Biomedical subjects

Asgeir Haraldsson

Publications and source records attributed to Asgeir Haraldsson.

16 recordsLinked to original sources

PubMed2006

Proteome analysis of vernix caseosa.

Vernix caseosa (vernix) is a white creamy substance covering the skin of the fetus during the last trimester of pregnancy. The function of vernix has long been debated but no consensus has been reached. We here report a proteome analysis of vernix using two-dimensional gel electrophoresis, matrix-assisted laser desorption/ionization mass spectrometry and liquid chromatography coupled to tandem mass spectrometry. We have identified 41 proteins, of which 25 are novel to vernix. Notably, 39% of the identified vernix proteins are components of innate immunity, and 29% have direct antimicrobial properties. These results form a substantial contribution to the knowledge of vernix composition and demonstrate that antimicrobial protection of the fetus and the newborn child is a major and important function of vernix.

Chromatography, Liquid↗

PubMed2006

[Telemedicine consultations in Iceland].

OBJECTIVE: A Telemedicine project was initiated to evaluate the usefulness of medical teleconsultations in Iceland and to gain experience for further planning of Telemedicine in the country. MATERIAL AND METHODS: The consultations were based on videoconference and store and forward method. Electronic stethoscope, spirometry, otoendoscope and digital pictures were used along with conventional videoconsultations. Doctors in six specialties in Landspitali University Hospital and one in private practice and Primary Care Physicians from five Health Care Centers in Iceland participated in the project. RESULTS: The results show that the Telemedicine consultations is practical and can be very useful. The doctors were content with the use of Telemedicine and the patients were pleased with the technique and the consults in general. All patients for example said that the consultation was just as or even better as if the specialist was in the room in person. The use of Telemedicine was helpful in almost all of the cases. Attention must be paid to organization of the consultations, payment, technical details and knowledge. CONCLUSION: Telemedicine have a role for Icelandic healthcare and may prove to be very useful. There are a number of factors who need preparation before the implementation of a Telemedicine service.

Humans↗

PubMed2005

Respiratory syncytial virus and other respiratory viruses during the first 3 months of life promote a local TH2-like response.

BACKGROUND: Respiratory syncytial virus (RSV) infections during infancy are considered to be a risk factor for developing asthma and possibly allergic sensitization. OBJECTIVE: The aim of this study was to investigate the cytokines, chemokines, and eosinophil cationic protein in the nasopharyngeal secretions of infants < or = 7 months of age with RSV infections or other respiratory viral infections and healthy infants as controls. Groups were also analyzed according to age, < or = 3 months and >3 months, and the levels were compared within and between groups. RESULTS: Thirty-nine infants with RSV, 9 with influenza or parainfluenza virus infections and 50 controls with no history of infections, were enrolled in the study. The RSV-infected infants had significantly higher levels of IL-4; macrophage inflammatory protein 1beta, a chemoattractant for T cells; and eosinophil cationic protein in nasopharyngeal secretions compared with the control group. The levels of the TH2 cytokine IL-4 were significantly higher in RSV-infected infants < or = months of age compared with RSV-infected infants >3 months of age. In infants < or = 3 months of age, infections with influenza or parainfluenza virus caused TH2-like responses similar to those produced by RSV. CONCLUSION: Infections with RSV as well as with influenza and parainfluenza virus during early infancy preferentially promote a TH2-like response in the nose with local production of IL-4, IL-5, and macrophage inflammatory protein 1beta and infiltration and activation of eosinophils.

Age Factors↗

PubMed2005

[Immunization coverage in the Monkey Bay Head zone Malawi].

OBJECTIVE: To assess the immunization coverage of children in the Monkey Bay head zone, Malawi where the Icelandic International Development Agency (ICEIDA) has been working to improve health care services in the recent years. MATERIALS AND METHODS: A 30 by 7 cluster sample survey, as defined by WHO's Expanded Programme on Immunization (EPI) was conducted to estimate immunization coverage of children aged 12-23 months for tuberculosis (BCG), diphtheria, tetanus and pertussis (DTP), polio (OPV) and measles immunizations. The Head Zone consists of 97 villages with a population of around 105,000 inhabitants. Five health centres provide immunization services in the area. In total were 217 children in 30 clusters randomly selected and their immunization status by card or history registered. RESULTS: Immunization coverage by card or history was 97% for BCG, and 99%, 95% and 85% for DTP1, DTP2 and DTP3 respectively. Coverage of OPV1, OPV2 and OPV3 by card or history was 99%, 93% and 85% respectively. Coverage for measles by card or history was 78%. Fully immunized children by card or history were 152 or 70%. Two children had not received any immunizations. Drop-out rate from DTP1 to DTP3 vaccination by immunization card or history was 14.5%, and drop-out from DTP1 to Measles by card or history was 21%. CONCLUSION: These results indicate that access to childhood immunization in the Monkey Bay head zone is good while drop-out rate is high. This indicates that access to health services is adequate. However, the coverage of measles appears to be insufficient to prevent outbreaks, and must be improved. The efficacy in delivering immunization can be improved and enhanced utilization of the services offered should be sought.

BCG Vaccine↗

PubMed2004

Congenital cardiac malformations in Iceland from 1990 through 1999.

INTRODUCTION AND BACKGROUND: About 1% of live-born children have congenital malformations of the heart. The aim of our study was to investigate the incidence of such defects in children born in Iceland during a period of 10 years, extending from 1990 through 1999. MATERIALS AND METHODS: Information about the patients was obtained from medical records from two hospitals that cover the whole country, a private clinic of pediatric cardiologists, an echocardiography database, autopsy reports, and death certificates. We investigated the distribution of specific malformations, the age at diagnosis, the symptoms leading to the diagnosis, the source of referral, and treatment and quality of life. RESULTS: Between 1990 and 1999, there were 44,013 live births in Iceland, of which 740 patients were diagnosed with congenital cardiac malformations, accounting for 1.7% of the live-born children. The distribution was made up of 338 patients with ventricular septal defect (45.7%), 90 with atrial septal defect (12.2%), 85 with patency of the arterial duct (11.5%), 48 with pulmonary valvar stenosis (6.5%), 38 with a bicuspid aortic valve (5.1%), 28 with aortic coarctation (3.8%), 22 with tetralogy of Fallot (3.0%), 14 with transposed great arteries (1.9%), 11 with aortic stenosis (1.5%), 10 with atrioventricular septal defect and common atrioventricular orifice (1.4%), 9 with mitral valvar regurgitation (1.2%), 7 with sub-aortic stenosis (0.9%), and 5 with hypoplasia of the left heart (0.7%). Extracardiac anomalies were seen in 89 patients (12.0%). Chromosomal defects were seen in 36 patients, of whom 28 had Down's syndrome. DISCUSSION: The annual incidence of diagnosis of patients with congenital cardiac malformations increased during the period of study. This was noted for minor defects, but the incidence of the major anomalies did not alter. Our observed yearly incidence, at 1.7%, was higher than noted in a previous study covering the years 1985 through 1989, and is also higher than in other population-based studies. The most likely explanation is the fact that access to pediatric cardiologists in Iceland is very good. Diagnosis, registration, and follow-up are conducted by only a few cardiologists, and take place at a single center for pediatric cardiology.

Cardiac Catheterization↗

PubMed2004

The effect of dietary fish oil on survival after infection with Klebsiella pneumoniae or Streptococcus pneumoniae.

Dietary fish oil is believed to have a beneficial effect in various infections and in autoimmune disorders. This effect may correspond to an altered immune response. In order to discover whether the effect of dietary fish oil is different in various infections, we studied the survival of mice fed fish oil or corn oil supplemented diets and infected in the lungs with either Klebsiella pneumoniae or Streptococcus pneumoniae. 120 NMRI mice were divided into 4 groups, of which 2 groups were fed a fish oil supplemented diet and 2 a corn oil supplemented diet. After 6 weeks the mice were infected in the lungs with Klebsiella pneumoniae (fish oil groups and corn oil groups) or with Streptococcus pneumoniae serotype 3 (both groups). The survival rate was monitored. The experiment was performed twice. The survival of the mice fed fish oil enriched diet and infected with Klebsiella pneumoniae was significantly better compared with the mice fed corn oil enriched diet (p = 0.0001 and p = 0.0013). No difference was found between the mice fed corn oil enriched diet or fish oil enriched diet and infected with Streptococcus pneumoniae serotype 3 (p = 0.74 and p = 0.15). Our results indicate that dietary fish oil has a beneficial effect on survival of mice after experimental pneumoniae when infected with Klebsiella pneumoniae, but not after infection with Streptococcus pneumoniae serotype 3.

Animals↗

PubMed2004

[Oesophageal atresia in Iceland 1963-2002; Incidence outcome.].

OBJECTIVE: Oesophageal atresia is an congenital anomali with incidence of 1/3000-1/4500 live births. The results of reconstructive surgery has improved greatly, to 80-92% survival reported in the last two decades. The aim of this study was to determine the incidence of oesophageal atresia in Iceland and to evaluate the results of operations at the Department of Pediatric surgery at The Children?s Hospital, Landspítal inn - University Hospital in Iceland. MATERIAL AND METHODS: This retrospective study included all children diagnosed with oesophageal atresia in Iceland between 1963 and 2002. Information was gathered from hospital records, including birth-weight, gestational age, the type of atresia and the presence of other congenital anomalies. The results of operation were determined including post operative complications. Information on life births in Iceland for the same period was gathered from the Icelandic National Register. RESULTS: Thirtyseven children were diagnosed with oesophageal atresia in these 40 years. The average birth-weight was 2626g, including 14 children (38%) with low birth-weight (<2500g). Fifteen children (41%) were prematurely born (<38 weeks). Thirtyfour children (92%) had the most common type of oesophageal atresia with proximal blind loop and distal tracheooesophageal fistula. Thirtyfour children were operated on, including one in Denmark. Nine children died within 60 days after surgery. The most common cause of death was lung inflammation (n=7, 78%). The survival after surgery in Iceland was 73% in the study period. Other congenital defects were common in this patient group with congenital heart defects as the most common ones (n=12, 32%). The incidence decresead in the study period from 1/3737 in the first ten years to 1/10639 in the last decade, this did not reach statistical signifiquance. CONCLUSION: It is interesting to see this decrease in incidence in the study period and this is the lowest incidence known to us. The survival has improved from previous study but is however still lower compared to our neighbouring countries. Other congenital anomalies are common in this patient group.

English Abstract↗

PubMed2003

Resistance in respiratory tract pathogens and antimicrobial use in Icelandic and Lithuanian children.

To assess resistance rates among respiratory tract pathogens and antimicrobial usage of children in Iceland and Lithuania, and to correlate usage patterns with resistance rates, nasopharyngeal swabs were taken from healthy children attending day-care centres in Reykjavik (n = 6) and Vilnius (n = 13), and cultured for pneumococci, Haemophilus influenzae and Moraxella catarrhalis. Information about recent antimicrobial use was obtained by a questionnaire. 50% and 51% carried pneumococci, 59% and 67% carried H. influenzae and 60% and 46% carried M. catarrhalis, in Reykjavik (n = 297) and Vilnius (n = 508), respectively. The prevalence of penicillin non-susceptible pneumococci was 11% in Reykjavik (mainly serotype 6B) and 5% in Vilnius (mainly 23F). At the time of sampling 3% of the children in Reykjavik and 8% in Vilnius were receiving antimicrobials. Children carrying penicillin non-susceptible pneumococci had used antimicrobials more frequently in the preceding month and this was significant for the Icelandic children (p < 0.0002). Antimicrobial use was more common in Vilnius than in Reykjavik, yet antimicrobial resistance was more common in Reykjavik. Resistance rates cannot be predicted only on the basis of recent antimicrobial use.

Anti-Bacterial Agents↗

PubMed2002

Familial predisposition and cosegregation analysis of adult obstructive sleep apnea and the sudden infant death syndrome.

Previous studies suggest a familial link between adult obstructive sleep apnea syndrome (OSAS) and sudden infant death syndrome (SIDS). However, most of these studies were hampered by the availability of too few cases of SIDS to draw conclusions. To examine the familial nature of this association in Iceland, hospital-based lists of all patients who were diagnosed with OSAS (n = 2,350) and SIDS (n = 58) from 1979 to 1998 were used to separately determine the familial occurrence of OSAS and SIDS and to search for evidence of cosegregation of these conditions in Icelandic families, using a nationwide genealogy database. The risk ratio for a first-degree relative of a patient with OSAS was 2.0 (1.7-2.8, 95% confidence interval). The risk ratio of the more severely affected patients with OSAS was slightly higher (2.3). Likewise, the kinship coefficient (KC) for the OSAS patient group, which determines the relatedness of the patients, was significantly larger than the mean KC of 1,000 matched control groups. Estimation of the KC for the SIDS group showed a trend toward significance when compared with control groups, but after excluding one of the half-siblings in the SIDS group from the analysis, the difference did not show any trend toward significance. Although the results of the analysis of the relatedness between all patients with OSAS and infants who died of SIDS were not significant, a trend toward significance was evident when the data were separately analyzed for the more severely affected patients with OSAS. Collectively, these results demonstrate a strong familial component in OSAS and suggest that infants who died of SIDS may have shared some of the same susceptibility factors with OSAS.

Adolescent↗

PubMed2002

[Henoch-Schönlein purpura, patients admitted to Landspítali-University Hospital 1984-2000.].

OBJECTIVE: Henoch-Schönlein purpura is a disease of small vessels which primarily affects children. The epidemiology of Henoch-Schönlein purpura in Iceland is not known. The main purpose of the study was to find out the incidence of the disease in Iceland and gather further epidemiological information. PATIENTS AND METHODS: All patients diagnosed with Henoch-Schönlein purpura during the years 1984-2000 and were admitted to the Children's Hospital Iceland, Landspítali Hringbraut as well as the paediatric department at the Landspítali Fossvogi were included in the study cohort. Information was gathered from medical records. The temporal relationship between the incidende of Henoch-Schönlein purpura and epidemics of three common infectious diseases was explored. RESULTS: A total of 101 patients were found to have Henoch-Schönlein purpura, 51 females and 50 males. The incidence of Henoch-Schönlein purpura in Iceland is therefore approximately six cases annually. The mean age at diagnosis was 5.4 years. In addition to the rash, 72.3% had arthralgia and 45.5% abdominalia, 36.6% had hematuria or proteinuria during the hospitalization and 5.9% had severe renal involvement. The disease was more common in the winter months (Nov. - April) compared to the summer months (May - Oct.) (p=0.045). CONCLUSIONS: The epidemiology of Henoch-Schönlein purpura in Iceland is comparable to other countries. The disease was most common in children aged 2-5 years, which could reflect a common infection in the community as a part of the pathogenesis. Older children may have antibodies against these infections resulting in a decreased incidence of the disease. Our results support the theory that infection may play an important role in the pathogenesis of Henoch-Schönlein purpura. However, some abnormalities or variations in the immune response are probably also involved.

English Abstract↗

PubMed2002

[Bacterial meningitis in one month-16 year old children at three Pediatric departments in Iceland during the period 1973-2000.].

OBJECTIVE: Bacterial meningitis is a serious disease most common in children. We report the epidemiology and outcome of bacterial meningitis in children between the age of one month to 16 years admitted to three Pediatric Departments in Iceland in 1973-2000 (28 years). MATERIAL AND METHODS: Information was collected retrospectively from the medical records of admitted children diagnosed with bacterial meningitis. RESULTS: 454 children were diagnosed; 255 boys and 199 girls; 77% were less than five years of age. Before 1989 the age specific incidence was 29/100.000/year and 12/100.000/year thereafter. The cerebral spinal fluid was culture positive in 74% but no organism was identified in 17%. The most common pathogens were N. meningitidis (44%), Hib (30%), and S. pneumoniae (7%). The incidence varied according to age. No child was diagnosed with Hib after launching of Hib vaccination in 1989. The mean age of the children increased significantly from less than two years prior to 1989 to less than three years thereafter and of children infected with N. meningitidis from around two year to three years. The mortality rate was 4,5%, none due to Hib. Fourteen percent suffered sensory-neural hearing impairment and no protective effects were seen of steroid therapy. CONCLUSIONS: The age specific incidence of bacterial meningitis of children in Iceland has decreased during the last decade, especially due to Hib vaccination. Further reduction can be expected by implementing general vaccination to N. meningitidis C and S. pneumoniae. Additionally, recognizing the symptoms of bacterial meningitis and starting proper therapy as soon as possible is crucial in order to minimize ominous outcome.

English Abstract↗

PubMed2002

[Congenital heart defects in Iceland 1990-1999.].

OBJECTIVE: About 1% of live born children have congenital heart defects (CHD). Knowledge of the true incidence of CHD is important because of the risk of bacterial endocarditis in patients with heart defects. This knowledge could also serve as a basis for research on the etiology of CHD. The aim of our study was to investigate the incidence of CHD in children born in Iceland during a ten year period, from 1990 to 1999. A similar study on CHD was carried out in Iceland for children born 1985-1989. The incidence of CHD in the present study was compared to the previous and to similar studies from other countries. MATERIAL AND METHODS: Information about the patients were obtained from medical records from two hospitals covering the whole country, a private clinic of pediatric cardiologists, echocardiography database, autopsy reports and death certificates. Distribution of specific heart defects, age at diagnosis, symptoms leading to the diagnosis, referral pattern, treatment and quality of life was investigated. Other congenital defects, chromosomal defects and syndromes in the patients were studied. Premature children with patent ductus arteriosus (PDA) and children with patent foramen ovale (PFO) or atrial septal defect (ASD) smaller than four millimeters were excluded. We also studied the incidence of bicuspid aortic valve (BAV). All diagnoses were confirmed with echocardiography and in some cases cardiac catheterization. RESULTS: Between 1990 and 1999 there were 44,013 live births in Iceland, 740 children were diagnosed with a CHD or 1.7% of live born children. Yearly incidence varied from 1.04% of live births in 1991 to 2.34% in 1997. Male/female ratio was 1/1. The distribution of the defects was following: ventricular septal defect (VSD) 338 (45.7%), ASD 90 (12.2%), PDA 85 (11.5%), valvar pulmonal stenosis 48 (6.5%), BAV 38 (5.1%), coarctation of the aorta 28 (3.8%), tetrology of Fallot 22 (3.0%), transposition of the great arteries 14 (1.9%), aortic stenosis 11 (1.5%), common atrioventricular septal defect 10 (1.4%), mitral valve regurgitation 9 (1.2%), sub-aortic stenosis 7 (0.9%) and hypoplastic left heart syndrome 5 (0.7%). Other defects were less frequent. About 47% of children with CHD were diagnosed either before birth or before discharge from the delivery institution. A cardiac murmur on examination was the most common symptom leading to the diagnosis of CHD, 631 patients (85.3%). Extracardiac anomalies were seen in 89 patients (12.0%). Chromosomal abnormalities were seen in 36 patients of whom 28 had Down's syndrome. The majority or 499 patients have no symptoms but are still in follow-up, 20 patients have daily symptoms and/or receive medical treatment and 27 patients have died. Conslusions: Annual incidence of patients diagnosed with a CHD has increased during the study period. This is observed in minor CHD but the incidence of major defects does not alter. This yearly incidence (1.7%) is higher than in the previous study, where it was 1.1%. The difference can partly be explained by the BAVs, which were excluded in the 1985-1989 study. But the number of CHD diagnosed each year has increased, this being most pronounced in the last three years. The annual incidence in our study is also higher than in other population studies. The most likely explanation for the higher incidence in our study is the fact that access to pediatric cardiologists is very good in Iceland. Diagnosis, registration and follow-up is conducted by only a few cardiologists for the whole nation and takes place at a single pediatric cardiology center. Of 740 patients diagnosed with CHD in the study period 713 are alive. The outcome of the therapy is good and the majority of the patients has no symptoms.

English Abstract↗

PubMed2002

[Beneficial effect of dietary fish-oil is independent of the infection site.].

OBJECTIVE: Fish-oil enriched diet has a protective effect on experimental animals infected intramuscularly with Klebsiella pneumoniae. It also has beneficial effect in several other diseases, including autoimmune disorders. The pathophysiological effects of dietary fish-oil have still not been revealed although it is expected to influence the immune response. We have previously shown that dietary fish-oil has beneficial effect in mice infected intramuscularly with Klebsiella pneumoniae. If the beneficial effect of dietary fish-oil is due to influence on the immune response it should be independent of the infection site. We therefore investigated whether dietary fish-oil has beneficial effect in intrapulmonary infection with Klebsiella pneumoniae as it has on intramuscular infection with the same bacteria. MATERIALS AND METHODS: Sixty NMRI mice were fed diets enriched with fish-oil (30 mice) or corn-oil (30 mice) for six weeks. The mice were then infected in the lungs with Klebsiella pneumoniae and the survival was monitored. The experiment was performed twice. The results were compared to our earlier results with intramuscular infections. RESULTS: The survival of the mice fed the fish-oil enriched diet and infected in the lungs with Klebsiella pneumoniae was significantly better compared to the survival of mice fed the corn-oil enriched diet in both experiments (p=0.0001 and p=0.0013). These results are similar to our earlier findings when the mice were infected intramuscularly. CONCLUSIONS: These results indicate that the beneficial effect of dietary fish-oil on infection is independent of the site of infection. These results are in accordance with the hypothesis that dietary fish-oil influences the immune response.

English Abstract↗

PubMed2002

[Effect of dietary fish-oil on survival of experimental animals after infection with Streptococcus pneumoniae or Klebsiella pneumoniae.].

OBJECTIVE: Dietary fish-oil has beneficial effect in infections and in autoimmune disorders. This effect is thought to be associated with alterations in the immune system. The Gram negative organism Klebsiella pneumoniae has been used as an infective agent in most studies investigating the effect of dietary fish-oil on infection. The immune response against Gram positive bacteria is somewhat different to the response to Gram negative oeganisms. Moreover, the Gram positive bacteria Streptococcus pneumoniae is a very common pathogen, particularly in children. To investigate whether dietary fish-oil has different effect in infections by Gram positive or Gram negative bacteria, we studied the survival of mice fed with fish-oil or corn-oil supplemented diets and infected in the lungs with either Klebsiella pneumoniae or Streptococcus pneumoniae. MATERIALS AND METHODS: 120 NMRI mice were divided into four groups and fed diets supplemented with fish-oil (two groups, 30 mice in each group) or corn-oil (two groups, 30 mice in each group). After six weeks, the mice were infected with Klebsiella pneumoniae (fish-oil group and corn-oil group) or with Streptococcus pneumoniae serotype 3 (fish-oil group and corn-oil group). The survival was monitored. The experiment was performed twice. RESULTS: The survival of the mice infected with Klebsiella pneumoniae was significantly better in the groups receiving the fish-oil enriched diet as compared to the groups fed the corn-oil enriched diet (p=0.0001 and 0.0013). There was no difference in the survival of mice infected with Streptococcus pneumoniae serotype 3, receiving the fish-oil or corn-oil enriched diets (p=0.74 and p=0.15). CONCLUSIONS: These results indicate that dietary fish-oil has beneficial effect on survival of mice after experimental infection with the Gram negative bacteria Klebsiella pneumoniae but not on experimental infections with the Gram positive bacteria Streptococcus pneumoniae serotype 3.

English Abstract↗

PubMed2002

[Late and long-term effects of leukaemia treatment in childhood.].

INTRODUCTION: The treatment of childhood leukemia has improved substantially over the last decades and now 65-75% of the patients recover. With increasing number of survivors it is important to know the long-term and late effects of leukemia and leukaemia treatment. PATIENTS: Of the 31 children diagnosed with leukemia in Iceland from 1981 to 1990, twenty were enrolled in the study. Average age at enrollment was16 years and 8 months (16:8) and average time since treatment ended was 8:3. METHODS: The study was carried out at the Children's Hospital at the University Hospital Iceland where patients were examined and data was gathered on height, weight, hearing, cognitive functions, bloodvalues, immunoglobulins and renal, endocrine, heart, liver and respiratory functions. RESULTS: The children studied were on average 0.48 standard deviations below target height and their body-mass index was higher at the time of study than at diagnosis. Two children had obvious obstructive lung disease. No abnormalities were found in complete blood count nor heart, liver or kidney functions. Two patients were found to have impaired hearing not attributable to acoustic trauma. In some cases abnormal values were found in immunoglobulin classes and 12 patients had decreased serum IgG2. Six needed remedial reading lessons. Three patients needed hormone replacement therapy. DISCUSSION: Minor impact on height and weight was found but the effects on lungs and hearing were inconclusive. Despite markedly decreased serum IgG2 the patients were not more prone to infections. The most obvious effects were on the endocrine system and performance at school. We conclude that the sequelae of childhood leukemia treatment in Iceland are significant and long-lasting, underlining the necessity of a careful long-term follow-up.

English Abstract↗

PubMed2002

[Central nervous system tumours in Icelandic children; diagnoses, treatment results and late effects.].

OBJECTIVE: Tumours in the central nervous system are the second most common malignant diseases in children. With improved treatment, the number of survivors is increasing. Therefore, better knowledge of the long-term effects of the disease and the therapy is needed. The aim of the current study was to find the incidence of central nervous system tumours in Iceland, evaluate the treatment results and study the long-term effects on the individuals. MATERIAL AND METHODS: Data on diagnosis and treatment as well as demographic data were gathered from hospital records from the Reykjavik City Hospital and The University Hospital and operating lists at the Department of Neurosurgery were reviewed. On survivors, physical examination was carried out, blood tests and urine-analysis were done and hearing was tested. Social adaptation, school performance, memory, concentration and general well being were studied by a questionnaire. RESULTS: In the years 1970-1995, 57 children, aged 16 and younger, were diagnosed in Iceland with central nervous system tumours, 30 girls and 27 boys. Two children with brain metastases were excluded. Of the 55 individuals, 38 are alive today, 19 girls and 19 boys. Seventeen children had astrocytoma, grade 1 or 2 and seven had astrocytoma of grade 3 or 4. Seven children had medulloblastoma, other tumours were less common. Four patients with benign tumours in the spine were excluded from the study; three are living abroad and three refused participation. Therefore, 28 patients were included in the further study, 15 males and 13 females. The mean age at diagnoses was 7 years and 8 months (7:8) (median 6:7 years, span 0:0-15:11), the mean age at study was 21:4 years (median 20:2 years, span 7:6-39:9) and the mean time from diagnosis until study was 12:8 years (median 11:5 years, span 2:5-26:3). The mean standard deviation score for height (SDS) was -0.63 at the time of study, five of the patients had SDS below two. Five individuals need hormone replacement therapy and one patient has scoliosis. Three patients have disabilities; two of those are incapable of activities of daily life. Three patients have hearing impairment; one of them is also blind. Of five patients who had seizures when diagnosed, two still have convulsions. Of 28 patients, twelve (43%) had learning difficulties in school and ten (36%) needed remedial teaching. CONCLUSIONS: The incidence of central nervous tumours in Icelandic children is comparable to what has been reported in other countries. The results of the treatment are similar to what has been found in the other Nordic countries which maybe better than in other countries. The most prominent long-term effects among the survivors are endocrine dysfunctions and specific learning disabilities. Other, severe long-term complications are rare but have considerable effect on the individuals. We emphazise that organised, long-term follow-up is essential for these individuals, paying special attention to learning difficulties and endocrine dysfunction.

English Abstract↗