Postgraduate medical education in Iceland; medical students' and residents' attitude

Hægt er að lesa greinina í heild sinni með því að smella á hlekkinn View/OpenBACKGROUND: Various parties have expressed interest in establishing formal postgraduate medical education programs. The interest of residents and medical students to such programs in Iceland has not been evaluated before. METHODS: A questionnaire was sent to 146 interns and residents and 84 senior medical students. The following variables were analyzed: Gender, attitude towards postgraduate training in Iceland, interest to participate in such training, preferred specialty and which factors might influence their decision. RESULTS: 100 subjects completed the questionnaire (response rate 45%), 61 interns and residents and 39 medical students. Of those completing the questionnaire, most interns and residents (97%) and medical students (87%) agreed or agreed strongly with the concept of postgraduate training in Iceland. The majority of responders wanted to undergo part of their postgraduate training in Iceland if this option would be available. Those who preferred postgraduate training in Iceland did so for the following reasons: The importance of "hands-on" training, availability of consultants, favorable social setting and organized teaching. Those who wanted to do all their postgraduate training abroad rated case variability, "hands-on" training, organized teaching and research opportunities as the main factors influencing their decision. CONCLUSIONS: Interns, residents and medical students are in favor of undergoing part of their postgraduate training in Iceland. Those who chose to train abroad rated case variability and research opportunities higher than those in favor of training in Iceland.Inngangur: Ýmsir hafa lýst áhuga á skipulegu sérfræðinámi í læknisfræði á Íslandi. Áhugi og afstaða unglækna og læknanema til slíks náms hefur ekki verið athuguð áður. Efniviður og aðferðir: Í ársbyrjun 2004 var sendur spurningalisti til 146 unglækna og 84 læknanema á fimmta og sjötta ári í læknisfræði. Spurt var um kyn, afstöðu til sérfræðináms á Íslandi, áhuga á að stunda slíkt nám og í hvaða sérgrein viðkomandi stefndi. Einnig var spurt hvaða þættir hefðu áhrif á ákvarðanir svarenda um val á sérfræðinámi og þáttum raðað eftir mikilvægi. Niðurstöður: Alls svöruðu 100 manns spurningalista (svarhlutfall 45%), 61 unglæknir (deildarlæknar og kandídatar) og 39 læknanemar. Af innsendum svörum voru langflestir unglæknar (97%) og lækna­nemar (87%) mjög hlynntir eða frekar hlynntir sérfræðinámi á Íslandi. Meirihluti þeirra er svaraði vildi stunda hluta sérfræðináms hérlendis. Þeir sem kusu hluta sérfræðináms á Íslandi sögðu verklega þjálfun, aðgengi að sérfræðingum, fjölskyldu­aðstæður og skipulega fræðslu ráða mestu um þetta val. Þeir sem vildu alfarið sérfræði­nám erlendis mátu mest sjúklingaúrval, verklega þjálfun, skipulega fræðslu og rannsóknatækifæri. Samantekt: Unglæknar og læknanemar eru hlynntir því að taka hluta síns sérfræðináms á Íslandi. Þeir sem kusu sérfræðinám erlendis mátu sjúklingaúrval og rannsóknatækifæri meir en þeir sem vildu sérfræðinám á Íslandi

Sex differences in reported and objectively measured sleep in COPD.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.The aim was to assess and compare reported sleep disturbances and objectively measured sleep in men and women with COPD compared with controls and also explore sex differences.A total of 96 patients with COPD and 90 age- and sex-matched controls answered a sleep questionnaire, underwent ambulatory polysomnography, a post-bronchodilatory spirometry, and blood sampling.Of the patients with COPD, 51% reported sleep disturbances as compared with 31% in controls (P=0.008). Sleep disturbances were significantly more prevalent in males with COPD compared with controls, whereas there was no significant difference in females. The use of hypnotics was more common among patients with COPD compared with controls, both in men (15% vs 0%, P=0.009) and women (36% vs 16%, P=0.03). The men with COPD had significantly longer recorded sleep latency than the male control group (23 vs 9.3 minutes, P<0.001), while no corresponding difference was found in women. In men with COPD, those with reported sleep disturbances had lower forced vital capacity, higher C-reactive protein, myeloperoxidase, and higher prevalence of chronic bronchitis.The COPD was associated with impaired sleep in men while the association was less clear in women. This was also confirmed by recorded longer sleep latency in male subjects with COPD compared with controls.Swedish Heart and Lung Foundation Swedish Association against Heart and Lung Disease

Clinical guidelines from Landspitali University Hospital on the diagnosis and treatment of acute asthma exacerbation

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)janúar 2003 voru gefnar út á vegum Scottish Intercollegiate Guidelines (SIGN) og The British Thoracic Society vandaðar leiðbeiningar um grein-ingu og meðferð bráðrar versnunar á astma. Birt-ust leiðbeiningarnar í Thorax 2003; 58 (Suppl 1) og eru aðgengilegar á pdf-formi á slóðinni: www.sign.ac.uk/guidelines/fulltext/63/index.html Ástæða þess að talið var æskilegt að þýða og staðfæra hluta leiðbeininganna hér á landi var að um algengt bráðavandamál er að ræða sem læknar þurfa að vera færir um að bregðast við. Því er til mikilla bóta ef hægt er að nálgast einfaldar og skýrar leiðbeiningar um greiningu og meðferð þessara sjúklinga. Rétt er að benda á að heildarleiðbeiningarnar frá SIGN eru mjög ítarlegar og taka meðal annars til astma í börnum, astma á meðgöngu auk almenns fróðleiks um greiningu og meðferð sjúkdómsins. Vinnuhópurinn sem tók að sér að þýða og staðfæra þessar leiðbeiningar um bráðaversnun á astma var skipaður eftirtöldum: Hjalti Már Björnsson, deildarlæknir Gunnar Guðmundsson, lungnalæknir Jón Steinar Jónsson, heilsugæslulæknir Unnur Steina Björnsdóttir, ofnæmislæknir Inga Sif Ólafsdóttir, deildarlæknir Ari J. Jóhannesson, formaður nefndar um klínískar leiðbeiningar á Landspítala. Þar sem um er að ræða gagnreynda (evidence based) ferla voru óverulegar breytingar gerðar á þeim við þýðingu. Nánari sundurliðun á öllum breytingum sem gerðar voru má finna á vefsvæði kínískra leiðbeininga á www.landspitali.is Uppsetning ferlanna miðast við að auðvelt sé að prenta þá út og hafa á veggspjöldum þar sem þeirra er þörf

Adults with symptoms of pneumonia : a prospective comparison of patients with and without infiltrates on chest radiography

Funding Information: The authors thank the staff at the emergency wards of Landspitali–The National University Hospital of Iceland for assistance with patient recruitment and Salvör Rafnsdóttir for her contribution in terms of patient recruitment. Funding Information: This work was supported by The Icelandic Centre for Research (Rannís) (grant number 217716-051), The Doctoral Grants of The University of Iceland Research Fund, The Scientific fund of Landspitali- The National University Hospital of Iceland, The Scandinavian Society for Antimicrobial Chemotherapy Foundation, and the Foundation of St. Josef's Hospital. The funding sources had no role in the study's design, conduct or reporting. Publisher Copyright: © 2022 The Author(s)OBJECTIVE: Most studies on patients hospitalized with community-acquired pneumonia (CAP) require confirmation of an infiltrate by chest radiography, but in practice admissions are common among patients with symptoms of pneumonia without an infiltrate (SPWI). The aim of this research was to compare clinical characteristics, microbial etiology, and outcomes among patients with CAP and SPWI. METHODS: Adults suspected of CAP were prospectively recruited at Landspitali University Hospital over a 1-year period, 2018 to 2019. The study was population based. Those admitted with two or more of the following symptoms were invited to participate: temperature ≥38°C or ≤36°C, sweating, shaking/chills, chest pain, a new cough, or new onset of dyspnea. Primary outcome was mortality at 30 days and one year. RESULTS: Six hundred twenty-five cases were included, 409 with CAP and 216 with SPWI; median age was 75 (interquartile range [IQR] 64-84) and 315 (50.4%) were females. Patients with CAP were more likely to have fever (≥38.0°C) (66.9% [273/408]) vs. 49.3% (106/215), p < 0.001), a higher CRP (median 103 [IQR 34-205] vs. 55 (IQR 17-103), p < 0.001), identification of Streptococcus pneumoniae (18.0% [64/355]) vs. 6.3% (10/159) of tested, p = 0.002) and to receive antibacterial treatment (99.5% [407/409]) vs. 87.5% (189/216), p < 0.001) but less likely to have a respiratory virus detected (25.4% [33/130]) vs. 51.2% (43/84) of tested, p < 0.001). The adjusted odds ratios for 30-day and 1 year mortality of SPWI compared to CAP were 0.86 (95% CI 0.40-1.86) and 1.46 (95% CI 0.92-2.32), respectively. DISCUSSION: SPWI is a common cause of hospitalization and despite having fever less frequently, lower inflammatory markers, and lower detection rate of pneumococci than patients with CAP, mortality is not significantly different.Peer reviewe

Inflammatory Markers, Respiratory Diseases, Lung Function and Associated Gender Differences

Systemic inflammation is associated with impaired lung function. Inflammation is part of asthma and chronic obstructive pulmonary disease (COPD), but the local and systemic inflammatory pattern differs. The overall aim was to evaluate systemic inflammatory markers in obstructive lung diseases and more specifically: To determine if CRP is related to respiratory symptoms, asthma, atopy and bronchial responsiveness (paper I), in a population sample from three countries (paper I and II); to evaluate if CRP is related to COPD, lung function and rate of lung function decline (paper II); to investigate the association of serum MMP-9 and TIMP-1 with lung function in a cross-sectional population based study (paper III); and finally, to study possible gender differences in the longitudinal association between CRP and lung function in a prospective population based study (paper IV). In the first study we reported that CRP was related to non-allergic asthma but not allergic asthma, and that CRP was related to respiratory symptoms such as wheeze, nocturnal cough and breathlessness after effort, but not associated with atopy or bronchial responsiveness. In the second study we found that COPD was more common in subjects in the highest CRP quartiles and higher CRP levels were associated with lower FEV1 values in both men and women, but the negative association between CRP and FEV1 was larger in men than women. The FEV1 decline was larger in men with high CRP levels, whereas no such association was found for women. In the third study we reported that lower FEV1 was associated with higher levels of MMP-9, TIMP-1 and their ratio MMP-9/TIMP-1. After stratification for gender this association was significant in men but not women. In the fourth study we found that CRP levels were associated with change in both FEV1 and FVC in men but not women. This association was found for both baseline CRP and change in CRP, confirming a stronger association between systemic inflammation and lung function decline in men than women. In conclusion, systemic inflammation is associated with non-allergic asthma but not allergic asthma. Our findings of a stronger association between the systemic inflammation and lung function impairment in men, but not women, may indicate a gender difference in the mechanisms of lung function decline

Inflammatory Markers, Respiratory Diseases, Lung Function and Associated Gender Differences

Systemic inflammation is associated with impaired lung function. Inflammation is part of asthma and chronic obstructive pulmonary disease (COPD), but the local and systemic inflammatory pattern differs. The overall aim was to evaluate systemic inflammatory markers in obstructive lung diseases and more specifically: To determine if CRP is related to respiratory symptoms, asthma, atopy and bronchial responsiveness (paper I), in a population sample from three countries (paper I and II); to evaluate if CRP is related to COPD, lung function and rate of lung function decline (paper II); to investigate the association of serum MMP-9 and TIMP-1 with lung function in a cross-sectional population based study (paper III); and finally, to study possible gender differences in the longitudinal association between CRP and lung function in a prospective population based study (paper IV). In the first study we reported that CRP was related to non-allergic asthma but not allergic asthma, and that CRP was related to respiratory symptoms such as wheeze, nocturnal cough and breathlessness after effort, but not associated with atopy or bronchial responsiveness. In the second study we found that COPD was more common in subjects in the highest CRP quartiles and higher CRP levels were associated with lower FEV1 values in both men and women, but the negative association between CRP and FEV1 was larger in men than women. The FEV1 decline was larger in men with high CRP levels, whereas no such association was found for women. In the third study we reported that lower FEV1 was associated with higher levels of MMP-9, TIMP-1 and their ratio MMP-9/TIMP-1. After stratification for gender this association was significant in men but not women. In the fourth study we found that CRP levels were associated with change in both FEV1 and FVC in men but not women. This association was found for both baseline CRP and change in CRP, confirming a stronger association between systemic inflammation and lung function decline in men than women. In conclusion, systemic inflammation is associated with non-allergic asthma but not allergic asthma. Our findings of a stronger association between the systemic inflammation and lung function impairment in men, but not women, may indicate a gender difference in the mechanisms of lung function decline

Inflammatory Markers, Respiratory Diseases, Lung Function and Associated Gender Differences

Systemic inflammation is associated with impaired lung function. Inflammation is part of asthma and chronic obstructive pulmonary disease (COPD), but the local and systemic inflammatory pattern differs. The overall aim was to evaluate systemic inflammatory markers in obstructive lung diseases and more specifically: To determine if CRP is related to respiratory symptoms, asthma, atopy and bronchial responsiveness (paper I), in a population sample from three countries (paper I and II); to evaluate if CRP is related to COPD, lung function and rate of lung function decline (paper II); to investigate the association of serum MMP-9 and TIMP-1 with lung function in a cross-sectional population based study (paper III); and finally, to study possible gender differences in the longitudinal association between CRP and lung function in a prospective population based study (paper IV). In the first study we reported that CRP was related to non-allergic asthma but not allergic asthma, and that CRP was related to respiratory symptoms such as wheeze, nocturnal cough and breathlessness after effort, but not associated with atopy or bronchial responsiveness. In the second study we found that COPD was more common in subjects in the highest CRP quartiles and higher CRP levels were associated with lower FEV1 values in both men and women, but the negative association between CRP and FEV1 was larger in men than women. The FEV1 decline was larger in men with high CRP levels, whereas no such association was found for women. In the third study we reported that lower FEV1 was associated with higher levels of MMP-9, TIMP-1 and their ratio MMP-9/TIMP-1. After stratification for gender this association was significant in men but not women. In the fourth study we found that CRP levels were associated with change in both FEV1 and FVC in men but not women. This association was found for both baseline CRP and change in CRP, confirming a stronger association between systemic inflammation and lung function decline in men than women. In conclusion, systemic inflammation is associated with non-allergic asthma but not allergic asthma. Our findings of a stronger association between the systemic inflammation and lung function impairment in men, but not women, may indicate a gender difference in the mechanisms of lung function decline

Postgraduate medical education in Iceland; medical students' and residents' attitude

Hægt er að lesa greinina í heild sinni með því að smella á hlekkinn View/OpenBACKGROUND: Various parties have expressed interest in establishing formal postgraduate medical education programs. The interest of residents and medical students to such programs in Iceland has not been evaluated before. METHODS: A questionnaire was sent to 146 interns and residents and 84 senior medical students. The following variables were analyzed: Gender, attitude towards postgraduate training in Iceland, interest to participate in such training, preferred specialty and which factors might influence their decision. RESULTS: 100 subjects completed the questionnaire (response rate 45%), 61 interns and residents and 39 medical students. Of those completing the questionnaire, most interns and residents (97%) and medical students (87%) agreed or agreed strongly with the concept of postgraduate training in Iceland. The majority of responders wanted to undergo part of their postgraduate training in Iceland if this option would be available. Those who preferred postgraduate training in Iceland did so for the following reasons: The importance of "hands-on" training, availability of consultants, favorable social setting and organized teaching. Those who wanted to do all their postgraduate training abroad rated case variability, "hands-on" training, organized teaching and research opportunities as the main factors influencing their decision. CONCLUSIONS: Interns, residents and medical students are in favor of undergoing part of their postgraduate training in Iceland. Those who chose to train abroad rated case variability and research opportunities higher than those in favor of training in Iceland.Inngangur: Ýmsir hafa lýst áhuga á skipulegu sérfræðinámi í læknisfræði á Íslandi. Áhugi og afstaða unglækna og læknanema til slíks náms hefur ekki verið athuguð áður. Efniviður og aðferðir: Í ársbyrjun 2004 var sendur spurningalisti til 146 unglækna og 84 læknanema á fimmta og sjötta ári í læknisfræði. Spurt var um kyn, afstöðu til sérfræðináms á Íslandi, áhuga á að stunda slíkt nám og í hvaða sérgrein viðkomandi stefndi. Einnig var spurt hvaða þættir hefðu áhrif á ákvarðanir svarenda um val á sérfræðinámi og þáttum raðað eftir mikilvægi. Niðurstöður: Alls svöruðu 100 manns spurningalista (svarhlutfall 45%), 61 unglæknir (deildarlæknar og kandídatar) og 39 læknanemar. Af innsendum svörum voru langflestir unglæknar (97%) og lækna­nemar (87%) mjög hlynntir eða frekar hlynntir sérfræðinámi á Íslandi. Meirihluti þeirra er svaraði vildi stunda hluta sérfræðináms hérlendis. Þeir sem kusu hluta sérfræðináms á Íslandi sögðu verklega þjálfun, aðgengi að sérfræðingum, fjölskyldu­aðstæður og skipulega fræðslu ráða mestu um þetta val. Þeir sem vildu alfarið sérfræði­nám erlendis mátu mest sjúklingaúrval, verklega þjálfun, skipulega fræðslu og rannsóknatækifæri. Samantekt: Unglæknar og læknanemar eru hlynntir því að taka hluta síns sérfræðináms á Íslandi. Þeir sem kusu sérfræðinám erlendis mátu sjúklingaúrval og rannsóknatækifæri meir en þeir sem vildu sérfræðinám á Íslandi

Fo shuo qi jü zhi fo mu xin da zhun ti tuo luo ni jing /

Caption title.; Special collection from London Missionary Society.; On double leaves, oriental style, in case.; Also available in an electronic version via the Internet at http://nla.gov.au/nla.gen-vn382916.880-02 Tuo luo ni jing.880-03 Tuo luo ni shuo.Buddhist magic formulae