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Solberg I.C.,University of Oslo | Cvancarova M.,University of Oslo | Vatn M.H.,University of Oslo | Moum B.,University of Sfax | And 7 more authors.
Inflammatory Bowel Diseases | Year: 2014

Background: Identifying patients with Crohn's disease with increased risk of subsequent complications is essential for appropriate treatment. Based on exploratory analysis, we developed a prediction model for assessing the probability of developing advanced disease 5 and 10 years after diagnosis. Methods: A population-based cohort of 237 patients with Crohn's disease diagnosed from 1990-1994 was followed for 10 years. In the 5-year analysis, advanced disease was defined as having intestinal resection, progression in disease behavior, or need for thiopurines. The analysis was limited to patients with uncomplicated disease at diagnosis who were alive (n = 140), excluding those who were lost during follow-up (n = 8). For the 10-year analysis, advanced disease was defined as having surgery, excluding those who had surgery within the first 30 days (n = 7), those who died (n = 18), or were lost during follow-up (n = 22). Based on the best fitted multiple model, the probabilities of advanced disease were computed for selected baseline levels of the covariates and the results were arranged in a prediction matrix. Except for ASCA, all predictors were measured at diagnosis. Results: ASCA status, disease location, age, and need for systemic steroids were included in the 5-year prediction matrix. The probabilities of advanced disease during this period varied from 8.6% to 92.0% depending on the combination of predictors. The 10-year matrix combined ASCA status, disease behavior, age, and need for systemic steroids; the probabilities of advanced disease ranged from 12.4% to 96.7%. Conclusions: Our prediction models revealed substantial differences in the probability of developing advanced disease in the short and intermediate course of Crohn's disease, suggesting that a model-based prediction matrix is useful in early disease management. Copyright © 2013 Crohn's & Colitis Foundation of America, Inc.


Bjerke E.,Ostfold Hospital | Hansen R.S.,University of Oslo | Solbakken O.A.,University of Oslo | Monsen J.T.,University of Oslo
Comprehensive Psychiatry | Year: 2011

Objective: No studies, to our knowledge, have examined what specific kinds of interpersonal problems characterize a general psychiatric outpatient population. Do they differ from the normal population in any specific way, apart from the expected "more of everything"? The aim of this study was to map and categorize a large psychiatric outpatient sample with regard to self-reported interpersonal problems. Method: First-admission psychiatric patients completed the 64-item version of the Inventory of Interpersonal Problems (Horowitz et al, Inventory of Interpersonal Problems Manual. San Antonio, TX: The Psychological Corporation 2000) before treatment. Scores were compared with Norwegian reference data. Profile characteristics of 8 subgroups (octant groups), corresponding to 8 different forms of predominant interpersonal problem, were calculated according to the structural summary method (Gurtman and Balakrishnan, Circular measurement redux: the analysis and interpretation of interpersonal circle profiles. Clin Psychol Sci Pract. 1998;5[3]:344-360). Results: The clinical sample had considerably more interpersonal problems than the normal reference sample. Among the 8 octant groups with different predominant interpersonal problems, the 3 most prevalent in the sample, characterized by a low degree of assertiveness (low agency), were also the most distressed with regard to interpersonal problems. Conclusions: Psychiatric outpatients seem to have the most severe interpersonal problems along the agency dimension; that is, they have problems being assertive. Patients within different octant groups of the 64-item version of the Inventory of Interpersonal Problems system, corresponding to different kinds of specific, predominant interpersonal problems, have characteristic ways of relating to others, which ought to be identified and addressed in therapy. © 2011 Elsevier Inc. All rights reserved.


Moritz V.,Telemark Hospital | Bretthauer M.,University of Oslo | Ruud H.K.,University of Oslo | Glomsaker T.,University of Stavanger | And 5 more authors.
Endoscopy | Year: 2012

Background and study aims: A withdrawal time of at least 6 min has been recommended as a quality indicator for colonoscopy. One drawback of many of the studies that have investigated withdrawal time and produced conflicting results has been their single-center design involving few endoscopists. Therefore, the validity of withdrawal time as a quality measure remains unclear. This study explores the value of individual withdrawal time in a nationwide analysis. Patients and methods: This prospective cohort study comprised data from outpatient colonoscopies performed at 19 Norwegian centers from January to September 2009 and registered in the Norwegian Gastronet Quality Assurance (QA) program. The participating endoscopists were characterized by their median withdrawal time for visual colonoscopies (diagnostic colonoscopies without biopsy or therapy) and categorized into two visual withdrawal time (VWT) groups (< 6 min or 6 min) to analyze the predictive value of VWT for detection of one or more polyps 5 mm in diameter using multiple logistic regression models. Results: The study included 4429 consecutive colonoscopies performed by 67 endoscopists. The adjusted odds ratio for the detection of polyps 5 mm was 1.21 (95 %CI 0.94 - 1.56, P = 0.14) for endoscopists with a median VWT 6 min compared with endoscopists with a median VWT < 6 min. Conclusion: Withdrawal time using 6 min as the threshold is not a strong predictor of the likelihood of finding a polyp during colonoscopy and should not be used as a quality indicator. © Georg Thieme Verlag KG Stuttgart. New York.


Ostman B.,Ostfold Hospital | Sjodin A.,Copenhagen University | Sjodin A.,Uppsala University | Michaelsson K.,Uppsala University | Byberg L.,Uppsala University
Nutrition | Year: 2012

Objective: The theoretically beneficial effects of coenzyme Q10 (Q10) on exercise-related oxidative stress and physical capacity have not been confirmed to our knowledge by interventional supplementation studies. Our aim was to investigate further whether Q10 supplementation at a dose recommended by manufacturers influences these factors. Methods: Using a randomized, double-blind, controlled design, we investigated the effect on physical capacity of 8 wk of treatment with a daily dose of 90 mg of Q10 (n = 12) compared with placebo (n = 11) in moderately trained healthy men 19 to 44 y old. Two days of individualized performance tests to physical exhaustion were performed before and after the intervention. Primary outcomes were maximal oxygen uptake, workload, and heart rate at the lactate threshold. Secondary outcomes were creatine kinase, hypoxanthine, and uric acid. Results: No significant differences between the groups were discerned after the intervention for maximal oxygen uptake (-0.11 L/min, 95% confidence interval -0.31 to 0.08, P = 0.44), workload at lactate threshold (6.3 W, -13.4 to 25.9, P = 0.36), or heart rate at lactate threshold (2.0 beats/min, -4.9 to 8.9, P = 0.41). No differences between the groups were detected for hypoxanthine or uric acid (serum markers of oxidative stress) or creatine kinase (a marker of skeletal muscle damage). Conclusion: Although in theory Q10 could be beneficial for exercise capacity and in decreasing oxidative stress, the present study could not demonstrate that such effects exist after supplementation with a recommended dose. © 2012 Elsevier Inc..


Jenssen I.H.,Ostfold Hospital | Johannessen K.B.,University of Aarhus
Body Image | Year: 2015

AAS users and contemplators report higher levels of aggression and body dissatisfaction than nonusers. No differences were found between AAS users and AAS contemplators on levels of aggression or body image concern. Interventions relating to aggression and body image concern may be useful to target at-risk and AAS using adolescents. AAS users and contemplators were investigated for differences in aggression and body image concern. Prevalence rates were sought as a secondary aim. 396 male adolescents at Norwegian high schools completed a questionnaire battery during school hours. Prevalence of AAS use showed 4.0%; AAS contemplation showed 5.1%. No significant differences between the AAS users and contemplators were found on levels of aggression and body image concern. AAS users and contemplators reported significantly higher levels of aggression and body image concern compared nonusing controls. AAS contemplators enhance understanding of AAS use by representing psychosocial factors contributing to increased aggression, and AAS use or risk thereof indicative of an aggressive personality profile. Body image concerns for AAS users and contemplators may indicate that AAS use does not diminish body image concern, and that body image concern is a risk factor for AAS use. This is supportive of previous research. © 2014 Elsevier Ltd.

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