Pancreatic mass leading to left-sided portal hypertension, causing bleeding from isolated gastric varices.

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.Mucinous cystic neoplasms (MCN) are an uncommon form of exocrine neoplasms of the pancreas. Symptoms are most often vague and this makes the diagnosis more difficult. The current case is one of three cases yet reported where the MCN caused left-sided portal hypertension leading to the formation of isolated gastric varices and subsequent bleeding from the varices. In the previously reported cases the main symptom was hematemesis. However in the current case the patient experienced no hematemesis, only isolated incidents of dark coloured diarrhea, but the main symptoms were those of iron-deficiency anemia. We present the case report of a 34-year-old woman who presented with dizziness and lethargy and was found to have 12 cm MCN in the pancreas

The value of magnetic resonance cholangiopancreatography for the exclusion of choledocholithiasis.

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.To investigate the ability of Magnetic resonance cholangiopancreatography (MRCP) to exclude choledocholithiasis (CDL) in symptomatic patients.Patients suspected of choledocholithiasis who underwent MRCP from 2008 through 2013 in a population based study at the National University Hospital of Iceland were retrospectively analysed, using ERCP and/or intraoperative cholangiography as a gold standard diagnosis for CDL.Overall 920 patients [66% women, mean age 55 years (SD 21)] underwent MRCP. A total of 392 patients had a normal MRCP of which 71 underwent an ERCP investigation demonstrating a CBD stone in 29 patients. A normal MRCP was found to have a 93% negative predictive value (NPV) and 89% probability of having no CBD stone demonstrated as well as no readmission due to gallstone disease within six months following MRCP. During a 6-month follow-up period of the 321 patients who did not undergo an ERCP nine (2.8%) patients were readmitted with right upper quadrant pain and elevated liver tests which later normalised with no CBD stone being demonstrated, three (0.9%) patients were readmitted with presumed gallstone pancreatitis, two (0.6%) patients were readmitted with cholecystitis and two (0.6%) patients were lost to follow-up. Seven patients of those 321 underwent an intraoperative cholangiography (IOC) and all were negative for CBD stones. For the sub-group requiring ERCP following a normal MRCP the NPV was 63%.Our results support the use of MRCP as a tool for exclusion of choledocholithiasis with the potential to reduce the amount of unnecessary ERCP procedures

Er þörf á sérstakri heilbrigðismóttöku fyrir háskólanemendur?

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnTilgangur: Víða erlendis hafa háskólanemendur aðgang að heilbrigðisþjónustu sem er sérstaklega ætluð þeim. Tilgangur þessarar könnunar meðal nemenda við Háskóla Íslands var að skoða þörf þeirra fyrir sérstaka heilbrigðismóttöku. Aðferð: Rafræn könnun var lögð fyrir 9744 nemendur við háskólann vorið 2011 sem voru á póstlista. Spurningalistinn var saminn af vinnuhópi sem í voru fulltrúar frá öllum deildum Heilbrigðisvísindasviðs Háskóla Íslands. Stuðst var við lýsandi tölfræði við gagnagreiningu. Niðurstöður: Alls bárust svör frá 1487 þátttakendum, 1427 íslenskumælandi og 60 enskumælandi, og gefa svörin því mynd af viðhorfum 15,2% nemenda við skólann. Úrtakið endurspeglar einkum viðhorf kvenstúdenta og nema í grunnnámi. Tæplega 40% íslensku nemanna og um 70% þeirra erlendu höfðu ekki heimilislækni á höfuðborgarsvæðinu. Niðurstöður sýndu að meirihluti þeirra þurfti á heilbrigðisþjónustu að halda á árinu fyrir könnunina en rúmlega helmingur beið með að leita eftir heilbrigðisþjónustu og var meginástæða þess kostnaður. Um þriðjungur íslensku nemanna og fimmtungur þeirra erlendu sögðust eiga í fjárhagsvanda. Um 92% þeirra íslensku og allir erlendu nemarnir sögðust mundu leita á móttöku þar sem þjónustan væri veitt af nemendum skólans undir leiðsögn kennara. Báðir hóparnir vildu hafa aðgang að fjölbreyttri heilbrigðisþjónustu. Ályktanir: Niðurstöðurnar gefa til kynna að þeir háskólanemendur, sem þátt tóku í könnuninni, hafi mikla þörf fyrir sérstaka heilbrigðismóttöku. Kostnaður hefur hvað mest hindrað þá í að leita eftir heilbrigðisþjónustu. Jafnframt er stór hópur án heimilislæknis, einkum sá erlendi, og hefur því ekki greiðan aðgang að heilbrigðisþjónustu á heilsugæslustöðvum.Purpose: In many neighbouring countries university students have access to health services which are specially geared to their needs. The purpose of this survey among university students at the University of Iceland was to explore their need for a special health service. Method: The online survey was administered to 9744 students at the university in the spring of 2011 who were registered e-mail recipients, both Icelandic and English-speaking. The questionnaire was developed by a working group which consisted of representatives from all the faculties at the School of Health Sciences. Data were analysed by descriptive statistical methods. Results: There were 1487 participants who responded, 1427 Icelandic and 60 English-speaking representing 15,2% of the university student population. The sample represents especially the attitudes of undergraduate and female students. Almost 40% of the Icelandic students and nearly 70% of the English-speaking students did not have a family practitioner in the capital area. The results showed that the great majority of respondents had needed health services in the year before the study took place. More than half of them reported that they had postponed seeking health services citing cost as the main reason. About 92% of the Icelandic students and all of the foreign students reported that they would attend a health clinic which was provided by university students under supervision. Both groups would like to have access to various health care services. Conclusions: The results indicate that university students who answered the questionnaire had a great need for special health clinic. Costs of service had mainly prevented them from seeking health care services. Additionally, the proportion of students without a family practitioner is high, especially among the foreign students, which is a further hindrance regarding access to primary health care services.Heilbrigðisvísindasvið Landspítal

„Það er fróðlegt og krefjandi að vinna í teymi“- Þverfræðilegt nám á heilbrigðisvísindasviði Háskóla Íslands: þriggja ára þróunarverkefni

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 Downloa

Multidrug-resistant Tuberculosis Management in Resource-limited Settings

Managing MDRTB through national programs can yield results similar to those seen in wealthier settings

The academic–vocational divide in three Nordic countries : implications for social class and gender

In this study we examine how the academic–vocational divide is manifested today in Finland, Iceland and Sweden in the division between vocationally (VET) and academicallyoriented programmes at the upper-secondary school level. The paper is based on a critical re-analysis of results from previous studies; in it we investigate the implications of this divide for class and gender inequalities. The theoretical lens used for the synthesis is based on Bernstein´s theory of pedagogic codes. In the re-analysis we draw on previous studies of policy, curriculum and educational praxis as well as official statistics. The main conclusions are that contemporary policy and curriculum trends in all three countries are dominated by a neo-liberal discourse stressing principles such as “market relevance” and employability. This trend strengthens the academic–vocational divide, mainly through an organisation of knowledge in VET that separates it from more general and theoretical elements. This trend also seems to affect VET students’ transitions in terms of reduced access to higher education, particularly in male-dominated programmes. We also identify low expectations for VET students, manifested through choice of textbooks and tasks, organisation of teacher teams and the advice of career counsellors.Peer reviewe

Healthy Privacy Measures: The legal framework of health data collection, storage, and use under the GDPR

The primary objective of this thesis is to shed light on the legal environment of the EU when it comes to the storage and processing of health data. Every aspect is explored, from data gathering to the grounds legitimizing such storage and processing, a pressing issue in light of new data-driven technologies that are pushing boundaries in the healthcare industry. Traditional methods legitimizing data processing and storage have faced criticism for being outdated, particularly concerning informed consent. Often, subjects may not fully comprehend the implications of their consent. Secondly, they may not be able to understand what they are consenting to because the processing involves an algorithm that uses reinforcement learning. This makes it difficult for the controller to explain the reasoning behind decisions. While some scholars argue that the consent requirement is overly burdensome, they often overlook the fundamental idea of informed consent, rooted in the ICCPR and other crucial documents. Controllers could enhance consent effectiveness by exploring updated forms, such as a standardized and dynamic consent solution. Controllers can also draw help from the technical and organisational measures and principles of the GDPR. Public education efforts could highlight potential dangers of special processing methods, possibly using standardized simple pictograms for better understanding. Further to that many questions have arisen about the IoT, cloud computing, and other eHealth solutions that appear to have only positive outcomes, but they also raise concerns about data protection which the manufacturers and developers of these technologies must keep in mind when designing their systems. Finally, we examine the European Data Health Space, an initiative aiming to enhance access to quality health data, benefiting researchers, healthcare providers, and the public through improved access to their own health data

Grenndarkynning: Brot á upplýsingaskyldu sem varðar aðra hluti en eiginleika fasteignarinnar sem slíkrar

Flest mál vegna galla í fasteignaviðskiptum má rekja til einhverskonar vankanta á lóð, íbúð eða húsi sem raktir verða til hönnunar, byggingar eða ónógs viðhalds. Af orðalagi fasteignakaupalaga nr. 42/2002 og lögskýringargögnum þeirra er þó ljóst að hugtakið galli er ekki bundið við slík atriði. Í þessari ritgerð er dómaframkvæmd rakin um nágranna sem galla, hvenær upplýsingaskylda virkjast og hversu ítarleg hún er. Ásamt umfjöllun um nágranna verður farið sérstaklega yfir upplýsinga- og aðgæsluskyldu vegna áforma um breytingar á nærumhverfi fasteigna. Loks verður litið til annarra mögulegra galla svo sem vegna lyktar- eða annars konar mengunar, forsögu íbúðarinnar og aðgæslu- og upplýsingaskyldu vegna slíkra þátta. Til skýringar ofangreindra þátta er vikið að nábýlisrétti og þolmörkum hans

Skaðminnkun vímuefnastefnu. Samanburður á stefnu Hollands, Portúgal og Kanada

Skaðaminnkun er nálgun við fólk sem á við erfiðan vímuefnasjúkdóm að stríða og hefur verið notuð til að minnka þann skaða sem vímuefnaneysla hefur í för með sér, með reyndum árangri. Nálgunin felur í sér að draga úr þeim heilsufarslega, fjárhagslega og félagslega skaða sem hægt er að fyrirbyggja. Þáttur í því er að beita aðgerðum sem minnka líkur á því að þeir einstaklingar sem neyta ólöglegra vímuefna fái á sig neikvæðan stimpil. Með skaðaminnkandi nálgun er litið á vímuefnasjúkdóm sem viðfangsefni heilbrigðiskerfisins og að þar með sé þörf á því að endurskoða viðurlagapólitík stjórnvalda þegar kemur að minniháttar vímuefnabrotum. Með minniháttar brotum er átt við t.d. meðferð eða vörslu lítilla neysluskammta einstaklinga sem haldnir eru vímuefnasjúkdómi. Tilgangur fræðilegu úttektarinnar er að skoða þætti í skaðaminnkandi vímuefnastefnu stjórnvalda og skoða hvaða margskonar áhrif stefna stjórnvalda getur haft á einstakling og samfélagið í heild. Í ritgerðinni verða auk þess bornar saman mismunandi leiðir til að móta stefnu í vímuefnamálum og síðan fjallað um hvaða árangri þær hafa skilað í þeim þremur löndum sem tekin eru til skoðunar. Í umræðukafla verður leitast við að varpa ljósi á orðræðu fjölmiðla og stjórnmálamanna að undanförnu um skaðaminnkun á Íslandi og hvernig sú umræða hefur áhrif á löggjöf og viðhorf stjórnvalda á Íslandi. Í ályktunarkafla er síðan velt upp spurningum um framtíðarsýn skaðaminnkunar sem hugmyndafræði á Íslandi.Harm reduction is an evidence based approach for people dealing with a severe substance abuse disease and has been used to reduce the harm substance abuse can cause. The approach has been shown to reduce foreseeable harm related to health, economical and social status of drug users. Harm reduction approach includes, among other, reducing stigma associated with illegal drug use. Substance abuse disease is viewed as an assignment for the healthcare system and a need to reevaluate penalty politics of government, in relation to small drug related offense is seen as imperative. Small drug related offense refers to drug possession for personal use and drug usage of people with a substance abuse disease. The aim of this review is to examine the emphasis of the authorities on harm reduction regulations, and look into the various effects governmental regulations can have on individuals and society as a whole. In addition, this final thesis will compare variable ways of forming drug addiction policies in three countries and what results they have achieved. In the discussion chapter light will be shed on current discourse of media and politicians in Iceland on harm reduction and how the discussion can affect legislation and position of authorities. In conclusion, questions about the future of harm reduction as an ideology in Iceland are raised