Að hreyfa við óúthvíldri þjóð

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Importance of waist circumference measurements when following children with obesity: Serious abnormalities in blood values of Iceandic children with obesity

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnInngangur: Offita barna er vaxandi heilbrigðisvandamál í heiminum. Gegnum tíðina hefur líkamsþyngdarstuðull (Body Mass Index, BMI) verið helsti mælikvarði á offitu en ágæti hans hefur verið dregið í efa hjá börnum. Heilsuskólinn var stofnaður árið 2011 þegar þverfaglegt teymi var sett saman á Barnaspítala Hringsins til að aðstoða börn og fjölskyldur þeirra við að bæta lífsvenjur sínar. Markmið rannsóknarinnar var að finna þann mælikvarða á offitu barna sem hafði mest forspárgildi um frávik í blóðgildum auk þess að fá heildstæða mynd af frávikum í efnaskiptum barna með offitu í Heilsuskólanum. Efniviður og aðferðir: Rannsóknin var afturskyggn, lýsandi og náði til allra barna sem leitað höfðu til Heilsuskóla Barnaspítalans á tímabilinu 1. janúar 2011 til 15. mars 2013 (n=181). Upplýsingatæknisvið Landspítalans tók saman upplýsingar um hæð, þyngd, BMI, mittismál og niðurstöður blóðrannsókna. Niðurstöður: Frávik í einu eða fleiri blóðgildum fundust hjá 54 börnum (47%). Af þeim börnum sem upplýsingar voru til staðar um höfðu fjögur (4%) staðfesta fitulifur og 28 (28%) höfðu insúlínhækkun, þar af átta (8%) að því marki að þörf væri á inngripi (hyperinsulinemia). Eitt barn hafði bæði fitulifur og marktæka insúlínhækkun. Ályktun: Frávik í blóðgildum barna með offitu eru algeng. Mittismál virðist hafa meira forspárgildi um frávik í efnaskiptum tengdum offitu en BMI-SDS. Mittismál mætti nota til að skima fyrir þeim börnum sem þurfa á reglulegu eftirliti að halda með tilliti til frávika í efnaskiptum. Mittismál bætir mikilvægum upplýsingum við í áhættumati á börnum með offitu. Rannsóknin sýnir því mikilvægi þess að heilbrigðisstarfsfólk mæli mittismál barna sem þeir hafa til meðferðar og eftirlits.Introduction:Childhood obesity is a growing health problem worldwide. Body mass index (BMI) has been used as the main measurement of obesity for years but its quality for children has been questioned. In 2011 the Health School was formed at the Childrens Medical Center at Landspitali University Hospital for treatment of obese children and their families. The aim of this study was to find the best predictor of blood test abnormalities and to get a clear picture of abnormalities in blood values in the group of obese children referred to the Health School. Methods:All children referred to the Health School from January 1st 2011 until March 15th 2013 were retrospectively studied (n=181). Information was gathered on height, weight, BMI, waist circumference and available blood variables. Results:Abnormal blood values were found in 54 cases (47%). Of the children where information was available, four (4%) had Non-Alchoholic Fatty Liver Disease (NAFLD) and 28 (28%) had a raised fasting insulin levels whereof 8 (8%) needed treatment. One child had both NAFLD and raised fasting insulin. Conclusion: Abnormal blood values are common in obese children. Waist circumference appears to have a better predictive value of these abnormalities than BMI-SDS. Waist circumference could be used to screen for children who need physician supervision because of risk of metabolic disorders. Waist circumference adds important information to the risk assessment of obese children. This study emphasises the importance of care givers measuring waist circumference in obese children

Childhood obesity [editorial]

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOffita barna er vaxandi vandamál í hinum vestræna heimi. Þrátt fyrir að mikil vakning hafi orðið í þessum málum hefur ekki tekist að snúa þróuninni við síðastliðin ár. Ef það tekst ekki mun það hafa mikil áhrif á lífsgæði og lífslíkur þjóða

Can science catch the tail of society?

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Íslenskir bændur fá röntgenteikn um lungnaþembu án þess að reykja

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)It has been noted for a long time that among patients admitted to Vifilsstaðir Hospital have been many farmers with severe emphysema without any smoking history. This study was undertaken to explore the relationship between farming and smoking history and X-ray criteria for emphysema. Patients were selected for this study from admissions during the period 1975-1984 on the basis of chest x-rays which were judged by two of the authors (TA and HH) for signs of emphysema by the method described by Sutinen et al. Patients' charts were reviewed and history of farming and smoking recorded. Spirometric results were also recorded and total lung capacity measured as described by Harris et al. A total of 852 chest x-rays were examined and 228 patients were found to have x-ray criteria that indicated the presence of emphysema. The results show that 30,3% of patients were farmers or ex-farmers which is proportionally very high compared to the total population of Iceland. Beside that 58% of farmers and ex-farmers in the patients' group had a history of smoking as compared to 94% of non-farmers. The results indicate that farmers may be exposed to some environmental factor other than smoking that causes them to develop x-ray signs of emphysema.Því hefur lengi verið veitt athygli að á Vífilsstaðaspítala hafa komið bændur með lungnaþembu á háu stigi án þess að hafa nokkurn tíma reykt. Alþekkt eru hinsvegar tengsl lungnaþembu og tóbaksreykinga. Tilgangur þessarar rannsóknar var að kanna fylgni röntgeneinkenna um lungnaþembu og tóbaksreykinga hjá fólki er stundað hefur búskap og bera saman við samskonar hóp sem ekki hefur unnið við búskap. Einnig var gerður samanburður á lungnastarfsemi þessara hópa

Paediatric obesity treatment in Iceland: Prevalence and changes in the prevalence of ADHD, Autism Spectrum Disorders, anxiety and depression

To access publisher's full text version of this article, please click on the hyperlink at the top of the page marked FilesErlendar rannsóknir hafa sýnt að börn með taugaþroskaraskanir (einhverfurófsröskun og athyglisbrest með ofvirkni (ADHD)) eru líklegri til að vera í offituflokki en börn án þessara raskana. Einnig eru börn með þunglyndi og kvíðaraskanir líklegri til að vera með offitu en börn án þessara raskana. Rannsóknir vantar á tíðni þessara raskana hjá íslenskum börnum í offituflokki. Markmið rannsóknar var að meta tíðni fylgiraskana barna sem vísað var í offitumeðferð til Heilsuskóla Barnaspítalans á árunum 2011-2016 sem og breytingar í tíðni raskana á tímabilinu. Rannsóknin var afturvirk og byggð á ópersónugreinanlegum upplýsingum úr sjúkraskrám 379 barna með offitu á aldrinum 4-18 ára. Í inntökuviðtali fengust bakgrunnsupplýsingar um foreldra, þyngdarstöðu barna (skipt í <3,5 og ≥3,5 LÞS-SFS), greiningar, hegðun, líðan og fleira. Upplýsingar voru færðar í REDCap gagnagrunn og unnið úr þeim í tölfræðiforritinu SPSS. Niðurstöður sýndu að hlutfall fylgiraskana er hátt hjá börnum sem koma í offitumeðferð. Aukning varð í hlutfalli barna með kvíða, ADHD, einhverfu og námserfiðleika en ekki þunglyndi á milli áranna 2011/12 og 2015/16. Börnum með ADHD fjölgaði mest. Tvöfaldar líkur voru á að börn með þunglyndi eða einhverfurófsröskun væru í hærri þyngdarflokki eða minnst 3,5 staðalfráviksstigum yfir líkamsþyngdarstuðli (LÞS-SFS) samanborið við börn án sömu raskana. Börn með ADHD og einhverfu voru 3,2 sinnum líklegri til að vera ≥3,5 LÞS-SFS en börn með kvíða eða ADHD með kvíða voru 1,8 sinnum líklegri til þess. Börn með kvíða voru tvisvar sinnum líklegri til að detta úr meðferð strax eftir inntökuviðtal og börn með þunglyndi voru þrisvar sinnum líklegri til þess. - Children with neurodevelopmental disorders such as Attention/Deficit Hyperactive Disorder (ADHD) and Autism Spectrum Disorder (ASD) are more likely to be obese than children without these disorders, especially when comorbid with psychopathology. No information is available on these groups in Iceland. The aim was to analyse the prevalence of and changes of prevalence in potential comorbid disorders among children referred to obesity treatment between 2011 and 2016. The participants were 4-18-year-old patients (n=379). Data was collected retrospectively from patients’ medical records, including weight and height. Information provided by parents included occupational status, education level and information on children’s disorders, behaviour and wellbeing. Data was recorded and stored in the REDCap database and statistically analysed using SPSS. From 2011 to 2016, there was an increase in all disorders, except depression (ASD, ADHD, anxiety, ASD with ADHD and anxiety and ADHD). Children with depression or ASD had a twofold likelihood of being ≥ 3.5 standard deviations above the mean in terms of Body Mass Index (BMI-SDS) compared with children without these disorders. Children with autism and ADHD were 3.2 times more likely, and children with anxiety or ADHD and anxiety combined were 1.8 times more likely to be ≥ 3.5 BMI-SDS than children without these disorders. Children with anxiety or depression were at least twice as likely to drop out of treatment at the onset as children without these disorders.Thorvaldsensfélagi

Family-based behavioral treatment for obese children - results and two year follow up

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnOffita barna hefur aukist á undanförnum áratugum. Brýn þörf er á gagnreyndu meðferðarformi til að sporna gegn þessari þróun og meðal annarra hefur fjölskyldumiðuð atferlismeðferð Epsteins mikið verið rannsökuð, en kallað hefur verið eftir rannsóknum í klínískum aðstæðum. Markmið þessarar rannsóknar var að kanna skammtíma- og eftirfylgdarárangur fjölskyldumiðaðrar atferlismeðferðar Epsteins í klínískum aðstæðum á Íslandi. Efniviður og aðferðir: Úrtakið samanstóð af 84 of feitum börnum á aldrinum 8-13 ára og einu foreldri hvers barns. Sextíu og ein fjölskylda lauk 12 vikna meðferð sem dreifðist yfir 18 vikur og var þeim þátttakendum fylgt eftir í tvö ár eftir að meðferð lauk. Fyrir og eftir meðferð var mæld hæð og þyngd barna, hreyfing, dagleg neysla ávaxta og grænmetis, blóðþrýstingur og ýmis blóðgildi. Lagðir voru fyrir börnin sjálfsmatslistar til að meta andlega líðan og félagsfærni. Hæð og þyngd foreldra var mæld fyrir og eftir meðferð og einnig svöruðu foreldrar sjálfsmatslista fyrir þunglyndi. Niðurstöður: Staðlaður líkamsþyngdarstuðull barnanna lækkaði marktækt frá upphafi til loka meðferðar (F(2,60)=110,31, p<0,001) og var árangri viðhaldið við eins (F(2,60)=1,33, p=0,253) og tveggja ára (F(2,60)= 3,19, p=0,079) eftirfylgd. Blóðþrýstingur lækkaði á meðferðartímabilinu (efri mörk: t(59)=-2,01, p<0,05, neðri mörk: t(59)=-4,00, p<0,001) og lækkun varð á insúlín- (t(22)=6,1, p<0,05), þríglýseríð- (t(22)=0,31, p<0,05) og heildarkólesterólgildum í undirúrtaki (t(22)=0,35, p<0,05). Við meðferð dró úr þunglyndis- (F(1,59)=6,67, p<0,05) og kvíðaeinkennum barnanna (F(1,57)= 4,54, p<0,05) og sjálfsmynd þeirra styrktist (F(1,59)=19,2, p<0,001). Lækkun varð á líkamsþyngdarstuðli foreldra á meðferðartímabilinu (F(1,59)= 71,54, p<0,001) en hann hækkaði aftur við eins árs eftirfylgd (F(1,59)=41,87, p<0,001). Þá dró úr þunglyndiseinkennum foreldra við meðferðina (F(1,60)= 12,93, p<0,01). -----------------------------------------------------------------------------------------------Childhood obesity has become a worldwide epidemic and Icelandic children have not been exempt from increasing rates of obesity. Epstein´s family-based behavioral treatment for childhood obesity has demonstrated favorable outcomes in research settings, but research in clinical settings has been called for. The objective of this study was to replicate and confirm the effects observed in the US research setting. MATERIAL AND METHODS: Participants were 84 obese children (age-range: 8-13 years) and a participating parent. Sixty-one families completed a 12 week treatment lasting 18 weeks, and were followed for one and two years post-treatment. Measurements at baseline and end of treatment included height and weight, daily activity, daily fruit and vegetable consumption, blood pressure, blood profiles and measures of psychological well-being. Measurements also included parental height, weight and depression scores. RESULTS: Among treatment completers BMI-SDS (body-mass index standard deviation score) decreased significantly from pre- to post- treatment (F(2.60)=110.31, p<0.001) which was maintained at one-year (F(2.60)=1.33, p=0.253) and two-years (F(2.60)= 3,19, p=0.079) post treatment. There was a significant reduction in blood pressure (upper: t(59)=-2.01, p<0.05, lower: t(59)=-4.00, p<0.001). Among a subsample (n=23) of participants, significant reductions were observed in fasting insulin levels, (t(22)=6.1, p<0.05), triglycerides (t(22)=0.31, p<0.05) and total cholesterol (t(22)=0.35, p<0.05). Significant improvements were observed for measures of psychological well-being (depressive symptoms: (F(1.59)=6.67, p<0.05); anxiety: (F(1,57)= 4.54, p%lt;0.05) and children´s self-concept (F(1.59)=19.2, p<0.001). A significant reduction was observed in parental BMI scores from pre- to post- treatment (F(1.59)= 71.54, p%lt;0.001) but a significant increase was evident at one year post-treatment (F(1.59)=41.87, p%lt;0.001). Improvements were observed for measures of parental depression from pre- to post- treatment (F(1.60)= 12.93, p<0.01). Epstein´s family-based behavioural treatment showed promising effects on weight status, and emotional as well as physical markers, both in the short and long term in a clinical sample of obese Icelandic children

The cryptic chromosomal deletion del(11)(p12p13) as a new activation mechanism of LMO2 in pediatric T-cell acute lymphoblastic leukemia

To identify new cytogenetic abnormalities associated with leukernogenesis or disease outcome, T-cell acute lymphoblastic leukemia (T-ALL) patient samples were analyzed by means of the array-comparative genome hybridization technique (array-CGH). Here, we report the identification of a new recurrent and cryptic deletion on chromosome 11 (del(11)(p12p13)) in about 4% (6/138) of pediatric T-ALL patients. Detailed molecular-cytogenetic analysis revealed that this deletion activates the LMO2 oncogene in 4 of 6 del(11)(p12p13)-positive T-ALL patients, in the same manner as in patients with an LMO2 translocation (9/138). The LMO2 activation mechanism of this deletion is loss of a negative regulatory region upstream of LMO2, causing activation of the proximal LMO2 promoter. LMO2 rearrangements, including this del(11)(p12p13) and t(11;14) (p13;q11) or t(7;11)(q35;p13), were found in the absence of other recurrent cytogenetic abnormalities involving HOX11L2, HOX11, CALM-AF10, TAL1, MLL, or MYC. LMO2 abnormalities represent about 9% (13/138) of pediatric T-ALL cases and are more frequent in pediatric T-ALL than appreciated until now

Genetics of gene expression and its effect on disease

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldCommon human diseases result from the interplay of many genes and environmental factors. Therefore, a more integrative biology approach is needed to unravel the complexity and causes of such diseases. To elucidate the complexity of common human diseases such as obesity, we have analysed the expression of 23,720 transcripts in large population-based blood and adipose tissue cohorts comprehensively assessed for various phenotypes, including traits related to clinical obesity. In contrast to the blood expression profiles, we observed a marked correlation between gene expression in adipose tissue and obesity-related traits. Genome-wide linkage and association mapping revealed a highly significant genetic component to gene expression traits, including a strong genetic effect of proximal (cis) signals, with 50% of the cis signals overlapping between the two tissues profiled. Here we demonstrate an extensive transcriptional network constructed from the human adipose data that exhibits significant overlap with similar network modules constructed from mouse adipose data. A core network module in humans and mice was identified that is enriched for genes involved in the inflammatory and immune response and has been found to be causally associated to obesity-related traits