Bone marrow transplantation

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenFor the last few decades there has been a major increase in the number of allogeneic bone marrow transplantations and every year several thousand transplants are performed. In the early days of transplantation the treatment was performed only in terminally ill patients but now transplantation is carried out early in the course of the disease with greatly improved results. The most common indications for treatment today include acute and chronic leukemia, Non-Hodgkin s lymphoma, Hodgkin s disease, multiple myeloma and congenital immune deficiencies. Sibling donors are the most common source of stem cells for transplantation but in recent years international donor registries have played an increasing role. Degree of HLA disparity between donor and recipient is the main risk factor for Graft versus Host disease which is still the major cause of morbidity and mortality after transplantation. Graft rejection is very rare when there is complete HLA match between the donor and recipient. Overall survival is also dependent on several other factors including disease stage at time of transplantation, age and disease categories. For the last few years an average of four Icelandic patients have received bone marrow transplantation each year and indicatioons are similar to other European countries.Allra síðustu áratugi hefur orðið mikil aukning á fjölda mergskipta en árlega fara mörg þúsund sjúklingar í slíka meðferð. Í dag eru mergskipti framkvæmd fyrr í sjúkdómsferlinu heldur en tíðkaðist í byrjun og hefur það leitt til bætts árangurs meðferðar. Illkynja blóð- og eitilfrumusjúkdómar eru algengustu ábendingar í dag. Helstu sjúkdómaflokkarnir eru hvítblæði, bæði brátt og langvinnt, eitilfrumukrabbamein (Non-Hodgkin´s lymphoma og Hodgkin´s disease), mergfrumuæxli (multiple myeloma) og meðfæddar ónæmistruflanir. Oftast er merggjafinn systkini sjúklings en á síðustu árum hafa alþjóðlegar gjafaskrár gegnt vaxandi hlutverki í leit að gjafa. Tegund vefjaflokkasamræmis milli þega og gjafa er helsti áhættuþáttur fyrir ónæmisröskun sem enn í dag er meginorsök alvarlegra veikinda og dauðsfalla við ígræðslumeðferðina. Höfnun græðlings er mjög sjaldgæf þegar um fullkomið vefjaflokkasamræmi er að ræða. Heildarlifun er einnig háð fjölmörgum öðrum þáttum, svo sem sjúkdómsgreiningu, aldri og framgangi sjúkdómsins. Síðustu ár hafa að meðaltali fjórir Íslendingar farið í mergskipti árlega en öll mergskipti hafa farið fram erlendis. Ábendingar eru svipaðar og í öðrum Evrópulöndu

The Iron-man : A case-report

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)The most common cause of microcytic anemia is iron deficiency. We report a 29 year old man with history of dyspnea, fatigue and severe microcytic anemia despite iron therapy for 3 years. Blood transfusions elevated the hemoglobin levels temporarily, but iv iron did not. Bone marrow showed sideroblastic anemia. The anemia resolved with pyridoxine treatment but severe iron overload necessitated multiple phlebotomies. Today the patient is asymptomatic on pyridoxine with a normal hemoglobin level.Algengasta orsök smáfrumublóðleysis er járnskortur. Sagt er frá 29 ára manni sem hafði verið með mæði, slappleika og svæsið smáfrumublóðleysi í þrjár vikur þrátt fyrir þriggja ára járntöku. Blóðgjafir hækkuðu blóðrauða tímabundið en járngjafir í æð höfðu engin áhrif. Beinmergsrannsókn greindi arfgengt járnkímfrumublóðleysi. Pýridoxín leiðrétti blóðleysið en maðurinn þurfti á endurteknum aftöppunum að halda vegna mikillar járnofhleðslu. Nú tekur hann pýridoxín, er einkennalaus og með eðlilegan blóðhag

Blood selenium levels and contribution of food groups to selenium intake in adolescent girls in Iceland.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.Significant changes have been reported in dietary habits and food availability in Iceland that would be expected to compromise selenium intake and status, especially among young people. These include substantial decreases in the consumption of fish and milk, as well as the selenium content of imported wheat. The aim of this study was to assess selenium in the diet and whole blood of adolescent girls, as well as define the most important foods contributing to intake and blood concentrations of selenium. The subjects were 96 randomly selected girls, aged 16-20, who answered a validated food frequency questionnaire (FFQ) for dietary assessment. Selenium intake from each food group was calculated in µg/day. Blood samples were collected for measurement of whole blood selenium. Mean dietary selenium was 51±25 µg/day. Milk/dairy products, including cheese, contributed 36±14% of total dietary selenium; fish 18±12%; and bread/cereal products 13±6%. Mean whole blood selenium was 117±12 µg/l (range 90-208); nearly 90% of subjects were above the optimal level of 100 µg/l. Fish and bread/cereal products were the only foods significantly correlated with selenium in blood (r=0.32; P=0.002 and r=0.22; P=0.04, respectively) while no correlation was found with milk and dairy products in spite of their greater contribution to total selenium intake. In this population of Icelandic adolescent girls, selenium intake and status seem acceptable. Judging from associations between intake and blood levels, fish and cereals may be the most important contributors to blood selenium.Landspitali University Hospital Research Fund Agricultural Productivity Fun

Recent warming across the North Atlantic region may be contributing to an expansion in barley cultivation

Although grass dominates most agricultural systems in the North Atlantic region (NAR), spring barley is the most important cereal and is used for animal feed and food and drink products. Recent changes in climate have resulted in warmer conditions across the NAR which have major implications for crop production. In this paper, we investigate the thermal requirement of spring barley in the region and use the results to examine the effects of recent trends in temperature and rainfall on barley cultivation, based on 11 regional meteorological sites. At these sites, between 1975 and 2015, we found significant warming trends for several months of the cropping season and significant trends for increases in the cropping season degree days (CSDD). In recent years, this has resulted in an increased proportion of years when the estimated minimum thermal requirement for barley has been met at sites above about 60°N. However, annual variations in CSDD are large and years still occur at these sites where this is insufficient. While warming could potentially allow an earlier start and later end to the cropping season, it is likely that high rainfall at maritime sites, and low rainfall at continental sites, will limit the ability of growers to benefit from this. Warming is considered to have been one of the main factors contributing to the large expansion of the area of barley cultivated in Iceland since the 1990s.publishedVersio

The evolution of cellular deficiency in GATA2 mutation.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageConstitutive heterozygous GATA2 mutation is associated with deafness, lymphedema, mononuclear cytopenias, infection, myelodysplasia (MDS), and acute myeloid leukemia. In this study, we describe a cross-sectional analysis of 24 patients and 6 relatives with 14 different frameshift or substitution mutations of GATA2. A pattern of dendritic cell, monocyte, B, and natural killer (NK) lymphoid deficiency (DCML deficiency) with elevated Fms-like tyrosine kinase 3 ligand (Flt3L) was observed in all 20 patients phenotyped, including patients with Emberger syndrome, monocytopenia with Mycobacterium avium complex (MonoMAC), and MDS. Four unaffected relatives had a normal phenotype indicating that cellular deficiency may evolve over time or is incompletely penetrant, while 2 developed subclinical cytopenias or elevated Flt3L. Patients with GATA2 mutation maintained higher hemoglobin, neutrophils, and platelets and were younger than controls with acquired MDS and wild-type GATA2. Frameshift mutations were associated with earlier age of clinical presentation than substitution mutations. Elevated Flt3L, loss of bone marrow progenitors, and clonal myelopoiesis were early signs of disease evolution. Clinical progression was associated with increasingly elevated Flt3L, depletion of transitional B cells, CD56(bright) NK cells, naïve T cells, and accumulation of terminally differentiated NK and CD8(+) memory T cells. These studies provide a framework for clinical and laboratory monitoring of patients with GATA2 mutation and may inform therapeutic decision-making.Lymphoma and Leukaemia Research British Society of Hematology Bright Red George Walker Trust Wellcome Trus

Genome-Wide Local Ancestry Approach Identifies Genes and Variants Associated with Chemotherapeutic Susceptibility in African Americans

Chemotherapeutic agents are used in the treatment of many cancers, yet variable resistance and toxicities among individuals limit successful outcomes. Several studies have indicated outcome differences associated with ancestry among patients with various cancer types. Using both traditional SNP-based and newly developed gene-based genome-wide approaches, we investigated the genetics of chemotherapeutic susceptibility in lymphoblastoid cell lines derived from 83 African Americans, a population for which there is a disparity in the number of genome-wide studies performed. To account for population structure in this admixed population, we incorporated local ancestry information into our association model. We tested over 2 million SNPs and identified 325, 176, 240, and 190 SNPs that were suggestively associated with cytarabine-, 5′-deoxyfluorouridine (5′-DFUR)-, carboplatin-, and cisplatin-induced cytotoxicity, respectively (p≤10−4). Importantly, some of these variants are found only in populations of African descent. We also show that cisplatin-susceptibility SNPs are enriched for carboplatin-susceptibility SNPs. Using a gene-based genome-wide association approach, we identified 26, 11, 20, and 41 suggestive candidate genes for association with cytarabine-, 5′-DFUR-, carboplatin-, and cisplatin-induced cytotoxicity, respectively (p≤10−3). Fourteen of these genes showed evidence of association with their respective chemotherapeutic phenotypes in the Yoruba from Ibadan, Nigeria (p<0.05), including TP53I11, COPS5 and GAS8, which are known to be involved in tumorigenesis. Although our results require further study, we have identified variants and genes associated with chemotherapeutic susceptibility in African Americans by using an approach that incorporates local ancestry information

Current Cereal Growing Situation In Five Northern Regions And The Potential For Using Local Cereals In Food And Drink Products

The status of cereal cultivation in Iceland, northern Norway, Faroe Islands, Orkney and Newfoundland has been studied in a project supported by the Northern Periphery and Arctic Programme (NPA). In Orkney, Iceland and northern Norway cereal cultivation is well established while the Faroe Islands are re-establishing, and Newfoundland is starting, cultivation. The project transfers knowledge between the regions and aims to increase the value of cereal products, indicate new innovative products and increase cultivation of cereals. In this report, the cereal value chain is described to inspire companies and initiators to identify new opportunities and create new jobs. Total cereal grain production in the five regions was about 38,000 tons in 2014 while imports were about 146,000 tons, just for Iceland, Orkney and Newfoundland. The population of the region is about 1.4 million and the annual number of visitors is above 2 million. Considerable amounts of cereal-based products are consumed in the regions. These include many different foods (bakery products, breakfast cereals, snacks, flour, porridges etc.) and beverages (e.g. beer and whisky) and offer many opportunities for using local cereals. Recent trends in the cereal food market are very conducive to the development of new products and greater local production within the project regions. Interest in local food and drinks is increasing and food producers need to respond to increasing demand from visitors. In all of the regions, barley is the most important cereal grown. Barley contains several health-enhancing nutritional components including β-glucan and antioxidants and, with growing awareness of the need for healthy eating, there is increased interest in it as a raw material for the food industry. Barley is also used for the production of malt which is a key ingredient for the production of beer and whisky. The number of microbreweries has grown and they are now found in remote regions. For breweries to distinguish themselves from competitors, product differentiation is becoming increasingly important and an attractive way of doing this is to use local ingredients (barley, malt and herbs). However, in order to utilise local barley for beverage production, it will usually be necessary to develop a local capacity for malting.publishedVersio

Betrakterens muligheter : Perspektiver på et verk av Mona Hatoum

Sammendrag Et møte med ett enkelt verk av Mona Hatoum er utgangspunkt for denne teksten. Verket Lili(Stay)Put ble opprinnelig laget til en utstilling i Anadiel Gallery i Jerusalem i 1996. I dag tilhører det Astrup Fearnley Museet for Moderne Kunst i Oslo. Teksten undersøker hvilke kunstneriske virkemidler som er avgjørende for lesning av verket slik det presenteres i dag, med utgangspunkt i betrakterens posisjon. Dette forholdet blir så relatert til den konteksten verket opprinnelig ble produsert og vist i. Problemstillingen er på den ene siden knyttet til det direkte møtet med verket og kunstnerens valg av form, materialer og plassering i omgivelsene, på den andre siden til betydningen av eventuell informasjon om kunstnerens bakgrunn og verkets opprinnelse for betrakteren. Disse aspektene blikk behandles separat i tekstens to deler eller kapitler, for så å bli sammenholdt i den avsluttende delen. I første kapittel settes verket inn i en kunsthistorisk og kunstteoretisk forståelsesramme. At verket, som består av en konstruksjon av fundne og ferdiglagde materialer, med en gammel sengeramme av metall som hovedelementet, danner utgangspunkt for å situere det i forhold til readymadens historiske betydning og betrakterens mulighet for en estetisk bedømmelse av en hverdagslig gjenstand. Kunstnerens bruk av readymades og verkets forankring i minimalistisk form gjør at dette både kan relateres til den historiske avantgardens tidlige og sene fase, og til nyere praksis mot slutten av det tyvende århundret. Teksten drøfter Mona Hatoums anvendelse av form på bakgrunn av strategier som bidrar til at formens autonomi blir undergravet gjennom materialer som viser til det reelle, samtidig som det skapes en kroppslig relasjon mellom verk og betrakter. Vektleggingen av det direkte møtet med verket gir også grunnlag for å se Hatoums verk i et fenomenologisk perspektiv. Andre kapittel behandler spørsmål om betydningen av kjennskap til kunstnerens bakgrunn og verkets geografiske opphavsted. I den sammenheng problematiseres forskjellen mellom måten tekstens nøkkelverk opprinnelig ble installert på i visningsrommet og den formen verket har i dag. Her blir kunstnerens virksomhet og en rekke av hennes andre verk forsøksvis også relatert til en palestinsk kontekst. At dette verket er et produkt av et arbeidsopphold i Jerusalem, gir grunnlag for å betrakte det som et eksempel på en kunstnerisk fremgangsmåte hvor verk skapes i dialog med nye steder. Tekstens diskusjon omkring betydningen av informasjon for betrakterens lesning av verket, inkluderer en problematisering av kunstnerens mulige rolle som den kulturelle ”andre”. Siste del inneholder en nyansert forståelse av hvordan kjennskap til verkets historie og kunstnerens bakgrunn kan influere betrakterens tilnærming, basert på en samlet analyse

Krabbamein í blöðruhálskirtli og hjónaband. Tengsl félagslegra hamla frá maka og ánægju í hjónabandi

Markmið þessarar rannsóknar var að athuga tengsl á milli hjónabands, heilsutengdra lífsgæða og streitu hjá körlum með krabbamein í blöðruhálskirtli. Þátttakendur voru þrjátíu og sjö nýgreindir karlar á aldrinum 48 til 85 ára. Spurningalisti var lagður fyrir þá innan fjögurra vikna frá greiningu krabbameinsins. Tilgátur rannsóknarinnar voru þrjár. Fyrsta tilgátan var að þeir karlar sem eru ánægðir hjónabandi væru með minni streitu, minni vanda við ákvörðunartöku, betri lífsgæði og minni félagslegar hömlur frá maka en þeir sem eru óánægðir í hjónabandi. Önnur tilgátan var að krabbameinssjúklingar sem urðu fyrir félagslegum hömlum frá maka þegar þeir vildu ræða tilfinningar sínar varðandi krabbameinið hefðu verri lífsgæði og meiri streitu. Þriðja tilgátan var að tengslin milli ánægju í hjónabandi, vanda ákvarðana og streitu væru til komin (mediated) vegna áhrifa félagslegra hamla frá maka á tjáningu tilfinninga varðandi krabbameinið. Niðurstöður rannsóknarinnar sýna að ánægja í hjónabandi hefur áhrif á vanda við ákvörðunartöku um meðferð. Þeir sem voru ánægðir í hjónabandi áttu í minni vanda. Ekki fundust tengsl milli ánægju í hjónabandi og streitu en almenn lífsgæði þeirra karla sem voru í góðu hjónabandi voru betri. Félagslegar hömlur frá maka hafa áhrif á vanda við ákvörunartöku um meðferð, almenna streitu og sjúkdósmtengda streitu. Þeir sem voru með meiri félagslegar hömlur frá maka áttu erfiðara með að taka ákvörðun og voru með meiri streitu en hinir. Tengslin milli ánægju í hjónabandi og vanda ákvarðana voru til komin vegna áhrifa félagslegra hamla. Félagslegar hömlur frá maka valda því að ekki er rætt um krabbameinið og tilfinningar sem tengjast því. Vegna sterkra tengsla félagslegra hamla frá maka við ánægju í hjónabandi og vanda við ákvörðunartöku er nauðsynlegt að finna einhverjar leiðir til að hjálpa körlum með krabbamein í blöðruhálskirtli og mökum þeirra að ræða saman og bæta með því lífsgæði þeirra