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Here we describe two cases of HaNDL (Headache with Neurological Deficits and cerebrospinal fluid Lymphocytosis). A thirty year old man with episodes of headache with lateralizing symptoms and confusion and a 41 year old man with headache, aphasia and right hemiparesis. Symptoms resolved completely in both patients. ⋯ Although the cause of HaNDL is unknown, it is thought to be triggered by a viral infection by some. The prognosis is excellent and symptoms normally resolve within 1-3 weeks. It is important to rule out more serious etiologies like stroke, subarachnoid hemorrhage or central nervous system infections.
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Diseases connected with work in hay have existed in Iceland since its settlement late in the 9th century. Haymaking was probably easier in those days because of better climate and land quality but became more difficult later when these factors deteriorated. First data on diseases connected with hay are from the early 17th century where the word "haysickness" (in Icelandic "heysótt") is used in a book on treatment of diseases. ⋯ The word "haysickness" is also found in dictionaries from that time. In a book from 1730-40 says: "Haysickness sometimes causes illness and loss of appetite in those that loosen hay in a compressed haystack with a hayneedle or a hook." At the end of the 18th century Jón Pétursson writes a good description of hay diseases: "It cannot be denied that haysickness not taken seriously or long ignored can cause many deaths in this country." Jón Finsen mentions in his doctoral thesis in 1874 that the symptoms of haysickness are different from those of allergy to pollen (hay fever) that had been recently described. In 1870 the Director of Health writes directions for farmers on how to reduce the danger of getting haysickness by using a thin cloth facemask when loosing hay from a haystack.
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Persistent physical symptoms that are medically unexplained can result in significant functional impairment. The aim of this study was to estimate the prevalence of persistent physical symptoms among people seeking primary healthcare in Reykjavík, Iceland, how they relate to functional impairment, symptoms of depression, general anxiety and health anxiety, and estimate the proportion of people with such symptoms who would likely benefit from psychological treatment. ⋯ The prevalence of persistent physical symptoms among health care patients in the capital area of Iceland is in line with previous studies. Similarly, the strong relationship between persistent physical symptoms and symptoms of depression and anxiety corresponds to previous studies. It is likely that at least two out of three patients with persistent physical symptoms would benefit from psychological treatment. Transdiagnostic cognitive behavioural therapy for persistent physical symptoms might be particularly useful as is focuses on the interplay between physical and mental symptoms.