Lung cancer--review

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenLung cancer is the second most common cancer in Iceland and the most frequent cause of cancer related deaths. Smoking is by far the most important cause but familial factors also contribute. The symptoms of lung cancer are often subtle and the diagnosis, in about 70% of cases, is made when metastases have occurred. Curative surgical treatment is therefore only possible in about a third of the cases whereas other patients receive chemotherapy and/or radiation therapy. In recent years some important advances have been made in the diagnostic and therapeutic approaches to lung cancer. New imaging techniques have improved diagnosis and staging practices and consequently also treatment. Recent evidence suggests that screening with low dose CT may improve survival. New approaches to chemotherapy have been shown to improve survival and well being of patients with advanced disease. Chemotherapeutic agents are now being used in conjunction with surgery to reduce the risk of tumour spread. Furthermore, advances in surgical techniques have made resections possible in cases deemed inoperable in the past. In this review we present important advances in the diagnosis and treatment of lung cancer as reflected by recent literature that should be of interest to a wide variety of specialists.Lungnakrabbamein er annað algengasta krabbameinið á Íslandi og það krabbamein sem dregur flesta Íslendinga til dauða. Orsökina má yfirleitt rekja beint til reykinga en erfðaþættir koma einnig við sögu. Einkenni lungnakrabbameins eru oft almenns eðlis. Sjúklingar greinast því oft seint og um 70% þeirra eru með meinvörp við greiningu. Skurðaðgerð í læknandi tilgangi kemur aðeins til greina í um þriðjungi tilfella en annars er beitt krabbameinslyfjum og/eða geislameðferð. Á síðustu árum hafa orðið framfarir í greiningu og meðferð lungnakrabbameins. Nýjungar í myndgreiningu auðvelda rannsóknir og stigun æxlanna og meðferð hefur því orðið markvissari. Margt bendir til þess að skimun með lágskammta tölvusneiðmyndum geti bætt horfur og lækkað dánartíðni. Nýjar tegundir krabbameinslyfja hafa bætt líðan og lengt líf sumra sjúklinga með útbreitt lungnakrabbamein. Þá er í vaxandi mæli farið að gefa krabbameinslyfjameðferð í tengslum við skurðaðgerðir, aðallega til að minnka líkur á því að krabbameinið nái að dreifa sér. Loks hafa nýjungar í skurðlækningum gert kleift að fjarlægja æxli sem áður voru talin óskurðtæk. Í þessari yfirlitsgrein eru helstu nýjungar í greiningu og meðferð lungnakrabbameins reifaðar. Byggt er á nýjustu þekkingu og heimildum en greinin er skrifuð með lækna úr sem flestum sérgreinum í huga

Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population.

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 DownloadObjective: To test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity. Design: Population-based cross-sectional study. Setting: Iceland. Participants: A total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19. Main outcome measures: Symptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities. Results: Compared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44). Conclusions: Severe disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19. Keywords: COVID-19; epidemiology; mental health; public health.Icelandic government NordFors

Lung cancer--review

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenLung cancer is the second most common cancer in Iceland and the most frequent cause of cancer related deaths. Smoking is by far the most important cause but familial factors also contribute. The symptoms of lung cancer are often subtle and the diagnosis, in about 70% of cases, is made when metastases have occurred. Curative surgical treatment is therefore only possible in about a third of the cases whereas other patients receive chemotherapy and/or radiation therapy. In recent years some important advances have been made in the diagnostic and therapeutic approaches to lung cancer. New imaging techniques have improved diagnosis and staging practices and consequently also treatment. Recent evidence suggests that screening with low dose CT may improve survival. New approaches to chemotherapy have been shown to improve survival and well being of patients with advanced disease. Chemotherapeutic agents are now being used in conjunction with surgery to reduce the risk of tumour spread. Furthermore, advances in surgical techniques have made resections possible in cases deemed inoperable in the past. In this review we present important advances in the diagnosis and treatment of lung cancer as reflected by recent literature that should be of interest to a wide variety of specialists.Lungnakrabbamein er annað algengasta krabbameinið á Íslandi og það krabbamein sem dregur flesta Íslendinga til dauða. Orsökina má yfirleitt rekja beint til reykinga en erfðaþættir koma einnig við sögu. Einkenni lungnakrabbameins eru oft almenns eðlis. Sjúklingar greinast því oft seint og um 70% þeirra eru með meinvörp við greiningu. Skurðaðgerð í læknandi tilgangi kemur aðeins til greina í um þriðjungi tilfella en annars er beitt krabbameinslyfjum og/eða geislameðferð. Á síðustu árum hafa orðið framfarir í greiningu og meðferð lungnakrabbameins. Nýjungar í myndgreiningu auðvelda rannsóknir og stigun æxlanna og meðferð hefur því orðið markvissari. Margt bendir til þess að skimun með lágskammta tölvusneiðmyndum geti bætt horfur og lækkað dánartíðni. Nýjar tegundir krabbameinslyfja hafa bætt líðan og lengt líf sumra sjúklinga með útbreitt lungnakrabbamein. Þá er í vaxandi mæli farið að gefa krabbameinslyfjameðferð í tengslum við skurðaðgerðir, aðallega til að minnka líkur á því að krabbameinið nái að dreifa sér. Loks hafa nýjungar í skurðlækningum gert kleift að fjarlægja æxli sem áður voru talin óskurðtæk. Í þessari yfirlitsgrein eru helstu nýjungar í greiningu og meðferð lungnakrabbameins reifaðar. Byggt er á nýjustu þekkingu og heimildum en greinin er skrifuð með lækna úr sem flestum sérgreinum í huga