflammation - a population-based survey in Greenland.

The traditional Inuit diet in Greenland consists mainly of fish and marine mammals, rich in vitamin D. Vitamin D has anti-inflammatory capacity but markers of inflammation have been found to be high in Inuit living on a marine diet. Yet, the effect of vitamin D on inflammation in Inuit remains unsettled.

An efficient case finding strategy to diagnose osteoporosis in a developing society with low treatment frequency.

Objectives: Osteoporosis is a debilitating condition with rising frequency of fragility fractures with advancing age. Life expectancy increases in developing societies with the emergence of osteoporosis. There is a need for a simple protocol to diagnose fractures that merit treatment for osteoporosis.

Hepatitis B among Inuit: A review with focus on Greenland Inuit.

Hepatitis B virus (HBV) infection is a disease with a highly variable course. Chronic HBV infection may cause end-stage liver disease including cirrhosis and hepatocellular carcinoma, which is the 3(rd) most common cause of cancer related death due to the poor prognosis. The prevalence of HBV infection is low in many countries.

Incidence and survival from lung cancer in Greenland is comparable to survival in the Nordic countries.

Introduction: Oncological treatment of lung cancer has been available in Greenland since 2004. We evaluated patient characteristics and survival rates for the first six years of local lung cancer treatment.

Methods: From September 2004 to August 2010, a total of 173 patients with lung cancer were referred to treatment at Queen Ingrid's Hospital.

Lifesaving pericardiocentesis due to purulent pericarditis with growth of Gram-negative rods in an immune-competent Inuit male.

Polymicrobial Gram-negative pericarditis is a rare entity in the immune-competent patient, and purulent pericarditis due to bacteria complicated by tamponade is a life-threatening condition with high mortality rates. A prompt diagnosis and treatment is, as in this case, lifesaving and facilitated by echocardiography but is not the case in rural areas in common. Change in the infectious aetiology indicates broad-spectrum antibiotics.

Preparing for emergency: a valid, reliable assessment tool for emergency cricothyroidotomy skills.

Objective: Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance on such a model becomes relevant with regard to performance on a high-fidelity model (cadaver).

An integrable, web-based solution for easy assessment of video-recorded performances.

Assessment of clinical competencies by direct observation is problematic for two main reasons the identity of the examinee influences the assessment scores, and direct observation demands experts at the exact location and the exact time. Recording the performance can overcome these problems; however, managing video recordings and assessment sheets is troublesome and may lead to missing or incorrect data. Currently, no existing software solution can provide a local solution for the management of videos and assessments but this is necessary as assessment scores are confidential information, and access to this information should be restricted to select personnel.

"I only smoke when I have nothing to do": a qualitative study on how smoking is part of everyday life in a Greenlandic village.

Background: Smoking-related illnesses, such as chronic obstructive pulmonary disease, cardiovascular disease and lung cancer, are common in Greenland. Factors such as age, gender, cigarette use, restricted smoking at home and socio-economic determinants are well-known predictors for smoking and smoking cessation. In 2005, 66% of the adult population in were Greenland smokers, despite widespread smoking cessation campaigns.

The HIV epidemic in Greenland--a slow spreading infection among adult heterosexual Greenlanders.

Introduction: We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths.

Study Design: The study design used was population-based nationwide cohort study.

Methods: We included all patients diagnosed with HIV in Greenland before 2011.

Living conditions, quality of life, adherence and treatment outcome in Greenlandic HIV patients.

Objectives: Despite a high level of sexually transmitted infections, HIV incidence has remained quite stable in Greenland with 5-6 new cases per year (approximately 10 per 100,000). However, disease control is suboptimal and mortality is relatively high. The aim of the present study was to determine associations between adherence to treatment and treatment outcome, living conditions and quality of life among HIV patients in Greenland.

A homozygous nonsense mutation (c.214C->A) in the biliverdin reductase alpha gene (BLVRA) results in accumulation of biliverdin during episodes of cholestasis.

Background: Green jaundice is a rare finding usually associated with end-stage liver disease. OBJECTIVE The authors investigated two unrelated Inuit women from different geographical areas in Greenland who had episodes of green jaundice associated with biliary obstruction.

Methods And Results: The crises were accompanied by increased biochemical markers of cholestasis, together with absent or moderate hyperbilirubinaemia.

Endocarditis in Greenland with special reference to endocarditis caused by Streptococcus pneumoniae.

Objectives: The aim of this retrospective study was to determine the incidence and outcome of infectious endocarditis in Greenland with an emphasis on pneumococcal endocarditis.

Study Design: Retrospective, non-interventional study.

Methods: Review of files and medical history of all patients with infectious endocarditis from the Patient Registry in Greenland in the 11-year period 1995-2005.

Reorganization of perinatal care in Greenland.

Introduction: September 2000 the planning of a major reform of health services was launched aimed at improving perinatal care and decreasing perinatal mortality and morbidity. The activities became effective from January 2002.

Methods: A new organization plan was developed, a special medical record was designed for perinatal care and training programs for health workers in perinatal care were instituted, including basic ultrasound scan for gestational age.

Ethnic, geographic and dietary influences upon vasoactive hormones and blood pressure among Greenland Inuit and Danes.

Aim: To study levels of vasoactive hormones and urinary excretion of sodium and potassium between groups of Greenland Inuit and Danes, and to analyse the relationship between these hormones and 24-h blood pressure, including nightly blood pressure dips and pulse pressure.

Methods: 145 Greenlandic participants were categorized in three groups according to degree of westernization, based on dietary habits and current place of residence; 41 Danes were included as controls. Twenty-four-hour blood pressure was measured.