Landspítali University Hospital Research Archive
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Early pregnancy plasma fatty acid profiles of women later diagnosed with gestational diabetes.
Get PDFTo 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 DownloadIntroduction: Fatty acid (FA) concentrations have previously been associated with gestational diabetes mellitus (GDM). However, few studies on GDM have examined FA profiles in early pregnancy or before diagnosis. This study aimed to compare early pregnancy plasma FA profiles of women with and without GDM diagnoses as well as their reported dietary consumption.
Research design and methods: The subjects comprised 853 women from the prospective study: Pregnant Women in Iceland II (PREWICE II), attending their 11-14 weeks ultrasound appointment in 2017-2018. During the visit, blood samples were collected for plasma FA analysis, and dietary habits were assessed using a short food frequency questionnaire. Information on GDM diagnoses was then later extracted from medical records. Differences in FA profile between GDM cases and non-cases were evaluated using the Mann-Whitney U test.
Results: GDM was diagnosed in 127 women (14.9%). Concentrations of saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids (PUFA) n-6, PUFA n-3 and total FA were higher in the women who later developed GDM compared with those who did not (p≤0.05). The medians for total FA were 2898 μg/mL for the women with GDM and 2681 μg/mL for those without GDM. Mean adjusted difference for total FA between the groups was 133 μg/mL (95% CI 33 to 233). Similar results were observed in prepregnancy normal-weight women and overweight women/women with obesity. Overall diet quality in early pregnancy appeared to be lower among the women later diagnosed with GDM.
Conclusion: We found that plasma FA profiles in early pregnancy were different for women later diagnosed with GDM compared with those who were not, independent of the women's body mass index.
Keywords: diabetes; diet; fatty acids; gestational; pregnancy.University of Iceland Research Fund
Science Fund of The National University Hospital in Icelan
Molecular Structure and Interactions of Lipids in the Outer Membrane of Living Cells Based on Surface-Enhanced Raman Scattering and Liposome Models.
No full textTo access publisher's full text version of this article click on the hyperlink belowThe distribution and interaction of lipids determine the structure and function of the cellular membrane. Surface-enhanced Raman scattering (SERS) is used for selective molecular probing of the cell membrane of living fibroblast cells grown adherently on gold nanoisland substrates across their whole contact areas with the substrate, enabling mapping of the membrane's composition and interaction. From the SERS data, the localization and distribution of different lipids and their interactions, together with proteins in the outer cell membrane, are inferred. Interpretation of the spectra is mainly supported by comparison with the spectra of model liposomes composed of phosphatidylcholine, sphingomyelin, and cholesterol obtained on the same gold substrate. The interaction of the liposomes with the substrate differs from that with gold nanoparticles. The SERS maps indicate colocalization of ordered lipid domains with cholesterol in the living cells. They support the observation of ordered membrane regions of micrometer dimensions in the outer leaflet of the cell membrane that are rich in sphingomyelin. Moreover, the spectra of the living cells contain bands from the groups of the lipid heads, phosphate, choline, and ethanolamine, combined with those from membrane proteins, as indicated by signals assigned to prenyl attachment. Elucidating the composition and structure of lipid membranes in living cells can find application in many fields of research.European Research Council (ERC)
European Commission
Icelandic Research Fund
University of Iceland Research Fun
Erlendar konur, upplýst val og ólík sjónarhorn fagaðila
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Bromotryptamine and Imidazole Alkaloids with Anti-inflammatory Activity from the Bryozoan .
No full textTo access publisher's full text version of this article click on the hyperlink belowChemical investigation of the marine bryozoan Flustra foliacea collected in Iceland resulted in isolation of 13 new bromotryptamine alkaloids, flustramines Q-W (1-7) and flustraminols C-H (8-13), and two new imidazole alkaloids, flustrimidazoles A and B (14 and 15), together with 12 previously described compounds (16-27). Their structures were established by detailed spectroscopic analysis using 1D and 2D NMR and HRESIMS. Structure 2 was verified by calculations of the 13C and 1H NMR chemical shifts using density functional theory. The relative and absolute configurations of the new compounds were elucidated on the basis of coupling constant analysis, NOESY, [α]D, and ECD spectroscopic data, in addition to chemical derivatization. The compounds were tested for in vitro anti-inflammatory activity using a dendritic cell model. Eight compounds (1, 3, 5, 13, 16, 18, 26, and 27) decreased dendritic cell secretion of the pro-inflammatory cytokine IL-12p40, and two compounds (4 and 14) increased secretion of the anti-inflammatory cytokine IL-10. Deformylflustrabromine B (27) showed the most potent anti-inflammatory effect (IC50 2.9 μM). These results demonstrate that F. foliacea from Iceland expresses a broad range of brominated alkaloids, many without structural precedents. The potent anti-inflammatory activity in vitro of metabolite 27 warrants further investigations into its potential as a lead for inflammation-related diseases.University of Iceland
AVS R&D Fund of The Ministry of Fisheries and Agriculture in Icelan
Increased risk of inflammatory bowel disease among patients treated with rituximab in Iceland from 2001 to 2018.
No full textTo access publisher's full text version of this article click on the hyperlink belowObjective: Immune-mediated diseases are on the rise after the introduction of powerful immunomodulating drugs. The objective of this study was to determine the population-based incidence rate of inflammatory bowel disease (IBD) among patients treated with the monoclonal antibody rituximab in Iceland and compare it to the baseline incidence rate of IBD in the general population.
Methods: We identified all patients treated with rituximab in Iceland from 2001 to 2018 through a central medicine database. IBD cases were indexed from medical records and ICD-10 codes and further confirmed by colonoscopy- and pathology reports. An experienced pathologist compared the pathology of IBD cases with matched controls of IBD patients.
Results: Lymphomas and related neoplasms were the most frequent indication for treatment with rituximab (n = 367) among the 651 patients included in the analysis. Following treatment, seven patients developed IBD: two cases of Crohn's disease, three with ulcerative colitis, and two with indeterminate IBD. The incidence rate of IBD among rituximab treated patients was 202 cases per 100,000 person-years. Comparing our data to IBD incidence in Iceland, rituximab treated patients have an age-adjusted hazard ratio of 6.6 for developing IBD. The risk did not correlate with dose or treatment duration. Prior diagnosis of an autoimmune illness did not increase the risk of IBD in rituximab treated patients.
Conclusions: Patients on rituximab have a sixfold increased risk of developing IBD compared to the general population. This risk was not affected by the indication for treatment and was not associated with concurrent immune-mediated diseases. Summary This population-based retrospective cohort study included all patients receiving treatment with rituximab between 2001 and 2018 in Iceland and identified a sixfold increased risk of developing IBD when compared to the general population.
Keywords: IBD-basic; IBD-clinical; Immunology; colonic-disorders; endoscopy-general
Polygenic risk score-analysis of thromboembolism in patients with acute lymphoblastic leukemia.
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 DownloadIntroduction: Thromboembolism (TE) is a common and serious toxicity of acute lymphoblastic leukemia (ALL) treatment, but studies of genetic predisposition have been underpowered with conflicting results. We tested whether TE in ALL and TE in the general adult population have a shared genetic etiology.
Materials and methods: We prospectively registered TE events and collected germline DNA in patients 1.0-45.9 years in the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 study (7/2008-7/2016). Based on summary statistics from two large genome-wide association studies (GWAS) on venous TE in adults (the International Network of VENous Thromboembolism Clinical Research Networks (INVENT) consortium and the UK Biobank), we performed polygenic risk score (PRS) analysis on TE development in the NOPHO cohort, progressively expanding the PRS by increasing the p-value threshold of single nucleotide polymorphism (SNP) inclusion.
Results and conclusion: Eighty-nine of 1252 patients with ALL developed TE, 2.5 year cumulative incidence 7.2%. PRS of genome-wide significant SNPs from the INVENT and UK Biobank data were not significantly associated with TE, HR 1.16 (p 0.14) and 1.02 (p 0.86), respectively. Expanding PRS by increasing p-value threshold did not reveal polygenic overlap. However, subgroup analysis of adolescents 10.0-17.9 years (n = 231), revealed significant polygenic overlap with the INVENT GWAS. The best fit PRS, including 16,144 SNPs, was associated with TE with HR 1.76 (95% CI 1.23-2.52, empirical p-value 0.02). Our results support an underlying genetic predisposition for TE in adolescents with ALL and should be explored further in future TE risk prediction models.
Keywords: Acute lymphoblastic leukemia; Polygenic risk score; Thromboembolism.Danish Cancer Society
Danish Childhood Cancer Foundation
Swedish Childhood Cancer Foundation
Nordic Cancer Union
Otto Christensen Foundation
University Hospital Rigshospitalet
Novo Nordisk Foundation
South-Eastern Norway Regional Health Authority, Norwa
Catamenial pneumothorax due to pulmonary endometriosis
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 DownloadEndómetríósa getur verið langvinn orsök verkja, blæðingaóreglu og
ófrjósemi meðal kvenna. Sjúkdómurinn er vanalega í grindarholi, en
getur birst á óvenjulegum stöðum. Hér er lýst tilfelli 39 ára konu með
gamla endómetríósugreiningu sem leitaði á heilsugæslu og sjúkrahús
í þrígang á öðrum degi blæðinga vegna andþyngsla, takverks og mæði.
Myndgreining sýndi loftbrjóst hægra megin í öll skiptin. Við brjóstholsspeglun voru endómetríósu-líkir blettir á yfirborði hægra lunga. Vefjagreining sýndi merki um endómetríósu. Konan hefur verið einkennalaus eftir kemíska fleiðruertingu og hormónameðferð.
Greining tíðatengds loftbrjósts þarf að byggjast á samhliða brjósthols- og kviðarholsspeglun með vefjasýnatöku til að fá staðfestingu á
sjúkdómnum og tryggja grundvöll meðferðar.Endometriosis is a chronic condition causing menstrual pain, irregular bleeding and
infertility among women. Although usually in the pelvis, it can manifest in atypical
places. We describe a 39-year old woman with a previous endometriosis diagnosis
who presented three times on the second menstrual day with dyspnea and chest
pain. Imaging showed right-sided pneumothorax on all three occasions. Thoracoscopy revealed endometriosis-like lesions. Histology was suggestive of endometriosis. After treatment with chemical pleurodesis and hormonal suppression she
has remained symptom-free.
Diagnosis should be obtained by concomitant thoraco- and laparoscopy with biopsies to verify the disease and give a basis for appropriate treatment
Cumulative Occupational Exposures and Lung-Function Decline in Two Large General-Population Cohorts.
No full textTo access publisher's full text version of this article click on the hyperlink belowRationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up.Objectives: To examine the potential association in two large cohorts: the ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults).Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 = -15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio = -0.52%, -0.43%, and -0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts.Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
NIH National Heart Lung & Blood Institute (NHLBI
Behavioural symptoms in nursing homes in association with health, leisure activities and restraint use
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 Íslandi fjölgar í hópi háaldraðra eins og annars staðar í heiminum.
Það kallar á aukna og bætta þjónustu við þennan aldurshóp. Einstaklingum með heilabilunarsjúkdóma fer því einnig fjölgandi en sjúkdómunum fylgja ýmis taugasálfræðieinkenni. Hegðunarvandi sem
birtist hjá allt að 90% einstaklinga með heilabilun veldur hinum
aldraða og aðstandendum hans mikilli streitu og dregur úr vellíðan
og lífsgæðum.
Tilgangur: Tilgangur rannsóknarinnar var að kanna hve hegðunarvandi er algengur hjá íbúum á íslenskum hjúkrunarheimilum og tengsl
hans við vitræna skerðingu, þunglyndi, verki, virkni og notkun fjötra.
Aðferð: Rannsóknin var megindleg, aftursýn og lýsandi. Við tölfræðilega greiningu var notað interRAI-MDS 2.0 mat 2596 íbúa sem
dvöldu á hjúkrunarheimilum árið 2014 og voru gögnin fengin hjá
Embætti landlæknis.
Niðurstöður: Meðalaldur íbúanna var 84,4 ár, 37,2% úrtaksins voru
karlar og 62,8% konur. Þá var meðaltal einkenna um hegðunarvanda
hæst hjá þeim sem voru með blandað form heilabilunar (0,34–1,15)
og minnst hjá einstaklingum sem ekki höfðu heilabilunarsjúkdóma
(0,07–0,31). Einnig kom í ljós jákvæð fylgni á milli hegðunarvanda
og þunglyndiseinkenna (Sp-ró = 0,399; p < 0,0001), meiri verkja
(Sp-ró = 0,099; p < 0,0001), minni virkni (Sp-ró = 0,224; p < 0,0001)
og fjötranotkunar (Sp-ró = 0,145; p < 0,0001).
Ályktun: Niðurstöðurnar gefa yfirlit yfir algengustu atferlis- og taugasálfræðieinkenni íbúa á hjúkrunarheimilum. Verkir, þunglyndi,
skortur á örvun og virkni og notkun fjötra eru þættir sem taka þarf
tillit til þegar verið er að meta og veita meðferð við hegðunarvanda
hjá íbúum hjúkrunarheimila til að bæta líðan þeirra. Aukin þekking
á þessum þáttum er mikilvæg til að greina og meta orsakir hegðunarvanda. Mikilvægt er að tryggja nægilega þekkingu þeirra sem starfa
á hjúkrunarheimilum í að meðhöndla hegðunarvanda til að hægt sé
að veita árangursríka, einstaklingsbundna meðferð.
__________________________________Background: the proportion of the very elderly is increasing in
Iceland, as elsewhere, requiring more and better care services for
this age group. therefore, the number of people with dementia is
also rising, but the disease presents various neurological symptoms. Behavioural symptoms is present in up to 90% of individuals
with dementia. This is stressfull for the induviduals and their families and decreases their well being and quality of life.
Aim: of the research was to investigate the frequency of behavioural symptoms in Icelandic nursing homes and the association
with cognitive impairment, depression, pain, activities and the use
of restraints.
Method: The research is quantitative, retrospective, and descriptive. Data for statistical analysis were 2596 interRAI-MDS 2.0 assessments of nursing home residents in 2014, obtained from the
Directorate of Health in Iceland.
Results: The average age of residents was 84.4 years, 37.2% of
whom were men and 62.8% women. Indviduals suffering from a
mixed type of dementia had the highest average for behavioural
symptoms (0.34–1.15) and residents without dementia had the
lowest (0.07–0.31). The findings showed a positive correlation between behavioural symptoms and symptoms of depression (Sp rho
= 0.399; p < 0.0001), higher levels of pain (Sp rho = 0.099; p <
0.0001), less time in activities (Sp rho = 0.224; p < 0.0001) and
restaraint use (Sp rho = 0.145; p < 0.0001).
Conclusions: The findings present the most common behavioural
and neuropsychological symptoms in nursing home residents. In
order to improve the wellbeing of nursing home residents, factors
such as pain, depression, lack of activities and use of restraints
must be taken into account when assessing and treating behavioral
problems. Increased knowledge of these factors is important when
diagnosing and assessing the causes of behavioural symptoms. It
is important to ensure that nursing home staff has sufficient
knowledge on how to treat behavioural symptoms so that the most
effective and individually designed treatment can be provided.
Keywords: Behavioural symptoms, pain, depression, activity, restraints and interRAI-MDSÖldrunarráð Íslands og B-hluti vísindasjóðs Félags íslenskra
hjúkrunarfræðing
Chinese elixirs of life and modern health
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