• 2,8- díhýdroxýadenínúría

      Þröstur Laxdal (Læknafélag Íslands, Læknafélag Reykjavíkur, 1994-04-01)
      Since 1983, total of 12 patients with 2,8-dihydroxyadeninuria have been detected in Iceland. This makes the prevalence of this autosomal recessively inherited disturbance in purine metabolism considerably higher in this country than elsewhere recorded, or 1: 22.000. There were 7 males and 5 females equally divided between children and adults, the age ranging from 6 months to 46 years. Most of the adults had many years' history of renal colic and stones before diagnosis. None of the 6 children had yet suffered urolithiasis at the time of diagnosis, but 2 had history of intermittent red-brownish spots in their diapers. All of the 12 patients were originally detected by the appearance of characteristic brownish, round crystals on regular light microscopy of their urine. Diagnosis was confirmed by UV and IR spectrophotometry of urine crystals and finally by enzyme analysis in their lyzed red blood cells. All of the patients showed red-brown sediment after urine centrifugation, which therefore might be used as an additional clue to diagnosis, along with the unique 2,8-dihydroxyadenine crystals, even in the absence of symptoms. Three of the asymptomatic children were coincidentally detected by routine urine microscopy, the first ones so reported in the literature. Unexpectedly high proportion, or 9 of the 12 patients, had red hair (vs 4-5% in the general Icelandic population). Identical missense mutation of the APRT gene was found in all the Icelandic patients, suggesting a founder effect. Five of the patients were distantly related through 5th to 7th generations and other three shared common great grandparents and great-great grandparents. All the patients were prescribed on allopurinol along with limitation of purine intake, whether asymptomatic or not. None has had further symptoms while abiding by recommended treatment. The keyrole of competent urine microscopists in the primary detection of this potentially lethal disease is underscored.
    • A-V fistill þrjátíu og tveimur árum eftir hlutabrottnám á maga : sjúkratilfelli

      Tómas Guðbjartsson; Sigurður V. Sigurjónsson; Tómas Jónsson; Einar Oddsson; Guðmundur Þorgeirsson; Jónas Björn Magnússon (Læknafélag Íslands, Læknafélag Reykjavíkur, 1997-09-01)
      Portal arteriovenous fistulas are uncommon and are most often seen following trauma to the abdomen. In a few cases they have occurred as complications of abdominal surgery. In this report we present a 74 year old man with a fistula between the left gastric artery and vein, secondary to a Billroth I partial gastrectomy that was performed 32 years earlier. The patient complained of a diffuse abdominal pain for two weeks and mild cardiac failure symptoms. An epigastric bruit was heard and the abdomen was distended with transudatic ascitic fluid. The fistula was diagnosed by Doppler-ultrasound and the diagnosis confirmed by angiography. At laparotomy the fistula was excised and the patient's symptoms subsequently subsided.
    • Activated and total coagulation factor VII, and fibrinogen in coronary artery disease

      Danielsen, R; Onundarson, P T; Thors, H; Vidarsson, B; Morrissey, J H; Department of Medicine, Landspítalinn, University Hospital, Reykjavik, Iceland. (Taylor & Francis, 1998-03-01)
      Fibrinogen (FBG) and total coagulation factor VII (FVIIc) concentrations are higher in those patients with coronary artery disease who are at increased future risk of acute ischemic events. The relationship between activated factor VII (FVIIa) and cardiovascular events, however, has not been intensively studied. Data were collected from 401 consecutive patients who underwent coronary angiography because of suspected coronary artery disease. Conventional risk factors FVIIc, FVIIa and FBG were assessed in relation to the severity of coronary artery disease, left ventricular ejection fraction, and previous clinical events. A strong positive correlation was found between FVIIa and FVIIc (p < 0.001), but neither FVIIa nor FVIIc correlated with FBG. No correlation was found between FVIIa, FVIIc or FBG levels and stenosis score for the severity of coronary artery disease, and all were similar in patients with stable or unstable angina pectoris. Multivariate regression analysis showed FVIIc to be higher in women (p = 0.004), and positively related to triglycerides (p = 0.001) and HDL cholesterol (p = 0.006), but not to a previous myocardial infarction or total cholesterol. FVIIa, on the other hand, was lower in patients with a previous myocardial infarction (p = 0.004), higher in women (p = 0.001) and those that previously had undergone percutaneous transluminal coronary angioplasty (p = 0.039), and positively related to total cholesterol (p = 0.011), duration of coronary artery disease (p = 0.032), and smoking (p = 0.008). FBG was positively associated with a previous myocardial infarction (p = 0.013), hypertension (p = 0.016), smoking (p = 0.005), and the thrombocyte count (p < 0.001). Finally, stepwise logistic regression analysis verified a previous myocardial infarction to be negatively associated with FVIIa (p = 0.03), and positively with FBG (p = 0.03), total cholesterol (p = 0.02), and the severity of coronary artery disease (p < 0.001). In conclusion, in patients suspected of coronary artery disease undergoing cardiac catheterization, FVIIa was decreased and FBG increased in those who had a previous myocardial infarction. FVIIa, FVIIc, or FBG levels were not, however, related to the severity of coronary artery disease, and they were similar in patients with stable or unstable angina pectoris.
    • ADHD meðal barna og unglinga: samsláttur við aðrar raskanir

      Urður Njarðvík; Sálfræðideild Háskóla Íslands (Sálfræðingafélag Íslands, 2018-04-18)
      Athyglisbrestur með ofvirkni (ADHD) er ein algengasta ástæðan fyrir tilvísunum barna í geðheilbrigðistengda þjónustu. Samsláttur ADHD við aðrar raskanir er svo tíður að algengara er að börn greinist með einhverja röskun til viðbótar heldur en eingöngu ADHD. Tilgangur þessarar greinar er að veita yfirlit yfir rannsóknir á tíðni samsláttar ADHD við aðrar raskanir meðal barna og unglinga. Fjallað er um helstu geð- og taugaþroskaraskanir sem greinast samhliða ADHD, tíðni þeirra skoðuð út frá mismunandi aðferðum rannsókna og fjallað um íslenskar rannsóknir þar sem þær eru til. Algengustu greiningarnar reyndust vera mótþróaþrjóskuröskun og kvíðaraskanir með allt að 40% tíðni. Lyndisraskanir voru einnig algengar, með um 20% tíðni, en raskanir á einhverfurófi og kipparaskanir voru sjaldgæfari. Lítið er til af íslenskum rannsóknum, en þær sem til eru benda til mjög hárrar tíðni samsláttar, einkum við kvíðaraskanir og þunglyndi. Þar sem viðbótargreiningar hafa neikvæð áhrif á framvindu barna með ADHD er nauðsynlegt að fagaðilar sem vinna með þessum hópi skimi reglulega fyrir þessum röskunum og fylgist vel með framvindu einkenna. -
    • Afdrif barna á Íslandi sem eru ættleidd erlendis frá

      Málfríður Lorange; Kristín Kristmundsdóttir; Guðmundur Skarphéðinsson; Björg Sigríður Hermannsdóttir; Linda Björk Oddsdóttir; Dagbjörg B. Sigurðardóttir; BUGL, Landspitali The National University Hospital, Reykjavik, Iceland. (Læknafélag Íslands, Læknafélag Reykjavíkur, 2012-01)
      OBJECTIVE: In recent years a number of children have been adopted to Iceland. The aim of our study was to evaluate which factors may affect their mental and behavioural health. MATERIALS AND METHODS: Information was collected on the health of internationally adopted children in Iceland as well as on pre-adoptive risk factors. This was done using a survey developed by Dr. Dana Johnson from the International Adoption Project at the University of Minnesota in the United States. Other questionnaires include the Child Behavior Checklist (CBCL), Strenghts and Difficulties Questionnaires (SDQ), Attention Deficit/Hyper activity Rating Scale (ADHD-RS-IV) and Austism Spectrum Screening Questionaire (ASSQ). For the comparative analysis data from the general population was used. RESULTS: Children adopted after 18 months of age and who have been institutionalised for 18 months or more showed higher risk for ADHD symptoms and behavioral and emotional problems than the general population. In addition, those who were subject to severe emotional neglect had significantly higher scores on CBCL, SDQ and ADHD-RS. A trend was seen between risk factors and scores on ASSQ. Children adopted before 12 months of age scored within the normal range on all questionnaires. CONCLUSION: These results suggest that children adopted after 18 months of age are at risk of psychopathological difficulties. These results emphasize the importance of early adoption and of minimizing the time spent in an institution.
    • Afdrif sjúklinga eftir aðsvif

      Anna Jóhannsdóttir; Gizur Gottskálksson; Jóhann Ragnarsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1994-10-01)
      Mortality and resyncope were investigated after five years in 111 patients with syncope, a prospective study conducted at the Reykjavik City Hospital 1985-1986. Twenty one (18.9%) patients have died in this interval, 90 living, 81 patients were traced and resyncope occurred among 20 (24.7%) due to the same cause in 14 of 20 patients. Four patients died in the group (11) that was originally diagnosed with CVD disease (36.4% p<0.001) compared to expected mortality corrected for age, similar results were found in the group (22) with orthostatic hypotension as the cause of syncope. In the total group 21 died versus four expected (p<0.001). This confirms previous results by other investigators that mortality is high among this group of patients. In repeated study 1988-1989 we found that near syncope was frequently cardiovascular in origin and was a cause in 28% of patients, and orthostatic hypotension 20%. A syncope or near syncope should be investigated thoroughly to arrive at a diagnosis, especially in elderly people.
    • Afdrif sjúklinga með iðraólgu

      Gísli Baldursson; Jón Steinar Jónsson; Stefán Þórarinsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1996-03-01)
      Irritable bowel syndrome (IBS) is among the most common gastrointestinal disorders. In this survey, the prognosis of patients diagnosed with IBS was examined. In 1982, 81 (2.9%) of the inhabitants in Egilsstaðir health care district had diagnosed IBS on their medical records (ICCH 558). Twelve years later, in 1994, the health records of those patients were examined. Information was gathered through a questionnaire, which 76% answered. Of those who answered 28% had no longer any symptoms, but 38% experienced symptoms once a month or more frequently. The medical records of 11 patients who died were checked, revealing that two had had a confirmed gastrointestinal disease, but not in the colon.
    • Afdrif sjúklinga með óútskýrða kviðverki á bráðamóttöku

      Ómar Sigurvin Gunnarsson; Guðjón Birgisson; Margrét Oddsdóttir; Tómas Guðbjartsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2011-04)
      Objective: Non-specific abdominal pain (NSAP) is the most common diagnosis of patients presenting to emergency departments (ED) with abdominal pain. The aim of this retrospective study was to investigate how many NSAP patients were re-admitted within 1 year to the ED with abdominal pain. Material and methods: Included were all patients discharged with NSAP from adult EDs of Landspítali University Hospital (gynecology and pediatric EDs excluded), from January 1, 2005 to December 31, 2005. Hospital records for patients re-admitted within 12 months with abdominal pain were reviewed. Symptoms, pain location, blood tests and imaging results were registered, also the subsequent discharge diagnosis at re-admission. Results: Out of 62.116 patients attending the EDs in 2005, 1411 (2.3%) were diagnosed with NSAP. During 12 months, 112 of these 1411 patients (7.9%) were re-admitted to the ED with abdominal pain, most of them ≥2 times. Out of 112 patients, 27 (24.1%) were discharged with a more specific diagnosis; cholelithiasis (29.6%), appendicitis (18.5%) and gastrointestinal cancer (7.4%) being the most common diagnosis. The other 85 (76%) patients were diagnosed with NSAP again. Surgery was performed in 17 of the 27 (63%) cases and 8 received specific treatment, most often antibiotics. Conclusion: Almost 8% of discharged NSAP patients were re-admitted within a year for abdominal pain. At re-admission, one of four patients received a more specific diagnosis, most often cholelithiasis or appendicitis. Our results suggest that the diagnosis of patients with NSAP, at the first visit to the ED, could be improved.
    • Afdrif þeirra sem gengist hafa undir æxlisminnkandi skurðaðgerð og hitaða lyfjameðferð innan lífhimnu

      Ástríður Pétursdóttir; Örvar Gunnarsson; Elsa B. Valsdóttir; 1)3) Kviðarholsskurðdeild, 2) lyflækningar krabbameina Landspítala, 3) læknadeild Háskóla Íslands. (Læknafélag Íslands, 2020-07)
      Inngangur Krabbameinager í kviðarholi er oft afleiðing krabbameins í ristli eða endaþarmi og er illlæknanlegt ástand. Lifun sjúklinga með krabbameinager hefur að meðaltali verið undir tveimur árum eftir kerfislæga krabbameinslyfjameðferð með eða án skurðaðgerðar. Einn meðferðarmöguleikinn felst í æxlisminnkandi skurðmeðferð og lyfjameðferð innan kviðarhols og hefur verið sýnt fram á að þessi meðferð getur bætt horfur valinna sjúklinga. Tilgangur þessarar rannsóknar var að kanna afdrif sjúklinga sem farið hafa frá Íslandi í þessa meðferð erlendis. Efniviður og aðferðir Afturskyggn rannsókn á öllum íslenskum sjúklingum sem gengust undir CRS-HIPEC-aðgerð erlendis á árunum 2008-2017. Upplýsingum var safnað frá Siglinganefnd Sjúkratrygginga Íslands og úr sjúkraskýrslum Landspítala. Niðurstöður Alls hafa 11 einstaklingar gengist undir CRS-HIPEC-meðferð eftir upphaflega meðferð á Landspítala. Allar aðgerðirnar voru framkvæmdar í Bandaríkjunum af sama skurðlækni. Hópurinn telur 10 konur og einn karl og var meðalaldur 53 ár. Orsök krabbameinagers var illkynja mein í botnlanga hjá 7 sjúklingum (67%) og illkynja mein í ristli hjá þremur sjúklingum (27%). Einn sjúklingur var með illkynja frummein í lífhimnu, iðraþekjuæxli. Þrír sjúklingar (27%) fengu fylgikvilla innan 30 daga frá aðgerð, tveir fengu sýkingu og einn garnatengingarleka. Einn sjúklingur fékk síðkominn fylgikvilla í formi þrenginga í görn og síðar fistilmyndunar. Fimm sjúklingar hafa lokið 5 ára eftirfylgd án endurkomu sjúkdóms en meðaltími eftirfylgdar eru 44 mánuðir. Af 11 sjúklingum eru 10 enn á lífi. Fimm manns hafa greinst með endurkomu krabbameins. Ályktanir Íslenskum sjúklingum sem gengist hafa undir CRS-HIPEC-aðgerð hefur í flestum tilvikum vegnað vel og lifun er sambærileg við erlendar rannsóknarniðurstöður. Helmingur sjúklinganna sem enn eru á lífi hafa lokið 5 ára eftirfylgd án endurkomu sjúkdóms. Horfur eru talsvert betri en þær voru áður en til þessarar meðferðar kom og því er full ástæða til að halda áfram að senda valda íslenska sjúklinga erlendis í þessa meðfer
    • Affrumað roð: Eðliseiginleikar sem styðja vefjaviðgerð

      Magnússon, Skúli; Baldursson, Baldur Tumi; Kjartansson, Hilmar; Thorlacius, Guðný Ella; Axelsson, Ívar; Rolfsson, Óttar; Petersen, Pétur Henry; Sigurjónsson, Guðmundur Fertram; Kerecis ehf, Landspítali, Læknadeild Háskóli Íslands, Kerfisfræðasetur Háskóli Íslands (Læknafélag Íslands, Læknafélag Reykjavi­kur, 2015-12-04)
      Inngangur: Affrumað roð Atlantshafsþorsks (Gadus morhua) hefur verið notað undanfarin ár til meðhöndlunar á þrálátum sárum. Tíðni sykursýki hefur aukist mikið í heiminum en ein af afleiðingum hennar eru þrálát sár. Markmið rannsóknanna var að kanna vefjasamrýmanleika og eiginleika sem skipta máli fyrir nýtingu roðsins til viðgerðar á líkamsvef. Efniviður og aðferðir: Bygging affrumaðs roðs var metin með smásjárskoðun. Mat á vefjasamrýmanleika græðlingsins var framkvæmd af vottaðri sérhæfðri rannsóknarstofu. Próteinhluti efnisins var kannaður með próteinrafdrætti. Seyting frumuboðanna interleukin-10 (IL-10) og IL-12p40, IL-6 og TNF-α frá einkjörnungum (monocytes) eða stórátfrumum (macrophages) í uppleystum próteinhluta efnisins var mældur með Elísu-prófi. Áhrif roðsins á nýmyndun æða in vivo var metin með æða- og þvagbelgshimnulíkani í hænufóstrum. Niðurstöður: Smásjármyndir sýna að bygging affrumaðs roðs er holótt. Efnið stóðst öll vefjasamrýmanleikapróf. Við rafdrátt próteinsýnis komu í ljós prótein á stærðarbilinu 115-130 kDa sem er einkennandi fyrir bandvef. Roðið reyndist ekki hafa marktæk áhrif á seytingu IL-10, IL-12p40, IL-6 eða TNF-αfrá einkjörnungum eða stórátfrumum. Græðlingurinn hefur marktæk örvandi áhrif á æðamyndun í æða- og þvagbelgshimnulíkani. Ályktun: Niðurstöðurnar sýna að affrumað roð er skaðlaust og veldur ekki bólgusvari. Græðlingurinn inniheldur meðal annars bandvef líkt og mannshúð. Affrumað roð hefur marktæk örvandi áhrif á æðamyndun og smásjármyndir af byggingu roðsins sýna að hún sé vel til þess fallin að styðja innvöxt frumna. Samanburðarrannsókn sem hefur verið birt, tvíblind og slembiröðuð, sýndi að sár meðhöndluð með affrumuðu roði greru hraðar en sár meðhöndluð með stoðefni úr svínavef. Líklegt er að ástæða þessa bætta sáragróanda sé meðal annars vegna eiginleika roðsins sem hér er lýst.
    • Afgreiðsla á neyðargetnaðarvörn í apótekum

      Margrét Lilja Heiðarsdóttir; Anna Birna Almarsdóttir; Reynir Tómas Geirsson (2009-05-01)
      Objective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, reynirg@landspitali.is.
    • Afleidd kalkkirtlaofvirkni hjá sjúklingum með nýrnabilun

      Ólafur Skúli Indriðason (Læknafélag Íslands, Læknafélag Reykjavíkur, 1999-01-01)
      In renal failure, several factors lead to parathyroid gland overactivity, manifested by hypersecretion of parathyroid hormone (PTH) and glandular hyperplasia eventually leading to monoclonal expansion of glandular cells in severe cases. Main factors contributing to this secondary hyperparathyroidism are increased end-organ resistance to PTH, low serum calcium and high serum phosphate concentrations and decreased production of 1,25-dihydroxyvitamin D3 by the kidneys. Treatment is directed towards correction of these underlying disturbances in mineral metabolism, however, such maneuvers are not always successful in controlling parathyroid gland activity. Functional disturbances within the parathyroid glands e.g., decrements in vitamin D or calcium sensing receptor number or function and/or increased cell mass have been implicated in therapeutic resistance. This article discusses the role of such functional derangements and details the results of a recent study demonstrating the importance of gland mass in this context.
    • Afstaða unglækna og læknanema til sérfræðináms á Íslandi

      Inga Sif Ólafsdóttir; Sædís Sævarsdóttir; Kolbrún Pálsdóttir; Hannes Petersen; Ólafur Baldursson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2005-06-01)
      BACKGROUND: Various parties have expressed interest in establishing formal postgraduate medical education programs. The interest of residents and medical students to such programs in Iceland has not been evaluated before. METHODS: A questionnaire was sent to 146 interns and residents and 84 senior medical students. The following variables were analyzed: Gender, attitude towards postgraduate training in Iceland, interest to participate in such training, preferred specialty and which factors might influence their decision. RESULTS: 100 subjects completed the questionnaire (response rate 45%), 61 interns and residents and 39 medical students. Of those completing the questionnaire, most interns and residents (97%) and medical students (87%) agreed or agreed strongly with the concept of postgraduate training in Iceland. The majority of responders wanted to undergo part of their postgraduate training in Iceland if this option would be available. Those who preferred postgraduate training in Iceland did so for the following reasons: The importance of "hands-on" training, availability of consultants, favorable social setting and organized teaching. Those who wanted to do all their postgraduate training abroad rated case variability, "hands-on" training, organized teaching and research opportunities as the main factors influencing their decision. CONCLUSIONS: Interns, residents and medical students are in favor of undergoing part of their postgraduate training in Iceland. Those who chose to train abroad rated case variability and research opportunities higher than those in favor of training in Iceland.
    • Afturvirk rannsókn á heilsufarsbreytum heimilismanna á Droplaugarstöðum árin 1983-2002

      Ársæll Jónsson; Ingibjörg Bernhöft; Karin Bernhardsson; Pálmi V. Jónsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2005-02-01)
      BACKGROUND: A municipal nursing home with 68 beds in Reykjavík, opened in mid-year 1982. OBJECTIVES: To analyse changes in demographic, health and outcome variables over 20 years. DESIGN: Retrospective analyses of data from medical records of all diseased persons with cross-sectional comparison of five four-year intervals. SETTING: Droplaugarstadir Nursing Home in Reykjavík. The nursing home is supervised by fully qualified nurses and provides maintenance rehabilitation. Medical services are delivered from a specialist geriatric hospital department. RESIDENTS: All residents who died 1983 to 2002 [corrected]. MEASUREMENTS: Demographic data, type of dwelling before admission, Nursing Home Pre-admission Assessment Score (NAPA), mobility- and cognitive score, drug usage and a list of medical diagnoses. All recorded health events during stay, falls and fractures, medical and specialist consultations. Advance directives, as recorded and end-of-life treatment, place of death, clinical diagnosis of cause of death and length of stay. RESULTS: The total number of medical records read numbered 385, including 279 females and 106 males. The mean age on admission was 85 (+/- 7) years. During the first 4 years the majority of residents came from their own private homes or residential settings but in the last four years, 60% were admitted directly from a hospital ward. The mortality rate was 17% per year in the first period and the majority died in a hospital. This ratio took a sharp turn as the mortality rate increased to 40%, and in the last period only 2 of 97 deaths took place in a hospital. Admission mobility- and cognitive scores showed increased disability with time. The most common diagnosis on admission was dementia (56%), ischemic heart disease (46%), fractures (35%) and strokes (27%). Parkinsonism and maturity onset diabetes had a low prevalence rate of 6%. A mean NHPA of 57 (+/- 17) points confirmed a high dependency selection. The mean number of drugs per patient was 5.3 (+/- 3), including 1.1 (+/- 1) for psychoactive drugs and sedatives. The most common health events during residents? stay were urinary and respiratory infections, heart failure, cardiac- and cerebral events and pulmonary disorders. Hip fractures occurred in 45 residents (12%) and other types of fractures in 47 during their stay in the nursing home. The number of medical visits and specialist referrals increased with time. Palliative care was the most common form of treatment at end of life. Pneumonia was most commonly recorded cause of death in medical notes. The yearly mortality rate was 29% and the mean length of stay was 3 (+/- 2,9) years for the whole period. LIMITATIONS: Retrospective analyses have many inherent drawbacks and the information in medical records tend to be scanty. Analyses of disabilities, as described in the medical record, can only be descriptive and health events are likely to be underreported. Statistical methods have a less meaningful role for interpretation as only diseased persons were included and survivors excluded. However, the length of time, uniform medical care and turnover rate of residents generate useful information on the patterns of the nursing home service during a time of considerable change. CONCLUSIONS: This retrospective analysis indicates increasing frailty in nursing home patients admitted over a period of 20 years. With time the residents are more often admitted directly from a hospital rather than from an individual dwelling. Most deaths took place in the nursing home and were preceded with informal or formal palliative care directives, which was a significant change over time. The data indicates growing efficiency in the nursing home selection processes due to the NHPA and improvements in holistic geriatric care. This development is in keeping with the Icelandic health care policy for elderly people to stay longer in their own home with access to a nursing home placement when needed.
    • AIS-ISS kerfi við mat á afdrifum slasaðra á gjörgæsludeild Borgarspítalans 1980-1984

      Þorbjörg Magnúsdóttir; Bergþóra Ragnarsdóttir; Bjarni Torfason (Læknafélag Íslands, Læknafélag Reykjavíkur, 1991-04-01)
      This is an account of a retrospective study on 401 trauma patients who were admitted to the Intensive Care Unit at The Reykjavik City Hospital in Reykjavik, Iceland, over a five years period (1980-1984). The aim of the study was to evaluate the outcome in accident cases by comparing the results of this study with results from other hospitals, using The Abbreviated Injury Scale (AIS) and The Injury Severity Score (ISS). Excluded from the study were patients with only femoral neck fracture and patients with chronic subdural hemmorrhage, no burn patients were in this study, as they were admitted elsewhere. The patients' age was from two months to 86 years, with mean age of 29.9 years. There were 285 male patients and 116 female. The patients were divided into 8 groups depending on cause of injury. The two most prominent groups were road traffic accidents 53.6% and falls 27.9%. The injuries were analysed by AIS-1980, and ISS was determined for each patient. Trauma to one region only was found in 34% of the patients and to more than one region in 66%. ISS scores less than 20 were found in 55.1% (221/401) of the patients and ISS scores > 20 in 44.9% (180/401). Mortality within 30 days was 10.2% but overall hospital mortality rate was 11.5% and 24.4% for the more severily injured, who had sustained ISS 20 and higher. There was a significant difference in mortality rate in patients less than 50 years, who had 7.8% mortality, and patients 50 years and older, who had 25.6% mortality. Central nervous system injury was the primary cause of death in 67.4% of the 46 patients who died and 19.6% died of complications, such as multible organ failure, sepsis or pulmonary infections. The conclusion is that the quality of treatment in our unit under this period was well acceptable.
    • Akonitín, eiturefni í bláhjálmi : yfirlitsgrein

      Kristín Ingólfsdóttir; Kjartan Ólafsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1997-03-01)
      Monkshood, Aconitum napellus L. (Ranunculaceae), is considered one of the most poisonous plants growing in Europe. Monkshood and other Aconitum species are still used in Oriental and homeopathic medicine as analgesics, febrifuges and hypotensives. The neurotoxin aconitine is the principal alkaloid in most subspecies of monkshood. A review is presented, which includes historical aspects of monkshood as a poisonous and medicinal plant, the mode of action of aconitine, symptoms of toxicity, treatment and reports of recent poisoning incidents. In addition, results of quantitative HPLC examination of hypogeous and epigeous organs from a population of A. napellus ssp. vulgare cultivated in Iceland are discussed. The fact that children in Iceland have commonly been known to eat the sweet tasting nectaries in monkshood prompted an investigation of the alkaloidal content of these organs specifically. The low aconitine content found in the nectaries as well as in whole flowers accords with the absence of reported toxicity arising from the handling of flowers and consumption of nectaries from A. napellus in this country.
    • Aldarafmæli spænsku veikinnar og viðbrögð við skæðum farsóttum á 21. öld

      Magnús Gottfreðsson; Ritstjóri Læknablaðsins (Læknafélag Íslands, Læknafélag Reykjavíkur, 2018-10)
    • Aldur tannfyllinga í almennum tannlæknapraxis á Íslandi árið 2000

      Svend Richter; Sigfús Þór Elíasson (Tannlæknafélag Íslands, 2002)
      Aldur 1917 bilaðra fyllinga í fullorðinstönnum var skráður. Niðurstöður sýna að miðgildi aldurs amalgamfyllinga var 10 ár, en 8 ár fyrir komposit. Miðgildi aldurs glerjonomerfyllinga var 4 ár, en 3 ár fyrir resin/-glerjonomerfyllingar. Miðgildi aldurs fyrir „aðrar" fyllingar, sem aðallega voru gullinnlegg, var mun hærra eða 16 ár. Miðgildi aldurs amalgam og kompositfyllinga borið saman við lögun (klassa) fyllinga var alltaf hærra fyrir amalgam fyllingar, eða 13.5 ár á móti 5 árum fyrir composit í I. klassa, 10 ár á móti 7 árum í II. klassa, 15,5 ár á móti 10 árum í II. klassa, 10 ár á móti 8 árum í V. klassa og 11 ár á móti 5 árum í stærri fyllingar. Séu niðurstöður flokkaðar eftir aldri og kyni kom í ljós að í yngsta hópnum var miðgildi aldurs komposit fyllinga 4 ár, en næstum helmingi hærra, eða 7,5 ár fyrir amalgamfyllingar. Ekki var munur á aldri amalgamfyllinga eftir kynferði, en miðgildi aldurs komposit fyllinga var nokkuð lægra hjá körlum en konum. Niðurstöður rannsóknarinnar að amalgamfyllingar endast lengur en kompositfyllingar. Glerjonomer- og plast/glerjonomerfyllingar endast skemur. Gullfyllingar endast lengst.
    • Aldursbundin hrörnun í augnbotnum : yfirlitsgrein

      Guðleif Helgadóttir; Friðbert Jónasson; Haraldur Sigurðsson; Kristinn P. Magnússon; Einar Stefánsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2006-10-01)
      Age-related macular degeneration (AMD) is the main reason for blindness today in the western hemisphere. According to Björn Olafsson, who was the first ophthalmologist in Iceland a century ago, this disease was not found in Iceland. In the blindness-registry of 1950 6% blindness was due to this disease. Today, AMD is responsible for 54% of legal blindness in Iceland. The incidence of the disease increases with age. Heredity and environmental factors are thought to influence its etiology. Indirect methods, including twin studies and increased frequency of this disease in some families, have demonstrated that hereditary factors may be important. This has been confirmed recently by demonstrating that genes on chromosome 1 and chromosome10 play a role. This disease is classified as early stage, with drusen and pigmentary changes and insignificant visual loss. Treatment options for this stage are limited. The use of vitamin E and C and Zinc has, however, been shown to delay its progress. The second and end stage involves visual loss, either as a dry form with pigment epithelial atrophy or wet form, with new vessel formation. Treatment options for the dry form are limited. The second form is more common in Iceland than in other countries. Treatment options for the wet form have increased. Localised laser and drug treatment to neovascular membranes, either alone or as a combination treatment with drugs that have anti-proliferate effect on new vessels (anti-VEGF) are increasingly used. New treatment methods are also used in assisting those that are already visually handicapped. The use of computers is increasing as are the patients' computer skills. As the number of the elderly increases, AMD will be an increasing health problem in Iceland as in other Western countries. It is therefore important to improve the treatment options and the service and counselling of patients.
    • Aldursbundið algengi mótefna gegn chlamydia pneumoniae á Íslandi

      Sigurður Einarsson; Helgi K. Sigurðsson; Sólveig D. Magnúsdóttir; Helga Erlendsdóttir; Haraldur Briem; Sigurður Guðmundsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1994-01-01)
      Chlamydia pneumoniae er nýlega uppgötvaður sýkill, og bendir flest til að hann sé algeng orsök loftvegasýkinga. Markmið þessarar athugunar var að kanna algengi hans á Íslandi. Rannsóknin var gerð á 1020 sermisýnum frá einstaklingum á aldrinum 10-99 ára. Sýnunum var deilt í hópa eftir aldri einstaklinga og tók hver hópur til 10 ára tímabils. IgG og IgM mótefni voru mæld með flúrskinsaðferð (micro-immunofluorescence). Jákvæð sýni voru þau talin þar sem IgG titer var 1/32 og IgM >1/16. Meðalalgengi (istaðalfrávik) IgG í aldurshópunum var 53±16% og vikmörk (range) 14-66%. Hvorki reyndist kynja- né árstíðamunur á algengi. Algengi IgG mótefna var lægst hjá börnum undir 10 ára aldri (p<0,001) en fór síðan stigvaxandi til sjötugs (P<0,005). Í fyrstu atrennu greindust IgM mótefni hjá 34 einstaklingum og voru flestir þeirra í elstu aldurshópunum. Eftir að þessi sýni höfðu verið meðhöndluð með IgG mótefni úr geitum til að fella út sértæk trufiandi IgG mótefni var ekkert sýni IgM jákVætt. Samkvæmt þessum niðurstöðum er algengi C. pneumoniae sýkinga hátt á Íslandi og svipað því er greinst hefur í nálægum löndum austan hafs og vestan. Nauðsynlegt er að gæta varúðar við túlkun jákvæðra prófa úr IgM mótefnamælingum hjá eldra fólki.