Attitudes of Icelandic young people toward sexual and reproductive health services

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldCONTEXT: Iceland has higher levels of fertility among both adult women and adolescents than many other western European countries. There is a need to make sexual and reproductive health services more accessible to teenagers in Iceland. METHODS: A descriptive, cross-sectional national postal survey was conducted in 1996 to explore the attitudes of 2,500 young people aged 17-20 toward sexual and reproductive health services in Iceland and to determine which factors might be of importance for the development of such services. RESULTS: Icelandic adolescents want specialized sexual and reproductive health services offered within a broad-based service setting. Half of them would prefer to have these services located in a sexual and reproductive health clinic, and about one-third want such services to be located in community health centers. Having services that are free, that are anonymous and that do not require an appointment are important to teenagers who live in Reykjavik, but proximity and equal access to services are more highly valued by adolescents who live outside Reykjavik. Characteristics that young women, in particular, value include close proximity to services, access to a comfortable environment, a friendly staff, absolute confidentiality, and the ability to come with a friend and to have enough time for discussion. Adolescents who have already used contraceptive services mentioned that they need enough time for discussion and that they value high-quality client-provider interaction. CONCLUSIONS: The attitudes of adolescents should be considered when specialized sexual and reproductive health services are developed for young people in Iceland. Specialized services that respond to the unique concerns of adolescents may increase their utilization of contraceptive methods and other reproductive health services

"Unexplainable" medical histories and childhood sexual abuse. New doctoral thesis tells you how to investigate the links

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldThis is a brief summary and a personal reflection on Anne Luise Kirkengen's PhD thesis "Embodiment of sexual boundary violations in childhood". It is written to encourage other clinicians to familiarise themselves with this original and important study. It has high relevance for every clinician who is ever confronted with patients that present medical histories that are "diffuse" or unexplainable according to traditional medical knowledge

Pneumoparotitis: a new diagnostic technique and a case report

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldPneumoparotitis is a rare cause of parotid gland swelling. We report a case of self-induced pneumoparotitis that resulted in subcutaneous emphysema and pneumomediastinum after an open biopsy of the parotid gland. We suggest a new method for diagnosing this condition. This is done by insufflation of the cheeks with contrast in the oral cavity. A reflux of air and contrast is subsequently demonstrated by a computed tomography scan of the area

Hereditary cystatin C amyloid angiopathy: monitoring the presence of the Leu-68-->Gln cystatin C variant in cerebrospinal fluids and monocyte cultures by MS

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldHereditary cystatin C amyloid angiopathy (HCCAA) is an autosomal dominant condition in which the patients suffer at an early age from repeated cerebral haemorrhages. The development of HCCAA is directly linked to a Leu-68-->Gln (L68Q) mutation in the cystatin C protein sequence. The concentration of cystatin C in cerebrospinal fluid (CSF) of HCCAA patients is markedly diminished and cultivated monocytes from affected individuals accumulate cystatin C. The goal of this work was to characterize cystatin C isolated from CSF and monocyte cultures originating from healthy persons and HCCAA patients with respect to the L68Q mutation. Cystatin C was isolated by carboxymethylpapain affinity chromatography. Proteins from CSF and monocyte cultures that bound specifically to the carboxymethylated papain column were resolved by reverse-phase HPLC chromatography and tryptic peptides were subsequently analysed by matrix-assisted laser desorption ionization MS. No evidence for mutated cystatin C protein was found in CSF samples from healthy subjects or HCCAA patients, but approx. 60% of the protein was found to be hydroxylated on Pro-3. No evidence was found for secretion of mutated cystatin C from HCCAA monocytes. However, we obtained evidence for the presence of mutated cystatin C in HCCAA monocytes. These results support the conclusion that the mutated cystatin C is retained in association with the monocytes and not secreted. An increased intracellular concentration would presumably promote the aggregation and denaturation of the mutated cystatin C, leading to the formation of amyloid fibrils and cell death

Preventive geriatrics

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe concepts of geriatric medicine and prevention are described. The first speciality recognition of geriatric medicine was granted in 1981 and over 10 speciality diplomas have since been granted by the health authorities in Iceland. The three stages of prevention and methods for detecting risk factors are described. General and special recommendations for medical prevention for the elderly are reviewed. It has been estimated that a third of recent reduction in coronary mortality in Iceland can be attributed to progress in medical technology and two thirds to reduction in risk factor prevalence. Nordic Geriatric Work-up has put an emphasis on geriatric assessment which has been shown to be of preventive value for the frail elderly. Life expectancy at birth has increased by 20 years over 75 years and the population ratio of centenarians has more than doubled for the past 20 years in Iceland. The demand for tertiary prevention and geriatric assessment will continue to grow.Í þessu stutta yfirliti verður fyrst lýst skilgreiningum á heitum í titli greinarinnar. Lýst er marklýsingu sérgreinarinnar en fyrsta sérfræðiviðurkenningin í öldrunarlækningum var veitt árið 1981 á Íslandi. Gerð er grein fyrir þríþátta eðli forvarna í læknisfræði og lýst aðferðum við leit að áhættuþáttum. Tekið er saman með hvaða forvörnum innlendar og erlendar rannsóknir mæla, bæði almennt og með sérstöku tilliti til aldraðra. Um þriðjung af nýlegri lækkun á dánartíðni vegna kransæðasjúkdóma á Íslandi má rekja til framfara í lækningum og um tvo þriðju til dvínandi áhættuþátta. Getið er samnorrænnar vinnu um fjölþátta mat til forvarna í öldrunarlækningum. Sýnt hefur verið fram á að sérhæfðar öldrunarlækningar skila marktækum árangri með öldrunarmati. Ævilíkur Íslendinga við fæðingu hafa aukist um 20 ár á 75 árum og breytingar á lifun yfir 100 ára aldur hefur meir en tvöfaldast á síðasta áratugi. Þessi þróun eykur þarfir fyrir þriðja stigs forvarnir og fjölþátta öldrunarmat

Manneldismál [tímarit]

Neðst á síðunni er hægt að nálgast ritið í heild sinni með því að smella á hlekkinn View/OpenTímaritið Manneldismál 2. tbl. 2 .árg. Mars 1980. Titill: Ráðstefnúútgáfa nr. 1. : neysluvenjur og heilsufar. - Ritstjóri Ársæll Jónsson - Tímaritið er skannað inn og er 65 MB að stærð - Ath töluverðan tíma getur tekið að sækja ritið

Ventilator treatment in the Nordic countries. A multicenter survey.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldBACKGROUND: A 1-day point prevalence study was performed in the Nordic countries to identify ventilator-treatment strategies in the region. MATERIAL AND METHODS: On 30 May 30 2001 all mechanically ventilated patients in 27 intensive care units (ICUs) were registered via the internet. The results are shown as medians (25th, 75th percentile). RESULTS: One hundred and eight patients were included (69% male) with new simplified acute physiology score (SAPS) 48 (37,57) and 4.5 d (2,11) of ventilator treatment. The most frequent indication for ventilator treatment was acute respiratory failure (73%). Airway management was by endotracheal tube (64%), tracheostomy (32%) and facial mask (4%). Pressure regulated ventilator modes were used in 86% of the patients and spontaneous triggering was allowed in 75%. The tidal volume was 7 ml/kg (6,9), peak inspiratory pressure 22 cmH2O (18,26) and positive end-expiratory pressure (PEEP) 6 cmH2O (6,9). FiO2 was 40% (35,50), SaO2 97% (95-98), PaO2 11 kPa (10,13), PaCO2 5.4 kPa (4.7,6.3), pH 7.43 (7.38,7.47) and BE 2.0 mmol/l (- 0.5,5). The PaO2/FiO2 ratio was 220 mmHg (166,283). The peak inspiratory pressure (r=0.37), mean airway pressure (r=0.36), PEEP (r=0.33), tidal volume (r=0.22) and SAPS score (r=0.19) were identified as independent variables in relation to the PaO2/FiO2 ratio. CONCLUSION: The vast majority of patients were ventilated with pressure-regulated modes. Tidal volume was well below what has been considered conventional in recent large trials. Correlations between the parameters of gas exchange, respiratory mechanics, ventilator settings and physiological status of the patients was poor. It appears that blood gas values are the main tool used to steer ventilator treatment. These results may help to design future interventional studies of ventilator treatment