Risk factors, coronary artery disease and mortality in giant cell arteritis: a population-based study

Giant Cell arteritis (GCA) is a systemic inflammatory disease that affects arteries of medium- and large size. Symptoms of GCA such as headache and fever usually promptly improve with treatment of glucocorticoids. Apart from advanced age, female sex and Northern-European descent, risk factors for GCA are unknown. Most studies have found that life expectancy for patients with GCA is not reduced compared with the general population and studies on cardiovascular disease in GCA have provided conflicting results. Data for the studies of this thesis are drawn from the Reykjavik Study (RS) that is a general population-based cohort study with continuous surveillance for coronary heart disease and vital status. Subjects born in 1907–1934 and living in Reykjavik, Iceland or adjacent communities in 1966 were invited for study visit from 1967-1994. Information on cardiovascular risk factors were collected at study visit. Diagnosis of GCA for this study was based on re-examination of all temporal arteries biopsies (TAB) from members of the RS cohort; however, information was also obtained from the original pathology report. Of 19,360 subjects included in the RS, 194 developed GCA during the follow-up period. Body mass index was inversely associated with the occurrence of GCA. Among men, but not women, hypertension was associated and smoking inversely associated with the occurrence of GCA. Among women, but not men, GCA was associated with coronary heart disease. Subjects with GCA had approximately 50% increase in mortality risk compared with the general population. Increase mortality was mainly observed among GCA patients based on the diagnosis of re-examination of TAB; however, no such an association was found if diagnosis of GCA was made based on the original pathology report. Those subjects were likely not clinically diagnosed with GCA, signaling that treatment for GCA might be beneficial with respect to mortality risk

Occupational accidents in Icelandic farmers. Risk factor analysis using questionnaire

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)BACKGROUND: There is limited information on occupational injuries among Icelandic farmers. It has been suggested that they are common. This is thought to be in part because of the unique work environment of farmers. The aims of the study were to study occupational accidents among farmers and their effects on absence from work, doctor visits and well-being. METHODS: A cross sectional study of all animal farmers in Iceland operating running a farm of more than 100 animal (sheep) units. A total of 2042 farmers were sent a detailed questionnaire concerning general health symptoms, occupational injuries and doctor visits (response rate 54%). RESULTS: Occupational accidents were common among middle aged and older farmers and lead often to prolonged absence from work. Livestock was most common cause of the accidents, while the association with using alcohol while working was clear. Those involved in occupational accidents more commonly visited a doctor for musculoskeletal symptoms and pain. They also estimated physical and mental well-being worse and had more psychiatric symptoms. CONCLUSIONS: Occupational accidents were common among farmers and lead to prolonged absence from work. They lead to more doctor visits and and worse wellbeing. These results can be used to reinforce health care and preventive measures against occupational accidents among farmers.Inngangur: Lítið er vitað um vinnuslys bænda á Íslandi. Oft er því haldið fram að vinnuslys séu algeng hjá þessum starfshópi. Sérstakt starfsumhverfi bænda er talið eiga þátt í því. Tilgangur rannsóknarinnar var að kanna vinnuslys meðal bænda og hvaða áhrif þau hefðu á líðan, fjarvistir frá vinnu og læknisheimsóknir. Efniviður og aðferðir: Þverskurðarrannsókn af öllum bændum á Íslandi með bú stærra en 100 ærgildi. Alls var 2042 bændum sendur ítarlegur spurningalisti um almenn heilsufarseinkenni, vinnuslys og læknisheimsóknir (svarhlutfall 54%). Niðurstöður: Vinnuslys voru algeng hjá miðaldra og eldri bændum og leiddu þau oft til langra fjarvista. Búpeningur var áberandi orsök slysanna, en tengsl við áfengisnotkun í tengslum við vinnu voru einnig skýr. Þeir sem höfðu orðið fyrir vinnuslysum leituðu oftar læknis vegna stoðkerfiseinkenna og verkja. Þeir mátu einnig líkamlega og andlega líðan verri og höfðu meiri geðræn einkenni. Ályktun: Vinnuslys voru algeng hjá bændum og leiddu til langra vinnufjarvista. Þau leiddu til fleiri læknisheimsókna og líðan var verri. Þessar niðurstöður má nota til að efla heilsugæslu og forvarnir gegn slysum. Bændur þurfa að endurskoða áhættumat sitt með tilliti til slysa

Mental health and wellbeing in Icelandic farmers

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)OBJECTIVE: Some studies have suggest increased prevalence of mental health problems in farmers while others suggest, they are less common. This study aimed to determine the prevalence of mental health problems in Icelandic animal farmers. MATERIAL AND METHODS: This was a cross sectional study of all animal farmers in Iceland (response rate 54%, 1021) with an age matched comparison group (response rate 46%, 637). Psychiatric health was evaluated with General Health Questionnaire-12 and CAGE. Work conditions were studied with eight questions from the General Nordic Questionnaire for Psychological and Social Factors at Work. RESULTS: Farmers were less commonly alcohol consumers. The prevalence of mental health problems among farmers was 17 % while it was 22 % among non-farmers. According to CAGE 16% of male nonfarmers versus 11 % of farmers (p<0,032) had alcohol problems. There was no difference for females. Male farmers less commonly sought medical attention than non-farmers for anxiety, alcoholism and drug abuse. Farmers more often felt that their work was challenging in a positive way and also that work tasks were too complicated. CONCLUSIONS: Mental health disturbances were less common in animal farmers. Educating farmers on work related issues might be important in improving the farming environment.Tilgangur: Rannsóknir sem lúta að heilsufari bænda hafa verið misvísandi hvað varðar andlega vanheilsu og algengi geðsjúkdóma. Markmið með þessari rannsókn var að meta geðheilsu og líðan íslenskra bænda borið saman við úrtak þjóðarinnar. Efniviður og aðferðir: Rannsóknin er þversniðsrannsókn á öllum fjár- og kúabændum á Íslandi (svarhlutfall 54%, N =1021) borið saman úrtak úr almennu þýði (svarhlutfall 46%, 637). Geðheilsa var metin með General Health Questionnaire-12 og CAGE-spurningalistunum. Vinnuumhverfi var metið með spurningum úr „General Nordic Questionnaire for Psychological and Social Factors at Work“. Niðurstöður: Bændur notuðu síður áfengi en almenningur. Algengi geðsjúkdóma meðal bænda samkvæmt GHQ-12 var 17% en meðal almennings 22%. Samkvæmt CAGE áttu 16% karla borið saman við 11% karlbænda (p< 0,032) við áfengisvanda að etja. Karlkyns bændur sóttu síður hjálp en kynbræður þeirra vegna kvíða, og áfengis- og vímuefnanotkunar. Bændur töldu verkefni sín oftar skemmtilega krefjandi en almenningur en samtímis töldu þeir verkefni sín oftar of erfið fyrir sig. Ályktun: Bændur hafa minni merki um andlega vanheilsu en úrtak fólks úr samfélaginu. Þeir leita síður hjálpar vegna geðheilsu sinnar. Vinnuumhverfi bænda er erfitt og krefjandi og virðist því brýnt að auka þekkingu á því hvernig bæta megi vinnuumhverfi þeirra

General health in Icelandic farmers

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenBACKGROUND: There is a limited information on the general health of Icelandic farmers. It has been suggested that it might be worse than among other professions. This is thought to be in part because of the unique work environment of farmers.The aims of the study were to compare the general health of animal farmers with a group of non-farmers, and test the hypothesis that animal farmers overall have a better general health than non-farmers. METHODS: A cross sectional study of all animal farmers in Iceland operating running a farm of more than 100 animal (sheep) units compared with a group of non-farmers. A total of 2042 farmers were sent a detailed questionnaire concerning general health symptoms and doctor visits (response rate 54%). The comparison group consisted of 1500 randomly chosen non-farming individuals (response rate 46%). RESULTS: Farmers comprised more males, were older and smoked less than non-farmers. When general health symptoms for the last 12 months were compared between farmers and non-farmers, minor differences were noted. Farmers less commonly had restless legs, fatigue, diarrhea, allergy and hearing loss. There were no differences in doctor visits for many chronic diseases such as diabetes and hypertension despite the age difference between the groups. Repeated absence from work was less common among farmers and they had shorter sick leaves than comparison group. CONCLUSIONS: Minor differences were noted in general symptoms and doctor visits between farmers and non-farmers despite the fact that farmers were older. Absence from work for illness is less common among farmers. This study suggest that farmers general health is not worse than that of others.Inngangur: Lítið er vitað um almennt heilsufar bænda á Íslandi. Oft er því haldið fram að það sé verra en meðal annarra starfshópa. Sérstakt starfsumhverfi bænda er talið eiga þátt í því. Tilgangur rannsóknarinnar var að bera almenna heilsu íslenskra bænda við samanburðarhóp og prófa þá tilgátu að almennt heilsufar bænda sé lakara en annarra. Efniviður og aðferðir: Þverskurðarrannsókn af öllum bændum á Íslandi með bú stærra en 100 ærgildi sem bornir voru saman við hóp fólks sem ekki eru bændur. Alls var 2042 bændum sendur ítarlegur spurningalisti um almenn heilsufarseinkenni og læknisheimsóknir (svarhlutfall 54%). Í samanburðarhópi voru 1500 manns sem ekki voru bændur, valdir með slembiúrtaki (svarhlutfall 46%). Niðurstöður: Bændur voru eldri og reyktu minna en samanburðarhópur. Þegar heilsufarseinkenni síðustu 12 mánaða voru borin saman kom lítill munur fram. Bændur höfðu sjaldnar fótaóeirð, þreytu, niðurgang, ofnæmi og heyrnartap. Það var enginn munur á læknisheimsóknum vegna margra langvinnra sjúkdóma eins og sykursýki og háþrýstings þrátt fyrir aldursmun hópanna. Bændur voru sjaldnar fjarverandi vegna veikinda og veikindaleyfi þeirra var styttra en samanburðarhóps. Ályktun: Lítill munur var á almennum heilsufarseinkennum og læknisheimsóknum vegna algengra sjúkdóma þegar bændur voru bornir saman við hóp af fólki sem ekki var í bústörfum þrátt fyrir að bændur væru eldri. Rannsóknin bendir til þess að heilsufar bænda sé ekki lakara en annarra

METEOROLOGICAL AND HYDROLOGICAL MODELING OF AN EXTREME PRECIPITATION EVENT IN S–ICELAND

The atmospheric conditions and surface runoff during an event of extreme precipitation have been simulated using numerical weather and hydrological runoff models. The results are compared to the available observations, indicating that the simulations are quite successful in reproducing the event. In the atmospheric simulations, there are very large orographic gradients in precipitation, but no direct observations to verify these gradients. The increase in runoff provides however an indirect validation and the quality of the results are such that numerically simulated precipitation will be used in future hydrological studies in the region. These studies are of great importance to improve flood prediction for the area and for the creation of design floods for various hydropower plants, reservoirs and diversion structures within the river basin

House dust mites at Icelandic farms

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenBACKGROUND: Sensitization to Dermatophagoides pteronyssinus (D. pteronyssinus) occurs in 9% of the Reykjavik population, despite the fact that no Der p 1 antigen has been found in the area. A recent study revealed that sensitized persons more often had a childhood history of work or holiday stay in rural areas than controls. As a follow up we studied the risk of exposure to mites in farmland dwellings. METHODS: In a survey of work-related lung disorders among farmers in the south and west of Iceland, 80 samples of house dust, representing 42 farms, were collected from bedroom mattresses and the floors in living rooms and examined for mites. Treatment of samples was identical with the method used earlier in the Reykjavik investigation (ECRHS II). RESULTS: In contrast to the Reykjavik results, dust from farm dwellings showed a large diversity of mites. Seventeen taxons were found, with Acarus siro and D. pteronyssinus in 13 and 8 farms respectively, but the samples did not show signs that any of the taxons actually had lived or reproduced where they were collected. CONCLUSION: The finding of D. pteronyssinus in farmland dwellings provides a possible explanation of why some Reykjavik citizens might have developed sensitization to this mite, even though cross sensitization to other species of mites could give a false positive reaction to D. pteronyssinus in at least some of those cases. Our observations did not support the idea that the mites were living in the dwellings and an explanation for their occurrence must be sought in the outdoor environment.Bakgrunnur: Næming fyrir Dermatophagoides pteronyssinus (D. pteronyssinus) finnst hjá 9% Reykvíkinga þrátt fyrir að engir Der p 1 mótefnavakar hafi fundist á Reykjavíkursvæðinu. Nýleg rannsókn sýndi að næmir einstaklingar höfðu unnið eða dvalið í sveit á barnsaldri oftar en samanburðarhópur. Til að fylgja þessu eftir könnuðum við líkur á útsetningu fyrir maurum á bóndabæjum. Efniviður og aðferðir: Sem hluti af rannsókn á heilsufari bænda var safnað 80 sýnum af ryki á 42 bóndabýlum á Suður- og Vesturlandi. Sýnum var safnað af dýnum í svefnherbergjum og af stofugólfi og leitað að maurum. Sýni voru meðhöndluð með sambærilegum aðferðum og notaðar voru í rannsókninni Lungu og heilsa sem framkvæmd var í Reykjavík. Niðurstöður: Öfugt við niðurstöður frá Reykjavík fundust í ryki af bóndabæjum 17 tegundir af maurum. Þar af fannst Acarus siro á 13 bæjum og D. pteronyssinus á átta bæjum. Það sáust þó ekki merki um að nein tegund hefði átt bólfestu eða fjölgað sér þar sem sýnunum var safnað. Ályktanir: Fundur D. pteronyssinus á bóndabæjum er hugsanleg skýring á því hvers vegna margir íbúar Reykjavíkur hafa þróað ofnæmi gegn þessum maur. Krossnæmi við aðrar maurategundir getur einnig verið orsökin í sumum tilfellum. Rannsóknir okkar styðja ekki þá hugmynd að maurarnir eigi sér bólfestu á bóndabæjum heldur hlýtur skýringa á fundi þeirra að vera að leita í umhverfi bóndabæjanna

Snow Avalanche Training Dike at Flateyri, Iceland

October 26, 1995 a snow avalanche hit a village in NW Iceland killing 20 people. Subsequently, extensive research on the properties and characteristics of avalanches and defence possibilities was instigated aiming at appraising preventive measures. Due consideration of the prevailing conditions showed training dikes (deflecting dams) of specific height and angles to be the most cost effective measures, provided that these could be constructed from materials available in the immediate vicinity. Additionally, the steeper the slope facing the avalanche (upstream) the more protective the dike. This was designed and constructed at 1 vertical to 1.25 horizontal upstream. The 1200 m long dikes extend from sea level to 60 m a.s.l. up a slope of 10 to 15°. The necessary height varied along the dikes’ alignment from 20 m at the top to 15 m at sea level. Total volume in the dikes amounts about 700.000 m³. The Flateyri fishing village is located in a fiord on a low, narrow promontory extending from a relatively steep mountain slope. The mountainside contains numerous circues and crevasses where appreciable amounts of snow may accumulate. The mountain, some 15 million years old, is built up from a succession of basalt lava flows, frequently intercalated with relatively thin sediments. The columnar core of each flow is typically adjoined by upper and lower scoriae. During the ice age the entire area was ice covered. The glacier left relics in the surroundings e.g. moraines. Thus the talus covering the slopes adjoining the village contains essentially eroded materials of glacial and erosional origin, with the angle of the talus gradually increasing with elevation from essentially zero to some 35°. The talus typically classifies on USCS as SM material, containing some 30 % fines, equal percentage of sand with the remainder being gravel and boulders. This constitutes the construction material

METEOROLOGICAL AND HYDROLOGICAL MODELING OF AN EXTREME PRECIPITATION EVENT IN S–ICELAND

The atmospheric conditions and surface runoff during an event of extreme precipitation have been simulated using numerical weather and hydrological runoff models. The results are compared to the available observations, indicating that the simulations are quite successful in reproducing the event. In the atmospheric simulations, there are very large orographic gradients in precipitation, but no direct observations to verify these gradients. The increase in runoff provides however an indirect validation and the quality of the results are such that numerically simulated precipitation will be used in future hydrological studies in the region. These studies are of great importance to improve flood prediction for the area and for the creation of design floods for various hydropower plants, reservoirs and diversion structures within the river basin

Diagnosing occupational diseases. Examples from shellfish industry

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIt is very important to report suspected occupational diseases in Iceland to the Administration of Occupational Safety and Health, so they can be diagnosed, investigated in details and improvements made. This article describes the illness of clam workers at Thornórshöfn, a small village in the northern part of Iceland. It lead to a detailed investigation and the diagnosis of clamworkers hypersensitivity pneumonitis. Many specialists participated in the study that lead to improvement in the factory that has benefitted the workers.Mikilvægt er að tilkynna um atvinnusjúkdóma til Vinnueftirlits ríkisins því þá er hægt að greina þá, rannsaka ítarlega og gera tillögur til úrbóta. Hér er lýst veikindum starfsmanna í kúskelvinnslu á Þórshöfn sem leiddu til mjög yfirgripsmikillar rannsóknar og til greiningar kúfisksóttar sem er tegund ofsanæmislungnabólgu. Margir aðilar tóku þátt rannsókninni sem leiddi til endurbóta á verksmiðjunni sem hafa komið starfsfólki til góða

Systematic literature review informing the 2022 update of the EULAR recommendations for the management of ANCA-associated vasculitis (AAV) : Part 2 - Treatment of eosinophilic granulomatosis with polyangiitis and diagnosis and general management of AAV

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Funding Information: The authors wish to thank the librarian Oliver Weiner (Medical Department of the Kiel University Library, Kiel, Germany) for advice and assistance, Susanne Blödt (AWMF Institute for Medical Knowledge-Management, Berlin, Germany) for helpful discussions regarding methodical aspects of the SLR as well as Max Yates (Norwich Medical School, University of East Anglia, United Kingdom) and Chetan Mukhtyar (Norfolk and Norwich University Hospital, United Kingdom) for providing evidence tables from the previous guideline update. DJ was supported by the NIHR Cambridge Biomedical Research Centre. Funding Information: This project was funded by EULAR. Publisher Copyright: © 2023 Author(s) (or their employer(s)).OBJECTIVE: To summarise and update evidence to inform the 2022 update of the European Alliance of Associations of Rheumatology (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: Three systematic literature reviews (SLR) were performed. PubMed, EMBASE and the Cochrane library were searched from 1 February 2015 to 25 February 2022. The evidence presented herein covers the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) as well as diagnostic testing and general management of all AAV syndromes. RESULTS: For the treatment of EGPA, diagnostic procedures and general management 3517, 4137 and 4215 articles were screened and 26, 110 and 63 articles were included in the final evidence syntheses, respectively. For EGPA patients with newly diagnosed disease without unfavourable prognostic factors, azathioprine (AZA) combined with glucocorticoids (GC) is not superior to GC monotherapy to induce remission (LoE 2b). In patients with active EGPA and unfavourable prognostic factors, cyclophosphamide or rituximab can be used for remission induction (LoE 2b). Treatment with Mepolizumab added to standard treatment results in higher rates of sustained remission in patients with relapsing or refractory EGPA without active organ-threatening or life-threatening manifestations (LoE 1b) and reduces GC use. Kidney biopsies have prognostic value in AAV patients with renal involvement (LoE 2a). In the context of suspected AAV, immunoassays for proteinase 3 and myeloperoxidase-ANCA have higher diagnostic accuracy compared with indirect immunofluorescent testing (LoE 1a). CONCLUSION: This SLR provides current evidence to inform the 2022 update of the EULAR recommendations for the management of AAV.Peer reviewe