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PubMed2001

[Hepatocellular carcinoma in Iceland.].

INTRODUCTION: The incidence of hepatocellular carcinoma (HCC) varies throughout the world, being relatively low in Northern Europe (less than five per 100,000 population) where the majority of the patients have cirrhosis. In Iceland the prevalence of viral hepatitis and cirrhosis, the main risk factors for HCC, is lower than reported in many other countries. The aim of our study was to investigate the incidence and etiology of HCC in Iceland. MATERIAL AND METHODS: All patients diagnosed with HCC in Iceland in 1984-1998 were included in the study. Histologic diagnosis was required for inclusion. Patients were identified from the Icelandic Cancer Registry and by reviewing autopsy and histopathology reports. Further information was obtained from medical records. RESULTS: A total of 71 cases of HCC were identified, 51 males and 20 females. The mean age for males was 69.3 years (18-95) and 73 years (52-89) for females. The age-standardized annual incidence rate of HCC was 1.08/100,000 (males 2.10, females 0.67). The incidence did not increase significantly during the study period. Alcohol abuse (15.5%) and hemochromatosis (11%) were the most common risk factors. Twenty-three (32%) had cirrhosis but 39 (55%) had no known risk factors. Of 55 cases where non-neoplastic tissue was available for examination, 27 had liver disease. CONCLUSIONS: 1) The incidence of HCC in Iceland is lower than reported in other countries. 2) Alcohol abuse and hemochromatosis are the most common risk factors. 3) The ratio of patients with cirrhosis is low.

English Abstract↗
PubMed1996

Evaluation of an Icelandic translation of the Basic Personality Inventory using a bilingual sample.

This study investigated the similarity of Icelandic and English versions of the Basic Personality Inventory (BPI), a 240-item measure of psychopathology. Eighty-nine native Icelandic graduate students studying in North America completed both language versions of the BPI in a counterbalanced order with a retest interval of approximately one month. The results of this bilingual retest study confirmed the adequacy of the Icelandic translation. Specifically, scale means, test-retest coefficients, and reliability coefficients demonstrated that the BPI performed highly similarly in both language versions. These findings provide additional support for the adequacy and applicability of the Icelandic translation of the BPI.

Adult↗
PubMed1994

Multiple sclerosis in Iceland, with observations on the alleged epidemic in the Faroe Islands.

The profile of multiple sclerosis (MS) in Iceland based on a total population study from 1900 to 1990 is reviewed. The first survey in the late 1950s was a retrospective one. Since then, there has been a continuous prospective study that extends over a period of 40 years. The incidence of MS, which was 2.5/100,000 in the 1930s, rose to 3.5 to 4.1/100,000 between 1975 and 1990, but the data from the 1930s must be considered unreliable. There was a similar stepwise increase in prevalence from 30 to approximately 100/100,000 in 1990. It is most likely that the changes in prevalence are the result of improved case ascertainment, the growing number of well-trained neurologists in the country, and the greater awareness of the disease due to the activities of the Icelandic MS Society. No local or regional clusters were identified, but from 1900 to 1980 there was a steady and unexpected increase in the number of cases in rural areas, both by date of clinical onset and date of putative disease acquisition. No evidence was found to support the hypothesis that an epidemic of MS had occurred in Iceland following the arrival of British, Canadian, and American troops during the Second World War. The proposed epidemic in the Faroe Islands was also reexamined, in particular because of the identical ethnic, historical, demographic, and geographical similarities with Iceland. The available data are not supportive of that idea.

Age of Onset↗
PubMed2001

Geographical distribution and host range of entomophthorales infecting the green spruce aphid Elatobium abietinum Walker in Iceland.

Entomophthora planchoniana and Neozygites fresenii caused infection in populations of the green spruce aphid, Elatobium abietinum, in Iceland. On this aphid species En. planchoniana was exclusively found in the western part of Iceland, while N. fresenii was exclusively found in the eastern part of Iceland. This discrete and nearly nonoverlapping geographical distribution correlates with the distribution of two different populations of El. abietinum found in Iceland. On other aphid species N. fresenii, En. planchoniana, Pandora neoaphidis, and Conidiobolus obscurus were documented throughout the country. Transmission experiments showed that Pa. neoaphidis and En. planchoniana could infect the eastern population of El. abietinum, although they have never been found on this population in nature. This strongly indicates that there is little or no interaction among El. abietinum, other aphids, and their respective entomophthoralean fungi in the field. Furthermore, this study is the first to record epizootics caused by N. fresenii and En. planchoniana in the subpolar region.

Animals↗
PubMed1991

Mortality from ischemic heart disease in Iceland, 1951-1985.

The objective of this study was to evaluate mortality rates from ischemic heart disease among Icelanders during the period of 1951 to 1985. In some developed countries, the number of deaths from ischemic heart disease declined markedly in this time period, and it is interesting to study whether the same has occurred in Iceland. The study was based on information obtained from the Statistical Bureau of Iceland, which keeps records of deaths based on death certificates as well as other population records. Nonparametric tests were used to correlate death rates and calendar years. Rates per 100,000 were calculated and plotted. The results indicated that the mortality rates from ischemic heart disease among Icelanders have not yet peaked.

Adult↗
PubMed2006

A novel modelling approach for evaluating the preindustrial natural carrying capacity of human population in Iceland.

The pre-industrial natural carrying capacity is believed to have limited the human population in Iceland to a maximum of fifty to sixty thousand inhabitants. Since AD 1800 the Icelandic population has gradually grown up to nearly 300 thousand in 2005. In this paper a simple approach is used to evaluate the potential population size that the pre-industrial Icelandic environment could possibly sustain. A dynamic model was constructed that simulates the population size according to potential biological production available for livestock. Biological production was determined by the extent of the total potential vegetation cover based on the Degree-Day concept. Fluctuations in the mean annual temperature causes changes in the potential vegetation cover and as a consequence change the biological production sustaining livestock and ultimately human population. The simulation's results indicate that the potential population that the Icelandic environments could sustain during the pre-industrial period fluctuated between 40 and 80 thousand. The results further indicate that the severe land degradation experienced after the Viking settlement period in AD 900 had a marginal impact on the population size. The pre-historical population did however overshoot the natural sustainability on several occasions.

Animals↗
PubMed2001

Molecular epidemiological confirmation and circumstances of occurrence of sheep (S) strains of Mycobacterium avium subsp. paratuberculosis in cases of paratuberculosis in cattle in Australia and sheep and cattle in Iceland.

Distinct strains of Mycobacterium avium subsp. paratuberculosis with a tendency to segregate in either sheep, or cattle and other ruminants, have been described and are known as S and C strains, respectively. These strains can be distinguished by a polymorphism in the IS1311 element and other DNA-based methods. C strains are relatively easy to culture from tissues and faeces of animals with paratuberculosis but S strains are difficult to culture. A retrospective survey of archival formalin-fixed paraffin-embedded tissue samples from culture negative Australian paratuberculous cattle was undertaken to determine whether infection in these cases was due to S strains. Polymerase chain reaction and restriction endonuclease analysis of the amplified product was used to identify the polymorphism in IS1311. Three cases of bovine paratuberculosis due to S strain were confirmed from three different farms. A serological survey led to the identification of a further two cases on one of these farms. S strains were also identified in archival tissues from paratuberculous sheep and cattle from Iceland, confirming epidemiological and microbiological evidence that paratuberculosis in Iceland was due to S strain following importation of infected sheep from Europe. In each bovine case in both Iceland and Australia there had been direct or indirect contact of calves with paratuberculous sheep. We were unable to determine whether S strains had established endemic infection in cattle or whether repeated infection from sheep had occurred. Limited epidemiological evidence suggests that transmission of S strains to cattle in Australia has been uncommon under extensive grazing conditions. In Iceland, different husbandry practices appear to have favoured transmission of S strains to cattle.

Animals↗
PubMed2002

Genetic epidemiologic aspects of gastric cancer in Iceland.

BACKGROUND: Association between gastric cancer and environmental factors (diet and infections) has been established, and genetic changes are well described in adenocarcinomas of the stomach. Less is known about clinical features of hereditary gastric cancer and whether the disease is associated with family clustering. STUDY DESIGN: Family trees of patients diagnosed with gastric cancer in Iceland between 1955 and 1999 were identified in the Genealogical Database of the University of Iceland. All probands with age of onset younger than 60 years were used in the study. Families of all probands (n = 455 men and 161 women) were traced to third degree. Through linkage of the genealogic data obtained by the Icelandic Cancer Registry (between 1955 and 1999), all reported cancers were identified in those families. The expected number of cases was calculated using age-specific population rates in Iceland. RESULTS: A relative risk (RR) of 2.2 (95% confidence interval [CI] = 1.6-3.0) and 1.3 (95% CI = 1.0-1.7) for the gastric cancer risk was observed among 2,846 first- and 8,658 second-degree relatives of male probands. For female probands the corresponding relative risks were 1.6 (95% CI = 1.1-2.6, n = 7,396) and 1.4 (95% CI = 0.9-2.0, n = 2,764). The increased risk was more pronounced for relatives of men and women diagnosed with gastric cancer before the age of 50 years. A minor difference in relative risk was found between relatives of probands who were diagnosed with intestinal type or diffuse type gastric cancer. Fifty-eight families with two or more relatives with cancer were identified. In 32 families 2 relatives with gastric cancer were identified and in 26 families 3 or more relatives had gastric cancer. CONCLUSIONS: Relatives of gastric cancer patients have two- to three-fold increased risk of developing gastric cancer. The risk is elevated for both genders.

Adult↗
PubMed1998

High incidence of classical Kaposi's sarcoma in Iceland and the Faroe Islands.

We have examined the incidence of non-AIDS-related Kaposi's sarcoma in Iceland (1955-79) and the Faroe Islands (1974-95). In Iceland, 19 cases, nine in men and ten in women, were identified, and in the Faroe Islands four cases in men and three cases in women were found. This corresponded to surprisingly high incidence rates. In men, world standardized rates (per 100000 person-years) were 0.4 and 0.6 in Iceland and the Faroe Islands, respectively, and for women, the figures were 0.3 (Iceland) and 0.5 (the Faroe Islands). These are among the highest rates ever reported. No explanation for the high rates of Kaposi's sarcoma in these two North Atlantic communities could be identified.

Aged↗
PubMed2000

Energy intake and growth of infants in Iceland-a population with high frequency of breast-feeding and high birth weight.

OBJECTIVE: To investigate infants' energy intake and growth in a population with a high frequency of breast-feeding and high birth weight. DESIGN: The infants' consumption was recorded once a month from 1 to 12 months of age. At the ages of 2, 4, 6, 9 and 12 months all ingested food was weighed accurately to calculate nutrient intake. A control group participated at the age of 9 months. SETTING: Participants, who were born healthy, were recruited from four different maternity wards. Growth data were collected from healthcare centres and consumption data with parents' assistance from the infants' homes. SUBJECTS: Infants (n=250) were randomly selected and divided into a research group (n=180) and a control group (n=70). The research group participants numbered 138 (77%) and the control participants 57 (81%). RESULTS: Energy intake was lower than current recommendations but was similar to that found in recent studies. Growth, as a percentage of birth weight, correlated negatively with birth weight, with r=0.77 (P<0.001) for growth to 12 months. Infants breast-fed at 7 months of age gained less weight from 6 to 9 months, 1057+/-58 g, than those not breast-fed, 1498+/-130 g (P<0.001). Analysis of the control group's intake showed that participation in the study did not affect intake. CONCLUSION: The findings support the need for new recommendations on energy intake and new growth charts based on current knowledge about breast-fed infants. Birth weight is a determining factor of growth in infancy, and percentage weight gain during the first year of life increases as birth weight decreases. SPONSORSHIP: The Icelandic Research Council, The Research Fund of the University of Iceland, The Icelandic Nutrition Council, The Students' Innovation Fund, The Icelandic Dairy Marketing Board

Birth Weight↗
PubMed2002

Epidemiology of hairy cell leukemia in Iceland.

INTRODUCTION: Hairy cell leukemia (HCL) is a rare B-cell lymphoproliferative disorder. Previous epidemiological studies have mainly focused on cases derived from single institutions or from localized cancer registries. This is the first study in which all cases diagnosed nationwide over a long period of time in a well defined population are analysed. We report the epidemiology of all HCL patients in Iceland, their clinical characteristics, treatment and follow-up. PATIENTS AND METHODS: : All patients diagnosed with HCL in Iceland over a 20 year period, were included in this study. Data was collected retrospectively. RESULTS: Sixteen patients, 13 males and three females were diagnosed with HCL in Iceland from 1981-2000, giving a mean incidence of 4.7/million/year (95% CI: 2.7-7.6) in the population 20 years and older. Eleven patients were treated with a purine analogue, 10 of whom achieved CR. One other patient obtained CR following splenectomy and IFN, giving a total CR rate of 69%. Three other patients (19%) obtained PR, giving a total response rate of 88%. One patient had a variant of HCL and did not respond to any therapy and one patient died of sepsis before any chemotherapy could be given. Six patients with HCL have died, one from complications of HCL. Three patients developed a second malignancy (19%). CONCLUSIONS: The mean incidence of HCL in Iceland is 4.7/million/year. This is slighty higher than the reported incidence in England and Wales, although not significantly higher. The incidence is based on a nationwide information from a well defined stable and racially homogenous island population. Other results are in accordance with previously published studies.

Adult↗
PubMed1998

The experience of people awaiting coronary artery bypass graft surgery: the Icelandic experience.

Prolonged waiting for major elective surgery has been a problem in several Western countries for many years. In Iceland coronary artery bypass graft (CABG) surgery was installed in 1986 and this descriptive study was conducted to describe systematically the experience of Icelandic people waiting for CABG surgery with the purpose of gaining information about what nursing services these people need during the waiting period. The survey used a mailed questionnaire developed by the authors. The target population consisted of people awaiting coronary artery bypass graft surgery at the National University Hospital in Iceland, at two predetermined days with a 10-month interval. The return rate was 81.8% (n = 72). Mean time on the waiting list was 5 to 6 months. The waiting for surgery had negative effects on the work and daily life of the majority of the subjects and they were dissatisfied with their health status. Prominent symptoms were fatigue, shortness of breath, chest pain, anxiety and depression. Most patients (86.6%) experienced stress with 28.4% of them reporting a serious level of stress. The majority reported considerable negative influences of their illness on their spouse and family, particularly on their emotional condition. The conclusion drawn is that shortening the waiting period for CABG surgery should be a primary objective; however, that may be unlikely with the present Icelandic health care system. Therefore, helping the individuals and their families live with the lengthy wait is a necessity.

Adult↗
PubMed2002

Listeriosis in Iceland, 1978-2000: a description of cases and molecular epidemiology.

The purpose of our study was to review all cases of listeriosis in Iceland during the period 1978-2000 and to analyse the genetic relatedness of their isolates. Case records of all patients in Iceland with listeriosis during the period were reviewed and the isolates compared using serotyping and pulsed-field gel electrophoresis (PFGE) using SmaI, AseI and ApaI restriction enzymes. Forty cases of listeriosis were diagnosed during the period, resulting in a mean annual incidence of 6.9 cases per million and a case fatality rate of 33%. In the first 5 y of the study only serotype 4b was observed; subsequently serotypes 1/2a and 1/2b appeared and serotype 4b declined in prevalence. PFGE yielded 24 different genotypes with 7 clusters of indistinguishable genotypes, each comprising 2-6 cases. During 1992-95 the annual incidence of listeriosis in Iceland rose to 15 cases per million. This was largely due to 2 clusters, 1 of 3 cases and the other of 6. No cases of listeriosis were diagnosed during 1998-2000. Our data show an increased number of cases within clusters in the latter half of the period. At the same time, food processing and distribution has become increasingly centralized in Iceland, suggesting an increased risk of listeriosis outbreaks.

Adolescent↗
PubMed2003

A population-based analysis of increased incidence and improved survival of testicular cancer patients in Iceland.

OBJECTIVE: For unknown reasons the incidence of testicular cancer has risen dramatically in many industrialized countries. At the same time, the prognosis for these patients has improved even more significantly. This has mostly been explained by the introduction of an effective cisplatin-based multidrug chemotherapy regimen for patients with metastatic or recurrent disease, but better diagnostic tools and surveillance may also play a role. In this population-based study the clinical behaviour of testicular cancer cases (n = 198) in Iceland between 1955 and 1999 was investigated, with a special emphasis on changes in incidence, staging and survival. MATERIAL AND METHODS: The tumours were staged and pathologically classified and the crude probability of survival evaluated. The incidence was calculated for the whole period and further clinical evaluation was done for all the patients diagnosed after 1970 (n = 172). RESULTS: Of 198 patients, 111 (58%) were diagnosed with seminomas and 82 with non-seminomas (42%). Age-adjusted incidence increased from 2.2 per 100,000 men between 1955 and 1959 to 5.3 per 100,000 men between 1995 and 1999 (p < 0.01). More patients were diagnosed with localized disease (stage I) in the second compared to the first time period of the study: 71% vs 52% respectively (p < 0.01). After the introduction of cisplatin-based multidrug chemotherapy in Iceland in 1978, 5-year survival has increased from 67% in the period 1955-77 to 96% in the period 1978-99. CONCLUSIONS: During the study period the incidence of testicular cancer in Iceland increased almost threefold. After multidrug chemotherapy was introduced in 1978 only two patients have died from the disease. Since 1987, patients with stage I disease have been followed with surveillance after orchiectomy, without any deaths. Our population-based findings of increased incidence, lower staging and improved survival of patients with testicular cancer in Iceland are important for planning future treatment strategies. The availability of effective treatment, even for patients with advanced disease, stresses the importance of reducing treatment-related morbidity (infertility and secondary malignancies).

Adolescent↗
PubMed2001

Cadmium, mercury, iron, copper, manganese and zinc in the liver and kidney of the Icelandic lamb.

The purpose of this study was to evaluate the levels of cadmium, mercury, iron, copper, manganese and zinc in lamb liver and kidney from six areas in Iceland and to compare the results against aerial deposition data for the same elements obtained using moss as an indicator organism. The total number of samples was 96 for each organ. Cadmium was determined by graphite furnace atomic absorption spectrophotometry, mercury by cold-vapour atomic absorption, and iron, copper, manganese and zinc by inductively coupled plasma atomic emission spectrophotometry. Analysis of variance determined significance differences among means for areas, and Pearson's correlation coeffcients were calculated to study correlation among trace elements in liver and kidney. The mean fresh weight concentrations in lamb liver and kidney respectively were 0.045 and 0.058 mgkg(-1) for cadmium, 0.009 and 0.012 mgkg(-1) for mercury, 141 and 52.7 mgkg(-1) for iron, 28.1 and 2.89 mgkg(-1) for copper, 4.01 and 1.13 mgkg(-1) for manganese and 48.7 and 25.2 mgkg(-1) for zinc. Concentrations of cadmium, mercury and copper in the liver and kidney of the Icelandic lamb were low compared with data from other countries. Iron concentrations in the organs, however, were high. No sample exceeded 46% of the proposed maximum level for cadmium in organs for human consumption in the EC. Cadmium, mercury, iron and copper in the liver and kidney differed significantly between areas. Deposition of cadmium and copper in moss was not a usefull indicator in the evaluation of the susceptibility of the Icelandic lamb to accumulation of cadmium and copper. However, iron levels in Icelandic lamb liver showed the same pattern as results for iron from the moss study. The cadmium and mercury levels of organs from lambs grazing in the vicinity of Mount Hekla a few months after its eruption did not indicate a significant contamination from volcanic activity.

Analysis of Variance↗
PubMed2003

A populationwide coalescent analysis of Icelandic matrilineal and patrilineal genealogies: evidence for a faster evolutionary rate of mtDNA lineages than Y chromosomes.

Historical inferences from genetic data increasingly depend on assumptions about the genealogical process that shapes the frequencies of alleles over time. Yet little is known about the structure of human genealogies over long periods of time and how they depart from expectations of standard demographic models, such as that attributed to Wright and Fisher. To obtain such information and to examine the recent evolutionary history of mtDNA and Y-chromosome haplotypes in the Icelandic gene pool, we traced the matrilineal and patrilineal ancestry of all 131,060 Icelanders born after 1972 back to two cohorts of ancestors, one born between 1848 and 1892 and the other between 1798 and 1742. This populationwide coalescent analysis of Icelandic genealogies revealed highly positively skewed distributions of descendants to ancestors, with the vast majority of potential ancestors contributing one or no descendants and a minority of ancestors contributing large numbers of descendants. The expansion and loss of matrilines and patrilines has caused considerable fluctuation in the frequencies of mtDNA and Y-chromosome haplotypes, despite a rapid population expansion in Iceland during the past 300 years. Contrary to a widespread assumption, the rate of evolution caused by this lineage-sorting process was markedly faster in matrilines (mtDNA) than in patrilines (Y chromosomes). The primary cause is a 10% shorter matrilineal generation interval. Variance in the number of offspring produced within each generation was not an important differentiating factor. We observed an intergenerational correlation in offspring number and in the length of generation intervals in the matrilineal and patrilineal genealogies, which was stronger in matrilines and thus contributes to their faster evolutionary rate. These findings may have implications for coalescent date estimates based on mtDNA and Y chromosomes.

Alleles↗
PubMed1977

Studies on the Pelger anomaly in Iceland.

An Icelandic family, containing 15 members with Pelger anomally, is reported. Affected individuals in two branches of the family, living in the south-east and east of Iceland, have been traced to common ancestors born 200 years age. The results of scanning of blood films from approximately 20% of the population of Iceland suggest that the Pelger family described contains the only mutation of this kind in Icelanders.

Female↗
PubMed2004

Translation and validation of the Nursing Outcomes Classification labels and definitions for acute care nursing in Iceland.

BACKGROUND: The Nursing Outcomes Classification (NOC), second edition, consists of 260 patient outcomes with definitions. This has been translated into five languages, but has not been clinically validated outside the United States of America (USA). AIM: The aim of this paper is to describe the translation of the labels and definitions from the NOC, second edition from English to Icelandic and validation for acute-care nursing in Iceland. METHOD: A survey that has been designed to identify nurses' perception of the percentage of patients' for whom each NOC outcome is relevant in clinical nursing practice was used for clinical validation in this study. The translation procedure involved source to target language translation, parallel comparison, pilot test and field test. Validation included test-retest to measure the reliability for each of the 260 outcome variables. Data collected from 140 clinical nurses from 54 departments within 13 nursing specialties at Landspitali University-Hospital in Iceland, in November 2001, were analysed to establish construct validity by confirmatory factor analysis. Internal consistency was calculated. RESULTS: Translation was successful. Test-retest showed that 181 of the 260 NOC outcomes were significant (P < 0.05) and moderately or highly correlated (r > 0.50) (Pearson's correlation). The confirmatory factor analysis showed that 22 of the 29 NOC classes had only one factor at the loading criteria > or =0.30. Of the 260 outcomes, 244 had loading on one factor (> or =0.30) within its class. Internal consistency was >0.80 (Cronbach's alpha). LIMITATIONS: Low response rate was a limitation. The indicators of each NOC outcome were not addressed. CONCLUSION: The Icelandic version of the NOC survey is a comprehensive tool that can be applied to nursing in acute-care for research purposes as well as to prepare for the implementation of NOC in clinical information systems.

Humans↗