• Bacterial meningitis in adults in Iceland, 1995-2010.

      Thornórðardóttir, Asgerður; Erlendsdóttir, Helga; Sigurðardóttir, Bryndís; Harðardóttir, Hjördís; Reynisson, Ingi Karl; Gottfreðsson, Magnús; Guðmundsson, Sigurður; Univ Iceland, Fac Med, Reykjavik, Iceland, Landspitali Univ Hosp, Dept Clin Microbiol, IS-105 Reykjavik, Iceland, Landspitali Univ Hosp, Dept Infect Dis, IS-105 Reykjavik, Iceland (Informa Healthcare, 2014-05)
      Bacterial meningitis is a serious disease with a mortality rate of 15-20% in adults. We conducted a population-based study of bacterial meningitis in adults (≥ 16 y) in Iceland, 1995-2010.
    • Herpes simplex encephalitis in Iceland 1987-2011.

      Dagsdóttir, Heiður Mist; Sigurðardóttir, Bryndís; Gottfreðsson, Magnús; Kristjánsson, Már; Löve, Arthur; Baldvinsdóttir, Guðrún Erna; Guðmundsson, Sigurður; 1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 2Department of Infectious Diseases, Landspítali University Hospital, Reykjavik, Iceland. 3Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland ; Department of Infectious Diseases, Landspítali University Hospital, Reykjavik, Iceland. 4Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland ; Department of Virology, Landspítali University Hospital, Reykjavik, Iceland. 5Department of Virology, Landspítali University Hospital, Reykjavik, Iceland. (SpringerPlus, 2014)
      Herpes simplex encephalitis (HSE) is a serious disease with 10-20% mortality and high rate of neuropsychiatric sequelae. This study is a long-term, nationwide study in a single country, Iceland. Clinical data were obtained from patient records and from DNA PCR and antibody assays of CSF. Diagnosis of HSE was classified as definite, possible or rejected based on symptoms, as well as virological, laboratory and brain imaging criteria. A total of 30 definite cases of HSE were identified during the 25 year period 1987-2011 corresponding to incidence of 4.3 cases/106 inhabitants/year. Males were 57% of all patients, median age 50 years (range, 0-85). Fever (97%), cognitive deficits (79%), impaired consciousness (79% with GCS < 13), headache (55%) and seizures (55%) were the most common symptoms. Brain lesions were found in 24 patients (80%) by MRI or CT. All patients received intravenous acyclovir for a mean duration of 20 days. Three patients (10%) died within one year and 21/28 pts (75%) had a Karnofsky performance score of <70% with memory loss (59%), dysphasia (44%), frontal symptoms (44%) and seizures (30%) as the most frequent sequelae. Mean delay from onset of symptoms to treatment was 6 days; this was associated with adverse outcome. In conclusion, the incidence of `HSE is higher than recently reported in a national registry study from Sweden. Despite advances in rapid diagnosis and availability of treatment of HSE, approximately three of every four patients die or are left with serious neurological impairment.
    • Immediate surge in female visits to the cardiac emergency department following the economic collapse in Iceland: an observational study.

      Guðjónsdóttir, Guðlaug Rakel; Kristjánsson, Már; Ólafsson, Örn; Arnar, Davíð O; Getz, Linn; Sigurðsson, Jóhann Ágúst; Guðmundsson, Sigurður; Valdimarsdóttir, Unnur; Department of Emergency, Landspítali University Hospital, Reykjavík, Iceland. (BMJ Publishing Group, 2012-09)
      The dramatic economic collapse in Iceland in October 2008 was associated with an immediate short-term increase in female attendance at the cardiac ED.
    • Native joint infections in Iceland 2003-2017: an increase in postarthroscopic infections.

      Gunnlaugsdóttir, Signý Lea; Erlendsdóttir, Helga; Helgason, Kristján Orri; Geirsson, Árni Jón; Thors, Valtýr; Guðmundsson, Sigurður; Gottfreðsson, Magnús; 1Medicine, Landspítali University Hospital, Reykjavík, Iceland. 2Clinical Microbiology, Landspítali University Hospital, Reykjavík, Iceland. 3Rheumatology, Landspitali, Reykjavik, Iceland. 4Paediatrics, Landspitali, Reykjavik, Iceland. 5Infectious Diseases, Landspitali, Reykjavik, Iceland. 6Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland. 7Infectious Diseases, Landspitali, Reykjavik, Iceland magnusgo@landspitali.is. (BMJ Publishing Group, 2021-09-17)
      Objectives: Nationwide study on the epidemiology, clinical characteristics and outcomes among patients with native joint infection (NJI) in Iceland, 2003-2017. Methods: All positive synovial fluid culture results in Iceland were identified and medical records reviewed. Results: A total of 299 NJI (40 children and 259 adults) were diagnosed in Iceland in 2003-2017, with a stable incidence of 6.3 cases/100 000/year, but marked gender difference among adults (33% women vs 67% men, p<0.001). The knee joint was most commonly affected, and Staphylococcus aureus was the most common isolate in both adults and children, followed by various streptococcal species in adults and Kingella kingae in children. NJI was iatrogenic in 34% of adults (88/259) but comprised 45% among 18-65 years and a stable incidence. Incidence of infections following arthroscopic procedures in adults increased significantly compared with the previous decade (9/100 000/year in 1990-2002 vs 25/100 000/year in 2003-2017, p<0.01) with no significant increase seen in risk per procedure. The proportion of postarthroscopic NJI was 0.17% overall but 0.24% for knee arthroscopy. Patients with postarthroscopic infection were more likely to undergo subsequent arthroplasty when compared with other patients with NJI (p=0.008). Conclusions: The incidence of NJI in Iceland has remained stable. The proportion of iatrogenic infections is high, especially among young adults, with an increase seen in postarthroscopic infections when compared with the previous decade. Although rare, NJI following arthroscopy can be a devastating complication, with significant morbidity and these results, therefore, emphasise the need for firm indications when arthroscopic treatment is considered. Keywords: arthritis; epidemiology; health services research; infectious; orthopedic procedures.
    • Poorer self-rated health in residential areas with limited healthcare supply.

      Haraldsdóttir, Sigríður; Valdimarsdóttir, Unnur A; Guðmundsson, Sigurður; Univ Iceland, Sch Hlth Sci, Ctr Publ Hlth Sci, Reykjavik, Iceland, Directorate Hlth, IS-107 Reykjavik, Iceland, Natl Univ Hosp Reykjavik, Reykjavik, Iceland (SAGE Publications Ltd, 2014-05)
      The aim of this study was to explore differences in self-rated health and physician-diagnosed disease across geographical regions in Iceland to better understand regional requirements for health services.