Landspítali University Hospital Research Archive
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Ventilator treatment in the Nordic countries. A multicenter survey.
No full textTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldBACKGROUND: A 1-day point prevalence study was performed in the Nordic countries to identify ventilator-treatment strategies in the region. MATERIAL AND METHODS: On 30 May 30 2001 all mechanically ventilated patients in 27 intensive care units (ICUs) were registered via the internet. The results are shown as medians (25th, 75th percentile). RESULTS: One hundred and eight patients were included (69% male) with new simplified acute physiology score (SAPS) 48 (37,57) and 4.5 d (2,11) of ventilator treatment. The most frequent indication for ventilator treatment was acute respiratory failure (73%). Airway management was by endotracheal tube (64%), tracheostomy (32%) and facial mask (4%). Pressure regulated ventilator modes were used in 86% of the patients and spontaneous triggering was allowed in 75%. The tidal volume was 7 ml/kg (6,9), peak inspiratory pressure 22 cmH2O (18,26) and positive end-expiratory pressure (PEEP) 6 cmH2O (6,9). FiO2 was 40% (35,50), SaO2 97% (95-98), PaO2 11 kPa (10,13), PaCO2 5.4 kPa (4.7,6.3), pH 7.43 (7.38,7.47) and BE 2.0 mmol/l (- 0.5,5). The PaO2/FiO2 ratio was 220 mmHg (166,283). The peak inspiratory pressure (r=0.37), mean airway pressure (r=0.36), PEEP (r=0.33), tidal volume (r=0.22) and SAPS score (r=0.19) were identified as independent variables in relation to the PaO2/FiO2 ratio. CONCLUSION: The vast majority of patients were ventilated with pressure-regulated modes. Tidal volume was well below what has been considered conventional in recent large trials. Correlations between the parameters of gas exchange, respiratory mechanics, ventilator settings and physiological status of the patients was poor. It appears that blood gas values are the main tool used to steer ventilator treatment. These results may help to design future interventional studies of ventilator treatment
Human Pseudoterranova and Anisakis cases in Iceland 2004-2020
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadÁ árabilinu 2004-2020 voru 18 hringormslirfur (Nematoda) sendar til rannsókna og tegundagreiningar á sníkjudýradeild Tilraunastöðvarinnar að
Keldum. Fjórtán lirfanna höfðu lifað tímabundið í fólki og voru lifandi þegar
þær fundust, þrjár fundust lifandi í fiski sem fólk var að borða, ein fannst
dauð. Pseudoterranova decipiens fannst í 16 tilvikum (89%), Anisakis simplex í
tveimur (11%).
Annað Anisakis-tilfellið var lirfa sem fannst spriklandi í bleyju barns sem talið
var að hefði fengið lirfuna úr vanelduðum fiski á barnaheimili. Í hinu tilvikinu
fannst dauð lirfa í soðinni ýsutuggu, sem barn, sem verið var að mata, spýtti
út úr sér.
Pseudoterranova-lirfur sem lifað höfðu í fólki (n=13) fundust oftast í munni
(11 tilvik), í einu tilfelli fann móðir spriklandi lirfu í ælu barns, í öðru fannst
hringormur hreyfa sig við endaþarmsop við þrif eftir salernisferð. Lengd lirfanna var 30 mm til 47 mm og voru þær taldar hafa lifað allt frá einum upp í 9
daga í fólkinu. Níu lirfanna höfðu þegar náð að þroskast upp á fjórða stig (L4),
fjórar voru enn á þriðja stigi (L3). Þorskur var oftast nefndur sem uppspretta
lirfanna (5 tilfelli af 14), tvær manneskjur töldu lirfurnar komnar úr steinbít,
einn nefndi báðar þessar tegundir. Sushi eða skarkoli voru álitin uppsprettan
í einu tilviki, einn smitaðist í sushi-veislu. Uppruninn var óþekktur í fjórum
tilvikum. Oftast töldu menn sig hafa smitast í heimahúsi, þrír álitu sig hafa
smitast á veitingastað, sama barn smitaðist tvisvar á barnaheimili og hafnarstarfsmaður smitaðist við að borða hráan fisk.During 2004-2020 in total 18 anisakid larvae (Nematoda) were sent in to the Laboratory
of Parasitology at Keldur for investigation and species identification. Fourteen had
temporarily lived within the human body and were alive when detected, three were noticed
alive in food just before being consumed, one larva was found dead. Pseudoterranova
decipiens was found í 16 instances (89%), Anisakis simplex in two (11%). The one Anisakis
case was a wriggling larva detected in the diaper of a baby that was believed to have
ingested the larva with undercooked fish three days earlier in the kindergarten. In the
other case a dead larva was found entangled in fish chew, spit out by a baby being fed with
boiled haddock.
Pseudoterranova larvae in humans (n=13) were most frequently detected in the mouth (11
persons). In one instance winding movements of larva in vomit of a baby attracted the
attention of the mother, in another case a person detected tickling movements of a larva
when cleaning the anal area after defecation. Length of the 13 Pseudoterranova larvae
varied between 30 and 47 mm. They were believed to have lived in their hosts from one
up to nine days. Nine larvae had already developed to the L4, stage, four were still in the
L3 stage. Cod was the most frequently mentioned source of infection (5 of 14 cases), two
persons regarded catfish to be the culprit, one named both fish species. In one case either
sushi or plaice was believed to be the infection source, one person presumably got the
larva participating in a sushi feast. In four cases the fish source remained unknown. Most
often the larva was consumed in private homes, three persons believed to have gotten the
larva when dining in a restaurant, a harbour worker got the worm when eating raw fish
and the same baby got a larva on two different occasions in the kindergarten
Liver Injury Associated With Drugs and Complementary and Alternative Medicines in India.
No full textTo access publisher's full text version of this article click on the hyperlink belo
Identification of genetic overlap and novel risk loci for attention-deficit/hyperactivity disorder and bipolar disorder.
No full textTo access publisher's full text version of this article click on the hyperlink belowDifferential diagnosis between childhood onset attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) remains a challenge, mainly due to overlapping symptoms and high rates of comorbidity. Despite this, genetic correlation reported for these disorders is low and non-significant. Here we aimed to better characterize the genetic architecture of these disorders utilizing recent large genome-wide association studies (GWAS). We analyzed independent GWAS summary statistics for ADHD (19,099 cases and 34,194 controls) and BD (20,352 cases and 31,358 controls) applying the conditional/conjunctional false discovery rate (condFDR/conjFDR) statistical framework that increases the power to detect novel phenotype-specific and shared loci by leveraging the combined power of two GWAS. We observed cross-trait polygenic enrichment for ADHD conditioned on associations with BD, and vice versa. Leveraging this enrichment, we identified 19 novel ADHD risk loci and 40 novel BD risk loci at condFDR <0.05. Further, we identified five loci jointly associated with ADHD and BD (conjFDR < 0.05). Interestingly, these five loci show concordant directions of effect for ADHD and BD. These results highlight a shared underlying genetic risk for ADHD and BD which may help to explain the high comorbidity rates and difficulties in differentiating between ADHD and BD in the clinic. Improving our understanding of the underlying genetic architecture of these disorders may aid in the development of novel stratification tools to help reduce these diagnostic difficulties.United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
Research Council of Norway
SouthEast Norway Regional Health Authority
KG Jebsen Foundatio
BRCA2 Haploinsufficiency in Telomere Maintenance
Full text linkTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadOur previous studies showed an association between monoallelic BRCA2 germline mutations and dysfunctional telomeres in epithelial mammary cell lines and increased risk of breast cancer diagnosis for women with BRCA2 999del5 germline mutation and short telomeres in blood cells. In the current study, we analyzed telomere dysfunction in lymphoid cell lines from five BRCA2 999del5 mutation carriers and three Fanconi Anemia D1 patients by fluorescence in situ hybridization (FISH). Metaphase chromosomes were harvested from ten lymphoid cell lines of different BRCA2 genotype origin and analyzed for telomere loss (TL), multitelomeric signals (MTS), interstitial telomere signals (ITS) and extra chromosomal telomere signals (ECTS). TL, ITS and ECTS were separately found to be significantly increased gradually between the BRCA2+/+, BRCA2+/- and BRCA2-/- lymphoid cell lines. MTS were found to be significantly increased between the BRCA2+/+ and the BRCA2+/-heterozygous (p < 0.0001) and the BRCA2-/- lymphoid cell lines (p < 0.0001) but not between the BRCA2 mutated genotypes. Dysfunctional telomeres were found to be significantly increased in a stepwise manner between the BRCA2 genotypes indicating an effect of BRCA2 haploinsufficiency on telomere maintenance. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Author keywords
BRCA2; Chromosomal instability; Fanconi anemia; Haploinsufficiency; TelomereIcelandic Centre for Researc
Ambient nitrogen dioxide is associated with emergency hospital visits for atrial fibrillation: a population-based case-crossover study in Reykjavik, Iceland.
Full text linkTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: In Iceland air quality is generally good; however, previous studies indicate that there is an association between air pollution in Reykjavik and adverse health effects as measured by dispensing of medications, mortality, and increase in health care utilisation. The aim was to study the association between traffic-related ambient air pollution in the Reykjavik capital area and emergency hospital visits for heart diseases and particularly atrial fibrillation and flutter (AF).
Methods: A multivariate time-stratified case-crossover design was used to study the association. Cases were those patients aged 18 years or older living in the Reykjavik capital area during the study period, 2006-2017, who made emergency visits to Landspitali University Hospital for heart diseases. In this population-based study, the primary discharge diagnoses were registered according to International Classification of Diseases, 10th edition (ICD-10). The pollutants studied were NO2, PM10, PM2.5, and SO2, with adjustment for H2S, temperature, and relative humidity. The 24-h mean of pollutants was used with lag 0 to lag 4.
Results: During the study period 9536 cases of AF were identified. The 24-h mean NO2 was 20.7 μg/m3. Each 10 μg/m3 increase in NO2 was associated with increased risk of heart diseases (ICD-10: I20-I25, I44-I50), odds ratio (OR) 1.023 (95% CI 1.012-1.034) at lag 0. Each 10 μg/m3 increase in NO2 was associated with an increased risk of AF (ICD-10: I48) on the same day, OR 1.030 (95% CI: 1.011-1.049). Females were at higher risk for AF, OR 1.051 (95% CI 1.019-1.083) at lag 0, and OR 1.050 (95% CI 1.019-1.083) at lag 1. Females aged younger than 71 years had even higher risk for AF, OR 1.077 (95% CI: 1.025-1.131) at lag 0. Significant associations were found for other pollutants and emergency hospital visits, but they were weaker and did not show a discernable pattern.
Conclusions: Short-term increase in NO2 concentrations was associated with heart diseases, more precisely with AF. The associations were stronger among females, and among females at younger age. This is the first study in Iceland that finds an association between air pollution and cardiac arrhythmias, so the results should be interpreted with caution.
Keywords: Atrial fibrillation; Cardiac arrhythmia; Case-crossover; Hospital registry; Ischemic heart diseases; Nitrogen dioxide; Population-based
Epidemiology of trauma in the subarctic regions of the Nordic countries.
Full text linkTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: The northern regions of the Nordic countries have common challenges of sparsely populated areas, long distances, and an arctic climate. The aim of this study was to compare the cause and rate of fatal injuries in the northernmost area of the Nordic countries over a 5-year period.
Methods: In this retrospective cohort, we used the Cause of Death Registries to collate all deaths from 2007 to 2011 due to an external cause of death. The study area was the three northernmost counties in Norway, the four northernmost counties in Finland and Sweden, and the whole of Iceland.
Results: A total of 4308 deaths were included in the analysis. Low energy trauma comprised 24% of deaths and high energy trauma 76% of deaths. Northern Finland had the highest incidence of both high and low energy trauma deaths. Iceland had the lowest incidence of high and low energy trauma deaths. Iceland had the lowest prehospital share of deaths (74%) and the lowest incidence of injuries leading to death in a rural location. The incidence rates for high energy trauma death were 36.1/100000/year in Northern Finland, 15.6/100000/year in Iceland, 27.0/100000/year in Northern Norway, and 23.0/100000/year in Northern Sweden.
Conclusion: We found unexpected differences in the epidemiology of trauma death between the countries. The differences suggest that a comparison of the trauma care systems and preventive strategies in the four countries is required.
Keywords: Epidemiology; Injury; Rural; Trauma.Finnmarkssykehuset Health Trust
University of Tromso
Northern Norway Regional Health Authorit
Effectiveness of Nursing Interventions for Patients With Cancer and their Family Members: A Systematic Review.
No full textTo access publisher's full text version of this article click on the hyperlink belowCancer diagnosis poses enormous physical and psychosocial challenges for both the affected person and their families. This systematic review identifies the characteristics and effectiveness of nursing interventions offered to adult patients with cancer and their families. Five databases were searched, and 19 studies published from 2009 to 2020 were included. Interventions were categorized as follows: (a) interventions with supporting and cognitive components (n = 3), (b) interventions that included skills training for the caregiver (n = 3), (c) interventions to enhance care through managing symptoms (n = 8), (d) interventions focusing on the dyad or family-patient relationship (n = 4), and (e) interventions targeted to the patient's condition (n = 1). The results of this review offer an overview from which to carry out new studies and are useful for providing future directions within family nursing practice, taking into account the impact that the family has on the disease and the consequences the condition may bring to the whole family
International links between Streptococcus pneumoniae vaccine serotype 4 sequence type (ST) 801 in Northern European shipyard outbreaks of invasive pneumococcal disease.
Full text linkTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: Pneumococcal disease outbreaks of vaccine preventable serotype 4 sequence type (ST)801 in shipyards have been reported in several countries. We aimed to use genomics to establish any international links between them.
Methods: Sequence data from ST801-related outbreak isolates from Norway (n = 17), Finland (n = 11) and Northern Ireland (n = 2) were combined with invasive pneumococcal disease surveillance from the respective countries, and ST801-related genomes from an international collection (n = 41 of > 40,000), totalling 106 genomes. Raw data were mapped and recombination excluded before phylogenetic dating.
Results: Outbreak isolates were relatively diverse, with up to 100 SNPs (single nucleotide polymorphisms) and a common ancestor estimated around the year 2000. However, 19 Norwegian and Finnish isolates were nearly indistinguishable (0-2 SNPs) with the common ancestor dated around 2017.
Conclusion: The total diversity of ST801 within the outbreaks could not be explained by recent transmission alone, suggesting that harsh environmental and associated living conditions reported in the shipyards may facilitate invasion of colonising pneumococci. However, near identical strains in the Norwegian and Finnish outbreaks does suggest that transmission between international shipyards also contributed to those outbreaks. This indicates the need for improved preventative measures in this working population including pneumococcal vaccination.
Keywords: Molecular epidemiology; Outbreak; PCVs; PPV23; Pneumococcal; ST801; Serotype 4; Streptococcus pneumoniae; Whole genome sequencing.Wellcome Trust
European Commission
Bill & Melinda Gates Foundation
European Research Council (ERC)
European Commissio
Breathlessness across generations: results from the RHINESSA generation study.
Full text linkTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: Breathlessness is a major cause of suffering and disability globally. The symptom relates to multiple factors including asthma and lung function, which are influenced by hereditary factors. No study has evaluated potential inheritance of breathlessness itself across generations.
Methods: We analysed the association between breathlessness in parents and their offspring in the Respiratory Health in Northern Europe, Spain and Australia generation study. Data on parents and offspring aged ≥18 years across 10 study centres in seven countries included demographics, self-reported breathlessness, asthma, depression, smoking, physical activity level, measured Body Mass Index and spirometry. Data were analysed using multivariable logistic regression accounting for clustering within centres and between siblings.
Results: A total of 1720 parents (mean age at assessment 36 years, 55% mothers) and 2476 offspring (mean 30 years, 55% daughters) were included. Breathlessness was reported by 809 (32.7%) parents and 363 (14.7%) offspring. Factors independently associated with breathlessness in parents and offspring included obesity, current smoking, asthma, depression, lower lung function and female sex. After adjusting for potential confounders, parents with breathlessness were more likely to have offspring with breathlessness, adjusted OR 1.8 (95% CI 1.1 to 2.9). The association was not modified by sex of the parent or offspring.
Conclusion: Parents with breathlessness were more likely to have children who developed breathlessness, after adjusting for asthma, lung function, obesity, smoking, depression and female sex in both generations. The hereditary components of breathlessness need to be further explored.
Keywords: asthma; clinical epidemiology; perception of asthma/breathlessness.Swedish Society for Medical Research
Swedish Research Council
European Commission
Research Council of Norway
228174
ERC StG project BRuSH
European Commission
Bergen Medical Research Foundation
Western Norwegian Regional Health Authorities
Bergen: World University Network
Bergen: Norwegian Labour Inspection
Bergen: Norwegian Asthma and Allergy Association
Albacete: Sociedad Espanola de Patologia Respiratoria (SEPAR) Fondo de Investigacion Sanitaria
Goteborg: Swedish Heart and Lung Foundation
Goteborg: Swedish Asthma and Allergy Association
Reykjavik: Iceland University
Melbourne: NHMRC Project
Tartu: Estonian Research Council
Arhus: The Danish Wood Foundation
Arhus: Danish Working Environment Authority
Arhus: Aarhus University (PhD scholarship)
Danish Lung Association
Estonian Science Foundation
Icelandic Research Council
Research Council of Norway
European Commission
Vardal Foundation for Health Care Science and Allergy Research
Medical Research Council (ECRHS III)
European Commission
European Commission Joint Research Centre
Huelva: Sociedad Espanola de Patologia Respiratoria (SEPAR) Fondo de Investigacion Sanitaria
Umea: Swedish Heart and Lung Foundation
Uppsala: the Swedish Heart and Lung Foundation
Umea: Swedish Asthma and Allergy Association
Uppsala: Swedish Asthma and Allergy Association
Melbourne: Melbourne University
Norwegian Asthma and Allergy Association
Swedish Asthma and Allergy Association
Swedish Heart-Lung Foundatio