• Adrenergic and metabolic effects of electrical weapons: review and meta-analysis of human data.

      Kunz, S N; Calkins, H G; Adamec, J; Kroll, M W; [ 1 ] Landspitali Univ Hosp, Dept Forens Pathol, IS-101 Reykjavik, Iceland Show more [ 2 ] Johns Hopkins Med Inst, Baltimore, MD 21205 USA Show more [ 3 ] Ludwig Maximilians Univ Munchen, Inst Forens Med, Munich, Germany Show more [ 4 ] Univ Minnesota, Dept Biomed Engn, Minneapolis, MN USA Show more [ 5 ] Calif Polytech Inst, San Luis Obispo, CA USA (Springer, 2018-09-01)
      Electronic control with the CEW (conducted electrical weapon) has gained widespread acceptance as the preferred force option due to its significant injury reduction. However, a CEW application does stress the human body. In the case of the CEW, the human body response is similar to the challenge of physical exercise combined with emotional stress over a very short time interval. There has been concern whether the tension of the skeletal-muscle system together with the emotional stress of being exposed to the effects of a CEW, can lead to severe metabolic dysfunction. A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological effects of CEWs. Additional publications were collected through a manual search of reference lists in retrieved articles. After preliminary exclusions, we carefully reviewed the remaining publications and found 24 papers reporting prospective human clinical research data on adrenergic, ventilation, or metabolic effects. Where there were multiple studies on the same endpoints, we performed meta-analyses. A CEW exposure provides a clinically insignificant increase in heart rate (7.5 BPM) and a drop in both systolic and diastolic blood pressure. Alpha-amylase goes down but cortisol levels increase-both epinephrine and norepinephrine levels are increased by levels similar to mild exercise. A CEW exposure increases ventilation but does not appear to interfere with gas exchange. Lactate is increased slightly while the pH is decreased slightly with changes equivalent to mild exercise. The lactate and pH changes appear quickly and do not appear to be affected by increasing the exposure duration from 5 to 30 s. Thorough review and meta-analyses show that electrical weapon exposures have mixed and mild adrenergic effects. Ventilation is increased and there are metabolic changes similar to mild exercise.
    • Anaplastic thyroid carcinoma transformation in a lateral neck node metastasis - A case report and a review of the literature

      Gunnarsdottir, Agnes B; Briem, Birgir A; Jonasson, Larus; Tryggvason, Geir; [ 1 ] Skanes Univ Sjukhus Lund, Dept Otolaryngol & Head & Neck Canc, Lund, Sweden Show more [ 2 ] Landspitali Univ Hosp, Dept Otolaryngol Head & Neck Surg, IS-108 Reykjavik, Iceland Show more [ 3 ] Landspitali Univ Hosp, Dept Surg Pathol, Reykjavik, Iceland (Taylor & Francis, 2018)
      Anaplastic thyroid carcinoma is thought to be derived from previous existing papillary or follicular thyroid carcinoma that dedifferentiates into its anaplastic counterpart. We present a case where this type of dedifferentiation occurs at a metastatic site in a regional lymph node, years after the primary papillary thyroid tumor had metastasized.
    • Association between healthy maternal dietary pattern and risk for gestational diabetes mellitus.

      Tryggvadottir, E A; Medek, H; Birgisdottir, B E; Geirsson, R T; Gunnarsdottir, I; [ 1 ] Univ Iceland, Landspitali Natl Univ Hosp, Unit Nutr Res, Eiriksgata 28, IS-101 Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital     University of Iceland [ 2 ] Univ Iceland, Fac Food Sci & Nutr, Eiriksgata 28, IS-101 Reykjavik, Iceland [ 3 ] Univ Iceland, Landspitali Univ Hosp, Womens Clin, Dept Obstet & Gynecol, Eiriksgata 28, IS-101 Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital     University of Iceland (Nature Publishing Group, 2016-02)
      Gestational diabetes mellitus (GDM) is associated with negative health effects for mother and child. The aim was to investigate the association between maternal dietary patterns and GDM.
    • Association of AADAC Deletion and Gilles de la Tourette Syndrome in a Large European Cohort.

      Bertelsen, Birgitte; Stefánsson, Hreinn; Riff Jensen, Lars; Melchior, Linea; Mol Debes, Nanette; Groth, Camilla; Skov, Liselotte; Werge, Thomas; Karagiannidis, Iordanis; Tarnok, Zsanett; Barta, Csaba; Nagy, Peter; Farkas, Luca; Brøndum-Nielsen, Karen; Rizzo, Renata; Gulisano, Mariangela; Rujescu, Dan; Kiemeney, Lambertus A; Tosato, Sarah; Nawaz, Muhammad Sulaman; Ingason, Andres; Unnsteinsdottir, Unnur; Steinberg, Stacy; Ludvigsson, Pétur; Stefansson, Kari; Kuss, Andreas Walter; Paschou, Peristera; Cath, Danielle; Hoekstra, Pieter J; Müller-Vahl, Kirsten; Stuhrmann, Manfred; Silahtaroglu, Asli; Pfundt, Rolph; Tümer, Zeynep; [ 1 ] Rigshosp, Copenhagen Univ Hosp, Kennedy Ctr, Appl Human Mol Genet,Dept Clin Genet, Glostrup, Denmark [ 2 ] deCODE Genet, Reykjavik, Iceland [ 3 ] Univ Med Greifswald, Dept Human Genet, Greifswald, Germany [ 4 ] Ernst Moritz Arndt Univ Greifswald, Interfac Inst Genet & Funct Genom, Greifswald, Germany [ 5 ] Herlev Hosp, Dept Pediat, Tourette Clin, DK-2730 Herlev, Denmark [ 6 ] Capital Reg Denmark, Mental Hlth Serv, Sct Hans, Inst Biol Psychiat,Mental Hlth Ctr, Hillerod, Denmark [ 7 ] Univ Copenhagen, Fac Med & Hlth Sci, Inst Clin Sci, Copenhagen, Denmark [ 8 ] IPSYCH, Initiat Integrat Psychiat Res, Roskilde, Denmark [ 9 ] Democritus Univ Thrace, Dept Mol Biol & Genet, Alexandroupolis, Greece [ 10 ] Vadaskert Child & Adolescent Psychiat Clin, Budapest, Hungary [ 11 ] Semmelweis Univ, Mol Biol & Pathobiochem, Dept Med Chem, H-1085 Budapest, Hungary [ 12 ] Catania Univ, Dept Med & Pediat Sci, Sect Child Neuropsychiat, Catania, Italy [ 13 ] Univ Halle Wittenberg, Dept Psychiat, Psychotherapy & Psychosomat, D-06108 Halle, Germany [ 14 ] Radboud Univ Nijmegen, Med Ctr, Dept Hlth Evidence, NL-6525 ED Nijmegen, Netherlands [ 15 ] Univ Verona, Sect Psychiat, Dept Publ Hlth & Community Med, I-37100 Verona, Italy [ 16 ] Landspitalinn Univ Hosp, Dept Pediat, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 17 ] Univ Utrecht, Dept Clin & Hlth Psychol, Utrecht, Netherlands [ 18 ] Altrecht Acad Anxiety Outpatient Clin, Utrecht, Netherlands [ 19 ] Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands [ 20 ] Hannover Med Sch, Psychiat Clin, Social Psychiat & Psychotherapy, Hannover, Germany [ 21 ] Hannover Med Sch, Inst Human Genet, Hannover, Germany [ 22 ] Univ Copenhagen, Dept Cellular & Mol Med, Wilhelm Johansen Ctr Funct Genome Res, Copenhagen, Denmark [ 23 ] Radboud Univ Nijmegen, Med Ctr, NL-6525 ED Nijmegen, Netherlands (Elsevier Science Inc, 2016-03-01)
      Gilles de la Tourette syndrome (GTS) is a complex neuropsychiatric disorder with a strong genetic influence where copy number variations are suggested to play a role in disease pathogenesis. In a previous small-scale copy number variation study of a GTS cohort (n = 111), recurrent exon-affecting microdeletions of four genes, including the gene encoding arylacetamide deacetylase (AADAC), were observed and merited further investigations.
    • Að efla heilbrigði: Næringarráðgjöf sem íhlutun fyrir of þungar konur fyrir og eftir fæðingu

      Helga Gottfreðsdóttir,; Inga Þórsdóttir; Hjúkrunarfræðideild Háskóli Íslands, Heilbrigðisvísindasvið, Háskóli Íslands og Landspítala (Ljósmæðrafélag Íslands, 2012)
      Nýjustu tölur um líkamsþyngd Íslendingasýna að tæplega 59% fólks á aldrinum 18–80ára er yfir kjörþyngd og þar af flokkast 21%með offitu. Rannsóknir benda til að hlutfallþeirra sem eru of feitir fari vaxandi. Konur ábarneignaraldri fara ekki varhluta af þessariþróun en niðurstöður fjölda rannsóknahafa sýnt tengsl offitu við ýmis vandamál ogsjúkdóma tengdum meðgöngu og fæðingu.Í þessari grein er varpað ljósi á þá stöðusem ríkir hér á landi varðandi yfirþyngd ogofþyngd kvenna á meðgöngu og afleiðingarþess en rannsóknir sýna að konur á barnsburðaraldri18–39 ára eru of þungar í 41%tilvika og þar af eru 18% of feitar. Nokkrarerlendar rannsóknir hafa sýnt fram á að meðþví að nota hvatningaviðtöl, næringarráðgjöfog upplýsingar um hreyfingu megi hafa áhrif áþyngdaraukningu kvenna á meðgöngu. Flestaríhlutunarrannsóknir eru þó með litlu úrtaki ogí fáum þeirra er konum fylgt eftir að fæðingulokinni.Mikilvægt er að horfa á offitu semviðfangsefni þar sem fjöldi þátta hefur áhrif.Í öllum tilfellum þarf að huga að mataræðiog næringu konunnar og næringarráðgjöfsem felur í sér hvatningu og kennslu er þvínauðsynleg. Þá þarf að virkja eiginleika ífari hvers einstaklings til að sem hagstæðustútkoma fáist fyrir móður og barn. Í greininnikynnum við hugmyndafræði sem nota má viðþróun íhlutana fyrir konur á meðgöngu sembyggir á því að nota styrkleika hverrar ogeinnar konu samfara því að veita fræðslu ográðgjöf á einstaklingsbundinn hátt .
    • Borrelia and subsequent risk of solid tumors and hematologic malignancies in Sweden.

      Chang, Cindy M; Landgren, Ola; Koshiol, Jill; Björkholm, Magnus; Löve, Thorvardur J; Kristinsson, Sigurdur Y; Landspitali University Hospital (2012-11-01)
    • Bronchiovenous fistula causing bleeding and air embolism: an unusual complication of bronchoscopic tumor resection.

      Sigurdsson, Martin I; Sigurdsson, Hjortur; Hreinsson, Kari; Simonardottir, Liney; Gudbjartsson, Tomas (American Thoracic Society, 2011-03-01)
    • Cardiac and skeletal muscle effects of electrical weapons : A review of human and animal studies.

      Kunz, Sebastian N; Calkins, Hugh; Adamec, Jiri; Kroll, Mark W; [ 1 ] Landspitali Univ Hosp, Dept Forens Pathol, V Baronstig 101, Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Reykjavik, Iceland Show more [ 3 ] Johns Hopkins Med Inst, Baltimore, MD 21205 USA Show more [ 4 ] Ludwig Maximilians Univ Munchen, Inst Forens Med, Munich, Germany Show more [ 5 ] Univ Minnesota, Dept Biomed Engn, Minneapolis, MN USA Show more [ 6 ] Calif Polytech Inst, San Luis Obispo, CA USA (Humana Press, 2018-09-01)
      Conducted Electrical Weapons (CEWs) are being used as the preferred non-lethal force option for police and special forces worldwide. This new technology challenges an exposed opponent similarly to the way they would be challenged by physical exercise combined with emotional stress. While adrenergic and metabolic effects have been meta-analyzed and reviewed, there has been no systematic review of the effects of CEWs on skeletal and cardiac muscle. A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological cardiac and skeletal muscle effects of CEWs. For skeletal muscle effects, we analyzed all publications providing changes in creatine kinase, myoglobin and potassium. For cardiac effects, we analyzed reported troponin changes and arrhythmias related to short dart-to-heart-distances. Conducted electrical weapons satisfy all relevant electrical safety standards and there are, to date, no proven electrocution incidents caused by CEWs. A potential cardiovascular risk has been recognized by some of the experimental animal data. The effects on the heart appear to be limited to instances when there is a short dart-to-heart-distance. The effect on the skeletal muscle system appears to be negligible. A responsible use of a CEW on a healthy adult, within the guidelines proposed by the manufacturer, does not imply a significant health risk for that healthy adult.
    • A Case of Complete Scotoma Following Intake of Conjugated Linoleic Acid Supplement

      Eliasson, Jon H.; Birgisdottir, Bryndis E.; Gudmundsson, Larus S.; 1 ] Centralsjukhuset, Dept Neurol, Kristianstad, Sweden Show more [ 2 ] Univ Iceland, Fac Food Sci & Nutr, Unit Nutr Res, Reykjavik, Iceland Show more [ 3 ] Landspitali Univ Hosp, Reykjavik, Iceland Show more [ 4 ] Univ Iceland, Fac Pharmaceut Sci, Hagi Hofsvallagata 53, IS-107 Reykjavik, Iceland; Department of Neurology; Centralsjukhuset; Kristianstad Sweden; Unit for Nutrition Research; Faculty of Food Science and Nutrition University of Iceland and Landspitali University Hospital; Reykjavik Iceland; Faculty of Pharmaceutical Sciences; University of Iceland; Reykjavik Iceland (Wiley, 2018-05)
    • Corrigendum to "Quantitative UPLC-MS/MS assay of urinary 2,8-dihydroxyadenine for diagnosis and management of adenine phosphoribosyltransferase deficiency" [J. Chromatogr. B 1036-1037 (2016) 170-177].

      Thorsteinsdottir, Margret; Thorsteinsdottir, Unnur A; Eiriksson, Finnur F; Runolfsdottir, Hrafnhildur L; Agustsdottir, Inger M Sch; Oddsdottir, Steinunn; Sigurdsson, Baldur B; Hardarson, Hordur K; Kamble, Nilesh R; Sigurdsson, Snorri Th; Edvardsson, Vidar O; Palsson, Runolfur; [ 1 ] Univ Iceland, Reykjavik, Iceland [ 2 ] ArcticMass, Reykjavik, Iceland [ 3 ] Landspitali Natl Univ Hosp Iceland, Childrens Med Ctr, Reykjavik, Iceland [ 4 ] Landspitali Natl Univ Hosp Iceland, Dept Clin Biochem, Reykjavik, Iceland Show more [ 5 ] European Acad Bolzano Bozen, Ctr Biomed, Bolzano, Italy [ 6 ] Landspitali Natl Univ Hosp Iceland, Div Nephrol, Reykjavik, Iceland (Elsevier Science, 2018-08-15)
    • Decreased postural control in adult survivors of childhood cancer treated with chemotherapy.

      Einarsson, Einar-Jón; Patel, Mitesh; Petersen, Hannes; Wiebe, Thomas; Fransson, Per-Anders; Magnusson, Måns; Moëll, Christian; Department of Clinical Sciences, Lund University, Lund, Sweden. 2Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3Division of Brain Sciences, Imperial College London, London, United Kingdom. 4Department of Otorhinolaryngology, Landspitali University Hospital, Reykjavik, Iceland. 5Department of Paediatrics, Skåne University Hospital, Lund, Sweden. 6Department of Otorhinolaryngology, Skåne University Hospital, Lund, Sweden. (Nature Publishing Group, 2016-11-10)
      The objective of cancer treatment is to secure survival. However, as chemotherapeutic agents can affect the central and peripheral nervous systems, patients must undergo a process of central compensation. We explored the effectiveness of this compensation process by measuring postural behaviour in adult survivors of childhood cancer treated with chemotherapy (CTS). We recruited sixteen adults treated with chemotherapy in childhood for malignant solid (non-CNS) tumours and 25 healthy age-matched controls. Subjects performed posturography with eyes open and closed during quiet and perturbed standing. Repeated balance perturbations through calf vibrations were used to study postural adaptation. Subjects were stratified into two groups (treatment before or from 12 years of age) to determine age at treatment effects. Both quiet (p = 0.040) and perturbed standing (p ≤ 0.009) were significantly poorer in CTS compared to controls, particularly with eyes open and among those treated younger. Moreover, CTS had reduced levels of adaptation compared to controls, both with eyes closed and open. Hence, adults treated with chemotherapy for childhood cancer may suffer late effects of poorer postural control manifested as reduced contribution of vision and as reduced adaptation skills. These findings advocate development of chemotherapeutic agents that cause fewer long-term side effects when used for treating children.
    • Downsheilkenni : eðli þess, uppruni og áhrif á líf og heilsu þeirra sem með það fæðast

      Gíslína Erna Valentínusdóttir; Jóhanna Ólafsdóttir; Guðrún Kristjánsdóttir; Margrét Eyþórsdóttir (Félag íslenskra hjúkrunarfræðinga, 2004-10)
      Í þessari grein verður fjallað um þætti sem tengjast heilsu og velferð barna sem fæðst hafa með downsheilkenni, farið yfir tíðni þess og rætt stuttlega um framtíðarhorfur barnanna og þau atriði sem hjúkrunarfræðingar þurfa að huga að við frekari rannsóknir til að skilja betur hjúkrunarlegt ástand þessara skjólstæðinga.
    • Dramatically improved survival in multiple myeloma patients in the recent decade: results from a Swedish population-based study.

      Thorsteinsdottir, Sigrun; Dickman, Paul W; Landgren, Ola; Blimark, Cecilie; Hultcrantz, Malin; Turesson, Ingemar; Björkholm, Magnus; Kristinsson, Sigurdur Y; 1 Department of Internal Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 2 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 4 Myeloma Service, Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, NY, USA. 5 Department of Internal Medicine, Hematology Section, Sahlgrenska University Hospital, Gothenburg, Sweden. 6 Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 7 Department of Hematology and Coagulation Disorders, Skane University Hospital, Malmo, Sweden. 8 Department of Internal Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland sigyngvi@hi.is. (Ferrata Storti Foundation, 2018-09-01)
    • Editor's Choice - The Impact of Centralisation and Endovascular Aneurysm Repair on Treatment of Ruptured Abdominal Aortic Aneurysms Based on International Registries.

      Budtz-Lilly, Jacob; Björck, Martin; Venermo, Maarit; Debus, Sebastian; Behrendt, Christian-Alexander; Altreuther, Martin; Beiles, Barry; Szeberin, Zoltan; Eldrup, Nikolaj; Danielsson, Gudmundur; Thomson, Ian; Wigger, Pius; Khashram, Manar; Loftus, Ian; Mani, Kevin; 1 Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden; Department of Cardio-Thoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark. Electronic address: jacobudt@rm.dk. 2 Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden. 3 Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland. 4 Department of Vascular Medicine, University Heart Centre Hamburg - Eppendorf, Hamburg, Germany. 5 Department of Vascular Surgery, St Olavs Hospital, Trondheim, Norway. 6 Australian and New Zealand Society for Vascular Surgery, East Melbourne, Australia. 7 Department of Vascular Surgery, Semmelweis University, Budapest, Hungary. 8 Department of Cardio-Thoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark. 9 National University Hospital of Iceland, Department of Surgery, Reykjavík, Iceland. 10 Department of Vascular Surgery, Dunedin School of Medicine, Dunedin Hospital, Dunedin, New Zealand. 11 Department of Cardiovascular Surgery, Kantonsspital Winterthur, Switzerland. 12 Department of Surgery, University of Otago, Christchurch, New Zealand. 13 Department of Vascular Surgery, St George's University of London, London, UK. (W.B. Saunders, 2018-08-01)
      Current management of ruptured abdominal aortic aneurysms (RAAA) varies among centres and countries, particularly in the degree of implementation of endovascular aneurysm repair (EVAR) and levels of vascular surgery centralisation. This study assesses these variations and the impact they have on outcomes. RAAA repairs from vascular surgical registries in 11 countries, 2010-2013, were investigated. Data were analysed overall, per country, per treatment modality (EVAR or open aortic repair [OAR]), centre volume (quintiles IV), and whether centres were predominantly EVAR (≥50% of RAAA performed with EVAR [EVAR(p)]) or predominantly OAR [OAR(p)]. Primary outcome was peri-operative mortality. Data are presented as either mean values or percentages with 95% CI within parentheses, and compared with chi-square tests, as well as with adjusted OR. There were 9273 patients included. Mean age was 74.7 (74.5-74.9) years, and 82.7% of patients were men (81.9-83.6). Mean AAA diameter at rupture was 7.6 cm (7.5-7.6). Of these aneurysms, 10.7% (10.0-11.4) were less than 5.5 cm. EVAR was performed in 23.1% (22.3-24.0). There were 6817 procedures performed in OAR(p) centres and 1217 performed in EVAR(p) centres. Overall peri-operative mortality was 28.8% (27.9-29.8). Peri-operative mortality for OAR was 32.1% (31.0-33.2) and for EVAR 17.9% (16.3-19.6), p < .001, and the adjusted OR was 0.38 (0.31-0.47), p < .001. The peri-operative mortality was 23.0% in EVAR(p) centres (20.6-25.4), 29.7% in OAR(p) centres (28.6-30.8), p < .001; adjusted OR = 0.60 (0.46-0.78), p < .001. Peri-operative mortality was lower in the highest volume centres (QI > 22 repairs per year), 23.3% (21.2-25.4) than in QII-V, 30.0% (28.9-31.1), p < .001. Peri-operative mortality after OAR was lower in high volume centres compared with the other centres, 25.3% (23.0-27.6) and 34.0% (32.7-35.4), respectively, p < .001. There was no significant difference in peri-operative mortality after EVAR between centres based on volume. Peri-operative mortality is lower in centres with a primary EVAR approach or with high case volume. Most repairs, however, are still performed in low volume centres and in centres with a primary OAR strategy. Reorganisation of acute vascular surgical services may improve outcomes of RAAA repair.
    • Family history of venous thromboembolism is associated with increased risk for thrombosis in multiple myeloma: a population-based study.

      Kristinsson, S Y; Goldin, L; Turesson, I; Hultcrantz, M; Björkholm, M; Landgren, O (Wiley-Blackwell, 2012-05)
    • Giant gastric lipoma successfully removed by endoscopic submucosal dissection: case report and systematic review.

      Ingason, Arnar B; Theodors, Asgeir; Agustsson, Arnar S; Arnarson, Adalsteinn; 1 a Department of Medicine , University of Iceland , Reykjavik , Iceland. 2 b Department of Gastroenterology , Landspitali University Hospital , Reykjavik , Iceland. 3 c Department of General Surgery , Landspitali University Hospital , Reykjavik , Iceland. (Taylor & Francis, 2018-08-01)
      Gastric lipomas are rare adipose tumors that constitute less than 1% of gastric tumors. While lipomas generally do not need removal unless symptomatic, endoscopic resection has been proposed as safe for gastric lipomas smaller than 2 cm. Yet, there is no consensus on the optimal treatment method for larger lipomas. We report a case of a giant 7-cm gastric lipoma successfully removed by endoscopic submucosal dissection (ESD) and systematically review the literature for gastric lipomas removed by ESD. Systematic review was conducted by searching PubMed and Scopus databases, up to 15 February 2018, using combinations of relevant terms. We report a 55-year-old male with known gastroesophageal reflux disease and asthma, who sought medical attention due to chronic heartburn and asthma exacerbations. These symptoms were attributed to a large 7 cm × 3 cm gastric lipoma that caused gastric outlet obstruction. The lipoma was safely removed by ESD, allowing quick recovery and alleviation of symptoms. In our review, we identified 20 gastric lipomas treated with ESD, with 15 (75%) being 2 cm or larger. The average size of the lipomas was 4 cm (range: 1.2-9 cm). All lipomas were limited to the submucosa, with 80% of the tumors located in the antrum. Three lipomas were removed by submucosal tunneling. All tumors were successfully removed en bloc and no major complications were reported. Our findings support the conclusion that ESD may be a safe alternative to conventional surgery for removal of large symptomatic gastric lipomas.
    • Glycaemic index: Relevance for health, dietary recommendations and food labelling

      Arvidsson-Lenner, Ragnhild; Asp, Nils-Georg; Axelsen, Mette; Bryngelsson, Susanne; Haapa, Eliina; Järvi, Anette; Karlström, Brita; Raben, Anne; Sohlström, Annica; Thorsdottir, Inga; Vessby, Bengt (Taylor & Francis, 2004-07-01)
      The glycaemic index (GI) concept is based on the difference in blood glucose response after ingestion of the same amount of carbohydrates from different foods, and possible implications of these differences for health, performance and well-being. GI is defined as the incremental blood glucose area (0-2 h) following ingestion of 50 g of available carbohydrates in the test product as a percentage of the corresponding area following an equivalent amount of carbohydrate from a reference product. A high GI is generally accompanied by a high insulin response. The glycaemic load (GL) is the GI x the amount (g) of carbohydrate in the food/100. Many factors affect the GI of foods, and GI values in published tables are indicative only, and cannot be applied directly to individual foods. Properly determined GI values for individual foods have been used successfully to predict the glycaemic response of a meal, while table values have not. An internationally recognised method for GI determination is available, and work is in progress to improve inter- and intra-laboratory performance. Some epidemiological studies and intervention studies indicate that low GI diets may favourably influence the risk of chronic diseases such as diabetes and coronary heart disease, although further well-controlled studies are needed for more definite conclusions. Low GI diets have been demonstrated to improve the blood glucose control, LDL-cholesterol and a risk factor for thrombosis in intervention studies with diabetes patients, but the effect in free-living conditions remains to be shown. The impact of GI in weight reduction and maintenance as well as exercise performance also needs further investigation. The GI concept should be applied only to foods providing at least 15 g and preferably 20 g of available carbohydrates per normal serving, and comparisons should be kept within the same food group. For healthy people, the significance of GI is still unclear and general labelling is therefore not recommended. If introduced, labelling should be product-specific and considered on a case-by-case basis
    • Health effects following the Eyjafjallajokull volcanic eruption: a cohort study.

      Carlsen, Hanne Krage; Hauksdottir, Arna; Valdimarsdottir, Unnur Anna; Gíslason, Thorarinn; Einarsdottir, Gunnlaug; Runolfsson, Halldor; Briem, Haraldur; Finnbjornsdottir, Ragnhildur Gudrun; Gudmundsson, Sigurdur; Kolbeinsson, Thorir Björn; Thorsteinsson, Throstur; Pétursdóttir, Gudrun; Centre of Public Health Sciences, University of Iceland, Reykjavík, Iceland. (2012)
      The study aimed to determine whether exposure to a volcanic eruption was associated with increased prevalence of physical and/or mental symptoms. Cohort, with non-exposed control group. Natural disasters like volcanic eruptions constitute a major public-health threat. The Icelandic volcano Eyjafjallajökull exposed residents in southern Iceland to continuous ash fall for more than 5 weeks in spring 2010. This study was conducted during November 2010-March 2011, 6-9 months after the Eyjafjallajökull eruption. Adult (18-80 years of age) eruption-exposed South Icelanders (N=1148) and a control population of residents of Skagafjörður, North Iceland (N=510). The participation rate was 72%. Physical symptoms in the previous year (chronic), in the previous month (recent), General Health Questionnaire (GHQ-12) measured psychological morbidity. The likelihood of having symptoms during the last month was higher in the exposed population, such as; tightness in the chest (OR 2.5; 95% CI 1.1 to 5.8), cough (OR 2.6; 95% CI 1.7 to 3.9), phlegm (OR 2.1; 95% CI 1.3 to 3.2), eye irritation (OR 2.9; 95% CI 2.0 to 4.1) and psychological morbidity symptoms (OR 1.3; 95% CI 1.0 to 1.7). Respiratory symptoms during the last 12 months were also more common in the exposed population; cough (OR 2.2; 95% CI 1.6 to 2.9), dyspnoea (OR 1.6; 95% CI 1.1 to 2.3), although the prevalence of underlying asthma and heart disease was similar. Twice as many in the exposed population had two or more symptoms from nose, eyes or upper-respiratory tract (24% vs 13%, p<0.001); these individuals were also more likely to experience psychological morbidity (OR 4.7; 95% CI 3.4 to 6.5) compared with individuals with no symptoms. Most symptoms exhibited a dose-response pattern within the exposed population, corresponding to low, medium and high exposure to the eruption. 6-9 months after the Eyjafjallajökull eruption, residents living in the exposed area, particularly those closest to the volcano, had markedly increased prevalence of various physical symptoms. A portion of the exposed population reported multiple symptoms and may be at risk for long-term physical and psychological morbidity. Studies of long-term consequences are therefore warranted.
    • Iceland's national information infrastructure

      Olafsson, Sveinn (Academic Press, 1999-11-01)
      This article discusses Iceland's national information infrastructure in the year 2000. It focuses on the current information policy and legislation of the country. It looks at this policy as it is presented in government publications from the last 5 years and evaluates its effects, with particular regard to the education, culture and health sectors. It describes the foundation of a nationwide health database in Iceland, which was established by an Act of Parliament taking force on 1 January 1999. The idea for this database came from deCODE, a company that proposes to make use of the homogeneity and the vast genealogical information of the Icelandic nation to develop better drugs for common diseases. The company is a genomics research company, and is currently working with Hoffmann La-Roche. It has gained a 12-year monopoly on building such a database, the formation of which brings up many ethical questions, and also new possibilities for health management.
    • Ichthyosis prematurity syndrome with separation of fetal membranes and neonatal asphyxia.

      Dereksson, Kristjan; Kjartansson, Sveinn; Hjartardóttir, Hulda; Arngrimsson, Reynir; Pediatrics Department, Skåne University Hospital, Malmö, Sweden. (2012)
      Ichthyosis prematurity syndrome (IPS) is a rare inherited skin disorder. Children are born prematurely with thick skin and have been found to develop neonatal asphyxia due to occlusions in the bronchial tree from debris in the amniotic fluid. At 31 weeks of gestation, separation of amniotic and chorionic membranes was identified as well as polyhydramnion. The child was born 2 weeks later, with thickened skin with a granular appearance and required immediate ventilation and intensive care. At 2 years of age, the patient has developed an atopic skin condition with severe itching, recurrent skin infections, food intolerance and periods of wheezing. Prenatal observation of separation of foetal membranes or dense amniotic fluid may be signs of IPS and severe complication immediately after birth.