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Heiberg K.E.,Baerum Hospital | Heiberg K.E.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Bruun-Olsen V.,University of Oslo | Mengshoel A.M.,University of Oslo
Archives of Physical Medicine and Rehabilitation | Year: 2013

Objectives: To investigate recovery of physical functioning in patients during the first year after total hip arthroplasty (THA), and to predict postoperative walking distance outcomes from preoperative measures. Design: A longitudinal prospective design was used. Data were analyzed by repeated-measures analysis of variance and multivariate regression analyses. Setting: Two hospitals. Participants: Patients with hip osteoarthritis were consecutively included and assessed preoperatively (n=88), at 3 months (n=88), and at 12 months (n=64) after THA. Interventions: Not applicable. Main Outcome Measures: Physical functioning was assessed by objective measures - the 6-minute walk test (6MWT), stair climbing test, Index of Muscle Function, figure-of-eight, and active hip range of motion - and the subjective measures by Harris Hip Score and Hip dysfunction and Osteoarthritis Outcome Score. Results: In objective measures, improvements were found from preoperatively to 3 months in 6MWT (P<.01) and stair climbing test (P<.05) scores, while all measures had improved from 3 to 12 months (P≤.001). In contrast, all the subjective measures showed substantial improvements at 3 months, but small further improvements from 3 to 12 months (P<.001). Age, sex, preoperative 6MWT distance, and hip range of motion predicted 6MWT outcomes at 3 and 12 months (P≤.01). Conclusions: The objective measures of physical functioning improved gradually during the first postoperative year, while the subjective measures showed large early improvements, but little further improvements. Younger age, male sex, and better scores of walking distance and hip flexibility before surgery predicted better score in walking distance at both 3 and 12 months after surgery. © 2013 by the American Congress of Rehabilitation Medicine.

Mellin-Olsen J.,Baerum Hospital | Staender S.,Regional Hospital Maennedorf
Current Opinion in Anaesthesiology | Year: 2014

Purpose of review Four years after the launch of the Helsinki Declaration on Patient Safety in Anaesthesiology, it is of interest to assess its role in European and Global Patient Safety efforts. Recent findings The Declaration is widely supported, not only in Europe, but also has attracted much attention and support globally. In Europe, it represented a major step in European-wide patient safety networking and initiatives. The European Patient Safety Task Force, created jointly by the European Board of Anaesthesiology and the European Society of Anaesthesiology, has developed useful monitoring and introduction tools. A new Patient Safety Committee is being introduced, and this will facilitate current and future initiatives. Summary The launch of Helsinki Declaration of Patient Safety in Anaesthesiology in 2010 was a major step forward for patient safety initiatives in European and Global anesthesiology. Several steps have been taken in the 4 years that have passed, but the task needs continuous attention to ensure that every patient received the safest possible anesthesiology care. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Berild G.H.,Gynekologene Pa Kolbotn | Kulseng-Hanssen S.,Baerum Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2012

Introduction and hypothesis The study seeks to determine whether a urinary cough and jump stress test is reproducible and whether there is a relationship between a stress test and a 24-h pad test and our subjective Stress Incontinence Index. Methods Multicenter prospective cohort study of women with subjective stress incontinence. Each patient completed a validated Stress and Urge Incontinence Questionnaire and a 24-h pad test and performed two standardized cough and jump stress tests. Results All 108 women were incontinent during both the first and second stress tests. There was a large variation in leakage and the leakage was significantly larger during stress test 2 than during stress test 1 (P<0.02). Correlations found between the stress test and the 24hour pad test and between the stress test and the Stress Incontinence Index were poor. Conclusion The cough and jump stress test is reproducible and able to document stress leakage. © The International Urogynecological Association 2012.

Ofstad A.P.,Baerum Hospital
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2016

Type 2 diabetes mellitus (T2DM) is strongly associated with increased risk of myocardial dysfunction and cardiovascular disease (CVD), two separate conditions which often co-exist and influence each other’s course. The prevalence of myocardial dysfunction may be as high as 75% in T2DM populations but is often overlooked due to the initial asymptomatic nature of the disease, complicating co-morbidities such as coronary artery disease (CAD) and obesity, and the lack of consensus on diagnostic criteria. More sensitive echocardiographic applications are furthermore needed to improve detection of early subclinical changes in myocardial function which do not affect conventional echocardiographic parameters. The pathophysiology of the diabetic myocardial dysfunction is not fully elucidated, but involves hyperglycemia and high levels of free fatty acids. It evolves over several years and increases the risk of developing overt HF, and is suggested to at least in part account for the worse outcome seen in T2DM individuals after cardiac events. CAD and stroke are the most frequent CV manifestations among T2DM patients and relate to a large degree to the accelerated atherosclerosis driven by inflammation. Diagnosing CAD is challenging due to the lower sensitivity inherent in the diagnostic tests and there is thus a need for new biomarkers to improve prediction and detection of CAD. It seems that a multi-factorial approach (i.e. targeting several CV risk factors simultaneously) is superior to a strict glucose lowering strategy in reducing risk for macrovascular events, and recent research may even support an effect also on HF outcomes. © 2016 Taylor & Francis

Heiberg K.E.,Baerum Hospital | Heiberg K.E.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Mengshoel A.M.,University of Oslo
BMC Musculoskeletal Disorders | Year: 2013

Background: In the field of rehabilitation, patients are supposed to be experts on their own lives, but the patient's own desires in this respect are often not reported. Our objectives were to describe the patients' desires regarding functional improvements before and after total hip arthroplasty (THA). Methods. Sixty-four patients, 34 women and 30 men, with a mean age of 65 years, were asked to describe in free text which physical functions they desired to improve. They were asked before surgery and at three and 12 months after surgery. Each response signified one desired improvement. The responses were coded according to the International Classification of Functioning, Disability and Health (ICF) to the 1§ssup§st§esup§, 2§ssup§nd§esup§ and 3§ssup§rd§esup§ category levels. The frequency of the codes was calculated as a percentage of the total number of responses of all assessments times and in percentage of each time of assessment. Results: A total of 333 responses were classified under Part 1 of the ICF, Functioning and Disability, and 88% of the responses fell into the Activities and Participation component. The numbers of responses classified into the Activities and Participation component were decreasing over time (p < 0.001). The categories of Walking (d450), Moving around (d455), and Recreation and leisure (d920) included more than half of the responses at all the assessment times. At three months after surgery, there was a trend that fewer responses were classified into the Recreation and leisure category, while more responses were classified into the category of Dressing (d540). Conclusions: The number of functional improvements desired by the patients decreased during the first postoperative year, while the content of the desires before and one year after THA were rather consistent over time and mainly concerned with the ability to walk and participate in recreation and leisure activities. At three months, however, there was a tendency that the patients were more concerned about the immediate problems with putting on socks and shoes. © 2013 Heiberg et al.; licensee BioMed Central Ltd.

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