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Carlsen S.M.,Norwegian University of Science and Technology | Svartberg J.,University Hospital of North | Svartberg J.,University of Tromsø | Schreiner T.,University of Oslo | And 6 more authors.
Clinical Endocrinology | Year: 2011

Objective Treatment with somatostatin analogues is the primary medical treatment of acromegaly. Controversies still exist whether acute octreotide effect predicts long-term biochemical effects, tumour regression or surgical cure. This prospective study investigates effect of 6-month treatment with octreotide long-acting repeatable (LAR) on insulin-like growth factor-1 (IGF-1) and growth hormone (GH) levels, pituitary function, tumour regression and postoperative cure in de novo acromegalic patients. Design and methods After a baseline evaluation including fasting hormone levels, MRI scan and an acute 50 Îg octreotide test, 32 patients were treated with octreotide LAR 20 mg every 28th day for 6 months before surgery. Treatment effects on IGF-1 and GH levels, serum hormone levels and tumour volume were monitored. Surgical cure was evaluated 3 months postoperatively. Results Mean tumour volume reduction was 35%, in one-third of the patients more than 50%, while approximately one-third achieved biochemical remission evaluated by normalized IGF-1 levels. The GH reduction following an acute octreotide test was 81 ± 19% and associated with long-term GH reduction (r = 0·78, P < 0·0005). However, neither acute (r = 0·29, P = 0·12) nor the long-term octreotide effect (r = 0·11, P = 0·58) on GH levels was associated with tumour volume reduction and did not predict subsequent surgical cure. Conclusion Six months of long-acting octreotide using a fixed dose, 1/3 of the patients came in biochemical remission, while 2/3 had significant tumour reduction. Moreover, an acute effect of octreotide seemed to be a prerequisite for long-term effect. © 2011 Blackwell Publishing Ltd.


Vedeler C.A.,Haukeland University Hospital | Vedeler C.A.,University of Bergen | Farbu E.,University of Stavanger | Mellgren S.I.,University Hospital of North | Mellgren S.I.,University of Tromsø
Acta Neurologica Scandinavica | Year: 2013

Background: Chronic immune-mediated demyelinating polyneuropathies can often lead to severe neurologic disability. Materials and methods: Literature review and personal experience with these types of neuropathies. Conclusions: It is important to recognize these immune-mediated neuropathies as they respond to treatment. © 2012 John Wiley & Sons A/S.


Hegstad K.,University Hospital of North | Hegstad K.,University of Tromsø | Mikalsen T.,University of Tromsø | Coque T.M.,CIBER ISCIII | And 3 more authors.
Clinical Microbiology and Infection | Year: 2010

Mobile genetic elements (MGEs) including plasmids and transposons are pivotal in the dissemination and persistence of antimicrobial resistance in Enterococcus faecalis and Enterococcus faecium. Enterococcal MGEs have also been shown to be able to transfer resistance determinants to more pathogenic bacteria such as Staphylococcus aureus. Despite their importance, we have a limited knowledge about the prevalence, distribution and genetic content of specific MGEs in enterococcal populations. Molecular epidemiological studies of enterococcal MGEs have been hampered by the lack of standardized molecular typing methods and relevant genome information. This review focuses on recent developments in the detection of MGEs and their contribution to the spread of antimicrobial resistance in clinically relevant enterococci. © 2010 European Society of Clinical Microbiology and Infectious Diseases.


Oliveira M.,University of Aveiro | Serrano J.A.,University Hospital of North
Proceedings - Frontiers in Education Conference, FIE | Year: 2010

This paper tends to present how eLearning strategies and policies used, in a Portuguese district (Aveiro), are enhancing learning and knowledge for heterogeneous audiences with constraints that are beyond the usual. Besides time to learn and physical distance, they face new challenges like, the need to get specialized in areas where economy is growing; where companies need to adapt to new markets; where the technology revolution is a priority. Experience achieved tells the professionals observed have shown great interest in eLearning actions and for a hybrid methodology. By a simple empirical evaluation, professionals agree that information and communication technologies (ICT) are, in fact, very helpful for those who have several constraints to learn. The use of Learning Management Systems (LMS) tends to accomplish the learning assessments and skills, although there are a lot of improvements that can be done through ICT, especially to promote self-study. The paper presents experiences done with a new learning application that enables a more intelligent and friendly content organization and promotes actor's participation powering efficient learning. © 2010 IEEE.

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