Drammen, Norway
Drammen, Norway

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Soraas A.,Vestre Viken Hospital Trust | Sundsfjord A.,University of Tromsø | Sandven I.,University of Oslo | Brunborg C.,University of Oslo | Jenum P.A.,Vestre Viken Hospital Trust
PLoS ONE | Year: 2013

Community-acquired urinary tract infection (CA-UTI) is the most common infection caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, but the clinical epidemiology of these infections in low prevalence countries is largely unknown. A population based case-control study was conducted to assess risk factors for CA-UTI caused by ESBL-producing E. coli or K. pneumoniae. The study was carried out in a source population in Eastern Norway, a country with a low prevalence of infections caused by ESBL-producing Enterobacteriaceae. The study population comprised 100 cases and 190 controls with CA-UTI caused by ESBL-producing and non-ESBL-producing E. coli or K. pneumoniae, respectively. The following independent risk factors of ESBL-positive UTIs were identified: Travel to Asia, The Middle East or Africa either during the past six weeks (Odds ratio (OR) = 21; 95% confidence interval (CI): 4.5-97) or during the past 6 weeks to 24 months (OR = 2.3; 95% CI: 1.1-4.4), recent use of fluoroquinolones (OR = 16; 95% CI: 3.2-80) and β-lactams (except mecillinam) (OR = 5.0; 95% CI: 2.1-12), diabetes mellitus (OR = 3.2; 95% CI: 1.0-11) and recreational freshwater swimming the past year (OR = 2.1; 95% CI: 1.0-4.0). Factors associated with decreased risk were increasing number of fish meals per week (OR = 0.68 per fish meal; 95% CI: 0.51-0.90) and age (OR = 0.89 per 5 year increase; 95% CI: 0.82-0.97). In conclusion, we have identified risk factors that elucidate mechanisms and routes for dissemination of ESBL-producing Enterobacteriaceae in a low prevalence country, which can be used to guide appropriate treatment of CA-UTI and targeted infection control measures. © 2013 Søraas et al.


Solbakken O.A.,University of Oslo | Solbakken O.A.,Vestre Viken Hospital Trust | Abbass A.,Dalhousie University
BMC Psychiatry | Year: 2014

Background: This protocol presents a systematic residential treatment- and research program aimed at patients who have not responded adequately to previous treatment attempts. Patients included in the program primarily suffer from anxiety and/or depressive disorders and usually from one or more comorbid personality disorders. The treatment program is time-limited (eight weeks) and has its basis in treatment principles specified in intensive short-term dynamic psychotherapy (ISTDP). This treatment modality is theoretically well-suited for the handling of various forms of treatment resistance presumably central to these patients' previous non-response to psychological and psychiatric interventions.Methods/Design: The research component of the project entails a naturalistic longitudinal research design which aims at systematic evaluation of the effectiveness of the program. To our knowledge, this is one of the first treatment programs and corresponding research projects that systematically select patients with previous non- or negative response to treatment and subjects them to a broad and comprehensive, but theoretically unified and consistent treatment system.Discussion: The present paper introduces the project, describes its theoretical and methodological underpinnings, and discusses possible future implications and contributions of the project. It thereby serves as a comprehensive background reference to future publications from the project. © 2014 Solbakken and Abbass; licensee BioMed Central Ltd.


Waldum B.,University of Oslo | Westheim A.S.,University of Oslo | Sandvik L.,University of Oslo | Flonaes B.,Vestre Viken Hospital Trust | And 5 more authors.
Journal of the American College of Cardiology | Year: 2012

Objectives: The aim of this study was to evaluate the prognostic impact of anemia in outpatients with chronic heart failure attending specialized heart failure clinics and specifically to investigate its prognostic utility in patients with severe renal dysfunction or advanced heart failure. Background: Anemia is an independent prognostic marker in patients with heart failure. The effect of anemia on mortality decreases with increasing creatinine levels. Methods: Multivariate Cox regression analyses were used to investigate the prognostic effect of anemia in 4,144 patients with heart failure from 21 outpatient heart failure clinics in Norway. Severe renal failure was defined as estimated glomerular filtration rate ≤45 ml/min/1.73 m2 and advanced heart failure as New York Heart Association functional classes IIIb and IV. Results: Baseline anemia was present in 24% and was a strong predictor of all-cause mortality (adjusted hazard ratio [HR]: 1.30, 95% CI: 1.09 to 1.56, p = 0.004). Baseline anemia did not predict mortality in the 752 patients with severe renal dysfunction (adjusted HR: 1.08, 95 % CI: 0.77 to 1.51, p = 0.662) and the 528 patients with advanced heart failure (adjusted HR: 0.87, 95% CI: 0.56 to 1.34, p = 0.542). In the 1,743 patients who attended subsequent visits, sustained anemia independently predicted worse prognosis (adjusted HR: 1.47, 95% CI: 1.10 to 1.94, p = 0.008), whereas transient and new-onset anemia did not. Conclusions: According to our study, baseline anemia was not an independent predictor of all-cause mortality in outpatients with heart failure and accompanied severe renal dysfunction or advanced heart disease. Sustained anemia after optimizing heart failure treatment might imply worse prognosis independently of renal function and New York Heart Association functional class. © 2012 American College of Cardiology Foundation.


Torgalsboen A.-K.,University of Oslo | Mohn C.,Vestre Viken Hospital Trust | Rishovd Rund B.,University of Oslo | Rishovd Rund B.,Vestre Viken Hospital Trust
Psychiatry Research | Year: 2014

In a Norwegian ongoing longitudinal study, we investigate the neurocognitive development in first-episode schizophrenia patients, and the influence of neurocognition on remission and real life functioning. In the present study, results from the early course of illness are reported.The sample includes 28 schizophrenia spectrum patients and 28 pairwise matched healthy controls. The patients were recruited from mental health service institutions and data on psychosocial functioning, remission and neurocognition were obtained through a clinical interview, an inventory on social and role functioning, operational criteria of remission, and a standardized neurocognitive test battery, the MATRICS Consensus Cognitive Battery (MCCB).Large effect size differences between patients and controls were observed at baseline on every cognitive domain, as well as statistically significant improvements on overall cognitive function at follow-up for the patient group. A remission rate of 61% was found. The neurocognitive baseline measure of Attention significantly predicted remission status at follow-up, whereas Attention and Working Memory at baseline predicted levels of social and role functioning.In the early course of the illness, more than half of the group of first-episode patients were in remission, and neurocognitive functions are significantly associated with both remission of symptoms and social and role functioning. © 2014 Elsevier Ireland Ltd.


Leivonen S.-K.,University of Oslo | Leivonen S.-K.,VTT Technical Research Center of Finland | Sahlberg K.K.,University of Oslo | Sahlberg K.K.,Vestre Viken Hospital Trust | And 5 more authors.
Molecular Oncology | Year: 2014

MicroRNAs (miRNAs) are non-coding RNAs regulating gene expression post-transcriptionally. We have characterized the role of miRNAs in regulating the human epidermal growth factor receptor 2 (HER2)-pathway in breast cancer. We performed miRNA gain-of-function assays by screening two HER2 amplified cell lines (KPL-4 and JIMT-1) with a miRNA mimic library consisting of 810 human miRNAs. The levels of HER2, phospho-AKT, phospho-ERK1/2, cell proliferation (Ki67) and apoptosis (cPARP) were analyzed with reverse-phase protein arrays. Rank product analyses identified 38 miRNAs (q < 0.05) as inhibitors of HER2 signaling and cell growth, the most effective being miR-491-5p, miR-634, miR-637 and miR-342-5p. We also characterized miRNAs directly targeting HER2 and identified seven novel miRNAs (miR-552, miR-541, miR-193a-5p, miR-453, miR-134, miR-498, and miR-331-3p) as direct regulators of the HER2 3'UTR. We demonstrated the clinical relevance of the miRNAs and identified miR-342-5p and miR-744* as significantly down-regulated in HER2-positive breast tumors as compared to HER2-negative tumors from two cohorts of breast cancer patients (101 and 1302 cases). miR-342-5p specifically inhibited HER2-positive cell growth, as it had no effect on the growth of HER2-negative control cells in vitro. Furthermore, higher expression of miR-342-5p was associated with better survival in both breast cancer patient cohorts. In conclusion, we have identified miRNAs which are efficient negative regulators of the HER2 pathway that may play a role in vivo during breast cancer progression. These results give mechanistic insights in HER2 regulation which may open potential new strategies towards prevention and therapeutic inhibition of HER2-positive breast cancer. © 2013 Federation of European Biochemical Societies.


Isaksen Jo.,Innlandet Hospital Trust | Diseth T.H.,University of Oslo | Schjolberg S.,Norwegian Institute of Public Health | Skjeldal O.H.,Vestre Viken Hospital Trust
European Journal of Paediatric Neurology | Year: 2013

Aim The aim of this paper is to report on how different external methodological factors influence estimates of ASD prevalence. Methods PubMed searches was conducted using the search terms, "Autism", "Autistic Disorder", "Autism Spectrum Disorders", "Asperger", "Prevalence" and "epidemiology", in combination. In total 49 studies were included. We also performed a manual search for and reviewed related articles referenced in the original articles. Results The reported prevalence rates of ASD vary widely, and so do the methodology used in the studies. Conclusion There are reasons to argue that the methods used in some studies cause the high prevalence rates reported recently. © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.


Sorensen I.M.,University of Oslo | Joner G.,University of Oslo | Jenum P.A.,Vestre Viken Hospital Trust | Eskild A.,University of Oslo | And 2 more authors.
Diabetes | Year: 2012

Previous studies indicate reduced risk of type 1 diabetes after intake of vitamin D supplements during pregnancy or early childhood. We aimed to test whether lower maternal serum concentrations of 25-hydroxy-vitamin D (25-OH D) during pregnancy were associated with an increased risk of childhood-onset type 1 diabetes. In this case-control study nested within a cohort of 29,072 women in Norway, 25-OH D levels were measured using a radioimmunoassay on samples from late pregnancy in 109 women delivering a child who developed type 1 diabetes before 15 years of age (case subjects) and from 219 control women. Dividing the levels of maternal 25-OH D into quartiles, there was a trend toward a higher risk of type 1 diabetes with lower levels of vitamin D during pregnancy. The odds of type 1 diabetes was more than twofold higher for the offspring of women with the lowest levels of 25-OH D compared with the offspring of those with levels above the upper quartile. Given future replication in independent cohorts, our findings provide support for the initiation of a randomized intervention trial to prevent type 1 diabetes in children by enhancing maternal 25-OH D status during pregnancy. © 2012 by the American Diabetes Association.


Fosse R.,Vestre Viken Hospital Trust | Richardson K.,Open University Milton Keynes
Frontiers in Psychiatry | Year: 2015

The classical twin method (CTM) is central to the view that schizophrenia is ~80% heritable. The CTM rests on the equal-environment assumption (EEA) that identical and fraternal twin pairs experience equivalent trait-relevant environmental exposures. The EEA has not been directly tested for schizophrenia with measures of child social adversity, which is particularly etiologically relevant to the disorder. However, if child social adversity is more similar in identical than fraternal pairs in the general twin population, the EEA is unlikely to be valid for schizophrenia, a question which we tested in this study. Using results from prior twin studies, we tested if intraclass correlations for the following five categories of child social adversity are larger in identical than fraternal twins: bullying, sexual abuse, physical maltreatment, emotional neglect and abuse, and general trauma. Eleven relevant studies that encompassed 9119 twin pairs provided 24 comparisons of intraclass correlations, which we grouped into the five social exposure categories. Fisher's z-test revealed significantly higher correlations in identical than fraternal pairs for each exposure category (z = 3.53, p < 0.001). The difference remained consistent across gender, study site (country), sample size, whether psychometric instruments were used, whether interviewing was proximate or distant to the exposures, and whether informants were twins or third persons. Combined with other evidence that the differential intraclass correlation for child social adversity cannot be explained by evocative gene-environment covariation, our results indicate that the CTM does not provide any valid indication of genomic effects in schizophrenia. © 2015 Fosse, Joseph and Richardson.


Dyrkorn O.A.,Vestre Viken Hospital Trust | Kristoffersen M.,Vestre Viken Hospital Trust | Walberg M.,Vestre Viken Hospital Trust
BMJ Quality and Safety | Year: 2012

Background: During 2006 and 2007 the rate of caesarean section surgical wound infection was 17,4% in Baerum Hospital. Objective: The objective was to reduce the incidence to below the Norwegian national level of 8%. Design: The intervention (a quality improvement project) was implemented in September 2008. A bundle of measures were introduced. Staff from all aspects of patient flow was recruited. Cochrane literature was used as gold standard. Data registration was based upon CDC criteria. Results were based on data collected through the Norwegian national surveillance system for infections in health care, NOIS. Study setting: This Maternity clinic has about 2500 births annually and a caesarean section rate pushing 15%. Patient group: The study was conducted on caesarean section patients registered in NOIS (2008-2010). From September 2009 data were harvested continuously. Assessment: Data were monitored as cumulative incidence rate and by statistical process control as g chart (number of surgeries between infections including a delayed moving average). Infection control staff reported results to Head of Maternity Clinic monthly. Results: The overall rate of caesarean section surgical wound infections was significantly reduced to 3,1% (2008-2010 about 1% in 2010). This result was demonstrated elegantly as a marked shift in process in g-chart. We found the g-chart was efficient, sensitive and simple to handle.


Avitsland T.L.,Vestre Viken Hospital Trust
British Journal of Cancer | Year: 2016

Background:Participation in cancer screening programmes might cause worries in the population outweighting the benefits of reduced mortality. The present study aimed to investigate possible psychological harm of participation in a colorectal cancer (CRC) screening pilot in Norway.Methods:In a prospective, randomised trial participants (aged 50–74 years) were invited to either flexible sigmoidoscopy (FS) screening, faecal immunochemical test (FIT), or no screening (the control group; 1 : 1: 1). Three thousand two hundred and thirteen screening participants (42% of screened individuals) completed the Hospital Anxiety and Depression Scale questionnaire as well as the SF-12—a health-related quality of life (HRQOL) questionnaire when invited to screening and when receiving the screening result. A control group was invited to complete the questionnaires only. Two thousand six hundred and eighteen control participants (35% of invited individuals) completed the questionnaire.Results:A positive screening result did not increase participants’ level of anxiety or depression, or decrease participants’ level of HRQOL. Participants who received a negative result reported decreased anxiety and improvement on some HRQOL dimensions. However, no change was considered to be of clinical relevance.Conclusion:The current study showed no clinically relevant psychological harm of receiving a positive CRC screening result or of participating in FS or FIT screening, in a Norwegian population.British Journal of Cancer advance online publication 11 February 2016. doi:10.1038/bjc.2016.14 www.bjcancer.com. © 2016 Cancer Research UK

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