Landspítali University Hospital Research Archive
Not a member yet
7973 research outputs found
Sort by
Preparation and handling of digital orthopantomograms for research work at the Faculty of Odontology of the University of Iceland
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 DownloadRannsóknir eru undirstaða faglegrar þekkingar og nútíma tannlækninga. Hlutverk Tannlæknadeildar Háskóla Íslands
(THÍ) er meðal annars að sinna rannsóknarstarfi. Miklu máli skiptir að hægt sé að nálgast þau gögn sem verða til á deildinni
og nýta til rannsóknarstarfs. Í dag er notast við hugbúnaðinn Sidexis XG til að halda utan um OPG myndir sem teknar eru
á THÍ. Leggja þarf í talsverða vinnu til að undirbúa myndir svo hægt sé að nýta þær til rannsókna. Miklu máli skiptir að sá
hugbúnaður sem notaður er styðji við og auðveldi rannsóknarstarf sem best. Sidexis XG torveldar aðgengi að myndum
á margan hátt og lýtur út fyrir að nýrri útgáfa hans geri það enn frekar. Hugbúnaðurinn er fyrst og fremst hugsaður til
að styðja við klínískt starf á tannlæknastofu og ekki er hugsað fyrir aðgengi vegna rannsóknarstarfs. Það er sárt til þess
að hugsa ef dýrmæt gögn á tannlæknastofum landsins eru óaðgengileg og þar með ónýtanleg til rannsóknastarfs.Researches is the foundation of professional knowledge and modern dentistry. One of the role of the Faculty of Odontology,
University of Iceland is to conduct research work. It is very important that the data available at the Faculty can be accessed and used
for study purposes. Today, the software Sidexis XG is used to manage OPG images taken on THÍ. Considerable work must be done
to prepare images for their use in researches. It is important that the software used supports and facilitates the study work. Sidexis
XG obstructs access to images in many ways and it seems like its successor does it even more. The software is primarily designed
to support clinical work and not researches. It is strange to think if valuable data in dental clinics of the country and especially in
university clinic are not accessible as a study material
Are dental implants better than natural teeth?
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 DownloadAlnetið býr yfir miklum fróðleik af ýmsum toga. Þar úir og grúir af upplýsingum um tannplanta, en upplýsingar um tennur eru af
skornum skammti. Í þessari grein eru bornar saman lifunarhorfur tannplanta við lifunarhorfur náttúrulegra tanna og áhrifaþættir
ræddir. Til einföldunar er umræðan byggð á hefðbundinni flokkun tanna í öruggar, vafasamar og vonlausar. Öruggar tennur ættu
að endast vel og lengi án mikillar meðferðarþarfar. Vafasamar tennur gætu þurft á talsverðri meðferð að halda og stöðugu eftirlit.
Eina meðferð sem skynsamleg er fyrir vonlausar tennur, er úrdráttur. Margvíslegir áhættuþættir geta aukið líkur á því að vafasöm
tönn lendi sem vonlaus tönn og sé fjarlægð. Rétt er að benda á að tannplantar eiga sér aldrei betri horfur en heil og heilbrigð tönn.
Tannplantar og plantaborin tanngervi eru afbragðskostir til að bæta fyrir tapaðar tennur, en eiga aldrei að koma í stað heilbrigðra,
náttúrulegra tanna.There is vast amount of information on dental treatment on the internet, often indicating excellent survival and success rates of
different types of implant-supported fixed dental prostheses. However, there is much less information regarding survival and success
rates of the natural teeth – sometimes leaving the reader a bit confused, if natural teeth are as good as dental implants. The present
article emphasizes the importance of making an evidence-based treatment plan with the best possible outcome for the patient.
Dental implants and implant-supported restorations are an excellent treatment modality, but it must always be kept in mind that
it is associated with a risk of biological and technical complications. Implants are supposed to replace missing teeth – they are not
supposed to replace teeth
Effect of vaccination on the use of antimicrobial agents: a systematic literature review.
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 DownloadBackground: Antimicrobial resistance is a growing global health threat. To preserve the effectiveness of antimicrobials, it is important to reduce demand for antimicrobials.
Objectives: The objective of the study was to screen the existing peer-reviewed literature to identify articles that addressed the potential impact of influenza or Pneumococcus vaccination on antibiotic usage. Data sources: PubMed, Embase Study eligibility criteria: Clinical studies where antimicrobial prescribing was assessed in both vaccinated and unvaccinated populations. Participants and interventions: All patient populations were included (infants, children, adults and elderly), where the effects of the intervention (vaccination) was assessed.
Results: We identified unique 3638 publications, of which 26 were judged to be of sufficiently high quality to allow the calculation of the potential impact of vaccination. Of these studies 23/26 found a significant reduction in antibiotic use by at least one of the parameters assessed.
Limitations: Different measures used to define anti-microbial use, studies typically focus on specific risk groups and most studies are from high-income countries. Conclusions and implications of key findings: Despite the limitations of the review, the evidence indicates that improved coverage with existing vaccines may significantly reduce antimicrobial demand. This suggests it may be a valuable tool for antimicrobial stewardship. Key messages While vaccines against a number of pathogens have been studied for their ability to reduce antimicrobial use, currently only vaccination against influenza or pneumococcus has generated sufficient data for analysis Vaccination against either influenza or pneumococcus significantly reduced overall antimicrobial prescribing rates, both in vaccinated individuals and at a population level Maintaining and expanding vaccination coverage thus appears to be a key tool for antimicrobial stewardship.
Keywords: Vaccination; antimicrobial resistance; antimicrobial use; meta-analysis.GlaxoSmithKlin
Sociodemographic and health status predictors of parental role strain: A general population study.
No full textTo access publisher's full text version of this article click on the hyperlink belowAims: Numerous studies indicate that stressors associated with parenthood can adversely affect parental well-being and children's psychosocial development. The aim of the study was to analyze sociodemographic differences in parental role strain in the general parental population. Methods: The study is based on a national postal survey of a random sample of 605 Icelandic mothers and fathers of children under 18. Results: Parental role strain was related to young parental age at first birth, female gender, non-married status, age of youngest child, age range of children, number of children in the household, and the parent's own chronic illness. Furthermore, chronic illness or disability of a child was markedly related to higher parental role strain, although the relationship was partly reduced with parental employment. Conclusions: Parental role strain is unevenly distributed in the parental population and varies by sociodemographic and health statuses of parents and children. Understanding and addressing parental role strain could improve parental mental health and help create a family environment that enhances the psychosocial development of children
Assessing cardiovascular risks from a mid-thigh CT image: a tree-based machine learning approach using radiodensitometric distributions.
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 nonlinear trimodal regression analysis (NTRA) method based on radiodensitometric CT distributions was recently developed and assessed for the quantification of lower extremity function and nutritional parameters in aging subjects. However, the use of the NTRA method for building predictive models of cardiovascular health was not explored; in this regard, the present study reports the use of NTRA parameters for classifying elderly subjects with coronary heart disease (CHD), cardiovascular disease (CVD), and chronic heart failure (CHF) using multivariate logistic regression and three tree-based machine learning (ML) algorithms. Results from each model were assembled as a typology of four classification metrics: total classification score, classification by tissue type, tissue-based feature importance, and classification by age. The predictive utility of this method was modelled using CHF incidence data. ML models employing the random forests algorithm yielded the highest classification performance for all analyses, and overall classification scores for all three conditions were excellent: CHD (AUCROC: 0.936); CVD (AUCROC: 0.914); CHF (AUCROC: 0.994). Longitudinal assessment for modelling the prediction of CHF incidence was likewise robust (AUCROC: 0.993). The present work introduces a substantial step forward in the construction of non-invasive, standardizable tools for associating adipose, loose connective, and lean tissue changes with cardiovascular health outcomes in elderly individuals
Transforming growth factor β-mediated micromechanics modulates disease progression in primary myelofibrosis.
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 DownloadPrimary myelofibrosis (PMF) is a Ph-negative myeloproliferative neoplasm (MPN), characterized by advanced bone marrow fibrosis and extramedullary haematopoiesis. The bone marrow fibrosis results from excessive proliferation of fibroblasts that are influenced by several cytokines in the microenvironment, of which transforming growth factor-β (TGF-β) is the most important. Micromechanics related to the niche has not yet been elucidated. In this study, we hypothesized that mechanical stress modulates TGF-β signalling leading to further activation and subsequent proliferation and invasion of bone marrow fibroblasts, thus showing the important role of micromechanics in the development and progression of PMF, both in the bone marrow and in extramedullary sites. Using three PMF-derived fibroblast cell lines and transforming growth factor-β receptor (TGFBR) 1 and 2 knock-down PMF-derived fibroblasts, we showed that mechanical stress does stimulate the collagen synthesis by the fibroblasts in patients with myelofibrosis, through the TGFBR1, which however seems to be activated through alternative pathways, other than TGFBR2.
Keywords: TGF-β; fibroblast activation; invasion; micromechanics; myelofibrosis; proliferation.School of Doctoral Studies-Iuliu Hatieganu University
Romanian Government
Ion Chiricuta Oncology Institute Cluj Napoca
international collaborative grant of the European Economic Space between Romania and Iceland 2020-2022
1
Estimation of intracardiac shunts in young children with a novel indicator dilution technology.
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 DownloadGenome-wide association studies have identified breast cancer risk variants in over 150 genomic regions, but the mechanisms underlying risk remain largely unknown. These regions were explored by combining association analysis with in silico genomic feature annotations. We defined 205 independent risk-associated signals with the set of credible causal variants in each one. In parallel, we used a Bayesian approach (PAINTOR) that combines genetic association, linkage disequilibrium and enriched genomic features to determine variants with high posterior probabilities of being causal. Potentially causal variants were significantly over-represented in active gene regulatory regions and transcription factor binding sites. We applied our INQUSIT pipeline for prioritizing genes as targets of those potentially causal variants, using gene expression (expression quantitative trait loci), chromatin interaction and functional annotations. Known cancer drivers, transcription factors and genes in the developmental, apoptosis, immune system and DNA integrity checkpoint gene ontology pathways were over-represented among the highest-confidence target genes.Swedish Children Heart Association (Stockholm, Sweden)
Anna & Edwin Bergers private foundation (Lidingo, Sweden)
Lund Universit
Interventions to prevent or reduce rationing or missed nursing care: A scoping review.
No full textTo access publisher's full text version of this article click on the hyperlink belowAims: To collate and synthesize published research on interventions developed and tested to prevent or reduce the rates of rationed or missed nursing care in healthcare institutions.
Background: Rationed and missed nursing care has been widely studied, including its predictors and associations with patient and nurse outcomes.
Design: Scoping review.
Data sources: We searched for eligible studies, published between 1980-2019, in six electronic databases.
Review methods: Researchers independently screened the abstracts of the retrieved studies using the inclusion and exclusion criteria. The decision of whether or not to include any given study was consensus-based.
Results: The search yielded 1,815 records, of which 13 were included. Three studies reported structural interventions, namely increased nurse staffing and improved nursing teamwork, both resulted in significant reductions in the rates of rationed or missed nursing care. The remaining 10 studies reported on process interventions: four concerned reminders (via technology or designated persons) and seven described interventions to change or optimize the relevant care processes. All 10 process interventions contributed to significant reductions in the rates of missed nursing care.
Conclusions: The results of the scoping review indicate that specific interventions can positively influence the performance of a selected nursing care activity, for example fall prevention. There is no evidence of a global reduction of rationed and missed nursing care through these interventions.
Impact: Clinicians, managers and researchers can use the results for adapting and implementing interventions to reduce rationed and missed nursing care.
Keywords: decision-making; interventions; nurse staffing; nursing care; prevention; quality of care; rationed and missed nursing care; scoping review; teamwork.European Cooperation in Science and Technology (COST
Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised 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 DownloadBackground: Parastomal hernia (PSH) after urinary diversion with ileal conduit is frequently a clinical problem.
Objective: To investigate whether a prophylactic lightweight mesh in the sublay position can reduce the cumulative incidence of PSH after open cystectomy with ileal conduit.
Design, setting, and participants: From 2012 to 2017, we randomised 242 patients 1:1 to conventional stoma construction (n = 124) or prophylactic mesh (n = 118) at three Swedish hospitals (ISRCTN 95093825).
Outcome measurements and statistical analysis: The primary endpoint was clinical PSH, and secondary endpoints were radiological PSH assessed in prone position with the stoma in the centre of a ring, parastomal bulging, and complications from the mesh.
Results and limitations: Within 24 mo, 20/89 (23%) patients in the control arm and 10/92 (11%) in the intervention arm had developed a clinical PSH (p = 0.06) after a median follow-up of 3 yr, corresponding to a hazard ratio of 0.45 (confidence interval 0.24-0.86, p = 0.02) in the intervention arm. The proportions of radiological PSHs within 24 mo were 22/89 (25%) and 17/92 (19%) in the two study arms. During follow-up, five patients in the control arm and two in the intervention arm were operated for PSH. The median operating time was 50 min longer in patients receiving a mesh. No differences were noted in proportions of Clavien-Dindo complications at 90 d postoperatively or in complications related to the mesh during follow-up.
Conclusions: Prophylactic implantation of a lightweight mesh in the sublay position decreases the risk of PSH when constructing an ileal conduit without increasing the risk of complications related to the mesh. The median surgical time is prolonged by mesh implantation.
Patient summary: In this randomised report, we looked at the risk of parastomal hernia after cystectomy and urinary diversion with ileal conduit with or without the use of a prophylactic mesh. We conclude that such a prophylactic measure decreased the occurrence of parastomal hernias, with only a slight increase in operating time and no added risk of complications related to the mesh.
Keywords: Bladder cancer; Cystectomy; Ileal conduit; Parastomal hernia; Prophylactic mesh.Swedish Cancer Society
Lund Medical Faculty (ALF)
Skane University Hospital Research Funds
Gyllenstierna Krapperup's Foundation
Skane County Council's Research and Development Foundation
Cancer Research Fund at Malmo General Hospital
Gosta Jonsson Research Foundation
Foundation of Urological Research
Bergqvist Foundation
Stig and Ragna Gohrton Research Foundation
Thelma Zoega Research Foundation
Hillevi Fries Research Foundatio
Stenting for colorectal cancer obstruction in Icelandic patients
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
Sjálfþenjandi málmstoðnet eru þekkt meðferð við þrengingum vegna
ristil- og endaþarmskrabbameins. Tilgangur rannsóknarinnar var
að kanna notkun slíkra stoðneta hérlendis fyrir tímabilið 2000-2018.
Skoðuð var þróun fjölda sjúklinga sem fengu stoðnet, ýmist sem brú
yfir í aðgerð eða sem líknandi meðferð, og mat lagt á fylgikvilla og
árangur.
EFNIVIÐUR OG AÐFERÐIR
Afturskyggn rannsókn á sjúklingum sem fengu sjálfþenjandi málmstoðnet á Landspítala vegna illkynja garnastíflu af völdum krabbameins
í ristli og endaþarmi. Leitað var eftir greiningar- og aðgerðalyklum í
sjúkraskrárkerfi Landspítala.
NIÐURSTÖÐUR
Alls fengu 43 sjúklingar með ristil- og endaþarmskrabbamein 53
stoðnet vegna þrengingar, sá fyrsti árið 2005. Fleiri sjúklingar fengu
stoðnet sem líknandi meðferð (n=27) en brú yfir í aðgerð (n=16). Rof á
ristli varð hjá 5 sjúklingum (12%). Meirihluti þeirra sjúklinga sem fékk
stoðnet sem brú yfir í aðgerð fór í aðgerð þar sem framkvæmd var bein
endurtenging (69%). Meirihluti sjúklinga sem fékk stoðnet sem líknandi
meðferð fór ekki í aðgerð (63%). Varanlegt stómahlutfall hjá brúar-hópi
var 27% og 22% hjá sjúklingum í líknandi meðferð.
ÁLYKTUN
Á rannsóknartímabilinu fóru flestir þeir sjúklingar, sem fengu stoðnet
sem brú yfir í aðgerð, í aðgerð með beinni endurtengingu og þeir
sjúklingar sem fengu stoðnet í líknandi tilgangi þurftu flestir ekki
aðgerð. Tíðni rofs var nokkuð há í erlendum samanburði. Skortur var á
rafrænum skráningum um tæknilegan og klínískan árangur. Í ljósi þess
að um afturskyggna rannsókn og fáa sjúklinga var að ræða, verður að
túlka allar niðurstöður með fyrirvara.INTRODUCTION: Self-expandable metal stents (SEMS) are a known treatment option for
obstruction due to colorectal cancer. The objective of this project was to estimate the usage of
such stents in Iceland between 2000-2018. We evaluated the number of patients who received the
stent as a bridge to surgery (BtoS) or as a palliative therapy (PT) and evaluated complication rate
and the technical and clinical success rate.
MATERIAL AND METHODS: Retrospective review of patients in Landspitali University Hospital who received SEMS for malignant colorectal obstruction. Search was conducted using
diagnostic and theraputic codes in the Icelandic electronic medical record system.
RESULTS: A total of 43 patients with colorectal cancer received in total 53 SEMS for obstruction,
the first patient in 2005. More patient received SEMS as PT (n=27) than as BtoS (n=16). Colon
perforation occurred in 5 patients (12%). A resection with primary anastomosis was performed
in 69% of the BtoS patients. The majority of the PT patients did not receive an operation (63%).
Permanent stoma ratio was 27% for BtoS patients and 22% for PT patients.
CONCLUSION: SEMS served as BtoS with resection and primary anastomosis for the majority
of patients in the BtoS group. For a majority of patients in the PT group, SEMS could be used to
avoid surgery. The perforation rate was relatively high. Information on techincal and clinical
success was poorly recorded. Because of the retrospective nature of the study and the small
population size all results should be interpreted with caution