The prevalence of mental disorders in the Greater-Reykjavik area

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe purpose of this study was to estimate the prevalence of mental disorders in a random sample of three age groups born in 1931, 1951 and 1971 and living in the Greater- Reykjavik Area. From the original sample of 300 in each birth cohort 805 were contacted and asked to take part in a survey of mental health. Of those 52% participated. The instrument used for diagnosing mental disorders was the CIDI-Auto. The lifetime prevalence of any ICD-10 disorder was found to be 49.8%. The most frequent diagnoses were mental and behavioral disorders due to use of tobacco (23,6%), somatoform disorders (19.0%) and mental and behavioral disorders due to use of acohol (10.8%).Any anxiety disorder was found in 14.4% and any mood disorder in 13.0%. The one-year prevalence for any disorder was 19.7%, for tobacco use disorder 6.5%, alcohol use disorder 6%, somatoform disorders 10.3%, anxiety disorders 5.5% and mood disorders 2.6%. Alcohol use disorders are more prevalent among men but somatoform disorders, anxiety disorders and mood disorders among women. The prevalence rates of mental disorders found in this study is the same or lower than rates found in other comparable studies. There is no indication of an increase in the rate of mental disorder in Iceland.Tilgangur: Að kanna algengi geðraskana hjá þremur aldurshópum á Stór-Reykjavíkursvæðinu. Efniviður og aðferðir: Algengi geðraskana var kannað í hópi 805 einstaklinga úr handahófsúrtaki af Stór-Reykjavíkursvæðinu. Í úrtakinu voru þrír aldurshópar, fæddir árin 1931, 1951 og 1971. Fólkinu var boðið að taka þátt í könnun á geðheilbrigði. Af mögulegum þátttakendum samþykktu 420 (52%) að taka þátt í rannsókninni. Kerfisbundið greiningarviðtal (CIDI-Auto) var notað til að meta geðheilsu. Því luku 416 þátttakendur. Niðurstöður: Lífalgengi geðröskunargreiningar er 49,8%. Algengastar eru geðröskun af völdum tóbaksnotkunar (23,6%), líkömnunarröskun (19%) og geðröskun vegna áfengisnotkunar (10,8%). Sögu um kvíðaröskun höfðu 14,4% og lyndisröskun 13%. Tæp 20% þátttakenda höfðu einkenni geðröskunar síðastliðið ár fyrir skoðun. Ársalgengi geðröskunar vegna tóbaksnotkunar var 6,5% og vegna áfengisnotkunar 6%. Ársalgengi líkömnunarraskana var 10,3%, kvíðaraskana 5,5% og lyndisraskana 2,6%. Geðraskanir vegna áfengisnotkunar voru algengari hjá körlum en líkömnunarraskanir, kvíðaraskanir og lyndisraskanir hjá konum. Ályktun: Algengi geðraskana í þessari rannsókn er svipað og/eða lægra en fundist hefur í sambærilegum athugunum. Niðurstöður hennar benda ekki til þess að algengi geðraskana hafi aukist

The prevalence of personality disorders in the greater-Reykjavik area

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe prevalence of personality disorders was estimated in a sample of 805 individuals randomly selected from the greater Reykjavik area. The sample consisted of 3 equally large cohorts of persons born in 1931, 1951 and 1971. The individuals were asked to participate in a survey of mental health. Of those contacted, 52% of the total group participated. The instrument used for estimating personality disorders was the DIP-Q. The results show that the overall percentage with any disorder was 11 % according to DSM-IV and 12 % according to ICD-10. The most frequent disorder of the whole group, according to DSM-IV criteria, was obsessive-compulsive personality disorder (7.3 %) and schizotypal personality disorder according to ICD-10 criteria, which was to be found in 9% of the group. Other disorders were less frequently found. Comorbidity was high among those with a personality disorder. Of those with disorders according to DSM-IV, 67% had more than one disorder. Similarly, according to the ICD criteria, comorbidity was to be found in 80% of the sample. Among women, anxious/avoidant personality disorder was the most common, with the highest sub-group prevalence found among those born in 1971. Similarly, among the men, schizotypal personality disorder was the most common, and most commonly found in the 1971 age group.Tilgangur: Að kanna hversu algengar persónuleikaraskanir væru á meðal einstaklinga á mismunandi aldri á Stór-Reykjavíkursvæðinu. Efniviður og aðferðir: Tíðni persónuleikaraskana var könnuð í hópi 805 einstaklinga, valinna af handahófi af Stór-Reykjavíkursvæðinu. Í úrtakinu voru þrír hópar fæddir árin 1931, 1951 og 1971. Einstaklingunum var boðið að taka þátt í könnun á geðheilbrigði. 52% þeirra sem haft var samband við samþykktu að taka þátt í könnuninni. Persónuleikaprófið DIP-Q var notað til að meta persónuleikaröskun. Niðurstöður: Niðurstöðurnar eru þær að 11% af öllum hópnum voru með einhverja persónuleikaröskun samkvæmt DSM-IV og 12% samkvæmt ICD-10 kerfinu. Algengasta röskunin samkvæmt DSM-IV var persónuleikaröskun þráhyggju- og áráttugerðar (7,3 %), en persónuleikaröskun geðklofagerðar samkvæmt ICD-10 (9%). Aðrar raskanir voru sjaldgæfari. Af þeim sem voru með persónuleikaröskun samkvæmt DSM-kerfinu höfðu 67% fleiri en eina röskun en samkvæmt ICD- kerfinu 80%. Á meðal kvenna var algengasta persónuleikaröskunin hliðrunarpersónuleikaröskun og var algengust hjá konum fæddum 1931. Á meðal karla var algengasta röskunin persónuleikaröskun geðklofagerðar og var algengust hjá körlum fæddum árið 1971. Ályktun: Þær tíðnitölur sem fram koma í rannsókninni eru mjög sambærilegar við þær sem fram hafa komið hjá nágrannaþjóðum okkar um fjölda þeirra sem búast má við að séu með persónuleikaraskanir í hverju þjóðfélagi. Þetta er fyrsta könnunin sem gerð hefur verið svo vitað sé um algengi persónuleikaraskana meðal almennings á Íslandi

Bacteraemia in children in Iceland 1994-2005

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Positive blood cultures from children suggest serious bloodstream infections. Quick medical response with targeted therapy is important, taking the child's age and medical history into account. Antibiotic therapy and vaccination programs must be based on accurate knowledge of the prevalence and antibiotic susceptibility of the bacteria. The aim of this study was to investigate epidemiological parameters associated with positive blood cultures in children in Iceland from September 20th 1994 to March 16th 2005. Materials and methods: All positive bacterial blood cultures from children 0-18 years of age identified at the Department of Clinical Microbiology of the Landspitali University Hospital during the study period. Age and sex of the children, bacterial aetiology, date of collection and results of antimicrobial susceptibility tests were registered. The children were divided into four age groups: neonates (Inngangur: Blóðsýkingar barna af völdum baktería geta verið alvarlegar. Skjót greining og viðeigandi meðferð geta skipt sköpum. Mikilvægt er að vita hvaða bakteríur eru algengastar hjá börnum á mismunandi aldri auk þess að þekkja sýklalyfjanæmi þeirra svo unnt sé að beita markvissri meðferð eða forvörnum. Markmið: Að draga fram helstu þætti í faraldsfræði blóðsýkinga barna á Íslandi á tímabilinu 20. september 1994-16. mars 2005. Efniviður og aðferðir: Allar jákvæðar niðurstöður blóðræktana hjá börnum 0-18 ára skráðar á Sýklafræðideild Landspítalans á rannsóknartímabilinu voru skoðaðar. Skráður var aldur og kyn sjúklings, tegund bakteríu sem ræktaðist, dagsetning sýnatöku og niðurstöður næmisprófa. Börnin voru flokkuð í fjóra aldurshópa; nýburar (<=30 daga), ungbörn (30 daga-1 árs), börn á leikskólaaldri (1-6 ára) og börn á skólaaldri (6-18 ára). Niðurstöður blóðræktana voru flokkaðar sem mengun, líkleg mengun, líkleg sýking eða sýking. Niðurstöður: Alls ræktuðust bakteríur í 1253 sýnum frá 974 börnum á tímabilinu, 647 sýni frá drengjum og 606 frá stúlkum. Flestar jákvæðar ræktanir voru hjá börnum á fyrsta aldursári (594; 47,4%) og þar af voru 252 hjá nýburum (42,4% barna á fyrsta aldursári). Kóagúlasaneikvæðir stafýlókokkar ræktuðust í 465 tilfellum. Af þeim ræktunum sem flokkuðust sem sýkingar voru Streptococcus pneumoniae algengastar (103 tilfelli), Staphylococcus aureus (94 tilfelli) og Neisseria meningitidis (72 tilfelli). Ekki ræktaðist N. meningitidis af hjúpgerð C hjá neinu barni eftir að bólusetning barna hófst árið 2002. Algengustu hjúpgerðir pneumókokka hjá börnum á Íslandi voru 23, 6B, 7, 19 og 14. Ónæmi fyrir makrólíðum var hátt hjá pneumókokkum (19%) og streptókokkum af flokki A (33%). Ályktun: Niðurstöðurnar gefa mikilvægar upplýsingar fyrir meðhöndlun barna með alvarlegar sýkingar og fyrirbyggjandi aðgerðir. Vaxandi ónæmi fyrir makrólíðum hindrar notkun þeirra við blinda meðferð hjá börnum með sýklasótt. Niðurstöður rannsóknarinnar sýna frábæran árangur bólusetningar barna gegn meningókokkum C auk þess sem þær gefa vísbendingu um mögulega gagnsemi af bólusetningum gegn ákveðnum hjúpgerðum pneumókokka

Individualised risk assessment for diabetic retinopathy and optimisation of screening intervals: a scientific approach to reducing healthcare costs.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.To validate a mathematical algorithm that calculates risk of diabetic retinopathy progression in a diabetic population with UK staging (R0-3; M1) of diabetic retinopathy. To establish the utility of the algorithm to reduce screening frequency in this cohort, while maintaining safety standards.The cohort of 9690 diabetic individuals in England, followed for 2 years. The algorithms calculated individual risk for development of preproliferative retinopathy (R2), active proliferative retinopathy (R3A) and diabetic maculopathy (M1) based on clinical data. Screening intervals were determined such that the increase in risk of developing certain stages of retinopathy between screenings was the same for all patients and identical to mean risk in fixed annual screening. Receiver operating characteristic curves were drawn and area under the curve calculated to estimate the prediction capability.The algorithm predicts the occurrence of the given diabetic retinopathy stages with area under the curve =80% for patients with type II diabetes (CI 0.78 to 0.81). Of the cohort 64% is at less than 5% risk of progression to R2, R3A or M1 within 2 years. By applying a 2 year ceiling to the screening interval, patients with type II diabetes are screened on average every 20 months, which is a 40% reduction in frequency compared with annual screening.The algorithm reliably identifies patients at high risk of developing advanced stages of diabetic retinopathy, including preproliferative R2, active proliferative R3A and maculopathy M1. Majority of patients have less than 5% risk of progression between stages within a year and a small high-risk group is identified. Screening visit frequency and presumably costs in a diabetic retinopathy screening system can be reduced by 40% by using a 2 year ceiling. Individualised risk assessment with 2 year ceiling on screening intervals may be a pragmatic next step in diabetic retinopathy screening in UK, in that safety is maximised and cost reduced by about 40%.Icelandic Research Counci

Bacteremia in children with tumors or malignant diseases 1991-2000

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIntroduction: Ten to twelve children with tumors or malignant diseases are diagnosed annually in Iceland. Cancer treatment can cause severe immune suppression, which makes the patients susceptible to serious infections. The aim of the current study was to evaluate sepsis in children with tumors or haematological malignancies, describe the types of bacteria cultured and their antibiotic susceptibilities, and collect information on associated risk factors. Materials and methods: This was a retrospective study on all children 0-15 years of age in Iceland who were diagnosed with a tumor or malignant disease between 1991 and 2000. Information was gathered on diagnosis, treatment, blood cultures, blood tests, antibiotic use, presence of foreign bodies (such as CVC) and survival. Results: Hundred-and-eighteen children were diagnosed with cancer or benign central nervous system (CNS) tumors in Iceland during the period 1991-2000. Central nervous system tumors were most common (N=28, 23.7%), leukemia (N=21, 17.8%) and lymphoma (N=17, 14%) were the second and third. The mean age at diagnosis was 5.9 years. Sufficient data was found in the hospital records on 99 children who were included in the study. Five hundred and twenty two blood cultures were drawn from 51 of the 99 children during the period. The mean number of blood cultures per patient was 14.8 for children with leukemia, but 2.6 for children with solid tumors. Of all blood cultures, 63.6% were from a central venous catheter or a Port-A Catheter , 5% from a peripheral site, but 30% were undisclosed. Of the 522 blood cultures, 90 grew bacteria (17.2%). Coagulase-negative staphylococci were isolated from 53 blood cultures (60%) and Staphylococcus aureus from 12 (13%). Positive cultures were regarded as a definite or possible infection in 47 blood cultures (52%), contamination in 17 (18.9% ), but uncertain in 26 (27.7%). Over 60 percent of the blood cultures (N=302) were drawn when a child was neutropenic (ANCInngangur: Árlega greinast 10-12 börn með æxli og illkynja sjúkdóma á Íslandi. Meðferð við illkynja sjúkdómum eykur hættu á alvarlegum sýkingum sem mikilvægt er að bregðast rétt við. Markmið rannsóknarinnar var að meta blóðsýkingar í börnum með æxli og illkynja sjúkdóma, þar með talið einstakar bakteríur og sýklalyfjanæmi þeirra. Áhættuþættir voru einnig kannaðir. Efniviður og aðferðir: Rannsóknin var aftur-skyggn og var rannsóknarþýðið öll börn á aldrinum 0-15 ára greind með illkynja sjúkdóm eða æxli á árunum 1991-2000 á Barnaspítala Hringsins. Upplýsingum var safnað um greiningu, meðferð, blóðræktanir, blóðgildi og fleira, svo sem sýklalyfjanotkun, aðskotahluti og afdrif. Niðurstöður: Alls greindust 118 börn með illkynja sjúkdóm eða æxli á tímabilinu. Æxli í miðtaugakerfi (MTK) voru algengust (N=28, 23,7%), þá hvítblæði (N=21, 17,8%) og eitlakrabbamein (N=17, 14%). Meðalaldur barna við greiningu var 5,9 ár. Upplýsingar úr sjúkraskrám voru fullnægjandi fyrir 99 börn. Af þeim var 51 barn blóðræktað. Fjöldi blóðræktana var 522. Meðalfjöldi blóðræktana var 14,8 hjá börnum með hvítblæði, en 2,6 hjá börnum með föst æxli. Blóðræktanir voru teknar úr holæðalegg eða lyfjabrunni í 63,6%, 5,4% úr útbláæð en 31% tilfella voru ótilgreind. Af 522 ræktunum voru 90 jákvæðar (17,2%). Algengasta bakterían var kóagúlasa-neikvæður stafýlókokkur (KNS) (N=53, 60%), en Staphylococcus aureus næstalgengastur (N=12, 13,3%). Jákvæð ræktun var talin tengjast líklegri eða sannaðri sýkingu í 47 tilfellum (52%), mengun í 17 (18,9%) en óvíst var með 26 ræktanir (27,7%). Barn hafði daufkyrningafæð (ANC ?1,0 *109/L) við 302 blóðræktanir (61,4%). Meðallengd daufkyrningafæðar var 9,0 dagar. C-reative protein (CRP) var að meðaltali 63,9 mg/L við blóðræktun og meðalhiti var 38,8 °C. Í 183 tilfellum var barn á sýklalyfjum við blóðræktun (35,1%). Rannsóknarniðurstöður barna með jákvæða blóðræktun voru ekki frábrugðnar öðrum. Ályktanir: Sýkingar af völdum Gram-jákvæðra baktería, sérstaklega KNS, eru nú mun algengari en Gram-neikvæðra baktería. Hluti jákvæðra ræktana getur þó verið mengun. Blóðrannsóknir virðast hafa lítið forspárgildi um niðurstöður blóðræktana. Ekkert barn lést úr blóðsýkingu af völdum baktería á tímabilinu. Reynslusýklalyfjameðferð hérlendis virðist enn árangursrík

Individual risk assessment and information technology to optimise screening frequency for diabetic retinopathy.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.AIMS/HYPOTHESIS: The aim of this study was to reduce the frequency of diabetic eye-screening visits, while maintaining safety, by using information technology and individualised risk assessment to determine screening intervals. METHODS: A mathematical algorithm was created based on epidemiological data on risk factors for diabetic retinopathy. Through a website, www.risk.is , the algorithm receives clinical data, including type and duration of diabetes, HbA(1c) or mean blood glucose, blood pressure and the presence and grade of retinopathy. These data are used to calculate risk for sight-threatening retinopathy for each individual's worse eye over time. A risk margin is defined and the algorithm recommends the screening interval for each patient with standardised risk of developing sight-threatening retinopathy (STR) within the screening interval. We set the risk margin so that the same number of patients develop STR within the screening interval with either fixed annual screening or our individualised screening system. The database for diabetic retinopathy at the Department of Ophthalmology, Aarhus University Hospital, Denmark, was used to empirically test the efficacy of the algorithm. Clinical data exist for 5,199 patients for 20 years and this allows testing of the algorithm in a prospective manner. RESULTS: In the Danish diabetes database, the algorithm recommends screening intervals ranging from 6 to 60 months with a mean of 29 months. This is 59% fewer visits than with fixed annual screening. This amounts to 41 annual visits per 100 patients. CONCLUSION: Information technology based on epidemiological data may facilitate individualised determination of screening intervals for diabetic eye disease. Empirical testing suggests that this approach may be less expensive than conventional annual screening, while not compromising safety. The algorithm determines individual risk and the screening interval is individually determined based on each person's risk profile. The algorithm has potential to save on healthcare resources and patients' working hours by reducing the number of screening visits for an ever increasing number of diabetic patients in the world

Random tree growth by vertex splitting

We study a model of growing planar tree graphs where in each time step we separate the tree into two components by splitting a vertex and then connect the two pieces by inserting a new link between the daughter vertices. This model generalises the preferential attachment model and Ford's $\alpha$-model for phylogenetic trees. We develop a mean field theory for the vertex degree distribution, prove that the mean field theory is exact in some special cases and check that it agrees with numerical simulations in general. We calculate various correlation functions and show that the intrinsic Hausdorff dimension can vary from one to infinity, depending on the parameters of the model.Comment: 47 page