Laeknabladid最新文献

A rare cause of cholecystitis is bacterial infection caused by Salmonella. Complications can be very severe, but are rare, and include fistula formation, intestinal obstruction caused by gallstones or inflammation, and even necrosis and rupture or perforation of adjacent tissue or organs.

Introduction: Acanthamoeba keratitis is a rare but serious eye infection primarily associated with contact lens use. Its diagnosis is often delayed due to treatment challenges, frequent co-infections, and the amoeba's high resistance, leading to significant visual impairment. This study assessed the incidence of Acanthamoeba keratitis in Iceland over 25 years, identified risk factors, diagnostic difficulties, and explored potential improvements.

Materials and methods: A retrospective descriptive study including all individuals diagnosed with amoebic corneal infection in Iceland from 1996-2021. Data were retrieved from culture results in Landspitali's Department of Microbiology and patient records. Selected cases were presented in detail.

Results: Nine cases were identified, with an incidence of 0.11 per 100,000 individuals over the period. All cases had a history of contact lens use, all but one experienced severe pain, and six were misdiagnosed with herpes viral infection. All patients were treated with diamidines and biguanides, but five received steroid treatment before amoeba diagnosis. Two patients required surgery. The total duration of treatment ranged from 5-24 months, with follow-up periods ranging from 4-110 months. Visual acuity at the last examination was 0-1,25 on the Snellen scale.

Discussion: Awareness of environmental amoebas and early diagnosis are key to preventing Acanthamoeba keratitis. Prevention efforts should focus on contact lens users, with targeted education. Diagnostic and treatment guidelines are lacking, and physicians should always consider Acanthamoeba in keratitis cases, particularly in contact lens wearers.

This case report describes a patient presenting with anterior chest pain, cough and polyarthritis with significant systemic inflammatory reaction. On FDG-PET scanning there was significant uptake in the the costochondral cartilage, trachea and joints leading to a diagnosis of relapsing polychondritis.

Restless legs syndrome (RLS) is a common sleep-related movement disorder marked by an urge to move one or both legs (sometimes the arms), especially during periods of immobility. This urge is often accompanied by uncomfortable sensations (dysesthesias) and is typically worse in the evening or at night. Movement provides temporary relief. RLS can significantly disrupt sleep and is frequently associated with periodic limb movement disorder (PLMD), characterized by involuntary muscle contractions during sleep, further impairing sleep quality. The most common causes of RLS are heredity and iron deficiency. New treatment guidelines have introduced major changes. First, dopamine agonists, previously first-line treatment in the 2012 guidelines, are no longer recommended for routine use due to the risk of symptom augmentation. If used, then at low doses for short durations only. Second, iron plays a critical role in the condition's pathophysiology and treatment. Iron therapy, either oral or intravenous, is advised when ferritin levels are below 75 ng/mL, to reach above 100 ng/mL. These recommendations differ from standard guidelines for the general population. Third, if iron levels are sufficient, gabapentin or pregabalin are now recommended as first-line treatment. This article reviews the symptoms, causes, and updated treatment guidelines for RLS.

Background: Head injuries are among the most common reasons for emergency department visits and can have long-term consequences for patients and the healthcare system. The aim was to study the incidence, causes, severity, and sex differences of head injuries at Landspítali during 2010-2023.

Methods: A retrospective study including all presentations of head injury between 2010 and 2023 to the Landspítali emergency department. Data were retrieved from the hospital's health database according to ICD-10 and NOMESCO. Injury scores (ISS/AIS) were calculated for all diagnoses. Descriptive statistics, Poisson regression analysis, chi-square, and Kruskal-Wallis tests with post hoc analyses were performed.

Results: Head injuries accounted for 81,111 presentations, during the period from 2010 until 2023, averaging 5,794 per year. The daily average decreased from 19.4 to 13 cases. Incidence declined significantly (5.6% annually), but the proportion of admissions rose from three to five percent. The most common diagnoses were soft-tissue injuries and concussions. Mild and moderate injuries decreased, and severe injuries increased across the research period. Men more often had mild and severe injuries, whereas women more often had moderate injuries. Most injuries among children were mild. Ninety-day mortality remained stable. Most injury events were due to accidents and mishaps; violence was more frequent among those aged 15-29 years.

Conclusion: Despite the reduction in head injury cases in recent years, head injuries remain a substantial public health problem. Strengthened epidemiological data collection is needed to support policymaking, especially for vulnerable age groups. There is a growing need for integrated services for both older adults and young people in risk groups.

Previous research: has shown that domestic violence is related to more symptoms of post-traumatic stress disorder (PTSD), depression, stress and anxiety, and lower happiness, and that social support can be crucial for survivors. However, limited research has been carried out on this topic in Iceland, particularly comparing men and women. The purpose of the current study is to examine the relationship between domestic violence victimization and symptoms of PTSD, depression, anxiety and stress, as well as happiness in a sample of Icelandic men and women, and to examine the role of social support.

Material and methods: A random sample was drawn from the Icelandic National Register and 1766 individuals responded to a survey (mean age 49 years). They were asked questions about lifetime domestic violence victimization, as well as questions about their current symptoms of PTSD, depression, anxiety, stress and happiness, and social support from friends and family. We tested relationships between victimization, symptoms of PTSD, depression, anxiety and stress, happiness and social support, as well as whether they were moderated by gender.

Results: 15% of participants had experienced domestic violence, which was more common among women (20%) than men (10%). Domestic violence survivors had significantly greater symptoms of PTSD, depression, anxiety and stress and lower happiness than non-victimized people, but this effect depended on sex. Women survivors reported significantly greater symptoms of PTSD, depression, anxiety andstress and lower happiness, and poorer social support than other women, and men survivors reported greater symptoms of PTSD, depression and stress, lower happiness and lower family support than other men. It should be noted that all group means were below clinical cutoff scores. Social support was related to lower symptoms of PTSD, depression, anxiety and stress, as well as greater happiness.

Conclusion: A considerable portion of the Icelandic population has experienced domestic violence, which is related to greater symptoms of PTSD, depression, anxiety and stress, and lower happiness. It is important to systematically intervene to boost social support, especially among survivors of domestic violence.