• Safety and efficacy of 7-day rabeprazole- and omeprazole-based triple therapy regimens for the eradication of Helicobacter pylori in patients with documented peptic ulcer disease.

      Hawkey, C J; Atherton, J C; Treichel, H C; Thjodleifsson, B; Ravic, M (Blackwell Scientific Publications, 2003-04-01)
      AIM: A double-blind, randomized study was designed to determine whether rabeprazole- and omeprazole-based triple therapy regimens are therapeutically equivalent in the eradication of Helicobacter pylori. METHODS: Three hundred and forty-five patients with current or previously active peptic ulcer and a positive H. pylori urease test were randomly assigned to receive RCA, OCA, RCM or OCM twice daily for 7 days (R, rabeprazole 20 mg; O, omeprazole 20 mg; C, clarithromycin 500 mg; A, amoxicillin 1000 mg; M, metronidazole 400 mg). H. pylori eradication was documented by negative 13C-urea breath tests at 4 and 12 weeks, and was evaluated using a 2 x 2 factorial design with proton pump inhibitor and antibiotic as factors. RESULTS: Overall eradication rates (per protocol/intention-to-treat) were 87%/77% and 85%/75% with rabeprazole and omeprazole, respectively (not significant). However, a statistical interaction between proton pump inhibitor and antibiotic was identified. RCA produced a somewhat higher eradication rate than OCA (94% vs. 84%; difference, 9.8%; 95% confidence interval, - 0.7% to + 20.4%), whereas RCM produced a lower eradication rate than OCM (79% vs. 86%; difference, 8.1%; 95% confidence interval, - 21.4% to + 5.1%). Ulcer healing rates were > 90% with H. pylori eradication. Each regimen was well tolerated. CONCLUSIONS: Rabeprazole- and omeprazole-based triple therapy regimens are therapeutically equivalent in the eradication of H. pylori and well tolerated. The statistical interaction observed between the proton pump inhibitor and supplementary antibiotic may be due to chance.
    • Safety and efficacy of pimecrolimus in atopic dermatitis: a 5-year randomized trial.

      Sigurgeirsson, Bardur; Boznanski, Andrzej; Todd, Gail; Vertruyen, André; Schuttelaar, Marie-Louise A; Zhu, Xuejun; Schauer, Uwe; Qaqundah, Paul; Poulin, Yves; Kristjansson, Sigurdur; et al. (Amer Acad Pediatrics, 2015-04)
      Atopic dermatitis (AD) primarily affects infants and young children. Although topical corticosteroids (TCSs) are often prescribed, noncorticosteroid treatments are needed because compliance with TCSs is poor due to concerns about their side effects. In this longest and largest intervention study ever conducted in infants with mild-to-moderate AD, pimecrolimus 1% cream (PIM) was compared with TCSs.
    • Safety and immunogenicity of CRM197-conjugated pneumococcal-meningococcal C combination vaccine (9vPnC-MnCC) whether given in two or three primary doses

      Sigurdardottir, Sigurveig Th; Davidsdottir, Katrin; Arason, Vilhjalmur A; Jonsdottir, Olof; Laudat, France; Gruber, William C; Jonsdottir, Ingileif; Department of Immunology, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland. (Elsevier Science, 2008-08-05)
      This randomized trial compares safety and immunogenicity when vaccinating infants with a pneumococcal-meningococcal conjugate vaccine in two doses vs. three doses. Infants (N=223) received 9vPnC-MnCC (CRM197-conjugated pneumococcal serotypes 1, 4, 5, 6B, 9V, 14, 18C, 19F, 23F and meningococcal C polysaccharides) either at 3 and 5 or 3, 4 and 5 months and a booster with either 9vPnC-MnCC or 23-valent pneumococcal-polysaccharide vaccine (23vPPS) and CRM197-MnCC, at 12 months. Safety was monitored and IgG measured at 3, 6, 12 and 13 months in all subjects and serum bactericidal activity (SBA) in half. The 9vPnC-MnCC vaccine was safe and induced significant IgG to all components. Three doses induced higher antibody GMCs (geometric mean concentrations) at 6 months to seven of nine pneumococcal serotypes. This was most significant for 6B and 23F (p<0.001), that also showed lower rate of responders >0.35 (6B, 23F) and >0.5mug/mL (6B). Antibody GMCs remained lower following 9vPnC-MnCC booster in subjects primed with two doses although only significant for serotype 18C. Significant memory responses were observed 1 week after the 23vPPS toddler dose. MnCC-IgG GMC was lower after two doses, however with comparable SBA. This study shows that the 9vPnC-MnCC vaccine is safe and induces successful immunological memory, whether given in two or three primary doses.
    • Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes.

      Escaned, Javier; Ryan, Nicola; Mejía-Rentería, Hernán; Cook, Christopher M; Dehbi, Hakim-Moulay; Alegria-Barrero, Eduardo; Alghamdi, Ali; Al-Lamee, Rasha; Altman, John; Ambrosia, Alphonse; et al. (Elsevier Science, 2018-08-13)
      The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04).
    • Saliva testosterone and cortisol in male depressive syndrome, a community study. The Sudurnesjamenn Study.

      Sigurdsson, Bjarni; Palsson, Sigurdur Pall; Aevarsson, Olafur; Olafsdottir, Maria; Johannsson, Magnus; [ 1 ] Univ Iceland, Dept Pharmacol & Toxicol, IS-107 Reykjavik, Iceland [ 2 ] Univ Hosp Iceland, Dept Psychiat, Reykjavik, Iceland [ 3 ] Univ Iceland, Ctr Sport & Hlth Sci, IS-107 Reykjavik, Iceland [ 4 ] Primary Hlth Care Ctr, Reykjavik, Iceland (Informa Healthcare, 2014-11)
      The association between testosterone levels and depression is unclear. The relationship has been described as complex, i.e. more U (J)-shaped than linear in some previous studies.
    • Salivary gland tumours in Iceland 1986-2015: a nationwide epidemiological analysis over a 30-year time period.

      Aegisdottir, Anna Lilja; Tryggvason, Geir; Jonsdottir, Anna Margret; Jonasson, Jon Gunnlaugur; 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Department of Otorhinolaryngology, The National University Hospital of Iceland, Reykjavik, Iceland. 3Department of Pathology, The National University Hospital of Iceland, Reykjavik, Iceland. (Wiley, 2020-10-16)
      Salivary gland tumours (SGT) are a vast and heterogenous group of neoplasms. There is a relative lack of comprehensive nationwide epidemiological studies on the subject. The aim of this nationwide analysis was to gain insight into epidemiological traits, such as site, incidence and histological subtypes of SGT in general. Patients diagnosed with a primary SGT between 1986 and 2015 were identified from The Icelandic Cancer Registry and registries from all pathology departments in Iceland. Information on age, sex, tumour location and histology was retrieved from pathology reports. A total of 687 patients were diagnosed with a SGT, 609 (89%) were benign and 78 (11%) malignant. 9% of parotid gland tumours, 22% of submandibular gland tumours and 26% of minor SGT were malignant. The most common malignant tumours were mucoepidermoid carcinoma, acinic cell carcinoma and adenoid cystic carcinoma. The incidence of benign SGT was 4.9 per 100 000 among men and 7.0 per 100 000 among women. The incidence of malignant tumours was 0.59 per 100 000 for men and 0.79 per 100 000 for women. The proportion of malignant SGT is lower than most often reported. Only 10% of parotid gland tumours, 20% of submandibular gland tumours and 25% of minor salivary gland tumours are malignant. Keywords: Salivary gland; epidemiology; histology; oncology; tumour.
    • Salmonella osteomyelitis in pregnancy

      Agustsson, AI; Olafsson, K; Thorisdottir, AS; Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland. (2009-07-28)
      Salmonella osteomyelitis is rare in the immunocompetent host, even though Salmonella is not an infrequent public health problem. Invasive salmonellosis has in general a poor outcome in pregnancy with regard to fetal survival. We report the case of a healthy woman who developed Salmonella osteomyelitis of the iliac bone four weeks after a febrile gastroenteritis in the first trimester of pregnancy. Diagnosis was confirmed by magnetic resonance imaging scanning of the iliac bone and a growth of Salmonella enteritidis in blood culture. The patient recovered fully after six weeks treatment with intravenous antibiotics and delivered a healthy infant at 40 weeks.
    • The same sequence variant on 9p21 associates with myocardial infarction, abdominal aortic aneurysm and intracranial aneurysm.

      Helgadottir, Anna; Thorleifsson, Gudmar; Magnusson, Kristinn P; Gretarsdottir, Solveig; Steinthorsdottir, Valgerdur; Manolescu, Andrei; Jones, Gregory T; Rinkel, Gabriel J E; Blankensteijn, Jan D; Ronkainen, Antti; et al. (Nature Publishing Group, 2008-02)
      Recently, two common sequence variants on 9p21, tagged by rs10757278-G and rs10811661-T, were reported to be associated with coronary artery disease (CAD) and type 2 diabetes (T2D), respectively. We proceeded to further investigate the contributions of these variants to arterial diseases and T2D. Here we report that rs10757278-G is associated with, in addition to CAD, abdominal aortic aneurysm (AAA; odds ratio (OR) = 1.31, P = 1.2 x 10(-12)) and intracranial aneurysm (OR = 1.29, P = 2.5 x 10(-6)), but not with T2D. This variant is the first to be described that affects the risk of AAA and intracranial aneurysm in many populations. The association of rs10811661-T to T2D replicates in our samples, but the variant does not associate with any of the five arterial diseases examined. These findings extend our insight into the role of the sequence variant tagged by rs10757278-G and show that it is not confined to atherosclerotic diseases.
    • Sarcoid arthropathy and the association with the human leukocyte antigen. The Icelandic Sarcoidosis Study.

      Petursdottir, Dyrleif; Haraldsdottir, Sigridur Olina; Bjarnadottir, Kristjana; Jonsson, Thorbjorn; Gislason, Thorarinn; Gudmundsson, Sveinn; Gudbjornsson, Bjorn; Landspitali Univ Hosp, Ctr Rheumatol Res, IS-101 Reykjavik, Iceland Landspitali Univ Hosp, Dept Resp Med, IS-101 Reykjavik, Iceland Landspitali Univ Hosp, Iceland Blood Bank, IS-101 Reykjavik, Iceland Univ Iceland, Fac Med, Reykjavik, Iceland (Clinical And Experimental Rheumatology S.A.S, 2013-09)
      The aim of the present study was to evaluate whether certain HLA antigens were risk factors for developing sarcoid arthritis and whether HLA antigens appear to account for the phenotype and the resolution of the arthritis condition in an unselected nationwide cohort.
    • The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans.

      Jyväkorpi, S K; Ramel, A; Strandberg, T E; Piotrowicz, K; Błaszczyk-Bębenek, E; Urtamo, A; Rempe, H M; Geirsdóttir, Ó; Vágnerová, T; Billot, M; et al. (Springer, 2021-02-13)
      Background: The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations. Keywords: Energy intake; Nutrition counselling; Nutrition intervention; Protein intake; SPRINTT.
    • The "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) randomized controlled trial: Case finding, screening and characteristics of eligible participants.

      Marzetti, Emanuele; Cesari, Matteo; Calvani, Riccardo; Msihid, Jérôme; Tosato, Matteo; Rodriguez-Mañas, Leocadio; Lattanzio, Fabrizia; Cherubini, Antonio; Bejuit, Raphaël; Di Bari, Mauro; et al. (Elsevier Science, 2018-11-01)
      The ongoing "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT)" randomized controlled trial (RCT) is testing the efficacy of a multicomponent intervention in the prevention of mobility disability in older adults with physical frailty & sarcopenia (PF&S). Here, we describe the procedures followed for PF&S case finding and screening of candidate participants for the SPRINTT RCT. We also illustrate the main demographic and clinical characteristics of eligible screenees. The identification of PF&S was based on the co-occurrence of three defining elements: (1) reduced physical performance (defined as a score on the Short Physical Performance Battery between 3 and 9); (2) low muscle mass according to the criteria released by the Foundation for the National Institutes of Health; and (3) absence of mobility disability (defined as ability to complete the 400-m walk test in 15 min). SPRINTT was advertised through a variety of means. Site-specific case finding strategies were developed to accommodate the variability across centers in catchment area characteristics and access to the target population. A quick "participant profiling" questionnaire was devised to facilitate PF&S case finding. During approximately 22 months, 12,358 prescreening interviews were completed in 17 SPRINTT sites resulting in 6710 clinic screening visits. Eventually, 1566 candidates were found to be eligible for participating in the SPRINTT RCT. Eligible screenees showed substantial physical function impairment and comorbidity burden. In most centers, project advertisement through mass media was the most rewarding case finding strategy. PF&S case finding in the community is a challenging, but feasible task. Although largely autonomous in daily life activities, older adults with PF&S suffer from significant functional impairment and comorbidity. This subset of the older population is therefore at high risk for disability and other negative health-related events. Key strategies to consider for successfully intercepting at-risk older adults should focus on mass communication methods.
    • Scandiatransplant: organ transplantation in the Nordic countries 1996

      Madsen, M; Asmundsson, P; Brekke, I B; Höckerstedt, K; Kirkegaard, P; Persson, N H; Tufveson, G; Scandiatransplant, Aarhus University Hospital, Skejby Sygehus, Denmark. (Elsevier Science Inc, 1997-11)
      The Nordic collaboration in organ transplantation was initiated nearly 30 years ago in the frame of Scandiatransplant. With a recent formalization of its structure, Scandiatransplant has become a modern organ exchange organization. The increasing activities of Scandiatransplant clearly reflect the continuously growing need for a close and firm Nordic collaboration in the transplantation field, for the benefit of the numerous patients waiting for an organ transplant.
    • Scandinavian clinical practice guideline on choice of fluid in resuscitation of critically ill patients with acute circulatory failure.

      Perner, A; Junttila, E; Haney, M; Hreinsson, K; Kvåle, R; Vandvik, P O; Møller, M H; [ 1 ] Copenhagen Univ Hosp, Dept Intens Care, Rigshosp, DK-2100 Copenhagen, Denmark [ 2 ] Oulu Univ Hosp, Dept Anaesthesiol, Div Intens Care, Tampere, Finland [ 3 ] Tampere Univ Hosp, Dept Anaesthesiol, Tampere, Finland [ 4 ] Umea Univ, Umea, Sweden [ 5 ] Landspitali Univ Hosp, Dept Anaesthesiol & Intens Care Med, Reykjavik, Iceland [ 6 ] Haukeland Hosp, Dept Intens Care, N-5021 Bergen, Norway [ 7 ] Innlandet Hosp Trust Div Gjovik, Dept Med, Gjovik, Norway [ 8 ] Norwegian Knowledge Ctr Hlth Serv, Oslo, Norway (Wiley-Blackwell, 2015-03)
      The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure.
    • Scandinavian clinical practice guideline on mechanical ventilation in adults with the acute respiratory distress syndrome.

      Claesson, J; Freundlich, M; Gunnarsson, I; Laake, J H; Vandvik, P O; Varpula, T; Aasmundstad, T A; [ 1 ] Umea Univ Hosp, Dept Intens Care, Div Surg, S-90185 Umea, Sweden [ 2 ] Aalborg Univ Hosp, Clin Anaesthesiol, Aalborg, Denmark [ 3 ] Landspitali Univ Hosp, Dept Anaesthesiol & Intens Care Med, Reykjavik, Iceland [ 4 ] Oslo Univ Hosp, Div Crit Care, Dept Anaesthesiol, Oslo, Norway [ 5 ] Innlandet Hosp Trust, Dept Med, Div Gjovik, Gjovik, Norway [ 6 ] Norwegian Knowledge Ctr Hlth Serv, Oslo, Norway [ 7 ] Helsinki Univ Hosp, Dept Intens Care Med, Helsinki, Finland (Wiley-Blackwell, 2015-03)
      The objective of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force on mechanical ventilation in adults with the acute respiratory distress syndrome (ARDS) is to formulate treatment recommendations based on available evidence from systematic reviews and randomised trials.
    • Scandinavian clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrest

      Castrén, M; Silfvast, T; Rubertsson, S; Niskanen, M; Valsson, F; Wanscher, M; Sunde, K; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden. maaret.castren@sodersjukhuset.se (Blackwell Munksgaard, 2009-03-01)
      BACKGROUND AND AIM: Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by mild therapeutic hypothermia (MTH). In several studies MTH has been proven to be safe, with few complications and improved survival, and is recommended by the International Liaison of Committee on Resuscitation. The aim of this paper is to recommend clinical practice guidelines for MTH treatment after cardiac arrest from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI). METHODS: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus opinion was used when high-grade evidence (Grade of Recommendation, GOR) was unavailable. A management strategy was developed as a consensus from the evidence and the protocols in the participating countries. RESULTS AND CONCLUSION: Although proven beneficial only for patients with initial ventricular fibrillation (GOR A), the SSAITFTH also recommend MTH after restored spontaneous circulation, if active treatment is chosen, in patients with initial pulseless electrical activity and asystole (GOR D). Normal ethical considerations, premorbid status, total anoxia time and general condition should decide whether active treatment is required or not. MTH should be part of a standardized treatment protocol, and initiated as early as possible after indication and treatment have been decided (GOR E). There is insufficient evidence to make definitive recommendations among techniques to induce MTH, and we do not know the optimal target temperature, duration of cooling and rewarming time. New studies are needed to address the question as to how MTH affects, for example, prognostic factors.
    • Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

      Jensen, A G; Callesen, T; Hagemo, J S; Hreinsson, K; Lund, V; Nordmark, J; Department of anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark. anders.gadegaard.jensen@ouh.regionsyddanmark.dk (2010-09-01)
      Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high-grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients should be given by, or under very close supervision by, experienced anaesthesiologists. Problems with the airway and the circulation must be anticipated. The risk of aspiration must be judged for each patient. Pre-operative gastric emptying is rarely indicated. For pre-oxygenation, either tidal volume breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre-oxygenation in the obese patients should be performed in the head-up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor influence on intubation conditions, and should be chosen on other grounds. Ketamine should be considered in haemodynamically compromised patients. Opioids may be used to reduce the stress response following intubation. For optimal intubation conditions, succinylcholine 1-1.5 mg/kg is preferred. Outside the operation room, rapid sequence intubation is also considered the safest method. For all patients, precautions to avoid aspiration and other complications must also be considered at the end of anaesthesia.
    • Scandinavian epidemiological research in gastroenterology and hepatology.

      Björnsson, Einar S; Ekbom, Anders; [ 1 ] Univ Iceland, Fac Med, Reykjavik, Iceland [ 2 ] Natl Univ Hosp Iceland, Dept Internal Med, Div Gastroenterol & Hepatol, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 3 ] Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, S-10401 Stockholm, Sweden [ 4 ] Karolinska Univ Hosp, Solna, Sweden (Informa Healthcare, 2015-06)
      In the last decades, a large number of epidemiological studies in gastroenterology and hepatology have originated from the Scandinavian countries. With the help of large health databases, with good validity and other registries related to patient outcomes, researchers from the Scandinavian countries have been able to make some very important contributions to the field. These countries, Sweden, Norway, Finland, Denmark and Iceland, have all universal access to health care and have shown to be ideal for epidemiological research. Population-based studies have been frequent and follow-up studies have been able to describe the temporal trends and changes in phenotypes. Our ability in Scandinavia to follow up defined groups of patients over time has been crucial to learn the natural history of many gastrointestinal and liver diseases and often in a population-based setting. Patient-related outcomes measures will probably gain increasing importance in the future, but Scandinavian gastroenterologists and surgeons are likely to have a better infrastructure for such endeavors compared to most other populations. Thus, there is a bright future for international competitive research within the field of gastrointestinal and liver diseases in Scandinavia.
    • A Scandinavian experience of register collaboration: the Nordic Arthroplasty Register Association (NARA).

      Havelin, Leif I; Robertsson, Otto; Fenstad, Anne M; Overgaard, Søren; Garellick, Göran; Furnes, Ove; The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, 5021 Bergen, Norway. leif.havelin@helse-bergen.no (Journal of Bone and Joint Surgery, 2011-12-21)
      BACKGROUND: The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research. METHODS: A collaboration called NARA (Nordic Arthroplasty Register Association) was started in 2007, resulting in a common database for Denmark, Norway, and Sweden with regard to hip replacements in 2008 and primary knee replacements in 2009. Finland joined the project in 2010. A code set was defined for the parameters that all registers had in common, and data were re-coded, within each national register, according to the common definitions. After de-identification of the patients, the anonymous data were merged into a common database. The first study based on this common database included 280,201 hip arthroplasties and the second, 151,814 knee arthroplasties. Kaplan-Meier and Cox multiple regression analyses, with adjustment for age, sex, and diagnosis, were used to calculate prosthesis survival, with any revision as the end point. In later studies, specific reasons for revision were also used as end points. RESULTS: We found differences among the countries concerning patient demographics, preferred surgical approaches, fixation methods, and prosthesis brands. Prosthesis survival was best in Sweden, where cement implant fixation was used more commonly than it was in the other countries. CONCLUSIONS: As the comparison of national results was one of the main initial aims of this collaboration, only parameters and data that all three registers could deliver were included in the database. Compared with each separate register, this combined register resulted in reduced numbers of parameters and details. In future collaborations of registers with a focus on comparing the performances of prostheses and articulations, we should probably include only the data needed specifically for the predetermined purposes, from registers that can deliver these data, rather than compiling all data from all registers that are willing to participate.
    • The Scandinavian Sarcoma Group Central Register: 6,000 patients after 25 years of monitoring of referral and treatment of extremity and trunk wall soft-tissue sarcoma.

      Trovik, Clement; Bauer, Henrik C F; Styring, Emelie; Sundby Hall, Kirsten; Vult Von Steyern, Fredrik; Eriksson, Sigvard; Johansson, Ingela; Sampo, Mika; Laitinen, Minna; Kalén, Anders; et al. (Taylor & Francis, 2017-06)
      Purpose - We wanted to examine the potential of the Scandinavian Sarcoma Group (SSG) Central Register, and evaluate referral and treatment practice for soft-tissue sarcomas in the extremities and trunk wall (STS) in the Nordic countries. Background - Based on incidence rates from the literature, 8,150 (7,000-9,300) cases of STS of the extremity and trunk wall should have been diagnosed in Norway, Finland, Iceland, and Sweden from 1987 through 2011. The SSG Register has 6,027 cases registered from this period, with 5,837 having complete registration of key variables. 10 centers have been reporting to the Register. The 5 centers that consistently report treat approximately 90% of the cases in their respective regions. The remaining centers have reported all the patients who were treated during certain time periods, but not for the entire 25-year period. Results - 59% of patients were referred to a sarcoma center untouched, i.e. before any attempt at open biopsy. There was an improvement from 52% during the first 5 years to 70% during the last 5 years. 50% had wide or better margins at surgery. Wide margins are now achieved less often than 20 years ago, in parallel with an increase in the use of radiotherapy. For the centers that consistently report, 97% of surviving patients are followed for more than 4 years. Metastasis-free survival (MFS) increased from 67% to 73% during the 25-year period. Interpretation - The Register is considered to be representative of extremity and trunk wall sarcoma disease in the population of Scandinavia, treated at the reporting centers. There were no clinically significant differences in treatment results at these centers.
    • The Scandinavian Sarcoma Group: 30 years' experience

      Alvegård, Thor; Bauer, Henrik; Rydholm, Anders; Hall, Kirsten Sundby; Lindholm, Paula; Sigurdsson, Svante; Scandinavian Sarcoma Group (SSG), Dept. of Cancer Epidemiology, University Hospital, Lund, Sweden. thor.alvegard@med.lu.se (Taylor & Francis, 2009-04)
      The article offers information on the Scandinavian Sarcoma Group (SSG) whose aim is to uphold and improve the quality of diagnostics, treatment and care of sarcoma patients by sharing information and education and stimulate and coordinate basic and clinical research. SSG is composed of oncologists, surgeons and radiologists. Since 1979, SSG is conducting the following studies which include soft tissue sarcoma, osteosarcoma and Ewing's sarcoma.