What is the most appropriate intraoperative baseline parathormone? A prospective cohort study.

Introduction: The time of drawing pre-incision intraoperative parathyroid hormone (ioPTH) is crucial to provide the right baseline for post-excision PTH measurement. The objective of this study was to identify the optimal time and the numbers of baseline PTH samples that best predict excision of all hypercellular parathyroid tissue when compared with 10-min post-excision PTH level.

Materials And Methods: In this prospective study, two pre-incision (pre-induction and 10-min post-induction) baseline ioPTH samples along with pre- and post-excision ioPTH were collected and analyzed for 352 parathyroidectomies in 341 patients for sporadic primary hyperparathyroidism at a University hospital.

Identifying the most appropriate age threshold for TNM stage grouping of well-differentiated thyroid cancer.

Objective: Age is integrated in most risk stratification systems for well-differentiated thyroid cancer (WDTC). The most appropriate age threshold for stage grouping of WDTC is debatable. The objective of this study was to evaluate the best age threshold for stage grouping by comparing multivariable models designed to evaluate the independent impact of various prognostic factors, including age based stage grouping, on the disease specific survival (DSS) of our population-based cohort.

Rofecoxib, but not celecoxib, increases the risk of thromboembolic cardiovascular events in young adults-a nationwide registry-based study.

Purpose: To examine the risk of thromboembolic cardiovascular events in users of coxibs and NSAIDs in a nationwide cohort.

Methods: Data were synchronised from three nationwide databases, the Icelandic Medicines Registry (IMR), The Icelandic National Patient Registry (INPR) and the Registry for Causes of Death at Statistics Iceland (RCD), for prescriptions for NSAIDs or coxibs with respect to hospitalisation for unstable angina pectoris, myocardial infarction and cerebral infarction over a 3-year period. The Cox proportional hazards model and Poisson regression were used to analyse the data.

The efficacy of HPV 16/18 vaccines on sexually active 18-23 year old women and the impact of HPV vaccination on organized cervical cancer screening.

Objective: Evaluate the efficacy of catch-up HPV vaccination in sexually active young women and the potential impact of HPV vaccines on the practice of organized screening.

Sample: (1) Women enrolled in the Future II study and (2) from a separate population-based study in Iceland.

Methods: (1) Analysis of cytological and histological results and colposcopic examinations among 710 women, aged 18-23, with less than five sexual partners, irrespectively of baseline HPV status at enrolment.

Risk factors and outcome in ICU-acquired infections.

Background: Nosocomial infections are common in intensive care units (ICU). The objectives of this study were to determine risk factors of ICU-acquired infections, and potential mortality attributable to such infections.

Methods: An observational study was performed in a 10-bed multidisciplinary ICU.

HPV genotypes in CIN 2-3 lesions and cervical cancer: a population-based study.

The distribution of human papillomavirus (HPV) varies between countries and continents leading to different effectiveness of upcoming prophylactic HPV vaccines. This study analyses the HPV distribution in CIN 2-3, recurrent CIN 2-3 and cervical cancer in Iceland. About 80% of incident cases with CIN 2-3 lesions in 1990 and 1999, 99% of cancer cases in 1990-1994 and 1999-2003, and cases with recurrent CIN 2-3 after conization in 1990 were tested with PCR analysis for the presence of 12 oncogenic HPV types.

Is it rational to start population-based cervical cancer screening at or soon after age 20? Analysis of time trends in preinvasive and invasive diseases.

The effect of starting screening at age 20 in 1988 was assessed by analysing (a) the age-specific incidence and distribution of stage and histology of invasive diseases, and (b) the detection rates of histologic moderate to high-grade intraepithelial neoplasia (CIN 2-3/AIS), and 1st abnormal cytology and repeat low-grade cytology after follow-up observation. Cancer incidence increased significantly at age 25-34 after 1979 due to early stage squamous cell and adenocarcinoma. After an initial increased rate of preinvasive disease, CIN 3 decreased significantly at age 30-34 after 1988, at age 25-29 after 1993, and levelled out after 1998 at age 20-24.

[Changes in myocardial infarction incidence and mortality in Iceland.].

Introduction: According to public health reports ischaemic heart disease was an uncommon cause of death in Iceland at the beginning of the last century. This death rate increased steadily until the ninety-eighties whereafter it leveled off and started to decline. The objective of the present study is to assess in detail the changes in myocardial infarction attack, incidence and death rate as well as case fatality.

[Survival and trends of ocurrence of left ventricular hypertrophy, gender differences during 1967-1992. The Reykjavík Study.].

Objective: We estimated the prevalence and incidence of left ventricular hypertrophy (LVH) in this large prospective cohort study of almost 20,000 participants and identified risk factors in them. Predictive factors of its appearance were evaluated along with morbidity and mortality calculations.

Material And Methods: LVH was defined as Minnesota Code 310 on ECG.

[In search for explanatory factors in the relationship between educational level and mortality.].

Objective: The connection between socioeconomic status and mortality is well known in Western countries. Educational level has frequently been used as a socioeconomic indicator. In a recent Icelandic prospective study, an inverse relationship between educational level and mortality was shown.

[The relationship between educational level, physical activity and mortality.].

Objectives: The relationship between educational level and mortality is well known. This has been shown in the Reykjavik Study and was only partly accounted for by unequal distribution of known risk factors. The objective of the present study was to explore the relationship between educational level and physical activity and whether that relationship could partly explain differences in mortality.

[Carcinoma of the colon in Iceland 1955-1989. An investigation of survival according to various pathological parameters.].

Objective: The purpose of this study was to estimate various pathological parameters of colon carcinoma over a 35 year time period and evaluate their effect on survival of the patients.

Material And Methods: All pathological specimens from patients diagnosed with colon carcinoma in Iceland in the period 1955 to 1989 were re-evaluated in order to determine the following pathological parameters: Tumour size, gross appearance, tissue type, grade, Dukes stage, lymphatic and/or blood vessel invasion, lateral margin involvement, Jass-group of tumour, peritumoural lymphocytic infiltrate, limitation of tumour growth to bowel wall, lymph node metastases, invasive tumour margin and colloid component in adenocarcinoma. Also the following parameters were determined in every case: Age at diagnosis, sex, year of diagnosis and tumour location within the bowel.

[Changes in smoking habits in the last thirty years in middle-aged Icelanders and their causes - Results from population surveys of the Icelandic Heart Association.].

Objective: During the last thirty years the Research Clinic of the Icelandic Heart Association has been engaged in several extensive cardiovascular population surveys. Smoking habits have been assessed by a questionnaire and the purpose of the present study is to describe the changes in smoking habits during the period 1967-2001, their causes and the reliability of the information gathered.

Material And Methods: The subjects were participants in four population surveys: The Reykjavik Study 1967-1996, Survey of "Young People" 1973-1974 and 1983-1985, MONICA Risk Factor Surveys 1983, 1988-1989 and 1993-1994 and the "Reykjavik Offspring Study" 1997-2001.

Epidemiology of kidney stones in Iceland: a population-based study.

Objective: The prevalence of kidney stones varies greatly between ethnic groups and geographic locations, ranging from 8% to 19% in males and from 3% to 5% in females in Western countries. The aim of this study was to examine the epidemiology of kidney stones in Iceland.

Material And Methods: Data were derived from the Reykjavik Study, a population-based cohort study carried out between 1967 and 1991.

Migraine patients have lower systolic but higher diastolic blood pressure compared with controls in a population-based study of 21,537 subjects. The Reykjavik Study.

Several studies have explored a possible association between migraine and hypertension, with contradictory results. Because of this uncertainty the relation between blood pressure (BP) and migraine was studied in 10,366 men and 11,171 women in a population-based longitudinal study. A modified version of the 1988 International Headache Society criteria was used for diagnosis of migraine.

Longitudinal trends in cervical histological lesions (CIN 2-3+): a 25-year overview.

Background: Trends in CIN 2-3+ lesions affect the choice of target age group and screening interval.

Methods: The following analyses were performed for CIN 2-3+ following 1st to 5th screening visits in the 20-34/35-69 age groups during 1979-2002: a) the relative risk of age and calendar year; b) the cumulative incidence rate after normal or low or higher grade cytology; c) the proper screening interval to detect these lesions at a fixed risk level after normal screening visits; d) the predictive power of these lesions for diagnosis of cancer after first biopsy; e) the prevalence rates in the 20-24/25-29 year age groups at first and at all subsequent screening visits.

Results: The cumulative rate decreased with the number of screening visits and advancing age.

Longitudinal trends in cervical cytological lesions and the effect of risk factors. A 30-year overview.

Background: Cytological preinvasive changes are important precursors in cervical cancer, therefore variations in their trends affect screening guidelines.

Methods: Trends in cytological preinvasive changes following the 1st to 5th screening visits in the 20-34 and 35-69 year age groups were analyzed for the period 1979-2002: a) the incidence rate (absolute risk) of higher grade cytology and the relative risk of risk factors on this rate; b) the cumulative incidence of low-grade and higher grade smears after normal and abnormal screening results; c) the cumulative incidence of higher grade cytology at a fixed risk level after normal screening results; and d) the prevalence of higher grade smears at first screening visit in the 20-24/25-29 year age groups during 1971-2002.

Results: An increased trend in the prevalence of higher-grade smears was observed at the first screening visit after 1980.

Effectiveness of cervical cancer screening in Iceland, 1964-2002: a study on trends in incidence and mortality and the effect of risk factors.

Background: Data on cervical cancer screening programs that have covered a whole nation over a prolonged time are scarce. The effectiveness of a 40-year established nationwide cervical screening program has been evaluated to define optimal age limits and screening intervals.

Methods: Trends in incidence and mortality by calendar time, age, histology, stage and attendance during 1964-2002 and the predictive power of calendar year, age, stage and histology on the cause-specific mortality rate were analyzed.

Population-based study of changing breast cancer risk in Icelandic BRCA2 mutation carriers, 1920-2000.

Background: Mutations in the BRCA genes increase the risk of breast cancer. Valid estimates of the magnitude of the lifetime risk of breast cancer in BRCA gene mutation carriers are needed for genetic counseling. Recent results suggest that penetrance has increased in recent birth cohorts.

[Coronary risk factors among men and women in Iceland. Results from the Reykjavik Study 1967-1985. 1992].

The Reykjavík Study 1967-1985: Risk factors for coronary heart disease mortality have been investigated in a prospective study of 8001 randomly selected Icelandic men and 8468 women. The men were aged 34-64 and the women 34-76 at the time of their first examination. After followup from 2-17 years 1140 (14.

Hypertension control as predictor of mortality in treated men and women, followed for up to 30 years.

Purpose: To examine the prognosis of treated, hypertensive individuals in the Reykjavik Study.

Methods: A population-based longitudinal study of 9328 men and 10 062 women. Subjects were included in the study during the period 1967-1996.

Risk factors for out-of-hospital cardiac arrest: the Reykjavik Study.

Aims: To examine risk factors for out-of-hospital cardiac arrest in the Reykjavik Study, a long-term, prospective, population-based cohort study that started in 1967.

Methods And Results: From 1987 to 1996, 137 men and 44 women out of the 8006 men and 9435 women in the study sustained out-of-hospital cardiac arrest due to cardiac causes. Determinants included coronary artery disease (CAD), its classical risk factors, and age, body mass index (BMI), heart rate, cardiomegaly, and erythrocyte sedimentation rate.

Familiality of benign and malignant paraproteinemias. A population-based cancer-registry study of multiple myeloma families.

Background And Objectives: The occurrence of two or more cases of multiple myeloma (MM) in the same family has been reported from time to time. The current study is the first population- and cancer-registry-based survey to investigate familiality of premalignant or malignant B-cell proliferation.

Design And Methods: A family registry of 218 multiple myeloma cases was compared with the records of the Icelandic Cancer Registry in order to analyze the pedigrees for the occurrence of families with multiple cases of paraproteinemia and hematologic malignancies.