• P300 Analysis Using High-Density EEG to Decipher Neural Response to rTMS in Patients With Schizophrenia and Auditory Verbal Hallucinations.

      Aubonnet, Romain; Banea, Ovidiu C; Sirica, Roberta; Wassermann, Eric M; Yassine, Sahar; Jacob, Deborah; Magnúsdóttir, Brynja Björk; Haraldsson, Magnús; Stefansson, Sigurjon B; Jónasson, Viktor D; et al. (Frontiers Research Foundation, 2020-11-20)
      Schizophrenia is a complex disorder about which much is still unknown. Potential treatments, such as transcranial magnetic stimulation (TMS), have not been exploited, in part because of the variability in behavioral response. This can be overcome with the use of response biomarkers. It has been however shown that repetitive transcranial magnetic stimulation (rTMS) can the relieve positive and negative symptoms of schizophrenia, particularly auditory verbal hallucinations (AVH). This exploratory work aims to establish a quantitative methodological tool, based on high-density electroencephalogram (HD-EEG) data analysis, to assess the effect of rTMS on patients with schizophrenia and AVH. Ten schizophrenia patients with drug-resistant AVH were divided into two groups: the treatment group (TG) received 1 Hz rTMS treatment during 10 daily sessions (900 pulses/session) over the left T3-P3 International 10-20 location. The control group (CG) received rTMS treatment over the Cz (vertex) EEG location. We used the P300 oddball auditory paradigm, known for its reduced amplitude in schizophrenia with AVH, and recorded high-density electroencephalography (HD-EEG, 256 channels), twice for each patient: pre-rTMS and 1 week post-rTMS treatment. The use of HD-EEG enabled the analysis of the data in the time domain, but also in the frequency and source-space connectivity domains. The HD-EEG data were linked with the clinical outcome derived from the auditory hallucinations subscale (AHS) of the Psychotic Symptom Rating Scale (PSYRATS), the Quality of Life Scale (QoLS), and the Depression, Anxiety and Stress Scale (DASS). The general results show a variability between subjects, independent of the group they belong to. The time domain showed a higher N1-P3 amplitude post-rTMS, the frequency domain a higher power spectral density (PSD) in the alpha and beta bands, and the connectivity analysis revealed a higher brain network integration (quantified using the participation coefficient) in the beta band. Despite the small number of subjects and the high variability of the results, this work shows a robust data analysis and an interplay between morphology, spectral, and connectivity data. The identification of a trend post-rTMS for each domain in our results is a first step toward the definition of quantitative neurophysiological parameters to assess rTMS treatment. Keywords: P300; TMS (repetitive transcranial magnetic stimulation); brain connectivity; high-density EEG; schizophrenia; spectral analysis; temporal analysis.
    • p53 abnormality and chromosomal instability in the same breast tumor cells

      Sigurdsson, S; Bodvarsdottir, S K; Anamthawat-Jonsson, K; Steinarsdottir, M; Jonasson, J G; Ogmundsdottir, H M; Eyfjörd, J E; Molecular and Cell Biology Research Laboratory, Icelandic Cancer Society, Reykjavik, Iceland. (Elsevier, 2000-09-01)
      To clarify the important role of the tumor-suppressor gene p53 in maintaining genetic integrity, we estimated chromosome instability and staining of overexpressed p53 protein in the same cells of five primary breast carcinomas. The method included both fluorescence immunohistochemistry and fluorescence in situ hybridization (FISH) on sections from formalin-fixed, paraffin-embedded breast cancer tissue. By using a centromeric FISH probe for chromosome 17 on interphase cells in these sections, we showed that cells with abnormal p53 protein expression had a statistically significant higher number of chromosome 17 than did cells with no p53 protein staining in the same samples as well as cells in four other tumor samples with no p53 protein staining. The samples identified positive for p53 abnormality by immunostaining were shown to have p53 mutation by constant denaturing gel electrophoresis analysis and DNA sequencing. These mutated samples were characterized by high DNA index, high S-phase, abnormal karyotype, and aneuploidy. The results strongly implicate p53 mutation as a cause for chromosomal instability and a crucial step in mammary carcinogenesis.
    • P53 mutations analysis in benign and malignant breast lesions: using needle rinses from fine-needle aspirations

      Gudlaugsdottir, S; Sigurdardottir, V; Snorradottir, M; Jonasson, J G; Ogmundsdottir, H; Eyfjord, J E; Molecular and Cell Biology Research Laboratory, Icelandic Cancer Society, Reykjavik, Iceland. (Wiley-Liss, 2000-05-01)
      The fine-needle aspiration (FNA) technique is a widely used method for diagnostic assessment of breast diseases. In the current study we investigated the feasibility of sampling material for genetic studies from the same FNA samples as would be used for breast cytology. After making smears for cytological examination, the needle was rinsed into phosphate-buffered saline (PBS) solution. The material gained was sufficient for a polymerase chain reaction (PCR)-based study. As the FNA samples reflect a broad range of breast diseases, it is possible to study genetic changes at various stages of the neoplastic process. We looked for mutations in the p53 tumor suppressor gene in 198 FNA needle rinses, 42 from carcinomas and 156 from cytologically benign lesions. In the malignant samples, 22% carried mutations in the p53 gene. We also looked for p53 mutations in matching tissue sections from tumors and found the FNA needle rinses to represent the tumor well. In addition, three mutations in cytologically benign lesions were found, but none of these 3 patients were diagnosed with malignant tumors in the time frame of the study. The clinical significance of p53 mutations in benign breast tissue remains to be determined.
    • Paediatric B-cell precursor acute lymphoblastic leukaemia with t(1;19)(q23;p13): clinical and cytogenetic characteristics of 47 cases from the Nordic countries treated according to NOPHO protocols.

      Andersen, Mette K; Autio, Kirsi; Barbany, Gisela; Borgström, Georg; Cavelier, Lucia; Golovleva, Irina; Heim, Sverre; Heinonen, Kristina; Hovland, Randi; Johannsson, Johann H; et al. (Wiley-Blackwell, 2011-10)
      The translocation t(1;19)(q23;p13)/der(19)t(1;19) is a risk stratifying aberration in childhood B-cell precursor acute lymphoblastic leukaemia (BCP ALL) in the Nordic countries. We have identified 47 children/adolescents with t(1;19)/der(19)t(1;19)-positive BCP ALL treated on two successive Nordic Society of Paediatric Haematology and Oncology (NOPHO) protocols between 1992 and 2007 and have reviewed the clinical and cytogenetic characteristics of these cases, comprising 1·8% of all cases. The translocation was balanced in 15 cases (32%) and unbalanced in 29 cases (62%). The most common additional chromosome abnormalities were del(9p), i(9q), del(6q), and del(13q). The median age was 7 years, the median white blood cell (WBC) count was 16 × 10(9)/l, and the female/male ratio was 1·2. The predicted event-free survival (EFS) at 5 and 10 years was 0·79, whereas the predicted overall survival (OS) at 5 and 10 years was 0·85 and 0·82, respectively. Nine patients had a bone marrow relapse after a median of 23 months; no patient had a central nervous system relapse. Additional cytogenetic abnormalities, age, gender, WBC count or whether the t(1;19) was balanced or unbalanced did not influence EFS or OS. Compared to cases with t(12,21) and high hyperdiploidy, EFS was similar, but overall survival was worse in patients with t(1;19)/der(19)t(1;19) (P = 0·004).
    • Paediatric burns in Iceland. Hospital admissions 1982-1995, a populations based study

      Elisdottir, R; Ludvigsson, P; Einarsson, O; Thorgrimsson, S; Haraldsson, A; Department of Paediatrics, The University Hospital of Iceland, Reykyavik. (Elsevier, 1999-03-01)
      Epidemiological data of 290 children admitted to the Paediatric Department, University Hospital of Iceland, over a 14 year period, 1982-1995, are presented. The sex ratio boys/girls was 1.6. 72.8% were children four years and younger. Hot fluids was the most common cause of burn injuries, mostly caused by geothermal hot water. Only one child suffered from electricity burn injuries and none from corrosives. Most of the accidents occurred at home (81.4%). A decreasing number of children suffering from electricity and corrosive burn injuries reflects heightened awareness and improved safety in the home. We found a significant increase in the incidence of hot fluid burn injuries in Icelandic children compared to previous studies. This calls for preventive measures with regard to geothermal and other hot water burns in Icelandic children.
    • Pain and other symptoms and their relationship to quality of life in cancer patients on opioids.

      Zoëga, Sigridur; Fridriksdottir, Nanna; Sigurdardottir, Valgerdur; Gunnarsdottir, Sigridur; Natl Univ Hosp Iceland, Landspitali, IS-101 Reykjavik, Iceland, Univ Iceland, Reykjavik, Iceland (Springer International, 2013-08)
      The purpose of this study was to assess pain, other symptoms and QOL, and the relationship between these variables, among cancer patients on strong opioids.
    • Pain and pain problems among subjects with systemic lupus erythematosus in Iceland

      Lindal, E; Thorlacius, S; Stefansson, J G; Steinsson, K; Department of Psychiatry, National University Hospital, Reykjavík, Iceland. (Informa Healthcare, 1993)
      This population study includes the majority of all systemic lupus erythematosus (SLE) patients in Iceland (n = 65). The study lists various self-rated pain descriptions both from a 54-item pain questionnaire and from the somatisation section of the Diagnostic Interview Schedule (DIS). Results show SLE patients to have significantly more joint and chest pain than does another patient group; to use analgesics more frequently; to have been in hospital more often during the past 10 years and to believe they know the reason for their pain. Also listed are factors that patients have found to increase and decrease SLE pain.
    • Pain management and medical interventions during childbirth among perinatal distressed women and women dissatisfied in their partner relationship: A prospective cohort study.

      Jonsdottir, Sigridur Sia; Steingrimsdottir, Thora; Thome, Marga; Oskarsson, Guðmundur Kristjan; Lydsdottir, Linda Bara; Olafsdottir, Halldora; Sigurdsson, Jon Fridrik; Swahnberg, Katarina; 1 Department of Health and Caring Sciences, Linnaeus University, Stagneliusgatan 14b, 392 34 Kalmar, Sweden; School of Health Sciences, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland. Electronic address: siaj@unak.is. 2 Women's Clinic, Landspitali University Hospital, v/Hringbraut, 101 Reykjavik, Iceland; School of Health Science, Faculty of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland. Electronic address: thoraste@landspitali.is. 3 School of Health Science, Faculty of Nursing, University of Iceland, Eiriksgata 34, Reykjavik, Iceland. Electronic address: marga@hi.is. 4 School of Business and Sciences, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland. Electronic address: gko@unak.is. 5 School of Health Science, Faculty of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland; VIRK - Vocational Rehabilitation Fund, Gudrunartuni 1, 105 Reykjavik, Iceland. Electronic address: linda@virk.is. 6 Division of Mental Health, Landspitali University Hospital, v/Hringbraut, 101 Reykjavik, Iceland. Electronic address: halldola@landspitali.is. 7 School of Health Science, Faculty of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland; Division of Mental Health, Landspitali University Hospital, v/Hringbraut, 101 Reykjavik, Iceland; School of Business, Department of Psychology, Reykjavik University, Menntavegur 1, 101 Reykjavik, Iceland. Electronic address: jonfsig@ru.is. 8 Department of Health and Caring Sciences, Linnaeus University, Stagneliusgatan 14b, 392 34 Kalmar, Sweden. Electronic address: katarina.swahnberg@lnu.se. (Elsevier Science, 2019-02-01)
      The purpose of this study was to investigate possible associations between distress in pregnant women and their use of pain management and medical interventions. Furthermore, we assessed the effects of reported dissatisfaction in relationship with their partner, or weak social support. This was a prospective cohort study. Women were invited to participate while attending prenatal care at participating Icelandic health care centres. Birth outcome data were obtained from the hospitals where these women gave birth. Women in this study participated in a research project where 2523 women were screened three times during pregnancy for anxiety and depression. Women who had positive results at screening were invited to a semi-structured interview during pregnancy as well as every fourth woman who had negative results. Five hundred and sixty-two women participated in the interviews and the final sample was 442 women.
    • Pancreatic mass leading to left-sided portal hypertension, causing bleeding from isolated gastric varices.

      Thrainsdottir, Helga; Petursdottir, Vigdis; Blöndal, Sigurdur; Björnsson, Einar S; Section of Gastroenterology, Department of Internal Medicine, The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland ; Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland. 2Department of Pathology, The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland. 3Department of Surgery, The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland. (Hindawi Pub. Corp, 2014)
      Mucinous cystic neoplasms (MCN) are an uncommon form of exocrine neoplasms of the pancreas. Symptoms are most often vague and this makes the diagnosis more difficult. The current case is one of three cases yet reported where the MCN caused left-sided portal hypertension leading to the formation of isolated gastric varices and subsequent bleeding from the varices. In the previously reported cases the main symptom was hematemesis. However in the current case the patient experienced no hematemesis, only isolated incidents of dark coloured diarrhea, but the main symptoms were those of iron-deficiency anemia. We present the case report of a 34-year-old woman who presented with dizziness and lethargy and was found to have 12 cm MCN in the pancreas.
    • Pandemic vaccination strategies and influenza severe outcomes during the influenza A(H1N1)pdm09 pandemic and the post-pandemic influenza season: the Nordic experience.

      Gil Cuesta, Julita; Aavitsland, Preben; Englund, Hélène; Gudlaugsson, Ólafur; Hauge, Siri Helene; Lyytikäinen, Outi; Sigmundsdóttir, Guðrún; Tegnell, Anders; Virtanen, Mikko; Krause, Tyra Grove; et al. (European Centre for Disease Prevention and Control (ECDC), 2016-04)
      During the 2009/10 influenza A(H1N1)pdm09 pandemic, the five Nordic countries adopted different approaches to pandemic vaccination. We compared pandemic vaccination strategies and severe influenza outcomes, in seasons 2009/10 and 2010/11 in these countries with similar influenza surveillance systems. We calculated the cumulative pandemic vaccination coverage in 2009/10 and cumulative incidence rates of laboratory confirmed A(H1N1)pdm09 infections, intensive care unit (ICU) admissions and deaths in 2009/10 and 2010/11. We estimated incidence risk ratios (IRR) in a Poisson regression model to compare those indicators between Denmark and the other countries. The vaccination coverage was lower in Denmark (6.1%) compared with Finland (48.2%), Iceland (44.1%), Norway (41.3%) and Sweden (60.0%). In 2009/10 Denmark had a similar cumulative incidence of A(H1N1)pdm09 ICU admissions and deaths compared with the other countries. In 2010/11 Denmark had a significantly higher cumulative incidence of A(H1N1)pdm09 ICU admissions (IRR: 2.4; 95% confidence interval (CI): 1.9-3.0) and deaths (IRR: 8.3; 95% CI: 5.1-13.5). Compared with Denmark, the other countries had higher pandemic vaccination coverage and experienced less A(H1N1)pdm09-related severe outcomes in 2010/11. Pandemic vaccination may have had an impact on severe influenza outcomes in the post-pandemic season. Surveillance of severe outcomes may be used to compare the impact of influenza between seasons and support different vaccination strategies.
    • PAP treatment in patients with OSA does not induce long-term nasal obstruction.

      Värendh, Maria; Andersson, Morgan; Björnsdóttir, Erla; Arnardóttir, Erna S; Gislason, Thorarinn; Pack, Allan I; Hrubos-Strøm, Harald; Johannisson, Arne; Juliusson, Sigurdur; 1 Department of Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden. 2 Faculty of Medicine, Lund University, Lund, Sweden. 3 Sleep Department, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. 4 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 5 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania. 6 Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway. 7 Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden. 8 Department of Otolaryngology, Head and Neck Surgery, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. (Wiley, 2019-10)
      We hypothesized that positive airway pressure treatment would induce nasal obstruction and decrease nasal cavity due to mucosal swelling. We further hypothesized that subjective and objective nasal obstruction at baseline would negatively affect positive airway pressure adherence. A total of 728 patients with sleep apnea were investigated in the Icelandic Sleep Apnea Cohort at baseline and 2 years after starting positive airway pressure. Patients underwent home sleep apnea testing at baseline. Questionnaires were answered and acoustic rhinometry was completed at baseline and follow-up. The proportion of patients reporting subjective nocturnal nasal obstruction was reduced (baseline: 35% versus follow-up: 24%; p < 0.001). Small interior nasal dimensions increased (p < 0.001) independent of adherence to treatment. Small nasal volume at baseline was a determinant for becoming a non-user of positive airway pressure treatment (odds ratio 2.22, confidence interval 95% 1.35-3.67, p = 0.002). Subjective nasal obstruction decreased 2 years after initiating positive airway treatment in sleep apnea, and objectively small nasal dimensions increased. Small nasal volume at baseline was a negative predictor for positive airway pressure treatment adherence. Maybe most importantly, positive airway pressure treatment did not cause long-term objective or subjective nasal obstruction.
    • Paracetamol intoxications: a retrospective population-based study in Iceland.

      Kjartansdottir, Ingibjörg; Bergmann, Ottar M; Arnadottir, Ragna S; Björnsson, Einar S; Faculty of Public Health, University of Iceland, Reykjavik, Iceland. (2012-11)
      Paracetamol is the most common cause of acute liver failure (ALF) in many countries. Much data on paracetamol toxicity originate from liver transplant centers and tertiary referral institutions. The authors analyzed the population-based annual incidence of paracetamol overdoses and ALF, and described the risk factors for hepatotoxicity. A search was undertaken for the diagnosis of paracetamol overdoses in the diagnoses registry of the National University Hospital of Iceland from 2004 to 2009 serving a population of 219,249 inhabitants. Relevant information was collected from medical records. A total of 1913 drug-related poisoning episodes were identified and reviewed, 352 (18%) involved paracetamol overdoses. The annual incidence of paracetamol overdoses declined from 30.0 (2004) to 16.0/100,000 per year (2009) (p < 0.05). The female/male ratio was 3.0 and the largest age group was 16-25 years. After the initial examination, 26% were discharged home. Hospitalized index visits were 182 with accidental overdoses constituting 16 (9%) with no gender difference. Compared with intentional overdose the accidental group had higher aminotransferases (p < 0.005). ALF occurred in 3.8% (7/182) of the index visits and the incidence was 0.7/100,000 per year. In the intentional group, 1.2% (2/163) developed ALF versus 25% (4/16) of the accidental group (p = 0.001). Only one patient died from ALF and none underwent liver transplantation. The annual incidence of paracetamol overdoses was high in this population-based study but declined. Young females with intentional overdose accounted for most of the cases, whereas accidental overdoses were more common in older patients. The occurrence of ALF was low and mostly associated with accidental overdose.
    • Paraesophageal hernia

      Oddsdottir, M; Department of Surgery, University Hospital-Landspitali Hringbraut, Reykjavik, Iceland. margreto@rsp.is (W.B. Saunders, 2000-08)
      The laparoscopic repair of paraesophageal hernia has proven to be safe and effective, with relatively low morbidity and mortality rates. The laparoscopic approach is feasible in patients with paraesophageal hernia because these patients are usually past middle age and commonly have multiple other medical problems. The procedure is technically demanding, but skilled laparoscopic surgeons should be able to perform the standard repair, that is, sac excision, crural closure, and fundoplication or gastropexy.
    • A parallel, randomized, double-blind, placebo-controlled study to investigate the effect of SagaPro on nocturia in men.

      Sigurdsson, Steinthor; Geirsson, Gudmundur; Gudmundsdottir, Hrefna; Egilsdottir, Perla B; Gudbjarnason, Sigmundur; SagaMedica, IS-104 Reykjavik, Iceland Univ Iceland, Inst Sci, IS-107 Reykjavik, Iceland Univ Iceland, Fac Med, Reykjavik, Iceland Landspitali Univ Hosp, Dept Urol, Reykjavik, Iceland Landspitali Univ Hosp, Dept Internal Med, Reykjavik, Iceland (Informa Healthcare, 2013-02)
      This study aimed to investigate the effect of SagaPro, a product derived from Angelica archangelica leaf, on nocturia.
    • Paravertebral Block for Post-Operative Analgesia after Breast Cancer Surgery, Effects of Adding Morphine: Double Blind, Randomised Clinical Trial

      Bjornsson G, Johannesdottir A , Valtysson B , Sigurdsson GH; Department of Anaesthesiology and Intensive Care, Landspitali University Hospital, Reykjavik, Iceland, Orkuhúsid Clinic, Reykjavik, Iceland, Faculty of Medicine, University of Iceland, Reykjavik, Iceland (Scientific Research, 2013-03)
      Introduction: Thoracic paravertebral block (PVB) block is frequently used in breast cancer surgery for postoperative pain management. Adding opioids to local anaesthetics has been shown to have beneficial effects during epidural analgesia. Our hypothesis was that adding morphine to bupivacaine for PVB would improve analgesia provided by this procedure. Methods: 60 patients (25 - 75 years) undergoing elective surgery for breast cancer were randomly assigned to one of two groups. Both groups received a single injection thoracic paravertebral block; group BAM with 20 ml 0.5% bupivacaine, epinephrine and morphine while group BA received identical block except morphine was given subcutaneously. All patients had general anaesthesia. Results: Severity of pain and nausea was low in both groups. Pain scores remained below 20/100 after the first 2 hours throughout the 72 hours of the study. There was no significant difference between the groups in pain scores, consumption of additional morphine or nausea scores. Shoulder mobility was also very good in both groups. Conclusion: Thoracic paravertebral block with bupivacaine and epinephrine was associated with good postoperative analgesic effects and low incidence of nausea and vomiting. The addition of morphine to the local anaesthetic solution in paravertebral block did not have any additional analgesic effects.
    • Parenchymal cystatin C focal deposits and glial scar formation around brain arteries in Hereditary Cystatin C Amyloid Angiopathy.

      Osk Snorradottir, Asbjorg; Isaksson, Helgi J; Kaeser, Stephan A; Skodras, Angelos A; Olafsson, Elias; Palsdottir, Astridur; Thor Bragason, Birkir; [ 1 ] Univ Iceland, Inst Expt Pathol, Keldur, IS-112 Reykjavik, Iceland [ 2 ] Landspitali Univ Hosp, Dept Pathol, Reykjavik, Iceland [ 3 ] Univ Tubingen, Dept Cellular Neurol, Hertie Inst Clin Brain Res, Tubingen, Germany [ 4 ] German Ctr Neurodegenerat Dis, DZNE, Tubingen, Germany [ 5 ] Univ Iceland, Fac Med, IS-112 Reykjavik, Iceland [ 6 ] Landspitali Univ Hosp, Dept Neurol, Reykjavik, Iceland [ 7 ] Univ Iceland, Fac Med, Sch Hlth Sci, Biomed Ctr, IS-112 Reykjavik, Iceland (Elsevier Science BV, 2015-10-05)
      Hereditary Cystatin C Amyloid Angiopathy (HCCAA) is an amyloid disorder in Icelandic families caused by an autosomal dominant mutation in the cystatin C gene. Mutant cystatin C forms amyloid deposits in brain arteries and arterioles which are associated with changes in the arterial wall structure, notably deposition of extracellular matrix proteins. In this post-mortem study we examined the neuroinflammatory response relative to the topographical distribution of cystatin C deposition, and associated haemorrhages, in the leptomeninges, cerebrum, cerebellum, thalamus, and midbrain of HCCAA patients. Cystatin C was deposited in all brain areas, grey and white matter alike, most prominently in arteries and arterioles; capillaries and veins were not, or minimally, affected. We also observed perivascular deposits and parenchymal focal deposits proximal to affected arteries. This study shows for the first time, that cystatin C does not exclusively form CAA and perivascular amyloid but also focal deposits in the brain parenchyma. Haemorrhages were observed in all patients and occurred in all brain areas, variable between patients. Microinfarcts were observed in 34.6% of patients. The neuroinflammatory response was limited to the close vicinity of affected arteries and perivascular as well as parenchymal focal deposits. Taken together with previously reported arterial accumulation of extracellular matrix proteins in HCCAA, our results indicate that the central nervous system pathology of HCCAA is characterised by the formation of a glial scar within and around affected arteries.
    • Parent perspectives on home participation of high-functioning children with autism spectrum disorder compared with a matched group of children without autism spectrum disorder.

      Egilson, Snæfrídur T; Jakobsdóttir, Gunnhildur; Ólafsdóttir, Linda B; [ 1 ] Univ Iceland, Reykjavik, Iceland Show more [ 2 ] Natl Univ Hosp Iceland, Reykjavik, Iceland (SAGE PUBLICATIONS LTD, 2018-07-01)
      Few studies have focused on home participation of high-functioning children with autism spectrum disorder. We employed a mixed-methods design to explore and compare parent perspectives on (1) participation of children with and without autism spectrum disorder in activities at home, (2) the environmental features and resources that affect these children's home participation and (3) the strategies parents use to help their children participate at home. The Participation and Environment Measure for Children and Youth (PEM-CY) was used to gather online survey and qualitative data from parents of 99 high-functioning children with autism spectrum disorder and 241 children without autism spectrum disorder. Independent sample t-tests and χ
    • Parent-youth agreement on symptoms and diagnosis: Assessment with a diagnostic interview in an adolescent inpatient clinical population

      Lauth, Bertrand; Arnkelsson, Gudmundur B; Magnússon, Pall; Skarphedinsson, Gudmundur A; Ferrari, Pierre; Petursson, Hannes; University of Iceland, Department of Child and Adolescent Psychiatry, Landspítali University Hospital, Dalbraut 12, 105 Reykjavík, Iceland. (Editions Scientifiques Elsevier, 2010-12)
      Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents´ reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive assessments as interesting tools. Thus, cognitive assessments can show discrepant results according to parents' or adolescents' reports and can therefore shed light on the parent-child interaction and relational dynamics. Inversely, cognitive neuroscience could benefit from psychoanalysis by taking into account, when interpretating the scores, the relational dynamics and the personal history of the rater.
    • Parental longevity and survival among patients with multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study.

      Sverrisdóttir, Ingigerður S; Lund, Sigrún H; Turesson, Ingemar; Björkholm, Magnus; Goldin, Lynn R; Landgren, Ola; Kristinsson, Sigurður Y; 1 Landspítali, National University Hospital, Reykjavík, Iceland. 2 Faculty of Medicine, University of Iceland, Reykjavík, Iceland. 3 Skåne, University Hospital Malmö, Malmö, Sweden. 4 Department of Medicine, Division of Haematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 5 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 6 Myeloma Service, Division of Hematology Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. 7 Department of Haematology, Landspitali, National University Hospital, Reykjavik, Iceland. (Wiley, 2019-07-01)
      Parental longevity is associated with an increased life expectancy; results with regard to specific diseases are conflicting. There are limited data focusing on host characteristics and their effect on survival among multiple myeloma (MM) patients and individuals with monoclonal gammopathy of undetermined significance (MGUS). Therefore, our aim was to evaluate the impact of parental longevity on survival of patients with MM and MGUS. A total of 4675 patients with MM, 6812 MGUS patients and 13 398 population-based controls for MM as well as 19 110 controls for MGUS, from 1988 to 2013, were included in the study. Longevity was defined as >90 years of age. Among MM patients, parental longevity was associated with a decreased risk of death [hazard ratio (HR) = 0·92, 95% confidence interval (CI) 0·84-0·99] and the same was true for MGUS patients (HR = 0·87, 95% CI 0·78-0·96). Having one long lived parent significantly decreased the risk of death in both groups, but was not statistically significant when both parents exceeded 90 years of age. In conclusion, parental longevity decreases the risk of death for patients with MM and MGUS which may reflect the importance of the host's genetic and environmental factors in relation to survival.
    • Parental occupational exposure pre- and post-conception and development of asthma in offspring.

      Pape, Kathrine; Svanes, Cecile; Sejbæk, Camilla S; Malinovschi, Andrei; Benediktsdottir, Byndis; Forsberg, Bertil; Janson, Christer; Benke, Geza; Tjalvin, Gro; Sánchez-Ramos, José Luis; et al. (Oxford University Press, 2021-01)
      Background: While direct effects of occupational exposures on an individual's respiratory health are evident, a new paradigm is emerging on the possible effects of pre-conception occupational exposure on respiratory health in offspring. We aimed to study the association between parental occupational exposure starting before conception and asthma in their offspring (at 0-15 years of age). Methods: We studied 3985 offspring participating in the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study. Their mothers or fathers (n = 2931) previously participated in the European Community Respiratory Health Survey (ECRHS). Information was obtained from questionnaires on parental job history pre- and post-conception which was linked to an asthma-specific job-exposure matrix (JEM). We assessed the association between parental occupational exposure and offspring asthma, applying logistic regression models, clustered by family and adjusted for study centre, offspring sex, parental characteristics (age, asthma onset, place of upbringing, smoking) and grandparents' level of education. Results: Parental occupational exposure to microorganisms, pesticides, allergens or reactive chemicals pre-conception or both pre- and post-conception was not related to offspring asthma; in general, subgroup analyses confirmed this result. However, maternal exposure both pre- and post-conception to allergens and reactive chemicals was associated with increased odds for early-onset asthma in offspring (0-3 years of age); odds ratio 1.70 (95% CI: 1.02-2.84) and 1.65 (95% CI: 0.98-2.77), respectively. Conclusions: This study did not find evidence that parental occupational exposure, defined by an asthma JEM before conception only or during pre- and post-conception vs non-exposed, was associated with offspring asthma. Keywords: job-exposure matrices; Epidemiology; air pollutants; asthma; generation study; occupation; occupational exposure.