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Browsing Artikler, rapporter og annet (klinisk medisin) by Author
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Bakke, Håkon Kvåle; Wisborg, Torben (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Finnmark County is the northernmost county in Norway. For several decades, the rate of mortality after injury in this sparsely inhabited region has remained above the national average. Following documentation of this discrepancy for the period 1991–1995, improvements to the trauma system were implemented. The present study aims to assess whether trauma-related mortality rates have subsequently improved. All injury-associated fatalities in Finnmark from 1995–2004 were identified retrospectively from the National Registry of Death and reviewed. Low-energy trauma in elderly individuals and poisonings were excluded. A total of 453 cases of trauma-related death occurred during the study period, and 327 of those met the inclusion criteria. Information was retrievable for 266 cases. The majority of deaths (86%) occurred in the prehospital phase. The main causes of death were suicide (33%) and road traffic accidents (21%). Drowning and snowmobile injuries accounted for an unexpectedly high proportion (12 and 8%, respectively). The time of death did not show trimodal distribution. Compared to the previous study period, there was a significant overall decline in injury-related mortality, yet there was no change in place of death, mechanism of injury, or time from injury until death. Changes in injury-related mortality cannot be linked to improvements in the trauma system. There was no change in the epidemiological patterns of injury. The high rate of on-scene mortality indicates that any major improvement in the number of injury-related deaths lies in targeted prevention. URI: http://hdl.handle.net/10037/3863 File(s) in this item: 1
article.pdf (291.0Kb) -
Becker-Merok, Andrea; Kalaaji, Manar; Haugbro, Kaia; Nikolaisen, Cathrin; Nilsen, Kirsten; Rekvig, Ole Petter; Nossent, Johannes C. (Journal article; Tidsskriftartikkel; Peer reviewed, 24-Oct-2006)[+][-]
Abstract: This study investigated the overall clinical impact of anti-α- actinin antibodies in patients with pre-selected autoimmune diseases and in a random group of anti-nuclear antibody (ANA)- positive individuals. The relation of anti-α-actinin antibodies with lupus nephritis and anti-double-stranded DNA (anti-dsDNA) antibodies represented a particular focus for the study. Using a cross-sectional design, the presence of antibodies to α-actinin was studied in selected groups, classified according to the relevant American College of Rheumatology classification criteria for systemic lupus erythematosus (SLE) (n = 99), rheumatoid arthritis (RA) (n = 68), Wegener's granulomatosis (WG) (n = 85), and fibromyalgia (FM) (n = 29), and in a random group of ANA-positive individuals (n = 142). Renal disease was defined as (increased) proteinuria with haematuria or presence of cellular casts. Sera from SLE, RA, and Sjøgren's syndrome (SS) patients had significantly higher levels of anti-α-actinin antibodies than the other patient groups. Using the geometric mean (± 2 standard deviations) in FM patients as the upper cutoff, 20% of SLE patients, 12% of RA patients, 4% of SS patients, and none of the WG patients were positive for anti-α- actinin antibodies. Within the SLE cohort, anti-α-actinin antibody levels were higher in patients with renal flares (p = 0.02) and correlated independently with anti-dsDNA antibody levels by enzyme-linked immunosorbent assay (p < 0.007) but not with other disease features. In the random ANA group, 14 individuals had anti-α-actinin antibodies. Of these, 36% had SLE, while 64% suffered from other, mostly autoimmune, disorders. Antibodies binding to α-actinin were detected in 20% of SLE patients but were not specific for SLE. They correlate with anti-dsDNA antibody levels, implying in vitro crossreactivity of anti-dsDNA antibodies, which may explain the observed association with renal disease in SLE. URI: http://hdl.handle.net/10037/1105 File(s) in this item: 1
article.pdf (273.7Kb) -
Besada, Emilio; Koldingsnes, Wenche; Nossent, Johannes C (Conference object; Konferansebidrag, 2013)[+][-]
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Kirov, Mikhail; Bjertnæs, Lars J.; Kuzkov, Vsevolod V.; Fernandez-Mondejar, Enrique (Journal article; Tidsskriftartikkel; Peer reviewed, 24-Jul-2006)[+][-]
Abstract: The evolution of extravascular lung water (EVLW) monitoring is an important step forward in the hemodynamic assessment of critically ill patients. URI: http://hdl.handle.net/10037/1109 File(s) in this item: 1
article.pdf (34.34Kb) -
Bolle, Stein Roald; Gilbert, Mads; Larsen, Frank Atle; Hagen, Oddvar (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
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Bolle, Stein Roald; Gilbert, Mads; Scholl, Jeremiah (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
Abstract: Background: Because mobile telephones may support video calls, emergency medical dispatchers may now connect visually with bystanders during pre-hospital cardiopulmonary resuscitation (CPR). We studied the quality of simulated dispatcher-assisted CPR when guidance was delivered to rescuers by video calls or audio calls from mobile phones. Methods: One hundred and eighty high school students were randomly assigned in groups of three to communicate via video calls or audio calls with experienced nurse dispatchers at a Hospital Emergency Medical Dispatch Center. CPR was performed on a recording resuscitation manikin during simulated cardiac arrest. Quality of CPR and time factors were compared depending on the type of communication used. Results: The median CPR time without chest compression (‘hands-off time’) was shorter in the video-call group vs. the audio-call group (303 vs. 331 s; P50.048), but the median time to first compression was not shorter (104 vs. 102 s; P50.29). The median time to first ventilation was insignificantly shorter in the video-call group (176 vs. 205 s; P50.16). This group also had a slightly higher proportion of ventiliations without error (0.11 vs. 0.06; P50.30). Conclusion: Video communication is unlikely to improve telephone CPR (t-CPR) significantly without proper training of dispatchers and when using dispatch protocols written for audio-only calls. Improved dispatch procedures and training for handling video calls require further investigation. Description: Denne artikkelen er en del av doktorgradsavhandlingen til Stein Roar Bolle. Avhandlingen finnes i Munin http://hdl.handle.net/10037/3597 URI: http://hdl.handle.net/10037/3598 File(s) in this item: 1
article.pdf (99.62Kb) -
Borch, Knut Håkon; Hansen-Krone, Ida; Brækkan, Sigrid Kufaas; Mathiesen, Ellisiv B.; Njølstad, Inger; Wilsgaard, Tom; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Broderstad, Ann Ragnhild (Research report; Forskningsrapport, 2011)[+][-]
Abstract: Senter for samisk helseforskning forbereder en survey i 2012 for personer som har flyttet fra samiske distriktsområder til byer. Undersøkelsen vil også omfatte barn av de som har flyttet. Som en innledende del ble det i samarbeid med NIBR gjennomført en registeranalyse. Denne rapporten gir noen resultater fra disse analysene. I første omgang var vi interessert i å undersøke hvor mange og hvor stor andel av de som hadde vokst opp i samiske områder som nå bor i en by, hvilke byer som peker seg ut, og hvordan variasjonene i flyttemønstrene for de ulike samiske områdene er. Vi valgte sju samiske kjerneområder i Nord-Norge bestående av til sammen 23 kommuner som utflyttingskommuner. By- kommunene det ble flyttet til er inndelt ti byer/bygrupper hvor alle de tradisjonelle byene i Norge er inkludert. Analysen omfatter 25 årskull, født 1950-74, altså de som var i alder 35-60 år. Av alle som hadde vokst opp i disse sju områdene bodde 36 prosent i en by i 2008. Siden surveyen også skulle omfatte barna til disse, inneholder rapporten også en analyse av fruktbarhetsnivå og barnetall for de som har flyttet til en by, til forskjell fra de som ikke har gjort det. URI: http://hdl.handle.net/10037/3722 File(s) in this item: 1
report.pdf (1.694Mb) -
Brodin, Ellen Elisabeth; Brækkan, Sigrid Kufaas; Vik, Anders; Brox, Jan; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Background Previous studies have shown an association between impaired kidney function, assessed by cystatin C-based estimated glomerular filtration rate, and venous thromboembolism. The aim of this study was to investigate whether serum cystatin C was associated with a risk of venous thromboembolism among subjects with normal kidney function in a prospective population-based study. Design and Methods Cystatin C was measured in serum from 3251 men and women with normal kidney function, aged 25–84 years, who participated in the Tromsø study in 1994–1995. Normal kidney function was defined as a creatinine-based estimated glomerular filtration rate greater than 90 mL/min/1.73 m2 and absence of microalbuminuria. Incident venous thromboembolism was registered from the date of inclusion through to the end of follow-up, September 1, 2007. Cox-regression models were used to calculate hazard ratios with 95% confidence intervals for venous thromboembolism. Results There were 83 incident venous thromboembolic events, of which 53 (63.9 %) were provoked, during a median of 12.3 years of follow-up. A one standard deviation (0.11 mg/L) increase in serum cystatin C levels was associated with a 43% (hazard ratio 1.43; 95% confidence interval 1.17–1.72) increased risk of total venous thromboembolism. Subjects with cystatin C levels in the top quartile (≥0.87 mg/L) had a 2.5-fold (hazard ratio 2.51; 95% confidence interval 1.27–4.96) increased risk of venous thromboembolism compared to those with levels in the bottom quartile (≤0.72 mg/L) in adjusted analysis. The risk estimates were even higher for provoked venous thromboembolism (hazard ratio 3.11; 95% confidence interval 1.23–7.86). Conclusions Serum cystatin C levels were associated with the risk of venous thromboembolism in subjects with normal kidney function. Our findings suggest that elevated serum cystatin C levels may promote venous thrombosis beyond reflecting impaired kidney function. URI: http://hdl.handle.net/10037/5040 File(s) in this item: 1
article.pdf (730.4Kb) -
Brækkan, Sigrid Kufaas; Mathiesen, Ellisiv B.; Njølstad, Inger; Wilsgaard, Tom; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Brøndbo, Per Håkan; Mathiassen, Børge Idar; Martinussen, Monica; Heiervang, Einar; Eriksen, Mads; Kvernmo, Siv (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Objective: This study examined the agreement between diagnoses and severity ratings assigned by clinicians using a structured web-based interview within a child and adolescent mental health outpatient setting. Method: Information on 100 youths was obtained from multiple informants through a web-based Development and Well-Being Assessment (DAWBA). Based on this information, four experienced clinicians independently diagnosed (according to the International Classification of Diseases Revision 10) and rated the severity of mental health problems according to the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (C-GAS). Results: Agreement for diagnosis was κ=0.69-0.82. Intra-class correlation for single measures was 0.78 for HoNOSCA and 0.74 for C-GAS, and 0.93 and 0.92, respectively for average measures. Conclusions: Agreement was good to excellent for all diagnostic categories. Agreement for severity was moderate, but improved to substantial when the average of the ratings given by all clinicians was considered. Therefore, we conclude that experienced clinicians can assign reliable diagnoses and assess severity based on DAWBA data collected online. Description: This paper is part of Per Håkon Brøndbo's doctoral thesis. Available in Munin at http://hdl.handle.net/10037/4521 URI: http://hdl.handle.net/10037/4435 File(s) in this item: 1
article.pdf (107.2Kb) -
Cabana, Álvaro; Valle-Lisboa, Juan C.; Elvevåg, Brita; Mizraji, Eduardo (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Abstract Several psychiatric and neurological conditions affect the semantic organization and content of a patient's speech. Specifically, the discourse of patients with schizophrenia is frequently characterized as lacking coherence. The evaluation of disturbances in discourse is often used in diagnosis and in assessing treatment efficacy, and is an important factor in prognosis. Measuring these deviations, such as “loss of meaning” and incoherence, is difficult and requires substantial human effort. Computational procedures can be employed to characterize the nature of the anomalies in discourse. We present a set of new tools derived from network theory and information science that may assist in empirical and clinical studies of communication patterns in patients, and provide the foundation for future automatic procedures. First we review information science and complex network approaches to measuring semantic coherence, and then we introduce a representation of discourse that allows for the computation of measures of disorganization. Finally we apply these tools to speech transcriptions from patients and a healthy participant, illustrating the implications and potential of this novel framework. URI: http://hdl.handle.net/10037/4094 File(s) in this item: 1
article.pdf (659.7Kb) -
Cavanagh, Jorunn Pauline; Klingenberg, Claus Andreas; Hanssen, Anne-Merethe; Aarag, Elizabeth; Francois, Patrice; Schrenzel, Jaques; Flægstad, Trond; Sollid, Johanna U Ericson (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: The notoriously multi-resistant Staphylococcus haemolyticus is an emerging pathogen causing serious infections in immunocompromised patients. Defining the population structure is important to detect outbreaks and spread of antimicrobial resistant clones. Currently, the standard typing technique is pulsed-field gel electrophoresis (PFGE). In this study we describe novel molecular typing schemes for S. haemolyticus using multi locus sequence typing (MLST) and multi locus variable number of tandem repeats (VNTR) analysis. Seven housekeeping genes (MLST) and five VNTR loci (MLVF) were selected for the novel typing schemes. A panel of 45 human and veterinary S. haemolyticus isolates was investigated. The collection had diverse PFGE patterns (38 PFGE types) and was sampled over a 20 year-period from eight countries. MLST resolved 17 sequence types (Simpsons index of diversity [SID] = 0.877) and MLVF resolved 14 repeat types (SID = 0.831). We found a low sequence diversity. Phylogenetic analysis clustered the isolates in three (MLST) and one (MLVF) clonal complexes, respectively. Taken together, neither the MLST nor the MLVF scheme was suitable to resolve the population structure of this S. haemolyticus collection. Future MLVF and MLST schemes will benefit from addition of more variable core genome sequences identified by comparing different fully sequenced S. haemolyticus genomes. URI: http://hdl.handle.net/10037/4354 File(s) in this item: 1
article.pdf (332.1Kb) -
Chen, Wei; Lim, Chi Eung Danforn; Kang, Hong-Jun; Liu, Jianping (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Chinese herbs are thought to be effective for type A H1N1 influenza. Series of Chinese herbs have been authorized recommended by the Chinese government, and until now a number of clinical trials of Chinese herbs for H1N1 influenza have been conducted. However, there is no critically appraised evidence such as systematic reviews or metaanalyses on potential benefits and harms of medicinal herbs for H1N1 influenza to justify their clinical use and their recommendation. CENTRAL, MEDLINE, EMBASE, CBM, CNKI, VIP, China Important Conference Papers Database, China Dissertation Database, and online clinical trial registry websites were searched for published and unpublished randomized controlled trials (RCTs) of Chinese herbs for H1N1 influenza till 31 August, 2011. A total of 26 RCTs were identified and reviewed. Most of the RCTs were of high risk of bias with flawed study design and poor methodological quality. The combination of several Chinese herbal medicines with or without oseltamivir demonstrated positive effect on fever resolution, relief of symptoms, and global effectiveness rate compared to oseltamivir alone. However, only one herbal medicine showed positive effect on viral shedding. Most of the trials did not report adverse events, and the safety of herbal medicines is still uncertain. Some Chinese herbal medicines demonstrated potential positive effect for 2009 type A H1N1 influenza; however, due to the lack of placebo controlled trial and lack of repeated test of the intervention, we could not draw confirmative conclusions on the beneficial effect of Chinese herbs for H1N1 influenza. More rigorous trials are warranted to support their clinical use. URI: http://hdl.handle.net/10037/3961 File(s) in this item: 1
article.pdf (186.0Kb) -
Chrisanthar, Ranjan; Knappskog, Stian; Løkkevik, Erik; Anker, Gun Birgitta; Østenstad, Bjørn; Lundgren, Steinar; Risberg, Terje; Mjaaland, Ingvil; Skjønsberg, Gudbrand; Aas, Turid; Schlichting, Ellen; Fjøsne, Hans Erikssønn; Nysted, Arne; Lillehaug, Johan R.; Lønning, Per Eystein (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: TP53 mutations have been associated with resistance to anthracyclines but not to taxanes in breast cancer patients. The MDM2 promoter single nucleotide polymorphism (SNP) T309G increases MDM2 activity and may reduce wildtype p53 protein activity. Here, we explored the predictive and prognostic value of TP53 and CHEK2 mutation status together with MDM2 SNP309 genotype in stage III breast cancer patients receiving paclitaxel or epirubicin monotherapy. Each patient was randomly assigned to treatment with epirubicin 90 mg/m2 (n= 109) or paclitaxel 200 mg/m2 (n = 114) every 3rd week as monotherapy for 4–6 cycles. Patients obtaining a suboptimal response on first-line treatment requiring further chemotherapy received the opposite regimen. Time from last patient inclusion to follow-up censoring was 69 months. Each patient had snap-frozen tumor tissue specimens collected prior to commencing chemotherapy. While TP53 and CHEK2 mutations predicted resistance to epirubicin, MDM2 status did not. Neither TP53/ CHEK2 mutations nor MDM2 status was associated with paclitaxel response. Remarkably, TP53 mutations (p = 0.007) but also MDM2 309TG/GG genotype status (p = 0.012) were associated with a poor disease-specific survival among patients having paclitaxel but not patients having epirubicin first-line. The effect of MDM2 status was observed among individuals harbouring wild-type TP53 (p = 0.039) but not among individuals with TP53 mutated tumors (p.0.5). TP53 and CHEK2 mutations were associated with lack of response to epirubicin monotherapy. In contrast, TP53 mutations and MDM2 309G allele status conferred poor disease-specific survival among patients treated with primary paclitaxel but not epirubicin monotherapy. URI: http://hdl.handle.net/10037/3971 File(s) in this item: 1
article.pdf (593.3Kb) -
Conley, Lene N.; Mortensen, Kim Erlend; Nygaard, Ingvild; Sorenesen, Peter; Mortensen, Elin; Bendixen, Christian; Revhaug, Arthur (Journal article; Tidsskriftartikkel; Peer reviewed, 20-Jan-2010)[+][-]
Abstract: Background: Hemodynamic changes in the liver remnant following partial hepatectomy (PHx) have been suggested to be a primary stimulus in triggering liver regeneration. We hypothesized that it is the increased sinusoidal flow per se and hence the shear-stress stimulus on the endothelial surface within the liver remnant which is the main stimulus to regeneration. In order to test this hypothesis we wanted to increase the sinusoidal flow without performing a concomitant liver resection. Accordingly, we constructed an aorto-portal shunt to the left portal vein branch creating a standardized four-fold increase in flow to segments II, III and IV. The impact of this manipulation was studied in both an acute model (6 animals, 9 hours) using a global porcine cDNA microarray chip and in a chronic model observing weight and histological changes (7 animals, 3 weeks).
Results: Gene expression profiling from the shunted segments does not suggest that increased sinusoidal flow per se results in activation of genes promoting mitosis. Hyperperfusion over three weeks results in the whole liver gaining a supranormal weight of 3.9% of the total body weight (versus the normal 2.5%). Contrary to our hypothesis, the weight gain was observed on the non-shunted side without an increase in sinusoidal flow.
Conclusions: An isolated increase in sinusoidal flow does not have the same genetic, microscopic or macroscopic impact on the liver as that seen in the liver remnant after partial hepatectomy, indicating that increased sinusoidal flow may not be a sufficient stimulus in itself for the initiation of liver regeneration.Description: This article is part of Kim Erlend Mortensen's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2893 URI: http://hdl.handle.net/10037/2895 File(s) in this item: 1
article.pdf (10.97Mb) -
Conley, LN; Mortensen, Kim Erlend; Nygård, Ingvild; Sørensen, Peter; Mortensen, Elin; Bendixen, C; Revhaug, Arthur (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Dalhaug, A; Nieder, Carsten; Haukland, E (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Damsgård, Elin; Thrane, Gyrd; Anke, Audny; Fors, Terese; Røe, Cecilie (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
Abstract: Purpose. Activity related pain may be a barrier to rehabilitation in patients with chronic musculoskeletal disorders. This study investigated patients’ reports of increased pain during activity, and the association between such pain and psychological factors and pain variables. Method. Questionnaires from 232 adults with chronic musculoskeletal pain measured pain intensity, spread of pain and pain duration. Pain during activity was assessed both on a 11 point Numeric Rating Scale (NRS), and operationalized as a dichotomous measure, where responders defined if they experienced pain during general activity and exercise. Psychological factors were measured by the Hopkins Symptom Check List 25, the Tampa Scale for Kinesiophobia and a subscale of the Arthritis Self – Efficacy Scale. Multiple and logistic regression was used to analyse associations between increased pain during activity and associated variables. Results. Increased pain during activity was reported by 69 % of participants. Fear of movement was a significant factor for reporting increased pain during activity, both general activity and exercise, also in a subsample with low psychological distress. Other significant factors were spread of pain and a low sense of self efficacy. Conclusion. Patients with high fear of movement, large spread of pain and low self efficacy were more likely to report increased pain during activity even in the absence of psychological distress. Description: Accepted manuscript version, reprinted with permission (Informa Helthcare).
Published version available at http://dx.doi.org/10.3109/09638280903567877
This article is part of Elin Damsgård's doctoral thesis which is available in Munin at http://hdl.handle.net/10037/2500URI: http://hdl.handle.net/10037/3549 File(s) in this item: 1
article.pdf (336.4Kb) -
Dehli, Trond; Fredriksen, Knut; Osbakk, Svein Are; Bartnes, Kristian (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Background: Admission with a multidisciplinary trauma team may be vital for the severely injured patient, as this facilitates rapid diagnosis and treatment. On the other hand, patients with minor injuries do not need the trauma team for adequate care. Correct triage is important for optimal resource utilization. The aim of the study was to evaluate our criteria for activating the trauma team, and identify suboptimal criteria that might be changed in the interest of precision. The study is an observational, retrospective cohort-study. All patients admitted with the trauma team (n = 382), all severely injured (Injury Severity Score (ISS) >15) (n = 161), and all undergoing an emergency procedure aimed at counteracting compromised airways, respiration or circulation at our hospital (n = 142) during 2006-2007 were included. Data were recorded from the admission records and the electronic patient records. The trauma team activation protocol was evaluated against the occurrence of severe injury and the occurrence of emergency procedures. A total of 441 patients were included. The overtriage was 71% and undertriage 32% when evaluating against ISS >15 as the standard of reference. When occurrence of emergency procedures was held as the standard of standard of reference, the over- and undertriage was 71% and 21%, respectively. Mechanism of injury-criteria for trauma team activation contributed the most to overtriage. The emergency procedures performed were mostly endotracheal intubation and external fixation of fractures. Less than 3% needed haemostatic laparotomy or thoracotomy. Approximately 2/3 of the overtriage represented isolated head or cervical spine injuries, and/or interhospital transfers. The over- and undertriage of our protocol are both too high. To decrease overtriage we suggest omissions and modifications of some of the criteria. To decrease undertriage, transferred patients and patients with head injuries should be more thoroughly assessed against the trauma team activation criteria. URI: http://hdl.handle.net/10037/3866 File(s) in this item: 1
article.pdf (239.6Kb)
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