Stockholm County Council

About: Stockholm County Council is a government organization based out in Stockholm, Sweden. It is known for research contribution in the topics: Population & Poison control. The organization has 1410 authors who have published 2429 publications receiving 78936 citations.

Tyrosine hydroxylase allelic distribution in suicide attempters

Abstract: A tetranucleotide repeat polymorphism in the first intron of the tyrosine hydroxylase (TH) locus was examined in a group of 118 adult suicide attempters and 78 control subjects. The suicide attempters were diagnosed according to DSM-III-R criteria at the index attempt and represented the following diagnoses: major depression (18), dysthymia (13), anxiety disorders (16), adjustment disorders (29), psychoactive substance abuse disorders (27) and psychotic disorders (15). A significant variation in the prevalence of carriers of the TH-K3 allele (high for suicide attempters with adjustment disorders, P =0.0023) and a tendency toward a variation of the TH-K1 allele (low among all suicide attempters, P =0.046) was observed. In light of other data the variation of TH-K1 and TH-K3 suggests that these alleles may reflect predisposition for a common phenotype with altered vulnerability for psychiatric disorders. © 1997 Elsevier Science Ireland Ltd.

Tick-borne Encephalitis Vaccine Failures: A 10-year Retrospective Study Supporting the Rationale for Adding an Extra Priming Dose in Individuals Starting at Age 50 Years

Abstract: Background Southern Sweden is endemic for tick-borne encephalitis (TBE), with Stockholm County as one of the high-risk areas. Our aim in this study was to describe cases of vaccine failures and to optimize future vaccination recommendations. Methods Patients with TBE were identified in the notification database at the Department of Communicable Disease Control and Prevention in Stockholm County during 2006-2015. Vaccine failure was defined as TBE despite adherence to the recommended vaccination schedule with at least 2 doses. Clinical data were extracted from medical records. Results A total of 1004 TBE cases were identified, 53 (5%) were defined as vaccine failures. In this latter group, the median age was 62 years (6-83). Forty-three (81%) patients were aged >50 years and 2 were children. Approximately half of the patients had comorbidities, with diseases affecting the immune system accounting for 26% of all cases. Vaccine failures following the third or fourth vaccine dose accounted for 36 (68%) of the patients. Severe and moderate TBE disease affected 81% of the cases. Conclusions To our knowledge, this is the largest documented cohort of TBE vaccine failures. Vaccine failure after 5 TBE vaccine doses is rare. Our data provide rationale for adding an extra priming dose to those aged ≥50 years.

Effect of parental migration background on childhood nutrition, physical activity, and body mass index.

Abstract: Background. Poor nutrition, lack of physical activity, and obesity in children have important public health implications but, to date, their effects have not been studied in the growing population of children in Sweden with immigrant parents. Methods. We estimated the association between parental migration background and nutrition, physical activity, and weight in 8-year-old children born in Stockholm between 1994 and 1996 of immigrants and Swedish parents (). Data were collected through clinical examination and questionnaires filled out by parents. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using multivariable logistic regression. Results. Children of immigrants complied more closely with Nordic Nutrition Recommendations compared with those of Swedes (OR = 1.35, 95% CI 1.11–1.64). They had higher intake of dietary fibre, vitamins C, B6, and E, folic acid, and polyunsaturated fatty acids (omega-3 and omega-6) reflecting higher consumption of foods of plant origin, but lower intake of vitamins A and D, calcium, and iron reflecting lower consumption of dairy products. Children of immigrants had higher intake of sucrose reflecting higher consumption of sugar and sweets. Furthermore, these children had a higher risk of having low physical activity (OR = 1.31, 95% CI 1.06–1.62) and being overweight (OR = 1.33, 95% CI 1.06–1.65) compared with children of Swedish parents. The odds of having low physical activity and being overweight were even higher in children whose parents were both immigrants. A low level of parental education was associated with increased risk of low physical activity regardless of immigration background. Conclusions. Culturally appropriate tools to capture the diverse range of ethnic foods and other lifestyle habits are needed. Healthcare professionals should be aware of the low levels of physical activity, increased weight, and lack of consumption of some important vitamins among children of immigrants.

Update of recent reforms in Germany to enhance the quality and efficiency of prescribing of proton pump inhibitors and lipid-lowering drugs.

Abstract: A plethora of reforms and initiatives have been introduced across Europe to enhance the prescribing of generics first line where they exist, obtain low prices for generics and, increasingly, to obtain low prices for interchangeable brands in a class once generics are available. In Germany, level 1 reference pricing, which contains products with identical bioactive ingredients, has been in operation since 1989 with patients paying the difference between the actual and reference prices if applicable. Level 2 reference pricing, where drugs are grouped by comparable pharmacological and therapeutic activity, was instigated in June and July 2004 for the proton pump inhibitors (PPIs) and statins, respectively. The formulas for setting prices have been described elsewhere. In Germany, alongside this, there has been a number of demand side measures to enhance the quality and efficiency of prescribing. These include agreements (‘Zielvereinbarungen’) and other initiatives between the sickness funds and Statutory Health Insurance (SHI) physicians to increase the prescribing of ‘primary substances’ over patented more expensive ‘me-too’ drugs as well as to encourage the prescribing of low-cost generics over both originators and high-cost generics. A recent analysis of the impact of level 1 and level 2 reference pricing for the PPIs and statins showed significant savings, particularly for the statins in 2006 versus 2003, despite a >50% increase in utilization on a defined daily dose (DDD) basis for both classes. This article updates these findings to provide an example to other European countries considering similar multi-faceted initiatives. The data source for this study is the Arzneiverordnungs Report 1999 to 2008. This report is based on total pharmaceutical costs on a DDD basis in ambulatory care to the SHI population covering approximately 90% of the population. End-user (ex-pharmacy) prices are used, irrespective of discounts and co-payments. Total pharmaceutical expenditure among the SHI population was h27.8 billion (year 2007 values) covering brand products (h15.8 billion), branded generic products (h9.1 billion) and drugs prepared in pharmacies in accordance with special prescriptions (h2.9 billion). A significant proportion was for PPIs and lipid-lowering products. Prescribing of PPIs continued to increase, with utilization in 2007 more than 2-fold higher than 2003 on a DDD basis (table I). This is a concern given significant prescribing for unspecified dyspepsia and the potential for discontinuation in a significant number of patients. In addition, there are concerns because of the increased risk of hip fractures with long-term use; however, potential ways to address this growing use of these drugs was outside the scope of this article. Omeprazole dominated PPI prescriptions, rising to 75% of total PPI DDDs in 2007. This pertains almost exclusively to branded generics at 99.6% of total omeprazole DDDs in 2007 following their availability in 1999. This dominance was helped by their lower cost/DDD versus the originator product and other PPIs combined with ongoing demand side measures. The cost/DDD for branded generic omeprazole was h0.68 (year 2007 value), 74.5% below originator cost/DDD in 1998. The cost/DDD of originator PPIs has also fallen, particularly following level 2 reference