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PubMed2004

Ground reaction forces and limb function in tölting Icelandic horses.

REASONS FOR PERFORMING STUDY: Gaited horses employ 4-beat stepping (singlefoot) gaits that extend into speeds typical of trots. Ground reaction force (GRF) patterns of these specialised gaits have not been reported; therefore, appraisal of these gaits using nongaited horse kinetics may lead to clinical misjudgements. HYPOTHESIS: GRFs of tölting Icelandic horses will be comparable in profile and magnitude with those of trotting horses. METHODS: Forelimb and hindlimb GRFs were obtained for 10 Icelandic horses ridden at a tölt. These data were evaluated across 3 speed ranges: <2, 2.5-5 and >5 m/sec. RESULTS: Virtually all vertical force tracings were single-peaked. Forelimbs typically had greater peak vertical forces and impulses compared with hindlimbs. Support duration and forelimb vertical impulse were correlated negatively with speed, whereas peak vertical, braking and propulsive forces and hindlimb braking and propulsive impulses were correlated positively with speed. CONCLUSIONS: GRF profiles of tölting Icelandic horses are more similar to profiles of trots than walks, suggesting that tölts follow bouncing mechanics. POTENTIAL RELEVANCE: Greater overlap of limb support in 4-beat gaits (even at high speeds) is associated with lower peak vertical force magnitudes of tölts compared with those reported for trots at comparable speeds, which may help limit the occurrence of overloading injuries in Icelandic horses.

Animals↗
PubMed2004

[Use of hormone replacement therapy by Icelandic women in the years 1996-2001.].

INTRODUCTION: Since the late seventies the use of hormone replacement therapy by peri- and postmenopausal women has been steadily increasing. This was shown in a former study of hormonal use among Icelandic women who had responded to a questionnaire when attending cancer screening at the Cancer Detection Clinic (CDC) of the Icelandic Cancer Society in the years 1979-1996. This current study is an independent extension of the former study with the goal of investigating menopausal hormone use among Icelandic women during the period of 1996-2001 and comparing the results with the former study period of 1979-1995. MATERIAL AND METHODS: We used data from the CDC for the period of 1996-2001 and reviewed the responses from Icelandic women aged 40-69 years to questions regarding hormonal use. We investigated changes in the proportion of women using hormones, the proportion of women using combined hormone replacement therapy, the proportion using long-time hormone replacement therapy, and also the relationship between hormonal use and smoking. We also compared our results to the former study results. RESULTS: During the period 1996-2001, 16.649 women aged 40-69 years responded to the questionnaire on hormonal use. There was an increase in use during that period, and also an increase compared to the period 1979-1995. Women born 1941-1945 were more likely to have ever used hormones (68%) than women born 1931-35 (42%). Present use of hormones was most prevalent among 52-57 year old women (57%). The proportion of women aged 50-55 years reporting present use did not change over the period ( approximately 50%). Long term use increased steadily during the period. During 1996-98 the proportion of women who had used hormones for more than 5 years was 49%, compared to 67% of women 1999-2001. This is also a considerable increase compared to the former study period. In the years 1996-2001, 19% of the women reported hormone use for 14 years or more. Smoking was more common among ever users of hormone replacement therapy (63%) than among never users of hormone replacement therapy (53%). CONCLUSIONS: The proportion of women who had used hormones and the duration of hormone use increased steadily during the period of 1996-2001. There was also a considerable increase compared to the former study period.

English Abstract↗
PubMed2004

[The relationship between physical activity, body mass index, body composition and grip strength in an Icelandic population.].

OBJECTIVE: To study physical activity among Icelandic adults and the relationship with anthropometric factors and grip strength. MATERIAL AND METHODS: Randomly selected participants, 30-85 years of age, answered questions regarding exercise and diet. Body composition was measured with DXA, which detects the proportions of different body tissues. Height, weight and grip strength were measured and the body mass index (kg/m(2)) was calculated. The prevalence of regular physical activity was studied for men and women in the age groups of 30-45 years, 50-65 years and 70-85 years and the relationship to body mass index, body composition and grip strength examined. The possible preventive effect of exercise on overweight and obesity was also studied. RESULTS: Of 2310 invited, 1630 subjects (70.6%) participated. Mean participation in regular physical activity was 3-4 times a week but 19% of the women and 24% of the men did no exercise at all. In general, swimming, walking and calisthenics of various types and intensities were the most common forms of exercise and in the age group 30-45 year old 16% of the women and 8% of the men did strength training. 50.4% of women 30-45 years of age and 68.2% of 50-65 year old men were overweight or obese. Mean fat mass was highest in 70-85 year old women (38%) and men (27%). Occupational activity was not related to body mass index, body composition or grip strength. Significant negative relationship was found between frequency of exercise and fat mass. The relationship between grip strength and lean mass or exercise was non-significant. The odds ratio of being overweight or obesity was 0.5 (CI was 0.37-0.77 for women and 0.37-0.94 for men) for those who exercised five or more days per week compared to those who exercised less frequently. CONCLUSION: One of four Icelandic men and one of five women do not participate in regular physical activity despite of strong scientific indications of various positive health effects of exercise. More than half of adult Icelanders are overweight or obese but the risk is halved among those who exercise at least five days per week, compared to those who exercise less frequently. Sedentary lifestyle is more common amongst Icelanders than in the neighboring countries and realistic goals need to be set to increase the participation in regular physical activity.

English Abstract↗
PubMed2003

[Extremely low birthweight infants in iceland. Survival and disability.].

OBJECTIVE: In recent years advances in medical care and technology have increased newborn survival rate, both fullterm and preterm. This is reflected in a low Perinatal Mortality Rate in Iceland. Survival of extremely low birthweight infants (ELBW with BW<1000g) has also increased, especially since the availability of surfactant therapy for Respiratory Distress Syndrome of Prematurity. The purpose of this geographically defined national study was to evaluate survival and longterm outcome of ELBW children in Iceland. MATERIAL AND METHODS: Information on all births in Iceland 1982-95 was collected from the National Birth Registry and Statistics Iceland with information on ELBW infants weighing 500-999g born in two periods 1982-90 and 1991-95, before and after the use of surfactant became routine therapy. Information on disability was obtained from records at the State Social Security Institute. Comparison was made between the two groups of ELBW infants. RESULTS: In 1982-90 the proportion of ELBW infants was 0.3% of all births (116 of 38.378) and longterm survival at five years of age was 19 of 87 liveborn children or 22%. In 1991-95 ELBW infants were 0.5% of all births (102 of 22.261) and longterm survival was 35 of 67 liveborn children or 52%. Of the 19 ELBW children born in 1982-90 three are considered handicapped (16%) and 6 of 35 ELBW children born in 1991-95 (17%). CONCLUSIONS: The study shows that at the same time that proportionally more children are of extreme low birthweight, the survival of ELBW infants has increased from 22% in 1982-90 to 52% in 1991-95. The proportion of ELBW children with disability is not increased significantly between the two periods.

English Abstract↗
PubMed2003

[Carriage of group B beta-haemolytic streptococci among pregnant women in Iceland and colonisation of their newborn infants.].

OBJECTIVE: To determine the carrier rate of group B beta-haemolytic streptococci (GBS) of pregnant women in Iceland and the colonisation of their newborns. MATERIAL AND METHODS: A prospective study was conducted from October 1994 until October 1997, where culture specimens for GBS were taken from vagina and rectum of pregnant women attending the prenatal clinics at the Department of Obstetrics and Gynecology, Landspitali University Hospital and the Reykjavik Health Centre. The samples were taken at 23 and 36 weeks gestation and at delivery. Culture samples were also taken from axilla, umbilical area and pharynx of their newborn infants immediately after birth. Included in the study were pregnant women born on every fourth day of each month. Carrier state was not treated during pregnancy, but Penicillin G was given i.v. at delivery if the last culture before delivery was positive and gestational age was <37 weeks, rupture of membranes was >12 hours before delivery or the mother had a fever >38 degrees C. RESULTS: Cultures were taken from 280 women and their children. GBS carrier rate of pregnant women in Iceland was 24.3%. Twelve newborns had GBS positive cultures. No newborn had a confirmed septicemia. Cultures from 25% of newborns, who s mothers were still GBS carriers at birth, were positive for GBS. Positive predictive value of cultures taken at 23 weeks gestation was 64% and 78% at 36 weeks. Negative predictive value was 95% and 99% respectively. CONCLUSION: One out of every four pregnant women in Iceland is a GBS carrier. Twentyfive percent of newborns become colonised with GBS if the mother is a GBS carrier at delivery. When screening for GBS carrier state is done cultures from both vagina and rectum is more sensitive than cultures from vagina only. At least five percent of all newborns in Iceland are therefore expected to have positive skin cultures at birth. If the mother does not have positive GBS cultures during pregnancy, the likelihood that she will give birth to a GBS colonised child is almost none.

English Abstract↗
PubMed2003

[Out-of-pocket health care costs among population groups in Iceland.].

OBJECTIVE: Total health expenditures, and out-of-pocket health care costs have increased in recent years in Western Europe and North America. Developments in Iceland appear to be similar. Access and cost are closely related and direct household health care costs often reduce subsequent use of services. The purpose of the study was to consider whether certain population groups spent more on health care than others both in absolute terms and as percentage of household income. MATERIAL AND METHODS: The study is based on a national health survey titled Health and Living Conditions in Iceland. A random sample of 18-75 year olds was drawn from the National Register, and the response rate was 69% (1924 respondents). Average household out-of-pocket health care costs (in krónur) and out-of-pocket household costs as percentage of household income were compared between sociodemographic groups. RESULTS: The largest health care expenditure items were dental care, drugs, other drug store items and equipment, and physician care (in this order). The middle aged (45-54), married/cohabiting, parents, large households, full-time employed, and people with high education and income, had the greatest household out-of-pocket costs in absolute terms. However, when considering costs as percentage of household income, women, older individuals (age 55 and older) and the young (age 18-24), the non-employed and unemployed, and low income people were on top. CONCLUSIONS: Household out-of-pocket health care costs differ substantially between sociodemographic groups in Iceland. It can be argued and empirically substantiated that out-of-pocket health care costs in Iceland are already at a risky level, affecting access of individuals and groups to health services.

English Abstract↗
PubMed2002

[Fitness for work after vocational rehabilitation organized by the State Social Security Institute of Iceland.].

OBJECTIVE: The evaluation of a vocational rehabilitation programme initiated by the State Social Security Institute in Iceland (SSSI) in 1999 with the aim of reducing disability. MATERIAL AND METHODS: New disability claimants who had been unable to work because of illness for a few months at least were referred by SSSI physicians to a multidisciplinary team for assessment of rehabilitation potentials and an advice on the appropriate type of rehabilitation. The study group included all the 109 individuals who were referred to the team in the year 2000. Data on marital status, number of children and level of education was compared with information about the Icelandic population obtained in a national survey. The outcome of the rehabilitation was assessed in a telephone survey, carried out by the Social Science Research Institute, University of Iceland, 1-2 years after the assessment and by information obtained from the disability register at SSSI. The effectiveness of the rehabilitation programme was evaluated by comparing the study group with a comparable group that had started to receive rehabilitation pension before the SSSI could offer vocational rehabilitation. Their progress was assessed a year and half after they had contacted the SSSI, the same length of time as the study group had been in the in the rehabilitation programme. RESULTS: In the study group there were about twice as many women as men. The mean age was 35 years (range 18-57 years). The main medical reasons for referral to the team were musculosceletal and psychiatric disorders. Those evaluated were more likely to be unmarried or divorced, had more children and a lower educational level than the general Icelandic population. After evaluation 40 individuals were referred to vocational rehabilitation for approximately 2 months in a rehabilitation clinic; 19 were referred to a 6 week personal computer training at a vocational rehabilitation centre and 15 to a longer (usually 18 months) rehabilitation program in the same centre. In all, 46 individuals received other treatment or education. Almost three quarters (72%) of the participants in the telephone survey said that their fitness for work had increased after rehabilitation, but only 47% had returned to work. At the time of the reserach, 23% were students and it is likely that a part of them will return to work when their studies are completed. Between one and two years after the evaluation by the multidisciplinary team 44 out of 109 (40.4%) in the study group received disability pension and a equal number received no social insurance benefits at all. In the comparison group 97 out of 119 (81.5%) received disability pension and 21 (17.7%) received no social insurance benefits at all. CONCLUSIONS: This study shows that vocational rehabilitation organized by the SSSI is effective and can prevent disability. The results of this study are similar to the results of two Swedish studies on the same topic.

English Abstract↗
PubMed2002

[Congenital heart defects in Iceland 1990-1999.].

OBJECTIVE: About 1% of live born children have congenital heart defects (CHD). Knowledge of the true incidence of CHD is important because of the risk of bacterial endocarditis in patients with heart defects. This knowledge could also serve as a basis for research on the etiology of CHD. The aim of our study was to investigate the incidence of CHD in children born in Iceland during a ten year period, from 1990 to 1999. A similar study on CHD was carried out in Iceland for children born 1985-1989. The incidence of CHD in the present study was compared to the previous and to similar studies from other countries. MATERIAL AND METHODS: Information about the patients were obtained from medical records from two hospitals covering the whole country, a private clinic of pediatric cardiologists, echocardiography database, autopsy reports and death certificates. Distribution of specific heart defects, age at diagnosis, symptoms leading to the diagnosis, referral pattern, treatment and quality of life was investigated. Other congenital defects, chromosomal defects and syndromes in the patients were studied. Premature children with patent ductus arteriosus (PDA) and children with patent foramen ovale (PFO) or atrial septal defect (ASD) smaller than four millimeters were excluded. We also studied the incidence of bicuspid aortic valve (BAV). All diagnoses were confirmed with echocardiography and in some cases cardiac catheterization. RESULTS: Between 1990 and 1999 there were 44,013 live births in Iceland, 740 children were diagnosed with a CHD or 1.7% of live born children. Yearly incidence varied from 1.04% of live births in 1991 to 2.34% in 1997. Male/female ratio was 1/1. The distribution of the defects was following: ventricular septal defect (VSD) 338 (45.7%), ASD 90 (12.2%), PDA 85 (11.5%), valvar pulmonal stenosis 48 (6.5%), BAV 38 (5.1%), coarctation of the aorta 28 (3.8%), tetrology of Fallot 22 (3.0%), transposition of the great arteries 14 (1.9%), aortic stenosis 11 (1.5%), common atrioventricular septal defect 10 (1.4%), mitral valve regurgitation 9 (1.2%), sub-aortic stenosis 7 (0.9%) and hypoplastic left heart syndrome 5 (0.7%). Other defects were less frequent. About 47% of children with CHD were diagnosed either before birth or before discharge from the delivery institution. A cardiac murmur on examination was the most common symptom leading to the diagnosis of CHD, 631 patients (85.3%). Extracardiac anomalies were seen in 89 patients (12.0%). Chromosomal abnormalities were seen in 36 patients of whom 28 had Down's syndrome. The majority or 499 patients have no symptoms but are still in follow-up, 20 patients have daily symptoms and/or receive medical treatment and 27 patients have died. Conslusions: Annual incidence of patients diagnosed with a CHD has increased during the study period. This is observed in minor CHD but the incidence of major defects does not alter. This yearly incidence (1.7%) is higher than in the previous study, where it was 1.1%. The difference can partly be explained by the BAVs, which were excluded in the 1985-1989 study. But the number of CHD diagnosed each year has increased, this being most pronounced in the last three years. The annual incidence in our study is also higher than in other population studies. The most likely explanation for the higher incidence in our study is the fact that access to pediatric cardiologists is very good in Iceland. Diagnosis, registration and follow-up is conducted by only a few cardiologists for the whole nation and takes place at a single pediatric cardiology center. Of 740 patients diagnosed with CHD in the study period 713 are alive. The outcome of the therapy is good and the majority of the patients has no symptoms.

English Abstract↗
PubMed2001

[Changes in the prevalence of disability pension in Iceland 1976-1996.].

OBJECTIVE: To determine changes in the prevalence of disability pension in Iceland and to describe the distribution of those receiving disability pension according to gender, age and main diagnoses between the years 1976 and 1996. MATERIAL AND METHODS: The study includes all those receiving disability pension on the 1st of December in the years 1976 and 1996 as ascertained by the disability register at the State Social Security Institute of Iceland. There are two levels of disability pension, full disability pension (disability assessed as being more than 75%) and reduced disability pension (disability assessed as being 50% or 65%). Information on age and gender distribution of the Icelandic population was obtained. Age-standardized risk ratio between the years 1976 and 1996 was calculated for both pension levels combined and for full disability pension alone. RESULTS: There was no significant change in crude prevalence rate for both pension levels combined between the years 1976 and 1996, when the increase in the population was accounted for but without paying attention to changes in gender or age distribution. However, the standardized risk ratio showed a significantly decreased risk for both pension levels combined both for men and women in the year 1996 as compared with the year 1976, the age-standardized risk ratio being 0.95 and 0.93 respectively. It also showed a significant change between pension levels with an increased risk of full disability pension and a decreased risk of reduced disability pension. The increase in full disability pension was noted for both males and females and was largely independent of age. There was a significant increase in full disability pension in most disease categories. Disability due to diseases of the nervous system and sense organs and injury and poisoning increased amongst women only. A significant decrease in full disability pension due to infections and diseases of the digestive system occurred in both men and women. CONCLUSION: The prevalence of a disability pension amongst men and women in the year 1996 as compared to the year 1976 was significantly decreased when changes in population size and age distribution had been accounted for. This is particularly interesting because unemployment was increasing just prior to the year 1996. The prevalence of full disability pension had however significantly increased in 1996 compared with 1976. A plausible explanation for the observed change in disability pension levels is a pressure from the labour market, with increasing unemployment and competition. Also, the introduction of a disability card for those with full disability pension in 1980, which granted lower price for medication and the services of physicians, is likely to have increased the pressure for the higher level of disability pension (full disability pension). It seems unlikely that the increase in full disability pension and the decrease in reduced disability pension is due to a deterioration of health of the Icelandic population. Increased disability due to injury and poisoning amongst women is probably a result of their increased participation in the labour market. The decrease in disability due to infections is a result of a reduction in the number of cases of tuberculosis and poliomyelitis. The decrease in disability due to diseases of the digestive system is probably a result of improvement in the treatment of oesophageal reflux and peptic ulcer.

English Abstract↗
PubMed2001

[Changes in treatment and cost of benign prostatic hyperplasia in Iceland.].

OBJECTIVE: During the last eight years there has been a dramatic change in the treatment of patients with benign prostatic hyperplasia (BPH) in Iceland. The number of transurethral resection of the prostate (TURP) has decreased while at the same time there has been a growing tendency to treat patients with a1-blockers and finasteride. The purpose of this study was to obtain statistical information regarding these changes and to estimate alterations in the cost of the BPH treatment. Possible changes in indications for TURP were also looked at. MATERIAL AND METHODS: Information on the number of patients who underwent surgery since 1984 was gathered from Icelandic hospitals. Information on the use and cost of medical treatment was obtained from the Icelandic Social Security. Medical records of 587 men who underwent surgery in the years 1988-1989 and 1998-1999 were reviewed. RESULTS: Since 1992 the number of TURP operations per year has dropped from its peak of about 560 to around 270 in 1999. This is more than a 50% reduction in eight years. The number of patients being treated for BPH has multiplied since the introduction of drugs and the total cost of BPH treatment has doubled since 1984. There was a trend but not a significant change in indications for TURP when the two periods were compared. CONCLUSIONS: Increasing number of Icelandic men with BPH are now recieving treatment although the number of TURP operations has decreased. The total cost of treatment has doubled since 1984, mainly attributed to the advent of medical treatment.

English Abstract↗
PubMed2000

[Predictors of mammography adherence among Icelandic women.].

OBJECTIVE: In Iceland, breast cancer is a second only to lung cancer as a cause of women s cancer related deaths. Despite the widely-recognized utility of mammography for detecting breast cancer at early stages when it is most curable, many Icelandic women do not adhere to mammography screening recommendations. The aim of the present population-based study was to identify factors that facilitate and hinder women s adherence to mammography screening in Iceland. MATERIAL AND METHODS: A randomly selected sample of Icelandic women between the ages of 40-69 years, not previously diagnosed with breast cancer (n=1000), were recruited to the study by mail. Participants (n=619) completed questionnaires assessing: demopgraphic variables, knowledge of screening guidelines, possible facilitators (e.g., physician recommendation) and barriers (e.g. concern about radiation) to adherence, as well as stages of mammography screening adoption (precontemplation, contemplation, action and maintenance). RESULTS: Women in the precontemplation stage were more afraid of radiation than women on other stages. They as well as women on contemplation stage were more afraid that mammography would be painful, and less satisfied with previous service at the mammography screening center. Doctors recommendations, as well as women s knowledge about mammography screening guidelines, were positively related to mammography adherence. CONCLUSIONS: These findings suggest that physicians may have an important role in motivating women to follow mammography screening recommendations. Educating women about mammography screening guidelines and addressing their concern about radiation and pain may increase mammography adherence further. Service at the mammography screening center may also improve adherence.

English Abstract↗
PubMed2000

[Results of percutaneous coronary interventions in Iceland during 1987-1998.].

PURPOSE: To evaluate potential changes in clinical indications and the composition of the patient population undergoing percutaneous coronary intervention (PCI) in Iceland from 1987 to 1998. Furthermore, to assess changes in success rate and major complications for the procedure during the study interval in a small nation with one PCI centre. MATERIAL AND METHODS: The first PCI was performed in Iceland in May 1987. A registry has been kept from the start that includes clinical and procedural data, and records of complications and mortality. During the study interval a total of 2440 PCIs were performed. The annual procedure rate was low at first, with a steep rise during the last years. Based on procedural changes over the years the study interval was divided into three periods: I. 1987-1992 (471 procedures); the learning years, II. 1993-1995 (796 procedures); increasing number of PCIs and the method established, III. 1996-1998 (1173 procedures); increasing use of stents and new antiplatelet regime used. RESULTS: From period I to III, the rate of elective PCI declined from 82% to 52% (p<0.001), subacute procedures increased from 14% to 44% (p<0.001), acute PCI from 0.8% to 3% (p<0.05), and ad hoc procedures from 0.4% to 28% (p<0.001). This reflects an increase in PCI on patients with acute coronary syndromes, as the ratio of patiens with unstable angina increased from 15% to 36% (p<0.001). Also, 1-vessel PCI decreased proportionally from 93% to 83%, while 2 and 3 vessel procedures increased from 7% to 17% (p<0.001). The proportion of patients 70 years or older increased from 7% to 27% (p<0.001). Still, the success rate for PCI increased from 83% to 93% (p<0.001) and the use of stents rose sharply from 0% to 56%. The ratio of PCI due to restenosis declined somewhat between period II and III, from 15% to 12% (p=0.06). Simultaneously, the rate of acute coronary bypass surgery after PCI decreased from 4.2% to 0.2% (p<0.001) and significantly fewer patients had elevated creatinine kinase levels (4.0% vs 2.7%, respectively, p<0.05). However, clinical acute myocardial infarction after PCI remained similar at 1.3% and 0.9%, and the in hospital mortality was 0.6% and 0.4%. CONCLUSIONS: On a national basis the rate of PCI in Iceland is amongst the highest in Europe. Thus, in 1998, when the population in Iceland was 275,000, 453 PCIs were done (1647 procedures per million inhabitants). An increased number of subacute and acute PCIs is carried out, more complicated procedures are performed in patients with widespread disease, and the patient population is growing older. Still, the success rate is high and the frequency of complications and mortality relatively low.

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PubMed2000

[Puberty in Icelandic girls.].

In a crosssectional study, 2775 healthy Icelandic girls, aged 6-16 years, were examined for physical signs of puberty. The study was performed in 1983-1987 and was a part of a larger crosssectional study of growth and development of 5526 Icelandic children all of whom were examined by the authors. Breast development stage 2 according to Tanner (B 2) was considered the first sign of puberty in girls. The mean age of Icelandic girls reaching B 2 was 10.84 years (SD 1.43). The mean time interval between B 2 and menarche was 2.42 years. The first signs of pubic hair growth, Tanner stage 2 (PH 2) were found at 11.46 years (SD 1.25). The mean time interval between PH 2 and PH 5 was 3.40 years. Comparison with studies from other countries is difficult because of different methods and different study designs, but the timing and tempo of puberty in Icelandic girls seems to be similar to what has been reported from other Nordic countries and countries in Western-Europe.

English Abstract↗
PubMed2000

[Puberty in Icelandic boys.].

In a crosssectional study, 2751 healthy Icelandic boys aged 6-16 years, were examined for physical signs of puberty. The study was performed in 1983-1987 and was a part of a larger crosssectional growth study of 5526 Icelandic children all of whom were examined by the authors. Testicular volume of 4 ml (T 4) was considered the first sign of puberty in boys. The mean age of Icelandic boys reaching T 4 was 11.89 years (SD 1.08). The mean time interval between T 4 and T 12 was 2.21 years. The first signs of pubic hair growth, Tanner stage 2 (PH 2), were found at 12.74 years (SD 1.37). The mean time interval between PH 2 and PH 5 was 2.43 years. Even though comparison with studies from other countries is difficult because of different methods and different study design, we find that the timing and tempo of puberty in Icelandic boys is similar to what has been reported from other Nordic countries and countries in Western-Europe.

English Abstract↗
PubMed2000

[The prevalence of sicca symptoms in Iceland.].

OBJECTIVES: Sjoegren' syndrome is one of the most common inflammatory systemic rheumatic disorders. The syndrome is characterised by tiredness, pain problems and mucosal dryness. The goal of this study is to elucidate the prevalence of sicca symptoms in the Icelandic population and to calculate the preliminary prevalence value for Sjoegren' syndrome in Iceland. MATERIAL AND METHODS: Random sample was retrieved from two age groups; 40-49 and 70-75 years Icelandic inhabitants of Reykjavík and Akureyri. Questionnaire with 14 questions of the most common symptoms of Sjoegren' syndrome was mailed to those sampled. A small sample was evaluated by Schirmer-I test, tear film break up time (BUT) and Rose Bengal score for keratoconjunctivitis sicca (KCS) and unstimulated salivary flow rate was performed. RESULTS: The questionnaire was sent to 621 subjects, 300 male and 321 female. The response rate was 74%. Of those 20.3% had subjective symptoms of dry eyes and 12.0% of dry mouth according to the six questions used in the European classification criteria (EEC). The prevalence of both was higher in females (p<0.05). Of the 23 subjects who reported sicca symptoms, fatigue and pain problems; 26% had abnormal Shirmer-I test, 13% had abnormal BUT and 39% had abnormal salivary flow rate, two of those individuals fulfilled the EEC criteria for Sjoegren' syndrome (0.2%; 0-0.5%, 95% CI). None in the age and sex matched control group fulfilled the EEC criteria. CONCLUSION: The subjective symptoms of dry eye and dry mouth are common in Iceland, as are the three major symptoms of Sjoegren' syndrome. Standardised objective diagnostic criteria is necessary when the diagnosis of the syndrome is made.

English Abstract↗
PubMed2001

[Familial hypercholesterolemia in Iceland. Review and outcome of family screening.].

Familial hypercholesterolemia is a genetic disorder causing lifelong elevation of cholesterol and severely increased risk of coronary heart disease. Cholesterol lowering drug treatment is usually effective and clinical trials indicate a substantial lowering of risk, thanks to treatment. The diagnosis is based on cholesterol level in the individual and in his/her closest relatives or on a genetic test. The prevalence is estimated 1/500. In Iceland nearly half of the estimated number of individuals with familial hypercholesterolemia has been diagnosed (about 200). Three mutations have been identified that cause familial hypercholesterolemia in the Icelandic population and the most common one is estimated to cause 60% of the disease in Iceland. In this paper we give a short review of the literature on familial hypercholesterolemia especially regarding risk of coronary heart disease and describe the results of screening for the disease in Iceland. Also we present a new campaign to find undiagnosed individuals with the disease.

English Abstract↗
PubMed2001

[Attitude of the Icelandic population towards performing cardiopulmonary resuscitation on strangers in the pre-hospital setting.].

OBJECTIVE: Initiation of bystander cardiopulmonary resuscitation (CPR) is directly linked to the outcome of cardiac arrest in the community. Recent reports have indicated a reluctance among witnesses to perform CPR on strangers especially mouth to mouth ventilation. The status of this in Iceland is unknown. The objective of this study was to assess the attitude of Icelanders towards bystander CPR. MATERIAL AND METHODS: A telephone survey was conducted on 1200 randomly selected Icelanders, aged 16-75 years, with regard to their attitude towards pre-hospital CPR on strangers. A total of 804 (70.1%) chose to participate. RESULTS: A large number had received some kind of training in CPR (73%), wheras only 6% had actually participated in CPR. In accordance, 50% thought they would be able to perform chest compressions adequately and 55% mouth to mouth ventilation. A total of 491 (65%) would likely volunteer to perform chest compressions on a stranger, while 178 (24%) would not and 84 (11%) were undecided. Similarly, 473 (64%) would likely volunteer to perform mouth to mouth ventilation on a stranger. One hundred seventy seven (24%) would not and 93 (12%) were unsure. An overwhelming majority, 620 (81%) said it would not make any difference regarding their participation in CPR if the procedure was simplified and included only chest compressions but not mouth to mouth ventilation. CONCLUSIONS: Icelanders have a very positive attitude towards bystander CPR, over two thirds have had some kind of CPR instruction and a large majority has no aversion towards performing mouth to mouth ventilation on strangers. These results are in contrast to similar data from the United States.

English Abstract↗
PubMed2001

[Fungemia and other invasive fungal infections in Icelandic children. A nationwide study.].

INTRODUCTION: Invasive fungal infections are increasing in incidence. Among those who are at increased risk of fungal blood stream infections (fungemia) and disseminated fungal infections are premature infants and immunosuppressed children. These infections are associated with high morbidity and mortality. Invasive fungal infections have not yet been studied in Iceland. MATERIAL AND METHODS: We studied all cases of fungemia and/or disseminated fungal infections in Icelandic children (16 years) during a 20 year period. Histopathology reports and autopsies were reviewed. Information on predisposing factors, symptoms, treatment and outcome was collected. All obtainable fungal blood stream isolates were subcultured and their susceptibility to common antifungals determined. RESULTS: In the 20 year period from 1980-1999, 19 episodes of invasive fungal infections were diagnosed in 18 infants and children in Iceland. Twelve episodes of fungemia occured in 11 children and the nationwide annual incidence increased from 0.28 to 1.90 cases/100,000/year (p=0.037) during the study period. Half of the children were premature infants. All patients had a central venous catheter at the time of blood culture and most had received intravenous antibiotics or corticosteroids. Candida albicans was the most commonly isolated species (nine of 12 episodes, 75%). In addition to patients with fungemia, three children were diagnosed with disseminated fungal infection by histology or autopsy. Two cases of fungal meningitis, without fungemia, were identified. Furthermore, two children had invasive infections with Aspergillus fumigatus and both patients survived. Three children (3/16; 19%) with invasive Candida-infections died. CONCLUSIONS: In this study of invasive fungal infections among Icelandic children we demonstrate that the incidence of fungemia has risen significantly in the past 20 years. Diagnosis of invasive fungal infections can be complicated and negative blood cultures do not exclude disseminated infection. Given the high attributable mortality, timely diagnosis and aggressive treatment is extremely important.

English Abstract↗