Primary Health Care Clinic

Nuuk, Greenland

Primary Health Care Clinic

Nuuk, Greenland

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Andersen S.,Queen Ingrids Hospital | Andersen S.,University of Aalborg | Kjaergaard M.,Queen Ingrids Hospital | Jorgensen M.E.,Queen Ingrids Hospital | And 2 more authors.
Atherosclerosis | Year: 2011

Background: Elevated blood pressure is a risk factor for cardiovascular disease and may be detected by left ventricular hypertrophy (LVH) in electrocardiogram (ECG). Pre-western Inuit had frequent signs of LVH in ECG predominantly in the 3rd decade while a low occurrence of ischemic heart disease. Methods: We evaluated the association between blood pressures and ECG signs of LVH, cardiac auscultation, and symptoms related to heart disease in the recently recovered data from the survey of 1851 Inuit conducted in 1962-1964 in East Greenland. Results: The participation rate was 97%. Among the 812 Inuit aged 18. years or above blood pressure was unaltered until the age of 39. years (systolic, p= 76; diastolic, p= 0.36) and increased subsequently (both, p< 0.001). Systolic blood pressure >140. mm. Hg was more frequent when aged >40. years (p< 0.001) and diastolic blood pressure >90. mm. Hg was more common in men (p< 0.001) and in men and women aged >40. years (p< 0.001). ECG signs of LVH were more frequent in men (p< 0.01) but the occurrence decreased from the age of 40. years (p< 0.01), and were not influenced by systolic (p= 0.97), diastolic (p= 0.87) or pulse pressure (p= 0.69). Conclusions: Blood pressure rose only after the age of 40. years in pre-western Inuit. Left ventricular hypertrophy peaked among 30-year olds and was independent of elevated blood pressure. It may be speculated that the common left ventricular hypertrophy was due to marked physical activity that contributed to the low occurrence of ischemic heart disease among pre-western Inuit. © 2011 Elsevier Ireland Ltd.


Rehabilitation after surgery repair of flexor tendon injuries of the hand remains challenging and requires experienced professionals and interdisciplinary approaches. The aim of this study was to evaluate rehabilitation results after surgery repair of flexor tendon injuries in the hand with the early passive mobilization--Kleinert protocol. In this retrospective case-series study rehabilitation results of flexor tendon injuries in the hand with the early passive mobilization--Kleinert protocol were evaluated in 35 patients, treated in the Orthopaedic Clinic University Clinical Centre of Kosovo between December 2007 and November 2008. Patients had unilateral injuries on right hand without associated injuries. Patients were divided in three groups: patient with injury of FPL (n = 15), patient with injury of FDP and FDS dig. I-V (n = 10) and patient with injury of FDP and FDS dig.II (n = 10). Patients were included in a rehabilitation program using the Kleinert-early passive mobilization protocol. Functional evaluation was made using the mean improvement on MCP, PIP and DIP joints motion, mean functional are of motion (FAM) and total active motion (TAM) scoring system of The American Society of Surgery of Hand. The functional outcomes were analyzed by Paired t-test, and One way Analysis of Variance, while the mean TAM score were compared using the Wilcoxon Matched-Pairs Signed-Ranks test with significance set at p < 0.05. About 67% of patients with FPL injuries achieved excellent range TAM score, and about 22% of patients with FDS&FDP injuries achieved excellent and 74% good range of total active motion. With earlier performed primary surgical tendon repair followed by Kleinert-early passive mobilization protocol may achieves satisfactory functional results for any flexor tendon injuries in zones I-IV of the hand.


Andersen S.,University of Aalborg | Andersen S.,Queen Ingrids Hospital | Fleischer Rex K.,University of Aalborg | Fleischer Rex K.,Queen Ingrids Hospital | And 4 more authors.
International Journal of Circumpolar Health | Year: 2013

Background. Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. Objective. This led us to reconsider the cut-off point for overweight among Inuit in Greenland. Design and findings. We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Conclusion. Defining overweight according to the WHO cut-off of a BMI above 25 kg/m2 in Greenland Inuit may overestimate the number of individuals with elevated BMI. © 2013 Stig Andersen et al.


Andersen S.,University of Aalborg | Andersen S.,Queen Ingrids Hospital | Rex K.F.,University of Aalborg | Rex K.F.,Queen Ingrids Hospital | And 6 more authors.
American Journal of Human Biology | Year: 2014

Objectives: Overweight and obesity associate with increased morbidity and premature death. Westernization of societies heralds rising obesity rates. A steep increase in body mass index (BMI) and overweight in Greenland from 1963 to 1998 led us to follow-up on height, weight, BMI, and rates of overweight among populations in Greenland and assess time trends between different stages of transition. Methods: BMI was calculated from height and weight measured on Inuit and non-Inuit aged 50 through 69 years surveyed in 1963, 1998, and 2008 in Ammassalik district in East Greenland and in 1998 and 2008 in the capital Nuuk in West Greenland. Results: A total of 1,186 were surveyed in 1963 (52 men/63 women), 1998 (309/226), and 2008 (297/239). BMI increased with time (P<0.001; 1963/1998/2008 23.3/24.3/26.2 kg/m2). In addition, BMI increased with urbanization in Inuit men (P=0.001; settlements/town/city, in 1998, 23.9/24.9/25.5 kg/m2; in 2008, 25.0/26.0/27.0 kg/m2) while not in Inuit women (P=0.18). The number of overweight Inuit (BMI >27 kg/m2) increased with time in men (4.0/25.6/33.2% in 1963/1998/2008, P=0.001) and in women (13.6/30.7/37.3%, P=0.001). BMI was above 30 kg/m2 in 2.0/10.8/17.5% of all Inuit men in 1963/1998/2008 (P=0.003) and in 8.3%/23.0/24.5% of all Inuit women (P=0.02) respectively. Conclusions: Overweight and obesity rates rise with time and with societal transition in Greenland. Settlements and town are catching up with the city where the rate of increase is diminishing, although there were gender differences. Am. J. Hum. Biol. 26:511-517, 2014. © 2014 Wiley Periodicals, Inc.


PubMed | Primary Health Care Clinic
Type: Journal Article | Journal: Medical archives (Sarajevo, Bosnia and Herzegovina) | Year: 2013

Rehabilitation after surgery repair of flexor tendon injuries of the hand remains challenging and requires experienced professionals and interdisciplinary approaches.The aim of this study was to evaluate rehabilitation results after surgery repair of flexor tendon injuries in the hand with the early passive mobilization--Kleinert protocol.In this retrospective case-series study rehabilitation results of flexor tendon injuries in the hand with the early passive mobilization--Kleinert protocol were evaluated in 35 patients, treated in the Orthopaedic Clinic University Clinical Centre of Kosovo between December 2007 and November 2008. Patients had unilateral injuries on right hand without associated injuries. Patients were divided in three groups: patient with injury of FPL (n = 15), patient with injury of FDP and FDS dig. I-V (n = 10) and patient with injury of FDP and FDS dig.II (n = 10). Patients were included in a rehabilitation program using the Kleinert-early passive mobilization protocol. Functional evaluation was made using the mean improvement on MCP, PIP and DIP joints motion, mean functional are of motion (FAM) and total active motion (TAM) scoring system of The American Society of Surgery of Hand. The functional outcomes were analyzed by Paired t-test, and One way Analysis of Variance, while the mean TAM score were compared using the Wilcoxon Matched-Pairs Signed-Ranks test with significance set at p < 0.05.About 67% of patients with FPL injuries achieved excellent range TAM score, and about 22% of patients with FDS&FDP injuries achieved excellent and 74% good range of total active motion.With earlier performed primary surgical tendon repair followed by Kleinert-early passive mobilization protocol may achieves satisfactory functional results for any flexor tendon injuries in zones I-IV of the hand.


McMahon B.J.,Alaska Native Tribal Health Consortium | McMahon B.J.,Centers for Disease Control and Prevention | Bruce M.G.,Centers for Disease Control and Prevention | Koch A.,Statens Serum Institute | And 8 more authors.
Epidemiology and Infection | Year: 2016

Helicobacter pylori infection is a major cause of peptic ulcer and is also associated with chronic gastritis, mucosa-associated lymphoid tissue (MALT) lymphoma, and adenocarcinoma of the stomach. Guidelines have been developed in the United States and Europe (areas with low prevalence) for the diagnosis and management of this infection, including the recommendation to 'test and treat' those with dyspepsia. A group of international experts performed a targeted literature review and formulated an expert opinion for evidenced-based benefits and harms for screening and treatment of H. pylori in high-prevalence countries. They concluded that in Arctic countries where H. pylori prevalence exceeds 60%, treatment of persons with H. pylori infection should be limited only to instances where there is strong evidence of direct benefit in reduction of morbidity and mortality, associated peptic ulcer disease and MALT lymphoma and that the test-and-treat strategy may not be beneficial for those with dyspepsia. Copyright © Cambridge University Press 2015 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited..


Hoyer B.B.,Aarhus University Hospital | Ramlau-Hansen C.H.,University of Aarhus | Vrijheid M.,Center for Research in Environmental Epidemiology | Vrijheid M.,University Pompeu Fabra | And 10 more authors.
Environmental Health Perspectives | Year: 2015

Background: In some animal studies, perfluorinated alkyl substances are suggested to induce weight gain. Human epidemiological studies investigating these associations are sparse. Objective: We examined pregnancy serum concentrations of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) and the prevalence of offspring overweight (> 1 SD) and waist-toheight ratio (WHtR) > 0.5 at 5–9 years of age. Methods: Sera from 1,022 pregnant women enrolled in the INUENDO cohort (2002–2004) from Greenland and Kharkiv (Ukraine) were analyzed for PFOA and PFOS using liquid chromatography– tandem mass spectrometry. Relative risks (RR) of being overweight and having WHtR > 0.5 in relation to continuous and categorized (tertiles) PFOA and PFOS were calculated at follow-up (2010–2012) using generalized linear models. Results: Pooled PFOA median (range) was 1.3 (0.2–5.1) and PFOS median (range) was 10.8 (0.8– 73.0) ng/mL. For each natural logarithm-unit (ln-unit) increase of pregnancy PFOA, the adjusted RR of offspring overweight was 1.11 [95% confidence interval (CI): 0.82, 1.53] in Greenlandic children. In Ukrainian children, the adjusted RR of offspring overweight was 1.02 (95% CI: 0.72, 1.44) for each ln-unit increase of pregnancy PFOA. Prenatal exposure to PFOS was not associated with overweight in country-specific or pooled analysis. The adjusted RR of having WHtR > 0.5 for each ln-unit increase of prenatal exposure to PFOA was 1.30 (95% CI: 0.97, 1.74) in the pooled analysis. For 1–ln-unit increase of prenatal exposure to PFOS, the adjusted RR of having a WHtR > 0.5 was 1.38 (95% CI: 1.05, 1.82) in the pooled analysis. Conclusions: The results indicate that prenatal PFOA and PFOS exposures may be associated with child waist-to-height ratio > 0.5. Prenatal PFOA and PFOS exposures were not associated with overweight. © 2015, Public Health Services, US Dept of Health and Human Services. All rights reserved.


PubMed | Centers for Disease Control and Prevention, Russian Academy of Medical Sciences, University of Alberta, Statens Serum Institute and 2 more.
Type: Journal Article | Journal: Epidemiology and infection | Year: 2015

Helicobacter pylori infection is a major cause of peptic ulcer and is also associated with chronic gastritis, mucosa-associated lymphoid tissue (MALT) lymphoma, and adenocarcinoma of the stomach. Guidelines have been developed in the United States and Europe (areas with low prevalence) for the diagnosis and management of this infection, including the recommendation to test and treat those with dyspepsia. A group of international experts performed a targeted literature review and formulated an expert opinion for evidenced-based benefits and harms for screening and treatment of H. pylori in high-prevalence countries. They concluded that in Arctic countries where H. pylori prevalence exceeds 60%, treatment of persons with H. pylori infection should be limited only to instances where there is strong evidence of direct benefit in reduction of morbidity and mortality, associated peptic ulcer disease and MALT lymphoma and that the test-and-treat strategy may not be beneficial for those with dyspepsia.


PubMed | University of Aarhus, Kharkiv National Medical University, Copenhagen University, National Institute of Public Health National Institute of Hygiene and 3 more.
Type: | Journal: BMC public health | Year: 2015

Prior studies on the association between prenatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE) and child motor development have found contradicting results. Using data collected in the INUENDO cohort in Kharkiv (Ukraine), Warsaw (Poland) and Greenland (N=1,103) between the years 2002 and 2012, we examined relations of prenatal exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p-DDE) and 2,2,4,4,5,5-hexachlorobiphenyl (CB-153) on motor development and developmental milestones; crawling, standing-up and walking.CB-153 and p,p-DDE were measured in maternal blood in second or third trimester of pregnancy. Motor development was measured in terms of the parentally assessed screening tool Developmental Coordination Disorder Questionnaire 2007 and developmental milestones were assessed via retrospective parental reports of child age at the first time of crawling, standing-up and walking.We saw no associations between tertiles of CB-153 and p,p-DDE or log-transformed exposures and retrospective reports of the developmental milestones crawling, standing-up and walking in infancy or the motor skills measured as developmental coordination disorder at young school age.In utero exposure to CB-153 and p,p-DDE was not associated with parentally retrospectively assessed developmental milestones in infancy or parentally assessed motor skills at young school age. The use of a more sensitive outcome measure may be warranted if subtle effects should be identified.


PubMed | Primary Health Care Clinic
Type: Journal Article | Journal: Home healthcare nurse | Year: 2012

Parents of children with chronic illnesses experience tremendous burden when caring for their children at home. There are many challenges that are present throughout the course of chronic illnesses. To provide better care to the family caring for an ill child at home, clinicians must understand the experiences family members go through on a daily basis. The purpose of this article is to help clinicians better understand these parental experiences; by increasing clinicians awareness, strategies can then be used, which will improve the outcome for the child, parents, and siblings.

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