Prevalence of hypertension, which is the most common risk factor for cardiovascular disease in elderly people, increases with age. The aim of the study was to investigate the association between diet and blood pressure in elderly Icelanders, with focus on cod liver oil, and to compare their diet to dietary guidelines.
Diet was assessed using three-day weighed food records and blood pressure was measured after a 12-hour-fast in 236, 65-91 years old, Icelanders living in the capital area of Iceland. 99 men (42%) and 137 women (58%) participated in the study.
According to Nordic nutrition recommendations, intake of nutrients was above lower intake levels among the majority of participants. However, 19% were under this level for vitamin-D, 13% for iodine, 17% of men for vitamin-B6, and 26% and 12% of men and women, respectively, for iron. Systolic blood pressure was inversely associated with cod liver oil intake, even when adjusted for age, body mass index, gender, and antihypertensive medications (P=0.01). Intake of long-chain omega-3 fatty acids correlated with blood pressure in a similar way. Other dietary factors were not associated with blood pressure.
The results indicate that intake of cod liver oil is associated with lower blood pressure among elderly people and may therefore have beneficial effects on health. A notable proportion of participants was at risk of vitamin D, vitamin B6, iodine, and iron deficiency.
OBJECTIVE: Hepatitis C is a common cause of chronic hepatitis and cirrhosis in Western countries. In recent years a large group of individuals have been diagnosed with the disease in Iceland. The aim of this study was to investigate histological parameters of patients with hepatitis C and to correlate histological findings with clinical findings. MATERIALS AND METHODS: In this retrospective study, all patients diagnosed with hepatitis C in Iceland that had a liver biopsy in the years 1991-2001 were included. Data on age, route of infection, duration of infection and co-infection was obtained from medical records. Liver biopsy specimens were evaluated and inflammatory activity graded and the degree of fibrosis staged. RESULTS: In all 97 patients (58 males, 39 females) were included in the study. The mean age was 35.6 years (range 11-64). Risk factors were intravenous drug abuse in 70 (72.6%), blood transfusion in 12 (12.4%) and eight had no known risk factors. Estimated duration of infection was 8.85 years (range 1-31). Average inflammatory grade was 2.84 (range 0-8) and average fibrosis stage was 0.95 (range 0-6). The majority (72.6%) of patients had minimal or no inflammation and 85.5% had minimal or no fibrosis. Only four patients had cirrhosis. Significant correlation was observed between the age at infection and the degree of fibrosis. No correlation was detected between the duration of infection or route of infection and histopathological parameters. CONCLUSION: Patients with hepatitis C that underwent a liver biopsy in 1991-2000 had mild histopathological changes in the liver. This is most likely due to short duration of infection and young age of the patients in this study.
OBJECTIVE: Many herbal products are known to be hepatotoxic. In a recent survey in Iceland concerning adverse reactions related to herbal medicines, Herbalife products were implicated in the majority of the reported cases of hepatotoxicity. METHODS: The clinical presentations of five cases of Herbalife related liver injury during the period of 1999-2008 are analysed. Causality was assessed by using the WHO-UMC system for causality assessment and the RUCAM method. RESULTS: Of the five cases there were four females and one male; median age was 46 years (range 29-78). Herbalife had been used for 1 to 7 months prior to presentation. Four patients presented with a hepatocellular and one with a cholestatic reaction. Median values were for bilirubin 190 micromol/L (range: 26-311; ref.
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.
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.
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.
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.
Liver transplantation is an important treatment option for end-stage liver disease. Since liver transplantation is not performed in Iceland, patients are sent abroad for this procedure. The aim of this study was to investigate indications and results of liver transplantations for Icelandic patients.
The study was retrospective and included all patients in Iceland who had undergone liver transplantation from the first transplantation in 1984 to the end of 2012. Information was gathered from medical records. The study period was divided into three subperiods in order to evaluate changes in frequency of transplantation and survival.
During the period, 45 liver transplantations, thereof five retransplantations, were performed. Of 40 patients 16 were males, 18 females, mean age 40 years. There were six children, 2 girls and 4 boys with an age range of 0.4-12 years. Number of transplantation per million inhabitants increased significantly (2.40 during 1984-1996; 5.18 during 1997-2006 and 8.90 during 2007-2013; p
Transarterial chemoembolization (TACE) is a loco-regional therapy performed to treat tumors in the liver. The branch of the hepatic artery supplying the tumor is catheterized and a mixture of iodized oil, chemotherapeutic agents and PVA embolic materials infused. TACE is a palliative treatment of unresectable cancer in the liver but can also be employed as adjunctive therapy to liver resection and/or radiofrequency ablation. The procedure can in certain instances downstage the disease and provide a bridge to liver transplantation. The aim of this study was to evaluate outcome in patients that have undergone loco-regional therapy in Iceland and the frequency and severity of complications related to the procedure.
All Icelandic patients that had undergone TACE, transarterial chemotherapy or bland embolization of liver tumors between 1 May 2007 and 1 March 2011 were included in the study.
Eighteen TACE, six transarterial chemotherapy treatments and two bland embolizations were performed on nine patients with hepatocellular carcinoma (HCC), and three patients with carcinoid metastases in the liver. Mean-survival of patients with HCC was 15.2 months. Survival of patients with carcinoid metastases was between 61 and 180 months. Complete response was achieved twice and partial response four times. The disease remained stable after eleven procedures but progressed after three procedures. Minor complications were diagnosed in 6 of 26 procedures and one major complication. No patient suffered from liver failure due to the procedure. Of the 9 HCC patients, 1 patient was on the liver transplant list before TACE and later underwent successful transplantation. Additionally, 3 of the remaining 8 patients were downstaged and put on to the transplant list.
Hepatitis C is a major cause of chronic liver disease and cirrhosis in Western countries. Its treatment aims at eradicating the virus and patients are considered cured if the virus is undetectable by PCR in blood 12-24 weeks after end of treatment (sustained virological response, SVR). The aim of this study is to investigate the results of treating hepatitis C in Iceland during the period 2002-2012.
Retrospective study including all patients with hepatitis C receiving treatment with peginterferone and ribavirin at Landspitali University hospital during the period 2002-2012. Patients who had been treated previously were excluded. Information was obtained from medical records and the hospital pharmacy.
A total of 207 patients were included, 136 (66%) males and 71 (34%) females. Mean age was 38 years (range 17-66). Genotyping revealed that 71 (34%) patients had genotype 1, 135 (65%) genotype 3 and one genotype 2. A total of 147 (71%) patients achieved SVR. The rate of SVR was 77.8% for genotype 3 and 57.7% for genotype 1. 9 patients (4%) had cirrhosis and 3 of them had SVR. Of 161 patients who finished treatment per protocol, 87.5% and 77.1% with genotypes 3 and 1 respectively had SVR.
The study demonstrates higher rates of SVR in clinical practice in Iceland compared to controlled clinical trials. The improved effectiveness may be explained by younger patient population, low rate of cirrhosis and close follow-up of patients. Key words: Hepatitis C, peg-interferon, sustained virological response. Correspondence: Sigurdur Olafsson, firstname.lastname@example.org.