Laeknabladid最新文献

{"title":"[Phenotypes and epidemiology of frontotemporal dementia in Iceland].","authors":"Fehima Lif Purisevic, Hrafnhildur Eymundsdottir, Jon Snaedal, Helga Eyjolfsdottir","doi":"10.17992/lbl.2025.05.840","DOIUrl":"https://doi.org/10.17992/lbl.2025.05.840","url":null,"abstract":"<p><strong>Background: </strong>Frontotemporal dementia (FTD) is a group of neurodegenerative disorders, with three distinctive phenotypes each presenting with different symptoms. The pathology of FTD is characterized by degeneration of the frontal and temporal lobes of the brain. The aim of this project was to investigate the prevalence and incidence of FTD in Iceland over the last few decades and gather information about demographics, clinical symptoms and diagnostic methods as well as to compare the three phenotypes with respect to clinical symptoms. Patients with FTD typically receive their diagnosis at Landspitali memory clinic in Reykjavik.</p><p><strong>Methods: </strong>The study population consisted of individuals who had been diagnosed with frontotemporal dementia from the beginning of electronic medical records at Landspítali until 2022. Medical records were used for data collection and descriptive and analytical statistical methods were used for data processing and analyses.</p><p><strong>Results: </strong>The frequency of FTD in Landspitali memory clinic population from the years 2008-2022 was found to be 1,7%. Over the entire period, a total of 97 individuals received the diagnosis, 50 men and 47 women. The prevalence was 45.3/100,000 inhabitants and the average incidence was 11.67/100,000/year. Mean age at onset of symptoms was 67 years. The behavioral variant of FTD was the most common phenotype, and the most common clinical feature of all three phenotypes was memory impairment.</p><p><strong>Discussion: </strong>The prevalence of frontotemporal dementia in Iceland is lower than has been reported in some previous studies, incidence comparison is difficult due to difference in age distribution in different studies. Prevalence in the memory clinic population was low, reflecting the rarity of FTD. The average age at diagnosis was higher in Iceland than described in foreign studies and the frequency of memory impairment as an initial symptom was higher compared to foreign studies. Diagnostic methods have developed in recent years and the diagnostic process is more precise than in the earlier years of the study period.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 5","pages":"217-224"},"PeriodicalIF":0.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Severe respiratory failure from COVID-19 pneumonia treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) - two case reports].","authors":"Luis Gisli Rabelo, Sigurdur Ingi Magnusson, Carlos Magnus Rabelo, Bryndis Sigurdardottir, Inga Lara Ingvarsdottir, Tomas Gudbjartsson","doi":"10.17992/lbl.2025.05.841","DOIUrl":"https://doi.org/10.17992/lbl.2025.05.841","url":null,"abstract":"<p><p>Venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy can be indicated as a last resort treatment in severe respiratory failure. It is a complex and resource demanding treatment that can pose challenges, particularly during a pandemic such as COVID-19. We report two cases of previously healthy, middle-aged men who suffered severe respiratory failure following COVID-19 pneumonia. Both patients required VV-ECMO therapy at a low-volume, geographically isolated center in Iceland, a country of 400,000 inhabitants. They recovered well after the VV-ECMO treatment and returned to full-time work approximately one year later.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 5","pages":"225-229"},"PeriodicalIF":0.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Palliative care knowledge and attitudes in Iceland].","authors":"Jon Eyjolfur Jonsson","doi":"10.17992/lbl.2025.05.837","DOIUrl":"https://doi.org/10.17992/lbl.2025.05.837","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 5","pages":"207"},"PeriodicalIF":0.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Palliative care knowledge and attitudes to end-of-life issues among the general public in Iceland.]","authors":"Valgerdur Sigurdardottir, Svandis Iris Halfdanardottir","doi":"10.17992/lbl.2025.05.839","DOIUrl":"https://doi.org/10.17992/lbl.2025.05.839","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, the number of older people will increase in the coming decades. With high-er age the likelihood of being diagnosed with a life-threatening illness increases, often leading to suffering and decreased quality of life. Earlier introduction to palliative care (PC) can help patients to better cope with their illness and improve quality of life. Knowledge of PC among the general public can affect attitudes towards accepting PC service.</p><p><strong>Material and methods: </strong>The Social Science Institute of University of Iceland performed a survey using online panel consisting of individuals 18 years and older. Random sample of 1963 individuals from Registers Iceland received the Palliative Care Knowledge Scale (PaCKS) with 7 right and 6 wrong statements and 8 questions on attitudes to end-of-life issues. Results Response rate was 41%. 730 (37%) answered the PaCKS, mean score of right answers was 6.37. A total of 95% had heard of PC, mostly from media or through a friend/relative who had received PC. A total of 70% thought PC was all about end-of life, 9 % had heard about advanced care planning. Half of the responders had never thought about writing down their wishes regarding end-of-life care, 32% thought about it but had not done anything about it. Over half would like to receive care at home in the last months of life, 70% would like to die at home. Around 80% were followers of euthanasia.</p><p><strong>Conclusion: </strong>Knowledge of PC among the general public in Iceland is lacking. It is important to promote knowledge of PC. Many had never thought of end-of-life care but are pro legalizing euthanasia.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 5","pages":"210-216"},"PeriodicalIF":0.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The new collective bargaining agreement for doctors from the perspective of the Primary Healthcare in the Capital Area?]","authors":"Nanna S Kristinsdottir","doi":"10.17992/lbl.2025.05.838","DOIUrl":"https://doi.org/10.17992/lbl.2025.05.838","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 5","pages":"209"},"PeriodicalIF":0.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Acute stroke treatment in Landspitali University hospital - current status and future aims].","authors":"Bjorn Logi Thorarinsson, Marianne Klinke, Olafur Arni Sveinsson","doi":"10.17992/lbl.2025.04.835","DOIUrl":"10.17992/lbl.2025.04.835","url":null,"abstract":"<p><strong>Background: </strong>Advances in acute stroke care including specialized stroke units, intraveneous thrombolysis and mechanical thrombectomy for ischemic stroke, and prompt blood pressure reduction in intracerebral hemorrhage, have significantly reduced its devasting consequences. This study investigates acute stroke care quality at Landspitali University Hospital in Iceland (LUH).</p><p><strong>Method: </strong>Retrospective, cross-sectional study describing the cohort of stroke patients seeking emergency treatment at LUH in 2022, comparing the quality of provided treatment to benchmarks set in neighbouring countries.</p><p><strong>Results: </strong>Among 337 adult ischemic strokes and 71 intracerebral hemorrhages, the mean age was 70,7 (SD: 14,4); 72,6% arrived to LUH within six hours of onset. Baseline NIHSS was documented in 29,8% and 24,3% received a CT scan within15 minutes. Revascularisation therapy was given to 17,8% of ischemic strokes. Median door-to-needle and door-to-puncture times were 31 and 93 minutes with thrombolysis and thrombectomy, respectively; 69% of thrombectomies achieved a good reperfusion grade (mTICI 2b-3). In cases of intracerebral hemorrhage, 57,9% had documented systolic blood pressure targets, with 36,0% aiming for <160 mmHg and 17,2% for <140 mmHg. Anticoagulation was associated with 19,7% of these hemorrhages, of which 66,7% received reversal treatment. In all, 67,0% of ischemic stroke cases and 57,7% of intracerebral hemorrhages were admitted to a Neurology department, with a median admission time of 7,82 hours. Additionally, 19,6% of ischemic stroke cases were referred to a TIA/stroke outpatient clinic.</p><p><strong>Conclusion: </strong>The hospital met benchmarks in thrombectomy rates and nearly in door-to-needle time in thrombolysis. There is room for improvement in other areas. The results can be used to support further enhancement of acute stroke treatment in Iceland and as a basis for policy development.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 4","pages":"166-174"},"PeriodicalIF":0.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clostridioides difficile Infections at Landspitali - timely revie].","authors":"Erna Milunka Kojic","doi":"10.17992/lbl.2025.04.833","DOIUrl":"https://doi.org/10.17992/lbl.2025.04.833","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 4","pages":"157"},"PeriodicalIF":0.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clostridioides difficile infections at Landspítali University Hospital 2017-2022].","authors":"Arnar Thor Sigtryggsson, Kristjan Orri Helgason, Agnar Bjarnason, Magnus Gottfredsson","doi":"10.17992/lbl.2025.04.834","DOIUrl":"10.17992/lbl.2025.04.834","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the epidemiology, severity, treatment, and prognosis of patients with C. difficile infections (CDI) diagnosed at Landspítali University Hospital from 2017-2022.</p><p><strong>Materials and methods: </strong>The study population consisted of adult patients at Landspítali with double-positive (PCR + ELISA) diagnostic tests. If the same patient had two or more positive samples within a 28-day period, they were considered to reflect the same infection, and the latter samples were excluded.</p><p><strong>Results: </strong>Overall, 358 CDI were identified in 301 patients. The majority of cases were diagnosed in women (59.5%). The incidence of healthcare-associated CDI was 3.23 infections/10.000 in-hospital days (range 2.65 - 3.26). Incidence of community-associated CDI was 0.57 infections/10.000 inhabitants of the Reykjavik metropolitan area. Incidence was positively correlated with increasing age and remained similar throughout the study period. The recurrence rate during the study period was 15.3% with a mean follow-up period of 1.6 person-years. At least 85.5% of patients had taken antibiotics within a month before diagnosis, most commonly from the penicillin class (57.8%), followed by cephalosporins (51.5%). More than half (54.7%) of patients had taken proton pump inhibitors preceding diagnosis. Metronidazole was the most common initial treatment (63.0%). Of these, 29.4% of cases required further treatment within 28 days of treatment start. Fecal microbiota transplantation was performed in 13 cases. The 30-day all-cause mortality rate was 7.3%.</p><p><strong>Conclusions: </strong>The incidence of CDI at Landspítali has remained stable and comparable to what has been reported in Europe during the same period. Most patients had one or more risk factors present. Most received antibiotics as treatment, most commonly metronidazole. The results of this study indicate that incidence and clinical presentation of CDI in Iceland are stable, whilst novel treatment options look promising.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 4","pages":"158-165"},"PeriodicalIF":0.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The way forward in stroke treatment].","authors":"Anna Bryndis Einarsdottir","doi":"10.17992/lbl.2025.04.832","DOIUrl":"https://doi.org/10.17992/lbl.2025.04.832","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 4","pages":"155"},"PeriodicalIF":0.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Elderly woman with a history of stroke and a mass in the aortic root. Papillary fibroelastoma. - Case report].","authors":"Matthias Loeve, Steinar Gudmundsson, Tomas Gudbjartsson","doi":"10.17992/lbl.2025.04.836","DOIUrl":"10.17992/lbl.2025.04.836","url":null,"abstract":"<p><strong>Introduction: </strong>A woman in her mid-seventies with a history of chronic atrial fibrillation (AF), coronary artery disease, polymyalgia rheumatica, and type 2 diabetes was found in a semi-comatose state in her home. In the emergency room, she presented with left arm weakness and aphasia. Magnetic resonance imaging of the brain revealed multiple acute infarcts attributed to cardiac emboli, although transthoracic echocardiography (TTE) did not detect cardiac thrombi. Following extensive rehabilitation, she was readmitted with chest pain and dyspnea, which were thought to be related to a bradycardia-induced heart failure. She received a pacemaker, but her clinical state did not improve. Therefore, cardioversion of her AF was planned; however, prior to the procedure, transesophageal echocardiography (TEE) revealed a mass in the aortic root. The mass, which was attached to the non-coronary aortic valve cusp, was surgically removed via open-heart surgery, and the valve was repaired to prevent aortic insufficiency. The patient fared well postoperatively. Histological analysis confirmed papillary fibroelastoma, which is the third most common benign heart tumor after myxoma and lipoma. This case, which is the first documented report of a papillary fibroelastoma of the aortic valve in Iceland, demonstrates the importance of considering cardiac tumors in patients with embolic stroke.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"111 4","pages":"175-177"},"PeriodicalIF":0.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}