Iceland

The question Icelandic neurologists get asked most frequently by colleagues visiting our island of 300 000 inhabitants in the North Atlantic is: "How many neurologists are practicing in Iceland?" The answer always raises an eyebrow. There are 13 more or less full-time neurologists, including 10 working at the only university hospital. This relative abundance of neurologists of one for every 25 000 contrasts with one for every 170 000 in the UK, for example.1 The principal hospital in Iceland, the Landspitali University Hospital in the capital Reykjavik, serves as the primary hospital for at least two thirds of the population and as the referral hospital for the rest of the population

Iceland

The question Icelandic neurologists get asked most frequently by colleagues visiting our island of 300 000 inhabitants in the North Atlantic is: "How many neurologists are practicing in Iceland?" The answer always raises an eyebrow. There are 13 more or less full-time neurologists, including 10 working at the only university hospital. This relative abundance of neurologists of one for every 25 000 contrasts with one for every 170 000 in the UK, for example.1 The principal hospital in Iceland, the Landspitali University Hospital in the capital Reykjavik, serves as the primary hospital for at least two thirds of the population and as the referral hospital for the rest of the population

Incidence and outcome of Guillain-Barré syndrome in Iceland: A population-based study.

To access publisher's full text version of this article click on the hyperlink belowIn this study, we determine the incidence and outcomes of Guillain-Barré syndrome (GBS) in Iceland over a 20-year period. Cases were identified from the records of both referral hospitals in the country. All cases met the Brighton Criteria for GBS. Disability was assessed at diagnosis, peak of symptoms, discharge, and follow-up using the Guillain-Barré Disability Scale. Sixty-three individuals fulfilled the diagnostic criteria with an average age of onset of 46 years (range 1-89 years) and a male:female ratio of 1. The average annual incidence was 1.1 per 100 000 person-years. Nerve conduction studies were consistent with demyelinating polyneuropathy in 87% of cases, acute motor axonal neuropathy (AMAN) in 4%, and were normal in 9%. Treatment was received by 89% of patients and included IVIG (84%), plasmapheresis (8%), or both treatments (3%). Mechanical ventilation was required by 22% of patients. Long-term follow-up with an average length of 6.5 years was available for 98% of patients, and the average GBS disability score at follow-up was 0.9. Four deaths related to GBS (6%) were observed. We believe we have identified all patients diagnosed with GBS in Iceland during the study period, with an incidence comparable to recent studies from well-defined populations around the world. Our reported mortality is similar to or higher than other population-based studies. At follow-up, 13% of patients still required a walking aid, but most survivors (74%) had minor or no symptoms.Helga Jonsdottir Memorial Fund Sigurlidi Kristjansso

Case fatality after acute stroke at the Reykjavik Hospital in 1996-1997

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: The purpose of this study was to describe case-fatality after acute stroke at the Reykjavik Hospital. A study describing the outcome of stroke patients in an Icelandic population has not been published before. Material and methods: A prospective hospital-based stroke registry has been conducted at the Reykjavik Hospital since January 1996. Patients with ischemic stroke and intracerebral hemorrhage were included in this study but patients with transient ischemic attack (TIA), subarachnoid hemorrhage and hemorrhage due to hereditary cystatin C amyloid angiopathy were excluded. We describe the severity of symptoms at stroke onset, length of hospital stay and outcome. Results: In 1996 and 1997 a total of 377 events were registered. Ischemic stroke was diagnosed in 88% and hemorrhagic stroke in 12%. The case-fatality was 17%, 71% of the patients were discharged home and 12% to nursing care. The average length of hospital stay was 28.7 days (95% CI 24.1-33.3) and 63% of patients were treated at the stroke unit. Eighty-five percent of patients could have been treated at the stroke unit but 15% needed intensive care unit (ICU) or other intensive medical care. Conclusions: Case-fatality was lower and the pro-portion of patients discharged home was higher than we have seen reported in foreign studies. Stroke may be a less severe disease in Iceland than in other Western countries.Tilgangur: Tilgangur rannsóknarinnar var að kanna fjölda og afdrif sjúklinga með heilablóðfall á Sjúkrahúsi Reykjavíkur. Skoðuð var hlutdeild heilablóðfallseiningar í þjónustu við þennan sjúklingahóp og athugaðar ástæður þess að sjúklingar lögðust ekki inn á heilablóðfallseiningu. Ekki hafa áður verið birtar niðurstöður rannsókna á Islandi sem lýsa afdrifum sjúklinga með heilablóðfall í stóru þýði. Efniviður og aðferðir: Skráðar voru upplýsingar um sjúklinga með heilablóðfall á Sjúkrahúsi Reykjavíkur á:árunum 1996 og 1997 jafnóðum og þeir greindust. Útilokaðir voru sjúklingar með skammvinna heilablóðþurrð (transient ischemic attack), innanskúmsblæðingu (subarachnoid hemorrhage) og heilablæðingu vegna arfgengs mýlildissjúkdóms (hemorrhage due to hereditary cystatin C amyloid angiopathy). Athugaður var legutími, alvarleiki einkenna við komu, dánarhlutfall (case-fatality) og hvort sjúklingar útskrifuðust heim eða á hjúkrunardeild. Niðurstöður: Á árunum 1996-1997 greindust 377 sjúklingar með heilablóðfall á Sjúkrahúsi Reykjavíkur. Með heiladrep greindust 88% og heilablæðingu 12%. Meðallegutími var 28,7 dagar (95% CI 24,1-33,3). Alls útskrifuðust 71% sjúklinga heim, 12% á hjúkrunardeildir og 17% létust í legunni á sjúkrahúsinu. Inn á heilablóðfallseiningu lögðust 63% sjúklinga. Heilablóðfallseiningin hefði geta tekið við 85% sjúklinga en 15% voru of veikir til þess. Ályktanir: Dánarhlutfall sjúklinga með heilablóðfall var lægra og hlutfall sjúklinga sem útskrifaðist heim var hærra en lýst hefur verið í sambærilegum erlendum rannsóknum. Það gæti bent til að heilablóðfall sé vægari sjúkdómur hér á landi en í öðrum vestrænum löndum

Etiology and treatment of cerebral ischemia at the Department of Neurology and Rehabilitation Medicine at Reykjavik City Hospital

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjectives: This is the first Icelandic study in which the etiology of cerebral ischemia is examined. The goal of the study was to examine how the etiology of cerebral infarcts and transient ischemic attacks was determined at the Department of Neurology and Rehabilitation Medicine at Reykjavik City Hospital and how the patients were treated. Material and methods: The study was retrospective and included 102 patients with cerebral infarcts and transient ischemic attacks that were admitted to the Department of Neurology and Rehabilitation Medicine at Reykjavik City Hospital in 1994. Patients with cerebral hemorrhage were excluded. The patients' mean age was 68.5 years (range 25-89) and the male:female ratio was 59:43. Cerebral computerized tomography was obtained from 98 (98%) patients. Carotid ultrasonography was done in 72 (72%) cases and carotid angiogram in 14 (14%) patients. Transthoracic echocardiography was done in 69 (69%) cases and transesophagal echocardiography in the 11 (11%) youngest patients. Results: Of the 102 patients, 79 (79%) had cerebral infarctions and 23 (23%) transient ischemic attacks. The probable cause of cerebral infarction was cardioembolic in 21 patients (27%), lacunar infarction in 16 patients (20%) and carotid artery disease in 13 patients (16%). In 37% of the cases the cause was unspecific. The etiology of transient ischemic attacks was carotid artery disease in four patients (17%), cardioembolic in two patients (9%) and lacunar in one patient (4%). In 70% of the cases the cause of transient ischemic attacks was undetermined. Nine of the 102 patients (9%) underwent carotid endarterectomy and 15 (15%) were treated with warfarin. Conclusion: A specific etiology was found in 2/3 of those with cerebral infarcts and in 1/3 of those with transient ischemic attacks. Determination of etiology led to specific preventive treatment in 1/4 of the patients.Inngangur: Ekki hafa áður verið birtar niðurstöður rannsókna á Íslandi sem lýsa orsökum heilablóðþurrðar. Tilgangur rannsóknarinnar var að athuga hvernig orsakir heiladreps og skammvinnrar heilablóðþurrðar voru greindar á endurhæfinga- og taugadeild Borgarspítalans árið 1994, hverjar þær voru og hvernig brugðist var við þeim. Efniviður og aðferðir: Litið var afturskyggnt á sjúkraskrár allra sjúklinga sem lögðust inn á endurhæfinga- og taugadeild Borgarspítalans árið 1994 með greininguna heiladrep og skammvinn heilablóðþurrð, en heilablæðingar voru undanskildar. Meðalaldur hópsins var 68,5 ár (25-89 ára) og hlutfall karla og kvenna 59:43. Tölvusneiðmynd af höfði var framkvæmd hjá 98 (98%) einstaklingum. Ómun af hálsslagæð um var gerð hjá 72 (72%) og æðamyndataka hjá 14 (14%) einstaklingum. Ómun af hjarta í gegnum brjóstvegg var gerð hjá 69 (69%) en ómun af hjarta í gegnum vélinda hjá 11 (11%) yngstu einstaklingunum. Niðurstöður: Alls greindust 102 einstaklingar með heilablóðþurrð (cerebral ischemia), 79 (79%) greindust með heiladrep (cerebral infarction) og 23 (23%) með skammvinna heilablóðþurrð (transient cerebral ischemia). Einkenni frá næringarsvæði hægri hálsslagæðar höfðu 26 (26%), frá svæði vinstri hálsslagæðar 41 (41%), frá svæði hryggslagæðar 25 (25%), en óvist var um staðsetninguna hjá 10 (10%) einstaklingum. Orsakir heiladreps skiptust þannig: hálsæðasjúkdómur 13 (16%), hjartasjúkdómur 21 (27%), smáæðasjúkdómur (lacunar infarction) 16 (20%), ósértæk orsök hjá 29 (37%) einstaklingum. Orsakir skammvinnrar heilablóðþurrðar voru: hálsæðasjúkdómur fjór-ir (17%), hjartasjúkdómur tveir (9%), smáæðasjúkdómur einn (4%), og ósértæk orsök hjá 16 (70%) einstaklingum. Af 102 einstaklingum sem greindust með heiladrep og skamvinna heilablóðþurrð gengust níu (9%) undir aðgerð á hálsslagæð og 15 (15%) einstaklingar voru settir á blóðþynningu með warfaríni að aflokinni orsakagreiningu. Ályktanir: Sértæk orsök fannst hjá tveimur þriðju þeirra einstaklinga sem greindust með heiladrep og þriðjungi þeirra sem höfðu skammvinna heilablóðþurrð. Orsakagreining leiddi til sértækrar fyrirbyggjandi meðferðar hjá fjórðungi einstaklinga

Case fatality after acute stroke at the Reykjavik Hospital in 1996-1997

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: The purpose of this study was to describe case-fatality after acute stroke at the Reykjavik Hospital. A study describing the outcome of stroke patients in an Icelandic population has not been published before. Material and methods: A prospective hospital-based stroke registry has been conducted at the Reykjavik Hospital since January 1996. Patients with ischemic stroke and intracerebral hemorrhage were included in this study but patients with transient ischemic attack (TIA), subarachnoid hemorrhage and hemorrhage due to hereditary cystatin C amyloid angiopathy were excluded. We describe the severity of symptoms at stroke onset, length of hospital stay and outcome. Results: In 1996 and 1997 a total of 377 events were registered. Ischemic stroke was diagnosed in 88% and hemorrhagic stroke in 12%. The case-fatality was 17%, 71% of the patients were discharged home and 12% to nursing care. The average length of hospital stay was 28.7 days (95% CI 24.1-33.3) and 63% of patients were treated at the stroke unit. Eighty-five percent of patients could have been treated at the stroke unit but 15% needed intensive care unit (ICU) or other intensive medical care. Conclusions: Case-fatality was lower and the pro-portion of patients discharged home was higher than we have seen reported in foreign studies. Stroke may be a less severe disease in Iceland than in other Western countries.Tilgangur: Tilgangur rannsóknarinnar var að kanna fjölda og afdrif sjúklinga með heilablóðfall á Sjúkrahúsi Reykjavíkur. Skoðuð var hlutdeild heilablóðfallseiningar í þjónustu við þennan sjúklingahóp og athugaðar ástæður þess að sjúklingar lögðust ekki inn á heilablóðfallseiningu. Ekki hafa áður verið birtar niðurstöður rannsókna á Islandi sem lýsa afdrifum sjúklinga með heilablóðfall í stóru þýði. Efniviður og aðferðir: Skráðar voru upplýsingar um sjúklinga með heilablóðfall á Sjúkrahúsi Reykjavíkur á:árunum 1996 og 1997 jafnóðum og þeir greindust. Útilokaðir voru sjúklingar með skammvinna heilablóðþurrð (transient ischemic attack), innanskúmsblæðingu (subarachnoid hemorrhage) og heilablæðingu vegna arfgengs mýlildissjúkdóms (hemorrhage due to hereditary cystatin C amyloid angiopathy). Athugaður var legutími, alvarleiki einkenna við komu, dánarhlutfall (case-fatality) og hvort sjúklingar útskrifuðust heim eða á hjúkrunardeild. Niðurstöður: Á árunum 1996-1997 greindust 377 sjúklingar með heilablóðfall á Sjúkrahúsi Reykjavíkur. Með heiladrep greindust 88% og heilablæðingu 12%. Meðallegutími var 28,7 dagar (95% CI 24,1-33,3). Alls útskrifuðust 71% sjúklinga heim, 12% á hjúkrunardeildir og 17% létust í legunni á sjúkrahúsinu. Inn á heilablóðfallseiningu lögðust 63% sjúklinga. Heilablóðfallseiningin hefði geta tekið við 85% sjúklinga en 15% voru of veikir til þess. Ályktanir: Dánarhlutfall sjúklinga með heilablóðfall var lægra og hlutfall sjúklinga sem útskrifaðist heim var hærra en lýst hefur verið í sambærilegum erlendum rannsóknum. Það gæti bent til að heilablóðfall sé vægari sjúkdómur hér á landi en í öðrum vestrænum löndum

Prevalence of symptomatic Charcot-Marie-Tooth disease in Iceland: a study of a well-defined population

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldBACKGROUND/AIM: To determine the prevalence and clinical spectrum of Charcot-Marie-Tooth disease (CMT) in Iceland. METHODS: We identified all individuals with symptomatic CMT, based on information from all practicing neurologists, both neurophysiology laboratories and the only neurology department in the country. The diagnosis was based on clinical features and neurophysiological testing. DNA testing was regarded as confirmatory. RESULTS: We identified 37 individuals in 18 families, which were not linked by identifying 5 generations of ancestors. The point prevalence (January 1, 2007) for all CMT subtypes in Iceland was 12.0/10(5), 10.1/10(5) for CMT1 and 2.0/10(5) for CMT2. The clinical features include lower limb weakness (95%), impaired gait (68%), decreased or absent deep tendon reflexes (86%), pes cavus (70%) and hammer toes (46%). Clinical symptoms were similar for the 2 main CMT subtypes. CONCLUSION: We report the prevalence and clinical spectrum of CMT, which is comparable to the results of other prevalence studies, in a well-defined, total population sample

Á heimahaugi er hani frakkastur : hvers vegna er skortur á erlendum fjárfestingum á Íslandi?

Í þessari ritgerð er aðalviðfangsefnið að fjalla um hvers vegna erlendar fjárfestingar á Íslandi eru ekki í ríkara mæli en nú er. Þar sem erlend fjárfesting er talin nauðsynleg fyrir lítil ríki eins og Ísland, velta höfundar fyrir sér hvers vegna Íslendingar leggi ekki meiri áherlsu á að laða til sín erlendar fjárfestingar. Til þess að afla betri innsýnar í hvað það er sem sé að hindra erlendar fjárfestingar hér á landi voru tekin hálfstöðluð djúpviðtöl við 8 aðila sem höfðu sérstaka þekkingu á efninu og stuðst var við eigindlega rannsóknaraðferð við úrvinnslu gagna ásamt því að setja upp SVÓT greiningu. Niðurstöður leiddu í ljós að viðmælendur töldu helstu ástæðurnar fyrir því að erlendar fjárfestingar ætti sér ekki stað í ríkari mæli væri meðal annars að laga- og skattamál hér á landi væru ekki samkeppnishæf og margt þyrfti að bæta til þess að laða að erlendu fjárfestana. Einnig var talað um áhættuna sem fylgir krónunni en viðmælendur voru flestir sammála um að hún væri ekki að hjálpa Íslandi. Þrátt fyrir helstu hindranir voru viðmælendur allir sammála um að á Íslandi væri mikið um tækifæri og að landið byggi yfir töluvert af styrkleikum eins og til dæmis ódýru og hreinu rafmagni, háu menntunarstigi þjóðarinnar og auðlindum sem væru fyrir hendi

Enzyme-histochemical and morphological characteristics of fast- and slow-twitch skeletal muscle after brain infarction in the rat

The right middle cerebral artery was permanently occluded in 12-week-old male spontaneously hypertensive rats. After the surgery the rats were subjected to repeated behavioural tests during the observation period. Fourteen weeks after surgery the fast-twitch extensor digitorum longus (EDL) and the slow-twitch soleus muscle of both sides were removed and examined with regard to muscle fibre characteristics obtained by histochemical and morphometrical methods. Comparisons were made with age-matched controls. Limb placement and the ability to traverse a beam or a rotating pole were repeatedly tested 2-13 weeks after the operation. In spite of permanent sensorimotor deficits in limb placement and when traversing a rotating pole or beam, no increase in pathological changes was noted in either EDL or soleus. The number and proportion of fibre types remained unchanged in both muscles. There was no difference in muscle fibre size in either EDL or soleus. It is concluded that brain infarction in the rat, although causing marked impairment of contralateral motor function, does not have a major influence on the muscle-fibre morphology or fibre-type composition, irrespective of muscle type

Transmo : transforming graphs to data

Transmo is a software which transforms graphs into data using computer vision to detect all of the different elements of a graph. This type of software is useful when an individual has access to a graph but wants to know what data was used to create the graph