• Database Studies on Drug-Induced Liver Injury: The Importance of Causality Assessment.

      Björnsson, Helgi K; Björnsson, Einar S; 1Department of Internal Medicine, Section of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland. 2Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. (Wolters Kluwer Health, 2021-05)
    • 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; et al. (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.
    • Effective treatment with balneophototherapy and narrowband UVB monotherapy reduces skin homing Th17/Tc17 and Th22/Tc22 effector cells in peripheral blood in patients with psoriasis.

      Eysteinsdóttir, Jenna Huld; Sigurgrímsdóttir, Hildur; Einarsdóttir, Helga Kristín; Freysdottir, Jona; Agnarsson, Bjarni A; Ólafsson, Jón Hjaltalín; Sigurgeirsson, Bárður; Lúðvíksson, Björn Rúnar; 1Faculty of Medicine, University of Iceland, Reykjavík, Iceland. Electronic address: jenna@hudlaeknastodin.is. 2Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Department of Immunology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. 3Department of Immunology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. 4Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Department of Immunology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland; Centre for Rheumatology Research, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. 5Department of Pathology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland. 6Faculty of Medicine, University of Iceland, Reykjavík, Iceland. (ELSEVIER IRELAND, 2019-10-15)
    • 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; et al. (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
    • Greetings from the land of snow where the hot springs glow.

      Arnarson, Eirikur Orn; University of Iceland (Association for Behavioral and Cognitive Therapies; US, 2016-10)
    • Haploinsufficiency of KMT2D is sufficient to cause Kabuki syndrome and is compatible with life.

      Luperchio, Teresa Romeo; Applegate, Carolyn D; Bodamer, Olaf; Bjornsson, Hans Tomas; 1 McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2 Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 3 Broad Institute of MIT and Harvard University, Cambridge, MA, USA. 4 Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 6 Landspitali University Hospital, Reykjavik, Iceland. (Wiley, 2019-12-08)
      We present the first patient described with haploinsufficency of KMT2D leading to Kabuki syndrome. Deletion of KMT2D has been thought to be lethal, but here we describe a patient with KMT2D deletion and classical Kabuki syndrome phenotype.
    • 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; et al. (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.
    • Inflammatory Breast Cancer: What surgeons need to know.

      Rafnsdóttir, Svanheiður Lóa; Audisio, Riccardo A; 1 Oncoplastic Breast Surgery, Department of Surgery, Landspitali University Hospital, 13-A Hringbraut, IS-101, Reykjavik, Iceland; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Blå Stråket 5, 413 45, Göteborg, Sweden. Electronic address: svanhra@landspitali.is. 2 Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Blå Stråket 5, 413 45, Göteborg, Sweden. Electronic address: raudisio@doctors.org.uk. (Elsevier, 2018-01-01)
      Strict criteria to identify Inflammatory Breast Cancer (IBC) have been made available - these are based on pathological as well as clinical observations. It is mandatory to confirm the criteria used in any further report. Scientific evidence accumulated so far is confusing, and unclear therefore no hard conclusion can be drawn from the available literature on the management of IBC. The advent of new medications results into an up-to-date management and different outcomes. It is mandatory to follow these criteria if reliable guidelines are to be made available in the next future.
    • International comparisons and holistic patient care.

      Zeitlin, J; Durox, M; Macfarlane, A; Alexander, S; Heller, G; Loghi, M; Nijhuis, J; Sól Ólafsdóttir, H; Mierzejewska, E; Gissler, M; et al. (Wiley, 2021-06-05)
    • Introducing the ReDO-TM programme and the ValMO-model in the Icelandic context

      Erlandsson, Lena-Karin; Halmstad University Sweden (Iðjuþjálfafélag Íslands, 2019)
    • The LIMD1 protein bridges an association between the prolyl hydroxylases and VHL to repress HIF-1 activity.

      Foxler, Daniel E; Bridge, Katherine S; James, Victoria; Webb, Thomas M; Mee, Maureen; Wong, Sybil C K; Feng, Yunfeng; Constantin-Teodosiu, Dumitru; Petursdottir, Thorgunnur Eyfjord; Bjornsson, Johannes; et al. (2012-02)
      There are three prolyl hydroxylases (PHD1, 2 and 3) that regulate the hypoxia-inducible factors (HIFs), the master transcriptional regulators that respond to changes in intracellular O(2) tension. In high O(2) tension (normoxia) the PHDs hydroxylate two conserved proline residues on HIF-1α, which leads to binding of the von Hippel-Lindau (VHL) tumour suppressor, the recognition component of a ubiquitin-ligase complex, initiating HIF-1α ubiquitylation and degradation. However, it is not known whether PHDs and VHL act separately to exert their enzymatic activities on HIF-1α or as a multiprotein complex. Here we show that the tumour suppressor protein LIMD1 (LIM domain-containing protein) acts as a molecular scaffold, simultaneously binding the PHDs and VHL, thereby assembling a PHD-LIMD1-VHL protein complex and creating an enzymatic niche that enables efficient degradation of HIF-1α. Depletion of endogenous LIMD1 increases HIF-1α levels and transcriptional activity in both normoxia and hypoxia. Conversely, LIMD1 expression downregulates HIF-1 transcriptional activity in a manner depending on PHD and 26S proteasome activities. LIMD1 family member proteins Ajuba and WTIP also bind to VHL and PHDs 1 and 3, indicating that these LIM domain-containing proteins represent a previously unrecognized group of hypoxic regulators.
    • Long-term Outcome of Implantable Cardioverter/Defibrillator Lead Failure.

      Davidsson, Gustav Arnar; Jonsdottir, Gudlaug M; Oddsson, Hjortur; Lund, Sigrun H; Arnar, David O; 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. (American Medical Association, 2019-12-20)
      This study compares outcomes of a recalled implantable cardioverter/defibrillator lead with a control lead in individuals in Iceland.
    • Low aspirin use and high prevalence of pre-eclampsia risk factors among pregnant women in a multinational SLE inception cohort.

      Mendel, Arielle; Bernatsky, Sasha B; Hanly, John G; Urowitz, Murray B; Clarke, Ann Elaine; Romero-Diaz, Juanita; Gordon, Caroline; Bae, Sang-Cheol; Wallace, Daniel J; Merrill, Joan T; et al. (BMJ Publishing Group, 2019-07)