LaeknabladidPub Date : 2024-02-01DOI: 10.17992/lbl.2024.02.780
Anna Run Arnfridardottir, Sigrun Thorsteinsdottir, Anna Sigridur Olafsdottir, Berglind Brynjolfsdottir, Ragnar Bjarnason, Tryggvi Helgason
{"title":"[Insulin Resistance and Abnormalities in Blood Values of Icelandic Children Receiving Obesity Treatment].","authors":"Anna Run Arnfridardottir, Sigrun Thorsteinsdottir, Anna Sigridur Olafsdottir, Berglind Brynjolfsdottir, Ragnar Bjarnason, Tryggvi Helgason","doi":"10.17992/lbl.2024.02.780","DOIUrl":"10.17992/lbl.2024.02.780","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, the rates of childhood obesity have risen dramatically in recent decades. Obesity may cause serious sequelae during childhood and throughout adulthood. Insulin resistance is prevalent metabolic abnormality in pediatric obesity. The Pediatric Obesity Clinic was established in 2011 at the Children's Medical Center, Landspítali University Hospital. This study aimed to observe metabolic abnormalities and insulin resistance in blood values of children receiving obesity treatment.</p><p><strong>Methods: </strong>The study included all children (n = 180) who received obesity treatment at The Pediatric Obesity Clinic between 2016 and 2020 and had at least eight out of the nine following serum values analyzed while fasting: HbA1c, glucose, insulin, ALAT, total cholesterol, HDL-cholesterol, triglycerides, TSH and free T4. HOMA-IR value was calculated from insulin and glucose values. Decreased insulin sensitivity was defined as HOMA-IR > 3.42.</p><p><strong>Results: </strong>84% of the children had at least one abnormality in their tested blood values. 50% had abnormal insulin values and 44% had abnormal ALAT values. 78% had decreased insulin sensitivity, and their mean HOMA-IR was 7.3 (± 5.0), surpassing twice the normal value.</p><p><strong>Conclusion: </strong>A large majority of the children undergoing obesity treatment already exhibited signs of metabolic sequelae during their treatment. The prevalence of affected children has increased compared to a similar study conducted in 2013. Of particular concern is the growing number of children with decreased insulin sensitivity. Proper measures must be taken to combat this alarming trend.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 2","pages":"79-84"},"PeriodicalIF":0.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547575","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}
LaeknabladidPub Date : 2024-02-01DOI: 10.17992/lbl.2024.02.778
Thorarinn Gudjonsson
{"title":"[Increasing the number of medical students at the University of Iceland: challenges and working plan].","authors":"Thorarinn Gudjonsson","doi":"10.17992/lbl.2024.02.778","DOIUrl":"10.17992/lbl.2024.02.778","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 2","pages":"75"},"PeriodicalIF":0.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547532","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}
LaeknabladidPub Date : 2024-02-01DOI: 10.17992/lbl.2024.02.781
Sunna Run Heidarsdottir, Leon Arnar Heitmann, Erla Liu Ting Gunnarsdottir, Sunna Lu Xi Gunnarsdottir, Egill Gauti Thorsteinsson, Arni Johnsen, Anders Jeppsson, Tomas Gudbjartsson
{"title":"[Incidence and outcomes of perioperative myocardial infarction associated with coronary artery bypass surgery].","authors":"Sunna Run Heidarsdottir, Leon Arnar Heitmann, Erla Liu Ting Gunnarsdottir, Sunna Lu Xi Gunnarsdottir, Egill Gauti Thorsteinsson, Arni Johnsen, Anders Jeppsson, Tomas Gudbjartsson","doi":"10.17992/lbl.2024.02.781","DOIUrl":"10.17992/lbl.2024.02.781","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative myocardial infarction (PMI) after CABG can contribute to in-hospital morbidity and mortality, however, its clinical significance on long-term outcome, remains inadequately addressed. We studied both 30-day mortality and long-term effects of PMI in Icelandic CABG-patients.</p><p><strong>Materials and methods: </strong>A retrospective nationwide-study on 1446 consecutive CABG-patients operated at Landspitali in Iceland 2002-2018 without evidence of preoperative myocardial infarction. PMI was defined as a tenfold elevetion in serum-CK-MB associated with new ECG changes or diagnostic imaging consistent with ischemia. Patients with PMI were compared to a reference group with uni- and multivariate analyses. Long-term and MACCE-free survival were estimated with the Kaplan-Meier method and logistic regression used to determine factors associated with PMI. The mean follow-up time was 8.3 years.</p><p><strong>Results: </strong>Out of 1446 patients 78 (5.4%) were diagnosed with PMI (range: 0-15.5%) with a significant annual decline in the incidence of PMI (12.7%, p<0.001). Over the same period preoperative aspirin use increased by 22.3% (p<0.018). PMI patients had a higher rate of short-term complications and a 11.5% 30-day mortality rate compared to 0.4% for non-PMI patients. PMI was found to be a predictor of 30-day mortality (OR 15.44, 95% CI: 6.89-34.67). PMI patients had worse 5-year MACCE-free survival (69.2% vs. 84.7, p=0,01), although overall survival was comparable between the groups.</p><p><strong>Conclusions: </strong>Although PMI after CABG is associated with significantly higher rates of short-term complications and 30-day mortality, long-term survival was similar to the reference group. Therefore, the mortality risk attributable to PMI appears to diminish after the immediate postoperative period.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 2","pages":"85-92"},"PeriodicalIF":0.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547523","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}
LaeknabladidPub Date : 2024-02-01DOI: 10.17992/lbl.2024.02.779
Gudrun Thuridur Hoskuldsdottir
{"title":"[Treatment of obesity, where does it belong?]","authors":"Gudrun Thuridur Hoskuldsdottir","doi":"10.17992/lbl.2024.02.779","DOIUrl":"10.17992/lbl.2024.02.779","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 2","pages":"77"},"PeriodicalIF":0.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547576","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}
LaeknabladidPub Date : 2024-01-01DOI: 10.17992/lbl.2024.01.773
Helga Agusta Sigurjonsdottir
{"title":"[Congratulations to Icelandic doctors - The 110th year of publication of The Icelandic Medical Journal].","authors":"Helga Agusta Sigurjonsdottir","doi":"10.17992/lbl.2024.01.773","DOIUrl":"10.17992/lbl.2024.01.773","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 1","pages":"7"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832711","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}
LaeknabladidPub Date : 2024-01-01DOI: 10.17992/lbl.2024.01.776
Solrun Dogg Arnadottir, G. Palsdottir, Karl Logason, R. H. Arnardottir
{"title":"[Lower Limb Amputations in Patients with Peripheral Arterial Disease and/or Diabetes in Iceland 2010-2019; revascularisation, comorbidities and risk factors].","authors":"Solrun Dogg Arnadottir, G. Palsdottir, Karl Logason, R. H. Arnardottir","doi":"10.17992/lbl.2024.01.776","DOIUrl":"https://doi.org/10.17992/lbl.2024.01.776","url":null,"abstract":"INTRODUCTION No recent studies exist on lower extremity amputations (LLAs) in Iceland. The aim of this study was to investigate LLA incidence in Iceland 2010-2019 and preceding procedures in amputations induced by peripheral arterial disease (PAD) and diabetes mellitus (DM). MATERIAL AND METHODS Retrospective study on clinical records of all patients (>18 years) who underwent LLA in Iceland's two main hospitals during 2010-2019. Patients were excluded if LLA was performed for reasons other than DM and/or PAD. Symptoms, medication and circulation assessment were recorded from first hospital visit due to symptoms, and prior to the last LLA, respectively. Previous arterial surgeries and amputations were also recorded. RESULTS A total of 167 patients underwent LLA. Thereof, 134 (77 ± 11 years, 93 men and 41 woman) due to DM and/or PAD. The LLA-rate due to those diseases increased from 4.1/100,000 inhabitants in 2010-2013 to 6.7/100,000 in 2016-2019 (p=0,04). Risk factors were mainly hypertension, 84%, and smoking, 69%. Chronic limb-threatening ischemia induced 71% of first hospital visits. Revascularisations were performed (66% endovascular) in 101 patients. Non-diabetic patients were 52% and had statins less frequently prescribed than DM patients (26:45, p<0.001). CONCLUSION DM and/or PAD are the leading causes of LLA in Iceland. Amputation rate increased during the period but is low in an international context. Amputation is most often preceded by arterial surgery. DM is present in almost half of cases, similar or less than in most other countries. Opportunities for improved prevention should aim on earlier diagnosis and preventive treatment of non-diabetic individuals with PAD.","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"71 5","pages":"20-27"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126276","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}
LaeknabladidPub Date : 2023-12-01DOI: 10.17992/lbl.2023.12.770
Michael Clausen
{"title":"[Breastfeeding benefits both mother and child].","authors":"Michael Clausen","doi":"10.17992/lbl.2023.12.770","DOIUrl":"10.17992/lbl.2023.12.770","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"109 12","pages":"549"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463906","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":"[De Garengeot hernia - a case report].","authors":"Rebekka Ros Tryggvadottir, Pall Helgi Moller, Halla Vidarsdottir","doi":"10.17992/lbl.2023.12.772","DOIUrl":"https://doi.org/10.17992/lbl.2023.12.772","url":null,"abstract":"<p><p>We report a case of a 79-year-old woman with a previous history of polycythemia vera, glaucoma and hypertension. Her previous surgeries included a cholecystectomy with an incidental finding of a gallbladder carcinoma with following partial liver resection and a hysterectomy. The surgery department was consulted regarding this patient due to abdominal pain in her lower abdomen and tumor in her right groin. A CT scan of the abdomen was obtained that showed a hernia with the appendix vermiformis in the hernia sac. She was operated with a preperitoneal open approach and an inflamed appendix from a femoral hernia sac was removed and a herniorrhaphy with a mesh was performed. The patient was discharged the day after the surgery. Femoral hernia with the appendix in the hernia sac is a rare type of hernia first descriped by Rene-Jacques De Garengeot in 1731 and now bearing his name.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"109 12","pages":"560-562"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463908","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":"[Breastfeeding in Iceland: Changes in prevalence and duration over a century].","authors":"Ingibjorg Eiríksdottir, Elinborg J Olafsdottir, Laufey Tryggvadottir, Thora Steingrimsdottir","doi":"10.17992/lbl.2023.12.771","DOIUrl":"https://doi.org/10.17992/lbl.2023.12.771","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, the health-promoting effects of breastfeeding on children and their mothers are indisputable. The frequency and duration of breastfeeding varies greatly internationally but studies on prevalence and influencing factors of breastfeeding in Iceland are scanty and the published ones deal with small groups. The aim of this research is to describe the epidemiology of breastfeeding duration and its influencing factors in Iceland among a large cohort in a whole population over almost one century.</p><p><strong>Material and methods: </strong>This is a historical cohort study, using data from The Cancer Detection Clinic Cohort of The Icelandic Cancer Society, collected retrospectively by questionnaires during the years 1964-2008. The data consisted of mothers´ reported information on breastfeeding of their 81,889 children, 36,537 first-borns and 45,352 younger siblings. The frequency and duration of breastfeeding was calculated and the effects of the following exposure variables were assessed: Maternal age, BMI (N=4950, data collected 1979-2008) and smoking (N=32.087, data collected 1995-2008), the child's year of birth and its order in the sibling group.</p><p><strong>Results: </strong>The children were born in the period of 1917-2008. In the late 1970s, the average duration of breastfeeding began to increase, in all age groups of mothers, increasing rapidly from 3 months to 7-8 months. At about the same time, the breastfeeding duration increased depending on the birth order of the children, younger children were breastfed for longer than their older siblings. Women with normal weight (BMI 18.5 to 24.9) breastfed their babies the longest, while obese women breastfed the shortest. Women with any history of smoking reported shorter duration of breastfeeding than women who had never smoked.</p><p><strong>Conclusion: </strong>The increase in the average duration of breastfeeding in Iceland a few decades ago is in accordance with the information in the World Health Organization's database from European countries 1975-2000, where the Nordic countries and most Northern European countries promoted breastfeeding at a similar time. High BMI and maternal smoking are important variables when studying breastfeeding and this study indicates their negative association with the duration of breastfeeding.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"109 12","pages":"551-558"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463907","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}