Læknablađiđ
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Review Case Reports
[A 49 year old male with a giant pulmonary bulla--a case report and review of the literature].
A 49 year old previously healthy smoker was diagnosed with a giant bulla in his right lung, following a history of dry cough, repeated upper airway infections and increasing dyspnea for several years. Computed tomography (CT) confirmed the presence of a giant bulla in the right inferior lobe and several smaller bullae in the right superior lobe. The giant bulla was 17 cm in diameter, occupying more than half of the right hemithorax. ⋯ Five months postoperatively the patient is in good health and is back at work. Postoperatively significant improvements in spirometry values and lung volume measurements have been documented. This case demonstrates that giant bullae can be successfully managed with surgical resection and their size can be determined by different techniques, including lung volume measurements and chest CT.
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The importance of adequate metabolic control in Type 1 DM has been repeatedly demonstrated in recent years. The care of diabetic children and adolescents in Iceland is centralized to one unit. The aim of the study was to analyze the quality of treatment and acute complications of Icelandic children with Type 1 diabetes. ⋯ Overall the metabolic control in children and adolescents with IDDM in Iceland is satisfactory compared to internationally published results. It is important to focus attention on children with inadequate metabolic control, especially adolescent girls, and children experiencing serious hypoglycaemic episodes.
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We evaluated the efficacy of activated recombinant factor VIIa (rFVIIa) administration for critical bleeding during cardiothoracic surgery in Iceland. ⋯ rFVIIa can be used effectively to stop intractable bleedings in open heart surgery, with 8 out of 11 patients in this small series achieving hemostasis after its administration. Mortality in this group of patients was high (50%), however, in all cases rFVIIa was used as an end-of-the-line treatment where other therapy had failed. One patient died from pulmonary embolism and cerebral infarct, raising the question of hypercoagulation. Further studies on the side effects and indications of rFVIIa treatment are necessary.
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Allergies to antibiotics are reported by 8-14% of the adult population out of which half is thought to be due to penicillins. Women are two thirds of those. It is estimated that 20.000 Icelanders believe they are allergic to beta-lactam drugs. ⋯ The beta-lactam allergy is diagnosed by a precise history, measuring drug specific IgE, by prick- and intradermal skin tests and challenge tests with the drug in question. The purpose of this article is to draw the attention of Icelandic doctors to the importance of drug allergy with specific emphasis on beta-lactam drugs and the value of accurate recording of symptoms and signs in the patient's records. We also describe the diagnostic methods used and propose an algorithmic approach to diagnose beta-lactam allergy in Icelandic children and adults.
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To examine and explain the effect of unemployment on the number of disability pensioners in Iceland by examining changes in this relationship from 1992 to 2006. ⋯ Health and capability condition determine the overall disability rate, but fluctuations over time are related to environmental conditions in the labour market, especially the unemployment rate. The features of the welfare system, especially the benefit and rehabilitation system, as well as the extent and character of activation measures in the labour market also influence the number of disability pensioners. A new method of disability assessment from late 1999 may have had some influence on the relationship during the latter part of the period and increasing applications from people with mental and psychiatric deficiencies seems to have had a significant influence on the growing disability rate during the last few years.