Levanger, Norway
Levanger, Norway

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Asvold B.O.,Norwegian University of Science and Technology | Bjoro T.,University of Oslo | Platou C.,Levanger Hospital | Vatten L.J.,Norwegian University of Science and Technology
Clinical Endocrinology | Year: 2012

Objective In a mortality follow-up of the HUNT Study, serum TSH within the reference range was positively associated with the risk of coronary death in women. We now aimed to confirm the association of high serum TSH with the risk of coronary heart disease, using hospital-based diagnoses of myocardial infarction. Design Prospective population-based study with linkage to hospital information on myocardial infarction and to the national Cause of Death Registry. Participants A total of 26 707 people without previously known thyroid or cardiovascular disease or diabetes at baseline. Measurements Hazard ratios (HR) of coronary death and HRs of hospitalization with a first-time acute myocardial infarction, by baseline thyroid function. Results During 12 years of follow-up, 960 (3·6%) participants had been hospitalized with first-time myocardial infarction and 558 (2·1%) had died from coronary heart disease. High TSH within the reference range was associated with increased risk of coronary death in women (Ptrend 0·005), but not in men. The risk of coronary death was also increased among women with subclinical hypothyroidism or subclinical hyperthyroidism, compared to women with TSH of 0·50-1·4 mU/l. However, thyroid function was not associated with the risk of being hospitalized with myocardial infarction. Conclusions High serum TSH was associated with increased mortality from coronary heart disease in women, but we found no association of thyroid function with the risk of being hospitalized with myocardial infarction. Thus, the morbidity finding does not confirm the suggestion that low thyroid function within the clinically normal range is associated with increased risk of coronary heart disease. © 2012 Blackwell Publishing Ltd.


Roe O.D.,Norwegian University of Science and Technology | Roe O.D.,Levanger Hospital | Roe O.D.,University of Aalborg | Stella G.M.,University of Pavia
European Respiratory Review | Year: 2015

Asbestos is the term for a family of naturally occurring minerals that have been used on a small scale since ancient times. Industrialisation demanded increased mining and refining in the 20th century, and in 1960, Wagner, Sleggs and Marchand from South Africa linked asbestos to mesothelioma, paving the way to the current knowledge of the aetiology, epidemiology and biology of malignant pleural mesothelioma. Pleural mesothelioma is one of the most lethal cancers, with increasing incidence worldwide. This review will give some snapshots of the history of pleural mesothelioma discovery, and the body of epidemiological and biological research, including some of the controversies and unresolved questions. Translational research is currently unravelling novel circulating biomarkers for earlier diagnosis and novel treatment targets. Current breakthrough discoveries of clinically promising noninvasive biomarkers, such as the 13-protein signature, microRNAs and the BAP1 mesothelioma/cancer syndrome, are highlighted. The asbestos history is a lesson to not be repeated, but here we also review recent in vivo and in vitro studies showing that manmade carbon nanofibres could pose a similar danger to human health. This should be taken seriously by regulatory bodies to ensure thorough testing of novel materials before release in the society. ©ERS 2015.


Danielsen M.,Levanger Hospital | Oyvind R.,University of Oslo
Eating Disorders | Year: 2012

This study investigated changes and predictors during inpatient treatment of 55 adult in a transdiagnostic sample of patients with eating disorders. Patients were assessed at admission and discharge with the Body Attitude Test (BAT), Symptom Check List 90 Revised, Circumplex of Interpersonal Problems, Body Mass Index (BMI) and Eating Disorder Inventory 2 (EDI-2). Significant changes were found in all measures. Regression analyses showed that BAT changes during treatment were the strongest predictor of EDI-2 changes. No predictors of changes in BMI were found. Improvement of body image is important for the efficacy of inpatient treatment. © Taylor & Francis Group, LLC.


News Article | September 1, 2016
Site: www.biosciencetechnology.com

Researchers were able to cut the number of patients who died from sepsis, or infections that spread to the bloodstream, by 40 percent (from 12.5 percent to 7.1 percent) after the introduction of relatively simple steps at the wards at Levanger Hospital in Nord-Trøndelag, Norway. The steps, which included increased training and a special observation chart, were introduced as part of a research project carried out by Nord University, Levanger Hospital, and the Mid-Norway Centre for Sepsis Research at NTNU and St. Olavs Hospital in Trondheim, Norway. "This study suggests that ward nurses have a key function in increasing the survival for patients with serious infection. The use of cost-effective and clear tools for the identification of sepsis and the scoring of severity in patients as well as a standardized treatment course can achieve this," says Erik Solligård, the senior author of the study and head of the Mid-Norway Centre for Sepsis Research. "These simple steps should be implemented in all Norwegian hospitals." According to the Global Sepsis Alliance, a worldwide alliance of health care providers working to increase knowledge about the problem, the majority of sepsis cases are caused by common infections. Pneumonia, urinary tract infections, skin infections like cellulitis and infections in the abdomen (such as appendicitis) can cause sepsis, as well as invasive medical procedures like the insertion of a catheter into a blood vessel. The Alliance says sepsis is the primary cause of death from infection, despite advances in modern medicine like vaccines, antibiotics, and intensive care. Sepsis is a "common" disease that occurs relatively often and affects individuals of all ages. The illness can quickly evolve from being relatively mild to life-threatening. With a mortality rate of over 10 percent, sepsis is among the seven most common causes of death in North America and parts of Europe. Mortality increases further for every hour the patient goes without treatment in the form of antibiotics and fluids. It is therefore vital to identify sepsis early and start treatment quickly. "Sepsis is a very common and serious condition that many people die from," Solligård says. "Patients with lifestyle diseases such as diabetes or cancer are particularly at risk. However, sepsis is not as easy to detect as lifestyle diseases, and it doesn't attract nearly as much attention." Solligård said rates of sepsis are expected to increase in the future, fueled by the double problem of increasing incidences of lifestyle diseases and antibiotic-resistant bacteria. For that reason, hospitals should have a standardized observation regime so sepsis can be diagnosed early in its progression, and should create clear treatment plans for addressing sepsis, he said. "We need much more research on sepsis, especially on how the illness can be prevented," he said. In their study, the researchers created a flow-chart for the identification of sepsis and an observation chart with a severity score that nurses at Levanger Hospital could use at the ward (for triage). Doctors who worked in the ward were given written information, whereas nurses and nursing students were given a 4-hour training course, and the treatment course was standardized with clear guidelines for doctors and nurses. In addition to increasing survival, the use of these measures reduced the development of serious sepsis during hospital stays by 30 percent and the number of days in intensive care was reduced by an average of 3.7 days per patient, thus making the methods not only life-saving, but simple and cost effective. The study, Early identification of in-hospital sepsis by ward nurses increases 30-days survival was published in the internationally renowned clinical intensive care journal Critical Care.


Xanthoulis A.,Levanger Hospital | Tiniakos D.G.,National and Kapodistrian University of Athens
World Journal of Gastroenterology | Year: 2013

E2F family of transcription factors regulates various cellular functions related to cell cycle and apoptosis. Its individual members have traditionally been classified into activators and repressors, based on in vitro studies. However their contribution in human cancer is more complicated and difficult to predict. We review current knowledge on the expression of E2Fs in digestive system malignancies and its clinical implications for patient prognosis and treatment. E2F1, the most extensively studied member and the only one with prognostic value, exhibits a tumor-suppressing activity in esophageal, gastric and colorectal adenocarcinoma, and in hepatocellular carcinoma (HCC), whereas in pancreatic ductal adenocarcinoma and esophageal squamous cell carcinoma may function as a tumorpromoter. In the latter malignancies, E2F1 immunohistochemical expression has been correlated with higher tumor grade and worse patient survival, whereas in esophageal, gastric and colorectal adenocarcinomas is a marker of increased patient survival. E2F2 has only been studied in colorectal cancer, where its role is not considered significant. E2F4's role in colorectal, gastric and hepatic carcinogenesis is tumor-promoting. E2F8 is strongly upregulated in human HCC, thus possibly contributing to hepatocarcinogenesis. Adenoviral transfer of E2F as gene therapy to sensitize pancreatic cancer cells for chemotherapeutic agents has been used in experimental studies. Other therapeutic strategies are yet to be developed, but it appears that targeted approaches using E2F-agonists or antagonists should take into account the tissue-dependent function of each E2F member. Further understanding of E2Fs' contribution in cellular functions in vivo would help clarify their role in carcinogenesis. © 2013 Baishideng. All rights reserved.


Ness-Jensen E.,Norwegian University of Science and Technology | Ness-Jensen E.,Levanger Hospital | Lindam A.,Karolinska Institutet | Lagergren J.,Karolinska Institutet | And 2 more authors.
American Journal of Gastroenterology | Year: 2013

OBJECTIVES:High body mass index (BMI) is an established risk factor of gastroesophageal reflux symptoms (GERS). The aim of this study was to clarify if weight loss reduces GERS.METHODS:The study was part of the Nord- Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted in Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. In 1995-1997 (HUNT 2) and 2006-2009 (HUNT 3), 58,869 and 44,997 individuals, respectively, responded to a questionnaire on heartburn and acid regurgitation. Among these, 29,610 individuals (61% response rate) participated at both times and were included in the present study. The association between weight loss and reduction of GERS was calculated using logistic regression. The analyses were stratified by antireflux medication and the results adjusted for sex, age, cigarette smoking, alcohol consumption, education, and physical exercise.RESULTS:Weight loss was dose-dependently associated with a reduction of GERS and an increased treatment success with antireflux medication. Among individuals with >3.5 units decrease in BMI, the adjusted odds ratio (OR) of loss of any (minor or severe) GERS was 1.98 (95% confidence interval (CI) 1.45-2.72) when using no or less than weekly antireflux medication, and 3.95 (95% CI 2.03-7.65) when using at least weekly antireflux medication. The corresponding ORs of loss of severe GERS was 0.90 (95% CI 0.32-2.55) and 3.11 (95% CI 1.13-8.58).CONCLUSIONS:Weight loss was dose-dependently associated with both a reduction of GERS and an increased treatment success with antireflux medication in the general population.


Ness-Jensen E.,Norwegian University of Science and Technology | Ness-Jensen E.,Levanger Hospital | Lindam A.,Karolinska Institutet | Lagergren J.,Karolinska Institutet | And 2 more authors.
Gut | Year: 2012

Objective: Changes in the occurrence of gastro-oesophageal reflux symptoms (GORS) in the population remain uncertain. This study aimed to determine the prevalence changes, the incidence and the spontaneous loss of GORS. Design: This population-based cohort study was conducted within the Nord-Trøndelag Health Study (the HUNT study), a longitudinal series of population-based health surveys in Nord-Trøndelag County, Norway. The study base encompassed all adult residents in the county, and the participants reported the degree of GORS during the previous 12 months. The number of participants included were 58 869 (64% response rate) in 1995-7 and 44 997 (49%) in 2006-9. Of these, 29 610 persons (61%) were prospectively followed up for an average of 11 years. Results: Between 1995-7 and 2006-9, the prevalence of any, severe and at least weekly GORS increased by 30% (from 31.4% to 40.9%), 24% (from 5.4% to 6.7%) and 47% (from 11.6% to 17.1%), respectively. The average annual incidence of any and severe GORS was 3.07% and 0.23%, respectively. In women, but not men, the incidence of GORS increased with increasing age. The average annual spontaneous loss (not due to antireflux medication) of any and severe GORS was 2.32% and 1.22%, respectively. The spontaneous loss of GORS decreased with increasing age. Conclusion: Between 1995-7 and 2006-9 the prevalence of GORS increased substantially. At least weekly GORS increased by 47%. The average annual incidence of severe GORS was 0.23%, and the corresponding spontaneous loss was 1.22%. The incidence and spontaneous loss of GORS were influenced by sex and age.


Ness-Jensen E.,Norwegian University of Science and Technology | Ness-Jensen E.,Levanger Hospital | Lindam A.,Karolinska Institutet | Lagergren J.,Karolinska Institutet | And 2 more authors.
American Journal of Gastroenterology | Year: 2014

OBJECTIVES:Tobacco smoking increases the risk of gastroesophageal reflux symptoms (GERS), but whether tobacco smoking cessation improves GERS is unclear. The aim of this study was to clarify if tobacco smoking cessation improves GERS.METHODS:The study was based on the Nord-Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted from 1995-1997 to 2006-2009 in Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. The study included 29,610 individuals (61% response rate) who reported whether they had heartburn or acid regurgitation. The association between tobacco smoking cessation and improvement in GERS was assessed by logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). The analyses were stratified by antireflux medication, and the results were adjusted for sex, age, body mass index (BMI), alcohol consumption, education, and physical exercise. Subgroup analyses were also stratified by BMI.RESULTS:Among individuals using antireflux medication at least weekly, cessation of daily tobacco smoking was associated with improvement in GERS from severe to no or minor complaints (adjusted OR 1.78; 95% CI: 1.07-2.97), compared with persistent daily smoking. This association was present among individuals within the normal range of BMI (OR 5.67; 95% CI: 1.36-23.64), but not among overweight individuals. There was no association between tobacco smoking cessation and GERS status among individuals with minor GERS or individuals using antireflux medication less than weekly.CONCLUSIONS:Tobacco smoking cessation was associated with improvement in severe GERS only in individuals of normal BMI using antireflux medication at least weekly, but not in other individual with GERS. © 2014 by the American College of Gastroenterology.


Bjorngaard J.H.,Norwegian University of Science and Technology | Bjerkeset O.,Levanger Hospital | Bjerkeset O.,Norwegian University of Science and Technology | Romundstad P.,Norwegian University of Science and Technology | Gunnell D.,University of Bristol
Sleep | Year: 2011

Objectives: To investigate the association of sleeping problems with suicide risk. Design: Prospective cohort study linking health survey information on sleep problems to Norway's national mortality registry. Participants were followed up from 1984-6 until December 31, 2004. Setting: Residents of Nord-Trøndelag County, Norway, aged 20 years or older in 1984-6. Participants: Altogether 87,285 people were eligible for the survey and 74,977 (86%) took part in one or more aspects of the study. Interventions: N/A Measurements and Results: Three percent of participants experienced sleeping problems every night, 5% experienced problems "often" and 31% reported problems "sometimes." There were 188 suicides during follow-up. Sleeping problems at baseline were strongly associated with subsequent suicide risk. Compared to participants who reported no sleeping problems the age- and sex- adjusted hazard ratios for suicide were 1.9 (CI 1.3-2.6), 2.7 (CI 1.4-5.0), and 4.3 (CI 2.3-8.3) for reporting sleeping problems sometimes, often, or almost every night, respectively. Associations were stronger in younger (< 50 years) participants, but we found no statistical evidence for gender differences. Adjusting for measures of common mental disorder and alcohol use at baseline weakened the associations, but the 3% of subjects with the worst sleep patterns remained at two fold increased risk of suicide. Conclusions: Sleeping problems are a marker of suicide risk, mainly due to the presence of both sleeping problems and mixed anxiety and depression. Physicians should be aware of the possible vulnerability for people affected by sleeping problems.


Krokstad S.,Norwegian University of Science and Technology | Krokstad S.,Levanger Hospital | Langhammer A.,Norwegian University of Science and Technology | Hveem K.,Norwegian University of Science and Technology | And 7 more authors.
International Journal of Epidemiology | Year: 2013

The HUNT Study includes large total population-based cohorts from the 1980ies, covering 125 000 Norwegian participants; HUNT1 (1984- 86), HUNT2 (1995-97) and HUNT3 (2006-08). The study was primarily set up to address arterial hypertension, diabetes, screening of tuberculosis, and quality of life. However, the scope has expanded over time. In the latest survey a state of the art biobank was established, with availability of biomaterial for decades ahead. The three population based surveys now contribute to important knowledge regarding health related lifestyle, prevalence and incidence of somatic and mental illness and disease, health determinants, and associations between disease phenotypes and genotypes. Every citizen of Nord-TrØndelag County in Norway being 20 years or older, have been invited to all the surveys for adults. Participants may be linked in families and followed up longitudinally between the surveys and in several national health- and other registers covering the total population. The HUNT Study includes data from questionnaires, interviews, clinical measurements and biological samples (blood and urine). The questionnaires included questions on socioeconomic conditions, health related behaviours, symptoms, illnesses and diseases. Data from the HUNT Study are available for researchers who satisfy some basic requirements (www.ntnu.edu/hunt), whether affiliated in Norway or abroad. © The Author 2012; All rights reserved.

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