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Shiryaeva O.,University Institute of Health Sciences | Shiryaeva O.,University Hospital North Norway | Aasmoe L.,University Hospital North Norway | Aasmoe L.,University Institute of Health Sciences | And 3 more authors.
American Journal of Industrial Medicine | Year: 2011

Trawler fishermen and merchant seafarers have tough working conditions. While workers in both occupations are exposed to a challenging environment, trawler fishermen are also engaged in onboard fish processing, which is considered to be additional exposure. The aim of the present study was to characterize respiratory health status in both groups of seamen. Methods: In total 127 trawler fishermen and 118 merchant seafarers were enrolled during their regular medical health examinations. The study protocol comprised a standardized questionnaire, lung function test and measurements of fractional nitric oxide concentrations (FE NO) in exhaled air. Results: Doctor-diagnosed asthma was reported only by trawler fishermen (3.9%, P<0.05, Pearson Chi-square test). Adjusted odds ratios (OR) of respiratory symptoms were more often elevated in trawler fishermen compared to merchant seafarers. Trawler fishermen had reduced spirometric parameters: FEV 1 % of predicted values (adjusted β: -5.28, 95%CI: -9.28 to -1.27), FVC % of predicted values (adjusted β: -5.21, 95%CI: -9.25 to -1.17). Increased OR of the work-related cough with phlegm (OR: 6.6, 95% CI: 1.8-21.9), running nose (OR: 3.0, 95%CI: 1.2-7.7), and frequent sneezing (OR: 3.4, 95%CI: 1.0-12.7) were found among those trawler workers whose work tasks included filleting of fish. FE NO levels were not significantly different between trawler and merchant seamen. Conclusions: The present study indicated that trawler fishermen exhibited impaired lung function and were more likely to have asthma. The environment of the onboard factories where fishermen fillet fish is suggested as a risk factor for work-related respiratory symptoms. © 2011 Wiley Periodicals, Inc.


Kilminster S.,Institute of Naval Medicine | Muller S.,University Hospital North Norway | Menon M.,Ford Motor Company | Joseph J.V.,University of Rochester | And 2 more authors.
BJU International | Year: 2012

What's known on the subject? and What does the study add? Over the last decade, the surgical treatment of prostate cancer has evolved towards minimal access surgery, particularly via a robot-assisted technique. However, there is still debate regarding the true benefit for patients with respect to a functional outcome such as erectile function. The present prediction model provides a reliable estimation of the likelihood of regaining erectile function after prostatectomy. OBJECTIVE To identify the reported rates of potency after prostatectomy in the recent literature for men without preoperative erectile dysfunction (ED) and to develop a statistical model for predicting the expected potency after prostatectomy. MATERIALS AND METHODS A Medline search was conducted with the keywords 'potency' and 'prostatectomy' from 2003 to 2009. In total, 33 studies in the English language reporting pre- and postoperative erectile function were identified. Data from studies reporting outcome after open, laparoscopic and robot-assisted prostatectomy were analyzed separately. Only data obtained from potent men before surgery were included in the analysis. RESULTS In potent men before surgery, the main predictors of post-treatment erectile function are age and time after treatment. The cumulative range of potency rates at 48 months for all ages (45-75 years) was 49-74% for open, 58-74% for laparoscopic and 60-100% for robotic prostatectomy. The predicted outcome differs by type of operation and patient age. CONCLUSIONS Men aged <60 years have a significant likelihood of regaining erectile function after radical prostatectomy. The reported statistical model provides a reliable estimation of erectile function outcome after prostatectomy for men with localized prostate cancer and intact erectile function. © 2011 BJU INTERNATIONAL.


Rosner A.,University of Tromsø | Avenarius D.,University of Tromsø | Malm S.,University Hospital North Norway | Malm S.,University of Tromsø | And 4 more authors.
European Heart Journal Cardiovascular Imaging | Year: 2015

Aims: Detection and correct localization of transmural lesions can be important for optimal treatment of patients with chronic coronary artery disease(CAD). The aim of the studywas to investigate the ability of peak longitudinal ejection strain (PLS) to detect the presence and extent of scar-tissue in CAD patients with normal or near normal ejection fraction, in comparison to cardiac magnetic resonance (CMR). Methods and results: Before coronary artery bypass grafting, 57 patients underwent late gadolinium enhancement (LGE) CMR and echocardiography at rest and dobutamine stress (DS). According to the degree of LGE, segments were allocated to groups of none, subendocardial (1-50%), subtotal (51-75%), and total transmural scars (>75%). Dysfunctional segments were identified by PLS or wall motion scores (WMS). The finding of normal/near normal resting WMS and PLS, excellently identified segments without transmural LGE (AUC 94.0 CI 90.6-97.3 and AUC 85.7 CI 79.0-92.3, respectively). However, the finding of akinesia did not necessarily indicate transmural scarring. The negative predictive value was high (99%, CI 98-100%) while the positive predictive value was low. Detection-rates for subendocardial LGE were low. Conclusion: Normo- and slightly hypokinetic myocardium by resting WMS or strain detects the absence of transmural scars. However, the finding of severe hypo- and akinesia does not reliably predict transmural scarring, with no improvement by the addition of DS. Detection of predominant akinesia with less than two normo- or hypokinetic segments in the territory of a high-grade coronary stenosis or occlusion, warrants further examination by LGE-CMR. © The Author 2015.


Nenad T.,University of Tromsø | Reiner W.,Berufsgenossenschaftliche Unfallklinik | Michael S.,Berufsgenossenschaftliche Unfallklinik | Reinhard H.,Berufsgenossenschaftliche Unfallklinik | Hans H.,University Hospital North Norway
Journal of Trauma - Injury, Infection and Critical Care | Year: 2010

Background: The management strategies for reconstruction of soft-tissue defects of the lower leg and the foot remain disputed. To date, no comprehensive studies have been reported on the saphenous perforator flaps in reconstructive surgery in patients with posttraumatic osteomyelitis. MATERIAL:: Fifty patients with lower leg postinjury chronic osteomyelitis were included in a retrospective, noncontrolled clinical study conducted from 1995 to 2006. All study patients were managed by distally based saphenous neurofasciocutaneous perforator flaps, the feeding perforators originating from the tibial artery. An endpoint survey was conducted after flap surgery, mean follow-up period 4 years, response rate 60%. Results: Six patients had short-term flap failure (12%, 95% confidence interval: 5-24). An additional six patients had flap necrosis of <1/4 that healed without surgical revision. Based on the endpoint data, the long-term success rate was 70% (95% confidence interval: 51-85). Three variables had impact on flap failure rates: the number of previous reconstructive operations, the identity of the performing surgeon, and the area of the primary defect. Other assumed risk factors had no statistically significant impact on short- or long-term results. The anatomic localization of the perforating arteries is described. Conclusion: The saphenous perforator flap is a sturdy flap with low short-term failure rates, also in high-risk patients. The success rate compares well with results of free flap transfers in the management of posttraumatic osteomyelitis. The saphenous flap is a feasible option for posttraumatic reconstructions of osteomyelitis, especially in low-resource settings. © 2010 Lippincott Williams & Wilkins.


Murad M.K.,Foundation Medicine | Husum H.,University Hospital North Norway
Prehospital and Disaster Medicine | Year: 2010

Introduction: Recent studies demonstrate that early, in-field, basic life support by paramedics improves trauma survival where prehospital transport times are long. So far, no case-control studies of the effect of layperson trauma first responders have been reported. It was hypothesized that trained layperson first responders improve trauma outcomes where prehospital transit times are long.Methods: A rural prehospital trauma system was established in the mine and war zones in Iraq, consisting of 135 paramedics and 7,000 layperson trauma first responders in the villages. In a non-randomized clinical study, the outcomes of patients initially managed in-field by first-responders were compared to patients not receiving first-responder support.Results: The mortality rate was significantly lower among patients initially managed in-field by first responders (n = 325) compared to patients without first-responder support (n = 1,016), 9.8% versus 15.6%, 95% CI = 1.3-10.0%.Conclusions: Trained layperson first responders improve trauma outcomes where prehospital evacuation times are long. This finding demonstrates that simple interventions done early - by any type of trained care provider - are crucial for trauma survival. Where the prevalence of severe trauma is high, trauma first-responders should be an integral element of the trauma system. © World Association for Disaster and Emergency Medicine 2010.


Viet L.,Dong - A University | Husum H.,University Hospital North Norway
Southeast Asian Journal of Tropical Medicine and Public Health | Year: 2012

The study examines the epidemiology of cluster weapon and land mine accidents in Quang Tri Province since the end of the Vietnam War. The province is located just south of the demarcation line and was the province most affected during the war. In 2009, a cross sectional household study was conducted in all nine districts of the province. During the study period of 1975-2009, 7,030 persons in the study area were exposed to unexploded ordnances (UXO) or land mine accidents, or 1.1% of the provincial population. There were 2,620 fatalities and 4,410 accident survivors. The study documents that the main problem is cluster weapons and other unexploded ordnances; only 4.3% of casualties were caused by land mines. The legacy of the war affects poor people the most; the accident rate was highest among villagers living in mountainous areas, ethnic minorities, and low-income families. The most common activities leading to the accidents were farming (38.6%), collecting scrap metal (11.2%), and herding of cattle (8.3%). The study documents that the people of the Quang Tri Province until this day have suffered heavily due to the legacy of war. Mine risk education programs should account for the epidemiological findings when future accident prevention programs are designed to target high-risk areas and activities.


Eckhoff C.,University Hospital North Norway | Eckhoff C.,Health Science University | Kvernmo S.,University Hospital North Norway | Kvernmo S.,Health Science University
BMC Public Health | Year: 2014

Background: Pain is common in otherwise healthy adolescents. In recent years widespread musculoskeletal pain, in contrast to single site pain, and associating factors has been emphasized. Musculoskeletal pain has not been examined in Arctic indigenous adolescents. The aim of this study was to explore the prevalence of widespread musculoskeletal pain and its association with psychosocial factors, with emphasis on gender- and ethnic differences (Sami vs. non-Sami), and the influence of pain related functional impairment. Methods. This is a cross-sectional study based on The Norwegian Arctic Adolescent Health Study; a school-based survey responded by 4,881 10th grade students (RR: 83%) in North Norway, in 2003-2005. 10% were indigenous Sami. Musculoskeletal pain was based on reported pain in the head, shoulder/neck, back and/or arm/knee/leg, measured by the number of pain sites. Linear multiple regression was used for the multivariable analyses. Results: The prevalence of musculoskeletal pain was high, and significantly higher in females. In total, 22.4% reported 3-4 pain sites. We found a strong association between musculoskeletal pain sites and psychosocial problems, with a higher explained variance in those reporting pain related functional impairment and in females. There were no major differences in the prevalence of musculoskeletal pain in Sami and non-Sami, however the associating factors differed somewhat between the indigenous and non-indigenous group. The final multivariable model, for the total sample, explained 21.2% of the variance of musculoskeletal pain. Anxiety/depression symptoms was the dominant factor associated with musculoskeletal pain followed by negative life events and school-related stress. Conclusions: Anxiety/depression, negative life events, and school-related stress were the most important factors associated with musculoskeletal pain, especially in those reporting pain related functional impairment. The most important sociocultural aspect is the finding that the indigenous Sami are not worse off. © 2014 Eckhoff and Kvernmo; licensee BioMed Central Ltd.


Murbraech K.,University of Oslo | Wethal T.,Norwegian University of Science and Technology | Smeland K.B.,University of Oslo | Holte H.,University of Oslo | And 8 more authors.
JACC: Cardiovascular Imaging | Year: 2016

Objectives This study assessed the prevalence and associated risk factors for valvular dysfunction (VD) observed in adult lymphoma survivors (LS) after autologous hematopoietic stem cell transplantation (auto-HCT), and to determine whether anthracycline-containing chemotherapy (ACCT) alone in these patients is associated with VD. Background The prevalence of and risk factors for VD in LS after auto-HCT is unknown. Anthracyclines may induce heart failure, but any association with VD is not well-defined. Methods This national cross-sectional study included all adult LS receiving auto-HCT from 1987 to 2008 in Norway. VD was defined by echocardiography as either more than mild regurgitation or any stenosis. Observations in LS were compared with a healthy age- and gender-matched (1:1) control group. Results In total, 274 LS (69% of all eligible) participated. Mean age was 56 ± 12 years, mean follow-up time after lymphoma diagnosis was 13 ± 6 years, and 62% of participants were males. Mean cumulative anthracycline dosage was 316 ± 111 mg/m2, and 35% had received radiation therapy involving the heart (cardiac-RT). VD was observed in 22.3% of the LS. Severe VD was rare (n = 9; 3.3% of all LS) and mainly aortic stenosis (n = 7). We observed VD in 16.7% of LS treated with ACCT alone (n = 177), corresponding with a 3-fold increased VD risk (odds ratio: 2.9; 95% confidence interval: 1.5 to 5.8; p = 0.002) compared with controls. Furthermore, the presence of aortic valve degeneration was increased in the LS after ACCT alone compared with controls (13.0% vs. 2.9%; p < 0.001). Female sex, age >50 years at lymphoma diagnosis, ≥3 lines of chemotherapy before auto-HCT, and cardiac-RT >30 Gy were identified as independent risk factors for VD in the LS. Conclusions In LS, ACCT alone was significantly associated with VD and related to valvular degeneration. Overall, predominantly moderate VD was prevalent in LS, and longer observation time is needed to clarify the clinical significance of this finding. © 2016 American College of Cardiology Foundation.


Bania E.V.,Health Science University | Lydersen S.,Norwegian University of Science and Technology | Kvernmo S.,Health Science University | Kvernmo S.,University Hospital North Norway
BMC Public Health | Year: 2016

Background: Education is closely associated with health. Non-completion of upper secondary school influences academic achievement, employment, income and personal well-being. The purpose of the study is to explore predictors of non-completion of upper secondary school among female and male young adults in relation to mental health and educational factors in a socio-cultural, Arctic context. Methods: The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003-2005. Eighty-three percent of the population of 5,877 10th graders participated; 49.1%females, 450 reported indigenous Sami ethnicity, and 304 reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database (NUDB) Norway for 3,987 adolescents who gave their consent for follow-up studies. Results: Non-completion of upper secondary school was 36.9 % among females and 36.6 % among males. Among females, predictors for non-completion were related to mental health symptoms, and among males, to residency in the northernmost and remote areas and self-reported functional difficulties at school, home and in leisure activities due to mental health problems. There was marginal significance between ethnicity and non-completion of upper secondary school, measured at 41.3 % for Sami and 36.8 % for non-Sami, respectively. Conclusions: The gender differences found in this study emphasize the need for gender-specific interventions in preventing non-completion of upper secondary school. There is a need to recognize and treat extensive pro-social behaviour and social problems in young females. Young males from remote areas and those who in early adolescence struggle with functional impairment due to mental health problems need early interventions in lower secondary school. Enhancing parents' and teachers' ability to detect symptoms and problems as well as low-threshold health services starting in primary school can be effective means. Education, mental health and social inclusion are prominent factors for future employment, income and independent living for young people. Future research should focus more on gender-specific patterns of risk and protective factors for completion of upper secondary school. © 2016 The Author(s).


PubMed | University Hospital North Norway, Norwegian University of Science and Technology and University of Oslo
Type: Journal Article | Journal: JACC. Cardiovascular imaging | Year: 2016

This study assessed the prevalence and associated risk factors for valvular dysfunction (VD) observed in adult lymphoma survivors (LS) after autologous hematopoietic stem cell transplantation (auto-HCT), and to determine whether anthracycline-containing chemotherapy (ACCT) alone in these patients is associated with VD.The prevalence of and risk factors for VD in LS after auto-HCT is unknown. Anthracyclines may induce heart failure, but any association with VD is not well-defined.This national cross-sectional study included all adult LS receiving auto-HCT from 1987 to 2008 in Norway. VD was defined by echocardiography as either more than mild regurgitation or any stenosis. Observations in LS were compared with a healthy age- and gender-matched (1:1) control group.In total, 274 LS (69% of all eligible) participated. Mean age was 56 12 years, mean follow-up time after lymphoma diagnosis was 13 6 years, and 62% of participants were males. Mean cumulative anthracycline dosage was 316 111 mg/m(2), and 35% had received radiation therapy involving the heart (cardiac-RT). VD was observed in 22.3% of the LS. Severe VD was rare (n = 9; 3.3% of all LS) and mainly aortic stenosis (n = 7). We observed VD in 16.7% of LS treated with ACCT alone (n = 177), corresponding with a 3-fold increased VD risk (odds ratio: 2.9; 95% confidence interval: 1.5 to 5.8; p = 0.002) compared with controls. Furthermore, the presence of aortic valve degeneration was increased in the LS after ACCT alone compared with controls (13.0% vs. 2.9%; p < 0.001). Female sex, age >50 years at lymphoma diagnosis, 3 lines of chemotherapy before auto-HCT, and cardiac-RT >30 Gy were identified as independent risk factors for VD in the LS.In LS, ACCT alone was significantly associated with VD and related to valvular degeneration. Overall, predominantly moderate VD was prevalent in LS, and longer observation time is needed to clarify the clinical significance of this finding.

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