Landspítali University Hospital Research Archive
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Patients in need of comprehensive geriatric assessment: The utility of the InterRAI emergency department screener.
No full textTo access publisher's full text version of this article click on the hyperlink belowIntroduction: The interRAI Emergency Department-Screener (ED-screener) is a risk stratification instrument incorporating functional and social aspects to identify older adults in EDs. The aim was to assess the construct validity and utility of the ED-screener in comparison with more established instruments.
Methods: The ED-screener, Triage Risk Screening Tool (TRST) and Identification of Seniors at Risk (ISAR) were administered to older ED-patients. Construct validity was assessed by correlation with TRST and ISAR. The ED-screener scores that corresponded to the established cut-offs for ISAR and TRST were assessed with linear regression. The sensitivity and specificity of the ED-screener for mortality at 4-months were calculated.
Results: Two hundred patients were included (mean age 78.5 years, 44% male). Majority (85%) lived at home, 43% lived alone and 53% received home care. The scores of 3.02 and 3.01 on ED-screener corresponded to the cut-off score of 2 on the other instruments. The correlation of the ED-screener with ISAR and TRST was 0.56 and 0.41 respectively. A score of 3 on the ED-screener was 100% sensitive and 28% specific for 4-month mortality.
Conclusion: These findings provide support for the construct validity of the ED-screener and its ability to predict outcomes in its intended setting.
Keywords: Comprehensive geriatric assessment; Emergency department; InterRAI ED-screener; Screening.Landspitali University Hospital Research Fund
University of Iceland Research Fun
Correction to: Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials.
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Clinical practice guideline on the management of septic shock and sepsis-associated organ dysfunction in children: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine.
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 DownloadThe Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the clinical practice guideline Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. The guideline can serve as a useful decision aid for clinicians managing children with suspected and confirmed septic shock and sepsis-associated organ dysfunction.
Keywords: AGREE II; children; clinical practice guideline; paediatrics; sepsis; septic shock.SSA
Analyzing Metabolic States of Adipogenic and Osteogenic Differentiation in Human Mesenchymal Stem Cells via Genome Scale Metabolic Model Reconstruction.
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 DownloadSince their initial discovery in 1976, mesenchymal stem cells (MSCs) have been gathering interest as a possible tool to further the development and enhancement of various therapeutics within regenerative medicine. However, our current understanding of both metabolic function and existing differences within the varying cell lineages (e.g., cells in either osteogenesis or adipogenesis) is severely lacking making it more difficult to fully realize the therapeutic potential of MSCs. Here, we reconstruct the MSC metabolic network to understand the activity of various metabolic pathways and compare their usage under different conditions and use these models to perform experimental design. We present three new genome-scale metabolic models (GEMs) each representing a different MSC lineage (proliferation, osteogenesis, and adipogenesis) that are biologically feasible and have distinctive cell lineage characteristics that can be used to explore metabolic function and increase our understanding of these phenotypes. We present the most distinctive differences between these lineages when it comes to enriched metabolic subsystems and propose a possible osteogenic enhancer. Taken together, we hope these mechanistic models will aid in the understanding and therapeutic potential of MSCs.
Keywords: GEM; MSCs; adipogenesis; metabolic differences; metabolic reconstruction; osteogenesis.Icelandic Research Fun
Comorbidities in a Cohort of 66 Patients With Psoriatic Arthritis Mutilans-Results From the Nordic PAM Study.
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 DownloadObjective: Psoriatic arthritis mutilans (PAM) is the most severe phenotype of psoriatic arthritis due to excessive bone erosion causing joint destruction and decreased functional capacity. The aim of this study was to investigate the prevalence of comorbidities among patients with PAM and the association between comorbidities and joint involvement. Methods: A total of 66 patients aged ≥18 years from the Nordic countries with past or present psoriasis along with at least one mutilated joint were included in the present study. Results: The median number of comorbid conditions per patient was 1 [interquartile range (IQR) 0-2] and 16.7% reported three or more comorbidities. The most frequent comorbidity was hypertension (36.4%). The median number of mutilated joints per patient was 3 (IQR 1-8.3; range 1-38). Conclusion: Two thirds of the patients with PAM reported comorbid conditions and the most frequent was hypertension which affected more than a third of the patients. However, this study was unable to detect any association between comorbidities and the severity of PAM.NORDPS
Neonatal Screening in Europe Revisited: An ISNS Perspective on the Current State and Developments Since 2010.
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 DownloadNeonatal screening (NBS) was initiated in Europe during the 1960s with the screening for phenylketonuria. The panel of screened disorders ("conditions") then gradually expanded, with a boost in the late 1990s with the introduction of tandem mass spectrometry (MS/MS), making it possible to screen for 40-50 conditions using a single blood spot. The most recent additions to screening programmes (screening for cystic fibrosis, severe combined immunodeficiency and spinal muscular atrophy) were assisted by or realised through the introduction of molecular technologies. For this survey, we collected data from 51 European countries. We report the developments between 2010 and 2020 and highlight the achievements reached with the progress made in this period. We also identify areas where further progress can be made, mainly by exchanging knowledge and learning from experiences in neighbouring countries. Between 2010 and 2020, most NBS programmes in geographical Europe matured considerably, both in terms of methodology (modernised) and with regard to the panel of conditions screened (expanded). These developments indicate that more collaboration in Europe through European organisations is gaining momentum. We can only accomplish the timely detection of newborn infants potentially suffering from one of the many rare diseases and take appropriate action by working together.
Keywords: ISNS; International Society for Neonatal Screening; congenital endocrine disorders; congenital metabolic disorders; dried blood spot screening; neonatal screening; newborn screening; public health; rare diseases.Estonian Research Counci
Stroke survivors' experiences with rebuilding life in the community and exercising at home: A qualitative study.
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 DownloadAim: This study aimed to explore how stroke survivors deal with stroke-related impairments when rebuilding their lives in the community and their experiences of exercising at home.
Design: An explorative and descriptive qualitative study.
Methods: A purposive sample of ten stroke survivors residing at home was recruited to explore experiences of rebuilding their lives in the community and exercising at home. One focus group interview was conducted followed by semi-structured interviews. Data were analysed using thematic analysis.
Results: Three main themes were identified: "Framing exercise within the context of everyday life" describes how stroke survivors integrate exercise in everyday activities with varying success and the social importance of exercising; "Managing the challenges of physical impairment" describes the taxing undertakings in daily living, loss of concentration and identity; "Long-term challenges of everyday life" describes how the stroke survivors manage depression and live with a sense of uncertainty.
Keywords: home rehabilitation; qualitative research; rehabilitation; stroke patients; stroke rehabilitation.NordForsk programme on Health and Welfar
Expanding the genotypic and phenotypic spectrum in a diverse cohort of 104 individuals with Wiedemann-Steiner syndrome.
No full textWiedemann-Steiner syndrome (WSS) is an autosomal dominant disorder caused by monoallelic variants in KMT2A and characterized by intellectual disability and hypertrichosis. We performed a retrospective, multicenter, observational study of 104 individuals with WSS from five continents to characterize the clinical and molecular spectrum of WSS in diverse populations, to identify physical features that may be more prevalent in White versus Black Indigenous People of Color individuals, to delineate genotype-phenotype correlations, to define developmental milestones, to describe the syndrome through adulthood, and to examine clinicians' differential diagnoses. Sixty-nine of the 82 variants (84%) observed in the study were not previously reported in the literature. Common clinical features identified in the cohort included: developmental delay or intellectual disability (97%), constipation (63.8%), failure to thrive (67.7%), feeding difficulties (66.3%), hypertrichosis cubiti (57%), short stature (57.8%), and vertebral anomalies (46.9%). The median ages at walking and first words were 20 months and 18 months, respectively. Hypotonia was associated with loss of function (LoF) variants, and seizures were associated with non-LoF variants. This study identifies genotype-phenotype correlations as well as race-facial feature associations in an ethnically diverse cohort, and accurately defines developmental trajectories, medical comorbidities, and long-term outcomes in individuals with WSS.
Keywords: KMT2A; MLL1; Wiedemann-Steiner syndrome; hypertrichosis; syndromic intellectual disability; syndromic short stature.Institute for Translational Medicine and Therapeutics of the Perelman School of Medicine at the University of Pennsylvania
United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
NIH National Center for Advancing Translational Sciences (NCATS)
United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
Hartwell Foundatio
Reply to Deepansh Dalela, Isaac Palma-Zamora, and Craig Rogers' Letter to the Editor re: Fredrick Leidberg, Petter Kollberg, Marie Allerbo, et al. Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised Study. Eur Urol 2020;78:757-63.
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Prevalence and incidence of type 2 diabetes in Iceland 2005-2018
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 DownloadINNGANGUR
Fjöldi fólks með sykursýki 2 hefur vaxið undanfarna áratugi á Íslandi. Í
þessari rannsókn var notaður Lyfjagagnagrunnur Embættis landlæknis
til að meta algengi og nýgengi sykursýki 2 og sett fram spá um algengi
sykursýki 2 eftir 10 og 20 ár.
EFNIVIÐUR OG AÐFERÐIR
Algengi og nýgengi sykursýki á tímabilinu 2005-2018 var metið út frá
ávísunum sykursýkilyfja samkvæmt skráningum í Lyfjagagnagrunni og
borið saman við niðurstöður Áhættuþáttakönnunar Hjartaverndar frá
2004-2011 og birtar tölur frá Bandaríkjunum frá 1980-2016.
NIÐURSTÖÐUR
Algengi sykursýki 2 meira en tvöfaldaðist í nær öllum aldurshópum hjá
bæði körlum og konum á tímabilinu (18-79 ára). Nýgengi jókst um 2,8%
á ári (18-79 ára). Fólk með sykursýki 2 á Íslandi var 10.600 manns árið
2018 og hafði fjölgað úr um 4200 manns árið 2005.
Gögn úr Lyfjagagnagrunni samanborið við Áhættuþáttakönnun Hjartaverndar sýna undirmat á nýgengi sykursýki (29% hjá körlum og konum).
Haldi fólki með sykursýki á Íslandi áfram að fjölga með svipuðum
hraða og varð á árabilinu frá 2005 til 2018 gæti fjöldinn verið kominn í
tæp 24.000 manns árið 2040.
ÁLYKTUN
Línuleg aukning varð á algengi og nýgengi sykursýki 2 á Íslandi á
árunum 2005-2018. Svipuð þróun sást í Bandaríkjunum frá 1984. Til að
sporna gegn því að fjölgunin hér á landi fari inn á svipaða braut þarf að
grípa til víðtækra og markvissra aðgerða.INTRODUCTION: The number of people with type 2 diabetes has increased in Iceland in
the last few decades. We utilized the national database on prescribed medication from the
Directorate of Health to estimate the prevalence and incidence of type 2 diabetes in Iceland
and made prediction on the prevalence of type 2 diabetes in Iceland in 10 and 20 years.
MATERIAL AND METHODS: Prevalence and incidence of type 2 diabetes for the period
2005-2018 was estimated based on prescriptions of diabetes medication in the national
prescription database containing all prescriptions in Iceland during the period. The result
was compared to the result from the REFINE-Reykjavik study (prospective, population-based
cohort study) from 2004 to 2011 and published data from the USA from 1980 to 2016.
RESULTS: The prevalence of type 2 diabetes more than doubled in near all age groups in both
men and women in the period 2005-2018. The incidence increased by 2.8% annually (in 18-79
years old). The number of people in Iceland with type 2 diabetes was 10600 in 2018 and had
increased from 4200 in the year 2005.
Comparison with the results of the REFINE-Reykjavik study showed an underestimation (29%
in men and women) of the prevalence of type 2 diabetes.
If the increase in type 2 diabetes continues at a similar rate as in the years 2005-2018 the
number of people with diabetes in Iceland could be near 24000 in the year 2040.
CONCLUSION: Linear increase was seen in incidence and prevalence of people with type 2
diabetes in the years 2005-2018. Similar evolution was seen in USA from 1984. In order to
counteract the increase of type 2 diabetes following the same path as has been seen in the
USA, targeted measures are needed.Rannsóknin er kostuð af Rannsóknastöð Hjartaverndar og
með samningi Hjartaverndar og heilbrigðisráðuneytisins