Haugesund, Norway
Haugesund, Norway

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Bentsen S.B.,Stord/Haugesund University College | Bentsen S.B.,Haugesund Hospital | Rokne B.,University of Bergen | Wahl A.K.,University of Oslo
Scandinavian Journal of Caring Sciences | Year: 2013

Background: Chronic obstructive pulmonary disease (COPD) is associated with lower health-related quality of life (HRQOL). Previous research has focused primarily on HRQOL in these patients, whereas few studies have compared HRQOL between patients with COPD and the general population. Aim: The aim of this study was to evaluate differences in HRQOL between patients with COPD stage 2 to COPD stage 4 waiting to begin an outpatient pulmonary rehabilitation (PR) programme and Norwegian individuals with and without other chronic conditions. Methods: A comparative survey design was used in this study of 100 patients with COPD waiting to begin PR and 3594 individuals from the general population. The SF-36 questionnaire was used to evaluate HRQOL. Results: Compared with the healthy general population, COPD patients waiting to begin PR had lower scores on all SF-36 components and on the physical and mental health summary components (p < 0.001). Scores for physical function, physical role, general health, vitality, social function, emotional role and the physical health component differed markedly between patients and the general population. Patients with COPD stage 4 had lower HRQOL than did the general population and those with COPD stage 2 and COPD stage 3. Conclusions: The burden of COPD significantly affects HRQOL in patients with COPD waiting to begin PR, and those with COPD stage 4 are most affected. Action should be taken to support especially those patients with COPD stage 4. © 2012 Nordic College of Caring Science.


Berentsen S.,Haugesund Hospital | Tjonnfjord G.E.,University of Oslo
Blood Reviews | Year: 2012

Exact diagnosis of the subtype has essential therapeutic consequences in autoimmune hemolytic anemia. Cold-antibody types include primary chronic cold agglutinin disease (CAD) and rare cases of cold agglutinin syndrome (CAS) secondary to cancer or acute infection. Primary CAD is a clonal lymphoproliferative disorder. Not all patients require pharmacological therapy, but treatment seems indicated more often than previously thought. Corticosteroids should not be used to treat primary CAD. Half of the patients respond to rituximab monotherapy; median response duration is 11. months. The most efficient treatment to date is fludarabine and rituximab in combination, resulting in responses in 75%, complete responses in 20% and median response duration of more than 66. months. Toxicity may be a concern, and an individualized approach is discussed. Erythrocyte transfusions can be given provided specific precautions are undertaken. No evidence-based therapy exists in secondary CAS, but optimal treatment of the underlying disorder is essential when feasible. © 2012 Elsevier Ltd.


Berentsen S.,Haugesund Hospital | Randen U.,University of Oslo | Tjonnfjord G.E.,University of Oslo
Hematology/Oncology Clinics of North America | Year: 2015

Cold antibody types account for about 25% of autoimmune hemolytic anemias. Primary chronic cold agglutinin disease (CAD) is characterized by a clonal lymphoproliferative disorder. Secondary cold agglutinin syndrome (CAS) complicates specific infections and malignancies. Hemolysis in CAD and CAS is mediated by the classical complement pathway and is predominantly extravascular. Not all patients require treatment. Successful CAD therapy targets the pathogenic B-cell clone. Complement modulation seems promising in both CAD and CAS. Further development and documentation are necessary before clinical use. We review options for possible complement-directed therapy. © 2015 Elsevier Inc.


Berge G.,Norwegian University of Science and Technology | Berge G.,Haugesund Hospital | Berge G.,University of Stavanger
Journal of neurology, neurosurgery, and psychiatry | Year: 2014

BACKGROUND: Results conflict concerning the relevance of APOE alleles on the development of dementia with Lewy bodies (DLB), though they are well established in connection with Alzheimer's disease (AD). The role of APOE alleles in a Norwegian cohort of patients with DLB was therefore examined compared with patients with AD and healthy control individuals.METHODS: The study included 156 patients with DLB diagnosed according to the consensus criteria guidelines, 519 patients diagnosed with AD according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ARDRA) criteria and 643 healthy elderly volunteers. Patients were recruited through hospitals, outpatient clinics, nursing homes or from local care authorities in central and south-western parts of Norway. Healthy individuals were recruited from caregivers and societies for retired people.RESULTS: Subjects carrying an APOE ε2 allele had a reduced risk for developing DLB (OR 0.4, CI 0.3 to 0.8, p=0.004), and the onset of disease was delayed by 4 years (p=0.01, Mann-Whitney U test). Conversely, the APOE ε4 allele increased the risk for development of DLB (OR 5.9, CI 2.7 to 13.0, p<0.0005 for homozygotes). Similar results were found for patients with AD regarding the effect of APOE ε2, though the protective effect appeared to be slightly less pronounced than in DLB. This study is one of the largest regarding DLB and APOE to date.CONCLUSION: The results indicate that APOE ε2, a protective factor in AD, has a clear beneficial effect on the development of DLB also. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.


Sandvik M.K.,University of Bergen | Hallan S.,Norwegian University of Science and Technology | Svarstad E.,University of Bergen | Vikse B.E.,University of Bergen | Vikse B.E.,Haugesund Hospital
Clinical Journal of the American Society of Nephrology | Year: 2013

Background and objectives A recentmeta-analysis found that about 30%ofwomenwith a previous preeclamptic pregnancy had persistent microalbuminuria at follow-up. The analysis was, however, based on small studies, and more data are needed. Design, setting, participants, & measurements Using data from the Medical Birth Registry in Norway, this study identified women with or without preeclampsia in their first pregnancy 9-11 years previously (1998-2000). Women with diabetes, rheumatic disease, essential hypertension, or renal disease before first pregnancy and/or preeclampsia in later pregnancieswere excluded. Eighty-ninewomenwith and 69womenwithout preeclampsia participated in the study. Urinary albumin-to-creatinine ratio (ACR) was measured in three morning urine samples. Estimated GFR (eGFR) was calculated using the CKD-Epidemiology Collaboration formula. Results Median urinaryACR in follow-up urine sampleswas 0.53mg/mmol forwomenwith and 0.50 mg/mmol for women without preeclampsia (P=0.54). Only one woman (1%) with previous preeclampsia had urinary ACR>2.5mg/mmol in two of three urine samples. Preeclampsiawas not associatedwith urinary ACR above the 75th percentile.Women with preeclampsia did not have significantly higher eGFR than womenwithout preeclampsia (107.9 versus 104.9 ml/min per 1.73 m2; P=0.12), but preterm preeclampsia was significantly associated with eGFR above the 75th percentile (P=0.03). Conclusions In this population-based study of otherwise healthy women, preeclampsia 10 years earlier was not associated with increased risk of persisting microalbuminuria. Estimated GFR was not significantly different between women with and those without preeclampsia, but preterm preeclampsia was associated with high normal eGFR. © 2013 by the American Society of Nephrology.


Hove O.,Haugesund Hospital | Havik O.E.,University of Bergen
Social Psychiatry and Psychiatric Epidemiology | Year: 2010

Background: Studies of the relationship between the level of intellectual disability and mental and behavioural disorders have reported divergent findings regarding the direction of the relationship and how it is related to different mental disorders. Aims: To investigate the relationship between levels of intellectual disability and mental disorders and problem behaviour after adjusting for other relevant factors: age, gender, autism, genetic syndromes, the neurological conditions cerebral palsy and epilepsy, negative life events and quality of the social care provided. Methods: A community sample of adults with intellectual disabilities (N = 593) were assessed using the Psychopathology Checklists for Adults with Intellectual Disability. A hierarchical regression model with forced entry was employed. Results: Both linear and curvilinear relationships between intellectual disability and mental disorders were found after controlling for relevant factors that was independently associated with specific mental disorders. Conclusions: Psychopathology models for adults with intellectual disabilities should include the level of intellectual disability, either in a linear or a non-linear way. Future research on this issue should focus on people with borderline intellectual disability. © 2009 Springer-Verlag.


Bakkevold K.E.,Haugesund Hospital
Clinical and Experimental Gastroenterology | Year: 2010

Objective: The aim of this study was to examine time trends in the incidence of peptic ulcer bleeding and risk factors in a defined geographical area in Norway. Material and methods: Retrospective data were collected for 306 patients with bleeding peptic ulcers admitted to one hospital during the 1985-1986, 1995-1996, and 2007-2008 periods. Results: The incidence in 1985-1986 was 52/100,000 and in 2007-2008 was 45/100,000. In the group aged 20-75 years, the incidence decreased by 54% from 54/100000 in 1985-1986 to 25/100000 in 2007-2008 (P = 0.001) and increased by 49% in the group aged >75 years from 272/100000 to 406/100000 (P = 0.0001). The use of aspirin or nonsteroidal anti-inflammatory steroid drugs (NSAIDs) was 31% in 1985-1986 and increased to 67% in 2007-2008 (P = 0.004). In patients using aspirin or NSAIDs, Helicobacter pylori was present in 73% in 1995-1996 and in 51% in 2007-2008. H. pylori infection declined from 84% to 52% between 1995-1996 and 2007-2008. Conclusions: The incidence rate of peptic ulcer bleeding did not change between 1985-1986 and 2007-2008, but decreased in the age group #75 years and increased in the age group >75 years. The use of low-dose aspirin and NSAIDs increased substantially over time, and H. pylori infection was still present in 51% of these patients in 2007-2008. © Bakkevold.


Berentsen S.,Haugesund Hospital
Transfusion Medicine and Hemotherapy | Year: 2015

The classification of autoimmune hemolytic anemias and the complement system are reviewed. In autoimmune hemolytic anemia of the warm antibody type, complement-mediated cell lysis is clinically relevant in a proportion of the patients but is hardly essential for hemolysis in most patients. Cold antibody-mediated autoimmune hemolytic anemias (primary cold agglutinin disease, secondary cold agglutinin syndrome and paroxysmal cold hemoglobinuria) are entirely complement-mediated disorders. In cold agglutinin disease, efficient therapies have been developed in order to target the pathogenic B-cell clone, but complement modulation remains promising in some clinical situations. No established therapy exists for secondary cold agglutinin syndrome and paroxysmal cold hemoglobinuria, and the possibility of therapeutic complement inhibition is interesting. Currently, complement modulation is not clinically documented in any autoimmune hemolytic anemia. The most relevant candidate drugs and possible target levels of action are discussed. © 2015 S. Karger GmbH, Freiburg.


Berentsen S.,Haugesund Hospital | Sundic T.,Haugesund Hospital
BioMed Research International | Year: 2015

Autoimmune hemolytic anemia (AIHA) is a collective termfor several diseases characterized by autoantibody-initiated destruction of red blood cells (RBCs). Exact subclassification is essential. We provide a review of the respective types of AIHA with emphasis on mechanisms of RBC destruction, focusing in particular on complement involvement. Complement activation plays a definitive but limited role in warm-antibody AIHA (w-AIHA), whereas primary cold agglutinin disease (CAD), secondary cold agglutinin syndrome (CAS), and paroxysmal cold hemoglobinuria (PCH) are entirely complement-dependent disorders. The details of complement involvement differ among these subtypes. The theoretical background for therapeutic complement inhibition in selected patients is very strong in CAD, CAS, and PCH but more limited in w-AIHA. The optimal target complement component for inhibition is assumed to be important and highly dependent on the type of AIHA. Complement modulation is currently not an evidence-based therapy modality in any AIHA, but a number of experimental and preclinical studies are in progress and a few clinical observations have been reported. Clinical studies of new complement inhibitors are probably not far ahead. Copyright © 2015 S. Berentsen and T. Sundic.


Berentsen S.,Haugesund Hospital
British Journal of Haematology | Year: 2011

Primary chronic cold agglutinin disease (CAD) is a clonal lymphoproliferative disorder accounting for 13-15% of autoimmune haemolytic anaemias. Significant advances have been made in treatment, which was largely unsuccessful until recently. The essential clinical, immunological and pathological features are reviewed, focusing on their relevance for therapy. Non-pharmacological management still seems sufficient in some patients. With the recent improvements, however, drug therapy seems indicated more often than previously thought. Corticosteroids should not be used to treat CAD. Half of the patients respond to rituximab monotherapy; median response duration is 11months. Fludarabine-rituximab combination therapy is very effective, resulting in 75% response rate, complete remissions in about 20%, and more than 66months estimated response duration. Toxicity is a concern, and benefits should be carefully weighed against risks. An individualized approach is discussed regarding the choice of fludarabine-rituximab combination versus rituximab monotherapy. Patients requiring treatment should be considered for prospective trials. © 2011 Blackwell Publishing Ltd.

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