Mariusdottir E.,Reykjavik University |
Jonsson E.,Reykjavik University |
Jonsson E.,University of Iceland |
Marteinsson V.T.,Akureyri Hospital |
And 4 more authors.
Scandinavian Journal of Urology | Year: 2013
Objective. The aim of this retrospective study was to compare kidney function in a population-based cohort of renal cell carcinoma (RCC) patients after partial (PN) or radical nephrectomy (RN). Material and methods. Forty-four consecutive RCC patients who had undergone PN in Iceland between 2000 and 2010 were compared with 44 controls matched for tumour, node, metastasis (TNM) stage who had undergone RN during the same period. Estimated glomerular filtration rate (eGFR) and survival were calculated, and predictors of chronic kidney disease (CKD) were evaluated with multivariate analysis. Results. In 16 cases (36%), PN was performed for imperative reasons (single kidney, decreased kidney function or bilateral kidney tumours) but 28 patients had a normal contralateral kidney. The groups were similar regarding preoperative eGFR, median follow-up and TNM stage, but age and American Society of Anesthesiologists (ASA) score were significantly higher in the RN group. Six months after surgery, eGFR was significantly higher in the PN group. By multivariate analysis, RN contributed negatively to eGFR 6 months after surgery (-12.6 ml/1.73 m2, p < 0.001) and increased the risk of new-onset CKD (odds ratio = 3.07, 95% confidence interval 1.03-9.79, p = 0.04), compared to PN. At median follow-up of 44 months, no patients in either group had a recurrence of RCC. The 5-year overall survival (Kaplan-Meier) was 100% and 65% in the PN and RN groups, respectively (log-rank test, p < 0.001). Conclusion. eGFR was significantly lower after RN, and these patients were three times more likely to develop new-onset CKD. These findings suggest that PN successfully preserves kidney function compared to RN, with good oncological outcome and survival. © 2013 Informa Healthcare.
Adalsteinsdottir B.,Reykjavik University |
Adalsteinsdottir B.,University of Iceland |
Teekakirikul P.,Harvard University |
Maron B.J.,Minneapolis Heart Institute Foundation |
And 17 more authors.
Circulation | Year: 2014
Background - The geographic isolation and homogeneous population of Iceland are ideally suited to ascertain clinical and genetic characteristics of hypertrophic cardiomyopathy (HCM) at the population level. Methods and Results - Medical records and cardiac imaging studies obtained between 1997 and 2010 were reviewed to identify Icelandic patients with HCM. Surviving patients were recruited for clinical and genetic studies. A previously identified Icelandic mutation, MYBPC3 c.927-2AG, was genotyped, and mutation-negative samples were sequenced for HCM genes and other hypertrophic genes. Record review identified 180 patients with HCM. Genetic analyses of 151 patients defined pathogenic mutations in 101 (67%), including MYBPC3 c.927-2AG (88 patients, 58%), 4 other MYBPC3 or MYH7 mutations (5 patients, 3.3%), and 2 GLA mutations (8 patients, 5.3%). Haplotype and genetic genealogical data defined MYBPC3 c.927-2AG as a founder mutation, introduced into the Icelandic population in the 15th century, with a current population prevalence of 0.36%. MYBPC3 c.927-2AG mutation carriers exhibited phenotypic diversity but were younger at diagnosis (42 versus 49 years; P=0.001) and sustained more adverse events (15% versus 2%; P=0.02) than mutation-negative patients. All-cause mortality for patients with HCM was similar to that of an age-matched Icelandic population (hazard ratio, 0.98; P=0.9). HCM-related mortality (0.78%/y) occurred at a mean age of 68 compared with 81 years for non-HCM-related mortality (P=0.02). Conclusions - A founder MYBPC3 mutation that arose 550 years ago is the predominant cause of HCM in Iceland. The MYBPC3 c.927-2AG mutation is associated with low adverse event rates but earlier cardiovascular mortality, illustrating the impact of genotype on outcomes in HCM. © 2014 American Heart Association, Inc.
Brun A.C.,Vestfold Hospital |
Stordal K.,Ostfold Hospital Trust |
Johannesdottir G.B.,Akureyri Hospital |
Bentsen B.S.,University of Oslo |
Medhus A.W.,University of Oslo
Clinical Nutrition | Year: 2012
Background & aim: Dysmotility, nausea and vomiting are common among children with cerebral palsy. This study aimed to evaluate influence of protein composition on rate of gastric emptying and study the relation between gastric emptying and postprandial gastrointestinal symptoms. Methods: 15 children with cerebral palsy, using gastrostomy, received four liquid test meals on separate days in random order. The meals contained a standard carbohydrate and fat base plus one of four protein modules (100% casein (A), hydrolysed whey (B), amino acids (C) and 40% casein/60% whey (D)) with a total energy of 1kcal/ml. The 13C octanoic acid breath test was applied to assess gastric emptying. Results: When comparing half emptying time (T 1/2) of the fast emptying meals (meal B, C and D) with the slowest emptying meal (meal A), more rapid emptying was demonstrated for meal D (p<0.001). For meal D, emptying was significantly faster in children with postprandial symptoms than in those without (p<0.01). Conclusion: In children with cerebral palsy using gastrostomy, gastric emptying is influenced by type of protein in the meal. The present results also suggest that there is a relation between rapid gastric emptying and postprandial gastrointestinal symptoms. ClinicalTrials.gov: UUSKBK 28200706. © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
Steingrimsson S.,Reykjavik University |
Carlsen H.K.,University of Iceland |
Sigfusson S.,Akureyri Hospital |
Magnusson A.,Reykjavik University
Addiction | Year: 2012
Aims: To study changes over a 25-year period in the gender gap in discharge diagnoses of alcohol use disorder (AUD) and other substance use disorder (SUD) in psychiatric in-patients. Design, setting and participants: A register-based study of all admissions to psychiatric hospitals in Iceland between January 1983 and December 2007. Measurements: Annual rate of admissions to psychiatric hospitals, adjusted for changes in the size of the population. Furthermore, gender-specific analysis of changes in discharge diagnoses of AUD solely and other SUD (including AUD with other SUDs). Findings: Of all psychiatric admissions, the proportion of any SUD admissions increased considerably during the study period. This increase was most pronounced in SUDs other than solely AUD. AUD increased for women and decreased for men. The male to female ratio of AUD alone decreased from 4.2 to 1.5 (P<0.001). There was no significant change in the gender gap for other SUDs (P=0.96). Conclusions: There has been a marked convergence of the gender gap in discharge diagnosis of alcohol use disorder among psychiatric in-patients in Iceland over the last decades. For other substance use disorders, the change was not as pronounced. Our results emphasize the importance of monitoring changes in substance use disorder diagnosis as this may uncover different treatment needs in this group of vulnerable individuals. © 2012 Society for the Study of Addiction.
Bergmann O.M.,Reykjavik University |
Kristjansson G.,Akureyri Hospital |
Jonasson J.G.,Reykjavik University |
Jonasson J.G.,University of Iceland |
And 2 more authors.
Digestive Diseases and Sciences | Year: 2012
Statin drugs are widely used worldwide and are generally considered safe and well tolerated. Only small proportion of patients receiving statins develop elevations of liver enzymes and an even smaller proportion will have clinically significant hepatitis induced by statins. We describe four patients with jaundice caused by druginduced liver injury, where the most likely agent was a statin drug, over a period of approximately three year in Iceland. We calculate the risk of jaundice caused by statin drugs, from sale in the whole country of Iceland, to be one in 17,434 users a year. This is a higher risk than has previously been estimated and we challenge the current opinion that statins rarely cause clinically significant druginduced liver injury and encourage alertness when managing patients with statins with regard to clinical signs of hepatitis before jaundice occurs. © Springer Science+Business Media, LLC 2012.
Kristinsson K.G.,University of Iceland |
Heiddal S.,Akureyri Hospital
Clinical Microbiology and Infection | Year: 2011
Little is known about temporal changes in the epidemiology of Staphylococcus aureus bacteraemia. The objective of the present study was to analyse changes in the incidence and mortality of adult S. aureus bacteraemia in Iceland. Individuals 18 years or older with a positive blood culture for S. aureus between 1 January 1995 and 31 December 2008 were identified, with the participation of all clinical microbiological laboratories performing blood cultures in Iceland. Infections were categorized as nosocomial, healthcare-associated or community-acquired. National population statistics and dates of death were retrieved from the National Registry. During the study period, 692 individuals from 19 institutions had 721 distinct episodes of S. aureus bacteraemia. The incidence rose from 22.7 to 28.9 per 100000 per year during the period (p0.012). Nosocomial infections comprised 46.3% of cases, 14.6% were healthcare-associated, and 39.1% were community-acquired. The proportion of nosocomial infections decreased during the period (p<0.001), whereas an increase was seen in the proportion of community-acquired infections (p<0.001). All-cause 30-day mortality decreased from 25.0% to 8.1% (p0.001) and 1-year mortality decreased from 37.0% to 27.9% (p0.061) between the periods 1995-1996 and 2007-2008. Four cases of bacteraemia caused by methicillin-resistant S. aureus were seen (0.6%), none of which was fatal. In conclusion, there was a significant increase in the incidence of S. aureus bacteraemia in Iceland between 1995 and 2008. Concomitantly, there was a significant reduction in mortality, towards one of the lowest reported. Further studies are needed to understand the basis for these changes. © 2010 The Authors. Journal Compilation © 2010 European Society of Clinical Microbiology and Infectious Diseases.
PubMed | Nordic Bioscience A S, Garvan Institute of Medical Research, Amgen, Akureyri Hospital and 2 more.
Type: Clinical Trial | Journal: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research | Year: 2016
We conducted a genome-wide association study of low bone mineral density (BMD) at the hip and spine utilizing sequence variants found through whole-genome sequencing of 2636 Icelanders. We found two rare missense mutations, p.Gly496Ala and p.Gly703Ser, in the COL1A2 gene that associate with measures of osteoporosis in Icelanders. Mutations in COL1A2 are known to cause the autosomal dominant disorder osteogenesis imperfecta. Both variants associate with low BMD and with osteoporotic fractures. p.Gly496Ala (frequency of 0.105%) shows the strongest association with low BMD at the spine (p=1.810(-7) , odds ratio [OR]=4.61 [95% confidence interval (CI) 2.59, 8.18]), whereas p.Gly703Ser (frequency of 0.050%) is most strongly associated with low BMD at the hip (p=1.910(-8) , OR=9.34 [95% CI 4.28, 20.3]). Association with fractures was p=2.210(-5) , OR=3.75 (95% CI 2.03, 6.93) and p=0.0023, OR=4.32 (95% CI 1.69, 11.1), respectively. The carriers of these variants do not have signs of osteogenesis imperfecta other than low BMD, demonstrating that similar mutations in COL1A2 can affect skeletal phenotypes in more than one way.
PubMed | University of Iceland, Gothenburg University and Akureyri Hospital
Type: | Journal: European psychiatry : the journal of the Association of European Psychiatrists | Year: 2016
Identify risk factors of death or imprisonment within classes defined by demographic factors and diagnoses within one year of first psychiatric admission.Nationwide data was obtained from hospital registers from psychiatric hospitals in Iceland 1983-2007. Mortality and cause of death as well as information about imprisonments during the study period, and discharge diagnoses for the first year after initial admission were obtained for each individual. Individuals aged 18 during the study period with at least one year of follow-up were included. Latent Class Analysis was used to identify groups with distinguishable risk of either being alive, dead or having been imprisoned at the end of follow-up.Among psychiatric patients, 4677 were included, average age was 27 years (range 18-43). Four latent classes were identified with different risks of adverse outcomes. Class B (16%), predominantly males with substance use disorder (SUD) diagnoses, had highly increased risk of imprisonment and death accounting for 85 and 34% of these outcomes, respectively. Class A (12%), all with alcohol use disorder, had similar mortality rate as the general population and no imprisonments. Class C (23%) were younger at first admission with some SUD and increased risk of mortality. Class D (46%) had increased mortality rate, SUDs were rare but depression common.Risk of mortality and criminal trends among psychiatric inpatients can be described as distinct clusters of risk factors present at first admission to a psychiatric hospital. Treatment and interventions to reduce mortality and criminality should take these risk differences into account.
PubMed | University of Iceland, Reykjavik University, Gothenburg University and Akureyri Hospital
Type: Journal Article | Journal: Nordic journal of psychiatry | Year: 2016
Patients with severe mental illness have a shortened lifespan, and substance use disorder (SUD) is an especially important diagnosis in this respect. There have been no studies comparing directly SUD to other diagnoses in a nationwide cohort.To directly compare differences in mortality rates of psychiatric inpatients with a discharge diagnosis of SUD versus other psychiatric diagnoses.A register-based study was made of all patients admitted to psychiatric hospitals in Iceland between 1983 and 2007. Patients were grouped according to discharge diagnoses. Survival with respect to SUD was compared using Cox-proportional hazard ratio, excluding those with an organic mental disorder. Furthermore, the survival of patients with SUD and co-morbid diagnoses was evaluated.A total of 14,281 patients (over the age of 18 years) were admitted to a psychiatric hospital in Iceland during the study period, with a total of 156,356 years of follow-up. For both men and women, a diagnosis of SUD conferred similar mortality as a diagnosis of schizophrenia without SUD, while individuals with a diagnosis of a mood disorder or other disorders had significantly lower mortality than SUD. For men with SUD, a co-occurring mental disorder was associated with an increased risk of dying, however, this was not found for women.SUD was the psychiatric diagnosis that had the highest mortality rate among psychiatric inpatients, in both men and women. An additional psychiatric diagnosis on a pre-existing SUD diagnosis did increase the risk for men but not women.
PubMed | University of Minnesota, QIMR Berghofer Medical Research Institute, Reykjavik University, DeCODE Genetics Inc. and 10 more.
Type: Journal Article | Journal: American journal of human genetics | Year: 2016
Spontaneous dizygotic (DZ) twinning occurs in 1%-4% of women, with familial clustering and unknown physiological pathways and genetic origin. DZ twinning might index increased fertility and has distinct health implications for mother and child. We performed a GWAS in 1,980 mothers of spontaneous DZ twins and 12,953 control subjects. Findings were replicated in a large Icelandic cohort and tested for association across a broad range of fertility traits in women. Two SNPs were identified (rs11031006 near FSHB, p = 1.54 10(-9), and rs17293443 in SMAD3, p = 1.57 10(-8)) and replicated (p = 3 10(-3) and p = 1.44 10(-4), respectively). Based on 90,000 births in Iceland, the risk of a mother delivering twins increased by 18% for each copy of allele rs11031006-G and 9% for rs17293443-C. Ahigher polygenic risk score (PRS) for DZ twinning, calculated based on the results of the DZ twinning GWAS, was significantly associated with DZ twinning in Iceland (p = 0.001). A higher PRS was also associated with having children (p = 0.01), greater lifetime parity (p = 0.03), and earlier age at first child (p = 0.02). Allele rs11031006-G was associated with higher serum FSH levels, earlier age at menarche, earlier age at first child, higher lifetime parity, lower PCOS risk, and earlier age at menopause. Conversely, rs17293443-C was associated with later age at last child. We identified robust genetic risk variants for DZ twinning: one near FSHB and a second within SMAD3, the product of which plays an important role in gonadal responsiveness to FSH. These loci contribute to crucial aspects of reproductive capacity and health.