• Banaslys af völdum bruna

      Sigurður E. Björnsson; Árni Björnsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1995-05-01)
      A retrospective study was made on mortality due to burn injuries in Iceland 1971-1992. Data was obtained from the Bureau of Statistics, the Icelandic University Hospital and Department of Forensic Medicine. Analyzed were etiology, sex and age distribution, associated risk factors and mortality rate. In addition there were analyzed wound size and depth, complications and cause of death for patients admitted to the Burn Unit at the University Hospital. Mortality Model was used to calculate probability of death. Following burn injury 46 died, the overall mortality rate was 0.9/100,000 persons per year, the mortality rate had decreased and was 0.5/ 100,000 persons during 1983-92. Admitted to the University Hospital were 27. The cause of death was due to complications of the burn injury, except in two cases where death was due to preexisting disease and they had the lowest probability of death. Probability of death over 0.45 had 80 percent and 60 percent over 0.8. Only one patient died the last 10 years with probability of death lower than 0.8. Mortality due to burns has decreased over the last decade and later causes of death have proportionally increased. Calculated probability of death was very high and it is therefore assumed that the result of treatment was acceptable.
    • Bandvefsmyndandi berkjungateppa með lungnabólgu : klínísk sérkenni 19 sjúklinga á Íslandi

      Ófeigur Tryggvi Þorgeirsson; Steinn Jónsson; Bjarni Agnar Agnarsson; Tryggvi Ásmundsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1993-11-01)
      The diagnosis of BOOP is based on characteristic changes on lung biopsy in patients with a variety of symptoms and radiographic changes. We studied nineteen patients, ten males and nine females, with biopsy proven BOOP. The most common clinical findings were fever, shortness of breath and non-productive cough for less than eight weeks and inspiratory crackles on auscultation. Laboratory tests often revealed increased erythrocyte sedimentation rate, low grade anemia, moderate increase in white blood cell count and arterial hypoxemia. Irregular alveolar infiltrates were the most common radiographic abnormalities. Open lung biopsy was required in three. Seven patients in our study were considered to have idiopathic or primary BOOP with no identifiable cause. Twelve patients had either an underlying bacterial lung infection, rheumatologic disease or cancer. Thirteen patients received corticosteroid treatment, usually oral prednisolone at an initial dose of 30-60 mg/day, for a variable length of time. Predisolone treatment resulted in recovery with clearing of lung infiltrates in all patients but one, who died of myocardial infarction five days after treatment was begun. However relapses occurred in more than half (57%) of those receiving prednisolone. Relapses usually occurred when the prednisolone doses had been reduced below 15 mg/day, and in patients who had been treated for up to 10 months. Recovery ensued when perdnisolone doses were increased. Four patients recovered after treatment with antibiotics alone. BOOP probably represents a non-specific inflammatory response of the lung to a number of insults. The high proportion of cases with an established underlying disease in our study is unique. Our data also suggest that infection may be the most frequent underlying condition in BOOP. Corticosteroids were effective treatment but relapses were common. A thorough search for an underlying disease is warranted, and if recognized, should be treated accordingly.
    • Bandvefsstofnfrumur : yfirlitsgrein

      Ólafur E. Sigurjónsson; Kristbjörn Orri Guðmundsson; Sveinn Guðmundsson.; The Blood Bank, Landspitali University Hospital, Barónsstíg, 101 Reykjavík, Iceland. oes@landspitali.is. (Læknafélag Íslands, Læknafélag Reykjavíkur, 2001-07-01)
      The bone marrow contains various types of stem cells. Among them are hematopoietic stem cells, which are the precursors of all blood cells, and mesenchymal stem cells. Mesenchymal stem cells have recently received a lot of attention in biological research because of their capability to self renewal, to expand and transdifferentiate into many different cell types; bone cells, adipocytes, chondrocytes, tendocytes, neural cells and stromal cells of the bone marrow. Mesenchymal stem cells can be cultured in vitro although their differentiation potential is not yet fully understood. Several experiments have been conducted in animal models where mesenchymal stem cells have been transplanted in order to enhance hematopoiesis or to facilitate the repair of mesenchymal tissue. Similar experiments are being conducted in humans. Mesenchymal stem cells are believed to be able to enhance hematopoietic stem cells transplantation by rebuilding the bone marrow microenvironment which is damaged after radiation- and/or chemotherapy. Mesenchymal stem cells are promising as vehicles for gene transfer and therapy. It may prove possible to tranduce them with a gene coding for a defective protein i.e. collagen I in osteogenesis imperfecta. The cells could then be expanded ex vivo and transplanted to the patients where they home to the bone marrow, differentiate and produce the intact protein. Future medicine will probably involve mesenchymal stem cells in various treatment settings.
    • Baráttan við lungnakrabbamein : betur má ef duga skal [ritstjórnargrein]

      Tómas Guðbjartsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2006-12-01)
      Til er saga af Landspítalanum frá því á árunum fyrir seinna stríð. Prófessor í skurðlækningum var á stofugangi og kallaði til sín læknanema. Tilefnið var karlmaður sem lá á deildinni nýgreindur með lungnakrabbamein. Taldi prófessorinn mikilvægt að nemarnir kynntu sér þetta einstæða tilfelli, enda ósennilegt að þeir myndu sjá slíkt aftur síðar á ferlinum. Því miður reyndist prófessorinn ekki sannspár og rúmum sextíu árum síðar er lungnakrabbamein næstalgengasta krabbamein á Íslandi hjá báðum kynjum og það mein sem leggur flesta Íslendinga að velli, um 110 manns á ári (1). Svipaða sögu er að segja annars staðar í heiminum og nú er svo komið að ámóta margir látast úr lungnakrabbameini og af völdum brjósta-, ristil- og blöðruhálskirtilskrabbameins (1). Hér er því um gífurlegt heilbrigðisvandamál að ræða, ekki einungis á Íslandi heldur á heimsvísu.
    • Barksterameðferð við erfiðum lungnasjúkdómi hjá fyrirburum

      Erna Hinriksdóttir; Hrólfur Brynjarsson; Þórður Þorkelsson; 1 Læknadeild Háskóla Íslands, 2 Barnaspítali Hringsins, Landspítala (Læknafélag Íslands, Læknafélag Reykjavi­kur, 2016-05-04)
      Tilgangur: Margir fyrirburar með erfiðan lungnasjúkdóm eru meðhöndlaðir með barksterum í æð eða á úðaformi í þeim tilgangi að ná þeim af öndunarvél og/eða minnka súrefnisþörf þeirra. Umdeilt er hvort ávinningurinn af meðferðinni sé nægur til að vega upp á móti hugsanlegum aukaverkunum, einkum sterameðferðar í æð. Megintilgangur rannsóknarinnar var að kanna áhrif barksterameðferðar í æð eða á úðaformi á þörf fyrirbura fyrir öndunarvélameðferð og súrefnisgjöf og kanna hugsanlegar aukaverkanir meðferðarinnar. Efniviður og aðferðir: Rannsóknin var afturskyggn hóprannsókn á fyrirburum á vökudeild Barnaspítala Hringsins, fæddum 2000-2014, sem fengu barksterameðferð í æð (n=28) eða á úðaformi (n=30) við erfiðum lungnasjúkdómi. Eitt viðmið var valið fyrir hvert tilfelli, parað á meðgöngulengd. Niðurstöður: Marktæk lækkun varð á súrefnisþörf barna sem fengu barkstera í æð eða á úðaformi fyrstu dagana eftir að meðferð hófst en ekki hjá viðmiðum. Marktækt fleiri tilfelli en viðmið þurftu öndunarvélameðferð við upphaf steragjafar í æð, en ekki fjórum dögum síðar. Marktækt minni þyngdaraukning varð hjá tilfellum sem fengu stera í æð en viðmiðum á meðferðartímabilinu, en við 35 vikna meðgöngualdur var ekki marktækur þyngdarmunur milli hópanna tveggja. Ekki reyndist marktækur munur á öðrum hugsanlegum aukaverkunum milli hópanna, svo sem tíðni heilalömunar. Ályktanir: Barksterameðferð í æð eða á úðaformi minnkar súrefnisþörf fyrirbura og barksteragjöf í æð flýtir því að börnin náist af öndunarvél, án verulegra aukaverkana. Því kemur til greina að nota barkstera hjá fyrirburum með erfiðan lungnasjúkdóm í völdum tilvikum.
    • Barna og unglingasími Rauðakrosshússins

      Helgi Hjartarson; Eiríkur Örn Arnarson (Sálfræðingafélag Íslands, 2000)
      Farið var yfir öll skráð símtöl sem borist höfðu barna og unglingasíma Rauðakrosshússins frá opnun árið 1987 alls 26.837. Markmið rannsóknarinnar var meðal annars að kanna símahegðun og ástæður símhringinga ungmenna og fullorðinna. Skráningablað símaþjónustu Rauðakrosshússins var notað sem mælitæki, sem skiptist í tvo hluta: almennar upplýsingar um símhringjanda og ástæður hringingar. Í samræmi við niðurstöður annarra rannsókna hringdu mun fleiri stúlkur en piltar. Meðalaldur í hópi barna og unglinga var 14 ár, en 36 ár meðal fullorðinna. Helmingur þeirra sem hringdu í hópi barna og unglinga var utan af landi (49%). Skýring kann að vera að félagsleg þjónusta sé í lágmarki í dreifbýli og persónuleg nálægð folks valdi því að unglingur kjósi frekar að leita með vandamál sin til utanaðkomandi aðila. Flest börn og unglingar hringdu á milli 12 og 16 í símaþjónustuna eftir skóla þegar foreldrar voru ekki heima. Þegar litið var á umræðuefni kom fram í flestum tilvikum munur á ungmennum og fullorðnum. Umræðuefni barna og unglinga tengdust þeim sem algeng eru í bernsku og gelgjuskeiði. Flestir fullorðinna hringdu til að leita ráða vegna barns. Stór hluti ungmenna og fullorðinna hrindi vegna vanlíðunar. Einnig kom fram verulegur munur á milli kynja eftir umræðuefnum. Hins vegar var aðeins í fáum tilvikum munur á milli fólks af höfuðborgarsvæðinu og landsbyggðinni eftir umræðuefnum.
    • Barneign og heilsa: ferilrannsókn meðal íslenskra kvenna frá því snemma á meðgöngu þar til tveimur árum eftir fæðingu barns.

      Hildur Kristjánsdóttir,; Þóra Steingrímsdóttir; Ólöf Ásta Ólafsdóttir; Amalía Björnsdóttir; Jóhann Ág. Sigurðsson; Embætti landlæknis, Hjúkrunarfræðideild Háskóli Íslands, Námsbraut í ljósmóðurfræði, Háskóli Íslands, Þróunarstofa (Ljósmæðrafélag Íslands, 2012)
      Rannsókninni ,,Barneign og heilsa“, er ætlað að varpa ljósi á reynslu kvenna af barneignarþjónustunni, heilsu þeirra, væntingar um og líðan á meðgöngu og eftir fæðingu. Í fyrsta áfanga, á tímabilinu febrúar 2009 til mars 2010, var sendur spurningalisti til 1765 barnshafandi kvenna við 11–16 vikna meðgöngu, sem komu í meðgönguvernd á 26 heilsugæslustöðvum um land allt. Svar hlutfall var 63% (n=1.111). Í öðrum áfanga var annar listi sendur til þeirra 5–6 mánuðum eftir fæðingu (mars 2010 til janúar 2011) og var svarhlutfall 69% (n=765). Í þriðja áfanga, 18–24mánuðum eftir fæðingu, á tímabilinu janúar 2011 til október 2011, svöruðu 59% (n=657). Upplýsinga var aflað um félagslegan bakgrunn, samskipti við heilbrigðisstarfsmenn og fjölskyldu, viðhorftil og reynslu af barneignarþjónustu, t.d. ómskoðunar á meðgöngu, verkjameðferðar, keisarafæðinga, heimafæðinga og um fyrri barneignarreynslu. Fjölbyrjur voru 60% þátttakenda, meðalfjöldi skoðana í meðgönguvernd voru 8,9. Hlutfall þátttakenda sem fæddu með keisaraskurði var 14,3% og 2,2% fædduheima. Konur með háskólamenntun voru líklegri til að skipuleggja meðgönguna samanborið við konur með minni menntun. Algengara var að frumbyrjur í samanburði við fjölbyrjur leituðu fyrst til heimilislæknis og þær voru líklegri en fjölbyrjur til að fá mænurótardeyfingu og fara í bráðakeisara skurð. Konur á landsbyggðinni töldu síður en konur á höfuðborgarsvæðinu að þær hefðu farið alltof snemma heim af fæðingardeild. Samanburður á niðurstöðum rannsóknarinnar við sambærilegar upplýsingar úr Fæðingaskrá Íslands og frá Hagstofu Íslands sýna gott samræmi. Niðurstöður rannsóknarinnar gefa glögga mynd af reynslu kvenna af barneignarþjónustu og barneignarferli hér á landi. Þær ættu að nýtast fagfólki og stjórnendum heilbrigðismála við frekari þróun og skipulag þjónustunnar. Abstract in English The purpose of our study “Childbirth and Health” was to explore women´s experience of maternity services, their health, wellbeing, attitudes and expectations during pregnancy and after birth. In this article, the research methodology is described and different aspects of the results discussed in the context of age, residency and education. In the first phase (from February 2009 to March 2010), 1765 women 11–16 weeks pregnant, attending antenatal care at 26 health care centres received a postal questionnaire. In all 63% (1111) women replied. In the second phase, a new postal questionnaire was sent 5–6 months postpartum (March 2010 until January 2011) and 765 (69%) women replied. During the third phase, 18–24 months postpartum (January 2011 until October 2011), 657(59%) women replied. Data was gathered about social background, interactions with professionals and family, attitudes towards and experiences of childbearing care like ultrasoundscans pain relief, caesarean section, homebirth and previous pregnancies. Multiparas were 60% of the participants ,number of antenatal visits were 8.9 (mean),14.3% underwent ceasarean section and 2.2% gave birth at home. Women with higher education were more likely to plan their pregnancy compared to women with lower education. Primiparous women were more likely than multiparas to have their first contact in antenatal care with their GP,to an Epidural and emergency Caesereansection. Women living in urban areas were more likely than women living in the capital area to feel their stay in hospital had been too short. Comparison between results from this study with outcomes from the Icelandic Birth register and Icelandic statistics are consistent. We conclude that this study gives a clear picture of women´s experience regarding childbirth and maternity services in Iceland. The research findings should be useful for further development of the organisation of maternity services and health care management.
    • Bein útgjöld íslenskra heimila vegna heilbrigðismála

      Rúnar Vilhjálmsson; runarv@hi.is (Læknafélag Íslands, Læknafélag Reykjavíkur, 2009-10-01)
      OBJECTIVE: Out-of-pocket health expenditures affect access to health care. The study investigated trends in these expenditures, and whether certain population groups spent more than others. MATERIAL AND METHODS: The data come from two national health surveys among Icelandic adults from 1998 and 2006. The response rate was 69% in the former survey (N=1924), and 60% in the latter (N= 1532). Average household health expenditures and household expenditure burden (expenditures as % of total household income) were compared over time and between groups. RESULTS: Household health expenditures increased by 29% in real terms between 1998 and 2006. The biggest items in 2006 were drugs and dental care. Women, younger and older individuals, the single and divorced, smaller households, the unemployed and non-employed, individuals with low education and income, the chronically ill, and the disabled, had the highest household expenditure burden. Comparison between 1998 and 2006 indicated increased expenditure burden among young people, students, the unemployed, and the least educated, but decreased burden among the elderly, the widowed, and parents of young children. CONCLUSIONS: Household health expenditures differ substantially between groups, suggesting reconsideration of current health insurance policies, especially with regard to disabled, non-employed, low-income, and young individuals.
    • Bein útgjöld íslenskra heimila vegna heilbrigðisþjónustu

      Rúnar Vilhjálmsson; Guðrún V Sigurðardóttir (Læknafélag Íslands, Læknafélag Reykjavíkur, 2003-01-01)
      Objective: Total health expenditures, and out-of-pocket health care costs have increased in recent years in Western Europe and North America. Developments in Iceland appear to be similar. Access and cost are closely related and direct household health care costs often reduce subsequent use of services. The purpose of the study was to consider whether certain population groups spent more on health care than others both in absolute terms and as percentage of household income. Material and methods: The study is based on a national health survey titled Health and Living Conditions in Iceland. A random sample of 18-75 year olds was drawn from the National Register, and the response rate was 69% (1924 respondents). Average household out-of-pocket health care costs (in krónur) and out-of-pocket household costs as percentage of household income were compared between sociodemographic groups. Results: The largest health care expenditure items were dental care, drugs, other drug store items and equipment, and physician care (in this order). The middle aged (45-54), married/cohabiting, parents, large households, full-time employed, and people with high education and income, had the greatest household out-of-pocket costs in absolute terms. However, when considering costs as percentage of household income, women, older individuals (age 55 and older) and the young (age 18-24), the non-employed and unemployed, and low income people were on top. Conclusions: Household out-of-pocket health care costs differ substantially between sociodemographic groups in Iceland. It can be argued and empirically substantiated that out-of-pocket health care costs in Iceland are already at a risky level, affecting access of individuals and groups to health services.
    • Beina- og kalkbúskapur sjúklinga með herslismein

      Bjarki Þór Alexandersson; Árni Jón Geirsson; Ísleifur Ólafsson; Leifur Franzson; Gunnar Sigurðsson; Björn Guðbjörnsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2007-07-01)
      AIMS: To elucidate bone mineral density (BMD) and bone turnover in an un-selected group of patients with Systemic Sclerosis (SSc) in national based registry. MATERIAL AND METHODS: All patients who have been diagnosed with SSc in Iceland were invited to participate in the study. Participants underwent standardized interview and delivered urine and blood samples for measurements of various bone metabolites (e.g. PTH, osteocalcin, Cross Laps, PINP, IGF-1, Cystatin-C and 25-OH-vitamin-D), before they underwent measurement of BMD with DEXA (QDR 4500 Elite). RESULTS: Twenty-four individuals, 20 female and four male, of 29 diagnosed patients with SSc in Iceland accepted to participate in the study (83%). The mean age was 60 +/- 15 years. Seventeen of 20 females were postmenopausal. Twelve patients had history of fractures. Only four patients were on treatment with bisphosphonate. All measured bone metabolites were in normal ranges, but U-calcium was in the lower ranges. According to DEXA, eight patients had osteopenia (T-value = -1.0 - -2.5) and three osteoporosis (T-value <---2.5), while six patients had BMD more than one standard deviation below the mean of age matched controls. CONCLUSION: Although the majority of patients with SSc have normal bone turnover and BMD, every fourth patient may have low BMD. No single pathogenic factor was observed, however, several individuals are in calcium saving stages reflected in low urinary calcium excretion. This may be result of defects in intestinal absorption of calcium due to gastrointestinal involvement of the disease. This study does not give opportunity to evaluate effects of treatment on BMD in this group of patients. Thus, individual evaluation concerning osteoporosis is recommended in patients with SSc.
    • Beina- og liðasýkingar barna á Íslandi af völdum baktería á tímabilinu 1996-2005

      Ásgeir Þór Másson; Þórólfur Guðnason; Guðmundur K. Jónmundsson; Helga Erlendsdóttir; Karl G. Kristinsson; Már Kristjánsson; Ásgeir Haraldsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2011-02)
      Objective: The main objective was to determine the incidence and causative pathogens of osteomyelitis and septic arthritis in Icelandic children, as well as presenting symptoms and diagnosis. Methods: A nationwide retrospective review was done of all children <18 year old, 1996-2005. Subjects were divided into three equal age groups, 0-5, 6-11 and 12-17 years old. Cultures were reviewed and postive and negative cases compared. Results: Over the study period 220 cases were identified, 161 osteomyelitis and 59 septic arthritis cases. The incidence increased significantly over the period (p=0.019), mostly in the youngest age group (p<0.001) with osteomyelitis. Incidence of cases with a pathogen identified was unchanged over the period while culture negative cases increased significantly (p<0.001). Median age for osteomyelitis (6,1 years) was higher than in cases of septic arthitis (1,8 years) (p=0.003). A pathogen was identified in 59% of cases with osteomyelitis and 44% with septic arthritis. S. aureus was most common (65% and 27%, respectively) and K. kingae was second most common pathogen (7% and 11%, respectively). Methicillin resistant S. aureus was not identified. The tibia and knee were the predominant sites for osteomyelitis and septic arthritis respectively. Conclusions: An increased incidence was found in the youngest age group with osteomyelitis, especially in cases without a pathogen identified. The most commonly cultured pathogen was S. aureus, followed by K. kingae. A more sensitive technique to identify pathogens might be indicated in culture negative cases.
    • Beinbrot og liðhlaup eftir krampaköst

      Þorvaldur Ingvarsson; Brynjólfur Mogensen (Læknafélag Íslands, Læknafélag Reykjavíkur, 1994-01-01)
      Fractures and dislocation after epileptic seizures were first descriped in 1907 by Lhendorf. The most common locations for fractures after epileptic seizures are compression fractures of the spine, fracture of upper end of the humerus and the hip but every sites are known. Epileptic patients, especially those treated with anticonvulsants, are more likely to sustain fractures than the general population. Recently six patients in Iceland sustained fractures or fracture dislocation after epileptic seizures. Some of those injuries seem to be very rare. Four of our patients sustained multiple and/or severe injuries and three were initially misdiagnosed. One patient had a bilateral posterior shoulder fracture dislocation. Four patients had vertebral fractures. Two had central fractures dislocation of the hip. Three of our patients had osteoporosis. We conclude that epileptic seizures may cause bizarre fractures and/or fracture dislocations. Fracture should top the differential diagnostic list when a patient complains of muskuloskeletal pain after epileptic seizure.
    • Beingarðar efri kjálka

      Svend Richter; Sigfús Þór Elíasson; Tannlæknadeild Háskóla Íslands (Tannlæknafélag Íslands, 2008)
      Of 38 available cranium from the archaeological site at Skeljastadir in Thorsardalur in Iceland, dated older than 1104, a total of 15 or 39.5% had torus palatinus, 47.4% of male and 31.6 % of female. The prevalence is similar or somewhat less among those in the northern hemisphere from the same time period but higher than among those living further south. According to a number of authors, environmental and functional factors, particularly high masticatory activity, play a predominant part in the aetiology. People from arctic- and sub arctic areas lived more or less on animal diet, mostly fish and flesh but people living more south in temperate climate are living more on agricultural diet. Other studies strongly suggest that hereditary factors play a predominant part in the occurrence of the trait. Majority of the tori were of the size small or medium. The prevalence of torus palatinus in the medieval population studied was higher than found in modern Icelanders.
    • Beingarðar neðri kjálka

      Svend Richter; Sigfús Þór Elíasson; Tannlæknadeild Háskóla Íslands (Tannlæknafélag Íslands, 2007)
      Of 48 available cranium from the archaeological site at Skeljastadir in Thorsardalur in Iceland, dated older than 1104, 24 or 50% had torus mandibularis. There was no sex difference. The prevalence is similar among those in the northen hemisphere in the same time period. According to a number of authors, environmental and functional factors, particularly high masticatory activity, play a predominant part in the etiology. People from artic- and sub artic areas lived more or less on animal diet, mostly fish and meat but people living more south in temperate climate are living more on agricultural diet. Higher prevalence was found in the age group above 36 years than in the group 35 years and below. Majority of the tori were of the size small or medium. The most frequent occurring variant was the multiple bilateral form, followed by the multiple unilateral form. The prevalence of torus mandibularis in the study was much higher than found in modern Iceland.
    • Beinkröm hjá barni

      Harpa Kristinsdottir,; Soffía Jónasdottir,; Sigurður Björnsson; Pétur Lúðvígsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2011-09)
      Vitamin D is necessary for normal bone growth. Deficiency of vitamin D can lead to rickets in children and osteomalacia in adults. It is difficult to reach the recommended daily dose of vitamin D in children without cod liver oil or other vitamin D supplementation. Several cases of rickets have been diagnosed in Iceland the past few years. Studies suggest a worldwide increase in the prevalence of the disorder. We report on a girl who was diagnosed with rickets at the age of 27 months. She received inadequate amounts of vitamin D supplementation in the form of AD drops and cod liver oil. Because of food allergy she was on a restricted diet which limited her intake of dietary vitamin D. After diagnosis, she received a high-dose vitamin D therapy (Stoss therapy) which corrected the deficiency. Key words: rickets, food allergy, vitamin D.
    • Beinþéttni og líkamsþjálfun 70 ára reykvískra kvenna

      Sigríður Lára Guðmundsdóttir; Díana Óskarsdóttir; Gunnar Sigurðsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2003-07-01)
      Objective: It is generally believed that exercise positively influences bone mineral density (BMD). Athletes have been found to have higher BMD than controls but it has proven difficult to reproduce these findings in the general population. Results from cross-sectional studies on the relationship between exercise and BMD in postmenopausal women have been contradictory. In most studies the age range of subjects has been quite large. Few studies have concentrated on this relationship in elderly women, the largest risk group for osteoporosis and little is known if, and in that case what kind of, exercise has positive effects on BMD in these women. The purpose of this study was to examine the relation of BMD to exercise and current and lifetime occupational activity in 70-year-old Icelandic women. Material and methods: 248 women, all inhabitants in Reykjavik were investigated. BMD in the lumbar spine, femoral neck, total hip and total body was measured with dual energy X-ray absorptiometry (DXA) and the women filled out a questionnaire regarding general health issues, leisure time and occupational activity. Questions included number of leisure walks per week, frequency of other exercises and an attempt was made to estimate the intensity of the activities. Occupational activity was evaluated at ages 20-29 years, 30-44 years, 45-65 years as well as currently, and defined in four grades, from "mostly sedentary" to "hard work including walking". Results: No relationship was found between number of walks and BMD. Significant positive correlation was found between number of other exercise sessions per week and total body BMD (b=0.008, p=0.01), but not total hip (p=0.09), femoral neck (p=0.15) or lumbar spine (p=0.07). Significant negative correlation was found between number of leisure walks and height loss from the age of 25 years (r=-0.211, p=0.001). No significant relationship was found between occupational activity and BMD. Conclusion: Results indicate that leisure time exercise can bring on some bone density benefits for elderly women. Leisure walking alone may not provide high enough stimuli to influence BMD but increasing number of other exercise sessions per week has positive relations to total body and possibly total hip and lumbar spine BMD. A randomized controlled study on the relationship between exercise and BMD in this age group should be conducted.
    • Beinþéttni ungra kvenna með sögu um lystarstol

      Rebekka Guðrún Rúnarsdóttir; Guðlaug Þorsteinsdóttir; Ólafur Skúli Indriðason; Gunnar Sigurðsson; Landspitali The National University Hospital, Reykjavík, Iceland. Faculty of Medicine, University of Iceland, Iceland. (Læknafélag Íslands, Læknafélag Reykjavíkur, 2012-10)
      OBJECTIVE: A decrease in bone mineral density (BMD) is frequently seen in patients with anorexia nervosa (AN). This study was designed to assess BMD of young Icelandic women with current or previous history of AN and identify predictors which might be targets for preventive measures. MATERIAL AND METHODS: The study was retrospective. Participants were women aged 18-40 years, with diagnosis of AN (F50.0, F50.1) attending the anorexia unit at Landspítali - The National University Hospital of Iceland - in 2001-2009, who had undergone measurement of BMD by dual-energy X-ray absorptiometry. A control group consisted of 58 healthy 30 years old women participating in a study of bone health in 2001-2003. RESULTS: At time of BMD measurement the median body mass index (BMI: kg/m2) in the AN group (n=40) was 17.4 (12.3-25.2) compared to 23.6 (18.1-43.7) in the control group (p<0,001). Lumbar spine and hip BMD were 15.3-17.5% lower in AN patients than in control subjects (p<0.001). In both groups there was a strong correlation between BMD and body weight (r=0.354-0.604, p<0.05) and lean mass (r=0.425-0.588, p<0.05). Among patients with AN a correlation was also seen between BMD and lowest weight during the illness (r=0.482-0.499, p<0.01). Among the 26 AN patients who had repeated BMD measurement, a significant decrease in BMD at femoral neck (-6.6%, p=0.030) was observed in those who lost weight between the measurements (n=9). Those who had BMI ≤17.5 between BMD measurements lost 5.5-7.1% of the BMD at the hip (p<0.05). CONCLUSION: Young women with AN have 15% lower bone mass than healthy young women. The relationship between BMD and body weight seems to be a continuum across disease states. Increased body weight may be the most important factor for recovery of bone mass in AN patients.
    • Beinþéttnimælingar í framhandlegg íslenskra kvenna

      Katrín Ruth Sigurðardóttir; Gunnar Sigurðsson; Jón Ingi Jósafatsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1994-03-01)
      Bone mineral density (BMD) was measured with single photon absorptiometry (SPA) in the forearm of 347 Icelandic women 20-84 years. Peak bone mass was reached at the age of 20 and BMD remained steady thereafter until beyond the age of 50. Between the age of 50-60 years there was an exponential decline in BMD starting earlier at the ultra distal site (reflecting 35-40% trabecular bone) than at the distal site (95% cortical bone). After the age of 60 the decline in BMD was linear at the rate 1 % per year. At the age of 70 Icelandic women have lost on average 27% of their peak forearm bone mass, 2/3 of this loss seems to be related to oestrogen deficiency in the decade post menopause but by the age of 80 the loss in BMD is equally related to oestrogen deficiency and age related loss (which may be due to calcium imbalance). These results are similar to published data from Scandinavia.
    • Belgæxli í brisi : þrjú sjúkratilfelli og yfirlit

      Steinar Guðmundsson; Bjarni A. Agnarsson; Gunnar Gunnlaugsson; Jónas Magnússon (Læknafélag Íslands, Læknafélag Reykjavíkur, 1995-06-01)
      Cystic neoplasms of the pancreas are pathologically divided into macrocystic and microcystic adenomas. Macrocystic adenomas are multilocular, composed of large cysts (>2 cm), with or without septa, lined with columnar mucin-producing epithelium. This type has malignant potential. The microcystic adenomas are composed of many tiny cysts (<2 cm) lined by small cuboidal cells containing glycogen but little or no mucin. This adenoma is completely benign and is therefore important to differentiate from the former. Cystadenomas represent 10-15% of cystic lesions of the pancreas. Roughly one-half of the cystadenomas of the pancreas are found to be microcystic. The remainder is accounted for by the mucinous cystic neoplasms, either macrocystic adenomas or cystadenocarcinomas. These adenomas occur most frequently in middle aged women. Upper abdominal pain and weight loss are often the presenting symptoms. An abdominal mass can often be palpated during physical examination of these patients. Ultrasound and CT of the abdomen are the most useful diagnostic tools in the evaluation of cystic lesions of the pancreas. CT can also be helpful in differentiating microcystic from macrocystic adenomas. It is possible to do a CT or ultrasound guided percutaneous aspiration for diagnosis of the lesions. This technique permits preoperative cytologic and biochemical analysis of the cyst content. Surgery however is often necessary for accurate diagnosis where the tumor is biopsied for histology. The primary pancreatic lesions to be considered in the differential diagnosis include pseudocyst, whether of inflammatory or traumatic origin, congenital cysts, ductal adenocarcinoma or islet cell tumors. Some agree that surgical resection may not be mandatory if an accurate diagnosis of microcystic adenoma can be made. Others emphasize that all pancreatic cystadenomas can have malignant potential and that total excision should be the treatment of choice. Both macrocystic adenomas and cystadenocarcino¬mas have a slow and indolent course and tend to be well resectable in spite of late diagnosis. Three cases of pancreatic cystadenomas have been diagnosed in Iceland since 1972. These cases are presented here with a review of the literature.
    • Beratíðni β-hemólýtískra streptókokka af flokki B meðal þungaðra kvenna á Íslandi og smitun nýbura

      Ingibjörg Bjarnadóttir; Karl G Kristinsson; Arnar Hauksson; Arnar Vilbergsson; Gestur Pálsson; Atli Dagbjartsson (Læknafélag Íslands, Læknafélag Reykjaví­kur, 2003-02-01)
      Objective: To determine the carrier rate of group B beta-haemolytic streptococci (GBS) of pregnant women in Iceland and the colonisation of their newborns. Material and methods: A prospective study was conducted from October 1994 until October 1997, where culture specimens for GBS were taken from vagina and rectum of pregnant women attending the prenatal clinics at the Department of Obstetrics and Gynecology, Landspitali University Hospital and the Reykjavik Health Centre. The samples were taken at 23 and 36 weeks gestation and at delivery. Culture samples were also taken from axilla, umbilical area and pharynx of their newborn infants immediately after birth. Included in the study were pregnant women born on every fourth day of each month. Carrier state was not treated during pregnancy, but Penicillin G was given i.v. at delivery if the last culture before delivery was positive and gestational age was <37 weeks, rupture of membranes was >12 hours before delivery or the mother had a fever >38 degrees C. Results: Cultures were taken from 280 women and their children. GBS carrier rate of pregnant women in Iceland was 24.3%. Twelve newborns had GBS positive cultures. No newborn had a confirmed septicemia. Cultures from 25% of newborns, who s mothers were still GBS carriers at birth, were positive for GBS. Positive predictive value of cultures taken at 23 weeks gestation was 64% and 78% at 36 weeks. Negative predictive value was 95% and 99% respectively. Conclusion: One out of every four pregnant women in Iceland is a GBS carrier. Twentyfive percent of newborns become colonised with GBS if the mother is a GBS carrier at delivery. When screening for GBS carrier state is done cultures from both vagina and rectum is more sensitive than cultures from vagina only. At least five percent of all newborns in Iceland are therefore expected to have positive skin cultures at birth. If the mother does not have positive GBS cultures during pregnancy, the likelihood that she will give birth to a GBS colonised child is almost none.