Background: There is increasing attention paid to the arrival of migrants from outwith the EU region to the European countries. Healthcare that is universally and equably accessible needs to be provided for these migrants throughout the range of national contexts and in response to complex and evolving individual needs. It is important to look at the evidence available on provision and access to healthcare for migrants to identify barriers to accessing healthcare and better plan necessary changes. Methods: This review scoped 77 papers from nine European countries (Austria,

No reports of the incidence rates for primary systemic amyloidosis (AL) have come to our attention. Records of all residents of Olmstead County, Minnesota, with a diagnosis of amyloidosis were obtained from the Mayo Clinic and its affiliated hospitals, as well as other medical groups that might have seen local patients for the period January 1, 1950 to December 31, 1989. Twenty-one patients fulfilled the criteria for the diagnosis of AL. The median age was 73.5 years, and 62% were men. In all but one patient the diagnosis was made ante mortem. The clinical data of the 21 patients were similar to those referral patients with AL seen at Mayo Clinic. Immunohistochemical stains were positive for monoclonal light chains in the amyloid deposits in 15 of the 21 cases. In six cases, tissue was not available for immunohistochemical studies. Three of the six patients without immunohistochemical stains had a free monoclonal lambda light chain in the urine, and the other three had a monoclonal serum protein. Immunoelectrophoresis/immunofixation detected a monoclonal (M)-protein in the serum of 16 of 17 patients tested. A monoclonal light chain was found in the urine of 10 of 15 patients. The overall sex- and age- adjusted rate per million person-years was 6.1 from 1950 to 1969 and 10.5 from 1970 to 1989. The similarity of these rates suggests no significant increase over time.

A study of the incidence and prevalence of rheumatoid arthritis conducted in Rochester, MN, during the period 1950 through 1974 revealed an average annual incidence rate of 28.1 per 100,000 population for males and of 65.7 per 100,000 for females. These rates include classic, definite, and probable cases. Age-specific rates generally increased with age. The secular trend of the incidence in males and females differed. Rates for males, although fluctuating, remained relatively stable throughout the entire 25-year period, whereas rates for females declined dramatically during the last 10 years of the study. The decline was present both in cases presenting as definite at the time of earliest diagnosis and in the probable cases. No explanation was found for the observed decline, but the authors believe that a factor introduced in the 1960s and acting selectively on females has affected the incidence rates. From recent evidence, it could be inferred that oral contraceptives and postmenopausal estrogens are likely causes. Prevalence rates for January 1, 1975, were 4.0 per 1000 for males and 10 per 1000 for females. Among adults, prevalence rates were 5.8 per 1000 for males and 13.4 for females. Mortality among the patients with rheumatoid arthritis was not different from that for the total Olmsted County population.

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Consumption of both cooked vegetables and olive oil was inversely and independently associated with risk of RA in this population. Further research is needed to elucidate the underlying mechanisms of this finding, which may include the antioxidant properties or the high n-9 fatty acid content of the olive oil.