Tønsberg, Norway
Tønsberg, Norway

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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.


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.


Spasojevic M.,Vestfold Hospital | Stimec B.V.,University of Geneva | Fasel J.F.,University of Geneva | Terraz S.,University of Geneva | Ignjatovic D.,Vestfold Hospital
Surgical Endoscopy and Other Interventional Techniques | Year: 2011

Background 3-D relations between the ileocolic (ICA), right colic artery (RCA) with the superior mesenteric vein (SMV) have been described in cadavers. However, no data exists on preoperative evaluation of these relations. Aim To define the length of crossing and 3-D position of the ICA and RCA to the SMV in patients undergoing multidetector computerized tomography (MDCT) angiography. Methods MDCT angiographies were analyzed with the aid of Osirix v.3.0.2. image processing application. All the datasets included arterial and venous phase, undergoing multimodal visualization: 2D multiplanar reconstruction with maximum intensity projection and 3D Volume rendering. The anatomical relations were analyzed in various planes (orthogonal and oblique), depending upon their particular course. When a clear spatial reference was achieved, the distance of the colic artery from their origin on the aorta to the right border of the SMV was measured, and its position noted. Results 50 MDCT were analyzed (29 male).RCA occurred in 27 patients (54.0%), 25 (92.6%) passed anterior to the SMV. Length of crossing was 22.7 ± 8.1 (8.3-41.3) mm. The ICA occurred in 48 (96%) passing under the SMV in 38 (79.2%). Length of crossing 15.4 ± 5.8 (14.0-26.6) mm. Conclusions RCA occurs in 54% patients, passes over the SMV in 92.6%specimens and leaves a 22.7 mmstump. ICA passes under the SMV in most cases, leaving a 15.4 mm stump. These data could be of crucial importance to the surgeon facing laparoscopic right colectomy for cancer. © Springer Science+Business Media, LLC 2010.


Hoff S.R.,Aalesund Hospital | Hoff S.R.,Norwegian University of Science and Technology | Abrahamsen A.-L.,Vestfold Hospital | Samset J.H.,Aalesund Hospital | And 4 more authors.
Radiology | Year: 2012

Purpose: To compare the percentages and mammographic features of cancers missed at full-field digital mammography (FFDM) and screen-film mammography (SFM) in women who participated in the Norwegian Breast Cancer Screening Program in 2002-2008. Materials and Methods: Social Science Data Services approval was obtained; the requirement for informed consent was waived. Cases were all the interval and screening-detected cancers from 35 127 FFDM and 52 444 SFM examinations in two Norwegian counties. Prior and diagnostic FFDM examinations of 49 interval and 86 screening-detected breast cancers were reviewed by four breast radiologists and compared with a review of SFM examinations of 81 interval and 123 screening-detected cancers. Cancers were classified as missed or true, mammographic features were described, percentages were compared by using the x2 or Fisher exact test, and 95% confidence intervals (CIs) were calculated. Results: The percentages of interval and screening-detected cancers missed at FFDM and SFM did not differ significantly. (interval cancers missed: 33% [16 of 49] at FFDM vs 30% [24 of 81] at SFM [P = .868]; screening-detected cancers missed: 20% [17 of 86] at FFDM vs 21% [26 of 123] at SFM [P = .946]). Asymmetry was present in 27% (95% CI: 13.3%, 45.5%) of prior mammograms of cancers missed at FFDM and 10% (95% CI: 3.3%, 21.8%) of those missed at SFM (P = .070). Calcifications were observed in 18% (95% CI: 7.0%, 35.5%) of the cancers missed at FFDM and 34% (95% CI: 21.2%, 48.8%) of those missed at SFM (P = .185). Average mammographic tumor size of missed cancers manifesting as masses was 10.4 mm at FFDM and 13.6 mm at SFM (P = .036). Conclusion: The use of FFDM has not reduced the challenge of missed cancers. Cancers missed at FFDM tend to have different mammographic features than those missed at SFM. © RSNA, 2012.


Stoknes M.,Norwegian University of Science and Technology | Andersen G.L.,Norwegian University of Science and Technology | Andersen G.L.,Vestfold Hospital | Dahlseng M.O.,Norwegian University of Science and Technology | And 7 more authors.
Pediatrics | Year: 2012

BACKGROUND AND OBJECTIVES: To investigate the probable timing of events leading to cerebral palsy (CP) in singletons born small for gestational age (SGA) at term, taking neonatal death into consideration. METHODS: In this registry-based cohort study, data on 400 488 singletons born during 1996-2003 were abstracted from the Medical Birth and the CP registries of Norway. Among 36 604 SGA children (birth weight <10th percentile), 104 died in the neonatal period and 69 developed CP. Apgar scores at 5 minutes, risk factors, MRI findings, and CP subtypes were used to assess the timing of events leading to CP or neonatal death. RESULTS: Intrapartum origin of CP was considered in 5 SGA children (7%; 95% confidence interval: 3-16) in comparison with 31 of 263 (12%; 95% confidence interval: 8-16) non-SGA children (P = .28). The proportions of children who died in the neonatal period after a probable intrapartum event did not differ between the groups when children with congenital malformations were excluded. Probable antenatal events leading to CP and neonatal death were more common among SGA than non-SGA children (P < .001). CONCLUSIONS: In ∼90% of children born SGA the event leading to CP is of probable antenatal origin. The low proportion of SGA children with CP after a probable intrapartum event was not outweighed by a higher neonatal mortality rate when congenital malformations were excluded. The higher risk of CP among SGA than among non-SGA children is probably due to a higher prevalence of antenatal risk factors. Copyright © 2012 by the American Academy of Pediatrics.


Hervik J.,Vestfold Hospital | Mjaland O.,Sorlandet Sykehus
International Journal of Women's Health | Year: 2010

Objective: The aim of this study was to examine the quality of life of breast cancer patients medicated with estrogen antagonists, 2 years after having acupuncture treatment for hot flashes. Methods and materials: Our sample was taken from women who had recently participated in a randomized controlled trial investigating the effects of acupuncture on hot flashes, a side effect of estrogen-antagonist treatment. Forty-one women from the true acupuncture treatment group and 41 women from the control group (sham acupuncture), who had 2 years previously received a course of 15 acupuncture treatments over a period of 10 weeks, were asked to answer an open question. The question, "Would you like to share your thoughts and experiences related to your breast cancer diagnosis, treatments or anything else?" was by being open, broad, and nonspecific,intended to stimulate subjective information, which was not included in the original, or future quantitative studies. Qualitative data were analyzed using systematic text condensation.Results: Most women were troubled by two or more side effects due to anti-estrogen medication, negatively affecting their life quality. Symptoms included hot flashes, sleep problems, muscle and joint pain, arm edema, fatigue, weight gain, depression, and lack of sexual desire. Women previously treated with sham acupuncture complained that hot flashes were still problematic, whilst those previously treated with traditional Chinese acupuncture found them less of a problem and generally had a more positive outlook on life. These results compare favorably with the findings from our original study that measured quantitatively health related quality of life. Conclusion: Side effects due to anti-estrogen treatment seriously affect the quality of life of breast cancer operated patients. Patients who had previously been treated with traditional Chinese acupuncture complained less of hot flashes, and had a more positive outlook on life, than women who had previously been treated with sham acupuncture. © 2010 Hervik and Mjåland, publisher and licensee Dove Medical Press Ltd.


Elkamil A.I.,Norwegian University of Science and Technology | Andersen G.L.,Vestfold Hospital | Skranes J.,Norwegian University of Science and Technology | Lamvik T.,Norwegian University of Science and Technology | Vik T.,Norwegian University of Science and Technology
European Journal of Paediatric Neurology | Year: 2012

Background/aim: To study proportions and characteristics of children treated and un-treated with Botulinum neurotoxin (BoNT) in a population-based cohort of children with cerebral palsy (CP). Methods: All children with CP born during 1999-2003, recorded in the Norwegian CP Register were included (N = 411). Gross motor function was assessed using the gross motor classification system (GMFCS). Results: Sixty-eight percent of children with bilateral spastic, 63% with unilateral spastic and 41% with dyskinetic CP had received BoNT. The percentage of children treated increased from 62% at GMFCS level I to 88% at level IV, but was only 38% among children at level V. A similar trend was seen for fine motor function. Ninety-four percent of the children received BoNT in their lower limbs. Children without significant cognitive impairment were more often treated than children with such impairment (OR: 2.61; 95% CI: 1.49-4.58). Interpretation: In this first population-based study, approximately 2/3 of all children with spastic CP were treated with BoNT. The results suggest preference for treatment of children with potential for functional improvement, while treatment to relieve pain and facilitate care, and of children with cognitive impairment appeared to be less common. Whether the latter groups are treated appropriately requires further studies. © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.


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.

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