Recent Submissions

  • Hearing Status in Survivors of Childhood Acute Myeloid Leukemia Treated With Chemotherapy Only: A NOPHO-AML Study.

    Skou, Anne-Sofie; Olsen, Steen Ø; Nielsen, Lars H; Glosli, Heidi; Jahnukainen, Kirsi; Jarfelt, Marianne; Jónmundsson, Guðmundur K; Malmros, Johan; Nysom, Karsten; Hasle, Henrik; 1 Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus. 2 Departments of Otorhinolaryngology, Head and Neck Surgery, and Audiology. 3 Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 4 Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland. 5 Department of Pediatric Oncology, The Queen Silvia Children's Hospital, Gothenburg. 6 Department of Pediatrics, Landspitalinn University Hospital, Reykjavik, Iceland. 7 Department of Pediatric Oncology, Karolinska University Hospital. 8 Department of Women´s and Children's Health, Karolinska Institutet, Stockholm, Sweden. 9 Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark. (Lippincott Williams & Wilkins, 2019-01-01)
    As more children survive acute myeloid leukemia (AML) it is increasingly important to assess possible late effects of the intensive treatment. Hearing loss has only sporadically been reported in survivors of childhood AML. We assessed hearing status in survivors of childhood AML treated with chemotherapy alone according to 3 consecutive NOPHO-AML trials. A population-based cohort of children treated according to the NOPHO-AML-84, NOPHO-AML-88, and NOPHO-AML-93 trials included 137 eligible survivors among whom 101 (74%) completed a questionnaire and 99 (72%) had otologic and audiologic examination performed including otoscopy (72%), pure tone audiometry (70%), and tympanometry (60%). Eighty-four of 93 (90%) eligible sibling controls completed a similar questionnaire. At a median of 11 years (range, 4 to 25) after diagnosis, hearing disorders were rare in survivors of childhood AML and in sibling controls, with no significant differences. None had severe or profound hearing loss diagnosed at audiometry. Audiometry detected a subclinical hearing loss ranging from slight to moderate in 19% of the survivors, 5% had low-frequency hearing loss, and 17% had high-frequency hearing loss. The frequency of hearing disorders was low, and hearing thresholds in survivors of childhood AML were similar to background populations of comparable age.
  • Lyme-sjúkdómur á Íslandi - faraldsfræði á árunum 2011-2015

    Hannes Bjarki Vigfússon; Hörður Snævar Harðarson; Björn Rúnar Lúðvíksson; Ólafur Guðlaugsson; 1 Sýkla- og veirufræðideild Landspítala, 2 barnadeild Hringsins,3 ónæmisfræðideild Landspítala, 4 læknadeild Háskóla Íslands, 5smitsjúkdómadeild Landspítala. (Læknafélag Íslands, Læknafélag Reykjavíkur, 2019-02)
    Inngangur: Lyme-sjúkdómur stafar af sýkingu með Borrelia burgdorferi sensu latu (B. burgdorferi sl.) og smitast með biti Ixodes mítla. Sjúkdómurinn hefur ekki verið talinn landlægur á Íslandi og aldrei hefur verið lýst tilfelli af innlendum uppruna. Engar rannsóknir hafa verið gerðar á Lyme-sjúkdómi hérlendis. Markmið rannsóknarinnar var að skoða faraldsfræði Lyme-sjúkdóms á Íslandi með sérstakri áherslu á það hvort innlent smit hafi átt sér stað. Efniviður og aðferðir: Rannsóknin náði til allra einstaklinga á Íslandi sem áttu mælingu á mótefnum gegn B. burgdorferi sl. eða höfðu fengið greininguna Lyme-sjúkdómur (ICD-10, A69.2) á Landspítala á árunum 2011-2015. Klínískum upplýsingum var safnað úr rafrænni sjúkraskrá og gagnagrunni sýkla- og veirufræðideildar Landspítala. Niðurstöður: 501 einstaklingur átti mælingu á mótefnum gegn B. burgdorferi sl. á rannsóknartímabilinu og 11 einstaklingar voru greindir með Lyme-sjúkdóm á klínískum forsendum eingöngu. 33 einstaklingar uppfylltu greiningarskilmerki fyrir staðfestu tilfelli af Lyme-sjúkdómi. 32 (97%) einstaklingar voru með erythema migrans og einn (3%) einstaklingur var með Lyme-sjúkdóm í taugakerfi. Að meðaltali greindust 6,6 tilfelli á ári (tvö tilfelli á 100.000 íbúa/ári) og áttu öll tilfellin sér erlendan uppruna. Ályktanir: Lyme-sjúkdómur er sjaldgæfur á Íslandi. Árlega greinast að meðaltali 6-7 tilfelli af sjúkdómnum hérlendis og er fyrst og fremst um að ræða staðbundnar sýkingar með erythema migrans útbrotum. Ekki fannst neitt tilfelli sem hægt er að segja að eigi sér innlendan uppruna og virðist tilfellum af sjúkdómnum ekki hafa farið fjölgandi seinustu árin.
  • Drawing forward family strengths in short therapeutic conversations from a psychiatric nursing perspective.

    Sveinbjarnardottir, Eydis Kristin; Svavarsdottir, Erla Kolbrun; 1 Faculty of Nursing, School of Health Sciences, University of Akureyri, Akureyri, Iceland. 2 Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 3 Center of Family Nursing Research and Development, Landspitali National University Hospital, Reykjavik, Iceland. (Hillsdale, N. J., Nursing Publications, 2019-01-01)
    The aim of the narrative is to describe the therapeutic process and experience from a psychiatric nursing perspective, in therapeutic communication, with a father and his son in acute psychiatry. In this case scenario, the Family Strength-Oriented Therapeutic Conversation Intervention (FAM-SOTC Intervention) was used. The FAM-SOTC Intervention was found to be beneficial for the father-son relationship. It is encouraging for nurses in acute psychiatry to know that three short therapeutic conversations can make a difference within the family system. FAM-SOTC seemed to offer cognitive and emotional support to the father-and-son dyad.
  • Development of a dietary screening questionnaire to predict excessive weight gain in pregnancy.

    Hrolfsdottir, Laufey; Halldorsson, Thorhallur I; Birgisdottir, Bryndis E; Hreidarsdottir, Ingibjörg Th; Hardardottir, Hildur; Gunnarsdottir, Ingibjorg; [ 1 ] Univ Iceland, Landspitali Univ Hosp, Unit Nutr Res, Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Fac Food Sci & Nutr, Reykjavik, Iceland [ 3 ] Akureyri Hosp, Dept Educ Sci & Qual, IS-600 Akureyri, Iceland Show more [ 4 ] Statens Serum Inst, Dept Epidemiol Res, Ctr Fetal Programming, Copenhagen, Denmark Show more [ 5 ] Landspitali Univ Hosp, Dept Obstet & Gynecol, Reykjavik, Iceland Show more [ 6 ] Univ Iceland, Fac Med, Reykjavik, Iceland (Wiley-Blackwell, 2019-01)
    Excessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11-14, using a 40-item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0-5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confidence interval, CI [1.002, 1.50]) and higher odds of delivering a macrosomic offspring (odds ratio = 2.20, 95% CI [1.14, 4.25]). The results indicate that asking simple questions about women's dietary intake early in pregnancy could identify women who should be prioritized for further dietary counselling and support.
  • Herding cats: managing gold atoms on common transparent dielectrics

    Milewska, Adrianna; Ingason, Arni S; Sigurjonsson, Olafur E; Leosson, Kristjan; [ 1 ] Innovat Ctr Iceland, Arleynir 2-8, IS-112 Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Sch Engn & Nat Sci, Saemundargata 2, IS-101 Reykjavik, Iceland [ 3 ] Grein Res Ehf, Dunhaga 5, Reykjavik, Iceland Show more [ 4 ] Landspitali Univ Hosp Iceland, Blood Bank, Snorrabraut 60, IS-105 Reykjavik, Iceland Show more [ 5 ] Reykjavik Univ, Sch Sci & Engn, Menntavegur 1, IS-101 Reykjavik, Iceland Show more [ 6 ] Univ Iceland, Sci Inst, Dunhaga 5, IS-107 Reykjavik, Iceland
    Simple methods to control the self-organization of gold atoms on commonly employed transparent dielectrics are presented. On one hand, surface diffusion of gold atoms can be suppressed to a sufficient degree as to realize ultra-thin (as low as approximately 5 nm) void-free semi-transparent conducting gold films over macroscopic areas while, on the other hand, their high surface mobility can be harnessed to fabricate large-area substrates compatible with cell culturing and imaging, having widely tunable field-enhancement properties for surface-enhanced Raman scattering.
  • Meta-analysis of Alzheimer's disease on 9,751 samples from Norway and IGAP study identifies four risk loci.

    Witoelar, Aree; Rongve, Arvid; Almdahl, Ina S; Ulstein, Ingun D; Engvig, Andreas; White, Linda R; Selbæk, Geir; Stordal, Eystein; Andersen, Fred; Brækhus, Anne; Saltvedt, Ingvild; Engedal, Knut; Hughes, Timothy; Bergh, Sverre; Bråthen, Geir; Bogdanovic, Nenad; Bettella, Francesco; Wang, Yunpeng; Athanasiu, Lavinia; Bahrami, Shahram; Le Hellard, Stephanie; Giddaluru, Sudheer; Dale, Anders M; Sando, Sigrid B; Steinberg, Stacy; Stefansson, Hreinn; Snaedal, Jon; Desikan, Rahul S; Stefansson, Kari; Aarsland, Dag; Djurovic, Srdjan; Fladby, Tormod; Andreassen, Ole A; 1 NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. 2 Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 3 Department of Molecular Medicine, University of Oslo, Oslo, Norway. 4 Department of Research and Innovation, Helse Fonna, Haugesund, Norway. 5 Department of Clinical Medicine, University of Bergen, Bergen, Norway. 6 Department of Neurology, Akershus University Hospital, Lørenskog, Norway. 7 University of Oslo, AHUS Campus, Oslo, Norway. 8 Department of Psychiatry of Old Age, Oslo University Hospital, Oslo, Norway. 9 Department of Internal Medicine, Oslo University Hospital, Oslo, Norway. 10 Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway. 11 Department of Neurology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway. 12 Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. 13 Institute of Health and Society, University of Oslo, Oslo, Norway. 14 Department of Psychiatry, Namsos Hospital, Namsos, Norway. 15 Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway. 16 Department of Community Medicine, University of Tromsø, Tromsø, Norway. 17 Geriatric Department, University Hospital Oslo and University of Oslo, Oslo, Norway. 18 Department of Geriatrics, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway. 19 Department of Medical Genetics, Oslo University Hospital, Oslo, Norway. 20 Centre for Old Age Psychiatry Research, Innlandet Hospital Trust, Ottestad, Norway. 21 NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway. 22 Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway. 23 Departments of Cognitive Sciences, University of California, San Diego, La Jolla, CA, USA. 24 Departments of Neurosciences, University of California, San Diego, La Jolla, CA, USA. 25 Department of Radiology, University of California, San Diego, La Jolla, CA, USA. 26 deCODE Genetics, Reykjavik, Iceland. 27 Landspitali University Hospital, Department of Geriatrics, Reykjavik, Iceland. 28 Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA. 29 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 30 Center for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway. 31 NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. o.a.andreassen@medisin.uio.no. 32 Institute of Clinical Medicine, University of Oslo, Oslo, Norway. o.a.andreassen@medisin.uio.no. (Nature Publishing Group, 2018-12-27)
    A large fraction of genetic risk factors for Alzheimer's Disease (AD) is still not identified, limiting the understanding of AD pathology and study of therapeutic targets. We conducted a genome-wide association study (GWAS) of AD cases and controls of European descent from the multi-center DemGene network across Norway and two independent European cohorts. In a two-stage process, we first performed a meta-analysis using GWAS results from 2,893 AD cases and 6,858 cognitively normal controls from Norway and 25,580 cases and 48,466 controls from the International Genomics of Alzheimer's Project (IGAP), denoted the discovery sample. Second, we selected the top hits (p < 1 × 10
  • Comparison of the effect of allopurinol and febuxostat on urinary 2,8-dihydroxyadenine excretion in patients with Adenine phosphoribosyltransferase deficiency (APRTd): A clinical trial.

    Edvardsson, Vidar O; Runolfsdottir, Hrafnhildur L; Thorsteinsdottir, Unnur A; Sch Agustsdottir, Inger M; Oddsdottir, G Steinunn; Eiriksson, Finnur; Goldfarb, David S; Thorsteinsdottir, Margret; Palsson, Runolfur; 1 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Children's Medical Center, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. Electronic address: vidare@lsh.is. 2 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 3 Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 4 Children's Medical Center, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 5 Department of Clinical Biochemistry, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 6 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; ArcticMass, Reykjavik, Iceland. 7 Nephrology Section, New York University Langone Medical Center, New York, NY, USA. 8 Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland; ArcticMass, Reykjavik, Iceland. 9 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Division of Nephrology, Internal Medicine Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. Electronic address: runolfur@landspitali.is. (Elsevier Science, 2018-01-01)
    Adenine phosphoribosyltransferase (APRT) deficiency is a rare, but significant, cause of kidney stones and progressive chronic kidney disease. The optimal treatment has not been established. The purpose of this pilot study was to compare the effect of the xanthine oxidoreductase inhibitors allopurinol and febuxostat on urinary 2,8-dihydroxyadenine (DHA) excretion in APRT deficiency patients. Patients listed in the APRT Deficiency Registry of the Rare Kidney Stone Consortium, currently receiving allopurinol therapy, were invited to participate. The trial endpoint was the 24-h urinary DHA excretion following treatment with allopurinol (400mg/day) and febuxostat (80mg/day). Urinary DHA was measured using a novel ultra-performance liquid chromatography - electrospray tandem mass spectrometry assay. Eight of the 10 patients invited completed the study. The median (range) 24-h urinary DHA excretion was 116 (75-289) mg at baseline, and 45 (13-112) mg after 14days of allopurinol therapy (P=0.036). At the end of the febuxostat treatment period, 4 patients had urinary DHA below detectable limits (<20ng/mL) compared with none of the participants following allopurinol treatment (P=0.036). The other 4 participants had a median 24-h urinary DHA excretion of 13.2 (10.0-13.4) mg at the completion of febuxostat therapy (P=0.036). Urinary DHA excretion in APRT deficiency patients decreased with conventional doses of both allopurinol and febuxostat. Febuxostat was, however, significantly more efficacious than allopurinol in reducing DHA excretion in the prescribed doses. This finding, which may translate into improved outcomes of patients with APRT deficiency, should be confirmed in a larger sample.
  • DPYD, TYMS and MTHFR Genes Polymorphism Frequencies in a Series of Turkish Colorectal Cancer Patients.

    Amirfallah, Arsalan; Kocal, Gizem Calibasi; Unal, Olcun Umit; Ellidokuz, Hulya; Oztop, Ilhan; Basbinar, Yasemin; [ 1 ] Univ Iceland, Fac Med, Biomed Ctr, IS-101 Reykjavik, Iceland Show more [ 2 ] Landspitali Univ Hosp, Dept Pathol, Cell Biol Unit, IS-101 Reykjavik, Iceland Show more [ 3 ] Dokuz Eylul Univ, Inst Oncol, Dept Basic Oncol, TR-35350 Izmir, Turkey [ 4 ] Genom Res Ctr BIFAGEM, Personalized Med & Pharmacogen, TR-3535 Izmir 0, Turkey Show more [ 5 ] Hlth Sci Univ, Bozyaka Educ & Res Hosp, Dept Internal Med, Div Med Oncol, TR-35170 Izmir, Turkey Show more [ 6 ] Dokuz Eylul Univ, Inst Oncol, Dept Prevent Oncol, TR-35350 Izmir, Turkey Show more [ 7 ] Dokuz Eylul Univ, Fac Med, Dept Med Informat & Biostat, TR-35350 Izmir, Turkey Show more [ 8 ] Dokuz Eylul Univ, Fac Med, Dept Clin Oncol, TR-35350 Izmir, Turkey Show more [ 9 ] Dokuz Eylul Univ, Inst Oncol, Dept Translat Oncol, TR-35350 Izmir, Turkey (MDPI AG, 2018-12-13)
    Fluoropyrimidine-based chemotherapy is extensively used for the treatment of solid cancers, including colorectal cancer. However, fluoropyrimidine-driven toxicities are a major problem in the management of the disease. The grade and type of the toxicities depend on demographic factors, but substantial inter-individual variation in fluoropyrimidine-related toxicity is partly explained by genetic factors. The aim of this study was to investigate the effect of
  • Ethical elements in priority setting in nursing care: A scoping review.

    Suhonen, Riitta; Stolt, Minna; Habermann, Monika; Hjaltadottir, Ingibjörg; Vryonides, Stavros; Tonnessen, Siri; Halvorsen, Kristin; Harvey, Clare; Toffoli, Luisa; Scott, P Anne; 1 University of Turku, Department of Nursing Science, Turku University Hospital, and City of Turku, Welfare Division, Turku, Finland. Electronic address: riisuh@utu.fi. 2 University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland. Electronic address: minna.stolt@utu.fi. 3 Hochschule Bremen Neustadtswall 30, 28199 Bremen, Germany. Electronic address: monika.habermann@hs-bremen.de. 4 University of Iceland, Clinical Nurse Specialist, University Hospital of Iceland, Iceland. Electronic address: ingihj@hi.is. 5 Cyprus University of Technology, School of Health Sciences, Department of Nursing, Limassol, Cyprus. Electronic address: svrionii@cytanet.com.cy. 6 University of Southeast Norway, Vestfold, Norway. Electronic address: Siri.Tonnessen@usn.no. 7 Oslo Metropolitan University, Oslo, Norway. Electronic address: kristin.halvorsen@oslomet.no. 8 Central Queensland University Australia, School of Nursing, Midwifery and Social Sciences, Tertiary Education Division, Mackay, Australia. Electronic address: c.l.harvey@cqu.edu.au. 9 School of Nursing and Midwifery, University of South Australia, Australia. Electronic address: luisa.toffoli@unisa.edu.au. 10 National University of Ireland Galway, Galway, Ireland. Electronic address: anne.scott@nuigalway.ie. (Pergamon Press, 2018-12-01)
    Nurses are often responsible for the care of many patients at the same time and have to prioritise their daily nursing care activities. Prioritising the different assessed care needs and managing consequential conflicting expectations, challenges nurses' professional and moral values. To explore and illustrate the key aspects of the ethical elements of the prioritisation of nursing care and its consequences for nurses. A scoping review was used to analyse existing empirical research on the topics of priority setting, prioritisation and rationing in nursing care, including the related ethical issues. The selection of material was conducted in three stages: research identification using two data bases, CINAHL and MEDLINE. Out of 2024 citations 25 empirical research articles were analysed using inductive content analysis. Nurses prioritised patient care or participated in the decision-making at the bedside and at unit, organisational and at societal levels. Bedside priority setting, the main concern of nurses, focused on patients' daily care needs, prioritising work by essential tasks and participating in priority setting for patients' access to care. Unit level priority setting focused on processes and decisions about bed allocation and fairness. Nurses participated in organisational and societal level priority setting through discussion about the priorities. Studies revealed priorities set by nurses include prioritisation between patient groups, patients having specific diseases, the severity of the patient's situation, age, and the perceived good that treatment and care brings to patients. The negative consequences of priority setting activity were nurses' moral distress, missed care, which impacts on both patient outcomes and nursing professional practice and quality of care compromise.
  • Status on fasting definition for blood sampling in the Nordic countries - time for a harmonized definition.

    Grankvist, Kjell; Sigthorsson, Gudmundur; Kristensen, Gunn B; Pelanti, Jonna; Nybo, Mads; 1 a Department of Medical Biosciences , Clinical Chemistry Umeå University , Umeå , Sweden. 2 b Department of Clinical Biochemistry , Landspitali University Hospital , Reykjavik , Iceland. 3 c Norwegian Quality Improvement of Laboratory Examinations (Noklus) , Haraldsplass Deaconess Hospital , Bergen , Norway. 4 d Labquality Oy , Helsinki , Finland. 5 e Department of Clinical Biochemistry and Pharmacology , Odense University Hospital , Odense , Denmark. (Taylor & Francis, 2018-10-19)
    The preanalytical phase contains a vast number of practices whose variation may influence the results of laboratory testing and should, therefore, be standardized. The Working Group on Preanalytical Phase of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM WG-PA) has suggested a standardization of venous blood specimen collection (VBSC) requirements for fasting samples including 12 h fasting time and water ad lib in the morning prior to specimen collection. The Nordic Scientific Preanalytical Working Group investigated the fasting definitions used in the Nordic countries. The Internet was assessed for stated fasting definitions of official organizations, larger laboratories, or laboratory groups. Fasting instructions for VBSC generally demanded patients to abstain from alcohol a day prior to, and to abstain from coffee, tea, smoking, and snuff intake in the morning of VBSC. Norway had a national fasting definition. Required fasting times varied from 8 to 14 h. The amount of water allowed in the morning of VBSC varied from ad lib to half a glass of water. The list of analytes, where fasting was required, held 9-15 analytes except for Finland with 65 analytes. Implementation of the EFLM WG-PRE standardization of VBSC requirements for fasting samples would decrease preanalytical variability and be beneficial for medical decisions and patient data comparison. We suggest the laboratories in the Nordic countries to implement the suggested fasting requirements, which are in line with those used when fasting reference intervals were established in the Nordic reference interval project.
  • Incorporating Appetite Awareness Training Within Family-Based Behavioral Treatment of Pediatric Obesity: A Randomized Controlled Pilot Study.

    Njardvik, Urdur; Gunnarsdottir, Thrudur; Olafsdottir, Anna S; Craighead, Linda W; Boles, Richard E; Bjarnason, Ragnar; [ 1 ] Univ Iceland, Dept Psychol, Saemundargata 1, IS-101 Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Fac Med, Reykjavik, Iceland Show more [ 3 ] Univ Iceland, Fac Hlth Promot Sport & Leisure Studies, Reykjavik, Iceland Show more [ 4 ] Emory Univ, Dept Psychol, Atlanta, GA 30322 USA Show more [ 5 ] Univ Colorado, Sch Med, Anschutz Med Campus, Boulder, CO 80309 USA Show more [ 6 ] Univ Iceland, Fac Med, Reykjavik, Iceland Show more [ 7 ] Landspitali Univ Hosp, Childrens Med Ctr, Reykjavik, Iceland (Oxford University Press, 2018-10-01)
    To assess additive effects of incorporating appetite awareness training (AAT), a strategy to encourage eating in response to hunger and satiety cues, within a family-based behavioral treatment (FBT) for childhood obesity. Total 84 families with a child with obesity in the age range of 8-12 years, Body Mass Index Standard Deviation Score (BMI-SDS)  ≥ 2, and a participating parent were randomly allocated to two conditions; standard FBT was compared with FBT incorporating AAT strategies (FBT-AAT). Treatment consisted of group therapy sessions (held separately for children and parents) as well as single-family (parent-child dyad) sessions (24 sessions total) delivered over 18 weeks at a tertiary care outpatient clinic. One booster session was provided 1-year posttreatment and a final follow-up assessment was conducted at 2 years. The primary outcome was change in child standardized body mass index (BMI-SDS). The two conditions did not differ significantly at posttest, but the FBT-AAT group was at a significantly lower weight compared with FBT at both the first-year, F(1, 82) = 4.150, p<.05, and the second-year follow-ups, F(1, 82) = 14.912, p <.001. It was notable that over the second-year of follow-up, the FBT-AAT group continued to show improvement, whereas the FBT group did not. Incorporating specific self-regulatory training in attending to hunger and fullness signals during a standardized family-based treatment may have enhanced the long-term maintenance of treatment effects. Findings are promising and warrant further study.
  • Health status and functional profile at admission to nursing homes A population based study over the years 2003-2014: comparison between people with and without diabetes

    Sigurdardottir, A. K.; Olafsson, K.; Arnardottir, R. H.; Hjaltadottir, I.; [ 1 ] Univ Akureyri, Sch Hlth Sci, Solborg V Nordursloo, Akureyri, Iceland [ 2 ] Akureyri Hosp, Eyrarlandsvegi, Akureyri, Iceland [ 3 ] Univ Akureyri, Sch Humanities & Social Sci, IS-600 Solborg V Nordursloo, Akureyri, Iceland Show more [ 4 ] Uppsala Univ, Dept Med Sci Resp Allergy & Sleep Res, Akad Sjukhuset, Uppsala, Sweden Show more [ 5 ] Univ Iceland, Sch Hlth Sci, Reykjavik, Iceland Show more [ 6 ] Landspitali Univ Hosp Iceland, Reykjavik, Iceland (Pacini Editore SRL, 2018-03)
    Background & Aims. Prevalence of diabetes in adults has been increasing in the last decades. Diabetes increases demand for nursing homes admission which is expensive for public and private finances. The aims of the study were to examine the prevalence of diabetes at admission to nursing homes in Iceland over 12 years, and to compare overall health, functioning, medication and medical diagnosis of residents with diabetes to those without diabetes. Methods. A retrospective study of data obtained from the Minimum Data Set records at admission to nursing homes in Iceland during the years 2003-2014. Statistical analysis was carried out using a Chi-square-test, unpaired Student´s t-test, linear regression and logistic regression. Results. In total 5242 residents were assessed within 180 days from admission, 730 had diabetes (13.9%). Prevalence of diabetes increased from 9.4% in 2003 to 15% in 2014, with a peak of 19.1% in 2013. Mean age was 81.0 (SD 8.2) and 82.7 (SD 8.7) years for residents with and without diabetes, respectively (p < 0.001). Comorbidities like hypertension, congestive heart-failure, kidney-failure, arthritis, ulcers and amputations were more common among residents with diabetes, whereas cognitive diseases were more common in the other group. Conclusions. The prevalence of diabetes in Icelandic nursing homes is increasing. Residents with diabetes are younger and have better cognitive performance, but suffer more physical disability and serious comorbidities than others. Nursing homes’ staff need to be current in diabetes management to provide quality care.
  • Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study.

    Peters, Lars; Mocroft, Amanda; Grint, Daniel; Moreno, Santiago; Calmy, Alexandra; Jevtovic, Djordje; Sambatakou, Helen; Lacombe, Karine; De Wit, Stephane; Rockstroh, Jürgen; Smidt, Jelena; Karpov, Igor; Grzeszczuk, Anna; Haziosmanovic, Vesnadarjan; Gottfredsson, Magnus; Radoi, Roxana; Kuzovatova, Elena; Orkin, Chloe; Ridolfo, Anna Lisa; Zapirain, Jose; Lundgren, Jens; 1 CHIP, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. 2 University College London Medical School, Primary Care and Population Sciences, London, United Kingdom. 3 London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, United Kingdom. 4 Hospital Universitario Ramón y Cajal-IRYCIS, Infectious Diseases Department, Madrid, Spain. 5 University Hospital Geneva, Geneva, Switzerland. 6 The Institute for Infectious & Tropical Diseases, Belgrade, Serbia. 7 Athens Medical School, Hippokration General Hospital, Athens, Greece. 8 Hopital Saint-Antoine, Paris, France. 9 CHU Saint-Pierre Hospital, Brussels, Belgium. 10 University of Bonn, Department of Medicine I, Bonn, Germany. 11 Narva AIDS Centre, Kohtla-Järve, Estonia. 12 Belarus State Medical University, Minsk, Belarus. 13 Uniwersytet Medyczny w Bialymstoku, Department of Infectious Diseases, Bialystok, Poland. 14 Klinicki Centar Univerziteta Sarajevo, Sarajevo, Bosnia & Herzegovina. 15 University of Iceland and Landspitali University Hospital, Reykjavik, Iceland. 16 Dr. Victor Babes Hospital, Spitalul de Boli Infectioase si Tropicale, Bucharest, Romania. 17 Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology, Nizhny Novgorod, Russia. 18 Royal London Hospital, London, United Kingdom. 19 Osp. L. Sacco, Milan, Italy. 20 Hospital Universitario de Alava, Vitoria-Gasteiz, Spain. (International Medical Press, 2018-01-01)
    According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study. All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events. 953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4 Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy.
  • Skills and Practices of European Orthopedic Nurses in Empowering Patient Education.

    Klemetti, Seija; Ingadottir, Brynja; Katajisto, Jouko; Lemonidou, Chryssoula; Papastavrou, Evridiki; Valkeapää, Kirsi; Zabalegui, Adelaida; Leino-Kilpi, Helena; 1 Department of Nursing Science, University of Turku, Turku, Finland seija.klemetti@utu.fi seija.klemetti@tyks.fi. 2 CNS, Department of Otorhinolaryngology, Head and Neck Surgery, Turku University Hospital, Turku, Finland. 3 Department of Surgery, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. 4 Faculty of Nursing, University of Iceland, Reykjavik, Iceland. 5 Department of Mathematics and Statistics, University of Turku, Turku, Finland. 6 Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece. 7 Cyprus University of Technology, Limassol, Cyprus. 8 Department of Nursing Science, University of Turku, Turku, Finland. 9 Hospital Clinic of Barcelona, Barcelona, Spain. 10 Nurse Director, Turku University Hospital, Turku, Finland. (Springer, 2018-11-01)
    This study provides an overview of the self-defined skills and practices of European orthopedic nurses in empowering patient education. Nurses themselves have highlighted the necessity to enhance their own skills, but possibilities for further education have been limited.
  • Early Introduction of Egg and the Development of Egg Allergy in Children: A Systematic Review and Meta-Analysis.

    Al-Saud, Bandar; Sigurdardóttir, Sigurveig T; 1 Section of Pediatric Allergy/Immunology, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabiabanderkh@hotmail.com. 2 College of Medicine, Alfaisal University, Riyadh, Saudi Arabiabanderkh@hotmail.com. 3 Department of Immunology, Landspitali University Hospital, Reykjavik, Iceland. 4 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. (Karger, 2018)
    The timing of the introduction of egg to an infant's diet is of current interest, as new evidence raises questions regarding the benefit of delaying egg introduction. The objective of this study was to systematically review the existing literature regarding the effect of the early introduction of egg on the development of egg allergy. Literature searches were conducted in MEDLINE, EMBASE, and CENTRAL, and trial protocols were searched in Meta Register and OpenGREY. Only randomized controlled trials (RCTs) comparing early (between 3 and 6 months of age) egg introduction to no early introduction were included. The primary outcome was the development of egg allergy. Of the 416 articles identified and screened, 6 RCTs met the eligibility criteria for data extraction. Allergic outcomes were evaluated in a total of 3,032 participants. A low to moderate level of evidence showed a benefit of the early introduction of egg (relative risk, RR 0.60, 95% CI 0.44-0.82, p = 0.002, mild heterogeneity, I2 = 23%). The absolute risk reduction for a population with an incidence of egg allergy of 9.3% was 37 fewer cases (95% CI 17-52) per 1,000 people. Consumption of < 4,000 mg/week of egg protein had a greater preventive effect than a higher dose. This systematic review and meta-analysis showed an association between the early introduction of egg and a lower risk of egg allergy. Furthermore, the nature and dose of egg protein exposure may play a role. These findings should be addressed in the context of primary studies.
  • Discovery of the first genome-wide significant risk loci for attention deficit/hyperactivity disorder.

    Demontis, Ditte; Walters, Raymond K; Martin, Joanna; Mattheisen, Manuel; Als, Thomas D; Agerbo, Esben; Baldursson, Gísli; Belliveau, Rich; Bybjerg-Grauholm, Jonas; Bækvad-Hansen, Marie; Cerrato, Felecia; Chambert, Kimberly; Churchhouse, Claire; Dumont, Ashley; Eriksson, Nicholas; Gandal, Michael; Goldstein, Jacqueline I; Grasby, Katrina L; Grove, Jakob; Gudmundsson, Olafur O; Hansen, Christine S; Hauberg, Mads Engel; Hollegaard, Mads V; Howrigan, Daniel P; Huang, Hailiang; Maller, Julian B; Martin, Alicia R; Martin, Nicholas G; Moran, Jennifer; Pallesen, Jonatan; Palmer, Duncan S; Pedersen, Carsten Bøcker; Pedersen, Marianne Giørtz; Poterba, Timothy; Poulsen, Jesper Buchhave; Ripke, Stephan; Robinson, Elise B; Satterstrom, F Kyle; Stefansson, Hreinn; Stevens, Christine; Turley, Patrick; Walters, G Bragi; Won, Hyejung; Wright, Margaret J; Andreassen, Ole A; Asherson, Philip; Burton, Christie L; Boomsma, Dorret I; Cormand, Bru; Dalsgaard, Søren; Franke, Barbara; Gelernter, Joel; Geschwind, Daniel; Hakonarson, Hakon; Haavik, Jan; Kranzler, Henry R; Kuntsi, Jonna; Langley, Kate; Lesch, Klaus-Peter; Middeldorp, Christel; Reif, Andreas; Rohde, Luis Augusto; Roussos, Panos; Schachar, Russell; Sklar, Pamela; Sonuga-Barke, Edmund J S; Sullivan, Patrick F; Thapar, Anita; Tung, Joyce Y; Waldman, Irwin D; Medland, Sarah E; Stefansson, Kari; Nordentoft, Merete; Hougaard, David M; Werge, Thomas; Mors, Ole; Mortensen, Preben Bo; Daly, Mark J; Faraone, Stephen V; Børglum, Anders D; Neale, Benjamin M; 1 The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark. 2 Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark. 3 Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark. 4 Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 5 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA. 6 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 7 MRC Centre for Neuropsychiatric Genetics & Genomics, School of Medicine, Cardiff University, Cardiff, UK. 8 Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 9 Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden. 10 Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany. 11 National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark. 12 Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark. 13 Department of Child and Adolescent Psychiatry, National University Hospital, Reykjavik, Iceland. 14 Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark. 15 Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA. 16 23andMe, Inc, Mountain View, CA, USA. 17 Program in Neurogenetics, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. 18 Center for Autism Research and Treatment and Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA. 19 Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. 20 Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA. 21 QIMR Berghofer Medical Research Institute, Brisbane, Australia. 22 Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark. 23 deCODE genetics/Amgen, Reykjavík, Iceland. 24 Faculty of Medicine, University of Iceland, Reykjavík, Iceland. 25 Institute of Biological Psychiatry, MHC Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark. 26 Genomics plc, Oxford, UK. 27 Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany. 28 Department of Epidemiology, Harvard Chan School of Public Health, Boston, MA, USA. 29 Queensland Brain Institute, University of Queensland, Brisbane, Australia. 30 NORMENT KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway. 31 Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 32 Psychiatry, Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, Canada. 33 Department of Biological Psychology, Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands. 34 EMGO Institute for Health and Care Research, Amsterdam, The Netherlands. 35 Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain. 36 Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain. 37 Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain. 38 Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Barcelona, Catalonia, Spain. 39 Departments of Human Genetics (855) and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands. 40 Department of Psychiatry, Genetics, and Neuroscience, Yale University School of Medicine, New Haven, CT, USA. 41 Veterans Affairs Connecticut Healthcare Center, West Haven, CT, USA. 42 The Center for Applied Genomics, The Children´s Hospital of Philadelphia, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 43 K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway. 44 Haukeland University Hospital, Bergen, Norway. 45 Department of Psychiatry, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 46 Veterans Integrated Service Network (VISN4) Mental Illness Research, Education, and Clinical Center (MIRECC), Crescenz VA Medical Center, Philadephia, PA, USA. 47 School of Psychology, Cardiff University, Cardiff, UK. 48 Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany. 49 Department of Neuroscience, School for Mental Health and Neuroscience (MHENS), Maastricht University, Maastricht, The Netherlands. 50 Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 51 Child Health Research Centre, University of Queensland, Brisbane, Australia. 52 Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia. 53 Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany. 54 Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 55 ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 56 Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 57 Institute for Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 58 Friedman Brain Institute, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 59 Mental Illness Research Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, New York, USA. 60 Institute of Psychiatry, Psychology & Neuroscience, Kings College, London, UK. 61 Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC, USA. 62 Department of Psychology, Emory University, Atlanta, GA, USA. 63 Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark. 64 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 65 Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark. 66 Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland. 67 Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA. sfaraone@childpsychresearch.org. 68 The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark. anders@biomed.au.dk. 69 Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark. anders@biomed.au.dk. 70 Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark. anders@biomed.au.dk. 71 Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. bneale@broadinstitute.org. 72 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA. bneale@broadinstitute.org. 73 Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA. bneale@broadinstitute.org. (Nature Publishing Group, 2019-01-01)
    Attention deficit/hyperactivity disorder (ADHD) is a highly heritable childhood behavioral disorder affecting 5% of children and 2.5% of adults. Common genetic variants contribute substantially to ADHD susceptibility, but no variants have been robustly associated with ADHD. We report a genome-wide association meta-analysis of 20,183 individuals diagnosed with ADHD and 35,191 controls that identifies variants surpassing genome-wide significance in 12 independent loci, finding important new information about the underlying biology of ADHD. Associations are enriched in evolutionarily constrained genomic regions and loss-of-function intolerant genes and around brain-expressed regulatory marks. Analyses of three replication studies: a cohort of individuals diagnosed with ADHD, a self-reported ADHD sample and a meta-analysis of quantitative measures of ADHD symptoms in the population, support these findings while highlighting study-specific differences on genetic overlap with educational attainment. Strong concordance with GWAS of quantitative population measures of ADHD symptoms supports that clinical diagnosis of ADHD is an extreme expression of continuous heritable traits.
  • Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis.

    Cassini, Alessandro; Högberg, Liselotte Diaz; Plachouras, Diamantis; Quattrocchi, Annalisa; Hoxha, Ana; Simonsen, Gunnar Skov; Colomb-Cotinat, Mélanie; Kretzschmar, Mirjam E; Devleesschauwer, Brecht; Cecchini, Michele; Ouakrim, Driss Ait; Oliveira, Tiago Cravo; Struelens, Marc J; Suetens, Carl; Monnet, Dominique L; Gudlaugasson, Olafur; [ 1 ] European Ctr Dis Prevent & Control, S-16973 Solna, Sweden Show more [ 2 ] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands Show more [ 3 ] Univ Hosp North Norway, Tromso, Norway Show more [ 4 ] UiT Arctic Univ Norway, Res Grp Host Microbe Interact, Fac Hlth Sci, Tromso, Norway Show more [ 5 ] Sante Publ France, St Maurice, France Show more [ 6 ] Natl Inst Publ Hlth & Environm RIVM, Ctr Infect Dis Control, Bilthoven, Netherlands [ 7 ] Sciensano, Dept Epidemiol & Publ Hlth, Brussels, Belgium Show more [ 8 ] Univ Ghent, Fac Vet Med, Dept Vet Publ Hlth & Food Safety, Merelbeke, Belgium [ 9 ] Org Econ Cooperat & Dev, Paris, France [ 10 ] Fed Minist Hlth & Women, Vienna, Austria [ 11 ] Sciensano, Brussels, Belgium [ 12 ] Natl Ctr Infect & Parasit Dis, Sofia, Bulgaria [ 13 ] Univ Hosp Infect Dis, Zagreb, Croatia Show more [ 14 ] Univ Zagreb, Univ Hosp Ctr Zagreb, Sch Med, Zagreb, Croatia [ 15 ] Amer Med Ctr, Nicosia, Cyprus Show more [ 16 ] Natl Inst Publ Hlth, Prague, Czech Republic Show more [ 17 ] Charles Univ Prague, Univ Hosp, Hradec Kralove, Czech Republic Show more [ 18 ] Charles Univ Prague, Fac Med, Hradec Kralove, Czech Republic Show more [ 19 ] Statens Serum Inst, Copenhagen, Denmark [ 20 ] West Tallinn Cent Hosp, Estonia & Hlth Board, Tallinn, Estonia [ 21 ] East Tallinn Cent Hosp, Tallinn, Estonia Show more [ 22 ] Natl Inst Hlth & Welf THL, Helsinki, Finland [ 23 ] French Publ Hlth Agcy, Paris, France Show more [ 24 ] Robert Koch Inst, Berlin, Germany Show more [ 25 ] Univ Athens, Athens, Greece Show more [ 26 ] Univ Hosp Heraklion, Iraklion, Greece Show more [ 27 ] Univ Athens, Med Sch, Athens, Greece [ 28 ] Hellen Ctr Dis Control & Prevent, Athens, Greece [ 29 ] Natl Publ Hlth Inst, Budapest, Hungary [ 30 ] Minist Human Capac, Budapest, Hungary Show more [ 31 ] Landspitali Univ Hosp, Reykjavik, Iceland Show more [ 32 ] Univ Iceland, Reykjavik, Iceland [ 33 ] Hlth Protect Surveillance Ctr, Dublin, Ireland Show more [ 34 ] Ist Super Sanita, Rome, Italy [ 35 ] Reg Agcy Hlth & Social Care Emilia Romagna, Bologna, Italy Show more [ 36 ] Univ Latvia, Pauls Stradins Clin Univ Hosp, Riga, Latvia [ 37 ] Ctr Publ Hlth Technol, Inst Hyg, Vilnius, Lithuania [ 38 ] Natl Hlth Lab, Luxembourg, Luxembourg [ 39 ] Mater Dei Hosp, Msida, Malta Show more [ 40 ] Univ Malta, Msida, Malta Show more [ 41 ] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands Show more [ 42 ] Norwegian Inst Publ Hlth, Oslo, Norway Show more [ 43 ] Natl Med Inst, Warsaw, Poland Show more [ 44 ] Nicolaus Copernicus Univ, Torun, Poland Show more [ 45 ] Ludwik Rydygier Coll Med, Bydgoszcz, Poland Show more [ 46 ] Natl Med Inst, Warsaw, Poland [ 47 ] Directorate Gen Hlth, Lisbon, Portugal Show more [ 48 ] Natl Inst Hlth Dr Ricardo Jorge, Lisbon, Portugal Show more [ 49 ] Natl Inst Infect Dis Prof Dr Matei Bals, Bucharest, Romania [ 50 ] Natl Inst Publ Hlth, Bucharest, Romania [ 51 ] Louis Pasteur Univ Hosp, Kosice, Slovakia [ 52 ] Publ Hlth Author, Trencin, Slovakia Show more [ 53 ] Alexander Dubcek Univ, Trencin, Slovakia [ 54 ] Natl Inst Publ Hlth, Ljubljana, Slovenia Show more [ 55 ] Hosp Univ Puerta Hierro Majadahonda, Madrid, Spain Show more [ 56 ] Inst Salud Carlos III, Madrid, Spain [ 57 ] Publ Hlth Agcy Sweden, Stockholm, Sweden [ 58 ] Hlth Protect Scotland, Glasgow, Lanark, Scotland Show more [ 59 ] Glasgow Caledonian Univ, Glasgow, Lanark, Scotland (Elsevier Science, 2019-01-01)
    Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs). We estimated the incidence of infections with 16 antibiotic resistance-bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011-12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature. From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148-763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480-38 430) attributable deaths and 874 541 (768 837-989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece. Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases.
  • Genetic counselling and testing of susceptibility genes for therapeutic decision-making in breast cancer-an European consensus statement and expert recommendations.

    Singer, Christian F; Balmaña, Judith; Bürki, Nicole; Delaloge, Suzette; Filieri, Maria Elisabetta; Gerdes, Anna-Marie; Grindedal, Eli Marie; Han, Sileni; Johansson, Oskar; Kaufman, Bella; Krajc, Mateja; Loman, Niklas; Olah, Edith; Paluch-Shimon, Shani; Plavetic, Natalija Dedic; Pohlodek, Kamil; Rhiem, Kerstin; Teixeira, Manuel; Evans, D Gareth; 1 Medical University of Vienna, Department of Obstetrics and Gynecology, Vienna, Austria. Electronic address: christian.singer@meduniwien.ac.at. 2 Medical Oncology Department, Hospital Vall d'Hebron, Vall d'Hebron, Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain. 3 Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Spitalstrasse 21, 4031, Basel, Switzerland. 4 Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France. 5 Department of Medical Oncology, University Hospital of Modena, Via del Pozzo, Modena, Italy. 6 Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark. 7 Department of Medical Genetics, Oslo University Hospital, Oslo, Norway. 8 Department of Gynecology and Obstetrics, UZ Leuven, Leuven, Belgium. 9 Landspitali-the National University Hospital of Iceland, Reykjavik 101, Iceland. 10 Breast Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel. 11 Institute of Oncology Ljubljana, Slovenia, Zaloska 2, 1000 Ljubljana, Slovenia. 12 Department of Clinical Sciences, Division of Oncology and Pathology, Lund University Hospital, 221 85 Lund, Sweden. 13 Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary. 14 Shaare Zedek Medical Centre, Jerusalem, Israel. 15 Department of Oncology, Division of Medical Oncology, University Hospital Centre Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia. 16 Second Department of Gynecology and Obstetrics, Comenius University of Bratislava, Faculty of Medicine, 82606 Bratislava, Slovakia. 17 Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology, Medical Faculty, University Hospital of Cologne, D-50931 Cologne, Germany. 18 Department of Genetics, Portuguese Oncology Institute, Porto, Portugal. 19 Department of Genomic Medicine, Division of Evolution and Genomic Science, University of Manchester, MAHSC, St Mary's Hospital, Manchester M13 9WL, United Kingdom. (Elsevier Science, 2019-01-01)
    An international panel of experts representing 17 European countries and Israel convened to discuss current needs and future developments in BRCA testing and counselling and to issue consensus recommendations. The experts agreed that, with the increasing availability of high-throughput testing platforms and the registration of poly-ADP-ribose-polymerase inhibitors, the need for genetic counselling and testing will rapidly increase in the near future. Consequently, the already existing shortage of genetic counsellors is expected to worsen and to compromise the quality of care particularly in individuals and families with suspected or proven hereditary breast or ovarian cancer. Increasing educational efforts within the breast cancer caregiver community may alleviate this limitation by enabling all involved specialities to perform genetic counselling. In the therapeutic setting, for patients with a clinical suspicion of genetic susceptibility and if the results may have an immediate impact on the therapeutic strategy, the majority voted that BRCA1/2 testing should be performed after histological diagnosis of breast cancer, regardless of oestrogen receptor and human epidermal growth factor receptor 2 (HER2) status. Experts also agreed that, in the predictive and therapeutic setting, genetic testing should be limited to individuals with a personal or family history suggestive of a BRCA1/2 pathogenic variant and should also include high-risk actionable genes beyond BRCA1/2. Of high-risk actionable genes, all pathological variants (i.e. class IV and V) should be reported; class III variants of unknown significance, should be reported provided that the current lack of clinical utility of the variant is expressly stated. Genetic counselling should always address the possibility that already tested individuals might be re-contacted in case new information on a particular variant results in a re-classification.
  • The impact of nursing education and job characteristics on nurse's perceptions of their family nursing practice skills.

    Svavarsdottir, Erla Kolbrun; Sigurdardottir, Anna Olafia; Konradsdottir, Elisabet; Tryggvadottir, Gudny Bergthora; 1 University of Iceland, School of Health Sciences, Faculty of Nursing, Reykjavik, Iceland. 2 Landspitali- The National University Hospital in Iceland, Reykjavik, Iceland. 3 University of Iceland, Statistical Unit, Reykjavik, Iceland. (Wiley, 2018-12-01)
    Implementing family system nursing in clinical settings is on the rise. However, little is known about the impact of graduate school education as well as continuing education in family systems nursing (FSN) on nurses' perceptions of their family nursing practice. To evaluate the level of nursing education, having taken a continuing hospital educational course in family system nursing (FN-ETI programme), and the impact of job characteristics on nurses' perceptions of their family nursing practice skills. Participants were 436 nurses with either a BSc degree or graduate degree in nursing. The Job Demand, Control and Support model guided the study (R. Karasek and T. Theorell, 1992, Healthy Work: Stress, Productivity, and the Reconstruction of Working Life, Basic Books, New York, NY). Scores for the characteristics of job demands and job control were created to categorise participants into four job types: high strain (high demand, low control), passive (low demand, low control), low strain (low demand, high control) and active (high demand, high control). Nurses with a graduate education who had taken the FN-ETI programme scored significantly higher on the Family Nursing Practice Scale than nurses with an undergraduate education. Nurses who were characterised as low strain or active scored significantly higher on the Family Nursing Practice Scale than the nurses who were characterised as high strain. Further, the interaction of education by job type was significant regarding family nursing practice skills. Hierarchical regression revealed 25% of the variance in family nursing practice skills was explained by job control, family policy on the unit, graduate education and employment on the following divisions: Maternal-Child, Emergency, Mental Health or Internal Medicine.
  • NT5C2 germline variants alter thiopurine metabolism and are associated with acquired NT5C2 relapse mutations in childhood acute lymphoblastic leukaemia.

    Tulstrup, Morten; Grosjean, Marie; Nielsen, Stine Nygaard; Grell, Kathrine; Wolthers, Benjamin Ole; Wegener, Peder Skov; Jonsson, Olafur Gisli; Lund, Bendik; Harila-Saari, Arja; Abrahamsson, Jonas; Vaitkeviciene, Goda; Pruunsild, Kaie; Toft, Nina; Holm, Mette; Hulegårdh, Erik; Liestøl, Sigurd; Griskevicius, Laimonas; Punab, Mari; Wang, Jinhua; Carroll, William L; Zhang, Zeyu; Dalgaard, Marlene D; Gupta, Ramneek; Nersting, Jacob; Schmiegelow, Kjeld; 1 Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark. 2 Department of Bio and Health Informatics, Technical University of Denmark, Kongens Lyngby, Denmark. 3 Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 4 Department of Pediatric Hematology and Oncology, H. C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. 5 Department of Pediatrics, Landspitali University Hospital, Reykjavík, Iceland. 6 Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. 7 Department of Laboratory Medicine, Faculty of Medicine and Health sciences, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway. 8 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. 9 Department of Pediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 10 Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 11 Department of Onco-haematology, Talinn Children's Hospital, Talinn, Estonia. 12 Department of Hematology, University Hospital Rishospitalet, Copenhagen, Denmark. 13 Department of Haematology, Aarhus University Hospital, Aarhus, Denmark. 14 Department of Hematology and Coagulation, Sahlgrenska University Hospital, Göteborg, Sweden. 15 Department of Hematology, Ullevål University Hospital, Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway. 16 Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 17 Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania. 18 Clinic of Hematology and Oncology, Tartu University Clinic, Tartu, Estonia. 19 Masonic Cancer Center, Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA. 20 Department of Pediatrics, New York University Medical Center, Perlmutter Cancer Center, New York, NY, USA. 21 Sino-Danish Center for Education and Research, University of Chinese Academy of Sciences, Beijing, China. 22 Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark. kjeld.schmiegelow@regionh.dk. 23 Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. kjeld.schmiegelow@regionh.dk. (Nature Publishing Group, 2018-12-01)
    The antileukaemic drug 6-mercaptopurine is converted into thioguanine nucleotides (TGN) and incorporated into DNA (DNA-TG), the active end metabolite. In a series of genome-wide association studies, we analysed time-weighted means (

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