Childhood diet in relation to Sámi and Norwegian ethnicity in northern and mid-Norway – the SAMINOR study

Objective

The purpose of this work was to identify dietary patterns in the past using cluster analysis of reported diet in childhood, and to assess predictors for dietary patterns in relation to ethnicity in the population in the Sámi core areas in Norway. The Sámis are an indigenous population living in the border areas of Norway, Sweden, Finland and Russia.

Design

Population-based, cross-sectional study, using self-administered questionnaires. A food-frequency questionnaire covering selected food items eaten in childhood was used. The questionnaire also provided data on ethnicity.

Subjects and setting

This study was based on data collected from 7614 subjects participating in The Population Based Study of Health and Living Conditions in Areas with a Mixed Sámi and Norwegian Population (the SAMINOR study) who grew up in the SAMINOR geographical areas, i.e. areas with mixed Sámi and Norwegian populations in Norway.

Results

Four dietary clusters were identified: a reindeer meat cluster; a cluster with high intakes of fish, traditional fish products and mutton, in addition to food sources from the local environment; a Westernised food cluster with high intakes of meat balls and sausages; and a cluster with a high intake of fish, but not any other foods in the questionnaire. The cluster distribution differed by ethnicity, but the effect of ethnicity on diet differed by coastal and inland residence.

Conclusion

Our study has shown that data gathered through the limited questionnaire could be used to group the study sample into different dietary clusters, which we believe will be useful for further research on relationships between diet in childhood and health in the Sámi core areas in Norway.

[Voiding problems and urinary tract complications in adolescents and adults with myelomeningocele]

BACKGROUND

The aim of this study was to describe voiding dysfunction and urinary tract complications in a population above 16 years of age with myelomeningocele.

MATERIAL AND METHODS

51 persons were included in the study. Data were obtained by questionnaires, ultrasound and glomerular filtration rate; in those with intact urinary bladder, by cystometry and videocystography.

RESULTS

30 out of 33 persons with intact urinary bladder were incontinent. Those with daily incontinence described this as a major problem. Cystometry concluded with normal detrusor contractions in three, detrusor hyperreflexia in five, and a detrusor hyporeflexia in 25 persons. Three out of 30 had vesicoureteral reflux. Ultrasound showed mild hydronephrosis and/or scarring in three persons. Average glomerular filtration rate was 86% (50-131%). 11 had Bricker diversion and seven continent reservoirs. 15 out of 18 persons with urinary diversion were satisfied with this solution. In persons with urinary diversion, the average glomerular filtration rate was 78% (44-109%). Ultrasound showed hydronephrosis and/or scarring in seven out of 16. Overall, urinary tract infections last year were reported by 56%, and pyelonephritis was more common in those with urinary diversion.

INTERPRETATION

Incontinence is a common problem in adults with myelomeningocele. About one third had upper urinary tract changes, but none had renal failure.

[Follow up of urinary tract problems in adults with myelomeningocele]

BACKGROUND

More than 90% of persons with myelomeningocele have a neurogenic bladder disturbance with incontinence and risk of upper urinary tract deterioration. Both aspects need to be considered when planning treatment and follow-up.

MATERIAL AND METHODS

The study is based on review of articles and clinical experience.

RESULTS

A thorough examination of the patient's voiding methods and incontinence is necessary. Examinations for renal function, reflux and hydroureteronephrosis as well as cystometry should also be carried out. The results of such examinations, together with an assessment of the patient's motor and cognitive function, as well as motivation, will provide a basis for further treatment and follow-up. We suggest a flow-chart for treatment and follow-up of persons above 16 years of age with myelomeningocele.

INTERPRETATION

Patients with myelomeningocele should have a thorough examination and an individual plan for treatment and follow-up of their urinary tract dysfunction. Depending on the pathological findings, routine follow-up should be in done intervals from six months to five years.

[Diagnostic imaging of annular pancreas]

BACKGROUND

Annular pancreas is a rare congenital anomaly. A ring of pancreatic tissue encircles the second part of the duodenum and results in varying degrees of obstruction. When the first symptoms occur in adults, they are non-specific and may consist in epigastric pain, fullness after meals, indigestion and nausea. Concomitant lesions such as ulcer or pancreatitis may obscure the diagnosis.

MATERIAL AND METHODS

A case report documents that radiologic examination with barium meal disclosed the duodenal stenosis.

RESULTS

A properly performed CT examination revealed the ring of pancreatic tissue which encircled the duodenum. Endoscopic retrograde pancreatography may show a duct with a characteristic circular pattern around the duodenum. MR and endoscopic ultrasonography are supplementary examinations in equivocal cases.

INTERPRETATION

A CT examination is a good non-invasive primary examination when annular pancreas is suspected.