• Tafarlaus kransæðavíkkun : nýjung í meðferð bráðrar kransæðastíflu á Íslandi

      Þórarinn Guðnason; Guðmundur Þorgeirsson; Kristján Eyjólfsson; Einar H. Jónmundsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1996-04-01)
      In recently published articles it has been possible to show better results with primary immediate PTCA (percutaneous transluminal coronary angioplasty) than thrombolysis in acute myocardial infarction. This method also has advantages for patients after failed thrombolysis and if thrombolysis is contraindicated. Further advantages are fewer in-hospital days and lower follow-up costs. In this article we discuss immediate PTCA in Iceland and present a follow-up of all patients that underwent this procedure during the first year it was performed in this country. Our conclusion is that immediate PTCA was successfully carried out during the first year it was performed in Iceland.
    • Takmörkun meðferðar á gjörgæsludeild

      Erla G. Sveinsdóttir; Ólafur Þ. Jónsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1997-06-01)
      Background and objective: Increased medical and technical knowledge has saved the lives of more patients than was possible a few decades ago. This has also raised many ethical questions. It is now regarded to be justifiable to limit treatment for some terminally ill patients because certain treatment options are not felt to be in the patient's best interest. At The Reykjavik Hospital guidelines regarding the limitation of treatment were instituted in 1992. This study was undertaken to find out how these guidelines were implemented, how often treatment was limited, what reasons were given and how the documentation was carried out. Material and methods: Included were all patients in the intensive care unit for whom treatment was limited in the year 1993. When the decision was made to limit treatment a questionnaire was filled out. Information was recorded from this and the medical record. Results: There were 606 patients admitted to the intensive care unit in 1993. Decisions to limit treatment were made for 25 patients (4%). The mean age was 67.6 years. The reasons for limiting treatment were neurological deficit in 15 patients, multiple organ failure in seven patients and circulatory failure in three patients. The decision to limit treatment was made most frequently by the patient's primary hospital physician after consultation with the intensive care physician on call and the patient's relatives. Twenty-two of the patients were unconscious when the decision to limit treatment was made. Twenty-one died in the intensive care unit and four were discharged to a general patient ward. Discussion: Comparing our findings with those of similar studies in other countries it was found that the decision to limit care in our institution was made less frequently and, if made occurred later in the course of the patient's care. The documentation was considered to be less than optimal in some cases.
    • Talídómíð, lyf hörmunga og hjálpræðis : yfirlitsgrein : síðari hluti: verkanir og verkunarhættir talídómíðs og notkun til lækninga

      Þorkell Jóhannesson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2003-11-01)
      The story of thalidomide to 1964 or thereabout is the topic of Part 1 of this review. Part 2 deals with recent work on the actions and mechanisms of actions of thalidomide and clinical trials with the drug up to the present day. In 1964 it was found that thalidomide had an unexpected therapeutic effect on erythema nodosum leprosum. About the same time it was suggested that thalidomide might be effective against malignant diseases. Due to molecular similarities between thalidomide and guanosine it is considered likely that thalidomide molecules intercalate in guanosine-rich promoter regions in genes of certain integrins that steer vascularization, and at the same time formation of other tissues, especially in limbs of the fetus. This could interfere with transcription of particular genes and explain fetal damage due to thalidomide and in part, at least, its effect on neoplastic diseases. Thalidomide has a remarkable inhibitory effect on production of TNFa, which is central to its therapeutic effect on inflammatory diseases like erythema nodosum leprosum and Crohn's disease. Thalidomide also induces proliferation in T cells and increases their output of IL-2 and INFg. This could, along with other things, explain its effects on neoplastic diseases. Thalidomide, with dexamethasone, is now the drug of choice in treatment of multiple myeloma. Thalidomide and its derivatives (analogues), considered to have a more specific and intense effect than thalidomide itself, are now being tested in well planned clinical trials for treatment of neoplastic diseases. These are diseases where few or no other therapeutic options are present. The path of thalidomide through time is quite remarkable: From being the drug of sheer horror 40 years ago, it is now occasionally the drug of last resort for heavily suffering and often dying patients.
    • Talídómíð, lyf hörmunga og hjálpræðis : yfirlitsgrein : tilurð talídómíðs, sameindargerð og fyrsti ferill

      Þorkell Jóhannesson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2003-10-01)
      Thalidomide was originally a hypnotic, sedative and anxiolytic drug that was first used in 1955. It was considered to have little toxicity and have smooth activity. Thalidomide was in fact poorly studied both in animals and for therapeutic purposes. It was nevertheless agressively advertised, and inter alia for use in pregnancy, and accordingly it was a much used drug. During the year 1961 it became evident that intake of thalidomide in therapeutic doses could result in severe peripheral neuritis and, when taken early in pregnancy, in horrendous damage to the fetus. Thalidomide was thus shortly afterwards generally removed from the market and its use prohibited. Nevertheless, interest rose a few years later to use thalidomide on other indications than before. This is the topic of Part 2 of this review as well as discussion of studies pertinent to the mechanisms of action of thalidomide.
    • Tannheilsa og tóbaksreykingar : tannmissir, tannáta og tannholdssjúkdómar eru algengari meðal reykingafólks

      Einar Ragnarsson; Sigfús Þór Elíasson; Sigurjón H. Ólafsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1993-08-01)
      A random sample from a group (code named MONICA), participating in a population survey at the Heart Preventive Clinic of the Icelandic Heart Association in Reykjavik Iceland was examined. The sample consisted of 1544 people, men and women, born in the years 1914-1963 (25-74 years of age) from the Reykjavik area, and a farming area in Southern Iceland including both agricultural and fishing villages. The examination was carried out in 1989-90. The number of remaining teeth, total edentulousness, caries, number of fillings (DMFT) and periodontal disease based on CPITN were recorded and compared to data from the Heart Preventive Clinic regarding smoking habits submitted by the subjects at time of examination. Edentulousness was more common in the rural area than in the urban counterpart. In general smokers had fewer remaining teeth and were more often edentulous than non-smokers. Decayed teeth were more common among men, but women had more fillings. Decayed teeth were significantly more common among the smokers than the non-smokers regardless of sex, and the smokers of both sexes had fewer fillings. When CPITN was compared significant differences were found between smokers and non smokers. The percentage of non-smokers of both sexes, who had »0« as the highest score, i.e. were free of periodontal disease, was almost twice as high as that for the smokers (P<0.01). Statistically significant difference was also found as men-smokers showing 3 as a highest score (pockets 4-5mm), where more common than their non-smoking counterparts (P<0.05) (table IV). For women this difference was not statistically significant. The average number of healthy sextants was 60¬70% higher among non-smokers than smokers of both sexes (P<0:001) (table V). Smokers were in greater need for periodontal treatment than non-smokers (P<0.01 both sexes).
    • Tannhirðuvenjur unglinga á Íslandi í 10. bekk árin 2014 og 2016

      Inngangur: Markmið rannsóknarinnar var að kanna venjur unglinga í 10 bekk á Íslandi árin 2014 og 2016 við munnhirðu svo sem tíðni tannburstunar, notkun á tannþræði og flúormunnskoli. Kannað var hvort börnin fari reglulega í skoðun til tannlæknis, hvort þau þekki og viti að þau falli undir samning á milli Sjúkratrygginga Íslands og Tannlæknafélags Íslands um gjaldfrjálsar tannlækningar barna. Með þessu er hægt að gera fræðslu markvissari og efla forvarnir. Efniviður og aðferðir: Megindlegri rannsóknaraðferð var beitt þar sem prentaðir spurningalistar voru lagðir fyrir unglinga í 10 bekk árin 2014 og 2016. Við úrvinnslu gagna var notað tölfræðiforritið R og Rstudio. Skýribreytur voru búseta, kyn og upprunaland foreldra. Lýsandi tölfræði var notuð fyrir niðurstöður rannsóknarinnar. Niðurstöður: Svörun var alls 49% (n=4116), nokkuð jöfn eftir kynjum, 51% (n=2092) strákar og 49% (n=2023) stelpur. Flestir voru búsettir á höfuðborgarsvæði og nágrenni (67%), 30% til sjávar og 3% bjuggu til sveita. 86% (n=3521) áttu foreldra af íslenskum uppruna en 14% (n=593) foreldri eða foreldra af erlendum uppruna. 76,6% (n=446) unglinga með foreldra að erlendum uppruna leita tannlæknaþjónustu reglulega samanborið við 91,3% (n=3185) unglinga með íslenska foreldra. Árið 2013 var gerður samningur um greiðsluþátttöku ríkis vegna tannlæknaþjónustu barna að 18 ára aldri sem tók gildi í áföngum fram til 2018. 88,2% (n=2021) fóru reglulega til tannlæknis árið 2014 en 90,3% (n=1626) árið 2016. Strákar bursta sjaldnar en stelpur, nota síður tannþráð og flúormunnskol og því með marktækt lakari munnhirðu en stelpur. Umræða: Rannsóknin nær yfir allt landið og veitir góða innsýn í munnhirðu 15 ára unglinga á Íslandi. Ekki er marktækur munur á milli landshluta sem gefur til kynna að landið sé orðið einsleitara eins og fyrri rannsóknir hafa sýnt fram á. Niðurstöðurnar benda til að strákar hafi almennt lakari munnhirðu en stelpur og þarf mögulega að sníða forvarnir betur að þeim.
    • Tannholdsbólga og tengsl hennar við aðra algenga sjúkdóma : yfirlitsgrein

      Þórarinn J. Sigurðsson; Háskólin á Akureyri (Tannlæknafélag Íslands, 2007)
      Periodontal disease is a chronic inflammatory disease caused by infection in the supporting tissues of teeth and frequently results in tooth mobility and tooth loss. Approximately 10% of the adult population suffers from serious destruction of the tooth supporting tissues (periodontitis), but much higher percentage have inflammation in the gingival tissues without having lost support for the teeth. In resent years interest has emerged if there could be a link between periodontal disease and some common diseases like cardiovascular diseases and diabetes. Also, preterm birth has been discussed in this perspective. The surge of interest is, if there could be a causative link between infected oral cavity and these common diseases. The biologic rationale given, focuses on the role of general immune reaction and the role inflammatory mediators evoked by the oral infection. The purpose of this paper is to discuss current views on the connection of periodontal disease and some common general diseases.
    • Tannlaust bil - Hvort er skynsamlegra að gera tann- eða tannplantaborið tanngervi?

      Lára Hólm Heimisdóttir; Bjarni E. Pjetursson (Tannlæknafélag Íslands, 2016)
    • Tannmyndunargallar – klínískar áskoranir við greiningu og meðferð

      Eva Guðrún Sveinsdóttir; Ivar Espelid; 1)Tannlæknadeild Háskóla Íslands 2)Tannlæknadeild Háskólans í Osló (Tannlæknafélag Íslands, 2019)
      Myndunargallar í hörðu vefjum tanna ná yfir víðtækt svið tannlækninga og útsetja tannlækninn fyrir miklum áskorunum við greiningu og meðferðarval. Þegar greina skal á milli eðlilegrar og óeðlilegrar tannmyndunar er þörf á ítarlegu mati á sjúklingi, þar með talið læknisfræðilegri-, tannlæknisfræðilegri- og fjölskyldusögu, ásamt klínískri- og röntgenskoðun. Mikilvægar upplýsingar þurfa að liggja fyrir og þær metnar í samhengi til að hægt sé að ákveða rétta greiningu, sem annaðhvort getur verið af erfðafræðilegum eða áunnum toga. Þegar hún liggur fyrir er meðferðarplan ákveðið á kerfisbundinn hátt þar sem horft er til framtíðar. Í mörgum tilfellum eiga sjúklingar með tannmyndunargalla langa meðferð fyrir höndum. Af þeim sökum er mikilvægt að tannlæknir sem meðferðinni stýrir hafi þekkingu og skilning til að veita sjúklingi bestu meðferð sem völ er á. Skoðun sjúklings er einnig mikilvæg þegar meðferðarleið er valin. Í flóknum tilfellum er oft þörf fyrir sérhæfðan tannlækni, svo sem sérfræðing í barnatannlækningum, til að samræma aðgerðir annarra sérfræðinga sem koma að meðferðinni. Í grein þessari er lögð áhersla á mikilvægustu þætti greiningar og meðferðar algengustu tannmyndunargalla.
    • Tannrótarígerðir í Íslendingum til forna

      Svend Richter; Sigfús Þór Elíasson; Tannlæknadeild Háskóla Íslands (Tannlæknafélag Íslands, 2007)
      A total of 51 sculls with 1001 teeth from archaeological site at Skeljastadir in Thjorsardalur in Iceland, were examined both clinically and radiographically. Of the 51 sculls 24 were sex estimated as male and 25 as female with two cases that could not be differentiated. Root abscesses were found in 22 sculls or 43% of cases. Abscesses were significantly more frequent in 36 years and older than in 35 years and younger (p < 0.001) and significantly more frequent in males (p < 0.001). Excessive tooth wear explains most likely the high rate of root abscesses where the wear in many cases reached into the pulp chamber. The study showed direct connection between root abscesses and tooth wear. Most wear was found in 1. molars, where also most abscesses were found. Caries was not a causative factor in the high prevalence of root abscesses.
    • Tannslit Íslendinga til forna

      Svend Richter; Sigfús Þór Elíasson; Tannlæknadeild Háskóla Íslands. (Tannlæknafélag Íslands, 2010)
      Úr fornleifauppgreftri á Skeljastöðum í Þjórsárdal voru 915 tennur í 49 höfuðkúpum nothæfar til skoðunar, 24 konur, 24 karlar og ein kúpa sem ekki tókst að kyngreina. Tvær aðferðir voru notaðar til að flokka slit. Sú fyrri: 0. ekkert slit, 1. slit í glerungi, 2. slit í tannbeini, 3. slit inn í tannkviku. Sú seinni var byggð á 13 flokkunarstigum Brothwell á tannsliti. Til aldursgreiningar voru notaðar 5 aðferðir byggðar á tannþroska tanna, ein á tannsliti og ein á beinsaumum kúpu. Til kyngreiningar voru notuð kyneinkenni á kúpu, neðri kjálka og í nokkrum tilfellum mjaðmagrind. Tannslit var marktækt algengara (p < 0.001) í eldri aldurshópnum en þeim yngri, en enginn marktækur munur var milli kynja. Mesta slit reyndist vera á fyrsta jaxli, sem einnig var oftast með rótarígerð, en minnst á endajöxlum. Tannslit í Skeljastaðaþýðinu sýndi öll merki slits af völdum harðrar og grófrar fæðu. Að sumu leiti komu fram líkindi við glerungseyðingu, sem sjá má nútíma Íslendingaum sem neyta gosdrykkja og annarra súrra drykkja í óhófi. Mysa var notuð til drykkjar og varðveislu matar allt fram á okkar daga. Telja verður að gróf fæða og súrir drykkir hafi skipt verulegu máli í orsökum tannslitsins. ----------------------------------------------------------------------------------------------------------
    • Tannvegsástand, munnhirða og munnhirðuvenjur 16-18 ára unglinga í Reykjavík

      Sigurjón Arnlaugsson; Björn Ragnarsson; Árni Þórðarson; Berglind Jóhannsdóttir; Karl Örn Karlsson; Eiríkur Örn Arnarson; Þórður Eydal Magnússon (Tannlæknafélag Íslands, 2005)
      The aim of this investigation was to study the periodontal health, oral hygiene and oral hygiene habits of 16 - 18 year olds in Reykjavik, Iceland and to evaluate the effects of smoking on these parameters. In 1987 and 1988, 402 six year olds attending 13 elementary schools in Reykjavik were invited to participate in a study on the prevalence of malocclusion, craniofacial skeletal and soft tissue morphology and also to have their gingival condition evaluated at the same time. Ten years later, all those who had participated in the original study were again invited to take part in a second similar study and this time 276 accepted the invitation. Before the clinical examination was performed, the subjects were asked to complete a written questionnaire on oral hygiene practices and smoking habits. The gingival status was assessed on the mesiobuccal and buccal of 6 teeth (Ramfjord teeth) using the Gingival Bleeding Index (GBI). Dental plaque was assessed on the mesial, lingual and buccal surfaces of the same 6 teeth using the Plaque Index (PLI). The periodontal condition was determined using the Community Periodontal Index of Treatment Needs (CPITN). Only 5.8% were determined to be healthy according to the criteria of the CPITN, 39.1% had gingivitis as the highest score and 55.1% had calculus. None was found to have 4 mm. or deeper pockets. The majority of subjects (66.3%) stated that they brushed their teeth twice or more often daily but 5 subjects (1.8%) brushed their teeth less than once a day. Those using dental floss or toothpicks daily were 10.5%, girls using dental floss significantly more often than boys (p<0.001). Smoking was practiced by 21.5% of respondents and of those 80.7% smoked between 6 and 20 cigarettes per day. No significant difference was found between the number of boys and girls who smoked or the number of cigarettes smoked per day. Smokers had significantly higher PLI scores than non smokers (p<0.001) but no difference was found for either GBI or CPITN scores between smokers or non smokers. Subjects who brushed their teeth once daily had significantly higher mean PLI and GBI scores for total surfaces than those who brushed two or more times daily (p<0.05). No statistically significant difference in PLI, GBI or CPITN scores was found between those who practiced interdental cleaning and those who did not. The results of this study show that gingivitis is common amongst 16-18 year old Icelandic adolescents but periodontal pockets were not found. The daily use of toothbrush and toothpaste is almost universal in this population but only 10.5% practice daily interdental cleaning. Smoking does not seem to have had a deleterious effect on the periodontal condition of subjects of this age.
    • Taugakerfi tengd ýfingaráhrifum í sjónskynjun : niðurstöður úr taugasálfræði- og segulómmyndunarrannsóknum

      Árni Kristjánsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2005-04-01)
      When we look around us, we are overall more likely to notice objects that we have recently looked at; an effect known as priming. For example, when the color or shape of a visual search target is repeated, observers find the target faster than otherwise. Here I summarize recent research undertaken to uncover the temporary changes in brain activity that accompany these priming effects. In light of the fact that priming seems to have a large effect on how attention is allocated, we investigated priming effects in a visual search task on patients suffering from the neurological disorder "hemispatial neglect" in which patients typically fail to notice display items in one of their visual hemifields. Priming of target color was relatively normal for these patients, while priming of target location seemed to require awareness of the briefly presented visual search target. An experiment with functional magnetic resonance imaging of normal observers revealed that both color and location priming had a strong modulatory influence on attentional mechanisms of the frontal and parietal cortex. Color priming was also correlated with changes in activity in visual cortex as well as color processing areas in the temporal lobe. Location priming was correlated with changes in activity near the temporo- parietal junction and lateral inferior frontal cortex, areas that have been connected with attentional capture; which ties well with our finding of deficits of location priming for the neglect patients who indeed have lesions in the temporo-parietal junction. Overall, the results confirm the tight coupling of visual attention and priming in vision, and also that the visual areas of the brain show some modulation of activity as priming develops.
    • Tekist á við tíðarhvörf : um líðan og afstöðu 47 til 53 ára kvenna til tíðarhvarfa og notkunar tíðarhvarfahormóna

      Herdís Sveinsdóttir (2005-12-01)
      Background: The unexpected findings of the WHI-study, made public in July 2002, showed that the risk of using combined hormone therapy (HT) exceeded its benefits. This complicated women’s decision making about whether to use HT or not and makes it important to study the determinants of women’s attitudes to HT. Aim: This study sought to illuminate what influences women’s decisions about HT, describe the extent and source of menopausal education, symptom experience, health and lifestyle, knowledge about the findings of the WHI-study and attitudes towards HT and towards menopause. Methods: A self-administered questionnaire based on dichotomous questions, multiple choice questions and questions on attitudes, was mailed to 1000 women randomly selected from the National Registry of Iceland. Response rate was56%. Findings: 252 participants had used HT and 46% had stopped its use. Younger women were less likely to use HT. The reasons given for HT use were mostly symptom management. Older women and users of HT held more positive view towards HT than the comparison groups. However, never HT users held more positive attitudes towards menopause than users. 51% of participants received adequate menopausal education while 84% stated that the health authorities should provide more menopausal education. Major source of menopausal education was media and female friends. The participants discussed use of HT mostly with a physician. 65% had heard about the WHI-study and the findings influenced the decision of a large proportion of HT users as well as women intending to use HT about whether to continue, stop, or start using HT. Conclusion: Perimenopausal Icelandic women have stopped or are considering to stop using HT due to the findings of the WHI-study. They also want more menopausal education provided by the health authorities. Physicians are very influential in their decision making regarding HT use.
    • Tengsl atvinnuleysis og nýgengis örorku á Íslandi 1992-2003

      Sigurður Thorlacius; Sigurjón B. Stefánsson; Stefán Ólafsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2004-12-01)
      Objective: To evaluate the effect of unemployment and the introduction of a new method of disability assessment on the number of recipients of disability pension in Iceland by examining changes in the incidence of disability pension and unemployment year by year from 1992 to 2003. Material and methods: Information on gender, age and disability grade of new recipients of disability pension in Iceland and corresponding information on the Icelandic population for each year in the period 1992 to 2003 was used to calculate the incidence of disability pension. The results were compared with data on the rate of unemployment in Iceland. Results: The incidence of disability pension was relatively high from 1992 to 1995, was lower from 1996 to 2002 and then increased markedly in 2003. There is a strong correlation between the incidence of disability pension and the rate of unemployment among both genders in Iceland during the period covered by the study. An increase from 1999 to 2000 in the incidence of disability pension among females coincided in time with the introduction of a new method of disability assessment in September 1999, but also with an increase in the rate of unemployment among females. Conclusion: It is not warranted to claim that the introduction of a new method of disability evaluation in September 1999 has resulted in a decisive increase in the incidence of disability pension in Iceland. The increase in the number of recipients of disability pension in Iceland recently has a strong statistical correlation with changes in the labour marked, especially with rising unemployment and increased pressure at work.
    • Tengsl búsetu fyrstu 20 æviárin við áhættu á sykursýki af tegund 2

      Elín Ólafsdóttir; Thor Aspelund; Jóhanna E Torfadóttir; Laufey Steingrímsdóttir; Gunnar Sigurðsson; Bolli Þórsson; Rafn Benediktsson; Guðný Eiríksdóttir; Unnur Anna Valdimarsdóttir,; Vilmundur Guðnason; et al. (Læknafélag Íslands, Læknafélag Reykjavíkur, 2012-12)
      Inngangur: Kyrrseta og ofneysla orkuríkrar fæðu tengjast aukinni áhættu á að fá sykursýki af tegund 2 en áhrif aðbúnaðar í uppvexti á slíka áhættu síðar á ævinni hafa lítt verið athuguð. Tilgangur þessarar rannsóknar var að kanna tengsl búsetu í dreifbýli fyrstu 20 æviárin við áhættu á að fá sykursýki 2 miðað við búsetu í Reykjavík frá fæðingu. Efniviður og aðferðir: Í lýðgrunduðu þýði 17.811 karla (48%) og kvenna, meðalaldur 53 ár (aldursbil 33-81), sem tóku þátt í Reykjavíkurrannsókn Hjartaverndar á árunum 1967-1991, bjuggu 29% í sveit og 35% í sjávarþorpum að meðaltali í 20 ár áður en þeir fluttu til Reykjavíkur, en 36% bjuggu í Reykjavík frá fæðingu. Reiknuð var hlutfallsleg áhætta á að fá sykursýki 2 eftir búsetu. Niðurstöður: Hlutfallsleg áhætta á að fá sykursýki 2 var 43% lægri í körlum (RR 0,57; 95% CI 0,43-0,77) og 26% lægri í konum (RR 0,74; 95% CI 0,56-0,99) sem bjuggu í sveit fyrstu 20 ár ævinnar í samanburði við þá sem bjuggu í Reykjavík frá fæðingu. Hið lága algengi meðal þeirra sem ólust upp í sveit fannst bæði í aldurshópunum 55-64 ára og 65 ára og eldri. Ályktanir: Niðurstöður okkar benda til þess að þeir sem bjuggu í sveit á fyrri hluta 20. aldar á Íslandi voru í minni hættu á að fá sykursýki 2 síðar á ævinni, en jafnaldrar þeirra sem bjuggu í Reykjavík frá fæðingu. Við vörpum fram þeirri tilgátu að aðbúnaður snemma á ævinni hafi langvarandi áhrif á sykurefnaskipti líkamans.
    • Tengsl D-vítamíns og áhættuþátta hjarta- og æðasjúkdóma meðal íslenskra barna

      Þórunn Hannesdóttir; Hannes Hrafnkelsson; Erlingur Jóhannsson; Emil Sigurðsson; 1 Háskóli Íslands, heimilislæknisfræði, 2 Heilsugæslan Sólvangi, 3 Heilsugæslan Seltjarnarnesi, 4 Íþrótta- og heilsufræði við Háskóla Íslands, Reykjavík. 5 Department of Sport and Physical Activity, Bergen University College,Bergen, Norway (Læknafélag Íslands, Læknafélag Reykjavíkur, 2017-09-07)
      Tilgangur: Að kanna tengsl á milli D-vítamíngilda í blóði og þekktra áhættu­þátta fyrir hjarta- og æðasjúkdómum meðal heilbrigðra íslenskra barna og jafnframt að kanna þessi tengsl óháð líkamsþyngdarstuðli (BMI). Efniviður/aðferðir: Metin voru tengsl milli styrks 25-hydroxyvítamín D í blóði, líkamsþyngdarstuðuls og sjö áhættuþátta hjarta- og æðasjúkdóma (háþrýstings, heildarkólesteróls, HDL, LDL, þríglýceríðs, blóðsykurs og styrks insulíns í blóði). Þátttakendur voru 7 ára skólabörn í 6 grunnskólum Reykjavíkur, haustið 2006. Niðurstöður: D-vítamín var mælt hjá 159 börnum. 35 þeirra (22%) voru undir 37,5 nmól/L, 70 (44%) á milli 37,5 og 50,0 nmól/L og 55 (34%) yfir 50 nmól/L. D vítamínskortur var skilgreindur sem gildi undir 37,5 nmól/L. Ekki reyndist vera marktækur munur á milli kynja, stelpur (n:85 = 44,2 nmól/L), strákar (n:74 = 46,9 nmól/L), p-gildi 0,52 milli hópa. Börn með D-vítamínskort höfðu tilhneigingu til að hafa hærri líkamsþyngdarstuðul (p=0,052), lægra HDL (p=0,044) og hærra HbA1C (p=0,015) og serum insúlín (p=0,014) samanborið við börn með eðlileg D-vítamíngildi, það er yfir 50 nmól/L. Marktæk fylgni var á milli lágs D-vítamíns og hárra gilda insúlíns í blóði (p=0,014) og hárra gilda HbA1c (p=0,015), óháð líkamsþyngdarstuðli. Ályktanir: D-vítamínskortur hefur verið tengdur við þróun hjarta-og æðasjúkdóma. Mikilvægt er að kanna tengsl milli þekktra áhættuþátta hjarta- og æðasjúkdóma og D-vítamíns, sérstaklega hjá börnum og ungu fólki. Hugsanlegt er að D-vítamínskortur auki áhættuna á að þróa með sér hjartasjúkdóm snemma í lífinu gegnum insúlínviðnám og breytta blóðsykurstjórnun. Mikilvægt er að fylgja opinberum ráðleggingum varðandi D-vítamíngjöf fyrir alla aldurshópa, en rannsóknin sýndi að 2/3 barnanna voru undir þeim kjörgildum sem Embætti landlæknis mælir með.
    • Tengsl félags- og efnahagslegrar stöðu og tannheilsu barna í 1., 7. og 10. bekk

      Björg Steinarsdóttir; Tinna Laufey Ásgeirsdóttir,; Hagfræðideild Háskóla Íslands, Reykjavík, Ísland (Tannlæknafélag Íslands, 2014)
      Tannáta er á meðal algengustu sjúkdóma hjá börnum. Tengsl á milli félags- og efnahagslegrar stöðu barna og tannheilsu þeirra eru þekkt úr erlendum rannsóknum. Hollar neysluvenjur og góð tannhirða barna eru taldar tengjast menntunarstigi foreldra þeirra. Rannsóknir sýna einnig að börn sem koma frá tekjuháum heimilum búa við betri tannheilsu en börn sem koma frá tekjulágum heimilum. Markmið þessarar rannsóknar var að kanna tengsl félags- og efnahagslegrar stöðu íslenskra barna í 1., 7. og 10. bekk við tannheilsu þeirra. Einnig var skoðað að hve miklu leiti tengslin eru tilkomin vegna mismunandi tíðni sælgætisneyslu, forvarna heima (tannhirða) og hjá tannlækni (skorufyllingar). Í greininguna voru notuð þversniðsgögn úr MUNNÍS-rannsókninni sem fram fór árið 2005. Úrtakið var slembið og lagskipt klasaúrtak og náði til 20% einstaklinga í 1., 7. og 10. bekk. Alls samþykktu 82% úrtaksins þátttöku en skoðaðir voru 2.251 einstaklingur. Tengslin voru metin með línulegri aðhvarfsgreiningu, þar sem tekið var tillit til úrtaksaðferðar með því að flokka skóla sem klasa. Háða breytan heilar fullorðinstennur (HFT) var notuð sem mælikvarði á tannheilsu barna í 7. og 10. bekk en heilar barnatennur (HBT) í 1. bekk. Til þess að meta félags- og efnahagslega stöðu barnanna voru notaðar breyturnar menntun móður og heimilistekjur. Niðurstöður rannsóknarinnar sýna að marktæk jákvæð tengsl eru á milli tannheilsu barna og menntunar móður og heimilistekna í öllum aldurshópum þegar tengslin eru metin fyrir bæði kynin saman. Í 1. bekk er forspárgildi fyrir börn háskólamenntaðra mæðra í hæsta tekjuhópi 2,5 HBT (p <0,05) hærra en fyrir börn mæðra með grunnskólapróf sem lokamenntun í lægsta tekjuhópi. Í 7. bekk er munurinn 5,6 HFT (p <0,01) og einnig 5,6 HFT (p <0,05) í 10. bekk. Tannheilsuójöfnuðurinn lækkar um 10,2% í 1. bekk þegar leiðrétt er fyrir áhrifum forvarna heima og hjá tannlækni auk tíðni sælgætisneyslu en lækkar um 15,7% hjá 7. bekk og 11,6% hjá 10. bekk. Tannheilsuójöfnuður er til staðar hjá börnum á Íslandi en rannsóknin sýnir þó ekki fram á orsakasamband.
    • Tengsl fæðutakmörkunar og óánægju með líkamsvöxt við líkamsþyngdarstuðul og innfæringu á gildum um grannt vaxtarlag

      Unnur Guðnadóttir; Ragna B. Garðarsdóttir; Fanney Þórsdóttir; Háskóli Íslands (2011)
      A huge emphasis is placed on the female thin-ideal in contemporary society, especially in popular media. Research evidence shows that internalization of the thin-ideal increases risk for body dissatisfaction and dietary restraint. The aim of the present questionnaire study (N = 303) was to (a) examine the extent of body dissatisfaction and dietary restraint among Icelandic female college students and (b) examine simultaneously the associations between body dissatisfaction, dietary restraint, BMI, and thin-ideal internalization, using a structural equation model. More than half of the participants were dissatisfied with their body and restricted their food intake. The conceptual model that was tested received support. Internalization of the thin-ideal was positively associated with dietary restraint, regardless of participants BMI. Furthermore, when the effects of body dissatisfaction and internalization on dietary restraint were controlled for, a previously significant association between BMI and dietary restraint was reduced to non-significance.
    • Tengsl greiningar og meðferðar á áfengisvanda : hófdrykkja, bindindi og áfengismeðferð

      Oddi Erlingsson (Sálfræðingafélag Íslands, 1992)
      Hlutfallslega fara hvergi fleiri í áfengismeðferð en á Íslandi. Ýmsir annmarkar eru á ráðandi meðferð hér á landi. Greining, markmið og meðferðarform eru ósveigjanleg. Fjallað er um þróun áfengismeðferðar síðustu 30 ára og byggt á íslenskum en þó einkum erlendum rannsóknum. Sjúkdómshugtakið um alkóhólisma tekur ekki mið af ólíkum stigum áfengisvandans. Fjöldi rannsókna sýnir þó að fíkn getur verið á ólíkum stigum. Fjallað er um þrjá þætti sem hafa áhrif á árangur meðferðar: stig fíknar, viðhorf neytandans og þjóðfélagslega þætti. Nákvæmari greining áfengissýki og aukin fjölbreytni í meðferð stuðlar að markvissari, árangursríkari og eftirsóknarverðari meðferð. Spurningin er ekki um það hvort áfengismeðferð skilar árangri eða ekki, heldur hverjum hentar hvaða meðferð, sé áfengismeðferð talin nauðsynleg. Sumir ná árangri með minni neyslu, aðrir með bindindi, og innlögn virðist ekki vænlegur kostur fyrir alla. Undirstrikað er samspil nákvæmrar greiningar við árangur meðferðar. Í þeim tilfellum þar sem tengsl greiningar og árangurs eru ekki kunn, er lagt til að veitt sé meðferð sem er ódýr og sannanlega betri en engin meðferð.