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Browsing Artikler, rapporter og annet (klinisk medisin) by Author
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Efskind, Marianne; Heskestad, Ben Ottar; Ingebrigtsen, Tor; Romner, Bertil; RØNNING, PÅL ANDRE; Helseth, Eirik (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: In 2000 the Scandinavian Neurotrauma Committee published guidelines for safe and cost-effective management of minimal, mild and moderate head injured patients. The aims of this study were to investigate to what extent the head injury population is under the influence of alcohol, and to evaluate whether the physicians’ compliance to the guidelines is affected when patients are influenced by alcohol. This study included adult patients (≥15 years) referred to a Norwegian University Hospital with minimal, mild and moderate head injuries classified according to the Head Injury Severity Scale (HISS). Information on alcohol consumption was recorded, and in most of these patients blood alcohol concentration (BAC) was measured. Compliance with the abovementioned guidelines was registered. The study includes 860 patients. 35.8% of the patients had consumed alcohol, and 92.1% of these patients had a BAC ≥ 1.00‰. Young age, male gender, trauma occurring during the weekends, mild and moderate head injuries were independent factors significantly associated with being under the influence of alcohol. Guideline compliance was 60.5%, and over-triage was the main violation. The guideline compliance showed no significant correlation to alcohol consumption or to BAC-level. This study confirms that alcohol consumption is common among patients with head injuries. The physicians’ guideline compliance was not affected by the patients’ alcohol consumption, and alcohol influence could therefore not explain the low guideline compliance. URI: http://hdl.handle.net/10037/3947 File(s) in this item: 1
article.pdf (237.9Kb) -
Eilertsen, Gro Østli; Ghelue, Marijke van; Nossent, Johannes C (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: B cell activating factor (BAFF) inhibitor therapy has recently been approved for non-renal Systemic Lupus Erythematosus (SLE). While BAFF plays a role in experimental lupus nephritis (LN), its role human LN is not well studied. Case control study in 102 SLE patients, 30 with LN (+LN) and 72 without LN (-LN) and 31 healthy controls. We analysed BAFF mRNA expression in PBMCs (BAFF-RQ) and serum BAFF (s-BAFF) levels and investigated their relation with clinical, histological- and additional acute phase proteins. Results: s-BAFF and BAFF-RQ were increased in +LN patients compared to controls, but their expression did not correlate with ISN/RPS class, Activity- or Chronicity index on biopsy. s-BAFF correlated with levels of anti-nucleosome antibodies, C1 inhibitor and α-1-acid-glycoprotein (AGP), while BAFF-RQ correlated inversely with Factor VIII. s-BAFF and BAFF mRNA levels are increased in LN patients, but do not reflect histological disease severity. The association of increased BAFF expression with both pro- and anti-inflammatory markers and reduced endothelial activation suggest that BAFF inhibition in LN may have diverse effects. URI: http://hdl.handle.net/10037/4748 File(s) in this item: 1
article.pdf (1.568Mb) -
Eilertsen, Gro Østli; Becker-Merok, Andrea; Nossent, Johannes C (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
Abstract: The influence of the 1997 updated classification criteria for systemic lupus erythematosus: epidemiology, disease presentation, and patient management. Eilertsen GØ, Becker-Merok A, Nossent JC. Department of Rheumatology, Medical School, University of Tromsø, 9037 Tromsø, Norway. gro.ostli.eilertsen@unn.no OBJECTIVE: The 1997 update of the American College of Rheumatology classification criteria (ACR97) for systemic lupus erythematosus (SLE) has not been validated. We determined to what extent their introduction influenced the epidemiology and clinical characteristics of the disease in northern Norway. METHODS: Annual incidence and point-prevalence rates, clinical manifestations, and outcome were determined in an inception cohort of patients with SLE in northern Norway, included between 1996 and 2006, using ACR97 criteria (97acr). These findings were compared with a cohort from the same area enrolled 1978-1995 using the 1982 revised criteria ACR82 (82acr). RESULTS: The mean annual incidence of SLE was 3.00 for cohort 97acr (n = 58) versus 2.63 for cohort 82acr (n = 81) (p = 0.5). All patients in the 97acr cohort also fulfilled the 1982 criteria; however, significantly fewer patients presented with discoid rash [odds ratio (OR) 0.31)], arthritis (OR 0.24), renal (OR 0.28) or hematological disorder (OR 0.27), and significantly more with anti-dsDNA (OR 2.57) and antiphospholipid antibodies (OR 27.9). Initial treatment with intravenous pulse methylprednisolone (OR 9.23), azathioprine (OR 6.32), and low-dose aspirin (OR 20.9) was increased in cohort 97acr. Five- (95.2%) and 10-year survival (91.9%) rates were also improved for cohort 97acr. CONCLUSION: The ACR97 criteria set has construct validity compared to the ACR82 criteria set. SLE incidence remains unchanged in northern Norway, but a significant reduction of renal disease and further improvements in survival rates occurred simultaneously with increased serological surveillance with ELISA-based assays and early immunosuppressive and anticoagulant therapy. URI: http://hdl.handle.net/10037/3282 File(s) in this item: 1
article.pdf (157.2Kb) -
Eilertsen, Gro Østli; Van Ghelue, Marijke; Nossent, Johannes C (Journal article; Tidsskriftartikkel, 2011)[+][-]
Abstract: Objectives. To determine whether increased levels of B-cell activating factor (BAFF) in patients with SLE are due to disease activity or genetic variations in the promoter region of the BAFF gene and BAFF gene expression. Methods. The case-control study included 101 SLE patients and 111 healthy controls. Five single nucleotide polymorphisms (SNPs) in the BAFF promoter region were investigated by melting point analysis: c.-2841 (T > C), c.-2704 (T > C), c.-2701 (A > T), c.-871 (C > T) and c.-514 (A > G). BAFF mRNA levels were determined by real-time PCR (BAFF-RQ) and serum BAFF (s-BAFF) levels were measured by ELISA. Independent predictors that might be correlated with increased s-BAFF in SLE patients were analysed by multivariate regression methods. Results. Although s-BAFF levels were increased in SLE patients (1.73 vs 0.98 ng/μl, P < 0.001), no specific BAFF genotype was found to associate with SLE. The different genotypes defined by the investigated SNPs were identified both in SLE patients and healthy controls with similar frequencies. No association was found between BAFF genotype and BAFF-RQ. s-BAFF was independent of other factors, correlated with CRP (β = 0.40, P < 0.001) and physician's visual analogue score (R = 0.21, P = 0.046) and inversely with haemoglobin (β = -0.32, P < 0.001) and IgA (β = -0.33, P = 0.001). Conclusions. Increased s-BAFF levels in SLE patients are associated with the acute-phase responses, CRP and haemoglobin, but probably not dependent on BAFF genotype or expression. This indicates that s-BAFF production occurs at sites of inflammation. Description: This article is part of Gro Østli Eilertsen's doctoral thesis. Available in Munin at http://hdl.handle.net/10037/3594 URI: http://hdl.handle.net/10037/3837 File(s) in this item: 1
article.pdf (212.7Kb) -
Ekeland, Anne G.; Bowes, Alison; Flottorp, Signe (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Previous reviews have expressed concerns about the quality of telemedicine studies. There is debate about shortcomings and appropriate methodologies. The aim of this review of systematic reviews of telemedicine is to summarize methodologies used in telemedicine research, discuss knowledge gaps and recommendations and suggest methodological approaches for further research. URI: http://hdl.handle.net/10037/4591 File(s) in this item: 1
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Ellingsen, Gunnar; Munkvold, Glenn (Journal article; Tidsskriftartikkel; Peer reviewed, 2007)[+][-]
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Ellingsen, Gunnar Adelsten; Røed, Kristoffer (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Elstad, Ingunn (Chapter; Bokkapittel, 2007)[+][-]
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Elstad, Ingunn (Chapter; Bokkapittel, 2007)[+][-]
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Elstad, Ingunn (Working paper; Arbeidsnotat, 2006)[+][-]
Abstract: The article explores the history of voluntary district nursing in Northern Norway 1880- 1940. A popular movement of women’s associations met the tuberculosis epidemic, which peaked late in the North. District nursing was developed partly from the European movement of Christian relief and sick care, partly from local traditions of neighbourly assistance. Local girls were trained and employed by local associations. This service was especially important to sick peasant women with families, as the nurses stayed in the homes during a crisis, and did the work that was needed as well as nursing. Between the wars, the international public health movement brought a focus on preventive public health nursing to the central leaders of the tuberculosis movement of Norway. Funds were made available to local associations, on condition that the nurse’s work was re-defined from sick care to public prevention, and directed by the medical officer. This medical corporativism was only partly successful, as sick nursing continued locally. District nursing in the North illustrates the central-local difference, the implicit gender issue, and the tension between sickness or health focus in the development of modern health care. Description: Dette er manus til den trykte artikkelen, den elektroniske utgaven kan derfor avvike fra den trykte utgaven i enkelte detaljer. URI: http://hdl.handle.net/10037/759 File(s) in this item: 1
article.pdf (67.20Kb) -
Elvevåg, Brita; Helsen, Kim; De Hert, Marc; Sweers, Kim; Storms, Gert (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The nature of putative semantic anomalies in schizophrenia is controversial. Metaphor interpretation and use provide a useful methodology with which to probe semantics since metaphors are critical in reasoning processes and in how conceptual knowledge is organized. The first study examined free speech for figurative language. The second study explored whether emotional versus non-emotional metaphorical language interpretation elicits differences in the tendencies to produce idiosyncratic (bizarre) or literal interpretations or use of other metaphors to describe the meaning of a metaphor. The third study examined the interpretation of time metaphors. We expected the time perspective in ambiguous sentences to be differentially influenced by previously presented unambiguous sentences of a specific perspective, either events moving relative to a stationary observer (moving-time) or an observer moving relative to a stationary event (moving-ego). First, we found that patients used a similar amount of figurative language as control participants. Second, we did not find any difference between the groups in terms of idiosyncratic interpretations, although patients did interpret more metaphors literally and controls utilized more figurative language. Third, we did not find evidence of a difference between the groups in terms of time perspectives influencing ambiguous target sentences differentially. As operationalized here, the interpretation and use of metaphors is similar in patients with schizophrenia to that of healthy control participants. To the extent that metaphors recruit semantic processes this area of cognition is generally intact in schizophrenia. URI: http://hdl.handle.net/10037/4095 File(s) in this item: 1
article.pdf (331.4Kb) -
Eriksen, Bjørn Odvar; Evensen, Elin (Journal article; Tidsskriftartikkel; Peer reviewed, 2006)[+][-]
Abstract: Bakgrunn: Norsk medisinsk forskning hevder seg dårlig i nordisk sammenheng. Ved UniversitetssykehusetNord-Norge (UNN) ble forskningsaktivitet og hindringer for klinisk forskning undersøktmed en spørreskjemaundersøkelse i år 2000. Denne undersøkelsen er nå gjentatt etter fem år for å se omforholdene er endret.Materiale og metode: Alle leger og psykologer ved UNN fikk i mai 2005 tilsendt det samme spørreskjemaetsom ble brukt i år 2000.Resultater: Etter purring hadde 433 (82%) av 530 spurte svart. 48% deltok i et pågående forskningsprosjekt(38% i et prosjekt som kvalifiserte til medforfatterskap, 5% i et prosjekt initiert av industrien, 5% ibegge typer prosjekter). 22% av de spurte oppgav å ha doktorgrad, 28% hadde publisert i fagfellevurderttidsskrift uten å ha doktorgrad, mens 28% ikke hadde publisert i slike tidsskrifter. Av faktorersom hindret forskning eller økt forskningsaktivitet, angav 84% mangel på tid, 52% faktorer sompotensielt kunne avhjelpes av sykehusets apparat for forskningsstøtte og 35% andre faktorer. Uttrykt iprosentandeler var det små endringer i svarene i forhold til år 2000.Fortolkning: Det har ikke skjedd noen endring i andelen ansatte engasjert i forskning ved UNN fra2000 til 2005. Fortsatt oppleves mangel på tid som den viktigste hindringen for forskning. URI: http://hdl.handle.net/10037/3283 File(s) in this item: 1
article.pdf (417.3Kb) -
Fattah, Sabina; Krüger, Andreas J.; Andersen, Jan Einar; vigerust, trond; Rehn, Marius (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: A major incident has occurred when the number of live casualties, severity, type of incident or location requires extraordinary resources. Major incident management is interdisciplinary and involves triage, treatment and transport of patients. We aimed to investigate experiences within major incident preparedness and management among Norwegian rescue workers. A questionnaire was answered by 918 rescue workers across Norway. Questions rated from 1 (doesn’t work) to 7 (works excellently) are presented as median and range. Health-care personnel constituted 34.1% of the participants, firefighters 54.1% and police 11.8%. Training for major incident response scored 5 (1, 7) among health-care workers and 4 (1, 7) among firefighters and police. Preparedness for major incident response scored 5 (1, 7) for all professions. Interdisciplinary cooperation scored 5 (3, 7) among health-care workers and police and 5 (1, 7) among firefighters. Among health-care workers, 77.5% answered that a system for major-incident triage exists; 56.3% had triage equipment available. The majority – 45.1% of health-care workers, 44.7% of firefighters and 60.4% of police – did not know how long it would take to get emergency stretchers to the scene. Rescue personnel find major incident preparedness and on-scene multidisciplinary cooperation to function well. Some shortcomings are reported with regard to systems for major incident triage, tagging equipment for triage and knowledge about access to emergency stretchers. URI: http://hdl.handle.net/10037/4933 File(s) in this item: 1
article.pdf (842.8Kb) -
Fattah, Sabina; Rehn, Marius; Reierth, Eirik; Wisborg, Torben (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Introduction In 2010, a total of 385 natural disasters killed more than 297 000 people worldwide and affected over 217 million others. More standardised reporting of major incident management have been advocated in the previous years. Prevention, mitigation, preparedness and major incident response may be improved through collection and analysis of high-quality standardised data on medical management of major incidents. Standardised data may elevate the level of scientific evidence within disaster medicine research. Methods and analysis A systematic literature review will be conducted to identify templates for reporting pre-hospital major incident medical management. The first set of entry terms aims to describe major incidents published during the last 20 years. The second set aims to focus the number of search results from the first set to those publications that describe templates based on data collections from these major incidents. Predefined free search phases will be combined with the first two sets. URI: http://hdl.handle.net/10037/4155 File(s) in this item: 1
article.pdf (574.7Kb) -
Figenschau, Kristian; Hunskaar, Steinar; Breivik, Jarle; Hansen, John-Bjarne; Siebke, Else-Marie; Tømmerås, Karin (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
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Gilje, Fredricka; Fjelltun, Aud-Mari Sohini; Henriksen, Nils; Norberg, Astrid; Normann, Hans Ketil (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
Abstract: Aim: The aim of this study was to explore experiences with overnight respite care (ORC) of Norwegian carers who provided care to frail elderly awaiting nursing home placement.
Background: In many Western countries respite care has become part of health care service provision, and various types of respite care are available. The intent with respite care can be twofold; caring for the care receiver and supporting the carer.
Methods: This is a descriptive qualitative study. Interviews were conducted with 15 carers, transcribed and analysed by qualitative content analysis.
Findings: The carers described various experiences with ORC. If ORC supported the whole family, it was welcomed by carers and experienced as supportive. If ORC did not support the whole family, many carers rejected ORC, and it was experienced as non-supportive. Two categories were constructed: ‘experiencing ORC as supportive for the family as a whole’ and ‘not experiencing ORC as supportive for the family as a whole’.
Conclusion: To support more carers, nurses have to listen to carers’ experiences about ORC. Nurses need to take responsibility for the family as a whole and provide more flexible ORC services based on both carers’ and elderly’s needs.URI: http://hdl.handle.net/10037/2159 File(s) in this item: 1
article.pdf (72.01Kb) -
Florholmen, Jon; Kristiansen, Magnhild Gangsøy; Steigen, sonja eriksson; Sørbye, Sveinung Wergeland; Paulssen, Eyvind Jakob; Kvamme, J.M.; Zbigniew, Konopski; Gutteberg, tore jarl; Goll, Rasmus (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The role of chemokines in chronic hepatitis C virus (HCV) infection is not fully understood. The present study aimed to characterize the baseline serum concentrations and the initial β-chemokine response to treatment with interferon-α and ribavirin with respect to the final clinical outcome of virological response to treatment. Serum concentrations of alanine aminotransferase (ALT) and of the CC subfamily chemokines [macrophage inflammatory protein (MIP)-1α, MIP-1β, monocyte chemoattractant protein (MCP)-1 and the regulated on activation, normal T expressed and secreted (RANTES) chemokine] were measured in patients with chronic HCV infection and in healthy individuals. Necroinflammation and fibrosis were scored in liver biopsies. Treatment outcomes were classified as with or without a sustained virological response after a full-course treatment according to the genotypes. The main treatment group consisted of 72 patients with chronic hepatitis C, whereas 24-h blood samples were available for 42 patients. Increased baseline levels of all CC chemokines were found in the two responder groups compared to the healthy controls, although significant levels were reached only for MIP-1α and MCP-1. No correlation was observed between chemokine levels and serum ALT levels, any histological necroinflammatory parameters, or the fibrosis grade. After 24 h of treatment, increases in MIP-1α, MIP-1β and RANTES levels were exclusively observed in the group with sustained virological response. MCP-1 was also significantly increased after 24 h in both responder groups, although no differences were observed between the two responder groups. In conclusion, an early MIP-1α, MIP-1β, and RANTES response may predict a sustained response to virological treatment. URI: http://hdl.handle.net/10037/4048 File(s) in this item: 1
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Gabarron, Elia; Serrano, Jose Artur F S Vale; Wynn, Rolf; Armayones Ruiz, Manuel (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Sexually transmitted diseases (STDs), especially the Chlamydia trachomatis bacterial infection, a common cause of infertility, are highly prevalent in developed countries, and a worrying problem in North Norway, where the incidence of chlamydia twice the Norwegian average. Seventy percent of reported chlamydia cases are found in people below 25 years of age, and although its spread could be controlled with proper prevention, young people are more aware of the risks of unwanted pregnancy than their risk of acquiring a STD. Information and Communication Technologies, including, the Internet, social media and/or smartphones, should be valued for sexual health promotion for their potential to engage young audiences. And in these media, avatars guarantee anonymity to users when handling sensitive information. The main objective of this project is to achieve that North Norwegian youngsters become more aware of STDs through the use of popular technologies among young people. URI: http://hdl.handle.net/10037/4891 File(s) in this item: 1
article.pdf (188.5Kb) -
Krogstad, Unni; Gilbert, Mads; Ormstad, Sari Susanna; Rygh, Liv; Arntzen, Elisabeth; Baalsrud, Anders; Nilsen, Stein Tore (Research report; Forskningsrapport, 2007)[+][-]
Abstract: Helse Øst RHF har bedt Kunnskapssenteret om å vurdere dokumentasjonen for de seks satsingsområdene kampanjen fokuserer på: Etablere 'Rapid response team' (ekspertgruppe som tilkalles ved forverret tilstand hos pasienter) gjennomføre evidensbaserte behandlingstiltak for alle hjerteinfarktpasienter, forebygge legemiddelrelaterte pasientskader, forebygge postoperative sårinfeksjoner, forebygge respiratorassosierte lungebetennelse og forebygge alvorlige infeksjoner i forbindelse med sentralt venekateter."Pasientsikkerhet i sykehus – kunnskap eller kampanje?" (no english title) URI: http://hdl.handle.net/10037/3214 File(s) in this item: 1
article.pdf (595.7Kb) -
Olsen, Trine; Goll, Rasmus; Florholmen, Jon; Cui, Guanglin (Journal article; Tidsskriftartikkel; Peer reviewed, 03-Mar-2006)[+][-]
Abstract: Background In real-time PCR data analysis, the cycle threshold (CT) method is currently the gold standard. This method is based on an assumption of equal PCR efficiency in all reactions, and precision may suffer if this condition is not met. Nonlinear regression analysis (NLR) or curve fitting has therefore been suggested as an alternative to the cycle threshold method for absolute quantitation. The advantages of NLR are that the individual sample efficiency is simulated by the model and that absolute quantitation is possible without a standard curve, releasing reaction wells for unknown samples. However, the calculation method has not been evaluated systematically and has not previously been applied to a TaqMan platform. Aim: To develop and evaluate an automated NLR algorithm capable of generating batch production regression analysis. Results Total RNA samples extracted from human gastric mucosa were reverse transcribed and analysed for TNFA, IL18 and ACTB by TaqMan real-time PCR. Fluorescence data were analysed by the regular CT method with a standard curve, and by NLR with a positive control for conversion of fluorescence intensity to copy number, and for this purpose an automated algorithm was written in SPSS syntax. Eleven separate regression models were tested, and the output data was subjected to Altman-Bland analysis. The Altman-Bland analysis showed that the best regression model yielded quantitative data with an intra-assay variation of 58% vs. 24% for the CT derived copy numbers, and with a mean inter-method deviation of × 0.8. Conclusion NLR can be automated for batch production analysis, but the CT method is more precise for absolute quantitation in the present setting. The observed inter-method deviation is an indication that assessment of the fluorescence conversion factor used in the regression method can be improved. However, the versatility depends on the level of precision required, and in some settings the increased cost effectiveness of NLR may justify the lower precision. URI: http://hdl.handle.net/10037/1120 File(s) in this item: 1
article.pdf (420.2Kb)
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