Pediatric life support

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenDiseases which result in respiratory failure or hypotension are the most common cause of cardiac arrest in children. Whereas heart diseases are the most common cause of cardiac arrest in adults, they are uncommon cause in children. Accidents are the most common cause of out-of-hospital cardiac arrest. Prompt and skilled resuscitation efforts are important for favourable resuscitation outcome. This article provides guidelines for resuscitation in children from one month of age for health care providers. They are mainly based of recently published International Liaison Committee on Resuscitation (ILCOR) guidelines on resuscitation in children.Inngangur Sem betur fer er sjaldgæft að endurlífga þurfi börn, ef frá eru taldir nýburar sem geta þurft öndunaraðstoð í stuttan tíma fyrst eftir fæðinguna. Árangur endurlífgunartilrauna á börnum sem komin eru af nýburaskeiði er því miður ekki góður, einkum ef hjartastopp verður utan sjúkrahúsa (1-3). Hins vegar hefur sýnt sig að auknar líkur eru á að endurlífgun takist ef hún er hafin sem fyrst eftir að öndunar- eða hjartastopp verður (4). Því er mikilvægt að sem flestir kunni til verka á þessu sviði og að sérhæfð hjálp berist sem fyrst við öndunar- og hjartastopp. Gerður er greinarmunur á grunnendurlífgun (basic life support) sem framkvæmd er án sérhæfðs búnaðar og sérhæfðri endurlífgun (ad-vanced life support) þar sem notuð eru lyf og sérhæfður endurlífgunarbúnaður. Hér verður bæði fjallað um grunn- og sérhæfða endurlífgun miðað við þarfir heilbrigðisstarfsfólks, en áður hafa verið gefnar út leiðbeiningar um grunnendurlífgun fyrir almenning á vegum Skyndihjálparráðs Íslands (5). Einkum er stuðst við endurskoðaðar leiðbeiningar um endurlífgun á börnum sem gefnar voru út í lok síðasta árs á vegum European Resuscitation Council (6, 7) og American Heart Association (8-10). Í þeim er ráðlagt að nota endurlífgunarleiðbeiningar fyrir börn að kynþroskaaldri, eða ef viðkomandi lítur út fyrir að vera barn. Þetta er ólíkt eldri leiðbeiningum þar sem miðað var við ákveðið aldursmark. Hér eru gefnar leiðbeiningar um endurlífgun á börnum sem komin eru af nýburaskeiði (>1 mánaðar gömul)

Afterglow Light Curves and Broken Power Laws: A Statistical Study

In gamma-ray burst research it is quite common to fit the afterglow light curves with a broken power law to interpret the data. We apply this method to a computer simulated population of afterglows and find systematic differences between the known model parameters of the population and the ones derived from the power law fits. In general, the slope of the electron energy distribution is overestimated from the pre-break light curve slope while being underestimated from the post-break slope. We also find that the jet opening angle derived from the fits is overestimated in narrow jets and underestimated in wider ones. Results from fitting afterglow light curves with broken power laws must therefore be interpreted with caution since the uncertainties in the derived parameters might be larger than estimated from the fit. This may have implications for Hubble diagrams constructed using gamma-ray burst data.Comment: 4 pages, 5 figures, accepted for publication in ApJ Letter

Metachronous Colorectal Cancer in Icelandic MSH6 and PMS2 Lynch Syndrome Carriers in 1955-2017 : A Population-based Study

Funding Information: Funding The study was partially funded by the Research Fund at Landspitali University Hospital. The funder had no role in the design of the study, collection, analysis, and interpretation of the data or in writing the manuscript.Peer reviewe

Host Galaxies of Gamma-Ray Bursts and their Cosmological Evolution

We use numerical simulations of large scale structure formation to explore the cosmological properties of Gamma-Ray Burst (GRB) host galaxies. Among the different sub-populations found in the simulations, we identify the host galaxies as the most efficient star-forming objects, i.e. galaxies with high specific star formation rates. We find that the host candidates are low-mass, young galaxies with low to moderate star formation rate. These properties are consistent with those observed in GRB hosts, most of which are sub-luminous, blue galaxies. Assuming that host candidates are galaxies with high star formation rates would have given conclusions inconsistent with the observations. The specific star formation rate, given a galaxy mass, is shown to increase as the redshift increases. The low mass of the putative hosts makes them difficult to detect with present day telescopes and the probability density function of the specific star formation rate is predicted to change depending on whether or not these galaxies are observed.Comment: 11 pages, 10 figures. Accepted for publication in MNRA

The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics

„Við munum að eilífu minnast þess“ - Tilviksrannsókn á áfalli og upplýsingamiðlun

Ritgerð þessi fjallar um upplýsingamiðlun á áfallatímum. Frá fræðilegu sjónarhorni er fjallað er um áföll í starfsemi fyrirtækja og helstu þætti upplýsingamiðlunar í áfallastjórnun. Fjallað er um raundæmi úr íslensku samfélagi, þegar erlendur tölvuþrjótur braust inn á vefsíðu Fjarskipta hf. og stal þaðan viðkvæmum gögnum. Höfundur framkvæmdi tilviksrannsókn með það að markmiði að varpa ljósi á upplifun starfsmanna Fjarskipta hf. á upplýsingamiðlun í kjölfar áfallsins. Um eigindlega rannsókn var að ræða en gagna var aflað með djúpviðtölum þar sem notast var við opnar spurningar til að fá innsýn í upplifun viðmælenda í samræmi við aðferðir fyrirbærafræðinnar

Áreiðanleiki dánarvottorða

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenDeath certificates are a crucial source of vital statistics in society. Major policy decisions and the allocation of funds in the health sector are based on data derived from death certificates. Autopsy, despite its limitations, remains the standard against which ante mortem clinical diagnoses may best be measured. Further, the reliability of death certificates should be enhanced for those deaths, where autopsy was performed. We compared the entries on death certificates with autopsy reports for autopsies performed at three hospitals in. Reykjavik during two years, 1976 (250 cases) and 1986 (339 cases), excluding stillbirths, perinatal and forensic deaths. Overall discrepancy between death certificates and autopsy reports was 49% (1976) and 48% (1986). For immediate cause of death, discrepancies were observed in 24% (1976) and 26% (1986) of cases. For major diseases other than the immediate cause of death, discrepancies were seen in 32% (1976) and 34% (1986). We investigated changes in discrepancy when the death certificate was signed before (38 autopsies) or on the same day or later (551 autopsies) than the autopsy. No significant improvement occurred except for other major disease, where discrepancies dropped from 45% to 33%. We conclude that death certificates 1. are an unreliable source of information on causes of death and major contributing diseases, 2. do not appear to be completed using information obtained at autopsy, even when such information is accessible. 3. have not improved with the introduction, between 1976 and 1986, of sophisticated imaging techniques.Dánarvottorð veita mikilvægar upplýsingar um heilbrigði hvers þjóðfélags og byggja ákvarðanir um ráðstöfun opinberra fjármuna meðal annars á upplýsingum af dánarvottorðum. Krufning (líkrannsókn) er enn í fullu gildi til ákvörðunar sjúkdómsgreiningu og aðdraganda dauða og mætti ætla, að dánarvottorð krufinna væru áreiðanlegri en hinna er eigi voru krufðir. Bornar voru saman krufninganiðurstöður og færslur á dánarvottorð 589 látinna fyrir tvö ár með tíu ára millibili, 1976 (250 skýrslur) og 1986 (339 skýrslur). Misræmi fannst í 49% (1976) og 48% (1986) tilvika. Hvað varðar beina dánarorsök var misræmi í 24% (1976) og 26% (1986) skýrslna og hvað varðar alvarlega sjúkdóma aðra en beina dánarorsök var misræmi í 32% (1976) og 34% (1986). Misræmi var kannað eftir því hvort dánarvottorð var ritað á undan (38 skýrslur) eða sama dag (eða síðar) (551 skýrslna) og frumgreining krufningar. Ekki dró úr misræmi nema hvað varðaði aðra sjúkdóma en beina dánarorsök, þar féll misræmi úr 45% í 33%. Samkvæmt þessari athugun virðast dánarvottorð: 1. Óáreiðanleg heimild um dánarorsakir og aðra alvarlega sjúkdóma. 2. Ekki aukast að marktæki þótt vottorðsritari hafi handbærar niðurstöður krufningar. 3. Ekki aukast að marktæki frá 1976-1986 þrátt fyrir framfarir í rannsóknaraðferðum á sjúkrahúsum