Laeknabladid最新文献

A case is reported of a man in his 70s that presented to the emergency department due to difficulty swallowing after a fall. He was found to have a large retropharyngeal hematoma, which led to complete airway obstruction about an hour after the injury. As oral endotracheal intubation was impossible due to the bleeding, an emergency cricothyrotomy was performed in an ambulance by an emergency medicine trainee. The patient was then transferred to Landspitali for further treatment, but was discharged home in good health 19 days later. Retropharyngeal bleeding following trauma is rare. A pre-hospital cricothyrotomy has not previously been reported for this injury.

Trigeminal neuralgia is the most common cause of facial pain in individuals over 50 years old and can have a profoundly negative impact on quality of life. Epidemiological studies have measured the annual incidence of trigeminal neuralgia at around 4-5 cases per 100,000 inhabitants per year. In Iceland, this would amount to about 16-20 new cases annually. The incidence increases steadily with age, peaking between 50 and 70 years. The pain is sudden and often compared to an electric shock. The attacks usually occur in the second or third branches of the trigeminal nerve. The pain is often triggered by sensory stimulation. Chewing, brushing teeth, speaking, or exposure to cold wind on the face, can all trigger an attack. The most common cause of trigeminal neuralgia is believed to be pressure from a nearby blood vessel on the nerve at its origin in the brainstem. Other underlying causes include multiple sclerosis (MS), tumors and in some cases, no cause is found. Treatment for trigeminal neuralgia involves medication with drugs such as carbamazepine, oxcarbazepine, gabapentin, or various types of surgical procedures. This article will review the epidemiology, pathogenesis, clinical symptoms, diagnosis and treatment of trigeminal neuralgia.

Nordic nutrition recommendations 2023 (NNR2023) advised for the first time certain amounts of foods from food-groups based on scientific data on healthy and environment-friendly diet. The food-based-dietary-guidelines are intended for adults and children above age two, but children's energy requirement and intake are lower than those of adults. In this review, reference amounts of food from different food-groups are calculated for children to align with the combination recommended for adults in NNR2023. The calculated reference consumption for children aged three to 9 years was 50%-76% of that for adults, which means at least 250-380 grams daily of vegetables, fruits and berries, with at least half being vegetables. A comparison with results from studies on diet of randomly selected children in Iceland, in the capital area or country-wide, 2003-2012 (N=943), indicates that children's diet needs to be improved. The data are 10-20 years old, and new data are necessary, but changes in consumption of the food groups compared in the current paper are not expected to be large. Below 5% of the children had lower consumption of vegetables than advised. The median of meat intake was higher than advised maximum intake of red meat for pre-schoolers and adolescents. Pre-schoolers had high fish intake, while older children, especially adolescent girls, had a lower intake. New studies on children's diet are needed in Iceland to analyse their diet today.

Diverticula of gallbladder are very rare and only a few publications are found. Diverticula have typical appearance on radiology and often the diagnosis can be confirmed with ultrasound and magnetic resonance imaging of the gallbladder. Here we present a 61 year old patient that was referred to Landspitali University hospital because of abdominal discomfort, mostly pressure like symptoms in the upper right quadrant. Workup of the patient showed a cystic lesion of the gallbladder. The patient was operated with a laparoscopic cholecystectomy and pathological report showed a diverticula of the gallbladder.

Introduction: Epilepsy is one of the most common chronic illnesses among women of childbearing age, and it is known that antiepileptic drugs can be teratogenic. Recommendations for the treatment of women with epilepsy during pregnancy focus on minimizing the risk of seizures and fetal damage. In general, changes in antiepileptic treatment are not recommended, except to avoid the use of valproate, and the use of high-dose folic acid is advised before and during pregnancy. This article describes the results of a study on the outcomes of pregnancy and childbirth in women with epilepsy on anti-epileptic treatment in Iceland from 2011 to 2020.

Materials and methods: A retrospective, matched case-control study over a 10-year period. Data were obtained from the Icelandic Medical Birth Registry and the Prescription Database of the Directorate of Health. Statistical analysis was based on t-tests, Wilcoxon tests, chi-square tests, and Fisher test, and a linear mixed model was used in cases where adjustment was made for confounding factors.

Results: The study group included 107 births, and 202 in the control group. Women with epilepsy attended more frequent antenatal visits and had higher rates of labor induction, cesarean section and use of anesthesia during labor. There was no difference in mean gestational age, mean labor duration, mean blood loss during labor, or median Apgar score between the groups. Use of antiepileptic medication was lower during pregnancy than before, mainly due to reduced use of valproate.

Conclusions: Pregnancy and delivery outcomes of women with epilepsy were generally favorable. There was no increased risk of serious complications in pregnancy and labor, nor congenital anomalies or deviations in the newborns. We consider our results important for women with epilepsy in Iceland, as well as for doctors and other health care professionals providing their care.