• Yale-Brown obsessive compulsive scale: psychometric properties of the self-report version in a student sample

      Olafsson, Ragnar P; Snorrason, Ivar; Smari, Jakob (Springer Netherlands, 2010-06)
      The aim of the present study was to investigate the psychometric properties of an Icelandic translation of the self-report version of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR). The Y-BOCS-SR was administered to a sample of 427 Icelandic university students along with another measure of OCD symptoms (OCI-R) and measures of general anxiety and worry (GAD-Q-IV and PSWQ). The internal consistency of the Y-BOCS-SR total severity score and its obsession and compulsion subscales was very good. Confirmatory factor analysis supported the original two- factor structure of the severity dimensions but a three-factor model with obsession, compulsion and resistance/control factors fitted the data equally well. Five factors described best the latent structure of the symptom dimensions. Support was found for the convergent and divergent validity of the Y-BOCS-SR. The results indicate that the Y-BOCS-SR is a reliable and valid instrument for assessing the severity of obsessions and compulsions in a student population.
    • yCD/HPyCD mixtures as solubilizer: solid-state characterization and sample dexamethasone eye drop suspension.

      Jansook, Phatsawee; Ritthidej, Garnpimol C; Ueda, Haruhisa; Stefansson, Einar; Loftsson, Thorsteinn; Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland. (The Society, 2010)
      PURPOSE: Study the complexation of dexamethasone in combinations of γ-cyclodextrin (γCD) and 2-hydroxypropyl-γ-cyclodextrin (HPγCD) with emphasis on solid characterization and development of aqueous dexamethasone eye drop suspension for drug delivery through sclera. METHODS: Dexamethasone/cyclodextrin (dexamethasone/CD) solid complex systems were prepared and characterized by Fourier transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC), X-ray diffractometry (XRD), and by in vitro drug dissolution testing. Sample eye drop suspensions were prepared applying solubilizer/suspender consisting of γCD/HPγCD mixtures, poloxamer 407 (P407) and polyvinylpyrrolidone. The eye drop suspension was characterized by its physicochemical properties. RESULTS: The solid characterization techniques applied suggested that solid complexes were being formed. The results indicated that dexamethasone formed non-inclusion or micelle-like aggregates with HPγCD and the γCD/HPγCD mixture. The dissolution and dexamethasone release from the solid dexamethasone/γCD/HPγCD complexes was much faster than from the solid dexamethasone/γCD and dexamethasone/HPγCD complexes. The diameter of the solid particles in the dexamethasone eye drop suspension formulations were in all cases less than 10 μm with a mean diameter from 2.5 to 5.8 μm. The particle size decreased with increasing amount of P407. Permeation studies through semipermeable membrane and porcine sclera showed that increasing the amount HPγCD could enhance drug transport through the membrane barriers and this was related to enhanced drug solubility. The permeation rates were, however, decreased compared to formulation containing γCD alone due to larger hydrodynamic diameter of dexamethasone/γCD/HPγCD complex aggregates. All formulations were both chemically stable for at least 8 months at 25°C and 40°C. CONCLUSIONS: Combination of γCD and HPγCD, i.e., formation of dexamethasone/γCD/HPγCD complexes, resulted in synergistic effect. That is the mixture had greater solubilizing effect than the individual CD, resulted in enhanced dissolution and drug delivery through membranes. Furthermore, it is possible to control the drug release rate by adjusting the γCD:HPγCD ratio in the solid dexamethasone/γCD/HPγCD complexes.
    • Yes we can! Successful examples of disallowing 'conscientious objection' in reproductive health care.

      Fiala, Christian; Gemzell Danielsson, Kristina; Heikinheimo, Oskari; Guðmundsson, Jens A; Arthur, Joyce; [ 1 ] Gynmed Clin Abort & Family Planning, Mariahilfergurtel 37, A-1150 Vienna, Austria [ 2 ] Karolinska Inst, Karolinska Univ Hosp, Dept Womens & Childrens Hlth, Div Obstet & Gynaecol, Stockholm, Sweden [ 3 ] Univ Helsinki, Dept Obstet & Gynecol, Helsinki, Finland [ 4 ] Univ Helsinki, Cent Hosp, Helsinki, Finland [ 5 ] Univ Iceland, Womens Clin, Dept Obstet & Gynecol, Reykjavik, Iceland [ 6 ] Landspitali Univ Hosp, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 7 ] Abort Rights Coalit Canada, Vancouver, BC, Canada (Taylor & Francis Ltd, 2016-06)
      Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient's access to a legal medical treatment - usually abortion or contraception - by citing their 'freedom of conscience.' However, the authors' position is that 'conscientious objection' ('CO') in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries - Sweden, Finland, and Iceland - do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of 'CO' when the service is part of their professional duties. The purpose of investigating the laws and experiences of these countries was to show that disallowing 'CO' is workable and beneficial. It facilitates good access to reproductive health services because it reduces barriers and delays. Other benefits include the prioritisation of evidence-based medicine, rational arguments, and democratic laws over faith-based refusals. Most notably, disallowing 'CO' protects women's basic human rights, avoiding both discrimination and harms to health. Finally, holding HCPs accountable for their professional obligations to patients does not result in negative impacts. Almost all HCPs and medical students in Sweden, Finland, and Iceland who object to abortion or contraception are able to find work in another field of medicine. The key to successfully disallowing 'CO' is a country's strong prior acceptance of women's civil rights, including their right to health care.
    • YKL-40/CHI3L1 facilitates migration and invasion in HER2 overexpressing breast epithelial progenitor cells and generates a niche for capillary-like network formation.

      Morera, Erika; Steinhäuser, Sarah Sophie; Budkova, Zuzana; Ingthorsson, Saevar; Kricker, Jennifer; Krueger, Aileen; Traustadottir, Gunnhildur Asta; Gudjonsson, Thorarinn; 1 Stem Cell Research Unit, Biomedical Center, Department of Anatomy, Faculty of Medicine, School of Health Sciences, University of Iceland, Vatnsmyrarvegi 16, 101, Reykjavik, Iceland. 2 Heidelberg Institute for Stem Cell Technology and Experimental Medicine, Heidelberg, Germany. 3 Stem Cell Research Unit, Biomedical Center, Department of Anatomy, Faculty of Medicine, School of Health Sciences, University of Iceland, Vatnsmyrarvegi 16, 101, Reykjavik, Iceland. tgudjons@hi.is. 4 Department of Laboratory Hematology, Landspitali - University Hospital, Reykjavik, Iceland. tgudjons@hi.is. (Springer, 2019-12)
      Epithelial to mesenchymal transition (EMT) is a developmental event that is hijacked in some diseases such as fibrosis and cancer. In cancer, EMT has been linked to increased invasion and metastasis and is generally associated with a poor prognosis. In this study, we have compared phenotypic and functional differences between two isogenic cell lines with an EMT profile: D492M and D492HER2 that are both derived from D492, a breast epithelial cell line with stem cell properties. D492M is non-tumorigenic while D492HER2 is tumorigenic. Thus, the aim of this study was to analyze the expression profile of these cell lines, identify potential oncogenes, and evaluate their effects on cellular phenotype. We performed transcriptome and secretome analyses of D492M and D492HER2 and verified expression of selected genes at the RNA and protein level. One candidate, YKL-40 (also known as CHI3L1), was selected for further studies due to its differential expression between D492M and D492HER2, being considerably higher in D492HER2. YKL-40 has been linked to chronic inflammation diseases and cancer, yet its function is not fully understood. Knock-down experiments of YKL-40 in D492HER2 resulted in reduced migration and invasion as well as reduced ability to induce angiogenesis in an in vitro assay, plus changes in the EMT-phenotype. In summary, our data suggest that YKL-40 may provide D492HER2 with increased aggressiveness, supporting cancer progression and facilitating angiogenesis.
    • 'You should always look at the washing machine without actually being in it!' Thematic framework analysis of patients' understanding of transdiagnostic cognitive behaviour therapy and its mechanisms.

      Sighvatsson, Magnus Blondahl; Salkovskis, Paul M; Sigurdsson, Engilbert; Valdimarsdottir, Heiddis B; Thorsdottir, Fanney; Sigurdsson, Jon Fridrik; 1University of Iceland, Reykjavík, Iceland. 2Reykjavik University, Iceland. 3University of Oxford, UK. 4Landspitali-The National University Hospital of Iceland, Reykjavík, Iceland. 5Mount Sinai School of Medicine, New York City, New York, USA. (Wiley, 2019-02-07)
      Objective: Transdiagnostic cognitive behaviour therapy (TCBT) is an efficacious treatment for anxiety and depression, but its mechanisms of change remain poorly understood. The current study used thematic framework analysis to analyse how patients, recruited in a recent trial on transdiagnostic group CBT (TGCBT), understood the treatment and its mechanisms. Design: Cross-sectional thematic framework analysis. Method: The sample included 24 participants suffering from anxiety and/or depression, divided into two groups by treatment efficacy (i.e., group doing well and group doing not so well) in order to evaluate whether different understandings of the treatment affected its efficacy. The participants were interviewed and completed self-report measures. They were encouraged to discuss what they believed to be helpful and unhelpful in the TGCBT and what they believed to be the mechanisms of change in the treatment. Each interview was recorded, transcribed verbatim and themes were identified. Results: The analysis revealed four overarching themes and 18 subthemes. The overarching themes were as follows: Cognitive and behavioural flexibility, Awareness/understanding of symptoms and triggers, Therapeutic alliance and engagement, and finally Attitudes towards treatment. Four of the 18 subthemes corresponded to a differentiation between the groups: Cognitive flexibility and Comparison with others in the group on the one hand and Cognitive inflexibility and Negative attitudes towards treatment on the other. Conclusion: The most important difference between the groups appeared to be CBT-specific, that is, cognitive flexibility that characterized the group doing well where thematic analysis did not indicate that other themes were important. Practitioner points: Findings The analysis revealed four overarching themes and 18 subthemes, four of which corresponded to the difference between the two groups of participants based on treatment efficacy. The four differentiating subthemes were cognitive flexibility and comparison with others, which characterized the group doing well, and cognitive inflexibility and negative attitude towards treatment, which characterized the group doing less well. The theme evaluated as the most important for the efficacy of the transdiagnostic cognitive behaviour therapy and patients' understanding of the treatment was cognitive flexibility, which characterized the group doing well. Limitations Use of qualitative methodology restricts the generalizability of our results. Data are built on answers from only 24 participants.
    • "You stop thinking about yourself as a woman". An interpretive phenomenological study of the meaning of sexuality for Icelandic women during pregnancy and after birth.

      Bender, Sóley S; Sveinsdóttir, Edda; Fridfinnsdóttir, Hilda; [ 1 ] Univ Iceland, Fac Nursing, Eiriksgata 34, IS-101 Reykjavik, Iceland [ 2 ] Landspitali Natl Univ Hosp Iceland, Dept Obstet & Gynecol, IS-101 Reykjavik, Iceland (Elsevier Science Ltd., 2018-07)
      There exists considerable evidence about reduced sexual desire and sexual disorders during pregnancy and after giving birth. More in-depth qualitative evidence is needed. The purpose of this study was to find out how Icelandic women experienced their sexuality during pregnancy and after giving birth.
    • Young adult survivors of childhood acute lymphoblastic leukemia: spontaneous GH secretion in relation to CNS radiation

      Jarfelt, M; Bjarnason, R; Lannering, B; Department of Pediatrics, Division of Hematology and Oncology, Sahlgrenska Academy of Göteborg University, Göteborg, Sweden. marianne.jarfelt@vgregion.se (John Wiley, 2004-06-01)
      BACKGROUND: Young adults who are long-term survivors of acute lymphoblastic leukaemia (ALL) in early childhood usually do well and do not have to go to regular medical checkups. Many of these survivors did receive prophylactic cranial radiotherapy during their oncological treatment. The effect of cranial irradiation on the hypothalamus is considered to be progressive. Therefore, late effects, such as reduced growth hormone (GH) secretion, may remain undetected until adulthood. PROCEDURE: Records from all patients treated for ALL before the onset of puberty in the region of West Sweden, between 1 January 1973 and 31 December 1985 were included, provided they were in first remission with a minimum follow-up time of 15 years, and a minimum age of 20. These criteria were met by 47 young adults aged 20-32 years, of whom 35 agreed to participate. We studied spontaneous GH secretion over 24 hr, IGF-I and IGFBP-3, final height and BMI. The patients had been treated according to three consecutive Swedish childhood leukaemia group protocols. The median follow-up time was 20 years, and 19 of the patients had been treated with cranial irradiation (CRT+), 16 had not (CRT-). RESULTS: CRT+ patients had significantly lower maximal peaks of GH than CRT- patients. Fifty percent of the CRT+ patients had a GH(max) below the cut-off level (3.3 microg/l), for GH treatment. CRT- patients all had GH(max) levels considered within the normal range. Final height of all the patients, except one CRT+ women, was in the range of expected midparental height, the median loss in final height in the CRT+ patients was 0.8 standard deviation (SD). No patient in this study was obese by definition (BMI <30 kg/m(2)). IGF-I and IGFBP-3 concentrations did not correlate to variations in spontaneous GH secretion in these patients. CONCLUSIONS: In spite of the little effect on final height, we found impaired spontaneous GH secretion in 79% of young adults 20-32 years of age, and GH deficiency (GHD) in 47% after low-dose cranial irradiation in early childhood. The consequences of this low-GH secretion need to be investigated.
    • Young maternal age at delivery is associated with asthma in adult offspring

      Laerum, Birger N; Svanes, Cecilie; Wentzel-Larsen, Tore; Gulsvik, Amund; Torén, Kjell; Norrman, Eva; Gislason, Thorarinn; Janson, Christer; Omenaas, Ernst (W.B. Saunders, 2007-07-01)
      OBJECTIVE: Some studies have shown an association between lower maternal age at delivery and increased asthma in children and young adults. It is unclear whether this represents an effect of maternal ageing or a protective effect of siblings. In a North-European population based study, we investigated whether mother's age at delivery was associated with risk for asthma and hay fever in adult offspring, taking into account relevant confounders. METHODS: A total of 16,190 subjects (74%) aged 23-54yr answered a postal questionnaire in a follow-up of the European Community Respiratory Health Survey (ECRHS I). RESULTS: The associations of maternal age at delivery with hay fever, respiratory symptoms and diagnosed asthma were analysed using logistic regression, adjusting for household size, dwelling, parental education, centre, gender, adult hay fever, smoking, age and body mass index (BMI). The adjusted odds ratios (95% CI) for wheeze with breathlessness, wheeze without a cold and asthma in the offspring were 0.94 (0.90-0.99), 0.89 (0.86-0.94) and 0.92 (0.88-0.97), respectively, per 5yr increase in maternal age. No heterogeneity between centres was found (p=0.84). The estimates remained similar in sub-sample analyses when adjusting for siblings, maternal smoking (n=3109) and for birth weight (n=1686). Hay fever was more common among those with the youngest and oldest mothers. CONCLUSIONS: In this large North-European multi-centre study, asthma was less common with increasing maternal age. This effect was consistent between centres and persisted with adjustment for several potential confounders, suggesting that the association may possibly be explained by biological changes related to maternal ageing.
    • Young overweight and obese women with lower circulating osteocalcin concentrations exhibit higher insulin resistance and concentrations of C-reactive protein.

      Lucey, Alice J; Paschos, Georgios K; Thorsdottir, Inga; Martínéz, J Alfredo; Cashman, Kevin D; Kiely, Máireád; Natl Univ Ireland Univ Coll Cork, Sch Food & Nutr Sci, Cork, Ireland, Univ Iceland, Unit Nutr Res, Reykjavik, Iceland, Landspitali Univ Hosp, Reykjavik, Iceland, Univ Navarra, Dept Physiol & Nutr, E-31080 Pamplona, Spain, Natl Univ Ireland Univ Coll Cork, Sch Med, Cork, Ireland (Pergamon Elsevier Science, 2013-01)
      The role of the skeleton in the regulation of energy metabolism in humans is not clear. This study investigates the hypothesis that biomarkers of bone turnover are associated with indices of glucose homeostasis and systemic inflammation in young adults. A cross-sectional study investigating the relationships between biomarkers of bone turnover (serum total and uncarboxylated osteocalcin, bone-specific alkaline phosphatase, C-telopeptide of type I collagen, urinary N-telopeptide of type I collagen) and glucose metabolism (fasting plasma glucose [FPG], insulin, insulin resistance [homeostatic model assessment of insulin resistance]), systemic inflammation (high-sensitivity C-reactive protein [hsCRP] and interleukin-6), adipokines (leptin and adiponectin), and body composition was conducted in 268 young, nondiabetic overweight and obese adults aged 20 to 40 years (116 men, 152 women; body mass index, 27.5-32.5 kg/m(2)). Data on diet, physical activity, serum 25-hydroxyvitamin D, and parathyroid hormone were also collected. In women, there was a stepwise increase in lean body mass (P < .05) and a decrease in serum hsCRP (P < .001) across tertiles of total osteocalcin. Multiple linear regression analysis showed significant inverse associations between total osteocalcin and FPG (β = -0.350; P = .016; 95% confidence interval [CI], -0.35 to -0.04), insulin (β = -0.455; P = .002; 95% CI, -1.9 to -0.46), and homeostatic model assessment of insulin resistance (β = -0.508; P = .001; 95% CI, -10.93 to -3.17) in women with total osteocalcin concentrations below the group median. Men in the lowest tertile of uncarboxylated osteocalcin had twice the concentration of hsCRP than did other men (P = .05). In this sample, women with less lean body mass had lower circulating total osteocalcin concentrations and exhibited higher FPG, insulin resistance, and hsCRP compared with their similarly sized counterparts, suggesting that associations between osteocalcin and systemic inflammation, glucose homeostasis, and insulin resistance may be influenced by differences in sex and body composition.
    • Ziprasidone versus olanzapine, risperidone or quetiapine in patients with chronic schizophrenia: a 12-week open-label, multicentre clinical trial

      Lublin, Henrik; Haug, Hans-Joachim; Koponen, Hannu; Sigmundsson, Thordur; Kolb, Stefan A; Psychiatric University Center Glostrup, University of Copenhagen, Glostrup, Denmark. henlub01@glo.regionh.dk (Informa Healthcare, 2009)
      The efficacy, safety and tolerability of ziprasidone versus the comparators olanzapine, risperidone or quetiapine were investigated in adult patients with chronic schizophrenia, schizoaffective and schizophreniform disorders, with lack of efficacy or intolerance to their previous antipsychotic treatment based on clinical judgement of the investigator. A total of 293 patients were randomized to 12 weeks treatment with either ziprasidone 80-160 mg/day (n=147) or with one of the comparator drugs (n=146). In the latter group the investigator could choose between olanzapine 10-20 mg/day (n=24), risperidone 4-8 mg/day (n=22) or quetiapine 300-750 mg/day (n=97). The study comprised four visits including a baseline examination prior to randomization and further examinations at the end of weeks 1, 4 and 12. Ziprasidone was non-inferior (defined as a difference of 7 units or less on the PANSS scale to the disadvantage of ziprasidone) to the composite group (olanzapine, risperidone or quetiapine) on the total PANSS score as well as on all subscores (P<0.0001); there were no significant between-group differences in the CGI-S and I and UKU scores. Ziprasidone-treated patients lost an average of 2.1 kg in the 12 weeks of the study, the mean weight for risperidone and quetiapine remained unchanged, and patients receiving olanzapine gained 3.1 kg on average.
    • Zonulin-Dependent Intestinal Permeability in Children Diagnosed with Mental Disorders: A Systematic Review and Meta-Analysis.

      Asbjornsdottir, Birna; Snorradottir, Heiddis; Andresdottir, Edda; Fasano, Alessio; Lauth, Bertrand; Gudmundsson, Larus S; Gottfredsson, Magnus; Halldorsson, Thorhallur Ingi; Birgisdottir, Bryndis Eva; 1Unit for Nutrition Research, Faculty of Food and Nutritional Sciences, University of Iceland, 101 Reykjavik, Iceland. 2Faculty of Medicine, School of Health Sciences, University of Iceland, 101 Reykjavik, Iceland. 3Children's and Adolescents Psychiatric Unit, Landspitali University Hospital, 101 Reykjavik, Iceland. 4Division of Pediatric Gastroenterology and Nutrition, Harvard Medical School, MassGeneral Hospital for Children, Boston, MA 02114, USA. 5Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, 101 Reykjavik, Iceland. 6Department of Scientific Affairs, Landspitali University Hospital, 101 Reykjavik, Iceland. (MDPI Publishing, 2020-07-03)
      Worldwide, up to 20% of children and adolescents experience mental disorders, which are the leading cause of disability in young people. Research shows that serum zonulin levels are associated with increased intestinal permeability (IP), affecting neural, hormonal, and immunological pathways. This systematic review and meta-analysis aimed to summarize evidence from observational studies on IP in children diagnosed with mental disorders. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of the Cochrane Library, PsycINFO, PubMed, and the Web of Science identified 833 records. Only non-intervention (i.e., observational) studies in children (<18 years) diagnosed with mental disorders, including a relevant marker of intestinal permeability, were included. Five studies were selected, with the risk of bias assessed according to the Newcastle-Ottawa scale (NOS). Four articles were identified as strong and one as moderate, representing altogether 402 participants providing evidence on IP in children diagnosed with attention deficit and hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and obsessive-compulsive disorder (OCD). In ADHD, elevated serum zonulin levels were associated with impaired social functioning compared to controls. Children with ASD may be predisposed to impair intestinal barrier function, which may contribute to their symptoms and clinical outcome compared to controls. Children with ASD, who experience gastro-intestinal (GI) symptoms, seem to have an imbalance in their immune response. However, in children with OCD, serum zonulin levels were not significantly different compared to controls, but serum claudin-5, a transmembrane tight-junction protein, was significantly higher. A meta-analysis of mean zonulin plasma levels of patients and control groups revealed a significant difference between groups (p = 0.001), including the four studies evaluating the full spectrum of the zonulin peptide family. Therefore, further studies are required to better understand the complex role of barrier function, i.e., intestinal and blood-brain barrier, and of inflammation, to the pathophysiology in mental and neurodevelopmental disorders. This review was PROSPERO preregistered, (162208).
    • γ-Cyclodextrin nanoparticle eye drops with dorzolamide: effect on intraocular pressure in man.

      Gudmundsdottir, Birna S; Petursdottir, Dyrleif; Asgrimsdottir, Gudrun M; Gottfredsdottir, Maria S; Hardarson, Sveinn H; Jóhannesson, Gauti; Kurkov, Sergey V; Jansook, Phatsawee; Loftsson, Thorsteinn; Stefánsson, Einar; et al. (Association For Ocular Pharmacology And Therapeutics, 2014-02)
      To test a new drug delivery platform with dorzolamide γ-cyclodextrin (γCD) nanoparticle eye drops for intraocular pressure (IOP) control and safety and compare with Trusopt.(®)