Medical abortions - experience from the first 246 treatments in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)OBJECTIVE: Medical abortion is a safe and effective treatment and is increasingly being used for termination of early pregnancy. In February 2006 medical abortion became available to women in Iceland. The purpose of this study is to assess the efficacy of medical abortion and evaluate whether it is a suitable alternative to surgical abortion in Iceland. MATERIAL AND METHODS: All eligible women (pregnancy <63 days, n=246) who chose medical abortion from February 2006 until July 2007 were included in the study. Data was collected on those who needed surgical evacuation and on other complications. RESULTS: The proportion of women who had medical abortion was 17.4% (n=246/1171). Curettage was needed in 8.9% of cases. Antibiotics were prescribed in 4.1% of cases and four women were admitted for complications without need for evacuation (urinary tract infection=2, bleeding=2), one woman was admitted to the intensive care unit for 24 hours because of unexplained fever and one woman needed blood transfusion. CONCLUSION: The success rate of more than 90% is comparable to what has been reported in other studies (92-99%) and this treatment option has proven to be safe in our settings. In total 17.4% of women opting for abortion had a medical abortion compared to 50% in Sweden and 46% in Denmark. With more experience and general awareness of the possibilities of medical abortion the ratio is likely to increase.Tilgangur: Fóstureyðing með lyfjum er örugg og árangursrík meðferð og er í auknum mæli beitt sem fyrsta vali snemma á meðgöngu. Í febrúar 2006 var byrjað að bjóða konum á Íslandi slíka meðferð. Tilgangur rannsóknarinnar er að meta árangur af fóstureyðingum með lyfjum og kanna hvort þær séu heppilegur valkostur við aðgerðir á Íslandi. Efniviður og aðferðir: Allar konur sem gengust undir fóstureyðingu með lyfjum frá febrúar 2006 til júlí 2007 og uppfylltu skilyrði (meðgöngulengd <63 dagar, n=246) voru teknar inn í rannsóknina. Safnað var upplýsingum um fjölda þeirra sem þurftu að fara í aðgerð og um aðra fylgikvilla. Niðurstöður: Hlutfall fóstureyðingar með lyfjum var 17,4% (n=246/1171) allra fóstureyðinga á kvennasviði Landspítala á rannsóknartímabilinu. Gera þurfti aðgerð í 8,9% tilfella. Sýklalyfjum var ávísað í 4,1% tilfella og fjórar konur voru lagðar inn vegna fylgikvilla án þess að gera þyrfti aðgerð (þvagfærasýking=2, blæðing=2), ein kona var lögð inn á gjörgæslu í einn sólarhring vegna óútskýrðs hita og ein kona þurfti blóðgjöf. Ályktun: Yfir 90% árangur er sambærilegur við það sem lýst hefur verið í öðrum rannsóknum (92-99%) og meðferðin reyndist örugg við okkar aðstæður. Aðeins 17,4% fóstureyðinga á tímabilinu voru með lyfjum samanborið við 50% í Svíþjóð og 46% í Danmörku. Með aukinni reynslu og almennri þekkingu um meðferðina má búast við því að hlutfallið muni hækka

Liver metastases of unknown origin

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Approximately 5% of cancer patients are diagnosed with tumour of unknown origin (3-4% in Iceland). Of those 10-30% have . Liver metastases of unknown origin is thus not an uncommon problem. In the present study information about the origin and histology of liver metastases of unknown origin was compiled. Material and methods: Records of all biopsies from liver metastases performed in the years 1987-1996 were retrieved from the medical database of the Department of Pathology at the University of Iceland. The biopsies came from a group of 176 patients. Ninety-two cases, in which the origin of the primary tumour was suspected or known, were excluded from the study, leaving 84 cases where the primary was completely unknown. The database of the Icelandic Cancer Society was used to gather data about the final tissue diagnosis and the location of the primary tumour when known. Results: The Cancer Society data revealed the location of the primary tumour in 55 of the 84 cases of liver metastases of unknown origin. The most prevalent (75%) primary tumours were cancers of the pancreas (15), lung (13) and colon/rectum (12). The tissue diagnosis was adenocarcinoma in 33 of the 55 cases. In the male patients 83% of the adenocarcinoma metastases came from the colon/rectum or pancreas. The corresponding figure for the female patients was 67%, while 20% of the tumours in females originated in the gallbladder and biliary tree. Conclusions: In two thirds of the cases of liver metastases of unknown origin the primary tumour was later discovered. The most prevalent tumours were cancers in the pancreas, lung and colon/rectum. Adenocarcinoma was the tissue diagnosis in 60% of cases.Tilgangur: Um 5% krabbameinssjúklinga greinast með æxli af óþekktum uppruna (3-4% á Íslandi). Af þeim hafa 10-30% meinvörp í lifur. Lifrarmeinvörp af óþekktum uppruna er því ekki sjaldgæft vandamál. Meinafræðingar eru oft beðnir um að skoða sýni frá lifrarmeinvörpum og koma með tillögur um staðsetningu frumæxlis. Í þessari rannsókn eru teknar saman upplýsingar um uppruna og vefjagerð lifrarmeinvarpa af óþekktum uppruna. Efniviður og aðferðir: Leitað var í skrám Rannsóknastofu Háskólans í meinafræði að öllum skráðum grófnálarsýnum frá meinvörpum í lifur frá árunum 1987-1996. Alls fundust sýni frá 176 sjúklingum. Útilokaðir voru 92 sjúklingar sem höfðu þekkt frumæxli eða vísbendingu um upprunastað. Þeir 84 sjúklingar sem eftir voru töldust hafa meinvörp af óþekktum uppruna. Könnuð var niðurstaða vefjagreiningar í gögnum Rannsóknastofunnar. Leitað var í Krabbameinsskrá Krabbameinsfélags Íslands að upplýsingum um endanlega vefjagreiningu og staðsetningu frumæxlis. Niðurstöður: Krabbameinsskrá gaf upplýsingar um staðsetningu frumæxlis hjá 55 sjúklingum af 84 sem greindust með lifrarmeinvörp af óþekktum uppruna. Algengustu frumæxlin (75%) voru krabbamein í brisi (15), lunga (13) og ristli/endaþarmi (12). Hjá 33 sjúklingum af 55 var vefjagerðin kirtlakrabbamein (adenocarcinoma). Hjá körlum voru 83% kirtlakrabbameinsmeinvarpa upprunnin í ristli eða brisi, en 67% hjá konum, þar sem 20% komu frá gallblöðru/gallvegum. Ályktanir: Í tveimur þriðju tilfella kom upprunastaður að lokum í ljós fyrir lifrarmeinvörp af óþekktum uppruna. Algengustu frumæxlin voru krabbamein í brisi, lungum og ristli/endaþarmi. Kirtlakrabbamein var vefjagreiningin í 60% tilfella

Young adults with type 1 diabetes and their experiences with diabetes follow‐up and participation in the DiaPROM pilot trial: A qualitative study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Aim To explore young adults' experiences of outpatient follow‐up appointments, completing electronic Patient‐Reported Outcome Measures (PROMs), and using the Problem Areas In Diabetes (PAID) scale during the Diabetes Patient‐Reported Outcome Measures (DiaPROM) pilot trial. Methods We performed a qualitative study among 19 young adults (aged 22–39 years) with type 1 diabetes who participated in the pilot trial. Between February and June 2019, we conducted individual, semi‐structured telephone interviews with participants from the intervention and control arms. We analysed the data using thematic analysis. Results Our analyses generated three themes, each with two subthemes: (1) Follow‐up with limitations; (i) Marginal dialogue about everyday challenges, (ii) Value of supportive relationships and continuity, indicate that previous follow‐up had been experienced as challenging and insufficient. (2) New insights and raised awareness; (i) More life‐oriented insights, (ii) Moving out of the comfort zone, suggest mostly positive experiences with completing questionnaires and discussing the PAID scores. (3) Addressing problem areas with an open mind; (i) Need for elaboration, (ii) Preparedness for dialogue, indicate that both openness and explanations were vital in the follow‐up. Conclusions Participants characterised the previous follow‐up as challenging and insufficient. They described completing and using the PAID as somewhat uncomfortable yet worthwhile. Our findings also suggest that by utilising diabetes distress data alongside health and biomedical outcomes, consultations became more attuned to the young adults' wishes and needs, mainly because the dialogue was more focused and direct. Hence, the PAID has the potential to facilitate person‐centredness and improve patient–provider relationships.publishedVersio

Resilience among older adults living at home : Urban-rural difference in a population-based study

Funding Information: The research was funded with grants from the Icelandic Regional Development Institute, the University of Akureyri Research Fund, the Akureyri Hospital Research Fund, and the Icelandic Nurses´ Association Research Fund. None of these hold a specific grant number. Publisher Copyright: © by Società Italiana di Gerontologia e Geriatria (SIGG).Objective. We examined how individual and contextual factors affect resilience in community-dwelling older adults living in urban or rural areas in Northern Iceland. Methods. A cross-sectional study, conducted from 2017–2018, ran-domly sampled community-dwelling older adults (age ≥ 65) stratified by residency (urban/rural), age, and gender. Results. Compared with rural dwellers (n = 75), urban dwellers (n = 105) had more education (p 0.001). Conclusions. We found a significant association between contextual and individual factors and resilience. To enable older adults to live lon-ger in their own homes, health care professionals should pay attention to health literacy and mental health factors that increase resilience.Peer reviewe

Cutavirus in cutaneous malignant melanoma

A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains to be investigated

Elections and Ethnic Civil War

Existing research on how democratization may influence the risk of civil war tends to consider only changes in the overall level of democracy and rarely examines explicitly the postulated mechanisms relating democratization to incentives for violence. The authors argue that typically highlighted key mechanisms imply that elections should be especially likely to affect ethnic groups’ inclination to resort to violence. Distinguishing between types of conflict and the order of competitive elections, the authors find that ethnic civil wars are more likely to erupt after competitive elections, especially after first and second elections following periods of no polling. When disaggregating to the level of individual ethnic groups and conflicts over territory or government, the authors find some support for the notion that ethno-nationalist mobilization and sore-loser effects provoke postelectoral violence. More specifically, although large groups in general are more likely to engage in governmental conflicts, they are especially likely to do so after noncompetitive elections. Competitive elections, however, strongly reduce the risk of conflict. </jats:p

Gradual caldera collapse at Bárdarbunga volcano, Iceland, regulated by lateral magma outflow

Large volcanic eruptions on Earth commonly occur with a collapse of the roof of a crustal magma reservoir, forming a caldera. Only a few such collapses occur per century, and the lack of detailed observations has obscured insight into the mechanical interplay between collapse and eruption.We usemultiparameter geophysical and geochemical data to show that the 110-squarekilometer and 65-meter-deep collapse of Bárdarbunga caldera in 2014-2015 was initiated through withdrawal of magma, and lateral migration through a 48-kilometers-long dike, from a 12-kilometers deep reservoir. Interaction between the pressure exerted by the subsiding reservoir roof and the physical properties of the subsurface flow path explain the gradual, nearexponential decline of both collapse rate and the intensity of the 180-day-long eruption.</p

Evidence of unidirectional hybridization and second‐generation adult hybrid between the two largest animals on Earth, the fin and blue whales

Biodiversity in the oceans has dramatically declined since the beginning of the industrial era, with accelerated loss of marine biodiversity impairing the ocean's capacity to maintain vital ecosystem services. A few organisms epitomize the damaging and long‐lasting effects of anthropogenic exploitation: some whale species, for instance, were brought to the brink of extinction, with their population sizes reduced to such low levels that may have cause a significant disruption to their reproductive dynamics and facilitated hybridization events. The incidence of hybridization is nevertheless believed to be rare and very little information exist on its directionality. Here, using genetic markers, we show that all but one whale hybrid sample collected in Icelandic waters originated from the successful mating of male fin whale and female blue whale, thus suggesting unidirectional hybridization. We also demonstrate for the first time the existence of a second‐generation adult (male) hybrid resulting from a backcross between a female hybrid and a pure male fin whale. The incidence of hybridization events between fin and blue whales is likely underestimated and the observed unidirectional hybridization (for F1 and F2 hybrids) is likely to induce a reproductive loss in blue whale, which may represent an additional challenge to its recovery in the Atlantic Ocean compared to other rorquals