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Skogen V, Langseth R, Rohde GE, Rysstad O, Sørlie T, Lie B. Prevalence of mental distress and factors associated with symptoms of major depression among people living with HIV in Norway. AIDS Care 2024; 36:173-180. [PMID: 37909108 DOI: 10.1080/09540121.2023.2275043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
For people living with HIV (PLHIV) who can access lifesaving treatment, HIV has become a chronic lifelong condition; however, PLHIV have more mental and somatic comorbidities than their HIV-negative peers. In this cross-sectional study, we assessed the prevalence of mental distress and identified factors associated with major depression among 244 well-treated PLHIV residing in Norway. Participants completed validated questionnaires covering mental and somatic health. The prevalence of mental distress, defined as a score on the Hopkins Symptom Check List-25 >1.75, was 32%, and that of symptoms of major depression, defined as a score on the Beck Depression Inventory-II ≥20, was 15%. The factors associated with major depressive symptoms identified using logistic regression were risk of drug abuse (adjusted odds ratio (AOR) 15.1, 95% confidence interval (CI) 3.28, 69.3), fatigue (AOR 12.5, 95% CI 3.90, 40.0), trouble sleeping (AOR 7.90, 95% CI 2.85, 21.9), African origin (AOR 3.90, 95% CI 1.28, 11.9), low education (AOR 3.31, 95% CI 1.18, 9.30), and non-disclosure (AOR 3.22, 95% CI 1.04, 10.0). Our findings indicate that the prevalence rates of mental distress and major depressive symptoms are higher among well-treated PLHIV residing in Norway than in the general population. These conditions are under-diagnosed and under-treated, and increased awareness is needed.
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Affiliation(s)
- Vegard Skogen
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
| | - Ranveig Langseth
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
| | - Gudrun E Rohde
- Department of Clinical Research, Hospital of Southern Norway, Kristiansand, Norway
- Faculty of Health & Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ole Rysstad
- Department of Internal Medicine, Hospital of Southern Norway, Kristiansand, Norway
| | - Tore Sørlie
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
- Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromso, Norway
| | - Birgit Lie
- Department of Psychosomatic and Trauma, Hospital of Southern Norway, Kristiansand, Norway
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Skogen V, Rohde GE, Langseth R, Rysstad O, Sørlie T, Lie B. Factors associated with health-related quality of life in people living with HIV in Norway. Health Qual Life Outcomes 2023; 21:14. [PMID: 36793070 PMCID: PMC9930362 DOI: 10.1186/s12955-023-02098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Despite the advances in the treatment of HIV, people living with HIV (PLHIV) still experience impairment of health-related quality of life (HRQOL). The aim of the study was to explore factors associated with HRQOL in a well-treated Norwegian HIV population. METHODS Two hundred and forty-five patients were recruited from two outpatient clinics to participate in this cross-sectional study of addiction, mental distress, post-traumatic stress disorder, fatigue, somatic health, and HRQOL. The latter was measured using the 36-Item Short Form Health Survey (SF-36). Stepwise multiple linear regression analysis was used to examine the adjusted associations between demographic and disease-related variables and HRQOL. RESULTS The study population was virologically and immunologically stable. Their mean age was 43.8 (SD = 11.7) years, 131 (54%) were men, and 33% were native Norwegians. Compared with the general population (published in previous studies), patients reported worse SF-36 scores for five of eight domains: mental health, general health, social function, physical role limitation, and emotional role limitation (all p < 0.001). Compared with men, women reported better SF-36 scores within the domains vitality (63.1 (23.6) vs. 55.9 (26.7), p = 0.026) and general health (73.4 (23.2) vs. 64.4 (30.1), p = 0.009). In the multivariate analyses, higher SF-36- physical component score values were independently associated with young age (p = 0.020), being employed, student, or pensioner (p = 0.009), low comorbidity score (p = 0.015), low anxiety and depression score (p = 0.015), being at risk of drug abuse (p = 0.037), and not being fatigued (p < 0.001). Higher SF-36-mental component score values were independently associated with older age (p = 0.018), being from a country outside Europe or from Norway (p = 0.029), shorter time since diagnosis, low anxiety and depression score (p < 0.001), answering 'no' regarding alcohol abuse (p = 0.013), and not being fatigued (p < 0.001). CONCLUSIONS HRQOL was poorer in PLHIV than in the general population in Norway. It is important to focus on somatic and mental comorbidities when delivering health-care services in the ageing population of PLHIV to improve HRQOL even among a well-treated group of PLHIV as found in Norway.
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Affiliation(s)
- Vegard Skogen
- Department of Infectious Diseases, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway. .,Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Breivika, 9037, Tromsø, Norway.
| | - Gudrun E Rohde
- Department of Clinical Research, Sørlandet Hospital, Kristiansand, Norway.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ranveig Langseth
- Department of Infectious Diseases, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Ole Rysstad
- Department of Internal Medicine, Sørlandet Hospital, Kristiansand, Norway
| | - Tore Sørlie
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Breivika, 9037, Tromsø, Norway.,Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Birgit Lie
- Department of Psychosomatic and Trauma, Sørlandet Hospital, Kristiansand, Norway
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Alkhaled T, Rohde G, Lie B, Johannessen B. Beyond challenges and enrichment: a qualitative account of cross-cultural experiences of nursing patients with an ethnic minority background in Norway. BMC Nurs 2022; 21:322. [PMID: 36419037 PMCID: PMC9685157 DOI: 10.1186/s12912-022-01102-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Substantial mass migrations to the Scandinavian countries have made them heterogeneous and multicultural societies. Migration has also influenced the workforce, especially the healthcare system that has had to accommodate a culturally diverse population. This qualitative study aimed to explore nurses' experiences in caring for patients with an ethnic minority background. METHODS Focus group interviews with a total of 21 nurses were conducted. Thematic analysis was performed on the transcribed and translated interviews. RESULTS The findings of this study revealed three major themes: various experiences concerning language barriers and the use of interpreters, the impact of religious and cultural values, and caring for patients with an ethnic minority background is professionally interesting but demanding. CONCLUSIONS Caring for culturally diverse patients offers both challenges and opportunities to enhance cultural competence and cultural sensitivity among nurses. Various culturally divergent needs of patients such as family visits, food preferences, expression of pain, and gender sensitivity are interlinked and depend on effective communication during encounters with nurses and the healthcare system at large.
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Affiliation(s)
- Tariq Alkhaled
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Gudrun Rohde
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway ,grid.417290.90000 0004 0627 3712Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
| | - Birgit Lie
- grid.417290.90000 0004 0627 3712Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
| | - Berit Johannessen
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Alkhaled T, Rohde G, Lie B, Johannessen B. Navigating the care between two distinct cultures: a qualitative study of the experiences of Arabic-speaking immigrants in Norwegian hospitals. BMC Health Serv Res 2022; 22:400. [PMID: 35346190 PMCID: PMC8959804 DOI: 10.1186/s12913-022-07833-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background During the past decades, there has been an increase in the number of immigrants to European and Scandinavian countries. This has challenged the health-care systems, which cater to the needs of patients despite their cultural and linguistic barriers, in these countries. Most studies on this topic have focused on the perspectives of health-care providers in delivering their service. The purpose of this qualitative study was to explore how hospitalized Arabic-speaking patients experienced their interaction with the Norwegian health-care system. Methods In-depth interviews with 20 participants and researcher’s participant observation were conducted to explore the idiosyncratic details and ascribed meanings that foreign-born patients attach to their everyday experience of the Norwegian health-care system. Thematic analysis was performed on the transcribed and translated versions of the in-depth interviews. Results The findings of this study indicated three interrelated core themes. Firstly, there exist challenges in understanding and being understood because of linguistic and cultural differences of newly migrated patients. Secondly, some patients missed the holistic and direct care available in their home countries. Finally, patients were satisfied with the Norwegian health-care system because of its compassion, care, and respect toward them as well as advanced health-care equipment. Conclusion Arabic-speaking patients in Norwegian hospitals experienced long waiting times and linguistic problems. Hence, a better and specialized interpreter service may resolve problems emanating from communication within the system and the subsequent delays in treatment. Compassionate care and the feeling of respect and love is the core strength of the Norwegian system as perceived by the patients.
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Langseth R, Berg RC, Rysstad O, Sørlie T, Lie B, Skogen V. Prevalence and predictors of fatigue among people living with HIV in Norway. AIDS Care 2021; 34:1008-1013. [PMID: 34074179 DOI: 10.1080/09540121.2021.1934379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Fatigue is the most commonly noted symptom among people living with human immunodeficiency virus (PLHIV). The aim of this study was to investigate the prevalence and predictors of fatigue among PLHIV in Norway. Two hundred and forty-four people were recruited from two hospitals to participate in a survey, which contained seven instruments used to investigate mental health, addiction, quality of life, and fatigue. More than a third of the participants (38.5%) suffered from fatigue. Predictors of fatigue were the presence of mental distress (adjusted odds ratio [AOR] 8.98, 95%CI 3.81, 21.15), multimorbidity (AOR 5.13, 95%CI 1.40, 18.73), living alone (AOR 2.99, 95%CI 1.36, 6.56), trouble sleeping (AOR 2.67, 95%CI 1.06, 6.71), and increased body pain (AOR 1.44, 95%CI 1.25, 1.67). To improve the quality of life for many PLHIV, the continuum of HIV care must address fatigue and its predictors.
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Affiliation(s)
- Ranveig Langseth
- Department of Infectious Diseases, Medical clinic, University Hospital of North Norway, Tromso, Norway.,Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromso, Norway
| | - Rigmor C Berg
- Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromso, Norway.,Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Ole Rysstad
- Department of Internal Medicine, Hospital of Southern Norway, Kristiansand, Norway
| | - Tore Sørlie
- Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromso, Norway.,Institute for Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromso, Norway
| | - Birgit Lie
- Department of Psychosomatic and Trauma, Hospital of Southern Norway, Kristiansand, Norway
| | - Vegard Skogen
- Department of Infectious Diseases, Medical clinic, University Hospital of North Norway, Tromso, Norway.,Institute for Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromso, Norway
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Stub T, Kiil MA, Lie B, Kristoffersen AE, Weiss T, Hervik JB, Musial F. Combining psychotherapy with craniosacral therapy for severe traumatized patients: A qualitative study from an outpatient clinic in Norway. Complement Ther Med 2020; 49:102320. [PMID: 32147031 DOI: 10.1016/j.ctim.2020.102320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 01/07/2020] [Accepted: 01/15/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Craniosacral therapy (CST) is an established complementary modality for several health complaints. A clinic for psychosomatics in Norway has included CST into a multimodal treatment approach for severely traumatized patients. The aim of this study was to investigate and describe the indications for the use of craniosacral therapy within trauma therapy. Specifically, to explore treatment philosophy, criteria for improvement, treatment aims, and the evaluation of the risk profile of the multimodal treatment approach. METHODS Semi-structured individual interviews (n = 8) and one focus group interview were conducted with the therapists at the Clinic for Psychosomatics, Hospital of Southern Norway, Kristiansand, Norway. The text data were transcribed verbatim, and the analysis of the material was conducted according to conventional and direct content analysis. RESULTS The therapists at the clinic applied a holistic treatment approach, based on their understanding of mind and body as one entity. To access emotions and traumata, they used a mixture of different treatment techniques. The therapists experienced patients with severe bodily symptoms as being less cognitively present and attributed this to the symptoms craving most mental resources. The craniosacral therapists' specific aims and task within the multimodal trauma therapy was to ease these physical complaints, so that cognitive and emotional resources could be utilized for therapy. The psychotherapists found that emotions and traumata were more accessible after CST. The general treatment goals were to increase symptom tolerance levels and to enable better self-care. Furthermore, the ability to transform negative behaviors and develop positive alternatives were considered to be signs of improvement. CONCLUSION The study participants considered that patients with complex traumas, including post-traumatic stress disorder, seemed to benefit from this multimodal treatment approach and appreciated its' holistic treatment philosophy, including craniosacral therapy. With regard to patient safety, the study participants recommended that craniosacral therapy for severely traumatized patients should only be provided in cooperation with psychotherapists, or other highly qualified health personnel working in specialized institutions.
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Affiliation(s)
- Trine Stub
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UIT The Arctic University of Norway, Norway.
| | - Mona A Kiil
- Psychiatry Research Group, Department of Clinical Medicine, UIT The Arctic University of Norway, Norway.
| | - Birgit Lie
- Clinic for Psychosomatics, Hospital of Southern Norway, Kristiansand, Norway.
| | - Agnete E Kristoffersen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UIT The Arctic University of Norway, Norway.
| | - Thomas Weiss
- Department of Biological and Clinical Psychology, Friedrich Schiller University of Jena, Germany.
| | - Jill Brook Hervik
- Department of Anesthesia, Pain Clinic, Vestfold Hospital Trust, 3116, Tonsberg, Norway.
| | - Frauke Musial
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UIT The Arctic University of Norway, Norway.
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Høyvik AC, Lie B, Willumsen T. Dental anxiety in relation to torture experiences and symptoms of post-traumatic stress disorder. Eur J Oral Sci 2018; 127:65-71. [PMID: 30444297 DOI: 10.1111/eos.12592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2018] [Indexed: 11/30/2022]
Abstract
Torture victims often show symptoms of dental anxiety when receiving dental care, but little systematic research is available. The purpose of this study was to explore torture experiences, symptoms of post-traumatic stress disorder (PTSD), and dental anxiety in refugees in Norway and to test the hypothesis that refugees with torture experiences are more prone to dental anxiety than refugees with no such experiences. A total of 173 refugees were interviewed shortly after an oral examination. The Modified Dental Anxiety Scale (MDAS) and the Harvard Trauma Questionnaire-PTSS16 were administered verbally through attending interpreters. Among torture victims (47%, n = 81), the prevalence of torture experiences involving mouth or teeth was 35% and 23%, respectively. Harvard Trauma Questionnaire mean sum scores were statistically significantly higher in torture victims (34.3 vs. 24.8). Torture survivors report a larger number of symptoms of PTSD, and dental anxiety shows a higher prevalence in refugees reporting PTSD symptoms than in refugees who do not report such symptoms. When analysed using logistic regression models, the data showed the odds of high levels of dental anxiety being 6.1 times higher in refugees with torture experiences compared with other refugees and 9.3 times higher in torture victims with PTSD symptoms. Oral health professionals should be aware of these associations when providing dental care to refugees. The hypothesis that tortured refugees are more prone to dental anxiety is supported.
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Affiliation(s)
- Ann C Høyvik
- Department of Pediatric Dentistry and Behavioral Science, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Birgit Lie
- Sorlandet Hospital, Kristiansand, Norway
| | - Tiril Willumsen
- Department of Pediatric Dentistry and Behavioral Science, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Abstract
Aims: The aim of this study was to explore possible differences in the longitudinal course of psychological symptoms and somatic symptoms between one group of Bosnian refugees returning to their home country (B) and one group remaining in the host country (N). The aim was also to look for possible differences in pre-flight traumatic experiences and psychological symptom load within the groups. In addition the experiences of returning home after a period in exile were studied, based on quantitative and qualitative data. Methods: The study is a follow-up study of 21 Bosnian refugees returning to Bosnia compared with 175 refugees remaining in exile in Norway. Quantitative results are supplemented with qualitative information. Results: Both groups demonstrated persistence of psychological symptoms, indicating severity and chronicity of the problems. The main findings were that refugees with a former history of traumatic experiences of a physical character were less willing to return. A decrease over time in all symptom parameters was found in the repatriated group with a statistically significant decline for the PTSS-16 and HTQ scores ( p<0.05). Conclusions: Chronicity of psychological symptom load was found in both groups. The decision to return home seems to be closely connected to pre-flight traumatic experiences. An early decision to return home seems to be persistent over time.
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Affiliation(s)
- Birgit Lie
- Psychosocial Centre for Refugees, University of Oslo, Norway.
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Chiaroni-Clarke R, Li Y, Munro J, Chavez R, Scurrah K, Pezic A, Akikusa J, Allen R, Piper S, Becker M, Thompson S, Lie B, Flato B, Forre O, Punaro M, Wise C, Saffery R, Finkel T, Hakonarson H, Ponsonby AL, Ellis J. OP0282 The Association of PTPN22 RS2476601 with Juvenile Idiopathic Arthritis is Specific to Females:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sanchez-Mazas A, Vidan-Jeras B, Nunes JM, Fischer G, Little AM, Bekmane U, Buhler S, Buus S, Claas FHJ, Dormoy A, Dubois V, Eglite E, Eliaou JF, Gonzalez-Galarza F, Grubic Z, Ivanova M, Lie B, Ligeiro D, Lokki ML, da Silva BM, Martorell J, Mendonça D, Middleton D, Voniatis DP, Papasteriades C, Poli F, Riccio ME, Vlachou MS, Sulcebe G, Tonks S, Nevessignsky MT, Vangenot C, van Walraven AM, Tiercy JM. Strategies to work with HLA data in human populations for histocompatibility, clinical transplantation, epidemiology and population genetics: HLA-NET methodological recommendations. Int J Immunogenet 2012; 39:459-72; quiz 473-6. [PMID: 22533604 PMCID: PMC3533781 DOI: 10.1111/j.1744-313x.2012.01113.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
HLA-NET (a European COST Action) aims at networking researchers working in bone marrow transplantation, epidemiology and population genetics to improve the molecular characterization of the HLA genetic diversity of human populations, with an expected strong impact on both public health and fundamental research. Such improvements involve finding consensual strategies to characterize human populations and samples and report HLA molecular typings and ambiguities; proposing user-friendly access to databases and computer tools and defining minimal requirements related to ethical aspects. The overall outcome is the provision of population genetic characterizations and comparisons in a standard way by all interested laboratories. This article reports the recommendations of four working groups (WG1-4) of the HLA-NET network at the mid-term of its activities. WG1 (Population definitions and sampling strategies for population genetics’ analyses) recommends avoiding outdated racial classifications and population names (e.g. ‘Caucasian’) and using instead geographic and/or cultural (e.g. linguistic) criteria to describe human populations (e.g. ‘pan-European’). A standard ‘HLA-NET POPULATION DATA QUESTIONNAIRE’ has been finalized and is available for the whole HLA community. WG2 (HLA typing standards for population genetics analyses) recommends retaining maximal information when reporting HLA typing results. Rather than using the National Marrow Donor Program coding system, all ambiguities should be provided by listing all allele pairs required to explain each genotype, according to the formats proposed in ‘HLA-NET GUIDELINES FOR REPORTING HLA TYPINGS’. The group also suggests taking into account a preliminary list of alleles defined by polymorphisms outside the peptide-binding sites that may affect population genetic statistics because of significant frequencies. WG3 (Bioinformatic strategies for HLA population data storage and analysis) recommends the use of programs capable of dealing with ambiguous data, such as the ‘gene[rate]’ computer tools to estimate frequencies, test for Hardy–Weinberg equilibrium and selective neutrality on data containing any number and kind of ambiguities. WG4 (Ethical issues) proposes to adopt thorough general principles for any HLA population study to ensure that it conforms to (inter)national legislation or recommendations/guidelines. All HLA-NET guidelines and tools are available through its website http://hla-net.eu.
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Lie B. Livet som flyktningbarn og ung voksen. Tidsskriftet 2012. [DOI: 10.4045/tidsskr.12.0552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Scherer HU, van der Woude D, Willemze A, Trouw LA, Knevel R, Syversen SW, van der Linden MP, Lie B, Huizinga TW, van der Heijde DM, van der Helm-van Mil AH, Kvien TK, Toes RE. Distinct ACPA fine specificities, formed under the influence of HLA shared epitope alleles, have no effect on radiographic joint damage in rheumatoid arthritis. Ann Rheum Dis 2011; 70:1461-4. [DOI: 10.1136/ard.2010.146506] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Scherer HU, van der Woude D, Willemze A, Trouw LA, Knevel R, Syversen SW, van der Linden MPM, Lie B, Huizinga TWJ, van der Heijde DMFM, van der Helm-van Mil AHM, Kvien TK, Toes REM. Distinct ACPA fine-specificities, formed under the influence of HLA shared epitope alleles, have no effect on radiographic joint damage in rheumatoid arthritis. Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.149096.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lie B. Solid om flyktninger og asylsøkere. Tidsskriftet 2011. [DOI: 10.4045/tidsskr.10.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Håland ÅT, Vogel PA, Lie B, Launes G, Pripp AH, Himle JA. Behavioural group therapy for obsessive–compulsive disorder in Norway. An open community-based trial. Behav Res Ther 2010; 48:547-54. [DOI: 10.1016/j.brat.2010.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 03/01/2010] [Accepted: 03/08/2010] [Indexed: 11/25/2022]
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Hollenbach JA, Meenagh A, Sleator C, Alaez C, Bengoche M, Canossi A, Contreras G, Creary L, Evseeva I, Gorodezky C, Hardie RA, Karlsen TH, Lie B, Luo M, Martinetti M, Navarette C, de Oliveira DCM, Ozzella G, Pasi A, Pavlova E, Pinto S, Porto LC, Santos P, Slavcev A, Srinak D, Tavoularis S, Tonks S, Trachtenberg E, Vejbaesya S, Middleton D. Report from the killer immunoglobulin-like receptor (KIR) anthropology component of the 15th International Histocompatibility Workshop: worldwide variation in the KIR loci and further evidence for the co-evolution of KIR and HLA. ACTA ACUST UNITED AC 2010; 76:9-17. [PMID: 20331834 DOI: 10.1111/j.1399-0039.2010.01459.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The killer immunoglobulin-like receptor (KIR) anthropology component of the 15th International Histocompatibility Workshop (IHIWS) sought to explore worldwide population variation in the KIR loci, and to examine the relationship between KIR genes and their human leukocyte antigen (HLA) ligands. Fifteen laboratories submitted KIR genotype and HLA ligand data in 27 populations from six broad ethnic groups. Data were analyzed for correlations between the frequencies of KIR and their known HLA ligands. In addition, allelic typing was performed for KIR2DL2 and 3DL1 in a subset of populations. Strong and significant correlations were observed between KIR2DL2, 2DL3 genotype frequencies and the frequency of their ligand, HLA-C1. In contrast, only weak associations were seen for 3DL1, 3DS1 and the HLA-Bw4 ligand. Although some aspects of the correlations observed here differ from those reported in other populations, these data provide additional evidence of linked evolutionary histories for some KIR and HLA loci. Investigation of allele-level variation for the B haplotype locus KIR 2DL2 showed that two alleles, *001 and *003, predominate in all populations in this study. Much more allelic variation was observed for the A haplotype locus 3DL1, with several alleles observed at moderate frequencies and extensive variation observed between populations.
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Affiliation(s)
- J A Hollenbach
- Center for Genetics, Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA.
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Greer T, Bedelbayev A, Igreja JM, Gomes JF, Lie B. A simulation study on the abatement of CO2 emissions by de-absorption with monoethanolamine. Environ Technol 2010; 31:107-115. [PMID: 20232684 DOI: 10.1080/09593330903373764] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Because of the adverse effect of CO2 from fossil fuel combustion on the earth's ecosystems, the most cost-effective method for CO2 capture is an important area of research. The predominant process for CO2 capture currently employed by industry is chemical absorption in amine solutions. A dynamic model for the de-absorption process was developed with monoethanolamine (MEA) solution. Henry's law was used for modelling the vapour phase equilibrium of the CO2, and fugacity ratios calculated by the Peng-Robinson equation of state (EOS) were used for H2O, MEA, N2 and O2. Chemical reactions between CO2 and MEA were included in the model along with the enhancement factor for chemical absorption. Liquid and vapour energy balances were developed to calculate the liquid and vapour temperature, respectively.
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Affiliation(s)
- T Greer
- Telemark University College, Faculty of Technology, Porsgrunn, Norway
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18
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Myhre K, Eggum R, Lie B, Iveland H. [A 78-year-old woman with upper abdominal pain]. Tidsskr Nor Laegeforen 2008; 128:2320-2322. [PMID: 19105261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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19
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Hoftvedt BO, Varvin S, Thorleifsson E, Hagestad K, Lie B, Rogde S. [Human rights and ethics in Chinese psychiatry]. Tidsskr Nor Laegeforen 2005; 125:314-6. [PMID: 15702157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Affiliation(s)
- Bjørn Oscar Hoftvedt
- Legeforeningens utvalg for menneskerettigheter, Den norske laegeforening, Postboks 1152 Sentrum, 0107 Oslo.
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Abstract
OBJECTIVE Few community studies have addressed the longitudinal course of post-traumatic stress disorder (PTSD) in traumatized refugees in early resettlement. This longitudinal study investigated changes from the first (T1) to the second interview (T2), 3 years later. The relationship between traumatic exposures and psychosocial factors/psychological symptom load were examined. METHOD Local health professionals performed the interviews, using rating scales and a structured questionnaire. A total of 240 (52%) refugees attended. RESULTS Unchanged Hopkins Symptom Checklist-25 and increase in Harvard Trauma Questionnaire and post-traumatic stress symptoms-16 between T1 and T2 were found, indicating the severity and chronicity of problems. Mean post-traumatic stress score was 15% above cut-off. Severe life-threatening trauma and present life in exile with unemployment and unresolved family reunion were risk factors. CONCLUSION Early diagnostic interview should be followed by targeted approach. Pinpointing those in need of specialist services is essential. An interdisciplinary approach is necessary in this work.
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Affiliation(s)
- B Lie
- Psychosocial Centre for Refugees, University of Oslo, Oslo, Norway.
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21
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Lie B. [Asylum and persons seeking asylum]. Tidsskr Nor Laegeforen 2002; 122:1639. [PMID: 12555602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
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22
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Lie B. [Knowledge concerning the sequelae of torture]. Tidsskr Nor Laegeforen 2001; 121:3366. [PMID: 11826776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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23
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Lie B. [Psychiatric health care for refugees]. Tidsskr Nor Laegeforen 2000; 120:3372. [PMID: 11187185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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24
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Eggum R, Lie B, Stavis P. [Phlegmasia cerulea dolens as the initial symptom of abdominal aortic aneurysm]. Tidsskr Nor Laegeforen 1999; 119:4460-1. [PMID: 10827484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Phlegmasia cerulea dolens is a serious condition and a result of central venous obstruction which can lead to venous gangrena and amputation of the affected limb. Multiple underlying conditions are described: malignant disease, trauma and hypercoagulable states such as heparin-induced thrombocytopenia, deficiency of protein C and antithrombin III. Phlegmasia cerulea dolens is also described as complication to insertion of a vena caval filter. We present a patient who developed phlegmasia cerulea dolens in his left lower limb as a result of an undiagnosed lumbal aortic aneurysm. To our knowledge this is the first report of phlegmasia cerulea dolens as the initial symptom of an abdominal aneurysm.
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Affiliation(s)
- R Eggum
- Karseksjonen Kirurgisk klinikk Buskerud sentralsykehus, Drammen
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25
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Eggum R, Skrede O, Lie B. [Ruptured splenic artery aneurysm in pregnancy--a case report]. Tidsskr Nor Laegeforen 1999; 119:1884. [PMID: 10382333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
Ruptured splenic artery aneurysm in pregnancy is a serious condition with high mortality rates for both mother and child. Early diagnosis and surgical intervention without delay is essential to avoid a fatal outcome. The diagnosis should be considered in pregnant women with upper abdominal pain. We describe a patient with ruptured splenic artery aneurysm in pregnancy. Both mother and child survived.
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Affiliation(s)
- R Eggum
- Kar/thoraxseksjonen, Kirurgisk klinikk, Buskerud sentralsykehus, Drammen
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26
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Lie B. [Shadows of the past over the victims of today. Rehabilitation of the torture victims in the center of Europe's undercurrents]. Tidsskr Nor Laegeforen 1997; 117:259-61. [PMID: 9064846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- B Lie
- Flyktninghelsetjenesten, Sentrum helse- og sosialdistrikt, Kristiansand
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27
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Lie B, Skjeie H. [Torture-related injuries--a medical challenge. Diagnosis and treatment of Falanga victims]. Tidsskr Nor Laegeforen 1996; 116:1073-5. [PMID: 8658474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Torture victims are generally reluctant to present complaints linked to the torture. Many patients from refugee populations have experienced traumatic events such as war, violence and torture. Health professionals need to know more about the nature of these traumas, and how to diagnose the sequelae of torture. If they are to give torture victims adequate treatment they need to be familiar with the relevant diagnostic procedures, and how to treat health problems caused by systematic violence. A clinical case history is used to present the method of torture called Falanga, the beating of the soles of the feet. The case shows how the diagnosis and treatment of the physical injuries have a marked effect on the rehabilitation process. After receiving treatment for his foot injuries, patient's physical and mental health both improved dramatically, as did his psychosocial rehabilitation.
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Affiliation(s)
- B Lie
- Flyktningehelsetjenesten, Tordenskjolds gate 16, Kristiansand
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Lie B, Os I, Bisgaard MB, Jacobsen D, Urdal P. [Rhabdomyolysis in self-induced poisoning. A prospective study]. Tidsskr Nor Laegeforen 1992; 112:2359-61. [PMID: 1412237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In a prospective study of 103 patients hospitalized for self-poisoning the incidence of rhabdomyolysis (creatine kinase > 1000 U/l) was nearly 7%. A further 9.7% had elevated creatine kinase activity, but lower than 1000 U/l. Two patients showed clinical symptoms of rhabdomyolysis at time of admission; one after heroin and the other after salicylate intoxication. Both developed renal failure, and one of them underwent peritoneal dialysis. The high incidence of rhabdomyolysis found in the study suggests that creatine kinase activity should be considered in all cases of intoxication admitted to hospital. Rhabdomyolysis may often present no symptoms even in conscious patients, and serious complications can be limited by preventive measures if rhabdomyolysis is recognized early.
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Affiliation(s)
- B Lie
- Medisinsk avdeling, Ullevål sykehus, Oslo
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Lie B. [Spontaneous gastrocolic fistula in stomach ulcer]. Tidsskr Nor Laegeforen 1992; 112:344-5. [PMID: 1553673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Spontaneous development of a gastrocolic fistula following a benign unoperated gastric ulcer is a rare complication. This complication seems to occur more frequently, however, as a side-effect of increased use of anti-inflammatory medication. A 61-year-old woman developed abdominal pain and diarrhoea, and lost weight, after several years of treatment with indomethacin. During diagnostic endoscopy the gastroscope unexpectedly passed to the transverse colon through a relatively large ulcerous gastrocolic fistula. The patient was successfully treated by en bloc resection of the stomach and transverse colon.
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Affiliation(s)
- B Lie
- Kirurgisk avdeling, Buskerud sentralsykehus, Drammen
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Lie B. [Nursing and health care administrator: hospitals should be our support. Interview by Kjell Arne Bakke]. J Sykepleien 1990; 78:12-3. [PMID: 2078468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
Germinal vesicle breakdown (GVBD) in cumulus-enclosed and denuded cattle oocytes was sensitive to puromycin at concentrations at or above 50 micrograms/ml. Media supplemented with 5-25 micrograms/ml of puromycin did not significantly reduce either rate or sequence of GVBD after 8 h of culture (82-96% GVBD). In concentrations of 50, 75, and 100 micrograms/ml, GVBD occurred in 15, 4, and 2% of oocytes, respectively. However, 50 micrograms puromycin/ml did postpone the time sequence of GVBD, since all treated oocytes underwent GVBD after 20 h of culture. Oocytes arrested in the germinal vesicle (GV) stage possessed GV filled with highly condensed bivalents. The puromycin block (100 micrograms/ml) was fully reversible, and the time sequence of GVBD was two times faster than in control medium. Proteins important for GVBD were synthesized during the first 4 h of culture, and 81% of oocytes underwent GVBD when puromycin (100 micrograms/ml) was added after 4 h of preincubation in control medium. The first polar body (I PB) expulsion was more sensitive to inhibition of protein synthesis, as shown by the observation that 2.5 and 5 micrograms puromycin/ml significantly (69 and 61%) reduced the incidence of Metaphase II, and 10 micrograms/ml highly significantly (31%) reduced it. The I PB expulsion in concentrations of 25 and 37 micrograms puromycin/ml was less than 5%. The subsequent culture in puromycin (8 h) and 6-dimethylaminopurine (8 h) proved that nuclear membrane breakdown is less sensitive to inhibition of protein phosphorylation than the process of chromatin condensation.
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Affiliation(s)
- J Motlík
- Czechoslovak Academy of Sciences, Libĕchov
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Kongsgaard UE, Holst-Larsen H, Lie B, Fauchald P. [Correction of severe hyponatremia]. Tidsskr Nor Laegeforen 1990; 110:3637-9. [PMID: 2260065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Profound hyponatremia is a life-threatening emergency which can result in permanent neurological damage. The rate at which severe hyponatremia should be corrected is the focus of clinical debate. It is important, however, to differentiate chronic from acute hyponatremia and to develop a plan for correcting hyponatremia. A treatment regime is suggested.
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Kongsgaard UE, Holst-Larsen H, Lie B, Fauchald P, Nakstad PH. [Severe, symptomatic hyponatremia]. Tidsskr Nor Laegeforen 1990; 110:3617-9. [PMID: 2260060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Severe hyponatremia (serum sodium levels less than 120 mmol/l) is associated with increased morbidity and mortality. We report three cases where patients developed hyponatremia and severe neurological manifestations after medical treatment. The first two patients experienced episodes of general seizures and coma, but recovered in 24 hours without neurologic sequelae after correction of the electrolyte disturbance. The third patient developed the syndrome central pontine myelinolysis with pseudobulbar palsy and quadriparesis. Marked improvement occurred, however, and in three months the patient was almost completely recovered. The development of hyponatremia deserves special attention in connection with the use of diuretics, infusion of sodium-free carbohydrates and immediately after operation.
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Lie B, Jacobsen D, Strømme JH, Breder O, Rygnestad T, Wickstrøm E. [Organophosphate poisoning]. Tidsskr Nor Laegeforen 1990; 110:3006-8. [PMID: 2237852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Three cases of poisoning by organophosphate dimethoate are described and the importance of correct diagnosis and adequate treatment emphasized. Therapy consists of large doses of atropine, to counteract the muscarinic and other effects on the central nervous system, followed by a reactivator (e.g. toxogonin) to reverse muscle weakness (nicotinic effects).
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Affiliation(s)
- B Lie
- Medisinsk avdeling, Ullevål sykehus, Oslo
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35
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Os I, Jacobsen D, Enger E, Lie B. [Forced alkalic diuresis. Still a current therapy in poisoning]. Tidsskr Nor Laegeforen 1989; 109:2154-5. [PMID: 2549656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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36
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Niessen W, Lie B, Jansen M, Junker G. [Abdominal bleeding after defibrillation]. Dtsch Med Wochenschr 1989; 114:318-9. [PMID: 2784097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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37
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Strøm EH, Lie B. [Metastasizing glioma]. Tidsskr Nor Laegeforen 1988; 108:2490. [PMID: 3206462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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38
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Abstract
A prospective study based upon interviews included 92 women who had undergone cesarean section, 38% with epidural analgesia and 62% under general anesthesia. The two groups were compared with respect to anesthesiological complications, postoperative morbidity and birth experience. The puerperal period was less complicated after epidural analgesia than after general anesthesia. There was a quicker re-establishment of the gastrointestinal function after epidural analgesia and the patients were more quickly mobilized and less tired. The overall morbidity after cesarean section, 16%, was lower than in other studies. Nearly half of the patients in the epidural experienced slight peroperative pain. In the case of repeated cesarean section, 86% of women who had epidural analgesia wanted the same anesthesia again. On the basis of this study, epidural analgesia is recommended for cesarean section.
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Affiliation(s)
- J Juul
- Department of Obstetrics and Gynecology, Sct. Maria Hospital, Vejle, Denmark
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Abstract
In a prospective interview study, two groups each consisting of 28 sectio caesarea patients were compared concerning the course of breastfeeding. The women in the two groups were delivered under either epidural analgesia or general anesthesia. The two groups were identical with respect to age, parity, participation in antenatal preparatory courses and former breastfeeding. A significantly higher breastfeeding frequency and longer breastfeeding periods were were found after epidural analgesia than after general anesthesia.
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Affiliation(s)
- B Lie
- Department of Obstetrics and Gynecology, Sct. Maria Hospital, Vejle, Denmark
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Lie B, Hust W, Asgarzadeh A, Mann H. [Acquired renal cysts in maintenance dialysis patients]. Urologe A 1986; 25:109-12. [PMID: 3521045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Ultrasonographic examination of the kidneys of 111 patients on long term maintenance hemodialysis was performed. None of the patients had genuine polycystic kidney disease. In many patients acquired cysts were found. Frequency and volume of these cysts were the same on the right and left side. There was no correlation between the age of the patients and the number of cysts. There were no differences concerning sex and type of primary renal disease. There was a significant positive correlation between time on maintenance hemodialysis and number of cysts but no correlation between number of cysts and hemoglobin concentration. This is in contrast to data in the literature. Clinical relevance of acquired kidney cysts in dialysis patients concerns hematuria, retroperitoneal bleeding, kidney stone formation, septicemia and malignancy.
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