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  • 1
    Online Resource
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    Subjective health complaints predict functional outcome six months after stroke
    Hindawi Limited ; 2017
    In:  Acta Neurologica Scandinavica Vol. 135, No. 2 ( 2017-02), p. 161-169
    Details
    In: Acta Neurologica Scandinavica, Hindawi Limited, Vol. 135, No. 2 ( 2017-02), p. 161-169
    Type of Medium: Online Resource
    ISSN: 0001-6314
    URL: Issue
    URL: Article
    DOI: 10.1111/ane.2017.135.issue-2
    DOI: 10.1111/ane.12624
    RVK:
    XA 10000
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2017
    detail.hit.zdb_id: 2001898-8
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  • 2
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    Risk Factors for Complications following Introduction of Radical Surgery for Colon Cancer: A Consecutive Patient Series
    SAGE Publications ; 2019
    In:  Scandinavian Journal of Surgery Vol. 108, No. 2 ( 2019-06), p. 144-151
    Details
    In: Scandinavian Journal of Surgery, SAGE Publications, Vol. 108, No. 2 ( 2019-06), p. 144-151
    Abstract: Rectal cancer surgery is standardized, resulting in improved survival. Colon cancer has fallen behind and therefore more radical surgical techniques have been introduced. One technique is complete mesocolic excision. The aim of this article was to study the complications after the introduction of standardized complete mesocolic excision in a single center. Methods: Complete mesocolic excision was introduced in 2007, and data were collected from 286 patients prior to surgery (2007–2010). The surgeon decided on open or laparoscopic surgery. Follow-up information was recorded until 31 December 2015. Complications were classified according to a modified Clavien–Dindo classification. Results: Complications occurred in 47%, severe complications (grade III and IV) in 15%. In-hospital mortality was 3.5%. A total of 142 patients (49.7%) were operated by open surgery. Logistic regression revealed anemia (p = 0.001), open surgery (p  〈  0.001), and long operating time (p  〈  0.001) as significant factors for complications in general. Multinomial logistic regression revealed that severe complications occurred more often in males (odds ratio: 2.56; 95% confidence interval: 0.98–6.68), patients with anemia (odds ratio: 3.49; 95% confidence interval: 1.27–9.60), elevated body mass index (odds ratio: 1.14; 95% confidence interval: 1.02–1.28), and in open surgery (odds ratio: 9.95; 95% confidence interval: 2.58–38.35). Age was not associated with severe complications. Survival was not significantly influenced by complications. Overall survival (5 years) was 90% among patients with complications and 92% among those without complications. Conclusion: Severe complications following the introduction of complete mesocolic excision are patient dependent and related to open surgery. Patients selected for laparoscopy had less number of complications; therefore, introducing complete mesocolic excision by laparoscopy is justified. Identification of these factors can improve selection of appropriate surgical approach and postoperative patient safety.
    Type of Medium: Online Resource
    ISSN: 1457-4969 , 1799-7267
    URL: Article
    DOI: 10.1177/1457496918798208
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2486211-3
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  • 3
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    Online Resource
    Accuracy of surgical complication rate estimation using ICD-10 codes
    Oxford University Press (OUP) ; 2019
    In:  British Journal of Surgery Vol. 106, No. 3 ( 2019-02-06), p. 236-244
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 106, No. 3 ( 2019-02-06), p. 236-244
    Abstract: The ICD-10 codes are used globally for comparison of diagnoses and complications, and are an important tool for the development of patient safety, healthcare policies and the health economy. The aim of this study was to investigate the accuracy of verified complication rates in surgical admissions identified by ICD-10 codes and to validate these estimates against complications identified using the established Global Trigger Tool (GTT) methodology. Methods This was a prospective observational study of a sample of surgical admissions in two Norwegian hospitals. Complications were identified and classified by two expert GTT teams who reviewed patients' medical records. Three trained reviewers verified ICD-10 codes indicating a complication present on admission or emerging in hospital. Results A total of 700 admissions were drawn randomly from 12 966 procedures. Some 519 possible complications were identified in 332 of 700 admissions (47·4 per cent) from ICD-10 codes. Verification of the ICD-10 codes against information from patients' medical records confirmed 298 as in-hospital complications in 141 of 700 admissions (20·1 per cent). Using GTT methodology, 331 complications were found in 212 of 700 admissions (30·3 per cent). Agreement between the two methods reached 83·3 per cent after verification of ICD-10 codes. The odds ratio for identifying complications using the GTT increased from 5·85 (95 per cent c.i. 4·06 to 8·44) to 25·38 (15·41 to 41·79) when ICD-10 complication codes were verified against patients' medical records. Conclusion Verified ICD-10 codes strengthen the accuracy of complication rates. Use of non-verified complication codes from administrative systems significantly overestimates in-hospital surgical complication rates.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.10985
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2006309-X
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  • 4
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    Postinfectious and sporadic functional gastrointestinal disorders have different prevalences and rates of overlap: results from a controlled cohort study 3 years after acute giardiasis
    Wiley ; 2016
    In:  Neurogastroenterology & Motility Vol. 28, No. 10 ( 2016-10), p. 1561-1569
    Details
    In: Neurogastroenterology & Motility, Wiley, Vol. 28, No. 10 ( 2016-10), p. 1561-1569
    Abstract: Irritable bowel syndrome ( IBS ) is a common complication following gastroenteritis, and a high prevalence of postgiardiasis IBS has previously been reported. This study aims to investigate the prevalence, adjusted relative risk ( RR adj), and overlap of different functional gastrointestinal disorders ( FGID ) according to Rome III criteria following infection with Giardia lamblia . Methods All patients ≥18 years of age with verified giardiasis during an outbreak in 2004, and a control group matched by age and gender, were mailed a questionnaire 3 years later. Key Results The prevalence of functional dyspepsia ( FD ) was 25.9% in the exposed and 6.9% in the control group, RR adj: 3.9 (95% confidence intervals [ CI ]: 3.1–4.8). The prevalence of IBS was 47.9% and 14.3%, respectively, with RR adj: 3.4 (95% CI : 3.0–3.8). Prevalence of other gastrointestinal symptoms ranged from 70.0% vs 39.7% for bloating ( RR adj: 1.8) to 8.3% vs 2.9% for nausea ( RR adj: 3.0) in the G iardia and the control group, respectively. Among individuals fulfilling criteria for IBS 44% in the exposed group and 29% in the control group also fulfilled criteria for FD . IBS subtypes based on Rome III criteria (stool consistency) showed poor agreement with subtypes based on frequency of bowel movements (Kappa‐values: 0.17 and 0.27). Conclusions & Inferences There were high prevalences and RR s of IBS , FD and other gastrointestinal symptoms following acute giardiasis, and a high degree of overlap between the disorders. The agreement between different IBS subtype criteria varied, and there were also differences between the exposed and control group.
    Type of Medium: Online Resource
    ISSN: 1350-1925 , 1365-2982
    URL: Issue
    URL: Article
    DOI: 10.1111/nmo.2016.28.issue-10
    DOI: 10.1111/nmo.12856
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2008278-2
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  • 5
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    Thromboelastography may predict risk of grade 2 bleeding in thrombocytopenic patients
    Wiley ; 2017
    In:  Vox Sanguinis Vol. 112, No. 6 ( 2017-08), p. 578-585
    Details
    In: Vox Sanguinis, Wiley, Vol. 112, No. 6 ( 2017-08), p. 578-585
    Abstract: Platelet count is used as a prophylactic platelet transfusion trigger, although evidence suggests that it is a poor predictor of bleeding. Thus, alternative tests are required. The primary objective of this study was to compare thromboelastography ( TEG ) parameters on days with and without bleeding symptoms. The secondary objectives were to investigate the relationship between TEG parameters and haematological variables, fever, C‐reactive protein ( CRP ) and platelet transfusion. Materials and methods This is a prospective, observational pilot study of 13 thrombocytopenic, haemato‐oncologic patients, over 17 cycles of chemotherapy. Bleeding assessment was performed daily together with a total platelet count ( TPC ), reticulated platelet per cent ( RPP ) and count ( RPC ), haemoglobin, mean platelet volume, white blood cell count ( WBC ), CRP and temperature. TEG analyses were performed on weekdays. Results TEG alpha angle was significantly lower on days with World Health Organization ( WHO ) grade 2 bleeding than on days without bleeding. Haematologic variables, CRP and platelet transfusion the previous day were associated with the outcome of TEG analysis, but fever was not. Conclusion We found a highly significant correlation between the TEG alpha angle and WHO grade 2 bleeding. This finding suggests that fibrinogen–platelet interactions may affect the bleeding risk in thrombocytopenic patients.
    Type of Medium: Online Resource
    ISSN: 0042-9007 , 1423-0410
    URL: Issue
    URL: Article
    DOI: 10.1111/vox.2017.112.issue-6
    DOI: 10.1111/vox.12544
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 1483587-3
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  • 6
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    Antibody response to seasonal influenza vaccination in patients with multiple sclerosis receiving immunomodulatory therapy
    Wiley ; 2018
    In:  European Journal of Neurology Vol. 25, No. 3 ( 2018-03), p. 527-534
    Details
    In: European Journal of Neurology, Wiley, Vol. 25, No. 3 ( 2018-03), p. 527-534
    Abstract: We have previously shown that patients with multiple sclerosis receiving immunomodulatory treatment have reduced seroprotection rates after influenza immunization. The aim of this study was to further investigate the influence of immunomodulatory therapies on the antibody response and seroprotection rates in patients immunized with seasonal influenza vaccine in 2012/2013 compared with healthy controls. Methods Ninety patients receiving fingolimod, glatiramer acetate, interferon beta‐1a/1b, natalizumab or no therapy were compared with 62 healthy controls. All subjects received the inactivated split virus vaccine in 2012 and serum samples were collected pre‐vaccination and 3, 6 and 12 months post‐vaccination. The vaccine responses were evaluated by the hemagglutination inhibition assay and adjusted for age and gender. Results No significant differences in rates of protection against H1N1 for interferon beta‐1a/1b and glatiramer acetate were observed as compared with controls at 3, 6 and 12 months. Fingolimod provided reduced protection at all time points post‐vaccination, whereas natalizumab displayed reduced protection at 3 and 6 months. Patients without immunomodulation did not display protection rates that were significantly different from the controls at 3 and 12 months. Conclusion These findings suggest that patients with multiple sclerosis receiving fingolimod or natalizumab should be considered for a second dose of the vaccine in cases of insufficient protection. Our results further indicate that new immunomodulatory treatment regimens should be systematically evaluated for their influence on influenza‐specific vaccine responses.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.2018.25.issue-3
    DOI: 10.1111/ene.13537
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2020241-6
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  • 7
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    Can the cardiovascular family history reported by our patients be trusted? The Norwegian Stroke in the Young Study
    Wiley ; 2016
    In:  European Journal of Neurology Vol. 23, No. 1 ( 2016-01), p. 154-159
    Details
    In: European Journal of Neurology, Wiley, Vol. 23, No. 1 ( 2016-01), p. 154-159
    Abstract: Family history ( FH ) is used as a marker for inherited risk. Using FH for this purpose requires the FH to reflect true disease in the family. The aim was to analyse the concordance between young and middle‐aged ischaemic stroke patients' reported FH of cardiovascular disease ( CVD ) with their parents' own reports. Methods Ischaemic stroke patients aged 15–60 years and their eligible parents were interviewed using a standardized questionnaire. Information of own CVD and FH of CVD was registered. Concordance between patients and parents was tested by kappa statistics, sensitivity, specificity, predictive values and likelihood ratios. Regression analyses were performed to identify patient characteristics associated with non‐concordance of replies. Results There was no difference in response rate between fathers and mothers ( P  = 0.355). Both parents responded in 57 cases. Concordance between patient and parent reports was good, with kappa values ranging from 0.57 to 0.7. The patient‐reported FH yielded positive predictive values of 75% or above and negative predictive values of 90% or higher. The positive likelihood ratios ( LR +) were 10 or higher and negative likelihood ratios ( LR −) were generally 0.5 or lower. Interpretation regarding peripheral arterial disease was limited due to low parental prevalence. Higher age was associated with impaired concordance between patient and parent reports (odds ratio 1.05; 95% confidence interval 1.01–1.09; P  = 0.020). Conclusions The FH provided by young and middle‐aged stroke patients is in good concordance with parental reports. FH is an adequate proxy to assess inherited risk of CVD in young stroke patients.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.2016.23.issue-1
    DOI: 10.1111/ene.12824
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2020241-6
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  • 8
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    Measured acoustic intensities for clinical diagnostic ultrasound transducers and correlation with thermal index
    Wiley ; 2017
    In:  Ultrasound in Obstetrics & Gynecology Vol. 50, No. 2 ( 2017-08), p. 236-241
    Details
    In: Ultrasound in Obstetrics & Gynecology, Wiley, Vol. 50, No. 2 ( 2017-08), p. 236-241
    Abstract: To investigate if the thermal index for bone ( TIB ) displayed on screen is an adequate predictor for the derated spatial‐peak temporal‐average ( I SPTA .3 ) and spatial‐peak pulse‐average ( I SPPA .3 ) acoustic intensities in a selection of clinical diagnostic ultrasound machines and transducers. Methods We calibrated five clinical diagnostic ultrasound scanners and 10 transducers, using two‐dimensional grayscale, color Doppler and pulsed‐wave Doppler, both close to and far from the transducer, with a TIB between 0.1 and 4.0, recording 103 unique measurements. Acoustic measurements were performed in a bespoke three‐axis computer‐controlled scanning tank, using a 200‐ μ m‐diameter calibrated needle hydrophone. Results There was significant but poor correlation between the acoustic intensities and the on‐screen TIB . At a TIB of 0.1, the I SPTA .3 range was 0.51–50.49 mW /cm 2 and the I SPPA .3 range was 0.01–207.29 W/cm 2 . At a TIB of 1.1, the I SPTA .3 range was 19.02–309.44 mW /cm 2 and the I SPPA .3 range was 3.87–51.89 W/cm 2 . Conclusions TIB is a poor predictor for I SPTA .3 and I SPPA .3 and for the potential bioeffects of clinical diagnostic ultrasound scanners. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
    Type of Medium: Online Resource
    ISSN: 0960-7692 , 1469-0705
    URL: Issue
    URL: Article
    DOI: 10.1002/uog.2017.50.issue-2
    DOI: 10.1002/uog.17298
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2020512-0
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  • 9
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    Population-based study on resection rates and survival in patients with colorectal liver metastasis in Norway
    Oxford University Press (OUP) ; 2017
    In:  British Journal of Surgery Vol. 104, No. 5 ( 2017-03-14), p. 580-589
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 104, No. 5 ( 2017-03-14), p. 580-589
    Abstract: Detailed knowledge about the proportion of patients with colorectal liver metastases (CLM) undergoing resection is sparse. The aim of this study was to analyse cumulative resection rates and survival in patients with CLM. Methods For this population-based study of patients developing CLM during 2011–2013, data were extracted from the Norwegian Patient Registry and the Cancer Registry of Norway. Results A total of 2960 patients had CLM; their median overall survival was 10·9 months. Liver resection was performed in 538 patients. The cumulative resection rate was 20·0 per cent. The cumulative resection rate was 23·3 per cent in patients aged less than 40 years, 31·1 per cent in patients aged 40–59 years, 24·7 per cent in those aged 60–74 years, 17·9 per cent in those aged 75–79 years and 4·7 per cent in patients aged 80 years or more (P & lt; 0·001). In multivariable analysis, resection rate was associated with age, extrahepatic metastases, disease-free interval and geographical region. Overall survival after diagnosis of CLM was affected by liver resection (hazard ratio (HR) 0·54, 95 per cent c.i. 0·34 to 0·86), rectal cancer (HR 0·82, 0·74 to 0·90), metachronous disease (HR 0·66, 0·60 to 0·74), increasing age (HR 1·32, 1·28 to 1·37), region, and extrahepatic metastases (HR 1·90, 1·74 to 2·07). Three- and 4-year overall survival rates after hepatectomy were 73·2 and 54·8 per cent respectively. Conclusion The cumulative resection rate in patients with CLM in Norway between 2011 and 2013 was 20 per cent. Resection rates varied across geographical regions, and with patient and disease characteristics.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.10457
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2006309-X
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  • 10
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    Strain Elastography Evaluation of Rectal Tumors: Inter- and Intraobserver Reproducibility
    Georg Thieme Verlag KG ; 2015
    In:  Ultraschall in der Medizin - European Journal of Ultrasound Vol. 36, No. 06 ( 2015-4-15), p. 611-617
    Details
    In: Ultraschall in der Medizin - European Journal of Ultrasound, Georg Thieme Verlag KG, Vol. 36, No. 06 ( 2015-4-15), p. 611-617
    Type of Medium: Online Resource
    ISSN: 0172-4614 , 1438-8782
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.1055/s-005-30540
    DOI: 10.1055/s-00000089
    DOI: 10.1055/s-0034-1398985
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2015
    detail.hit.zdb_id: 2028670-3
    SSG: 12
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