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Tønsberg, Norway

Brun A.C.,Vestfold Hospital | Stordal K.,Ostfold Hospital Trust | Johannesdottir G.B.,Akureyri Hospital | Bentsen B.S.,University of Oslo | Medhus A.W.,University of Oslo
Clinical Nutrition | Year: 2012

Background & aim: Dysmotility, nausea and vomiting are common among children with cerebral palsy. This study aimed to evaluate influence of protein composition on rate of gastric emptying and study the relation between gastric emptying and postprandial gastrointestinal symptoms. Methods: 15 children with cerebral palsy, using gastrostomy, received four liquid test meals on separate days in random order. The meals contained a standard carbohydrate and fat base plus one of four protein modules (100% casein (A), hydrolysed whey (B), amino acids (C) and 40% casein/60% whey (D)) with a total energy of 1kcal/ml. The 13C octanoic acid breath test was applied to assess gastric emptying. Results: When comparing half emptying time (T 1/2) of the fast emptying meals (meal B, C and D) with the slowest emptying meal (meal A), more rapid emptying was demonstrated for meal D (p<0.001). For meal D, emptying was significantly faster in children with postprandial symptoms than in those without (p<0.01). Conclusion: In children with cerebral palsy using gastrostomy, gastric emptying is influenced by type of protein in the meal. The present results also suggest that there is a relation between rapid gastric emptying and postprandial gastrointestinal symptoms. ClinicalTrials.gov: UUSKBK 28200706. © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.

Rimstad L.,University of Oslo | Larsen E.S.,Baerum Hospital | Schiotz H.A.,Vestfold Hospital | Kulseng-Hanssen S.,Baerum Hospital
Neurourology and Urodynamics | Year: 2014

Aim The aim of the study was to test the ability of pad stress tests with increasing load (supine, jumping on the floor, and jumping on a trampoline) to document stress incontinence in subjectively stress incontinent women. Methods In this prospective study 147 subjectively stress and mixed incontinent women performed consecutively the three pad stress tests with a bladder volume of 300ml. Nineteen women performed a second trampoline pad stress test to test repeatability of the test. Nine continent women performed a trampoline pad stress test in order to determine if subjectively continent women would leak during the test. Results Seventy-two women (49%) leaked during the supine, 136 (93%) leaked during the jumping, and 146 (99%) leaked during the trampoline pad stress test. The differences between pad stress tests were significant with P<0.005. Correlation between the two trampoline pad stress tests was high at 0.8. None of the nine continent women leaked during the trampoline pad stress test. Conclusion: The supine pad stress test has low sensitivity and is therefore often falsely negative. The jumping pad stress test is a simple test to perform and is satisfactory for everyday use. Subjectively stress incontinent women who do not leak during the jumping pad stress test may perform a trampoline pad stress test to document stress incontinence. The trampoline pad stress test is also simple to perform and detected leakage in 91% of the women who did not leak during the jumping pad stress test. © 2013 Wiley Periodicals, Inc.

Svenningsen R.,University of Oslo | Staff A.C.,University of Oslo | Schiotz H.A.,Vestfold Hospital | Western K.,Ostfold Hospital | Kulseng-Hanssen S.,Asker and Baerum Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2013

Introduction and hypothesis Retropubic tension-free vaginal tape (TVT) was introduced in 1996 as a new and innovative surgical approach in the treatment of stress urinary incontinence (SUI). In this study we evaluate the longterm objective and subjective outcomes in a non-selected patient population 10 years after the retropubic TVT procedure. Methods All women (603) operated on with retropubic TVT at four gynecological departments from September 1998 through December 2000 were identified, and those still alive (542) were invited to participate in this population-based prospective study. For subjective data a short-form urinary incontinence disease-specific questionnaire was used. For objective evaluation the women underwent a stress test. Data collected were merged with previously stored data in the Norwegian National Incontinence Registry Database. Results We included 483 women; 327 attended a clinical follow-up consultation and 156 had a telephone interview. Median duration of follow-up was 129 months. Objective cure rate was 89.9 %, subjective cure rate was 76.1 %, and 82.6 % of the patients stated they were "very satisfied" with their surgery (treatment satisfaction rate). Only 2.3 % of the women had undergone repeat SUI surgery. Subjective voiding difficulties were reported by 22.8 %, the majority describing slow stream or intermittency. De novo urgency incontinence increased significantly from 4.1 % 6-12 months after surgery to 14.9 % at the 10-year follow-up. Conclusions Long-term objective and subjective outcome after retropubic TVT is excellent with a low number of reoperations even in a non-selected cohort of patients. © The International Urogynecological Association 2013.

Kulseng-Hanssen S.,Baerum Hospital | Moe K.,Baerum Hospital | Schiotz H.A.,Vestfold Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2013

Introduction and hypothesis The study examined how often detrusor overactivity (DO) causes leakage during a stress test in women with mixed urinary incontinence (MUI) and whether there are differences between those who do and those who do not have DO during the stress test. Methods A retrospective study was performed in 100 women who had an ambulatory urodynamic recording done where bladder, urethral, and vaginal pressures, and leakage were recorded. The stress test consisted of 20 jumping jacks and three forceful coughs. Results All the women leaked during the stress test: five due to simultaneous stress test and DO, 87 due to the stress test only, and eight during the stress test as well as due to DO before or after the stress test. Conclusions During the stress test, 5 % of women with MUI leaked due to the coughs and jumps and simultaneous DO. Women in whom DO was detected had significantly higher Urgency Incontinence Index and leakage during the 24-h pad test.

Ignjatovic D.,Vestfold Hospital | Spasojevic M.,University North Norway Narvik Hospital | Stimec B.,University of Sfax | Stimec B.,University of Belgrade
American Journal of Surgery | Year: 2010

Background: The use of the gastrocolic trunk of Henle (GTH) as a landmark has been advocated in laparoscopic right colectomy. The aim of this study was to evaluate the GTH as a possible landmark in laparoscopic right colectomy in the context of the adjacent arteries. Methods: Corrosion casting (30 specimens) and anatomic dissection were performed on formol-fixed cadavers (12 specimens). Results: The GTH was found in 34 specimens (81.0%). Among its closely related neighboring arterial vessels, the right colic artery was the most frequent (19 cases [55.9%]). It passed by the GTH at a mean distance of 3.6 mm. The course of the arteries in relation to the GTH was caudal and parallel in most cases (29 [85.3%]), but there was also a significant portion of crossing schemes (11.7%). Conclusions: Although the GTH is a constant and conspicuous anatomic entity, it is not easily accessible, because of its tight relations to the right colon arteries. Instead, the authors advocate the use the superior right colic vein as an anatomic landmark leading to the GTH during laparoscopic right colectomy. © 2010 Elsevier Inc. All rights reserved.

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