Van Leeuwen J.A.M.J.,Betanien Hospital |
Grogaard B.,University of Oslo |
Nordsletten L.,University of Oslo |
Rohrl S.M.,University of Oslo
Acta Orthopaedica | Year: 2015
Background and purpose - Intraoperatively, patient-specific positioning guides (PSPGs) represent the preoperatively planned alignment. We investigated the degree of correlation between preoperative planning and the alignment achieved postoperatively with the PSPG technique. Patients and methods - TKAs performed with the PSPG technique between 2009 and 2011 were included. 39 patients (42 TKAs) volunteered for a postoperative CT scan. 2 independent observers performed the postoperative CT measurements. Preoperative component angles (target angles) in the coronal and axial planes were defined as 0 degrees, and in the sagittal plane on average 2.8 degrees for the femoral component and 3 degrees for the tibial component. A postoperative full-length standing anteroposterior radiograph was carried out in 41 TKAs. Results - The femoral component was on average 1.2 (SD 1.5) degrees in varus, 4.4 (SD 4.0) degrees in flexion, and 0.5 (SD 1.4) degrees in external rotation. The tibial component was on average 0.4 (SD 2.5) degrees in varus and 3.7 (SD 2.3) degrees in flexion. A statistically significant difference between the target (preoperative software plan) and postoperative CT measurement was found for the femoral component angle in the frontal plane (p < 0.001; CI: 0.8-1.7), the sagittal plane (p = 0.01; CI -5.6 to -3.1), and the axial plane (p = 0.03; CI: 0.04-0.88). HKA angles were greater than 3 degrees from the neutral axis in 10 of the 41 cases. Interpretation - We found our postoperative component alignment angles to be close to the software plan, especially for the tibial component. However, we found outliers in all planes and we cannot therefore conclude that the PSPG technique is a method that reproduces preoperatively planned alignment in a consistent manner. Copyright © 2014 Nordic Orthopaedic Federation.
Dobloug G.C.,University of Oslo |
Antal E.A.,OUH |
Sveberg L.,OUH |
Garen T.,University of Oslo |
And 5 more authors.
European Journal of Neurology | Year: 2015
Background and purpose: Knowledge about the occurrence of sporadic inclusion body myositis (sIBM) in the general population is limited. Here, our aim was to identify and characterize every sIBM patient living in southeast Norway (population 2.64 million) from 2003 to 2012. Method: Two sIBM case finding strategies were applied. First, all hospital databases in southeast Norway were screened to identify cases with sIBM-compatible International Classification of Diseases 10 (ICD-10) codes. These cases were then manually chart reviewed. Secondly, all muscle histology reports encoded with inflammation were independently reviewed. Finally, cases were classified according to the 1997 and the 2011 European Neuro-Muscular Centre (ENMC) Research Diagnostic Criteria for sIBM. Results: The combined case finding strategy identified 3160 patients with sIBM compatible ICD-10 codes, and a largely overlapping cohort of 500 patients having muscle biopsies encoded with inflammation. Detailed retrospective review of chart and histology data showed that 95 patients met the 2011 ENMC sIBM criteria and 92 met the 1997 criteria. Estimated point prevalence of sIBM was 33/1 000 000, equal with both criteria sets. Mean age at diagnosis was 66.9 years and mean diagnostic delay was 5.6 years. Chart review revealed higher frequencies of dysphagia (94% vs. 65%) and anti-Sjøgren syndrome A antibodies (39% vs. 12%) in female sIBM patients (n = 40) than in males. Coexisting rheumatic diseases were present in 25% of sIBM cases, with Sjøgren's syndrome in 10%. Conclusion: An estimated point prevalence of sIBM seven times higher than previously observed in Europe is reported. Our data show considerable diagnostic delay, a major challenge with new sIBM treatments in the pipeline. © 2014 EAN.
Zangi H.,Diakonhjemmet Hospital |
Mowinckel P.,Diakonhjemmet Hospital |
Finset A.,University of Oslo |
Eriksson L.R.,Diakonhjemmet Hospital |
And 3 more authors.
Annals of the Rheumatic Diseases | Year: 2012
Objective: To evaluate the effects of a mindfulnessbased group intervention, the Vitality Training Programme (VTP), in adults with inflammatory rheumatic joint diseases. Methods: In a randomised controlled trial, the VTP-a 10-session mindfulness-based group intervention including a booster session after 6 months-was compared with a control group that received routine care plus a CD for voluntary use with mindfulnessbased home exercises. The primary outcome was psychological distress measured by the General Health Questionnaire-20. Self-efficacy (pain and symptoms) and emotion-focused coping (emotional processing and expression) were used as co-primary outcomes. Secondary outcomes included pain, fatigue, patient global disease activity, self-care ability and well-being. Effects were estimated by mixed models repeated measures post-intervention and at 12-month follow-up. Results: Of 73 participants randomised, 68 completed assessments post-intervention and 67 at 12 months. Significant treatment effects in favour of the VTP group were found post-treatment and maintained at 12 months in psychological distress (adjusted mean between-group difference -3.7, 95% CI -6.3 to -1.1), self-efficacy pain (9.1, 95% CI 3.4 to 14.8) and symptoms (13.1, 95% CI 6.7 to 19.3), emotional processing (0.3, 95% CI 0.02 to 0.5), fatigue (-1.1, 95% CI -1.8 to -0.4), self-care ability (1.0, 95% CI 0.5 to 1.6) and overall well-being (0.6, 95% CI 0.1 to 1.2). No significant group differences were found in emotional expression, pain or disease activity. Conclusion: The VTP improved most primary and secondary outcomes compared with individual use of CD exercises. Improvements were maintained at 12 months, suggesting that the VTP is a beneficial complement to existing treatments for patients with inflammatory rheumatic joint diseases.
Dobloug G.C.,University of Oslo |
Garen T.,University of Oslo |
Bitter H.,Sorlandets sykehus |
Stjarne J.,Betanien Hospital |
And 5 more authors.
Annals of the Rheumatic Diseases | Year: 2014
Objectives: The occurrence of polymyositis (PM) and dermatomyositis (DM) in the general population is largely unknown and unbiased data on clinical and laboratory features in PM/DM are missing. Here, we aim to identify and characterise every PM/DM patient living in southeast Norway (denominator population 2.64 million), 2003-2012. Method: Due to the structure of the Norwegian health system, all patients with PM/DM are followed at public hospitals. Hence, all public hospital databases in southeast Norway were screened for patients having ICD-10 codes compatible with myositis. Manual chart review was then performed to identify all cases meeting the Peter & Bohan and/or Targoffclassification criteria for PM/DM. Results: The ICD-10 search identified 3160 potential myositis patients, but only 208/3160 patients met the Peter & Bohan criteria and 230 the Targoffcriteria (100 PM, 130 DM). With 56 deaths during the observation period, point prevalence of PM/DM was calculated to 8.7/100 000. Estimated annual incidences ranged from 6 to 10/1 000 000, with peak incidences at 50-59 (DM) and 60-69 years (PM). Myositis specific antibodies (Jo-1, PL-7, PL-12, signal recognition particle (SRP) and Mi-2) were present in 53% (109/204), while 137/163 (87%) had pathological muscle MRI. Frequent clinical features included myalgia (75%), arthritis (41%) dyspnoea (62%) and dysphagia (58%). Positive anti-Jo-1, present in 39% of DM and 22% of PM cases, was associated with dyspnoea, arthritis and mechanic hands. Conclusions: Our data indicate that the population prevalence of PM/DM in Caucasians is quite low, but underscores the complexity and severity of the disorders. © 2014 BMJ Publishing Group Ltd & European League Against Rheumatism.
Kass A.S.,Betanien Hospital |
Lea T.E.,Norwegian University of Life Sciences |
Torjesen P.A.,University of Oslo |
Gulseth H.C.,Betanien Hospital |
Forre O.T.,University of Oslo
Scandinavian Journal of Rheumatology | Year: 2010
Objectives: Disease activity in rheumatoid arthritis (RA) varies substantially during periods when luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels change, for example during pregnancy, postpartum, and menopause. We wanted to investigate whether small fluctuations in these hormones could be associated with similar fluctuations in cytokines and disease activity in RA. Methods: Disease activity markers, serum LH, FSH, and 24 cytokines were assessed on days 1 and 8 in 20 RA patients (median age 58 years, six males) and 19 controls (median age 56 years, six males). Results: Percentage changes in LH and FSH correlated positively with percentage changes in key proinflammatory cytokines such as tumour necrosis factor (TNF)α (LH r 0.737, p 0.0007; FSH r 0.680, p 0.001) and interleukin (IL)-1β (LH r 0.515, p 0.050; FSH r 0.749, p 0.0008). Similar correlations were observed with IL-2, IL-2R, IL-8, monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1α, MIP-1β, and eotaxin, but not with the anti-inflammatory cytokine IL-10, in RA and not in controls. Percentage changes in LH, FSH, and cytokines were not correlated with percentage changes of several disease activity markers but were correlated positively with cross-sectional levels of disease activity markers [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Visual Analogue Scale (VAS) pain, VAS global (physician/patient), and the modified Health Assessment Questionnaire (MHAQ)]. Conclusions: The significant associations between percentage changes in LH and FSH and percentage changes in key cytokines and several cross-sectional markers of disease activity may indicate that LH and FSH influence crucial points of the cytokine cascade in RA. This may help to explain, partially, why disease activity initiates or worsens during periods of increased LH and FSH, such as the postpartum period and the menopause. © 2010 Informa UK Ltd.
van Leeuwen J.A.M.J.,Betanien Hospital |
Rohrl S.M.,University of Oslo
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2016
Purpose: To investigate whether the intended preoperative planning corresponded with the postoperative component position after medial UKA using patient-specific positioning guides (PSPGs). Methods: Twenty-five consecutive UKAs performed with the PSPG technique (Signature™) were included. Two independent observers performed postoperative CT measurements. The preoperative angles for the femoral component were defined in the frontal plane as 0°. In the first eight cases, a femoral component with single peg was inserted, and the flexion of the femoral component was set to 5°. In the last 17 cases, a twin-peg component was used and flexion set to 10°. In the axial plane, the femoral component was on average set at 2.5° internal rotation. The preoperative tibial component angles in the frontal and axial plane were defined as 0° and in the sagittal plane as 4° in flexion. Results: The postoperative femoral component angles were on average 0.8° of valgus (SD 3.2, range 12.2° valgus to 5.1° varus, n.s., CI −2.1 to 0.6), 5.0° of flexion (SD 3.9, range 10.2° flexion to 6.0° extension, p = 0.001, CI −5.3 to −1.5) and 4.0° of internal rotation (SD 1.7, range 1.4° to 6.9° int.rot., p < 0.001, CI −4.7 to −3.4). The tibial component angles were on average 3.0° of varus (SD 1.9, range 1.3° valgus to 6.8° varus, p < 0.001, CI 2.2 to 3.8), 3.2° of flexion (SD 2.4°, 6.7° flex to 1.8° ext, n.s., CI −0.2 to 1.7) and 2.7° of internal rotation (SD 7.0, range 16.6° int.rot. to 10.7° ext.rot., n.s., CI −5.6 to 0.2). Conclusion: This study showed no agreement between preoperative planning and postoperative component alignment (p < 0.05) for the femoral component angle in sagittal and axial plane and for the tibial component angle in the coronal plane. Although the results did not show significant difference for the tibial component angle in the axial plane, a considerable range of the component angles was found varying from 17° internal to 11° external rotation. This study suggests that the use of PSPGs for UKA does not lead to consistent component position. Level of evidence: IV. © 2016 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)
PubMed | Sorlandet Hospital, f The Norwegian Rheumatism Association, Betanien Hospital, i Jeloy Kurbad Rehabilitation Center and 3 more.
Type: | Journal: Disability and rehabilitation | Year: 2017
To explore and describe rehabilitation goals of patients with rheumatic diseases during rehabilitation stays, and examine whether goal content changed from admission to discharge.Fifty-two participants were recruited from six rehabilitation centers in Norway. Goals were formulated by the participants during semi-structured goal-setting conversations with health professionals trained in motivational interviewing. An inductive qualitative content analysis was conducted to classify and quantify the expressed goals. Changes in goal content from admission to discharge were calculated as percentage differences. Goal content was explored across demographic and contextual characteristics.A total of 779 rehabilitation goals were classified into 35 categories, within nine overarching dimensions. These goals varied and covered a wide range of topics. Most common at admission were goals concerning healthy lifestyle, followed by goals concerning symptoms, managing everyday life, adaptation, disease management, social life, and knowledge. At discharge, goals about knowledge and symptoms decreased considerably, and goals about healthy lifestyle and adaptation increased. The health profession involved and patient gender influenced goal content.The rehabilitation goals of the patients with rheumatic diseases were found to be wide-ranging, with healthy lifestyle as the most prominent focus. Goal content changed between admission to, and discharge from, rehabilitation stays. Implications for rehabilitation Rehabilitation goals set by patients with rheumatic diseases most frequently concern healthy lifestyle changes, yet span a wide range of topics. Patient goals vary by gender and are influenced by the profession of the health care worker involved in the goal-setting process. To meet the diversity of patient needs, health professionals need to be aware of their potential influence on the actual goal-setting task, which may limit the range of topics patients present when they are asked to set rehabilitation goals. The proposed framework for classifying goal content has the capacity to detect changes in goals occurring during the rehabilitation process, and may be used as a clinical tool during goal-setting conversations for this patient group.
Oyen J.,University of Bergen |
Gjesdal C.G.,University of Bergen |
Brudvik C.,University of Bergen |
Hove L.M.,University of Bergen |
And 4 more authors.
Osteoporosis International | Year: 2010
Summary: One third of 218 men and half of 1,576 women with low-energy distal radius fractures met the bone mineral density (BMD) criteria for osteoporosis treatment. A large proportion of patients with increased fracture risk did not have osteoporosis. Thus, all distal radius fracture patients ≥50 years should be referred to bone densitometry. Introduction Main objectives were to determine the prevalence of patients with a low-energy distal radius fracture in need of osteoporosis treatment according to existing guidelines using T-score ≤ -2.0 or ≤-2.5 standard deviation (SD) and calculate their fracture risk. Methods: A total of 218 men and 1,576 women ≥50 years were included. BMD was assessed by dual energy X-ray absorptiometry (DXA) at femoral neck, total hip, and lumbar spine (L2-L4). The WHO fracture risk assessment tool (FRAX®) was applied to calculate the 10-year fracture risk. Results T-scores ≤-2.0 and ≤-2.5 SD at femoral neck was found in 37.7% and 19.6% of men and 51.1% and 31.2% of women, respectively. The risk of hip fracture was 6.2% for men and 9.0% for women. The corresponding figures for patients with T-score ≤-2.0 SD were 11.6% and 14.5% and for T-score ≤-2.5 SD 16.3% and 18.2%, respectively. A large proportion of distal radius fracture patients with a high 10-year FRAX® risk did not have osteoporosis. Conclusions: Every second to every third fracture patient met the present BMD criteria for osteoporosis treatment. Because a large proportion of distal radius fracture patients did not have osteoporosis, treatment decisions should not be based on fracture risk assessment without bone densitometry. Thus, all distal radius fracture patients ≥50 years should be referred to bone densitometry, and if indicated, offered medical treatment. © International Osteoporosis Foundation and National Osteoporosis Foundation 2009.
Betanien Hospital | Date: 2015-02-23
The present invention relates to methods for the treatment of rheumatoid arthritis. In particular, the present invention relates to methods of treating rheumatoid arthritis with GnRH antagonists in patients with high gonadotropin and/or GnRH levels.
Betanien Hospital | Date: 2016-08-12
The present invention relates to the screening, diagnosis, prognostic evaluation, and treatment or prevention of age associated inflammation, chronic inflammation, and inflammatory diseases. In particular, the present invention relates to treating or preventing inflammatory diseases (e.g. rheumatoid arthritis or spondyloarthritis) or patients with inflammatory peripheral GnRH with GnRH antagonists or drugs that lower the effects of GnRH.