Immunisation of healthcare workers in the Nordic countries: Variation in recommendations and practices and a lack of assessment

Healthcare workers (HCWs) are at increased risk of both exposure and transmission of infectious disease. Two European Union (EU) directives state that health services are responsible for assessing their employees’ potential exposure to infectious diseases and offering immunisation free of charge. We assessed current policy for immunisation of HCWs and the availability of vaccine coverage data in the Nordic countries by surveying national vaccination experts in Denmark, Finland, Iceland, Norway and Sweden, as well as Swedish county medical officers (CMOs). All national experts and 17 of 21 Swedish CMOs responded. All EU countries had transposed the European directives into national law, while Norway and Iceland had similar national legislation. Recommendations or guidelines were issued in Denmark, Finland, Iceland, Norway and 15 of 17 responding Swedish counties. The range of diseases covered differed by countries and Swedish counties. HCW vaccine coverage data were not systematically collected; incomplete estimates were only available for Finland and two Swedish counties. In conclusion, recommendations or guidelines exist in the Nordic countries, but their impact cannot be assessed, as vaccine uptake among HCWs is not currently measured. Systematic collection of data is a necessary step towards improving HCW immunisation policy and practice in the Nordic countries.     

Parenchymal pericytes are not the major contributor of extracellular matrix in the fibrotic scar after stroke in male mice

Scar formation after injury of the brain or spinal cord is a common event. While glial scar formation by astrocytes has been extensively studied, much less is known about the fibrotic scar, in particular after stroke. Platelet-derived growth factor receptor ß-expressing (PDGFRß⁺) pericytes have been suggested as a source of the fibrotic scar depositing fibrous extracellular matrix (ECM) proteins after detaching from the vessel wall. However, to what extent these parenchymal PDGFRß⁺ cells contribute to the fibrotic scar and whether targeting these cells affects fibrotic scar formation in stroke is still unclear. Here, we utilize male transgenic mice that after a permanent middle cerebral artery occlusion stroke model have a shift from a parenchymal to a perivascular location of PDGFRß⁺ cells due to the loss of regulator of G-protein signaling 5 in pericytes. We find that only a small fraction of parenchymal PDGFRß⁺ cells co-label with type I collagen and fibronectin. Consequently, a reduction in parenchymal PDGFRß⁺ cells by ca. 50% did not affect the overall type I collagen or fibronectin deposition after stroke. The redistribution of PDGFRß⁺ cells to a perivascular location, however, resulted in a reduced thickening of the vascular basement membrane and changed the temporal dynamics of glial scar maturation after stroke. We demonstrate that parenchymal PDGFRß⁺ cells are not the main contributor to the fibrotic ECM, and therefore targeting these cells might not impact on fibrotic scar formation after stroke.     

The combination syndrome: a literature review

Although combination syndrome is recognized by many clinicians, documented observations seem to be rare. The aim of this article was to critically review the literature regarding combination syndrome to evaluate the evidence for this concept. A search of the dental literature with Medline/PubMed through July 2002, focusing on the combination syndrome and related features, was undertaken and combined with a hand search of older references and textbooks on removable prosthodontics.     

Congruence between self-reported and actually provided prosthodontic services among Swedish dentists

The purpose of this study, comprising two parts, was to investigate the congruence between answers given by general dentists in questionnaires concerning prosthodontic services and the recorded information on the services actually performed by each dentist. In Part I it is investigated whether questionnaire reports of weekly working hours devoted to prosthodontics can be used as indicators of actual prosthodontic production. Part II deals with the dentists' self-reported numbers of single crowns, fixed partial dentures (FPDs), and removable dentures. These reported services are compared with the services actually provided. Part I: A regression analysis indicates a lacking precision for the individual dentist, indicated by a relatively low explained variance (R2 = 0.20). However, a highly significant association is seen between the two production measures (P = 0.000). Part II: The congruence between stated and actually provided services is higher for single crowns and removable dentures than for FPDs. Bivariate regression models are statistically significant for all three services. In Part II, the reported weekly working hours used for prosthodontics covaries significantly with prosthodontic production, but the association is not as strong as in Part I. Although the precision in both Part I and Part II is low for the individual dentist, the questionnaire measure is found to be useful as an indicator in a population of dentists. It is concluded that the questionnaire data can be used as reasonably valid expressions of prosthodontic activity in population-oriented analyses among general dentists.     

An investigation of some factors associated with occlusal tooth wear in a selected high-wear sample

The aim of the present study was to investigate the influence of some factors associated with occlusal tooth wear in a selected high-wear Swedish sample. The material comprised 59 persons having a mean age of 35 yr within the range 16–70 yr, the criteria for selection being a full or near-full complement of natural teeth, and the presence of definite clinical signs of occlusal wear. A dentition wear index, in addition to anterior, posterior, and arch subindices, was derived from a tooth-by-tooth evaluation of casts. Factors which were found to correlate significantly with increased occlusal wear were age, sex, self-perception of wear, number of teeth, and general health, as well as a number of variables from study-cast analysis. On the basis of the findings, not only is the multifactorial etiology of occlusal tooth wear a reality, but so, too, is the complex interdependence of these factors in the severity of wear.