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Article ; Online: [What I talk about when I talk about COVID-19].

Aspelund, Thor

2020 Volume 106, Issue 9, Page(s) 395

MeSH term(s)	Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Health Communication ; Host-Pathogen Interactions ; Humans ; Iceland/epidemiology ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Prognosis ; SARS-CoV-2
Keywords	covid19
Language	Icelandic
Publishing date	2020-09-09
Publishing country	Iceland
Document type	Editorial
ZDB-ID	806661-9
ISSN	1670-4959 ; 0023-7213
ISSN (online)	1670-4959
ISSN	0023-7213
DOI	10.17992/lbl.2020.09.594
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Zs.A 6323: Show issues

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Article ; Online: [Maternal death in Iceland 1976-2015].

Birgisdottir, Hera / Aspelund, Thor / Geirsson, Reynir Tomas

Laeknabladid

2023 Volume 109, Issue 3, Page(s) 134–140

Abstract: Introduction: Maternal deaths are rare and an indirect measure of the societal framework surrounding pregnancy and childbirth. We surveyed and classified maternal mortality in Iceland using international guidelines, calculating changes over a 40-year ... ...

Abstract	Introduction: Maternal deaths are rare and an indirect measure of the societal framework surrounding pregnancy and childbirth. We surveyed and classified maternal mortality in Iceland using international guidelines, calculating changes over a 40-year period. Material and methods: Information from Statistics Iceland on women aged 15-49 years who died in 1985-2015 were cross-checked against birth registration and hospital admission data to identify women who died in pregnancy or ≤42 and within 43-365 days from birth or termination of a pregnancy. Data for 1976-1984 were searched manually. Case records and autopsy reports were scrutinized. Deaths were classified as direct, indirect or coincidental and as early or late. Results: Among 1600 women 48 died in pregnancy or within a year after pregnancy. Births totaled 172369 and overall maternal mortality was 27.8/100.000 births. Maternal mortality by World Health Organization criteria (direct/indirect ≤42 days) occurred in 14 instances giving a maternal mortality ratio (MMR) of 8.1/100.000. Rates lowered between the first and last 10-year periods, particularly initially followed by a lesser downward trend. Direct deaths were 6, indirect 20, coincidental 22 (accidents, diseases). Causes of direct deaths were severe preeclampsia, pulmonary embolism and choriocarcinoma. Underlying causes of indirect deaths included cancer, diabetes, brain/heart conditions and suicide. No deaths occurred from ectopic pregnancy, hemorrhage or anesthesia. Conclusions: Maternal mortality in Iceland is among the lowest reported. Women died because of the pregnancy, from worsening of underlying conditions or coincidentally. Risk groups require better support. Continued attention to adverse health connected to maternity is essential.
MeSH term(s)	Pregnancy ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Iceland ; Parturition ; Brain
Language	Icelandic
Publishing date	2023-03-01
Publishing country	Iceland
Document type	English Abstract ; Journal Article
ZDB-ID	806661-9
ISSN	1670-4959 ; 0023-7213
ISSN (online)	1670-4959
ISSN	0023-7213
DOI	10.17992/lbl.2023.03.734
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Article ; Online: [Flexitarian diet to the rescue].

Torfadottir, Johanna E / Aspelund, Thor

Laeknabladid

2019 Volume 105, Issue 6, Page(s) 264–265

MeSH term(s)	Diet, Healthy ; Food Supply ; Humans ; Iceland
Language	Icelandic
Publishing date	2019-06-13
Publishing country	Iceland
Document type	Editorial
ZDB-ID	806661-9
ISSN	1670-4959 ; 0023-7213
ISSN (online)	1670-4959
ISSN	0023-7213
DOI	10.17992/lbl.2019.06.234
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Article ; Online: Nocturnal gastro-oesophageal reflux and respiratory symptoms are increased in sleep apnoea: comparison with the general population.

Emilsson, Össur Ingi / Aspelund, Thor / Janson, Christer / Benediktsdottir, Bryndis / Juliusson, Sigurdur / Maislin, Greg / Pack, Allan I / Keenan, Brendan T / Gislason, Thorarinn

BMJ open respiratory research

2024 Volume 11, Issue 1

Abstract: Aim: To assess respiratory symptoms and nocturnal gastro-oesophageal reflux (nGER) among untreated obstructive sleep apnoea (OSA) patients, compared with the general population. Also, if nGER associates differently with respiratory symptoms among OSA ... ...

Abstract	Aim: To assess respiratory symptoms and nocturnal gastro-oesophageal reflux (nGER) among untreated obstructive sleep apnoea (OSA) patients, compared with the general population. Also, if nGER associates differently with respiratory symptoms among OSA patients. Methods: 2 study cohorts were included: 822 newly diagnosed subjects with moderate-severe OSA and 738 Icelandic general population study participants. All participants answered the same questionnaires. Those reporting nGER symptoms at least once per week were defined as 'with nGER'; those without nGER symptoms and without nGER medication were defined as 'no nGER'; and other participants were defined as having 'possible nGER'. Propensity score-based weights were used to minimise confounding and selection bias and facilitate causal interpretations. Results: The prevalence of nGER among OSA patients was 14.1%, compared with 5.8% in the general population. This increased prevalence in OSA was not explained by differences in age, gender, body mass index, smoking, hypertension and diabetes (adjusted OR (95% CI)=3.79 (2.24 to 6.43)). OSA patients 'with nGER' and with 'possible nGER' reported more wheezing (44% and 44% vs 25%, respectively) and productive cough (47% and 42% vs 29%, respectively), compared with OSA patients with 'no nGER'. The same pattern was seen in the general population, although with a generally lower prevalence. The effect of nGER on respiratory symptoms was similar between the two cohorts. Conclusion: nGER was more often reported among untreated moderate-severe OSA patients than in the general population. Participants with nGER had more wheezing and productive cough, both among untreated OSA patients and in the general population.
MeSH term(s)	Humans ; Respiratory Sounds ; Sleep Apnea Syndromes/diagnosis ; Gastroesophageal Reflux ; Sleep Apnea, Obstructive/diagnosis ; Cough
Language	English
Publishing date	2024-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2023-002192
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Article ; Online: Refracture and mortality risk in the elderly with osteoporotic fractures: the AGES-Reykjavik study.

Praveen, Anitha D / Aspelund, Thor / Ferguson, Stephen J / Sigurðsson, Sigurður / Guðnason, Vilmundur / Pálsson, Halldór / Matchar, David / Helgason, Benedikt

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

2024

Abstract: There is imminent refracture risk in elderly individuals for up to six years, with a decline thereafter except in women below 75 who face a constant elevated risk. Elderly men with fractures face the highest mortality risk, particularly those with hip ... ...

Abstract	There is imminent refracture risk in elderly individuals for up to six years, with a decline thereafter except in women below 75 who face a constant elevated risk. Elderly men with fractures face the highest mortality risk, particularly those with hip and vertebral fractures. Targeted monitoring and treatment strategies are recommended. Purpose: Current management and interventions for osteoporotic fractures typically focus on bone mineral density loss, resulting in suboptimal evaluation of fracture risk. The aim of the study is to understand the progression of fractures to refractures and mortality in the elderly using multi-state models to better target those at risk. Methods: This prospective, observational study analysed data from the AGES-Reykjavik cohort of Icelandic elderly, using multi-state models to analyse the evolution of fractures into refractures and mortality, and to estimate the probability of future events in subjects based on prognostic factors. Results: At baseline, 4778 older individuals aged 65 years and older were included. Elderly men, and elderly women above 80 years of age, had a distinct imminent refracture risk that lasted between 2-6 years, followed by a sharp decline. However, elderly women below 75 continued to maintain a nearly constant refracture risk profile for ten years. Hip (30-63%) and vertebral (24-55%) fractures carried the highest 5-year mortality burden for elderly men and women, regardless of age, and for elderly men over 80, lower leg fractures also posed a significant mortality risk. Conclusion: The risk of refracture significantly increases in the first six years following the initial fracture. Elderly women, who experience fractures at a younger age, should be closely monitored to address their long-term elevated refracture risk. Elderly men, especially those with hip and vertebral fractures, face substantial mortality risk and require prioritized monitoring and treatment.
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1064892-6
ISSN	1433-2965 ; 0937-941X
ISSN (online)	1433-2965
ISSN	0937-941X
DOI	10.1007/s00198-024-07096-3
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Zs.A 3163: Show issues

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Article ; Online: Postpartum pelvic organ prolapse and pelvic floor muscle training: secondary analysis of a randomized controlled trial of primiparous women.

Sigurdardottir, Thorgerdur / Steingrimsdottir, Thora / Geirsson, Reynir T / Halldorsson, Thorhallur I / Aspelund, Thor / Bø, Kari

International urogynecology journal

2023 Volume 34, Issue 6, Page(s) 1319–1326

Abstract: Introduction and hypothesis: Pelvic floor dysfunction is common after childbirth. We hypothesize that physiotherapist-guided pelvic floor muscle training (PFMT) is effective regarding pelvic organ prolapse (POP) symptoms during the first postpartum year. ...

Abstract	Introduction and hypothesis: Pelvic floor dysfunction is common after childbirth. We hypothesize that physiotherapist-guided pelvic floor muscle training (PFMT) is effective regarding pelvic organ prolapse (POP) symptoms during the first postpartum year. Methods: This was a secondary analysis from a randomized controlled trial (RCT), carried out at a physiotherapy clinic, Reykjavik. Participants were eighty-four primiparous women with a singleton delivery. They were screened for eligibility 6-13 weeks postpartum. Women in a training group conducted 12 weekly individual sessions with a physiotherapist within an RCT, starting on average 9 weeks postpartum. Outcomes were assessed after the last session (short term) and at approximately 12 months postpartum (long term). The control group received no instructions after the initial assessment. Main outcome measures were self-evaluated POP symptoms by the Australian Pelvic Floor Questionnaire. Results: Forty-one and 43 women were in the training and control groups, respectively. At recruitment, 17 (42.5%) of the training group and 15 (37%) of the control group reported prolapse symptoms (p = 0.6). Five (13%) from the training group and nine (21%) controls were bothered by the symptoms (p = 0.3). There was a gradual decrease in the number of women with symptoms and no significant short-term (p = 0.08) or long-term (p = 0.6) differences between the groups regarding rates of women with POP symptoms. The difference between groups regarding bother in the short (p = 0.3) or longer term (p = 0.4) was not significant. Repeated-measures analyses using Proc Genmod in SAS did not indicate a significant effect of the intervention over time (p > 0.05). Conclusions: There was an overall decrease in postpartum symptoms of POP and bother during the first year. Physiotherapist-led PFMT did not change the outcomes. Clinical trial registration: The trial was registered 30 March 2015 at https://register. Clinicaltrials: gov (NCT02682212). Initial participant enrollment was on 16 March 2016 and reported following CONSORT guidelines for randomized controlled trials.
MeSH term(s)	Female ; Humans ; Pelvic Floor ; Exercise Therapy ; Australia ; Pelvic Organ Prolapse/therapy ; Postpartum Period ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1050631-7
ISSN	1433-3023 ; 0937-3462
ISSN (online)	1433-3023
ISSN	0937-3462
DOI	10.1007/s00192-023-05502-8
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Zs.A 3070: Show issues

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Article ; Online: Twin birth rates and obstetric interventions in Iceland: A nationwide study from 1997 to 2018.

Ontiveros, Jamie / Gunnarsdóttir, Jóhanna / Guðnadóttir, Sigurbjörg Anna / Aspelund, Thor / Einarsdóttir, Kristjana

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2023 Volume 163, Issue 1, Page(s) 226–233

Abstract: Objective: Twin pregnancies are associated with increased antepartum and intrapartum risks. Limited multiple embryo transfers are associated with decreased twin birth rates. We aimed to study the effect of 2009 Icelandic regulations on twin birth rates ... ...

Abstract	Objective: Twin pregnancies are associated with increased antepartum and intrapartum risks. Limited multiple embryo transfers are associated with decreased twin birth rates. We aimed to study the effect of 2009 Icelandic regulations on twin birth rates and examine obstetric intervention rates for twin births during the study period. Methods: The study included all births (N = 94 028) in Iceland during 1997-2018. Twin birth rates and obstetric intervention rates were compared over birth year periods using modified Poisson regression adjusted for confounders. Results: An observed decrease in the twin birth rate trend was most notable from 2006 until 2009. Twin birth decreased in 2009-2013 (prevalence ratio [PR] 0.74, 95% confidence interval [CI] 0.64-0.86) and in 2014-2018 (PR 0.74, 95% CI 0.64-0.86) compared with 1997-2002. This decrease was only evident for women aged 30+ years in stratified analysis. Induction of labor rates increased from 26% in 1997-2002 to 44% in 2014-2018 (adjusted rate ratio [ARR] 2.10, 95% CI 1.72-2.57) whereas elective cesarean section (ARR 0.80, 95% CI 0.59-1.07) and urgent cesarean section (ARR 0.79, 95% CI 0.63-1.00) rates appeared to decline. Conclusion: Twin births decreased during the study period. International guidelines published before the Icelandic regulations may have affected twin birth rates in Iceland. Induction of labor rates for twins increased while cesarean section rates decreased.
MeSH term(s)	Pregnancy ; Female ; Humans ; Cesarean Section ; Birth Rate ; Iceland/epidemiology ; Labor, Obstetric ; Parturition ; Pregnancy, Twin ; Retrospective Studies
Language	English
Publishing date	2023-05-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14817
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Article: Positive airway pressure treatment affects respiratory symptoms and gastro-oesophageal reflux: the Icelandic Sleep Apnea Cohort Study.

Emilsson, Össur Ingi / Aspelund, Thor / Janson, Christer / Benediktsdottir, Bryndis / Juliusson, Sigurdur / Maislin, Greg / Pack, Allan I / Keenan, Brendan T / Gislason, Thorarinn

ERJ open research

2023 Volume 9, Issue 5

Abstract: Aim: To study the effect of positive airway pressure (PAP) treatment on nocturnal gastro-oesophageal reflux (nGOR) and respiratory symptoms among clinical obstructive sleep apnoea (OSA) patients.: Methods: 822 patients newly diagnosed with OSA ... ...

Abstract	Aim: To study the effect of positive airway pressure (PAP) treatment on nocturnal gastro-oesophageal reflux (nGOR) and respiratory symptoms among clinical obstructive sleep apnoea (OSA) patients. Methods: 822 patients newly diagnosed with OSA referred for PAP treatment were recruited. 732 patients had a 2-year follow-up visit with continuous PAP compliance data (366 full PAP users, 366 partial/non-PAP users). They answered questionnaires, including reporting of nGOR, sleep and respiratory symptoms and general health. Patients with nGOR symptoms once a week or more were defined as "with nGOR". Those without nGOR symptoms and nGOR medication were defined as "no nGOR". Others were defined as "possible nGOR". Results: At 2-year follow-up, PAP treatment among full users resulted in decreased nGOR (adjusted OR 0.58, 95% CI 0.40-0.86) and wheezing (adjusted OR 0.56, 95% CI 0.35-0.88) compared with partial/non-PAP users. Decreased nGOR, among both full and partial/non-users of PAP treatment, was associated with a decrease in productive morning cough (adjusted OR 4.70, 95% CI 2.22-9.99) and a decrease in chronic bronchitis (adjusted OR 3.86, 95% CI 1.74-8.58), but not decreased wheezing (adjusted OR 0.90, 95% CI 0.39-2.08). A mediation analysis found that PAP treatment directly led to a decrease in wheezing, not mediated through nGOR. Conversely, PAP treatment decreased productive cough mediated through a decrease in nGOR. Conclusion: In an unselected group of OSA patients, PAP treatment for 2 years was associated with a decrease in nGOR and respiratory symptoms. The PAP treatment itself was associated with less wheezing. A decrease in nGOR through PAP treatment was associated with a decrease in productive cough.
Language	English
Publishing date	2023-09-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00387-2023
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Article: Correlates of Coronavirus Disease 2019 Inpatient Mortality at a Southern California Community Hospital With a Predominantly Hispanic/Latino Adult Population.

Gatto, Nicole M / Freund, Debbie / Ogata, Pamela / Diaz, Lisa / Ibarrola, Ace / Desai, Mamta / Aspelund, Thor / Gluckstein, Daniel

Open forum infectious diseases

2023 Volume 10, Issue 1, Page(s) ofad011

Abstract: Background: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino ... ...

Abstract	Background: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino patients. In a retrospective cohort study of 4881 consecutive adult COVID-19 hospitalizations at a single community hospital in Los Angeles County with a majority Hispanic/Latino population, we evaluated factors associated with mortality. Methods: Data on demographic characteristics, comorbidities, laboratory and clinical results, and COVID-19 therapeutics were abstracted from the electronic medical record. Cox proportional hazards regression modeled statistically significant, independently associated predictors of hospital mortality. Results: Age ≥65 years (hazard ratio [HR] = 2.66; 95% confidence interval [CI] = 1.90-3.72), male sex (HR = 1.31; 95% CI = 1.07-1.60), renal disease (HR = 1.52; 95% CI = 1.18-1.95), cardiovascular disease (HR = 1.45; 95% CI = 1.18-1.78), neurological disease (HR = 1.84; 95% CI = 1.41-2.39), D-dimer ≥500 ng/mL (HR = 2.07; 95% CI = 1.43-3.0), and pulse oxygen level <88% (HR = 1.39; 95% CI = 1.13-1.71) were independently associated with increased mortality. Patient household with (1) multiple COVID-19 cases and (2) Asian, Black, or Hispanic compared with White non-Hispanic race/ethnicity were associated with reduced mortality. In hypoxic COVID-19 inpatients, remdesivir, tocilizumab, and convalescent plasma were associated with reduced mortality, and corticosteroid use was associated with increased mortality. Conclusions: We corroborate several previously identified mortality risk factors and find evidence that the combination of factors associated with mortality differ between populations.
Language	English
Publishing date	2023-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofad011
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Article ; Online: Mental health and sociodemographic characteristics among Icelanders, data from a cross-sectional study in Iceland.

Sigurðardóttir, Svala / Aspelund, Thor / Guðmundsdóttir, Dóra G / Fjorback, Lone / Hrafnkelsson, Hannes / Hansdóttir, Ingunn / Juul, Lise

BMC psychiatry

2023 Volume 23, Issue 1, Page(s) 30

Abstract: Background: Mental health challenges are on the rise worldwide. In Iceland, little is known about the sociodemographic factors associated with poor mental health. This study aimed to investigate symptoms of depression, anxiety, stress, and psychiatric ... ...

Abstract	Background: Mental health challenges are on the rise worldwide. In Iceland, little is known about the sociodemographic factors associated with poor mental health. This study aimed to investigate symptoms of depression, anxiety, stress, and psychiatric medication for mental disorders in a nationally representative sample in Iceland and to explore its associations with sociodemographic factors. Methods: This Icelandic cross-sectional study 'Health and Wellbeing of Icelanders' was conducted in 2017 and included 9,887 randomly chosen adults. Participants' depression, anxiety, and stress levels were measured with the Depression Anxiety and Stress scale-21(DASS-21) and the association with sociodemographic factors and prescribed psychiatric medication was assessed in a multinominal logistic regression analysis. Results: The youngest age group (18 to 29 years old) had the poorest mental health. Males had a higher risk of medium and high depression scores than females, RRR 1.23 (95% CI 1.06-1.44) and RRR 1.71 (95% CI 1.25-2.33) when adjusted for sociodemographic factors (age, sex, education, marital status, financial status, living area, employment) and use of psychiatric medication. Participants with the most considerable financial difficulties had the highest risk of high scores on depression RRR 11.19 (95% CI 5.8-21.57), anxiety RRR 12.35 (95% CI 5.62-27.14) and stress RRR 11.55 (95% CI 4.75-28.04) when compared to those that do not. Conclusions: The youngest participants and those with the most extensive financial difficulties had the highest depression, anxiety, and stress scores. Males scored higher than females on depression. There was a trend towards worse mental health with lower sociodemographic status. Higher education, living with someone, and financial security were associated with better mental health. These results implicate the importance of government actions to counteract social inequalities in the Icelandic nation.
MeSH term(s)	Male ; Adult ; Female ; Humans ; Adolescent ; Young Adult ; Mental Health ; Iceland/epidemiology ; Depression/diagnosis ; Cross-Sectional Studies ; Anxiety/diagnosis
Language	English
Publishing date	2023-01-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2050438-X
ISSN	1471-244X ; 1471-244X
ISSN (online)	1471-244X
ISSN	1471-244X
DOI	10.1186/s12888-022-04504-y
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