ÁGRIP VEGGSPJALDA
V01 Teacher beliefs about motivational strategies at a health sciences school
Abigail G. Snook1, Ásta B. Schram2, Brett D. Jones3, Þórarinn Sveinsson4
1Physical Therapy/Medicine, University of Iceland, 2HVS, University of Iceland, 3Educational Psychology, Virginia Polytechnic Institute and State University, 4Faculty of Medicine, University of Iceland
abigail@hi.is
Introduction: We wanted to examine teachers'
attitudes towards and use of motivational strategies at the University of Iceland's
School of Health Sciences.
Methods:Two-hundred-ninety-eight teachers (35%
response rate) participated in an online survey that assessed teacher attitudes
towards and recent classroom use of strategies based on a well-known motivation
model (www.themusicmodel.com). Teachers rated the following statements: It is a
part of a teacher's responsibility to: (1) give students some choices in
learning, (2) make learning useful, (3) provide timely feedback and good
organization so that students perceive they can be successful, (4) make
learning interesting, and (5) communicate caring and respect for students and
their goals. Teachers also rated five similar statements regarding their
classroom use of strategies in the last year.
Results: The percentage of “strongly agree” or
“agree” responses for each of the belief statements were (in order): 51%, 93%,
71%, 97%, 96%. The percentage of “strongly agree” or “agree” for the classroom
use statements were (in order): 36%, 77%, 51%, 78%, 85%.
Conclusions: We found that faculty are less likely
to believe it is part of their responsibility or use: (1) giving students some
choices as a part of supporting autonomy and (2) making sure students believe
they can be successful by providing timely feedback and good organization.
Faculty development programs need to educate faculty on the importance of
giving students some choices and supporting autonomy, as well as supporting
student expectancy to succeed as a way to enhance student motivation and
promote self-regulation.
V02 Spáir alvarleiki vinnuslysa fyrir um langtíma heilsutengd lífsgæði (HL)?
Steinþóra Jónsdóttir1, Jóhann Friðrik Friðriksson2, Kristinn Tómasson2
1Rannsókna- og heilbrigðisdeild Vinnueftirlitsins, 2Vinnueftirlitið
steinthora@ver.is
Inngangur: Þekking á áhættuþáttum, alvarleika,
tíðni og orsökum vinnuslysa er víðtæk en fáar rannsóknir hafa kannað
heilsutengd lífsgæði (HL) þeirra sem lenda í vinnuslysum. Þær rannsóknir sem til
eru benda til þess að vinnuslys hafi veruleg áhrif á heilsutengd lífsgæði.
Markmið þessarar rannsóknar var að greina áhrif alvarlegra og almennra
vinnuslysa á HL útkomur og bera kennsl á þá þætti sem spá fyrir um HL hjá þeim
sem lent hafa í vinnuslysum.
Efniviður
& aðferðir: Gagnaöflun
fór fram á tímabilinu mars til júní 2018. Fjögur hundruð slysa úrtak var tekið
úr öllum tilkynntum vinnuslysum á Íslandi 2016, þar af var helmingur flokkaður
sem alvarleg slys. Spurningalisti var sendur út rafrænt á þátttakendur og
annara gagna aflað úr vinnuslysaskrá Vinnueftirlitsins. Notast var við T-test og
ANOVA til að greina muninn á meðalstigum HL milli þeirra sem höfðu lent í
alvarlegum og almennum vinnuslysum.
Niðurstöður: Það var ekki marktækur munur á
meðalstigum HL milli alvarlegra og almennra vinnuslysa (p=0,944). Þeir sem
töldu sig hafa varanlegar afleiðingar af slysinu höfðu marktækt lægri meðalstig
HL (p=0,044), sérstaklega þegar kemur að verkjum (p<0,001) og líkamlegri
heilsu (p=0,009). Slæm fjárhagsleg staða, minnkuð vinnufærni,
veikindafjarvistir, fjöldi einkenna, verkir, kvíði/þunglyndi, og fjöldi áverka
voru allt marktækir áhrifaþættir fyrir HL þátttakenda (p≤0,001).
Ályktanir: Endurhæfing og önnur þjónusta við þá
sem lent hafa í vinnuslysum ætti að beina sinni þjónustu að þeim sem ekki
komast aftur til fyrri vinnu. Niðurstöður rannsóknarinnar benda til þess að
verkjameðferð, sálfélagslegur stuðningur, starfsþjálfun og starfsendurhæfing
ætti að vera forgangsmál fyrir þennan hóp.
V03 Árangur sjúkraþjálfunar hjá sjúklingum með starfræn einkenni: Kerfisbundin samantektarrannsókn
Birna Ó Aradóttir1, Soffía Klemensdóttir1, G. Þóra Andrésdóttir2, Björg Guðjónsdóttir1
1Læknadeild, námsbraut í sjúkraþjálfun, Háskóla Íslands, 2Landspítali
birnaoa@landspitali.is
Inngangur: Starfræn einkenni eru skilgreind sem
taugaeinkenni án vefrænna skýringa. Konur greinast oftar með sjúkdóminn en
karlar og er meðalaldur við greiningu í kringum 40 ár. Einkenni sjúkdómsins eru
fjölbreytt, misalvarleg og misalgeng. Sjúkraþjálfun er þekkt meðferðarúrræði
fyrir sjúklinga með starfræn einkenni. Markmiðið var að gera kerfisbundna
samantekt á árangri meðferða sjúkraþjálfara hjá þessum hópi sjúklinga.
Efniviður
& aðferðir: Gagnabankarnir
Cinahl, Medline – Ovid, Proquest og CSA, Science direct – Elsevier og Medline –
Pubmed voru notaðir við að finna greinar sem lýsa meðferðum og árangri
sjúkraþjálfara við meðhöndlun sjúklinga með starfræn einkenni. Leitað var að
rannsóknum á ensku sem birst höfðu frá 6. september 2012 til 19. febrúar 2017.
Niðurstöður: Við leitina komu upp 881 grein en
aðeins 12 rannsóknir uppfylltu inntökuskilyrðin sem voru notuð í kerfisbundnu
samantektinni. Ein slembivalin samanburðarrannsókn fannst við leitina en aðrar
rannsóknir voru af lægra sönnunarstigi. Rannsóknirnar innihéldu fáa
þátttakendur og var helmingur þeirra tilfellarannsóknir með einum þátttakanda.
Mismunandi aðferðir voru notaðar við sjúkdómsgreiningu, mat á árangri og
meðferð var fjölbreytt. Allar rannsóknirnar nema ein rannsökuðu áhrif af
þverfaglegri nálgun í meðferð þessa sjúklinga þar sem sjúkraþjálfun var hluti
af heildarmeðferð og því erfitt að ákvarða hvaða íhlutun skilar mestum árangri.
Algengasta meðferðarnálgun sjúkraþjálfara var atferlismótun og var hún notuð í
helmingi rannsóknanna. Niðurstöður bentu til mögulegra jákvæðra áhrifa af
sjúkraþjálfun.
Ályktanir: Fáar hágæða rannsóknir um meðferðir
sjúkraþjálfara fundust við leitina. Vísbendingar eru um jákvæð áhrif af
sjúkraþjálfun en frekari rannsókna er þörf til að hægt sé að álykta um að
sjúkraþjálfun beri árangur.
V04 Fóstureyðingar og líðan íslenskra kvenna
Rúnar Vilhjálmsson
Hjúkrunarfræðideild Háskóla Íslands
runarv@hi.is
Inngangur: Erlendar rannsóknir á fóstureyðingum
hafa einkum beinst að fóstureyðingartíðni og ástæðum fóstureyðinga, fremur en
mögulegum afleiðingum. Rannsóknin athugar tengsl fóstureyðinga og sálrænnnar vanlíðunar
kvenna og mögulegar skýringar á þessum tengslum.
Efniviður
& aðferðir: Á
fyrri hluta árs 2015 fór fram heilbrigðiskönnun meðal íslenskra ríkisborgara,
búsettra á Íslandi, á aldrinum 18-75 ára. Svarendur fengu póstsendan
spurningalista en var einnig gefinn kostur á að fylla spurningalistann út á
netinu. Alls tóku 1599 einstaklingar þátt í heilbrigðiskönnuninni og voru
heimtur tæp 60%. Rannsóknin byggir á svörum þeirra 792 kvenna sem þátt tóku í
heilbrigðiskönnuninni. Vanlíðan var mæld með undirkvörðum SCL-90
einkennalistans varðandi kvíða, þunglyndi og reiði.
Niðurstöður: Tæp 2% kvenna í rannsókninni höfðu
gengist undir fóstureyðingu sl. 12 mánuði. Konur sem gengist höfðu undir
fóstureyðingu upplifðu mun meiri kvíða, þunglyndi og reiði en aðrar konur í
rannsókninni, þótt tekið væri tillit til aldurs, menntunar og fjölskyldutekna
(p<0,001). Tengsl fóstureyðingar við sálræna vanlíðan skýrðust aðeins að
litlum hluta af andlegum og líkamlegum veikindum sl. 12 mánuði, eða áföllum og
þrálátum erfiðleikum, eða félagslegum stuðningi maka/sambýlismanns eða
vina/vandamanna.
Ályktanir: Rannsóknin bendir til að konum sem hafa
gengist undir fóstureyðingu líði mun verr en öðrum konum. Veikindi og aðrar
erfiðar aðstæður skýra þessar niðurstöður að takmörkuðu leyti, því eftir sem
áður eru veruleg tengsl milli fóstureyðingarinnar og sálrænnar vanlíðunar. Gefa
þarf sérstakan gaum að líðan kvenna sem hyggjast gangast undir fóstureyðingu og
leita leiða til að draga úr vanlíðan þeirra.
V05 Self-reported complications, goals and beneficial activities in community-dwelling individuals with spinal cord injury in Sweden
Anestis Divanoglou1, Richard Levi2, Claes Hultling3, Marika Augutis4, Þórarinn Sveinsson5
1University of Iceland, 2Department of Rehabilitation Medicine, Linköping University Hospital, 3Spinalis, 4Research and Development, Sundsvall Hospital, 5Department of Physiotherapy, University of Iceland
anediv@hi.is
Introduction: Needs of people with spinal cord
injury (SCI) may vary based on age, years since injury (YSI) and level/type of
lesion. Systematic monitoring of these aspects is important to inform the
design of effective services. This study aimed to explore self-reported
physical and psychological problems, functional goals, and perceived activities
that could improve quality of life (QoL) in community-dwelling individuals with
SCI in Sweden.
Methods: Cross-sectional descriptive study. The
survey was designed by an experienced peer mentor with SCI and was distributed
online by the organisation RG Active Rehabilitation to individuals with SCI in
Sweden.
Results: 203 individuals (55% males, 90%
acquired SCI) from all regions in Sweden responded. 33% reported living with
>2 unbearable physical or psychological problems. While some problems (e.g.
problems related to bladder) were consistently ranked high across all YSI and
type of SCI, distribution of some other unbearable problems (e.g. type of pain,
excessive weight) varied between subgroups. YSI, level of SCI and gender, but
not age-groups or type of SCI, explained some of the variation in the goals.
Trips to sunny places and regular physical training were reported to be more
likely to improve QoL, while practicing elite sports and ski.
Conclusions: The high proportion of reported
“unbearable” problems point to the stronger need for systematic, comprehensive,
life-long, multi-disciplinary follow-up for people with SCI. The high rate of
goals related to improving strength and fitness across all participants
independently of their characteristics highlight the important role of
community organizations that offer such lifetime services.
V06 Dynamic joint stiffness of prosthetic feet
Guðni Harðarson1, Anna Ármannsdóttir2, Chadi Barakat2, Christophe Lecomte2, Ragnar Ö. Gunnarsson3, Sigurður Brynjólfsson2, Kristín Briem2
1Centre of Movement Science, Faculty of Medicine, University of Iceland, 2University of Iceland, 3Össur, Research and development
ala20@hi.is
Introduction: One way of evaluating the dynamics of
the human ankle joint, is to analyze the slope of the curve representing the
ankle angle vs. ankle moment during different subphases of the stance phase of
gait, thereby estimating the so-called dynamic joint stiffness (DJS) of the
joint (Garbriel 2008, Crenna 2011). This method was used in this pilot study, contrasting
the DJS of a prosthetic foot with diverse forefoot stiffness properties during
level ground walking, in an attempt to understand subtle mechanical changes in
prosthetic feet.
Methods: Biomechanical data were collected as a
unilateral transtibial amputee walked with a prosthetic foot in which the
stiffness of the forefoot could be varied with a softer forefoot (SoF) versus a
stiffer forefoot (StF). The data from repeated measurements were processed and
ankle vs. moment graphs derived for the stance phase of the gait cycle.
Results: Data for the push-off phase of stance
reflected the anticipated SoF vs. StF properties of the prosthetic foot.
Unexpectedly, results showed that during controlled plantarflexion (from
initial contact to foot flat) and controlled dorsiflexion (midstance), the DJS
of SoF foot was higher than that of StF foot, indicating greater stiffness
despite the softer forefoot.
Conclusions: This way of interpreting the ankle
dynamics allows a detailed description of this relationship between the ankle
angle and the ankle moment, which could provide implications for prosthetic
foot design (Safaeepour 2014), as it gives more insight into the behavior of
the prosthesis at a given time in the gait cycle.
V07 Aukning kókaín misnotkunar 2008-2017
Hrefna Ólafsdóttir, Sólveig S. Halldórsdóttir
Rannsóknastofu í lyfja- og eiturefnafræði, Háskóli Íslands
hrefnao@hi.is
Inngangur: Vímuefnanotkun ökumanna gefur
vísbendingar um fíkniefnanotkun á Íslandi. Á hverju ári berast rannsóknarstofu
í lyfja- og eiturefnafræði (RLE) um 1000-2000 mál þar sem einstaklingar eru
grunaðir um að aka undir áhrifum ólöglegra ávana, fíkniefna og lyfja.
Algengustu fíkniefnin hafa verið kannabis og amfetamín, en síðasta ár var
misnotkun kókaíns áberandi. Markmið rannsóknarinnar var að kanna breytingar á
fjölda jákvæðra kókaínsýna og hvort tengsl væru á milli kaupmáttar Íslendinga
og misnotkunar á kókaíni. Borinn var saman fjöldi lífsýna þar sem kókaín
greindist í ökumönnum, magn kókaíns sem lögregla og tollgæsla lögðu hald á og
kaupmáttur skv. Hagstofu Íslands á árunum 2008-2017.
Efniviður
& aðferðir: Fastfasa
súluskiljun er notuð við úrhlutun blóðsýna og kókaín er magngreint með GC-MS.
Gögn frá tímabilinu 2008-2017 voru skoðuð; lífsýni frá lögreglu þar sem kókaín
mældist í blóði, kaupmáttur lágmarkstaxta frá Hagstofu Íslands og gögn frá
afbrotatölfræði ríkislögreglustjóra um magn af haldlögðu kókaíni.
Niðurstöður: Sýnileg aukning er á jákvæðum sýnum
hjá RLE. Árið 2008 voru um 120 jákvæð sýni en á milli 2009-2015 var fjöldi jákvæðra
sýna nokkuð stöðugur undir 100 sýnum á ári. Nokkur aukning var á fjölda sýna á
milli 2015-2016 en frá 2016-2017 rúmlega tvöfaldaðist fjöldi sýna úr 140 í 330.
Miðað við mæld sýni fyrstu 7 mánuði ársins 2018 stefnir heildarfjöldi jákvæðra
sýna í 500.Tölur frá ríkislögreglustjóra sýna svipaða aukningu síðan 2015. Gögn
frá hagstofunni sýna einnig aukinn kaupmátt fyrir sama tímabil. Jákvæð fylgni
(um 0,8) er á milli gagna RLE, lögreglu og Hagstofunnar.
Ályktanir: Með vaxandi kaupmætti eykst neysla og
innflutningur kókaíns.
V08 Þróun nýrra talgreiningarlista fyrir íslenska fullorðna kuðungsígræðsluþega
Þóra Másdóttir1,3, Sigríður E. Guðmundsdóttir2,4
1Talmeinafræði, Háskóli Íslands, 2Háskóli Íslands, 3Heyrnar- og talmeinastöð Íslands, 4Reykjavíkurborg
thoramas@gmail.com
Inngangur: Á Íslandi fer hópur fullorðinna
kuðungsígræðsluþega stöðugt stækkandi. Eitt af því sem ígræðsluþegar binda hvað
mestar vonir við er að greina og skilja talað mál. Fyrir ígræðslu er
talgreining metin og að ígræðslu lokinni hefst endurhæfingarferli með
endurteknum prófunum. Það próf sem nú er notað til talgreiningar á Íslandi er
komið vel til ára sinna auk þess sem hluti þess er ekki staðlaður. Með betri
tækni hefur færni til talgreiningar aukist og hafa talgreiningapróf víða erlendis
verið endurskoðuð. Tilgangur þessa verkefnis er að þróa nýja talgreiningarlista
og forprófa á íslenskum fullorðnum kuðungsígræðsluþegum.
Efniviður
& aðferðir: Fyrirmynd
íslensku listanna er bandarískt próf sem víða er notað. Þar sem ekki er hægt að
þýða slíka lista beint voru búnar til formúlur sem byggðust á hljóðkerfislegum
og setningafræðilegum þáttum. Auk þess voru bæði fengnir sérfræðingar og óháðir
aðilar til að meta eðlileika setninga. Jafngildi lista (erfiðleikastig) var
síðan rannsakað með forprófun á tíu fullheyrandi einstaklingum.
Niðurstöður: Niðurstöður forprófunar sýndu ekki
marktækan mun á listunum sem bendir til að um þeir séu jafngildir og
áreiðanlegir. Þrátt fyrir að talgreiningarskor beggja lista hafi verið afar
svipað kom í ljós að skor setningalista var marktækt hærra en orðalista og er
það í takt við erlendar niðurstöður. Í orðalistunum áttu þátttakendur helst í
erfiðleikum með að greina á milli málhljóða með sama myndunarhátt. Í
setningalistum komu helst fram villur þar sem setningafræðileg uppbygging var í
flóknara lagi.
Ályktanir: Um er að ræða jafngilda
talgreiningarlista sem þróaðir verða áfram í átt að fullri stöðlun.
V09 Creating a Musculoskeletal Model for Dynamic Change-of-Direction Movements
Oliver Daliet1, Haraldur B. Sigurðsson2, Kristín Briem2
1Department of Physical Therapy, University of Iceland, 2Department of Physical Therapy, Research Center for Movement Science
odaliet4@gmail.com
Introduction: OpenSim is an open source software
used to perform musculoskeletal simulations of the force generated by each
muscle during a described movement. This feature is particularly useful when
analyzing the forces exerted through specific joints in the body since there is
no way to measure these forces in-vivo. Thus, the purpose of this pilot study
is to create an opensim model to simulate a change-of-direction movement
through the lower extremities that generates a plausible muscle output.
Methods: Movement data, captured by 8 Qualisys
cameras, and ground reaction forces from an in-ground force plate were
collected from one subject who performed a single-leg drop jump from a height
of 30 cm and a cutting maneuver on the right leg. The data were then used as
inputs for a custom opensim model derived from two existing models (Gait2392 and
a 6dof knee model) scaled to the anthropomorphics of the subject.
Results: The preliminary results show that the
average muscle force (AMF) estimates produced by OpenSim for some muscle are
too weak to perform the desired motion. For example, the AMF for the right
gluteus medius during the change-of-direction movement was 30.5 N.
Consequently, the range of the reserve actuators, additional forces applied to
the model to produce a movement, varies from -91.2 N to 416.3 N.
Conclusions: The initial results of our model show
potential for achieving a realistic simulation. However, more calibration of
the model parameters is necessary.
V10 Mat á munnslímhúð hjá sjúklingum með krabbamein á höfuð- og hálssvæði sem eru í geislameðferð
Arnfríður Magnúsdóttir1, Nanna Friðriksdóttir1, Valgerður Sigurðardóttir2, Sigríður Zoëga1
1Hjúkrunarfræðideild Háskóla Íslands, 2Landspítali
arm20@hi.is
Inngangur: Geislameðferð á höfuð- og hálssvæði
veldur munnslímhúðarbólgu hjá um 80-100% sjúklinga og þriðjungur fær alvarlega
munnslímhúðarbólgu. Tilgangur rannsóknarinnar var að meta hvenær
munnslímhúðarbólga kom fram, hversu alvarleg hún var og hversu lengi hún varði.
Einnig hvort samræmi var milli Oral Assessment Guide mælitækisins (OAG) og The
World Health Organization Oral Toxicity Scale (WHO-OTS) mælitækisins.
Efniviður
& aðferðir: Gerð
var lýsandi framsýn rannsókn með endurteknum mælingum. Munnhol var metið hjá
öllum sjúklingum sem uppfylltu skilyrði á 8 tímapunktum meðan á meðferð stóð og
2 vikum eftir meðferð lauk með OAG og WHO-OTS af tveimur
heilbrigðisstarfsmönnum. OAG metur átta atriði í munnholi þar sem hvert atriði
fær 1-3 stig eftir alvarleika. WHO-OTS metur breytingar á munnslímhúð og getur
til að nærast á skalanum 0 - 4.
Niðurstöður: Þátttakendur voru 21 talsins, 13
karlar og 8 konur. Meðalaldur var 56,2 ár (spönn 38-80 ár). Alvarleg
munnslímhúðarbólga kom fram í annarri viku meðferðar en þá voru 8 einstaklingar með alvarlega munnslímhúðarbólgu samkvæmt OAG og sex með gráðu 3
samkvæmt WHO-OTS. Undir lok meðferðar voru átján með alvarlega
munnslímhúðarbólgu samkvæmt OAG og fimmtán með gráðu 3 samkvæmt WHO-OTS. Rúmum tveimur vikum eftir geislameðferð eru 10 með alvarlega munnslímhúðarbólgu samkvæmt
OAG og sex með gráðu 3 samkvæmt WHO-OTS. Nánari greining á gögnum er í vinnslu.
Ályktanir: Fyrstu niðurstöður benda til þess að
samræmi sé á milli niðurstaðna úr OAG og WHO-OTS mælitækjana. Fyrstu
niðurstöður benda til þess að alvarleg munnslímhúðarbólga sé enn til staðar hjá
um helmingi sjúklinga rúmum tveimur vikum eftir lok meðferðar.
V11 Are reading problems related to both the dorsal and ventral visual pathways?
Alexandra Arnardóttir1, Hilma R. Ómarsdóttir2, Eydís Þ. Halldórsdóttir2, Anna S. Valgeirsdóttir2, Heiða M. Sigurðardóttir2
1Faculty of Psychology, University of Iceland, 2University of Iceland
ala34@hi.is
Introduction: Two lines of research have been
notable when looking into visual deficits for individuals with reading
problems. One view focuses on the dorsal visual stream and the other on the
ventral visual stream. The aim of the current study was threefold. Firstly, to
investigate if reading problems are associated with deficits in feature-based
face processing (ventral view). Secondly, to replicate previous findings on a relationship
between visual search and reading problems (dorsal view). Lastly, to see if
there is a link between visual-attentional problems and problems with facial
perception for people with reading problems.
Methods: 60 participants participated in the study.
All were undergraduate students or had graduated within the past two years.
Reading problems were measured using the ARHQ-questionnaire and the IS-FORM and
the IS-PSEUDO reading tests. Featural and holistic processing of faces was
assessed with a face matching task. Visual conjunction search, an
attention-demanding task, was measured using lines with a specific combination
of orientation and brightness and visual feature search was measured using a
pop-out task.
Results: Reading problems appear to be associated
with both task-specific problems in feature-based face matching and slower
visual search, especially conjunction search. However, the association between
task-specific problems in feature-based face matching and reading problems do
not seem to be driven by attentional problems.
Conclusions: There is evidence for both the ventral
and dorsal view in visually driven reading deficits, but they do not seem to be
connected. This indicates that reading problems have more than one underlying
factor.
V12 Þverfagleg samvinna á fyrsta námsári við námsbrautir heilbrigðisvísindasviðs
Inga S. Ólafsdóttir
Læknadeild Háskóla Íslands
ingasif@landspitali.is
Inngangur: Störf í heilbrigðisvísindum eru
fjölbreytt og möguleikar til sérhæfingar miklir. Til að samnýta þekkinguna
reynir sífellt meir og meir á þverfaglega samvinnu. Í janúar 2018 var haldið
námskeið í þverfaglegri samvinnu hjá öllum fyrsta árs nemum við námsbrautir
Heilbrigðisvísindasviðs HÍ. Námskeiðið var haldið að sænskri fyrirmynd frá
Sahlgrenska háskólanum í Gautaborg þar sem slíkur þverfaglegur dagur hefur
verið haldin frá árinu 2015. Mannréttindi og þverfagleg samvinna eru megin
áhersla þessa námskeiðs sem skiptist í fyrirlestra fyrir hádegi og umræðuhópa
með handleiðurum eftir hádegi. Námsmat nemenda er hluti af námskeiðinu. Þegar
nýjungar í kennslu eru reyndar er mikilvægt að skoða og meta slíkar
niðurstöður.
Efniviður
& aðferðir: Námsmat
nemenda á námskeiðinu var skoðað og lýsandi tölfræði beitt til að meta
niðurstöðurnar.
Niðurstöður: Fjöldi nemenda sem tóku þátt í
námskeiðinu voru 293. Af þeim töldu 97% námskeiðið virka vel eða mjög vel.
Nemar voru mjög ánægðir með fyrirlestrana (56-86%). Nemendur voru ánægðir með
umræðuhópa og töldu efni þeirra eiga vel við (68-80%). Nemendur töldu að
jafnaði að tími fyrir umræðutímana væri mátulega mikill (58-63%). Allir
nemendur sem tóku prófið í lok námskeiðsdags stóðust prófið. Handleiðarar voru
jákvæðir eftir námsdaginn og töldu umræðuhópana hafa gengið vel.
Ályktanir: Nemendur og handleiðarar eru ánægðir
með námskeiðið. Við sem stýrum námskeiðinu teljum mikilvægt að kennsla í
þverfaglegri samvinnu byrji snemma í námi. Mannréttindi er nokkuð sem sameinar
alla sem starfa við heilbrigðisvísindi. Það er því miklvægt að ræða
mannréttindi og stuðla að vitundarvakningu um það sem getur haft áhrif á
samskipti og meðferð skjólstæðinga okkar.
V13 The restorative effects of nature on attentional fatigue differ between high and low spatial frequencies
Brynjólfur G. Jónsson1, Málfríður G. Kolbeinsdóttir2, Heiða M. Sigurðardóttir2
1Faculty of physical sciences, 2Department of Psychology, University of Iceland, Háskóli Íslands
bgj2@hi.is
Introduction: In general, people find natural
environments to be visually more aesthetically pleasing than urban
environments, and viewing images of natural environments, more than urban, can
have a restorative effect on attentional fatigue. However, natural environments
also tend to be visually complex, and being exposed to disorderly and complex
environments can affect people negatively. Why then do natural environments
have this restorative effect? The objective of this study was to investigate
whether the restorative effects of natural environments on attentional fatigue
are dependent on the visual information contained in high and low spatial
frequency components.
Methods: 60 university students and adults took
part in this study. Participants performed three rounds of the Sustained
Attention to Response Test (SART) between which they were shown
grayscale images according to their experimental condition. The images
portrayed natural or urban environments and were filtered to contain either
only high spatial frequencies or only low spatial frequencies.
Results: Tests showed no significant main
effects of environment or spatial filter on SART performance but the
interaction of the two factors was significant. Participants in the high
spatial frequency condition tended to do worse after watching natural
environments than urban environments, while the trend was reversed for low
spatial frequencies.
Conclusions: The restorative visual effects of
nature are not fixed, and might rely on the visual information conveyed by different
spatial frequencies.
V14 Study of the acarofauna of native bumblebee species (Bombus spp.) in Iceland
Guðný R. Pálsdóttir1, Karl Skírnisson2
1Faculty of Medicine, UI Institute For Experimental Pathology, Keldur, 2UI Institute For Experimental Pathology, Keldur
gudnyrut@hi.is
Introduction: Bees are important to natural
ecosystems and human agriculture worldwide as pollinators for flowering plants.
In exchange for pollination, plants provide the bees with food in the form of
pollen and nectar. Mites associated with bees have a range of lifestyles on
their hosts, either as parasites feeding on the bees themselves, disease
vectors, as kleptoparasites feeding on the bees' food, or as mutualists or
commensals feeding on waste or harmful organisms in bees' nests. The acarofauna
of bumblebees (Bombus spp.) occurring in Iceland is poorly
known. The aim of the present study was to identify which mite species were
associated with mated queens coming out of hibernation in the spring, examine
the role of the mites in the nest and evaluate if harmful species were present.
Methods: Fifty-four bumblebee queens, three
species, were collected in late April and May 2017 in the Reykjavík area and
Egilsstaðir/Fellabær, eastern Iceland. Each queen and associated mites were
immediately fixed in 70% EtOH.
Results: So far, mites representing five
different genera have been identified. The species already identified to
genus/species levels include both kleptoparasitic species (Pneumolaelaps) and mutualists or commensals (Parasitellus, Kuzinia, Scutacarus). The feeding habits of the
representative of the fifth genus, Proctolaelaps, is unknown as mites of this genus are either
generalists or bee-specialists.
Conclusions: Preliminary results indicate abundant
and diverse mite fauna associated with bumblebees in Iceland. The relationship
is complex and represents long-lasting evolution into mutual adaptation. The
parasitic role of the mites involved need further attention.
V15 Lipidomic analysis of fish skin xenograft versus skin grafts of mammalian origins
Aristotelis Kotronoulas1, Hulda Jónasdóttir1, Skúli Magnússon2, Óttar Rolfsson1
1Center for Systems Biology, University of Iceland, 2Kerecis Company
aris@hi.is
Introduction: Acellular dermal matrices are commonly
used as a safe and effective treatment for hard-to-heal chronic wounds.
Recently, clinical studies have shown that fish skin grafts promoted a faster
healing and provided a longer lasting bacterial barrier than other tested
matrices of mammalian origin. These beneficial effects can be strongly linked
to the presence of a high omega-3 polyunsaturated fatty acids (PUFA) content in
the fish skin. In this study, the total fatty acid (FA) content and lipid
profile of the fish skin grafts were assessed and compared to that of cadaver
human skin and that of two different bovine collagen matrices.
Methods: Lipids were extracted from the grafts
by liquid-liquid extraction. Hydrolyzed FA quantification was performed by
GC-MS and the lipid profile analysis by UPLC-MS/MS.
Results: Fish skin graft contained significantly
higher omega-3 FAs and PUFA than all other tested grafts, with percentages that
exceeded 20% and 30% of the total FAs content respectively. Regarding the
grafts' lipidomic profile, both unsupervised PCA and supervised PLS analysis
demonstrated that all analyzed materials had very different lipid composition.
Based on the heatmap and the hierarchical clustering, approximately 50 lipids
from positive and negative ESI mode were identified as the most distinctive
between the four materials and their structure was annotated.
Conclusions: Data presented here shows abundant
omega-3 fatty acids in the fish skin, which may be related to faster healing
via production of SPM or other pathways. Moreover, the lipidic compounds that
mostly differentiate fish skin grafts from other grafts of mammalian origin
were annotated.
V16 DNA methylation in Arctic charr: Epigenetics to help understand polymorphism
Sebastien Matlosz1, Zophonías O. Jónsson2, Benjamín Sigurgeirsson2, Arnar Pálsson2, Sigríður R. Franzdóttir2, Sigurður S. Snorrason2
1Faculty of Life and Environmental Sciences, School of Engineering and Natural Sciences, University of Iceland, 2School of Engineering and Natural Sciences, University of Iceland
seb.matlosz@hotmail.fr
Introduction: Arctic charr (Salvelinus alpinus) is a polymorphic cold-water fish
species belonging to the Salmonidæ family. In Iceland, Salvelinus alpinus is found in many places, but in Lake
Þingvallavatn it displays remarkable morphological variation, in particular in
terms of head and trophic apparatus development. The research team led by
Professor Sigurður S. Snorrason has been working on understanding the reasons
for these morphological differences for years now, and some molecular pathways
and gene expression differences have been highlighted recently. The main focus
of this PhD project is to highlight DNA methylation differences during early
development between those morphotypes. Differentially methylated regions will
then allow to identify new candidate genes that might be responsible for the
differences in craniofacial bone development in this species.
Methods: In order to assess DNA methylation, Reduced
Representation Bisulfite Sequencing (RRBS) is used. This technique combines:
the targeting of specific regions in the genome called CpG islands (known, when
methylated, for being associated with gene silencing and being a prevalent
feature of abnormally silenced genes in cancer), bisulfite conversion (chemical
reaction which converts every non-methylated cytosine in thymine) and Illumina
sequencing.
Results: The preliminary results show very
clearly that there are methylation differences between morphs. The data is
still being analysed and no new candidate gene names have been revealed yet.
Conclusions: Reduced Representation Bisulfite
Sequencing has allowed us to assess DNA methylation differences between
phenotypically distinct morphs of Arctic charr. Now, further sequencing and
analyses are necessary in order to highlight genes impacted by those
differences.
V17 Pharmacokinetics of Placental Protein 13 (PP13) after intravenous and subcutaneous administration in rabbits
Tijana Drobnjak1, Sveinbjörn Gizurarson2
1University of Iceland, 2Faculty of Pharmaceutical Sciences, University of Iceland
tidrobnjak@gmail.com
Introduction: Human placental protein 13 (PP13) is a
galectin predominantly expressed by the placenta. Low serum concentrations of
PP13 in early pregnancy indicate a higher risk to develop preeclampsia.
Methods: The pharmacokinetic disposition and
bioavailability of PP13 were determined by single intra-venous and subcutaneous
(S.C.) administration to twelve healthy New Zealand white rabbits. The serum
pharmacokinetic values were determined by ELISA assay.
Results: Basic pharmacokinetic (PK) parameters
were obtained using a two-compartment model. Both volume of distribution (Vd)
and the area under the curve (AUC) were dose dependent for the IV group
(p<0.01). PP13 elimination half-life was also found to be different between
the groups (p<0.01). The bioavailability of PP13 following S.C.
administration was found to be 57%.
Conclusions: This study shows that the concentration
of total PP13 released into in the maternal circulation during pregnancy might
be much higher than previously estimated.
V18 Uterine vessels stimulation effect of Placental Protein 13 (PP13) after subcutaneous slow-release administration in rats
Tijana Drobnjak1, Sveinbjörn Gizurarson2
1University of Iceland, 2Faculty of Pharmaceutical Sciences, University of Iceland
tidrobnjak@gmail.com
Introduction: Placental protein 13 (PP13) is a
placental specific galectin that is present only in primates. Low serum
concentrations of PP13 in early pregnancy are associated with elevated risk for
a subsequent development of preeclampsia, being the leading cause of maternal
and perinatal mortality and morbidity. Our previous studies have shown that
PP13 lowers blood pressure in pregnant rats affecting the size and weight of
pups and placentas and induces vasodilation of resistance arteries trough
endothelial signaling pathways.
Methods: Sixteen non-pregnant female
Sprague-Dawley rats received mini osmotic pumps in periscapular region by
subcutaneous (S.C.) implantation. The administration of PP13, histidine-tagged
PP13, or saline, by slow-release osmotic pumps lasted over seven-day period.
The rats were sacrificed six days after pumps emptied and the explanted uteri
were fixed, processed for histology and samples sections were stained with
Hematoxylin-Eosin for size assessment.
Results: The uterine vasculature was visibly
more dilated in the group exposed to the recombinant PP13 compared to the
control group. The effect of histidine-tagged PP13 was less effective.
Histological results confirmed that both veins and arteries were dilated by
PP13 and the effect on uterine veins appears to be more pronounced compared to
corresponding arteries.
Conclusion: In conclusion PP13 might be an
essential molecule for preconditioning the vessels in the uterus to enable the
elevated blood flow during pregnancy. Uterine veins are more affected than the
respective uterine arteries, suggesting that uterine veins might be more
susceptible than the arteries to PP13, even after the protein administration
has stopped.
V19 First steps in exosomal isolation using ultrafiltration-SEC for their future use as nanodrug carriers
Berglind E. Benediktsdóttir1, Anita S. Sigurðardóttir2, Sarah S. Steinaeuser2
1Faculty of Pharmaceutical Sciences, University of Iceland, 2University of Iceland
bergline@hi.is
Introduction: The ability of exosomes, nanosized
endogenous vesicles, to carry labile molecules in addition to having long
circulation half-life and endogenous homing, has led to increased interest in
exploring their feasibility as nanodrug carriers. A suitable method is needed
for exosomal isolation that results in their pure, bioactive form in enough
quantity for their use as a potential nanodrug carrier. The aim of this study
was to determine if ultrafiltration (UF) followed by size exclusion
chromatography (SEC) was applicable in isolating nanocarrier-grade exosomes.
Methods: The breast cancer epithelial cell line
MDA-MB-231 was selected for exosomal isolation, due to their known exosomal
secretion. Exosomes were isolated from the MDA-MB-231 cell culture medium with
UF-SEC (UV 280 nm), 280 min run. Transmission electron microscope (TEM),
dynamic light scattering (DLS), confocal microscopy and western blotting (WB)
were used for particle characterization.
Results: UF-SEC was sufficient to isolate
exosomes from the cell line, with exosomes eluting from a fraction isolated
early in the SEC (rt 83 min) followed by proteins and protein aggregates. This
was confirmed with the presence of the exosomal characteristic protein alix by
WB. The isolated exosomes measured 20 nm with TEM and ~170 nm with DLS. They did
not contain protein contamination from the endoplasmic reticulum, as determined
with WB. Additionally, confocal imaging strongly suggested that the exosomes
maintained their uptake affinity and thus biological activity post-isolation.
Conclusions: UF-SEC is an appropriate method for
exosomal isolation and will be useful in future work isolating therapeutically
active exosomes as a drug delivery vesicle.
V20 UF-SEC is promising for exosomal isolation from D492 and D492HER2+ epithelial cell lines
Berglind E. Benediktsdóttir1, Sarah S. Steinaeuser2, Helga S. Snorradóttir2
1Faculty of Pharmaceutical Sciences, University of Iceland, 2University of Iceland
bergline@hi.is
Introduction: Despite recent developments in breast
cancer research and therapy, there is still need for a more targeted approach.
Exosomes (40-100 nm), endogenous nanovesicles released from human cells, are an
attractive choice as nanodrug carriers due to their size, stability and their
unique targeting specificity. The aim of this study was to isolate exosomes
from the two epithelial breast cell lines D492 and D492HER2+,
representing the tissue of interest, with ultrafiltration combined with size
exclusion chromatography (UF-SEC).
Methods: Cell culture media from the
immortalized breast epithelial cell lines was concentrated with UF followed by
isolation with SEC using ÄKTA Start (280 nm), 240 min each run. The resulting
particles were analyzed with nanoparticle tracking analysis (NTA), western
blotting (WB) and transmission electron microscopy (TEM).
Results: A prevalent peak was observed late in
the SEC chromatogram (180 min) after sample injection. However, protein
analysis, TEM and WB confirmed that this peak did not contain exosomes but free
proteins. Although SEC did not show any prevalent peaks from early eluting
regions previously shown to contain exosomes, fractions F1-F3 (40-130 min) were
collected from D492HER2+ cell culture medium. Interestingly, both
NTA and TEM strongly suggest that F2 and F3 contained exosomes as the isolated
particles measured 65 and 58 nm, respectively and TEM revealed spherical
particles 20-50 nm in diameter.
Conclusions: UF-SEC is a promising method for exosomal
isolation for pharmaceutical applications, but further work is needed to
optimize the isolation process for these cell lines.
V21 The Protection of Oxytocin from Degradation in Aqueous Solutions using Glucosamine and Tetraethylenglycol
Mostafa Ghasemisarabbadieh1, Benjamín R. Sveinbjörnsson2, Sveinbjörn Gizurarson1
1Faculty of Pharmaceutical Sciences, University of Iceland, 2Department of Chemistry, University of Iceland
mog7@hi.is
Introduction: Oxytocin is a small peptide used to
induce labor and prevent bleeding after childbirth. Due to its instability,
storage and transport of oxytocin formulations are problematic in hot climate
and under tropical conditions. The aim of this study was to investigate and
test some solution compositions that may increase the stability of oxytocin at
temperatures above room temperature, or up to 50°C.
Methods: The effect of the aminosugar,
glucosamine, and tetraethylenglycol (TEG), on the stability of oxytocin in
citrate/phosphate buffer solution at pH 4.5 was determined using HPLC analysis,
following storage at 6℃, 40℃
and 50℃.
Results: The results show that the stability of
oxytocin was strongly affected by the excipients, glucosamine and
tetraethyleneglycol, in the formulation and the concentration of each of them.
Conclusions: Oxytocin is a compound that is very
sensitive to the surroundings and to the components in the formulation. The
concentration of each excipient is also of importance and may affect the
stability of the peptide.
V22 Optimization and investigation of assay conditions for evaluation of the antibacterial activity of chitosan
Sigríður Ólafsdóttir1, Sankar Rathinam1, Hélène L. Lauzon2, Martha Á. Hjálmarsdóttir3, Már Másson1
1Faculty of Pharmaceutical Sciences, University of Iceland, 2Primex ehf, 3Faculty of Medicine, University of Iceland
sio37@hi.is
Introduction: The antimicrobial activity of the
natural biopolymer chitosan and chitosan derivatives has been widely researched
and it has shown to be effective against many Gram negative and Gram positive
bacteria as well as fungi. This study aimed to show the effect of different
ways to solubilize chitosan at variable pH ranges and NaCl concentrations on
the minimal inhibitory concentration (MIC) of chitosan using broth
microdilution.
Methods: The MIC of seven different types of
chitosan was observed at pH levels 4.0 to 8.5, and NaCl concentrations 0.005 M
to 0.2 M. The MIC was measured for chitosan that was dissolved in acetic acid,
hydrochloric acid and chitosan hydrochloride salts dissolved in water. The MIC
values were measured with broth microdilution. The antibacterial activity was
tested against Staphylococcus
aureus and Escherichia coli.
Results: The results demonstrated that neither
acetic acid nor hydrochloric acid were a suitable solvent for chitosan for
broth microdilution because the solvents themselves showed antimicrobial
activity. Therefor a more suitable way is making chitosan hydrochloride salts
dissolved in water. Chitosan showed the best antimicrobial activity at pH
5.5-6.5 for S. aureus and pH 4.5-6.5 for E. coli. At pH 5.5 for S. aureus the MIC decreased a little with
increasing NaCl concentration but at pH 7.2 the MIC increased with increasing
NaCl concentration.
Conclusions: These results are an important step
towards creating a standardized procedure for antimicrobial testing of chitosan
which is a big need for so that comparing results from different laboratories
will be possible.
V23 Effect of molecular weight on antibacterial properties of chitosan and N,N,N-trimethyl chitosan
Priyanka Sahariah1, Dorota Wojciechowska2, Dorota Zeleinski2, Martha Á. Hjálmarsdóttir3, Már Másson1
1Pharmaceutical Sciences, University of Iceland, 2Material and Commodity Sciences and Textile Metrology, Lodz University of Technology, 3Department of Biomedical Science, University of Iceland
prs@hi.is
Introduction: The antimicrobial properties of the
biopolymer, chitosan, are influenced by several factors, one of them being the
chain length or the average molecular weight (Mw) of the polymer. In
this study, we performed a more systematic study over a wider Mw range to
investigate the effect on antimicrobial properties.
Methods: In this study, we synthesized TMC from
chitosan using conditions MeI/NaOH in DMF–H2O to produce 60-70%
quaternisation. We performed the acidic hydrolysis of chitosan (Mw
of 294 kDa) and TMC (Mw of 186 kDa) both under mild (1M HCl) and
strong (12 M HCl) acidic conditions to obtain a series of 15 low Mw polymers in
each case.
Results: The rate of degradation was 1.7-3 times
higher in case of concentrated HCl at an optimized temperature. On treating the
different Mw polymers of chitosan and TMC against Staphylococcus aureus (S. aureus), we found that the antibacterial activity of chitosan remained
constant as the Mw dropped from its original value to about 50 kDa.
Between 50-14 kDa the activity decreased slowly and below 14 kDa, a sharp
decline in the activity was observed. We observed a similar trend in activity
for TMC, where polymers within 144-20 kDa remained highly active (MIC=16-32
µg/mL).
Conclusions: The activity of TMC against S. aureus increased sharply with Mw
until a certain Mw value (critical mole weight for high activity,
CMW) was reached. After the CMA, the activity was not affected by further
increase in the Mw. A similar pattern of activity was observed for
chitosan.
V24 Quaternary ammonium chitosan derivatives for controlling Staphylococcus aureus biofilms
Priyanka Sahariah1, Rikke L. Meyer2
1Pharmaceutical Sciences, University of Iceland, 2INANO, Aarhus University
prs@hi.is
Introduction: Due to the increased emergence of
antibiotic resistant biofilms, several strategies for combating bacterial
biofilms have recently been developed such as using amphiphilic small
molecules, nanoparticles and biomaterials. One such new approach uses the
biodegradable biopolymer chitosan and its derivatives as antimicrobials for the
treatment and prevention of bacterial biofilms.
Methods: In this study, we synthesized a series
of water soluble chitosan derivatives containing quaternary ammoniumyl groups
and investigated their efficacy towards Staphylococcus aureus biofilms. For this purpose, we utilised
TBDMS-protected chitosan to selectively introduce different moieties at varying
ratios at the 2-amino position of chitosan. The average molecular weight of the
polymers after size exclusion chromatography was 8-21 kDa.
Results: We investigated how the combination of
different functional groups influenced chitosan's efficacy against planktonic
bacteria and biofilm. Minimum Biocidal Concentrations (MBC) against planktonic
bacteria was 16 µg/mL for all compounds, while the Minimum Biofilm Eradication
Concentration (MBEC) was more variable. The antimicrobial efficacy of cationic
chitosan derivatives towards biofilms was greatly enhanced in presence of hydrophobic
groups (alkyl chains), and the extent of their effect was determined by the
ratio and length of the alkyl chains. Three-dimensional imaging of biofilms by
confocal laser scanning microscope confirmed the accessibility and
antimicrobial effect of chitosan derivatives with alkyl chains in the full
depth of the biofilms.
Conclusions: The results showed that the presence of
certain functional groups or their combinations can either lower or enhance the
antibiofilm activity of chitosan and hence these results can be used for the
development of future antimicrobial materials.
V25 Numerical and experimental studies of diclofenac diffusion properties through hydrogels
Svetlana Solodova1, Andreia F. R. Pimenta2, Kristinn Guðnason3, Ana P. Serro4, Fjóla Jónsdóttir3, Sven Th. Sigurdsson3, Már Másson5
1Faculty of Pharmaceutical Sciences, University of Iceland, 2Department of Mechanical Engineering and IDMEC, University of Lisbon, 3Faculty of Industrial Engineering, Mechanical Engineering and Computer Science, University of Iceland, 4University of Lisbon, 5Faculty of Pharmaceutical Science, University of Iceland
svetlana@hi.is
Introduction: Hydrogel materials are highly
promising polymeric biomaterials which attract the attention of a large number
of researchers of different areas, due to their important properties like
hydrophilicity, biocompatibility, good transport properties and non-toxicity.
The present study was focused on experimental and numerical studies of
transport properties of two types of polymer materials used in the production
of contact lenses: pHEMA based hydrogel and TRIS silicone-based hydrogel.
Methods: Experimental study was carried out by
Franz diffusion cells at different temperatures (25, 35, 45 °C). The diffusion
and release profiles of Na-diclofenac, a model drug, were measured by
HPLC-analysis. Numerical simulation was conducted was conducted on base of one
dimensional multi-layer mathematical model.
Results: Various conditions of drug diffusion
experiments, such as different thicknesses of hydrogel membranes and different
temperatures were examined. A numerical model was constructed and validated by
comparison with experimental data. It was found that the temperature and
thickness effects on the drug uptake profiles from hydrogels.
Conclusions: The physical parameters for hydrogels were
estimated from drug diffusion experiments at different temperatures and
different type of hydrogels. Effects and interdependencies of physical
parameters on the drug release profiles of pHEMA and TRIS at different
temperatures were analyzed to see which part of the curve is influenced by
which parameter. We succeeded in simulating all experimental data sets.
V26 Identifying biomarkers in FFPE breast TMAs using DESI-MSI
Ólöf G. Ísberg1, Renata Soares2, James McKenzie2, Dipa Gurung2, Hiromi Kudo2, Rathi Ramakrishnan2, Jón G. Jónasson3, Sigríður K. Böðvarsdóttir4, Margrét Þorsteinsdóttir5, Zoltan Takats2
1School of Health Sciences, University of Iceland, 2Computational and Systems Medicine, Department of Surgery and Cancer, Imperial College, 3Department of Pathology, Landspítali University Hospital, 4Biomedical Center, 5Faculty of Pharmaceutical Sciences, University of Iceland
ogi1@hi.is
Introduction: Different mass spectrometry imaging
techniques have been used to investigate cancer including matrix assisted laser
desorption ionization mass spectrometry (MALDI-MS), secondary ion mass
spectrometry (SIMS) and desorption electrospray ionization mass spectrometry
(DESI-MS). By using DESI-MSI the spatial distribution of biomolecules in
biological tissue can be investigated, where it is particularly suited for
detection of metabolites. Additionally, it has been shown that the
reproducibility of DESI-MSI is accurate and suitable for the purpose of
clinical research and diagnosis. The project aim was to metabolic phenotype
FFPE TMA slides of 30 breast cancer samples and 30 normal samples using
DESI-MSI.
Methods: Breast cancer tissue was obtained from
30 breast cancer patients undergoing mastectomy as well as normal control
tissue was acquired from 30 individuals. The samples were formalin fixed and
paraffin embedded (FFPE). DESI-MSI was used to collect spectra over the area of
interest. Multivariate statistical analysis was conducted on log transformed
spectral data as well as univariate statistical analysis was performed.
Furthermore, putative peak identification of m/z values based on accurate mass
was carried out using Metlin (https://metlin.scripps.edu).
Results: Our results indicate that DESI-MSI
shows a potential to differentiate between breast cancer FFPE TMA and normal
breast FFPE TMA based on their metabolic profile.
Conclusions: FFPE clinical tissue samples are the standard
for histopathological analysis at hospitals where the paraffin blocks can be
stored for many years. By using DESI-MSI we were able to distinguish between
normal and cancerous FFPE breast tissues, which allows us to screen for breast
cancer.
V27 Fat-mass and obesity-associated (FTO) gene, stearoyl-CoA desaturase and cholic acid levels after a low-fat meal
Harpa Óskarsdóttir
Institute of Physiology, Faculty of Medicine, University of Iceland
harpaoskars@gmail.com
Introduction: Dietary macronutrient composition,
stearoyl-CoA desaturase (SCD) activity, primary bile acid (BA) chenodeoxycholic
acid (CDCA) and cholic acid (CA) concentrations have been associated with lipid
metabolism. We investigated the effect of a low-fat breakfast on SCD activity
and BA concentrations in young and healthy subjects focusing on different FTO rs9939609 alleles.
Methods: A total of 56 young (20-36 years)
subjects were divided into three groups, one homozygous for the obesity-risk A
allele (AA; n=18), one homozygous for the low-risk T allele (TT; n=26), and one
heterozygous for the obesity-risk A allele (AT; n=12). Fasting and post-meal
blood samples were collected, and SCD mRNA expression, primary BA concentrations, and fatty acids in
phospholipids were determined. SCD activity indices were determined as ratios
16:1n-7/16:0. One-way ANOVA and Mann-Whitney test were used to calculate the
differences in SCD activity and the concentration of BAs, respectively, between
the groups. Linear regression analyses were performed for the estimation of
relationship between plasma concentrations of BAs as an outcome variable and SCD mRNA and BMI as independent variables.
Results: The SCD activity was elevated
(P<0.05) in the AA genotype group compared with the TT genotype group
following the low-fat breakfast. After adjusting for BMI, the highest 50%
concentrations of CA were negatively (P=0.010) correlated with the level of SCD mRNA expression.
Conclusions: FTO AA carriers may be at a higher risk for obesity
through higher SCD activity in a low-fat diet environment. This effect may be
partly pronounced by very low CA concentrations.
V28 Cytotoxic activity of novel organotin compounds against different cancer cell lines
Michaela Balogova1, Paulina Cherek2, Krishna Damodaran2, Helga M. Ögmundsdóttir2
1Faculty of Medicine, University of Iceland, 2University of Iceland
michaelabalogovaa@gmail.com
Introduction: Cisplatin has been a successful drug
in oncology for decades but its use is limited by toxicity and development of
resistance. Organotin compounds have shown potential therapeutic cytotoxic
effects. Two new organotin complexes, SNO7 and SNO8, with summarized formula [R2P(O)CS2]
(R=phenyl (a) or benzyl (b) ligand) were synthesized and screened for cytotoxic
activity.
Methods: The following cell lines A549, Aspc-1, D492, D492 HER-2,
HCT116+Chr.2, HCT116+Chr.3, MCF-10, OVCAR-3, T47-D were used. Crystal violet assay was used to
determine IC50. Induction of apoptosis was assessed by Annexin V
staining and monitored via IncuCyte. Cell cycle analysis was performed using PI
staining and flow cytometry. Double-strand DNA breaks were detected using γH2X
and 53BP1 staining, analysed by confocal microscopy. Cisplatin was used as
reference.
Results: The range of IC50 values was
2.7 - 22.0 for SNO7; 17.0 -37.0 for SNO8; for Cisplatin 1.8-30.0. For the
breast cancer cell line the T47-D IC50 value was 7.7 for SNO7, but
30.0 for Cisplatin. SNO7 (10 µg/ml) induced apoptosis in several cell lines.
SNO7 (5 µg/ml) caused a shift from G1 to G2 phase and cisplatin (5 µg/ml) from
G1 to S phase in sensitive cell lines. SNO8 showed no effects on cell cycle.
SNO7 induced double-strand DNA breaks. Treatments lasted 24 hours.
Conclusions: These results indicate potential
cytotoxic effects of compound SNO7 at low concentrations against some cancer
cell lines. Interestingly, T47-D was significantly more sensitive to SNO7 than
Cisplatin. Different modes of action of compound SNO7 and cisplatin need to be
further investigated.
V29 Metabolomics analysis and modelling shows sub-groups of trauma patient and suggests potential interventions
Sarah McGarrity1, Hanne H. Henriksen2, Rósa S. Sigurðardóttir3, Pär I. Johansson4, Óttar Rolfsson3
1School of Engineering and Natural Sciences, University of Reykjavík, 2Rigshospitalet, København Ø, Denmark, Department of Anethsetics, 3Center for Systems Biology, University of Iceland, 4Department of Anethsetics
sarahm@ru.is
Introduction: Trauma is one of the leading causes of
death worldwide. Endothelial damage has been shown to contribute to trauma
outcome. This project has combined extensive measurements of metabolites with
the use of an endothelial cell genome scale metabolic model to contextualise
and interpret the data.
Methods: We used liquid chromatography mass
spectrometry (LC-MS) to analyse plasma samples from trauma patients. This data
was then analysed using multivariate statistical methods and iEC2812 an
endothelial genome scale metabolic model. This model has been updated to better
account for the metabolism of functionally relevant glycocalyx components. The
new trauma patient plasma metabolic measurements have been used to constrain
the uptake and secretion fluxes of this model.
Results: Twenty-two metabolites have been
identified as differentiating between patients and controls Further we have
identified metabolically distinct sub-groups of patients. These sub-groups are
largely distinguished by their fatty acid metabolism. These sub-groups also
have some distinct clinical features, suggesting that they may be clinically
relevant. Model analysis suggests that differences in metabolism between the
groups are in line with cell culture observations of damaged endothelium with
regards to acetyl-CoA production, tryptophan metabolism and heparan-sulphate
proteoglycan metabolism. Modelling has also suggested that alterations to
carnitine, sphingolipid, fatty acid and glycan metabolism may be of benefit to the
sickest trauma patients.
Conclusions: This approach combining metabolomics
data with genome scale modelling has allowed us to contextualise a complex data
set. It is hoped that this approach will lead to practical hypotheses for
trauma interventions.
V30 An isoform of ATG7 is unable to perform its characterized autophagy function
Sigríður St. Hlynsdóttir1, Linda Sooman2, Valerie Fock2, Ramile Dilshat2, Eiríkur Steingrímsson2, Margrét H. Ögmundsdóttir2
1Faculty of Medicine, Biomedical Center, University of Iceland, 2Biomedical Center, University of Iceland
ssh19@hi.is
Introduction: Autophagy is a degradation mechanism
important for cellular homeostasis. The process starts with the formation of a
double membraned autophagosome which then fuses with the lysosome for
degradation. ATG7 is an important protein for the autophagosomal formation and
its best characterized function is to lipidate LC3/GABARAP proteins of the
growing autophagosomal membrane. Recently we identified an ATG7 isoform,
missing an exon of 27 amino acids, which is unable to mediate this lipidation.
We have analyzed the mRNA expression of this shorter isoform ATG7(2) and our aim is to characterize its
protein expression in different cell lines and tissues and subsequently dissect
out the function of ATG7(2).
Methods: We used the GTEx and TCGA databases to
analyze the mRNA expression of ATG7(2). We furthermore analyzed the protein expression of endogenous ATG7 in
various cell lines. Western blotting following electrophoresis of the extracted
cell lysates was used with an ATG7 specific antibody. For size comparison we
transiently over-expressed ATG7(1) or ATG7(2) and ran lysates on the same gels.
Results: ATG7(1) is the predominantly expressed isoform
across tissues whereas ATG7(2) is expressed at a lower level. The
mRNA expression levels were different across tissues, and e.g. in blood ATG7(2) has a higher expression than ATG7(1).
Conclusions: ATG7 is known to be involved in
intracellular processes independent of its lipidation activity. It will be
important to dissect out which physiological role ATG7(2) plays. Furthermore,
ATG7(2) could prove to be a useful tool to study the role of ATG7, unrelated to
the autophagy pathway.
V31 Stability and post-translational modifications of the MITF following simulated activity in neuronal cell lines
Fatich Mechmet1, Eiríkur Steingrímsson2, Pétur Henry Petersen3
1Department of Anatomy, Faculty of Medicine, University of Iceland, School of Health Sciences, Biomedical Center, 2Department of Biochemistry and Molecular Biology, Faculty of Medicine, Uni Iceland, Biomedical Center, 3Department of Anatomy, Faculty of Medicine, University of Iceland, Biomedical Center
fatich.mechmet@gmail.com
Introduction: Neuroplasticity is the brain's ability
to reorganize and remodel itself by allowing neurons to strengthen or form new
neuronal circuits in an activity-dependent manner. Neuroplasticity can be
divided into intrinsic or synaptic plasticity. The Microphthalmia associated
transcription factor (Mitf), which is best characterized in
melanocytes and melanoma, is expressed by olfactory bulb projection neurons,
the tufted and mitral cells. We have shown that Mitf links neuronal activity with intrinsic homeostatic neuroplasticity in
the olfactory bulb (OB). The goal of the current project is to determine how
neuronal activity affects the MITF protein.
Methods: The HEK293T and N2A cell lines were
transfected transiently with epitope tagged mMITF-M. N2A cells were then
differentiated towards a post-mitotic neuronal fate. Both cell lines were
treated with forskolin, KCL and L-glutamic acid to simulate neuronal activity.
Cells were harvested at different time points for Western blotting.
Results: In both cell lines, forskolin treatment
significantly increased MITF-M expression after 120 min. KCL and L-glutamic
acid treatments did not appear to cause any change in protein amount, but lead
to gradual loss of MITF´s phosphorylation at serine 73.
Conclusions: Proxies of neuronal activity affect
both levels of MITF protein and its phosphorylation state in cell lines. This
suggests that activity leads to posttranslational changes in MITF protein,
which likely affect its transcriptional activity in neurons.
V32 The role of MITF in DNA damage cell-cycle checkpoint regulation
Drífa H. Guðmundsdóttir1, Þorkell Guðjónsson2, Stefán Þ. Sigurðsson2
1Faculty of Medicine, University of Iceland, 2University of Iceland
dhg1@hi.is
Introduction: MITF is best known for its role as the
master regulator of melanocytes. The protein also plays a key role in melanoma,
where it functions as an oncogene and is often referred to as a driver of
melanoma progression. Cell-cycle
checkpoints are central regulatory components that safeguard the genome
stability throughout the cell-cycle. In response to stress, cells activate DNA
damage checkpoint signaling pathways, which block cell-cycle progression to
prevent the transmission of damaged DNA to daughter cells. Studies have
shown that MITF interacts with P53, a key regulator of the cell-cycle
checkpoints. MITF also affects the expression of P21, another key component of
the checkpoint regulation. In this study
we aim to reveal a potential role of MITF in this important surveillance system
of the cell.
Methods: Flow-cytometry-based analysis of
cell-cycle progression is used to analyze the effect of MITF on the cell-cycle
checkpoints. Staining of genetic material, along with staining of cell-cycle
phase markers is used to assess the cell-cycle distribution.
Results: We show that following MITF depletion
P53 protein levels are increased. MITF depletion
also results in accumulation of cells in G1 after exposure to DNA damaging agents,
suggesting a hyperactive G1/S checkpoint after MITF depletion.
Conclusions: Studies have shown that MITF interacts
with P53 and affects expression of P21. Here we show that when MITF is knocked
down, P53 accumulates in the cell. Our results also suggest that this
accumulation of P53 after MITF depletion results in a hyperactive G1/S
checkpoint that prevents progression from G1 to S-phase.
V33 Sequence analysis of the HPR and F-gene of HPR0 isolates of ISAV in Iceland
Þórunn S. Björnsdóttir, Harpa M. Gunnarsdóttir, Sabrina Natale, Þorbjörg Einarsdóttir, Heiða Sigurðardóttir, Birkir Þ. Bragason, Sigríður Guðmundsdóttir
Keldur Institute for Experimental Pathology
thorunnsoley@hi.is
Introduction: Infectious salmon anemia (ISA) is a
serious viral disease of Atlantic salmon (Salmo salar L.) caused by the ISA virus (ISAV).
Virulent strains of ISAV-HPRdel have deletions in a highly polymorphic region
(HPR) of the hemagglutinin-esterase (HE) gene on segment 6, avirulent strains
ISAV-HPR0 have none. In addition, a Q266L substitution or insertion adjacent to
the putative proteolytic cleavage site of the fusion protein encoded by the
F-gene on segment 5 has been suggested as a virulence marker.
Methods: Total RNA was extracted from heart,
kidney and gill tissue samples using the RNeasy kit (Qiagen). ISAV-HPR0
isolates were detected by One-Step qPCR. Amplification of the HPR and the
F-gene was done by RT-PCR and sequenced.
Results: ISAV-HPRdel was not detected and only
0.63% of 17.778 screened samples were positive for ISAV-HPR0. Sequence analysis
showed great homogeneity within the Icelandic isolates. The Icelandic HPR0
isolates were 96-99% identical to Norwegian, Faroese and Chilean isolates.
Phylogenetic analysis placed the Icelandic isolates in the European clade of
ISAV.
Conclusions: This study shows that ISAV-HPR0
positives are in low abundance in farmed Atlantic salmon in Iceland. Knowledge
of the genotypes of the Icelandic ISAV-HPR0 isolates will be useful for further
research, analyses and risk assessment for ISAV in Iceland.
V34 Effects of Pontin and Reptin in Drosophila sensory neurons: associations with motor proteins and tubulins
Samantha Jeng1, Theresa Marie Quinkler2, Hörður Guðmundsson2, Zophonías O. Jónsson2, Sigríður R. Franzdóttir2
1Faculty of Life and Environmental Sciences, University of Iceland, 2University of Iceland
saj46@hi.is
Introduction: Pontin and Reptin are two highly
conserved members of the AAA+ (ATPases Associated with diverse celluar
Activities) family, and are involved in diverse processes such as chromatin
remodeling, cell signaling, and migration. We and others have observed
interactions of both Pontin and Reptin with motor proteins and tubulins. This
project focuses on verifying these interactions and studying the
microtubule-related roles of Pontin and Reptin in Drosophila melanogaster. We had observed that knock-down of Pontin/Reptin
in dendritic arbor sensory neurons (ddaC IV cells) caused beading in the
dendrites, which might indicate transport failure, microtubule disorganization
or aggregate formation. The role of Pontin and Reptin in ddaC cells was
therefore studied further.
Methods: Associations between Pontin or Reptin
and motor proteins or tubulins were determined via co-immunoprecipitation and
Western blot. The Gal4/UAS system was used to knock down Pontin and Reptin in
ddaC IV neurons and over-express ATPase-dead proteins. The cells were
positively labelled with fluorescent proteins. In vivo confocal imaging was performed on larvae immobilized in a silicone
chip. The extent of the dendritic arbor was determined using Scholl analysis.
Results: Co-immunoprecipitation results
suggested α-tubulin had direct interactions with Pontin, and indirect
interactions with Reptin. Further analysis is needed to determine other
interaction partners. Phenotypic
analysis of ddaC IV neurons shows that knock-down of Pontin and Reptin affects
the dendritic arbor, with Walker mutations producing a similar but less
pronounced effect.
Conclusions: The effect of knock-down, mutations or
over-expression on transport, microtubules and aggregation in these cells is
currently under investigation.
V35 Updating a genome-scale metabolic model of the endothelial cell
Rósa S. Sigurðardóttir1, Sarah McGarrity2, Óttar Rolfsson2
1Center for systems biology, University of Iceland, 2University of Iceland
rss10@hi.is
Introduction: Cell specific genome-scale metabolic
models represent the metabolism of a specific cell type. These models are
reconstructed from genomic information and literature, which are integrated
into a stochiometric model of metabolism that can be used for detailed analysis
of a cells metabolism. Last year, the first ever endothelial cell specific
metabolic model was generated within our research group. Our next aim was to
integrate the synthesis of the endothelial glycocalyx and thus make the model
more specific and accurate in analysing endothelial cell metabolism. Here, this
update is presented.
Methods: Using metabolic databases (BiGG Models,
KEGG PATHWAY Database) and literature review, the building blocks necessary to
form the glycocalyx were identified. The reactions needed to synthesize the
components and precursors were identified in the same manner. Databases
(Virtual Metabolic Human, GeneCards) were used to identify genes encoding the
enzymes catalyzing the reactions. The reactions were integrated into the model
using Matlab and the COBRA Toolbox.
Results: The synthesis of 11 building blocks of
the glycocalyx were integrated into the model. In doing so, 84 reactions and 48
genes were added to the model.
Conclusions: By utilizing databases, literature
review and computational methods, the synthesis of the endothelial glycocalyx
was integrated into the worlds first and only genome-scale metabolic model
specific to endothelial cells. This addition makes the model more detailed in
terms of glycan metabolism.
V36 Transcriptome analyses of cryptic genetic variation in gene expression exposed by heat shock
Dagný Á. Rúnarsdóttir1, Baldur Kristjánsson2, Sarah Marzec3, Ian Dworkin3, Arnar Pálsson2
1University of Iceland, 2Department of Biology, University of Iceland, 3Department of Biology, McMaster University
dar11@hi.is
Introduction: The human population and
subpopulations have faced many environmental changes in the last 20.000 years.
Variation in environmental factors during an organism's development can lead to
changes in phenotypes, either beneficial or harmful. In 1953 Waddington
demonstrated that heat-shocked fly pupae, developed into flies with partly or
fully lost crossveins of the adult wing. Furthermore, with artificial selection
this trait could be fixed into a population. We build on this study and ask:
what are the molecular basis of this fixation?
Methods: A wild-type population of Drosophila
melanogaster was subjected to heat-shock during development, divided into two
groups: lacking crossveins (Up) or still retaining them (Down). Replicate
populations were subject then to artificial selection on these phenotypes,
repeated for 20 generations. Transcriptome libraries were prepared from
wing-discs and brains of 3rd instar larvae, sequenced on Illumina HiSeq2500
platform, mapped and counted with Kallisto and analyzed with DEseq2.
Results: Around 100 genes were differently
expressed in wing discs, between the crossveinless groups and the control
groups. A lot fewer genes showed expression differences in larval brains in the
same comparison. Thus, environmental perturbation and artificial selection
exposed cryptic genetic variation in wild populations, that affects expression
of many genes. We also ask: how similarly do the replicate lineages evolve, and
via which molecular mechanisms?
Conclusions: Thus natural selection can act on
cryptic genetic variation exposed by environmental changes, changing gene
expression. Information of this variety is important for understanding of how
humans respond, function and evolve in rapidly changing environments.
V37 Expression, regulation and role of PXDN, a collagen IV crosslinker, in the mammary gland
Anna K. Sigurðardóttir1, Eiríkur Briem2, Zuzana Budkova2, Þórarinn Guðjónsson2, Gunnhildur Á. Traustadóttir2
1Faculty of Medicine, Stem Cell Research Unit, 2Stem Cell Research Unit
aks6@hi.is
Introduction: Peroxidasin (PXDN) is involved in
collagen IV crosslinking in the basement membrane and has been linked to
various diseases, in particular fibrosis and cancer. Data from BreastMark
indicates that women with Her2 positive breast cancers have 20% worse survival
rates if their tumors express high PXDN compared to women with low PXDN. With
this study we aim to elucidate the expression, regulation and function of PXDN
in the breast.
Methods: D492 is a breast epithelial progenitor
cell line that generates TDLU-like structures in 3D culture and in co-culture
with endothelial cells undergoes EMT that has given rise to the D492M cell
line. We have shown that D492 and D492M differ greatly in terms of gene and
microRNA expression. One of the most downregulated miRNAs in D492M compared to
D492 is miR-203a that has previously been shown to target EMT transcription
factors. When we overexpressed miR-203a in D492M we observed that the most
downregulated gene was PXDN, which we subsequently confirmed as a novel target
for miR-203a. We are currently overexpressing and knocking down PXDN in six
cell lines, both normal and cancerous, to investigate the effect the protein
has on phenotype and function.
Results: Our preliminary data shows that PXDN is
expressed in epithelial cells and fibroblasts in the breast. However, the
function of this protein in both normal mammary development and cancer
progression is still unknown.
Conclusions: In the future PXDN could potentially be
used as drug target or a biomarker for women with Her2 positive breast cancers.
V38 SERS investigation of bone marrow mesenchymal stem cells grown on gold nanoisland substrates
Adrianna Milewska1, Ólafur E. Sigurjónsson2, Milos Miljkovic3, Igor Sokolov3, Kristján Leósson4
1Department of Materials, Biotechnology and Energy, Innovation Center Iceland, 2The Blood Bank, Landspitali University Hospital, 3Tufts University, 4Innovation Center Iceland
adrianna@nmi.is
Introduction: Bone marrow mesenchymal stromal cells
(BM-MSCs) are multipotent stem cells which play an important role in
regenerative medicine. Therefore, understanding the structural organization of
those cells is essential for learning their functions. Tools that are most
commonly used for identification of the MSCs have several drawbacks, such as
complicated sample preparation and destroying the cellular construct in order
to perform the assay. In this study, we report on novel surface-enhanced Raman
scattering (SERS) substrates for non-invasive identification of MSCs.
Methods: SERS surfaces are manufactured by
repeated magnetron sputtering deposition and post-deposition annealing
processes, preceded by spin coating with fluoropolymer layer. Mesenchymal
stromal cells are cultured on these surfaces for 7 days (proliferation and
cytotoxicity assays are being performed) and fixed for SERS measurements.
Simultaneously, they are marked with TRITC-conjugated Phalloidin, DAPI and
Anti-Vinculin for confocal microscopy. The Raman imaging is performed to obtain
SERS spectra of MSCs fingerprints.
Results: Repeated deposition and annealing
method produced a gold surface with the mean distance between adjacent
nanoparticles of <10 nm. Presto Blue assay exposed increasing cell
proliferation with time on all surfaces. LDH assay demonstrated that the level
of substrates' cytotoxicity was low. Focal adhesion staining revealed the cells
attachment to the substrates via numerous filopodia. The SERS measurements
demonstrated the Raman peaks that can be associated with actin filament-building
proteins.
Conclusions: Preliminary results suggest that the
SERS technique based on triple processed gold nanoisland arrays can provide a
sensitive and non-destructive method for studying mesenchymal stromal cells.
V39 Lack of MITF induces extracellular matrix reorganization in melanoma cells
Ramile Dilshat, Sara Sigurbjörnsdóttir, Katrín Möller, Margrét H. Ögmundsdóttir, Eiríkur Steingrímsson
Faculty of Medicine, University of Iceland
dir2@hi.is
Introduction: The Microphthalmia-associated
transcription factor (MITF) acts as a master regulator of melanocyte
development and differentiation, and is known as a melanoma oncogene.
Differential activity of MITF has been proposed to alter phenotypic behaviour
of melanoma cells. The scope of this study was to further characterize the role
of MITF in melanoma development.
Methods: To this end, we used CRISPR technology
to knock out MITF in melanoma cells and generated miR-MITF stable knock down
cell lines. RNA-sequencing was performed to identify differentially expressed
genes and invasion, migration and proliferation assays were carried out to test
the phenotypic behaviour of MITF depleted cells.
Results: MITF CRISPR knock out cells and
miR-MITF cell lines showed reduced proliferation rate when compared to the
parental lines. Furthermore, the migration and invasion ability of MITF-KO
cells was found to be significantly diminished. RNA sequencing showed that
transcriptome profile of MITF-KO cells and MITFlow melanoma tumours
from TCGA overlap extensively. GO term analysis showed that differentially
expressed genes were associated with pathways involved in extracellular matrix,
cell adhesion and pigmentation. Interestingly, the many of the differentially
expressed genes involved in extracellular matrix are bound by MITF according to
ChIP-seq studies.
Conclusions: Our results indicate that MITF null
cells are less migratory and proliferative than the parental cells.
Transcriptome profile of MITF-KO cells overlap extensively with MITF-low
tumours. In addition, lack of MITF induces expression of extracellular matrix
associated gene signature. All together we showed that MITF is directly needed
for reprogramming of the extracellular matrix of melanocytes and melanoma
cells.
V40 Non-coding RNAs on the DLK1-DIO3 locus enhances the basal phenotype of breast epithelial progenitor cells
Zuzana Budkova1, Bylgja Hilmarsdóttir2, Gunnhildur Traustadóttir1, Anna K. Sigurðardóttir1, Eiríkur Briem1, Þórarinn Guðjónsson1
1University of Iceland, 2Norwegian Radium Hospital
zub1@hi.is
Introduction: Developmental events underlying breast
epithelial morphogenesis are closely related to pathways important to cancer
progression. In this study, we have analyzed the role of non-coding RNA
(ncRNAs) on the DLK1-DIO3 locus in differentiation and epithelial to
mesenchymal transition (EMT) in the breast progenitor cells. The DLK1-DIO3
locus is on imprinted region on chromosome 14 and contains three paternally
expressed protein coding genes and maternally expressed ncRNAs, including lncRNA
MEG3 and a cluster of 54 miRNAs.
Methods: We have used breast progenitor
epithelial cell line D492 and its mesenchymal derivative D492M. Total RNA and
small RNA sequencing revealed marked upregulation of MEG3 and the miRNAs on the
DLK1-DIO3 locus in D492M compared to D492. qRT PCR analysis of primary tissue
shows that MEG3 expression is higher in stromal cells than epithelial cells of
the breast. Using CRISPRa for upregulating expression of the target gene MEG3,
we have generated working model: D492 with overexpression of MEG3 (D492MEG3)
and the control cell line D492 with scrambled sgRNA (D492ctrl).
Results: D492MEG3 shows upregulation
of miRNAs from the DLK1-DIO3 locus compared to D492ctrl. Without the
loss of epithelial phenotype, we see increase of some mesenchymal and basal
markers in D492MEG3. When cultured in 3D, D492MEG3 has
increased cloning efficiency compared to D492ctrl. Moreover, D492MEG3
shows higher migration rate compared to D492ctrl, while the invasion
and proliferation remains unaffected.
Conclusions: Our data indicates that MEG3 is a
critical regulator of basal phenotype and may enhance partial EMT.
V41 Getur NGS komið í stað
FISH við greiningu mögnunar á ERBB2
geninu í brjóstakrabbameinsfrumum?
Katrín Halldórsdóttir1, Guðrún Jóhannesdóttir1, Edda S. Freysteinsdóttir1, Bjarni A. Agnarsson1, Sigrún Kristjánsdóttir1, Margrét Steinarsdóttir2, Erla Sveinbjörnsdóttir2, Rósa B. Barkardóttir1
1Meinafræðideild, 2erfða- og sameindafræðideild Landspítala
katrinh@landspitali.is
Inngangur: Viðtakapróteinið HER2 (human epidermal
growth factor receptor 2) kemur að stjórnun á vexti og viðhaldi brjóstafrumna.
Mögnun á ERBB2-geninu veldur aukinni tjáningu
próteinsins og ýtir þannig undir stjórnleysi í frumuskiptingu og
krabbameinsmyndun í brjóstum. HER2-jákvæð brjóstakrabbamein eru illvíg en til
eru meðferðarúrræði sem eru sérhönnuð að þessari mögnun. Ef mögnunin greinist
snemma og hægt er að hefja markvissa meðferðeru góðar líkur á bata. Hér könnum
við hvort hægt er að meta fjölgun eintaka af þessu geni með
raðgreininguerfðaefnisins í stað flúrljómandi litunar á litningunum (FISH) en
það hefði mikinn sparnað í för með sér.
Efniviður
& aðferðir: Erfðaefni
var einangrað úr paraffin-innsteyptum vefjasýnum úr brjóstakrabbameinum. Gerð
var markraðgreining þar sem ákveðin svæði erfðaefnisins eru fjölfölduð og
bútarnir raðgreindir í miklum fjölda. Notast var við next generation sequencing
(NGS) raðgreiningartækni sem hefur rutt sér til rúms á undanförnum árum.
Samanburður var gerður á sýnum sem höfðu áður verið metin með FISH og voru nú
líka greind með NGS.
Niðurstöður: NGS raðgreining sýnir jafn greinilega
og FISH ef um mikla mögnun á geninu er að ræða. Í sýnum þar sem mögnunin er
lítil eða á frumstigi verða niðurstöður beggja aðferða erfiðari í túlkun.
Ályktanir: Full ástæða er til að ætla að hægt
verði að nota NGS í stað FISH við mat á mögnun ERBB2-gensins. Til þess þarf þó að kanna til hlítar afdrif sjúklinga sem
greinst hafa við viðmiðunarmörk hvorrar aðferðar til að meta til fulls hvaða
viðmiðunargildi er æskilegt að notast við í NGS.
V42 Effect of CagA on dysplastic processes in the gastric mucosa in chronic gastritis
Daryna Sukhan
Department of Pathological Anatomy, Forensic Medicine and Law, Vinnytsia National Pirogov Memorial Medical University
d.suxan@gmail.com
Introduction: There are certain contradictions
regarding the manifestation of virulent and pathogenic properties of CagA +
strains of H. pylori. Also, the effect of the CagA + H.pylori genotype on
precancerous changes in the gastric mucosa remains unclear.
Methods: 77 people with chronic non-atrophic
gastritis (CNG) and 48 with chronic atrophic gastritis (CAG) infected with H.
pylori were examined. In the process of fibroesophagogastroduodenoscopy,
multiple biopsies (body, antrum, stomach angle) were performed, taking into
account the requirements of the modified Sydney system with subsequent
histological examination of the biopsy specimens. Genotyping of Helicobacter
pylori infection was carried out with the help of polymerase chain reaction.
Results: Among the 26 examined patients with CNG
without dysplasia, 15 CagA - and 11 CagA + were detected. Dysplasia was
significantly more prevalent in CagA + patients, both in patients with CNG (χ²
= 19.49, p = 0.0005) and CAG (χ² = 19.49, p = 0.015; Fisher's exact test score
= 0.0143, p <0.05). At the same time, mild degree of dysplasia was
determined in 46 (60%) of patients among 77 in CNG and severe dysplasia in 31
(40%), respectively. Similar indicators were obtained in patients
with CAG, with 31 (64%) patients among 48 with mild dysplasia and 17 (36%) with
severe dysplasia.
Conclusions: Dysplasia of gastric mucosa is
significantly more frequent in patients with CNG and CAG infected with CagA +
strains of H. pylori (p <0.001 and p <0.05, respectively) in comparison
with the CagA - group.
V43 Áhrif próteinanna BMP og lysyl oxidasa í æðakerfi krabbameina
Marta S. Alexdóttir1, Daniela Kocher2, Kristian Pietras3, Guðrún Valdimarsdóttir2
1Læknadeild, HVS, Háskóla Íslands, 2læknadeild BMC, Háskóli Íslands, 3rannsóknarstofa krabbameinsfræða, Háskólanum í Lundi
msa8@hi.is
Inngangur: Breytingar á utanfrumuefninu geta leitt
til meinvarpamyndunar. Lysyl oxidasar (LOX) eru ensím sem gegna hlutverki í
endurmótun utanfrumuefnisins með því að krosstengja kollagen og elastín, og
viðhalda þannig stífni utanfrumuefnisins. LOX hvetur til frumuskriðs, íferðar
og myndunar meinvarpa í ýmsum krabbameinum.
Vitað er að EGFL7 er seytt og tjáð af æðaþelsfrumum og hafi áhrif á frumuskrið.
Æðaþelsfrumur tjá viðtakann ALK1. Óbirtar niðurstöður okkar sýna að BMP9/ALK1
boðleiðin ýti undir EGFL7 tjáningu og stuðli þannig að æðamyndun. Rannsakað var
hvort LOX sé seytt af æðaþelsfrumum fyrir tilstilli EGFL7 og hvort það hafi
áhrif á frumuskrið brjóstakrabbameinsfruma.
Efniviður
& aðferðir: HUVEC
æðaþelsfrumur og MDA-MB-231 ífarandi brjóstakrabbameinsfrumur voru notaðar.
HUVEC frumur voru sýktar með adenoveiru sem tjáir sívirkan eða óvirkan ALK1
viðtaka annars vegar og örvaðar með BMP9 og EGFL7 vaxtarþáttum hinsvegar.
Jafnframt var æti af þessum frumum safnað. RNA var einangrað og PCR hvarf
framkvæmt með vísum fyrir EGFL7 og LOX. Til að meta áhrif LOX á frumuskrið
krabbbameinsfruma var framkvæmt sáraviðgerðarpróf þar sem skilyrt HUVEC æti var
notað með og án LOX hindra.
Niðurstöður: BMP9 ýtir undir tjáningu á EGFL7 í
æðaþelsfrumum, sem ýtir undir tjáningu á þremur mismunandi LOX ísómyndum. Ekki
sást marktækur munur á frumuskriði brjóstakrabbameinsfruma sem voru
meðhöndlaðar með og án LOX hindra.
Ályktanir: Niðurstöður gefa til kynna að LOX sé
tjáð í æðaþelsfrumum fyrir tilstilli EGFL7. Af þessu er þó ekki hægt að álykta
að það hafi áhrif á frumuskrið. Það má mögulega skýra með því að LOX gegni í
raun innanfrumuhlutverki sem er enn óskilgreint.
V44 Efling í starfsumhverfi og starfsánægja hjúkrunarfræðinga á bráðasjúkrahúsi: Lýsandi rannsókn
Anna D. Brynjólfsdóttir1, Sigrún Gunnarsdóttir2, Helga Bragadóttir2
1Hjúkrunarfræðideild Háskóla Íslands, 2Háskóli Íslands
annadiab@internet.is
Inngangur: Rannsóknir sýna að starfsumhverfi
tengist starfsánægju hjúkrunarfræðinga og stöðugleika í starfi og þar með gæðum
hjúkrunar og öryggi sjúklinga. Eflandi þættir í starfsumhverfi eru góð
hjúkrunarstjórnun á deild, viðunandi mönnun, árangursrík teymisvinna og
möguleikar til starfsþróunar. Skortur á hjúkrunarfræðingum er vaxandi og því
mikilvægt að huga að starfsánægju þeirra. Tilgangur rannsóknarinnar var að
skoða eflingu í starfsumhverfi hjúkrunarfræðinga á bráðasjúkrahúsi og tengsl
við starfsánægju og áform um að hætta.
Efniviður
& aðferðir: Rannsóknin
var megindleg lýsandi þversniðsrannsókn með þátttöku 867 hjúkrunarfræðinga og
hjúkrunardeildarstjóra. Gagna var aflað með rafrænni spurningakönnun með NWI-R
mælitækinu um eflingu í starfsumhverfi auk spurninga um starfsánægju og áform
um að hætta í starfi.
Niðurstöður: Starfsánægja mældist almennt nokkur
eða 2,6 (á kvarðanum 1-4) en tæplega fimmtungur þátttakenda ráðgerir að hætta í
núverandi starfi innan eins árs. Af eflandi þáttum í starfsumhverfi hefur teymisvinna
mest vægi, þar á eftir kemur stuðningur næsta yfirmanns og minnst vægi hefur
viðunandi mönnun. Tengsl starfsánægju og eflandi þátta í starfsumhverfi sýna
jákvæð og marktæk tengsl starfsánægju við teymisvinnu (OR=2,797; p<0,05) og
stuðning stjórnenda (OR=2,956; p<0,05) en tengsl starfsánægju og mönnunar
reyndust ekki marktæk. Minni líkur á áformum um að hætta í starfi reyndust
marktækt og jákvætt tengd við stuðning stjórnenda (OR=2,679; p<0,05) og
mönnun (OR=1,753; p<0,05) en ekki komu þar fram marktæk tengsl við
teymisvinnu.
Ályktanir: Niðurstöður benda til að stuðningur
stjórnenda og viðunandi mönnun geta dregið úr áformum hjúkrunarfræðinga um að
hætta í starfi og að stuðningur stjórnenda auk góðrar teymisvinnu lækna og
hjúkrunarfræðinga geta haft jákvæð áhrif á starfsánægju hjúkrunarfræðinga.
V45 Gallstasi á meðgöngu, algengi og fylgikvillar á tíu ára tímabili á Íslandi
Þóra S. Guðmundsdóttir1, Einar S. Björnsson1,3, Þóra Steingrímsdóttir1,2
1Læknadeild Háskóla Íslands, 2kvenna- og barnasviði Landspítala, 3lyflækningasvið Landspítala
thg47hi@gmail.com
Inngangur: Gallstasi á meðgöngu (GM) er
lifrarsjúkdómur sem einskorðast við meðgöngu og einkennist af kláða og hækkun á
gallsýrum í sermi. Tíðni GM í Evrópu er 0,5-1,5%. Tíðni greininga GM fer eftir
árstíðum, færri tilfelli greinast á sumrin. Fylgikvillar fósturs eru algengari
hjá konum með GM þar sem alvarlegustu fylgikvillarnir eru fósturdauði og
fyrirburafæðing. Fáar lýðgrundaðar rannsóknir á GM eru til. Tilgangur þessarar rannsóknar
var að ákvarða tíðni sjúkdómsins og algengi fylgikvilla hjá konum með GM á tíu
ára tímabili.
Efniviður
& aðferðir: Rannsóknin
var afturskyggn og lýðgrunduð.
Rannsóknarhópurinn samanstóð af öllum konum á meðgöngu sem greindar voru með
hækkaðar gallsýrur á árunum 2007-2016 á Íslandi (1124 meðgöngur, 1028 konur).
GM var greindur þegar gallsýrustyrkur var hærri en >15 µmól/L. Upplýsingar
um sjúkrasögu þessara kvenna voru fengnar frá öllum níu spítölum á Íslandi.
Samanburðarhópur var búinn til með hjálp Fæðingaskrár Landlæknis.
Niðurstöður: Tíðni GM á þessu tíu ára tímabili var
2,7%. Tíðni GM í fjölburameðgöngum var töluvert hærri, 7,8% (p=0,016). Hlutfall
greininga GM á vetrarmánuðum (desember – mars) var 39% samanborið við 26% á
sumarmánuðum (júní - september), p<0,001. Fyrirburafæðingar (<37 vikur)
voru 11,3% fæðinga í rannsóknarhóp miðað við 6,0% í rannsóknarhópnum,
p<0,005. Framköllun fæðinga í rannsóknarhóp var 50% samanborið við 26,7% í
samanburðarhóp (p<0,005).
Ályktanir: Algengi GM var hærri á Íslandi en
annars staðar í Evrópu. Tíðni greininga var marktækt hærri á vetrarmánuðum.
Hærri tíðni GM í fjölburameðgöngum endurspeglar mikilvægi hormóna í meinmyndun
GM. Tíðni fyrirburafæðinga og framköllunar fæðingar var marktækt hærri í
rannsóknarhópnum.
V46 Þróun hlaupabólubólusetninga frá 2007 til 2017: Þekking, viðhorf og verklag heilsugæsluhjúkrunarfræðinga
Hildur Holgersdóttir1, Brynja Viktorsdóttir2, Kristín B. Flygenring2, Brynja Örlygsdóttir2
1Hjúkrunarfræðideild Háskóla Íslands, 2Háskóli Íslands
hildur93@gmail.com
Inngangur: Á Íslandi var byrjað að bólusetja gegn
hlaupabólu með bóluefninu Varilrix árið 1995 en árið 2012 var mælt með tveimur
skömmtum fyrir betri langtímavirkni. Tilgangur rannsóknarinnar var að skoða
algengi ónæmisaðgerða með bóluefninu Varilrix hér á landi frá árunum 2007 til
2017 með tilliti til tíðni, aldursdreifingar og fjölda skammta. Einnig var
þekking, viðhorf og verklag heilsugæsluhjúkrunarfræðinga kannað.
Efniviður
& aðferðir: Rannsóknin
var megindleg lýsandi. Í fyrri hluta var unnið með gögn úr bólusetningagrunni
Embætti landlæknis frá árunum 2007 til 2017. Þýðið (N=3993) var þeir sem
bólusettir voru með hlaupabóluefninu Varilrix á tímabilinu. Seinni hlutinn var
þversniðsrannsókn þar sem spurningalisti var sendur rafrænt til 174
heilsugsæsluhjúkrunarfræðinga HH starfandi í klíník. 88 hjúkrunarfræðingar
svöruðu sem gerir 50,6% svarhlutfall.
Niðurstöður: Mikil fjölgun hefur orðið síðustu tíu
ár í bólusetningum með bóluefninu Varilrix. Árið 2007 voru einungis 36 bólusettir
hér á landi með fyrsta skammti en árið 2017 voru þeir orðnir 1228 talsins.
Algengast var að börn yngri en 5 ára væru bólusett (83,52%). Niðurstöður sýndu
að 10,5% (n=9) hjúkrunarfræðinga kynna hlaupabólubólusetninguna alltaf eða oft
að fyrra bragði fyrir skjólstæðingum sínum. Þrátt fyrir það eru 60,7%
heilsugæsluhjúkrunarfræðinga mjög/fremur hlynntir því að hlaupabólubólusetning
verði hluti af almennum bólusetningum barna.
Ályktanir: Þrátt fyrir að meirihluti
hjúkrunarfræðinga sé hlynntir því að hlaupabólubólusetning verði hluti af
almennum bólusetningum barna eru einungis 10,5% sem kynna hana oft fyrir
skjólstæðingum sínum að fyrra bragði. Vegna þessa og fjölgunar á bólusettum
einstaklingum gegn hlaupabólu er skýrt að verklag vantar á heilsugæslustöðvarnar
svo samræmi sé milli starfa hjúkrunarfræðinga.
V47 Fjarhjúkrun um síma á Íslandi - inntak starfsins eins og hjúkrunarfræðingar lýsa því: Eigindleg lýsandi rannsókn
Hulda Gestsdóttir2, Helga Bragadóttir2,3, Helga Jónsdóttir2,3, Brynja Örlygsdóttir4
1Hjúkrunarfræðideild, heilbrigðisvísindasviði Háskóla Íslands, 2Heilbrigðisstofnun Vesturlands, 3Landspítali, 4hjúkrunarfræðideild
hug3@hi.is
Inngangur: Fjarhjúkrun um síma (telenursing) er ein tegund fjarheilbrigðisþjónustu
á Íslandi. Þjónustunni er ætlað að auðvelda almenningi aðgang að
heilbrigðisstarfsmanni og sporna gegn rangri notkun á grunn- og bráðaþjónustu.
Tilgangur rannsóknarinnar er að varpa ljósi á inntak fjarhjúkrunar um síma á
Íslandi að mati hjúkrunarfræðinga sem veita hana.
Efniviður
& aðferðir: Rannsóknin
er lýsandi eigindleg rannsókn með hálfstöðluðum viðtalsramma. Úrtakið voru 17
hjúkrunarfræðingar sem starfa við fjarhjúkrun um síma og voru þátttakendur 13
eða 76,5%.
Niðurstöður: Gögnin voru innihaldsgreind og fimm
flokkar fundnir sem lýstu því hvað felst í fjarhjúkrun um síma. Yfirflokkur; Að
tryggja öryggi. Undirflokkar; 1) Beiting vísindalegrar aðferðar; 2) Beiting
heildrænnar einstaklingshæfðrar nálgunar; 3) Þróun á færni í að greina hið
óséða; 4) Innri og ytri ógnir. Niðurstöður benda til þess að fjarhjúkrun um
síma felist í því að tryggja öryggi skjólstæðinga og hjúkrunarfræðinga í þeim
aðstæðum sem þeir eru þegar símtal á sér stað. Hjúkrunarfræðingarnir nota til
þess hjúkrunarferli sem felur í sér upplýsingasöfnun, greiningu og ráðgjöf.
Þeir veita einstaklingshæfða þjónustu og flétta saman eigin hjúkrunarþekkingu,
færni og faglega og persónulega reynslu við upplýsingar frá skjólstæðingum og
eru meðvitaðir um þætti sem geta haft áhrif á öryggi fjarhjúkrunarinnar. Þannig
ná hjúkrunarfræðingar að gera heildrænt mat á heilbrigðisvanda og veita
viðeigandi ráðgjöf.
Ályktanir: Rannsóknarniðurstöður gefa hagnýtar
upplýsingar um hvað fjarhjúkrun um síma felur í sér, hvers hún krefst af
hjúkrunarfræðingum og hvar skórinn kreppir. Niðurstöðurnar geta nýst sem
grunnur að umbótum á fjarhjúkrun um síma. Greina þarf hvernig nýta má sem best
fjarhjúkrun um síma á Íslandi.
V48 Experiences and preferences of women accepting first-trimester combined screening in Iceland in the years 2012-2016
Eirný Þórólfsdóttir1, Kristín R. Haraldsdóttir2, Åshild Lunde3
1Department of Genetics and Molecular Medicine,, Landspítali University Hospital, 2Prenatal Diagnostic Unit, Women's and Children's Services, Landspítali University Hospital, 3Department of Global Health and Primary Care, University of Bergen
eirnyt@landspitali.is
Introduction: First-trimester combined screening
(FTS) has been offered to all pregnant women in Iceland from 2006, while
non-invasive prenatal testing (NIPT) has not been taken up yet. In the years
2012-2016 a total of 255 women received false-positive FTS results.
Methods: An online retrospective study-specific
survey was introduced to women who received false-positive FTS results in
2012-2016, as well as to an equal number of women who received true-negative
results during the same period. Statistical analysis was applied to numerical
data and thematic analysis on open-ended responses.
Results: A total of 104 women answered the
survey. The false-positive group reported in retrospect statistically
significantly higher anxiety levels at the time of receiving the results than
the true-negative group and they gave a deeper insight into their experiences
and feelings in open-ended responses. Only 21% of the responders had heard
about NIPT, but after a brief introduction 77% said they would prefer it in
their next pregnancy.
Conclusions: The study gave insight into prenatal
screening experiences of Icelandic women, with women who received
false-positive FTS results reporting high anxiety levels at the time of
receiving them. It would thus be a positive move to introduce NIPT as a
prenatal screening method in Iceland, given the low false-positive rates of
NIPT, but the fact that only one fifth of the women within the study had heard
about the method emphasizes the need for comprehensive NIPT pretest-information
to be available prior to its uptake to ensure informed and autonomous decision-making.
V49 Socio-demographic features of the hospitalized patients with viral hepatitis B and C
Stanislav Struts
Vinnytsia Pirogov National Memorial Medical University
acregzhde@gmail.com
Introduction: According to experts' assessment of
the World Health Organization (WHO) ≈150 million people suffer from chronic
viral hepatitis C, and 350,000 die annually due to liver damage. Approximately
3% (≈1 million 170 thousand of Ukrainian people) are infected.
Methods: A descriptive retrospective
epidemiological study of patients with viral hepatitis B and C was conducted
during 2011-2013 years. The sources of information were the medical records of
the hospitalized patients to the infectious department of Vinnytsia Municipal
Clinical Hospital no. 1 in quantity 362 units. Bibliographic, epidemiological,
statistical methods were used with analytical-synthetic and organizational
design.
Results: 76 (21%) patients had viral hepatitis B
and 286 (79%) - viral hepatitis C. 45.3% (164 people) were women and 54,7% (198
people) were men. The average age of
patients (M ± SD) - 40.7 ± 11.6 years. It was proved that 40.8% of the
hospitalized patients were at the age of 26-40 years. The distribution of
patients showed that 44.7 ± 2.6% of the patients were workers. Among the hospitalized
patients with viral hepatitis men dominated (7.6% vs. 1.2%; t = 3.09; p
<0.01). It was determined that surgical interventions were indicated in 31,8
± 2,8% patients with hepatitis C and 26,3 ± 5,1% with hepatitis B.
Conclusions: Critical risk groups according to
socio-demographic features are defined: people aged 26-40; males in the onset
of viral hepatitis B; workers; existence in the history of performed surgical
interventions.
V50 FertiQoL Spurningalisti um lífsgæði tengd frjósemi Þýðing og prófun spurningakvarðans
Hildur Sigurðardóttir, Rut Vestmann, Ólöf Ý. Ragnarsdóttir
Hjúkrunarfræðideild Háskóla Íslands
hildusig@hi.is
Inngangur: Um það bil eitt af hverjum sex pörum
glíma við ófrjósemi. Rannsóknir hafa sýnt fram á að ófrjósemi og það álag sem
frjósemismeðferðir fela í sér geti haft veruleg áhrif á líf og líðan parsins.
Árið 2002 var FertiQol spurningalistinn hannaður sem alþjóðlegt mælitæki í þeim
tilgangi að kanna lífgæði kvenna og karla sem glíma við ófrjósemi en síðan þá
hefur hann verið þýddur á yfir fjörutíu tungumál. Spurningalistinn samanstendur
af þrjátíu og sex spurningum sem eru hannaðar til þess að meta lífsgæði fólks
sem er í frjósemismeðferð í kjölfar ófrjósemis.
Efniviður
& aðferðir: Greint
verður frá bakgrunni og þýðingarferli FertiQol spurningakvarðans á íslensku og
prófun íslenskrar þýðingar hans. Við prófun íslenskrar þýðingar var
spurningalisti lagður fyrir pör sem gengu í gegnum frjósemismeðferðir á
IVF-klíníkinni á tímabilinu 18.apríl 2017 til 8.maí 2017. Úrtakið var þægindaúrtak
18 þátttakenda sem voru einstaklingar og pör sem komu vegna frjósemismeðferðar
á IVF-klíník á tímabilinu. Svarhlutfall var 95%. Úrvinnsla gagna fór fram í
SPSS tölfræðiforritinu.
Niðurstöður: Áreiðanleikastuðull Cronbachs alpha
var notaður til að kanna áreiðanleika og innra samræmi FertiQol og reyndist
mælitækið áreiðanlegt þar sem Cronbach´s alpha var 0,937.
Ályktanir: Niðurstöður rannsóknarinnar gefa til
kynna að íslensk þýðing spurningalistans FertiQoL sé góð og niðurstöður benda
einnig til þess að íslenska útgáfa FertiQoL sé áreiðanleg og hægt er að taka
næsta skref í rannsókninni sem er að leggja listann fyrir stærra úrtak og fá
viðmiðunartölur fyrir Ísland.
V51 Lifun og afdrif minnstu fyrirburanna
Ellen M. Gunnarsdóttir1, Kristín Leifsdóttir2, Snjólaug Sveinsdóttir2, Þórður Þórkelsson2
1Læknadeild Háskóla Íslands, 2Barnaspítala Hringsins
emg21@hi.is
Inngangur: Undanfarin ár og áratugi hafa lífslíkur
fyrirbura aukist umtalsvert, einkum minnstu barnanna. Margvísleg vandamál geta
fylgt því að fæðast fyrir tímann. Markmið rannsóknarinnar var að kanna lifun og
afdrif minnstu fyrirburanna hér á landi og bera saman við sambærileg lönd.
Efniviður
& aðferðir: Rannsóknin
náði yfir alla fyrirbura sem fæddust á Íslandi 2007-2015 eftir 24-31 vikna
meðgöngu og voru <1500 g. Upplýsingar fengust úr gagnagrunni Vökudeildar
Barnaspítala Hringsins og sjúkraskrám. Rannsóknartímabilinu var skipt í tvennt
og tímabilin borin saman. Við samanburð við önnur lönd fengust upplýsingar úr
nýlegri erlendri rannsókn (J Pediatr 2016;177:144-52).
Niðurstöður: 204 börn uppfylltu rannsóknarskilyrði;
105 fædd 2007-2010 og 99 fædd 2011-2015. Fjöldi látinna barna lækkaði úr 7
(6,7%) í 4 (4,0%) milli tímabila (p=0,5395). Aukning var á fjölda barna sem
fengu alvarlega heilablæðingu (3,8% og 9,1%; p=0,1557) og þeirra sem fóru í
aðgerð vegna fyrirburaaugnsjúkdóms (1,9% og 4,0%; p=0,4342). Færri börn
greindust með langvinnan lungnasjúkdóm (26,7% og 23,2%; p=0,6859) og skemmdir á
hvíta efni heilans (4,8% og 2,0%; p=0,4464). Í sambærilegum löndun var lifunin
83-95%, en hún var næst hæst á Íslandi (93%). Hlutfall langvinns lungnasjúkdóms
var 27% á Íslandi en 13-32% annarsstaðar. Á Íslandi fengu 9% alvarlega
heilablæðingu og/eða hvítaefnisskemmdir en 7-15% í sambærilegum löndum.
Ályktanir: Tiltölulega fá börn í rannsókninni
gerir tölfræðilegan samanburð erfiðan, en niðurstöður gefa visbendingar um
árangur hér á landi. Dánartíði minnstu fyrirburanna er lág og hlutfall
alvarlegra sjúkdómsgreininga tiltölulega lágt. Aukning á alvarlegri heilablæðingu
og hátt hlutfall langvinns lungnasjúkdóms og er visst áhyggjefni sem þyrfti að
skoða nánar.
V52 Fæðingar frumbyrja á Íslandi 1997-2015
Ólöf Á. Guðjónsdóttir1, Þóra Steingrímsdóttir2, Alexander K. Smárason3, Kristjana Einarsdóttir1, Ragnheiður I. Bjarnadóttir2
1Læknadeild Háskóla Íslands, 2kvennadeild Landspítala, 3heilbrigðisvísindastofnun Háskólans á Akureyri
oag6@hi.is
Inngangur: Fyrsta fæðing konu hefur áhrif á
frjósemi hennar, meðgöngur og fæðingar síðar meir. Með minnkandi frjósemi kvenna
á Íslandi og hækkandi meðalaldri frumbyrja hefur hlutfall frumbyrja af öllum
fæðandi konum hækkað. Tíðni keisaraskurða fer hækkandi í heiminum og ein af
ástæðunum er talin vera hækkandi keisaratíðni hjá frumbyrjum og hækkandi
hlutfall kvenna sem hefur áður farið í keisaraskurð. WHO hefur lagt til að
Robson flokkunarkerfið verði alþjóðlegur staðall til að fylgjast með og bera
saman tíðni keisaraskurða og annarra útkoma fæðinga.
Efniviður og
aðferðir: Rannsóknin
var afturskyggn og fengust öll gögn úr Fæðingaskrá Íslands. Við flokkun voru
notaðar breytur fyrir fjölburafæðingu, fósturstöðu, ör á legi, upphaf fæðingar
og fullar meðgönguvikur.
Niðurstöður: Flestar frumbyrjur voru á aldrinum
20–29 ára og hlutfallsleg stærð þess flokks hélst jöfn á tímabilinu eða um 70%
fæðinga, frumbyrjum undir tvítugt fækkaði en frumbyrjum yfir þrítugu fjölgaði.
Langflestar frumbyrjur voru í Robson flokki 1, sjálfkrafa sótt, eða 71,5%
kvenna. Framkölluðum fæðingum frumbyrja fjölgaði og þar af leiðandi stækkaði
Robson flokkur 2 en hlutfallsleg stærð Robson flokks 1, sjálfkrafa sótt,
minnkaði. Þegar Robson flokkar 1 og 2 voru skoðaðir sem ein heild lækkaði tíðni
keisaraskurða á tímabilinu (p=0,01). Tíðnin í flokki 2 var 36,0% á árunum
1997–2000 en 26,4% 2011–2015 (p=1,1*10-6).
Ályktanir: Þrátt fyrir hækkandi meðaldur
frumbyrja og aukna tíðni framkallaðra fæðinga lækkaði tíðni keisaraskurða á
tímabilinu. Lækkun á tíðni keisaraskurða er hugsanlegur ávinningur þess að
útkomur fæðinga á Íslandi hafa verið settar fram með flokkunarkerfi Robson frá
árinu 2004.
V53 Meðfæddir gallar í miðtaugakerfi greindir á fósturskeiði og eftir fæðingu á Íslandi 1992-2016
Ásdís B. Gunnarsdóttir1, Hildur Harðardóttir2, Hulda Hjartardóttir2, Sara L. Þorsteinsdóttir2
1Læknadeild Háskóla Íslands, 2fósturgreiningardeild kvennadeildar Landspítala
abg41@hi.is
Inngangur: Nýgengi meðfæddra galla í
miðtaugakerfi (MTK) meðal fóstra og barna á Íslandi hefur verið rannsakað fyrir
tímabilið 1972-1991. Þessi rannsókn miðaði að því að meta nýgengi galla í MTK fyrir
næsta 25 ára tímabil, 1992-2016, ásamt því að rannsaka áhættuþætti meðal mæðra
og afdrif fóstra og barna.
Efniviður
& aðferðir: Rannsóknin
var afturskyggn og fengust upplýsingar um rannsóknarþýðið (n=206) úr
Fæðingaskrá Íslands og sjúkraskrám mæðra og barna. Notast var við lýsandi
tölfræði við útreikninga á nýgengi og tíðni ákveðinna breyta.
Niðurstöður: Heildarnýgengi galla í MTK var hæst
2,44 tilfelli á hver 1000 fædd börn á tímabilinu 2012-2016. Rúmlega 89%
tilfellanna greindust á fósturskeiði og styttist meðallengd meðgöngu í vikum
við greiningu heilaleysis marktækt úr 19,3 vikum í 11,6 vikur milli tímabilanna
1992-1996 og 2012-2016 (p=0,006). Tilfelli sem greindust eftir fæðingu
tilheyrðu hlutfallslega sjaldnar, eða í 41% tilvika, heilbrigðisumdæmi
höfuðborgarsvæðisins samanborið við 72% fyrir tilfelli sem greindust á
fósturskeiði (p=0,006). Tíðni þekktra áhættuþátta meðal mæðra var lág fyrir
utan hátt hlutfall mæðra með offitu á tímabilinu 2012-2016, eða 23%. Meirihluti
meðganga endaði með meðgöngurofi, eða 71,8%. Af 57 lifandi fæddum börnum með
galla í MTK voru 37 eða 65% enn á lífi þegar rannsóknin fór fram.
Ályktanir: Aukin þjálfun meðal
heilbrigðisstarfsfólks og bættur tækjabúnaður hefur skilað auknum fjölda
greininga galla í MTK á fósturskeiði miðað við fyrri rannsókn ásamt því að
heilaleysi greinist marktækt fyrr nú. Færri ómskoðanir og því e.t.v. minni
sérhæfing við greiningu fósturgalla gæti skýrt minna næmi við greiningu
miðtaugakerfisgalla á fósturskeiði utan höfuðborgarsvæðisins.
V54 Nutritional support in patients with COPD: A randomised controlled feasibility trial
Áróra R. Ingadóttir1, Anne M. Beck2, Christine Baldwin3, C. Elizabeth Wekkes3, Ólöf G. Geirsdóttir4, Alfons Ramel4, Þórarinn Gíslason5, Ingibjörg Gunnarsdóttir4
1Faculty of Food Science and Nutrition, University of Iceland, 2Faculty of Health and Copenhagen, 3Department of Nutritional Sciences, Kings College, 4University of Iceland, 5Department of Sleep, Landspítali University Hospital
aroraros@landspitali.is
Introduction: Intervention studies have mainly used
oral nutritional supplements (ONS) for the management of patients with chronic
obstructive pulmonary disease (COPD) identified as at nutritional risk. In this
12-month randomised feasibility trial we assessed the 1) feasibility of the
recruitment, retention and provision of two interventions: ONS and
between-meals snacks (snacks) and 2) the potential impact of the provision of
snacks and ONS on body weight and QoL in patients with COPD.
Methods: Hospitalised COPD patients, at
nutritional risk, were randomized to ONS (n=19) or snacks (n=15) providing 600
kcal a day in addition to regular daily diet. The intervention started in
hospital and was continued for 12 months after discharge from the hospital.
Results: Study recruitment rate was n=34 (45%)
and retention rate at 12-months was similar for both groups n=13 (68%) in the
ONS group and n=10 (67%) in the snacks group. Both groups gained weight from
baseline to 12 months (2.3±4.6 kg (p=0.060) in the ONS group and 4.4±6.4 kg (p=0.030)
in the snacks group). The St George´s Respiratory Questionnaire (SGRQ) total
score improved significantly from baseline to 12 months in the snacks group
(score 8.9±14.1, p=0.041) while the improvements in the ONS group were not
statistically significant (improvements by 3.9±11.0 scores, p=0.176).
Conclusions: In patients with COPD who are at
nutritional risk snacks are at least as feasible and effective as ONS however,
adequately powered RCTs that take account of the difficulties in recruiting this
patient group are required to confirm this effect.
V55 Forprófun á endurskoðuðum PIPP-R við verkjamat nýbura á nýburagjörgæslu á Íslandi
Guðrún Kristjánsdóttir1, Theja Lankathilaka2, Sigríður M. Atladóttir3
1Hjúkrunarfræðideild Háskóla Íslands, 2Háskóli Íslands, 3Landspítali
gkrist@hi.is
Inngangur: Íslensk þýðing á PIPP-R (e. Premature
Infant Pain Profile - Revised), fjölþátta verkjamatskvarði fyrir fyrirbura og
nýbura sem tekur til greina lífeðlislegar, hegðunarlegar og bakgrunnsbreytur,
er til prófunar. Tilgangur þessarar rannsóknar er að forprófa
IcePIPP-R-kvarðann í íslenskri þýðingu og leggja mat á réttmæti og áreiðanleika
hans.
Efniviður
& aðferðir: Í
úrtaki voru 21 inniliggjandi barn á ungbarna- og nýburagjörgæslu Landspítala
21, fyrirburar og nýburar, með leiðréttan meðgöngualdur frá 25-40 vikur við
mælingu. Tveir framkvæmdu verkjamat með IcePIPP-R-kvarðanum og voru börnin sín
eigin viðmið. Þrjár mælingar voru framkvæmdar við þrjár algengar en mismunandi
aðstæður; sársaukafullar, raskaðar og hlutlausar. Engin inngrip voru framkvæmd
af hálfu rannsakenda.
Niðurstöður: ANOVA-próf sýndi marktækan mun á milli
þrenns konar aðstæðna og heildarstigagjafar hjá báðum rannsakendum og greindi
IcePIPP-R-verkjamatskvarði mun á því þegar fyrirburar og nýburar voru í hvíld,
urðu fyrir áreiti við raskaðar aðstæður eða sársaukafull inngrip. Í niðurstöðum
t-prófs á heildarstigum við þrenns konar aðstæður kom í ljós að ekki er
marktækur munur á heildarstigagjöf rannsakenda í hverjum aðstæðum og bendir til
áreiðanleika IcePIPP-R-verkjamatskvarðans. Innra samræmi IcePIPP-R-verkjamatskvarða
var skoðað með Cronbachs α og reyndist ekki nægilegt innra samræmi milli
rannsakenda í röskuðum aðstæðum, þó var það ásættanlegt í sársaukafullum
aðstæðum. Niðurstöður úr Pearson´s-fylgni prófi sýndi fram á að það var sterk
fylgni á milli rannsakenda og flestra matsþátta IcePIPP-R-verkjamatskvarða og
veik fylgni hjá örfáum matsþáttum.
Ályktanir: Forprófunin sýndi fram á áreiðanleika
og réttmæti IcePIPP-R-verkjamatskvarðans. Þó er þörf á frekari rannsóknum með
stærra úrtaki til að meta betur réttmæti og áreiðanleika IcePIPP-R
verkjamatskvarða.
V56 Kóagulasa neikvæðir stafýlókokkar á Landspítala
Helga L. Káradóttir
Læknadeild Háskóla Íslands
hlk8@hi.is
Inngangur: Kóagúlasa neikvæðir stafýlokokkar
(CoNS) eru algengasta örveran sem vex úr blóðræktun, eru hluti eðlilegrar flóru
húðar og slímhúða auk þess að geta valdið tækifærissýkingum. Markmið
rannsóknarinnar var að kanna faraldsfræði CoNS blóðsýkinga á Landspítala,
hlutfall sýkinga og mengana ásamt tegundadreifingu og helstu áhættuþætti.
Efniviður
& aðferðir: Afturskyggn
rannsókn byggð á úttekt úr gagnagrunni sýkla- og veirufræðideildar Landspítala.
Þýðið samanstóð af sjúklingum sem áttu á árunum 2011 – 2016 a.m.k. 1 atvik af
a.m.k. tveimur jákvæðum blóðræktunum með CoNS teknar á 72 klst tímabili.
Tilfellin voru flokkuð sem sýking eða mengun eftir alþjóðlega viðurkenndum
skilgreiningum (AVS) annars vegar og mati læknis hins vegar.
Niðurstöður: Þátttökuskilyrði uppfylltu 161
tilfelli, 73 tilfelli (45,3%) metin sem sýking skv. AVS og 97 (60,2%) skv. mati
læknis. Af síðarnefnda hópnum voru 41 (42,3%) tilfelli spítalasýking, 9 (9,3%)
voru samfélagssýking og 47 (48,5%) heilbrigðiskerfistengd samfélagssýking. Í 72
(74,2%) tilfellum var sýkingin tengd miðbláæðalegg. Í sex tilfellum (6%) var blóðsýking
talin upprunnin í þvagfærum. Sjö CoNS tegundir greindust í hinum 97 tilfellum; S. epidermidis var algengasta tegundin 74 (76,3%). Í
27 (37%) af þeim 64 tilfellum skilgreind sem mengun skv. mati læknis ræktuðust
fleiri en einn CoNS tegund úr hverju tilfelli.
Ályktanir: Í þessari fyrstu íslensku rannsókn á
CoNS í blóði voru 60% af tilfellum sem uppfylltu inntökuskilyrðin metin sem
sýking. Blóðsýkingin var oftast íhlutatengd, nokkur tilfelli fundust þar sem
uppruni sýkingar var úr þvagvegum. Rannsóknin gefur góða mynd af faraldsfræði
CoNS blóðsýkinga hérlendis og niðurstöður leggja grundvöll að endurskoðun á
meðferðarnálgun, sýkingarvörnum og frekari sýklarannsóknum á CoNS.
V57 Partar sem tanngervi. Nýjungar og framtíðin
Berglind Sigurþórsdóttir1, Sigríður Á. Einarsdóttir1, Aðalheiður S. Sigurðardóttir2
1Námsbraut í tannsmíði, Háskóla Íslands, 2Háskóli Íslands
adalhsvana@hi.is
Inngangur: Markmið rannsóknar var að gera
sögulega samantekt um parta og að bera saman smíðaferli hefðbundinnar
stálgrindar við nýjustu framleiðsluferla með CAD/CAM tölvutækni þar sem notað
var Peek efni.
Efniviður
& aðferðir: Fylgt
var eftir partagerðartilfelli til meðferðar hjá Tannlæknadeild HÍ. Skrásettar
voru í máli og myndum tvær framleiðsluaðferðir og gerður samanburður á ásetu,
þykkt og vikt partanna. Niðurstöður voru birtar fram í texta, með myndum og
töflum.
Niðurstöður: Í samanburði var Peekgrindin 2,17 g
eða 8 g léttari en stálgrindin, það tók lengri tíma að gera hana þó ferlið tæki
færri skref í framleiðslu. Þykktarmælingar á krókum og burðarvirki leiddu í
ljós að ekki var afgerandi munur á grindunum, nema á hægri hlið burðarvirkis,
þar mældist málmurinn þykkari og bláendar Peek króka á öðrum jaxli (17) voru
nærri helmingi þykkari en á málminum. Áseta beggja grinda var stöðug en
stálgrindin var þéttari í sæti sínu, plata Peekgrindarinnar var óþétt við
framtannasvæði og gapti við samtengingar og í áhvílum. Hagkvæmara reyndist að
framleiða Peek grind en stálgrind og munar þar um nærri helming í verði
Ályktanir: Sagan sýnir fram á að stálgrindur hafa
sannað sig sem meðferðarlausn fyrir sjúklinga sem misst hafa hluta af eigin
tönnum og getur aukið lífsgæði þeirra. Klíníska reynslu skortir vegna notkunar
Peek parta í munni og langtímarannsóknir á endingartíma þeirra. Meðan ekki er
meiri reynsla á Peekgrindum sem sanna yfirburði hennar yfir stálgrindur, mætti
hugleiða hvort nota ætti efnið til framleiðslu bráðabirgðagrinda ef brúa þarf
bilið fyrir þá sem ekki standa undir fjárhagslegum kostnaði við
stálgrindarsmíði.
V58 Dregið til baka
V59 Komur 0-4 ára barna á Landspítalann á árunum 2012-2017 vegna höfuðáverka
Heiðrún G. Káradótir, Guðrún Kristjánsdóttir
Hjúkrunarfræði Háskóla Íslands
hgk8@hi.is
Inngangur: Höfuðáverkar eru algengir meðal ungra
barna og í flestum tilfellum vægir. Alltaf er þó möguleiki á að vægur áverki sé
alvarlegri en virðist í fyrstu og brýnt að fagfólk þekki merki þess hjá þessum
aldurshópi. Þessi rannsókn leitaðist við að svara spurningum um algengi,
nýgengi, orsakir og alvarleika höfuðáverka hjá 0-4 ára börnum.
Efniviður
& aðferðir:Rannsóknin
var afturskyggn, lýsandi gagnarannsókn. Úrtakið voru öll börn 0-48 mánaða, sem
komu inn á bráðamóttökur Landspítala eða Barnaspítalans með höfuðáverka árin
2012-2017. Upplýsingar um aldur, kyn, búsetu, áverkaskor, ICD-10 greiningar,
orsök áverka og innlagnir voru fengnar, en einnig fengust upplýsingar um hvaðan
og hvernig börnin komu á spítalann, komutíma og komudag.
Niðurstöður: Alls komu 5092 börn í 6265 skipti inn
með höfuðáverka á rannsóknartímabilinu. Nýgengi höfuðáverka hjá 0-4 ára börnum
reiknaðist 8,3/100 á ári. Meðalaldur var 26,4 mánuðir og drengir voru í
meirihluta. Algengasta orsök áverka var fall, alvarleikastig var oftast lágt og
heildarhlutfall innlagna einungis 0,6%. Rúmlega þriðjungur barnanna hlaut endurtekna
áverka. Um 94% barnanna sem komu áttu búsetu á höfuðborgarsvæðinu, flest í
Reykavík.
Ályktanir: Í ljósi hárrar komutíðni á sjúkrahús
vegna höfuðáverka hjá þessum hópi barna er ástæða til að gera nánari skoðun á
viðfangsefninu svo hægt sé að bregðast betur við með bættri þjónustu í samvinnu
við heilsugæslu. Frekari rannsókna er þörf svo að hægt sé að fá nákvæmari mynd
af því hvar vandinn liggur.
V60 Líkamleg virkni barna með gigtarsjúkdóma
Auður Kristjánsdóttir, Svanhildur A. Óskarsdóttir, Björg Guðjónsdóttir
Læknadeild, námsbraut í sjúkraþjálfun, Háskóla Íslands
auk9@hi.is
Inngangur: Markmið var að skoða og meta nýlegar
rannsóknir þar sem líkamleg virkni barna með gigtarsjúkdóma (Juvenile idiopathic arthritis,
JIA) var mæld og borin
saman við jafnaldra eða hreyfiráðleggingar. Einnig var samband á milli
sjúkdómsvirkni og líkamlegrar virkni skoðað.
Efniviður
& aðferðir: Leitað
var í gagnagrunnunum Pubmed, Chinal og Web of science. Notast var við
leitarorðin physical
activity og Juvenile idiopathic arthritis og þær greinar skoðaðar sem komu út á
tímabilinu 1. janúar 2013 - 1. febrúar 2018. Leit var framkvæmd í byrjun
febrúar 2018. Eftir útilokun voru fimm greinar sem uppfylltu skilyrði fyrir
samantekt.
Niðurstöður: Þrátt fyrir ólíka mælikvarða í rannsóknunum
eru niðurstöður samantektarinnar þær að börn með JIA hreyfa sig marktækt minna
en jafnaldrar. Fjórar rannsóknir af fimm báru saman hreyfingu barna og
hreyfiráðleggingar. Allar komust þær að því að lægra hlutfall barna með JIA en
heilbrigðra nái ráðleggingum um hreyfingu. Fjórar af fimm rannsóknum skoðuðu
tengsl á milli sjúkdómsvirkni og líkamlegrar virkni. Tvær þeirra sýndu fram á
að aukin sjúkdómsvirkni getur orsakað minni líkamlegri virkni en tvær þeirra
fundu ekki tengsl þar á milli.
Ályktanir: Börn með JIA hreyfa sig minna en
jafnaldrar og lægra hlutfall þeirra hreyfir sig samkvæmt hreyfiráðleggingum
samanborið við önnur börn. Ekki var samræmi á milli niðurstaðna hvað varðar
tengsl á milli sjúkdómsvirkni og líkamlegrar virkni þannig að ekki er hægt að
segja til um samband þessara þátta. Þörf er á viðameiri rannsóknum sem skoða
áhrif sjúkdómsvirkni og annara sjúkdómstengdra þátta á hreyfingu barna með JIA.
V61 Börn sem eru sein til máls: Orðaforðaþjálfun barns á þriðja ári
Marta Eydal1, Jóhanna T. Einarsdóttir2, Þóra S. Úlfsdóttir3
1Landspítali, 2læknadeild Háskóla Íslands, 3miðja máls og læsis, Skóla- og frístundasvið Reykjavíkurborgar
martaeydal@gmail.com
Inngangur: Tveggja ára börn sem hafa ekki að
lágmarki 50 orð á valdi sínu og/eða eru ekki farin að tengja saman orð í
setningar eru talin sein til máls (late talker) (Rescorla, 1989). Sum börn ná sér á strik en hjá öðrum verður vandinn
þrálátur. Á Íslandi hafa ekki verið gerðar rannsóknir á börnum sem eru sein til
máls. Markmið þessarar rannsóknar var að meta áhrif íhlutunar á barn sem er
seint til máls.
Efniviður
& aðferðir: Einn
drengur tók þátt í rannsókninni, hann var 30 mánaða við upphaf þjálfunar.
Íhlutunin fólst í þjálfun fyrir fram ákveðinna markorða, einnig voru valin
samanburðarorð sem ekki voru þjálfuð. Þjálfunartímar voru 14 talsins. Við
fyrirlögn orðanna var lögð áhersla á fjölbreytileika og ákefð að fyrirmynd
rannsóknar Alt og félaga (2014).
Niðurstöður: Almennur orðaforði drengsins, sem
mældur var með staðlaða málþroskaprófinu Orðaskil, jókst yfir
meðferðartímabilið. Við upphaf þjálfunar hafði drengurinn 166 orð á valdi sínu
sem er 1,86 staðalfrávikum undir meðaltali drengja á sama aldri. Strax eftir íhlutun,
þegar drengurinn var 32 mánaða, fékk hann 323 stig sem er 1,23 staðalfrávikum
undir meðaltali. Drengurinn notaði fleiri markorð en samanburðarorð yfir
tímabilið, einnig jókst notkun hans á markorðunum eftir því sem leið á.
Ályktanir: Markviss orðaforðaþjálfun sem byggði á
fjölbreytileika og ákefð hafði jákvæð áhrif á orðaforðatileinkun hjá barni sem
seint er til máls á þann hátt að barnið bætti við sig fleiri orðum meðan á
íhlutun stóð en hægt væri að gera ráð fyrir vegna almenns þroska.
V62 Loftháð þol og efnaskiptavilla hjá sundmönnum með þroskahömlun
Ingi Einarsson1, Dan Daly2, Sigurbjörn Arngrímsson3
1TVD - Papesh, Háskólinn í Reykjavík, 2KUL, 3íþrótta og heilsufræði, Háskóla Íslands
ingithore@ru.is
Inngangur: Það er vel þekkt að einstaklingar með þroskahömlun
(ÞH) eru líklegri til að hreyfa sig minna, vera feitari og hafa minna loftháð
þol en ófatlaðir einstaklingar (OF). Einstaklingar með ÞH eru einnig líklegri
til að þróa með sér efnaskiptavillu (MetS) þrátt fyrir að engar augljósar
líkamlegar ástæður finnist. Markmiðið var að kanna hvort regluleg þolþjálfun
einstaklinga með ÞH hafi sömu jákvæðu áhrif og áður hefur verið sýnt fram á
fyrir OF.
Efniviður
& aðferðir: 25
unglingar með ÞH (ÞHS) og 24 OF (OFS) sem allir æfðu sund að lágmarki 6
klukkustundir á viku voru bornir saman við 51 einstakling með ÞH sem ekki
stunduðu þolþjálfun og 53 OF. Allir fóru í gegnum sömu mælingar á
líkamssamsetningu, blóðprufu og þoli sem mælt var með
hámarkssúrefnisupptökuprófi (VO2max) á þrekhjóli. Aldurs- og kynjamiðuð viðmið
um slag (SBP) og þanþrýsting (DBP), mittismál (WC), lágþéttnifituprótein
(LDL-C) og blóðsykur voru notuð til að meta MetS. Gögnum var safnað veturinn
2013.
Niðurstöður: Engir sundmenn, hvorki með ÞH eða án
voru greindir með MetS (þrjú gildi fyrir utan ráðlögð viðmið) en 15%
einstaklinga með ÞH og 3% úr OF greindust með MetS. Innan hóps ÞH voru öll mæld
gildi betri fyrir ÞHS en hjá þeim sem ekki stunduðu sund. Aftur á móti höfðu
OFS einungis betra þol en óþjálfaðir á meðal OF. Enginn munur fannst á milli
ÞHS og OFS.
Ályktanir: Koma má í veg fyrir flest
lífsstílstengd heilsuvandamál með einungis 6 klukkustunda þolþjálfun á viku
meðal einstaklinga með ÞH. Leggja þarf sérstaka áherslu á að hvetja
einstaklinga með ÞH að hreyfa sig reglulega.
V63 Könnun á þekkingu, öryggi og hindrunum íslenskra skólahjúkrunarfræðinga til að sinna geðheilbrigði grunnskólabarna
Sigrún E. Ólafsdóttir1, Stefanía Ó. Margeirsdóttir2, Kristín I. Grímsdóttir2, Brynja Örlygsdóttir3
1Blóðlækningadeild Landspítala, 2Landspítali, 3Háskóli Íslands
seo8@hi.is
Inngangur: Geðraskanir barna og unglinga geta
haft áhrif á vellíðan, lífsgæði, námsárangur og námsktækifæri. Tilgangur
rannsóknarinnar var að kanna hversu öruggir og virkir íslenskir
skólahjúkrunarfræðingar telja sig vera í að sinna geðheilbrigðismálum og hvaða
hindrunum þeir mæta.
Efniviður
& aðferðir: Spurningalisti
var sendur rafrænt til allra skólahjúkrunarfræðinga landsins og var svörunin
58,7% (n=84). Notast var við lýsandi tölfræði, skífurit, krosstöflur og
kí-kvaðrat próf.
Niðurstöður: Um helmingur (48,8%) taldi sig vera
mjög örugga/örugga til að sinna geðheilbrigði barna og unglinga. Þeir töldu sig
óöruggasta að veita nemendum reglulegan stuðning. Það voru 69,0%
skólahjúkrunarfræðinga sem töldu sig vera virka í að sinna geðheilbrigði
grunnskólabarna, en 73,8% upplifðu tímaskort og 69,0% töldu sig einungis verja
0-25% af tíma sínum í að sinna geðheilbrigði barna og unglinga. Helstu
hindranir skólahjúkrunarfræðinga til að sinna geðheilbrigði grunnskólabarna var
óöryggi, tímaskortur og einungis 32,1% töldu sig hafa fengið nægjanlega
þjálfun. Það voru 62,4% sem töldu sig vera með nægjanlega þekkingu til að sinna
geðheilbrigði barna og unglinga. Skólahjúkrunarfræðingar tilgreindu hvað þeir
töldu sig þurfa til að sinna geðheilbrigði barna og unglinga betur. Þar kom
helst fram að þeir þyrftu betri úrræði, handleiðslu og á þverfaglega
teymisvinnu að halda.
Ályktanir: Hlutverk skólahjúkrunarfræðinga í að
sinna geðheilbrigði barna og unglinga hérlendis er mikilvægt en hefur lítið
verið rannsakað. Í þessari könnun voru skólahjúkrunarfræðingar spurðir út í
öryggi, hindranir og þekkingu þeirra á geðheilbrigði barna og unglinga.
Mikilvægt er að rannsaka hlutverk þeirra nánar í tengslum við geðheilbrigði þar
sem þeir gegna veigamiklu hlutverki í efla geðheilbrigði barna og unglinga.
V64 ‘…ekkert spennandi við það að fá kynsjúkdóm': Smokkanotkun unglingspilta
Sóley S. Bender1, Sigurbjörg L. Ellertsdóttir2, Snæfríður Jóhannesdóttir2
1Hjúkrunarfræðideild Háskóla Íslands, 2Háskóli Íslands
ssb@hi.is
Inngangur: Nýgengi klamydíusýkinga á Íslandi er
mjög há miðað við önnur lönd. Flestir greinast á aldrinum 15-24 ára.
Smokkanotkun 15 ára íslenskra unglingspilta á árunum 2013 og 2014 var 72% við
síðustu samfarir. Það hlutfall var hærra í 12 Evrópulöndum. Í framkvæmdaáætun
WHO í Evrópu um kynheilbrigðismál er lögð áhersla á greitt aðgengi að öruggum
getnaðarvörnum. Tilgangurinn með þessari rýnihóparannsókn var að skoða
áhrifaþætti á smokkanotkun unglingspilta.
Efniviður
& aðferðir: Gerð
var rýnihóparannsókn vorið 2018 á smokkanotkun meðal unglingspilta í Reykjavík
og á Akureyri. Þátttakendur voru nemendur í framhaldsskólum. Viðtölin voru
tekin í skólunum, skráð frá orði til orðs og greind með rammaaðferð Gale og
félaga (2013).
Niðurstöður: Tekin voru viðtöl við sex rýnihópa,
alls 35 unglingspilta á aldrinum 18-23 ára. Greind voru þrjú þemu, þ.e. a)
þekkja smokkinn, b) hafa smokkinn í hendi og c) notkunin sjálf- þegar á reynir.
Þekking þeirra á smokknum var mismundandi. Þeir höfðu aldrei séð heildstætt
myndband um smokkanotkun frá A-Ö, þeim fannst vanta meiri kynfræðslu í skólunum
og þeir fengu takmarkaða kynfræðslu frá foreldrum sínum. Þeir lýstu ýmsum
erfiðleikum við að kaupa smokkinn og töldu hann vera dýran. það gat reynst
erfitt að nota smokkinn þegar á hólminn var komið en það var háð aðstæðum.
Ályktanir: Rannsóknin sýnir margvíslegar hindranir
varðandi smokkanotkun sem þarf að ryðja úr vegi. Það er lífsseigt viðhorf meðal
unglingspilta að telja smokkinn of dýran og þarf að leiðrétta slíkt. Rannsaka
þarf betur hvernig “augnablikið” skiptir máli við smokkanotkun en jafnframt
hvernig sjálfsvirðing og sjálfstrú tengist viðhorfum til smokksins.
V65 Smoking and drinking behaviour of Bissau-Guinean adolescents aged 15-16 compared to European peers
Geir Gunnlaugsson1, Aladje Baldé2, Zeca Jandi3, Hamadou Boiro4, João R.B. Có3, Jónína Einarsdóttir5
1Faculty of Sociology, Anthropology and Folkloristic, University of Iceland, 2Jean Piaget University Guinea-Bissau, 3Instituto Nacional de Estudos e Pesquisa (INEP), 4Faculty of Sociology, Anthropology and Folkloristic, Instituto Nacional de Estudos e Pesquisa (INEP), 5University of Iceland
geirgunnlaugsson@hi.is
Introduction: In sub-Saharan Africa adolescents
comprise 23% of the population compared to 12% in high-income countries. With
the Sustainable Development Goals 2016-2030 increased attention is given to
adolescents' health and well-being. Here we describe and analyse the prevalence
of smoking and use of alcohol by Bissau-Guinean adolescents aged 15-16 and
compare to peers in eight European cities.
Efniviður
& aðferðir: Survey
with the locally adapted and pilot tested Planet Youth questionnaire that was conducted in randomly selected classes of
adolescents aged 15-16 in secondary schools in the capital Bissau in June 2017
with comparable data from eight European cities in 2015-2016.
Results: In Bissau, 871 (42%) adolescents aged
15-16 participated (52% girls and 46% boys) compared to 6,534 peers in eight
European cities (49% girls and 51% boys). In total, 2.2% of the Bissau-Guineans
reported daily smoking (B=3.9%; G=0.7%) compared to 11.3% of the European peers
(B=13.2%; G=9,4%). About 1/3 of the Bissau Guineans had life-time experience of
drinking alcohol compared to about 2/3 of the European ones, with no difference
among boys and girls; 10,6% of Bissau-Guineans reported having been drunk
during the last 30 days compared to 14% of the Europeans, the prevalence being
slightly higher among boys compared to girls.
Conclusions: Bissau-Guinean adolescents aged 15-16 report
less smoking and drinking than European peers. It is urgent to initiate health
promotional activities in secondary schools in Bissau to inform and educate
adolescents on the detrimental effect of such behaviours on their long-term
health and wellbeing.
V66 Einelti og heilsa íslenskra skólabarna
Rúnar Vilhjálmsson
Hjúkrunarfræðideild Háskóla Íslands
runarv@hi.is
Inngangur: Erlendar rannsóknir á einelti meðal
ungs fólks benda til fjölþættra neikvæðra afleiðinga meðal þeirra sem fyrir því
verða. Rannsóknin athugar tengsl eineltis og heilsu meðal nemenda í efri
bekkjum íslenskra grunnskóla.
Efniviður
& aðferðir:
Rannsóknin byggir á landskönnuninni Heilsa og líðan skólabarna (HBSC) sem fram
fór árið 2014 meðal nemenda í 6., 8. og 10. bekk í íslenskum grunnskólum. 161
skóli tók þátt í landskönnuninni og svöruðu nemendur nafnlausum spurningalista
í skólastofunni. 11.018 nemendur tóku þátt og voru heimtur 84%. Nemendur voru
spurðir um tíðni leiða, svefnörðugleika og svimakasta og beðnir að meta almennt
heilsu sína. Einelti var skilgreint sem endurtekin áreitni eða ofbeldi frá
nemanda/nemendum þrisvar í mánuði eða oftar.
Niðurstöður: Þolendur eineltis af báðum kynjum og í
öllum bekkjardeildum greindu mun oftar frá leiða, svimaköstum og
svefnörðugleikum og mátu heilsu sína almennt mun lakar en aðrir nemendur af
sama kyni og aldri. Hin neikvæðu tengsl eineltis og heilsufars voru svipuð hjá
piltum og stúlkum, og einnig svipuð hjá eldri og yngri nemendum.
Ályktanir: Rannsóknin undirstrikar mikilvægi þess
að vinna gegn einelti og afleiðingum þess í íslenskum grunnskólum. Sú vinna
snýr bæði að fyrirbyggingu eineltisins og virkni aðstoð við þá sem fyrir því
verða í skólunum. Kennarar og skólahjúkrunarfræðingar eru í lykilhlutverki í
þeirri vinnu.
V67 Komur barna á slysa- og bráðamóttöku Landspítala með útlimaáverka á árunum 2013-2017
Guðrún Kristjánsdóttir, Sóley Ívarsdóttir, Valgerður A. Hannesdóttir
Hjúkrunarfræðideild Háskóla Íslands
gkrist@hi.is
Inngangur: Lengi hefur verið vitað að
stoðkerfisáverkar eru helstu ástæður fyrir komum barna á heilbrigðisstofnanir
en fáar rannsóknir eru til um efnið. Markmið rannsóknarinnar var að skoða komur
barna á slysa- og bráðamóttöku Landspítala vegna útlimaáverka og þá í tengslum
við orsakir, kynja- og aldursdreifingu og helstu útlimaáverka sem börn verða
fyrir.
Efniviður
& aðferðir: Rannsóknin
var afturskyggn þar sem fengnar voru gagnaskrár úr rafræna sjúkraskrárkerfinu
Sögu. Í úrtaki voru öll börn á aldrinum 0-18 ára sem leitað höfðu á slysa- og
bráðamóttöku Landspítala vegna útlimaáverka á tímabilinu 1. janúar 2013 til 31.
desember 2017.
Niðurstöður: Heildarfjöldi koma barna á slysa- og
bráðadeild Landspítala vegna útlimaáverka árin 2013-2017 var 17.419 börn. Börn
komu misoft, allt frá 1 til 23 sinnum á þessu tímabili. Nýgengi var 312,6 börn
á hver 1000 með lögheimili á stórhöfuðborgarsvæðinu. Drengir voru marktækt
fleiri en stúlkur eða 52,9%. Meðalaldur við komu var 10,96 ára (0-18 ára) og
algengasti aldur 12 ára. Flestar komur voru hjá aldurshópnum 10-14 ára (42,4%).
Algengustu orsakir áverka voru fall (44,8%) og árekstrar á hluti og mennn
(25,2%). Algengasta greining barna við komu var “Tognun og ofreynsla á ökkla”
(31,17%) og “Úlnliður og hönd” (11,4%).
Ályktanir: Nýgengi íslenskra barna með lögheimili
á höfuðborgarsvæðinu var hærra en í erlendum samanburðarrannsóknum. Orsakir og
greiningar barna með útlimaáverka voru svipaðar og í erlendum rannsóknum. Ljóst
er að þörf er á frekari rannsóknum á áverkum barna og þá sérstaklega
stoðkerfisáverkum og myndu þær rannsóknir nýtast til að bæta meðferð og koma í
veg fyrir afleiðingar áverka.
V68 Convergent and divergent validity of K-SADS-PL diagnoses in a sample of youth with OCD
Kristín Kragh1, Bernhard Weidle2, Nor C. Torp3, Davíð R.M.A. Højgaard4, Katja A. Hybel4, Judith B. Nissen4, Per H. Thomsen4, Guðmundur Skarphéðinsson1
1Faculty of psychology, University of Iceland, 2Medicine, Norges teknisk- naturvitenskaplige universitet, 3Division of Mental Health and Addiction, Vestre Viken Hospital, 4Center for Child and Adolescent Psychiatry, Aarhus University Hospital
kristin.kragh@gmail.com
Introduction: In this study we investigated the
utility of the K-SADS-PL for the assessment of children diagnosed with
obsessive compulsive disorder (OCD). Paediatric OCD is associated with several
psychiatric disorders, with reported rates of comorbidity ranging from 50-80%.
Given these high comorbidity rates, it is important to have a diagnostic tool
with strong psychometric properties that allows accurate identification of
comorbid disorders in young people with OCD in order to choose the adequate
treatment strategy. This study provides new insights into the diagnostic
procedures for children with OCD as no previous studies have examined the
validity of K-SADS-PL diagnoses specifically in children and adolescents with
OCD.
Methods: The K-SADS-PL was applied in a clinical
sample of youth aged 7-17 years (N=269), who were participants in the Nordic
long-term OCD-treatment study (NordLOTS). Youth and parents completed measures
to evaluate symptoms of anxiety, depression, ADHD, and ODD. Means comparisons
were analysed using student's t-tests. The convergent and divergent validity of
K-SADS-PL anxiety disorders, depressive disorders, ADHD, and ODD were examined
using hierarchical linear regressions.
Results: In short, our results confirm
convergent and divergent validity of K-SADS-PL anxiety disorders, depression
disorders, ODD and ADHD in children and adolescents with OCD.
Conclusions: The present study provides support for
the utility of this diagnostic instrument in the assessment of children and
adolescents with OCD.
V69 Psychometric properties of the DSM-5 K-SADS-PL: Depressive disorders, Anxiety disorders, PTSD and OCD
Harpa H. Harðardóttir, Hjördís Ólafsdóttir, Guðmundur Skarphéðinsson
Faculty of Psychology, University of Iceland
harpahronnh@gmail.com
Introduction: K-SADS-PL is the most commonly used
standardized diagnostic interview in clinical and research settings, and
requires extensive clinical training. The most current version of the K-SADS-PL
evaluates psychiatric symptoms in accordance with DSM-5. K-SADS-PL DSM-IV has
shown fair to good validity and reliability in clinical trials. Research
suggest strong inter-rater reliability and convergent validity is fair to good.
Our aims were to translate part of the DSM-5 K-SADS-PL to Icelandic; OCD, PTSD,
anxiety and depressive disorders.
Methods: We recruited 29 participants from BUGL
and Litla KMS aged 6-18. The convergent validity was evaluated by comparing it
to commonly used rating scales; RCADS, CDI, BYI and MASC. Inter-rater
reliability was acquired by assessing symptoms using audio recording of the
primary administration of the K-SADS-PL.
Results: Mean age of participants was 11.7 (SD =
3.8) and range 6-17 years old, 14 girls. We found considerable comorbidity as
the mean number of diagnosed disorders was 1.89 (SD = 1.16, range = 0-5). The
results showed good to perfect consistency between raters on all the disorders
diagnosed (Kappa 0.91-1.00) except panic disorder (Kappa 0.65). We used a
series of t-tests to compare participants with and without a specific diagnosis
(e.g., anxiety disorders) and those who without a specific disorder on a
construct-related measure (e.g., RCADS). The findings revealed moderate to high
association between diagnoses and construct-related measures.
Conclusions: The preliminary Icelandic version of
the DSM-5 K-SADS-PL seems to be a valid and reliable estimate of depressive
disorders, anxiety disorders, OCD, and PTSD.
V70 Börn á gjörgæsludeildum Landspítala á árunum 2006-2015
Guðrún Kristjánsdóttir1, Sigríður Árna Gísladóttir1, Kristinn Sigvaldason2, Sigurbergur Kárason2, Guðrún Jónsdóttir2
1Hjúkrunarfræðideild Háskóla Íslands, 2Landspítali
gkrist@hi.is
Inngangur: Á Íslandi er ekki sérstök
barnagjörgæsla heldur eru gjörgæsludeildir Landspítalans ætlaðar bæði fyrir
fullorðna og börn. Umfang innlagna barna á gjörgæsludeildir hér á landi er ekki
þekkt svo vitað sé. Markmið var að
kortleggja fjölda innlagðra barna á gjörgæsludeildir Landspítala á árunum 2006
- 2015, legutíma á gjörgæslu, alvarleika veikinda, innlagnarástæður.
Efniviður
& aðferðir: Notast
var við afturskyggnt rannsóknarsnið barna á gjörgæsludeildir Landspítala árin
2006 - 2015. Undirliggjandi sjúkdómar og núverandi sjúkdómsgreining voru
skráðir samkvæmt ICD 10 skráningu. Aldur barns í mánuðum, kyn, hæð, þyngd,
búseta, undirliggjandi sjúkdómar og núverandi sjúkdómsgreining, innlagnarástæða
á gjörgæsludeild og hvort um skipulagða innlögn eða bráðainnlögn var að ræða,
innlagnarmánuður og ár var skráð ásamt tímasetningu innlagnar, legutími á
gjörgæsludeild og heildarlegutími á sjúkrahúsi og hvort barnið hefði áður legið
á gjörgæslu. Könnuð voru afdrif einstaklinga og ef um andlát var að ræða,
hvenær það varð. Notast var við PRISM III til að meta alvarleikastig í legu.
Niðurstöður: Alls lögðust 439 börn inn í 674
innlögnum á gjörgæsludeildir Landspítalans á árunum 2006 – 2015. 80% voru
bráðainnlagnir og voru helstu innlagnarástæður öndunarbilun og/eða lungnabólga
og vandamál frá taugakerfi. Meðallegutími var 3,93 sólarhringar. 22 börn
(5,01%) létust og 24,4% barna áttu fleiri en eina gjögæslulegu. Marktækur munur
var á PRISM-gildi eftir legulengd. Meðaltals-PRISM-gildi barna sem létust í
gjörgæslulegunni var 23,3 en meðaltals-PRISM-gildi barna sem lifðu af var 4,5.
Meðaltals-PRISM-gildi þeirra sem þurftu öndunarvélameðferð var 8,7 og hjá þeim
sem þurftu þess ekki 2,8.
Ályktanir: Fjöldi innlagna barna á
gjörgæsludeildir Landspítala er meiri en talið var í upphafi.
V71 Source, transmission and development of Ichthyophonus hoferi infection in the Icelandic summer-spawning herring
Hrólfur S. Pétursson1, Árni Kristmundsson2, Birkir Þ. Bragason2, Guðmundur J. Óskarsson3
1Faculty of Medicine, Institute For Experimental Pathology, University of Iceland, Keldur, 2Institute For Experimental Pathology, University of Iceland, Keldur, 3Marine and Freshwater Research Institute in Iceland
hrolfurs@hi.is
Introduction: In the mid 2000s, the herring (Clupea harengus) population had been relatively strong
and stable since its collapse in 1960s, which was likely due to overfishing.
However, in 2008, severe and highly prevalent (up to 70-80%) Ichthyophonus hoferi infections were experienced in older
cohorts of herring, followed by a significant decline in the stock. The reason
for this sudden increase in infections of this endemic pathogen is unclear and
a decade later, the epidemic is still ongoing. The aim is to investigate the
source, transmission and development of Ichthyophonus infections to shed light on this prolonged
epidemic in the Icelandic population of summer spawning herring.
Methods: Different age groups of herring and
various species of pelagic crustaceans are examined for infections using PCR,
conventional histology and in situ hybridization.
Results: Preliminary results indicate that
various pelagic crustacean species carry Ichthyophonus infections and therefore a reservoir for the
parasite. Furthermore, infections do not seem to be restricted to any specific
age-groups, as asymptomic juvenile herrings, previously thought to be free of
infections, have subclinical infections suggesting that the apparent
age-related presence of clinical signs cannot be explained by a difference in
diet.
Conclusions: Possibly the stressful process of
maturation leads to intensified infections and a clinical disease to emerge. In situ hybridization technique, intended to
reveal the transmission route, has been successfully-optimized and applied on
samples highly positive for I. hoferi. Examinations on the route of
transmission and the development of the parasite in fish- and crustacean hosts
are in process.
V72 Um hænsnasníkjudýr á Íslandi að fornu og nýju
Karl Skírnisson, Guðný R. Pálsdóttir
Læknadeild, tilraunastöð HÍ í meinafræði að Keldum
karlsk@hi.is
Inngangur: Löng hefð er fyrir hænsnahaldi í
sveitum landsins og færst hefur í vöxt á seinni árum að fólk í þéttbýli haldi
varphænur í bakgörðum heimila sinna. Engar skipulegar athuganir hafa verið
gerðar á því á síðari árum hvaða sníkjudýr hrjá hænsn hérlendis en fyrir
ríflega hálfri öld gerðu Halldór Vigfússon og Guðmundur Gíslason, sérfræðingar
við rannsóknardeild dýrasjúkdóma á Keldum, ýmsar brautryðjandi rannsóknir á
sníkjudýrum og sjúkdómum í hænsnum.
Efniviður
& aðferðir: Nú
skal þráðurinn tekinn upp að nýju því nýverið var hænum safnað frá 10 heimilum
á ýmsum stöðum á landinu. Til að undirbúa þessar fyrirhuguðu rannsóknir var
farið skipulega í gegn um sýnasafn sníkjudýradeildarinnar á Keldum frá árunum
1971-2017 og hænsnasníkjudýrin greind í þeim tilvikum þar sem slíkt hafði ekki
áður verið gert.
Niðurstöður: Óværutegundir reyndust vera sjö. Tvær
tilheyra mítlum, rauði hænsnamítillinn Ornithonyssus gallinae og fótamítillinn Knemidocoptes mutans. Fimm tegundir naglúsa fundust í safninu, þrjár Ischnocera naglýs (Goniocodes gallinae, Goniodes dissimilis og Lipeurus caponis) og tvær Amblycera tegundir (Menacanthus stramineus og Menopon gallinae). Þrjár tegundir þráðorma voru í safninu:
hænsnaspóluormurinn Ascaridia
galli,
botnlangaormurinn Heterakis
gallinae og hárormur
af ættkvíslinni Capillaria. Takmarkaðar rannsóknir hafa farið
fram á frumdýrasýkingum hænsna á Íslandi. Þó er vitað um tilvist tveggja
hníslategunda af ættkvíslinni Eimeria. Aðrar tegundir sem staðfest er hrjáð hafa hænsn hér á landi eru
veggjalúsin Cimex
lectularius og
hænsnaflóin Ceratophyllus
gallinae.
Ályktanir: Forvitnilegt verður að skoða núverandi
sníkjudýrafánu íslenskra hænsna í ljósi ofangreindrar þekkingar þar sem 14
tegundir hafa þegar verið nafngreindar.
V73 Yfirlit yfir riðutilfelli 2004-2017
Stefanía Þorgeirsdóttir
Tilraunastöð Háskóla Íslands í meinafræði að Keldum
stef@hi.is
Inngangur: Virkt eftirlit með riðu á Íslandi
hefur falist í skimun á sláturhúsafé frá árinu 1978. Árið 2004 var tekin upp ný
aðferð við skimun fyrir riðu í sauðfé; fljótvirk elísupróf í stað hefðbundinnar
vefjalitunar. Með henni greindist fyrsta tilfellið í þessum sýnahópi, en áður
hafði eingöngu greinst riða í kindum sem prófaðar voru vegna sjúkdómseinkenna.
Einnig greindist fyrsta tilfelli óhefðbundinnar riðu (Nor98) á Íslandi með
þessari aðferð árið 2004.
Efniviður
& aðferðir: Á
árunum 2004-2017 greindust 28 riðutilfelli með elísuprófi, en með tilfelli er
átt við einstakan bæ þar sem sjúkdómurinn greinist. Á þessum árum voru prófuð
47.344 sýni úr heilbrigðu sláturhúsafé auk 477 sýna úr veikum kindum. Í þessu
yfirliti eru ofangreind riðutilfelli skoðuð nánar, m.a. með tilliti til
uppruna, aldurs, arfgerðar og fjölda viðbótartilfella sem greindust við
niðurskurð.
Niðurstöður: Af 28 riðutilfellum voru 21 af
hefðbundinni gerð, en sjö óhefðbundin. Tveir þriðju tilfella hefðbundinnar riðu
greinist út frá einkennum, annað hvort þar sem grunur er um riðu eða í dýrum
sem slátrað er af öðrum ástæðum en til manneldis. Hins vegar er algengara að
Nor98 greinist í sláturhúsasýnum en út frá einkennum. Áhættuarfgerð er áberandi
í hefðbundinni riðu, en stór hluti tilfella er einnig af hlutlausri arfgerð.
Þar sem hjörðin (eða hluti hennar) var prófuð eftir niðurskurð, var algengt að
finna viðbótartilfelli þar sem hefðbundin riða hafði greinst, en aðeins í einu
tilfelli Nor98.
Ályktanir: Samanburður hefðbundinna og
óhefðbundinna tilfella riðu sýnir að þau hafa ýmsa mismunandi eiginleika, m.a.
hvað varðar uppruna, einkenni, arfgerð og smit í hjörð.
V74 The VIce study: The effect of pneumococcal vaccination on antimicrobial susceptibility and serotype distribution
Martha Á. Hjálmarsdóttir1, Júlía Quirk2, Hildigunnur Sveinsdóttir3, Gunnsteinn Haraldsson4, Helga Erlendsdóttir3, Ásgeir Haraldsson5, Karl G. Kristinsson5
1Faculty of Medicine, University of Iceland, 2Landspítali, University Hospital, 3BioMedical Centre of the University of Iceland, 4Children's Hospital
hjalmars@hi.is
Introduction: The proportion of penicillin
non-susceptible pneumococci, PNSP, was increasing in the years before
implementation of the 10-valent pneumococcal vaccine (PHiD-CV) into the
childhood vaccination program in 2011, reaching 37.7% in 2010. The aim was to
investigate antimicrobial susceptibility and serotype distribution in samples
from patients in Iceland, 2011-2017.
Methods: All pneumococcal isolates (except from
nasopharynx and throat) from patients, identified in 2011-2017 were included
(except repeat isolates within 30 days). Analyses were performed at the
Department of Clinical Microbiology, Landspitali University Hospital, serving
the greater capital area (about 2/3 of the Icelandic population) and as
reference laboratory for the whole country. Susceptibility testing was
performed using EUCAST methods and criteria. PNSP were serotyped using latex
agglutination and/or PCR.
Results: The number of pneumococcal isolates
2011-2017 was 1729 (2011;354, 2017;169). Total PNSPs were 534 (30.8%), (2011:
146 (41.3%), 2017: 61 (36.1%)). In 2011 89.0% of PNSP had penicillin >0.5
mg/L but 32.8% in 2017, and respectively 92.3% and 80.3% were multi-resistant.
In 2011, 90.2% of PNSPs were of vaccine serotypes (VT) and 44.3% in 2017. The
proportion of PNSPs from <2 years old children declined from 48.3% in 2011
to 6.6% in 2017 and the PNSP isolates of VTs from 93.1% to 16.7% (two
children).
Conclusions: The reduction of pneumococcal isolates, PNSPs,
multi-resistant pneumococci and VTs was considerable following the vaccination.
PNSP isolates of non-VTs have relatively low penicillin MICs. The proportion of
PNSP remains high, both due to VTs found in the older population and overall
non-VT replacement.
V75 The VIce study: The effect of pneumococcal vaccination on penicillin non-susceptible pneumococci of serotype 19F
Martha Á. Hjálmarsdóttir1,2,3, Júlía Quirk1,2,3, Gunnsteinn Haraldsson1,2,3, Andries J. Van Tonder4, Stephen D. Bentley4, Helga Erlendsdóttir1,2,3, Ásgeir Haraldsson1,5, Angela B. Brueggemann6,7, Karl G. Kristinsson1,2,3
1Faculty of Medicine, University of Iceland, 2Landspítali University Hospital, 3BioMedical Centre of the University of Iceland, Reykjavik, 4Infection Genomics, Wellcome Trust Sanger Institute, Hinxton, 5Children's Hospital, 6Nuffield Department of Medicine, University of Oxford, 7Department of Medicine, Imperial College London
hjalmars@hi.is
Introduction: Penicillin non-susceptible pneumococci
(PNSP) of serotype 19F, CC236/271/320, appeared in Iceland in 1998, spread
rapidly and became dominating PNSP serotype after 2004. In 2010, the clone
represented almost a third of all pneumococcal isolates from patients cultured
at Landspitali. The aim was to follow the epidemiology of PNSP of serotype 19F
after the implementation of 10-valent vaccine (PHiD-CV) into childhood
vaccination program, 2011-17.
Methods: All PNSP isolates (except from
nasopharynx and throat) from patients, identified in 2011-2017 were included
(except repeat isolates within 30 days). Analyses were performed at the
Department of Clinical Microbiology, Landspitali, serving the greater capital
area and the whole country as reference laboratory. Serotyping was done using
agglutination and/or PCR. Whole genome sequencing (WGS) was done on selected
isolates from 2009-14.
Results: There were 316 PNSP isolates of
serotype 19F, or 59.2% of all PNSP (2011: 119 (81.5%), 2017: 20 (32.8%)). In
2011, 76.5% of the isolates were from children <7 years old but in 2017
10.0% (two children), most from middle ear. In these years 23.5% and 90.0% were
from adults, respectively, most from lower respiratory tract. Penicillin MICs
ranged 0.094-8.0 mg/L, most commonly (27.5%) 2,0 mg/L, and were in concordance
with the penicillin binding-proteins and ribosomal sequence-types. All
multi-resistant isolates were of CC236/271/320 (single- or double-locus
variants of Taiwan19F-14).
Conclusions: Vaccination has almost eliminated the
multiresistant 19F clone in children. Reduction in their number is more than
two fold in adults where it is still found, mostly in specimens from lower
respiratory tract.
V76 Lambleysi hjá gemlingum - vísbendingar um smitandi orsök
Charlotta Oddsdóttir
Tilraunastöð HÍ í meinafræði að Keldum og auðlinda- og umhverfisdeild Landbúnaðarháskóla Íslands
charlotta@hi.is
Inngangur: Lambleysi gemlinga hefur þekkst lengi
hér á landi, og hafa sést talsverðar sveiflur milli ára. Áður var talið að
ástæðan væri áramunur í kynþroska og hæfni til að festa fang. Þegar
fósturtalningar með ómsjá hófust árið 2003 kom í ljós að stór hluti gemlinga á
einstaka búum gekk með dauð fóstur, og skilaði ekki lambi um vorið. Gemlingar festa
sem sagt fang en talsvert er um að þeir láta fóstri fyrripart meðgöngu.
Efniviður
& aðferðir: Veturinn
2016-2017 var fylgst með 143 gemlingum á Tilraunabúi LbhÍ að Hesti og
fanggreiningar gerðar þrisvar sinnum: um 30 daga meðgöngu, 70 d og 100 d. Auk þess
voru niðurstöður sauðburðar skráðar.
Niðurstöður: Í janúar var staðfest fang í 85%
gemlinga, mánuði síðar var fanghlutfall 74% og um 100d meðgöngu var það 60%. Í
allt höfðu 49 (34%) misst eitt eða fleiri fóstur á fyrstu þremur mánuðum
meðgöngunnar, meirihlutinn eftir fyrri fósturtalningu. Á sauðburði 2017 báru
57% gemlinga fullburða lambi. Þegar fanghlutfall gemlinga var skoðað eftir króm
á fengitíð kom í ljós áberandi slakt fanghlutfall í tveimur króm sem deildu
fóðurgrind og voru áberandi fæst lömb borin úr þessum króm (14% og 39%). Í
flestum króm var lambleysi of mikið (25-29%), en hinar krærnar voru þó mun
skárri.
Ályktanir: Þetta mynstur fósturtaps bendir til
þess að einhvers konar smitefni hafi valdið snemmbæru fósturtapi í einni kró,
smitast yfir í aðliggjandi kró með fóðri í sameiginlegri fóðurgrind og valdið
fósturtapi á miðri meðgöngu í þeirri kró. Ástæða er því að leita smitefnis hjá
gripum á fengitíð.
V77 The VIce study: The effect of pneumococcal vaccination on Haemophilus influenzae in carriage and middle-ear
Gunnsteinn Haraldsson1, Hildigunnur Sveinsdóttir1, Jana B. Björnsdóttir1, Helga Erlendsdóttir1, Martha Á. Hjálmarsdóttir1, Birgir Hrafnkelsson2, Ásgeir Haraldsson3, Karl G. Kristinsson1
1Department of Clinical Microbiology, Landspítali University Hospital, 2Department of Mathematics, University of Iceland, 3Childrens Hospital, Landspítali University Hospital
gah@hi.is
Introduction: The 10-valent pneumococcal vaccine
(PHiD-CV), which uses Protein-D (PD) from H. influenzae as a conjugate, was introduced to the childhood
vaccination schedule in Iceland in 2011. The hpd gene, coding for PD, is well preserved, but cannot be found in all
strains. The aim was to evaluate the impact of vaccination on H. influenzae colonizing healthy children attending
day care centers (DCC), and in middle ear (ME).
Methods: Approximately 500 nasopharyngeal swabs
were collected annually (March, 2009, and 2012-2017), from healthy children
attending 15 DCC in the greater Reykjavik area. In addition, all samples from
ME (from 2012-2016) sent to the Department of Clinical Microbiology, Landspitali
University Hospital, serving the greater Reykjavik area, were used. H. influenzae was cultured using standard methods,
and the hpd gene detected with PCR.
Results: A total of 3,603 DCC samples yielded
2,574 H.
influenzae isolates.
The carriage rate was 86.9% in 2009 and 61.5%, 73.5%, 65.2%, 77.9%, 75.2%, and
58.9% in 2012-2017, respectively. A total of 6,230 ME samples yielded 1,541 H. influenzae isolates. The annual number of ME
samples was 966, 926, 951, 849, 894, 687, 452, and 505 in 2009-2016, respectively.
However, there were no changes in the proportion of H. influenzae positive samples. There was no change in the
proportion of hpd negative isolates, between children
born after the initiation of the vaccine and those older, in neither sample
groups.
Conclusions: The PHiD-CV reduced the number of
samples received from ME, but did not increase the proportion of hpd negative isolates.
V78 The VIce study: The effect of vaccination on pneumococci isolated from the middle-ear of children
Gunnsteinn Haraldsson1, S. Júlía Quirk1, Martha Á. Hjálmarsdóttir1, Andries J. Van Tonder2, Helga Erlendsdóttir1, Birgir Hrafnkelsson3, Stephen B. Bentley2, Ásgeir Haraldsson4, Angela B. Brueggemann5, Karl G. Kristinsson1
1Department of Clinical Microbiology, Landspítali University Hospital, 2Infection Genomics, Wellcome Sanger Institute, 3Department of Mathematics, University of Iceland, 4Childrens Hospital, Landspítali University Hospital, 5Nuffield Department of Medicine, University of Oxford
gah@hi.is
Introduction: The 10-valent pneumococcal vaccine
(PHiD-CV) was introduced in Iceland in 2011. Our aim was to assess the impact
of PHiD-CV on pneumococcal serotypes and genetic lineages isolated from middle
ear (ME) specimens, by comparing data from three years before (2009-2011;
PreVac), to six years after (2012-2017; PostVac) vaccine implementation.
Methods: All pneumococci isolated from ME
specimens of children <7 years old, submitted from health care facilities in
the greater Reykjavik area (2/3 of Icelandic population), from 2009-2017 were
included (n=976). Whole genome sequencing (WGS) was done on every other isolate
from
2009-2014 (n=441). All
isolates were serotyped using PCR and/or WGS, and multilocus sequence types
(ST) were extracted from the WGS data. STs assigned to clonal complexes (CC)
using Phyloviz.
Results: The annual number of pneumococcal
isolates decreased from 197 in 2009 to 23 in 2017. Serotypes included in
PHiD-CV (VT) decreased from PreVac (n=399; 16.8/1000 children) to PostVac
(n=102; 4.2/1000) while serotypes not included in PHiD-CV (NVT) increased from
PreVac (n=144; 6.1/1000) to PostVac (n=331; 13.7/1000). The most prevalent NVTs
PostVac were serotypes 15B/C, 6C, 6A, 23A and 19A. Isolates of serotypes 6C
(n=1; 0.04/1000 PreVac and n=41; 1.7/1000 PostVac, mostly CC315/ST386) and 23A
(n=2; 0.1/1000 PreVac and n=22; 0.9/1000 PostVac, mostly CC439/ST42) were
double locus variants of VT lineages.
Conclusions: PHiD-CV vaccination has led to a
reduction in ME specimens, pneumococci recovered from the ME and VTs. The
increase of pneumococcal clones expressing NVTs, such as CC315/ST3866C,
may indicate capsular switching events and requires additional monitoring in
the future.
V79 The VIce study: The effect of vaccination on pneumococci isolated from healthy children attending day-care-centres
Gunnsteinn Haraldsson1, S. Júlía Quirk1, Helga Erlendsdóttir1, Andries J. Van Tonder2, Martha Á. Hjálmarsdóttir1, Birgir Hrafnkelsson3, Stephen B. Bentley2, Ásgeir Haraldsson4, Angela B. Brueggemann5, Karl G. Kristinsson1
1Department of Clinical Microbiology, Landspítali University Hospital, 2Infection Genomics, Wellcome Sanger Institute, 3Department of Mathematics, University of Iceland, 4Childrens Hospital, Landspítali University Hospital, 5Nuffield Department of Medicine, University of Oxford
gah@hi.is
Introduction: The 10-valent pneumococcal vaccine
(PHiD-CV) was introduced in Iceland in 2011. Our aim was to assess the effect
of PHiD-CV on pneumococcal serotypes and genetic lineages carried by healthy
children attending day care centres by comparing data from three years before
(2009-2011; PreVac) to six years after (2012-2017; PostVac) vaccination.
Methods: Nasopharyngeal swabs were collected
annually (March, 2009-2017), from children 1-6 years old attending 15 DCCs in
the greater Reykjavik area, for pneumococcal culture and serotyping. Whole
genome sequencing (WGS) was done on every other isolate from 2009-2014 (n=987).
All isolates were serotyped using latex agglutination and/or PCR and/or WGS.
Multilocus sequence types (ST) were extracted from the WGS data and STs were
assigned to clonal complexes (CC) using Phyloviz.
Results: Overall, 4473 children were sampled, yielding 3020 pneumococcal
isolates. Carriage rates ranged from 50-73%. Serotypes included in PHiD-CV (VT)
decreased from PreVac (n=446; 323.2/1000 samples) to PostVac (n=304; 98.4/1000)
while serotypes not included in PHiD-CV (NVT) increased from PreVac (n=545;
394.9/1000) to PostVac (n=1725; 558.1/1000). The most prevalent NVTs PostVac
were serotypes 23B, 6A, 15B/C, 19A and 6C. Isolates of serotypes 23B (n=1; 0.7
PreVac and n=152; 49.2/1000 PostVac, mainly CC439/ST439) and 6C (n=9; 6.6/1000
PreVac and n=138; 44.6/1000 PostVac, CC315/ST386) belonged to lineages related
to VTs.
Conclusions: Considerably fewer children carried
pneumococci of VTs following PHiD-CV implementation; however, due to serotype
replacement of NVTs the overall carriage rate remained unchanged. VT lineages
expressing NVTs, such as the multidrug resistant CC315/ST3866C,
which may represent a capsular switching event, will require further
monitoring.
V80 Population genomic structure of Haemophilus influenzae strains recovered in Iceland
Gunnsteinn Haraldsson1, Helga Erlendsdóttir1, Hildigunnur Sveinsdóttir1, Stephen B. Beres2, Wesley Long2, Matthew O. Saavedra2, Karl G. Kristinsson1, James M. Musser2, Randall J. Olsen2
1Department of Clinical Microbiology, Landspítali University Hospital, 2Houston Methodist Hospital and Research Institute
gah@hi.is
Introduction: Haemophilus influenzae (Hin) naturally and exclusively colonizes the
human oropharynx. However, Hin is also capable of causing localized infections
of the upper respiratory tract such as otitis media and systemic infections
such as pneumonia, bacteremia, and meningitis. Despite considerable disease
burden, the genomic determinates of Hin molecular pathogenesis remain poorly
understood.
Methods: To begin closing this knowledge gap, we
sequenced the genome of 1,738 Hin strains recovered in Iceland, using Illumina
short read sequencing. Seven strains were further analyzed using Oxford
nanopore long read sequencing. The strains were collected as part of large,
comprehensive, population based studies in Iceland, including 704 isolates from
patients countrywide with infections (1996-2017) and 1,034 isolates from
asymptomatic carriers screened at 15 day care centers across the greater
capital region (2009-2017).
Results: The genomic diversity was extensive
among the 1,738 Hin strains. In total, 620,370 loci with polymorphisms were
identified relative to reference strain Rd1. Bioinformatics analysis classified
the strains into 20 diverse phylogenetic clades, consisting of 142 different
multi-locus sequence types. Recombination events and mobile gene content were
the primary cause of Hin strain diversification. 94% of the strains are
non-typeable (lack capsule) and 17% have genes encoding a diverse assortment of
beta-lactamase enzymes, including 21 different TEM alleles.
Conclusions: Sequencing the genomes of 1,738 Hin strains
from Iceland revealed a complex population genomic structure. Recombination
events strongly contribute to Hin strain diversification. An improved
understanding of Hin genomic diversity may guide future studies seeking to
develop a vaccine that prevents infections caused by all circulating strains.
V81 Surveillance of MRSA in the Nordic countries
Gunnsteinn Haraldsson1, Anders R. Larsen2, Laura Lindholm3, Sara Haegmann4, Kjersti W. Larssen5, Hege Enger5, Christina Gabrielsen5, Andreas Petersen2, Jaana Vuopio3, Frode W. Gran5
1Department of Clinical Microbiology, Landspítali University Hospital, 2Statens Serum Institut, 3National Institute for Health and Welfare, 4The Public Health Agency of Sweden, 5St. Olavs Hospital
gah@hi.is
Introduction: National surveillance of Methicillin-resistant Staphyl-ococcus aureus
(MRSA) is maintained by national Staphylococci Reference Laboratories (SRLs)
using shared protocols that include spa typing and antimicrobial susceptibility
testing. Recently a GIS based online tool has helped sharing of information on
clonal population structure of MRSA in the Nordic countries
(www.nordicmrsa.org). The aim was to compare the national MRSA data in terms of
incidence, spa typing data and to look for shared and unique MRSA clones in the
Nordic countries.
Methods: All MRSA reported to the SRLs between
2000-2016 were compared with population data to give data on MRSA incidences.
Clonal distribution of MRSA with respect to spa types and presence of Panton-
Valentine leukocidine was compared.
Results: In 2016, the incidence rate per 100.000
inhabitants was 25.1 in Iceland and 30.94 to 61.82 in the other Nordic
countries. In Finland, MRSA has remained at a relatively stable incidence
between 23.65 and 30.94 since 2004, whereas Norway, Sweden and Denmark have experienced
a 6-9 fold increase in new MRSA cases from year 2004 to 2016. SInce 2010, the
number of new cases took off in Denmark, due to the epidemic of livestock
associated (LA) MRSA CC398.
Conclusions: The combination of shared methodology
and a close collaboration between the Nordic SRLs combined with the use of GIS
mapping provides a powerful cross border surveillance of MRSA. The number of
MRSA in our region is still low compared to most other countries, but the
increase due to LA-MRSA provides an increasing challenge to the health care
systems.
V82 Omega-3 polyunsaturated fatty acids have immunomodulating effects on co-cultured NK cells and neutrophils
Sunnefa Y. Ómarsdóttir, Kistine N. Jensen, Jóna Freysdóttir, Ingibjörg Harðardóttir
Faculty of Medicine, University of Iceland
syo2@hi.is
Introduction: Dietary fish oil, rich in omega-3
polyunsaturated fatty acids (n-3 PUFA), enhanced resolution of antigen-induced
inflammation in mice and induced an early increase in the number of NK cells at
the inflamed site, indicating that NK cells may play a role in resolution of
inflammation. As neutrophil apoptosis is a fundamental step in resolution of
inflammation, the objective of this study was to examine the effects of n-3
PUFA on human NK cell function and their effect on neutrophil activation and
apoptosis in vitro.
Methods: NK cells were isolated from buffy coat
using MACS negative selection. They were cultured for 18 h with/without 50 µM
of the n-3 PUFA eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), or
with the n-6 PUFA arachidonic acid (AA), and then stimulated with IL-2, IL-12
and IL-15 for 18 h. Neutrophils, isolated from fresh peripheral blood by
dextran sedimentation, were co-cultured with NK cells. Cytokine concentration
in the medium was measured by ELISA and expression of surface markers by flow
cytometry.
Results: EPA and DHA decreased NK cell
expression of the inhibitory receptor NKG2A. EPA-treated NK cells increased
expression of the anti-apoptosis marker CD47 on neutrophils. EPA and DHA
decreased secretion of the pro-inflammatory cytokines TNF-α and IL-1β, and the
chemokine CCL3 that mediates migration of immune cells to the inflamed site.
Pre-treatment of NK cells with n-3 PUFA did not affect neutrophil apoptosis.
Conclusions: These results suggest that EPA and DHA
modulate NK cell function and their effect on neutrophil activation in vitro.
V83 Ofnæmisvakar framleiddir í byggi eru hentugir til að meta ónæmissvörun hjá hestum
Sigríður Jónsdóttir1, Sara B. Stefánsdóttir1, Sæmundur B. Kristínarson1, Vilhjálmur Svansson1, Jón M. Björnsson2, Arna Rúnarsdóttir2, Bettina Wagner3, Eliane Marti4, Sigurbjörg Þorsteinsdóttir1
1Tilraunastöð Háskóla Íslands í Meinafræði að Keldum, 2ORF Líftækni hf., 3Departments of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, 4Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Berne
sij9@hi.is
Introduction: Sumarexem í hestum er IgE-miðlað
ofnæmi gegn próteinum úr munnvatnskirtlum smámýstegunda af ættkvíslinni Culicoidesspp. sem lifa ekki á Íslandi. Tíðni
exemsins er mun hærri hjá útfluttum íslenskum hestum en hjá hestum fæddum
erlendis. Til að meta árangur ónæmismeðferðar og til að greina sjúkdóminn þarf
hreina ofnæmisvaka. Framleiðsla próteina í byggi er hagkvæm, án eiturefna og
fræin góð geymsla.
Markmið rannsóknarinnar var að bera saman í
ónæmisprófum, ofnæmisvakana Culn3 og Culn4 framleidda í þremur tjáningakerfum; E.coli, skordýrafrumum og byggi.
Efniviður
& aðferðir: Hestar
á Íslandi voru bólusettir með Culn3 og Culn4 framleiddu í E.coli. Mótefnasvörun var mæld í ELISA og
boðefnasvörun var mæld í frumufloti eftir in vitro örvun á hvítfrumum. IgE mótefni voru mæld í hestum í Sviss með og án
sumarexems og hóparnir bornir saman með ROC greiningu.
Niðurstöður: Ofnæmisvakarnir framleiddir í
tjáningarkerfunum þremur reyndust sambærilegir til að mæla IgG mótefnasvar
hesta sem höfðu verið bólusettir með samsvarandi próteinum framleiddum í E.coli. Vakarnir framleiddir í byggi og
skordýrafrumum voru einnig sambærilegir til örvunar á hvítfrumum og mæla
boðefnasvörun í kjölfarið, en örvun með vökunum framleiddum í E.coli gaf kröftuga ósértæka boðefnasvörun
hjá óbólusettum kontrólum. IgE mótefnasvörun í hestum með sumarexem var
marktækt hærri gegn báðum ofnæmisvökunum en hjá heilbrigðum viðmiðunarhestum.
Culn4 úr öllum þremur framleiðslukerfum og Culn3 úr skordýrafrumum og E.coli voru sambærilegir þegar þeir voru
bornir saman í ROC greiningu.
Ályktanir: Ofnæmisvakar framleiddir í byggi lofa
góðu við mat á ónæmissvörun bólusettra hesta og við greiningu á sumarexemi.
V84 Prevalence of Enterobacterales and antimicrobial resistance in vegetables and berries in Iceland
Guðný K. Bjarnadóttir1, Kristján O. Helgason2, Viggó Marteinsson3, Karl G. Kristinsson1
1Faculty of Medicine, University of Iceland, 2Department of Clinical Microbiology, Landspítali University Hospital, 3MATÍS
gudnykb@landspitali.is
Introduction: Antimicrobial resistance is one of the
main threats to public health and is associated with antimicrobial use, both in
humans and agriculture. Antimicrobial use in Icelandic agriculture is one of
the lowest in Europe and the difference between Northern and Southern Europe is
great. The aim was to culture vegetables and berries in Iceland for
Enterobacterales and test for antimicrobial resistance.
Methods: From October 2017 to March 2018, 416
vegetables and berries (288 imported, 127 domestic and 1 unknown) were
collected from the main grocery stores in the Reykjavik capital area and one
wholesale distributer. 25g of each sample were homogenised in buffer and
cultured selectively for Gram negative bacilli. Antimicrobial susceptibility
testing was performed by disc diffusion using EUCAST methods and criteria.
Results: Gram negative bacilli were not isolated
from any of the 73 berries, but found on 111 vegetable samples (43 domestic,
36% and 68 imported 31%; p=0,33). Of the 142 Enterobacterales isolated, the most common species was Enterobacter cloacae complex (n=99, 70%). E. coli was only isolated from 6 samples. All
the E. coli samples were fully sensitive and all
the E. cloacae isolates were resistant to ampicillin,
amoxycillin+clavulanic acid, cephalexin and cefpodoxime (constitutive
resistance). Of the 14 Enterobacterales (Citrobacter, 2; Enterobacter 12) with acquired resistance 13 came
from Southern Europe and none from Iceland. No isolates produced extended
spectrum beta lactamases.
Conclusions: Imported vegetables can be a vehicles
for antimicrobial resistance, whereas acquired resistance was not found in Enterobacterales isolated from domestic vegetables.
V85 Novel system for cyclically stretching air-liquid interface cultured lung cells
Jón Pétur Jóelsson
Biomedical department, University of Iceland
jpj8@hi.is
Introduction: Mechanical ventilation (MV) is a
life-saving therapy for critically ill patients. MV can cause injury to the
lung by baro/volu-trauma and atelectrauma resulting in ventilator-induced lung
injury (VILI). VILI can lead to acute respiratory distress syndrome (ARDS), a
serious clinical condition with a high mortality. There is a need for specific
biomarkers and a testing platform for VILI/ARDS research. By culturing
bronchial epithelial cells in air-liquid interfase (ALI) condition it is
possible to generate a pseudostratified epithelium and mimic the histology of
the bronchi and bronchioles. We have developed a device that enables cyclical
stretch of ALI cultured bronchial cells, thus mimicking the effects of MV in
vitro.
Methods: We constructed a chamber that would
fit Flexcell 5000 tension system plates and then we 3D printed transwell filter
holders that would fit into the wells. Assembled Flexcell plate with fully
differentiated lung cells can be placed in a groove in an airtight pressure
chamber where the bottom of the Flexcell plate is exposed to atmospheric
pressure allowing the silicon membranes to give in and expand when the pressure
is increased cyclically.
Results: We show differential expression of
VILI/ARDS associated biomarker genes along with innate immunity genes. Stress
fibers are more pronounced in stretched cells and protein expression of
VILI/ARDS associated biomarkers is upregulated.
Conclusions: We have designed and constructed a
pressure chamber that mimics mechanical ventilation on ALI cultured
pseudostratified lung epithelial cells in vitro. A differential expression of
important VILI/ARDS associated genes was observed along with increased
expression of chosen proteins.
V86 The Icelandic MCI study - evaluation of novel biomarkers in Alzheimer's disease
Unnur D. Teitsdóttir1, Jón Snædal2, Skarphéðinn Halldórsson3, Óttar Rolfsson3, Pétur H. Petersen4
1Department of Medicine, University of Iceland, 2Landspítali University Hospital, 3Center for Systems Biology, University of Iceland, 4Department of Biochemistry and Molecular Biology, University of Iceland
udt1@hi.is
Introduction: The main goal of the Icelandic MCI
study is to evaluate the diagnostic accuracy of various potential Alzheimer's
disease (AD) biomarkers in a clinical cohort. The focus of this analysis was on
analytes expressed in myelinated neurons - protein Neurofilament light (NFL)
and Sphingomyelins (SMs) C16:0 and C18:0. The aim was to compare levels of
these potential AD markers in cerebrospinal fluid (CSF) across different
diagnostic groups and to evaluate their association with established AD CSF
markers.
Methods: All individuals referred to the
Landspítali Hospital Memory Clinic who fulfilled the criteria of Subjective
(SCI) or Mild Cognitive Impairment (MCI) at first visit from 2014 to 2018, were
invited to join the study. Proteins in CSF were measured with commercial ELISA
kits. Targeted lipid analysis in CSF was performed on UPLC-mass spectrometer.
Results: Of 200 participants recruited, 53 had
both CSF samples and complete registration into the database. CSF NFL levels
were significantly higher in AD patients compared to those with MCI and SCI (p<0.001). After adjusting for sex and age, NFL
levels significantly associated with levels of established AD neurodegeneration
markers p-tau and t-tau as well as with SM C16:0 (p<0.01).
SM C18:0 associated significantly with established AD pathology marker
t-tau/AB42 (p<0.05).
Conclusions: Levels of NFL protein in CSF shows a
potential as a diagnostic marker in AD. The Sphingomyelins SM C16:0 and SM
C18:0 did not show as strong association with diagnosis as established markers,
but could be of potential use as complemental markers.
V87 Aukið nýgengi Sjálfsofnæmislifrarbólgu á Íslandi tengizt aukinni notkun líftæknilyfja
Kjartan B. Valgeirsson1, Jóhann P. Hreinsson2, Einar S. Björnsson2
1Lyflækningasvið Landspítala, 2Landspítali
kjartanbragi88@gmail.com
Inngangur: Lýðgrundaðar rannsóknir á faraldsfræði
Sjálfsofnæmis-lifrarbólgu (e.
Autoimmune Hepatitis, AIH) eru fáar. Nýgengi sjúkdómsins á Norðurlöndum er á bilinu 0,83 – 1,9 á
hverja 100.000 íbúa. Lyfja-orsakaðri sjálfsofnæmislifrarbólgu (e. Drug-induced AIH, DIAIH) er lýst í vaxandi mæli í tengzlum við
notkun líftæknilyfja.
Efniviður
& aðferðir: Gagna
var aflað um nýgreiningu sjúkdómsins á árunum 2006 - 2015. Framkvæmd var texta-
og kóðaleit í rafrænu sjúkraskárkerfi og þeir sjúklingar er uppfylltu ný
einfölduð greiningarskilmerki sjúkdómsins eða kröfðust ónæmisbælandi meðferðar
taldir til rannsóknarhóps. DIAIH var skilgreind sem lyfjaviðbragð við þekktum
orsakavald DIAIH; ásamt jákvæðum kjarnamótefnum (ANA), sléttvöðvamótefnum (SMA)
eða hækkuðum ónæmisglóbúlínum G (IgG); eða nauðsynjar ónæmisbælingar þrátt
fyrir stöðvun upphaflegrar lyfjameðferðar.
Niðurstöður: Alls fundust 403 möguleg tilfelli, þar
af uppfylltu 71 inntökuskilyrði. Nýgengi AIH á Íslandi var 2,2 á hverja 100.000
og algengi í árslok 2015 25,9/100.000. Meðalaldur við greiningu var 54 ár og
86% sjúklinga voru kvenkyns. Alls uppfylltu 31% ný greiningarskilmerki fyrir
örugga AIH en 38% fyrir líklega AIH. 18% tilfella voru talin vegna DIAIH; þar
af 8 tilfelli vegna Infliximab, 2 vegna Nitrofurantoin og eitt hvert vegna
Etanercept, Imatinib og Natalizumab. Sjúklingum var að jafnaði fylgt eftir í 6 ár
og voru 66 (93%) á lífi í lok eftirfylgdartíma, enginn hafði farið í
lifrarskipti, einn dáið vegna Lifrarfrumukrabbameins en fjórir af
lifrar-ótengdum orsökum.
Ályktanir: Nýgengi og algengi
sjálfsofnæmislifrarbólgu á Íslandi eru hærri en áður hefur verið lýst á
Norðurlöndum. Ónæmisbælandi meðferð virðist áhrifarík og horfur eru góðar til
skamms tíma. Aukið nýgengi má að hluta til skýra með vaxandi notkun
líftæknilyfja.
V88 Lýðgrunduð rannsókn á svörun sjúklinga með frumkomna gallskorpulifur við meðferð með ursodeoxycholsýru
Kristján Örnólfsson1, Einar Björnsson1, Sigrún Lund2, Sigurður Ólafsson3, Óttar Bergmann3
1Læknadeild Háskóla Íslands, 2Háskóli Íslands, 3meltingarlækningadeild Landspítala
krisornolfs@gmail.com
Inngangur: Primary biliary cholangitis (PBC) er
langvinnur bólgusjúkdómur í litlum gallvegum lifrarinnar sem leitt getur til
skorpulifrar. Skortur er á lýðgrunduðum rannsóknum á svörun PBC sjúklinga við
meðferð með ursodeoxycholsýru (UDCA). Tilgangur rannsóknarinnar var því að nýta
lýðgrunduð gögn um meðhöndlun PBC sjúklinga, kanna svörun þeirra við UDCA
meðferð og tengsl svörunar við þróun á skorpulifur.
Efniviður
& aðferðir: Svörun
sjúklinga við UDCA meðferð var metin út frá tveimur áður skilgreindum
svörunarskilmerkjum, þ.e.a.s. Barcelona svörunarskilmerkjunum: Lækkun á
alkalískum fosfatasa (ALP) um meira en 40 % af grunngildi eða eðlilegur ALP ári
eftir upphaf meðferðar og Toronto svörunarskilmerkinu: ALP ≤1,67 x eðlilegt
gildi tveimur árum eftir upphaf meðferðar. Athugað var hvort tengsl væru á
milli svörunar við lyfjameðferð og tilkomu skorpulifrar.
Niðurstöður: 135 sjúklingar voru meðhöndlaðir með
ursodeoxycholsýru á rannsóknartímabilinu. Nægar upplýsingar fundust um
lyfjameðferð og ALP gildi 94 (70%) og 93 (69%) sjúklinga til að unnt væri að
meta svörun við lyfjameðferðinni skv. Barcelona og Toronto skilmerkjunum. Alls
svöruðu 70% sjúklinga meðferðinni skv. Toronto skilmerkinu en 54 % sjúklinga
svöruðu meðferð skv. Barcelona skilmerkjunum. Af sjúklingum sem ekki svöruðu
meðferð skv. Toronto skilmerkinu þróuðu 46% með sér skorpulifur samanborið við
9% þeirra sem svöruðu meðferðinni, HR 6,07 (P<0,001). Meðal þeirra sem ekki svöruðu meðferð skv. Barcelona skilmerkinu
þróuðu 30% með sér skorpulifur samanborið við 12% þeirra sem svöruðu meðferð,
HR 2,15 (P=0,12).
Ályktanir: Niðurstöðurnar benda til þess að PBC
sjúklingar sem ekki svara lyfjameðferð skv. Toronto skilmerkinu séu í verulega
aukinni áhættu á því að þróa með sé skorpulifur.
V89 Lýðgrunduð rannsókn á ættlægni frumkominnar gallskorpulifrar á Íslandi
Kristján Örnólfsson1, Einar Björnsson1, Sigurður Ólafsson2, Óttar Bergmann2
1Læknadeild Háskóla Íslands, 2meltingarlækningadeild Landspítala
krisornolfs@gmail.com
Inngangur: Primary biliary cholangitis (PBC) er
langvinnur bólgusjúkdómur í litlum gallvegum lifrarinnar. Fyrri rannsóknir á
ættlægni sjúkdómsins hafa einungis náð að sýna fram á aukna áhættu á sjúkdómnum
meðal fyrstu gráðu ættingja sjúklinga. Tilgangur rannsóknarinnar var því að
nýta lýðgrunduð gögn um greiningar á PBC á Íslandi til að varpa skýrara ljósi á
ættlægni sjúkdómsins.
Efniviður
& aðferðir: Gögnum
um PBC á Íslandi á tímabilinu 1991-2015 var aflað með því að fara yfir jákvæðar
mælingar á mótefnum gegn mótefnavökum hvatbera (anti-mitochondrial antibodies) og vefjasýni sem samrýmast PBC. Þeir sjúklingar
sem uppfylltu alþjóðleg greiningarskilmerki sjúkdómsins voru teknir inn í
rannsóknina. Ættfræðigagnagrunnur Íslenskrar erfðagreiningar, Íslendingabók,
var svo notaður til að reikna út hlutfallslega áhættu ættingja PBC sjúklinga á
sjúkdómnum (familial
relative risk). Fyrir
hvert tilfelli af PBC voru valdir 10.000 samanburðareinstaklingar úr
Íslendingabók þegar hlutfallsleg áhætta var reiknuð.
Niðurstöður: Alls uppfylltu 222 einstaklingar
alþjóðleg greiningarskilmerki PBC á rannsóknartímabilinu, þar af voru 182 konur
og 40 karlar. Fyrstu, annarrar og þriðju gráðu ættingjar PBC sjúklinga höfðu
marktækt hækkaða hlutfallslega áhættu á sjúkdómnum eða 9,13 (p<0,0001); 3,61
(p=0,01) og 2,59 (p=0,008). Hjá fjórðu og fimmtu gráðu ættingjum var
hlutfallsleg áhætta einnig hækkuð eða 1,66 (P=0,08) og 1,42 (p=0,08).
Ályktanir: Niðurstöðurnar benda til þess að
ættingjar PBC sjúklinga hafi verulega aukna áhættu á því að þróa með sér
sjúkdóminn samanborið við almennt þýði. Þessi rannsókn hefur þá sérstöðu umfram
fyrri rannsóknir að hún sýnir að þessi aukna áhætta virðist einnig ná til
annarrar og þriðju gráðu ættingja.
V90 Blóðsegamyndun í portabláæð og miltisbláæð hjá sjúklingum með bráða brisbólgu
Berglind A. Magnúsdóttir1, María B. Baldursdóttir2, Evangelos Kalaitzaki3, Einar S. Björnsson4
1Læknadeild Háskóla Íslands, 2Háskóli Íslands, 3Gastro unit Herlev Hospital, 4meltingarlækningadeild Landspítala
berglindannam@gmail.com
Inngangur: Blóðsegamyndun í portabláæð og
miltisbláæð (PMB) er þekktur en sjaldgæfur fylgikvilli hjá sjúklingum með bráða
brisbólgu en skortur er á rannsóknum á áhættuþáttum og afleiðingum þessa
fylgikvilla. Markmið rannsóknarinnar var að skoða algengi, áhættuþætti og
afdrif sjúklinga með blóðsegamyndun tengt bráðri brisbólgu.
Efniviður
& aðferðir: Allir
sjúklingar sem greindust með fyrstu bráðu brisbólgu á 10 ára tímabili á Íslandi
og í Lundi, Svíþjóð. Upplýsingar voru fengnar um orsök brisbólgu, fylgikvilla
og afdrif sjúklinga. Sjúklingar sem höfðu farið í tölvusneiðmynd af kvið voru
sérstaklega skoðaðir m.t.t. staðbundinna fylgikvilla og þróun á blóðsegamyndun
í PMB.
Niðurstöður: Samtals greindust 2559 sjúklingar með
fyrstu bráðu brisbólgu á rannsóknartímabilinu (57% Svíþjóð, meðalaldur 59±19
ár, 47% konur, 45% gallsteinatengd brisbólga, 19% áfengistengd brisbólga, 8%
kerfislægir fylgikvillar og 21% staðbundnir fylgikvillar). Blóðsegi í PMB
greindist í 30/2559 (1,2%). Sjálfstæðir áhættuþættir voru fylgikvillar
brisbólgu, bæði kerfislægir (gagnalíkindahlutfall (odds ratio, OR) 5,27, 95% öryggisbil (confidence interval, CI) 1,04-26,68) og staðbundnir (OR 6,74, 95%CI
1,48-30,71). Þegar eingöngu voru skoðaðir sjúklingar sem fóru í tölvusneiðmynd
(n=1348) voru staðbundnir fylgikvillar eini sjálfstæði áhættuþátturinn (OR
7,51, 95%CI 1,54-36,74), þá sérstaklega ef sýking var í kringum bris.
Dánarhlutfall við fyrstu brisbólgu var 2.5%, ekki var munur á dánartíðni milli
sjúklinga með (1,2%) og án (0%) blóðsega í PMB (p=1,00).
Ályktanir: Blóðsegamyndun í portabláæð og
miltisbláæð kom fyrir í u.þ.b. 1% sjúklinga með fyrstu bráðu brisbólgu. Slíkt
var algengara á meðal sjúklinga með fylgikvilla tengda brisbólgu, sérstaklega
ef sýking var í kringum bris. Segamyndun virtist ekki hafa áhrif á afdrif
sjúklinga.
V91 Height velocity and risk of breast cancer
Álfheiður Haraldsdóttir1, Unnur A. Valdimarsdóttir2, Thor Aspelund2, Laufey Tryggvadóttir3, Inga Þórsdóttir2, Bryndís E. Birgisdóttir2, Ingibjörg Gunnarsdóttir2, Þórhallur I. Halldórsson2, Vilmundur Guðnason4, Laufey Steingrímsdóttir2, Jóhanna E. Torfadóttir2
1Faculty of Food Science and Nutrition, University of Iceland, 2University of Iceland, 4Icelandic Cancer Registry, 4Icelandic Heart Association
alfheih@gmail.com
Introduction: Recent studies indicate that rapid
hormonal changes during growth spurts in early life may affect cancer risk. We
explored the association between height velocity in two periods (from age 8 –
13 years and from age 13 – adult height) and breast cancer.
Methods: Participants were 991 Icelandic women
born between 1915 – 1935 who took part in the Reykjavik Study (established
1967) and had annual measures of height between ages 8 - 13 years of age,
obtained from clinical school records. Information on adult height was obtained
at Reykjavik Study entry. Cancer diagnosis were obtained from the Icelandic
Cancer Registry through 2015. We used adjusted multivariable Cox proportional
models to calculate hazard ratios (HR) with 95% confidence intervals (CI) for height
velocity in tertiles and breast cancer diagnosis.
Results: During a mean follow-up time of 66
years, 115 women (12%) were diagnosed with breast cancer. Women in the highest
tertile (7.8 cm mean increase per year) of height velocity from age 13 until attained
height had increased risk of breast cancer (HR 2.28, 95% CI 1.25 – 4.15) when
compared with women in the lowest tertile (2.6 cm). No association was for
women in the highest tertile (6.5 cm) for height velocity between ages 8 – 13
years when compared with the lowest tertile (4.9 cm), or HR 1.46, 95% CI 0.83 –
2.59.
Conclusions: Rate and timing of growth in the adolescence
period may contribute to breast cancer risk although further studies are needed
to confirm our findings.
V92 Nontuberculous mycobacterial infections in Iceland 2006-2016
Halldór A. Guðmundsson1, Sigurður Guðmundsson2, Helga Erlendsdóttir3
1University of Iceland, Faculty of Medicine, 2Department of Infectious disease, Landspítali University Hospital, 3Department of Clinical Microbiology, Landspítali University Hospital
halagud@gmail.com
Introduction: Nontuberculous mycobacteria (NTM) are
free-living organisms that are ubiquitous in the environment and can cause a
variety of clinical infections. The purpose of this study was to examine the
epidemiology, species and clinical syndromes of NTM in a single high-income
country.
Methods: The study was a retrospective analysis
of all positive cultures of NTM in Iceland 2006 – 2016. Mycobacteria are
indentified in a single microbiological laboratory in Iceland, The University
Hospital Microbiological Laboratory. The ATS/IDSA diagnostic criteria of NTM
infections were employed to characterize true infections. Clinical information
on the patients was obtained from patient records at the Landspitalinn
University Hospital.
Results: A total of 154 positive NTM cultures
were identified and 75 (49%) were considered to represent infection by the
ATS/IDSA criteria, mean incidence: 2.15 cases/105/yr. Mycobacterium avium complex (MAC) was the most common species,
n=55, 73%, causing 83% of the pulmonary infections. The most common clinical
syndrome was pulmonary disease, n=60, 80%. 23 patients, 46%, with pulmonary
disease were offered antimicrobial treatment.
Conclusions: The incidence of NTM infections was lower than
in previously published reports from elsewhere. Approximately half of the NTM
isolates identified were regarded as being responsible for infection in this
cohort. The majority of NTM infections were pulmonary due to MAC. The infections
were more common in females and the yearly incidence was age-related.
Nevertheless more than 50% of patients with pulmonary MAC infection were not
treated. Almost a quarter of the patients died within 12 months, but from their
underlying disease.
V93 Incidence of chronic kidney disease stages 1-5 in Iceland
Arnar Jónsson1, Sigrún H. Lund2, Ólafur S. Indriðason3, Runólfur Pálsson3
1Department of Internal Medicine, Landspítali, 2University of Iceland, 3Landspítali
arnarjan@gmail.com
Introduction: Incidence
of chronic kidney disease (CKD) is unclear due to lack of longitudinal data.
The aim of this study was to estimate the incidence of CKD stages 1-5 based on
serum creatinine (SCr) measurements, albuminuria and other markers of kidney
damage.
Methods: In this retrospective study from 2008
to 2016, we obtained all standardized SCr and urine protein measurements from
every clinical laboratory in Iceland. The CKD_EPI equation was used to
calculate eGFR. Incidence of CKD was defined as presence of kidney damage or
eGFR <60 mL/min/1.73m2 for more than 3 months, in individuals
without CKD at study entry and staged according to the KDOQI guidelines. Kidney
damage was defined as albuminuria or presence of kidney-specific diagnoses.
Results: We obtained 2,049,482 SCr values for
213,011 individuals. The median (range) age was 63 (18–109) years; 47% were
men. The annual age-standardized incidence of CKD 1–5 per 100,000 was 1,023 in
men and 1,323 in women. The annual age-standardized incidence of CKD per
100,000 in men was 117; 153; 2,514; 184; 58; and 16 for stage 1, 2, 3A, 3B, 4
and 5 respectively and 198; 141; 2,678; 247; 63 and 12 for stage 1, 2, 3A, 3B,
4 and respectively for women.
Conclusions: This nationwide study comprising SCr
values and other markers of kidney damage from the majority of the Icelandic
population indicates a CKD incidence of approximately 1% per year, although
slightly higher in women than men.
V94 Incorporation of kidney disease diagnoses for detection of chronic kidney disease stages 1 and 2
Arnar Jónsson1, Sigrún H. Lund2, Runólfur Pálsson3, Ólafur S. Indriðason3
1Department of Internal Medicine, Landspítali, 2University of Iceland, 3Landspítali
arnarjan@gmail.com
Introduction: Most studies have reported prevalence
of CKD stages 1-2 based solely on albuminuria. The aim of this study was to
determine the prevalence of CKD stages 1-2 using various markers of kidney
damage.
Methods: In this retrospective study from 2008
to 2016, we obtained all standardized SCr and urine protein measurements from
every clinical laboratory in Iceland. Information on age, sex, kidney diseases
and co-morbid conditions was obtained from nationwide electronic medical
records. eGFR was calculated using the CKD-EPI equation. Albuminuria was
defined according to KDOQI guidelines. For other markers of kidney damage, we
used ICD-9 and 10 diagnostic codes indicative of chronic kidney disease.
Results: We obtained 2,129,029 SCr values for
218,941 individuals and urine test for proteinuria for 84,429 individuals, of
whom 4,972 had persistent albuminuria. A total of 28,681 individuals (13.1%)
had CKD in the study period, of whom 3,250 (11.3%) had CKD stage 1 and 4,193
(14.6%) CKD stage 2. In CKD stage 1, 22.7% of cases were solely based on
albuminuria, 74.5% on kidney disease diagnosis and 2.8% with both albuminuria
and kidney disease diagnosis and 33.0%, 61.2% and 5.8% for CKD stage 2,
respectively. The most common kidney disease diagnoses for CKD stage 1–2 were chronic
tubulo-interstitial disease (77.2%), glomerular disease (11.7%), polycystic
kidney disease (4.5%) and chronic kidney disease (4.5%).
Conclusions: Minority of individuals with CKD stage 1–2 are
diagnosed based on albuminuria, stressing the importance of incorporating other
markers of kidney disease for true estimation of the prevalence of CKD 1–2.
V95 Risk factors for 30-day re-bleeding in patients with acute lower gastrointestinal bleeding
Jóhann P. Hreinsson1, Ragna Sigurðardóttir2, Einar Björnsson1
1Landspítali - The National University Hospital of Iceland, 2University of Iceland
hreinssonjp@gmail.com
Introduction: Information is limited on risk factors
for 30-day re-bleeding in patients with Acute lower gastrointestinal bleeding
(ALGIB). We aimed to identify risk factors for 30-day re-bleeding in patients
with ALGIB.
Methods: A retrospective, population-based study
that included patients with ALGIB from 2010 to 2013 in the Landspítali – The
National University Hospital of Iceland. Patients were found through
electronically stored endoscopy reports. ALGIB was defined as rectal bleeding
leading to hospitalization or occurring in a hospitalized patient. Re-bleeding
was defined as overt bleeding after the initial bleeding was stabilized and
within 30 days of the index bleeding.
Results: Overall, 423 patients had ALGIB during
the study-period, of those, 5% (22/423) had a re-bleeding within 30 days. In
univariate analysis, when compared to those who did not re-bleed, those who
re-bled were older, had a higher comorbidity burden, were more likely to have a
history of GIB, less likely to use non-steroidal anti-inflammatory drugs
(NSAIDs) and more likely to have unexplained GIB (p < 0.05 for all
comparisons). When age, Charlson's comorbidity index, history of GIB and NSAID
use were entered into a multiple logistic regression model, none of the
variables independently predicted 30-day re-bleeding.
Conclusions: Higher age, comorbidity burden, history of GIB
and unknown cause of bleeding were associated with an increase in risk of
re-bleeding. Independent risk factors of re-bleeding were not identified but
aforementioned variables may indicate that a closer follow-up after discharge
among these patients is appropriate.
V96 Hátt hlutfall steina í gallrás sem greinast á MRCP ganga sjálfkrafa niður gallvegi án íhlutunar
Jón H. Hjartarson1, Pétur H. Hannesson2,3, María B. Baldursdóttir3, Berglind A. Magnúsdóttir3, Sigurður Blöndal4, Einar S. Björnsson1,3
1Meltingardeild Landspítala lyflækningasviði, 2 röntgendeild Landspítala, 3læknadeild Háskóla Íslands, 4skurðlækningasviði Landspítala
jonhalldor91@gmail.com
Inngangur: Steinar í gallrás eru ein algengasta
orsök bráðrar brisbólgu en náttúrulegur gangur gallsteinabrisbólgu er ekki vel
þekktur. Það er þó ljóst að ákveðið hlutfall steina í gallrás gengur niður
gallvegi sjálfkrafa án íhlutunar og hafa rannsóknir sýnt tölur allt frá 15% til
73%.
Efniviður
& aðferðir: Afturskyggn
rannsókn á sjúklingum sem grunaðir voru um steina í gallrás og undirgengust
segulómun af bris- og gallvegum (MRCP) á Landspítala á árunum 2008-2013.
Sjúklingar þurftu að auki að uppfylla skilmerki fyrir bráðri brisbólgu, þ.e.
tvennt af eftirfarandi þrennu: 1) kviðverkur 2) þrefalt gildi á lípasa eða
hærra 3) merki um bráða brisbólgu á myndgreiningu. Gullstaðall (gold standard) í greiningu gallrásarsteina var
álitinn vera ERCP.
Niðurstöður: Alls uppfylltu 219 sjúklingar
skilmerki rannsóknarinnar, 40 sjúklingar (18%) reyndust vera með stein í
gallrás á MCRP. Tólf af þeim 40 sjúklingum (30%) sýndu klínísk merki þess að
hafa skilað steinum sjálfkrafa niður gallvegi en 28 sjúklingar (70%) sem höfðu
haft stein í gallrás á MRCP reyndust vera með stein á ERCP. Sjúklingar sem
skiluðu steinum sjálfkrafa niður gallvegi reyndust vera með hærra meðaltalshágildi
á ASAT, 430 vs. 235 U/L (p<0,001), og ALAT, 406 vs. 283 (p=0,051). Þeir
sjúklingar sem reyndust vera með stein í gallrás á ERCP undirgengust allir ERCP
innan 48 klukkustunda (100%) samanborið við 67% þeirra sem skiluðu steinum
sjálfkrafa niður gallvegi, (p=0,03).
Ályktanir: Tæplega 30% steina í gallrás sem
greinast á MRCP ganga niður gallvegi af sjálfsdáðum án íhlutunar. Tímasetning
ERCP rannsóknar eftir MRCP virðist skipta máli varðandi náttúrulegan
sjúkdómsgang í gallsteinabrisbólgu.
V97 Krabbamein í brisi og tengsl við bráða brisbólgu
María Baldursdóttir1, Berglind Magnúsdóttir1, Evangelos Kalaitzakis2, Einar S. Björnsson3
1Læknadeild Háskóla Íslands, 2meltingasjúkdómadeild Herlev-sjúkrahússins, 3Landspítali
mbb9@hi.is
Inngangur: Langvinn brisbólga er þekktur
áhættuþáttur fyrir krabbamein í brisi en tengslin á milli bráðrar brisbólgu og
krabbameins í brisi eru minna þekkt. Brisbólga er sjaldgæf birtingarmynd
krabbameins í brisi og lítið rannsökuð. Markmið rannsóknarinnar var að meta
klíníska birtingarmynd og útkomu sjúklinga með sína fyrstu bráðu brisbólgu og
krabbameins í brisi.
Efniviður
& aðferðir: Þetta
var afturskyggn þýðisrannsókn á öllum sjúklingum með fyrstu bráðu brisbólgu á
Íslandi og í Lundi, Svíþjóð á 10 ára tímabili. Upplýsingar um orsakir
brisbólgunnar, rannsóknir, legu, endurteknar brisbólgur og þróun á langvinnri
brisbólgu sem og krabbameini í brisi voru fengnar úr sjúkraskrám.
Niðurstöður: Af 2559 sjúklingum, greindust 49
sjúklingar (1,9%) með krabbamein í brisi, (51% kk, miðgildi 70 ár). Sjúklingum
var fylgt eftir í 4,5 ár. Sex sjúklingar voru með þekkt krabbamein í brisi við
greiningu brisbólgunnar. Í 13 sjúklingum leiddi brisbólgan til greiningu
krabbameins á meðan 30 sjúklingar (61%) þróuðu með sér krabbamein eftir fyrstu bráðu
brisbólguna, að meðaltali 12 mánuðum seinna (Fjórðungsmark: 2,6-43).
Gallsteinar og áfengi, sem eru algengustu orsakir bráðrar birsbólgu, voru
sjaldgæf orsök brisbólgu hjá þessum hóp. Endurteknar brisbólgur voru algengari
í þeim sem voru með krabbamein samanborið við þá sem ekki fengu krabbamein
(19/49 (39%) vs. 554/2559 (22%), p=0,008).
Ályktanir: Í sjúklingum með sína fyrstu bráðu
brisbólgu greindist krabbamein í brisi í um 2%. Greiningu á krabbameini í brisi
var að meðaltali seinkað um tæpa 12 mánuði. Endurteknar brisbólgur, hækkandi
aldur og brisbólga af öðrum orsökum en gallsteinum og áfengi reyndust
sjálfstæðir áhættuþættir fyrir krabbamein í brisi.
V98 Incidence of diverticular bleeding: a population-based study
Dagur Ólafsson1, Jóhann P. Hreinsson2, Einar S. Björnsson2
1University of Iceland, 2Landspítali
dagurol@gmail.com
Introduction: Diverticular bleeding is the most
common cause of acute lower gastrointestinal bleeding (ALGIB) leading to
hospitalization. Recent studies have differed with regard to the trend in the
incidence of diverticular bleeding. Our aim was to ascertain the incidence of
diverticular bleeding (DB) and examine the time trend of the incidence.
Methods: A retrospective, population-based study
of patients with DB in a National University Hospital from 2006-2016. Patients
were identified in the electronically stored colonoscopy database. A definite
diverticular bleeding was defined as active bleeding, a nonbleeding visible
vessel or adherent clot. A diagnosis of presumptive diverticular bleeding was
assigned in case of acute painless rectal bleeding leading to hospitalization
with visible diverticula with no evidence of bleeding, but no other colonic
lesions or bleeding sites identified on endoscopy. A 30day re-bleeding was
determined after discharge.
Results: A total of 3683 colonoscopy reports
were reviewed, including 345 patients (males 51%) with presumptive 95% (n=327)
or definitive 5% (n=18) bleeding. Overall 96% were treated conservatively, 3%
endoscopically and 1% surgically. Only approximately 5.8% had a 30-day rebleed.
After exclusions, 315 patients were included in the incidence calculations. The
mean cumulative incidence of DB was 14/100.000 inhabitants per year. A time
trend analysis of the incidence of DV, revealed no significant change in
incidence during the study period.
Conclusions: The incidence of DB does not seem to
have changed in the past decade. The vast majority of patients with DB did not
require endoscopic therapy and could be managed with conservative treatment.