Laeknabladid最新文献

{"title":"[MDMA-assisted therapy for PTSD].","authors":"Helga Thorarinsdottir, Berglind Gudmundsdottir, Engilbert Sigurdsson","doi":"10.17992/lbl.2024.05.793","DOIUrl":"10.17992/lbl.2024.05.793","url":null,"abstract":"<p><p>MDMA is a potential novel treatment for post-traumatic stress disorder (PTSD). Our goal is to review current knowledge on MDMA and its use in MDMA-assisted psychotherapy for PTSD. Literature searches were done on PubMed, Web of Science and Google Scholar and references reviewed in identified articles. MDMA-assisted therapy for PTSD usually consists of a few preparatory sessions before two or three sessions where one or two oral doses of MDMA are given along with supportive psychotherapy. The therapy is delivered in the presence of two therapists for about eight hours each time. In addition, the patient receives up to 9 integrative sessions in due course. This use of MDMA as a part of psychotherapy for PTSD is proposed to lessen the psychological distress that often arises in the processing of traumatic events to facilitate the treatment process and reduce the risk of drop-out. Recent studies indicate that MDMA-assisted psychotherapy reduces PTSD symptoms and is generally well tolerated. These studies are necessary if this MDMA-assisted treatment is to be approved by licensing authorities. There is an urgent need for new effective treatments for PTSD and for comparisons between this MDMA-assisted psychotherapy and currently approved psychotherapies with and without MDMA-use.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 5","pages":"254-261"},"PeriodicalIF":0.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877761","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":"[Gastroschisis and omphalocele: Incidence and outcome].","authors":"Kristin Fjola Reynisdottir, Hulda Hjartardottir, Thrainn Rosmundsson, Thordur Thorkelsson","doi":"10.17992/lbl.2024.03.785","DOIUrl":"10.17992/lbl.2024.03.785","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroschisis and omphalocele are the most common congenital abdominal wall defects. The main purpose of this study was to investigate the incidence, other associated anomalies and the course of these diseases in Iceland.</p><p><strong>Material and methods: </strong>The study was retrospective. The population was all newborns who were admitted to the NICU of Children's Hospital Iceland due to gastroschisis or omphalocele in 1991-2020. Furthermore, all fetuses diagnosed prenatally or post mortem where the pregnancy ended in spontaneous or induced abortion, were included.</p><p><strong>Results: </strong>During the study period, 54 infants were born with gastroschisis and five with omphalocele. The incidence of gastroschisis was 4.11 and omphalocele 0,38/10,000 births. There was no significant change in the incidence of the diseases during the study period. In addition, five fetuses were diagnosed with gastroschisis and 31 with omphalocele where the pregnancy was terminated. In addition to gastroschisis in the live born infants and fetuses the most common associated anomalies were in the gastrointestinal or urinary tract but in infants and fetuses with omphalocele anomalies of the cardiac, central nervous or skeletal systems were the most common. Sixteen fetuses diagnosed with omphalocele had trisomy 18. Mothers aged 16-20 were more likely to give birth to an infant with gastroschisis than older mothers (p< 0.001). Primary closure was successful in 86% of the infants. Those reached full feedings significantly earlier and were discharged earlier. Overall survival rate was 95%. Three children were still receiving parenteral nutrition at discharge due to short bowel syndrome.</p><p><strong>Conclusions: </strong>The incidence of gastroschisis in Iceland is in accordance with studies in other countries but but the incidence of omphalocele is lower, which can be partly explained by spontaneous or induced abortions. Other anomalies associated with omphalocele are more severe than those associated with gastroschisis. Primary closure was associated with more benign course. Children with gastroschisis may need prolonged parenteral nutrition due to shortening of their intestines.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 3","pages":"144-150"},"PeriodicalIF":0.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991601","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":"[Perinatal outcomes of preterm births occuring to native-born and migrant mothers in Iceland].","authors":"Asdis Bjork Gunnarsdottir, Thordur Thorkelsson, Ragnheidur I Bjarnadottir, Embla Yr Gudmundsdottir","doi":"10.17992/lbl.2024.03.784","DOIUrl":"10.17992/lbl.2024.03.784","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the incidence and perinatal outcomes of preterm births in Iceland during 1997-2018 and compare outcomes of Icelandic and migrant mothers.</p><p><strong>Methods: </strong>The population in this historical population-based cohort study was all preterm (p<37 weeks gestation) live-born singletons born in Iceland from January 1, 1997 to December 31, 2018 and their mothers; a total of 3837 births. Data was obtained from the Icelandic Medical Birth Registry. The group of migrant women was defined as women with other citizenship than Icelandic. Migrant women were divided into three groups based on their country of citizenship Human Development Index (HDI). Both descriptive and analytical statistics were used in data processing.</p><p><strong>Results: </strong>The incidence of preterm births in Iceland increased during the study period (3,9% 1998-2001 vs. 4,5% 2012-2018, p<005) and was significantly higher among migrant mothers, especially from countries with the lowest HDI (OR 1,49 (CI 1,21-1,81) p<,001). Infants of mothers from countries with the lowest HDI had a significantly lower prevalence of respiratory distress syndrome compared with infants of Icelandic mothers (4,5% vs. 11,4%, p=0,035) meanwhile infants of mothers from countries with a medium high HDI were more often small for gestational age compared with infants of Icelandic mothers (11,4% vs. 6,9%, p=0,021).</p><p><strong>Conclusion: </strong>Preterm births have become more common in Iceland and the incidence is significantly higher among migrant mothers, however the outcomes of preterm infants are generally good and mostly comparable between Icelandic and migrant mothers.</p>","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 3","pages":"135-143"},"PeriodicalIF":0.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991654","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":"[General Practicioners Activist Group].","authors":"Gunnar Thor Geirsson","doi":"10.17992/lbl.2024.03.782","DOIUrl":"10.17992/lbl.2024.03.782","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 3","pages":"131"},"PeriodicalIF":0.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991602","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":"[Rare diseases in Iceland].","authors":"Olof Jona Eliasdottir","doi":"10.17992/lbl.2024.03.783","DOIUrl":"10.17992/lbl.2024.03.783","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 3","pages":"133"},"PeriodicalIF":0.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991655","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":"[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}

{"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}

{"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}

{"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}

{"title":"[Medication certificate].","authors":"Sigridur Bjornsdottir","doi":"10.17992/lbl.2024.01.774","DOIUrl":"10.17992/lbl.2024.01.774","url":null,"abstract":"","PeriodicalId":49924,"journal":{"name":"Laeknabladid","volume":"110 1","pages":"9"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832714","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}