Laeknabladid最新文献

Lambert-Eaton Myasthenic Syndrome (LEMS) is a rare neurological disorder caused by autoimmune antibodies attacking the presynaptic neuromuscular junction, in some cases caused by underlying cancer. The main clinical finding is fluctuating weakness of the extremities and a triad of symtoms can help physicians suspect the disease. A key to the diagnosis are the electrophysiological abnormalities seen in this group of diseases. Treatment with symtomatic and/or immunosuppressive therapy is important as well as a workup for possible malignancy. This article identifies the clinical features, diagnosis and treatment of this uncommon disease.

Introduction: Interest in the use of psychedelics has increased following reports of their possible therapeutic potential. However, little is known about the knowledge of and attitudes towards the substances among health care professional who provide treatment for mental disorders in Iceland. An online survey was therefore conducted among members of the Icelandic associations of psychiatrists, general practitioners and psychologists.

Methods: Respondents were 256 in total, including 177 psychologists, 38 psychiatrists and 41 general practitioners that provided information on their background, type of work, knowledge of and attitude towards different types of psychedelic substances and their views on optimal service delivery if psychedelics were approved by licencing authorities and used for treatment.

Results: Around half of psychiatrists reported having received questions about treatment with psychedelics in their clinical work, compared to only 14,6% of general practitioners and 17,5% of psychologists. The majority of respondents had little, or no knowledge of the substances targeted in the survey. A majority also expressed negative attitudes towards treatment with psilocybin mushrooms, but was positive towards ongoing scientific research and felt that such a treatment should be prescribed and provided by psychiatrists. Moreover, the majority view was that psilocybin treatment should be provided in specialised clinics or psychiatric units in a hospital setting. Scientific articles on the topic, discussions with colleagues and information in the media were identified as having had most influence on respondents´ attitudes towards psychedelics. Most respondents were interested in further education on psychedelics.

Conclusions: Respondents among these three professions felt that the time has not yet come to use psychedelics in the treatment of mental disorders in Iceland but thought more education on psychedelics, their potential efficacy and adverse health effects is important given the increased interest in psychedelics.

An eleven month old girl was referred to the pediatric emergency department at Landspitali Hospital due to fever and lethargy. On examination she was acutely ill with fluctuating level of conciousness. She deteriorated quickly after arrival at the emergency department and was diagnosed with pneumococcal meningitis. In the past year several cases of bacterial meningitis have been diagnosed with Streptococcus pneumoniae as the most common pathogen. The disease causing serotypes have been serotypes that were not in the vaccine that was used in iceland and the Icelandic health authorities have decided to change the vaccination programme accordingly.

Introduction: Taking medicines can induce risks leading to negative health issues that can grow in accordance with the number of medicines used. Many studies on the prevalence of polypharmacy have been carried out in other countries, but such studies are lacking in Iceland. The aim of this study was to analyse the prevalence of polypharmacy in primary care in the Reykjavik metropolitan area.

Methods: The study population consisted of individuals who had been prescribed five or more drugs by physicians in primary care in the Reykjavik metropolitan area during the study period. Data was collected on all drug prescriptions for individuals in the area. Those who had five or more drugs prescribed in the primary healthcare database from 1 January 2010 through 31 December 2019 were included in the study. According to Statistics Iceland, the total number of inhabitants in the area was 200.907 in 2010 and 228.222 in 2019.

Findings: The prevalence of polypharmacy increased gradually in 2010-2019, or by 37.9% during this period. Patients with polypharmacy were 9.8% (19.778) at the beginning of the study in 2010 and increased to 13.6% (30.970) in 2019. A clear association was observed between age and polypharmacy, and the study showed polypharmacy to be more common among women. The study findings revealed that the greatest relative increase in polypharmacy was among young people from 20-49 years of age. ATC class analysis showed a sharp increase in the first and third levels of the ATC subgroups.

Conclusion: The findings suggest polypharmacy to be common in the Reykjavik metropolitan area. Similarly, its prevalence seems to be increasing in younger patients. It is important to gain a better understanding of the reasons for the development of polypharmacy and evaluate the increasing medicalisation in society. The underlying reasons, as well as the effects of polypharmacy, can lead to both positive and negative health outcomes.

Background: Skills labs and simulation centers have become an integrated part of teaching methods in many medical schools. This study aims to describe the status of simulation in medical education in Iceland by examining student and faculty experience, facilitating and barring factors for its use in teaching and how the concept appears in the Course Catalog.

Materials and methods: The study was threefold. In parts one and two, electronic surveys were sent to students and faculty members at the Faculty of Medicine, University of Iceland. Part three was a key word search in the University´s course catalogue relating to simulation.

Results: Response rate for both student and faculty surveys was 65%. Simulation as a teaching method was reported for 10% of faculty according to students but approximately a third of faculty, according to faculty. Attitudes of students and faculty were positive. Faculty, previously exposed to simulation, were more likely to use simulation, as were those who had received training in educational methods. Main barriers identified were lack of facilities, equipment, funds, and training. Key words related to simulation appeared rarely in the University Course Catalogue.

Conclusion: Student and faculty experience with simulation is limited, less than third of faculty claim to have used simulation when teaching medical students. Barring factors in Iceland are similar to what has been reported elsewhere. Lack of words describing simulation in the Course Catalog may raise questions about emphasis on teaching methods or lack thereof. Potential ways to increase the use of simulation could be to improve infrastructure and offer training in diverse educational methods, including simulation, to selected faculty.

Intrauterine devices (IUDs) are a safe and common form of contraception. Uterine rupture and migration of the IUD is a rare complication of insertion but can be serious and cause damage to adjacent organs. We present a case report of a 43 year old woman with chronic abdominal pain who was diagnosed with an IUD in the wall of the sigmoid colon. That IUD had been inserted in the uterine cavity 22 years earlier.