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Svendsen JR, Pedersen ML, Hauerberg J, Gredal O. Subarachnoid haemorrhage and intracranial aneurysms in Greenland in the period 2018-2021: incidence, outcome and familial disposition. Int J Circumpolar Health 2024; 83:2356889. [PMID: 38788126 PMCID: PMC11134107 DOI: 10.1080/22423982.2024.2356889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Subarachnoid haemorrhages (SAH) caused by rupture of intracranial aneurysms (IA) are a severe condition. Earlier studies found a higher incidence of SAH in Greenlandic patients compared to Danish patients, with familial aggregation also higher in Greenland. However, updated data is lacking. To investigate the contemporary incidence, outcome, and familial disposition of SAH/IA in Greenlandic patients in 2018-2021. Greenlandic patients diagnosed with ruptured or unruptured IA (UIA) during 2018-2021 were included. Data was obtained from patient files, x-ray department, and discharge registry. Incidence rates were estimated as cases/100,000/year. Direct age-standardised incidence rates were calculated using WHO 2000-2025 as standards. Of 30 SAH patients, 20 (66.7%) were females, 10 (33.3%) males. Of 36 UIA patients, 27 (75.0%) were females, 9 (25.0%) males. For SAH, crude incidence was 13.4/100,000/year, age-standardised incidence was 10.8/100,000/year. Familial history was observed in 30.0% of SAH patients. 5 patients (16.7%) died before treatment, 28-day case-fatality rate (CFR) for all patients was 23.3%. Overall and age-standardised incidence rates were similar to previous studies but higher among females and compared to neighbouring countries. A high occurrence of familial history was reported. SAH remains a serious condition in Greenland, as evidenced by five fatalities before treatment was administered.
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Affiliation(s)
| | - Michael Lynge Pedersen
- Greenland Center for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland; Steno Diabetes Center Greenland, Nuuk, Greenland, Nuuk, Greenland
| | - John Hauerberg
- Department of neurosurgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Ole Gredal
- Medical Department, Queen Ingrid’s Hospital, Nuuk, Greenland
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Albertsen N, Hansen AS, Skovgaard N, Riahi S, Lynge Pedersen M, Andersen S. Ischemic Strokes Are Common Among Young Greenlanders: A Cross-Sectional Study. Stroke 2023; 54:e438-e439. [PMID: 37548007 DOI: 10.1161/strokeaha.123.042989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Affiliation(s)
- Nadja Albertsen
- Department of Geriatric Medicine, Aalborg University Hospital, Denmark (N.A., A.-S.H., S.A.)
- Department of Clinical Medicine, University of Aalborg, Denmark (N.A., S.R., S.A.)
- Greenland's Center for Health Research, University of Greenland (N.A., N.S., M.L.P., S.A.)
| | - Anne-Sofie Hansen
- Department of Geriatric Medicine, Aalborg University Hospital, Denmark (N.A., A.-S.H., S.A.)
| | - Nils Skovgaard
- Greenland's Center for Health Research, University of Greenland (N.A., N.S., M.L.P., S.A.)
| | - Sam Riahi
- Department of Clinical Medicine, University of Aalborg, Denmark (N.A., S.R., S.A.)
- Department of Cardiology, Aalborg University Hospital, Denmark (S.R.)
| | - Michael Lynge Pedersen
- Greenland's Center for Health Research, University of Greenland (N.A., N.S., M.L.P., S.A.)
- Steno Diabetes Center, Nuuk, Greenland (M.L.P.)
| | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital, Denmark (N.A., A.-S.H., S.A.)
- Department of Clinical Medicine, University of Aalborg, Denmark (N.A., S.R., S.A.)
- Greenland's Center for Health Research, University of Greenland (N.A., N.S., M.L.P., S.A.)
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Albertsen N, Hansen AS, Skovgaard N, Pedersen ML, Andersen S, Riahi S. Is the Pattern Changing? Atrial Fibrillation and Screening with Holter Electrocardiograms among Ischemic Stroke Patients in Greenland from 2016 to 2021. J Clin Med 2023; 12:5378. [PMID: 37629419 PMCID: PMC10455734 DOI: 10.3390/jcm12165378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
A standardized examination regime for ischemic stroke (IS) patients was implemented in Greenland in 2010. Prevalence of atrial fibrillation (AF) of 32% was found among discharged IS patients from 2011 to 2012, and our study aims to estimate the use of Holter ECGs for AF diagnostics and the current prevalence of AF among IS patients in Greenland. Patients discharged from Queen Ingrid's Hospital in Nuuk between 2016 and 2021 with an ICD-10 diagnosis of IS or stroke without specification were included. Data on Holter recordings, age, gender, medical treatment with rivaroxaban or warfarin, and ICD-10 and ICPC codes for AF were extracted for each patient. The overall incidence of IS from 2016 to 2021 was 133/100,000 and unchanged since 2012. Sixty-eight of the study's IS patients (14.5%) had AF, and 46% of IS patients with Holter data accessible had a recording according to international recommendations. Our results indicate that fewer IS patients in Greenland have AF than previously. However, the insufficient use of Holter as a diagnostic tool may explain part of the drop, as well as improved preventive treatment with rivaroxaban among AF patients in Greenland. Regardless, IS remains common, and a focus on diagnostics and preventable risk factors should be maintained.
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Affiliation(s)
- Nadja Albertsen
- Department of Geriatric Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.S.H.); (S.A.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark;
- Center for Health Research, Ilisimatursarfik (University of Greenland), 3900 Nuuk, Greenland (M.L.P.)
| | - Anne Sofie Hansen
- Department of Geriatric Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.S.H.); (S.A.)
| | - Nils Skovgaard
- Center for Health Research, Ilisimatursarfik (University of Greenland), 3900 Nuuk, Greenland (M.L.P.)
| | - Michael Lynge Pedersen
- Center for Health Research, Ilisimatursarfik (University of Greenland), 3900 Nuuk, Greenland (M.L.P.)
- Steno Diabetes Center Nuuk, 3900 Nuuk, Greenland
| | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark; (A.S.H.); (S.A.)
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark;
- Center for Health Research, Ilisimatursarfik (University of Greenland), 3900 Nuuk, Greenland (M.L.P.)
| | - Sam Riahi
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark;
- Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark
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Bjerregaard P, Larsen CVL, Olesen I, Ottendahl CB, Backer V, Senftleber N, Christensen MMB, Larsen TJ, Byberg S, Hansen T, Jørgensen ME. The Greenland population health survey 2018 - methods of a prospective study of risk factors for lifestyle related diseases and social determinants of health amongst Inuit. Int J Circumpolar Health 2022; 81:2090067. [PMID: 35711125 PMCID: PMC9225753 DOI: 10.1080/22423982.2022.2090067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Since 1993, regular population health surveys in Greenland have supported and monitored the public health strategy of Greenland and have monitored cardiometabolic and lung diseases. The most recent of these surveys included 2539 persons aged 15+ from 20 communities spread over the whole country. The survey instruments included personal interviews, self-administered questionnaires, blood sampling, anthropometric measurements, blood pressure, ECG, oral glucose test, pulmonary function, hand grip strength and chair stand test. Blood samples were analysed for glucose, glycated haemoglobin (HbA1c), insulin, incretin hormones, cholesterol, kidney function, fatty acids in erythrocyte membranes and mercury, urine for albumin-creatinine ratio, and aliquots were stored at -80°C for future use. Data were furthermore collected for studies of the gut microbiome and diabetes complications. Survey participants were followed up with register data. The potential of the study is to contribute to the continued monitoring of risk factors and health conditions as part of Greenland's public health strategy and to study the epidemiology of cardiometabolic diseases and other chronic diseases and behavioural risk factors. The next population health survey is planned for 2024. The emphasis of the article is on the methods of the study and results will be presented in other publications.
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Affiliation(s)
- Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark.,Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | - Ingelise Olesen
- Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | | | - Vibeke Backer
- Department of otorhinolaryngology Head & Neck surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Ninna Senftleber
- Steno Diabetes Center Greenland, Nuuk, Greenland.,Steno Diabetes Center Copenhagen, Denmark
| | | | - Trine Jul Larsen
- Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | | | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marit Eika Jørgensen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark.,Institute of Health and Nature, University of Greenland, Nuuk, Greenland.,Steno Diabetes Center Greenland, Nuuk, Greenland.,Steno Diabetes Center Copenhagen, Denmark
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Zhu Y, Li C, Jin H, Sun L. Classifying Motion Intention of Step Length and Synchronous Walking Speed by Functional Near-Infrared Spectroscopy. CYBORG AND BIONIC SYSTEMS 2021; 2021:9821787. [DOI: 10.34133/2021/9821787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/25/2021] [Indexed: 11/06/2022] Open
Abstract
In some patients who have suffered an amputation or spinal cord injury, walking ability may be degraded or deteriorated. Helping these patients walk independently on their own initiative is of great significance. This paper proposes a method to identify subjects’ motion intention under different levels of step length and synchronous walking speed by using functional near-infrared spectroscopy technology. Thirty-one healthy subjects were recruited to walk under six given sets of gait parameters (small step with low/midspeed, midstep with low/mid/high speed, and large step with midspeed). The channels were subdivided into more regions. More frequency bands (6 subbands on average in the range of 0-0.18 Hz) were decomposed by applying the wavelet packet method. Further, a genetic algorithm and a library for support vector machine algorithm were applied for selecting typical feature vectors, which were represented by important regions with partial important channels mentioned above. The walking speed recognition rate was 71.21% in different step length states, and the step length recognition rate was 71.21% in different walking speed states. This study explores the method of identifying motion intention in two-dimensional multivariate states. It lays the foundation for controlling walking-assistance equipment adaptively based on cerebral hemoglobin information.
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Affiliation(s)
- Yufei Zhu
- Key Laboratory of Robotics and System of Jiangsu Province, School of Mechanical and Electric Engineering, Soochow University, China
| | - Chunguang Li
- Key Laboratory of Robotics and System of Jiangsu Province, School of Mechanical and Electric Engineering, Soochow University, China
| | - Hedian Jin
- Key Laboratory of Robotics and System of Jiangsu Province, School of Mechanical and Electric Engineering, Soochow University, China
| | - Lining Sun
- Key Laboratory of Robotics and System of Jiangsu Province, School of Mechanical and Electric Engineering, Soochow University, China
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Andersen MK, Hansen T. Genetics of metabolic traits in Greenlanders: lessons from an isolated population. J Intern Med 2018; 284:464-477. [PMID: 30101502 DOI: 10.1111/joim.12814] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this review, we describe the extraordinary population of Greenland, which differs from large outbred populations of Europe and Asia, both in terms of population history and living conditions. Many years in isolation, small population size and an extreme environment have shaped the genetic composition of the Greenlandic population. The unique genetic background combined with the transition from a traditional Inuit lifestyle and diet, to a more Westernized lifestyle, has led to an increase in the prevalence of metabolic conditions like obesity, where the prevalence from 1993 to 2010 has increased from 16.4% to 19.4% among men, and from 13.0% to 25.4% among women, type 2 diabetes and cardiovascular diseases. The genetic susceptibility to metabolic conditions has been explored in Greenlanders, as well as other isolated populations, taking advantage of population-genetic properties of these populations. During the last 10 years, these studies have provided examples of loci showing evidence of positive selection, due to adaption to Arctic climate and Inuit diet, including TBC1D4 and FADS/CPT1A, and have facilitated the discovery of several loci associated with metabolic phenotypes. Most recently, the c.2433-1G>A loss-of-function variant in ADCY3 associated with obesity and type 2 diabetes was described. This locus has provided novel biological insights, as it has been shown that reduced ADCY3 function causes obesity through disrupted function in primary cilia. Future studies of isolated populations will likely provide further genetic as well as biological insights.
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Affiliation(s)
- M K Andersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rønn PF, Lucas M, Laouan Sidi EA, Tvermosegaard M, Andersen GS, Lauritzen T, Toft U, Carstensen B, Christensen DL, Jørgensen ME. The obesity-associated risk of cardiovascular disease and all-cause mortality is not lower in Inuit compared to Europeans: A cohort study of Greenlandic Inuit, Nunavik Inuit and Danes. Atherosclerosis 2017; 265:207-214. [DOI: 10.1016/j.atherosclerosis.2017.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/14/2017] [Accepted: 08/17/2017] [Indexed: 01/28/2023]
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Pourghasem A, Takamjani IE, Karimi MT, Kamali M, Jannesari M, Salafian I. The effect of a powered ankle foot orthosis on walking in a stroke subject: a case study. J Phys Ther Sci 2016; 28:3236-3240. [PMID: 27942156 PMCID: PMC5140836 DOI: 10.1589/jpts.28.3236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 07/19/2016] [Indexed: 01/22/2023] Open
Abstract
[Purpose] Standing and walking are impaired in stroke patients. Therefore, assisted
devices are required to restore their walking abilities. The ankle foot orthosis with an
external powered source is a new type of orthosis. The aim of this study was to evaluate
the performance of a powered ankle foot orthosis compared with unpowered orthoses in a
stroke patient. [Subjects and Methods] A single stroke subject participated in this study.
The subject was fitted with three types of ankle foot orthosis (powered, posterior leg
spring, and carbon ankle foot orthoses). He was asked to walk with and without the three
types of orthoses, and kinetic and kinematic parameters were measured. [Results] The
results of the study showed that the moments applied on the ankle, knee, and hip joints
increased while walking with the powered ankle foot orthosis. [Conclusion] As the powered
ankle foot orthosis influences the moments of the ankle, knee, and hip joints, it can
increase the standing and walking abilities of stroke patients more than other available
orthoses. Therefore, it is recommended to be used in rehabilitation programs for stroke
patients.
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Affiliation(s)
- Ali Pourghasem
- Department of Orthotics and Prosthetics, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, School of Rehabilitation Sciences, Iran
| | | | - Mohammad Taghi Karimi
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Iran
| | - Mohammad Kamali
- Rehabilitation Research Center, Iran University of Medical Sciences, Iran
| | - Mohammad Jannesari
- Department of Mechanical Engineering, Isfahan University of Technology, Iran
| | - Iman Salafian
- Department of Mechanical and Material Engineering, University of Nebraska-Lincoln, USA
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Tvermosegaard M, Dahl-Petersen IK, Nielsen NO, Bjerregaard P, Jørgensen ME. Cardiovascular Disease Susceptibility and Resistance in Circumpolar Inuit Populations. Can J Cardiol 2015; 31:1116-23. [PMID: 26239003 DOI: 10.1016/j.cjca.2015.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/05/2015] [Accepted: 06/05/2015] [Indexed: 11/26/2022] Open
Abstract
Cardiovascular disease (CVD) is a major public health issue in indigenous populations in the Arctic. These diseases have emerged concomitantly with profound social changes over the past 60 years. The aim of this study was to summarize the literature on CVD risk among Arctic Inuit. Literature on prevalence, incidence, and time trends for CVD and its risk factors in Arctic Inuit populations was reviewed. Most evidence supports a similar incidence of coronary heart disease and a higher incidence of cerebrovascular disease among Arctic Inuit than seen in western populations. Factors that may increase CVD risk include aging of the population, genetic susceptibility, and a rapid increase in obesity, diabetes, and hypertension in parallel with decreasing physical activity and deterioration of the lipid profile. In contrast, and of great importance, there has been a decrease in smoking and alcohol intake (at least documented in Greenland), and contaminant levels are declining. Although there have been marked socioeconomic and dietary changes, it remains unsolved and to some extent controversial how this may have influenced cardiovascular risk among Arctic Inuit. The increase in life expectancy, in combination with improved prognosis for patients with manifest CVD, will inevitably lead to a large increase in absolute numbers of individuals affected by CVD in Arctic Inuit populations, exacerbated by the rise in most CVD risk factors over the past decades. For preventive purposes and for health care planning, it is crucial to carefully monitor disease incidence and trends in risk factors in these vulnerable Arctic populations.
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Affiliation(s)
- Maria Tvermosegaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark
| | - Inger K Dahl-Petersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Nina Odgaard Nielsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Marit Eika Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark.
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Bjorn-Mortensen K, Lynggaard F, Lynge Pedersen M. High prevalence of atrial fibrillation among Greenlanders with ischemic stroke - atrial fibrillation found in more than 30% of cases. Int J Circumpolar Health 2013; 72:22628. [PMID: 24282782 PMCID: PMC3838969 DOI: 10.3402/ijch.v72i0.22628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/07/2013] [Accepted: 10/24/2013] [Indexed: 12/05/2022] Open
Abstract
Objectives To estimate the prevalence of atrial fibrillation among Greenlanders with ischemic stroke. Study design A cross-sectional study. Methods Information on atrial fibrillation and vitamin K antagonistic treatment at admittance and at discharge was obtained for Greenlanders admitted to Queen Ingrid's Hospital in Nuuk with an ischemic stroke in 2011 or in 2012 with methods described in details elsewhere. Results Of 139 patients (64 males and 75 females) Greenlanders with an ischemic stroke in 2011 (n=74) or 2012 (n=65), 5.0% (n=7) had known atrial fibrillation prior to stroke compared to 32.4% (n=45) after discharge (p<0.01). Conclusions More than 30% of ischemic stroke patients in this study had atrial fibrillation and only 5% were diagnosed prior to the stroke, suggesting that unknown atrial fibrillation is a substantial risk factor of ischemic stroke among Greenlanders.
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Affiliation(s)
- Karen Bjorn-Mortensen
- Queen Ingrid's Health Center, Nuuk, Greenland ; Greenland Center for Health Research, University of Nuuk, Nuuk, Greenland
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