A Severe Throat Infection - Case Report

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenWe report a case of Lemierre?s syndrome or, human necrobacillosis, in a 33 year old icelandic male. A severe clinical picture, fulfilling all the criteria for this syndrome, is described. With antibiotic therapy, and critical care, the outcome was successful. A brief overview of infections due to Fusobacterium necro phorum, with special emphasis on Lemierre?s syndrome, is presented. Etiology, clinical symptoms, treatment and prognosis of this syndrome are dis cussed. We believe this to be the first case of human necrobacillosis to be reported in Iceland.Sjúkrasaga Þrjátíu og þriggja ára gamall bóndi, áður hraust­ur, kom á bráðamóttöku Fjórðungssjúkrahússins á Akureyri (FSA). Hann hafði veikst sex dögum áður með háum hita, miklum slappleika og verkjum aftan í hálsi. Hann var alveg rúmfastur, kastaði mikið upp en var ekki með niðurgang. Allan tímann var hann með óstöðv­andi hiksta. Kona hans tók eftir að hann var móður og svaf illa. Hann mældist með hita um 40° C og fór að lokum til heilsugæslulæknis sem sá að hann var gulur og fárveikur og sendi hann á bráðamóttöku FSA. Við komu á FSA var hann fárveikur (septískur), lá á bekk, vakandi og áttaður, mjög þvoglumæltur, og skalf mikið. Blóðþrýstingur var 140/85 mmHg liggj­andi og 128/64 mmHg sitjandi. Púls 119/mín, reglu­legur. Öndunartíðni 36/mín. Hiti 39,8°C í enda­þarmi. Hann var gulur á húð og í augnhvítu. Mikil þreifi­eymsli voru í hnakka og aftan á hálsi en ekki hnakkastífleiki. Hann var mjög þurr á vörum, með blóð­skorpur í munni og brúnleita, að því er virt­ist, fláka af yfirborðsdrepi á tungu. Hann var mjög bólginn í koki. Fíngert brak heyrðist yfir hægra lunga. Við hjartahlustun heyrðust eðlilegir hjartatónar og slagbilsóhljóð (systólískt). Kviður var aumur undir hægri rifjaboga en engar líffærastækkanir né aðrar fyrirferðaraukningar fundust. Hann var með kylfufingur (talið vera meðfætt) og flísablæðingar sáust undir nöglum. Nöglin á hægri stórutá var inngróin og talsvert sár og bólguholdgun (granulation) umhverfis en ekki merki um bráða sýkingu. Maðurinn var að nálgast sýkingalost án augljósrar orsakar

Polariton vortex Chern insulator

We propose a vortex Chern insulator, motivated by recent experimental demonstrations on programmable arrangements of cavity polariton vortices by [Alyatkin et al., ArXiv:2207.01850 (2022)] and [Wang et al., National Sci. Rev. 10, Nwac096 (2022)]. In the absence of any external fields, time-reversal symmetry is spontaneously by through polariton condensation into structured arrangements of localized co-rotating vortices. We characterize the response of the rotating condensate lattice by calculating the spectrum of Bogoliubov elementary excitations and observe the crossing of edge-states, of opposite vorticity, connecting bands with opposite Chern numbers. The emergent topologically nontrivial energy gap stems from inherent vortex anisotropic polariton-polariton interactions and does not require any spin-orbit coupling, external magnetic fields, or elliptically polarized pump fields

Directional planar antennae in polariton condensates

We report on the realization of all-optical planar microlensing for exciton-polariton condensates in semiconductor microcavities. We utilize spatial light modulators to structure a nonresonant pumping beam into a planoconcave lens-shape focused onto the microcavity plane. When pumped above condensation threshold, the system effectively becomes a directional polariton antenna, generating an intense focused beam of coherent polaritons away from the pump region. The effects of pump intensity, which regulates the interplay between gain and blueshift of polaritons, as well as the geometry of lens-shaped pump are studied and a strategy to optimize the focusing of the condensate is proposed. Our work underpins the feasibility to guide nonlinear light in microcavities using nonresonant excitation schemes, offering perspectives on optically reprogrammable on-chip polariton circuitry

A large rock avalanche onto Morsarjökull glacier, south-east Iceland. Its implications for ice-surface evolution and glacier dynamics

In spring 2007, a large rock avalanche descended onto the Morsárjökull valley glacier in southeast Iceland, leaving one fifth of the glacier buried. The insulating effect of the deposit on the ice was quickly observed as a difference in the ablation between the exposed ice and that under the deposit. After three melt seasons, the ice surface under the deposit was 29 m above the surrounding glacier surface. A reduced rate of ice melting beneath the area of the deposit would likely alter the longitudinal profile of the glacier

Modelling the 20th and 21st century evolution of Hoffellsjökull glacier, SE-Vatnajökull, Iceland

The Little Ice Age maximum extent of glaciers in Iceland was reached about 1890 AD and most glaciers in the country have retreated during the 20th century. A model for the surface mass balance and the flow of glaciers is used to reconstruct the 20th century retreat history of Hoffellsjökull, a south-flowing outlet glacier of the ice cap Vatnajökull, which is located close to the southeastern coast of Iceland. The bedrock topography was surveyed with radio-echo soundings in 2001. A wealth of data are available to force and constrain the model, e.g. surface elevation maps from ~1890, 1936, 1946, 1989, 2001, 2008 and 2010, mass balance observations conducted in 1936–1938 and after 2001, energy balance measurements after 2001, and glacier surface velocity derived by kinematic and differential GPS surveys and correlation of SPOT5 images. The approximately 20% volume loss of this glacier in the period 1895–2010 is realistically simulated with the model. After calibration of the model with past observations, it is used to simulate the future response of the glacier during the 21st century. The mass balance model was forced with an ensemble of temperature and precipitation scenarios derived from 10 global and 3 regional climate model simulations using the A1B emission scenario. If the average climate of 2000–2009 is maintained into the future, the volume of the glacier is projected to be reduced by 30% with respect to the present at the end of this century. If the climate warms, as suggested by most of the climate change scenarios, the model projects this glacier to almost disappear by the end of the 21st century. Runoff from the glacier is predicted to increase for the next 30–40 yr and decrease after that as a consequence of the diminishing ice-covered area

Public or private primary health care: A comparison of efficiency and patient satisfaction

Skipulag heilbrigðisþjónustu er meðal erfiðustu viðfangsefna stjórnvalda. Líkt og aðrar þjóðir sem reka félagslegt heilbrigðiskerfi standa Íslendingar frammi fyrir spurningunni um hvert eigi að vera hlutverk einkarekstrar innan heilsugæslunnar. Markmið rannsóknarinnar var tvíþætt: að bera saman einkarekstur og ríkisrekstur 17 heilsugæslustöðva á höfuðborgarsvæðinu og greina ánægjukannanir þeim tengdar. Við upphaf Íslandsbyggðar verður til lögbundin samhjálp þar sem kveðið er á um skyldur samfélagsins við þá sem þarfnast hjálpar og með lögum um heilbrigðisþjónustu árið 1973 féll íslenska heilbrigðiskerfið undir norræna velferðarsamfélagið með jöfnu aðgengi og þéttu öryggisneti. Rannsóknin sýnir að einkareknu heilsugæslustöðvarnar voru með lágan kostnað á hverja verkeiningu en þó ekki þann lægsta. Fjórar til sjö ríkisreknar stöðvar voru með lægri kostnað á hvern skráðan einstakling en þær einkareknu. Kostnaður á hverja stöðu læknis var hæstur hjá annarri einkareknu stöðinni. Þjónustukannanir sýndu að enginn munur var á ánægju með gæði þjónustu milli þessara tveggja ólíku rekstrarforma. Þá ályktun má draga af þessari rannsókn að ekki sé hægt að fullyrða að einkarekstur í heilsugæslu bæti meðferð opinbers fjár eða auki gæði þjónustunnar.The organization of health care is one of the most complex present day challenges. Like other countries that run socialized health care systems, Icelanders face the question of the role of private enterprise in health care. The objective of this study was two-fold: to compare the cost of 17 private and state-run health care centers in the metropolitan area, and to compare consumer satisfaction related to these. At the beginning of Icelandic settlement, there were statutory laws decreeing that community services should be provided for those in need. By the Health Care Act in 1973, the Icelandic health care system fell under the Nordic welfare society with equal access and a tight safety net. The results show that the private health care centers had a low cost per work unit, but not the lowest. Four to seven state run health care centers had less expenditure per patient than the private centers. The cost of each doctor’s position was highest in one of the private clinics. Patient satisfaction surveys showed that there is no difference in the quality of services between these two different operating modes. A conclusion can be drawn from this study that it is not clear whether private health care improves the use of public funds or increases the quality of services.Félag íslenskra heimilislækna fær þakkir fyrir að styrkja verkefnið úr vísindasjóði.Peer Reviewe

New genetic loci implicated in fasting glucose homeostasis and their impact on type 2 diabetes risk.

Levels of circulating glucose are tightly regulated. To identify new loci influencing glycemic traits, we performed meta-analyses of 21 genome-wide association studies informative for fasting glucose, fasting insulin and indices of beta-cell function (HOMA-B) and insulin resistance (HOMA-IR) in up to 46,186 nondiabetic participants. Follow-up of 25 loci in up to 76,558 additional subjects identified 16 loci associated with fasting glucose and HOMA-B and two loci associated with fasting insulin and HOMA-IR. These include nine loci newly associated with fasting glucose (in or near ADCY5, MADD, ADRA2A, CRY2, FADS1, GLIS3, SLC2A2, PROX1 and C2CD4B) and one influencing fasting insulin and HOMA-IR (near IGF1). We also demonstrated association of ADCY5, PROX1, GCK, GCKR and DGKB-TMEM195 with type 2 diabetes. Within these loci, likely biological candidate genes influence signal transduction, cell proliferation, development, glucose-sensing and circadian regulation. Our results demonstrate that genetic studies of glycemic traits can identify type 2 diabetes risk loci, as well as loci containing gene variants that are associated with a modest elevation in glucose levels but are not associated with overt diabetes

What’s the catch with lumpsuckers? A North Atlantic study of seabird bycatch in lumpsucker gillnet fisheries

Worldwide, incidental bycatch in fisheries is a conservation threat to many seabird species. Although knowledge on bycatch of seabirds has increased in the last decade, most stems from longline fisheries and the impacts of coastal gillnet fisheries are poorly understood. Gillnet fishing for North Atlantic lumpsucker (Cyclopterus lumpus) is one such fishery. We collated and synthesized the available information on seabird bycatch in lumpsucker gillnet fisheries across the entire geographical range to estimate and infer the magnitude of their impact on the affected seabird populations. Most birds killed were diving ducks, cormorants and auks, and each year locally high numbers of seabirds were taken as bycatch. We found large differences in bycatch rates among countries. The estimated mean bycatch in Iceland was 2.43 birds/trip, while the estimates in Norway was 0.44 and 0.39 birds/trip, respectively. The large disparities between estimates might reflect large spatial differences in bycatch rates, but could partly also arise due to distinctions in data recorded by onboard inspectors (Iceland), self-administered registration (Norway) and direct observations by cameras (Denmark). We show that lumpsucker gillnet fisheries might pose a significant risk to some populations of diving seabirds. However, a distinct data deficiency on seabird bycatch in terms of spatio-temporal coverage and the age and origins of the birds killed, limited our abilities to fully assess the extent and population consequences of the bycatch. Our results highlight the need for a joint effort among countries to standardize monitoring methods to better document the impact of these fisheries on seabirds.© 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/). The attached file is the published pdf